Search PubMed⌕ Search

Biomedical subjects

R H Kaufman

Publications and source records attributed to R H Kaufman.

At least 55 records · Page 3Linked to original sources
PubMed1991

Human papillomavirus DNA in tissue biopsy specimens of vulvar vestibulitis patients treated with interferon.

Thirteen women with the diagnosis of vulvar vestibulitis based on clinical symptoms, presence of vestibular tenderness on physical examination, and acetowhite changes of the vulvar vestibule were treated with intradermal injection of alpha-interferon. Biopsies of the acetowhite areas were analyzed for human papillomavirus (HPV) DNA using polymerase chain reaction amplification and dot blot hybridization. Eleven of 13 subjects harbored one of the HPV DNA types; six of these were type 16 and/or 18 and the others were unidentified. Five subjects (all HPV DNA-positive) reported resolution of symptoms with interferon therapy. Our results indicate the presence of HPV DNA in a subset of patients with vulvar vestibulitis, but its presence is not predictive of response to interferon therapy.

Adult↗
PubMed1991

Fungal vulvovaginitis.

Fungal vulvovaginitis remains one of the most frequent conditions affecting the lower genital tract. Recent advances in the understanding of the pathophysiology of the condition have improved our ability to treat recurrent or persistent cases. More clinical data have become available on the optimal duration of treatment with some of the newer antifungal agents.

Antifungal Agents↗
PubMed1991

Vulvar malignancy.

Treatment of invasive vulvar malignancy has become more individualized during the past decade. In the past, radical vulvectomy with bilateral inguinofemoral lymphadenectomy was the standard therapy for invasive squamous cell carcinoma and melanoma of the vulva. This is no longer always the case. The treatment of stage I and stage II invasive squamous cell carcinoma of the vulva has become more individualized. Less radical surgery appears to produce the same results as ultraradical surgery. Wide local excision of early lesions associated with ipsilateral lymph node dissection appears to be adequate therapy in many cases. Likewise, treatment of early melanoma (0.75 mm in thickness) can be managed by wide local excision with or without groin dissection of the ipsilateral side. This more conservative approach has resulted in significantly fewer postoperative complications and has improved the self-image of many women undergoing treatment for vulvar malignancy.

Female↗
PubMed1990

Detection of human papillomavirus DNA before and after development of invasive vulvar cancer.

Biopsy and surgical specimens were studied from two patients with squamous cell carcinoma in situ of the vulva and one with verrucous carcinoma of the vulva. All three patients subsequently developed invasive squamous cell carcinoma of the vulva. In two, human papillomaviruses (HPVs) 16 and 18 were found in the lesions before the development of invasive carcinoma. In the specimens with invasive squamous cell carcinoma, HPV 16 or 18 or both was found. The third patient had HPV 18 DNA in the specimen demonstrating squamous cell carcinoma in situ; when invasive squamous cell carcinoma was diagnosed 9 years later, HPVs 16 and 18 were found in the latter lesion. These findings lend support to the role of HPVs 16 and 18 in the development of invasive squamous cell carcinoma of the vulva.

Aged↗
PubMed1990

Vaginitis.

This article is a review of the diagnosis and therapy of the common vaginal infections encountered by the clinician. The saline and wet mount preparations and vaginal pH are easy-to-use and effective means of establishing the correct diagnosis and should not be given until the patient has been examined and appropriate diagnostic tests carried out.

Adult↗
PubMed1989

[Perineoplasty for vulvar vestibulitis].

28 premenopausal women with severe dyspareunia were diagnosed as having vulvar vestibulitis. A modified perineoplasty, consisting of removal of the vestibule and exteriorization of the vagina to cover the denuded area and to relax a tight perineum, was performed. 70% of 26 women with adequate follow-up experienced significant relief of vulvar discomfort. In young women with dyspareunia, vestibulitis may be a significant, remediable, causative factor.

Dyspareunia↗
PubMed1989

Human papillomavirus associated with adenocarcinoma and adenosquamous carcinoma of the cervix: analysis by in situ hybridization.

The incidence of adenocarcinoma of the cervix appears to be increasing. Recent reports have demonstrated an association between adenocarcinoma of the cervix and human papillomavirus (HPV) by Southern blot hybridizations. In situ deoxyribonucleic acid (DNA) hybridization was performed on paraffin-embedded specimens to localize the source of HPV DNA. In pure adenocarcinoma five of six specimens were positive for HPV DNA. Four specimens contained HPV type 18 and one HPV type 16. Only one of three adenosquamous lesions was positive and it contained both HPV types 16 and 31. These findings suggest an association between HPV and adenocarcinoma of the cervix.

Adenocarcinoma↗
PubMed1989

Primary malignant melanoma of the vagina: report of four cases and review of the literature.

Four cases of malignant melanoma arising in the vagina are described, and the literature related to this unusual tumor is reviewed. The 2-year survival rate is better following radical surgery than after other treatment modalities; however, the 5-year survival rate is unrelated to type of therapy. Radical surgery appears to control local disease, but fails to address systemic spread of the tumor. Therefore, improvement in survival will require effective systemic therapy.

Adult↗
PubMed1989

Comparison of three-day butoconazole treatment with seven-day miconazole treatment for vulvovaginal candidiasis.

In this multicenter, parallel, randomized, investigator-blind trial, we compared the safety and efficacy of a three-day regimen of 2% butoconazole vaginal cream with those of a seven-day regimen of 2% miconazole vaginal cream. Enrolled were 271 nonpregnant women with vulvovaginal candidiasis. Each patient administered her assigned study medication to the posterior vaginal fornix for three or seven consecutive nights. All 271 patients were included in the safety evaluation, and 225 (111 receiving butoconazole and 114 receiving miconazole) were included in the efficacy evaluation. Eight to ten days after treatment completion, 88% of the butoconazole-treated patients and 91% of the miconazole-treated patients were Candida negative; 80% of the butoconazole-treated patients and 82% of the miconazole-treated patients were considered clinically cured. Thirty days after treatment completion, 73% of the butoconazole-treated patients and 69% of the miconazole-treated patients remained Candida negative; 78% of the butoconazole-treated patients and 80% of the miconazole-treated patients remained free of clinical symptoms of vulvovaginitis. None of the differences between the two treatment groups was statistically significant. Six patients (four receiving butoconazole and two receiving miconazole) reported increased symptoms of vulvovaginal irritation, and three of them (two receiving butoconazole and one receiving miconazole) withdrew from the trial. Thus, the efficacy and safety of the three-day butoconazole treatment regimen were equivalent to those of the seven-day miconazole treatment regimen. The advantage of the shorter butoconazole treatment is increased patient compliance with maintenance of high efficacy.

Administration, Intravaginal↗
PubMed1988

Multicentric intraepithelial neoplasia involving the vulva. Clinical features and association with human papillomavirus and herpes simplex virus.

Sixteen of 46 patients (35%) with Grade 3 vulvar intraepithelial neoplasia (VIN 3) were found to have an additional site of lower genital tract squamous cell neoplasia, primarily in the cervix. The frequency of multicentricity decreased significantly with age. In addition, patients with multicentric disease (involving the vagina and/or cervix in addition to the vulva) had a significantly higher frequency of multifocal disease involving the vulva (involving more than one location on the vulva) and of recurrence than patients without multicentric disease. Human papillomavirus (HPV) DNA was detected by in situ hybridization in 81% of the women with multicentric squamous cell neoplasia. No significant difference was noticed between patients with multicentric and unicentric squamous cell neoplasia in the detection rate of papillomavirus antigen, HPV DNA, the various HPV types, herpes simplex virus Type 2 (HSV2)-related antigen, type-specific antibodies to HSV, and dual HPV and HSV2 infections. These findings suggest that HPV and HSV2, although strongly associated with VIN 3, do not influence the development pattern of squamous cell neoplasia, and that all patients with VIN 3, especially if they are younger than 50 years of age, should be evaluated periodically for additional centers of lower genital tract squamous cell neoplasia.

Adult↗
PubMed1988

Combination of surgical excision and carbon dioxide laser vaporization for multifocal vulvar intraepithelial neoplasia.

Ten patients with multifocal grade 3 vulvar intraepithelial neoplasia were treated by a combination of surgical excision and carbon dioxide laser vaporization of selected areas. The lesions treated by the laser were either on the clitoris or distal to the vulva. These areas could be functionally and anatomically deformed if surgically excised. Combining the carbon dioxide laser with surgery, however, resulted in a satisfactory cosmetic outcome and provided an adequate specimen for histopathologic diagnosis.

Adult↗
PubMed1988

Human papillomavirus and herpes simplex virus in vulvar squamous cell carcinoma in situ.

Human papillomavirus deoxyribonucleic acid were detected in tissue specimens from 38 to 46 patients (83%) with squamous cell carcinoma in situ of the vulva. Herpes simplex virus type 2--related antigen ICSP 34/35 was demonstrated in 23 of the lesions (50%), and antibodies to herpes simplex virus types 1 and 2 were found in 74% and 65% of the serum samples tested, respectively. Both human papillomavirus deoxyribonucleic acid and herpes simplex virus type 2 antigen were detected in 19 cases (41%). Correlation of human papillomavirus type to the ages of the patients revealed that types 16, 18, and 31 are most often seen in older patients, although the frequencies do not differ significantly. No relationship between the presence or absence of herpes simplex virus type 2--related antigen to age of the patient was observed.

Adult↗
PubMed1988

Establishing a correct diagnosis of vulvovaginal infection.

Vulvovaginitis is a common problem and a prime reason for physician consultation. The organism most frequently responsible for vulvovaginal infection is Candida albicans, and in a large majority of cases identification of the causative organism and diagnosis are easy to establish. Recurrent or persistent infection, however, presents a perplexing diagnostic problem that usually can be solved with the use of appropriate supportive laboratory tests and awareness of the distinguishing features of the possible etiologic agents. Problems in diagnosis or complications in treatment are usually due to concurrent infection by two or more organisms or to treatment without proper identification of the infectious agents.

Animals↗