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Biomedical subjects

R Reid

Publications and source records attributed to R Reid.

At least 181 records · Page 10Linked to original sources
PubMed1988

Genital condylomas in pregnancy: use of trichloroacetic acid and laser therapy.

Genital condylomas in pregnancy pose several management problems for the obstetrician, including the mechanical problems of large condylomas and the issues relating to transmission of the human papillomavirus to the fetus during delivery. Transmission of papillomavirus occurs infrequently, but respiratory papillomatosis can result in mortality or lifelong morbidity. We evaluate our experience in treating condylomas in 32 pregnant women, using carbon dioxide laser therapy and 85% trichloroacetic acid. Condylomas in 31 (97%) of 32 women were controlled with this combination therapy. The only maternal complication was an episode of acute pyelonephritis secondary to urethral catheterization. One patient had premature rupture of the membranes 4 days after laser therapy and subsequently was delivered of a healthy neonate at 36 4/7 weeks. Prenatal photovaporization of condylomas appears to offer a method of treatment with a low complication and recurrence rate and helps avert the dilemma of whether patients with extensive genital condylomas should be delivered by cesarean section.

Adolescent↗
PubMed1988

Sexually transmitted papillomaviral infection in the male: II. The urethral reservoir.

Urethral cytobrushing for hybridization studies was obtained from the anterior urethra of 75 male consorts of known HPV-infected female partners. Our findings revealed a 24 per cent (19 patients) incidence of positive hybridization, identifying HPV-16 or HPV-18 in six instances associated with mixed papillomaviral infection of the shaft and the presence of HPV-6 and HPV-11 in 7 cases clinically related to exophytic disease of the shaft. Although no histologic evidence of virus-tissue interaction could be demonstrated, careful follow-up is recommended to detect early recurrent disease with its potential for partner reinfection.

Adolescent↗
PubMed1988

Analysis of individual human papillomavirus types in cervical neoplasia: a possible role for type 18 in rapid progression.

Histologic and molecular analyses of 214 cervical biopsy specimens were performed to test the hypothesis that certain individual human papillomavirus types that are usually grouped together are differentially distributed in various grades of cervical intraepithelial neoplasia and invasive squamous carcinoma. Specifically, types 16 and 18, which are commonly grouped together, were analyzed separately and compared. Biopsies obtained from three different geographic sites in the United States and Brazil were analyzed by Southern blot hybridization and correlated with the histologic diagnosis from the same tissue sample. There was a highly significant correlation between papillomavirus type and histologic grade comparing all grades of cervical intraepithelial neoplasia with invasive cancer (p less than 0.001). Of particular interest was the striking deficit of type 18 in intraepithelial neoplasia (3%) as compared with invasive carcinoma (22%; p less than 0.001). In contrast, there was no significant difference in the distribution of type 16 in intraepithelial neoplasia (37%) as compared with invasive carcinoma (41%). The deficit of type 18 in intraepithelial neoplasia compared with invasive carcinoma could represent a rapid transit time through the precursor stage. Human papillomavirus type 18 may therefore play a role in the development of rapidly progressive cervical cancer.

Brazil↗
PubMed1988

Osteogenic sarcoma of the ethmoid sinus.

A case of osteogenic sarcoma of the ethmoid sinus is reported in a 45 year old man. The tumour extended superiorly through the frontal sinus and involved the medial wall of the left orbit causing diplopia. Treatment comprised partial excision followed by radiotherapy and chemotherapy with symptomatic improvement, although 13 months later the patient died from progressive local and metastatic disease. A possible relationship to previous radiation exposure is discussed.

Ethmoid Sinus↗
PubMed1988

Comparison of active and combined passive/active immunization of Navajo children against Haemophilus influenzae type b.

In a high risk Navajo population we compared the immunogenicity of a new Haemophilus influenzae type b mutant-diphtheria toxic conjugate vaccine (HbOC) with simultaneous active (HbOC) and passive immunization with bacterial polysaccharide immunoglobulin prepared from adults immunized with H. influenzae b, pneumococcal and meningococcal vaccines. Only 7 of 26 (27%) 2-month-olds had an increase in H. influenzae b capsular polysaccharide antibody after a single dose of HbOC, a proportion similar to that of saline controls (9 of 25, 36%). After a second HbOC dose at 4 months 88% had antibody concentrations of 0.15 microgram or more, and after a third dose at 6 months all had antibody levels greater than or equal to 0.15 microgram/ml. The group receiving both HbOC and bacterial polysaccharide immunoglobulin at 2 months uniformly had H. influenzae b CP antibody concentrations of greater than or equal to 0.15 microgram/ml at 4 months (P less than 0.001 relative to "HbOC alone" group) and subsequently responded similarly to second and third doses of HbOC vaccine as did also the "HbOC alone" group. We conclude that combined passive/active immunization with bacterial polysaccharide immunoglobulin and HbOC at 2 months maintains antibody at concentrations thought to be protective (greater than or equal to 0.15 microgram/ml) without interfering with the active antibody response to second and third doses of HbOC at 4 and 6 months of age.

Bacterial Capsules↗
PubMed1988

Cefoperazone in the treatment of peritonitis in continuous ambulatory peritoneal dialysis patients.

Cefoperazone is a third-generation cephalosporin that is active against a broad spectrum of gram-positive and gram-negative bacteria. We added this antibiotic to peritoneal dialysis solution at a concentration of 62.5 mg/L to treat peritonitis in six continuous ambulatory peritoneal dialysis (CAPD) patients. Serum drug concentrations were obtained at 0, 0.5, 1, 2, 4, and 24 h after instituting antibiotic therapy. Rapid uptake by blood of the antibiotic across the peritoneal membrane occurred when the latter was inflamed. Adequate bactericidal serum levels for many bacteria were obtained in less than 4 h. Cefoperazone effectively eradicated peritonitis in all patients.

Cefoperazone↗
PubMed1988

Colposcopic findings in women with vulvar pain syndromes. A preliminary report.

Of 105 women referred for vulvar discomfort, 77 had idiopathic vulvodynia (pain, dyspareunia, burning or pruritus not explicable by a standard diagnosis). Physical examination showed that patients with those complaints fell into one of two categories: (1) diffuse, irritative acetowhitening of both the cutaneous and mucosal surfaces (42 patients), and (2) painful vestibular erythema, with or without acetowhitening (35 patients). The physical findings appeared to be predictive of therapeutic response. Among women with only diffuse, irritative acetowhitening, low-dose topical 5 fluorouracil was about 75% effective in milder cases, while CO2 laser photovaporization controlled 77% of cases with moderate and severe symptomatology. In contrast, medical regimens succeeded in just 8% of women with painful vestibular erythema, and only 59% were cured by hymenal resection. Several of the remaining cases have responded to selective argon laser photocoagulation of the hyperemic blood vessels within symptomatic areas.

Adolescent↗
PubMed1987

Prevention of Haemophilus influenzae type b infections in high-risk infants treated with bacterial polysaccharide immune globulin.

Apache Indian infants have a high frequency of Haemophilus influenzae type b (Hib) and pneumococcal infections. Forty percent of Hib infections in these infants occur before the age of six months, when active immunization may not be protective. To evaluate the efficacy of passive immunization with a human hyperimmune globulin (bacterial polysaccharide immune globulin [BPIG]) prepared from the plasma of immunized adult donors, we randomly assigned 703 infants in a double-blind fashion to receive 0.5 ml of BPIG per kilogram of body weight (n = 353) or 0.5 ml of saline (n = 350) intramuscularly at 2, 6, and 10 months of age. Hib-antibody levels were significantly higher in BPIG recipients than in placebo recipients at 4, 6, and 10 months of age (P less than 0.001). During the first 90 days after BPIG or placebo injection, no Hib or pneumococcal infections were detected in the BPIG group, whereas seven Hib infections (six cases of bacteremia and one of meningitis) and four pneumococcal infections (bacteremia) were detected in the placebo group (P = 0.007 and 0.06, respectively). During the fourth month, one case of Hib meningitis and two cases of pneumococcal bacteremia developed in the BPIG group, whereas there were no Hib or pneumococcal infections in the placebo group. We conclude that BPIG given at four-month intervals provided significant protection against serious Hib disease for three months, and that in high-risk infants it might be used alone, perhaps at three-month intervals, or together with active immunization.

Antibodies, Bacterial↗
PubMed1987

Action mechanism of Escherichia coli DNA photolyase. I. Formation of the enzyme-substrate complex.

Escherichia coli DNA photolyase (photoreactivating enzyme) is a flavoprotein. The enzyme binds to DNA containing pyrimidine dimers in a light-independent step and, upon illumination with 300-600 nm radiation, catalyzes the photosensitized cleavage of the cyclobutane ring thus restoring the integrity of the DNA. We have studied the binding reaction using the techniques of nitrocellulose filter binding and flash photolysis. The enzyme binds to dimer-containing DNA with an association rate constant k1 estimated by two different methods to be 1.4 X 10(6) to 4.2 X 10(6) M-1 S-1. The dissociation of the enzyme from dimer-containing DNA displays biphasic kinetics; for the rapidly dissociating class of complexes k2 = 2-3 X 10(-2) S-1, while for the more slowly dissociating class k2 = 1.3 X 10(-3) to 6 X 10(-4) S-1. The equilibrium association constant KA, as determined by the nitrocellulose filter binding assay and the flash photolysis assay, was 4.7 X 10(7) to 6 X 10(7) M-1, in reasonable agreement with the values predicted from k1 and k2. From the dependence of the association constant on ionic strength we conclude that the enzyme contacts no more than two phosphodiester bonds upon binding; this strongly suggests that the pyrimidine dimer is the main structural determinant of specific photolyase-DNA interaction and that nonspecific ionic interactions do not contribute significantly to substrate binding.

Collodion↗
PubMed1987

Sexually transmitted papillomaviral infections. I. The anatomic distribution and pathologic grade of neoplastic lesions associated with different viral types.

Multiple colposcopic biopsy specimens were collected from 160 women, with sampling of principal cervical and vulvar lesions as well as secondary areas of either minor acetowhitening or normal epithelium. Papillomaviral deoxyribonucleic acid was detected by Southern blot hybridization in 197 (90%) of the 218 principal biopsy specimens and 93 (46%) of 198 secondary biopsy specimens. Although different papillomaviruses were found at different sites in 31 women, only six of 416 specimens contained multiple types within the same sample. Specific viral types were associated with specific disease patterns. Only one of 80 type 6 or 11 infections had a diagnosis greater than cervical intraepithelial neoplasia, grade 2. In contrast, 42 of 48 (90%) biopsy specimens of cervical intraepithelial neoplasia, grade 3, or invasive cancer contained type 16, 18, or 31. Nonetheless, 12 of 124 (10%) cases of condyloma and cervical intraepithelial neoplasia, grade 1, were associated with types 16, 18, and 31 infections. Of 58 women with multicentric disease, 46 had positive hybridizations for both cervical and vulvar lesions (32 showing the same type in both samples and 14 showing different viruses). Differing patterns of papillomavirus-induced disease arise partly from the predilection of specific viral types for certain anatomic sites and partly through variations in host response. Detection of viral deoxyribonucleic acid in 46% of the secondary biopsy specimens suggests that disease expression may represent focal breakdown of host surveillance within a field of latent papillomaviral infection.

Biopsy↗
PubMed1987

Sexually transmitted papillomaviral infections in the male: I. Anatomic distribution and clinical features.

The epidemic of sexually transmitted papillomaviral infection and the suspected role of this virus in the etiology of squamous cancer within the lower genital tract make the clinical assessment of male consorts an essential component in disease control. Of 223 infected sites in 154 males, only 56 per cent of areas showed classic exophytic condylomata. The remaining 44 per cent were detected only after application of 3% acetic acid. Despite the dramatic macroscopic differences between the subclinical and condylomatous variance of human papillomaviral (HPV) infection, both forms showed infectious virus particles. Hence, soaking with 3% acetic acid and examination using a hand lens should become a routine part of the clinical examination for papillomaviral infection in the male genitalia.

Adolescent↗
PubMed1987

Sarcoma at the site of a single hip screw. A case report.

We report a case of malignant fibrous histiocytoma of the hip which occurred 30 years after the insertion of a single chrome-cobalt alloy screw for a slipped femoral epiphysis. The possible aetiological association between malignant tumours and metallic implants is discussed.

Adult↗
PubMed1987

Human papillomaviral infection. The key to rational triage of cervical neoplasia.

The most common manifestation of sexually transmitted human papillomaviral (HPV) infection is a nonpapilliferous hyperplasia in the transformation zone. Such subclinical papillomaviral infections (SPI) closely resemble cervical intraepithelial neoplasia (CIN) and were previously misdiagnosed as such. In essence, the triage of the abnormal Papanicolaou smear amounts to the differentiation between benign warty proliferation, minor-grade dysplasia, and full-thickness intraepithelial neoplasia. Hence, a clear understanding of the morphologic expression and natural history of different types of HPV infection is now essential to the rational management of patients with lower genital tract neoplasia.

Epidemiologic Methods↗
PubMed1987

Sexually transmitted papillomaviral infection in men.

Clinical experience gained from the assessment of 291 men over the last 8 years is analyzed to determine the clinical features of sexually transmitted papillomaviral infection in males, the patterns of anatomic distribution, the results of follow-up, the types of HPV associated with specific disease patterns, and the outcome of different methods of therapy.

Follow-Up Studies↗
PubMed1987

Physical and surgical principles governing expertise with the carbon dioxide laser.

There is widespread misconception that the unique physical properties of the carbon dioxide (CO2) laser essentially guarantee favorable results. In reality, the margin between excellence and mediocrity is very narrow. Unless sophisticated strategies are employed to restrict lateral heat conduction during photovaporization, the laser will produce the same kind of conduction burn as a hot cautery. This article examines the rationale for the use of the CO2 laser and provides an overview of six physical and six surgical principles governing expertise with the CO2 laser in the lower genital tract.

Carcinoma in Situ↗
PubMed1987

The management of genital condylomas in pregnant women.

Genital condylomas complicating pregnancy pose several management problems for the obstetrician, including the issues of mechanical difficulties in women with large lesions and possible viral transmission to the fetus during delivery. Although respiratory papillomatosis is infrequent, this complication can be catastrophic and produce significant long-term morbidity in affected children. Hence, we believe that condylomas in pregnancy should not be ignored. In view of the precision, high success rate, and low risk of complications, CO2 laser surgery appears to offer the best option in patients with extensive condylomas and those whose disease proves resistant to simpler therapies.

Condylomata Acuminata↗
PubMed1986

Development of a stability-indicating assay for nafimidone [1-(2-naphthoylmethyl)imidazole hydrochloride] by high-performance liquid chromatography.

The rational development of a stability-indicating assay for nafimidone [1-(2-naphthoylmethyl)imidazole hydrochloride] is demonstrated. It allows resolution of the decomposition products, obtained both on melting and resulting from decomposition in solution. Ion-pair chromatography was used to elute the solution decomposition products before the parent compound, thus producing maximum sensitivity of detection of these in the presence of undecomposed reactant. Stability data in terms of first-order rate constants were obtained in two different buffer solutions both from conventional integrated-rate equations using reactant concentration measurements, and by the initial rate method using decomposition product concentrations. In the light of this investigation, additional criteria for stability-indicating assays are suggested, which exploit the sensitivity as well as specificity of high-performance liquid chromatography.

Chromatography, High Pressure Liquid↗