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Biomedical subjects

R U Levine

Publications and source records attributed to R U Levine.

27 records · Page 2Linked to original sources

Intraepithelial squamous lesions of the vulva: biologic and histologic criteria for the distinction of condylomas from vulvar intraepithelial neoplasia.

We reviewed 65 intraepithelial lesions of the vulva and distal vagina and compared the presence of koilocytosis, abnormal mitoses, and parabasal or basal nuclear enlargement with DNA microspectrophotometric distribution patterns and the presence of human papillomavirus antigen as determined by immunoperoxidase. Abnormal mitoses and cytologically atypical nuclear enlargement were specific predictors of aneuploidy and were reliable for distinguishing vulvar intraepithelial neoplasia (VIN) from condylomas. Koilocytosis was present in 100% of condylomas and 71% of aneuploid (VIN) lesions, but there were qualitative and quantitative differences in the distribution of koilocytic cells in the two classes of lesions. On the basis of these findings, criteria for distinguishing between VIN and condyloma are proposed.

Antigens, Viral↗

Treatment of vaginal carcinoma in situ with the carbon dioxide laser.

Thirty-six patients with vaginal intraepithelial neoplasia were treated with the carbon dioxide laser. More than half of the patients had grade 3 vaginal intraepithelial neoplasia (carcinoma in situ). The majority of patients were treated in a single session; six patients were treated twice, and two patients were treated three times. In 92% of the patients, the lesions were completely removed by the laser without significant side effects.

Adult↗

Vulvar intraepithelial neoplasia: correlation of nuclear DNA content and the presence of a human papilloma virus (HPV) structural antigen.

Immunoperoxidase localization of a human papilloma virus structural antigen (HPV) was attempted in 68 intraepithelial lesions of the vulva, 39 of which were analyzed for nuclear DNA content by microspectrophotometry. Overall, 5.9% (4/68) stained positive for HPV. Ninety percent (35/39) of the cases tested were aneuploid, and, of these, 2.8% (1/35) stained positive for HPV. In contrast, 50% (2/4) of the polyploid lesions were positive. Hence DNA microspectrophotometry and immunoperoxidase localization of HPV are useful coparameters for distinguishing wart virus infection (condylomata) from vulvar intraepithelial neoplasia. HPV is detected infrequently within aneuploid lesions, in keeping with the concept that epithelial maturation is required for virion assembly. Whether the HPV genome exists in a nonreplicative state within the aneuploid cell population is unknown.

Antigens, Viral↗

Management of vulvar intraepithelial neoplasia by carbon dioxide laser.

Thirty-three patients with vulvar intraepithelial neoplasia were treated with the carbon dioxide (CO2) laser. In 31 of these patients the lesion was completely eradicated by the laser treatment. All patients experienced moderate pain following the procedure, and 2 had severe pain. The only other complications were 1 case of bleeding and 1 of infection. The CO2 laser appears to be an acceptable treatment modality for vulvar cancer precursors provided patients are carefully evaluated prior to treatment and invasive carcinoma is ruled out.

Adult↗