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At least 307 records · Page 17Linked to original sources
PubMed1987

Multiple primary gynecologic neoplasms.

Some patients may be predisposed to the development of more than one gynecologic neoplasm. We evaluated 130 cases of synchronous or metachronous tumors among 5967 patients followed up by The Ohio State University Gynecologic Tumor Registry for the past 44 years from 1939 to 1983. Based on primary tumor site and invasive behavior, expected incidences for a specific second malignancy were calculated by the person-years method. A second malignancy of the lower genital tract occurred in patients with cervical, vulvar, and vaginal cancers, 1.6%, 4.3%, and 9.6%, respectively, which supports the theory of multicentric cancer of the lower genital tract. Prior radiation therapy was rarely associated with increased second gynecologic malignancies (two of 41 patients, 4.9%). Four patients had three gynecologic tumors.

Female↗
PubMed1977

Male genitourinary abnormalities and maternal diethylstilbestrol.

In view of the risk of vaginal cancer developing in young female subjects exposed in utero to maternally ingested diethylstilbestrol a pilot study was undertaken of male subjects similarly exposed. A healthy questionnaire was mailed to 306 male subjects whose mothers were known to have taken diethylstilbestrol in the early part of their pregnancies and to 231 age and sex-matched controls identified from the same record source. Although there was no increased history of cancer, heart disease or asthma when the groups were compared there was a higher incidence of reported urinary tract symptoms and genital abnormalities in the group exposed to diethylstilbestrol. The presence of these abnormalities was confirmed by physical examination of 15 respondents. Studies in experimental animals also have shown that in certain species maternally ingested stilbestrol may result in abnormalities of the genitaltensive clinical studies be undertaken to determine the level of risk, if any, to which many thousands of young men are subject.

Abnormalities, Drug-Induced↗
PubMed1996

Persistence of injectable collagen in human urethra: case report.

A polypoid lesion was found near the bladder neck during cystoscopy in a woman with urinary incontinence who had undergone periurethral collagen (Contigen) injections 3 years before. She had previously received radiation therapy in addition to a radical vulvectomy for vaginal cancer. On transurethral resection of the lesion, particles of unresorbed collagen material extruded from the capsulated suburothelial space. Histologic evaluation verified the material as the foreign collagen. The persistence of glutaraldehyde cross-linked collagen in our patient was much longer than previously reported and may have been due to effects of previous radiation treatment.

Aged↗
PubMed2002

Less common gynecologic malignancies.

OBJECTIVES: To review the incidence, etiology, diagnosis, treatment, and nursing implications of the uncommon gynecologic malignancies of vulvar carcinoma, vaginal carcinoma, sex cord-stromal tumors of the ovary, and gestational trophoblastic tumors. DATA SOURCES: Research studies, review articles, medical and nursing textbooks. CONCLUSIONS: Vulvar and vaginal cancers, sex cord-stromal tumors of the ovary, and gestational trophoblastic tumors are rare malignancies constituting less than 5% of all malignant diagnoses. If detected early these malignancies have a high possibility of cure. IMPLICATIONS FOR NURSING PRACTICE: Nurses play an important role in the education of women and patients to the signs and symptoms of gynecologic malignancies, the disease process, treatment options, follow-up care, and resources available to these women.

Adult↗
PubMed2006

Age at natural menopause in women exposed to diethylstilbestrol in utero.

Age at natural menopause is related to several health outcomes, including cardiovascular disease and overall mortality. Age at menopause may be influenced by the number of follicles formed during gestation, suggesting that prenatal factors could influence menopausal age. Diethylstilbestrol (DES), a nonsteroidal estrogen widely prescribed during the 1950s and 1960s, is related to reproductive tract abnormalities, infertility, and vaginal cancer in prenatally exposed daughters but has not been studied in relation to age at menopause. The authors used survival analyses to estimate the risk of natural menopause in 4,210 DES-exposed versus 1,829 unexposed US women based on responses to questionnaires mailed in 1994, 1997, and 2001. DES-exposed women were 50% more likely to experience natural menopause at any given age (hazard ratio = 1.49, 95% confidence interval: 1.28, 1.74). Among women for whom dose information was complete, there were dose-response effects, with a greater than twofold risk for those exposed to >10,000 mg. The causal mechanism for earlier menopause may be related to a smaller follicle pool, more rapid follicle depletion, or changes in hormone synthesis and metabolism in DES-exposed daughters. Age at menopause has been related, albeit inconsistently, to several exposures, but, to the authors' knowledge, this is the first study to suggest that a prenatal exposure may influence reproductive lifespan.

Age Factors↗
PubMed1999

Follow up of women with simple ovarian cysts detected by transvaginal sonography in the Tokyo metropolitan area.

OBJECTIVE: To investigate the management of women with asymptomatic ovarian masses, to determine the appropriate duration of follow up, and to identify diagnostic indicators of growing cysts. DESIGN: Review of women's hospital records. SETTING: Tokyo Metropolitan Cancer Detection Center, Japan. POPULATION: Two hundred and twenty-five pre- and postmenopausal women with a diagnosis of ovarian cyst < 6 cm in diameter and normal serum level of CA125, diagnosed between 1 October 1990 and 25 December 1991. MAIN OUTCOME MEASURE: Change in size of cyst as shown by ultrasound. RESULTS: Seventy-five months after initial diagnosis, 29 (13%) of the masses had progressed, 31 (14%) had persisted, and 165 (73%) had regressed. One hundred and nine masses (48%) had regressed within six months of the initial diagnosis. In univariate analysis transvaginal ultrasonographic assessment of morphology findings, cyst diameter, carcinoembyronic antigen (CEA) and CA19-9 were associated with the prognosis of the cyst. Multivariate regression analysis demonstrated that only the initial serum CA19-9 level and serum CEA level were significant predictors of ovarian masses that regressed (P for trend = 0.004 and 0.02, respectively). CONCLUSION: Simple ovarian cysts in patients with a normal level of CA125 have a low risk for ovarian cancer. Vaginal ultrasound at six months will identify regression of most simple cysts. CA19-9 and CEA at the initial diagnosis are useful parameters to predict future regression of ovarian cysts.

Adult↗
PubMedDate not supplied

A case with multiple gynecological malignancies.

A patient with cervical non-Hodgkin lymphoma was treated with chemotherapy. Fourteen months after the diagnosis of the lymphoma, an endometrial adenocarcinoma was detected as a secondary malignant tumor. The patient was treated with surgery followed by radiotherapy. Approximately 7 years after the diagnosis of endometrial cancer, vaginal invasive squamous cell carcinoma was diagnosed as the third primary malignancy, and a second-line palliative radiotherapy was applied. Seven months after the last radiotherapy, postradiational sarcoma in the vagina was diagnosed. Congenital and acquired immune system disorders, viral oncogenes, and various human leukocyte antigen (HLA) types were investigated. Total blood count and lymphocyte subset analysis were performed, and CD4+ lymphopenia was detected. Serologic tests were carried out for human immunodeficiency virus, hepatitis B virus, human papillomavirus, Epstein-Barr virus, and herpes simplex virus infection. Epstein-Barr virus viral capsid antigen IgG was found positive. Low-risk human papillomavirus panel was detected by Hybrid Capture method in the cervical smear. The HLA investigation revealed HLA-A2, HLA-A3, HLA-B57, HLA-B35, HLA-B4, HLA-B6, HLA-DR3, HLA-DR1, HLA-DR51, HLA-DR52, HLA-DQ6(1), and HLA-DQ7(3). The patient died because of the disease.

Adenocarcinoma↗
PubMed1989

Surgical transposition of the ovaries: imaging findings in 14 patients.

Pelvic radiation therapy for cervical or vaginal cancer often leads to ovarian failure. To remove the ovaries from the radiation portal and preserve their function, they can be transposed to the lateral abdomen. Serial imaging studies in 14 patients who had undergone ovarian transposition (five bilateral, nine unilateral) were reviewed. Images obtained included 32 CT scans, 20 sonograms, and one MR image. Most transposed ovaries were located along the paracolic gutters near the iliac crests, creating an extrinsic mass effect on adjacent bowel. Detection of surgical clips on the ovary on CT scans allowed confident recognition of all 19 transposed ovaries. Cysts in the transposed ovaries, noted on most imaging studies, did not correlate with complications of pain or hormonal dysfunction. In one case, a large physiologic cyst in a transposed ovary distorted the cecum and was mistaken for a mucocele of the appendix. In another case, a large ovarian cyst was thought to be tumor recurrence or a lymphocele. These findings indicate that although the transposed ovaries can be recognized on CT scans by the surgical clips attached to the ovaries, the appearance of the ovary does not predict reliably the development of complications.

Adult↗
PubMed1976

[Specific toxicological considerations on anabolic agents; transmitted toxicity].

The growth of populations and the spread of urbanization, resulting in new agricultural structures, have entailed a concentration of livestock production and recourse to new techniques. Of some importance among these techniques is the enteric or parenteral administration of substances in very low doses. These substances include anabolic agents, some of which, like many natural feeds, exhibit hormonal activity. They may be divided into two classes: --those of the DES type, synthetic compounds non-existent in the natural state, --natural agents, which are normally distributed throughout the animal and human organism, and hence in food of animal origin---milk, meat, eggs. The compounds belonging to the second class may also be synthesized and the main toxicological consideration is that they then have to meet clear-cut standards of identity and purity. A compound belonging to the first class, diethylstilbestrol (DES), administered to rats in doses as small as 60 mug/kg of feed or even smaller, causes in general lower growth rates as well as alterations in the genital system and reproductive functions. In long-term experiments (12 months) using rats and mice and applying so-called toxicity "de relais" tests, developed and described by the authors, it also appeared that meat from calves in which DES pellets were implanted under normal rearing conditions, inhibits growth and reproduction in mice and rats fed a diet containing 20% of this meat. Studies in which the livers from treated calves constituted 6% of the diet of these two rodent species also led to the conclusion that fertility was impaired in the second reproduction test. The authors also recall cases of vaginal cancer observed in young girls whose mothers had been treated with DES during pregnancy. Compounds belonging to the second class (estradiol-progesterone and estradiol-testosterone) gave no evidence of harmful effects upon rats when mixed with their rations during short and medium-term trials. Similar results were obtained from studies with rats and mice fed a diet containing 20% veal or 6% liver of calves in which pellets of these natural hormones had been implanted. In these studies, which lasted 23--24 months with rats and 347 days with mice, the toxicity "de relais" test was applied under similar conditions to those undertaken using meat and livers of implanted calves. The report also refers to trenbolone and to "zéralénone" but no toxicity "de relais" tests were carried out with the meat and livers of animals treated with these substances. The authors reached the following conclusions: DES should not be used as an anabolic agent in livestock production. Natural hormones prepared through synthesis or otherwise could be used as anabolic agents in livestock production since no risk to the consumer has been witnessed when they were administered at doses similar to those used in the author's experiments. However, it is recommended that they should be applied under veterinary supervision...

Anabolic Agents↗
PubMed2005

[Pelvic exenteration].

OBJECTIVE: Review of literature concerning pelvic exenterative procedures. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, Charles University, Prague. METHODS: Review and critical assessment of published data. CONCLUSION: Pelvic exenterations are standard procedures in oncogynecology which have no alternative in certain indications. The most frequent indications are recurrences or progressions of cervical, vulva or vaginal cancers. Exenterative procedures might be used in primary treatment in some cases of locally advanced tumors. Mortality of current procedures reaches 5% to 10%, early and late postoperative morbidity is frequent (40-60%). Recently explorative laparoscopy is used in preoperative staging to decrease the number of aborted procedures due to distant metastasis or pelvic tumor inoperability. The procedure with high morbidity, causing impairment of quality of life, is justified due to good follow-up results--5-years overall survival is about 50-60%. It should be emphasized that with no treatment in these patients median of survival reaches about 6 months.

Female↗
PubMed1990

Frequency and activity of autorosette forming cells in Con-A activated PBL from women with hyperplasia or carcinoma of the endometrium--possible role of estrogens.

In a previous study we showed that endometrial carcinoma (EC) patients have a T cell deficiency manifested in a reduced ability to be stimulated in vitro by PHA and to produce IL-2. In an attempt to understand the mechanism responsible for this alteration we present in this paper a study on T cells characterized by the ability to form rosettes, with human erythrocytes, following Con-A activation (designated auto-rosette forming cells--ARFC). These cells are also known to manifest suppressive activity. We show that the frequency of ARFC in con-A activated peripheral blood leukocytes (PBMC) of EC patients is significantly (2-5 fold) higher than that of healthy age-matched controls or that of patients with stage--I colon or vaginal cancer. Endometrial carcinoma is known to be associated with long term exposure to estrogens unopposed by progestins. Examining the possible role of estrogens in increasing the frequency of ARFC from EC patients, we found that in vitro addition of estradiol to Con-A stimulated PBMC from healthy donors increased the frequency of ARFC to levels found in EC patients. Tamoxifen, an anti estrogen drug, reduced the frequency of the estrogen stimulated ARFC to the original low level. Our results suggest a dual role for estrogen in carcinogenesis as well as in immunomodulation.

Concanavalin A↗
PubMed1984

Californium-252: isotope for modern radiotherapy of cervix, uterine and vaginal carcinomas.

Cf-252 is an isotope that can easily be after loaded into available gynecological applicators and used for bulky cervix, uterus or vaginal cancer therapy. It is economical, time and cost effective in use, and can be applied to the therapy of many patients throughout the world. It is more effective for neutron therapy than machine fast neutron therapy and is the only form of neutron therapy producing consistent complication-free 5-year cure of advanced cancers currently available. Cf-252 is an isotope for modern gynecological tumor therapy for the future. Isodose curves for Cf-252 implants revealed dose distributions conforming well to tumor.

Brachytherapy↗
PubMed1997

[Current methods in brachytherapy of female genital malignancies].

The procedures of computed brachytherapy using Co-60; Cs-137 and Ir-192 sources of radiation are discussed. The standards for designing contact radiotherapy, including three-dimensional systems, and principles of monitoring chosen schedules are presented. Criteria for identifying equivalent radiation doses on the basis of the existing radiobiological schedules involved in brachytherapy using different dosage are evaluated. The results of radiation treatment of cervical and vaginal cancers versus tumor process extension are presented.

Brachytherapy↗
PubMed1984

Design and thermometry of an intracavitary microwave applicator suitable for treatment of some vaginal and rectal cancers.

The construction of a modified coaxial cable as an intracavitary microwave applicator suitable for use in some vaginal and rectal cancers is presented. Thermometry was performed for microwave frequencies of 300, 400, 650, and 915 MHz. Temperature profiles in tissue phantoms were obtained with non-perturbing temperature probes and thermography, and the data were compared with those obtained in dogs. The temperature profiles were dependent on the frequency of the microwaves and the insertion depth of the applicator. In addition, an acrylic cylindrical spacer external to the applicator also altered the heating pattern. Therefore, with proper combinations of frequency, insertion depth and spacer, the applicator can be used for heating tumors in some clinical situations.

Animals↗
PubMed2004

Validation of a questionnaire for self-assessment of sexual function and vaginal changes after gynaecological cancer.

The Sexual function-Vaginal changes Questionnaire (SVQ), was developed to investigate sexual and vaginal problems in gynaecological cancer patients. The instrument consists of 20 core items, measuring sexual interest, lubrication, orgasm, dyspareunia, vaginal dimensions, intimacy, sexual problems of partner, sexual activity, sexual satisfaction, and body image. Seven additional items assessing current levels of sexual and vaginal problems compared to pre-diagnosis are intended to be used only once in longitudinal studies. The SVQ was validated in two ways: first, the comprehensibility of each item was investigated through combined quantitative and qualitative assessment of patient-observer agreement in 75 gynaecological cancer patients, second, multitrait analyses and principal component analyses were applied to responses from 257 patients with cervical cancer to investigate the scale properties. The level of agreement between the patients' and the observer's ratings was high (median overall agreement 0.84, range 0.46-1.00; median kappa: 0.80, range 0.52-1.00). From the 10 items applicable to all patients, three scales were hypothesized: intimacy, sexual interest and global sexual satisfaction. For sexually active respondents an additional two scales were hypothesized: vaginal changes and sexual functioning. The psychometric analyses confirmed these scales. The internal consistency of the scales ranged 0.76-0.83 (Cronbach's alpha). The study supports the validity and reliability of the SVQ.

Adult↗
PubMed1979

[Diagnostic value of vaginal mouldings in uterine cancer (author's transl)].

Vaginal mouldings were originally introduced as applicators for uterovaginal radium therapy. After 13 years of experience with this method in the Gustave-Roussy Institute we have found that it is also of great value for diagnostic purposes: it enables the site of the uterine cervical and vaginal lesions to be determined in a more precise manner; areas of invasion of the vagina can be detected which would normally not have been found, either because of the difficulty of performing previous investigations, or because of the extremely superficial nature of certain vaginal lesions: the extent of invasion and the subsequent therapeutic approach can then be radically modified; objective records can be kept in the form of photographs which can be compared with any future mouldings. The vaginal moulding can, in fact, be used as a diagnostic tool during supervision of the patients, when there is the least suspicion of an abnormal finding.

Female↗
PubMed1994

[Vaginal metastasis from cancer of the kidney].

Authors report a new case of vaginal metastasis from renal cell carcinoma. Their main characteristics are reviewed. Possible retrograde venous spread and genital vein ligation prior to manipulation of the kidney are highlighted.

Angiography↗