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Biomedical subjects

D Cavanagh

Publications and source records attributed to D Cavanagh.

At least 163 records · Page 9Linked to original sources
PubMed1989

Adenocarcinoma of the endometrium and endometrioid carcinoma of the ovary associated with pregnancy.

Nine well-accepted cases of endometrial carcinoma associated with pregnancy have been reported. A 10th patient is added and the cases are briefly summarized. At the time of her definitive surgery 6 weeks postpartum, our patient was also found to have a Stage I endometrioid ovarian carcinoma. Nine of the 10 cases have been well-differentiated adenocarcinoma or adenoacanthoma and the lesions have tended to be focal with minimal or no invasion. Given the small number of patients, conclusions regarding prognosis and treatment are difficult to make. However, in younger patients with noninvasive adenocarcinoma of the endometrium, the adnexa may be spared. Endometrioid adenocarcinoma of the ovary, discovered incidentally in our patient, is associated with a concomitant adenocarcinoma of the endometrium in 5-29% of cases, but the present case in which the lesions coexisted with pregnancy appears to be the first such report in the literature.

Abortion, Induced↗
PubMed1989

Recent modifications in the treatment of invasive squamous cell carcinoma of the vulva.

The curative potential of therapy should not be sacrificed. However, an effort must be made to determine methods that will reduce the morbidity while at least retaining the curative potential. Modifications which potentially may reduce the morbidity of regional nodal management include deletion of the inguinal lymphadenectomy or use of superficial inguinal lymphadenectomy in selected early lesions, the use of separate groin incisions, the selected use of unilateral inguinal lymphadenectomy, and the use of primary radiation therapy to the inguinal and/or pelvic nodal areas. Modifications which potentially may reduce the morbidity of the primary tumor management include wide local excision for superficial lesions, modified radical vulvectomy for regionalized lesions, the use of skin flaps in selected cases, the development of more sophisticated plastic surgical procedures for the management of posterior lesions, and the use of combined treatment modalities in the management of locally advanced disease.

Carcinoma, Squamous Cell↗
PubMed1989

Early cervical cancer coexistent with idiopathic inflammatory bowel disease.

Early invasive carcinoma of the cervix may be treated by surgery or radiation therapy. Two patients with early cervical cancer are presented whose concomitant inflammatory bowel disease figured significantly in the selection of surgery as treatment. The use of radiotherapy in the face of inflammatory bowel disease, however, is not clearly addressed in the literature.

Adult↗
PubMed1989

The management of diaphragmatic lesions in ovarian carcinoma.

Cytoreduction is currently an essential feature of the treatment of carcinoma of the ovary. Occasionally, optimal reduction is achieved except for localized diaphragmatic lesions. Two patients who were treated with primary cytoreduction for epithelial ovarian carcinoma had localized full-thickness diaphragmatic metastasis. Often resection is avoided because of concern about pneumothorax. A safe and easy method is described for removing peritoneal and diaphragmatic muscular metastasis without the need for a thoracostomy tube. These patients were cytoreduced without morbidity. The first patient is currently free of disease at 17 months after surgery. The second patient had a 13-month disease-free interval before her abdominal recurrence.

Adenocarcinoma, Mucinous↗
PubMed1989

Neoplasia in vaginal cuff epithelial inclusion cysts after hysterectomy.

Between Jan 1, 1985, and Dec 31, 1987, 26 women were treated for vaginal intraepithelial neoplasia (VAIN). Twenty-two of them had undergone hysterectomy, 15 for a cervical intraepithelial neoplasia or cancer. Five patients were identified whose management was complicated by the presence of the neoplastic process within vaginal cuff inclusion cysts (or sinuses). All five patients ultimately underwent upper vaginectomy as part of their treatment, and two of them were found to have an invasive squamous cell carcinoma of the vagina. Women who are found to have an abnormal Papanicolaou smear or VAIN in the upper vagina following hysterectomy should be examined carefully for vaginal cuff abnormalities. Those with nodularity or distortion of the cuff are best managed with surgical excision for both treatment of VAIN and discovery of an occult invasive cancer.

Adult↗
PubMed1989

Wound hematoma: prophylaxis with topical thrombin.

We studied 123 patients having elective exploratory laparotomy through a midline vertical incision for gynecologic disease; patients were randomized to receive wound irrigation with either saline or topical thrombin before closure of the incision. Seven patients were not evaluable. No patient received low-dose heparin therapy perioperatively. No patient in either group had a clinically significant wound hematoma or disruption. Minor wound hematomas were more common in the saline group, a finding that approached statistical significance. Blood coagulation profiles were not different in the two groups either preoperatively or postoperatively. Topical thrombin is probably not clinically useful in preventing wound hematomas in patients who do not receive perioperative treatment with low-dose heparin; however, it seems to be safe for application to open wounds.

Administration, Topical↗
PubMed1988

Infiltration of interleukin-2-inducible killer cells in ascitic fluid and pleural effusions of advanced cancer patients.

Using ascitic fluid or pleural effusion obtained from 13 ovarian or metastatic breast cancer patients, we separated tumor cells from effusion-associated lymphocytes (EAL) with Percoll density centrifugation. Lymphocytes were incubated with recombinant interleukin 2 (IL-2) for 3-4 days and then assessed for tumoricidal activity in a 51chromium-release assay. The IL-2-activated EAL were found to lyse autologous fresh tumor cells, as well as allogeneic fresh tumor cells and FMEX tumor cells, a melanoma cell line which is resistant to natural killer cell activity but is sensitive to lysis by lymphokine-activated killer cells. There was little or no tumoricidal activity seen in freshly isolated EAL or in EAL which were cultured in medium without IL-2. Phenotypically, the IL-2-activated EAL were largely CD3-, although some cytolytic activity was found in CD3+ populations. Also, most activity was found in cells positive for CD2 (OKT11) and CD16 (Leu 11b), and negative for the monocyte marker Leu M3. These results indicate that the activated cell types found in EAL were predominantly natural killer/lymphokine-activated killer-like with a small contribution from T-cells. Finally, EAL were readily activated by IL-2 in medium containing autologous effusion fluid, indicating that in situ activation of tumoricidal activity by IL-2 can occur in the face of potentially inhibitory substances or cells that may exist in the effusions. Direct introduction of IL-2 may therefore be a potential therapeutic modality of effusion-forming cancers.

Adult↗
PubMed1988

Comparative effectiveness and safety of cefotetan and cefoxitin as prophylactic agents in patients undergoing abdominal or vaginal hysterectomy.

In a multicenter, randomized clinical trial, 282 women who underwent abdominal or vaginal hysterectomy were given a single preoperative 2 g dose of cefotetan (171 evaluable patients) or three perioperative 2 g doses of cefoxitin (84 evaluable patients) as antibiotic prophylaxis. A successful clinical response occurred in 92 percent of those receiving cefotetan and 90 percent of those receiving cefoxitin who underwent abdominal hysterectomy, and in 94 percent of those receiving cefotetan and 93 percent of those receiving cefoxitin who underwent vaginal hysterectomy. The incidence of vaginal cuff cellulitis was 3.4 percent and 5 percent for cefotetan and cefoxitin patients, respectively, who underwent abdominal hysterectomy, and 4.8 percent and 4.5 percent, respectively, for those who underwent vaginal hysterectomy. The incidence of major wound infection was 3.4 percent and 2.5 percent for cefotetan and cefoxitin, respectively, in the abdominal hysterectomy group. Postoperative changes in oral body temperature, duration of hospitalization, and postoperative grading of surgical wounds were similar. Both drugs were well tolerated. These results suggest that a single dose of cefotetan is equally effective and as safe as multiple-dose cefoxitin for prophylaxis in patients undergoing hysterectomy.

Adult↗
PubMed1988

Treatment of recurrent and metastatic cervical cancer with cis-platin, doxorubicin, and cyclophosphamide.

The combination of cisplatin, doxorubicin, and cyclophosphamide was used to treat 28 patients with recurrent and metastatic cervical cancer. Five patients had a complete response and one patient had a partial response, yielding a total response rate of 21%. Eleven patients had stable disease. The median survival for the whole group was 42 weeks. Responders had a statistically significant prolongation of survival at a median of 113 weeks (P less than 0.01). There was no statistically significant difference in progression-free interval between responders and patients with stable disease. The overall median progression-free survival was 26 weeks. The toxicities noted were primarily nausea, vomiting, and myelosuppression. The combination of cis-platin, doxorubicin, and cyclophosphamide has modest effectiveness in the treatment of metastatic or recurrent carcinoma of the cervix.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Amino acids within hypervariable region 1 of avian coronavirus IBV (Massachusetts serotype) spike glycoprotein are associated with neutralization epitopes.

The spike glycoprotein (S) gene of IBV codes for a precursor protein which is cleaved into the N-terminal S1 and C-terminal S2 glycopolypeptides. The S1 glycopolypeptide, which induces neutralizing antibody, comprises approximately 520 amino acid residues. We have determined the nucleotide sequence of S1 of seven strains of the Massachusetts (Mass) serotype and the first 337 bases of two additional Mass strains. Despite the fact that the strains had been isolated over three decades in Europe and the U.S.A. there was only 4% base and 6% amino acid variation within the group. Nearly one third of the 32 amino acid differences in S1 were in two hypervariable regions (HVRs 1 and 2) comprising residues 38-51 and 99-115, identified by Niesters et al. (1986), showing that HVRs 1 and 2 are a feature of the Mass serotype. Amino acid variation within HVRs 1 and 2 was 29% and 40% respectively. Five vaccine strains could be distinguished from each other by sequencing of the first 337 nucleotides. Variants of M41 which resisted neutralization by two monoclonal antibodies (A13 and A38) had the same, single base change at position 134, resulting in substitution of proline residue 45 by histidine. This indicates that residues within HVR 1 are associated with epitopes which induce neutralizing antibody.

Amino Acid Sequence↗
PubMed1988

Pneumovirus-like characteristics of the mRNA and proteins of turkey rhinotracheitis virus.

Electronmicroscopy has indicated that turkey rhinotracheitis virus (TRTV), the causative agent of an acute respiratory disease in turkeys, is a member of the Paramyxoviridae family. To determine if TRTV belongs to one of the three defined genera of this family (Paramyxovirus, Morbillivirus and Pneumovirus) we have analysed the RNA and proteins induced during replication of TRTV in Vero cells. Following replication in the presence of actinomycin D 10 polyadenylated RNA bands, ranging in Mr from 0.22 to 2.0 X 10(6), were detected in infected cells; some bands probably contained 2 or more RNA species. Viral proteins were studied after radiolabelling in the presence of [35S]methionine and [3H]glucosamine. Comparison of the polypeptides in mock-infected and infected cells, virions and nucleocapsids and after lentil-lectin chromatography and immunoprecipitation revealed seven virus-specific polypeptides (p), some of which were glycosylated (gp): gp82 (Mr 82K), gp68, gp53, gp15, p43, p40 and p35. These are considered to be analogous to the large glycopolypeptide (HN, H and G), fusion protein precursor F0, the F protein cleavage products F1 and F2, nucleocapsid (N), phosphorylated (P) and matrix (M) polypeptides, respectively, of the Paramyxoviridae. Two other polypeptides (Mr 200K and 22K) were also detected, as was a glycopolypeptide of Mr 97K, probably related to gp82. Tunicamycin inhibited glycosylation of gp53 and gp15 but gp82 was little affected, most glycans still being present on a glycopolypeptide of approximately 79K. This finding, indicating that gp82 has mostly O-linked glycans, considered with the mRNA profile and the molecular weight of the N protein shows that of the three genera in this family, TRTV most closely resembles the Pneumovirus genus.

Animals↗
PubMed1988

The effect of prostaglandin D2 on angiotensin converting enzyme.

Intravenous administration of prostaglandin D2 (2, 4 and 8 micrograms/kg) in the rat resulted in a dose-dependent decrease in arterial pressure with partial recovery occurring during the course of the experiment. Hematocrit and hemoglobin decreased in all groups, probably related to the blood withdrawal and volume replacement. Increase in serum glucose is not specific to prostaglandin D2 and a progressive increase occurred even in the vehicle controls. Despite the fact that arterial pressure decreased with the injection of this prostanoid, angiotensin-converting enzyme did not change significantly. The results of this study demonstrate no association between the administration of prostaglandin D2 and angiotensin-converting enzyme within the concentrations we have used in these experiments.

Animals↗
PubMed1988

Neuropathies associated with radical pelvic surgery for gynecologic cancer.

Nerve injury is an infrequent complication of gynecologic surgery. We reviewed, over the previous academic year, our experience with this complication after radical pelvic surgery. Four cases are reported (1.06%) and discussed. In our experience, neuropathies are infrequently associated with radical pelvic surgery. However, they are often irreversible. Careful surgical technique and care in the methods of obtaining hemostasis are probably the most important factors in the prevention of these complications. In gynecologic operations in general, the most important factors in prevention of postoperative neuropathies include careful placement of the self-retaining retractor for abdominal operations, and careful positioning of the patient in stirrups whenever they are used.

Aged↗
PubMed1988

Restaging laparotomy and ovarian cancer.

We retrospectively reviewed the records of 41 patients who had restaging laparotomy after initial surgery and chemotherapy for ovarian cancer. In 37 of them, the cancer was epithelial. Stage and amount of residual disease after initial cytoreductive surgery correlated with laparotomy outcome. There were no operative deaths, and perioperative morbidity was relatively minor. Of the 25 patients with residual disease after initial cytoreductive surgery ten had a complete response, eight had a partial response, two had stable disease, and five had progression. Three patients (11.5%) had recurrent disease after a negative restaging laparotomy. We discuss salvage therapy and the value of restaging laparotomy in ovarian cancer.

Female↗
PubMed1988

Carcinoma in situ of the vulva: 24 years' experience in southwest Florida.

We retrospectively studied 125 patients treated for carcinoma in situ of the vulva from 1961 through 1984, with follow-up ranging from one to 24 years. Patients' ages ranged from 24 to 90 years, with a mean age of 53 years. Multifocal disease was more common in women under age 40. Pruritus was the most common complaint, but 60% of the patients were asymptomatic. Twenty-five patients (20%) had other associated malignancies: carcinoma in situ of the cervix in ten patients, invasive carcinoma of the cervix in six, multifocal carcinoma in situ involving vulva, vagina, and cervix in five, vaginal carcinoma in situ in two, and endometrial carcinoma in two. Sixty-five patients were treated primarily with wide excision, 45 with total vulvectomy, seven with "subtotal" vulvectomy, three with skinning vulvectomy, and three with vulvectomy and bilateral groin node dissection; two patients refused treatment. Fifteen patients had a recurrence--recurrent carcinoma in situ in ten, and invasive carcinoma of the vulva in five. Whether the patient had had total vulvectomy or a lesser procedure appeared to make no difference in the recurrence rate. Thus a well planned excision of vulvar carcinoma in situ appears to be the treatment of choice. All recurrences were in patients over age 40, so although the lesion is histopathologically identical in the younger patients, its biologic behavior seems to be more benign. Since it is possible, however, that invasive disease will ultimately develop in some of the younger patients, careful follow-up is still required.

Adult↗