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Biomedical subjects

E J Wilkinson

Publications and source records attributed to E J Wilkinson.

At least 91 records · Page 5Linked to original sources

Laser treatment of cervical and vaginal neoplasia.

The conservative management of cervical intraepithelial neoplasia (with electrodiathermocautery and cryosurgery) is unsuitable for the treatment of similar vaginal lesions because of complications of scarring, stenosis, and fistulas. A new modality of treatment with the use of a carbon dioxide laser beam was evaluated for the treatment of cervical and vaginal intraepithelial neoplasia. Histopathologic examination of cervical tissue after laser beam therapy showed that most of the tissue destruction resulted from evaporation of tissue and that the zone of tissue necrosis was much less than after cryosurgery or electrocautery. Laser therapy was used in 50 patients, 46 of whom had varying degrees of cervical and vaginal intraepithelial neoplasia. Treatment failures occurred in five patients (10 per cent). The experience of this study suggests that the major value of laser treatment of the lower genital tract will be in the management of vaginal intraepithelial lesions, while similar results in the treatment of cervical neoplasia may be achieved by much simpler methods.

Carbon Dioxide↗

Danazol therapy in hormone-sensitive mammary carcinoma.

The effect of Danazol, a synthetic gonadotropin inhibitor, on two groups of Sprague-Dawley rats with dimethylbenze (a) anthracine (DMBA) induced mammary carcinoma was studied. Twenty-four (83%) of 29 control animals developed mammary tumors. Forty-four rats in one treatment group received Danazol after tumor reached 0.5 cm in diameter. Twenty-nine (66%) demonstrated tumor regression (p less than 0.005) and in 16 (36%) tumor disappeared (p less than 0.005). In a second treatment group (given Danazol daily after administration of DMBA), only seven of 50 rats (14%) developed palpable mammary carcinoma (p less than 0.0005). Danazol therapy resulted in regression of established mammary carcinoma in rats, and produced a striking inhibition of carcinogenesis in those animals treated from the time DMBA was administered. Danazol is clinically safe; studies using it in the treatment of breast cancer in women who are candidates for hormonal ablative therapy seem warranted.

9,10-Dimethyl-1,2-benzanthracene↗

Amniotic fluid lecithin/sphingomyelin ratio changes related to centrifugal force.

Lecithin/sphingomyelin ratio (L/S ratio) in amniotic fluid has gained wide clinical acceptance as an index of fetal lung maturity. We determined L/S ratios of amniotic fluids centrifuged at various "g-forces." Our studies demonstrate that the L/S ratio value is highly dependent on the g-force used to prepare the fluid. We recommend standardization of the g-force, time, and temperature used in preparation of the amniotic fluid for L/S ratio determination.

Amniotic Fluid↗

Peritoneal osteosarcoma following irradiation therapy of ovarian cancer.

A peritoneal osteosarcoma occurring after irradiation therapy for cystadenocarcinoma of ovary is described. Only 6 cases of postradiation extraosseous osteosarcomas have been reported and none of them have arisen within the peritoneum. The clinical presentation and histopathology of this unusual tumor is presented with a review of the literature.

Autopsy↗

Xerographic evaluation of radical vulvectomy specimens.

Xerography of the radical vulvectomy specimen provides a permanent and visible record of the major lymph node distribution within the specimen. Such documentation is valuable to both pathologist and surgeon alike when making decisions regarding the necessity of further therapy. The combined effort represented by this "team" approach results in a high degree of accuracy not available with other techniques. Only if this kind of lymph node assessment is applied to each and every case will it be possible to evaluate accurately the logic and efficacy of the new therapeutic concepts regarding invasive carcinoma of the vulva.

Female↗

Paget's disease of the vulva and carcinoma of the breast.

Vulvar Paget's disease is an intraepithelial change which is locally recurrent and has minimal if any propensity to invasion. Its major significance lies in the frequency with which concomitant carcinomas are discovered in association with the vulvar skin lesion. Adenocarcinoma of the vulvar apocrine glands is the most commonly associated tumor. Another apocrine adenocarcinoma, carcinoma of the breast, either antecedent or concomitant, is the second most frequently associated tumor, having been noted in 14 cases of vulvar Paget's disease. A case report illustrating this association is presented, and the importance of preoperative breast screening procedures in all patients with vulvar Paget's disease is demonstrated.

Aged↗

Computed tomography of uterine papillary serous carcinoma.

We describe the CT appearances of a fairly commonly encountered "special variant" carcinoma of the uterine corpus called uterine papillary serous carcinoma ( UPSC ). UPSC closely resembles ovarian papillary serous carcinoma microscopically but CT with contrast can differentiate between these two entities. In addition CT in this patient clearly showed the characteristic spread mode of this particularly aggressive form of endometrial carcinoma. Because UPSC has a significantly higher relapse rate than other histologic types of endometrial carcinoma it is important to recognize it at the time of the CT staging procedure. The spread pattern of UPSC suggests the need for adjuvant irradiation or chemotherapy.

Aged↗

Benign cellular changes in Pap smears. Causes and significance.

OBJECTIVE: We reviewed consecutive cases classified as benign cellular changes (BCC) over a four-month period. STUDY DESIGN: Cases classified as BCC were retrieved from the cytology files. A search was carried out to identify the previous Pap smears and concomitant cervical biopsies. RESULTS: One thousand one hundred three cases (23% of our gynecologic smears) were classified as BCC. Ninety-two patients (8.3%) underwent concurrent cervical biopsies. Specific infections accounted for 8% of BCC cases; reactive changes accounted for 92%. Of the biopsy specimens, 8.3% had no significant pathologic change. The most common biopsy diagnoses were cervicitis (31.5%), immature squamous metaplasia (16.3%) and reserve cell hyperplasia (10.8%). Miscellaneous benign diagnoses accounted for 21.7%. Cervical intraepithelial neoplasia (CIN) 1/human papillomavirus (HPV) was present in 14% of cases. All patients with biopsy diagnoses of CIN 1 had at least two previous abnormal Pap smears. Previous biopsy reports were available for review in 127 (12%) of the 1,103 patients. Of these 127 cases, 53.5% had a previous diagnosis of CIN/HPV; 9.4% had invasive carcinoma. A benign diagnosis was reported in 36.5%. CONCLUSION: The majority of BCC cases are due to reactive and inflammatory processes. In patients with a previous history of CIN, BCC may be of some significance. In patients with no significant prior cervical abnormalities, a Pap smear classified as BCC represents a reactive process.

Biopsy↗