PubMed Health⌕ Search

Biomedical subjects

H M Shingleton

Publications and source records attributed to H M Shingleton.

At least 109 records · Page 6Linked to original sources
PubMed1981

Impact of a colposcopy satellite clinic.

A community educational program and the introduction of a colposcope in Decatur, Alabama, led to a dramatic decrease in the relative percent of patients evaluated by conization after a positive Pap smear, and a corresponding increase in the relative percent of colposcopic evaluations. The percent of negative or dysplastic tissue diagnoses from conization was reduced from 78% before the colposcopy program to 61% after the program. It was estimated that the colposcopy program resulted in an 81% reduction in the number of conizations and that colposcopy used in lieu of conization resulted in a substantial reduction in both morbidity and cost.

Adolescent↗
PubMed1981

Cervical intraepithelial neoplasia associated with exposure to diethylstilbestrol in utero: a clinical and pathologic study.

The anatomic, colposcopic, cytologic, and histologic findings of the cervix in 300 women exposed to diethylstilbestrol (DES) in utero are reported. Structural cervical abnormalities were found in 51.7% of these patients and an abnormal colposcopic examination was present in 50.6%. The initial interpretation of the pathologic specimens revealed that 26.6% of patients had cytologic or histologic evidence of cervical dysplasia. A uniform pathologic review demonstrated that 10.8% of the cytologic specimens and 37.5% of the histologic specimens had been overread by the initial pathologist. A correlation of the review cytology and histology revealed that the Papanicolaou smear sensitivity for the prediction of abnormal histology was 83.9% and specificity was 86.3%. The probability of an atypical cytologic finding predicting an abnormal histologic pattern was highly significant (P less than .00001). Colposcopic and structural cervical abnormalities were not predictive of an abnormal histologic diagnosis. Of the 18 patients (6%) with histologic evidence of mild-moderate dysplasia, 12 have been followed with no treatment, and cytologic and colposcopic examination has been normal. Marked dysplasia-carcinoma in situ was found in 14 patients (4.7%). Their therapy is summarized. These data strongly suggest that women exposed to DES may be followed safely with Papanicolaou smears and colposcopic examinations provided that both cytopathologists and colposcopists are cognizant of the metaplastic changes in the DES progeny that distinguish them from patients with cervical intraepithelial neoplasia (CIN) who were not exposed to DES. Biopsy should be performed only if indicated by cytologic atypia, colposcopic evidence of advanced CIN, or the presence of an invasive lesion.

Adolescent↗
PubMed1981

Cryosurgery of cervical intraepithelial neoplasia.

Nine hundred sixty-eight patients with cervical intraepithelial neoplasia (CIN) were evaluated with colposcopy and treated with cryosurgery; 722 had a pretreatment diagnosis of CIN I or II and 246 had CIN III. Of those patients available for 2 follow-up smears, histologically proved persistence of CIN was found in 10% of patients with CIN I and II and 20% of patients with CIN III. Recurrent disease was detected in 3.2 and 3.8%, respectively. No patients had a recurrence after 5 negative Papanicolaou smears. One patient had invasive carcinoma 30 months after treatment. Failure of patients to return for follow-up was a significant problem. When the present results were compared to those published in the literature, cryosurgery was found to be less effective than conization in treating CIN III.

Carcinoma, Squamous Cell↗
PubMed1980

Early physiologic squamous metaplasia of the cervix: light and electron microscopic observations.

A light and electron microscopic study was undertaken of the early phases of cervical squamous metaplasia. A study of areas of columnar epithelium with one row of subcolumnar cells revealed a spectrum of squamous differentiation ranging from cytologically undifferentiation to more characteristically basal type squamous cells. With increasing differentiation, squamous characteristics, such as tonofibrils and desmosomes, became qualitatively and quantitatively more evident in the cells. Ultrastructural examination also revealed cells in the subepithelial stroma with prominent basal lamina and hemidesmosome-like structures along the periphery. From a light and electron microscopic viewpoint, the most likely origin for the subcolumnar progenitor cells appears to be the subepithelial stromal cells. The resemblance of these subepithelial stromal cells to the subcolumnar cells in very early stages of metaplasia is often striking.

Adult↗
PubMed1980

Verrucous lesions of the female genitalia. I. Giant condylomata.

Small condylomata acuminata are easily diagnosed clinically and are not often difficult to treat. Giant condylomata, however, can pose real problems in diagnosis and treatment. They must be distinguished from verrucous carcinomas or giant condylomata with squamous malignant change. Large biopsy specimens that include the stroma are necessary in order to make the correct diagnosis, since these entities have somewhat similar histologic features. Treatment should be surgical because radiation and podopyhyllum have both proved to be of little benefit. Surgical removal also allows excellent pathologic study to determine the presence of squamous malignant change or verrucous carcinoma.

Condylomata Acuminata↗
PubMed1980

Verrucous lesions of the female genitalia. II. Verrucous carcinoma.

Verrucous carcinoma is a variant of squamous cell carcinoma that often presents as a large cauliflower-like lesion with locally destructive growth. A high index of suspicion on the part of the clinician and pathologist is needed for an accurate diagnosis since the pathologic findings may be benign on an individual cell basis or may even resemble those of a condyloma. Deep biopsy that includes the base of the lesion is needed for accurate histologic diagnosis, and the pathologist should be aware of the aggressive nature of the lesion. The treatment of choice is surgical, with wide local excision being sufficient in most cases. Radiotherapy often fails to eradicate the lesion and may even cause it to become more anaplastic.

Carcinoma, Papillary↗
PubMed1980

Elevated titers of the beta subunit of human chorionic gonadotropin in oophorectomized women being treated for trophoblastic disease.

Radioimmunoassay has shown a cross-reaction of the beta subunit of human chorionic gonadotropin (HCG) with high levels of luteinizing hormone (LH) in the serum of four women who underwent bilateral oophorectomy as part of their treatment for trophoblastic disease. Administration of oral contraceptives led to suppression of the LH and beta subunit HCG titers.

Adult↗
PubMed1980

Prognostic significance of age in stage I carcinoma of the cervix.

Controversy exists as to the influence of age on the prognosis of patients with carcinoma of the cervix. We present a series of patients with International Federation of Gynecology and Obstetrics (FIGO) stage I squamous cell carcinoma of the cervix, who were treated at a single institution with uniform radiation technics or radical surgery. A multifactorial analysis showed that age above or below 40 was not of prognostic significance after adjusting for race, substage, and treatment. Equal five-year survival was obtained by either radiation therapy or radical surgery. Complications in patients treated with radiation therapy appeared to be more serious than those in the surgical group. Theoretical reasons are advanced to favor surgical management in younger patients.

Adult↗
PubMed1980

Ultrastructural and morphometric study of diethylstilbestrol-associated lesions diagnosed as cervical intraepithelial neoplasia III.

Investigations were carried out to characterize diethylstilbestrol (DES)-associated squamous lesions and to assess their biological significance. Five DES-associated cervical lesions displayed architectural features which were diagnosed as cervical intraepithelial neoplasia (CIN) III, such as full-thickness replacement by atypical squamous cells with vertical orientation and absence of normal polarity. Electron microscopic examination revealed only one of the five to be consistent with the generally recognized ultrastructural picture of non-DES CIN III. In the remaining four lesions, the moderate-to-large numbers of tonofibrils and well-developed desmosomes distinguished them from the true CIN III lesions. Morphometric studies indicate the five DES-associated lesions in this study as a group to be significantly different from normal squamous epithelium, from maturing metaplasia, and from non-DES-related CIN III in the parameters of differentiation studied. Their intermediary position between maturing metaplasia and non-DES CIN III suggests that they are more differentiated than CIN III and less differentiated than maturing metaplasia. Nuclear area measurements indicate the increased nuclear-cytoplasmic ratio observed in the DES-associated CIN III lesions of this study is due to a decrease in cytoplasmic volume, as opposed to an increased nuclear size.

Cell Nucleus↗