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Biomedical subjects

J Benda

Publications and source records attributed to J Benda.

At least 19 recordsLinked to original sources
PubMed1996

Surgical management of cervical cancer complicating pregnancy: a case-control study.

A retrospective, case-control analysis of 30 women with cervical cancer associated with pregnancy, surgically managed at the University of Iowa between 1960 and 1994, was performed. Controls were matched with cases based on age, histology, stage, treatment, and year of treatment. Patients were divided into two groups: Group I, radical hysterectomy (26 patients) and group II, simple hysterectomy (4 patients). Eleven patients underwent surgical treatment in the third trimester with a mean planned delay in therapy of 16 weeks. None of the patients with a planned delay in therapy developed recurrent disease. No neonatal morbidity was encountered in these patients. Among group I patients, there was longer anesthesia time (P < 0.03), but there were no differences in the mean operative time. There was more blood loss at the time of surgery among pregnant patients (1493 cc vs 1065 cc for group I, P = 0.005; 812 cc vs 362 cc for group II, P = 0.03); however, there was no difference in the frequency of blood transfusion. The percentage of patients receiving a transfusion decreased significantly after 1991 (33% versus 90%, P = 0.01 for pregnant patients and 33% versus 85%, P = 0.03 for nonpregnant patients). There were no differences in the time required for postoperative bladder drainage, mean hospital stay, febrile morbidity, incidence of wound infection, wound separation, pelvic abscess, thromboembolic disease, or urinary tract infection. One case patient and 3 control patients died of disease, but this difference was not statistically significant. Based upon our data, in selected cases of early-stage cervical cancer, surgical management of cervical cancer is safe during pregnancy. For early Stage I squamous cancers, planned delay in therapy is safe.

Adult↗
PubMed1989

Use of the concept of subjective probability in undergraduate training in differential diagnosing.

In teaching clinical problem solving the probabilistic component should be emphasized. In the domain of empirical medical knowledge to be utilized in diagnostic strategies the prediction according to clinicians' subjective probabilities is used in medical decision making concerning patient problem definition and diagnosis. Two approaches in teaching differential diagnosing by decision models using short case studies are compared. The first is traditional one with the concept of one "true" diagnosis selected from proposed diagnoses group in a MCQ-test. The second approach reflects more the medical practice reality: the students have to predict quantified subjective probabilities of each diagnosis in a suggested diagnoses group considering all the diagnoses probable and not excluding each other. The advantages of the second procedure are evaluated.

Cohort Studies↗
PubMed1987

Ovarian sarcoma.

A 30-year review of primary ovarian sarcomas seen at The University of Iowa Hospitals and Clinics and a review of the literature are presented. Stage at presentation and resectability were the most significant prognostic indicators. Most recurrences appeared outside the pelvis, indicating a need for systemic chemotherapy. With aggressive treatment, patients with early stage disease can have long term survival. A plea is made for multicenter protocols to develop effective programs of treatment.

Adult↗
PubMed1987

Inoperable adenocarcinoma of endometrium: radiation therapy.

Between 1960 and 1979, 41 patients with adenocarcinoma of the endometrium who were poor surgical risks were treated with radiation therapy at the University of Iowa. Local tumor control was achieved in 78% of the patients, 5% manifested complications, and 46% survived 5 years ("uncorrected" 5-year survival rate). Intercurrent disease was the major cause of death (54%), and intrauterine recurrence (22%) was the most frequent recurrence. Intraperitoneal spread (12%) occurred as commonly as hematogenous metastases (12%). Three of nine local failures occurred after 5 years. Local control rates correlated well with clinical stage, and the survival rates correlated well with the stage and grade of the tumor. Local tumor control was achieved in 95% of patients who received greater than 7,000 mg-h intracavitary radium, compared with 63% of patients treated with less than 7,000 mg-h.

Adenocarcinoma↗
PubMed1987

Abnormal pregnancy sonogram: selective indication for fetal karyotype.

The inability to make a definitive diagnosis in the fetus with a sonographically identified abnormality often results in parental and physician uncertainty. An antenatal chromosome evaluation could resolve this uncertainty. Forty-one fetuses with an abnormal ultrasound examination were tested for karyotypic abnormality using a variety of specimens. Nearly one-third (13 of 41) of these fetuses had various chromosome abnormalities. There were only seven survivors in this series, underscoring the often poor prognosis when a significant ultrasound defect is detected antenatally. Knowledge of the fetal chromosome constitution in the setting of an abnormal ultrasound has important epidemiologic, cost-benefit, counseling, and pregnancy management implications.

Adult↗
PubMed1987

Dysgerminoma of the ovary.

Twenty-four patients with pure dysgerminoma of the ovary were treated at The University of Iowa Hospitals and Clinics between 1935 and 1985. Ten patients had stage I unilateral tumors, and all are free of disease from 20-455 months (median, 100 months). All patients treated by unilateral adnexectomy alone for stage IA disease survived. Nine of 11 patients with advanced disease whose therapy began or was completed at our institution are alive without disease from 12-204 months (median, 60 months). Three patients were referred with recurrent disease, and none survived.

Adolescent↗
PubMed1985

Adenoid cystic carcinoma of the vulva with lung metastases. A case report.

The presenting symptoms of adenoid cystic carcinoma of the vulva in a 57-year-old woman were a vulvar mass and pain. The mass was excised locally. The disease recurred in the lung four years later. The patient was treated with several regimens of chemotherapy, without significant effect. She died of pulmonary failure six years after diagnosis.

Carcinoma, Adenoid Cystic↗
PubMed1984

Alveolar soft-part sarcoma of the vagina.

A 26-year-old female with an alveolar soft-part sarcoma of the vagina, manifesting itself during and after pregnancy, is described. The presenting symptoms were pain and an increase in the size of the mass. Local excision, followed by radiotherapy and chemotherapy, was ineffective and the tumor reoccurred within 6 weeks. Reoperation with removal of a portion of the vagina, surrounding tissues, and adjacent periosteum of the pubic bone has resulted in a stabilization of the disease.

Adult↗
PubMed1983

Evaluation of commonly used adjuvants in the prevention of postoperative adhesions.

The uterine horns of 30 rats were subjected to both division and microsurgical anastomosis of the proximal segment and division only of the distal segment. They were equally assigned to three groups, of which group 2 received dexamethasone and group 3 received ibuprofen preoperatively and postoperatively for a total of eight doses. During operation, five rats of each group were irrigated with normal saline and the other five, with 32% dextran 70 (Hyskon). The left uterine horn was anastomosed with 7-0 coated Vicryl, and the right horn, with 7-0 Dexon-S sutures. At repeat laparotomy 2 weeks later, the intraperitoneal adhesions were graded blindly according to their severity. Tissue blocks were obtained from the areas of anastomosis and division only for histologic assessment. Total adhesion scores were 104 for group 1, 53 for group 2 (p less than 0.05), and 90 for group 3 (p = 0.7). The histologic evaluation showed no difference between the three groups. The inflammatory tissue reaction was least around the areas of division only and greatest at the anastomotic sites, where it was most pronounced around the surgical knots. No difference in gross adhesions or histologic assessment was observed between the left horn and the right horn. Adhesions were significantly less in the Hyskon-treated animals (p less than 0.05) but the histologic evaluation showed similar inflammatory reactions. These results suggest that in this species there is no difference between Dexon-S and coated Vicryl sutures, that dexamethasone and Hyskon are effective in preventing postoperative adhesions, and that the inflammatory tissue reaction is not altered by these adjuvants but is significantly augmented by the presence and quantity of suture material.

Animals↗