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Biomedical subjects

J F Russo

Publications and source records attributed to J F Russo.

At least 19 recordsLinked to original sources
PubMed2000

Controversies in the management of abnormal Pap smears.

Cytology is not 100% accurate. Overdiagnoses and underdiagnoses occur. Changes in classification systems and new devices have not changed the reliability of the Pap smear. The majority of squamous intraepithelial lesions will remit spontaneously and less than 1% will progress to invasive cancer. HPV-DNA testing has not provided a foolproof way to triage lesions. Therefore, the management of abnormal Pap smears is dependent on the personal experience of the physician, who must consider the following questions. What is the accuracy of your cytology laboratory? Does it overdiagnose or underdiagnose? How often has an ASCUS or LSIL become HSIL or invasive cancer on histologic evaluation? Will your patients come back for follow up? Will their health insurance cover frequent follow-up Pap smears or colposcopies? Do you have the resources to follow every patient who needs it? Do you want to avoid the development of every invasive cancer that may develop during the period of follow up?

Female↗
PubMed1997

Prenatal ultrasonographic and molecular diagnosis of Apert syndrome.

Apert syndrome is a rare craniosynostosis syndrome with significant bilateral syndactyly of the hands and feet. Usually it is detected by ultrasonography during the third trimester unless there is a family history. We present an interesting sporadic case with features consistent with Apert syndrome detected as early as the first trimester. A first-trimester ultrasound evaluation prior to chorionic villus sampling (CVS) for maternal age 41 was within normal limits except for the suggestion of a 'mitten-like' hand and proximally placed thumb. Mid-trimester ultrasound was not diagnostic; however, following the development of polyhydramnios in the third trimester, the evaluation of the digits and facial features were strongly suggestive of Apert syndrome. Amniocentesis was performed and a molecular diagnosis of Apert syndrome was made and confirmed on cord blood.

Acrocephalosyndactylia↗
PubMed1994

Enhanced peripheral glucose utilization in transgenic mice expressing the human GLUT4 gene.

Human GLUT4 protein expression in muscle and adipose tissues of transgenic mice decreases plasma insulin and glucose levels and improves glucose tolerance compared with nontransgenic controls (Liu, M.-L., Gibbs, E. M., McCoid, S. C., Milici, A. J., Stukenbrok, H. A., McPherson, R. K., Treadway, J. L., and Pessin, J. E. (1993) Proc. Natl. Acad. Sci. U.S.A. 90, 11346-11350). We examined the basis of improved glycemic control in hGLUT4 transgenic mice by determining glucose homeostasis and metabolic profiles in vivo. Glucose turnover experiments indicated a 1.4-fold greater systemic glucose clearance in hGLUT4 mice relative to controls (p < 0.05), whereas hepatic glucose production was similar despite 26% lower (p < 0.05) glucose levels. Glucose infusion rate during an euglycemic-hyperinsulinemic clamp was 2-fold greater (p < 0.05) in hGLUT4 mice versus controls, and skeletal muscle and heart glycogen content were increased 3-5-fold (p < 0.05). The increased peripheral glucose clearance in hGLUT4 mice was associated with increased (25-32%) basal and insulin-stimulated glucose transport rate in soleus muscle (p < 0.01), and increased muscle plasma membrane-associated GLUT4 protein. Fed hGLUT4 mice displayed 20-30% lower plasma glucose and insulin levels (p < 0.05) and 43% elevated glucagon levels (p < 0.001) compared with controls. Triglycerides, free fatty acids, and beta-hydroxy-butyrate were elevated 43-63% (p < 0.05) in hGLUT4 mice due to hypoinsulinemia-induced lipolysis. Free fatty acids and beta-hydroxybutyrate levels in hGLUT4 mice increased further upon fasting, and skeletal muscle glycogen levels decreased markedly compared with controls. The data demonstrate that high level expression of hGLUT4 increases systemic glucose clearance and muscle glucose utilization in vivo and also results in marked compensatory lipolysis and muscle glycogenolysis during a fast.

Animals↗
PubMed1988

The significance of atypical cervical smears.

The significance of and approach to cervical smears showing cytologic atypia without dyskaryosis remains controversial. A review of 139 colposcopies performed for atypical cytology revealed cervical intraepithelial neoplasia (CIN) in 25%. Of the CIN found, 85% was CIN I and 15%, II. No case of more advanced disease was found. The type and severity of the cytologic atypia correlated with the presence of CIN. However, all degrees of atypia were found to have a significant association with CIN, and the degree of cytologic atypia therefore cannot be used to exclude colposcopy in any women with atypical smears. This study suggested that cytologic atypia is an expression of early CIN, and the results support our endorsement of routine colposcopy in the evaluation of women with persistent atypia.

Adolescent↗
PubMed1984

Cervical intraepithelial neoplasia in adolescents.

Three hundred and eleven adolescent patients with abnormal Pap smears were referred for evaluation. Two hundred and ninety-three were evaluated with colposcopy and directed biopsies. Fourteen percent had normal findings, 42% CIN I, 22% CIN II, and 22% CIN III. The distribution of pathologic findings was similar to that in an adult population in the same clinic except that no invasive carcinomas were found in our adolescents. Since there was a predominance of exocervical lesions, only 3% of the patients required diagnostic conization. Ninety-four percent of the adolescents were treated by cryotherapy as compared to 68% of the adults. Since adolescents have significant cervical intraepithelial neoplasia, an abnormal Pap smear should be evaluated and a tissue diagnosis obtained. Outpatient therapy is well suited for the majority of teenagers because the lesions are commonly confined to the exocervix.

Adolescent↗
PubMed1984

Abnormal cervical cytology in sexually active adolescents.

A routine Pap smear was performed on 1,207 sexually active adolescents seen in a public health department family planning clinic. One hundred and thirty-two (11%) had abnormal findings and were referred for evaluation to the gynecologist of their choice. Thirty-five patients (27%) failed to keep their initial referral appointment, and twenty-eight patients (21%) were inadequately evaluated. Therefore, only 69 patients (52%) were evaluated by colposcopy with directed biopsies. Fifty of the 69 patients (72%) had cervical intraepithelial neoplasia. Sexually active adolescents should be routinely screened with Pap smears and those with abnormal findings should be evaluated and a tissue diagnosis obtained. The primary care provider must reinforce the need for complete evaluation and therapy. Referral must be made to a gynecologist who is expert in the evaluation of abnormal Pap smears.

Adolescent↗
PubMed1981

Mycoplasma hominis, Ureaplasma urealyticum, and Corynebacterium genitalium recovered from the lower genital tracts of adolescent women.

The lower genital tracts of 137 adolescent women were examined for the presence of Mycoplasma hominis, Ureaplasma urealyticum, and Corynebacterium genitalium in relation to sexual activity, previous pregnancy, presence of vaginal discharge and oral contraceptive use. None of the sexually inactive and 10% of the sexually active adolescent females were colonized with U. urealyticum. None of the sexually inactive and 4% of the sexually active adolescent females were colonized with C. genitalium. Nineteen percent of the sexually inactive and 36% of the sexually active adolescent females were colonized with M. hominis. The presence of M. hominis in the lower genital tract was not associated with any clinically identifiable vaginal discharge or inflammatory changes in exfoliated cervical and vaginal epithelial cells. The presence of M. hominis in the lower genital tract did not appear to be related to the use of oral contraceptives or antecedent pregnancy. There was no significant difference in the recovery rates of these microorganisms when we compared women who had non-specific vaginitis with those who did not. There is no evidence from this study that any of these microorganisms is responsible for non-specific vaginitis.

Adolescent↗
PubMed1981

Preliminary study of the flora in the lower genital tracts of sexually active adolescent females in relation to symptoms and inflammatory response.

The lower genital tracts of 20 sexually active adolescent females were examined for the presence of Mycoplasma hominis, Ureaplasma urealyticum, Corynebacterium genitalium, and Corynebacterium pseudogenitalium. Fifty percent of the asymptomatic adolescent females and 50% of the symptomatic adolescent females were colonized with M. hominis, which is higher than the percentage reported in adult females. None of the asymptomatic adolescent females and only 10% of the symptomatic adolescent females were colonized with U. urealyticum, which is much lower than the percentage reported in adults. None of the study patients was colonized with C. genitalium, but 25% were colonized with C. pseudogenitalium. No relationship was found between the presence of M. hominis in the lower genital tract and a clinically identifiable vaginal discharge or inflammatory changes in exfoliated cervical and vaginal epithelial cells. The presence of M.hominis in the lower genital tract does not appear to be influenced by use of oral contraceptives or antecedent pregnancy.

Adolescent↗