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Biomedical subjects

J G Blythe

Publications and source records attributed to J G Blythe.

At least 19 recordsLinked to original sources
PubMed1999

Ovarian carcinoma, endometrial carcinoma, and pregnancy.

A 31-year-old G1 P0 patient with a history of infertility presented with light spotting and cramping at the end of her first trimester. An ultrasonogram at 19 weeks gestation revealed an intrauterine gestation of 21 weeks, a large leiomyoma, and a 8.9 x 6.8 cm complex left ovarian mass. At 35 weeks gestation she had an emergency cesarean section and left salpingo-oophorectomy due to a presumed ruptured ovarian mass. The ovarian mass was diagnosed as a serous cystadenocarcinoma. An exploratory laparotomy with a total abdominal hysterectomy, a right salpingo-oophorectomy, omental biopsy, and periaortic node sampling at 9 weeks postpartum revealed a diagnosis of stage IC ovarian serous cystadenocarcinoma and a stage IA secretory endometrial adenocarcinoma. Adjunctive 32P therapy was successfully administered and at this time the patient has had no recurrence.

Adenocarcinoma↗
PubMed1999

Once-daily valacyclovir hydrochloride for suppression of recurrent genital herpes.

OBJECTIVE: To document the frequency of genital herpes recurrences in men and women with histories of recurrent genital herpes during 1 year of continuous, suppressive therapy with valacyclovir hydrochloride (HCl). METHODS: In an open-label clinical trial conducted at 11 centers, 127 subjects (46 women and 81 men) with histories of recurrent genital herpes (at least 6 recurrences per year) were treated with valacyclovir HCl (500 mg once daily), and their clinical status was followed up for 1 year. Genital herpes recurrences were documented in diaries, and quarterly clinic visits were made for evaluating lesion recurrences and drug safety. In cases of recurrence, subjects self-treated with valacyclovir HCl 500 mg twice daily for 5 days, then resumed once-daily treatment. RESULTS: After the first 3 months of suppressive therapy, 81% of subjects were free of recurrence. Recurrence-free rates remained undiminished during the second, third, and fourth quarters (84%, 84%, and 91%, respectively) and were similar for men and women. Thirty of 46 women (65%) and 56 of 81 men (69%) remained recurrence free during the study and therapy was well tolerated. Adverse events were mild, infrequent, and not considered related to the study drug. CONCLUSION: Valacyclovir HCl was highly effective and well tolerated as continuous suppressive therapy in men and women with recurrent genital herpes. Potential benefits of the once-daily regimen of valacyclovir HCl include improved patient compliance.

Acyclovir↗
PubMed1997

Paraaortic lymph node biopsy: a twenty-year study.

OBJECTIVES: Paraaortic lymph node biopsy is a controversial but proved technique to determine the extent of spread of cancers from the uterine cervix or endometrium. This article explores the following questions. Does the presence of positive paraaortic lymph nodes result in modification of the patient's therapy? Does the evidence gained from a paraaortic lymph note biopsy improve patient survival? STUDY DESIGN: Five hundred sixty-eight patients had paraaortic lymph node sampling in conjunction with another operative procedure between 1976 and 1995. Five hundred seven (89.3%) of these patients had either endometrial or cervical cancer. RESULTS: Paraaortic lymph node biopsies led to a survival rate of 9.1% for cervical carcinoma and 46.6% for endometrial carcinoma and were associated with acceptable morbidity. CONCLUSIONS: We believe that paraaortic lymph node biopsies should be part of the routine evaluation of patients with gynecologic cancers. The knowledge gained by this procedure along with appropriately administered radiation therapy can save lives.

Adult↗
PubMed1995

Lateral hemostatic sutures in cold knife conization of the cervix. What do they accomplish?

OBJECTIVE: The purpose of cold knife conization is to ligate the descending cervical branch of the uterine artery and thus to decrease bleeding. The aim of this study was to investigate the actual frequency of ligation. STUDY DESIGN: Two lateral sutures were placed in the cervix at the 3 and 9 o'clock positions in 97 patients (194 sutures) as part of vaginal hysterectomy. The position of each suture was determined during evaluation of the surgical specimen. RESULTS: Because the specimens from 10 patients contained only single sutures, only 184 sutures were actually evaluated. Upon microscopic examination, 50 of the 184 (27%) appeared to contain no artery. Of the remaining 134 sutures, 95 (71%) enclosed an artery, and 9 (7%) lay within a 10 x field of a branch. Only 30 sutures (22%) missed the artery entirely. Thus, in the 73% of cases where an artery of significant size could be identified, the artery lay within a lateral stitch 71% of the time. CONCLUSION: If the descending cervical branch of the uterine artery supplies most of the blood to the cervix, advance placement of lateral sutures would be expected to reduce blood loss during conization.

Arteries↗
PubMed1993

Comparison of the Cytobrush plus plastic spatula with the Cervex Brush for obtaining endocervical cells.

OBJECTIVE: To compare the effectiveness of the Cytobrush plus plastic spatula with that of the Cervex Brush for obtaining acceptable yields of endocervical cells in Papanicolaou smears. METHODS: We collected 309 smears over a 6-month period, 132 with the Cytobrush plus spatula and 177 with the Cervex Brush. About one-third of the patients in each group were pregnant. Numbers of endocervical cells in the smears were described as none, few, moderate, or many. RESULTS: Moderate or large numbers of endocervical cells were collected from 60.5% of the women in the Cervex Brush group and 65.2% of those in the Cytobrush-spatula group. The percentages were not statistically different. CONCLUSION: The Cytobrush plus spatula and the Cervex Brush sampling methods were equally effective in obtaining endocervical cells in routine Papanicolaou smears.

Adolescent↗
PubMed1990

Continuous postoperative epidural analgesia for gynecologic oncology patients.

The efficacy of continuous postoperative epidural analgesia (CPEA) was assessed in 193 patients who collectively underwent 254 gynecologic oncology procedures. Seventy-five patients elected to receive CPEA; 118 did not. The CPEA patients received an epidural catheter the morning of surgery. Postoperatively, a bolus of meperidine was placed in each catheter. An IVAC pump continued to deliver meperidine at the rate of 14 to 20 mg per hour. The 193 patients also received a total of 655 postoperative intramuscular narcotic injections. CPEA patients were three times less likely to request injections, and those who did required an average of 6.58 compared with 12.42 for non-CPEA patients. The presence or absence of CPEA was the only significant variable. The use of CPEA led to no secondary complications, and it greatly enhanced mood and ability to participate in postoperative care. We conclude that CPEA provides excellent postoperative analgesia for such high-risk patients.

Adult↗
PubMed1989

Colposcopy of condylomatous men.

The male partners of women diagnosed with human papilloma virus (HPV) or dysplasia were examined colposcopically. Anogenital infection was found in 82% of the men, and dysplasia in two of the partners of dysplastic women. Men may not be merely asymptomatic carriers of HPV.

Adult↗
PubMed1989

One-year suppression of frequent recurrences of genital herpes with oral acyclovir.

A double-blind, placebo-controlled study was undertaken to evaluate the long-term efficacy and safety of oral acyclovir suppressive therapy over a 1-year period. Results from the multicenter trials, based on a total of 261 patients with frequently recurring genital herpes, were analyzed. Of the patients enrolled in the study, 131 received oral acyclovir capsules (800 mg) daily and 130 received placebo capsules. Medication was taken twice daily. Analysis of data from patients who completed a full year of therapy demonstrated that only 5% of patients receiving placebo were free from recurrences, as compared with 46% of acyclovir recipients. The mean number of recurrences for patients on acyclovir therapy was 1.8, as compared with a rate of 8.7 recurrences for the placebo group over the course of the year. The mean time to the first recurrent herpes outbreaks was 19 days for the placebo group and 274 days for the acyclovir-treated patients. There were no significant differences between the two groups in laboratory data or in the frequency or nature of side effects reported. Daily administration of acyclovir capsules for 1 year is a safe and effective therapy for control of frequent recurrences of genital herpes.

Acyclovir↗
PubMed1988

A comparison between peritoneal sheathing of the ureters (Ohkawa technique) and retroperitoneal pelvic suction drainage in the prevention of ureteral damage during radical abdominal hysterectomy.

Sixty patients had a radical abdominal hysterectomy with or without a bilateral salpingo-oophorectomy. The Ohkawa procedure was utilized in 26 (43.3%) of the patients and retroperitoneal ureteral placement with suction drainage in 34 (56.7%) of the patients. These two operative procedures were evaluated for complications such as fistula, obstruction, and hydronephrosis by comparing preoperative and postoperative intravenous pyelograms. Five of the 60 patients (8.3%) had surgical complications within one postoperative month. A ureteral obstruction occurred in two patients, and a uretrovaginal fistula occurred in two patients. Hydronephrosis was found in both sets of patients. All of these complications occurred in an additional two patients, both of whom had an Ohkawa procedure. The study led us to conclude that retroperitoneal ureteral placement is not only quicker to perform but also leads to fewer complications than the Ohkawa technique.

Carcinoma↗
PubMed1986

Para-aortic node biopsy in cervical and endometrial cancers: does it affect survival?

Two hundred ten patients with endometrial and cervical carcinoma had para-aortic node biopsies. Nineteen of the 210 patients (9.0%) had positive para-aortic nodes. These 19 patients received pelvic irradiation, and 18 patients received para-aortic irradiation. The incidence of para-aortic nodal involvement in cervical carcinoma was directly related to the stage of the disease. Eleven of the 12 patients with cervical carcinoma and positive para-aortic nodes received both pelvic and para-aortic irradiation. Three of these patients are alive without disease, resulting in a survival rate of 25%. These patients are surviving for 16, 30, and 41 months. The incidence of positive para-aortic nodes in endometrial adenocarcinoma was related to the uterine length and the histologic grade. The survival rate for patients with endometrial adenocarcinoma and positive para-aortic nodes in this study was 57.1%. Four patients have survived for 1, 30, 60, and 71 months. There were no surgical deaths or radiation therapy complications directly attributable to para-aortic biopsy or irradiation.

Adenocarcinoma↗
PubMed1985

Cervicography: a preliminary report.

Cervicography is a photographic method to document abnormal cervical lesions. Screening for abnormal cervical lesions, one of the seven proposed purposes for cervicography, was investigated in this study. We evaluated 578 cervigrams obtained from patients with normal cervical cytologic tests. The evaluated cervigrams were placed in one of four categories. Seventy-nine (13.7%) of the patients had normal cervigrams; in 152 (26.4%) the result was unsatisfactory; in 159 (27.5%) the cervigram was technically defective; and in 188 (32.5%) the result was suspicious. One hundred one of the patients with suspicious cervigrams had colposcopic evaluations. In 69 patients colposcopically directed biopsies were done; 14 patients had koilocytotic atypia, seven had grade 1 cervical intraepithelial neoplasia, three had grade 2 cervical intraepithelial neoplasia, and one patient had an invasive cervical carcinoma. Although cervicography has not been proved to be cost effective, it is a method worthy of further evaluation.

Biopsy↗
PubMed1985

Cytologic diagnosis of endometrial adenocarcinoma using the Endo-pap sampler.

Six hundred ambulatory women were screened with the Endo-pap cytology sampler in two medical centers. None of the women developed complications from the use of the instrument. Their smears were routinely processed together with cervical cytology smears. One hundred fifty-three of these women had a tissue diagnosis by endometrial biopsy, dilatation and curettage, or hysterectomy. Adequate cytology specimens were obtained in 93% of these patients. In these 153 patients, 32 (18%) had a tissue diagnosis of endometrial adenocarcinoma, and 31 patients had a tissue diagnosis of endometrial hyperplasia. The cytology samples obtained with this device were diagnostic of endometrial adenocarcinoma in 30 (94%) of these 32 patients and ten (32%) of the patients with endometrial hyperplasia. Two patients (1.6%) were diagnosed falsely positive. The Endo-pap cytology sampler is considered a safe and effective screening tool for endometrial adenocarcinoma. Its value in diagnosing endometrial hyperplasia remains to be determined.

Adenocarcinoma↗
PubMed1983

The value of colposcopy in follow-up care of the treated gynecologic oncology patient.

The diagnostic value of colposcopy for primary gynecologic malignancies is well accepted. This study was conducted to determine the value of colposcopy in follow-up examinations of treated gynecologic oncology patients. The original gynecologic malignancies included carcinomas of the cervix, endometrium, ovary, vulva, vagina, fallopian tubes, and uterine sarcomas. Distinct colposcopic changes could be identified secondary to radiation therapy, granulation tissue, surgery, and recurrent disease. One-hundred eight treated gynecologic oncology patients were colposcopically examined. Twenty-four of the one-hundred eight patients developed recurrent disease. Thirteen of twenty-four patients had recurrent disease in the vagina, on the cervix, or the vulva. The recurrent disease in these 13 patients was colposcopically diagnosed.

Colposcopy↗
PubMed1983

Colposcopic and pathologic features in two cases of DES-related vaginal clear-cell adenocarcinoma.

Two cases of vaginal clear-cell adenocarcinoma occurred as a result of maternal ingestion of diethylstilbestrol during pregnancy. The first case was diagnosed during the patient's first office visit. The second patient was first seen by the authors in 1976 and was followed at six-month intervals during the ensuing six years; the adenocarcinoma developed during this interval. Colposcopy and cytology were important in the diagnosis of both cases.

Adenocarcinoma↗