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Biomedical subjects

L Burke

Publications and source records attributed to L Burke.

At least 55 records · Page 3Linked to original sources
PubMed1987

Villous adenoma presenting as a vaginal polyp in a rectovaginal tract.

A 72-year-old woman had a villous adenoma of endodermal derivation involving the rectovaginal septum and contiguous mucosal surfaces that presented clinically as a vaginal polypoid tumor. To explain the vaginal involvement, we postulate that the adenoma traversed a tract of developmental origin within the rectovaginal septum. This is the first report of such a unique constellation of findings.

Adenoma↗
PubMed1986

The subspecialty of pediatric dermatology.

Department chairmen of 127 certified pediatric and eighty-six certified dermatology residency programs were surveyed in an attempt to characterize the subspecialty of pediatric dermatology. Responses were received from 114 different institutions. The results indicate that pediatric dermatologists are located mainly in large teaching hospitals (pediatric wards with more than 100 beds or children's hospitals) and selected private practice settings. Fifty-eight percent of pediatric dermatologists are less than 40 years of age. Forty-nine percent of these individuals are board-certified in both specialties. Very few "pediatric dermatologists" see pediatric patients exclusively. Only 20% have a patient population that is composed of more than 75% children. The responses also suggest that professional opportunities in this subspecialty are limited at the present time.

Adult↗
PubMed1985

Thermal effects of the Nd:YAG and carbon dioxide lasers on the central nervous system.

The use of laser is becoming commonplace in neurological surgery because of the potential for surgical precision with minimal surrounding trauma, improved hemostasis, freedom from electrical interference of evoked potentials recordings, and a variety of other benefits. Despite this enthusiasm, there are little significant data regarding various laser-neural tissue interactions. Thermal transformation was studied using both carbon dioxide and Nd: YAG lasers on rat cerebral cortex. The Nd: YAG laser produced a significant quantity of heat which spread far beyond the boundaries of the histologically identified lesion. The thermal profile of the carbon dioxide laser on brain indicated minimal thermal spread change, even immediately adjacent to the physical edge of the lesion. Mechanisms and ramifications are discussed.

Animals↗
PubMed1984

Choreoballismus: a nonhemorrhagic complication of venous angiomas.

Choreoballismus, developing subacutely in a 48-year-old man, is reported for the first time as a complication of a cerebral venous angioma, demonstrated by computed tomography scanning and angiography. There was no apparent hemorrhage or mass effect from the angioma, which was located in the right caudate nucleus. The movement disorder, which did not respond to haloperidol alone, disappeared after the addition of clonazepam. The necessity for dual therapy implies that there was a disorder of more than one neurotransmitter system in this patient. The clinical and pathological features of these unusual vascular malformations are reviewed.

Brain Neoplasms↗
PubMed1982

Immunoperoxidase staining for involucrin: a potential diagnostic aid in cervicovaginal pathology.

Involucrin, a protein subunit of keratinocyte cross-linked envelopes, is a distinctive marker for suprabasal differentiation in stratified squamous epithelium. Immunoperoxidase staining for involucrin was used to evaluate paraffin sections of tissue obtained by colposcopically directed biopsies of infectious, metaplastic, and dysplastic lesions of the cervix and vagina. Areas of normal squamous epithelium, papillary and flat condyloma acuminatum, and mature and immature squamous metaplasia showed positive staining in 99 per cent of samples lacking significant inflammation and in 60 per cent of those with moderate or severe inflammation. In contrast, only 19 per cent of the squamous cell dysplasias, even those without much inflammation, showed positive staining, and no area with moderate or severe inflammation showed positive staining. These findings indicate that expression of involucrin is modulated by cellular pathologic features and microenvironment. We suggest that immunoperoxidase staining for involucrin may be useful in distinguishing mild dysplasia from immature metaplasia and flat condyloma in some biopsy specimens in which routine histologic examination yields an indeterminate diagnosis.

Carcinoma, Squamous Cell↗
PubMed1981

Evolution of diethylstilbestrol-associated genital tract lesions.

The evolution of the colposcopic manifestations of adenosis involving the cervicovaginal hood and vagina was determined by the long-term follow-up of 173 diethylstilbestrol-exposed women. Serial gross observations in conjunction with histopathologic data showed that adenosis is a dynamic lesion that undergoes progressive squamous metaplasia over time. Ultimately, adenosis may disappear completely, to be replaced by normally glycogenated mucosa. A schema for the evolution of adenosis is presented.

Cervix Uteri↗
PubMed1980

Natural history of diethylstilbestrol-associated genital tract lesions: Cervical ectopy and cervicovaginal hood.

There was a marked regression of structural abnormalities associated with in utero exposure to diethylstilbestrol (DES) among 173 women observed for up to 5 years. Cervical ectopy, present in 121 women at initial examination, decreased in extent in 91 women (75.2%) and disappeared completely in 38 (31.4%). The cervicovaginal hood (CVH), present initially in 123 women, diminished in 65 patients (52.8%) and disappeared completely in 35 (28.4%). The longer the follow-up period, the greater the extent of resolution of these lesions. Patients with both findings at entry into the study showed parallel diminution of ectopy and CVH. The investigation documents that DES-associated ectopy and CVH are labile lesions which tend to decrease in extent with time and may eventually disappear.

Adolescent↗
PubMed1980

Carbon dioxide laser therapy of cervical intraepithelial neoplasia: factors determining success rate.

Sixty patients with biopsy proven CIN were treated with CO2 laser. Severity of the lesion was equally divided among all three grades of CIN. All patients were biopsied immediately after laser therapy and at six and twelve weeks past treatment. Persistence or absence of disease was evaluated with respect to severity of disease, size of lesion, method of applying laser, whether the endocervical canal was involved, whether only the lesion or the entire transformation zone was lasered, and depth of laser effect. The persistence of disease was 36.7 percent after therapy. Success was not related to severity of disease, size of lesion, or whether the endocervical canal was involved. It was related to depth of coagulation necrosis, method of applying the laser bean, and if the entire transformation zone was treated.

Adolescent↗
PubMed1980

Post-transfusion purpura as a gynecologic complication.

Post-transfusion purpura (PTP) is a recently separated category of thrombocytopenic purpura occurring mainly in women. It is an acute, severe thrombocytopenic state with clinical manifestations of hemorrhage that may be fatal. It usually occurs 5 to 8 days after transfusion, usually after administration of whole blood. The typical patient is a middle-aged, multiparous white woman who has received a transfusion and has undergone an operation, often a gynecologic procedure. Diagnosis may be suspected by normal clotting studies, bone marrow biopsy showing increased megakaryocytes, and demonstration of a potent antibody reactive against platelets by clot-retraction inhibition, complement fixation, or 51Cr-release studies. The treatment of choice is exchange transfusion or plasmapheresis, unless these procedures are medically contraindicated. Because of the lack of reports in the gynecology literature on PTP, a case report and discussion are presented.

Biopsy↗
PubMed1980

Observations on the psychological impact of diethylstilbestrol exposure and suggestions on management.

The emotional impact of diethylstilbestrol (DES) exposure is described in a series of 50 mothers and daughters interviewed by psychiatrists. Patterns of response to this trauma and methods of resolution are discussed, and opportunities for preventive intervention by gynecologists are suggested. Specific, open dialogue about DES with the patient as a colleage can minimize the emotional sequelae of the experience.

Affective Symptoms↗
PubMed1979

Glandular dysplasia in diethylstilbestrol-associated vaginal adenosis. A case report and review of the literature.

A case of diethylstilbestrol-associated vaginal adenosis in which dysplastic glands were identified and examined by light and electron microscopy is reported. Transitions between normal and dysplastic glands were documented in subserial sections. These alterations may characterize an intermediate phase in the development of clear-cell adenocarcinoma of the vagina.

Adenocarcinoma↗
PubMed1978

Vaginal and cervical squamous cell dysplasia in women exposed to diethylstilbestrol in utero.

Two hundred and fifty patients were examined because of a history of in utero exposure to diethylstilbestrol (DES) or because of the presence of physical findings suggesting such exposure. One thousand biopsies were examined for the presence of neoplasia and then compared to the colposcopic findings. There were no cases of glandular or squamous cell carcinoma. Fifteen (6 per cent) of the patients had squamous cell dysplasia. The degree of dysplasia was mild in 11 and moderate in only 4 (1.6 per cent) of the women. The majority of the cases of dysplasia involved the cervix, whereas the vagina was involved in only four cases, with simultaneous cervical dysplasia in three of these. Patients with cervical mosaic and white epithelium had dysplasia on biopsy much more frequently as compared with patients with similar colposcopic appearances in the vagina. Our results suggest a low incidence of significant squamous precancerous change in the DES-exposed population and provide evidence that colposcopic data concerning dysplasia pertinent to the cervix cannot be applied without modification to the evaluation of dysplasia in vaginal adenosis.

Adolescent↗