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Biomedical subjects

P B Underwood

Publications and source records attributed to P B Underwood.

At least 19 recordsLinked to original sources
PubMed2000

B-Lynch suture for postpartum hemorrhage.

BACKGROUND: Postpartum hemorrhage is a major contributor to maternal morbidity and mortality. Numerous medical and surgical therapies have been used, but none has been uniformly successful. CASE: Two women with postpartum hemorrhage due to uterine atony after cesarean for twins are presented. Neither responded to medical management. In the first subject, O'Leary uterine artery ligation and utero-ovarian branch ligations were done without benefit. The B-Lynch suture immediately sustained correction of hemorrhage in both subjects. Magnetic resonance imaging and hysterosalpingogram after the first case showed no uterine defects. CONCLUSION: The B-Lynch suture might be a valuable addition to the surgical treatment of postpartum hemorrhage due to uterine atony.

Adolescent↗
PubMed1993

Vaginal telangiectasias: unusual presentation of the Osler-Weber-Rendu syndrome.

BACKGROUND: The Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia) is an autosomal dominant disorder of blood vessels associated with mucocutaneous telangiectasis and arteriovenous malformations of internal organs. CASE: A 23-year-old woman was found on routine gynecologic examination to have asymptomatic vaginal telangiectasias, a previously unreported initial site of involvement in this syndrome. CONCLUSION: The finding of asymptomatic vaginal telangiectasias on routine pelvic examination should alert the clinician to the possibility of the Osler-Weber-Rendu syndrome.

Adult↗
PubMed1991

Primary invasive vaginal carcinoma.

A review of primary vaginal carcinoma treated at the Medical University of South Carolina from January 1970 through December 1989 included 76 squamous carcinomas, 12 adenocarcinomas, and 3 undifferentiated carcinomas. Staging was done according to the system of the International Federal of Gynecology and Obstetrics as modified by Perez et al. Stages I, II, III, and IV included 25, 39, 15, and 12 patients, respectively. Corrected 5-year survival rates were 73% for stage I, 39% for stage II, 38% for stage III, and 25% for stage IV. Sixteen percent of patients had received prior pelvic radiation. Invasive cervical cancer preceded vaginal cancer in 21% of patients. Detection of cancer was accomplished by routine cytologic testing in 17% of patients, palpation of an asymptomatic mass in 10% of patients, or palpation of a symptomatic mass in 72% of patients. Eighty-seven percent of patients were treated with radiation therapy. Survival curves of patients grouped by stage and other potential prognostic factors were compared. Lower stage (p less than 0.01), younger age (p less than 0.02), and no symptoms at detection (p less than 0.01) were statistically significant favorable prognostic factors. Histologic type, extent of vaginal involvement, vaginal location, prior radiation therapy, prior cervical cancer, and prior hysterectomy are factors that did not significantly affect survival.

Adult↗
PubMed1990

White sponge nevus.

A case is presented of white sponge nevus involving the vaginal, labial, and oral mucosae of a 34-year-old woman. White sponge nevus is a rare, benign, autosomal dominant leukokeratosis that predominantly affects the oral mucosa. Less frequently, it affects extraoral sites including the vulvovaginal mucosa. In this case, histopathologic study of vulvovaginal lesions, subsequent examination of extragenital mucosae, and inquiry into the family history led to the correct diagnosis. The genetics, clinical appearance, and histopathology of white sponge nevus are discussed in relation to the differential diagnosis of oral and vaginal leukokeratoses.

Adult↗
PubMed1987

The screening Papanicolaou smear: contribution of the endocervical brush.

Between September 1984 and February 1985, cervical cytologic smears were collected from 510 patients using a spatula and an endocervical swab. These smears were compared with those collected from 510 patients between September 1985 and February 1986 using a spatula and an endocervical brush. The use of the endocervical brush increased the number of smears that contained endocervical cells, for both reproductive-age and postmenopausal women. In women without previous radiation therapy, the rate of suboptimal smears (those without endocervical cells) fell from 12.0 to 1.7% when the endocervical brush was used. This modified smear collection technique improved the quality of the cytologic material.

Adolescent↗
PubMed1986

Endometrial carcinoma: the role of irradiation.

The role of irradiation in endometrial carcinoma has been discussed. Patients with well-differentiated carcinomas in small uteri with clinical and pathological minimal disease do not require irradiation. For those patients who do benefit from irradiation, the pros and cons of preoperative vs postoperative administration and intracavitary vs external irradiation has been discussed. Techniques and dosages have been suggested. At the present time there exist two schools of thought about the treatment of endometrial carcinoma. Both appear equally effective. It is predicted that, with time and prospective studies, the two schools of therapy will be brought closer together.

Brachytherapy↗
PubMed1985

Endodermal sinus tumor of the vagina. The role of primary chemotherapy.

Endodermal sinus tumor of the vagina, a rare pediatric malignancy, was managed with primary chemotherapy (vincristine, dactinomycin, cyclophosphamide [VAC]) followed by local excision without radical surgery or pelvic irradiation. Treatment-related complications were acceptable, and there is no evidence of disease 30 months after discontinuing all therapy (50 months after diagnosis). As a treatment option, primary chemotherapy is viewed as a highly attractive alternative modality, preserving potential reproductive and sexual function in long-term survivors, and appears to be the treatment of choice.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1979

Radical hysterectomy: a critical review of twenty-two years' experience.

One hundred seventy-eight patients who had radical hysterectomy performed for management of invasive carcinoma of the cervix over 22 year period at the Medical University of South Carolina were critically analyzed. The degree of differentiation of the malignancy appeared to be of more significance than tumor size in Stage 1 lesions. With proper patient selection and excellent operative technique, survival rates well over 90% with minimal complications can be obtained. The radical hysterectomy should never be used in association with irradiation.

Adenocarcinoma↗
PubMed1977

Genital malignancy in pregnancy.

The clinical problems associated with the presence of genital malignancies occurring during pregnancy are presented. This report represents the clinical experience at one medical institution over a 20 year period. Eighty cases of cervical neoplasm, four cases of ovarian carcinoma, five vulva carcinomas, and one vaginal carcinoma are presented. The diagnostic and therapeutic approaches to malignant neoplasia of each area are discussed separately.

Adenocarcinoma↗
PubMed1977

Carcinoma of the endometrium: radiation followed immediately by operation.

A prospective study was established in August, 1967, to treat all adenocarcinomas of the endometrium by protocols of preoperative radiation followed immediately by operation. Two hundred and ninety-five women have been treated, 220 of whom had Stage I disease. In these cases, factors known to be associated with survival were studied, and their influence upon survival was noted. Preoperative radium followed immediately by operation was the primary method of therapy. Life tables demonstrated a five-year survival rate of 91 per cent with a low complication rate in patients with Stage I disease. Cell type, degree of differentiation, and depth of myomentrial invasion were the primary factors influencing survival.

Adenocarcinoma↗
PubMed1977

Ureteral injury following irradiation therapy for carcinoma of the cervix.

Ureters tolerate radiation well as manifested by the low incidence of injury. However, ureteral injury can occur with high-dose radiation especially when the majority is delivered by radium. Eight such cases are presented. A retrospective study of 100 asymptomatic women treated with radiation for cervical carcinoma over 5 years previously demonstrated only 4 incidences of ureteral injury if dilatation was used as the indicator. To the contrary, 5 patients had improvement of their pre-treatment intravenous pyelogram following radiation. Emphasis was placed on closer followup of the ureters by intravenous pyelograms after high-dose radiation.

Adult↗