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Biomedical subjects

P J Disaia

Publications and source records attributed to P J Disaia.

7 recordsLinked to original sources

Laparoscopy in the evaluation of gynecologic cancer.

Laparoscopy was used to evaluate 60 patients with a variety of known or suspected gynecologic neoplasms. Diagnostic laparoscopy was performed on 18 patients to confirm benign or malignant pelvic masses or to confirm peritoneal carcinomatosis. Ten of these 18 patients (56%) were found to have unresectable carcinomatosis or benign disease which did not require further surgery. Staging laparoscopy was performed on 13 patients of which 3 had clinically unsuspected intraperitoneal spread of their disease. Surveillance laparoscopy was performed on 29 patients to determine the remission, regression, or progression of their disease following treatment; 8 (27%) had progressive or unresectable persistent disease. Despite the fact that the study comprised a high-risk group of previously operated on or irradiated patients, there was only one major complication. There was, however, a 10% incidence of laparoscopic failure from inadequate visualization. Twenty-one of the study patients (35%) were spared a laparotomy by the use of laparoscopy. The findings of this investigation help to identify those gynecologic oncology patients who should benefit most from the use of laparoscopy as an adjunct to the diagnosis, staging, or surveillance of intraabdominal malignant tumors.

Abdominal Neoplasms

Clinical and laboratory correlates of molar pregnancy and trophoblastic disease.

From January 1, 1970 to July 1, 1976, 128 women had hydatidiform moles evacuated at the Los Angeles County-University of Southern California Women's Hospitals. Of the 121 patients with follow-up, persistent trophoblastic disease (TD) was diagnosed in 32 (26.4 per cent). Remission was achieved in all treated patients. The frequency of TD was significantly increased in pregnancies large for dates (47.8 per cent), with a uterus greater than 20 weeks' gestational size (45.0 per cent) or with theca-lutein cysts greater than 5 cm. in diameter (50.0 per cent). A normal regression curve for serum beta-human gonadotropin as measured by radioimmunoassay has been constructed as an aid to the early recognition of postmolar TD (invasive mole and choriocarcinoma).

Adult

Pelvic celiotomy in the obese patient.

We have responded to the challenge of surgery in the overweight patient by promoting it to an area of special interest. These individuals should not be deprived of good medical care although their obesity makes the physician's task more arduous and increases the risk of a poor result. With the use of intensive preoperative preparation, including prophylactic antibiotics and heparinization, a modified operative technique, and an active recovery regimen, a more sanguine view toward the surgical care of obese women can be taken.

Adult

Impact of cephalosporin prophylaxis on conization-vaginal hysterectomy morbidity.

A prospective, randomized, double-blind evaluation of Loridine-Keflex prophylaxis in a homogeneous group of 32 patients undergoing sequential cervical conization and vaginal hysterectomy is reported. There was no infectious or febrile morbidity in the 18 oatuebts receuvubg abtubuitucs, Morbidity occurred in six of 14 patients receiving placebos (P is less than 0.05). Antibiotic prophylaxis and conization-hysterectomy morbidity are discussed.

Adult

Vaginal embryogenesis, estrogens, and adenosis.

The recent outbreak of vaginal adenocarcinoma and the associated genital tract anomalies in women with histories of prenatal exposure to diethylstilbestrol (DES) has generated interest in vaginal embryogenesis and the influence of hormones on the developing genital tract. In this report the embryology of the vagina and the role of sex hormones in normal and abnormal sex duct development are presented and discussed in relation to the DES-induced anomalies. Although the teratogenic activity of DES in humans has been confirmed, the available evidence suggests that the clear cell carcinomas are initiated by endogenous estrogens and not the prenatally administered DES.

Abnormalities, Drug-Induced

Evaluation of carcinoma of the cervix using 111In-bleomycin.

Indium-111 attached to bleomycin is useful in the scintigraphic localization of a variety of tumors. Since it does not normally accumulate in bowel and feces, it is superior to other radiopharmaceuticals, such as gallium-67 citrate, in the demonstration of abnormalities in the abdomen and pelvis. Twenty-eight patients with know carcinoma of the cervix were studied with whole body 111In-belomycin scans. Two "false-positive" scans were produced by local inflammation. Six "false-negative" scans were attributed to small tumors escaping scintigraphic detection. In the remaining 20 patients, scan findings correlated well with site and extent of the tumor as determined by other means. 111In-bleomycin scintiscanning may prove to be a highly useful adjunct in the evaluation of patients with carcinoma of the cervix.

Adenocarcinoma