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Biomedical subjects

R E Girtanner

Publications and source records attributed to R E Girtanner.

10 recordsLinked to original sources

Vulvar malignancy.

Treatment of invasive vulvar malignancy has become more individualized during the past decade. In the past, radical vulvectomy with bilateral inguinofemoral lymphadenectomy was the standard therapy for invasive squamous cell carcinoma and melanoma of the vulva. This is no longer always the case. The treatment of stage I and stage II invasive squamous cell carcinoma of the vulva has become more individualized. Less radical surgery appears to produce the same results as ultraradical surgery. Wide local excision of early lesions associated with ipsilateral lymph node dissection appears to be adequate therapy in many cases. Likewise, treatment of early melanoma (0.75 mm in thickness) can be managed by wide local excision with or without groin dissection of the ipsilateral side. This more conservative approach has resulted in significantly fewer postoperative complications and has improved the self-image of many women undergoing treatment for vulvar malignancy.

Female

Human dura mater allografts in repair of pelvic floor and abdominal wall defects.

Freeze-dried human dura mater has been used as an allograft for reconstructive gynecologic surgery since 1980. So far, 33 grafts have been placed. This versatile and immunologically inert material has been used to reconstruct the pelvic floor after exenterative procedures, replace rectus fascia in the repair of wound dehiscence and ventral or parastomal hernias, and cover the femoral vessels after nodal dissection. In seven patients, dura mater was grafted into infected sites without subsequent rejection. Biopsy of an allograft one year after implantation confirmed the natural tendency of the body to convert the dura mater to a viable and neovascularized tissue. This reconstructive material is a safe and versatile allograft for gynecologic oncologists.

Abdominal Muscles

Evaluation of the Gravlee Jet Washer using combined cell block/cytologic interpretations.

Two hundred patients at high risk for endometrial adenocarcinoma were screened using the Gravlee Jet Washer. Tissue obtained from the first 100 patients was processed by cell block technic alone; tissue from the second 100 patients was processed by cell block plus direct smear and Nucleopore filtration stained by the Papanicolaou method. All patients had histologic diagnosis by fractional curettage. Six of 12 patients with a tissue diagnosis of carcinoma were missed by the jet washer using the cell block technic alone. In the second 100 patients, no cases of cancer were missed using both cell block and cytologic technics. Technic and application of the jet washer in screening for endometrial carcinoma are discussed. We conclude that the Gravlee Jet Washer is a safe, effective screening tool which frequently may replace diagnostic curettage; however, if abnormal bleeding persists, curettage must be done.

Adenocarcinoma

Cell kinetics and programmed chemotherapy for gynecologic cancer. I. Squamous-cell carcinoma.

The results of current investigation into cellular kinetics of both normal and abnormal human genital tissue have stimulated interest in programming chemotherapeutic drug regimens for the treatment of genital cancer. This report outlines the results of cell kinetic studies of normal and abnormal squamous epithelium of the female genital tract and presents preliminary results of a regimen utilizing methotrexate, hydroxyurea, and vincristine in patients with far-advanced squamous-cell cancer of the vulva, vagina, and cervix. A total of 92 patients have received 444 courses of programmed chemotherapy by either pelvic intra-arterial infusion or systemic administration of the drugs. Our results are presented and the theoretical basis of the research is discussed.

Carcinoma, Squamous Cell

Adenosis and adenocarcinoma of the vagina in young women: a review.

Prior to 1971, adenosis and primary adenocarcinoma of the vagina were unusual entities. Since then, a marked increase in both processes has occurred, felt to be related to maternal ingestion of Diethylstibestrol (DES) and other estrogenic compounds during the first trimester, with subsequent abnormalities in female offspring. To date, there are over 170 cases of adenocarcinoma reported, and there may be as many as one million patients with adenosis. Treatment of benign adenosis is somewhat of a controversy but adenocarcinoma is treated with surgery radiation or a combination thereof, depending upon the specifics of the patients. Four patients are presented, one treated surgically and three with radiotherapy, all with complete remission over one to two years. It behooves all phys-cians caring for young women to be aware of these disease processes for the maximum therapeutic benefit to be achieved.

Adenocarcinoma