PubMed Health⌕ Search

Biomedical subjects

S Pace

Publications and source records attributed to S Pace.

At least 37 records · Page 2Linked to original sources
PubMed1995

Cervical intraepithelial neoplasia: carbon dioxide laser vaporization and conization. Our experience.

Between 1984 and 1992, the CO2 laser was used to treat 341 patients affected by CIN of various degrees. On the basis of specific indications these patients underwent vaporization or conization. Two hundred and twenty eight patients underwent vaporization of intraepithelial lesions, 221 (96.92%) of whom were free of disease after one laser treatment, as observed during the subsequent years of follow-up. In 105 out of the 113 patients treated with conization the cone margin was free of disease. One hundred and one (96.19%) of the these 105 patients had no evidence of disease after one year of follow-up. In the remaining 8 (7.07%) cases examination of the cone revealed the presence of invasive carcinoma. The major complication was vaginal discharge observed in 115 (33.72%) patients. The CO2 laser is a very effective therapeutic procedure for the treatment of intraepithelial lesions of the cervix and permits to preserve reproductive function and anatomic integrity.

Adolescent↗
PubMed1995

Diagnostic methods of early detection of endometrial hyperplasia and cancer.

Endometrial carcinoma is the most frequent genital neoplasia in women. Our own experience is based on a group of 3310 patients who were studied between 1985 and April 1994. In 2148 cases, equivalent to 56.4%, hysteroscopy was performed because of the presence of abnormal uterine bleeding (AUB). We found 672 endometrial hyperplasia (601 low risk-71 high risk) and 93 endometrial carcinoma. According to our experience we can assert that: hysteroscopy allows the measurement of the extension of the intracavitary neoplastic pathology and the definition of its topographic map; it is the only method that allows a target biopsy; it facilitates the evaluation of the extension of the neoplasia in the cervical canal, with the help of a deep biopsy into the cervical tissue (as proposed by La Sala) increasing its diagnostic accuracy.

Aged↗
PubMed1994

Plasma concentration, urinary excretion and renal clearance of L-carnitine during pregnancy: a reversible secondary L-carnitine deficiency.

Plasma concentration, urinary excretion and renal clearance of free, total and esterified L-carnitine were monitored monthly in 14 women during the last 6 months of pregnancy and 1 month after delivery. Plasma concentration and renal clearance measured 1 month after delivery overlapped with normal values for females of comparable age, and were considered the reference values for further comparisons. Plasma concentration of free, total and esterified L-carnitine decreased during pregnancy, reaching values as low as half of those measured 1 month after delivery, whereas urinary excretion and renal clearance, mainly of L-carnitine esters, increased, with renal clearance reaching a peak at the 16th week of pregnancy. Pregnancy thus leads to a reversible secondary deficiency of L-carnitine. The involvement of L-carnitine in the excretion of an excess of acyl-S-coenzyme A groups to prevent a possible systemic acidosis, as well as hormonal changes and a reduction of L-carnitine biosynthesis, could play a significant role in the variations in L-carnitine metabolism encountered in pregnancy. As physiological components of L-carnitine are excreted via a saturable tubular reabsorption, their threshold seems to follow plasma concentration, even when they decrease markedly, as in pregnancy.

Adolescent↗
PubMed1994

Low-risk endometrial hyperplasia: hysteroscopy and histologic evaluation after treatment with LH-RH analogue.

Endometrial hyperplasia is an endometrial pathologic condition often found at perimenopausal age. Abnormal uterine bleeding (A.U.B.) is the most frequent symptom of endometrial hyperplasia. The combination of hysteroscopy and endometrial biopsy is the most suitable approach for the diagnosis of endometrial hyperplasia in symptomatic patients. We have studied endometrial modifications due to LHRH-analogue in 75 patients with AUB and with a hysteroscopic and histologic picture of low-risk endometrial hyperplasia. LHRH analogue is a valid treatment for all estrogen induced pathologies, because of its suppressive action on hypothalamic-hypophysary gonadotropins. The administration of LHRH for 4 months induced an improvement of the menstrual cycle within the first month of treatment in 53.3% of cases. At the end of treatment 100% of the patients were in amenorrhea. The hysteroscopic follow-up at 3 months showed an endometrial thinning with a tendency to hypoatrophy of the mucosa in 72% of cases. Three months after the end of treatment 20 patient had regular menstrual cycles and hysteroscopic and a histologic picture of normal endometrium. Only 30 patients had persistent amenorrhea with a consequent hysteroscopic and histologic picture of endometrial hypoatrophy. The use of LHRH analogue seems to have a great impact on the management of estrogen-dependent gynaecological benign diseases.

Adult↗
PubMed1993

[Hysteroscopic evaluation of female infertility].

Three-hundred-seventy-one infertile patients underwent hysteroscopic evaluation. The test was performed in an outpatient setting without any form of anesthesia. A comparison has been made among this technique, the hysterosalpingography and ultrasounds: hysteroscopy showed to be more accurate in the evaluation of intracavitary pathology, because of its capability to obtain a direct view of the uterine cavity. We can evaluate hysteroscopically nature, dimension and localization of the lesions. However HSG remains the best technique for the study of tubal factors of infertility. We think that hysteroscopy should be used besides other diagnostic methods, in order to obtain a better evaluation of the infertile patients.

Adult↗
PubMed1993

Vulvar and penile HPV lesions: laser surgery and topic anaesthesia.

Treatment of genital warts (HPV lesions) by Laser-surgery was performed in 90 patients and 90 male partners under topical anaesthesia with 1-3 gr EMLA cream and in 45 patients and 45 males (control groups) under 1-2 ml 2% Carbocaine infiltration. EMLA cream was applied to warts 5-18 minutes (median = 7) before operation. Pain from application of anaesthetic and Laser surgery was significantly less (p < .001) in the groups treated by EMLA. Side effects were minimal in the EMLA groups. The results suggest that EMLA cream could be the anaesthetic of choice in Laser surgery of genital warts.

Adolescent↗
PubMed1992

Determination of pentoxifylline and its metabolites in human plasma by high-performance liquid chromatography with solid-phase extraction.

A simple and reliable method for the determination of pentoxifylline and its main metabolites in human plasma has been developed using high-performance liquid chromatography. After selective solid-phase extraction, pentoxifylline, its metabolites and an internal standard, 7-(2'-chloroethyl)theophylline, were separated on a 5-micron LiChrospher 100 RP-18 column using water-dioxan-acetonitrile (87:6.5:6.5, v/v/v) acidified with acetic acid (0.5%, v/v) as the mobile phase. The analytes were detected at 275 nm. The lowest detectable concentration for all analytes was 25 ng/ml; the recovery was 85%. The assay has been successfully applied to analysis of these compounds in human plasma after administration of an oral dose of 400 mg of pentoxifylline to healthy volunteers.

Administration, Oral↗
PubMed1992

[Viral and/or intraepithelial lesions of the lower female genital tract: diagnostic and prognostic value of in situ molecular hybridization].

Fourteen patients (mean age 37 years) suffering from viral and/or intraepithelial cervico-vagino-vulvar pathologies underwent colposcopic and cyto-histological tests and molecular hybridization. The following types of HPV were assayed: 6/11-16/18-31/35/51 in cytological tissues (exocervical scraping) and biopsy material immersed in paraffin and fixed in formalin buffered with 10% PBS. The aim of the study was to identify different types of HPV using molecular hybridisation in situ. The paper reports the results and correlations with colposcopic, cytological and histological diagnosis, and then discuss the clinico-biological and prognostic aspects of this method.

Adult↗
PubMed1992

Hysteroscopy as an elective tool in abnormal uterine bleeding in perimenopausal women.

Abnormal Uterine Bleeding is a very frequent pathology particularly in perimenopausal age (> or = 45 years). The Authors report the experience of the 2nd Department of Ob/Gyn. of Rome University "La Sapienza" from January 1985 up to September 1991. The hysteroscopic evaluation of 789 patients in perimenopausal age is reviewed. The Authors analyze in detail the main cause of metrorrhagia describing the hysteroscopic aspect and relative incidence. Finally, some considerations concerning the great usefulness that a simple and accurate diagnostic investigation such as hysteroscopy represents in a routine diagnostic procedure, are reported.

Aged↗
PubMed1992

[Myomectomy via hysteroscopy. Indications, technics, results].

Nowadays operative hysteroscopy represents the elective treatment of submucous and partially intramural fibroids. Seventy patients underwent hysteroscopic resection of fibroids, because of abnormal uterine bleeding in 58 (82.8%) cases, and infertility in 12 (17.2%) cases. The evaluation of the lesion was performed by diagnostic hysteroscopy and abdominal (57 patients) or transvaginal (13 patients) ultrasounds. In particular, for the evaluation of the intramural portion of the lesion, the hysteroscopic study of the angle between fibroid and myometrium was fundamental: the more acute the angle is the more intracavitary the myoma is. Forty-six (65.7%) out of 70 had a completely intracavitary fibroid; in 14 (20%) cases the intramural development was less than 1.5 cm and in the remaining 10 (14.3%) cases was more than 1.5 cm. Integration of hysteroscopy and ultrasounds for the assessment of myomas and the preoperative preparation by LH-RH analogues allow to perform an endoscopic resection of myomas which has up to, and sometimes over, 50% of their volume in the uterine wall.

Female↗
PubMed1992

[Diagnosis and therapy of low-risk endometrial hyperplasia. Experience with LH-RH-A].

Endometrial hyperplasia is a endometrial condition often found in perimenopausal age. AUB is the most frequent symptom of endometrial hyperplasia. The combination of hysteroscopy and endometrial biopsy is the most suitable approach for the diagnosis of endometrial hyperplasia in symptomatic patients. The Authors have studied endometrial modifications due to LH-RH analogue, a depot formula, in 60 perimenopausal patients with AUB and with hysteroscopic and histologic picture of low-risk endometrial hyperplasia. They report the result of treatment efficacy (disappearance of symptoms and tendency to hypoatrophy of the mucosa). The use of LH-RH A seems to have a good result in the management of oestrogen-dependent gynaecological benign diseases.

Adult↗
PubMed1992

[Diagnostic and therapeutic aspects of endometrial polyps].

The diagnostic and therapeutic utility of hysteroscopy in intracavity uterine pathologies is now widely recognised. The Authors have evaluated the efficacy of hysteroscopy in 640 patients in a study of endometrial polyps for which the endoscopic technique represents the elective form of therapy, avoiding excessive trauma to the patient and preserving the endometrial mucosa intact. The results obtained are fully discussed. Hysteroscopic resection of polyps was carried out in 49 patients in a day-hospital setting and without further complications.

Adult↗
PubMed1992

[LH-RH analogues in the preparation of hysteroscopic resection of uterine fibromyoma].

Ten patients with submucous and/or intracavitary myomas, aged between 40 and 50 years old, underwent preliminary and preoperative (endoscopic resection) treatment with LH-RH. A using a depot formula. The Authors report the results of treatment efficacy (disappearance of symptoms and reduced myoma volume) in relation to an optimal surgical approach using an endoscopic route. This form of treatment allowed both operating times and intraoperative bleeding to be reduced.

Adult↗
PubMed1992

[Colpo-cyto-histological correlations in intraepithelial lesions of the uterine cervix].

The aim of this study was to assess the clinical efficiency of colposcopic findings as diagnostic tests for intraepithelial lesion using the analysis of colpo-cyto-histological correlations. The results of 3340 colposcopic tests performed in the Colposcopy Unit of the Second Clinic of Obstetrics and Gynecology between March 1990 and May 1991 were analysed, taking into account 326 (9.7%) cases of Abnormal Transformation Zone (ANTZ). The colpo-histological correlation in ANTZ 1 cases (52 cases of white epithelium, 92 standard mosaic, 42 standard dotted and 61 mixed cases) was 65.2% (52.3%) for HPV; 12.9% for CIN). The colpo-histological correlation in ANTZ 2 cases (30 cases of thickened white epithelium, 5 irregular mosaic, 4 irregular dotted, 2 atypical vessels, 4 thickened gland outlets and 6 mixed cases) was 70.5% (43.3% for HPV; 27.2% for CIN an and Ca). In this retrospective study colposcopy showed a diagnostic accuracy of 64.6% in the cases examined and played a decisive role in the diagnosis of intraepithelial lesions of the uterine cervix.

Colposcopy↗
PubMed1992

[Laser CO2: results of treatment of HPV lesions in male the partner].

Hundred-fifty-seven male partners of patients affected by Human Papillomavirus (HPV) lesions, underwent CO2 Laser vaporization between January 1989 and January 1990. The age ranged between 18 and 45 (median 28.2). The vaporization was performed with a Coherent System 451 CO2 Laser equipment, at a power of 16 watt in continuous mode, depth of 2 mm and a free margin of 2 mm. First Laser treatment proved successful in 129 patients (82.1%); 17 out of 28 patients with persistent or relapsed pathology underwent a second CO2 Laser vaporization with a total cure percentage equal to 92.9%. Laser-surgery is the method of choice in the treatment of HPV genital lesions.

Adult↗