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S Spuhler

Publications and source records attributed to S Spuhler.

16 recordsLinked to original sources
PubMed1996

[Role of the histologic examination in the diagnosis of cervical intraepithelial cancer].

AIM: Retrospective analysis of preoperative histology examinations in patients with intra-epithelial cancer of the cervix. PATIENTS AND METHODS: Histological examination in 501 cases of cervical dysplasia leading to excision therapy. CONCLUSION: The major contribution of the histological examination is to confirm dysplasia suspected on the basis of cytology and/or colposcopy examinations. It also gives the stage of the dysplasia to orient treatment. However, the choice of a therapy cannot be based on the results of the preoperative histology examination alone. Decisions must be made after comparing all the colposcopy and histology findings. In advanced stage intra-epithelial cancer of the cervix or when the cytology and colposcopy examination give conflicting results, excision would be the preferred choice. These observations confirm the importance of the colposcopic examination.

Algorithms↗
PubMed1995

[Consequences of laser CO2 treatment of cervical intraepithelial neoplasias on the anatomic and functional integrity of the cervix].

OBJECTIVES: Retrospective study to analyse objectively the effectiveness and anatomic and functional consequences for the cervix of conservative CO2 laser treatment for cervical intraepithelial neoplasia. PATIENTS AND METHODS: Analysis of therapeutic effectiveness and anatomic consequences of 1,114 treated patients followed at our colpolaparotomy surgery clinic for cervical dysplasia since 1987. Evaluation of function consequences by comparison with a group of patients who delivered after laser CO2 therapy for dysplasia (n = 56) and a group of control patients (n = 95) with a similar type of dysplasia after delivery and no treatment. The clinical course of the pregnancy and delivery were compared between the groups in search for risk of prematurity. RESULTS: Good preservation of cervical anatomy was achieved after a rigorous treatment protocol only applicable with CO2 laser. The preservation of the junctional zone facilitated diagnosis of recurrence. The risk of prematurity was low. Therapy was successful in 93.4% of the cases. CONCLUSION: The choice of conservative therapy is essential, not only when the patient desires a pregnancy but also in others since preserved anatomy facilitates diagnosis of recurrence. This findings implicate the need for an unagressive energy source and also accepting the early diagnosis and treatment.

Female↗
PubMed1994

[Identification of genital papillomavirus using PCR].

Over 20 different types of human papillomaviruses (HPV) are associated with tumoral lesions of the anogenital tract. Some of these lesions may become cancerous at a frequency which depends, among other risk factors, upon the type of HPV. Genital papillomaviruses with high oncogenic risk (HPV16, 18, 31, 33, 35 ...) are associated with the majority of cervical cancers and to a high proportion of high grade anogenital lesions, while HPV6 and HPV11 are most often associated with benign condylomas. The recently introduced PCR (Polymerase Chain Reaction) has distinctly simplified and improved detection and typing of genital HPVs. PCR detection of HPV has its place in epidemiologic studies and basic research, its application in daily clinical practise is, however, still controversial. For routine analysis, PCR serves more as a complementary tool to cytology.

Base Sequence↗
PubMed1994

[Value of penis endoscopy in sexual partners of women with condylomatous or dysplastic lesions].

TYPE OF STUDY: A retrospective study of 532 male sexual partners of patients who were examined for condylomatous or dysplasic lesions of the lower genital tract between January 1990 and June 1993. AIM: To evaluate the balanoscopy examination. The value of this examination for the follow-up of papilloma virus and dysplasic lesions in women. METHOD: Balanoscopy was performed after application of acetic acid (5%). Lesions were treated with viralytic agents or by CO2 laser destruction. Computer analysis of the data from the microscopic examination and treatment in partners was performed. MAIN RESULTS: Globally, peniscopy revealed a papilloma virus lesion in 43.3% of the cases. Nevertheless, for infectious lesions (condylomas) in women, 63% of the women had a papilloma virus lesions. CONCLUSION: Severe dysplasia of the penis is rare in our geographical area and balanoscopy is useful for the eradication of sexually transmitted diseases, sometimes for oncological examinations and to decrease the incidence of recurrent condylomatous or dysplasic lesions in women partners. Globally, the results are disappointing since the rate of recurrence was similar whether or not the male partner had been examined. The only difference was in case of rapid effective treatment in the partner which was obtained in 27% of the partners.

Adult↗
PubMed1993

[Colposcopic aspects of the cervix (cervical score CCL)].

TYPE OF STUDY: A retrospective study reviewing 481 colposcopic scores carried out on patients examined at CCL with a suspicion of dysplasia of the cervix, between January 1990 and September 1992. AIM: To evaluate the use and the reliability of a score designed to estimate the degree of severity of cases of cervical intra-epithelial neoplasia (CIN). METHOD: Each method that describes the appearances of cervical pathology has been introduced in to a computerised programme. This places the score empirically limited to each parameter according to certain specific criteria worked out at CCL. RESULTS: The correlation of the CCL cervical score has been proven to be excellent because the sensitivity of this test is 88.7% and contributes to the majority of controlled diagnoses. CONCLUSION: The principal value of a colposcopic score lies in the strictness with which the lesions are described and contributes to raising the quality of training of colposcopists and teaching this sub-specialty. Furthermore a systematic application of the analysis carried out makes it possible to take biopsies clearly directed and this is judged necessary. (CCL is the Centre of Colposcopy and Laparoscopy in the Department of Gynaecology and Obstetrics in the University of Lausanne.)

Acetates↗
PubMed1993

[Current indications for colposcopic examination].

OBJECTIVE: It has become necessary to set out exactly the indications for colposcopic examination and to improve out-patient therapy. A response has been made to the ever increasing pre-cancerous pathological conditions of the lower genital tract. TYPE OF STUDY: A review of the pathological conditions of the lower genital tract has led to colposcopic examinations being carried out to work out how far grounded its indications are. The authors particularly lead to the future for colposcopy and histology of so called "atypical" cytology. MATERIAL: A review of the literature and a retrospective study of the agreement between the cytology and the histology in 1,454 patients who were examined and followed up at the centre for laparoscopy and colposcopy between 1.1.1987 and 31.12.1991. THE PRINCIPLE: A study of the information is being gathered about the cytological, colposcopic and histological diagnoses. PRINCIPLES RESULTS: Dysplasias diagnosed cytologically were confirmed in 95% of cases by colposcopic examination and by the results of directed biopsy. In over 90% cases of smears showing "atypical" cells the colposcopy confirmed the pathology that was found and in more than 85% of cases the histological examination confirmed a papillomavirus lesion or a dysplasia of the cervix or elsewhere in the lower genital tract. CONCLUSION: Over and above the indication for colposcopic examination, cytological dysplasias were found and to were condylomata of the lower genital tract or leukoplakia of the vulva, and one has to add "atypical" smears. Furthermore repeating a smear in cases of atypical cytology is useless, and can be deceptive. Systemic control of the vulva and vagina has to be carried out when the cervix is examined because there is a frequent association of dysplasic lesions and there is a possible presence of isolated extracervical lesions when cytologically pathological smears are found.

Ambulatory Care↗
PubMed1992

[Hysterectomy and intraepithelial neoplasia of the lower female genital tract].

THE OBJECT: Delimiting the place of hysterectomy in cases of lower genital tract intraepithelial neoplasias in women. LOCATION: The laser and colposcopy centre (CCL) of a maternity unit in Lausanne in the Vaudois University Hospital Centre (CHUV). THE TYPE OF STUDY: Retrospective on 1,303 patients between 1986 and 1990. THE SUBJECTS AND TREATMENT: 853 cases of cervical intraepithelial neoplasia (CIN) and 79 cases of vaginal intraepithelial neoplasia (VAIN) were treated with CO2 laser. The situations in which hysterectomy could be considered in the course of treatment are discussed. They are: 1) Dysplasia persisting after treatment, 2) when pathological tissue is found on examining slides from conisation specimens, 3) micro-invasive carcinoma, 4) post-operative obstructive stenosis. PRINCIPLE RESULTS: The multiple location of dysplasia lesions of the lower genital tract was calculated for all the patients examined. It shows that hysterectomy itself will be insufficient to remove all dysplasias since frequently (9.2%) of lesions are found in the vagina in cases that have dysplasia of the cervix. Residual lesions after hysterectomy are shown up by VAIN which are responsible for the persistence of changes in the control smears (in which there were 9 cases of VAIN3 after hysterectomy in this series). Treatment therefore is hazardous and only poorly successful because the site of these lesions is often hidden in the scar through the top of the vagina. Furthermore their discovery in uncertain since there is a tendency at present to avoid out cytological screening of these patients once they have undergone hysterectomy. CONCLUSION: The high incidence of multifocal lesions and the possibility that is very real of residual dysplasia after hysterectomy has made the authors limit the place of hysterectomy in these cases, preferring to use conservative treatments and emphasizing the need to continue cytological controls for after treatment.

Biopsy↗
PubMed1991

Low-dose antacid therapy in the treatment of duodenal ulcer--a multicentre double-blind trial vs. misoprostol.

We conducted a 4-week double-blind randomized controlled multicentre trial to compare low-dose-antacid (AA) therapy (225 meq total neutralizing capacity per day) with therapy using the prostaglandin E1-analogue, misoprostol (MS) (400 micrograms bid), on ulcer healing and relief of symptoms in 100 outpatients with endoscopically proven duodenal ulcer (DU, 49 patients on AA, 51 patients on MS). Of the 100 patients enrolled in the study 96 could be evaluated; 49 received AA, 47 MS. Endoscopies were performed before treatment, 2 and 4 weeks after initiation of treatment. Healing rates of AA- and MS-treatment were 36.7% vs. 25.5% (2 weeks) and 79.6% vs. 74.4% (4 weeks) and did not differ as much as relief of pain during the daytime. Rates of relief of nighttime pain were significantly higher on AA-treatment after 2 weeks of treatment (81.1% vs. 48.6%; p less than 0.05), but not during the later course of treatment. Thus, it can be concluded that low-dose AA-treatment using an aluminum/magnesium hydroxide preparation in tablet form represents an effective and safe therapy for duodenal ulcer.

Adult↗