Biomedical subjects

Ted M Roth

Publications and source records attributed to Ted M Roth.

9 recordsLinked to original sources

PubMed2006

Expression profile of several genes in human myometrium and uterine leiomyoma.

OBJECTIVE: To screen several genes that are differentially expressed in uterine leiomyoma and matched unaffected myometrium by using microarray-based hybridization and real-time polymerase chain reaction analyses. DESIGN: Screen by arrays for < or =2,400 known genes in leiomyoma and control myometrium. SETTING: University clinical research laboratory. PATIENT(S): Four patients with leiomyoma scheduled for surgery during the proliferative phase. INTERVENTION(S): Four paired samples of leiomyoma and adjacent myometrium were obtained from patients undergoing hysterectomy. MAIN OUTCOME MEASURE(S): Fold-changes in expression of leiomyoma and matched myometrium (L/M). RESULT(S): A comparison of expression patterns revealed 73 genes significantly up- or down-regulated in each paired tissue sample, of which 30 genes showed increased expression (mean L/M of >2) and 43 showed decreased expression (mean L/M of <0.5) in leiomyoma compared with normal myometrium. When considering only growth factors, pleiotropin (PTN) was expressed 3.5-fold more in leiomyomas compared with in myometrium. No other growth factors were similarly affected. In addition, real-time polymerase chain reaction analysis correlated well with microarray data. CONCLUSION(S): Data obtained from the present study suggest that several genes are selectively overexpressed in leiomyomas compared with in myometrium. Increased expression of growth factor PTN may represent a promising target for therapy.

Adult↗

PubMed2006

Interstitial cystitis in a woman with systemic mastocytosis.

Studies have reported detrusor mastocytosis in patients with interstitial cystitis. The author describes a patient with systemic mastocytosis who was confirmed to have detrusor mastocytosis and interstitial cystitis. She responded to therapy with pentosanpolysulfate. The literature on systemic mastocytosis and the role of mast cells in the pathophysiology of interstitial cystitis are reviewed.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2006

Pyometra and recurrent prolapse after Le Fort colpocleisis.

The Le Fort colpocleisis is a surgical option for advanced pelvic organ prolapse in elderly and infirm women who no longer desire coital function. It is thought that the creation of adequate lateral drainage channels will prevent the occurrence of a pyometra. The author describes the occurrence of a pyometra, despite adequate vaginal channels, necessitating hysterectomy. A 78-year-old woman presented with a 3-year history of purulent vaginal discharge that began shortly after an uncomplicated Le Fort colpocleisis. She also complained of recurrent symptomatic prolapse. Radiologic evaluation revealed a pyometra, which was confirmed at the time of laparotomy. At the time of hysterectomy, she benefitted from total colpocleisis, vaginectomy, and levator plication. The approach to recurrent prolapse after Le Fort colpocleisis is discussed. The occurrence of pyometra despite adequate drainage should affect how patients undergoing obliterative procedures for pelvic organ prolapse are counseled.

Aged↗

PubMed2006

Sacral neuromodulation and lower urinary tract dysfunction in cerebral palsy.

Given the emerging role of sacral neuromodulation in treatment of neurogenic voiding dysfunction, the author describes the use of sacral neuromodulation in a patient with voiding dysfunction caused by cerebral palsy (CP). A 45-year-old patient with cerebral palsy presented with progressive complaints of urgency and overflow incontinence and was found to be in retention. She underwent sacral neuromodulation and had complete resolution of her symptoms. The literature of lower urinary tract dysfunction in CP is reviewed. It is concluded that sacral neuromodulation may be a valuable tool in treating storage and voiding disorders associated with CP.

Cerebral Palsy↗

PubMed2004

Stage II-B carcinoma of the cervix complicated by bilateral pelvic kidneys.

BACKGROUND: The simultaneous occurrence of advanced cervical cancer and a pelvic kidney is uncommonly reported. It is an interesting clinical problem because the pelvic kidney lies within the radiation field. CASE: A patient found to have bilateral pelvic kidneys and stage II-B cervical cancer underwent an anterior exenteration. This was complicated by urinary conduit leakage and eventual nephrectomy for hemorrhage. She has been followed for 14 months with normal renal function and no evidence of disease. CONCLUSION: A primary surgical approach to stage II-B cervical carcinoma was offered to this patient because of bilateral pelvic kidneys. Anastomotic breakdown with urinary leakage after an ileal conduit remains a significantly morbid problem.

Female↗

PubMed2004

Low-grade myofibroblastic sarcoma of the vulva.

BACKGROUND: Vulvar sarcomas are rare tumors. A distinctive low-grade myofibroblastic sarcoma is described. CASE: A 46-year-old female presented with a progressively enlarging vulvar mass. Pathological evaluation revealed a low-grade myofibroblastic sarcoma. The immunophenotype is outlined and ultrastructural features are highlighted. Tumor cells were positive for p53 protein, smooth muscle actin, steroid receptors, and showed myofibroblastic differentiation on electron microscopy. The patient has been followed for >14 months without evidence of recurrence. CONCLUSION: The tumor was positive for p53, mitotically active, but was categorized as a low-grade malignancy. Immunohistochemical and ultrastructural criteria were utilized to distinguish this tumor from other neoplasms.

Female↗

PubMed2004

Tuboovarian abscess: a postoperative complication of endometrial ablation.

BACKGROUND: Global endometrial ablation may be associated with serious complications. CASE: We present a case of bilateral tuboovarian abscesses that developed 50 days postoperatively after a thermal ablation. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. CONCLUSION: Infectious morbidity is known to occur after thermal endometrial ablation. Further investigation is required into ways of reducing the risks of endometrial ablation.

Abscess↗

PubMed2003

Effects of race and clinical factors on short-term outcomes of abdominal myomectomy.

OBJECTIVE: To estimate the effects of race and preoperative uterine anatomy on complication rates after myomectomy. METHODS: A total of 239 abdominal myomectomies were performed at Duke University Medical Center from July 1992 through June 1998. Charts were abstracted using standardized forms. We assessed patient characteristics, surgical indications, preoperative hematocrit, and operative findings. Outcomes were defined as any complication, including transfusion. RESULTS: The population (n = 225) was 53% black and 47% white. The mean body mass index was 26. Fourteen percent had comorbidities. Twenty percent required transfusion. Black women were found to be more likely to have uteri with more than four leiomyomata and less likely to have only one leiomyoma (P =.001). Black women were 2.48 times more likely to have a complication (P <.006). Race was no longer a significant predictor for complications (odds ratio [OR] 1.36, 95% confidence interval [CI] 0.56, 3.15) after adjustment for uterine size (OR 1.86, 95% CI 1.3, 2.67), number of leiomyomata (OR 1.83, 95% CI 1.1, 3.14), and comorbidities (OR 2.77, 95% CI 1.1, 7.69). A similar pattern was seen for blood transfusion. CONCLUSION: Black women undergoing myomectomy are more than twice as likely to have in-hospital complication or blood transfusion than white women. This is largely attributable to differences in uterine size and leiomyoma number. Research is needed to explore why black women are more likely to have larger and more numerous leiomyomata at the time of presentation for surgery.

Adult↗

PubMed2003

High dose rate intraoperative radiotherapy for recurrent cervical cancer and nodal disease.

BACKGROUND: Patients with pelvic sidewall recurrences of cervical cancer have a dismal prognosis. Intraoperative radiation therapy (IORT) has demonstrated encouraging results. Patients have traditionally been excluded from IORT if they had distant metastases. CASE: A patient underwent radical tumor resection and high dose rate (HDR) IORT for a pelvic sidewall recurrence of cervical cancer. She also had metastatic disease in a para-aortic node. The patient has been followed for >20 months with no evidence of disease recurrence. CONCLUSIONS: HDR-IORT may be offered to select patients with recurrent cervical cancer and isolated metastatic para-aortic lymph nodes.

Aged↗