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Biomedical subjects

W G Watring

Publications and source records attributed to W G Watring.

32 records · Page 2Linked to original sources
PubMed1979

Development of DES-associated clear-cell carcinoma: the importance of regular screening.

Because the rate of malignancies in young women exposed in utero to diethylstilbesterol (DES) is low, appropriate population screening methods have not been established. A case is presented that is believed to represent the first reported instance of a DES-exposed daughter who developed clear cell adenocarcinoma of the vagina after initially negative examinations. The patient was followed with Papanicolaou smears, pelvic examinations, and colposcopy every 6 months for 2 years prior to the discovery of malignancy. Initially negative, Papanicolaou smears successfully predicted the presence of an early adenocarcinoma. Palpation aided by colposcopy allowed directed biopsy of the small asymptomatic lesion. This case underscores the necessity for frequent vaginal cytologic smears and pelvic examinations at intervals no greater than 6 months. Colposcopy is indicated to direct biopsies when an abnormal cytologic smears is reported or when abnormal bleeding or discharge occurs. Biopsy of any palpable lesion is mandatory.

Adenocarcinoma↗
PubMed1978

Treatment of recurrent Paget's disease of the vulva with topical bleomycin.

Seven patients with recurrent Paget's disease of the vulva underwent treatment with topical bleomycin (NSC 125066-Blenoxane, Bristol Laboratories) ointment. None had an associated invasive carcinoma. Four patients experienced a complete, objective response to this therapy, and one of these has responded completely to treatment of a subsequent recurrence. In two patients the response could not be evaluated. All patients experienced pain in the treated area; one, developed systemic toxicity to bleomycin requiring cessation of therapy. Topical bleomycin appears to benefit selected patients with recurrent Paget's disease of the vulva.

Administration, Topical↗
PubMed1978

Continent vesicostomy. Application in a patient.

Continent vesicostomy, as performed in the laboratory animal, allows the severely dysfunctional bladder to be emptied at predetermined intervals by transabdominal catheterization. The formation of a continent vesicostomy in a patient with markedly impaired bladder function secondary to an extended pelvic operation for the treatment of cancer is described. This technique provides a possible alternative to the construction of a urinary conduit in patients disabled from the treatment of a pelvic malignancy.

Adult↗
PubMed1977

The operative evaluation of patients with cervical carcinoma by an extraperitoneal approach.

Seventy patients with cervical cancer who were not candidates for primary operative treatment underwent operative evaluation prior to radiation therapy. Thirty-one were explored through a transperitoneal approach and 39 through an extraperitoneal approach. The operative procedure consisted of bilateral pelvic and periaortic lymphadenectomy and exploratory laparotomy, with additional intraperitoneal biopsies taken as indicated by operative findings. Poor correlation was seen between operative findings, lymphangiography, and clinical staging. Radiation therapy was extended to include sites of biopsy proven metastases. The group of patients operated on through a transperitoneal approach experienced a 30% complication rate secondary to small bowel damage following radiation therapy, and 2 patients died as a result of complications. All patients with small bowel complications explored in this manner required surgical correction. The group of patients operated on through an extraperitoneal approach had a 2.5% morbidity secondary to small bowel complications, and there were not deaths or serious complications in these patients. No patients explored in this manner required subsequent operation for complications following radiation therapy.

Female↗
PubMed1976

Vaginal reconstruction following extensive treatment for pelvic cancer.

Since 1970, 23 patients at UCLA and The City of Hope who have undergone extensive treatment for pelvic malignancy have had vaginal function successfully restored. A combination of methods, including split-thickness skin graft and the construction of an external vulvar pouch, is often necessary to obtain maximal functional results. The external vulvar pouch was very useful, although not as anatomically appealing as internal methods of reconstruction. In young patients who required an exenteration, a new technique using part of the anterior bladder fundus was developed. Preliminary experience with this method was promising. Among the gorup of 23 patients, there have been no overt failures. By combining restoration of rectal function with vaginal reconstruction, two major steps have been taken toward total rehabilitation of the patient undergoing extensive treatment for pelvic malignancy. Persistence, ingenuity, and planning by the surgeon are essential to obtain a maximum functional result for each patient.

Adolescent↗
PubMed1976

Intravenous alcohol -- a single blind study in the prevention of premature delivery: a preliminary report.

A single blind study for the evaluation of intravenous ethanol in the prevention of premature delivery is reported. Randomly selected patients admitted to Tripler General Hospital with uncomplicated pregnancies between 24 and 36 weeks' gestation having regular, sustained contractions were evaluated. Therapy consisted of intravenous 5% ethanol in 5% dextrose/water according to a weight-time-dose schedule. Control patients were given conventional treatment. Statistical evaluation of data has shown no significant difference between success and failure between the study and control groups to date.

Female↗
PubMed1976

Gonococcemia in pregnancy.

A case of gonococcemia in pregnancy in which the patient presented with the classic clinical manifestations of gonococcemia--cutaneous lesions, arthritis, and possibly pericarditis--is reported. A review of the literature reveals a dramatic increase in incidence of gonorrhea and the increasing importance of the complications associated with this disease, particularly in pregnancy. Recommendations regarding recognition of gonococcemia, criteria for diagnosis, and treatment are presented.

Adult↗
PubMed1974

Combination Adriamycin and radiation therapy in gynecologic cancers.

Anthracyclic antibiotics, of which Adriamycin is representative, have the ability to bind to cellular DNA and thereby interfere with the X-ray repair process. When radiation survival curves of tissue cultures were studied, increased cell-killing was noted in those cultures with Adriamycin over those without the drug. The mechanism by which this occurs may be related to a reduced rate of DNA strand break rejoining, as demonstrated by use of alkaline sucrose gradient techniques. A preliminary clinical Phase I study, in which patients with advanced gynecologic malignancy were treated by simultaneous Adriamycin and X radiation, suggests that combined therapy is well-tolerated, and that such combinations may prove useful in selected patients.

Cell Survival↗