A comparison of adenocarcinoma and squamous cell carcinoma of the cervix.

A comparison and survival analysis of 203 patients (21%) with adenocarcinoma and 756 (79%) with squamous cell cancer of the cervix for the time period 1970-1985 is reported. The mean number of new cases of adenocarcinoma (N = 12) remained the same, while squamous cell cases decreased from 57 to 32. The clinical features were compared; oral contraceptive usage, node status, diabetes, and symptoms of bleeding were not related to cell type.

Application of quadFERM+ for the identification of fastidious gram-positive and gram-negative bacilli.

The 2-hr quadFERM+ kit (qF) (Analytab Products, Plainview, NY) was compared with conventional tube tests for the identification of the HACEK bacteria (Haemophilus aphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae), other Haemophilus and Kingella spp., Capnocytophaga, Corynbacterium, and Moraxella spp. Test results were identical for 296 comparisons with 74 isolates (74%).

Hematocrit in relation to Apgar scores in SGA infants.

SGA infants have an increased incidence of low Apgar scores. At the same time they frequently have a high hematocrit. Since both affect outcome, it is important to know if a relationship exists between these two factors.

Characterization of epidermal growth factor receptor in normal and neoplastic human endometrium.

Growth factors, including epidermal growth factor (EGF), have been implicated in the growth of several types of cancer. This study compares EGF receptors in normal and neoplastic endometrium. Membrane fractions were isolated from surgical specimens.

Training obstetrics-and-gynecology residents to manage breast disease. Incorporation into a breast care clinic.

The American Board of Obstetricians and Gynecologists recently issued a directive that education in breast disease be incorporated into all residency training programs. At the University of Michigan Medical Center, the Comprehensive Breast Care Center (BCC) provides the vehicle for the education and training of residents in the area of breast disease. The department of obstetrics and gynecology is fully integrated and participates actively in the care of patients in the BCC.

In vivo proton magnetic resonance spectroscopy of alcohol in human brain.

The covariance between blood and brain alcohol levels and subjective reports of mood were examined in 6 healthy adult men after consumption of 0.7 g/kg of beverage alcohol. There was significant (p less than 0.

Regulation of epidermal growth factor and insulin-like growth factor I receptors by estradiol and progesterone in normal and neoplastic endometrial cell cultures.

Growth factors are polypeptides which regulate cell proliferation through binding to specific receptor proteins. Normal and neoplastic human endometrium have been shown to express epidermal growth factor (EGF) and insulin-like growth factor I (IGF-1) receptors. Endometrial cell cultures were used to test modulation of EGF and IGF-1 receptors in response to steroid hormones.

Localization of trophoblastic disease with vaginal ultrasonography. A report of two cases.

Two patients had elevated beta-human chorionic gonadotropin levels and normal abdominal ultrasound examinations. In both instances transvaginal ultrasonography demonstrated a persistent nodule of trophoblastic disease confirmed at the time of hysterectomy. This new imaging modality can assist in the diagnosis of persistent trophoblastic disease in the uterus.

The surgical management of recurrent squamous cell carcinoma of the vulva.

Thirty-four patients with recurrent/persistent squamous cell carcinoma of the vulva were treated at the University of Michigan Medical Center from 1975-1988. At follow-up, 19 patients (56%) were free of disease and 15 were dead of disease. Three patients developed a "bridge" recurrence, one patient each with original stages I, II, and IV.

Phenotypic characterization, karyotype analysis and in vitro tamoxifen sensitivity of new ER-negative vulvar carcinoma cell lines, UM-SCV-1A and UM-SCV-1B.

Two cell lines (University of Michigan squamous carcinoma of the vulva UM-SCV-1A and UM-SCV-1B) were established from the primary tumor and a malignant pleural effusion of a 62-year-old woman. Both tumor specimens grew vigorously in vitro and could be passaged after only 14 and 10 days in culture, respectively. Both cell lines undergo 3 population doublings in 4 days, reaching saturation densities of 5 x 10(5) cells/cm2, and have been carried through more than 30 in vitro passages.

Repetitive intravenous DHE in the treatment of refractory headache.

We analyzed retrospectively the data for 300 patients with refractory headache who were treated with dihydroergotamine (DHE) at the Comprehensive Headache Center at Germantown Hospital. The patients had either chronic daily headache (with drug rebound -216, without rebound -42), short-duration headache (18), or cluster headache (24). Treatment consisted of withdrawal of overused medications (usually analgesics and ergots), repetitive IV administration of DHE, and use of metoclopramide and prophylactic medications, together with educational and psychological support.

Infection on a gynecologic oncology service.

Little information is available pertaining to infectious morbidity in women with genital malignancy. To define the magnitude of this problem, all patients admitted to the gynecologic oncology services at the University of Michigan Medical Center between January 1, 1986, and December 31, 1986, were followed prospectively for the development of infectious morbidity. One hundred nine bacteriologically confirmed infections occurred in 297 patients during 510 admissions.

Urinary incontinence following radical vulvectomy.

Although incontinence has been reported after radical vulvectomy, its relationship to operative technique, anatomy, and treatment has not been defined. Twenty-one patients having vulvectomies for vulvar cancer were prospectively evaluated preoperatively and postoperatively with urodynamic function studies. A portion of the urethra was removed in four patients undergoing radical vulvectomy, and 14 had a vulvectomy excision that came within 1 cm of the distal urethra.

Invasive cervical cancer treated initially by standard hysterectomy.

Ninety-two patients with invasive cervical cancer initially treated by standard hysterectomy were evaluated for features related to survival. The cell type included squamous cell (64) and adenocarcinoma (28). Posthysterectomy therapy included radiation therapy (78), pelvic lymphadenectomy (3), and radical parametrectomy (1).

Psychosocial factors as predictors of length of stay of Medicare patients under the prospective payment system.

The Prospective Payment System methodology is designed to predict inpatient hospital resource utilization. The system sets standards based on medical diagnosis (Diagnosis Related Groups), but it ignores psychosocial characteristics which often determine discharge options and therefore, directly affect a patient's length of stay. A study is described which examined the psychosocial characteristics of 234 elderly hospitalized patients in relation to length of stay and route of admission (elective or emergency room).

Pelvic exenteration, University of Michigan: 100 patients at 5 years.

One hundred patients undergoing pelvic exenteration (total 69, anterior 13, posterior 18) at the University of Michigan Medical Center from 1964-1984 are reported. All patients were followed for at least 5 years or until time of death. The overall cumulative survival was 66% at 3 years and 61% at 5 years.

A CT-compatible version of the Fletcher system intracavitary applicator: clinical application and 3-dimensional treatment planning.

A new acrylic version of the familiar Fletcher intracavitary applicator, the Ann Arbor (AA) applicator, has been developed. This new device eliminates the problem of "streak" artifacts on CT images, but unlike other plastic applicators the ability to shield portions of the bladder and rectum is retained through the use of tungsten alloy shields which are afterloaded with the radioactive sources. To minimize changes in placement geometry and to take advantage of the wide clinical experience with the Fletcher system, the new applicator nearly duplicates the physical dimensions of the Fletcher applicator.

Optimal coverage of peritoneal surface in whole abdominal radiation for ovarian neoplasms.

Patterns of failure in ovarian carcinoma include early seeding of the entire peritoneal cavity. Inability to encompass the anatomic extent of the peritoneal cavity is a possible factor leading to relapse. However, little has been published regarding technical advances in optimal coverage of the peritoneal surface in whole abdominal radiation.

The second-look operation and surgical reexploration in ovarian tumor of low malignant potential.

Patients at the University of Michigan Medical Center who were reoperated on for either operative staging, suspected disease, or a second-look procedure with the diagnosis of ovarian tumor of low malignant potential are reported. At the time of initial surgery, 29 patients were thought to have benign disease based on visual inspection of the ovarian mass, and seven patients had a frozen-section report of benign disease. Fifteen patients underwent restaging operation, and disease was found in seven patients.

Primary melanoma of the vagina: a clinicopathologic analysis.

Primary melanoma of the vagina is a rare tumor associated with a poor prognosis. The clinical and pathologic features of 15 patients treated at the University of Michigan Medical Center and Bowman Gray School of Medicine are reviewed. The presenting symptom of bleeding was noted in 80% of the patients.

Hot legs.

The recent glorious weather throughout the country brings with it a recurrent and seemingly unresolveable problem.