Stage I adenocarcinoma of the uterine cervix: tumour size, grade, lymph node metastases and 5-year survival

This study includes 22 cases of Stage I cervical adenocarcinoma. The lymph node metastases and 5-year survival according to the size of lesion and grade of tumour were evaluated. The overall pelvic and para-aortic lymph node metastases were found to be 31.8% and 0% respectively. Metastases in the pelvic lymph nodes were found in 16.6% of patients with lesions less than 2 cm and 50.0% of patients with lesions 2 cm or greater in size. Pelvic lymph node metastases were found to be 0% for Grade 1, 25% for Grade 2 and 46% for Grade 3 tumours. The overall 5-year survival was 68.2%. This figure varied from 60% to 75% according to the size of lesion and from 61.5% to 100% according to the grade of tumour.

Topical testosterone for lichen sclerosus

Twenty-three patients diagnosed as lichen sclerosus with colposcopic directed biopsy were given topical testosterone as a first line therapy. The overall remission rate was found to be 87.7%; 8.7% of the patients experienced undesirable androgenic side effects. Of the three patients who did not respond satisfactorily to testosterone treatment, two had alcohol injection to the vulva and one had vulvar denervation.

The testes after unilateral incarcerated inguinal hernia in prepubertal rats

The ipsilateral and contralateral testes after unilateral incarcerated inguinal hernia were evaluated, and compared to the contralateral testis after unilateral testicular torsion in 30 prepubertal rats. Control, torsion and detorsion at 24 hours, and incarcerated inguinal hernia and reduction in the 24 hour groups, each consisting of ten rats were established. The testes were harvested after 15 days. Mean seminiferous tubular diameters (MSTD) and mean testicular biopsy scores (MTBS) were determined and compared. A decrease in MSTD and depression in MTBS, which was more prominent in the ipsilateral testes, were found in both ipsilateral and contralateral testes following unilateral incarcerated inguinal hernia. The testicular damage encountered after unilateral incarcerated inguinal hernia was similar to the contralateral testicular damage following unilateral testicular torsion with the utilized parameters.

The fate of testes following unilateral incarcerated inguinal hernia in adult rats

The histological effects of unilateral incarcerated inguinal hernia on the ipsilateral and contralateral testes were examined in adult rats. Three groups were established. In the first group the left testis and caecum were exposed and replaced. In group 2 a left-sided incarcerated inguinal hernia was created with bilateral orchiectomy 24 h later. In group 3 a left-sided incarcerated inguinal hernia was created with reduction after 24 h. The testes of animals in groups 1 and 3 were removed after 15 days. The mean seminiferous tubular diameter (MSTD) and mean testicular biopsy score (MTBS) were determined for ipsilateral and contralateral testes in each of the 3 groups. A decreased MSTD and depressed MTBS, were pronounced in the ipsilateral testes, were found in the testes of group 3 animals. While unilateral incarcerated inguinal hernias caused more pronounced histological changes in the ipsilateral testes, they also affected the contralateral testes, but a time interval was required for the changes to become manifest.

Lymph node metastasis in early endometrium cancer

The incidences of pelvic and paraaortic lymph node metastases in 106 patients with clinical Stage 1 endometrium cancer are presented. All patients were primarily surgically staged and treatment consisted of peritoneal cytology assessment, type II radical hysterectomy, bilateral salpingooophorectomy, pelvic and paraaortic total lymphadenectomy. Pelvic lymph node metastases were present in 15.1% and paraaortic lymph node metastases in 8.5% of the patients. Multiple prognostic factors were evaluated in respect to nodal status. This study adds credence to primary surgical staging with total pelvic and paraaortic lymphadenectomy regardless of presence or absence of the various risk factors.

Vulvar dystrophies: an evaluation

Of 86 patients diagnosed as having vulvar dystrophy in a 10-year period 56 (65.1%) had hyperplastic dystrophy, 23 (26.7%) had lichen sclerosus and 7 (26.7%) had mixed vulvar dystrophy. The diagnoses were made by colposcopic or toluidine blue directed biopsies. Fluorinated corticosteroids were given to patients with hyperplastic dystrophy with a response rate of 90.1%. Patients with lichen sclerosus received topical testosterone propionate and the response rate was 87.7%. Topical fluorinated corticosteroids followed by testosterone propionate was given to patients with mixed dystrophy and 85.8% of the patients responded. Surgical therapy was reserved for patients with failed medical treatment.

Analysis of 20,291 deliveries in a Turkish institution

Data of 20,291 deliveries are presented; 6.85% (1389) of the patients were 19 years old or under and 6.24% (1276) were 35 or over; 7352 women had one child (primipara) and 1475 had five or more. Cephalic presentation constituted 94.2% of deliveries. The total induction rate was 9%. The incidence of prematurity and post-term gestation was 13 and 7.2%, respectively. Prolonged labor was encountered in 4% of the patients. Anesthesia was employed in 65.8% of all deliveries. Total and primary cesarean section rates were 9.77 and 7%, respectively. The incidence of fetal mortality was 2.55% and congenital anomalies were seen in 1.53% of the infants. The birth weight was under 2499 g in 9.5% of the newborns. Pregnancy complications of different magnitude were encountered in 23.7% of the cases. Uterine rupture and inversion rates were 0.12% and 0.005% respectively. The maternal mortality rate was found to be 64.06 per 100,000 deliveries.

Histopathological changes in adult cryptorchid testes

The histological specimens of 73 patients who presented with undescended testes after puberty were re-evaluated. None of the specimens revealed carcinoma in situ but in the specimens of 5 patients severe atypia was detected. None of the patients, including 5 with severe atypia, has shown any evidence of invasive testicular tumour during follow-up.

Radical vulvectomy for squamous cell carcinoma of the vulva

Twenty-one patients with squamous cell carcinoma of the vulva who were subjected to radical vulvectomy and inguinal-pelvic lymphadenectomy were studied. The overall mortality rate was 24%. Operative- and tumor-related mortalities were 9.5% and 14.2%, respectively. Recurrence was seen in 5 patients. The most common complication was wound infection and breakdown.

CO2 laser therapy for cervical intraepithelial neoplasia

One hundred and fifty-six patients with cervical intraepithelial neoplasia (CIN) were treated with CO2 laser and followed for 2 1/2 to 6 years. There were 19 recurrences, of which 14 occurred in patients treated with a power density of less than 1000 W/cm2 to a depth of 6 mm. All of the recurrences were subjected to a second laser treatment. Overall failure rate was 4.5%. The incidence of acute bleeding during, and late bleeding 6 to 14 days following treatment, were 8 and 4%, respectively. Late bleeding occurred in patients who were treated with 800 to 1000 W/cm2 power density and to a 3 to 10 mm depth of destruction. Complications were directly and failures were inversely proportional to the power density and depth of destruction. Following therapy, the transformation zone was adequately seen in the majority of the patients.