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Denehy TR, Einstein M, Gregori CA, Breen JL. Symmetrical periumbilical extension of a midline incision: a simple technique. Obstet Gynecol 1998; 91:293-4. [PMID: 9469292 DOI: 10.1016/s0029-7844(97)00653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Periumbilical extension of midline incision often results in an irregular, unaesthetic scar with beveled edges. TECHNIQUE An Allis clamp is placed at the lateral margin of the umbilicus with subsequent medial traction. This straightens the proposed periumbilical incision, resulting in a symmetrical scar. EXPERIENCE We have used this technique extensively over the past several years with excellent results and no adverse sequelae. CONCLUSION This simple technique results in the symmetrically curvilinear, nonbeveled periumbilical extension of a midline incision.
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Affiliation(s)
- T R Denehy
- Department of Obstetrics and Gynecology, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.
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Abstract
OBJECTIVE To evaluate endocervical curettage (ECC) and cone margin involvement in the management of adenocarcinoma in situ of the cervix. METHODS Forty-two women with adenocarcinoma in situ without any associated invasive component underwent 49 cervical conizations. The ECC, cone margin involvement, and residual endocervical glandular disease were evaluated in a retrospective descriptive study. RESULTS The patients ranged from 18 to 65 years old, with a median of 34 years and a mean of 37 years. Nineteen of 42 (45%) of the women presented with initial cervicovaginal cytology suggesting endocervical glandular abnormality. Twenty-seven patients (64%) had mixed lesions of adenocarcinoma in situ and squamous dysplasia noted in their cervical biopsy, conization, or hysterectomy specimens. Forty ECCs were performed at colposcopy or immediately after conization; 28 patients with ECCs subsequently underwent conization, and 12 underwent hysterectomy. Residual adenocarcinoma in situ was found in 18 (67%) of the 27 patients with negative ECCs and in ten of 13 women with positive ECCs. Residual adenocarcinoma in situ was found in two of seven patients with negative cone margins and seven of ten patients with positive margins. CONCLUSION We found that negative ECCs and uninvolved cone margins in patients with cervical adenocarcinoma in situ were not reassuring of the absence of residual endocervical glandular disease in subsequent surgical specimens. Conservative management and subsequent surveillance of adenocarcinoma in situ should be undertaken with caution.
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Affiliation(s)
- T R Denehy
- Department of Obstetrics and Gynecology, Saint Barnabas Medical Center, Livingston, New Jersey, USA
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Denehy TR, Eastman R, SanFilippo L, Gregori CA, Breen JL. Bolus mitomycin C and 5-FU with sequential radiation for poor-prognosis locally advanced cervical cancer. Gynecol Oncol 1996; 60:64-71. [PMID: 8557230 DOI: 10.1006/gyno.1996.0013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Forty patients with locally advanced cervical carcinoma were entered into a protocol utilizing the bolus administration of both mitomycin C (10 or 15 mg) on Day 1 and 5-fluorouracil (400 mg) on Day 1-5 followed by sequential pelvic irradiation on Day 6 between September 1980 and October 1985. All patients had poor-prognosis FIGO stage IB, IIB, IIIB, or IVA disease. Only patients with poor prognosis factors such as bulky tumor masses of 5 cm or greater noted on the initial physical exam (37 patients) or poorly differentiated histology (3 patients) were eligible for this study. There were three severe side effects seen in the 24 patients receiving 15 mg mitomycin C. One patient developed thrombocytopenia, one patient developed acute radiation enteritis, and the third patient developed radiation proctitis requiring laser therapy. Only 1 of 16 patients receiving 10 mg mitomycin C developed a complication (thrombocytopenia). Neutropenia was mild in all patients. No infections were seen. Thrombocytopenia never warranted platelet transfusion. No patients developed therapy-related bowel obstruction or fistulae. Median follow-up was 11.3 years with a range of 6.2-14.2 years. A complete response rate of 63%, a local control rate of 58%, and a 5-year survival rate of 44% were obtained. This does not appear to offer any benefit over radiation alone. This present study supports the superiority of higher dose concurrent infusional chemotherapy and radiation over low-dose sequential bolus chemotherapy and radiation.
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Affiliation(s)
- T R Denehy
- Department of OBstetrics and Gynecology, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA
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Denehy TR, Choe JY, Gregori CA, Breen JL. Modified Le Fort partial colpocleisis with Kelly urethral plication and posterior colpoperineoplasty in the medically compromised elderly: a comparison with vaginal hysterectomy, anterior colporrhaphy, and posterior colpoperineoplasty. Am J Obstet Gynecol 1995; 173:1697-701; discussion 1701-2. [PMID: 8610747 DOI: 10.1016/0002-9378(95)90412-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- T R Denehy
- Department of Obstetrics and Gynecology, Saint Barnabas Medical Center, Livingston, NJ 07039, USA
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Comerci JT, Denehy T, Gregori CA, Breen JL. Wilms' tumor of the uterus. A case report. J Reprod Med 1993; 38:829-32. [PMID: 8263878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Extrarenal Wilms' tumors (nephroblastomas) are considered rare, with only 36 cases reported to date. A primary Wilms' tumor of the uterus has been reported on two previous occasions. A third case is presented and the histologic features and histogenesis of the tumor discussed.
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Affiliation(s)
- J T Comerci
- Department of Obstetrics and Gynecology, St. Barnabas Medical Center, Livingston, New Jersey
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Abstract
Mitral valve prolapse is usually a benign condition, however, serious complications have been reported to be associated with it. A report of retinal artery occlusion associated with mitral valve prolapse and pregnancy is presented.
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Affiliation(s)
- P A Bergh
- Department of Obstetrics and Gynecology, Saint Barnabas Medical Center, Livingston, NJ 07039
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Breen JL, Gregori CA, Neilson RN. Travel by airplane during pregnancy. N J Med 1986; 83:297-9. [PMID: 3461316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Dreyfuss P, Breen JL, Gregori CA. Guidelines for immunization during pregnancy. J Med Soc N J 1983; 80:511-4. [PMID: 6350593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Bonamo J, Gregori CA, Breen JL. Anencephaly: an overview. J Med Soc N J 1980; 77:439-441. [PMID: 6930498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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DeMarsico R, Gregori CA, Breen JL. Smoking and pregnancy. J Med Soc N J 1978; 75:124-35. [PMID: 340696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Smith C, Gregori CA, Breen JL. Ultrasonography in threatened abortion. Obstet Gynecol 1978; 51:173-7. [PMID: 622231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Florio P, Gregori CA, Breen JL. Anovulation: etiology, investigation and treatment. J Med Soc N J 1978; 75:21-32. [PMID: 271235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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DiBenedetto RJ, Gregori CA, Breen JL. Permanent contraception. J Med Soc N J 1977; 74:449-56. [PMID: 266615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Breen JL, Neubecker R, Gregori CA, Franklin JE. Placenta accreta, increta, and percreta. A survey of 40 cases. Obstet Gynecol 1977; 49:43-7. [PMID: 299782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Forty patients with placenta accreta, increta, or percreta are presented. Clinical features revealed an average age of 29.5 years and an average parity of 3-2-1. Twenty-five had no antepartum complications. Nine were admitted with silent hemorrhage, of which 6 had a total placenta previa and 1 a low-lying previa. Postpartum hemorrhage occurred in 39% with an associated perinatal mortality of 25% and 1 maternal death. Histopathologic evaluations revealed the predominant factor to be an absent decidua. Etiologic in decidual deficiency was a previous cesarean section (12 patients). Therapy consisted of total abdominal hysterectomy in 38 patients.
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Sladowski CF, Gregori CA, Breen JL. Sacrococcygeal teratoma in the neonate. Int Surg 1976; 61:175-7. [PMID: 1262154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Three cases of sacrococcygeal teratoma of the neonate occurred during a two-year period in which approximately 6,000 live births occurred in our hospital. Two infants were delivered vaginally and one by cesarean section. One infant underwent immediate surgery and survived, whereas the other two were in too poor condition to warrant surgery. Early excision is the treatment of choice; radiotherapy and chemotherapy are not effective in the malignant variety of sacrococcygeal lesion.
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DiBenedetto RJ, Gregori CA, Breen JL. Acute fatty metamorphosis of the liver in pregnancy. Int Surg 1976; 61:94-7. [PMID: 1082868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Breen JL, Neubecker RD, Greenwald E, Gregori CA. Basal cell carcinoma of the vulva. Obstet Gynecol 1975; 46:122-9. [PMID: 1153145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A clinical and histopathologic study of material from a series of 17 patients with basal cell carcinoma of the vulva are reviewed. The tumors occurred primarily in elderly patients (average age, 59 years), the majority of whom were Causasian. Presenting symptomatology consisted primarily of pruritus vulvae and/or the presence of a vulvar mass (79%) of long duration (average, 6 years, 7 months). The lesions were described grossly as ulcerations or masses located on the anterior labium majus. Etiologies were indeterminate although 2 patients had previously received vulvar irradiation. Therapy consisted primarily of wide local excision and was effective in that follow-up studies in 16 patients revealed no deaths attributable to basal cell carcinoma. These data indicate that basal cell carcinoma is a locally invasive nonmetastasizing tumor best treated by wide local excision providing the tumor edge does not extend to the margin of excision.
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DiBenedetto RJ, Gregori CA, Breen JL. The physiology of the uterine tube. J Med Soc N J 1975; 72:561-8. [PMID: 1056480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Quartell AC, Gregori CA, Breen JL. Contraception. A survey of the literature: past, present, and future. J Med Soc N J 1974; 71:935-49. [PMID: 4612160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Smith H, Gregori CA, Breen JL. Disseminated intravascular coagulation in pregnancy. J Med Soc N J 1974; 71:729-36. [PMID: 4607971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Koch P, Gregori CA, Breen JL. Diabetes in pregnancy: a review and survey. J Med Soc N J 1974; 71:209-16. [PMID: 4592936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Greenwald E, Gregori CA, Breen JL. Ovarian liposarcoma. A case report. J Med Soc N J 1974; 71:105-7. [PMID: 4521660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Greenwald E, Gregori CA, Breen JL. Regression of metastatic uterine carcinosarcoma. Following cyclophosphamide chemotherapy. J Med Soc N J 1973; 70:196-8. [PMID: 4510802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Breen JL, Gregori CA, Connolly W. Aggressive management of incomplete or inevitable abortion. Report of 1002 septic and aseptic patients. J Med Soc N J 1970; 67:711-5. [PMID: 5273362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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