Philip J. Krupp

Prognostic parameters and clinical staging criteria in the epidermoid carcinoma of the vulva.

An evaluation and a critique of prognostic parameters and criteria involved in the classification and clinical staging of epidermoid carcinoma of the vulva are presented, comparing the FIGO system and a proposed more definitive system. Biostatistical as well as clinical evidence for an improved system is presented. The proposed system is based on statistically valid data, has good patient distribution, and an orderly progression for therapy and prognosis. In addition, it is well suited for computer programming and for the comparison of patients and therapy, as well as for delineating the natural history of vulvar cancer.

Malignant mixed Müllerian neoplasms (mixed mesodermal tumors)

Summary 1. Fifty-one cases of malignant mixed Mullerian neoplasms are reviewed. 2. The clinical picture is reviewed in detail. 3. Methods of therapy with survival times are presented. 4. Suggestions for therapy are made.

Early repair of vesicovaginal fistula

Abstract Thirty-eight patients with vesicovaginal fistula were treated within 60 days of diagnosis of the fistula (acute fistula). The fistulas resulted from obstetrical injuries, surgical procedures, and irradiation and operation for cancer. The majority of the patients were treated within 30 days. This is possible with the use of cortisone as an anti-inflammatory agent. We believe it is no longer necessary for the patient with vesicovaginal fistula to wait six months before attempting repair. With the exception of the use of cortisone preoperatively, the surgical technique employed and the postoperative care, with stress on the importance of maintenance of excellent catheter drainage, are the same basic principles advocated by most authorities. Over two thirds of the patients treated were cured within two weeks after diagnosis.

Current status of the treatment of epidermoid cancer of the vulva

Epidermoid cancer accounts for 81% of the malignancies of the vulva. Although the etiology has not been delineated, chronic vulvitis is associated with cancer in almost one‐third of the patients. The staging system should utilize the most precise and accurate parameters delineated for improved treatment. A new staging system is utilized. Proven treatment is primarily surgical.

Antihypertension therapy in toxemia of pregnancy; a 30 month progress report.

Abstract The results of a thirty-month continuing evaluation of protoveratrine and protoveratrine-Apresoline combinations in the treatment of the hypertensive toxemias of pregnancy are recorded. That this method of therapy is safe, effective, and advantageous is apparent. Tolerance to protoveratrine has infrequently been noted, and it is in these patients and those who require a further reduction in blood pressure that Apresoline has found its greatest usefulness. The complications arising from hypertension have definitely been reduced. The nursing care is markedly simplified. From this large series we have shown that the toxic manifestations of protoveratrine and Apresoline are few and mild.

Protoveratrine in The Treatment of Toxemia of Pregnancy

Summary 1. Protoveratrine (Puroverine) is a potent drug effective orally and intravenously for the release of the vasospasm of toxemia of pregnancy. 2. In spite of apparent control the disease may progress to fetal death, hence delivery is indicated in patients with unstable blood pressure, continuing albuminuria, or increasing levels of blood urea nitrogen and uric acid. Continuing evaluation of the retina by funduscopic examination is also important. 3. No oliguria could be demonstrated twenty-four hours after admission. 4. Toxic manifestations (vomiting, bradycardia, and hypotension) are easily controlled. 5. No fetal deaths were attributable to the drug understudy. 6. There is no interference with adaptive reflexes in the doses used. 7. Apresoline may be used to advantage in seleeted patients in conjunction with protoveratrine.