Search PubMed⌕ Search

Biomedical subjects

C B Hammond

Publications and source records attributed to C B Hammond.

At least 91 records · Page 5Linked to original sources
PubMed1981

Endocrine aspects of trophoblastic neoplasia.

The trophoblastic cells in both benign and malignant trophoblastic disease secrete a variety of steroid, polypeptide and hormonal agents. Those substances that are known to be elaborated by the neoplastic trophoblastic tissue include hCG, a substance with TSH-like activity, estrogens, progestogens and placental lactogen. The most well characterized of these is hCG, which can be assayed easily. The level of hCG plays an important role in the diagnosis, management and follow-up of patients with trophoblastic disease. Because of this, a sensitive assay that does not cross-react with LH would be ideal. It appears that some of the clinical signs and symptoms seen in these patients (including toxemia, theca lutein cyst, hyperthyroidism and thyrotoxicosis, and galactorrhea) are a direct manifestation or reflection of the level of hCG. There is very little information available at this time on the pathophysiologic role that hCG plays at the cellular level in causing these signs and symptoms. Many questions remain to be answered regarding the role of the other hormones in trophoblastic disease and how they affect the patient. Additionally, very little is known about the potential use of the other hormones in diagnosis, management and follow-up of patients with trophoblastic disease.

Chorionic Gonadotropin↗
PubMed1981

Pulmonary resection in the management of metastases from gestational choriocarcinoma.

Case histories of five patients with pulmonary metastases from choriocarcinoma resistant to multidrug chemotherapy are presented. Thoracotomy was performed in all cases. All tumor was removed in three patients with no other site of active disease, and these patients are surviving with no evidence of recurrent disease. In one patient, the lesion could not be completely excised because of involvement of contiguous structures, and she died of progressive disease. A second patient, with liver metastases at the time of thoracotomy, also died of progressive disease. The indications for performing thoracotomy in the management of pulmonary metastases of choriocarcinoma are discussed.

Adult↗
PubMed1981

Production of testosterone and estrogen in vitro by gonadal tissue from a 46,XY true hermaphrodite with gonadal failure and gonadoblastoma.

A phenotypic female patients with 46,XY true hermaphroditism and clitoromegaly was found at laparotomy to have normal müllerian structures with a right streak gonad and a left dysgenetic ovotestis that contained a gonadoblastoma. Karyotypes of peripheral lymphocytes and cells from labial skin and both gonads were all 46,XY, so an unrecognized mosaic or chimera was unlikely. Tissue from both gonads was studied in vitro and estrogen and testosterone production measured. The streak produced 186.6 pg/mg/24 hr of estrogen and 78 pg/mg/24 hr of testosterone, whereas the dysgenetic ovotestis produced 85.8 pg/mg/24 hr of estrogen and 184.6 pg/mg/24 hr of testosterone (more than double the testosterone produced by the streak). Comparisons between these data and those previously published suggest that dysgenetic streak gonadal tissue is more active steroidogenically than postmenopausal ovarian stroma.

Adolescent↗
PubMed1980

Utility of assay of alpha subunit of human chorionic gonadotropin in management of gestational, trophoblastic malignancies.

All patients who were treated with chemotherapy for malignant gestational trophoblastic neoplasms at the Southeastern Regional Trophoblastic Disease Center and who experienced remission during the period January 1, 1978, through December 31, 1979, were studied in an attempt to determine if the application of an assay for the alpha subunit of human chorionic gonadotropin (hCG-alpha) could predict those patients who would have recurrences. For each patient, the first three weekly serum samples with undetectable HCG by the hCG beta-subunit radioimmunoassay as well as the two preceding samples with detectable hCG were assayed in a homologous hCG-alpha assay. Results reaffirm previous data that the latter assay is useful only in patients receiving oral contraceptives for suppression of pituitary gonadotropin secretion. No patient who has remained in remission had a mean level of hCG-alpha in the three hCG-negative samples greater than 1 ng/ml. Of those patients who had recurrences of trophoblastic disease, two of three had hCG-alpha levels greater than 1.5 ng/ml. Although these data are preliminary, they suggest that the routine measurement of hCG-alpha in patients successfully treated for trophoblastic disease may aid in identification of a group of patients who require additional or more intensive follow-up and/or additional chemotherapy to prevent later recurrences.

Adolescent↗
PubMed1980

Late recurrences of gestational trophoblastic neoplasia.

Presented are two cases of recurrence of gestational trophoblastic neoplasia more than 1 year after apparently successful therapy. Both patients initially had had nonmetastatic disease, were clinically free of disease, and had had repetitively negative serum radioimmunoassay titers for the beta subunit of human chorionic gonadotropin for 2 to 3 years. The development of these late recurrences re-emphasizes the need for prolonged follow-up monitoring of patients after apparently successful therapy for gestational trophoblastic neoplasia.

Adult↗
PubMed1980

Risk of exogenous estrogen therapy and endometrial cancer.

A retrospective study was carried out on 431 patients with endometrial cancer and 431 control subjects matched as to age, race, and parity. They were seen at Duke University Medical Center from 1940 to 1975. The study was performed in order to evaluate the risk of exogenous estrogen therapy and the development of adenocarcinoma of the endometrium. The overall risk was 2.38, with certain subgroups demonstrating different degrees of risk. Increased risk was associated with estrogen therapy of longer than 5 years' duration in white patients. The risk also was confined to Stage I, grade 1 lesions and more superficial myometrial invasion. Five-year survival for patients who used estrogen replacement and had Stage I, grade 1 lesions was 94.7%. The risks associated with exogenous estrogens are real but should be considered in a risk/benefit context when prescribing for the needs of an individual patient.

Adenocarcinoma↗
PubMed1980

Spontaneous regression of prolactin-producing pituitary adenomas.

Two women evaluated for amenorrhea, galactorrhea, and hyperprolactinemia had radiographic changes of the sella turcica (localized erosion on trispiral tomography) suggestive of a pituitary tumor. Both patients experienced spontaneous regression of apparent prolactin-secreting adenomas with a marked decrease in the quantity of galactorrhea and a reduction of serum prolactin concentrations to the normal range. One patient noted a marked improvement of headaches and spontaneous menses resumed in the other patient.

Adenoma↗
PubMed1980

The role of operation in the current therapy of gestational trophoblastic disease.

Results of therapy of 257 patients with gestational trophoblastic disease (GTN), treated at one institution and by the same group of physicians (1966 to 1978), are presented. An overall remission rate of 92% was achieved: nonmetastatic disease, 139/139 (100%); "good" prognosis metastatic GTN, 55/55 (100%), "poor" metastatic GTN, 42/63 (66%). Chemotherapy, single- or multi-agent, was the primary treatment modality but selected patients were also treated with operation and/or x-ray therapy. Surgical therapy (hysterectomy), performed coincident with the institution of systemic chemotherapy, was shown to significantly reduce the duration of hospitalization and the amount of chemotherapy used to achieve remission, regardless of whether or not metastases were present. Delayed surgical excision of chemotherapy-resistant foci of GTN was of benefit, though less effective than initial operation. Surgical intervention for other diseases or for complications of GTN or its treatment was quite useful to stabilize patients and allow successful chemotherapy to be completed. There were no problems attributable to chemotherapy when wound healing or other postoperative complications were considered.

Antineoplastic Agents↗
PubMed1980

Endocrine changes at operation under general anesthesia: reproductive hormone fluctuations in young women.

This study investigated changes in peripheral serum estrogen (E), Progesterone (P), luteinizing hormone (LH), follicle-stimulating hormone, and prolactin (PRL) in 11 women of reproductive age undergoing a variety of operations under general anesthesia without compromise of ovarian vasculature. All hormone determinations were plotted in relation to the midcycle LH peak; eight women with cyclic ovulatory menses served as controls. The absolute value of E declined after surgery but did not reach statistical significance. P levels postoperatively were significantly lower following ovulation (P less than 0.01) on cycle days +1 through +5. Intraoperative and postoperative PRL values were significantly greater than those of control subjects (P less than 0.05). Aside from a transient intraoperative decline in LH, the pattern of gonadotropin secretion was similar to that of control subjects. The decline in peripheral ovarian steroid levels appeared to be independent of abdominal entry or pelvic manipulation. The evidence favors direct inhibition of ovarian steroidogenesis by (1) toxic effects of anesthetic agents or (2) stress-induced changes in other hormone levels, e.g., hyperprolactinemia.

Adult↗
PubMed1980

Prolactin-producing pituitary tumors: medical therapy.

Although the traditional alternatives for treatment of pituitary tumors have been radiotherapy or surgery or both, further investigation and better understanding of the pathophysiology of this disturbance might make it possible to select a few small pituitary tumors to treat with bromoergocryptine with only a slight risk if pregnancy occurs. Although it appears that the risks of pregnancy are minimal in small tumors, it is still necessary to follow the patients through pregnancy to avoid any catastrophic events. The use of medical therapy in selective patients at minimal risk may thus avoid the risk of surgical procedures and the loss of other trophic hormone function from radiotherapy.

Bromocriptine↗
PubMed1980

Cerebral metastatic choriocarcinoma: intensive therapy and prognosis.

Choriocarcinoma is known to be sensitive to chemotherapy. Remission rates of 70% are reported for patients with metastatic disease. The Southeastern Regional Trophoblastic Disease Center of Duke University has reviewed its experience with the treatment of cerebral metastases from choriocarcinoma. Fourteen patients were identified as having cerebral metastases from a group of more than 500 patients with gestational trophoblastic disease (GTD) other than primary hydatidiform mole. The remission rate of 50% (7/14) was achieved by vigorous, multiagent chemotherapy and combined cerebral irradiation therapy. This series of patients is reviewed with regard to diagnosis, details of multiagent chemotherapy with cerebral irradiation, complications, and survival. The key factors for successful outcome seem to be early diagnosis and vigorous therapy.

Adolescent↗
PubMed1980

Treatment of metastatic trophoblastic disease with poor prognosis.

Fifty-one patients are presented who were treated for poor-prognosis gestational trophoblastic disease by physicians at Duke University Medical Center (Southeastern Regional Trophoblastic Disease Center) between 1968 and 1978. Disease in 72% (37 of 51 patients) is currently in remission (8 months to 10 years). Treatment was primarily by multiagent chemotherapy, with adjunctive surgery and radiation therapy in selected patients. Unsuccessful chemotherapy prior to treatment at this center, a prolonged interval from the antecedent pregnancy to treatment, and liver metastases portended a worse prognosis in these patients.

Adolescent↗
PubMed1979

Ovulation induction with luteinizing hormone--releasing hormone in amenorrheic, infertile women.

Thirteen women with infertility thought due to anovulation were treated with LRH. Etiologic diagnoses of amenorrhea included hypothalamic or "idiopathic" and PCOD. All patients had normal gonadotropins and otherwise normal endocrinologic and infertility evaluations; none had ovulated with clomiphene. Patients were studied for six 35 day cycles, single blind, and received LRH or placebo by subcutaneous injections for 28 days/cycle (LRH dosage 1.0 mg 2 or 3 times each day). Frequent assessments of physical status, cervical mucus, vaginal cytology, and serum LH, FSH, estrogen, and progesterone were performed. Ovulation was documented by basal temperature, serum progesterone and, on occasion, endometrial biopsy. Follow-up was continued for 6 months after therapy. Of the 13 patients treated, eight have ovulated and five have conceived. There were no complications of therapy.

Adult↗