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Biomedical subjects

F Flam

Publications and source records attributed to F Flam.

At least 73 records · Page 4Linked to original sources

Successive activation of the platelet-derived growth factor beta receptor and platelet-derived growth factor B genes correlates with the genesis of human choriocarcinoma.

The hydatidiform mole is a benign disease of the placenta characterized by the absence of the maternal genome. Approximately 3% of the reported cases will develop into malignant choriocarcinoma. In situ hybridization analysis reveals that the paternal platelet-derived growth factor (PDGF) beta receptor gene is up to 2 orders of magnitude more active in cytotrophoblasts of the complete hydatidiform moles than in normal placentae. The transition between hyperplasia (complete hydatidiform mole) and neoplasia (choriocarcinoma) in these cells correlates with at least a 10- to 20-fold activation of the PDGF-B gene. Since the neoplastic cytotrophoblasts have maintained an abnormally high level of PDGF beta receptor expression, we propose that a deregulated PDGF autostimulatory loop is involved in the genesis of human choriocarcinoma from hydatidiform moles.

Choriocarcinoma↗

IGF2 is parentally imprinted during human embryogenesis and in the Beckwith-Wiedemann syndrome.

The phenomenon of parental imprinting involves the preferential expression of one parental allele of a subset of chromosomal genes and has so far only been documented in the mouse. We show here, by exploiting sequence polymorphisms in exon nine of the human insulin-like growth factor 2 (IGF2) gene, that only the paternally-inherited allele is active in embryonic and extra-embryonic cells from first trimester pregnancies. In addition, only the paternal allele is expressed in tissues from a patient who suffered from Beckwith-Wiedemann syndrome. Thus the parental imprinting of IGF2 appears to be evolutionarily conserved from mouse to man and has implications for the generation of the Beckwith-Wiedemann syndrome.

Alleles↗

Psychosocial impact of persistent trophoblastic disease.

The female identity of women who suffer from hydatidiform mole developing into persistent trophoblastic disease is threatened in two ways. The reproductive failure is shortly followed by a disease originating in the uterus requiring chemotherapy. Although somatic treatment results are excellent, the psychological effects may be severe and protracted. We conducted a study of 22 women who were between 6 months and 5 years after the end of successful treatment. It appeared that 19 women suffered from psychological sequelae. The three oldest women of the study group, 50 years or older, belonged to the group of women demonstrating signs of prolonged psychological effects.

Adaptation, Psychological↗

Ovarian carcinoma causing cerebellar degeneration.

Subacute cerebellar degeneration can be associated with malignancies. If the underlying tumor is a gynecological one, Purkinje cell cytoplasmic antibodies in serum serve as tumor markers.

Antibodies, Neoplasm↗

Incidence of gestational trophoblastic disease in Stockholm County, 1975-1988.

An epidemiological study with the aim of establishing the incidence of hydatidiform mole, persistent trophoblastic disease and choriocarcinoma in Stockholm County was performed. Based on the regional cancer registry and hospital registers, the incidence for 1975-1988 was calculated for the number of deliveries as well as the total number of pregnancies. Of the molar pregnancies, 6% were treated with chemotherapy because of invasive mole or choriocarcinoma. Non-molar choriocarcinoma occurred in 1/33,717 deliveries. Difficulties in assessing the incidence of gestational trophoblastic disease are discussed.

Adolescent↗

Under-registration of gestational trophoblastic disease in the Swedish Cancer Registry.

The paper presents a study of completeness of registration of hydatidiform mole and gestational trophoblastic neoplasia in the Swedish Cancer Registry. The study is based on patients treated in Stockholm County, Sweden from 1971 through 1986. Non-notified cases were identified through a computerized register covering nearly all hospital admissions in the region and local hospital patient register. The results show that 25% of the cases with a diagnosis of hydatidiform mole were not included in the cancer register. Of all patients treated for trophoblastic malignancy, 66% were not recorded in the Cancer Registry. The frequent absence of histopathological confirmation in cases with malignant trophoblastic disease was probably the main factor contributing to the observed under-registration. The study indicates that the Swedish Cancer Registry alone does not provide sufficient data for studies on the incidence of gestational trophoblastic disease.

Female↗

Benign mixed Müllerian tumor of the ovary.

A case of benign Müllerian tumor of the ovary in a 53-year old woman is reported. The stromal element consisted of rhabdomyoblasts which clearly indicate that this tumor belongs to the Müllerian family. She remains free of disease 12 months following an abdominal hysterectomy and bilateral salpingo-oophorectomy.

Female↗

Medical induction prior to surgical evacuation of hydatidiform mole: is there a greater risk of persistent trophoblastic disease?

A retrospective study was undertaken to assess whether stimulation of uterine contractility prior to surgical evacuation of a molar pregnancy will lead to an increased frequency of persistent trophoblastic disease. Forty-seven patients treated with chemotherapy for persistent trophoblastic disease after a hydatidiform mole between 1971 and 1988 were evaluated. The use of medical methods in this study group was compared to a control group of 219 patients with hydatidiform mole not requiring further treatment. A medical method, mainly treatment with prostaglandins, was used in 61.7% in the study group compared to 35.2% in the control group. This difference was, however, due to different stage distribution in the groups. Persistent disease was significantly correlated to uterine size and medical methods were mainly used in patients where uterine size corresponded to 15 weeks gestation or more. In this subset of patients, a medical method was used in the same frequency in both groups. Thus, large uterine size seems to be an independent risk factor. We conclude that stimulation of uterine contractility, which in Sweden is frequently used before surgical evacuation of the uterus in patients with hydatidiform mole and large uteri, carries no additional risk.

Adolescent↗