Search PubMed⌕ Search

Biomedical subjects

J C Weed

Publications and source records attributed to J C Weed.

At least 37 records · Page 2Linked 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↗
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

Conservative management of cervical intraepithelial neoplasia.

A brief review of cervical intraepithelial neoplasia has been presented. Attempts have been made to identify the high-risk patient, and etiologic considerations have been detailed. The conservative management of cervical intraepithelial neoplasia is available and applicable to many patients. Regardless of the definitive therapy used in CIN, it is absolutely mandatory that proper pretreatment evaluation be performed. This includes cytology, colposcopy, colposcopy-directed biopsies, and clinical examination to rule out invasive cancer. If this can be done according to the stated criteria, one may proceed with outpatient treatment. If performed accurately, such treatment can be very effective, saving the patient a major surgical procedure. This is of tremendous benefit to the patient in time and money saved, as well as to the saving of hospital bed space and operating-room time. For the young patient who has not yet completed her family or the patient who is pregnant, outpatient evaluation is probably the optimal method. If the techniques are unavailable or the physician managing the patient does not have the expertise to perform them, standard management by means of conization, which historically has been used in this disease, should continue to be used. The consequence of inadequate outpatient management of CIN can be catastrophic. If the procedures are properly followed, then the patient with CIN can be managed safely and effectively.

Adolescent↗
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↗
PubMed1979

Recurrent endodermal sinus tumor during pregnancy.

A case is reported of a patient who was found to have an endodermal sinus tumor coincident with pregnancy. She maintained a complete clinical response for 12 months after conservative surgery, uterine aspiration, and multiple-agent chemotherapy. Tumor recurrence appeared with a second pregnancy. A healthy infant was delivered despite resumption of chemotherapy. The use of cytotoxic chemotherapy during pregnancy is reviewed.

Adolescent↗
PubMed1978

Fertility after cryosurgery of the cervix.

Fertility in patients following cryosurgery of the cervix was evaluated in 412 women. Cryosurgery does not appear to have any effect on subsequent fertility when compared with the general population.

Adult↗
PubMed1977

Endometriosis and infertility: an enigma.

In our efforts to overcome infertility and subjective complaints in young women with endometriosis, we have performed conservative surgical procedures upon 142 women 30 years of age or less. In these women, multiple endometriomata were resected from the pelvic peritoneum, one or both ovaries, the large and small bowel, and the appendix. In addition, uterine and ovarian suspension, bowel resection, appendectomy, myomectomy, and presacral neurectomy (PSN) were performed when indicated. Conception occurred in 70% of the women wishing to conceive; the highest rate was found among those who had developed endometriosis after a previous conception. Ovarian involvement seemed to reduce the conception rate by 10%. Uterine suspension and PSN did not affect conception but did provide a symptomatic relief. We conclude that early examination for endometriosis and aggressive surgical management is indicated in young women with demonstrable disease.

Adolescent↗
PubMed1977

Cerebral necrosis following irradiation and chemotherapy for metastatic choriocarcinoma.

A case of cerebral necrosis following radiation and chemotherapy in a patient with metastatic cerebral choriocarcinoma is reported. Computed tomography (EMI Scan) demonstrated evolution and enlargement of the necrotic lesion. This focus was surgically excised and histology is presented. The possible enhancement of radiation necrosis by chemotherapy is noted, but the continued need for simultaneous use of radiation and chemotherapy is recognized and discussed.

Adult↗
PubMed1977

Combined irradiation and extensive operations in the treatment of stages I and II carcinoma of the cervix uteri.

Since 1947, carcinoma of the cervix uteri, Stage I, has been treated at the Ochsner Clinic with intracavitary irradiation and a radical hysterectomy--Wertheim type--and pelvic node dissection. If metastasis to the lymph node is demonstrated, external irradiation is administered postoperatively. Carcinoma of the cervix uteri, Stage II, has been treated with intracavitary radium and external radiation, followed by the same surgical procedure. All patients were treated surgically, except those with medical conditions precluding extensive operation. Five and ten year survival rates for Stage I cancer were 81.5 and 68.7 per cent, respectively; for Stage II, these rates were 64.5 per cent and 54.0 per cent, respectively. There were moderate complications from the combined therapy, with a ureteral fistula rate of 1.9 per cent. Although the combined use of irradiation and operation for carcinoma of the cervix uteri has been looked upon in this country with disfavor because of poor healing and complications, we have not found this to be so. With improvement of both radiation therapy and surgical management, these patients can be offered treatment based upon sound physiologic principles and can live in freedom from fear of recurrence in later years. The outlook is good for continued improvement in the complication rate, surgical technique and possibly, chemotherapy.

Adenoma↗
PubMed1976

Screening techniques in endometrial cancer.

Carcinoma of the uterus is the most frequently seen malignancy of female genital tract. Screening techniques have lowered the incidence and morbidity of cervical neoplasia. Attempts to identify premalignant and silent cancers of the uterus have been made. A single diagnostic procedure has not been uniformly successful. It would appear that multiple techniques, using both cytologic and histologic material, would increase the possibility of achieving the goal of early diagnosis in uterine disease.

Adenocarcinoma↗
PubMed1976

The specificity of gonadotropin binding by the human corpus luteum.

The specificity of gonadotropin binding was studied in fresh and frozen human corpora lutea. Ovine, bovine, and porcine luteinizing hormone (LH) competed with 125I-labeled human LH (125I-hLH) and 125I-labeled human chorionic gonadotropin (125I-hCG) for binding to tissue receptors in homogenates of human corpora lutea frozen for 3 to 12 months. In contrast, oLH, bLH, and pLH competed minimally for 125I-hLH and 125I-hCG binding sites in homogenates of fresh human corpora lutea. Ovine follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH) did not compete in homogenates of fresh or frozen tissue. Competition of oLH and hCG for 125I-hCG binding sites at several dose levels in a homogenate of a fresh corpus luteum was studied. One hundred micrograms of oLH and ten nanograms of hCG gave an equivalent competition--a 10,000-fold difference in competitive potency. Only hCG competed with 125I-hCG for binding when the competition of oLH, bLH, pLH, oFSH, oTSH, hCG and hCG subunits, and hCG were compared at the 10-mug level in a homogenate of fresh human corpus luteum. The binding of 125I-labeled homologous human hormones by the corpus luteum was examined in a limited fashion. 125I-Prolactin did not bind to preparations of fresh stroma from a patient with polycystic ovaries nor did it bind to three separate preparations of fresh corpora luteum which did bind 125I-hCG. 125I-hTSH did not show significant binding to a fresh human corpus luteum preparation which did bind 125I-hCG. These studies indicate that the gonadotropin receptor of the fresh human corpus luteum possesses a unique species specificity and illustrate the importance of working with human corpora lutea in their most native state.

Binding, Competitive↗