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J G Stolk

Publications and source records attributed to J G Stolk.

At least 19 recordsLinked to original sources
PubMed1990

Endocervical curettage by Vabra aspiration as part of colposcopic evaluation.

Endocervical curettage as routine part of colposcopic examination in patients with abnormal cervical cytology is recommended by many experts. Endocervical curettage (ECC) by Vabra aspiration has never been reported in literature. The results of Vabra ECC in 103 patients are analyzed and compared to the results of a second endocervical specimen, obtained by conventional curettage, cone biopsy, or hysterectomy. An accordance of over 98% is demonstrated and the difference is discussed. In 88% and 71% adequate Vabra ECC specimens were available for cytological and histological examination, respectively. In any patient at least one result was present. Both cytological and histological specimens are of reliable quality. No cases of invasive (adeno)carcinoma were missed. In addition, the results are compared to literature data concerning Vabra aspiration for endometrial disease and ECC by other techniques. Vabra ECC is considered an efficient, safe, and well-tolerated diagnostic outpatient method and recommended as a standard part of colposcopic evaluation.

Adult↗
PubMed1989

Importance of steroid receptors and aromatase activity in the prognosis of ovarian cancer: high tumor progesterone receptor levels correlate with longer survival.

The presence of steroid receptors (82 tumors) and aromatase activity (39 tumors) in ovarian carcinomas was correlated with patient survival. No statistically significant correlation was found between the presence or absence of estrogen receptors (ER, 56.1%), progesterone receptors (PR, 57.3%), androgen receptors (AR, 91.5%), or aromatase activity (33.3%) and survival. However, high levels of PR were associated with better survival (P less than 0.05). Furthermore, there was a tendency for patients with advanced disease and PR-positive tumors to have better survival than those with advanced disease and PR-negative tumors (P = 0.13). Patients with tumors that did not contain any of the receptors and those in which ER and AR were absent, or in which PR and AR were absent, had poor survival. It is concluded that receptor status, especially of PR, may be of prognostic importance and that status of receptors and aromatase activity may become useful in selecting ovarian cancer patients for endocrine therapy.

Adenocarcinoma↗
PubMed1987

Androgen receptor predominance in human ovarian carcinoma.

Cytosols of 94 untreated common epithelial ovarian cancer tissues were analysed for the presence of estrogen-, progesterone- and androgen receptors. Androgen receptors clearly predominated (90%) over and above estrogen- (55%) and progesterone receptors (52%). Further characterisation particularly of the androgen receptor revealed steroid-receptor complex with the sedimentation coefficient similar to ovalbumin (3,6 S). Only androgens, natural and synthetic, were able to alter the sedimentation profile. Estrogen appeared to slightly lower the peak, while progesterone and cortisol did not alter the profile at all. No difference in receptor concentrations between tumor tissues from pre-, peri- and postmenopausal women was found. The serum hormone levels (estradiol-17 beta, testosterone, FSH, LH) measured preoperatively in 20 postmenopausal patients did not correlate with the receptor status. Majority of the ovarian carcinomas studied contained androgen receptors. We therefore suggest consideration of the addition of anti-androgens to the therapeutic strategies applicable to ovarian cancer.

Adolescent↗
PubMed1987

The accuracy of colposcopically directed biopsy in diagnosis of CIN.

During the last decade there has been an increasing interest in the use of the colposcope. A quality-control study for the evaluation and understanding of the limitations of cytology and colposcopy in our clinic is presented. The results in 132 patients are analysed and compared to previous reports from the literature. Cytologic results correlated with the histological diagnosis only in 47% of the patients. Colposcopically directed biopsies were accurate in 88.8% when the entire squamocolumnar junction was visualized. The accuracy of the directed biopsies in patients with unsatisfactory colposcopy was 58.3%. In the presence of a Gardnerella vaginalis cervicitis the colposcopic accuracy decreased to 70.9%.

Adult↗
PubMed1987

Estrogen synthesizing rare malignant Brenner tumor of the ovary with the presence of progesterone and androgen receptors in the absence of estrogen receptors.

A case of a malignant Brenner tumor of a postmenopausal woman presenting with vaginal bleedings is described. Clinical and laboratory findings demonstrated estrogenic secretory function and action. The presence of aromatase activity based on in vitro tumor microsomal metabolism of androgen to estrogen is described. Tumor cytosol contained progestin and androgen binding components in the absence of estrogen binding activity. Estrogen binding activity was undetectable both by biochemical as well as histochemical assays.

Aged↗
PubMed1987

Prognostic factors in borderline and invasive ovarian tumors of the common epithelial type.

Present reports show that surgical factors, response to therapy and histological criteria are important for predicting the prognosis of patients with common epithelial types of ovarian tumors. Newer techniques such as morphometry, DNA cytometry, immunological and immunopathological techniques may help to define prognostic factors even more accurately. As a result, these recently developed methods may enhance the value of well-established classical predictors of the outcome in case of borderline or invasive ovarian tumour.

Carcinoma↗
PubMed1987

Correlation of multiple steroid receptors with histological type and grade in human ovarian cancer.

One hundred eight human ovarian cancers were analyzed for estrogen (ER), progestin (PgR), and androgen (AR) receptors. The receptor levels were related to histological type and grade of the tumor. There were 103 common epithelial carcinomas subdivided into serous (36), endometrioid (36), mucinous (18), clear cell (5), malignant Brenner (3), mixed epithelial (2), and undifferentiated (3) types. Of the remaining five, four were sex cord-stromal tumors and there was a single case of germ cell tumor. ER was detected in 52%, PgR in 52%, and AR in 91% of the cases. There was no correlation between the presence of ER and AR and the tumor histology. The presence of PgR correlated with the grade of endometrioid carcinoma, while no clear correlation existed for the other tumor types. PgR was absent in the three undifferentiated carcinomas. Interestingly, high PgR levels were detected in the three granulosa cell tumors.

Adenocarcinoma↗
PubMed1987

Relation of quantitative features of visually normal intermediate cells in cervical intraepithelial neoplasia I and II smears to progression or nonprogression of the lesion.

The relationship between the quantitative features extracted from digitized images of visually normal intermediate cells in cervical intraepithelial neoplasia (CIN) I and II smears and the subsequent follow-up diagnosis was studied. Using the ISPAHAN interactive system of pattern recognition, the average rate of correct classification of progressive or nonprogressive lesions was 80% at the specimen level. It is concluded that additional diagnostic information regarding the probability of progression of CIN I and II lesions may be obtained by studying the microphotometric features of visually normal intermediate cells in the cervical smears. Significant differences were found between intermediate cells close to obviously dysplastic cells and those at a distance. The implication of this finding and the problems involved in the selection of the cells are briefly discussed.

Female↗
PubMed1986

Invasive mole.

A case of persistent trophoblastic disease with resistance to chemotherapy is presented. The value of continued and frequent serum hCG measurements in such cases is discussed as well as the indications for performing hysterectomy.

Adult↗
PubMed1986

Predictive value of a positive endocervical curettage in diagnosis and treatment of CIN.

Predictive values of endocervical curettage (ECC) in the investigation of patients with abnormal Pap-smears were calculated with regard to a second histological diagnosis and with regard to results of conservative treatment of CIN. By using the combined follow up data of all 290 patients with colposcopically directed biopsies and ECC, the predictive value of a positive ECC for invasive cancer in patients with satisfactory colposcopy was 2%, and for unsatisfactory colposcopy 15%. Predictive value of a negative ECC was 100% in patients with satisfactory colposcopy, and 98% for unsatisfactory colposcopy. It is concluded that ECC should be used routinely in the investigation of patients with abnormal Pap smears. However, a positive ECC is not considered an absolute contraindication to conservative treatment, provided that colposcopy is satisfactory, that there is no suspicion of invasive cancer, and that a strict follow-up scheme can be maintained during the first year.

Biopsy↗
PubMed1986

Masking effect of hormonal contraceptives on discriminating quantitative features of visually normal intermediate cells in positive and negative cervical smears.

In quantitative studies of visually normal intermediate cells in smears from patients with cervical neoplasia, the contraceptive status of the patients has not previously been taken into account. In this study cervical smears from 151 patients with cervical intraepithelial neoplasia (CIN) III or invasive carcinoma and from 360 normal controls were grouped according to week of menstrual or pill cycle and mode of hormonal contraception. The nuclear-cytoplasmic (N/C) ratio of visually normal intermediate cells in smears from patients with neoplasia was significantly different from that of the normal controls (P less than .001). Based on nuclear area and N/C ratio, the percentages of intermediate cells correctly classified as having come from positive or negative smears were significantly better in women with ovulatory cycles (non-users) than in women using hormonal contraceptives (P less than .025). It is concluded that hormonal contraceptives can mask the salient quantitative features of visually normal intermediate cells from patients with CIN and the contraceptive status thus has to be taken into account in such studies.

Carcinoma↗
PubMed1985

Quantitative morphology. A study of the trophoblast.

It is difficult to predict the possible development of a malignant trophoblastic tumor after the evacuation of a hydatidiform mole. In order to help resolve this difficulty, a morphometric study has been carried out. The mean nuclear area of the trophoblast in a group of hydatidiform moles, followed by a trophoblastic malignancy, was found to be statistically significantly larger than that of the trophoblast in a group of hydatidiform moles which were not followed by malignant trophoblastic disease. However, the mean trophoblast/nontrophoblast ratio in villi demonstrated no statistically significant difference between those 2 groups of hydatidiform moles. Therefore it is not advisable to grade hydatidiform moles on the basis of trophoblastic proliferation alone. It is suggested that the trophoblastic lining of hydropic villi in the placental tissue of hydatidiform moles has malignant features already, but these are more pronounced in those hydatidiform moles which are subsequently followed by a choriocarcinoma.

Choriocarcinoma↗
PubMed1985

The involvement of dendritic cells in the handling of the immune stimulant C. parvum. A morphological investigation using immunoperoxidase techniques.

In earlier experiments we showed that locally administered Corynebacterium parvum (C. parvum) stimulated the T-cell system and had a beneficial effect on the recurrence rate of surgically resected cancers of the uterine cervix. In this paper we report the use of an immunoperoxidase technique to trace C. parvum antigen in the draining lymph nodes. In a guinea pig model the popliteal lymph node was studied after the injection of 70 micrograms of C. parvum in the hind footpad. At 6 h, intact bacteria were detected in sinus histiocytes. A transient granuloma formation was apparent between days 2 and 6, originating in the subcapsular and interfollicular areas. Three antigen-positive cell types were observed in these granulomas: a) cytophagocytic macrophages which were weakly positive, the antigen being distributed in clumps; b) dendritic cells with a strong, fine-granular positivity and c) some epithelioid cells with a small positive cytoplasmic rim. The majority of epithelioid cells was negative. Antigen-positive dendritic cells were also observed just beyond the granulomas in the T-dependent paracortical area. These cells are known as interdigitating cells (IDC) and present antigen to T-cells. Ten days following C. parvum injection the lymph node follicles became positive and the antigen could be detected in the long cellular protrusions of the dendritic reticulum cells (DRC). DRC probably play a part in immunological memory by trapping antigen in the form of immune complexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Fluctuations in quantitative features of intermediate cells in normal cervical smears during the menstrual cycle of ovulating women and contraceptive users.

In this study we report on the variation in nuclear and cytoplasmic size of intermediate cells in normal cervical smears, in relationship to the week of the menstrual cycle and in relationship to the mode of contraception. A total of 18000 cells from 360 different women was studied. A significant difference in nuclear size of intermediate cells in smears from ovulating women not using contraception was found in comparison with intermediate cells in smears from women using contraceptive pills (ANOVA: F(1.312) = 4.98, p less than 0.02). Also a significant difference in the nuclear size of intermediate cells in smears from women using norgestrel- (or levonorgestrel)-containing formulas compared with lynestrenol-containing formulas was found (ANOVA: F(1.232) = 5.82, p less than 0.01). The influence of exogenous and endogenous hormones on cell populations in cervical smears is discussed. It is concluded that in studies on intermediate cells in cervical smears the contraceptive status of the women has to be taken into account.

Adult↗
PubMed1985

Laser or cryotherapy for cervical intraepithelial neoplasia: a randomized study to compare efficacy and side effects.

A randomized study was performed to compare efficacy and side effects of laser and cryotherapy: 51 patients were treated with laser vaporization and 50 patients with cryotherapy. Success rates for laser and cryotherapy were not significantly different. Success rates were significantly related to lesion size. Grade of CIN, positive endocervical curettage, parity, and age at treatment were not found to be related. Vaginal discharge, both in duration and amount, was significantly less in patients treated with laser vaporization, compared with cryotherapy, but pain and bleeding occurred more often in patients treated with laser vaporization. A brief review of possible sources of bias in comparative studies on laser and cryotherapy is given, indicating the preference for a randomized study. It is concluded that widespread introduction of laser facilities in smaller centers is not justified, because the success rates are not better than those of cryotherapy, and because the advantages of less discharge are outweighed by the high cost.

Adult↗