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Biomedical subjects

K D Hatch

Publications and source records attributed to K D Hatch.

124 records · Page 7Linked to original sources
PubMed1981

Cryosurgery of cervical intraepithelial neoplasia.

Nine hundred sixty-eight patients with cervical intraepithelial neoplasia (CIN) were evaluated with colposcopy and treated with cryosurgery; 722 had a pretreatment diagnosis of CIN I or II and 246 had CIN III. Of those patients available for 2 follow-up smears, histologically proved persistence of CIN was found in 10% of patients with CIN I and II and 20% of patients with CIN III. Recurrent disease was detected in 3.2 and 3.8%, respectively. No patients had a recurrence after 5 negative Papanicolaou smears. One patient had invasive carcinoma 30 months after treatment. Failure of patients to return for follow-up was a significant problem. When the present results were compared to those published in the literature, cryosurgery was found to be less effective than conization in treating CIN III.

Carcinoma, Squamous Cell↗
PubMed1980

Verrucous lesions of the female genitalia. I. Giant condylomata.

Small condylomata acuminata are easily diagnosed clinically and are not often difficult to treat. Giant condylomata, however, can pose real problems in diagnosis and treatment. They must be distinguished from verrucous carcinomas or giant condylomata with squamous malignant change. Large biopsy specimens that include the stroma are necessary in order to make the correct diagnosis, since these entities have somewhat similar histologic features. Treatment should be surgical because radiation and podopyhyllum have both proved to be of little benefit. Surgical removal also allows excellent pathologic study to determine the presence of squamous malignant change or verrucous carcinoma.

Condylomata Acuminata↗
PubMed1980

Verrucous lesions of the female genitalia. II. Verrucous carcinoma.

Verrucous carcinoma is a variant of squamous cell carcinoma that often presents as a large cauliflower-like lesion with locally destructive growth. A high index of suspicion on the part of the clinician and pathologist is needed for an accurate diagnosis since the pathologic findings may be benign on an individual cell basis or may even resemble those of a condyloma. Deep biopsy that includes the base of the lesion is needed for accurate histologic diagnosis, and the pathologist should be aware of the aggressive nature of the lesion. The treatment of choice is surgical, with wide local excision being sufficient in most cases. Radiotherapy often fails to eradicate the lesion and may even cause it to become more anaplastic.

Carcinoma, Papillary↗
PubMed1980

Elevated titers of the beta subunit of human chorionic gonadotropin in oophorectomized women being treated for trophoblastic disease.

Radioimmunoassay has shown a cross-reaction of the beta subunit of human chorionic gonadotropin (HCG) with high levels of luteinizing hormone (LH) in the serum of four women who underwent bilateral oophorectomy as part of their treatment for trophoblastic disease. Administration of oral contraceptives led to suppression of the LH and beta subunit HCG titers.

Adult↗
PubMed1980

Prognostic significance of age in stage I carcinoma of the cervix.

Controversy exists as to the influence of age on the prognosis of patients with carcinoma of the cervix. We present a series of patients with International Federation of Gynecology and Obstetrics (FIGO) stage I squamous cell carcinoma of the cervix, who were treated at a single institution with uniform radiation technics or radical surgery. A multifactorial analysis showed that age above or below 40 was not of prognostic significance after adjusting for race, substage, and treatment. Equal five-year survival was obtained by either radiation therapy or radical surgery. Complications in patients treated with radiation therapy appeared to be more serious than those in the surgical group. Theoretical reasons are advanced to favor surgical management in younger patients.

Adult↗
PubMed1979

The Swan-Ganz catheter and management of patients undergoing pelvic exenteration.

A Swan-Ganz catheter has been used in 10 consecutive patients undergoing pelvic exenteration and has made the intraoperative and postoperative management of these patients a much easier task. Use of this catheter eliminates the guesswork involved in managing fluid and volume status by providing an accurate assessment of left ventricular end diastolic pressure. The complication rate is reported as 5% and consists mostly of ruptured balloons, infection, coiling of the catheter, and cardiac irritability. There have been no complications in the 10 patients in whom we have used the catheter. We believe that the use of the Swan-Ganz catheter in these difficult-to-manage patients is justified because of its low complication rate, easy use, and the accurate valuable information obtained.

Cardiac Catheterization↗
PubMed1978

Southern Regional Trophoblastic Disease Center, 1972--1977.

The experience of the Southern Regional Trophoblastic Disease Center includes 222 patients who were referred from January 1972 to October 1977. The initial tissue diagnosis was hydatidiform mole in 212 patients and choriocarcinoma in ten. There was spontaneous remission of 142 (69%) of the moles and one of the choriocarcinomas, and 77 patients developed persistent trophoblastic disease. Of these, 58 had no evidence of metastasis, and all achieved remission with single-drug therapy. Nineteen patients developed metastases; 13 were in the "good prognosis" category, and all achieved remission with single-drug therapy. Five (83%) of the six patients with metastases in the "poor prognosis" group achieved remission with triple chemotherapy; one died of her disease.

Cancer Care Facilities↗
PubMedDate not supplied

Folate deficiency and cervical dysplasia.

OBJECTIVE: To test the hypothesis that nutritional deficiency affects the incidence of cervical dysplasia in young women. DESIGN AND SETTING: Case-control study. Participants were derived from community family-planning clinics and referrals to a colposcopy center. PARTICIPANTS: A total of 726 subjects were screened, yielding 294 cases of dysplasia and 170 controls defined by coexistent cytologic and colposcopic evidence. MAIN OUTCOME MEASURES: Planned prior to data collection. Odds ratios were computed using logistic regression models to evaluate association between cervical dysplasia and sociodemographic, sexual, and reproductive factors; smoking; oral contraceptive use; human papillomavirus (HPV) infection; and 12 nutritional indices determined by blind analysis of nonfasting blood specimens. RESULTS: The number of sexual partners, parity, oral contraceptive use, and HPV-16 infection were significantly associated with cervical dysplasia. Plasma nutrient levels were generally not associated with risk. However, red blood cell folate levels at or below 660 nmol/L interacted with HPV-16 infection. The adjusted odds ratio for HPV-16 was 1.1 among women with folate levels above 660 nmol/L but 5.1 (95% confidence interval, 2.3 to 11) among women with lower levels. Interactions of red blood cell folate levels with cigarette smoking and parity were also present but were not statistically significant. CONCLUSION: Low red blood cell folate levels enhance the effect of other risk factors for cervical dysplasia and, in particular, that of HPV-16 infection.

Adolescent↗
PubMedDate not supplied

Uterine corpus and cervical cancer.

Cancers of the cervix and uterus occur in approximately 50,000 women each year in the United States. As a group, these cancers represent our sixth most common cancer overall, are second only to breast cancer, and are roughly equal to the lung cancer incidence in women. Although they comprise 11% of all cancers in females, they represent only 4% of cancer deaths in women. This results from the effective application of surgery and radiation therapy in the management of these two malignancies as well as effective techniques for early diagnosis. The overall death rate from these two malignancies has decreased more than 70% in the last 40 years. Successful outcome rests on both early diagnosis and the careful application of established treatment approaches. This monograph summarizes the management approaches to both uterine corpus and cervical cancer and discusses the role of adjuvant therapy for these major malignancies. Detailed presentations of the management of special problems, including the uterine sarcomas, are also presented. Although standard management approaches are detailed, discussion of experimental approaches, including adjuvant hormonal treatment, single agent and combination chemotherapy, and the use of radiation sensitizers is included.

Combined Modality Therapy↗