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Biomedical subjects

M Altaras

Publications and source records attributed to M Altaras.

At least 37 records · Page 2Linked to original sources
PubMed1996

Low molecular heparin (Enoxaparin) as an alternative treatment of acute deep venous thrombosis in gynecologic oncology patients.

While heparin has been the standard treatment in established deep vein thrombosis (DVT), it carries associated potential hazards of hemorrhage and induction of thrombocytopenia. Enoxaparin (Rhone-Poulenc Rorer Pharm. Inc., France) is a low molecular weight heparin which has antithrombotic properties, and has been demonstrated effective in prophylaxis of DVT, apparently without severe treatment related bleeding complications. Six patients with genital malignancies, presenting with Doppler sonography confirmed deep venous thrombosis, were treated with Enoxaparin. A uniform dosage of 2 mg/kg/day in two divided doses was administered subcutaneously for 10 days during hospitalization and then continued on an out-patient basis. The clinical symptoms of venous thromboses diminished in all six patients. Enoxaparin represents an effective treatment of DVT, with the potential advantage of a lessening hemorrhagic complications. With administration of low molecular heparin, the activated partial thromboplastin time (aPTT) is not dramatically altered, making laboratory monitoring unnecessary. Our clinical findings demonstrate an easily applied therapy for gynecologic oncology patients, which is potentially safer to use, less costly, and less dependent on laboratory monitoring than the normal regimen.

Adult↗
PubMed1994

Characterization of the prenylated protein methyltransferase in human endometrial carcinoma.

The processing of ras and of other GTP-binding proteins includes a final reversible step in which the carboxy terminal prenylated cysteine is methylated by the enzyme prenylated protein methyltransferase (PPMTase). The significance of this modification and of the role of PPMTase in human tumors has yet to be fully elucidated. Here we characterize the PPMTase of human endometrial carcinomas (tumors in which the frequency of ras gene mutations is relatively high) and compare it to the PPMTase of the normal endometrium. Our results show that in both types of tissues the enzyme is bound to the membranes. It can utilize synthetic substrates such as N-acetyl-S-farnesyl-L-cysteine (Km = 18-20 microM) and is blocked by the PPMTase inhibitor S-farnesylthioacetic acid (Ki = 2 microM). In vitro methylation assays and [alpha-32P]GTP blot-overlay assays showed that the major endogenous PPMTase substrates are small GTP-binding proteins. Methylation of these proteins in vitro is blocked by farnesylthioacetic acid. The kinetic properties of PPMTase from the carcinomas and the normal tissues are very similar. However, levels of PPMTase activity (but not of its endogenous substrates) are higher in the carcinomatous endometrium than in the normal one. The elevated enzyme activity is restricted to the crude mitochondrial fraction (8.0 +/- 0.4 vs. 5.4 +/- 0.1 pmol N-acetyl farnesylcysteine methyl ester formed/min/mg protein by the carcinoma and by the normal endometrial preparations, respectively). As this fraction is enriched in plasma membranes, it appears that the elevated enzyme activity could be related to ras protein methylation; if so, selective methylation blockers might inhibit the growth of endometrial carcinomas.

Endometrial Neoplasms↗
PubMed1994

Continuous tamoxifen treatment in asymptomatic, postmenopausal breast cancer patients does not cause aggravation of endometrial pathologies.

Adjuvant tamoxifen therapy for breast cancer patients has been found to be associated with various endometrial pathologic conditions, including endometrial cancer. This preliminary case control study evaluated whether prolonged and continuous exposure to tamoxifen in the menopause may aggravate existing endometrial pathologies. Two vaginal ultrasound evaluations of endometrial thickness and histologic findings of two endometrial biopsies, performed 18 months apart, were evaluated for 25 asymptomatic, postmenopausal breast cancer patients who were continuously treated with tamoxifen. In the first endometrial biopsy, 4 patients (16.0%) were found to have endometrial pathologies: 2 patients had proliferative endometrium, 1 had hyperplastic endometrium, and 1 had an endometrial polyp. In the second endometrial biopsy, none of these patients showed any endometrial pathologies. Another patient (4.0%) with no endometrial pathology in the first visit had endometrial hyperplasia in the second visit. None of the patients developed endometrial cancer, and generally there was no increase in ultrasonographically-measured endometrial widths. The results of this preliminary study may suggest that there is no increased risk of development of endometrial pathologies during an additional 18 months of continuous tamoxifen therapy nor is there aggravation of already existing endometrial pathologies.

Aged↗
PubMed1994

The role of color Doppler flow in the management of nonmetastatic gestational trophoblastic disease.

Three patients with findings suggestive of invasive gestational trophoblastic neoplasm and lung metastasis were assessed by color Doppler transvaginal ultrasound, before and during chemotherapy. The sonographic findings were correlated with beta-hCG levels measured at various stages of treatment. Results were compared with blood flow indices found during normal first trimester pregnancies, and those following elective termination of pregnancy. The mean resistance indices were significantly lower in the patients treated with chemotherapy (0.410 +/- 0.04) than in the early pregnancy control group (5-8 weeks gestation; n = 20, resistance index = 0.494 +/- 0.06). The difference between the groups was statistically significant (chi 2; p < 0.05). No pathological flow patterns could be discerned in 10 patients, who after termination of pregnancy had beta-hCG levels below 5 IU/ml. The response of gestational trophoblastic neoplasms to chemotherapy could be reliably assessed by observing the changes in flow resistance, which paralleled the gradual decrements in serial measurements of beta-hCG levels. Thus, the statistically significant results of our study are very encouraging and may indicate that color Doppler flow is a noninvasive, reproducible, useful and highly reliable new diagnostic approach for the diagnosis and management of patients suffering from uterine malignant gestational trophoblastic disease.

Animals↗
PubMed1994

Estrogen and progesterone receptor expression of decidual endometrium in a postmenopausal woman treated with tamoxifen and megestrol acetate.

To the best of our knowledge, this is the first report of in vivo endometrial estrogen and progesterone receptor induction as a result of tamoxifen exposure in a postmenopausal breast cancer patient. The following observations, that the postmenopausal endometrium is sensitive to tamoxifen, that this agent can act as an estrogen-like substance, and that it may cause proliferation of the endometrium in the absence of progestin, may explain the endometrial decidual changes described herein as a protective mechanism against possible neoplastic endometrial changes.

Breast Neoplasms↗
PubMed1994

Doppler flow evaluation of pathologic endometrial conditions in postmenopausal breast cancer patients treated with tamoxifen.

A prospective pilot study was conducted to evaluate the usefulness of uterine artery blood flow in the detection of various pathologic endometrial conditions in 39 asymptomatic postmenopausal breast cancer patients who were treated with tamoxifen. No specific pattern was seen for the uterine artery pulsatility index values in the tamoxifen-treated patients that could be related to any specific endometrial lesions, nor were any specific changes observed in the pulsatility index value with increasing severity of the pathologic endometrial conditions. Similarly, no correlation was found between ultrasonographically measured endometrial widths and uterine artery pulsatility index values. Thus, although pulsed Doppler flow ultrasonography has been shown previously to be effective in the detection of uterine cancer in non-tamoxifen-treated post-menopausal patients, it probably does not contribute to the assessment of endometrial lesions in post-menopausal breast cancer patients treated with tamoxifen.

Arteries↗
PubMed1994

Penile condylomata: a gynecological epidemic disease: a review of the current approach and management aspects.

Viral venereal infection caused by human Papillomavirus has reached epidemic state. The proper management of this infection in men is of great benefit, because it may possibly decrease the reservoir of disease in both sexes from which genital condylomata and associated lesions may arise. We report a selection of current knowledge about the epidemiology, etiology, diagnosis, and treatment of male condyloma, occurring predominantly among male consorts of women with genital human Papillomavirus infection. In a review of 1455 affected women, compiled from the literature, 1019 (70 per cent) of their sexual partners were diagnosed as having been infected with the same viral disease. The current diagnostic and treatment modalities and their outcomes are discussed with appropriate recommendations for their use.

Algorithms↗
PubMed1993

Direct in-vivo detection of atypical hormonal expression of a Sertoli-Leydig cell tumour following stimulation with human chorionic gonadotrophin.

A 60-year-old woman presented with progressive hirsutism and elevated serum testosterone levels. Selective bilateral ovarian and adrenal vein catheterization demonstrated mild elevated testosterone and androstenedione levels in the right ovarian vein, which increased considerably 15 minutes following intravenous injection of 5000 IU human chorionic gonadotrophin. Androgen levels decreased remarkably after administration of gonadotrophin hormone releasing hormone-agonist (GnRH-a). On histological examination, diffuse stromal hyperplasia of both ovaries was noted, with a small Sertoli-Leydig cell tumour in the right ovary. This is the first report of preoperative, direct selective diagnosis of a small Sertoli-Leydig cell tumour with such a hormonal expression. Ovarian Sertoli-Leydig cell tumours are rare sex cord stromal tumours that exhibit testicular-like structure and differentiation. These tumours are potentially malignant, can cause progressive virilization (Young & Scully, 1985), and are often clinically manifested as palpable pelvic masses and virilization (Meldrum & Abraham, 1979; Friedman et al., 1985). We describe a patient with postmenopausal virilization due to Sertoli-Leydig cell tumour, in whom a remarkable increase in androgens was detected following intravenous human chorionic gonadotrophin injection, during adrenal and ovarian selective vein blood sampling. A remarkable decrease in the serum androgen level was noticed following an injection of gonadotrophin hormone releasing hormone-agonist (GnRH-a).

Androgens↗
PubMed1989

Advanced primary ovarian carcinoma in pregnancy.

A case of advanced ovarian carcinoma in pregnancy is described. The entity is usually difficult to diagnose; when it does occur, the objective should be to optimize both fetal and maternal outcome.

Adult↗
PubMed1988

Serum-specific antibodies for Chlamydia trachomatis in premature contractions.

A case-control study was undertaken to examine the possible morbidity associated with Chlamydia trachomatis in 28 pregnant women having idiopathic premature contractions, in 35 healthy preterm pregnant women, and in 43 healthy pregnant women at term. Serum C. trachomatis IgG- and IgA-specific antibodies were determined by the single serovar inclusion immunoperoxidase assay. There were no significant differences in the prevalence rate of elevated C. trachomatis IgG-specific antibodies (titer greater than or equal to 1:128) between pregnant women suffering from idiopathic premature contractions as compared with healthy preterm and term pregnant women (11%, 28%, and 26%, respectively). The known prevalence rate in a normal healthy population is 23%. The prevalence rate of elevated C. trachomatis IgA-specific antibodies (titer greater than or equal to 1:16) was significantly lower in the pregnant women with idiopathic premature contractions as compared with the healthy preterm and term pregnant women (0%, 20%, and 17%, respectively; p less than 0.002 and p less than 0.012). These findings do not support the assumption that C. trachomatis has a role in premature contractions.

Adult↗
PubMed1988

Huge mesenteric mucinous cystadenoma in normal pregnancy.

A 36-year-old woman required laparotomy early in the puerperium after a normal delivery because of the presence of a large abdominal cyst. At laparotomy, a large mucinous cystadenoma was found attached to the root of the ileal mesentery; the ovaries were normal. This is the third case of mesenteric cyst published in association with pregnancy, but the first with a mucinous pattern. Pathologic aspects, possible complications, and treatment are discussed.

Adult↗