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Biomedical subjects

R I Demopoulos

Publications and source records attributed to R I Demopoulos.

At least 55 records · Page 3Linked to original sources
PubMed1989

Immunocytochemical staining patterns of placentas associated with hydrops fetalis.

This study examined the morphology and immunocytochemical staining patterns of distribution of beta-human chorionic gonadotropin (beta-HCG), human placental lactogen (HPL), placental alkaline phosphatase (PLAP), and pregnancy-specific beta-1 glycoprotein (SP1) in 13 third-trimester placentas associated with hydrops fetalis and six normal control placentas matched for gestational age (+/- 2 weeks). Seven placentas were hydropic (540-1,080 g) and demonstrated histologic immaturity with large edematous chorionic villi showing few blood vessels, most of which contained immature hematopoietic elements. These placentas showed consistently increased staining for beta-HCG and decreased staining for PLAP when compared with control placentas, a pattern reminiscent of less mature placentas. HPL and SP1 staining were similar to those of controls. Six placentas were either sclerotic (four) or histologically unremarkable (two), and these did not differ in their immunocytochemical staining properties from control placentas. We conclude that third-trimester hydropic placentas, in addition to showing histologic immaturity, exhibit an immunocytochemical staining pattern associated with first-trimester placentas.

Chorionic Gonadotropin↗
PubMed1989

Placental protein distribution in maternal diabetes mellitus: an immunocytochemical study.

Placentas associated with maternal diabetes are generally characterized by features of villous immaturity. We correlated the villous histology with the immunocytochemical distribution of four trophoblastic proteins: beta human chorionic gonadotropin (beta HCG), placental alkaline phosphatase (PLAP), pregnancy specific beta-1-glycoprotein (SP1), and human placental lactogen (HPL) in 14 third-trimester placentas associated with diabetes mellitus. Staining was increased for beta HCG and decreased for PLAP, SP1, and HPL in the diabetic placentas compared to control placentas of similar gestational age. This pattern was most prominent in areas of marked architectural villous immaturity within individual placentas and suggests concomitant functional immaturity.

Alkaline Phosphatase↗
PubMed1987

Secondary ovarian carcinoma: a clinical and pathological evaluation.

A retrospective clinical and pathological analysis was performed of 96 patients with secondary ovarian carcinoma diagnosed between January 1972 and June 1985 at New York University Medical Center. Secondary tumors accounted for 17.4% (96/553) of ovarian malignancies. The most common sites of origin were breast (32 cases), unilateral ovary (with contralateral metastases) (20), endometrium (14), colon (12), stomach (6), cervix (2), ileum (2), and 1 each for 8 additional sites. The patients ranged in age from 19 to 87 years, averaging 54.8 years, and 55 patients were postmenopausal. Ninety percent of the patients had extraovarian metastases at the time of abdominal surgery. The ovarian metastases tended to be bilateral for breast, colon and stomach, and unilateral for endometrial and ovarian primary sites. The metastases tended to be solid except for colon. The overall survival rate was 24.1% at 5 years and 7.1% at 10 years. Comparison of median survival times for the various major primary sites showed a significant overall difference (p = 0.04) and was as follows: gastric primary 0.79 years, breast 1.9 years, ovary 2.0 years, colon 3.0 years, and endometrium 3.4 years. Postmenopausal patients with unilateral ovarian carcinoma and contralateral metastases had a significantly (p = 0.04) longer median survival time (4.2 years) than analogous premenopausal patients (1.3 years). For breast and endometrium, menopausal status was not significantly associated with survival differences. These findings should prove useful in the differential diagnosis of ovarian tumors and in the medical management of these patients.

Adult↗
PubMed1986

The evaluation of the omentum in ovarian cancer.

Little published data exists on omental evaluation in ovarian cancer. In a retrospective study we reviewed 334 consecutive operations for adnexal masses; 159 had ovarian cancer, and 119 omentectomies were performed, with complete information available on 109. Mean omentectomy was 203.5 cm2 (normal omentum = 792 cm2) and 190 g, with a significant correlation of weight to size. Secondary ovarian cancer was present in 66 omenta (61%). All 32 omenta examined in the pathology laboratories and described as grossly involved with tumor had ovarian cancer histologically. Of the 55 grossly negative omenta, 12 had histologically proven tumor (22%). Slide review of the grossly negative, histologically positive omenta revealed the mean tumor diameter to measure 6.7 mm. Lymph node dissection occurred in 16 patients and was positive in 10, with simultaneous absence of tumor in the omenta of 3 of these patients. Conversely, 2 patients with positive omenta had negative lymph nodes. The optimal extent of omental resection and histological examination remains undetermined.

Diagnostic Errors↗
PubMed1986

Prognostic significance of squamous differentiation in stage I endometrial adenocarcinoma.

The prognostic implication of benign and malignant squamous differentiation was examined in 267 consecutive patients with stage I endometrial carcinoma. Patients with adenosquamous carcinoma had a significantly poorer ten-year survival rate (54.7%) than patients with adenocarcinoma (70.5%) or adenoacanthoma (87.4%). This was related to a tendency for adenosquamous carcinoma to be associated with poorly differentiated glandular elements and to deeply invade the myometrium. The mean depth of myometrial penetration was 57% for adenosquamous carcinoma compared with 24% for adenocarcinoma and 19% for adenoacanthoma. To examine the prognostic significance of malignant squamous differentiation independently of the grade of the associated glandular component, the subgroup of patients with well-differentiated adenocarcinoma was compared. Patients with well-differentiated adenosquamous carcinoma persisted in having a worse prognosis (58.3% ten-year survival rate), compared with adenocarcinoma (84.3% ten-year survival rate), which was explained by the propensity of adenosquamous carcinoma to deeply invade the myometrium.

Actuarial Analysis↗
PubMed1986

Vulvovaginal melanoma. A clinicopathologic study.

A retrospective study was done on 14 patients with vulvar and vaginal melanoma treated at the New York University Medical Center from 1972 through 1984. Pathologic evaluation included a measurement of tumor volume, tumor thickness, growth pattern and cell type. The most common morphologic appearance was a superficial spreading growth pattern with a nevoid cell type, which seemed to correlate with a favorable outcome. Nodular growth pattern with an epithelioid cell type was less common and associated with a poorer prognosis and inguinal lymph node metastases. No patient had deep pelvic node metastases. Tumor thickness, as measured with Breslow's method, was inversely related to survival, as previously reported. We were able to define a low-risk group of patients, with tumor volume under 100 mm3. It appears that tumor volume, in addition to thickness and growth pattern, can contribute to the evaluation of vulvar melanoma. Evaluation of our findings in conjunction with those in the literature on cutaneous and vulvar melanomas led us to question the routine management of these lesions with radical vulvectomy plus inguinal and pelvic lymph node dissection.

Actuarial Analysis↗
PubMed1984

Characterization and survival of patients with serous cystadenocarcinoma of the ovaries.

Factors affecting survival of 241 patients with ovarian serous carcinoma diagnosed and/or treated at New York University Medical Center from 1960 through 1980 are analyzed. Characteristics independently correlated with a favorable prognosis include low tumor stage and grade, presenting sign of a mass, and omentectomy. Patients under 50 years of age have a lower mortality rate (corrected for stage and grade) than older women. The presenting complaints of patients with a poor survival include nausea and/or vomiting, anorexia, and abdominal swelling. For patients with stage I disease neither bilaterality (stage Ib versus Ia) nor transcapsular extension of tumor adversely affected prognosis. However, patients with stage I disease with ascites appear to have a survival experience similar to patients with stage III disease.

Adult↗
PubMed1983

The fine structure of a virilizing human granulosa-theca cell tumor. Observations on the nature of the hormone producing cell.

The ultrastructure of a virilizing granulosa-theca cell tumor is reported. Although the histologic appearance is characteristic of a granulosa-theca tumor, several tumor cells contain crystalloids of Reinke which have not been associated with sex-cord-stromal tumors, but which are often present in ovarian hilus cells and Leydig cells. The steroidogenic cell in this case displays many fine structural features common to mammalian steroidogenic cells, namely abundant smooth endoplasmic reticulum, a dispersed Golgi, mitochondria with tubular cristae, and lipid droplets. Other features of this cell, which contains crystalloids of Reinke, more closely resemble those of a theca-lutein cell than a granulose-lutein or hilus cell and support a stromal origin. However, this tumor illustrates the striking overlap in morphologic features and function among granulosa, theca, hilus, and Leydig cells.

Adult↗
PubMed1983

Epithelial carcinoma of the ovary in the reproductive years: clinical and morphological characterization.

In the 10-year interval from 1972 through 1981, 247 patients were treated for epithelial ovarian carcinoma at New York University Medical Center. Of this group, 31 patients (12.6%) were below age 40, and this group had distinctive features favoring longer survival. Of these patients 12 (38.7%) had borderline tumors, compared to 9 of 216 patients (4.2%) over 40 years of age (P less than 0.001). Stage I disease and well differentiated lesions were also common in the younger group. Early symptomatology and frequent gynecologic examinations during the childbearing years may also contribute to early detection of these tumors. The median survival in this group (7 years) was better than that reported for all ages. After careful evaluation, conservative surgical management can be considered for patients with Stage Ia disease which is either borderline or grade 1 carcinoma.

Adult↗
PubMed1983

Mucinous metaplasia of the endometrium: ultrastructural and histochemical characteristics.

The histologic, ultrastructural, and histochemical characteristics of a focus of mucinous metaplasia in the endometrium of a postmenopausal woman are described and compared with normal endocervical and endometrial epithelium. While, architecturally, the simple coiled metaplastic glands resembled endometrial glands, cytologically, they resembled endocervical cells in the ultrastructural appearance of the mucin, as well as in the histochemical-staining properties of the intracellular secretory product. The location of the focal area of metaplasia in the fundus, apparently isolated from endocervical mucosa, as well as its architectural resemblance to endometrium, indicates that it originates from endometrium rather than endocervix.

Endometrium↗
PubMed1983

Endometrial carcinoma, stage II: route and extent of spread to the cervix.

The spread of endometrial carcinoma to the cervix was studied in 19 hysterectomy specimens from patients with stage II disease. None received preoperative irradiation. The tumor was found to spread in continuity from corpus to endocervix, where it involved only the surface in five patients, the surface and underlying stroma in 13, and only stroma in one case. Surface only involvement tended to correlate with a lower grade of tumor, less myometrial invasion, and a better prognosis than was associated with endocervical stromal invasion. Review of preoperative endocervical curettings, in the ten patients who underwent this fractional procedure, revealed tumor in all specimens. The authors were unable, however, to distinguish stromal involvement from surface only involvement by study of these curettings.

Carcinoma↗
PubMed1981

Infected endometriotic cysts: clinical characterization and pathogenesis.

Although endometriotic cysts are common, the occurrence of infection in these lesions has not been reported. Of 510 consecutive endometriotic cysts diagnosed at New York University Medical Center between 1965 and 1979, eleven had pathologically confirmed evidence of infection. These patients were nulliparous and had a mean age of 34.7 years at time of diagnosis and without long histories of endometriosis or pelvic infection. All were anemic. Six patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, and five patients were treated with conservative surgery. The morbidity of both groups was similar. The latter had a poor prognosis for fertility. Infected endometriotic cysts demonstrate a strong association with concomitant tubal infection and a weaker association with antecedent hysterosalpingography.

Adult↗
PubMed1981

Gonadotropic hormone binding to human ovarian tumors.

A variety of normal human ovarian tissues as well as benign and malignant human ovarian neoplasms have been examined in vitro for the presence of gonadotropin binding sites and gonadotropin-stimulable cAMP production, in order to determine whether gonadotropic hormones have an effect on ovarian tumors. Binding of either FSH or hCG, or both, was demonstrated in several tumors from each of the histologic subgroups of primary ovarian tumors, including epithelial, sex cord-stromal, and germ cell types. Cyclic AMP stimulation was found in one tumor of sex cord-stromal origin, in two of epithelial origin, in two of germ cell origin, and in one tumor-like condition, pregnancy luteoma. Additional biochemical studies are needed to characterize receptor sites and to relate them to histologic features, growth behavior in vivo, and serum gonadotropin levels.

Adolescent↗
PubMed1981

Fine structural evidence on the origin of gonadotropin-induced ovarian tumors in mice.

A nonluteinized granulosa cell ovarian tumor and a purely luteinized ovarian tumor, induced by gonadotropin stimulation in mice, were studied ultrastructurally to obtain evidence concerning the possible origin of these tumors, whether from granulosa cells only or from granulosa and theca. Evidence including the presence of cells sharing features of both nonluteinized and luteinized cells, the presence of desmosomes and other junctional complexes in both cell types, and the presence of partially extracted lipid droplets in the luteinized cells suggests that the luteinized cells represent granulosa-lutein cells rather than theca-lutein cells. These findings are consistent with the concept that these tumors represent a spectrum of differentiation from nonluteinized granulosa cells to luteinized granulosa cells. The lack of theca and theca-lutein cells in both tumors implies that theca cells are not involved as progenitor cells.

Animals↗
PubMed1980

Ultrastructural study of a female adnexal tumor of probable wolffian origin.

A broad-ligament tumor, of probable wolffian origin, is presented. The ultrastructural features of this histologically benign tumor have not been previously described. The fine structure of this tumor is compared with normal structures and tumors derived from wolffian and müllerian anlage. The findings are consistent with derivation from wolffian duct.

Adnexal Diseases↗