Biomedical subjects
Publications and source records attributed to S L Romney.
The DNA content of nuclei extracted from separate biopsies of normal cervical epithelium and from dysplastic sites in the same patient was determined biochemically. Mean percentage increase in the DNA content of dysplasias (mild: 143.3 +/- 14.9; moderate: 225.8 +/- 51.1; and severe: 359.8 +/- 45.8) was found to be statistically significant (F-Test: p less than 0.001) over the normal values in control cervical tissues.
Cellular retinol-binding protein (CRBP) and cellular retinoic acid-binding protein are present in the cytosol of normal human uterine cervical tissues, as detected by ultracentrifugation analysis. Both binding proteins have characteristically high specificity for their respective ligands. In sucrose gradients, both proteins sediment in the 2S region and are of similar molecular weight (M.W. approximately 14,000). In blind analyses of cervical biopsies, obtained under direct vision by colposcopy of normal women (control) or from patients histopathologically diagnosed to have dysplasias or carcinoma in situ (study group), CRBP was not detectable by sucrose gradient analysis in 78.8% of the 33 abnormal biopsies, compared to 23.5% of the 34 controls. This difference was statistically significant (p less than 0.005). In biopsies in which CRBP was detected, the mean levels were 2.76 and 0.72 pmol/mg protein in the cytosol for the control and study groups, respectively. In some subjects from each group, cellular retinoic acid-binding protein but not CRBP was detected in the biopsied tissue. The presence and role of these binding proteins in vitamin A metabolism, epithelial maturation and differentiation in cervical dysplasias, and in situ lesions remain to be investigated.
Symptoms and signs of interstitial pregnancy cannot be differentiated from symptoms and signs of other ectopic pregnancies. Unruptured interstitial gestations are usually diagnosed incidental to the work-up of a suspected ectopic gestation. Unlike some teaching, a characteristic pelvic mass was palpable in 3 of 4 cases. Incomplete induced abortion helped in diagnosing 2 cases. Ultrasound and laparoscopy will aid in establishing the correct diagnosis.
Eight of 11 consecutive patients with metastatic endometrial adenocarcinoma completed more than one course of treatment with a doxorubicin-cyclophosphamide combination. Six of these patients improved, with three showing a complete remission of all disease manifestations and two experiencing an objective partial response (greater than 50 per cent tumor shrinkage). Median duration of all responses was 10 months, with three patients surviving more than one year. Review of patient characteristics suggests that, unlike progestin therapy, this new program is effective in the presence of poorly differentiated tumors and short progression-free intervals. Therefore, chemotherapy should probably supplement progestins in future clinical trials and should certainly be considered when hormone therapy fails in advanced endometrial cancer. Moreover, if the degree of efficacy reported herein is confirmed, it will justify clinical trials that include patients in earlier stages of disease.
A 22 year-old phenotypic female with a 45,x/46,x, r(x) mosaic complement had anovulatory cycles, histologically normal ovaries, and atypical endometrial hyperplasia which, when clinically followed by repeated biopsies, was found to progress to locally invasive endometrial carcinoma. This was successfully managed by the induction of ovulation with Clomid, which resulted in conversion of the endometrium to a normal secretory pattern for two subsequent years.
In a total of 53 patients, most of whom were over 40 years of age and who presented symptoms of vaginal bleeding, total plasma estrogens were measured with gas liquid chromatography, and the clinical correlates were studied. The results revealed that total plasma estrogen levels in the endometrial hyperplasia and endometrial carcinoma groups were significantly higher than those measured in the control group. In addition, a positive, significant correlation was found between the plasma estrogen levels and obesity in the patients with endometrial carcinoma. The study provides objective data that document the clinical impressions that hyperestrogenism and obesity are significant findings in endometrial carcinoma.
Primary malignant melanoma of the uterine cervix in a 70-year-old Negro female is reported. Only 9 other cases have been reported in the literature. The diagnosis, prognosis, and modern trends in therapy for this lesion are discussed.
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