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Biomedical subjects

T H Parmley

Publications and source records attributed to T H Parmley.

At least 73 records · Page 4Linked to original sources
PubMed1980

Neoplastic and non-neoplastic mesothelial proliferations in pelvic lymph nodes.

Knowledge of gland-like inclusions in pelvic lymph nodes has existed since 1897. The histogeneses proposed to explain such alterations have included congenital rests, endometriosis, metastatic neoplasia, and mesothelial metaplasia. The correct interpretation of the lymph node involvement is important in order to institute appropriate therapy. In the present study, there were 12 examples of benign mesothelial inclusions found in routine sections from pelvic lymph nodes removed in the treatment of 337 cases of gynecologic cancer. In an additional 4 cases, an intraabdominal neoplasm was present. The variations in the histologic patterns are described as is the clinical course of the disease.

Adenocarcinoma, Papillary↗
PubMed1980

Carcinoma in situ of the vulva.

Of 106 patients with carcinoma in situ (CIS) of the vulva, 102 have been followed from 1 to 15 years. The average age of the patient was 47 years; however, 40% were under the age of 41. Twenty-seven percent had associated cervical malignancy. Only 4 patients developed invasive cancer. Of these, 2 were postmenopausal and the 2 younger patients had been immunosuppressed because of systemic disease; thus the subsequent invasive cancer. The incidence of recurrence was essentially the same whether the patient was treated by vulvectomy or wide local excision. In view of the uncertainties about the invasive potential of CIS of the vulva in young patients and the absence of a proved need for an extensive procedure, it is suggested that this entity be treated only by local excision.

Adult↗
PubMed1979

Gestational trophoblastic disease within an elective abortion population.

Gestational trophoblastic disease, most commonly hydatidiform mole, is an unusual condition within the United States. The incidence of hydatidiform mole has been reported to vary from 1 in 1,200 to 1 in 2,000 pregnancies. This report described eight cases of hydatidiform mole among 4,829 patients presenting for elective first-trimester abortion. Factors which might account for the frequency of hydatidiform mole of 1 in 600 are discussed. Although the clinical course of patients with hydatidiform mole appears benign- gross examination of tissue obtained at suction curettage and the liberal use of histologic evaluation in questionable cases is required to make the diagnosis.

Abortion, Induced↗
PubMed1979

Endometrial pathology and estrogens.

Endometrial biopsies were obtained from 46 hypogonadal patients (44 with gonadal dysgenesis; 2 panhypopituitary) who were receiving estrogen-progestogen therapy. Endometrial abnormalities occurred only in patients receiving a total lifetime conjugated estrogen dose of greater than or equal to 2500 mg and who had received estrogen treatment for a period longer than 4.2 years. The biopsy outcome was significantly related (P less than 0.01) to the estrogen dose at time of biopsy and to the total lifetime dose (P less than 0.05). The progestational drugs administered did not protect against development of endometrial abnormalities. None of the abnormal endometrial patterns were associated with abnormal vaginal bleeding.

Adolescent↗
PubMed1979

Placental histopathology of midtrimester termination.

Placentas spontaneously passed after second-trimester terminations of pregnancy using either hypertonic sodium chloride or hyperosmolar urea plus prostaglandin F2alpha (PGF2alpha) were examined to determine histologic characteristics. The placentas of hypertonic sodium chloride terminations demonstrated a type of "coagulation necrosis" that has been described previously, while placentas of pregnancies terminated by hyperosmolar urea plus PGF2alpha showed a similar pattern in about one half the cases but a histologic pattern of less severe damage in the remaining cases. The 2 groups showed no significant differences when characteristics such as injection-abortion interval or estimated hypertonicity of the fluid were examined.

Abortion, Induced↗
PubMed1979

Intramembranous localization of bacteria in beta-hemolytic group B streptococcal chorioamnionitis.

An unusual pathologic finding consisting of large colonies of bacteria, localized immediately beneath the epithelial layer of the amnion, has been observed in association with an example of group B beta-hemolytic streptococcal chorioamnionitis. Postpartum endometritis as well as neonatal sepsis and meningitis occurred. Histologic examination of the umbilical cord and placenta revealed routine features of intraamniotic inflammation, but the membranes were characterized by the presence of unusual darkly staining deposits of material immediately beneath the amniotic epithelium. Subsequent special stains revealed these to be colonies of gram-positive cocci. We have been unable to find a previous description of this observation in association with streptococcal or with other types of chorioamnionitis.

Adult↗
PubMed1978

Intrauterine ethanol-induced termination of pregnancy in cynomolgus monkeys (Macaca fascicularis).

The effectiveness of locally applied ethanol in terminating early pregnancy in cynomolgus monkeys was studied. In a randomized trial ethanol (70 per cent, 1 ml.) or saline (0.9 per cent, 1 ml.) was injected extra-amniotically through a sterile blunt-end needdle inserted through the cervix into the uterine cavity. Six of seven monkeys receiving ethanol showed vaginal bleeding beginning one or two days after treatment. With the one failure, alcohol leakage occurred from the Luer-lock needle joint at the time of injection and the amount entering the uterus was unknown. No animal receiving saline showed any vaginal bleeding. The six monkeys showing vaginal bleeding were found to have nonenlarged or subnormally enlarged uteri one month after treatment. All monkeys subsequently resumed menstrual cycles within one year. Three monkeys became pregnant and were delivered at term of healthy offspring. Histologic evaluation of uteri from ethanol-treated monkeys revealed necrosis of decidua and, to a lesser degree, of the placenta one day after injection. The high efficacy of 70 per cent ethanol in inducing endometrial sloughing and the documentation of normal subsequent pregnancies in 50 per cent of treated monkeys make this technique worthy of consideration as a menstrual induction agent in women.

Abortion, Induced↗
PubMed1978

Sporadic (nonepidemic) puerperal mastitis.

Sporadic puerperal mastitis is an acute cellulitis, characterized by fever and segmental erythema in the breast. Staphylococcus aureus can be cultured in approximately one-half of the cases. With early antibiotic therapy, the infection can be cleared and abscess formation prevented. Breast engorgement may also contribute to abscess formation, and so nursing should not be discontinued. No ill effects are observed in infants who continue to nurse. Twenty women with acute puerperal mastitis had breast milk cultures, and Staphylococcus aureus was recovered in seven cases. All patients were treated with antibiotics and continued nursing. No abscesses developed, and no ill effects were observed in any infants.

Female↗
PubMed1978

Unilateral ovarian abscess associated with the intrauterine device.

Four cases of primary ovarian abscess associated with intrauterine contraceptive devices are presented. It is proposed that both their unilaterality and the fact that they were primary in the ovary rather than tuboovarian are due to the fact that bacteria from the intrauterine device are shed continuously through the fallopian tubes, resulting in the inoculation of the corpus luteum, a unilateral structure. Removal of the ovarian abscess without additional surgical therapy is sufficient for a patient with this type of pelvic infection.

Abscess↗
PubMed1977

A two-year experience with the Falope ring sterilization procedure.

The use of cautery laparoscopic sterilization procedures has two major disadvantages: (1) occasional inadvertent thermal injury to organ structures other than the Fallopian tube and (2) the inability to limit the injury to the Fallopian tube in a manner that might allow subsequent reconstructive surgery. In an effort to avoid the use of thermal energy to effect female sterilization, the Falope ring laparoscope was developed. From October, 1973, through September, 1975, 4,390 sterilization procedures were completed employing this approach; 902 cases have been completed at the Woman's Clinic of the Johns Hopkins Hospital, 1,741 cases were completed by gynecologists in various cities in the United States, and 1,747 procedures were completed by physicians in various locations throughout the world sponsored by the International Fertility Research Program.

Cautery↗
PubMed1976

Proliferative capacity of cell cultures derived from the human placenta.

The placenta consists largely of fetal tissue, yet at term it displays histological signs of deterioration not apparent in the fetus. To determine whether the apparent degeneration of the placenta is genetically determined, the life-spans of placental cell cultures and the proportion of placental cells capable of incorporating [3H]thymidine for replicative DNA synthesis in vitro were measured. Under the culture conditions employed, the placental cells were removed from the influence of many extrinsic factors thought to play a role in the degeneration of the placenta in vivo. Cultures of fibroblast-like cells derived from the placenta exhibited a reduced life-span and correspondingly reduced proportion of cells able to incorporate [3H]thymidine for DNA synthesis in comparison to cultures derived from the fetal skin and the maternal decidua. These results suggest that intrinsic cellular processes may be involved in the apparent degeneration of the placenta.

Adolescent↗
PubMed1976

The possible deleterious effects of the intramyometrial injection of hypertonic urea.

Hypertonic urea has been shown to be an effective midtrimester abortifacient. Although safer than hypertonic saline when injected intravascularly, it has not been compared to saline in the case of inadvertent intramyometrial injection. This report documents that intramyometrial injection of hypertonic urea will result in the same type of muscle necrosis as that produced by saline.

Abortifacient Agents↗
PubMed1975

Menstrual extraction.

This report documents the clinical outcome of 137 consecutive menstrual extractions. The pre- and postprocedural pregnancy testing is correlated with histologic examination of tissue obtained. This report reviews the management of the unsuccessful cases.

Abortion, Induced↗