Biomedical subjects

W Faught

Publications and source records attributed to W Faught.

9 recordsLinked to original sources

PubMed2000

Lack of expression of c-KIT in ovarian cancers is associated with poor prognosis.

The c-KIT protooncogene encodes a tyrosine kinase receptor, KIT, that is expressed in many normal and cancerous tissues. In this study, we have examined the expression of c-KIT and its ligand, stem cell factor (SCF), in human epithelial ovarian tumors, in normal ovaries and in cultured ovarian surface epithelium (OSE). Cultured cells, normal tissues and tumors were analyzed by Northern and Western blot analyses, reverse transcription-polymerase chain reaction and immunohistochemistry. Normal OSE expressed SCF, but not c-KIT; however, epithelial invaginations and inclusion cysts often expressed KIT protein. Of 15 benign ovarian tumors and tumors of low malignant potential, 87% expressed c-KIT, and 92% of these co-expressed SCF, suggesting the possibility of autocrine growth regulation. Of 35 malignant ovarian cancers, 71% expressed c-KIT (92% co-expressed SCF), with a trend for decreased c-KIT expression in advanced stage disease. Of 34 patients with malignant tumors for whom follow-up information was available (median follow-up time of 24 months), 9 had tumors that did not express c-KIT, 8 (89%) of whom have died and the remaining 1 has recurrent disease. Of the 25 patients with tumors expressing c-KIT, 56% are still alive. Eight of the patients have no evidence of disease and all had KIT-expressing tumors. Statistical analysis indicated that patients whose tumors did not express c-KIT had a significantly shorter (p < 0.05) disease-free survival time than patients who had KIT-expressing tumors. Our results suggest that c-KIT may play a role in early ovarian tumorigenesis, and that loss of c-KIT expression is associated with poor prognosis.

Blotting, Northern↗

PubMed1998

A survey of practice in management of malignant ascites.

The purpose of this study was to determine physicians' attitudes toward and preferences for palliative management of malignant ascites. A random sample of eighty physicians practicing in Canada was selected from the memberships of the Canadian Association of Medical Oncologists, the Canadian Association of Gastroenterology, the Canadian Society of Palliative Care Physicians, and the Society of Gynecologic Oncologists of Canada. Physicians were questioned on their use of different modalities in management of malignant ascites, and preferences based on attitudes toward efficacy of various treatments. Eighty surveys were mailed, with a second mailing, followed by telephone contact. The response rate was 76% (59/78), with two potential respondents deemed ineligible. Among the 44 physicians who treat malignant ascites, paracentesis is employed by 43 (98%), and felt to be effective by 39 (89%). Diuretics are used by 61% (27/44), although fewer feel diuretics are effective management (20/44, 45%). Peritoneovenous shunts, dietary measures, and other modalities are used less frequently than either paracentesis or diuretics. The most commonly used means of managing malignant ascites is paracentesis, which is also felt to be the most effective by the group surveyed. After paracentesis, diuretics and peritoneovenous shunting are used most frequently, but there is no apparent consensus as to their effectiveness. Managing malignant ascites remains problematic, and we propose further study of management strategies to clarify the role of various treatments.

Adult↗

PubMed1997

Comparison of Fourier-transform infrared spectroscopic screening of exfoliated cervical cells with standard Papanicolaou screening.

To compare Fourier-transform infrared (FTIR) spectroscopy in screening cervical cytology and standard Papanicolaou (Pap) screening with colposcopic directed biopsy as a "gold standard," we prospectively gathered FTIR samples and Pap smears of all patients attending our program's colposcopy clinics, from February to October 1995. We recorded demographic data for each patient including colposcopy, cytology, treatment follow-up, and histology. Using the colposcopically directed biopsy as the gold standard, exfoliated cervical cells from 301 patients were collected to compare cytology and FTIR spectroscopy. Based on previously established criteria, we provided distinctive definitions of both negative/positive FTIR, cytology, and histology. Results of 301 cases showed 196 positive and 105 negative cytologies. The sensitivity, specificity, false-negative rate, and false-positive rate for the Pap test were 86.6, 90.5, 13.4, and 9.5%, respectively. However, FTIR results versus histology showed 215 positive and 86 negative with a sensitivity of 98.6% and specificity of 98.8%. False-negative and false-positive rates were 1.4 and 1.2%, respectively. In the 12 cervical cancers there were no false-negative FTIR results but 3 false-negative Pap smears. The positive and negative predictive values for FTIR were 99.5 and 96.5% while the Pap values were 95.9 and 72.3%. Compared to standard Pap smears, FTIR has a better false-negative rate and negative predictive value in this preliminary study. Further work, to establish the range of each of the spectral criteria for different grades of dysplasia and that among various infectious effects, needs to be conducted before applying this research tool to a population-based study.

Biopsy↗

PubMed1997

Does persistent postmenopausal bleeding justify hysterectomy?

Postmenopausal vaginal bleeding is an early sign of endometrial cancer. persistent postmenopausal bleeding refers to uterine bleeding for which no malignant cause can be demonstrated by endometrial sampling. Hysterectomy has routinely been performed in this group of patients because of a perceived risk of endometrial cancer. The objective of this study was to quantify the risk of endometrial cancer in patients undergoing hysterectomy for postmenopausal bleeding after benign histology on endometrial sampling. One thousand four hundred and sixty-three patients underwent a hysterectomy during the study period. Forty hysterectomies (2.7%) were performed for persistent postmenopausal bleeding. The final pathology of the 40 hysterectomy specimens demonstrated hyperplasia with atypia in four patients (10%), hyperplasia without atypia in 14 (35%), and other non malignant pathology in 22 (55%). There were no cases of carcinoma of the endometrium. We conclude that persistent postmenopausal bleeding with non malignant pathology on endometrial sampling is not an indication for hysterectomy.

Aged↗

PubMed1997

Should endocervical excision and curettage be done during LEEP?

OBJECTIVE: To evaluate the need for routine endocervical sampling and endocervical curettage at the time of loop electrosurgical excision procedure (LEEP) in patients with satisfactory colposcopic assessment being treated for dysplasia. STUDY METHODS: One hundred and eight patients having a satisfactory colposcopy referred for excision of their dysplasia with LEEP (four case) were studied. The procedure was carried out with a standard ectocervical excision to a depth of 6 mm and an endocervical excision centrally to a further 3 mm. An endocervical curettage was performed at the end of the procedure. RESULTS: Of the 108 patients, 94 (87%) had a negative endocervical excision and endocervical curettage. Thirteen percent had a positive endocervical excision or endocervical curettage. Only 2 patients had endocervical pathology worse than the ectocervical pathology. There was no difference in the distribution of CIN I to CIN III in patients who had a negative endocervical excision or a positive endocervical excision. In the overall group, complications arose in 2.7% of patients and were minor and self-limiting. The overall long-term follow-up cure rate was 99% in the entire group. CONCLUSIONS: Satisfactory colposcopy is not an adequate discriminant for the use of an ectocervical excision only for patients with dysplasia. Thirteen percent of patients would theoretically have had persistent disease if an endocervical excision was not performed. Adequate endo- and ectocervical excisions are an important component of the LEEP procedure and cannot be separated.

Adolescent↗

PubMed1996

Early ovarian cancer: value of a negative staging laparotomy.

OBJECTIVE: To assess the risk of recurrence in patients with stage I (negative cytology) epithelial ovarian cancer receiving no adjuvant therapy. METHODS: Between 1976 and 1991, 51 patients with apparent stage I ovarian cancer underwent a comprehensive surgical staging that included: peritoneal cytology, omentectomy, pelvic and para-aortic lumphadenectomy, peritoneal biopsies and either unilateral salpingo-oophorectomy or TAH and BSO. RESULTS: Eleven of 51 patients (22%) were found to have stage II or III disease based on a positive staging laparotomy. Thirty-seven of 40 patients with stage I disease received no further therapy. There was one recurrence (stage 1C - grade 1) in patients with surgical stage 1C while there were no recurrences in patients with either stage 1A or 1B disease. CONCLUSION: This study concludes that surgical staging in apparent early stage ovarian cancer can identify a group of patients that require surgical therapy alone.

Adolescent↗

PubMed1995

Changes in protein C and protein S levels in normal pregnancy.

OBJECTIVE: The objective of the study was to determine the normal changes in the plasma concentrations of protein C and protein S that occur during each trimester of pregnancy. STUDY DESIGN: The study was a prospective cross-sectional study of 91 normal pregnant women who had plasma concentrations of protein C and protein S measured during the first, second, and third trimesters. RESULTS: There was no statistically significant change in antigenic or functional protein C levels during normal pregnancy. Total protein S levels also remained unchanged. Free protein S levels fell significantly from first to second trimesters (0.45 U/ml mean to 0.26 U/ml mean, p < 0.001), but no further fall occurred during the third trimester. CONCLUSIONS: The second-trimester fall in free protein S levels is a physiologic pregnancy adaptation. Women with a thromboembolic event appearing for the first time during pregnancy should have investigations for protein S deficiency delayed until the postpartum period, to avoid misdiagnosis and treatment.

Cross-Sectional Studies↗

PubMed1995

Peritoneovenous shunt for palliation of gynecologic malignant ascites.

BACKGROUND: Ascites is a common sequela of advanced or recurrent gynecologic malignancies, such as carcinoma of the ovary, fallopian tube, or endometrium. Symptomatic treatment with repeated paracentesis is the initial management after failure of chemotherapy. STUDY DESIGN: This study was done to evaluate the safety and effectiveness of a peritoneovenous shunt (PVS) in the palliation of these patients with recurrent ascites. A retrospective review of 25 patients having a PVS between 1982 and 1992 was performed. RESULTS: The 25 patients consisted of 21 patients with carcinoma of the ovary, two with primary carcinoma of the peritoneum, one with carcinoma of the endometrium, and one patient with carcinoma of the fallopian tube. The mean weight and abdominal girth decreased after shunt insertion (p < 0.001). Gastrointestinal dysfunction and dyspnea also improved with PVS insertion. There was no change in mean Karnofsky score after placement of a PVS. Two patients died within ten days postoperatively. The median survival period was 80 days and shunt occlusion occurred in four patients. CONCLUSIONS: The insertion of a PVS is effective in relieving refractory malignant ascites in gynecologic malignancies. The impact on quality of life requires further study.

Ascites↗

PubMed1994

Should selective paraaortic lymphadenectomy be part of surgical staging for endometrial cancer?

Surgical staging of adenocarcinoma of the endometrium attempts to identify the true distribution of disease. The survival value of paraaortic lymphadenectomy selectively performed in patients with histologic risk factors is unproven. The objective of this study was to determine if a staging procedure that did not include paraaortic lymphadenectomy predicted recurrence-free survival in disease surgically confined to the uterus. Between 1978 and 1990, 273 patients underwent surgical staging. Two hundred and sixty-nine were clinical stage I and 4 were stage II. The staging procedure included peritoneal cytology, TAH and BSO, and pelvic lymphadenectomy. Postoperative therapy, if any, consisted of whole pelvis and vault radiotherapy in disease confined to the uterus and systemic chemotherapy in patients with extrauterine disease. Surgical staging resulted in 220 (81%) stage I, 20 (7%) stage II, 27 (10%) stage III, and 6 (2%) stage IV. Eighty-eight patients in stages I and II had deep myometrial invasion or a grade 3 tumor. There were 12 recurrences, 8 in stage I and 4 in stage II, in patients with disease confined to the uterus. Four patients (1.7%) recurred outside the pelvis. Had paraaortic lymphadenectomy been performed in patients with risk factors, this would have mandated 88 dissections to potentially benefit 4 patients. We conclude that paraaortic lymphadenectomy would have been of small benefit to these surgically staged patients.

Adenocarcinoma↗