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Biomedical subjects

W R Hart

Publications and source records attributed to W R Hart.

100 records · Page 6Linked to original sources
PubMedDate not supplied

The familial ovarian cancer registry: progress report.

BACKGROUND: Ovarian cancer can be cured if detected early enough, but usually has already metastasized when diagnosed. A family history of ovarian cancer is still the strongest known risk factor. OBJECTIVE: To identify women at risk for ovarian cancer and design a program of surveillance. METHODS: Prospective registry of women with a family history of ovarian cancer. RESULT: From April 1991 to July 1993, 137 women (119 families), mean age 43, registered with the Familial Ovarian Cancer Registry. The 119 pedigrees revealed 171 cases of ovarian cancer. Only one family is undocumented by pathology. Forty of 137 registrants have more than one relative with ovarian cancer. Six percent of pelvic examinations were abnormal for potential adnexal disease. In 4% of registrants, initial CA125 concentrations were abnormal. Ultrasound examinations were abnormal in ovarian size (5%), in morphology (3%), and by resistive indices (4%). Four ultrasounds were repeated earlier than routine. Using "standard" fees, the total cost to diagnose the one case of ovarian cancer discovered was $68,848. CONCLUSIONS: This approach still cannot be considered cost-effective. We are continuing to search for genetic and molecular markers of disease in women at greatest risk and in their affected relatives.

Adult↗
PubMedDate not supplied

Cytologic findings in stilbestrol exposed females with emphasis on detection of vaginal adenosis.

This prospective study of 271 females believed to have had prenatal exposure to stilbestrol documents the cytologic findings in separate vaginal and cervical preparations. In 233 patients, direct circumferential scrapings of the upper vaginal wall were taken after potentially contaminating mucous secretions had been removed. These specimens were considered evaluable for the cytologic detection of vaginal adenosis. Cellular evidence of vaginal adenosis was observed in 105 (45%) of these patients as determined by the identification of columnar cells and/or metaplastic squamous cells in the vaginal samples. Columnar cells were observed in 87 (37%) of the 233 patients. Metaplastic squamous cells accompanied the columnar cells in 54 cases. In an additional 18 patients (8%) metaplastic squamous cells were the only cytologic evidence of adenosis. Similar cellular changes were observed in 88 per cent of the vaginal samples from 25 patients with biopsy-proven vaginal adenosis. Malignant cells were not found in any of the cytologic or histologic specimens. Dysplastic squamous cells, however, were present in cytosmears from four patients. Biopsies from two of these patients confirmed the diagnosis of squamous dysplasia. Dysplasia also was identified by biopsy in four others. We believe cytology is a valuable aid in the evaluation of patients with a history of intrauterine exposure to stilbestrol. Vaginal adenosis as well as neoplastic and dysplastic lesions can be reflected in properly obtained cellular specimens.

Adolescent↗
PubMedDate not supplied

Bizarre atypia in gastric brushings associated with hepatic arterial infusion chemotherapy.

Hepatic arterial infusion chemotherapy (HAIC) for unresectable hepatic neoplasms has been associated with gastric ulcers and epithelial atypia that may be misinterpreted as carcinoma. Gastric brushings were reviewed from six patients who developed gastric ulcers with histologically proven atypia following HAIC. Marked cytologic atypia, reminiscent of a pronounced radiation effect, was present in gastric epithelial cells in five patients. The atypical cells occurred singly or in small sheets. They were markedly enlarged but a low nuclear-cytoplasmic ratio was preserved. The abundant cytoplasm was vacuolated or foamy. Binucleation and multinucleation were common, and massive nucleoli were characteristic. The brushings also contained the reparative, inflammatory and necrotic changes associated with usual benign gastric ulcers. The bizarre atypia associated with HAIC can be a source of misdiagnosis of cancer in cytologic as well as in histologic specimens.

Adult↗