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Biomedical subjects

D W Fortune

Publications and source records attributed to D W Fortune.

At least 37 records · Page 2Linked to original sources
PubMed1986

The association between vulvar condylomata acuminata, cervical wart virus infection and cervical intraepithelial neoplasia.

Vulvar condylomata acuminata are the commonest clinical expression of human papilloma virus infection of the female genital tract. Various epidemiological factors were examined in a group of patients with vulvar warts in whom the incidence of biopsy proven human papilloma virus infection of the cervix was 39.7% and the incidence of biopsy proven cervical intraepithelial neoplasia was increased significantly (16.2%).

Adult↗
PubMed1985

Congenital absence of pyramids and its significance in genetic diseases.

Bilateral absence of the pyramids, best assessed in transverse sections of the medulla oblongata, was found in 0.7% of 2,850 autopsies performed at the Royal Children's Hospital, Melbourne (Australia). A strong association with some forms of congenital aqueductal stenosis was observed and evaluated in further cases ascertained through other hospitals. The very strong association observed with X-linked congenital aqueduct stenosis may be useful diagnostically but must be evaluated in other centres. At least, the presence of pyramids seems strong evidence against this diagnosis. Absence of the pyramids was also observed in several known or new genetic syndromes - Meckel's syndrome, the HARD syndrome, two sisters with congenital aqueductal stenosis and polydactyly and two families with microcephaly and arthrogryposis.

Abnormalities, Multiple↗
PubMed1985

Endometrial carcinoma in premenopausal women: a clinicopathological study.

A clinicopathological review of 106 cases of premenopausal endometrial carcinoma has confirmed the good prognosis in such patients. Women less than 40 years old were more likely to be nulliparous, over 80 kg in weight, and to present with irregular or heavy and irregular bleeding, than women 40 years or older. Seven patients developed malignancies at other sites. A detailed pathological review of 32 cases revealed poor prognostic features in 30% of patients; corpora lutea were identified in the ovaries of 13 patients. It is suggested that factors other than anovulation are related to the development of endometrial cancer in the over 40 age group.

Adult↗
PubMed1985

Mortality and two year outcome of infants of birthweight 500-1500 g: relationship with neonatal cerebral ultrasound data.

Cranial ultrasounds were performed on 218 (96%) of 227 liveborn infants of birthweight 500-1500 g delivered in the Royal Women's Hospital, Melbourne, Australia, in an 18-month period concluding in March 1982. Seventy-two (31.7%) of the children died; 28 children (38.9%) had cerebroventricular haemorrhage, 35 (48.6%) showed no bleeding and there were nine (12.5%) with no data. Paired necropsy and ultrasound data were congruent in 22 (88%) of 25 children. One hundred and forty-eight (95.5%) of 155 survivors were seen at 2 years of age. Forty-one (28%) had cerebroventricular haemorrhage; nine children (6%) had both ventricular dilatation and haemorrhage and two had ventricular dilatation alone. Apart from a marginal advance in gestation and higher number of immigrant and less educated mothers in children without cerebroventricular haemorrhage, all other perinatal, biographical and social variables between those with haemorrhage and those without were similar. The major handicap rate overall was 14.2% (21 patients). The children with cerebroventricular haemorrhage had a trend for greater prevalence of handicap and lower mean Bayley psychological scores. This was even more evident with ventricular dilatation being present. Of children with major handicap 57.1% (12/21) had normal serial ultrasound findings during their primary hospitalization. Major handicap occurred in 15% (3/20) of children with grade 1 haemorrhage, 23.5% (4/17) with grade 2 or 3 bleeds and 25% (1/4) of those with grade 4 haemorrhage. Laterality of cerebral palsy did not correlate with ultrasound findings. Ultrasound findings did not improve statistical prediction of deaths or major handicap.

Analysis of Variance↗
PubMed1985

Correlation between cytoplasmic steroid receptors and tumour differentiation and invasion in endometrial carcinoma.

The incidence and levels of cytoplasmic steroid receptors were studied in 155 endometrial carcinomas: oestrogen receptors (ER) were measured in all samples, progesterone receptors (PR) in 148 and androgen receptors (AR) in 118. Well-differentiated adenocarcinomas were significantly more likely to contain ER, PR and AR than were poorly-differentiated tumours, and mean values of ER and PR content were significantly higher in well-differentiated adenocarcinomas than in less-differentiated tumours. Receptor profiles in adenosquamous carcinomas and clear-cell carcinomas were similar to those in adenocarcinomas. Deeply invasive tumours were significantly less likely to be ER, PR or AR positive and, even when positive, such tumours had significantly lower mean levels of ER and PR. Poorly-differentiated tumours were significantly more likely to be ER-negative PR-positive than well-differentiated adenocarcinomas and adenosquamous carcinomas.

Adenocarcinoma↗
PubMed1985

Hydatidiform mole in Victoria: aetiology and natural history.

A retrospective study was made of 455 patients referred to the Hydatidiform Mole Register of the Royal Women's Hospital from 1973-1982 who fulfilled the criteria for diagnosis of hydatidiform mole. The incidence of hydatidiform mole was 1:1,357 livebirths in Victoria. Age greater than 40 years (P less than 0.001), nulliparity (P less than 0.005) and parity greater than 4 (P less than 0.001) were the only predisposing factors found. An association with artificial insemination with donor semen was also noted (P less than 0.025). The need for further treatment for persistent trophoblastic activity (13.6% of patients) was independent of the method of evacuation employed and of gestation at evacuation. Only 2 cases of histologically proven postmolar choriocarcinoma occurred, one of which was also the only death recorded from all patients registered following a molar pregnancy.

Adult↗
PubMed1985

Ultrasound-guided puncture for gynaecological and pelvic lesions.

A series of 34 patients who underwent a total of 37 ultrasound-guided cyst punctures and fine needle biopsies for diagnosis and treatment of pelvic lesions are reported. In all but 1 patient the lesion visualized was entered and cytological diagnosis was achieved, although 1 patient required a second attempt under general anaesthesia. Seven cysts were endometriotic; these and all the remaining cysts were benign and only 4 patients developed a recurrence of the cyst following puncture. No patient in whom the ultrasound appearance suggested a benign cyst was found to have an ovarian malignancy. Three patients with malignant lesions had a total of 4 punctures or biopsies and a final patient had a fine needle biopsy of an ovary to exclude malignancy.

Adult↗
PubMed1985

Angiosarcoma of breast metastatic to the ovary and placenta.

Angiosarcoma of the breast with spread to the ovary and placenta during a pregnancy 6 years after initial diagnosis is described. The ovarian lesion was discovered during Caesarean section. It is postulated that the pregnancy altered the biological behaviour of the tumor.

Adult↗
PubMed1984

Adenocarcinoma in situ of the cervix.

Adenocarcinoma in situ (ACIS) of the cervix is rare and is frequently overlooked. To characterize this disease more fully, 21 cases were studied. All except two patients presented with abnormal smears. The distribution of ACIS was focal in two cases, multicentric in three, and diffuse and continuous in 15 (in one case it was unknown). The depth of crypt involvement varied from 0.5 to 4 mm and the volume was estimated to range from 0.25 to 1,500 mm3. ACIS should and can be distinguished from early ("microinvasive") adenocarcinoma in most cases by its limitation to the glandular field, by the constant admixture of neoplastic and normal glands, and by the lack of stromal response. Invasive adenocarcinoma cannot be excluded by target biopsy, the diagnosis of ACIS requiring conization. If the surgical margins are disease free, conization alone may be adequate therapy.

Adenocarcinoma↗
PubMed1983

Non-immune hydrops fetalis: changing contribution to perinatal mortality.

During the decade to 1979, 203 hydropic infants died in the State of Victoria, Australia. Non-immune hydrops fetalis (NIHF) became more common than immune hydrops fetalis as a cause of fetal hydrops, and its contribution to the total perinatal mortality increased from 0.1% to 3%. The perinatal mortality rate of infants with NIHF was virtually 100%. The most consistent finding at post-mortem was pulmonary hypoplasia which was probably due to compression from serous cavity effusions. Survival may be improved by early diagnosis and termination of the pregnancy in selected patients with viable infants before the development of gross serous cavity effusions. The most constant clinical sign associated with hydrops fetalis was polyhydramnios which is an indication for ultrasonography and cardiotocography to detect cases of NIHF and to select the optimum time for delivery.

Australia↗
PubMed1982

Endometrial carcinoma in young women.

Endometrial carcinoma in young women is uncommon. The majority of cases occur in women who have been taking oestrogen-containing oral contraceptives, in those with the Stein-Leventhal syndrome, or in those with gonadal dysgenesis treated by long-term oestrogen replacement therapy. We have observed 4 women under 40 years of age with adenocarcinoma of the uterus in whom chromosomal abnormalities associated with Turner's syndrome were confirmed only after the diagnosis of carcinoma had been made. None of these had received replacement oestrogen therapy. It is postulated that chromosomal abnormalities in young women with endometrial carcinoma are more common than previously thought. As the disease in this group appears to behave in a benign fashion, a conservative approach to therapy is advocated.

Adenocarcinoma↗
PubMed1982

Nonimmunologic hydrops fetalis: a review of 61 cases.

Sixty-one cases of nonimmunologic hydrops fetalis were studied. The incidence of nonimmunologic hydrops fetalis, 1 in 3748 births, was unchanged in 2 decades. The mortality from nonimmunologic hydrops fetalis remained high (98%). Polyhydramnios (75%), anemia (45%), and preeclampsia (29%) were the commonest prenatal maternal complications, whereas postpartum hemorrhage or difficulty with placental delivery, or both, occurred in 64%. Ultrasound examination always was successful in detecting the hydropic state. Many presumed etiologic factors were noted, although in 38% no possible cause was found. A major congenital anomaly was present in 41%. The obstetric and neonatal care of nonimmunologic hydrops fetalis must be improved. If nonimmunologic hydrops fetalis is diagnosed during the investigation of polyhydramnios, consideration should be given to early delivery in the interest of the fetus.

Edema↗
PubMed1981

Premature rupture of the membranes, oligohydramnios and pulmonary hypoplasia.

The clinical and pathological features of oligohydramnios associated with severe pulmonary hypoplasia are described in 10 infants without renal anomalies. In 8 patients the condition was associated with prolonged premature rupture of the membranes at 16 and 36 weeks of gestation in a study of 244 patients (3.3%). Seven of the infants died of respiratory failure within 24 hours of delivery; the other infant survived. In the remaining 2 patients with severe oligohydramnios at term, but unassociated with premature rupture of the membranes, both infants succumbed. Problems with resuscitation should be anticipated in pregnancies complicated by prolonged leakage of amniotic fluid or oligohydramnios, and pulmonary hypoplasia should be recognized as a cause of respiratory distress. Apart from the ultrasonic predelivery confirmation of normal kidneys to exclude Potter's syndrome it is recommended that ultrasonic assessment of thoracic cage volume should be made before delivery.

Adult↗
PubMed1981

Functioning ovarian tumors in postmenopausal women.

Estrogen excretion was higher than normal (more than 9 microgram/24 hr) in 40 of 80 postmenopausal women with benign and malignant epithelial tumors of the ovary, including 8 metastatic tumors. High estrogen excretion was noted in 19 of 27 (70.4%) patients with mucinous tumors in only 1 of 25 (4%) patients with serous tumors (P less than .001). Endometrioid and metastatic tumors were also noted to be frequently associated with high estrogen excretion. In the high estrogen excretion group 27 of 37 (73%) patients showed stromal luteinization and/or condensation in the tumor, but in the normal estrogen excretion group these changes were seen in only 6 of 38 (15.8%) patients (P less than .001). A possible mechanism of stromal stimulation in these tumors is discussed. Although there was often evidence of estrogen activity in the endometrium and the tubal epithelium in the high estrogen excretion group, the correlation between these epithelia and estrogen excretion was imperfect. Postoperative estrogen excretion remained elevated in 3 of 16 patients, of whom 1 was obese and 2 had residual tumor. This study emphasizes the importance of identifying epithelial tumors of the ovary as functioning or endocrine tumors.

Carcinoma, Squamous Cell↗
PubMed1980

Angiomyxomas of the umbilical cord.

Rare benign angiomyxomatous tumors of the umbilical cord, associated with a macerated stillbirth, are described. Only 12 cases of vascular tumor of the cord have been reported and only 2 of these were associated with fetal death. The histopathology of this unusual tumor is presented together with a review of the literature.

Adult↗
PubMed1980

Benign and low grade variants of mixed Müllerian tumour of the uterus.

The clinico-pathological features of 11 examples of a rare group of uterine neoplasms composed of both epithelial and stromal components are reported. The patients complained of abnormal vaginal bleeding or discharge. Two of the tumours arose in the cervix, seven in the endometrium and two from both, forming large polypoid masses projecting from the cervix and/or filling the uterine cavity. Microscopically, the epithelial elements ranged from benign to adenocarcinoma. A similar range of stromal elements was also seen, varying from entirely bland to low grade to high grade sarcoma. The variable histology of the tumours is reflected in their biologic behaviour. Of the three tumours with the highest histological grade of malignancy, one recurred and killed the patient. One tumour, in which both components were regarded histologically as benign, recurred twice before hysterectomy. Our findings lend support to the concept that these tumours are variants of mixed Müllerian tumour. We advocate the acceptance of the latter term so that all grades of this tumour can be accommodated under one designation.

Adenocarcinoma↗
PubMed1980

Choriocarcinoma coexistent with intrauterine pregnancy.

Two cases of choriocarcinoma coexisting with intrauterine pregnancy are presented. The literature on 28 previously reported cases is reviewed with reference to mode of presentation, maternal survival and pathogenesis.

Adult↗