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Biomedical subjects

H W Baker

Publications and source records attributed to H W Baker.

At least 163 records · Page 9Linked to original sources
PubMed1983

Geographic pathology of uterine cancers in Oregon: risks of double primaries and effects of socioeconomic status.

An intensive statewide study of uterine cancer incidence for the period 1968-1972 revealed that women with one histologic type of uterine cancer were much more susceptible to the simultaneous presence of a second histologic type than were the rest of the residents of the state. Squamous cell carcinoma was the most common uterine cancer; peak number and rate were found in the age group 25-29 years, indicating the need for periodic screening of young adult women and the need for discussion of neoplasia risk in adolescent sex education classes. Risks of squamous cell carcinoma and leiomyosarcoma were excessive among blacks. Socioeconomic status had a strong and consistent inverse relationship with uterine squamous cell carcinoma incidence, implying that its major risk determinant, sexual behavior, could have a similar socioeconomic pattern. Uterine adenocarcinoma incidence had a weaker but consistent direct relationship with socioeconomic status for which the cause is unknown.

Adenocarcinoma↗
PubMed1983

Response of a mucinous ovarian tumor of borderline malignancy to human chorionic gonadotropin.

Plasma and urinary steroid hormones were measured before and after an injection of human chorionic gonadotropin (hCG) to a postmenopausal woman with a mucinous ovarian tumor of borderline malignancy. Hormones were also measured in blood from a vein draining the tumor, and circulating gonadotropins and plasma and urinary steroids were measured before and after tumor removal. Baseline levels of plasma progesterone (P), androstenedione (delta 4 A), and estradiol (E2), and urinary estrogens and pregnanediol were high; they increased dramatically in response to hCG and fell after tumor removal. A less striking increase in testosterone, dihydrotestosterone, dehydroepiandrosterone (DHEA), and DHEA sulfate was noted after hCG injection. A gradient existed between tumor vein and peripheral vein levels of P, 17 alpha-hydroxyprogesterone, delta 4 A, E2, DHEA, and cortisol. Plasma follicle-stimulating and luteinizing hormones initially low but rose to the postmenopausal range after surgery. These results indicate the presence of delta 4 and delta 5 androstene pathways within the tumor. The responsiveness of the tumor to hCG provides further evidence that hCG may be the endogenous stimulus to steroid hormone production by epithelial ovarian tumors.

Chorionic Gonadotropin↗
PubMed1983

Treatment of sperm autoimmunity in men.

Positive sperm immobilization tests were found in the sera of 6.3% of 491 infertile men. There was a higher frequency of family histories of autoimmune diseases than for other subfertile men. Prognosis for fertility was related to results of sperm-mucus penetration tests: progressively motile sperm indicated a fair outlook--8 of 15 couples conceived within 7 months either spontaneously or with artificial insemination with husband's semen. Absence of progressively motile sperm indicated severe infertility - only 6 of 72 couples produced pregnancies. Treatment of the latter group by temporary suppression of spermatogenesis with testosterone or with Artificial Insemination by Husband (AIH) appeared to be ineffective. However, sperm immobilization titres fell and sperm concentrations, motility and mucus penetration increased during treatment of 14 of the men with prednisolone (0.5-0.75 mg/kg per day) for 4-7 months and there were three pregnancies. It is concluded that sperm autoimmunity in men causing failure of sperm to penetrate cervical mucus produces severe but not absolute infertility. Immunosuppression with continuous high dose glucocorticoid reduces antibody levels and improves semen quality. A controlled trial is needed to determine if this treatment is a practical method for improving fertility in men with sperm autoimmunity.

Adult↗
PubMed1983

Selection of high fertility donors for artificial insemination programmes.

One hundred and seventy-seven semen donors were used in an artificial insemination service using frozen semen over a 4 year period. Although the donors were selected for good semen quality, pregnancy rates varied markedly from less than five to greater than 20 pregnancies per 100 treatment cycles. When the characteristics of the 25 most fertile and 25 least fertile donors were compared, only sperm morphology was significantly different. Sperm concentration and motility before and after thawing of semen were similar in the two groups as were the proportions of adverse prognostic factors in the recipients. It is concluded that using more stringent criteria for selection of donors on the basis of sperm morphology and discarding donors who do not produce pregnancies within 12 cycles should improve overall pregnancy rates.

Adolescent↗
PubMed1983

Outcome of AID in initial and subsequent courses of treatment.

The life table pregnancy rates for 801 courses of artificial insemination by donor semen were compared between the first treatment and subsequent treatments. The pregnancy rate was significantly (P less than 0.001) higher for subsequent courses of treatment.

Australia↗
PubMed1982

Free jejunal mucosal patch graft reconstruction of the oropharynx.

We used microvascular anastomoses to transpose free pedicle jejunal mucosal patch grafts in seven patients. The procedure has been particularly helpful in rebuilding large intra-oral mucosal defects created by extensive resections for advanced carcinomas. Some of the benefits of this technique have included a one-stage procedure, which requires two to three weeks for healing; abundant donor tissue with characteristics similar to oral mucosa; near-normal facial appearance; and preservation of maximum tongue function. An unexpected benefit has been relief of annoying xerostomia by the jejunal mucous secretion. The most severe complication, which resulted in one death, was the excessive oral jejunal mucous secretion in the early postoperative period. It led to significant aspiration pneumonitis. To prevent this problem, we recommend a routine tracheostomy combined with rigorous pulmonary care whenever a jejunal patch graft is used.

Aged↗
PubMed1982

Regional hyperthermia for cancer.

The clinical use of regional hyperthermia combined with radiation therapy, chemotherapy, or both in 107 patients with advanced cancer is reported. Surgery was subsequently carried out in eight patients. The radiofrequency equipment used is capable of heating tumors at any depth with few adverse side effects. Complete responses to therapy occurred in 16 percent of patients, and partial responses in 52 percent. Striking pain relief was observed in both responders and nonresponders.

Female↗
PubMed1982

Effect of stress on steroid hormone levels in racehorses.

Cortisol and testosterone were measured by radioimmunoassay in plasma samples from race horses. None of 6 stressed male horses had low cortisol levels but testosterone levels (0.81 +/- 0.15 nmol/l) were significantly lower than in healthy horses (1.86 +/- 0.31 nmol/l). The conclusion was made that adrenocortical insufficiency is not a common association of stress in race horses. The reduction in testosterone levels is probably a nonspecific response similar to that seen in other species.

Adrenal Insufficiency↗
PubMed1982

Gonadotrophin releasing hormone causes a biphasic secretion of luteinizing hormone and follicle stimulating hormone by cultures of rat anterior pituitary cells.

Primary monolayer cultures of adult male rat anterior pituitary cells secreted both LH and FSH in a biphasic manner when incubated with gonadotrophin releasing hormone (GnRH). The peaks of secretion of LH and FSH were coincident: the first occurred between 15 and 30 min and the second between 1 and 3 h after the addition of GnRH. Approximately 20% of the total amount of gonadotrophins secreted in the 6 h treatment with GnRH was contained in the first peak. Inhibitors of the secretion of gonadotrophins affected LH and FSH secretion differently. Inhibin suppressed the secretion of FSH to a greater extent than that of LH, whereas testosterone and cycloheximide had a greater effect on LH. Neither phase of secretion of LH or FSH was reduced preferentially by inhibin or testosterone but the greater effect of cycloheximide was on the second phase of secretion.

Animals↗
PubMed1981

Reversible male infertility due to congenital adrenal hyperplasia.

We have studied a patient who was azoospermic and infertile. The cause of his infertility was unusual and curable: untreated congenital adrenal hyperplasia resulting from a partial 21-hydroxylase deficiency. The diagnosis was suggested by the combination of small testes, elevated levels of testosterone and suppressed levels of gonadotrophins.

Adrenal Hyperplasia, Congenital↗
PubMed1981

Factors affecting the variability of semen analysis results in infertile men.

UNLABELLED: Infertile men who had 3 or more semen analyses performed in one laboratory were placed in 2 groups (I) oligozoospermic group (n = 106), mean sperm concentration between 1 and 20 million/ml (II) asthenozoospermic group (n = 71), mean sperm concentration greater than 20 million/ml, and mean motility less than 60%. With increasing durations of abstinence from ejaculation before the tests there were significant increases in semen volume and sperm concentration. Semen volume increased over the first 4 days to a similar extent in both groups. Sperm concentrations increased over 15 days, but the effect of abstinence was much greater in the asthenozoospermic group than in the oligozoospermic group (14% compared with 1.4% of the within subject variation). Significant changes in results accompanied repeated testing, notably rises in sperm concentration and motility. Sperm motility was lower in winter and higher in summer in both groups and also, but to a lesser extent, in artificial insemination donors who collected semen in the laboratory. CONCLUSIONS: duration of abstinence, the elapse of time and seasonal temperature changes affect semen analysis results, and therefore controls for these variables must be incorporated in any therapeutic trial for male infertility. On the other hand, they only account for a small proportion of the total variability and thus routine correction of results would not greatly improve the value of semen analysis in the prediction of fertility. Furthermore because differences in the duration of abstinence have only a small effect on sperm concentration in oligozoospermic men, restricting sexual intercourse to the time of ovulation may not enhance fertility.

Humans↗
PubMed1980

Management and survival of female breast cancer: results of a national survey by the American College of Surgeons.

This is a resume of a Breast Cancer Survey carried out by the American College of Surgeons in 1978. Four hundred and ninety-eight hospitals in 47 states, Washington, D.C., and Puerto Rico participated, contributing a total of 24,136 female patients with histologically confirmed breast cancer. In these patients, five-year cure rates were 60.5% for clinically localized disease and 33.9% for regional disease. Five-year survival rates were 72.8% for localized disease and 49.1% for regional disease. From the 1960's into the early 1970's, there was a gradual shift away from radical mastectomy towards so-called modified radical mastectomy. In a group of patients treated by either radical or modified mastectomies, the axillary nodal status, size of the tumor, and location of the tumor were examined in relation to the prognosis. In the study of number of metastatic nodes in the axilla, there were reduced cure and survival rates in patients with one or more positive nodes as compared to those with negative axillary nodes. With the increase in the number of positive nodes, there was a continuing associated decline in survival and cure. The clinical size of the tumor also correlated well to the prognosis. With the increase in the size of the tumor, there was a gradual increase in the probability of axillary nodal involvement. However, in the group of patients with tumor size smaller than 1 cm, axillary metastasis occurred in 25%. When the axillary nodes were involved, the cure rate in those patients was not significantly better than the rates for those with larger primary tumors in this study. Tumors located in the medial half of the breast were associated with a slightly lower cure rate than those in the lateral half. Young women under 35 years of age had poorer survival and cure rates, although in women 35-44 years of age, the five-year results were comparable to the older group of patients. In blacks, breast cancer was diagnosed in a relatively more advanced stage than in whites. Survival and cure rates were generally lower for blacks, and such lower rates seem to be associated with the relatively advanced stage of the disease.

Adult↗