Endocrine and clinical aspects of new compounds for treatment of hormone-related cancer in gynecology.
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Biomedical subjects
Publications and source records attributed to H von Matthiessen.
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Severe aplastic anaemia was diagnosed in a 24-year-old woman in the 16th week of her pregnancy. She was delivered by cesarean section in the 35th week of a healthy boy, treatment in the intervening period having been exclusively by supportive measures. Allogenic bone marrow transplantation, planned after delivery, had to be cancelled owing to the sudden death of the female donor. Immunosuppressive treatment with antithymocyte globulin, corticosteroids and cyclosporin A failed to improve the haematological picture and the patient died one year after the delivery of intracerebral haemorrhage.
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Tumor samples from 74 patients with gynecologic malignancies including breast cancer were processed in a soft agar colony-forming assay. None of the samples resulted in a pure single cell suspension. Of the 10 samples meeting our criteria of evaluability for chemosensitivity testing, only 5 samples showed in vitro sensitivity to any drug. Of the 3 evaluable correlations between in vitro and in vivo results, 2 were correct. Due to the low rate of evaluable samples the assay has only limited value in the assignment of chemotherapeutic drugs for patients treated at our institution.
A patient who had a systemic reaction to cisplatin chemotherapy had a reaction to subsequent i.c. and i.v. test doses. Notwithstanding she had a more severe systemic reaction during a further course of cisplatin chemotherapy.
Between January 1978 and October 1980 97 tissue samples of histologically verified carcinoma of the breast were received for performance of the short-term incubation test. 25 tumour samples could not be prepared as cell suspension sufficient for testing. Among the 72 performed tests there were 9 with stimulation of 3H-uridine uptake by doxorubicin. Thus only 63 tests could be evaluated. Results were correlated with clinical data of the patients. No significant correlations could be established between tumour stage at time of diagnosis, age, menopausal state, receptor state, and the test result. There was also no differentiation between favourable and unfavourable prognoses as regards free interval and rate of survival. A correlation between results of tests and success or failure of cytostatic treatment could not be ascertained.
The effect of medroxyprogesterone acetate, oestradiol-17 beta and testolactone on 3H-thymidine incorporation in human mammary carcinoma was studied in vitro. 54% of the tumours reacted to medroxyprogesterone, while testolactone and oestradiol-17 beta changed 3H-thymidine incorporation in 45.1 and 41.3%, respectively. Both inhibition and the in vivo undesirable stimulation of 3H-thymidine incorporation was observed. No relation could be established between oestrogen receptor content and reaction of the mammary carcinoma to oestradiol-17 beta. On the other hand, the gestagen receptor content and the reaction of the mammary carcinoma to medroxyprogesterone acetate correlated significantly (P < 0.001). This underlines the increasing significance of the gestagen receptor in the selective endocrine treatment of mammary carcinoma.
The danger of maternal complications during local and conduction anaesthesia during delivery is important for the indication for the choice of the method and for informed consent from the patient prior to delivery. Data on maternal complications since 1960 in the use of the pudendal block, the paracervical block, spinal anaesthesia for vaginal deliveries and Caesarean sections, single shot lumbar epidural anaesthesia and continous catheter lumbar epidural anaesthesias and caudal anaesthesias are presented. The respective anaesthetic risk apparent from this data are discussed.
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