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Biomedical subjects

J C Weed

Publications and source records attributed to J C Weed.

15 recordsLinked to original sources
PubMed1991

Diagnosis and management of brain metastasis from gestational trophoblastic disease.

Significant advances have been made since the introduction of methotrexate towards the improvement of long-term survival in patients with brain metastases from gestational trophoblastic disease. Early diagnosis via computed tomography of the head and beta-hCG serum testing along with aggressive, multiagent intervention have greatly improved patient prognosis from this once highly fatal condition. Although toxicity is commonly associated with this treatment, death from sepsis or drug reactions is unusual. Surgery has been found useful only to relieve intracranial pressure and is discouraged as part of diagnosis.

Brain Neoplasms↗
PubMed1979

Recurrent endodermal sinus tumor during pregnancy.

A case is reported of a patient who was found to have an endodermal sinus tumor coincident with pregnancy. She maintained a complete clinical response for 12 months after conservative surgery, uterine aspiration, and multiple-agent chemotherapy. Tumor recurrence appeared with a second pregnancy. A healthy infant was delivered despite resumption of chemotherapy. The use of cytotoxic chemotherapy during pregnancy is reviewed.

Adolescent↗
PubMed1978

Fertility after cryosurgery of the cervix.

Fertility in patients following cryosurgery of the cervix was evaluated in 412 women. Cryosurgery does not appear to have any effect on subsequent fertility when compared with the general population.

Adult↗
PubMed1977

Endometriosis and infertility: an enigma.

In our efforts to overcome infertility and subjective complaints in young women with endometriosis, we have performed conservative surgical procedures upon 142 women 30 years of age or less. In these women, multiple endometriomata were resected from the pelvic peritoneum, one or both ovaries, the large and small bowel, and the appendix. In addition, uterine and ovarian suspension, bowel resection, appendectomy, myomectomy, and presacral neurectomy (PSN) were performed when indicated. Conception occurred in 70% of the women wishing to conceive; the highest rate was found among those who had developed endometriosis after a previous conception. Ovarian involvement seemed to reduce the conception rate by 10%. Uterine suspension and PSN did not affect conception but did provide a symptomatic relief. We conclude that early examination for endometriosis and aggressive surgical management is indicated in young women with demonstrable disease.

Adolescent↗
PubMed1977

Cerebral necrosis following irradiation and chemotherapy for metastatic choriocarcinoma.

A case of cerebral necrosis following radiation and chemotherapy in a patient with metastatic cerebral choriocarcinoma is reported. Computed tomography (EMI Scan) demonstrated evolution and enlargement of the necrotic lesion. This focus was surgically excised and histology is presented. The possible enhancement of radiation necrosis by chemotherapy is noted, but the continued need for simultaneous use of radiation and chemotherapy is recognized and discussed.

Adult↗
PubMed1977

Combined irradiation and extensive operations in the treatment of stages I and II carcinoma of the cervix uteri.

Since 1947, carcinoma of the cervix uteri, Stage I, has been treated at the Ochsner Clinic with intracavitary irradiation and a radical hysterectomy--Wertheim type--and pelvic node dissection. If metastasis to the lymph node is demonstrated, external irradiation is administered postoperatively. Carcinoma of the cervix uteri, Stage II, has been treated with intracavitary radium and external radiation, followed by the same surgical procedure. All patients were treated surgically, except those with medical conditions precluding extensive operation. Five and ten year survival rates for Stage I cancer were 81.5 and 68.7 per cent, respectively; for Stage II, these rates were 64.5 per cent and 54.0 per cent, respectively. There were moderate complications from the combined therapy, with a ureteral fistula rate of 1.9 per cent. Although the combined use of irradiation and operation for carcinoma of the cervix uteri has been looked upon in this country with disfavor because of poor healing and complications, we have not found this to be so. With improvement of both radiation therapy and surgical management, these patients can be offered treatment based upon sound physiologic principles and can live in freedom from fear of recurrence in later years. The outlook is good for continued improvement in the complication rate, surgical technique and possibly, chemotherapy.

Adenoma↗
PubMed1976

Screening techniques in endometrial cancer.

Carcinoma of the uterus is the most frequently seen malignancy of female genital tract. Screening techniques have lowered the incidence and morbidity of cervical neoplasia. Attempts to identify premalignant and silent cancers of the uterus have been made. A single diagnostic procedure has not been uniformly successful. It would appear that multiple techniques, using both cytologic and histologic material, would increase the possibility of achieving the goal of early diagnosis in uterine disease.

Adenocarcinoma↗
PubMed1976

The specificity of gonadotropin binding by the human corpus luteum.

The specificity of gonadotropin binding was studied in fresh and frozen human corpora lutea. Ovine, bovine, and porcine luteinizing hormone (LH) competed with 125I-labeled human LH (125I-hLH) and 125I-labeled human chorionic gonadotropin (125I-hCG) for binding to tissue receptors in homogenates of human corpora lutea frozen for 3 to 12 months. In contrast, oLH, bLH, and pLH competed minimally for 125I-hLH and 125I-hCG binding sites in homogenates of fresh human corpora lutea. Ovine follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH) did not compete in homogenates of fresh or frozen tissue. Competition of oLH and hCG for 125I-hCG binding sites at several dose levels in a homogenate of a fresh corpus luteum was studied. One hundred micrograms of oLH and ten nanograms of hCG gave an equivalent competition--a 10,000-fold difference in competitive potency. Only hCG competed with 125I-hCG for binding when the competition of oLH, bLH, pLH, oFSH, oTSH, hCG and hCG subunits, and hCG were compared at the 10-mug level in a homogenate of fresh human corpus luteum. The binding of 125I-labeled homologous human hormones by the corpus luteum was examined in a limited fashion. 125I-Prolactin did not bind to preparations of fresh stroma from a patient with polycystic ovaries nor did it bind to three separate preparations of fresh corpora luteum which did bind 125I-hCG. 125I-hTSH did not show significant binding to a fresh human corpus luteum preparation which did bind 125I-hCG. These studies indicate that the gonadotropin receptor of the fresh human corpus luteum possesses a unique species specificity and illustrate the importance of working with human corpora lutea in their most native state.

Binding, Competitive↗
PubMed1975

Arteriography and infusional chemotherapy in localized trophoblastic disease.

Despite recent advances in the systemic chemotherapy of patients with malignant trophoblastic disease, there remains a small group of patients who fail to achieve remission with this type of treatment. The present study presents 19 patients with malignant trophoblastic disease who underwent a total of 25 arteriographic studies for localization of persistent malignant lesions and 8 patients who underwent arterial infusional chemotherapy after they had failed to achieve remission by standard administration of systemic methotrexate or actinomycin D. Patients underwent pelvic, pulmonary, carotid, and multiple abdominal selective arteriograms with a high correlation of positive findings and the later documented presence of persistent malignant disease. Findings include prominent uterine arteries, arteriovenous shunts, hypervascularity, irregular vessels, and tumor staining within the tumor. Arterially infused chemotherapy with methotrexate or actinomycin D was used in 8 patients whose disease was resistant to systemic chemotherapy. Technics of arterial infusion are discussed.

Angiography↗