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Biomedical subjects

L D Stoddard

Publications and source records attributed to L D Stoddard.

At least 19 recordsLinked to original sources
PubMed1989

Immunocytochemical study of ras and myc proto-oncogene polypeptide expression in the human menstrual cycle.

The human endometrium is a unique and dynamic tissue model system characterized by cyclic processes of cellular proliferation, differentiation, and menstrual desquamation. Both the glandular epithelial and stromal mesenchymal components work in synchronous response to the mitogenetic effect of estradiol and the antimitogenetic effect of progesterone. Mechanisms whereby estradiol and progesterone exert their effects are not completely understood. This study was undertaken to evaluate the expression and localization of the polypeptide products of the ras and myc proto-oncogenes sequentially during the menstrual cycle. Sixteen endometrial biopsy specimens were evaluated. Immunocytochemical quantitation of ras and myc expression was done by use of color image analysis (CoreScan). There was no cyclic variation in the ras polypeptide product, but the expression of myc polypeptide was low in the secretory phase and high in the proliferative phase.

Cell Division↗
PubMed1989

Acute bacterial aortitis resulting in an aortoesophageal fistula. A fatal complication of untreated esophageal carcinoma.

Exsanguination in a case of esophageal carcinoma resulted from an aortoesophageal fistula. The squamous carcinoma was undiagnosed clinically and was untreated. Ulceration of the carcinoma gave rise to mediastinitis and an abscess containing necrotic tumor and bacteria. Infection spread from the abscess to the adjacent aorta, producing focal bacterial aortitis, necrosis of the aortic media, and aortic perforation. A fistula was thus established between the aorta, the abscess cavity, and the esophagus. Terminally, the patient had a large hematemesis, and massive hemorrhage acutely distended the stomach which ruptured to produce a large hemoperitoneum.

Acute Disease↗
PubMed1985

Multifocal tumorigenesis in the upper female genital tract--implications for staging and management.

A review of 128 cases of "primary" ovarian müllerian carcinoma treated at the King George V Memorial Hospital was undertaken to determine the relative frequency with which such tumors were associated with evidence of multifocal primary neoplasia. Of the 128 cases studied, 115 were invasive carcinomas and 13 were noninvasive or borderline ovarian tumors ("tumors of low malignant potential"). Eight of 10 borderline serous ovarian tumors (80%) and 37 of 75 invasive serous carcinomas (49%) exhibited evidence of independent primary neoplasia at more than one anatomical site in the biopsy material available for review. Many of these cases represented bilateral primary ovarian tumors, but autochthonous extraovarian neoplasia was also commonly encountered. A single borderline endometrioid ovarian tumor and six of 15 endometrioid carcinomas (40%) were associated with biopsy-proven multifocal primary tumorigenesis. These were predominantly neoplasms in one or both ovaries plus adenocarcinoma in the uterine corpus. Other histological types of malignant common epithelial tumors of the ovaries did not demonstrate any such tendency, highlighting major differences in pathogenesis between members of this loosely associated group of ovarian cancers. Our study suggests that gynecological endometrioid and serous malignancies are commonly multifocal and we feel this has significant implications for the way these neoplasms are staged and therefore treated.

Biopsy↗
PubMed1982

The protective role of progesterone in the prevention of endometrial cancer.

An association between endometrial hyperplasia and corpus cancer has long been suspected. Genetically predisposed women are at greater risk of developing endometrial cancer if subjected to long uninterrupted period of estrogen stimulation. Endometrial cancer need not be inevitable if 14 day courses of an oral progestogen are continued for as long as is necessary; in some women, however, the lesions will progress and, therefore, should be carefully followed with repeated endometrial biopsies. Epidemiological evidence suggests a true link between unopposed estrogens and early, less invasive endometrial cancer, and progestogens appear capable of protecting against the development of cancer and hyperplasia, although complete protection has not yet been achieved. The protective action of progestogens is supported by the fact the none developed endometrial cancer in a series of 490 women of reproductive age who received continuous estrogens by way of pellet implants of 17 beta estradiol for conception control for 1--10 years. Evidence for the protective action of progestogens in estrogen-treated menopausal women was less solid than in non-menopausal women but was nonetheless considerable. Our study of 1058 women, 45 years of age and older, receiving continuous estrogens by way of 17 beta estradiol pellets over a period varying from 1 to 21 years, revealed that the incidence of cancer was not greater and was possibly less than that expected in an untreated population of menopausal women.

Adolescent↗
PubMed1980

Toward a new human pathology. I. Biopathological populations, or sets: a substitute for the old pathology's diseases.

Diseases are class concepts. They are used to group biomedical cases according to biopathological similarities perceived among them. Because calss concepts are mutually exclusive, a patient's ailment has to be considered as one, and only one, disease. However, as biotechnical data have multiplied, cross-over similarities among cases in different disease classes have become troublesomely frequent. For that reason, the abundance of data requires a method to handle overlap. Set theory differs from classification theory by allowing overlap among categories. Using set theory, a pathologist can assign a given case to as many biopathological sets as the data require. Therefore, biopathological set theory provides a substitute for mutually exclusive diseases, which are no longer a serviceable way to categorize cases and to organize the data of human pathology.

Diagnosis↗
PubMed1978

The estrogen--cancer controversy.

Postmenopausal women should not be denied estrogen therapy because of the controversy about the alleged causal relationship of estrogens to endometrial cancer. A prestigious team of biostatisticians reviewed three publications that claimed this relationship and concluded that no such association could be confirmed. Although the incidence of endometrial cancer has doubled in the past 25 years, there is no valid basis for the assumption that the widespread use of estrogens is the cause. The incidence also has increased in Norway and Czechoslovakia where estrogens are rarely used. Moreover, the histologic pattern of endometrial dysplasias is such that many pathologists will make a diagnosis of endometrial cancer as a safeguard for the patient. Thus the statistics for the incidence of endometrial cancer may be inflated. As a test, the administration of 200 mg of an oral progestogen over 5-10 days will convert a histologic pattern of pseudomalignancy, but not of adenocarcinoma, into one of secretory endometrium. Unopposed endogenous or exogenous estrogens may induce hyperplasia, atypical adenomatous hyperplasia or adenocarcinoma in women who are genetically predisposed. To minimize such a possibility, it is advisable to give a 5-7 day course of an oral progestogen so that the endometrium will be shed as monthly intevals. The benefits of hormone replacement therapy for the postmenopausal woman far outweigh the putative risk of endometrial cancer.

Endometrial Hyperplasia↗