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Biomedical subjects

T Parmley

Publications and source records attributed to T Parmley.

At least 19 recordsLinked to original sources
PubMed1995

Endometrial effects of long-term low-dose administration of RU486.

OBJECTIVE: To examine endometrial response to long-term low-does RU486 administration. DESIGN: Retrospective controlled study of women with endometriosis treated for 6 months with 50 mg RU486 daily for 6 months. Controls consisted of women in the follicular phase of a spontaneous cycle undergoing endometrial biopsy. SETTING: Patients from the clinical practice of the authors at the University of California, San Diego Medical Center. PATIENTS AND INTERVENTIONS: Nine patients treated with long-term low-dose RU486 and nine normal cycling controls undergoing hysterectomy or endometrial biopsy for benign disease. MAIN OUTCOME MEASURES: Changes in endometrial morphology and immunohistochemical analysis for estrogen receptor (ER) and progesterone receptor (PR) protein. RESULTS: All patients treated with RU486 exhibited abnormal endometrial morphology. The endometrial glands were irregular in size and shape. The stroma was varied but consisted predominantly of dense cellular stroma with frequent mitotic figures. The glands were lined by a combination of epithelial types some of which were secretory. No cytologic atypia was seen. Levels of ER immunoreactivity, as determined by image analysis, were greater in the stroma with no difference in PR immunoreactivity compared with controls. No difference in ER and PR immunoreactivity were seen in the glands compared with normal controls. CONCLUSION: The generalized cystic changes demonstrated are consistent with a chronic unopposed estrogen effect and are concordant with hormonal data showing early to midfollicular phase levels of estrogens. They also are consistent with our findings of increased ER immunoreactivity in the stroma. Evidence of minimal P agonist effect was noted.

Adolescent↗
PubMed1993

Endometriosis and ascites.

A 29-year-old black woman had increasing abdominal girth, dullness to percussion, and an irregular mass in the left adnexal region. At laparotomy, 6 L of dark brown fluid was removed, and the abdominal cavity had the appearance of extensive carcinomatosis. Subsequent histology was consistent with endometriosis. Fourteen cases of endometriosis producing symptoms resembling ovarian cancer have been previously reported. Of the 10 patients whose race was mentioned, 9 were black, as was our patient. The etiology of the ascites is unknown. Histologically, the endometrial implants show dense stroma and a slightly hyperplastic epithelium rather than the physiologic proliferative endometrium usually associated with endometriosis. This leads us to question the prognosis of the lesion despite its apparently benign histology.

Adult↗
PubMed1987

Inter- and intra-pathologist variability in the diagnosis of gestational trophoblastic neoplasia.

All 190 cases of gestational trophoblastic neoplasia diagnosed in the Baltimore metropolitan area from 1975-1982 were identified. Histologic slides were requested and reviewed independently by two pathologists who agreed upon uniform criteria for the diagnosis of hydatidiform (complete) mole, invasive mole, and choriocarcinoma. A representative sample of the slides was selected and resubmitted to one of the study pathologists for a second review. The inter- and intra-pathologist variability in the diagnosis of gestational trophoblastic neoplasia was calculated using the kappa statistic (K). Our findings indicated that the variability in the diagnosis of gestational trophoblastic neoplasia was low whereas that for the related tumor of incomplete mole was high.

Choriocarcinoma↗
PubMed1986

Development of interstitial cells and ovigerous cords in the human fetal ovary: an ultrastructural study.

Differentiation and subsequent regression of interstitial cells in the human fetal ovary was studied by light and electron microscopy in specimens obtained from twelve fetuses between 12 and 40 weeks of gestation. Interstitial cells possessing the ultrastructural features associated with steroid production first differentiate from fibroblast-like cells by 15 weeks. This occurs within the medullary fibrous tissue penetrating the cortex. The number of such cells is maximal at 18 weeks around the ovigerous cords in the inner half of the cortex. In addition, gap junction formation is seen in the pregranulosa cells forming ovigerous cords. From 21 to 31 weeks primordial follicles develop from ovigerous cords, which themselves develop from undifferentiated cortex, in a sequence that is most advanced in the medullary portion of the gonad and least advanced at its surface. During this time the interstitial cells decrease in number. They are not observed around the follicles, but are occasionally seen in the outer layer of the cortex which is still at the stage of ovigerous cords. At 40 weeks, growing follicles associated with several layers of enveloping theca cells are observed in the innermost region of the cortex. Interstitial cells are rare in all parts of the ovary. The development of interstitial cells independent of follicles in the human fetal ovary implies that such cells are distinct from theca cells, and that they correspond to the primary interstitial cells of other mammalian species. In addition anatomical and temporal relationships are observed between the interstitial cells, the ovigerous cords, developing primordial follicles and the formation of gap junctions in pregranulosa cells.

Cell Differentiation↗
PubMed1986

Adenomas in minor vestibular glands.

Sixty-four patients were treated by minor vestibular adnexectomy for persistent dyspareunia and vulvar pain and burning between 1982 and 1984. The incidental finding of vestibular gland adenomas was found in 12 cases. These masses were 1 to 2 cm in size and composed of mucous secreting glands characteristic of the vestibular glands. These lesions were benign and were associated with previous surgical manipulation and chronic inflammatory reaction of the vestibular tissues. Previous recognition of vestibular adenomas in the literature is rare.

Adenoma↗
PubMed1985

Risk factors for gestational trophoblastic neoplasia.

A case-control study to determine the gynecologic and reproductive risk factors for gestational trophoblastic neoplasia was conducted in the Baltimore Metropolitan Area. All cases (N = 190) that were pathologically diagnosed from 1975 to 1982 as hydatidiform mole, invasive mole, or choriocarcinoma were ascertained. Slides were independently reviewed by two pathologists. Cases were matched by age, race, and last menstrual period to controls who were delivered of normal pregnancies at term. In the analysis of medical record and interview data, factors found to be positively associated with gestational trophoblastic neoplasia included professional occupations (odds ratio = 2.56, p less than 0.0001), prior spontaneous abortions (odds ratio = 2.32, p = 0.02), and the mean number of months from the last pregnancy to the index pregnancy (cases = 35.9, controls = 28.2; p = 0.03). Factors found not to be associated with disease included contraceptive history, irradiation, ABO blood group, and smoking factors of the male partner. The findings suggest that gestational trophoblastic neoplasia may be part of a continuum of early (first-trimester) reproductive abnormalities.

Abortion, Spontaneous↗
PubMed1984

Placental senescence.

As the nature of any intrinsic biologic aging process or even of its existence independent of disease is unknown, it is not possible to state whether or not the placenta gets old. As term approaches, the placenta accumulates a variety of lesions which seem pathological. In most cases, however, it is not certain that they represent intrinsic disease in the sense that older people tend to develop cancer or atherosclerosis. Several placental functions decrease near term, but it is not possible to attribute these to aging. In fact, some may represent adaptive additional maturation. A variety of laboratory phenomena seen in aging cells may be detected in the placenta but again, their significance is uncertain. In short, the placenta looks and acts as if it grows old. That is clinically important and probably all the clinician needs to know, but whether or not it truly grows old remains a mystery, an important point for the biologist. For if the placenta truly ages, then the embryo and its placenta represent genetically identical tissues which age at different rates. Such a model might give us much more specific information about our limits than a currently popular reference, the 90th Psalm.

Cell Survival↗
PubMed1982

Mixed Mullerian tumors of the uterus: clinical and pathologic correlations.

The 10-year experience at The Johns Hopkins Hospital with 61 cases of mixed Mullerian tumors were reviewed. The patients had a mean age of 63.7 years and the similar constitutional factors of diabetes mellitus, hypertension and nulliparity of endometrial adenocarcinoma. Only one patient had estrogen exposure. Eighteen percent had had prior exposure to pelvic radiation. The life table survival of the 61 patients was 41.1% at 5 years. The 2-year life table survival was 76% for disease confined to the uterus and 16.5% for extrauterine disease. There was no difference in survival between homologous and heterologous tumors. The surgical staging and the autopsies reviewed documented widely disseminated disease even when the tumor appeared to be confined to the uterus. It thus appears essential in order to improve survival these patients require aggressive staging and consideration of systemic adjuvant chemotherapy.

Adult↗
PubMed1981

Atypical epithelial proliferations in the fallopian tube.

Between the years 1950 and 1979, thirty-nine diagnoses of "atypical epithelial proliferation in the fallopian tube" were made in the Gynecologic Pathology Laboratory at The Johns Hopkins Hospital. In this discussion, the criteria for histopathologic diagnosis of such alterations are described. This series demonstrated an association of the tubal proliferations with malignancy in the upper genital canal and exogenous or endogenous estrogen stimulation. However, progression of these proliferative conditions to invasive tubal cancer was not documented.

Epithelium↗
PubMed1980

Benign cystic teratomas in postmenopausal women.

Postmenopausal benign cystic teratomas occurred in 16 women in a 6-year period. In this group the incidence of malignancy was 19%, and the incidence of bilaterality was 20%. Marked collagenization of the tissue of the teratoma indicated an "end-stage" process. The high incidence of malignancy in this group of patients in an indication for vigorous surgical staging for extent of disease.

Adolescent↗