Plasma ribonuclease: a marker for the detection of ovarian cancer

There were no significant differences between the mean blood plasma (leukocyte-free) RNAase activity among 128 healthy women volunteers age 13-70 and 49 women with benign gynecological tumors. Exceptions to this finding were three apparently healthy women volunteers who had plasma enzyme activity which was higher than two standard deviations from the mean of the control subjects. Increased plasma RNAase activity was also demonstrated for 21 of 22 patients with ovarian carcinomas of differential histological types. This group included two patients with Stage IA, two patients with Stage IC ovarian carcinoma, and 17 patients with advanced ovarian carcinoma. The one exception was a patient with a well encapsulated, mucinous cystadenocarcinoma, Stage IA. The plasma RNAase activity returned to normal values in all of the cancer patients who had no clinical evidence of residual malignant tissue after surgical treatment. However, the enzyme activity also returned to a normal value in one of the 17 women in whom all of the malignant tissue was not removed. These data indicate that plasma RNAase activity can be utilized as a tumor marker for the presence of ovarian malignancies of various histological types, and to differentiate between malignant and benign neoplasms.

Closure of the human umbilical artery: a physiological demonstration of Burton's theory

30 umbilical cords of normal full-term infants were examined immediately after birth for closure of the arteries. Multiple constrictions were observed in the arteries at birth, which increased in number and degree with time. Between the constrictions there were segments of dilatations with trapped blood. Cutting through the constrictions in the cords clamped later than 1 min after birth did not result in leakage of blood from the adjoining dilated segments which contained trapped uncoagulated blood indicating complete closure. This behavior of the vessels is a physiologic example of critical closure of small arteries according to Burton's theory.

Ureterovaginal fistula as a complication of radical pelvic surgery

The main objection to radical hysterectomy and pelvic node dissection as a method of primary treatment for cervical carcinoma is the inherent danger to the ureters that may result in ureterovaginal fistula formation. The purpose of this paper is twofold: (1) to show that with adoption of certain surgical and clinical measures our incidence of fistula formation has been significantly reduced, and (2) to discuss the management of ureterovaginal fistula when it occurs.

The barrel-shaped cervical carcinoma

Twelve patients had barrel-shaped cervical carcinoma among 493 new patients with primary invasive cervical carcinoma, at the Downstate Medical Center, New York from January, 1964 to December, 1972. The incidence of barrel-shaped lesions among invasive carcinoma of the cervix was 2.43%. All 12 patients were treated with external radiation to the whole pelvis followed by two radium applications. In six patients an extrafascial hysterectomy was performed 6 to 12 weeks after radiation. Six patients died and six survived (50%). Six patients survived for over 2 years after therapy with no evidence of recurrence. Of these, four are alive and well for over 5 years. All six patients died within 20 months after therapy. The barrel-shaped cervical carcinoma fared poorly (six deaths among 12 patients or 50%) when compared with the over-all Stage I and Stage II cervical carcinoma (87 deaths among 339 patients or 25.5%).