Diagnostic and therapeutic efficacy of cervical conization

Cervical conization was perfromed on 756 patients at the University of Kentucky Medical Center from July 1, 1964, to January 1, 1973. Sixty-six patients were pregnant at the time of conization. Eighty-six per cent of patients with cytologic findings of carcinoma in situ had histologic verification of carcinoma in situ or severe dysplasia, and there was absolute correlation between cytology and histology in 75 per cent of patients will occult invasive cancer. Cervical biopsies without colposcopic direction predicted either severe dysplasia or carcinoma in situ in 77 per cent of cases but were accurate in only seven of 24 patients with occult invasive cancer. Carcinoma in situ was present in 30 per cent of hysterectomy specimens following conization but recurred in only seven per cent of patients followed without hysterectomy. Recurrent carcinoma in situ following hysterectomy was more common in patients with residual intraepithelial cancer in the uterus but was independent of the size of the vaginal cuff removed. Major postconization complications requiring hospitalization occurred in 3.4 per cent of nonpregnant patients and in 7.5 per cent of pregnant patients.

Effect of ischemia and infarction on regional content of adenine nucleotides and derivatives in canine left ventricle

Samples of myocardium from four areas of ischemic and infarcted canine ventricle were examined over a 20-day period for content of the three adenine nucleotides as well as inosine, hypoxanthine, adenosine, and inosine monophosphate. The adenosine triphosphate (ATP) content of central and peripheral areas within the infarct fell to 11% and 8% of control, respectively, 1 day after coronary occlusion. The total adenine nucleotide (TAN) content in these areas fell to 17% of control and showed no significant recovery during the period of study. In the functional myocardium immediately surrounding the infarct the ATP content was depressed to 58% control after 1 day, and the TAN content was also depressed. In the healthy myocardium near the apex, the ATP content was significantly depressed only at the 3-day sample period. Adenine nucleotide derivatives were detected only at 30 min in the central ischemic area. The absence of the nucleoside and nucleobase compounds formed during adenine nucleotide degradation is attributed to their high membrane diffusibility. Loss of these compounds is considered a contributing factor in the prolonged depression of adenine nucleotide content in both ischemic and non-ischemic regions.

Plasma CEA, tumor CEA, and tumor histology

Carcinoembryonic antigen (CEA) has been thought to be a diagnostic and prognostic indicator of colorectal cancer. Initial descriptions of CEA as a tumor specific antigen suggests a relationship between tumor CEA and circulating plasma CEA. To define the relationship between CEA and colorectal carcinoma, we have studied the CEA concentration of preoperative plasma, tumor tissue, and normal bowel distant from tumor in 35 patients who had clinically curative resections. Tumor histology was evaluated for Dukes class, histologic grade, necrosis, and vessel invasion. Regression analysis yielded no evidence of correlation between tumor CEA and plasma CEA. No correlation could be shown between tumor concentration of CEA and the histological parameters previously noted. CEA was found in all specimens of normal bowel. Furthermore, in 34% of the cases studied, the tumor CEA was not significantly higher than in normal bowel. No significant difference was shown when histopathological findings were compared to normal and abnormal plasma CEA values. These findings suggest the following conclusions: CEA is not tumor specific. Increased levels of CEA in tumor tissue are not a constant finding in colorectal carcinoma. Tumor levels of CEA do not appear to correlate with histologic degree of tumor differentiation. Elevated plasma levels of CEA do not necessarily connote elevated tumor tissue levels of CEA, and conversely, normal plasma levels of CEA do not necessarily mean low levels of tumor CEA.

Biological behavior of the primitive neuroectodermal tumors: significant supratentorial childhood gliomas

Supratentorial gliomas in the pediatric age group at the University of Kentucky Medical Center accounted for 20% of all childhood brain tumors. Seventeen of the 20 children with these tumors, regardless of histologic type, mode of therapy, or other parameters died within five years after tissue diagnosis, and most were dead within two years. Unlike the astrocytic gliomas, the poorly differentiated primitive neuroectodermal tumors tended to spread diffusely throughout the central nervous system and accounted for 35% of the supratentorial gliomas in children at our institution. Results of this study suggest that therapy for the primitive neuroectodermal tumor, unlike other childhood supratentorial gliomas, should be considered for the entire neuraxis.

Carcinoembryonic antigen in patients with gynecologic malignancy

Carcinoembryonic antigen (CEA) was elevated (greater than 2.5 ng/ml) in 81 of 100 patients with gynecologic malignancy and in 17 of 95 patients with benign gynecologic disease. CEA concentration was, in general, related to the extent of disease, and in early stage cancer often returned to normal following complete surgical excision. Tumors were classified morphologically according to cell type, lymphoplasmacytic infiltration, necrosis, vascular invasion, desmoplasia, and degree of differentiation. The only histologic characteristic associated with elevated CEA levels was the presence of vascular invasion. Further investigation is needed to define the structure, function, and metabolism of CEA in patients with gynecologic malignancy.

Comparative vasodilator effects of nitroglycerin, pentaerythritol trinitrate and biometabolites, and other organic nitrates

Previous studies in man have shown pentaerythritol (PE) trinitrate, given either sublingually or orally, produces a prolonged hypotensive effect. The coronary vasodilator and systemic vasodepressor activities of PE trinitrate and its metabolites, PE dinitrate, PE mononitrate and PE, were evaluated in dogs to determine whether the metabolites were active and contributory. Coronary vasodilator activity was estimated with a flow transducer placed on the left anterior descending artery, and reduction of arterial pressure was determined directly via the femoral artery. Quantitative comparisons were made from dose-response curves established for nitroglycerin (ng), PE nitrates, and other common organic nitrates after intrajugular administration. Increase of coronary blood flow and reduction of arterial pressure were proportionally related, and the proportionality was the same for all drugs. Relative to NG, the potency of PE trinitrate was about 20 percent, erythrityl tetranitrate 12 percent, and isosorbide dinitrate 3.5 percent. The ratios of vasodilator activity of PE trinitrate and its metabolities were: PE trinitrate 100; PE dinitrate 1.5; PE mononitrate 0.5; and PE O. Tachyphylaxis was observed after close-order injections of NG or PE trinitrate. In addition, there was cross tolerance between NG and PE trinitrate and also between PE trinitrate and its less active metabolites.

Role of calcium in volume regulation by dog red blood cells

Dog red blood cells (RBC) are shown to regulate their volume in anisosmotic media. Extrusion of water from osmotically swollen cells requires external calcium and is associated with net outward sodium movement. Accumulation of water by osmotically shrunken cells is not calcium dependent and is associated with net sodium uptake. Net movements of calcium are influenced by several variables including cell volume, pH, medium sodium concentration, and cellular sodium concentration. Osmotic swelling of cells increases calcium permeability, and this effect is diminished at acid pH. Net calcium flux in either direction between cells and medium is facilitated when the sodium concentrations is low in the compartment from which calcium moves and/or high in the compartment to which calcium moves. The hypothesis is advanced that energy for active sodium extrusion in dog RBC comes from passive, inward flow of calcium through a countertransport mechanism.

Intracellular restraint: a new basis for the limitation in response to oxidative stress in human erythrocytes containing low-activity variants of glucose-6-phosphate dehydrogenase

Several mechanisms recently proposed for regulation of the hexose monophosphate shunt require the concentration of NADP to be low or that of NADPH to be high. The present study indicates that the first enzyme of the hexose monophosphate shunt of human erythrocytes is under severe restraint even when these conditions do not exist. In human erythrocytes containing low-activity variants of this enzyme, glucose-6-phosphate dehydrogenase (D-glucose-6-phosphate:NADP(+) 1-oxidoreductase; EC 1.1.1.49), measurements of the rate of oxidation of C-1 labeled glucose show that the enzyme is operating at a rate much closer to its maximum than in normal cells. This requires that the ratio of inhibitory NADPH to NADP be much lower in the variant cells than in normal cells. A small increase in oxidative rate, induced by naphthol, then causes a disappearance in reduced glutathione in the variant cells, presumably because a significant further decrease in NADPH occurs in these cells, whereas the same oxidative stress in normal cells would not lower the NADPH level appreciably. A low NADPH/NADP ratio in unstressed cells deficient in glucose-6-phosphate dehydrogenase is confirmed by direct measurement. The maximum activity of the variant enzyme in the cell, as measured with methylene blue to keep most of the NADP in the oxidized form, is only about 1/60 of that found in hemolysates, thus accounting for the failure to compensate for a relatively small oxidative stress in vivo in spite of an apparent sufficiency of enzyme. The reason for the limitation on maximum intracellular activity is unknown. A similar limitation is seen with normal cells incubated with methylene blue, where the maximum intracellular rate is also only about 1/60 of that found in hemolysates.

A spontaneous lower motor neuron disease apparently caused by indigenous type-C RNA virus in wild mice

A high incidence of spontaneous lower-limb paralysis occurred in a population of wild mice (Mus musculus) which had a high incidence of naturally occurring lymphoma and elevated indigenous type-C virus activity. Experimental transmission evidence indicated that both the neurologic and lymphomatous disorders almost certainly were caused by the indigenous type-C virus. The virus appeared to have a direct neurotropic effect on anterior horn neurons in the lower spinal cord.

Dog red blood cells. Adjustment of salt and water content in vitro

Dog red blood cells (RBC) lack a ouabain-sensitive sodium pump, and yet they are capable of volume regulation in vivo. The present study was designed to find in vitro conditions under which dog RBC could transport sodium outward, against an electrochemical gradient. Cells were first loaded with sodium chloride and water by preincubation in hypertonic saline. They were then incubated at 37 degrees C in media containing physiologic concentrations of sodium, potassium, chloride, bicarbonate, glucose, and calcium. The cells returned to a normal salt and water content in 16-20 h. Without calcium in the medium the cells continued slowly to accumulate sodium. Removal of glucose caused rapid swelling and lysis, whether or not calcium was present. The net efflux of sodium showed a close relationship to medium calcium over a concentration range from 0 to 5 mM. Extrusion of salt and water was also demonstrated in fresh RBC (no hypertonic preincubation) when calcium levels in the media were sufficiently raised. The ion and water movements in these experiments were not influenced by ouabain or by removal of extracellular potassium. Magnesium could not substitute for calcium. It is concluded that dog RBC have an energy-dependent mechanism for extruding sodium chloride which requires external calcium and is quite distinct from the sodium-potassium exchange pump.

Classification of Mouse Thymic Virus as a Herpesvirus

Classical herpesvirus particles were observed by thin-section electron microscopy in thymus tissues from mice inoculated with mouse thymic virus. Intranuclear particles measured approximately 100 nm in diameter, and cytoplasmic and extracellular particles measured 135 nm in diameter. The morphology of mouse thymic virus particles together with its properties of heat and ether lability suggest that thymic virus should be classified as a member of the herpesvirus group.

Dog red blood cells. Adjustment of density in vivo

Red blood cells from mature dogs contain less Na and more K than would be the case if they were in Donnan equilibrium with plasma. They have no ouabain-sensitive Na pump, and their membranes are deficient in Na, K-ATPase. Experiments are reported in which dog red cells were first loaded with supranormal quantities of Na and water and then reinjected into the dog. Over the course of 26-40 h the Na- and water-loaded cells returned to a normal state of hydration as judged by their density. It is concluded that dog red cells possess some means of correcting their swollen status in vivo, despite their lack of a ouabain-sensitive cation transport apparatus.

Reye's syndrome. Possible causes and pathogenetic pathways

Reye's syndrome of brain swelling and fatty change of the viscera usually begins with a febrile upper respiratory tract infection, followed by the onset of coma. These patients typically assume a flexed elbows, extended legs, and clenched fists posture. Common laboratory findings include a low blood sugar, low cerebrospinal fluid sugar, metabolic acidosis, elevated blood urea nitrogen, ketonuria, aminoaciduria, and, marked elevations in SGOT and blood ammonia. Few children who develop this illness under the age of two years survive.

Uncommon morphologic features in subacute sclerosing panencephalitis (SSPE). Report of two cases with virus recovery from one autopsy brain specimen

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