A.W. Diddle

Epinephrine and norepinephrine in pregnancy: A comparative study of the adrenal gland and catechol output in different species of animals and man

Abstract The purpose of these studies was to determine the adrenal medullary changes produced by pregnancy and evaluate urinary output of epinephrine and norepinephrine during pregnancy, labor, and the postpartum period. The adrenals of 18 goats, 12 sheep, 42 cats, and 45 rats were obtained at various times during pregnancy and the postpartum period and bioassayed for epinephrine and norepinephrine. Further, daily 24 hr. urinary outputs of epinephrine and norepinephrine were determined on 20 women during pregnancy, labor, and the postpartum period. The results indicate that pregnancy, labor, and the postpartum period produce no significant alterations in the epinephrine and norepinephrine content of the adrenal gland (Tables I to IV). Urinary output of epinephrine and norepinephrine during the course of pregnancy remains within normal limits until the onset of labor. Concomitant with the onset of labor, there is a marked increase in the output of both epinephrine and norepinephrine, especially the latter (Table VI). Further, after delivery, there is also a gradual increase in both hormones, reaching the highest level at the 6 to 18 hr. postpartum period (Tables V and VII). A patient with hydatidiform mole of the Destrusens type showed a normal urinary output of epinephrine and norepinephrine; small amounts of epinephrine and norepinephrine were demonstrated in the mole.

Oral contraceptive medication: a prolonged experience.

Abstract We find no reason to feel that norethindrone and norethindrone acetate with or without ethinyl estradiol produces deleterious metabolic effects when administered continuously for as long as 6 years. The capsules of an ovary removed from each of 3 women treated for 46 to 62.5 cycles each appeared thickened with fibrotic change. The incidence of carcinoma in situ among treated patients has not varied appreciably from the norm for this community. The average effort time for conception subsequent to administration of the above-mentioned drugs for nearly 3.5 years or less was 6.5 months with a range of 1 to 42 months. Some isolated experiences with thrombophlebitis complicating treatment and treatment being administered concomitant with the occurrence of thrombophlebitis are included.

Protein-bound iodine and T4 tests after vaginal application of povidone-iodine

Abstract Serum PBI and T4 determinations were done on ten patients before and one day, one week, and one month after the use of povidone-iodine ∗ ∗Betadine, Purdue-Frederick Company, Yonkers, New York. as a vaginal preoperative preparation. A significant rise was found at one day in the PBI but no significant change was found for the most part at one week and one month. The T4 levels were not significantly altered the first week after the use of Betadine.

Acute pancreatitis in gynecologic and obstetric practice

Abstract A review of acute pancreatitis in gynecologic and obstetric practice is presented. Cognizance is taken of the rarity of the process in this field; however, the importance of the clinicians index of suspicion is emphasized. Three case presentations are given along with a review of historical facts, incidence, etiology, clinical manifestations, laboratory data, pathology, and current therapy of the disease.

Cervical carcinoma; cancer cells in the circulating blood.

Abstract This study was designed to determine if cancer cells could be found in the venous blood of patients with invasive cervical carcinoma.

Cervical carcinoma: Metastases to the solar region

The symptomatology, anatomic route of spread, disturbance in gastrointestinal physiology, pathology of the metastasis, and diagnostic problems presented by solar metastases arising from primary invasive cervical carcinoma are discussed. Thirteen of 742 women suffered this fatal complication. Since the complication predominated in women previously untreated and with relatively early lesions, the question is raised whether or not cervical dilatation at the time of intracavitary application of radium predisposed to the process.

Integration of obstetric and gynecologic inpatients: Morbidity

Abstract Over an interval of nearly 6½ years obstetric and selected gynecologic inpatients were integrated in the same wing of the hospital. The same nursing personnel provided care for all the patients. Isolation techniques were used in the care of those febrile or with infectius disease. A febrile response of 2 days or more occurred in 2 and nearly 9 per cent of the obstetric and gynecologic patients, respectively. The coliform microorganisms or Streptococcus faecalis predominated in the vagina of afebrile and febrile gynecologic patients. Contrariwise, febrile obstetric patients more often harbored streptococci, staphylococci, and diphtheroids. There were no maternal or fetal mortalities or postoperative or postpartum complications that could be attributed to mixing of the patients. It is recommended that mixing of obstetric and gynecologic units be done only if there is motivation, vigilance, and supervision on the part of the professional staff to protect susceptible hosts from prevalent nosocomial bacteria.

Hepatic metastases from genital cancer: Diagnosis by scanning with radioactive gold

Abstract Nine women with genital neoplasm were studied by scintillation scanning of the liver with colloidal Au 198 . Six of the 9 patients had abnormal hepatic scans. Subsequent tissue studies proved that 5 of the patients had hepatic lesions; the nature of the sixth remains equivocal. Four of the 5 with hepatic lesions had metastatic carcinoma; the fifth had miliary tuberculosis of the liver. This preliminary study indicates that scintillation scanning of the liver is helpful in identifying the presence or absence of hepatic metastaus from genital cancer. For this reason we have adopted the procedure as part of the diagnostic work-up for all patients with known invasive pelvic cancer. This is being done on an experimental basis to ascertain the frequency of hepatic spread at the time of a correct diagnosis.

Nitrogen and phenylalanine mustard: Use in women with intrauterine cancer

Abstract Thirteen women with either cervical or endometrial carcinoma or choriocarcinoma were given nitrogen or phenylalanine mustard. Leukopenia, pancytopenia, and anemia occurred in varying degrees of severity in different patients; two women died of sepsis during or shortly after the most acute phase of bone marrow depression. A third person acquired permanent partial motor paralysis of both legs from neurotoxic effects. The intrapelvic soft tissues were “frozen” in the fourth patient by the radiomimetic action of nitrogen mustard. Only those with endometrial carcinoma and with an initial favorable prognosis were living 2 years later. It is our present opinion that the undesirable toxic effects of the drugs outweigh the beneficial amelioration for these particular tumors, given in the manner and dosages described here.