Mary Jane Gray

SECRETION RATE OF ALDOSTERONE IN NORMAL PREGNANCY

There is a progressive rise in excretion of the metabolites of the estrogens (1) and of progesterone 1 (2) during pregnancy in humans. In late pregnancy, these hormones are largely placental in origin (3-6). The physiological role of the adrenal gland in pregnancy is still not well understood. The high levels of blood hydrocortisone found in pregnancy were initially explained as a reflection of an increased secretion of adrenal cortical hormones (7). More recently, it has been shown that the high blood levels of hydrocortisone in pregnancy could be accounted for by the increased binding of this hormone to blood proteins (8). It has been reported that aldosterone is secreted in increased amounts during pregnancy (9, 10). From available evidence, it has been concluded that in humans aldosterone is not a secretory product of the placenta (11-14), but that it is formed in the adrenal gland. In earlier studies (15-17), bioassay of the crude urinary extract revealed little or no increase in the salt-retaining factor in pregnancy as compared with the normal nonpregnant state. Barnes and Quilligan (18) reported the same findings with a bioassay of urinary extracts purified by three paper chromatographic systems. In 1956, Venning and Dyrenfurth (19) bioassayed extracts

THE ROLE OF THE FETUS IN THE WATER EXCHANGE OF THE AMNIOTIC FLUID OF NORMAL AND HYDRAMNIOTIC PATIENTS

In a preceding report on exchange mechanisms in pregnant monkeys (1), evidence has been presented that the water exchange between the maternal organism and the products of gestation can be represented by a kinetic model composed of three major compartments, all of which exchange with each other. The three compartments are defined as: 1) the amniotic fluid, 2) the maternal, and 3) the fetal body water. It could be shown that the introduction of a hydrogen tracer into fetus or amniotic fluid results in retention curves of predictable shape and that transfer rates for water can be calculated with reasonable accuracy when the amniotic fluid was used as the primary compartment. It should therefore be possible to devise methods whereby the transfer rates for the human could be calculated and to study the role which the fetus plays in the exchange of water between the amniotic fluid and the mother. For the calculation of transfer rates it is necessary to know the change in concentration of tracer as a function of time for each compartment. Continuous measurements on pregnant women are limited to the two accessible compartments: mother and amniotic fluid. In addition, a single sample of fetal or cord blood can be obtained at the time of delivery. Under these conditions there are two possible ways in which a time-activity curve for the fetal compartment can be calculated from available data. The first is based upon the

The lymphocyst: A complication of pelvic lymph node dissections

Abstract Nine of 55 patients with carcinoma of the cervix who were treated with pelvic lymphadenectomy 3 months after full radium and external radiotherapy developed retroperitoneal collections of fluid one to 6 months after operation. These lymphocysts were responsible for a large proportion of the morbidity and mortality resulting from this operation and constitute one of the major reasons for abandoning this procedure.

Total body water, sodium space, and total exchangeable sodium in normal and toxemic pregnant women.

Abstract 1. Simultaneous measurements of sodium space and total body water as well as total exchangeable sodium have been made on a series of toxemic patients and the values compared with the range obtained for normal pregnant women near term. 2. The relationship of total body water and body weight was found to be influenced by body build; i.e., lean pregnant women were found to have a higher (58.7 per cent body weight) and obese pregnant women a lower (45.4 per cent body weight) water content than the mean (53.3 per cent body weight). The ratio of sodium to water space showed no significant difference when lean, obese, and average normal pregnant patients were compared. 3. The mean sodium space of pre-eclamptic patients with and without hypertensive vascular disease constitutes a significantly higher percentage (56.0) of the total body water than the corresponding mean for normal (49.5) and hypertensive patients without pre-eclampsia (50.0). 4. The mean value for the total exchangeable sodium of pre-eclamptic patients is significantly higher (46.0 mEq. per kilogram) than that of normal pregnant patients (39.6 mEq. per kilogram) of comparable gestational age. 5. Additional evidence has been presented that normal pregnant women do not retain sodium beyond the limits for the nonpregnant state.

The role of the monkey fetus in the exchange of the water and sodium of the amniotic fluid.

Isotopic tracers allow for the expedient investigation of the exchange of elements or metabolic products between the maternal organism and conceptus. The quantity of carrier transferred per unit of time can be estimated from the behavior of tracers if the experimental data are subjected to the proper mathematical treatment. The general background and practical applications of the theory of multi-compartment systems to related biologic problems have recently been reviewed (1). Depending upon the aim of the investigation and the nature of the available experimental data, one can subdivide a given system into an arbitrary number of hypothetical compartments which exchange, or are assumed to exchange, their constituents at constant rates. If such a system is to be completely defined, time-activity curves for all compartments must be known and all must be accessible. Once the applicability of a certain kinetic model is established, the transfer rates can be calculated from a minimum of experimental data. It is the purpose of these investigations to test the applicability of a proposed kinetic model in order to provide the theoretical basis for further studies on clinical material. It is known that the human fetus participates in the exchange of water and electrolytes between amniotic fluid and mother (2), but because of its inaccessibility a quantitative formulation of these mechanisms is not easily accomplished. A knowledge of the tracer concentration in fetal blood as a function of time is a prerequisite for the calculation of transfer rates. Such a time-activity curve for the fetal compartment can be determined directly on some experimental animals where * This investigation was, in part, supported by a grantin-aid from the National Institutes of Health, Department of Health, Education and Welfare. samples of fetal blood can be obtained without disturbing the continuity of the system. The pregnant primate, a miniature model of the human maternal organism, should serve this purpose very well if it can be shown that the two species are comparable in the more pertinent aspects of water and electrolyte exchange. For the study of these problems three sets of experiments were carried out. The first was intended to show that the transfer rates of water in and out of the amniotic fluid compartment of pregnant monkeys at term are identical within the limits of error of the method. The second was intended to estimate the ratio of water to sodium transfer and to compare this ratio with values previously reported for the human. Finally, attempts were made to determine time-activity curves for all three compartments simultaneously and to estimate the overall transfer rates involving the fetus in utero.

Hydrodynamic Model of A 3-Compartment Catenary System with Exchanging End Compartments

Summary A hydrodynamic model of a 3 compartment system analogous to the maternal organism has been constructed. Its schematic representation is that of a catenary 3 compartment system in which the end compartments exchange. The mathematical basis for this system has been reviewed and experimental “time-activity” curves for the 3 compartments used to calculate the transfer rates.

The clinical evaluation of 2-acetylamino-5-nitro-thiazole, an orally effective trichomonacide

Abstract Routine examination of vaginal smears by the culture method of Kupferberg, Johnson, and Sprince showed that 31.6 per cent of gynecologic clinic patients harbored Trichomonas vaginalis . Twenty per cent of pregnant patients were found to be infected when the same diagnostic technique was used. About 60 per cent of these patients had symptoms attributable to the disease. A potent trichomonacidal agent, 2-acetylamino-5-nitrothiazole, was shown to be effective when administered orally. The parasites were eradicated in 35 per cent of infected patients regardless of the presence or absence of symptoms when the drug was administered in a daily dose of 300 mg. as enteric-coated tablets for a period of seven to ten days. With dosages exceeding 450 mg. per day, side reactions such as anorexia, abdominal cramps, nausea, and dark discoloration of the urine became pronounced without a corresponding rise in the parasitologic cure rate. There was no demonstrable change in the hemograms of these patients during and after therapy. Evidence has been presented that T. vaginalis can be cradicated by the systemic action of a new trichomonacidal agent.

THE ROLE OF THE MONKEY FETUS IN THE EXCHANGE OF THE WATER AND SODIUM OF THE AMNIOTIC FLUID

Isotopic tracers allow for the expedient investigation of the exchange of elements or metabolic products between the maternal organism and conceptus. The quantity of carrier transferred per unit of time can be estimated from the behavior of tracers if the experimental data are subjected to the proper mathematical treatment. The general background and practical applications of the theory of multi-compartment systems to related biologic problems have recently been reviewed (1). Depending upon the aim of the investigation and the nature of the available experimental data, one can subdivide a given system into an arbitrary number of hypothetical compartments which exchange, or are assumed to exchange, their constituents at constant rates. If such a system is to be completely defined, time-activity curves for all compartments must be known and all must be accessible. Once the applicability of a certain kinetic model is established, the transfer rates can be calculated from a minimum of experimental data. It is the purpose of these investigations to test the applicability of a proposed kinetic model in order to provide the theoretical basis for further studies on clinical material. It is known that the human fetus participates in the exchange of water and electrolytes between amniotic fluid and mother (2), but because of its inaccessibility a quantitative formulation of these mechanisms is not easily accomplished. A knowledge of the tracer concentration in fetal blood as a function of time is a prerequisite for the calculation of transfer rates. Such a time-activity curve for the fetal compartment can be determined directly on some experimental animals where