Morton A. Stenchever

Chromosome breakage in users of marihuana

Forty-nine users of marihuana (29 male and 20 female) and 20 control subjects (12 male and 8 female) were studied with peripheral blood lymphocyte cultures for the presence of chromosome breaks and abnormal forms. An average of 3.4 cells with breaks per 100 cells (range 0 to 8) were noted in the user group, and 1 to 2 cells with breaks per 100 cells (range 0 to 5) were noted in the control group. No significant differences were noted in chromosome breakage between heavy and light users, users of mixed drugs when compared to users of marihuana only, users of marihuana and caffeine when compared to marihuana users not using caffeine, and male and female users. There were increases in numbers of cells with abnormal chromosome configuration in users as compared to control subjects, but the numbers were too small to be significant. The possible significance of these data is discussed.

Cytogenetics of habitual abortion and other reproductive wastage

Twenty-eight couples were studied with standard chromosome analyses and Giemsa-banding (G-banding) techniques. Sixteen couples had had three or more spontaneous abortions. Of these, five (31.2 per cent) demonstrated balanced chromosome translocations in females. The abnormal karyotypes seen were 46,XX,t(2pxa0−;7pxa0+) in 75 per cent of cells, 46,XX,t(2qxa0+;8qxa0−) in 50 per cent of cells, 46,XX,t(3pxa0−;8qxa0+), 46,XX,t(l pxa0+;17qxa0−), and 46,XX,t( 1qxa0−;16qxa0+) in 50 per cent of cells. Of the twelve couples with pregnancy wastage, two (16.6 per cent) demonstrated balanced translocations—one in a male and one in a female. The anomalies seen were 46,XY,t(7qxa0+: 10pxa0−) and 46,XX,t(lpxa0+;2qxa0−) in 50 per cent of cells. All studies were carried out on blood leukocytes. It is concluded that these chromosome and G-banding analyses are justified in the work-up of couples with reproductive failure, particularly in those suffering from habitual abortion.

Amniotic fluid lecithin/sphingomyelin ratio as an assessment of fetal pulmonary maturity

Abstract The method of Gluck and associates 1 for estimating the lecithin/sphingomyelin ratio in amniotic fluid has proved to have a high degree of accuracy in predicting fetal lung maturity. One hundred and eighty-five samples of amniotic fluid from 167 patients in various weeks of gestation were assayed. A lecithin/sphingomyelin (L/S) ratio of 1.5 or less indicated an immature fetal lung, and, in all spontaneously delivered infants, where the values were in this range, the infant developed the respiratory distress syndrome (RDS) and hyaline membrane disease. An L/S ratio of 1.51 to 1.80 suggested a transitional fetal lung in which some of the infants developed RDS, and possibly a mild hyaline membrane disease, but all recovered. If the L/S ratio was over 1.80, the lung was considered to be mature for normal function in the external evironment, and respiratory distress did not develop. The L/S ratio in amniotic fluid is a rapid, accurate method to assess fetal lung maturity and is an invaluable aid in the management of increased risk pregnancies and in cases of repeat cesarean section where the gestational age is unknown.

Continuous electronic monitoring of fetal heart rate during labor

Abstract At the University of Utah Medical Center, 749 labors were monitored electronically. All labors were monitored where feasible; there was no distinction between normal and high-risk pregnancies. The cesarean section rate during this time was 6 per cent compared to 3.5 per cent for the 2 previous years. Late and variable deceleration patterns were found in 41 per cent of these cases, and, of these, 66.2 per cent showed Agar scores of 6 or less at one minute. There were 72 cases of late deceleration, 53 had placentas of 400 grams or less, and, of these, 40 had a low Apgar score. Two hundred and thirty-six variable deceleration patterns were found; 178 had cord problems and 145 of these had low Apgar scores. The perinatal mortality rate decreased from 29.49, in 1970, to 18.2 during the monitoring period. Neonatal deaths decreased by two thirds.

Teaching pelvic examination to second-year medical students using programmed patients

A great deal of interest has been expressed in the use of the programmed patient during the past several years. This pilot study used programmed patients to teach medical students the techniques of pelvic examination. From the study, it was concluded that the experience with the programmed patient adds significantly to an undergraduate learning program, that this technique is well accepted by students and faculty, and that it adds realism to the study of obstetrics and gynecology early in a medical school curriculum.

The effect of delta-9-tetrahydrocannabinol on the chromosomes of human lymphocytes in vitro

Abstract Human leukocytes from 4 healthy donors were exposed to concentrations of delta-9-tetrahydrocannabinol in 72 hour tissue cultures. Concentrations studied were 100.0, 10.0, 1.0, and 0.1 μg per milliliter of culture material. For each experiment a control culture was evaluated. There was no increase in the incidence of chromosome breaks or gaps in any of the study cultures when compared to controls. The 100.0 μg cultures did not grow in tissue culture, and no cells in mitosis were noted in any preparations from this concentration. The significance of these negative data is discussed.

Electronic fetal monitoring as a routine practice in an obstetric service: A progress report

We feel that electronic fetal monitoring is an improvement over earlier methods for detecting fetal distress. Fetal distress is detected earlier, and positive action is taken at an earlier stage of the labor. Our statistics underscore Hon’s findings that variable-deceleration patterns relate to cord complications; and late-deceleration patterns, to placental insufficiency. The marked decrease in the number of neonates with low Apgar scores is the result of fetal monitoring and improved clinical judgment.

Combined therapy for endometrial carcinoma preoperative intracavitary irradiation followed promptly by hysterectomy.

A group of 99 patients with endometrial cancer clinically confined to the uterus has been treated with preoperative adjunctive intracavitary irradiation followed within 72 hours by total abdominal hysterectomy and bilateral salpingooophorectomy. Those patients with poorly differentiated tumors, deep myometrial invasion, cervical involvement, or pelvic metastases were then considered for external beam radiotherapy to the whole pelvis because of the increased risk of involvement of pelvic nodes or other pelvic structures. Only one of 16 patients so treated has failed in the pelvis. The overall Berkson‐Gage actuarial survival at 3 years, uncorrected for death from intercurrent disease, is 85.8%. No vaginal recurrences have been identified. Although this series has not been randomized, it appears that there has been a reduction in vaginal and pelvic recurrences when compared with patients reported by others who have received no adjuvant radiotherapy. The low recurrence rate and favorable survival in this group of patients was achieved with low morbidity from this treatment technique.

A competency-based educational approach to reproductive biology

Because of the advancement in general system theory applied to educational programs, it is possible to approach curricula with the use of more rigorous planning techniques and to design and implement teaching programs from an interdisciplinary approach. The competency-based educational model presented and conceptualized will be implemented at the University of Utah during the 1973 to 1974 academic year. Methods used to assess needs, derive competency statements, and establish performance expectations are reported, based on data obtained from the interdisciplinary faculty committee responsible for the reproductive biology program for sophomore medical students. Additionally, specification of attainment procedures, assessment of competence attainment, and means of validating the consequence of the approach are detailed. The need to base curricula change upon sound information should result in enhancing faculty and students capability to distinguish fads and tail chasing from real progress.

The effect of selected antiepileptic drugs on the chromosomes of human lymphocytes in vitro.

Abstract Three anticonvulsive drugs, phensuximide, primidone, and mephenytoin, were studied in tissue culture for effects on the chromosomes of human leukocytes in concentrations of 100.0, 10.0, 1.0, and 0.1 μg per cubic centimeter of culture media. No significant increase in chromosome breaks, gaps, or abnormal forms was noted for any of the drugs studied when compared with control cultures. While these data are reassuring with respect to chromosome damage, it must be pointed out that these drugs may still cause congenital malformations as chromosome damage is but one cause of teratogenesis. The obstetrician is cautioned to use only those drugs during pregnancy which are necessary for the mothers well-being as potential risk must always be considered to be present.