Therese Lu

Incidence, significance, and follow-up of para-aortic lymph node metastases in late invasive carcinoma of the cervix

One hundred and four patients with Stages II and III of cervical carcinoma underwent para-aortic node biopsies. Of these, 12.5 per cent of patients with Stage IIA, 14.9 per cent of patients with Stage IIB, and 38.4 per cent of patients with Stage III carcinoma of the cervix had positive para-aortic nodes. They subsequently recieve 6,000 rads to the para-aortic area. The radiotherapy complication rate was high. Within four years, 50 per cent of the patients with positive para-aortic nodes had other distant metastases. The two- and four-year follow-up is presented. Only one of 13 patients with positive para-aortic nodes was alive at the end of four years.

The incidence and significance of para-aortic lymph node metastases in late invasive carcinoma of the cervix

Abstract Patients with Stages IIB and III carcinoma of the cervix were subjected to laparotomy with special attention directed to para-aortic lymph nodes. Of the patients with Stage IIB carcinoma of the cervix, 16.1 per cent had metastatic disease in the para-aortic lymph nodes. Of the patients with Stage III cervical carcinoma, 46.4 per cent had positive para-aortic lymph nodes. In addition, one patient with Stage III carcinoma of the cervix had metastatic disease to the small intestine and ascending colon. Thus, 50 per cent of the patients with Stage III carcinoma of the cervix had disease beyond the usual field of radiation therapy. It is suggested that these findings demand an alteration in the concept of treatment of Stage III carcinoma of the cervix.

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%).

Effect of prenatally and postnatally induced hypoxia on blood volume newborn lambs

Abstract The effect of both prenatally and postnatally induced acute hypoxia on the blood volume was studied in 16 newborn lambs. Hypoxia was induced by 8% O 2 inhalation for 10–20 minutes prenatally in 7 term pregnant ewes immediately before caesarean section delivery of the lambs (Group 1), and postnatally in nine 2–4 day old lambs born spontaneously (Group 11). The umbilical cords of Group 1 lambs were clamped early (E.C.) within 10 seconds after birth. Group 11 lambs had their cords severed within one minute of birth by the ewes. Blood volume (BV) was measured by the double label, radioiodinated human serum albumin-125 (RIHSA-125) plasma tag and radiochromium-51 (Cr 51 ) red cell tag dilution technique. The red cell volume (RCV), which reflects the size of placental transfusion best, is significantly higher in Group 1 (42.1 ± 1.6 ml/kg) than in normal E.C. lambs (29.8 ± 2.0 ml/kg). The RCV in Group 1 was smaller than that in late clamped (L.C.) lambs, in whom an almost complete placental transfusion (RCV = 50.4 ± 2.3 ml/kg) had occurred; and close to those of spontaneously born lambs (S.B.) who received a partial placental transfusion (RCV = 36.7 ± 2.1 ml/kg). This finding in Group 1 suggests that with prenatal hypoxia, a partial placental transfusion had occurred in utero. In Group 11 lambs in whom hypoxia was postnatally induced, the BV, RCV, and plasma volume (109.7 ± 5.2, 44.1 ± 1.7 and 65.1 ± 4.2 ml/kg) were slightly, but not significantly, increased from control values of 101.6 ± 4.9, 40.8 ± 1.7 and 60.8 ± 4.3 mg/kg), respectively. It is suggested that postnatally induced hypoxia does not significantly increase the blood volume of newborn lambs due to the absence of placental reservoir of blood. Prenatally induced hypoxia appeared to bring about a higher blood volume than expected in E.C. lambs due to a transfer of placental blood to the fetus in utero. Blood volume redistribution in the feto-placental unit in utero is an unique adaptational response to prenatal hypoxia.

Single-stranded regions in DNA from pre- and postmenopausal human ovaries.

Abstract No differences were noted between the percent (2–4%) of single-stranded regions in DNA isolated from pre- and postmenopausal human ovaries as determined by nuclease S 1 digestion.

Placental transfusion in the naturally born lamb.

Abstract Neonatal blood volume was measured in 22 full-term lambs using the double label, radioiodinated human serum albumin-125 (RIHSA-125) plasma tag and radiochromium-51 (Cr51) red cell tag dilution technique. Nine lambs (Group I) were born naturally and unassisted. Thirteen lambs were delivered by cesarean section, of which eight (Group II) had early clamping and five (Group III) had late clamping of their umbilical cords. The size of placental transfussion, as reflected in mean red cell volume (RCV) was 36.7 ± 2.1 ml/kg in Group I, which was significantly greater than that of Group II, 29.8 ± 2.0 ml/kg; but smaller than that of Group III, 50.4 ± 2.3 ml/kg. The findings indicate that a partial, rather than a complete, placental transfusion occured in the naturally born lambs. It is suggested that this may reflect Natures way of regulating the volemic state in the newborn lamb.

PLACENTAL TRANSFUSION IN THE NATURALLY BORN LAMBS

The degree of placental transfusion in the unassisted naturally born lambs (NB) was investigated and compared with both early (EC) and late cord clamped (LC) lambs delivered by cesarean section. Blood volume was measured in 22 full-term, lambs at ages 40 min to 12 hrs using the double label dilution technique (PIHSA-125 plasma tag and radiochromium-51 red cell tag). The lambs were of 137-148 days gestation and weighed 2500-5500 g. The umbilical cords of the 9 NB lambs were severed by the mothers either by chewing it within a minute or standing up ijimediately after delivery which allowed the weights of the lambs to stretch and break the cords. The cords were clamped 10 sec after birth in the 8 EC lambs and after 3-5 min in 5 LC lambs. Blood and plasma volumes showed no significant differences amongst the 3 groups probably due to the varying degrees of plasma extravasation during the first hours of life. Mean red cell volume (± S.E.) was 36.7 ± 2.1 ml/kg in the NB group which was significantly greater than the 29.8 ± 2.0 ml/kg of the EC group, p < .05; but smaller than that of LC group, 50.4 ± 2.3 ml/kg, P< .005. These findings indicated that a partial placental transfusion (about 20% more than EC group) occurred in the naturally born lambs, rather than a more complete one as in the LC group.