Ectopic pregnancy associated with the intrauterine device: a study of seventy cases

Seventy cases of ectopic pregnancy associated with an IUD comprised 10% of all ectopics in a 9 year period. This increased to 15% in the last 19 months as more IUD's were in use. In two thirds of the ectopics the IUD had been in situ more than 1 year. Unusual bleeding and cramping attributed to the IUD obscured the diagnosis and resulted in removal or replacement of the IUD in over one half the cases 1 to 8 weeks before surgery. The episodic nature of the abdominal hemorrhage in two thirds of all ectopics resulted in surgery on day 44 average gestational age. The IUD is probably not causal in ectopic pregnancy but does not protect the predisposed patient from ectopic pregnancy which should be suspected in any patient with an IUD who has irregular bleeding and abdominal pain.     

Congenital stricture of male urethra

It was intendet to characterize the isoenzymes of serum alkaline phosphatase in healthy infants. Quantitative estimation of the activity of serum alkaline phosphatase resulted in relatively low values in the newborns and a distinct increase during the first three months of live. As a rule most of the newborns appeared to present one uniform isoenzyme fraction, which was comparable to the isoenzyme of bone origin of the adult. Some of the newborns already exhibited another less marked isoenzyme, the isoenzyme of liver origin. During babyhood this isoenzyme becomes more and more distinct. In most cases this development had become perfect at the end of the first year. Liver tissue of newborns apparently does not synthesize the same liver isoenzyme as liver tissue of adults.     

Conformations of satellite DNAs

X-ray fiber diffraction studies of satellite DNAs from Gecarcinus lateralis, Drosophila virilis and Mus musculus, all of which have highly repetitious base sequences but with different degrees of sequence complexity, reveal only classical polynucleotide duplex structures in contrast to some highly repetitious synthetic DNAs.     

Species identification of blood meals from Culex tarsalis that had fed on passeriform birds

Blood-engorged Culex tarsalis (4,209) collected during 1960 to 1965 in Kern County, California and previously shown to have fed on passeriform birds by the precipitin test were further tested by the more sensitive passive hemagglutination inhibition test (PHI). It was shown that these mosquitoes fed principally on House Finches and House Sparrows, the most common passeriform birds found in the collection areas. These data demonstrate the usefulness of the PHI test for the identification of arthropod blood meals from closely related species.     

Women's attitudes to mastectomy for breast cancer

One hundred patients who had been subjected to mastectomy for carcinoma were interviewed retrospectively to gauge their attitudes to any physical and/or emotional disabilities relating to their operation or disease. It was found that 40% of the patients had delayed for longer than a month after the onset of symptoms before seeking medical advice, but the reasons for this were not readily forthcoming. However, fear of mastectomy was not a common cause. Anxiety and embarassment due to an absent breast occurred in about one-third of patients, and did not diminish with time. Knowledge and the use of mammary prostheses was far from universal, and disturbingly only two-thirds were counselled in these matters by their medical advisers. Physical complications were common, particularly lymphoedema of the arm, and as expected this was closely related to the type and extent of treatment undertaken.     

Anticonvulsant drug concentrations in epileptic patients

Using Wistar stain male rats, it has been shown that 2 atmospheric pressures associated with oxygen saturation, together or singly for 90 minutes daily for successive 46 days, resulted in no significant change on the ratio of testes to body weight. No significant change was observed in the incorporation of 3H-thymidine into testes and pituitary glands between the pressure-treated groups and the control group.     

Serum albumin. A CAP survey

The results of a 1974 survey of albumin measurements as performed by more than 1,300 laboratories are presented. The most widely used methods are the dye-binding technics: bromcresol green (BCG) and 2-(4'-hydroxyazobenzene) benzoic acid (HABA). These are followed by electrophoresis and salt fractionation. All methods yielded comparable albumin concentrations except electrophoresis, which manifested a consistent low bias. This close agreement is attributed, in part, to the normal-range concentration of albumin in the test specimen. Type of standardization, i.e., commercial serum, bovine serum albumin, human serum albumin, or pooled serum, did not appear to be a factor in the estimation of albumin in the normal serum submitted for analysis. Surprisingly, interlaboratory variation, from method means, was the lowest for salt fractionation and electrophoretic technics.     

Ultrasound in the management of acute pancreatitis

Thirty-eight patients have been examined by ultrasound when symptoms or sign suggested the development of a pseudocyst following an attack of proven acute pancreatitis. Pseudocyst was diagnosed in 23 of the 38 cases. Five patients had multilocular cysts, four of which were shown to be communicating. Laparotomy was carried out on 14 of the 23 patients and surgical drainage was performed in 12 cases. The remaining nine cases were monitored and showed steady regression. Small cysts arising in the head of pancreas may give rise to recurrent or persistent pancreatitis and may be demonstrated pre-operatively by ultrasound but not readily by other means. A further 12 patients showed an area of irregular absorption of ultrasound interpreted as an inflammatory mass. Monitoring of these cases showed progressive resolution without cyst formation. Three of these cases subsequently required laparotomy-one developed an abscess and one necrosis of the body and tail of pancreas while a third developed severe pancreatic fibrosis of the area identified by ultrasound. The ability to distinguish between pseudocysts and inflammatory masses and to demonstrate communication between multiple cysts is of considerable value in pre-operative diagnosis.