Reactions in rabbit Fallopian tube after plastic reconstruction. I. Gross pathology, tubal patency, and pregnancy.

PIP: Rabbit tubal repair surgery was aseptic with Nembutal and ether anesthesia. Both tubes were cut at the uterotubal junction, a .61 mm thick polyethylene splint was inserted, sutured to the myometrium, and the junction sutured. At 2, 6, 10, 16, and 24 weeks the splint was removed through an incision. After a dye test for patency, 1 tube was removed and the rabbit was mated 1 week later. Results were 30% distorted placement of tube, 30% fibrose tubes (especially after 16 weeks), 47% adhesion (particularly after 6 weeks), some infection, and 55% positive dye flow test. 3 out of 7 rabbits delivered, all in those of the 2-week group that had no adhesions. 2 of the pregnancies occurred in rabbits with no dye passage.^ieng

Reactions in the rabbit Fallopian tube after plastic reconstruction. II. Histopathology.

PIP: In this histological study of tubal repair in rabbits, both fallopian tubes were cut at the uterotubal junction, a .61 mm thick polyethylene splint was inserted, sutured to the myometrium, and the junction sutured. At 2, 6, 10, 16, and 24 weeks the splint was removed through an incision. After a dye test for patency, 1 tube was removed and the rabbit mated 1 week later. Histological stains used included hematoxylin and eosin for detail, periodic acid (Schiff) for secretion, and Herovici for collagen. The normally folded epithelium remained flat. There were few mitoses but many basophilic cells and polymorphonuclear leucocytes appeared in the 2- and 6-week groups. Fibrous replacement of muscle seemed to prevent pregnancy, but absence of folded ciliated epithelium permitted pregnancy in 3 rabbits.^ieng

The reversal immune surveillance hypothesis: part II.

The first part of the reversal immune surveillance hypothesis (RISH. I) describes the conceptual framework of the immune system as a homoeostatic mechanism for the control of cell differentiation and replication. The thymic dependent lymphocytes (T-cells) are considered to be tissue specific and identify aberrations in the cell surface pattern (antigens), that represent that particular cell type. The T-cells may then recruit antibody forming B-lymphocytes (B-cells) to produce antibodies (humoral response) to the cell surface antigens in order to return the cell surface pattern to its correct state. The antigens may also be removed from the cell surface as immune complexes by the complement system, which under normal conditions does not cause cell lysis. The cellular arm of the immune system, that of killer cells or activated macrophages are considered to be primarily involved with tissue remodelling. Whether or not the humoral or cellular arm of the immune system is activated depends upon the antigens displayed by the stimulating cell. The proposed system, which is self monitoring, is considered to have evolved from the invertebrates through to the vertebrates to become more complex in the mammals. Therefore the immune system is considered to be based on the identification of self and self-foreignness, rather than on foreignness per se.

The reversal immune surveillance hypothesis.

The proposed reveral immune surveillance hypothesis is based on the identification primarily of self and secondarily of foreignness, unlike the original hypothesis that is based on the identification of foreignness per se. The proposed system is considered to have evolved from the invertebrates through to the vertebrates to become more complex in the mammals, and involves the identification of cell types by lymphocytes through the cell type surface pattern and major histocompatibility antigens. The identification of self and associated foreignness by the immune system is required for the regulation of cell differentiation and replication, and because of this design, the ability of the immune system to destroy foreignness can be regarded as a natural consequence. The reversal immune surveillance hypothesis explains why spontaneously occurring tumours may not be antigenic, in the sense of eliciting their own destruction, and is consistent with the destruction of tumour cells that display significant amounts of viral antigens or gross antigenic changes induced by carcinogenic agents. It is also able to explain the stimulation and inhibition of tumour development.

The physiology of labour.

The time of onset of labour is usually reasonably clear-cut and will be described by the patient as the onset of painful uterine contractions. The exact reason whereby the uterus changes from a retentive to an expulsive organ is not yet clearly understood. It probably is the summation of several factors: the drop in the hormone progesterone, either in absolute terms or relative to the level of oestrogen; attainment of a critical degree of distension and intrauterine pressure; a critical change in the consistency or sphincteric quality in the cervix; a critical build up of contractile protein in the uterine muscle cells and its increasing sensitivity to oxytocic hormone(s).

Cigarette smoking by pregnant women with particular reference to their past and subsequent breast feeding behaviour.

1,790 postpartum women were asked about their smoking habits and baby feeding practices and about a number of other attitudes and physical attributes. For those variables not concerned with baby feeding, our findings generally support previous research; for example, smokers in comparison to non-smokers tended to have more emotional problems, more reproductive failures and babies with lower birth-weights. For baby feeding, we found that smokers tended to have little prior knowledge of breast feeding, favour bottle feeding, have been fed by bottle by their mothers, and wean earlier than non-smokers or ex-smokers. In fact, non-smokers as a group were similar to breast feeders as a group, and smokers like bottle feeders for over 20 characteristics. These similarities were mostly the result of features of smoking and baby feeding behaviour being found in a common personality type; for example, use of tobacco and choice of bottle feeding are probably attributes of nervous, insecure mothers. But some similarities were the result of the influence of tobacco smoke; for example smokers who do breast feed wean earlier, probably because chemicals in tobacco smoke inhibit milk production.

Smoking habits of pregnant women in Brisbane, Australia.

A survey of postpartum women in Brisbane revealed that many gave up smoking just before or shortly after becoming pregnant, and that many of the remainder reduced their rate of consumption. Husbands who smoked showed no comparable changes in behaviour. Thus apparently many couples were aware of the dangers to the fetus of active smoking by the woman, but not of the dangers of her passive inhalation of smoke. Other significant findings included (i) increasing rates of consumption during successive pregnancies, (ii) high degrees of conformity for most habits (e.g. use of filters), and (iii) stronger addiction and earlier starting ages among heavy smokers than light smokers.

Carcinoembryonic antigen (CEA) in ovarian cancer: factors influencing its incidence and changes which occur in response to cytotoxic drugs.

We report the serum levels of carcinoembryonic antigen (CEA) in 109 patients with ovarian cancer. Histology, degree of differentiation, and clinical stage influenced the incidence of positive CEA. Although CEA was significantly raised in patients with a variety of tumours, the highest incidence (77 per cent) was found in those with serious cystadenocarcinoma. Nearly all (94 per cent) of the poorly differentiated tumours were associated with a positive CEA result. Serial CEA levels provided a useful guide to management during cytotoxic chemotherapy, rapidly falling levels indicating a favourable tumour response which was reflected clinically. However, only two-thirds of tumours were associated with detectable CEA levels in serum, day-to-day variations in individual serum levels occurred, and CEA levels tended to fall paradoxically during terminal illness. The significance of persistently low levels in the apparent absence of disease was uncertain.

Peritoneal fluid biochemistry in infertile women with mild pelvic endometriosis. Prognostic value of prostaglandin F2 alpha concentration to subsequent pregnancy.

Although the factors involved in the pathophysiology of endometriosis are probably multiple and interrelated, prostaglandins may play an important role in the infertility of women with mild disease. In the present study, prostaglandin F2 alpha (PGF2 alpha) and 17 beta-oestradiol were measured in the peritoneal fluid of a selected group of infertile women who had mild pelvic endometriosis (without anatomical distortion) and compared with those values in normal women who had no pelvic disease and in women with pelvic infection. Although there was a wide scatter of PGF2 alpha values, the mean (1,066 pg/ml) in the endometriosis group was significantly greater than that in the other 2 groups (542 pg/ml, normal and 688 pg/ml, pelvic infection); the increase was found in both phases of the menstrual cycle. The mean concentration of 17 beta oestradiol was markedly higher in the luteal than the follicular phase in all 3 groups; however, no significant differences were found between the groups. Interestingly, the mean value of PGF2 alpha and 17 beta-oestradiol was higher in women with endometriosis who failed to conceive than in those who became pregnant. An estimation of PGF2 alpha in the peritoneal fluid may have prognostic value in the evaluation of infertile patients, especially those with mild endometriosis or in whom the problem is unexplained.

A comparison of maternal serum levels of alpha-fetoprotein in normal and pre-eclamptic pregnancies.

Alpha-fetoprotein (AFP) concentrations were measured by radioimmunoassay in serum from women with normal and pre-eclamptic pregnancies. An analysis of the results obtained in normal pregnancy was made using arithmetic and semi-logarithmic scales, and a statistical conversion of the AFP values in relation to gestational age was introduced to allow an easier interpretation of results. In pre-eclampsia, significantly lower mean AFP values were obtained, with the majority of individual values being lower than the mean for normal pregnancy. These low levels were not associated with fetal death, but appeared to be related to the severity of disease. The significance of these findings remains to be evaluated.

Seminal plasma biochemistry. I. Preliminary report: a possible mechanism for the liquefaction of human seminal plasma and its relationship to spermatozoal motility.

Based on indirect evidence it has been suggested that the liquefaction of human seminal plasma involves fibrinolytic and proteolytic enzymes and that the coagulum is formed by proteins. In this preliminary investigation evidence is presented for the involvement of seminal plasma sialyltransferase in liquefaction which suggests that the coagulum may be composed of glycoproteins. It is proposed that the glycoproteins form a polymer by the chelation of divalent metal ions via the carboxylic acid moieties of the sialic acid groups of the glycoproteins. The glycoprotein polymer may then be dismantled by the reduction of the meal ions by the oxidation of L-ascorbic acid, possibly allowing enzymes to complete the liquefaction process. A total of 100 semen samples from 30 male subjects whose semen profiles were considered "normal" by an independent assessor, were examined for the following: (i) liquefaction time of the seminal plasma; (ii) seminal plasma sialyltransferase activity; (iii) spermatozoal motility, defined as directional or nondirectional; (iv) spermatozoal count, and (v) seminal plasma content of free L-ascorbic acid, dehydroascorbic acid and glutathione. Linear regression analysis showed a significant correlation between sialyltransferase activity and the liquefaction time for seminal plasma. Similarly, multilinear regression analysis of the data showed that as the seminal plasma levels of L-ascorbic acid, total dehydroascorbic acid and glutathione increase, there is a decrease in spermatozoal motility and a decrease in the liquefaction time of the seminal plasma. The possible metabolic relationship of seminal plasma L-ascorbic acid and glutathione is discussed and a metabolic pathway is suggested.

Bivariate analyses of attitudes towards breast-feeding.

1,790 postpartum women were asked about their breast-feeding attitude, physical and other attitudinal variables. Bivariate analyses were conducted between attitude and each of 38 other variables. Of the causally independent variables, education and occupation were the most strongly related to attitude, and along with doctor's preference were perhaps the most important influences on a mother's baby-feeding attitude. No physical or health measure was strongly related to attitude towards breast-feeding, although there were consistent associations between favourable attitudes and optimal categories of the physical and health variables. A hypothesized model of the influences on breast-feeding attitude and behaviour is presented.

PIP: 1790 postpartum women were asked about their breastfeeding attitude, physical, and other attitudinal variables. Bivariate analyses were conducted between their attitude and each of 38 other variables. Of the causally independent variables, education and occupation were the most strongly related to attitude, and along with doctor's preference were perhaps the most important influences on a mother's baby feeding attitude. No physical or health measure was strongly related to attitude towards breastfeeding, although there were consistent associations between favorable attitudes and optimal categories of the physical and health variables. A hypothesized model of influences on breastfeeding attitude and behavior is presented.

A review of recent developments in human fertility control.

Recent and significant developments in the field of fertility control are reviewed. Consideration is given to new aspects of existing methods, recent modifications to steroidal formulations and Intrauterine devices, increased utilization of older methods (abortion and sterilization) and evaluation of new fields (postcoital contraception, prostaglandins and immunological techniques). There is an increasing demand for better application of newly developed methods and a rational decision in the selection of appropriate methods.

Immunoglobulins reactive to carcinoembryonic antigen and their relationship to the antigen in malignant ascitic fluid of ovarian carcinoma.

Samples of malignant ascitic fluid from 30 patients with advanced ovarian carcinoma were examined for the presence of IgM antibodies to CEA and PEG-precipitable proteins binding to 125I-CEA. The IgM antibodies to CEA were measured by a solid-phase radioimmunoassay using ovarian CEA. There was no correlation between the level of IgM antibodies to CEA and that of total IgM in the fluid. In 11 of 30 (37%) samples tested, significant amounts of IgM antibodies to CEA were found. The CEA-binding proteins were measured by the ability of ascitic fluid to incorporate 125I-colonic-CEA into PEG-precipitable complexes. In 9 of 39 (30%) samples, the precipitation was significant. There was no association between antibodies to the ABO and Lewis blood group factors and these antibodies to CEA. An inverse relationship was observed between the level of CEA and that of CEA-binding proteins shown by the two assays. When 125I-CEA was incubated with these "positive" samples, a high molecular weight fraction was demonstrated by chromatography. By contrast, in the "negative" samples, there was no incorporation of 125I-CEA. These findings would indicate the presence of CEA-reactive proteins possibly existing as immune-complex-like material in ascitic fluid of some patients.

A comparison of the physicochemical properties of carcinoembryonic antigen in extracts of tumour tissue, ascitic and cyst fluid from ovarian cancer.

In view of the reported disagreement in the physicochemical properties of ovarian carcinoembryonic antigen (CEA), this study was undertaken to compare the properties of CEA obtained from extracts of ovarian tumour tissue, ascitic fluid and cyst fluid. On the basis of molecular weight estimation and binding properties with Concanavalin A and wheat germ lectin, ovarian CEA from these three sources appeared similar, and also possessed similar properties to those of colonic CEA. On isoelectric focusing, however, it was found that the isoelectric point of CEA from tumour tissue and cyst fluid differed from that from ascitic fluid. It is most likely that this is due to a loss of sialic acid from the CEA released into ascitic fluid.