Reactivity of monoclonal antibody F36/22 with human ovarian adenocarcinomas.

Monoclonal antibody F36/22 recognizes high-molecular-weight glycoprotein components associated with neoplastic development of the ovary. Indirect immunoperoxidase staining techniques were performed on a panel of nonmalignant ovarian tissues, primary ovarian tumors, exfoliated ascitic tumor cells, and metastatic lesions. Normal ovarian tissue components (n = 20) failed to exhibit detectable levels of antigen, whereas benign ovarian tissues show a low incidence of immunostaining (three of 26) restricted to some ductal elements. One hundred % (19 of 19) of the immunopositive primary malignant tumors were histologically classified as adenocarcinomas. Each of the predominant adenocarcinoma histotypes consistently showed expression of the antigen with 30 to 100% of the tumor cells scored as immunopositive. Ascitic tumor cells obtained from all of the ovarian adenocarcinoma patients examined (47 of 47) displayed immunopositive reactions, whereas normal mesothelial cells in these specimens exhibited undetectable staining. In addition, ovarian adenocarcinoma metastases (12 of 12) exhibited very intense immunoreaction products. No detectable antigen was expressed by nonadenocarcinoma ovarian tumor cells.

Obstetric factors in cerebral palsy.

A study was carried out on the patient population of two cerebral palsy facilities serving Northeast New York State to evaluate obstetric factors which might be associated with the development of cerebral palsy. A combination of available medical records and a maternal questionnaire was used for analysis. Of 605 contracted, 158 mothers (26%) provided valid and detailed data, and the study was confined to these 158 patients. A positive association was found with increased reproductive loss, prematurity, and vaginal breech delivery. The need to develop and adopt a comprehensive uniform record system for the pregnant patient and her child is underscored. The limitations of a single factor retrospective study are acknowledged.

Congenital atresia of the cervix.

A case of rare müllerian anomaly, congenital atresia of the cervix in a functional bicornuate uterus, is presented together with a review of the literature in English. The patient in this case took an active role in the decision regarding the nature of the surgical treatment she was to undergo. It is suggested that total hystrectomy with preservation of the ovaries is the treatment of choice.

Antepartum fetal arrythmia. A case report.

On a number of occasions fetal heart arrythmias have been detected during the course of routine antepartum patient examination. A case is presented to illustrate the difficulty of making a definitive diagnosis of the nature of the arrythmia, and its significance in relation to fetal status. Investigation included stressed and nonstressed FHR monitoring, but a definitive diagnosis could not be made during the antepartum period and the patient could, therefore, not be assured of the essentially benign nature of the arrythmia until shortly after the birth of her child. The electrocardiogram obtained from external fetal electrocardiographic monitoring is not sufficiently refined to aid in the antepartum diagnosis of fetal cardiac arrythmias.

Geriatric gynecology.

The quality of life of the postmenopausal woman can be significantly improved by active investigation and treatment of gynecologic disorders, such as postmenopausal osteoporosis, in this age group. Surgical intervention should never be excluded simply on the basis of chronologic age.

Vulvar dystrophies in geriatric patients.

The term vulvar dystrophies has received international acceptance and replaces the confusing terminology formerly used to describe vulvar epithelial disorders. The classification is based on histopathologic features and has provided a more rational foundation for the use of specific therapies. The risk of malignant change is small and depends on the presence or absence of atypical cells. Biopsies are mandatory for diagnosis and therapy. Vulvar dystrophies without atypia are benign lesions whose primary treatment is medical.

Postmenopausal osteoporosis: concerns and costs in clinical management.

There are a number of social, political and medical concerns for the clinician dealing with female patients who are postmenopausal and at risk for the development of osteoporosis which may lead to chronic disability and possibly death. A brief overview of the role of current therapies is given together with their potential for adverse effects. Further research into etiology, diagnosis and optimum management is obviously necessary.

Obstetric care in a family health-oriented university associated neighborhood health center.

The structure, staffing, and planning methods of the obstetric component of a family-oriented University Hospital associated family health care facility are briefly described. The interviews and screening procedures are outlined necessary to develop a broad data base for total health care planning. The roles of the members of the multiprofessional team employed are described with particular emphasis on the use of a nurse midwife as the primary obstetric care professional. Management procedures are referred to as well as the educational component present within such a program. The program is evaluated in terms of clinical outcome, patient and professional acceptance, and cost.

The rate of early fetal growth in the human subject.

PIP: Data from 354 embryos and fetuses between 20 and 200 mm crown rump length obtained by therapeutic abortion in 3 different countries were evaluated. All Danich and Hungarian and the majority of American specimens were measured immeditely after delivery in the fresh condition. In the mathematical evaluation linear regressions were calculated by the method of least squares for arbitrarily defined ranges to 20-50 mm and 50-200 mm crown rump lenghts. The material was analyzed statistically so that confidence limits could be drawn for the estimation of gestational age from crown rump length measurements. All data in the 20-50 mm range were combined, but beyond that fetal length the statistics for the Hungarian group were calculated separatley. The equation calculated to fit the data in the 20-50 mm rage is A = 46 + 0.71 L where A is gestational age in days and L is crown rump lenght in mm. The 95% confidence limits of regression are 0.57-0.83 days/mm and the correlation between gestational age and crown rump length is 0.65. Estimates of gestational age from sitting height measurements can be made + or - 15 days with 95% confidence. The equation for the combined Danish and American data in the range 50-200 mm is A = 64 + 0.41 L. The 95% confidence limits for the regression are 0.36-0.46 days mm and the correlation between gestational age and crown rump length is 0.70. Estimates of gestational age from crown rump length can be made + or - 26 days with 95% confidence. The data from the Hungarian study in the 50-200 mm sitting height range differ from those of the combined Danish and American material. The regression of days/mm (0.22) was significantly less at p. 01 level supporting the suspected bias in the Hungarian material, but the correlation between gestational age and crown rump length, 0.62, was not significantly less than that of the combined Danish and American data. Thus, if the difference in the slope was due to a bias, the bias was relatively consistent from patient to patient. Comparison of the results with those of Streeter (1920, 1951) indicates that the considerable discrepancy at the embryonic stages diminishes gradually in the fetal period and eventually becomes quite insignificant.^ieng