Retrospective analysis of patients with primary fallopian tube carcinoma treated at the University of Louisville.

Medical records of patients diagnosed with primary fallopian tube carcinoma between 1979 and 1989 were reviewed. Twenty-six patients were eligible; 8 patients were excluded after pathologic review, leaving 18 patients included in the study for this analysis. The median and mean age were 61 and 59 years, respectively, with a range of 39-80 years. There were three Stage I, five Stage II, seven Stage III, and three Stage IV patients. The most common presenting symptoms were abdominal/pelvic pain, abdominal distension, and vaginal discharge/bleeding. The primary site of the lesion was determined to be the right tube in 44% of the cases, the left tube in 39% of the patients, bilateral lesions in 11% of the patients, and indeterminate in 6%. Histologic grade was poorly differentiated (Grade III) in 13 patients, moderately differentiated (Grade II) in 4 patients, and well differentiated (Grade I) in one. No patient was correctly diagnosed preoperatively. Survival at 5 years of the entire group was 35% with a 3 year minimum followup. Corresponding disease free survival was 30%. Mean and median survival times were 74 and 37 months, respectively. The range of survival times was from 1 to 120 months. All Stage I patients, 80% (4/5) of Stage II, and 29% (2/7) of Stage III patients are alive without disease. None (0/3) of the Stage IV patients are alive. Treatment regimens consisted of intraperitoneal P-32, external beam radiotherapy, and/or chemotherapy. Radiotherapy was associated with a low incidence of treatment-related complications, the majority being gastrointestinal related. There was one chemotherapy-related death. These patients and their treatment outcomes add to the data base of numerous previous reports on fallopian tube carcinoma. Stage I and II patients fared excellently with primary surgical and adjuvant therapy. While the prognosis of Stage III and IV patients is much worse, significant levels of long term survival can be achieved with aggressive treatment.

Lack of teratogenic effects of air at high ambient pressure in rats.

The purpose of the research was to determine if pregnant rats subjected to a maximum tolerated duration of exposure to air at 6 atmospheres absolute pressure (ATA) (50.3 meters seawater) would have an increased frequency fetal death, resorption, low birth-weight, or malformations. Ninety pregnant rats were assigned to one of three exposure schedules during organogenesis: days 9-11, 12-14, or 15-17, and were randomized between one treatment and two control groups. The treatment group was subjected to 6 ATA for 70 minutes with compression and decompression at 1.8 ATA (18.3 meters seawater)/minute. Control groups were exposed to either 1 ATA of air (surface) within the hyperbaric chamber, or 1 ATA of air outside the chamber. For 30 minutes following decompression, chamber-treated animals were placed in a slow, motor-driven rotating cage, and assessed for gait disturbances from decompression sickness. On Day 20 of gestation, laparotomy was performed, and corpora lutea, implantations, and resorptions were counted. Fetuses were weighed, sexed, and examined for gross malformations. Subsequently, they were fixed, sectioned, and examined for visceral anomalies. Minor visceral anomalies and anatomical variations were present in 16.3% of all fetuses; however, no significant differences existed between groups. Similarly there were no significant differences when number of resorptions, number of dead fetuses, mean fetal weights, and malformations were compared by analysis of variance. Finally, there was no relation between symptoms of decompression sickness and any of the above measures. These results indicate that exposing rats to air at increased atmospheric pressure does not affect fetal health or survival.

Scuba diving and fetal well-being: a survey of 208 women.

Scuba diving is an increasingly popular sport among women of childbearing age. It causes physiological changes that are possibly lethal or teratogenic to the fetus. The subject of diving during pregnancy is seldom mentioned in diving courses, however, and few obstetricians are familiar with the physiology of diving. The study employed mailed questionnaires for description and comparison of the extent of diving and obstetric and fetal outcome of 208 women divers, 136 of whom dived during one or more pregnancies. Depths to which these women dived averaged 42.6 ft; 24 women, however, reported dives deeper than 99 ft during the first trimester. I analyzed the prevalence of six specific fetal complications and found that the frequency of birth defects was significantly greater among children from pregnancies during which women dived (P < 0.05) but was within the range for the general population.