Abdominal radical trachelectomy (ART) performed during pregnancy: a case report.

PURPOSE OF INVESTIGATION: Cervical cancer is one of the most frequent malignant diseases diagnosed during pregnancy. Abdominal or vaginal radical trachelectomies are fertility-preserving alternatives to radical hysterectomy for young women with early-stage cervical cancer that can be performed during ongoing pregnancy. MATERIAL AND METHODS: The authors report a pregnancy complicated by cervical cancer treated by abdominal radical trachelectomy (ART) at 16-17 gestational weeks with preservation of the concurrent pregnancy. RESULTS: The pregnancy evolved normally and delivery occurred at 38-39 gestational weeks by elective caesarean section. CONCLUSIONS: Radical trachelectomy could be offered as an option for pregnant patients with early invasive cervical cancer. It may help women to avoid the triple losses of a desired pregnancy, fertility, and motherhood.

Capillary instabilities by fluctuation induced forces.

The spontaneous break-up of thin films is commonly attributed to the destabilizing effect of van der Waals forces. Dispersion forces can be considered in terms of the confinement of the electromagnetic fluctuation spectrum. The principle of confinement is more general than the usual argument of interacting dipole fluctuations. It includes also disjoining pressures that are caused by thermal fluctuations. In this context, we review recent publications on the dewetting of thin polymer films, and argue that the presence of an acoustic disjoining pressure is necessary to adequately describe some of these experimental results.

Multiple sclerosis in American blacks.

In the period 1968 through 1977, multiple sclerosis (MS) was diagnosed in 349 patients at the Henry Ford Hospital. Of these 312 were accepted in the study and 53 were blacks. In this medical center where the overall population consists of approximately 50% blacks, the MS blacks comprised only 17% of the total MS population. White and black MS patients did not differ significantly for clinical characteristics of MS or for death rates. The MS black patients were divided in two groups, Northern- and Southern-born. The mean age of migration was 11.9 years. Southern-born blacks lived an average of 20 years in the North before the symptoms of MS began. Northern-born MS patients had a 5.5 earlier age of onset and the diagnosis was made 9 years sooner when compared with the Southern-born MS blacks. The Southern-born MS group more often showed a chronic progressive course wither initially or following a few exacerbations and remissions. These findings suggest that a possible genetic predisposition, as well as a geographically determined exposure to an environmental agent, may be related not only to the risk of developing MS, but in the American blacks may also influence the age of onset, the age of diagnosis, and even the clinical course of MS.

Multiple sclerosis and serial computerized tomography. Delayed contrast enhancement of acute and early lesions.

By demonstrating periventricular contrast-enhanced lesions cranial computerized tomography (CT) supported the diagnosis of multiple sclerosis in a patient with recurrent transient hemiparesis. These abnormalities were present only on delayed films taken one hour after contrast injection and probably represented acute and early demyelinating plaques. Areas of contrast enhancement evolved to isodensity with and without corticosteroid treatment. Brain scan findings mirrored cranial CT abnormalities, and both could be correlated with the clinical status and the course of the disease.

Progressive supranuclear palsy and normal-pressure hydrocephalus.

In three patients who fulfilled the clinical criteria of progressive supranuclear palsy, radiologic investigations suggested normal-pressure hydrocephalus. Shunt procedures in all three resulted in temporary improvement of gait, mentation, and bladder control, but gaze paralysis and extrapyramidal findings did not change.

Transient traumatic "locked-in" syndrome.

The first clinical case of transient traumatic locked-in syndrome is presented. The locked-in state lasted for 3 months. The patient's neurologic deficit and the abnormal auditory evoked responses pointed to a lesion involving the left pons and ventral midbrain. The locked-in syndrome caused by a traumatic damage of the brain stem structures can be transient and thus it may have a better prognosis than the locked-in syndrome secondary to the occlusion of the basilar artery.

Experimental allergic encephalomyelitis in cobra venom factor-treated and C4-deficient guinea pigs.

Experimental allergic encephalomyelitis (EAE) was studied in guinea pigs with an inherited deficiency of the fourth component of complement (C4) and in guinea pigs injected with cobra venom factor to deplete the third component and late-acting components of complement. EAE was elicited by immunization with homologous spinal cord or purified basic protein. Administration of cobra factor after the injection of encephalitogenic emulsion delayed the onset and reduced the intensity of the clinical manifestations of EAE. In addition, cobra factor markedly reduced mortality during the sixty days of observation. However, pathological changes of perivascular infiltration and demyelination were similar in cobra factor-treated and untreated animals. Clinical signs of EAE an mortality in C4-deficient guinea pigs were no different from those in normocomplementemic controls. Thus, although activation of the classic complement pathway does not appear to be involved in the production of EAE in guinea pigs, our results suggest a possible role of the alternative complement pathway in the pathogenesis of EAE.