Changes in plasma proteins during pregnancy.

Changes in maternal plasma proteins during pregnancy are now well documented. These changes may be quantitative, as seen in the electrophoretically separated fractions of serum and in the various binding globulins; or they may be represented by the appearance of a protein which is present only in the serum of pregnant women. These include the placental isoenzyme of alkaline phosphatase, oxytocinase, human chorionic gonadotropin and the "pregnancy-associated plasma proteins." Other constituents, such as alpha-fetoprotein, salivary amylase, prolactin and the proteins of the "pregnancy zone," which are present in small quantities in non-pregnant women as well as in men, show a substantial increase in concentration in the maternal circulation during pregnancy. An important factor in the etiology of protein changes is the effect of hormones, especially estrogen, on the synthesis and degradation of these proteins. While certain quantitative changes such as those seen in hormone binding proteins may interfere with diagnostic procedures, a number of pregnancy-associated changes in protein composition of the maternal circulation may be used to follow the course of pregnancy by monitoring placental function as well as fetal maturity and well being.

Management of carcinoma in situ of the cervix.

Sixty-eight patients with in situ and seven patients with microinvasive cervical carcinoma were reviewed. Thirty per cent of the patients with carcinoma in situ were 30 years old and under. The mean age for carcinoma in situ was 37.8 years; for microinvasion, 42.6 years; and for postconization residual carcinoma, 48.5 years. Forty per cent of the patients were para 0 or 1. There was a 13 per cent incidence of postconization complications. The incidence of residual carcinoma in 58 patients who underwent conization and subsequent hysterectomy was only 10.3 per cent. The residual carcinoma was present high in the endocervical canal of the hysterectomy specimen. None of the patients with microinvasion had residual carcinoma. A positive correlation was found between the anatomic extent of the lesion on the conization specimen and the incidence of residual carcinoma. We conclude that conization and careful follow-up frequently are effective therapy for treating cervical carcinoma in situ, thereby reducing the incidence of hysterectomy.

Conformational equilibria in spin-labeled hemoglobin.

A component characteristic of deoxyhemoglobin appears in the paramagnetic resonance spectrum of spin-labeled oxyhemoglobin, and vice versa, under conditions of pH and ionic strength consistent with the interpretation that the spectrum is sensitive to the conformational equilibrium of the carboxy-terminal histidines. The oxygenation-induced change in the resonance spectrum is discussed in terms of shifts in this equilibrium.