Treasure of the Past: III: Gravitational Anisotropy in Crystals.

Einstein's theory of gravitation is based upon a fundamental postulate which asserts that gravitation and inertia are identical in nature and hence indistinguishable. This if true, is of the greatest theoretical importance, for gravitation has heretofore refused to show any relationship to other physical phenomena. A most delicate test of this postulate is possible in a crystal of one of the nonisometric systems; for in such a crystal every known physical property (except inertia and, possibly, weight) varies with the axial direction in the crystal; and it is an interesting question whether, in such a crystal, gravitation will be found to align itself with inertia or will show some variability which will classify it with the great majority of physical phenomena. To test this point, large crystals were weighed in different axial positions with respect to the earth. The specimens examined represented all five nonisometric systems, and were weighed to a precision, in most cases, of 1 part in 10(9). The results were uniformly negative, and to this degree of precision are in Einstein's favor. Incidentally, this work has shown the practical possibility of using the gravity balance to a precision of I part in 10(9), even when the swing of the beam must.be stopped and the object turned through a considerable angle. A precision of about the same order was attained by Majorana in 1920. In this work it was not necessary to arrest the beam or to touch the load. The next best record (in work of a somewhat different kind) at the International Bureau of Weights and Measures is 7 parts in 10(9).

Attempted vaginal birth after cesarean section: a multicenter comparison of outpatient prostaglandin E(2) gel with expectant management.

Objective: To compare the clinical effectiveness and safety of outpatient administration of an intracervical prostaglandin (PG) E(2) gel with expectant management for women with an unfavorable cervix who wish to attempt a vaginal birth after cesarean section.Study Design: This outpatient study was a randomized, multicenter investigation involving pregnant women at term with one previous low transverse cesarean section. Each had an unfavorable cervix (Bishop score

Familial recurrence of pulmonary sequestration.

BACKGROUND: Pulmonary sequestration is not believed to be familial. We report two male infants with this anomaly who were born to the same parents. CASES: The prenatal diagnosis of pulmonary sequestration was made in a woman's two consecutive pregnancies by demonstrating systemic arterial supply to an echogenic mass located in the left lower lung of each fetus. Postnatal radiographic evaluation confirmed the prenatal diagnoses. CONCLUSION: Recurrent pulmonary sequestration in two male offspring from the same parents raises the possibility of a genetic predisposition for this condition.

Hexadecylphosphocholine differs from conventional cytostatic agents.

Alkylphosphocholines, and especially their main representative hexadecylphosphocholine (HPC), show high anticancer activity in methylnitrosourea (MNU)-induced autochthonous rat mammary carcinoma. The regression of MNU-induced rat mammary carcinoma during HPC treatment can be evaluated by computed tomography and sonography. This allows a noninvasive monitoring of therapy in vivo (tumor size, morphology, and blood supply). Both diagnostic modalities can show a rapid concentric decrease in tumor volume as well as the appearance of cystic, scarry, and necrotic areas in the tumor tissue as a result of HPC treatment. In addition, prior to, during and after therapy tumor perfusion can be assessed by color Doppler sonography in vivo. A more than 4-fold difference in HPC efficacy was observed when the colony growth of explanted MNU-induced mammary carcinoma cells was measured in the methylcellulose colony assay (IC50 = 180 mumol HPC/l) and the Hamburger Salmon colony assay (IC50 = 740 mumol HPC/l). In the latter assay, growth of concomitantly seeded untransformed cells, especially of fibroblasts, is much lower than in the methyl-cellulose colony assay. We therefore assume that the antitumor efficacy of HPC against MNU-induced mammary carcinoma is enhanced by neighboring cells such as fibroblasts. Cell culture experiments with the three MNU-induced rat mammary carcinoma cell clones 1-C-2, 1-C-30, and 1-C-32 revealed IC50 values in the range of 50-70 mumol HPC/l. The volume of 1-C-2 cells increased up to 4-fold after 72 h of permanent exposure to 100 mumol HPC/l, a concentration that completely inhibited proliferation of tumor cell numbers without being cytotoxic. Nucleotide triphosphate levels dropped significantly after 24 h and were slowly restored in spite of continued exposure. After 72 h, they nearly reached those levels observed in plateau-phase cells. This suggests that HPC-induced growth inhibition has similarities with physiologically occurring growth arrest. Finally, replication of RNA viruses and DNA viruses was suppressed 30-fold and 7-fold, respectively, at low concentrations of HPC (12 mumol/l), which caused no or negligible growth inhibition in the virus-harboring cells, thus demonstrating specific antiviral activity of HPC. From these observations we conclude that HPC differs in many important aspects from conventional cytostatic agents and is certainly worth following-up in further investigations.

Effect of miltefosine on transplanted methylnitrosourea-induced mammary carcinoma growing in Fischer 344 rats.

Miltefosine (hexadecylphosphocholine, HPC, CAS 58066-85-6) was investigated in transplanted primary methylnitrosourea-induced PYH mammary carcinoma of F344 rats. The therapy was performed in the 5th and 10th passage. At first HPC (113 mg/kg body weight) significantly reduced the median tumor volume, but a loss of activity was observed in the 10th passage. To explain the loss of sensitivity and to obtain information on the mechanism of action histology, cytoskeleton and hormone receptor content were investigated. The most important change was observed in the histopathology of the tumor. The initial tubular papillary adenocarcinoma was transformed into a malignant adenoacanthoma with epithelial structure. Vimentin as an endothelial marker of the cytoskeleton was equally expressed in all passages. Cytokeratin was weakly expressed in the earlier passages and intensively present in the late passages. The histopathological change from tubular adenocarcinoma to malignant adenoacanthoma might be caused by an overgrowth of the primary epithelial tumor cells or by a real transformation in the morphological characteristics of the tumor, which may occur during repeated transplantation.

Maternal serum screening for aneuploid pregnancy by alpha-fetoprotein, hCG, and unconjugated estriol.

A number of serum screening protocols are either currently in use or proposed to identify pregnant women under 35 years of age who are at increased risk for a Down syndrome fetus. It has been suggested that these same screening methods be applied to gravidas over 35 years of age to identify those women who should be offered amniocentesis. To evaluate the efficacy of screening for detection of aneuploid pregnancy in this age group, the serum samples of 34 women who underwent amniocentesis and who had confirmed fetal aneuploidy were assayed for alpha-fetoprotein (AFP), hCG, and unconjugated estriol (E3). These concentrations were compared with those of 85 women with known euploid pregnancy who underwent amniocentesis for advanced maternal age. The mean multiple of the median (MoM) for each of the three markers was significantly different from control values in cases of trisomy 21 (AFP median MoM = 0.82; unconjugated E3 median MoM = 0.77; and hCG median MoM = 1.89). These differences were not found when other aneuploidies were considered. Likelihood ratios were calculated for cases and controls and examined for their ability to predict the need for amniocentesis, based on currently recommended risk levels. There was a significant difference between the mean likelihood ratio for cases of trisomy 21 compared with that of controls (mean likelihood ratio = 13.48); there was no significant difference for other aneuploidies (mean likelihood ratio = 1.08). Of the 16 cases of trisomy 21 analyzed, four would not have been diagnosed antenatally if recommendation against amniocentesis had been made based on each woman's individual age-specific risk as modified by her likelihood ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

Antenatal ultrasonographic diagnosis of fetal seizure activity.

A case is reported in which fetal seizure activity was observed ultrasonographically but the growth-retarded fetus was chromosomally normal.

3H-dopamine clearance from the intravascular compartment of the maternal and fetal rhesus monkey.

The clearance of epinephrine and norepinephrine from the intravascular compartment has previously been demonstrated in both pregnant and nonpregnant models. With the use of the pregnant rhesus monkey, this study describes the clearance of dopamine from the fetal and maternal intravascular compartments. In both, the dopamine clearance was biphasic with an initial half-life of 1.5 minutes in fetal blood and 1.0 minute in maternal blood. These studies also confirmed that dopamine does not significantly cross the placenta in an intact form. These observations are consistent with those made for the other two major catecholamines.

Maternal and perinatal morbidity resulting from placenta previa.

One hundred forty-seven cases of partial or complete placenta previa from 1975 to 1982 were reviewed. A history of prior cesarean section was associated with a significant increase in maternal morbidity, including massive hemorrhage, placenta accreta, and hysterectomy. Despite tocolysis and transfusions to delay delivery, nearly two-thirds of the patients were delivered before 36 weeks' gestation. Onset of bleeding before 20 weeks' gestation was associated with a very poor fetal prognosis. The perinatal mortality rate was 81 of 1000. The overall incidence of respiratory distress syndrome was 22%; this was a major cause of neonatal mortality and morbidity. There was a statistically significant correlation between antepartum maternal hemorrhage and the need for neonatal transfusion, and between the neonatal anemia and the amount of intrapartum maternal blood loss.

Recurrent inversion of the puerperal uterus managed with 15(s)-15-methyl prostaglandin F2 alpha and uterine packing.

The present report describes an unusual case of recurrent puerperal uterine inversion causing major postpartum hemorrhage. Blood replacement, oxytocin, and ergot therapy along with manual reduction failed to prevent immediate recurrence, but treatment with 15(S)-15-methyl prostaglandin F2 alpha (Prostin 15M) and uterine packing were successful. It is recommended that 15(S)-15-methyl prostaglandin F2 alpha be available in all obstetric suites for the management of similar emergencies.

Treatment of premature labor with subcutaneous terbutaline.

Terbutaline was administered subcutaneously to treat premature labor for several years. As ritodrine has been approved by the Food and Drug Administration for this purpose, the authors considered it necessary to determine the efficacy of their terbutaline protocol. The hospital records were reviewed for all patients treated for premature labor with subcutaneous and oral terbutaline sulfate during a recent 4-month period. The regimen was highly effective in prolonging pregnancy for the 44 patients with intact fetal membranes, 88.6% of whom delivered 72 hours or more after start of therapy and 79.5% of whom had delivery delayed by 1 week or more. These results are comparable with those reported for intravenous administration of terbutaline or ritodrine hydrochloride. Efficacy was much less among the 19 patients in whom terbutaline was used to delay delivery after labor with premature rupture of the membranes. Of this group, 52.6% had delivery delayed to 72 hours or more, but only 10.5% had a delay of 1 week or more. Maternal side effects and neonatal complications were minimal. Successful tocolysis with beta2-sympathomimetic drugs appears to be possible without the need for intravenous therapy and at lower doses than customarily used.