Human genome meeting. The price of success.
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Biomedical subjects
Publications and source records attributed to H Gee.
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A study of data from 318 cases of uterine sarcoma presenting during a 10-year period (1967-1976) is reported. All but 6 of the patients had at least a 5-year follow-up (98% 5-year follow-up). Overall 5-year survival was 31%, with the major prognostic indicator being tumour stage. Despite the tendency for mixed mesodermal tumours to present in older women with more advanced disease, survival was not statistically different to those patients with leiomyosarcomas. Thus, the propensity for tumour dissemination in leiomyosarcomas should not be underestimated. Leiomyosarcomas are less likely to present with abnormal symptoms than are other sarcomas, and their occurrence as an incidental finding on histological examination underlines the need for an adequate inspection of the intra-abdominal contents at hysterectomy. The tendency to treat all sarcomas as if they were endometrial tumours may be fallacious, and an alternative classification (such as the TNM system) may be required. Recurrence of tumour tended to be at distant sites (distant:pelvic recurrence rate 3:1). Adjuvant radiotherapy is unlikely to alter distant disease foci, and thus the development of combination chemotherapeutic regimens using agents which have shown to result in tumour response seem warranted. Such trials will need to be organised on a multicentre basis to attain statistically evaluable numbers of patients.
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A series of 12 trials of scar associated with scar rupture is reviewed. Uterine activity patterns were assessable in 10 of them. Clinical features and characteristics of the intrauterine pressure waveform and uterine activity are discussed in relation to the integrity of the scar.
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The zinc concentration of placental tissue and cord blood in sixteen mothers who gave birth to normal babies was measured. The blood volume of each placenta was estimated from measurements of haemoglobin concentration of placental homogenate and cord blood, and, by deduction, the Zn content of blood-free placental tissue was calculated. Results were compared with eleven mothers whose fetuses showed a low biparietal diameter velocity between 17 and 28 weeks gestation and with ten mothers who gave birth to intra-uterine growth-retarded (IUGR) babies. As expected, placental weight was significantly correlated with infant birth weight. Blood-free placental tissue contained about four times more Zn (approximately 10 micrograms Zn/g) than cord blood (approximately 2.5 micrograms Zn/ml). Concentrations of Zn in blood-free placental tissue were similar in all three groups, but the cord blood Zn of mothers producing IUGR babies was significantly lower than that of the other two groups. Results of the present study suggested that fetal growth retardation in the mothers studied could not be explained by differences in blood-free placental Zn concentration, but that there may be some association between lower cord blood Zn levels and intra-uterine growth retardation.
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Two cases are presented in which sinusoidal heart-rate (SHR) patterns were recorded antenatally. In the first case the pattern was associated with severe maternal exertion and prolonged exposure to freezing temperatures. The pattern returned to normal within an hour of maternal recovery. The second case was associated with fetal death due to high-output cardiac failure associated with a large liver haemangioma. A hypothesis is proposed to link the aetiology for this heart-rate pattern which would explain these, and previously reported cases.