Intrauterine contraceptive devices in women with proven fertility: a 5-year follow-up study

Between December 1962 and January 1968, 301 private patients (ages 17-34) were inserted with either the Lippes loop or the Margulies spiral; the latter being abandoned after 1 year due to frequency of bleeding and irritation to husband during intercourse. While the study was limited (1st 3 years) to women with 2 or more children who were living with their husbands, it has since been expanded to include 3 nulliparous women and 14 with a parity of 1. All women attended preinsertion lectures since patient orientation is considered necessary to reduce the number of IUD removals. Follow-up in the 1st 4 years consisted of examination 1 month after insertion followed by regular 6-month checkups; follow-up was later done by telephone conversation. Results based on 642 woman-years of use show 30 removals for bleeding and pain, 6 due to lack of confidence, 2 because of infection, 7 for hysterectomies, 13 for desired pregnancies, 1 because of endometriosis, 8 no longer needed the device, and 10 were lost to follow-up. From a study group of 269, 192 (71%) devices remained in place. The pregnancy rate was 3.2/100 woman-years of use.     

The effect of suramin on laboratory tests of coagulation.

The antitrypanosomal drug suramin, which has recently been under investigation as a cancer chemotherapeutic agent, has previously been found to induce heparin-like anticoagulants in treated patients. In the currently reported work suramin is shown to have an additional anticoagulant activity that is due to direct effects of the drug on procoagulant proteins. The studies were conducted with pooled normal plasma treated in vitro with suramin and with plasma samples obtained from patients who had received the drug intravenously for 2 weeks. It is demonstrated that in plasma suramin inhibits factors V, VIII, IX, X, XI, and XII, while thrombin, prothrombin, and factor VII are unaffected. The inhibition of factor V is virtually irreversible, although the effect of suramin on the other factors is readily reversed by dilution.     

Antibody-dependent enhancement of respiratory syncytial virus infection by sera from young infants.

Respiratory syncytial virus (RSV) convalescent-phase sera and control sera from both infants ( < 6 months) and older individuals (1.5 to 90 years) were assayed for RSV-specific antibodies by neutralization, in vitro enhancing activity, and immunoprecipitation. Enhancement of RSV infection in U937 cells was demonstrated with convalescent-phase sera and was shown to be dependent on Fc receptors by blocking with human immunoglobulin G (P < 0.01). Convalescent-phase sera from infants enhanced infection at concentrations closer to physiological ones (10(-1) to 10(-3) dilutions of serum), while convalescent-phase sera from older individuals enhanced infection only at much lower concentrations (10(-3) to 10(-6) dilutions of serum; P < 0.01). To our knowledge, this is the first report of RSV-enhancing antibody activity in the sera of infants. The observed enhancing activity and the low neutralizing antibody levels are confined mostly to convalescent-phase sera from infants aged 0 to 6 months, suggesting that these factors may contribute to the increased severity of RSV disease frequently encountered in young infants.     

Metastases to the vertebral column.

Review of 643 autopsies revealed 374 cases of malignant neoplasms, of which 140 were found to have evidence of disease metastatic to the vertebral bodies of the thoracolumbar spine. A comparison is made of the proportion of cases detected by clinical radiographs antemortem vs. the cases of metastatic tumor of the spine detectable by radiographs of slabs of the spine and by histologic examination. A high degree of correlation was found between metastases detected by fine-detail radiography and those detected by microscopic examination. Thus, the incidence of neoplastic metastases to the thoracic and lumbar vertebral bodies is presented, and the reliability of fine-detail radiography is assessing the presence of neoplastic metastases at autopsy is indicated.     

Factors affecting the formation of white particulate matter in red blood cell components

BACKGROUND: Recently white particulate matter (WPM) in red blood cell (RBC) components has received increased attention. The nature and causes of WPM formation were investigated. STUDY DESIGN AND METHODS: Whole-blood units were collected from 18 healthy subjects with three different types of collection sets. Six units were collected into each type. Units were divided into four equal parts and stored for 4 hours: two parts at room temperature and two at 4 degrees C. RBCs were prepared from each quarter-unit: two by heavy centrifugation (5000 x g) and two by light centrifugation (2000 x g). Whole blood was inspected for WPM over 4 hours and RBCs over 1 hour. RESULTS: No WPM was detected in whole blood, but WPM was detected in at least one RBC component from 9 of the 18 donations. The 36 components prepared by heavy centrifugation were more likely to contain WPM than the 36 prepared by light centrifugation (50% vs. 19%; p < 0.02). The incidence of WPM was similar among RBCs stored at room temperature and 4 degrees C. Donors of RBCs with WPM had higher total cholesterol levels than donors of components without WPM (191 +/- 20 mg/dL vs. 163 +/- 32 mg/dL; p < 0.04), but there was no difference in triglyceride levels between the two groups. CONCLUSIONS: WPM is an expected consequence of standard RBC manufacturing methods, but it is more frequent in RBCs prepared by heavy centrifugation and from donors with higher cholesterol levels.