The view that common warts (verrucae vulgares), juvenile warts (verrucae planae), and genital warts (condylomata acuminata) are caused by the same virus and that differences in appearance are the result of variations in location and host reactivity has been shared by dermatologists for several decades (Frey, 1924; Waelsch and Habermann, 1924; Young, 1964; Rowson and Mahy, 1967; Nasemann, 1974; Lever and Schaumburg-Lever, 1975). This has probably reduced the interest in specific types of human papillomas.

Human papillomaviruses and their possible role in squamous cell carcinomas.

The sublethal effects of high predation risk on both prey behavior and phys- iology may have long-term consequences for prey population dynamics. We tested the hypothesis that snowshoe hares during the population decline are chronically stressed be- cause of high predation risk whereas those during the population low are not, and that this has negative effects on both their physiology and demography. Snowshoe hares exhibit 10- yr population cycles; during declines, virtually every hare that dies is killed by a predator. We assessed the physiological responsiveness of the stress axis and of energy mobilization by subjecting hares during the population decline and low to a hormonal-challenge protocol. We monitored the population demography through live-trapping and assessed reproduction through a maternal-cage technique. During the 1990s' decline in the Yukon, Canada, hares were chronically stressed-as indicated by higher levels of free cortisol, reduced maximum corticosteroid-binding ca- pacity, reduced testosterone response, reduced index of body condition, reduced leucocyte counts, increased overwinter body-mass loss, and increased glucose mobilization, relative to hares during the population low. This evidence is consistent with the explanation that predation risk, not high hare density or poor nutritional condition, accounted for the chronic stress and for the marked deterioration of reproduction during the decline. Reproduction and indices of stress physiology did not improve until predation risk declined. These findings may also account for the lag in recovery of hare reproduction after predator densities have declined and thus may implicate the long-term consequences of predation risk on prey populations beyond the immediate effects of predators on prey behavior and physiology.

/pdf/the-impact-of-predator-induced-stress-on-the-snowshoe-hare-2zvlxhng9k.pdf

The impact of predator-induced stress on the snowshoe hare cycle

*This article is a US Government work and, as such, is in the public domain of the United States of America. Knowledge of the embryology and microscopic anatomy of the ovary is fundamental to the understanding of the various cancer types that originate in this organ. A complete description of the embryology and anatomy of the ovary is beyond the scope of this monograph; however, comprehensive reviews are available for those who seek more detail. The current discussion focuses on key developmental events and anatomic features that shed light on the natural history of ovarian cancers. At approximately five weeks of gestation, thickenings of the lining of the posterior embryonic body cavity, the coelomic epithelium, form the genital ridges. Continued proliferation of the coelomic epithelium into the underlying primitive connective tissue, known as the mesenchyme, leads to the formation of the primordial indifferent gonads. Cells from adjacent transient embryonic structures, known as mesonephros, concurrently invade the mesenchyme, and the primordial germ cells arrive after a long journey that starts at their place of origin in the yolk sac and takes the cells along the distal embryonic intestine and the posterior wall of the embryonic body cavity. The different tumor types that arise in the ovary are linked to the different cell types that are present at this stage of development: coelomic epithelial, mesenchymal, mesonephric, and germ cells. Ovaries and testes develop in similar fashion until approximately the fourth month of embryonic life. This finding explains the origin of tumors that are commonly associated with testicular tissue but appear in the ovaries and vice versa. At two months gestation, the primitive gonad is recognized as an ovary because of the lack of development of the well-defined testicular sex cords. Instead, mesonephric cells and germ cells remain closely associated, forming illdefined ovarian sex cords embedded in the primitive mesenchyme. The coelomic epithelium remains at the periphery, enwrapping the developing ovary. In the adult, the ovaries are flat, nodular, oval structures that measure between 3 and 5 cm in their greatest dimension and weigh between 2 and 4 g. They are suspended by peritoneal folds and ligaments on either side of the uterus and attached to the back of the broad ligament of the uterus, behind and below the uterine tubes. A single layer of cells, the surface epithelium, which is derived from the coelomic epithelium, lines their external surface. A dense, fibrous tissue, the stroma, which is derived from the mesenchyme, makes up most of their internal substance. The germ cells, also known as oocytes, are located near the periphery of the stroma. The granulosa cells, specialized cells of probable mesonephric origin that are derived from the sex cords, surround the germinal cells that form the follicles. The stroma immediately surrounding the follicles differentiates into plum elongated cells known as theca cells. When stimulated, theca 2631

Pathology and classification of ovarian tumors.

We studied 374 women taking oral contraceptives, 284 women taking estrogen preparations after menopause, and 1086 women taking no hormones, to determine the relation of plasma lipids and lipoprotein cholesterol concentrations to various types of estrogen/progestin formulations. Premenopausal women, using oral contraceptives containing a relatively low dose of estrogen combined with a medium or high dose of progestin (Norlestrin, Ovral, or Demulen) had a 24 per cent higher median concentration of low-density-lipoprotein cholesterol than did those not using hormones (P less than 0.05). Women using oral contraceptives that are high in estrogen and low in progestin (Enovid or Oracon) had significantly higher concentrations of high-density-lipoprotein cholesterol than did nonusers; those using Ovral, a low-estrogen and high-progestin formulation, had significantly lower levels of high-density-lipoprotein cholesterol. In postmenopausal women the use of estrogen was associated with concentrations of low-density-lipoprotein cholesterol that were 11 to 19 per cent below the levels in postmenopausal women who did not use hormones. The effects of estrogen-progestin balance on low-density and high-density lipoproteins may underlie the increased incidence of stroke and myocardial infarction in women of childbearing age who take oral contraceptives.

Effect of Estrogen/Progestin Potency on Lipid/Lipoprotein Cholesterol

Benign cystic teratomas of the ovary; a clinico-statistical study of 1,007 cases with a review of the literature.

Cancers in pregnancy are uncommon but do occur with an average frequency of 1 in 1,000 births. This gives rise to opposing emotional reactions in these women: they are happy they are pregnant, but usually devastated when they hear they have cancer. The major reasons for suspecting that pregnancy adversely affects the clinical course of cancer is the immunologic tolerance that characterizes both conditions. It has been pointed out that normal pregnancy and cancer are the only two biologic conditions in which the antigenic tissues is tolerated by a seemingly intact system. It may be stated that the mechanisms that insure the survival of fetus during pregnancy presumably also favors the progress of the neoplasia. Management requires individualization with careful thought as whether termination is necessary or whether continuing with the pregnancy is possible prior to definitive treatment. The physician's aim must be to cure the cancer and deliver live, healthy infants. This is one question when a joint decision is probably best reached among the obstetrician, surgical and medical oncologists and other disciplines. The life-threatening cancer should be managed both for the diagnosis and treatment as in the non-pregnant state. An early small cancer gives a better prognosis than an advanced cancer. The same holds for the non-pregnant patient. The survival in the non-pregnant patient stage for stage is the same as for the pregnant patient. However, all too often in the pregnant state the cancer is more advanced than in the non-pregnant patient. The disease must be evaluated and treated in full light of its exact location in conjunction with an understanding of the natural history within the context of the pregnancy with the potentially viable unborn infant. Concern that maternal cancer may metastasize to the fetus is not justified from a review of the accumulated literature. Infrequency of fetal involvement has led to speculation about biologic protective mechanisms that may exist for the placenta and the fetus and the role circulatory separation in the placenta and immunologic responses of the fetus may play. The association of cancer in pregnancy represents a major physiologic process for the maintenance of the race and a major pathologic process that accounts for numerous deaths. It presents a controlled growth and an uncontrolled growth in the same host.

Malignant disease in pregnancy.

Peritoneal effusions of patients with ovarian cancer contain sizable amounts of free and complexed immunoglobulins. By means of salt precipitation procedures, antibodies were recovered that after purification and concentration displayed a high degree of specificity against ovarian carcinoma cells. In indirect immunofluorescence, immunoglobulins recovered from seven different peritoneal effusions showed bright cytoplasmic staining with tissue cultures and fresh suspensions of ovarian carcinoma cells but not of normal ovaries or non-ovarian tumors. Immunoglobulins isolated from fluids of benign ovarian cysts or from effusions of non-ovarian tumors were negative in immunofluorescence tests. Autologous antibodies recovered from peritoneal effusions will be hopefully utilized in sensitive radioimmunoassay tests that are greatly needed for the early detection of ovarian cancer, the leading cause of death from gynecologic neoplasia.

Hugh R. K. Barber

Papers

Malignant disease in pregnancy.

Isolation of tumor-specific antibodies from effusions of ovarian carcinomas.

Gynecological tumors in childhood and adolescence.

Pelvic exenteration combined with resection of segments of bony pelvis.

Operative management of patients previously operated upon for a benign lesion with cervical cancer as a surprise finding