We conclude that balloon occlusion of the hypogastric arteries is a safe and effective adjunct to cesarean hysterectomy in an attempt to minimize blood loss in patients with abnormal placentation.

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Am J Obstet Gynecol 1999;180(4):883–8 To increase our understanding of the clinical significance of atypical glandular cells of undetermined origin, all Papanicolaou smears were reviewed and classified using the Bethesda System. Charts of all patients with a diagnosis of atypical glandular cells of undetermined origin were reviewed for previous medical history, diagnostic study, histologic diagnosis, and prior Papanicolaou smear abnormalities. The incidence of atypical glandular cells of undetermined origin in 76,018 Papanicolaou smears was 0.196%. We reviewed 133 patient medical records with cytologic diagnoses. Eighty of these patients have had appropriate follow‐up. Thirty‐six (45%) of these were found to have significant histologic abnormalities, including 6 patients with cervical intraepithelial neoplasia, grades 2 and 3, and 4 invasive cancers. The frequency of underlying serious histologic changes is much greater in atypical glandular cells than in atypical squamous cells of undetermined significance. On the basis of our results, we believe that all patients with atypical glandular cells should undergo intensive evaluation including colposcopy, cervical biopsy, and endocervical curettage. When diagnosis cannot be clearly established, patient should undergo endometrial biopsy. Editorial Comment: Manetta et al. reiterate in a retrospective review of Pap smears classified as atypical glandular cells of undetermined significance (AGUS), the significance of this smear and significant histological abnormalities. Cytologyl is a screening test. An AGUS Pap smear is a positive screen and the further evaluation must be done. In this group 45% of the patients had significant histological abnormalities, including 6 patients with CIN and 4 with invasive carcinoma. (LBT)

The relationship between tubulin gene expression and cell elongation was explored in developing internodes of Glycine max (L.) Merr., using light as a variable to alter the rate of elongation. Illumination of 10-day-old etiolated seedlings not only stopped first internode elongation, but also brought about a 80% decrease in the steady state level of ,-tubulin mRNA over the course of the subsequent 12 hours. This strong down regulation of j6-tubulin mRNA occurred without significant changes in the size of the soluble tubulin pool and it was accompanied by a marked increase in chlorophyll a/b binding protein mRNA.cases, the tubulin dimer pool is maintained through both transcriptional and post-transcriptional control of tubulin gene expression (1,17). Little is known about the regulation of tubulin synthesis in plants, but Cyr et al. (8) observed changes of several fold in the levels of tubulin protein and mRNA during carrot somatic embryogenesis. Furthermore, Fukuda (11) reported that the rate of tubulin synthesis increased during the formation of cortical microtubules in differentiating tracheary elements. The involvement of cortical microtubules in cell elongation and the increase in tubulin levels and in microtubule assembly which has been shown to accompany cell elongation (9, 29), make elongating tissues attractive as systems for investigating the regulation oftubulin synthesis in higher plants. Here, we show that changes in ,Btubulin mRNA steady state levels and internode elongation rates vary concomitantly in light-grown and etiolated soybean seedlings. Internodes of etiolated seedlings exhibited elongation rates that were four to five fold greater than those observed in control seedlings grown under a 12 h light/dark cycle. The rapidly elongating internodes of dark-grown seedlings exhibited proportionally higher steady-state levels of jtubulin mRNA. Furthermore, subsequent illumination of the dark-grown seedlings brought about a reduction in the rate of elongation and a concomitant decrease in the steady-state level of #-tubulin mRNA.Microtubules are formed by the regulated self-assembly of the heterodimeric protein tubulin from a soluble tubulin dimer pool, and cytoplasmic microtubules are in a dynamic equilibrium with this tubulin dimer pool (18). Since microtubules can form and persist only when the tubulin dimer concentration exceeds a critical value, maintenance of the tubulin dimer pool at a level above this critical concentration is essential for microtubule formation. Where it has been examined, tubulin synthesis is regulated by a mechanism that is sensitive to changes in the amount of assembled microtubules. In cultured mammalian cells, tubulin synthesis is autoregulated by a post-transcriptional mechanism that is responsive to the size of the tubulin dimer pool (5).

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