Episiotomy scar tumor implantation arising from a cervical carcinoma is rare. This report details a patient who developed an episiotomy implant from a "microinvasive" adenocarcinoma of the cervix 5 months following vaginal delivery. The implant behaved as a primary focus for metastases to the inguinal lymph nodes. Despite subsequent treatment with chemotherapy and radiotherapy the patient succumbed to the disease. The case is the first reporting a poor outcome following an episiotomy scar implant from a primary cervical adenocarcinoma. The poor outcome highlights the controversy regarding the use of the term microinvasive with respect to glandular cervical lesions.

Cold forging processes are used frequently in the manufacture of high-strength headed fasteners. These processes are characterised often by high tool loads and stresses with the consequent risk of tool failure. Increasingly, engineers are attempting to develop a better understanding of the nature of the metal flow arising during closed-die cold-forging operations. This is being done in an effort to establish more reliable mathematical models of the process, to aid in the selection of the most appropriate forming machines, and in the design of the tooling to be used on these machines. The work reported in this paper involves an experimental and theoretical analysis of the metal deformation arising during the cold forging of countersunk headed fasteners. A set of expressions for the punch-workpiece interface and the mean forging pressure were derived by the author using the slab-analysis method. The predicted values for interface and mean forging pressures obtained using the derived slab-analysis equations were compared with results obtained using standard open-extrusion and cylinder-compression expressions. The results predicted using each of the theoretical deformation models were compared with those obtained from a series of experimental forging tests. It was found that the slab-analysis expressions predicted results that were in close agreement with those obtained experimentally. Furthermore, it was determined that the form of the derived equations was such that changes in both interfacial friction conditions and die angles could be catered for very easily.

The continuous increase in the area of contact that occurs between the workpiece and the tooling during metalforming processes gives rise to many difficulties when attempting to analyse such processes using finite-element analysis. This paper reports on a number of changes made to an elasto-plastic finite-element package to enable it to handle such changing boundary conditions and additionally to render it more user friendly. The modified package has been used to model a two-hit heading process, the predicted results, for both metal flow and the highlighting of regions of stress concentration, comparing well with those obtained experimentally.

Metal-matrix composites are a relatively new range of materials possessing several characteristics that make them useful in situations where low weight, high strength, high stiffness, and an ability to operate at elevated temperatures are required. These materials are difficult to machine, however, consisting of a hard abrasive ceramic reinforcing medium set within a more ductile matrix material. This paper presents results from a series of turning tests in which a number of different cutting-tool materials were used to machine an Al/25 vol% SiC metal-matrix composite. The influence of the cutting speed on the tool wear, the surface finish, and the cutting forces was established for each tool material. It was found that carbide tools, both coated and uncoated, sustained significant levels of tool wear after a very short period of machining. The best overall performance was achieved using a solid cubic boron nitride, CBN, insert whilst the worst was encountered using a solid silicon nitride, Sylon, tool.

Hobbing is a well established industrial process used to produce die cavities within solid blocks of material; while superplastic alloys are characterised by high ductility under the application of low forces when deformed at a temperature specific to the particular material. The work outlined in this paper involves an investigation of the factors influencing the production of forming dies for use in a low temperature polymer injection moulding machine by hobbing a superplastic aluminium bronze. The results obtained indicate that the area of the hobbing punch, rather than its geometry, has the greatest influence on the magnitude of the hobbing forces and stresses. It was also found that the die cavity taper, a feature of all industrial hobbing processes, is very strain rate sensitive and this has implications for the application of superplastic hobbing in a production environment. The die cavities produced by hobbing the superplastic material were found to be dimensionally accurate with excellent reproduction of the punch geometries. This was also the case for the polymer components subsequently produced when the hobbed dies were fitted to a small laboratory injection moulding machine. The results obtained from the investigation suggest that the hobbing of superplastic alloys to produce forming dies for use in low stress and low temperature applications appears to be an attractive industrial proposition and worthy of further study.

There are three major prognostic parameters which can be ascertained postoperatively; they are tumour residuum, lymph node status and degree of differentiation. It is difficult to be certain of the value of this knowledge to either the clinician or the patient.

This paper investigates the coining stage of a closed-die axisymmetric cold-forging operation. Coining processes are characterised by high forming loads and tooling stresses. Consequently the calculations of these loads and stresses is of considerable importance in the design of tooling and the selection of optimum forming sequences. This paper uses an upper-bound technique to establish a generalised expression capable of being used in conjuction with a small computer or programmable calculator for the calculation of forging loads. The influence of preform geometry on die corner fill-out is also investigated, the results showing that while initial preform geometry does not significantly influence the material flow at the final stages of fill-out, it does influence the maximum loads required to achieve complete die-filling.

Clinical staging has serious limitations. Operative staging, although invasive, has significant advantages in identifying patients with metastatic disease; identification of this group will allow the extension of normal pelvic treatment methods and the more appropriate targeting of studies to assess therapy protocols for this difficult management group. This chapter has served to introduce contributions from the world's leading authorities in gynaecological oncology. Each chapter deals in great detail with the specific experience of each contributor.

The formation of hexagonal and square shapes by forging circular workpieces within closed-dies is a common practice particularly in the manufacture of “headed” fasteners. In this paper an upper-bound method of solution is proposed which can be used on any polygonal shape. The solution is based on observed velocity fields, and die geometry and takes into account the effect of friction on all surfaces of contact between the die and workpiece. Very close agreement was found between the predicted values of mean forging pressure and those obtained from experimental test performed on hexagonal and square shapes.

An anencephalic pregnancy was first diagnosed by measurement of α-feto-protein (A.F.P.) in maternal serum at 16 weeks and then 21 weeks of gestation. After confirmation of the diagnosis by amniotic-fluid A.F.P. measurement and ultrasonic and X-ray scan, the pregnancy was terminated. It is suggested that maternal serum-A.F.P. levels may be useful in the screening of large numbers of pregnancies for possible central-nervous-system malformations.

SummaryThe specific activity patterns of a group of enzymes were studied in the supernatants of amniotic fluid obtained between 10 weeks of gestation and term. A number of different patterns were found. α‐l,4‐Glucosidase showed a peak in specific activity between 13 and 18 weeks of gestation. Heat‐labile alkaline phosphatase had an early peak of specific activity which was similar to that of α‐l,4‐glucosidase and, in addition, a specific activity peak after 37 weeks. Acid phosphatase showed a peak of specific activity after 32 weeks. Hexosaminidase remained unchanged during most of pregnancy, although the lowest levels were found before 14 weeks. Finally, placental alkaline phosphatase showed a gradual increase in specific activity between 10 and 30 weeks, after which time a more rapid increase occurred. Expression of the results on a protein basis led to an exaggeration of the specific activity peaks in early and late gestation. The significance of the results is discussed in the context of their possible use for the estimation of fetal maturity.