Characteristics of vitamin and mineral supplement products in the United States

A 1986 nationwide survey of 11,775 adults 18 y or older and 1877 children 2-6 y old identified approximately 3400 different (unique) vitamin and mineral supplement products being taken. The most commonly included nutrient listed on the product labels was vitamin C, which was present in 50% of the unique products examined. Calcium and iron were the most commonly included minerals and were present in 25% of the unique products examined. Prenatal and children's chewable products came in a relatively narrow potency range and generally contained nutrients in amounts approximating or less than the US recommended daily allowances. These products also contained significant minimum amounts of nutrients. Potencies of products not targeted for use by these special groups, particularly those products that were self-prescribed, varied widely and ranged from insignificant to extremely large amounts of nutrients. Units used to declare product potency or to prescribe the dosage varied.

Identification and regulation of insulin-like growth factor binding proteins produced by hormone-dependent and -independent human breast cancer cell lines

Using molecular hybridization, ligand blotting and immunoprecipitation, our studies were designed to identify the insulin-like growth factor binding proteins (IGFBPs) produced by human breast cancer cells in culture and evaluate their regulation by estradiol (E2) and polyamines (PA). We demonstrate that the hormone-dependent MCF-7 and -independent BT-20 cell lines express the mRNA for IGFBP-2 (1.7 kb) and secrete this BP (31 kDa) in the conditioned medium. In contrast, the hormone-independent MDA-MB-231 cell line does not express the IGFBP-2 gene, while synthesizing and secreting IGFBP-1. E2 administration (10(-9) M) did not significantly influence IGFBPs secretion in MCF-7 cells. Addition of alpha-difluoromethylornithine (DFMO, 4 mM), an inhibitor of PA biosynthesis, consistently lowered IGFBP-2 mRNA in the MCF-7 and BT-20 cell lines and IGFBP-1 mRNA in MDA-MB-231 cells. Surprisingly, however, this compound either did not influence IGFBPs secretion in MCF-7 cells or actually increased their secretion in the BT-20 and MDA-MB-231 cell lines. PA involvement in IGFBPs production by breast cancer cells is complex and may involve differential regulation of transcriptional and post-translational events.

Arteriovenous malformation of the uterus--a cause of massive operative bleeding

Arteriovenous malformations of the uterus are extremely rare and they occur either in congenital or acquired forms. The most common clinical presentation is abnormal uterine bleeding, which may be aggravated by therapeutic curettage. Because of their rare incidence and clinical importance in management of patients, we report a case of arteriovenous malformation causing serious bleeding during a hysterectomy for uterine leiomyoma. The patient was a 47-year-old multiparous woman who had a history of chronic vaginal bleeding for one year. Numerous anomalous blood vessels draining into the right and left uterine arteries were found on the anterior wall of the uterus and parametrium.

Polyamine involvement in the secretion and action of TGF-alpha in hormone sensitive human breast cancer cells in culture

These experiments were designed to test polyamine (PA) involvement in the secretion and action of transforming growth factor alpha (TGF-alpha) in hormone responsive MCF-7 breast cancer cells in liquid culture. At the same time, we evaluated the influence of culture conditions (with serum vs. serum depleted) and subclonality of MCF-7 cells on PA involvement in estrogen (E2) and TGF-alpha stimulated cell proliferation. Despite inducing a profound suppression of cellular PA levels and inhibiting basal and E2-stimulated growth, administration of the PA synthesis inhibitor alpha-difluoromethylornithine (DFMO) did not influence either basal or E2-induced TGF-alpha secretion. In the same experiments, on the other hand, addition of DFMO completely blocked the growth stimulatory effect of exogenous TGF-alpha. However, when the culture conditions were changed to serum-free medium, TGF-alpha and E2-induced cell proliferation was affected modestly or not at all by DFMO administration, despite similar suppression of cellular ornithine decarboxylase (ODC) activity and PA levels. In addition, different clones of MCF-7 cells differed in their sensitivity to the antiproliferative effect of DFMO as well as in basal levels of ODC activity and PA. We conclude that PAs are not involved in basal or E2-stimulated TGF-alpha secretion in MCF-7 breast cancer cells. On the other hand, PAs do seem to be important mediators of TGF-alpha and E2-induced breast cancer cell proliferation, though the degree of such involvement appears to be influenced by serum factors and clonal variability of MCF-7 cells.

[Emergency therapy with granulocyte-macrophage colony-stimulating factor (GM-CSF)]

Granulocyte-macrophage colony stimulating factor (GM-CSF) has been tested for tolerability and efficacy on a compassionate need case basis in 17 patients (5 females, 12 males aged 4-72 years, median 35 years). GM-CSF was given at the rate of 3.5-32 micrograms/kg for 2-64 days as a continuous infusion for the following indications: impending rejection following bone marrow transplantation (5 patients), severe neutropenia secondary to chemotherapy in tumor patients (5), severe aplastic anemia (3), immune granulocytopenia (2) and accidental overdose with cytostatic agents (2 patients). Tolerance of GM-CSF was good in regard to doses of up to 16 micrograms/kg. Fever, myalgia and eosinophilia were the most frequent side effects. The patient treated with 32 micrograms/kg developed thrombosis of the vena cava. Efficacy is more difficult to assess in this heterogenous population, but 11 of 17 patients showed increased granulocyte counts and 3 patients clearly recovered from severe neutropenia. The role of GM-CSF in this recovery, however, cannot be proven. The results further indicate that GM-CSF cannot reverse ongoing rejection following allogenic BMT and cannot correct immune neutropenia. The value of GM-CSF therapy in patients with severe aplastic anemia and in the context of chemotherapy still needs to be defined. It is certainly indicated in patients with an accidental overdose of chemotherapeutic agents.

Indications for surgical treatment of putaminal hemorrhage. Comparative study based on serial CT and time-course analysis

Serial computerized tomography (CT) scans were correlated with a precise time-course analysis of the neurological condition of 180 patients with hypertensive putaminal hemorrhage. All patients entered the study within 3 hours of the ictus. In this series, 111 patients were treated conservatively and 69 surgically. The neurological condition of each patient was measured by means of a newly proposed grading system for intracerebral hemorrhage-intracranial hemorrhage (ICH grade) which is a modification of the Glasgow Coma Scale. Serial CT scans revealed that most hemorrhages were completed within 6 hours after ictus. Based on the ICH grade at 6 hours postictus, a clinical classification of the severity of putaminal hemorrhage was defined: fulminant, rapidly progressive, slowly progressive, and nonprogressive. According to this classification, precise time courses of the ICH grade were compared between the conservative and surgical treatment groups in a 7-day postictal period. Activities of daily living at 6 months after ictus were also compared. Surgical treatment for a rapidly progressive hemorrhage appears to be beneficial if undertaken in patients under 65 years of age. Surgery in a slowly progressive hemorrhage should be considered only in a small number of patients who deteriorate neurologically with conservative treatment. In this series of patients, surgical treatment of fulminant and nonprogressive hemorrhage was not likely to improve the quality of life or functional recovery. Regardless of treatment modality, CT provided evidence that patients with anterior capsular hemorrhage (16% in this series) showed good recovery of motor and speech function.

Serum LDH and LDH isoenzymes in chronic renal failure: effect of hemodialysis

Serum levels of several commonly measured enzymes are abnormal in patients with end-stage renal disease (ESRD). In the present study we measured serum total LDH activity and LDH isoenzymes in a group of 25 ESRD patients shortly before, during, and immediately after hemodialysis. Baseline serum total LDH activity in the ESRD group was midly but significantly higher than that found in the normal control group. The observed elevation was associated with an isomorphic pattern. Single passage of blood through the extracorporeal apparatus led to a rise in total LDH, LDH-3, LDH-2 and LDH-4, a pattern consistent with release from the platelets. A steady increase was noted in total LDH, LDH-5 and LDH-1 of arterial blood during hemodialysis. This was thought to be due to ultrafiltration-induced hemoconcentration, enzyme release from the formed elements within the extracorporeal circuit and complement-mediated leukocyte activation and pulmonary leukostasis. These observations should be taken into consideration with regards to interpretation of LDH and LDH isoenzyme values and proper time of blood sampling in ESRD patients.

The response of nerve tissue to chymopapain

This study was undertaken to clarify the effects of topically injected chymopapain on the spinal cord and peripheral nerves in rabbits, and also the effect of ganglioside on sciatic nerves which had been damaged by chymopapain. There were no abnormal macroscopic or microscopic findings when chymopapain was injected around the sciatic nerve sheath or around the spinal dura mater, but when it was injected directly into the nerve sheath there was immediate paralysis and severe axonal necrosis; the Schwann sheath remained intact and there was haemorrhage. Injection into the dura resulted in massive haemorrhage, perivascular neutrophil infiltration and necrosis of grey matter. In those treated with ganglioside, regeneration of the damaged sciatic nerve was shorter than in those not so treated.

[Comparison of five modes of dialysis in neurosurgical patients with renal failure]

In neurosurgical patients with renal failure, dialysis entails specific problems, chief of which is increased intracranial pressure and progressive brain edema as a result of rapid lowering of the serum osmolality. Another major problem is a tendency to hemorrhage, in response to either systemic heparinization or insufficient dialysis. The authors describe the results obtained with hemodialysis (HD), continuous arteriovenous hemofiltration (CAVH), continuous ambulatory peritoneal dialysis (CAPD), continuous peritoneal dialysis (CPD), and intermittent peritoneal dialysis (IPD). Nine patients were treated with HD, one with CAVH, five with CAPD or CPD, and two with IPD. Three of the six patients treated with continuous dialysis (CAVH, CAPD, and CPD) died, whereas intermittent dialysis (HD and IPD) carried an 82% mortality rate (nine of 11 patients). The causes of death were progressive brain edema in three cases, intracranial hemorrhage in three, gastrointestinal bleeding in three, overhydration due to insufficient dialysis in one, septicemia in one, and rupture of a cerebral aneurysm in one. Continuous dialysis appeared to be superior to intermittent dialysis in these neurosurgical patients in that it produced less brain edema and was less often associated with hemorrhage due to insufficient dialysis. In HD and CAVH, systemic heparinization was also thought to account for the high incidence of hemorrhage. However, CAVH with short half-life anticoagulants may be useful in patients who have abdominal complications and are therefore not suitable candidates for peritoneal dialysis.

Pathophysiology of rhinitis. Lactoferrin and lysozyme in nasal secretions

The antimicrobial proteins lactoferrin (Lf) and lysozyme (Ly) are invariably found in nasal secretions. To investigate the cellular sources and the secretory control of these nasal proteins in vivo, 34 adult subjects underwent nasal provocation tests with methacholine (MC), histamine (H), and gustatory stimuli. Nasal lavages were collected and analyzed for total protein (TP), albumin (Alb), Lf, and Ly. MC (25 mg), H (1 mg), and gustatory stimuli (spicy foods) all increased the concentrations of TP, Alb, Lf, and Ly. However, when each protein was assessed as a percentage of TP (i.e., Alb% = Alb/TP; Lf% = Lf/TP; Ly% = Ly/TP), MC and gustatory stimuli, which both induce glandular secretion, selectively augmented Lf% and Ly% without changing Alb%, while H, which primarily increases vascular permeability, increased Alb% without significantly affecting Lf% or Ly%. Gel electrophoresis and immunoblotting analysis of nasal secretions demonstrated both Lf and Ly in cholinergically induced secretions. Furthermore, histochemical analyses of nasal turbinate tissue revealed Lf and Ly colocalization within the serous cells of submucosal glands, providing evidence that both proteins are strictly glandular products within the nasal mucosa. Therefore, both Lf and Ly are produced and secreted from the glands, and their secretion may be pharmacologically regulated in attempts to improve host defenses.

Effects of progesterone or luteinizing hormone on folliculogenesis in intact or hypophysectomized immature hamsters

Since exogenous progesterone (P4) causes superovulation in hypophysectomized (hypoxed) cyclic hamsters treated with gonadotropins, the current study was performed to evaluate the roles of P4 and luteinizing hormone (LH) as a folliculotropic complex in the immature hamster. Intact or hypoxed immature hamsters were injected daily, beginning on Day 23, with 1 mg P4 and/or 20 micrograms LH for 4 days. Treatment with P4 alone or combined with LH in intact immature hamsters increased the number of antral follicles (6.7 and 4.3, respectively, vs. 1.5 per ovary in controls), but neither treatment maintained large follicles in hypoxed animals. In contrast, in hypoxed hamsters, the number of small preantral follicles was enhanced by P4 or LH (406 and 409, respectively, compared to 302 per ovary in untreated controls), but with no additive effects by combined treatment. The stimulatory effect of P4 in intact hamsters was unrelated to serum levels of follicle-stimulating hormone, estradiol, or LH. Moreover, in the hypoxed hamster, P4 or LH acts directly to increase the numbers of small preantral follicles with 2 to 5 layers of granulosa cells, whereas equally large doses of stilbestrol or estradiol cyclopentylpropionate are ineffective. In the hypoxed or intact hamster, the effects of P4 or LH may involve either recruitment of smaller follicles into larger stages or prevention of atresia. The present experimental design can not distinguish between these possibilities.

Nuclear magnetic resonance microscopic ocular imaging for the detection of early-stage cataract

A nuclear magnetic resonance (NMR) microscopic ocular imaging was performed at 7.0 Tesla to investigate its usefulness in the detection of early-stage cataracts. For this study, galactose cataracts were generated in experimental rabbits through diet (35% galactose), and enucleated eyes were imaged at various times after initiation of the diet. In previous studies using a 0.6 Tesla conventional magnetic resonance imager (MRI), the contrast between normal and cataractous tissues in the lens was not well defined, mainly due to the partial volume effect coming from the limitation of resolution and signal-to-noise ratio (SNR). With resolution of 60 X 60 X 80 microns, early localized precataractous tissue changes were clearly observed after 5 days diet. Precataractous tissue changes were seen histologically but no visible evidence of lens change was detected by the conventional slit lamp biomicroscope at this time. Substantially elongated spin-spin relaxation times (T2) in localized cataractous tissues (72.4 +/- 8.8 msec) were consistently observed compared with those in normal lens region (16.1 +/- 3.2 msec); however, the changes of the spin-lattice relaxation time (T1) were not significant. Some ocular NMR microscopic images with corresponding histological photographs are demonstrated to show the potential of NMR microscopy.

The role of serial angiography in the management of bacterial and fungal intracranial aneurysms--report of two cases and review of the literature

The authors review 149 cases of bacterial and mycotic intracranial aneurysms reported since 1957 and describe two cases of bacterial aneurysms managed in their institution. The overall mortality rate was 39%. Bacterial aneurysms accounted for 0.49-4.3% of all intracranial aneurysms. Among the reported cases, the mortality rate for patients treated with antibiotics alone was high, whereas it was low among those who underwent elective surgery. The authors conclude the following: 1) Distal aneurysms should be treated with high-dose antibiotics and followed with serial cerebral angiography at 7 days, 14 days, 1 month, 3 months, and 1 year after the initiation of therapy; 2) proximal aneurysms should be treated with high-dose antibiotics, and surgery is rarely indicated; 3) any significant associated hematoma should be evacuated and the aneurysm resected, if possible; and 4) if serial angiography shows enlargement of an aneurysm, surgery should be considered. The clinical features and management of mycotic and bacterial aneurysms are discussed in detail.

Timolol side effects and inadvertent overdosing

The case reports demonstrate that significant and potentially dangerous side effects from timolol maleate occur as a result of inadvertent overdosing. Because many glaucoma patients are elderly and vision is frequently impaired, overdosing may be the mechanism of side effects in many patients especially the elderly. A simple dropper that would withdraw only one drop and deliver the same would resolve this problem.

Nucleolar organizer regions of lymphomas in Korea

Nucleolar organizer regions (NORs) are loops of DNA which occur in the nucleoli of cells and which possess ribosomal RNA (rRNA) genes. The numbers and/or configurations of NORs have been thought to be related to cellular activities. To assess the applicability of NORs associated protein (Ag-NORs) in the field of diagnostic histopathology, a silver staining was done in paraffin sections of malignant lymphomas, tonsils and reactive lymph nodes and the numbers of Ag-NORs in the nuclei of low-grade and those of high-grade lymphomas were compared. A significant difference was found between the numbers of Ag-NORs in the nuclei of low-grade lymphoma (a mean of 1.3 per nucleus) and those of high-grade lymphomas (a mean of 4.2 to 8.3 per nucleus). The Ag-NORs were often observed in nuclei in areas where nucleoli themselves were not visible in H&E stain. It is suggested that this method would be of great value in the field of tumor histopathology.

Conservative treatment of tuberculosis of the thoracic and lumbar spine in adults and children

We have treated 75 cases of spinal tuberculosis with chemotherapy as outpatients. The drugs used were INH, rifampicin and ethambutol for the 48 adults, and INH, rifampicin and PAS for the 27 children. No operations, apart from the evacuation of large abscesses, were carried out. Every patient was followed up for at least three years and the outcome was judged to be favourable in 95%. This is better than in some series in which radical surgery has been used. Although we recognize the advantages of operation in certain circumstances, we believe that our conservative regimen can be confidently recommended for use in less privileged countries, where adequate facilities for hospital treatment may not be available.

Effect of estrogens on follicular development and ovarian and uterine estrogen receptors in the immature rabbit, guinea pig and mouse

Immature rabbits, guinea pigs and mice were injected with estradiol cyclopentylpropionate (ECP) or diethylstilbestrol (DES) for 3 days to evaluate whether estrogen enhances follicular maturation. Also, estrogen receptors in the ovary and uterus from these animals were measured. Uterine weight increased in all animals treated with ECP or DES, whereas actual ovarian weight increased only in the guinea pig. This correlated with the ability of estrogens to significantly increase the number of antral follicles in the guinea pig ovary. In the rabbit and mouse, estrogen increased only the number of small or large preantral follicles. However, the number of estrogen binding sites in the ovarian cytosol and nucleus was greater in the rabbit and the mouse than in the guinea pig. The affinity of ovarian cytosol receptors was the lowest for the guinea pig among the 3 species. Thus it is seen that estrogen does not enhance follicular maturation in all animal species. The ovarian response to estrogen is not only dependent upon estrogen receptors but also unknown mechanism(s) that may be related to paracrine or autocrine functions.

Blood-flow measurement in muscle with Xe-133

An alternative method to the conventional miniature probe system for the measurement of blood flow in muscle has been developed. Xenon-133 was injected into the quadriceps muscles of ten subjects. A gamma camera and an online computer were then used to measure the half-clearance time of the Xe-133 while the subject was both at rest and exercising on an upright bicycle ergometer. The blood flow in the muscle was then calculated from the acquired data.

Differences in the pattern of weight growth of nutritionally at-risk and well-nourished infants

A mathematical model was used to examine the patterns of weight growth of two groups of infants exposed to various ecological and nutritional conditions and practices. Statistical comparison of the parameters of weight model estimated from longitudinal data demonstrated different level and profile contour of weight growth in these two populations. In addition to differences in the growth levels, the growth patterns of these two groups are significantly different. The Taiwanese infants experience more pronounced upward and downward changes in growth velocity than the United States (US) infants in the first 6 mo of life. In the second 6 mo, the US infants show a decline in growth velocity whereas the Taiwanese infants maintain a low and constant growth rate. Possible explanations for the different growth profile of the Taiwanese infants in the first 6 mo may be related to: catch-up growth after possible intrauterine undernutrition, genetic growth pattern of Taiwanese infants, and growth characteristics of breast-fed infants.

Primary well differentiated lymphocytic lymphoma of the lung--a clinical and immunohistochemical study of four cases

Four cases of well differentiated lymphocytic lymphoma with or without plasmacytoid differentiation of the lung are described. Two cases were single and the others were multiple. Histologic pictures of the lesion showed mass with perivascular, interstitial and alveolar extension in three cases and only interstitial and perivascular involvement in one. Histologically three cases were lymphoplasmacytic lymphoma and one was small lymphocytic lymphoma. Dutcher bodies, granulomas and germinal centers were also found in tumors. Immunohistochemical study revealed monoclonal lymphocytic proliferation in all cases in fresh frozen sections and in three in paraffin sections. Treatment is surgical resection. Chemotherapy is used for residual disease after surgery.

Stimulatory and inhibitory effects of progesterone on follicular development in the hypophysectomized follicle-stimulating hormone/luteinizing hormone-treated hamster

Cyclic hamsters hypophysectomized at estrus (Day 1 of the cycle) and injected with 5 micrograms follicle-stimulating hormone (FSH) on Day 1 and 20 micrograms luteinizing hormone (LH) in polyvinylpyrrolidone (PVP) from Days 1-4 ovulated 15.3 ova, in response to 30 IU human chorionic gonadotropin (hCG) administered at 1500 h on Day 4 (Kim and Greenwald, 1984). When 1 mg progesterone (P4) was administered daily from Days 1-4 concurrent with the above regimen, ovulation increased to 38 ova, a clearcut superovulatory response. However, daily injection of 1, 10, or 100 micrograms P4 plus FSH and LH reduced the number of antral follicles present on the afternoon of Day 4 to 3-4 per ovary, compared to 9 per ovary after FSH-LH alone, and the ovulation rate was drastically reduced with most animals being anovulatory. Substituting 1 mg 17 alpha-hydroxyprogesterone or estradiol cyclopentylpropionate for P4 on Days 1-4 did not alter the number of antral follicles on Day 4 from FSH-LH alone, whereas 1 mg androstenedione or 1 mg testosterone cyclopentylpropionate reduced the number of antral follicles to 3 or less. Hence, the stimulatory effects of 1 mg P4 are not attributable to its conversion to other P4 derivatives. After the concurrent injection of 1 mg P4 and FSH-LH, on the afternoon of Day 3, an average of only 1.8 large preantral follicles was present per ovary. By the morning of Day 4, however, the ovary contained 14 large preantral and early antral follicles in addition to 8 large antral follicles. Injection of hCG at this time resulted in the ovulation of 14.5 ova.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of lactate dehydrogenase-X by imino-derivatives of gossypol:structure activity relationship

Six imino-derivatives (II, III, IV, V, VI, VII) of gossypol (I) have been synthesized, and their effects were evaluated on the purified mouse lactate dehydrogenase-X. Three of these derivatives (V, VI, VII) with aldehyde groups substituted with hydrophobic functionalities showed equivalent or more inhibitory effects on lactate dehydrogenase-X than gossypol, whereas three other derivatives (II, III, IV) with aldehyde groups substituted with hydrophilic functional groups lost the ability to inhibit lactate dehydrogenase-X. It is suggested that two aldehyde groups of gossypol are not essential to inhibit lactate dehydrogenase-X. Furthermore, the hydrophobic property of the gossypol molecule seems to play a more important role in inhibiting lactate dehydrogenase-X. Therefore, lactate dehydrogenase-X inhibition by gossypol may not be associated with its antifertility mechanism, because the aldehyde group of gossypol is known to be required for its antifertility effect.

Estrogen receptors in ovary and uterus of immature hamster and rat: effects of estrogens

Cytosolic and nuclear estrogen receptors in the ovary and uterus of immature rats and hamsters were determined to evaluate why exogenous estrogens were ineffective in stimulating follicular maturation in the hamster compared to the rat. Animals were injected sc with oil or single injection of 1 mg estradiol cyclopentylpropionate (ECP) on Day 23 or a daily injection of 2 mg diethylstilbestrol (DES) on Days 23-25 and killed on Day 26. Total binding sites for estrogen in ovarian cytosol of control hamsters were half the number in the rat ovary (28 fmole/mg protein) and about 50% of the receptors were occupied in the hamster. The apparent affinity of the estrogen-cytosol receptor complex was also lower in the hamster (Kd; 1.41 nM) than in the rat (Kd; 0.52 nM). After ECP treatment, there was a tendency for translocation in all 4 tissues examined even though some differences were not statistically significant. However, after DES treatment both cytosol and nuclear estrogen receptors decreased in both species. This discrepancy may be due to the difference in the time course of the nuclear translocation, the difference in metabolism and difference in the binding potencies of ECP and DES. The lack of ovarian responsiveness to estrogen in the hamster thus appears to be due to the reduced number of cytosol receptor sites which have a low affinity for estrogen and are already partially occupied.

Cavernous angioma of the cauda equina producing subarachnoid hemorrhage. Case report

A case of a cavernous angioma of the cauda equina is presented. The patient was a 28-year-old man who experienced sudden low-back pain and headache without neurological symptoms. Lumbar puncture revealed subarachnoid hemorrhage. He had suffered a similar episode 3 years previously. Selective spinal angiography did not demonstrate any abnormal vascularity. Metrizamide myelography and magnetic resonance imaging were useful in demonstrating the presence of a tumor. Laminectomy at L1-3 and total removal of the tumor were performed without neurological deficit.

Occupied and unoccupied FSH receptors in follicles of cyclic, hypophysectomized or hypophysectomized/gonadotropin-treated hamsters

Occupied and unoccupied FSH receptors were measured in follicles from intact cyclic hamsters or in animals hypophysectomized on day 1 (= estrus) which were untreated or given ovine FSH on day 1 plus LH on days 1-4 or FHS and LH plus 1 mg progesterone on days 1-4. Intact hamsters, from days 2-4, the number of occupied and unoccupied FSH receptors and receptor affinity was unchanged in antral follicles. For the untreated hypophysectomized hamsters, serum FSH was undetectable beyond day 3 but receptor affinity increased on day 2 and the number of occupied FSH receptors was still very high on day 4. Thus, in the hypophysectomized untreated hamster the ovary is not hormonally deprived - at least up until day 4. Treatment of the hypophysectomized hamsters with FSH-LH restored all follicular values of levels of intact hamsters on days 2 and 3. On day 4, although serum FSH was undetectable since day 3 the number of occupied FSH receptors was 70% of control values. The FSH-LH regimen developed by day 4 large antral follicles in the hypophysectomized hamsters. Collectively, the experiments demonstrate that in intact hamsters as a result of the prolonged peak of serum FSH on day 1 FSH binds avidly to receptors in granulosa cells and persists until day 4. Thus, the follicles in the hypophysectomized groups develop in response to exogenous LH but with hamster FSH still present, bound to granulosa cells.

Steroidogenic effects of lipoproteins and 25-hydroxycholesterol on luteal and ovarian cells: a comparison of two pseudopregnant rat models

Steroidogenesis was compared between luteal cells from immature pseudopregnant (PSP) rats induced by either 5 IU pregnant mare serum gonadotropin (PMSG) alone or 50 IU PMSG combined with 25 IU human chorionic gonadotropin (hCG). It was also determined whether differences in steroidogenesis existed when the entire ovary (ovarian cells) or just luteal cells from Day 4 PSP rats were exposed in vitro to lipoproteins or 25-hydroxycholesterol (25-OH chol). In the absence of luteinizing hormone (LH), basal steroid accumulation, especially progesterone (P4) was around fourfold greater in luteal cells from rats treated with PMSG alone than from rats receiving PMSG-hCG. However, serum P4 and LH were about fivefold greater in the latter group. It is therefore likely that net cellular cholesterol uptake per luteal cell is lower in the PMSG-hCG treated rats, but this is offset by a much greater mass and number of corpora lutea. Lipoproteins (HDL and LDL) and 25-OH chol stimulated in vitro luteal steroidogenesis from rats treated with PMSG alone or PMSG-hCG, and their responses were virtually identical. Therefore, luteal steroidogenesis in the rat always depends on exogenous cholesterol even though treatment in the preovulatory period with PMS or PMSG-hCG and serum LH and follicle-stimulating hormone (FSH) levels on Day 4 PSP are very different. When ovarian cells from PMSG-hCG treated rats were incubated with LH plus HDL or 25-OHP, the production of 20 alpha-DHP was considerably greater than luteal cell production which may be due to a contribution from nonluteal cells. Indeed, about 30% of the cells in the PMSG-hCG group represent nonluteal components as estimated by weight and deoxyribonucleic acid content.

Iron deficiency anemia and educational achievement

The present study investigates the effect of iron supplementation on measures of school performance among 78 iron-deficient anemic and 41 nonanemic children in an economically deprived rural area in Central Java, Indonesia. All the subjects were treated for ancylostomiasis before iron supplementation. They were randomly assigned to either an iron or placebo group. Hematological and behavioral measurements were obtained immediately before (T1) and after (T2) the iron and placebo treatments. Iron treatment for a 3-mo period resulted in substantive increases in mean Hgb, Hct, and transferrin saturation among the iron-deficient anemic children. Furthermore, changes in the iron status of iron-deficient anemic children were associated with significant changes in the school achievement test scores of iron-deficient anemic children. T2 evaluation of achievement test scores indicated that the difference between iron-treated anemic and nonanemic children was still statistically significant. However, when T1 scores were entered as a covariate, iron-deficient anemic subjects treated with iron obtained significantly higher delta achievement scores. Findings from the present study indicate that iron supplementation among iron-deficient anemic children benefits learning processes as measured by the school achievement test scores.

Evidence for rapid loss of spare hCG receptors in the corpora lutea of the hypophysectomized rat

In pregnant mare serum gonadotropin treated immature rats hypophysectomized on the day of ovulation (day 1) the corpora lutea (CL) persist as normal morphological structures and produce steroids, especially 20 alpha-dihydroprogesterone (20 alpha-DHP), for at least 40 days (Taya and Greenwald, 1982), although there is a rapid decline in human chorionic gonadotropin (hCG) binding sites (Kim and Greenwald, 1984). In this study the number of occupied and non-occupied hCG receptors in CL from hypophysectomized rats decreased to 14% and 36%, respectively, compared to intact day 5 pseudopregnant animals, but the binding affinity was unchanged. Decreased concentration of occupied hCG receptors paralleled hormonal levels of serum luteinizing hormone (LH) which were measurable in only 9 out of 20 animals and were near the lower limits of the assay (40 pg/ml). Luteal progesterone (P4) production in response to LH was markedly decreased after hypophysectomy, but the maximal P4 response to LH and 20 alpha-DHP production in response to LH and 8-Br-cAMP were the same in hypophysectomized and intact animals. Although hCG receptor concentration in CL decreased significantly after hypophysectomy, LH-stimulated luteal production of cAMP was almost the same in both groups. These results indicate that LH spare receptors which are uncoupled from cAMP exist in the CL of the intact pseudopregnant rat and that after hypophysectomy they quickly disappear within 4 days.

Leydig cell tumors of the testis. A clinicopathological analysis of 40 cases and review of the literature

The clinical and pathological features of 40 Leydig cell tumors of the testis were analyzed. The patients ranged from 2 to 90 (average 46.5) years of age. The most common initial manifestation was testicular swelling, which was sometimes associated with gynecomastia; 15% of the patients presented because of gynecomastia and were found to have palpable testicular tumors. All three children were brought to the physician because of isosexual pseudoprecocity. The tumors, one of which was asynchronously bilateral, ranged from 0.5 to 10.0 (average 3) cm in greatest diameter. They were usually well circumscribed, but in seven of them the margin with the adjacent testis was ill-defined. On microscopic examination the most common pattern was that of diffuse sheets of neoplastic cells, but insular, trabecular, pseudotubular, and ribbon-like patterns were also encountered. The neoplastic cells were most often large and polygonal with abundant eosinophilic, slightly granular cytoplasm; occasionally the cytoplasm was abundantly vacuolated. In eight tumors some of the cells were spindle-shaped, and in six some had scanty cytoplasm. Crystalloids of Reinke were identified in 35% of the tumors. Conspicuous nuclear atypicality was present in 12 tumors and the mitotic rate ranged from less than 1 to 32/10 high-power fields. Blood vessel invasion, lymphatic invasion, or both were identified in four tumors. Follow-up of 2 months to 22 years (average 4 years) was available for 30 patients. Five of them died as a result of spread of their tumor. A comparison of the clinically malignant tumors with those associated with survival for 2 or more years postoperatively revealed that the former occurred in older patients and were accompanied by symptoms of shorter duration and an absence of endocrine manifestations. The malignant tumors were larger, often had an infiltrative margin and had spread beyond the testis, frequently exhibited blood vessel or lymphatic invasion, and had a greater degree of cellular atypia and necrosis and a higher mitotic rate than the benign tumors.

Specific inhibition of the testicular mitochondrial respiratory chain in vitro by gossypol

Optically inactive gossypol is an effective male antifertility agent in several mammalian species, while optically active (+)-gossypol has no antifertility effect in the rat and hamster. Recently, it was suggested that the mitochondria of spermatogenic cells may be a subcellular target of gossypol. We are reporting the effects of optically inactive gossypol and (+)-gossypol on the respiratory chain of mitochondria isolated from the testes and liver of rats and hamsters. The mitochondria were incubated with the test compounds and difference spectra were recorded. Complete inhibition of the testicular mitochondrial respiratory chain was observed at a concentration of approximately 75 microM. In contrast, no inhibition of the liver mitochondrial respiratory chain was observed with the test compounds at concentrations as high as 300 microM. These results demonstrate selective inhibition of the testicular mitochondrial respiratory chain by gossypol isomers.

A species difference between hamster and rat in the effect of oestrogens on growth of large preantral follicles

Intact or hypophysectomized 23-day-old hamsters and rats were injected s.c. with 2 mg diethylstilboestrol (DES) or 1 mg oestradiol cyclopentylpropionate (OECP) on Days 23-25 and killed on Day 26. Although serum oestradiol was elevated to the same high levels by OECP, ovarian and uterine weights were increased in the rat by OECP or DES whereas only the uterus responded in the hamster. This correlated with the ability of the oestrogens to increase significantly the number of large preantral and antral follicles in the intact rat but only the number of follicles with 2-3 layers of granulosa cells in the immature hamster. Qualitative study revealed that DES and OECP increased the number of large preantral follicles in the adult hypophysectomized rat but were ineffective in the adult hamster. It is concluded that for the immature and adult hamster oestrogens do not play a major role in the recruitment of large preantral follicles.

Application of receiver-operator analysis to diagnostic tests of iron deficiency in man

The objective of the present report is to demonstrate the use of receiver-operator characteristics (ROC) analysis in the selection of diagnostic tests for iron deficiency in a specific population. Conventional ROC curves were prepared with true positive fraction (TPF) and false positive fraction (FPF) determined by the application of different cut-off points for four indicators of iron status. ROC plots were then transformed into normal deviate scales. The advantages of Gaussian transformation of TPF and FPF when underlying decision functions are normally distributed are: the ROC curve is a straight line; and the separation between the two distributions and shape of these distributions can be simply quantitated as intercepts and slopes. In the present study, pretreatment hemoglobin concentration was the most robust diagnostic indicator of iron deficiency as operationally defined by a response of hemoglobin to iron treatment. Free erythrocyte protoporphyrin was a more sensitive and specific predictor than either serum ferritin or transferin saturation when a stringent operational definition of iron deficiency was used. These findings illustrate the utility of ROC analysis in discriminating between diagnostic indicators having different degrees of accuracy.

Hormonal requirements for maintenance of follicular and luteal function in the hypophysectomized cyclic hamster

The amounts of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin (Prl) required for follicular development or luteal maintenance were established by hypophysectomizing hamsters between 0900-1100 h of Day 1 of the cycle (=morning of ovulation) and injecting the animals s.c. over the next 4 days to stimulate the normal cycle. Animals were killed at 1300 h on Day 4 or injected with human chorionic gonadotropin (hCG) at 1500 h on Day 4 and killed the next morning to determine the ovulation rate. Daily injection of 20 IU hCG resulted in 8 antral follicles per ovary and ovulation of 12.4 ova, but 20 micrograms LH (in saline) failed to develop any antral follicles; 20 micrograms LH in polyvinylpyrrolidone (PVP) - which prolongs its biological activity - matured 2-4 antral follicles per ovary and the animals ovulated 3 ova in response to hCG. However, injection of 5 micrograms FSH on Day 1 plus 20 micrograms LH (in PVP) on Days 1-4 produced normal numbers of antral follicles and ovulation of 15 ova. When 5 micrograms FSH was injected daily along with LH (in PVP), follicular development was accentuated and the animals ovulated 49 ova. Keeping FSH constant at 5 micrograms/day and reducing LH from 20 micrograms to 10 or 5 micrograms per day did not reduce the number of follicles maturing or ovulating. Daily injection of Prl did not affect follicular development but maintained corpora lutea (CL) in some animals. Combined injection of Prl and LH (in PVP), but not FSH, maintained active CL in all animals. Thus, the hypophysectomized hamster requires tonically high levels of LH for the hormone to exert its follicular and luteal effects with FSH and Prl, respectively.

Further studies on in vitro steroidogenesis by luteal cells from long-term hypophysectomized rats

Immature pregnant mare's serum gonadotropin-treated rats were hypophysectomized on the day of ovulation (Day 1 of luteal function), and luteal steroidogenesis and human chorionic gonadotropin (hCG) and prolactin (Prl) binding sites were determined on Days 5, 10, 20 and 30 (H5- H30 ) compared with intact rats on Days 5 or 10 (C5 or C10). On H5, dispersed luteal cells secreted large amounts of progesterone (P), 20 alpha-dihydroprogesterone (20 alpha-DHP), 17 alpha-hydroxyprogesterone (17 alpha-OHP), and small amounts of testosterone (T) and estradiol-17 beta (E2), but between H10 and H30 , reduced levels of all steroids were produced except for 20 alpha-DHP. Addition of large amount of pregnenolone (P5) or P (100-1000 ng) to dispersed luteal cells increased production of P and 20 alpha-DHP in C5 and H5 rats. The higher serum levels and basal in vitro production of 20 alpha-DHP from H5 to H30 indicates that 20 alpha-oxidoreductase persists in the corpora lutea (CL) at high levels and that 3 beta-ol-dehydrogenase is also present but with P rapidly shunted into its principal metabolite. From H5 to H30 , addition of 10 ng P to luteal cells increased the production of 17 alpha-OHP and addition of 10 ng androstenedione (A) or T enhanced production of T and E2, indicating that 17 alpha-oxidoreductase, 17 beta-hydroxysteroid dehydrogenase and aromatase also persist in the CL. In vitro addition of 10 ng LH significantly stimulated production of P from luteal cells on C5 and H5, whereas on C10 and H10, 100 ng LH was required and on H20 and H30 , 1 microgram LH produced a minimal increase in P.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of prostaglandin F2 alpha on Na+-K+-ATPase activity in luteal membranes

Slices of rat corpora lutea (CL) incubated with prostaglandin F2 alpha (PGF2 alpha) in Krebs-Hensenleit (K-H) Ringer solution showed a decrease in Na+-K+-ATPase activity after 60 min of incubation. However, PGF2 alpha in vitro did not alter Na+-K+-ATPase activity of isolated luteal membrane fractions. Following PGF2 alpha-induced in vivo luteal regression, reduction of Vmax and elevation of the activation energy above transition temperature of the lipid phase of the membrane occurred without changes in Km, optimum pH and transition temperature. These results suggest that reduction of Na+-K+-ATPase activity after PGF2 alpha treatment may be due to reduction in the number of enzyme molecules or to masking of the active site of the enzyme without any change in enzyme characteristics. In addition, a change in membrane-bound enzyme activity may be an early step in PGF2 alpha-induced luteolysis.

Anterior interbody fusion in fractures and fracture-dislocations of the spine

Twenty-five cases of unstable fractures and fracture-dislocations of the spine are reviewed. They were treated at the Catholic Medical College and Centre in a 3-year period, 1975 to 1978. 1. Eleven of the 25 patients were treated by anterior interbody fusion performed at 6 to 8 weeks from injury or initial surgery. 2. Eleven patients had neurological deficits, 3 with incomplete lesions and 8 with complete lesions. Open reduction and decompression laminectomies were performed on patients having neurological deficits prior to anterior interbody fusion. Two patients with incomplete paraplegia showed marked neurological recovery whilst one with complete paraplegia regained some sensation. 3. Solid clinical fusion was obtained in all but one patient within four months of interbody fusion. 4. Amongst the 18 patients with kyphosis at the time of admission 10 had a final improvement of their kyphosis ranging from 3 to 10 degrees (average 6 degrees). Three had no change and 5 demonstrated a mild increase of kyphosis (average 4 degrees). 5. Pain was relieved in 21 patients out of 25. The advantages of this technique include effective stabilization, prevention of late deformity and relatively early mobilization without internal fixation.

[Thrombectomy of the middle cerebral artery (author's transl)]

The case reports on the thrombo-embolectomy in the middle cerebral artery have been presented in a little frequency since 1954 when it was reported by Welch. But those in the acute stage have been reported very little. The present case concerns a male of 55 years old, who begun with the partial paralysis of the left upper limb and at the time of his entering the hospital, 24 hours later from onset, he showed the complete paralysis of the left upper limb and partial paralysis of the lower limb. His consciousness was in a mild confusional state. By the cerebral angiography, we could recognize the findings of obstruction in the right middle cerebral artery (the origin of angular artery), and see the retrograde filling from the right anterior cerebral artery. CT showed normal findings. Thrombectomy of the right middle cerebral artery was performed 30 hours later from the appearance of upper limb palsy (about 6 hours later from the onset of left hemiparesis). A fresh thrombus was easily extracted from the angular and central sulcus arteries. There occurred no serious complications after operation and then the improvement of the paralysis was recognized. This case was reported to be of help to judge the indication of such operation in an acute period and its effectiveness.

Synovial biopsy by Franklin--Silverman needle

Franklin-Silverman needles, commonly used for liver biopsies, were used for biopsy of synovia of 75 joints. The results indicate a higher percentage of success in obtaining pathologic specimens than with previously reported instruments. Complications were rare, with only milk transient hemarthrosis being found in 5 cases. For an accurate diagnosis, multiple specimens should be obtained since single specimens are too small to interpret histopathologically. Being simpler and safer, the Franklin-Silverman needle biopsy is recommended as a routine procedure for early diagnosis of synovial diseases of the joint in conjunction with joint aspiration. The success rate depends not only on the type of needle used but also on the proper selection of the biopsy site.

Arm wrestler's injury: report of seven cases

Seven cases of fractures of the humerus from arm wrestling included 2 types of fractures. Two were spiral fractures of the humeral shaft with large butterfly fragments at the junction of the middle and distal one third caused by a violent uncoordinated muscular action. Five were fractures of the medial epicondyle of the humerus as a result of a sudden blow to the elbow. In all 7 cases, the fractures healed and arm function returned to normal.

[On the phenomena of multiple extravasations of contrast medium in cerebral angiogram of the cases of hypertensive intracerebral hematoma (author's transl)]

It is interesting to note the pathological findings that the rupture of multiple microaneurysms in the basal ganglia appears to be the cause of the hypertensive intracerebral hematoma. But there is few report that the carotid angiogram demonstrated multiple leakages of contrast medium of intracerebral hematoma in vivo than in Westberg's postmortem angiogram. The authors experienced 15 cases of hypertensive intracerebral hematoma whose cerebral angiogram showed extravasation of contrast material. It was fifty-seven per cent of which angiogram within 6 hours after the stroke showed leakage of contrast medium. However, there was remarkably decreased appearance of the extravasation after 9 hours after the stroke. Moreover, emphasis showed be placed upon the facts that eleven cases of 15 cases showed more than two adjacent spotty extravasations of contrast medium and that six cases demonstrated the simultaneous multiple leakages of contrast material from more than two lentriculostriate arteries. These angiographic findings has led us to the conclusion that there is intimate correlation between the large hematoma and multiple ruptures of the microaneurysms of lentriculostriate arteries.