Effects of the antiprogesterone steroid RU 486 during midluteal phase in normal women

The antiprogesterone steroid RU 486 (17 beta-hydroxy-11 beta-4-dimethyl-aminophenyl)17 alpha(1-propynyl)estra-4,9-dien-3-one) was given orally to 32 normally cycling women for 4 days, starting on the fourth day of the luteal phase. Uterine bleeding occurred on the third day of RU 486 administration in all 14 women treated with 100 mg/day, in 7 of the 8 women treated with 50 mg, and in 8 of 10 women receiving 25 mg/day. Premature luteal regression induced by RU 486 occurred in 8 women treated with 100 mg/day, in 3 treated with 50 mg, and in 2 receiving 25 mg/day. Plasma LH was measured every 15 min from 0800-1200 h for 5 days in 17 women. Mean LH levels decreased and pulsatile release disappeared in 7 of the 8 women treated with 100 mg, in 2 of 4 receiving 50 mg, and in 1 of 5 treated with 25 mg. RU 486 had no effect when given to 5 women with anovulatory cycles for 4 days starting on day 18 of the cycle.

IN CONCLUSION

1) RU 486, given to normally cycling women at midluteal phase, provokes uterine bleeding. 2) This effect occurs whether or not luteal regression is induced by the compound, indicating that RU 486 acts directly upon the endometrial tissue, very likely at the progesterone receptor level. 3) The drug may impair simultaneously or separately luteal function and gonadotropin secretion in a dose-dependent manner. 4) The lack of antiglucocorticosteroid activity, at the dosage of 100 mg/day, suggests that RU 486 may be useful for fertility control.

Phospholipase A activities in embryonic palate mesenchyme cells in vitro

Incubation of palate mesenchyme cells in vitro in the presence of [3H]arachidonate and [14C]palmitate resulted in incorporation of radiolabel into all major families of phospholipids. Almost all (more than 90%) of the 3H and about one-half of the 14C in the phospholipids were in the sn-2 position. The [14C] fatty acid in the sn-2 position was saturate. When [14C]stearate was added to the culture medium with [3H]arachidonate, 30-40% of the total 14C in phospholipids was in the sn-2 position. 80% of the 14C in the sn-2 position was found in unsaturated fatty acids. Hydrolysis of phospholipids could be demonstrated at acid, neutral and alkaline pH. Calcium stimulated phospholipase activity at neutral and alkaline pH, but inhibited hydrolytic activity at acid pH. Radiolabeled lysophospholipid indicative of phospholipase A2 activities accumulated at acid pH, whereas little, if any, radiolabeled lysophospholipids accumulated at neutral and alkaline pH. Quantitative analysis revealed the production of some lysophosphatidylethanolamine at alkaline pH.

Effects of dexamethasone on phospholipase activities in palate mesenchyme cells in vitro

Treatment of primary cultures of palate mesenchyme cells from AJAX strain embryos with dexamethasone inhibited only phospholipase activity expressed at pH 7.5. A similar treatment did not have such an effect on palate mesenchyme cells from C57BL/6J strain embryos. Since the AJAX strain embryo is sensitive to the induction of cleft palate by exogenous glucocorticoids and the C57BL/6J strain is less so, these data allow consideration of phospholipase activity as a site of regulation for development of the palate.

Phase II trial of bleomycin in patients with advanced ovarian cancer: an EORTC Gynecological Cancer Cooperative Group Study

Bleomycin was administered by continuous i.v. infusion at a dose of 20 mg/m2/day for 7 days to 18 evaluable patients with advanced ovarian epithelial cancer resistant to conventional chemotherapy. The toxicity pattern was no different from that known from earlier studies using continuous infusion of bleomycin with the exception of the occurrence of a life-threatening allergic reaction in one patient, which led to discontinuation of treatment after 3 days. Only one patient showed a partial response for 2 months (5.5%), indicating that the drug has no significant activity in this unfavorable group of patients.

Anaerobic flora in trophic ulcers in leprosy patients

Material from 108 trophic ulcers from leprosy cases were studied bacteriologically. 4 cases showed growth of pure anaerobes and 69 showed mixed growth of aerobic and anaerobic bacteria. The predominant anaerobes were Fusobacteria (41), anaerobic cocci (30) and Bacteroides (25). Clostridia were isolated only in 10 cases. Metronidazole, chloramphenicol, penicillin and ampicillin were found effective against anaerobes in in-vitro studies.

[Treatment of low cardiac output following extracorporeal circulation with captopril]

Seven patients in low-output cardiac failure, resistant to conventional vasodilators and inotropic agents, following surgery with extra-corporeal circulation were given oral captopril, an angiotensin converting enzyme inhibitor. The effects of captopril on haemodynamic and renal function were studied after 2, 6, 12 and 24 hours of treatment. After two hours, there was a mean reduction in systemic arterial resistance of 29%, in pulmonary arterial resistance of 18% and in pulmonary wedge pressure of 15%. The mean increase in the cardiac index was 28%. This marked initial haemodynamic improvement was either maintained or increased over the rest of the 24 hours. By 24 hours there had been a mean increase in urinary sodium excretion of 200%. The urinary sodium/potassium ratio increased from 0.62 to 1.45. Oral captopril thus seems suitable for treating low-output cardiac failure following surgery requiring extra-corporeal circulation.

Endometrial and pituitary responses to the steroidal antiprogestin RU 486 in postmenopausal women

The effects of the antiprogestin RU 486 on the human endometrium were investigated. Seventeen postmenopausal women were injected with estradiol (E2) benzoate (0.625 mg/day) for 15 days. Progesterone (P) (25 mg/day) and/or RU 486 (100 or 200 mg/day) were given to groups of 2-3 women during the last 6 days of E2 benzoate treatment. Serial blood samples were drawn for the measurement of plasma E2, P, and LH and FSH. An endometrial biopsy was performed on the last day of treatment, and processed for histology or for assays of DNA polymerase alpha, E2-dehydrogenase (E2DH), and P receptor (PR). Treatment with E2 benzoate alone resulted in a marked decrease of plasma gonadotropins; in those patients who received either P, RU 486, or both, in addition to E2 benzoate, the concentrations of plasma LH and FSH were further decreased to premenopausal levels. In absence of glycerol, the affinity of RU 486 for the endometrial PR (Kd = 0.8 nM) was higher than that of P (Kd = 1.2 nM). Glycerol decreased markedly the affinity of RU 486, whereas the affinity of P for the PR was unchanged. RU 486 had negligible affinity for plasma transcortin. Either P or RU 486, but not both together, induced secretory changes in the endometrium as determined from histologic sections of tissue biopsies. Either P or RU 486 decreased DNA polymerase alpha and increased E2-DH activities in the endometrium. Unexpectedly, when P and RU 486 were given together. E2-DH activity remained at the level found in E2-treated women. In vitro cultures of proliferative endometrium treated with the synthetic progestagen R 5020 or with RU 486 also had increased E2-DH activity; RU 486 counteracted R 5020 effects. We conclude that, contrary to previous results with experimental animals, the anti-P RU 486 has some progestomimetic activity in humans under specific conditions. Paradoxically, when given together with P, RU 486 lost most of its progestomimetic activity in the endometrium and behaved as a pure antagonist.

[Anesthesia with flunitrazepam/fentanyl in the severe coronary patient. Hemodynamic study]

Twenty three patients on class 3 or 4 NYHA were anesthetized with flunitrazepam 30 micrograms/kg. fentanyl 20 micrograms/kg, N2O for coronary bypass surgery. Hemodynamics data before and after induction reveal a 30% fall of cardiac index with stability of systolic vascular resistance. This higher value refer to literature on flunitrazepam. The clinical association with N2O and fentanyl can explain negatively inotropic effect. The bad ventricular function of this patients is probably the cause of a underestimate vascular filling.

[Anovulation of hypothalamic origin. Treatment by pulsatile injection of hypothalamic gonadotropin releasing hormone]

In two patients with severe hypogonadotrophic hypogonadism intermittent pulsatile delivery of gonadotrophin hormone (LHRH) 5 to 20 micrograms every 90 minutes by means of the Zyklomat pump promptly resulted in ovulation and pregnancy. The comparative effectiveness of the intravenous and subcutaneous routes was evaluated by radioimmuno assay of LHRH in plasma. The pulsatile patterns of LH was satisfactory with both routes, but plasma levels of LHRH were about 7 times lower with the subcutaneous route. The dosage range (5-20 micrograms) of LHRH must be adjusted to the severity of the hypothalamic deficiency and to the route of administration. The use of the pump, the monitoring of ovulation and the indications for this type of treatment are discussed.

[X-ray computed tomography of cancers of the uterine body (stages I and II). Anatomopathologic correlations. Apropos of 25 cases]

Twenty-five patients with endometrial cancer of body of uterus were examined by CT before and after intravenous administration of contrast medium. Hypodensity was noted before injection and was accentuated after injection in 4 cases, was observed after injection only in 9 and was totally absent in 12 cases. Comparison of findings with results of examination of frozen specimens indicated lack of correlation between size of tumor and depth to which myometrium was invaded, and results of CT imaging.

Immunochemical study of nutritionally variant streptococci

Nutritionally variant streptococci (NVS) have been characterized by their growth as satellite colonies around colonies of staphylococci or several other gram-positive or gram-negative bacterial strains. The majority of the NVS strains were isolated from patients with subacute bacterial endocarditis. Organisms identified as NVS were subdivided into three serotypes by rocket-line electrophoresis and hemagglutination inhibition assays. Ninety-nine of 103 strains expressed one or more of the three serotype antigens; however, a group antigen was not demonstrated in the various extracts of these streptococci. Surface protein studies confirmed the NVS differentiation into serotypes. Serotype I organisms expressed surface protein(s) specific for the serotype, whereas the serotype II and III NVS demonstrated common protein(s) on their surface. Furthermore, SDS extraction released a greater amount of radioiodinatable surface protein from serotypes I and III bacteria than serotype II. Finally, there was no correlation between the serotype or the disease of the patients from which the NVS strains were isolated.

Immunochemical study of nutritionally variant streptococci

Nutritionally variant streptococci (NVS) have been characterized by their growth as satellite colonies around colonies of staphylococci or several other gram-positive or gram-negative bacterial strains. The majority of the NVS strains were isolated from patients with subacute bacterial endocarditis. Organisms identified as NVS were subdivided into three serotypes by rocket-line electrophoresis and hemagglutination inhibition assays. Ninety-nine of 103 strains expressed one or more of the three serotype antigens; however, a group antigen was not demonstrated in the various extracts of these streptococci. Surface protein studies confirmed the NVS differentiation into serotypes. Serotype I organisms expressed surface protein(s) specific for the serotype, whereas the serotype II and III NVS demonstrated common protein(s) on their surface. Furthermore, SDS extraction released a greater amount of radioiodinatable surface protein from serotypes I and III bacteria than serotype II. Finally, there was no correlation between the serotype or the disease of the patients from which the NVS strains were isolated.

[Value of x-ray computed tomography in the diagnosis and surveillance of abdominopelvic recurrence of cancers of the uterine cervix. Apropos of 38 cases]

A retrospective study was conducted involving all case reports of patients treated for uterine cervix cancer, and investigated by a CT scan for suspected or follow up of a recurrence between Jan. 1981 and Nov. 1982. CT scan findings are described and the value of the method assessed; it appears to be very effective for diagnosis of recurrence in lumbar aortic lymph nodes, since it was the only examination enabling positive diagnosis in 13 out of 15 cases. Its diagnosis value is less in pelvic tumor recurrence, directly accessible to clinical examination (3 diagnoses only out of 9 cases). The CT scan is a reliable exploratory procedure since only 4 examinations were normal of the 38 completed. Possible therapeutic applications are discussed.

[Congenital esophagobronchial fistula in the adult]

The authors report the case of a 60-year-old man presenting with an esophagobronchial fistula. The congenital origin of the lesion was demonstrated by the history of the clinical symptomatology and by radiological, endoscopic and anatomical arguments. While it is a rare complaint in adults, it is worth considering in the diagnosis of a chronic cough, because it can be cured surgically without any problems.

Proliferation of cells undergoing chondrogenesis in vitro

Continuous exposure of chicken embryo limb bud mesenchyme cells undergoing chondrogenesis in vitro to [3H] thymidine thymidine [(3H]TdR) revealed that more than 90% of the cells synthesized DNA at least once during 120 h of culture. When cells were exposed to [3H]TdR for 24 h beginning at various times throughout the culture period, the percentage of cells which incorporated [3H]TdR during each period was approximately 92%. However, when the period for incorporation of radioisotope was limited to two hours, the number of cells which incorporated [3H]TdR was found to decline during chondrogenesis in vitro. This decline was coincident with the appearance of extracellular matrix material and occurred in those cells which had, and had not, expressed the cartilage phenotype. We conclude from these studies that (1) practically all of the cells continue to proliferate while chondrogenesis is occurring in vitro, (2) there is an increase in the length of the cell cycle during chondrogenesis in vitro, and (3) withdrawal from the cell cycle is not required for differentiation of mesenchyme into cartilage.

Ultracytochemical localization of guanylate cyclase in the oviduct of estrogen-stimulated rat

Many reports have indicated that estrogens increase uterine guanosine 3',5'-cyclic monophosphate (cGMP) levels via increasing the activity of guanylate cyclase. In the present study, guanylate cyclase activity was studied cytochemically in the oviduct of immature rats 24 hours after one or two doses (20 micrograms/kg, subcutaneously) of diethylstilbestrol (DES), one dose per day. The reaction product indicating guanylate cyclase was localized in the plasma membrane of epithelial cells, endothelial cells, and smooth muscle cells of all DES-treated animals, but was absent from those of the vehicle control immature rats. The Golgi saccules of secretory cells and the periciliary membrane of ciliated cells were stained for the enzyme 24 hours after the first and second dose of DES, but the activity seemed diminished 24 hours after the second dose. Likewise, reaction product indicating guanylate cyclase was more prominent in the plasma membrane of epithelial cells of animals treated with one dose of DES than those animals treated with two doses of DES. However, in the endothelial and smooth muscle cells, guanylate cyclase activity increased after two doses of the estrogen. Further, pinocytotic vesicles or caveolae in these cells were also strongly stained for the enzyme after one and two doses of DES. These findings confirm the suggestion that guanylate cyclase plays a significant role in the growth, differentiation, and function (secretion and transport) of the oviduct.

Genetic control of prophage induction in haemophilus influenzae after exposure to psoralen plus near-UV light

Prophage S2 could be induced by psoralen plus near-UV light (PNUV) from a wild-type strain of Haemophilus influenzae, from UV light-sensitive strains uvr-1 and uvr-2 and PNUV-sensitive strains PSO1 amd PSO7, but not from a recombination-deficient strain, rec-1. The levels of prophage induction were comparable in the wild type and an ATP-dependent DNase-deficient strain, KW31, even though the PNUV-induced degradation in the latter strain was considerably lower. Prophage induction could be observed even with chloramphenicol present before, during, and 30 min after PNUV treatment.

[The management of ovarian adenocarcinoma. "Second look" surgical operation after chemotherapy (author's transl)]

Forty patients with adenocarcinoma of the ovary (including 34 in stages III and IV) underwent a "second look" surgical operation after a first course of chemotherapy. The operation, which carried negligible morbidity, demonstrated complete remission in 27,5% of the cases; whenever necessary and possible achieved complete remission by surgical excision; and helped in establishing a second course of chemotherapy or chemo-immunotherapy. This therapeutic strategy seems to have had overall favourable repercussions on the patients' short- and mid-term survical. Long-term results cannot yet be assessed, but the knowledge of late failures suggests that applying intensive chemotherapy or, preferably, chemo-immunotherapy after the "second look", or even reserving potent cytostatic drugs for that period, could be beneficial. From the very favourable survival rate in patients found on second look to have complete remission, one may conclude that surgically confirmed remission should be considered as the primary target of the initial treatment.

Migration of binucleate cells in the sheep placenta during normal pregnancy

The maternofetal interface in the placentomes of the sheep placenta consists of a fetal cellular chorion layer whose apical microvilli interdigitate with those of a syncytial layer which borders the maternal connective tissue. Most of the granulated binucleate cells found in the chorion epithelium reach neither its basement membrane nor its microvillar junction apex. However, up to one fifth of the binucleate cells can be shown to be part of or push pseudopodia across the microvillar junction or are located within the syncytium. The syncytium and chorionic binucleate cells both have a nuclear chromatin structure and distinctive cytoplasmic granules which are not found in any other placental cells. This suggests that most, if not all, of the syncytium is derived by fusion of fetal binucleate cells which have migrated across the microvillar junction from the chorion, and that the immunological maternofetal junction does not lie between chorion and syncytial layers.

The treatment of hypertension with propranolol and bendrofluazide

In 101 hypertensive patients, the effects of a combination of propranolol and bendrofluazide were compared with those of each drug alone. After an introductory period with a placebo, the patients received, in a double-blind randomized trial, propranolol 80 mg twice a day, bendrofluazide 2.5 mg twice a day, or both drugs together twice daily. The combination produced significantly greater reductions in lying, standing, and post-exercise systolic and diastolic blood pressure than either drug separately. Side-effects were minimal and the combination was well accepted by patients.

Rapid evolution of animal mitochondrial DNA

Mitochondrial DNA was purified from four species of higher primates (Guinea baboon, rhesus macaque, guenon, and human) and digested with 11 restriction endonucleases. A cleavage map was constructed for the mitochondrial DNA of each species. Comparison of the maps, aligned with respect to the origin and direction of DNA replication, revealed that the species differ from one another at most of the cleavage sites. The degree of divergence in nucleotide sequence at these sites was calculated from the fraction of cleavage sites shared by each pair of species. By plotting the degree of divergence in mitochondrial DNA against time of divergence, the rate of base substitution could be calculated from the initial slope of the curve. The value obtained, 0.02 substitutions per base pair per million years, was compared with the value for single-copy nuclear DNA. The rate of evolution of the mitochondrial genome appears to exceed that of the single-copy fraction of the nuclear genome by a factor of about 10. This high rate may be due, in part, to an elevated rate of mutation in mitochondrial DNA. Because of the high rate of evolution, mitochondrial DNA is likely to be an extremely useful molecule to employ for high-resolution analysis of the evolutionary process.

Analysis of HeLa cell hypoxanthine phosphoribosyltransferase mutants and revertants by two-dimensional polyacrylamide gel electrophoresis: evidence for silent gene activation

The spot corresponding to hypoxanthine phosphoribosyltransferase (HPRT; IMP:pyrophosphate phosphoribosyltransferase, EC 2.4.2.8) has been identified in two-dimensional polyacrylamide gels of HeLa cell extracts. This spot is absent in gels of 24 HPRT dificient mutants. A missense mutant displays a new HPRT spot at the same molecular weight but different isoelectric focusing position. Five independently isolated revertants of the missense mutant display spots corresponding to both the wild-type and mutant proteins indicating that they synthesize HPRT from two separate genes. If the missense protein is synthesized from a mutated form of the initially active HPRT gene, then wild-type HPRT protein in the revertants must be snythesized from a newly activated but prevously silent wild-type gene. The newly activated gene in the revertants of the missense mutation appears unstable producing a high frequency of spontaneous HPRT mutants.

Letter: Glomerulonephritis Associated with Coxiella burnetii tendocarditis

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