The perurethral technique for ultrasound directed follicle aspiration in an in-vitro fertilization and embryo transfer programme: a report of 636 patient cycles

The data from 636 patient cycles from an outpatient-based in-vitro fertilization and embryo transfer programme are presented. Between 1984 and 1988, 545 women (86%) underwent ultrasound directed follicle aspiration (UDFA) exclusively by the perurethral route. The mean follicle aspiration rate was 93%, and the mean number of oocytes per procedure was 5.8. The complication rate was 6%, but none was major. From July 1985 the clinical pregnancy rate per UDFA was 17% and per embryo transfer 21%. The perurethral approach was used in combination with another UDFA route in 91 women (14%) but the need to change route decreased with increasing operator experience. Perurethral UDFA is an efficient and safe method for harvesting oocytes.

Ultrasound directed follicle aspiration for oocyte collection using the perurethral technique

Our experience in 242 consecutive ultrasound directed follicle aspirations using the perurethral technique is reported. The mean number of follicles punctured per patient was 9.6 (range 20 to 35), resulting in a mean oocyte yield of 6.1 (range 0 to 31) per patient. It was necessary to change to another ultrasound directed route in 20 patients, and we failed to retrieve oocytes in a further 6 patients. There were no serious complications. The fertilization and cleavage rates were 68% and 91%, respectively. Embryo transfer was performed in 178 cases, resulting in 39 clinical pregnancies (21.9%). Ultrasound directed follicle aspiration by the perurethral route is an efficient way of collecting oocytes and is acceptable to patients. There is no need for general anaesthesia, so this technique is well suited to in vitro fertilization programs based on outpatient procedures.

Transabdominal versus transvaginal ultrasound scanning of ovarian follicles: are they comparable?

The results of this study show that ultrasound measurements by the transabdominal and transvaginal routes are statistically comparable and reproducible between observers. The somewhat larger standard deviations found with transabdominal scanning suggest that the transvaginal route may be more accurate in the daily monitoring of follicular development.

Voices in unison: stressful events in the lives of children in six countries

A 20-event, 7-point scale on the stressfulness of selected unpleasant experiences was administered to 1814 children in Australia, Canada, Egypt, Japan, the Philippines, and the U.S.A. (two groups). Responses indicated that, among these 3rd through 9th graders, there is a remarkable degree of agreement not only in the stress ratings but also in the reported incidences of life events. Granted certain cultural contrasts, the overall findings gave credence to the presence of widespread, common perceptions and attitudes among children. The worlds of the young and of the grown-ups may overlap with each other much less than usually believed.

Two years' experience of ultrasound-directed oocyte retrieval

The first 2 years' data of an outpatient-based in vitro fertilization program relying on transabdominal transvesical ultrasound-directed oocyte retrieval (TUDOR) is presented. A total of 935 patients were treated. Ovarian stimulation was performed in 1538 cycles, oocyte retrieval in 1226, and embryo transfer in 960. All ovaries were accessible for oocyte retrieval, even in those patients in whom laparoscopic retrieval had failed previously or was deemed impossible. No major complications due to TUDOR occurred and the incidence of all complications was 1.5%. The clinical pregnancy rate was 19.0% per embryo transfer, but increased throughout the 2 years to 30.0% per embryo transfer. The technique is easy to learn, effective, and appears to be superior to laparoscopy in terms of ovarian accessibility and safety.

Recombinant type I regulatory subunit of the cAMP-dependent protein kinase is biologically active

The cDNA for the porcine type I regulatory subunit (RI) of the cAMP-dependent protein kinase (cAMP-PK) was cloned into two different bacterial expression vectors: pKK223 and pUC18. Recombinant RI was produced by bacteria transformed with either construct, and purified by affinity chromatography. Both the native RI from the pKK223 construct and the RI with an amino terminal extension of eight amino acids from the pUC18 construct were found to be completely native with regard to inhibition of the catalytic subunit activity and cAMP binding.

Variation in Phospholipid Ester-Linked Fatty Acids and Carotenoids of Desiccated Nostoc commune (Cyanobacteria) from Different Geographic Locations

Profiles of phospholipid fatty acids and carotenoids in desiccated Nostoc commune (cyanobacteria) collected from China, Federal Republic of Germany, and Antarctica and in axenic cultures of the desiccation-tolerant strains N. commune UTEX 584 and Hydrocoleum strain GOEI were analyzed. The phospholipid fatty acid contents of the three samples of desiccated Nostoc species were all similar, and the dominant compounds were 16:1ω7c, 16:0, 18:2ω6, 18:3ω3, and 18:1ω7c. In comparison with the field materials, N. commune UTEX 584 had a much higher ratio of 18:2ω6 to 18:3ω3 (5.36) and a significantly lower ratio of 18:1ω7c to 18:1ω9c (1.86). Compound 18:3 was present in large amounts in the samples of desiccated Nostoc species which had been subject, in situ, to repeated cycles of drying and rewetting, but represented only a small fraction of the total fatty acids of the strains grown in liquid culture. This finding is in contrast to the data obtained from studies on the effects of drought and water stress on higher plants. Field materials of Nostoc species contained, in contrast to the axenic strains, significant amounts of apocarotenoids and a P384 pigment which, upon reduction with NaBH 4 , yielded a mixture of a chlorophyll derivative and a compound with an absorption maximum of 451 nm. A clear distinction can be made between the carotenoid contents of the axenic cultures and the desiccated field materials. In the former, β-carotene and echinenone predominate; in the latter, canthaxanthin and the β-γ series of carotenoids are found.

Differential localization of mRNAs of collagen types I and II in chick fibroblasts, chondrocytes, and corneal cells by in situ hybridization using cDNA probes

We have employed a highly specific in situ hybridization protocol that allows differential detection of mRNAs of collagen types I and II in paraffin sections from chick embryo tissues. All probes were cDNA restriction fragments encoding portions of the C-propeptide region of the pro alpha-chain, and some of the fragments also encoded the 3'-untranslated region of mRNAs of either type I or type II collagen. Smears of tendon fibroblasts and those of sternal chondrocytes from 17-d-old chick embryos as well as paraffin sections of 10-d-old whole embryos and of the cornea of 6.5-d-old embryos were hybridized with 3H-labeled probes for either type I or type II collagen mRNA. Autoradiographs revealed that the labeling was prominent in tendon fibroblasts with the type I collagen probe and in sternal chondrocytes with the type II collagen probe; that in the cartilage of sclera and limbs from 10-d-old embryos, the type I probe showed strong labeling of fibroblast sheets surrounding the cartilage and of a few chondrocytes in the cartilage, whereas the type II probe labeled chondrocytes intensely and only a few fibroblasts; and that in the cornea of 6.5-d-old embryos, the type I probe labeled the epithelial cells and fibroblasts in the stroma heavily, and the endothelial cells slightly, whereas the type II probe labeled almost exclusively the epithelial cells except for a slight labeling in the endothelial cells. These data indicate that embryonic tissues express these two collagen genes separately and/or simultaneously and offer new approaches to the study of the cellular regulation of extracellular matrix components.

What is the relationship between postpartum withdrawal from school and repeat pregnancy among adolescent mothers?

An association between the failure of teenage mothers to return to school postpartum and rapid repeat pregnancy (recidivism) has been described. We report the postpartum education pursuits and contraceptive practices of 29 teenage mothers. Our data, together with the literature, suggest that with close postpartum follow-up, young mothers who are not motivated to return to school following delivery can effectively postpone pregnancy.

Respiratory and cardiac effects of metoprolol and bevantolol in patients with asthma

The effects on standing heart rate and respiratory function of two relatively selective beta 1-adrenoceptor antagonists, metoprolol and bevantolol, were compared in a double-blind, randomized, crossover study of 16 patients with asthma. After control observations on 2 separate days, the patients received approximately equivalent cardiac beta-adrenoceptor antagonist doses of metoprolol, 12.5, 25, 50, and 100 mg, and bevantolol, 18.75, 37.5, 75 and 150 mg, at intervals of 2 hours. Dosing was stopped if symptoms warranted or if there was a fall of greater than or equal to 20% in the forced expiratory volume in 1 second. In general, the cumulative dosing regimen proved a safe and effective means of assessing bronchial responsiveness to these beta-blockers in asthma, but one patient had to be dropped from the study because of severe bronchoconstriction after the first dose. Of the 15 patients studied who were taking both drugs, seven patients were withdrawn prematurely. In these seven patients, the average maximum tolerated cumulative doses were 45.5 mg bevantolol and 26.8 mg metoprolol, doses that are much lower than those usually required for therapeutic activity. The respiratory response to either drug could not be predicted.

Transbronchial radioactive implantation using a Flexible Injector System. An improved technique for endobronchial brachytherapy

A new implantation device for endobronchial brachytherapy is described. This implantation system is flexible and can be easily passed through the suction channel of a flexible bronchofiberscope (FBF) for radionuclide implantation of the tumor. All four patients implanted using this system, experienced excellent palliation of their symptoms. We think that the flexible system described is an improvement over the rigid system for endobronchial implantation in most patients.