Pregnancy following oocyte donation and tubal embryo transfer in patients with premature ovarian failure: report of two cases

Two pregnancies in patients with premature ovarian failure utilizing donated oocytes, in-vitro fertilization (IVF) and tubal embryo transfer (TET), are reported. The recipients received cyclic hormone replacement therapy for six months to prepare the endometrium for implantation. An evaluation cycle was tested to document that the hormone milieu established by the hormone replacement protocol was similar to that of a natural ovulatory cycle. During the oocyte donation cycle, the recipient received incremental estrogen replacement treatment of flexible length during the follicular phase of the donor's stimulated cycle to synchronize the recipient's endometrium to the donor's embryo. Concurrently, the donor underwent controlled ovarian hyperstimulation and transvaginal ultrasound-guided oocyte retrieval. After fertilization of the donated oocytes with sperm from the recipient's husband and cleavage of the fertilized oocytes into the 2- to 4-cell stage, laparoscopic embryo transfer into the recipient's fallopian tube was performed. Case 1 received 4 embryos by the TET procedure. Pregnancy was confirmed by visualization of a gestational sac in the uterine cavity 3 weeks after TET, but miscarriage occurred at the tenth gestational week. In Case 2, the pregnancy was established after TET of 2 embryos. Estrogen and progesterone supplements were maintained until day 100 after TET. The patient delivered a healthy male baby, weighing 2,520 g at 38 weeks of gestation.

Treatment of patients with unexplained infertility: gamete intrafallopian transfer (GIFT) versus tubal embryo transfer (TET)

This study compares the results of 65 cycles of gamete intrafallopian transfer (GIFT), and 19 cycles of tubal embryo transfer (TET) in couples with unexplained infertility (UI). Oocyte retrievals were carried out by laparoscopy in GIFT and transvaginally in TET, in which the embryos were transferred by laparoscopy into the fallopian tubes 48 hours later. The mean age, duration of infertility, serum estradiol levels on the day of human chorionic gonadotropin administration, number of large follicles (mean diameter greater than 10 mm) and the number of oocytes recovered were similar between these two groups. From the 65 GIFT cycles, 20 clinical pregnancies resulted (30.8%). From the 19 cycles of TET, 10 conceptions occurred (52.6%). The implantation and pregnancy rates after TET were higher than that after GIFT, but the differences were not statistically significant. The data suggest that GIFT has a similar success rate to TET in couples with UI.

Selective reduction of multiple pregnancies in the first trimester or early second trimester

Nine cases of multiple pregnancies, including 7 sets of triplets and 2 sets of quadruplets, were enrolled for selective fetal reduction between March 1989 and July 1990 at the National Taiwan University Hospital. Under transabdominal or transvaginal ultrasound guidance, potassium chloride was injected into the fetal cardiac chamber to kill the selected fetus during the 10-14th gestational week. The number of fetuses was reduced to two in all cases. No maternal complications occurred during the procedure. Six gravidas have given birth to 6 sets of healthy twins; two pregnancies are progressing smoothly at 26 and 23 weeks of gestation, respectively, and one case underwent spontaneous abortion 4 weeks after the procedure. Selective fetal reduction under ultrasound guidance is an acceptable method of preventing high perinatal mortality and morbidity of immature fetuses in grand multiple pregnancies.

Correlation between sperm penetration assay and acrosome reaction in sperm treated with human follicular fluid

In this study, we determined whether there was a correlation between sperm penetration assay (SPA) and acrosome reaction (AR) in sperm after being treated with human follicular fluid (hFF). Sperm specimens were obtained from 13 men participating in our in vitro fertilization program. After washing and preincubation, aliquots of sperm samples were treated with either hFF or Ham's F-10 medium (control). Approximately 1.0 x 10(6) motile sperm from the control and hFF-treated samples were coincubated individually with zona-free hamster eggs for SPA. Sperm remaining in the suspension after coincubation with eggs were taken to determine the incidence of AR by a triple-stain technique. The data revealed that an increased SPA score in hFF-treated samples was related to a higher incidence of acrosome-reacted sperm.

Nonserine esterases from rat liver cytosol

An effort to identify the major general esterases of rat liver cytosol that are insensitive to the serine esterase inhibitor paraoxon (diethyl 4-nitrophenyl phosphate) has led to the isolation of a dozen enzymes. Four of these are electrophoretically homogeneous. Although purified on the basis of their hydrolytic activity toward 4-nitrophenyl acetate, each of the enzymes has a very broad and overlapping substrate specificity for aromatic esters. Thiol esters serve as substrates but, within the limits of the methods used, amides are not hydrolyzed.

Aspirin hydrolyzing esterases from rat liver cytosol

Unlike most esterases, which are predominantly bound to the microsomal fraction, the enzymes hydrolyzing acetylsalicylic acid are present in an equal amount in the cytosol. Two soluble isozymes were purified to homogeneity from rat liver and characterized as serine esterases with a Mr of 35,000. Both had the wide substrate spectrum characteristic of enzymes active in detoxication. Both had a very low Km for acetylsalicylate. Three other cytoplasmic enzymes active with aspirin were observed but these differed in their high Mr (about 220,000) and their lack of reactivity with antibody to one of the homogeneous isozymes.

A survey of 790 cases of astrocytoma

790 cases of cerebral astrocytoma, which consisted of 181 cases of astrocytoma grade I, 282 cases of grade II, and 327 cases of grade III-IV, histopathologically verified, are presented. The sex and age distribution, topographical distribution of the tumours, and clinical manifestations are analyzed. A total of 862 operations were performed, and 69 cases (8.6%) were operated on more than twice for recurrence. The operative mortality was 7.7%. 179 of the survivors following operation received a combined treatment with radiotherapy and/or chemotherapy. Based on the follow-up study of 170 cases, the factors which may correlate with the length of survival, are discussed.

Hypertensive disorders in pregnancy: analysis of 110 cases

One hundred and ten cases of hypertensive disorders in pregnancy were analyzed retrospectively. There were 16 cases of gestational hypertension, 36 cases of mild preeclampsia, 43 cases of severe preeclampsia, 6 cases of eclampsia, and 9 cases of chronic hypertension with superimposed severe preeclampsia. The principle of management was conservative in order to prolong pregnancy for patients remote from term. Corticosteroids were used to accelerate fetal lung maturity for patients with gestations of less than 36 weeks and magnesium sulfate was administered to prevent seizures. Fetal heart rate monitoring was done routinely and doppler blood flow velocity time wave form study of uterine and umbilical arteries was also performed in the latter part of the study. The cesarean section rate in gestational hypertension and mild preeclampsia was comparable to the general obstetric population in our institute (26.9% vs. 21.2%), but the rate of severe forms of the disease including severe preeclampsia, eclampsia, and chronic hypertension with superimposed severe preeclampsia was as high as 77.6%. Fetal distress was the main indication of section. There were 2 cases (6.9%) of mild respiratory distress syndrome, and all recovered uneventfully. The patients with severe forms of the disease had a higher incidence of small infants for gestational age (72%) and delivery at less than 36 weeks' gestation (48.2%). The corrected perinatal mortality rate was 5.4%. No maternal death was encountered. It was concluded that pregnancy could be prolonged in the interest of fetal lung maturity under meticulous maternal-fetal monitoring without endangering the mother.

Human sperm chromosome analysis in primary infertility: a preliminary report

Human sperm chromosomes can be analyzed using the zona-free hamster egg system. In order to familiarize ourselves with this new technique and to investigate the chromosome aberration frequency in fertile and possibly infertile men, we performed sperm chromosome analysis in 39 successful experiments. The subjects were divided into two groups. Group 1 was healthy men with proven fertility. Group 2 was husbands of couples with unexplained infertility. Semen samples were prepared freshly or preserved in TEST-yolk buffer for 12 to 72 hours. In group 1 using fresh samples, the mean penetration rate was 67.40 +/- 14.08% (mean +/- 2SD), the maturation index was 1.33 +/- 0.31. For samples treated with yolk buffer, the mean penetration rate was 91.34 +/- 7.42%, and the maturation index was 1.58 +/- 0.42. There was a statistically significant increase in penetration after yolk buffer treatment (p less than 0.001). In group 1 there were 89 haploid chromosomes, four were aneuploidy (4.5%), and three with structural aberrations (3.4%). In group 2, for fresh samples, the mean penetration rate was 71.34 +/- 27.96%, and the maturation index was 1.37 +/- 0.25. For samples treated with yolk buffer, the penetration rate was 86.33 +/- 25.18%, and maturation index 1.40 +/- 0.23. In group 2, there were 135 haploid chromosomes, 6 were aneuploidy (4.4%), and 4 with structural aberrations (3.0%). There was no statistically significant difference between group 1 and group 2 in the penetration rate, maturation index and frequency of chromosome abnormalities.

Overproduction of thermostable leucine dehydrogenase of Bacillus stearothermophilus and its one-step purification from recombinant cells of Escherichia coli

We have cloned the leucine dehydrogenase (EC 1.4.1.9) gene from a thermophile, Bacillus stearothermophilus, into Escherichia coli MV1184 with a vector plasmid, pUC119. The cloned cells produced a large amount of the thermostable enzyme, which corresponds to about 60% of the total soluble protein. The enzyme was purified to more than 95% homogeneity by only one step, heat treatment of the cell-extracts, with an average yield of 75 mg/g of wet cells (obtained from 100 ml of the culture).

2-ketoacid dehydrogenase complexes of Escherichia coli: stereospecificities of the three components for (R)-lipoate

Stereospecificities of component enzymes in the pyruvate dehydrogenase complex and 2-ketoglutarate dehydrogenase complex from Escherichia coli for lipoate and dihydrolipoate are determined. Assays of the component enzymes using R,S-, R-, or S-lipoate or the enantiomers of dihydrolipoate show that only the R-enantiomers are substrates for these enzymes. Nonenzymatic reactions involving acetyl group transfer and coupled electron and acetyl group transfer between enantiomeric molecules of lipoate or/and dihydrolipoate proceed at significant rates. Coupled acetyl group and electron transfer from enzyme-bound acetyldihydrolipoyl moieties to free lipoate is also observed. The S-enantiomers are neither substrates nor inhibitors; however, products of S-enantiomers are slowly generated in enzymatic reactions owing to nonenzymatic reactions between enzyme-bound acetyldihydrolipoyl-groups and free S-lipoate or S-dihydrolipoate.

Acrosome reaction of human spermatozoa in zona-free hamster egg penetration test

The acrosomal status of human sperm during preparation for the process of zona-free hamster egg penetration test (ZFHEPT) was determined. The incidence of acrosome reaction (AR), as assessed by triple-stain technique, was significantly increased after 24 hours of incubation at 4 degrees C in TES-Tris (TEST)-yolk buffer, but the absolute values were relatively low (20% or less). Sperm from fertile donors and infertile patients with normal or abnormal semen analysis displayed similar capacity to undergo the AR in vitro. Although a positive correlation was found between the incidence of AR and the score of ZFHEPT, a remarkable individual variation was noted. The incidence of AR in freely swimming human sperm does not accurately reflect the fertilizing ability of the sperm.

Histone gene switching in murine erythroleukemia cells is differentiation specific and occurs without loss of cell cycle regulation

We investigated the expression characteristics of the fully replication-dependent (FRD) and the partially replication-dependent (PRD) histone gene variants by measuring changes in steady-state mRNA levels during hexamethylene bisacetamide (HMBA)-induced differentiation of murine erythroleukemia (MEL) cells. Between 24 and 60 h after induction, there was a dramatic switch in histone gene expression, such that the ratio of PRD to FRD transcripts increased severalfold over that found in uninduced MEL cells. We demonstrated that this gene switching was not simply a partial or complete uncoupling of PRD gene expression from DNA synthesis. PRD and FRD transcript levels were regulated coordinately upon treatment of uninduced or induced MEL cells with inhibitors of DNA synthesis, protein synthesis, or both. Using several criteria, we were unable to detect any difference in PRD and FRD gene expression under any conditions except in cells undergoing differentiation. MEL cells were arrested at a precommitment stage of differentiation by induction with HMBA in the presence of dexamethasone (DEX). If DEX was subsequently removed, DNA synthesis resumed, the cells underwent commitment, and histone gene switching was observed. In contrast, if both DEX and HMBA were removed, DNA synthesis still resumed, but commitment did not occur and no gene switching was observed. These results imply that histone gene switching is intimately related to the differentiation process.

Isolation and characterization of a mouse fully replication-dependent H1 gene within a genomic cluster of core histone genes

We have used an oligonucleotide complementary to a sequence coding for the conserved central globular domain of H1s to screen a mouse genomic library for H1 genes. We then used a series of universal histone oligonucleotides to identify five different H1 genes which were linked to core histone genes. We characterized one of the H1 genes which was linked to an H2a, an H2b, an H3, and an H4 histone gene. This characterization involved: 1) sequencing of the coding region of the gene and several hundred base pairs of flanking region. 2) Comparison of this sequence to other H1 sequences from other organisms. This sequence analysis clearly showed that the gene coded for an H1 and identified H1 consensus sequences in the 5'- and 3'-flanking region. 3) Mapping of the 5'- and 3'-ends of the mRNA complementary to this gene by S1 nuclease analysis. 4) Identifying this gene and an adjacent H3 gene as being of the fully replication-dependent expression class, by measuring changes in the steady state levels of their mRNAs in the presence of hydroxyurea and during differentiation of murine erythroleukemia cells.