Biodegradable microparticles of influenza viral vaccine: comparison of the effects of routes of administration on the in vivo immune response in mice

The objective of this study was to investigate the comparative immune response following administration of biodegradable microparticles loaded with influenza viral vaccine using subcutaneous and oral routes. Influenza viral vaccine was entrapped in poly(d,l-lactide-co-glycolide) (PLG) and poly(isobutylcyanoacrylate) (PIBCA) microparticles. Stability and immunogenicity of entrapped antigen were retained, as evaluated by SDS-PAGE and immunoblot. Microparticles in the size range of <11 microm were evaluated for protein loading and in vitro antigen release. The mice were immunized with microparticle loaded antigen and IgG levels in blood and IgA levels in saliva and gastric secretions were monitored by ELISA method. When the mice were immunized with microparticle suspensions, IgG levels were higher if administered by subcutaneous primed by oral route compared to oral primed by subcutaneous route or subcutaneous or oral route. The IgA level in saliva and gastric secretions were also found to be higher when subcutaneous immunization was given followed by oral booster than oral priming followed by subcutaneous booster. The polymer types of the microparticles had effects on both IgG and IgA levels. This study provided insights into the design of microparticles of influenza vaccine for subcutaneous administration followed by an unlimited oral boosting, which will have high cost-effectiveness and patient compliance.

Clinical profile of multiple sclerosis in Bengal

Forty five patients of multiple sclerosis diagnosed on the basis of Poser's criteria from West Bengal were studied. The male-female ratio was 1:1.5, mean age of onset 31.83 years in male and 29.11 years in females. The maximum cases were between the 3rd and 4th decade. Definite MS comprised of 60%, while remaining 40% were probable. Visual impairment (53.33%), weakness of limbs (31.11%) and sensory paraesthesia (20%) were the common presenting symptoms whereas pyramidal tract involvement (93.33%) with absent abdominal reflexes (90%) and optic pallor (64.44%) were common signs. Posterior column and spinothalamic sensations were involved in 55% and 51% of cases respectively. Inter-nuclear ophthalmoplegia was present in 6.66% of cases. Pattern of involvement commonly showed three or more sites of lesion. Optico-spinal affection was present in 22.2% of cases. Relapsing and remitting course was found in 48. 91%, relapsing and progressive course in 33.33% and chronic progressive in 17.8%. MRI of brain showed positive results in 16 out of 23 cases. CSF study showed increased positivity in estimation of immunoglobulin level than oligoclonal band. Findings revalidate the disease pattern as being similar to that in other parts of India as well as Asia.

Computational techniques for fast hyperthermia temperature optimization

Hyperthermia temperature optimization involves arriving at a temperature distribution which minimizes a stated goal function, the goal function having a biological basis in maximizing tumor cell kill while not exceeding normal tissue toxicity. This involves the computationally intensive process of multiple evaluations of the temperature goal function, requiring repeated evaluations of the power deposition and its corresponding temperature distribution. Two computational schemes are proposed to expedite the temperature optimization process: (1) temperature distribution evaluation by superpositioning precomputed distributions, and (2) using representative tissue groups (rather than every point in the domain) to evaluate the goal function. The application of these schemes is illustrated with a typical optimization problem, as applied to symmetric and asymmetric, heterogeneous models. Application of these schemes reduced the optimization time on a DEC Alpha 1000 4/266 (Alpha is a registered trademark of Digital Equipment Corporation.) from several h to min, with little difference in results. The computational schemes, though demonstrated in the context of electromagnetic hyperthermia, are generally applicable to other forms of nonionizing radiation employed in hyperthermia therapy.

Changes in uterine expression of leukemia inhibitory factor during pregnancy in the Western spotted skunk

Mutation of the leukemia inhibitory factor (LIF) gene results in reproductive failure in LIF -/- mice due to an inability to implant their blastocysts. This condition is reversed by infusion of LIF or by transferral of embryos to pseudopregnant, wild-type mice. This led us to hypothesize that embryonic diapause in the spotted skunk is due to insufficient uterine expression of LIF whereas resumption of development and implantation are associated with increased LIF expression. We also investigated the hormonal control of LIF expression. Uterine concentrations of LIF mRNA were determined by quantitative reverse transcription-polymerase chain reaction. Changes in cell-specific localization of LIF mRNA and protein were determined by in situ hybridization and immunocytochemistry. LIF mRNA was detected but was not abundant during embryonic diapause; it then increased when blastocysts resumed development and remained elevated prior to implantation. LIF mRNA and protein could not be localized in the uterus during embryonic diapause but were quite apparent in luminal and glandular epithelium during blastocyst activation. Prolactin, progesterone, and estradiol failed to increase uterine concentrations of LIF mRNA above those in ovariectomized controls. These data are consistent with the initial hypothesis and suggest that LIF may somehow be involved in preparing the uterus for implantation in the spotted skunk.

Profile of non-compressive myelopathy in eastern India: a 2-year study

Eighty-two patients with non-compressive myelopathy have been studied from July 1994 to June 1996 in Bangur Institute of Neurology and S.S.K.M. Hospital, Calcutta, of which 48 patients were men and 34 patients were women. Presentation was acute in 40 patients (48.78%), subacute in 7 (8.53%), chronic in 27 (32.92%) and history of relapse and remission in 8 (9.75%) patients. Preceding as well as simultaneous fever was observed in 16 cases (19.5%); vaccination (anti-rabies) in 1 case (1.21%); drug abuse in 1 case (1.21%); arthralgia-myalgia and rash in 2 cases (2.42%) and history of electrocution in 2 cases (2.42%). Only pyramidal tract involvement was present in 24 cases (29.26%) and remaining 58 cases (70.73%) had pyramidal tract affection with other sites of involvement. CSF study carried out in 60 cases, revealed rise of protein in 31 (37.8%); oligoclonal band had been detected in 6 (7.31%), pleocytosis in 18 cases (21.95%) and increased IgG index greater than 6.66 in 2 cases (2.42%). CT myelogram done in 23 cases revealed no abnormality. MRI study carried out in 59 cases showed myelomalacia in 1 (1.21%); demyelination plaque in 14 cases (17.07%); atrophy of cord in 3 (3.65%); infarction of cord in 1 (1.21%) and in 40 cases (48.78%) no abnormality could be detected. Etiological diagnosis could be established in 59 (71.95%) cases such as transverse myelitis or myelopathy (post infectious) in 24 (29.26%); demyelination in 16 (19.51%); vascular and vasculitis in 3 (3.65%); toxic in 1 (1.21%); physical (electrocution) in 2 cases (2.42%). In the remaining 23 cases (28.04%) no aetiological factors could be found.

Cyclin D3 in the mouse uterus is associated with the decidualization process during early pregnancy

In the mouse, the attachment reaction between the blastocyst trophectoderm and the receptive uterine luminal epithelium occurs at 2200-2300 h on day 4 of pregnancy and is rapidly followed by transformation of stromal cells into decidual cells (decidual cell reaction). This process can also be induced experimentally (deciduoma) by intraluminal oil infusion in the uterus on day 4 of pseudopregnancy. The decidual cell reaction is associated with up- and down-regulation of many genes in a cell-specific manner. Using mRNA differential display, we identified cyclin D3 as one of the genes that is upregulated in the uterus at the sites of blastocyst apposition during the attachment reaction. The levels of expression were low in the morning of days 1-4 as determined by Northern hybridization. In situ hybridization analysis showed that on days 1 and 2, signals were primarily localized in uterine epithelial cells, while signals were detected in both the stromal and epithelial cells on days 3 and 4. In contrast, with the initiation and progression of decidualization on days 5, 6 and 7, the levels of cyclin D3 mRNA were remarkably upregulated in stromal cells both at the mesometrial and the antimesometrial poles. However, on day 8, signals were primarily localized in stromal cells at the mesometrial decidual bed. Implanting blastocysts on these days also expressed cyclin D3 mRNA. In the progesterone-treated delayed implanting mice, the uterine levels of cyclin D3 mRNA were modest at the sites of blastocyst apposition, but were upregulated with the onset of implantation by estradiol-17beta. However, the decidual expression of cyclin D3 mRNA was not dependent on the presence of blastocysts, since increased expression also occurred in experimentally induced deciduoma in the absence of blastocysts. The importance of cyclin D3 in decidualization was further examined in Hoxa-10-deficient mice which show defective decidualization. The expression of cyclin D3 mRNA in Hoxa-10(-/-) uteri on day 5 was severely compromised after application of a deciduogenic stimulus on day 4 of pseudopregnancy. Collectively, the results suggest that cyclin D3 could be important for the process of decidualization.

erbB genes in the mouse uterus: cell-specific signaling by epidermal growth factor (EGF) family of growth factors during implantation

We previously described spatiotemporal expression of various epidermal growth factor (EGF)-like ligands and receptor subtypes, ErbB1 and ErbB2, during the peri-implantation period. To better understand the roles of these ligands and their possible signaling schemes in implantation, it is important to define the status of all the ligands and receptor subtypes in the uterus/embryo. No information is available about uterine and embryonic status of ErbB3 or ErbB4 during implantation. We cloned mouse erbB3 and erbB4 cDNAs and examined their expression and bioactivity in the peri-implantation uterus (days 1-8). Two erbB3 (cytoplasmic and extracellular) and three erbB4 (two cytoplasmic and one extracellular) clones were generated. Both forms of the erbB3 clone showed similar transcript profiles, while different transcript profiles were obtained with erbB4 clones. The steady-state levels of erbB3 and erbB4 mRNAs in whole uterine poly(A)+ RNA samples showed little changes during the peri-implantation period, while their unique cell-specific accumulation was noted. erbB3 is predominantly expressed in the epithelial cells, although decidual and embryonic cells also accumulate this mRNA. In contrast, the erbB4 mRNA is primarily expressed in the submyometrial stroma and myometrial connective tissues during this period. Additionally, the extracellular form of the erbB4 clone detected signals in a subpopulation of stromal cells. Autophosphorylation and immunoprecipitation studies provided evidence that uterine ErbB3 and ErbB4 are biologically active. This study provides a comprehensive analysis of possible ligand-receptor signaling schemes for EGF-like ligands in implantation.

Coordination of differential effects of primary estrogen and catecholestrogen on two distinct targets mediates embryo implantation in the mouse

In the mouse, estrogen is essential for blastocyst implantation in the progesterone (P4)-primed uterus. The mechanism(s) by which estrogen initiates this response still remains elusive. The present investigation, using delayed implantation in the mouse, examined the differential role of estradiol-17beta (E2) and its catechol metabolite 4-hydroxy-E2 (4-OH-E2) in uterine and blastocyst activation for implantation. The conditions of delayed implantation were induced by ovariectomizing mice on day 4 (day 1 = vaginal plug) of pregnancy or pseudopregnancy and maintaining them with P4 from days 5-7. The binding of EGF to blastocysts was used as a marker for blastocyst activation. Our results show that whereas E2 fails to activate dormant blastocysts (with respect to EGF binding in vitro), 4-OH-E2, cAMP, or prostaglandin E2, is effective in this response. Further, whereas 4-OH-E2 induced-activation is not blocked by an antiestrogen, an inhibitor of PG synthesis, adenylyl cyclase or protein kinase A effectively blocks this activation. These results suggest that 4-OH-E2 effects on blastocysts are mediated by PGs, which, in turn, stimulate cAMP production and thus activation of protein kinase A. Two-fluoro-E2 is a poor substrate and an inhibitor of catecholestrogen synthesis, but it is estrogenic, with respect to uterine growth and gene expression. Using blastocyst transfer experiments, we observed that dormant blastocysts incubated with 4-OH-E2 in vitro, but not with E2, are capable of implanting in P4-treated delayed implanting mice receiving two-fluoro-E2. The results suggest that whereas E2 is necessary for preparation of the uterus, uterine-derived catecholestrogen is important for blastocyst activation for implantation. Indeed, the receptive uterus has the capacity to synthesize 4-OH-E2. Collectively, we demonstrate that the primary ovarian estrogen E2, via its interaction with nuclear estrogen receptors, participates in the preparation of the P4-primed uterus to the receptive state in an endocrine manner, whereas its metabolite 4-OH-E2, produced from E2 in the uterus, mediates blastocyst activation for implantation in a paracrine manner. Our results also establish that these target-specific effects of primary estrogen and catecholestrogen are both essential for implantation and that successful implantation occurs only when the activated stage of the blastocyst coincides with the receptive state of the uterus.

Clinical profile of myasthenia gravis

Seventy three patients with myasthenia gravis were studied over 9 years period (1987-1995) in departments of neuromedicine, respiratory care unit, cardiothoracic unit of Institute of Postgraduate Medical Education and Research and Bangur Institute of Neurology, Calcutta, with reference to their clinical presentations, laboratory findings and various modes of treatment. Commonest age of presentation was 5th decade in men and 3rd decade in women. Fifty five percent of patients belong to type 2A myasthenia gravis (Osserman classification). Presentation was insidious (67.2%) and course was slowly progressive (65.7%) in majority of cases. Fatigability and ptosis were commonest clinical presentation and diurnal variation was noticed in 60% of cases. Edrophonium test was positive in 90.4% of cases and repetitive nerve stimulation showed 93.5% positivity in 30 cases. 27 patients (36.9%) underwent thymectomy and out of these, 89% of patients showed hyperplastic change and thymoma in 11% of cases. Mortality rate including both operated and nonoperated patients was recorded to be 9.6%. We observed earlier onset of myasthenia in male, higher incidence of oculo-bulbar involvement and lower incidence of respiratory problem and thymoma.

Intramolecular Excited State Proton Transfer of 2-(2'-Hydroxyphenyl)benzimidazole in Nonionic Micelles: Tweens

Spectral characteristics and prototropic reactions of 2-(2'-hydroxyphenyl)benzimidazole (HPBI) in Tween-20, Tween-40, Tween-60, Tween-80, and dioxane-water mixtures of different compositions have been studied. Comparison of the fluorescence band maxima of the tautomer band in nonionic micelles with the correlation diagram, drawn between the fluorescence band maxima and the dielectric constants of the dioxane-water mixtures, have shown that the effective dielectric constant (epsiloneff) at the binding site of HPBI is 18 +/- 2 for all the Tweens. Fluorescence lifetimes (tauf) and fluorescence quantum yields (phifl) have shown that the hydrophobicity of these micelles is maximum for Tween-80 and at a minimum for Tween-20. Similar results have also been observed from the pKa values for the deprotonation of HPBI, whereas the protonation reaction of HPBI occurs at the site in nonionic micelles which is more hydrophilic than that where the deprotonation reaction takes place. The protonation reaction in 2-(2'-methoxyphenyl)benzimidazole (MPBI) has shown that the value of epsiloneff in Tweens where this reaction occurs is less hydrophobic than the site where the same reaction occurs in HPBI. Copyright 1998 Academic Press.

Histidine decarboxylase gene in the mouse uterus is regulated by progesterone and correlates with uterine differentiation for blastocyst implantation

Cell-cell interactions between the blastocyst trophectoderm and uterine luminal epithelium are essential to the process of implantation. The factors that participate in these interactions or their mechanism of actions are poorly understood. Histamine has long been suspected as one of the factors that is involved in implantation. Histamine is formed from L-histidine by histidine decarboxylase (HDC). We examined the expression and regulation of HDC gene in the mouse uterus during early pregnancy and under steroid hormonal stimulation. Northern blot hybridization detected a 2.6-kb transcript of HDC messenger RNA (mRNA) in uterine poly(A)+ RNA samples. Maximum uterine accumulation of HDC mRNA occurred on days 3 and 4 of pregnancy, followed by marked declines on later days (days 5-8). In ovariectomized mice, uterine mRNA levels were up-regulated by an injection of progesterone (P4) by 6 h, and the levels were maintained through 24 h. In contrast, an injection of estradiol-17beta neither stimulated nor antagonized P4-induced HDC mRNA accumulation. P4-induced up-regulation was considerably abrogated by pretreatment with RU-486, a P4 receptor antagonist, suggesting involvement of P4 receptor. In situ hybridization detected HDC mRNA specifically in uterine epithelial cells but not in other cell types. Again, high epithelial accumulation occurred on day 4 of pregnancy. With the progression of implantation (days 5-8), HDC mRNA levels declined in the luminal epithelium surrounding the implanting blastocysts, as compared with that away from the blastocysts. Immunoreactive histamine and HDC were colocalized with HDC mRNA. Western blotting detected a 54-kDa protein in epithelial cell extracts, which also exhibited HDC activity. Expression of HDC in epithelial cells, preceding implantation on day 4, at lower levels after initiation of implantation on day 5, and its regulation by P4 suggest that this gene plays an important role in implantation.

Short-term macrophage interleukin-1 response to injected silicone in a rat model

The short-term effects of silicone particles on the ability of splenic and peritoneal macrophages to produce Interleukin-1 (IL-1) were assessed. Lewis rats were divided into three groups. Group 1 animals (n=12) were injected subcutaneously with 2.5 ml of sterile saline; Group 2 animals (n=12) received 2.5 ml of Freund's Complete Adjuvant (FCA); Group 3 animals (n=12) received subcutaneous injections (2.5 ml) of a sonicated slurry comprised of equal parts of FCA and silicone. At days 1, 4, and 7 single-cell suspensions of splenic (10(8) cells/ml) and peritoneal (10(6) cells/ml) macrophages of four animals from each group were prepared. The supernatants from macrophages cultured in the presence or absence of lipopolysaccharide (LPS) were added to IL-1 dependent mouse thymocytes for 72 hrs, and subsequently pulsed with 3H-thymidine. Radioactivity incorporation was determined after 18 hrs. Peritoneal macrophage culture supernatants had significantly higher activity than splenic macrophages and all macrophages stimulated with LPS had significantly higher activity. At days 1 and 7, there were no significant differences in 3H-thymidine uptake. At day 4 there was an elevation of 3H-thymidine uptake from supernatant of peritoneal macrophages treated with FCA/silicone suggesting subcutaneous silicone injection has short-term effects.

A Hindi version of the Diagnostic Interview for Genetic Studies

The validity of a Hindi version of the Diagnostic Interview for Genetic Studies (DIGS) was investigated. The original English version was initially translated into Hindi. The Hindi version was then back-translated and compared with the original. Next, a group of psychiatric inpatients and outpatients were interviewed using the Hindi version. The resultant diagnoses were compared with those obtained for the same patients using a Hindi version of the Present State Examination (PSE), and the clinical diagnoses given by the treating psychiatrists. The DIGS diagnoses were significantly correlated with both the PSE diagnoses (Cohen's kappa = 0.80) and the clinical diagnoses (kappa = 0.56). Interrater reliability between three interviewers for diagnoses obtained using the Hindi version of the DIGS varied (kappa = 0.45-1.00). Possible causes for this variability are discussed. The Hindi version of the DIGS fulfills the need for a current comprehensive interview schedule not only for psychiatric genetic research in India, but also for nongenetic research.

Effect of immunostimulation on cytotoxic activity of intestinal intraepithelial lymphocytes of chickens in infectious bursal disease and Eimeria tenella infections

In chickens, intestinal intraepithelial lymphocytes (iIELs) exhibit spontaneous natural killer (NK) cell like activity, by which they are active in the first line of defence on gut epithelial linings. In the present study, the cytotoxic activity of iIELs was found to be drastically suppressed in chickens experimentally infected with infectious bursal disease (IBD) virus at the age of 5 weeks and also in chickens experimentally infected with Eimeria tenella oocysts at the age of 8 weeks (p < 0.01). As nonspecific immunostimulation is gaining importance, immunostimulants such as immunostimulating Mycobacterium phlei (ISMP) and bone marrow culture supernatant (BMCS) were tested for their influence on the functional activity of iIELs of chickens in IBD and E. tenella infections. In chickens primed with ISMP a week prior to respective experimental infections, it was found that the cytotoxic activity of iIELs was restored (p < 0.01) in both IBD and E. tenella infections. At the same time, in chickens primed with BMCS a week prior to respective experimental infections, the cytotoxic activity of iIELs was restored to a certain extent (p < 0.01) in E. tenella but not at all in IBD infection. These results showed that application of immunostimulation helped potentiate and restore the functional activity of iIELs of chickens in IBD and E. tenella infections.

Preparation and in vitro dissolution profile of dual polymer (Eudragit RS100 and RL100) microparticles of diltiazem hydrochloride

A microparticulate dosage form for a highly soluble drug, diltiazem hydrochloride, was formulated with Eudragit RS100 and RL100 using a novel dual polymer technique. A mixture of diltiazem with Eudragit RS100 (low water permeability) in acetone was coacervated into soft polymer microdrops, following which a mixture of diltiazem and RL100 (high water permeability) was added to produce microparticles consisting of both polymers with diltiazem dispersed in the matrix. A second formulation was developed using the same method except using Eudragit RS100 for both steps. For a comparative study, diltiazem, Eudragit RS100 and RL100 were combined together in a single matrix and formulated into microparticles. In vitro drug release profiles using USP paddle dissolution apparatus 2 revealed that dual polymer matrix microparticles containing Eudragit RS100 in the inner and Eudragit RL100 in the outer core exhibit a suitable release profile with an initial release of the drug followed by a plateau level for the test period of 5 h. Differential scanning calorimetric analysis showed no interaction of the drug with the polymers.

Composition of lipids from the glands of the external ear canal of the adult chicken

Six classes of neutral lipids, i.e. triacylglycerol (TG), free fatty acids (FFA), monoester waxes (MW), free- and esterified sterols (FST and SE), and squalene (SQ) were identified by thin layer chromatography of the lipid materials extracted separately from the secretion as well as from the isolated whole glands present in the skin of the floor of the external ear canal of the domestic fowl. Secretory lipids contained considerable proportions of MW fractions (17.03%), TG (22.23%), and SQ (14.66%), while TG was the major component (41.10%) in the lipids from the isolated glands. Polar lipids, which comprised about 16-20% of total glandular lipids, were shown to be composed primarily of sphingomyelin.

Regain of fertility and normality of progeny born during below protective threshold antibody titers in women immunized with the HSD-hCG vaccine

PROBLEM

Phase II clinical trials with the heterospecies dimer of beta hCG and alpha-subunit of ovine luteinizing hormone (HSD)-human chorionic gonadotrophin (hCG) vaccine showed that pregnancy was prevented at and above 50 ng/ml titers, whereas conceptions occurred below 35 ng/ml of hCG bioneutralization capacity. The effect of below-protective threshold anti-hCG antibodies on the progression of pregnancy and the normality of progeny was studied.

METHOD OF STUDY

Four women enrolled by informed consent in the Phase II trials. The women studied were immunized with the HCG vaccine and did not receive booster injections in consideration of their desire to have another child. They were examined clinically at least once every month until delivery. The babies were followed up from 2 to 3.5 years, and their anthropometric indices were compared with elder siblings.

RESULTS

The pregnancies progressed to 35 to 38 weeks with the usual obstetric problems, and the children developed normally.

CONCLUSIONS

The anti-fertility effect of the HSD-hCG vaccine is reversible and low titers of antibodies below the protective threshold have no apparent side effects on the progression of pregnancy and on the early development of the progeny.

Differential spatiotemporal regulation of lactoferrin and progesterone receptor genes in the mouse uterus by primary estrogen, catechol estrogen, and xenoestrogen

Many xenobiotics are considered reproductive toxins because of their ability to interact with the nuclear estrogen receptors (ERalpha and ERbeta). However, there is evidence that these xenobiotics can regulate gene expression in the reproductive targets by mechanisms that do not involve these ERs. To examine this further, we compared the effects of estrogenic (o,p'-DDT [1-(o-chlorophenyl)-1-(p-chlorophenyl)2,2,2-trichloroethane] and Kepone, chlordecone) and nonestrogenic (p,p'-DDD [1,1-dichloro-2,2-bis(p-chlorophenyl)ethane], a metabolite of p,p'-DDT) xenobiotics with those of 17beta-estradiol (E2) and 4-hydroxyestradiol-17beta (4-OH-E2), a catechol metabolite of E2, on uterine expression of lactoferrin (LF) and progesterone receptor (PR). These genes are estrogen responsive in the mouse uterus. Normally, LF is expressed in the uterine epithelium, whereas PR is expressed in both the epithelium and stroma in response to estrogenic stimulation. Ovariectomized mice were injected with xenobiotics (7.5 mg/kg), E2 (10 microg/kg), 4-OH-E2 (10 microg/kg), or the vehicle (oil, 0.1 ml/mouse), and uterine tissues were processed for Northern blot and in situ hybridization. The pure antiestrogen ICI-182780 (ICI; 1 or 20 mg/kg) was used to interfere with estrogenic responses that were associated with the ERs. The results of Northern and in situ hybridization demonstrated increased uterine levels of PR and LF messenger RNAs (mRNAs) by all of these xenobiotics, but quantitatively the responses were much lower than those induced by E2 or 4-OH-E2. The results further showed that the E2-inducible epithelial LF mRNA accumulation was markedly abrogated by pretreatment with ICI (20 mg/kg). In contrast, this treatment retained the epithelial expression of PR mRNA, but down-regulated the stromal expression. In contrast, ICI had negligible effects on LF and PR mRNA responses to 4-OH-E2, indicating that this catechol estrogen exerted its effects primarily via a mechanism(s) other than the ERs. The heightened accumulation of LF mRNA in the epithelium in response to Kepone and o,p'-DDT was also severely compromised by pretreatment with ICI, but this antiestrogen had little effect on responses to p,p'-DDD. Similar to E2, Kepone increased the expression of PR mRNA in both uterine epithelium and stroma. However, pretreatment with ICI decreased stromal cell expression, whereas epithelial cell expression remained unaltered or increased. These responses were not noted in mice treated with o,p'-DDT or p,p'-DDD. Collectively, the results demonstrate that catechol estrogens or xenobiotics can alter uterine expression of estrogen-responsive genes by mechanisms that are not totally mediated by the classical nuclear ERs, and these alterations are cell type specific. We conclude that an interaction of a compound with the nuclear ERalpha and/or ERbeta is not an absolute requirement for producing specific estrogen-like effects in the reproductive target tissues.

Left ventricular long axis disturbances as predictors for thallium perfusion defects in patients with known peripheral vascular disease

OBJECTIVE

To compare resting long axis echocardiography with adenosine thallium-201 emission tomography in detecting myocardial ischaemic abnormalities in patients before peripheral vascular surgery.

DESIGN

A prospective and blinded preoperative examination of resting left ventricular minor and long axes and myocardial perfusion during adenosine vasodilatation using thallium-201 emission tomography.

SETTING

A tertiary referral centre for cardiac and vascular disease equipped with invasive, non-invasive, and surgical facilities.

SUBJECTS

65 patients (40 men) with significant peripheral vascular disease, mean (SD) age 63 (10) years, and 21 control subjects of similar age.

METHODS

Segments were classified as normal, with fixed or reversible defects according to thallium-201 myocardial perfusion tomography. Systolic long axis abnormalities were either reduced excursion and/or abnormal shortening after A2, and diastolic abnormalities either delayed onset of lengthening > 80 ms and/or reduced peak lengthening rate < 4.5 cm/s. Segmental perfusion defects were compared with the equivalent long axes; anteroseptal for septal, inferoseptal for posterior, and lateral for left side giving a total of 195 segments.

RESULTS

Systolic long axis abnormalities predicted fixed thallium defects (sensitivity 86%, specificity 87%, positive predictive value 0.78, negative predictive value 0.93, p < 0.001), and diastolic abnormalities correlated with reversible perfusion defects (sensitivity 90%, specificity 85%, positive predictive value 0.72, negative predictive value 0.95, p < 0.001). Echocardiography characteristics of the true and false positive segments were not different in the site or the extent of abnormalities.

CONCLUSION

Systolic long axis abnormalities predict fixed and diastolic reversible thallium perfusion defects in patients with peripheral vascular disease. Ventricular long axis may thus have a value as a screening test before peripheral vascular surgery as well as providing a means of monitoring myocardial perfusion. The high negative predictive values indicate that a negative long axis study makes significant perfusion abnormalities very unlikely in patients with high pretest probability of coronary artery disease.

Expression of neu differentiation factor during the periimplantation period in the mouse uterus

Complex cellular interactions occur between the blastocyst and the uterus during implantation. The expression of various polypeptide growth factors and their receptors in the uterus and/or blastocyst during the periimplantation period suggest that growth factors participate in the implantation process. Neu differentiation factor (NDF) is a member of the epidermal growth factor (EGF) family of growth factors and is represented by multiple conserved isoforms. The expression of several EGF-like ligands in the periimplantation uterus has been characterized, including EGF, heparin binding-EGF, transforming growth factor alpha, amphiregulin, betacellulin, and epiregulin. We analyzed the expression pattern of NDF in the periimplantation mouse uterus because of its mitogenic and differentiation-promoting effects. By using Northern analysis and isoform-specific polymerase chain reaction, we found that multiple isoforms are expressed in the periimplantation uterus. NDF displays a highly restricted temporal and spatial expression, with autoradiographic signals localized to the uterine stroma immediately surrounding the implanting blastocyst. NDF expression was absent in mice with delayed implantation but briefly reappeared with the same restricted distribution after termination of the delay by an injection of estrogen. Taken together, these results suggest that an activated blastocyst is required for the expression of NDF and that multiple isoforms may be involved in the complex network of cell-signaling events between the implanting blastocyst and the receptive uterus.

Cytohormonal evaluation of vaginal smears by phase contrast microscopy with special reference to progesterone deficiency pattern during early pregnancy as predictor of abortion

Cytohormonal profile of unstained vaginal smears were studied under phase contrast microscope to define various cell morphologies in detail and build up of smear pattern serially in various stages of menstrual cycle and first trimester of pregnancy. The findings were correlated clinically and found comparable to Papanicolaou stained smears. The maturation index was calculated more objectively by phase contract microscopy because of the refractile appearance of the pyknotic nuclei of superficial cells. The prognostication of abortion was done by combining abnormal maturation index and the presence of syncytiotrophoblasts in vaginal smears. Under phase contrast microscope, the sensitivity of abnormal smear was 87.5%, the specificity was 95%, the positive predictive value was 96.55% and the overall accuracy was 90% as compared to positive Papanicolaou smear whose sensitivity though 93%, had low specificity of 50% only. Phase contrast study appears to offer certain distinct advantage over the conventional light microscopy for quick, comprehensive and quantitative assessment of the study material. It allows the physician to detect changes in the material obtained from the patients without detour of laboratory fixation and staining. It is technically easy as errors in interpretation due to unsatisfactory fixation, staining and artefacts are obviated. Thus phase contrast microscopy offers an alternative and easy method of cytohormonal evaluation of wet and unstained smears.