Systemic lupus erythematosus with obstructive uropathy. Case report and review

We report a case of patient with documented SLE who displayed dysuria, gastrointestinal (GI) symptoms and renal insufficiency associated with the unusual occurrence of bilateral hydroureteronephrosis due to urterovesical junction stricture (obstructive uropathy). Pathologic investigations disclosed chronic interstitial cystitis (IC) with evidence of focal immune complex deposition in the blood vessel walls of the bladder. The GI symptoms and dysuria regressed with initial therapy for SLE with steroids. However, the persistent obstructive uropathy (OU) and renal insufficiency required bilateral nephrostomy followed by steroids plus intravenous pulse injection of cyclophosphamide. The obstructive uropathy was relieved even after removing the nephrostomy tube and renal function remained stable. Including this case, nineteen SLE patients associated with clinical and radiographic findings of OU were found in the world literature and reviewed to find any consistent pattern of clinical features. Most of the patients with OU in SLE were female (mean age, 31.7 yr) and orientals (63%), and had interstitial cystitis (89%) as a common underlying cause with concomitant involvement of the GI tract (89%) and WHO class IV or V advanced glomerulonephritis (67%). Despite the remarkable response (68%) to steroids in majority of OU patients associated with SLE, certain patients still required surgical correction (32%) and some even died (32%). OU, potentially reversible, was not an exception in patients with SLE, which might be overshadowed by other major organ involvement of SLE.

NMR investigation of echinomycin binding to d(ACGTTAACGT)2: Hoogsteen versus Watson-Crick A.T base pairing between echinomycin binding sites

The structure of the echinomycin complex with the self-complementary DNA decamer d(ACGTTAACGT)2 has been investigated in solution by proton NMR spectroscopy. Echinomycin binds as a bisintercalator at the CpG steps. An analysis of the intermolecular NOE patterns defined the position and orientation of the bound drug molecule. The terminal A.T base pairs are Hoogsteen base-paired, whereas the central four A.T base pairs are clearly Watson-Crick base-paired. Thus, the presence of the extra A.T base pairs between the binding sites appears to prevent the formation of Hoogsteen base pairs immediately adjacent to the binding site. All four central A.T base pairs are destabilized relative to those in the free DNA. Because there is no evidence for unwinding of the DNA duplex in the complex relative to the free DNA, we conclude that the hypersensitivity to DNA cleavage reagents distal to echinomycin binding sites might be due to the destabilization of DNA structure induced by the drug binding.

Glomerular hyperfiltration in Koreans with non-insulin-dependent diabetes mellitus

Glomerular hyperfiltration (GHF) may play an important role in the pathogenesis of diabetic nephropathy. The prevalence of GHF in non-insulin-dependent diabetes mellitus (NIDDM) is reported to vary in different populations, ranging from 35% in black Americans with new-onset diabetes to less than 5% in whites. We measured glomerular filtration rate (GFR) by 51Cr-EDTA clearance methods in 284 Korean NIDDM patients without overt nephropathy. Glomerular hyperfiltration (defined as GFR > 140 mL/min/1.73 m2) was found in 25% (71 of 284) of the patients. Thirty percent and 15% of the patients with known duration of diabetes less than 5 years and more than 10 years, respectively, showed GHF. Microalbuminuria (defined as urinary albumin excretion rate 20 to 200 micrograms/min) was found in 23% (64 of 284) of the patients. The mean GFR of the microalbuminuric patients was not significantly different from that of the normoalbuminuric patients (121.5 +/- 30.1 mL/min/1.73 m2 v 124.9 +/- 26.4 mL/min/1.73 m2; P = NS). However, when the patients with microalbuminuria were divided according to the presence or absence of retinopathy, the microalbuminuric patients with retinopathy had a lower GFR compared with the microalbuminuric patients without retinopathy (109.6 +/- 35.5 mL/min/1.73 m2 v 130.0 +/- 26.3 mL/min/1.73 m2; P < 0.01). These results show that the prevalence of GHF in Korean NIDDM patients without overt nephropathy is higher than that reported in whites and that it is similar to that in black Americans. The high prevalence of GHF in Korean NIDDM patients may contribute to the relatively higher prevalence of clinical diabetic nephropathy in this population.

Use of distortion product otoacoustic emissions to assess middle ear transducers in rhesus monkeys

Distortion product otoacoustic emissions (DPOAEs) can provide an objective and noninvasive assessment of the peripheral cochlear function. Auditory brainstem responses measured from implanted rhesus monkeys have shown that middle ear transducers, coupled directly to the incus, are capable of delivering the signals to the central auditory system. The DPOAEs were used as a noninvasive method of assessing the frequency specificity of this mechanical transduction. In two rhesus monkeys implanted with the middle ear transducers, one primary stimulating tone (f1) was presented acoustically, and the other primary tone (f2) was presented by the transducer, which converted the signal into a mechanical motion of the probe tip attached to the body of the incus. The nonlinear characteristics of the cochlea produced the distortion product responses at the expected frequencies (2f1 - f2). This demonstrates the fidelity of the middle ear implant signal transduction in vivo. The DPOAEs also indicate minimal changes in the post-implant middle ear transmission. This study demonstrates that the DPOAEs can be used to assess the function of implanted middle ear transducers objectively and noninvasively.

Prevalence and associated features of albuminuria in Koreans with NIDDM

OBJECTIVE

To determine the prevalence and the associated features of microalbuminuria and overt proteinuria in Korean subjects with non-insulin-dependent diabetes mellitus (NIDDM) attending a hospital clinic.

RESEARCH DESIGN AND METHODS

A total of 631 Korean outpatients with NIDDM were studied cross-sectionally for the presence of albuminuria and other micro- and macrovascular complications. Urinary albumin excretion rate (AER) was determined in timed overnight urine samples. Subjects were divided into three groups: no nephropathy (AER < 20 micrograms/min), microalbuminuria (AER 20-200 micrograms/min), and overt proteinuria (AER > 200 micrograms/min).

RESULTS

Increased AER was present in 34% of our patients: 20% had microalbuminuria and 14% had overt proteinuria. Of patients with diabetes duration > or = 15 years, 35% had overt proteinuria. Most (82%) patients with overt proteinuria had retinopathy. Although the prevalence of microalbuminuria as a whole did not differ according to diabetes duration, the prevalence of microalbuminuria in the patients with retinopathy increased with diabetes duration. The microalbuminuric patients without retinopathy (diabetes duration < 5 years) were characterized by higher prevalence of hypertension and previous obesity, higher plasma triglyceride level, and lower plasma high-density lipoprotein cholesterol level.

CONCLUSIONS

The prevalence of overt proteinuria in Korean NIDDM patients with a long diabetes duration was higher than that reported in Caucasians. Our data also suggest that the clinical meaning of microalbuminuria may be different based on the presence or the absence of retinopathy. Microalbuminuria in patients with retinopathy most probably would reflect diabetic nephropathy. In contrast, some recent-onset NIDDM patients with microalbuminuria in the absence of retinopathy had features of syndrome X.

Distortion product otoacoustic emissions in rhesus (Macaca mulatta) monkey ears: normative findings

Distortion product otoacoustic emissions (DPOAEs) in rhesus monkeys were characterized and the optimal parameters for their generation were determined. Robust DPOAEs were readily measurable from the ear canals of six rhesus monkeys (n = 12 ears). The nonmonotonic behavior of the f2/f1 ratio functions in rhesus monkeys was found to be similar to other animals and humans. The optimal mean f2/f1 ratio of 1.21 and the effect of the primary frequency and level on the optimal f2/f1 ratios were also similar to human measurements. The contour of the rhesus monkey DPOAE 'audiograms' and their behavior were also comparable to human measurements with slight differences in peak frequencies. The rhesus monkey DPOAE input/output (I/O) functions were generally monotonic with a slope approaching unity with increasing frequency. Therefore, our study shows that many basic DPOAE characteristics are remarkably similar in the two species and emphasizes the appropriateness of the rhesus monkey as a model for DPOAE research. Detailed studies of the behavior of DPOAEs can be carried out in a model that is phylogenetically close to human both in hearing and in the gross structure and histology of the inner ear.

Quantitative binding site model generation: compass applied to multiple chemotypes targeting the 5-HT1A receptor

We present enhancements to the Compass algorithm that automatically deduce interchemotype relationships and generate predictive quantitative models of receptor binding based solely on structure-activity data. We applied the technique to a series of compounds assayed for 5-HT1A binding. A model was constructed from 20 compounds of two chemotypes and used to predict the affinities and bioactive conformation of 35 new compounds, most of which had new underlying scaffolds and/or functional groups. The model's mean error of prediction was 0.5 log units (essentially the assay resolution), even on quite divergent series. The predictions are supported by an interpretable hypothesis for the binding determinants of the receptor and the geometric relationships of the chemotypes.

High incidence of resistance to multiple antimicrobials in clinical isolates of Streptococcus pneumoniae from a university hospital in Korea

One hundred thirty-one strains of Streptococcus pneumoniae isolated from clinical specimens between January 1991 and April 1993 were serotyped and tested for susceptibility to 10 antimicrobials by the agar dilution method. Five serotypes (6A, 6B, 14, 19F, and 23F) accounted for 67% of all isolates. Seventy percent of isolates were not susceptible to penicillin, exhibiting either intermediate resistance (37%) or high-level resistance (33%); 82% of isolates from children and 59% of those from normally sterile body fluids were resistant to penicillin. A significantly increased rate of penicillin resistance (P < .01, Fisher's exact or chi 2 test) was associated with hospitalization, an age of < or = 15 years, ongoing antimicrobial therapy at the time of isolation of the organism, nosocomial acquisition, and several specific serotypes (6, 14, 19F, and 23F). No penicillin-resistant strain showed beta-lactamase activity. Various proportions of the penicillin-resistant strains also displayed resistance to cefaclor (89%), cefotaxime (82%), chloramphenicol (65%), erythromycin (52%), and ciprofloxacin (15%), but none was resistant to teicoplanin or vancomycin. The prevalence of pneumococcal resistance documented in Korea in this study is among the highest figures published to date.

cDNA sequence analysis confirms that the etiologic agent of callitrichid hepatitis is lymphocytic choriomeningitis virus

Callitrichid hepatitis is an infection of New World primates caused by an arenavirus, currently referred to as callitrichid hepatitis virus, that is closely related to lymphocytic choriomeningitis virus (LCMV). We have cloned and sequenced the GP-C gene of callitrichid hepatitis virus and found that the cDNA sequence is 84 to 86% identical to those of the GP-C genes of LCMV strains Armstrong and WE, while the deduced amino acid sequence is 95 to 96% identical to those of the GP-C gene products of the same strains. This high degree of similarity indicates that the etiologic agent of callitrichid hepatitis is in fact LCMV. The wide geographic distribution of callitrichid hepatitis outbreaks in the United States serves as a reminder that LCMV is also a human pathogen whose public health implications are not well understood.

Clinical heterogeneity of insulin dependent diabetes mellitus in Korea

This study was undertaken to find out how many current Korean patients with insulin dependent diabetes mellitus (IDDM) had a previous history of non-insulin requiring phase. Fasting serum C-peptide levels were measured in the 2300 diabetic patients during the visit to the Asan Medical Center, Seoul, Korea. Fifty-nine patients showed fasting serum C-peptide levels below 0.13 nmol/l. These 59 patients were classified further into two groups according to their history of insulin requirement: group A who required insulin within 1 year after diagnosis or presented initially as diabetic ketoacidosis and group B who had non-insulin requiring phase at least for 1 year (median: 5 years; range: 1-23 years). Twenty-six patients (44%) were classified into group A and 27 patients (46%) into group B. Median age of onset was 26 years (range: 10-50 years) and 45 years (range: 23-73 years) in groups A and B, respectively (P < 0.001). While the two groups had similar values in the current and maximum body mass indices, sex ratio and the prevalence of islet cell antibodies, 58% of the group A and 7% of the group B patients had histories of diabetic ketoacidosis. These results suggest a clinical heterogeneity in patients with IDDM in Korea.

[Surface ultrastructure of Parvatrema timondavidi (Digenea: Gymnophallidae) according to its developmental stages]

Surface ultrastructure of Parvatrema timondavidi developmental stages was studied using a scanning electron microscope. The metacercariae were collected from the marine clam. Tapes philippinarum, and juvenile and adult worms were recovered at 1, 2, 3 and 7 days after experimental infection of mice. The metacercariae had a large oral sucker and characteristic lateral projections. Around the lip of the oral sucker many type I and type II sensory papillae were observed, and type III papillae were located symmetrically on the medial side of the lateral projection. Numerous type I papillae were grouped around the genital pore. The tegumental spines were distributed over the worm surface except the lip of the suckers and genital pore. The 1-day old worm had a well-developed ventral sucker, with 6 type II sensory papillae on its outer surface and another 6 type I papillae on the inner side. Two small type I papillae were seen on the anterior side of the ventral sucker. The genital pore was small and opened separately from the ventral sucker and 15 type I papillae were grouped around it. The 2-, 3-, and 7-day worms revealed that as they grew to be adults, the spine tips became multipointed, the genital pore formed a genital atrium, and the cytoplasmic process became well differentiated. In 2- and 3-day worms 10 type II papillae encircling the lip of the oral sucker, and additional 4 papillae at the dorsal side of 4 dorsal type II papillae were a characteristic feature. The distribution pattern of sensory papillae around the oral sucker and genital pore, and 2 type I papillae on the anterior side of the ventral sucker, was so peculiar in P. timondavidi, that they seem to be useful keys for taxonomic differentiation from other gymnophallids.

Vitamin A deficiency impairs some aspects of the host response to influenza A virus infection in BALB/c mice

We examined the impact of vitamin A deficiency on the host response to an acute, viral infection of the respiratory tract by infecting BALB/c mice with a mouse-adapted strain of influenza A virus. Several indicators of the severity of infection were examined, including the rate of virus clearance from the lungs, the extent of inflammatory lesions, and percentage of survival. None of these was affected by vitamin A deficiency. Following the acute phase of infection, however, the regeneration of normal, respiratory epithelium was impaired and adenomatoid, metaplastic lesions developed within inflammatory foci in the lungs of deficient animals. The antibody response to infection was also characterized: the influenza A-specific immunoglobulin A (IgA) response in the respiratory tract was markedly decreased by vitamin A deficiency, but tracheal and lung lavage IgG titers were not affected. The serum IgM and IgG responses, and the serum hemagglutination-inhibition response, were also diminished by vitamin A deficiency. Decreased mucosal IgA titers and impaired regeneration of normal respiratory epithelium could impair recovery from a primary infection and increase susceptibility to opportunistic secondary infections.

Enzymatic action of basic arginine amidases in human seminal plasma

Three basic arginine amidases with different affinities to lima bean trypsin inhibitor (LBTI) and aprotinin affinity columns were separated in the middle molecular weight (MMW) preparation obtained from Cellulofine GCL-2000 gel filtration of CM-cellulose adsorbed human seminal plasma and were tentatively called basic human seminal plasma arginine amidase-L (BHSAA-L, with affinity to LBTI), -A (BHSAA-A, with affinity to aprotinin), and -TH (BHSAA-TH, without affinity to either). Some enzymatic properties were measured, including Ki values of LBTI and human seminal plasma proteinase inhibitor (HSP-PI) toward present enzymes. The Ki values of LBTI toward BHSAA-L and -TH were lower than those of HSP-PI and no Ki values for LBTI toward BHSAA-L were observed. The Km values of BHSAA-L and -A to some tripeptidyl-p-nitroanilide substrates seemed relatively lower than that of BHSAA-TH.

Protein oxidation associated with aging is reduced by dietary restriction of protein or calories

The accumulation of unrepaired oxidative damage products may be a major factor in cellular aging. Both oxidative lesions in DNA and oxidatively damaged proteins have been shown to accumulate during aging. The accumulation of oxidized proteins in Fischer 344 rats was compared for animals consuming protein-restricted and calorically restricted diets--both of which have been shown to extend lifespan. Rats were fed diets restricted in either protein (5% or 10% of the diet as compared with the normal 20% casein), or calories (25% or 40% less than normal), or total diet (40% less than normal). In addition, some of the rats fed a diet providing 5% or 20% protein were irradiated twice weekly (125 rads per exposure; 1 rad = 0.01 Gy). The level of oxidative damage to proteins (protein carbonyls) was determined in rats sacrificed at various times. The oxidative damage to proteins increased with aging and with radiation. Either protein or calorie restriction markedly inhibited the accumulation of oxidatively damaged proteins. Protein restriction reduced the accumulation of oxidatively damaged proteins during the oxidative stress of chronic irradiation.

Organ-selective induction of cytochrome P-450-dependent activities by indole-3-carbinol-derived products: influence on covalent binding of benzo[a]pyrene to hepatic and pulmonary DNA in the rat

Indole-3-carbinol (I3C) is a dietary modulator of carcinogenesis that can reduce the level of carcinogen binding to DNA. I3C-derived products are potent inducers of certain cytochrome P-450(CYP)-dependent enzyme activities. To investigate whether the protective effects of I3C against carcinogen damage to DNA are associated with increased activities of CYP1A1 enzymes, we examined the relationship of I3C-mediated organ-specific CYP enzyme induction with total levels of benzo[a]pyrene (BP) binding to hepatic and pulmonary DNA of rats. Oral intubation (PO) of I3C (500 mumol/kg body wt.) in 10% DMSO in corn oil produced after 20 h, increases in ethoxyresorufin O-deethylase (EROD) activities (associated with CYP1A1 isozyme) of 700-fold, 245-fold and 36-fold in small intestine, lungs and liver, respectively, compared with activities in untreated controls. Hepatic aryl hydrocarbon hydroxylase (AHH) activity was increased 4-fold under these conditions. Pentoxyresorufin O-depentylase (PROD) activity (associated with CYP2B isoenzyme) was increased 6-fold in the liver but was unaffected in lung and small intestine. Intraperitoneal injection (IP) of I3C (500 mumol/kg body wt.) produced no significant change in EROD or PROD activities in lung, liver, or small intestine. PO administration of the acid reaction mixture (RXM) of I3C increased hepatic AHH activity (5-fold) and EROD activities in small intestine (650-fold), lung (100-fold) and liver (18-fold). IP administration of RXM (equivalent to 500 mumol I3C/kg body wt.) significantly increased only EROD activity in lung and liver, but did not affect EROD activity in small intestine, AHH activity in liver, or PROD activity in any of the organs examined. Twenty hours after inducer treatment, half of the rats were treated PO with 0.2 mumol [3H]BP in corn oil. Analysis of tissues 5 h after BP administration indicated that compared with untreated controls, administration of I3C and RXM by either route reduced by 30-50% the level of BP binding to hepatic DNA, an effect that was not correlated to CYP1A1 enzyme induction in any of the organs examined. However, PO administration of I3C and RXM produced a 50-70% decrease in carcinogen binding to pulmonary DNA, while IP administration of inducers had no effect on DNA binding in this organ. These results with the lung are consistent with an increased presystemic clearance of BP in the intestine and are discussed in terms of the role of induction of intestinal CYP1A1 activity in the decreased lymphatic and venous transport of unmetabolized BP to the lung.

Trypsin-like arginine amidases including plasminogen and plasmin in human seminal plasma by affinity adsorption and elution

An enzyme preparation with affinity to a lysine column was detected from a DEAE-cellulose-adsorbed preparation of human seminal plasma containing plasminogen and plasmin. Two kinds of trypsin-like acidic arginine amidase activity with different affinity to lima bean trypsin inhibitor (LBTI) and aprotinin affinity column were detected from the DEAE-cellulose-adsorbed preparation after treatment of the lysine column. Two kinds of trypsin-like basic arginine amidase activity were also separated by the above-mentioned affinity adsorptions from a CM-cellulose-adsorbed preparation of human seminal plasma. The effect of calcium chloride on these two enzymes was different from human acrosin.

Detection of antibodies to human nerve antigens in sera from leprosy patients by ELISA

Anti-neural antibodies have been implicated to play a role in the pathogenesis of nerve damage in leprosy patients. To find the relationship between anti-neural antibodies and clinical findings, we attempted to detect antibodies against neurofilament-enriched proteins by ELISA in sera from leprosy patients. Of 289 sera from leprosy patients, 74 (25.6%) had significant anti-neural antibodies; in contrast, 1 (5.0%) of 20 tuberculosis patients and 11 (7.1%) of 154 controls were seroreactive to nerve antigen. When clinical types were considered, a significant level of anti-neural IgG antibodies was detectable in 53 (30.1%) of 176 sera from lepromatous patients compared with 21 (18.6%) of 113 sera from tuberculoid patients, indicating that lepromatous patients were more likely to be seropositive to nerve antigens in ELISA. Some of the ELISA-reactive sera showed antibody reactivity with 38-kD, 40-kD and 43-kD nerve antigens in Western blotting analysis. There was no apparent correlation between seroreactivity to nerve antigens and bacterial load in leprosy patients. Although there was no statistical significance, anti-neural antibodies were detectable more often among the patients on chemotherapy than the untreated and among the patients with erythema nodosum leprosum than without. The results, therefore, suggest that anti-neural antibodies are elicited during the course of leprosy and may be associated with the extensiveness of nerve involvement in the patients.

Basic arginine esterase from human seminal plasma: purification and some properties

Basic arginine esterase (amidase) with a specific activity of 3.2 mumol N-alpha-tosyl-L-arginine methyl ester (Tos-Arg-Me) esterolysis per A280 was purified about 230-fold from a CM-cellulose absorbed preparation of human seminal plasma. The purified enzyme was a single band with an apparent molecular weight of 3.4-4.1 x 10(4). The amidolytic activity of this enzyme was suppressed by aprotinin, soybean trypsin inhibitor (SBTI), leupeptin, and antipain, while alpha 1-antitrypsin, ovomucoid trypsin inhibitor (OTI), EDTA, and chymostatin had no or weak effect. This enzyme hydrolyzed synthetic basic amino acid derivatives and N-alpha-tosyl-glycyl-L-prolyl-arginine-p-nitroanilide (Tos-Gly-Pro-Arg-pNA) and N-alpha-tert-butyloxycarbonyl-L-leucyl-L-prolyl-L-arginine-p-nitroanilid e (Boc-Leu-Pro-Arg-pNA) were the best substrates. The enzymatic characteristics of present enzyme were clearly different from tissue kallikrein, acrosin, and seminin in human semen.

Detection of arginine esterase activity in human follicular fluid

One major fraction hydrolysing arginine ester and amido derivative (major preparation) was detected and separated from human follicular fluid by Cellulofine GCL-2000 gel filtration. The best ester and amide substrates for this preparation were acetyl-glycyl-lysine methyl ester (Ac-Gly-Lys-Me) and D-valyl-L-leucyl-L-arginine-p-nitroanilide (Val-Leu-Arg-pNA), respectively. The preparation contained plasmin and plasminogen; lysine-Cellulofine adsorption and elution changed the substrate specificity of its esterolytic activity. After treatment by lysine-Cellulofine adsorption and elution, the basic and acidic arginine esterase activities of the major preparation were separated by CM- and DEAE-cellulose adsorption and elution, respectively. The substrate specificity of these two esterolytic enzyme activities differed before and after adsorption of the major preparation to the lysine affinity column.

A simplified technique for freezing human sperm for AIH: cryosyringe/floating platform of liquid nitrogen vapor

A cryosyringe and floating platform were developed to simplify the procedures for human sperm cryopreservation without sacrificing post-thaw sperm quality. The cryosyringe was developed as a vessel for cryopreservation and as a device for post-thaw insemination. A platform-like polystyrene foam board 3-cm in height was floated on the surface of liquid nitrogen in a polystyrene foam freezing container. The cryosyringe containing sperm/KS-II medium mixture was placed on it for 5 min, then it was dropped into the liquid nitrogen. Freezing velocity was -27 degrees C/min. Poor quality semen specimens (40 +/- 14 x 10(6)/ml, 18 +/- 2.6% motility, n = 9) were concentrated (87 +/- 46 x 10(6)/nl, 29 +/- 9.1%) previously and then cryopreserved in the cryosyringe or in a commercial tuberculin syringe under the conditions established in the present study. The post-thaw sperm motility of the specimens in the cryosyringe (18 +/- 7.4%) was significantly superior (p less than 0.05) to that in the commercial tuberculin syringe (13 +/- 5.3% motility).

Intravascular papillary endothelial hyperplasia of superior vena cava: a rare cause of the superior vena cava syndrome

The superior vena cava syndrome associated with an intraluminal vascular proliferative lesion is extremely rare. A case of intravascular papillary endothelial hyperplasia of the superior vena cava causing obstructive symptoms is reported that was successfully managed by surgical excision.

An in vitro and clinical comparison of corneal storage with chondroitin sulfate corneal storage medium with and without dextran

The safety and efficacy of 1% dextran in Chondroitin Sulfate Corneal Storage Medium (CSM) in reducing corneal swelling after 4 degrees C storage was assessed in a corneal endothelial cell culture system. No difference was found in 3H-thymidine incorporation by cells incubated in either CSM-dextran medium or CSM medium alone. Subsequently, 21 pairs of corneas, stored in either CSM or CSM-dextran from 30 to 112 hours, were transplanted into 42 eyes of 42 patients, paired by diagnostic group and procedure. All CSM grafts and 19 of 21 CSM-dextran grafts were clear at 4 months with no primary donor failures in either group. Intraoperative corneal thickness was significantly greater in the CSM group (0.82 +/- 0.07 mm) than the CSM-dextran group (0.76 +/- 0.06 mm); however, the two groups did not differ thereafter. No differences in all endothelial morphometric parameters were noted between the two groups pre- and postoperatively. Average endothelial cell loss by 4 months was 13.0 +/- 16.4% for the CSM group and 16.4 +/- 15.5% for the CSM-dextran group. The addition of dextran to CSM medium results in significant intraoperative corneal thinning without adversely affecting endothelial DNA synthesis in vitro and endothelial survival in vivo.

The role of inhibin in women with polycystic ovary syndrome (PCOS)

Human follicular fluids from normal women and from women with polycystic ovary syndrome (PCOS) were collected at various stages of the menstrual cycle, and inhibin and steroid contents were determined by rat anterior pituitary cell monolayer bioassay system and specific RIAs, respectively. Inhibin contents in viable follicles were significantly higher than those in atretic and in cystic follicles. Preovulatory and luteal phase follicles had lower inhibin levels than viable follicles in normal women. A significant inverse correlation was found between inhibin contents and androstenedione to estrogen ratios. The inhibin contents in PCOS follicles were not significantly different from those of viable follicles of normal women at the early follicular phase, but they were significantly higher than in atretic follicles. Since PCOS ovaries often contain more antral follicles than normal ovaries, it could be that this potential source of inhibin may be greater than in normal ovaries. Furthermore, 9 out of 10 follicles in any ovary of normal women are atretic and contribute less inhibin production, whereas PCOS ovaries contain many follicles capable of secreting considerable amounts of inhibin. Therefore, PCOS ovaries totally may secrete more inhibin than normal ovaries. This higher potency of PCOS ovaries to secrete inhibin along with higher serum estrogen levels may be responsible for the disparity between basal LH and FSH levels in PCOS.