Delay of testicular differentiation in the B6.YDOM ovotestis demonstrated by immunocytochemical staining for müllerian inhibiting substance

It has been found that when the Y chromosome from Mus musculus domesticus (YDOM) is placed onto the C57BL/6J (B6) mouse background, the XY progeny (B6.YDOM) develop ovaries or ovotestes but not normal testes during fetal life. We examined the ontogeny of the abnormal testicular differentiation in the B6.YDOM ovotestis by immunocytochemical staining for Müllerian inhibiting substance (MIS). We found that the B6.YDOM ovotestis initiated testicular differentiation later in development than did the control B6 testis. When the YDOM was transferred onto the SJL J mouse background by crossing B6.YDOM males with SJL/J females, all XY progeny developed normal testes. The onset of testicular differentiation was at the same developmental stage as in the B6 male fetus. These results suggest that the delay of testicular differentiation is not due to the effect of the YDOM chromosome itself, but due to improper interaction of the testis-determining gene on the YDOM chromosome with autosomal genes of B6. In addition, we found a close correlation between the arrest of germ cells at the prespermatogonia stage and MIS production of adjacent somatic cells in the B6.YDOM ovotestis. This result may support the hypothesis that MIS is involved in the regulation of germ cell differentiation.

Gonadotropins moderate rejection of trophic-specific congenic testes grafts

Factors that favor graft survival of fetal and neonatal testis relative to adult testis were explored by studying the effects of rapid growth on immunogenicity. Tissue-specific growth was initiated by elevated gonadotropins created by oophorectomy and allografted target testes were examined. Three-day postnatal testes were implanted under the subrenal capsule of oophorectomized (as confirmed by elevated gonadotropins) and nonoophorectomized females. Immunosuppressive therapy with cyclosporine A was administered to selected animals of both groups. Preliminary studies in outbred rats and more extensive studies in allogenic/congenic mice (C57BL/6J to B10.A) showed that testicular allografts exposed to the elevated gonadotropins caused by previous host oophorectomy grow larger, have less lymphocytic infiltrate, and show better preservation of architecture than do allografts in nonoophorectomized female recipients. The graft survival resulting in vivo from elevated gonadotropins approximated that permitted by either maximal immunosuppression or syngeneic transplantation.

Computer-aided cell colony counting

Counting cell colonies is a tedious task when performed with the light microscope. Moreover, unless strict double-blind protocols are adhered to, biased counts are difficult to avoid. Presented here is a computer software application that performs accurate, reproducible cell colony counts with a minimum of user generated bias. The application is based upon the Apple IICX computer system with Image software and AppleScan. Colonies are grown on 24-well plates and prepared in such a way as to permit good quality scanning. The scans are then transferred to Image and the individual colonies in each well are counted. Good correlation with counts done by light microscopy is achieved.

Aberrant colonic expression of MHC class II antigens in Hirschsprung's disease

The major histocompatibility complex (MHC) Class I and II cell surface antigens responsible for the recognition of self vs non-self were studied in patients with documented Hirschsprung's disease. Monoclonal antibodies reactive with monomorphic determinants of human lymphocyte antigen (HLA)-A,B,C (Class I) and HLA-DR (Class II) were used to demonstrate immunohistochemically the expression of MHC antigens in 27 biopsy specimens from a variety of colorectal disorders. The rectal specimens examined from patients with Hirschsprung's disease showed an unexpected, marked elevation of Class II antigens with abnormal localization in the mucosa and lamina propria. This ectopic expression was not seen in any portion of the small or large bowel of patients who did not have Hirschsprung's disease. Furthermore, proximal normal colon of children with Hirschsprung's disease failed to show increased expression of Class II antigen. In an attempt to better define the effector arm at a cellular level, the distribution of helper T cells (CD4+), cytotoxic/suppressor T cells (CD8+) and natural killer cells (NK; CD16+) was examined in 5 cases. In Hirschsprung's disease, rectal infiltration of CD8+ and CD16+ cells was found, but not CD4+ cells. Ectopic expression of Class II antigen with increased numbers of rectal T cells and NK cells suggested that an early immunologic event may be causal in Hirschsprung's disease.

Human müllerian inhibiting substance inhibits tumor growth in vitro and in vivo

Müllerian inhibiting substance (MIS) causes regression of the müllerian duct in the male fetus. Bovine MIS has been reported to inhibit the growth of some gynecological tumors. Recombinant human MIS (rhMIS) produced in transfected Chinese hamster ovary cells has been highly purified by immunoaffinity chromatography. The introduction of a salt wash prior to elution of MIS from the affinity column removes a growth-stimulating factor(s) derived from Chinese hamster ovary cells. This immunopurified rhMIS caused significant inhibition (34-59% survival) of A431 (a vulvar epidermoid carcinoma), HT-3 (a cervical carcinoma), HEC-1-A (an endometrial adenocarcinoma), NIH:OVCAR-3 (an ovarian adenocarcinoma), and OM431 (an ocular melanoma) human cell lines in colony inhibition assays. Two cell lines, Hep 3B (a hepatocellular carcinoma) and RT4 (a bladder transitional cell papilloma), were unresponsive to immunopurified rhMIS. Using an in vivo subrenal capsule assay in irradiated CD-1 mice, the growth of A431 and OM431 cells was inhibited by immunopurified rhMIS. We conclude that rhMIS inhibits the growth of certain tumor cell lines in vitro and in vivo.

Mullerian inhibiting substance ontogeny and its modulation by follicle-stimulating hormone in the rat testes

Mullerian Inhibiting Substance (MIS) production in rat testes from the late fetal to the adult period and its modulation by gonadotropins in neonatal testes were studied using immunohistochemistry, northern analysis, and a graded organ culture bioassay for MIS. The intense immunohistochemical staining for MIS seen in fetal and newborn testes began to decrease gradually after the third postnatal day, then decreased dramatically on the fifth postnatal day. MIS immunohistochemical activity was then present at a low level until about the 20th postnatal day, after which it was barely detectable. The testes from rats treated with FSH at birth showed a considerable drop in MIS immunohistochemical activity on the third postnatal day to 29% of control testes, and a less profound decrease on the second and fourth postnatal days to 46% and 61% of control, respectively; thereafter MIS levels were the same in treated and untreated animals. With shorter courses of FSH treatment, immunohistochemical staining showed less depression of MIS on the third day, and no difference by the fourth postnatal day, indicating that the inhibitory effect on testicular MIS production may require continued FSH exposure. Three-day testes that had been treated with FSH for 2-1/2 days had less MIS messenger RNA compared to control testes of the same age, suggesting that the inhibitory effect of FSH on MIS production could be transcriptionally mediated. In contrast LH treatment produced no difference in either messenger RNA expression or immunohistochemical staining for MIS. These findings suggested that FSH may be a modulator of MIS production in neonatal testes.

Sex-specific fetal lung development and müllerian inhibiting substance

Male neonates develop respiratory distress syndrome (RDS) with a greater incidence and mortality than do female neonates; the cause of this male disadvantage remains obscure. Male fetuses are exposed to higher levels of androgens and Müllerian inhibiting substance (MIS). Androgens have been shown to inhibit fetal lung maturation, and recent evidence in vitro indicates that MIS, a Sertoli cell-derived glycoprotein made early in ontogeny of the testis, may also inhibit lung development. To study whether this fetal regressor might inhibit maturation of the fetal lung in vivo, we injected human recombinant MIS (rMIS) into fetal rats, measured serum levels of rMIS using an enzyme-linked immunosorbent assay, and analyzed fetal lung tissue histologically and for protein, glycogen, DNA, and disaturated phosphatidylcholine content. Peak serum levels of recombinant MIS were measured at 6 h, with an apparent elimination half-life of 3 h, and without leakage into adjacent littermates injected with vehicle alone. Female fetal rat lung tissue exposed to recombinant MIS (10(-9) M, 10(-8) M) revealed depressed disaturated phosphatidylcholine content both 48 and 72 h after injection compared with female vehicle-injected littermates. Male lungs of the same gestational age appeared inhibited at a higher (10(-8) M) rMIS dose. These inhibitory effects observed in vivo confirm those previously seen in vitro and suggest that MIS, as well as androgens, may play a causative or important ancillary role in the sexual dimorphism that characterizes the neonatal respiratory distress syndrome.

An immunoassay to detect human müllerian inhibiting substance in males and females during normal development

An enzyme-linked immunosorbent assay has been developed to measure human Müllerian inhibiting substance (MIS) in biological fluids. The enzyme-linked immunosorbent assay is specific for MIS, with a sensitivity in human serum to 0.5 ng/ml and does not recognize transforming growth factor-beta 1 or -beta 2, LH, or FSH. It similarly fails to recognize other proteins secreted from the cell type into which the MIS gene was cloned. MIS was detected in the serum of normal newborns, infants, children, and adults. In males the serum level of MIS is 10-70 ng/mL at birth. The level increases slightly after birth, and then decreases to a basal level of 2-5 ng/mL after the first 10 yr of life. Newborn male urine contains minimal amounts of MIS (0.5 ng/mL). In females MIS is barely detectable in serum at birth, but rises to the basal level equal to that seen in males after 10 yr of age. Similar basal levels of MIS were found in adult ovarian follicular fluid. MIS levels were high in the serum of a female patient with a sex cord tumor (3200 ng/mL), but fell to 100 ng/mL after multiple excisional operations. In addition, a serum MIS level of 20 ng/mL was detected in a patient with an ovarian granulosa cell tumor. A sensitive assay for MIS could be useful in the diagnosis of patients with congenital abnormalities of sexual development and patients with Sertoli cell and/or other MIS-producing neoplasms. Other applications may also be recognized as the biology of MIS in both males and females is further elucidated.

Müllerian inhibiting substance is present in testes of dogs with persistent müllerian duct syndrome

Breeding studies in a strain of miniature schnauzer dogs with Persistent Müllerian Duct Syndrome (PMDS) indicate this syndrome is inherited as an autosomal recessive trait, as it is in man. Testes of neonatal dogs affected with PMDS and normal male littermates were examined for Müllerian Inhibiting Substance (MIS) production by immunohistochemistry and bioassay. MIS immunoactivity was detected in Sertoli cells of normal and affected pups using an avidin-biotin complex-enhanced method. Rat embryonic Müllerian ducts regressed when cocultured with testis fragments of both normal and affected pups in a graded organ culture bioassay, demonstrating that the MIS produced was bioactive. These findings indicate that Müllerian duct persistence in affected dogs is not due to a mutation in the structural gene for MIS, but rather, by inference, to a failure of response to MIS at the receptor level.

Mullerian inhibiting substance in the adult rat ovary during various stages of the estrous cycle

Mullerian inhibiting substance (MIS) in the adult rat ovary can be detected by immunohistochemistry in the granulosa cells of growing preantral follicles and in the cumulus oophorus and periluminal granulosa cells of antral follicles in estrus, metestrus, diestrus, and proestrus. Neither the corpus luteum nor atreitic follicles stained for MIS. During proestrus, dramatic changes occurred in the large preovulatory antral follicles, which early in the day manifest intense MIS-specific staining in the granulosa cells located close to the oocyte, however, at 2300 h, just before ovulation when the germinal vesicle was extruded to indicate resumed meiotic division, MIS staining waned. When the morphology of the late preovulatory stage was created experimentally in 26-day-old immature ovaries by stimulating 48 h earlier with hCG, the intense staining of the granulosa cells surrounding the oocytes from untreated ovaries was lost in the cumulus cells of such hCG-treated animals. This temporal pattern of MIS staining and the prior demonstration that MIS could inhibit in vitro meiosis of oocytes from untreated immature rats suggest that this regressor, well characterized in the fetal testis, might function in the ovary as a regulator of oocyte maturation and follicular development during the adult reproductive cycle.

Minimal antiproliferative effect of recombinant müllerian inhibiting substance on gynecological tumor cell lines and tumor explants

Múllerian Inhibiting Substance (MIS) is a testicular hormone that promotes involution of the Múllerian duct during embryogenesis. The Múllerian duct gives rise to adult female reproductive ducts including the fallopian tubes, uterus, and upper vagina. Thus, testicular MIS ensures the regression of female sex organ primordia. Partially purified bovine MIS was reported to inhibit proliferation of tumor cells derived from human gynecological cancers. These observations suggest that MIS might be an effective anticancer agent for some human tumors. Recombinant human MIS (rHu-MIS) has recently become available. To assess the antiproliferative activity of rHu-MIS, we examined its effects on 11 ovarian, six endometrial, and two nongynecological human tumor cell lines. rHu-MIS had no effect on proliferation of these cell lines in five independent assays. Forty-three primary human tumor explants were also examined in human tumor colony forming assays, gel-supported primary culture assays, and subrenal capsule assays. rHu-MIS significantly inhibited the growth of five of these tumors including four ovarian and one small cell lung cancer explant. The four ovarian cancer responses include three of 13 (23%) explants tested in human tumor colony-forming assays and one of eight (12.5%) explants tested in gel-supported primary culture assays. We conclude that rHu-MIS may have antiproliferative activity against some human ovarian cancers.

Correlation of fetal kidney and testis congenic graft survival with reduced major histocompatibility complex burden

Prolonged survival was enjoyed by fetal and postnatal testis and midgestational renal grafts transplanted beneath the renal capsule of adult congenic mice, confirming previous findings in nonimmunosuppressed outbred rats (3,5). The strategies that enable immature tissues to escape rejection in a graft survival assay were studied by comparing expression of major histocompatibility class I and class II protein and messenger ribonucleic acid (mRNA) in each tissue at different ages. In general, graft survival was best when class I and II expression was low. After transplantation, surviving kidney and testis grafts both showed marked induction of class I and II mRNA measured using donor and recipient-specific oligonucleotide probes. Immunohistochemically detected protein of both classes, however, could not be found in the kidney and was minimal in the testis. Fetal tissues appear to express lower levels of protein and mRNA--and, although invading lymphocytes may induce expression of class I and II mRNA after transplantation, protein was not inducible. The failure of these tissues to express significant levels of transplantation antigens may explain the prolonged survival of these immature grafts.

Cellular localization of müllerian inhibiting substance in the developing rat ovary

The ontogeny of Müllerian Inhibiting Substance (MIS) production was studied in the immature developing rat ovary using immunohistochemistry and bioassay. In a graded organ culture assay, in which regression of the Müllerian duct of the 14 1/2-day rat fetus was used as a measure of bioactivity, MIS could not be detected in ovarian fragments from fetal rats. After birth, however, MIS bioactivity first became detectable at 4 days of age. Fragments from ovaries of rats 7 days of age and older contained moderate levels of MIS activity which remained detectable throughout the prepubertal period, although extreme individual variability was characteristic. A rabbit polyclonal antibody against human recombinant MIS was used to localize MIS in rat ovarian tissue. Avidin-biotin enhanced immunoperoxidase staining could not detect MIS in the 15-day fetal or 1 day postnatal ovary, where no follicular growth was noticed. In ovaries from rats 1 week or older, where follicular growth was apparent, MIS could be localized specifically and exclusively in the cytoplasm of granulosa cells. MIS was found more in the innermost layers of granulosa cells than in the peripheral layers in preantral follicles. In antral follicles, MIS was found predominantly in the cumulus oophorus cells and periantral cells. In these developing ovaries, MIS could not be found in follicles with features of atresia.

Stainless steel mesh supports high density cell growth and production of recombinant müllerian inhibiting substances

Stainless steel mesh supported the high density growth of anchorage dependent CHO fibroblasts without the use of a special culture system. CHO cells, designated B-9, containing an amplified genomic construct of the human gene for Müllerian Inhibiting Substance (MIS), grew to a high confluent density on stainless steel meshwork while producing substantial amounts of human recombinant MIS over a long period of time. The mesh could be easily coated with various extracellular matrix proteins, such as Laminin, Fibronectin, Collagen or Matrigel, which permitted the testing of the effects of surface modifications on cell yield and recombinant protein production. Since the amount of medium per surface area required for optimal cell growth is lower than for some large volume cell culture methods, media costs can be reduced using mesh. In addition, no special cell culture equipment or complex manipulations are required. Thus, the use of meshwork for anchorage-dependent cells can increase the efficiency of growth and decrease the cost of recombinant protein production.

Recombinant human müllerian inhibiting substance inhibits epidermal growth factor receptor tyrosine kinase

Autophosphorylation of the epidermal growth factor (EGF) receptor in A-431 cells and plasma membrane fractions was inhibited by partially purified recombinant human Müllerian Inhibiting Substance (MIS). Immunoprecipitation of the EFG receptor using anti-EGF receptor or anti-phosphotyrosine antibodies, and phosphoamino acid analysis of this receptor, demonstrated that MIS specifically inhibited EGF-induced tyrosine phosphorylation. Inhibition of EGF receptor autophosphorylation by MIS in membrane preparations was not affected by increasing concentrations of EGF, manganese or [gamma-(32)P] ATP. Thus, it is unlikely that MIS competes for EGF binding sites or sequesters substrate. Immunoabsorption of MIS with anti-human MIS antibody blocked the MIS inhibition of EGF receptor autophosphorylation, indicating that the inhibition was due to MIS. Our data suggest that MIS regulates the activity of the EGF receptor tyrosine kinase in A-431 cells.

Proteolytic processing of mullerian inhibiting substance produces a transforming growth factor-beta-like fragment

Mullerian inhibiting substance (MIS) is a differentiation factor that causes the Mullerian duct to regress during the development of the male reproductive tract. The active form is a disulfide-linked dimer consisting of two identical 70-kDa subunits. Recently, the amino acid sequence for MIS was deduced from its gene sequence and revealed that the carboxyl-terminal region shares homology with transforming growth factor (TGF)-beta. Since TGF-beta is produced as a large latent precursor that requires proteolytic activation for activity, we sought to determine if MIS might undergo a similar processing event. Here we demonstrate that typically 5 to 20% of the protein in MIS preparations is cleaved at a site 109 amino acids from the carboxyl terminus. Concurrent cleavages from both chains of the MIS dimer produces a 25-kDa TGF-beta-like fragment and a high molecular mass complex derived from the amino terminus of the protein. Although the two fragments are noncovalently linked, they remain tightly associated after cleavage, and thus are structurally organized like TGF-beta within its precursor. The same cleavage products also can be generated by limited proteolysis with plasmin, which provides a simple method for converting the entire preparation into the cleaved form. The plasmin-digested MIS is fully active in the organ culture assay.

Müllerian inhibiting substance depresses accumulation in vitro of disaturated phosphatidylcholine in fetal rat lung

Respiratory distress syndrome and associated pulmonary surfactant deficiency are more common in male neonates. Androgens have been shown to depress surfactant production. We tested the hypothesis that müllerian inhibiting substance, another fetal testicular product, might inhibit lung maturation measured as disaturated phosphatidylcholine accumulation. Initially, female fetal rat lungs were incubated with fetal testis or ovary or nanomolar concentrations of bovine müllerian inhibiting substance. Cultured lungs produced less disaturated phosphatidylcholine after incubation for 5 days with either testis (p = 0.012) or müllerian inhibiting substance than after coculture with ovary. In more comprehensive experiments, female lung fragments of 17.5 days' gestation, when incubated with nanomolar concentrations of bovine müllerian inhibiting substance or picomolar concentrations of human recombinant müllerian inhibiting substance, showed significant suppression of disaturated phosphatidylcholine accumulation (p less than 0.004) when compared with incubation with vehicle buffer. The suppression of surfactant accumulation produced in vitro by müllerian inhibiting substance, a potent male-specific fetal regressor, may be a factor in the increased susceptibility of male infants to respiratory distress syndrome.

Human recombinant mullerian inhibiting substance inhibition of rat oocyte meiosis is reversed by epidermal growth factor in vitro

Mullerian inhibiting substance (MIS), a glycoprotein responsible for the regression of Mullerian duct in the male mammalian embryo, was recently localized not only in the fetal and newborn testis, but also in the older ovary throughout reproductive life. Bovine MIS purified from newborn testicular tissue inhibited spontaneous oocyte meiosis in vitro in the rat. These studies show that partially purified recombinant MIS produced from a human MIS genomic construct caused inhibition of oocyte meiosis, but when purified to homogeneity, the effect was lost. Addition of low concentrations of the detergent Nonidet P-40, used to maintain stability in the purified bovine preparations, however, restored the MIS inhibitory effect to the human preparation, which could, in turn, be blocked by a polyclonal antibody raised to human recombinant MIS; Nonidet P-40 itself caused no inhibition. Since we have shown that epidermal growth factor (EGF) and MIS are antagonistic in a number of other systems, we tested the effect of EGF on the ability of MIS to inhibit oocyte meiosis. EGF added to the medium at a dose that caused no effect on oocytes (25 ng/ml) blocked the MIS inhibitory action on spontaneous rat oocyte meiosis, while EGF had no effect on a known oocyte meiosis inhibitor, 3-isobutyl-1-methylxanthine. These data indicate that human recombinant MIS can inhibit oocyte meiosis in the ovary and that its regulatory effect can be modulated by EGF, which appears to be an antagonist of MIS.

Neoseminal vesicle created from retained mullerian duct to preserve the vas in male infants

Patients with retained mullerian ducts who have a predominantly male phenotype must undergo removal of the mullerian structure in addition to preservation of male structures. Often the vas conjoins with the vaginal wall. Whereas formerly we divided the vas from the mullerian structures, we now attempt to preserve the vas to maintain as much testicular function as possible by creation of a neoseminal vesicle. This procedure can be done separately or can accompany hypospadias reconstruction.

Imperforate anus with long but apparent low fistula in females

Despite the low entry of the rectum into the vagina in some females with imperforate anus, the fistula may be deceivingly long. This variation should alert the surgeon to measure the fistula prior to anoplasty. During surgery, biopsies of the mobilized segment should also be done to assure that cloacal-transitional lined structures have been removed and rectal mucosa anastamosed to the perineum.

Fetal and postnatal testis shows immunoprivilege as donor tissue

We evaluated the immunogenicity of the testis by transplanting adult, postnatal, and fetal rat testicular tissue into outbred adult female and male rats for 10 days. Testis grafts were evaluated morphometrically and histologically, and selectively compared to renal grafts previously reported in part. Testis grafts from days 15 to 21 of gestation, and from three, nine, 12 and 15 days after birth showed an overall increase in growth, with maintenance of architecture and minimal lymphocytic infiltrate. In contrast, only fetal renal tissue from days 15 to 17 demonstrated an increase in growth with maintenance of architecture and minimal lymphocytic infiltrate; grafts from later in gestation grew only slightly and showed progressive deterioration in architecture with an increasing lymphocytic infiltrate. Fifteen day fetal testis grafts were also implanted for longer intervals up to 45 days. The fetal testis grafts implanted for 20 and 30 days showed an increase in size with maintenance of architecture and minimal lymphocytic infiltrate. The observed fetal and postnatal testis growth in the non-immunosuppressed adult host makes compelling further studies directed at determining those factors contributing to the decreased immunogenicity of this organ.

Müllerian inhibiting substance in sex-reversed dogs

In normal males, Müllerian Inhibiting Substance (MIS), produced by testes during an embryonic critical period, is thought to induce regression of the Müllerian duct system, including the oviducts and uterus. In XX sex-reversed dogs, an apparent contradiction has been reported: The uterus persists in the presence of testes or ovotestes. The objective of this study is to determine whether testes of XX male and ovotestes of true hermaphrodite dogs produce MIS, and to examine the anatomy of Müllerian duct derivatives of affected dogs for evidence of regression. Gonadal samples were tested for MIS activity in a bioassay. The mean MIS activity score of XX males was similar to that of normal XY males and significantly greater than that of normal XX females. The mean MIS activity score of XX true hermaphrodites was intermediate between normal XX females and XY males. Within the true hermaphrodite group, ovotestes in which the proportion of testicular tissue was greater than or equal to 1/2 had higher MIS scores than those in which the proportion of testicular tissue was less than 1/2. XX males had a well-developed epididymis adjacent to each testis, but no oviducts. In true hermaphrodites, the oviduct regressed and an epididymis was present when greater than or equal to 1/2 of the adjacent ovotestis was testicular, and MIS activity in that gonad was high. A few ovotestes with intermediate levels of MIS activity had both an oviduct and an epididymis. Regression of the oviductal portion of the Müllerian duct system was positively correlated to the amount of testicular tissue and the MIS activity of the gonad, as would be predicted by Jost's original hypothesis.(ABSTRACT TRUNCATED AT 250 WORDS)

The diagnosis and treatment of infants with intersex abnormalities

Management of these children, which begins in the newborn period and often extends throughout adolescence, should be done as a team approach with pediatric surgeons/urologists and pediatric endocrinologists. Careful attention must be paid to the technical aspects of these repair to ensure successful anatomic, functional, and psychological outcome for these often difficult patients. Although this article concentrates on the technical aspects of the surgical repairs of these children, careful consideration is given to the circumstances dictating gender assignment and the factors that affect the choice and timing of operation.

Complications of vaginal atresia in association with a duplicated mullerian duct

A mullerian duct duplication with a vaginal atresia can present as a painful abdominal mass in a female caused by a hematometrocolpos and a hemosalpinx. This set of signs and symptoms, if caused by an associated unilateral vaginal atresia, may be found in a female with normal menstrual periods, and (1) can be misdiagnosed with often tragic consequences caused by unnecessary salpingectomy, or even hysterectomy; (2) can be successfully treated by creating an adequate channel for drainage through the area of vaginal atresia; and (3) has a high association with unilateral renal agenesis. Because of this last point, recognition of either a mullerian duct duplication or unilateral renal agenesis should prompt an investigation for the other abnormality.

Liver regeneration during immunosuppression

As a preface to studies on the feasibility of liver segment transplantation, we studied the course of liver regeneration in immunosuppressed rats. Partial hepatectomies were performed in young adult male rats who were then treated with daily cyclosporine, dexamethasone, the combination of both agents, or vehicle. Body weight, liver weight, and liver DNA content were measured in subgroups of rats studied at various times after partial hepatectomy. All treated animals experienced weight loss, a phenomenon most marked in animals treated with both dexamethasone and cyclosporine. The DNA content of regenerating liver increased initially after partial hepatectomy in all animals. Restoring their original hepatic DNA in a fashion indistinguishable from controls, animals treated with cyclosporine increased liver DNA four fold within the first six days after partial hepatectomy. Animals treated with dexamethasone and both dexamethasone and cyclosporine increased their complement of liver DNA 2.5 fold, to 80% of that originally present. After day 6, the combined cyclosporine and dexamethasone treatment group became extremely catabolic and experienced a sharp decline in liver DNA. We conclude that despite the deleterious effects of cyclosporine and dexamethasone, especially in combination, on weight gain following partial hepatectomy, these agents do not prevent DNA synthesis and the accretion of new liver mass. We are encouraged by these studies to proceed with experimental studies on the normal growth and repair of liver segments transplanted into an immunosuppressed host.

Müllerian inhibiting substance blocks autophosphorylation of the EGF receptor by inhibiting tyrosine kinase

The fetal regressor Müllerian inhibiting substance (MIS), in concentrations as low as picomolar, inhibited the growth of A-431 cells and the autophosphorylation of its epidermal growth factor (EGF) receptor. The inhibition of membrane phosphorylation was due neither to the reduction of the total number of EGF receptor binding sites, nor to stimulation of intrinsic phosphates, but rather to inhibition of tyrosine kinase activity. MIS control of EGF receptor autophosphorylation by tyrosine kinase may be one mechanism by which Müllerian duct regression in the embryo and the inhibition of A-431 proliferation is initiated. In addition, MIS as an inhibitor of phosphorylation may furnish a tool to probe the role of membrane phosphorylation in growth control.

Preputial unfurling to correct the buried penis

Recognition of the buried penis is necessary both to ensure its proper management and to avoid performance of a standard circumcision, which can result in penile degloving. We describe a simple technique of unfurling the prepuce which provides adequate functional and cosmetic replacement for the penile shaft skin.

Fetal allograft survival in immunocompetent recipients is age dependent and organ specific

This study explores whether fetal allograft survival is age dependent and organ specific. Fetal rat tissue (renal, gonadal, hepatic) from the third trimester of gestation (days 15-21) was transplanted into 306 outbred adult rats for 10-30 days. Grafts were studied by morphometric and histologic analysis. Ten days after implantation, renal tissue (N = 75) from late gestation (days 19-21) showed no increase in size. In contrast, 17-day fetal grafts (N = 20) grew 6.8 +/- 3.4 times,* while 15-day fetal grafts (N = 28) grew 17.5 +/- 6.1* times. (The symbol "*" indicates p less than 0.05, compared to original size). Twenty days after implantation, these 15-day fetal grafts (N = 20) grew 48.8 +/- 17.7* times. Ten days after grafting, the younger fetal tissue showed excellent maturation of renal elements and no sign of rejection; older fetal grafts had poor renal architecture and a dense lymphocytic infiltrate. The 15-day fetal gonadal tissue (N = 18) showed a moderate 10.6 +/- 3.2* increase in size while the 15-day hepatic grafts (N = 16) were regularly rejected within 10 days. Selected fetal allografts from early in the third trimester can not only survive but can grow and mature in an immunocompetent recipient. This fetal graft growth appears to be both age dependent and organ specific. The use of fetal organs may broaden the potential pool for transplantation. However, further studies are needed to define the ontogeny of graft acceptance.

Müllerian inhibiting substance as oocyte meiosis inhibitor

Müllerian inhibiting substance (MIS) inhibited the resumption of meiosis in both denuded and cumulus cell-enclosed rat oocytes in vitro. Spontaneous germinal vesicle breakdown was prevented in both types of oocytes treated by a purified MIS preparation at protein concentrations of 15 micrograms to 150 pg/ml. The inhibiting effect of MIS on the resumption of meiosis was dose dependent, reversible and cyclic AMP independent. Neither follicular-stimulating hormone, luteinizing hormone, progesterone, estradiol, nor testosterone acted significantly to influence MIS-mediated inhibition of rat oocyte maturation. In contrast, MIS had no influence on meiosis in the mouse, where other protein has been reported to inhibit the cumulus cell-enclosed oocyte in a cyclic AMP-dependent fashion. Thus MIS may be yet another inhibitor of oocyte meiosis, acting in the rat by a mechanism different from those inhibitors known, in the mouse ovary, to exert their effect in a cyclic AMP-dependent manner.

The ontogeny of mullerian inhibiting substance in granulosa cells of the bovine ovarian follicle

Mullerian Inhibiting Substance (MIS) previously detected in the Sertoli cells of the calf testis has been localized in the granulosa cells of the ovarian Graafian follicle by using an immunoperoxidase technique and a monoclonal antibody (IG8) to MIS that almost completely blocks its biological activity. The immunoperoxidase technique (avidin-biotin complex method) demonstrated specific localization of MIS in the cytoplasm of the ovarian granulosa cells in the bovine Graafian follicles over a wide age span, i.e. one day, one week, three months, two-and-a-half years and five years. The presence of MIS in the ovary implies a function that is as yet unknown.

Sertoli cell production of müllerian inhibiting substance in vitro

Sertoli cell cultures were monitored for müllerian inhibiting substance with a solid phase radioimmunoassay. Sertoli cells from newborn calf testes were placed in defined media free of serum in monolayer culture after treatment with trypsin-collagenase followed by gravity separation. Immunoreactive müllerian inhibiting substance was detected in the culture media of Sertoli cells but not National Institutes of Health 3T3 cells. To verify that the Sertoli cells were intact, cyclic adenosine monophosphate levels were determined after follicle-stimulating hormone stimulation. Cyclic adenosine monophosphate levels were elevated in Sertoli cells but not National Institutes of Health 3T3 cells. The newborn calf Sertoli cell culture provides a useful system in which to study factors affecting müllerian inhibiting substance production and release, and documents this substance as another reliable marker for the Sertoli cell. Müllerian inhibiting substance levels also could be measured in media beneath testicular fragments in organ culture, and were increased and prolonged in comparison to müllerian inhibiting substance release from Sertoli cell monolayer cultures. Modulation of müllerian inhibiting substance release from monolayer and organ cultures then was attempted. Neither gonadotropin nor steroid additions affected the release of müllerian inhibiting substance during 24 to 72 hours in organ or tissue culture. We are using the müllerian inhibiting substance radioimmunoassay to monitor attempts to immortalize a Sertoli cell line capable of continuous müllerian inhibiting substance production using viral deoxyribonucleic acid transfection techniques.

Can fetal and newborn allografts survive in an immunocompetent host?

This study explores methods of prolonging allograft survival by varying the ontogeny of the donor tissue (fetal, newborn, and adult), and the recipient (newborn and adult) in a series of outbred Sprague-Dawley rats. Allografts of renal or adrenal tissue (1 mm2) were implanted under the renal capsule of the recipient animal. Six experimental groups were constructed with the adult as the recipient in the first three, and four-to six-day-old newborn rat pups in the last three groups. A total of 212 animals were grafted and the animals were killed between 7 and 83 days later, and we carried out morphometric and histologic analyses of all grafts. In Group I (adult donor----adult host), all 17 grafts implanted for ten days or longer were completely rejected. In Group II, newborn tissue was implanted into 23 adults. By nine days after implantation, 17 grafts were fully rejected and the average graft had decreased in size by 68% +/- 78.7% (P less than .05 compared with their initial size). In contrast, when fetal renal or adrenal grafts were implanted into 93 adults (Group III) we saw a 17.6 +/- 9.7 fold increase in graft size when recipients were killed at least 7 days after implantation (P less than .05 compared with their initial size). When we used the newborn as a recipient, we found that all 20 adult grafts (Group IV) were rejected within 10 days. When newborn tissue was implanted into 15 newborns (Group V) all 15 animals rejected their grafts within ten days.(ABSTRACT TRUNCATED AT 250 WORDS)

Primary genitourinary tuberculosis: rapid progression and tissue destruction during treatment

We report a case of primary genitourinary tuberculosis associated with severe progressive scarring, and obstruction of the left collecting system and proximal ureter, a contracted bladder with persistent vesicoureteral reflux and a bulbar urethral stricture. Scarring commenced soon after initiation of medical therapy, and resulted in left nephrectomy and reconstruction with colocystoplasty, right ureteral reimplantation and urethroplasty. The rapidity of disease progression and severity of tissue destruction in this case suggest that patients with genitourinary tuberculosis require close supervision starting at initiation of drug treatment. When complications do arise appropriate surgical intervention may become mandatory to decrease morbidity and to conserve renal function. The pathophysiology, clinical manifestations, radiological findings and treatment of genitourinary tuberculosis are reviewed.

Acetylcholinesterase and manometry in the diagnosis of the constipated child

We studied 309 constipated infants and children who underwent rectal manometry (n = 261) and/or punch rectal biopsy, in which acetylcholinesterase histochemistry (n = 124) was compared with routine histologic examination (n = 93) for diagnostic accuracy. A 99% diagnostic accuracy was achieved with acetylcholinesterase histochemistry compared with 61% accuracy with routine hematoxylin-eosin staining on punch rectal biopsy. We recommend screening cooperative, quiet patients with rectal manometry. Most patients with abnormal manometric studies or those on whom manometry cannot be performed should have superficial punch biopsy (except those ill infants who require urgent operative intervention). This plan of management provides the least invasive but the most accurate evaluation of the constipated child. Deep rectal biopsy can be avoided except in the very rare child with hypoganglionosis or "skip-area" aganglionosis, which can be detected by manometry.

Detection of Müllerian inhibiting substance in biological samples by a solid phase sandwich radioimmunoassay

Müllerian inhibiting substance (MIS) is a 140,000-dalton glycoprotein responsible for regression of Müllerian ducts in a male embryo. It has recently been demonstrated that MIS inhibits the growth of tumors in vivo and in vitro. In this study, we have constructed a sensitive, solid phase sandwich RIA using monoclonal antibodies raised to bovine MIS. The amount of MIS detected was based on the protein concentration of Green 3, the most purified fraction of MIS available. The assay could detect 20 ng Green 3 or 0.14 pmol in physiological samples. There was no evidence of cross-reactivity of the antibodies raised to bovine MIS with chicken, rat, mouse, or human MIS.

Mullerian inhibiting substance: a fetal hormone with surgical implications

Mullerian Inhibiting Substance (MIS) is secreted from the fetal (and postnatal) testis and is known to cause regression of the Mullerian ducts, the anlage of the fallopian tubes, uterus and upper vagina. It is a large glycoprotein hormone, the action of which appears to be modulated by sex steroids: mainly testosterone in mammals and oestrogen in birds. Recent evidence has raised the possibility that its action may be to diminish cell surface phosphorylation and thereby change the direction of differentiation of the Mullerian duct towards regression. Other suspected functions for MIS include control of testicular descent and inhibition of malignant tumours of the female genital tract.

Mullerian inhibiting substance reduction of colony growth of human gynecologic cancers in a stem cell assay

Mullerian Inhibiting Substance (MIS), a fetal testicular product that causes regression of the Mullerian duct in the male mammalian embryo, was evaluated for its antitumor effect on the premise that a substance active against this genital precursor in the fetus might also be active against tumors derived from these tissues. Increasingly pure fractions of biologically active MIS, prepared from newborn calf testes, were tested in the soft agar colony inhibition assay against single cell suspensions of fresh tumors derived in ascitic or solid form from patients with gynecologic malignancies. Twenty-eight tumor specimens placed in soft agar culture have provided sufficient growth to assess an MIS effect. Twenty-five of these 28 tumors showed significant colony inhibition after incubation with MIS. Increased antitumor response correlated with increased purification of MIS when the same tumor was treated with preparations of different purity. Samples obtained from the same patient at different times, from both ascites and solid tumor sources, produced nearly identical responses to MIS. MIS preparations, previously shown to be active in microcytotoxicity and colony inhibition assays against established human ovarian and endometrial carcinoma lines demonstrate consistent antitumor activity against fresh human gynecologic cancers removed at surgery.

The effect of fibronectin on cholinergic differentiation of the fetal colon

In an effort to determine the factors which affect cholinergic development after completion of migration of neural crest cells to the colon, the extracellular matrix constituents, fibronectin, collagen IV, laminin, and heparan sulfate were studied during this later postmigration stage of differentiation. Distal colons of the 14 1/2 day embryo rat were incubated in vitro with antibodies to the above constituents or with fibronectin alone. Cholinergic function of the colon was assessed by acetylcholinesterase staining and choline acetyltransferase activity. When 100 micrograms/mL of fibronectin was added to the medium, the choline acetyltransferase activity was enhanced; when antibody to fibronectin (50 or 100 micrograms/mL) was added, acetylcholinesterase staining and choline acetyltransferase activity were inhibited. Addition of anti-laminin, anti-collagen IV, or anti-heparan sulfate did not affect either acetylcholinesterase staining or choline acetyltransferase activity. Fibronectin may be an important factor in cholinergic differentiation of the enteric nervous system during the postmigration stage of development.

Steroid modulation of Mullerian duct regression in the chick embryo

The recent demonstrations that Mullerian inhibiting substance (MIS) is present in embryonic chick ovaries (P. K. Hutson, H. Ikawa, and P. K. Donahoe (1981). J. Pediatr. Surg. 16, 822-827), and that exogenous diethylstilbestrol does not significantly inhibit MIS secretion from feminized testes (Hutson et al. (1982) J. Pediatr. Surg. 17, 953-959), suggest that ovarian estrogens protect the female left Mullerian duct from MIS-induced regression. The possibility exists, however, that ovarian MIS may be inactive. This study was designed to see if interference with estrogen action in ovo would allow MIS to cause regression of the female left Mullerian duct. The "antiestrogens," tamoxifen and LY117018, had little effect on the female Mullerian ducts unless given in high doses or with added testosterone (greater than 0.1 mg). Two compounds known to inhibit estrogen synthesis, aminoglutethimide and 4-hydroxyandrostenedione, had no effect on their own, even in high doses (less than 1.0 mg/egg). However, when administered together (0.5 mg each) there was significant disappearance of the lower ends of both Mullerian ducts. Norethindrone, which has been described recently as an aromatase inhibitor (Y. Osawa, C. Yarborough, and V. Osawa (1982). Science (Washington, D. C.) 215, 1249-1251) caused partial regression of the upper end of the left Mullerian duct as well as complete loss of the lower ends of both ducts in the female. These results suggest that the steroid environment is a critical factor in the response of the Mullerian ducts to MIS, and that estrogen blockage may allow endogenous MIS from the ovary to induce partial regression of the Mullerian ducts in the female chick embryo.

Subrenal capsule assay to test the viability of parenterally delivered müllerian inhibiting substance

Production of bovine müllerian inhibiting substance (MIS) has been increased to allow generation of large quantities of biologically active purified material. The limited MIS previously available allowed only pretreatment of tumors prior to colony inhibition or implanting in nude mice. In preparation for posttransplantation tumor treatment, a subrenal capsule assay, which was first used against human tumors heterotransplanted into nude mice and subsequently against those heterotransplanted into immunocompetent mice, was adapted to determine (1) if MIS preparations could traverse the bloodstream without degradation and (2) the optimal dose required to produce a biologic effect. Urogenital ridges from female 14-day-old rat embryos were transferred atraumatically to small pouches beneath the renal capsule of the immunocompetent male CDF1 mice. The cranial-caudal orientation of the ridge with its müllerian duct was maintained. Over the next 72 hours, the mice were injected via the tail vein with 0.1 mL of an MIS-containing solution over a 100-fold concentration range. After three days, the kidneys were removed and shaved just below the ridge, which was then placed in soft agar for orientation and subsequent serial sectioning. After fixation, dehydration, and paraffin embedding, sections were stained and regression of the müllerian duct was graded and compared according to concentration and number of MIS doses administered. Regression diminished from almost complete (4+) at the highest dose, to minimal (1 to 2+) at 1/100 of that dose. Heat-inactivated and vehicle controls caused no regression of the müllerian ducts.(ABSTRACT TRUNCATED AT 250 WORDS)

Perineal reconstruction in ambiguous genitalia infants raised as females

Sixty-six patients with ambiguous genitalia, representing a combined experience, underwent reconstruction of the perineum to achieve a feminine phenotype. These patients represent four major etiologic groups, adrenogenital syndrome, male pseudohermaphroditism, mixed gonadal dysgenesis, and true hermaphroditism. If the patient is to be raised as a female, the perineum is reconstructed early in the neonatal period by doing a clitoral recession, labial reduction, and vaginal exteriorization. The latter is delayed if the vagina enters the urogenital sinus high, until 2 years. The factors affecting the choice of gender and the details and the timing of the surgical techniques are described.