Narcotic receptor blockade and its effect on the analgesic response to placebo and ibuprofen after oral surgery

The purpose of this study was to evaluate the contribution of endogenous opiates to the analgesic response after treatment with placebo, codeine, and ibuprofen after oral surgery. Eighty-one patients undergoing complicated dental extractions were pretreated with either a placebo or the narcotic antagonist naltrexone 50 mg, 30 minutes before surgery. After surgery, patients self administered one of three possible postsurgical medications, which included placebo, codeine 60 mg, and ibuprofen 400 mg, when their pain reached a moderate or severe intensity. The study was double-blind with the three postsurgical treatments being randomly allocated within each presurgical treatment block. Pain intensity, pain relief, pain half gone, and overall evaluations were assessed for up to 6 hours. Ibuprofen was significantly more efficacious (p < .05) than codeine or placebo for most analgesic measures. The administration of naltrexone before surgery reduced the analgesic response to both placebo and codeine. Pretreatment with naltrexone did not diminish the peak analgesic response to ibuprofen, but surprisingly prolonged (p < .05) the duration of its action. The results suggest that a blockade of endogenous opiates by naltrexone diminished the placebo response, but that naltrexone may prolong ibuprofen analgesia by some unknown mechanism.

Monensin inhibits synthesis of plasma membrane sphingomyelin by blocking transport of ceramide through the Golgi: evidence for two sites of sphingomyelin synthesis in BHK cells

The monovalent cationophore monensin, which is known to interfere with vesicular transport through the Golgi apparatus, inhibits synthesis of sphingomyelin in BHK cells by up to 40%. The monensin-sensitive component of sphingomyelin synthesis appears to be the pool which normally reaches the cell surface since treatment of cells with exogenous sphingomyelinase causes an almost identical loss of sphingomyelin. Monensin causes increases in ceramide and glucosylceramide labelling which together are equivalent to the decrease in sphingomyelin labelling. Monensin also increases synthesis of cholesterol ester, probably due to the decreased delivery of sphingomyelin to the plasma membrane. However, monensin has no effect on resynthesis of plasma membrane sphingomyelin which has been degraded by extracellular sphingomyelinase. The results support the idea that synthesis of sphingomyelin destined for the plasma membrane does not occur in the cis- or medial-Golgi but depends on vesicular transport of ceramide to a second synthesis site which is distal to the medial-Golgi.

Intracellular pH regulation in isolated myocytes from adult rat heart in HCO3(-)-containing and HCO3(-)-free media

1. Using microfluorimetry, intracellular pH, buffering capacity and intracellular pH recovery from intracellular acidosis were determined in isolated adult rat ventricular myocytes, in buffers with and without HCO3-. 2. In nominally HCO3(-)-free media, the intracellular pH was higher than in HCO3(-)-containing media. Buffering capacity at resting intracellular pH and at a pH of about 6.3 was also lower in HCO3(-)-free media. 3. In HCO3(-)-free media, recovery from an acid load after an NH4Cl prepulse was almost completely inhibited by the Na+/H+ antiport activity specific inhibitor ethylisopropyl amiloride. However, in the presence of HCO3-, H+ efflux rate was enhanced, and ethylisopropyl amiloride led to only partial inhibition of H+ efflux. Complete inhibition was achieved only with further addition of the anion-transport inhibitor 4,4'-di-isothiocyanatostilbene-2,2'-disulphonate. 4. Thus, in adult rat ventricular myocytes, recovery from intracellular acidosis in the absence of HCO3- was almost wholly due to Na+/H+ antiport activity. In the more physiological situation with HCO3- present, a third of the recovery from an intracellular acid load was attributed to an additional external Na(+)-dependent di-isothiocyanatostilbene-disulphonate-sensitive H+ efflux.

Effects of brefeldin A on sphingomyelin transport and lipid synthesis in BHK21 cells

1. Addition of brefeldin A (BFA) to BHK cells incubated for 4 h with [3H]acetate led to a 3-4-fold increase in incorporation of label into sphingomyelin, monoglucosylceramide and cholesterol ester compared with untreated controls. There was a similar increase in incorporation of [3H]choline into sphingomyelin. The level of cholesterol ester increased 3-fold when BFA was added to cells labelled to equilibrium with [3H]acetate, but no statistically significant changes in the levels of other lipids were seen. 2. BFA appeared to act by diverting incorporation of acetate into sphingolipids and cholesterol ester at the expense of phosphatidylcholine (decreased by up to 15%), cholesterol (decreased by 30-40%) and triacylglycerol (decreased by 35-50%). 3. Forskolin (100 microM) prevented the changes in labelling induced by 0.25 micrograms of BFA/ml, but in the presence of 1 micrograms of BFA/ml it had no effect on sphingomyelin and triacylglycerol labelling and only partly blocked the effects of BFA on labelling of cholesterol and cholesterol ester. 4. None of the labelled sphingomyelin was degraded in BFA-treated cells which were subsequently exposed to an extracellular sphingomyelinase, showing that all the newly synthesized sphingomyelin remained inside the cells. Determinations of phospholipid phosphorus in unlabelled cells confirmed that, in the presence of BFA, no newly synthesized sphingomyelin was able to reach the cell surface, supporting the idea that sphingomyelin normally depends on vesicular transport for its passage to the plasma membrane. 5. The results are consistent with the hypothesis that cholesterol synthesis and esterification processes in BHK cells are sensitive to the plasma-membrane deficit of sphingomyelin caused by BFA.

Two separate pools of sphingomyelin in BHK cells

In BHK cells labelled to equilibrium with [3H]choline and treated with sphingomyelinase the surface pool of sphingomyelin is degraded very rapidly (half-time 10 min) but the internal pool of sphingomyelin which accounts for about 30% of the total is only degraded slowly (half-time about 80 h) showing that the internal pool does not normally reach the surface. In [3H]choline incorporation experiments the internal pool begins to accumulate radioactivity at about the same time as phosphatidylcholine (30 min) but label does not enter the surface pool of sphingomyelin for a further 90 min. The internal and external pools reach the same specific activity only after about 20 h. Pulse-chase analysis with [3H]choline shows that radioactivity in each pool of sphingomyelin continues to increase when the specific radioactivity of phosphatidylcholine is decreasing, consistent with both pools being synthesised from a phosphatidylcholine precursor. The results suggest that sphingomyelin in BHK cells is present not only in the plasma membrane but also in a more rapidly labelling pool which does not mix with the surface pool.

Isolation of plasma membrane exovesicles from BHK cells using merocyanine 540

Treatment of cultured BHK cells with merocyanine 540 caused the non-lytic release of vesicular material having the phospholipid composition characteristic of plasma membrane. The protein composition of the vesicles closely resembled that of the soluble fraction of the cell, as expected for exovesicles budding from the cell surface. Vesicles prepared from cells surface-iodinated with 125I contained no obvious iodinated membrane polypeptides, suggesting that no major proteins in the plasma membrane of the BHK cell are free to diffuse with lipids. The procedure described should represent a general method, applicable to a wide range of cell types, for isolating plasma membrane vesicles.

Isolation of Mycoplasma pneumoniae from pleural fluid

We describe an unusual case of Mycoplasma pneumoniae infection that presented as a lobar pneumonia and pleural effusion. Mycoplasma pneumoniae was isolated from the pleural fluid of this patient.

Effects of feeder cells on the X-ray sensitivity of human colon cancer cells

The survival responses to 250 kVp X-irradiation of 20 different exponentially growing human colon tumor lines have been described using the linear-quadratic equation of cell survival. Because some of these tumor lines (6/20) showed statistically significant increases in colony forming efficiency (CFE) when feeder cells (FCs) were added (10(5) FCs/60 mm dish), radiation survival parameters were determined for all 20 tumor lines with and without added feeder cells. In neither FC independent nor FC dependent lines did addition of FCs significantly affect any of the derived radiation survival parameters, including the alpha and beta inactivation constants, the mean inactivation dose (D, Gy), or the surviving fraction of cells at 2 Gy (S2). The average alpha, beta, and S2 values for these 20 human colon cancer cell lines with added feeder cells were: 0.281 Gy-1, 0.0711 Gy-2, and 0.443. A cumulative frequency distribution plot of the mean inactivation dose (D) which includes other published radiobiological data on human colon cancer cell lines (N = 26) indicates that the D50 value is 2.17 Gy.

In vitro radiation survival parameters of human colon tumor cells

As part of an ongoing research program in the biology of human colon cancer cells, a database is being generated on the radiation responses of established lines in vitro. In this report, data are summarized on the graded single dose clonogenic survival responses to graded single doses of 250 kVp X rays of 16 exponentially growing lines. These data were analyzed using the linear quadratic (LQ) formalism for X ray inactivation; the 95% confidence limits on the colony forming efficiencies (CFEs), the alpha and beta parameters from the LQ equation, the surviving percentage at 2 Gy, and the mean inactivation dose (D, Gy) are listed herein. The average D from these 16 colon tumor lines was 2.35 Gy (95% confidence limits 2.10-2.60 Gy), which indicates that these tumor cells are of equal radioresistance to melanoma or head and neck cells, with only glioblastoma cells being of greater radioresistance.

Between-lot variability in chromatographic and biochemical properties of hMG

Ten lots of dissociated hMG were characterized by reverse-phase gradient high-performance liquid chromatography. Areas of 12 discrete peaks were directly related to dosages of hMG injected. The lots were further analysed for immunoactive-FSH (41.6-106.2 IU/ampule), immunoactive-LH (11.0-20.4 IU/ampule), bioactive-LH (2.7-17.1 IU/ampule) and bioactive-hMG (149-298 pg E2/mIU immunoactive-FSH/ml). Relationships between integrated areas of the HPLC peaks and biochemical properties of the hMG lots were analysed by stepwise multiple linear regression. Between-lot differences in immunoactive-LH and immunoactive-FSH were related to HPLC peak areas (p less than 0.05); differences in bioactive-LH were not. Areas of 8 peaks were related to differences in bioactive-hMG activity, facilitating close approximation of bioactive-hMG from the derived multi-linear model (p less than 0.001). Rapid characterization of hMG by HPLC is of relevance as recent reports have shown that ovarian responses and pregnancy outcomes of patients are related to the immunoactive and bioactive gonadotropin content of hMG preparations used to induce multiple folliculogenesis before oocyte aspiration, in vitro fertilization, and embryo replacement.

Grouping students for instruction: effects of learning style on achievement and attitudes

The present study examined the effects of matching and mismatching American middle-school students with a preference for learning alone or learning with peers with selected instructional treatments in order to determine the impact upon their attitudes and achievement in social studies. Analysis revealed that the learning-alone preference performed significantly better in the learning-alone condition and that the learning-with-peers preference performed significantly better in the learning-with-peers condition. However, no-preference students also performed significantly better in the learning-alone condition than with peers. In addition, data revealed that the learning-alone and the learning-with-peers students had significantly more positive attitudes when matched with their preferred learning style; the nopreference students had more positive attitudes in the learning-alone condition.

Tris reversibly inhibits secretion of albumin and alpha-1-antitrypsin at different sites

We have investigated the effect of the weak base Tris on the processing and secretion of albumin and alpha-1 antitrypsin by hepatocytes in culture. We show that the secretion of both proteins is 90% inhibited by 30 mM Tris. The post-synthetic processing of both proteins is inhibited to the same extent. These effects are completely reversible. Cell fractionation indicates that albumin accumulates in the Golgi, whereas alpha-1 antitrypsin fails to leave the endoplasmic reticulum.

Effect of human follicular fluids from pregnant and nonpregnant patients on the development of mouse zygotes in vitro

Mouse zygotes were cultured in medium containing follicular fluid from patients who had follicles containing oocytes which fertilized, did not fertilize, or were atretic and who did or did not become pregnant after in vitro fertilization and embryo replacement. The inhibitory effect was least with the follicular fluid from follicles in which the oocytes subsequently fertilized, greater when the oocytes did not fertilize, and most inhibitory when the follicle contained an atretic oocyte. More mouse zygotes developed to blastocysts when culture medium was supplemented with follicular fluid from patients who became pregnant compared to those who did not become pregnant. There was no difference in pregnancy outcome when an oocyte which subsequently fertilized was obtained from the follicle. These results indicate that follicles contain a substance(s) which inhibits mouse zygote development in vitro and that the inhibitory activity is related to the developmental potential of the oocyte in the follicle.

Male germ cell specific sulfogalactoglycerolipid is recognized and degraded by mycoplasmas associated with male infertility

Sulfogalactosylglycerolipid (SGG) is the major mammalian male germ cell glycolipid and has been implicated in sperm/egg binding. Mycoplasma pulmonis, a species of Mollicutes, is associated with male infertility in rodents. Purified SGG incubated in the presence of M. pulmonis was enzymatically degraded by both desulfation and deacylation. Desulfation occurred primarily at alkaline pH, and deacylation also increased with increased pH, indicating that these represent novel enzymatic activities. Digestion was facilitated, but not dependent on, the presence of detergent. Rat spermatozoa exposed to M. pulmonis showed a reduction in SGG content which was particularly marked for cauda (mature) spermatozoa. With the aid of tlc overlay binding procedure, intact M. pulmonis were found to bind specifically to sulfated glycolipids and thus SGG may provide the cell membrane receptor for this organism. The topology of mycoplasma binding to rat sperm was consistent with the known topology of sperm SGG. The reduced binding (and subsequent digestion) of caput spermatozoan SGG correlates with the membrane colocalization of SGG and its endogenous binding protein at this stage. Separation of SGG and its binding protein during epididymal sperm maturation appears to facilitate M. pulmonis binding to and digestion of cauda sperm SGG. The binding and degradation of the sperm SGG by M. pulmonis may play a role in the induction of infertility which follows infection with these organisms by interfering in sperm/egg receptor recognition.

Suboptimal laboratory conditions can affect pregnancy outcome after embryo transfer on day 1 or 2 after insemination in vitro

We have demonstrated that the replacement of pronuclear stage human embryos on the day after insemination in IVF-ET results in a pregnancy rate as good as, if not better than, the rate after ET on day 2. The pregnancy rate appears to be influenced by the culture environment used for the gametes. We would recommend that ET be undertaken as soon as possible after insemination on day 1 so that if suboptimal culture conditions are present, they do not have sufficient time to affect the viability of the embryos and reduce the subsequent chance of pregnancy after replacement. If culture conditions have been optimized there is no difference in pregnancy rate after embryo transfer on day 1 or day 2 and one can then replace embryos on either day and expect the pregnancy rate obtained in either case to be similar.

Responses of patients to different lots of human menopausal gonadotropins during controlled ovarian hyperstimulation

Responses of patients treated with different lots of human menopausal gonadotropin (hMG) during controlled ovarian hyperstimulation were analyzed. Levels of luteinizing hormone (LH) in serum varied between groups of patients treated with different hMG lots, serum follicle-stimulating hormone (FSH) levels did not differ. In the analysis of levels of estradiol (E2) in serum of patients pretreated with leuprolide acetate (gonadotropin-releasing hormone analog; GnRH-a), there was an interaction between hMG lot and day of stimulation. E2 levels/follicle also diverged between hMG batches as ovum pick-up approached. Within the groups of patients pretreated with GnRH-a, serum FSH/LH ratios varied between 5 and 20, with a batch x day interaction. Ongoing pregnancy rates in the hMG-treatment groups ranged between 0/24 and 7/33 (21%).

Tailoring a commercial radioimmunoassay to the range of levels of progesterone occurring in human serum during controlled ovarian hyperstimulation and following embryo/gamete transfer

While the Pantex direct P radioimmunoassay is used widely in programs of assisted conception, its sensitivity and range do not encompass the wide range of levels of P in serum of many patients during COH and through the first trimester of pregnancy. The present communication details minor modifications to the proprietary Pantex assay which accommodate these requirements. The nature of the changes does not compromise the performance characteristics or simplicity of the original assay and facilitates precise, accurate, and rapid measurement of serum P between 0.05 and 1280 ng/ml.

Levels of interleukin-2 receptor in serum of patients during the menstrual cycle and following embryo/gamete transfer

In an attempt to establish whether nidation elicits a measureable systemic immunologic response in vivo, levels of interleukin-2 receptor (IL-2R) have been determined in serum drawn from 34 pregnant patients (IUP) immediately before embryo/gamete transfer, and 7 and 14 days later. For comparison, these same values were determined for 41 subjects who did not conceive, and for 18 who spontaneously aborted (SAB) during the first trimester of gestation. Serum IL-2R values were near 320 U/ml and did not differ between days within outcomes, or within days between outcomes. Furthermore, levels of IL-2R and beta-hCG in serum were not interrelated on days 7 or 14 of pregnancy (SAB or IUP). Serum IL-2R levels did not change during the menstrual cycle. The present results appear to traverse presumptive elements of existing hypotheses of "placental immunotropism."

Gonadotropin and estradiol levels during ovarian stimulation in women treated with leuprolide acetate

Levels of FSH, LH, and estradiol (E2) were measured in the serum of 209 gonadotropin-releasing hormone analogue-treated women and in 202 control subjects during the final 5 days of ovarian stimulation in our in vitro fertilization program. Levels of FSH and E2 in serum of gonadotropin-releasing hormone analogue-treated subjects significantly exceeded control values during the sampling period, whereas LH levels were significantly lower. Concentrations of E2 in serum of gonadotropin-releasing hormone analogue-treated and control subjects were similar when corrected for differences in numbers of follicles aspirated at oocyte retrieval (mean of 8.9 and 7.2 follicles per subject, respectively). Pregnancy rates by diagnostic ultrasound were 18 and 11%, respectively, a statistically significant difference.

Development of mouse embryos cryopreserved by an ultra-rapid method of freezing

High concentrations of cryoprotectant combined with sucrose were utilized in an ultra-rapid freezing protocol for mouse preimplantation embryos. Dimethylsulphoxide (DMSO, 1.5 or 3.5 M) or propanediol (PROH, 1.5 or 3.0 M) combined with 0.25 M sucrose were used as freezing solutions. One-, 2- or 8-cell embryos were placed directly into these solutions at room temperature, loaded into straws and plunged into liquid nitrogen within 2-3 min. The straws were rapidly thawed and the embryos expelled into the solution in which they were frozen for 10 min. The cryoprotectants were then removed by single- or multi-step dilution. Survival and development of the embryos in vitro and in vivo were assessed. DMSO (1.5 M) and both concentrations of PROH were totally inadequate as a cryoprotectant in this freezing protocol. A concentration of 3.5 M DMSO gave high survival and development rates when a multi-step dilution procedure was used, but not with a single-step dilution. One-cell embryos gave 71% survival, 35% in-vitro development and 10% in-vivo viability; 2-cell embryos showed 87% survival, 77% in-vitro development and 66% in-vivo viability; and 8-cell embryos showed 97% survival, 87% in-vitro development and 62% in-vivo viability. The results for the 2- and 8-cell stages compared favourably with non-frozen controls, which had 71% in-vivo viability. This method of cryopreservation is therefore fast and viable.

Pain clinic #12. The use of a self-administration system for oral analgesics on an orthopaedic service

The use of patient-controlled analgesia systems in the postoperative period has become quite popular over the past several years. The systems to date have been limited to analgesics administered intravenously. The purpose of this study was to extend the use of a patient-controlled analgesia system to include oral analgesics during a patient's hospital stay.

The effect of transferring pronuclear embryos on pregnancy outcome after in vitro fertilization

In a prospective clinical trial the pregnancy rate in patients matched for infertility status, degree of hyperstimulation, and number of oocytes recovered was unaffected by whether embryos were transferred while still pronuclear (day 1) or after they had undergone cleavage (day 2). The pregnancy rates per transfer were 27% and 22%, respectively, for the two transfer times. Unlike results of a previous study, no difference was detected in the outcome of pregnancies from the two groups.

Methods used to improve gamete efficiency

Male factor infertility accounts for a significant percentage of problems in infertile couples. With clinical utilization of the technologies for selection of good-quality spermatozoa from the ejaculate, our ability to successfully treat the severely affected male factor couple has improved. However, it must be remembered that even with current technologies, fertilization success is reduced in these patients but remains above a 50% level. Other factors that can be used in the future to improve on these statistics are being investigated in regard to the in vitro environment for gametes, that is, the type of culture medium, the methods of coincubation of the sperm and egg, and other methods of enhancement of sperm fertilizing potential. However, methods of sperm preparation will achieve improvement in a percentage of these males treated, and can be used to improve fertilization and pregnancy success. It is important to understand the limitations of the zona-free hamster test, but it is also important to use that test as a screening method for sperm handling. By utilizing the SPA to select out the optimal method of sperm preparation, the fertilization and pregnancy outcome can be improved. Overall, the live-birth rate in male factor infertile couples is lower than non-male-factor couples treated by IVF and GIFT. Until more is known about basic spermatozoal function, and the ability to improve that function in affected males, the live-birth rate should not be expected to change substantially.

Resynthesis of sphingomyelin from plasma-membrane phosphatidylcholine in BHK cells treated with Staphylococcus aureus sphingomyelinase

About 60-65% of the total sphingomyelin in intact BHK cells is in a readily accessible pool which is rapidly degraded by Staphylococcus aureus sphingomyelinase. No more sphingomyelin is broken down in cells which have been fixed with glutaraldehyde or lysed with streptolysin O, suggesting that all the sphingomyelin which is available to the enzyme is on the cell surface. The inaccessible pool of sphingomyelin does not equilibrate with the plasma-membrane pool, even after prolonged incubation. Experiments using [3H]-choline show that much more phosphocholine is released from the intact cells treated with sphingomyelinase than can be accounted for by breakdown of the original cell-surface pool of sphingomyelin; the excess appears to be a consequence of the breakdown of sphingomyelin newly resynthesized at the expense of a pool of phosphatidylcholine which represents about 8% of total cell phosphatidylcholine and may reside in the plasma membrane. This would be consistent with resynthesis of cell-surface sphingomyelin by the phosphatidylcholine: ceramide phosphocholinetransferase pathway, which has previously been shown to be localized in the plasma membrane. However, in [3H]palmitate-labelled cells there appeared to be no accumulation of the diacylglycerol expected to be produced by this reaction, and no enhanced synthesis of phosphatidate or phosphatidylinositol; instead there was an increased synthesis of triacylglycerol. A similar increase in labelling of triacylglycerol was seen in enzyme-treated cells where the sphingomyelinase was subsequently removed, allowing resynthesis of sphingomyelin which occurred at a rate of about 25% of total sphingomyelin/h. Treatment of BHK cells with sphingomyelinase caused no change in the rates of fluid-phase endocytosis or exocytosis as measured with [3H]inulin.

Interrelationships between plasma hormone levels and the content of total protein, gonadotropins and steroid hormones in antral fluids of women undergoing in vitro fertilization

Follicle development was induced in 41 women with follicle-stimulating hormone (FSH) and human menopausal gonadotropin. Blood samples were drawn and follicular fluids (FF) were aspirated when two or more follicles attained diameters of 15 to 17 mm. Levels of estradiol (E2), progesterone (P), FSH, and luteinizing hormone (LH) were determined in samples by radioimmunoassay, and relationships between the measured parameters in antral fluids and in serum were examined by least-squares linear regression analysis. Levels of LH in serum correlated with LH and FSH levels in FF (P less than 0.005). Concentrations of FSH in serum were positively related to levels of LH, FSH, E2, and total protein in FF (P less than 0.005). E2 levels in serum were predictive of E2 levels in FF only, and levels of P in serum were directly correlated with P levels in FF (P less than 0.05). With respect to the peculiarly broad range of predictions that could be drawn from the FSH content of serum, peripheral FSH provided a better predictive index of the chemical composition of antral fluid than did the level of any other single hormone measured in serum.

Introduction of a porcine growth hormone fusion gene into transgenic pigs promotes growth

Six transgenic pigs have been produced by microinjecting a human metallothionein promoter/porcine growth hormone gene construct into the pronuclei of fertilized eggs which were transferred to synchronized recipient sows. The resulting transgenic animals contained between 0.5 and 15 copies of the gene construct per cell, and at least one of the animals expressed the introduced gene and grew at an increased rate compared to both transgenic and non-transgenic littermates. Some of the transgenic animals that did not appear to grow at increased rates were found to contain rearranged gene sequences. Two of the transgenic pigs have been shown to pass on the introduced genes to their offspring.

Occurrence of a spontaneous luteinizing hormone surge in superovulated cycles--predictive value of serum progesterone

A preovulatory increase in serum progesterone (P) precedes the occurrence of an endogenous luteinizing hormone (LH) surge in a majority of women. This study evaluates whether a single daily measurement of serum P could reliably identify a spontaneous LH surge in women undergoing controlled ovarian hyperstimulation. Eighty-four infertile women received either clomiphene citrate and human menopausal gonadotropin (hMG), or hMG alone. Serum P levels were increased significantly the morning of the day of an endogenous LH surge (P less than 0.01). A 2-fold rise in the serum P levels was associated with a predictability of 64.4% of a LH surge; however, a 4-fold increase in serum P could accurately predict a spontaneous endogenous LH discharge in 93.3% (P less than 0.001) of cases.

An alternate approach to controlled ovarian hyperstimulation in "poor responders": pretreatment with a gonadotropin-releasing hormone analog

Pharmacologic hypophysectomy was induced with a subcutaneous injection of leuprolide acetate before the administration of exogenous gonadotropins for multiple follicle development in 27 women who had previously responded poorly to conventional controlled ovarian hyperstimulation (COH). Pituitary desensitization occurred within 6 days and concurrent COH with exogenous gonadotropins resulted in an enhanced yield of oocytes in comparison to previous COH attempts (P less than 0.05). Fertilization and pregnancy rates also were higher with gonadotropin-releasing hormone agonist (GnRHa) treatment (P less than 0.01). The administration of leuprolide acetate effectively suppressed endogenous gonadotropin secretion when initiated in the follicular or luteal phase of the menstrual cycle. GnRHa therapy can appreciably facilitate the management of gonadotropin therapy, and increase the probability of oocyte collection and pregnancy.

The effect of porcine relaxin on the fertilisation of mouse oocytes in vitro

The mouse in vitro fertilisation (IVF) model was used to investigate the effect of porcine relaxin on fertilisation. Porcine relaxin (10 ng/ml) significantly increased the proportion of oocytes fertilised by suboptimal concentrations of mouse spermatozoa. Pronuclear formation was significantly greater in the presence of relaxin. These findings may have clinical importance in the future for improving the success of IVF procedures, and improving pregnancy rates.

Increased susceptibility to Mycoplasma infection in patients with hypogammaglobulinemia

The incidence and morbidity of Mycoplasma infections were examined in a group of 23 patients with hypogammaglobulinemia. Among this group of patients, 18 had one or more episodes of acute respiratory illness during which Ureaplasma urealyticum, Mycoplasma orale, or Mycoplasma pneumoniae were isolated from sputum. Resolution only followed institution of specific antibiotic therapy and elimination of the Mycoplasma. In addition to respiratory illness, U. urealyticum was isolated from the urine of two patients with urinary tract infection and from an area of cellulitis in another patient. M. pneumoniae was isolated from the joint of a patient with arthritis. In six patients with chronic lung disease, Mycoplasma was frequently isolated and clinical improvement, albeit transient, coincided with negative Mycoplasma culture results. These findings emphasize the unique susceptibility to Mycoplasma infection in patients with hypogammaglobulinemia.

Experience with the cryopreservation of human embryos using the mouse as a model to establish successful techniques

Mouse embryos at the one-, two-, and eight-cell stages have been used to optimize the conditions for cryopreservation of human oocytes and embryos. For storage in glass vials using 1.5 M dimethyl sulfoxide (DMSO) as a cryoprotectant and slow cooling (approximately 0.3 degrees C/min), phosphate-buffered medium was superior to Hepes-buffered medium. Termination of slow cooling at -80 degrees C before transfer to liquid nitrogen with subsequent slow thawing (approximately 8 degrees C/min) resulted in more embryos surviving than when cooling terminated at -40 degrees C and rapid thawing (approximately 500 degrees C/min) was employed. Dilution of DMSO upon thawing with medium containing 0.5 M sucrose gave higher embryo survival rates than a stepwise (0.25 M decrements) dilution. Using these techniques, three pregnancies were established upon the transfer of 11 frozen-thawed embryos to seven patients. Rates of embryo survival using the simpler cryopreservation technique of ice-free vitrification in 0.25-ml straws have been disappointing.

Improved pregnancy rate in human in vitro fertilization with the use of a medium based on the composition of human tubal fluid

Significantly more mouse zygotes developed to blastocysts in culture in a medium formulated on the composition of human tubal fluid (HTF) than in modified Tyrode's medium (T6). In a randomized 2 X 2 factorial trial of human in vitro fertilization that compared the two media and culture under oil versus culture in loosely capped tubes, significantly more clinical pregnancies (30% of 60 transfers) were obtained with HTF medium than with T6 medium (11% of 53 transfers). Decreasing the K+ content of HTF medium to that present in T6 medium significantly decreased the number of mouse zygotes that developed in culture. Modifying Ca++ levels had no effect. It is therefore likely that the higher K+ content in HTF medium is primarily responsible for the superiority of HTF medium over T6 medium, but other differences in the composition of the two media could contribute to the results observed.

Vascular reactivity in the hind limb of the pregnant ewe

The data generated by this study are consistent with the fact that pregnancy and progesterone treatment are associated with an increase in vascular reactivity to phenylephrine and a decrease in reactivity to angiotensin II in the circulation to the hind limb of the ewe. This shows that the way in which vascular reactivity changes during pregnancy is dependent both upon the circulation and the vasoconstrictor being examined. It suggests that sensitivity and contractility could change in opposite directions in this circulation during pregnancy. This will require additional verification, both as to its existence and whether this is an important normal cardiovascular adaptation to pregnancy.

Adrenaline and the development of spontaneous hypertension in rats

The effects of chronic alterations in plasma adrenaline levels, on the development of a raised blood pressure in young spontaneously hypertensive (SHR) rats, have been investigated. Bilateral adrenal demedullation (at 4 weeks) significantly reduced plasma adrenaline levels and attenuated the development of hypertension. Pressor responses to phenylephrine (0.3-10 micrograms, i.v.), measured in the pithed animals 11 weeks after demedullation, were unaffected although neurogenic pressor responses were significantly reduced. Subcutaneous implants of procaterol and salbutamol (0.005 and 0.165 mumol/kg, respectively) restored hypertension development in demedullated rats and significantly enhanced neurogenic pressor responses, while responses to i.v. phenylephrine remained unaltered, in the pithed rats. Implants of adrenaline (0.165 and 0.5 mumol/kg, s.c.) also restored hypertension development. However, pressor responses to phenylephrine were reduced and neurogenic responses only slightly enhanced when compared to those obtained in untreated pithed demedullated rats. The pro-hypertensive effect of adrenaline (0.5 mumol/kg, s.c.) was abolished by treatment with the beta 2-adrenoreceptor selective antagonist ICI 118551 (25 mg/kg/day, p.o.). In the subsequently pithed rats, neurogenic pressor responses were slightly reduced when compared to those in animals treated with adrenaline alone. In control demedullated rats, ICI 118551 had no effect on blood pressure nor on the neurogenic and phenylephrine-induced pressor responses. However, in sham-operated animals, ICI 118551 attenuated the development of hypertension and significantly reduced neurogenic pressor responses in the subsequently pithed rats. Responses to phenylephrine remained unaltered. The results support the suggestion that a beta 2-adrenoreceptor-mediated facilitation of sympathetic neurotransmission may be involved in mediating the pro-hypertensive effects of circulating adrenaline in the SHR rat.