Natural killer cell subpopulations and cytotoxicity for infertile patients undergoing in vitro fertilization

PROBLEM

We evaluated the participation of the lymphocyte subpopulations in the endometrium and peripheral blood on in vitro fertilization and embryo transfer (IVF-ET) outcomes.

METHOD OF STUDY

Peripheral blood samples were analyzed for the expression of CD3, CD4, CD8, CD16, and CD56, using a FACScan, and for natural killer (NK) cell cytotoxicity, using a 51Cr assay. Endometrial samples obtained at a previous phase of the IVF cycle were analyzed for the expression of CD16 and CD56, using a FACScan.

RESULTS

The percentages of CD56+ cells and CD16+CD56+ cells in the peripheral blood on the day of ET were significantly higher in the failed group than in the implanted group. In the endometrial tissue, the increase of the percentage of CD16+CD56dim cells and the decrease of the percentage of CD16-CD56bright cells in the aborted group were significant when compared with the those of the delivered group.

CONCLUSIONS

The increase of cytotoxic NK cells in the peripheral blood and the endometrium may affect the therapeutic results of IVF-ET. It was suggested that modifications of NK cytotoxicity or of NK subpopulations might contribute to the improvements of IVF outcomes.

Elevated circulating levels and cardiac secretion of soluble Fas ligand in patients with congestive heart failure

The circulating levels of soluble Fas ligand was increased in patients with advanced congestive heart failure. This study also indicates that the failing heart may contribute to the increased concentration of soluble Fas ligand in patients with congestive heart failure.

Molecular remodeling of complement regulatory proteins for xenotransplantation

In pig-to-human discordant xenotransplantation, human complement is a major barrier against long survival of xenografts. Human complement regulatory proteins expressed on xenografts have been adapted as safeguards against host-induced hyperacute rejection of xenografts. For successful xenotransplantation, there have been many attempts to generate molecules with potent human complement regulatory activity but without activities related to harmful functions such as infection, immunosuppression and signal transduction devastating cellular homeostasis. Here, we summarize the strategy by which molecules for xenotransplantation should be designed and propose a GPI-anchored form of monomeric human C4bp as a candidate for efficient protection of swine xenografts from human complement attack.

Transfer of a pedicled venous flap containing perivenous areolar tissue and nerve: an experimental study

In this paper, we evaluated experimentally the feasibility of transferring a pedicled venous flap with perivenous areolar tissue into an ectopic site and investigated the role of each vein, the perivenous areolar tissue and nerve in the viability of pedicled venous flaps. Three groups of flaps were created using a rabbit-ear model: Group 1 (n = 11), containing perivenous areolar tissue and a draining vein; Group 2 (n = 10), perivenous areolar tissue, a draining vein and nerve; Group 3 (n = 10), only perivenous areolar tissue. Macroscopic, angiographic and histological assessments were performed 14 days after transfer. The total survival areas including superficial necrosis of Groups 1, 2 and 3 were 52.7%, 82.5% and 0%, respectively. There were significant differences in mean survival area and mean total survival area including superficial necrosis between Group 1 and Group 2 (P < 0.05). In contrast, all flaps in Group 3 became necrotic. These data suggest that a preserved vein is the necessary condition, and additional arterial flow through the preserved nerve and a small vascular network within the areolar tissue may play an important role in flap survival.

Evidence that far-infrared radiation promotes growth of Xenopus laevis

In most ectotherms, environmental temperature has differential effects on growth and differentiation. For example, amphibian size at maturity decreases with increasing temperature. To address how radiant heat in the form of far-infrared radiation (FIR) may affect development of the aquatic ectotherm Xenopus laevis, we continuously irradiated swimming larvae as they developed into young adults. Here we report evidence that FIR promotes growth of these organisms in an aqueous environment.

Effect of mutations at the residues R25, D27, P69, and N70 of B95a-MCP on receptor activities for the measles viruses Nagahata wild-type strain and CAM vaccine strain

Human membrane cofactor protein (MCP, CD46) is a regulator of complement activation and also serves as a receptor for measles virus (MV). We recently isolated an MCP homolog from B95a, an Epstein-Barr virus-transformed marmoset B-lymphoblastoid cell line, which is 76% identical to human-MCP. B95a-MCP acts as an MV receptor for CAM, a vaccine strain of MV, but not for Nagahata, wild-type MV strain. The four residues in human-MCP (Asp27, Lys29, Arg69, and Asp70) are reportedly MV binding sites, and these are changed in B95a-MCP (Glu27, Asp29, Pro69, and Asn70). In the present study, we constructed B95a-MCP mutants by replacing the four residues with those in human-MCP, and tested whether the Chinese hamster ovary (CHO) transfectants expressing B95a-MCP mutants become susceptible to the Nagahata strain. The CHO transfectants expressing B95a-MCP mutants formed syncytium with the CAM strain but not with the Nagahata strain. The binding of the hemagglutinin (H) of MV with B95a-MCP mutants was observed with the CAM strain but not with the Nagahata strain. These results suggest that the failure of B95a-MCP as the MV receptor for the Nagahata strain is not due simply to the natural mutations at these four residues. The critical residues for MV binding in an MCP molecule seem to differ depending upon the structure of the MV H protein.

Reducing multiple pregnancies by restricting the number of embryos transferred to two at the first embryo transfer attempt

Though the multiple pregnancy rate in in-vitro fertilization-embryo transfer must be reduced, strict and uniform regulation of the number of embryos transferred may make it impossible for women with little natural fecundity to carry children. We therefore restricted the number of embryos per transfer. In the first half of the observation period (n = 100), we limited the number of embryos transferred to three regardless of the number of previous transfers. In the second half (n = 137), we strictly regulated the number of embryos transferred to two at the first attempt and three in the second and later attempts. The multiple pregnancy rate per pregnancy was significantly lower (P < 0.005) in the second period (20.4%) than in the first period (52.9%), while the clinical pregnancy rate and the implantation rate per transfer were similar in both observation periods. 60.7% (17/28) of the multiple pregnancies arose from the first embryo transfer attempt, and 17.9% (5/28) of them arose from a second attempt. The 18 multiple pregnancies in the first period involved six sets of triplets, while the 10 multiple pregnancies that arose in the second period all involved twins. The implantation rate per transfer at the first attempt was significantly higher than that at the second or later attempts. The criterion for determining the number of embryos transferred should be simple to minimize errors of judgement. We believe that our method of restricting the numbers of embryos transferred may be one method of reducing multiple pregnancies without eliminating the possibility of having children for women with low fecundity.

Histologic findings in polyacrylamide-coated polytetrafluoroethylene (PTFE) arterial grafts in the rat abdominal aorta

To improve cell attachment without inducing thrombogenesis, the authors coated the inner surface of polytetrafluoroethylene (PTFE) prostheses (I.D.: 1 mm; length: 10 mm; wall thickness: 0.5 mm; fibril length: 30 microm) with polyacrylamide (PAA), known to have a strong antithrombotic effect (PAA-PTFE). They implanted the prostheses into the abdominal aorta of rats, and retrieved them at intervals of up to 9 months. Graft healing was observed under light and scanning electron microscopy. All the inner surfaces of the grafts examined were barely covered with fibrin or platelets. The PAA-coated fibers had many projections, in contrast to the original PTFE prostheses. Neo-endothelium was observed to be directly attached to these structural fibers of the PAA-PTFE grafts. Restoration of the neointima was also observed in these vascular prostheses.

Subzero nonfreezing preservation in a murine limb replantation model

This study was designed to examine the most effective temperature for hypothermic storage, without freezing, to prolong ischemic tolerance in an amputated murine hindlimb model. We measured freezing points in the calf muscle and the subcutaneous tissue of the foot in the amputated limbs of Fisher 344 strain male inbred rats. The highest freezing point was -1.5 degrees C, which was recorded in the calf muscle. To prevent freezing in any of the tissues in the amputated limb, the temperature for the lowest nonfreezing preservation was defined as -1 degrees C. The amputated limbs were preserved at subzero nonfreezing temperature (-1 degrees C) and at 4 degrees C for 4, 8, 12, 24, 48, and 72 h, and were then transplanted to other inbred rats by microsurgical techniques. We evaluated the vascular patency of the anastomoses by direct observation and performed histological examinations on the seventh day after replantation. Subzero nonfreezing preservation of a limb at -1 degrees C for 72 h was significantly superior to hypothermic preservation at 4 degrees C for 72 h in terms of anastomotic patency rates (P < 0.05). The histology of skeletal muscles preserved at -1 degrees C for 8 h showed greater similarity to the normal situation than the histology of those preserved at 4 degrees C for 8 h. Bone viability with osteoblastic activity was maintained in grafted limbs preserved at -1 degrees C for 72 h, but in the limbs preserved at 4 degrees C for 72 h the bone was not viable, showing no osteoblastic activity. Clinically, the period of ischemia in major limb replantation at normal ambient temperatures is limited to about 6 h. In this study, the maximum ischemia time for replantation of a limb containing muscle tissue was prolong to 8 h at -1 degrees C, but the maximum ischemia time at 4 degrees C could not be prolonged to 8 h. Our results suggest that, in the major replantation of a limb containing muscular tissue, hypothermic preservation at -1 degrees C would be more useful than preservation at 4 degrees C.

A monomeric human C4b-binding protein (C4bp) more efficiently inactivates C3b than natural C4bp: participation of C-terminal domains in factor I-cofactor activity

We designed a cDNA construct encoding an artificial membrane molecule consisting of all 8 short consensus repeats (SCRs) of human monomeric C4b-binding protein (C4bp) followed by DAF's GPI anchor, named mC4bp, and expressed the protein on swine endothelial cells (SEC). At the same level of expression, mC4bp protected host cells as effectively as DAF, the most potent complement (C) regulator on the membrane. This result was unexpected from the reported functional properties of natural multimeric C4bp. Here, we investigated the mechanism whereby mC4bp has potent cell-protective activity. Our results were as follows: (1) mC4bp serves more efficiently as a methylamine-treated C3 (C3ma)-inactivating factor I-cofactor than natural C4bp and as efficiently as MCP as a methylamine-treated (C4ma)-inactivating cofactor by fluid-phase cofactor assay: (2) the potency of C3ma inactivation by mC4bp and factor I is quite high compared to those of other cofactors: (3)blocking studies using mAbs against C4bp suggested that both the 48 kDa N-terminal fragment and the C-terminal domain near the portion responsible for bundle formation participate in the high C3ma-inactivating capacity of mC4bp. Thus, acquiring high C3ma-inactivating capacity secondary to monomeric alteration leads to high C regulatory activity of mC4bp. These results infer that mC4bp differs from C4bp in its potent factor I-cofactor activity and is a good candidate as a safeguard against hyperacute rejection of xenografts.

Molecular cloning of membrane cofactor protein (MCP; CD46) on B95a cell, an Epstein-Barr virus-transformed marmoset B cell line: B95a-MCP is susceptible to infection by the CAM, but not the Nagahata strain of the measles virus

Measles virus (MV) infects not only human beings but also some simian species. The MV receptor on Vero cells (a cell line established from African Green monkey kidney cells) and human cells has been shown to be the membrane cofactor protein MCP/CD46, which is an inhibitor of autologous complement (C) activation. B95a, an Epstein-Barr virus (EBV)-transformed marmoset B cell line, is a simian cell line used for MV selection and is much more susceptible to MV than Vero cells. In the present study, we isolated cDNAs encoding MCP homologues from B95a cDNA library and assessed whether B95a-MCP is responsible for the high susceptibility of B95a to MV. The deduced amino acid sequence of the cDNA of B95a-MCP was 76% identical to that of human-MCP, and the recombinant B95a-MCP exerts C inhibitor activity. Although CAM, a vaccine strain of MV, infected Chinese hamster ovary (CHO) cells expressing B95a-MCP, Nagahata strain, a wild type of MV, failed to infect the CHO transfectants, suggesting that additional membrane molecules of B95a are responsible for the high susceptibility of B95a to the Nagahata strain.

Evidence that far infrared radiation promotes growth of Xenopus laevis

In most ectotherms, environmental temperature has differential effects on growth and differentiation. For example, amphibian size at maturity decreases with increasing temperature. To address how radiant heat in the form of far-infrared radiation (FIR) may affect development of the aquatic ectotherm Xenopus laevis, we continuously irradiated swimming larvae as they developed into young adults. Here we report evidence that FIR promotes growth of these organisms in an aqueous environment.

[Clinical usefulness of 201Tl-chloride scintigraphy for the evaluation of metastatic bone lesions]

201Tl-Chloride scintigraphy (early and delayed images) was performed in 40 patients with suspected metastatic bone lesions. The sensitivity and specificity of 201Tl scanning for detecting metastatic bone lesions were 66.7% and 77.4%, respectively. The uptake ratio of 201Tl per voxel of the lesions to the normal site was significantly different between the metastatic bone lesion and benign lesions. In 20 sites of 15 patients, 201Tl-Chloride scintigraphy was performed before and after radio- or radiothermotherapy. There was a significant difference in the mean uptake ratios in the early and delayed scans between before and after therapy. The mechanism of intracellular uptake of 201Tl is considered to be one of active transport, which might make 201Tl an accurate indicator of the viability of tumor cells and metabolic activity as long as there is sufficient blood flow to prompty transport 201Tl to tumor cells. Thus it would seem that decreased uptake of 201Tl and change in retention index after therapy depends partially on tumor blood flow. In conclusion, 201Tl-Chloride scintigraphy is very useful not only for clinically detecting metastatic bone lesions but also for assessing the therapeutic effects.

A method for prevention of arterialized venous flap necrosis

The authors used a delayed arteriovenous (A-V) shunt method to prevent congestion and necrosis of arterialized venous flaps. Two weeks before elevating the flap, an A-V shunt between the central artery and vein was created at the more proximal flap end. Twelve rabbits (24 flaps) were used for this experiment. Flaps were followed for 4 weeks. Twelve of 24 flaps survived completely; another 10 flaps showed partial necrosis; and two flaps became completely necrotic. These results demonstrated that this method is superior to a simple A-V shunt in preventing congestion and necrosis in the arterialized venous flap.

An interferon regulatory factor-related gene (xIRF-6) is expressed in the posterior mesoderm during the early development of Xenopus laevis

Out of a Xenopus neurula cDNA library, we isolated a clone which encodes a 52.4-kDa protein highly similar to the mouse interferon regulatory factor, IRF-6, whose function is unknown. The mRNA of this gene, named xIRF-6, seems to be maternally transmitted, but its amount rapidly decreases after the tailbud stage. Whole-mount in situ hybridization showed that xIRF-6 mRNA is expressed in the presumptive somitic mesoderm in the late gastrula, and then confined to a segment of posterior somite during the neurula through the tailbud stage. The temporally and spatially limited expression of the xIRF-6 gene product may contribute to the transcriptional regulation of specific genes which are necessary for the development of the posterior somites.

The effects of clomiphene citrate on normally ovulatory women

OBJECTIVE

To investigate the efficacy of clomiphene citrate (CC) on normally ovulatory women who complained of infertility.

DESIGN

A randomized study.

SETTING

University Hospital.

PATIENT(S)

Thirty-three normally ovulatory women with unexplained infertility.

INTERVENTION(S)

Eighteen women received CC at a 50-mg dosage. Fifteen women received no ovulation-induction drugs.

MAIN OUTCOME MEASURES

The pregnancy rate (PR) per patient, the PR per cycle, and the cumulative pregnancy rate.

RESULT(S)

Seven patients in the CC group stopped taking CC, and observations were terminated because of antiestrogenic effects. The pregnancy rate (PR) per patient and the PR per cycle were significantly decreased (P < 0.005) in the CC group (4 of 18 [22.2%] and 4 of 66 [6.1%], respectively) than in the spontaneous group (11 of 15 [73.3%] and 11 of 52 [21.2%], respectively). Kaplan-Meier tests showed that the cumulative pregnancy rate in the CC group was significantly lower than in the spontaneous group (P < 0.05). Five of seven patients who had stopped taking CC became pregnant in spontaneous cycles.

CONCLUSION(S)

Administration of CC to normally ovulatory women is not efficacious in terms of increasing the pregnancy rate.

The Na+,K+-ATPase alpha subunit requires gastrulation in the Xenopus embryo

Na+,K+-ATPase participates in reabsorption of ions and water and produces an electrochemical gradient between the intra- and extracellular spaces across the cell membrane. It also plays an important role in many developmental phenomena such as a blastocoele formation and neural formation. To elucidate the expression pattern of Na+,K+-ATPase in the Xenopus embryo, the spatial expression patterns of the Na+,K+-ATPase alpha subunit were studied in a normal embryo by whole-mount in situ hybridization. These transcripts were localized around the dorsal blastopore at the gastrula stage, in the neural tube at the neurula stage, and then in the pronephros and cloaca at the tail-bud stage. To study the function of Na+,K+-ATPase in embryogenesis after mid-blastula transition, the expression of the Na+,K+-ATPase alpha subunit was inhibited by the injection of specific antisense RNA. Embryos injected with Na+,K+-ATPase antisense RNA showed inhibition of gastrulation. When antisense RNA was injected into the dorsal blastomeres, head differentiation was markedly inhibited. These results suggest that this transcript plays an important role during gastrulation and head differentiation.

Two-stage arterialized flow-through venous flap transfer for third-degree burn defects on the dorsum of the hand

A modified, two-stage arteriovenous flow-through venous flap was designed to repair skin defects due to third-degree burns on the dorsum of the hand in four patients. Two weeks after plasty of an arteriovenous (A-V) shunt between the greater saphenous vein and dorsalis pedis artery, the arterialized flow-through venous flap was transferred using the greater saphenous vein as the pedicle. The size of the flaps utilized ranged from 7 x 13 cm to 9 x 13 cm. In three patients the entire flap survived without complication. In one patient whose flap had only one drainage vein, the flap survived with superficial necrosis of about 10 percent of the flap at the borders. During the 2 weeks after A-V shunt creation, the authors believe that microcirculation around the arterialized vein probably develops, contributing to better irrigation and thereby to flap survival. Using this two-stage procedure, it might be feasible to obtain larger grafts and to attain a higher flap survival rate.

[Limits and expansion of the clinical use of salvaging autologous transfusion]

As salvaging autologous transfusion(SAT) is conducted by employing blood lost by the patient during surgery, the limits of its clinical use are automatically determined. A thorough understanding of the characteristics and problems of SAT to reduce complications and to avoid the use of homologous blood should lead to the expansion of its clinical use. To achieve an expansion of SAT's use the following steps should be taken. Combining of SAT with another method of autotransfusion, increasing of the preoperative blood volume(volume of erythrocytes), prevention of destruction of erythrocytes in the process of bleeding, salvaging, cleaning and concentration (improvement in the rate of salvaging), preservation of the function of the erythrocytes obtained, immediate salvaging of blood by reduction in the processing time, improvement in the salvaging rate, recycling of the plasma substance separated in the process, removal of mixed harmful substances(malignant tumor cells, urine, bacteria), extension of indications, extension of subjects for whom SAT may be used to children, increase in the remuneration point in the Health Care System, and improvement in the limits of hemodilution of the organic body.

An essay on the similarities and differences between inductive interactions in anuran and urodele embryos

As a first step towards providing a conceptual approach to understanding similarities and differences in the mechanisms which guide inductive interactions among related organisms (e.g. various amphibia), a set of five principles is offered here. These principles were formulated by analyzing literature examples of classical embryological phenomena and by performing experiments with activin, a peptide growth factor which is currently suspected to play for a role in mesoderm induction. Mechanisms which account, at least in part, for the observed differences between anuran and urodele inductive processes can be derived from these principles.

Treatment of massive hemorrhage with liposome encapsulated human hemoglobin (NRC) and hydroxyethyl starch (HES) in beagles

The efficacy of NRC as a substitute for blood transfusion for treatment of acute, massive hemorrhage was evaluated in this study. Fourteen beagles, anesthetized with a mixture of 50% nitrous oxide, 0.97% sevoflurane and oxygen and ventilated by a respirator, were hemodiluted by withdrawal of 12 ml/kg of blood and infusion of isovolemic HES (hemodilution: HD) four times every 10 min. Then the animals were divided into two groups; an HES group, in which the same HDs were continued and an NRC group, in which the HDs were done with NRC. The hematocrit value decreased to 11% in the HES group after eight HDs and to 13% in the NRC group, which had a 3.9% NRCcrit value during the same period. In the NRC group, Cao2 decreased to 7.9 ml/min, which was significantly higher than the 5.9 ml/dl of the HES group. Oxygen consumption decreased to 56 ml/min in the HES group, but in the NRC group, it dropped to 74 ml/min, which was significantly higher than that of the HES group. Cardiac output increased to 1.2 times that of the control after eight HDs and arterial mean pressure decreased to approximately 60%. The above data indicated that NRC delivered sufficient oxygen to tissues, substituting for circulating red cells and maintained aerobic metabolism. Therefore, it should be possible to use NRC successfully for the treatment of cute, massive hemorrhage.

[Effect of aprotinin on endothelial cell functions during cardiopulmonary bypass]

Fourteen patients undergoing cardiac or great vessel surgery using cardiopulmonary bypass (ECC) were divided into two groups. Group A of 7 patients received 2 x 10(6) units of aprotinin (apr) 15 min before ECC and 0.5 x 10(6) unit immediately after the ECC. Group B of 7 patients received 0.5 x 10(6) unit of aprotinin 15 min before ECC and 2 x 10(6) units immediately after the ECC. Several physiological parameters were measured two hours before ECC, immediately after the cessation of the ECC and 4 hours thereafter. No difference was noted in coagulation time, which remained within normal range, and postoperative hemorrhage between the groups after ECC. Although thrombomodulin, ELAM-1 and ICAM-1 tended to decrease slightly in the two groups immediately after ECC, recovery of the thrombomodulin was much more rapid in the A group than in the B group. On the other hand, blood endothelin level and von Willebrand factor activity were elevated progressively after the ECC. Blood granulocyte-elastase activity and IL-8 increased markedly immediately after the ECC and then tended to decrease. These data indicate that no marked damage would be caused on the endothelial cells during ECC which was carried out using a relatively small dose of apr. However, the protective effect of apr remained to be clarified in the future.