Human cytomegalovirus infection stimulates Cl-/HCO-3 exchanger activity in human fibroblasts

The effects of human cytomegalovirus (HCMV) infection on Cl-/HCO-3 exchanger activity in human lung fibroblasts (MRC-5 cells) were studied using fluorescent, ion-sensitive dyes. The intracellular pH (pHi) of mock- and HCMV-infected cells bathed in a solution containing 5% CO2-25 mM HCO-3 were nearly the same. However, replacement of external Cl- with gluconate caused an H2DIDS-inhibitable (100 microM) increase in the pHi of HCMV-infected cells but not in mock-infected cells. Continuous exposure to hyperosmotic external media containing CO2/HCO-3 caused the pHi of both cell types to increase. The pHi remained elevated in mock-infected cells. However, in HCMV-infected cells, the pHi peaked and then recovered toward control values. This pHi recovery phase was completely blocked by 100 microM H2DIDS. In the presence of CO2/HCO-3, there was an H2DIDS-sensitive component of net Cl- efflux (external Cl- was substituted with gluconate) that was less in mock- than in HCMV-infected cells. When nitrate was substituted for external Cl- (in the nominal absence of CO2/HCO-3), the H2DIDS-sensitive net Cl- efflux was much greater from HCMV- than from mock-infected cells. In mock-infected cells, H2DIDS-sensitive, net Cl- efflux decreased as pHi increased, whereas for HCMV-infected cells, efflux increased as pHi increased. All these results are consistent with an HCMV-induced enhancement of Cl-/HCO-3 exchanger activity.

Antioxidant activity, packed cell transfusions, and outcome in premature infants

AIM

To evaluate the relative importance of biochemical markers of antioxidant status, gestational age, and parameters of neonatal care in the clinical outcome of premature infants.

METHOD

A prospective, observational, longitudinal study of the association between these factors was conducted. Blood was collected from an in situ arterial line within two hours of birth and at intervals thereafter, when blood was drawn for routine clinical purposes. Outcome was assessed as death, or survival with or without bronchopulmonary dysplasia (BPD). One hundred and forty four babies of 22 to 39 weeks of gestation, who required intensive care at the Jessop Hospital for Women, between January 1993 and April 1994, were recruited.

RESULTS

Low gestational age at birth was the most important predictor of mortality and the development of BPD. Having corrected for gestational age, low plasma antioxidant activity at birth was an independent risk factor for mortality. Plasma vitamin C at birth was significantly higher in the babies who died compared with those with a good outcome, but this effect was not sustained after correcting for gestational age. Repeated measures of Analysis of Variance revealed a postnatal increase in antioxidant activity, caeruloplasmin, retinol, cholesterol corrected alpha tocopherol, and red blood cell superoxide dismutase (SOD) activity. Vitamin C, on the other hand, declined in all groups after birth. Logistic regression analysis revealed that the greater the number of packed cell transfusions received during intensive care, and the higher the concentration of vitamin C on the second day of life, the greater the risk of developing BPD.

CONCLUSIONS

After correcting for the effect of gestational age, low plasma antioxidant activity at birth was an independent risk factor for mortality. Frequent blood cell transfusions over the first week of life are associated with an increased risk of developing BPD. This association may be causal.

HIV infected women and women's services

HIV/AIDS is increasing faster in women than any other segment in the population. The typical woman who is HIV infected is young, poor, a minority, and in the childbearing stage of life. Only 1 study was found that explored medical services in relation to usage and cost by men and women infected with HIV (F.J. Hellinger, 1993). The purpose of this study was to examine the types of services and the groupings of those services within facilities that were offered for women who were HIV positive. Seventeen of the 28 facilities (61%) that provide care to this population responded to a telephone survey. The research suggests that care for women who are HIV positive is fragmented, and there are access barriers to care and support. Many services that are especially important to HIV-infected women were not found or were not made available by many facilities.

SPECT image analysis using statistical parametric mapping: comparison of technetium-99m-HMPAO and technetium-99m-ECD

The goal of this study was to examine the apparent differences in regional cerebral blood flow (rCBF) between two groups of normal individuals who received either of the two tracers, 99mTc-D,L-hexamethylpropylene amine oxide (99mTc-HMPAO, or exametazime) or 99mTc-ethylene-dicysteine diethylester (99mTc-ECD, or bicisate).

METHODS

Individuals were screened for drug use, head injury, medication status and other psychiatric and medical illnesses. The two groups were matched for age, sex and race. SPECT measurement of brain perfusion was performed in 35 individuals who received 99mTc-HMPAO and in 55 who received 99mTc-ECD. Subsequent analysis of these scans was done using computer software including Statistical Parametric Mapping and Analyze. Images were intensity-thresholded and spatially normalized to a standardized stereotactic (Talairach) space. This allowed for the objective, quantitative analysis of these data, demonstrating the extent and magnitude of rCBF changes.

RESULTS

Our results showed significant changes between these two groups of normal individuals, presumably due to differences in pharmacokinetics between the two radiolabeled tracers. Specifically, large areas of the parietal, occipital and superior temporal cortices were significantly lower in the 99mTc-HMPAO group than in the 99mTc-ECD group. Increases were seen in the subcortical nuclei, parts of the brain stem, hippocampus and small areas of the cerebellum in the 99mTc-HMPAO group as compared to the 99mTc-ECD group.

CONCLUSION

We present a method of image analysis to semiquantitatively measure rCBF in SPECT images and the changes seen due to differences between the two radiotracers.

Abl expression in human fetal and adult tissues, tumours, and tumour microvessels

Abl kinases encoded by the abl oncogenes inhibit apoptosis without affecting cell proliferation. The aim of this study was to examine a wide range of normal fetal and adult human tissues and a variety of tumour types for Abl immunoreactivity. Sections from 193 paraffin blocks of normal fetal and adult tissues and 72 blocks from representative tumours were stained immunohistochemically using a polyclonal antibody to c-Abl/Bcr-Abl oncoprotein. Weak Abl immunoreactivity was observed in many adult tissues. Moderately intense or strong staining (cytoplasmic, nuclear or membranous) was consistently seen in hyaline cartilage, adipocytes, and ciliated epithelium. In fetal tissues, there was a broadly similar staining pattern, but Abl expression was also seen in muscle (all types) and occasionally in endothelial cells. The most intense staining was seen in sites of endochondral ossification and in the umbilical cord stroma. Negatively staining tissues included epidermis and squamous mucosa, lymph nodes, tonsil, spleen, hepatocytes, and adrenals. Most tumours showed focal or weak Abl immunoreactivity. The most intense staining was seen in chondrosarcoma, liposarcoma, and diffuse gastric (signet ring) adenocarcinoma. In the latter two tumour types, Abl expression was also observed in tumour microvessels. These results suggest that Abl not only functions as an apoptosis inhibitor, but also may have a role in connective tissue maturation and differentiation and in tumour growth and angiogenesis.

Enhanced mucosal permeability and nitric oxide synthase activity in jejunum of mast cell deficient mice

BACKGROUND

Recent reports have described a modulating influence of nitric oxide (NO) on intestinal mucosal permeability and have implicated a role for mast cells in this NO mediated process.

AIMS

To assess further the contribution of mast cells to the mucosal permeability changes elicited by the NO synthase (NOS) inhibitor NG-nitro-L-arginine methylester (L-NAME), using mast cell deficient (W/Wv) and mast cell replete mice (+/+).

METHODS

Chromium-51 EDTA clearance (from blood to jejunal lumen), jejunal NOS and myeloperoxidase (MPO) activities, and plasma nitrate/nitrite levels were monitored.

RESULTS

The increased EDTA clearance elicited by intraluminal L-NAME in W/Wv mice (4.4-fold) was significantly greater than the response observed in control (+/+) mice (1.8-fold). The exacerbated response in W/Wv mice was greatly attenuated by pretreatment with either dexamethasone (1.3-fold) or the selective inducible NOS inhibitor, aminoguanidine (1.4-fold), and partially attenuated by the mast cell stabiliser, lodoxamide (2.9-fold). Jejunal inducible NOS activity was significantly higher in W/Wv than in +/+ mice, while jejunal MPO was lower in W/Wv mice than in +/+ mice, suggesting that the higher inducible NOS in W/Wv does not result from the recruitment of inflammatory cells into the gut. The higher inducible NOS activity in the jejunum of W/Wv was significantly reduced by dexamethasone treatment.

CONCLUSIONS

Our results suggest that mast cells normally serve to inhibit inducible NOS activity tonically in the gut and that inhibitors of NOS elicit a larger permeability response when this tonic inhibitory influence is released by mast cell depletion.

Human cytomegalovirus infection enhances osmotic stimulation of Na+/H+ exchange in human fibroblasts

Infection with human cytomegalovirus (HCMV) causes an enlargement (cytomegaly) of human fibroblasts (MRC-5). As a first step toward determining whether solute uptake, mediated in part by Na+/H+ exchange, is responsible for the development of cytomegaly, we studied the effects of HCMV infection on intracellular pH (pHi) regulation (nominal CO2/ HCO3- concn = 0) by comparing cytomegalic cells with mock-infected cells. Seventy-two hours after HCMV infection of MRC-5 cells we observed the following changes relative to mock-infected cells: resting pHi is 0.1-0.2 pH unit more alkaline; the intrinsic buffering power of the cytoplasm was reduced by approximately 40-50%; acid-loading H(+)-equivalent fluxes were reduced; and there were alterations of Na+/H+ exchanger (NHE) properties, including an alkaline shift of the pHi dependence of activity, a reduction of the apparent affinity for extracellular Na+, and an increase of the apparent maximum velocity and a large increase in stimulation by a hyperosmotic challenge. These results indicate that HCMV infection exerts a profound effect on functional properties of the NHE, on acid-loading mechanisms, and on intrinsic cellular buffering power. These effects are consistent with a role for the NHE in the development of cytomegaly.

Effects of intestinal stasis on intercellular adhesion molecule 1 expression in the rat: role of enteric bacteria

BACKGROUND & AIMS

The mechanisms underlying the inflammatory changes associated with intestinal stasis are poorly understood. The objective of this study was to assess whether endothelial expression of intercellular adhesion molecule 1 (ICAM-1) and leukocyte recruitment are altered after intestinal stasis.

METHODS

ICAM-1 expression and granulocyte recruitment were quantified in different tissues of Sprague-Dawley rats using the double-radiolabeled monoclonal antibody technique and peroxidase activity, respectively.

RESULTS

Both constitutive and endotoxin-induced ICAM-1 expression were significantly higher in the cecum than in distal colon, a finding that cannot be explained by a difference in endothelial surface area between the two organs. Surgical procedures to improve cecal stool flow (cecostomy, ileocecostomy) elicited a significant decrease in constitutive ICAM-1 expression in both cecum and distal colon. Tissue peroxidase activity was normally higher in cecum than in distal colon, and this difference was significantly reduced by ileocecostomy. Oral administration of antibiotics (kanamycin and/or metronidazole for 2 days) significantly reduced constitutive ICAM-1 expression in the cecum, but not in the distal colon.

CONCLUSIONS

This study indicates that intestinal stasis is associated with an increased expression of ICAM-1 and granulocyte infiltration, which may be mediated by enteric bacteria.

Temporal lobe perfusion asymmetries in schizophrenia

Structural and functional neuroimaging techniques have consistently demonstrated that abnormal lateralization of temporal lobes may be important in identifying the pathophysiologic processes in schizophrenia. The exact nature of these reported abnormalities has not been consistent.

METHODS

We examined temporal lobe perfusion using HMPAO-SPECT in 22 individuals with schizophrenia in an effort to establish whether temporal lobe perfusion asymmetry is seen in these individuals, as compared to a group of 22 age- and sex-matched controls.

RESULTS

We found that the asymmetry index, a measure of perfusion differences between two homologous compared areas, was lower (more negative) in schizophrenic individuals. The asymmetry indices of patients considered with the results from globally corrected ROI means indicated that the left temporal lobes of individuals with schizophrenia were significantly hypoperfused when compared to controls. This finding does not appear to be caused by medication effects, demographic variables, handedness, imaging artifacts or analysis techniques.

CONCLUSION

In our sample, patients with schizophrenia appear to have significant left hypoperfusion relative to right of their temporal lobes. Abnormal lateralization of temporal lobe blood flow may have important clinical implications by assisting with diagnosis and appropriate treatment for individuals with schizophrenia.

Antibody-induced arterial thromboembolism resulting in amputation after total knee arthroplasty

Heparin-induced thrombocytopenia is a rare drug reaction that can be associated with thrombotic complications leading to myocardial infarct, stroke, or ischemic loss of a limb. Because of the broadening indications of low-molecular-weight heparin use, the current emphasis on ambulatory care, and the difficulty in clinical diagnosis and treatment of this drug reaction, heparin-induced thrombocytopenia is the most important allergic drug reaction that physicians must manage. An antibody-mediated drug reaction to low-molecular-weight heparin that resulted in a below-knee amputation after an elective total knee arthroplasty is reported.

Prospective assessment of incontinence after radical retropubic prostatectomy: objective and subjective analysis

OBJECTIVES

To assess prospectively-using pad test and questionnaire-the rate and degree of incontinence after radical retropubic prostatectomy, to analyze factors that may predispose individuals to postoperative incontinence, and to assess the impact of incontinence on patient lifestyle.

METHODS

Fifty-one consecutive patients were assessed at 3-month intervals for 1 year after radical retropubic prostatectomy. Patients were objectively assessed using a 1-hour pad test and subjectively assessed by questionnaire. Incontinence was graded objectively according to the change in weight of the pad at 1 hour and subjectively by the number of pads used per day. Lifestyle modifications were assessed by questionnaire at 12 months. A number of variable factors were studied to assess risk factors for postoperative incontinence.

RESULTS

Continence continued to improve up to 12 months. At 12 months, pad testing revealed 84% of patients were dry, 6% were mildly incontinent. 6% were moderately incontinent, and 4% were severely incontinent. Questionnaire assessment revealed 80% wore no pad, 14% had mild incontinence, 4% had moderate incontinence, and 2% had severe incontinence. Pad testing was not as sensitive as the questionnaire for the detection of minimal incontinence but was more reliable for moderate and severe levels. Patients made lifestyle changes proportional to the level of incontinence. No predisposing factor was identified for the development of incontinence after radical retropubic prostatectomy.

CONCLUSIONS

Significant incontinence after radical prostatectomy occurs in as many as 10% of patients. Pad testing provides an inexpensive and simple form of objective assessment in patients with bothersome incontinence and allows documentation of improvement over time.

Efficacy of prophylactic antibiotics in arthroscopic surgery

A prospective, randomized, double-blind study of 437 patients undergoing arthroscopic diagnostic and operative procedures found that no deep infections occurred in any patient and only one superficial infection occurred in a patient who did not receive prophylactic antibiotics. One patient had a mild allergic reaction to the antibiotic that resolved after treatment with Benadryl. These results suggest that the routine use of prophylactic antibiotics is not indicated for patients undergoing arthroscopic surgery and that the slight risk of infection is outweighed by the cost of the antibiotics and the slight risk of allergic reaction.

Effects of chronic arterial hypertension on constitutive and induced intercellular adhesion molecule-1 expression in vivo

Recent reports indicate that bacterial endotoxin (lipopolysaccharide) and cytokines elicit a more profound increase in the surface expression of intercellular adhesion molecule-1 (ICAM-1) in cultured endothelial cells derived from spontaneously hypertensive (SHR) versus normotensive Wistar-Kyoto rats (WKY). Our objective in this study was to characterize and compare in vivo ICAM-1 expression in SHR and WKY under basal conditions and after 5 hours of endothelial cell activation with either lipopolysaccharide (5 mg/kg i.p.) or tumor necrosis factor-alpha (TNF-alpha; 1, 5, and 10 micrograms/kg i.p.). ICAM-1 expression was quantified in different tissues by the double-radiolabeled monoclonal antibody technique. When constitutive (baseline) ICAM-1 expression was corrected for endothelial cell surface area, significantly higher values were noted in SHR than WKY but only in splanchnic organs. Lipopolysaccharide and TNF-alpha elicited significant increases in ICAM-1 expression in all tissues of both WKY and SHR. However, the magnitude of the lipopolysaccharide-induced ICAM-1 upregulation in heart, stomach, skeletal muscle, and brain was significantly lower in SHR than WKY. A similar blunted ICAM-1 upregulation was noted in the stomach of SHR after administration of 5 micrograms/kg TNF-alpha. The differences in induced ICAM-1 expression between SHR and WKY do not appear to be due to differences in endothelial cell surface area or plasma glucocorticoid levels. These results suggest that chronic arterial hypertension results in altered ICAM-1 expression on the endothelium, which may contribute to the abnormal inflammatory responses associated with this disease.

Elevated [Cl-]i, and [Na+]i inhibit Na+, K+, Cl- cotransport by different mechanisms in squid giant axons

Bumetanide-sensitive (BS) unidirectional fluxes of (36)Cl- or (22)Na+ were measured in internally dialyzed squid giant axons while varying the intra- or extracellular concentrations of Na+ and/or Cl-. Raising either [Cl-]i or [Na+]i resulted in a concentration-dependent reduction of the BS influx of both (36)Cl- and (22)Na+. Raising [Cl-]i above 200 mM completely blocked BS influxes. However, raising [Na+]i to 290 mM resulted in saturable but incomplete inhibition of both BS Na+ influx and BS Cl- influx. The consequences of varying intracellular Cl- on cotransporter effluxes were complex. At lower [Cl-]i values (below 100 mM) intracellular Cl- activated cotransporter effluxes. Surprisingly, however, raising [Cl-]i levels > 125 mM resulted in a [Cl-]i-dependent inhibition of BS effluxes of both Na+ and Cl-. On the other hand, raising [Na+]i resulted only in the activation of the BS Na+ efflux; intracellular Na+ did not inhibit BS efflux even at 290 mM. The inhibitory effects of intracellular Na+ on cotransporter-mediated influxes, and lack of inhibitory effects on BS effluxes, are consistent with the trans-side inhibition expected for an ordered binding/release model of cotransporter operation. However, the inhibitory effects of intracellular Cl- on both influxes and effluxes are not explained by such a model. These data suggest that Cl may interact with an intracellular site (or sites), which does not mediate Cl transport, but does modulate the transport activity of the Na+, K+, Cl- cotransporter.

A double-blind randomized placebo cross-over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated male infertility

OBJECTIVE

To determine the effectiveness of the in vivo administration of vitamin E as treatment for reactive oxygen species-associated male infertility.

SETTING

University-based center for reproductive medicine.

DESIGN

Double-blind randomized placebo cross-over controlled trial.

PATIENTS, PARTICIPANTS

Thirty healthy men with high levels of reactive oxygen species generation in semen and a normal female partner.

INTERVENTIONS

Patients were allocated to two groups according to the blinded randomization. Each patient received either 600 mg/d of vitamin E (Ephynal, 300 mg tablets; F. Hoffman-La Roche Ltd., Basle, Switzerland) (order A) or identical placebo tablets (order B) for 3 months. Then after a 1-month wash-out period the patients were crossed-over to the other treatment.

MAIN OUTCOME MEASURES

Improvement in the in vitro function of the spermatozoa measured by conventional semen analysis, computerized motility assessment, determination of reactive oxygen species generation, binding to the zona pellucida of the unfertilized human oocyte in a competitive zona binding assay, development of hyperactivated motility (both spontaneous and in the presence of 20% of the natural agonist, human follicular fluid) and pregnancy.

RESULTS

Rise in the blood serum vitamin E levels after treatment accompanied by improvement in one of the sperm function tests: the zona binding assay. The zona binding ratio for order A improved from 0.2 (range 0 to 0.5) before treatment to 0.5 (range 0.1 to 1.0) after treatment, the corresponding values for order B were 0.2 (range 0 to 1.0) before treatment and 0.3 (range 0.1 to 0.7) after treatment.

CONCLUSION

Oral administration of vitamin E significantly improves the in vitro function of human spermatozoa as assessed by the zona binding test.

Effects of okadaic acid and intracellular Cl- on Na(+)-K(+)-Cl- cotransport

The Na(+)-K(+)-Cl- cotransporter of the squid giant axon requires ATP and is inhibited by intracellular Cl- (Cli-) in a concentration-dependent manner ([Cl-]i > or = 200 mM completely inhibits the cotransporter). In the present study we address the question of whether inhibition of cotransport by Cli- is due to a Cl(i-)-induced increase of protein phosphatase activity. Intracellular dialysis was used to apply the phosphatase inhibitor okadaic acid (OKA) under conditions of [Cl-]i at 0, 150, or 300 mM during measurement of cotransporter-mediated unidirectional Cl- influx into axons. At 0 mM [Cl-]i, the application of 250 nM OKA had no effect on the cotransport-mediated Cl- influx when axons were dialyzed with the normal intracellular ATP concentration ([ATP]i = 4 mM). Reduction of [ATP] to 50 microM resulted in a significant decrease of the bumetanide-sensitive CL- influx, which could be partially reversed by OKA treatment. Similarly, in ATP-limited axons with [Cl-]i at 150 mM, cotransporter influx was partially stimulated by treatment with OKA. However, axons dialyzed with 300 mM [Cl-]i ([ATP]i = 50 microM) had no measurable cotransport influx, nor was subsequent treatment with OKA able to induce a cotransport-mediated Cl- influx. We conclude that the inhibition of cotransport caused by Cli- is not the result of an increase in the OKA-sensitive protein phosphatase activity.

A Reevaluation of the Ozone Budget with HALOE UARS Data: No Evidence for the Ozone Deficit

Recently, additional ozone production mechanisms have been proposed to resolve the ozone deficit problem, which arises from greater ozone destruction than production in several photochemical models of the upper stratosphere and lower mesosphere. A detailed ozone model budget analysis was performed with simultaneous observations of O(3), HCl, H(2)O, CH(4), NO, and NO(2) from the Halogen Occultation Experiment (HALOE) on the Upper Atmosphere Research Satellite (UARS) under conditions with the strongest photochemical control of ozone. The results indicate that an ozone deficit may not exist. On the contrary, the use of currently recommended photochemical parameters leads to insufficient ozone destruction in the model.

Femoral lengthening in patients having abnormal ipsilateral hip or knee

Femoral lengthening using the Wagner technique was performed for 13 patients with abnormal adjacent joints. An average of 6.3 cm (19.5%) of lengthening was achieved. Three patients had no difficulties during lengthening. Transient non-surgical problems identified were blood pressure elevation, nerve palsy, and psychiatric reactions. Significant obstructions or complications occurred 13 times in nine cases. These included contractures of ipsilateral joints, angulations of the lengthened femur, Wagner device slippage, nonunion, and late hip subluxation. Other authors have reported similar difficulties in patients with normal ipsilateral joints. In this series, the advantage of achieving greater length appeared to outweigh the complications.

Pharyngeal flora in a sexually active population

During a 7-week period 1141 patients attending the Genitourinary Clinic at Charing Cross Hospital completed a brief questionnaire and had pharyngeal swabs cultured for Neisseria spp, beta-haemolytic streptococci, corynebacterium and yeasts. The study included 397 heterosexual men, 492 heterosexual women, 189 homosexuals, 41 lesbians and 22 bisexual men and women. Four hundred and sixty patients (40%) admitted oro-genital contact in the preceding 2 weeks. The meningococcal carriage rate was 11.6%. Homosexuals had the highest carriage 23.8% and heterosexual females the lowest 5.9%. Significant differences in carriage rates were found between homosexual and heterosexual men (P < 0.0001), heterosexual men and women (P < 0.005) and between lesbian and heterosexual women (P < 0.025). Recent oro-anal contact significantly increased meningococcal isolation (P < 0.001). A significant association between beta-haemolytic streptococci and concomitant meningococcal carriage was also found (P < 0.01). Sexual orientation and oro-genital contact influences both meningococcal and pharyngeal yeast isolation and should be considered when interpreting pharyngeal culture results.

Evaluating a designated family planning clinic within a genitourinary medicine clinic

OBJECTIVE

To evaluate an integrated family planning clinic (FPC) established by genitourinary medicine (GUM) staff held within a GUM women-only clinic (WOC).

DESIGN

A retrospective case note review of women attending the FPC during the first year January-December 1992.

RESULTS

One hundred and thirteen women, aged 13-41 years, attended the FPC; 45 were new attenders, six had previously tested antibody positive for the human immunodeficiency virus (HIV), seven were intravenous drug users; 54% had a history of sexually transmitted disease (STD); 17.7% were using no contraception; 32.7% had previous termination of pregnancy (TOP) with 70 TOPs in total. Within three months of FPC attendance 89 (78.8%) women had genital STD screening performed; syphilis, HIV and hepatitis B serology, together with cervical cytology were performed in 77, 18, 13 and 62 women respectively. Infections identified were similar to those identified in the GUM clinic but the prevalence of Chlamydia trachomatis in diagnosed infections was commoner in FPC attenders and epidemiological treatment commoner in GUM attenders. No high grade cytology abnormalities were detected. No positive syphilis or new HIV positive results were identified; five women were found to be hepatitis B surface antibody positive. Contraception was changed in 60.8%. Most frequently supplied was the combined oral contraceptive pill (COCP). At the first FPC attendance six women required post coital contraception (PCC) and five were already pregnant, three suspected it, two were unaware. During the year three women conceived; two used COCP, but were non compliant; one used a diaphragm with unclear compliance. Seven of the eight pregnancies were terminated. Over the following year, 1992-93, contraception was supplied to 42 women; four required PCC; two intentional pregnancies occurred. Only one of the TOP women returned.

CONCLUSION

An integrated FPC provides co-ordinated sexual health care. Pregnancy, TOP and FPC re-attendance rates together with improvement strategies are discussed. Avoiding unwanted pregnancy remains a universal challenge.

Effects of tenidap on leukocyte-endothelial cell adhesion in mesenteric venules

OBJECTIVE

To compare the proinflammatory effects of tenidap to those of indomethacin, and to assess the influence of lipoxygenase inhibition with either a leukotriene synthesis inhibitor (L663,536) or tenidap on platelet activating factor (PAF) induced leukocyte adhesion.

METHODS

Adherent leukocytes, emigrated leukocytes, number of rolling leukocytes/100 microns venule, flux of rolling leukocytes, and leukocyte rolling velocity were quantitated in mesenteric venules (25-35 microns diameter and > 150 microns length) of Sprague-Dawley rats using intravital microscopy. In some experiments, the mesentery was superfused with indomethacin (25 micrograms/ml), tenidap (30 micrograms/ml), or both drugs simultaneously. In other experiments the mesentery was superfused with PAF 100 nM and the effects of treatment with L663,536 (10 mg/kg given orally) or superfusion with tenidap were determined.

RESULTS

Indomethacin significantly increased leukocyte rolling and adhesion. Tenidap did not promote leukocyte-endothelial cell adhesion and blocked the increased leukocyte rolling and adhesion promoted by indomethacin. Both L663,536 and tenidap significantly attenuated PAF induced leukocyte-endothelial cell adhesion.

CONCLUSION

Tenidap does not exhibit the proinflammatory properties of indomethacin. The reduction of indomethacin or PAF induced leukocyte-endothelial cell adhesion by tenidap appeared to result from its lipoxygenase inhibitory activity. Modulation of leukocyte-endothelial cell adhesion may be a novel mechanism of the antiinflammatory activity of tenidap and may reduce the relative risk of gastric ulceration with tenidap.

Who is publishing in Theriogenology and on what subjects?

An analysis of 503 articles published in the journal Theriogenology in 1984, 1987 and 1990 was conducted to identify research trends and researchers publishing in the journal. A 30.5% increase in the number of papers published was found for 1990. During the 3 yr period studied, the United States and Canada accounted for 63.1% of the total number of articles published, followed by European countries with 14.3%, and by Asia with 12.0%. At least 1 paper was published from 41 countries. The United States, at the top of the list, increased its share from 16% in 1984 to 21% in 1990. The number of papers from Japan increased significantly while the percentage of participation from Europe declined. The female animal was the sole subject of 63.2% of the articles, and cattle were the most researched species, appearing in 44.3% of the studies. Although the estrous cycle was the most studied reproductive event in all 3 yr, there was also a trend for the popularity of this topic to decrease in favor of the subject fertilization. The number of authors per paper increased significantly over the years analyzed, as did the number of studies carried out in international cooperation. Institutes of higher education were represented in almost 70% of the papers, followed by research institutes (12.8%). The present analysis confirms the central role that the journal Theriogenology plays in the world-wide communication of research results in animal reproduction.