Two steroidogenic pathways present in the chicken ovary: theca layer prefers delta 5 pathway and granulosa layer prefers delta 4 pathway

It has been suggested that there is a shift in steroidogenic pathways of the theca layer from delta 5 to delta 4 during follicular maturation in the chicken ovary. However, the preferred steroid metabolic pathway in the theca and granulosa layers of small and preovulatory follicles has not been identified. Therefore, the goal of our study was to identify the preferred steroidogenic pathways used by these follicles. Previously, we found that small follicles that had not entered the follicular hierarchy did not use cholesterol but did use pregnenolone (P5) to produce testosterone and estradiol. For this reason, P5 was used as the substrate for steroid production in the present study. The theca layer of small follicles (2-4 mm in diameter), and the theca and granulosa layers of the fifth largest (F5), third largest (F3), and largest (F1) preovulatory follicles were isolated from the chicken ovary 22 hr before ovulation. The granulosa layer of small follicles was excluded from the study because it is steroidogenically incompetent. Tissues were incubated with [3H]-P5 for 1 hr at 37 degrees C. Production of steroid metabolites was determined on the basis of comparison with known steroid standards using two-dimensional thin layer chromatography (2D-TLC). Conversion of [3H]-P5 to [3H]-DHEA was greater than that of [3H]-P4 in the theca layer of small and preovulatory follicles. Even though the amount of [3H]-P4 was less than that of [3H]-DHEA, theca cells from F3 and F1 follicles did produce [3H]-P4. In contrast to the theca layer, conversion of [3H]-P4 was greater than that of [3H]-DHEA in the granulosa layer of preovulatory follicles. Conversion of [3H]-P5 to [3H]-DHEA by the granulosa layer gradually decreased as the follicle matured and approached ovulation. We conclude that both delta 5 and delta 4 pathways are functional in theca and granulosa cells. However, in contrast to earlier speculation, the theca layer preferentially metabolizes steroids via the delta 5 pathway regardless of the maturational stage of the follicle, whereas the granulosa layer of preovulatory follicles preferentially metabolizes steroids via the delta 4 pathway.

An overview of sleep and common sleep problems

The purpose of this article is to review what is currently known about healthy sleep patterns, physiological alterations during various sleep stages, and factors that affect sleep patterns. How sleep patterns are altered, either by illness or environmental situations is of major concern to nursing practice. Sleep pattern disturbances are categorized and discussed as dyssomnias, parasomnias, and sleep disorders associated with medical or psychiatric disorders. Implications for nursing research and practice are briefly addressed in the conclusion.

Chromosome and spindle configurations of human oocytes matured in vitro after cryopreservation at the germinal vesicle stage

OBJECTIVE

To investigate effects of cryoprotectant and cryopreservation on the chromosome and microtubule configuration of human immature oocytes.

DESIGN

Intact cumulus-enclosed immature oocytes were collected from unstimulated ovaries and divided into three groups: group 1, no treatment (control); group 2, only 1,2-propanediol treatment, and group 3, cryopreserved oocytes. Oocytes in groups 1 and 2, and oocytes that survived after cryopreservation in group 3 were cultured for 48 hours.

SETTING

Infertility Medical Center at the CHA General Hospital, Seoul, Korea.

PATIENT(S)

Oocytes were obtained from patients undergoing gynecologic surgery.

MAIN OUTCOME MEASURE(S)

Maturation rate and abnormality in chromosomes by fluorescence in situ hybridization and in the spindle by immunostaining for tubulin.

RESULT(S)

There was no effect of propanediol-only treatment on the chromosomal (41.4%) and spindle abnormalities (35.3%) in group 2 compared with control oocytes (31.8% and 22.2%, respectively), whereas a statistically significant increase in abnormalities in chromosomes (77.8%) and spindles (70%) was found in group 3.

CONCLUSION(S)

Human oocytes matured in vitro after cryopreservation at the germinal vesicle stage showed increased incidence of chromosomal and spindle abnormalities. These abnormalities may impair the capacity for further development of the embryos derived from frozen-thawed oocytes.

Effects of 1,2-propanediol and freezing-thawing on the in vitro developmental capacity of human immature oocytes

OBJECTIVE

To investigate effects of 1,2-propanediol and freezing-thawing treatment on the maturation and developmental capacity of the human immature oocytes obtained from unstimulated ovaries.

DESIGN

Intact cumulus-enclosed immature oocytes collected from unstimulated ovaries were divided into three groups, such as no treatment as control (group 1), only 1,2-propanediol-treated (group 2), and cryopreserved group (group 3). Oocytes in group 1, group 2, and survived oocytes from cryopreservation in group 3 were cultured for 48 hours. A random selection of matured oocytes was inseminated with normal donor sperm to evaluate the fertilization and developmental capacity.

SETTING

Infertility Medical Center at the CHA General Hospital, Seoul, Korea.

PATIENT(S)

Oocytes were obtained from patients undergoing gynecological surgery.

MAIN OUTCOME MEASURE(S)

Rates of survival, maturation to metaphase II, fertilization, and cleavage.

RESULT(S)

Survival rate after freezing-thawing in group 3 was 55.1% (54/98). Oocytes were cultured in Dulbecco's modified Eagle's medium (DMEM) supplemented with 20% fetal bovine serum, 10 IU/mL pregnant mare serum gonadotropin, and 10 IU/mL hCG. Maturation rates were 76.8% (63/82), 67.1% (47/70), and 59.3% (32/54) in the groups 1, 2, and 3, respectively. Maturation rate in group 3 was significantly lower than that of group 1. Fertilization rates were 90.5% (19/21), 81.0% (17/21), and 42.9% (6/14), and cleavage rates were 94.7% (18/19), 88.2% (15/17), and 16.7% (1/6) in groups 1, 2, and 3, respectively. Fertilization and cleavage rates of survived oocytes in group 3 also were significantly lower than those of groups 1 and 2.

CONCLUSION(S)

Results suggest that the pretreatment with 1.5 M 1,2-propanediol itself before the freezing has no inhibitory effect on the maturation, fertilization, and cleavage of human immature oocytes in vitro. However, the freezing-thawing procedure used had detrimental effects on the maturation and developmental capacity.

Differences between primigravidae and multigravidae mothers in sleep disturbances, fatigue, and functional status

The purpose of this study was to describe the differences between primigravidae and multigravidae women in their experience of sleep efficiency, fatigue and vitality, and level of functioning in the third trimester of pregnancy and the first month postpartum. A secondary analysis of a descriptive, longitudinal study was done. A convenience sample of 31 pregnant women was used to test the hypothesis that multigravidae would have significantly higher levels of functioning in the household, increased fatigue, and decreased sleep efficiency and vitality than primigravidae at both phases of the study. Results indicate, however, that primigravidae experienced significantly more disturbed sleep, with sleep efficiency falling from 89.79% in the third trimester to 77.25% postpartum. Multigravidae had only a minor reduction in sleep efficiency from 86.76% in the third trimester to 83.99% postpartum. Although there was no statistically significant difference in level of vitality, primigravidae experienced more fatigue (73.58 +/- 15.22) than multigravidae (64.35 +/- 18.96) at 1 month postpartum. These results suggest that maternal role "acquisition," experienced by primigravidae, results in more fatigue and sleep disruption than does maternal role "expansion." The significant decrease in sleep efficiency and increase in fatigue in primigravidae after delivery indicate that health care professionals need to provide anticipatory guidance to primigravidae to help smooth the transition from pregnancy to motherhood.

A descriptive study of current neonatal nurse practitioner practice

This study describes the role of the neonatal nurse practitioner (NNP) in current practice and identifies facilitators and constraints to practice perceived by individuals currently practicing as NNPs. The 7-point scale used in this study allowed respondents to identify specific conditions of NNP practice, from highly facilitating (+3) to very constraining (-3). Each item was followed by a clarification section. The questionnaire was mailed to 1,521 individuals holding current NNP certification in the U.S. Data were analyzed using a total facilitation score. The possible range for this score (+225 - (-)225) is based on the numerical range of the scale (+3 - (-)3) multiplied by the 75 items in the facilitation section of the questionnaire. Actual scores ranged from +195 to -114, indicating that NNPs are more facilitated than constrained in their practice. Empirical data generated by this study will help in developing a theoretical model for NNP practice and provide important information for shaping the future role of the NNP.

Depression and HIV. A nursing perspective on a complex relationship

This article (1) addresses current perspectives on depression as a psychobiologic condition, which in the case of major depression constitutes a bona fide disease state, (2) explores the complex relationship between HIV and depressive illness, and (3) addresses how this new knowledge serves to enhance nursing assessment and intervention in these persons diagnosed with HIV disease and concurrent depression. By attaining these three goals, the nursing clinician gains a broader perspective on depression and HIV.

Copurification of casein kinase II with transcription factor ATF/E4TF3

We have developed a simple method to purify sequence-specific DNA-binding proteins directly from crude cell extracts by using DNA affinity latex beads. The method enabled us to purify not only DNA-binding proteins, but also their associated proteins. Using beads bearing the ATF/E4TF3 site from the adenovirus E4 gene promoter, a protein kinase activity was copurified with the ATF/E4TF3 family. We found that the kinase interacted with ATF1 in vitro efficiently. The kinase did not bind directly to DNA. The kinase mainly phosphorylated ATF1 on serine 36, which was one of target amino acids for casein kinase (CK) II. Biological features of the kinase were the same as those of CKII and an anti-CKII serum reacted with the kinase, indicating that the kinase was CKII. Moreover, it was clearly shown that one of CKII subunits, the CKII alpha protein bound to glutathione-S-transferase (GST) fusion ATF1 but not GST in vitro. It has been reported that a specific CKII inhibitor, 5,6-dichloro-1-beta-D-ribo-furanosylbenzimidazole (DRB) inhibits transcription by RNA polymerase II [Zandomeni et al., (1986) J. Biol. Chem. 261, 3414-3419]. Taken together, these results suggest that ATF/E4TF3 may recruit the CKII activity to a transcription initiation machinery and stimulate transcription.

Asthma self care efficacy and morbidity in polyclinic outpatients

The new guidelines for the management of asthma require patients to participate in the management of their condition by exercising a high level of decision-making skills in self treatment. We evaluated the self care efficacy and morbidity of 198 asthmatic patients in primary care clinics and examined the factors likely to influence these management outcomes. About 70% of the patients were considered by conventional criteria to have significant morbidity requiring medical supervision. The most significant factors determining morbidity were knowledge of medications and attack management skills. Only a minority of the patients had satisfactory levels of these skills and knowledge. A high level of stigmatization from asthma was generally present among the patients but most of them appeared to possess a high level of self-confidence in the management of their asthma. These factors were also associated with asthma morbidity, but they were as likely to have resulted from morbidity as to have influenced it. The patients' attitude towards medications were mostly negative but their confidence in their doctors and their level of family support were high; none of these factors, however, were associated with morbidity. Attack management skills as a behavioural measure of self care efficacy was not significantly predicted by any of these personal or psychosocial factors. A practical implication of these findings is that asthma self management should focus on developing specific knowledge and skills in the self treatment of asthma attacks.

Promoters containing ATF-binding sites are de-regulated in cells that express the EWS/ATF1 oncogene

Chromosomal translocations that fuse the N-terminal region of the Ewings sarcoma oncogene (EWS) to the C-terminal region (including the DNA-binding domain) of the cellular transcription factor ATF1 are associated with a tumour type termed malignant melanoma of soft parts (MMSP). It is envisioned that transformation by the EWS/ATF1 fusion protein results from aberrant transcriptional regulation of genes that are normally regulated by ATF1. To examine this hypothesis we have expressed exogenous EWS-ATF1 in JEG3 cells and tested its ability to activate several promoters that contain binding sites for ATF1. We show that EWS-ATF1 is a strong constitutive activator of some promoters tested but represses others. Significantly, the ability of particular promoters to be activated by EWS/ATF1 in JEG3 cells correlates with promoter activity in two MMSP-derived cell lines (SU-CCS-1 and DTC1). Our results therefore provide evidence that endogenous EWS/ATF1 can de-regulate transcription and that this capacity may contribute to transformation in MMSP.

Fatal alkali burns

A case is reported of a worker in an aluminium plant who was found lying in a shallow pool of concentrated caustic solution, which had been heated to approximately 95 degrees C. He had been employed to operate a pump draining a sump. A pressurised ruptured airline lay nearby, this being the likely precipitating cause of an alkaline spray. The spray led to the deceased running towards the nearest safety shower, at the base of which he was subsequently found. This is a relatively uncommon form of death, resulting from contact with a hot concentrated alkali solution. Subsequent experimentation indicated that the deceased had been in contact with the fluid for a period of approximately 13 min.

A 50-year prospective study of the psychological sequelae of World War II combat

OBJECTIVE

The authors took advantage of a 50-year prospective study of World War II veterans to examine the predictors and correlates of combat exposure, symptoms of posttraumatic stress disorder (PTSD), and trait neuroticism.

METHOD

The subjects were 107 veterans who had been extensively studied before and immediately after serving overseas in World War II. All served as members of the study until the present time, and 91 completed questionnaires of both PTSD symptoms and neuroticism.

RESULTS

In this study group, variables associated with positive psychosocial health in adolescence and at age 65 predicted combat exposure. Combat exposure and number of physiological symptoms during combat stress--but not during civilian stress--predicted symptoms of PTSD in 1946 and 1988. Combat exposure also predicted early death and study attrition. Psychosocial vulnerability in adolescence and at age 65 and physiological symptoms during civilian stress--but not during combat stress--predicted trait neuroticism at age 65.

CONCLUSIONS

Combat exposure predicted symptoms of PTSD but not nonspecific measures of psychopathology. Premorbid vulnerability predicted subsequent psychopathology but not symptoms of PTSD.

Gunshot suicide with nasal entry

A man with a long history of depression had recently borrowed a rifle. His body was found on its back in bed in his caravan. A rifle lay over the body with the muzzle pointing towards the head. A suicide note was found at the scene. Autopsy revealed entry via the nose with the track passing through the base of the skull to the right parietal region where the main bullet fragments were located beneath the scalp. The history, scene and autopsy findings were consistent with the gunshot wound being suicidal. We can find only one mention of a suicidal gunshot wound with nasal entry in the English-language literature, although a personal communication informed us of a similar case in the Republic of Ireland within the past two years. We report this case because of its unusual nature.

An in vivo assay for members of the cAMP response element-binding protein family of transcription factors

The CREB/ATF family of dimeric basic/leucine zipper (bZIP) transcription factors have been implicated in signal transduction by several agents including intracellular cAMP. The ubiquity of the cAMP-signaling pathway in mammalian cells has made it difficult to assay individual family members in their native form and dissect their roles in signal transduction. In light of observations that ATF1 exhibits several cell-specific characteristics and is allosterically regulated, the above problem has represented a particular limitation for studying ATF1. To address this we have exploited the modular nature of the bZIP domain to design fusion proteins that closely resemble native ATF1 but have altered DNA binding and dimerization specificity. The activity of these novel proteins can be monitored following their introduction into a cAMP-responsive cell type. Thus we describe an assay for members of the CREB family that should be generally applicable in a range of cell types and to other bZIP protein families.

A comparison of outcomes between joint and physician-only obstetric practices

Since 1981, the cesarean birth rate of a joint practice has been consistently lower than that of physician-only practices at a private community hospital in Yolo County, California. This study sought to determine whether differences in perinatal outcomes were influenced by women's use of a joint versus a physician-only practice or were associated with parity, maternal age, or newborn birthweight. Data from the hospital's 1634 consecutive singleton births in 1990 were examined, using a prospective concurrent analytic cohort study design. Chi square statistics and stepwise logistic regressions were used for data analysis. The joint practice had a significantly lower rate of total cesarean births (9.3%) compared with the physician-only practices (17.7%); the frequencies of severe lacerations were 1.0 percent and 6.4 percent, respectively. No significant differences were found in parity, birthweight, or newborn outcomes in the two types of practice. Type of practice was the major determinant of cesarean birth (p < 0.0001). All variables studied, including type of practice, were significant determinants of primary cesarean birth. Parity and practice type were significant determinants of third- and fourth-degree lacerations (p < 0.0001). The type of practice from which women receive care is significantly associated with both method of birth and possibility of severe perineal trauma.

Homicidal strangulation by victim's own hair presenting as natural death

We report an unusual case of homicidal strangulation of a healthy woman using her own head hair as the ligature. An attempt was made by the accused murderer to mask the homicide. Autopsy findings are presented that emphasize the lack of injuries to the deep neck structures when a soft, broad ligature is used. This case also highlights the difficulties arising in interpretation of pathological findings in asphyxial deaths, when the circumstances are not available and the ligature is not in place. Review of the English language literature found no similar case.

A monomeric derivative of the cellular transcription factor CREB functions as a constitutive activator

The mammalian transcriptional activator CREB binds as a dimer to a broad spectrum of inducible promoters. CREB activity is modulated by several signalling agents (protein kinase A [PKA], Ca2+, and transforming growth factor beta) and via functional interactions with cell-specific transcription factors. In addition, CREB can activate transcription constitutively and repress the activity of several other transcriptional activators. The mechanisms that allow CREB to act in such a malleable manner and the role that CREB dimerization might play in this are poorly understood. To probe the latter issue, we have created monomeric forms of CREB by fusing CREB to the DNA-binding domain of a protein (B-cell specific activator protein [BSAP]) that binds to DNA as a monomer. Remarkably, monomeric CREB acts as a potent, constitutive activator under conditions in which native CREB is inducible by PKA. Thus, CREB contains constitutive activation regions that are unable to function in native CREB. Two glutamine-rich domains that are important for native, PKA-inducible CREB activity are required for the constitutive activity of monomeric CREB. In contrast, two elements within the kinase-inducible domain of CREB are dispensable for constitutive activity. We discuss our results in relation to inducible and constitutive CREB activity and the potential modes of action of other activators that directly interact with CREB.

Immunosuppression by corticosteroid has no effect on the pregnancy rate in routine in-vitro fertilization/embryo transfer patients

Immunosuppression by exogenous corticosteroids has been used to improve the rates of embryo implantation and pregnancy in in-vitro fertilization (IVF) patients who have micromanipulated embryos replaced. The present study was conducted, in a prospective design, to evaluate effects of corticosteroid on the pregnancy rate in IVF/embryo transfer patients who have non-micromanipulated embryos replaced. Infertile women < 40 years old with tubal factor were included in this study. Patients were grouped according to the different follicle stimulation protocols, and received various doses of 16 beta-methylprednisolone (0, 16 or 60 mg/day) for 4 days from the day of oocyte retrieval. The mean age, duration of infertility, length of folliculogenesis and serum oestradiol concentrations at the time of human chorionic gonadotrophin (HCG) injection were not significantly different between control and corticosteroid-treated groups of patients. Short-term immunosuppression by 16 beta-methylprednisolone administration did not show any effects on the pregnancy and miscarriage rates in IVF/embryo transfer patients. Also, immunosuppression showed no dose effects in any groups. There was no relationship between the types of follicle stimulation protocols and the effect of 16 beta-methylprednisolone. Therefore, we concluded that short-term immunosuppression by exogenous corticosteroids in IVF/embryo transfer patients who have embryos with intact zona pellucida replaced has neither positive nor negative effects on pregnancy rates.

Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study

OBJECTIVE

To evaluate the effectiveness of acupressure in reducing nausea and vomiting of pregnancy.

METHODS

Symptomatic pregnant women were randomized to one of two acupressure groups: one treatment group using an acupressure point (PC-6) and one sham control group using a placebo point. Subjects were blind to the group assignment. Each evening for 10 consecutive days, the subjects completed an assessment scale describing the severity and frequency of symptoms that occurred. Data from the first 3 days were used as pre-treatment scores. Beginning on the morning of the fourth day, each subject used acupressure at her assigned point for 10 minutes four times a day. Data from day 4 were discarded to allow 24 hours for the treatment to take effect. Data from days 5-7 were used to measure treatment effect.

RESULTS

Sixty women completed the study. There were no differences between groups in attrition, parity, fetal number, maternal age, gestational age at entry, or pre-treatment nausea and emesis scores. Analysis of variance indicated that both groups improved significantly over time, but that nausea improved significantly more in the treatment group than in the sham control group (F1,58 = 10.4, P = .0021). There were no differences in the severity or frequency of emesis between the groups. There was a significant positive correlation (r = 0.261, P = .044) between maternal age and severity of nausea.

CONCLUSIONS

Our results indicate that acupressure at the PC-6 anatomical site is effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women.

Utilization of substrates for testosterone and estradiol-17 beta production by small follicles of the chicken ovary

A study was conducted to characterize steroidogenesis in small ovarian follicles (1-10 mm in diameter) of the hen.

THE AIMS OF OUR STUDY WERE

1) to determine basal estradiol-17 beta (E2) production by different sizes of small follicles; 2) to determine the ability of intact small follicles to utilize exogenous substrates for testosterone (T) and E2 production; and 3) to investigate the preferred steroidogenic pathway in small follicles. Small follicles which had not entered the hierarchy were isolated from ovaries obtained 2 hr after oviposition and divided into three groups: small white follicles (SWF; 1-2 mm in diameter), large white follicles (LWF; 2-4 mm in diameter), and small yellow follicles (SYF; 5-10 mm in diameter). Yolk and granulosa cells were removed from LWFs and SYFs and the remaining theca layer was called a follicle shell. Intact follicles or follicle shells (4/4 ml/tube) were incubated in avian Ringer's buffer supplemented with 10 mM HEPES and 0.1% BSA at 37 degrees C for 3 hr with various treatments. Testosterone and E2 were measured in the medium. The SYFs and their corresponding follicle shells produced the greatest amount of E2 when E2 production was expressed per follicle. Addition of 2 mM 8-Br-cAMP to the incubation medium stimulated E2 production by all sizes of follicles and follicle shells. However, follicle shells produced lower basal- and 8-Br-cAMP-stimulated E2 secretion compared to corresponding intact follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Fatigue as a response to environmental demands in women's lives

Fatigue is a significant health care problem of interest to professionals in many disciplines. Yet, it is poorly understood. Fatigue, as an indicator of adaptation, is examined in relationship to internal and external environmental demands in women's lives. From a secondary analysis of data collected from a large group of women in a Northwest urban community in the U.S., it was found that internal demands such as depression or anxiety are more significantly related to fatigue and vitality than external demands such as negative life events or employment status.

Management of malignant pleural effusions with pleuroperitoneal shunting

Malignant pleural effusions are often debilitating conditions for the patient with advanced carcinoma. Traditionally, treatment has been repeated thoracentesis or tube thoracostomy with instillation of sclerosing agents. However, this required the patient to be hospitalized and to have pain and inconveniences of the chest tubes. The drainage also had to be low enough for sclerotherapy to be effective. In 1982, the pleuroperitoneal shunt became a feasible alternative to sclerotherapy. We began using the Denver pleuroperitoneal shunt in July 1991. Twenty shunts were inserted into 19 patients during a two year period ending June 30, 1993. All patients but one were relieved of dyspnea. The mean duration of patency was 26 months and fewer than 25 percent of the shunts clotted before the death of the patient. Our favorable experience with the shunt has resulted in us recommending the Denver pleuroperitoneal shunt for treatment of recurrent malignant pleural effusions and selectively as primary treatment.