[Strategics of medical centers and regional hospitals in response to new labour insurance fee schedule]

The purpose of this paper is to evaluate the medical centers and regional hospitals, strategic response to the implementation of new labour insurance fee schedule. This survey selects fifty-one medical centers and regional hospitals, with the response rate of 92.73%. This questionnaire was developed and evaluated by the authors and mailed to the questionnaire response by hospital's director or relative department director. We have selected Shortell et al. (1985) theory as the framework for evaluating and explaining hospital response to regulation environment (ex: change in the reimbursement system) at institutional-level response (ex: hospital association activity aimed at influencing regulation), managerial-level response (ex: increased physician participation in hospital-wide decision making; starting or expanding a planning department) and technical-level response (ex: shared clinical services such as lab., X-ray, pharmacy). The result found that hospitals with the characteristics as non-public ownership, medical centers, bigger size, and more administrative staff are more inclined to adopt institutional-level response. And a technical-level response occurs to hospital when market competibility becomes more intense which leads to higher reimbursement resource dependency.

Cytokines, endotoxin, and glucocorticoids regulate the expression of inducible nitric oxide synthase in hepatocytes

Nitric oxide (NO.) is a short-lived mediator which can be induced in a variety of cell types and produces many physiologic and metabolic changes in target cells. The inducible or high-output NO. synthase (NOS) pathway was first characterized in macrophages activated by lipopolysaccharide (LPS) and interferon gamma (IFN-gamma). Hepatocytes also express an inducible NOS following exposure to the combination of endotoxin (LPS) and tumor necrosis factor (TNF), interleukin 1 (IL-1), and IFN-gamma. In this study, to identify which of these cytokines, if any, was acting to induce the gene expression for hepatocyte NOS, we measured the levels of rat hepatocyte NOS mRNA by Northern blot analysis after stimulation by various combinations of endotoxin and cytokines in vitro. We found the mRNA for hepatocyte NOS to be a single band at approximately 4.5 kilobases which was maximally up-regulated (approximately 70-fold) by the combination of TNF, IL-1, IFN-gamma, and LPS. Abundance of NOS mRNA peaked 6-8 hr after stimulation and then declined by 25% at 24 hr. Unstimulated hepatocytes in vitro showed only a trace mRNA band after prolonged autoradiographic exposure. As single agents, TNF and IL-1 were the most effective inducers of hepatocyte NOS mRNA. Combinations of two or three stimuli revealed strong synergy between TNF, IL-1, and IFN-gamma. The increased mRNA levels correlated with elevated nitrogen oxide release and cGMP levels in the culture supernatants. Dexamethasone and cycloheximide inhibited induction of mRNA for hepatocyte NOS in a dose-dependent fashion. The addition of NG-monomethyl-L-arginine had no effect on mRNA levels but effectively blocked NO. formation. The inducible hepatocyte NOS mRNA was also detected in rat hepatocytes following chronic hepatic inflammation triggered by Corynebacterium parvum injection in vivo. These data demonstrate that the inducible NOS is functional in rat hepatocytes both in vitro and in vivo and that this pathway is under complex control. Endotoxin and inflammatory cytokines act synergistically to up-regulate gene expression for hepatocyte NOS, whereas glucocorticoids down-regulate the mRNA.

Induction of hepatocyte lipopolysaccharide binding protein in models of sepsis and the acute-phase response

Lipopolysaccharide binding protein (LBP) is a serum glycoprotein that complexes with lipopolysaccharide (LPS) to facilitate macrophage response to endotoxin. To determine the conditions that stimulate LBP production in vivo, we measured the induction of LBP in models of inflammation produced by LPS, Corynebacterium parvum, and turpentine injection. Plasma aspartate aminotransferase and alanine aminotransferase concentrations and hepatocyte fibrinogen synthesis were elevated in all models. Northern blot analysis revealed 17-, 14-, and 20-fold upregulation of hepatocyte LBP mRNA following treatment with LPS, C parvum, and turpentine, respectively. Peritoneal macrophage interleukin 6 and tumor necrosis factor production following endotoxin stimulation was augmented by cultured hepatocyte supernatants, suggesting increased LBP synthesis in these groups. The results show that LBP mRNA is induced during hepatic inflammation and suggest that LBP is an acute-phase protein important in regulating the in vivo response to endotoxin.

Graft cytokine mRNA activity in rat single lung transplants by reverse transcription-polymerase chain reaction: effect of cyclosporine

Intragraft levels of cytokine mRNA were studied in an orthotopic rat left lung transplant model. Three groups of rats were compared at 7 days after transplantation. Isogeneic (Lewis to Lewis), allogeneic (Brown-Norway to Lewis) untreated, and cyclosporine-treated (25 mg/kg/day, intramuscularly) allogeneic animals underwent analysis of cytokine mRNA isolated from total RNA in freshly excised grafts. Reverse transcription-polymerase chain reaction amplification of interleukin (IL)-2, IL-4, and actin (control) mRNA was performed with custom-synthesized oligonucleotide amplimers targeted to known sequences of rat IL-2 and IL-4 cDNA. Semiquantitative analysis was performed by radioanalytic scanning of gel preparations. Sample specimens from the retrieved grafts were also graded histologically for rejection on a five-point scale. Rejection was most severe in the untreated allografts (p < 0.003). IL-2 mRNA was significantly greater in the untreated allografts when compared with isografts (p < 0.05) and cyclosporine-treated allografts (p < 0.05). No significant differences in IL-4 mRNA between groups were observed. We conclude that semiquantitative analysis of cytokine mRNA by reverse transcription-polymerase chain reaction is a useful and sensitive method for the study of acute rejection in lung grafts and that this technique may become an important tool in future studies of cytokine-mediated responses in cyclosporine-treated allografts.

[Lung hamartoma: a report of 30 cases and review of 477 cases]

507 cases of lung hamartoma (30 cases reported and 477 reviewed) were analysed. 467 cases of them were of intrapulmonary type, 30 were endobronchial, 8 were multiple and 2 were diffuse. 505 were benign and 2 malignant. The male to female ratio was 1.74:1. The age span was from infant to 67 years with a mean of 41.4 years. 44.3% of the lesions showed no symptoms. The frequently seen symptoms were cough and chest pain. X-ray findings of the intrapulmonary type were characterized by sharply outlined round or oval mass (87.9%), with diameters 3.0 cm (62.1%), lobulation (33.5%), calcification (23.6%). These tumors grew slowly. The average doubling time for 16 cases was 4.2 years. The diagnosis was confirmed in only 18% cases preoperatively. The other cases were misdiagnosed as lung cancer, tuberculoma, metastatic tumors of the lung, etc. The etiological causes, classification, diagnosis, differential diagnosis and treatment of the tumors were discussed.

FK-506 inhibits proliferation and IL-4 messenger RNA production by a T-helper 2 cell line

FK-506 is a potent immunosuppressant which is known to decrease the generation of allospecific cytotoxic T cells, possibly through its effect on cytokine production. FK-506 has been reported to have a suppressive effect on cytokine synthesis and secretion by pooled lymphocytes; its action on more selective subsets of lymphocytes is unknown. We currently report the effect of FK-506 on proliferation and IL-4 messenger RNA production by the differentiated mouse T-helper 2 cell line Ly1+2-/9. Ly1+2-/9 cells were grown in culture and treated with (1) media alone, (2) Con A, (3) FK-506, and (4) Con A + FK-506. Proliferation to Con A was determined by treating cells with 10 micrograms/ml Con A +/- FK-506 and measuring [3H]TdR uptake. Reverse transcriptase-polymerase chain reaction amplification was used to quantitate the level of IL-4 mRNA expression. FK-506 markedly inhibits Con A-induced proliferation and IL-4 mRNA production by the T-helper 2 cell line Ly1+2-/9. The ability of FK-506 to block the proliferation and IL-4 production by this helper cell subset suggests that this effect may contribute to its observed marked immunosuppressive properties in vitro and in vivo.

[Combined use of glucose and rest period between noise exposure to reduce noise--induced hearing loss]

This paper reports the way which protects hearing from harmful effects of noise. 67 guinea pigs were divided into four groups, 8-9 guinea pigs in each group. The total time of noise exposure at 125 dB SPL white noise in each group was one hour. The control was exposed continuously for 1 hour. Group I was exposed to noise for 30 minutes after intraperitoneal injection of glucose at 2 mg/g body wt., then rest for 30 minutes and exposed for 30 minutes again. Group II was exposed continuously to noise for 1 hour after intraperitoneal injection of glucose at 2 mg and 4 mg/g body wt. Group III was exposed to noise for 30 minutes, rested for 30 minutes and exposed for 30 minutes again without glucose injection. The auditory brain stem response (ABR) was measured before, immediately, 3 days, and 7 days after noise exposure. The effect on hearing conservation was evaluated according to ABR threshold. We observed that the auditory threshold in group I was significantly lower than that of the control in the given time after noise exposure (P less than 0.05), but not so in group II and III. Combined use of glucose and rest period between noise exposure was able to decrease the threshold shift by 15 dB and 10 dB immediately and 7 days after noise exposure respectively.

Purification of radioiodinated human insulin by high performance liquid chromatography for a sensitive radioimmunoassay

The optimal sensitivity of a radioimmunoassay depends on the purity of the radiolabeled antigen. The conventional purification methods are not complete and are time consuming. The combination of a Sep-pak C18 cartridge and high performance liquid chromatography (HPLC) for the purification of 125I-labeled insulin in our study revealed that the Sep-pak cartridge can serve as the preliminary step to remove unreacted radioactive iodide, the reactants, and labeled but presumably damaged materials unadsorbed to the cartridge. The fractions eluted from the Sep-pak containing high radioactivity and high immunoreactivity to the antibody were chosen for further purification by HPLC to eliminate undesirable radiolabeled substances with a lesser immunoreactivity. The purified radiolabeled insulin was used to develop a sensitive radioimmunoassay with detecting limits of 0.03 microU/mL per tube.

Ferrioxamine B derivatives as hepatobiliary contrast agents for magnetic resonance imaging

Succinyl (SDF), phenylsuccinyl (PSDF), glutaryl (GDF), and phenylglutaryl (PGDF) derivatives of desferrioxamine B (DF) have been synthesized. In rats given the 59Fe(III) chelates of each these ligands at tracer levels, 82-94% of the 59Fe was eliminated within 1-2 days. 59Fe given as DF, SDF, and GDF chelates was excreted primarily in the urine, while nearly 50% of that given as PSDF and PGDF was excreted in the feces. Correspondingly, Fe-DF, Fe-SDF, and Fe-GDF (0.2 mmol/kg) produced early, marked renal, but no gastrointestinal magnetic resonance imaging (MRI) enhancement. Fe-PSDF and Fe-PGDF (0.2 mmol/kg) produced marked and rapid MRI enhancement of the upper small intestine. In animals with cannulated bile ducts, 59Fe from 59Fe-PGDF (carrier added, 0.1 mmol/kg) appeared rapidly in the collected bile, but not in the intestinal contents, proving that the contrast agent reaches the bowel via the bile. These changes in the excretion and MRI enhancement patterns brought about by the presence of a phenyl substituent apparently were not related to changes in lipophilicity or protein binding.

Innervation of the knee joint in the rabbit and the Formosan rock-monkey (Macaca cyclopis): a retrograde HRP study

The number and segmental distribution of cell bodies of sensory afferents and sympathetic efferent innervating to the knee joint of the rabbit and the Formosan rock-monkey were investigated using retrograde transport with horseradish peroxidase (HRP). After injecting HRP into the articular knee joint capsule of the rabbits, labeled neurons were found in the ipsilateral L4-S2 dorsal root ganglia (DRG). However, following injection of HRP into the articular cavity of the knee joint in the rabbit and the monkey, labeled neurons were found in both the ipsilateral DRG (L5-S2 and L4-S1 of the rabbit and monkey, respectively) and in the ipsilateral sympathetic ganglia (SG) (L4-S3 (rabbit) and L3-S1 (monkey)). The majority of labeled neurons within the DRG and the SG were composed of medium and large neurons in the monkey and the rabbit, respectively. The present findings suggest that the sensory projections from and sympathetic projection to the knee joint in rabbits and monkeys are similar, but that both projections of monkeys were "shifted" one segment cranially compared to the rabbit on both projections.

The study of serum apoprotein levels as indicators for the severity of angiographically assessed coronary artery disease

Serum apoprotein A-I (Apo A-I) and B (Apo-B) concentrations were determined in 40 subjects undergoing coronary angiography for past myocardial infarction and angina pectoris, and the authors studied the relationship between the apoprotein concentrations and the severity of coronary artery disease (CAD). During this study, serum total cholesterol, triglyceride, and high-density lipoprotein, low-density lipoprotein, and very low density lipoprotein cholesterol concentrations were determined to control analysis. The results showed that the decrease in serum Apo A-I levels was the best indicator distinguishing CAD from non-coronary artery disease; the Apo B/Apo A-I ratio had the most consistent association with the severity of CAD as assessed by angiography; Apo B/Apo A-I values ranging from 0.98 to 1.00 might be considered critical values for early CAD.

[Activation of neutrophils in allergic asthmatics]

Neutrophil chemotactic activity (NCA) and activity of myeloperoxidase (MPO) of the neutrophils in asthmatic patients during attacks and in remission and normal controls were determined. The results showed that NCA and activity of MPO in asthmatic patients during attacks were significantly higher than those in remission and in the controls. There was no difference of either NCA or the activity of MPO between asthmatic patients in remission and the controls. There was definite correlation between NCA and activity of MPO in asthmatic patients during attacks, but no correlation between the asthmatic patients in remission and the controls. The results suggest that chemotaxis and activation of neutrophils by neutrophil chemotactic factor may play an important role in pathophysiology of asthma.

Soft tissue expansion in the treatment of scar alopecia in preschool children

Indigenous rubber silicon gel soft tissue expanders were used to treat 5 preschool children with scar alopecia. The scar resection rate wa 100%; no severe complication happened. The average healing time was 25 days after the improvement of technical method. This method is simple, effective and the expansion duration is short.

[Clinical and experimental study on treatment of anorexy in children with the activating spleen prescription]

The treatment of 488 cases with anorexy in children showed that the curative effect of the group using Chinese medicines based on the differentiation of symptoms and signs by (1) activating the Spleen, (2) invigorating and activating the spleen was significantly higher than the control using concentrated vitamin B complex (P less than 0.001). The results of the experimental study were as follows: Erbao instant granules (the medicine for activating the Spleen) had the effect of raising the D-xylose excretion rate of urine; increasing the ratio of T-lymph cells in blood; raising the quality of 8 mineral elements in hair and the quality of SIgA in saliva; adjusting the abnormal peristalsis of the experimental rabbits and promoting the ability that duodenums which had been separated from rabbits had to absorb different amino acids and glucose. Jian'er syrup (the medicine for invigorating and activating the Spleen) had the effect of raising the quality of 14 mineral elements in hair; increasing the ratio of T-lymph cells in blood; increasing the index of thymus and spleen in the experimental rats and stimulating them to produce hemolysin. The authors tend to think that the therapeutic principle of activating the Spleen can improve appetite, help the body to absorb and utilize various nutrients which contain many kinds of essential trace elements.

Treatment of renal transplant stones by extracorporeal shock-wave lithotripsy in the prone position

Two patients with renal transplant lithiasis were successfully treated with extracorporeal shock-wave lithotripsy (ESWL) in the prone position. Pathogenesis and treatment of transplant lithiasis are discussed. Performing ESWL on renal transplant patients in the prone position has advantages over standard positioning techniques.

Nifedipine pretreatment for autonomic dysreflexia during electroejaculation

Ten spinal-cord-injured males who exhibited autonomic dysreflexia during electroejaculation were given sublingual calcium channel blocker nifedipine pretreatment to prevent this complication. Nifedipine was successful in decreasing peak systolic, diastolic, and mean blood pressures during the procedure. The use of nifedipine resulted in fewer aborted trials and allowed higher energy delivery during the procedure.

Evaluation of Gd-DTPA-labeled dextran as an intravascular MR contrast agent: imaging characteristics in normal rat tissues

Dextran covalently linked to moieties of gadolinium diethylenetriamine pentaacetic acid (DTPA), for use as a macromolecular, intravascular blood pool marker for contrast material-enhanced magnetic resonance (MR) imaging was characterized by means of physicochemical and relaxivity measurements and MR imaging in healthy rats. Dextran labeled with 15 Gd-DTPA moities (molecular weight of approximately 75,000 d) had a T1 relaxivity at 0.25 T and 37 degrees C of 157.1 mmol-1.sec-1 per molecule and 10.5 mmol-1.sec-1 per gadolinium atom, more than twice that of unbound Gd-DTPA. Osmolality was 300-350 mOsm/kg at a gadolinium concentration of 0.01 mmol/L. Tissue enhancement was essentially linearly related to injected dose in the gadolinium dose range of 0.01-0.05 mmol/kg of body weight. Approximate typical enhancement values over baseline for normal tissues at 10 minutes after a gadolinium dose of 0.05 mmol/kg were as follows: cardiac muscle, adrenal gland, and liver, 40%-50%; lungs, 160%-200%; renal cortex, 130%; renal medulla, 240%; spleen, 75%; muscle, 15%; and brain, 5%-10%. Projection-subtraction images showed that dextran-(Gd-DTPA)15 remained intravascular for at least 1 hour after injection. The prolonged and easily appreciated levels of tissue enhancement with dextran-(Gd-DTPA)15, at a gadolinium dose less than that routinely used in Gd-DTPA, indicate further evaluation of this macromolecular marker.

A scrotal graft technique for the repair of prostatic-cutaneous fistulas

Three patients who had a prostatic urethral fistula into the presacral space and perineal urinary drainage after rectal resection or vascular injury with rectal sloughing were treated successfully by a transperineal, extraurethral scrotal inlay flap.

Urethral dilation in the management of urological complications of myelodysplasia

Urethral dilation was performed in 11 of 65 myelodysplastic children with high intravesical pressures. These 11 children had persistent bladder pressure elevations uncontrolled by intermittent catheterization and anticholinergic agents. After dilation intravesical pressures decreased, and upper tract function and measured bladder compliance improved. No discernible effect on continence function occurred. The procedure appears to be a safe alternative to temporary vesicostomy in myelodysplastic children with high intravesical pressures that cannot be controlled by intermittent catheterization and anticholinergic agents.

The production of polyclonal and monoclonal antibodies in mice using novel immunization methods

Two novel immunization methods (intrasplenic and intra-inguinal lymph node) have been developed for the production of polyclonal and monoclonal antibodies in mice. Freund's complete adjuvant and antigen were mixed in the ratio of 1:2 (v/v). Various concentrations of human serum albumin (HSA) were used as antigen. No primary immune response was induced with 0.1 microgram of HSA in either of the methods studied. Intrasplenic immunization resulted in the strongest primary immune responses using all other doses of HSA. The primary immune response induced by intrasplenic immunization with 0.5 microgram of HSA was higher than any response induced by subcutaneous immunization with various doses of HSA. Inguinal lymph node immunization was less effective than intrasplenic immunization but better than subcutaneous immunization with 1-50 micrograms of HSA. Comparisons were also made of the efficacy of different adjuvants when inducing primary immune responses with 1 microgram of HSA. Freund's complete adjuvant resulted in a much stronger response than Freund's incomplete adjuvant and alum. Both intrasplenic and inguinal lymph node immunization using 1-5 micrograms of HSA were able to induce strong primary immune responses. Secondary immunization with either method or intravenous injection 3 days before fusion resulted in a higher frequency of specific monoclonal antibodies.

Emission properties of surface-emitting distributed-feedback and distributed-Bragg-reflector semiconductor lasers

We use a single-mode transfer equation model to study the performance of vertical-cavity surface-emitting distributed- feedback (DFB) and distributed-Bragg-reflector (DBR) semiconductor lasers above threshold. We find that DBR lasers exhibit less envelope spatial hole burning than both single and double phase-shifted DFB lasers and therefore may achieve more stable single-longitudinal-mode operation.

A brief overview of nuclear medicine in China

The year 1956 witnessed the birth of Nuclear Medicine in China, when the first course, Biomedical Applications of Isotopes, was offered in our country by the Peking Union Medical College (PUMC). This course was preceded by a training course in nuclear instruments in which students learned to construct the radiation detection devices required for performing experiments using radioisotopes. In 1958, several courses in clinical nuclear medicine brought up the first generation of nuclear medicine physicians in China. Historically, some of the chief events include: (1) operation of the first reactor, producing 33 radioactive isotopes in 1958; (2) first linear scanner built in 1960; (3) setting up an organization for the control of radiopharmaceuticals in 1961; (4) distribution of the first batch of cyclotron-produced isotopes in 1963; (5) development and use of the first radioimmunoassay (RIA) procedure in 1963; (6) production of tritium in 1964; (7) production of 99.8% enriched heavy water in 1965; (8) supply of 99mTc and 113mIn generators in 1972; (9) first gamma camera imported in 1972 and first homemade gamma camera installed in 1977; (10) founding of Chinese Society of Nuclear Medicine (CSNM) in 1980; (11) publication of the Chinese Journal of Nuclear Medicine beginning in 1981; (12) first single photon emission computed tomography (SPECT) imported in 1983. At present, there are 556 nuclear medicine departments in China with 4,000 staff.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro effects of cycloheximide and luteinizing hormone on the estradiol-to-progesterone shift in follicular steroidogenesis

The objectives of this study were to establish a completely in vitro system that would simulate the in vivo effects of cycloheximide (cyclo) on preovulatory serum levels of estradiol (E2) (prolonged) and progesterone (P4) (reduced). Graafian follicles were removed from proestrous hamsters at 0900 h and incubated for a basal hour (Hour 1) with various doses of cyclo before the medium was replaced; in Hour 2, 100 ng luteinizing hormone (LH) was added with cyclo added every hour for 5 or 6 h. The endpoints were steroid levels/follicle/h per ml medium of P4, 17 alpha-hydroxyprogesterone (170HP), androstenedione (A), and E2. The goal was best accomplished with hourly addition of 400 ng cyclo, which reduced follicular protein synthesis by 76%. Cyclo suppressed P4 and 170HP and prolonged the accumulation of A and E2, in Hour 5 and Hour 6, correlated with sustained thecal C-17,20-lyase/17 alpha-hydroxylase as determined by enzyme assays. Cyclo therefore prevented the early demise of the enzyme complex after LH stimulation and hence prolonged the ability of the theca to provide androgens for conversion to E2 by the granulosa cells. Our earlier work established that one of the major effects of LH is to recruit the granulosa compartment as a source of C-21 steroids, and cyclo interferes with the availability of cholesterol to mitochondrial side-chain cleavage (Greenwald and Limback, 1984). Thus, cyclo affects follicular steroidogenesis through different mechanisms in theca and granulosa.

Vascular mapping using albumin-(Gd-DTPA), an intravascular MR contrast agent, and projection MR imaging

An intravascular magnetic resonance (MR) contrast agent is valuable for vascular mapping of tissues when used in combination with projection spin-echo MR imaging. The primary advantage of using projection imaging lies in its global depiction of anatomy. Also, relatively short echo time values can be readily achieved, reducing flow dephasing signal losses from blood and increasing overall signal-to-noise. These advantages, coupled with the reduction of blood pool T1 values due to the presence of the intravascular contrast agent, allow for detailed spatial mapping of slow-flow vascular structures using MR.

Stereoscopic MR imaging

The visual fusion of two projection or slice-selective magnetic resonance (MR) images taken at two oblique angles imparts three-dimensional (3D) information within the projection or slice. This approach to 3D MR is rapid and straightforward, requiring only two oblique images and, at most, only a simple optical stereoscope for viewing. Stereoscopic images of the vascular system of a rat were obtained using the intravascular contrast agent albumin-(Gd-diethylenetriaminepentaacetic acid). Stereoscopic images of the human head showing CSF distribution were acquired using a long echo time sequence. These images illustrate the potential clinical applications of this technique.

A bladder pressure management system for myelodysplasia--clinical outcome

A program for the management of neurogenic bladder in patients with myelodysplasia was instituted in July 1983. Of the 114 patients entered into the program who have been followed for a minimum of 18 months 42 per cent required treatment for high intravesical pressures. None of this group or the larger group with low bladder pressures showed progressive upper urinary tract deterioration. In 8 children (17 per cent of those with high pressure bladder dysfunction) high intravesical pressure persisted despite anticholinergic medication and intermittent catheterization, and they required an operation to achieve a low pressure bladder. These results confirm the findings in other studies that about 40 per cent of myelodysplastic children are at high risk for the development of upper tract changes, and that approximately 6 to 8 per cent will not respond sufficiently to anticholinergic agents and intermittent catheterization.

Fascial sling to correct male neurogenic sphincter incompetence: the McGuire/Raz approach

We report the surgical approach used in 4 male myelomeningocele patients suffering from severe urinary incontinence owing to poor bladder compliance and sphincter incompetence. While bladder compliance was corrected by enlargement cystoplasty the sphincteric incompetence was treated by an autologous fascial sling around the bladder neck with excellent results. We consider this operation as an alternative to the artificial urinary sphincter in cases of male neurogenic sphincter incontinence.

Effects of cycloheximide during the periovulatory period on ovarian follicular FSH, hCG, and prolactin receptors and on follicular maturation in the hamster

Hamsters were injected sc at 1400 hr on proestrus with either 4 mg cycloheximide (which blocks ovulation but only transiently affects ovarian protein synthesis) or saline and killed at 2-hr intervals until 0400 hr on estrus. After cycloheximide, the first surge of FSH (at 1600 hr) was half the normal value and the second surge of FSH (beginning at 2200 hr) was eliminated. Control follicles at 1400 hr had approximately the same number of FSH and hCG receptors with about one-third as many PRL receptors. Down regulation of FSH and hCG receptors for control follicles occurred by 2400 hr while PRL receptors dropped abruptly 4 hr earlier. Compared to the 1400-hr control values, the maximal loss of FSH, LH, and PRL receptors was 40, 45, and 85%, respectively. Although cycloheximide tended to slightly delay the loss of FSH receptors at 2000-2200 hr it did not prevent the ultimate fall in FSH and hCG receptors; the loss of PRL receptors was accelerated by 4 hr. Cycloheximide prevented or delayed follicular growth, resumption of meiosis, and cumulus expansion. The altered proestrous profile of steroids after cycloheximide (prolonged follicular estradiol and reduced progesterone) is therefore not associated with drastic alterations in the number of FSH and hCG binding sites. On the other hand, PRL receptors represent fast turnover protein(s).