Plasma thrombomodulin levels in women with systemic lupus erythematosus

Thrombomodulin (TM), an endothelial cell membrane glycoprotein, is released into blood as a soluble TM antigen after inflammation or injury to endothelium. Systemic lupus erythematosus (SLE) is characterized by multisystem inflammation of vascular endothelium. The objective of this study is to determine the circulating TM levels in pregnant and nonpregnant SLE women and the correlation of plasma TM levels with variables used to assess SLE activity. We found that there were no significant differences in plasma TM levels among pregnant SLE, nonpregnant SLE, and normal pregnant patients. However, significantly higher plasma TM levels were found in some SLE women with active disease or preeclampsia.

Telling stories: metaphors of the Human Genome Project

Scientists of the Human Genome Project tend to rely on three metaphors to describe their work, each of which implicitly tells much the same story. Whether they claim to interpret the ultimate “book,” to fix a flawed “machine,” or to map a mysterious “wilderness,” they invariably cast the researcher as one who dominates and exploits the Other. This essay, which explores the ways such a story conflicts with feminist values, proposes an alternative.

Addition of ruminally degradable crude protein and branched-chain volatile fatty acids to diets containing hydrolyzed feather meal and blood meal for lactating cows

This study investigated the effects of amounts of RDP and branched-chain VFA on milk production and DMI by 32 early lactation Holstein cows fed diets based on corn silage and corn. All supplemental dietary protein was supplied by animal protein by-products and urea. Hydrolyzed feather meal and ring-dried blood meal served as sources of supplemental protein and were fed in a 3:1 ratio on a N basis. The experimental design was a completely randomized design with a 2 x 2 factorial arrangement of treatments. Main factors were percentage of RDP (8.0 vs. 9.5% of dietary DM) and amount of branched-chain VFA in the diet (0 vs. 90 g/d per cow). Urea was used to adjust the amount of degradable CP. Individual DMI, milk production, and milk composition were monitored during wk 5 to 19 of lactation. Ruminal fluid and blood were collected to examine the treatment effects on ruminal VFA patterns and plasma urea N concentrations. The DMI, total milk production, and milk component yield were unaffected by treatments. The molar percentages of isobutryate, isovalerate, and n-valerate increased when branched-chain VFA were fed, and concentrations of urea N in plasma increased with higher percentages of RDP. A combination of feather meal and blood meal can be used as supplemental protein to support high milk production (> 37 kg/d) in early lactation. No production benefits were observed by increased dietary RDP or branched-chain VFA.

Maternal perception and Doppler detection of fetal movement

Fetal movement can be used as a tool for assessment of prenatal well-being. Maternal perception of fetal movement, using a formal graphic "count-to-ten" system is often used as an adjunct in high risk and normal pregnancies. Doppler detection of fetal movement is a newly introduced, easy to perform methodology. Identification of coupling fetal heart rate accelerations to fetal movement as an aid for nonstress testing and recognition of fetal behavior, fetal behavioral states and cycling between states, is a current clinical application of this new technique.

Flows of nitrogen and amino acids in dairy cows fed diets containing supplemental feather meal and blood meal

Four Holstein cows, fitted with ruminal and duodenal cannulas, were used to determine the effects of supplemental feather meal and blood meal on ruminal fermentation and flows of N and AA to the duodenum. The basal diet contained (DM basis) 9.9% chopped alfalfa hay, 39.7% corn silage, 34.7% cracked corn, 8.2% corn starch, 2.1% vitamins and minerals, 4.4% casein, and 1% urea. A combination of feather meal and blood meal (3:1 on an N basis) was used to replace 0, 33, 67, and 100% of the casein and urea in the basal diet in a Latin square design. Intakes of DM, OM, and N were similar for all diets. Flows of total N, NAN, individual AA, total AA, and total essential AA were unaltered as supplemental feather meal plus blood meal increased. Flows of microbial N tended to decrease, but flow of non-ammonia, nonmicrobial N increased as supplemental feather meal plus blood meal increased. Increased proportions of dietary feather plus blood meal decreased the proportions of Ile, Lys, Met, and Thr in duodenal digesta. Molar percentages of ruminal pH and VFA were unchanged, but concentrations of ruminal NH3 N decreased linearly as supplemental feather meal plus blood meal increased. For the diets fed in this study, inclusion of one-third of the supplemental protein from feather plus blood meal resulted in maximum flows of NAN and microbial N to the small intestine.

Elevated urine thrombomodulin/creatinine ratio in severely preeclamptic pregnancies

A relationship between the urine thrombomodulin/creatinine ratio and preeclampsia was investigated. Preeclamptic women had a higher urine thrombomodulin/creatinine ratio than did matched controls. However, significantly elevated urine thrombomodulin/creatinine ratios were found in severely, but not mildly, preeclamptic pregnancies.

Gene therapy of murine teratocarcinoma: separate functions for insulin-like growth factors I and II in immunogenicity and differentiation

Teratocarcinoma is a germ-line carcinoma giving rise to an embryoid tumor with structures derived from the three embryonic layers: mesoderm, endoderm, and ectoderm. Teratocarcinoma is widely used as an in vitro model system to study regulation of cell determination and differentiation during mammalian embryogenesis. Murine embryonic carcinoma (EC) PCC3 cells express insulin-like growth factor I(IGF-I) and its receptor, while all derivative tumor structures express IGF-I and IGF-II and their receptors. Therefore the system lends itself to dissect the role of these two growth factors during EC differentiation. With an episomal antisense strategy, we define a role for IGF-I in tumorigenicity and evasion of immune surveillance. Antisense IGF-I EC transfectants are shown to elicit a curative anti-tumor immune response with tumor regression at distal sites. In contrast, IGF-II is shown to drive determination and differentiation in EC cells. Since IGF-I and IGF-II bind to type I receptor and antisense sequence used for IGF-II cannot form duplex with endogenous IGF-I transcripts, it follows that this receptor is not involved in determination and differentiation.

Interpretation of biophysical profiles by nurses and physicians

OBJECTIVE

To determine the agreement between nurse and physician interpretation of biophysical profile scores.

DESIGN

A prospective evaluation of videotaped biophysical profiles was independently scored by four nurse and four physician interpreters and compared to that of an expert physician.

SETTING

The fetal assessment center of a large tertiary-care center; study included women from public and private practices.

PATIENTS

Twenty-three women with high-risk pregnancies who were regularly scheduled for a biophysical profile. Women pregnant with multiple fetuses or whose fetuses were less than 28 weeks' gestational age or had severe fetal anomalies were excluded.

MAIN OUTCOME MEASURE

The proportion of agreement between the physicians and nurses and the physician expert was calculated for each biophysical profile criterion.

RESULTS

The kappa statistic was used to evaluate the proportion of agreement with the "gold standard." When compared with the expert, physicians showed 60% moderate or substantial agreement, and the nurses showed 80% moderate or substantial agreement.

CONCLUSIONS

Nurses' interpretations of biophysical profiles were at least as reliable as physicians' when compared with an expert reviewer.

Uterine rupture associated with recent antepartum cocaine abuse

BACKGROUND

The diagnosis of uterine rupture is aided by the identification of risk factors, such as oxytocin administration. In several experiments, cocaine has been shown to stimulate uterine contractility. Complications from cocaine abuse during pregnancy have increased dramatically in the United States, and cocaine may increase the risk for uterine rupture.

CASES

Two cases of uterine rupture were associated with recent cocaine abuse.

CONCLUSION

These cases and recent experiments on the effect of cocaine on the pregnant uterus suggest that antepartum cocaine abuse may increase the risk of uterine rupture.

Elevated serum human chorionic gonadotropin as evidence of secretory response in severe preeclampsia

OBJECTIVE

Because preeclampsia is a trophoblastic disorder and human chorionic gonadotropin is secreted from trophoblast, we sought to determine whether measurement of serum human chorionic gonadotropin might reflect a different trophoblastic secretory response of preeclampsia.

STUDY DESIGN

Twenty patients with mild preeclampsia and 12 with severe preeclampsia were matched with 32 healthy, normotensive women in the third trimester with singleton pregnancies. Serum total human chorionic gonadotropin and total human chorionic gonadotropin-beta were measured by a two-site immunoenzymometric assay, and total hCG-alpha was determined by a double-antibody radioimmunoassay. Wilcoxon signed-rank and Mann-Whitney rank-sum tests were used for statistical analysis.

RESULTS

Serum total human chorionic gonadotropin, total human chorionic gonadotropin-alpha, and total human chorionic gonadotropin-beta levels were significantly higher in severely preeclamptic women (p < 0.05), but not in those with mild preeclampsia, compared with those in their matched controls.

CONCLUSION

Elevated serum human chorionic gonadotropin levels in severely preeclamptic women might reflect a significantly pathologic change and secretory reaction of the placenta.

Expression of insulin-like growth factors I and II in conceptuses from normal and diabetic mice

Insulin-like growth factors (IGF-I and IGF-II) play an important regulatory role in fetal growth and development. Alterations in expression of these growth factors may result in developmental abnormalities, macrosomia, and intrauterine growth retardation, which occur with a higher incidence in diabetic pregnancies. In situ hybridization histochemistry was employed to investigate the distribution and abundance of IGF-I and IGF-II in peri-implantation and postimplantation conceptuses from normal and streptozotocin-treated diabetic mice. Animals were sacrificed on gestational days 5, 6, 7, 8, and 9. The entire uterine horn was prepared for hybridization with antisense and sense alpha 35S-dATP labeled oligonucleotide probes for IGF-I, IGF-II, and mouse beta-actin. IGF-I transcript was apparent only in myometrium at 6 days of gestation in normal and diabetic mice. IGF-II transcripts were restricted to trophoectoderm cells within the implantation chamber on day 5. Following implantation, IGF-II transcripts were found in trophoectodermal derivatives, primitive endoderm, mesoderm, heart, walls of the foregut, and mesenchyme in normal and diabetic postimplantation conceptuses. There were no apparent differences between normal and diabetic samples in the distribution and abundance of the IGF-II transcript from gestational days 7, 8, and 9. The embryos from the diabetic mother at day 6 were growth retarded and had a significant decrease in the expression of IGF-II. These results suggest that maternal hyperglycemia may retard development of the early implanting conceptus in a narrow window around day 6 through a mechanism involving decreased IGF-II expression.(ABSTRACT TRUNCATED AT 250 WORDS)

Nutrient digestion, nitrogen, and amino acid flows in lactating cows fed soybean hulls in place of forage or concentrate

Five Holstein cows in early lactation were used in a 5 x 5 Latin square design to study substitution of soybean hulls for portions of forage or concentrate in diets. The control diet consisted of (DM basis) 10% alfalfa hay, 40% corn silage, 25% high moisture corn, 23% protein supplement, and 2.3% vitamins and minerals. Soybean hulls were used to replace approximately 25 and 50% of the forage or concentrate DM in the control ration. The DMI decreased linearly as soybean hulls replaced forage. The DM and OM flow to the duodenum and apparent and true digestion of OM in the stomach were similar among treatments. Ruminal pH was similar among treatments, but concentrations of NH3 N decreased linearly when soybean hulls replaced forage. Total VFA concentrations were similar when soybean hulls replaced forage but showed a positive quadratic response when soybean hulls replaced concentrate. Microbial N averaged 59% of NAN flow and showed a negative quadratic response when soybean hulls replaced concentrate. Flows of total AA and total essential AA to the duodenum were not altered when soybean hulls were fed. Yields of milk and milk components were similar among treatments; hulls can be used effectively to replace forage or concentrate in lactation diets.

Multiple pregnancy

The incidence of multiple gestations has increased markedly over the past decade. This review will focus on new interventions and techniques such as selective fetal reduction, optimizing maternal weight gain, bed rest, home uterine monitoring, ultrasound, and Doppler velocimetry, which have been employed to improve outcomes in these pregnancies.

The ideal twin pregnancy: patterns of weight gain, discordancy, and length of gestation

OBJECTIVE

Our purpose was to evaluate factors associated with the best intrauterine growth and lowest morbidity among twins ("ideal twin pregnancy").

STUDY DESIGN

A historic prospective study of 163 twin births was performed. Ten models were formulated with multiple regression and multivariate logistic regression.

RESULTS

In the models of birth weight, gestations of 28 to 36 and 39 to 41 weeks, black race, > or = 15% discordancy, and smoking were all significant negative factors. The pattern of early low weight gain (< 0.85 pounds per week before 24 weeks) and late low weight gain (< 1.0 pound per week after 24 weeks) was negatively associated with all eight models of intrauterine growth.

CONCLUSIONS

The best intrauterine growth and lowest morbidity is achieved earlier for twins than for singletons. Using length of stay and growth retardation criteria, nearly 70% of "ideal" twin pregnancies were between 35 and 38 weeks. In addition, poor weight gain and poor patterns of weight gain were associated with all measures of intrauterine growth and adverse pregnancy outcomes.

Elevated circulating thrombomodulin in severe preeclampsia

A relationship between serum thrombomodulin and preeclampsia was investigated. In women with severely preeclamptic pregnancies, serum thrombomodulin levels were found to be significantly elevated as compared with those of matched control subjects (p < 0.005). Serum thrombomodulin levels correlated positively with serum creatinine (r = 0.854, p < 0.0001) and uric acid levels (r = 0.784, p < 0.001).

Effect of rapid intravenous crystalloid infusion on uteroplacental blood flow and placental implantation-site oxygen delivery in the pregnant ewe

OBJECTIVE

Our purpose in this study was to investigate the effects of rapid intravenous crystalloid infusion on placental implantation-site blood flow and oxygen delivery in the near-term pregnant ewe.

STUDY DESIGN

Maternal left ventricular, femoral arterial and venous, and bilateral fetal hind limb arterial catheters were placed in nine near-term ewes 5 days before the start of the study. Maternal and fetal arterial blood gas values, maternal hemodynamic measurements, and maternal organ blood flows (microsphere technique) were obtained before and after the intravenous infusion of 2.0 to 2.5 L of normal saline solution. Myometrial and placental implantation-site vascular resistances and oxygen delivery were calculated. The t test for paired comparisons was used for statistical analysis, with p < or = 0.05 considered significant.

RESULTS

Significant postinfusion increases in maternal mean arterial pressure, placental implantation-site blood flow, and skin, skeletal muscle, and renal blood flows were recorded. In the six animals that demonstrated a fall in hemoglobin concentration, a significant increase in placental implantation-site oxygen delivery and a significant decrease in placental implantation-site vascular resistance were also seen. No significant changes were seen in myometrial blood flow or myometrial vascular resistance.

CONCLUSION

Rapid intravenous crystalloid infusion selectively increases placental implantation-site blood flow in the near-term pregnant ewe and may improve oxygen delivery to the fetus, especially if hemodilution occurs.

Unusual fetal movement in congenital myotonic dystrophy

Congenital myotonic dystrophy is the most extreme and early expression of a multisystem autosomal dominant disorder. Decreased fetal and infantile movement is a defining feature. We report a case of congenital myotonic dystrophy with an unusual pattern of persistent repetitive fetal movements detected by a Doppler fetal movement detector.

Transgenic strategies in reproductive endocrinology

The present discussion surveys some of the recently published studies utilizing transgenic strategies to address questions in reproductive endocrinology. Beginning with a brief introduction of the transgenic method itself, the following areas are covered: 1. Sexual development and Müllerian-inhibiting substance; 2. Hypogonadal mice and hypothalamic GnRH; 3. The GnRH neuron: generation of immortalized rare cell types; 4. Glycoprotein hormones: immortalized cells, development and evolution; 5. Growth hormone and reproduction; and, 6. Gestation and the insulin-like growth factors. In each section, the discussion attempts to be integrative with respect to the significance of the results to physiological, cellular and molecular biology. We believe this approach is appropriate, as transgenic science itself is necessarily an integration of all of these levels of investigation and participation from those working at all levels is needed.

Treatment and prevention of rat glioblastoma by immunogenic C6 cells expressing antisense insulin-like growth factor I RNA

Rat C6 glioma cells express insulin-like growth factor I (IGF-I) and form rapidly growing tumors in syngeneic animals. When transfected with an episome-based vector encoding antisense IGF-I complementary DNA, these cells lost tumorigenicity. Subcutaneous injection of IGF-I antisense-transfected C6 cells into rats prevented formation of both subcutaneous tumors and brain tumors induced by nontransfected C6 cells. The antisense-transfected cells also caused regression of established brain glioblastomas when injected at a point distal to the tumor. These antitumor effects result from a glioma-specific immune response involving CD8+ lymphocytes. Antisense blocking of IGF-I expression may reverse a phenotype that allows C6 glioma cells to evade the immune system.