Laparoscopic surgery and DNA analysis in patients with XY pure gonadal dysgenesis

The sex-determining region on the Y chromosome (SRY) encodes a gene that has many of the properties expected of the testis-determining factor. The XY pure gonadal dysgenesis is characterized by streak gonads in phenotypic females who lack the somatic abnormalities and short stature associated with Turner's syndrome. Abnormalities within the SRY have been described in these patients. However, we have experienced several patients with short stature whose SRY are apparently normal. The DNA sequencing of the SRY gene showed a 100% nucleotide sequence identity with the reported cloned sequence. Sex reversal in two of the present cases may be due to mutation at a locus other than SRY in the sex determining pathway, a gene potentially involved in the determination of human constitution. The risk of developing malignancy in the dysgenetic gonads has been reported to be 25%, dictating early prophylactic removal of the streaks. Laparoscopic surgery is recommended because of the amount of the surgery and the rapid postoperative recovery of the patient.

Effects of steroid hormones on fibrinolytic system in cultured human endometrial cells

In a primary human endometrial cell culture, the addition of progesterone resulted in an approximately 2-fold increase in the amount of tissue-type plasminogen activator (t-PA) released into the culture media, with the minimal effective dose being 10(-7) M. In contrast, progesterone significantly reduced the release of urokinase-type PA (u-PA). Endometrial cells are known to release a major PA inhibitor, PAI-1. Progesterone stimulated the release of PAI-1. These observed effects of progesterone seem to be mediated through the progestin receptor in that R5020, a specific ligand for progestin receptor, mimicked the effects of progesterone, and RU486, an antagonist of progesterone, completely eliminated the effects of progesterone. It is notable that estradiol, when added alone or in combination with progesterone, caused no discernible effect on the release of PAs and PAI-1. These results suggest that progesterone is a key hormone in regulating the PA/plasmin system in the human endometrium, thereby playing a pivotal role in implantation and ensuing embryonal development.

Cloning and functional expression of a Na(+)-dependent phosphate co-transporter from human kidney: cDNA cloning and functional expression

A cDNA clone encoding a protein 69% identical in amino acid sequence with that of the Na/P(i) co-transporter NaP(i)-1 was isolated from a human kidney cDNA library. The DNA sequence was identical with that of NPT-1 cDNA published by Chong, Kristjansson, Zoghbi and Hughe (1993) (Genomics, 18, 355-359). In the present study, we have characterized the function of the encoded protein and the tissue distribution of its mRNA. Injection of RNA transcribed from NPT-1 into Xenopus oocytes resulted in expression of Na/P(i) co-transport activity showing a high affinity for P(i) transport (Km 0.29 mM). Kinetic characterization ([P(i)], [Na+]) demonstrated that the expressed transport activity has properties similar to those displayed by oocytes injected with human kidney poly(A)+ RNA. Northern blotting demonstrated that NPT-1 mRNA is expressed in renal cortex, liver and brain but not in other tissues. Hybrid depletion with antisense oligonucleotides to NaP(i)-3 and NPT-1 completely inhibited poly(A)+ RNA-induced Na(+)-dependent P(i) uptake in oocytes. These findings indicate that two high-affinity Na/P(i) cotransporters (NaP(i)-3 and NPT-1) are present in human kidney cortex.

Suppressed mixed lymphocyte reaction in couples with intrauterine growth retardation pregnancies

OBJECTIVE

The objective of this study was to gain insight into the pathogenesis of intrauterine growth retardation (IUGR).

METHOD

Immune reactivity against paternal MHC class-II antigens was determined in 18 women with IUGR pregnancies and 18 normal pregnant women, employing one-way mixed lymphocyte reaction (MLR).

RESULTS

One-way MLR between the women with IUGR pregnancies and their husbands was significantly suppressed compared with that between the women with IUGR pregnancies and males unrelated to them. However the MLR of normal pregnant women was essentially similar regardless of whether stimulating cells were obtained from their husbands or not. The degree of HLA class-II antigen shared by IUGR couples was not related to the degree of specific suppression of MLR towards the husbands.

CONCLUSION

IUGR may be associated with specifically suppressed patients' MLR towards their husbands, which may provide insight into the underlying pathophysiology of IUGR.

Characterization of the rabbit intestinal fructose transporter (GLUT5)

Recent studies suggest that the jejunal/kidney-type facilitative glucose transporter (GLUT5) functions as a high-affinity D-fructose transporter. However, its precise role in the small intestine is not clear. In an attempt to identify the fructose transporter in the small intestine, we measured fructose uptake in Xenopus oocytes expressing jejunal mRNA from five species (rat, mouse, rabbit, hamster and guinea-pig). Only jejunal mRNA from the rabbit significantly increased fructose uptake. We also cloned a rabbit GLUT5 cDNA from a jejunal library The predicted amino acid sequence of the 487-residue rabbit GLUT5 showed 72.3 and 67.1% identity with human and rat GLUT5 respectively. Northern-blot analysis revealed GLUT5 transcripts in rabbit duodenum, jejunum and, to a lesser extent, kidney. After separation of rabbit jejunal mRNA on a sucrose density gradient, the fractions that conferred D-fructose transport activity in oocytes also hybridized with rabbit GLUT5 cDNA. Hybrid depletion of jejunal mRNA with a GLUT5 antisense oligonucleotide markedly inhibited the mRNA-induced fructose uptake in oocytes. Immunoblot analysis indicated that GLUT5 (49 kDa) is located in the brush-border membrane of rabbit intestinal epithelial cells. Xenopus oocytes injected with rabbit GLUT5 cRNA exhibited fructose uptake activity with a Km of 11 mM for D-fructose. D-Fructose transport by GLUT5 was significantly inhibited by D-glucose and D-galactose. D-Fructose uptake in brush-border membrane vesicles shows a Km similar to that of GLUT5, but was not inhibited by D-glucose or D-galactose. Finally, cytochalasin B photolabelled a 49 kDa protein in rabbit brush-border-membrane preparations that was immunoprecipitated by antibodies to GLUT5. Our results suggest that GLUT5 functions as a fructose transporter in rabbit small intestine. However, biochemical properties of fructose transport in Xenopus oocytes injected with GLUT5 cRNA differed from those in rabbit jejunal vesicles.

[A phase II study of BMS-181339 in patients with ovarian cancer. BMS-181339 Ovarian Cancer Study Group]

We conducted a multicenter Phase II study of BMS-181339 in patients with ovarian cancer. The facilities participating were 23 in number. The total number of cases registered for the study were 62; 57 of them entered for evaluation in drug efficacy, and 58 cases were evaluable in drug safety. All the cases were previously treated with chemotherapy including platinum-based drugs. The clinical responses of BMS-181339 were as follows: CR, 1 case; PR, 13 cases; MR, 3 cases; NC, 13 cases and PD, 27 cases. The response rate was 24.6% (95% CI: 14.1-37.8%). Histologically, the drug showed its efficacy on serous adenocarcinoma 28.2% (11/39), mucinous adenocarcinoma 20.0% (1/5) and clear cell adenocarcinoma 20.0% (1/5). In regional evaluation, the drug demonstrated its efficacy not only on endopelvic lesions 19.0% (4/21) and abdominal lesions 14.3% (2/14), but also on remote metastatic lesions such as hepatic metastasis 30.8% (4/13) and lung/pleura 33.3% (2/6). The drug also showed its efficacy on the cases 22.9% (8/35) refractory to the platinum-based drugs. Major adverse reactions were fever 63.8% (37/58), alopecia 59.3% (32/54), peripheral nerve disorders 28.1% (16/57) such as numbness of the extremities, nausea/vomiting 24.1% (14/58), arthralgia 20.7% (12/58) and diarrhea 20.7% (12/58) etc.. Abnormal alterations in laboratory test values were an incidence rates of 100% for both leukopenia and neutropenia. However, these symptoms were clinically manageable by transient withdrawal of medication, dose reduction and administration of antibiotics and G-CSF. In addition, decrease in hemoglobin 93.1% (54/58), decrease in platelet counts 31.0% (18/58), elevation in GOT 27.6% (16/58), in GPT 31.0% (18/58) and in LDH 20.7% (12/58) were seen, but no serious organopathy was observed. Thus, we confirmed that BMS-181339 was a clinically useful chemotherapeutic agent in patients with ovarian cancer.

Pseudopregnancy-dependent accumulation of cholesterol sulfate due to up-regulation of cholesterol sulfotransferase and concurrent down-regulation of cholesterol sulfate sulfatase in the uterine endometria of rabbits

The uterine endometria of rabbits induced into pseudopregnancy by intramuscular injection of 17 beta-estradiol, followed by intravenous injection of human chorionic gonadotropin, expressed cholesterol sulfate at a significantly high concentration. The highest concentration of cholesterol sulfate was observed 4 days after the injection of gonadotropin for formation of the corpus luteum, being 10 times higher than that in nonpregnant endometria, and 15.2% of the total cholesterol in the endometrium was converted to the sulfated form, whose percentage in nonpregnant endometrium was 3.2%. However, no significant change in the concentration of gangliosides was observed during the period of pseudopregnancy. In the pseudopregnant endometria, the activity of cholesterol sulfotransferase, a cytosolic thiol enzyme, was increased thirtyfold over that in the nonpregnant endometria, whereas cholesterol sulfate sulfatase, a microsomal enzyme, exhibited approximately one-tenth of the activity in nonpregnant endometria. Arylsulfatase C, but not arylsulfatases A and B, exhibited the same change in activity as cholesterol sulfate sulfatase. Thus, the striking increase in cholesterol sulfate after induction of pseudopregnancy was found to be due to the activation of cholesterol sulfotransferase and the simultaneous inhibition of cholesterol sulfate sulfatase.

The CpG island of the FMR-1 gene is methylated differently among embryonic tissues: implication for prenatal diagnosis

We studied the methylation status of the CpG island of the FMR-1 (fragile X syndrome) gene to recognize the possibility of its prenatal diagnosis with early pregnant subjects. Southern hybridization using EcoRI/BssHII restriction enzymes double digestion was performed in the brain and chorionic villi of 8th week embryos, and the placenta and cord blood of newborns. No methylation of the FMR-1 gene occurred in both of the tissues examined in males, while 50% of the cells in females were methylated in both the brain and the cord blood, indicating that methylation occurs with inactivation of the X-chromosome in accordance with the literature. However, there was no methylation in either the chorionic villi or placenta in female as well as in males. Some extra-embryonic tissues such as the chorionic villi and the placenta escape X-chromosome FMR-1 gene inactivation and it can be the exception in the lyonization. To assess the methylation status in prenatal diagnosis, precautions are needed and they are not suitable for prenatal diagnosis.

In vitro treatment of embryos with epidermal growth factor improves viability and increases the implantation rate of blastocysts transferred to recipient mice

OBJECTIVE

Our purpose was to study, by means of a mouse embryo donation model, the possible role of epidermal growth factor in the development of preimplantation embryos.

STUDY DESIGN

Seven blastocysts developed either in vivo or in vitro, with or without treatment with epidermal growth factor, were transferred to a uterine horn of pseudopregnant recipient mice on day 3 (the presence of a vaginal plug indicated day 1 of pseudopregnancy). Recipients were killed on day 8 of pseudopregnancy, and the number of implantation sites was counted.

RESULTS

The implantation rate in recipient mice of in vitro-cultured blastocysts was significantly lower than that of embryos grown in vivo (i.e., 57.1% vs 84.2%) (p < 0.001). Treatment of embryos in vitro with epidermal growth factor, 10 ng/ml, effectively prevented a decrease in implantation rate (77.9%).

CONCLUSION

Epidermal growth factor may play a stimulatory role in the development of the preimplantation mouse embryo.

Effects of cyclopiazonic acid on rhythmic contractions in uterine smooth muscle bundles of the rat

1. We studied the effects of cyclopiazonic acid (CPA) on rhythmic contractions and on Ca2+ uptake by the intracellular stores in longitudinal muscle strips of the rat uterus at 30 degrees C. 2. Oxytocin (1 microM) in Ca(2+)-free solution induced a transient rise in the intracellular Ca2+ concentration ([Ca2+]i) and contraction after Ca2+ loading of the stores in high-K(+)- and Ca(2+)-containing solution. CPA inhibited oxytocin-induced Ca2+ release and contraction, the half and full inhibitory concentrations of CPA being 0.3 and 10 microM, respectively. In contrast, addition of CPA after Ca2+ loading exerted no significant inhibitory effects. 3. Oxytocin (10 nM) applied in Ca(2+)-containing solution induced rhythmic increases in both force and [Ca2+]i. CPA (10 microM) had no effect on oxytocin-induced rhythmic contractions. 4. At a high concentration (300 microM), CPA inhibited the rhythmic contractions induced by 10 nM oxytocin; the frequency and the peak height were decreased, and in many bundles contractions were completely abolished. These inhibitory effects were reversed after CPA washout. 5. CPA (300 microM) inhibited the rate of rise of [Ca2+]i due to depolarization induced by high-K(+)-containing solution. 6. These results suggest that low concentrations of CPA inhibit the loading of Ca2+ into intracellular stores in intact tissue strips, and that the Ca2+ stores are not directly involved in the uterine rhythmic contractions. It is also suggested that a high concentration of CPA inhibits the mechanism that is responsible for the generation of rhythmic contractions as well as voltage-dependent Ca2+ channels.

Intact sex determining region Y (SRY) in a patient with XY pure gonadal dysgenesis and a twin brother

A patient with an apparently normal 46, XY karyotype, suffering from pure gonadal dysgenesis and of short stature was investigated. The patient, who was growth retarded, was a 30-year-old married Japanese woman with a history of primary amenorrhea and infertility with a weight of 42 kg and a height of 146 cm. She has a phenotypically and karyotypically normal dizygotic twin brother with normal development. Southern-blot and polymerase chain-reaction analyses revealed no apparent deletions in the patient's Y chromosome, including the sex-determining region Y (SRY). The DNA sequencing of the SRY gene showed a 100% nucleotide sequence identity with the reported cloned sequence. Sex reversal in the present case may be due to mutation at a locus other than SRY in the sex determining pathway, a gene potentially involved in the determination of human constitution.

Modulatory role of epidermal growth factor in follicle-stimulating hormone-induced DNA synthesis in cultured rat granulosa cells

Epidermal growth factor (EGF) modestly increased DNA synthesis by cultured rat granulosa cells. FSH also stimulated DNA synthesis dose-relatedly with the maximal effect occurring at FSH 100 ng/ml. The stimulatory effect of FSH was still greater than that of EGF. However, in the presence of EGF, the stimulatory effect of FSH at any concentration was regulated to the level as high as when EGF alone stimulates. In addition, EGF inhibited DNA synthesis induced by forskolin, but enhanced the action of (Bu)2cAMP additively, which indicates that EGF attenuates DNA synthesis of granulosa cells by suppressing the activity of adenylate cyclase or cAMP production. As it is suggested that cAMP is the most likely intracellular second messenger for FSH, the regulatory effect of EGF on FSH-induced DNA synthesis could be, in part, due to suppression of cAMP production. These results suggest that EGF is involved in granulosa cell proliferation, irrespective of the presence of FSH, in a different pathway from FSH and additionally modulates the FSH growth-promoting effect as a local regulator. The interaction between EGF and FSH may be important in the control of follicular development.

Studies on the induction of cyclooxygenase isozymes by various prostaglandins in mouse osteoblastic cell line with reference to signal transduction pathways

A mouse osteoblastic cell line MC3T3-E1 has a cyclooxygenase enzyme, and produces prostaglandin E2. When the cells were cultured in the presence of iloprost (a stable analogue of prostacyclin) or prostaglandin E1 or F2 alpha, the activity of cyclooxygenase increased in a dose- and time-dependent manner. The increase of the enzyme activity was attributed mostly to the cyclooxygenase isoform-2 because immunoprecipitation using an anti-cyclooxygenase-2 antibody removed the majority of the cyclooxygenase activity from the solubilized enzyme fraction, and the corresponding activity was detected in the immunoprecipitant. In addition, there was a marked increase in the cyclooxygenase-2 protein which was demonstrated by Western blotting. As analyzed by Northern blotting, the cyclooxygenase-2 mRNA increased and reached a maximum 1 and 3 h after the addition of iloprost and prostaglandin F2 alpha (about 15- and 60-fold increase), respectively, whereas the cyclooxygenase-1 mRNA increased slowly and only by about 3-fold. Iloprost and prostaglandin E1 stimulated the production of cAMP by 60-fold over the basal level, whereas the cAMP level was almost unchanged by prostaglandin F2 alpha. In contrast, prostaglandin F2 alpha stimulated IP3 production more efficiently than iloprost and prostaglandin E1. These results suggest that the stimulated syntheses prominently of cyclooxygenase-2 and to a lesser extent of cyclooxygenase-1 are mediated by at least two distinct signal transduction pathways involving the cAMP-synthesis stimulated by iloprost and prostaglandin E1 and the phosphoinositide turnover stimulated by prostaglandin F2 alpha.

Impaired follicular growth and abnormal luteinizing hormone surge in luteal phase defect

OBJECTIVE

To determine whether luteal phase defect (LPD) is associated with follicular growth or LH surge.

DESIGN

The length of luteal phase was determined by the date of ovulation assessed by serial ultrasound measurements of follicle growth on a daily basis. Luteal phase defect was defined when the length of the luteal phase was < 11 days and/or the midluteal serum P level was < 10 ng/mL (31.8 nmol/L). Preovulatory follicular growth was examined by transvaginal ultrasonography. Blood samples taken at midluteal phase were assayed for P. Urine LH levels were determined in samples collected twice a day during periovulatory cycles using rapid urinary assay kits.

SETTING

Infertility outpatient clinic, Tokyo University Hospital.

PATIENTS

Eighty-one menstrual cycles from 63 normally cycling infertile women who were not administered any medications.

RESULTS

Thirty-six of 81 cycles showed LPD. The mean +/- SD maximal preovulatory follicular diameter was significantly smaller in LPD cycles than in non-LPD cycles (16.5 +/- 2.7 versus 19.0 +/- 2.8 mm). The mean +/- SD peak level of urinary LH surge was significantly lower in LPD cycles compared with non-LPD cycles (50 +/- 25 versus 65 +/- 21 IU/L). Luteal phase defect cycles showed a relatively high incidence of abnormal LH surges, namely, lower peak levels or prolonged duration.

CONCLUSIONS

Luteal phase defect was associated with impaired follicular growth and/or abnormal LH surge. These factors may be involved in the pathogenesis of LPD.

Glucose transporter GLUT1 mRNA expression in the ontogeny of glucose incorporation in mouse preimplantation embryos

Glucose incorporation and utilization in mouse embryos increases during preimplantation development. A reverse transcription-polymerase chain reaction (RT-PCR) was applied to quantitatively determine the levels of glucose transporter GLUT1 mRNA in preimplantation mouse embryos. The levels of GLUT1 mRNA increased during embryonic development, and it was 11-fold greater in blastocysts than in 2-cell embryos. Similar increases were observed in glucose incorporation as measured by 2-deoxyglucose uptake in the embryos. Increases in GLUT1 mRNA and glucose uptake are also observed when 2-cell embryos are developed to blastocysts in vitro, although the levels are one-third to half of those of the in vivo blastocysts. These results suggest that glucose incorporation during preimplantation development depends at least in part on the expression of GLUT1 mRNA transcription, which results in increased amounts of GLUT1 protein and that the difference in its expression in vivo and in vitro may serve as a clue for studying the preimplantation development of embryos.

Hexokinase activity in mouse embryos developed in vivo and in vitro

Micro-determination methods were used for quantitative examination of possible differences in energy metabolism in mouse embryos arising after spontaneous ovulation or after gonadotrophin stimulation. Comparisons of embryonic development in vivo and in vitro were also made. The relevance of the results to human development and their clinical significance are discussed. The enzymatic activity of hexokinase, phosphofructokinase, glucose 6-phosphate dehydrogenase, malate dehydrogenase and lactate dehydrogenase in individual mouse embryos throughout preimplantation development was evaluated. Hexokinase activity in 1-cell embryos was the lowest by far of the five enzymes measured, and the 0.035 +/- 0.010 pmol of nicotinamide adenine dinucleotide phosphate hydrogenase formed/embryo/min was also lower than in any of the somatic organs examined. Hexokinase activity, unlike the other enzymes, progressively increased in the morulae and blastocyst stages in embryos obtained either by spontaneous ovulation or via gonadotrophin stimulation. Although there is a significant delay, this increase was also observed when 2-cell embryos developed in vitro. Increases in hexokinase activity were observed 68-75 h after human chorionic gonadotrophin administration in vivo, but after 80-86 h in vitro. These increases in vitro were inhibited by the administration of actinomycin D added to the medium. The results suggest that hexokinase may be a key enzyme synthesized as the zygotic genome is expressed in preimplantation embryos, and its measurement may help to assess the quality of embryos developed in vitro.

[Advanced system for real-time fetal breathing movements tracking using pulsed Doppler ultrasound]

Utilization of the fetal behavioral information in clinical medicine requires the development of an automated monitoring technique. As previously reported, the off-line signal processing of the low frequency Doppler signals by high accuracy displacement estimation made it possible to measure fetal breathing movements (FBM). However, there were several problems to solve before clinical application. We propose an advanced system that provides real-time calculation. The multi-channel pulsed doppler device was newly developed by modifying the Doppler ultrasound module of the cardiotocograph (CTG). A new signal processing algorithm was designed to produce real-time measurements. To improve the resolution, the backing module was attached to the probe. On-line signal processing produced a successful real-time and continuous calculation of displacement inside tissue. By means of an on-line 2/3 Hz high pass filter, the very low frequency noises and the artifacts derived from maternal respiration etc. were removed. The signal/noise ratio was obviously increased and the waves of fetal tissue movements due to FBM were easily recognized in real-time LCD outputs. Although there is a limitation in measuring accuracy as far as using modified CTG units, the results demonstrate that our system has commendable quality in FBM tracking.

Transvaginal sonographic appearance of hemorrhagic functional ovarian cysts and their spontaneous regression

OBJECTIVES

To obtain information on the characteristic feature of transvaginal sonograms of hemorrhagic functional ovarian cysts (HFOCs) and their natural course.

METHODS

Thirty-four cases of suspected HFOC based on our tentative criteria were ultrasonically followed-up for 3 months. After the study period, the sonographic findings and their changes with time were analyzed.

RESULTS

Twenty-four cases were clinically diagnosed as HFOCs, as the masses disappeared naturally. At the first examination, 5 cases (20.8%) showed a diffuse echogenic pattern which seems to consist of a blood clot, 9 (37.5%) were mixed pattern with a clearly demarcated solid part, 3 (12.5%) were hyperechoic sponge-like reticular pattern and 7 (29.2%) were cysts including vague echo inside which looked cotton-like. Seven masses (29.2%) disappeared within 2 weeks and the remaining had a different sonographic appearance with time until they disappeared finally within 8 weeks.

CONCLUSIONS

HFOCs show the characteristic changes in transvaginal sonographic appearance and can be diagnosed by short-term follow-up.

New method for tracking fetal breathing movements using real-time pulsed Doppler ultrasonographic displacement measurement

To develop a clinical device for monitoring FBM with a simplified mechanism, the multichannel pulsed Doppler device was achieved by modifying the ultrasonographic module and probe of a cardiotocograph. A new algorithm of signal processing with a high-accuracy displacement estimation technique produced real-time and continuous displacement calculations. In vivo measurements demonstrated that real-time output produced commendable quality in FBM tracking. The displacement of a few hundred micrometers because of FBM was measured successfully. The results suggest that quantitative assessments of FBM should be possible with this technique.

Phosphofructokinase activity as a measure of maturation of rat oocytes developed in vivo and in vitro

We determined the activity of phosphofructokinase (PFK), a rate-limiting enzyme of glycolysis, in the rat oocyte during maturation either by luteinizing hormone stimulation in vivo or by cultivation under various conditions. In vivo, the activity of PFK in the maturing oocyte increased significantly, suggesting that the glycolytic pathway developed as the first meiotic division proceeded. A breakdown of the germinal vesicle and an increased activity of PFK were observed when denuded oocytes were cultured. Treatment of the oocytes with dibutyryl cAMP and 3-isobutyl-1-methyl xanthine almost completely inhibited germinal breakdown, whereas the activity of PFK increased significantly. The data suggest that regulation of PFK activity is not directly dependent on cAMP or cAMP-dependent protein kinase, and is not necessarily dependent on meiotic maturation. Our study also revealed that epidermal growth factor (EGF) significantly increased PFK activity, showing that EGF may be a potent inducer of oocyte maturation.

Sex identification by polymerase chain reaction using a Y-autosome homologous primer set

We have developed a one-step polymerase chain reaction (PCR) technique which detects a sequence on the human Y chromosome and an autosomal sequence in one reaction. The method is very reliable for the sex determination, as the detection of the autosome-specific signal ensures the presence of DNA in the specimen even in the absence of the Y-specific signal.

Development of an artificial placenta: survival of isolated goat fetuses for three weeks with umbilical arteriovenous extracorporeal membrane oxygenation

The purpose of our study was to examine the feasibility of long-term extrauterine incubation of an isolated premature fetus in artificial amniotic fluid with arteriovenous extracorporeal circulation. Two premature goat fetuses (age 120 and 128 days) were incubated in an isothermal artificial amniotic fluid incubator with arteriovenous extracorporeal membrane oxygenation via the umbilical vessels. We administered pancuronium bromide to suppress fetal movement and swallowing because movement and swallowing have been implicated in fetal deterioration during extrauterine fetal incubation. The fetuses maintained stable circulatory and respiratory parameters. The total incubation time was 494 and 543 h. The animals were then removed from the incubator and stimulated to initiate lung respiration. With ventilator support, both animals maintained stable blood-gas exchange and survived for more than 1 week. These results clearly indicate that umbilical arteriovenous extracorporeal membrane can effectively support extended extrauterine incubation of an isolated premature fetus.

Investigation of the oxygenation of phospholipids by the porcine leukocyte and human platelet arachidonate 12-lipoxygenases

When arachidonate 12-lipoxygenase purified from porcine leukocytes was incubated aerobically with 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine, the phospholipid reacted at up to 30% of the rate of a free fatty acid substrate; the esterified arachidonic acid was oxygenated predominantly to the (12S)-12-hydroperoxy product. The porcine leukocyte enzyme was also capable of metabolizing phosphatidylcholine containing esterified (15S)-15-hydroperoxy-5,8,11,13-eicosatetraenoic acid; oxygenation occurred predominantly at the 14R position. Reaction with mitochondrial and endoplasmic membranes of rat liver produced esterified (12S)-12-hydroperoxy-5,8,10,14-eicosatetraenoic acid and (13S)-13-hydroperoxy-9,11-octadecadienoic acid as major oxygenation products. Thus, porcine leukocyte 12-lipoxygenase is capable of oxygenating not only free polyenoic fatty acids but also more complex substrates such as phospholipids and biomembranes. In contrast, the human platelet 12-lipoxygenase is almost inactive with these esterified polyenoic fatty acids. In regard to the function of these enzymes, the leukocyte-type of 12-lipoxygenase has similar catalytic activities to the mammalian 15-lipoxygenase and its physiological function may include the structural modification of membrane lipids.

Local regulatory effects of activin A and follistatin on meiotic maturation of rat oocytes

Activin A and follistatin identified in follicular fluids have been shown to regulate follicular development. Activin A, in a dose responsive manner, increased the percentage of germinal vesicle breakdown that served as a marker for the resumption of meiosis of oocytes in vitro, especially these obtained from immature follicles. This effect of activin A was inhibited by the activin-binding protein, follistatin. Follistatin alone exerted an inhibitory effect on oocyte maturation. Reverse transcription and polymerase chain reaction revealed the expression of activin beta A and activin type IIA receptor gene transcripts in the oocytes. Activin A, along with follistatin, appears to play a local regulatory role in the meiotic maturation of rat oocytes.

Differential responses of intestinal glucose transporter mRNA transcripts to levels of dietary sugars

Dietary sugars are known to stimulate intestinal glucose transport activity, but the specific signals involved are unknown. The Na(+)-dependent glucose co-transporter (SGLT1), the liver-type facilitative glucose transporter (GLUT2) and the intestinal-type facilitative glucose transporter (GLUT5) are all expressed in rat jejunum [Miyamoto, Hase, Taketani, Minami, Oka, Nakabou and Hagihira (1991) Biochem. Biophys. Res. Commun. 181, 1110-1117]. In the present study we have investigated the effects of dietary sugars on these glucose transporter genes. A high-glucose diet stimulated glucose transport activity and increased the levels of SGLT1 and GLUT2 mRNAs in rat jejunum. 3-O-Methylglucose, D-galactose, D-fructose, D-mannose and D-xylose can mimic the regulatory effect of glucose on the SGLT1 mRNA level in rat jejunum. However, only D-galactose and D-fructose increased the levels of GLUT2 mRNA. The GLUT5 mRNA level was increased significantly only by D-fructose. Our results suggest that the increase in intestinal transport activity in rats caused by dietary glucose is due to an increase in the levels of SGLT1 and GLUT2 mRNAs, and that these increases in mRNA may be caused by an enhancement of the transcriptional rate. Furthermore, for expression of the SGLT1 gene, the signal need not be a metabolizable or transportable substrate whereas, for expression of the GLUT2 gene, metabolism of the substrate in the liver may be necessary for signalling. Only D-fructose is an effective signal for expression of the GLUT5 gene.

Presence and possible function of activin-like substance in human follicular fluid

We assessed the presence of an activin-like substance in human follicular fluid that was obtained from women undergoing in-vitro fertilization using a bioassay for activin A. Activin activity was not detected in crude follicular fluids; the bioactivity of standard activin A was inhibited by the addition of follicular fluid. After the follistatin (binding protein of activin A) was removed from follicular fluid using a purification procedure, activin activity was detected in the follicular fluids (mean concentration: 131 +/- 40 ng/ml). Activin activity was inhibited by the addition of follistatin to fluid. The concentration of activin activity was substantially higher (approximately 100-fold) than that reported in serum. The concentration negatively and significantly correlated with the number of developed follicles in the ovary (r = 0.501, P < 0.01). These results suggest that activin A and its binding protein are present in follicular fluid in large amounts and that they may have a role in local ovarian regulation.

Is personality involved in the expression of dysmenorrhea in patients with endometriosis?

OBJECTIVE

To investigate whether a relationship exists between personality and expression of pain in women with endometriosis.

STUDY DESIGN

With use of the Rosenzweig picture frustration study, the personality of women with endometriosis was assessed. These results were then correlated with the manifestation of pain.

RESULTS

Women without dysmenorrhea tended to be less assertive compared with women who complained of dysmenorrhea and women without endometriosis. Those women without dysmenorrhea showed a destructive attitude in face of a problem.

CONCLUSIONS

Personality affected the expression of pain. Pain caused by endometriosis was influenced by each personality type.

The uterine growth-promoting action of epidermal growth factor and its function in the fertility of mice

Epidermal growth factor (EGF) levels in the submandibular glands and plasma are increased in pregnant and aged female mice. The possible role of EGF in fertility was studied in virgin and pregnant mice ranging in age from 10 to 90 weeks of age, employing sialoadenectomy, administration of EGF antibody and EGF replacement. The uterine weight in pregnant, 10-week-old, sialoadenectomized mice was significantly less than in normal mice and the administration of EGF antibody to these mice further decreased uterine weight, resulting in an increased rate of abortion. Replacement EGF treatment in the sialoadenectomized mice prevented these changes. Uterine weight was about 70 mg at 10 weeks of age, and significantly increased from 30 to 80 weeks when it reached a plateau level of 275 mg. These changes closely followed the increase in the concentration of EGF in the submandibular glands and plasma and coincided with the decline in fertility. In contrast, uterine weight in the sialoadenectomized mice decreased immediately after the operation and remained at about 50-60 mg throughout the experimental period. Pregnancy, as judged by implantation, was achieved in the sialoadenectomized mice at later ages than in the controls. These findings suggest that elevated EGF levels may have a dual function in the control of fertility via uterine growth, depending on the age of mice.

Enzymatic inactivation of leukotriene B4 by a novel enzyme found in the porcine kidney. Purification and properties of leukotriene B4 12-hydroxydehydrogenase

Leukotriene B4 (LTB4) 12-hydroxydehydrogenase was purified to apparent homogeneity from the cytosol fraction of the porcine kidney. The N-terminal amino acid sequence analysis revealed that this enzyme is a novel protein with a molecular weight of 35,000. Although the enzyme is ubiquitously distributed in various tissues and leukocytes of porcine, the kidney and liver had the highest enzyme activities. In the presence of NADP+ as a cofactor, the enzyme catalyzes the conversion of LTB4 to 12-oxo-LTB4, the structure identified by gas chromatography/mass spectrometry. 12-Oxo-LTB4 was further converted by other enzymes to 10,11,14,15-tetrahydro-12-oxo-LTB4, which was determined by proton NMR and gas chromatography/mass spectrometry. 12-Oxo-LTB4 was 100-fold less potent than LTB4 in increasing intracellular calcium concentrations of human leukocytes. 6-trans-LTB4 and LTB4 proved to be the best substrates of the enzyme, whereas various types of monohydroxyeicosatetraenoic acids, 5(S),12(S)-dihydroxyeicosatetraenoic acid, prostaglandins, cortisol, or pregnenolone could not serve as a substrate. These results suggest that the enzyme acts specifically on the 12(R)-hydroxy group of leukotriene B4 and is involved in the metabolic inactivation of LTB4 in the porcine kidney.

Association of the antibodies against human papillomavirus 16 E4 and E7 proteins with cervical cancer positive for human papillomavirus DNA

Occurrence of the antibodies against human papillomavirus (HPV) 16 proteins E4 and E7 is specifically but independently associated with cervical cancer. To correlate HPV DNA and antibody data, we examined the biopsy specimens and sera, by polymerase chain reaction (PCR) and by ELISA, respectively, from 51 patients with cervical cancer (including 3 recurrent cases) and 22 with cervical intra-epithelial neoplasia. Consensus primers for the L1 region were used for PCR and bacterially expressed, purified fusion protein HPV-16 E4 and non-fusion protein HPV-16 E7 were used for ELISA. HPV-16 DNA and other HPV types were detected in 17 and 25, respectively, out of 51 cases of cervical cancer. Ten out of the 17 HPV-16-DNA-positives were positive either for anti-E4 or for anti-E7: positivities for anti-E4, for anti-E7, and for both were 6/17, 5/17 and 1/17 respectively. Three anti-E7-positives consisted of those for HPV-33, -52 and -58 DNA, suggesting that limited cross-reaction occurred between the HPV types. Among the HPV-16-DNA-positive cases of cancer, lymph-node or distant metastasis was recorded more frequently in the seropositives than in the seronegatives. Our results show that the HPV-16 anti-E4 or anti-E7 occurs in some, but not in all, of the HPV-16-DNA-positive cases, and support the hypothesis that the presence of the HPV-16 antibodies can be used as a marker for possible metastasis.

Y chromosome analysis and laparoscopic surgery in XY pure gonadal dysgenesis: a case report and a review of literature

DNA analysis and laparoscopic surgery were performed on a patient with 46, XY pure gonadal dysgenesis. Southern-blot and polymerase chain-reaction analyses revealed that she had no apparent deletion of the Y chromosome, including the SRY gene (sex-determining region Y), suggesting that the patient might have some other abnormality. Since the risk of gonadal neoplasia in XY gonadal dysplasia is high, operative laparoscopy was performed to ensure that there was no malignancy in the patient. Laparoscopic surgery is recommended because of the amount of the surgery and the rapid postoperative recovery of the patient.

Intrauterine growth retardation and fetal losses are caused by epidermal growth factor deficiency in mice

The plasma concentration of epidermal growth factor (EGF) in female mice increases during pregnancy. Sialoadenectomy (surgical removal of the submandibular glands) on day 13 of gestation attenuates the rise in plasma EGF and significantly reduces the percent of live pups on day 19 of pregnancy to 80% compared with 95% for the control animals. EGF replacement therapy given to the sialoadenectomized mice successfully prevented this reduction in the percent of live pups on day 19. The average weight of the live fetuses from sialoadenectomized mothers was significantly lower than those from the control mothers, i.e., 1.00 +/- 0.14 (SD) g vs. 1.13 +/- 0.07 g. The administration of anti-EGF antiserum to the sialoadenectomized mice further affected fetal viability; only 70% of the pups were alive on day 19, with a mean weight of 0.93 +/- 0.15 g. The mean weight of the fetal body and that of the liver caused by sialoadenectomy were similarly reduced, but the brain was not affected, which shows that the growth retardation was asymmetrical. These findings suggest that EGF plays a physiological role in fetal growth and that EGF deficiency may be a cause of asymmetrical intrauterine growth retardation, which might be due to uteroplacental dysfunction.

Evidence for the involvement of epidermal growth factor in fertility decline in aging female mice

A decline in fertility, defined as the number of implantation sites, was observed in mice as they aged; the decline started at 30 weeks of age and reached a nadir by 60 weeks when no implantation was detected. Epidermal growth factor (EGF) levels in the submandibular gland and plasma increased as the female mice aged, and sialoadenectomy (surgical removal of the submandibular glands) attenuated the rise in the plasma EGF level without affecting the overall health or survival of the animals. Uterine weight at 10-20 weeks of age was about 70 mg, and it significantly increased with age. This weight has increased more than 2-fold by 60 weeks. These changes closely followed the increase in the concentrations of EGF in the submandibular gland and the plasma. After sialoadenectomy, uterine weight decreased immediately and remained at about 50-60 mg throughout the experimental period. Interestingly, sialoadenectomized mice became pregnant at an older age than the controls. These findings suggest that elevated levels of EGF may have a physiological role in fertility decline in aging mice perhaps via uterine hypertrophy.

Role of liver-type glucose transporter (GLUT2) in transport across the basolateral membrane in rat jejunum

To obtain information on the regulation of glucose transport across the basolateral membrane (BLM) of intestinal epithelial cells, we measured the number of [3H]cytochalasin B binding sites and the level of liver-type glucose transporter (GLUT2) protein in the BLM in the jejunum of rats (i) with diabetes (ii) given a high-carbohydrate diet or (iii) with experimental hyperglycemia (12 h infusion of a high-glucose solution). A glucose uptake and the number of D-glucose inhibitable [3H]cytochalasin B binding sites in BLM vesicles were significantly increased in all three conditions. Western blot analysis showed that the amount of GLUT2 protein in BLM vesicles was increased in rats with diabetes and those given a high-carbohydrate diet, but not in those with experimental hyperglycemia. These results suggest that there is a mechanism for rapid regulation of glucose transport in the BLM that does not depend on change in the amount of GLUT2.

Determination of enzyme activities of energy metabolism in the maturing rat oocyte

Enzyme activities were determined quantitatively in individual rat oocytes to study their energy metabolism during maturation. Low hexokinase activity and high activities of lactate dehydrogenase and enzymes in the phosphate pathway, i.e., glucose 6-P and 6-P gluconate dehydrogenases, were characteristic of immature oocytes. Hexokinase may be a rate-limiting enzyme that enables oocytes to use glucose as an energy source. During maturation, the activities of hexokinase, phosphofructokinase, and malate dehydrogenase increased significantly, suggesting that the glycolytic pathway, as well as the tricarboxylic acid cycle, developed as the first meiotic division proceeded. In contrast, the activities of glucose 6-P and 6-P gluconate dehydrogenases decreased in maturing oocytes. The observation that the enzyme pattern in mature oocytes resembles more closely that in somatic cells appears to be significant, especially in light of previous studies showing this developmental trend in preimplantation embryos.

Expression and possible function of glucose transporter protein GLUT1 during preimplantation mouse development from oocytes to blastocysts

A micro-Western analysis method both sensitive and quantitative enough to analyze oocytes and embryos is developed. GLUT1 protein is present in mouse oocytes and preimplantation embryos and levels are increased by fertilization and with time in ensuing embryonic development; the levels were 20-fold greater in blastocysts than in unfertilized oocytes. Similar increases were observed in glucose uptake by oocytes and embryos, suggesting that they may depend on GLUT1 expression. These results suggest that GLUT1 expression may explain a switch in substrate preference of the embryo from pyruvate to glucose during preimplantation development.

Hormonal regulation of endometriotic cell growth in primary cell culture system

A primary cell culture of endometriotic cells was established to examine the hormonal regulation of endometriosis. The addition of estradiol had no effect on the DNA synthesis of cultured endometriotic cells. Progesterone at 10(-7) M caused a significant reduction in the amount of the DNA synthesis. An inhibitory effect of progesterone was completely eliminated by the concomitant addition of RU486, an antiprogesterone. The addition of epidermal growth factor (EGF) at 1 ng/ml significantly increased the DNA synthesis. Other growth factors, such as fibroblast growth factor and insulin-like growth factor also produced a modest but significant increase in DNA synthesis. These results seem to provide clues for clarifying the pathophysiology of endometriosis.

Comparison of cytokine levels and embryo toxicity in peritoneal fluid in infertile women with untreated or treated endometriosis

OBJECTIVE

Our aim was to examine the relationship between the levels of cytokines in peritoneal fluid and its embryo toxicity.

STUDY DESIGN

The levels of interleukin-1 and tumor necrosis factor were measured in peritoneal fluid from infertile women who did not have endometriosis (n = 21), who had untreated endometriosis (n = 19), and who had undergone medical treatment for endometriosis (n = 10). Embryo toxicity was investigated in mouse two-cell embryos cocultured with the oviducts in culture media that contained various concentrations of peritoneal fluid.

RESULTS

The levels of cytokines were significantly higher in the peritoneal fluid from women who had untreated endometriosis than in women who did not have endometriosis, but they were extremely low in women who had undergone medical treatment with either danazol or buserelin. The peritoneal fluid from women who had untreated endometriosis adversely affected the cleavage of mouse two-cell embryos. After medical treatment the embryo toxicity of the peritoneal fluid was almost undetectable.

CONCLUSION

These results offer some theoretic bases in support of medical treatment to improve reproductive performance in infertile women who have endometriosis.

Developmental changes in intestinal glucose transporter mRNA levels

Developmental changes in glucose transporter mRNA levels in the jejunum of rats of different ages were examined by using slot blot RNA analysis. The level of SGLT1 mRNA did not change significantly through life. The GLUT5 mRNA level was highest in 10-day-old rats and then decreased reaching the adult level by day 20 after birth. The GLUT2 mRNA level was low in rats of 5 and 10 days old, but then increased progressively reaching the adult value by day 25 after birth. These results indicate that the expressions of intestinal facilitative glucose transporter genes change markedly in the third week after birth.

Hormonal regulation of the cell growth in an endometriotic cell culture system

A primary cell culture of endometriotic cells was established to examine the hormonal regulation involved in the growth of endometriosis. The addition of estradiol had no effect on the DNA synthesis of cultured endometriotic cells. Progesterone at 10(-7) M caused a significant reduction in the amount of the DNA synthesis. An inhibitory effect of progesterone was completely eliminated by the concomitant addition of RU486, an antiprogesterone. The addition of epidermal growth factor (EGF) at 1 ng/ml significantly increased the DNA synthesis. Other growth factors, such as fibroblast growth factor and insulin-like growth factor also produced a modest but significant increase in the DNA synthesis. These results provide clues to the pathophysiology of endometriosis.

Diabetes and glucose transporter gene expression in rat small intestine

The expressions of Na(+)-dependent glucose transporter (SGLT1) and five facilitative glucose transporter genes (GLUT1-5) in the small intestine of streptozotocin (STZ)-induced diabetic rats were examined by RNA blotting analysis. The transcripts of SGLT1 mRNA gave bands of 4.5 Kilobases (Kb) and 2.8Kb (very faint band). The levels of SGLT1 mRNA were significantly increased in 30- and 60-day STZ rats, but not changed in acute diabetic rats (2- to 10- day STZ rats). The GLUT2 mRNA levels changed in parallel with the D-galactose transport activity, being increased about 4-fold in 5-day STZ rats. The transcripts of GLUT5 mRNA gave three bands of 5.1Kb, 2.8Kb and 2.OKb, whose levels were significantly reduced in 30- and 60-day STZ rats. These results suggest that the facilitative glucose transporter (GLUT2), in addition to the Na(+)-dependent glucose transporter (SGLT1), may play an important role in intestinal glucose transport in diabetic rats.

EGF rapidly stimulates tyrosine phosphorylation in cultured endometrial cells

Recent increasing evidence suggests that EGF has a role in modulating the differentiated functions of human endometrial cells in an autocrine/paracrine fashion. To explore the signal transduction pathway of EGF in endometrial cells, we used cultured human endometrial cells to examine whether EGF induces tyrosine-phosphorylation. EGF phosphorylated the 175 kDa protein on tyrosine residues within 10 seconds of stimulation. EGF induced tyrosine phosphorylation at as low as 0.1 ng/ml with the maximal effect occurring at 10 ng/ml. Estradiol was shown to enhance the phosphorylation by EGF in this system. These results thus suggest that tyrosine-phosphorylation might be an important step in the signal transduction of EGF in human endometrial cells. Furthermore, the observed stimulatory action of estradiol on tyrosine-phosphorylation by EGF might provide a clue in the elucidation of the cellular mechanism of estrogen action in endometrium.

Evidence for direct regulation of epidermal growth factor receptors by steroid hormones in human endometrial cells

Recent evidence suggests that epidermal growth factor (EGF) may serve as a paracrine and/or autocrine mediator of oestrogen action in uterine growth. In this study, the effects of various steroid hormones on EGF receptors in primary cultures of human endometrial cells were examined. Human endometrial cells exhibited a single class of high-affinity binding sites for EGF (Kd: 0.14 nM) with approximately 3600 receptors/cell. The addition of progesterone increased the EGF binding without affecting the Kd value. Cortisol also increased EGF binding and acted additively with a relatively low concentration of progesterone (10(-10) M). Oestradiol alone had no effect on EGF binding. However, oestradiol in combination with progesterone and cortisol further increased EGF binding. These results present evidence for the direct regulation of EGF receptors by steroid hormones in human endometrial cells, and raise the possibility that steroid hormones may act on these cells in part by modulating EGF receptors.

Stimulatory effect of epidermal growth factor on the development of mouse early embryos in vitro

Effects of epidermal growth factor (EGF) on the development of mouse 2-cell embryos cultured in vitro were investigated. The addition of EGF at a concentration of 0.5 ng/ml enhanced the development of 2-cell embryos during 24 h of incubation. As expected, EGF stimulated the synthesis of DNA in the 2-cell embryos about 4-fold over the control. The growth-promoting effect of EGF seemed to be specific in that other growth factors, such as transforming growth factor-alpha (TGF-alpha), transforming growth factor-beta (TGF-beta), insulin-like growth factor-1 (IGF-1), platelet-derived growth factor (PDGF), nerve growth factor (NGF) and fibroblast growth factor (FGF) had no effect on the embryonal development. The addition of EGF also increased the rate of RNA synthesis in a dose-related manner between 0.1 and 50 ng/ml. However, protein synthesis was unaffected by EGF. These results raise the possibility that EGF may participate in the process of early embryogenesis in vivo.

Endometriosis impairs glycogen synthesis in human endometrium

Glycogen content in endometrium with endometriosis was about half of that without endometriosis at the secretory phase, whereas no difference was found in the proliferative phase. The activity of glycogen synthetase in endometrium with endometriosis was reduced to 25% and 23% of that without endometriosis in the late proliferative and midsecretory phase, respectively. The activity of glycogen phosphorylase was also significantly lower in endometrium with endometriosis in the late proliferative phase. However, the activity increased conspicuously in the midsecretory phase, and thus there was no difference in activity in endometrium with or without endometriosis. The observed lowered capacity of glycogen synthesis may lead to understanding the mechanism of infertility associated with endometriosis.