Evaluation of chronic diarrhea in patients newly diagnosed with HIV infection through the FilmArray® gastrointestinal panel

INTRODUCTION

The treatment and diagnosis of chronic diarrhea in the immunocompromised patient depends on the ability to rapidly detect the etiologic agents.

AIMS

Our aim was to evaluate the results of the FilmArray® gastrointestinal panel in patients newly diagnosed with HIV infection that presented with chronic diarrhea.

MATERIAL AND METHODS

Utilizing nonprobability consecutive convenience sampling, 24 patients were included that underwent molecular testing for the simultaneous detection of 22 pathogens.

RESULTS

In 24 HIV-infected patients with chronic diarrhea, enteropathogen bacteria were detected in 69% of the cases, parasites in 18%, and viruses in 13%. Enteropathogenic Escherichia coli and enteroaggregative Escherichia coli were the main bacteria identified, Giardia lamblia was found in 25%, and norovirus was the most frequent viral agent. The median number of infectious agents per patient was three (range of 0 to 7). The biologic agents not identified through the FilmArray® method were tuberculosis and fungi.

CONCLUSIONS

Several infectious agents were simultaneously detected through the FilmArray® gastrointestinal panel in patients with HIV infection and chronic diarrhea.

Temporal Dynamics and Neuronal Specificity of Grin3a Expression in the Mouse Forebrain

GluN3A subunits endow N-Methyl-D-Aspartate receptors (NMDARs) with unique biophysical, trafficking, and signaling properties. GluN3A-NMDARs are typically expressed during postnatal development, when they are thought to gate the refinement of neural circuits by inhibiting synapse maturation, and stabilization. Recent work suggests that GluN3A also operates in adult brains to control a variety of behaviors, yet a full spatiotemporal characterization of GluN3A expression is lacking. Here, we conducted a systematic analysis of Grin3a (gene encoding mouse GluN3A) mRNA expression in the mouse brain by combining high-sensitivity colorimetric and fluorescence in situ hybridization with labeling for neuronal subtypes. We find that, while Grin3a mRNA expression peaks postnatally, significant levels are retained into adulthood in specific brain regions such as the amygdala, medial habenula, association cortices, and high-order thalamic nuclei. The time-course of emergence and down-regulation of Grin3a expression varies across brain region, cortical layer of residence, and sensory modality, in a pattern that correlates with previously reported hierarchical gradients of brain maturation and functional specialization. Grin3a is expressed in both excitatory and inhibitory neurons, with strong mRNA levels being a distinguishing feature of somatostatin interneurons. Our study provides a comprehensive map of Grin3a distribution across the murine lifespan and paves the way for dissecting the diverse functions of GluN3A in health and disease.

Protein in culture and endogenous lipid interact with embryonic stages in vitro to alter calf birthweight after embryo vitrification and warming

Short-term protein removal in vitro improves long-term blastocyst competence to survive vitrification. We investigated the mechanisms and effects underlying protein removal. Day-6 morulae and early blastocysts were cultured individually with and without protein for 24h. Development and lipid content were analysed in expanded blastocysts derived from morulae (M-XB) and from early blastocysts (EB-XB). Expression of genes involved in lipid metabolism, stress responses and apoptosis was analysed in fresh and vitrified-warmed M-XB produced with and without protein. Pregnancy rates, birth rates and birthweight (BW) were recorded after transfer of embryos. Day-7 EB-XB production rates (with, 66.9±6.2 and without, 68.8±6.0 protein) were higher than M-XB rates (with, 21.4±4.6 and without, 9.4±4.6 protein; P<0.005). EB-XB showed fewer lipids than M-XB (P=0.03). In fresh M-XB, expression of sterol regulatory element binding protein (SREBP1) was lower with (4.1±2.2) than without (13.6±2.2) protein, contrary to results obtained for Patatin-like phospholipase domain containing 2, Hormone-sensitive lipase and Bcl-2-associated X protein (P<0.05). Protein did not affect pregnancy rates and birth phenotypes (P>0.05). However, BW was higher (P<0.01) in calves born from vitrified M-XB (48.6±3.4kg) than from EB-XB (39.8±2.9kg). Such effects were more pronounced in females (P<0.001). Calves from fresh embryos did not show BW differences. These results indicate that embryonic kinetics and vitrification impact birth phenotypes, at least in females. Alterations might involve exogenous protein and mobilisation of lipid stocks.

RNAi-Based GluN3A Silencing Prevents and Reverses Disease Phenotypes Induced by Mutant huntingtin

Huntington's disease (HD) is a dominantly inherited neurodegenerative disease caused by expansion of a polyglutamine tract in the huntingtin protein. HD symptoms include severe motor, cognitive, and psychiatric impairments that result from dysfunction and later degeneration of medium-sized spiny neurons (MSNs) in the striatum. A key early pathogenic mechanism is dysregulated synaptic transmission due to enhanced surface expression of juvenile NMDA-type glutamate receptors containing GluN3A subunits, which trigger the aberrant pruning of synapses formed by cortical afferents onto MSNs. Here, we tested the therapeutic potential of silencing GluN3A expression in YAC128 mice, a well-established HD model. Recombinant adeno-associated viruses encoding a short-hairpin RNA against GluN3A (rAAV-shGluN3A) were generated, and the ability of different serotypes to transduce MSNs was compared. A single injection of rAAV9-shGluN3A into the striatum of 1-month-old mice drove potent (>90%) and long-lasting reductions of GluN3A expression in MSNs, prevented dendritic spine loss and improved motor performance in YAC128 mice. Later delivery, when spine pathology is already apparent, was also effective. Our data provide proof-of-concept for GluN3A silencing as a beneficial strategy to prevent or reverse corticostriatal disconnectivity and motor impairment in HD and support the use of RNAi-based or small-molecule approaches for harnessing this therapeutic potential.

A quantitative trait locus on chromosome 1 modulates intermale aggression in mice

Aggression between male conspecifics is a complex social behavior that is likely modulated by multiple gene variants. In this study, the BXD recombinant inbred mouse strains (RIS) were used to map quantitative trait loci (QTLs) underlying behaviors associated with intermale aggression. Four hundred and fifty-seven males from 55 strains (including the parentals) were observed at an age of 13 ± 1 week in a resident-intruder test following 10 days of isolation. Attack latency was measured directly within a 10-minute time period and the test was repeated 24 hours later. The variables we analyzed were the proportion of attacking males in a given strain as well as the attack latency (on days 1 and 2, and both days combined). On day 1, 29% of males attacked, and this increased to 37% on day 2. Large strain differences were obtained for all measures of aggression, indicating substantial heritability (intraclass correlations 0.10-0.18). We identified a significant QTL on chromosome (Chr) 1 and suggestive QTLs on mouse Chrs 1 and 12 for both attack and latency variables. The significant Chr 1 locus maps to a gene-sparse region between 82 and 88.5 Mb with the C57BL/6J allele increasing aggression and explaining about 18% of the variance. The most likely candidate gene modulating this trait is Htr2b which encodes the serotonin 2B receptor and has been implicated in aggressive and impulsive behavior in mice, humans and other species.

Abstract P2-06-02: Breast cancer HER2 epigenetic intratumoral heterogeneity results from lack of HER2 protein translation

Research objective

Previously, we reported the negative correlation between pathological complete response (pCR) and HER2 positive breast cancer exhibiting amplified HER2 gene tumor cells without HER2 protein overexpression (HER2 epigenetic intratumoral heterogeneity) among trastuzumab-based neoadjuvant chemotherapy treated patients. Our objective in this study was to elucidate if tumor cells with HER2 epigenetic intratumoral heterogeneity express HER2 RNA using a HER2 RNA in situ hybridization (ISH) method.

Materials and methods

Formalin-fixed, paraffin-embedded (FFPE) sections of breast cancer biopsy samples were investigated for HER2 RNA expression at the individual cell level using a HER2 RNA ISH assay. RNA preservation in tissue sections was examined using a peptidylprolyl isomerase B (PPIB) RNA ISH assay.

Three groups of cases were examined:

1) HER2 negative breast cancer cases (HER2 RNA ISH negative control group).

2) HER2 positive breast cancer cases with homogeneous HER2 positive tumor cells (HER2 RNA ISH positive control; pCR group)

3) HER2 positive breast cancer cases with HER2 epigenetic intratumoral heterogeneity (a mixture of HER2 gene and protein positive tumor cells and HER2 gene positive tumor cells without HER2 protein expression; incomplete response group)

Consecutive sections of HER2 RNA ISH slides were stained for HER2 gene and protein concurrently on the same tissue section using HER2 gene-protein assay (GPA) which is a combination of FDA-approved HER2 immunohistochemical (HER2 protein) and HER2 dual ISH (HER2 gene and chromosome 17 centromere) assays. Analyses of HER2 RNA expression in individual cells was microscopically evaluated and matched to HER2 GPA slides.

Results

RNA preservation was confirmed in tissue sections of all three groups by a PPIB RNA ISH assay. Tumor cells of HER2 negative breast cancer cases (negative control group) lacked HER2 RNA ISH signal while HER2 gene and protein positive tumor cells of homogeneous breast cancer cases (positive control group) demonstrated high HER2 RNA expression levels. HER2 gene and protein positive tumor cells of HER2 positive intratumoral heterogeneity cases showed high HER2 RNA expression. However, amplified HER2 gene breast cancer cells without HER2 protein overexpression of HER2 positive intratumoral heterogeneity cases also showed high levels of HER2 RNA expression. Thus, revealing in cases with intratumoral heterogeneity, transcription of HER2 RNA occurs, but translation of HER2 protein is altered by some mechanism(s) in tumor cells.

Conclusions

Transcription of HER2 RNA was observed in breast tumor cells with amplified HER2 gene but absence of HER2 protein overexpression (HER2 epigenetic intratumoral heterogeneity) of patients who showed incomplete response to neoadjuvant trastuzumab therapy. Our study suggests that inconsistent HER2 protein translation in breast cancer with HER2 epigenetic heterogeneity might be the primary resistance mechanism to trastuzumab-based neoadjuvant chemotherapy.

Citation Format: Nitta H, Horii R, Murillo A, Portier B, Akiyama F. Breast cancer HER2 epigenetic intratumoral heterogeneity results from lack of HER2 protein translation [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-06-02.

In vitro cultured bovine endometrial cells recognize embryonic sex

Endometrial cell co-culture (ECC) with single embryo may reflect endometrium responses in vivo. Bovine Day-6 in vitro-produced morulae were cultured until Day-8 in modified synthetic oviductal fluid (mSOF), or on the epithelial side of ECC. Expression of epithelial- and stromal-cell transcripts was analyzed by RT-PCR in ECC with one male (ME) or female embryo (FE). Concentrations of ARTEMIN (ARTN) and total protein were determined in epithelial cell-conditioned medium. ECCs yielded embryos with more cells in the inner cell mass than embryos cultured in mSOF. Embryos altered transcript expression only in epithelial cells, not in stromal ones. Thus, ME induced larger reductions than FE and controls (i.e., no embryos cultured) in hexose transporter solute carrier family 2 member 1 (SLC2A1) and member 5 (SLC2A5), connective tissue growth factor (CTGF), artemin (ARTN), and interferon alpha and beta receptors subunit IFNAR1 and IFNAR2. FE reduced SLC2A1 and SLC2A5, and increased ARTN expression with respect to controls. ME tended to reduce total protein concentration (P < 0.082) in ECC-conditioned medium, while ARTN protein and gene expressions strongly correlated (R > 0.90; P < 0.05) in the group of ME or FE, but not in controls (without embryo). Isolated male and female embryos may differentially release signaling factors that induce sexually dimorphic responses in endometrial cells.

Low serum concentration in bovine embryo culture enhances early blastocyst rates on Day-6 with quality traits in the expanded blastocyst stage similar to BSA-cultured embryos

In bovine, single in vitro embryo culture in protein-free medium from Day-6 to Day-7 leads to expanded blastocyst (XB) with improved pregnancy and birth rates after cryopreservation. Under these conditions, early blastocysts (EB) progress to the XB stage at higher rates than morulae (M). However, embryo production with BSA in culture prior to Day-6 leads to low EB rates. We investigated whether a very low FCS concentration (0.1%) in culture from Day-1 to Day-6 would improve EB rates and, subsequently, increase XB rates on Day-7 after single culture in protein-free medium. The quality of embryos produced was evaluated in terms of survival to cryopreservation, apoptosis percentage, lipid accumulation and transfer to recipients. On Day-6, EB rates from embryos cultured with FCS were higher than with BSA (P=0.022). On Day-7, XB rates were higher in embryos from Day-6 EB than from Day-6M, both with and without FCS (P<0.005). After vitrification/warming of Day-7 XB, 100% embryos survived at 24h in all treatments, and total cell number and apoptosis percentage were not affected by the presence of FCS or embryonic stage on Day-6. Cryopreserved and fresh embryos produced with FCS until Day-6, and then deprived of protein and cultured individually, led to pregnancies after ET. In conclusion, minute FCS concentration improves EB rates on Day-6 leading, after one-day single culture without protein, to more XBs. The quality of XB produced with FCS compares well with XB produced with BSA in terms of apoptosis, lipid accumulation and pregnancy.

Hepatoma-derived growth factor: Protein quantification in uterine fluid, gene expression in endometrial-cell culture and effects on in vitro embryo development, pregnancy and birth

Hepatoma-derived growth factor (HDGF) is present in the endometrium of cows and other mammals. Recombinant HDGF (rHDGF) improves bovine blastocyst development in vitro. However, specific culture conditions and essential aspects of HDGF uterine physiology are yet unknown. In this work we quantified total HDGF protein in uterine fluid (UF) by multiple reaction monitoring (MRM), and analyzed effects of rHDGF on specific embryonic stages with Day-6 bovine embryos cultured in vitro with and without BSA, and on pregnancy viability and calf phenotypes after embryo transfer to recipients. In addition, mRNA abundance of HDGF in endometrial cells co-cultured with one male or one female embryo was quantified. In the presence of BSA, rHDGF had no effect on blastocyst development; however, in BSA-free culture rHDGF mainly promoted development of early blastocysts in contrast with morulae. As the presence of HDGF contained in commercial BSA replacements was suspected, western blot confirmed HDGF identification in BSA both with and without fatty acids. Total HDGF quantified by MRM tended to increase in UF without vs. UF with embryos (P = 0.083). Pregnancy and birth rates, birth weight and calf measurements did not differ between embryos cultured with rHDGF and controls without rHDGF. However, HDGF abundance in cultured epithelial, endometrial cells tended to increase (P < 0.08) in culture with one male embryo. rHDGF acts selectively on specific embryonic stages, but care should be taken with specific macromolecular supplements in culture. The endometrial expression of HDGF can be regulated by the embryonic sex. The use of rHDGF is compatible with pregnancy and birth of normal calves.

97 ONE-DAY PROTEIN-FREE CULTURE SELECTS FOR BOVINE BLASTOCYSTS WITH IMPROVED LONG-TERM VIABILITY AFTER VITRIFICATION

Single embryo culture in SOF with BSA allows efficient noninvasive analysis of culture medium (CM). Defined protein-free CM avoids contaminants present in commercial BSA. In this work we studied the performance of a single culture step with and without protein. In vitro-matured and -fertilized oocytes were cultured in SOF+6 mg mL–1 BSA. From Day-6 onwards, n = 1351 morulae and early blastocysts were singly cultured in 12 µL SOF+6 mg mL–1 BSA or 0.5 mg mL–1 polyvinyl-alcohol (PVA; 20 replicates). Development was recorded as % Day-6 cultured embryos. Day-7 and Day-8 expanded blastocysts were vitrified and cultured upon warming in SOF+10% FCS for 48 h. Expression of genes of stress, metabolism, and imprinting was measured by RT-qPCR in Day-7 fresh expanded and in vitrified/warmed hatched blastocysts. Day-7 vitrified blastocysts were allowed to re-expand for 2 h before embryo transfer (recipients used once or twice). Day 40 pregnancy, miscarriage and birth rates, and morphometry and weight of calves, were recorded. Data were analysed by GLM and REGWQ test. Protein removal reduced Day 7 blastocyst rate (71.3 ± 2.7 v. 51.6 ± 2.7; P < 0.0001) and tended to reduce expansion rate (46.6 ± 3.1 v. 38.4 ± 3.0; P = 0.054). Survival rates of all vitrified embryos cultured with PVA tended to increase over BSA at 2 h and 24 h after warming (97.2 ± 1.7 v. 93.6 ± 1.6; P = 0.09, and 96.4 ± 1.9 v. 91.8 ± 1.8; P = 0.07, respectively). Interestingly, almost all vitrified Day-7 embryos cultured without protein reexpanded 2 h after warming (138/139 v. 137/144 with BSA). This allows suppressing the culture period before embryo transfer. Fresh embryos cultured without protein showed higher expression of IGF2R and the ER stress genes ATF4 and DDIT3 (P < 0.03), and DNMT3A tended to increase (P = 0.062). After warming, only G6PD was overexpressed in protein-free embryos (P < 0.01). Day 40 pregnancy rates did not differ, but birth rates were higher in PVA [58% (11/19)] than in BSA [31% (14/45); P = 0.039]. Pregnancy losses from Day 40 increased with [30% (6/20)] v. without protein [8% (1/12); P = 0.034]. Calf weight, size, thorax circumference, and gestation length did not vary (P > 0.41; not shown). Protein starvation limits blastocyst development but selects for improved viability. Such a profile agrees with the quiet embryo hypothesis (Leese et al. 2008 Mol. Hum. Reprod. 14, 667–672), by which the most viable embryos use endogenous nutrients efficiently and cope with stress successfully. Differences in gene expression seen before vitrification are abolished after warming, with G6PDH perhaps reflecting superior ability of protein-free cultured embryos to counteract stress induced by cryopreservation. Without protein, more embryos reach birth as morphologically normal calves. Research was supported by MICINN (AGL2012–37772) and FEDER; AM: SENESCYT-Ecuador-II Fase 2013. The authors are members of the COST Action FA1201 (Epiconcept).

In vitro evaluation of an oscillating dual-mode ultrasound probe for sector imaging and directive therapy

Interstitial probes have been shown as effective devices to deliver high-intensity ultrasound therapy. Here, cylindrically-focused dual-mode transducers with either one or 5-elements were characterized, and a monoelement probe was evaluated in vitro. In therapy mode, the transducers were maximally efficient (> or =70%) at 5.6 MHz with surface intensities up to 20 W/cm(2). In imaging mode, fractional bandwidths were 46% and 50+/-4% (ave+/-std) for the monoelement and 5-element transducers respectively. Axial and lateral resolutions were 0.5 mm and 1.0 mm, respectively, for both transducers as measured with a point scatterer in the focal plane. After characterization, the oscillating probe was used to image and apply therapy to porcine liver. B-mode images over a 140 degrees sector were formed before and after therapy, which was applied for 90 s at each of 5 angles separated by 20 degrees (e.g. -40 degrees , -20 degrees, 0 degrees, 20 degrees, 40 degrees) to form a composite lesion. Transducer surface intensity was 18 W/cm(2). Therapy was interrupted at 125 ms intervals to collect pulse/echo data along the therapy axes. Data were displayed in real-time as an M-mode image to monitor therapy. B-mode images adequately represented the liver tissue. M-mode image data agreed well with the formation of lesions in the liver.

Genética de poblaciones amazónicas: la historia evolutiva del jaguar, ocelote, delfín rosado, mono lanudo y piurí, reconstruida a partir de sus genes

Amazon population genetics: the evolutionary history of the jaguar, ocelot, pink river dolphin, woolly monkey and wattled curassow reconstructed through their genes The Amazon has more than the half of the world’s biodiversity. Nevertheless, the major fraction of the Amazon species has unknown evolutionary histories. This is also certain for mammals and birds. Population genetics, employing molecular markers and theoretical mathematics models, can reconstruct these evolutionary histories and offer very powerful tools for the application of correct conservation politics. Herein, we show a comparative view of population genetics results obtained for Amazon populations of jaguar, ocelot, pink river dolphin, woolly monkey and wattled curassow and provide recommendation for their biological conservation. Each species showed its own specific evolutionary particularities, characteristics that were not shared by the other species. This finding should be taken into consideration for any effective biological conservation program.

[Breast cancer screening program. Results of the process and impact indicators (1990-2002)]

BACKGROUND

There is a general consensus on the recommendation of applying breast cancer screening programs to the population. In March 1990, the Health Department set in motion a Program for the Early Detection of Breast Cancer, with the aim of reducing mortality due to this tumour. At present, the program is reaching the end of its seventh round. The present study aims to analyze the results obtained, describing the principal indicators of the process and the impact predictions according to the most determinant factors.

METHODS

Data was collected for the screening explorations carried out from the start of the program up until December 31st 2002; the data was classified according to age at the time of exploration, type of exploration and round.

RESULTS

During the period, 354,575 explorations were carried out. Process indicators: an additional exploration was recommended for 11.22% of the women. Naught point sixty seven percent (0.67%) of the women were sent to hospital units for a diagnostic evaluation. A malignant tumour was confirmed in 0.34% of the women subjected to exploration. It was recommended that 8.37% of the women should carry out an intermediate exploration before the next call from the screening program. Predictive impact indicators: global recruitment was 88.68%; global participation 87.91%; and adherence to the program was 96.32%. The rate of detection reached the figure of 3.95 per 1,000 women explored. Of the tumours detected: 19.17% were intraductal and 37.23% of the invasive tumours had a size equal to or below 10mm. Seventy-four point eighty nine percent (74.89%) of total tumours did not show ganglionary invasion.

CONCLUSIONS

Considering the references established by the European Union for screening programs, all of the calculated predictive indicators exceed the required standards.

[Endotrachael aspiration protocol in patients with serious cranial trauma. study of neurophysiological variables]

Aspiration of tracheobronchial secretions can cause noxious effects on neurophysiological variables. Different studies that refer to aspiration of secretions in Serious Cranial Trauma use hyperinsuflation and hyperoxygenation to minimize its repercussion on Intracranial Pressure and thus try to not contribute to the secondary lesion. After reviewing these studies, a protocol of tracheobronchial secretion aspiration was performed in our ICU in patients with serious cranial trauma subjected to mechanical ventilation in order to assess the effect of the aspiration of secretions in the neurophysiological variables following homogeneous and standardized guidelines. Neurological, hemodynamic, oxygenation and ventilation variables were analyzed before, during and after aspiration of secretions. When the results were compared before and during this, we observed a decrease in the Intracranial Pressure with increase of Cerebral Perfusion Pressure (due to increase of Mean Blood Pressure), maintaining the levels of PaCO2 and jugular saturation of O2, with an increase in the airway pressures. After finishing the aspiration process, all the affected values recovered. It is concluded that the aspiration of tracheobronchial secretions in patients with Severe Cranial Trauma, after standardized hyperinsuflation and hyperoxygenation, does not alter the hydrodynamics or brain use of O2.

Geographic differences in bone mineral density of Mexican women

The aim of this study was to generate standard curves for normal spinal and femoral neck bone mineral density (BMD) in Mexican women using dual-energy X-ray absorptiometry (DXA), to analyze geographic differences and to compare these with 'Hispanic' reference data to determine its applicability. This was a cross-sectional study of 4460 urban, clinically normal, Mexican women, aged 20-90 years, from 10 different cities in Mexico (5 in the north, 4 in the center and 1 in the southeast) with densitometry centers. Women with suspected medical conditions or who had used drugs affecting bone metabolism, were excluded. Lumbar spine BMD was significantly higher (1.089 +/- 0.18 g/cm2) in women from the northern part of Mexico, with intermediate values in the center (1.065 +/- 0.17 g/cm2) and lower values (1.013 +/- 0.19 g/cm2) in the southeast (p < 0.0001). Similarly, femoral neck BMD was significantly higher in women from the north (0.895 +/- 0.14 g/cm2), intermediate in the center (0.864 +/- 0.14 g/cm2) and lower (0.844 +/- 0.14 g/cm ) in the southeast part of Mexico (p < 0.0001). Northern Mexican women tend to be taller and heavier than women from the center and, even more, than those from the southeast of Mexico (p < 0.0001). However, these differences in BMD remained significant after adjustment for weight (p < 0.0001). A significant loss (p < 0.0001) in BMD was observed from 40 to 69 years of age at the lumbar spine and up to the eighth decade at the femoral neck. Higher and lower lumbar spine values, as compared with the 'Hispanic' population, were observed in Mexican mestizo women from the northern and southeastern regions, respectively. In conclusion, there are geographic differences in weight and height of Mexican women, and in BMD despite adjustment for weight.

[Evaluation of the cervical factor in ovulation induction]

Post coital sperm penetration tests performed in 66 women under study for infertility, the purpose was to evaluate the ovulation induction effect over mucus quality and over sperm penetration. They were divided in three groups: 1) 28 women with evidence of spontaneous ovulation (control group), 2) 26 patients in which ovulation was induced with comiphene citrate and 3) 12 patients in which ovulation was induced with menotropins. The results showed that CC had an adverse effect over cervical mucus (p < 0.001), while in patients treated with menotropins the cervical mucus quality was not modified. Sperm penetration in patients under CC had a tendency to lower values than those in women of the control group, but these were statistically lower than those in patients under menotropins (p < 0.05). These results show the adverse effect of CC and the benefit of menotropins over cervical mucus and sperm penetration.

Accuracy of flow convergence estimates of mitral regurgitant flow rates obtained by use of multiple color flow Doppler M-mode aliasing boundaries: an experimental animal study

The proximal flow convergence method of multiplying color Doppler aliasing velocity by flow convergence surface area has yielded a new means of quantifying flow rate by noninvasively derived measurements. Unlike previous methods of visualizing the turbulent jet of mitral regurgitation on color flow Doppler mapping, flow convergence methods are less influenced by machine factors because of the systematic structure of the laminar flow convergence region. However, recent studies have demonstrated that the flow rate calculated from the first aliasing boundary of color flow Doppler imaging is dependent on orifice size, flow rate, aliasing velocity and therefore on the distance from the orifice chosen for measurement. In this study we calculated the regurgitant flow rates acquired by use of multiple proximal aliasing boundaries on color Doppler M-mode traces and assessed the effect of distances of measurement and aliasing velocities on the calculated regurgitant flow rate. Six sheep with surgically induced mitral regurgitation were studied. The distances from the mitral valve leaflet M-mode line to the first, second, and third sequential aliasing boundaries on color Doppler M-mode traces were measured and converted to the regurgitant flow rates calculated by applying the hemispheric flow equation and averaging instantaneous flow rates throughout systole. The flow rates that were calculated from the first, second, and third aliasing boundaries correlated well with the actual regurgitant flow rates (r = 0.91 to 0.96). The mean percentage error from the actual flow rates were 151% for the first aliasing boundary, 7% for the second aliasing boundary, and -43% for the third aliasing boundary; and the association between aliasing velocities and calculated flow rates indicates an inverse relationship, which suggests that in this model, there were limited velocity-distance combinations that fit with a hemispheric assumption for flow convergence geometry. The second aliasing boundary with an aliasing velocity, of 102 cm/sec, (which was achieved by use of a 4 kHz pulse repetition frequency, a 3.75 MHz transducer, and no color baseline shift), provided the closest fit to the actual regurgitant flow rates (r = 0.99; y = 0.95x + 0.07). The averaged calculated flow rates from all aliasing velocities also resulted in excellent correlation (r = 0.97; y = 0.99x + 0.5). A hemispheric flow convergence method that is based on color Doppler M-mode echocardiography is a feasible and automatable method for quantifying mitral regurgitant rate.(ABSTRACT TRUNCATED AT 400 WORDS)

[Ovulation induction with gonadotropins aided by cervix mucus analysis and echography]

Induction of ovulation was performed in 148 cycles using human menopausal gonadotropins (HMG) in 52 patients, seven with hypothalamic-pituitary failure and 45 suffering dysfunction at this level. Several induction schemes were used beginning on the second day of the cycle, until one or more follicles larger than 14 mm were found, to administrate 10,000 UI of human chorionic gonadotropin (HCG). Clinical valuation of cervical mucus and ultrasound of the ovaries to assess follicular development were done, from day eight of the cycle. Twenty five pregnancies resulted in 23 patients (44%), three in patients with failure and 22 in the dysfunction group. A total of 19 healthy babies were taken home, however three neonatal deaths, four miscarriages and one ectopic pregnancy occurred. Multiple gestation was present in three patients (12%), one was quadruplet, one triplet and one twin. The ovarian hyperstimulation syndrome (OHS) was detected in seven patients (13.4%), three were mild, two moderate and two severe; two cases of OHS had multiple pregnancies. Although induction of ovulation with HMG in patients with anovulation is a complex procedure requiring strict clinical vigilance and advanced technological resources, in this clinical study it was possible to obtain similar results to other series, using high resolution ultrasound only, without daily measurements of hormones.

[Treatment and prevention of the ovarian hyperstimulation syndrome]

Frequency and features of ovarian hyperstimulation syndrome (OHS) were reviewed in 41 women stimulated with human menopausal gonadotropin (HMG) during 130 cycles. There were 7 cases of OHS, since 17% of patients and 5.3% of cycles were affected; 3 cases were mild, 2 moderate and 2 severe. Of these 41 women, 21 pregnancies occurred (51%) and 19 newborns were healthy. The patients with OHS received 1060 +/- 235 (X +/- DE) UI of HMG and there was not a significative difference with the amount of HMG units in remaining subjects. Symptoms began 3-6 days after human chorionic gonadotropin (HCG) administration. Women with mild OHS were treated as out patients with bed rest and 100 mg indomethacin in suppositories two times a day. Moderate and severe OHS were hospitalized with bed rest; careful monitoring of fluid intake and output, weight and abdominal perimeter daily, as well as vital signs were withdrawn. Patients with severe OHS were treated in the intensive care unit for detection and management of complications. One patient was submitted to laparotomy because of a probably ovarian rupture, but it was discarded in the surgery. OHS remained between 6 and 8 days. Patients with OHS presented 3 pregnancies, 2 were twins and the other was ectopic. Emphasis was made in the prophylactic measures to avoid the OHS.

Doppler color flow mapping of simulated in vitro regurgitant jets: evaluation of the effects of orifice size and hemodynamic variables

The spatial distribution of simulated regurgitant jets imaged by Doppler color flow mapping was evaluated under constant flow and pulsatile flow conditions. Jets were simulated through latex tubings of 3.2, 4.8, 6.35 and 7.9 mm by varying flow rates from 137 to 1,260 cc/min. Color jet area was linearly related to flow rate at each orifice (r = 0.96, SEE = 3.4; r = 0.99, SEE = 1.6; r = 0.97, SEE = 2.3; r = 0.97, SEE = 3.2, respectively), but significantly higher flow rates were required to maintain the same maximal spatial distribution of the jet at the larger regurgitant orifices. Constant flow jets were also simulated through needle orifices of 0.2, 0.5 and 1 mm, with a known total volume (5 cc) injected at varying flow rates and with differing absolute volumes injected at the same flow rate (0.2, 1.0 and 2.0 cc/s, respectively). Again, maximal color jet area was linearly related to flow rate at each orifice (r = 0.97, SEE = 2.3; r = 0.97, SEE = 2.4; r = 0.92, SEE = 3.9, respectively), but was not related to the absolute volume of regurgitation. Color encoding of regurgitant jets on Doppler color flow maps was demonstrated to be highly dependent on velocity and, hence, driving pressure, such that color encoding was obtained from a constant flow jet injected at a velocity of 4 m/s through an orifice of 0.04 mm diameter with flow rates as low as 0.008 cc/s. Mitral regurgitant jets were also simulated in a physiologic in vitro pulsatile flow model through three prosthetic valves with known regurgitant orifice sizes (0.2, 0.6 and 2.0 mm2). For each regurgitant orifice size, color jet area at each was linearly related to a regurgitant pressure drop (r = 0.98, SEE = 0.15; r = 0.97, SEE = 0.20; r = 0.97, SEE = 0.23, respectively), regurgitant stroke volume (r = 0.77, SEE = 0.55; r = 0.94, SEE = 0.30; r = 0.91, SEE = 0.41, respectively) and peak regurgitant flow rate (r = 0.98, SEE = 0.16; r = 0.97, SEE = 0.21; r = 0.93, SEE = 0.37, respectively), but the spatial distribution of the regurgitant jets was most highly dependent on the regurgitant pressure drop. Jet kinetic energy calculated from the summation of the individual pixel intensities integrated over the jet area was closely related to driving pressure (r = 0.84), but integration of the power mode area times pixel intensities provided the best estimation of regurgitant stroke volume (r = 0.80).(ABSTRACT TRUNCATED AT 400 WORDS)

Potential long-acting contraceptive agents: esters and ethers of testosterone with alpha- and/or beta-chain branching

The synthesis of ten esters and two ethers of testosterone (17 beta-hydroxyandrost-4-en-3-one) is described. All these possess some form of alpha - and/or beta - substitution in the ester/ether side-chain. The work was undertaken in order to evaluate the long-acting antifertility effect of such compounds in males.

[Radiologic indices and measurements in the evaluation of pulmonary artery hypertension in chronic obstructive lung disease]

Radiologic indexes proposed as useful in the non-invasive evaluation of pulmonary arterial hypertension (HAP) were analyzed in a group of 35 patients with stable chronic obstructive pulmonary disease (NOC) and secondary HAP (mean pulmonary artery pressure = 29 +/- 2 mmHg). Indices included the PL/T (L = point of union of the external border of the upper lobe artery with the pars interlobaris; PL = the sum of horizontal distances of the right and left L's to the midline: T = transverse diameter of the thorax), the width of the right pulmonary artery at the pars interlobaris (R) and the relation between R and the transverse diameter of the hemithorax (R/H). Our results were as follows: R index was abnormal (greater than 17 mm) in 25 out of 35 patients (71%). PL/T was found abnormal (greater than 38%) in 16 of the patients (45.7%). R/H was abnormal in 10 of the patients (28%). There was no correlation between any of the indexes, and the levels of HAP or pulmonary arteriolar vascular resistance nor the magnitude of lung over inflation or bronchial obstruction. We conclude that the proposed indexes are also of value in NOC with HAP. The width of the right pulmonary artery (R) will be abnormal in two-thirds of the cases with HAP and NOC.

Long-acting contraceptive agents: esters of norethisterone with alpha- and/or beta-chain branching

The synthesis of eighteen esters of norethisterone (17 alpha-ethynyl-17 beta-hydroxyestr-4-en-3-one) is described. These all possess some form of alpha- and/or beta-substitution in the ester side-chain. The work was undertaken in order to evaluate any long-acting fertility control effect intrinsic in such compounds. A pentamethyl disiloxy ether was also included in the group of substances prepared for testing because of its similar substitution pattern.

[Absorption of calcium by growing goats: effect of oxalates]

The influence of sodium oxalate and calcium oxalate upon calcium digestibility was studied in growing goats. Furthermore, and in the same animals, calcium absorption efficiency was estimated after performing duodenal fistula which allowed us to introduce calcium chloride or calcium oxalate and sodium oxalate, in order to avoid ruminal bacteria action upon the forementioned compounds. Finally, calcium absorption of an isolated intestine loop was studied in conscious goats with a Crocker Markowitz fistula, in the presence or absence of oxalate. The addition of sodium oxalate to the diet did not significantly decrease calcium absorption; but when calcium was given as oxalate, absorption was considerably lower. When calcium was introduced as calcium chloride through duodenal fistula, absorption was the same as when the substance was given in the diet. Calcium absorption drastically decreased when sodium oxalate was introduced directly into the duodenum, this fact is confirmed when calcium absorption is estimated in a jejunal loop, which shows that the differences found in relation to the effect of dietary sodium oxalate or directly introduced in duodenum are due to the substance destruction by ruminal bacteria.

[The nutritive utilization of phosphorus in dietary calcium deprivation (author's transl)]

The influence of alimentary calcium deprivation on the nutritional utilization of phosphorus and its corporal retention, after ingestion of diethylstilbesterol has been studied in quail. When female quail are given a highly calcium-deficient diet, egg-laying stops and there follows a substantial decrease in phosphorus utilization and retention, as well as a clear drop in bone mineralization, with calcium and phosphorus content losses in the femur. In males, deprivation of alimentary calcium shows tangible effects on phosphorus retention only when this situation concurs with prior ingestion of diethylstilbestrol.

[Protein nutritive utilization in goats with and without exclusion of rumen and reticulum (author's transl)]

The digestive utilization of protein in fistulated goats has been studied through a system of three cannulae. The protein digestibility coefficient is greater with casein in the rumen than with it in the abomasum, explainable by a higher ammonium production. On the other hand, with casein in the abomasum the duodenal digest contains more protein, and aminoacid composition improves in quality and quantity. The differences found in the above mentioned results are mainly due to a rumen bacterial action upon aminoacids and the subsequent absorption of the ammonium formed.

[Some aspects of vagal control of exocrine pancreatic secretion in rabbits (author's transl)]

Stimulation of the thoracic vagus nerves in anesthetized rabbit appears to act only by increasing the amylase content of pancreatic juice. Stimulation of the abdominal vagus nerve slightly increased the flow of juice and clearly its amylase content, effects which were respectively reduced and abolished by atropine. The vagal control of the exocrine pancreas in rabbits shows substantial differences when compared with other herbivorous monogastric species such as horse and pig.

[Diet effect on fatty acids composition in trout (salmo gairdnerii). rev. esp. fisiol., (author's transl)]

The effect of diets with different fatty acids composition on muscular and hepatic fatty acids of rainbow trout (Salmo gairdnerii) was studied. The effect was higher on muscular fatty acids than on hepatic ones. The lack of correlation between dietary and liver fatty acids in diets with a high level of linoleic acid, showed a better utilization of this acid by the liver. The change in muscular fatty acids pattern was observed within a week of diet change, showing a significant tendency to approach the new dietary fatty acids pattern.

Calcium balance in the quail (Coturnix coturnix japonica). 1, Influence of sex and diethylstilbestrol

Young adult male and laying female quail, fed with a diet containing 2.64% Ca and 0.70% P, were used to study nutritive utilization, corporal calcium retention and endogenous excretion, calcemia, laying and properties of the egg (including the shell structure), mineralization of the femur bone, as well as the influence of diethylstilbestrol upon these parameters. The coefficient of nutritive utilization (C.N.U.) in the female was high and logically superior to that of the male, while the corporal retention was quite similar for both sexes. Most of the Ca absorbed (81.8%) and not excreted in urine, went to the egg and only 18.2% remained in the body. The diethylstilbestrol caused a big reduction of the C.N.U. in the female, but not in the male, parallel to an inhibition of laying, and an increase of corporal retention of used calcium. In both sexes the calcemia surprisingly increased, and the calcium level of the femur bone was higher, and even though the cortical osseous zone was slightly wider, the effect of treatment was noticeable, particularly in the medular tissue, which incremented in the female and appeared in the male. When quail were fed a calcium-restricted diet, the endogenous excretion of this mineral was small in the case of the female and significantly smaller in the male. This situation suppressed egg laying and resulted in a clearly decreased bone mineralization. The ingestion of diethylstilbestrol before feeding a diet poor in calcium provoked an increase of the endogenous excretion of calcium in both female and male quail.

[Parasympathetic control of secretion of pancreatic juice in the rabbit (author's transl)]

The secretion of pancreatic juice in response to stimulation of the vagus nerves in the neck, and to injection of parasympathomimetic drugs, was studied in anesthetized rabbits. Vagal stimulation caused a marked increase of protein content in pancreatic juice, and also a small increase in flow of juice, highly variable from one amimal to another, preceded by a short period of inhibition. Atropine supressed vagal effect on protein concentration, but failed to abolish the flow response. Injection of parasympathomimetic drugs closely imitated the results of vagal stimulation, with the difference that secretory action was fully abolished by atropine. The possibility that effects the parasympathetic stimulation on the flow of juice were secondary to vasodilatation, was discussed. The obtained data were compared with those described for other mammalian species, and the conclusion was reached that rabbit behaves like carnivora rather than herbivora.