Muscle Evaluation and Hospital-Associated Disability in Acute Hospitalized Older Adults

OBJECTIVES

We aimed to examine the association of muscle evaluation, including muscle ultrasound, with hospital-associated disability (HAD), focusing on ADL categories.

DESIGN

A prospective observational cohort study.

SETTING AND PARTICIPANTS

We recruited patients aged 65 years or older who were admitted to the geriatric ward of an acute hospital between October 2019 and September 2021.

MEASUREMENTS

Handgrip strength, bioimpedance analyzer-determined skeletal muscle mass, bilateral thigh muscle thickness (BATT), and the echo intensity of the rectus femoris on muscle ultrasound were performed as muscle assessments. HAD was evaluated separately for mobility impairments and self-care impairments.

RESULTS

In total, 256 individuals (mean age, 85.2 years; male sex, 41.8%) were analyzed. HAD in mobility was more common than HAD in self-care (37.5% vs. 30.0%). Only BATT was independently associated with HAD in mobility in multiple logistic regression analysis. There was no significant association between muscle indicators and HAD in self-care.

CONCLUSION

A lower BATT was associated with a higher prevalence of HAD in mobility, suggesting the need to reconsider muscle assessment methods in hospitalized older adults. In addition, approaches other than physical may be required, such as psychosocial and environmental interventions to improve HAD in self-care.

Work-sharing and male employees' mental health during an economic recession

Background

One approach to reducing occupational stress during an economic recession is to share work amongst employees. This may include reducing employees' working hours to avoid redundancies.

Aims

To examine whether work-sharing influenced the psychosocial work environment and depressive symptoms encountered by Japanese employees, and to determine which psychosocial factors predict employees' mental health during an economic recession.

Methods

A survey was performed in a Japanese manufacturing company at the beginning (T1) and end (T2) of a 6-month period during the 2008 economic recession using the validated Job Content Questionnaire (JCQ) and Self-Rating Depression Scale (SDS).

Results

Three hundred and thirty-six male employees completed the questionnaire. Twenty-four per cent of participants showed depressive symptoms at T1. Despite reductions in employees' working hours and job strain (P < 0.001), SDS scores showed no change after 6 months. Logistic regression analyses showed that low social support between the two surveys was associated with depressive symptoms at T2 after adjusting for demographic, lifestyle, workplace factors, scheduled working hours and depressive symptoms at T1.

Conclusions

Reductions in job strain did not affect employees' depressive symptoms. Employees with low social support during the study had a significantly higher risk of having depressive symptoms. These findings indicate that social and emotional support within the workplace is important during the work-sharing period.

Clinical and safety profiles of bipolar transurethral vaporization of the prostate in saline: a preliminary report

Transurethral vaporization of the prostate in saline (TURisV) is an innovative endoscopic surgical modality for the treatment of benign prostatic hyperplasia (BPH) that vaporizes prostate tissue using a uniquely designed mushroom electrode. TURisV promises instant hemostatic tissue ablation under saline irrigation and offers clinical advantages for endoscopic BPH operations. From July 2008 to February 2009, TURisV was performed in 17 cases with clinically significant BPH. Median operation time was 127.0 min and median volume of vaporized prostate tissue was 41.1 g. Median International Prostate Symptom Score improved from 20 to 4 after 12 months. Median maximum flow rate increased from 5.3 mL/s to 13.8 mL/s after 12 months. Postoperative median residual urine improved from 48.0 mL to 7.0 mL after 12 months. No changes in hemoglobin or electrolyte levels were seen postoperatively. Our results suggest that TURisV is a safe and efficacious treatment for BPH.

[Coronary artery bypass grafting for simultaneous subacute stent thrombosis after sirolimus-eluting stent implantation]

An 82-year-old man developed simultaneous stent thrombosis 11 days after the implantation of a sirolimus-eluting stent (SES) in the proximal left anterior descending artery (LAD) and the proximal right coronary artery (RCA). The patient immediately underwent percutaneous coronary intervention; however, his condition became critical due to the development of recurrent stent thrombosis, and emergent coronary artery bypass grafting with saphenous vein grafts was performed. Postoperative angiography showed good patency of both grafts; thrombus formation in the LAD and RCA was negative. Since the patient had a history of liver dysfunction due to ticlopidine administration, the thienopyridine derivative was not administered; this was believed to be the main cause of subacute stent thrombosis. He was administered aspirin, cilostazol, and sarpogrelate instead. A good postoperative course was achieved only using aspirin. This case demonstrates that simultaneous SES thrombosis in multivessel lesions poses a life-threatening situation.

[Emergent coronary artery bypass grafting in a survivor of out-of-hospital cardiac arrest]

We report a case of emergent coronary artery bypass grafting (CABG) in a survivor of an out-of-hospital cardiac arrest. A 64-year-old male driver lost consciousness and collapsed in a rice paddy field. A bystander placed him in a car and immediately started cardiopulmonary resuscitation after confirming the presence of pulselessness and apnea. Emergency medical service providers performed a defibrillation of ventricular fibrillation by using an automated external defibrillator (AED), and the patient was transferred to the critical care center in our hospital. Coronary angiography revealed a thrombus in the left main trunk (LMT), total occlusion of the left anterior descending artery (LAD) and the right coronary artery (RCA), and 90% stenosis of the left circumflex artery (Cx). Since the patient recovered consciousness 1 hour after admission and did not undergo any critical trauma, an on-pump CABG was performed for 3 vessels. He was discharged on the postoperative day 23, and he resumed a normal life.

Effects of prolactin and growth hormone on plasma immunoglobulin M levels of hypophysectomized rainbow trout, Oncorhynchus mykiss

Immunoglobulin M (IgM) is a major component of the humoral immune system of teleosts. This study examines the effects of hypophysectomy and subsequent replacement with prolactin (PRL) or growth hormone (GH) upon the plasma IgM levels of the rainbow trout (Oncorhynchus mykiss). Plasma IgM levels of the hypophysectomized fish were decreased to 30% of those in sham-operated fish 1 or 4 weeks after operation. Implantation of a cholesterol pellet containing salmon PRL or GH restored plasma IgM levels of the hypophysectomized fish, suggesting important roles for PRL and GH in the regulation of circulating IgM level in trout.

Molecular cloning of the cDNAs encoding pituitary glycoprotein hormone alpha- and gonadotropin II beta-subunits of the Japanese eel, Anguilla japonica, and increase in their mRNAs during ovarian development induced by injection of chum salmon pituitary homogenate

cDNAs encoding the glycoprotein hormone alpha- and gonadotropin (GTH) II beta-subunits of Japanese eel (Anguilla japonica) pituitary were cloned using the polymerase chain reaction. The nucleotide sequence of the glycoprotein hormone alpha-subunit cDNA was 364 base pairs (bp) long, encoding 117 amino acids, and that of the GTH II beta-subunit cDNA was 433 bp long, encoding 140 amino acids. The deduced amino acid sequence of each mature subunit showed high homology with those of other teleosts, indicating that the structure of GTH subunits has been conserved during the evolution of teleosts. Changes in the expression of these subunit genes during ovarian development induced artificially by the injection of chum salmon pituitary homogenate were examined using Northern blot analysis. Glycoprotein hormone alpha-subunit mRNA increased almost linearly during ovarian development, whereas GTH II beta-subunit mRNA was detected only at the late vitellogenic and migratory nucleus stages. These data indicate that eel GTH II is synthesized mainly at the late vitellogenic and migratory nucleus stages, and suggest that GTH II plays an important role in final oocyte maturation of Japanese eel. Changes in the expression of glycoprotein hormone alpha- and GTH II beta-subunits mRNA correlate with the serum estradiol-17 beta (E(2)) and testosterone profile during ovarian development. The increase in mRNA of both subunits is probably due to positive feedback of E(2) and testosterone produced by ovarian follicles in response to the GTH contained in chum salmon pituitary homogenate.

Monoclonal antibody against an amniotic protein carrying ABH blood group epitopes and its forensic application

A mouse monoclonal antibody against an amniotic protein carrying ABH antigenic epitopes was established. BALB/c mice were immunized by an amniotic protein of molecular weight over 200 kDa, which had proved to be the carrier protein of ABH blood group epitopes by analysis with SDS-PAGE and immunoblotting. The antibody, ASP-1, was directed to the amniotic carrier protein without affecting the ABH blood group antigenicity, and did not cross-react with other body fluids which included blood, saliva, semen, urine or vaginal secretion. The immunoglobulin class of ASP-1 was IgG1 with a titer of 1 : 1,600. ASP-1 was used to detect the ABH blood group of amniotic fluid by the sandwich ELISA in which wells of plates were coated with ASP-1, and the ABH blood group of the captured protein was detected with mouse IgM anti-A and -B antibodies and enzyme conjugated anti-mouse IgM. The sandwich ELISA could successfully detect the blood group of amniotic fluid in mixed body fluids.

Molecular biologic analyses of tetragametic chimerism in a true hermaphrodite with 46,XX/46,XY

OBJECTIVE

To investigate the mechanism of the formation of a tetragametic chimera with true hermaphroditism (46,XX/46,XY).

DESIGN

Molecular biologic analyses.

SETTING

Outpatient clinic and laboratories of a university hospital.

SUBJECTS

A true hermaphrodite with 46,XX/46,XY and the parents. MAIN OUTCOME ANALYSIS: Restriction fragment length polymorphism (RFLP) of the pseudoautosomal region on sex chromosomes.

RESULTS

Whereas a normal diploid individual showed two bands, the true hermaphrodite showed four bands in the RFLP analyses. Evaluation of the molecular weights of the bands revealed two of them to be of maternal origin and the other two to be of paternal origin.

CONCLUSION

The two cell lineages composing the true hermaphrodite are heterogeneous because those originated from the fertilization of two genetically different maternal haploid cells by two different spermatozoa.

The effect of cortisol administration on blood plasma immunoglobulin M (IgM) concentrations in masu salmon (Oncorhynchus masou)

Immunoglobulin M (IgM) is known as a main factor in the humoral immune system of teleosts. In the present study, the effect of cortisol on plasma IgM concentrations was investigated using a specific antibody to IgM in masu salmon (Oncorhynchus masou). Cortisol was orally administered each day for 2 weeks at a dose of 1 mg g(-1) in the diet, and for the following week the fish were fed a non-treated diet. Blood plasma samples were collected at 0, 1, 2 and 3 weeks after the initiation of treatment. Oral administration of cortisol elevated plasma cortisol concentrations to about 40 ng/ml for 2 weeks after administration and slightly reduced plasma IgM concentration; the suppression was statistically significant one week after the period of hormone administration. However, treatment with cortisol did not affect plasma concentrations of total protein or α1-protein, one of the major serum proteins, during the experimental period. These results indicate that cortisol specifically suppresses plasma IgM concentrations.

[Two unusual cases of half-sibling test with DNA polymorphism]

In usual paternity cases, the putative man and the mother-child couple are alive. However, there are some cases in which putative man and mother were deceased and only children were available for analyses. It is difficult to determine the presence or absence of half-sibling relationship from analyses of conventional blood group markers (CBGM). In this study, five kinds of single locus DNA probes were applied to 2 half-sibling cases. To decide usefulness of single locus DNA probes, we defined likelihood ratio of half-sibling (LRHS) based on the likelihood ratio of paternity (LRP) and also investigated the distribution curves of log10 LRHS in cases of unrelated combinations and half-sibling combinations. Distribution curves of log10 LRHS from DNA analyses in the cases of unrelated combinations and half-sibling combinations is more clearly separated than from CBGM. Single locus DNA probes are considered to be more informative for half-sibling cases.

Na(+)-H+ exchange inhibitors decrease neointimal formation after rat carotid injury. Effects on smooth muscle cell migration and proliferation

The presence of multiple growth stimuli at the sites of vascular injury following angioplasty suggests that therapies targeted toward common growth pathways will be more effective than therapies that inhibit only a single growth factor. We tested this hypothesis using amiloride and ethyl isopropyl amiloride (EIPA), which are inhibitors of the Na(+)-H+ exchanger, whose activity is required in many cells for proliferation and migration. In the rat carotid injury model, EIPA (100 micrograms/h for 15 days) significantly decreased intimal area and the ratio of intimal to medial area, whereas amiloride (25 micrograms/h) showed an inhibitory trend that was similar to that observed for captopril (80 mg/kg per day) and heparin (25 U/h). EIPA and amiloride inhibited rat vascular smooth muscle cell DNA synthesis, with IC50 values of 8.8 and 82.2 microM, respectively. Using platelet-derived growth factor as a chemoattractant, EIPA caused a concentration-dependent inhibition of migration (IC50, approximately 60 microM). Because amiloride and EIPA have nonspecific effects on cellular function (especially inhibition of tyrosine kinases), we sought to characterize the specific role of the Na(+)-H+ exchanger in vascular smooth muscle cell proliferation and migration. We generated a Na(+)-H+ exchanger-deficient mutant cell line [RNHE(-)]. Studies with these cells suggested that the inhibitory effects of EIPA and amiloride were mediated only in part via Na(+)-H+ exchange because (1) RNHE(-) cells grew well at pH 6.8 to 7.5 in bicarbonate-containing medium, and (2) there was no difference in migration in response to platelet-derived growth factor in the RHNE(-) cells. In summary, these data indicate that amiloride and EIPA inhibit neointimal formation in the rat carotid after injury. However, the mechanism of inhibition is likely to involve cellular events other than Na(+)-H+ exchange, such as an effect on tyrosine kinases.

Effects of thyroid hormone on gonadotropin-induced steroid production in medaka, Oryzias latipes, ovarian follicles

Blood and ovarian samples were collected at intervals of 4h prior to spawning time from medaka (Oryzias latipes) that were maturationally synchronized with artificial photoperiod (14h light: 10h dark). Plasma estradiol-17β (E2) levels increased rapidly from 16h before spawning and peaked at 8h before spawning. Follicle-enclosed oocytes (ovarian follicles) at different stages of development were isolated from the ovaries and used to study the in vitro effects of thyroid hormone (triiodothyronine; T3) on pregnant mare serum gonadotropin (GTH)-induced E2 production. GTH at a concentration of 100 IU/ml stimulated E2 production by ovarian follicles collected between 32 and 16h before spawning. At 32h before spawning, T3 (5 ng/ml) administered along with GTH (100 IU/ml) resulted in a 3.5 fold increase in E2 production, compared with GTH administered alone. These results suggest that T3 can act on ovarian follicles directly to modulate GTH-stimulated E2 production in the medaka.

Prenatal paternity testing with DNA analyses

Two PCR amplified loci and 3 single locus DNA probes were applied in a paternity case in which a married woman became pregnant after being raped. DNA analysis were performed using samples from the woman, her husband and amniotic fluid cells taken during the 16th week of pregnancy. The combined probability of paternity for her husband was calculated as 0.999997107. The application of PCR analyses and single locus DNA probes were considered to be extremely informative in prenatal paternity testing.

Blood grouping of minute samples using monoclonal anti-A,B antibody

The availability of a monoclonal anti-A,B antibody (AB-E6E2) for blood grouping of blood and saliva stains was investigated. The antibody, which was reacted with A, B and AB antigens but not with O antigen, was produced from BALB/c mouse-mouse hybridoma raised to group AB red blood cells. AB-E6E2 had heat-elutability enough to detect ABO antigens in blood and saliva stains by absorption-elution test, whereas it had extremely weak double combining potency in mixed agglutination test. Application of elution-ELISA method will enable the detection of smaller amount of ABH antigens. The antibody, therefore, would be useful to segregate group O minute samples from the other blood group ones.

Impact of influenza virus infection as a cause of pediatric hospitalization

From winter 1989 to spring 1990, a severe epidemic caused by influenza A (H3N2) and B viruses developed in Japan. During the epidemic (December 1989 to February 1990), 244 children were admitted to the pediatric ward of Nippon Kokan Hospital: 53 (21.7%) were hospitalized with influenza virus infection, 22 (9.0%) with rotavirus gastroenteritis, and 17 (7.0%) with respiratory syncytial virus infection. Among those with influenza, 24 had type A and 29 had type B. Most were young healthy children without underlying illnesses (mean age, 4.8 +/- 3.4 years). The impact of the influenza epidemic on pediatric hospitalization is probably much greater than generally thought when a severe epidemic occurs.

[Study of the profiles of prolactin and other hormones in both maternal plasma and amniotic fluid during labor]

The effects of a dopamine antagonist and stress of labor on prolactin (PRL) concentrations were studied in maternal plasma and amniotic fluid during term delivery. In procedure 1, maternal blood and amniotic fluid samples were obtained from 5 normal full-term deliveries at 20-minute intervals for 180 minutes after the intravenous bolus of 10 mg metoclopramide (MCP) during labor just before delivery. Amniotic fluid samples were drawn through a transcervical intrauterine pressure catheter to avoid contamination with maternal blood. PRL, 17 beta-estradiol (E2), progesterone (P) and cortisol were measured by means of radioimmunoassay (RIA), and free MCP concentrations were measured by high pressure liquid chromatography. In procedure 2, maternal blood and amniotic fluid samples were obtained from 12 full-term pregnancies with spontaneous delivery and 10 cases of elective cesarean section when birth was imminent. The amniotic fluid was obtained by direct sampling from the forewaters in spontaneous delivery and by means of a syringe inserted through amniotic membrane after the uterine wall had been incised in cesarean section. PRL, beta-endorphin (beta-EP) and cortisol were measured by RIA. The PRL levels in maternal plasma increased significantly (p less than 0.01) after the MCP injection. The peak value of PRL net increase (delta PRL) was 676.5 +/- 189.6 ng/ml. However, the PRL levels in amniotic fluid did not change significantly after the administration of this drug. Although the delta PRL levels in maternal plasma were significantly (p less than 0.001) correlated with MCP concentrations (r = 0.812) after the MCP injection, there was no correlation between delta PRL and MCP concentrations in amniotic fluid. No significant changes in E2, P and cortisol levels in both samples were observed after the MCP injection. The plasma PRL levels in vaginal delivery cases were significantly (p less than 0.05) lower than those in elective cesarean section cases (123.3 +/- 15.8 ng/ml vs. 181.0 +/- 22.2 ng/ml), and the plasma beta-EP and cortisol levels in vaginal delivery cases were significantly (p less than 0.01, p less than 0.001) higher than those in elective cesarean section cases respectively (beta-EP: 134.8 +/- 25.6 pg/ml vs. 49.7 +/- 12.3 pg/ml, cortisol: 79.4 +/- 5.8 micrograms/dl vs. 30.2 +/- 3.3 micrograms/dl). Therefore, a significant reduction in plasma PRL levels was accompanied by a marked rise in plasma beta-EP and cortisol levels during labor. In amniotic fluid, however, there were no significant differences of PRL, beta-EP and cortisol levels in vaginal delivery cases and elective cesarean cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Prolactin-releasing system in maternal, fetal, and amniotic compartments during labor

The effect of a dopamine antagonist on prolactin concentrations was studied in maternal, fetal plasma, and amniotic fluid in term gestation. Twenty-three women with normal full-term pregnancies received 10 mg metoclopramide intravenously during labor. The prolactin levels in maternal plasma increased significantly after metoclopramide. However, the prolactin levels in amniotic fluid and fetal plasma did not change significantly after administration of this drug. Although the increased values of prolactin in maternal plasma were significantly correlated with metoclopramide concentrations after metoclopramide injection, there was no correlation between these two values in amniotic fluid. The authors conclude that the prolactin-releasing system in amniotic fluid is independent of the maternal hypothalamopituitary axis.

Developmental changes in contractile protein adenosine 5'-triphosphatase in the rabbit heart

This study was designed to investigate developmental changes in contractile protein adenosine 5'-triphosphatase in the rabbit heart. Myofibrils and myosin were isolated from ventricular muscles from the fetal, newborn, and adult rabbits. Actin and troponin-tropomyosin complex were isolated from the adult skeletal muscle. Myofibrillar (actomyosin) adenosine 5'-triphosphatase measured at low ionic strength increased with development. In contrast, myofibrillar calcium adenosine 5'-triphosphatase at high ionic strength was the greatest in the newborn and the lowest in the adult. Myosin calcium adenosine 5'-triphosphatase and actin-activated myosin adenosine 5'-triphosphatase were also the greatest in the newborn and the lowest in the adult. The relative proportion of myosin isozyme V1 was the greatest in the newborn and the lowest in the adult. The addition of troponin-tropomyosin complex stimulated myosin adenosine 5'-triphosphatase in the presence of calcium in the adult, but not in the newborn and fetus. As a result, actin-activated myosin adenosine 5'-triphosphatase in the presence of troponin-tropomyosin complex was the greatest in the adult, followed by the newborn and fetus. These data suggest that the low myofibrillar adenosine 5'-triphosphatase activity at low ionic strength in the premature heart may be due to the age-related difference in the interaction of myosin with troponin-tropomyosin. Developmental change in myosin calcium adenosine 5'-triphosphatase (which is determined by the relative proportion of isomyosin V1 and V3) may not be directionally identical to that of the physiologically important myofibrillar adenosine 5'-triphosphatase.

[Effect of dopaminergic agents on the endocrine profile in labor and early puerperium]

The purpose of this study was to investigate the prolactin (PRL) releasing mechanism of the hypothalamo-pituitary axis during labor and early puerperium. Ten full-term gravidas during labor and 42 women in early puerperium were examined in this study. The plasma PRL levels rose significantly (p less than 0.001 approximately 0.05) after an intravenous bolus of 10mg metoclopramide (MCP). The peak values for PRL increase were 609.3 +/- 194.1ng/ml during labor and 447.0 +/- 62.3ng/ml in early puerperium. However, there were no significant differences in PRL response to MCP between these two groups. The plasma PRL levels dropped significantly (p less than 0.001 approximately 0.01) after an oral administration of 2.5mg bromocriptine (BRC), and the PRL release from the pituitary by MCP was suppressed significantly (p less than 0.001) by pretreatment with BRC in the puerperium. In addition, no significant changes in plasma 17 beta-estradiol (E2), progesterone (P) and cortisol levels could be observed after MCP. We concluded that the control mechanism of PRL secretion remained unchanged during labor and early puerperium.

The prolactin-releasing mechanism of the hypothalamo-pituitary axis in pregnancy

The purpose of this study was to investigate the prolactin (PRL)-releasing mechanism of the hypothalamo-pituitary axis in pregnancy. Forty-six gravidas in the first and second trimesters received bromocriptine (BRC), 2.5 mg orally, metoclopramide (MCP), 10 mg intravenously, or thyrotropin-releasing hormone (TRH), 500 micrograms intravenously. Additionally, BRC was given orally to another 42 gravidas 60 minutes prior to the intravenous injection of MCP or TRH. The plasma PRL levels decreased significantly after BRC and remained significantly elevated after MCP or TRH administration. However, there were no significant differences of PRL response to these agents between the first- and second-trimester groups. The PRL release from the pituitary by MCP or TRH was suppressed significantly by pretreatment of BRC in the gravidas. We concluded that the control mechanism of PRL secretion remained unchanged in the first and second trimesters.

Selective urinary excretion of phosphatidyl ethanolamine in patients with chronic glomerular diseases

Urinary phospholipids and lipoproteins in chronic glomerular diseases were analyzed. The subjects used were 26 patients consisting of 14 with chronic glomerulonephritis and 12 with nephrotic syndrome. Nine healthy normals served as controls. Phospholipids were isolated by one-dimensional thin-layer chromatography (TLC) using an internal standard for quantification and partially by two-dimensional TLC and, furthermore, quantified by two different methods to ascertain the kinds of phospholipids. Urinary lipoproteins were isolated by density gradient ultracentrifugation and analyzed by electrophoresis. The urinary excretion of phosphatidyl ethanolamine (PE) was recognized exclusively in the patient group and that of phosphatidyl serine (PS) in most cases with nephrotic syndrome. The daily urinary PE excretion rate was closely correlated to the urinary albumin excretion rate. However, phosphatidyl choline (PC) and sphingomyelin (SPH), which are main phospholipids in serum and red blood cell membranes, in most cases were hardly detected in urine. These observations were confirmed by two-dimensional TLC using valuable spot tests for identification of phospholipids and also by the two different quantification methods. In density gradient ultracentrifugation, urinary lipoproteins did not form such peaks as seen in the profiles of serum lipoproteins. The presence of urinary lipoproteins in two nephrotic patients has been shown, but although the method used was not very sensitive, it was suggested that lipoproteins were hardly excreted into urine as the lipoprotein deficient fraction (LPDF) (d greater than 1.21 g/ml), in which albumin is predominant. PE was found mainly in LPDF of urine, although the amount of PE in urinary lipoproteins was very limited.(ABSTRACT TRUNCATED AT 250 WORDS)

[The effects of metoclopramide on maternal, umbilical and amniotic fluid prolactin at delivery]

Sixteen normal pregnant woman at delivery were administered 10 mg of Metoclopramide (MCP) intravenously, and the Prolactin (PRL) levels in the maternal plasma and in the amniotic fluid were measured by RIA before and after the administration, and in the umbilical plasma after the administration. Eight other pregnant women at term were studied similarly without the administration of MCP and served as the control. In this experiment, there was a significant increase only in the maternal plasma PRL but not in the amniotic fluid PRL nor in the umbilical plasma PRL. Furthermore, by using an intrauterine pressure catheter and a maternal intravenous cannula we measured the amniotic fluid PRL and the maternal plasma PRL about every 20 minutes during 3 hours before and after the intravenous administration of MCP 10mg. The maternal plasma PRL increased promptly and remained high for 150 minutes, while there was no significant change in the amniotic fluid PRL. This obvious discrepancy supports the hypothesis that decidua is the source of amniotic fluid PRL and suggests an independent regulation of amniotic fluid PRL.