Factors associated with negative 99mTc-MIBI scanning in patients with primary hyperparathyroidism

OBJECTIVE

The objective was to evaluate the clinical and biological factors associated with negative ^99mTc-MIBI scanning in patients with primary hyperparathyroidism (PHPT).

MATERIAL AND METHODS

A retrospective observational study was designed in 195 patients (mean age: 59.2±13.0years; 77% woman) with PHPT (calcium: 11.3±1.1mg/dl and PTH: 218±295pg/ml) studied in endocrinology setting between 2013 and 2020. An univariate and multivariate analysis was made to evaluate the clinical and biological factors associated with negative ^99mTc-MIBI scanning.

RESULTS

50 patients (26%) with negative ^99mTc-MIBI scanning had lower PTH levels (146±98 vs. 244±334; p<0.001), adenomas with smaller sonographic dimensions (maximum diameter: 1.2±0.4 vs. 1.7±0.9cm; p=0.001 and volume: 0.36±0.43 vs. 1.7±4.1cm³; p<0.001), localized more frequently in upper parathyroid glands (37% vs. 14%; p=0.005) and associated more frequently to thyroid nodules (72% vs. 57%; p=0.045) than patients with positive scanning. 116 patients were operated and parathyroid adenomas were smaller (maximum diameter: 1.3±0.5 vs. 1.9±1.1cm; p=0.008 and volume: 0.30±0.20 vs. 1.2±1.1cm³; p<0.001), less heavy (567±282 vs. 1470±1374mg; p=0.030) and were localized more frequently in upper situation (65% vs. 16%; p<0.001) than patients with positive scanning. In the multivariate analysis an independent association between negative ^99mTc-MIBI scanning and size of removed adenoma ≤1cm (OR: 5.77; 95% CI: 1.46-22.71) and upper adenoma localization were observed (OR: 8.05; 95% IC: 2.22-29.16).

CONCLUSIONS

One in four patients studied for PHPT had a negative ^99mTc-MIBI scanning and were independent associated with size of adenoma ≤1cm and upper adenoma localization.

Form factor π0γ*γ in lightcone sum rules combined with renormalization-group summation vs experimental data

We consider the lightcone sum-rule (LCSR) description of the pionphoton transition form factor in combination with the renormalization group of QCD. The emerging scheme represents a certain version of Fractional Analytic Perturbation Theory and significantly extends the applicability domain of perturbation theory towards lower momenta Q2 ≲ 1 GeV2. We show that the predictions calculated herewith agree very well with the released preliminary data of the BESIII experiment, which have very small errors just in this region, while the agreement with other data at higher Q2 is compatible with the LCSR predictions obtained recently by one of us using fixed-order perturbation theory.

Middle Miocene closure of the Central American Seaway

Uranium-lead geochronology in detrital zircons and provenance analyses in eight boreholes and two surface stratigraphic sections in the northern Andes provide insight into the time of closure of the Central American Seaway. The timing of this closure has been correlated with Plio-Pleistocene global oceanographic, atmospheric, and biotic events. We found that a uniquely Panamanian Eocene detrital zircon fingerprint is pronounced in middle Miocene fluvial and shallow marine strata cropping out in the northern Andes but is absent in underlying lower Miocene and Oligocene strata. We contend that this fingerprint demonstrates a fluvial connection, and therefore the absence of an intervening seaway, between the Panama arc and South America in middle Miocene times; the Central American Seaway had vanished by that time.

Peptide sr11a from Conus spurius is a novel peptide blocker for Kv1 potassium channels

More than a hundred conotoxins are known today and from them, only seven conopeptides have been identified to target voltage-gated potassium channels (Kv). Conotoxin sr11a belongs to the I(2)-superfamily which is characterized by four disulfide bridges and provokes muscle stiffness when injected intracranially in mice. The aim of this work was to test the biological activity of sr11a on recombinant voltage-gated Kv1 potassium channels expressed in Xenopus laevis oocytes. Peptide sr11a was purified by high-performance liquid chromatography from the venom of the vermivorous Conus spurius. We found that peptide sr11a inhibits the delayed rectifiers Kv1.2 and Kv1.6 but had not effect on the slowly inactivating Kv1.3 channel. The functional dyad composed of a basic Lys and a hydrophobic amino acid residue is a crucial structural element, regarding the binding properties and blocking activities of more than a hundred K(+) channel toxins. Peptide sr11a does not contain Lys residues and then, it lacks the functional dyad. Molecular modeling of peptide sr11a reveals the presence of exposed basic residues of Arg and suggests that Arg17 and Arg29 are important on its biological activity.

Tumor-associated stroma cell therapy in patients with pancreatic cancer potentiates therapeutic effect of tumor B-cell hybrid (TBH) auto-vaccines

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Background: Pancreatic Cancer (PC) tumor-associated stroma cells play an important role in PC’s immune surveillance escape. Secretion of Transforming Growth Factor β (TGFβ) and IL10 by PC tumor cells disturb the antigen presenting function of the stroma cells. It may explain the poor results of most immunotherapeutic approaches. Granger et al. reported a successful approach for treating small size pancreatic tumors, namely Mixed Lymphocyte Culture (MLC) cytoimplant. MLC cytoimplants, acting as a Th1 cytokine pump inside the tumor, are thought to revert the tumor-associated stroma cell dysfunction, and facilitate an immune attack. In view that TBH auto-vaccines have modest activity in advanced PC, we considered the possibility that a combination of MLC cytoimplant and TBH vaccines might potentiate the immune response. In this study we compared the response of MLC cytoimplant, TBH vaccines, and combinations of both therapies. Methods: 40 patients with advanced PC were treated: Group 1 MLC cytoimplan (10); Group 2 TBH vaccines (3); Group 3 one MLC cytoimplant and three TBH vaccines (9); Group 4 one MLC cytoimplant and six TBH vaccines (12) and Group 5 one MLC cytoimplant followed by two TBH immunizations, then second MLC cytoimplant followed by 4 TBH vaccines (6). Anti-tumor immune response was measured by Lymphocyte proliferation assay against autologous PC. Results: MLC cytoimplant combined with TBH vaccines appears to have synergistic and effective anti-tumor activity in advanced PC. Kaplan Meyer analysis showed a significant difference in the survival of group 4 as compared with the other four groups (P<0.001). After cytoimplant administration, 1/12 patients in Group 4 and 1/6 patients in Group 5 experienced transient bleeding episodes (lasting less than 12 hours). After the second MLC cytoimplant, all patients in Group 5 developed significant Graft Vs Host Disease (GVHD), an occurrence that probably contributed to the Group’s shorter survival when compared to Group 4’s survival. Conclusions: The observation that a second MLC cytoimplant leads to GVHD is consistent with a pro-inflammatory change in the tumor-associated stroma cells. MLC cytoimplant followed by TBH vaccines appear to prolong survival.

No significant financial relationships to disclose.

Utilization of commercial laboratory results in management of hyperandrogenism in women

OBJECTIVE

To compare results from testosterone radioimmunoassay kits commonly used by commercial laboratories as well as their reference ranges and to analyze the scientific literature for ranges of serum testosterone levels in normal women and those with hyperandrogenism.

METHODS

We reviewed quality assurance reports of various testosterone ligand challenges from four groups of laboratories and summarized testosterone data from 17 published reports about normal women and 14 studies of hyperandrogenic women.

RESULTS

A significant variability was demonstrated between the radioimmunoassay kits at all concentrations (for example, a sample with a mean testosterone level of 96.1 ng/dL was reported by some laboratories as containing 71.8 ng/dL and by others as 123.4 ng/dL). All laboratories provide essentially the same "reference range" (approximately 10 to 90 ng/dL) but do not report how the range was established. The scientific literature clearly shows a significant separation in serum testosterone levels between normal (that is, not hyperandrogenic) and hyperandrogenic women. Most hyperandrogenic women had testosterone levels >50 ng/dL, whereas most normal control subjects had levels <40 ng/dL. Thus, most of these women with hyperandrogenism would have been considered to have normal testosterone levels if the reference ranges of commercial laboratories were used.

CONCLUSION

These data illustrate the difficulty that physicians face when they are required to use different commercial laboratories to measure serum testosterone levels. We propose that (1) reference ranges be established on a clinically defined population for each hormone and method used, (2) laboratory reports include information about method and reference range population, and (3) physicians be allowed to choose which laboratories are used for their patients' hormone determinations, for consistency of results.

Chromosomal abnormalities in fetuses with open neural tube defects: prenatal identification with ultrasound

OBJECTIVES

To determine the prevalence of chromosomal abnormalities in fetuses with open neural tube defects (NTD) undergoing prenatal chromosome analysis. The role of prenatal ultrasound in detecting those with an underlying chromosomal abnormality was also investigated.

METHODS

Over a 6-year period, 144 fetuses with open NTD underwent prenatal chromosome analysis between 12 and 37 weeks of gestation, as part of a prospective, multicenter prenatal diagnosis and counseling program in Chile. This population included 66 fetuses with spina bifida, 46 with acrania/anencephaly, 21 with cephalocele and 11 with iniencephaly. A confident prenatal diagnosis was made in 143 fetuses (99%) and confirmed postnatally in all cases.

RESULTS

An underlying chromosomal abnormality was diagnosed in 10 fetuses (7%), six with spina bifida, three with cephalocele and one with craniorachischisis. The prevalence of chromosomal abnormality varied according to the defect present in the fetus, with a 14% (3/21) prevalence among those with cephalocele, 9% (6/66) among those with spina bifida and 2% (1/57) among those with lethal defects such as acrania, anencephaly or iniencephaly. Karyotype results revealed trisomy 18 in seven cases, trisomy 13 in two and mosaicism for a marker chromosome in one. Prenatal ultrasound before the procedure showed that all chromosomally abnormal fetuses had additional findings. The prevalence of chromosomal abnormality in fetuses with spina bifida and cephalocele was higher when chromosome analysis was performed at or before 24 weeks of gestation in comparison to those performed after 24 weeks (5/31 (16%) vs. 4/56 (7%), respectively). However, this difference did not reach statistical significance, probably due to the small number of cases.

CONCLUSIONS

A significant number of fetuses with open NTD are chromosomally abnormal. Although prenatal chromosome analysis should be considered in all cases, prenatal ultrasound seems effective in identifying those fetuses with an underlying chromosomal abnormality.

Unit costs for house spraying and bednet impregnation with residual insecticides in Colombia: a management tool for the control of vector-borne disease

A study of unit costs and cost components of two malaria-control strategies (house spraying and bednet impregnation with residual insecticides) was undertaken in 11 malaria-endemic states (departamentos) of Colombia, using data provided by control staff on self-administered questionnaires. The accuracy of the data was verified by personal visits, telephone conversations and complementary information from 10 other states. Allthe financial-cost components of the malaria-control operations carried out in the previous 6 months and the results of the control operations themselves (including the numbers of houses sprayed and numbers of bednets impregnated/day) were recorded. The information was stratified according to whether the target communities were 'near' or 'far away' from an operational base, the far-away communities being those that needed overnight stays by the control staff. The main variables analysed were unit costs/house treated, and annual cost/person protected. The results show that house spraying was generally more expensive for the health services than bednet impregnation. This is particularly the case in 'nearby' communities, where most of those at-risk live. In such communities, spraying one house was 7.2 times more expensive than impregnating one bednet. Even if only those sleeping under an impregnated net were assumed to be protected, the unit costs/person protected in a 'nearby' community were twice as high for house spraying than for bednet impregnation. In 'nearby' communities, where technicians could return to the operational base each evening, insecticides made up 80% of the total spraying costs and 42% of the costs of bednet impregnation. In 'far-away' communities, however, salaries and 'per diems' were the most important cost components, representing, respectively, 23% and 22% of the costs of spraying, and 34% plus 27% of the costs of impregnation. Insecticide wastage and non-use of discounts on insecticide prices (available through the national Ministry of Health) increased the overall costs considerably. The multiple uses of these cost calculations for district health managers are presented.

Racial/ethnic disparities in mortality by stroke subtype in the United States, 1995-1998

Healthy People 2010 objectives for improving health include a goal to eliminate racial disparities in stroke mortality. Age-specific death rates by stroke subtype are not well documented among racial/ethnic minority populations in the United States. This report examines mortality rates by race/ethnicity for three stroke subtypes during 1995-1998. National Vital Statistics' death certificate data were used to calculate death rates for ischemic stroke (n = 507,256), intracerebral hemorrhage (n = 97,709), and subarachnoid hemorrhage (n = 27,334) among Hispanics, Blacks, American Indians/Alaska Natives, Asians/Pacific Islanders, and Whites by age and sex. Comparisons with Whites as the referent were made using age-standardized risk ratios and age-specific risk ratios. Age-standardized mortality rates for the three stroke subtypes were higher among Blacks than Whites. Death rates from intracerebral hemorrhage were also higher among Asians/Pacific Islanders than Whites. All minority populations had higher death rates from subarachnoid hemorrhage than did Whites. Among adults aged 25-44 years, Blacks and American Indians/Alaska Natives had higher risk ratios than did Whites for all three stroke subtypes. Increased public health attention is needed to reduce incidence and mortality for stroke, the third leading cause of death. Particular attention should be given to increasing awareness of stroke symptoms among young minority groups.

[Subclinical thyroid disease in institutionalised healthy geriatric population]

BACKGROUND

Our aim was to determine the prevalence of subclinical thyroid disease in a healthy institutionalised geriatric population.

PATIENTS AND METHOD

We determined TSH, free T4 and antithyroid antibodies from 242 healthy elderly subjects living in Andalusian public nursing homes.

RESULTS

Subclinical hypothyroidism was detected in 3.71% of cases; clinical hypothyroidism in 1.65%; subclinical hyperthyroidism in 0.82%,and autoimmune disease in 10.33%.

CONCLUSIONS

There is a high rate of clinically undetected thyroid dysfunction among the healthy institutionalised geriatric population. Therefore, a hormonal screening may be justified in this population.

Novel[1n]-meta-heterophane frameworks with a bis-betaine nature

A convergent "5 + 1" and "5 + 3" synthetic strategy allowed the synthesis of the first examples of bis-betaines 2 and 3, a prototype of phanes that incorporate heterocyclic betaines. The structure of the quadrupolar macrocyclic systems 2 and 3 together with the dicationic [1(6)]- and [1(8)] meta-heterophane precursors 5*2X and 6*2X were examined by spectroscopy using 1H and 13C NMR techniques together with 1H-DNMR studies and electrospray ionization mass spectrometry.

Polynucleating open-chain systems with imidazole and proton-ionizable 1,2,4-triazole structural motifs

A multistep route for obtaining the polynucleating open-chain systems 3-5 is reported. These advanced intermediates required elaborate processes that proceeded for the pentanuclear protophanes 3 in seven steps, whereas the trinuclear compounds 4 and 5 were obtained in six steps

Synthesis of 1-amino-6,7,8,8a-tetrahydroacenaphthene and its effect on the inhibition of the MAO-enzyme at the brain cortex and liver level

(+/-)-1-Amino-6,7,8,8a-tetrahydroacenaphthene was synthesized and evaluated as a novel drug acting on the dopaminergic system. It was shown that the new compound displays activity as MAO inhibitor.

Serum Testosterone Levels And Reference Ranges In Reproductive-Age Women

OBJECTIVE

To determine the levels of serum testosterone and dehydroepiandrosterone sulfate (DHEAS) in women with no clinical signs of hyperandrogenism and no history of glucocorticoid or oral contraceptive use and to compare these levels with the reference ranges provided by commercial laboratories.

METHODS

We undertook a cross-sectional retrospective study of 271 reproductive-age women encountered at an endocrinology clinic for complaints of potential thyroid problems. Serum testosterone and DHEAS levels were determined, and statistical analyses were performed.

RESULTS

The serum testosterone level in women with no acne, hirsutism, or menstrual dysfunction was 14.1 +/- 0.9 ng/dL (mean +/- standard error of the mean) (95% confidence interval [CI] = 12.4 to 15.8). This group was considered our study reference population. In women with menstrual dysfunction but no acne or hirsutism, the mean testosterone level was significantly higher (17.9 +/- 1.1 ng/dL; 95% CI = 15.7 to 20.0; P<0.002); with mild hirsutism, it further increased (38.4 +/- 5.1 ng/dL; 95% CI = 27.4 to 49.4; P<0.005); and with moderate to severe hirsutism, it was still higher (49.0 +/- 2.3 ng/dL; 95% CI = 44.4 to 53.6; P<0.003). Serum DHEAS levels showed similar patterns. The upper limit (mean + 2 standard deviations) of testosterone in our study reference population was 28 ng/dL, a level that provided a sensitivity of 84% for detecting hyperandrogenemia. The detection of hyperandrogenemia is essentially impossible when the upper limit of the reference range for testosterone from commercial laboratories (95 ng/dL) is used.

CONCLUSION

The testosterone levels reported herein and in the literature for hyperandrogenic women both are within the reference (normal) ranges provided by commercial laboratories. These observations demonstrate why diagnosis of hyperandrogenemia in hyperandrogenic women is difficult when commercial laboratories are used and why this condition is not detected in most affected women. Commercial laboratories should reevaluate the methods used for establishing their reference ranges for serum testosterone.

The relationship of serum androgens and ovulatory status to blood pressure in reproductive-age women

The objective of this cross-sectional study was to determine the relationship between hyperandrogenemia and blood pressure in women with menstrual irregularities seen at an endocrinology clinic. Women with serum testosterone levels (T) > or = 30 ng/dL were more likely to have general obesity (odds ratio [OR] = 6.8, 95% confidence intervals [CI] = 2.2-27.2) and central obesity (OR = 14.5, 95% CI = 6.1-38.7) than euandrogenemic women. Hyperandrogenemic women (HA) had an OR of 2.4 (95% CI = 1.0-6.2) for elevated SBP and an OR of 2.7 (95% CI = 0.8-8.8) for elevated DBP, independent of age and ovulatory status. Obese HA had an OR of 4.7 (95% CI = 2.3-10.4) for elevated SBP and an OR of 2.9 (95% CI = 1.9-9.9) for elevated DBP. In conclusion, T is associated with an increased risk for obesity and central adiposity. T predicts BP elevation independent of age and ovulatory status. There was a synergistic relationship between obesity and androgens in their affect on BP.

Protein C deficiency in microvascular head and neck reconstruction

OBJECTIVE

To determine the incidence of perioperative protein C deficiency in patients undergoing free flap reconstruction of cancer-related defects in the head and neck.

STUDY DESIGN

Prospective case series.

INTERVENTION

Ten patients underwent microvascular reconstruction after surgical therapy of carcinomas of the oral cavity or oropharynx. Coagulation studies were determined in all patients 72 hours after surgery.

SETTING

Academic tertiary care medical center

RESULTS

Protein C deficiency was detected in 70% of patients. One free flap failure was attributed to protein C deficiency.

CONCLUSIONS

Vitamin K-dependent clotting factors are frequently deficient during the postoperative period after major head and neck surgery, which may result in a state of hypercoagulability. Protein C deficiency should be considered as a possible cause of free flap thrombosis in patients who undergo microvascular head and neck reconstruction.

Conception after iodine-131 therapy for differentiated thyroid cancer

We reviewed the medical history of 26 women with differentiated thyroid cancer who became pregnant after receiving therapeutic doses of radioactive iodine (131I) in order to document the possibility of a greater risk for disorders in these pregnancies. There were a total of 39 pregnancies, 6 of which occurred during the first year after therapy. In 3 cases the following anomalies were encountered: a male suffering Trisomy 18 (Edward's syndrome), a female with constitutional aplastic anemia, and a male with a congenital hip dysplasia. Of the 33 pregnancies that occurred after the first year post-therapy, there were 2 spontaneous abortions and a male effected by ureteral stenosis. Based on these data, although it cannot be confirmed that these congenital disorders are due to the 131I therapy, we recommend that pregnancy be avoided for the first year after therapy.

[Evaluation of energy metabolism in burn patients: indirect calorimetry predictive equations]

INTRODUCTION

Knowing the most reliable method for measuring the metabolic energy use (MEU), is of great importance in patients with severe burns. For the calculation of the energetic requirements of large burn patients, several predictive equations (PE's) are used, based on weight, size, age, body surface area (BSA), and burned body surface (BBS). Previous studies note the tendency for over-or underestimating the MEU, depending on whether one or another PE is used, which is why it is considered necessary to calculate the energy requirements in the most exact manner possible, which can be done by means of indirect calorimetry (IC).

MATERIAL AND METHODS

18 patients (14 men and 4 women) who were admitted to the Burn Unit between 1994 and 1995, were included in the study, with the following inclusion criteria; age > 18 years and < 65 years, and who presented deep burns on are than 15% of the body surface. The MEU of the patients was evaluated by means of IC, using a Deltatrac il unit. The MEU calculated by means of IC was compared with that calculated by means of the four most commonly used PE's in literature: Long Formula: MEU = Basal energy use (BEU) x activity factor x aggression factor which is variable according to the BBS; Curreri Formula: MEU = (Weight x 25) + (total BBS x 40); MEU = 2000 x BSA. As statistical methods, one looked for the existence of correlation, by means of the Pearson method, and the "r" were compared by means of the Fischer conversion. The regression coefficient was found among the values obtained through the PE's and those measured by IC, as well as among those of IC and the percentage of deep burn and the total burned body surface.

RESULTS

All the formulate included overestimated the MEU measured between 30.6% and 43.8% with the 2 x MEU formula being the one which did so least (30.6%). In any of them, there is an important variation of the percentage of overestimation with respect to the average MEU in this group. All are correlated in an important way with the MEU. The reliability of these PE's is variable, as is shown by the slopes of the regression lines, with the most reliable PE being that of 2000 x BSA, and that of 2 x MEU, by Harris-Benedict. There is also correlation between the average MEU by IC and the deeply burned body surface.

CONCLUSION

This study proves the usefulness of the IC for knowing the EME in burn patients, to prevent their hypernutrition, as well as the relative value of the formulae usually used clinically to estimate this parameter.

The influence of semen analysis parameters on the fertility potential of infertile couples

The objective of this study was to investigate the relationship between couples' fertility potential and several parameters of semen analysis (from a single semen sample/male partner) in a cohort of 1,055 infertile couples seen at the Texas Institute for Reproductive Medicine and Endocrinology for a total of 9,409 follow-up months. The medians of sperm concentrations (SC), total sperm counts (TSC), percent motility (MOT), motile sperm concentrations (MSC), and total motile sperm counts (TMSC) were significantly higher (P < 0.0001) in the group that achieved pregnancy. When the entire group was divided into "high" and "low" groups on the basis of the various parameters of semen analysis, the relative risk ratios for conception for the "high" groups were as follows: SC, 1.5; MOT, 8.5; TSC, 8.1; MSC, 5.8; and TMSC, 6.1. Life table analysis showed a statistically significant difference (P < 0.0001) in the initial rise and overall slope of the conception rates between the two groups for a number of the semen analysis parameters (TSC, MOT, MSC, and TMSC). This study showed that certain semen analysis parameters are positively correlated, with a high degree of statistical probability, with the time required for the occurrence of conception. The quantitative impact of the male fertility potential on conception rates was shown to correlate not solely with the SC or MOT values, but even more so with their derivatives (i.e., MSC and TMSC). Therefore, in an in vivo environment it is not only the number of sperm and their motility but also their derivatives that provide a quantitative insight into the male fertility potential. The data may provide a quantitative expression of the relative risk ratio for conception to occur and the time required until conception is achieved. Further studies will be necessary to clarify the effect of the other semen analysis parameters (i.e., morphology, velocity, linearity, and "efficient" MSC) on conception rates, cumulative conception rates, relative risk ratio for conception, and time until conception in a large population of infertile couples.

Glucocorticoid therapy in hyperandrogenism

Hyperandrogenism is a common disorder in the reproductive age female. It is associated with cutaneous manifestations and ovulatory dysfunction. The degree of hyperandrogenaemia is directly related to the severity of ovulatory dysfunction. The ovulatory dysfunction frequently leads to infertility. The most common form of hyperandrogenism is idiopathic glucocorticoid-suppressible hyperandrogenism (IGSH). The management of this disorder involves appropriate use of physiological doses of glucocorticoids. This treatment leads not only to normalization of serum androgen levels but also to amelioration of cutaneous symptoms and improvement in ovulatory function. In infertile women with ovulatory dysfunction secondary to IGSH, occurrence of pregnancy after treatment with glucocorticoids is directly related to the degree of the suppression of serum androgen levels. In other words, this treatment does not 'induce ovulation', but its effectiveness in improving ovulatory function is a result of a correction of the hyperandrogenic state. At physiological doses glucocorticoid therapy does not appear to be associated with significant side-effects. With appropriate management, androgen levels can be maintained within the normal range indefinitely. Furthermore, in a majority of patients, androgen levels remain within the normal range for a long time (years) after discontinuation of chronic glucocorticoid therapy.

Prolactin response to thyrotropin-releasing hormone in normoprolactinemic patients with ovulatory dysfunction and its use for selection of candidates for bromocriptine therapy

It has been suggested in the past that some normoprolactinemic patients with amenorrhea or infertility respond to treatment with bromocriptine. However, the beneficial effect of this therapy in normoprolactinemic women remains controversial. Some authors have suggested that the responders suffer with "reactive" hyperprolactinemia and that this may be detected with thyrotropin releasing hormone (TRH) stimulation. In this study, we performed TRH stimulation tests in 538 patients with ovulatory dysfunction. Only those patients showing a peak prolactin response after TRH which exceeded 40 ng/ml were treated with bromocriptine. A direct correlation between peak prolactin level after TRH and a favorable response to treatment was observed. Serum testosterone and DHEA-sulfate levels did not correlate with prolactin response to TRH. A majority of patients with prolactin hyperresponse to TRH did not show a hyperresponse of TSH to TRH. This study suggests that incidence of beneficial response to bromocriptine therapy in normoprolactinemic women with ovulatory dysfunction is significantly higher in subjects exhibiting excessive prolactin response to TRH stimulation.

[Soluble and insoluble dietary fiber in cereals and legumes cultivated in Chile]

Insoluble, soluble and total dietary fiber (DF) were determined in 35 varieties of certified whole seeds (without processing) of cereals (rice, oat, rye, and wheat) and legumes (pea, cowpea, beans, chikpea, lentil and lupine). The enzymatic method of Asp, Johansson and Siljestrom was used, with modifications in relation to time of incubation with alpha amylase, filtration system and volumes of the filtrates. Results were expressed as g/100 g dry weight. Total DF for cereals showed a range from 10.1 (wheat var. Chasqui) to 22.2 (rice var Quella). Rye, var. Tetra Baer and oats var. Pony Baer presented the highest soluble fiber content (3.3 and 3.9, respectively). In legumes, total DF fluctuated between 12.7 (pea, var. yellow) and 36.6 (lupine, var. Multolupa). Bean, var. Pinto INIA and lupine var. Multolupa presented the highest soluble fiber values (5.8 for both). Based on the results of this research work, it might be concluded that great variation exists in regard to the amount of total soluble and insoluble DF in cereals and legumes, a fact which impedes generalization as to its content in each food item.

Relationship between the results of sperm analysis and GIFT

In vitro fertilization (IVF) and GIFT have been proposed as therapeutic approaches in infertile couples where a significant male factor is present. To date, few published data are available relating the success rate of GIFT to the severity of the male factor. In this report the results of the first 172 GIFT cases were analyzed. The overall pregnancy rate was 18.0%. The relationship between the occurrence of pregnancy and sperm count (millions/ml), total sperm count (millions/ejaculate), % motility, motile sperm count (millions/ml) and total motile sperm count (millions/ejaculate) were examined. Significant direct correlations were observed between the clinical pregnancy rate and sperm count, total sperm count, motile sperm count and total motile sperm count. Motile sperm count and total motile sperm count had the best correlations with clinical pregnancy rates, which were over 24.0% in groups with motile sperm counts exceeding 40 X 10(6) cells/ml or total motile sperm counts greater than 100 X 10(6)/ejaculate. The clinical pregnancy rates were 12.5% and 7.7%, respectively, for groups with motile sperm counts under 10 X 10(6)/ml and total motile sperm counts below 25 X 10(6)/ejaculate. No correlation was found between percent motile cells and pregnancy rate. Results of the sperm penetration assay using zona-free hamster eggs were available in a subpopulation of 27 patients. No significant correlation between this sperm penetration assay and pregnancy rate could be demonstrated. The incidence of chemical pregnancy showed a significant negative correlation with the total motile sperm count, indicating a higher incidence of early pregnancy wastage in cases of oligozoospermia.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavioural effects produced in mice infected with venezuelan equine encephalomyelitis virus

Pixuna, a strain of intermediate virulence of venezuelan equine encephalomyelitis virus, was inoculated intracranially to 24-day-old mice. Signs of encephalitis were present in 60% of the animals between 6 and 9 days with a maximum at 7 days postinoculation. The rest of the infected mice did not show clinical signs of encephalitis. In order to study the functional state of serotonergic systems a series of tests susceptible to modifications by serotonin activity were carried out. Locomotor activity was measured in an open field test. Virus-inoculated animals presented a variety of changes in their locomotor behavior at various days postinoculation with respect to the sham-inoculated group, however, they were not significant. Central serotonergic function was examined by the production of the serotonergic syndrome with the receptor agonist, 5-methoxy-N,N-dimethyltryptamine and the precursor, 5-hydroxytryptophan, both administered 4 days after the inoculation. The dose of the agonists was established by a prior drug-response analysis. Intensity of the syndrome was significantly higher in infected mice than in the sham-inoculated group only in 5-methoxy-N,N-dimethyltryptamine-treated animals. The behaviour in the swim test was also measured. Duration of immobility was much shorter in infected than in control mice. The decrease in central serotonin turnover previously reported might be responsible for the modification in locomotor behaviour and for the supersensitivity of serotonin receptors observed in infected mice.

Dopamine and noradrenaline content in fish retina: modulation by serotonin

The presence of noradrenaline (NA) and the possible interaction of serotonin (5-HT) with dopaminergic and noradrenergic neuronal elements was studied in the retina of the teleost Eugerres plumieri. By means of a histofluorescent technique, paired amacrine cells can be visualized after intravitreal injection of NA or 5,6-dihydroxytriptamine, suggesting their probable catecholaminergic and indoleaminergic nature. With a high-performance liquid chromatographic (HPLC) method and after pargyline treatment of the animal, 6.86 ng/mg protein of dopamine (DA) was detected, while NA content was 0.50 ng/mg protein. The NA levels of the retina increased, whereas the DA levels decreased in a significant manner after in vivo treatment with 5-HT. 5-methoxy-N,N-dimethyltryptamine, a 5-HT agonist, was able to mimic this effect partially, while the agonists tryptamine and quipazine did not affect the levels of DA and NA. The antagonists methysergide, metergoline, and cyproheptadine significantly blocked the 5-HT-induced NA increase, whereas only the first two antagonists were effective in inhibiting the 5-HT-induced DA decrease. The 5-HT modulation of NA and DA is apparently receptor mediated and is not due to a hetero-exchange, since imipramine was not able to block the 5-HT effect. These findings support the suggested interaction between serotoninergic and dopaminergic cells [Negishi et al: J Neurosci Res 5:621-635, 1980; Neurosci Lett 25:1-5, 1981]. Furthermore, they demonstrate the possible modulation which 5-HT exerts on the endogenous levels of NA.

Serotonin containing neurons in the retina of the teleost Eugerres plumieri

The concentration and localization of serotonin was determined in the retina of the teleost Eugerres plumieri by using high performance liquid chromatography (HPLC) and immunohistochemical techniques. Serotonin and dopamine were measured simultaneously, their concentrations in the retina being 77 +/- 8 and 516 +/- 23 ng/mg tissue respectively. Treatment of the animals with pargyline significantly increased the levels of dopamine and serotonin. When retinas were treated with the neurotoxin 5,6-dihydroxytryptamine, the level of serotonin was reduced by more than 90% while the dopamine content only diminished by 20% when compared to controls. By using immunohistochemistry with a monoclonal anti-serotonin antibody it was possible to localize this amine in cell bodies of a population of amacrine cells with processes extending mainly into a thin layer of the most external lamina of the inner plexiform layer. Very few ramifications were seen projecting to the internal lamina of this layer. When visualized in flat mount preparations, dense arborization of fluorescent processes was observed. This is the first direct evidence that serotonin is apparently present in amacrine cells of the retina of E. plumieri with a distribution of the serotonergic terminals similar to goldfish but somewhat different when compared to other species.

Species differences in structure-activity relationships of adenosine agonists and xanthine antagonists at brain A1 adenosine receptors

A series of 28 adenosine analogs and 17 xanthines has been assessed as inhibitors of binding of N6-R-[3H]phenylisopropyladenosine binding to A1 adenosine receptors in membranes from rat, calf, and guinea pig brain. Potencies of N6-alkyl- and N6-cycloalkyladenosines are similar in the different species. However, the presence of an aryl or heteroaryl moiety in the N6 substituent results in marked species differences with certain such analogs being about 30-fold more potent at receptors in calf than in guinea pig brain. Potencies at receptors in rat brain are intermediate. Conversely, 2-chloroadenosine and 5'-N-ethylcarboxamidoadenosine are about 10-fold less potent at receptors in calf brain than in guinea pig brain. Potencies of xanthines, such as theophylline, caffeine and 1,3-dipropylxanthine are similar in the different species. However, the presence of an 8-phenyl or 8-cycloalkyl substituent results in marked species differences. For example, a xanthine amine conjugate of 1,3-dipropyl-8-phenylxanthine is 9-fold more potent at receptors in calf than in rat brain and 110-fold more potent in calf than in guinea pig brain. Such differences indicate that brain A1 adenosine receptors are not identical in recognition sites for either agonists or antagonists in different mammalian species.