Effect of sulpiride-induced hyperprolactinaemia on catecholamine turnover and LRH concentration in the medial basal hypothalamus of rats

In order to clarify the mechanism of hyperprolactinaemic anovulation, the medial basal hypothalamic (MBH) catecholamine (CA) turnover and LRH concentration, and the serum levels and pituitary contents of gonadotrophins and prolactin (Prl) in hyperprolactinaemic female rats were examined. Hyperprolactinaemia (HPrl) was produced by oral administration of sulpiride for 10 consecutive days; each measurement made on the sulpiride-treated rats was compared with that of control dioestrus rats. Prl, LH, FSH and LRH were determined by radioimmunoassay; CA turnover, as assessed by the accumulation of CA following monoamine oxidase inhibition, was assayed by high performance liquid chromatography with electrochemical detection. Sulpiride treatment induced (1) an increase in the serum Prl and a decrease in the serum LH, (2) an increase in the pituitary FSH and LH contents, (3) an increase in the MBH LRH concentration, and (4) an increase in the MBH dopamine (DA) turnover. These results suggest that HPrl may induce anovulation by impaired LH secretion which was caused by the suppression of LRH release due to an increase in DA turnover in the MBH.

Reactivity of bovine blood coagulation factor IXa beta, factor Xa beta, and factor XIa toward fluorogenic peptides containing the activation site sequences of bovine factor IX and factor X

The published activation site sequences of bovine factors IX and X have been utilized to synthesize a number of peptides specifically designed respectively as substrates for bovine factors XIa and IXa beta. The substrates contain a fluorophore (2-aminobenzoyl group, Abz) and a quenching group (4-nitrobenzylamide, Nba) that are separated upon enzymatic hydrolysis with a resultant increase in fluorescence that was utilized to measure hydrolysis rates. Factor XIa cleaved all of the peptides bearing factor IX activation site sequences with Abz-Glu-Phe-Ser-Arg-Val-Val-Gly-Nba having the highest kcat/KM value. The kinetic behavior of factor XIa toward the synthetic peptide substrate indicates that it has a minimal extended substrate recognition site at least five residues long spanning S4 to S1' and has favorable interactions over seven subsites. The hexapeptide Abz-Glu-Phe-Ser-Arg-Val-Val-Nba was the most specific factor XIa substrate and was not hydrolyzed by factors IXa beta or Xa beta or thrombin. Factor IXa beta failed to hydrolyze any of the synthetic peptides bearing the activation site sequence of factor X. This enzyme slowly cleaved four hexa- and heptapeptide substrates with factor IX activation site sequences extending from P4 or P3 to P3'. Factor Xa beta poorly hydrolyzed all but one of the factor XIa substrates and failed to cleave any of the factor IXa beta substrates. Thrombin failed to hydrolyze any of the peptides examined while trypsin, as expected, was highly reactive and not very specific. Phospholipids had no effect on the reactivity of either factors IXa beta or Xa beta toward synthetic substrates. Both factor IXa beta and Xa beta cleaved the peptide substrates at similar rates to their natural substrates under comparable conditions. However the rates were substantially lower than optimum activation rates observed in the presence of Ca2+, phospholipids, and protein cofactors. In the future, it may be useful to investigate synthetic substrates that can bind to phospholipid vesicles in the same manner as the natural substrates for factors IXa beta and Xa beta.

Treatment of carcinoma of the uterine cervix by remotely controlled afterloading intracavitary radiotherapy with high-dose rate: a comparative study with a low-dose rate system

From September, 1974 through December, 1979, a total of 249 patients with carcinoma of the cervix uteri Stage IIb and III were randomly allocated to either remotely controlled high-dose-rate intracavitary radiotherapy or manual afterloading low-dose-rate therapy, with radiotherapy of 20 Gy in 2 weeks to Point A to whole pelvis and 40 Gy in 4 weeks to the parametria. The dose to Point A by intracavitary radiotherapy was 40-60 Gy with one or two fractions in the low-dose-rate group and 30 Gy for the high-dose-rate group by 3 fractions with a once a week schedule. The purpose of this paper is to compare the results between the groups and to clarify the problems in the high-dose-rate group clinically. The local control rate was higher in the high-dose-rate group; however, the complication rate was also higher in this group than in the low-dose-rate group. The dose schedule and the place of rectal dose measurement is discussed. The overall cumulative survival rate was nearly the same in both groups (55% at 5 years), although some difference was noted in each stage. The most common cause of death was distant metastasis outside the pelvis and the second most common was intercurrent disease in Stage IIb and local failure in Stage III.

Feto-maternal plasma oxytocin levels in normal and anencephalic pregnancies

In 4 women with anencephalic fetuses, the oxytocin level was measured in the maternal plasma in the second stage of labor and in the umbilical artery (UA) and umbilical vein (UV) by radioimmunoassay (RIA). In these cases, the mean maternal OT level was 13.4 +/- 8.0 microU/ml (mean +/- S.E.), which was not significantly different from the OT levels in cases of normal spontaneous birth and elective cesarean section. The UA and UV plasma OT levels in these cases were below the detectable level (less than 2 microU/ml), whereas in normal spontaneous births, they were 18.2 +/- 4.9 microU/ml and 12.2 +/- 2.3 microU/ml, respectively. The OT level in the UA was higher than that in the UV. There was no difference between the mean OT levels in patients with, versus those without contractions, but the plasma OT levels in the second stage of labor were higher than those in the first stage. In normal pregnancies the plasma OT concentration increased during parturition. These results suggest that placental transfer of maternal plasma OT to the fetal circulation is limited, and that in cases of anencephalic fetuses, maternal labor does not necessarily require fetal OT as a trigger or for its maintenance.

Isolation and characterization of a cDNA coding for human factor IX

A cDNA library prepared from human liver has been screened for factor IX (Christmas factor), a clotting factor that participates in the middle phase of blood coagulation. The library was screened with a single-stranded DNA prepared from enriched mRNA for baboon factor IX and a synthetic oligonucleotide mixture. A plasmid was identified that contained a cDNA insert of 1,466 base pairs coding for human factor IX. The insert is flanked by G-C tails of 11 and 18 base pairs at the 5' and 3' ends, respectively. It also included 138 base pairs that code for an amino-terminal leader sequence, 1,248 base pairs that code for the mature protein, a stop codon, and 48 base pairs of noncoding sequence at the 3' end. The leader sequence contains 46 amino acid residues, and it is proposed that this sequence includes both a signal sequence and a pro sequence for the mature protein that circulates in plasma. The 1,248 base pairs code for a polypeptide chain composed of 416 amino acids. The amino-terminal region for this protein contains 12 glutamic acid residues that are converted to gamma-carboxyglutamic acid in the mature protein. These glutamic acid residues are coded for by both GAA and GAG. The arginyl peptide bonds that are cleaved in the conversion of human factor IX to factor IXa by factor XIa were identified as Arg145-Ala146 and Arg180-Val181. The cleavage of these two internal peptide bonds results in the formation of an activation peptide (35 amino acids) and factor IXa, a serine protease composed of a light chain (145 amino acids) and a heavy chain (236 amino acids), and these two chains are held together by a disulfide bond(s). The active site residues including histidine, aspartate, and serine are located in the heavy chain at positions 221, 270, and 366, respectively. These amino acids are homologous with His57, Asp102, and Ser195 in the active site of chymotrypsin. Two potential carbohydrate binding sites (Asn-X-Thr) were identified in the activation peptide, and these were located at Asn157 and Asn167. The homology in the amino acid sequence between human and bovine factor IX was found to be 83%.

Changes in luteinizing hormone-releasing hormone in human placenta throughout pregnancy

The distribution and content of luteinizing hormone-releasing hormone (LH-RH) in human placental tissues were detected by enzymatic antibody and immunofluorescence techniques. Anti-LH-RH was taken up strongly by cytotrophoblasts and the villous stroma at 8 weeks of pregnancy; the uptake decreased with the progress of pregnancy. Anti-LH-RH was not taken up at all by syncytiotrophoblasts throughout pregnancy. These findings suggest that LH-RH is synthesized in the cytotrophoblast and villous stroma. The role of placental LH-RH in the synthesis of human chorionic gonadotropin is discussed.

Abortifacient effect and uterine cervix-dilating action of 16, 16-dimethyl trans delta 2 PGE1 methyl ester (ONO 802) in the form of a vaginal suppository (a randomized, double-blind, controlled study in the second trimester of pregnancy)

A newly synthesized 16, 16-dimethyl trans delta 2 PGE1 methyl ester (ONO 802) was clinically applied in the form of a vaginal suppository for therapeutic abortion of second trimester pregnancies. Its effects were studied in a double-blind test comparing it with an inactive placebo suppository. The study was conducted at 12 Japanese university hospitals. The number of patients was 125 in total, i.e. 63 receiving ONO 802 vaginal suppository (containing 1.0 mg ONO 802) and 62 receiving inactive placebo suppository. ONO 802 was more effective than placebo with a success rate of 87% (complete (71%) and incomplete (16%) abortions). The onset of uterine contractions was observed in 154.3+/-18.1 min. and the onset of uterine bleeding in 323.6+/-41.0 min. The expulsion of the fetus and placenta was observed in 955.4+/-97.0 and 961.6+/-97.0 min., respectively. The cervix dilating effect of ONO 802 was observed in 63.5% of the patients at 3 hours after the start of administration. Nausea, vomiting, abdominal cramps, diarrhea and pyrexia were noticed. However, all these side effects were transient and mild, requiring no treatment. No abnormality was observed in the puerperal course, duration of uterine bleeding or onset of subsequent menstruation following the therapeutic abortion. Therefore, the present study demonstrated that ONO 802 vaginal suppository was an effective and valuable drug for therapeutic abortion of second trimester pregnancies.

[Clinicopathological study of ovarian embryonal carcinoma (Higuchi-Kato)]

Prognoses of embryonal carcinoma (Higuchi-Kato) of the ovary are extremely poor, and new modalities of the treatment are desired. In the present paper, we describe a clinicopathological study of ovarian embryonal carcinoma (Higuchi-Kato) with special references to the treatment and prognosis. 1) The patients examined were 20 in all, 8 belonging to embryonal carcinoma (Higuchi-Kato) Group A, 6 to the Group B, and 6 to the Group C. 2) The median age of patients was 20 years old. 3) The development of tumor was unilateral in all patients but one unsettled. 4) One patient was pregnant when the tumor was discovered. 5) The prognoses of patients in Group C were better than those of others. 6) Serum AFP is a good tumor marker, correlating well with the clinical courses of the patients. 7) To maintain ovarian function of young patients in stage Ia, unilateral adnexectomy with contralateral wedge resection and postoperative intensive chemotherapy are considered to be a choice of treatment method.

Effect of sulpiride on poor puerperal lactation

Forty-two primiparous and 54 multiparous women with total yields of milk not exceeding 50 ml for the first 3 postpartum days were treated with 100 mg of oral sulpiride or placebo for 4 days from the third postpartum day. In the primiparous mothers, the mean daily yield of milk in the sulpiride group increased significantly (p less than 0.01) over that in the control group after the fourth postpartum day. Mean (+/- SE) total volumes of milk for the third to fifth postpartum days were 661.5 +/- 64.4 and 441.2 +/- 51.2 ml in the sulpiride and the control groups, respectively. However, in the multiparous mothers, no significant difference between the control and the sulpiride group was noted in total yield of milk, since a good increase in the secretion of milk was obtained without medication in these mothers. Determinations of daily serum levels of prolactin in 20 primiparous women revealed significantly higher concentrations in the sulpiride group. The ratio of primiparous mothers with complete breast-feeding 1 month after delivery was higher in the sulpiride group (55%) than in the control group (30%), whereas there was no difference between the control group and the sulpiride group of multiparous women. These data indicate that poor initiation of puerperal lactation in primiparous mothers can be effectively treated with oral sulpiride.

Restoration of oestrogen-positive feedback effect on LH release in women with prolactinoma by transsphenoidal surgery

The effects of hyperprolactinaemia on the hypothalamo-pituitary axis by iv injection of 100 micrograms luteinizing hormone releasing hormone (LRH) in 7 women with prolactinoma before and 3 months after normalization of the Prl level by transsphenoidal surgery. A dose of 20 mg of conjugated oestrogen (Premarin) was also infected iv into patients with prolactinoma before and 4 months after surgery, and the serum LH levels were determined serially for 120 h after the injection. Surgical treatment caused significant reduction of the mean (+/- SE) serum prolactin (Prl) level from 123.3 +/- 7.8 to 19.4 +/- 5.6 ng/ml. But the differences in the basal levels of HL (11.3 +/- 2.2 to 8.6 +/- 1.5 mIU/ml), FSH (8.3 +/- 2.4 to 10.6 +/- 3.7 mIU/ml) and oestradiol (26.6 +/- 8.6 to 37.5 +/- 5.5 pg/ml) before and 4 months after surgery were not significant. An exaggerated LH response to LRH in untreated prolactinoma patients was also observed after surgical treatment. After surgical treatment, patients showed LH release with a peak between 48 and 72 h after the injection of Premarin, whereas before treatment they did not show any LH discharge. The mean percent increase in LH between 48 and 72 h was also significantly higher after operation than before operation. These results suggest that the hyperprolactinaemia in prolactinoma patients may cause an impaired positive feedback effect of oestrogen on LH release and that this derangement can be reversed by reduction of the Prl level by adenomectomy.

Aggravation of thyrotoxicosis in early pregnancy and after delivery in Graves' disease

The effect of pregnancy on the clinical course of Graves' disease was examined by studies on 41 pregnancies in 35 patients with Graves' disease, who were considered to be in a state of remission or near remission and were not receiving antithyroid drugs, during and after delivery. Eighteen of the 41 cases (44%) showed transient increases in the serum free T4 index (FT4 index) during weeks 10--15 of pregnancy, but normal thyroid function in the second and third trimesters. Similar transient increases in the serum free T3 index (FT3 index) were observed in early pregnancy in these patients. These early increases in the FT4 and FT3 indexes were specific to Graves' disease and were not observed in Hashimoto's disease. Two to 4 months postpartum, 32 cases (78%) developed various degrees of thyrotoxicosis, which was divided into 3 types: 1) persistent thyrotoxicosis with high radioactive iodine (RAIU) (10 cases), 2) transient thyrotoxicosis with normal or high RAIU) (10 cases), and 3) destruction-induced thyrotoxicosis with low RAIU (12 cases). An increase in the FT4 index in early pregnancy was significantly (P less than 0.001) associated with relapse of stimulation-induced thyrotoxicosis of either the persistent or transient type. Patients who developed destruction-induced thyrotoxicosis after delivery had significantly higher titers of antithyroid microsomal antibodies (P less than 0.001) and a longer euthyroid period before pregnancy (P less than 0.01) than patients who had recurrent persistent thyrotoxicosis. These data indicate that Graves' disease is aggravated in early pregnancy and after delivery and ameliorates in the latter half of pregnancy. Postpartum relapse of persistent hyperthyroidism could be predicted from an early increase in the FT4 index during pregnancy.

Sequence homology and structural comparison between the chromosomal human alpha 1-antitrypsin and chicken ovalbumin genes

The human chromosomal alpha 1-antitrypsin gene has been cloned. This gene is approximately 5 kilobase pairs long and contains three intervening sequences in the peptide-coding region. DNA sequences coding for the amino and carboxyl termini of a alpha 1-antitrypsin have been identified. Human alpha 1-antitrypsin and chicken ovalbumin show significant sequences homology and belong to a common protein super-family. Yet the number, position and size of intervening sequences reveal that the two genes are dissimilar.

Improved method for determination of catecholamines in rat brain by isolation on boric acid gel and high-performance liquid chromatography with electrochemical detection

An improved sensitive, simple and time-saving method for determining catecholamine (CA) in rat brain is described. The method involves isolation on boric acid gel and high-performance liquid chromatography with electrochemical detection. Boric acid gel effectively adsorbs CA at weakly alkaline pH and the over-all recoveries of 5 ng and 10 ng samples of authentic norepinephrine (NE) and dopamine (DA) added to a homogenate of rat brain were 98.9 +/- 9.2% and 103.4 %/- 9.3% for NE and 96.2 +/- 4.6% and 99.4 +/- 4.8% for DA, respectively. Intra-assay variation was 5.3% (5 ng) and 3.0% (10 ng) for NE and 4.4% (5 ng) and 3.8% (10 ng) for DA. Inter-assay variation was 7.7% (1 ng) for NE and 5.0% (1 ng) for DA. With this analytical system, the lowest amount of NE or DA detectable was 40 pg. Application of this method to determination of the DA and NE contents of rat hypothalamus during estrous cycle revealed significant increases in the turnovers of both in the proestrus stage. This method should be useful for routine determination of plasma NE and DA because it is sensitive and inexpensive.

Effects of amine precursor administration on the morphological findings of transplanted argyrophil cell adenocarcinoma of the endometrium

Argyrophil cell adenocarcinoma of the endometrium has been kept serially in nude mice. Histological appearances of the tumor were not much changed by transplantations. Argyrophil granules were located mainly in the apical portion of glandular tumor cells in the transplanted tumors as in the original one. However, the cells with argyrophil granules in the entire cytoplasm were made conspicuous after the administration of L-DOPA. These results may suggest the existence of latent APUD cells in the argyrophil cell adenocarcinoma of the endometrium which are activated by the treatment of amine-precursor.

Immunohistological study of mucous antigens in gynecologic tumors with special reference to argyrophil cells

Mucinous tumors of the ovary and adenocarcinomas of the female genital tract with or without argyrophil cells were studied by immunohistology for mucous antigens. These were isolated from intestinal mucosa and ovarian mucinous cyst fluid. Mucous antigen, M1 which is primarily associated with ovarian mucinous cystadenoma, was found in all mucinous tumors of the ovary, adenocarcinoma of the cervix, and endometrium. Intestinal mucous antigen (IMA), which is specific for goblet cells of the normal intestinal mucosa, was detected only in a few mucinous tumors of the ovary, with or without argyrophil cells. It was concluded that, while M1 was common to glandular gynecologic neoplasms, no special relationship existed between IMA and argyrophil cells in tumors of the ovary, endometrium, and endocervix.

Endometrial argyrophil cell adenocarcinoma with indole- or catecholamine precursor uptake and decarboxylation

The capacity for indole- or catecholamine precursor uptake and decarboxylation of the argyrophil cell adenocarcinoma of the endometrium was examined by fluorescence microscopy, microspectrofluorometry, and biochemical analyses. Both argyrophil and nonargyrophil cell adenocarcinomas of the human endometrium have been grown serially in nude mice. With the use of the formaldehyde-induced wet-histofluorescence method, yellowish green fluorescence was demonstrated in the cytoplasm of some cells of the argyrophil cell adenocarcinomas after exposure in vitro and in vivo to L-dopa. When 5-hydroxytrytophan was administered in vitro and in vivo to these tumors, an intense yellow fluorescence was also obtained in the cytoplasm. These fluorescent products were located in the argyrophil cells and corresponded to argyrophil granules. Microspectrofluorometrical and biochemical analyses strongly suggested that the yellowish green fluorescent products were dopamine and the yellow ones were serotonin, produced by decarboxylation of each amine precursor.

Mapping the active sites of bovine thrombin, factor IXa, factor Xa, factor XIa, factor XIIa, plasma kallikrein, and trypsin with amino acid and peptide thioesters: development of new sensitive substrates

The subsite specificities of bovine factor IXa, factor Xa, factor XIa, factor XIIa, thrombin, plasma kallikrein, and trypsin were mapped with amino acid, dipeptide, and longer peptide thioester substrates. Each substrate contained a P1 Arg residue. The P1' residues included thiol residues which are analogues of valine, leucine, and isoleucine, respectively, and the P2 residue included 12 representative amino acid residues. Longer substrates with the sequence at the antithrombin III reactive site and at the zymogen activation site of various coagulation factors were also studied. The enzymatic hydrolysis of the thioesters was measured in the presence of 4,4'-dithiodipyridine which provides a very sensitive assay for the free thiol. The thioesters were excellent substrates for the coagulation factors studied, and the kcat/Km values for the best thioester substrates were higher than those previously reported for most of these enzymes. Thrombin and plasma kallikrein were the most active of the coagulation factors toward the thioester substrates. The best substrate for thrombin was Z-Gly-Arg-SCH2C6H5, although substrates containing proline in the P2 position were also quite effective. Some of the better substrates for plasma kallikrein had a P2 Phe or Trp residue. Factor IXa was the least reactive of the coagulation factors and hydrolyzed only four of the dipeptide thioesters. Substrates with bulky hydrophobic groups such as Phe or Trp in the P2 position were the most reactive with factor IXa. Factor Xa hydrolyzed all the thioester substrates tested, the most reactive being Z-Gly-Arg-SCH2C6H5. This is consistent with the fact that glycine and arginine are present in the P2 and P1 positions, respectively, of the factor Xa sensitive bonds in prothrombin which is the physiological substrate for factor Xa. Bovine factor XIa showed the least amount of specificity of the various coagulation factors and was quite reactive toward all of the thioester substrates. The most sensitive substrate for this enzyme was also Z-Gly-Arg-SCH2C6H5. Factor XIIa preferred the dipeptide with a P2 Phe, although the simpler thioester Z-Arg-SCH2CH(CH3)2 was more reactive. Trypsin hydrolyzed all of the thioester substrates at a high rate and showed little substrate specificity. With all enzymes studied, extension of the thioester substrate beyond P2 or the P1' thiol leaving group did not lead to an improvement in hydrolysis. Due to their high kcat/Km values and the ease of detecting the thiol leaving group, thioester substrates should be extremely useful for future studies of coagulation proteases.

[An evaluation of fetal movement during non stress testing (author's transl)]

The measuring methods of fetal rolling movements, which are very important diagnostic informations at the case of Non Stress Test, are analysed. In normal pregnant women (from 29 to 40 gestational weeks), the observation of fetal head and trunk rolling movements by real-time B-scan, and maternal perception of fetal movements are simultaneously recorded in analog data recorder. Analysing these recorded data, we found that 76.7% of fetal rolling movements could be detected by observation of head rolling movements only, and 72.4% with trunk observation only. But maternal perception could find only 28.5% of fetal rolling movements. These results and analysis may suggest us that, if only one machine is available, the observation of fetal head rolling movements by real-time B-scan is the most effective method for the analysis if fetal rolling movements on NST.

Increase in plasma thyrotropin-releasing hormone in normal human pregnancy

Maternal thyroid regulation in pregnancy was examined by measuring the concentrations of TRH, T4, T3, free T4 (by RIA), T4-binding globulin, TSH, PRL, and hCG in the sera of 30 normal pregnant women, 10 puerperally lactating women, and 10 normal pregnant women, 10 puerperally lactating women, and 10 normal nonpregnant female controls. Results showed that serum T4, T3, T4-binding globulin, PRL, and hCG, but not free T4 (by RIA), increased significantly during pregnancy. The plasma level of TRH was significantly higher (P less than 0.01) in the second trimester and significantly lower (P less than 0.05 1 month post partum than those values in nonpregnant controls. No significant correlations, however, were observed between the serum level of TRH and those of the thyroid hormones TSH, PRL, and hCG in pregnancy. The TRH-degrading activity of the plasma in the second trimester was normal. These results indicate that TRH secretion may be increased in the second trimester of pregnancy.

Restoration of the ovarian response to gonadotropins in patients after molar abortion

The recovery of the ovarian response to gonadotropin stimulation after molar abortion was investigated in relation to the serum human chorionic gonadotropin (hCG) level. Thirteen women with an aborted mole were given 225 IU of human menopausal gonadotropin (hMG) per day for 3 consecutive days, and their serum levels of estradiol (E2) were determined by radioimmunoassay on days 1, 3, 5, and 7 after hMG administration. Women with serum hCG levels of less than 200 mIU/ml exhibited a normal increase in serum E2 levels in response to hMG, whereas women with serum hCG levels of 2000 mIU/ml or more did not show any change after hMG administration. These findings suggest that a serum level of hCG in excess of 2000 mIU/ml prevents normal ovarian E2 responsiveness to exogenous gonadotropin stimulation.