Correlation of heel pain with body mass index and other characteristics of heel pain

A prospective, descriptive study was performed at Oakwood Healthcare medical clinics to determine the body mass index (BMI) of patients with heel pain and of a control group of patients presenting for other reasons. A questionnaire was used to obtain information in each of the patient groups and to determine characteristics of patients with plantar fascial heel pain. Standard weightbearing lateral radiographs were taken to determine overall foot structure. The typical patient was female, had heel pain for just over 1 year, with a sedentary to moderate activity level. Although height was comparable, patients with heel pain had a higher BMI (30.4 +/- 0.7) than those without heel pain (28.2 +/- 0.7, p = .04). The BMI appears to play a greater role in heel pain than does foot structure, as the authors found no structural commonalities that would explain these patients' pain. Control patients also reported a higher level of activity. Fifty-one percent exercised three or more times per week for more than 20 minutes each time, while less than half that (25.4%) of heel pain patients did so. While half of the heel pain patients had been treated by other providers prior to visiting our clinic, fewer than 25% of these patients had been instructed to lose weight by a physician. The authors feel that a BMI of 25 (the target for decreased cardiovascular risk) represents a reasonable goal for weight loss that may reduce heel pain.

Attenuation of the magnitude of suckling-induced prolactin release with advancing lactation: mechanisms

To study why suckling-induced plasma prolactin levels decline in magnitude with advancing lactation, we examined prolactin release in lactating rats following suckling and pharmacologic manipulations during early, mid- and late lactation. On day 2 of lactation, litters were adjusted to 8 pups. On day 3, dams were implanted with an atrial catheter and experiments were conducted on lactation days 5, 11 and 17. To examine suckling-induced prolactin release, pups were removed at 0800 h, an extension was attached to the catheter at 1100 h, and pups returned to dams at 1200 h. Blood samples were obtained before, and at 10, 30, 60, 90 and 120 min after suckling started. Prolactin responses to sulpiride and thyrotropin releasing hormone (TRH) administration were studied in lactating rats separated from their litters for 4 hours. Blood samples were obtained before, and at 10, 30, 60 and 90 min after sulpiride (10 or 40 micrograms/kg BW) and 5, 10, 20 and 30 min after TRH (1 or 4 micrograms/kg BW) in rats pretreated with sulpiride. Prolactin release in response to suckling, administration of sulpiride or sulpiride and TRH diminished as lactation advanced. From these results, we conclude that refractoriness in anterior pituitary lactrotropes to prolactin-releasing stimuli is at least partially responsible for the decline in suckling-induced prolactin release with advancing lactation.

Alcohol effects on TRH-induced prolactin response in lactating rats: in vivo and in vitro studies

The site of action of alcohol in inhibiting suckling-induced prolactin release in lactating rats was examined by in vivo and in vitro studies. In vivo, sulpiride- and thyrotropin-releasing hormone (TRH)-induced prolactin release was studied in lactating rats separated from their litter. On day 7, dams were implanted with an atrial catheter. On day 10, pups were removed from dams at 0800 h and, after 5 h, an extension was attached to the catheter. An hour later, a baseline blood sample was removed and was followed by sulpiride (40 micrograms/kg) administration. Additional blood samples were withdrawn over 1 h. After the 60-min sample, sulpiride-administered rats were infused with 0.0, 1.0, or 2.0 g/kg b.wt. alcohol. Following alcohol, a postinfusion blood sample was removed, TRH (4.0 micrograms/kg) was administered, and subsequent blood samples were obtained 5, 10, 20, and 30 min after TRH. For in vitro studies, cells from lactating rats in midlactation were enzymatically dissociated, plated, and on culture day 5 were exposed to 0 or 10 nM TRH. Each set of cells were additionally exposed to 0, 100, or 300 mg% alcohol and media harvested after 4 h. In a subsequent study, plated cells were exposed to increasing doses of TRH in the presence of 0, 100, or 300 mg% alcohol and media harvested as above. Prolactin in plasma (in vivo studies) and medium (in vitro studies) was measured by RIA.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of oocyte exposure to local anesthetics on in vitro fertilization and embryo development in the mouse

The effect on fertilization and development of local anesthetics routinely used during ultrasound-guided oocyte retrieval in women undergoing in vitro fertilization was examined in a mouse in vitro fertilization system. Mouse oocytes were exposed in vitro to lidocaine, chloroprocaine, and bupivacaine at concentrations of 0 (control), 0.01, 0.1, 1.0, 10.0, 100.0 micrograms/mL for 30 min, washed, and then inseminated. In vitro oocyte fertilization at 24 and 48 h and embryo development at 72 h were determined. Bupivacaine adversely affected mouse in vitro fertilization and embryo development only at the highest exposure concentration, 100 micrograms/mL, while lidocaine and chloroprocaine produced adverse effects at concentrations as low as 1.0 and 0.1 microgram/mL, respectively. Furthermore, an adverse dose-related effect on fertilization and embryo development was shown for lidocaine and chloroprocaine, but not for bupivacaine. These data demonstrate that the local anesthetics, lidocaine (L), chloroprocaine (C), and bupivacaine (B), adversely affect mouse in vitro fertilization and embryo development in the order of C greater than L greater than B.

Cocaine inhibits mating-induced, but not human chorionic gonadotropin-stimulated, ovulation in the rabbit

The effects of cocaine on ovulation and corpus luteum function were investigated in New Zealand White rabbits. Forty females were randomly assigned to control and cocaine-treated groups. Controls were given vehicle s.c. daily for 5 days and cocaine-treated rabbits received 40 mg/kg cocaine hydrochloride s.c. daily for 5 days. One hour after the last cocaine dose, half the control and half of the cocaine-treated groups were mated with fertile males and the other half of each group received hCG i.v. Serial blood samples were obtained over 4 h on the day of mating or hCG treatment (Day 0), and then at intervals from Days 1-18. No mated, cocaine-treated rabbits ovulated, vs. 6 of 10 controls (chi-square: p = 0.01). In contrast, all animals given hCG had comparable numbers of corpora lutea (control: 7.1 +/- 0.8; cocaine: 5.7 +/- 0.8). Peak levels of benzoylecgonine (the major cocaine metabolite) occurred between 180 and 240 min after cocaine administration. In cocaine-treated animals that were mated, Day 0 serum LH (repeated measures MANOVA, p less than 0.01) and FSH (p less than 0.03) concentrations were lower than those in pregnant controls. Serum LH and FSH levels for all hCG recipients (cocaine-treated and control) did not differ. Serum prolactin concentrations in mated, pregnant rabbits were higher than in all other groups; cocaine treatment did not affect this hormone.(ABSTRACT TRUNCATED AT 250 WORDS)

The gonadotropin-releasing hormone agonist leuprolide affects the thymus and other non-reproductive systems of female rats

To evaluate the effects of a gonadotropin-releasing hormone agonist on non-reproductive systems, we administered [D-Leu6,Des-gly10]-GnRH ethylamide (leuprolide; 5 micrograms/day) for 21 days to female Sprague-Dawley rats. In Experiment 1, continuous infusion (Alzet minipumps sc) was compared to injection. Increased thymus and body weights and decreased estradiol and uterine weights were noted for both administration methods. Spleen weight increased only in rats treated by continuous infusion. Ovary, kidney and liver weights did not change. Only leuprolide-injected rats had elevated LH with decreased corticosterone and ACTH levels, possibly related to the injection process. Glucose, insulin, progesterone, FSH and corticosterone/ACTH were not different. In Experiment 2, intact and ovariectomized rats were implanted with minipumps delivering leuprolide or 0.9% NaCl. Body and thymus weights increased, whereas uterine weight and estradiol declined in both leuprolide-treated and ovariectomized rats. No synergism between leuprolide and ovariectomy was noted. Thymosin alpha 1, but not thymosin beta 4, increased in leuprolide-treated ovariectomized rats. Peripheral white blood cell count was elevated in leuprolide-treated intact rats and ovariectomized rats. In bone marrow, non-nucleated cell count declined in leuprolide-treated intact rats, contributing to the decreased total cell count in this group. Nucleated cell count was unaffected. Therefore, thymus weight gain was accompanied only in some cases by functional changes. Our results demonstrate that leuprolide affects non-reproductive systems, in a similar manner to ovariectomy. We suggest that such alterations may be due to the hypoestrogenic environment produced by leuprolide.

Alcohol inhibition of suckling-induced prolactin release in lactating rats: threshold evaluation

Prolactin release in response to suckling was examined in primiparous lactating rats two hours after alcohol administration. Litters were adjusted to eight pups on lactation day 2 and dams were implanted with an atrial catheter on day 6. On day 10, pups were separated from the mother at 0800 h. An extension was attached to the catheter at 1100 h. Following removal of a baseline blood sample an hour later, rats were infused with alcohol doses of 0, 0.5, 1.0, 2.0 or 2.5 g/kg body weight. Two hours later, pups were returned to dams. Subsequent blood samples were obtained 10, 30, 60, 120 and 180 min after the onset of suckling. Following 10 min of suckling, plasma prolactin for groups of rats infused with alcohol at 2.0 and 2.5 g/kg body weight were lower than control, 0.5 and 1.0 g/kg groups. The blood alcohol level (BAL) for the 2.0 g/kg group was 94 +/- 8 mg% and for the 2.5 g/kg group was 162 +/- 4 mg%. After 30 min, the BAL for the 2.5 g/kg group was 134 +/- 5 mg% and plasma prolactin was suppressed in this group compared to control, 0.5 and 1.0 g/kg groups. The BAL for the 2.0 g/kg group after 30 min of suckling was 74 +/- 9 mg% but prolactin was not significantly lower than controls. We conclude that in rats, alcohol inhibition of suckling-induced prolactin release is directly correlated to the BAL. The threshold BAL which effectively inhibits this prolactin release is lower than the human legal intoxication level.

Human granulosa-luteal cell response to vinblastine exposure in vitro

We examined the response of isolated human granulosa-luteal cells (HGLCs) to a cancer chemotherapeutic agent, vinblastine (VLB), that has been implicated in ovarian failure during treatment for Hodgkin's disease. VLB doses of 1.0 micrograms/mL for 4 h or 0.1 micrograms/mL for 24 h reduced HGLC progesterone production during exposure. The effect of high doses (10.0 and 100.0 micrograms/mL) persisted for at least 1 day after exposure. Previous 24 h, but not 4 h, high-dose VLB exposure reduced subsequent progesterone release in response to 10 IU of human chorionic gonadotropin (hCG). Without hCG stimulation, only cells previously exposed to 100.0 micrograms/mL had persistently reduced progesterone release. We conclude that HGLCs can completely recover from a short exposure to VLB, but longer exposures to 10.0 and 100.0 micrograms/mL are detrimental to their hormone secreting capacity.

The effect of cocaine on oocyte development and the follicular microenvironment in the rabbit

We examined the effects of cocaine exposure in the rabbit on in vitro oocyte development and on steroidal content of follicular fluid (FF) and serum progesterone (P). Cocaine hydrochloride (0, 10, 20, 40, or 80 mg/kg) was administered daily subcutaneously for 5 days to New Zealand White female rabbits before superovulation. On the last day of cocaine administration, animals were given human chorionic gonadotropin intravenously, and laparotomy was performed 6 to 8 hours later. During laparotomy, ovaries were removed, the number of follicles recorded, oocytes retrieved, and FF was obtained. In vitro fertilization (IVF) was then performed on the oocytes and the rate of cleavage observed. For all cocaine dosage groups, no differences were observed in the number of follicles present, number of oocytes retrieved, or IVF and cleavage rates. Cocaine did, however, decrease periovulatory serum P, and FF P, whereas FF estradiol concentrations increased. This suggests that short-term cocaine exposure affects the follicular steroid milieu, possibly by delaying granulosa cell luteinization.

Acute alcohol infusion does not alter plasma gonadotropins or prolactin in ovariectomized rats

We examined the effects of acute alcohol on basal plasma FSH, LH, and prolactin in ovariectomized rats. Alcohol infusion and blood sampling were done via an indwelling atrial catheter. Blood samples for alcohol and hormone determinations were collected before, and 5 to 120 min after completion of saline (control) or alcohol in saline (experimental) infusion. Plasma follicle-stimulating hormone, luteinizing hormone, and prolactin were not altered during the 2-hr period. Peak blood alcohol concentrations achieved following 1.0- and 2.0-g/kg body weight of alcohol doses were approximately equal to, and twice, the legal human intoxication levels, respectively. Alcohol clearance rates from blood for the two groups were: 130 +/- 3 mg/kg/hr for the 1.0-g/kg body weight group and 151 +/- 3 mg/kg/hr for the 2.0-g/kg body weight group. These results show that acute alcohol does not affect basal gonadotropins and prolactin secretion in ovariectomized rats.

Vinblastine reduces progesterone and prostaglandin E production by rat granulosa cells in vitro

To elucidate the possible mechanism(s) of vinblastine-induced premature ovarian failure, we studied the effect of vinblastine (VLB) on progesterone (P) and prostaglandin E (PGE) production by rat granulosa cells in vitro. Granulosa cells obtained from immature, pregnant mares' serum gonadotrophin-primed rats were incubated for 5 h in modified Medium 199 +/- LH (10 ng/mL) with varying concentrations of VLB (0.001 to 10.0 micrograms/mL) and cells plus media were assayed for total P and PGE. VLB reduced production of both basal and LH-stimulated P in granulosa cells, with VLB at a concentration of 0.1 micrograms/mL showing the first significant difference from control. This dose also suppressed basal and LH-stimulated PGE. Granulosa cell survival was similar for all groups. Thus VLB, an agent known to disrupt microtubular function, reduced granulosa cell production of both P and PGE. Our results suggest that at a concentration (0.1 micrograms/mL) lower than that routinely achieved during chemotherapy (0.3 micrograms/mL), VLB depresses rat granulosa cell function in vitro. This system appears to be a valid model for preliminary assessment of the cytotoxic effects of chemotherapy on an ovarian component.

Low dose alcohol contracts the human umbilical artery in vitro

Beginning at very low concentrations (0.001 g/100 ml), alcohol elicited dose-dependent contractions of the human umbilical artery in vitro. Additionally, 16 of the 108 arteries tested had a 5-10-min spasm in response to alcohol. Alcohol (0.2 g/100 ml) also increased tension developed in response to all angiotensin II doses, but had no effect on serotonin-induced contractions. These results suggest that alcohol may increase umbilicoplacental resistance in vivo, thus decreasing fetal-placental blood flow.

Effect of general anesthesia on fertilization and cleavage of human oocytes in vitro

To determine whether anesthesia affects in vitro fertilization (IVF), the authors examined 3 1/2 years' experience with IVF. Anesthesia length significantly predicted fertilization and cleavage at stage 0 of stepwise multiple logistic regression analysis, but not at the final step. Oocyte grade, retrieval order, and a quadratic term for grade remained significant for fertilization; cleavage, order, the interaction of order and grade, and the quadratic term for grade remained significant. Order correlated with anesthesia (r = 0.675, P less than 0.001). Also inherent in order are CO2 pneumoperitoneum, increased prolactin, decreased gonadotropins, ovarian trauma, and time. First oocytes of equivalent grade from contralateral ovaries were compared. Fertilization rates were equivalent, but significantly fewer mature oocytes from the second ovary cleaved. Anesthetic agents and CO2 appear to adversely affect fertilization and cleavage in vitro.

Effect of porcine relaxin on the human umbilical artery

Relaxin decreases human myometrial contractions in vitro; that effect is synergized by progesterone. We examined the effects of porcine relaxin on the contractility of isolated perfused human umbilical arterial strips in vitro. One experimental group received relaxin (1.5 micrograms/mL), the second received progesterone (500 ng/mL) plus relaxin, and the control strips received neither. Both resting and agonist-stimulated (KCl or serotonin) isometric tension were compared with profile analysis for all groups. Relaxin had no effect on either resting or agonist-stimulated tension either with or without progesterone. Neither higher concentrations of relaxin nor longer exposures altered contractility. Therefore, the human umbilical artery, unlike the cervix and myometrium, is not sensitive to porcine relaxin. Porcine relaxin could be used as a tocolytic or cervical ripening agent without adversely affecting fetal placental circulation.

Detection of folliculostatin: a sensitive and specific bioassay using the female rat

To establish a sensitive and specific bioassay for the FSH-suppressing activity present in porcine follicular fluid (pFF), we examined the latency of pFF action when injected IV in the acutely ovariectomized (ovax) metestrous rat. By 2h post injection (5.5h after ovax), FSH was suppressed significantly in pFF vs. porcine serum-injected controls. LH was unaltered. In an experiment establishing a dose-response curve for pFF 4.5h after injection, 1.77 mg of pFF protein significantly suppressed FSH. The index of precision (-0.2188) and precision of slope (1.088) were well within acceptable limits for bioassays. We conclude that the ovax metestrous rat, injected 3.5h after surgery and sacrificed at 4.5 or 5.5h, is a sensitive and specific bioassay for folliculostatin.

Characterization of monoclonal antibodies against rat glandular kallikrein

Monoclonal antibodies can be produced in large amounts, are homogenous and can be highly purified. A specific monoclonal antibody against glandular kallikrein could be very useful in studies of the kallikrein-kinin system, both in vivo and in vitro. Two monoclonal antibodies against rat glandular kallikrein (rgKK) were produced by immunized mouse spleen and lymph node fusion with myeloma Ag8.653. Both antibodies, named 2E9.8 and 2E9.9, bound active 125I-kallikrein and phenylmethylsulfonyl fluoride (PMSF)-inactivated 125I-kallikrein. A radioimmunoassay (RIA) was developed with each of the antibodies using rabbit anti-mouse gamma globulin to separate bound from free 125I-rgKK. The standard curve (range 10-1000 ng/tube) was curved even when subjected to logit-log transformation. Using 3% polyethylene glycol (PEG) to assist separation of bound from free, the standard curve became straight for 2E9.8 and the RIA was more sensitive, with a binding range of 0.35-2.4 ng/tube. Both antibodies were specific for rgKK since they had negligible cross-reaction with purified proteases from the submandibular gland of the rat (tonin, esterases B and E). They did not cross-react with mouse nerve growth factor, epidermal growth factor, nor with pig pancreatic kallikrein. Antibody 2E9.9 did appear to bind some human kallikrein when tested with high concentrations of this enzyme, while 2E9.8 did not. When preincubated with purified rgKK, both antibodies prevented the enzyme from releasing kinins from semi-purified dog kininogen and from cleaving [3H]-L-arginine methyl ester (3H-TAME). These results suggested that both antibodies bind an epitope near to, and maybe including, the active site of the enzyme. Monoclonal antibody 2E9.8 appears to be specific for rgKK, can be used in a sensitive RIA, and is capable of inhibiting the enzymatic activity of kallikrein. It should prove to be useful in vivo for examining the role of kallikrein in physiological processes.

The effects of long-term androgen treatment on the ovary

Ten patients with female gender dysphoria were treated with exogenous androgen (testosterone [T] enanthate USP) and underwent sex reassignment surgery. Histologic changes of the ovaries of this treated group were studied and compared with those of patients with polycystic ovarian syndrome (PCO) and a normal control group. Significant differences among groups were observed for thickness of the tunica albuginea (639.8 +/- 56.5 micron, 529.2 +/- 59.3 micron, and 170.1 +/- 29.8 micron in the exogenous androgens, PCO, and normal groups, respectively), basal membrane thickness (72.8 +/- 2.8 micron, 46.2 +/- 4.2 micron, and 25.2 micron), number of cystic follicles (2.0 +/- 0.4, 5.8 +/- 0.7, and 1.8 +/- 0.8), and T and luteinizing hormone concentrations. Theca cell hyperplasia was present only in the PCO group. It is concluded that exogenous androgen can thicken the tunica albuginea and basal membrane and that these histologic changes are similar to those seen in PCO ovaries under excess endogenous androgen production.

Pituitary gonadotropin-releasing hormone receptors during the rat estrous cycle

The binding of [6-alanine]gonadotropin-releasing hormone to pituitary plasma membranes increased threefold between metestrus and early proestrus in female rats. Receptor numbers fell rapidly on the afternoon of proestrus coincident with the preovulatory gonadotropin surge. The numbers of receptors for gonadotropin-releasing hormone were positively correlated with concentrations of estradiol in serum; this pattern may be a necessary component of increased pituitary sensitivty to gonadotropin-releasing hormone observed during proestrus.

Hormonal measurement in rat anterior pituitary cell cultures: loss of immunoreactive LH counteracted by fetal calf serum and bacitracin

Immunoassayable LH in media samples from rat anterior pituitary cell cultures declines during storage and only 20% of the LH remains after 4 weeks at -20 degrees C. The LH loss was not due to bacterial contamination or to damage to the hormone from repeated freezing and thawing. SDS-PAGE of 125IrLH in media samples showed greater recovery of 125IrLH when 1 mM bacitracin or 2% fetal calf serum were present in the medium. The ratio of intact: subunit 125IrLH was unchanged by the presence of bacitracin or fetal calf serum indicating that the loss of immunoreactive LH was not due to dissociation of intact hormone. LH appears to be irreversibly altered in stored culture media, a process which can be prevented by the addition of bacitracin or fetal calf serum to the media prior to storage. The use of either substance allows accurate and reproducible measurement of LH released from pituitary cells in culture.