A novel method of measuring intra-abdominal fat volume using helical computed tomography

OBJECTIVES

:We present a novel method of scanning for intra-abdominal fat volume by helical computed tomography (CT), and describe the clinical significance of measuring the volumes of intra-abdominal visceral fat (V(vol)) and subcutaneous fat (S(vol)) vs these respective areas determined by conventional slice-by-slice CT at the umbilical level.

METHOD

Subjects with obesity or hyperlipidemia (79 men, 74 women) were recruited for this study. We obtained helical CT scans with a tube current of 150 mA, voltage of 120 kV and 2:1 pitch (table speed in relation to slice thickness), starting at the upper edge of the liver and continuing until the pelvis. The intra-abdominal visceral fat volume was measured by drawing a line within the muscle wall surrounding the abdominal cavity. The abdominal subcutaneous fat volume was calculated by subtracting the visceral fat volume from the total abdominal fat volume. By comparison, the intra-abdominal visceral and subcutaneous fat areas were determined at the umbilical level by the established slice-by-slice CT scanning technique.

RESULTS

V(vol) was correlated positively with visceral fat area (V(area)) measured by conventional CT in both genders (in men (n=79) V(vol) vs V(area), r=0.81 P<0.0001; in women (n=74) V(vol) vs V(area), r=0.85, P<0.0001). S(vol) also showed a positive correlation with subcutaneous fat area (S(area)) in both genders (in men (n=78) S(vol) vs S(area), r=0.95, P<0.0001; in women (n=74) S(vol) vs S(area), r=0.92, P<0.0001).

CONCLUSION

We have reported a novel method for measuring intra-abdominal fat volume by the use of helical CT.

Preperitoneal fat thickness determined by ultrasonography is correlated with coronary stenosis and lipid disorders in non-obese male subjects

OBJECTIVE

To investigate the relationship between preperitoneal fat thickness (PFT) determined by ultrasonography and the risk of coronary arterial disease, 130 non-obese patients with ischemic heart disease (77 men and 53 women) were examined.

RESULTS

There was a positive correlation between PFT and coronary artery stenosis score (r = 0.212, P < 0.05). After dividing the patients by gender, the correlation was recognized only in men (r = 0.246, P< 0.05). Also, PFT was positively correlated to serum total cholesterol (r = 0.259, P < 0.01), triglyceride (r = 0.205, P < 0.05) and low density lipoprotein (LDL)-cholesterol (r = 0.205, P < 0.05), and negatively correlated to serum high density lipoprotein (HDL)-cholesterol (r = -0.261, P < 0.01). Again, these correlations were found only in men, not in women.

CONCLUSION

PFT shows good correlations with coronary artery stenosis score and dyslipidemia, and may lead to the development of coronary artery disease in non-obese male subjects.

Cumulative pregnancy rates in couples with anovulatory infertility compared with unexplained infertility in an ovulation induction programme

Using a retrospective analysis, we compared cumulative pregnancy rates, early pregnancy failure rates and multiple pregnancy rates in couples with polycystic ovarian syndrome (PCOS) (n = 148), hypogonadotrophic or eugonadotrophic hypogonadism (n = 91) and unexplained infertility (n = 117), who were treated in an ovulation induction clinic between January 1991 and December 1995. The women were treated with either human menopausal gonadotrophin (HMG) or purified follicle stimulating hormone (FSH). The cumulative pregnancy rate (derived from life-table analysis) after four ovulatory treatment cycles was 70% in the PCOS group, 74% in the hypogonadism group and 38% in the unexplained infertility group. The cumulative pregnancy rate in the unexplained infertility group was significantly lower than the other groups (P < 0.001) but there was no significant difference between PCOS and hypogonadism using the log rank test. The early pregnancy failure rate was 25% in the PCOS group, 27% in the hypogonadism group and 26% in the unexplained infertility group (chi(2) = 0.132, not significant). The multiple pregnancy rate was 20% in the PCOS group, 30% in the hypogonadism group and 17% in the unexplained infertility group (chi(2) = 2.105, not significant). Treatment of anovulatory infertility using HMG or FSH is effective irrespective of the cause. Couples with unexplained infertility are less successfully treated using HMG: correction of unexplained infertility may involve more than simple correction of possible subtle ovulatory defects.

[Expression of prolactin receptor gene in human decidua of early pregnancy]

This study was designed to examine the expression of the prolactin receptor (PRL-R) gene in the human decidualized endometrium and to determine the localization of endometrial cells expressing the PRL-R gene.

METHOD

Decidua and trophoblast tissues of normal and ectopic pregnancy were obtained by curettage from patients undergoing artificial abortion at 8 -10 weeks of gestation. Total RNA was extracted to perform northern blot hybridization with a radiolabeled human PRL-R cDNA probe. Some tissues were cut and processed for in situ hybridization histochemistry with a radiolabeled RNA probe.

RESULTS

1. Northern blot hybridization: Approximately 9.0, 3.6 and 2.8kb size bands were detected in decidua in normal and ectopic pregnancy. No hybridization signal was detected in the chorionic villi. 2. In situ hybridization: Hybridization signals were detected in the cytoplasm of the decidual cells not only in normal pregnancy but also in ectopic pregnancy. No hybridization signal was detected in the trophoblast cells or endometrial glands.

CONCLUSION

The human PRL-R gene is expressed in the decidual cells in early pregnancy not only in normal pregnancy but also in ectopic pregnancy. And it has been reported that the decidual cells produce PRL. These results suggest that PRL may act directly on the decidual cells by paracrine and/or autocrine mechanisms.

Regional comparison of prolactin gene expression in the human decidualized endometrium in early and term pregnancy

Prolactin (PRL) is known to be expressed in the decidualized human endometrium and secreted into amniotic fluid. Although the site of synthesis of endometrial PRL is known to be the decidual cells, the difference in PRL gene expression within each area of decidua, i.e. decidua basalis, decidua parietalis and decidua capsularis, during pregnancy is not clear. We have applied an in situ hybridization histochemistry technique using a radiolabeled RNA probe to compare the difference in expression of PRL gene within each area of the decidualized endometrium. Specific hybridization signals were distributed over the decidual cells in early and term pregnancy. More intense hybridization signals were always detected in the tissues of early pregnancy than in those of term pregnancy. In the decidua capsularis of early pregnancy, labeled cells were concentrated close to the amniotic cavity, whereas cells were concentrated close to the maternal surface of the fetal membrane in term pregnancy. In the decidua parietalis, almost all decidual cells were labeled, but no specific labeling was seen in the endometrial glands or capillary endothelium in both groups. In the decidua basalis, most decidual cells showed hybridization signals whereas no hybridization signal was seen over the trophoblast cells. These results show that there are regional and periodic differences in PRL gene expression in the decidual cells during pregnancy.

Localization of prolactin and its receptor messenger RNA in the human decidua

Prolactin (PRL) is known as an anterior pituitary hormone. On the other hand, PRL is also produced in the human decidualized endometrium. The physiological role and site of action of endometrial PRL have not yet been clarified. This study was designed to investigate the localization of PRL receptor (PRL-R) gene-expressing cells in the human decidualized endometrium using in situ hybridization histochemistry. Sense and antisense 35S-labeled RNA probes for human PRL-R mRNA were hybridized with cryostat sections of human decidua, which were obtained from patients undergoing therapeutic abortion at 8-10 weeks of gestation. Hybridization signals for PRL-R mRNA were seen over the decidual cells. No labeled cells were seen in the chorion, amnion, or trophoblast. Comparing the localization of PRL-R gene-expressing cells to that of PRL gene-expressing cells using adjacent sections, their distributions were quite similar. These results indicate that not only PRL but also PRL-R transcripts are located in the decidual cells.

Treatment of obesity by personality classification-oriented program

It is apparent that personality is related to the pathogenesis of obesity, and that understanding the personality of the patient may be a key to successful treatment of the disease. Using the Rorschach test and interviews by a psychiatrist, the types of personality were classified into four groups according to the healthiness of personalities. The judgment of healthiness was based mainly on the scores obtained from the Rorschach test. This classification revealed that the occurrence of mental and physical symptoms during therapy with a very low calorie diet (VLCD) and subsequent rebound of bodyweight were more frequently observed in patients with relatively less healthy personalities. We used this classification to adapt our program to treat obese patients. In this program, severe diet restrictions were applied to patients with relatively healthy personalities. These restrictions were applied with modifications to patients with less healthy personality, because severe restrictions would be possibly very stressful for them and would bring about an undesirable reaction. For strengthening the patients' motivation for therapy, the significance of body weight reduction was explained in different ways to patients with different types of personality. The target of bodyweight reduction, reward for patients with successful weight reduction, and the duration of therapy were set up differently for patients with different personalities types. The results showed that bodyweight rebound one or two years after treatment was reduced with the personality-oriented therapy program compared to that observed with the previous conventional therapies. Also, the incidence of psychological problems was remarkably decreased.

Expression of prolactin gene in human decidua during pregnancy studied by in situ hybridization histochemistry

The prolactin (PRL) gene is known to be expressed not only in the anterior pituitary but also in the decidualized human endometrium. This study was designed to detect the site of synthesis of PRL during pregnancy by in situ hybridization histochemistry. Decidual and trophoblast tissues from early pregnancy were obtained from patients undergoing therapeutic abortion at 8-10 weeks of gestation. Term placentae were obtained from patients with uncomplicated deliveries at 38-40 weeks. Sections of these tissues were hybridized with 35S-labeled RNA probe complementary to human PRL mRNA. Specific hybridization signals were distributed over the decidual cells in early and term pregnancy. In the decidua capsularis of early pregnancy, labeled cells were concentrated close to the amniotic cavity, although decidual cells were distributed evenly. In the decidua parietalis, almost all decidual cells were labeled, but no specific labeling was seen in the endometrial glands or capillary endothelium. In the decidua basalis, greater signals were always detected over the decidual cells in early pregnancy than in term pregnancy, when sections, which were hybridized with the same probe and exposed simultaneously, were compared. No specific hybridization was detected in the trophoblast cells. These results not only confirm that PRL is specifically synthesized in the decidual cells but also indicate that there are regional and periodical differences in PRL gene expression in the decidual cells during pregnancy.

[Expression of prolactin gene in human decidua]

This study was designed to detect the localization of prolactin gene expressing cells in the human utero-placental unit during pregnancy.

METHODS

Human endometrium was obtained at hysterectomy from normally cycling women who underwent surgery for myoma uteri. Decidual and trophoblast tissues from early pregnancy were obtained by curettage from patients undergoing therapeutic abortion at 8-10 weeks of gestation. Term placenta was obtained from patients with uncomplicated deliveries at 38-40 weeks. Total RNAs of these tissues were extracted to perform Northern blot hybridization (NBH) with the radiolabelled human pituitary prolactin cDNA probe. Frozen sections of these tissues were cut and processed for in situ hybridization (ISH) with the radiolabelled RNA probe complementary for human prolactin mRNA.

RESULTS

1. By NBH, approximately a 1.3 kilobase (kb) size band was detected in the total RNA obtained from late secretory endometrium (day 26), decidua of early pregnancy and placenta of term pregnancy, and the decidua had the most significant signal. No hybridization signal was detected in the chorionic villi in early pregnancy. 2. By ISH, a significant hybridization signal was detected in the cytoplasm of the decidual cells in early and term pregnancy. No hybridization signal was detected in the endometrial grandsand trophoblast cells.

CONCLUSION

These results indicate that prolactin is synthesized in the decidual cells in the human uterus during pregnancy.

Transformation of arylamines into direct-acting mutagens by reaction with nitrite

Arylamines including aniline (I), 1-naphthylamine (II), 2-naphthylamine (III), 2-aminofluorene (IV), 1-aminoanthracene (V) and 1-aminopyrene (VI) were treated with 4 equivalent amounts of nitrite at pH3 and 37 degrees C for 4 h. The reaction mixtures of I, IV, V and VI showed mutagenicity to Salmonella typhimurium TA98 and TA100 strains without metabolic activation. The numbers of His+ revertant colonies to TA98 strain were 110/0.05 mumole I, 970/0.055 mumole IV, 620/0.10 mumole V and 870/0.02 mumole VI. These arylamines were converted into mutagens with diazoquinone, diazonium and nitro functions depending on their structures. The mutagen from I was p-diazoquinone (I2). The mutagen from IV was highly unstable fluorene-2-diazonium salt (IV1). The mutagens from V were N3O3-introduced anthracene (V1-1) and 1-nitroanthracene (V2), and those from VI were unidentified nitro-introduced compound (VI1) and 1-nitropyrene (VI2).

[The effect of epidermal growth factor (EGF) with estradiol and progesterone on prolactin secretion from cultured human decidual tissues of early pregnancy]

Prolactin is now accepted as a normal product of the decidual cells of the human endometrium. We investigated the effect of epidermal growth factor (EGF) with estradiol and progesterone on prolactin secretion by the decidual tissues from the early pregnant endometrium. The decidual tissues were separated from villi, minced and cultured in collagen gel matrix with serum-free medium. Immunological staining of the cultured decidual tissues showed prolactin localization and EGF receptors on the stromal cells. Cultured media were collected every 2 days. The culture for the first 2 days was incubated with the serum-free medium alone (= preculture), and the following test culture was supplemented with/without additives. The prolactin content in cultured media was quantified by EIA. The results of the effect of steroid(s) and EGF were represented as a comparison of prolactin contents in the preculture and the test culture. An increase in prolactin secretion was found after the tissues were treated with a combination of 10(-8)M estradiol and 10(-6)M progesterone or 10(-6)M progesterone alone. After 8 days, the prolactin secretion rate increased about 3-fold over the precultured value. Estradiol alone kept the prolactin secretion at the precultured value. Prolactin secretion gradually decreased in the non-additive culture. These results indicate that progesterone was essential in the secretion of prolactin. Simultaneously, similar decidual tissues were incubated with a combination of EGF and steroid(s). The secretion of prolactin in the group treated with progesterone alone decreased dose-dependently responding to added EGF on the 8th day of culture. In the presence of estradiol and progesterone, the secretion rate decreased to the values similar to the progesterone alone group with the addition of 0.1, 1 ng/ml EGF, and the decrease in prolactin secretion was less with the addition of 10 ng/ml EGF. Mixed cultures of the decidual tissues and villi showed that the prolactin secretion rate increased in all groups treated with/without estradiol and/or progesterone. These results imply that progesterone derived from villi might control decidual prolactin secretion. The effect of high concentration EGF (50 ng/ml) on the prolactin secretion appeared similar to the isolated decidual tissues. These results suggest that decidual prolactin secretion is regulated by the combined effects of steroids and EGF.

Oxygen consumption and guanosine diphosphate binding by fetal brown adipose tissue in diabetic pregnancy

Oxygen consumption and 3H-guanosine diphosphate (GDP) binding were determined in brown adipocytes and mitochondria from 28-day gestation fetuses of alloxan-diabetic rabbit does and saline-injected controls. Maternal diabetes was classified as severe or mild determined by whether maternal blood glucose values were greater or less than 200 mg/dL, respectively, at death. Basal oxygen consumption and adipocyte diameters did not vary among groups. A significant reduction in maximal norepinephrine (NE) stimulated O2 consumption by fetal brown adipose tissue (BAT) cells was seen in offspring of severely diabetic pregnancies when compared with control values (248 +/- 53 +/- v482 +/- 32 microL O2/10(6) cells/h; P less than .005). In contrast, a significant increase in maximal NE-stimulated O2 consumption by fetal BAT cells occurred in offspring of mild diabetic pregnancies (807 +/- 60, P less than .001 v controls). A highly significant inverse correlation between serum glucose levels and maximal O2 consumption by fetal BAT was observed in fetuses from mild and severe diabetic pregnancies (r = -.98, P less than .005), and there was no correlation between these two parameters in offspring of normal pregnancies. A significant inverse correlation was observed between maximal O2 consumption by fetal BAT cells and serum insulin levels in offspring of both control and diabetic pregnancy (r = -.74; P less than .02). Tissue cytochrome oxidase activity was lower in offspring of severely affected diabetic does, indicating a reduction in BAT mitochondrial content compared with controls. BAT mitochondria from fetuses of severely diabetic does exhibited reduced 3H-GDP capacity, which was 2.5-fold lower than controls.(ABSTRACT TRUNCATED AT 250 WORDS)

[Correlation of LH and prolactin pulses in normoprolactinemic women with ovulatory disturbances and variation of LH and FSH pulses and secreting capacity by administration of bromocriptine in the same cases]

The difference between prolactin (PRL) basal levels on separate days in the 6 normoprolactinemic women--one case with an anovular cycle and 5 cases with 1 degree amenorrhea--among 14 normoprolactinemic women with ovulatory disturbances, showed significantly variation over 13 ng/ml within the normal range of the PRL basal level. PRL pulse frequencies of the same cases from 0900 h. to 1400 h. increased slightly compared with follicular phase. At the same time, the PRL pulse amplitudes were significantly higher than in the follicular phase but significantly lower than the PRL pulse amplitudes in hyperprolactinemic women. The net increase in PRL to TRH in the 6 cases was over 100 ng/ml. When the PRL net increase to TRH was over 100 ng/ml in normoprolactinemic women with ovulatory disturbances, the case is regarded as latent hyperprolactinemia. And 1 or 2 may be latent hyperprolactinemic syndrome. The LH/FSH basal level and delta LH/delta FSH to LH-RH before administration of bromocriptine increased in these cases compared with the follicular phase. During the administration of bromocriptine, the ratios decreased and approached the ratio in the follicular phase. The effect of clomid was improved by increased E2 in these cases.

Neuroendocrine regulation of LHRH and gonadotropin

Analysis of gonadotropin secretion patterns throughout the menstrual cycle revealed a complex rhythm. Especially at 1-3 hour intervals this was seen, with a frequency that was dependent on the phase of the menstrual cycle. There is little information available concerning the role of plasma luteinizing hormone-releasing hormone (LHRH) in the regulation of donadotropin secretion in amenorrheic and postmenopausal women. In this paper, the authors present the results of a detailed investigation into the secretory pattern of LH, follicle stimulating hormone, and LHRH in normal women with a normal menstrual cycle, amenorrheic women, and postmenopausal women.