The subpopulations of T lymphocyte and the function of suppressor T cell in normal pregnancy and pregnancy-induced hypertension

T-lymphocyte subpopulations were determined by the monoclonal antibodies (OKT3, OKT4, OKT8) in 20 cases of normal pregnancy, 36 cases of pregnancy-induced hypertension (PIH) and 20 cases of normal non-pregnant women. The assaying of ConA-induced suppressor T cell (Ts cell) function was carried out in another 20 cases of late pregnancy, 20 cases of moderate and severe PIH, and 10 cases of normal non-pregnant women. The results showed: the percentage of Ts cell increased significantly and the ratios of Th/Ts decreased significantly during normal pregnancy as compared with normal non-pregnant women. As compared with the late pregnant women, a lowering of Ts cell and elevating ratio of Th/Ts were found in PIH cases with statistical significance in severe PIH. A decrease of Ts cell function was also seen in moderate and severe PIH cases. All these findings suggest that the changes of Ts cell in amount and function may play an important role in maintaining normal pregnancy and in the pathogenesis of PIH.     

Postnatal blues: a risk factor for postnatal depression

Postnatal blues have been regarded as brief, benign and without clinical significance. However, several studies have proposed a link between blues and subsequent depression but have methodological problems. We report a prospective, controlled study of postpartum women with severe blues which uses systematically devised and validated instruments for that purpose which tests the hypothesis that severe blues increases the risk of depression in the six months following childbirth. 206 first-time mothers were recruited in late pregnancy. Blues status was defined using the Blues Questionnaire and those with severe blues and their controls who had no blues (matched for age, marital status and social class) were followed for 6 months with postal Edinburgh Postnatal Depression Scale. RDC diagnoses were made following SADS-L interview at the end of the protocol. Backwards stepwise Cox regression analysis found severe blues and past history of depression to be independent predictors each raising the risk by almost 3 times. Depression in those with severe blues onset sooner after delivery and lasted longer. The difference was largely accounted for by major depression. Severe postpartum blues are identified as an independent risk factor for subsequent postpartum depression. Screening and intervention programs could be devised.     

Postnatal blues: A risk factor for postnatal depression

Postnatal blues have been regarded as brief, benign and without clinical significance. However, several studies have proposed a link between blues and subsequent depression but have methodological problems. We report a prospective, controlled study of postpartum women with severe blues which uses systematically devised and validated instruments for that purpose which tests the hypothesis that severe blues increases the risk of depression in the six months following childbirth. 206 first-time mothers were recruited in late pregnancy. Blues status was defined using the Blues Questionnaire and those with severe blues and their controls who had no blues (matched for age, marital status and social class) were followed for 6 months with postal Edinburgh Postnatal Depression Scale. RDC diagnoses were made following SADS-L interview at the end of the protocol. Backwards stepwise Cox regression analysis found severe blues and past history of depression to be independent predictors each raising the risk by almost 3 times. Depression in those with severe blues onset sooner after delivery and lasted longer. The difference was largely accounted for by major depression. Severe postpartum blues are identified as an independent risk factor for subsequent postpartum depression. Screening and intervention programs could be devised.     

The psychological effects of aromatherapy-massage in healthy postpartum mothers

This study examined the effect of aromatherapy-massage in healthy postpartum mothers. A quasi-experimental between-groups design was used. Mothers who received aromatherapy-massage were compared with a control group who received standard postpartum care. Thirty-six healthy, first-time mothers with vaginal delivery of a full-term, healthy infant participated in this study. Sixteen mothers received a 30-minute aromatherapy-massage on the second postpartum day; 20 mothers were in the control group. All mothers completed the following four standardized questionnaires before and after the intervention: 1) Maternity Blues Scale; 2) State-Trait Anxiety Inventory; 3) Profile of Mood States (POMS); and 4) Feeling toward Baby Scale. In the aromatherapy-massage group, posttreatment scores significantly decreased for the Maternity Blues Scale, the State-Anxiety Inventory, and all but one of the Profile of Mood States subscales. Posttreatment scores in the intervention group significantly increased in Profile of Mood States-Vigor subscale and the Approach Feeling toward Baby subscale. Scores in the intervention group significantly decreased in Conflict Index of Avoidance/Approach Feeling toward Baby subscale. Our results suggest that aromatherapy-massage might be an effective intervention for postpartum mothers to improve physical and mental status and to facilitate mother-infant interaction.     

Molecular characterization and expression of dipeptidase 3, a testis-specific membrane-bound dipeptidase: complex formation with TEX101, a germ-cell-specific antigen in the mouse testis

We previously established an anti-sperm head auto-monoclonal antibody designated Ts4. The immunoreactivity of this antibody was also observed in other reproduction-related cells, such as testicular germ cells and early embryos, suggesting that the Ts4-recognized molecules might play a role in the reproductive process. However, the molecular characteristics and functions of the antigens warrant further clarification. In this study, we primarily attempted identification of the mAb-recognized molecules within the mouse testis. An immunoprecipitation method, together with liquid chromatography-tandem mass spectrometry, revealed that the testicular immunoprecipitants with Ts4 contained dipeptidase 3 (DPEP3), a member of the membrane-bound dipeptidase family. A Western blot analysis using an anti-DPEP3 polyclonal antibody established in this study showed that this molecule was glycosylated and formed a disulfide-linked homodimer within the testis. Expression of DPEP3 protein was observed in the testicular germ cells, but not in the Sertoli or interstitial cells, or in any other major organs. Although Western blot analysis of testicular proteins separated by two-dimensional SDS-PAGE failed to demonstrate binding of Ts4 to DPEP3, we found that DPEP3 forms complexes with Ts4-immunoreactive molecules, such as TEX101, on the surfaces of spermatocytes, spermatids, and testicular spermatozoa. Based on data showing in the present study, further studies concerning DPEP3 on the testicular germ cells may help to clarify the molecular mechanisms of testicular germ-cell development.     

Lymphocyte Subclasses in Pregnancy Induced Hypertension

Peripheral blood lymphocyte subclasses were studied by flow cytofluorimetry and monoclonal antibodies in 21 women with Pregnancy Induced Hypertension (PIH), 20 healthy women in their third trimester of pregnancy and in 20 nulliparous, nonpregnant women. The cells were stained with the monoclonal antibodies OKT3, OKT4 and OKT8 to define total T cells, T helper cells (Th) and T suppressor-cytotoxic cells (Ts/c) respectively. B lymphocytes were defined by their surface immunoglobulin. Absolute numbers of total T cells and Ts/c cells were significantly decreased (p less than 0.05) in patients with PIH compared to either control group. The proportion of B lymphocytes was significantly (p less than 0.01) increased and absolute numbers were marginally increased. These findings reflect an immune disturbance which may be of prime importance in the pathogenesis of this disease.     

Cytokine and chemokine alterations in down syndrome

Objective?Down syndrome (DS) is the leading genetic cause of intellectual disability, affecting ~1/800 newborns. Previously we have shown alterations in N-methyl-D-aspartic acid (NMDA) receptors and neuropeptides (activity-dependant neuroprotective protein, glia fibrillary acidic protein) in a murine model of DS. Cytokines and chemokines have neuromodulatory and neurotransmitter roles and interact with the NMDA receptors. The objective of this study was to evaluate if cytokines and chemokines in the hippocampus and cerebellum are altered in this model.Study Design?We used 8- to 10-month-old animals from the well-characterized mouse model of DS (Ts65Dn). Learning and memory were assessed in the Morris water maze with the Ts65Dn animals demonstrating a learning deficit. After completion of the behavioral testing, the brains were removed and the hippocampus and cerebellum were separated by microdissection. A panel of cytokines, chemokines, and fractalkine were measured in the protein lysates using a microsphere-based multiplex immunoassay (Luminex xMAP, Millipore) and normalized to total protein concentration. Statistical analysis included the nonparametric Mann-Whitney U for the cytokine, chemokine, and fractalkine levels; p?相似文献   

Influence of immunotherapy on the cellular immunity of unexplained recurrent aborters.

Changes in lymphocyte subsets in whole blood were analyzed sequentially by flow cytometry with an automated leukocyte differential system in 15 patients with unexplained recurrent spontaneous abortions, each of whom underwent vaccination(s) with her husband's lymphocytes. Mitogen responses of peripheral blood lymphocytes (PBL) were also examined in these patients. The reactivity of PBL against mitogens revealed no significant change in each patient before and after vaccination(s) with her husband's lymphocytes. The CD4:8 ratio was observed to decrease significantly during 22 and 28 days after the first vaccination with a significant increase in the percentage of T suppressor-cytotoxic (CD8) cells. This change was also observed after the second vaccination. The percentages of other subsets did not change significantly after vaccination(s). In 11 patients out of 15, the pregnancy continued successfully and correlated with a predominance of Ts/c (CD8) over TH/I (CD4) cells in the first trimester. These changes in lymphocyte subsets may indicate the induction of immune enhancing mechanisms and it is suggested that continuation of the predominance of Ts/c cells induced by immunotherapy might be important for the successful maintenance of pregnancy.     

Inside–out: the role of anger experience and expression in the development of postpartum mood disorders

Purpose: Among negative emotions, anger has not been studied in as much depth in her connection to postpartum mood disorders. The study aimed to investigate the role of anger as a potential vulnerability factor increasing the risk of Maternity Blues (MB) and Postpartum Depression (PPD).

Materials and methods: Pregnant women in their third trimester of pregnancy underwent the following tests: the State Trait Anger Expression Inventory 2 – STAXI-2 (baseline visit), the Blues Questionnaire -BQ (3 and 5 days after delivery), and the Edinburgh Postnatal Depression Scale (EPDS) (3 and 6 months following delivery).

Results: One hundred ten subjects were included in this study. The prevalence rate of mothers with MB was about 35%, whereas about 4% of women developed a PPD. Significant positive correlations were found among State anger (SANG), Trait anger (TANG), anger expression out (AXO) and in (AXI) and postpartum depressive disorders, as measured by blues questionnaire (BQ) and EPDS.

Conclusions: Anger experience and expression can be considered as vulnerability factors for postpartum mood disorders onset. Particularly, the expression of angry feelings toward other persons or objects in the environment (AXO) predicts the onset of MB, whereas holding in or suppressing angry feelings (AXI) could be a risk factor for subsequent PPD.     

Analysis of minor complications in copper IUD wearers

Minor complications occuring after insertion of 3216 copper IUDs between October 1976 and December 1980 were studied. 1813 of the device were Cu 7 200s, 176 were Cu T 200s, 237 were ML Cu 250s, and 990 were Nova Ts. 133 partial and 71 total expulsions, 21 removals for bleeding, 24 for pain, 10 for bleeding and pain, and 115 for other causes were studied. 5.23% of Cu 7 200, 4.54% of Cu T 200, 2.53% of ML Cu 250, and 2.42% of Nova T devices were partially expelled, while 3.23% of Nova T, 1.87% of Cu T 200, 1.68% of ML Cu 250, and .56% of Cu T 200 devices were totally expelled. Considering all types of IUD, the frequency of expulsions declined with age, but great differences were not observed in relation to parity. 67.6% of total and 48.9% of partial expulsions occurred in the 1st 6 months of use. All total expulsions in the ML Cu 250 and the Cu T 200 occurred in the 1st 3 months. 58.14% of partially expelled IUDs which were reinserted presented no further problems. 16 of 21 IUDs removed for bleeding were Cu 7 200s, 2 each were ML Cu 250s and Nova Ts, and 1 was a Cu T 200. Slightly over 1/2 were removed in the 1st year of use. 20 fo the 24 IUDs removed for pain were Cu 7 200s, and 37.5% of them were used by nilliparas. 9 of the 10 removed for pain and bleeding wer Cu 7 200s, 40% of them in nulliparas. Psychological intolerance of the method (63.35%) and removal by other doctors (18.26%) were the other causes of removal. For the Cu 7 200, Cu T 200, ML Cu 250 and Nova T respectively, the Pearl indices of expulsion were 1.97, 2.22, 2.76, and 4.89, while for pain and/or bleeding they were 1.39, 1.33, 1.18, and .29.     

"Spurious" Labour — Does it Matter?

Summary: The obstetrical outcome of 357 pregnancies complicated by "spurious" labour was documented and compared with that in a control group. Patients with spurious labour were more likely to have had a spontaneous or induced abortion in the preceding pregnancy. In almost 85% of patients, the painful uterine contractions had ceased within 1 hour of hospital admission and there was no increased fetal morbidity in this group. There was a significantly increased incidence of meconium-stained liquor in patients who continued to have painful uterine contractions, but in whom labour did not ensue. Placental abnormalities were significantly more common in patients with spurious labour.     

如何规范产后出血的药物治疗

产后出血（postpartum hemorrhage）是导致孕产妇死亡的首要原因。引起产后出血的原因分别为子宫收缩乏力、胎盘因素、软产道裂伤及凝血功能障碍。产后出血的病因治疗是最根本的治疗,是产后出血救治成功的关键。产后出血的药物治疗主要是针对子宫收缩乏力宫缩剂的治疗。缩宫素为一线用药,当单独手法按摩子宫和缩宫素不能达到止血目的时,可以考虑使用卡贝缩宫素、卡前列素氨丁三醇或卡前列酸栓。在没有注射用宫缩剂或注射用宫缩剂使用禁忌时可以考虑使用米索前列醇。当药物加强宫缩治疗无效时应注意不同药物的起效时间及持续时间。此外,一方面要重新核对有无合并其他原因所致产后出血;另一方面应及时采用必要的进一步治疗如宫腔填塞或子宫动脉栓塞等。     

Molecular diversity of TEX101, a marker glycoprotein for germ cells monitored with monoclonal antibodies: variety of the molecular characteristics according to subcellular localization within the mouse testis

TEX101 was characterized as a unique germ cell marker molecule using the specific monoclonal antibody (mAb), TES101. Although this mAb has strong affinity/specificity for TEX101, TES101 mAb loses its reactivity under reducing conditions. In this study, we have generated new mAbs against TEX101 to compensate for the shortcomings of the TES101 mAb using different approaches. First, we immunized mice with the antigen on a baculovirus expression system and isolated new anti-TEX101 mAbs, 6002 and 6035. Second, we raised the mAb Ts4 from spleen cells of an immunologically naive old mouse. Western blot analysis revealed that the new mAbs possess immunoreactivity under reducing/non-reducing conditions. Immunopositive staining of the mAbs against Bouin-fixed sections was observed in spermatocytes, spermatids and testicular spermatozoa, but not in other cells, similar to paraformaldehyde (PFA)-fixed frozen sections stained with TES101 as previously reported. However, whereas the mAbs 6002/6035 mainly showed immunoreactivity only in spermatocytes in PFA-fixed frozen sections, the reactivity of the mAbs to spermatids and testicular spermatozoa was clearly recovered when the PFA-fixed sections were autoclaved or treated with SDS. Peptide mapping and deglycosylation analysis indicated that the epitopes for TES101, 6002 and 6035 are located within TEX101(25-94), whereas Ts4 recognized N-linked carbohydrate moieties on TEX101 in Triton X-100-soluble mouse testicular extracts but not in the extracellular or water-soluble fractions. These results suggest strongly that the molecular association or structure of N-linked carbohydrate moieties of TEX101 varies according to its subcellular localization within the seminiferous tubules. These new mAbs will be valuable tools for further analysis of TEX101, including its function(s).     

Experimental combination chemotherapy with vincristine and carboquone in human ovarian cancer transplanted into nude mice

The tumor killing effects of combination chemotherapy with vincristine (VCR) and carboquone (CQ) administrated either simultaneously or sequentially with time intervals of up to 36 hours were studied in serially transplantable human ovarian cancer (JOG-1) in nude mice. Using 3H-thymidine pulse labeling, some tumor cell kinetic parameters were estimated as 13.8 hours for Ts and 42.2 hours of Tc, respectively. The induction of partial synchronization after treating with VCR in vivo was confirmed by estimating both the labeling index and the mitotic index. Sequential treatment with VCR followed by CQ at intervals of 24 hours was the most effective anti-tumor schedule in this treatment system. This sequence of drug administration also resulted in either weight loss nor toxic death of the animals during the schedule. These results indicate that the sequential administration of VCR followed by CQ chemotherapy is strongly recommended for clinical application.     

Benign "metastasizing" lipoleiomyoma of the uterus.

A 62-year-old woman presented with an enlarged uterus and numerous pulmonary nodules. On histological examination, the multiple uterine and lung tumors were lipoleiomyomas and histologically identical. Tumors in both sites were immunoreactive for estrogen and progesterone receptors and had a low MIB index. Although intrapulmonary emboli from a benign lipoleiomyoma of the uterus cannot be entirely excluded, the theory of synchronous multifocal lipoleiomyomatous proliferation may provide a more satisfactory explanation in this case.     

Comparison of "instrument-associated" and "spontaneous" obstetric depressed skull fractures in a cohort of 68 neonates

OBJECTIVE: A depressed skull fracture is an inward buckling of the calvarial bones and is referred to as a "ping-pong" fracture. This study aimed to look at differences between "spontaneous" and "instrument-associated" depressed skull fractures. STUDY DESIGN: This retrospective, case-control analysis included every neonate who was admitted with a depressed skull fracture between 1990 and 2000. Cases after a spontaneous vaginal delivery, elective cesarean delivery, or cesarean delivery that was performed during labor without previous instrument use were classified as "spontaneous" (n = 18 cases). Cases after a delivery in which forceps or a vacuum cup had been used either successfully or unsuccessfully were classified as "instrument-associated" (n = 50 cases). Continuous data were analyzed with 2-tailed unpaired t tests; chi 2 analysis was used for nominal data. A probability value of <.05 was considered statistically significant. RESULTS: Fifty depressed skull fractures were associated with an instrument delivery, and 18 depressed skull fractures were classified as "spontaneous." The only obstetric parameter that differed significantly between the 2 groups was the length of the active phase. Among the 68 neonates, 15 neonates underwent prolonged second stage, forceps or manual head rotation, or forceps use during elective cesarean delivery. All "instrument-associated" cases were caused by forceps application or sequential instrument use; depressed skull fractures never occurred after isolated vacuum extraction. Every type of forceps was involved. Intracranial lesions were significantly more frequent in the instrument-associated group (30% vs 0%; P = .02). Two infants sustained persistent severe motor disabilities. CONCLUSION: Depressed skull fractures occur in the setting of spontaneous and operative deliveries, although the incidence is higher in the latter case. Depressed skull fractures that are associated with instrumental deliveries are significantly more likely to be associated with intracranial lesions. Persistent disabilities are rare.     

Mothering problems and child morbidity amongst "mothers with emotional disturbances"

In a study of 1,955 primigravidae who gave birth to a live singleton baby, 227 (11.6%) scored 'positive' (7+) in an antenatal Health Questionnaire enquiring into pre-pregnancy emotional disturbances. This group of mothers had more frequent depression, and this was of longer duration after their delivery compared with those scoring less than 7 (less than or equal to 6). Those scoring 7+ were less likely to breast-feed and the infants were more often ill during the first year of life. There were also differences in 'minor obstetric complications' between the two survey groups. This suggests that the application of this Health Questionnaire antenatally can identify emotionally vulnerable women, who could benefit from support and education during the antenatal period.     

Crystaline mineral deposits on copper intrauterine devices. Study involving diffraction by X-rays on whole IUDs

The crystallized mineral deposits on 91 copper IUDs removed by normal procedures were analyzed using x-ray diffraction. 50 Nova-T, 27 Multiload 375, and 14 Gravigard devices were divided into a group of 32 in place for 10-36 months and a group of 59 in place for over 36 months. Studies were performed by x-ray diffraction on whole IUDs in the fresh or dry state and by using classic x-ray, infrared, and atomic absorption spectrometry methods on deposits. Coils of all the IUDs were covered with a layer of cuprous oxide adherent to the metal that flaked over time. Crystals or coatings formed white deposits on 63% of all IUDs, especially when cuprous oxide adhered to the metal. The deposits covered 65-85% of adherent oxides and only 33-38% of flaked oxides for the 1st and 2nd durations of use respectively. Deposits were more abundant on Nova T and Gravigard than on Multiload devices. For the short and long periods of use, the respective frequencies were 67 and 74% on Nova Ts, 25 and 47% on Multiloads, and 88 and 67% on Gravigard. Calcium carbonate (CaCO3) was the only crystalline inorganic compound found, and was present with or without white deposit on 80% of IUDs. It was in the form of calcite, accompanied by vaterite in 40% of cases and rarely by aragonite. Calcium was substituted by magnesium, with an average of 3.7 atoms. Sodium, potassium, and excess magnesium were not in the organic crystalline phase.