The production of leukaemia inhibitory factor by human endometrium: presence in uterine flushings and production by cells in culture

The concentration of leukaemia inhibitory factor (LIF) was measured in uterine flushings obtained from normal fertile women, from women with unexplained infertility and from women who suffered recurrent miscarriage. In normal fertile women, LIF was not detected in flushings obtained on days luteinizing hormone (LH)+0 to LH+6 of the cycle, but concentrations gradually increased from day LH+7 to a maximum at day LH+12. The amount of LIF in flushings obtained from women with unexplained infertility was significantly lower than in those from normal fertile women on day LH+10 (P < 0.05). The production of LIF by cultured human epithelial and stromal cells was also investigated. LIF was not detectable in the supernatants of cultured stromal cells. Basal LIF production by epithelial cells varied according to the stage in the cycle at which the biopsy was taken. Significantly more LIF was produced by epithelial cells from late proliferative and early secretory endometrium compared with amounts produced by cells from early proliferative (P < 0.001) and late secretory (P < 0.01) endometrium. High doses of progesterone and oestradiol caused a small decrease in epithelial cell LIF production: the combined effect of progesterone and oestradiol (P < 0.01) was greater than the effect of either steroid alone (P < 0.05). The results show, for the first time, the capability of human endometrium to produce LIF in vivo. The fact that maximum LIF concentrations are present at implantation and that decreased concentrations occur in women with unexplained infertility suggest the importance of this cytokine in embryo implantation.      

Cytokines and immuno-endocrine factors in recurrent miscarriage

Recurrent miscarriage remains an enigma. The main aetiologiesare endocrinological, immunological and unexplained. With thegrowth in molecular biology, it is now possible to look at theeffect of these aetiologies in more detail, allowing greaterunderstanding of the underlying pathogenesis. Keywords: cytokines/recurrent miscarriage     

Laterality effects in voice recognition

Dichotic voice recognition was assessed in three groups of 16 right-handed subjects by a procedure in which a sample voice was presented binaurally and the subject was required to indicate which of two dichotically-presented voices was that of the sample speaker. Consonants, vowels, nonsense syllables, and words were used as speech stimuli. Significant right- ear superiority occurred for subjects who responded by naming the ear in which the matching speaker was heard and for subjects who circled the stimulus spoken by the matching speaker on a response sheet, but no significant ear difference was found for subjects who orally repeated the utterance of the matching speaker. Overall accuracy of recognition tended to be greatest with words and nonsense syllables and least with vowels and consonants as speech stimuli. There was no significant interaction between ears and speech stimuli. It was concluded that the right-ear superiority in voice recognition by ear naming and visual choice responses is associated with left-hemisphere dominance for voice recognition.     

Sphincter of Oddi stenosis: diagnosis using hepatobiliary scintigraphy and endoscopic manometry

To determine the role of radionuclide imaging in diagnosing sphincter of Oddi stenosis, 21 patients with symptoms suggesting this disorder underwent endoscopic retrograde cholangiopancreatography, cholescintigraphy, and, when possible, endoscopic manometry. Those patients with abnormal hepatobiliary scintigraphy results--based on our criteria of delayed biliary intestinal transit, abnormal duct size, and abnormal time-activity dynamics and obstruction--had a mean basal sphincter pressure of 38.5 mm Hg. Sphincter pressures could not be measured in six patients with sphincters too tight to cannulate. Ten patients who underwent hepatobiliary scanning both before and after sphincter surgery had normal scan results on the repeat study. Hepatobiliary imaging appears useful for diagnosis of sphincter of Oddi stenosis in selected patients in whom manometry cannot be performed and for objective assessment of response to therapy.     

Vascular trauma to the extremities and lower neck: initial assessment with intravenous digital subtraction angiography

Rapid assessment of a patient with possible major peripheral vascular injury is essential to preserve limb function. Intravenous digital subtraction angiography (IV DSA) allows rapid evaluation of these patients without the need for intraarterial examination. We report our experience in 295 vessels studied by IV DSA for the evaluation of possible traumatic arterial injury to the extremities or neck. Of our study population requiring angiography (469 patients), 63.4% were appropriate candidates for IV DSA. Of the vessels studied by IV DSA, 93.6% required no further radiologic evaluation. A normal appearance on IV DSA study indicates no major vascular injury; patients with positive studies may proceed to surgery without further interventional assessment.     

Interstitial fluid pressure and alkaline gastric secretion.

The interstitial fluid pressure of the submucosa of the gastric fundus was monitored by means of Guyton's capsules in dogs anesthetized with pentobarbital. The intracapsular pressure (ICP) was measured during secretion produced by: a) hypertonic solutions placed inside the stomach; b) arterial hypertension (200 mmHg) applied during intra-arterial infusion of histamine, and c) intra-arterial infusion of acetylcholine. The first procedure did not modify the ICP. On the other hand, whenever interstitial fluid appeared in the gastric lumen during hypertension plus histamine, the mean ICP increased, mostly due to augmented capillary filtration. The hydraulic coefficient measured in these experiments was at least 4 orders of magnitude larger than the respective osmotic coefficient. The action of acetylcholine was complex: large doses enlarged the net capillary filtration, but small doses increased the mean ICP by muscle stimulation only. Contraction of the muscularis mucosae might be the most important mechanism underlying bulk flow of interstitial fluid in physiological conditions. It is concluded that hydraulic gradients across the epithelium might account for the "secretion" of "alkaline" juice.