Luteal blood flow and luteal function

Background

Blood flow in the corpus luteum (CL) is associated with luteal function. The present study was undertaken to investigate whether luteal function can be improved by increasing CL blood flow in women with luteal phase defect (LFD).

Methods

Blood flow impedance in the CL was measured by transvaginal color-pulsed-Doppler-ultrasonography and was expressed as a resistance index (RI). The patients with both LFD [serum progesterone (P) concentrations < 10 ng/ml during mid-luteal phase] and high CL-RI (≥ 0.51) were given vitamin-E (600 mg/day, n = 18), L-arginine (6 g/day, n = 14) as a potential nitric oxide donor, melatonin (3 mg/day, n = 13) as an antioxidant, or HCG (2,000 IU/day, n = 10) during the subsequent menstrual cycle.

Results

In the control group (n = 11), who received no medication to increase CL blood flow, only one patient (9%) improved in CL-RI and 2 patients (18%) improved in serum P. Vitamin-E improved CL-RI in 15 patients (83%) and improved serum P in 12 patients (67%). L-arginine improved CL-RI in all the patients (100%) and improved serum P in 10 patients (71%). HCG improved CL-RI in all the patients (100%) and improved serum P in 9 patients (90%). Melatonin had no significant effect.

Conclusion

Vitamin-E or L-arginine treatment improved luteal function by decreasing CL blood flow impedance. CL blood flow is a critical factor for luteal function.     

When should tracheotomy be performed in bilateral vocal cord paralysis involving multiple system atrophy?

OBJECTIVES: Bilateral vocal cord paralysis caused by central nervous system dysfunction results from such diverse causes as cerebrovascular disorder and neurodegenerative disease. Otolaryngologists are often consulted about indications of tracheostomy for such cases, but if their recognition of causative disease is insufficient, it is difficult to judge indications of tracheostomy. We reviewed tracheostomy cases due to bilateral vocal cord paralysis caused by multiple system atrophy (MSA) and considered points to keep in mind in such cases. MATERIALS AND METHODS: We diagnosed 9 cases of vocal cord midline fixation due to central bilateral vocal cord paralysis caused by MSA and treated by tracheostomy. We reviewed clinical conditions and suitable time for tracheostomy because it presents a specific clinical course. RESULTS: 7 cases were MSA-P and 2 cases were MSA-C. Inspiratory stridor in awaking and dysphasia was aggravated at the almost same time in 7 cases. DISCUSSION: Vocal cord abductor paralysis in MSA may cause sudden death, but when an otolaryngologist not familiar with this disease is asked for air way evaluation, it is possible to be diagnosed as no vocal cord paralysis because there is no an adductor disorder, so clinical course of MSA should be clarified more. In vocal cord midline fixation, it was expected that intervention by hypermyotony in the progress of Parkinsonism was a main factor, as was vocal cord abductor disorder due to a neurogenic change in the posterior cricoarytenoid muscle in MSA. The aggravation of dysphasia is an important index in judging the indication of tracheostomy.     

Analyses of factors contributing to hearing aids use and both subjective and objective estimates of hearing

The use of hearing aids, regardless actual implementation, may be interpreted as a cry for help in hearing difficulty. We assessed factors contributing to hearing aid possession and predicted needs of hearing assistance from the distribution of hearing level in self-estimated (subjective) hearing loss and hearing loss pointed out by others (objective) in a population-based aging cohort. Of 1192 men and 1163 women aged 40 to 84 years, the prevalence of hearing loss using the criteria of a mean hearing threshold>25dB at frequencies of 0.5, 1, 2, and 4 kHz in the better ear was 23.6%. Hearing aids were possessed by 11.0% in the hearing loss group. Statistical analysis by gender was done to identify factors associated with hearing aid possession using stepwise multiple regression in which independent variables were age, hearing in the better and worse ear, and items from response to a questionnaire on self-estimated hearing loss, hearing loss pointed out by others, job, household income, financial satisfaction, education, housemate, how often others were talked to and how often those surveyed went out. Age, better-ear hearing, worse-ear hearing, and education statistically influenced hearing aid possession in men, and age, better-ear hearing, and hearing loss pointed out by others statistically influenced women. Age had a negative effect on hearing aid possession in both men and women, indicating that possession decreased with aging. Scattergrams were plotted with worse-ear hearing on the y axis and better-ear hearing on the x axis for 4 groups of respondents divided into groups with self-estimated hearing loss or hearing loss pointed out by others: (1) no subjective and objective hearing loss, (2) subjective but no objective hearing loss, (3) objective but no subjective hearing loss, and (4) both subjective and objective hearing loss. Many respondents had either subjective or objective or both subjective and objective hearing loss, even within 20 dB of hearing level of both ears in their 40s. These facts implied that early-stage candidates for hearing aids may not require threshold reduction, although aided thresholds were commonly used indicators in fitting.     

A novel function of CD82/KAI-1 on E-cadherin-mediated homophilic cellular adhesion of cancer cells

In this study, we analyzed the effect of the metastasis suppressor CD82/KAI-1, a member of the tetraspanin superfamily, on intercellular adhesion on cancer cells. The newly established invasion assay and the cell aggregation assay revealed that CD82 strengthens E-cadherin-mediated intercellular adhesion. Interestingly, ectopic expression of CD82 stabilized E-cadherin/beta-catenin complex formation. Furthermore, CD82 reduced tyrosine phosphorylation of beta-catenin on HGF stimulation. Taken together, CD82 may stabilize or strengthen E-cadherin-dependent intercellular adhesion by regulating beta-catenin-mediated signal transduction on cancer cells, and consequently, prevent cancer cells from seceding from the primary tumor site.     

Differences in treatment and survival between elderly patients with thoracic esophageal cancer in metropolitan areas and other areas

To address the major issue of regional disparity in the treatment for elderly cancer patients in an aging society, we compared the treatment strategies used for elderly patients with thoracic esophageal cancer and their survival outcomes in metropolitan areas and other regions. Using the national database of hospital-based cancer registries in 2008-2011, patients aged 75 years or older who had been diagnosed with thoracic esophageal cancer were enrolled. We divided the patients into two groups: those treated in metropolitan areas (Tokyo, Kanagawa, Osaka, Aichi, Saitama, and Chiba prefectures) with populations of 6 million or more and those treated in other areas (the other 41 prefectures). Compared were patient backgrounds, treatment strategies, and survival curves at each cancer stage. In total, 1236 (24%) patients from metropolitan areas and 3830 (76%) patients from nonmetropolitan areas were enrolled. Patients in metropolitan areas were treated at more advanced stages. There was also a difference in treatment strategy. The 3-year survival rate among cStage I patients was better in metropolitan areas (71.6% vs. 63.7%), and this finding mainly reflected the survival difference between patients treated with radiotherapy alone. For cStage II-IV patients, there were no differences. Multivariable Cox proportional hazard analysis including interaction terms between treatment areas, cStage, and the first-line treatments revealed that treatments in the metropolitan areas were significantly associated with better survival among patients treated with radiotherapy alone for cStage I cancer. Treatment strategies for elderly patients with thoracic esophageal cancer and its survival outcomes differed between metropolitan areas and other regions.     

Design of novel zinc finger proteins: towards artificial control of specific gene expression.

In this review, we summarize design strategies for generating proteins with desired sequences such as long contiguous base pairs and diverse sequence specificities based on the nature of Cys(2)-His(2) zinc finger proteins. Recent progress towards artificial DNA binding proteins has been achieved by structure-based design processes and by selection strategies. Indeed, a multi-zinc finger protein with an 18 (or 27)-base pair address, and new zinc finger proteins for diverse DNA target sites (TATA-box and p53 binding site) have been created successfully. Such novel zinc finger proteins will probably be useful tools in molecular biology and potentially in human medicine.     

Analysis of 5-HT3 receptor antagonist, ramosetron hydrochloride, based on receptor occupancy considering its active metabolite]

Severe nausea and vomiting induced by antineoplastics diminish the patient's quality of life and the ability to tolerate further chemotherapy. Ramosetron hydrochloride is a 5-HT3 receptor antagonist, which has an active metabolite (M-1), expected to be useful in the inhibition of chemotherapy-induced nausea and vomiting. In the present study, in order to analyze the pharmacological effect of ramosetron hydrochloride in a comprehensive manner, we estimated the 5-HT3 receptor occupancy after intravenous administration of ramosetron hydrochloride using pharmacokinetic parameters and the dissociation constants for the 5-HT3 receptor. The average total receptor occupancy after intravenous administration of 0.3 mg of ramosetron hydrochloride to human was calculated to be 82.9% (ramosetron, 77.8%; M-1, 5.1%), thus exhibiting a significant antiemetic activity. Furthermore, the estimated time course of 5-HT3 receptor occupancies after intravenous administration of 0.3 mg of ramosetron hydrochloride suggested a substantial impact of the active metabolite (M-1). It suggested that M-1 contributed to the long duration of binding on the 5-HT3 receptor. The present analysis method should be useful for designing the rational dosage regimen of ramosetron hydrochloride and predicting the duration of its antiemetic activity in a quantitative manner.     

Activation in the Ipsilateral Posterior Parietal Cortex during Tool Use: A PET Study

The basis of perceptual assimilation of tool and hand has been considered to be in modification of body schemata, for which integration of multimodal sensory information about our body parts is required. Using positron emission tomography and H(2)(15)O, we aimed to identify brain regions that change their neural activity in association with changes in neural processing of visual and/or somatosensory information when humans use a simple tool. Normal subjects were instructed to manipulate a small graspable object with a pair of tongs or with the fingers of their right or left hand. The only site activated during manipulation with the tool, compared with the fingers, with the right hand was the lateral edge of the right intraparietal sulcus (IPS). During manipulation using the left hand with the tool, compared with using the fingers, an area in the middle part of the left IPS was activated. Areas in the contralateral hemisphere were activated during both the tool-use and the finger-use tasks compared to the control task, but there was no statistically significant difference between the tool-use and the finger-use tasks. Therefore, the results suggest that the ipsilateral posterior parietal cortex was recruited during the tool-use tasks to integrate visuosomatosensory information.     

IgE-positive epidermal Langerhans cells in allergic contact dermatitis lesions provoked in patients with atopic dermatitis

Summary To see whether or not IgE-bearing epidermal Langerhans cells are specific to skin lesions of atopic dermatitis (AD), we performed immunohistochemical and immunoelectron microscopic examinations of dinitrochlorobenzene (DNCB) contact dermatitis lesions provoked in uninvolved skin of eight patients with AD. In all of the eight examined, IgE-positive epidermal Langerhans cells were observed in the DNCB dermatitis lesions. Typical staining of anti-IgE was absent in the epidermis of normal-appearing skin of five patients with AD. Thus, it is likely that IgE positive epidermal Langerhans cells non-specifically occur in different eczematous diseases provoked in patients with AD.