Comparison of ovarian response in the same women with the same or different lots of human menopausal gonadotropin.

A variation in the bioactivity of different production lots of human menopausal gonadotropin (hMG) has been suggested. Therefore, we evaluated ovarian response to hMG in 14 women during three separate IVF cycles. The first two cycles were performed with the same lot (#03310027; Cycles A1 and A2); the third cycle utilized different lots of hMG (Cycle B). In all cycles, hMG was administered 3 ampules/day beginning cycle Day 3 and continued for at least 6 days. Estradiol and ultrasound evaluations were performed on Day 3, and then daily, beginning on cycle Day 8. Fourteen women completed all three cycles. There were no significant differences in baseline estradiol and ultrasound. Estradiol levels on Day 8 (A1, 754 +/- 130; A2, 700 +/- 107; B, 520 +/- 80 pg/ml, analysis of variance p greater than 0.5) and on Day 9 (A1, 1051 +/- 144; A2, 1140 +/- 155; B, 840 +/- 124 pg/ml, p greater than 0.05) were similar as well. The number of small (1.0-1.4 cm) follicles, large (greater than or equal to 1.5 cm) follicles, and total follicles (Day 8: total A1, 5.5 +/- 0.9; A2, 4.0 +/- 0.7; B, 4.5 +/- 0.9, p greater than 0.05; Day 9: total A1, 6.7 +/- 0.9; A2, 6.9 +/- 0.8; B, 6.9 +/- 0.9, p greater than 0.05) in all three cycles were also similar.(ABSTRACT TRUNCATED AT 250 WORDS)     

Further evidence to support disconjugate eye torsion as a predictor of space motion sickness.

Disconjugate eye torsion in hypo- and hypergravity of parabolic flight was examined in four former astronauts and four previously tested ex-astronauts to replicate an earlier study and to further test the asymmetry hypothesis of otolith function. Results in the new subjects supported the asymmetry hypothesis and confirmed previous findings that those with low scores of torsional disconjugacy on the KC-135 did not suffer space motion sickness in their prior Shuttle missions while those with high scores did. Tilting subjects with high disconjugacy scores slightly to one side and the other failed to find a position that decreased disconjugacy in hypergravity, leading to the conclusion that a simple planar asymmetry about the y-axis was probably not the cause of the observed torsional differences in the two eyes. Disconjugacy increased at 0 G with increasing parabolas, much more so in subjects who had suffered SMS. Because of this, 10 to 20 parabolas were deemed to be a more certain discriminator than a fewer number.     

Successful treatment of periungual warts using photodynamic therapy: a pilot study

AIM: The aim of this pilot study was an investigation on photodynamic therapy (PDT) whether it is a good alternative for treating periungual and subungual warts of the hands. STUDY DESIGN: Twenty patients (mean age: 30.5 years) with a total of 40 periungual and subungual warts were treated with PDT. A photosensitizer, 20%delta-aminolevulinic acid was applied on the warts. After a mean incubation time of 4.6 h (SD: 1.2), the warts were irradiated with the VersaLight for 5-30 min (15.2 +/- 4.3 min). RESULTS: After a mean of 4.5 treatments a mean clearance of 100% was achieved in 90% of the patients. One patient (5%) showed a clearance of 50% and another showed no improvement. The subungual or periungual location of the wart had no influence on the number of treatments or end result (P > 0.05). There were two recurrences during the mean follow-up period of 5.9 months (SD: 7.6). Besides mainly pain and hyperpigmentation, most treatments had no side-effects. CONCLUSION: PDT can offer a good alternative for treating periungual warts of the hands. Larger studies are indicated.     

Evaluation of kemptide, a synthetic serine-containing heptapeptide, as a phosphate acceptor for the estimation of cyclic AMP-dependent protein kinase activity in respiratory tissues

In the search for a phosphate acceptor to estimate cyclic AMP-dependent protein kinase (A-kinase) activity in respiratory tissues devoid of the disadvantages inherent with the use of histones, we compared and contrasted a conventional substrate, histone IIa, with that of a novel heptapeptide phosphate acceptor, Kemptide (Kemp et al., J Biol Chem 252: 4888-4894, 1977). The specific activities of soluble A-kinase isolated from guinea-pig lung parenchyma and from bovine tracheal smooth muscle were significantly (12-16-fold) greater when Kemptide was used as substrate when compared to histone IIa. Moreover, studies with a specific inhibitor of A-kinase demonstrated that whilst the cyclic AMP-stimulated phosphorylation of Kemptide was catalysed exclusively by A-kinase, only approximately 89% of the phosphate incorporated into histone IIa was attributed to the activity of this enzyme. The activation constant (Kact) of cyclic AMP for A-kinase was estimated to be 1.5 microM when Kemptide was used as substrate, 25-fold higher than that obtained using histone IIa (60 nM) under identical conditions. In a complementary series of experiments it was found that both the basal and isoprenaline-stimulated A-kinase activity ratios were significantly higher when histone IIa was used as substrate when compared with that obtained using Kemptide. Elevating the ionic strength of the homogenization buffer or assay cocktail with NaCl produced a reversible (following dialysis), concentration-dependent, mixed uncompetitive, inhibition of cyclic AMP-stimulated histone phosphorylation; phosphokemptide formation was unaffected. The ability of salt to inhibit A-kinase activity also affected the elution profile of A-kinase isoenzymes following their separation by DEAE-cellulose chromatography. With histone IIa as substrate the Type I:Type II isoenzyme ratio in guinea-pig lung and in bovine tracheal smooth muscle was 9:91 and 35:65, respectively. Changing the phosphate acceptor to Kemptide reduced these respective ratios to 5:95 and 29:71. Although the effect on the isoenzyme ratio was small, the specific activities of the two isoenzymes isolated from both tissues were markedly attentuated by ca. 9% (Type I) and 36% (Type II). It is concluded that Kemptide is without many of the disadvantages inherent with histone IIa and is, thus, a preferable phosphate acceptor for estimating soluble A-kinase activity and determining the isoenzyme ratio in guinea-pig lung and in bovine tracheal smooth muscle.     

Prescribing strengthening exercises for my patients: which equipment should I select?

This paper examines various devices used in strength building exercise programs. These include free weights, pulley machines, variable resistance weight machines, isokinetic units and elastic tubing and banding. Advantages and disadvantages of each are discussed and examined from the view point of the health care provider and the suitability of each type of device for prescribed progressive resistance exercise programs for patients. In addition to such practical aspects such as cost and maintenance, biomechanical factors, types of contraction elicited, ease of patient instruction and proprioception benefits are also compared in order to assist the clinician in selecting the most appropriate equipment for each individual patient.     

Reproducibility of lateral spine scans using dual energy X-ray absorptiometry

Summary Reproducibility of lateral spine dual energy X-ray absorptiometry (LAT DEXA) scans using a Lunar DPX-L scanner was assessed in a cadaveric phantom and in patients. One hundred phantom measurements over 7 months demonstrated a longitudinal stability of 1.7% (coefficient of variation, CV). Additional scans were performed with the phantom rotated by up to 20° in each of the three orthogonal planes to assess the effects of variable patient positioning. Horizontal and vertical rotation of the spine had little effect on the estimated bone mineral density (BMD), however, axial rotation of greater than 8° led to errors in the BMD measurement. One hundred consecutive patients had two lateral scans performed within 1 month. BMD (range 0.10–1.6 g/cm²) was determined for each scan by one operator. Significant overlap from ribs and pelvis was often seen with L2 and L4 vertebrae but one vertebra (L3) could be measured in every case. Intraoperator and interoperator variability was assessed by three experienced operators, each analyzing 10 patients' scans on five separate occasions, and was found to be less than 1.1% for a single vertebra. BMD estimation of vertebral bodies and midslices by lateral DEXA scans (CV% of 3.8% and 4.6%) have a 95% confidence interval of 0.074 g/cm² and 0.096 g/cm², respectively for two vertebrae. This variability is due mainly to axial rotation, with operator variability, horizontal rotation, and vertical rotation having little effect on BMD estimation.     

Quantitative evolutionary design

The field of quantitative evolutionary design uses evolutionary reasoning (in terms of natural selection and ultimate causation) to understand the magnitudes of biological reserve capacities, i.e. excesses of capacities over natural loads. Ratios of capacities to loads, defined as safety factors, fall in the range 1.2-10 for most engineered and biological components, even though engineered safety factors are specified intentionally by humans while biological safety factors arise through natural selection. Familiar examples of engineered safety factors include those of buildings, bridges and elevators (lifts), while biological examples include factors of bones and other structural elements, of enzymes and transporters, and of organ metabolic performances. Safety factors serve to minimize the overlap zone (resulting in performance failure) between the low tail of capacity distributions and the high tail of load distributions. Safety factors increase with coefficients of variation of load and capacity, with capacity deterioration with time, and with cost of failure, and decrease with costs of initial construction, maintenance, operation, and opportunity. Adaptive regulation of many biological systems involves capacity increases with increasing load; several quantitative examples suggest sublinear increases, such that safety factors decrease towards 1.0. Unsolved questions include safety factors of series systems, parallel or branched pathways, elements with multiple functions, enzyme reaction chains, and equilibrium enzymes. The modest sizes of safety factors imply the existence of costs that penalize excess capacities. Those costs are likely to involve wasted energy or space for large or expensive components, but opportunity costs of wasted space at the molecular level for minor components.