Treatment of Prolactin-Secreting Pituitary Tumours in Young Women by Needle Implantation of Radioactive Yttrium

Twentyone young female patients are described who presentedwith amenorrhoea, galactorrhoea or infertility, and were treatedby ⁹⁰Y pituitary implantation of 20 000 rads. There was no morbidity.In all patients serum prolactin values were elevated and radiographsof the pituitary fossa were abnormal. Observations are available for 1–76 months (mean 27) afterimplantation. The median fall in prolactin values was 60 percent while there was no deterioration in pituitary functionif normal pre-operatively. Luteinizing hormone values, bothbasally and following gonadotrophin-releasing hormone, roseto normal after operation; several instances of sellar remodellingwere observed radiologically, and no instance of relapse wasfound radiologically, biochemically or clinically. Thirteen patients desiring fertility have been observed sinceimplantation; so far nine have become pregnant, in three instanceswithout any additional therapy; since four patients became pregnanttwice, a total of 13 pregnancies have occurred. No case of tumourexpansion was observed during pregnancy. ⁹⁰Y implantation can be considered as a therapeutic procedurein young female patients requiring fertility which is competitivewith surgical methods, and together with a short course of bromocriptineif needed, could prove to be the treatment of choice.     

Chymotrypsin-Galactose Treatment of Sperm With Antisperm Antibodies Results in Improved Pregnancy Rates Following in Vitro Fertilization

PROBLEM : To determine if chymotrypsin-galactose (CG) treatment of sperm bound with antisperm antibodies (ASA) improves pregnancy rates (PRs) following in vitro fertilization (IVF). METHOD : Patients with >50% ASA who failed to conceive despite six intrauterine insemination (IUI) cycles were included. Initially the sperm treatments were randomized with CG vs culture medium; subsequently only CG treatment was used. RESULTS : There was a significantly lower fertilization rate in those patients inseminated with sperm incubated in culture medium vs CG (27% vs 47%, P<.05 t-test). Similarly, a higher percentage of patients receiving culture medium treatment of sperm had failed fertilization (45%) compared to CG (11%). Though the clinical PRs were higher with CG (21%) than medium (9.5%), there was no statistical difference. CONCLUSIONS : Though the percentage of sperm bound with antibodies are not reduced, we hypothesize that the CG treatment improves fertility by possibly mitigating the antagonistic action of these antibodies.     

Humoral responses in mice following vaccination with DNA encoding glutathione S-transferase of Fasciola hepatica: effects of mode of vaccination and the cellular compartment of antigen expression

The humoral responses in mice following vaccination with DNA constructs encoding Fasciola hepatica glutathione S-transferase (GST) have been evaluated. GST47 cDNA was subcloned into two DNA vaccine vectors, VR1012 and VR1020, which direct expression to the cytoplasmic and extracellular compartments, respectively. Expression was confirmed by transfection into COS 7 cells. Groups of mice were vaccinated with these constructs, by either intramuscular injection with the VR1012-or VR1020-based constructs, or intradermal vaccination (with a gene gun) with the VR1020-based construct. Vaccination with the construct designed for secretion resulted in an increased humoral response compared to vaccination with the nonsecretory construct. The level of the total humoral response after vaccination with the secretion construct was not dependent on the route of vaccination. However, the isotype profile of the response differed between the groups; intramuscular vaccination with the construct directing cytoplasmic expression yielded an immuoglobulin (Ig)G2a dominant (Th1-type) response, intradermal vaccination with the secretory construct a IgG1/IgE dominant (Th2-type) response, and intramuscular vaccination with the secretory construct a mixed isotype response. These results demonstrate that the immunogenicity of a DNA vaccine based on Fasciola GST, as well as the isotype of the response against GST, is determined by the mode of vaccine administration.