Early medical and surgical treatment of cryptorchidism: clinical,anatomic, and histologic findings

In 56 boys more than 6 month of age with cryptorchidism, luteinizing hormone releasing hormone (LHRH) was administered as a nasal spray 1.2 mg/day for 4 weeks. The nonresponders received human chorionic gonadotropin (HCG) 500 IU i.m. three times a week for 3 weeks. With the combined treatment, 46.5% of testes descended into the scrotum. Testicular descent occured more often in patients whose testes were located in a lower position. The initial position of the testes at clinical examination correlated significantly with the position at surgical inspection and the extent of epididymal malformation: the higher the clinical position of the testes, the more pronounced the maldescent and epididymal malformation. Histological findings indicated a paucity of germinal epithelium and atrophy of the Leydig cells. A significant inverse correlation existed between age at surgery and number of spermatogonia. Therefore, we advocate the earliest feasible treatment for cryptorchidism with a combination of LHRH and HCG, and for non-responders a surgical corrective procedure.     

Vasopressin and gonadotropin deficiency in a boy with the ectrodactyly-ectodermal dysplasia-clefting syndrome

A boy presented with ectrodactyly (lobster claw deformity), bilateral cleft lip and palate, semilobar holoprosencephaly and microcephaly, associated with congenital hypogonadotropic hypogonadism and central diabetes insipidus. Other aspects of pituitary function were normal. We suggest that the ectrodactyly-ectodermal dysplasia-clefting syndrome can be associated with a variety of hypothalamo-pituitary dysfunctions, in addition to the already described isolated growth hormone deficiency.     

Effects of a gonadotropin releasing hormone agonist on oocyte maturation,fertilization, and embryonal development in mice

Purpose The effects of a GnRH agonist (GnRHa) on oocyte quality were investigated by assessing the influence of GnRHa on oocytes, and fertilized oocytes were examined in vivo and in vitro. Administration of gonadotropin in conjunction with GnRHa induced a significantly greater degree of germinal vesicle breakdown, significantly higher rates of in vitro fertilization, and significantly faster development of the oocytes than with pregnant mare serum gonadotropin alone.Results The hatching-success rate in the GnRHa treated hypophysectomized mice was higher than in control mice. The rate of in vitro fertilization was also higher in oocytes cultured in the presence of low doses of GnRHa and these effects were reversed by a GnRH antagonist.Conclusion Oocytes obtained following ovarian stimulation with GnRHa were of higher quality than control oocytes, and the efficacy of GnRHa may be due in part to its direct action on the ovary.     

Gonadotropin hyperstimulation influences the35S-methionine metabolism of mouse preimplantation embryos

The effects of gonadotropin stimulation on mouse embryo uptake and incorporation of ³⁵ S-methionine were studied. We found that the uptake of ³⁵ S-methionine was reduced in embryos of stimulated females in both the two-cell and the blastocyst developmental stage. The incorporation of ³⁵ S-methionine into protein was not statistically significantly different between the embryos of stimulated and those of unstimulated females. Qualitatively, protein synthesis was equal in both groups as determined with one-dimensional SDS-PAGE. The results are discussed and we conclude that mouse embryo viability in vivo is decreased by ovarian stimulation.     

The day of initiation of human menopausal gonadotropin stimulation affects follicular growth in in vitro fertilization cycles

The attainment of synchronous follicular development in human menopausal gonadotropin/human chorionic gonadotropin-stimulated cycles for in vitro fertilization (IVF) continues to be a perplexing problem. Two regimens of follicle stimulation for IVF cycles were, therefore, compared. Twenty-nine patients commenced human menopausal gonadotropin (hMG) therapy on day I of the menstrual cycle (Group I), while 30 women received hMG from the third day of the cycle (Group II). The hMG therapy was tailored to the individual patients's response, based on ultrasonographic measurements of follicular size and serum estradiol (E₂) levels. Both groups of patients received a mean of 19.6±1.4 ampules of hMG over a mean of 6.1±0.2 days. The pattern of serum E₂ and progesterone levels in the periovulatory and luteal phase was not affected by the day of initiation of hMG therapy, although Group I patients demonstrated lower (P<0.05) E₂ levels on the 2 days prior to human chorionic gonadotropin (hCG) administration. In terms of follicle growth, Group II follicles consistently demonstrated a significantly (P<0.01,x ² test) larger proportion of medium- and large-sized follicles compared to Group I follicles on almost all of the days when ultrasonographic measurements were taken. In addition. Group II follicles demonstrated an earlier shift (day—1) to the larger follicles than Group I follicles (day 0). Significantly (P<0.001) more oocytes were recovered per uspirated follicle in Group II patients, but the fertilization rate per oocyte was greater (P<0.003) for Group I oocytes. Nevertheless, pregnancy rates did not differ between the two groups. It is suggested that a difference between the two groups of patients in the quantity or quality of gonadotropin receptor sites in the early part of the follicular phase may account for both the diminished E₂ production in the follicular phase and the persistent depressed follicular growth in Group I patients.     

Preliminary experince with a combination of clomiphene and variable dosages of menopausal gonadotropins for enhanced follicular recruitment

A combination of clomiphene citrate and human menopausal gonadotropin was employed for enhanced follicular recruitment in an in vitro fertilization program. All patients received 50 mg of clomiphene and 1 ampule of human menopausal gonadotropin daily from cycle day 5 through cycle day 9. Follicular monitoring was begun on day 10 using a combination of ultrasound measurement of follicular size and number and determination of peripheral estradiol levels. Based on the size and number of follicles, the peirpheral levels of estradiol, and the rate of follicular growth and increase in estradiol, human menopausal gonadotropin was continued at a dosage of 1 to 3 ampules/day through the day of human chorionic gonadotropin administration. Human chorionic gonadotropin was administered on the evening of the day the largest follicle reached or exceeded 20 mm in mean diameter if the estradiol levels had been rapidly rising or reaching a plateau and had exceeded a minimal level of 300 pg/ml. Using this protocol, 30 of 33 patients underwent laparoscopy, 29 patients had successful oocyte recovery, and 23 patients underwent embryo replacement, with the establishment of six clinical pregnancies.     

Sex-specific patterns of galanin,cholecystokinin, and substance P expression in neurons of the principal bed nucleus of the stria terminalis are differentially reflected within three efferent preoptic pathways in the juvenile rat

Neurons in the principal bed nucleus of the stria terminalis (BSTp) integrate hormonal and sensory information associated with reproduction and transmit this information to hypothalamic nuclei that regulate neuroendocrine and behavioral functions. The neuropeptides galanin (GAL), cholecystokinin (CCK), and substance P (SP) are highly expressed in BSTp neurons and are differentially regulated by sex steroids. The current experiments investigated whether developmental or peripubertal hormone-mediated changes in GAL, CCK, and SP expression are reflected within efferent pathways to the preoptic structures that regulate gonadotropin secretion and sexual behavior. Anterograde labeling of projections from the BSTp of male and female juvenile rats combined with immunohistochemical labeling of GAL-, CCK-, and SP-containing fibers in the anteroventral periventricular preoptic nucleus (AVPV) and the central and medial divisions of the medial preoptic nucleus (MPNc, MPNm, respectively) revealed unique sex differences in each region. In the AVPV, Phaseolus vulgaris leucoagglutinin-labeled fibers were seen at a greater density in males than in females, and higher percentages of these fibers contained GAL in males than in females. In contrast, fibers projecting from the BSTp to the MPNc were more likely to contain SP in females than in males. Treatment of gonadectomized, peripubertal males and females with exogenous testosterone and estradiol did not alter the densities of GAL-, CCK-, or SP-containing fibers in any of the three brain areas examined. Collectively, these results suggest that patterns of neuropeptide expression in BSTp projections are established during development, resulting in a distinct, stable, and sex-specific chemoarchitectural profile for each projection pathway.     

Enhancement of radiosensitivity of the MCF-7 breast cancer cell line with human chorionic gonadotropin

Secretion of human chorionic gonadotropin (hCG) during pregnancy induces differentiation of the mammary gland, thereby making breast tissue less susceptible to carcinogenesis. HCG binds to specific hCG receptors on mammary epithelial cells inducing changes in gene expression that can inhibit cell proliferation and, therefore, interfere with tumorigenesis. Since breast cancer cells also contain a relatively high level of the hCG receptor, hCG has potential as a therapeutic agent. We postulated that hCG might also enhance the radiosensitivity of breast cancer cells and, therefore, be useful as an adjunctive therapy. In the present study, MCF-7 breast cancer cells grown in cell culture were treated with hCG (0.2–5IU/ml) for 24h prior to exposing the cells to 0 Gy, 3Gy, 4Gy, or 5Gy of radiation. Following irradiation, the MCF-7 cells were incubated either in the presence or absence of hCG. Cell survival was monitored with an MTT assay 1 day, 4 days, and 7 days after irradiation. All of the concentrations of hCG tested enhanced radiosensitivity of MCF-7 cells. The maximum enhancement occurred with MCF-7 cells that had been exposed to 2IU/ml of hCG for at least 24h prior to irradiation with 4Gy. The use of higher concentrations of hCG or a higher dose of radiation did not increase the enhancement effect. Treatment of MCF-7 cells with hCG for only 24h was sufficient to achieve the maximum effect. However, maintaining the cells in hCG beyond 24h increased the effectiveness of the lowest hCG concentration. Using a linear-quadratic equation to analyze the data, we determined that the use of hCG would result in an 8–10% reduction in MCF-7 cell survival at a dose of 2Gy, a typical dose used in conventional cancer therapy.     

绝经后女性脑梗死患者血清垂体促性腺激素、催乳素的检测及其意义

目的探讨血清促卵泡刺激素(FSH)、黄体生成素(LH)及催乳素(PRL)在绝经后女性脑梗死患者发病过程中的变化特点及其意义。方法采用放免法动态测定110例绝经后女性脑梗死患者血清FSH、LH及PRL的水平。分析其与病程、病情、梗死范围及梗死部位的关系。结果①绝经后女性脑梗死患者急性期血清FSH、LH值下降,PRL值升高,与恢复期及对照组比较,差异有统计学意义(P<0.01);恢复期血清FSH、LH及PRL值与对照组比较,差异无统计学意义(P>0.05)。②急性期中、重型组血清FSH、PRL值明显高于轻型组(P<0.05),二组间血清LH差异无统计学意义(P>0.05)。③梗死范围≥2cm×2cm×2cm组血清PRL明显高于梗死范围<2cm×2cm×2cm组(P<0.05);二组间血清FSH、LH差异无统计学意义(P>0.05)。④急性期皮质组、皮质下组、混合组比较,血清FSH、LH及PRL值差异无统计学意义(P>0.05)。结论绝经后女性脑梗死患者急性期存在垂体促性腺激素(FSH、LH)及PRL的紊乱,而随着疾病的恢复趋于正常。且这种紊乱不受梗死部位的影响,除PRL外也不受梗死范围影响,而与病情程度密切相关。     

早期自然流产中卵泡休止素的变化及与HCG的相关研究

目的:探讨早期自然流产中卵泡休止素(FS)的变化,比较其与人绒毛膜促性腺激素(HCG)有无相关性以及FS的高低与妊娠结局有无关系.方法:应用酶联免疫法对早期自然流产孕妇、正常早期妊娠孕妇血清FS进行测定,用放射免疫法对上述2组妊娠42～43 d的孕妇进行HCG测定.结果:早期自然流产孕妇组血清FS和HCG水平明显低于正常早期妊娠孕妇组(P＜0.01),保胎失败孕妇组血清FS水平明显低于保胎成功孕妇组(P＜0.01),FS与HCG的变化在早期自然流产及正常早期妊娠中均呈正相关.结论:血清FS水平的变化参与了早期妊娠的维持,FS减少容易引起早期自然流产,FS值的高低决定了早期自然流产的妊娠结局.