Five years' experience of intrauterine contraception with the Nova-T and the Copper-T-200

A randomized study was performed for the comparison of two copper-releasing intrauterine contraceptive devices (IUDs), the Nova-T and the Copper-T-200, simultaneously in Denmark, Finland, and Sweden. Five years' experience demonstrated that Nova-T users had a significantly lower pregnancy rate than Copper-T-200 users. The Pearl index over 5 years was 0.8 for Nova-T users and 2.0 for Copper-T users. The performance and tolerance of the Nova-T were less affected by parity and age than was the performance of the Copper-T. Infections were treated by removal of the device and with antibiotics. The cumulative rate of removals because of infections and suspected infections was below 5 with both devices over 5 years. The copper wire in the Nova-T has a silver core which prevents corrosion-induced fragmentation of the wire. Hence, the effective lifetime of this device is more than 5 years. The results indicate that the Nova-T, which is easy to insert and remove and is associated with a low pregnancy rate and a low medical termination rate, is a real improvement over other IUDs.     

Continuous milrinone infusion during preoperative anti-inflammatory therapy in inflammatory aortic aneurysm complicating severe congestive heart failure

We report a 48-year-old man with inflammatory aortic aneurysm in the ascending aorta complicating severe heart failure due to massive aortic regurgitation. Continuous intravenous milrinone infusion was highly effective in reducing pulmonary arterial pressure and improving subjective symptoms during preoperative anti-inflammatory corticosteroid therapy over 7 weeks without any adverse effects or tolerance. Bentall's operation with a valved conduit was successfully performed after complete stabilization of inflammatory markers, and then milrinone was tapered off uneventfully. We consider that continuous milrinone infusion may be suitable for patients with surgically correctable inflammatory cardiovascular diseases complicating severe heart failure in whom maintenance of optimal hemodynamics is necessary for several weeks during preoperative anti-inflammatory corticosteroid therapy. Received: April 11, 2002 / Accepted: June 15, 2002 Correspondence to Y. Goto     

A novel steroid from Tylophora atrofolliculata Metc

A novel steroid, tylophoriside A, was isolated from Tylophora atrofolliculata Metc. The structure was elucidated on the basis of spectroscopic methods and X-ray diffraction.     

Progesterone attenuates the effect of the 5-HT1A receptor agonist, 8-OH-DPAT,and of mild restraint on lordosis behavior

Ovariectomized, hormone-primed rats were used to test the hypothesis that progesterone treatment attenuated the effects of the 5-HT(1A) receptor agonist, (+/-)-8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), on female rat lordosis behavior. Based upon prior evidence that prepriming with estradiol benzoate (EB) reduced the ability of 8-OH-DPAT to inhibit lordosis behavior, rats were preprimed with 10 microg EB 7 days before a second priming with 10 microg EB followed 48 h later with 500 microg progesterone or vehicle. Independent of the presence of progesterone, prepriming with EB attenuated the lordosis-inhibiting effects of systemic treatment with 8-OH-DPAT. However, progesterone also reduced the effects of 8-OH-DPAT and this effect was also seen in females primed only once with EB. In contrast, progesterone was relatively ineffective in attenuating the effects of bilateral infusion with 8-OH-DPAT into the ventromedial nucleus of the hypothalamus (VMN). The failure of progesterone to substantially reduce the effects of VMN infusion with 8-OH-DPAT contrasts with prior studies in which estrogen's protective action against the drug did include the VMN. Thus, while both estrogen and progesterone reduce the lordosis-inhibiting effect of 8-OH-DPAT, the mechanisms responsible for the effects of the two gonadal hormones may be different. Priming with progesterone also prevented the effects of 5 min of restraint. When rats were hormonally primed with EB and oil, rats showed a transient, but significant, decline in lordosis behavior 5 and 10 min after restraint. Rats primed with EB and progesterone were unaffected by the restraint. These results are discussed in terms of their implications for the role of progesterone in altering the 5-HT(1A) receptor modulation of lordosis behavior.     

Enhancing effects of estrogen on inhibitory avoidance performance may be in part independent of intracellular estrogen receptors in the hippocampus

Estradiol (E(2)) can have classical actions via intracellular estrogen receptors (ERs) in the dorsal hippocampus, as well as effects independent of ERs ('non-genomic' mechanisms). These experiments investigated whether E(2)'s cognitive enhancing effects in the inhibitory avoidance task require actions at ERs in the dorsal hippocampus. Ovariectomized (ovx) rats were administered E(2) (s.c. or to the dorsal hippocampus), an E(2) conjugate (E(2):BSA), or vehicle and/or an ER antagonist, tamoxifen (10 mg/kg s.c.) or ICI 182,780 (10 microg intrahippocampally), or vehicle for 2 days prior to training (Day 3) and testing (Day 4) in the inhibitory avoidance task. Exp 1: crossover latencies in the inhibitory avoidance task were significantly increased in ovx rats with s.c. E(2) silastic capsules or s.c. injections of 1000 or 10 microg E(2) compared to vehicle-administered rats. Exp 2: bilateral inserts of E(2) to the dorsal hippocampus significantly increased crossover latencies compared to vehicle. Exp 3: s.c. tamoxifen, the ER antagonist, did not block the increased crossover latencies produced by 10 microg E(2) s.c. (compared to vehicle). Exp 4: s.c. tamoxifen did not block the increased crossover latencies produced by intrahippocampal E(2) (compared to vehicle). Exp 5: ICI 182,780 was unable to attenuate the increased crossover latencies produced by intrahippocampal E(2). Exp 6: E(2):BSA administered to the dorsal hippocampus significantly enhanced performance on the inhibitory avoidance task compared to control implants to the hippocampus. The ability of systemic and intrahippocampal E(2) to similarly enhance inhibitory avoidance performance suggests that actions of E(2) in the dorsal hippocampus are sufficient to enhance cognitive performance. Further, that neither tamoxifen nor ICI 182,780 blocked E(2)'s enhancing effects on inhibitory avoidance and that E(2):BSA was able to enhance performance suggest that non-genomic mechanisms may in part mediate E(2)'s cognitive enhancing performance in this task.     

高压氧对兔激素性股骨头坏死的血液流变学影响

目的:通过检测兔激素性股骨头坏死造模及高压氧治疗过程中的血液流变学变化,探讨激素性股骨头坏死的发病机理。方法:健康日本成年大耳白兔48只,随机分模型组(36只)及对照组(12只)。模型组每周2次肌肉注射醋酸泼尼松龙10 mg/kg,对照组每周2次肌肉注射生理盐水2 m l,共6周。随后将模型组随机分高压氧治疗组(12只)及对照组(12只),治疗组行高压氧治疗,对照组呼吸常压新鲜空气。检测试验后2周、4周、6周、8周、10周、12周兔血液流变学参数变化、观察组织形态学变化。结果:模型组实验2、4、6周全血粘度、血浆粘度均显著高于对照组;股骨头骨质疏松,镜下空骨陷窝数和脂肪细胞数逐渐增多,骨细胞体积缩小,核固缩。高压氧治疗后全血粘度、血浆粘度均低于对照组,坏死的骨细胞有修复现象,并可见新生骨细胞。结论:大剂量激素可造成兔血流变学特性恶化,可能是兔股骨头坏死的重要原因之一;高压氧可使恶化的血液流变学趋向好转,对股骨头坏死有一定治疗作用。     

Growth and renal function after steroid-free tacrolimus-based immunosuppression in children with renal transplants

Steroid withdrawal after renal transplantation and cyclosporine-based immunosuppression enhances growth in children, but this practice is not widely employed because of a 50%–60% rate of rejection, graft dysfunction, or graft loss. The current study evaluates growth and renal function after withdrawal and discontinuation of steroids within 1 year of transplantation in 52 children receiving tacrolimus (FK-506)-based immunosuppression. Height Z-score, weight-for-height index (WHI), and body mass index (BMI), as well as graft loss and calculated creatinine clearance as a measure of glomerular filtration rate (GFR), were assessed. Children were divided into three groups according to age at transplantation: group I, 16 children aged 0–5 years; group II, 17 children aged 6–12 years; group III, 19 children aged 13–16 years. Significant and sustained improvement in height occurred in groups I and III, with Z-scores increasing by 1.51 and 1.57 standard deviations at 3 years after transplantation compared with the Z-score at transplantation (P<0.02). Mean WHI values remained near 100% in groups I and III, and significantly increased above 100% only in group II at 2 years after transplantation. Although actual BMI scores improved significantly in groups II and III at both 2 and 3 years post transplantation (P<0.05), when BMI scores were adjusted for height age, none of these groups had values >95% denoting obesity. Failure of steroid withdrawal, defined as reinstitution of steroids, graft dysfunction, or graft loss, occurred in 9 of 68 (13%) children who underwent steroid withdrawal at any time after transplantation, and resulted in graft dysfunction or graft loss in 5 (7%). Over a 3-year period, rates of renal dysfunction, as manifested by >50% rise in the serum creatinine level above baseline, or graft loss were lower in these 68 children compared with 8 children who never had steroid withdrawal (P<0.05). Mean GFR at 3 years after transplantation ranged from 96 to 102 ml/min per 1.73 m² in all three steroid withdrawal groups, and remained stable during the 3 years of follow-up. These data indicate that steroid withdrawal enables normalization of growth without obesity, and without imposing an excessive risk for graft dysfunction or graft loss. Received: 29 March 1999 / Revised: 23 December 1999 / Accepted: 2 January 2000     

肾病综合征患儿肾组织原位血管紧张素转换酶mRNA表达与激素疗效关系的研究

目的　探讨肾病综合征 (NS)患儿肾脏局部肾素 血管紧张素系统 (RAS)、激素耐药、肾脏病理损害程度之间的关系 ,阐述激素耐药的部分机制。方法　 85例原发性NS患儿按激素敏感型NS(SSNS)、激素依赖型NS(SDNS)、激素耐药型NS(SRNS)分成 3组 ,选 6例行肾切除的肾肿瘤患儿的正常肾组织作为对照组。采用原位杂交的方法检测 4组患儿肾脏原位血管紧张素转换酶 (ACE)mRNA的表达水平 ;评分法半定量评估肾脏的病理损害程度。分析NS患儿肾组织ACEmRNA表达水平、激素反应性、肾脏的病理损害程度间的关系。结果　①在肾小球和小管间质区域的ACEmRNA表达水平均为SRNS组 >SSNS组 >对照组 (P <0 0 1)。②SRNS、SDNS、SSNS肾小球病理损害的评分分别为 :6 6 7± 2 4 3,4 6 8± 2 30 ,4 4 2± 2 87(P <0 0 1) ;小管间质病理损害评分分别为 :10 4 8± 3 77,7 2 0± 2 79,4 2 5± 1 4 8(P <0 0 1)。③肾组织ACEmRNA的表达与肾小球和小管间质病理损害程度呈正相关 ,相关系数分别为 0 4 82 ,0 85。结论　SRNS型NS患儿肾组织ACEmRNA表达增强 ,并且与肾脏的病理损害程度密切相关     

Testosterone modulates the dendritic architecture of arcuate neuroendocrine neurons in adult male rats

Recent studies have demonstrated that gonadectomy of adult male rats induces dendritic growth of neuroendocrine neurons in the arcuate nucleus. We have hypothesized that these changes are secondary to the loss of testosterone negative feedback. In the present study, we examined the effects of testosterone replacement on the dendritic morphology of arcuate neuroendocrine neurons in castrated rats. Rats were orchidectomized and implanted with silastic capsules designed to produce physiological levels of plasma testosterone (n=9) or empty silastic capsules (n=9) for 2 months. Retrograde labeling with systemically injected Fluoro-Gold, followed by intracellular injection of labeled neurons in a fixed slice preparation, were used to visualize arcuate neuroendocrine neurons. Quantitative analysis of dendritic morphology was performed using three-dimensional computer reconstruction. Serum levels of LH (luteinizing hormone) and testosterone were measured by radioimmunoassay. Treatment of castrated rats with physiological levels of testosterone significantly reduced dendritic length, volume and terminal branch number relative to the castrated rats receiving empty silastic capsules. Dendritic spine density was also greater in the testosterone-treated animals, although the total numbers of spines per dendrite was not significantly different between the two groups. In addition, testosterone replacement was effective in reducing serum LH to levels found in intact rats. These studies demonstrate that testosterone replacement suppresses the dendritic outgrowth of arcuate neuroendocrine neurons that occurs in response to castration. The parallel changes in dendritic arbor and serum LH after castration and hormone replacement suggests that the suppressive effects of testosterone are related to steroid negative feedback.