Structural polymorphism of glycophorins demonstrated by immunoblotting techniques

We have explored the polymorphism of the glycophorin system in the human erythrocyte membrane using the immunoblotting techniques and examining 52 individuals selected without prior bias as to their serologic state and ten documented serologic variants of M, N, S, s blood group system. Polyclonal antisera to alpha glycophorin and to alpha glycophorin CNBr carboxyl terminal fragment C (residues 82-131) and M and N specific monoclonal antibodies (MoAbs) were used. The first two reagents detect specific regions of the alpha glycophorin molecule and all electrophoretically resolved species of glycophorins immunologically related to alpha and delta glycophorins (delta glycophorin, [alpha-delta] hybrids and other glycophorins with an alteration in the carboxyl terminal segment); the M and N MoAbs identified the glycophorin species containing or lacking the M or N determinant in the amino terminal octapeptide structures. We find that immunoblotting confirmed in all cases the serologically determined phenotype; we also find that polymorphic forms of the glycophorin system are relatively infrequent; immunoblotting, independent from serologic testing, was capable of detecting five mutants, two most likely S-s-U-phenotypes; a new glycophorin species was detected in normal red cells with both antiglycophorin and antipeptide C sera, which is not evident with MoAbs; immunoblots of known glycophorin variants (En(a-), U-, Mg, Mi I, II, III, V, and Sta) confirmed but also extended our knowledge of the abnormal glycophorins involved; and the He+ and Wrb(-) cells showed normal patterns.     

Chronic inflammatory demyelinating polyradiculoneuropathy associated intracranial hypertension

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated demyelinating neuropathy. In this report, we detail the course of a 58-year-old male patient who had headache and double vision followed by progressive paresthesia and difficulty in walking. The patient had bilateral papilledema and mild leg weakness, absent ankle jerks and loss of sensation in distal parts of his lower and upper extremities. His electromyography (EMG) was concordant with CIDP and lumbar puncture revealed high opening pressure. The polyradiculoneuropathy as well as the papilledema and elevated cerebrospinal fluid (CSF) pressure improved under steroids. The improvement in intracranial hypertension (IHT) and papilledema under steroid treatment suggests that the IHT in this patient might be associated with CIDP.     

Labor induction at term: a comparison of the effects of 50 microg and 25 microg vaginal misoprostol

PURPOSE OF INVESTIGATION: To compare the effects of 50 microg of vaginal misoprostol with 25 microg for labor induction at term. METHODS: One hundred and forty-seven pregnant women with indications for labor induction and cervical Bishop's score of < or = 6 were randomly assigned to receive either 50 microg (n = 74) or 25 microg (n = 73) of vaginal misoprostol every four hours until either a Bishop's score of > or = 8 or adequate uterine contraction frequency had been achieved. Induction-to-vaginal-delivery time was considered the primary outcome measure. RESULTS: Mean induction-to-vaginal-delivery time was significantly shorter in the 50-microg group than in the 25-microg group (526 +/- 141 min vs 745 +/- 218 min, respectively); oxytocin was administered to 65.8% of the patients in the 25-microg group and to 35.1% in the 50-microg group (p < .05). The incidence of tachysystole was significantly higher in the 50-microg group than in the 25-microg group (12% vs 2.7%, p < .05). We found no statistically significant difference between the two groups with respect to the rate of primary cesarean section, incidence of hyperstimulation syndrome, or neonatal outcome (p > .05). CONCLUSION: Fifty micrograms of vaginally administered misoprostol is an effective and inexpensive means of inducing labor at term. Uterine tachysystole may be associated more frequently with a 50-microg dose of vaginal misoprostol than with a 25-microg dose. Clinicians must accurately document the frequency and intensity of uterine contractions before every 50-microg dose of misoprostol is administered.     

Giant adrenal cyst in a pregnant woman: a case report

In this case report, a rare example of a pregnant woman with a huge adrenal cyst is reported. No other published reports were found to have an outcome like the present case. A 27-year-old primiparous patient admitted to our clinic with complaints of gaining weight, abdominal distension and dyspnea. On physical examination abdominal distension was prominent. She weighed 78 kg. At abdominal ultrasonography, there was an 11 week, single live fetus within the uterine cavity. There was also an approximately 30 x 40 cm sized cyst. The origin of the cyst could not be detected by ultrasonography and magnetic resonance imaging. It was suspected to originate from the ovaries. Tumor markers and other laboratory tests were normal. Laparotomy was planned. During laparotomy, it was observed that there was a huge, thin capsulated cystic lesion filling the abdomen. The uterus and bilateral ovaries were normal. Eleven liters of yellow-colored fluid was drained from the cyst. At exploration, the cyst capsule was originating from a right adrenal lodge and was extirpated. The postoperative weight of the patient decreased to 67 kg. On the third postoperative day, the patient was discharged without any problems. The pathology result of the patient was reported as an epithelial adrenal cyst. The patient did not have any problems on antenatal follow up and had a cesarean delivery at term for cephalopelvic disproportion. A 3500 g, healthy female fetus was delivered.     

Insulin and oral antidiabetic agents for treatment of polycystic ovary syndrome

Insulin plays a major role in polycystic ovary syndrome (PCOS). Insulin resistance and resultant hyperinsulinemia stimulate both the ovary and adrenal to produce androgens. Oral antidiabetic agents have been used to alleviate the symptoms and to induce ovulation in women with PCOS. This review focuses on the relation between insulin and PCOS and discusses the use of oral antidiabetic agents.