Role of estradiol-17 beta and progesterone in regulating constriction of ovine uterine arteries

Fistulas between the abdominal aorta and renal vein are exceedingly rare. Diagnostic delays are not unusual. Correction can be extremely difficult because of anatomical distortion and size of the arterialized veins. A young woman with such a fistula following a gunshot wound is presented. Four years following injury, the fistula was repaired successfully during intentional arrest of the circulation for 7 minutes. This was accomplished with deep hypothermia and cardiopulmonary bypass. No serious problems occurred during the operation. The patient tolerated the procedure well and has been relieved of her symptoms completely. Most patients with traumatic or spontaneous arteriovenous fistulas can be managed safely and effectively by conventional operative techniques. In selected situations, the risk of total circulatory arrest and deep hypothermia may be less than the risk of uncontrollable bleeding inherent in conventional techniques. Suggested indications for use of total circulatory arrest in vascular surgery are (1) inability to achieve vascular control by more conventional means, (2) massive distention of regional veins as occurrs in well established fistulas of the trunk, (3) one or more prior corrective attempts with use of conventional techniques, and (4) anticipated anatomical distortion and/or multiple abnormal vascular communications. This technique is a valuable approach to the correction of otherwise inoperable cardiovascular lesions.     

Plasma concentrations of unconjugated estrone, estradiol-17beta and estriol, and HCS throughout pregnancy in diabetics and gestational diabetics

Plasma unconjugated estrone (E1), estradiol-17beta (E2) and estriol (E3), and HCS were measured in the same plasma samples collected throughout pregnancy in 19 gestational diabetics (GD) and 21 diabetics (D). When compared to the results obtained in 22 normal subjects, plasma levels of E1 and E2 were significantly elevated in D in the second half of gestation. The results were intermediate although closer to the normals, in GD. E3 values were not different from the normals in both D and GD. HCS values were lower than normal in early pregnancy in both D and GD. In late pregnancy HCS levels were not different from normal in either D or GD, although some individual values were much above the upper limit in some diabetic patients. The hormonal ratios in D and GD parallel those in normals, although E3/E2 and HCS/E2 were lower in D. These results are discussed with respect to the different behaviour of E2 and E3, taking into account the difference in their respective biosynthetic pathways. Besides a possible quantitative modification of the placental function in D, the results could tentatively be explained by a qualitative change in the fetal estrogen precursors to placental aromatization, in favour of the 16 non-hydroxylated compound. However, maternal modifications in precursor production or in estrogen metabolism can be an alternative hypothesis. Finally, the present work does not support the hypothetical estrogen deficiency in diabetic pregnancy. Estrogen treatment appears to have no objective justification.     

Increase in transforming growth factor beta1 in ovarian follicular fluid following ovarian stimulation and in-vitro fertilization correlates to pregnancy

Talin, an actin-binding protein from smooth muscle, is shown to bind to myosin in such a way that it stimulates the ATPase activity of myosin irrespective of the phosphorylation state of myosin. The binding site is shown to be localized at the N-terminal, 47 KDa fragment. The position of the actin-binding site at the C terminal suggests that talin may work as a crosslinker between myosin and actin.     

Changes in serum triiodothyronine, thyroxine, estradiol-17 beta, progesterone levels and egg production in hypocholesterolemia induced Japanese quails Coturnix coturnix japanica

Mature healthy female Japanese quails injected (i.p.) with gemfibrozil at two dose levels for 1,2,3 and 4 weeks induced hypocholesterolemia as observed by the serum cholesterol concentration which was more severe with the higher dose. Liver and ovarian cholesterol contents decreased in 3rd and 4th week of the treatment. Significant (P > 0.05) increase in serum triiodothyronine (T3) and thyroxine (T4) level were observed between 3rd and 4th week while serum estradiol-17 beta and progesterone levels declined continuously from Ist week till the termination of the treatment. The quantity and quality of the eggs produced by the treated quails were inferior. These results indicate that induction of hypocholesterolemia impaired the reproductive efficiency of quails.     

Soluble intercellular adhesion molecule-1 in ovarian follicles: production by granulosa luteal cells and levels in follicular fluid

OBJECTIVE: To determine the concentration of the soluble form of intercellular adhesion molecule (ICAM)-1 in granulosa luteal cell-conditioned media and in follicular fluid (FF). DESIGN: Granulosa cells and FF samples were obtained at the time of oocyte retrieval for IVF. In 10 women, a total of 33 fluids were obtained from individual follicles, whereas in 70 women, the follicular aspirates were pooled. SETTING: Clinica "L. Mangiagalli" and Reproductive Center, San Raffaele Hospital, Milan, Italy. PATIENT(S): Eighty women referred for IVF for tubal factor or male factor infertility. INTERVENTION(S): Women underwent ovarian hyperstimulation. MAIN OUTCOME MEASURE(S): Soluble ICAM-1 was measured by an ELISA, and its levels were correlated with follicular size, the number of retrieved oocytes, and the number of follicles with a diameter of >15 mm. RESULT(S): The concentration of soluble ICAM-1 in granulosa luteal cell-conditioned media was 17.8 +/- 1.8 ng/5 x 10(5) cells. Interleukin-1beta can stimulate soluble ICAM-1 release in a dose-dependent manner. A significant positive correlation was demonstrated between levels of soluble ICAM-1 in pooled FF and the number of retrieved oocytes or the number of follicles with a diameter of >15 mm. CONCLUSION(S): Soluble ICAM-1 can be released by granulosa luteal cells and can be detected in FF after ovarian hyperstimulation. Levels of soluble ICAM-1 in FF correlate directly with some indices of ovarian function.     

Studies on human sexual development. V. Concentrations of testosterone, 17-hydroxyprogesterone and progesterone in human amniotic fluid throughout gestation

Concentrations of unconjugated testosterone, 17-hydroxyprogesterone (170HP) and progesterone were measured by radioimmunoassay in amniotic fluid (AF) specimens from normal pregnancies of 9-40 weeks gestation. In two-thirds of samples from pregnancies with male fetuses. AF testosterone exceeded the upper limit found in female samples, with minimal overlap in the 12-18 week period of gestation. Although AF testosterone levels associated with male and female fetuses were both significantly lower toward term, the sex-difference persisted. Between 9-19 weeks gestation, fetal sex was also found to influence AF 170HP, a steroid thought to be predominantly of placental and fetal adrenal origin; in this case, female levels exceeded male. Awareness of the influence of sex and gestation upon AF concentrations of these steroids is an important prerequisite for their application to the prenatal diagnosis of endocrine disease (e.g., congenital adrenal hyperplasia). There was no sex difference in AF progesterone concentrations at 12-18 weeks gestation. The median progesterone concentration at 34-40 weeks was higher with female fetuses, but this difference may be related to a difference in gestational age between AF samples obtained from male and female fetuses.     

Effect of estradiol-17 beta on basal and hCG stimulated progesterone secretion by porcine luteal cells isolated in various stages of the luteal phase

T cells of mice display V beta-specific reactivity for a spectrum of mouse mammary tumor virus (Mtv) antigens; confrontation with these antigens during ontogeny causes substantial "holes" in the T cell repertoire. Since endogenous Mtv antigens are rare in other species, the question arises whether V beta-specific recognition of Mtv antigens is unique to mice. To examine this question, rat T cells were allowed to differentiate from stem cells in severe combined immunodeficiency (SCID) mice. These rat-->mouse xenochimeras were prepared under a variety of conditions. The results show that rat T cells are strongly reactive to mouse Mtv antigens, both in terms of tolerogenicity and immunogenicity. In fact, the V beta specificity of rat and mouse T cells for Mtv antigens is almost indistinguishable.     

Quantification of receptors for estradiol-17 beta and progesterone in the pituitary and hypothalamus of prepubertal gilts induced to ovulate with pregnant mare's serum and human chorionic gonadotropin

Nuclear and cytoplasmic exchange assays were developed and validated to quantify receptors for estradiol-17 beta (E217 beta) and progesterone (P4) in hypothalamic and pituitary tissues of gilts before, during, and after treatment with pregnant mare's serum (PMS) and human chorionic gonadotropin (hCG). Prepubertal gilts, 5 months old, were assigned randomly to four treatments. One group of gilts received 500 IU PMS (Day 0) and were sacrificed 2 days later (2 days post-PMS); another group received 500 IU PMS on Days 0 and 2, and were sacrificed 4 days from the initial injection (4 days post-PMS). A third group of gilts received PMS (500 IU) on Days 0 and 2, 1000 IU hCG on Day 4, and were sacrificed 5 days after hCG (5 days post-hCG). Controls were given saline on Days 0, 2 and 4 and sacrificed on Day 6. In pituitary tissues, there were no significant changes in numbers of cytoplasmic E2 17 beta receptors, cytoplasmic P4 receptors, nuclear P4 receptors or nuclear E2 17 beta receptors among the control, 2 days post-PMS, 4 days post-PMS or 5 days post-hCG treatment groups. In hypothalamic tissues, no differences in cytoplasmic E2 17 beta receptors, cytoplasmic P4 receptors or nuclear P4 receptors were found among any of the treatments. Nuclear receptors for E2 17 beta in hypothalamic tissues were greater, however, in gilts 2 days post-PMS (P less than 0.05) than in controls or 5 days post-hCG gilts, but they were not different from gilts 4 days post-PMS. Follicular development and serum concentrations of E2 17 beta followed the expected patterns after PMS; only ovaries from hCG-treated pigs contained corpora lutea. Because the PMS-hCG regimen simulated the onset of puberty, it seems that gilts attain puberty without a significant change in the number of receptors for E2 17 beta and P4 in the pituitary or hypothalamus.     

17beta-Estradiol, progesterone, and testosterone inversely modulate low-density lipoprotein oxidation and cytotoxicity in cultured placental trophoblast and macrophages

OBJECTIVES: We have previously shown that low-density lipoprotein oxidation is diminished by 17beta-estradiol and enhanced by progesterone and testosterone. In these experiments we wished to learn whether sex hormone effects on low-density lipoprotein oxidation alter placental cell viability in primary tissue culture. STUDY DESIGN: Primary tissue culture of human term placental cells was performed. RESULTS: Addition of 17beta-estradiol decreased low-density lipoprotein oxidation (measured as lipid peroxides, thiobarbituric acid-reacting substances, and low-density lipoprotein electrophoretic mobility) and placental cell toxicity (measured as chromium 51 release) with maximum reductions of 28% (macrophages) (p < 0.05) and 26% (trophoblasts) (p < 0.01). Conversely, progesterone and testosterone increased low-density lipoprotein oxidation and chromium 51 release, the latter a maximum of 28% and 18%, respectively, for progesterone and testosterone in macrophages (p < 0.05 in both instances) and 23% in trophoblasts (p < 0.05, testosterone only). Collectively, cytotoxicity was proportional to low-density lipoprotein oxidation and estradiol, progesterone, and testosterone concentrations. CONCLUSIONS: Estradiol inhibits placental macrophage- and trophoblast-mediated low-density lipoprotein oxidation and cytotoxicity, whereas progesterone and testosterone promote these effects. Sex steroid hormones may modulate the effects of oxidative stress on placental function in pregnancy.     

Suppression of apoptosis by gonadotropin, 17beta-estradiol, and epidermal growth factor in rainbow trout preovulatory ovarian follicles

In this study we present the first evidence for the occurrence of apoptotic cell death in ovarian follicles from teleost fish. Preovulatory ovarian follicles from mature hatchery-raised rainbow trout (Oncorhynchus mykiss) were collected and either immediately frozen in liquid nitrogen or incubated in serum-free medium at 18 degrees for 24 hr. The extent of ovarian apoptotic DNA fragmentation was determined using 3'-end labeling of DNA with [32P]dideoxy-ATP, size fractionation by agarose gel electrophoresis, and quantification of low-molecular-weight (<15 kb) DNA using autoradiography and liquid scintillation counting. The extent of apoptotic DNA fragmentation was eightfold greater in immediately frozen preovulatory follicles than in previtellogenic ovarian follicles collected from immature rainbow trout (P < 0.05), suggesting differences in the degree of apoptosis at different stages of follicular development. In preovulatory trout follicles, the extent of apoptotic DNA fragmentation was fivefold greater in follicles incubated for 24 hr. Treatment of incubated preovulatory follicles with either partially purified salmon gonadotropin SG-G100 (1 microg/ml) or epidermal growth factor (EGF; 100 ng/ml) suppressed apoptotic DNA fragmentation by 31 and 41%, respectively, in comparison to untreated incubated follicles (P < 0.01). Treatment of incubated follicles with 17beta-estradiol (1-100 ng/ml) caused a concentration-dependent suppression of apoptotic DNA fragmentation (P < 0.05). These results suggest that apoptosis is involved in teleost ovarian development and that several of the hormonal factors acting as follicle survival factors in mammalian and avian ovaries may play a similar role in teleost ovarian follicles.     

Biological day-to-day variation and daytime changes of testosterone, follitropin, lutropin and oestradiol-17beta in healthy men

The Alberta Infant Motor Scale (AIMS) is a norm-referenced measure of infant gross motor development. The objectives of this study were: (1) to establish the best cut-off scores on the AIMS for predictive purposes, and (2) to compare the predictive abilities of the AIMS with those of the Movement Assessment of Infants (MAI) and the Peabody Developmental Gross Motor Scale (PDGMS). One hundred and sixty-four infants were assessed at 4 and 8 months adjusted ages on the three measures. A pediatrician assessed each infant's gross motor development at 18 months as normal, suspicious, or abnormal. For the AIMS, two different cut-off points were identified: the 10th centile at 4 months and the 5th centile at 8 months. The MAI provided the best specificity rates at 4 months while the AIMS was superior in specificity at 8 months. Sensitivity rates were comparable between the two tests. The PDGMS in general demonstrated poor predictive abilities.     

Effect of an ovulatory dose of luteinizing hormone on the concentration of oestrone, oestradiol and progesterone in the rabbit ovarian follicles

This study was done to determine the effect of an ovulatory dose of LH on the concentration of oestrone, oestradiol and progesterone in the follicular tissue and in follicular fluid of ovaries of sexually mature female rabbits. Eight animals were sacrificed without treatment while others (4 to a group) were sacrificed at 1, 3, 4, 6, 8 and 10 h after administration of LH (50 mug). In each animal follicles from both ovaries were pooled and the follicular tissue was separated from the fluid. Determination of oestrone, oestradiol and progesterone was done by radioimmunoassay separately in the follicular tissue and in fluid. One hour after LH treatment oestrogen levels were found elevated, as compared to the control, in the fluid but not in the tissue. Thereafter oestrogen levels declined and reached levels much below control at times nearing ovulation. On the other hand, progesterone levels were elevated over the control in both the tissue and fluid at 1 and 3 h. The tissue progesterone levels were, however, below control at and after 6 h. The sustained high concentrations of tissue progesterone in the earlier period after LH stimulation could play a role in the chain of events leading to follicular rupture.     

Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 concentrations in cerebrospinal fluid predict ventriculoperitoneal shunt infection

OBJECTIVE: To determine the diagnostic value of cerebrospinal fluid tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, and IL-6 released into the cerebrospinal fluid of patients with ventriculoperitoneal shunt infection. DESIGN: Prospective, observational study. SETTING: University teaching hospital. PATIENTS: Sixty-four patients requiring cerebrospinal fluid aspiration for suspected ventriculoperitoneal shunt malfunction. INTERVENTIONS: Cerebrospinal fluid samples were obtained by shunt aspiration at the time of patient presentation. MEASUREMENTS AND MAIN RESULTS: TNF-alpha and IL-1 beta concentrations were measured by enzyme-linked immunosorbent assay, and IL-6 activity by bioassay. The sensitivity, specificity, predictive values, and overall efficiency for each cytokine were determined based on the cerebrospinal fluid culture results. Ten patients had positive cerebrospinal fluid cultures, eight of which yielded Staphylococcus species, and one each Acinetobacter and Pseudomonas. Cerebrospinal fluid TNF-alpha, IL-1 beta, IL-6, protein, and leukocyte concentrations were significantly increased in patients with shunt infection. Cerebrospinal fluid IL-6 activity had the highest diagnostic accuracy of the cytokines evaluated, with sensitivity of 80% and specificity of 98%. CONCLUSIONS: The presence of cerebrospinal fluid inflammatory cytokines strongly suggests ventriculoperitoneal shunt infection. Detection of these cytokines in the cerebrospinal fluid could be used for earlier diagnosis of bacterial infection.     

Substitution with testosterone as aromatizable substrate for induction of follicular maturation, estradiol production and ovulation in a patient with 17 alpha-hydroxylase deficiency

17 alpha-Hydroxylase Deficiency (17 alpha-OHDS) is a rare defect of steroid biosynthesis, characterized by the inability to synthesize cortisol, androgens or estrogens, by the complete absence of follicular maturation, hypergonadotropic hypogonadism, primary amenorrhea and hypertension. Since the ovaries of such patients contain numerous primordial follicles, we hypothesized that the absence of spontaneous follicular maturation could be due to a lack of aromatizable substrate. To provide this substrate, testosterone was administered either by intra-ovarian injection or by vaginal administration. Ovarian stimulation was performed with human urinary gonadotropins. Follicular maturation and ovulation could be induced by this treatment, as determined from ultrasonography, the analysis of LH, estradiol and progesterone serum levels and the aspiration of oocytes from the mature follicles. Fertilization of these oocytes in vitro, however, did not succeed. We conclude that follicular maturation can be induced in 17 alpha-OHDS by gonadotropins when testosterone is provided as an aromatizable substrate and that estrogens are a necessary component of follicular maturation.     

Human chorionic gonadotrophin and steroid concentrations in follicular fluid: the relationship to oocyte maturity and fertilization rates in stimulated and natural in-vitro fertilization cycles

The study investigates the relationship of follicular fluid steroids and human chorionic gonadotrophin to oocyte maturity and fertilization rates in stimulated and natural cycles. Oestradiol, progesterone, testosterone and human chorionic gonadotrophin were quantified in 129 samples of follicular fluid and the progesterone:oestradiol ratio calculated. Both stimulated cycles (short and long luteinizing hormone-releasing hormone/human menopausal gonadotrophin regimens) and natural cycles were compared. A total of 60 women were studied, 20 in each group. In the natural cycles, testosterone was significantly lower in follicles with intermediate oocytes (P = 0.015). Both oestradiol and testosterone were significantly lower in stimulated cycles compared to natural cycles (P = 0.032 and P = 0.034 respectively). In the ovarian stimulation cycles, the progesterone:oestradiol ratio was significantly higher when oocytes fertilized (P = 0.052). Moreover, in the stimulated cycles, oestradiol and human chorionic gonadotrophin were singnificantly lower in the short protocol compared to the long protocol. The data demonstrate that the hormonal milieu of the follicle is altered in down-regulated stimulated cycles to varying degrees, depending partially on the type of protocol used. Furthermore, the progesterone:oestradiol ratio, rather than individual hormone concentrations, may be a useful predictor of the fertilizing capacity of the oocytes.     

Studies on low-dose oral contraceptives: cervical mucus and plasma hormone changes in relation to circulating D-norgestrel and 17alpha ethynyl-estradiol concentrations

A study was undertaken to determine the effects of a low-dose oral contraceptive comprising 150 mug of D-norgestrel and 30 mug of 17alpha-ethynyl estradiol (Microgynon) on the plasma levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17BETA-ESTRADIOL, AND PROGESTERONE AND ON THE PHYSICAl properties of cervical mucus. Samples of blood and cervical mucus were obtained from three women during a treated cycle and the immediately-following "withdrawal" cycle. Specific radioimmunoassay methods were used to determine LH, FSH, 17beta-estradiol, and progesterone levels in treated and withdrawal cycles, and D-norgestrel and 17alpha-ethynyl estradiol in samples obtained during treated cycles. The concentration of synthetic steroids was also measured in blood samples obtained before and 1 hour after ingestion of the contraceptive to determine the maximal daily variation. The results indicated that the contraceptive action of this combined low-dose oral contraceptive is mediated through suppression of ovulation and by rendering the cervical mucus impenetrable to sperm. Plasma FSH levels appeared to be one of the most sensitive indices of suppression. Determination of D-norgestrel and 17alpha-ethynyl estradiol showed that 3 to 4 days were required to reach maximal plasma levels and that daily fluctuations were considerable. Withdrawal of the pill resulted in an immediate return to ovulatory cycles in all three subjects studied.