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BACKGROUND: Efforts to prevent malnutrition in children under five are crucial for both short-term and long-term impact, especially in resource-constrained low- and middle-income countries, where ensuring minimal food diversity remains an urgent challenge. Our organization implemented initiatives to improve dietary diversity among children under five in rural areas of Lao People's Democratic Republic (Lao PDR). METHODS: We carried out educational and awareness programs directed at caregivers of children aged 6-59 months. These programs were delivered by healthcare professionals and trained community volunteers in specific areas of Xaybouathong District, Khammouane Province. To evaluate the impact of our interventions, we conducted surveys both at the beginning and end of the project. We designated the Individual Dietary Diversity Score IDDS as the objective variable, serving as an indicator of child dietary diversity. Using sociodemographic and economic indicators as explanatory variables, we assessed the impact of the intervention through multivariate analysis with a generalized linear model as well as a bivariate analysis. RESULTS: The comparison between 210 children at baseline and 205 children at endline revealed a significant increase in IDDS among children aged 6-23 months (from 3.36 to 4.22) and children aged 24-59 months (from 3.29 to 3.83). Multivariate analysis indicated a significant association between the intervention effect (baseline vs. endline) and the village of residence. Furthermore, significant improvements were observed in each food group that constitute IDDS, including vegetables and fruits, eggs, and legumes and nuts. CONCLUSIONS: Even in resource-limited settings, such as rural areas of Lao PDR, it is possible to improve child dietary diversity through educational approaches that encourage the utilization of locally available foods.
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Understanding climate variability and stability under extremely warm 'greenhouse' conditions in the past is essential for future climate predictions. However, information on millennial-scale (and shorter) climate variability during such periods is scarce, owing to a lack of suitable high-resolution, deep-time archives. Here we present a continuous record of decadal- to orbital-scale continental climate variability from annually laminated lacustrine deposits formed during the late Early Cretaceous (123-120 Ma: late Barremian-early Aptian) in southeastern Mongolia. Inter-annual changes in lake algal productivity for a 1091-year interval reveal a pronounced solar influence on decadal- to centennial-scale climatic variations (including the ~ 11-year Schwabe cycle). Decadally-resolved Ca/Ti ratios (proxy for evaporation/precipitation changes) for a ~ 355-kyr long interval further indicate millennial-scale (~ 1000-2000-yr) extreme drought events in inner-continental areas of mid-latitude palaeo-Asia during the Cretaceous. Millennial-scale oscillations in Ca/Ti ratio show distinct amplitude modulation (AM) induced by the precession, obliquity and short eccentricity cycles. Similar millennial-scale AM by Milankovitch cycle band was also previously observed in the abrupt climatic oscillations (known as Dansgaard-Oeschger events) in the 'intermediate glacial' state of the late Pleistocene, and in their potential analogues in the Jurassic 'greenhouse'. Our findings indicate that external solar activity forcing was effective on decadal-centennial timescales, whilst the millennial-scale variations were likely amplified by internal process such as changes in deep-water formation strength, even during the Cretaceous 'greenhouse' period.
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Sedimentos Geológicos , Agua , Tiempo , Asia , PlantasRESUMEN
PURPOSE: To assess the effects of light from an integrated optical microscope and evaluate the safety of time-lapse observations using a built-in microscope incubator. METHODS: We prospectively compared the fertilization rate and embryonic morphology after intracytoplasmic sperm injection between embryos cultured with time-lapse observations every 15 min in an incubator with an integrated optical microscope and embryos with intermittent observations (once a day) in conventional incubators. RESULTS: No significant differences were observed in the fertilization rate (57.5% vs. 57.5%) or the rate of excellent-good cleavage embryos (36.0% vs. 36.0%). CONCLUSIONS: These results suggest that time-lapse observations using an incubator with an integrated optical microscope may therefore be safely utilized in clinical practice.
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Fase de Segmentación del Huevo/efectos de la radiación , Luz/efectos adversos , Fotomicrografía/efectos adversos , Adulto , Fase de Segmentación del Huevo/fisiología , Fase de Segmentación del Huevo/ultraestructura , Técnicas de Cultivo de Embriones/instrumentación , Transferencia de Embrión , Desarrollo Embrionario/efectos de la radiación , Femenino , Fertilización , Humanos , Incubadoras , Masculino , Fotomicrografía/instrumentación , Fotomicrografía/métodos , Embarazo , Resultado del Embarazo , Índice de Embarazo , Seguridad , Inyecciones de Esperma IntracitoplasmáticasRESUMEN
BACKGROUND: Helicobacter pylori (H. pylori) infection in gastric mucosa may cause systemic inflammatory reaction. This study aimed to examine the association between the infection and serum high sensitivity C-reactive protein (hsCRP). METHODS: Subjects were comprised of three groups; 453 health checkup examinees from Yakumo town inhabitants in Hokkaido, Japan (YTI, 153 males and 300 females), 449 health checkup examinees (ENUH, 273 males and 176 females), and 255 female patients of an infertility clinic (PIC), Nagoya University Hospital. Twenty participants with hsCRP more than 1 mg/dl were excluded from the analysis. Those with hsCRP more than 0.1mg/dl were defined as high hsCRP individuals. H. pylori infection status was examined with a serum IgG antibody test. RESULTS: When the three groups were combined, the geometric mean of hsCRP concentration was significantly higher among the seropositives (0.047 mg/dl) than among the seronegatives (0.035 mg/dl); p<0.0001 by a t-test. The percentage of high hsCRP individuals was also higher in the seropositives than in the seronegatives among any group; 23.3% and 20.1% in YTI, 22.0% and 16.0% in ENUH, and 32.7% and 18.7% in PIC, respectively, although the difference was significant only in ENUH. The summary odds ratio of the high hsCRP for the seropositives relative to the seronegatives was 1.38 (95% confidence interval, 1.01-1.89), when age, sex, body mass index, smoking, and subject group were adjusted by a logistic model. CONCLUSIONS: In three groups, hsCRP was higher among the infected individuals. The summary odd ratio indicated that H. pylori infection could influence the serum hsCRP level.
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Proteína C-Reactiva/metabolismo , Infecciones por Helicobacter/sangre , Helicobacter pylori , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Proteína C-Reactiva/análisis , Femenino , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/epidemiología , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Factores Sexuales , Fumar/sangreRESUMEN
The expression of endothelin-1 (ET-1), which has been proposed to have a potential autocrine/paracrine role, varies during the menstrual cycle, and therefore, ET-1 may be involved in the cyclic change of the human endometrium. However, neither the synthesis nor the degradation of ET-1 in the endometrium has been determined in detail. We investigated endothelin-converting enzyme-1 (ECE-1), which converts big-ET-1 to active ET-1, and neutral endopeptidase (NEP), which cleaves and inactivates ET-1 in human endometrium in vivo and in vitro. Western blot analysis demonstrated that the change in the expression of ECE-1 during the menstrual cycle differed from that of NEP in the endometrium. ECE-1 was expressed by endometrial epithelial cells, whereas NEP was predominantly expressed by stromal cells in vivo and in vitro. In conclusion, our results suggest that spacio-temporal expression of two endopeptidases, ECE-1 and NEP, involved in the synthesis and degradation of ET-1, might regulate ET-1 action in human endometrium.
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Ácido Aspártico Endopeptidasas/metabolismo , Endometrio/enzimología , Metaloendopeptidasas/metabolismo , Neprilisina/metabolismo , Endometrio/citología , Enzimas Convertidoras de Endotelina , Células Epiteliales/enzimología , Femenino , Humanos , Ciclo Menstrual , Células del Estroma/enzimologíaRESUMEN
Previous experiments indicated that 1-bromopropane (1-BP), an alternative to chloroflurocarbons, is neurotoxic and inhibits spermiation in the testis. Here we investigated the reversibility of the toxic effects of 1-BP in rats. Male Wistar rats were divided into three equal groups of 24 each and exposed by inhalation to 0, 400 or 1000 ppm of 1-BP for 6 weeks (8 hrs/day, 7 days/week). Eight rats from each group were sacrificed at the end of 6 weeks exposure, and at 4 and 14 weeks after the end of exposure, to assess the recovery processes. We studied sperm count, motility, morphology and testicular histopathology, as well as blood pressure, skin temperature and hindlimb muscle strength. At the end of 6 weeks of exposure to 1000 ppm (0 week recovery), testicular weight, epididymal weight, sperm count and motility were low, morphologically abnormal sperm were increased and spermatogenic cells showed diffuse degeneration. These changes did not show full recovery at 14 weeks recovery, with the exception of the prostate and seminal vesicular weights, which recovered back to control values. At 400 ppm, increased retained spermatids at 0 week recovery returned to normal at 4 weeks recovery. Exposure to 1000 ppm produced sustained reduction of hindlimb muscle strength at 14 weeks recovery, whereas normalization of the skin temperature and blood pressure was noted after transient changes. Our study showed that the effect of 1-BP on spermatogenesis is dose-dependent; low exposure inhibited spermiation and hormone-dependent organ weight reduction and these changes were transient, while a higher dose of 1000 ppm 1-BP caused persistent depletion of spermatogenic cells.
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Contaminantes Ambientales/toxicidad , Recuperación de la Función , Espermatogénesis/efectos de los fármacos , Testículo/efectos de los fármacos , Administración por Inhalación , Animales , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Temperatura Corporal/efectos de los fármacos , Temperatura Corporal/fisiología , Relación Dosis-Respuesta a Droga , Miembro Posterior , Hidrocarburos Bromados/toxicidad , Masculino , Fuerza Muscular/efectos de los fármacos , Fuerza Muscular/fisiología , Tamaño de los Órganos/efectos de los fármacos , Ratas , Ratas Wistar , Organismos Libres de Patógenos Específicos , Recuento de Espermatozoides , Motilidad Espermática/efectos de los fármacos , Motilidad Espermática/fisiología , Espermatogénesis/fisiología , Testículo/patología , Testículo/fisiopatologíaRESUMEN
Human pregnancy serum and placenta have the ability to degrade uterotonic peptide oxytocin (OT). Placental leucine aminopeptidase (P-LAP), which is also called cystine aminopeptidase, is the only membrane aminopeptidase known to functionally degrade OT as oxytocinase (OTase). P-LAP/OTase hydrolyzes several peptides other than OT including vasopressin and angiotensin III. P-LAP/OTase predicted from cDNA sequence is a type II integral membrane protein, which is converted to a soluble form existing in maternal serum by metalloproteases, possibly ADAM (a disintegrin and metalloproteinase) members. P-LAP/OTase activity increases with normal gestation, while decreases in the patients with preterm delivery and severe preeclampsia. In placenta, P-LAP/OTase is predominantly expressed in differentiated trophoblasts, syncytiotrophoblasts. Activator protein-2 (AP-2) and Ikaros transcription factors play significant roles in exerting high promoter activity of P-LAP/OTase in the trophoblastic cells. Moreover, P-LAP/OTase is transcriptionally regulated in a trophoblast-differentiation-dependent fashion via up-regulation of AP-2, putatively AP-2alpha. P-LAP/OTase may be involved in maintaining pregnancy homeostasis via metabolizing peptides such as OT and vasopressin.
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Cistinil Aminopeptidasa/biosíntesis , Cistinil Aminopeptidasa/fisiología , Oxitocina/metabolismo , Placenta/enzimología , Embarazo/fisiología , Cistinil Aminopeptidasa/sangre , Proteínas de Unión al ADN/fisiología , Femenino , Feto/enzimología , Regulación de la Expresión Génica , Humanos , Factor de Transcripción Ikaros , Trabajo de Parto/fisiología , Proteínas de la Membrana/metabolismo , Complicaciones del Embarazo/enzimología , Estructura Terciaria de Proteína , Factor de Transcripción AP-2 , Factores de Transcripción/fisiología , Trofoblastos/enzimologíaRESUMEN
Endothelin-1 (ET-1) in human endometrium has been proposed to have a potential paracrine role, for its receptors are also present within this tissue. In addition, the expression of ET-1 varies during the menstrual cycle, and therefore, ET-1 may be involved in the cyclic change of the human endometrium, such as proliferation and decidualization. However, neither the inactivation of ET-1 in the endometrium nor the paracrine effect of ET-1 on endometrial cells has been determined. We investigated the production of ET-1 and the presence of neutral endopeptidase (NEP), which cleaves and inactivates ET-1, in primary cultured human endometrial cells. We found primary cultured endometrial epithelial cells, not stromal cells, to be the major source of ET-1. Western blot analysis and RT-PCR demonstrated that NEP was predominantly expressed by endometrial stromal cells. We also demonstrated that ET-1 stimulated the phosphorylation of Akt and DNA synthesis in endometrial stromal cells via the ET(A) receptor and phospahtidylinositol-3 kinase signaling pathways. The effect of ET-1 was regulated by NEP expressed by stromal cells. We also found that conditioned medium containing ET-1 from endometrial epithelial cell culture stimulated phosphorylation of Akt via the ET(A) receptor. In conclusion, ET-1 has a paracrine effect of Akt phosphorylation and cell proliferation on endometrial stromal cells, which occurs via the ET(A) receptor and phospahtidylinositol-3 kinase signaling pathways, and is regulated by cell-surface NEP.
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ADN/biosíntesis , Decidua/enzimología , Endometrio/metabolismo , Endotelina-1/farmacología , Neprilisina/fisiología , Proteínas Proto-Oncogénicas c-akt/metabolismo , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Decidua/citología , Endotelina-1/biosíntesis , Células Epiteliales/metabolismo , Femenino , Humanos , Oligopéptidos/farmacología , Péptidos Cíclicos/farmacología , Fosfatidilinositol 3-Quinasas/fisiología , Fosforilación , Piperidinas/farmacología , Células del Estroma/enzimologíaRESUMEN
OBJECTIVE: Optimized ovarian stimulation protocols are required for the success of in vitro fertilization (IVF). The purpose of this study was to estimate whether the ovarian reserve test using exogenous follicle-stimulating hormone (FSH) could predict ovarian response in IVF. METHODS: This was a prospective observational study of 110 patients who underwent their first IVF cycle. The FSH test was administered as 150 IU of urinary FSH daily from day 3 to day 6 of the menstrual cycle preceding the IVF cycle for evaluation of the plasma estradiol level. Outcomes of IVF, including ovarian response, were analyzed. RESULTS: A negative correlation was observed between the duration of stimulation and the result of the FSH test (r = -.238, P = .014) and between the dose of FSH per retrieved mature oocyte (metaphase II oocyte) and the result of the FSH test (r = -.308, P < .001). In addition, our results showed that the result of the FSH test was significantly lower in poor responders defined by FSH of 400 IU/metaphase II oocyte or greater (207 +/- 149 compared with 293 +/- 174 pg/mL, P = .007). CONCLUSION: The FSH test can be a useful tool for determining the conditions of individualized clinical management plans and optimizing stimulation protocols in IVF.
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Estradiol/sangre , Fertilización In Vitro , Hormona Folículo Estimulante , Pruebas de Función Ovárica , Inducción de la Ovulación , Adulto , Clomifeno/administración & dosificación , Femenino , Fármacos para la Fertilidad Femenina/administración & dosificación , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Menotropinas/administración & dosificación , Oocitos , Valor Predictivo de las Pruebas , Embarazo , Sensibilidad y Especificidad , Inyecciones de Esperma IntracitoplasmáticasRESUMEN
Gonadotropin-producing pituitary adenomas are extremely rare in reproductive-age women. We report here a case of gonadotroph microadenoma with ovarian hyperstimulation. It was found in a 29-yr-old infertile Japanese woman with enlarged multicystic ovaries. The patient had an elevated basal serum estradiol level (up to 6755 pM, or 1840 pg/ml). Serum FSH and prolactin were mildly elevated (15.4 IU/liter, 1.4 nM or 31.4 ng/ml), whereas LH was low (0.5 IU/liter). The FSH level was paradoxically elevated in response to TRH administration. Dynamic magnetic resonance imaging revealed a pituitary microadenoma. Daily administration of bromocriptine, a dopamine agonist, normalized the ovarian size, and the patient ovulated naturally. She conceived after 3 months of bromocriptine therapy and delivered a normal child. She underwent elective transsphenoidal pituitary surgery, 3 yr after the delivery. Immunostaining of the resected tumor showed that 80% and less than 5% of the tumor cells stained for FSH-beta and prolactin, respectively. Furthermore, RT-PCR suggested that dopamine type 2 receptor was expressed in the adenoma. Gonadotroph microadenoma should be considered in women with spontaneous ovarian hyperstimulation, even if they have no neurological symptoms or marked pituitary enlargement. In such cases, bromocriptine therapy may be an alternative to pituitary surgery.
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Adenoma/complicaciones , Bromocriptina/uso terapéutico , Infertilidad Femenina/etiología , Síndrome de Hiperestimulación Ovárica/etiología , Neoplasias Hipofisarias/complicaciones , Adenoma/metabolismo , Adenoma/terapia , Adulto , Anovulación/etiología , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/análisis , Hormona Folículo Estimulante/biosíntesis , Hormona Folículo Estimulante/sangre , Hormona Folículo Estimulante de Subunidad beta/análisis , Humanos , Infertilidad Femenina/terapia , Imagen por Resonancia Magnética , Neoplasias Hipofisarias/metabolismo , Neoplasias Hipofisarias/terapia , Embarazo , Prolactina/análisis , ARN Mensajero/análisis , Receptores de Dopamina D2/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tomografía Computarizada por Rayos XRESUMEN
Aminopeptidase A (APA, BP-1) is a membrane-bound zinc metallopeptidase that converts angiotensin II (AngII) into AngIII by selectively hydrolyzing the N-terminal aspartyl residue. AngII has been proposed as a candidate for the initial vasoconstrictor of endometrial spiral arteries/arterioles in the preliminary step of menstruation. In the late secretory phase, endometrial stromal cells (ESC) around the blood vessels begin to differentiate into decidual cells, and AngII has been reported to accumulate around such vessels. However, whether there is a concurrent increase in renin or angiotensin-converting enzyme in this area has not been determined. We hypothesized that APA may be involved in the metabolism of AngII in the cycling endometrium. Western blot analysis in the present study demonstrated that a considerable amount of APA was present in the secretory phase endometrium. ESC in the secretory phase showed strong expression of APA by immunohistochemical analysis and of APA mRNA by in situ hybridization. In contrast, both APA mRNA and protein were absent in decidual cells. The enzyme activity and the biosynthesis of [(35)S]methionine-labeled APA significantly decreased during the in vitro decidualization of cultured ESC. These results suggest that the perivascular disappearance of APA is a differentiation-specific change that occurs along with the decidualization, and that the disappearance of APA might accelerate the accumulation of AngII around the vessels.
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Aminopeptidasas/metabolismo , Decidua/fisiología , Endometrio/irrigación sanguínea , Endometrio/enzimología , Menstruación/metabolismo , Células del Estroma/enzimología , Adulto , Aminopeptidasas/genética , Arterias , Arteriolas , Células Cultivadas , Endometrio/citología , Femenino , Glutamil Aminopeptidasa , Humanos , Inmunohistoquímica , Hibridación in Situ , ARN Mensajero/metabolismoRESUMEN
Human endometrial epithelial cells are known to express oxytocin receptors around the time of ovulation. Moreover, oxytocin (OT) and OT-induced prostaglandins appear to play a pivotal role in the switching of endometrial glands from the proliferative to the secretory phase. However, there have been few studies of oxytocinase (OTase), which is identical to placental leucine aminopeptidase (P-LAP)/insulin-regulated membrane aminopeptidase (IRAP). We confirmed the expression of P-LAP/OTase in human endometrium and also observed the changes in the expression of P-LAP/OTase throughout the menstrual cycle. P-LAP/OTase and its mRNA were localized in endometrial epithelial cells but not in stromal cells. In the follicular phase, immunoreactive P-LAP/OTase was homogeneously distributed on the plasma membrane and in cytoplasmic granules. Immunoblot analysis demonstrated that the majority of P-LAP/OTase was produced around the time of ovulation. After ovulation, the immunostaining was restricted to the glycogen-rich subnuclear vacuoles, a glandular marker of progesterone release from the corpus luteum. Thereafter, the membrane-bound P-LAP/OTase was released by apocrine secretion during the period of blastocyst implantation and became depleted toward the time of menstruation. Further understanding of the function of P-LAP/OTase in the endometrium appears likely to yield insights into the cyclic changes during the normal menstrual cycle.
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Aminopeptidasas/metabolismo , Cistinil Aminopeptidasa/metabolismo , Endometrio/enzimología , Leucil Aminopeptidasa/metabolismo , Placenta/enzimología , Adulto , Western Blotting , Endometrio/citología , Femenino , Humanos , Inmunohistoquímica , Hibridación in Situ , Leucil Aminopeptidasa/genética , Ciclo Menstrual/metabolismo , Persona de Mediana Edad , Ovulación/metabolismo , ARN Mensajero/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
Adipocyte-derived leucine aminopeptidase (A-LAP, endoplasmic reticulum aminopeptidase ERAP1) is specialized to produce peptides presented on the class I major histocompatibility complex (MHC) by trimming epitopes to eight or nine residues, in addition to its enzymatic activity to degrade angiotensin II. Previously we identified placental leucine aminopeptidase (P-LAP), another member of the oxytocinase subfamily of aminopeptidases, in human uterine endometrial epithelial cells. Here we analyzed the distribution of A-LAP in human cyclic endometrium. Western blotting analysis showed that A-LAP was present in the endometrial tissue throughout the menstrual cycle. Immunohistochemical (IHC) analysis of A-LAP showed a similar distribution to that of P-LAP. A-LAP was localized predominantly in the endometrial glands and the luminal surface epithelium. However, the intracellular localization change that accompanied apocrine secretion, which was observed in P-LAP, was not shown in A-LAP. Subcellular localization of A-LAP, demonstrated by immunofluorescence, was ER in the cultured glandular epithelial cells. Our results indicate that A-LAP may fit the endometrial localization as an antigen-presenting ER aminopeptidase. Further understanding of the function(s) of A-LAP in the endometrium appear likely to yield insights into the cyclic changes during the normal endometrial cycle.
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Aminopeptidasas/metabolismo , Endometrio/enzimología , Adulto , Endometrio/citología , Células Epiteliales/citología , Células Epiteliales/metabolismo , Femenino , Humanos , Inmunohistoquímica , Ciclo Menstrual , Persona de Mediana Edad , Antígenos de Histocompatibilidad MenorRESUMEN
The mechanism of monozygotic multifetal pregnancy and its association with assisted reproductive technology are uncertain. This report presents two cases of dizygotic triplet pregnancy after the transfer of three embryos in utero. The incidence of monozygotic twinning following assisted conception procedures is higher than in the general population. Zonal manipulation may be a major factor in the increased incidence of monozygotic twinning. As both cases followed the conventional in vitro fertilization (IVF), the reason for these monozygotic twinnings might be because of the changes in the zona pellucida in in vitro conditions. In one case, fetuses developed into severe twin-to-twin transfusion syndrome (TTTS), resulting in one intrauterine fetal death at 26 weeks gestation. (Reprod Med Biol 2003; 2: 41-44).
RESUMEN
OBJECTIVES: To evaluate the efficacy of oral progestogen, chlormadinone acetate, and intramuscular (IM) progesterone for luteal support in patients, undergoing assisted reproductive technology (ART) treatment, who were treated with a gonadotropin-releasing hormone agonist (GnRHa). METHODS: This was a prospective randomized study of 40 patients with normal and high response (serum estradiol > 2,000 pg/ml) in GnRHa down-regulation. Patients were randomized to receive either oral chlormadinone acetate or IM progesterone. The outcomes of ART treatment, including pregnancy and embryo implantation rates, were analyzed. RESULTS: There were no significant differences in the clinical pregnancy rates (25 vs. 20%) and in the implantation rates (12.7 vs. 9.1%) of patients who received IM progesterone and oral chlormadinone acetate. Endometrial thickness was also comparable between oral chlormadinone acetate and IM progesterone. CONCLUSION: Oral progestogen, chlormadinone acetate showed a comparable pregnancy rate and live birth rate with IM progesterone as luteal support for the high responders. The optimal methods for luteal support may be dependent on responses to stimulation with gonadotropin, although it is not concluded that oral chlormadinone acetate is recommended as an option for luteal support in high responders.
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Antagonistas de Andrógenos/administración & dosificación , Acetato de Clormadinona/administración & dosificación , Gonadotropinas/administración & dosificación , Fase Luteínica/efectos de los fármacos , Luteolíticos/administración & dosificación , Progesterona/administración & dosificación , Técnicas Reproductivas Asistidas , Administración Oral , Adulto , Antagonistas de Andrógenos/uso terapéutico , Acetato de Clormadinona/uso terapéutico , Regulación hacia Abajo , Implantación del Embrión , Femenino , Hormona Liberadora de Gonadotropina/agonistas , Humanos , Inyecciones Intramusculares , Hormona Luteinizante , Luteolíticos/efectos adversos , Embarazo , Resultado del Embarazo , Progesterona/sangre , Progesterona/uso terapéutico , Estudios ProspectivosRESUMEN
The aim of the present study was to confirm the seropositive rate of Helicobacter pylori to which antibodies cross-react with spermatozoon flagella in patients with infertility. Of the 204 patients in whom the anti-H. pylori IgG antibody in serum and follicular fluids were measured, 45 (22.1%) were seropositive for H. pylori and the seropositive percentage of infertile patients without any possible cause was higher than that of patients with one or more known infertility factors [8 of 21 patients (38.3%) vs. 37 of 183 patients (20.2%), respectively], which suggests a new concept: H. pylori-related infertility.
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Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Infertilidad Femenina/epidemiología , Medición de Riesgo/métodos , Adulto , Comorbilidad , Estudios de Factibilidad , Femenino , Humanos , Incidencia , Japón/epidemiología , Factores de RiesgoRESUMEN
PURPOSE: To assess the expression of PTEN and total and phosphorylated Akt in human ovarian follicles during follicular growth. METHODS: Immunohistochemistry of ovarian tissues and Western blotting and immunofluorescence of primary cultured luteinized granulosa cells for PTEN and Akt. RESULTS: Immunoreactivity of Akt was found in the oocytes, granulosa cells and theca cells in primordial follicles, follicles at each growing stage and luteal cells. As the follicles grew, staining for PTEN became intense in the granulosa cells, whereas the intensity of phospho-Akt became weak. Western blotting and immunofluorescence analysis using primary cultured granulosa-lutein cells showed Akt and PTEN expression, and phosphorylation of Akt in vitro. CONCLUSIONS: PTEN and Akt are present in the granulosa cells during folliculogenesis. An increase in PTEN may lead to changes in proliferation and/or differentiation of granulosa cells during follicular growth via regulation of Akt phosphorylation.
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Folículo Ovárico/enzimología , Fosfohidrolasa PTEN/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Células Cultivadas , Femenino , Células de la Granulosa/citología , Células de la Granulosa/enzimología , Humanos , Inmunohistoquímica , Oocitos/enzimología , Oocitos/crecimiento & desarrollo , Folículo Ovárico/crecimiento & desarrollo , Células Tecales/citología , Células Tecales/enzimologíaRESUMEN
When human blastocysts hatch through the zona pellucida, gaining the ability to adhere to the endometrium, crosstalk between the embryo and the uterus may represent a successful outcome of their synchronized development and differentiation. CD26/dipeptidyl peptidase IV is known as a marker molecule of the implantation phase endometrium. To study the role of CD26 in implantation, 35 human hatched blastocysts were prepared by enzymatic treatment of expanded blastocysts that had been grown on schedule from frozen-thawed surplus embryos at the 2- or 4-cell stage. The blastocysts were placed on CD26-overexpressing or mock-transfected control monolayer cell cultures. The CD26-overexpression caused significantly higher blastocyst adhesion rate (53.3% versus 25.0%, P < 0.05) and significantly larger outgrowth area of trophectoderm (1.7-fold, P < 0.05). The second part of the present study was to show the expression of fibronectin, a CD26 ligand, in human preimplantation embryos, using the same donated resources. Fibronectin mRNA was detected by RT-PCR from the single hatched blastocyst (2/2) and from the single early blastocyst (3/6) but not from the single morula (0/5) samples. An indirect immunofluorescence technique verified the localization of fibronectin on the surface of the blastocyst. These results indicate that the adhesion mechanism by endometrial CD26 and embryonal fibronectin may be involved in human blastocyst implantation.
Asunto(s)
Dipeptidil Peptidasa 4/metabolismo , Implantación del Embrión/fisiología , Endometrio/metabolismo , Fibronectinas/metabolismo , Blastocisto/citología , Blastocisto/metabolismo , Adhesión Celular/genética , Adhesión Celular/fisiología , Línea Celular Tumoral , Células Cultivadas , Dipeptidil Peptidasa 4/genética , Dipeptidil Peptidasa 4/fisiología , Implantación del Embrión/genética , Embrión de Mamíferos/citología , Embrión de Mamíferos/metabolismo , Embrión de Mamíferos/fisiología , Desarrollo Embrionario/genética , Desarrollo Embrionario/fisiología , Endometrio/citología , Femenino , Fibronectinas/genética , Fibronectinas/fisiología , Técnica del Anticuerpo Fluorescente Indirecta/métodos , Expresión Génica/genética , Humanos , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
OBJECTIVE: To assess the expression and cellular distribution of angiotensin II (Ang II), angiotensin type 1 receptor (AT1R), angiotensin-converting enzyme (ACE), aminopeptidase A (APA), adipocyte-derived leucine aminopeptidase (A-LAP), and vascular endothelial growth factor (VEGF) in human ovarian tissue during the menstrual cycle. DESIGN: Ovarian tissues (n = 52) and corpora lutea (n = 34) were obtained from patients undergoing hysterectomy/oophorectomy, and tissue sections were immunostained for each antigen. SETTING: University hospital. PATIENT(S): Patients undergoing hysterectomy or oophorectomy for benign conditions. INTERVENTION(S): Immunostaining of tissue sections using antibodies to each antigen. MAIN OUTCOME MEASURE(S): Microscopic evaluation to assess the presence, distribution, and cellular localization. RESULT(S): The luteal tissue is the major site of Ang II, ACE, AT1R, and VEGF, with highest staining intensity found during the midluteal phase and at pregnancy. The AT1R was found in theca cells. The APA was strongly immunolocalized in pericytes. Immunolocalization of AT1R was almost similar to that of VEGF including oocytes in the primordial and intermediate follicles. CONCLUSION(S): The expression and distinct pattern of the cellular localization of Ang II and its related proteins in human ovarian tissue during folliculogenesis and in the luteal tissue suggest their roles in the growth and differentiation of theca, granulose, and luteal cells.
Asunto(s)
Angiotensina II/metabolismo , Ciclo Menstrual/metabolismo , Ovario/metabolismo , Péptido Hidrolasas/metabolismo , Receptor de Angiotensina Tipo 1/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Aminopeptidasas/metabolismo , Cuerpo Lúteo/metabolismo , Femenino , Glutamil Aminopeptidasa/metabolismo , Humanos , Inmunohistoquímica/métodos , Antígenos de Histocompatibilidad Menor , Ovario/citología , Peptidil-Dipeptidasa A/metabolismo , Embarazo , Embarazo Ectópico/metabolismo , Coloración y Etiquetado , Distribución TisularRESUMEN
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is an important and dangerous aspect of assisted reproduction techniques. Although elective cryopreservation of all embryos can prevent pregnancy-induced late OHSS, it cannot prevent early OHSS, which is induced by hCG administration. METHODS: We undertook this trial to assess the efficacy with which the combined oral administration of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) could prevent early OHSS in IVF patients at very high risk for this syndrome. Four women, who had serum estradiol concentration > or =8000 pg/ml on the day of hCG injection, were treated with the combination of the ACEI alacepril and the ARB candesartan cilexetil for 8 days starting the day after oocyte retrieval. Embryos were cryopreserved and embryo transfer was postponed until later cycles. RESULTS: Despite the extremely enlarged ovaries, no ascites was accumulated in any of the cases. Haematocrit (34.1 +/- 1.0) and serum albumin concentration (4.1 +/- 0.2 g/dl) were normal throughout the treatment period. These patients showed elevated plasma renin and angiotensin II concentration before the treatment. CONCLUSIONS: The dual renin-angiotensin blockade therapy used here would be worth exploring further in a study with more patients and a prospective, randomized design.