Placental concentrations of progesterone, estradiol-17 beta, and cyclic AMP at delivery.

In contrast to most mammals, human parturition is not preceded by a rise in the estradiol : progesterone ratio in peripheral plasma. Thus tissue concentrations of progesterone, estradiol-17 beta, and cyclic adenosine monophosphate (AMP) were measured in placentas obtained after spontaneous vaginal delivery (SVD, N = 11), after oxytocin-induced labor (OXIL, N = 5), and at elective cesarean section (ECS, N = 8). Both progesterone and estradiol were higher in placentas obtained from SVD compared with those from ECS (progesterone: 2.95 +/- 0.26 versus 1.96 +/- 0.29 ng/mg tissue, P < .025; estradiol: 33.6 +/- 5.2 versus 26.4 +/- 3.8 pg/mg). Placentas from OXIL had intermediate progesterone (2.50 +/- 0.47 ng/mg) but the highest estradiol concentration (41.4 +/- 3.2 pg/mg). Cyclic AMP was 29.8 +/- 1.5, 39.6 +/- 8.0, and 35.9 +/- 3.9 pmoles/100 mg tissue in SVD, OXIL, and ECS placentas, respectively. Thus no rise in the placental estradiol : progesterone ratio was found in association with spontaneous labor.

Diagnostic and therapeutic approach to Ethiopian immigrants seropositive for syphilis.

Serologic tests for syphilis are frequently positive in Ethiopian Jewish immigrants in Israel. Forty-three of 358 adults (greater than 15 years of age) examined were found to have positive treponemal tests. Of the 418 children (1 to 15 years of age) none were found to have positive treponemal serology. Forty seropositive adults were examined for signs of tertiary syphilis and underwent lumbar puncture. No evidence of skin or cardiovascular involvement of tertiary syphilis was found. In three patients whose cerebrospinal fluid (CSF) was reactive in treponemal tests, there was no evidence of neuropsychiatric involvement. CSF cell count and protein content were normal in all three, and VDRL in the CSF was negative. None of the subjects was found to have stigmata of congenital syphilis. Negative serological findings in all the children led us to hypothesize whether the disease in question is venereal syphilis with an unusual course rather than endemic syphilis or yaws, both of which are known to exist in Africa. Due to the apparent benign course of syphilis in this ethnic group and recent evidence that lumbar puncture is not mandatory in patients with latent syphilis or asymptomatic neurosyphilis, we suggest that CSF should not be routinely examined in these patients. In view of the recommendations in the literature and the data that we have collected, we strongly feel that treatment with weekly i.m. injections of 2.4 x 10(6) u benzathine penicillin for a 3-week period is sufficient.

A new type of peroxisomal disorder with variable expression in liver and fibroblasts.

We describe two siblings, presently 5 and 9 years of age, who had neurodegenerative symptoms after the first year of life. Although they lacked clinical characteristics of a peroxisomal disorder, they had elevated levels of plasma very long chain fatty acids, pipecolic and phytanic acids, and abnormal bile acid intermediates, which suggested a generalized peroxisome deficiency disorder. Immunocytochemical study and electron microscopy of the liver disclosed absence of peroxisomes in approximately 90% of hepatocytes. However, the remaining 10% of the hepatocytes had numerous normal-looking peroxisomes containing catalase activity and catalase antigen. Alanine glyoxylate aminotransferase and the peroxisomal beta-oxidation enzymes acyl-coenzyme A oxidase and 3-ketoacyl coenzyme A thiolase were also present in the organelles. Both cell types were grouped in clusters. In contrast to most of the liver cells, fibroblasts cultured from skin biopsy specimens had normal peroxisomal functions. Thus this defect in peroxisome biogenesis is characterized by variable expression in different tissues (liver vs fibroblasts), as well as within individual cells in the same tissue (liver mosaicism). Awareness of the heterogeneity in tissue expression of peroxisomal disorders could be of critical importance in prenatal diagnosis.