Assessment and selection of the recipient cows' corpus luteum at the time of embryo transfer, and its influence on conception rate.

OBJECTIVES: To describe the influence of physical traits of the corpus luteum (CL), as described by transrectal ultrasonography on day 6 post-oestrus, on the conception rate following embryo transfer (ET) in recipient beef cows. To investigate if higher recipient utilisation rates were achievable, without compromising conception rates to ET. DESIGN/RESULTS: Data were analysed from Holstein Friesian embryos (n = 1075) frozen in ethylene glycol thawed for direct transfer into one herd of Angus recipient cows. For pregnancies achieved in the program (n = 693), no statistically significant effect was found for the physical traits of the recipients' CL on conception rate (CL volume (P = 0.20), CL side (P = 0.14). Conception rates were similar for recipients with a central lacuna (62%, n = 245) and recipients with no central lacuna (66%, n = 448) (P = 0.10). Of the pregnant recipients with a central lacuna (n = 245), 98.3% had no remaining luteal cavity by the 30-day pregnancy ultrasound. No effect on conception rate was found with either the small (<50% of CL diameter) or large (>50% of CL diameter) central lacunae (P = 0.18). For recipients with CLs that did not meet previous industry selection guidelines (n = 172, 16% of study population), the conception rate (63%) was not significantly different to the routinely selected recipient CLs (n = 903, conception rate 65%) (P = 0.83). CONCLUSIONS: The suitability of a potential ET recipient is determined by observing an appropriately timed oestrus and a detectable CL, regardless of size or quality.

[A Buschke and Lowenstein tumor in a female patient]. / La tumeur de Buschke et Löwenstein. A propos d'un cas féminin.

Although it presents clinically as a malignant formation, the Buschke-Lowenstein tumour is known to be a histologically benign tumour caused by a papillomavirus infection from an condyloma acuminatum. The Buschke-Lowenstein tumour is generally observed in male subjects, usually on the penis, and rarely occurs in women. A female case is reported. In the literature, human papillomavirus 6 is the most common type although types 11, 16 and 18 are also reported. Surgery is the only treatment for this tumour which recurs readily.

[Comparative study of ofloxacin+amoxicillin-clavulanic acid versus doxycycline+amoxicillin-clavulanic acid combination in the treatment of pelvic Chlamydia trachomatis infections]. / Etude comparative des associations ofloxacine+amoxicilline-acide clavulanique versus doxycycline+amoxicilline-acide clavulanique dans le traitement des infections génitales hautes à Chlamydia trachomatis.

OBJECTIVE: To evaluate the efficacy and safety of ofloxacin+coamoxiclav versus doxycycline-coamoxiclav in the treatment of chlamydial pelvic infections. DESIGN: An open, comparative, randomised, monocentric study. SUBJECTS: A hundred and eighteen patients (85 endometritis and 33 salpingitis) were included. Clinical, laparoscopic and bacteriological assessments were performed before treatment. 30.4% of salpingitis were considered as severe (COGIT score > 6). 25.4% of acute pelvic infections were only caused by Chlamydia trachomatis. TREATMENT: A hundred and eighteen patients were treated orally with 3 week combination ofloxacin (200 mg b.i.d.) + coamoxiclav (1 g b.i.d.) (n = 60) or with a 6 week coamoxiclav (1 g b.i.d.) + doxycycline (100 mg b.i.d.) (n = 58). RESULTS: Oral combination ofloxacin-coamoxiclav is as effective as oral combination doxycycline+coamoxyclav with respectively 96.7% versus 96.6% and 100% versus 98.4% satisfactory clinical et bacteriological results.

Respiratory mu-opioid and benzodiazepine interactions in the unrestrained rat.

Interactions of mu-opioid receptors with the benzodiazepine system were studied by examining the modulatory effects of flumazenil (a benzodiazepine antagonist) and alprazolam (a benzodiazepine agonist) on the respiratory effects of the opioid peptide dermorphin. Dermorphin, 1-30 nmol administered i.c.v., to conscious, unrestrained rats decreased ventilation rate (VR) and minute volume (MV) dose-dependently. The ventilatory depression was antagonized by naloxone and by the benzodiazepine antagonist flumazenil. The benzodiazepine alprazolam potentiated the respiratory inhibition of a small (1 nmol) dose of dermorphin but antagonized that of a higher dose (3 nmol). The results suggest that the benzodiazepine/GABA receptor complex modulates respiratory depression induced by central mu-receptor stimulation in the rat.

Antiovary antibodies, repeated attempts, and outcome of in vitro fertilization.

OBJECTIVE: To determine whether the microtrauma induced by repeated puncture of ovarian follicles could result in the production of autoantibodies in women submitted to in vitro fertilization (IVF). DESIGN: Antiovarian antibodies were assayed in serum samples obtained from women engaged in IVF and in serum samples from healthy controls. SETTING: Blood samples were obtained after oocyte collection in the local hospital's IVF unit. PATIENTS: One hundred ten women undergoing IVF entered the study. Oocyte division, numbers of embryos, and pregnancy were recorded for each woman. Control samples were from 40 individuals with no sign of autoimmune disorder. INTERVENTIONS: Antiovarian antibodies were assayed in indirect immunofluorescence and enzyme-linked immunosorbent assay (ELISA) using human ovary as antigen. Specific immunoglobulin (Ig)G, IgA, and IgM were tested separately in an ELISA. MAIN OUTCOME MEASURE: Antiovarian antibody levels were compared between patients and controls and correlated with the subsequent results of IVF. RESULTS: Significantly higher levels of IgG, IgA, and IgM antiovarian antibodies were observed in the group of IVF women (P less than 0.001). IgM antiovarian antibodies correlated with a lower number of embryos (P less than 0.001) and IVF failure (P less than 0.05). CONCLUSIONS: These data suggest that ovarian trauma may lead to the production of autoantibodies.

Cowden disease in a young girl: gynecologic and immunologic overview in a case and in the literature.

There is an increased risk of cancer (mainly breast cancer) in patients with Cowden disease. Little is known of the etiopathogenic mechanisms of this condition, but immunologic abnormalities may be evoked. A young patient with Cowden disease was submitted for gynecologic examination and immunologic investigations. Although no neoplastic disorder had appeared, laboratory investigations disclosed abnormalities of the humoral and cellular immune compartments in the peripheral blood. This rare observation of gynecologic involvement in a very young girl with family antecedents of Cowden disease prompted a review of the gynecologic features and etiopathogenic bases of Cowden disease. The possible role of neoplasia such as breast cancer in this syndrome makes early diagnosis a criterion for good prognosis.

Amoxycillin/clavulanic acid ('Augmentin') compared with a combination of aminopenicillin, aminoglycoside and metronidazole in the treatment of pelvic inflammatory disease.

A randomized, multi-centre trial was carried out in 152 hospitalized women with pelvic inflammatory disease to evaluate the efficacy and tolerability of amoxycillin/clavulanic acid compared with that of a standard regimen using three antimicrobial agents (aminopenicillin, an aminoglycoside and metronidazole). Seventy patients initially received 3 to 4 intravenous doses per day of 1 g amoxycillin/200 mg clavulanic acid (mean 7.7 days) and then 4 to 6 tablets per day of 500 mg amoxycillin/125 mg clavulanic acid (mean 11.2 days). The other group of 82 patients initially received parenteral therapy daily (mean 7.7 days) with a combination of 3 to 4 g amoxycillin or ampicillin, 160 mg gentamicin (or 150 mg dibekacin or tobramycin) and 1.5 g metronidazole, and then oral therapy with 2 to 3 g amoxycillin or ampicillin and 1 to 1.5 g metronidazole daily (11.1 days). Clinical results, assessed at discharge from hospital (mean 10 days in both groups), were comparable in both groups, with 96% complete or partial response and no failures in the amoxycillin/clavulanic acid group, and 90% complete or partial successes and 5 failures with the triple therapy regimen. Both treatments were well tolerated and very few side-effects were reported.

[Congenital malformations and socio-occupational status]. / Malformations congénitales et catégories socio-professionnelles.

A case-control study was conducted in a maternity hospital, in order to look for the relationships between the occurrence of birthdefects and the socio-occupational status of the parents. Cases were 189 new-born children with one or several congenital malformations diagnosed at birth or within the first 8 days of the life. Birthdefects were listed according to the British Paediatric Association classification of diseases. Controls were 5,896 new-born children without any congenital malformation detected within the first 8 days of life. Cases and controls were all children born in the same maternity hospital, between 1980 and 1983. The socio-occupational status (INSEE classification) of the parents of cases and controls was ascertained within the first trimester of the pregnancy, before a possible congenital malformation was known. In order to look for the relationships between the socio-occupational status of the parents and the occurrence of birthdefects, we compared the proportions, in each of the socio-occupational classes, of the fathers and of the mothers of cases and controls. These comparisons (for all birthdefects together and for the most frequent ones) were tested using the chi-square test, when the expected number was greater than 5, and the Fischer's test, when it was equal to, or lower than 5. The incidence rate of birthdefects in this sample was 3,1%. Their distribution according to the types of malformations did not differ from that observed in 1982 among the new-borns in Paris. There was no significant difference between the parents of cases and controls, for: age, degree of instruction, ethnic origin, marital status.(ABSTRACT TRUNCATED AT 250 WORDS)

[Immunohistology in assessment of the spread of cancer]. / L'immunohistologie dans le bilan d'extension des cancers.

The prognosis of cancers is conditioned by tumoral extension. We report a case of a squamous carcinoma of the vulva where pathological examination had been at fault. An immunohistological study performed with monoclonal antibodies revealed a lymph node micro-metastasis. This case emphasizes the importance of estimating the tumoral extension by simultaneous pathological and immunological examinations.

Neurofilament gene expression: a major determinant of axonal caliber.

Within the wide spectrum of axonal diameters occurring in mammalian nerve fibers, each class of neurons has a relatively restricted range of axonal calibers. The control of caliber has functional significance because diameter is the principal determinant of conduction velocity in myelinated nerve fibers. Previous observations support the hypothesis that neurofilaments (NF) are major intrinsic determinants of axonal caliber in large myelinated nerve fibers. Following interruption of axons (axotomy) by crushing or cutting a peripheral nerve, caliber is reduced in the proximal axonal stumps, which extend from the cell bodies to the site of axotomy. (The distal axonal stumps, which are disconnected from the cell bodies, degenerate and are replaced by the outgrowth of regenerating axonal sprouts arising from the proximal stump). This reduction in axonal caliber in the proximal stumps is associated with a selective diminution in the amount of NF protein undergoing slow axonal transport in these axons, with a decrease in axonal NF content, and with reduced conduction velocity. The present report demonstrates that changes in axonal caliber after axotomy correlate with a selective alteration in NF gene expression. Hybridization with specific cDNAs was used to measure levels of mRNA encoding the 68-kDa neurofilament protein (NF68), beta-tubulin, and actin in lumbar sensory neurons of rat at various times after crushing the sciatic nerve. Between 4 and 42 days after axotomy by nerve crush, the levels of NF68 mRNA were reduced 2- to 3-fold. At the same times, the levels of tubulin and actin mRNAs were increased several-fold. These findings support the hypothesis that the expression of a single set of neuron-specific genes (encoding NF) directly determines axonal caliber, a feature of neuronal morphology with important consequences for physiology and behavior.

[Contraception and informatics. SELF, a system to aid medical decisions applied to the prescription of contraceptive methods]. / Contraception et informatique. SELF, un système d'aide à la décision médicale appliqué à la prescription des méthodes contraceptives.

SELF (systeme en logique floue = system in soft discware), developed by the Computer Sciences Laboratory of the Faculté de Médecine in Nancy, is, by comparison to many systems of assistance in medical decisions already existing, a comprehensive and simple unit enabling the construction and modification of basic knowledge as well as its questioning. The first application of SELF concerned the field of gynecology, by producing a system of assistance applied to the prescription of a contraceptive method. The systematic use of this computer program along with the traditional prescription of a contraceptive method, was tested for three months in the Regional Maternity Hospital by several physicians in the Gynecology Clinic. The system was extremely well accepted and the responses have generated numerous discussions between physicians leading to an improvement of SELF and a better rationalization of the prescription. The medical and paramedical personnel in training at the hospital found SELF to be a teaching tool which, on the basis of simulated cases, permits an easier and more concrete explanation of the practical management in advising or prescribing a contraceptive method.