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A further analysis was made by evaluating the data over the range of pulmonary function (Table 2). For patients with FEV! values of less than 50 percent predicted, the mean SD between the three efforts was 3.30 for FEVX compared with 5.47 for the JPF, and 4.67 for the WPF. Similar differences are noted in the remaining ranges, the variability of FEV^! being less than that for peak flows by either the JPF or the WPF in all ranges of pulmonary function. A one-way analysis of variance was applied to the three groups of data. The variability of FEV! was significantly less than that of either JPF or WPF in all ranges of function (p<0.05). Finally, a Newman-Keuls analysis was performed, which demonstrated the FEV, to have significantly less variability at all levels of pulmonary function between 50 and 100 percent predicted (p<0.01). …Read the rest of this article

Several studies performed in rats have demonstrated the in vivo or in vitro antigonadal effects of GnRH analogs. In previous studies, we have demonstrated that GnRH-a treatment produces a failure in the steroidogenic luteal capability and an increase in the apoptotic process in the ovary, eliciting consequently an interference in the follicular recruitment, growth, and luteinization induced by gonadotropins. These observations led us to study the in vivo effect of GnRH analogs on follicular development, atresia, and programmed cell death. The results presented in this work, assessed by the determination of ovarian weight and the number of follicles at different stages, confirm the inhibitory effect of the GnRH-agonist, LA, on ovarian development previously observed by our laboratory. Particularly interesting is that coinjection of the GnRH-antagonist, Ant, reverts the inhibitory effect of LA, suggesting that LA action is mainly mediated by an ovarian GnRH receptor. Of interest, the injection of Ant alone increased the number of preovulatory follicles, reflecting the augmentation also observed in ovarian weight, suggesting that this compound improves follicular development.

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RESULTSMorphological Studies

Prepubertal rats were superovulated with eCG (control group, C) and treated with LA (LA group; 1 ^g rat day during 48 h), or Ant (Ant group; 10 ^g rat day during 48 h), or both (LA + Ant group). When the GnRH-agonist, LA, was injected alone, the ovarian weight decreased by 0.5-fold, whereas injection of GnRH-Ant increased ovarian weight by 0.4-fold compared with controls. Coinjection of both GnRH substances did not show differences from that of controls (Table 1).

Histological ovarian slides were stained with hematox-ylin-eosin to determine the number of different follicle stages and the percentage of apoptotic cells (Fig. 1). Table 1 shows that injection of LA significantly increased the number of PFs and atretic follicles (ATFs).

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Hormones and Reagents

The GnRH-a leuprolide acetate (Lupron), was a donation from Abbott Laboratories (Buenos Aires, Argentina). The original ampoule (2.8 mg/5 ml) was dissolved in saline solution. SYNTEX S.A (Buenos Aires) generously provided eCG (Novormon). HEPES, SDS, Antide [W-Ac-D-Nal1, D-pCl-Phe2, D-Pal3, Ser4, Nic-Lys5, D-Nic-Lys6, Leu7, Ipr-Lys8, Pro9, D-Ala10NH2; Nal-Lys antagonist] was purchased from Sigma Chemical Co. (St. Louis, MO). Dulbecco modified Eagle medium (DMEM, 4.5 g glucose/L), Ham F-12 nutrient mixture (F12), fungizone (250 |xg/ml), and gentamicine (10 mg/ml), were from Gibco Laboratories (Grand Island, NY). Polyclonal primary antibodies for BAX (N-20), cytochrome C (H-104), FAS (FL-335), and FASL (Q-20) were purchased from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA). Rabbit antibody against bovine cytochrome P450scc was a generous gift from Dr. Anita H. Payne (Stanford, CA). Anti-rabbit secondary antibody conjugated with horseradish peroxidase was purchased from Sigma.

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In the mammalian ovary, only a small fraction of oocytes ovulate during reproductive life, whereas the majority of ovarian follicles undergo atresia by a hormonally regulated apoptotic mechanism.

Gonadotropin-releasing hormone (GnRH) and its analogs have been widely used to prevent the spontaneous LH surge in assisted reproduction techniques. Suppression of gonadotropin secretion can be achieved with either GnRH-agonist (GnRH-a) or GnRH-antagonist (GnRH-ant). Chronic administration of GnRH-a leads to pituitary desensitization and inhibition of gonadotropin and sex steroid levels by reducing the number of GnRH receptors on the cell membrane. Conversely, GnRH-ant achieves suppression of gonadotropin secretion by the competitive blockade of the GnRH receptors. canadian healthcare mall

Aside from the effects of GnRH analogs on the pituitary-gonadal axis, studies have shown that GnRH and its analogs have extrapituitary effects, particularly on the ovaries of rats and humans. However, there is some controversy about the physiological relevance of an endogenous GnRH-like molecule during folliculogenesis.

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A guide to contraindications to childhood vaccinations

The infant and childhood immunization program in Can­ada has led to extraordinary decreases in serious infec­tions with diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, hepatitis B, measles, mumps and rubella. There is a danger that this successful immunization program may lead to complacency about vaccine preventable illnesses such that parents, and sometimes physicians, may become too focused on potential adverse events of vaccination and lose sight of the serious and sometimes even fatal consequences of the disease being prevented. Physicians and parents need reli­able accurate information on true contraindications so that opportunities to immunize an infant or child are not missed. In fact, there are very few true contraindications. Deferral or delay of immunization based on misconceptions about contra­indications puts an infant or child at risk. The following tables summarize the answers to the most frequently raised ques­tions about contraindications. Tables 1 to 3 are based upon recommendations from the National Advisory Committee on Immunization and the American Advisory Committee on Immunization. Additional information written for par­ents is available in the publication entitled, Your Child’s Best Shot.
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The differential diagnosis of small intestinal ulceration and stricture formation is extensive. This is generally classi­fied into broad groups such as congenital, mechanical, in­flammatory, vascular, neoplastic and miscellaneous. Most formations are self-evident from clinical history and are rare. Granulomatous disease, especially with broad-based stric­tures, raises the possibility of Crohn’s disease or an in­fection such as tuberculosis. Congenital duodenal stenoses, including webs and rings, may occur and are evi­dent soon after birth. Occasionally, they may be associ­ated with Down’s syndrome. Post-traumatic strictures that simulate Crohn’s disease rarely have been described in the ileum, but stricture of the duodenum and jejunum has been recorded in association with physical child abuse. Ischemic strictures may develop in the more distal small intestine, are usually broad-based and typically have iron-laden macrophages. Ulceration in the small intes­tine may be related to celiac disease, sometimes with intesti­nal lymphoma. Strictures have also been associated with celiac disease, particularly in the duodenum. Drug-induced strictures and diaphragm-like changes have been reported with a number of medications, including po­tassium chloride, ASA and other nonsteroidal anti- inflammatory medications. Usually, these occur in the distal small intestine and colon rather than the duodenum. In spite of careful, clinical and pathological evaluation, the cause of some small intestinal strictures remain unex­plained. Some of these differ from the changes seen in the present case because the strictures are broad-based and often require surgical resection to resolve symptoms. In contrast, the diaphragm-like strictures seen in the present patient were quite distinctive and multiple; they usually involve the distal small intestine or colon. Pathological features of diaphragm disease, as previously detailed in this journal, also seem quite specific and, in some instances, appear to be directly related to medication use. In the present patient, no specific cause could be defined.

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