Pregnancy rates after peritoneal ovum-sperm transfer.

We present the technique of peritoneal ovum-sperm transfer as an option for treatment in couples with unexplained infertility factors. In 1989 we reported the first successful pregnancy, in the United States, after transferring sperm and oocyte into the peritoneal cavity. We now report the results of a prospective study of this procedure.

Intraoperative radiation therapy for recurrent head and neck cancer.

Forty-seven patients with recurrent head and neck cancer in a previously irradiated field were treated with surgical resection and intraoperative radiation therapy (IORT). Recurrent disease occurred at a median of 18 months from primary treatment, and was at the primary tumor site in 31 and metastatic to regional lymph nodes in 16. Recurrences were squamous cell carcinomas in 42 and adenoid cystic in five.

Factors in the diagnostic delays of small bowel malignancy.

The overall survival from primary malignancies of the small intestine has not changed over more than four decades. This generally is ascribed to delays in establishing the diagnosis and the advanced stage of the disease when treatment is begun. There has been no critical analysis of these delays.

Radiologic features of closed loop obstruction: analysis of 25 confirmed cases.

The obstruction of a segment of bowel at two points results in a closed loop obstruction. Progression to strangulation is not an invariable component of this entity when surgical intervention is delayed. Enteroclysis is increasingly being used to evaluate obstruction of the small intestine.

Major histocompatibility antigens in transplanted human hearts before perfusion.

The expression of major histocompatibility class I and II antigens is described in human normal donor hearts before perfusion with recipients' blood. Class I and II major histocompatibility antigens were found on interstitial but not on myocardial cells. Endothelial cells accounted for most of the generic class I reactions (that is, W6/32 and beta 2 microglobulin), and endothelial cells accounted for most of the HLA-DR and -DP reactivity.

Immunology of ovarian failure.

Ovarian failure is the result of depletion of ovarian follicles. Naturally occurring ovarian failure usually takes place around 50 years of age in the human. Premature ovarian failure occurs in 1% of women and is the result of acceleration of rate of ovarian follicular depletion in the majority of cases.

Syncytiotrophoblast brush border proteins recognized by monoclonal antibody TRA-2-10 and rabbit anti-TLX sera.

Different subsets of placental trophoblast epithelium are directly exposed to the maternal immune system during pregnancy and consequently represent major elements in allogeneic interactions. It has been proposed that the trophoblast--lymphocyte cross-reactive (TLX) alloantigen system is involved in maternal allogeneic recognition during pregnancy. Monoclonal antibody TRA-2-10 putatively recognizes TLX antigens, but its reactivity with trophoblast and normal tissues has not been documented in detail.

Quality in ambulatory care: the two minute demonstration.

When asked to produce convincing evidence of quality, 281 ambulatory healthcare professionals suggested 98 different components of an ambulatory program. Obviously no overwhelming majority exists, nor is there a clear focus on what constitutes quality in the ambulatory setting. This demonstrates and highlights both the diversity of ambulatory care and the difficulty of defining quality in the ambulatory environment.

Diferric transferrin reduction by K562 cells. A critical study.

This paper critically examines the redox activity of K562 cells (chronic myelogenous leukemia cells) and normal peripheral blood lymphocytes (PBL). Ferricyanide reduction, diferric transferrin reduction, and ferric ion reduction were measured spectrophotometrically by following the time-dependent changes of absorbance difference characteristic for ferricyanide disappearance and for the formation of ferrous ion:chelator complexes. Bathophenanthroline disulfonate (BPS) and ferrozine (FZ) were used to detect the appearance of ferrous ions in the reaction mixtures when diferric transferrin or ferric reduction was studied.

Promoting bicycle helmets: a new focus for injury prevention.

Bicycle accidents cause many serious injuries and deaths in the United States, often as a result of head injury in riders not wearing helmets. Helmets reduce the incidence of head injury, and an aggressive safety education campaign has been shown to increase the number of children wearing helmets while riding. Such a campaign has been initiated in the Central Indiana area.

HIV proteins in normal human placentae.

Cryostat sections of human normal term placentae were studied for evidence of immunopathology by using antibodies to lymphocytes, macrophages, platelets, and coagulation factors. Areas of so-called chronic villitis of unestablished etiology were identified in all placentae. The same tissues were examined for HIV protein antigens gp120, p17, p24, and gp41.

Occurrence of other reproductive failures among women with recurrent spontaneous abortion.

We have previously reported an association between recurrent spontaneous abortion and ectopic pregnancy. We now report that not only ectopic pregnancy, but also other reproductive failures including hydatidiform moles, preterm births, and stillbirths are also associated with recurrent spontaneous abortion. The obstetrical histories of 455 women who had experienced two or more consecutive spontaneous abortions were studied for the occurrence of term births, preterm births, stillbirths, spontaneous abortions, ectopic pregnancies, and hydatidiform moles.

Evidence in support of the plasma membrane as the target for transferrin-adriamycin conjugates in K562 cells.

We have used transferrin-adriamycin conjugates to deliver drug to transferrin receptors and have shown that the conjugates bind to and kill tumor cells in vivo and in vitro. This has been studied with the use of qualitative and quantitative assays. In this report, we present evidence indicating that the primary target of transferrin-adriamycin cytotoxicity is the plasma membrane.

Tissue factor in chronic villitis of unestablished etiology.

We have previously reported the presence in normal human placentae of coagulation, macrophages and helper T lymphocytes in inflammatory foci known as villitis of unestablished etiology. In order to investigate the link between coagulation and immunity, we have studied fetal stem vessel endothelium for tissue factor, which is made available by cytokines and activates coagulation via the extrinsic pathway. We found that fetal stem vessel endothelial cells of normal chorionic villi did not react with antibody to tissue factor.

Cytoskeletal proteins in chronic villitis of unestablished etiology.

Cytoskeletal proteins (i.e., cytokeratins, vimentin, actin, and desmin) are normally present in the placental chorionic villi and are related to the maintenance of the villous shape, and to the ability of the villi to contract and permit a normal blood flow.

The accuracy of preoperative staging for surgically resected laryngeal cancer.

A retrospective analysis was undertaken to evaluate the accuracy of preoperative staging for laryngeal cancers. T (primary tumor) stage was evaluated more accurately by the combined assessment (clinical examination plus computed tomography (CT) for all laryngeal tumors when compared to the clinical examination (75% versus 31%, p less than 0.04).

Direct measurement of high-density lipoprotein cholesterol by the reflotron assay with no manual precipitation step.

We evaluated the quantification of high-density lipoprotein (HDL) cholesterol in plasma with the Boehringer Mannheim Reflotron reflectance photometric analyzer. The Reflotron is designed for testing in small to medium-size laboratories and physicians' offices. This HDL method does not require a manual precipitation step because the reagent tab contains dextran sulfate (Mr 50,000) and magnesium acetate.

The role of the physician in the late diagnosis of primary malignant tumors of the small intestine.

Survival from primary malignancies of the small intestine has not improved during the last four decades. One reason for this is the advanced stage of disease at the time of surgery. In order to determine why diagnosis is made late, we reviewed the records of all patients with small bowel malignancy diagnosed between 1967 and 1988.

Immunogenetic studies of soluble Fc receptor (CD16) antigens in human seminal plasma.

Two forms of CD16 Fc receptors (FcRIII) have been defined on human leukocytes. Type 1, present on polymorphonuclear neutrophils (PMN), expresses the NA alloantigen system and type 2, present on natural-killer (NK) cells and macrophages, has no known polymorphic variations. We have described the presence of soluble FcRIII antigens in human seminal plasma (SP).

Antigens of immunoglobulin G-Fc receptor III in human male reproductive tract accessory glands.

We have documented the presence of soluble antigens of immunoglobulin (Ig)G-Fc receptor type III (FcRIII) in human seminal plasma that retain an affinity for the Fc fragment of IgG. The origin of these FcRIII antigens within the male reproductive tract was not known. By using polyclonal and monoclonal antibodies directed against different epitopes on FcRIII molecules, we demonstrated FcRIII reactivity in human prostate and seminal vesicle epithelial cells as well as in their glandular secretions.

Anchoring villi in human placental basal plate: lymphocytes, macrophages and coagulation.

We have studied basal plates in 25 normal placentae, ten placentae from primary aborters and six placentae from secondary aborters for leukocyte markers and coagulation components. Anchoring villi contained class II MHC antigen-reactive (HLA-DR, DP and DQ) macrophages and T-lymphocytes of the helper (CD4) phenotype. Antibodies to coagulation components revealed the presence of tissue factor, factor IX and fibrin in and around anchoring villi.

Uterine adnexal torsion: a case report.

Uterine adnexal torsion is a surgical condition that requires prompt diagnosis and intervention. An ultrasound examination demonstrating a unilaterally enlarged, hypoechoic ovary with several small spherical, peripherally located sonolucent structures in the involved ovary, in addition to a history and physical consistent with torsion, confirms the need for surgical intervention. In this article, we present a case of uterine adnexal torsion and discuss the etiologic, diagnostic and therapeutic aspects of this entity.

Factor VIII procoagulant: a marker of fibrinoid necrosis in normal term human placentae.

Factor VIII procoagulant (FVIIIPC) is a plasma glycoprotein cofactor for activated factor IX that activates factor X in prothrombin convertase and results in fibrin deposition. We have studied 50 normal term placentae for the presence of FVIIIPC, and found it in granular deposits almost exclusively in areas of fibrinoid necrosis. This observation was made in all fibrinoid areas.

Conversion of IgG-mediated complement-dependent cytotoxicity by reducing reagents.

Reducing reagents used in complement-dependent crossmatches reduce IgM but not IgG. A positive IgM crossmatch is not an absolute contraindication to allografting. We have studied an alloantiserum from a patient with 100% panel reactive antibody awaiting heart transplantation whose serum was reduced.