[Benefit of cardiac examination in competitive sports]. / Nutzen von kardiologischen Vorsorgeuntersuchungen beim Leistungssport.

The sudden and unexpected death in young athletes is always a tragic event. At the age < 35 years distinct structural cardiac disorders such as hypertrophic cardiomyopathy, inflammatory disorders, coronary artery anomalies, as well as conditions without structural cardiac abnormalities such as primary electrical diseases (Brugada's syndrome, long QT, short QT syndrome and catcholaminergic polymorphic ventricular tachycardia) are important causes of sudden death. At the age > 35 years coronary artery disease is the most common cause of cardiac death in athletes. In this review we give an overview about actual evaluation of competitive athletes and prevention of sudden cardiac death.

Echocardiogram-gated multislice spiral CT in functionally univentricular heart following long-lasting Waterston-Cooley anastomosis.

Waterston-Cooley anastomosis may be carried out in patients with tricuspid atresia to provide pulmonary perfusion. It is associated with several complications, including preferential blood flow to the right lung, hypoplasia of the left pulmonary artery, obstruction of the anatomosis or rupture of pulmonary aneurysms. We study a patient with thrombosis in the pulmonary arteries following surgical construction of a Waterston shunt in childhood. Imaging findings and clinical symptoms are discussed with emphasis on echocardiogram-gated multislice spiral CT.

Calcium scoring of aortic valve calcification in aortic valve stenosis with a multislice computed tomography scanner: non-enhanced versus contrast-enhanced studies.

PURPOSE: Previous studies have shown a positive correlation between amount of aortic valve calcification (AVC) and degree of aortic valve stenosis (AVS). We have investigated whether calcium scoring of AVC from contrast-enhanced images is reliable. MATERIAL AND METHODS: Nineteen patients with suspected AVS underwent retrospectively ECG-gated multislice computed tomography (MSCT). Standardized scan protocols were applied prior to (120 KV, 133 mAseff) and after (120 KV, 500 mAseff) the administration of non-ionic contrast material. Image reconstruction was performed at 60% of the RR interval (slice thickness 3 mm, reconstruction increment 2 mm). AVC was quantified using Agatston score and calcium mass. The number of lesions was calculated. All nonenhanced images were scored using thresholds of 130 HU and 350 HU. Contrast-enhanced images were assessed with a threshold of 350 HU exclusively. RESULTS: Fifteen patients with AVCs were included in the statistical analysis. The mean Agatston score (calcium mass) in non-enhanced images was 2888.4 +/- 2844.4 (694.2 mg +/- 869.3 mg). Altering the threshold from 130 HU to 350 HU led to a 58.2% (30.5%) decrease in the AVC score (P values < 0.001). Contrast-enhanced images showed an increased Agatston score (calcium mass) of 56.2% (33.5%) compared to non-enhanced images (P values <0.05) with the same threshold of 350 HU. CONCLUSION: Quantification of AVC from contrast-enhanced images is not reliable, as contrast material simulates calcification.

Home Monitoring in an ICD patient with incessant ventricular tachycardia.

Due to the increasing number of patients and complexity of modern tachycardia devices, efficient therapy surveillance as offered by Home Monitoring (HM) is of increasing importance. We report of an ICD patient with incessant ventricular tachycardia, in whom immediate arrhythmia transmission by HM permitted hospitalization and change of medication without time delay.

Telephonic transmission of 12-lead electrocardiograms during acute myocardial infarction.

To test the feasibility of a small and simple system for telephonic transmission of 12-lead electrocardiograms (ECGs), 70 patients with acute coronary syndrome admitted to the cardiac care unit (CCU) were included in a feasibility study. The transmission system consisted of a belt with multiple electrodes, which was positioned around the chest. The ECG signal was sent to a call centre via a standard telephone line. In parallel, a standard 12-lead ECG was recorded on site. In a retrospective analysis, each lead of the transmitted ECG was compared with the on-site 12-lead ECG with regard to ST-segment changes and final diagnosis. In all 37 patients with acute ST-elevation myocardial infarction, the diagnosis was correctly established on the basis of telephone-transmitted ECGs. In 96% of limb and 88% of chest leads, ST elevations which were visible in standard ECGs were correctly displayed on telephonically transmitted ECGs. In the remaining 33 patients no false-positive diagnosis was made using transtelephonic ECG analysis. A control group of 31 patients without apparent heart disease showed high concordance between standard ECGs and telephonically transmitted ECGs. Telephonically transmitted 12-lead ECGs interpreted by a hospital-based internist/cardiologist might allow a rapid and accurate diagnosis of ST-elevation myocardial infarction and may increase diagnostic safety for the emergency staff during prehospital decision making and treatment of acute myocardial infarction.

[Value of cardiac multislice spiral CT for the assessment of degenerative aortic stenosis: comparison with echocardiography]. / Wertigkeit der kardialen Mehrschicht-Spiral-CT zur Beurteilung der degenerativen Aortenklappenstenose: Vergleich zur Echokardiographie.

OBJECTIVE: To non-invasively assess the severity of aortic valve stenosis (AS) by the determination of aortic valve calcification (AVC) using multislice spiral computed tomography (MSCT). MATERIALS AND METHODS: Forty-one consecutive patients (17 male, 24 female, mean age 71.0 +/- 7.9 years) with a history of AS and an aortic valve area < or = 2 cm (2) underwent retrospectively ECG-gated 4-slice MSCT and echocardiography. The AVCs were quantitatively assessed using the score described by Agatston as well as by calculating the calcium mass. The echocardiographically determined aortic valve area (AVA) and the severity of AS according to the ACC/AHA guidelines were compared to the degree of aortic valve calcifications. Pearson's correlation coefficient, cut-off values, kappa test and F-test with post hoc Bonferroni t-tests were calculated. RESULTS: Calcium scores were significantly higher in patients with severe AS, when compared to mild or moderate AS (p < 0.001). In patients suffering from severe AS, the mean Agatston score was 4125.5 +/- 1168.9 (calcium mass 904.1 +/- 263.3) while in patients with moderate and mild AS the corresponding values were 1596.3 +/- 987.0 (319.1 +/- 208.3) and 785.9 +/- 390.1 (149.1 +/- 90.2), respectively. Pearson's correlation coefficients were r = - 0.75 for the Agatston score and r = - 0.72 for the calcium mass. There was a moderate agreement between severity of AS according to the ACC/AHA guidelines and the degree of AS determined from AVC scores with kappa = 0.6091 and kappa = 0.6985, respectively. CONCLUSION: Severe AS may be differentiated from moderate or mild AS using cardiac MSCT. Extensive calcifications of the aortic valve presenting with an Agatston-Score > or = 2824 (calcium mass > or = 611) indicate a severe AS and should be taken as an indication for further diagnostic workup.

Individually weight-adapted examination protocol in retrospectively ECG-gated MSCT of the heart.

The standard protocol in multislice spiral CT (MSCT) angiography for coronary arteries with fixed tube current-time settings leads to an overexposure and thus to an unnecessary high radiation dose in patients with lower weight when compared to heavier patients. The purpose of this study was to estimate the effect of reducing the radiation dose by adapting the tube current-time settings individually. Fifty patients underwent retrospectively ECG-gated MSCT of the heart. In 25 patients (group A1) a standard protocol with constant tube current-time settings was used (4 x 1-mm collimation, 120 kV, 400 mAs(eff)). Subsequently, artificial image noise was added to the data of these patients simulating a directive for weight-adapted tube current-time settings (group A2). In the other 25 patients (group B) an alternative protocol with individually weight-adapted tube current-time settings was applied. The data of all groups were evaluated by a regression analysis. The image quality was assessed objectively by measuring the CT attenuation in standardised regions of interest and subjectively by three radiologists using a five-point scoring system in a consensus reading. Applying the weight-adapted tube current-time settings the effective radiation dose was reduced by 17.9% for men and 26.3% for women. The standard protocol leads to an overexposure in light patients as seen in the plot of noise vs weight (slope 0.16+/-0.07 HU/kg). By applying the weight-adapted tube current-time settings a weight-independent, constant image noise is achieved (slope 0.04+/-0.1 HU/kg). Diagnostic image quality was preserved in all patients. Individually weight-adapted tube current-time settings allow for a substantial dose reduction when performing retrospectively ECG-gated MSCT angiography for coronary arteries without impairment of diagnostic image quality.

Detection of coronary calcifications: feasibility of dose reduction with a body weight-adapted examination protocol.

OBJECTIVE: The purpose of this study was to assess the applicability of individual body weight-adapted tube current time settings in multidetector CT for detection of coronary calcifications and to evaluate the effect of reducing the radiation dose on the coronary calcium score. SUBJECTS AND METHODS. One hundred patients underwent retrospectively ECG-gated MDCT for detection of coronary calcifications. First, fixed tube current time settings were used in 50 patients. Second, image noise corresponding to body weight-adapted tube current time settings was added to these images. Finally, body weight-adapted tube current time settings were applied to another 50 patients. For each patient group, the radiation dose was calculated. Coronary calcium scores were compared for the patient groups with the fixed tube current time settings with and without artificially added image noise. In all image series, image noise was assessed by a region-of-interest methodology. Image noise was analyzed using a regression analysis. RESULTS: The effective radiation dose was reduced by 11.6% for men and 24.8% for women using the body weight-adapted tube current time settings. There were no statistically significant changes in the coronary calcium score after the addition of artificial image noise (p = 0.84). Adaptation of the tube current time settings did not lead to a relevant increase in image noise. The radiation doses for the plotted noise-to-body weight (slope, 0.081) and noise-to-body mass index (slope, 0.378) ratios for the standard protocol proved relatively high for patients of lower weight. An improved noise-to-body weight (slope, 0.054) and noise-to-body mass index (slope, 0.190) ratio was achieved by application of the body weight-adapted tube current time settings, resulting in nearly constant image noise related to body weight. CONCLUSION: Individual body weight-adapted current time settings are applicable for coronary calcium scoring without a change of the coronary calcium score or relevant increase of the image noise.

Developmental regulation of vascular endothelial growth/permeability factor messenger ribonucleic acid levels in and vascularization of the villous placenta during baboon pregnancy.

Vascular endothelial growth/permeability factor (VEG/PF) has an important role in angiogenesis; however, very little is known about the developmental regulation of VEG/PF and the vascular system within the placenta during human pregnancy. In the present study, therefore, a developmental approach was used in the baboon to determine the placental source of VEG/PF and its fms-like tyrosine kinase (flt-1) and kinase-insert domain containing (KDR/flk-1) receptors, and whether the rise in estrogen with advancing pregnancy was associated with a corresponding increase in placental VEG/PF expression and vascularization. VEG/PF messenger RNA (mRNA) levels were determined by competitive RT-PCR in villous cell fractions isolated by Percoll gradient centrifugation from placentas obtained on days 45 and 54 (very early), 60 (early), 100 (mid), and 165-170 (late) of baboon pregnancy (term = 184 days). Maternal peripheral serum estradiol increased from very low concentrations early in gestation (0.15-0.20 ng/ml) to an early surge of over 2.5 ng/ml on days 60-85, and peak levels of 4-6 ng/ml late in baboon pregnancy. VEG/PF mRNA was expressed in low level in the syncytiotrophoblast (<2,000 attomol/microgram total RNA), and values in this fraction did not change significantly with advancing gestation. VEG/PF mRNA expression was slightly greater in the inner villous core cell fraction; however, levels decreased (P < 0.05) between early and late gestation. Cytotrophoblasts were a major source of VEG/PF mRNA and levels increased (P < 0.01) from 3,631 +/- 844 attomol/microgram total RNA on day 45 to 25,807 +/- 5,873 attomol/microgram total RNA on day 170. VEG/PF protein expression determined by immunocytochemistry was abundant in cytotrophoblasts and lower in the syncytiotrophoblast and inner villous core cells. The flt-1 and KDR/flk-1 receptors were expressed in the vascular endothelial cells of the baboon villous placenta. The percentage of villous placenta occupied by blood vessels and the number of vessels/mm(2) villous tissue, determined by image analysis, progressively increased (P < 0.001; r = 0.97) from 3.4 +/- 0.2% and 447 +/- 29, respectively, on day 54 to 15.9 +/- 0.9% and 1,375 +/- 71, respectively, on day 170. In summary, the present study shows that villous cytotrophoblasts were a major source of VEG/PF mRNA and protein in the baboon villous placenta, and that cytotrophoblast VEG/PF mRNA levels and vascularization of the villous placenta closely paralleled the increase in estradiol concentrations of advancing pregnancy. These results are consistent with the concept that estrogen has an important role in establishing the new vascular system within the developing placenta during primate pregnancy and that VEG/PF mediates this process.

[Treatment results of childhood Hodgkin's lymphoma in Hungary] / A gyermekkori Hodgkin-lymphoma kezelési eredményei Magyarországon.

Lymphomas are the third most frequent malignancies in childhood. The Hungarian Pediatric Oncology Group was founded in 1971, and since then the same chemotherapeutic protocols have been used in the whole country. In this study we analyzed the data of childhood Hodgkin's lymphoma in Hungary in the last 11 years (1988-1998). We also compared our results with the international (German) data. The incidence of Hodgkin's lymphoma (0-15 years) was 7.1/1,000,000 child/year (the same for non-Hodgkin's lymphoma was 7.5/1,000,000/year); 5.5% of all pediatric malignancies in Hungary). The patients were treated according to the German DAL-HD-82 and 90 protocols. The therapy consisted of 2-6 cytostatic blocks, depending on the stage, followed by involved field irradiation. The overall survival was 94.7+/-2.0% at 5 years and 91.9+/-2.7% at 10 years. These results are very similar to the German data: 94% at 5 years and 93% at 10 years. The good results are due to the well organised network and the uniformed treatment. The results may be ameliorated by using autologous bone marrow transplantation.

[Results of limb-saving surgery and prognostic factors in patients with osteosarcoma]. / Végtagmegtartó mútétek eredményei és prognosztikai tényezók osteosarcomás betegeknél.

Ninety six patients with high-grade osteosarcoma of the extremities were treated between 1986 and 1997 in the authors institution. They were divided into three groups: in group I, all of 75 patients with non-metastatic OS received intensive chemotherapy and underwent surgery. In group II, 9 patients already had metastases at the time of referral. In group III, 12 patients received chemotherapy in delayed or suboptimal form. In group I, local recurrences occurred in 7 per cent (3 patients), metastases in 20 per cent of the patients with limb-saving, whereas these numbers were 3 per cent and 38 per cent in the amputation group. The 5-year disease free survival (DFS) was 72% v 69% in the limb-saving and amputation group, respectively. In groups II and III, 5-year DFS was extremely poor, 10 and 20% only. With univariate analysis, factors having a positive influence on the survival were: tumor volume < 60 cm3, wide or radical surgical margin, distal location of osteosarcoma, cartilagineous ground substance less than 20% and response to chemotherapy. The last 4 variables maintained their significance in the multivariate Cox model as well. Age > 30 showed indirect negative influence on the final outcome (enhanced intolerability to the drugs and less co-operability of the patients etc.). This data confirm the competence of the limb-saving surgery at certain indications beside the amputation.

Limb-saving surgery, survival, and prognostic factors for osteosarcoma: the Hungarian experience.

BACKGROUND AND OBJECTIVES: There are many factors thought to have an influence on the prognosis of osteosarcoma that have been reported in the literature. Their significance, however, still remains controversial in most cases. Experience with osteogenic sarcoma (OS) was reviewed in order to evaluate surgical results and survival and to determine the prognostic factors. METHODS: Ninety-six patients with high-grade osteosarcoma of the extremities were treated between 1986 and 1997 in the authors' institution. They were divided into 3 groups: In group I, all 75 patients with nonmetastatic OS received intensive chemotherapy (high-dose methotrexate, doxorubicin, ifosfamide, and cisplatin) and underwent surgery. In group II, 9 patients already had metastases at the time of referral. In group III, 12 patients received chemotherapy in delayed or suboptimal form. Results and Conclusions In group I, there were local recurrences in 3 patients (7%) and metastases in 8 patients (20%) with limb-saving, whereas these numbers were 1 (3%) and 14 (38%) in those who had amputation. The 5-year disease-free survival (DFS) was 72% and 69% in the limb-saving and amputation groups, respectively. In groups II and III, 5-year DFS was extremely poor, 10% and 20% only, underlining the importance of stage and intensity of chemotherapy, respectively. With univariate analysis, sex, duration of symptoms, and radiographic appearance of OS had no prognostic value, whereas tumor volume <60 cm(3), wide or radical surgical margin, distal location of OS, cartilagineous ground substance <20%, and response to chemotherapy were positive prognostic factors. The last 4 variables maintained their significance in the multivariate Cox model as well. Age >30 years showed indirect negative influence on the final outcome through enhanced intolerability to the drugs and less cooperability of the patients. The results on survival with limb-saving surgery were well comparable with those of amputation.

Relaxin stimulates uterine edema via activation of estrogen receptors: blockade of its effects using ICI 182,780, a specific estrogen receptor antagonist.

Relaxin's ability to stimulate uterine growth is well established. The mechanisms by which relaxin exerts this effect, however, remain unclear. In light of previous work demonstrating peptide growth factor activation of estrogen receptors (ERs), the present study was conducted to determine if relaxin similarly stimulates ERs. Twenty-five day-old female Sprague-Dawley rats were bilaterally ovariectomized and treated with estradiol or porcine relaxin alone or in combination with the ER antagonist ICI 182,780. Following treatment with 17beta-estradiol or relaxin alone, the uterine weight/body weight ratio (UtW/BW) increased significantly over control values (+98% and +77% respectively, p<0.0003). Pre-treatment of animals with ICI 182,780 (3 microg/g BW) prior to either estradiol or relaxin treatment completely inhibited the hormone-induced increases in uterine weight (p<0.0005). ICI 182,780 alone had no significant effect. Histological analysis of uterine cross-sections revealed that the edema present in the endometrium of animals treated with estradiol or relaxin alone was completely absent in the uteri of animals pre-treated with ICI 182,780. These data indicate that relaxin-induced uterine edema and growth is mediated by ERs.

Activation of vascular endothelial growth factor gene transcription by hypoxia-inducible factor 1.

Expression of vascular endothelial growth factor (VEGF) is induced in cells exposed to hypoxia or ischemia. Neovascularization stimulated by VEGF occurs in several important clinical contexts, including myocardial ischemia, retinal disease, and tumor growth. Hypoxia-inducible factor 1 (HIF-1) is a heterodimeric basic helix-loop-helix protein that activates transcription of the human erythropoietin gene in hypoxic cells. Here we demonstrate the involvement of HIF-1 in the activation of VEGF transcription. VEGF 5'-flanking sequences mediated transcriptional activation of reporter gene expression in hypoxic Hep3B cells. A 47-bp sequence located 985 to 939 bp 5' to the VEGF transcription initiation site mediated hypoxia-inducible reporter gene expression directed by a simian virus 40 promoter element that was otherwise minimally responsive to hypoxia. When reporters containing VEGF sequences, in the context of the native VEGF or heterologous simian virus 40 promoter, were cotransfected with expression vectors encoding HIF-1alpha and HIF-1beta (ARNT [aryl hydrocarbon receptor nuclear translocator]), reporter gene transcription was much greater in both hypoxic and nonhypoxic cells than in cells transfected with the reporter alone. A HIF-1 binding site was demonstrated in the 47-bp hypoxia response element, and a 3-bp substitution eliminated the ability of the element to bind HIF-1 and to activate transcription in response to hypoxia and/or recombinant HIF-1. Cotransfection of cells with an expression vector encoding a dominant negative form of HIF-1alpha inhibited the activation of reporter transcription in hypoxic cells in a dose-dependent manner. VEGF mRNA was not induced by hypoxia in mutant cells that do not express the HIF-1beta (ARNT) subunit. These findings implicate HIF-1 in the activation of VEGF transcription in hypoxic cells.

[Immunophenotyping of childhood leukemias--results of the first 100 bone marrow tests]. / Gyermekkori leukémiák immunfenotipizálása során kapott eredményeink (az elsó 100 csontvelvizsgálat tapasztalatai).

The authors used a cell-surface-marker analysis by flow cytometry for immunophenotyping of pediatric leukemia from 1993. Results of their first one-hundred cases were summarized. They examined 68 bone-marrow samples from 58 patients affected by leukemia, and diagnosed 19 acute myeloid leukemia (32%), 5 T-cell acute lymphoid leukemia (8%), 32 B-cell acute lymphoid leukemia (54%) and 2 biphenotypic leukemia (5%). A higher CD34 antigen positivity was found compared to adults. They analysed the incidence and prognostic significance of myeloid + lymphoid leukemia and lymphoid + myeloid leukemia cases. Nondiagnostic and unsuccessful cases were got according to the literature.

Childhood leukemia and statistical characteristics in 0- to 18-year-old patients in Hungary, diagnosed between 1988 and 1992.

A population-based cancer registry for childhood leukemia was started in Hungary in 1971. Data processing and analysis have been done at the Second Department of Pediatrics, Semmelweis University Medical School in Budapest, which is the main center for the treatment of childhood malignancies in Hungary. In 1992 a new computerized database structure was created in collaboration with Kansas University Medical Center, Kansas City, Kansas, United States. This work presents childhood leukemia frequency distribution and treatment results between 1988 and 1992 in Hungary. The number of patients diagnosed with leukemia under 18 years of age fluctuates between 69 and 82 cases per year. We present the main causes of death and outline our future objectives to improve the survival rate and quality of life.

Developmental increase in low density lipoprotein receptor messenger ribonucleic acid levels in placental syncytiotrophoblasts during baboon pregnancy.

We have previously shown that there was an estrogen-regulated developmental increase in low density lipoprotein (LDL) uptake by placental syncytiotrophoblasts during baboon pregnancy. To determine whether this reflected enhanced expression of the LDL receptor, the levels of LDL receptor messenger RNA (mRNA) were determined by Northern blot and reverse transcription-polymerase chain reaction in placental tissue obtained from baboons (Papio anubis) in early (days 58-64; pooled to yield 5 samples), mid- (days 97-110; pooled to yield 12 samples), and late (days 161-175; pooled to yield 15 samples) gestation (term = 184 days). Whole villous tissue and a trophoblast cell fraction isolated by 50% Percoll gradient centrifugation were analyzed. The latter cell fraction was equally comprised predominantly of syncytiotrophoblasts at early, mid-, and late gestation as determined by extensive immunocytochemical reactivity with antisera to syncytiotrophoblast-specific peptides. Tissues were extracted with guanidine isothiocyanate and 5 micrograms polyadenylated-enriched RNA hybridized to a 32P-labeled human LDL receptor complementary DNA (cDNA). A major 6.2-kilobase LDL receptor mRNA transcript was expressed in syncytiotrophoblasts and whole villous tissue, as determined by Northern blot. In the syncytiotrophoblast-rich cell fraction, LDL receptor mRNA levels, analyzed by Northern blot and autoradiodensitometry and expressed as a ratio of beta-actin, were similarly low in early (0.66 +/- 0.12 arbitrary units) and mid- (1.15 +/- 0.23) gestation, then increased to a level in late gestation (2.71 +/- 0.33) that was over 4- and 2-fold greater (P < 0.01) than that in early or midgestation, respectively. In contrast, in whole villous tissue, LDL receptor and beta-actin mRNA levels exhibited no consistent change or decreased slightly with advancing pregnancy, so that when corrected for beta-actin, LDL receptor mRNA levels were similar in early (1.53 +/- 0.33), mid- (1.44 +/- 0.16), and late (2.32 +/- 0.29) gestation. The unchanged levels of LDL receptor mRNA in whole placental villous tissue with advancing primate gestation may reflect potential villous tissue with advancing primate gestation may reflect potential confounding effects that nontrophoblast, e.g. vascular, components of the developing placenta may have on assessing trophoblast endocrine function in whole villous tissue. Amplification of trophoblast RNA by reverse transcription-polymerase chain reaction with LDL receptor primers generated a single cDNA product of approximately 258 base pairs.(ABSTRACT TRUNCATED AT 400 WORDS)

Increased expression of vascular endothelial growth/permeability factor in the rat ovary following an ovulatory gonadotropin stimulus: potential roles in follicle rupture.

Ovulation is accompanied by a large increase in the permeability of the capillaries surrounding the follicle, beginning a few hours after the ovulatory stimulus. The resulting edema may play a role in ovulation as well as in the formation and vascularization of the CL. Vascular endothelial growth/permeability factor (VEG/PF) is both a specific mitogen for endothelial cells and a potent stimulator of vascular permeability. The purpose of this study was to determine whether or not the ovulatory stimulus induces an increase in the expression of VEG/PF in the ovary. Female rats were primed with 8 IU of eCG at 27 days of age. Follicular maturation and ovulation were induced with an injection of hCG (5 IU) in the early afternoon on the second day after priming. Ovaries were removed 0, 1, 2, 4, 8, 10, and 18 h later. VEG/PF mRNA levels were compared through use of quantitative reverse transcription-polymerase chain reaction (RT-PCR). There was a marked increase (approximately 8-fold) in steady state levels of the transcripts for VEG/PF120 and VEG/PF164 between 1 and 4 h after hCG in whole ovaries. Increases were detectable both in granulosa cells and in thecal/stromal tissue. The high level of expression was maintained at 10 and 18 h (Day 1 CL). Thus, the preovulatory increase in follicular vascular permeability is closely associated with a marked, sustained increase in VEG/PF expression. VEG/PF, therefore, may play an important role in that increase and, consequently, in the process of ovulation as well as the subsequent vascularization of the CL.