Assessing menstrual cycles with urinary hormone assays.

The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of middle-aged women enrolled at seven US sites. A subset of 848 women completed a substudy in which their urinary gonadotropins and sex steroid metabolites were assessed during one complete menstrual cycle or up to 50 consecutive days. Urine was analyzed for LH, FSH, estrone conjugates (E1c), and pregnanediol glucuronide (Pdg). To prepare for serial analysis of this large, longitudinal database in a population of reproductively aging women, we examined the performance of algorithms designed to identify features of the normal menstrual cycle in midreproductive life. Algorithms were based on existing methods and were compared with a "gold standard" of ratings of trained observers on a subset of 396 cycles from the first collection of Daily Hormone Substudy samples. In evaluating luteal status, overall agreement between and within raters was high. Only 17 of the 396 cycles evaluated were considered indeterminate. Of the 328 cycles rated as containing evidence of luteal activity (ELA), 320 were considered ELA by use of a Pdg threshold detection algorithm. Of 51 cycles that were rated as no evidence of luteal activity, only 2 were identified by this algorithm as ELA. Evaluation of the day of the luteal transition with methods that detected a change in the ratio of E1c to Pdg provided 85-92% agreement for day of the luteal transition within 3 days of the raters. Adding further conditions to the algorithm increased agreement only slightly, by 1-8%. We conclude that reliable, robust, and relatively simple objective methods of evaluation of the probability and timing of ovulation can be used with urinary hormonal assays in early perimenopausal women.

Immune effects of hormone replacement therapy in post-menopausal women.

Hormone replacement therapy (HRT) confers many health benefits to post-menopausal women. Despite links between estrogen and immune function prior to menopause, the immune status of women receiving HRT has not been rigorously investigated. This case-control study uses clinical laboratory assessment, flow cytometry, and functional assays to measure immune function. Participants included 27 post-menopausal women taking estrogen/progestin combinations, and 22 post-menopausal women not receiving HRT. Compared to the (-)HRT group, the (+)HRT group had more B-cells (p<0.05), higher mitogen-induced T-cell proliferation (p<0.05), and higher levels of induced TNF-alpha (p<0.05). There was a trend towards a lower proportion of CD4+ T-cells expressing the activation marker CD25+ (p<0.10). These findings represent a reversal of immune alterations associated with normal aging, suggesting that preservation or improvement of immune function may be associated with the use of HRT.

Desaturation, dioxygenation, and monooxygenation reactions catalyzed by naphthalene dioxygenase from Pseudomonas sp. strain 9816-4.

The stereospecific oxidation of indan and indene was examined with mutant and recombinant strains expressing naphthalene dioxygenase of Pseudomonas sp. strain 9816-4. Pseudomonas sp. strain 9816/11 and Escherichia coli JM109(DE3)[pDTG141] oxidized indan to (+)-(1S)-indanol, (+)-cis-(1R,2S)-indandiol, (+)-(1S)-indenol, and 1-indanone. The same strains oxidized indene to (+)-cis-(1R,2S)-indandiol and (+)-(1S)-indenol. Purified naphthalene dioxygenase oxidized indan to the same four products formed by strains 9816/11 and JM109(DE3)[pDTG141]. In addition, indene was identified as an intermediate in indan oxidation. The major products formed from indene by purified naphthalene dioxygenase were (+)-(1S)-indenol and (+)-(1R,2S)-indandiol. The results show that naphthalene dioxygenase catalyzes the enantiospecific monooxygenation of indan to (+)-(1S)-indanol and the desaturation of indan to indene, which then serves as a substrate for the formation of (+)-(1R,2S)-indandiol and (+)-(1S)-indenol. The relationship of the desaturase, monooxygenase, and dioxygenase activities of naphthalene dioxygenase is discussed with reference to reactions catalyzed by toluene dioxygenase, plant desaturases, cytochrome P-450, methane monooxygenase, and other bacterial monooxygenases.

Ambulatory care in the public sector: perinatal care in Los Angeles County.

In planning its response to the increasing demand for perinatal services and the increasing rate of infant mortality and low-birthweight infants the Los Angeles County Department of Health Services faces a formidable set of tasks. Initiatives already in place are attempting to deal with some of the most pressing problems. However, increased services must be made available to enable the increasing number of women to access the system of care, and further outreach is necessary to encourage more women to begin prenatal care early in pregnancy. The county needs to increase the availability of perinatal care services, and these services must respond to the cultural and socioeconomic needs of pregnant women. Financial barriers to care must be eased, and the process of qualifying for Medi-Cal must be simplified. Additional private providers need to be brought into the system, and alternative care providers--such as birthing centers and delivery by midwives--should be expanded for low-risk pregnancies. The DHS has been forced to respond to staggering increases in demands for perinatal care services, and the population pressures and the widening socioeconomic gaps are unlikely to decrease in the near future. These same forces also require the DHS to respond to the increased demand for other health services. The DHS is being required to develop and maintain a complex program of health services without adequate financial resources. The solution to the perinatal care crisis in Los Angeles County and other localities with high rates of poverty cannot be found solely within local governments. It is unrealistic to expect that local taxation can support an increase of this magnitude in the need for care, and increased state and federal support is essential. Other nations, spending far less for health care, produce significantly better results: how much longer will it take this nation to recognize its responsibilities to its most vulnerable citizens?

Microbial transformation of the tetrazolinone herbicide f5231.

Microbial transformation of the tetrazolinone herbicide F5231 was accomplished with the filamentous fungus Absidia pseudocylindrospora Hesseltine et Ellis (ATCC 24169). The fungus converted the herbicide to six metabolites which were identified spectrally by mass, infrared, and nuclear magnetic resonance spectroscopy.

Bacterial oxidation of the polycyclic aromatic hydrocarbons acenaphthene and acenaphthylene.

A Beijerinckia sp. and a mutant strain, Beijerinckia sp. strain B8/36, were shown to cooxidize the polycyclic aromatic hydrocarbons acenaphthene and acenaphthylene. Both organisms oxidized acenaphthene to the same spectrum of metabolites, which included 1-acenaphthenol, 1-acenaphthenone, 1,2-acenaphthenediol, acenaphthenequinone, and a compound that was tentatively identified as 1,2-dihydroxyacenaphthylene. In contrast, acenaphthylene was oxidized to acenaphthenequinone and the compound tentatively identified as 1,2-dihydroxyacenaphthylene by the wild-type strain of Beijerinckia. Both of these products were also formed when the organism was incubated with synthetic cis-1,2-acenaphthenediol. A metabolite identified as cis-1,2-acenaphthenediol was formed from acenaphthylene by the mutant Beijerinckia sp. strain B8/36. Cell extracts prepared from the wild-type Beijerinckia strain contain a constitutive pyridine nucleotide-dependent dehydrogenase which can oxidize 1-acenaphthenol and 9-fluorenol. The results indicate that although acenaphthene and acenaphthylene are both oxidized to acenaphthenequinone, the pathways leading to the formation of this end product are different.