Maternal interleukin-6 (-174) C/C polymorphism is associated with chorioamnionitis and cystic periventricular leucomalacia of the preterm infant.

OBJECTIVE: To evaluate the association between maternal interleukin (IL)-6 G(-174)C polymorphism and cystic periventricular leukomalacia (cPVL) of the preterm newborn. STUDY DESIGN: After searching a local database, we recruited 132 preterm infants with diagnosis of cPVL, 44 Caucasian mothers were also recruited to participate in this candidate gene-association study at a single teritary care center. Data related to maternal IL-6 G(-174)C polymorphisms were compared with 41 controls, and furthermore compared with data from umbilical cord blood samples from a consecutive birth cohort of 395 healthy newborns, and published data from Caucasian populations including 1104 adults, respectively. In addition, subgroup analysis was performed in cases with either history of preterm premature rupture of the membranes (PPROM) or clinical chorioamnionitis (CCA). IL-6 genotyping was performed using an allele-specific polymerase chain reaction technique. RESULT: Frequencies of the IL-6 G(-174)C polymorphisms did not differ between cases (GG, 29.5%; GC, 54.5% and CC, 15.9%) and controls (GG, 34.2; GC, 51.2 and CC, 14.6%). Subgroup analysis of 31 cases with history of PPROM (GG, 25.8; GC, 54.8 and CC 19.4%) and controls did not reveal significant differences, but a significantly higher frequency of the CC genotype was found in 23 cases with a history of CCA (34.8%) compared with controls by either univariate (P=0.032; odds ratio 3.11, 95% confidence interval (CI) 1.11 to 8.68) or multivariate analysis (P=0.049, odds ratio 2.54, 95% CI 1.01 to 6.45). These data were confirmed by a comparing the CC genotype frequency to 395 term controls (CC 14.7%, P=0.005) and to the mean CC genotype frequency of 1104 Caucasian adults (CC 15.6%, P<0.0001). CONCLUSION: Frequencies of the IL-6 G(-174)C polymorphisms did not differ between groups. Subgroup analysis revealed an association of the CC genotype with CCA and cPVL in the preterm newborn.

Localization of indoleamine 2,3-dioxygenase in human female reproductive organs and the placenta.

Indoleamine 2,3-dioxygenase (IDO) has been implicated in regulation of feto-maternal tolerance and protection against intracellular and extracellular pathogens. We have studied the expression of IDO in the human female reproductive tract and the placenta by immunohistochemistry. Endometrial glandular and surface epithelial cells showed increasing IDO expression during the course of the menstrual cycle. In term placenta, IDO was irregularly localized to the mesenchymal core and found in isolated areas of the syncytiotrophoblast. In first trimester pregnancy, IDO was not present in placental villi, but was present in glandular epithelium of the decidua, and there were distinctly positive cells scattered in the connective tissue, sometimes in conjunction with lymphoid aggregates. The endothelium of spiral arteries and of capillaries showed some, albeit no generalized, reactivity. IDO was also present in the epithelium of cervical glands and of Fallopian tubes. Specificity of antibody binding was confirmed by Western blot analysis. IDO mRNA was detected in first trimester decidua as determined by RT-PCR. IDO is secreted, as determined by analysis of cervical mucus by high pressure liquid chromatography for the presence of the tryptophan metabolite L-kynurenine, indicating IDO activity. Our results support the concept of IDO providing a mechanism of innate immunity protecting against ascending infections in the female reproductive tract.

High-performance liquid chromatography-electrospray ionization mass spectrometry using monolithic capillary columns for proteomic studies.

The use of tetrahydrofuran/decanol as porogens for the fabrication of micropellicular poly(styrene/divinylbenzene) monoliths enabled the rapid and highly efficient separation of peptides and proteins by reversed-phase high-performance liquid chromatography (RP-HPLC). In contrast to conventional, granular, porous stationary phases, in which the loading capacity is a function of molecular mass, the loadability of the monoliths both for small peptides and large proteins was within the 0.40.9-pmol range for a 60- x 0.2-mm capillary column. Lower limits of detection obtained by measuring UV-absorbance at 214 nm with a 3-nl capillary detection cell were 500 amol for an octapeptide and 200 amol for ribonuclease A. Upon reduction of the concentration of trifluoroacetic acid in the eluent from the commonly used 0.1-0.2 to 0.05%, the separation system was successfully coupled to electrospray ionization mass spectrometry (ESI-MS) at the cost of only a small decrease in separation efficiency. Detection limits for proteins with ESI-MS were in the lower femtomole range. High-quality mass spectra were extracted from the reconstructed ion chromatograms, from which the masses of both peptides and proteins were deduced at a mass accuracy of 50-150 ppm. The applicability of monolithic column technology in proteomics was demonstrated by the mass fingerprinting of tryptic peptides of bovine catalase and human transferrin and by the analysis of membrane proteins related to the photosystem II antenna complex of higher plants.

Fas and Fas-ligand are expressed in the uteroplacental unit of first-trimester pregnancy.

PROBLEM: Fas and Fas-ligand (FasL) are thought to provide a strategy for reducing graft rejection in immunologically 'privileged' tissues by controlling injurious lymphocyte reactions. As the uteroplacental unit is often defined as an immune-privileged site, we investigated the expression of Fas and FasL in this tissue in the first trimester of pregnancy. METHOD OF STUDY: Western blotting, immunohistochemistry, and double immunofluorescence were used for this examination. RESULTS: Western blotting with purified first-trimester trophoblast cells revealed one specific band for FasL. The presence of FasL on different trophoblast populations could be confirmed by immunohistochemistry and double immunofluorescence. In the villous part of the placenta, FasL is mostly located on cytotrophoblast cells with no access to maternal blood flow, whereas in trophoblast-invaded uterine tissue, interstitial trophoblast cells, which are in close contact with maternal leukocytes, revealed a strong signal for FasL, but no staining for Fas on these cells. However, Fas was found on CD45+ maternal leukocytes. CONCLUSION: Based on our experimental findings, we speculate that the abundant presence of FasL on trophoblast cells within the maternal decidua may play an important role in the maintenance of immune privilege in the pregnant uterus by endowing fetal trophoblast cells with a defense mechanism against activated maternal leukocytes, whereas in the villous part of the placenta, the Fas FasL system seems to be involved in the regulation of placental growth.

Immunohistochemical examination of trophoblast populations in human first trimester and term placentae and of first trimester spiral arteries with the monoclonal antibody GZ 112.

This paper presents an immunohistochemical study with a monoclonal mouse antibody GZ 112, an IgG1 kappa, which is directed against an antigen expressed in first trimester placenta by all proliferative and invasive extravillous trophoblast populations including a population of Langhans cells that represent extravillous stem cells. Additionally, the GZ 112 antigen is associated with morphological changes of spiral arteries preceding local trophoblast invasion. In term placentae, GZ 112 also strongly reacts with all extravillous trophoblast populations, but additionally recognizes partly villous cytotrophoblast and syncytiotrophoblast too, displaying a heterogeneous staining pattern. GZ 112 is directed against a 42-KDa antigen. Intracytoplasmic network-like staining and cross-reactivity with various human surface and glandular epithelia indicate a cytokeratin intermediate filament or a cytokeratin intermediate filament associated molecule as antigen.

Phenotypic comparison of natural killer cells from peripheral blood and from early pregnancy decidua.

In this descriptive flow cytometric study we analyzed the phenotype of human large granular lymphocytes from the decidua (DLGL) of first-trimester pregnancy. Expression of CD56 at high density on DLGL suggests a relationship to the small CD56bright+ subpopulation of peripheral blood natural killer (PBNK) cells. In comparison, these cell types differ in respect to the expression of a variety of adhesion molecules and receptors implicated in homing, migration and activation. In contrast to CD56bright+ PBNK cells, DLGL were still brighter for CD56 and show higher expression for CD29 and CD45RO. Less expression was found for CD15s, CD43, CD44, CD45RA, CD62L and HLA-DR. CD11a to c and CD18 were distributed in bimodal form on DLGL, part of the cells being negative. In summary, we found considerable differences between the cell surface marker profiles of DLGL and PBNK cells (subpopulations of the latter being separately analyzed).

Twin labour complicated by umbilical cord knotting.

We report a case of intrapartum distress of the first twin due to a knot in the umbilical cord. Cord blood flow is reduced according to Poiseuille's law as the knot tightens.

[The obstetric risk in adolescent primiparous females]. / Zur Frage des Geburtsrisikos bei jugendlichen Erstgebärenden.

The obstetric risks in primiparae between 12 and 17 years of age have been reviewed in cases treated at our hospital from 1982 to 1987. We looked for intrauterine foetal deaths, premature deliveries (birth weight less than 2500 g), breech presentations, preeclampsia, Caesarean sectio rate, forceps rate, and thirdstage complications. The risks found in the group of 476 young primiparae were compared to those amongst the 26,768 overall deliveries during the same period. The incidence of breech presentations, preterm deliveries and forceps deliveries was about the same as in the general group. Intrauterine foetal death, thirdstage complications, Caesarean section deliveries, and, especially preeclampsia, were (markedly) less common than in the overall group. As a result, we no longer consider youthful mothers from our area a higher obstetric risk.

[The psychosocial background of sterile patients]. / Untersuchungen zum psychosozialen Hintergrund von Sterilitätspatienten.

The psychosocial background of 300 childless couples from the Infertility Clinic of the Department of Gynecology and Obstetrics, University of Graz, was evaluated by means of a questionnaire and statistical analysis of data from their files. Points of special interest were problems such as interactions of the couple, motivations for the desire of children, psychosomatics, andrological investigation within the gynecological department, sexual habits and motivation and compliance concerning investigations and treatment. 72% of the questionnaires were returned. 50% of the sterile couples preferred to attend the infertility clinic together. 26% felt restrictions in their sexual behaviour due to the unrealized desire of children, 48% expected improvements in their partnership if they could have children. Compliance of male partners concerning the regular intake of prescribed medicaments was 83%, 63% accepted to stop smoking in cases of pathospermia.

[Sexuality following radical operations]. / Sexualität nach Radikaloperationen.

In a retrospective study to evaluate the sexuality of patients after radical surgery for cervical cancer, we interviewed with a standardized questionnaire 87 women who had undergone radical abdominal (N = 76) or radical vaginal (N = 11) hysterectomy between 1971 and 1985. Apart from employment and partnership, we assessed sexual behaviour as reflected by frequency of coitus, libido, and orgasm. The patients were questioned about each aspect preoperatively before knowing the diagnosis, post-operatively after the immediate effects of surgery had passed, and at the time of the interview. 6.6% of the women could be considered invalids. There was a clear decrease in frequency of coitus and an anxiety-related decrease of libido. However, the number of patients without sexual activity was not statistically different from that in an age-matched group of women who did not undergo surgery. 4.5% of partnerships broke up as an immediate consequence of the surgery. Only 20% of the patients felt they had been adequately informed of possible sexual consequences of treatment by the surgeon.