Glenn M Hashiro

The utility of serum leptin and follicular fluid leptin, estradiol, and progesterone levels during an in vitro fertilization cycle

AbstractPurpose: To prospectively evaluate serum and follicular fluid leptin, estradiol, and progesterone levels during in vitro fertilization. Methods: Prospective observational study measuring serum levels at six points during the IVF cycle and follicular fluid at the time of retrieval. Results: Serum leptin and estradiol levels both significantly increased for the individual patients during the IVF stimulation process. None of the leptin levels differed based on pregnancy outcome. BMI significantly correlated with all leptin levels. Follicular fluid estradiol correlated with serum estradiol only in pregnant patients (r = 0.97, p<0.01) and was unrelated in non-pregnant patients (r=−0.15, p=0.81). Conclusion: Serum and follicular leptin levels are highly correlated. Leptin levels increase during the IVF cycle and vary between patients based on maternal BMI, but do not correlate with other serum hormone levels or pregnancy outcome. Pregnancy outcome success was reflected in the relationship between follicular fluid and serum levels of estradiol, independent of leptin levels.

Developmental Changes in Sodium Nitroprusside and Atrial Natriuretic Factor Mediated Relaxation in the Guinea Pig Aorta

ABSTRACT: Sodium nitroprusside (SNP), a nonreceptor mediated stimulant of soluble guanylate cyclase, and atrial natriuretic factor, a receptor-dependent stimulator of particulate guanylate cyclase, mediate relaxation responses by increasing intracellular cGMP. This in vitro study was designed to compare the ontogeny of relaxation responses to SNP and atrial natriuretic factor in the guinea pig thoracic aorta. Aortic rings from fetuses at 55-60 d gestation (term = 68 d), 1- to 3-d-old newborn, and 12-wk-old adult Hartley guinea pigs were mounted in an organ bath, bathed in Krebs solution, and connected to a force-displacement transducer to measure isometric tension. Relaxation responses to SNP and atriopeptin III were studied with the vessels at optimal resting tension and after preconstriction with an EC85 concentration of norepinephrine. SNP-mediated relaxation showed a significant increase in sensitivity with development among the three age groups (p < 0.05). Methylene blue, an inhibitor of soluble guanylate cyclase, produced no inhibition of relaxation to SNP in fetal aortae, significantly decreased responses along the straight portion of the concentration-response curve in newborn aortae (p < 0.05), and significantly shifted the concentration-response curve to the right (p < 0.05) in adult aortae; but did not prevent vessels from relaxing almost 100% in any age group. However, atriopeptin III-mediated responses were similar in the three age groups and were unaffected by methylene blue. These results suggest that 1) sensitivity to SNP increases with age from fetal through adult life; 2) relaxation mediated by atriopeptin III is similar during development; 3) methylene blue does not affect SNP mediated relaxation in fetuses but progressively decreases sensitivity to SNP in newborns and adults; and4) methylene blue does not affect atriopeptin III-mediated relaxation in any age group.

Effect of baseline lung compliance on the subsequent response to positive end-expiratory pressure in ventilated piglets with normal lungs.

Objective: To determine the pulmonary function and hemodynamic effects of incremental positive end‐expiratory pressure in two groups of normal ventilated newborn piglets with different baseline dynamic lung compliance. Design: Prospective, controlled, intervention study. Setting: Animal laboratory. Interventions: One group of piglets (inflation group) was prepared with 3 cm H2O (0.29 kPa) positive end‐expiratory pressure and a maximal lung inflation to increase baseline lung compliance as compared with the other group (noinflation group), prepared by 3 hrs of ventilation at zero end‐expiratory pressure. Both groups were then subjected to a sequence of incremental positive end‐expiratory pressures from 0 to 12 cm H2O (0 to 1.18 kPa) in 2‐cm increments for 15‐min periods at each level followed by a 60‐min recovery period at zero end‐expiratory pressure. Measurements and Main Results: Pulmonary function, hemodynamic and blood gas data were collected at each positive end‐expiratory pressure value and at 15‐min intervals during recovery. Baseline dynamic lung compliance was 5.2 ± 0.3 mL/cm H2O (53.04 ± 3.06 mL/kPa) in the inflation group and 2.5 ±0.1 mL/cm H2O (25.5 ± 1.02 mL/kPa) in the no‐inflation group. No differences were found in any other pulmonary function, hemodynamic or blood gas value at baseline. Incremental positive end‐expiratory pressure resulted in a decrease in dynamic lung compliance and an increase in end‐expiratory lung volume in both groups of piglets; dynamic lung compliance was greater in the inflation group at all times. No differences were found in end‐expiratory lung volume between groups. Hemodynamic changes in both groups of piglets included: decreased cardiac output and increased pulmonary vascular resistance and systemic vascular resistance. The changes in cardiac output (‐23% vs. ‐32%), pulmonary vascular resistance (+53% vs. +95%), and systemic vascular resistance (17% vs. 51%) were less in the inflation group as compared with the noinflation group. Conclusions: Baseline dynamic lung compliance is an important determinant of the subsequent effect of positive end‐expiratory pressure on pulmonary function and hemodynamics in the ventilated piglet with normal lungs. (Crit Care Med 1994; 22:1631–1638)