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Unclassifiable seronegative spondyloarthropathy (SSA) syndrome is primarily considered to be an affliction of males. In this report from northern India, 25 HLA-B27 antigen positive females with this condition are described and compared with 39 HLA-B27-positive males with the same disease. All these patients presented with typical features of spondyloarthropathy such as predominantly lower limb synovitis, enthesopathy and inflammatory spinal pain. The onset was insidious in 56% of the females and in 64% of the males. The mean age of onset as also the mean duration of symptoms prior to diagnosis were significantly higher in females (26.2 vs 19.4 yr and 8 vs 2 yr, respectively). A mono- or oligo-arthritis was seen in 52% of the females and in 53% of the males, but the average number of joints involved was less in females (4.8 vs 7.7). Lower limb joints alone were involved in 56% of the females and 49% of the males, with the knees, ankles and hips being most commonly involved, often asymmetrically. The mean degree of symmetry was significantly lower in females (62 vs 76). Ninety-two per cent of females and 74% of males had inflammatory spinal pain. Radiographic sacroiliitis was demonstrable in 56% females and 74% males. It is concluded that 'unclassifiable' SSA syndrome is not infrequent in females but is diagnosed late. Fewer joints tend to be involved and there is greater tendency towards asymmetry in females.
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The serum pharmacokinetics of recombinant human inhibin A (rh-inhibin A) and rh-activin A were examined in immature female Sprague Dawley-derived rats after iv and sc injection of the drugs. After iv administration of rh-inhibin A (120 micrograms/kg), the serum concentrations were described by a biexponential equation. The weight-normalized clearance was 21.3 ml/min.kg, and the initial (t1/2 alpha) and terminal (t1/2 beta) half-lives were 2.9 min and 37.9 min, respectively. Subcutaneous administration of 120 micrograms/kg rh-inhibin A resulted in a peak serum concentration of 10.6 ng/ml at 30.8 min after injection. Approximately 24% of the sc administered material was absorbed. Serum concentrations of rh-activin A also declined biexponentially after iv injection of the drug (120 micrograms/kg). The clearance of rh-activin A was 5.1 ml/min.kg, the t1/2 alpha was 6.1 min, and the t1/2 beta was 46.3 min. The peak serum concentration of rh-activin A (104.7 ng/ml) was achieved 24.7 min after sc delivery of the drug. The bioavailability of the sc dose was 38%. Iodinated rh-inhibin A and rh-activin A were used to examine the serum forms and metabolites of the drugs. [125I]rh-inhibin A and [125I]rh-activin A associated with two serum-binding proteins. Within 2 min of iv injection, the labeled hormones bound follistatin and alpha-2-macroglobulin. Even though rh-inhibin A and rh-activin A are structurally similar and appear to bind to the same serum proteins, their disposition in the immature rat differ.
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144 patients were treated by 5 different stimulation protocols in the IVF-program of the University Women's Hospital Rostock (Clomiphene/hCG, Clomiphene/Anthrogon/hCG, Pergonal/hCG, Anthrogon/hCG, Folistiman/hCG). Estradiol-17 beta and progesterone were determined during the follicular phase of 172 cycles by RIA. The results were compared between the treatment groups by means of Student's t-test or Mann-Whitney's nonparametric test. Additionally, in 37 cycles prolactin was determined. The levels of estradiol-17 beta in all treated groups were higher as compared with spontaneous cycles. Between the groups statistically significant differences were found in start and velocity of E2-rise, in the average level of E2, and in the level of preovulatory peaks. The latent phase of stimulation was significantly longer in patients treated with pergonal than in Anthrogon treated patients. Moreover, in the Anthrogon group the rate of "high responder" was higher. On average, in patients with a very fast growth rate of estradiol-17 beta (greater than 1.9 nmol/l) during the late follicular phase the percentage of less mature oocytes was increased after follicular puncture. The levels of progesterone started to rise in all groups between day-2 and -1 (day 0: day of LH-peak). On day 0, patients with Pergonal and Anthrogon had the significantly highest level. Levels above the 1s-range occurred in 12 patients during the follicular phase. This elevation of progesterone took place in 3 patients without any rise of basal LH-levels. 80.4% of 37 patients investigated were found to have prolactin levels above 500 mE/l during the late follicular phase. This transient hyperprolactinemia correlated with the rise of estradiol levels and continued during the early and mid luteal phase. Hence preventive administration of bromocryptine appears to be advisable in cycles stimulated with gonadotropins.
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The morphological organisation of the face reflects the individual's social context and heredity and also reveal certain personality traits. Emotional facial expression is a very special form of communication. This functional and behavioural dynamic leads to the formation of a certain anatomical structure as a result of repetitive functions. The psychological examination of nineteen retrognathic patients and seven prognathic patients revealed the timid, inhibited of even anxious personality of the first group of patients in contrast with the extraverted and frequently aggressive personality of prognathic patients.
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