Localization of chorionic gonadotropin in the albino rat placenta was studied by an immunofluorescent staining method. Intense apple-green fluorescence was observed in the cytoplasm of the trophoblast giant cells of the junctional zone from the 12th to 19th day of pregnancy. The trophospongial cells and glycogen cells of the junctional zone, and decidual cells showed no distinct green fluorescence, but granular green fluorescence wasobserved in the cytoplasm of the trophoblast cell of the labyrinth from the 16th to 18th day of pregnancy. The epithelium of the amnion investing the fetal surface of the placenta and the umbilical cord, which is covered with a single layer of amnion cells, showed no fluorescence. Methyl-green pyronin positive substance (RNA) appeared in relatively large amounts in the cells of yolk sac, labyrinth, junctional zone, and decidua from the 8th day of pregnancy. Albino rat chorionic gonadotropin was localized mostly in the cytoplasm of the trophoblast giant cells in the junctional zone and a smaller amount in the trophoblast cells of the lobyrinth by means of the immunofluorescent technic.
Animals ; Chorionic Gonadotropin/*analysis ; Female ; *Fluorescent Antibody Technique ; Placenta/*analysis ; Rabbits ; Rats

OBJECTIVETo study the effect of mifepristone on the expression of chorionic gonadotropin beta subunit (beta-CG) and collagen type IV in female Rhesus monkey decidua and villus during the first trimester of pregnancy.

METHODSEighteen sexually mature female Rhesus monkeys were allowed to cohabitate with their male counterparts and diagnosed as being pregnant by B-ultrasound at days 38-45 of the menstrual cycle. They were randomly divided into mifepristone treatment group (15 mg/ml.kg.day, 3 days), control group(no treatment) and CMC-Na treatment group(0.5% CMC-Na, 1 ml/kg.day, 3 days). The content and distribution of chorionic gonadotropin beta subunit and collagen type IV in the female Rhesus monkeys were examined by immunohistochemical technique.

RESULTSCompared with the control group, the immunohistochemical reaction intensity of chorionic gonadotropin beta subunit in the plasm of stroma cells, glandular epithelial cells and decidual cells of decidua, and synctial trophoblast cells of villus significantly decreased in the mifepristone treatment group. The positive staining of collagen type IV surrounding the epithelial glandular basal membrane, decidual cells and blood vessels in decidua and surrounding the synctial trophoblast cells in villus were significantly reduced.

CONCLUSIONMifepristone may have a strong effect in decreasing the bioactivity of beta-CG in decidua and the synthesis of beta-CG in villus, and in accelerating the degradation of collagen type IV in decidua and villus.

Animals ; Chorionic Gonadotropin, beta Subunit, Human ; analysis ; Chorionic Villi ; chemistry ; Collagen Type IV ; analysis ; Decidua ; chemistry ; Female ; Immunohistochemistry ; Macaca mulatta ; Mifepristone ; pharmacology ; Pregnancy

BACKGROUNDThe second-trimester maternal serum screening in twin pregnancy is still controversial, as the serum marker levels in twins are not as clear as those in singletons. This study aimed to evaluate the relationship between the levels of the second-trimester maternal serum free beta-human chorionic gonadotropin (free beta-HCG) and alpha-fetoprotein (AFP) in normal twin and singleton pregnancies and to estimate feasible analysis methods for utilizing these markers in second trimester screening for twin pregnancy.

METHODSOn the basis of a prospective population-based study of second-trimester maternal serum screening, the concentrations of maternal serum AFP and free beta-HCG of 195 normal twin pregnancy and 26,512 singleton controls at gestational weeks 15 to 20 were measured by time-resolved fluoroimmunoassay in one laboratory. The levels of markers were compared between the twins and singletons using weight-correction and gestational age-specific model.

RESULTSAccording to the research protocol, 95 communities were randomly sampled, which covered the whole Jiangsu province, the east of China. A total of 26 803 pregnant women (98%), from the target population accepted prenatal screening for maternal serum AFP, beta-HCG detection, and all babies were followed up for at least six months. There were 197 (0.73%) twin pregnancies, of which one case had fetal trisomy 18, and one case with fetal anencephaly. The others were normal twin pregnancy. From a total enrollment of 26 803 women participants, 26 512 women with normal singleton pregnancies were selected as the model controls. The other 291 pregnancies, including trisomy 21, neural tube defect (NTD), trisomy 18, and other fetal abnormalities, were excluded. No significant differences were found in the medians of gestational age-specific maternal serum free beta-hCG and AFP in normal twin pregnancy comparing with twice those in model controls with the exception of the medians for free beta-hCG during the 16th gestational week (P = 0.012).

CONCLUSIONThe weight-correction and gestational age-specific levels of Chinese Han population maternal serum free beta-hCG and AFP in normal twins were twice the levels as those in the singleton controls during the 17-19 gestational weeks.

Adult ; Chorionic Gonadotropin, beta Subunit, Human ; blood ; Female ; Humans ; Pregnancy ; blood ; Pregnancy Trimester, Second ; Twins ; alpha-Fetoproteins ; analysis

OBJECTIVE: To evaluate the predictive factors associated with the success of medical abortion by misoprostol monotherapy within 24 hours in the first trimester of pregnancy. METHODS: The records of 228 women with miscarriage up to 11 weeks of gestational age who underwent medical abortion by intravaginal misoprostol monotherapy were reviewed. Success of abortion was defined as complete expulsion of the conceptus without the need for surgical intervention. Outcomes of interest were success of abortion within 24 hours following administration of misoprostol. RESULTS: Among 222 women who continued the process of medical abortion for 24 hours, 209 (94.1%) had a successfully completed abortion. Multivariate logistic regression showed that serum β-human chorionic gonadotropin (β-hCG) above 40,000 mIU/mL is significantly associated with failed medical abortion within 24 hours (odds ratio [OR], 7.13; 95% confidence interval [CI], 1.60–37.32; P=0.011). The area under the receiver operating characteristic curve of β-hCG level associated with successful abortion within 24 hours was 0.705 (95% CI, 0.63–0.77; P=0.007). Previous vaginal delivery seems to be significantly associated with successful abortion within 24 hours on univariate analysis (P=0.037), but the association was lost in multivariate analysis. CONCLUSION: Misoprostol monotherapy has a high success rate for first trimester abortion. Women with serum β-hCG less than 40,000 mIU/mL are likely to achieve a successful abortion within 24 hours after intravaginal administration of misoprostol.
Abortion, Spontaneous ; Administration, Intravaginal ; Chorionic Gonadotropin ; Female ; Gestational Age ; Humans ; Logistic Models ; Misoprostol* ; Multivariate Analysis ; Pregnancy ; Pregnancy Trimester, First ; ROC Curve

BACKGROUND: The purpose of this study was to analyze the cytogenetic results of amniocentesis in terms of patients' ages and indications. It was further intended to examine the temporal trend in amniocentesis indications for cytogenetic analysis. METHODS: A total of 651 cases of amniocentesis were examined at Masan Samsung Hospital dur-ing the period 1996 to 2001 and were used to analyze the age distribution, indications, and chromo-somal results in relationship to maternal age and with the indication for amniocentesis. RESULTS: The overall rate for chromosomal abnormalities was 3.8% (25 out of 651 cases). In addi-tion, the 25-29 age group fell into the most common age distribution group with 261 from 651 amnio-centesis cases (40.1%). It turned out that the abnormal triple test for alpha-fetoprotein (AFP), the human chorionic gonadotropin (hCG), and the unconjugated estriol (nE3 ) were the most common indications for amniocentesis (51.4%), and 3.9% (13 out of 335 cases) showed chromosomal abnormalities. Among 25 cases of chromosomal abnormalities, 18 cases were numerical and 7 cases were struc-tural abnormalities. In 18 cases of numerical abnormalities, there were 12 Down syndrome cases, 4 Edwards syndrome cases, 1 Patau syndrome case and 1 Turner syndrome case. In 7 cases of struc-tural abnormalities, there were 6 cases of reciprocal translocation and 1 case of Robertsonian translo-cation. CONCLUSIONS: A primary indication for cytogenetic analysis in mid-trimester amniocentesis appeared as an abnormal triple test. Although such triple tests were effective enough in detecting chromoso-mal abnormalities in fetuses, it increased unnecessary amniocentesis. It is proposed that a new technique for non-invasive prenatal diagnosis for chromosomal abnormalities with a sufficient detection rate and a low false positive rate (such as analysis of fetal nucleated red blood cells from maternal blood) should be introduced.
Age Distribution ; alpha-Fetoproteins ; Amniocentesis* ; Chorionic Gonadotropin ; Chromosome Aberrations ; Cytogenetic Analysis* ; Cytogenetics* ; Down Syndrome ; Erythrocytes ; Estriol ; Fetus ; Humans ; Maternal Age ; Prenatal Diagnosis ; Turner Syndrome

PURPOSE: Hypogonadotropic hypogonadism (HH) is an uncommon cause of virilization and male infertility. We evaluated the effect of the combination therapy with human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) in patients with HH. MATERIALS AND METHODS: Between May 2000 and April 2007, we evaluated 15patients with HH. Testicular volume, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone, and semen analysis were consecutively monitored at 6, 12, 24, 36 and 48 months after hCG/hMG combination therapy. Statistical analysis was performed by Paired Student's t-test. RESULTS: Testicular volume showed a time-dependent increase in all patients who received hCG/hMG combination therapy (p<0.01). At 12 months, 12 patients showed and were significant improvement in FSH (1.6+/-0.97mIU/ml, p<0.033) and in serum total testosterone (71+/-2.73ng/ml, p=0.003), respectively. During hCG/hMG combination therapy, semen volume, sperm number, sperm motility, and sperm morphology were improved. However, there was no significant change in LH levels. CONCLUSIONS: Our experience in the management of the patients with HH suggests that hCG/hMG combination therapy might be effective in improving the sperm volume, sperm number, sperm motility, sperm morphology, plasma FSH, total testosterone level, and testicular volume. Thus hCG/hMG therapy seems a better choice in the patients with HH who want pregnancy.
Chorionic Gonadotropin ; Follicle Stimulating Hormone ; Gonadotropins ; Humans ; Hypogonadism ; Infertility, Male ; Luteinizing Hormone ; Male ; Plasma ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Testosterone ; Virilism

OBJECTIVETo establish a new function method for the analysis of a-fetoprotein (AFP) and beta-hCG in testicular tumors.

METHODSWe reexamined the serum levels of AFP and beta-hCG after radical orchiectomy, and calculated the measured coordinate, with the abscissa representing the number of the half-lives of tumor markers, and the ordinate representing the measured value of tumor markers. Referring to the measured value of tumor markers before surgery as a, the number of half-lives as x, and their theoretical value over a period of x elimination half-lives as y (logarithm to the base 2 of y), we calculated the predicted coordinate according to the formula y = log2(a/2x) ==> x + y = log2a (function 1). Then we assessed tumor residue and metastasis by analyzing the relationship between the measured and predicted coordinates.

RESULTSThe pathological examination of case 1 revealed a germ cell tumor of a mixed histological pattern of syncytiotrophoblast and yolk sac tumor. The measured coordinates of AFP and beta-hCG were (2.22, 6.21) and (10, 8.38), and the predicted coordinates (2.22, 6.34) and (10, 4.41) , indicating the elimination of the yolk sac tumor and metastasis of the syncytiotrophoblast tumor. Case 2 demonstrated the mixed pathological nature of teratocarcinoma and yolk sac tumor. The measured coordinates of AFP and beta-hCG were (2.67, -1.03) and (12, -3.32), and the predicted coordinates (2.67, 1.41) and (12, -5.80). But the review times of AFP and beta-hCG were out of the effective range of half-lives, with the measured values below the normal, which suggested no tumor residue or metastasis. Case 3 was found to be embryonal carcinoma. The measured coordinate of AFP was (0.22, 9.25) , and the predicted coordinate (0.22, 9.55) , indicating the elimination of tumor.

CONCLUSIONThe change of the tumor markers predicted by the function method coincided with the natural course of disease in the three cases. The coincidence of the measured with the predicted coordinate after radical orchiectomy indicates no metastasis, while their disagreement suggests possible residue and metastasis of the tumor.

Adult ; Biomarkers, Tumor ; blood ; Chorionic Gonadotropin, beta Subunit, Human ; blood ; Humans ; Male ; Models, Statistical ; Orchiectomy ; Testicular Neoplasms ; metabolism ; pathology ; alpha-Fetoproteins ; analysis

Pure choriocarcinoma is very rare in the testes, and host immune responses including tumor infiltrating lymphocytes are unusual in choriocarcinoma. This study reports a case of pure testicular choriocarcinoma with extensive lymphocytic infiltrate and granulomatous inflammation. Scrotal ultrasonography revealed a heterogeneous, hyperechoic intratesticular mass. -human chorionic gonadotropin levels were elevated in a radioimmunoassay. The hemorrhagic and necrotic solid mass was composed of two cell populations - mononuclear pleomorphic cells and intimately admixed multinucleated smudged cells. The tumor cells were positive for cytokeratin 7, epidermal growth factor receptors, human placental lactogen and p57. Many inflammatory cells were present within the tumor. The majority of infiltrating cells were CD8-positive cytotoxic cells, which also expressed granzyme-B and TIA-1. The tumor cells were positive for FasL, but negative for Fas. Therefore, this case seemed to escape the host defense response to the tumor due to the loss of Fas, although the cellular host immune response was still active.
Tumor Markers, Biological/analysis ; Testicular Neoplasms/*pathology/ultrasonography ; Male ; Lymphocytes, Tumor-Infiltrating/*pathology ; Humans ; Granuloma/*pathology/ultrasonography ; Chorionic Gonadotropin, beta Subunit, Human/metabolism ; Choriocarcinoma/*pathology/ultrasonography ; Adult

Pure choriocarcinoma is very rare in the testes, and host immune responses including tumor infiltrating lymphocytes are unusual in choriocarcinoma. This study reports a case of pure testicular choriocarcinoma with extensive lymphocytic infiltrate and granulomatous inflammation. Scrotal ultrasonography revealed a heterogeneous, hyperechoic intratesticular mass. -human chorionic gonadotropin levels were elevated in a radioimmunoassay. The hemorrhagic and necrotic solid mass was composed of two cell populations - mononuclear pleomorphic cells and intimately admixed multinucleated smudged cells. The tumor cells were positive for cytokeratin 7, epidermal growth factor receptors, human placental lactogen and p57. Many inflammatory cells were present within the tumor. The majority of infiltrating cells were CD8-positive cytotoxic cells, which also expressed granzyme-B and TIA-1. The tumor cells were positive for FasL, but negative for Fas. Therefore, this case seemed to escape the host defense response to the tumor due to the loss of Fas, although the cellular host immune response was still active.
Tumor Markers, Biological/analysis ; Testicular Neoplasms/*pathology/ultrasonography ; Male ; Lymphocytes, Tumor-Infiltrating/*pathology ; Humans ; Granuloma/*pathology/ultrasonography ; Chorionic Gonadotropin, beta Subunit, Human/metabolism ; Choriocarcinoma/*pathology/ultrasonography ; Adult

The objectives of this study were to explore whether ovarian vascular endothelial growth factor (VEGF) expression in mice can be regulated by IL-6 (interleukin-6), angiotensin II, FSH, and hCG; and to test whether the mouse ovarian VEGF expression can result in angiogenesis. The ICR mice were sacrificed, and their ovaries were recovered. Recovered ovaries were treated with IL-6, angiotensin II, FSH, and hCG separately and incubated for 24 hours in alpha-MEM. Expression of mRNA and protein of VEGF were assessed by RT-PCR and immunohistochemistry. The resulting angiogenesis was evaluated through immunohistochemical analysis for CD34. Treatment of mice ovaries with IL-6, FSH, and hCG resulted in a significant increase of VEGF mRNA, and IL-6 was the most potent inducer of VEGF. IL-6 and FSH resulted in increased neovascularization in the follicular phase of mouse ovaries. In contrast, angiotensin II could not increase VEGF expression or neovascularization. We documented an in vitro increase in VEGF expression by IL-6, FSH, and hCG; and reaffirmed that the proliferative response of murine ovarian endothelial cells paralleled an increase of VEGF expression.
Vascular Endothelial Growth Factor A/analysis/*genetics ; RNA, Messenger/analysis ; Ovary/*metabolism ; Mice, Inbred ICR ; Mice ; Interleukin-6/pharmacology ; Immunohistochemistry ; Gene Expression Regulation/*drug effects ; Follicle Stimulating Hormone/pharmacology ; Female ; Chorionic Gonadotropin/pharmacology ; Antigens, CD34/analysis ; Animals