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Rheumatic diseases such as rheumatoid arthritis (RA) have an autoimmune basis, in which the body inappropriately makes antibodies that recognize and attack the body's own tissues. The efficacy and toxicity of two drugs, azathioprine (AZA) and methotrexate (MTX), were compared in 64 patients (43 female) with RA who were unresponsive or had suffered side effects from gold therapy or d-penicillamine. Of the 33 subjects taking AZA, 13 discontinued due to severe side effects, chiefly severe vomiting. MTX side effects were primarily consisted of elevated blood levels of liver enzymes (suggestive of liver dysfunction), mouth ulcers, nausea, and vomiting. Of the 50 patients (20 receiving AZA and 30 receiving MTX) who completed 24 weeks of drug therapy, patients using MTX improved significantly compared with baseline status, medical symptoms, and laboratory results. This improvement extended to 48 weeks of therapy. Assessments at monthly intervals up to 24 weeks showed significantly greater improvement with time in the number of swollen joints, level of pain, and laboratory tests indicating severity of inflammatory disease. Seventy-six percent of MTX patients and 50 percent of AZA patients had a significant improvement in the disease activity score after 48 weeks, but MTX patients responded more rapidly. Overall, the study indicates that, for treating RA, MTX is more effective and produces fewer severe side effects than AZA. (Consumer Summary produced by Reliance Medical Information, Inc.)

Twenty-two infertile women with repeated deficient results in the postcoital test received clomiphene citrate or tamoxifen. The patterns of luteinizing hormone, follicle-stimulating hormone, prolactin, 17β-estradiol (E2), and progesterone were examined during the follicular and periovulatory phases of the menstrual cycle, as were the cervical mucus characteristics.

In 14 healthy, potentially fertile men, pituitary gonadotropin responses were studied under standardized conditions. Luteinizing hormone-releasing hormone (LH-RH) was given as a continuous infusion of 1μg/minute for 4hours or in a pulsatile fashion with 20μg as an intravenous bolus at intervals of 20minutes for 4hours. Blood was collected continuously by means of an integrated sampling technique.

Routine semen analysis and a zona-free hamster ovum sperm penetration assay (SPA) were carried out for 220 men from a group of infertile couples. The grade of sperm motility was determined after a preincubation period. For both the normal and abnormal semen samples, the number of positive SPAs was significantly higher when the postcapacitation motility was normal. This difference was observed also when the routine semen characteristics of density, motility, and morphologic features were considered separately regarding their relationship with the SPA. Motility after preincubation showed the most significant positive correlation with the SPA result. Therefore, the SPA score should be limited to semen samples showing adequate postincubation motility.

Exogenous luteinizing hormone-releasing hormone (LH-RH) was intravenously administered as a single-bolus injection to 26 healthy normal men. LH-RH doses were selected at 1, 2.5, 5, and 20μg for exploration of the optimum LH-RH dose to obtain adequate pituitary stimulation. Blood samples (for LH-RH and LH determinations) were collected at frequent intervals from 10minutes before to 60 or 90minutes after injection.

The buffering capacity of 270 semen samples derived from 196 men of infertile couples was determined from titration curves. The average buffering capacity in the physiologic range (pH 7.0 to 6.0) was 41.1 slyke (standard deviation [SD], 9.9), which is significantly higher (P< 0.01) than that in serum (23.3 slyke; SD, 7.5; n = 42). When the buffering capacity of several semen samples of one man in the course of time was measured, the variation between these samples was larger than the determination error. No correlation was found between the buffering capacity of serum and semen of the same man, nor between the buffering capacity of semen and the fertility grade determined by physical and morphologic analysis of the samples.

Twenty-two women in whom a routine infertility workup had shown no abnormality except for repeated deficient results in the postcoital test (PCT), the patterns of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), 17β-estradiol (E2), and progesterone (P) were examined during the follicular and periovulatory phases of the menstrual cycle. Cervical mucus (CM) characteristics were also investigated during the pre- and periovulatory phases and scored using a CM score and a sperm penetration meter (SPM) score.

Serum levels of luteinizing hormone-releasing hormone (LH-RH), LH, and follicle-stimulating hormone (FSH) were measured for 60 minutes after 5- and 20-μg bolus doses of LH-RH given either intravenously or subcutaneously to 20 healthy men, for the study of LH-RH pharmacokinetics and the corresponding pituitary gonadotropin release.

In 22 potentially fertile men, pituitary gonadotropin secretion was investigated by intravenous luteinizing hormone-releasing hormone (LH-RH) administration. LH-RH was administered continuously (1 μg/minute) and in a pulsatile fashion (20 μg at 20-minute intervals, 20 μg at 60-minute intervals, and 60 μg at 60-minute intervals), for 3 hours, under standarized conditions. Blood was collected continuously by means of an integrated sampling technique.