Topics in reproduction & development

1. Topics in reproduction & development Here’s what we’re gonna do: Write down any questions you have. Don’t need names, we’ll collect it at the end of class

2. Table of contents Human Pappillomavirus and cervical/penile cancers Impotence, prostatitis and prostate cancer If two sexes are such a good idea then why not have more? SRY gene Mifepristone Spontaneous abortions & Down Syndrome Folic acid deficiency & brain defects Risks to young mothers Thalidomide Cloning Newborn organ donor ethics

3. HPV • A group of about 100 strains of virus • Some cause warts • Others alter nuclei in cervix • Almost all cases of cervical cancer had HPV first • Strains 16 & 18 cause 70% • Merck’s got a vaccine out, marketed towards females 9-26 • Have to take it before infection

4. From medicinenet.com • Some types of HPV you’ll have for life • Some you’ll never know • HPV: most common STD in US • ~ 20 mil have it, • 5.5 mil new cases a year, that’s 10/min

5. Cervical cancer • 2006 ~10,000 U.S. women diagnosed • 4,000 will die from it. • Regular pap smears needed to catch it pre-malignantly • Just getting a sample of cervical cells • Trivia pap in pap smear and pap in papillomavirus don’t have anything to do with each other.

6. Impotence (erectile dysfunction) (Brewer’s Droop) • Physical or psychological causes erections • Touch or the limbic system • Nitric oxide a vasodilator is secreted • Physical or psychological things take them away • Diabetes can cause it • Psychologically there’s a strong placebo effect • Ever had a wet dream? Your brain is in control

7. You go to the doctor and report this. • They’ll get blood tests to make sure there’s no underlying disease causing it. • Also your general health, diet, weight, and heart contribute • They see if you ever have erections • As opposed to sometimes • 5 or 6 happen during R.E.M. sleep

8. Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders and some personality disorders. • Zoloft, prozac, paxil • Some of these can cause E.D. some for months after you’re off of them

9. Does circumcision lead to an increased risk of E.D.? • People argue this both ways • However everyone agree excessive drinking is a cause. • Also cycling can increase risk

10. (cGMP) is your friend for relaxing • Cyclic guanosine monophosphate • Note relation to ATP, ADP, or AMP • relaxes smooth muscle. • leads to vasodilation and increased blood flow. • When it breaks down blood flow decreases • Phosphodiesterases (PDEs) do this

11. Viagra • Viagra inhibits PDE’s so cGMPs stay around increasing blood flow • Also making some people very very rich

12. Herbal Supplements • Enzyte • Weak evidence for this supplement, and is currently in Big Lawsuits for false advertising • Korean Red Ginseng • There’s a double blind study showing that this is better than a placebo. That’s 1 study

13. Why muck about with blood vessels? • Lets get right to the libido in the CNS • Lets mess with your brain • Bremelanotide is a nasal spray • A synthetic aphrodisiac • This is how close it is to being released • Phase 3 trials starts in 2007 • RICH RICH PEOPLE

14. Word of the Day: Priapism • From ancient god Priapus, fertility god • Painful medical condition where an painful erection does not painfully go away for a long painful time. • Don’t mess around with your bodies homeostasis

15. What gets us into this situation in the first place? • Our SRY gene • Its one of the few things that the Y chromosome is good for • There are other more important sex determining genes in mammals • If you have this gene you’re going to be male, no matter what else you’ve got • Mr. T is 120% man • 5 % gold • 3 % pity

16. SRY and olympics • In 1992 olympics they ruled that anyone with an SRY gene can’t compete as a woman, but has since been eliminated • XXY or XXYY humans exist usually as males • XXY females exist, with no SRY gene

17. Tough Question • Suppose that during meiosis in a man, the SRY of his Y chromosome crossed over and rejoined to his X chromosome. What would be the consequences to his sons and daughters?

18. Big answer • His XX children will appear to be boys and his XY children will appear to be girls.

19. Before the advent of antibiotics, how would society’s view of syphilis have been similar to today’s view of HIV? • Both infections most often exist without symptoms for a long time. Most STD’s also have several features in common, according to Saladin: an incubation period, a communicable period, and certain asymptomatic carriers. (Clinical application 27.5 on p. 1043) Some students may also know that syphilis, like HIV, for most of our history was incurable.

20. If the cilia of the uterine tubes were to reverse the direction towards which they beat and the muscles of the tubes were also to reverse directions, what might the consequences be? • It would be much more difficult for the ova to pass down the tubes and into the uterus. On the other hand, the sperm would have an easier time going up the uterine tubes. (p. 1052) Those eggs that were fertilized would most likely implant in the tubes, an ectopic pregnancy, or in the abdominal cavity, an abdominal pregnancy. (Table 28.5) Many eggs would fall into the abdominal cavity and die (p. 1066).

21. Sally started training seriously to participate in the 10,000 meter run for the summer Olympics. After a few months of training, she noticed that she stopped menstruating. What is the probable cause of this failure? • Sally probably trained to such an extent that she lost a lot of body fat, dropping below 22% fat. Since this makes it difficult for a woman to maintain a fetus and to milk production. Therefore, her body acted to prevent pregnancy so her menstruation also stopped

22. Breast cancer is cancer of breast tissue. Worldwide, it is the most common form of cancer in females, affecting approximately one out of eleven to twelve women at some stage of their life in the Western world. Risk factors: age, genes, alcohol, hormones Men can get it but it is rare Less breast tissue, also hormonal differences Case 06 A day in the histopathology lab

23. What finding suggests Ms. Bennett’s tumor is benign? • Circular shape and surrounding of dense fibrous connective tissue containing it.

24. Fibroadenoma: Common benign breast tumor appearing before age 30

25. Why might Ms. Malcom’s doctor recommend a biopsy of the axillary lymph nodes? • Since malignant cancer cells break off of the tumor and spread throughout the blood stream checking the lymph nodes will determine if the cancer has spread there.

27. Why would the mitotic index be relevant to a diagnosis of breast cancer? • The mitotic index is a ratio between the number of cells in mitosis and the total number of cells. • The closer to 1 the index is then the more cells are undergoing mitosis. • Cellomics makes kits to detect this with fluoroscopy.

28. MRI Showing Malignant Breast Cancer

29. Tamoxifen blocks estrogen receptors so that estrogen cannot bind to them. How could tamoxifen help in the treatment of certain forms of breast cancer? • Estrogen promotes the growth (mitosis) of breast cancer cells. If breast cells can’t receive the signal for estrogen then it should reduce mitosis. Tamoxifen is the world’s largest selling breast cancer treatment. sold under the brand names Nolvadex, Istubal, and Valodex. Tamoxifen is sometimes used to treat gynecomastia in men. • Photomicrograph of Tamoxifen  • http://www.3dchem.com/molecules.asp?ID=181

30. The National Surgical Adjuvant Breast and Bowel Project (NSABP) is a clinical trials cooperative group supported by the National Cancer Institute (NCI). • Based in Pittsburgh • NSABP is undertaking a Study of Tamoxifen and Raloxifene (STAR). To see if Raloxifene which is used to treat osteoporosis could be as effective as Tamoxifen. Its using 19,000 volunteers at 400 sites around the country. • Interestingly side effects of Tamoxifen include increased chance of uterine cancer and blood clots in the lungs.

31. Considering that X rays are known to induce mutations and that mutations cause cancer, why are women in their 40s and beyond advised to have routine mammograms? • It’s the widest and most easily available form with the highest success rate. Ultrasound, Ductography, and Magnetic Resonance are adjuncts to mammography. The National Cancer Institute, the American Cancer Society, and the American College of Radiology • Despite continuous improvements and innovations, mammography has garnered a sizable opposition in the medical community because of an error rate that is still high and the amount of harmful radiation used in the procedure. Mammography has a false-negative (missed cancer) rate of at least 10 percent. This is partly due to dense tissues obscuring the cancer and the fact that the appearance of cancer on mammograms has a large overlap with the appearance of normal tissues.

32. Died from Breast Cancer • Carina Bleeth, Mother of Yasmine Bleeth • Rachael Carson, Pittsburgh Environmentalist went to Catham, author of Silent Spring • Madonna’s Mother Died when Madonna was 6 • Hitler’s Mother • Nas’ Mother • Clinton’s Mother • Paul McCartney’s Mother and Wife • Bernie Mac’s Mom • Condie Rice’s Mom

33. Fighting/Surviving with Breast Cancer • Andre Agassi’s Mom and Sister • Baldwin Brother’s Mother • Brigette Bardot • Shirley Temple • Sheryl Crow • Melissa Etheridge • Betty Ford • Nicole Kidman’s Mom • Kylie Minogue • Sandra Day O'Connor • Nancy Reagan • Richard Roundtree

34. Is there female sexual dysfunction? • Female sexual arousal disorder decreased, insufficient, or absent lubrication in females during sex, even despite normal sexual arousal • More psychological usually • Lifelong versus Acquired, Generalized versus Situational, • Childhood impact, relationship impacts, Stress, fatigue • Physical causes vary, diabetes sometimes.

35. What if you’re XY and your SRY gene is mutated • There are XY women. • It varies but some can’t have kids

36. Turner’s & Klinefelter’s