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Biomedical subjects

C B Coulam

Publications and source records attributed to C B Coulam.

At least 163 records · Page 9Linked to original sources
PubMed1982

Endometriosis and infertility: a laparoscopic study of endometriosis among fertile and infertile women.

To test the widely accepted--but not well-supported--impression that endometriosis and infertility are associated, we compared the prevalence of endometriosis visualized at laparoscopy in 100 patients being evaluated for infertility and in 200 fertile control subjects (two age-matched to each patient) undergoing tubal ligation. The extent of endometriosis and adhesions noted in the operative reports was classified according to the system proposed by The American Fertility Society. Endometriosis was found in 21 of the 100 infertile patients--mild in 11, moderate in 8, severe in 2. It was found in 4 (2%) of the 200 controls and was mild in all 4. Thus, endometriosis is more often present, and more often severe, among infertile patients. The risk of infertility was estimated to be almost 20 times greater with endometriosis than without. These data support the clinical impression that an association exists.

Adult↗
PubMed1981

Evidence for an androgen receptor in the human placenta.

A steroid-binding protein was examined in human placental and nuclei which had several characteristics of an androgen receptor. It binds R 1881 (methyltrienolone), a steroid specific for androgen receptors, with high affinity (dissociation constant equals 1.3 to 50 nM) and low capacity (n equals 1.2 to 21 moles/mg of protein). The steroid-binding protein is found in the nuclei as well as the cytosol of the placenta but is not found in either the cytosol or the nuclei of fetal membranes; thus, it is tissue-specific. Among the natural steroids, 5 alpha-dihydrotestosterone competes most efficiently with R1881 for binding to the protein. Testosterone is the next best competitor. When the ranges of dissociation constants and concentrations of binding sites for placentas of various gestational periods are compared, not significant differences are observed between period of gestation and magnitude of binding constants.

Binding, Competitive↗
PubMed1981

Primary amenorrhea and pituitary adenomas.

From 1972 to 1980, 210 patients underwent transsphenoidal operation for removal of a prolactin-secreting tumor. Eight of the patients had primary amenorrhea. All eight patients had had a normal thelarche and pubarche without menarche, and all eight had hyperprolactinemia and abnormal findings on sella turcica tomography. After operation, only one patient did not have persistent hyperprolactinemia, and this patient was the only one who began spontaneous menses. The data indicate that although prolactin hypersecretion interferes with menstrual function, it does not alter other pubertal development and that, if the source of the excessive prolactin can be removed, the removal alone may initiate spontaneous menses. In this report, however, patients with prolactin-secreting adenomas and primary amenorrhea had a high incidence of persistent hyperprolactinemia after operation (seven of eight patients).

Adenoma↗
PubMed1981

Age, Estrogens, and the psyche.

At the time of menopause, some women present with a clinical picture that has not only the specificity of estrogen deficiency, such as hot flushes, but also a nonspecific psychologic syndrome characterized largely by anxiety and depression. Both the physiology of aging and environmental stress factors unique to this age contribute to psychologic changes. Estrogen deficiency can further aggravate these psychologic changes. This effect of estrogen lack is mediated or modulated by catecholamines and prostaglandins at the level of the central nervous system. The conceptualization of the magnitude of contributions to psychologic changes occurring at menopause is shown in Figure 2. The therapeutic principle that emerges from this review is that the psychologic aspects of the menopausal syndrome should be treated as any other anxiety or depressive reaction and that only when the relief is persistently incomplete, showing unequivocally the predominance of estrogen deficiency, should replacement hormone therapy be considered.

Affective Symptoms↗
PubMed1981

Estrogen secretion in a renal allograft population.

Four pregnancies after renal transplantation, during which estrogen metabolism was monitored, were reviewed. Urinary estrogen levels were obtained in all four pregnancies, and all values were low. This phenomenon has been ascribed to suppression via the fetal pituitary of the fetal adrenal glands by exogenously administered corticosteroids. However, definitive data substantiating this theory are lacking. Serum or amniotic fluid estrogen levels were measured concomitantly, and in each instance the levels were below normal for the period of gestation. This finding suggests that the mechanism producing low levels of urinary estrogens is related to the suppressed synthesis of estrogen rather than to altered renal excretion of estrogen.

Amniotic Fluid↗
PubMed1981

Absence of high-affinity binding of progesterone (R 5020) in human placenta and fetal membranes.

Increased levels of maternal serum progesterone occur during the last stages of human gestation. The function of the high level of this steroid is unknown. The presence of a progesterone receptor in the placenta was investigated to determine whether progesterone action on the placenta might serve as one function of the high level of this steroid. Cytosol and nuclear fractions, derived from human placentae and fetal membranes, were examined for the presence of progesterone receptors by conducting exchange assays, using tritiated R 5020 (17,21-dimethyl-19-norpregna-4,9-diene-3,20-dione) as the radiolabelled ligand. High-affinity, low-capacity binding, characteristic of steroid receptors, was estimated as the difference between binding of radiolabelled ligand in the presence of no unlabelled ligand and that in the presence of a 100-fold excess of unlabelled ligand. These exchange assays were conducted during a 24-hour period at 0 degrees C, to allow maximal stability of the receptor, and during a 3-hour period at 20 degrees C, to allow the rapid exchange of radiolabelled ligand for any bound endogenous progesterone. The assays of all fractions showed no specific binding of the R 5020, thus indicating the absence of progesterone receptors in the cytosol and nuclei of the human placenta and the fetal membranes.

Extraembryonic Membranes↗
PubMed1980

Total and free testosterone during pregnancy.

Total and free testosterone levels were measured throughout pregnancy and were compared with values found in nonpregnant women to determine whether the increase in plasma testosterone levels during pregnancy can be accounted for entirely by an increase in sex hormone-binding globulin or by an increase in testosterone production that would be reflected by an elevation in plasma free testosterone. The study employed a practical and precise method of determining free testosterone by means of equilibrium dialysis. Even though the testosterone level increased significantly throughout pregnancy, the free testosterone level remained within the range for nonpregnant women until week 28, after which time it was significantly elevated. This indicates that the increase in the total testosterone level before week 28 is due to a decrease in metabolic clearance rate, but after week 28 the production rate is increased. The source of this increase is unknown, but it might be fetal.

Female↗
PubMed1980

Concentration of cytosolic estrogen receptors in patients with postmenopausal osteoporosis.

Although all postmenopausal women are relatively estrogen-deficient, osteoporosis develops in only some of them. This could be related to a greater-than-normal degree of postmenopausal failure in sex hormone production or to a decrease in biologic effect at target tissue sites. We compared the concentration of sex steroids in serum and the concentration of cytosolic estrogen receptors in one target tissue (obtained by biopsy of the uterine cervix) in 18 women with postmenopausal osteoporosis and in 18 age-matched postmenopausal control subjects. Serum androstenedione and estrone were not significantly lower and serum estradiol was only marginally lower in the osteoporotic patients. Estrogen-receptor concentration in cervical tissue from both postmenopausal groups was not significantly different. We concluded that abnormalities of residual postmenopausal production of sex steroids and binding of sex steroids to cervical target tissue are not the major factors accounting for the decreased bone mass in women with postmenopausal osteoporosis.

Aged↗
PubMed1980

Specific binding of human chorionic gonadotropin to human corpora lutea in the menstrual cycle.

Luteal tissue from 26 premenopausal women undergoing surgery for nonendocrine disease was examined for specific binding to human chorionic gonadotropin. Results showed a nadir in the percentage of binding on day 10, with a gradual increase until maximal binding was obtained on days 22 through 26. Binding then markedly declined to that seen on day 1 of the menses and decreased gradually to its lowest level on day 10.

Adult↗