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Biomedical subjects

C B Hammond

Publications and source records attributed to C B Hammond.

At least 127 records · Page 7Linked to original sources
PubMed1977

Treatment of functional amenorrhea-galactorrhea with 2-bromoergocryptine.

The present study was undertaken to investigate not only the effectiveness of bromoergocryptine therapy in 13 women with amenorrhea-galactorrhea and hyperprolactinemia without evidence of organic pathology, but also to assess the value of pretreatment evaluation in predicting the response to therapy. Sella turcica tomography, base line serum follicle-stimulating hormone, luteinizing hormone (LH), thyroid-stimulating hormone, T4, plasma cortisol levels, and the growth hormone reserve were normal in all patients. The pretreatment administration of LH-releasing factor (LRF) (100 microng subcutaneously) resulted in either a normal or excessive release of LH. On bromoergocryptine therapy, cyclic menses were reintiated in 10 of the women, while conception occurred prior to reinitiation of menses in the remaining three women. The time required for resumption of menses or conception on therapy correlated well with the magnitude of gonadotropin response to LRF. No correlation was seen with pretreatment prolactin levels nor with the degree of suppression of prolactin during bromoergocryptine therapy. In four women the mean prolactin levels during therapy were above normal, and in one patient prolactin levels approached pretreatment values during therapy. The initiation of cyclic menses despite continued hyperprolactinemia may indicate a possible direct effect of bromoergocryptine on hypothalamic LRF secretion as a partial explanation for its therapeutic action. On discontinuation of bromoergocryptine therapy, serum prolactin levels rapidly returned to pretreatment values or higher in all of the patients studied. In contrast to previous studies in which amenorrhea recurred in all patients after discontinuation of therapy, three of our patients maintained cyclic menses despite continued hyperprolactinemia. The recurrence of hyperprolactinemia after discontinuation of bromoergocryptine would indicate a persistent autonomy of the mechanisms involved. Periodic endocrine evaluation will be necessary to substantiate the presence or absence of pituitary microadenoma in these women.

Adult↗
PubMed1977

Pregnancy following the "insensitive ovary syndrome".

A patient in whom the "insensitive ovary syndrome" was followed by a successful pregnancy is reported and discussed. Conception occurred while this patient was receiving estrogen therapy. The marked differences in her ovarian responsivity to endogenous and exogenous gonadotropin stimulation remain enigmatic.

Adult↗
PubMed1977

Failure of L-tryptophan to stimulate prolactin secretion in man.

The effect of oral L-tryptophan (90 mg/kg BW) on prolactin secretion in eight normal women studied either in the early or late follicular phase of the menstrual cycle was compared to the effect of a placebo alone. Plasma prolactin levels were measured before and at frequent intervals over a period of 240 min after the administration of the amino acid or placebo. Plasma free L-tryptophan concentrations were determined prior to and 60 min after ingestion of the amino acid in two of the women. Despite a 25-fold increase in plasma free L-tryptophan levels following the administration of this amino acid, the prolactin response to L-tryptophan was not significantly different from a placebo.

Adult↗
PubMed1977

The pulmonary metastases of choriocarcinoma.

The radiographic appearance of the pulmonary metastases of choriocarcinoma and other malignancies of gestational trophoblastic origin is described. Quantitative, though not qualitative, differences from other large series in the literature are noted. These observations may more accurately reflect the experience with this disease in North America. Three basic types of metastases are described--typical, alveolar, and embolic with emphasis placed on the most common typical metastatic lesion. The possible relation of methotrexate therapy to alveolar metastases is queried. That residual pulmonary nodules in the appropriate clinical setting need not represent viable tumor is noted.

Choriocarcinoma↗
PubMed1977

Endometriosis.

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Endometriosis↗
PubMed1977

The diagnosis and therapy of luteal phase deficiency.

Between 1973 and 1975, 16 patients evaluated for infertility at Duke University Medical Center were diagnosed as having luteal phase deficiency. A majority had had prior infertility surveys, and the average duration of their infertility exceeded 2 years. The diagnosis was suspected after study of basal body temperature charts and menstrual patterns in more than 80% of the patients. This diagnosis was established by timed endometrial biopsy. The primary method of therapy was supplementation of the luteal phase with progesterone vaginal suppositories. The pregnancy rate after therapy was 50% and pregnancy occurred after a mean of five treatment cycles. The minimal follow-up of patients who failed to conceive was 8 months. To date, the majority of these pregnancies have been completed without complication and the remainder are progressing satisfactorily. Two additional patients developed luteal phase deficiency while taking clomiphene citrate and became pregnant with progesterone supplementation.

Body Temperature↗
PubMed1976

Diagnosis of prolactin-secreting pituitary microadenoma.

Four women with secondary amenorrhea associated with hyperprolactinemia were studied. Baseline hormonal evaluation, including serum FSH, serum LH, TSH, T3, T4, and plasma cortisols were normal. Plain sella turcia x-rays were also normal. Prolactin-secreting pituitary microadenomas were found in all of the patients only after further diagnostic studies were done. These studies included polytomography of the sella turcia, dynamic pituitary testing of growth hormone reserve, ACTH reserve, gonadotropin reserve, and prolactin suppression with L-dopa. The early diagnosis of a small prolactin-secreting adenoma may be possible if several diagnostic criteria are ulilized. The most sensitive techniques available are: (1) polytomography, (2) the magnitude of plasma prolactin evaluation, and (3) the failure of suppression of prolactin secretion with L-dopa. Our findings emphasize the importance of an extensive evaluation of all women with amenorrhea associated with hyperprolactinemia.

Adenoma↗
PubMed1976

Vasomotor symptoms, serum estrogens, and gonadotropin levels in surgical menopause.

Hormonal parameters of young women who developed vasomotor symptoms in the immediate postoperative period following castration are compared to those who remained asymptomatic. Only 37.5 per cent of 16 premenopausal women developed "hot flushes" after operation. Perimenopausal women with vasomotor symptoms and elevated follicle-stimulating hormone levels demonstrated normal luteinizing hormone and estrogen values preoperatively. There were no statistically significant differences in total serum estrogen, follicle-stimulating hormone, or luteinizing hormone concentrations between the group of patients with symptoms and the group withoyt symptoms. The results of the study indicate that rising gonadotropin or declining estrogen values appear to have no direct correlation to the onset of vasomotor symptoms in the immediate postoperative period. Thus, the precise etiology of the "hot flush" remains to be elucidated.

Adult↗
PubMed1976

The HCG-beta-subunit radioimmunoassay: potential error in HCG measurement related to choice of labeled antigen.

Antiserum generated against the hormone-specific beta-subunit of hCG uas used with different labeled antigens to measure circulating hCG in patients having trophoblastic disease. When 125 I-hCGbeta served as the labeled antigen, a small number of patient sera failed to show parallelism with the second IS-hCG reference and erroneous estimates of hormone concentrations were obtained. Replacement of the 125I-hCGbeta with labeled hCG corrected the nonparallelism exhibited by these samples. Inhibition curves obtained with purified hCG and hCGbeta suggested that both the nonparallelism and its correction with the change in labeled antigen would be consistent with the possibility that this assay aberration may result from the presence of free hCGbeta in these sera.

Antigens↗
PubMed1976

Letter: CB-154.

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Adenoma↗
PubMed1976

Gonadotropin release in patients with androgen insensitivity. Testicular feminization syndrome.

Two siblings are presented, both with classic androgen-insensitivity syndrome (AIS). Endocrine testing was carried out and then gonadectomy was performed. Studies in these patients with AIS revealed low control serum FSH. In these patients serum FSH was not significantly suppressed by intravenous estrogen nor adequately stimulated by FSH-LH-releasing hormone but rose normally after castration. The various studies are interpreted in the light of the known kinetics of pituitary gonadotorpins and their modulation by gonadal steroids. A third sibling is also presented.

Adult↗
PubMed1976

Conservative treatment of endometriosis: the effects of limited surgery and hormonal pseudopregnancy.

This study compares the effects of limited surgery or hormonal pseudopregnancy, or a combination of these two, upon fertility and the need for subsequent surgery with respect to the extent of the disease at the time of initial diagnosis in patients with endometriosis externa. Of the 61 patients who desired to enhance or preserve reproductive capacity, 20 patients became pregnant, for a pregnancy rate of 33%. The pregnancy rate in all categories, that is, those patients treated with pseudopregnancy, conservative surgery, and combined pseudopregnancy and surgery, was found to be in direct relationship to the initial extent of disease. In such patients, conservative surgery alone seemed to give the best results in the achievement of pregnancy. There seemed to be little difference between pseudopregnancy alone and conservative surgery in regard to the need for subsequent surgery after initial therapy, although there seemed to be a significantly greater chance for the need for subsequent surgery in patients receiving a combination of the two forms of therapy. The need for subsequent surgery after initial therapy in 80 patients increased in direct relationship to the initial extent of disease present, despite the form of therapy used. Fifty-nine other patients with endometriosis, who did not desire to preserve fertility and presented for relief of other symptoms, underwent initial "radical" therapy. Forty-six patients underwent complete operation, including removal of uterus, tubes and ovaries, and none required subsequent reoperation. Of the 13 remaining patients, who underwent incomplete surgical removal, leaving one or both ovaries in situ, 11 required subsequent reoperation for recurrent pelvic endometriosis.

Adolescent↗
PubMed1976

Prolactin after gonadotropin-induced pregnancy.

Prolactin levels during a gonadotropin-induced pregnancy have not been previously reported. A patient with Forbes-Albright syndrome is described. She received radiation therapy, with cessation of her galactorrhea, but she remained amenorrheic. Three years after irradiation, a pregnancy was successful induced with human menopausal gonadotropins and human chorionic gonadotropin. Prolactin levels determined prior to gonadotropin therapy, during an insulin hypoglycemia stimulation test, serially during pregnancy, and postpartum during lactation are presented. These levels are compared with the previously reported levels for basal prolactin, response to insulin hypoglycemia, pregnancy, and lactation. Possible etiologies for the abnormal values and responses obtained from investigation of this patient are discussed.

Adult↗
PubMed1976

Plasma prostaglandin F 2-alpha levels in dysmenorrehic women.

Plasma prostaglandin F 2-alpha (PGF 2-alpha) concentrations were compared in nine ovulatory dysmenorrheic women, one dysmenorrheic oral contraceptive user, and two nondysmenorrheic control subjects, in an effort to demonstrate a relationship between plasma PGF 2-alpha levels and dysmenorrhea. In addition, the effects of aspirin, a known inhibitorof prostaglandins synthesis, on dysmenorrhea and on PGF 2-alpha levels were investigated. No statistical difference was demonstrated between the plasma PGF 2-alpha levels of dysmenorrheic and nondysmenorrheic subjects throughout the menstrual cycle. Attainment of an adequate salicylate level was accompanied by a significant decrease in PGF 2-alpha levels. All dysmenorrheic subjects reported improvement in symptoms while taking aspirin. The greatest subjective relief was reported by women who began taking aspirin (10 grains every 4 hours) 3 or more days prior to the onset of bleeding.

Adult↗
PubMed1975

Hypothalamic and pituitary function in hypogonadotropic hypogonadism.

Hypogonadotropic hypogonadism has been identified as a cause of partial or complete failure of puberty, may be familial and may have other associated abnormalities of hyposmia, intellectual retardation, perceptive deafness, color blindness, skeletal deformities, and gynecomastia. Pituitary function is usually normal with the primary defect believed to be hypothalamic. A twenty-year-old white male with a clinical diagnosis of hypogonadotropic hypogonadism and anosmia under-went complete endocrine evaluation with evaluation of the pituitary response to luteinizing hormone-releasing hormone. FSH (follicle-stimulating hormone) and LH (luteinizing hormone) release after luteinizing hormone-releasing hormone did occur, but the response was less than that seen in normal controls. Evaluation demonstrated that the pituitary-gonadal axis was intact with the hypothalamic-pituitary axis being defective. Therapy with the synthetic decapeptide (luteinizing hormone-releasing hormone) is correct theoretically and may be superior to therapy with exogenous gonadotropins.

Adult↗