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Biomedical subjects

C M Herbert

Publications and source records attributed to C M Herbert.

53 records · Page 3Linked to original sources
PubMed1985

A new second-puncture probe for CO2 laser laparoscopy.

A new second-puncture probe system was designed for aiming and firing the CO2 laser under laparoscopic control. The probe allows simultaneous suction of the smoke from vaporization and insufflation of fresh CO2 for maintenance of an adequate pneumoperitoneum during use. A 200-mm focusing lens attaches the probe to any surgical CO2 laser with an articulated arm. The new probe is 10 cm shorter than standard probes, allowing the application of a wider range of power densities during laser laparoscopy and making surgery easier to perform. Our initial experiences with this new instrument have involved both laboratory animals and patients with endometriosis, adnexal adhesions and distal tubal obstruction.

Animals↗
PubMed1984

One ovary or two: differences in ovulation induction, estradiol levels, and follicular development in a program for in vitro fertilization.

The choice of clomiphene citrate (CC) and human menopausal gonadotropin (hMG) protocols for stimulation of ovarian follicular maturation has traditionally not been made with regard to the anatomic status of the pelvis. To evaluate whether hormone production and/or follicular development vary based on the number of ovaries and/or the method of stimulation, 117 cycles were reviewed. Forty-five women received CC, 29 with two ovaries and 16 with one ovary. Seventy-two women received hMG, 50 with two ovaries and 22 with one ovary. Among women receiving CC, those with two ovaries tended to have higher initial estradiol levels and a greater number of large (greater than or equal to 15 mm) follicles. Among women receiving hMG, those with two ovaries tended to have higher estradiol levels, but the number of large follicles (greater than or equal to 15 mm) was similar. With either stimulation protocol, women with two ovaries developed a higher total number of follicles than women with one ovary. The total number of follicles in women with one ovary was similar for hMG and CC stimulations. The number of oocytes recovered at laparoscopy was greater in women with two ovaries who received hMG in comparison with CC, but did not significantly vary between women with one or two ovaries who received CC nor between women with one or two ovaries who received hMG. The number of oocytes was also similar for the women with one ovary regardless of stimulation protocol.

Castration↗
PubMed1984

Laparoscopic salpingostomy utilizing the CO2 laser.

A new technique for performing a terminal salpingostomy using the CO2 laser via laparoscopy has been developed. This operative procedure is described, and the clinical results of the first 22 patients are reported. A hysterosalpingogram-documented tubal patency rate of 75% was noted 2 months postoperatively. Within the first 12 months postoperatively, there have been five pregnancies, including one ectopic gestation and one spontaneous abortion. Operative laparoscopy with the CO2 laser for distal salpingostomy may provide an acceptable alternative to laparotomy in selected patients.

Carbon Dioxide↗
PubMed1984

Antiestrogenic effect of clomiphene citrate: correlation with serum estradiol concentrations.

The antiestrogenic effect of clomiphene citrate (CC) on cervical mucus was evaluated in women receiving 150 mg CC daily for 5 days. Daily cervical mucus scores and serum estradiol (E2) concentrations were determined in control (n = 25) and CC (n = 24) cycles. E2 concentrations were significantly higher in the CC-treated women (mean +/- standard error of the mean, 1254 +/- 102 pg/ml versus 337 +/- 18 pg/ml, P less than 0.0001). Despite supraphysiologic E2 concentrations, however, cervical mucus scores were significantly reduced in the CC-treated group (P less than 0.01). These data indicate that CC exerts a direct suppressive effect on cervical mucus despite markedly increased E2 concentrations.

Adult↗
PubMed1984

Outcome of progesterone treatment of luteal phase inadequacy.

Diagnosis, choice of therapy, and pregnancy outcome were analyzed in 79 women evaluated for luteal phase inadequacy. Criteria for the diagnosis were established, and groups at risk for luteal inadequacy were identified. Treatment choices, tailored to the suspected cause, included progesterone suppositories in 54 women, with 23 pregnancies and 19 deliveries; clomiphene citrate in 6 women, with 2 pregnancies and deliveries; and combined treatment in 7 women, with 5 pregnancies and 4 deliveries. Eight women received no treatment, including three who underwent endometrial biopsy in the cycle of conception and who subsequently delivered. These data suggest that careful diagnosis and the proper choice of treatment are important, and that progesterone supplementation may result in improved pregnancy outcome for patients with infertility and pregnancy wastage who have luteal phase inadequacy.

Adult↗
PubMed1982

Initial evaluation of a convection counter streaming galvanization technique of sex separation of human spermatozoa.

A new method for separating X and Y human spermatozoa called convection counter streaming galvanization was evaluated. The method was independently performed by this semenology laboratory with the use of the special separation equipment and extending media provided by its developer, Dr. Bhairab C. Bhattacharya. The mean number of Y spermatozoa increased from 48% to 77% in the separated fraction predicted to be Y-enriched. The fraction predicted to be X-enriched increased from a mean of 52% to 77%. The one separation process allowed accumulation of both enriched fractions simultaneously. The separated portions of spermatozoa maintained good motility and penetration of cervical mucus but produced a mean recovery concentration in the X- and Y-enriched fractions of only 15% to 16% of the preseparation concentration.

Cell Separation↗
PubMed1981

Prolonged end-stage fetal heart rate deceleration: a reanalysis.

In an earlier publication we reported on 18 patients who had what was described as prolonged fetal heart rate (FHR) deceleration in the second stage of labor and who had uniformly good outcome. It was believed that the reason for the good outcome was early diagnosis and rapid delivery when the FHR deceleration did not improve by the time the patient entered the delivery room. We have continued to handle this type of deceleration pattern in a similar fashion with good results, but 18 additional cases of prolonged end-stage FHR deceleration associated with a poor outcome are reported along with 1 case of intrauterine demise. Physicians who use the fetal monitor need to be aware of this potentially ominous FHR pattern.

Apgar Score↗
PubMed1980

Skeletal maturity in seven year old Dunedin children.

A study of 433 boys' and 403 girls' left hand/wrist radiographs taken within 0.1 years of the child's seventh birthday shows that the median equivalent skeletal maturity using the TW 2 20-bone score is identical to the English standards, and the RUS score is only slightly above the standards. It is thus valid to use Tanner's standards when assessing New Zealand white children. The wide range of values in a healthy population is stressed.

Age Determination by Skeleton↗
PubMed1973

Determinants of serum antipyrine half-lives in patients with liver disease.

Antipyrine has been used as a model drug to investigate the effects of liver disease on drug metabolism in man. A prolongation in antipyrine half-life (T(1/2)) was found in patients with liver disease, patients with chronic liver disease showing a greater increase than those with acute, reversible pathology. The most marked prolongation in T(1/2) was found in association with hypoalbuminaemia and hypoprothrombinaemia, suggesting that the cause for these changes was defective protein synthesis of microsomal enzyme protein. This hypothesis was supported by demonstrating that enzyme-inducing agents, which are known to increase the amount of microsomal enzyme protein, reduced the antipyrine half-life.

Adult↗