Search PubMed⌕ Search

Biomedical subjects

D R Mishell

Publications and source records attributed to D R Mishell.

At least 217 records · Page 12Linked to original sources
PubMed1977

Absence of circulating chorionic gonadotropin in wearers of intrauterine contraceptive devices.

Daily measurements of human chorionic gonadotropin (HCG) beta subunit, luteinizing hormone (LH), and progesterone were carried out in 24 subjects wearing intrauterine contraceptive devices. Detectable HCG was not found in any subject, but in four subjects delayed LH pulses resulted in apparent low levels of HCG because of cross-reactivity in the HCG beta subunit radioimmunoassay.

Adult↗
PubMed1977

Serum levels of d-norgestrel, luteinizing hormone, follicle-stimulating hormone, estradiol, and progesterone in women during and following ingestion of combination oral contraceptives containing dl-norgestrel.

Three formulations of dl-norgestrel were administered daily to groups of three women for five consecutive days. The serum levels of d-norgestrel were related to the dosage of dl-norgestrel ingested. Peak concentrations in the circulation of synthetic gestagen were attained a half hour to three hours after oral administration, followed by a rapid and sharp decline in levels until the next dose. Three women received 500 micrograms of dl-norgestrel and 50 micrograms of ethinyl estradiol for 21 days followed by six to seven days of no medication for two consecutive cycles. The gonadotropins remained suppressed for four to six days when therapy was discontinued. The daily concentrations of estradiol varied from less than 5 to 81 pg. per milliliter, and there was no difference in estrogen values during the nontreatment and treatment days. Due to the long half life of norgestrel, the one-week pill-free interval is not long enough for the complete recovery of the reproductive axis from the inhibition of oral contraceptives.

Adult↗
PubMed1977

Clinical and laboratory correlates of molar pregnancy and trophoblastic disease.

From January 1, 1970 to July 1, 1976, 128 women had hydatidiform moles evacuated at the Los Angeles County-University of Southern California Women's Hospitals. Of the 121 patients with follow-up, persistent trophoblastic disease (TD) was diagnosed in 32 (26.4 per cent). Remission was achieved in all treated patients. The frequency of TD was significantly increased in pregnancies large for dates (47.8 per cent), with a uterus greater than 20 weeks' gestational size (45.0 per cent) or with theca-lutein cysts greater than 5 cm. in diameter (50.0 per cent). A normal regression curve for serum beta-human gonadotropin as measured by radioimmunoassay has been constructed as an aid to the early recognition of postmolar TD (invasive mole and choriocarcinoma).

Adult↗
PubMed1977

A new procedure for the statistical evaluation of intrauterine contraception.

An improved statistical method for assessing the efficacy of intrauterine contraception is presented. This method, called the log-rank method, is based on a daily life table, which yields the best estimates of the cumulative net termination probabilities. It provides a sensitive chi-square test statistic to detect differences among these probabilities for two or more contraceptive devices. When three or more devices are compared, the chi-square statistic may be partitioned into additive components representing comparisons among groups of devices. The log-rank method also permits adjusting for differences among subgroups by controlling for factors such as parity or age. Although calculations may be performed on a desk calculator, a FORTRAN-IV computer program is made available to interested researchers.

Computers↗
PubMed1977

The effect of contraceptive steroids on hypothalamic-pituitary function.

A study was performed to obtain additional information about the effects of oral contraceptives on pituitary function. A sequential pituitary stimulation test (SST) was used to study normal control women who then received either a combination pill with 50 mug of ethinyl estradiol or an injectable or oral progestin for three weeks, after which the test was repeated. The same test was also performed on five long-term oral contraceptive users. The SST consists of measurement of growth hormone (GH), thyroid-stimulating hormone (TSH), prolactin (PRL), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) at frequent intervals after stimulation by hypoglycemia, thyrotropin-releasing hormone, and gonadotropin-releasing hormone. GH and TSH release following stimulation were unaffected by the use of contraceptive steroids, while PRL release was increased by both the combination pill and the progestin alone. LH and FSH release was decreased in the three short-term and most of the long-term users of the combination pills but was not decreased in two of the long-term users as well as in those receiving the progestin alone. These results indicate that the combination oral contraceptives have a direct effect upon the pituitary gland, causing an increase in prolactin release and a decrease in gonadotropin release. This effect varies among individuals receiving the same formulation and may be related to the development of syndrome of postpill amenorrhea-galactorrhea.

Contraceptives, Oral↗
PubMed1977

Copper T 22oC.

Explore the source record for details and available documents.

Female↗
PubMed1977

Gonadotropin, prolactin, and steroid hormone levels after discontinuation of oral contraceptives.

Serum levels of LSH, LH, estradiol, progesterone, and prolactin were measured daily for 2 months in six women after discontinuation of combination oral contraceptives. The initial LH peak occurred from 21 to 28 days after ingestion of the last tablet. Apart from variable prolongation of the follicular phase in the first postcontraceptive cycle, the patterns and levels of all hormones were indistinguishable from those found in normal ovulatory subjects. These results indicate that after a variable brief interval following discontinuation of oral contraceptive steroids, their suppressive effect on the hypothalamic-pituitary-ovarian axis disappears. This initial recovery results in completely normal endocrine function.

Adult↗
PubMed1977

Termination of early gestation with a vaginal polysiloxane device impregnated with (15S)-15 methyl prostaglandin F2alpha methylester.

An investigation of the abortifacient activity of (15S)-15 methyl prostaglandin F2alpha methyl ester released from a vaginal polysiloxane device was performed in eleven pregnant women of 49 days gestation or less. Bleeding and contractions were induced in all women, but only seven aborted their pregnancies. Five subjects received a vaginal device impregnated with 3 mg of drug and two aborted fetal tissue. Six women were given a vaginal device containing 5 mg of drug and five aborted fetal tissue. Ten of the patients had significant side effects, nausea, emesis, diarrhea and chills. Six women expelled the device prior to the termination of therapy. This prostaglandin analogue, when administered from a vaginal polysiloxane device in early gestation was an effective abortifacient but was accompanied by systemic side effects and a high incidence of expulsion of the device prior to its scheduled removal.

Abortion, Induced↗
PubMed1977

Serum medroxyprogesterone acetate (MPA) concentrations and ovarian function following intramuscular injection of depo-MPA.

A sensitive radioimmunoassay measuring serum medroxyprogesterone acetate (MPA) has been developed in order to measure and correlate serum MPA concentrations and ovarian function in women following im administration of deop-MPA (DMPA), employing goat anti-MPA-3-(O-carboxymethyl) oxime-bovine serum albumin and MPA-3-(O-carboxymethyl) imino-125I-iodohistamine. In the 3 women studied, im injection of 150 mg of DMPA yielded brief initial serum MPA concentrations ranging from 1.5 to 3 ng/ml for a few days. Serum MPA concentrations gradually declined and remained relatively constant at about 1 ng/ml for 2 to 3 months, declined gradually thereafter reaching 0.2 ng/ml during the 6th month and became undetectable (less than 0.02 ng/ml) about 7-1/2 to 9 months following administration. Serum estradiol remained at early to midfollicular phase levels for 4 to 6 months after DMPA injection and rose to preovulatory levels when serum MPA levels fell below 0.5 to 0.25 ng/ml. Ovulation, however, as evidenced by serum progesterone concentrations did not occur, apparently due to suppression of the LH peak by positive feedback inhibition. Prolonged inhibition of cyclic ovarian function following DMPA injection is caused by slow MPA absorption and persists until serum MPA levels have decreased below 0.1 ng/ml or become undetectable about 7 to 9 months after DMPA administration.

Adult↗
PubMed1977

Ectopic pregnancy following tubal sterilization surgery.

In a consecutive study of 100 women with the surgical diagnosis of ectopic pregnancy confirmed by histologic examination, 7 women were found to have had prior tubal sterilization surgery. In 3 of these cases the sterilization procedure was bilateral tubal fulguration. The diagnosis of ectopic pregnancy must be given careful consideration if patients conceive after a tubal sterilization procedure of any type.

Adult↗
PubMed1977

Diagnosis of pregnancy with a radioreceptor assay for hCG.

A new serum assay for human chorionic gonadotropin, the radioreceptor assay (RRA), was compared with three commercial urinary agglutination inhibition pregnancy tests (AITs) in a group of women with suspected early pregnancies and ectopic gestations. The accepted definitions by which a laboratory test is characterized, including clinical sensitivity and specificity as well as predictive value of positive and negative tests and efficiency, were calculated for each test in three different time periods of gestation: less than 7 days, between 7 and 14 days, or more than 14 days after the expected menses had been missed. The results of the study showed that the RRA had greater clinical sensitivity and efficiency than the AITs in cases of both early gestation and ectopic pregnancy. The RRA has the disadvantages of requiring the capability to handle radioactive materials and gamma counter. This test is chiefly useful for those patients desiring early termination of pregnancy and those infertility patients anxious for early confirmation of pregnancy.

Chorionic Gonadotropin↗
PubMed1976

Effect of clomiphene citrate upon amount and duration of human menopausal gonadotropin therapy.

Human menopausal gonadotropin (HMG) was given to 10 patients who failed to ovulate after treatment with clomiphene citrate. Prior to one or more treatment courses, 200 mg. of clomiphene were administered daily for 5 days; at least one other treatment course was not preceded by clomiphene. Before therapy, progesterone in oil was administered and serum FSH, LH, and estrogen were measured. Those patients who had normal serum FSH levels and had withdrawal bleeding following progesterone had a reduction in amount and duration of HMG requirements for those patients with low serum FSH who did not withdraw. Thus, sequential clomiphene-HMG therapy is of benefit only for those women with normal serum FSH levels and is the treatment of choice.

Adult↗
PubMed1976

The Copper T 220C: a new long-acting copper intrauterine contraceptive device.

The Copper T(TCu) intrauterine contraceptive device (IUD) has been found to be an effective method of contraception but has the disadvantage of needing periodic replacement due to loss of copper through dissolution and fragmentation of the copper wire. Modification of the Copper T to overcome this disadvantage involved substitution of copper sleeves for wire on the vertical arm and the addition of copper sleeves to the horizonal arms to give an effective surface area of 220 sq. mm. of copper and an estimated life span of 20 years. A randomized comparative study was undertaken in 999 women to determine if the new model performed as well as the wire-wound Copper T 300. Net cumulative first-event rates at one year were as follows: TCu 220C-pregnancy 0.9, expulsion 3.7, removal for pain or bleeding 14.4; TCu 300-pregnancy 1.1, expulsion 3.1, removal for pain or bleeding 9.3. None of the differences in event rates were significant. If long-term follow-up confirms these findings, this new long-lasting copper intrauterine device could become the IUD of choice for all women.

Adolescent↗