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Biomedical subjects

J E Buster

Publications and source records attributed to J E Buster.

At least 73 records · Page 4Linked to original sources
PubMed1988

Effect of abstinence on sperm motility in normal men.

We investigated the effect of varying the length of ejaculatory abstinence on sperm motility by a method of automated videomicrography. Ten fertile donors to an artificial insemination clinic provided semen samples at randomly assigned intervals of 12, 24, 72, and 120 hours. All specimens were produced on site, immediately incubated at 37 degrees C, and processed in triplicate. In comparing ejaculates obtained after 12 hours' abstinence with those after 120 hours, semen volume and sperm concentration demonstrated a significant increase with increasing abstinence time (p = 0.03). However, no correlation between abstinence time and percentage of motility, lateral head amplitude, cross-beat frequency, mean velocity, and mean linearity was found. We conclude that motility does not change with ejaculatory frequency and that in normal men prescribed abstinence before analysis of semen for motility characterization may not be necessary.

Humans↗
PubMed1988

Ectopic pregnancy without laparotomy: defining the incidence of manageable patients.

To assess the incidence of ectopic pregnancies meeting published criteria for laparoscopic or medical therapy, we retrospectively evaluated tubal pregnancies admitted during a 12-month period. Because 41/121 (34%) were visible laparoscopically, unruptured, and less than or equal to 3 centimeters in diameter, we conclude that substantial numbers of ectopics may be managed without laparotomy.

California↗
PubMed1988

Survey of attitudes regarding the use of siblings for gamete donation.

We conclude that the acceptability of using a sister for gamete donation is high among couples desiring ovum donation. On the contrary, couples undergoing AID generally rejected the concept of using the husband's brother as a known donor. Thus, although similar in concept, disparity exists regarding the use of siblings for gamete donation. Though the use of sibling gamete donation may provide a short-term solution to the dwindling supply of acceptable gamete donors, the long-term acceptability of such practice remains unknown.

Attitude↗
PubMed1988

Successful nonsurgical treatment of cervical pregnancy with methotrexate.

Although cervical pregnancy is a rare complication of gestation, previously described treatments are associated with a high morbidity. A case of cervical pregnancy successfully treated without surgery is presented. When the diagnosis is made early in gestation, the use of methotrexate should be considered for the treatment of cervical pregnancy when future fertility is desirable.

Abortion, Induced↗
PubMed1988

Divergent correlations of circulating dehydroepiandrosterone sulfate and testosterone with insulin levels and insulin receptor binding.

We evaluated the insulin response to a standard oral glucose tolerance test (OGTT) and in vitro insulin binding to erythrocytes (RBC) in 26 women from 3 groups: Group NW, normal women (n = 11); Group DS, women (n = 9) with elevated serum DHEAS concentrations, greater than 400 micrograms/dl (greater than 10.84 mumol/L); and Group IR, women (n = 6) with elevated basal plasma insulin concentrations (IRI). There was a significant linear correlation between the area under the insulin response curve (IRI-AUC) and serum testosterone (T) (r = 0.78, p = 0.0001). Using stepwise multiple linear regression, IRI-AUC was characterized as a function of both serum T and DHEAS; positively with T and negatively with DHEAS. In vitro (n = 17), there was a positive correlation between RBC-insulin binding and serum DHEAS (r = 0.54, p = 0.029) and a negative correlation between RBC-binding and T (r = -0.57, p = 0.017). We conclude that DHEAS may enhance insulin binding and action and that DHEAS and T have divergent functional relationships with IRI. DHEAS and T may therefore exert opposing effects on insulin secretion and action.

Dehydroepiandrosterone↗
PubMed1988

Reliability of ultrasound in predicting uterine leiomyoma volume.

Recently ultrasound has been used to size and track individual myoma volumes for patients undergoing medical therapy. However, little is known about the specific performance characteristics and limitations of this technique with respect to volume measurements. We performed and prospectively interpreted serial ultrasound examinations on myoma patients and confirmed the location, size and number of myomas in the surgical specimens. The smallest detectable tumor was 2.7 cm in diameter. The specificity was 94%; reproducibility had a 14% coefficient of variation for tumors with diameters greater than 6 cm. We conclude that ultrasound is suitable for imaging and sizing myomas provided that the diagnosis is otherwise certain and the tumors tracked are large.

Female↗
PubMed1988

Induction of premature delivery in sheep following infusion of cortisol to the fetus: the effect of maternal progestagen treatment on the C21-steroid-17 alpha-hydroxylase, C-17,20 lyase and aromatase pathways.

Infusion of cortisol to the fetus of late pregnant sheep caused an increase in maternal and fetal plasma oestrone and oestrone sulphate concentration and subsequent delivery of the fetus. Administration of progesterone or medroxyprogesterone acetate to late pregnant sheep inhibited the induction of labour. The changes in maternal and fetal plasma concentrations of pregnenolone, 17 alpha-hydroxypregnenolone, dehydro-epiandrosterone and their respective sulphates were not significantly altered by the administration of progestagens during induction of delivery. Placental delta 5-3 beta-hydroxysteroid dehydrogenase was not, therefore, significantly inhibited by progestagen administration. Furthermore induction of 17 alpha-hydroxylase and C17-20 lyase by cortisol was not suppressed. Similarly, since the changes in maternal and fetal oestrone and oestrone sulphate concentrations were not affected by treatment of the ewe with either progesterone or medroxyprogesterone acetate, the increase in the activity of aromatase, observed during induced parturition, was not inhibited, not did the exogenous progesterone provide any further substrate for placental oestrogen production. Progestagen treatment is, however, able to inhibit delivery when administered in sufficient quantities to overcome the stimulatory effect of the oestrogens produced by the placenta from endogenous precursors.

Animals↗
PubMed1988

Corpus luteum activity in tubal pregnancy.

Corpus luteum activity was monitored in 20 women undergoing nonsurgical management of ectopic pregnancy with methotrexate and citrovorum factor (N = 15) or observation (N = 5). The functional integrity of the corpus luteum was assessed by measuring progesterone and 17-hydroxyprogesterone. Trophoblastic viability was assessed by measuring the immunoreactive beta subunit of human chorionic gonadotropin. Ten of 15 methotrexate-treated patients demonstrated initial progesterone levels above 1.0 ng/mL, declining to levels below 1.0 ng/mL after treatment. Five of 15 methotrexate-treated patients and all five managed by observation alone demonstrated progesterone and 17-hydroxyprogesterone values below 1.0 ng/mL both initially and throughout the surveillance period, leading to resolution, indicating previous death of the corpus luteum. We conclude the following regarding ectopic pregnancy: 1) Corpus luteum function declines early in the biologic history of some gestations while persisting in others, and 2) corpus luteum function varies from active to inactive independent of serum levels of immunoreactive beta-human chorionic gonadotropin.

17-alpha-Hydroxyprogesterone↗
PubMed1988

An instrument for the recovery of preimplantation uterine ova.

This report describes an instrument to recover fertilized ova from the human uterus without anesthesia. Two hundred sixty-five lavages were performed on 20 normal and presumed fertile women and on seven infertile women. Using 60 mL of fluid, median fluid recovery was 97% (range 65-100%). In the fertile women, ova were recovered in 40 of 90 insemination cycles (44%). Complications were rare (3%), but included two retained pregnancies, three minor pelvic infections, three occurrences of catheter kinking on insertion, and one failure to obtain insertion. Reproductive function in the subjects after repeated use does not appear to be impaired.

Embryo Transfer↗
PubMed1987

Sterilization reversals performed by fellows in training: what success rates can we reasonably expect?

To assess outcomes of sterilization reversal procedures performed by fellows in training, we retrospectively analyzed 44 women who had undergone this procedure at a large teaching institution. All women studied had been followed postoperatively for a minimum of 12 months. Sixty-five percent of patients became pregnant. Fifty-four percent of patients successfully delivered a term infant. Compared to results tallied by experienced microsurgeons, no significant differences in outcomes were noted. We conclude that clinically inexperienced microsurgeons can obtain reasonable success rates for sterilization reversal procedures by carefully following established microsurgical principles.

Adult↗
PubMed1987

Timely diagnosis of early ectopic pregnancy using a single blood progesterone measurement.

We obtained a single serum P measurement in 70 subjects at risk for an EP. Retrospectively, a P less than 15 ng/ml was 100% predictive of either an EP or otherwise nonviable IUP, while P greater than 15 ng/ml would have ruled out an EP in all cases. Because of this high degree of diagnostic accuracy, we speculated on the clinical utility of an outpatient D and C for those patients in our series having a P less than 15 ng/ml. Laparoscopy would be reserved for those cases without identifiable chorionic villi on frozen section of curettings. Following this course of management could have potentially diagnosed all EPs at the first ER visit without disruption of a single normal IUP in our series. This sequence could have expedited the diagnosis of EP by up to 14 days compared with a standard hCG/US protocol. This report describes a promising new test for the early detection of EP. The findings, however, require confirmation in a prospective trial before widespread clinical implementation.

Female↗
PubMed1987

Establishing early pregnancy levels of serum progesterone in functionally agonadal women using polysiloxane vaginal rings and cylinders.

Using a polysiloxane cylinder impregnated with crystalline progesterone (P4), combined with a 17 beta-oestradiol (E2) and P4 vaginal ring, we produced first trimester pregnancy levels of serum P4 in six functionally agonadal women scheduled for transfer of donated embryos. With this 4 g P4 cylinder worn from cycle day 15 to day 30, overall mean serum P4 concentrations were 15.03 +/- 1.56 ng/ml, with a mean peak level of 21.34 +/- 1.85 ng/ml. These levels were significantly higher than those obtained by us previously in five subjects using a 2 g P4 cylinder [P = 0.007]. The cylinder produced minor but significant complications including small vulvovaginal lacerations, difficulty in removing the device, and vaginal discharge. We conclude that the steroid impregnated polysiloxane vaginal ring and cylinder system provides: continuous and sustained hormone release, and levels of serum P4 in the normal range for early pregnancy. Side effects however, may limit its clinical usefulness.

Administration, Intravaginal↗
PubMed1987

In-vivo blastocyst production and ovum yield among fertile women.

We evaluated ova recovered from 13 fertile women undergoing uterine lavage for purposes of embryo donation, and assessed differences in blastocyst production and ovum yield among subjects. Six women produced 10 blastocysts during 31 insemination cycles (32%). Yet, despite undergoing at least four insemination cycles apiece, seven women produced no blastocysts in 52 lavage attempts. Comparing the ovum recovery rates between the blastocyst-producing and non-blastocyst-producing groups, we found the former more likely to yield ova (P less than or equal to 0.05), and more importantly 10 to 20 recovered ova were blastocysts. We conclude that donor fecundity is highly variable among fertile women, and that reproductive history alone does not predict ovum donor efficiency.

Adult↗
PubMed1987

Variability of midcycle estradiol positive feedback: evidence for unique pituitary responses in individual women.

In women the preovulatory estradiol (E2) level must reach a peak concentration and dose (strength and duration) to initiate the LH surge. The variability of the surge-initiating serum E2 level in individual women from cycle to cycle, however, has not been studied. Accordingly, we studied 24 normally ovulating women longitudinally during a total of 221 menstrual cycles (range, 4-17 cycles/woman). In those women we measured periovulatory serum E2 and LH concentrations daily from 3 days before the LH peak to the day after the LH peak. The mean peak E2 concentration was 343 pg/mL, and the mean E2 dose (concentration X time) was 979 pg/mL. When the values in individual women were compared between women by components of variance analysis of variance, the differences were significant (concentration, P less than 0.01; dose, P less than 0.005), indicating that individual women have discrete and characteristic responses to E2 positive feedback. When E2 peaks and doses from initial cycles were compared with subsequent cycles by regression analysis, there were strong positive correlations (peak: r = 0.47; P less than 0.001; dose: r = 0.60; P less than 0.001). Of the total group variance in mean E2 peak and mean dose, 67% of the peak and 54% of the dose variance resulted from an individual woman's cycle to cycle variability, while 33% of the peak and 46% of the dose variance was attributable to differences among the women's responses to positive feedback. We conclude that individual women have characteristic and predictable periovulatory E2 production, leading to a LH surge which is maintained from cycle to cycle; and approximately two thirds of the total variance in mean peak E2 concentration (67%) and approximately half the variance in mean dose (54%) are the result of cycle to cycle biological variability around this characteristic periovulatory pattern of E2 production.

Adult↗
PubMed1987

Nonsurgical management of unruptured ectopic pregnancy: an extended clinical trial.

Unruptured tubal pregnancies diagnosed at laparoscopy were treated with either methotrexate/citrovorum factor (MTX/CF) (n = 21) or observation (n = 5). Entry criteria required that the ectopic pregnancy be visualized, less than or equal to 3 cm in diameter, with intact serosa and no active bleeding. Treatment selection was based upon preoperative levels of beta-human chorionic gonadotropin (beta-hCG), with MTX/CF given to subjects exhibiting a plateaued or rising pattern and observation alone given to those with falling levels. Twenty-five of 26 ectopic pregnancies resolved without need of laparotomy. Two subjects received blood transfusions and one required a second operation for intra-abdominal bleeding. In both cases, fetal cardiac activity was noted pretreatment on ultrasound. The authors conclude the following: (1) MTX/CF may be safely used to treat selected unruptured ectopic pregnancy; (2) many ectopic pregnancies resolve spontaneously; and (3) ectopic pregnancies that form fetal elements, as evidenced on ultrasound, should not be managed medically.

Adult↗
PubMed1987

Fetal gender effects on maternal serum prolactin levels.

Circulating maternal prolactin (PRL) levels have been reported to be higher in term pregnancies yielding male infants. The mechanism for this gender difference is unknown, but we theorized that it was mediated through the fetal adrenal cortex. To test this theory we measured circulating PRL and estriol (E3) concentrations with radioimmunoassay in 37 pregnant women at 34 and 36 weeks' gestation. We then separated the groups by newborn gender. Maternal serum PRL levels were significantly higher in the women bearing male fetuses. There was no significant difference by gender in E3 concentrations, and there was no PRL surge corresponding to the E3 surge at 34-36 weeks' gestational age. There was no correlation between E3 and PRL levels. Transmission of the fetal gender effect on maternal PRL does not appear to be mediated through the fetal adrenal as measured by the fetoplacental production of E3. The effect probably is mediated by the fetal gonad.

Adrenal Cortex↗