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Biomedical subjects

J F Randolph

Publications and source records attributed to J F Randolph.

At least 55 records · Page 3Linked to original sources

Trichinosis in a dog.

Trichinella spiralis infection was identified by direct fecal examination as the cause of gastrointestinal disease in a dog. The source of infection was believed to be a woodchuck. Management included supportive care and benzimidazole treatment. Vomiting, diarrhea, anorexia, and myalgia are the main signs of trichinosis, but routine fecal examination seldom reveals T spiralis in natural infections. Mebendazole is the recommended anthelmintic and should be used to eliminate intestinal larvae and prevent muscle invasion. Although the prevalence of trichinosis is decreasing in swine, wild mammals may still be a potential source for dogs and cats. Nevertheless, because of the nonspecific clinical signs of trichinosis, many cases probably go undiagnosed.

Animals↗

Delayed growth in two German shepherd dog littermates with normal serum concentrations of growth hormone, thyroxine, and cortisol.

Four German Shepherd Dogs from a litter of 10 were evaluated because of postnatal onset of proportionate growth stunting that clinically resembled well-documented hypopituitary dwarfism in that breed. Although 2 pups had histologic evidence of hypopituitarism, the remaining 2 pups had normal serum growth hormone concentration and adrenocorticotropin secretory capability, and normal adrenal function test and thyroid function study results. Furthermore, the initially stunted German Shepherd Dogs grew at a steady rate until at 1 year, body weight and shoulder height approximated normal measurements. Seemingly, delayed growth in these pups may represent one end of a clinical spectrum associated with hypopituitarism in German Shepherd Dogs.

Adrenal Cortex↗

Combined electroejaculation and in vitro fertilization in the evaluation and treatment of anejaculatory infertility.

Seven couples underwent combined electroejaculation and in vitro fertilization for anejaculatory infertility after a failed regimen of electroejaculation and intrauterine insemination. Two pregnancies resulted, one proceeding to a term vaginal delivery and one ending in a 6-week spontaneous abortion. Poor sperm binding and no fertilization were seen in two of the couples. Fertilization of the oocytes but no subsequent pregnancy were seen in the other three couples. Combined in vitro fertilization and gamete intrafallopian transfer was performed in four of the couples. The combination of electroejaculation and in vitro fertilization offers the opportunity to evaluate the female pelvis, observe the sperm-oocyte interaction, and achieve a pregnancy in couples with anejaculatory infertility.

Adult↗

In vitro induction of prolactin production and aromatase activity by gonadal steroids exclusively in the stroma of separated proliferative human endometrium.

Prolactin production by decidualized human endometrium has been demonstrated in organ explant cultures and presumed to be of stromal origin by immunocytochemistry and the presence of simultaneous stromal histologic changes. To test the hypothesis that endometrial prolactin production is exclusively of stromal origin, late proliferative human endometrium was separated into glands and stroma and cultured for 3 days. Confluent cultures were incubated with progesterone, 50 ng/ml; estradiol, 5 ng/ml; or both progesterone and estradiol for 4, 8, and 15 days. Prolactin concentration was measured at 2-day intervals by specific radioimmunoassay throughout a 15-day culture in all samples. Aromatase activity at 15 days was assayed by the production of tritiated water from 1 beta 3H-androstenedione. Possible contamination of gland cultures by stromal cells was controlled by the substitution of D-valine in the culture media. No prolactin was detected in the D-valine-treated gland cultures. Stromal cell cultures demonstrated increasing prolactin with continuous incubation with progesterone (15-day control: 11.28 +/- 0.91 ng/100 micrograms deoxyribonucleic acid versus 15-day progesterone: 245.8 +/- 4.24 ng/100 micrograms). Prolactin levels increased after progesterone was removed at day 4 and 8, reaching peak production 4 days later, followed by a steady decline. Estradiol induced a sustained increase in prolactin production even after withdrawal of steroids. Aromatase activity in gland cells exposed to steroids exhibited no change with time. Steroid-treated stromal cell cultures showed an increase in aromatase activity in all 15-day (controls: 21.6 +/- 0.7 pmol substrate converted per mg of deoxyribonucleic acid per 24 hours versus progesterone: 43.4 +/- 4.2 versus estradiol: 34.2 +/- 3.5 versus progesterone and estradiol: 47.5 +/- 2.4) but not in 4- or 8-day incubations. These studies support these conclusions: (1) nongestational endometrial prolactin is of stromal, not glandular origin; (2) stromal prolactin production is induced and maintained by progesterone: (3) stromal prolactin production is induced by estradiol but does not require continued exposure for maintenance; (4) aromatase activity is increased by long-term exposure to progesterone and estradiol in stroma but not in glands.

Adult↗

Localization of trophoblastic disease with vaginal ultrasonography. A report of two cases.

Two patients had elevated beta-human chorionic gonadotropin levels and normal abdominal ultrasound examinations. In both instances transvaginal ultrasonography demonstrated a persistent nodule of trophoblastic disease confirmed at the time of hysterectomy. This new imaging modality can assist in the diagnosis of persistent trophoblastic disease in the uterus.

Adult↗

Sensitivity and specificity of blood test kits for feline leukemia virus antigen.

Enzyme-linked immunosorbent assay (ELISA) test kits have been used widely to diagnose FeLV infection. Several companies have licensed such kits, but because these test kits are designed somewhat differently, a demonstration of their relative merits was needed. Differences in the sensitivity and specificity of 7 commercial test kits were determined by testing sera that induce false-negative (limiting dilution of FeLV group specific antigen, p27), and false-positive (cat anti-mouse antibody) test results. Among the panels of sera used in this study, significant differences in test kit sensitivity were not observed, but differences in specificity were identified. An interim report of these studies, supplied to the manufacturers, prompted changes in some of the kits, resulting in improved specificities. Generally, FeLV test kits are now more efficient in accurately detecting p27 in blood, serum, or plasma of cats. Nevertheless, some kits still lack specificity attributable to reagents supplied by the manufacturer.

Animals↗

Stimulation of uterine prolactin secretion by human chorionic gonadotropin and progesterone in the cynomolgus monkey.

The ovulating cynomolgus monkey secretes immunoreactive prolactin (PRL) into the uterine cavity. Consistent with human endometrial explant data, uterine PRL is undetectable in the early secretory phase, then increases from the mid to late secretory phase, peaking premenstrually. The anovulatory monkey does not produce detectable uterine PRL. Human chorionic gonadotropin given repeatedly fails to induce PRL secretion in anovulatory monkeys but prolongs the luteal phase and thereby PRL secretion in ovulatory monkeys. Progesterone (P) induces PRL secretion in anovulatory monkeys after estrogen priming with a time delay of several days, indicating probable de novo synthesis. P appears to be an important stimulating factor in the control of uterine PRL secretion.

Animals↗

Cancellation rates and gas scores for air contrast barium enema immediately after 65-CM flexible sigmoidoscopy. A randomized clinical trial.

A randomized prospective study examined the impact of bowel gas introduced by 65-cm flexible sigmoidoscopy (FS) on the ability to perform air-contrast barium enema (ACBE) on the same day. Seventy-five patients at risk for colorectal cancer were randomly assigned to two groups. Of these, 28 patients in each group completed the protocol. The study group received flexible sigmoidoscopy and air-contrast barium enema on the same day, whereas the control group had their air-contrast barium enema on a different day. Bowel gas observed on an abdominal scout film prior to air-contrast barium enema was quantified on a scale of 1 (excessive gas) to 5 (no gas). The cancellation rate for the air-contrast barium enema was measured in each of the groups. The study group had significantly more bowel gas compared with the control group (p = 0.000003). The air-contrast barium enema cancellation rate was also higher in the study group (36%) than in the control group (14%) (p = 0.06). Greater than 60% of the study group patients were successfully examined. Same-day scheduling would reduce the number of bowel preparations required in the evaluation of patients at risk for colorectal cancer. Although retrospective studies have suggested no impact of same-day FS on ACBE quality, radiologists in this study canceled approximately one-third of scheduled patients due to perceived excessive bowel gas.

Adult↗

A bleeding disorder (von Willebrand's disease) in a Himalayan cat.

A bleeding disorder (von Willebrand's disease) was diagnosed in a 9-year-old male Himalayan cat examined because of persistent oral bleeding after routine dental extraction. Bleeding subsided after empirical treatment, which included prednisolone, vitamin K1, and transfusion of fresh blood, but recurred spontaneously after 8 months of apparent good health. Pertinent results of routine laboratory testing included an inconstant prolongation of the activated partial thromboplastin time and recurring iron-deficiency anemia. Assays of specific coagulation factors revealed low factor VIII coagulant activity and undetectable factor VIII-related antigen, a pattern considered to be diagnostic of von Willebrand's disease. This condition, not previously reported in a cat, should be included in the differential diagnosis when cats are examined because of abnormal bleeding.

Anemia, Hypochromic↗

The effect of insulin on aromatase activity in isolated human endometrial glands and stroma.

Hyperinsulinemic states have been associated with an increased incidence of estrogen-dependent endometrial neoplasia. To study the effect of insulin on the ability of endometrium to aromatize androgens to estrogens, late proliferative endometrium was obtained from normally cycling women at the time of indicated surgery, separated into component glands and stroma, and grown to confluence. Separated gland and stromal cultures were incubated in triplicate with increasing insulin concentrations and epidermal growth factor. Aromatase activity was assayed by the production of tritiated water from tritium-labeled androstenedione. The activity was noted to increase proportionally with increasing concentrations of insulin greater than 10 U/ml, and the effect was specific. These data suggest the following conclusions: (1) Insulin stimulates aromatase activity in both endometrial glands and stroma; (2) hyperinsulinemia may predispose to endometrial neoplasia by enhancing endogenous endometrial estrogen production.

Adult↗

Medical management of hyperprolactinemia: a lower dose of bromocriptine may be effective.

This prospective study includes 31 women with a prolactin (PRL) level greater than 20 ng/ml (upper limits of normal in our laboratory) on at least three different occasions and chemically euthyroid. Each woman received bromocriptine mesylate (BRC) 1.25 mg (1/2 tablet)/day for 2 weeks, at which time a repeat PRL level was obtained. If needed, the dose was increased in a stepwise fashion until the PRL level was in the normal range. Results show that 12 of 15 patients with an initial PRL greater than 20 but less than 50 ng/ml required 2.5 mg or less of BRC daily. Of 9 patients with a PRL greater than 50 but less than 100 ng/ml, 5 required 2.5 mg daily with the remaining 4 needing 5.0 mg. Five of 7 patients with a PRL greater than 100 ng/ml required 5.0 mg or more, while one responded to 1.25 mg. These findings confirm that a lower than manufacturer-recommended dose of BRC is usually effective in normalizing PRL levels, especially when the initial PRL is less than 100 ng/ml.

Adult↗

Electroejaculation of paraplegic males followed by pregnancies.

Semen obtained by electroejaculation was used to achieve pregnancies in the spouses of T5-6 and T4-5 paraplegics. Viable semen was recovered in both an antegrade and retrograde fashion. In both cases, the SPA test was positive. Semen recovered for AIH IUI was washed and swum up prior to insemination.

Adult↗

Ultrasonographic monitoring of follicular growth for luteal phase defects.

In the evaluation of 39 patients with untreated and treated luteal phase defect (LPD), serial ultrasonographic monitoring of follicular development identified three morphologically distinct growth patterns: normal-sized follicles, small follicles, and luteinized-unruptured follicles. All three patterns were observed in both untreated (46% had normal-sized follicles, 39% had small follicles, 15% had luteinized-unruptured follicles) and treated patients. A small follicle was observed uncommonly in histologically corrected LPD patients (6%). However, a luteinized-unruptured follicle (38%) may persist or be induced in situations where clomiphene citrate has been used to correct LPD or induce ovulation. Ultrasonographic evaluations of follicular growth in luteal phase defect support the theory that luteal phase defect represents a spectrum of normal and abnormal ovarian cycle events.

Adult↗

An evaluation of late luteal phase endometrium in women requesting reversal of tubal ligation.

It has been suggested that tubal ligation may cause luteal phase defects. To assess this possibility, we performed a retrospective analysis of the incidence of luteal phase defects in 72 women who had undergone tubal sterilization. In preparation for tubal reanastomosis, late luteal phase endometrial biopsy was performed. The biopsy was dated in a blind manner and designated either normal or out of phase. This group of patients was compared with a group of 32 women seen for artificial insemination with donor sperm. Luteal phase defect was defined as two biopsies out of phase by two or more days. There were no cases of luteal phase defect in either of the two groups; luteal phase defects were found in 4% of all infertility patients seen during the time of this study. These data do not support the contention that sterilization by tubal ligation leads to an increased incidence of luteal phase defect.

Adult↗

Successful pregnancy outcome after therapy for a müllerian anomaly with concomitant sex chromosomal mosaicism. A case report.

Recurrent abortion associated with both a chromosomal abnormality and a müllerian anomaly has been reported previously only once. A 31-year-old woman was referred for secondary habitual abortion and found to have sex chromosome mosaicism, subseptate uterus and chronic endometritis. Following hysteroscopic resection of the subseptum and antibiotic therapy for the endometritis, a term pregnancy ensued. Complete evaluation and treatment of all correctable etiologies of recurrent pregnancy loss are essential in such cases.

Abortion, Habitual↗

Luteal phase defect and premenstrual syndrome in an infertile population.

To test the hypothesis that an abnormal luteal phase is associated with significant symptoms of premenstrual syndrome, psychologic and somatic premenstrual syndrome symptoms were evaluated in a group of 83 infertile patients undergoing timed endometrial biopsy for the assessment of luteal phase adequacy. The severity of psychologic and somatic symptoms was evaluated separately. It was found that luteal phase defect, defined by endometrial biopsy, was associated with less severe psychologic and no more severe somatic symptoms of premenstrual syndrome in comparison with normal luteal phase controls. The data suggest that the hormonal milieu associated with luteal phase defects does not correlate with premenstrual syndrome symptoms and do not support the hypothesis that suboptimal ovarian function causes premenstrual syndrome.

Adult↗

Uterine fluid and prolactin secretion in the ovulating cynomolgus monkey.

Immunoreactive prolactin is produced by late secretory human endometrium in vitro. Human myometrium in explant culture also produces prolactin. A primate model with the use of the cynomolgus monkey is described that allowed repeated samplings of uterine secretions in vivo. The uterine secretory prolactin thus measured appears immunoreactively similar to human serum prolactin, and the pattern of secretions reflects the previously described pattern of endometrial prolactin production in vitro.

Animals↗