Biomedical subjects

N Kase

Publications and source records attributed to N Kase.

At least 37 records · Page 2Linked to original sources

PubMed1982

[Effects of gamma-oryzanol on the hypothalamo-pituitary axis in the rat].

The effects of gamma oryzanol (gamma-OZ), a ferulic acid of triterpene alcohol, on the synthesis and release of the growth hormone (GH) and prolactin (PRL) in vitro and turnover rates of hypothalamic catecholamines were investigated. A single subcutaneous injection of 20 mg/kg of gamma-OZ suppressed GH synthesis and PRL release 1 hour after the injection. gamma-OZ increased medial basal hypothalamic (MBH) dopamine (DA) content, and the DA content was decreased by a treatment of alpha-methyl-p-tyrosine (alpha MpT), a tyrosine hydroxylase inhibitor, indicating increased synthesis and release of DA in MBH by gamma-OZ. gamma-OZ did not alter norepinephrine (NE) content in MBH, while the NE content was significantly decreased, indicating unchanged synthesis and increased release of NE in MBH by gamma-OZ. These results may explain the previous data concerning the changes in serum levels of GH and PRL by gamma-OZ and also suggest that gamma-OZ can affect the synthesis and/or release of at least two hypothalamic neurotransmitters, DA and NE, resulting in the alterations of anterior pituitary hormone synthesis and/or release.

Animals↗

PubMed1982

Abnormal ovarian cycles as diagnosed by ultrasound and serum estradiol levels.

A significant portion of human infertility is presumably due to defective ovulation, including patients who fail to conceive despite medical induction of ovulation, those who fail despite repeated timely donor inseminations, and those with "infertility of unknown etiology". All point out the inadequacy of standard criteria for normal ovulation. This investigation correlates preovulatory serum estradiol and gonadotropin concentrations with dominant follicle growth measured ultrasonographically and serum progesterone levels. The data indicate a 35% incidence of cycles with significantly abnormal serum estradiol levels, decreased dominant follicle size, and abnormal progesterone levels despite biphasic basal body temperature curves and normal cycle length. If these cycles represent inadequate or abnormal ovulation, they can be distinguished from adequate cycles prior to follicle rupture and may benefit the treatment of human infertility.

Adult↗

PubMed1982

Use of intravenous Premarin in the treatment of dysfunctional uterine bleeding--a double-blind randomized control study.

Dysfunctional uterine bleeding results from disruption of the normal sequence of ovarian cyclic hormonal stimulation of the uterine endometrium. Treatment of dysfunctional uterine bleeding previously consisted of surgical or hormonal manipulation, or both. The present study was conducted on 34 patients in a randomized double-blind fashion to evaluate the efficacy of treating dysfunctional uterine bleeding with intravenous Premarin. Bleeding stopped in 72% of patients who received intravenous Premarin and in 38% who received placebo (P = .021). Premarin was effective in terminating endometrial bleeding in patients with biopsy-proved pathology consisting of secretory, proliferative, menstrual, polypoid, or cystic hyperplasia, as well as endometritis.

Adolescent↗

PubMed1981

A comparison of treatment for bilateral fimbrial occlusion.

Eighteen patients with bilateral tubal occlusion were divided in an alternating fashion just prior to surgery into two groups for definitive treatment. One group consisted of nine women who underwent a two-stage procedure utilizing a Rock-Mulligan prosthesis; the other nine women underwent terminal salpingostomy utilizing microsurgical technique. Microsurgical technique was defined as the use of microcautery, lavage, and careful handling of tissues; the operating microscope was employed to achieve better visualization and hence better hemostasis and minimized tissue trauma. Both groups received pre-, intra-, and postoperative antibiotics, Decadron, and Phenergan. Hysterosalpingography revealed a patency rate of 89% in the hood group and in the group in which microsurgical technique was used. The term intrauterine pregnancy rates were 22.2% in the hood group (two of nine) and 44.4% in the group in which microsurgical technique was used (four of nine). In this small series there were no ectopic pregnancies or early pregnancy wastage. Subsequently, a series of 54 patients was treated by terminal salpingostomy with an over-all term intrauterine pregnancy rate of 26%. From this study, we conclude that the use of Rock-Mulligan hoods offers no distinct advantage over microsurgical salpingostomy, but has the disadvantage of requiring two surgical procedures.

Constriction, Pathologic↗

PubMed1981

Estrogen replacement therapy.

The use of estrogen replacement therapy in postmenopausal women is under close scrutiny. The indications and side effects of replacement therapy are reviewed, and recommendations regarding its use are made. Hot flashes, atrophy of the vaginal epithelium, and prevention of osteoporosis have been established as indications for estrogen replacement therapy. Prevention of cardiovascular disease, aging changes of skin, and the occurrence of mental illness have also been suggested as indications, but beneficial effects of estrogen replacement therapy for these problems have not been clearly established. Studies have shown that side effects of estrogen replacement therapy include endometrial cancer, hypertension, gallbladder disease, and angina pectoris. Breast cancer may also be a risk factor, but a consensus of opinion has not been established. Pulmonary embolism, cerebral vascular accident, or myocardial infarction has not been associated with estrogen replacement therapy. The use of progesterone with estrogen replacement therapy has been shown to reduce the occurrence rate of endometrial carcinoma, but it does not prevent all the actions of estrogen. Oral administration of estrogen is the preferred route despite misgivings about portal absorption and liver metabolism. Further studies must examine this question. Various agents have been shown to be effective in treating some climacteric symptoms. These include progesterone for hot flashes and calcium for the prevention of osteoporosis. Other agents may also be effective but have not been tested critically.

Aged↗

PubMed1980

Comparative study of high-dose chorionic gonadotropin on the human and rat corpus luteum and effect of gonadotropin-releasing hormone on human luteal function.

Human chorionic gonadotropin (hCG) was administered to pseudopregnant rats with 4-day-old corpora lutea and to normal women on days 16 to 18 following onset of menses. In the rat serum progesterone levels fell by 90% within 8 hours as did unoccupied luteal luteinizing hormone (LH) receptors following treatment with hCG (100 IU). Total receptor number for LH, however, remained unchanged until after 12 hours. In the woman 20,000 or 40,000 IU of hCG given on day 16 and day 18 of the cycle did not reduce serum progesterone or serum estradiol levels although the serum hCG level was similar to that achieved in the rat. In fact, serum progesterone levels rose and the cycle length was extended by hCG treatment in the human. Conversely, treatment of the woman with gonadotropin-releasing hormone (GnRH, 500 microgram on day 16 and on day 18) caused an initial rapid rise, then a fall in serum progesterone levels and the cycle length was shortened. It was concluded that the human corpus luteum may be resistant to densensitization by hCG but possibly not to LH. However, the possibility cannot be excluded that GnRH may compromise luteal function through mechanisms independent of effects on pituitary gonadotropin secretion or action.

20-alpha-Dihydroprogesterone↗

PubMed1980

Microsurgical technique in the management of tubal ectopic pregnancy.

Microsurgical techniques employing fine instruments and suture, microelectrocautery and continuous lavage, and careful handling of tissue have been applied to a variety of gynecologic procedures in which the microscope itself is not warranted. The thesis underlying this practice is straightforward: if successful outcome in chronic tubal disease is enhanced by these procedures, then they may have a beneficial role in acute tubal disease. To test this premise, in the past 2 years nine patients with tubal ectopic pregnancies have been managed by microsurgical techniques at Yale-New Haven Hospital. Five of the ectopic pregnancies were unruptured and four were ruptured. The products of conception were removed either by meticulous debridement or linear antimesenteric salpingostomy in association with the microsurgical methods noted above. Tubal healing was by secondary intention. All patients were treated with prophylactic antibiotics and intra-abdominal low molecular weight dextran. Four months postoperatively, all tubes operated upon were patent by salpingography. Subsequently, three of the five women with unruptured pregnancies and two of the four with ruptured pregnancies achieved intrauterine pregnancies. However, one has spontaneously aborted. According to these preliminary results, microsurgical techniques may be beneficially applied in the treatment of selected cases of ectopic pregnancy.

Adult↗

PubMed1979

The conservative surgical management of unruptured ectopic pregnancy.

With the earlier and more accurate diagnosis of ectopic pregnancy based on rapid beta-subunit pregnancy tests and the use of ultrasound and laparoscopy, the percentage of diagnosed unruptured ectopic pregnancies is rapidly increasing. This, coupled with the earlier treatment of pelvic inflammatory disease, the use of IUDs, and increasing numbers of tubal plastic surgery, caused the authors to evaluate the problem of conservative management of ectopic pregnancy. In this study 98 patients at the Yale-New Haven Hospital who had ectopic pregnancies between 1972 and 1977 are evaluated. Fifty of these patients underwent a salpingectomy or salpingo-oophorectomy. Forty-eight patients underwent salpingostomy. This represents an increase in the conservative surgery rate from 8 to 35.5%. The overall term viable pregnancy rate was 40%, along with a 10% repeat ectopic rate. There was no advantage as far as term viable pregnancy when comparing salpingostomy and salpingectomy. Conservative surgery did not increase the repeat ectopic rate. Salpingostomy is therefore recommended in unruptured ampullar ectopic pregnancies in order to preserve reproductive function. If current trends continue, this will be an increasingly important problem. The statistics are based on a 73% follow-up, with all patients actively trying to conceive.

Castration↗

PubMed1976