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Biomedical subjects

R A Wild

Publications and source records attributed to R A Wild.

At least 55 records · Page 3Linked to original sources
PubMed1990

Subtle variations in tubal anatomy in infertile women.

The frequency of tubal variations was recorded in 100 infertile and 100 fertile women at cesarean section. The infertile women had significantly more tubal/pelvic anatomical variation than did their fertile counterparts. Fimbrial agglutinations (25%), accessory tubes (13%), accessory ostia (10%), phimoses (13%), and sacculations (7%) were found more commonly in the infertile women. Paratubal cysts were found with equal numbers in both groups. There was no statistical difference in history of sexually transmitted disease/pelvic inflammatory disease (PID) or endometriosis. No significant relationship between a positive PID history and fimbrial agglutination was found; the majority of agglutinations were present with no associated adhesions.

Fallopian Tubes↗
PubMed1990

Lipoprotein lipids in women with androgen excess: independent associations with increased insulin and androgen.

Concentrations of triglycerides are increased and concentrations of high-density lipoprotein (HDL) cholesterol are low in women with hyperandrogenism. These alterations could be related to excessive androgen or estrogen, to hyperinsulinism, or to a combination of these abnormalities. We examined their independent influences on lipids in 21 women with hyperandrogenism, subgrouped according to apparent source of androgen excess. Results for lipid, androgen, and insulin did not differ among subgroups, so these data were pooled. Free plus albumin-bound testosterone (uT) was correlated with triglycerides (r = 0.69, P less than 0.01) and HDL cholesterol (r = -0.56, P less than 0.01). Both triglycerides (r = 0.66, P less than 0.01) and HDL cholesterol (r = -0.48, P less than 0.05) were also correlated with insulin measured during fasting. Partial correlation revealed that, after adjusting for insulin, lipids were associated with uT. This suggests that androgen excess is independently related to lipid excess. Insulin also was correlated with lipids when adjusted for uT. Free plus albumin-bound estradiol was not associated with any of the lipids. We conclude that altered lipids in women with hyperandrogenism result from the independent effects of androgen and insulin.

Adult↗
PubMed1988

The influence of body weight on lipoprotein lipids in patients with polycystic ovary syndrome.

Lipoprotein lipid and androgen profiles were compared after a 12-hour fast that involved 13 women with polycystic ovary syndrome and 13 who did not have the syndrome. All women were matched for percent ideal body weight. As expected, patients with polycystic ovary syndrome had significantly higher luteinizing hormone--to--follicle-stimulating hormone ratios, higher testosterone levels, higher free testosterone levels, higher dehydroepiandrosterone sulfate levels, and lower testosterone-estradiol-binding globulin binding capacity than the other women. Patients with polycystic ovary syndrome had significantly higher mean serum triglyceride levels, very-low-density lipoprotein cholesterol levels, and lower high-density lipoprotein cholesterol levels. Differences in body weight do not explain the male pattern of lipoprotein lipid concentrations in women with polycystic ovary syndrome. The association of hyperandrogenism with lipoprotein lipid abnormalities should be evaluated in regard to the influence of endogenous sex steroids on differences between the sexes in incidence of cardiovascular disease.

Adult↗
PubMed1988

Virilizing paraovarian tumors: a consequence of Nelson's syndrome?

In a patient with Nelson's syndrome, elevated peripheral concentrations of androgens usually associated with neoplasm prompted ovarian vein catheterization. Androgen excess was limited to the right ovary. However, laparotomy revealed bilateral multiple paraovarian nodules with histologic appearance of adrenocortical tissue. The occurrence of virilization from ectopic adrenal tissue with markedly elevated ACTH concentrations is exceedingly rare.

Adult↗
PubMed1987

Adrenal androgens, sex-hormone binding globulin and bone density in osteoporotic menopausal women: is there a relationship?

The relationships among sex steroids, sex hormone binding globulin (SHBG) and vertebral bone density as measured by computerized tomography were studied in 18 post-menopausal women. A significant negative correlation was found between SHBG binding capacity (SHBG-BC) and bone density. Bone density and the adrenal androgen dehydroepiandrosterone sulfate (DHEAS) declined with age, and SHBG-BC was correlated significantly with DHEAS concentrations. The relationship between SHBG-BC and bone density may be affected by adrenal androgen output.

Adrenal Cortex Hormones↗
PubMed1987

Epithelial localization of antiendometrial antibodies associated with endometriosis.

Antiendometrial antibodies have been demonstrated in patients with endometriosis. As a further step in understanding the immunological alterations against the endometrium, isolated glandular and stromal monolayer endometrial cell preparations and endometrial, breast, and ovarian carcinoma cell lines were tested by indirect immunofluorescence assay utilizing sera of patients with endometriosis previously shown to have antibodies against endometrium. In dilutions of serum of 1:1 to 1:16, significant fluorescence staining was noted only in the glandular (epithelial) component and not in the stromal component of normal endometrium without regard to phase of the menstrual cycle. The significance of this finding as it relates to the pathophysiology of endometriosis awaits further study.

Antibodies↗
PubMed1987

Declining adrenal androgens: an association with bone loss in aging women.

Bone loss in aging women is a major contributing factor to the onset of osteoporosis. To determine whether a decline in adrenal androgen output might be important in the loss of bone with age, we studied a highly selected group of 14 women, average age 70, and measured adrenal androgens in relationship to trabecular bone density. Dehydroepiandrosterone sulfate (DHEAS) levels were used as a marker of adrenal sex steroid output while quantitative, computerized tomography was used to determine trabecular bone density. Our results showed that both bone density (r = -0.69, P less than 0.01) and DHEAS levels (r = -0.68, P less than 0.01) declined with age, and that DHEAS was positively correlated with bone density (r = 0.66, P = 0.01). These data emphasize the association of declining adrenal sex steroid production with declining bone density during the process of aging.

Adrenal Cortex↗
PubMed1987

Clinical significance of naturally occurring anti-zona pellucida antibodies in infertile women.

Although implicated in the etiology of unexplained infertility, a primary role for antibodies to zona pellucida antigens remains uncertain. We therefore prospectively studied 21 infertility patients found to have significant anti-zona pellucida antibody titers (1:4 to 1:16). When treated for endometriosis or other concurrent fertility problems, 7 of the 21 (33%) delivered viable infants. Two other patients conceived without treatment. Decreases in anti-zona antibody titers were found in most but not all women with successful outcomes. In a given individual, anti-zona antibodies may coexist with other fertility disorders. Therefore, these antibodies should not preclude treatment of concurrent fertility disorders.

Autoantibodies↗
PubMed1986

Serum progesterone levels as an aid in the diagnosis of ectopic pregnancy.

Progesterone levels in 29 women with ectopic pregnancies and 20 women with early intrauterine pregnancies were evaluated using a new direct radioimmunoassay that offers results within four hours. Patients with normal intrauterine pregnancies had serum progesterone levels greater than 20 ng/mL (mean = 30.9 ng/mL) while all patients with ectopic pregnancies had progesterone levels less than 15 ng/mL (mean = 5.7 ng/mL). The incorporation of the progesterone assay into the workup of a patient with suspected ectopic pregnancy can be a useful clinical adjunct to the conventional methods of evaluation.

Chorionic Gonadotropin↗
PubMed1986

Lymphocytic hypophysitis in a patient with amenorrhea and hyperprolactinemia. A case report.

Lymphocytic hypophysitis is a rare condition reported to occur only in women. A patient with amenorrhea and hyperprolactinemia was thought to have a pituitary microadenoma but was subsequently found to have lymphocytic hypophysitis and pituitary-specific autoantibodies. Photomicrographs taken upon transsphenoidal surgical exploration revealed the lymphohistiocytic infiltrate of the pituitary. The pituitary reserve was tested. Autoimmune hypophysitis should be included in the differential diagnosis of amenorrhea and galactorrhea.

Adult↗
PubMed1986

Endometrial biopsy in the infertility investigation. The experience at two institutions.

The combined experience at two institutions was reviewed to evaluate endometrial biopsy and the prognosis for pregnancies affected by endometrial sampling during the cycle of conception. In the evaluation of 1,084 patients, 1,174 biopsies were performed. Twenty-seven endometrial biopsies were done during the cycle of conception, with spontaneous abortion occurring in six cases (22.2%). Multiple diagnoses were made (including luteal phase defects, endometritis and polyps), and interruption of pregnancy occurred. Several cases illustrate disturbing complications. Methods of minimizing pregnancy interruption and patient discomfort are available.

Biopsy↗
PubMed1985

Antiendometrial antibodies in patients with endometriosis.

Sera from 42 patients complaining of infertility were evaluated by indirect immunofluorescence for the presence of antibodies to the endometrium. The presence or absence of antibodies was matched with the findings at laparoscopy. Of the 42 patients examined for infertility, 28 (66.7%) had laparoscopic findings that corresponded to the presence or absence of endometriosis. Of 28 patients with positive antibody tests, 24 (85.7%) were found to have endometriosis. No correlation between the degree of immunofluorescence and the clinical severity of endometriosis could be determined. These findings suggest the possibility of developing a noninvasive immunological test for the presence of endometriosis.

Autoantibodies↗
PubMed1985

Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome.

Twenty-nine patients with polycystic ovary syndrome (PCOS) and 30 normal women had lipoprotein lipid and androgen profiles compared after a 12-h fast. Both PCOS and normal women were evaluated in the proliferative phase of the cycle. PCOS patients had higher serum LH to FSH ratios [2.0 +/- 1.3 (+/- SEM) vs. 0.6 +/- 0.1), higher testosterone (T; 66 +/- 5 vs. 33 +/- 2 ng/ml), higher free T (1.1 +/- 1 vs. 0.4 +/- 0.02 ng/dl), and higher dehydroepiandrosterone sulfate (291 +/- 28 vs. 140 +/- 12 micrograms/dl) levels, and lower T-estrogen-binding globulin-binding capacity (1.5 +/- 0.2 vs. 2.2 +/- 0.1 micrograms/dl) than normal women (all P less than 0.05). The PCOS patients had higher mean serum triglycerides [122 +/- 11 (+/- SEM) 63 +/- 3 mg/dl] and very low density lipoprotein cholesterol levels (24 +/- 2 vs. 13 +/- 1 mg/dl), but lower high density lipoprotein cholesterol levels (43 +/- 2 vs. 58 +/- 2 mg/dl; P less than 0.05). While PCOS patients were heavier and more sedentary and their diets were higher in saturated fat and lower in fiber (P less than 0.01, respectively), the differences in lipoprotein lipid concentrations could not be attributed to body weight. T-estrogen-binding globulin-binding capacity correlated with high density lipoprotein cholesterol in PCOS patients (r = 0.42; P = 0.025) after adjusting for weight. We conclude that hyperandrogenemia in women may result in a male pattern of lipoprotein lipid concentrations. These findings suggest that PCOS patients may have increased atherogenic potential.

Adolescent↗
PubMed1983

Androgen parameters and their correlation with body weight in one hundred thirty-eight women thought to have hyperandrogenism.

The first objective of this study was to determine which plasma androgen assay or combination of assays would be the most useful in documenting hyperandrogenism in women with hirsutism, acne, oligomenorrhea, or unexplained infertility. Plasma levels of androstenedione (A), total testosterone (T), and dehydroepiandrosterone sulfate (DHEAS) were measured and free T (FTc) was calculated from the measured total T and T-estradiol-binding globulin binding capacity (TeBG-BC) in 138 consecutive women referred to our clinic for hirsutism, acne, oligomenorrhea, and/or unexplained infertility. FTc was elevated in 82% and was most frequently elevated parameter. DHEAS was elevated in 59% of the women, and 93% were noted to have hyperandrogenemia on the basis of a combination of FTc and DHEAS levels. The second objective of this study was to determine whether there was significant correlation between the androgen parameters and any of the clinical features. Body weight was significantly negatively correlated with DHEAS and TeBG-BC in those women with a normal DHEAS level but not in those with an elevated level. A strong positive correlation (simple and partial) was noted between body weight and plasma T levels in the whole group of patients, as well as in those with a normal or an elevated DHEAS level. It is suggested that the relationship between T and body weight is multifaceted. Conceivably, T could influence body mass by effects on food intake or through alterations in intermediary metabolism.

Acne Vulgaris↗