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Biomedical subjects

R C Strickler

Publications and source records attributed to R C Strickler.

At least 73 records · Page 4Linked to original sources
PubMed1978

Interstitial pregnancy following ipsilateral salpingo-oophorectomy.

A case of interstitial pregnancy, which occurred 12 years after ipsilateral salpingo-oophorectomy, was managed by cornual wedge resection. Internal (transuterine) migration of the fertilized ovum is the most probable explanation for this ectopic gestation. During the past 10 years three other cases of interstitial gestation have been managed at St. Michael's Hospital, Toronto, an incidence of 3% of all ectopic pregnancies seen at the hospital during that period.

Adult↗
PubMed1977

The role of oestrogen replacement in the climacteric syndrome.

Using a double-blind placebo-controlled cross-over design, the effect of equine conjugated oestrogens tablets (Premarin) was studied in 20 women with the climacteric syndrome followed during 15 months. Sixteen women were equally improved on placebo and oestrogen. Only 2 patients had an improved sense of well-being on oestrogen and not on placebo. The psychological diagnosis was unrelated to the subjective response to oestrogen or placebo. Performance in psychological tests administered before and during treatment periods was not changed by oestrogen or placebo.

Adult↗
PubMed1977

Giant ovarian cyst in a dwarf.

The authors describe a case of giant mucinous cystadenoma in a dwarf. The cystadenoma weighed 32 kg, almost half the patient's normal weight, Such tumours are rare and are sometimes mistaken for ascites. They are usually benign, but care should be taken to remove them intact since malignant degeneration of mucinous cysts occurs in 5 to 15% of cases. Understanding of the possible complications allows for a favourable prognosis.

Aged↗
PubMed1977

Infant survival following uterine rupture and complete abruptio placentae.

This report concerns a case of spontaneous rupture of the uterus through a previous cesarean scar with resulting complete abruptio placentae and extrusion of the fetus inside the intact membranes and the placenta into the peritoneal cavity. That the infant survived this dual insult is worthy of reporting.

Abruptio Placentae↗
PubMed1977

Adenomyosis: a neglected diagnosis.

Adenomyosis was present in 161 of 1619 consecutive hysterectomy specimens. Adenomyosis coexisted with other pelvic pathology in 97 women and was the only histologic finding in 64 women. Most patients were 35 to 50 years of age, parous, white, had not taken steroid hormones, had not had uterine surgery, and complained of abnormal uterine bleeding and/or pelvic pain. Adenomyosis was most associated with leiomyomata, endometrial hyperplasia and carcinoma, and endometriosis. The clinical signs of uterine enlargement and tenderness were rarely observed. The diagnosis was suspected preoperatively in 10% of women. At surgery, adenomyosis was not recognized in 65% of patients. Adenomyosis is a disease of unknown etiology whose uncharacteristic clinical profile and frequent association with more obvious pelvic pathology make it a neglected diagnosis.

Adult↗
PubMed1976

Laparoscopy: is it replacing clinical acumen?

One thousand sixty-one laparoscopic procedures (80% for diagnostic indications and 20% for therapeutic indications) performed during a 51-month period were reviewed to assess the effectiveness of laparoscopy in improving clinical diagnosis and avoiding major surgery. The error in preoperative clinical assessment as compared to postlaparoscopic diagnosis was approximately 50%: disease was suspected more often than found. Pelvic inflammatory disease, endometriosis, and ovarian cyst were the entities most often confused. Tubal coagulation was the most common procedure performed for therapeutic reasons. The complication rate for all laparoscopies and associated procedures was 2.6%.

Adolescent↗
PubMed1975

Artificial insemination with fresh donor semen.

A total of 141 patients received donor insemination during a 21/2-year period. Pregnancy was achieved by 57 per cent of these patients. When patients who were inseminated for less than three cycles are excluded, the pregnancy rate is 77 per cent. The mean conception time was three treatment cycles. In 69 pregnancies, the occurrence of abortion was that of the general population, and an increased male-to-female ratio was observed in the 36 live-born infants. Questionnaires sent to all couples and returned by 81 per cent indicated that donor insemination was not emotionally harmful to their marriage. Heterologous insemination is a safe, effective therapeutic alternative to adoption for selected couples.

Abortion, Spontaneous↗
PubMed1975

Affinity labeling of steroid binding sites. Study of the active site of 20beta-hydroxysteroid dehydrogenase with 2alpha-bromoacetoxyprogesterone and 11alpha-bromacetoxyprogesterone.

To further characterize the active site of 20beta-hydroxysteroid dehydrogenase (EC 1.1.1.53) from Streptomyced hydrogenans we synthesized 2alpha-bromoacetoxyprogesterone, a substrate for the enzyme in 0.05 M phosphate buffer at 25 degrees, pH 7.0, with Km and Vmax values of 1.90 X 10(-5) M and 6.09 nmol/min/mg of enzyme, respectively. This affinity labeling steroid inactivates 20beta-hydroxysteroid dehydrogenase in an irreversible and time-dependent manner which follows pseudo-first order kinetics with a t1/2 value of 4.6 hours. 2alpha-[2-3H]Bromoacetoxyprogesterone was synthesized and used to radiolabel the enzyme active site. Amino acid analysis of the acid hydrolysate of the radiolabeled enzyme supports a mechanism whereby the steroid moiety delivers the alkylating group to the steroid binding site of the enzyme where it reacts with a methionyl residue. Both 2alpha- and 11alpha-bromoacetoxyprogesterone alkylate a methionyl residue at the active site of 20beta-hydroxysteroid dehydrogenase. The enzyme was inactivated with a mixture containing both 2alpha-[2-3H]Bromoacetoxyprogesterone and 11alpha-2[2-14C]bromoacetoxyprogesterone. Following degradation of separate aliquots of the radiolabeled enzyme by cyanogen bromide or trypsin, the protein fragments were separated by gel filtration and ion exchange chromatography. Resolution of peptides carrying the 3H label from those possessing the 14C label demonstrates that 2alpha-bromoacetoxyprogesterone and 11alpha-bromoacetoxyprogesterone each label a different methionine at the steroid binding site of 20beta-hydroxysteroid dehydrogenase.

Affinity Labels↗
PubMed1975

Effect of pentobarbital anaesthesia on luteinizing hormone levels in intact and ovariectomized ewes.

In six intact ewes, deep anaesthesia lasting 1-2 h was induced with pentobarbital given intravenously at the onset of oestrus. In a second group of six ovariectomized ewes, light pentobarbital anaesthesia was induced following a control period of 4 h and then maintained for 2, 3, or 4 h. No drug was given to control animals (seven in the first group, three in the second). Serum levels of luteinizing hormone (LH) were determined by radioimmunoassay hourly in the first group, and at intervals of 5 or 10 min in the second. In the oestrous ewes, pentobarbital did not prevent or modify the expected LH surge. In the ovariectomized ewes, the drug, while not affecting the pulsatile release pattern of LH, reduced average LH levels to about half their control values (P smaller than 0.001) when given in a dosage maintaining 3 or 4 of light sleep; the 2-h dosage had no such effect. These differential effects of pentobarbital indicate that LH secretion in ewes is regulated by more than one mechanism. In particular, our findings are consistent with a hypothesis that there are, in ovariectomized ewes, independent central regulatory mechanisms for the amount of LH released, and for the time pattern of its release.

Anesthesia, General↗