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Biomedical subjects

R V Haning

Publications and source records attributed to R V Haning.

68 records · Page 4Linked to original sources

Renal failure wit XY gonadal dysgenesis: report of the second case.

The second case is reported of renal failure in association with XY gonadal dysgenesis. The random association of these conditions appears unlikely. Recognition of a possible association is important because of potential fatality due to renal failure or gonadoblastoma in unrecognized cases. In groups at risk, follicle-stimulating hormone (FSH) studies are appropriate in cases of renal disease occurring in phenotypic prepubertal females; in women with XY gonadal dysgenesis, BUN and urinalysis should be studied.

Adult↗

A practical approach for the evaluation of women with abnormal polytomography or elevated prolactin levels.

Based upon the experience gained in the evaluation of 60 patients with abnormal polytomography and/or elevated prolactin levels, the following observations can be made: Patients with amenorrhea, amenorrhea and galactorrhea, galactorrhea alone, or anovulatory cycles and infertility may or may not have pituitary tumors. Clinical symptoms do not always correlate with the prolactin level, and patients with normal prolactins may have pituitary tumors. The incidence of empty sella is significant (15.8% in this series). Visual field examination is not a useful screening procedure, but evaluation of thyroid function is important to detect the occasional patient with hypothyroidism (3.5% in this series). The insulin tolerance test is not helpful in detecting the presence of pituitary tumors or in guiding management decisions, and the CT scan contributes little and should be omitted from the evaluation process. A straightforward, economical, and efficient approach to this clinical problem is presented.

Adenoma↗

The value of hysterosalpingography prior to donor artificial insemination.

The value of hysterosalpingography as a tool in the pretreatment evaluation of candidates for donor artificial insemination has been retrospectively evaluated. In 89 consecutive artificial inseminations by donor candidates, hysterosalpingograms were evaluated for genital tract abnormalities. In only four of these studies was there a failure of dye to spill into the peritoneal cavity. The low incidence of significantly abnormal hysterosalpingographic studies, and the failure of these studies to correlate with pregnancy outcome, strongly argues against the use of hysterosalpingography in the preliminary evaluation of the patient considered for donor artificial insemination.

Adult↗

Plasma estradiol window and urinary estriol glucuronide determinations for monitoring menotropin induction of ovulation.

The plasma estradiol response is maximal 8--10 hours following mentropin injection. To obtain closer control, a menotropin protocol using 5 PM--8 PM injections and 8 AM blood sampling with a plasma estradiol window of 1000--2000 pg/ml was evaluated with simultaneous calibration of a urinary estriol glucuronide radioimmunoassay. One hundred twenty-eight paired urine and plasma samples were assayed in 48 cycles. In 26 cycles with paired samples on the day of human chorionic gonadotropin (hCG) injection, there were no cases of severe hyperstimulation, 2 cases of moderate hyperstimulation, and 11 pregnancies (42% of cycles given hCG). A window of between 40 and 100 micrograms/day of urinary estriol glucuronide corresponded to the 1000--2000 pg/ml plasma estradiol window by regression analysis. The pregnancy and hyperstimulation rates were compared with those observed in protocols previously published. Radioimmunoassay of urinary estriol glucuronide is faster and simpler than radioimmunoassay of plasma estradiol.

Abortion, Spontaneous↗

Interrelationships between maternal and cord prolactin, progesterone, estradiol, 13,14-dihydro-15-keto-prostaglandin F2alpha, and cord cortisol at delivery with respect to initiation of parturition.

Estradiol, progesterone, prolactin, and 13,14-dihydro-15-keto prostaglandin F2alpha (PGFM) were measured in both maternal and cord venous blood obtained at the time of delivery in 24 maternal infant pairs evenly divided among six different physiologic groups. Progesterone and prolactin were significantly higher and estradiol was significantly lower in cord than in maternal blood. There were no significant differences between the groups for cortisol, estradiol, or progesterone in maternal or cord blood. A significant increase in prolactin was demonstrated in women receiving oxytocin for induction of labor. Both estradiol and PGFM were highly correlated between maternal and cord blood. PGFM was significantly higher in cesarean section patients in labor than in those not in labor in both the maternal and cord circulations. Among those delivered vaginally, PGFM tended to be higher in those in spontaneous labor than in those with induced labor. PGFM in induced labor was intermediate between spontaneous labor aptients delivered by cesarean section and those delivered vaginally. Duration of labor was negatively correlated with cord estradiol concentration. The physiologic significance of these findings is discussed.

Animals↗

Incomplete testicular feminization with multiple congenital abnormalities.

A female infant presented with absent vagina and uterus, absent left kidney, absent right gonad, growth failure, mental retardation, seizure disorder, and facial, limb, and hand anomalies. The chromosome karyotype was 46, XY in her blood and cultured cells, including cells from the sites of both gonads. Her H-Y antigen was positive. Specific dihydrotestosterone binding was reduced in cells from a labial skin biopsy. The case might be due to a minute deletion of the short arm of the X chromosome, resulting in loss of a gene for androgen receptors and of adjacent chromosomal material responsible for the growth failure and the somatic and neurologic anomalies.

Abnormalities, Multiple↗

A direct radioimmunoassay for estriol-16-glucuronide in urine for monitoring pregnancy and induction of ovulation.

Antibodies to estriol-16alpha-[beta-D-glucuronide] were raised in sheep with the use of keyhold limpet hemocyanin and bovine serum albumin conjugates of estriol-16alpha-[beta-D-glucuronide]. A simple, rapid method is presented for direct radioimmunoassay of estriol-16alpha-[beta-D-glucuronide] in urine with dextran-coated charcoal used for separation of free from bound and deionized water used for dilutions. The method is thrifty in its use of reagents. The assay has been evaluated in the pregnancy range, and the sensitivity has been extended into the range necessary for monitoring induction of ovulation with Pergonal.

Animals↗

A radioimmunoassay for 13, 14-dihydro-15-keto prostaglandin F2alpha with chromatography and internal recovery standard.

Antibodies to the 13, 14-dihydro-15-keto metabolite of prostaglandin F2alpha(PGF2alphaM) were raised in sheep using a bovine thyroglobulin conjugate of PGF2alphaM. Labeled 13, 14-dihydro-15-keto prostaglandin A2(PGA2M), 13, 14-dihydro-15-keto prostaglandin E2 (PGE2M) and PGF2alphaM were prepared from their corresponding high specific activity parent prostaglandins with swine kidney homogenate and purified using reverse phase liquid-liquid partition chromatography. A rapid method of column chromatography for use prior to radioimmunnoassay was developed. Mathematical corrections for the effect of recovery tracer on the logit/log transformation are presented with a new approach to expression of radioimmunoassay cross reactions allowing continuous expression of the variation of these cross reactions with displacement. These mathematical approaches are widely applicable to other radioimmunoassay systems and transformations. The assay was used for measurement in groups of human volunteers: males, females, women at delivery and paired venous umbilical cord bloods. A correlation between venous cord and maternal peripheral PGF2alphaM levels is demonstrated with a gradient from the cord plasma to maternal plasma.

Antibody Formation↗

The effect of angiotensin II and indomethacin on uterine artery blood flow in pregnant monkeys.

In experiments performed in anesthetized monkeys in the third trimester of pregnancy, mean maternal arterial blood pressure was continuously monitored, the uterine artery blood flow was measured with an electromagnetic flow probe, and prostaglandin levels were assayed in the uterine venous effluent. After inhibition of prostaglandin systhesis with indomethacin, the mean arterial blood pressure in response to angiotensin II was greater than the response prior to indomethacin treatment, and an increase in uterine artery blood flow was prevented. These findings are consistent with the suggestion that prostaglandins mediate the uterine artery blood flow response to angiotensin II, as well as modifying the maternal systemic blood pressure response.

Angiotensin II↗

Uterine artery blood flow studies in the pregnant monkey.

Studies were performed in anesthetized monkeys in the third trimester of pregnancy, with continuous monitoring of maternal blood pressure and uterine artery blood flow by electromagnetic flow probe and with measurement of prostaglandin levels in uterine vein samples. Acute elevation of the systemic blood pressure by intravenous infusion of angiotensin II was associated with increased uterine artery blood flow and an increase in the levels of prostaglandin E measured in the uterine vein. An increase in PGE levels was also observed following the discontinuation of the angiotensin II infusion, when blood pressure and uterine artery blood flow returned to baseline levels. Intravenous administration of indomethacin was associated with a slight rise in maternal blood pressure. The changes in uterine artery blood flow following indomethacin treatment were variable, perhaps reflecting the stresses of surgery and anesthesia. In single experiments, intravenous diazoxide produced a profound hypotension, and intravenous furosemide induced a prompt and marked diuresis, associated with a very marked fall in uterine artery blood flow.

Angiotensin II↗

The status of the ethics of in vitro fertilization in 1985.

In many respects in vitro fertilization has been accepted as ethical by the majority of people in the Western world. Controversy now involves the ancillary issues of embryo freezing, embryo adoption, surrogate mothering of in vitro fertilization embryos, donor fathering of in vitro fertilization embryos, and research on embryos. The acceptance of in vitro fertilization as ethical was withheld until in vitro fertilization was demonstrated to be safe and effective under controlled circumstances. A similar approach to the ancillary issues is advocated.

Ethics, Medical↗

Absence of immunoreactive cytokines in supernatants of individual preimplantation human embryos.

PROBLEM: The purpose of this study was to determine if it was possible to use commercially available enzyme-linked immunosorbent assay (ELISA) kits to quantitate specific cytokine production from individual embryos. METHODS: We examined the supernatants of individual two to six cell preimplantation human embryos using commercially available kits for IL-1 alpha, IL-1 beta, IL-6, and LIF. RESULTS: Cytokines were undetectable in all media samples analyzed. CONCLUSION: While it is possible that individual preimplantation embryos may produce cytokines, we believe these concentrations are below the detectable limits of the commercial assays used in this study.

Blastocyst↗