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S J Ory

Publications and source records attributed to S J Ory.

53 records · Page 3Linked to original sources
PubMed1988

Comparison of Dacron-tipped applicator and cytobrush for detection of chlamydial infections.

Endocervical samples were obtained from 435 females for Chlamydia detection by using both a Dacron swab and a cytobrush. Positive results were obtained from 35 swabs and 34 cytobrush specimens. All specimens positive with the cytobrush were detected also with swab samples. The cytobrush and Dacron swab appear to be comparable for the detection of endocervical infections with Chlamydia trachomatis.

Chlamydia Infections↗
PubMed1987

Pelvic endometriosis.

The recent heightened interest in endometriosis has led to remarkable progress in the elucidation of the pathophysiology of this enigmatic disease. Presently, it is not clear why some individuals with endometriosis develop infertility and pelvic pain, whereas others with a similar degree of disease do not. Several tantalizing clues have been extracted from studies of the molecular pathogenesis, immunology, and biochemistry of endometriosis. Investigations are now under way to determine the specific relevance to infertility of macrophage aggregation; prostaglandin and related metabolite production by endometriotic lesions and macrophages; specific factors released by endometriosis that might directly impair ovum pick-up, fertilization, embryo transfer, or implantation; and ovulatory dysfunction including luteal phase deficiency and LUFS. There are probably a host of potential mechanisms of infertility in endometriosis; additional research should enable us to determine their regulatory features and to formulate effective clinical intervention. We now have a broader array of options for the treatment of endometriosis than ever before. However, most of the extant reported clinical experience consists of case reports and limited series of patients without the use of controls, follow-up intervals, and appropriate statistical analysis. The diverse course and presentation of the disease have limited our ability to develop a staging system that provides consistent scoring among different clinicians and appropriate relative emphasis on the various manifestations of the disease. Some additional resolution will be necessary to assess the relative contribution to infertility by fresh and recurrent lesions, endometriomas, and adhesions. These problems are now in sharp focus, and data should be available in the future giving us an accurate appraisal of the clinical effectiveness of danazol, gestrinone, GnRH analogues, conservative surgery, laparoscopic surgery including use of the laser, IVF-ET, and GIFT. Also, it is anticipated that potentially fertile patients with endometriosis might be identified so that they could avoid therapy altogether.

Endometriosis↗
PubMed1986

Conservative treatment of ectopic pregnancy with methotrexate.

Six subjects with distal ampullary ectopic pregnancies were treated with four doses of intravenous methotrexate (1.0 mg/kg) followed by four doses of leucovorin (0.1 mg/kg, intramuscularly). The diagnosis was established in all cases by laparoscopy following sonography and radioimmunoassay for serum beta subunit of human chorionic gonadotropin. Subjects were followed with daily quantitative serum beta-human chorionic gonadotropin radioimmunoassay and sonography. Five of the six subjects experienced resolution of their ectopic pregnancy without additional surgical treatment. One subject underwent salpingectomy following treatment. Morbidity also included three patients with mild stomatitis or gastritis, and two patients had transient elevations of serum transaminase levels. Two patients had protracted courses and received blood transfusions. The most abrupt response and most uncomplicated courses were experienced in the three subjects with initial human chorionic gonadotropin levels below 1000 mIU/ml. This preliminary experience suggests that methotrexate may be an effective alternative for the treatment of early ectopic pregnancy.

Adolescent↗
PubMed1986

Methotrexate inhibition of normal trophoblasts in vitro.

Methotrexate is a folic acid inhibitor useful in the treatment of gestational trophoblastic disease. Its effect on normal trophoblast in vitro was studied to help establish a minimum effective dose in vivo for the conservative treatment of ectopic pregnancy. In vitro inhibition of normal trophoblastic cell growth was measured after 48 hours of exposure to variable concentrations of methotrexate (10(-2) to 10(-9) mol/L) and rescue with leucovorin. A modification of Cotte's method of trophoblastic cell enrichment was used. Long-term (10 days) linear growth inhibition was observed at concentrations greater than 10(-5) mol/L. Leucovorin control cultures showed no inhibition of cell growth. The study demonstrates that methotrexate is effective in inhibiting normal trophoblastic cell culture growth in vitro at concentrations 1000 times those reported necessary to inhibit deoxyribonucleic acid synthesis in choriocarcinoma cell cultures.

Cell Division↗
PubMed1986

Endometrial adenocarcinoma associated with drug-induced hyperprolactinemia.

A 54-year-old woman with hyperprolactinemia and amenorrhea that occurred with phenothiazine and tricyclic antidepressant use developed a stage IBG2 endometrial adenocarcinoma. This is believed to be the first case reported of endometrial carcinoma associated with drug-induced hyperprolactinemia.

Adenocarcinoma↗
PubMed1985

Ovulation induction with pulsatile gonadotropin-releasing hormone administration in patients with polycystic ovarian syndrome.

Gonadotropin-releasing hormone (0.025 microgram/kg) was administered intravenously in a pulsatile fashion to four subjects with polycystic ovary syndrome for a total of six cycles. Five of the six cycles culminated in ovulation, although in one course the response occurred too early to be attributed to the therapy alone. No pregnancies resulted. All luteal phases were of normal duration, but progesterone production as manifested by serum progesterone determination was deficient in some. If additional investigation confirms these preliminary findings, this form of therapy may offer a safe and economic alternative for anovulatory patients refractory to clomiphene citrate therapy. The response of the four subjects suggests that pulsatile gonadotropin-releasing hormone administration may override hypothalamic-pituitary dysfunction and result in ovulatory menstrual cycles.

Adult↗
PubMed1983

The outcome of pregnancy in patients with treated and untreated prolactin-secreting pituitary tumors.

Few data document pregnancy risks in patients with prolactin-secreting pituitary tumors, particularly risks relating to the likelihood and severity of increased tumor size. This study presents three groups of women with such lesions. Group 1 consisted of 47 women with transsphenoidal resection who were euprolactinemic postoperatively. Of this group 20 of 22 previously infertile women conceived 25 pregnancies. Group 2 was composed of 17 women who were operated upon but in whom prolactin was still raised (greater than 50 ng/ml) postoperatively and bromocriptine was subsequently used. Seven of these 17 patients were previously infertile, and six of the seven have conceived. In group 3 22 infertile women with small pituitary tumors were not operated upon but received bromocriptine. Eighteen of these patients have achieved 24 pregnancies. Methods of diagnosis, surveillance during pregnancy, and medical and surgical management are presented. Only two patients, both in group 3, developed signs of expanding tumor size in pregnancy.

Female↗
PubMed1983

The effect of a biodegradable contraceptive capsule (Capronor) containing levonorgestrel on gonadotropin, estrogen, and progesterone levels.

Eight ovulatory women participated in the preliminary evaluation of a new method of contraception. The technique consisted of subdermal implantation of a biodegradable capsule capable of controlled release of levonorgestrel. The study spanned five menstrual cycles: three observation cycles to confirm ovulation, a cycle with the capsule implanted, and a follow-up observation cycle after its removal. All subjects who were sexually active relied on barrier contraception during the study. Basal body temperature determinations were made throughout all five cycles, and the last three cycles included serum assays of luteinizing hormone, follicle-stimulating hormone, estradiol, progesterone, and levonorgestrel on days 5, 8 to 18, and 22. All subjects except one experienced suppression of ovulation while the capsule was in place. No serious adverse effects were encountered. These results would seem to justify a larger clinical trial to assess the actual efficacy of this contraceptive method.

Biodegradation, Environmental↗
PubMed1981

Estrogen secretion in a renal allograft population.

Four pregnancies after renal transplantation, during which estrogen metabolism was monitored, were reviewed. Urinary estrogen levels were obtained in all four pregnancies, and all values were low. This phenomenon has been ascribed to suppression via the fetal pituitary of the fetal adrenal glands by exogenously administered corticosteroids. However, definitive data substantiating this theory are lacking. Serum or amniotic fluid estrogen levels were measured concomitantly, and in each instance the levels were below normal for the period of gestation. This finding suggests that the mechanism producing low levels of urinary estrogens is related to the suppressed synthesis of estrogen rather than to altered renal excretion of estrogen.

Amniotic Fluid↗
PubMedDate not supplied

Prolonged inhibition of presynaptic catecholamine synthesis with alpha-methyl-para-tyrosine attenuates the circadian rhythm of human TSH secretion.

OBJECTIVE: Originating from the pituitary gland, TSH secretion is regulated predominantly by thyroid-releasing hormone (TRH) neurons located in the hypothalamus. Norepinephrine and dopamine have important effects in modulation of TSH secretion. An inhibitor of catecholamine synthesis, alpha-methyl-para-tyrosine (AMPT) has been used in several studies of the regulation of human TSH secretion. The short-term effects (<8 hours) of low doses of AMPT include stimulation of pituitary TSH secretion by selective lowering of brain dopamine levels. After prolonged administration of AMPT (>24 hours), theoretically both dopamine and norepinephrine levels are lowered significantly in the brain, although this has not been reported previously. METHODS: Nine subjects (five women and four men) received a total of five 1-g doses of AMPT or five 50-mg doses of promethazine (active placebo) over 28 hours in a randomized, double-blind, placebo-controlled crossover design in which the active and control tests were separated by 4-6 weeks. Blood samples were obtained over 24 hours (18 time points) on day 2 of each condition. RESULTS: Changes in prolactin secretion and 6-hydroxymelatonin sulfate excretion indirectly showed the effects of AMPT on dopamine and norepinephrine. The typical circadian rhythm of TSH secretion was blunted by AMPT throughout the night; at ten time points, the difference between the two groups was statistically significant (P <.01). The long-term effects of repeated doses of AMPT were inhibition of TSH secretion and significant attenuation of the circadian rhythm of TSH. Additionally, AMPT induced low norepinephrine levels, which counteracted the stimulatory effect of low dopamine levels on TSH. CONCLUSION: Through its inhibitory effect on TRH, norepinephrine appeared to be involved in the regulation of TSH.

Adult↗
PubMedDate not supplied

New options for diagnosis and treatment of ectopic pregnancy.

The incidence of ectopic pregnancy has increased 4.5-fold in the United States since 1970. Several risk factors have contributed to this rate of increase, but the primary underlying cause remains undefined. Significant advances in the diagnosis of ectopic pregnancy have occurred during this same interval as a consequence of an enhanced understanding of the natural course of the disease. Characteristic changes in human chorionic gonadotropin levels, ultrasound findings, and more frequent use of laparoscopy have contributed to earlier, more consistent diagnosis. Advances in treatment, including tubal-conserving operations, laparoscopic approaches, and medical treatment with methotrexate, have all proved to be safe and effective. The remaining principal challenge is to improve future fertility, which is often adversely affected by recurrence of an ectopic pregnancy.

Chorionic Gonadotropin↗