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Biomedical subjects

S L Corson

Publications and source records attributed to S L Corson.

At least 19 recordsLinked to original sources
PubMed1992

Update on a family with hand-foot-genital syndrome: hypospadias and urinary tract abnormalities in two boys from the fourth generation.

We describe a fourth generation of involvement with hand-foot-genital syndrome. The first 3 generations of this family, which included 5 affected females and no affected males, were reported previously by Verp et al. [1983]. In the fourth generation, 2 affected males are identified. To our knowledge, the findings of bilateral vesicoureteral reflux in one boy and bilateral ureteropelvic junction obstruction in his cousin represent the first reports of urinary tract abnormalities in males with this syndrome.

Adult↗
PubMed1992

Characteristics of participants in a gestational carrier program.

Genetic parents and gestational carriers in our gestational carrier program were evaluated by psychodiagnostic interview and by the Minnesota Multiphasic Personality Interview-2 (MMPI-2), a widely used objective psychological test, to identify psychopathology and describe personality characteristics. Overall, participants exhibited no overt psychopathology. Personality differences were found between gestational carriers and genetic mothers and genetic fathers and mothers. Clinical interviews revealed that gestational carriers tended to be the dominant partner in the relationship, were motivated by a wish to help an infertile couple, enjoyed being pregnant, showed narcissistic needs, and expressed a wish for secondary financial gain. The majority of gestational carriers stated that they had considered becoming a traditional surrogate but felt they could not surrender a child that was genetically theirs. These results indicate that there is not any predisposing psychopathology which attracts participants to the gestational carrier program.

Adult↗
PubMed1992

Genetic offspring in patients with vaginal agenesis: specific medical and legal issues.

OBJECTIVE: There are new options for genetic offspring in patients with vaginal agenesis (Mayer-Rokitansky-Küster-Hauser syndrome). The reported world experience to date with genetic offspring of patients with vaginal agenesis consists of five pregnancies (including two reported here and two frozen embryos). The specifics of these cases are presented for discussion. STUDY DESIGN: We present a retrospective description of two women with vaginal agenesis and their matched gestational carriers with positive outcome of two live births. Care was delivered in a private in vitro fertilization and gamete intrafallopian transfer program. RESULTS: In vitro fertilization of oocytes gathered from the genetic mother with vaginal agenesis and sperm from the genetic father were transferred to a gestational carrier. Two live births and one blighted ovum pregnancy resulted. CONCLUSION: Until recently, treatment for patients with vaginal agenesis (Mayer-Rokitansky-Küster-Hauser syndrome) has centered on the creation of a functional vagina. The technology of in vitro fertilization and embryo transfer, allowing for collection of oocytes from the genetic mother, fertilization by the genetic father, and placement into a gestational carrier, enables a woman without a uterus to have her own genetic children. The specific medical and legal issues involved in facilitating genetic offspring in these instances must be considered; these include the initial matching of the genetic parents with the gestational carrier, cycle synchronization for in vitro fertilization and embryo transfer, anatomic difficulties of oocyte retrieval, birth certificate documentation, and the current legal status of a gestational carrier.

Adult↗
PubMed1992

Leuprolide acetate-prepared in vitro fertilization-gamete intrafallopian transfer cycles: efficacy versus controls and cost analysis.

OBJECTIVE: To evaluate the effect of gonadotropin-releasing hormone agonist (GnRH-a) when given through stimulation with gonadotropins versus stopping it as stimulation was initiated versus a control group unprepared in this manner. Also, to construct a cost analysis for this type of therapy in an in vitro fertilization-gamete intrafallopian transfer program (IVF-GIFT). DESIGN: Prospective, consecutive, randomized, with a control group. SETTING: An out-patient IVF-GIFT program. PATIENTS: One hundred new patients entering an IVF-GIFT program. INTERVENTIONS: In vitro fertilization or GIFT cycles with or without preparation (pituitary suppression) by GnRH-a administration in which suppression was continued or halted as gonadotropins were begun. MAIN OUTCOME MEASURES: Cancellation rates, ampules, and days of gonadotropin use, costs, estradiol (E2) level, egg numbers and quality, and pregnancy rates. RESULTS: Stopping GnRH-a (leuprolide acetate) therapy as stimulation was begun did not lessen the suppressive effect in reduction of spontaneous luteinizing hormone surge as seen with continued use of agonist. In contrast, the control group had a 30.3% cancellation rate before ovum retrieval. The E2 and egg data among the groups were similar, but as expected, agonist use led to the need for more and longer duration of gonadotropin stimulation. Pregnancy rates were not different by group. Costs were approximately even by the third initiated cycle.

Adult↗
PubMed1992

Comparative review of third-generation progestins.

Desogestrel, gestodene, and norgestimate represent a new generation of progestins designed for use in oral contraceptives. A high degree of efficacy has been retained in these progestins, and the adverse metabolic impact exhibited by older progestins has been reduced considerably. The clinical profile of each progestin, as it is marketed in Europe in combination with ethinyl estradiol, is reviewed. Direct comparisons are made whenever applicable. The major advantages of these formulations over the older combined oral contraceptives are that they have less effect on lipid metabolism and on carbohydrate metabolism, and they are less androgenic. The clinical implications of these findings are discussed.

Contraceptives, Oral↗
PubMed1992

Insemination data on men with varicoceles.

OBJECTIVE: To determine possible benefits of sperm processing and intrauterine insemination (IUI) for a group of men with a varicocele history who had not achieved a pregnancy by natural coitus (mean duration of infertility 42.2 months). DESIGN: A retrospective study including infertile men with varicoceles who were classified by their semen analyses and sperm penetration assays (SPAs). SETTING: Private practice of infertility. PATIENTS: Seventy-one infertile couples. The husbands had a varicocele history and were grouped into four clinical categories (14 untreated, 5 medical treatment, 34 varicocelectomies, and 18 varicocelectomies plus medical treatment). The wives were studied or treated before IUI. INTERVENTIONS: Varicocelectomies were performed on the males when indicated. Female studies included laparoscopies as indicated intrauterine insemination with Tomcat catheter (Sherwood Medical, St. Louis, MO) was performed in all cases. MAIN OUTCOME MEASURES: Overall pregnancy rates (PRs) and fecundity rates with sperm processing and IUI. RESULTS: Six pregnancies occurred with 66 cycles of sperm processing and IUI among 28 men with normal SPAs (PR 21%, fecundity rate = 0.09). In contrast, there were no pregnancies with 121 cycles among 43 varicocele patients with abnormal SPA results or with low values for all three semen parameters. CONCLUSIONS: Sperm processing and IUI may be beneficial for selected patients with varicoceles who had not achieved a pregnancy by coitus.

Adult↗
PubMed1991

Resectoscopic myomectomy.

OBJECTIVE: To evaluate safety and efficacy of resectoscopic myomectomy for control of menorrhagia, dysmenorrhea, and/or reproductive wastage. DESIGN: Retrospective consecutive patient follow-up. SETTING: Private practice, outpatient, hospital. PATIENTS: All patients (92) having resectoscopic myomectomy between September 1, 1986 and December 31, 1989. INTERVENTIONS: Resectoscopic myomectomy with or without concomitant procedures such as endometrial ablation. MAIN OUTCOME MEASURES: Assessment of dysmenorrhea, menorrhagia, and reproductive outcome after surgery. RESULTS: Elimination of dysmenorrhea in 24 of 28, absence of menorrhagia in 65 of 80, and pregnancy in 10 of 13 with two abortions in a total of 11 gestations. One patient was admitted and treated with one unit of autologous blood and mechanical tamponade with an intrauterine balloon. Three cases of uterine perforation had no sequelae. One patient had mild endometritis responding to outpatient antibiotics. Two cases of leiomyosarcoma were diagnosed histologically and accounted for two of the three hysterectomies noted during follow-up. CONCLUSIONS: Resectoscopic myomectomy is a safe, effective, and relatively simple outpatient surgical procedure.

Adult↗
PubMed1991

Physiology of menopause and update on hormonal replacement therapy.

Menopause is the period during which ovarian function declines. It is a time that may last for years, during which changes in many organ systems occur as a consequence of estrogen deficiency. For some women, estrogen replacement therapy can alleviate some of these changes and prevent others. The physiologic basis, principles of therapy, contraindications, and side effects for this approach are discussed.

Climacteric↗
PubMed1991

Surgical treatment of endometriosis at the time of gamete intrafallopian transfer.

Gamete intrafallopian transfer (GIFT) was performed on 77 women with endometriosis in 92 cycles with or without concomitant laser therapy or electrofulguration of endometriosis. The pregnancy rates were 45% for laser cases, 25% for electrofulguration cases and 36.4% for GIFT only. The pregnancy rate for stage III endometriosis was 53% versus 14% and 47% for stages II and I, respectively. Although there was a trend toward an increased pregnancy yield with active therapy, no statistically significant difference was achieved. The postoperative fecundity in patients not conceiving with GIFT was poor for all the groups.

Adult↗
PubMed1991

Use of the YAG laser in laparoscopic gynecologic procedures.

The YAG laser with the contact sapphire probe has definite advantages over other laser systems. Compared with CO2 lasers, its flexible fiber delivery system can be more easily used. Moreover, the laser can be used within a liquid environment with the production of little or no smoke. The probes allow a contact technique with discrete transfer of energy that can be modulated by the probes chosen and the wattage used. Unlike with the CO2 laser, energy delivery to unintended targets downstream is rarely a problem. As with other lasers, the initial purchase of a YAG laser is expensive. The YAG laser, however, has been used widely in lower generative tract surgery to the cervix and vulva and within the uterus itself for ablation procedures. It is also used with increasing frequency by other subspecialty groups performing urologic procedures, ophthalmologic procedures, and even general surgery. Therefore, its overall cost-effectiveness within an institution is probably excellent.

Animals↗
PubMed1991

Terconazole and miconazole cream for treating vulvovaginal candidiasis. A comparison.

In a double-blind, randomized, multicenter study, 900 patients diagnosed with vulvovaginal candidiasis received either 0.4% (307 patients) or 0.8% (299 patients) terconazole cream or 2.0% miconazole nitrate cream (294 patients). After seven days of treatment the combined microbiologic and clinical cure rates were 87.9% for the 0.4% terconazole group, 83.8% for patients treated with 0.8% terconazole and 81.3% for the 2.0% miconazole nitrate group. The microbiologic and clinical cure rates were similarly high. The 0.4% terconazole formulation consistently provided a greater degree of symptom relief and significantly fewer adverse genital-reproductive reactions as compared with 2.0% miconazole nitrate. All three preparations were well tolerated, with only minor adverse reactions; all three seem to be useful for the treatment of vulvovaginal candidiasis.

Administration, Intravaginal↗