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Biomedical subjects

V C Buttram

Publications and source records attributed to V C Buttram.

At least 55 records · Page 3Linked to original sources
PubMed1979

Surgical treatment of endometriosis in the infertile female: a modified approach.

Two groups of infertile women underwent conservative surgery for endometriosis, group I (107 patients) prior to 1970 and group II (138 patients) after 1970. To determine whether modifications to the surgical approach after 1970 further increased the likelihood of conception, postoperative pregnancy rates were examined. The data suggest that postoperative pregnancy rates can be improved by (1) removal rather than "repair" of diseased adnexa if the involvement is unilateral and (2) leaving diseased areas undisturbed where excision or cauterization may predispose to the development of postoperative ovarian and/or tubal adhesions. The current surgical technique (used for group II) is described in detail.

Adnexa Uteri↗
PubMed1977

Circulating prolactin levels. I. Normal females.

A specific, homologous radioimmunoassay was used to quantitate circulating levels of prolactin in females in various stages of life. They were grouped in periods of newborns to peripubertal females, reproductive, gravid and puerperal, and postmenopausal females. The results reveal dynamic changes of prolactin throughout various stages of life and support the mounting evidence that prolactin's role in humans might mimic that of animals. The role of prolactin in the ovarian cycle is unclear and will have to be ascertained at the molecular level.

Adolescent↗
PubMed1977

Uterine synechiae: variations in severity and some conditions which may be conducive to severe adhesions.

Considerable variability in the severity of Asherman's syndrome was observed, and a high incidence of other gynecological disorders was discovered, mainly by endoscopy, in patients with intrauterine synechiae. Fifty-seven cases were reviewed in an attempt (1) to discover factors contributing to severity, (2) to examine possible relationships between other pelvic pathologies and the development of synechiae, and, subsequently, (3) to revise methods of treatment. Thirty-nine women underwent some form of pelvic visualization; twenty-seven (69%) were found to have other gynecological disorders. Forty-six patients had had a recent D & C. Signs of pituitary hypogonadotropism appeared in five of the 17 women with severe adhesions, suggesting that severity of adhesions developed after D & C may be increased in the presence of a concurrently existing hypoestrogenic state.

Abortion, Habitual↗
PubMed1976

Artificial insemination using homologous semen: a review of 158 cases.

One hundred fifty-eight women underwent artificial insemination with homologous semen (AIH) in an attempt to achieve conception. Only 15 (9.5%) were successful. Women with anatomical abnormalities were not excluded from the study and they were less successful than the normal women, but results were disappointing in both groups. The most frequently recorded indication for AIH was decreased density or motility of the husband's sperm, but pregnancy occurred in only 2 of the 48 cases in which sperm count was consistently less than 50 X 10(6)/ml and in only 3 of the 63 cases in which sperm motility was consistently less than 60%. When several semen analyses revealed considerable fluctuation in semen quality, the chances for impregnation by natural means appeared to be greater than the likelihood of success with AIH. The procedure does not seem to compensate for diminished count or motility, does not seem to be of particular value in cases of unexplained infertility, and appears to be indicated only in very special cases, if at all.

Adult↗
PubMed1976

Artificial insemination using donor semen: a review of 171 cases.

This report represents a summary of our experience with 171 unselected cases of artificial insemination by donor (AID) over a 4-year period. It must be stressed that the study was retrospective and subject to many of the problems of analyzing such data. However, the information gained may aid the clinician in his approach to candidates for AID. The most critical points revealed by the survey are as follows: 1. Age, length of infertility, and proven fertility, within certain limitations, appear not to be of prime importance in determining the outcome of AID. 2. Of those patients conceiving, the majority will do so within three cycles of exposure, and 90% will have done so within six cycles of exposure. 3. An adequate trial of AID therapy should last at least 6 months. 4. Although the frequently reported conception rate of up to 70% may be expected in patients with correctable anovulation or with normal reproductive organs, a marked diminution in the success rate should be expected in candidates with disorders such as endometriosis, tubal disease, pelvic adhesions, and uterine abnormalities.

Adult↗
PubMed1975

Post-ovarian wedge resection adhesive disease.

Our purpose was to determine how frequently adhesions develop after wedge resection for polycystic ovarian disease and to investigate the possibility of their contributing to subsequent infertility. Medical records spanning 15 years were compiled on 173 patients who had been followed for at least 1 year after ovarian wedge resection. Ovarian adhesions were found either by endoscopy or laparotomy at varying times after surgery in 59 of 111 patients not lost to follow-up. Forty-three patients who desired conception did not conceive; forty developed postoperative adhesions. Drug therapy for polycystic ovarian disease seems to offer results comparable to those of surgery and eliminates the risk of adhesions.

Female↗
PubMed1975

The use of synthetic luteinizing hormone-releasing hormone in induction of ovulation.

Each of 14 anovulatory patients received a single injection of 150 micrograms of synthetic luteinizing hormone-releasing hormone (LH-RH) in one induced menstrual cycle. In two subsequent cycles, patients were pretreated with clomiphene before LH-RH injection. Four patients received LH-RH after pretreatment with human menopausal gonadotropin (HMG) in another cycle. In each cycle, gonadotropin release and ovulation were recorded. All patients had previously failed to ovulate when treated with large doses of clomiphene. No patient ovulated following injection of LH-RH alone, although five patients exhibited a good pituitary response. Nine patients ovulated when they received LH-RH after pretreatment with clomiphene, and one patient ovulated when pretreated with HMG. The diagnostic value of a single injection of LH-RH is not clear. In the present study, gonadotropin response to LH-RH was not an entirely accurate predictor of a patient's ovulatory response in any of the four cycles. On the other hand, when clomiphene-LH-RH was administered, a good response was associated with ovulation in that cycle. The exact role of LH-RH in inducing ovulation is unclear, but the results of using LH-RH in conjunction with clomiphene are encouraging enough to warrant continued use and further study.

Clomiphene↗
PubMed1975

Total urinary estrogens in complicated pregnancies.

One hundred fifty-seven pregnancies complicated by different degrees of diabetes, toxemia, and hypertension were studied with serial urinary placental estrogen determinations. A simple and fast method for total placental estrogen determination was used. The level of total estrogen excretion was related to Apgar score in cases of class B diabetes, severe toxemia, and also in moderate toxemia when estrogen excretion was falling. Mean estrogen levels did not differ as a function of severity of diabetes. Levels did differ with severity of toxemia; however, only the difference in mean estrogen excretion between mild and severe toxemia was significant. Estrogen excretion was very low in hypertension but was not related to Apgar score. This study concludes that total urinary estrogens constitute only a single parameter necessary in the management of high-risk pregnancies.

Apgar Score↗
PubMed1975

The immature HPO axis.

One cause or anovulation may be an immature hypothalamic-pituitary-ovarian axis. The fact that initial menstrual cycles are usually irregular and often anovulatory implies that a maturation process is taking place in the HPO axis and that cyclic ovulatory menstruation begins only when adequate maturation occurs. Moreover, the external appearance of the ovary of a severely oligomenorrheic or amenorrheic female frequently is similar to that of a prepubertal female--this is, the ovary appears normal in size of slightly smaller, has a smooth, glistening surface without convolutions, and its capsule-like outer surface reveals few, if any, underlying follicles. A reasonable assumption is that there is inadequate gonadotropin stimulation of these ovaries possibly as a result of an immature HPO axis. The studies by radioimmunoassay of FSH and LH levels in prepubertal and pubertal females offer no statistical data by which to measure the maturity of the HPO axis, although consistently low FSH and LH levels may prove meaningful. Studies of FSH and LH in patients exhibiting gonadal dysgenesis neither support or disprove the immature HPO axis theory, but studies of idiopathic sexual precocity tend to support it. Studies using LH-RF in prepubertal and pubertal females indicate a pattern of response which may give useful information in the area.

Adolescent↗