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Biomedical subjects

W N Spellacy

Publications and source records attributed to W N Spellacy.

At least 109 records · Page 6Linked to original sources
PubMed1983

Changes in the LH response to GnRH in the ovine fetus and neonate.

The in vivo responsiveness of the ovine fetal and neonatal pituitary was investigated using acute and chronic preparations. Several studies were performed on six fetuses and six lambs from 112 days' gestation through 5 weeks after birth. Ten micrograms of gonadotropin-releasing hormone (GnRH) was injected intravenously into each fetus and lamb, and serial blood samples were collected from the fetus, ewe and lamb. The luteinizing hormone (LH) content of each sample was determined by species-specific radioimmunoassay. Both the fetus and the neonate showed a response to GnRH. A significant elevation of LH was found in all animals by 15 minutes. There was no response in the ewe when GnRH was injected into its fetus. Great variability in response was noted among various age groups and between animals, with the maximum individual LH response reaching 33.7 ng/ml. The maximum LH response of the neonate during the first week of life was significantly depressed (p < 0.05) as compared to that of the fetus and the older neonate.

Age Factors↗
PubMed1983

Abnormal bleeding.

Dysfunctional uterine bleeding (DUB) is a common cause of abnormal uterine bleeding and its diagnosis depends upon excluding organic lesions of the reproductive tract. The workup of the patient requires a complete medical history, physical examination, studies for ovulation, and genital tissue sampling. Whereas DUB is a physiologic normal phenomenon in the early and late years of the reproductive cycle, it is a pathologic entity at other times and can result from mild emotional or physical diseases in the patient. Management requires periodic progesterone replacement, increased iron intake, and therapy for any disease that is detected. Generally, oral contraceptives are not indicated, and hysterectomy is rarely needed. If infertility is also a complaint, specific ovulation induction therapy may also be needed. Control of the bleeding abnormality is the expected therapeutic response, and failure to achieve this suggests that a specific genital organic lesion has been overlooked.

Adolescent↗
PubMed1983

Intraligamentous pregnancy. A case report.

A patient experienced fetal demise at 33 weeks' gestation. Numerous attempts at induction of labor failed. It was not until a laparotomy was performed that the intraligamentous location of the pregnancy was determined. Although this diagnosis is rarely made preoperatively, repeated failure of induction should raise the suspicion of an abnormal implantation site.

Adnexa Uteri↗
PubMed1983

Jogging during pregnancy: an improved outcome?

Little information is available concerning the effects of jogging during pregnancy on fetal and maternal outcomes. Through the use of a questionnaire, data were obtained on 67 experienced runners who continued to jog during pregnancy. The women had been running for an average of 3.8 years before the pregnancy, and ran an average of 470 miles during the pregnancy. The average number of miles run decreased as the pregnancy progressed (P less than .05). There was no correlation between the number of miles run during the pregnancy, or in the third trimester alone, and either infant birth weight or gestational age. The incidence of maternal and fetal complications was low. Although there are limitations with questionnaire retrospective studies, these data suggest that jogging during pregnancy by healthy women accustomed to such activity is not harmful to the infant.

Adult↗
PubMed1982

Survival of departments of obstetrics and gynecology: ten points for Association of Professors of Gynecology and Obstetrics action in the 1980s.

Major changes have occurred in medicine during the past few years: the number of medical students who graduate per year has recently doubled, the federal government pays a significant portion of health care costs, and the body of scientific information is expanding logarithmically. The changes which will occur during the next 10 to 15 years will be equally dramatic, and in order for our specialty to increase its presence and position in medicine, it needs to begin to consider these changes and take actions to capitalize on them. Four areas of change were singled out and discussed in terms of their significance and possible plans of action to address them. The four include the increased numbers of women in obstetrics and gynecology, the demand for departments to generate more practice income, the reduced support for research, and the large numbers of physicians being trained in obstetrics and gynecology. Ten places for action by academic departments of obstetrics and gynecology were outlined, and these are listed in Table III. Continued review of the past and the present will allow us to be prepared for the future.

Education, Medical, Graduate↗
PubMed1982

Carbohydrate metabolism during treatment with estrogen, progestogen, and low-dose oral contraceptives.

The combination oral contraceptives have generally been shown to have an adverse effect on carbohydrate metabolism with resultant elevations of both blood glucose and insulin in users. Studies of the individual steroid components suggest that the estrogen is not at fault. The 19-norprogestins can produce these carbohydrate changes and seen to act at the insulin receptor level. Norgestrel, ethynodiol diacetate, and norethindrone alter carbohydrate metabolism, but norgestrel produces the most marked changes. Use of oral contraceptives containing less than 50 microgram of estrogen resulted in fewer metabolic changes than were seen with the drugs containing higher doses of estrogen.

Blood Glucose↗
PubMed1982

Carbohydrate metabolism studies in women using Brevicon, a low-estrogen type of oral contraceptive, for one year.

A prospective study of carbohydrate metabolism was done in 12 normal women over 1 year's time while they were using the low-estrogen type of oral contraceptive Brevicon, which contains 0.035 mg of ethinyl estradiol and 0.5 mg of norethindrone. The women had a 3-hour oral glucose tolerance test before starting the drug and then in 12 months, both blood glucose and plasma insulin levels were measured. After 1 year, there was no significant change in weight, blood pressure, or plasma insulin levels. There was a slight decrease in the fasting blood glucose value after 1 year's use (67.5 +/- 1.5 versus 63.2 +/- 1.3 mg/dl). The other glucose values were unchanged. The importance of these data in terms of mechanisms of action of the steroids on metabolism and the safety of oral contraceptive usage is discussed.

Adolescent↗
PubMed1982

The effects of two years of mestranol treatment on carbohydrate metabolism.

Twenty-nine menstrual age women who had a hysterectomy and oophorectomy were treated cyclically with 80 micrograms of mestranol per day for 2 yr. Their carbohydrate metabolism was evaluated prospectively by doing a 3 hr oral glucose tolerance test after a 100 g glucose load and measuring both blood glucose and plasma insulin levels. The tests were performed before drug treatment and after 2 yr of drug use. Those women that had a "normal" predrug test had some carbohydrate metabolism changes at the 2 yr test with significant elevations of the fasting, 1 and 2 hr blood glucose values, and also significant elevations of the 2 and 3 hr plasma insulin values. Those women with a "borderline abnormal" predrug test had no significant change in either parameter of carbohydrate metabolism however a trend toward similar changes was noted.

Adult↗
PubMed1982

Distribution of guaiacol peroxidase in human endometrium and endocervical epithelium during the menstrual cycle.

Guaiacol peroxidase (G-Px) was measured in extracts from five sections along the length of human uterus on different days of the menstrual cycle or after menopause. The lower uterine-endocervical region had a significantly higher G-Px content (expressed as enzyme units per g wet tissue) than the other sections, although in postmenopausal patients the G-Px activity was uniformly low in all sections of the uterine cavity. We observed no significant changes in G-Px levels during the menstrual cycle, except, possibly, a decrease around ovulation, which precluded a positive correlation between plasma estrogen levels and uterine G-Px content; such estrogen dependence of G-Px has been previously shown in the rat. In vitro, G-Px was inhibited by estriol and 17 beta-estradiol, marginally inhibited by estrone, and most notably inhibited by the catecholestrogens tested (2-hydroxy-17 beta-estradiol, 2-hydroxy-estriol, and 2-hydroxy-estrone), which were equipotent inhibitors; LH and FSH, progesterone, or cortisol had no effect on G-Px activity. We hypothesize that catecholestrogens are natural substrates and regulations of G-Px activity in the human uterus.

Contraceptives, Oral↗
PubMed1982

Gonadotropin responses to graded GNRF injections in women with prior twin pregnancies.

Fifteen women with prior twin pregnancies and 20 women with prior singleton pregnancies were investigated in the luteal phase of their menstrual cycles. Measurements were made of their basal LH, FSH, estradiol, progesterone, testosterone and dihydrotestosterone levels as well as their LH and FSH responses to serial graded (0.5 microgram, 5.0 micrograms and 50.0 micrograms) intravenous injections of gonadotropin-releasing factor. The women with prior twin pregnancies were heavier and had a higher parity. Their basal serum progesterone and testosterone levels were not different, but they had lower basal serum estradiol levels and higher basal serum dihydrotestosterone levels. No differences were noted between either the basal or the stimulated gonadotropin (LH and FSH) levels. Thus, no identifiable pituitary trophic factors associated with or causing twinning could be identified in the population studied.

Female↗
PubMed1982

Relaxin in normal and pathogenic pregnancies.

Serum relaxin concentrations were quantitated throughout pregnancy. Relaxin levels were higher in the first than in either succeeding trimester of pregnancy. Relaxin concentrations in third-trimester twin pregnancies were not significantly different from those in singleton pregnancies. Relaxin levels in toxemic pregnancies were similar to those of normal pregnancy. In contrast, relaxin concentrations in pregnancies beyond 43 weeks' gestation and in women with premature labor were significantly lower than levels in normal women in the third trimester of pregnancy.

Female↗