Biomedical subjects

W S Maxson

Publications and source records attributed to W S Maxson.

50 records · Page 3Linked to original sources

PubMed1984

Hyperprolactinemic response after bromocriptine withdrawal in women with prolactin-secreting pituitary tumors.

In patients with prolactin (PRL)-secreting tumors, plasma PRL concentrations after discontinuation of bromocriptine therapy have been used clinically as an index of tumor activity. To investigate the pattern of PRL response under these conditions, seven women on chronic bromocriptine therapy for PRL-producing pituitary tumors were followed with serial PRL determinations for 2 months after bromocriptine withdrawal. In these patients, peak PRL concentrations were achieved 28.1 days (mean; range, 14 to 49 days) after bromocriptine discontinuation. However, PRL concentrations did not usually plateau until at least 40 days after cessation of therapy, and the pattern of PRL response was highly variable. Because of the inconsistent pattern of serum PRL response during the first 40 days after discontinuation of bromocriptine, decisions regarding tumor activity based on PRL concentrations should not be made until at least 6 weeks after withdrawal of the drug.

Adenoma↗

PubMed1984

One ovary or two: differences in ovulation induction, estradiol levels, and follicular development in a program for in vitro fertilization.

The choice of clomiphene citrate (CC) and human menopausal gonadotropin (hMG) protocols for stimulation of ovarian follicular maturation has traditionally not been made with regard to the anatomic status of the pelvis. To evaluate whether hormone production and/or follicular development vary based on the number of ovaries and/or the method of stimulation, 117 cycles were reviewed. Forty-five women received CC, 29 with two ovaries and 16 with one ovary. Seventy-two women received hMG, 50 with two ovaries and 22 with one ovary. Among women receiving CC, those with two ovaries tended to have higher initial estradiol levels and a greater number of large (greater than or equal to 15 mm) follicles. Among women receiving hMG, those with two ovaries tended to have higher estradiol levels, but the number of large follicles (greater than or equal to 15 mm) was similar. With either stimulation protocol, women with two ovaries developed a higher total number of follicles than women with one ovary. The total number of follicles in women with one ovary was similar for hMG and CC stimulations. The number of oocytes recovered at laparoscopy was greater in women with two ovaries who received hMG in comparison with CC, but did not significantly vary between women with one or two ovaries who received CC nor between women with one or two ovaries who received hMG. The number of oocytes was also similar for the women with one ovary regardless of stimulation protocol.

Castration↗

PubMed1984

Hexabrix as a contrast agent for hysterosalpingography.

Hexabrix, a monoacidic dimeric iodinated contrast material, was compared with Renografin 60 (diatrizoate meglumine) for safety, tolerance, and efficacy in hysterosalpingography, in a double blind study of 52 patients. No serious adverse reactions were noted in either group of patients. Discomfort during and after the procedure was not statistically different in the two groups. No difference in radiographic quality was seen. It was concluded that Hexabrix, despite reduced osmolality and increased viscosity, offers no significant benefit over Renografin 60, but it is a safe and acceptable contrast agent for hysterosalpingography.

Contrast Media↗

PubMed1984

Antiestrogenic effect of clomiphene citrate: correlation with serum estradiol concentrations.

The antiestrogenic effect of clomiphene citrate (CC) on cervical mucus was evaluated in women receiving 150 mg CC daily for 5 days. Daily cervical mucus scores and serum estradiol (E2) concentrations were determined in control (n = 25) and CC (n = 24) cycles. E2 concentrations were significantly higher in the CC-treated women (mean +/- standard error of the mean, 1254 +/- 102 pg/ml versus 337 +/- 18 pg/ml, P less than 0.0001). Despite supraphysiologic E2 concentrations, however, cervical mucus scores were significantly reduced in the CC-treated group (P less than 0.01). These data indicate that CC exerts a direct suppressive effect on cervical mucus despite markedly increased E2 concentrations.

Adult↗

PubMed1984

Outcome of progesterone treatment of luteal phase inadequacy.

Diagnosis, choice of therapy, and pregnancy outcome were analyzed in 79 women evaluated for luteal phase inadequacy. Criteria for the diagnosis were established, and groups at risk for luteal inadequacy were identified. Treatment choices, tailored to the suspected cause, included progesterone suppositories in 54 women, with 23 pregnancies and 19 deliveries; clomiphene citrate in 6 women, with 2 pregnancies and deliveries; and combined treatment in 7 women, with 5 pregnancies and 4 deliveries. Eight women received no treatment, including three who underwent endometrial biopsy in the cycle of conception and who subsequently delivered. These data suggest that careful diagnosis and the proper choice of treatment are important, and that progesterone supplementation may result in improved pregnancy outcome for patients with infertility and pregnancy wastage who have luteal phase inadequacy.

Adult↗

PubMed1983

Methoxyflurane hepatitis: two cases following obstetric analgesia.

Methoxyflurane is utilized in obstetrics for analgesia during labor. It has been recognized as an unpredictable hepatotoxin. Although hepatitis has been seen after its use in anesthesia, only one case of hepatitis has been reported after its use for analgesia in labor. Two more cases of hepatitis following methoxyflurane analgesia are reported. Direct toxic effects of its metabolites and host idiosyncrasy may underlie the hepatic injury from methoxyflurane.

Adult↗

PubMed1983

Combined screening laparoscopy and timed follicle aspiration for human in vitro fertilization.

Twenty-seven patients underwent ultrasonographic and clinical monitoring of a spontaneous cycle so that human chorionic gonadotropin administration could be timed in an attempt to schedule the screening laparoscopy at the optimal time for oocyte aspiration. Inadequate ovarian access was encountered in only 2 of 26 laparoscopies. Seven patients had ovulated by the time of scheduled laparoscopy. Nine mature, seven immature, and three postovulatory oocytes were obtained, and seven embryo transfers were accomplished. The number of eggs obtained per laparoscopy was 0.73. The attempt to control the time of ovulation was unpredictable, few mature oocytes were obtained, and the procedure offered little ultimate benefit to the patient.

Adult↗

PubMed1983

The role of laparoscopic adhesiolysis in an in vitro fertilization program.

Adhesiolysis was evaluated in 82 women who had 129 laparoscopies for in vitro fertilization and embryo transfer (IVF-ET). Fifty-five women (67%) had lysis during the first laparoscopic attempt, and 20 of the 129 laparoscopies (16%) required lysis for identification and aspiration of follicles. In 11 women who had a second laparoscopy, 69% of the ovaries had improved access. With the use of laparoscopic lysis, only 3 of 82 women (4%) had insufficient ovarian access, preventing recovery of at least one oocyte. The findings support the efficacy of laparoscopic adhesiolysis and indicate that it has an important role in a program of IVF-ET in assuring initial access for oocyte recovery and in improving access for subsequent attempts.

Adnexal Diseases↗

PubMed1983

A comparison of the CO2 laser and electrocautery on postoperative intraperitoneal adhesion formation in rabbits.

The effect of the CO2 laser and microelectrocautery on postoperative intraperitoneal adhesions was examined in 31 female rabbits. Standard injuries were performed and/or repaired with each technique on the uterine peritoneum, the right uterine horn, and the left ovary. The animals were sacrificed 5 weeks later, and the adhesions were graded at each site. No significant differences were found between the two techniques for each site or all sites collectively (P greater than 0.05). The ovary had more extensive adhesions than the other soft tissue site (P less than 0.01) with both techniques. The present study suggests that there is no apparent difference between CO2 laser and conventional microelectrocautery on adhesion formation, and that the ovary seems particularly prone to adhesion formation with either technique.

Animals↗

PubMed1983

The problem of polyspermy in in vitro fertilization.

Polyspermy is a potential complication of attempts at in vitro fertilization. Nine polyspermic oocytes were identified among 169 oocytes obtained from 67 cycles stimulated by human menopausal gonadotropin. Cleavage to the 2-, 3-, and 4-cell stage was observed. Four polyspermic oocytes were identified among 85 oocytes obtained from 47 cycles stimulated by clomiphene citrate. Cleavage was not observed. Careful dispersion of cumulus cells at 15 to 18 hours and examination of the oocytes for polyspermy is essential, because the condition may not be apparent at 40 hours from insemination, when normal-appearing cleavage stages may be observed.

Adult↗

PubMed1982