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Biomedical subjects

E E Jones

Publications and source records attributed to E E Jones.

At least 19 recordsLinked to original sources
PubMed1992

Baseline ovarian cysts do not affect clinical response to controlled ovarian hyperstimulation for in vitro fertilization.

OBJECTIVE: To evaluate the effect of baseline ovarian cysts at the onset of controlled ovarian hyperstimulation for in vitro fertilization (IVF) on cycle outcome. DESIGN, PATIENTS: A review of 82 IVF cycles in 29 women in which each patient served as her own control. The stimulation regimen for each patient remained constant over time. Each woman had at least one cycle in which an ovarian cyst measuring 14 to 53 mm was present at baseline and one cycle in which no such cyst was present. SETTING: The In Vitro Fertilization Program at Yale University School of Medicine. RESULTS: There was no statistically significant difference in cycle cancellation rates, baseline serum estradiol (E2), peak serum E2, number of follicles present at retrieval, number of oocytes retrieved, or fertilization rate between groups. Stimulation regimen, cyst size, and age were unrelated to outcome. The number of cysts present at baseline correlated positively with the number of follicles present at retrieval. CONCLUSION: Baseline ovarian cysts in the setting of a low baseline E2 level do not affect the clinical response to controlled ovarian hyperstimulation in IVF cycles.

Adult↗
PubMed1992

Flow cytometric analysis of deoxyribonucleic acid in human granulosa cells as a function of chronological age and ovulation induction regimen.

We examined whether the proliferative index of granulosa cells as determined by flow cytometry varied with a women's age or ovulation induction regimen that included leuprolide acetate (LA). This prospective cohort study included three groups of patients undergoing assisted reproductive technologies. Group I consisted of 9 women age less than or equal to 30 yr, who received LA plus human menopausal gonadotropin (hMG). Group II included 9 women age more than or equal to 40 yr, who received LA plus hMG. Group III consisted of 6 women age less than or equal to 30 yr who received hMG alone. A total of 79 preovulatory follicles containing greater than 10(4) granulosa cells were obtained from these 24 women and examined by flow cytometry. Group I was compared to group II to match for ovulation induction regimen and to examine proliferative index as a function of age. Group I was compared to group III to match for age and to examine proliferative index as a function of ovulation induction regimen. Outcome measures included proliferative index of granulosa cells as a function of age, ovulation induction regimen, ampules of hMG, estradiol on day of hCG, and serum FSH. Group I demonstrated a greater proliferative index than group II: 23.4% +/- 1.4 vs. 18.4% +/- 0.96 (P less than 0.01). Group I had a greater proliferative index than group III: 23.4% +/- 1.4 vs. 11.9 +/- 0.61 (P less than 0.001). Although both age and the presence of LA appeared to affect the PI, multiple linear regression demonstrated that only the addition of LA and not age, per se, had an independent effect upon granulosa cells undergoing proliferation (P less than 0.0005). We conclude that LA followed by hMG leads to an increase in the percentage of granulosa cells undergoing proliferation when compared to ovulation induction regimens that include hMG alone. Chronological age does not appear to have a significant independent influence upon the proliferative index.

Adult↗
PubMed1992

Nafarelin versus leuprolide in ovulation induction for in vitro fertilization: a randomized clinical trial.

Gonadotropin-releasing hormone agonists vary in structure and route of administration. We performed this study to compare patient response to intranasal nafarelin acetate versus subcutaneous leuprolide acetate as adjuncts to ovulation induction for in vitro fertilization (IVF). Forty-two patients entering their first cycle of IVF were randomized to receive either nafarelin acetate or leuprolide acetate. Patient characteristics in the two groups did not differ significantly, nor did cycle cancellation rates or outcome. There was no significant difference in patient response as indicated by follicular phase serum levels of estradiol (E2), FSH, or LH, luteal phase E2, and progesterone. Luteal phase progesterone-dependent endometrial protein was significantly lower in those taking nafarelin acetate, though it remained in the normal range. However, those receiving nafarelin acetate required significantly less human menopausal gonadotropin (hMG) and had significantly more embryos frozen for later transfer than those receiving leuprolide acetate. Intranasal nafarelin acetate can be used successfully in ovulation induction regimens that include GnRH agonists. The use of nafarelin acetate may decrease a patient's hMG requirement and increase the number of frozen embryos available for later transfer as compared with leuprolide acetate. Further studies are needed to optimize the dosing regimen.

Administration, Intranasal↗
PubMed1991

Carnitine status and lipid utilization in neonatal piglets fed diets low in carnitine.

Forty-eight newborn piglets were assigned to dietary regimens to examine carnitine status and lipid utilization by piglets nursing sows (Diet 1), fed a high-carnitine (1507 mumol carnitine/kg dry matter) casein-whey formula (Diet 2) or fed a low-carnitine (35 mumol carnitine/kg dry matter) egg white protein formula (Diet 3). Four piglets were killed at birth, and four per dietary group were killed at 3, 7, 14 and 21 d of age. Piglets fed Diet 3 had lower (P less than 0.01) carnitine in plasma and liver by d 7 and carnitine remained lower to d 21. Heart carnitine tended to be lower in piglets fed Diet 3, but the differences were not significant. Longissimus muscle carnitine was not affected. In vitro palmitate oxidation was lower (P less than 0.05) on d 7 in the liver from piglets fed Diet 3 but not on d 3, 14 and 21. Low dietary carnitine did not affect in vitro liver beta-hydroxybutyrate production or oxidation of palmitate by longissimus muscle. Plasma glucose and nonesterified fatty acids were higher (P less than 0.05) in piglets nursing sows than those fed Diets 2 or 3. Piglets receiving Diet 3 had reduced carnitine in plasma and certain tissues, and liver lipid oxidation was depressed on d 7 of age, compared with those receiving the other two diets. Feeding the low carnitine diet did not alter glucose status or plasma lipids and ketones.

Animal Nutritional Physiological Phenomena↗
PubMed1991

Reproductive function in epilepsy.

The hypothalamic-pituitary-gonadal axis is a complex system within which both positive and negative feedback occur among its elements and higher brain systems. The occurrence of seizures and changes in the secretion of pituitary hormones can affect the feedback loop. Both seizures and antiepileptic drugs can affect the hypothalamic-pituitary-gonadal axis of males and females and cause changes in hormones and sexuality. Reproductive dysfunction has a social impact because of reduced fertility. Once conception occurs, live birth rates are not diminished. Prospective studies of men and women with epilepsy are needed.

Anticonvulsants↗
PubMed1991

Effect of insulin-like growth factor-I on protein synthesis in porcine embryonic discs cultured in vitro.

Porcine embryos at Day 13 (Day 0 = first day of oestrus) were collected surgically and embryonic discs were isolated microsurgically. The discs were washed and cultured in Dulbecco's modified Eagle's medium without serum, with either 14C-leucine alone or 14C-leucine plus insulin-like growth factor-I (IGF-I) (100 ng/ml) at 37 degrees C for 48 h in 5% CO2 in air. After incubation, discs were morphologically evaluated, frozen in liquid nitrogen and stored at -70 degrees C. No statistical differences in morphology were observed between embryonic discs cultured in medium with IGF-I and those cultured in medium alone (control). Although more radioactivity was incorporated by embryonic discs in the presence of IGF-I than by those cultured in medium without the growth factor, the difference between the two groups was not significant. From two-dimensional gel electrophoresis, it was observed that IGF-I selectively stimulated the synthesis of four new proteins with Mr of 24,000, 70,000, 77,000 and 95,000, respectively and pI between 5.5 and 6.5. At least 90% of the other proteins in the gels was synthesized in greater amount by embryonic discs cultured in the presence of IGF-I than in the controls. These results show that IGF-I can stimulate protein synthesis in pig embryonic discs cultured in vitro and suggest that this growth factor may play an important role in regulating early development.

Animals↗
PubMed1991

Ectopic pregnancy: common and some uncommon misdiagnoses.

Several diseases of the peritoneal cavity may present in manners that are difficult to distinguish from ectopic pregnancy. A careful history and a thorough physical examination are paramount to making the correct diagnosis. Diseases of the gastrointestinal and urinary tracts usually present in specific manner. The difficulty arises when the clinical presentations of these disease processes are atypical. Under such circumstances, other diagnostic modalities, including serial beta-hCG testing and pelvic ultrasound, are extremely useful in distinguishing ectopic pregnancy from other diseases that occur in the abdominal peritoneal cavity. Generous use of the laparoscope facilitates diagnostic exclusion of certain entities, decreases the frequency of misdiagnosis, prevents unnecessary surgical procedures, and reduces morbidity and mortality.

Abortion, Spontaneous↗
PubMed1990

Estrogen effects on the tuberoinfundibular dopaminergic system in the female rat brain.

Estrogen effects on tyrosine hydroxylase (TH), monoamine oxidase types A and B (MAO), and dopamine (DA) in microdissected regions of the hypothalamus, preoptic area and substantia nigra (SNR) of the female rat brain were investigated. Ovariectomized (OVX) young adult female rats were implanted with single silastic capsules containing 100% estradiol valerate (EV). Control rats received empty silastic capsules. Two weeks following capsule insertion, EV decreased TH activity and DA concentration in the arcuate nucleus (AN) while no significant changes in TH activity or DA concentration were observed in the SNR, ventromedial nucleus (VMN), suprachiasmatic nucleus, paraventricular nucleus, medial preoptic nucleus, or the periventricular preoptic nucleus. Although estrogen suppressed TH and DA in the AN, 2 weeks following removal of the estrogen containing capsules, TH activity and DA concentration were restored to control (OVX) levels. Suppression of MAO activity occurred in both the AN and the VMN of rats implanted with EV capsules and returned to OVX levels following the removal of the estradiol load. These results revealed that estrogen effects on TH and MAO activities and DA concentration in the midbrain are region specific and reversible; and that among the dopaminergic systems studied, estrogen effects on TH and DA are confined to the tuberoinfundibular dopaminergic system (TIDAS). Furthermore, these results support our hypothesis that estrogen is a key regulator of DA function in the TIDAS via effects on TH. The importance of these findings to the control of gonadotropin secretion and reproductive cyclicity is discussed.

Animals↗
PubMed1990

Secondary hypogonadism in hemochromatosis.

Hemochromatosis is a rare disorder of iron storage. This report illustrates a case of hypogonadotropic-hypogonadism in a female with biopsy-proven hemochromatosis. Dynamic pituitary and gonadal testing revealed subnormal gonadotropin responses to gonadotropin-releasing hormone (GnRH) but normal ovarian reserve, as shown by normal follicular stimulation with hMG. Thus, abnormalities of ovulation and menstruation in patients with hemochromatosis are most likely because of inadequate pituitary responsiveness to GnRH.

Adult↗
PubMed1990

The psychoanalytic case study: toward a method for systematic inquiry.

This study represents a contribution toward the systematic and empirical investigation of psychoanalytic treatments. The method used, the Q-technique, allows the transformation of clinical data into a form amenable to quantitative analysis, thereby providing an empirical means to test theoretically and clinically derived understandings of psychoanalytic process. The treatment hours of a six-year analysis were audio-recorded and transcribed, and blocks of ten sessions were selected at regular intervals throughout the course of the analysis. Transcripts of these hours were then rated in random fashion by clinical judges with a Q-set designed to provide a standard language for the description and classification of analytic process. These descriptions of analytic hours, as structured by the Q-set, proved highly reliable, demonstrating the method's promise for addressing the long-standing problem of achieving reliable clinical judgments. Results suggest that subjecting the traditional psychoanalytic case study to systematic inquiry can contribute to establishing an empirical science base for some psychoanalytic propositions.

Humans↗
PubMed1990

Persistent ectopic pregnancy following laparoscopic linear salpingostomy.

As the surgical approach for ectopic pregnancies evolves from radical to conservative procedures, the potential hazard of persistent ectopic pregnancy has become increasingly pertinent. From September 1, 1986 to August 31, 1989, 11 women with persistent ectopic pregnancy after laparoscopic salpingostomy were diagnosed and treated at Yale-New Haven Hospital. Persistent ectopic pregnancy was suspected in nine cases because of symptoms and in two because of plateauing beta-hCG titers. Ten of 11 patients underwent repeat surgery. Eight had partial or complete salpingectomy of the involved ipsilateral tube, two had repeat salpingostomies, and one was treated with methotrexate. When the 11 women with persistent ectopic pregnancies were compared with 70 patients treated successfully by laparoscopic salpingostomy using multivariate stepwise logistic regression, smaller size of the ectopic (P less than .01) and fewer days of amenorrhea (P less than .05) predicted persistent ectopic pregnancy after laparoscopic salpingostomy. Based upon our experience, we believe that earlier-treated ectopic pregnancies (ie, fewer than 42 days of amenorrhea) and/or smaller ectopics (ie, 2.0 cm or less in diameter) require treatment with particular caution and close postoperative surveillance.

Chorionic Gonadotropin↗
PubMed1989

Hyperprolactinemia and female infertility.

Hyperprolactinemia is a common endocrine cause of infertility in women. The pathophysiology of hyperprolactinemia in infertility is understood incompletely; however, the adverse effects of high circulating levels of prolactin on the hypothalamic-pituitary-ovarian axis cause chronic anovulation and other defects of ovarian function. Mechanisms for prolactin-induced anovulation have been postulated, and there are several contemporary approaches to the diagnosis and treatment of prolactin-secreting pituitary adenomas.

Amenorrhea↗
PubMed1988

Basis of the stereospecific preference of porcine kidney fibroblasts for D-2-hydroxy-4-methylthiobutanoic acid as a source of methionine.

In previous studies we have found that porcine kidney fibroblasts will grow in medium containing D-2-hydroxy-4-methylthiobutanoic acid (D-methionine hydroxy analogue, D-MHA) as the sole source of methionine but not in medium containing the L-isomer (L-MHA) alone. The fibroblasts have been found to have both D-2-hydroxy acid dehydrogenase (EC 1.1.99.6), which uses D-MHA as substrate (Km = 6.0 mM) and L-2-hydroxy acid oxidase (EC 1.1.3.1), which uses L-MHA as substrate (Km = 7.1 mM). These two activities should make it possible for the fibroblasts to grow on either isomer. Only one protein band with L-2-hydroxy acid oxidase activity can be detected with enzyme-specific staining of protein profiles obtained after polyacrylamide gel electrophoresis. The enzyme L-2-hydroxy acid oxidase from porcine kidney has properties that are different from the two porcine isozymes reported previously by others. Passage of DL-[14C]MHA at tracer levels into the porcine kidney fibroblasts in culture is reduced to 31% of control in the presence of 3.75 mM D-MHA, 86% of control with 3.75 mM L-MHA and 65% with 3.75 mM D-lactate but is not affected by up to 3.75 mM L-lactate. It appears that the transport specificity is the basis for the growth promotion of kidney fibroblasts by the D-isomer of MHA as opposed to L-MHA when each is used as the sole source of methionine.

Alcohol Oxidoreductases↗
PubMed1988

Chlorpromazine plasma level monitoring of schizophrenic patients.

In general, plasma level monitoring and pharmacokinetics are widely studied and have been successfully applied in the field of epileptic therapy. Before similar monitoring can be used with psychiatric drugs the possible problems of obtaining samples from the type of patient who receives this therapy should be considered. Patients who receive chlorpromazine sometimes show plasma levels lower than the recommended range, even though their symptoms are considered controlled. Correct interpretation of plasma level results depends on an understanding of the factors responsible for these low plasma levels.

Chlorpromazine↗