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Biomedical subjects

E E Wilson

Publications and source records attributed to E E Wilson.

15 recordsLinked to original sources

The effect of gonadotropin-releasing hormone agonists on adrenocorticotropin and cortisol secretion in adult premenopausal women.

GnRH agonists are known to suppress LH, FSH, and subsequent ovarian estradiol production by down-regulation of pituitary gonadotropin receptors. Previous investigations have demonstrated that GnRH agonists also suppress GHRH-stimulated GH release in normal men and women and PRL levels in subjects with hyperprolactinemia. Little is known about the effects of GnRH agonists on the hypothalamic-pituitary-adrenal axis. The purpose of the present investigation was to determine the secretion of ACTH and cortisol after an iv infusion of hCRH in control women (n = 11) and in women undergoing treatment with GnRH agonists (n = 10). The plasma and serum levels of ACTH and cortisol increased after infusion of CRH in all women. The basal and CRH-stimulated plasma levels of ACTH and cortisol at each time point were not statistically different between GnRH agonist-treated women and controls. Thus, the chronic use of GnRH agonists is known to suppress the hypothalamic-pituitary-ovarian axis and is associated with GH and PRL suppression as well, but does not apparently alter the hypothalamic-pituitary-adrenal axis.

Adrenocorticotropic Hormone↗

Laparoscopic removal of dysgenetic gonads containing a gonadoblastoma in a patient with Swyer syndrome.

Dysgenetic streak gonads were removed laparoscopically from a phenotypic female with Swyer syndrome (ie, XY karyotype, sexual infantilism, primary amenorrhea, and müllerian structures). Pathologic examination revealed a small (3 mm) gonadoblastoma in one of her gonads without evidence of malignant transformation. The patient tolerated the procedure well and was back at work the next day. We propose that laparoscopy is a safe, cost-effective, and simple procedure to perform on individuals requiring prophylactic gonadectomy for the prevention of neoplasia.

Adolescent↗

Effect of superovulation with human menopausal gonadotropins on growth hormone levels in women.

GH synthesis and secretion are influenced by several factors, including age, body weight, and sex steroid hormones. Endogenous and exogenous estrogens influence the circulating levels of GH. The purpose of the present investigation was to define the relationship between serum GH and estradiol levels during the follicular phase in women with normal ovulatory menstrual cycles compared with that in women undergoing superovulation with human menopausal gonadotropins (hMG) alone or hMG plus GnRH agonists during treatment for infertility. Serum GH and estradiol levels were determined by immunoassay in eight women during the follicular phase of a spontaneous natural cycle (group I). Thirty women underwent ovulation induction with hMG alone (group II), and 30 women received GnRH agonists followed by hMG (group III). During the follicular phase estradiol levels increased gradually in group I and reached a peak estradiol level of 1.19 +/- 0.2 nmol/L (mean +/- SEM). As expected, estradiol levels rose faster and reached higher levels in groups II and III (5.44 +/- 0.62 and 8.73 +/- 0.91 nmol/L, respectively). Whereas serum GH levels increased minimally in group I, reaching a peak level of 2.54 +/- 1.15 nmol/L, serum GH concentrations increased markedly after day 8 in groups II and III, reaching peak levels of 8.70 +/- 1.58 and 7.54 +/- 1.12 nmol/L, respectively (P less than 0.01). Basal to peak GH levels were higher in groups II and III than in group I. In summary, there are modest increases in GH levels during the follicular phase of the normal menstrual cycle, but the levels are markedly increased during superovulation with hMG or hMG plus GnRH agonists, and parallel increases in estradiol levels.

Adult↗

Vulvovaginal sequelae of Stevens-Johnson syndrome and their management.

We describe a woman with Stevens-Johnson syndrome, a life-threatening form of erythema multiforme characterized by bullae formation, extensive mucosal damage, and systemic toxicity, and known to be triggered by various drugs, infections, ingestants, or contactants. Serious complications have been reported in most body systems, including cases of permanent damage to the urogenital tract. Three methods of surgical treatment for severe vaginal complications, depending on the degree of vaginal mucosal damage, are described, including the successful treatment of our patient, who had vaginal adenosis, endometriosis, and severe stenosis from this disease. Methods of therapy are presented for possible prevention of severe vaginal sequelae from Stevens-Johnson syndrome.

Adult↗

Use of ultrasound scan in prostatic I-125 implantation.

The average dimension of prostate was measured by transabdominal ultrasonography preoperatively to compare with direct intraoperative measurements in 28 patients undergoing suprapubic I-125 seed implantation for the treatment of prostatic cancer. A highly significant correlation (r = 0.932) was found between these two measurements. Transabdominal ultrasonography is a relatively simple and accurate non-invasive method of determining the number of I-125 seeds needed to implant the patient with prostatic malignancy.

Adenocarcinoma↗

Pharmacists' role in smoking cessation.

"Time to quit", a program piloted in Winnipeg in 1983, is an example of the importance of the pharmacist in the smoking cessation issue. Through the Manitoba Pharmaceutical Association, pharmacies were utilized as distribution centres for a self-help smoking cessation booklet. In the city of Winnipeg, 82% of city pharmacies received a total of 40,500 books; 93.5% of these booklets were picked up by the public. Pharmacists also had the option to become more involved in the anti-smoking campaign if they so desired. Pharmacists not only have the knowledge to discuss the area of smoking cessation, they arein a strategic position for dissemination of that knowledge.

Canada↗

Use of ultrasonography in planning intracavitary radiotherapy of endometrial carcinoma.

A diagnostic ultrasound examination is a simple and reliable method of obtaining anatomical information for intracavitary irradiation of endometrial carcinoma of the uterus. Scanning before treatment to determine uterine size and shape assists in choosing the most appropriate applicator. Scanning after insertion of an afterloading applicator facilitates calculation of radiation doses at critical points within and on the surface of the uterus. Poor applicator position can also be detected. Diagnostic ultrasound examinations should be adopted as a routine procedure in establishing intracavitary irradiation programs for adenocarcinoma of the uterine fundus.

Female↗