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Biomedical subjects

J H Mattox

Publications and source records attributed to J H Mattox.

At least 19 recordsLinked to original sources
PubMed1996

The application of positron emission tomography to the study of the normal menstrual cycle.

Positron emission tomography (PET) was used to investigate regions of the brain that are selectively affected during different phases of the normal menstrual cycle. A total of 10 healthy 18-29 year old female volunteers had PET measurements of brain glucose metabolism between days 5 and 9 of the follicular phase when plasma concentrations of oestradiol and progesterone were relatively low and between days 5 and 8 of the luteal phase when plasma concentrations of oestradiol and progesterone were relatively high. Automated algorithms were used to align the PET images in each individual, transform them into the coordinates of a brain atlas, control for variations in whole brain measurements and compute t-score maps of phase-related differences in regional glucose metabolism. The mid-follicular phase was associated with significantly higher glucose metabolism in thalamic, prefrontal, temporoparietal and inferior temporal regions. The mid-luteal phase was associated with significantly higher glucose metabolism in superior temporal, anterior temporal, occipital, cerebellar, cingulate and anterior insular regions. While this study should be considered to be exploratory, it provides normative data for future studies and illustrates how PET can be used to help characterize relationships between phases of the female life cycle, temporally related disorders and local functions of the living human brain.

Adolescent↗
PubMed1994

Estradiol and progesterone production by cultured granulosa cells cryopreserved from in vitro fertilization patients.

Gonadotropin-stimulated steroidogenesis was studied in cultured human granulosa-lutein cells obtained from patients undergoing procedures for in vitro fertilization. The impact of cryopreservation on cell function in vitro was studied. Granulosa cells obtained from in vitro fertilization patients were cultured in serum-supplemented medium or cryopreserved at -135 degrees C for 2-22 months. Fresh (unfrozen) cells (10(5) produced estradiol at a rate of 1320 pmol/l (over 72 h) and progesterone at about 2500 nmol/l. Estradiol production by either fresh or cryopreserved granulosa cells in culture was unaffected by physiological concentrations of follicle-stimulating hormone (7 IU/l). Adding testosterone (10(-7) mol/l) to the medium increased estradiol secretion approximately sixfold. In contrast, progesterone production was not affected by follicle-stimulating hormone or testosterone. No significant differences were observed in cultures of cryopreserved granulosa cells compared to cultures of unfrozen cells with respect to estradiol secretion, the effects of follicle-stimulating hormone or testosterone on estradiol secretion, or progesterone production. Progesterone production by fresh and cryopreserved cells was stimulated by human chorionic gonadotropin. These data indicate that cryopreservation offers the potential to facilitate prospective studies utilizing large numbers of human granulosa-lutein cells in culture.

Aromatase↗
PubMed1994

Antepartum diagnosis of noncoiled umbilical cords.

OBJECTIVE: The null hypothesis is that fetuses with noncoiled umbilical cords diagnosed in the antepartum period will have outcomes no different from those with normally coiled cords. STUDY DESIGN: We prospectively gathered data from Jan. 1 through May 18, 1992, from all fetuses undergoing routine ultrasonographic evaluation. The outcomes of fetuses noted to have noncoiled umbilical cords were compared with those of a control group of fetuses with normally coiled cords. The control group consisted of those subjects undergoing ultrasonography during the study period who were ultimately transferred to our perinatal practice for the remainder of the pregnancy (i.e., the highest-risk patients). Two outcome parameters were selected for comparison: fetal anomalies and fetal death. RESULTS: Six hundred eighty-seven consecutive ultrasonographic examinations were performed. Twenty-five subjects (3.7%) had noncoiled umbilical cords identified ultrasonographically (mean gestational age at diagnosis 20.3 +/- 3.5 [SD] weeks). The control group had 197 subjects. The combined incidence of fetal anomalies or death in the noncoiled group (16%) was significantly greater (p < or = 0.05, relative risk 4.6 [95% confidence interval 1.41 to 14.15]) than that of the control group (3.5%). The noncoiled group had two fetal deaths (8%), whereas two deaths (1%) occurred among controls (p < or = 0.05, relative risk 8 [95% confidence interval 1.16 to 50]). Two (8%) fetal anomalies (anencephaly, prune-belly syndrome) occurred in the noncoiled group, whereas the controls (n = 197) had five fetuses (2.5%) with anomalies (not significant). CONCLUSION: The antepartum identification of noncoiled umbilical cords appears to be a risk factor for suboptimal pregnancy outcome.

Case-Control Studies↗
PubMed1990

Assessment of the viability and acrosome status of fresh and frozen-thawed human spermatozoa using single-wavelength fluorescence microscopy.

The purpose of this study was to use fluorescence microscopy to determine the viability and acrosome status of fresh and frozen-thawed human spermatozoa. Sperm cells were stained with the viability stains Hoechst 33258 (H33258) alone, or propidium iodide (PI) alone, and PI in combination with FITC-conjugated Pisum sativum agglutinin (PSA). The PSA stains the acrosome contents of permeabilized acrosome-intact sperm. Viability by fluorescence microscopy was compared to conventional eosin nigrosin staining. The overall viability using H33258 was not significantly different from that using PI. Therefore, PI was used in combination with PSA for simultaneous measurement of viability and acrosome status at the same excitation wavelength (488 nm). By combining PI and PSA, four subgroups of cells could be detected: group I, PI-neg/PSA-neg--viable, physiologic acrosome reacted (AR); group II, PI-neg/PSA-pos--viable, non-AR; group III, PI-pos/PSA-neg--nonviable, non-AR; group IV, PI-pos/PSA-neg--nonviable, degenerative AR. The postthaw sperm exhibited a significantly greater percent of sperm that were acrosome reacted (both viable and degenerative) (groups I and IV) than the fresh semen. We conclude that frozen-thawed sperm may undergo premature break-down of the acrosome prior to interaction with the oocyte, thus explaining the reduced fertility potential of cryopreserved semen.

Acrosome↗
PubMed1990

Pregnancy rates after double versus single insemination with frozen donor semen.

Ninety-nine females (mean age 34 years +/- 1) were seen for therapeutic donor insemination using frozen semen. All patients used over-the-counter urinary ovulation predictor kits, with the insemination scheduled either the day after the positive test (group I; n = 46) or consecutively the day of and the day after the positive test (group II; n = 53). Group I patients underwent a total of 113 cycles of insemination (mean 2.5 cycles/patient). Seven pregnancies were achieved in group I for an overall success of 15.2% and a monthly fecundability of 0.06. Group II patients underwent a total of 100 cycles of therapeutic donor insemination (mean of 1.9 cycles/patient). Twenty-one pregnancies were achieved in this group for an overall success rate of 39.6% and fecundability of 0.21. The estimated cumulative probability of conception (F) for 6 months was 0.32 in group I and 0.78 in group II. These data indicate that the F after therapeutic donor insemination with frozen semen is greater if two consecutive inseminations are performed at midcycle.

Cryopreservation↗
PubMed1987

The evaluation of adult females with testosterone producing neoplasms of the adrenal cortex.

Although uncommon, testosterone producing neoplasms of the ovary and the adrenal cortex occur periodically. Forty-seven instances involving the adrenal gland have been published since 1925; five, including the present patient, have occurred since 1981. Confusion concerning the site of the androgen secretion has been generated in the past because of limited roentgenographic study and the poor predicability of selective suppression or stimulating testing of the adrenal gland and the ovary. Of the 22 patients with testosterone producing neoplasms of the adrenal cortex reported since 1973, 45 per cent underwent needless ovarian surgical treatment prior to the correct diagnosis. By recognizing the significant correlation between a serum testosterone of 200 nanograms per deciliter or greater, a serum dehydroepiandrostenone of greater than 6,600 nanograms per milliliter coupled with a thorough pelvic examination, pelvic ultrasound and a more liberal use of high resolution computerized tomography of the adrenal gland, the correct diagnosis can be made. The patient presented herein illustrates the pitfalls inherent in the management of a patient with this problem.

Adolescent↗
PubMed1987

Persistent ectopic syndrome: a case report and literature review.

A case report is presented of an ampullary ectopic pregnancy which was treated by salpingostomy. Twenty-six days later, the patient underwent repeat operation due to the persistence of trophoblastic tissue within the fallopian tube. A review of the English literature reveals nine cases including our own that have been reported to date. In eight of nine cases, trophoblastic tissue was recovered at the time of the second operation. In the four cases where human chorionic gonadotropin (hCG) titers were available before and after the second procedure, the titers were positive initially and reverted to negative postoperatively. The disappearance curve for human chorionic gonadotropin after excision of an ectopic gestation is discussed. A recommendation is made for a single determination of beta-hCG two weeks after a conservative procedure for an ectopic gestation to screen for persistence of trophoblastic tissue.

Adult↗
PubMed1986

The effect of cauterization of the rabbit ovary on adhesion formation.

A new treatment modality that involves laparoscopic electrocautery of the ovary has been described as an alternative to ovarian wedge resection. The authors investigated the effect of multiple cautery of the rabbit ovary on adhesion formation. Twenty animals were studied after being divided into four groups of five animals each. Group 1 animals underwent a control operation that involved opening and closing of the peritoneum only. All other animals underwent cautery of the right ovary, with the left ovary used as a control. Group 2 animals had no intraperitoneal substance instilled. Group 3 animals had 2.5 ml/kg of sterile normal saline instilled intraperitoneally. Group 4 animals had 2.5 ml/kg of 32% dextran 70 instilled intraperitoneally. Two weeks later, adhesions were evaluated with a macroscopic and a microscopic scoring system. Cautery of the ovaries was associated with the formation of a significant amount of adhesions. The mean macroscopic adhesion score for a cauterized ovary was 2.73 +/- 0.38 and for the control ovary was 0.00 +/- 0.00 (P less than 0.01). According to the microscopic scoring system, the adhesion scores were 1.86 +/- 0.16 and 1.20 +/- 0.28, respectively (P less than 0.05). The 32% dextran 70 group had the lowest mean macroscopic adhesion score, but this was not statistically significant.

Animals↗
PubMed1986

Control of hyperprolactinemia with pergolide.

Ten patients with clinical, laboratory and radiographic evidence compatible with the diagnosis of prolactinoma were treated with two dopamine agonists. One group (N = 6) took bromocriptine and the other group (N = 4) used pergolide, a longer-acting agent. Both medications were found to reduce prolactin levels significantly from baseline, but an oscillatory pattern with significant fluctuation was seen in the mean prolactin levels in the patients taking bromocriptine. Three patients did not achieve euprolactinemia on bromocriptine, 2.5 mg qid, the maximum dose used in this study. All of the study group taking pergolide became euprolactinemic rapidly; no more than a single dose of 100 micrograms/day was required. Tumor reduction was noted in two patients taking bromocriptine and two taking pergolide. The duration of side effects was shorter and compliance was improved on pergolide therapy.

Bromocriptine↗
PubMed1986

Prolactin response to perphenazine. A sensitive and specific test for pituitary tumor in hyperprolactinemic women.

A simple biochemical screening test for prolactin-secreting pituitary tumors is needed because computed tomography is expensive and may be insensitive in the detection of microadenomas. We compared serial prolactin levels following perphenazine stimulation in 20 women with histologically documented tumors to those in 22 normal controls. In addition, seven women who were diagnosed as having functional (nontumor) hyperprolactinemia were tested. All subjects were given perphenazine, 8 mg orally. Baseline and hourly serum prolactins for six hours were compared. A 200% or greater response occurred in all control patients and functional hyperprolactinemic subjects within six hours following medication. Without exception, tumor patients exhibited a markedly blunted or absent response. This markedly diminished response pattern was compatible with the presence of a pituitary adenoma and suggests that the presence of a tumor interferes with normal pituitary secretory responsiveness.

Adenoma↗
PubMed1984

Thymoma in pregnancy.

The natural history of slow, localized progression usually seen with thymomas seems to be transformed by pregnancy into one of rapid growth and distant metastatic spread. Five of the six previously reported cases had died of the malignancy within 6 months postpartum. The one previous long-term survivor died of treatment-induced complications. Two important questions remain unresolved: What is the risk of recurrence in the patient who has no residual disease at the time of conception? Approximately 50 per cent of female patients can anticipate having complete resection of their thymoma, and their recurrence risk is about 2 per cent. Potentially, there are many patients who have conceived and delivered after surgical therapy. Documentation of these case histories is needed for an accurate prediction of the true risk. Two of the cases within the present review fall within this category. The clinical course in these two patients is consistent with the natural history of the disease. One exhibited local recurrence and progression. The other patient died from sepsis, probably related to immunosuppression. Whether there is a cause and effect relationship between pregnancy and their recurrences is unknown. What is the risk to the patient who is first diagnosed while pregnant? The only survivor in this category was presented by Goldman. This patient underwent immediate therapeutic abortion following diagnosis. She had radiation therapy for invasive unresectable disease and subsequently delivered two term pregnancies, but died of postcesarean cardiac arrest. She had no evidence of recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

The value of prolactin dynamics as a predictor of ovulation with bromocriptine in patients with polycystic ovary syndrome.

Six euprolactinemic polycystic ovary syndrome (PCOS) patients were subjected to a 24-hour study with serum sampling every 30 minutes and a perphenazine stimulation test. The serum prolactin (PRL) levels were compared with those of five healthy normoprolactinemic women whose cases were evaluated in a similar fashion. In addition to evaluating the PRL secretory pattern and lactotroph response, the PCOS individuals were given dopamine agonist therapy in a graduated dosage schedule, increasing each month, over a 3-month interval. The PCOS patients exhibited parallel but lower PRL levels than the control subjects during the late evening and early morning hours (P less than 0.0001) and were less responsive to perphenazine at the 6-hour sampling (P less than 0.05). Only one PCOS individual had suggestive evidence of ovulation over the 15 cycles the group was monitored. Therefore, we conclude that euprolactinemic PCOS patients who are nocturnal hyposecretors of PRL and who hyporespond to a perphenazine stimulation test are not likely to ovulate on bromocriptine in the dosages used in this study.

Adult↗