PubMed Health⌕ Search

Biomedical subjects

J V van der Merwe

Publications and source records attributed to J V van der Merwe.

29 records · Page 2Linked to original sources
PubMed1983

The outcome of pregnancy in patients with treated and untreated prolactin-secreting pituitary tumors.

Few data document pregnancy risks in patients with prolactin-secreting pituitary tumors, particularly risks relating to the likelihood and severity of increased tumor size. This study presents three groups of women with such lesions. Group 1 consisted of 47 women with transsphenoidal resection who were euprolactinemic postoperatively. Of this group 20 of 22 previously infertile women conceived 25 pregnancies. Group 2 was composed of 17 women who were operated upon but in whom prolactin was still raised (greater than 50 ng/ml) postoperatively and bromocriptine was subsequently used. Seven of these 17 patients were previously infertile, and six of the seven have conceived. In group 3 22 infertile women with small pituitary tumors were not operated upon but received bromocriptine. Eighteen of these patients have achieved 24 pregnancies. Methods of diagnosis, surveillance during pregnancy, and medical and surgical management are presented. Only two patients, both in group 3, developed signs of expanding tumor size in pregnancy.

Female↗
PubMed1981

The effect of clomiphene and conjugated oestrogens on cervical mucus.

The analysis of 157 menstrual in 50 patients on ovulation-inducing regimens showed that in restoring ovulation clomiphene citrate inhibited cervical mucus production and caused hypersecretion of oestradiol. The inhibitory effect was inversely proportional to serum oestradiol levels, and the addition of conjugated oestrogens did not rectify the inhibitory effect, increase plasma oestradiol levels or increase cycle length. Doubling the clomiphene dosage made no significant difference to any of the parameters examined. The mechanism of this inhibitory effect is still obscure.

Cervix Mucus↗
PubMed1981

[The polycystic ovarian syndrome].

The polycystic ovarian syndrome remains one of the enigmas of gynaecological endocrinology. A review of the literature is presented, with emphasis on practical aspects, as illustrated by the results of a study of 139 patients with this condition. In the majority of patients the diagnosis entails clinical judgement combined with minimal biochemical determinations. However, the differential diagnosis may depend on sophisticated investigations. Since the treatment of some of these patients is as yet unsatisfactory, early diagnosis with prevention of androgenic side-effects is desirable.

Diagnosis, Differential↗
PubMed1981

[Contemporary physiology of the menstrual cycle. Part II. The reproductive hormones, regulatory mechanisms and cyclical hormonal changes].

Knowledge of the biochemistry of the hormones that regulate the normal menstrual cycle provides the clinician with a tool that allows physiological management of the patient. The biochemistry of the gonadotrophins and their roles in the physiology of the normal menstrual cycle are briefly reviewed. The present state of knowledge of the regulatory mechanisms is discussed and the hormonal events during the normal menstrual cycle in 50 patients are presented.

Female↗
PubMed1981

[A diagnostic oriented approach to amenorrhea].

A practical approach to the diagnosis of amenorrhea is presented. By utilizing a flow-chart 410 patients with amenorrhea were categorized in the following groups: (i) polycystic ovarian disease; (ii) hypergonadotrophic amenorrhoea; (iii) hyperprolactinaemic amenorrhoea; (iv) normogonadotrophic amenorrhoea; and (v) hypergonadotrophic amenorrhoea. This approach helps the practising physician to come to a logical aetiological diagnosis in each category and saves time as well as money. This approach depends on clinical as well as appropriate laboratory examinations, most of which can be done by the private practitioner. Only a minority of patients need sophisticated and costly examinations.

Amenorrhea↗
PubMed1981

[Gonadotropins in amenorrhea].

Serum gonadotrophin values were measured in 410 patients with amenorrhoea. These patients were grouped into five groups in order to determine diagnostic gonadotrophin values, since the latter are most often implicated in the diagnostic investigation of patients with amenorrhoea. Statistically significant differences were noted. To differentiate between hypergonadotrophin amenorrhoea and polycystic ovarian disease, determination of both gonadotrophins, namely follicle-stimulating hormone (FSH) and luteinizing hormone (LH), is necessary. Because of overlapping of values in the polycystic ovarian disease group and the normogonadotrophic group, the LH:FSH ratio is important.

Amenorrhea↗
PubMed1981

[Pituitary adenomas (prolactinomas) and amenorrhea-galactorrhea].

The syndrome of amenorrhoea-galactorrhoea has been known for years, but new diagnostic methods opened up a new approach to the treatment of patients with this syndrome. Whether the increasing awareness of hyperprolactinaemia is due only to the impact of these newer diagnostic methods, or whether there is an increasing incidence due to modern civilization, is unsettled. The clinical picture is variable and therefore a high-risk group should be delineated, namely those patients with amenorrhoea-galactorrhoea and hyperprolactinaemia. Since this condition responds very well to treatment with bromergocriptine, and since there is a 5% (micro-adenomas) - 35% incidence of tumour extension during pregnancy, this high-risk group should be scrutinzed for a possible pituitary adenoma. The treatment of pituitary adenomas is at the present stage best labelled as an emotional matter, more particularly for micro-adenomas. This is certainly so for the patient not interested in pregnancy. The long-term outcome in patients with hyperprolactinaemia effectively treated with bromergocriptine is not known. The group with macro-odenomas interested in pregnancy should be treated by some form of destructive procedure. For the rest, the future will tell.

Adenoma↗
PubMed1981

Premature gonadal failure.

Fifty patients with premature gonadal failure were subdivided into primary and secondary failure groups. Karyotyping in the primary and ovarian histological examination in the secondary group are preferred diagnostic procedures. Several rare clinical syndromes are mentioned. Possible aetiological factors are identified, and a plea is made for the accurate diagnosis of this condition. Diagnostic pitfalls are also presented.

Adult↗
PubMedDate not supplied

[Leiomyoma and leiomyosarcoma of the vulva].

Patients with leiomyoma and leiomyosarcoma of the vulva are described. The clinical features of these conditions are summarized and the diagnostic criteria for differentiating leiomyomas from leiomyosarcomas are mentioned. The treatment and follow-up of patients with vulval leiomyosarcomas is discussed briefly.

Aged↗