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Biomedical subjects

K Outch

Publications and source records attributed to K Outch.

8 recordsLinked to original sources
PubMed1991

Treatment of anovulation due to polycystic ovarian syndrome by laparoscopic ovarian electrocautery.

Our experience of ovarian electrocautery for the treatment of polycystic ovarian syndrome (PCOS) in ten women is described. We found that nine responded favourably, either ovulating spontaneously or becoming more responsive to ovulation induction. There was a significant and persistent fall in serum testosterone levels, and a transient fall with subsequent rise in inhibin. We recommend that laparoscopic ovarian electrocautery is considered as an alternative to ovulation induction with gonadotrophins, in women with PCOS who fail to respond to clomiphene citrate.

Adult↗
PubMed1988

The dexamethasone suppression test: a study in a normal population.

One hundred healthy, non-depressed volunteers were given a standard dexamethasone suppression test (DST) to determine the appropriate criterion values of plasma cortisol to define suppression or nonsuppression. By radioimmunoassay (RIA) of cortisol, the criterion value for 5% nonsuppression was plasma cortisol greater than 187 nmol/l, and for suppression less than 153 nmol/l, with an indeterminate range between these values. Use of the widely accepted pre-determined criterion value of 138 nmol/l gave a significantly greater frequency of nonsuppression. Values of cortisol measured by two RIAs in a subset of 43 volunteers were not equivalent. With the experimentally determined criterion value, no significant differences between nonsuppressors and suppressors were found for any measured physical or psychological parameters. Women taking oral contraceptives had significantly higher plasma cortisol pre-dexamethasone and post-dexamethasone. Their exclusion did not alter the calculated criterion value for the remainder, but their separately estimated criterion value was significantly higher. Caution should be exercised when classifying the DST status of women on oral contraceptives, particularly when values are at the lower end of the nonsuppressor range. Determination of a separate normal range for them may be warranted.

Adrenocorticotropic Hormone↗
PubMed1985

Macronutrients have different metabolic effects in nondiabetics and diabetics.

The glycemic and hormonal responses to protein, fat and carbohydrate alone and together were studied in normal, noninsulin-dependent (NIDD) and insulin-dependent (IDD) diabetic subjects. Fat and protein markedly reduced the glycemic response to oral carbohydrate in nondiabetics. In NIDD, the presence of protein and fat had no significant effect on the glycemic response. In IDD, while fat had no effect, protein enhanced the glycemic response. The insulin and GIP responses to the macronutrients together and individually were remarkably similar in all subject groups. Protein behaved as an insulin secretagogue in normal and NIDD while fat acted as a GIP secretagogue in normal and both diabetic groups. Protein appeared to function as a GIP secretagogue when combined with both fat and carbohydrate. It is concluded that caution is required when the glycemic responses to foods observed in nondiabetics are extended to diabetics.

Adult↗
PubMed1985

Food physical factors have different metabolic effects in nondiabetics and diabetics.

Physical properties of food may account for differences in glycemic and other metabolic responses to food with similar amounts of carbohydrate, fat and protein. Blending of cooked beans made no difference to plasma glucose, insulin, or GIP (gastric inhibitory polypeptide) responses in nondiabetics, NIDD (noninsulin-dependent diabetics), and IDD (insulin-dependent diabetics). The cooked blended beans gave a greater plasma glucose response and a lesser hormonal response than a cooked flummery (containing cornstarch, protein and fat) in nondiabetics. In NIDD and IDD, however, the reverse applied for plasma glucose. In nondiabetics, cooked flummery gave a lesser glycemic response at some time points than uncooked flummery. In NIDD the opposite occurred. Cooking led to no significant change in insulin response in nondiabetics, but to a lesser insulin response in NIDD. The effect of some physical properties of food on diabetic control cannot be inferred from findings in nondiabetics.

Adult↗
PubMed1984

Induction of ovulation and fertility in amenorrheic women by pulsatile low-dose gonadotropin-releasing hormone.

In functional hypothalamic amenorrhea, failure of ovulation probably results from deficient hypothalamic secretion of gonadotropin-releasing hormone (GnRH). We treated 14 infertile women in whom this condition was resistant to clomiphene with pulses of 5 to 15 micrograms of GnRH administered subcutaneously by portable pumps at 90-minute intervals in 36 cycles of treatment. Ovulation occurred in 30 cycles (83 per cent) and was followed by normal luteal function in 24. Singleton pregnancy occurred after 13 (54 per cent) of these cycles. Ovarian ultrasound consistently showed a single dominant follicle, and follicular-phase levels of gonadotropins and urinary estrone glucuronide were in the normal range in all cycles of treatment except two in which mild ovarian overstimulation occurred. Plasma profiles of GnRH and luteinizing hormone were highly pulsatile after subcutaneous administration of GnRH, and mean peak plasma levels of GnRH were comparable to those in pituitary portal blood. We conclude that treatment with low-dose subcutaneous pulses of GnRH is a safe, effective, and physiologic method of restoring reproductive function in hypothalamic amenorrhea and that it has advantages over gonadotropin therapy.

Adult↗
PubMed1980

Role of cortisol ion cardiac glucose metabolism in vivo.

Little is known about how physiological concentrations of glucocorticoid relate to cardiac metabolism in vivo. Healthy conscious dogs with catheters implanted for blood sampling and glucose infusion were studied. The range of blood glucose values produced by glucose infusion was 3700 to 74,400 mumol/liter. Arterial glucose concentration (Ca) was not significantly correlated with the arterial-coronary sinus difference in concentration of glucose, Ca-cs glucose (N = 50, r = 0.23). However, at or above glucose infusion rates of 2120 mumol/min, significant increases in cardiac glucose extractions were seen. The range of plasma cortisol values was 13 to 438 nmol/liter. Cortisol immunoreactivity in arterial plasma (Ia cortisol) was significantly and negatively correlated with Ca-cs glucose (N = 50, r = -0.37, P < 0.01). Nonparametric analysis confirmed this association (Spearman rank correlation coefficient, rs = -0.44, P < 0.01). The heart took up and released cortisol in relation to Ia cortisol (N = 50, r = 0.75, P < 0.001; rs = 0.58, P < 0.001). The range of Ia-cs cortisol was -31 to 138 nmol/liter (mean +/- SEM, 12 +/- 4, P < 0.01). The Ca-cs glucose was negatively correlated with Ia-cs cortisol (N = 50, r = -0.43, P < 0.01; rs = 0.50, P < 0.001). Thus, higher plasma cortisol immunoreactivity may lead to greater myocardial cortisol extraction and suppression of myocardial glucose extraction in vivo. At the same time arterial insulin immunoreactivity had a significant positive relationship to myocardial glucose extraction (N = 50, r = 0.37, P < 0.05; rs = 0.38, P < 0.01) and arterial plasma free fatty acids a negative relationship (N = 50, rs = -0.30, P < 0.05).

Animals↗