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Biomedical subjects

W N Spellacy

Publications and source records attributed to W N Spellacy.

At least 181 records · Page 10Linked to original sources
PubMed1977

Plasma concentrations of four pregnancy proteins in complications of pregnancy.

Toxemia of pregnancy was associated with an elevation of the pregnancy-associated plasma protein (PAPP)-A concentration, as compared to the level in normal pregnancy in the last month of gestation. The other pregnancy proteins measured were not altered in toxemia. In twin pregnancies, the PAPP-A, PAPP-C, and human placental lactogen levels were all increased, particularly PAPP-A. On the other hand, pregnancy zone protein was not affected by twinning. Pregnancy with diabetes showed normal levels of these proteins.

Blood Proteins↗
PubMed1977

Vitamin B6 treatment of gestational diabetes mellitus: studies of blood glucose and plasma insulin.

Thirteen women with late pregnancy gestational diabetes mellitus were tested with an intravenous glucose tolerance test and both blood glucose and plasma insulin levels were measured. Each woman was then treated with 100 mg. of vitamin B6 per day for 2 weeks and the intravenous glucose tolerance test was then repeated. There was a statistically significant improvement in the glucose tolerance curve after the vitamin B6 treatment, with a lowering of blood glucose levels at all points on the curve except for the 5 minute value. This glucose effect occurred despite an unchanged or lowered plasma insulin level. These results suggest that a relative deficiency in vitamin B6 is associated with some cases of gestational diabetes mellitus and that the replacement of this vitamin improves the metabolic state. The low vitamin B6 levels appear to alter metabolic pathways which result in a lowering of the biologic activity of endogenous insulin.

Blood Glucose↗
PubMed1977

The effect of smoking on serum human placental lactogen levels.

Serial serum samples (162) were drawn weekly from normal pregnant women (53) during the last month of gestation and measurements were made of the human placental lactogen (HPL) content. The women were interviewed as to their smoking habits and divided into nonsmokers (32) and smokers of from one to two packages of cigarettes per day (21). The infant birth weight and placental weights were not significantly different. The HPL levels were elevated in the women who smoked and the differences were significant at the thirty-sixth and thirty-eighth weeks. The importance of this in interpreting HPL as a placental function test and in terms of the biology of placental function and the control of protein hormone synthesis is emphasized.

Birth Weight↗
PubMed1977

Plasma human placental lactogen, oxytocinase, and placental phosphatase in normal and toxemic pregnancies.

A total of 625 serum samples were drawn from 400 normal and 225 hypertensive toxemic pregnant women. Each sample was simultaneously assayed for its human placental lactogen (HPL), oxytocinase (O), and placental phosphatase (PP) concentration. In addition, accurate placental and infant birth weights were determined in those cases where the serum sample was obtained within 14 days of delivery. The results showed a significant rise and correlation of each of the three proteins with increasing weeks of gestation. Although the infant birth weight was unrelated to the serum level of the three proteins, both the HPL and O concentrations were significantly correlated with the placental weight in the normal pregnancies. In both types of pregnancies, the concentration of O was significantly related to that of PP and this was also true for HPL and O and HPL and PP. In all instances O was more strongly related than PP. In the toxemic pregnancies there was a higher O and lower PP level than in normal gestations. These data suggest that placental enzyme measurements, especially O, could be clinically helpful in monitoring high-risk pregnancies.

Aminopeptidases↗
PubMed1977

Factors influencing the dynamics of gonadotropin response following bolus infusion of luteinizing hormone-releasing factor in women with menstrual abnormalities.

Thirty-five women with menstrual abnormalities were given 100 microng of luteinizing hormone-releasing hormone (LHRH) by bolus intravenous injection in an attempt to simplify and quantitate the usefulness of this test in clinical management. Peak and total gonadotropin responses are highly correlated. Peak and total LH are significantly related to basal LH but no similar relationship could be established for follicle-stimulating hormone (FSH). There is no association between gonadotropin response and prolactin levels or body weight. Basal estradiol levels are inversely related to FSH response but not to LH response. It is concluded that the use of an intravenous 100-microng bolus of LHRH is of little use as a clinical test for the gynecologic endocrine patient.

Adolescent↗
PubMed1977

The effect of gonadotropin-releasing hormone on blood glucose insulin, luteinizing hormone, and follicle-stimulating hormone levels.

Sixteen women volunteers with menstrual irregularities were studied with an intravenous injection of 100 microgram of gonadotropin-releasing hormone (GNRH). Serial blood samples were obtained for 2 hours after the injection and assayed for their concentration of glucose, insulin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). There was a significant increase in the levels of both gonadotropins following the injection, with the peak for LH occurring at 30 minutes and the peak for FSH occurring at 90 minutes. There was a slight decrease in the glucose level at 45 minutes and in the insulin levels at 60 and 120 minutes. Because GNRH causes only minor changes in these parameters of carbohydrate metabolism, it would appear to be safe to use in women with ovulatory abnormalities secondary to diabetes mellitus.

Blood Glucose↗
PubMed1977

The effects of a "low-estrogen" oral contraceptive on carbohydrate metabolism during six months of treatment: a preliminary report of blood glucose and plasma insulin values.

A prospective study of carbohydrate metabolism was carried out on seven women by using an oral glucose tolerance stimulation test and measuring blood glucose and plasma insulin values over a 3-hour time period. The test was performed before and after 6 months of treatment with a "low-estrogen" oral contraceptive containing 0.4 mg of norethindrone and 35 micrograms of ethinylestradiol. There was no change in the weight or diastolic blood pressure of the women, but there was a slight elevation of the systolic blood pressure with treatment. There was no significant change in the plasma insulin values or in four of five blood glucose values. The 1-hour blood glucose value was significantly lower after 6 months of treatment. These results suggest that the "low-estrogen" oral contraceptives may reduce the secondary effects on carbohydrate metabolism seen with regular oral contraceptives.

Adult↗
PubMed1977

Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women.

Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Culture Media↗
PubMed1977

A national survey of medical school obstetrics and gynecology departments, 1965 to 1975.

Representatives of 108 departments of obstetrics and gynecology completed a written questionnaire in 1976 designed to assess the changes that had occurred in the teaching resources of the departments for the years 1965, 1970, and 1975. There was a statistically significant increase in the number of students per clerkship during that decade. In addition, there was an increase in the numbers of full-time faculty members, residents, beds, and patients. As a consequence, the teaching ratios improved. This might explain in part the increased numbers of medical students selecting obstetrics and gynecology as a career.

Education, Medical↗
PubMed1977

Three-year prospective study of carbohydrate metabolism in women using Ovulen.

Twenty-eight women were tested with a standard three-hour oral glucose tolerance test before and after three years of using a combination-type oral contraceptive containing mestranol and ethynodiol diacetate (Ovulen). At the three-year test time there was a significant elevation of the patients' weights and their 1-, 2-, and 3-hour blood glucose and 2- and 3-hour plasma insulin values. Pretreatment control tests had shown no "abnormal" blood glucose curves, whereas at the three-year test 17.2% of the curves were "abnormal". Serial follow-up studies in two women after stopping the medication showed that the abnormal glucose curves reverted to their pretreatment status within 12 months.

Adolescent↗
PubMed1977

Fetal movements and placental lactogen levels for fetal-placental evaluation. A preliminary report.

Fetal movements were measured by 37 pregnant women during a 10-minute period while they were lying on their left side at various times during the day with the highest rates in the evening. Preliminary assessments of fetal movement and serum hPL levels in pregnant women suggest that the two tests might complement each other in providing more information about the status of the placenta and fetus.

Circadian Rhythm↗
PubMed1977

Amniotic fluid L/S ratio in twin gestation.

Transabdominal amniocenteses were performed on both sacs of 14 sets of twins. In each instance one sac was marked with methylene blue to correctly identify the fluids. The lecithin/sphingomyelin ratio was determined on each fluid, and the correlation coefficient between the two sets of fluids was 0.86. There was no significant difference in the fluids' L/S ratios. The importance of this in terms of understanding the variables affecting fetal lung maturation and in clinically managing twin pregnancies is stressed.

Amniocentesis↗
PubMed1977

Membrane stripping to induce labor.

A group of 91 pregnant women at term were studied randomly to see the effect of digital stripping of the membranes from the lower uterine segment upon the onset of labor. The women with unfavorable cervices (Bishop score 0 to 5) demonstrated a significant increase in the onset of labor within 48 hours as compared to controls. When the cervix was favorable (Bishop score 6 to 10), there was no significant effect. The overall success rate for induction of labor was not significantly altered (43.5% in membrane-stripped patients, 22.2% in controls). There were no major complications of the procedure.

Cervix Uteri↗
PubMed1976

Respiratory distress syndrome with mature lecithin/sphingomyelin ratios: diabetes mellitus and low Apgar scores.

A detailed study was made of 150 women delivered of their infants within 72 hours of an amniocentesis where the lecithin/sphingomyelin (L/S) ratio was 2.0 or greater. There were nine neonates with respiratory distress (6.0 per cent). There were two neonatal deaths, both due to severe congenital heart disease. A mature amniotic fluid L/S ratio predicts a newborn infant who will not have respiratory distress syndrome (RDS) in most pregnancies. There is a significantly increased risk of RDS in neonates with a mature L/S ratio if the mother has insulin-dependent diabetes or if there is a resulting low Apgar score. The method of delivery (cesarean section or vaginal) does not affect the frequency of RDS where the L/S ratio is 2.0 or more.

Amniotic Fluid↗
PubMed1976

The effects of norgestrel on carbohydrate and lipid metabolism over one year.

Carbohydrate and lipid metabolism were studied with the use of a three-hour oral glucose tolerance test in 71 women before and after one year of daily oral norgestrel, 0.075 mg., treatment. There was no significant change in weight or fasting plasma triglyceride and cholesterol levels. There was a significant elevation of both the blood glucose and plasma insulin levels after one year of treatment. This was true for both the fasting and the glucose-stimulated values. Whereas all of the individual glucose tolerance curves at the pretreatment control test were normal by selection, 15.5 per cent of the curves were borderline abnormal to abnormal at the one-year test. The significance of these metabolic alterations is discussed.

Adult↗