Obstetrics and Gynecology Commons^™

Decreases In Ovarian Cytochrome P450c17 Alpha Activity And Serum Free Testosterone After Reduction Of Insulin Secretion In Polycystic Ovary Syndrome, John E. Nestler , M.D., Daniela J. Jakubowicz , M.D.

Obstetrics and Gynecology Publications

BACKGROUND

Insulin resistance and increased ovarian cytochrome P450c17α activity are both features of the polycystic ovary syndrome. P450c17α, which is involved in androgen biosynthesis, has both 17α-hydroxylase and 17,20-lyase activities. Increased activity of this enzyme results in exaggerated conversion of progesterone to 17α-hydroxyprogesterone in response to stimulation by gonadotropin. We hypothesized that hyperinsulinemia stimulates ovarian P450c17α activity.

METHODS

We measured serum steroid concentrations during fasting and the response of serum 17α-hydroxyprogesterone to leuprolide, a gonadotropin-releasing hormone agonist, and performed oral glucose-tolerance tests before and after oral administration of either metformin (500 mg three times daily) or placebo for four to …

Ua35/11 Student Honors Research Bulletin, Wku Honors Program

WKU Administration Documents

The WKU Student Honors Research Bulletin is dedicated to scholarly involvement and student research. These papers are representative of work done by students from throughout the university.

• Brooks, Lynnette and Cindy Calisi. The Effect of Selenium Supplementation on the Immune Response of Mice with Experimental Chagas' Disease
• Hildreth, John. Teasing the Muse
• Jenkins, Rhonda. Steinbeck's Portraits of Prostitutes: Progression of an Author's Vision
• Kirkham, Michelle. The Prenatal Use of Crack Cocaine: How It Affects Children and How Schools Can Respond
• Gibson, Jeanette and Juli McCay. Circadian Rhythm of Brain GABA Levels in the Cockroach, Leucophaea Maderae
• Patterson, Dana. Home Schooling …

Preventing Perinatal Transmission Of Hiv Costs And Effectiveness Of A Recommended Intervention, Robin D. Gorsky, P G. Farnham, Walter L. Straus, Blake Caldwell, D R. Holtgrave, R. J. Simonds, M F. Rogers, Mary Guinan

School of Public Health Faculty Research

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.¹ Without intervention, an estimated 15-30% of these infants would become infected.² In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.^3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal …

Clinic-Based Investigation Of The Typology And Self-Reporting Of Fgm In Egypt, Population Council

Reproductive Health

This clinic-based study of female genital mutilation (FGM) was designed and carried out by the Egypt Fertility Care Society to gather detailed information on the types of FGM practiced in Egypt. The study involved interviews with clinic clients to elicit information about their experience and attitudes concerning FGM, and gynecological examinations by specially trained OB/GYN physicians. In all, 93% of the women in this study were found to have some type of FGM. The study's findings were incorporated in the final report of the 1995 Egyptian Demographic and Health Survey, with the aim of contributing to the scientific understanding of …

Hepatocyte Growth Factor And Its Receptor Are Expressed In Cardiac Myocytes During Early Cardiogenesis, Daniel A. Rappolee, Anand Iyer, Yogesh Patel

Department of Obstetrics and Gynecology Research Publications

In the mouse, the heart primordium arises when mesodermis set aside during gastrulation, is induced by pharyngeal endoderm, migrates ventrally to the midline of the embryo, forms a tube, and begins beating. Little is known of the molecular mechanisms that mediate the determination, mitosis, differentiation, and migration that lead to the beating heart. Transcripts for hepatocyte growth factor/scatter factor (HGF) and its receptor are coexpressed transiently and dynamically in the premyocardium but not in other heart progenitor cells. Transcripts for HGF ligand and receptor are first detected before cardiac function and looping and persist through the first looping stage, when …

Knowledge, Sources Used And Factors Considered In The Surgical Treatment Decisions Of Women With Breast Cancer, Debra J. Bisel

Masters Theses

The purpose of this replication study was to examine how women with breast cancer reached their decision for surgical treatment (Ward, Heidrich and Wolberg 1989). Twenty-one women who met the surgical criteria, i.e. option for Breast Conserving surgery or Modified Radical Mastectomy, completed four surveys 1 to 7 days post operatively. The women were divided into two groups, 13 who had Breast Conserving surgery and 8 who had Modified Radical Mastectomy. The surveys assessed demographic characteristics of the groups, the level of knowledge regarding breast cancer, factors considered important in reaching the decision for surgery and the sources of information …

Strategies For Prevention Of Varicella Pneumonia: A Cost-Effectiveness Analysis., G A Macones, S Ewing, N S Silverman

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The objective of this study was to compare the cost-effectiveness of 3 strategies of serologic enzyme-linked immunosorbent assay (ELISA) testing and post-exposure varicella zoster immune globulin (VZIG) prophylaxis for the prevention of maternal varicella pneumonia during pregnancy in patients with negative or uncertain histories of varicella infection.

METHODS: A decision tree was constructed to compare the following strategies: 1) routine serologic testing for varicella immunity followed by targeted post-exposure VZIG prophylaxis, 2) post-exposure serologic testing followed by targeted VZIG prophylaxis, and 3) untargeted post-exposure VZIG administration. The probabilities for the model were obtained from the medical literature and supplemented …

Numerical Chromosome Abnormalities In Sperm From Oligoasthenoteratozoospermic Patients And Fertile Males, Myung-Geol Pang

Theses and Dissertations in Biomedical Sciences

Artificial fertilization protocols have been developed which bypass natural barriers for reproduction. One aspect of infertility which has received little attention is the potential importance of aneuploidy in sperm. To more clearly understand the cytogenetic make-up of sperm from OAT patients, multi-probe, multi-color FISH was performed to determine aneuploidy.

The introduction of intracytoplasmic sperm injection (ICSI) has revolutionized protocols used in in vitro fertilization centers. The pregnancies resulting from ICSI suggest an increased frequency of sex chromosome aneuploidy in livebirths. Preliminary data by others' suggest that sperm tail swelling patterns following hypo-osmotic swelling (HOST) can be predictive of fertilizing ability. …

Perceived Barriers And Perceived Motivators To Receiving Prenatal Care, Christine M. Davis

Masters Theses

The Health Belief Model served as the conceptual framework for this retrospective descriptive study that identified women's perceived barriers and perceived motivators to obtaining prenatal care. A 50 item questionnaire, including both forced-choice and open-ended questions, was administered to 29 women who had delivered a healthy infant within the previous 6 to 8 weeks. The sample was predominantly white (82.2%), {dollar}>{dollar}19 years of age (62.1%), single (62.1%), unemployed (51.7%), and receiving Medicaid insurance (69%). Univariate statistics were calculated for each item. Each item was then compared to the timing of the start of prenatal care. The most important motivators …

Expression Of Genes Encoding Antioxidant Enzymes In Preimplantation Mouse And Cow Embryos And Primary Bovine Oviduct Cultures Employed For Embryo Coculture., M B Harvey, M Y Arcellana-Panlilio, X Zhang, G A Schultz, A J Watson

Obstetrics & Gynaecology Publications

Preimplantation embryos from a variety of mammalian species contrast markedly in their response to culture in vitro. Murine preimplantation embryos display a wider tolerance than other mammalian species to culture environments, and this has contributed to the development of several effective defined culture media. Embryo coculture on somatic cells remains the most effective method of supporting reasonable rates of bovine preimplantation development in vitro. The patterns of gene expression for several antioxidant enzymes during preimplantation murine and bovine development were examined by use of the reverse transcription-polymerase chain reaction technique to determine whether the differential developmental capacity of mammalian preimplantation …

The Health Belief Model As A Predictor Of Gynecological Exams: Does Sexual Orientation Matter?, Lynn Elizabeth Kunkel

Dissertations and Theses

Screening and early detection are essential for the management and control of most diseases. It is important for women to practice routine health care that includes both clinical and self examinations. Today, many women go without health care due to barriers which prevent them from obtaining adequate care. The present study was designed to investigate, using the Health Belief Model, whether there is a difference between heterosexual and lesbian women in obtaining gynecological exams. Responses from 238 participants, 70 heterosexuals and 168 lesbians, indicated that the Health Belief Model was a significant predictor of whether women complied with recommended guidelines …

Audit Changes Clinical Practice! Impact On Rate Of Justification Of Hysterectomy Indication, Khalid S. Khan, J H. Rizvi

Department of Obstetrics & Gynaecology

After performing a baseline audit in 1986-89, an ongoing quality assurance process was initiated in January, 1990 and all hysterectomies performed over the next 2 year period were analyzed. Hysterectomy indications were divided into two groups: one in which the uterine specimen was expected to show pathology and another in which no pathology was expected. The hysterectomy was considered justified in the former if the pathology report verified the indication or showed a significant alternate pathology. In the latter, validation criteria showing documentation of certain prerequisite diagnostic procedures performed before reverting to hysterectomy, were used to ascertain justification. The overall …

Method For Inhibiting Angiogenesis With Aurintricarboxylic Acid, Its Analogues Or Salts, Delwood C. Collins, Antonio Gagliardi, Anjan Bhattacharyya

Obstetrics and Genecology Faculty Patents

Aurintricarboxylic acid has potent anti-angiogenic activity and may be used for new therapeutic approaches for diseases of neovascularization including the treatment of solid tumors, diabetic retinopathy and arthritis, among others.

Are Non-Diabetic Women With Abnormal Glucose Screening Test At Increased Risk Of Pre-Eclampsia, Macrosomia And Caesarian Birth?, Khalid S. Khan, Firasat A. Hashmi, J H. Rizvi

Department of Obstetrics & Gynaecology

To determine, in non-diabetic women, the relationship of abnormal glucose screening test, with the incidence of pre-eclampsia, macrosomia and caesarian delivery, from 1988-92, 5646 consecutive women attending antenatal clinic were screened with a glucose challenge test (GCT) on their first visit (usually at 16-20 weeks); those with risk factors i.e., history of unexplained perinatal loss, macrosomia or family member with diabetes and an initial abnormal screening test were rescreened at 28-32 weeks, In 482 cases the GCT was abnormal (plasma glucose value was >140 mg% 2 hours after 75g glucose challenge). Of these, 292 had one or more abnormal critical …

In Vitro Expression Of Human Zona Pellucida Protein 3, Chih-Wei Chen

Theses and Dissertations in Biomedical Sciences

Human zona pellucida protein 3 (hZP3) is the putative receptor on the zona pellucida of the mature oocyte that recognizes and binds sperm, and therefore plays a critical role in fertilization.

A full length cDNA of hZP3 (1278 bp) was amplified from the human ovary mRNA by reverse transcription-polymerase chain reaction (RT-PCR). The hZP3 cDNA was subcloned into PSK and pREP4 expression vectors. The cDNA of hZP3 was further characterized by restriction mapping, PCR, auto-sequencing and Southern blot analysis by using an internal oligonucleotide probe, and found to be identical to the one reported by J. Dean. Using autosequencing, 289 …

The Relationship Between Diet, Activity, And Other Factors, And Postpartum Weight Change By Race, Debra J. Boardley, Roger G. Sargent, Ann L. Coker, James R. Hussey, Patricia A. Sharpe

CRVAW Faculty Journal Articles

Objective: To identify the impact of dietary intake and activity level on postpartum weight change.

Methods: White (n = 121) and black (n = 224) women, 7-12 months postpartum, participating in the Special Supplemental Feeding Program for Women, Infants, and Children were assessed for dietary intake, activity level, body weight, and other maternal characteristics.

Results: For both black and white women, the most important variables in predicting postpartum weight loss were pre-pregnancy weight, gestational weight gain, parity, and prenatal exercise. After these factors were controlled, race predicted that black women retained 6.4 lb more than white women. These results may …

Lewis Phenotype In Women With Preterm Labor And Premature Rupture Of The Membranes, William F. O'Brien, German F. Leparc, Jodi Holbrook

Obstetrics & Gynecology Faculty Publications

Objective: The purpose of this study was to evaluate the possible association between Lewis phenotype status in pregnant women and preterm labor (PTL) or preterm rupture of the membranes (PROM).Methods: Red blood cell (RBC) Lewis phenotype was determined in 113 pregnant women admitted for PTL or PROM and in 121 controls. The results were controlled for the influence of race on Lewis phenotype.Results: Pregnancy was associated with a higher frequency in women with the a–b– phenotype. There was no association between RBC Lewis phenotype and the occurrence of PTL or PROM.Conclusions: A susceptibility to PTL or PROM …

Climatic Factors And The Incidence Of Pyelonephritis During Pregnancy, John D. Busowski, Ronald A. Chez

Obstetrics & Gynecology Faculty Publications

Objective: Numerous published reports have linked various disease states and pregnancy-related conditions with meteorologic factors such as weather, humidity, and temperature. The purpose of this study was to determine if temperature and dew point affect the incidence of pyelonephritis during pregnancy.Methods: A retrospective chart review of a 4-year period from 1989 to 1992 was performed. The records of women who were diagnosed with pyelonephritis during pregnancy were abstracted for the dates of admission. The climatic records of the Tampa Bay area of Florida were obtained from the National Weather Service.Results: The average, minimum, or maximum daily temperature or …

Low Income Women's Perception Of Preparedness For Self Care And Infant Care Following Discharge From A Less Than Forty-Eight Hour Hospitalization For Birth, Patricia M. Ritola

Masters Theses

The purpose of this study was to describe perceptions of preparation for self care and infant care of new mothers of low income following a short hospitalization for childbirth. Orem's nursing model was used as the conceptual framework for the study. A descriptive correlational, cross sectional design was used to examine preparedness for self care and infant care. The sample (N = 50) consisted of women who were served by Michigan Medicaid, 18 years or older and were hospitalized less than 48 hours. A telephone interview was conducted seven days after discharge.; Data were analyzed using descriptive statistics. Findings identified …

Randomized Trial Of Erythromycin And Azithromycin For Treatment Of Chlamydial Infection In Pregnancy., M F Rosenn, G A Macones, N S Silverman

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The purpose of this study was to compare erythromycin and azithromycin in the treatment of chlamydial cervicitis during pregnancy with regard to efficacy, side effects, and compliance.

METHODS: In a prospective manner, 48 pregnant patients with cervical chlamydial infections diagnosed by routine screening tests were randomly assigned to receive either erythromycin, 500 mg q.i.d. for 7 days (N = 24), or azithromycin, 1 g as a one-time dose (N = 24). All sexual partners were given prescriptions for doxycycline, 100 mg b.i.d. for 7 days. The treatment efficacy was assessed by follow-up chlamydia testing 3 weeks after the therapy …

Perceptions Of Control And Satisfaction With Hospital Birth Experiences For First-Time Mothers, Clelia Tedeschi

Theses : Honours

Satisfaction with childbirth is associated with women's future emotional wellbeing. This study examined whether first- time mother's antenatal expectations, postnatal evaluations of control during labour and delivery, and the discrepancy between expectations and evaluations were significant predictors of women's satisfaction with their childbirth experiences. The effect of medical interventions (e.g., obstetrical interventions and pain relief medication) on women's perceptions of control and satisfaction was also examined. The purposive sample of eighty first-time mothers, mean age 26 years (excluding women who had caesareans) delivered at the public hospital where they attended antenatal classes. During their fourth antenatal class women completed a …

A Phenomenological Study Of Infertility : The Couple's Perspective, M. Imeson

Theses: Doctorates and Masters

The purpose of this phenomenological study was to describe and interpret the experience of infertility from the perspective of infertile couples, in order to gain an in-depth understanding of how it affects their lives. Ten to twenty per cent of the global population share the experience of infertility, however, little is known of their experiences and perceptions related to infertility. Literature to date mainly focuses on the physiological effects of infertility and does not take into account the context in which the experience takes place, or the meanings that people assign to this experience. To be effective, health carers need …

Patients As Subjects For Research: Ethical Dilemmas For The Primary Care Clinician-Investigator, Susan F. Slatkoff, Peter Curtis, Ann L. Coker

CRVAW Faculty Journal Articles

Background: Past studies suggested an association between human papillomavirus (HPV) and cervical intraepithelial neoplasia (CIN). In 1987, University of North Carolina (UNC) Hospitals Family Practice Center clinicians were approached for a control population to study this association. Methods: One hundred fives patients attending the UNC Hospitals Neoplasia Clinic with biopsy-proven CIN 2 or 3 and 268 control patients attending the UNC Family Practice Center for a routine Papanicolaou smear were enrolled in this case-control study. Case and control patients consented to having an additional cervical specimen taken and to being interviewed. The cervical specimens were classified by the Southern blot …

Menopausal Hormone Replacement: Not Necessarily Routine, Mary Guinan

School of Public Health Faculty Research

No abstract provided.

Preimplantation Development Of In Vitro-Matured And In Vitro-Fertilized Ovine Zygotes: Comparison Between Coculture On Oviduct Epithelial Cell Monolayers And Culture Under Low Oxygen Atmosphere., A J Watson, P H Watson, D Warnes, S K Walker, D T Armstrong, R F Seamark

Obstetrics & Gynaecology Publications

The roles of medium composition, serum source, embryo coculture, and culture under low O2 conditions on the development of in vitro-matured and in vitro-fertilized (IVMF) ovine zygotes were investigated in three separate experiments. In the first experiment, the proportion of cocultured IVMF zygotes developing to the blastocyst stage was significantly higher (38.0% vs. 3.5%; p < 0.05) than that of non-cocultured zygotes treated within three embryo culture media (TCM-199 + 10% fetal bovine serum [FBS]; bicarbonate-buffered, glucose-free synthetic oviduct fluid medium [mod-SOFM] + 10% FBS; and bicarbonate-buffered BSA-free Tyrode's salt solution [mod-TALP] + 10% FBS) under a 5% CO2 atmosphere in air. In a second experiment, a significantly higher (p < 0.05) proportion of cocultured zygotes placed in TCM-199 medium survived to the blastocyst stage (37.4% blastocysts vs. 23.4% in mod-SOFM). No significant effect of serum (FBS vs. human serum [HS]) was observed on embryonic development, but coculture was confirmed to exert a significant influence on development to the blastocyst stage. In the final experiment, survival of the embryo under a reduced oxygen (5% CO2:5% O2:90% N2) atmosphere was investigated. In contrast to results in the initial experiments, embryonic survival was significantly higher (p < 0.05) in the non-cocultured treatment groups (21.9% blastocysts vs. 0.4% for cocultured zygotes). Serum source also had a significant (p < 0.05) influence upon the development of non-cocultured zygotes: 32.3% of zygotes cultured with HS progressed to the blastocyst stage vs. 11.5% of zygotes cultured in FBS-supplemented medium. These results have characterized two distinct culture environments, each capable of supporting the development of high frequencies of unselected IVMF zygotes to the blastocyst stage in vitro.

A Growth Factor Phenotype Map For Ovine Preimplantation Development., A J Watson, P H Watson, M Arcellana-Panlilio, D Warnes, S K Walker, G A Schultz, D T Armstrong, R F Seamark

Obstetrics & Gynaecology Publications

The reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the patterns of expression for several growth factor ligand and receptor genes during ovine preimplantation development. Transcripts for insulin-like growth factor (IGF)-I, IGF-II, and the receptors for insulin and IGF-I were detected throughout ovine preimplantation development from the 1-cell to the blastocyst stage. Transforming growth factor alpha (TGF alpha) transcripts were also detected throughout ovine preimplantation development. The mRNAs encoding basic fibroblast growth factor (bFGF) were detected in all stages of the ovine preimplantation embryo, although the relative abundance of this transcript consistently decreased from the 1-cell to the blastocyst …

Immunologic Evaluation Of Ectopic Gestation, Tawfig Amin Nasser

Health Services Research Dissertations

Ectopic gestation is an error in the implantation site of the blastocyst. Extrauterine implantation presents a unique environment since the protective features of the uterus are absent. This study is an investigation into the immunoregulatory differences that may develop as a result of a change in the feto-maternal junction.

The effects of female plasma on one-way mixed lymphocyte cultures and mitogen-stimulated cultures, anti-paternal lymphocytotoxicity, and lymphocyte phenotypes were determined on normal, ectopic and non-pregnant females. The results indicated that pregnant female plasma enhanced the response of autologous lymphocytes to spouse and male control lymphocytes. Enhancement was not seen in the …

Possible Roles Of Insulin And Insulin-Like Growth Factors In Rat Preimplantation Development: Investigation Of Gene Expression By Reverse Transcription-Polymerase Chain Reaction., X Zhang, G M Kidder, A J Watson, G A Schultz, D T Armstrong

Obstetrics & Gynaecology Publications

The sensitive mRNA phenotyping technique of reverse transcription-polymerase chain reaction was used to demonstrate that insulin receptor mRNA is present in rat embryos during the preimplantation period. In addition, mRNA encoding insulin-like growth factor (IGF) type I and type II receptors have also been detected in rat preimplantation embryos. IGF-I mRNA was not detected in preimplantation embryos but was found in oviducts and uteri of prepubertal and early pregnant rats. IGF-II mRNA was present in both embryos and in oviducts and uteri during the preimplantation period. These findings suggest that insulin and IGF-I could influence early embryo development in endocrine …

Malakoplakia Of The Uterus, H Shaikh, P E. Khan, N Faridi

Department of Pathology and Laboratory Medicine

No abstract provided.

Laparoscopic Appraisal Of Infertility And Pelvic Pain In Pakistani Women: A 5 Years Audit, R Hamid, K S. Khan, T Mubeen, J A. Razzak

Department of Obstetrics & Gynaecology

Five hundred and nine Laparoscopic examinations performed between 1987-91, (147 procedures for evaluation of gynaecologic pelvic pain and 313 for infertility) revealed ectopic pregnancy (27%), twisted ovarian cyst (18%) and acute pelvic inflammatory disease (14%) in cases of acute gynaecologic pain, and endometriosis (17%) and chronic pelvic inflammatory disease (16%) in chronic pelvic pain. Adhesions (20%), tubal block (15%), endometriosis (9%) and polycystic ovary (7%) were common findings in cases of infertility. These data support the usefulness of this minimally invasive procedure in accurate diagnosis of gynaecological disorders and provides insight into the spectra of diseases seen in Pakistani women …