James O. Ellegood
Georgia Regents University
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American Journal of Obstetrics and Gynecology | 1979
Manubai Nagamani; Paul G. McDonough; James O. Ellegood; Virendra B. Mahesh
Concentrations of testosterone, dihydrotestosterone, androstenedione, progesterone, 17 alpha-hydroxyprogesterone, and estradiol were measured by radioimmunoassay in the amniotic fluid and maternal peripheral blood obtained from normal pregnancies between 14 and 40 weeks of gestation. There was a sex difference in the levels of all the androgenic steroids in the amniotic fluid before 20 weeks with higher levels in pregnancies with male fetuses. Amniotic fluid 17 alpha-hydroxyprogesterone levels were significantly elevated in a pregnancy with the fetus affected with congenital adrenal hyperplasia. The levels of all the steroids in the amniotic fluid were significantly elevated in the pregnancy with molar degeneration of the placenta. There was a sex difference in the levels of dihydrotestosterone in the maternal peripheral blood before 20 weeks with higher levels in pregnancies with male fetuses. There was no correlation between the steroid levels in the maternal serum and amniotic fluid even though most of the samples of maternal serum were drawn at the same time as amniocentesis.
American Journal of Obstetrics and Gynecology | 1978
Manubai Nagamani; Paul G. McDonough; James O. Ellegood; Virendra B. Mahesh
17 alpha-Hdroxyprogesterone levels (17 alpha-OHP) were measured in 70 samples of amniotic fluid and 30 samples of maternal serum obtained at different stages of normal pregnancy and in samples of maternal serum and amniotic fluid from a pregnancy with the fetus affected with congenital adrenal hyperplasia. The mean level of 17 alpha-hydroxyprogesterone in the amniotic fluid from control pregnancies was 133.9 +/- 7.6 ng. per 100 ml. (range, 25.1 to 266.6 ng. per 100 ml). The levels were significantly higher in midpregnancy (157.4 +/- 8.4 ng. per 100 ml.) than in late pregnancy (79.2 +/- 6.8 ng. per 100 ml.) (p less than 0.01). Amniotic fluid 17 alpha-OHP levels in the affected pregnancy were significantly higher than the control levels. Mean maternal 17 alpha-OHP level during early pregnancy and midpregnancy was 259.5 +/- 22 ng. per 100 ml. and there was a two-to three-fold increase after 37 weeks (672.2 +/- 61 ng. per 100 ml.) The maternal 17 alpha-OHP levels in the affected pregnancy were significantly higher than the control levels after 34 weeks, but before 34 weeks, the level was within the range seen in control pregnancies. Measurement of 17 alpha-OHP levels in the amniotic fluid before 24 weeks and maternal serum after 34 weeks can be utilized for the prenatal diagnosis of congenital adrenal hyperplasia.
Journal of Steroid Biochemistry | 1977
W.E. Braselton; T.J. Lin; Thomas M. Mills; James O. Ellegood; Virendra B. Mahesh
Abstract Urinary metabolites of norethindrone (17β-hydroxy-17α-ethynyl-4-estren-3-one) in the free, sulfate, and glueuronide fractions were identified by gas chromatography-mass spectrometry following treatment of a volunteer with a 25 mg dose of norethindrone. Compounds identified in the three fractions were norethindrone, the four ring A reduced isomers, a reduced and hydroxylated metabolite, and ethynyl estradiol (17α-ethynylestra-l,3,5(10)-triene-3, 17β-diol). Plasma free, sulfate and glucuronide conjugated metabolites of norethindrone were identified and quantified by mass fragmentography. Blood metabolites identified in the three fractions 3 h following oral administration of 25 mg of norethindrone were unchanged drug, and ring A reduced metabolites 17α-ethynyl-5α-estrane-3α,17β-diol, 17α-ethynyl-5β-estrane-3α,17β-diol, 17α-ethynyl-5β-estrane-3β, 17β-diol, and 17β-hydroxy-17α-ethynyl-5β-estrane-3-one. These plasma metabolites were also quantified using mass fragmentography in blood obtained from a volunteer undergoing daily treatment with 2 mg norethindrone, 0.1 mg mestranol (17α-ethynylestra-1,3,5(10)-triene-3,17β-diol-3-methyl ether) (Orth-o-Novum, 2 mg).
American Journal of Obstetrics and Gynecology | 1974
T.M. Mills; T.J. Lin; S. Hernandez-Ayup; Robert B. Greenblatt; James O. Ellegood; Virendra B. Mahesh
The plasma metabolic clearance rate (MCR) and the urinary excretion of norethindrone were measured in 8 volunteer women, who took Norlutin (2.5 mg norethindrone per day for 20 days per month) for 6 to 7 months. MCR increased significantly (p.05) after 6 months of norethindrone medication. Urinary excretion of norethindrone and its metabolites did not change significantly after the 6 month course. Variability in the MCR measurements among the subjects could not be accounted for by size differences or different times of the menstrual cycle. Total plasma radioactivity (from tritiated norethindrone) fell much more slowly than plasma norethindrone levels; this is probably due to conjugated metabolites of norethindrone.
American Journal of Obstetrics and Gynecology | 1979
W.E. Braselton; T.J. Lin; James O. Ellegood; Thomas M. Mills; Virendra B. Mahesh
Blood levels of free, sulfate, and glucuronide conjugates of norethindrone (NE) and its ring A reduced metabolites 17alpha-ethynyl-5beta-estrane-3alpha, 17beta-diol and 17alpha-ethynyl-5alpha-estrane-3alpha, 17beta-diol were measured in a female volunteer who received six consecutive daily doses of 2.5 mg. of NE and in four female volunteers undergoing chronic treatment with Orthonovum 2 mg. (2 mg. of NE and 0.1 mg. of mestranol [ME]). The blood levels were quantified by gas chromatograph-mass spectrometry. During treatment for 6 days with 2.5 mg. of NE daily, the 3 hour blood levels of NE and the ring A reduced metabolites increased in a stepwise fashion. During long-term treatment the concentrations of NE, NE sulfate, and the conjugates of the ring A reduced metabolites were seen to build up to a peak at approximately the midpoint of the treatment phase of each cycle, and drop to near baseline during the time when no drug was administered. Individuals varied as to their tendency to accumulate the drug and metabolites, and as to the relative proportion of metabolites formed.
American Journal of Obstetrics and Gynecology | 1972
Paul G. McDonough; Virendra B. Mahesh; James O. Ellegood
Abstract Identical twins (age 16) with polycystic ovarian disease documented by laparoscopy are compared to a “normal” 18-year-old sibling. Fractionation and individual estimation of urinary 17-ketosteroids, 17-ketogenic steroids, pregnanetriol, and total estrogen were performed on both amenorrheic twins and their normal menstruating sibling. Steroid values were obtained during adrenal suppression and after adrenal provocation with adrenocorticotropic hormone nd metyrapone. Serum levels for follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were obtained periodically over a period of 16 months on the twins with polycystic ovarian disease. All 3 siblings gave evidence of androgen overproduction on the part of the ovaries and adrenals. Serum LH values in the twins were elevated but exhibited considerable fluctuation. Serum FSH values were lower but also manifested considerable variation. The similar steroid profile in the 3 siblings and the LH/FSH pattern in the identical twins are discussed.
American Journal of Obstetrics and Gynecology | 1976
Thomas M. Mills; T.J. Lin; W.E. Braselton; James O. Ellegood; Virendra B. Mahesh
Previous studies from this laboratory reported that 3H-labeled metabolites with half-lives of more than 24 hours may remain in the plasmaa of women receiving an intravenous injection of 3H norethindrone or 3H mestranol. To confirm the presence of these metabolites, blood samples were collected for five days after injection of 3H norethindrone or 3H mestranol; 3H representing metabolites of norethindrone disappeared with half-life values of 42 to 84 hours (mean 67 hours), while 3H representing metabolites of mestranol declined with an average half-life of 45 hours (range 37 to 65 hours). When the 3H-labeled drugs were administered orally, metabolites of similar half-life were formed. Because these compounds exist for several days after a single administration and since oral contraceptive drugs are normally taken daily, the possiblity of the accumulation of 3H in the plasm of women receiving several consecutive doses of 3H norethindrone was investigated. The results of this study show a stepwise accumulation of the 3H metabolites when 3H norethindrone was administered in six daily oral doses. However, the 3H levels declined from the peak on the sixth and last day of the treatment at a rate equivalent to those previously measured after intravenous or oral administration.
American Journal of Obstetrics and Gynecology | 1974
T.M. Mills; T.J. Lin; S. Hernandez-Ayup; Robert B. Greenblatt; James O. Ellegood; Virendra B. Mahesh
Abstract Mestranol, a synthetic estrogenic drug, was administered to seven normal females and the rate of disappearance of the drug and its metabolites from the plasma was followed. In addition, urine was collected over the 5 days following injection and analyzed for daily excretion rates and for types of conjugation of mestranol metabolites. The rate of clearance of mestranol from the plasma was rapid with an average metabolic clearance rate (MCR) of 1,247 L. per day. Following these initial determinations, subjects were placed on a commercial oral contraceptive preparation containing 80 μg of mestranol per day. Each subject completed six cycles of this drug preparation; after completion, the MCR and urinary excretion rate of the drug were redetermined. Statistical comparisons of the MCR and urinary excretion rates made before and again after the six cycles of the drug show that prolonged mestranol administration had no effect on the rate of clearance (MCR), the rate of urinary excretion, or the mode of conjugation of mestranol or its metabolites.
American Journal of Obstetrics and Gynecology | 1969
Guy L. Faucher; James O. Ellegood; Virendra B. Mahesh; Robert B. Greenblatt
The mechanism of action of the intrauterine contraceptive device is still poorly understood. Endocrine studies were carried along with basal body temperature, serial vaginal smears, and endometrial biopsies in 4 normal menstruating females of reproductive age during one menstrual cycle prior to insertion of the IUCD. The studies were repeated in a total of six cycles with the IUCD in place. The endocrine data indicated that ovulation took place in all six cycles studied after the insertion of the IUCD. The luteal phase was shortened in four out of six cycles. The urinary pregnanediol values were lower in all six cycles studied after the insertion of the IUCD and urinary estrogens were lower in three out of the six cycles. If substantiated by a larger series, these changes in the levels of urinary estrogens or pregnanediol after insertion of the IUCD might give a further insight in the understanding of the mechanism of action of the IUCD.
Fertility and Sterility | 1980
Jaime M. Vasquez; James O. Ellegood; Stanley J. Nazian; Virendra B. Mahesh
An inverse relationship between prolactin and gonadotropins has been recognized in humans as well as in experimental animals. The mechanism of such changes is poorly understood. In the present work, basal levels of serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and the response to LH-releasing hormone (LHRH) have been determined in intact and ovariectomized animals with hyperprolactinemia induced by perphenazine (5mg/kg of body weight/day). Perphenazine significantly depressed basal LH and FSH levels in intact and castrated females. This depression could be due to lowered LHRH release by the hypothalamus, altered pituitary responsiveness to LHRH, or both. Hyperprolactinemia induced by perphenazine significantly depressed the pituitary LH response to LHRH in intact animals (P β -estradiol (1 μ g/kg of body weight/day) or 17 β -estradiol and progesterone was injected after castration. LHRH responsiveness was increased or unaltered, respectively. These results indicate that perphenazine induced a decreased release of hypothalamic LHRH resulting in gonadotropin suppression. In addition, in the intact animals, decreased pituitary sensitivity to LHRH also occurred as a result of increased progesterone secretion brought about by hyperprolactinemia.