Obstetrician & Gynecologist
45 years of experience

Accepting new patients
Shantara Plaza
8380 Warren Pkwy
Ste 201
Frisco, TX 75034
972-377-2625
Locations and availability (1)

Education ?

Medical School Score
Loyola University Chicago (1965)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Associations
American Board of Obstetrics and Gynecology

Affiliations ?

Dr. Madden is affiliated with 5 hospitals.

Hospital Affilations

Score

Rankings

  • Texas Health Presbyterian Hospital Plano
    6200 W Parker Rd, Plano, TX 75093
    • Currently 4 of 4 crosses
    Top 25%
  • Texas Health Presbyterian Hospital Of Dallas *
    8200 Walnut Hill Ln, Dallas, TX 75231
    • Currently 3 of 4 crosses
    Top 50%
  • Parkland Health & Hospital System
    5201 Harry Hines Blvd, Dallas, TX 75235
    • Currently 1 of 4 crosses
  • TX Health Plano
  • Texas Health Dallas
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Madden has contributed to 47 publications.
    Title A Randomized Controlled Study of Human Serum Albumin and Serum Substitute Supplement As Protein Supplements for Ivf Culture and the Effect on Live Birth Rates.
    Date June 2009
    Journal Human Reproduction (oxford, England)
    Excerpt

    It has been speculated that the addition of proteins more complex than human serum albumin (HSA) to culture media may improve IVF outcomes. Whether the expense, labor and risk of adding additional human-derived protein to IVF media are warranted is a question unanswered.

    Title A Controlled Randomized Trial Evaluating the Effect of Lowered Incubator Oxygen Tension on Live Births in a Predominantly Blastocyst Transfer Program.
    Date April 2009
    Journal Human Reproduction (oxford, England)
    Excerpt

    The potentially damaging effect of free O(2) radicals to cultured embryos may be reduced by adding scavengers to the culture media or by reducing the incubator O(2) levels. However, lowering the O(2) in the culture environment can be expensive, troublesome and may not be justifiable. The objective of this study was to evaluate the effect of lowered incubator O(2) tension on live birth rates in a predominately Day 5 embryo transfer program.

    Title Electric Field and Vibration-assisted Nanomolecule Desorption and Anti-biofouling for Biosensor Applications.
    Date December 2007
    Journal Colloids and Surfaces. B, Biointerfaces
    Excerpt

    A novel anti-fouling mechanism based on the combined effects of electric field and shear stress is reported. A lead zirconate titanate (PZT) composite is used to generate an electric field and an acoustic streaming shear stress that increase nanomolecule desorption. In vitro characterization showed that (1) 58+/-5.5% and 39+/-5.2% of adsorbed bovine serum albumin (BSA) proteins can be effectively removed from fired silver and titanium coated PZT plate, respectively; and (2) 43+/-9.7% of the anti-mouse immunoglobulin G (IgG) can be effectively removed from a fired silver coated PZT plate. Theoretical calculations on protein-surface interactions (van der Waals (VDW), electrostatic, and hydrophobic) and shear stress describe the mechanism for protein desorption from model surfaces. We have shown that the applied electric potential is the major contributor in reducing the adhesive force between protein and surface, and the desorbed protein is taken away by acoustic streaming shear stress. We strongly believe that the present method offers the possibility of minimizing nanomolecule adsorption without further surface treatment.

    Title Mobile Robots: Motor Challenges and Materials Solutions.
    Date December 2007
    Journal Science (new York, N.y.)
    Excerpt

    Bolted-down robots labor in our factories, performing the same task over and over again. Where are the robots that run and jump? Equaling human performance is very difficult for many reasons, including the basic challenge of demonstrating motors and transmissions that efficiently match the power per unit mass of muscle. In order to exceed animal agility, new actuators are needed. Materials that change dimension in response to applied voltage, so-called artificial muscle technologies, outperform muscle in most respects and so provide a promising means of improving robots. In the longer term, robots powered by atomically perfect fibers will outrun us all.

    Title Materials Science. Artificial Muscle Begins to Breathe.
    Date March 2006
    Journal Science (new York, N.y.)
    Title 5 Alpha-androstane-3,17-dione in Peripheral Plasma of Men and Women.
    Date April 1992
    Journal The Journal of Steroid Biochemistry and Molecular Biology
    Excerpt

    An antibody to androstanedione obtained in a rabbit by immunization with androstenedione-7 alpha-carboxymethyl-thioether conjugated to bovine serum albumin was found to cross-react 100% with 5 alpha-androstane-3,17-dione, a property that was used to develop a radioimmunoassay for this steroid. Plasma 5 alpha-androstane-3,17-dione concentrations were determined in young men, and in women throughout an ovulatory cycle. In the men (n = 6), plasma 5 alpha-androstane-3,17-dione concentrations were in the range of 84 to 273 pg/ml with a mean (+/- SD) value of 164 +/- 57 pg/ml. The plasma levels in the women (n = 5) were in the ranges of 35 +/- 14 to 145 +/- 75 pg/ml during the follicular phase, and 109 +/- 50 to 151 +/- 44 pg/ml during the luteal phase. The tissue sites of origin of 5 alpha-androstane-3,17-dione have not been defined, however, some extraglandular tissues are known to contain enzymes that convert C19-steroids to 5 alpha-androstane-3,17-dione. It is possible that 5 alpha-androstane-3,17-dione in circulation serves as a substrate for peripheral synthesis of 5 alpha-dihydrotestosterone.

    Title Effect of Environs and Seasonality on Metal Residues in Tissues of Wild and Pond-raised Crayfish in Southern Louisiana.
    Date May 1990
    Journal Archives of Environmental Contamination and Toxicology
    Excerpt

    Two commercially important species of Louisiana crayfish, Procambarus clarkii (Girard) and P. acutus acutus (Girard), from the Atchafalaya River Basin, from open ponds and from the sediment and water of these environs were sampled three times during two consecutive fishing (production) seasons. The abdominal muscle and hepatopancreatic tissue were analyzed separately. Lead, mercury, and cadmium, if present, were in concentrations below the detection limit. In the hepatopancreatic tissue, barium was present in concentrations below 8 mg/kg, copper 11-15 mg/kg, and iron below 640 mg/kg. Abdominal muscle samples had less than 3 mg/kg of most metals. Locations with the highest levels of metal residues in sediment were not necessarily locations where crayfish had the highest levels in their tissues.

    Title Survey of Persistent Pesticide Residues in the Edible Tissues of Wild and Pond-raised Louisiana Crayfish and Their Habitat.
    Date December 1989
    Journal Bulletin of Environmental Contamination and Toxicology
    Title Auditory Brainstem-evoked Potentials in Term Infants Born to Mothers Addicted to Opiates.
    Date November 1989
    Journal Journal of Perinatology : Official Journal of the California Perinatal Association
    Excerpt

    A series of 20 normal newborn term infants and 12 infants born to mothers who had abused opiates during pregnancy were studied. Auditory brainstem-evoked potentials were used to describe neurophysiologic dysfunction in a group of drug-addicted term infants. Significant differences in the auditory brainstem-evoked potentials were found between the two groups. Specifically, a decrease in the central conduction times was noted for the I-III interpeak interval, suggesting neurophysiologic dysfunction in the area of the pons and cerebellum.

    Title Maternal Cocaine Abuse and Effect on the Newborn.
    Date February 1986
    Journal Pediatrics
    Excerpt

    Cocaine has been increasingly available to a wider population of potential users in the United States. Information concerning possible effects of this agent on the fetus and newborn is lacking. We observed eight infants whose mother's gave a history of cocaine abuse and, in whom, results of a urine screen for cocaine were positive. We observed no evident symptomatology or signs of teratogenicity on these infants. Although this is encouraging, more studies, including Brazelton assessment, and long-term follow-up of infants born to cocaine-abusing mothers is necessary.

    Title Long-term Use of Verapamil for Control of Persistent Supraventricular Tachycardia.
    Date May 1985
    Journal American Journal of Diseases of Children (1960)
    Title Applying Industrial Material Control Techniques to the Hospital Setting.
    Date October 1983
    Journal Hospital Purchasing Management
    Title Citrobacter Ventriculitis in a Neonate Responsive to Trimethoprim-sulfamethoxazole.
    Date July 1983
    Journal Clinical Pediatrics
    Excerpt

    There are increasing reports of citrobacter central nervous system infections in neonates. These organisms cause brain abcesses in a high percentage of patients. They may be resistant to commonly used antibiotics. We report a term male infant with underlying meningo-myelocoele and hydrocephalus in whom Citrobacter diversus meningitis and ventriculitis developed. Initial antibiotic therapy including intraventricular amikacin failed to sterilize the ventricles or alter a deteriorating clinical course. Adding intravenous trimethoprim-sulfamethoxazole to the therapeutic regimen resulted in reversal of a progressively worsening condition and eventual recovery. Trimethoprim-sulfamethoxazole should be considered as a potentially useful alternative antibiotic for susceptible central nervous system infections.

    Title Studies of Gonadotropin-gonadal Dynamics in Patients with Androgen Insensitivity.
    Date June 1983
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    Four patients with androgen insensitivity had plasma LH and FSH measured at 20-min intervals for 24 h and at 15- to 30-min intervals for 3 h after the injection of LRH. Twenty-four-hour mean testosterone (T), estradiol, and androstenedione (delta 4) levels were also measured. Patients with androgen insensitivity had significantly elevated LH levels (P less than 0.05) and an increase in the number of LH secretory episodes (P less than 0.001) compared to normal subjects. The amplitude of the LH secretory episodes, expressed as the absolute increment, was significantly higher than normal controls (P less than 0.005). The LH response to LRH (absolute increment) was twice that of normal, but was not significantly different from normal subjects. The 24-h mean FSH levels were normal in three of the patients and elevated in one. This patient had the mildest degree of androgen insensitivity on clinical exam and the greatest degree of testicular atrophy. The 24-h mean T, estradiol, and delta 4 levels were higher than normal, but only the delta 4 was significantly increased (P less than 0.05). To determine if the elevated LH levels were in response to a decrease in the free T level, we measured T-binding capacity (TBG), TBG was higher than normal controls but was not significantly different, suggesting that elevated LH levels were probably in response to a decrease in T action at the hypothalamic-pituitary level. This was further supported by the inability of prolonged dihydrotestosterone administration to affect LH secretion in one of the patients with the Reifenstein syndrome.

    Title Extraadrenal Steroid 21-hydroxylase Activity in a Woman with Congenital Adrenal Hyperplasia Due to Steroid 21-hydroxylase Deficiency.
    Date January 1983
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    The 21-hydroxylation of plasma progesterone (P) has been demonstrated in pregnant, nonpregnant, and adrenalectomized women and in men. The fractional conversion of plasma progesterone to deoxycorticosterone (DOC), [rho]P-DOC BU, among those subjects was 0.009 +/- 0.001 (mean +/- SEM, n = 32). The [rho]P-DOC BU in a woman with congenital adrenal hyperplasia due to apparent adrenal steroid 21-hydroxylase deficiency was 0.010 when she was taking cortisone acetate, and the [rho]P-DOC BU determined when she was not taking cortisone acetate was 0.012. Moreover, the value computed for the fractional conversion of 17 alpha-hydroxyprogesterone to 11-deoxycortisol in this woman (0.004) was similar to that observed in a woman with normal adrenal function (0.005). Therefore, extraadrenal 21-hydroxylase activity in a woman with nonsalt-losing congenital adrenal hyperplasia due to 21-hydroxylase deficiency was similar to that found in persons with normal adrenal function.

    Title Educational Priorities in the Newborn Nursery.
    Date November 1981
    Journal Journal of Medical Education
    Excerpt

    The newborn nursery provides an ideal setting for introducing basic concepts in primary care. The incorporation of the new born (low risk) nursery as a component of a division of ambulatory and community pediatrics presents an opportunity to address many of these issues and provides a focus for mother-child and family-institution bonding. In the University of California, Irvine, Medical Center nursery, management plans of residents and medical students are reviewed by a multidisciplinary team. The team considers the many physiologic adjustment a newborn infant must undergo to adapt successfully to its environment and discusses the impact of psychosocial stress, economic conditions, citizenship status, and environmental concerns on the ability of the parents to provide a supportive environment for their infant. Supervision of direct patient care and administrative responsibility for medical decisions in the nursery are the duties of the child health associate assigned to the nursery and his supervising physician.

    Title Maternal Plasma Adrenocorticotropin and Cortisol Relationships Throughout Human Pregnancy.
    Date April 1981
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    Adrenocorticotropin (ACTH) and cortisol in plasma were measured weekly from early in gestation through delivery in five women whose pregnancies were normal. During the twelfth week of pregnancy, the concentration of ACTH in plasma of blood samples obtained between 0800 and 0900 hours was 23 +/- 4.6 pg/ml (mean and SEM) and rose progressively to 59 +/- 16 pg/ml at 37 weeks. The levels of ACTH in plasma were significantly lower throughout pregnancy than those found in nonpregnant women. During labor and delivery, ACTH levels rose strikingly to values of 301 +/- 137 pg/ml. As pregnancy advanced, the concentration of cortisol in plasma increased progressively from 149 +/- 34 ng/ml (mean and SEM) at 12 weeks to 352 +/- 90 ng/ml at 26 weeks' gestation but changed minimally thereafter until labor commenced, during which values of 706 +/- 148 ng/ml were achieved. ACTH and cortisol secretory patterns over a 24-hour period were also investigated in one subject during each trimester of pregnancy. Diurnal variations were observed that were qualitatively similar to those seen in nonpregnant women. From the results of these studies, we conclude that ACTH levels are suppressed in plasma of normal pregnant women but are higher in late pregnancy than in early pregnancy. The rise in plasma ACTH concentrations, as pregnancy advances, in spite of increasing levels of plasma cortisol, estrogens, and progesterone, is suggestive of the possibility that a source of ACTH exists that is not subject to negative feedback control, that the clearance of free cortisol increases as pregnancy advances, or that there is an alteration in the metabolism of the ACTH precursor protein produced by the pituitary and/or placenta.

    Title Neuroendocrine Control of Gonadotropin Secretion.
    Date November 1980
    Journal Federation Proceedings
    Excerpt

    Luteinizing hormone releasing hormone (LHRH), a hypothalmic peptide that is concentrated in granules of neurons, has the capacity to release gonadotropins (luteinizing hormone (LH) and follicle stimulating hormone) from the pituitary gland. LHRH has been found in hypophysial portal blood of rats, monkeys, and rabbits. Antibodies to LHRH depress plasma LH concentrations in castrated animals and evoke testicular atrophy, but passive immunization against LHRH does not block the LH surge induced by estrogen in monkeys. Estrogens, progestin, prolactin, and dopamine have marked effects on LH secretion, yet an association between these effects and altered hypophysial portal blood concentrations of LHRH is not established. In view of the paucity of evidence demonstrating such a cause and effect relationship, two alternative proposals have become tenable. One, hormones and neurotransmitters may not alter the levels of portal blood LHRH, but rather alter the frequency of pulsatile LHRH secretion. Two, hormones, such as estrogens, progesterone, and prolactin, may alter the responsiveness of the gonadotropin-secreting cells to LHRH by affecting the secretion of dopamine.

    Title Origin of Estrogen in Normal Men and in Women with Testicular Feminization.
    Date February 1980
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    The purpose of this study was to quantify the various sources of estrone (E1) and 17 beta-estradiol (E2) production in normal men and in women with testicular feminization. The mean production rate of E1 in four young adult men was 58 micrograms/24 h, while that of E2 was 44 micrograms/24 h. In these men, E1 production could be accounted for totally by extraglandular formation through 1) aromatization of plasma androstenedione, 2) conversion of E2 which was formed from the aromatization of plasma testosterone, and 3) conversion of secreted E2. In these men, only 12 micrograms or less of E2 production could not be accounted for by extraglandular formation from plasma C19 precursors, and is presumed to have arisen by testicular secretion. In six women with testicular feminization, the mean production rate of E1 was 99 micrograms/24 h, while that of E2 was 77 micrograms/24 h. THe amount of E2 production that arose by glandular secretion could be computed in four of these women and was considerably greater than that found in the young adult men. In these women with testicular feminization, an average of 44 micrograms/24 h E2 could not be accounted for by extraglandular formation and is presumed to have arisen by testicular secretion. The mean plasma production rate of testosterone in the normal men was 5.7 mg/24 h, while that in the women with testicular feminization was 8.3 mg/24 h. However, the range of plasma production rates of testosterone in the women with testicular feminization was large (1.3--17.0 mg/24 h).

    Title Familial Nesidioblastosis: Severe Neonatal Hypoglycemia in Two Families.
    Date November 1979
    Journal The Journal of Pediatrics
    Excerpt

    Severe neonatal hypoglycemia with pathologic findings of diffuse nesidoblastosis of the pancreas is described in five children of both sexes from two families with unaffected parents. This appears to represent an autosomal recessive disorder of pancreatic development. Despite extensive testing, the diagnosis of hyperinsulinism was difficult in the index case of each family and delayed definitive treatment. Medical therapy with steroids and diazoxide was unsuccessful; pancreatectomy was required to treat persistent hypoglycemia. An abnormality of circulating glucagon found in one child with this disorder suggested that hyperinsulinism may not be the sole hormonal imbalance present, but rather that this disease is one of generalized disturbance of islet cell function. The history of severe, persistent neonatal hypoglycemia in an older sibling should lead the physician to investigate subsequent children for the presence of asymptomatic hypoglycemia.

    Title Plasma Levels of Adrenocorticotropin and Cortisol in Women Receiving Oral Contraceptive Steroid Treatment.
    Date October 1979
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    The secretion rate and plasma concentration of the adrenocortical steroid cortisol is modified in subjects treated with estrogenic and/or progestational steroids. The effects of contraceptive steroids on the secretion of ACTH are poorly documented, however, In the current investigation, we found that concentrations of ACTH and cortisol in plasma obtained at 0800--0900 h from a group of women with normal cyclic menses (n = 4) ranged from 78--120 pg/ml and 77--137 ng/ml, respectively. Although significant cyclic changes in the plasma levels of LH, FSH, 17 beta-estradiol, and progesterone occurred during the ovarian cycle, no obvious cyclic fluctuations in plasma levels of ACTH or cortisol were observed. In women treated with Norinyl 1 + 80 (1.0 mg norethindrone plus 0.08 mg mestranol), plasma concentrations of LH, FSH, 17 beta-estradiol, and progesterone were significantly lower (P less than 0.001) than plasma levels of these hormones in normal women during the ovarian cycle. The mean daily plasma concentrations of ACTH were significantly lower (P less than 0.001), whereas plasma cortisol levels were significantly higher (P less than 0.001) in women treated with oral contraceptive steroids compared to the levels of these hormones in the untreated ovulatory women.

    Title Dehydroisoandrosterone Sulfate in Peripheral Blood of Premenopausal, Pregnant and Postmenopausal Women and Men.
    Date May 1979
    Journal Journal of Steroid Biochemistry
    Title Fetal Considerations. Metabolic Clearance Rate of Maternal Plasma Dehydroisoandrosterone Sulfate.
    Date March 1979
    Journal Seminars in Perinatology
    Title The Effect of Oral Contraceptive Treatment on the Serum Concentration of Dehydroisoandrosterone Sulfate.
    Date December 1978
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    Dehydroisoandrosterone sulfate (DS), the major C19-steroid in the human circulation, was measured in serum obtained from blood samples collected daily (8 to 10 A.M.) throughout the menstrual cycles of eight normal, presumably ovulatory women and daily throughout the treatment cycles in four women taking an oral contraceptive (norethindrone, 1 mg., plus mestranol, 80 mcg.). The serum concentrations of DS in the ovulatory women ranged from 1,025 to 4,200 ng. per milliliter; mean, 2,062 +/- 137 ng. per milliliter (mean and standard error; n = 213). Serum DS concentrations during the follicular and luteal phases of the menstrual cycles of these women were similar. In women taking the oral contraceptive, the plasma DS concentrations ranged from 475 to 1,400 ng. per milliliter (mean, 895 +/- 83; n = 119). The 24 hour secretory pattern of DS was evaluated in one subject during a nontreatment cycle and again after 20 days of oral contraceptive treatment. In this subject, the mean serum DS level was 34 per cent lower during oral contraceptive treatment than the level before treatment. The decrease in the serum concentration of DS during oral contraceptive treatment likely results from a reduction in adrenal DS secretion since DS secretion by the normal human ovary is negligible and ovarian dehydroisoandrosterone secretion is small. Therefore, it is likely that the reduced serum DS levels in women taking oral contraceptives are the consequence of reduced adrenal secretion of DS resulting from reduced release of adrenocorticotropic hormone.

    Title Study of the Kinetics of Conversion of Maternal Plasma Dehydroisoandrosterone Sulfate to 16 Alpha-hydroxydehydroisoandrosterone Sulfate, Estradiol, and Estriol.
    Date December 1978
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    The transfer constants of conversion of maternal plasma dehydroisoandrosterone sulfate to estradiol ([rho]DS-E2BU) and to 16alphaOH-dehydroisoandrosterone sulfate ([rho]DS-160HDS BU) and of maternal plasma 16alphaOH-dehydroisoandrosterone sulfate to estriol ([rho]160HDS-E3 BU) were measured in women late in pregnancy. The mean [rho]160HDS-E3 BU, 0.17, was considerably less than the mean [rho]DS-E2 BU, 0.29. However, the extent of 16alpha-hydroxylation of maternal plasma dehydroisoandrosterone sulfate was great, the mean [rho]DS-160HDS BU being 0.36.

    Title Analysis of Secretory Patterns of Prolactin and Gonadotropins During Twenty-four Hours in a Lactating Woman Before and After Resumption of Menses.
    Date December 1978
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    Twenty-four hour secretory patterns of prolactin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were obtained on two separate occasions from a woman with late physiologic lactation. The studies were performed 26 and 34 months after her child's birth. During the initial study, she had amenorrhea, and her child suckled 13 per cent of the 24 hour period (Study 1). At the time of the second study, she had resumed regular menses and her child suckled for 7 per cent of the 24 hour period (Study 2). The average concentrations of prolactin during Studies 1 and 2 were 40 +/- 1.0 (mean and standard error; No. = 72) and 31 +/- 1.4 ng. per milliliter, respectively. The mean plasma prolactin concentration in Study 1 was significantly greater than that in Study 2 (p less than 0.001). The plasma concentrations of LH and FSH were significantly less in Study 1 than in Study 2 (p less than 0.001 and less than 0.01, respectively). It is concluded that hyperprolactinemia and hypogonadotropinemia were endocrinologic correlates of the amenorrhea of late physiologic lactation in this woman.

    Title Problems Pertaining to the Care of Newborn Infants of Drug-addicted Women.
    Date September 1978
    Journal The Journal of Reproductive Medicine
    Title Clinical and Endocrinological Evaluation of Patients with Congenital Microphallus.
    Date September 1978
    Journal The Journal of Urology
    Excerpt

    Eight patients with congenital microphallus were investigated. Plasma luteinizing hormone, follicle-stimulating hormone, testosterone and androstenedione levels were obtained in all cases. In addition, the response to the administration of human chorionic gonadotropin, luteinizing horomone-releasing hormone and adrenocorticotropic hormone, the assessment of testicular histology by electron microscopy and the measurement of dihydrotestosterone formation by preputial skin were determined in some patients. The results of these studies were compared to similar studies in 6 normal prepubertal boys, 4 boys with bilateral cryptorchidism, 1 male infant with anorchia and 1 adult with hypogonadotropic hypogonadism. The clinical and endocrinological findings in the 8 patients with microphallus can be divided into 2 distinct categories. In 5 patients the disorder is familial, gonadotropin levels are low and there is a normal response to stimulation with chorionic gonadotropin. The data are compatible with the possibility that 3 (possibly 5) of the 8 patients with microphallus have hypogonadotropic hypogonadism. In the other group the cases are sporadic, serum luteinizing hormone and follicle-stimulating hormone levels are elevated and plasma testosterone failed to increase after short-term treatment with chorionic gonadotropin. In these patients a primary testicular disorder appears to be responsible. Experimental and clinical evidence suggests that microphallus results from defective testicular function during the second and third trimesters of pregnancy, either as the result of defective gonadotropin secretion or defective androgen synthesis.

    Title Association of Prune Belly Syndrome and Gastroschisis.
    Date June 1978
    Journal American Journal of Diseases of Children (1960)
    Title Origin of Estrogen in Isosexual Precocious Pseudopuberty Due to a Granulosa-theca Cell Tumor.
    Date March 1978
    Journal Obstetrics and Gynecology
    Excerpt

    The purpose of the present study was to quantify the rates of production and to define the mechanism(s) or origin of sex steroid hormones in a 3 1/2-year-old girl with isosexual precocious pseudopuberty caused by a granulosa-theca cell tumor of the ovary. The results suggest that the hyperestrogenism occurs principally due to the secretion of estradiol-17beta synthesized de novo by the tumor, but that the tumor in vivo was also capable of aromatizing C19 plasma precursor hormones to estrogen.

    Title Progesterone and 5alpha-pregnane-3,20-dione in Peripheral Blood of Normal Young Women: Daily Measurements Throughout the Menstrual Cycle.
    Date December 1977
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    The peripheral plasma concentrations of progesterone and 5alpha-pregnane-3,20-dione were measured daily throughout the ovarian cycle of five presumptively ovulatory women. The concentrations of progesterone and 5alpha-pregnane-3,20-dione during the follicular phase were 0.11 +/- 0.02 ng/ml (mean +/- SE) and 0.16 +/- 0.01 ng/ml, respectively. In four of these women the concentrations of both progesterone and 5alpha-pregnane-3,20-dione began to rise immediately after the luteinizing hormone (LH) peak and reached maximal concentrations five to eight days later (progesterone: 8.6 to 19.9 ng/ml; 5alpha-pregnane-3,20-dione: 1.4 to 2.8 ng/ml). The luteal phases in these women, measured from the day of the LH peak to the onset of the next menses, varied from 13 to 18 days. In the other woman with a late LH surge (day 27 of the cycle) the peak concentrations of progesterone and 5alpha-pregnane-3,20-dione were reached four days after the LH peak (8.9 ng/ml and 0.8 ng/ml, respectively). The luteal phase in this woman was 11 days. From the results of this study, it appears that the concentrations of 5alpha-pregnane-3,20-dione in peripheral blood during the luteal phase are proportional to the availability of progesterone as substrate for the 5alpha-reductase enzyme system.

    Title The Endocrinology of Human Chorionic Gonadotropin-secreting Testicular Tumors: New Methods in Diagnosis.
    Date May 1977
    Journal The Journal of Urology
    Excerpt

    Serum from 59 men with testicular masses was examined for the presence of human chorionic gonadotropin-beta. Results indicate: 1) In patients with testicular tumor human chorionic gonadotropin-beta serves as a sensitive and specific marker of tumor activity with an incidence of 28%. 2) Because human chorionic gonadotropin-beta levels correlate with response to therapy this test will be useful in selecting men for adjunctive irradiation or chemotherapy. 3) Radioimmunoassay for human chorionic gonadotropin-beta is far more sensitive and specific than conventional methods for detecting human chorionic gonadotropin production. 4) After unilateral orchiectomy for carcinoma of the testis elevated serum luteinizing hormone levels are common and may be unrelated to the presence or activity of residual tumor. 5) Human chorionic gonadotropin-beta-producing tumors were associated with increased estradiol and testosterone levels and significantly depressed serum follicle stimulating hormone levels in this series. 6) The prognostic implications of the presence of human chorionic gonadotropin-beta are not yet fully understood. The importance of this study is the fact that men with testicular tumors have a high incidence of human chorionic gonadotropin-beta secretion and this fact provides the physician with a powerful new tool for examining the various aspects of tumor activity. It also shows the feasibility for prospective screening of patients with a wide variety of neoplasms of differing histologic types.

    Title Observation and Treatment of Neonatal Narcotic Withdrawal.
    Date February 1977
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    A total of 110 infants born to mothers who were either in a methadone maintenance program, using heroin, or recently detoxified, were studied during the neonatal period. Of these infants, 93.6 per cent developed withdrawal symptoms. No significant differences were determined in therapeutic response among those infants treated with methadone, phenobarbital, and diazepam. There was a significant reduction in the frequency of withdrawal symptoms among infants born to mothers whose methadone dose at time of delivery was less than 20 mg (17.9 per cent). It is suggested that reduction of methadone dosage in late pregnancy results in reduced incidence of withdrawal but must be carefully carried out.

    Title The Pattern and Rates of Metabolism of Maternal Plasma Dehydroisoandrosterone Sulfate in Human Pregnancy.
    Date September 1976
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    The present study was done to map the metabolic pathways and rates of maternal plasma clearance of dehydroisoandrosterone sulfate (MCRDS) in pregnancy. In the present study, maternal plasma dehydroisoandrosterone sulfate (DS) metabolism was largely accounted for by two major pathways not present or not prominent in the nonpregnant woman. The first major pathway was clearance of maternal plasma DS by placental aromatization of DS to form estradiol (E2). This pathway accounted for approximately 35 per cent of the total clearance. The second major pathway of metabolism of maternal plasma DS was by 16 alpha-hydroxylation within the maternal compartment. This pathway accounted for approximately 32 per cent of maternal plasma DS clearance. Two other minor pathways of DS metabolism, that is, loss to the fetus and excretion as unaltered DS into urine, accounted for less than 1 per cent of total metabolism in each instance. The final pathway of DS metabolism was excretion as neutral steroids such as urinary 17-ketosteroids and other undefined losses. By combining the rate of DS clearance (MCRDS) from maternal plasma via all pathways with that fraction of DS removed uniquely by placental conversion of DS to estradiol (DS leads to E2), the placental clearance of DS leads to E2 (PCDSE2) may be measured. The measurement of PCDSE2 may be expected to reflect uteroplacental perfusion and as such may provide an investigative tool capable of assessing the dynamics of uteroplacental function in a variety of clinical conditions.

    Title Congenital Absence of the Vagina. The Mayer-rokitansky-kuster-hauser Syndrome.
    Date September 1976
    Journal Annals of Internal Medicine
    Excerpt

    We describe 14 patients with congenital absence of the vagina associated with a variable abnormality of the uterus and review the literature. Associated developmental anomalies of the urinary tract and skeleton are common. As a result of the analysis of two affected families, we believe that the disorder may represent the variable manifestation of a single underlying genetic defect that can be expressed alone or in any combination of vertebral, renal, and genital abnormalities. Some affected persons may have lethal manifestations such as absence of both kidneys, and some cases may result from multifactoral causes rather than a single gene defect. Whatever the cause, the defect involves mesodermal development and the mesonephric kidney, the latter resulting in abnormalities in the paramesonephros (uterus and vagina) and in the metanephric kidney. Both nonoperative and surgical treatments are generally successful in repairing the vaginal abnormality.

    Title Metabolic Clearance Rate of Dehydroisoandrosterone Sulfate. Vii. Effect of Lateral Versus Supine Recumbency.
    Date June 1976
    Journal Obstetrics and Gynecology
    Excerpt

    The physiologic events which may occur with the gravid women in the supine position suggest that uteroplacental blood flow may be impaired as a consequence of decreased venous return to the heart and the resulting decrease in cardiac output. Since the metabolic clearance rate of dehydroisoandrosterone sulfate (MCRDS) previously has been shown to reflect alterations in uteroplacental perfusion, the MCRDS was measured in a variety of different obstetric conditions during lateral and supine recumbency. No significant difference in the MCRDS was induced by this specific positional change, suggesting that uteroplacental perfusion was not altered. Experimental data are discussed which support this observation, and a possible mechanism for maintenance of uteroplacental blood flow under these circumstances is presented.

    Title Metabolic Clearance Rate of Dehydroisoandrosterone Sulfate. V. Studies of Essential Hypertension Complicating Pregnancy.
    Date April 1976
    Journal Obstetrics and Gynecology
    Excerpt

    The metabolic clearance rate of dehydroisoandrosterone sulfate (MCRDS) was determined prospectively in gravidas with and without chronic essential hypertension. In normotensive patients, the MCRDS increased in linear fashion throughout pregnancy. In patients with chronic essential hypertension the MCRDS also increased progressively, but at higher values than in normotensive subjects. In normotensive gravidas who ultimately developed pregnancy-induced hypertension, the MCRDS increased progressively at a higher level than in gravidas who remained normotensive until approximately 4 weeks prior to the onset of clinical symptoms, at which time the MCRDS slowly decreased. Similarly, in gravidas with chronic hypertension who developed superimposed pregnancy-induced hypertension, the MCRDS increased progressively at higher levels than all groups studied until approximately 4 weeks prior to onset of hypertension, when a progressive decline in the MCRDS began.

    Title Metabolic Clearance Rate of Dehydroisoandrosterone Sulfate. Vi. Studies of Eclampsia.
    Date April 1976
    Journal Obstetrics and Gynecology
    Excerpt

    The metabolic clearance rate of dehydroisoandrosterone sulfate (MCRDS) was measured in 11 women during an eclamptic episode, and the subjects were then followed for at least 5 years. The MCRDS was usually decreased in primigravid women with eclampsia. However, in eclamptic primigravid women who later developed essential hypertension and/or recurrent hypertension in subsequent pregnancies the MCRDS was elevated. Also, in multiparous women with chronic essential hypertension plus superimposed eclampsia, the MCRDS was increased to above normal values.

    Title Warfarin Therapy Initiated During Pregnancy and Phenotypic Chondrodysplasia Punctata.
    Date April 1976
    Journal The Journal of Pediatrics
    Excerpt

    An infant is described who has clinical manifestations and roentgenographic features consistent with the diagnosis of chondrodysplasia punctata. The mother of this infant received warfarin during pregnancy. Eight cases demonstrating an association between warfarin therapy during pregnancy and chondrodysplasia punctata in the child have been reported; in the present case therapy was initiated following conception (see following case report). Warfarin may be teratogenic, producing a phencopy of the heritable forms of chondrodysplasia punctata. Because of the evident association we suggest (1) warfarin is contraindicated in pregnancy and alternative anticoagulants should be used; (2) products of at-risk pregnancies should be screened for the characteristic radiologic findings; and (3) preconceptual counselling and antenatal diagnosis of the disease may be beneficial.

    Title The Metabolic Clearance Rate of Dehydroisoandrosterone Sulfate. Iv. Acute Effects of Induced Hypertension, Hypotension, and Naturesis in Normal and Hypertensive Pregnancies.
    Date March 1976
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    In the present study, the metabolic clearance rate of dehydroisoandrosterone sulfate (MCRDS) decreased in normotensive gravidas during short-term studies utilizing angiotensin II-induced elevation of blood pressure. Therapy with hydralazine hydrochloride in chronic hypertensive gravidas resulted in a decrease in blood pressure and an accompanying decrease in the MCRDS. A variable response was observed in the apparent volume of distribution of DS (AVDDS) during therapy with hydralazine hydrochloride. Decreases in MCRDS also occurred in chronic hypertensive gravidas following therapy with 40 mg. of intravenously administered furosemide despite a failure of blood pressure to be altered. The AVDDS increased in four of five patients receiving furosemide, suggesting a possible direct action of furosemide upon vascular smooth muscle.

    Title Isolation and Characterization of 5alpha-pregnane-3,20-dione and Progesterone in Pepipheral Blood of Pregnant Women. Measurement Throughout Pregnancy.
    Date January 1976
    Journal Gynecologic Investigation
    Excerpt

    5alpha-Pregnane-3,20-dione and progesterone were isolated from a pregnancy plasma pool and were identified by using a combination of chromatographic techniques and mass spectrometry. Antibodies to progesterone were obtained in rabbits by immunization with progesterone-1alpha-carboxyethyl-thioether-thyroglobulin. The raised antibodies were of high affinity and one of them cross-reacted (137%) with 5alpha-pregnane-3,20-dione. This property was used to develop radioimmunoassays for measuring circulating levels of both progesterone and 5alpha-pregnane-3,20-dione in pregnancy plasma. The levels of both progesterone and 5alpha-pregnane-3,20-dione increase throughout pregnancy, but a highly significant increase is observed only after the 32nd week of gestation.

    Title Clinical and Endocrinologic Characterization of a Patients with the Syndrome of Incomplete Testicular Feminization.
    Date December 1975
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    A 46 XY individual with male pseudohermaphroditism was investigated. The phenotype was distinctive in that the habitus was female in character, but partial fusion of the labioscrotal folds, testes, and male wolffian duct structures that terminated in the vagina were present. Müllerian structures were absent. At the expected time of puberty both feminization (breast development) and virilization (clitoral enlargement) took place. Studies of estrogen and androgen dynamics revealed plasma testosterone levels and production rates characteristic of normal men. Plasma estrogen levels and production rates were greater than those of normal men. Plasma gonadotropin levels were also high. These findings suggest that the fundamental defect in this patient is androgen resistance rather than defective androgen synthesis. Dihydrotestosterone formation from testosterone slices of epididymis and perineal skin was normal. The family history was uninformative. On endocrinologic, genetic, and phenotypic grounds the syndrome of incomplete testicular feminization can be separated from the complete form of testicular feminization and from familial incomplete male pseudohermaphroditism, Type 2. Additional studies will be required to determine whether this disorder is also distinct from the Type 1 form of familial incomplete male pseudohermaphromditism.

    Title The Metabolic Clearance Rate of Dehydroisoandrosterone Sulfate. Iii. The Effect of Thiazide Diuretics in Normal and Future Pre-eclamptic Pregnancies.
    Date November 1975
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    The present study reports that the metabolic clearance rate of dehydroisoandrosterone sulfate (MCRDS) is decreased by thiazide diuretics during normal and future pre-eclamptic pregnancies. This observation supports the thesis that diuretics represent a potential hazard to the fetus by decreasing placental perfusion.

    Title Familial Incomplete Male Pseudohermaphroditism, Type 2. Decreased Dihydrotestosterone Formation in Pseudovaginal Perineoscrotal Hypospadias.
    Date December 1974
    Journal The New England Journal of Medicine
    Title Letter: Student Education in a University-based General Pediatric Clinic.
    Date December 1974
    Journal Pediatrics
    Title The Effect of Thiazide Diuretics on Placental Function.
    Date January 1974
    Journal Texas Medicine
    Title Transection of Spinal Cord. A Rare Obstetrical Complication of Cephalic Delivery.
    Date August 1971
    Journal Archives of Disease in Childhood

    Similar doctors nearby

    Dr. Rinku Mehta

    Obstetrics & Gynecology
    11 years experience
    Frisco, TX

    Dr. Steven Trostel

    Obstetrics & Gynecology
    18 years experience
    Frisco, TX

    Dr. Kristen Innes

    Obstetrics & Gynecology
    10 years experience
    Frisco, TX

    Dr. Christine Ku

    Obstetrics & Gynecology
    9 years experience
    Frisco, TX

    Dr. David Fong

    Obstetrics & Gynecology
    15 years experience
    Frisco, TX

    Dr. Kathryn White

    Obstetrics & Gynecology
    22 years experience
    Frisco, TX
    Search All Similar Doctors