William LeMaire | University of Miami Miller School of Medicine (original) (raw)
Papers by William LeMaire
Reproduction, 1981
Rabbits were injected with 100 i.u. hCG to induce oocyte maturation. Oocytes removed from the ova... more Rabbits were injected with 100 i.u. hCG to induce oocyte maturation. Oocytes removed from the ovaries at various times and denuded showed increased oxygen consumption which began before the start of maturation.
Clinical examination and an open mind are two of the most powerful tools at a doctor’s disposal. ... more Clinical examination and an open mind are two of the most powerful tools at a doctor’s disposal. We report the surgical removal of a 17.5kg ovarian tumour in a patient with a raised body mass index who had been complaining of increasing abdominal girth for some time. It is clear from the literature that often the diagnosis of such lesions is delayed. With early clinical examination and consideration of the differential diagnosis of increasing abdominal girth, lesions such as this could be detected earlier. This would make the surgical treatment easier, would potentially reduce the spread of a tumour if it is found to be malignant, and would prevent the impaired function of a patient who carries such a lesion.
The journal of family planning and reproductive health care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists, 2015
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
At no time has an open discussion of the many issues that face the catholic family been more time... more At no time has an open discussion of the many issues that face the catholic family been more timely. On April 8th 2016, Pope Francis released his long awaited document on "Love in the Family" (Amoris Laetitia). 1 In this lengthy and comprehensive document the Pope summarizes the many statements made by himself since his ascendance to the Papacy in 2013 and the often contentious deliberations of the two Synods in Rome in 2014 and 2015 about issues related to the family. In this beautiful and sensitive written document, the Pope touches on issues that impact on the family, including, divorce, gay and lesbian marriage, sexuality and many other aspects of the family. One of the issues discussed by the Pope is family planning and it is on this issue that I would like to focus this discussion. The dilemma for the catholic practitioner The official position of the Roman Catholic Church (Church from here on) has for a long been time that artificial methods of family planning such as condoms and other barrier methods, contraceptive pills, patches and injections or implants, intrauterine devices and sterilization both male and female are opposed. Only the so called natural methods are allowed. 2 Using or prescribing artificial methods of family planning is considered a grave sin. This official position of the Church impacts not only on individual Catholic couples and patients but also has far reaching consequences for Catholic practitioners, including physicians (MD or DO), midwives, nurses, nurse practitioners, physician assistants and even health aides and anyone involved with the advice, prescription, injection, implantation or insertion of contraceptive medication or devices as well as male or female sterilization.
Prostaglandins, 1975
The concentrations of prostaglandin F (PGF) and prostaglandin E (PGE) were measured by radioimmun... more The concentrations of prostaglandin F (PGF) and prostaglandin E (PGE) were measured by radioimmunoassay in isolated Graafian follicles of mature female rats during the pre and post ovulatory period of the estrous cycle. The levels of these prostaglandins were low and relatively constant from 8 a.m. to 4 p.m. on the day of proestrus, but there was a marked increase at 8 p.m. of proestrus reaching an apparent maximum at midnight (PGF 18 fold, PGE 70 fold). By 4 a.m. to 8 a.m. on the morning of estrus these prostaglandins declined rapidly to levels similar to those observed between 8 a.m. and 4 p.m. on the day of proestrus. The increases in prostaglandin levels occurred after the LB peak and apparently before the time of ovulation. These data confirm the role of PGF and PGE in the local mechanism of ovulation in the normal adult of a spontaneously ovulating animal species.
Obstetrics and Gynecology, Nov 1, 2001
No cardiac measurements could be obtained from earlier ultrasounds.
J Clin Endocrinol Metab, 1983
The cytosol of human ovarian tissues was observed to promote protein phosphorylation in the combi... more The cytosol of human ovarian tissues was observed to promote protein phosphorylation in the combined presence of Ca2+, 1,2-diolein, and phosphatidylserine. Ca2+ alone or lipid alone did not produce full activation of this protein kinase(s). The addition of human erythrocyte calmodulin to the assay mixture, in the presence or absence of Ca2+, had no effect on protein kinase activity. Phosphorylation of cytosol proteins ranging in mol wt from 10,000 to 200,000 was selectively increased by Ca2+ plus lipid. This protein kinase activity may play a crucial role in the intracellular transmission of the action of hormones affecting cellular Ca2+ flux and/or phospholipid metabolism.
Obstet Gynecol Surv, 1974
The Journal of Pediatrics, Volume 83, Issue 5, Pages 851-853, November 1973, Authors:Patricia W. ... more The Journal of Pediatrics, Volume 83, Issue 5, Pages 851-853, November 1973, Authors:Patricia W. Conly, MD; William J. LeMaire, MD; Ellen F. Monkus, MD; William W. Cleveland, MD.
J Clin Endocrinol Metab, 1974
Gonadotropins and Gonadal Function, 1974
Endocrinology, 1978
LH stimulates an increase in prostaglandins in vitro in preovulatory follicles from rats pretreat... more LH stimulates an increase in prostaglandins in vitro in preovulatory follicles from rats pretreated with PMS gonadotropin. The role of cAMP in this action of LH was examined by incubating preovulatory follicles with various substances and determining the resultant prostaglandin (PG) E accumulation by radioimmunoassay. LH (5 microgram/ml) increased PGE accumulation to approximately 4 times the control (181 +/- 23 to 886 +/- 83 pg/follicle). The addition of 20 mM cAMP also stimulated PGE accumulation, and the addition of 20 mM cAMP in the presence of 0.5 mM 1-methyl-3-isobutylxanthine was as effective as LH. Other nucleotides such as ATP, ADP, 3'-AMP, 5'-AMP, cGMP, and O2'-monobutyryl-cAMP did not stimulate PGE accumulation. On the other hand, (Bu)2cAMP, 8-bromo-cAMP, and N6-monobutyryl-cAMP produced an increase in PGE accumulation similar to that observed with LH. In addition, 10 microgram/ml cholera toxin was shown to increase both cAMP and PGE accumulation in preovulatory follicles. These results indicate that the prostaglandin response of follicles is specific for cAMP-like nucleotides or substances capable of increasing intracellular cAMP. The data support the concept that cAMP mediates the effect of LH on PGE accumulation in preovulatory follicles in the rat.
Biology of Reproduction, Feb 1, 1972
In an attempt to prevent chemotherapy-induced ovarian follic- ular loss, (o-Leu6, des-Gly10-NH2)-... more In an attempt to prevent chemotherapy-induced ovarian follic- ular loss, (o-Leu6, des-Gly10-NH2)-luteinizing hormone-releasing hormone ethylamide (LHRHa) was given subcutaneously to Sprague-Dawley cycling female rats in two daily doses of 2.5 /*g starting 2 days prior to and concomitant with cyclophosphamide (CTX) (5 mg/kg/day for 21 days). Four groups of female cycling rats (10 in each) received either no treatment, CTX
Annales de Biologie Animale Biochimie Biophysique, 1978
Evidence accumulated using prostaglandin synthesis inhibitors, prostaglandin measurements, or pro... more Evidence accumulated using prostaglandin synthesis inhibitors, prostaglandin measurements, or prostaglandin antibodies in several species has supported the concept that a gonadotropin-induced preovulatory rise in follicular prostaglandins is required for ovulation. There are at least three questions which need to be answered for a further understanding of this requirement : 1) What is the mechanism by which gonadotropin can stimulate prostaglandin synthesis ? 2) In which cell type(s) are prostaglandins produced, and upon which do they act ? 3) What are the actions of prostaglandins which participate in ovulation ? There have been recent advances which partially answer the first two questions. Gonadotropins appear to stimulate prostaglandin synthesis by increasing the quantities of follicular cyclic AMP (or possibly cyclic GMP). Derivatives of both nucleotides have been found to be effective exogenously. The effect of gonadotropin on prostaglandin synthesis also exhibits a delay of several hours and requires macromolecular synthesis. As to the first portion of question two, it appears that granulosa cells produce the bulk of follicular prostaglandins. It is not clear at this time, however, which cell(s) respond to the preovulatory rise in follicular prostaglandins, nor precisely how that response relates to ovulation.
Alaska medicine
A Neurilemmoma (also called Schwannoma) is a benign, slowly growing neoplasm of the Schwann cells... more A Neurilemmoma (also called Schwannoma) is a benign, slowly growing neoplasm of the Schwann cells which may occur in association with any nerve. Its finding in the cervix of the uterus is extremely rare. At a routine annual exam, a 47-year-old woman was found to have a tumor on the posterior lip of the cervix. The patient was completely asymptomatic. The tumor was excised using a large electrical loop (LEEP) and found to be a benign Neurilemmoma. Subsequently a CT scan of the pelvis did not reveal any other abnormalities and no further treatment was contemplated. A benign neurilemmoma can present on the cervix as a vascular appearing tumor. This is a most unusual location for this tumor which arises from the Schwann cell of a nerve sheet.
American journal of obstetrics and gynecology, 1984
In isolated, perfused rat ovaries, the addition of luteinizing hormone (LH) to the perfusion medi... more In isolated, perfused rat ovaries, the addition of luteinizing hormone (LH) to the perfusion medium consistently induced follicular ruptures. These ruptures were preceded by a marked increase in the levels of estradiol in the perfusion medium. The addition of 4-hydroxyandrostene-3,17-dione (4-OH-A) to the perfusion medium blocked this increase in estradiol, but did not prevent ovulation. Levels of estradiol in follicular fluid were also reduced during perfusion with LH plus 4-OH-A, in comparison to LH alone. The conclusion drawn was that the marked rise in the production of estrogen by preovulatory follicles of the perfused rat ovary, induced by an ovulatory dose of LH, is not required for ovulation to occur.
Reproduction, 1981
Rabbits were injected with 100 i.u. hCG to induce oocyte maturation. Oocytes removed from the ova... more Rabbits were injected with 100 i.u. hCG to induce oocyte maturation. Oocytes removed from the ovaries at various times and denuded showed increased oxygen consumption which began before the start of maturation.
Clinical examination and an open mind are two of the most powerful tools at a doctor’s disposal. ... more Clinical examination and an open mind are two of the most powerful tools at a doctor’s disposal. We report the surgical removal of a 17.5kg ovarian tumour in a patient with a raised body mass index who had been complaining of increasing abdominal girth for some time. It is clear from the literature that often the diagnosis of such lesions is delayed. With early clinical examination and consideration of the differential diagnosis of increasing abdominal girth, lesions such as this could be detected earlier. This would make the surgical treatment easier, would potentially reduce the spread of a tumour if it is found to be malignant, and would prevent the impaired function of a patient who carries such a lesion.
The journal of family planning and reproductive health care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists, 2015
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
At no time has an open discussion of the many issues that face the catholic family been more time... more At no time has an open discussion of the many issues that face the catholic family been more timely. On April 8th 2016, Pope Francis released his long awaited document on "Love in the Family" (Amoris Laetitia). 1 In this lengthy and comprehensive document the Pope summarizes the many statements made by himself since his ascendance to the Papacy in 2013 and the often contentious deliberations of the two Synods in Rome in 2014 and 2015 about issues related to the family. In this beautiful and sensitive written document, the Pope touches on issues that impact on the family, including, divorce, gay and lesbian marriage, sexuality and many other aspects of the family. One of the issues discussed by the Pope is family planning and it is on this issue that I would like to focus this discussion. The dilemma for the catholic practitioner The official position of the Roman Catholic Church (Church from here on) has for a long been time that artificial methods of family planning such as condoms and other barrier methods, contraceptive pills, patches and injections or implants, intrauterine devices and sterilization both male and female are opposed. Only the so called natural methods are allowed. 2 Using or prescribing artificial methods of family planning is considered a grave sin. This official position of the Church impacts not only on individual Catholic couples and patients but also has far reaching consequences for Catholic practitioners, including physicians (MD or DO), midwives, nurses, nurse practitioners, physician assistants and even health aides and anyone involved with the advice, prescription, injection, implantation or insertion of contraceptive medication or devices as well as male or female sterilization.
Prostaglandins, 1975
The concentrations of prostaglandin F (PGF) and prostaglandin E (PGE) were measured by radioimmun... more The concentrations of prostaglandin F (PGF) and prostaglandin E (PGE) were measured by radioimmunoassay in isolated Graafian follicles of mature female rats during the pre and post ovulatory period of the estrous cycle. The levels of these prostaglandins were low and relatively constant from 8 a.m. to 4 p.m. on the day of proestrus, but there was a marked increase at 8 p.m. of proestrus reaching an apparent maximum at midnight (PGF 18 fold, PGE 70 fold). By 4 a.m. to 8 a.m. on the morning of estrus these prostaglandins declined rapidly to levels similar to those observed between 8 a.m. and 4 p.m. on the day of proestrus. The increases in prostaglandin levels occurred after the LB peak and apparently before the time of ovulation. These data confirm the role of PGF and PGE in the local mechanism of ovulation in the normal adult of a spontaneously ovulating animal species.
Obstetrics and Gynecology, Nov 1, 2001
No cardiac measurements could be obtained from earlier ultrasounds.
J Clin Endocrinol Metab, 1983
The cytosol of human ovarian tissues was observed to promote protein phosphorylation in the combi... more The cytosol of human ovarian tissues was observed to promote protein phosphorylation in the combined presence of Ca2+, 1,2-diolein, and phosphatidylserine. Ca2+ alone or lipid alone did not produce full activation of this protein kinase(s). The addition of human erythrocyte calmodulin to the assay mixture, in the presence or absence of Ca2+, had no effect on protein kinase activity. Phosphorylation of cytosol proteins ranging in mol wt from 10,000 to 200,000 was selectively increased by Ca2+ plus lipid. This protein kinase activity may play a crucial role in the intracellular transmission of the action of hormones affecting cellular Ca2+ flux and/or phospholipid metabolism.
Obstet Gynecol Surv, 1974
The Journal of Pediatrics, Volume 83, Issue 5, Pages 851-853, November 1973, Authors:Patricia W. ... more The Journal of Pediatrics, Volume 83, Issue 5, Pages 851-853, November 1973, Authors:Patricia W. Conly, MD; William J. LeMaire, MD; Ellen F. Monkus, MD; William W. Cleveland, MD.
J Clin Endocrinol Metab, 1974
Gonadotropins and Gonadal Function, 1974
Endocrinology, 1978
LH stimulates an increase in prostaglandins in vitro in preovulatory follicles from rats pretreat... more LH stimulates an increase in prostaglandins in vitro in preovulatory follicles from rats pretreated with PMS gonadotropin. The role of cAMP in this action of LH was examined by incubating preovulatory follicles with various substances and determining the resultant prostaglandin (PG) E accumulation by radioimmunoassay. LH (5 microgram/ml) increased PGE accumulation to approximately 4 times the control (181 +/- 23 to 886 +/- 83 pg/follicle). The addition of 20 mM cAMP also stimulated PGE accumulation, and the addition of 20 mM cAMP in the presence of 0.5 mM 1-methyl-3-isobutylxanthine was as effective as LH. Other nucleotides such as ATP, ADP, 3'-AMP, 5'-AMP, cGMP, and O2'-monobutyryl-cAMP did not stimulate PGE accumulation. On the other hand, (Bu)2cAMP, 8-bromo-cAMP, and N6-monobutyryl-cAMP produced an increase in PGE accumulation similar to that observed with LH. In addition, 10 microgram/ml cholera toxin was shown to increase both cAMP and PGE accumulation in preovulatory follicles. These results indicate that the prostaglandin response of follicles is specific for cAMP-like nucleotides or substances capable of increasing intracellular cAMP. The data support the concept that cAMP mediates the effect of LH on PGE accumulation in preovulatory follicles in the rat.
Biology of Reproduction, Feb 1, 1972
In an attempt to prevent chemotherapy-induced ovarian follic- ular loss, (o-Leu6, des-Gly10-NH2)-... more In an attempt to prevent chemotherapy-induced ovarian follic- ular loss, (o-Leu6, des-Gly10-NH2)-luteinizing hormone-releasing hormone ethylamide (LHRHa) was given subcutaneously to Sprague-Dawley cycling female rats in two daily doses of 2.5 /*g starting 2 days prior to and concomitant with cyclophosphamide (CTX) (5 mg/kg/day for 21 days). Four groups of female cycling rats (10 in each) received either no treatment, CTX
Annales de Biologie Animale Biochimie Biophysique, 1978
Evidence accumulated using prostaglandin synthesis inhibitors, prostaglandin measurements, or pro... more Evidence accumulated using prostaglandin synthesis inhibitors, prostaglandin measurements, or prostaglandin antibodies in several species has supported the concept that a gonadotropin-induced preovulatory rise in follicular prostaglandins is required for ovulation. There are at least three questions which need to be answered for a further understanding of this requirement : 1) What is the mechanism by which gonadotropin can stimulate prostaglandin synthesis ? 2) In which cell type(s) are prostaglandins produced, and upon which do they act ? 3) What are the actions of prostaglandins which participate in ovulation ? There have been recent advances which partially answer the first two questions. Gonadotropins appear to stimulate prostaglandin synthesis by increasing the quantities of follicular cyclic AMP (or possibly cyclic GMP). Derivatives of both nucleotides have been found to be effective exogenously. The effect of gonadotropin on prostaglandin synthesis also exhibits a delay of several hours and requires macromolecular synthesis. As to the first portion of question two, it appears that granulosa cells produce the bulk of follicular prostaglandins. It is not clear at this time, however, which cell(s) respond to the preovulatory rise in follicular prostaglandins, nor precisely how that response relates to ovulation.
Alaska medicine
A Neurilemmoma (also called Schwannoma) is a benign, slowly growing neoplasm of the Schwann cells... more A Neurilemmoma (also called Schwannoma) is a benign, slowly growing neoplasm of the Schwann cells which may occur in association with any nerve. Its finding in the cervix of the uterus is extremely rare. At a routine annual exam, a 47-year-old woman was found to have a tumor on the posterior lip of the cervix. The patient was completely asymptomatic. The tumor was excised using a large electrical loop (LEEP) and found to be a benign Neurilemmoma. Subsequently a CT scan of the pelvis did not reveal any other abnormalities and no further treatment was contemplated. A benign neurilemmoma can present on the cervix as a vascular appearing tumor. This is a most unusual location for this tumor which arises from the Schwann cell of a nerve sheet.
American journal of obstetrics and gynecology, 1984
In isolated, perfused rat ovaries, the addition of luteinizing hormone (LH) to the perfusion medi... more In isolated, perfused rat ovaries, the addition of luteinizing hormone (LH) to the perfusion medium consistently induced follicular ruptures. These ruptures were preceded by a marked increase in the levels of estradiol in the perfusion medium. The addition of 4-hydroxyandrostene-3,17-dione (4-OH-A) to the perfusion medium blocked this increase in estradiol, but did not prevent ovulation. Levels of estradiol in follicular fluid were also reduced during perfusion with LH plus 4-OH-A, in comparison to LH alone. The conclusion drawn was that the marked rise in the production of estrogen by preovulatory follicles of the perfused rat ovary, induced by an ovulatory dose of LH, is not required for ovulation to occur.
I consider myself a reasonably good catholic, yet I feel marginalized by the church I love. This ... more I consider myself a reasonably good catholic, yet I feel marginalized by the church I love. This is why. I am a retired obstetrician and gynecologist and throughout my career I have been dealing, almost on a daily basis, with issues of family planning. I am fully aware that the Catholic Church opposes any artificial methods of contraception and sterilization. Only the so called " fertility awareness methods " are condoned. That is just fine for motivated and somewhat educated couples, with some access to medical care and teaching; also this approach works best if the women has regular menstrual cycles. Medical advances have made these methods more sophisticated and precise than the original method, based on just counting the days of the menstrual cycle and abstaining from intercourse on the so called fertile days.(1) Under ideal circumstances these natural methods have a high success and low failure rate, equal or better than some artificial methods. Yet they still require a fair amount of effort. In my practice I have certainly made these methods available to couples who opted for them and I have helped these couples in their use. Many are very satisfied with them. Under less than ideal circumstances however, these natural methods have a high and unacceptable failure rate.(2) This is especially true in developing countries and areas (like refugee camps) where people live in squalor, lack food and most basic living needs, have no or inadequate medical care, and women often have very irregular or absent menstrual cycles, so that the natural methods of family planning become utterly impractical. Yet the Catholic Church insists that only these natural methods are acceptable. Proponents of the natural methods will argue that some methods of contraception might actually operate by preventing implantation of a fertilized ovum, and thus could be considered an abortifacient, which is certainly unacceptable to the Church. I acknowledge that some of the artificial methods may alter the lining of the uterus to the point that an ovum, if fertilized anyway, will not implant (abortifacient?). The majority of evidence however, points to the fact that these methods prevent either sperm transport, ovulation, or both, rather than preventing implantation, and therefor should not be considered abortifacients in the vast majority of instances.(3) One other argument that is often raised in this type of discussion is that artificial methods of family planning may have serious side effects. I also acknowledge that that may be so, even though the risks are small. As an example, the relative risk for a serious blood clot formation, a life threatening event, in a woman taking the combined oral contraceptive pill is certainly increased, but the absolute risk is very small.(4) However a consideration that is mostly overlooked, is the complication rate of failed contraception resulting in a pregnancy. As I argued earlier, that failure rate is considerably higher for natural methods when applied to the overall world population. An unwanted pregnancy, or any pregnancy for that matter, especially in developing countries, carries with it the risk of serious morbidity and even mortality associated