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Biomedical subjects

B M Sherman

Publications and source records attributed to B M Sherman.

At least 55 records · Page 3Linked to original sources
PubMed1982

Decreased glucocorticoid receptor binding in adrenal insufficiency.

To examine the effect of glucocorticoid deficiency on the glucocorticoid receptor, we examine the binding of [3H] dexamethasone to lymphocytes in normal subjects and patients with adrenal insufficiency before and after glucocorticoid replacement therapy. Using a whole cell competitive binding assay, normal human lymphocytes had 5977 +/- 1487 (mean +/- SD) binding sites/cell and a dissociation constant of 10 +/- 2 nM. Lymphocytes from patients with untreated adrenal insufficiency had fewer binding sites (3364 +/-322) and a 2-fold increase in binding affinity (5.4 +/- 0.9 mM). The administration of conventional replacement doses of cortisone acetate for 6 months caused no change in receptor number, but was associated with a decrease in binding affinity toward normal. After long term glucocorticoid replacement therapy, binding parameters were similar to those in patients before treatment. The physiological implications of the decreased receptor number and increased binding affinity in adrenal insufficiency remain to be elucidated.

Adrenal Insufficiency↗
PubMed1982

Cyclic ovarian function and breast cancer.

We postulated previously that systematic differences in menstrual cycle length and/or variability might be used as indicators of underlying hormonal abnormalities that could help explain the endocrine biology of some breast cancer risk factors. In the present study, we prospectively and retrospectively analyzed menstrual cycle patterns in breast cancer cases and controls in two populations. No significant differences were found. This and previous studies emphasize that contemporary women have a long reproductive experience characterized by uninterrupted, regular menses, which is a condition of maximum ovulation potential and which contributes to estrogen stimulation over time.

Adolescent↗
PubMed1981

Danazol: endocrine consequences in healthy women.

We studied the effects of danazol on pituitary and gonadal function in seven normal women who volunteered to take danazol, 400 mg twice daily, for 2 months. We measured circulating levels of sex steroids, gonadotropins, and prolactin on alternate days throughout a control menstrual cycle and during treatment. Danazol inhibited ovulation in all subjects. The amenorrheic state induced by danazol was characterized by normal basal levels of gonadotropins, prolactin, and estrogen. Serum androgen levels were significantly increased as was the urinary excretion of 17-ketosteroids. The LH and FSH responses to gonadotropin-releasing hormone were enhanced during treatment, and there was a normal LH rise following administration of estradiol valerate, indicative of intact positive feedback. These observations fail to support the contention that danazol suppresses pituitary gonadotropin secretion or directly inhibits steroidogenesis. The results suggest that danazol may have a primary site of action at the ovary by suppressing the normal, orderly process of follicular maturation.

Adult↗
PubMed1981

The effects of anti-leukemic therapy on gonadal histology in adult males.

Testicular histologic findings in 29 male patients who died of acute leukemia or blastic phase of chronic myelogenous leukemia are reviewed to evaluate the effect of therapy on morphology. Four histologic groups were identified that correlated with the duration of treatment: (1) normal testes associated with no therapy or therapy for less than 30 days; (2) maturation arrest in those treated for five days to 40 months; (3) hypospermatogenesis in those treated from 17 days to 84 months; and (4) Sertoli cells only in those treated from between three and 63 months. These histologic patterns correlated more with the duration of therapy than the type of anti-leukemic therapy used. There was some variability in the histologic effects among individuals receiving comparable durations and types of chemotherapy. In many patients who received extensive therapy, spermatogonia remain which may allow recovery of spermatogenesis and fertility.

Adult↗
PubMed1981

The relationship of menopausal hot flushes to medical and reproductive experience.

Information regarding the relationship of menopausal hot flushes to menstrual, reproductive and clinical events were obtained from women participating in a case-control study of breast cancer risk. Naturally menopausal women who reported the occurrence of menopausal hot flushes were compared with those without such complaints in an attempt to identify factors that might predict the occurrence of menopausal symptoms. Two-thirds of the women reported such symptoms. The symptomatic and asymptomatic groups did not differ in body weight, suggesting that extraglandular estrogen production in obese women does not protect against occurrence of menopausal symptoms. Neither past medical nor reproductive history were predictive of the occurrence of hot flushes. Women with hot flushes more commonly reported the occurrence of menstrual cycle variability and of long menstrual cycles during the 5 years before menopause. Since perimenopausal cycle variability probably reflects the irregular maturation of residual ovarian follicles accompanied by elevated gonadotropin concentrations, symptomatic women may have earlier activation of the neuroendocrine mechanism that has been associated with both pulsatile gonadotropin release and the hot flush.

Adolescent↗
PubMed1981

Abnormal regulation of prolactin secretion after successful surgery for prolactin-secreting pituitary tumours.

Patients with prolactin-secreting pituitary tumours have a diminished prolactin (PRL) response after administration of a variety of stimulatory agents, including thyrotrophin-releasing hormone (TRH), chlorpromazine (CPZ) and insulin-induced hypoglycaemia. We examined responses to these agents in sixty-seven women with PRL-secreting tumours before and after trans-sphenoidal surgery. Twenty-nine of the women were cured as defined by restoration of normal serum PRL concentrations and resumption of regular menses. One year following trans-sphenoidal surgery, patients with normal PRL concentrations and regular menses had normal PRL responses to TRH, while the responses to CPZ and insulin hypoglycaemia were not improved. The reversible impairment of PRL response to TRH reflects suppressed function of normal PRL-secreting cells, and the persistence of abnormal PRL responses to provocative stimuli after successful tumour removal may reflect some fundamental defect in the regulation of PRL secretion in patients with PRL-secreting adenomas. When growth hormone (GH) reserve after insulin hypoglycaemia was represented as the mean absolute increment above the basal concentration and compared with normal subjects, women with PRL-secreting tumours had a diminished response that returned to normal after successful surgery. This reversible impairment of GH secretion is not adequately reflected by standard criteria for GH response and suggests that PRL may have a role in the regulation of GH secretion.

Adenoma↗
PubMed1980

Hypothalamic-pituitary-adrenal axis activity in depressive illness. Its relationship to classification.

Serum cortisol response to the 1-mg overnight dexamethasone suppression test was studied in 221 depressed patients and 109 nondepressed psychiatric controls. Nonsuppression distinguished patients with primary unipolar depression (65/146) from patients with secondary unipolar depression (0/42) and nondepressed controls (0/109). Furthermore, nonsuppression distinguished the three familial subtypes of primary unipolar depressive illness: familial pure depressive disease (FPDD; 38/50 patients), sporadic depressive disease (SDD; 24/55 patients), and depression spectrum disease (3/41 patients). Moderate elevations in baseline serum cortisol levels were found in FPDD, SDD, and bipolar depression. Medication did not affect the results. The data suggest that the depressive syndrome is composed of separate illnesses, each of which has a distinctive pattern of hypothalamic-pituitary-adrenal axis activity during the depressed state as well as a specific clinical and familial psychiatric history.

Adolescent↗
PubMed1980

A relationship between artifical menopause, previous estrogen consumption, and estrogen receptor content of breast neoplasms: preliminary communication.

A history of prior total bilateral oophorectomy and exogenous estrogen use was elicited from 45 women with breast surgery for cancer, 19 of whose neoplasms were estrogen receptor (ER) positive and 26 ER negative. In the ER-positive group there was a history of oophorectomy in 0/19 and estrogen use in 3/19. In the ER-negative group, corresponding values were 8/26 and 12/26 (p less than 0.05). Manipulation of the female hormonal milieu during or prior to the menopause may be related to the subsequent ER status of incident breast cancers.

Breast Neoplasms↗
PubMed1980

Bromocriptine.

Explore the source record for details and available documents.

Acromegaly↗
PubMed1979

Probability of menopause with increasing duration of amenorrhea in middle-aged women.

The empirical percent probability that natural menopause has occurred after first presentation of amenorrhea of various durations in women greater than or equal to 45 years of age has been calculated using data from a cohort of subjects who prospectively recorded menstrual flow and related gynecologic events. The probability that menopause has occurred increases with the amenorrheal interval (duration), and for a given interval, the probability increases with age. After 180 days of amenorrhea, 45% to 72% of subjects were menopausal; after 360 days, 90%. These data may offer assistance in advising patients on the probability of menopause and the continuance of contraceptive practices, and in considering whether late genital bleeding after amenorrhea represents a physiologic or pathologic process.

Age Factors↗
PubMed1979

Genetic subtypes of unipolar primary depressive illness distinguished by hypothalamic-pituitary-adrenal axis activity.

Serum-cortisol response to the 1 mg overnight dexamethasone suppression test was investigated in 86 patients with unipolar primary depressive illness and 80 non-depressed controls (45 with mania and 35 with schizophrenia). The depressed patients were assigned to one of three genetic subtypes according to the family psychiatric history. Resistance to suppression of serum-cortisol by dexamethasone was found in 37 of 86 (43%) depressives and none of the 80 controls. Non-suppression distinguished the three genetic subtypes of depression, being found in 23 of 28 (82%) patients with familial pure depressive disease (F.P.D.D.), 13 of 35 (37%) patients with sporadic depressive disease (S.D.D.), and 1 of 23 (4%) patients with depression spectrum disease (D.S.D.). The three genetic subtypes were further distinguished by the age of onset, with S.D.D. the oldest, and by the number of previous depressive episodes, with F.P.D.D. the most. Severity of depression did not separate the three subtypes. This is the first report of a distinct neuroendocrine abnormality which supports an objectively defined classification of unipolar primary depressive illness. It is suggested that unipolar primary depressive illness is three or more separate illnesses, each with a potentially distinctive mode of inheritance, pathophysiology, neurochemistry, clinical course, and treatment response.

Adolescent↗
PubMed1979

Variations in the reporting of menstrual histories.

This investigation examined the accuracy of recall of females to questions concerning ages at memarche, natural and surgical menopause, first use of oral contraceptives and mean menstrual cycle length and variance. A sample of 160 women who had recorded their menstrual and reproductive events as they occurred were administered a questionnaire concerning these events, with responses compared to the original data. For the variables age at menarche, age at natural memopause, age at surgical menopause and age at first use of oral contraceptives, the percentage of women who correctly recalled within a year ranged from 75% to 90%. Recollection of menstrual cycle length and variability by interview was considered unreliable. These findings are encouraging regarding the ability to recall the age when certain menstrual and reproductive events occur, but not for menstrual cycle intervals or patterns. Because these women were well-educated and had once recorded study variables, these results might be considered optimal.

Adult↗
PubMed1979

Hormonal regulation of the menstrual cycle in women with breast cancer: effect of adjuvant chemotherapy.

The hormonal features of the menstrual cycle determined by measurement of serum LH, FSH, oestradiol, progesterone and prolactin were normal in thirteen breast cancer patients clinically disease free and not taking anti-tumour therapy. Results of similar studies during seven menstrual cycles in four patients on an adjuvant therapy programme of L-phenylalanine mustard (L-PAM) + 5-flurouracil (5-FU) also had normal hormonal characteristics after three to fourteen courses of chemotherapy. Amenorrhoea with elevated gonadotrophins occurred after seven courses of chemotherapy in one 48-year-old woman. Adjuvant chemotherapy does not appear to result in major alterations in hormone secretion during menstrual cycles of women who continue to menstruate while on therapy.

Adult↗
PubMed1979

Endocrine consequences of continuous antiestrogen therapy with tamoxifen in premenopausal women.

Daily administration of estrogen antagonists to premenopausal women has been incorporated into the adjuvant treatment of breast cancer. We have studied the changes in reproductive hormones, pituitary responses to hypothalamic-releasing hormones, and endometrial histology during treatment with the antiestrogen tamoxifen in five healthy, premenopausal women. These studies were carried out during one menstrual cycle before and during two cycles of antiestrogen treatment. All subjects continued to have regular menses with biphasic basal body temperature records. During treatment, estradiol (E2) levels were increased but followed the usual pattern reflecting follicular maturation and corpus luteum formation. The mean E2 concentration at the midcycle peak and during the luteal phase was twice that observed during the non-treatment cycle. By contrast, the concentrations and secretory patterns of luteinizing hormone and follicle-stimulating hormone were not greatly changed, and the gonadotropin responses to gonadotropin-releasing hormone were not suppressed. Endometrial biopsies obtained during the follicular phase of control and tamoxifen treatment cycles showed no differences whereas biopsies obtained during the luteal phase of tamoxifen cycles uniformly showed a lack of changes attributed to progesterone action with no progression of histologic changes beyond those expected on day 7-8 of the luteal phase. These observations are consistent with maturation of multiple ovarian follicles, a surprising finding considering the normal gonadotropin concentrations. The retarded development of the endometrium in the presence of supranormal serum E2 and progesterone concentrations is a morphologic demonstration of the antiprogestational effect of antiestrogens. The lack of gonadotropin suppression in the presence of hyperestrogenemia suggests a major antiestrogen action on the hypothalmus and pituitary gland.

Adult↗
PubMed1979

Coexistent empty sella and prolactin-secreting microadenoma.

The empty sella turcica may be found in people with no antecedent history of intracranial disease, as well as in those with known pituitary pathology or following therapy to the pituitary gland. We have evaluated 3 women with galactorrhea and hyperprolactinemia, 2 of whom had amenorrhea. Each had an empty sella. In all cases polytomograms demonstrated asymmetry of the sella floor with focal bony erosion, conventional pneumoencephalography showed intrasellar air, and polytomographic pneumoencephalography confirmed air limited to one side of the pituitary fossa with tumor and/or residual normal tissue on the opposite side. In 2 patients who had extensive endocrine evaluation, pituitary function was normal with the exception of hyperprolactinemia. Transsphenoidal excision of microadenomas resulted in postoperative normalization of the serum prolactin concentration and resumption of regular menses in the previously amenorrheic women.

Adenoma↗
PubMed1978

Pathogenesis of prolactin-secreting pituitary adenomas.

42 women with amenorrhoea and hyperprolactinaemia had trans-sphenoidal surgery and resection of histologically verified pituitary adenomas. 74% of these patients developed amenorrhoea and/or galactorrhoea in immediate association with the use or discontinuation of oral contraceptives or post partum. There was enough adenomatous tissue for immunocytochemical studies in 35 specimens and specific localisation of prolactin was possible in 31. There is evidence that about 10% of the population have small pituitary tumours, and the majority of these tumours, though asymptomatic, are potentially prolactin-secreting. It is suggested that oestrogens, which are known to modulate prolactin secretion in normal human beings and in animals, can induce the growth and expression of otherwise silent pituitary lesions and that this should be considered a risk of oral-contraceptive use.

Adenoma↗