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Biomedical subjects

C I Friedman

Publications and source records attributed to C I Friedman.

52 records · Page 3Linked to original sources
PubMed1987

Persistent progesterone production associated with autoimmune oophoritis. A case report.

A woman with autoimmune oophoritis was found to have luteal phase progesterone levels throughout a six-month period of amenorrhea. The common presentation of amenorrhea or metrorrhagia, despite the presence of a corpus luteum, in women with autoimmune oophoritis might result from this chronic progesterone production. A clinical picture consistent with a persistent corpus luteum may be a very early sign of autoimmune oophoritis.

Adult↗
PubMed1987

A rapid serum estrogen assay suitable for office use in monitoring follicular maturation.

Ovulation induction often requires the determination of serum estradiol levels. A rapid, sensitive, and simple non-radioactive serum estrogen assay was developed by modifying a hemagglutination-inhibition kit (Hi-Estrotec) originally designed to measure total urinary estrogens. With a minimum sensitivity of 100 pg of 17-beta-estradiol, the modified procedure generally takes less than 2.5 hours to complete and requires no special equipment or instrumentation. Randomly obtained serum samples assayed by both the hemagglutination-inhibition assay and radioimmunoassay achieved a correlation coefficient of 0.885 (P less than .001). Comparison of serum obtained from women undergoing ovulation induction with human menopausal gonadotropin-human chorionic gonadotropin measured by both techniques showed the same fluctuation pattern for serum estradiol levels during the stimulated cycles. The rapidity and reproducibility of this serum estrogen assay make it suitable for office use in monitoring ovulation induction and superovulation in in vitro fertilization-embryo transfer programs.

Estradiol↗
PubMed1986

The effects of enclomiphene and zuclomiphene citrates on mouse embryos fertilized in vitro and in vivo.

The ovulatory agent clomiphene citrate, a racemic mixture of the estrogenic zuclomiphene and antiestrogenic enclomiphene isomers, has been associated with gamete/embryo toxicity in various animal models. To assess the potential effects of these isomers on fertilization and early embryogenesis, 3200 embryos were obtained from mouse oocytes fertilized in vivo and in vitro and exposed to increasing concentrations of zuclomiphene, enclomiphene, and clomiphene citrate in culture. Fertilization rates (p less than 0.01), blastocyst formation rates (p less than 0.02), and degeneration rates (p less than 0.005) were all adversely affected in a dose-dependent fashion. There were no statistically significant differences between the two isomers. Preincubation with 17 beta-estradiol did decrease the degenerative changes induced by clomiphene citrate but did not improve the decreased rate of blastocyst formation. These findings suggest adverse effects of a high concentration of clomiphene citrate and its isomers on fertilization and early mouse embryo growth that may have implications in the clinical use of this drug.

Animals↗
PubMed1986

Intraluminal urethral pressure measurements in the female baboon: effects of hormonal manipulation.

Four female baboons underwent cystometry and simultaneous urethral pressure profilometry (UPP) in a hypoestrogenic castrate state, after estrogen treatment, and after concurrent testosterone and estrogen treatment. Studies were performed under general anesthesia both before and after skeletal muscle paralysis. The results provide objective evidence that estrogen replacement enhances the urethral sphincter mechanism in the castrate female baboon by significantly increasing the paralyzed and nonparalyzed urethral length as well as the paralyzed total UPP area and the paralyzed UPP area to maximum urethral closure pressure (MUCP). The area increases reflected both the increase in functional urethral length as well as increases in mean urethral pressure. Muscle paralysis significantly reduced MUCP in all three hormonal states. The addition of testosterone had no significant effect on the UPP measurements. These findings are discussed in light of conflicting human studies regarding objective evidence for the role of hormonal modulation of urethral function and the role of estrogen therapy for stress urinary incontinence.

Animals↗
PubMed1986

Oxidized cellulose for preventing adnexal adhesions.

Oxidized cellulose gauze (Surgicel) was evaluated for its ability to prevent postsurgical pelvic adhesions. Ten New Zealand white female rabbits were subjected to laparotomy and standardized bilateral trauma to the fimbria and ovaries. On one side in each rabbit the ovary and uterine tube were wrapped in Surgicel. The untreated side in each rabbit served as the control. Four weeks later the rabbits' pelvises were reexplored, and the adhesions on both sides were scored. The overall adhesion scores on the treated sides (mean +/- SD = 4.24 +/- 1.28) were significantly higher than those on the control sides (mean +/- SD = 1.5 +/- 1.06, P less than .001). Surgicel appeared to enhance, rather than prevent, adhesion formation in the rabbits.

Adnexal Diseases↗
PubMed1985

Premenstrual syndrome: concerns, controversies, and treatment.

Premenstrual syndrome is of interest to health care professionals today because of media attention and large numbers of women who are concerned about their premenstrual symptoms. At the same time, there is a lack of consensus as to diagnostic criteria and specific treatment. There appears to be a relationship between mood disorders such as major depression and luteal phase symptoms. An approach to the diagnosis and treatment of the patient with premenstrual syndrome is described.

Antidepressive Agents↗
PubMed1985

Embryo toxicity of clomiphene citrate on mouse embryos fertilized in vitro and in vivo.

The effect of the ovulatory agent clomiphene citrate on fertilization and early embryogenesis was investigated with the use of in vitro fertilized mouse oocytes. Alterations in early embryogenesis with clomiphene citrate exposure were further studied with the use of embryos obtained from mouse oocytes fertilized in vivo. In the nontreated group, the fertilization rate was 81%, and 61% of the oocytes reached the blastocyst stage by 96 hours. Both fertilization and blastocyst formation declined in a dose-dependent fashion when clomiphene citrate was added to the culture media in concentrations greater than or equal to 10 micrograms/ml (p less than 0.001). The rate of progressive embryo cleavage was also slower at 48 and 72 hours after drug exposure. Mouse embryos fertilized in vivo demonstrated similar findings, with decreased blastocyst formation and increased degeneration rates, again at clomiphene citrate concentrations greater than or equal to 10 micrograms/ml (p less than 0.01). Exposure to the drug beyond 24 hours had no additional effect. It appears that clomiphene citrate-exposed embryos may undergo subtle changes that later manifest themselves in the form of decreased embryo growth rates and increased embryo degeneration rates.

Animals↗
PubMed1985

Serum testosterone concentrations in the evaluation of androgen-producing tumors.

During a 5-year study period 18 women with a serum testosterone concentrations of greater than 2 ng/ml were evaluated for a possible androgen-producing tumor. All subjects were hirsute and had menstrual irregularities, with the exception of one postmenopausal woman. The majority of the women were obese and 72% were greater than 50% over ideal body weight. Only two of 11 women undergoing operative and histologic evaluation of the ovaries were found to have an androgen-producing neoplasm. Seven additional women with serum testosterone concentration of greater than 2 ng/ml have been followed for over 1 year with no additional evidence of an androgen-producing neoplasm. The poor predictive value of a serum concentration of greater than 2 ng/ml in identification of an androgen-producing neoplasm is partially explained by the apparent prevalence of high testosterone concentrations in chronically anovulatory, hyperandrogenic obese women and by the large coefficient of variation observed in this study when analyzing testosterone concentrations were analyzed over an 8-hour interval (range, 3% to 42%). In the absence of an adnexal mass or rapidly progressive virilization, it is suggested that the use of venography or operative exploration to diagnose an androgen-producing neoplasm be reserved for women with a mean testosterone concentration derived from three daily samples that is at least 2.5 times greater than the upper range of normal in the given laboratory.

Androgens↗
PubMed1984

Immunologic parameters in premature follicular depletion: T and B lymphocytes, T-cell subpopulations, cutaneous reactivity, and serum immunoglobulin concentrations.

In 13 women with premature follicular depletion (PFD) the concentration of T and B lymphocytes, T-cell subpopulation, and serum immunoglobulins was determined. Intending to study only women where no obvious cause for PFD existed, including autoimmune disease, five women were excluded because of significant titers of microsomal antibodies or antinuclear antibodies. In the remaining eight women a reduction in the percent of OKT4 (helper) lymphocytes (42.8 +/- 66 vs 50.7 +/- 3.7, P less than 0.005), the ratio of OKT4/OKT8 (suppressor/cytotoxic) lymphocytes (0.96 +/- 0.27 vs 1.6 +/- 0.25, P less than 0.001), and serum concentration of IgA (124 +/- 53 vs 210 +/- 81.5 mg/dl, P less than 0.01) were found compared to a control population. The concentration of T and B lymphocytes, IgG, IgM, and the cutaneous reactivity to mumps and candida antigens were similar in the two populations. It is hypothesized that a mild immune deficiency may predispose to PFD.

Antibodies↗
PubMed1983

Hypergonadotropic hypogonadism.

Etiologic factors in hypergonadotropic hypogonadism are discussed. On the basis of these data a classification system is proposed for women with hypergonadotropic hypogonadism to be used in future investigations of the natural history of this disorder. The classification system can also be used in attempts at therapeutic intervention in these women. Recommendations for clinical management and future studies of women with hypergonadotropic hypogonadism are provided.

Adult↗
PubMed1982

Serum lipoprotein responses during active and stable weight reduction in reproductive obese females.

An increase in high density lipoprotein-cholesterol (HDL-C) and a reduction in low density lipoprotein-cholesterol (LDL-C) accompany weight reduction in obese males. In contrast, obese females have had variable responses in these two lipoproteins after weight reduction. To evaluate the effects of weight reduction in obese women, 15 morbidly obese eugonadotropic women of reproductive age had serum lipids and lipoproteins measured before and after achieving a stable and reduced weight by either diet and/or a gastric stapling procedure. Total testosterone (T), free testosterone (free T), and testosterone-binding globulin serum concentrations were also determined before and after achieving a stable reduced weight to assess the role of androgens in modulating any lipoprotein changes. In 10 subjects, lipid analysis was also performed during active weight loss. Total serum triglycerides fell from 106 +/- 53 to 76 +/- 30 mg/dl during active weight loss (P less than 0.025). Total cholesterol, LDL-C, HDL-C, and the LDL-C to HDL-C ratio did not change. In contrast, after achieving a stable reduced weight (mean weight reduction, 25.9 +/- 6.7 kg), HDL-C rose from 24 +/- 8 to 32 +/- 9 mg/dl (P less than 0.005). This was accompanied by a reduction in LDL-C from 145 +/- 23 to 135 +/- 30 mg/dl (P less than 0.01) and in the LDL-C to HDL-C ratio from 6.7 +/- 2.6 to 4.8 +/- 1.9 (P less than 0.001). Total triglycerides and total cholesterol were unchanged. After obtaining a stable reduced weight, testosterone-binding globulin increased and free T fell, but no significant correlation existed between the changes in androgens and the changes in lipoprotein responses. Thus, in morbidly obese women, weight reduction increases HDL-C and lowers LDL-C serum concentrations. The reduction in the LDL-C to HDL-C ratio suggests that weight loss may favorably reduce the risk of coronary artery disease in these patients. A concurrent reduction of free T with weight loss does not appear to be a major controlling influence in these lipoprotein alterations.

Adult↗
PubMed1981

Hormonal screening of hyperestrogenic, elderly, obese females for a granulosa cell tumor.

Two elderly, obese, postmenopausal patients demonstrated, for their age, inappropriate estrogen stimulation, elevated serum concentrations of estrone (E1) and estradiol (E2) and low serum concentrations of gonadotrophins. Hormonal evaluations before and after hysterectomy and bilateral salpingo-oophorectomy are reported. The first patient represents the eighth reported case of a granulosa cell tumor with documented preoperative and postoperative estrogen serum concentrations. Though the second patient had no evidence of an ovarian neoplasm, she demonstrates the complexity of attempting to preoperatively diagnose an early granulosa cell tumor in the elderly, obese female by hormonal profiles. The contribution of gonadotrophins and estrogens in making this diagnosis is discussed.

Aged↗
PubMed1980

The effect of ampicillin on oral contraceptive effectiveness.

The effectiveness of oral contraceptives with concomitant use of ampicillin has been questioned. Eleven volunteer subjects were studied during 2 consecutive menstrual cycles; they were given Demulen with placebo or ampicillin during each of the cycles. Serum estradiol (E2), progesterone (P4), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were evaluated on days 13 and 19 of each cycle. Testosterone-binding globulin (TeBG) capacity and ferning of cervical mucus were evaluated on day 13 of each cycle. Subjective symptoms were recorded. All cycles appeared to be anovulatory. Steroid suppression was present in 10 of 11 patients during both cycles. Estrogen-dependent TeBG was not affected by ampicillin. It is possible that cervical mucus ferning was improved by concurrent ampicillin administration. Ampicillin appears unlikely to diminish the effectiveness of the oral contraceptive studied.

Adult↗
PubMed1979

Vasoactive intestinal polypeptide in tissues of the human female reproductive tract.

Vasoactive intestinal peptide (VIP) is a known potent hypotensive and vasodilatory agent. Studies were performed to determine the possible role of VIP in the human menstrual cycle in 44 patients in the reproductive age group, some of whom were using oral contraceptives, three pregnant patients, and four postmenopausal patients. No significant relationship between VIP and menstrual cycle phase was found.

Cervix Uteri↗