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Biomedical subjects

I Cohen

Publications and source records attributed to I Cohen.

At least 163 records · Page 9Linked to original sources
PubMed1996

Clinical significance of endometrial fluid collections in asymptomatic postmenopausal women.

Routine vaginal ultrasonographic evaluation of pelvic organs was performed in asymptomatic postmenopausal women to evaluate the diagnostic significance of sonographic findings of endometrial fluid collections in the presence of a thin endometrium in postmenopausal women. The study included nine women aged 61 to 79 years who had been postmenopausal for 7 to 30 years, and in whom endometrial fluid collections were incidently demonstrated. Endometrial samplings followed the ultrasonographic examinations in all nine patients, and the correlation between the histologic report and the endometrial ultrasonographic thickness was evaluated. The diameter of the endometrial fluid collections varied from 3 to 12 mm. The thickness of the endometrium surrounding the fluid ranged from 1 to 3 mm. Of the nine endometrial samples examined, five revealed atrophic endometrium, three had insufficient material for histologic evaluation, and one specimen revealed well-differentiated adenocarcinoma. The woman in whom endometrial carcinoma was diagnosed underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and lymph node sampling. The pathologic examination confirmed the previous histologic finding, and deep penetration into the myometrium was noticed with intact lymph nodes. Endometrial fluid collections found in asymptomatic postmenopausal patients still may be associated with endometrial malignancy, even in the presence of thin endometrium.

Adenocarcinoma↗
PubMed1996

LY353433, a potent, orally effective, long-acting 5-HT(4) receptor antagonist: comparison to cisapride and RS23597-190.

Although many 5-HT (serotonin, 5-hydroxytryptamine)(4) receptor antagonists have been described, none possess the requisite oral activity and duration of action for a clinically effective therapeutic agent. The present report identifies LY353433 (1-(1-methylethyl)-N-[2-[4-[tricyclo[3.3.1.1(3,7)]dec-1-ylcarbo nyl) amino]-1-piperidinyl]ethyl]-1H-indazole-3-carboxamide), an indazole amide, as a high affinity antagonist at the 5-HT(4) receptor in the rat esophagus. LY353433 (10(-8), 3 x 10(-8), 10(-7) M) inhibited 5-HT-induced relaxation of carbamylcholine-contracted esophagus with greater potency than cisapride or RS23597-190, a known 5-HT(4) receptor ligand. Furthermore, RS23597-190 possessed marked agonist activity as did cisapride, whereas LY353433 did not relax the rat esophagus in concentrations up to 10(-5) M. LY353433 (up to 10(-5) M) did not possess appreciable affinity for adrenergic, dopaminergic, histaminergic, muscarinic or GABAergic receptors and, thus, was a highly selective 5-HT(4) receptor antagonist. In addition, LY353433 only slowly associated with an dissociated from the 5-HT(4) receptor, an attribute that conferred long-lasting 5-HT(4) receptor antagonist activity, in contrast to RS23597-190, which rapidly dissociated from the 5-HT(4) receptor. LY353433 dose-dependently inhibited the 5-HT(4) receptor-mediated ex vivo relaxation in the rat esophagus after either i.v. (0.1, 0.3 and 1.0 mg/kg) or p.o. (0.1, 0.3, 1.0 and 3.0 mg/kg) administration. Furthermore, the p.o. to i.v. dose ratio was approximately one, suggesting that LY353433 was well absorbed with excellent pharmacodynamics in the rat. LY353433 (0.3 mg/kg p.o.) blocked esophageal 5-HT(4) receptors ex vivo through 6 hr after p.o. dosing with responses returning to control by 16 hr, indicative of long duration receptor blockade. Lastly, in rats LY353433 was exceptionally safe because acute doses up to 300 mg/kg p.o. did not result in either symptoms or deaths. Thus, LY353433 is a potent, selective, orally effective, long-acting and safe 5-HT(4) receptor antagonist that is highly suitable for clinical use.

Adamantane↗
PubMed1996

Ontogeny of growth hormone protein and mRNA in the gilthead sea bream Sparus aurata.

The ontogeny of growth hormone (GH) protein and mRNA was studied in the gilthead sea bream Sparus aurata by Northern blot, reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analyses. Total RNA was prepared from a pool of larvae collected on different days after hatching. When hybridized to Sparus aurata GH cDNA, GH specific mRNA was first seen on day 3 post-hatching. Levels increased on subsequent days and reached the highest levels on day 9; thereafter a decrease was noted to similar levels between days 10 and 16. RT-PCR amplification of larval RNA showed an amplified fragment on day 3, which hybridized to Sparus aurata GH cDNA but not on days 1 and 2 after hatching. Soluble proteins were electrophoresed and immunoreacted with antibodies raised against purified Sparus GH. A faint band was detected on day 2 after hatching, which had an electrophoretic mobility very similar to recombinant tilapia GH or Sparus pituitary extract. The immunoreactive material increased on days 3, 4 and 6. Specificity of the immunoreaction was demonstrated by the ability of recombinant tilapia GH to complete with GH bound to the membrane and inability of normal rabbit serum (NRS) to detect GH on the membrane. Our results suggest that both GH mRNA and protein are expressed in Sparus aurata shortly after hatching.

Aging↗
PubMed1996

Gender-dependent morality and gender rights in medical school ethics.

Evidence exists in the medical literature that medical treatment decision making by physicians may be unduly influenced by irrelevant forces, such as the gender of the physician and the patient. This article provides some evidence that this tendency already exists in medical schools and is growing.

Adult↗
PubMed1996

Nucleotide sequence of the promoter region of Sparus aurata insulin-like growth factor I gene and expression of IGF-I in eggs and embryos.

A genomic fragment of 3.1 kb, containing the promoter region of Sparus aurata insulin-like growth factor I (IGF-I) gene has been cloned and sequenced. This fragment contains exon 1 and exon 2 of Sparus aurata IGF-I gene. These two exons are identical in organization to the reported chum salmon IGF-I gene. Exon 1 contains 5' untranslated region and part of the signal peptide. Exon 2 codes for part of the signal peptide and part of the B domain. Nested polymerase chain reaction (PCR) revealed that a fragment was amplified from liver RNA when a common primer in the translated region and a primer located between 375 and 395 nucleotides upstream of the first methionine were used. No such amplification was obtained when the primer was located between 414 and 434 nucleotides upstream of the first methionine, suggesting that the first exon in Sparus IGF-I gene starts 400-410 nucleotides upstream of the first methionine. Expression of IGF-I mRNA was studied in Sparus aurata using reverse transcription (RT)-PCR. An amplified fragment was found in unfertilized eggs and in embryos 4, 8, and 12 hours after fertilization, when oligonucleotides specific for Sparus aurata IGF-I cDNA were used. A similar fragment was found when adult liver or one-day larval RNA were used. This fragment hybridized in a Southern blot to salmon IGF-I cDNA. These results demonstrate that the structure of IGF-I gene has been conserved in teleosts and IGF-I transcripts are present in fish during embryogenesis, probably of maternal origin.

Amino Acid Sequence↗
PubMed1995

Gender-related differences in clinical management after exercise nuclear testing.

OBJECTIVES: This study sought to determine the rate of referral to cardiac catheterization in men and women early after nuclear testing as a function of the magnitude of myocardial ischemia by radionuclide perfusion imaging. BACKGROUND: Although many previous studies have suggested that gender-related differences are present in the clinical management of coronary artery disease, the presence of such a difference with respect to referral to catheterization after noninvasive testing is disputed. METHODS: We examined 3,211 consecutive patients (1,074 women, 2,137 men) who underwent exercise dual-isotope single-photon emission computed tomography and had follow-up evaluation performed at least 1 year after nuclear testing (mean [+/- SD] follow-up 19 +/- 5 months) for "hard" events (cardiac death and myocardial infarction) and referral to cardiac catheterization or revascularization within 60 days of nuclear testing. Multiple logistic regression analysis was performed to determine the best predictors of referral to catheterization as well as to examine whether gender itself added further information to this model. RESULTS: Although men were referred to catheterization more frequently than women (10.6% vs 7.1%, p < 0.001) early after exercise nuclear testing, there were no differences in the rate of referral to catheterization or revascularization after stratification by the amount of abnormally perfused myocardium detected by the nuclear scan. Both men and women with normal scan results were infrequently referred to subsequent catheterization. In the setting of severe ischemia, women were referred to catheterization more frequently than men. This higher rate appears to be clinically appropriate because women with severely abnormal scan results had a significantly higher event rate than men (17.5% vs. 6.3%, p < 0.0001). This greater risk in women than in men appeared to be underappreciated because the increased rate of hard events in women with severely abnormal scan results was out of proportion to the smaller increase in their rate of referral to cardiac catheterization. Although gender added information to the multivariate model most predictive of referral to catheterization models when nuclear variables were not included, when nuclear variables were considered, the addition of gender added no further significant information. This finding suggests that adjusting for differences in perfusion scan abnormalities by the use of nuclear testing eliminated the apparent gender-related referral bias. CONCLUSIONS: After controlling for differences in perfusion scan abnormalities, no gender-related referral bias to catheterization was present. In the setting of severe ischemia, women had a greater rate referral to catheterization than men. As a function of risk, both men and women were appropriately referred to catheterization at a low rate when the scan result was normal. However, because women with severe perfusion abnormalities had a greater rate of cardiac death and myocardial infarction then men, women in this high risk subgroup were underreferred to catheterization relative to men. This finding points to the need to better identify women at high cardiac risk.

Aged↗
PubMed1995

Prior restraint: a Bayesian perspective on the optimization of technology utilization for diagnosis of coronary artery disease.

In conclusion, at least 1/3 of patients with suspected coronary artery disease are inappropriately referred for scintigraphic diagnostic testing from a Bayesian such as those described in this report, may be a powerful mechanism for encouraging more appropriate technology utilization while simultaneously controlling costs, and are thereby deserving of a formal prospective demonstration trial. However, since only half the patients currently being tested are referred for diagnostic purposes, analogous strategies must be developed with respect to prognostic and therapeutic evaluation.

Aged↗
PubMed1995

Renal hydatid cyst: urinary cytological diagnosis.

Echinococcal disease is endemic in many areas of Asia, Europe, South America, the Near East, Australia, and New Zealand. Hepatic and pulmonary cysts are the most common presentation. Isolated renal hydatid cyst is an uncommon presentation of echinococcal disease, since renal involvement occurs in only 2-3% of cases. We present the case of a young man with renal colic, in whom the diagnosis of renal hydatid disease was established cytologically. Urine cytology, performed because of persistent hematuria, revealed scolices of Echinococcus granulosus and prompted further imaging investigation, and, ultimately, surgical treatment.

Adult↗
PubMed1995

Adenomyosis in postmenopausal breast cancer patients treated with tamoxifen: a new entity?

Between September 1, 1989 and October 31, 1994, 173 postmenopausal breast cancer women on tamoxifen treatment were followed up in the authors' institutions. During this period, 14 (8.1%) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for various indications. Eight (57.1%) were found to have adenomyosis, of whom one had a large fundal adenomyotic lump and the other seven patients had two to four small microscopic foci of adenomyosis. In this study, the rate of adenomyosis described among those postmenopausal breast cancer patients treated with tamoxifen is nearly three to four times higher than the rate reported in the literature for pre- and postmenopausal women. There is no previous reported increased incidence of adenomyosis in postmenopausal breast cancer patients treated with tamoxifen. Thus, it is suggested that the prolonged and unopposed estrogen-like stimulation by tamoxifen may play a causal role rather than be a casual factor in the development of this pathologic entity.

Adult↗