Search PubMed⌕ Search

Biomedical subjects

I Schiff

Publications and source records attributed to I Schiff.

At least 37 records · Page 2Linked to original sources
PubMed1992

Endometrial ablation by means of photodynamic therapy with photofrin II.

OBJECTIVE: Photodynamic therapy is a technique in which tissue is irradiated with light after the use of a photosensitizing drug that produces singlet oxygen, which has a cytotoxic effect. The feasibility of using photodynamic therapy with photofrin II for endometrial ablation was studied. STUDY DESIGN: Fifty-eight rabbits were studied. Preferential uptake of photofrin II by endometrial tissue, compared with the myometrium, was established by drug extraction and fluorescence microscopy after administration of photofrin II intravenously. Dosimetry for endometrial ablation was established by administering photofrin II in 1, 2, 5, and 10 mg/kg doses and laser light (630 nm) at radiant exposures of 100 and 200 J/cm2. Histologic examination was performed at 24 hours, 5 days, and 10 days after treatment. There were two control groups. One group received laser light but no photofrin II, and the other received photofrin II without laser light. RESULTS: The concentration of photofrin II was three times higher in the endometrium than in the myometrium at doses of 1 and 2 mg/kg. Fluorescence microscopy of frozen sections of endometrium and myometrium showed a predominantly perivascular fluorescence from photofrin II. A dose of 1 and 2 mg/kg and a flow of 100 J/cm2 was adequate for endometrial ablation in rabbits. At 24 hours after treatment there was extensive hemorrhage and evidence of cell death in the entire endometrium and mild hemorrhage in 10% to 50% of the inner circular layer of the myometrium. At 5 days after treatment necrosis of the entire endometrium and the inner half of the myometrium was seen, but the outer half of the myometrium and the serosa were normal. There were no cases of uterine perforation. Similar results were seen at 10 days after treatment, except for the additional presence of inflammatory cells. Neither control group (drug without light, light without drug) showed any injury to the endometrium at 24 hours. CONCLUSION: We conclude that endometrial ablation can be effectively achieved in rabbits by means of photodynamic therapy with photofrin II without significant complications.

Animals↗
PubMed1991

Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins.

BACKGROUND: Postmenopausal estrogen-replacement therapy may reduce the risk of cardiovascular disease, and this beneficial effect may be mediated in part by favorable changes in plasma lipid levels. However, the effects on plasma lipoprotein levels of postmenopausal estrogens in the low doses currently used have not been precisely quantified, and the mechanism of these effects is unknown. METHODS: We conducted two randomized, double-blind crossover studies in healthy postmenopausal women who had normal lipid values at base line. In study 1, 31 women received placebo and conjugated estrogens at two doses (0.625 mg and 1.25 mg per day), each treatment for three months. In study 2, nine women received placebo, oral micronized estradiol (2 mg per day), and transdermal estradiol (0.1 mg twice a week), each treatment for six weeks. The metabolism of very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) was measured by endogenously labeling their protein component, apolipoprotein B. RESULTS: In study 1, the conjugated estrogens at doses of 0.625 mg per day and 1.25 mg per day decreased the mean LDL cholesterol level by 15 percent (95 percent confidence interval, 11 to 19 percent; P less than 0.0001) and 19 percent (95 percent confidence interval, 15 to 23 percent; P less than 0.0001), respectively; increased the HDL cholesterol level by 16 percent (95 percent confidence interval, 12 to 20 percent; P less than 0.0001) and 18 percent (95 percent confidence interval, 14 to 22 percent; P less than 0.0001), respectively; and increased VLDL triglyceride levels by 24 percent (95 percent confidence interval, 8 to 40 percent; P less than 0.003) and 42 percent (95 percent confidence interval, 26 to 58 percent; P less than 0.0001), respectively. In study 2, oral estradiol increased the mean concentration of large VLDL apolipoprotein B by 30 +/- 10 percent (P = 0.05) by increasing its production rate by 82 +/- 18 percent (P less than 0.01). Most of this additional large VLDL was cleared directly from the circulation and was not converted to small VLDL or LDL. Oral estradiol reduced LDL cholesterol concentrations by 14 +/- 3 percent (P less than 0.005), because LDL catabolism increased by 36 +/- 7 percent (P less than 0.005). The oral estradiol increased the HDL cholesterol level by 15 +/- 2 percent (P less than 0.0001). Transdermal estradiol had no effect. CONCLUSIONS: The postmenopausal use of oral estrogens in low doses favorably alters LDL and HDL levels that may protect women against atherosclerosis, while minimizing potentially adverse effects on triglyceride levels. The decrease in LDL levels results from accelerated LDL catabolism; the increase in triglyceride levels results from increased production of large, triglyceride-rich VLDL.

Administration, Cutaneous↗
PubMed1991

Menopause: advanced management strategies.

Estrogen replacement therapy may offer significant benefits to nearly all postmenopausal women, especially those for whom the menopause occurred at an early age. Women at high risk for atherosclerosis, or who already have cardiovascular disease, may particularly benefit from estrogen use. The increased risk for endometrial and breast cancer seen with estrogen replacement therapy is low in comparison with its protective effect against cardiovascular disease. For women who cannot or choose not to take estrogens, etidronate may be of value in preventing osteoporotic fractures. For women many years beyond menopause who consume low-calcium diets, calcium supplementation should be recommended.

Calcium↗
PubMed1990

Vasomotor flushes.

Explore the source record for details and available documents.

Adrenergic alpha-Agonists↗
PubMed1990

Effects of transdermal estrogen replacement on parathyroid hormone secretion.

The effect of transdermal 17 beta-estradiol replacement on ionized calcium and PTH levels was examined in 15 postmenopausal women. After baseline studies in the fasting state, the effect of a calcium infusion on PTH levels was studied. Estrogen replacement resulted in a fall in fasting resting ionized calcium and a rise in PTH levels. After calcium infusion there was no change in the shape of the relationship between plasma calcium and PTH. The level of nonsuppressible PTH secretion was not altered. Transdermal estrogen did not alter basal vitamin D-binding protein levels, 25-hydroxyvitamin D levels, or calcitriol levels. We conclude that the effect of transdermal estrogen replacement on PTH secretion is completely explained by the lowering of ionized calcium, causing a rise in PTH secretion. Thus, with this route of estrogen replacement, there is no necessity to postulate a direct effect of 17 beta-estradiol on the parathyroid gland.

Administration, Cutaneous↗
PubMed1989

Nonalcoholic carbonated beverage consumption and bone fractures among women former college athletes.

We report on data relating to nonalcoholic carbonated beverage consumption and bone fractures in 5,398 college alumnae, 2,622 former college athletes and 2,776 nonathletes, who responded to a detailed mailed questionnaire. A statistically significant association between nonalcoholic carbonated beverage consumption and bone fractures was found only in the former athletes, not the nonathletes. Among the athletes, the age-adjusted odds ratio (OR) for the association of drinkers (yes/no) with any fracture (yes/no) was 1.35, 95% confidence limits (CL) (1.14, 1.59). The dose-response relationship between the amount of carbonated beverages consumed daily and the number of bone fractures of the athletes was also statistically significant. Results of multiple logistic regression analysis, which included only alumnae greater than or equal to 50 years of age and which controlled for current exercise and other potential confounding factors, were as follows: (a) for athletes, the OR for the association of drinking nonalcoholic carbonated beverages and a first bone fracture at or after age 40 was 2.28, 95% CL (1.36, 3.84); (b) for all alumnae, a low milk diet was a risk factor for first bone fractures at or after age 40, OR = 1.92, 95% CL (1.15, 3.16); (c) former college athletes had a significantly lower risk of first fractures at or after age 40 than did nonathletes; OR = 0.63, 95% CL (0.40, 0.99). The deleterious effect of nonalcoholic carbonated beverage consumption on the risk of bone fractures has not been reported, as far as we know.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Monitoring skeletal response to estrogen.

Estrogen replacement therapy at accepted doses is not fully effective in preventing bone loss and fractures in postmenopausal women. Bone densitometry is useful for monitoring estrogen replacement therapy to assess dose, foster compliance, and check for secondary bone loss. The most appropriate site for bone loss monitoring is probably the spine because it shows larger decreases at the menopause than appendicular sites, it shows larger increases with therapy, and it has clinical import in terms of fracture. Both dual-photon absorptiometry (or dual-energy x-ray absorptiometry) and computed tomography are the preferred monitoring methods. The precision of these densitometry methods is generally adequate to permit interim decisions with regard to continuing therapy, as well as conclusive decisions on therapeutic efficacy after 1 to 2 years of monitoring. Judicious use of densitometry in combination with biochemical determinations can enhance therapeutic control and provide both patient and physician confidence in long-term estrogen replacement therapy.

Absorptiometry, Photon↗
PubMed1989

A randomized, placebo-controlled, double-blind study evaluating the efficacy of leuprolide acetate depot in the treatment of uterine leiomyomata.

Thirty-eight premenopausal women with uterine leiomyomata were enrolled in a randomized, double-blind, placebo-controlled study evaluating the efficacy of depot leuprolide acetate (LA), a gonadotropin-releasing hormone agonist, in decreasing uterine volume. Eighteen women received intramuscular (IM) depot LA 3.75 mg every 4 weeks for 24 weeks (group A); 20 women received IM placebo with the same injection schedule (group B). Group A patients had a mean reduction in pretreatment uterine volume from 505 +/- 93 cu cm (mean +/- standard error of the mean) to 305 +/- 57 cu cm after 12 weeks (P less than 0.05 versus pretreatment) and 307 +/- 57 cu cm after 24 weeks of therapy (P less than 0.05 versus therapy (P less than 0.05 versus pretreatment). At 3 months after cessation of therapy, the mean uterine volume in group A had increased to 446 +/- 92 cu cm (P less than 0.05 versus week 24). Group B patients had no significant change in uterine volume over the 24-week treatment period. These results suggest that depot LA therapy may significantly decrease uterine volume in patients with leiomyomata, but that regrowth of uterine size occurs shortly after cessation of therapy.

Adult↗
PubMed1989

The premenstrual syndrome--diagnosis and management.

Premenstrual syndrome is an extremely common disorder. Prospective documentation of symptoms and their temporal relationship to menstruation establishes the diagnosis of PMS. Because the pathophysiologic mechanisms causing PMS are still undetermined, therapy for PMS is largely empiric. A number of pharmacologic agents may be used to reduce PMS symptomatology, and therapeutic decisions should be tailored to the individual's symptom complex. Many women will be able to lead more productive lives if PMS is properly diagnosed and intelligently treated.

Clinical Trials as Topic↗
PubMed1989

Reproductive factors and melanoma of the skin among women.

A higher risk of reproductive system disorders, (which include benign tumors, endometriosis, dilation and curettage, hysterectomy, and other disorders requiring gynecologic biopsies) exist among women with cutaneous melanoma as compared to women with skin cancers: The odds ratio (OR) is 3.2, 95% confidence limits (1.0, 10.1), p = 0.049; as compared to a random sample of women with no melanoma or skin cancers, the OR is 3.9, 95% confidence limits (1.2, 12.4), p = 0.021. Confirming the observations of others, the authors found that melanoma was associated with red hair. The data also confirmed the finding that melanoma is associated with significantly fewer pregnancies. The mean numbers of pregnancies in the melanoma group is 1.83 +/- 1.6 (mean and standard deviation) compared to 2.99 +/- 1.9 in the skin cancer group and 2.93 +/- 1.9 in the random sample (p less than or equal to 0.05).

Analysis of Variance↗
PubMed1989

A preliminary report of the short-term effect of carbonated beverage consumption on calcium metabolism in normal women.

A variety of nutritional factors influence the bioavailability of calcium and increase a woman's risk of osteoporosis. Eight healthy women completed an 8-week metabolic study designed to investigate the effect of nonalcoholic carbonated beverage consumption on calcium metabolism. Compared with women receiving a control diet, women consuming a diet high in nonalcoholic carbonated beverages demonstrated similar mean serum levels of calcium, ionized calcium, phosphorus, alkaline phosphatase, parathyroid hormone, 1,25-dihydroxyvitamin D3, and osteocalcin. Twenty-four-hour urine volume, creatinine clearance, calcium-creatinine ratio, and phosphorus-creatinine ratio were similar during consumption of the diet high in nonalcoholic carbonated beverages and the control diet. Twenty-four-hour cyclic adenosine monophosphate-creatinine ratio was significantly lower in women consuming the diet high in nonalcoholic carbonated beverage compared with women receiving the control diet (342 +/- 27.4 nmol/mmol vs 409 +/- 22.1 nmol/mmol). Consumption of a diet high in nonalcoholic carbonated beverages on a short-term basis does not appear to affect adversely the serum or urinary markers of calcium metabolism.

Adult↗
PubMed1989

Lower prevalence of non-reproductive system cancers among female former college athletes.

Lower prevalence of non-reproductive system cancers among former college athletes. Med. Sci. Sports Exerc., Vol. 21, No. 3, pp. 250-253, 1989. The prevalence (lifetime occurrence) rates of cancers of nonreproductive organs and tissues were determined for 5,398 living alumnae, 2,622 of whom were former college athletes and 2,776 who had been nonathletes, from data on medical history, reproductive history, athletic training, and diet. The non-reproductive system cancers were divided into two classes: class I, which included cancers of the digestive system, thyroid, bladder, lung, and other sites and hematopoietic cancers (lymphoma, leukemia, myeloma, and Hodgkin's disease), and class II, which included skin cancers and cutaneous melanoma. The former college athletes had a significantly lower prevalence of class I cancers compared to the nonathletes; the age-adjusted relative risk (RR) equals 3.34, 95% confidence limits (1.35, 8.33), P = 0.009. In contrast, the prevalence rates of malignant melanomas and skin cancers did not differ significantly between the former athletes and nonathletes. The age-adjusted RR did not differ from 1.0. The lower prevalence rate of class I cancers among the former athletes is in accord with previous findings of a significantly lower prevalence rate of breast cancer and cancers of the reproductive system among former college athletes compared to nonathletes.

Adult↗
PubMed1988

A randomized, double-blind trial of a gonadotropin releasing-hormone agonist (leuprolide) with or without medroxyprogesterone acetate in the treatment of leiomyomata uteri.

A randomized, double-blind study was performed on 16 women to compare the efficacy of daily subcutaneous (SC) injections of leuprolide acetate (LA; TAP Pharmaceuticals, North Chicago, IL) plus oral placebo tablets (group A, n = 7) with SC LA plus oral medroxyprogesterone acetate (The Upjohn Company, Kalamazoo, MI; group B, n = 9) in the treatment of leiomyomata uteri. Patients in group A had a significant reduction in uterine size from a pretreatment volume of 601 +/- 62 cm3 (mean +/- standard error) to a mean uterine volume of 294 +/- 46 cm3 at 24 weeks of therapy (P less than 0.01). Group B patients had a reduction in uterine volume from 811 +/- 174 cm3 to 688 +/- 154 cm3, which was not statistically significant. However, only one patient in group B experienced hot flashes, whereas six patients in group A had this symptom (P less than 0.01). Both groups demonstrated significant increases in mean hemoglobin concentrations, hematocrits, and serum iron levels at 24 weeks of therapy compared with pretreatment levels.

Adult↗
PubMed1988

Serum parathyroid hormone (PTH) in pregnant women determined by an immunoradiometric assay for intact PTH.

Most studies of circulating PTH levels using traditional RIAs have supported the concept of physiological hyperparathyroidism of pregnancy, with pregnant women having serum immunoreactive PTH levels significantly higher than those in nonpregnant subjects. However, such RIAs are insensitive and often detect inactive PTH fragments, so that the correlation between PTH immunoreactivity and bioactivity is poor. Employing a new intact PTH immunoradiometric assay (Allegro-Nichols), we reassessed the effects of pregnancy on parathyroid function. The mean serum PTH level in 81 pregnant women was 14.4 +/- 6.3 (+/- SD) compared to 24.8 +/- 9.0 ng/L in 11 normally cycling nonpregnant women (P less than 0.001). The mean serum total and ionized calcium levels in the 2 groups were similar. In 5 of the pregnant women, serum bioactive PTH, determined by cytochemical bioassay, was slightly lower (7.7 +/- 3.4 ng/L) than in normal individuals (11.1 +/- 1.9 ng/L). Our findings suggest, in contrast with the results of most previous studies, that serum intact PTH may decline during pregnancy.

Adult↗
PubMed1988

Characterization of leukocyte subpopulations in the peritoneal fluid of women with endometriosis.

Monoclonal antibodies identifying leukocytes subpopulations were applied to smears of laparoscopically collected peritoneal fluid leukocytes and parallel samples of peripheral blood leukocytes from women with endometriosis (n = 33), those with unexplained infertility (n = 9), and fertile controls (n = 8). Peripheral blood leukocyte profiles in all groups were indistinguishable from reported normal values. Peritoneal fluid leukocyte profiles were observed to be different between groups. The most significant elevations in total leukocytes, macrophages, helper T lymphocytes and natural-killer cells were observed in women with stage I and II endometriosis. Significantly elevated levels of total leukocytes, macrophages, and T lymphocytes were also observed in peritoneal fluid from women with unexplained infertility. The results from this study indicate that the peritoneal environment is immunologically dynamic and suggest that cellular immune mechanisms may contribute to reproductive failure in women with endometriosis and unexplained infertility.

Antibodies, Monoclonal↗