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Biomedical subjects

J B Brown

Publications and source records attributed to J B Brown.

At least 127 records · Page 7Linked to original sources
PubMed1983

Urine estrogens, frequency of ovulation, and breast cancer risk: case-control study in premenopausal women.

Urine specimens from 94 premenopausal women with breast cancer and from 70 control women have been compared with respect to concentration of the three major estrogen fractions and to frequency of ovulation as assessed by urine pregnanediol. The probability of anovulation (0.14 in the breast cancer patients and 0.09 among the controls) was not significantly higher among the women with breast cancer (P approximately 0.30). However, there was a positive association between urine estrogen concentration and breast cancer risk. The association was statistically significant (P less than 0.05) for each of the three estrogens measured and in both the follicular and the luteal phases of the menstrual cycle; the relative risk increased from 1 in the referent category (less than 5 micrograms estrogen/g creatinine) to about 3 in the highest category (greater than or equal to 15 micrograms estrogen/g creatinine). The association between urine estrogens and breast cancer risk was consistently stronger when the comparison was restricted to specimens collected in menstrual cycles during which ovulation occurred.

Breast Neoplasms↗
PubMed1982

Use of ultrasound in monitoring ovulation induction with human pituitary gonadotropins.

Serial follicular growth was studied using real-time ultrasound scanning in 26 anovulatory patients in 55 cycles stimulated with exogenous human pituitary gonadotropin (hPG) and human chorionic gonadotropin (hCG). Dosage was monitored with urinary total estrogen estimations. The ultrasound findings were not made known to the attending physician. Forty-four cycles (80%) were ovulatory, and conception occurred in 13. The mean follicular diameter of 17 to 25 mm at ovulation corresponded with the range observed in spontaneous cycles, although the rate of follicular growth was faster with hPG. On the day the ovulatory dose of hCG was given, as determined by the first urinary estrogen value greater than 50 microgram/24 hours, estrogen excretion was similar whether single or multiple follicles of potential ovulatory size were present, but mean follicular diameters were significantly smaller when there was more than 1 follicle. During the last 4 days before ovulation, the mean diameters in conceptual cycles increased from 14.2 mm to 19.7 mm, values similar to those observed in spontaneous cycles, but different growth patterns occurred in some nonconceptual cycles. Ovarian hyperstimulation was identified by ultrasound scan in 4 of 5 cycles before urinary estrogen excretion exceeded the normal range. Although ultrasound scan does not supplant estrogen monitoring, it can assist in the early detection of hyperstimulation, in the more accurate timing of the ovulatory dose of hCG, and in the withholding of hCG when 3 or more ovulations are possible. It is recommended that ultrasound examination be performed in all patients before the ovulation-inducing dose of hCG is given to provide information on the number of follicles that are likely to ovulate and thus avoid conception of more than twins.

Chorionic Gonadotropin↗
PubMed1981

Elevated levels of prolactin in nulliparous women.

Follicular-phase (Day 11) plasma prolactin, and plasma and urinary oestrogen levels of 70 nulliparous nuns were compared with those of 80 of their sisters, of whom 62 were parous. The nuns and their nulliparous sisters did not differ significantly in their prolactin and oestrogen levels. No differences in plasma oestrogens or urinary oestriol ratio were found between the parous and the nulliparous women. However, the mean prolactin level of the nuns and their nulliparous sisters was 35% higher than that of the parous women in the sample taken approximately 1 3/4 h after rising (p less than 0.0005), and 24% higher (P less then 0.01) in the 2nd sample taken 2 h later. The elevation was independent of age, weight, and age at menarché. Age at first full-term pregnancy, at least up to the age of 30, and second or subsequent full-term pregnancies had no further effect on prolactin level. This study suggests that the effect of early first full-term pregnancy in lowering breast cancer risk may be mediated, at least in part, by permanently lowering the level of circulating prolactin.

Adult↗
PubMed1981

A double blind trial of extra-amniotic oestriol and prostaglandin F2 alpha gels in cervical ripening.

Forty nulliparous patients with Bishop score of 3 or less were given 15 mg oestriol gel, 10 mg PGF2 alpha gel or gel alone via the extra-amniotic route. Both the oestriol and prostaglandin treated patients had a significant increase in Bishop score and a significant reduction in induction-delivery interval compared to controls. Oestriol gel had significantly less stimulatory effect on uterine activity than prostaglandin gel, indicating a possible local action.

Cervix Uteri↗
PubMed1981

Circulating gonadotrophins and urinary oestrogens in postmenopausal diabetic women.

Serum FSH and LH and total urinary oestrogens were measured in 20 mature onset postmenopausal diabetic women and compared to 20 nondiabetic women matched for age, years since menopause, surface area and per cent ideal weight. Significantly higher levels of urinary oestrone, oestradiol and oestriol and significantly lower levels of FSH and LH were found in the diabetic women. Closer analysis of these findings showed that the differences were maintained for the diabetics who required insulin for adequate control, whereas diabetics controlled on diet alone or diet and oral hypoglycaemic drugs were not significantly different from control subjects except in urinary oestrone excretion.

Aged↗
PubMed1981

Monitoring induction of ovulation by rapid radioimmunoassays of oestrogen and pregnanediol glucuronides.

To increase the sample-handling capacity for an induction of ovulation programme, direct urinary radioimmunoassays (RIA) for three steroid glucuronides, pregnanediol-3-glucuronide (Pd-3-G), oestrone-3-glucuronide (E1-3-G), and oestriol-16 alpha-glucuronide (E3-16-G), were established. Results obtained for urinary Pd-3-G measured by direct RIA show an excellent correlation (r = 0.98, N = 46) with those for urinary pregnanediol measured by gas-liquid chromatography. Estrone-3-glucuronide (E1-3-G) and estriol-16 alpha-glucuronide (E3-16-G) values, measured by direct RIA, closely paralleled the total urinary oestrogen measured fluorimetrically. Ovarian response to ovulation induction therapy can be monitored by observing the changes in the levels of E1-3-G in urine. Pre-ovulatory levels of urinary E3-16-G were found to be too low for use in this regard. Direct RIA for E1-3-G and Pd-3-G are recommended as reliable indices of ovarian function in the monitoring of patients receiving treatment for the induction of ovulation.

Animals↗
PubMed1981

Incremental clomiphene therapy: a new method for treating persistent anovulation.

Thirty anovulatory patients, previously unresponsive to clomiphene citrate in standard dosage, were treated with a new incremental method of clomiphene therapy. Clomiphene was given continuously with dosage increments every 5 days, up to a maximum dose of 3750 mg, and ovarian response was monitored with urinary estrogen estimation and with ultrasound. Twenty-one patients (70%) ovulated on this regimen and 8 (27%) conceived; 6 patients who ovulated but did not conceive had other infertility factors. Clomiphene response was associated with a progressive rise in follicle-stimulating hormone, luteinizing hormone, and estrogen excretion; these parameters were unchanged in nonresponders. Side effects of treatment were minimal and only 1 case of hyperstimulation occurred. Preliminary testing with estrogen-amplified gonadotropin-releasing hormone did not differentiate responders from nonresponders. Incremental clomiphene treatment appears to be a less complicated alternative for patients who would otherwise require exogenous gonadotropin therapy.

Adult↗
PubMed1981

Elevated urine estrogen and pregnanediol levels in daughters of breast cancer patients.

Urine levels of three major estrogens and of pregnanediol were measured for 76 nulliparous daughters of breast cancer patients and for 115 control women of similar age and parity. Concentrations of estrone and estradiol tended to be higher in the daughters of breast cancer patients than in the controls; total estrogens were elevated in both phases than in the controls; total estrogens were elevated in both phases of the menstrual cycle and significantly so in the luteal phase. There was little difference between the daughters and the controls in estriol ratios--the ratios of the concentration of estriol to the sum of the concentrations of estrone and estradiol. Pregnanediol levels were higher in the daughters than in the controls.

Adolescent↗
PubMed1981

Diet and reproductive hormones: a study of vegetarian and nonvegetarian postmenopausal women.

In comparison with matched nonvegetarian women, postmenopausal vegetarian women were found to have lower urinary levels of estriol and total estrogens, lower plasma prolactin levels, and higher plasma sex hormone-binding globulin (SHBG) levels. These differences were not explained by differences in body weight or obesity. Plasma SHBG levels were highly correlated with plasma high-density lipoprotein cholesterol levels, which were also higher in vegetarians than in nonvegetarians. These hormonal differences may explain the lower rates of endometrial and possibly breast cancer that have been observed previously in vegetarian women.

Age Factors↗
PubMed1981

Functioning ovarian tumors in postmenopausal women.

Estrogen excretion was higher than normal (more than 9 microgram/24 hr) in 40 of 80 postmenopausal women with benign and malignant epithelial tumors of the ovary, including 8 metastatic tumors. High estrogen excretion was noted in 19 of 27 (70.4%) patients with mucinous tumors in only 1 of 25 (4%) patients with serous tumors (P less than .001). Endometrioid and metastatic tumors were also noted to be frequently associated with high estrogen excretion. In the high estrogen excretion group 27 of 37 (73%) patients showed stromal luteinization and/or condensation in the tumor, but in the normal estrogen excretion group these changes were seen in only 6 of 38 (15.8%) patients (P less than .001). A possible mechanism of stromal stimulation in these tumors is discussed. Although there was often evidence of estrogen activity in the endometrium and the tubal epithelium in the high estrogen excretion group, the correlation between these epithelia and estrogen excretion was imperfect. Postoperative estrogen excretion remained elevated in 3 of 16 patients, of whom 1 was obese and 2 had residual tumor. This study emphasizes the importance of identifying epithelial tumors of the ovary as functioning or endocrine tumors.

Carcinoma, Squamous Cell↗
PubMed1980

An unexpectedly high rate of ectopic pregnancy following the induction of ovulation with human pituitary and chorionic gonadotrophin.

Six tubal ectopic pregnancies occurred in a series of 193 pregnancies following ovulation induced with human pituitary gonadotropin (hPG) and human chorionic gonadotrophin (hCG). The ectopic pregnancy rate of 3.1 per cent is higher than quoted incidences in the general population and occurred in the absence of predisposing factors. There was an association between ectopic pregnancy and elevated urinary oestrogen excretion in the peri-ovulatory phases of the induced ovulatory cycles. A urinary oestrogen excretion of greater than 200 microgram/24 hours on day 0 (the day after hCG was given) was associated with a 10 per cent chance of ectopic pregnancy (P less than 0.05).

Anovulation↗
PubMed1980

Estrogen profiles of primiparous and nulliparous women in Athens, Greece.

Urine estrogens of 144 primiparous women and 122 nulliparous women of similar age were measured. The primiparae were at least 6 months post pregnancy. The ratio of the estriol concentration to the sum of the concentrations of estrone and estradiol (the estriol ratio) was higher among primiparous women under 25 years of age than among nulliparous women of the same age. The difference was greater in specimens collected in the luteal phase of the menstrual cycle than in those collected in the follicular phase and was statistically significant (P less than 0.05, one-tailed t-test) only in the luteal phase. The high estriol ratios of the primiparous women did not decline with increasing interval after pregnancy, at least up to 24 months. Among the younger women, significantly lower levels of pregnanediol, suggestive of a higher frequency of anovular menstrual cycles, were also seen in the nulliparous women. The findings were consistent with the hypothesis that the protective effect against breast cancer of a full-term pregnancy at an early age operates either through a change in the pattern of estrogen metabolism induced by the pregnancy or through a change in the frequency of ovular cycles.

Adolescent↗
PubMed1979

Amniotic fluid palmitic acid/stearic acid ratios. Lecithin/sphingomyelin ratios and palmitic acid concentrations in the assessment of fetal lung maturity in diabetic pregnancies.

The lecithin/sphingomyelin (L/S) ratio, palmitic acid concentration and palmitic to stearic acid (P/S) ratio were estimated on samples of amniotic fluid obtained from 66 patients with diabetes. These were compared with similar estimates on amniotic fluid obtained from 127 non-diabetic patients. At 35 to 40 weeks, significant differences were observed between the L/S ratio and palmitic acid concentration in diabetics and non-diabetics, whereas the P/S ratio was similar in the two groups. The amniotic fluid L/S ratio, palmitic acid concentration, and P/S ratio were estimated on amniotic fluid obtained from 20 diabetic patients within 48 hours of induction, and the clinical outcome of the newborn infant was used to assess the predictive value of the three parameters. In 19 out of 20 diabetics the P/S ratio correctly predicted fetal lung maturity, whereas the palmitic acid concentration was correct in 12 patients and the L/S ratio in only 10 patients.

Amniotic Fluid↗
PubMed1978

MMPL-differences between fee-paying and non-fee-paying psychotherapy clients.

Compared the MMPI profiles of 23 randomly selected fee-paying clients (FP group) of an out-patient psychiatry clinic to those of 23 clients who left unpaid bills (NFP group). All Ss had been terminated at least 2 months. No differences between groups were found on age, education, income, fee level, number of therapy sessions, sex, or marital status. The NFP group scored significantly higher on the F, Paranoia, and Schizophrenia scales. Additionally, the NFP group endorsed significantly more critical items and generated a greater number of mean scale scores over 70. These results suggest a relationship between degree of psychopathology and non-fee-payment.

Adult↗