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Biomedical subjects

W H Utian

Publications and source records attributed to W H Utian.

At least 55 records · Page 3Linked to original sources
PubMed1989

Biosynthesis and physiologic effects of estrogen and pathophysiologic effects of estrogen deficiency: a review.

Women are increasingly spending more years of their lives beyond the menopause, which places them at risk for various health problems due to estrogen deficiency. Tissues and organs with estrogen receptors such as the ovaries, endometrium, vaginal epithelium, hypothalamus, urinary tract, and skin are directly affected by a lack of estrogen production. Other tissues in which estrogen receptors have not been consistently identified, such as bone, are also affected by waning levels of estrogen. The postmenopausal woman frequently experiences neuroendocrine changes (hot flashes) that often dissipate over time and a steady rise in her risk of cardiovascular disease, which approaches that in men of comparable age.

Estrogens↗
PubMed1989

Preliminary experience with in vitro fertilization-surrogate gestational pregnancy.

This report documents the medical details and 3-year follow-up evaluation of the infertile and surrogate couples involved in the first successful in vitro fertilization gestational surrogate pregnancy and summarizes clinical experience and outcome of all patients treated to date. Results of the first 28 couples treated are presented. The pregnancy rate for 39 cycles reaching attempts at oocyte retrieval is 18%. The procedural aspects, ethical issues, legal issues, and subsequent program development are summarized. Recommendations are of a similar program. There are numerous potential pitfalls and traps for the unwary, but our experience has thus far been gratifyingly positive, and we endorse the further provision, observation, and documentation of this controversial approach to the care of the infertile couple.

Demography↗
PubMed1989

Retinoids, sex steroids and glucocorticoids regulate ectocervical cell envelope formation but not the level of the envelope precursor, involucrin.

In spite of extensive study of the reproductive tract, little knowledge is available regarding the function of ectocervical epithelial (ECE) cells. In the present study we utilized a feeder layer of 3T3 cells to grow homogeneous cultures of human ectocervical epithelial cells and demonstrated the presence of the cornified envelope precursor, involucrin. Treatment of these cultures with 1 nM Ro 13-6298, a synthetic analogue of trans-retinoic acid, suppresses envelope formation 6-fold with half-maximal suppression at 0.005-0.01 nM. Treatment with 1 microM hydrocortisone elevates envelope production 2.5-fold. Sex steroids also regulate desquamation: 10 nM diethylstilbestrol, a synthetic estrogen, increases envelope levels 2- to 3-fold, while 300 nM progesterone reduces envelope production 2- to 3-fold. In spite of the retinoid-, glucocorticoid- and sex-steroid-stimulated changes in envelope production, the level of the envelope precursor, involucrin, remains constant. Our results suggest: (1) that, in vivo, ectocervical cell squame formation is regulated by the combined direct action of estrogens, progestins, glucocorticoids and retinoids; and (2) that envelope formation is not regulated by changes in the cellular content of the envelope precursor, involucrin. We present a model summarizing the estrogen, progestin, glucocorticoid and retinoid effects on ectocervical epithelial cell function.

Benzoates↗
PubMed1987

Overview on menopause.

Postmenopausal women comprise an ever-increasing percentage of the population. The alteration in ovarian function with loss of cyclic hormonal activity after menopause appears to be an actual endocrinopathy that produces definite metabolic effects. Clinicians must therefore become able to differentiate postmenopausal endocrine changes from those associated with the aging process. Four criteria are necessary for endocrinopathy to be present: morphologic changes, functional changes, hormonal changes, and target-tissue changes. The metabolic and pathologic changes after menopause appear to satisfy these criteria. If an actual endocrinopathy is determined to be present, long-term hormonal replacement therapy may be appropriate.

Aging↗
PubMed1987

Transdermal estradiol overall safety profile.

The results of both single- and multicenter clinical studies have revealed that the transdermal therapeutic system of estrogen administration (Estraderm, CIBA Pharmaceutical Co., Summit, New Jersey) is both effective and well tolerated. In contrast to oral conjugated estrogens, the patch has no effect on certain liver proteins. Safety variables measured during one study showed no biochemical changes. Moderate bleeding has occurred in some patients with an intact uterus but can be controlled by the addition of a progestogen. The incidence of endometrial hyperplasia and breast tenderness has been relatively low, and minor side effects (such as fluid retention) have been limited. Several investigators have evaluated skin irritation resulting from the systems. Some erythema has been reported, but serious ulcerations or sloughing did not occur. A survey of patient attitudes comparing oral administration and transdermal systems indicated a preference for the transdermal method.

Administration, Cutaneous↗
PubMed1987

The fate of the untreated menopause.

The human female climacteric is the phase of life that marks the transition from the reproductive to the nonreproductive years. When symptoms occur, the term "climacteric syndrome" may be utilized. The purpose of this review is to demonstrate that sufficient evidence now exists to confirm that the climacteric syndrome is a specific one that can be regarded as an endocrinopathy. The statement that the human female climacteric represents a pathologic rather than a physiologic state should not generate antagonistic counter-arguments; rather, it should be recognized as a challenge for the identification, prediction, and prevention of organic disease in the woman during the climacteric and after.

Climacteric↗
PubMed1984

Implementation of an in vitro fertilization program.

The establishment of an in vitro fertilization program is described. Organization of the physical laboratory, media formulation, and preliminary mouse embryo culture are discussed. Parameters of patient eligibility, ovarian stimulation, and laparoscopy are also defined. At the conclusion of Phase I, 17 patients were induced; 10 went to laparoscopy, and at least one four-cell embryo was returned to 7, resulting in one continuing pregnancy.

Academic Medical Centers↗
PubMed1983

Microscopic versus macroscopic tubal anastomosis in rabbit fallopian tubes.

The importance of the operating microscope in rabbit tubal anastomosis was assessed by operating on 36 rabbits, half with the aid of the operating microscope and half with the aid of low-magnification loupes. The surgeons' operating comfort and sense of assuredness that the anastomoses were being done properly were increased by the operating microscope. However, the outcome of the anastomoses as measured by pregnancy rates, adhesion scores, and microscopic pathologic findings were not significantly different in the two groups.

Animals↗
PubMed1980

Prevention of adhesions after tubal surgery by use of dextran 70.

Pelvic adhesions are a common cause of infertility. Moreover, their formation or redevelopment after corrective surgery of the fallopian tube is an important reason for surgical failure. Various agents for preventing adhesions have been described, but their efficacy has been poorly substantiated. The purpose of this article is to demonstrate that the use of high molecular weight dextran may be the first scientifically justifiable method for the prevention of adhesions after tubal surgery.

Animals↗
PubMed1980

The place of oestriol therapy after menopause.

The therapeutic principles covering sex hormone replacement therapy after menopause have undergone profound modification in recent years. Initial optimism regarding benefits, proven and unproven, was followed by deep pessimism because of potential serious adverse effects. Some degree of equilibrium has resulted from the application of risk-benefit and cost-effectiveness formulae to such hormone replacement regimens. Cost-effectiveness analysis in particular has highlighted the fact that different hormones or hormone combinations can markedly affect the therapeutic outcome. The purpose of the present paper is to examine the place of oestriol therapy after menopause based on such risk-benefit analyses. Oestriol, it would appear, has the potential for reduced risk but similar benefit to alternative oestrogen or oestrogen-progestogen combinations. The potential risks and benefits of long-term oestrogen therapy are therefore surveyed from the general standpoint of all oestrogens and the specific role of oestriol alone.

Aged↗