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Biomedical subjects

J Warram

Publications and source records attributed to J Warram.

6 recordsLinked to original sources
PubMed1987

The effect of a low fat diet on estrogen metabolism.

Women who consume a diet low in fat are at lower risk for breast cancer than women whose diet is relatively high in fat. To investigate the effects of a low fat diet on estrogen metabolism, six normal young women were studied while eating a Western-style high fat diet and again after 2 months of consuming a defined low fat diet. Both studies involved the simultaneous administration of [3H]estradiol [( 3H]E2) orally and [14C]E2 iv and the subsequent collection of multiple blood samples and urine for 96 h. The blood samples were analyzed for radioactivity as estrone (E1), E2, their glucuronides, and E1 sulfate. An aliquot of the pooled 96-h urine was analyzed for radioactivity as the glucuronides and sulfates of E1, E2, estriol, 16 alpha-hydroxyestrone (16 alpha-OHE1), and the catechol estrogens, i.e. 2-hydroxy and 2-methoxy metabolites of E1 and E2. The low fat diet resulted in a consistent and significant (P less than 0.05) decrease in urinary excretion of both 16-hydroxylated metabolites, estriol and 16 alpha-OHE1, expressed as a percentage of administered dose of [3H]E2 and [14C]E2, and an increase in the excretion of the catechol estrogens. These changes in metabolite excretion were not, however, mirrored by changes in the MCRs or conversion ratios of either [3H]E2 or [14C]E2. Thus, while neither the clearance of E2 from the blood nor its absorption from the intestinal tract was altered by a relatively short term decrease in dietary fat, there was a shift in the pattern of urinary metabolites away from the purported carcinogenic estrogen (16 alpha-OHE1) and toward the less active catechol estrogens. This may represent an important mechanism whereby low fat diets decrease the risk of breast cancer.

Adult↗
PubMed1985

The metabolism of estradiol; oral compared to intravenous administration.

We administered [6,7-3H]estradiol p.o. and [4-14C]estradiol i.v. simultaneously to 5 women 22-35 years of age. Fourteen blood samples were collected over 480 min, and all urine was collected for 96 h. The blood samples were analyzed for radioactivity as estradiol, estrone, estrone-sulfate and estradiol glucuronide. The urine samples were analyzed for radioactivity as the glucuronide and pH 1 hydrolyzable conjugates of estradiol, estrone, estriol, 16 alpha-hydroxy-estrone, 2-hydroxy-estrone, 2-hydroxy-estradiol, 2-methoxy-estradiol and 2-methoxy-estrone. The major circulating estrogen, after either estradiol, p.o. or i.v. administration, was estrone sulfate; approximately 50% of estradiol administered by either route being converted to and measured as estrone sulfate in the blood. Following oral administration about twice as much estradiol was converted to and measured as estradiol glucuronide in the blood as after i.v. administration. Of the estradiol administered p.o., only 10% was absorbed into the blood as estradiol the rest being metabolized prior to absorption. After estradiol, p.o., the major radioactive compounds in the urine were the glucuronides of estrone and estradiol, but after estradiol, i.v., the conjugates of estrone, estradiol and estriol were present to about the same extent as the conjugates of the 2-oxygenated compounds. Following p.o., considerable metabolism of estradiol administration occurs in the splanchnic tissue, much of it in the intestinal wall.

Administration, Oral↗
PubMed1982

Nephrotoxicity from angiographic contrast material. A prospective study.

Three hundred and seventy-eight hospitalized patients undergoing nonrenal angiography were evaluated for subsequent changes in renal function. Acute renal failure was defined as a rise in the serum creatinine level of 1.0 mg/dl or more. Several factors that appeared to play no significant role in causing acute renal failure included: the volume of contrast material injected, the anatomic site of injection and the presence of a prior history of cardiovascular disease or diabetes mellitus. The single risk factor identified was the presence of preexistent azotemia (blood urea nitrogen of 30 mg/dl and serum creatinine of 1.5 mg/dl). Whereas nonazotemic patients had a 2 percent incidence of definite acute renal failure, patients with chronic azotemia (mean blood urea nitrogen/creatinine = 47/2.3 mg/dl) had a 33 percent incidence. Three patients required short-term dialysis, and two required potassium-exchange resin therapy. No patient required permanent dialysis, and no patient died of acute renal failure. The persistence of a positive nephrogram 24 hours after angiography was a sensitive detector of a rise in the serum creatinine level although more expensive than the creatinine determination. While urine sediment analysis confirmed the diagnosis in many cases, it was relatively insensitive. Monitoring of urine volume proved to be of little value. We recommend a screening serum creatinine determination 24 to 48 hours after infusion of angiographic contrast material in azotemic patients.

Acute Kidney Injury↗
PubMed1975

Preoperative irradiation of cancer of the lung: final report of a therapeutic trial. A collaborative study.

Between May, 1963 and December, 1966, 17 medical centers cooperated in two separate but integrated therapeutic trials of primary lung cancer. One study was of patients with lesions considered operable at the time of diagnosis, and the other of patients with initially inoperable cancer but who were considered potentially operable after radiotherapy. Patients operable at the time of diagnosis were randomly assigned to receive either immediate surgery (278 patients) or preoperative radiotherapy followed by surgery (290 patients). All but one were followed until death or 5 years survival. Survival to each anniversary after randomization was almost identical for the two groups. At 5 years the survival rate was 14% after preoperative radiotherapy and 16% after immediate surgery. On the basis of the small standard error of the difference between these survival rates, a large advantage or a large disadvantage for preoperative radiotherapy is unlikely. Recurrence of cancer either locally or as distant metastasis was also similar in the two groups. Postoperative mortality was estimated to be 11% in the immediate surgery group, but cannot be estimated in a comparable fashion for the irradiated group. Certain postoperative complications were more frequent in the irradiated group, but survival during the first was not affected. Out of 425 patients initially considered to be inoperable, 152 were considered resectable after radiotherapy. These patients were randomly assigned to have either a thoracotomy and resection of their cancer if possible (78 patients) or no surgery (74 patients). Survival to each anniversary after randomization was very similar. After 5 years the survival rate was 8% for the group assigned to surgery and 6% for the group assigned to no surgery. The difference has a standard error of 4%.

Carcinoma, Small Cell↗