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Biomedical subjects

R Fishman

Publications and source records attributed to R Fishman.

At least 19 recordsLinked to original sources
PubMed1998

The addition of paclitaxel to continuous infusion 5-fluorouracil is an active regimen for metastatic breast cancer.

Metastatic breast cancer is commonly thought to be incurable. Treatment advances have resulted in increased response rates, although such responses are often more palliative than curative. A regimen of continuous infusion 5-fluorouracil (5FU) or continuous infusion 5-fluorouracil with paclitaxel was studied in patients with metastatic breast cancer and measurable disease. The induction therapy preceded high-dose ifosfamide, carboplatin, and melphalan in a phase I-II trial. Eighty-seven patients were enrolled in the trial. Forty-five received continuous infusion 5-fluorouracil as induction and 42 received 5-fluorouracil and paclitaxel. The single-agent, continuous infusion 5-fluorouracil cohort had one complete response (2%) and eight partial responses (18%). The combination continuous infusion 5-fluorouracil and 3-hour paclitaxel regimen produced four complete responses (10%) and 17 partial responses (40%). The combination regimen of continuous infusion 5-fluorouracil with bolus paclitaxel was well tolerated and with a 50% response rate, is an active regimen for women with metastatic breast cancer.

Adult↗
PubMed1997

Depression in women.

Explore the source record for details and available documents.

Antidepressive Agents↗
PubMed1996

ICI 182,780 inhibits endogenous estrogen-dependent rat uterine growth and tamoxifen-induced developmental toxicity.

To assess the effects of the steroidal antiestrogen ICI 182,780 on postnatal uterine development, female Sprague-Dawley rats were given s.c. injections of ICI 182,780 (0.1-100 micrograms/rat) on each of postnatal days (PND) 10-14. ICI 182,780 inhibited uterine growth, as measured by uterine weight, in a dose-dependent manner but had no effect on either uterine luminal epithelium hypertrophy or gland genesis. Immunohistochemical analysis revealed that ICI 182,780 (10 micrograms) markedly reduced uterine estrogen receptor (ER) immunoreactivity in all uterine cell types while tamoxifen (10 micrograms) increased ER immunoreactivity, most notably in the luminal epithelium. In addition, tamoxifen increased uterine weight and induced luminal epithelium hypertrophy but inhibited uterine gland genesis--outcomes also seen with synthetic estrogens such as diethylstilbestrol. To test the hypothesis that these effects are a consequence of the estrogen agonist activity of tamoxifen, rats were cotreated with ICI 182,780 (10 micrograms, PND 8-14) and tamoxifen (10 micrograms, PND 10-14). ICI 182,780 greatly reduced or completely blocked tamoxifen-induced uterine weight gain, luminal epithelium hypertrophy, tamoxifen-induced ER immunoreactivity, and the inhibition of uterine gland genesis. ICI 182,780 given daily on PND 1-5 did not alter PND 5 uterine weight or uterine differentiation on PND 26. We conclude that postnatal exposure to ICI 182,780 does not affect uterine growth or differentiation at an age when the uterus is not dependent on estrogen for growth, i.e., PND 1-5, but does inhibit later endogenous estrogen-dependent uterine growth. The blockade of tamoxifen-induced uterine developmental alterations by ICI 182,780 demonstrates that these tamoxifen effects result from its estrogen agonist activity.

Animals↗
PubMed1995

Comparison of direct interview and family history diagnoses of alcohol dependence.

Using data from The Collaborative Study on the Genetics of Alcoholism, we compare direct interview diagnoses of alcohol dependence to those obtained by history from family members. Using a requirement of three or more positive implications by history, the specificity, sensitivity, and positive predictive values are 98%, 39%, and 45%, respectively. A logistic analysis found the gender of the relative and alcoholism in the informant to be significant, but not the gender of the informant. The partial odds ratio of a diagnosis at interview associated with a positive family history diagnosis was 13.6. The relationship between the informant and relative was significant, with negative reports from an offspring or mate more influential than a negative report from a parent or second-degree relative. We derived a recursive equation to combine a variable number of family history reports, wherein the probabilities associated with a single report are computed from the logistic analysis. This permits the use of family history information both as a proxy for an uninterviewed relative, as well as a second source of information to be used in the analysis of genetic family data.

Adult↗
PubMed1992

Changing incidence and management of abrupt closure following coronary intervention in the new device era.

Abrupt closure of the dilated segment occurs in approximately 4 to 7% of cases following conventional percutaneous coronary angioplasty. Additional balloon angioplasty reverses roughly 40% of these closures, to yield an overall 1.6 to 3.4% rate of emergent surgery. The impact of new devices on the incidence and reversal rate of abrupt closure has not been examined. Abrupt closure occurred in 80 (4.2%) of 1,919 consecutive coronary angioplasties performed in our single center, 389 (20%) of which were performed using newer interventions (208 Palmaz-Schatz stents, 170 directional coronary atherectomies, and 11 elective laser balloon angioplasties). Abrupt closure was less frequent following newer coronary interventions (1.8%) compared to standard balloon angioplasty (4.9%, P < 0.01), possibly reflecting case selection. When abrupt closure did occur, percutaneous rescue was successful in 53 (66%) patients, including 42 (53%) who were rescued using standard or perfusion balloon angioplasty, and 11 (13%) who were rescued using laser balloon balloon angioplasty after failure of additional angioplasty attempts. Medical therapy alone was used in 8 (10%), while emergent coronary bypass surgery was performed in 18 (23%), yielding an overall emergent surgery rate of 0.9%. Q-wave myocardial infarction was significantly less frequent (0.2%) following percutaneous rescue, compared to either medical therapy (25%) or emergent surgery (33%, P < 0.001). In our catheterization laboratory, use of these 3 new coronary interventional devices coincides with a trend towards a lower incidence of abrupt closure, a higher percutaneous rescue rate with reduced incidence of myocardial infarction, and a lower emergent bypass surgery rate.

Aged↗
PubMed1990

Impaired elastic matrix development in the great arteries after ablation of the cardiac neural crest.

The cells that form the aorticopulmonary septum in the avian embryo have been shown to be similar to the cells that form the walls of the great vessels in two ways: both are derived from the cardiac neural crest and both are able to synthesize an elastogenic matrix in the early embryo. Because of these similarities, and because ablation of the cardiac neural crest causes congenital defects of the outflow tract that are related to failure of proper septation, it was hypothesized that such an ablation also would cause the walls of the great vessels to be defective. The purpose of this study was to compare the elastic matrix in the mediae of the great vessels of normal embryos with those from which the cardiac neural crest had been ablated. The results show that the elastic matrix in the great vessels of the experimental embryos was impaired 1) in the rate of downstream propagation of the initiation of elastogenesis among younger embryos, incubation days 4-8 and 2) in the spatial configuration of the elastic matrix among the older embryos, incubation days 16-20. These results may provide a biological explanation for the elastin defect that affects the pulmonary artery of many patients with cyanotic congenital heart defects.

Aldehydes↗
PubMed1987

The familial transmission of bipolar illness.

As part of the National Institute of Mental Health Collaborative Program on the Psychobiology of Depression study, data were collected on 2225 first-degree relatives of 612 probands. We analyzed 187 families of bipolar patients (149 probands with a diagnosis of bipolar I disorder and 38 with a diagnosis of schizoaffective, manic subtype). Using traditional genetic methods, the morbid risk of bipolar illness in relatives was found to be 5.7% in the relatives of bipolar probands as contrasted with 1.1% in the relatives of probands with major depression. These values compared closely with those obtained using survival analysis. Relatives of probands with early onset were found to have a greater risk than relatives of probands with late onset. The sex of the relative, the sex of the proband, or the subtype of the proband (bipolar I or schizoaffective bipolar) did not influence the risk in the relative. The age at onset was found to be accelerated with birth cohort, with individuals born in more recent cohorts having an earlier onset. Multifactorial analysis found significant heterogeneity for sex-specific sibling correlations (with the brother-sister correlation smaller than the same-sexed correlations), and path analysis estimated transmissibility of liability to be 71%. The mixed model, which allows for a single major locus with a multifactorial background, gave evidence for the presence of a major locus when controlling for the effects of birth cohort and age at onset. However, this evidence is tempered when comparing the mixed model with a more general transmission model.

Adolescent↗
PubMed1986

The modulation of transmitter release in motor nerve endings varies with the type of muscle fiber innervated.

Electrophysiological studies of synaptic transmission in mammalian muscles revealed substantial differences between neuromuscular synapses associated with fast versus slow-twitch motor units. Synapses of fast units exhibited much higher tetanic and post-tetanic potentiation of neurotransmitter release than those of slow units. On the other hand, the tetanic potentiation of slow units increased faster as a function of the frequency of activation than that of fast units. These differences suggest a possible specialization of neuromuscular synapses with the type of motor units they are associated with.

Acetylcholine↗
PubMed1979

Psychiatric disorders among professional women.

A group of 111 women physicians and 103 women PhDs, selected from the general community, were studied for the presence of psychiatric illness. Fifty-one percent of the MDs and 32% of the PhDs were diagnosed as having primary affective disorder (P less than .01). Other psychiatric disorders were found in less than 10% of each group. Depression among the psychiatrists was significantly more common (73%) than among the other physicians (46%). More than 50% of all the women reported prejudice in training or employment, and depressed subjects reported prejudice more often than well subjects. The presence of children and depression were shown to disrupt a woman's professional career. The finding of a high prevalence of affective disorder among women physicians is consistent with the reported excessive suicide risk for this group.

Adult↗
PubMed1979

Psychiatric adolescent inpatients: eight- to ten-year follow-up.

Seventy-seven adolescent psychiatric inpatients, whose index hospitalization was at a mean age of 16, were followed up for eight to ten years after discharge. The important findings at follow-up were as follows. Twelve patients had bipolar affective disorder and were severely disabled (of these, 11 had a long-term clinical course and three committed suicide). Sixteen patients had unipolar depression: five had one depressive episode and were well throughout the follow-up period, one patient had many episodes with complete remissions, and the remaining ten patients had only partial remissions and their impairment of functioning corresponded to the severity of their symptoms. One of the ten committed suicide. Eighteen (23%) patients were psychiatrically well and functioned adequately throughout the follow-up period. Five had primary depressions, five had undiagnosed psychiatric illness, and eight were diagnosed as not having a psychiatric disorder.

Adjustment Disorders↗
PubMed1977

Quantitative aspects of computed tomography of the blood and cerebrospinal fluid.

Computed tomographic (CT) scans of fresh and coagulated blood in vitro as well as calcium and iron solutions demonstrate that the increased absorption seen in hematomas is primarily a reflection of hemoconcentration: calcium plays essentially no role in this increased absorption, while iron makes a minimal contribution. In vitro studies of cerebrospinal fluid (CSF) indicate that CT scanning is insensitive to pathological elevations of CSF protein.

Blood↗