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Biomedical subjects

A Caruso

Publications and source records attributed to A Caruso.

At least 253 records · Page 14Linked to original sources
PubMed1993

Human growth hormone enhances progesterone production by human luteal cells in vitro. II. Evidence of a distinct effect on two luteal cell types.

OBJECTIVE: To examine the differential effect of human GH (hGH) on basal and hCG-stimulated production by cultured small and large human luteal cells. DESIGN: Distinct cultures of small and large luteal cells from early and midluteal phase. SETTING: All corpora lutea were obtained from the Obstetrics and Gynecology Department of the Catholic University, a public care center in Rome, Italy. PATIENTS, PARTICIPANTS: Ten nonpregnant women between 31 and 43 years of age underwent surgery for various nonendocrine disorders such as leiomyomatosis. INTERVENTIONS: Corpora lutea were obtained at the time of hysterectomy. MAIN OUTCOME MEASURES: Small and large luteal cells were incubated with or without hCG and/or hGH at different concentrations. RESULTS: Human GH neither at 250 nor at 500 micrograms/L increased basal P production by small luteal cells, whereas from 1,000 micrograms/L, P concentration in media was significantly increased. The concomitant treatment with ineffective doses of hCG (30 and 60 IU/L) and hGH (250 and 500 micrograms/L) enhanced P production to that obtained with the highest doses of hGH (1,000 micrograms/L or more) or hCG (125 to 250 IU/L) alone. Human GH addition did not change the amount of P release by large luteal cells at any concentration. CONCLUSIONS: These results indicate a distinct and differential effect of hGH on in vitro luteal steroidogenesis by the two luteal cell types.

Adult↗
PubMed1993

The use of the AMS800 artificial urinary sphincter in combination with the gastric tube for continence in the canine model.

An experimental canine model was designed to examine the potential use of the artificial urinary sphincter around a gastric tube. The artificial urinary sphincter was placed around a tubularized gastric flap as part of a continent gastric reservoir in 4 dogs and in 2 additional dogs the gastric tube was anastomosed to the native bladder. Two dogs underwent placement of the artificial urinary sphincter around the gastric tube 4 weeks postoperatively and the remainder had the sphincter placed simultaneously with creation of the gastric tube. All dogs with the gastric reservoir underwent urodynamics before and after activation of the sphincter. Only 61 to 70 cm. water pressure balloons were used. All dogs were continent postoperatively on clean intermittent catheterization every 8 hours. There were no erosions or problems with catheterization. Urodynamics confirmed a complaint system and an average increase of capacity of 410% after artificial urinary sphincter activation (4 dogs). There was no leakage at capacity. Histology of the artificial urinary sphincter and neighboring (control) regions, and of the reservoir at 1 (2 dogs), 3 (3 dogs) and 6 months (1 dog) was obtained. Microscopic examination of the cuff site showed mild serosal hyperplasia and fibrosis, a well preserved muscularis and mild to moderate focal mucosal atrophy. These changes were slightly more evident at 6 months. Mucosal folds were well preserved with normal submucosa and lamina propria. In the control region histology was well preserved and similar to native stomach. We conclude that the artificial urinary sphincter around a gastric tube can provide urinary continence. The minimal changes in histology under the cuff are encouraging and support the potential for use of the gastric tube with the artificial urinary sphincter, although longer term effects are unknown.

Animals↗
PubMed1993

The role of human autoantibodies against gamma-interferon.

Natural antibodies to gamma-interferon (IFN-gamma) were detected in the serum of viral infected patients and also in the serum of healthy subjects at a lower titre. The increased titres of antibodies to IFN-gamma in sera from viral infected patients, and their decrease with clinical resolution, indicates that these antibodies are related to the viral infection and probably reflect IFN-gamma production as a result of antigenic stimulation in vivo. These antibodies were affinity-purified and studied for their capability to interfere with the multiple activities of IFN-gamma in vitro. Data obtained show that human anti-IFN-gamma antibodies interfere with the immunomodulating activity but not with the antiviral and antiproliferative activity of lymphokine. Autoantibodies to IFN-gamma may have a role in the immunoregulatory process serving to limit the intensity and or duration of the immune response. Being able to interfere with the immunomodulating activities of IFN-gamma, these antibodies might open up new therapeutic possibilities for those diseases which carry evidence of activated cell-mediated immunity.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Indomethacin in vivo inhibits the enhancement of the progesterone secretion in response to gonadotrophin-releasing hormone by human corpus luteum.

Different prostaglandins (PG) seem to have luteolytic or luteotrophic function in relation to the phases of life of the human corpus luteum and in-vitro studies demonstrate a luteotrophic function of PGE2, PGI2, PGD2. The present study evaluated the effect of an inhibitor of prostaglandin synthesis on the hypophyseal and luteal responses to gonadotrophin-releasing hormone (GnRH) in women during the mid-luteal phase. Twenty normal menstruating women participated in the study. Two different protocols were applied. After monitored ovulation (day 0), eight patients were treated with indomethacin for 7 days and 12 untreated patients served as controls. To evaluate luteal progesterone production, blood samples were taken every 15 min for 2 h basally and after a bolus of GnRH (25 micrograms i.v.); eight control patients were also treated with indomethacin for one day, and the endocrine study was repeated. The long-term administration of indomethacin significantly reduced basal as well as luteinizing hormone (LH)-stimulated progesterone production by the corpus luteum in respect to controls. Short-term administration failed to influence basal progesterone production, but abolished its secretory response to LH. A luteotrophic role for prostaglandins in human luteal function is suggested.

Adult↗
PubMed1993

The detection and biological activity of human antibodies to IL-2 in normal donors.

Antibodies to interleukin-2 (IL-2) have been reported in the sera of patients under therapies involving this cytokine and in the sera of patients infected with human immunodeficiency virus (HIV). Our study proves that auto-antibodies to IL-2 are present also, at a lower titre, in healthy individuals. These antibodies were affinity purified and studied for their capability to interfere with the in vitro biological activity of IL-2. Data obtained show that human anti-IL-2 antibodies can interfere with lymphocyte proliferation both in the lymphokine activated killer (LAK) cell assay and in the mixed lymphocyte reaction (MLR). However, the kinetics of inhibition by anti-IL-2 antibodies differs from LAK cell assay to MLR as the former are always inhibited in a time-independent manner, and the latter only by adding antibodies at the outset of culture. The neutralizing activity observed in vitro suggests that such antibodies play a part in the elaborate cytokine network by which the immune system regulates the amplitude and duration of its response.

Autoantibodies↗
PubMed1993

Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography. Implications for prognosis and therapy. The European Cooperative Study Group on Echocardiography.

BACKGROUND: Aortic dissection still has a poor prognosis despite progress in therapy. Therefore, this prospective follow-up study was designed to determine whether the degree of communication between true and false lumen in relation to the type of dissection, analyzed by transesophageal echocardiography, influences the risk after initiation of medical or surgical therapy. METHODS AND RESULTS: In eight centers, 168 patients (124 men and 44 women) of age range of 23-84 years with proven aortic dissection were examined by transesophageal echocardiography in the acute phase, after start of medical and/or surgical therapy, and during follow-up (0-65 months; mean, 10 months). Analyses were performed prospectively according to a detailed study protocol. Patients were subdivided by transesophageal echocardiography according to a modified DeBakey classification. Type I aortic dissection was found in 35%, type II aortic dissection in 17%, and type III aortic dissection in 48%. Preoperative mortality was 3%, 7%, and 2%, and survival rates were 52%, 69%, and 70%, respectively. Type III aortic dissection could be subdivided into those with communication and antegrade dissection (ca) (50%), with communication and retrograde dissection limited to the descending aorta (cr desc) (10%), with dissection extended to the aortic arch and ascending aorta (cr asc) (27%), and with noncommunicating (nc) aortic dissection (13%). An open false lumen with no thrombus formation was present in types I, II, III ca and III cr asc aortic dissection in 17%, 21%, 39%, and 27% respectively, although it was most pronounced in types III nc and III cr desc (75% and 78%). During follow-up in patients who survived, thrombus was demonstrated in the false lumen in 80% of type I aortic dissection and 81% of types III ca and III cr asc. Open false lumen was seen in type II aortic dissection in 18%. Spontaneous healing was found in 4% with type II and 4% with type III aortic dissection (mainly in patients with type III nc aortic dissection). Patients with fluid extravasation, pleural effusion, pericardial tamponade, and periaortic effusion as well as mediastinal hematoma had a mortality of 52%. Reoperations were necessary in 12-29%, with the highest rate in patients with type III ca aortic dissection. Survival for patients with types III nc and III cr desc aortic dissection was higher than those with types I, II, III ca, and III cr asc. CONCLUSIONS: Preoperative mortality appears to be reduced by transesophageal echocardiography, allowing rapid initiation of treatment. Intraoperative and postoperative mortality in aortic dissection remains high. Risk factors are fluid extravasation and an open false lumen with high communication. Thrombus formation in the false lumen can be regarded as a good prognostic sign. Surgery appears to be only a first step in the treatment of aortic dissection. Second surgery or closure of entry sites based on intraoperative echocardiography may be considered to induce thrombus formation and reduce aortic wall stress.

Adult↗
PubMed1993

Inhibitory effects of propionyl-L-carnitine on plasma extravasation induced by irritants in rodents.

The effects of propionyl-L-carnitine (PLC) in various models of inflammation were studied in rats and mice. PLC (50-200 mg/kg i.p.) dose-dependently inhibited the granuloma pouch induced by croton oil in rats, but failed to inhibit either cotton pellet granuloma or carrageenin-induced paw oedema and peritonitis. PLC (100 mg/kg i.p.) significantly reduced mouse ear oedema induced by croton oil, tetradecanoylphorbol acetate and arachidonic acid; in these models, PLC concomitantly reduced plasma extravasation, as evaluated by the leakage of Evans blue. In all the tested models, L-carnitine and acetyl-L-carnitine were ineffective, suggesting a specific protective role of PLC in the vascular component of the inflammatory process.

Acetylcarnitine↗
PubMed1993

Pregnancy outcome in relation to uterine artery flow velocity waveforms and clinical characteristics in women with antiphospholipid syndrome.

OBJECTIVE: To determine whether uterine artery velocimetry is a useful tool for identifying pregnancies with antiphospholipid syndrome at risk for adverse outcome. METHODS: Twenty-four women with antiphospholipid syndrome, who had experienced 56 fetal losses in 63 previous pregnancies (88.9%), were treated with prednisone (40 mg/day) and aspirin (100 mg/day) during 28 pregnancies. Color Doppler ultrasound was performed at 18-24 weeks' gestation to investigate the resistance index of the uterine arteries. RESULTS: Treated women delivered 23 live infants in the 28 pregnancies (82.1%). Three infants weighed less than the tenth percentile (13%). Five pregnancies were complicated by preeclampsia and ten by nonproteinuric gestational hypertension. Positive results for all three assays for antiphospholipid antibodies (anticardiolipin antibodies, lupus anti-coagulant, VDRL) at conception identified pregnancies destined to have poor fetal outcome and a significantly lower birth weight compared to pregnancies not having all three assays positive. An abnormal resistance index of the uterine arteries predicted pregnancies with poor fetal outcome in terms of week of delivery, birth weight, and birth percentile, as well as four of five cases of preeclampsia. CONCLUSIONS: Three assays positive for antiphospholipid antibodies at conception and an abnormal resistance index of the uterine arteries at 18-24 weeks' gestation predicted pregnancies at major risk for obstetric complications. Future studies should determine whether treatment can be modulated based on the Doppler findings.

Adult↗
PubMed1993

Effects of GABAergic drugs on ethanol-induced gastric lesions.

Different classes of GABAergic drugs--baclofen, GABA, muscimol, Na-valproate, Mg-valproate and diazepam--were tested per os on ethanol-induced gastric lesions in rats. The GABAB agonist baclofen failed to affect gastric susceptibility to ethanol damage, while all the other compounds exerted a dose-dependent inhibition on haemorrhagic-necrotic lesions. This effect was not significantly reversed by the specific GABAA antagonist bicuculline, suggesting it to be independent from GABAA receptors. The blockade of prostaglandin synthesis by indomethacin significantly decreased the gastroprotective action of GABA, Na- and Mg-valproate, but did not antagonize the effect of muscimol and diazepam. Gastric juice volume and pH showed remarkable differences between the various treatments.

Animals↗
PubMed1993

Evaluation of ovarian and adrenal sources of androgens in women with polycystic ovary syndrome. Dexamethasone and GnRH-agonist administration.

Ovarian and adrenal production of androgens was evaluated in 18 patients with polycystic ovary syndrome (PCOS) by administering a combination of short-term dexamethasone (DEX) and long-term gonadotropin-releasing hormone agonist (GnRH-A). At day 6 of the cycle, blood samples were collected at 7 A.M. (basal) and 11 P.M. At midnight, 2 mg DEX was given orally, and blood samples were collected at 7 A.M. the following day (DEX1). Blood samples were obtained for 6 weeks at the same time after administration of a potent GnRH-A (400 micrograms/day given subcutaneously). Eight normal subjects served as controls. The amounts of androgens and 17-hydroxyprogesterone (17-OHP) suppressed by using DEX (adrenal-source suppression) and GnRH-A (ovarian-source suppression) were greater in PCOS patients than in controls. We differentiated PCOS patients as having a normal or an exaggerated response to DEX or GnRH-A administration; threshold values were considered average +2SD of the suppressed androgen amounts of controls. Three patients had an exaggerated response to GnRH-A treatment for androstenedione, testosterone and 17-OHP, while DEX inhibition was similar to controls. The remaining 15 patients had an exaggerated response to DEX for all three androgens; seven also had an exaggerated response to GnRH-A. Thus, the combination of GnRH-A and DEX permitted us to selectively study and identify adrenal and ovarian sources of hyperandrogenemia.

Adrenal Glands↗
PubMed1993

Long-term naltrexone treatment reduces the exaggerated insulin secretion in patients with polycystic ovary disease.

OBJECTIVE: To evaluate the involvement of endogenous opiates in the pathophysiology of the hyperinsulinism in patients affected by polycystic ovary disease by administering naloxone and naltrexone. We also studied the hormonal status following long-term opioid antagonist administration. METHODS: Twenty-one women affected by polycystic ovary disease participated in the study. An oral glucose tolerance test (GTT) was performed at baseline and repeated after short-term naloxone infusion and after 6 weeks of naltrexone administration. Plasma glucose and insulin levels were evaluated in all samples. Gonadotropins, sex hormone-binding globulin, and androgen levels were determined initially and after the naltrexone treatment. RESULTS: None of the patients showed any alteration of glucose tolerance. Based on the insulin response to the GTT, the patients were classified as normo- or hyperinsulinemic. Opioid antagonist administration significantly reduced the insulin response to the GTT in hyperinsulinemic patients, without affecting their glycemic levels. In normoinsulinemic patients, glucose plasma levels were increased whereas insulin levels were not modified by the treatments. Gonadotropin and androgen plasma concentrations were not modified after naltrexone administration. CONCLUSIONS: This work supports a role for the endogenous opiates in the regulation of exaggerated insulin secretion in patients with polycystic ovary disease. The reduction of insulin secretion failed to demonstrate any hormonal modification in such hyperandrogenized patients.

Adult↗
PubMed1992

Natural human antibodies to gamma interferon interfere with the immunomodulating activity of the lymphokine.

Natural antibodies to gamma interferon (IFN-gamma) were found in patients suffering from different viral diseases and, at a lower titer, in healthy individuals. Such antibodies were affinity-purified and studied for their capability to interfere in vitro with the antiviral and immunomodulating activity of IFN-gamma. Data obtained show that these human anti-IFN-gamma antibodies have no inhibitory effect on the antiviral activity of IFN-gamma. On the contrary, they are able to inhibit the expression of Fc receptor sites and HLA-DR antigens induced by IFN-gamma on the U-937 cells, a human monocytoid/macrophage-derived cell line. These antibodies can also interfere in a mixed lymphocyte culture (MLC) with the proliferation of lymphocytes and the generation of cytotoxic lymphocytes. However, they showed only a moderate inhibitory effect on the cytotoxicity generated in MLC to K-562 cells. Human antibodies capable of interfering with the immunomodulating activities of IFN-gamma might open up a new field in clinical therapy for those diseases that carry evidence of activated cell-mediated immunity.

Animals↗
PubMed1992

Ultrasound diagnosis of fetal macrosomia.

Macrosomic infants and their mothers are at increased risk for intrapartum injury and perinatal morbidity and mortality. This study investigates the effectiveness of individual ultrasound fetal measurements, ponderal indices and estimated fetal weight in the identification of macrosomia in 732 pregnant patients who underwent ultrasound examination within 7 days of delivery. All the indices evaluated were compared for accuracy in predicting birth weight. Statistical comparison revealed that estimated fetal weight predicted macrosomia better than single ultrasound parameters and ponderal indices. The formulae tested yielded an accuracy of 94% and a positive predictive value of 90%. Abdominal diameter and abdominal circumference values above the 90th centile correctly predicted macrosomia in 82% and 72% of cases, respectively. Fetal length showed a sensitivity of 61% with a predictive positive test of 41%. Femur length-to-abdominal circumference ratio detected macrosomia with a sensitivity of 80% and an accuracy of 82%. The other single ultrasound parameters and ponderal indices were significantly less indicative of macrosomia. The combined use of four indices (growth profile) did not improve the effectiveness of ultrasound in detecting fetal macrosomia. We conclude that the optimal prediction of fetal macrosomia is obtained from mathematical formulae for fetal weight estimation, based on several fetal measurement parameters and adjusted for different gestational periods.

Journal Article↗
PubMed1992

The agglutinin response to whole-cell and acellular pertussis vaccines is Bordetella pertussis--strain dependent.

OBJECTIVE: To determine the significance of the Bordetella pertussis strain used as the antigen in the agglutinin assay for the evaluation of pertussis vaccines. DESIGN: Randomized, double-blind study. SETTING: Health maintenance organization clinics, primary care clinic at a referral hospital, and private practices in Los Angeles County, California. PARTICIPANTS: Forty healthy infants. SELECTION PROCEDURES: Convenience sample. INTERVENTIONS: Twenty infants received whole-cell pertussis-component diphtheria-tetanus-pertussis vaccine (DTP), and 70 infants received acellular pertussis-component diphtheria-tetanus-pertussis vaccine (APDT) at ages 2, 4, and 6 months. MEASUREMENTS: The agglutinin assay was performed using three separate B pertussis strain preparations: (1) strains 130 and 138 in equal quantities, the constituents of the DTP vaccine, (2) strain 460, and (3) strain Tohama, the constituent of the APDT vaccine. RESULTS: The agglutinin titers were highly strain dependent; in both groups of vaccinees at both ages the Tohama values were highest, followed by strain 460 and then strains 130/138. The vaccine groups had comparable titers at age 2 months regardless of the assay antigen used. However, at age 7 months, after three immunizations, the DTP group geometric mean titer was more than 10 times greater than that of the ADPT group using strains 130/138, but only 2.6 times higher using strain 460 and almost equivalent using Tohama strain. CONCLUSION: Vaccine group agglutinin value comparisons strongly depend on assay antigens used.

Agglutination Tests↗
PubMed1992

Acute thrombosis of prosthetic valves: a multivariate analysis of the risk factors for a lifethreatening event.

In 3231 prosthetic valves implanted between January 1975 and November 1990, we observed 61 cases of prosthetic obstruction of biological origin with clinical and laboratory findings of severe functional impairment which required surgery as emergency treatment. The hospital mortality was 19.67% (12/61). The obstruction was due to a primary thrombosis in all 5 bioprostheses which were not anticoagulated and in 11/56 (19.64%) mechanical prostheses of which 3 were not anticoagulated and 4 were not properly anticoagulated. The obstruction was due to fibrous tissue overgrowth in the other 45 mechanical prostheses (80.35%) with secondary thrombosis in 34 cases (60.71%) and no thrombosis in 11 (19.64%); 71.11% of these prostheses were adequately anticoagulated. Of the 61 obstructed prostheses, 53 were mitral and 8 were aortic. No tricuspid obstruction was observed. A statistical assessment by multiple correspondence, cluster and chi square analysis was performed in two groups of patients with different models of mechanical mitral prostheses. The 5-year actuarial incidence of obstruction was 6.08%. Significant risk factors were: tilting disc prostheses, prostheses without pyrocarbon coating, large prostheses, tilting disc prostheses with a small orifice posteriorly oriented, atrial fibrillation, enlarged left atrium, time from implant greater than 4 years, age between 40 and 50 years. In our opinion, prosthetic obstruction may be referred to a primary thrombosis only in cases where it may be prevented by adequate anticoagulation. In most cases, the obstruction is produced by periprosthetic fibroblastic proliferation which may develop in spite of adequate anticoagulation in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1992

Human growth hormone enhances progesterone production by human luteal cells in vitro: evidence of a synergistic effect with human chorionic gonadotropin.

OBJECTIVE: To examine the possible direct effect of human growth hormone (hGH) on basal and human chorionic gonadodotropin (hCG)-stimulated progesterone (P) production by cultured human luteal cells. DESIGN: Cultures of human luteal cells from early and midluteal phase. SETTING: All corpora lutea were obtained from the Obstetrics and Gynecology Department of the Catholic University, a public care center. PATIENTS, PARTICIPANTS: Twelve nonpregnant women between 35 and 47 years of age underwent surgery for various nonendocrine disorders such as leiomyomatosis. INTERVENTIONS: Corpora lutea were obtained at the time of hysterectomy. MAIN OUTCOME MEASURE: Luteal cells were incubated with or without hCG and/or hGH at different concentrations. RESULTS: Human growth hormone neither at 250 nor at 500 ng/mL increased basal P production, whereas from 1,000 ng/mL P concentration in media was significantly increased (P less than 0.05). The concomitant treatment with uneffective doses of hCG (6 and 12 ng/mL) and hGH (250 and 500 ng/mL) enhanced P production similarly to that obtained with the highest doses of hGH (1,000 ng/mL or more) or hCG (25 to 50 ng/mL) alone. CONCLUSIONS: These results indicate a direct effect of hGH on the luteal steroidogenesis in vitro.

Adult↗
PubMed1992

Differential androgen response to adrenocorticotropic hormone stimulation in polycystic ovarian syndrome: relationship with insulin secretion.

OBJECTIVE: To investigate the relationship between insulin and adrenal androgens in patients with polycystic ovarian disease (PCOD). DESIGN: Patients with PCOD and a group of volunteers who attended the department during a period of 6 months were studied. SETTING: Department of Gynaecology and Obstetrics, Università Cattolica del Sacro Cuore, Roma, Italy. PARTICIPANTS: Healthy women with ovulatory cycles (hospital personnel, n = 8) and women affected by PCOD (n = 32) were studied on day 5 to 6 of their follicular phase. INTERVENTIONS: All women had an oral glucose tolerance test (OGTT) (75 g) on day 5 to 6 of the cycle. Then plasma samples were collected at 7.00 A.M.; at 11.00 P.M., 2 mg of dexamethasone (DEX) were orally administered with blood samples collected the day after at 7.00 A.M. (effect of DEX). Then adenocorticotropic hormone (ACTH, Synacten; Ciba-Geigy, Varese, Italy) 250 micrograms was injected intravenously (IV) and samples collected 60 minutes later (effect of ACTH). MAIN OUTCOME MEASURES: Plasma glucose and insulin concentration were assayed on OGTT samples collected at time 0, 30, 60, 90, 120, 180, and 240 minutes after glucose ingestion. Data are expressed as area under the curve. Cortisol, 17 alpha-hydroxyprogesterone (17-OHP), testosterone (T), androstenedione (A), and dehydroepiandrosterone sulphate (DHEAS) plasma levels were evaluated on the samples collected before and after DEX or ACTH administration. Data are expressed as absolute concentrations and percent increase in respect to values before the treatment. RESULTS: According to the OGTT response, 21 patients were classified as hyperinsulinemic and 11 as normoinsulinemic. The ideal body weight was greater in hyperinsulinemic patients. No differences in baseline hormone levels were found between the two groups. Only sex hormone binding globulin levels were significantly greater in normoinsulinemic patients (P less than 0.05). Also, the plasma concentration of all steroids after DEX were similar in both groups. Intravenous injection of ACTH significantly increased plasma androgens levels. Cortisol, DHEAS, and T enhancement did not differ in normoinsulinemic and hyperinsulinemic patients, whereas significantly greater A (P less than 0.01) and 17-OHP (P less than 0.05) plasma concentrations were observed after ACTH injection in hyperinsulinemic when compared with normoinsulinemic PCOD subjects. Control group after IV ACTH showed an increase of A and 17-OHP similar to those found in normoinsulinemic PCOD group. CONCLUSIONS: These data suggest that insulin could be involved in the androgen production by adrenal gland and it could influence the responsiveness of adrenal to its trophic hormones.

17-alpha-Hydroxyprogesterone↗