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Biomedical subjects

J Spona

Publications and source records attributed to J Spona.

At least 109 records · Page 6Linked to original sources
PubMed1987

Prognostic value of tumor marker determinations in testicular cancer patients.

This report is based on the observation of 109 patients with testicular cancer over a period of 6 years. At the time of orchiectomy metastases were present in 54 patients. In 13 patients with an initially nonmetastatic disease, secondaries occurred later. The aim of this study was to evaluate the role of serum levels of human chorionic gonadotropin (beta-HCG) and alpha-fetoprotein (AFP) in the prognosis for achieving a complete remission. The importance of serial serum AFP and beta-HCG determinations for the early detection of tumor metastases was also evaluated. Remission rates were lowered significantly in patients with serum AFP levels above 500 micrograms/liter (8%, P less than 0.0005) and serum beta-HCG concentrations exceeding 5,000 U/liter (27%, P less than 0.05). For an early detection of metastases the best results (efficiency 0.92) were achieved with the combination of beta-HCG with AFP and X-ray examination of the chest.

Chorionic Gonadotropin↗
PubMed1987

Pharmacological and endocrine profiles of gestodene.

Efforts to minimize oral contraceptive side effects have focused on the use of new dosage schemes and the synthesis of new steroids that can be used in safer, low-dose formulations. To determine whether the new progestogen gestodene offers an advantage in this regard, we studied its pharmacological and endocrine profiles. Gestodene was found to exhibit relative binding affinity and biological activity profiles similar to or better than those of progestogens in current use. Modulation by gestodene of luteinizing hormone-releasing hormone (LH-RH)-stimulated gonadotropin release in vitro and in vivo in a rat model system indicated that gestodene is some three times as biologically active as levonorgestrel. The borderline dose for inhibition of ovulation by gestodene was estimated in a total of 23 women with normal cycles. Levels of LH-RH, follicle-stimulating hormone, 17 beta-estradiol, and progesterone were estimated during the ingestion of various doses of gestodene. A dose of 30 micrograms of gestodene caused inhibition of ovulation in 11 out of 12 subjects, and eight out of 11 showed follicular maturation. When 40 micrograms of gestodene was taken, six out of seven women did not ovulate, and one out of seven had a cycle with luteal insufficiency. These data indicate that 40 micrograms of gestodene is the borderline dose for inhibition of ovulation. A combination of 75 micrograms gestodene with 30 micrograms ethinyl estradiol was found to inhibit ovulation in ten subjects, and no follicular maturation was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Efficacy of topically applied 17 alpha-propylmesterolone in acne patients.

A new substance--17 alpha-propylmesterolone--was tested in the treatment of acne. 8 male and 5 females patients applied a 3% alcoholic solution of the substance twice daily on the face for a mean period of 13 weeks. Besides clinical controls with acne grading also the determinations of the sebum excretion rate (SER) and separation of the lipid fractions was done before onset of treatment, after 14 days and then monthly. Concomitantly, the levels of several hormones (serum testosterone, prolactine, follicle stimulating hormone, luteinizing hormone and estradiol) were determined. Clinical results were moderate to excellent in most of the patients. In two patients no therapy effects became apparent after 8 weeks. SER was decreased in all patients to values between 70 and 4% of pretreatment values. Sebaceous gland lipids and epidermal lipids were both inhibited effectively. Hormonal parameters showed no significant difference of pretreatment and posttreatment values. For the first time positive effects of a topical new antiandrogen--17 alpha-propylmesterolone--could be demonstrated. The interesting finding of decrease of dermal and epidermal lipids suggests that not only sebaceous glands but also overstimulated epidermal structures may be inhibited by this antiandrogen.

Acne Vulgaris↗
PubMed1987

[An effective topical antiandrogen--17 alpha-propylmesterolone--in acne].

17 alpha-Propylmesterolon, a new topically active antiandrogen, was administered to 25 patients with papulopustular or comedo acne and severe seborrhoea. The patients were supplied with a 3% solution of 17 alpha-propylmesterolone in 70% alcohol and were advised to apply it to the face twice daily for a mean duration of 14 weeks. Clinical follow-ups and thin-layer-chromatography determination of the sebum secretion rate (SER) and the lipid fractions were performed monthly. At the end of the treatment period 72% of the patients had improved. Comedo acne was reduced by 2 grades, papulopustular acne by 1.8 grade. The mean reduction of seborrhoea was 2 grades. SER was reduced in 62.5% of the patients to 76.4 +/- 8.8% of pretreatment values. In addition to sebaceous gland lipids, epidermal lipids were also inhibited effectively. This finding is in accordance with the marked reduction of comedones. Thus, in addition to sebaceous gland inhibition, epidermal structures may also be the target of the antiandrogen.

Acne Vulgaris↗
PubMed1987

[Interaction of plasma beta-endorphin and progesterone in the luteal phase].

Recent research indicates that opioid peptides may be participants in the coordination and control of the menstrual cycle. The peripheral ovarian steroids (progesterone and estradiol) seem to modulate endogenous opioid activity and thereby hypothalamic LH-RH-secretion. This mechanism works during the luteal-phase under the influence of progesterone. The purpose of this study is to investigate the interaction of endogenous opioid peptides and peripheral ovarian steroids in 24 women by comparing progesterone and beta-endorphin levels of unstimulated and HMG-stimulated cycles. The women with stimulated cycles showed significantly higher progesterone and beta-endorphin levels. The interaction of progesterone und beta-endorphin may partly be explained by the fact that progesterone acts on progesterone receptors in the central nervous system. This leads to activity of opioid neurons in the brain and finally influences LH-RH- and LH-release. Beta-endorphin production is also discussed to come from the ovary. Beta-endorphin is involved maintaining normal luteal phase and therefore plays an important role in reproduction.

Female↗
PubMed1987

Effects of low and high dose oral cimetidine on hormone serum levels in patients with peptic ulcers.

Luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (hPRL) and testosterone (T) were assayed in a total of 131 patients with peptic ulcer. Initial oral treatment was performed with 1000 mg cimetidine per day for 6 to 12 weeks. After healing was confirmed endoscopically, the patients were switched to a maintenance dose of 400 mg per day cimetidine for 3 years. Serum hormone levels before and during the two regimens were estimated in 48 male, 22 postmenopausal and 5 premenopausal subjects. Comparison between the two cimetidine doses was possible in 76 male, 44 postmenopausal and 6 premenopausal patients. In all patients hormone parameters assayed before therapy were within the normal ranges. FSH was noted to increase significantly in all but the premenopausal group but remained within the normal range. In contrast, hPRL declined significantly in all groups of subjects except for premenopausal females during cimetidine treatment. LH and T did not change during treatment and no differences of hormone serum levels were noted between the two regimens. Present data combine to suggest that an initial treatment with 1000 mg of cimetidine per day did not provoke hyperprolactinemia, and a switch from an initial high dose to a maintenance dose of 400 mg per day did not cause further changes in hormone serum levels. Changes of LH, FSH, hPRL and T recorded in the present study are too small to be considered responsible for possible endocrine disorders observed during cimetidine therapy.

Administration, Oral↗
PubMed1987

[Hyperandrogenemia as a cause of amenorrhea].

The so-called postpill amenorrhea remains a much debated subject in gynecological endocrinology. We have therefore scrutinized the reproductive history and endocrinological parameters of 145 patients with the presumptive diagnosis of postpill amenorrhea, seen at our department during the last two years. 166 cases of secondary amenorrhea served as a control group. Both groups showed a high incidence of late menarche (20%), previous oligomenorrhea and elevated androgen serum levels. There were no significant differences between both collectives. These findings suggest that although oral contraceptives may unfavorably influence the menstrual cycle, there is no causal relationship between such agents and the development of secondary amenorrhea. It seems that in many cases of presumptive postpill amenorrhea the common juvenile hyperandrogenemic ovarian insufficiency might be the underlying problem.

Adolescent↗
PubMed1987

[Naloxone-induced gonadotropin changes in females with amenorrhea].

Along with 51 amenorrheic patients the pituitary reactional situation was checked by means of an Gn-RH-stimulation test. Simultaneously to all these women the opiate antagonist Naloxone was infused in a further test series. In 7 from 51 women a significant increase of the LH was demonstrated in comparison to the basic values. Comparing the kinetics of the pituitary gland it was evident, that in all cases the gonadotropin emanation was detective respectively missing after the second Gn-RH-bolus, which followed immediately after the first one. The findings seem to proof the thesis that the endorphins mainly influence the gonadotropin reserve capacity. In cases, where it was possible to objectify the influence--the second pool was missing as well.

Amenorrhea↗
PubMed1987

[Treatment of mastopathies with cyclic mastodynia. Clinical results and hormonal profiles].

The therapeutic effect of a long-term Gestagen therapy (lynestrenol) and a phytotherapy (Mastodynon) in comparison to a placebo group is reported in 160 cases of severe mastopathy with cyclic mastalgia. In 82.1 percent of the patients in the gestagen-group and in 74.5 percent of the patients in the Mastodynon-group a good relief of the premenstrual symptoms was achieved. In the placebo group only 36.8 percent of the patients reported a relief of symptoms. The difference is significant. The evaluation and analysis of serum HPRL and serum-progesterone showed a significant rise of the HPRL-level and a significant decrease of the progesterone-level. Because of this severe influence on the endocrine balance the recommendation for an alternative phytotherapy prior to a long term gestagen therapy is justified.

Breast Diseases↗
PubMed1986

[Topical cimetidine treatment of acne].

We present first results of topically applied cimetidine in acne. Ten patients suffering from papulopustular and comedone acne administered 2% cimetidine in indifferent lotion on their face twice a day. Clinical controls were performed every two weeks; sebum was monthly determined. After treatment of 13 weeks on the average, the clinical success was generally good. Comedones responded best, followed by papules. Pustules were hardly reduced. There was no significant reduction of SER and the lipid fractions at the end of treatment. Low concentration or insufficient penetration might be possible explanations. The efficient reduction of comedones might be an antiandrogenic effect due to modulation of the keratinization in the follicle excretory duct. Immune-modulatory effects of cimetidine and effects on the skin vessels are other possible explanations for the clinical efficacy of topical application of cimetidine in acne.

Acne Vulgaris↗
PubMed1986

[Steroid hormone receptors in normal skin].

Hormonal influences modulate various skin functions. Despite of skin manifestations indicative of increased androgenic influence, many cases show normal hormone serum levels. The target organ sensitivity of skin may be figured out by hormone receptor analysis. Our study presents data from 60 volunteer patients regarding estrogen (ER), androgen (AR), and gestagen (PgR) receptor analysis in normal skin. The highest percentages of AR and ER were found in the face of male and female patients followed by the lower extremities. Equal AR levels in both sexes indicate equal androgenic stimulability at the cellular level in both sexes. ER levels were higher in female than in male patients. PgR was negative in 14 cases. Nor could we prove any receptors in the youngest group of patients. Our results correspond with the clinical observation of different hormonal stimulability in various skin regions.

Adolescent↗
PubMed1986

[Basal gonadotropin level and gonadotropin response to stimulation in patients with anorexia nervosa].

Serum gonadotropin (GN) levels were examined before and after stimulation with luteinizing-hormone-releasing-hormone (LHRH) (100 micrograms/m2 body surface) in 25 female patients with anorexia nervosa (AN) and in 19 healthy young women. 12 patients were reexamined after clinical improvement. Basal GN levels and the luteinizing hormone (LH) response to stimulation were significantly lower in patients than in controls, whereas the response of follicle-stimulating hormone (FSH) to LHRH was normal. The GN response in patients was weight dependent, displaying an inverse correlation to the weight loss. After clinical improvement the GN response was significantly higher than in the acute stage of the disease. The data demonstrate that the activity of the hypothalamic-hypophyseal-gonadal (H-H-G) axis, evaluated on the basis of the GN response to LHRH, depends on the body weight of the patient. Hence, the alteration in activity of the H-H-G axis seems to be a consequence, and not the cause of AN.

Adolescent↗
PubMed1986

The effect of pericervical PGE2 instillation on levels of maternal serum 13,14-dihydro-15-keto-PGF2 alpha and progesterone.

In a prospective, randomized study 30 post-term pregnant women with low cervical scores were treated by a pericervical application of either 3 ml of 0.9% saline or 3 ml of 0.9% saline containing 1.5 mg PGE2. Twelve patients in the PGE2 group and two in the placebo group were delivered within 24 h (P less than 0.001). Eight blood samples were taken from each patient and serum PGFM and progesterone levels were measured by radioimmunoassay. In the women in whom labor started, PGFM serum levels rose progressively and progesterone levels fell consistently as the cervix dilated. After successful induction with PGE2 the variations were more marked than with labor of spontaneous onset. The PGFM-rise after PGE2 treatment must be due to stimulation of endogenous PGF2 alpha production by local therapy.

Cervix Uteri↗
PubMed1986

Does cyclosporin A influence sex hormone level?

Cyclosporin A is an effective immunosuppressive substance which is extensively applied in various conditions. A well known side effect of high dose Cyclosporin A treatment is the occurrence of hypertrichosis, often referred to as hirsutism. The purpose of the study was therefore to investigate ovarian, adrenal and pituitary hormones as possible mediators of increased hair growth. In 5 female and 11 male patients who had developed hair overgrowth during Cyclosporin A treatment serum androgens (testosterone, dehydroepiandrosterone-sulfate, androstendione), sex hormone binding globuline (SHBG), prolactin (HPRL), 17-hydroxyprogesterone (17-OHP), 17 beta-estradiol (17 beta-E) and cortisol (F) were determined by standard radioimmunoassay methods. The same number of age matched patients with Azathioprine treatment served as control. Both patient groups received additive cortisone treatment of the same dosage. No significant differences of serum androgens were noted between Cyclosporin A treated patients and controls. In addition, normal prolactin levels were defected. 17-OHP was in the low normal range and cortisol below normal due to the additive cortisone treatment. SHBG was within normal range. The findings thus indicate that increased hair growth caused by Cyclosporin A seems not to be caused by an action of the substance on the hormonal level.

17-alpha-Hydroxyprogesterone↗
PubMed1986

[Inhibition of ovulation with 35 micrograms of ethinyl estradiol and 2 mg of cyproterone acetate (Diane 35)].

In the study reported here the ovulation inhibition dose for cyproterone acetate was determined. Experiments showed that the ovulation inhibition dose is 1 mg of cyproterone acetate, administered daily. Results proved that the cyproterone acetate dose cannot be reduced when cyproterone acetate is combined with ethinyl estradiol. However, the objective of this study was to determine whether it is possible to reduce the estrogen dose to 35 micrograms when the common combination of 2 mg cyproterone acetate and ethinyl estradiol is being used. After a control menstruation cycle, 2 mg cyproterone acetate and 35 micrograms ethinyl estradiol were administered daily to six women with normal menstruation. Drug administration began on Day 5 and ended on Day 25. During the control cycle, the first treatment cycle, and the third treatment cycle, LH, FSH, 17 beta estradiol, progesterone, testosterone, prolactin, and SHGB were examined daily. Cervix score and karyopyknosis index were determined at the same time. In addition, antithrombin III was examined during the control cycle and during the third treatment cycle. Present results show that ovulation inhibition is possible with dose reduction of ethinyl estradiol to 35 micrograms, combined with 2 mg of cyproterone acetate. Increase in SHBG and reduction in testosterone serum level point to an additional antiandrogenic effect of cyproterone acetate, aside from its cellular effect. The combined preparation discussed here does not bring about any changes in antithrombin III values. Results permit the conclusion that ovulation inhibition is insured with a reduction of the daily estrogen dose from 50 micrograms to 35 micrograms.

Adult↗