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Biomedical subjects

K E Friedl

Publications and source records attributed to K E Friedl.

At least 37 records · Page 2Linked to original sources

Psychological and serum homovanillic acid changes in men administered androgenic steroids.

We report a difference in the response of serum homovanillic acid (HVA) and in the performance of some psychological tasks before and after the administration of testosterone enanthate (TE, 100 or 300 mg/wk) or nandrolone decanoate (ND, 100 or 300 mg/wk) for 6 wk to healthy men. Serum HVA was significantly increased in both the low- and high-dose ND groups, from 8.4 +/- 1.0 and 8.7 +/- 0.5 pmol/ml (mean +/- SE) to 11.6 +/- 1.7 and 10.7 +/- 1.1 pmol/ml respectively. No significant changes in HVA were observed for the groups administered TE, nor in 5-HIAA for any of the groups. The influence of ND on the dopaminergic system, which is reflected in increased serum HVA, appears to be independent from the psychological effects which were produced by both androgens. The only change in psychomotor test performance was an improvement in the first trial of a pegboard task. All subjects except those receiving ND (100 mg/wk) were significantly more optimistic in the prediction of their own performance for all nondominant hand tasks (pegboard and finger tapping). The "hostility" and "resentment and aggression" subscales of the MMPI increased significantly in all groups, more so in the high-dose groups.

Adult↗

Comparison of the effects of high dose testosterone and 19-nortestosterone to a replacement dose of testosterone on strength and body composition in normal men.

We examined the extent to which supraphysiological doses of androgen can modify body composition and strength in normally virilized men. In doubly blind tests, 30 healthy young men received testosterone enanthate (TE) or 19-nortestosterone decanoate (ND), at 100 mg/wk or 300 mg/wk for 6 weeks. The TE-100 mg/wk group served as replacement dose comparison, maintaining pretreatment serum testosterone levels, while keeping all subjects blinded to treatment, particularly through reduction in testicular volumes. Isokinetic strength measurements were made for the biceps brachii and quadriceps femoris muscle groups before treatment and 2-3 days after the 6th injection. Small improvements were noted in all groups but the changes were highly variable; a trend to greater and more consistent strength gain occurred in the TE-300 mg/wk group. There was no change in weight for TE-100 mg/wk but an average gain of 3 kg in each of the other groups. No changes in 4 skinfold thicknesses or in estimated percent body fat were observed. Of 15 circumferences, significant increases were observed only for men receiving TE-300 mg/wk (shoulders) and ND-300 mg/wk (shoulders and chest). The data suggest that high dose androgens increase body mass and may increase strength in normal men but, except for a consistent weight gain with greater than replacement doses, the detectable changes were highly variable and relatively small, especially in comparison to the significant alterations which were observed for other markers of androgen action.

Adult↗

High-density lipoprotein cholesterol is not decreased if an aromatizable androgen is administered.

We examined the influence of aromatization of testosterone on serum high-density lipoprotein cholesterol (HDL-C) and postheparin plasma hepatic triglyceride lipase activity (HTLA) in men. Eighteen healthy lean nonsmokers (ages, 20 to 33) were administered androgens in a weekly total dose of 280 mg for 12 weeks in one of three groups: testosterone enanthate (TE) (280 mg/wk intramuscularly [IM]); TE (280 mg/wk IM) + testolactone (TL) (250 mg orally [PO] four times daily); or methyltestosterone (MeT) (20 mg PO twice daily). Serum testosterone achieved steady state levels by 4 weeks with greater than 40 nmol/L (TE and TE + TL) and less than 15 nmol/L (MeT) while 17b-estradiol (E2) rose to greater than 250 pmol/L (TE) or remained below 70 pmol/L (TE + TL and MeT). LH fell to less than 5 U/L (TE and TE + TL) but remained unchanged with MeT. By 4 weeks, HDL-C had decreased significantly from 1.20 +/- 0.13 to 0.77 +/- 0.13 mmol/L (MeT), from 1.18 +/- 0.15 to 0.89 +/- 0.13 mmol/L (TE TL), and demonstrated no decrease in the TE group across the time course of the study. These changes were preceded by mean increases in HTLA of 102% (MeT) and 55% (TE + TL) over baseline, and no significant change with TE. The changes in HDL-C and HTLA returned to baseline within 2 weeks of steroid cessation. There were no changes in total cholesterol, triglycerides, or insulin in any group but, in the MeT group, apo AI levels decreased and low-density lipoprotein cholesterol (LDL-C) increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Assessment of pubertal maturity in boys, using height and grip strength.

A method is described for the convenient, noninvasive assessment of pubertal maturity in boys, which is intended for use in studies of developmentally related sports injury. Ninety-eight boys were evaluated for Tanner stage, age, height, weight, body mass index, and maximum (right or left hand) and average grip strength. Height and average grip strength were selected by discriminate analysis as independent predictors of maturity. Immature boys (Tanner stages 1-3) fell below average grip strength of 25 kg and were less than 65 inches (165 cm) in height, whereas boys who exceeded both of these measurements were mature (Tanner stage 4 or 5). This method was validated in a second sample of 99 boys with 100% specificity and sensitivities of 93.5% (immature boys) and 81% (mature boys). A subset of mature boys met the height criterion but did not achieve the average grip strength criterion for maturity. We propose the use of height and grip strength as a practical, noninvasive method to classify physical maturity in boys. In addition, we speculate that the subset of boys who are tall, but weak, may be at increased risk for certain types of sports injuries.

Adolescent↗

Serum lipids and lipoproteins in continuous or cyclic medroxyprogesterone acetate treatment in postmenopausal women treated with conjugated estrogens.

This study evaluates effects on serum lipids of continuous or sequential progestogens for hormonal replacement in women. Subjects received either a cyclic regimen of replacement (0.625 mg/d of conjugated equine estrogens (Es) for 25 days/month and 10 mg medroxyprogesterone acetate [MPA] for the last 13 days of E) or 0.625 mg/d E along with either 5 or 10 mg MPA (Provera, Upjohn Company, Kalamazoo, MI). Study parameters were measured over a 24-week period. No differences in total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, apolipoproteins I and II, sex hormone-binding globulin, or serum MPA levels were noted between the sequential and 5 mg continuous group. The 10 mg MPA group did not have an increase in HDL or decrease in low-density lipoprotein as did the other groups.

Adult↗

Atropine absorption after intramuscular administration with 2-pralidoxime chloride by two automatic injector devices.

Compared with manual intramuscular injection, automatic injector delivery substantially enhances drug absorption rate. We examined the effect of two types of automatic injector delivery of two drugs which are components of the standard antidote to anticholinesterase poisoning and which have been previously shown to have a reduced absorption rate when mixed together in a manual injection. In crossover experiments one week apart, 20 nonsmoking healthy young male humans (ages 20-30) were studied after citrated atropine (6.9 mumol/0.7 mL) and pralidoxime chloride (3.5 mmol/2.0 mL; PAMCL) were injected sequentially into a single intramuscular site by either a multichambered autoinjector or a device which delivers the drugs into two separate intramuscular sites (MARK I). Atropine absorption was assessed by the appearance of atropine in the serum and by changes in heart rate, salivary secretion, pupil diameters, and near vision accommodation. Atropine absorption was significantly greater in the first 30 min following injection with the MARK I. The results of this study suggest that: (1) the MARK I device produces a faster absorption of atropine, probably through some combination of its broader dispersal of atropine in the muscle site and its separation of atropine from the PAMCL; (2) salivary secretion may be the most convenient and sensitive marker of atropine action; and (3) the 6.9- mumol (2-mg) dose of atropine delivered by either autoinjector gives near maximal antisialogogue activity in normal male humans.

Accommodation, Ocular↗

The administration of pharmacological doses of testosterone or 19-nortestosterone to normal men is not associated with increased insulin secretion or impaired glucose tolerance.

Excess androgen secretion and exogenous androgen administration may decrease insulin sensitivity and impair glucose tolerance. We examined the responses to an oral glucose tolerance test in 30 normal men before and after 6 weekly injections of androgen administered in a double-blinded study design. The men were randomly assigned to 1 of 4 treatment groups: testosterone enanthate (TE), 100 or 300 mg/week, or 19-nortestosterone decanoate (ND), 100 or 300 mg/week. Serum testosterone levels, measured 2-3 days after the last dose, did not change in the men given 100 mg TE/week, increased 3-fold in those given 300 mg TE/week, and decreased in both ND groups. All four groups had comparable reductions in serum LH levels. Weight increased significantly in all except the 100 mg TE/week group, but there was no change in waist to hip ratio in any group. In spite of the demonstrated biological effects of the doses of steroid administered, androgen administration for 6 weeks did not increase fasting serum glucose or insulin concentrations. There was also no increase in peak serum insulin levels and areas under the insulin and glucose response curves after a 100-g oral glucose load. However, the mean serum insulin area under the curve decreased significantly in the men given 300 mg ND/week. In contrast to the results of studies of 17-alkylated androgens, our results demonstrate that pharmacological doses of testosterone and the administration of 19-nortestosterone for 6 weeks do not impair glucose tolerance or alter insulin secretion in normal men.

Administration, Oral↗

Anabolic steroid use: indications of habituation among adolescents.

The use of anabolic steroids (AS) by adolescent males is argued to be more widespread than currently acknowledged. Although the long-term physiological and psychological ramifications of use are not well established, current research and anecdotal information suggest that there is reason for concern. In addition, very little is known about the attitudes and behaviors of these adolescent AS users. While the debate concerning the physiological versus the psychological dependence liability of various drugs continues to evolve, there seems to be a consensus that drug dependence is not a per se phenomenon and that the characteristics of dependence differ in accordance with the drug being used. The following article attempts to identify characteristics of the adolescent male AS user and suggests that AS use does have a dependence potential. The AS user population was found to be significantly different from nonusers in several areas such as self-perceptions of health and strength, interest in controlling AS use, and perceptions of peer AS use. The AS user group was also found to contain several subgroups (heavy users [greater than or equal to 5 cycles] versus other users, and those who initiated use prior to age sixteen who reported significantly different attitudes and/or behaviors. These differences suggest that prevention efforts will have to focus on different motivations for AS use.

Adolescent↗

Estimated prevalence of anabolic steroid use among male high school seniors.

The use of anabolic-androgenic steroids (AS) is perceived by the media, by segments of the sports medicine and athletic communities, and by the public to have grown to epidemic proportions. Unfortunately, the incidence and prevalence of AS use among elite, amateur, and recreational athletes is poorly documented. This study was designed to help identify AS use patterns among the male portion of the general adolescent population. The overall participation rate on a schoolwide basis was 68.7% and on an individual basis reached 50.3%. Participants in this investigation were 12th-grade male students (N = 3403) in 46 private and public high schools across the nation who completed a questionnaire that established current or previous use of AS as well as user and nonuser characteristics. Results indicate that 6.6% of 12th grade male students use or have used AS and that over two thirds of the user group initiated use when they were 16 years of age or younger. Approximately 21% of users reported that a health professional was their primary source. The evidence indicates that educational intervention strategies should begin as early as junior high school; the intervention should not be directed only toward those individuals who participate in school-based athletics.

Adolescent↗

Soccer injuries and their relation to physical maturity.

A prospective study of injuries encountered during participation in a summer soccer camp for youths aged 6 through 17 years revealed an injury incidence of 10.6 per 1000 hours for girls (107 injuries in 458 girls) and 7.3 per 1000 hours for boys (109 injuries in 681 boys). For both sexes, the incidence of injury increased at age 14 years. One certified athletic trainer (W.D.C.) assessed and documented all injuries during the course of the study. Seventy percent of injuries involved the lower extremities. Contusions represented 35.2%, strains 27.8%, sprains 19.4%, and fractures and dislocations 2% of all reported injuries. The ankle was the most frequent site of injury in both sexes. Quadriceps strain was a common injury in boys. The boys with the highest incidence of injury were tall (greater than 165 cm) and had a weak grip (less than 25 kg), suggesting that skeletally mature but muscularly weak boys may be more susceptible to injury while playing soccer with peers of the same chronological age.

Adolescent↗

Effect of eye color on heart rate response to intramuscular administration of atropine.

Melanin has been previously shown to modify the mydriatic response to atropine instillation. Skin and iris pigmentation has also been shown to modify aspects of the heart rate response to injected atropine, although these observations have been generally overlooked. In this study, 20 healthy non-smoker male subjects, ages 20-30 years, were injected by two different automatic injector devices and the mydriatic and heart rate responses in the first 90 min were reported. The group included 8 brown-eyed, 4 hazel-eyed, and 8 blue-eyed subjects. Although there were differences in the rate of atropine delivery between the two injection devices, the heart rate responses were independently modified by eye color to a magnitude of difference as great as the differences between injectors. Subjects with more pigmented irides (brown-eyed) showed a more rapid rise in heart rate compared to less pigmented irides (hazel-eyed and blue-eyed subjects). Following injection by the device with a slower atropine absorption rate, these differences were particularly enhanced and an abbreviated bradycardic phase of the heart rate response was observed for the brown-eyed subjects. This observation confirms earlier reports and suggests the possibility of an interference by melanin (in the iris or elsewhere) in atropine accessibility to selected muscarinic target sites.

Adult↗

Deadly defense?

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Adult↗

Elevation of plasma estradiol in healthy men during a mountaineering expedition.

The following study was undertaken to study the effects of multiple stressors on the pituitary-testicular axis in men. We examined the endocrine responses of 16 healthy young men participating in a mountain training exercise. Blood was drawn at 1830 m just before ascent (t = 0 h), after an overnight rest at 3050 m (t = 24 h), and immediately after a descent from 3050 m in adverse conditions (t = 48 h). Plasma E2 increased significantly through the study periods (medians: 74, 104, 164 pmol/l at t = 0, 24, 48 h) while 17 alpha-hydroxyprogesterone progressively decreased. Testosterone and the bioactive LH to immunoreactive LH ratio decreased only at 48 h. There were no changes observed for plasma cortisol, prolactin or thyroxine. The observed rise in E2 may be due to one or more stressors associated with altitude, including hypoxia and increased solar radiation. This data suggests a role for E2 in the secondary testosterone decrease.

Adolescent↗

Clinical usefulness of an algorithm for the early diagnosis of spinal metastatic disease.

We have previously reported an algorithm that invokes several imaging modalities in the early detection of metastatic and benign disease of the spine in patients with cancer (J Clin Oncol 4:576, 1986). The development of new lesions (shown by Tc99m bone scans) in cancer patients with normal neurological examinations is further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M). Of 60 patients in the original study, 28% were diagnosed as having only benign disease and the remainder had spinal metastases. Thecal sac impingement was seen in 47% of patients with metastatic disease and disruption of the posterior vertebral cortex was noted in all patients with epidural compression. We now report the 2-year follow-up of 55 of these patients. Without treatment, the 17 patients diagnosed with benign disease have shown no evidence of local failure in the spine and median survival is greater than 27 months. Thirty-eight patients diagnosed with spinal metastases had a median survival time of 16.9 months. Radiation therapy directed by CT-M findings provided pain relief in 78% of patients with back pain and metastatic disease. No patient, including 19 with thecal sac impingement, developed clinical myelopathy. These results demonstrate the usefulness of an imaging algorithm for the early identification and distinction of spinal metastatic disease and benign disease in patients with cancer.

Algorithms↗

Inhibition of sex hormone-binding globulin production in the human hepatoma (Hep G2) cell line by insulin and prolactin.

Sex hormone-binding globulin (SHBG) production in humans has been thought to be stimulated by estrogens and thyroid hormone and inhibited by androgens. However, recent data indicate that SHBG production in vitro is stimulated by both androgens and estrogens. This study was designed to determine what other hormonal factors regulate SHBG production. Since hyperinsulinemia and hyperprolactinemia both occur in disease states in which low serum SHBG levels are found, the effects of insulin and PRL were compared to and/or studied in combination with estradiol (E2), T4, and testosterone (T) in a human hepatoma cell line (Hep G2). Hep G2 cells were grown to near confluence in medium including 10% fetal calf serum, and then 72-h experimental incubations were carried out which used only fetal calf serum-free medium. Compared to control incubations, both insulin (10(-8) mol/L) and PRL (10(-8) mol/L) decreased SHBG production from 65.0 +/- 0.6 (+/- SE) to 46.8 +/- 1.1 and 46.8 +/- 1.2 nmol/10(6) cells, respectively (P less than 0.01). Insulin also inhibited both E2 and T4-stimulated SHBG production. T stimulated SHBG production to the same degree as E2. Finally, both E2 and insulin significantly increased cell number, an important consideration when expressing the effect of a hormone on SHBG production in cultured cells. We conclude that insulin and PRL inhibit SHBG production and confirm that T4, T, and E2 stimulate SHBG production in vitro. These findings suggest that insulin and PRL may be important factors in the regulation of SHBG production in vivo.

Carcinoma, Hepatocellular↗