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Biomedical subjects

P D Tsitouras

Publications and source records attributed to P D Tsitouras.

At least 19 recordsLinked to original sources

Serum testosterone and growth hormone/insulin-like growth factor-I in adults with spinal cord injury.

Aging is associated with relative growth hormone and/or testosterone (T) hormone deficiency, and those with SCI may have a premature deficiency of these two hormones. The effects of SCI, duration of injury (DOI), and advancing age with that of human growth hormone (hGH) and insulin-like growth factor I (IGF-I), as well as potential associations between them, were studied. Data were obtained from 20 male subjects with SCI and 16 gender- and age-matched controls. Serum total and free T were lower in subjects with SCI compared with controls (mean +/- SEM, 3.12 +/- 0.29 versus 4.68 +/- 0.28 ng/ml, p < 0.001 and 1.89 +/- 0.18 versus 2.46 +/- 0.22 ng/ml, p < 0.05, respectively). Nine of the 20 subjects with SCI, but none of the controls, had abnormally low serum total T. Arginine-stimulated values for hGH were lower in the group with SCI compared with controls (198 +/- 18 versus 267 +/- 27 ng/ml, p < 0.05). Serum luteinizing hormone and follicular stimulating hormone, as well as body mass index, were not significantly different between the groups. Serum total and free T were correlated with advancing age in controls (r = 0.62, p < 0.01 and r = 0.51, < 0.05, respectively) but not in SCI (r = 0.19, p > 0.43 and r = 0.39, p = 0.09). However, serum total and free T declined with increasing DOI in SCI (r = 0.56, p < 0.01 and r = 0.44, p = 0.05, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Myxedema coma.

Myxedema coma is a rare, hard-to-diagnose condition with a very high mortality rate. Prompt diagnosis and aggressive treatment are essential because they can greatly improve survival risks.

Aged↗

The aging male reproductive system.

The frequency of sexual activity declines dramatically with age, but this cannot be attributed, with any degree of certainty, to the rather modest hormonal and spermatogenic changes observed with advancing age. Despite the development of intrinsic age-related defects at all levels of the hypothalamic-pituitary-testicular axis, reproductive capacity is maintained in most healthy elderly men.

Aged↗

Blunted growth hormone response to intravenous arginine in subjects with a spinal cord injury.

The influence of the activities of daily living on human growth hormone (hGH) release and plasma insulin-like growth factor (IGF-I) levels is not known. Individuals with spinal cord injury (SCI) and paralysis generally have reduced levels of activity compared with ambulatory subjects. We studied sixteen subjects with SCI and sixteen nonSCI subjects matched for age, gender and body mass index (BMI) as controls. After an intravenous infusion of arginine hydrochloride (30 g/subject over 30 minutes), mean plasma hGH values at 30 and 60 minutes were significantly lower in the group with SCI compared with the control group (3.4 +/- 0.7 versus 10.7 +/- 2.5 ng/ml, p < 0.01; and 5.2 +/- 1.5 versus 12.5 +/- 2.7 ng/ml, p < 0.05). Also, peak and sum hGH responses were significantly lower in the group with SCI than in the control group (5.8 +/- 1.5 versus 14.1 +/- 2.8 ng/ml, p < 0.01; and 15.2 +/- 3.1 versus 34.8 +/- 7.2 ng/ml, p < 0.02). Controlling for age and BMI, the results remained significant. However, the mean plasma IGF-I level was significantly lower in SCI subjects younger than 45 years old than in the similar subgroup of age-restricted controls (202 +/- 19 versus 324 +/- 27 ng/ml, p < 0.05), whereas, a comparison of subgroups of subjects 45 years or older did not reveal a significant difference. These findings support the hypothesis that decreased daily physical activity results in depression of the hGH/IGF-I axis in younger individuals with SCI and may be considered to be a state of premature aging.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Chronic baclofen therapy improves the blunted growth hormone response to intravenous arginine in subjects with spinal cord injury.

Human GH (hGH) secretion is stimulated by vigorous physical activity, whereas immobilization reduces its release. In paralyzed subjects with spinal cord injury (SCI), it has recently been shown that the release of hGH to provocative stimulation and plasma insulin-like growth factor-I (IGF-I) levels are reduced. The acute administration of baclofen, a gamma-aminobutyric acid derivative, has been shown to stimulate hGH release. The present study investigated the effect of chronic administration of baclofen on the provocative testing of hGH secretion and plasma IGF-I levels. Sixteen subjects with SCI were studied; eight subjects were treated (40-80 mg/day; > 6 months) with baclofen (Bac+), and eight were not (Bac-). Additionally, 8 non-SCI subjects were studied as controls. The groups were matched for gender and age. The subjects were not receiving any medications known to influence hGH secretion. After an overnight fast, arginine hydrochloride (30 g/subject) was infused iv over 30 min, with blood drawn for hormone determinations at baseline and 30, 60, 90, and 120 min. In the Bac- group compared with the Bac+ group, the arginine-stimulated mean plasma hGH levels at 30 and 60 min (P < 0.05) and peak and sum plasma hGH levels (P < 0.01) were reduced. There were no significant differences in the plasma hGH response between the Bac+ group and the control group. Plasma IGF-I levels may reflect the integrated tissue response to hGH. A significant inverse relationship was present between age and plasma IGF-I levels for the control and Bac+ groups, but not for the Bac- group. The mean plasma IGF-I level was significantly reduced in the Bac- compared with the Bac+ group. No significant differences in mean plasma IGF-I levels were noted between the Bac+ and control groups. SCI is associated with body composition changes and metabolic alterations that may be exacerbated by reduced activity of the hGH-IGF-I axis. Oral chronic baclofen therapy appears to reverse the deleterious effects of paralysis and immobilization on hGH physiology.

Adult↗

Reproductive hormones in aging men. III: Basal and LHRH-stimulated serum concentrations of the common alpha-subunit of the glycoprotein hormones.

In a previous study, we described unaltered basal serum levels of sex steroids, increased basal luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and diminished and/or delayed gonadotropin responses to exogenous luteinizing hormone releasing hormone (LHRH) in 69 healthy men, aged 25 to 89 years, in the Baltimore Longitudinal Study of Aging. Here we report basal and LHRH-stimulated serum concentrations of the common alpha-subunit of the glycoprotein hormones in 53 of these same men, divided into groups: A, 25 to 49 years, (n = 22); B, 50 to 69 years, (n = 18); and C, 70 to 89 years, (n = 13). There were no significant (p greater than .2) age-related alterations in basal serum concentrations of the alpha-subunit. Using repeated measures analysis of variance (ANOVA), we found a significant difference between basal levels and peak responses to LHRH for alpha-subunit in each group (p less than .001); however, age per se did not influence the magnitude of this response (p greater than .1). Frequency distribution analysis of the time of the peak alpha-subunit response across age groups demonstrated a significant age-related delay in the timing of the peak alpha response (p less than .03). These data, in conjunction with our prior observations, suggest that in healthy men there may be age-related alterations in the secretion and/or metabolic clearance of pituitary gonadotropins and their component subunits.

Adult↗

Effects of age on testicular function.

Although frequency of sexual activity declines dramatically with age, most investigators have been able to define rather small physiologic function (hormonal and spermatogenic) changes with advancing age. Despite the development of subtle intrinsic age-related defects at all levels of the hypothalamic-pituitary-testicular axis, reproductive capacity is maintained in healthy elderly men.

Adult↗

In vivo pretreatment with human chorionic gonadotropin fails to reverse the dysfunction of isolated Leydig cells from chronically uremic rats.

In order to further investigate the previously reported hypogonadal state of chronically uremic rats, we examined the effects of in vivo pretreatment with human chorionic gonadotropin (hCG) on in vivo and in vitro Leydig cell function, comparing paired intact rats with rats made chronically uremic by 5/6 nephrectomy. The in vitro testosterone (T) secretory responses to varying concentrations of hCG or dibutyryl cAMP and the number of gonadotropin receptors were determined following hemicastration. The rats were then treated with hCG for 3 days and the remaining testes were removed and studied as before. Compared with intact rats, the uremic rats had higher serum concentrations of urea nitrogen (P less than 0.001); serum T concentrations were lower in uremic rats before (P less than 0.001), but not after (P greater than 0.6) treatment. Treatment produced increases in serum T only in uremic rats (P less than 0.001). Serum LH was lower in uremic rats before treatment (P less than 0.001) and was reduced (P less than 0.001) to similar levels (P greater than 0.8) in both groups after treatment. Baseline in vitro T secretion was lower (P less than 0.001) from Leydig cells of uremic than intact rats both before and after treatment. Analysis of variance of dose-response curves showed pre- and post-treatment T secretory responses to hCG or dibutyryl cAMP in vitro to be less from Leydig cells of uremic rats (P less than 0.01). Before treatment, Leydig cell gonadotropin receptor number was lower in uremic than intact rats (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Decreased in vitro secretion of LH, FSH, and free alpha-subunits by pituitary cells from old male rats.

Various in vivo and in vitro pituitary-Leydig cell functions were examined in mature (5-8 mo) vs. old (22-25 mo) male Wistar rats. Old rats exhibited decreased serum concentrations of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) (P less than 0.0025) but similar levels of prolactin (P less than 0.01) both before and 4 wk after castration. The in vitro release of LH, FSH, and free alpha-subunits was measured in primary cultures of dispersed anterior pituitary cells from both intact and castrated rats. During 48 h of incubation, basal secretion rates of the glycoproteins were decreased (P less than 0.001) from cells of both intact and castrated old rats. After stimulation with LH-releasing hormone (LRH) in single (10(-8) M) or multiple (10(-10) - 10(-7) M) doses, the total amounts of the glycoproteins secreted were also less from cells of both intact and castrated old rats. However, repeated measures analysis of variance revealed age-related hyporesponsivity to LRH stimulation only for LH secretion by cells from intact rats. The basal molar ratios of alpha/(LH + FSH) secreted by cells from intact but not castrated old rats were lower than those from cells of the corresponding mature rats. Moreover, after LRH stimulation (10(-10) - 10(-7) M), molar secretory ratios of alpha/(LH + FSH) decreased from cells of intact mature rats but increased from cells of intact old rats. These in vitro data suggest that the reduced serum LH and FSH levels in intact and castrated old male rats result in part from decreased secretion of these glycoproteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

In vivo chorionic gonadotropin administration reverses the testosterone secretory defect of Leydig cells from old rats.

Old male rats have decreased serum testosterone, luteinizing hormone (LH), follicle -stimulating hormone (FSH), Leydig cell testosterone secretory responsiveness to chorionic gonadotropin (hCG), and gonadotropin binding capacity. Although prolonged in vivo hCG administration restores serum testosterone, in vitro hCG exposure of Leydig cells does not reverse their age-related hyporesponsiveness. To explore this discrepancy, we studied Leydig cell function before and after hCG administration in vivo (treatment). Before treatment, old rats had lower serum testosterone, in vitro testosterone and cyclic adenosine monophosphate (cAMP) production, both basally and in response to hCG, and reduced hCG binding capacity. After treatment, old and young rats did not differ in any of these parameters. hCG binding and cAMP responses were reduced in both old and young rats. Thus, prolonged in vivo exposure to hCG appeared to reverse both the in vivo and in vitro age-related Leydig cell secretory defect, despite gonadotropin receptor down-regulation. This suggests that the "aging" defect(s) are caused by chronic gonadotropin deprivation.

Aging↗

Relationship of serum testosterone to sexual activity in healthy elderly men.

There are reports of decreases in both sexual activity and serum testosterone in older men but not of any clear association between the two variables. In healthy participants in the Baltimore Longitudinal Study on Aging, despite the fact that serum testosterone did not decline with age, sexual activity decreased in a highly predictable fashion. In men over 60 years old, those with higher levels of sexual activity (for age) had significantly greater levels of serum testosterone. Although we found an inverse correlation between testosterone and percentage of body fat, there was no relationship between percentage of body fat and sexual activity. We also found no correlation between testosterone or sexual activity and smoking or coronary heart disease. Subjects drinking more than 4 oz. of ethanol per day were more likely to have decreased sexual activity but not diminished testosterone concentration. Our data suggest that, although serum testosterone level and ethanol intake may affect sexual activity in older men to some degree, age itself still appears to be the most influential variable.

Aged↗

Emergency detention of the elderly: demographics, diagnoses, and outcome.

Involuntary medical detention is an increasing problem in many large teaching hospitals. Forty-two elderly patients involuntarily admitted for protective service to the general medical wards were compared with an age-matched group of 25 elderly persons voluntarily seeking care in the same institution. The comparison showed that most of the involuntarily admitted patients were more than 70 years of age, and more of them lived alone. On admission they had more dementia and dehydration but less urinary-tract infection than did the controls. Their hospital stays were longer. There was no difference between the groups with respect to discharge dispositions.

Age Factors↗

Evaluation of pituitary gonadotropic function in men: value of luteinizing hormone-releasing hormone response versus basal luteinizing hormone level for discrimination of diagnosis.

We examined the serum LH response to LRH in 40 normal men and 38 men with various forms of gonadal dysfunction in an attempt to determine whether the LH response to LRH was more useful than the basal LH level alone for categorizing pathophysiological subgroups of gonadal dysfunction. The subgroups studied included hypogonadotropic hypogonadism, delayed puberty, idiopathic oligospermia, and primary hypogonadism. Log transformation of all values was done in order to normalize the data. Spearman's correlation analysis showed that increased basal LH was associated with increased incremental LH responses. However, our preliminary analysis of LRH response data suggested that the changes in LH were smaller in the secondary hypogonadal and delayed puberty groups then could be accounted for by the differences in basal LH level. Accordingly, we used various statistical techniques to test whether, and under what conditions, LRH testing provides information beyond that evident from examination of basal LH values. We found that the relationship between basal LH and the LH response to LRH differs in men with and without hypothalamic-pituitary dysfunction and that this difference can be exploited to improve the discrimination of men with pituitary hypogonadism from normals.

Adolescent↗