Prognosis of COPD patients after an episode of acute respiratory failure.
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Biomedical subjects
Publications and source records attributed to S Campo.
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We have studied the acute effect of hOG and testosterone administration to immature rats, on testicular (particulate fraction and cytosol) and epididymal (cytosol) ABP levels. One and four hours after a single dose of 10 IU hCG/rat, ABP concentration decreased slightly in testicular membranes and cytosol, but increased markedly in epididymal cytosol (169 +/- 5 and 182 +/- 5 at 1 and 4 h respectively, compared to 113 +/- 13 fmoles/mg protein in control animals, mean +/- SEM). Since testicular and epididymal concentrations of testosterone increased after hCG, as expected, the effect might have been mediated by gonadotrophin stimulated testosterone production in Leydig cells. To test this hypothesis, the hCG effect was studied in rats that previously had received aminoglutethimide to block steroidogenesis. Under these conditions, hCG failed to increase epididymal ABP. Finally, administration of testosterone propionate was also able to stimulate epididymal ABP, but with delayed response: the increase was observed 4 h after injection (212 +/- 18 compared to 127 +/- 28 fmoles/mg protein in control animals, mean +/- SEM). It is concluded that the hCG-induced increase of intratesticular androgen levels results in rapid passage of ABP from testis to epididymis.
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Purified urinary follicle-stimulating hormone was used to induce ovulation in 18 patients with polycystic ovarian syndrome. Each ampule contained 75 IU of follicle-stimulating hormone and less than 0.11 IU of luteinizing hormone. Initial doses were 150 to 225 IU/day, later increased to a maximum of 375 IU, according to daily clinical controls and estradiol values. After 12 to 16 days, follicle-stimulating hormone treatment was suspended. Within 36 to 48 hours each patient received 5000 or 10,000 IU of human chorionic gonadotropin, rarely more. Ovulation occurred in 39 of 43 treatment cycles and hyperstimulation in nine. Seven patients had normal pregnancies with viable fetuses, including one pair of twins. Two had abortions. Analysis of the endocrine situation during therapy does not permit either pregnancy or hyperstimulation to be predicted. However, hyperstimulation is frequently accompanied by endogenous luteinizing hormone peaks and greater estradiol increases during the final phase of induction. Purified follicle-stimulating hormone has thus demonstrated its validity in inducing ovulation in patients with polycystic ovarian syndrome, apparently with equal or lower risks of hyperstimulation than with other gonadotropin preparations.
An androgen binding activity with characteristics similar to ABP is present in a particulate fraction (105,000 g pellet) obtained by differential centrifugation of seminiferous tubules, impure Sertoli cells and impure germ cells homogenates. Purification of germ cells through albumin gradients, results in almost a complete loss of androgen binding activity in the purified germ cell suspensions. Furthermore, Sertoli cell enriched testes from 22-, 32- and 40-day old rats showed increases in particulate androgen binding, when compared to matched controls, parallel to increments in the activity of a Sertoli cell marker enzyme (beta-glucuronidase). These results suggest that particulate androgen binding activity is only present in Sertoli cells and this protein may play a role in the compartmentalization of androgens in the testis.
The distribution and morphological behaviour of bombesin like immunoreactive cells in the proventriculus of chick embryos, newborns and adults were investigated by indirect immunoperoxidase procedure. The first immunoreactive cells appear around the 11th day of incubation. Initially few, they increase progressively to reach a peak around the 18th day. Throughout the embryonic period almost all immunoreactive cells are column-shaped, display a typical "open" behaviour, and are situated among other superficial lining epithelial cells. Around hatching time, these "open" cells suddenly decrease in number while another immunoreactive "closed" cell type becomes more evident in a deeper location. In newborns and adults, the majority of immunoreactive cells are oval shaped and are characteristically situated near the neck of lobular glands; they seem to display a "closed" behaviour. The results demonstrate two different kinds of peptide-containing cells which probably exert different functions. During the embryonic period, in fact, they resemble a chemioreceptor, but in postnatal life they appear as a paracrine/endocrine elements.
Cervical mucus forms channels when dried under a coverslip. The aim of the present work was: 1) to prove mucus canalization both in spontaneous ovulatory cycles and during ovulation induction with gonadotropins; 2) to prove the estrogen dependence of this phenomenon; 3) to check the importance of the proteidic and electrolytic concentration on chaneling; and 4) to use this phenomenon clinically, shortening the time in which it occurs. The number and arrangement of channels vary during the cycle. The phenomenon is estrogen-dependent. The comparison between estradiol values and the number of channels during spontaneous ovulatory cycles and treatment with gonadotropins showed a linear relationship. Treatment with estradiol 17 beta-valerate and ethinyl estradiol induced channel formation in women with primary amenorrhea. Canalization and ferning disappeared after dialysis or treatment with proteolytic enzymes. It follows that the two phenomena have similar characteristics. Canalization increases daily, as does estradiol, whereas ferning maintains the same grade for a longer period, and when a grade of + + + is reached, it provides no further indications. With the use of a thermostat, canalization occurred in only a few hours. Chaneling, a more precise index, could therefore substitute for ferning, particularly when monitoring the induction of ovulation.
Ovarian resection was performed by means of celioscopy in 12 patients with polycystic ovaries (PCO), who had not responded to clomiphene + HCG therapy. This therapy had induced ovulation in only 14% of 56 therapeutic cycles. Ovarian resection through celioscopy induced ovulation in 45% of cycles. Clomiphene + HCG therapy after resection in patients with no spontaneous ovulation induced ovulation in 44% of cycles. Seven pregnancies followed in 5 women, equal to 41% of patients. Hormonal patterns (FSH, LH, E2, progesterone, dehydroepiandrosterone sulfate, testosterone) before and after resection showed no significant variation. The authors emphasize other advantages of this technique, such as fewer surgical injuries than laparotomy, relative harmlessness of the treatment, the possibility of repeating it and of performing subsequent laparotomy.
Androgen binding activity was evaluated in different subcellular particulate fractions obtained by differential centrifugation of 32-day-old rat seminiferous tubules homogenates. After eliminating heavy particles by centrifugation at 4300 g during 4 min in 0.25 M sucrose buffer, a 27,000 g pellet was obtained and layered on 1.05 M sucrose buffer. The relatively light particulate interface (LPF) formed during centrifugation at 27,000 g 60 min, showed the highest androgen binding activity among particulate fractions. This binding was associated with the plasma membrane marker 5'-nucleotidase and it did not follow any of six other subcellular structure markers: DNA for nuclei, succinate dehydrogenase for mitochondria, acid phosphatase for lysosomes, NADPH-cytochrome C reductase for smooth endoplasmic reticulum, RNA for rough endoplasmic reticulum and lactate dehydrogenase for cytosol. In LPF, concentrations of sites were estimated to be 328 +/- 54 fmol per mg proteins and affinity constant 0.78 +/- 0.23 10(9) M-1. Heat stability, steroid specificity, affinity constant and rate of dissociation were similar to the well known androgen binding protein, ABP. Presence of ABP or a similar protein in subcellular particles might play a role in the mechanism of action of androgens in seminiferous tubules of maturing rats.
A case of retrograde ejaculation not responding to medical treatment is described in which the problem of sterility was overcome by artificial insemination. The semen was collected from urine after coitus by previous alkalinization with 1.63 g NaHCO3 once daily. Pregnancy occurred at the 4th insemination during the 1st treatment cycle. This technique seems to be the most suitable for artificial insemination in cases of retrograde ejaculation.
Testicular function was evaluated in forty-one prepubertal patients with male pseudohermaphroditism by determining serum concentrations of progesterone, 17-hydroxyprogesterone, dehydroepiandrosterone, androstenedione, testosterone and dihydrotestosterone before and after stimulation with hCG and, in some instances, ACTH. Testosterone response to hCG was normal in all subjects. In one patient, a 4-year-old boy, a deficiency of 17,20-desmolase activity was diagnosed based on the coexistence of elevated levels of pregnenolone, 17-hydroxypregnenolone, progesterone and 17-hydroxyprogesterone and low levels of dehydroepiandrosterone and androstenedione. In three other patients enzymatic blocks were suspected but not confirmed. Congenital deficiency of enzymes necessary for testosterone biosynthesis is an uncommon aetiology of male pseudohermaphroditism.
Tissue testosterone, dihydrotestosterone, and zinc concentrations have been determined in testis and epididymis of 13 patients with carcinoma of the prostate, 1 patient with carcinoma of the penis, and 3 patients with carcinoma of the prostate on estrogens. The 13 patients not receiving estrogens had the following testicular levels: testosterone, of 529 +/- 63.1 ng/g (mean +/- SE); dihydrotestosterone, 23.7 +/- 2.58 ng/g; and zinc 62.2 +/- 7.6 micrograms/g. The epididymal levels were as follows: testosterone, 40.6 +/- 3.4 ng/g; dihydrotestosterone, 20.5 +/- 2.36 ng/g; and zinc, 67.2 +/- 11.1 micrograms/g. Patients on estrogen therapy showed much lower androgen values in the two organs but zinc was not changed significantly. Concentrations of androgens were not significantly different in the epididymal fractions of caput, corpus, and cauda. In testis, there was a positive correlation between zinc and androgens contents, while the opposite was suggested by the data in the epididymis. Even though these patients were not normal, there was no evidence of testicular or epididymal disturbances.
Testicular testosterone concentration serum testosterone, LH and FSH, sperm count and testicular histology were evaluated in 17 patients with varicocele. Testicular testosterone was either normal or high (mean 906 +/- 723 ng/g of tissue), and serum testosterone was within the normal range in most patients. Serum LH was elevated in half of the patients. The degree of testicular damage observed was extremely variable and correlated with sperm analysis. Testicular testosterone tended to be higher in patients with severe microscopic lesions of the testis. It is concluded that even though Leydig cell function is partially altered, this deficiency is compensated by LH stimulation and therefore, failure of spermatogenesis is not secondary to low testosterone levels.
The ability of human luteal tissue to bind HLH was studied. The tissue was obtained from patients subjected to gynecological operations intended to correct other than ovarian lesions. HLH iodinated with carrier-free 125I according to the Greenwood method was used. This material has a relatively low specific radioactivity (7-20 microCi/micrograms); therefore the biological characteristics of the hormone were expected to remain intact. The 90% binding point was estimated at 37 degrees C after 5 minutes. Inhibition experiments with HLH and HCG had a characteristic effect, even those with FSH and ovine prolactin indicated a significant interference with the bound hormone. Scatchard plots demonstrated large variability in the number of binding sites and relatively modest variability of constant (Kd).
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Testicular endocrine function was studied in twelve post pubertal patients with male pseudohermaphroditism and 46 XY chromosomal constitution. Patients were divided into three groups, four subjects who became feminized during puberty, five who became masculinized during puberty and three who were castrated before puberty. Serum dehydroepiandrosterone, progesterone, 17-hydroxyprogesterone, androstendione, testosterone, dihydrotestosterone, LH and FSH were determined by radioimmunoassay. Patients of the first group had the clinical characteristics of testicular feminization secondary to absence of the androgen receptor. One of the five patients of the second group had deficient testosterone secretion but no enzymatic defect could be demonstrated. One of the subjects castrated before puberty had a deficiency in 17,20-desmolase. Therefore, evidence of a failure of the fetal testes could be found in only two of the twelve patients studied.
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