Clinical Practice Guidance for the Use Of Clomiphene Citrate in Male Hormone Replacement Therapy (HRT).

Introduction: Inhibition of pituitary gonadotropin secretion in men by testosterone (T) is principally mediated by aromatization to estrogen (E), which inhibits hypothalamic secretion of gonadotropin-releasing hormone (GnRH). Material and Methods: Longitudinal clinical investigation unit-based evaluation of the clinical and biochemical response to E-receptor blockade. Initial monotherapy with 50 mg of clomiphene citrate (CC) daily for a period of 9 months, with diurnal morning peak testosterone and luteinizing hormone (LH) levels evaluated at three-month intervals thereafter. Th e patient then resumed hormone replacement therapy (HRT) using T cream with adjuvant CC therapy. Main Outcome Measures were Baseline and stimulated T and LH levels; eff ect on sexual function. Result(S): CC therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. Conclusion(S): Isolated hypogonadotropic hypogonadism (IHH) may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. Reversal of gonadotropin defi ciency with CC was found to have a similar biological eff ect.

Prostatic disorders in acromegalic patients experience of a Brazilian center

Introduction Published data suggest that patients with acromegaly have an increased prevalence of prostate disorders. Objective To evaluate prostatic disorders in acromegalic patients comparing these results after one year of treatment of acromegaly and with a group of healthy men. Materials and Methods This study was composed of two parts: sectional study comparing patients with healthy controls (baseline) and prospective, longitudinal study (at baseline and after one year of treatment). Forty acromegalic patients were enrolled and evaluated at baseline and after one year with the application of international prostatic symptoms score (IPSS), digital rectal examination, measurements of growth hormone (GH), insulin-like growth factor-I (IGF-I), insulin-like growth factor-binding protein-3 (IGFBP-3), sex hormone-binding globulin (SHBG), prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, total and free prostate-specific antigen (PSA) levels and prostate ultrasonography (US). Thirty healthy men were selected as control group. Results We stratified patients and controls according to age, considering 40 years-old as cut off. Healthy controls under 40 had IPSS values lower than acromegalic patients. When considering only older patients and controls prostate hyperplasia and structural abnormalities were more frequent in acromegalics. After one year of treatment there was significant decrease in GH, IGF-I and prostate volume in acromegalics over 40 years-old. Conclusions Acromegalics under 40 have more urinary symptoms according to IPSS and above 40 years-old higher frequency of structural changes and increased prostate volume than healthy men. Significant reduction of GH and IGF-I levels during treatment of acromegaly leads to decrease in the prostate volume. .

Preservación de fertilidad con análogos agonistas de la hormona liberadora de gonadotropinas hipofisiarias (GnRH) en pacientes sometidas a tratamiento médico oncológico / Fertility preservation with agonist analgos of pituitary gonadotropin-relasing hormone (GnRH) in patients undergoing medical oncological treatment

Evaluar el potencial que tiene la utilización de los análogos de GnRH en la conservación de la función ovárica a mediano y largo plazo en pacientes sometidas a quimioterapia. Se evaluó la recuperación de la función ovárica de 6 pacientes sometidas a tratamiento oncológico que fueron tratadas concomitantemente con análogo de GnRH, mediante la medición de FSH, estradiol sérico y presencia de menstruaciones. En la Clínica Santa Sofía y Salud Chacao, Caracas. Cinco de las seis pacientes evaluadas (83,3 por ciento), recuperaron su función ovárica posterior al tratamiento oncológico y con análogo de GnRH. El uso de análogos de GnRH durante el tratamiento médico oncológico pareciera ser una alternativa válida para la protección de la función ovárica

To evaluate the potential of GnRH analogs use during chemotherapy in the preservation of short and long term ovarian function. Evaluation of ovarian function by measuring FSH, seric estradiol and menses, in six patient after use of GnRH analogs during chemotherapy. Clinica Santa Sofia y Salud Chacao, Caracas. Five of six patients (83,3 percent) reassumed their ovarian function after chemotherapy plus GnRH analog. The use of GnRH seems to be a good alternative to protect ovary function during chemotherapy

Effects of valproate sodium on pituitary gonadotropin in adolescent girls with epilepsy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of valproate sodium (VPA) on the level and axle of pituitary gonadotropin in adolescent girls with epilepsy.</p><p><b>METHODS</b>Twenty-three adolescent girls with epilepsy aged from 8 to 14 years were treated with VPA for 1 year. The levels of serum pituitary gonadotropin including estradiol, follicle-stimulating hormone, luteinizing hormone, prolactin and testosterone were measured before treatment and 3 months, 6 months and 1 year after treatment.</p><p><b>RESULTS</b>The serum levels of estradiol, follicle-stimulating hormone, luteinizing hormone and prolactin in the children with epilepsy were not significantly different during the 1 year VPA treatment compared with pretreatment. However, the serum level of testosterone was reduced 1 year after treatment (0.4±0.3 ng/mL) compared with pretreatment (0.7±0.4 ng/mL) and 3 months after treatment (0.7±0.4 ng/mL) (P<0.05).</p><p><b>CONCLUSIONS</b>VPA treatment for 1 year does not increase serum levels of androgen in adolescent girls with epilepsy, suggesting that VPA is an ideal choice of treatment for the girls.</p>

Serum levels of hypothalamic-pituitary-testicular axis hormones in men with or without prostate cancer or atypical small acinar proliferation

INTRODUCTION: Substantial controversy exists regarding the association between testosterone serum levels and prostate cancer. OBJECTIVE: To evaluate the levels of hypothalamic-pituitary-testicular axis hormones in the sera of men with prostate cancer and atypical small acinar proliferation as well as those with normal biopsies. METHODS: A study cohort of 186 men with suspected prostate cancer who had undergone transrectal prostate biopsies was used in this study. The patients were divided into the following three groups based on the histology of the biopsy samples: no neoplasia, atypical small acinar proliferation or prostate cancer. Demographic data were also collected. Levels of total testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, and serum prostate-specific antigen were measured in blood samples. RESULTS: Initially, 123 men were found to be without neoplasia, 26 with atypical small acinar proliferation and 37 with prostate cancer. After a second biopsy was taken from the men diagnosed with atypical small acinar proliferation, the diagnoses were revised: 18 were diagnosed with atypical small acinar proliferation and 45 with prostate cancer. No significant differences between the groups were identified regarding age, smoking history, chronic diseases, body mass index or PSA levels (P >.0.05). The mean serum levels of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin and estradiol were similar in all of the groups (P >.0.05). Furthermore, in individuals with prostate cancer, the Gleason scores and prevalence of hypogonadism were not significantly different (P.> 0.05). CONCLUSION: The present study revealed no difference in the serum levels of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin or estradiol in men without neoplasia compared with those with atypical small acinar proliferation or prostate cancer.

[ study of LHRHA2 and dopamine antagonists on gonadotropin II level in Abramis Brama orientalis [BERG, 1905]]

Synthetic LHRHa or its superactive analogues stimulate GTH release. It shows an overlap in the biological activity of LHRHa and GnRH in many teleost species. The aim of the present study was to investigate the effects of LHRIIa[2]. Metocloprarnide and Chlorpromazine on HPG axis and plasma levels of GHT II. Luteinizing Hormone Releasing Hormone Analogue 2 [LHRHa[2]] [3 micro g/kg] with dopamine antagonis's [Metoclopramide. [5 mg/kg] and Chlorpromazine [10 mg/kg]] were injected via I.M to 64 female Bream [Abramis brama orientalis] [0.71371 +/- 0.026 kg, BW] through combined and solilary teeatments: Positive Control [saline]. Metoclopramide [5 mg/kg]. Chlorpromazine [10 mg/kg]. LHRHa[2] [3 micro g/kg]. Metoclopramide [5 mg/kg] + LHRHa[2] [3 micro g/kg], Chlorpromazine [10 mg/kg]+LHRHa[2] [3 micro g/kg]. Metoclopramide [5 mg/kg] + Chlorpromazine [10 mg/kg]+LHRHa[2] [3 micro g/kg] and Negative Control [intact]. Fishes were examined through primary bleeding. injection and secondary bleeding. The time interval between two bleeding step was 5h. The GTH 11 measurement was conducted on the basis of RIA. Results indicate that while LHRHa, and Metocloptamide could significantly increase the level of GTH II [p<0.05]. Chlorpromazine did not showed any significant impact on the increase of GTH II [p> 0.05]. Meanwhile, compared to the complex treatments the individual treatments have had relatively significant effects [p< 0.05]. All compounds showed a positive stimulation effect on the HPG axis and GTH 11 level in plasma

Immunodetection of Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), Thyroid Stimulating Hormone (TSH) and Prolactin (PRL) in Brachionus calyciflorus (Rotifera: Monogononta)

The endocrine system controls and coordinates behavioral, biochemical, and physiological processes through signal mechanisms using neuropeptides or products of neurosecretory cells. Among invertebrates, this system is poorly studied in rotifers, in which estrogens and androgens significantly affect sexual reproduction. This is the first report of the presence of the Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), Thyroid Stimulating Hormone (TSH) and Prolactin (PRL) in rotifers. Analyses included the avidin-biotin-peroxidase complex method with primary antibodies LH (Anti-Rat LH serum for RIA), PRL (Anti-Rat PRL serum for RIA), FSH (Anti-Rat FSH serum for RIA) and TSH (Anti-Rat TSH serum for RIA). These hormones were found in females, males and parthenogenetic and sexual eggs of the freshwater Brachionus calyciflorus. The immunoreactivity of FSH, LH, TSH and PRL in females was observed in: ovaries, cerebrum, mastax, stomach, lorica, and the stomach gland. However, in males LH was observed only at the trochal disk and cerebrum. The hormones FSH, TSH and PRL, were observed in testicles, contractil vesicles, and cementary gland of males. Regarding amictic or parthenogenetic eggs, the hormones LH, FSH, TSH, and PRL were located mainly in the micromeres, and the staining in the macromeres was weak. On the other hand, in the mictic or sexual eggs the inner shell is stained for the hormones PRL and LH, opposite to the staining of FSH and TSH, located mainly in the embryo. In general, immuno-reactivity was observed in areas important for the reproductive, excretory, digestive and developmental processes. Rev. Biol. Trop. 57 (4): 1049-1058. Epub 2009 December 01.

Se logró detectar la presencia de las hormonas: Hormona Luteinizante (LH), Hormona Folículo Estimulante (FSH), Hormona Estimulante de la Tiroides (TSH) y Prolactina (PRL) en Brachionus calyciflorus siendo el primer reporte de la presencia de dichas hormonas en rotíferos. Estas hormonas fueron identificadas por un método inmunológico-histológico-químico usando el complejo avidina-biotina- peroxidasa con los siguientes anticuerpos primarios: LH (Anti-Rata LH suero para RIA), PRL (Anti-Rata PRL suero para RIA), FSH (Anti-Rata FSH suero para RIA) y TSH (Anti-Rata TSH en suero para RIA). Estas hormonas se encontraron en las hembras, machos, huevos partenogenéticos y huevos sexuales del rotífero dulceacuícola B. calyciflorus. La reactividad inmunológica de FSH, LH, PRL y TSH en las hembras se observó en ovarios, cerebro, mástax, estómago, lorica, y la glándula del estómago. Sin embargo, en machos, la LH se observó sólo en el disco trocal y cerebro mientras que las hormonas FSH, PRL y TSH, se observaron en testículos, vesícula contráctil, y la glándula cementaria. En cuanto a los huevos partenogenéticos o amícticos, las hormonas LH, FSH, TSH, y PRL, se encontraron principalmente en los micrómeros, y en los macrómeros la tinción es débil. Por otra parte, el huevo sexual o míctico muestra reactividad inmunológica en la cubierta interior del huevo para las hormonas LH y PRL, lo contrario para FSH y TSH, las cuales se observaron principalmente en el embrión. La reactividad inmunológica fue observada, en general, en áreas importantes para los procesos reproductivos, excretorios, digestivos y del desarrollo.

Avaliação tardia do eixo hipofisário-gonadal em pacientes adultos que sofreram traumatismo cranioencefálico grave / Late evaluation of the pituitary-gonadal axis in survivors of severe traumatic brain injury

OBJETIVO: Avaliar a função hipofisária-gonadal nos pacientes vítimas de TCE graves ocorridos na Grande Florianópolis, entre 2000 e 2004. MÉTODOS: Foram estudados 30 pacientes, sendo 22 homens e 8 mulheres, submetidos à avaliação clínica e laboratorial em seguimento médio de 4 anos após a data do traumatismo. RESULTADOS: Os homens possuíam em média 38 anos no ano da avaliação, enquanto as mulheres, 42 anos. A maioria dos traumatismos está relacionada aos acidentes de trânsito (63,3 por cento). Três pacientes (10 por cento) estavam com valores de FSH abaixo do normal e apenas 1 paciente (3,3 por cento) apresentou LH alterado. Nas mulheres avaliadas, os níveis de estradiol foram normais. Na população masculina, foi evidenciado nível de testosterona baixo em 2 pacientes (9,1 por cento). Todos os pacientes apresentavam normoprolactinemia. CONCLUSÃO: Dois casos de hipogonadismo masculino (9,1 por cento) foram diagnosticados neste estudo. Isso indica a necessidade de atenção aos pacientes sobreviventes de TCE grave para realizar diagnóstico precoce de hipogonadismo.

OBJECTIVE: The purpose of this study is to evaluate pituitary function impairment in order to verify the prevalence of sex hormone deficiency and to analyze the profile of TBI population. METHODS: Thirty patients were studied, 22 were male and 8 were female. All patients had their gonadal function assessed and they were evaluated at a median of 4 years post-trauma. RESULTS: The average age of the men was 38 years at the time of the evaluation, while the mean age of women was 42 years. The majority of TBI was related to traffic accidents (63.3 percent). Three patients (10 percent) had low FSH and only 1 patient (3.3 percent) had low LH. There was no biochemical evidence of hypogonadism in women. Two male patients presented low testosterone (9.1 percent) and were diagnosed with hypogonadism. Prolactin levels were normal in all patients. CONCLUSION: Two cases of hypogonadism (9.1 percent) were diagnosed among men in this study. It is therefore necessary that medical professionals involved in the management of TBI patients are aware of hypogonadism as a complication of TBI, in order to diagnose it early.

Gonadotrofinomas: análisis multicéntrico y retrospectivo de 66 pacientes / Gonadotrophinomas: multicenter and retrospective analysis of 66 patients

Objetivo: Analizar la presentación clínica, radiológica, bioquímica y el comportamiento posquirúrgico de una cohorte de pacientes portadores de gonadotrofinomas. Pacientes y Métodos: Se evaluaron pacientes con gonadotrofinomas estudiados en nueve centros endocrinológicos de la ciudad de Bs.As. durante el período 1983 a 2003. El criterio de inclusión fue la inmunohistoquímica (IH) positiva para hormona luteinizante (LH), folículoestimulante (FSH) y/o alfa subunidad (ASU). Los adenomas plurihormonales fueron excluidos. Resultados: Fueron analizados 66 pacientes de 51,8 ± 12,1 (X +/- DS) años (39 varones). Los síntomas mas frecuentemente observados fueron las alteraciones visuales (72,8%), seguidas por el hipogonadismo y las cefaleas. El 10,6% se diagnosticaron en forma incidental. El 98,5% fueron macroadenomas, 56,9% de los cuales correspondieron a un estadio Hardy (EH) 3 y 29,6% a un EH 4. El tiempo de seguimiento fue de 47,8 meses (r: 5-168). El hipogonadismo definido bioquímicamente se presentó en el 82,4% de los pacientes. En su mayoría presentaban niveles bajos o inapropiadamente normales de gonadotrofinas, pero 4 mujeres y 3 varones presentaron niveles séricos elevados y disociados de FSH y LH. La hiperprolactinemia por desconexión fue observada en 45,2% de la población (X: 65.6 ng/ml r: 30-172). El hipopituitarismo se detectó en 25,7% de los casos. La cirugía fue transeptoesfenoidal (TSE) en 80%; una segunda operación fue realizada en el 28% de la población. La IH fue positiva por orden de frecuencia para LH, FSH y ASU o las 3 combinaciones. La evolución posquirúrgica evidenció mejoría en el campo visual (CV) en el 41%. La presencia de restos tumorales y/o recidiva fue del 84%. Se indicó radioterapia en 37% y la sustitución hormonal fue necesaria en el 65% de los pacientes.

The aim of our study was to describe the clinical-biochemical and radiologic presentation and the post surgery outcome in a cohort of patients with gonadotrophinomas. Patients were selected from nine Endocrinology Units of the city of Buenos Aires from 1983 at 2003. The inclusion criteria was defined by nonfunctinoning pituitary adenomas with positive innmunohistochemical (IH) for luteinizing hormone (LH), follicle-stimulating hormone (FSH) and/or alpha subunit (ASU). Innmunohistochemically plurihormonal adenomas were excluded. Sixty six patients were analyzed, aged 51,8 ± 12,1 (X +/- DS) years; (39 men). More prevalent symptoms were visual alterations (72,8%), hypogonadism and headaches. Eleven percent was diagnosed as incidentalomas. Ninety eight percent were macroadenomas, 56,9% was Hardy stage (HS) 3 and 29,6% was HS 4. The patients were followed up for 47,8 months (r: 5-168). Hypogonadism was biochemically found in 82,4%. The majority showed low or inappropriately normal levels of gonadotrophins except for 4 women and 3 men that had high and dissociated levels. Hyperprolactinemia was observed in 45,2% and was interpreted as an interference with normal dopamine inhibition of prolactin secretion (X+/-DS: 65.6+/- ng/ml, r: 30-172). Hypopituitarism was found in 25,7% of the patients. Transsphenoidal surgery was carried out in 80% and in 28% a second surgery was needed. The IH was positive for LH, FSH and ASU in this order of frequency or its combinations. Tumor persistency and/or recurrency were found in 84% of the patients. Forty one percent showed improvement of visual defects. Radiotherapy was indicated in 37% and hormonal replacement was needed in 65% of the patients.

Gonadotropins and sex hormones in healthy Chinese infants.

This study was conducted to investigate the infantile changing regularity of gonadotropins and sex hormones. Serum samples were obtained from 416 healthy infants (male: 215; females: 201). In male infants, peaks in serum gonadotropins and testosterone concentrations were observed at 2-4 months. In female infants, serum FSH concentrations reached peak at 2-3 months. Before 6 months, serum testosterone and LH concentrations were higher in male, while FSH was on the contrary. Peaks in serum gonadotropins and sex hormones concentrations are reached and sexual dimorphism appears in the early infancy. Defining the range of mean values and the trends for infantile gonadotropins and sex hormones could be helpful for clinical evaluation.

Relationship of plasma ghrelin and adenohypophyseal hormone levels in female precocious puberty / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the relationship of plasma ghrelin and adenohypophyseal hormone levels in female precocious puberty.</p><p><b>METHODS</b>A total of 84 patients aged from 6 to 9 years were enrolled in this study. They were divided into idiopathic central precocious puberty (ICPP) and premature thelarche(PT)groups according to their secondary sexual characteristics, bone age, volumes of uterus and ovary, and results of GnRH test. Plasma ghrelin levels were measured by radioimmunoassay. ACTH, TSH, PRL, GH, LH and FSH were measured by chemoluminescence technique.</p><p><b>RESULTS</b>Ghrelin levels in ICPP group were Log (2.42+/-0.26) ng/L, which were significantly lower than those in PT group and controls [Log (2.62+/-0.21) ng/L and Log (2.58+/-0.44) ng/L, respectively, P<0.05]. However there was no significant difference between PT group and controls(P>0.05). Ghrelin levels of ICPP girls with Tanner III were Log (2.31+/-0.24) ng/L, significantly lower than those of ICPP girls with Tanner II [Log (2.53+/-0.24) ng/L, P<0.05]. By bivariate correlation analysis, ghrelin levels in precocious puberty girls were negatively correlated with ACTH, PRL and LH15, LH30 and LH60 in GnRH test(r=-0.248, -0.235, -0.445, 0.405, 0.398, respectively, P<0.05). No significant correlation was found between ghrelin and GH, LH0(-2), FSH0(-2), and FSH15, FSH30 and FSH60 in GnRH test.</p><p><b>CONCLUSION</b>ICPP girls have lower plasma ghrelin levels, which are decreased with the development of Tanner stage. The plasma ghrelin levels are negatively correlated with ACTH, PRL and LH.</p>

Male gonadal function, prolactin secretion and lactotroph population in an experimental model of cirrhosis

Liver cirrhosis, a highly prevalent chronic disease, is frequently associated with endocrine dysfunctions, notably in the gonadal axis. We evaluated lactotroph population by immunohistochemistry, gonadotropins and prolactin by immunoradiometric assay and testosterone and estradiol by radioimmunoassay in adult male Wistar rats with cirrhosis induced by carbon tetrachloride. No significant difference in mean ± SEM percentages of lactotrophs was found between cirrhotic animals and controls (N = 12, mean 18.95 ± 1.29 percent). Although there was no significant difference between groups in mean serum levels of prolactin (control: 19.2 ± 4 ng/mL), luteinizing hormone (control: 1.58 ± 0.43 ng/mL), follicle-stimulating hormone (control: 19.11 ± 2.28 ng/mL), estradiol (control: 14.65 ± 3.22 pg/mL), and total testosterone (control: 138.41 ± 20.07 ng/dL), 5 of the cirrhotic animals presented a hormonal profile consistent with hypogonadism, all of them pointing to a central origin of this dysfunction. Four of these animals presented high levels of estradiol and/or prolactin, with a significant correlation between these two hormones in both groups (r = 0.54; P = 0.013). It was possible to detect the presence of central hypogonadism in this model of cirrhotic animals. The hyperestrogenemia and hyperprolactinemia found in some hypogonadal animals suggest a role in the genesis of hypogonadism, and in the present study they were not associated with lactotroph hyperplasia.

Eixos hormonais na obesidade: causa ou efeito? / Hormonal axes in obesity: cause or effect?

Diversas alterações endócrinas são descritas na obesidade. O eixo corticotrófico encontra-se hiper-responsivo, com maior depuração dos hormônios e nível de cortisol normal. A caracterização do pseudo-Cushing é importante. A leptina parece ser um hormônio permissivo para o desencadeamento da puberdade. Em adultos, as gonadotrofinas são normais, hiperandrogenismo e hiperestrogenismo são encontrados. Nas mulheres, a resistência insulínica é central no desenvolvimento da síndrome dos ovários policísticos (SOP), associada a hiperandrogenemia ovariana. Nos obesos, GH geralmente é baixo e IGF1 normal. A função tireoidiana é habitualmente normal nos obesos.

Several endocrine changes have been described in the obesity state. The corticotropic axis is hyperresponsive and there is enhancement of hormonal clearance, but cortisol levels are within the normal range. It is important to characterize a pseudo-Cushing in obesity. Leptin seems to be a permissive hormone for the beginning of puberty. In adults, gonadotropines are normal, and hyperandrogenism and hyperestrogenism are found. In women, insulin resistance has a central role in polycystic ovarian syndrome (POS), which is associated to ovarian hyperandrogenemia. In obese subjects, growth hormone (GH) is generally low and IGF1 is normal. Thyroid function is commonly normal in obese subjects.

Pituitary down-regulation and ovulation stimulation with gradually increased gonadotropin in controlled ovarian hyperstimulation / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of ovulation stimulation protocol with gradual increment of gonadotropin in women with high ovarian response.</p><p><b>METHODS</b>A retrospective study was conducted between june 2005 and April 2006 in 70 women undergoing controlled ovarian hyperstimulation. The clinical outcomes of the women using gradual increment protocol were compared with those of women receiving other ovulation-stimulating protocols.</p><p><b>RESULTS</b>The mean number of large follicles (>or=14 mm) and retrieved oocytes on the day of retrival was significantly lower, but the duration of stimulation was significantly longer in the gradual increment group than in the control group. The rate of follicular puncture was also higher in the former group. The clinical pregnancy rate, total gonadotropin dosage, cancellation rate and incidence of ovarian hyperstimulation syndrome were similar for the two groups.</p><p><b>CONCLUSION</b>Ovulation stimulation protocol with gradually increased gonadotropin may provide a promising alternative for controlled ovarian hyperstimulation in women with a strong ovarian response.</p>

Possible neurogenic role of sildenafil citrate [viagra] on the regulatory pattern of pituitary-testis axis in diabetic males with and without neuropathy

Sexual dysfunctions due to neurogenic impotence decrease the testosterone levels through a central effect on the hypothalamic-pituitary axis. The present study deals with the effect of sildenafil citrate [Viagra] treatment for these neurogenic sexual disturbances on the reversibility of this neuro-endocrine pattern of the serum levels of pituitary-gonadal hormones. In this investigation 50 insulin dependent [IDDM] and 50 non insulin dependent [NIDDM] diabetic male patients with and without an objective evidence of neuropathy and 50 age matched non diabetic male controls were selected. Every male had age between 20 to 65 years with duration of diabetes distributed over 1 to 20 years. During treatment with sildenafil citrate [50 mg. oral dose] serum total testosterone, free testosterone, serum PRL, FSH and LH were measured. Treatment with 50 mg. of oral sildenafil citrate reversed this neuro-endocrine release pattern in both IDDM/ NIDDM neuropathic men by exhibiting a significant increase in serum total and serum free [urinary] testosterone levels [p<0.001] and a significant decrease in the levels of serum prolactin [PRL] and follicle stimulating hormone [FSH]. Decrease in luteinizing hormone [LH] was found to be less significant [p<0.01]. However both types of non neuropathic diabetics treated with sildenafil citrate showed a non significant difference in the in the serum levels of the above mentioned pituitary-gonadal hormones when compared with the untreated groups and their respective control subjects. These findings conclude that sildenafil citrate has a direct effect on the pituitary-testicular axis and is a well tolerated and highly effective oral therapy for restoring the potency with established neuropathic cause [irrespective of the type of diabetes] and may represent a new class of autonomically acting drug for the treatment of this condition. In other words it is worth trying sildenafil citrate for erectile dysfunctions of neuropathic etiology

Assessment of hormonal and metabolic effects of dietary fiber in young Thai women.

OBJECTIVE: To investigate whether daily dietary fiber intake at the reference level has any impact on studied hormones in a population of Thai women. MATERIAL AND METHOD: Twenty-eight healthy Thai women (aged 18-20 years, BMI 18.5-25 kg/m2) with a history of regular menstrual cycles committed themselves to prepared food without changing the usual ratio of three major macronutrients. Dietary fiber from natural source at the amount of 8-10 g/day equal to their regular consumption was added to their daily diet for one menstrual cycle, then, increased to be 25-30 g/day for another 2 successive cycles. A single blood sample on midluteal day (day 18-23) was obtained in all three cycles. Plasma luteinizing hormone, follicle stimulating hormone, prolactin, estradiol, progesterone, cortisol, and insulin together with total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were analyzed. RESULTS: The measured hormones and lipids did not change significantly when compared between a control and two experimental cycles (p > 0.05). CONCLUSION: Short-term consumption of 25-30 g/day fiber diet as recommended by the Reference Daily Intake (RDI) in a Thai population did not alter the studied hormones and lipids thus did not create any health problems.

Comparação entre menotropina altamente purificada e folitropina alfa para hiperestimulação ovariana controlada após supressão hipofásica nos ciclos de ICSI / A comparison of menotropin, highly-purified menotropin and follitropin alfa for controlled ovarian stimulation after pituitary down-regulation in ICSI cycles

OBJETIVO: Comparar a eficácia clínica entre três tipos de gonadotrofinas para a estimulação ovariana após a supressão hipofisária nos ciclos de ICSI. MATERIAL E MÉTODOS: Analisou-se retrospectivamente 865 ciclos consecutivos de ICSI envolvendo supressão hipofisária previamente à hiperestimulação ovariana controlada (HOC). A HOC foi realizada com menotropina (HMG: Menogon, Ferring; n=299), menotropina altamente purificada (HMG-HP: Menopur, Ferring; n=330) e FSH recombinante (r-hFSH: Gonal-F, Serono; n=236). Os protocolos laboratoriais e clínicos permaneceram inalterados ao longo do tempo, os últimos diferindo apenas no tipo de gonadotrofina utilizada, que foram introduzidas seqüencialmente na prática clínica, iniciando com o HMG, seguido pelo HMG-HP, e finalmente o r-hFSH. Os parâmetros de interesse primário foram a taxa de nascidos vivos e as doses totais de gonadotrofina utilizadas por ciclo, por gestação e por nascido vivo. Análise comparativa foi realizada com ANOVA, Kruskal-Wallis e Chi-quadrado quando apropriado. RESULTADOS: As taxas de nascidos vivos não foram significativamente diferentes entre os grupos HMG (26,4%), HMG-HP (34,6%) e r-hFSH (32,4%; p igual a 0,09). A dose total de gonadotrofina utilizada por ciclo foi significativamente superior nos grupos HMG (2.685±720UI) e HMG-HP (2.903 mais ou menos 867UI) em comparação com o r-hFSH (2.268 mais ou menos 747UI; p menor que 0,001). Diferenças relativas de 15,7% e 45,2%, e de 11% e 19,8% foram observadas a favor do r-hFSH em comparação ao HMG e HMG-HP, respectivamente, no que se refere às quantidades de gonadotrofina necessárias para se obter cada gestação e cada nascido vivo. CONCLUSÕES: Taxas de nascidos vivos similares foram obtidas com HMG, HMG-HP e r-hFSH quando utilizadas para HOC após supressão hipofisária nos ciclos de ICSI. Doses totais significativamente menores de r-hFSH foram utilizadas por ciclo em comparação às menotropinas. Para cada nascido vivo, quantidades consideravelmente maiores d...

Biologia de neurônios hipotalâmicos produtores do hormônio liberador das gonadotrofinas: novas informações sobre o uso das células imortalizadas secretoras desse hormônio / Biology of hypothalamic neurons producing gonadotropin releasing hormone (GnRH): new information on the use of immortalized cells secreting GnRH

O estudo dos neurônios que produzem o hormônio liberador das gonadotrofinas (GnRH), hormônio hipotalámico que estimula a secreção, das gonadotrofinas hipofisárias, tem recebido vigoroso impulso com a disponibilidade das células imortalizadas, que especificamente sintetizam e secretam o hormônio em questão. Duas são as linhas celulares obtidas por tumorigênese induzida em camundongos transgênicos: 1) as células GT1 (com os seus subclones GT1-1, GT1-3, GT1-7) e 2) as células GN (com os seus subclones GN10, GN11, NLT). As células GT1 foram derivadas de um tumor hipotalâmico. Pode-se constatar que elas são dotadas de propriedades dos neurônios maduros secretores de GnRH, que completaram o seu trajeto da sua sede de origem, o placóide olfatório, até a sua sede definitiva, o hipotálamo, e já perderam a capacidade de mover-se. Por essas características, as células GT1 são utilizadas sobretudo para o estudo das propriedades secretórias dos neurônios que produzem o GnRH e para identificar os sinais que ali chegam. Pode-se assim evidenciar uma série de receptores, que, ativados pelos seus ligantes (neurotransmissores, hormônios, fatores de crescimento), modulam a síntese e a secreção do GnRH. As células GN foram retiradas de um tumor do bulbo olfatório, portanto, elas são consideradas mais semelhantes aos neurônios imaturos secretores de GnRH que ainda estão desenvolvendo o processo de migração do placóide olfatório até o hipotálamo. Desse modo, tais células são utilizadas sobretudo para identificar e caracterizar os fatores que possam influenciar os processos de migração dos neurônios que produzem o GnRH. Em particular, pode-se constatar que a motilidade dos neurônios secretores desse hormônio é estimulada pela anosmina, a proteína codificada pelo gene KAL1, que, nas suas formas mutantes, ocasiona o hipogonadismo hipogonadotrófico conhecido como a síndrome de Kallmann, por alguns fatores de crescimento (fator de crescimento de fibroblasto, fator de crescimento...

The study of the neurons secreting the gonadotropin releasing hormone (GnRH), the hypothalamic hormone stimulating the release of pituitary gonadotropins, has been potentiated by the development of immortalized cells that specifically synthetize and secrete GnRH. Two cell lines have been obtained by targeted tumorigenesis in transgenic mice: 1) the GT1 cells (with GT1-1, GT1-3 and GT1-7 subclones), and 2) the GN cells (with the GN10, GN11 and NLT subclones). GT1 cells have been obtained from a hypothalamic tumor and exhibit the properties of fully mature GnRH secreting neurons after they reached their final destination in the hypothalamus starting from the olfactory placode. Because of their characteristics GT1 cells have been mainly utilized to investigate the secretory properties of GnRH neurons and to identify the inputs modulating their activity. By this way a consistent number of receptors responding to specific ligands (neurotransmitters, hormones, growth factors) controlling GnRH synthesis and secretion has been identified. GN cells have been derived from a tumor of the olfactory bulb and are considered to replicate the properties of immature GnRH secreting neurons still retaining the capacity of moving. Consequently these cells are used to identify and characterize the factors influencing the migratory process of GnRH neurons from the olfactory placode to the hypothalamus. It has been found that factors stimulating GnRH neuron motility include anosmin, the protein encoded by the KAL1 gene, whose mutations lead to the form of hypogonadotropic hypogonadism known as Kallmann’s syndrome, growth factors such as fibroblast growth factor, hepatocyte growth factor, vascular endothelial growth factor, and cytoskeleton associated proteins (stathmin). On the contrary GABA agonists and glucocorticoids depress GN cells motility. As a whole the findings reported in this review seem particularly important to provide further information on the central...

Dose-dependent effect of copper chloride on male reproductive function in immature rats.

BACKGROUND: Copper is essential as a trace element for metabolic processes. Exposure to copper in industries develops toxicity among the workers. Previous findings on adverse effects of copper on male reproductive function in adult albino rats led to investigate the effects of this metal on reproductive function of maturing male rats in the present experiment. METHODOLOGY: To study these effects, immature (30 to 35 days old) Wistar strain albino rats weighing about 50-60 g were treated intraperitoneally with copper chloride at doses of 1000, 2000 and 3000 microg/kg body weight/day for 26 days. RESULT: Significant fall in accessory sex organ weight and inhibition of testicular 17beta-hydroxysteroid dehydrogenase activity along with degeneration of testicular growing spermatogenic cells and reduction in serum testosterone, FSH and LH level were observed at the doses of 2000 and 3000microg/kg/day. On the other hand, at the dose of 1000 microg/kg/day significant increase in testicular steroidogenic enzyme activity and stimulation of testicular spermatogenesis along with rise in serum testosterone and LH level were observed, though no significant change was observed in serum FSH level. This suggests that copper has got a dose-dependent effect on testicular steroidogenesis and spermatogenesis and serum testosterone and LH level in maturing male rats.

Estudo do gene do receptor do neuropeptídeo Y-Y1 (NPY-Y1R) em pacientes com hipogonadismo hipogonadotrófico e puberdade precoce dependente de gonadotrofinas idiopáticos / Molecular analysis of the neuropeptide Y-Y1 receptor gene (NPY-Y1R) in patients with hypogonadism and gonadotropin-dependent precocious puberty

Para avaliar se mutações no gene do receptor do neuropeptídeo Y –Y1 (NPY-Y1R) estão associadas com variações na idade do início da puberdade humana, nós sequenciamos a região codificadora do NPY-Y1R em 55 pacientes com distúrbios puberais idiopáticos. Identificamos uma substituição do aminoácido lisina por treonina na posição 374 do NPY-Y1R em uma paciente com puberdade precoce dependente de gonadotrofinas familial. A introdução da mutação K374T em um vetor de expressão contendo o NPY-Y1R humano causou uma modesta redução da expressão do receptor na superfície celular e uma redução parcial do efeito inibitório do NPY na produção de AMPc. Em conclusão, nós identificamos uma mutação que inativa parcialmente o NPY-Y1R, podendo ter contribuído para a puberdade precoce humana / In order to establish if mutations in the neuropeptide Y-Y1 receptor gene (NPY-Y1R) could be responsible for alterations in the timing of human puberty, we investigated the entire coding region of the NPY-Y1R in 55 patients with idiopathic pubertal disorders. We identified a substitution of lysine by threonine at position 374 of the NPY-Y1R in one girl with familial gonadotropin-dependent precocious puberty. The introduction of the K374T mutation into an expression vector containing the human NPY-Y1R led to a modest decrease in cell surface expression of NPY-Y1R and it caused a partial reduction of the inhibitory effect of NPY on cAMP production in transfected cells. In conclusion, we have identified a mild inactivating mutation of the NPY-Y1R that may have contributed to human precocious puberty...