Dynamics of the hypothalamo-pituitary-gonadal axis in elderly Egyptian men

The endocrine system can be involved in the ageing process. Thirty healthy men aged >/ 70 years [group Ib] were studied in order to determine the effects of aging on the integrity of the hypothalamo-pituitary-gonadal axis. Ten healthy men aged 30-35 years were also included for comparison. In group Ib subjects, mean basal serum LH and FSH were significantly increased in comparison to those in group II men. Following GnRH injection, the percentage of increase in serum LH was lower in group Ib than that in group II, but the percentage of increase in serum FSH was comparable in these 2 groups. No significant difference was observed in basal serum LH and FSH and their responses to GnRH between groups Ia and II. Mean serum testosterone levels before and after HCG stimulation were significantly diminished in groups Ia and Ib in comparison to those in group II. Mean serum E2 levels were comparable in the three studied groups, while serum SHBG was significantly increased in groups Ia and Ib when compared to group II. Mean serum prolactin was only significantly increased in group Ib in comparison to group II. An inverse correlation was observed between serum testosterone levels and serum levels of LH, FSH and prolactin [P < 0.05]. A significant direct correlation was found between age and serum LH, FSH, SHBG and prolactin levels [P < 0.05, P < 0.05, P < 0.01 and P < 0.05, respectively], whereas serum testosterone levels decreased significantly with age [P < 0.001]. It was concluded that a decline in testosterone secretion occurs in men with age which is due to a primary testicular insufficiency, a pituitary or hypothalamic defect, and increased prolactin secretion. This alternated hormonal status is responsible for some of the changes observed in sexual activity with aging

Study of renal functions in diabetes mellitus with and without nephropathy

The present study included three groups of subjects. The first group included ten normal control subjects. The second group included 10 diabetic patients without clinical or laboratory evidences of diabetic nephropathy. The third group included 20 diabetic patients with confirmed diagnosis of diabetic nephropathy. The results showed significant decrease in renal function in patients with diabetic nephropathy with protein selectivity consistent with poorly selective proteinuria in 75% of cases and moderately selective proteinuria in the remaining 25%. Also, there was a significant increase in blood sugar, blood pressure, erythrocyte sedimentation rate and blood cholesterol in patients with diabetic nephropathy. Study of plasma proteins and their electrophoretic pattern showed a significant reduction of total serum proteins and the albumin fraction in patients with diabetic nephropathy, when compared with the diabetic control group or the normal controls. There was also a significant increase in alpha-globulin, beta and gamma globulin fractions, in the different groups. The results were analyzed and discussed

Study of the relevant diagnostic criteria of insulinoma

Insulinoma was considered to be a rare tumor. It has various presentations that may simulate many other conditions. With proper clinical assessment and some investigations, it can be properly diagnosed. The study included six cases in a trial to delineate the relevant diagnostic criteria. Simultaneous assay of immunoreactive insulin [IRI] and fasting blood glucose is the main guide for diagnosis

Blood groups and dental caries experience in an Egyptian population group

The exploration of the relationship between the bearing of blood groups and caries susceptibility begins with an observation reported by Aitcheson and Carmichael[1] who reported a high percentage of blood group "O" and low percentage of blood group "A" in caries-resistant subjects and the converse in caries-rampant persons. Conflicting results have been obtained from a study of a large group of Chilean children. The study failed to demonstrate an association between ABO and MN blood groups and caries scores. Similar trend was also evident for the ABO an MN blood groups and caries scores relationship in a different age group[3,4 and 5]. On the other hand the study of O'Roark and Leyshon[6] in a group of young adults aged 15-16 year, showed that the MN blood group was associated significantly with increased caries activity. In the present study it was decided to overlook the accepted predisposing factors of dental caries and to investigate the relationship, if any, between blood mutations and dental caries among a group of young adult Egyptian population among whom caries is a less acute problem in comparison with the western populations

Study of different insulin regimens in the management of diabetic ketoacidosis

Diabetic ketoacidosis was invariably fatal before the introduction of insulin therapy. Small doses of insulin are sufficient to lead to a smooth recovery from ketoacidosis. In this work, a comparative study was done between big and small doses regimens in the management of ketoacidosis. It was conducted on 24 patients with varying degrees of diabetic ketoacidosis. All patients were subjected to complete physical examination including the level of conciousness, cardiac, chest, and neurological examination, blood sugar level, urine for glycosuria, ketoaciduria, pus cells and casts, complete blood picture serum sodium and potassium, blood urea and ECG. The results were discussed in details

Study of platelet aggregation and fibrinolysis in maturity-onset diabetes mellitus before and after treatment

This work was carried out on 30 newly diagnosed insulin-independent diabetics and ten normal controls. The patients were selected to be free from cardiovascular, haematological, renal or gastrointestinal disorder. Diet alone was not effective in controlling their hyperglycaemia. Platelet aggregation using ADP and euglobulin clot lysis time were performed for all the patients in addition to the coagulation time, bleeding time and platlet count. The patients were then divided into two groups. One group was treated with gliclazide and the other group was treated with tolbutamide. After three months treatment, the above mentioned investigations were repeated again. Results were then analysed and discussed

Vascular reactivity in acromegaly

Vascular reactivity was estimated in both ten acromegalic patients and ten controls. The peripheral blood flow was measured by a venous occlusive plethysmography technique. Increased vascular reactivity in acromegalic patients was observed. This may be considered in the explanation of pathogenesis of hypertension in this disease. The probable mechanisms were discussed in the text

Study of plasma immunocreative corticotropin[ACTH] and cortisol in hepatosplenic schistosomiasis during intravenous insulin tolerance and metopirone tests

Plasma levels of immunoreactive corficotropin [ACTH] and cortisol were assayed under basal and resting conditions in 30 male patients with confirmed hepatosplenic schistosomiasis. These were divided into 3 groups, 10 patients with infantilism, 10 patients without infantilism and 10 patients with cor-pulmonale. Intravenous insulin tolerance and metopirone infusion tests were performed in the three patient groups and compared with 10 male healthy controls of matched age. Stimulation of corticotropin and cortisol secretion by insulin induced hypoglycaemia was inadequate, as well as the rise in plasma corticotropin during metopirone test was reduced in the 3 patient groups particularly when infantilism was associated indicating a compromised pituitary adrenal reserve

Radioimmunoassay of serum gonadotropins in hepatosplenic schistosomiasis with and without infantilism and their response to gonadotropin-releasing hormone stimulation

Radioimmunoassay of gonadotropins [L.H and FSH] were performed under basal conditions and their response to gonadotropin releasing hormone stimulation were studied in 22 male hepatosplenic schistose-miasis patients. They were divided into 2 groups; 12 patients with infantilism and 10 patients without infantilism and compared with 10 healthy male controls. Significant lower mean basal values of gonadotropins and a blunted response to gonadotropin- releasing hormone stimulation were found in hepatosplenic schistosomiasis with infantilism, while a reduced but more favourable LH response and a relatively increased FSH response were found in hepatosplenic schistosomiasis without infantilism. The mechanisms of the hypothalamic- pituitary dysfunction in both patient groups and the probable primary testicular defect in the group without infantilism were discussed

Glucagon infusion test in hypothyroidism before and after T[3] therapy

T twenty primary hypothyroid patients and ten control subjects were studied. They were all subjected to: intravenous glucagon infusion test to study the response of their blood glucose. Also I.V. lgucose tolerance test was performed to estimate the glucose disappearance rate [Kg. value]. The same tests were repeated in hypo thyroid patients after triiodothyronine [T[3]] therapy. A supernormal response of blood glucose level was observed in hypothyroid patients before treatment. This finding was attributed to increased tissue glucose utilisation. Decreased secretion and increased glucagon degradation were also suggested. The response to glucagon infusion and the tissue glucose utilisation were normalised after T[3] therapy