Liquid chromatography-mass spectrometry for simultaneous determination of spironolactone and canrenone in plasma samples

Abstract n our study, we aimed to validate a method based on liquid chromatography-mass spectrometry (LC-MS) to quantify spironolactone (SPI) and its active metabolite canrenone (CAN) simultaneously in plasma samples to support in vivo experiments. Compounds were separated by using a C18 column with the isocratic elution of a mobile phase composed of 0.1% (v/v) formic acid in methanol-water (60:40 v/v) at a flow rate of 0.4 mL min−1. SPI and CAN were detected in na electrospray interface operating in a positive ionization mode and quantified using the selective ion mode monitoring of mass-charge ratios (m/z) of 439.0 for SPI and 363.1 for CAN. After calculating the matrix effect using theoretical equations, we observed the strong interference of plasma in the equipment-generated signal, which required creating analytical curves using the matrix as a solvent. The method was nevertheless linear (r 2 > 0.999) in a concentration range of 0.4-5.0 µg mL−1, as well as precise, with a coefficient of variation less than 5%. SPI's and CAN's recovery rates from the plasma ranged from 87.4% to 112.1%, while their limits of detection (i.e., 0.07 µg mL−1 and 0.03 µg mL−1, respectively) and quantification (i.e., 0.20 µg mL−1 and 0.08 µg mL−1, respectively) in the presence of plasma contaminants were low. Therefore, the bioanalytical method seems to be feasible for quantifying SPI and CAN in plasma

Characteristics and management of PCOS-related hyperandrogenism / 中国实用妇科与产科杂志

Hyperandrogenism is one of the major clinical characteristics of PCOS,which can be assessed either by biochemical determination of hyperan⁃drogenism or clinical manifestations of hyperan⁃drogenism to make diagnosis.Hyperandrogenism leads to ovulatory dysfunction and menstrual disorder by affecting follicular development,and causes hirsutism and acne as well;it is closely associated with the de⁃velopment of endometrial cancers,diabetes and car⁃diovascular diseases from the long-term perspective.Therefore,it is imperative to fully understand charac⁃teristics and management of PCOS-related hyperan⁃drogenism,which is an important part of the compre⁃hensive therapy for PCOS.

Apalutamide: a better option for the treatment of non-metastatic castration resistant prostatic carcinoma

Prostate cancer is cancer of the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, some grow relatively quickly. The cancer cells may spread from the prostate to other area of the body, particularly the bones and lymph nodes. Factors that increase the risk of prostate cancer include older age, a family history of the disease, and race. About 99% of cases occur in males over the age of 50. Clinical features include hematuria, dysuria (painful urination),nocturia(urination at night). Lower blood levels of vitami D may increase the risk of developing prostate cancer. Infection with the sexually transmitted diseases, chlamydia, gonorrhea, syphilis and prostatitis seem to increase risk of prostate cancer. Diagnosis can be confirmed by digital rectal examination (DRE) with prostate-specific antigen (PSA) blood test, cystoscopy, transrectal ultrasonography and biopsy (The removal of small pieces of the prostate for microscopic examination). Medicines like 5-alpha-reductase inhibitors (finasteride and dutasteride) reduce the overall risk of prostate cancer. Apalutamide, sold under the brand name Erleada, is a nonsteroidal antiandrogen (NSAA) medication which is used in the treatment of prostate cancer. It is specifically indicated for use in conjunction with castration in the treatment of non-metastatic castration-resistant prostate cancer (NM-CRPC). It is taken by mouth. Apalutamide was first described in 2007 and was approved for the treatment of prostate cancer in February 2018. Apalutamide is used in conjunction with castration, either via bilateral orchiectomy or gonadotropin-releasing hormone analogue (GnRH analogue) therapy, as a method of androgen deprivation therapy in the treatment of non-metastatic castration-resistant prostate cancer (NM-CRPC).

Safety of important dermatological drugs (retinoids, immune suppressants, anti androgens and thalidomide) in reproductively active males with respect to pregnancy outcome: A brief review of literature

Paternally transmitted damage to offspring is recognized as a complex issue. Each parent contributes 23 chromosomes to a child; hence, it is necessary to know the effects of both maternal and paternal pre-and peri-conceptional exposure to drugs on pregnancy outcome. While there are many studies on the effects of maternal drug exposure on pregnancy outcome, literature on paternal exposure is scarce. Of late however, paternal exposure has been receiving increasing attention. We present a brief review on the safety of commonly used drugs in dermatology, focused on retinoids, immune suppressants, anti androgens and thalidomide.

Therapeutic Efficacy of Goserelin Acetate Sustained-release Implants Combined with Bicalutamide in the Treatment of Elderly Prostate Cancer Patients and Cognitive Function and Short-term Survival Rate Study / 中国药房

OBJECTIVE: To investigate therapeutic efficacy of Goserelin acetate sustained-release implants combined with bicalutamide in the treatment of elderly (≥70 years old) prostate cancer patients, and its effects on cognitive function and short-term survival rate. METHODS: A total of 56 prostate cancer patients treated in our hospital from Nov. 2014 to Nov. 2016 were divided into observation group and control group according to random number table, with 28 cases in each group. Observation group was given maximal androgen blokage (MAB) treatment which was Goserelin acetate sustained-release implant (subcutaneous injection of abdominal wall, 3. 6 mg/ times, once) combined with Bicalutamide tablet (orally, 50 mg/times, qd). Control group received surgical castration, and then was given docetaxel (intravenous dripping on 1st day) combined with Prednisone acetate tablets (lst-21st day, orally, 5 mg/time, bid) after surgery for adjuvant therapy. Treatment course of 2 groups lasted for 3 weeks, and all patients were followed up for 12 months. Clinical efficacy, Montreal cognitive function assessment table (MoCA) score, serum prostate specific antigen (PSA) levels and 12-month survival rate were observed in 2 groups. RESULTS: The total response rate of observation group was significantly higher than that of control group, with statistical significance (P<0. 05). Before treatment, there was no statistical significance in MoCA score and serum PSA levels between 2 groups (P>0. 05). After treatment, MoCA scores of 2 groups were decreased significantly, and the observation group was higher than the control group, with statistical significance (P<0. 05). 6 and 12 months after treatment, serum PSA levels of 2 groups were decreased significantly, and the observation group was significantly lower than the control group, with statistical significance (P<0. 05); 12-month survival rate of observation group (92. 86％) was significantly higher than that of control group (64. 29％), with statistical significance (P< 0. 05). CONCLUSIONS: Nonsteroidal anti-androgen drugs show significant therapeutic efficacy for elderly prostate cancer, reduce cognitive function damage, improve serum PSA levels, therapeutic efficacy and short-term survival rate.

Long-Lasting Antiandrogen Withdrawal Syndrome in Castration-Resistant Prostate Cancer: Three Cases With Complete Response

This is a case report of 3 patients who had a dramatic and long-term complete response after antiandrogen withdrawal. All 3 patients were diagnosed with advanced or metastatic prostate cancer with a high prostate-specific antigen (PSA) level. For all patients, we started combined androgen blockade as androgen deprivation therapy and the PSA concentration decreased to <0.1 ng/mL, but then started to increase. After discontinuation of antiandrogen the PSA concentration decreased again and has remained below the limit of sensitivity for more than 1 year in all 3 patients.

Treatment strategy for metastatic prostate cancer with extremely high PSA level: Reconsidering the value of vintage therapy / 亚洲男科学杂志(英文版)

The prognostic significance of initial prostate-specific antigen (PSA) level for metastatic prostate cancer remains uncertain. We investigated the differences in prognosis and response to hormonal therapies of metastatic prostate cancer patients according to initial PSA levels. We analyzed 184 patients diagnosed with metastatic prostate cancer and divided them into three PSA level groups as follows: low (<100 ng ml-1), intermediate (100-999 ng ml-1), and high (≥1000 ng ml-1). All patients received androgen deprivation therapy (ADT) immediately. We investigated PSA progression-free survival (PFS) for first-line ADT and overall survival (OS) within each of the three groups. Furthermore, we analyzed response to antiandrogen withdrawal (AW) and alternative antiandrogen (AA) therapies after development of castration-resistant prostate cancer (CRPC). No significant differences in OS were observed among the three groups (P = 0.654). Patients with high PSA levels had significantly short PFS for first-line ADT (P = 0.037). Conversely, patients in the high PSA level group had significantly longer PFS when treated with AW than those in the low PSA level group (P = 0.047). Furthermore, patients with high PSA levels had significantly longer PFS when provided with AA therapy (P = 0.049). PSA responders to AW and AA therapies had significantly longer survival after CRPC development than nonresponders (P = 0.011 and P < 0.001, respectively). Thus, extremely high PSA level predicted favorable response to vintage sequential ADT and AW. The current data suggest a novel aspect of extremely high PSA value as a favorable prognostic marker after development of CRPC.

Prior switching to a second-line nonsteroidal antiandrogen does not impact the therapeutic efficacy of abiraterone acetate in patients with metastatic castration-resistant prostate cancer: A real-world retrospective study / 亚洲男科学杂志(英文版)

Even in the era of novel targeted agents, switching to a second-line nonsteroidal antiandrogen (NSAA) is still widely used in treating metastatic castration-resistant prostate cancer (mCRPC), especially in undeveloped countries. However, whether prior treatment with a second-line NSAA would impact the efficacy of abiraterone acetate (Abi) remains uncertain. In the current study, 87 mCRPC patients treated with Abi were analyzed. Among them, 21 were treated with a second-line NSAA (from bicalutamide to flutamide) before receiving abiraterone, while the remaining 66 received Abi directly. Therapeutic efficacy of Abi was compared between those with and without prior second-line NSAA using Kaplan-Meier curves, log-rank test, and Cox regression models. The therapeutic efficacy of Abi was similar between those with or without the prior switching treatment of flutamide, in terms of either prostate-specific antigen progression-free survival (PSA-PFS, 5.5 vs 5.6 months, P = 0.967), radiographic progression-free survival (rPFS, 12.8 vs 13.4 months, P = 0.508), overall survival (OS, not reached vs 30.6 months, P = 0.606), or PSA-response rate (71.4% [15/21] vs 60.6% [40/66], P = 0.370). This is the first time that the impact of prior switching of treatment to a second-line NSAA on the efficacy of Abi in mCRPC patients has been addressed. Our data support that, use of prior sequential bicalutamide and flutamide does not seem to preclude response to abiraterone, although larger cohort studies and, ideally, a randomized controlled trial are needed. These findings will facilitate doctors' decision-making in the treatment of mCRPC patients, especially for those with previous experience of switching NSAA second-line treatments in the clinic.

Prior switching to a second-line nonsteroidal antiandrogen does not impact the therapeutic efficacy of abiraterone acetate in patients with metastatic castration-resistant prostate cancer: a real-world retrospective study / 亚洲男科学杂志(英文版)

Even in the era of novel targeted agents, switching to a second-line nonsteroidal antiandrogen (NSAA) is still widely used in treating metastatic castration-resistant prostate cancer (mCRPC), especially in undeveloped countries. However, whether prior treatment with a second-line NSAA would impact the efficacy of abiraterone acetate (Abi) remains uncertain. In the current study, 87 mCRPC patients treated with Abi were analyzed. Among them, 21 were treated with a second-line NSAA (from bicalutamide to flutamide) before receiving abiraterone, while the remaining 66 received Abi directly. Therapeutic efficacy of Abi was compared between those with and without prior second-line NSAA using Kaplan-Meier curves, log-rank test, and Cox regression models. The therapeutic efficacy of Abi was similar between those with or without the prior switching treatment of flutamide, in terms of either prostate-specific antigen progression-free survival (PSA-PFS, 5.5 vs 5.6 months, P = 0.967), radiographic progression-free survival (rPFS, 12.8 vs 13.4 months, P = 0.508), overall survival (OS, not reached vs 30.6 months, P = 0.606), or PSA-response rate (71.4% [15/21] vs 60.6% [40/66], P = 0.370). This is the first time that the impact of prior switching of treatment to a second-line NSAA on the efficacy of Abi in mCRPC patients has been addressed. Our data support that, use of prior sequential bicalutamide and flutamide does not seem to preclude response to abiraterone, although larger cohort studies and, ideally, a randomized controlled trial are needed. These findings will facilitate doctors' decision-making in the treatment of mCRPC patients, especially for those with previous experience of switching NSAA second-line treatments in the clinic.

Treatment strategy for metastatic prostate cancer with extremely high PSA level: reconsidering the value of vintage therapy / 亚洲男科学杂志(英文版)

The prognostic significance of initial prostate-specific antigen (PSA) level for metastatic prostate cancer remains uncertain. We investigated the differences in prognosis and response to hormonal therapies of metastatic prostate cancer patients according to initial PSA levels. We analyzed 184 patients diagnosed with metastatic prostate cancer and divided them into three PSA level groups as follows: low (<100 ng ml-1), intermediate (100-999 ng ml-1), and high (≥1000 ng ml-1). All patients received androgen deprivation therapy (ADT) immediately. We investigated PSA progression-free survival (PFS) for first-line ADT and overall survival (OS) within each of the three groups. Furthermore, we analyzed response to antiandrogen withdrawal (AW) and alternative antiandrogen (AA) therapies after development of castration-resistant prostate cancer (CRPC). No significant differences in OS were observed among the three groups (P = 0.654). Patients with high PSA levels had significantly short PFS for first-line ADT (P = 0.037). Conversely, patients in the high PSA level group had significantly longer PFS when treated with AW than those in the low PSA level group (P = 0.047). Furthermore, patients with high PSA levels had significantly longer PFS when provided with AA therapy (P = 0.049). PSA responders to AW and AA therapies had significantly longer survival after CRPC development than nonresponders (P = 0.011 and P < 0.001, respectively). Thus, extremely high PSA level predicted favorable response to vintage sequential ADT and AW. The current data suggest a novel aspect of extremely high PSA value as a favorable prognostic marker after development of CRPC.

Effect of anti-androgen and progesterone on development of regrowth antlers in 6 year old sika deer / 中国中药杂志

To investigate the effects of anti-androgen drugs and melengestrol acetate (MGA) on development of regrowth antlers in 6 year old sika deer, twenty healthysika deerwith similar body weight and antler weightwere randomly divided into five groups by using single factor test design: flutamide (=4), bicalutamide (=4), progesterone acetate (CPA, =4), melengestrol acetate (MGA, =4), control(=4). All deer were fed with same diets and were housed outside together in an opened fence of 15 m×30 m with free access to water and feed. Treatment groups were injected subcutaneously sustained-release agents of the four drugs respectively when two-branched antlers were harvested. The control group had no special treatment. In the experiment period of 60 d, blood sampleswere collected for 4 times for each deer. The concentration of testosterone in plasma was tested and analyzed to compare the changes between different groups. Development of regrowth antlers was observed. At the end of the experiment, regrowth antlers were weighted and analyzed. The resultsshowed that the weights of regrowth antlers in treatment groups were significantly greater than those from control group and the weight gain (as compared with the control group) was 100.50%, 64.46%, 87.16% and 117.46% respectively in flutamide group, bicalutamide group, progesterone acetate group and melengestrol acetate group. For plasma testosterone concentration, it was not significantly different in the early stage (in the first 35 d), but at the end of the experimen, it was significantly higher than that of earlier stage (<0.01) in various groups. Testosterone concentration of flutamide treated group was significantly lower than that of the other groups (<0.01), while the level inbicalutamide and MGA treated groups was significantly higher than that in other groups (<0.01). The results showed that both anti-androgen drugs and MGA treatment promoted the development of regrowth antlers and increased the weight of regrowth antlers, where the effect was most significant by MGA treatment. From the morphological observation of the antlers, it was found that anti-androgen and MGA treatments prolonged the growth period of regrowth antlers through delaying the ossification of antlers. However, plasma testosterone concentration was not affected by the treatments.

Hormetic Effects of Yttrium on Male Sprague-Dawley Rats / 生物医学与环境科学（英文）

To evaluate hormesis induced by Yttrium (Y) nitrate in male rats, Y was offered to F0 mother rats and F1 offspring at concentrations of 0, 20, 80, and 320 ppm daily from gestational day (GD) 0 through postnatal day 70 (PND 70). The F1 offspring were evaluated with respect to motor function, learning and memory, and histopathology. Administration of Y improved motor function in a dose dependent manner. In the 20 ppm group, body weight and spatial learning and memory were increased, while the latter was decreased in the 320 ppm group. Additionally, in the 20 ppm and 80 ppm, but not the 320 ppm groups, Y reduced the anogenital distance, which indicated an anti-androgen effect. These results suggest that Y follows a hormetic concentration-related trend with an inverted U-shape.

The effect of flutamide on the physical working capacity and activity of some of the key enzymes for the energy supply in adult rats / 亚洲男科学杂志(英文版)

The aim of the study was to assess the effects of androgen receptor antagonists on the physical working capacity and activity of some of the key muscle enzymes for the energy supply in rats. Young adult male Wistar rats were divided into two groups. One group received 15 mg kg-1 of flutamide daily for 6 days a week and the other group served as control for 8 weeks. At the beginning and at the end of the experiment, all rats were subjected to submaximal running endurance (SRE), maximum time to exhaustion (MTE), and maximal sprinting speed (MSS) tests. At the end of the trial, maximum oxygen consumption (VO2max) test was performed and the levels of testosterone, erythrocytes, hemoglobin as well as enzyme activity of succinate dehydrogenase (SDH), lactate dehydrogenase (LDH), and NAD.H2-cytochrome-c reductase (NAD.H2) of the gastrocnemius muscle were measured. Serum testosterone of the flutamide-treated rats was higher than that of the controls, which verifies the effectiveness of the dose chosen. MTE and SRE of the anti-androgen-treated group were lower compared with the initial values. Flutamide treatment decreased the activity of SDH and NAD.H2 compared with the controls. We found no effect of the anti-androgen treatment on MSS, VO2max, running economy, LDH activity, and hematological variables. Our findings indicate that the maintenance of the submaximal and maximal running endurance as well as the activity of some of the key enzymes associated with muscle oxidative capacity is connected with androgen effects mediated by androgen receptors.

Advances in understanding the mechanisms of anti-androgen ther-apeutic action and failure in castration-resistant prostate cancer / 中国肿瘤临床

Castration-resistant prostate cancer (CRPC) is the lethal form of prostate cancer with developed resistance to androgen deprivation therapy. However, anti-androgen therapy remains an important treatment option because androgen receptor activation is a major driver of the advanced phase of CRPC. Drug resistance is frequently manifested despite the development of various novel anti-an-drogens with significant clinical efficacy. This review introduces several drugs prevalently used to treat CRPC. The mechanisms of ac-tion and pathways to resistance of these drugs are also discussed.

Female pattern hair loss.

Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident from frequent lack of clinical or biochemical markers of hyperandrogenism in affected women. The role of genetic polymorphisms involving the androgen and estrogen receptors is being increasingly recognized in its causation and predicting treatment response to anti-androgens. There are different clinical patterns and classifications of FPHL, knowledge of which facilitates patient management and research. Chronic telogen effluvium remains as the most important differential diagnosis. Thorough history, clinical examination, and evaluation are essential to confirm diagnosis. Patients with clinical signs of androgen excess require assessment of biochemical parameters and imaging studies. It is prudent to screen the patients for metabolic syndrome and cardiovascular risk factors. The treatment comprises medical and/or surgical modalities. Medical treatment should be initiated early as it effectively arrests hair loss progression rather than stimulating regrowth. Minoxidil continues to be the first line therapy whereas anti-androgens form the second line of treatment. The progressive nature of FPHL mandates long-term treatment for sustained effect. Medical therapy may be supplemented with cosmetic concealment in those desirous of greater hair density. Surgery may be worthwhile in some carefully selected patients.

Alopecia androgenética femenina: Parte II: tratamiento / Female androgenetic alopecia: Part II: treatment

Como en el varón, el tratamiento tópico de alopecia de patrón femenino (AF) es con minoxidil al 3 por ciento - 5 por ciento dos veces al día. También puede usarse el minoxidil combinado con α-tocoferol o con otros tratamientos tópicos que elevan localmente el factor de crecimiento vascular endotelial. Comentamos nuestra experiencia con esta asociación. Los efectos secundarios más frecuentes en mujeres son la dermatitis de contacto y la hipertricosis de cara y antebrazos. Cuando la alopecia femenina se asocia a elevados niveles de andrógenos hay que utilizar terapéutica antiandrogénica. El síndrome de persistencia de la adrenarquía (SAHA suprarrenal) y alopecia en hiperandrogenismo suprarrenal deben tratarse con supresión suprarrenal y antiandrógenos. La supresión suprarrenal la efectuamos con glucocorticoides como dexametasona, prednisona o deflazacort. La terapia antiandrogénica incluye acetato de ciproterona, drospirenona, espironolactona, flutamida y finasterida. El síndrome por exceso de eliminación de andrógenos ováricos (SAHA ovárico) y alopecia del hiperandrogenismo ovárico pueden tratarse con supresión ovárica y andriandrógenos. La supresión ovárica incluye el uso de anticonceptivos que contengan un estrógeno, etinilestradiol, y un progestágeno. El antiandrógeno acetato de ciproterona, siempre acompañado de un anticonceptivo tricíclico, es la mejor terapéutica de la alopecia femenina. Los antagonistas de las hormonas liberadoras de gonadotropinas (GnRH) como el acetato de leuprolida suprimen la función hipofisaria y gonadal mediante la reducción de los niveles de LH y FSH, y como consecuencia se reducen los niveles de esteroides ováricos, especialmente en el síndrome de los ovarios poliquísticos. El SAHA hiperprolactinémico y alopecia del hiperandrogenismo de procedencia hipofisaria deben tratarse con bromocriptina o cabergolina. Las mujeres con alopecia posmenopáusica y altos niveles séricos de andrógenos en la premenopausia...

Topical treatment of female patgten hair loss (FPHL) is with minoxidil 3 percent-5 percent twice daily. Combination of minoxidil with α-tocopherol or with other topical treatment with possibility to enhance VEGF can be used. Our experience with this association is commented. Side effect of minoxidil is contact dermatitis and hipertricosis on face and forearm. When FPHL is associated with high levels of androgens systemic antiandrogenic therapy must be used. Persistent adrenarche syndrome (adrenal SAHA) and alopecia of adrenal hiperandrogenism must be treated with adrenal suppression and antiandrogens. Adrenal suppression is achieved with glucocorticosteroids such as dexametasona, prednisone ordeflazacort. Antiandrogen therapy includes cyproterone acetate, drospirenone, spironolactone, flutamide and finasteride. Excess release of ovarian androgens (ovarian SAHA) and alopecia of ovarian hiperandrogenism must be treated with ovarian suppression and antiandrogens. Ovarian suppression includes the use of contraceptives containing an estrogen, ethinyl estradiol, and a progestogen. Antiandrogens such as cyproterone acetate, always accompanied by tricyclic contraceptives, are the best antiandrogen to use in FPHL. Gonadotropin-releasing hormone (GnRH) agonists such as leuprolide acetate suppress pituitary and gonadal function through a reduction in LH andFSH levels. Subsequently, ovarian steroids levels will also be reduced, especially in patients with polycystic ovary syndrome. SAHA with hyperprolactinemia and alopecia of hyperprolactinemic hiperandrogenism should be treated with bromocriptineor cabergoline. Postmenopausal alopecia, with previous high levels of androgens or with PSA over 0.02 ng/ml improves with 2.5 mg/day of finasteride or 0,25 mg/day of Dutasteride. Although we do not know the reason, postmenopausal alopecia in normoandrogenic women also improves, probably in relation with the doses of 2.5 mg day that received...

A Clinical Review of Chemical Castration Against Sex Offenders for Children / 대한정신약물학회지

In the past, physical castration was adopted to punish sex offenders and prevent the recurrence of sexual crimes. However, it was abrogated because of human right issues and the irreversibility of fertility. Chemical castration of depot injection with hormones was introduced as an alternative method of physical castration. Antiandrogen is the most frequently used hormonal agents. Although there are several positive results such as changes of sexual behaviors and decrease of the recurrence rate of sexual crime after hormonal treatment, it also has serious limitations; difficulties in academic evaluation for control group and placebo effect; difficulties in the assessment of the therapeutic effect; and difficulties to decide the proper duration of treatment. Although the law for chemical castration to control sexual impulses in sex offenders was enforced since July, 2011 in Korea, there are not enough resources for treatment. We reviewed the appropriate references and suggested continuous long-term follow-up studies.

Increase in apoptosis and of the stress protein HSP70 in the mouse epididymis produced by the antiandrogen flutamide / El antiandrógeno flutamida produce un aumento de la apoptosis y de la proteína de stress HSP70 en el epidídimo del ratón

The general aim of this paper was to characterize some changes induced by androgen receptors blockage in the epithelial cells of the mouse epididymis. The antiandrogen flutamide was injected (10 mg/Kg b.w.) to adult male mice which were sacrificed 24h. and 72h. after. Controls injected with the vehicle (corn oil) were sacrificed at the same intervals. Cryosections were made of the epididymides and examined by the TUNEL method for quantification of apoptosis and also using immunocytochemistry to visualize the expression of the stress protein HSP70. The highest indexes of apoptosis were observed in the caput epididymis after 72 h. and were of 7.40 cells/1000 in contrast to controls (0.21 cells/1000). HSP70 appeared particularly increased in the caput and cauda epididymis after 72 h. treatment. Results indicated that the blockage of androgen receptors induces apoptosis and a HSP70 expression in the principal epithelial cells of the mouse epididymis, and that these changes occur in a region-specific fashion.

Este trabajo estudia los cambios inducidos por el bloqueador de receptores de andrógeno flutamida en el epitelio del epidídimo del ratón. Varios machos adultos fueron inyectados con flutamida (1Omg/Kg.b.w.) y se sacrificaron a las 24 y 72horas. Otros machos, que sirvieron de controles fueron inyectados sólo con el vehículo empleado para las inyecciones (aceite de maíz) y se sacrificaron a intervalos similares. Los epidídimos tratados y controles fueron examinados mediante el método TÚNEL para cuantificar la apoptosis y mediante procedimientos inmunocitoquímicos para localizar la proteína de stress HSP70. El índice apoptótico más alto fue observado en la cabeza del epidídimo después de 72 horas de tratamiento. HSP70 se observó también a las 72 horas en la cabeza y en la cauda epididimaria. Los resultados indican que el bloqueo de los receptores de andrógenos induce apoptosis y expresión de HSP70 en las células principales del epitelio epididimario, y que estos cambios ocurren afectando a regiones específicas del epidídimo.

Stuttering Priapism happened in Sleep / 대한남성과학회지

Priapism is an abnormal persistent penile erection that continues for more than 4 hours, without sexual stimulation according to the definition of the AUA (American Urological Association) guideline on the management of priapism. It was relatively rare in the past but has been increasing in the incidence since the advent of pharmacological agents. Stuttering priapism is a recurrent form of ischemic priapism and its treatment goal is to prevent the recurrences of priapism and resultant erectile dysfunction. We present the case of a patient who took tadalafil and thereafter had idiopathic recurrent episodes of ischemic priapism during the sleep and we show several treatment options of stuttering priapism with review of recent related articles.

Incidence of Flutamide-induced Liver Toxicity in Patients with Prostate Cancer in Korea / 대한비뇨기과학회지

PURPOSE: The incidence of flutamide-related liver toxicity was studied in 56 korean patients, treated for advanced prostate cancer with flutamide combined with a LHRH agonist or orchiectomy. MATERIALS AND METHODS: Serum glutamic oxaloacetic transaminase(SGOT), serum glutamic pyruvic transaminase(SGPT), total bilirubin and alkaline phosphatase were measured to assess liver function at baseline, 1, 2 and 3 months and every 3 months thereafter. When they were elevated three-fold or more than upper normal levels, we regarded it as a presence of liver toxicity. Viral marker studies (Hepatitis B, C) were performed in patients with elevated SGOT and/or SGPT after flutamide administration. RESULTS: Ten patients(17.9%) showed elevated SGOT and/or SGPT at an average of 3 months after flutamide administration. All patients who performed viral marker studies revealed negative results. Total serum bilirubin was elevated in three(5.4%) patients and clinical jaundice appeared in one(1.8%). All clinical and biochemical manifestations of liver toxicity disappeared within two months after discontinuation of flutamide and no sequelae was observed for 15 months. CONCLUSIONS: The Incidence of flutamide-Induced hepatotoxicity seems to be higher In Korea than in North America. But this might not be due to the fact that Korea is an endemic area of viral hepatitis. Further study will be necessary for the verification of dose-related toxicity of flutamide in Korean prostate cancer patients. We recommend liver function test periodically to patients treated with flutamide.