[Evaluation of selected parameters of collagen metabolism in patients with myopia]. / Ocena wybranych parametrów metabolizmu kolagenu u osób z krótkowzrocznoscia.

INTRODUCTION: Myopia is a common condition of vision deprivation characterized by the excessive lengthening of the eye axis. There are hypotheses that the elongation of the eye is connected with the connective tissue disorder in which the scleral collagens are inappropriately remodelled. The most common type of collagen and the first to be discovered is type I and it is the dominating one in cornea and sclera. Type III is always found in coexistence with type I. AIMS: The aim of the study was to evaluate the serum concentration of carboxyterminal propeptyde of procollagen type I (P I CP), aminoterminal propeptyde of procollagen type III (P III NP) (markers of collagen synthesis) and carboxyterminal telopeptyde of collagen type I (I CTP) (marker of collagen disintegration) as markers of the connective tissue metabolism in patients with myopia. MATERIAL AND METHODS: Serum concentration of P I CP, P III NP and I CTP were studied in 25 (15 female and 10 male) patients with myopia and in 15 emmetropic subjects using the RIA method (Orion Diagnostica). RESULTS: The serum concentration of P I CP and P III NP increased significantly in patients with myopia when compared with the control group. There was no significant difference in the concentration of both of them among patients with various degrees of myopia, although the concentration of P I CP and P III NP increased with the increase of myopia. The was no statistical difference in the concentration of I CTP in low and medium myopia but we found increased concentration of I CTP in high myopia comparing with control group. CONCLUSION: The mechanical properties as well as the increased remodelling of the collagen could be some of the factors involved in myopia pathogenesis. Changes in the collagen metabolism concern not only the eye tissue, but probably also disorders of the systemic connective tissue turnover.

[Growth hormone and its interactions with chosen parameters of hormonal state in pre-menopausal women after mastectomy for breast cancer on adjuvant chemotherapy]. / Hormon wzrostu i jego interakcje z wybranymi parametrami stanu hormonalnego u kobiet przed menopauza po mastektomii z powodu raka sutka, poddanych uzupelniajacej chemioterapii.

It seems, that quantitative changes of growth hormone (GH) in blood and imbalance between GH and hormones can influence the breast cancer cells proliferation, and can be a favourable element in breast cancer progression. The procedure to normalize hormonal system can have a therapeutic action. The aim of the presented work is to asses the plasma GH levels in 24 pre-menopausal women after mastectomy for breast cancer on adjuvant chemotherapy with cyclophosphamide, methotrexate, 5-fluorouracil (CMF). In this study interactions between GH and insulin like growth factor-I, prolactin, estradiol, progesterone (P), melatonin, cortisol and met-enkephalin were assessed. The control group was consisted of 16 healthy women. Plasma GH concentration and interactions between GH and studied parameters in women with breast cancer did not differ from healthy women. Highly significant positive correlation between GH and P after administration CMF was shown. CMF did not influence the interactions between GH and other studied parameters.

[Hormonal changes in male patients with primary open angle glaucoma]. / Ocena zmian hormonalnych u mezczyzn chorych na jaskre prosta otwartego kata przesaczania.

INTRODUCTION: Primary open angle glaucoma (POAG) is the most common type of glaucoma, pathogenesis of which is not completely known. Several clinical studies show that glucocorticoid hormones may be implicated in the pathogenesis of POAG and ocular hypertension. Glucocorticoid receptors have been identified in human outflow tissue of the eye. AIMS: The purpose of this study, therefore, was to evaluate the serum concentration of total cortisol (TF), total testosterone (TT), free testosterone (FT), FSH (follitropin), LH (lutropin), ACTH (adrenocorticotropin), SHBG (sex hormone-binding globulin), DHEA-SO4 (dehydroepiandrosterone sulfate) as well as free cortisol (UFF) and 17-OHCS in 24 hours urinary samples in patients treated because of POAG. PATIENTS AND METHODS: Studies were performed in the group of 30 male patients, aged 55 +/- 13 years, treated because of glaucoma for more than two years. Serum and urinary concentration of hormones were studied using RIA methods (DPC). RESULTS: The serum concentration of TF (652.03 +/- 315.43 nmol/l), UFF (248.75 +/- 99.39 nmol/l) and 17-OHCS (5.47 +/- 2.64 mg/24 h) in urine was increased compared with control group. There was not significant difference in concentration of pituitary-gonadal axis hormones in glaucomatous and control groups of patients. CONCLUSION: The results could point to the fact that changes in the endocrine system are one of the factors involved in the pathogenesis of POAG. We conclude that an elevated level of cortisol, free cortisol and its metabolites is closely related to the POAG.

Is positive correlation between cortisol and met-enkephalin concentration in blood of women with breast cancer a reaction to stress before chemotherapy administration?

The role of stress in the course of neoplastic diseases has been emphasised over the past few years. Organism defence in form of increased release of hormones, corticosteroids and endogenous opioids should be assessed as a particular form of adaptation. Interactions between stress hormones and others which may influence the growth of breast cancer cells are possible. In this study, the concentration of cortisol and met-enkephalin vis-à-vis growth hormone, insulin-like growth factor-I, prolactin, estradiol, progesterone and melatonin in blood of women with breast cancer before the first cycle of supplementary chemotherapy was compared to that of healthy women. In a group of patients with breast cancer, before the first cycle of chemotherapy, high hypercortisolemia and positive correlation between cortisol and met-enkephalin was observed which may be a result of stress at the beginning of such treatment. A negative correlation between prolactin and met-enkephalin in this group can indirectly testify to essential participation of endogenous opioids in hormonal regulation and can be a response to stress caused by beginning chemotherapy.

[Do enkephalins and other endogenous opioids participate in regulation of cancer growth?]. / Czy enkefaliny i inne endogenne opioidy uczestnicza w regulacji wzrostu nowotworów?

Attempts are interesting exploratory trend to define precisely relations between endogenous opioid system and neoplastic process development. Mechanism in which enkephalins and other endogenous opioides could influence on cancer growth is not clear. Several hypothesis were put and presented in the paper.

[Hyperprolactinemia--unappreciated clinical problem]. / Hiperprolaktynemia--niedoceniany problem kliniczny.

In the study, in concise way, actual knowledge concerning hyperprolactinemia was presented. Its causes, clinical symptoms, diagnostic proceeding, methods of treatment and prognosis were discussed.

[Long-term controlled release of drugs]. / Dlugotrwale kontrolowane uwalnianie leków.

The surveys of long-term controlled drugs supply systems have become recently one of more important branches of pharmacy. Many systems were elaborated. The systems differ from each other by the mechanism and time of drug release and the way of administering it. A large number of polymers have been developed with the capability of controlling the release rate over a long period of time (from 12 hr to 5 years). The programmed delivery of drugs offers advantages over conventional methods of administration. Controlled release drug delivery systems include oral, transdermal, injectable, implanted, intrauterine and intravaginal systems. In this paper different sustained-release systems in current use are reviewed.

[Insulin-like growth factor-I: pathophysiologic and clinical aspects]. / Insulinopodobny czynnik wzrostowy-I: aspekty patofizjologiczne i kliniczne.

The paper reviews the factors which affect synthesis and metabolic activity of the insulin-like growth factor-I (IGF-I), its receptor and binding proteins as age, nutritional state, hormonal state and liver function. Attention is also focused on the role of IGF-I in pathogenesis of osteoporosis and neoplastic diseases.

The application of microspheres from the copolymers of lactide and epsilon-caprolactone to the controlled release of steroids.

The microspheres made of the copolymers of lactide and epsilon-caprolactone were used for the controlled release of progesterone and beta-estradiol. The copolymers contained 83-94% of l or d,l-lactide. The influence of the microstructure of lactidyl blocks in the copolymer chains on the drug release rate was studied. More uniform release rate was observed in the case of the copolymer derived from d,l-lactide as composed to l-lactide. For the copolymer containing 83-94% of d,l-lactide units the progesterone and beta-estradiol release rate in vitro was found to be practically constant within over 40 days. The in vivo studies performed on rats revealed that the period of constant release rate of beta-estradiol can be prolonged to about 70 days. The microspheres made of the applied poly-(d,l-lactide-co-epsilon-caprolactone) are the convenient system for long time release of steroids.

[Liver and endocrine system. Part II: pituitary-gonadal axis and adrenal gland activity disturbances]. / Watroba a uklad wewnetrznego wydzielania. Czesc II: Zaburzenia czynnosci osi przysadkowo--gonadalnej i nadnerczy.

Up to date studies have demonstrated that more and more young people are affected by liver diseases. There is a close relationship between the liver and endocrine system as far as hormone inactivation and synthesis of protein binding hormones in the liver are related. Impairment of the hepatocyte function may lead to disturbed homeostasis of the endocrine system. In part II current opinions on plasma levels of pituitary--gonadal and--adrenal axis hormones and their binding proteins in chronic hepatic disorders are presented.

[Liver and endocrine system. Part I: pituitary-thyroid axis activity disorders]. / Watroba a uklad wewnetrznego wydzielania. Czesc I: Zaburzenia czynnosci osi przysadkowo-tarczycowej.

Recent studies have demonstrated that more and more young people suffer from liver diseases. There is a close relationship between endocrine system and the liver, where the hormone inactivation and synthesis of protein binding hormones takes place. Impairment of hepatocyte function may lead to disturbed homeostasis of the endocrine system. In part I current opinions on thyreometabolic state as well as plasma levels of pituitary-thyroidal axis hormones and their binding proteins in chronic hepatic disorders are presented.

Circadian variations of androstenedione, dehydroepiandrosterone sulfate and free testosterone in obese women with menstrual disturbances.

OBJECTIVE: To assess the 24 h profile of androgenemia related to the androgens of both the ovarian and adrenal origin in obese women with menstrual disturbances. METHODS: The association of body mass and body fat distribution with circadian variations of selected androgens of ovarian and adrenal origin was examined in 16 obese women with menstrual disturbances (BMI between 38 and 51 kg/m2; WHR between 0.80 and 0.99) and in 16 healthy volunteers with normal body weight (BMI between 21 and 24.6 kg/m2; WHR between 0.73 and 0.76). The age range of all subjects was 29 to 40 (mean: 36.9+/-3.2 years). RESULTS: lts. Both the patients and control subjects showed a significant 24 h rhythm of androstenedione (A) and free testosterone (FT), while the circadian oscillations of dehydroepiandrosterone sulphate (DHEAS) did not differ significantly. In all obese women mean 24 h A, DHEAS and FT levels were significantly higher than those in controls. Moreover, the disturbances of DHEAS and FT secretion in the form of acrophase shift (for DHEAS from 7.37 to 3.45 h and for FT from 6.04 to 3.31 h) and the elevation of their 24 h amplitude values were observed. All obese women showed higher values of FT/A and FT/DHEAS indexes in selected clock time of day/night cycle (except those at 8.00 h for FT/A and at 5.00 h for FT/DHEAS) when compared to control group. A positive correlation was noted in all women studied between the values of BMI index, WHR ratio and mean 24 h level of androgens studied as well as FT/A and FT/ DHEAS indexes. A weaker correlation was found between body mass and body fat distribution on the one hand and fasting level of hormones studied on the other. Higher correlation between the values of WHR ratio and mean 24 h FT levels as well as FT/DHEAS indexes were obtained in obese women when compared to those of healthy subjects. CONCLUSIONS: Our findings suggest that, when assessing the androgen disturbances in obese patients, it is more useful to determine their circadian pattern than the basal level. The most reliable indicators of hyperandrogenism in obese women are: the 24 h concentration profile of FT and the value of FT/DHEAS index, not only during fasting but also after a meal at various time intervals. Circadian FT concentration and FT/DHEAS index values are essential indicators for visceral distribution of adipose tissue.

Assessment of bone metabolism in obese women.

OBJECTIVE: To evaluate the bone metabolism in obese women by the estimation of selected markers of bone formation. METHODS: The concentration of plasma parathyroid hormone (PTH) and selected markers of bone formation [osteocalcin (BGP) in plasma, carboxyterminal propeptide of type I procollagen (PICP) and alkaline phosphatase (AP) activity in blood serum] and bone resorption [cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in blood serum and urinary excretion of calcium (Ca)] in 18 extremely obese women (BMI>40 kg/m2) with android phenotype (WHR>0.8) and in 20 healthy women with normal body weight. The age range of all subjects was 25 to 42 years (mean: 36.82 + 3.95). RESULTS: All obese women showed significantly increased concentration of plasma PTH, BGP and serum PICP, ICTP and elevated urinary excretion of Ca. CONCLUSIONS: The obtained results show that in extremely obese women with android phenotype bone metabolism disturbances may occur pointing at increased bone formation and resorption.

Diurnal rhythm of serum melatonin, ACTH and cortisol in asthma patients with long term glucocorticoid treatment.

Forty one patients (21 women and 20 men aged 35 to 45 years), with bronchial asthma were divided into two groups: those treated with glucocorticoids (with an equivalent daily dose of 8 mg prednisone) and those receiving no glucocorticoid preparations. The control group consisted of 27 healthy volunteers. The diurnal rhythm of serum melatonin, ACTH and cortisol was evaluated in all subjects. It was found that the dysfunction and reduced reactivity of the pituitary-adrenal axis in asthmatics receiving chronic glucocorticotherapy was accompanied by suppressed melatonin rhythm.

Assessment of the relationship between collagen metabolism and selected hormonal factors in extremely obese women before and after jejunoileostomy.

The majority of obese persons have hyperinsulinemia and disturbances in the secretion of melatonin, catecholamines and pituitary, thyroid, adrenal and gonadal hormones. These hormones play an important role in the regulation of collagen metabolism either by acting directly or by influencing IGF-I production. This study aimed at ascertaining whether, and to what degree, the changes in the concentration of hormones listed above as well as in the concentration of sex hormone-binding globulin (SHBG) and insulin-like growth factor-I (IGF-I) affect the metabolism of collagen as evaluated indirectly from the measurement of propeptides of type I (PICP) and type III procollagen (PIIINP) in blood serum and hydroxyproline in urine. The study compared 30 women with extreme obesity before and three to five years after jejunoileostomy with 20 healthy women of reproductive age. All non-operated obese women showed significantly increased concentration of serum insulin, IGF-I, melatonin, norepinephrine, free triiodothyronine, estradiol, total and free testosterone, PICP, PIIINP and urinary excretion of hydroxyproline, while the levels of epinephrine, progesterone and SHBG were significantly decreased. Changes in the level of the examined markers of collagen metabolism correlated positively with the concentration of insulin, IGF-I and sex hormones, while the correlation with epinephrine, cortisol and thyroid hormones was negative. All women who were treated previously by jejunoileostomy showed a decreased of body mass to regular values, normalization of hormonal disturbances and normal collagen metabolism. The obtained results show that the increased collagen metabolism observed in extremely obese women is caused indirectly by altered endocrine activity.

[Evaluation of selected parameters of connective tissue metabolism in patients with primary open angle glaucoma]. / Ocena wybranych parametrów metabolizmu tkanki lacznej u chorych na jaskre prosta.

PURPOSE: To evaluate the plasma concentration of P I CP and P III NP as markers of the connective tissue metabolism in human with and without POAG. The mechanical properties of the collagen could be one of the common factors involved in the pathogenesis of chronic open angle glaucoma. MATERIAL AND METHODS: P I CP and P III NP were studied in serum in 20 patients with POAG and in 10 healthy subjects using RIA method. RESULTS: The concentration of P III NP in the blood serum was markedly increased (3.99 +/- 1.5 micrograms/l) compared with control group (2.84 +/- 0.77 micrograms/l), p < 0.05. There was not significant difference in concentration of P I CP in both groups.

[Glucocorticosteroids in bronchial asthma. I. Mechanism of action and use in therapy]. / Glikokortykosteroidy w astmie oskrzelowej. Czesc. I. Mechanizm dzialania i zastosowanie w leczeniu.

Inflammation plays the main role in the pathogenesis of asthma. Glucocorticosteroids (GS), as the most effective anti-inflammatory drugs are widely used in asthma treatment. So far the mechanism of action, both molecular and on the level of tissues and organs has not been entirely explained. In this work molecular mechanism of glucocorticosteroids action is discussed especially in aspect of therapy. The influence of GS on adrenocortical function is also presented.

[Glucocorticosteroids in bronchial asthma. II. Use of cortisol markers in various biological materials for evaluation of adrenocortical function]. / Glikokortykosteroidy w astmie oskrzelowej Czesc II. Zastosowanie oznaczen kortyzolu w róznych materialach biologicznych do oceny funkcji kory nadnerczy.

Glucocorticosteroids (GS) being widely used in asthma treatment are sometimes applied in high doses and for long period. This treatment is often connected with adrenocortical suppression. Adrenocortical function assessment in GS treated patients with different doses and forms of drug is of great diagnostic and prognostic importance. In the presented work the methods of adrenocortical function assessment are discussed, especially serum cortisol level and non-invasive: saliva and urine cortisol assays.

ASSESSMENT OF BETA-ENDORPHIN AND MELATONIN CIRCADIAN RHYTHMS IN NORMOTENSIVE OBESE WOMEN OF REPRODUCTIVE AGE.

We have evaluated the relationship between beta-endorphin (beta-EP) and melatonin (MEL) secretion as determined at 3 h intervals over a 24 h period in 27 normotensive obese women of different phenotypes (12 showing gynoid-type and 15 showing android-type of adipose tissue distribution) as well as in 12 healthy volunteers with normal body weight, aged 30 to 40 years. A considerable increase of mean 24 h beta-EP secretion (mainly due to elevated afternoon and evening levels) and total absence of beta-EP circadian rhythm were observed in all obese patients. Mean 24 h MEL concentrations were markedly higher (mainly due to increased daytime levels) in all obese patients while the disturbances of MEL secretion in the form of acrophase shift and (or) suppression of its rhythmicity were observed especially in obese women with android phenotype. Circadian beta-EP levels correlated positively with BMI and WHR values and negatively with circadian MEL concentrations. In contrast, no significant correlation was found between the values of BMI, WHR and MEL levels. Our data indicate that alterations of beta-EP secretion occurring in obese women could play a role in inducing disturbances of MEL secretory pattern.

Assessment of relationship between hypothalamo-pituitary dysfunction and peripheral endocrine function in normotensive and hypertensive obese men.

The relationship between hypothalamo-pituitary function and various hormonal factors (insulin, cortisol, thyroid hormones, sex steroid hormones, SHBG, IGF-I) was investigated in 34 obese men (16 normotensive and 18 hypertensive) and 15 healthy male volunteers aged 35 to 50 years. Hyperinsulinaemia in obese men was associated with altered hypothalamo-pituitary function as indicated by impaired GH, PRL and cortisol secretion in response to insulin induced hypoglycaemia. On the other hand, hyperinsulinaemia and disorders in GH, PRL and cortisol release were associated with lower levels of reverse triiodothyronine, gonadotropins, testosterone, 17-corticoids and SHBG and higher levels of triiodothyronine, estradiol, 17-hydroxycorticoids and IGF-I. Various disorders of hypothalamo-pituitary axis and adrenal, thyroid and testicular function occur more frequently in hypertensive obese men with android distribution of adipose tissue.