ABSTRACT
The symptoms of cirrhosis are inconsistent and appear late in the course of the disease. Laboratory tests are also of variable value; generally speaking, cytolysis is observed infrequently. The gamma-GT test is the most sensitive in alcoholic cirrhosis, but may be more an expression of the degree of alcoholism than of the hepatic lesion per se. In cirrhosis, the best diagnostic method is a combination of laparoscopy and puncture biopsy. Endoscopy permits diagnosis not only of the hepatic lesion but also of the complications which may ensure, such as portal hypertension and ascites. Alcoholic abstinence appears to improve the prognosis of alcoholic cirrhosis. The prognosis in this condition may, in fact, be better than has been suspected.
Subject(s)
Liver Cirrhosis/diagnosis , Ascites/etiology , Biopsy, Needle , Female , Hepatitis/complications , Humans , Hypertension, Portal/etiology , Jaundice/etiology , Laparoscopy , Liver Cirrhosis, Alcoholic/diagnosis , Liver Cirrhosis, Alcoholic/therapy , Male , Prognosis , gamma-Glutamyltransferase/metabolismABSTRACT
1. Carbohydrate (CHO) oxidation was measured simultaneously in a group of five normal subjects after an oral load of 100 g naturally-labelled [13C]glucose, using indirect calorimetry and mass spectrometry. 2. CHO utilization, calculated from the results of indirect calorimetry, increased 30 min after the glucose load to reach a peak at 90 min. It then decreased to reach basal values at 380 min. Cumulative total CHO oxidation at 480 min was 83 +/- 8 g, and CHO oxidized above basal levels, 37 +/- 3 g. 3. Enrichment of expired carbon dioxide with 13C began at 60 min and maximum values were observed at 270 min. At 480 min, cumulative CHO oxidation measured by use of [13C]glucose was 29 g. The difference from calorimetric values can be attributed in part to the slow isotopic dilution in the glucose and bicarbonate pools. 4. Thus, approximately 30% of the glucose load was oxidized during the 8 h after its ingestion and this accounts for a significant part of the increased CHO oxidation (37 g), as measured by indirect calorimetry.
Subject(s)
Carbohydrate Metabolism , Glucose/metabolism , Adolescent , Adult , Blood Glucose , Calorimetry , Dietary Carbohydrates/metabolism , Energy Metabolism , Fatty Acids, Nonesterified/blood , Female , Humans , Insulin/blood , Male , Mass Spectrometry , Oxidation-ReductionABSTRACT
Some endocrine effects of prolactin (PRL), ACTH, and corticosteroids in testicular function were evaluated by measuring, in normal men, the effects of short-term experimental stimulation and suppression of either plasma PRL levels or adrenal function on plasma androgen profile. PRL levels were increased by administration of metoclopramide or sulpiride or suppressed with bromocryptine. Long-acting testosterone (T) was injected at 8 a.m. on one day in a control period and during a 9-day period of metoclopramide administration. PRL increase was accompanied by a rise in plasma 17-hydroxyprogesterone and T, whereas PRL suppression induced an increase in 5 alpha-dihydrotestosterone (DHT) plasma levels. Peripheral converions of T into DHT and androstenedione, noted after T injection, decreased during concomitant metoclopramide administration. Plasma testicular androgen levels were lowered after long-acting ACTH injections as well as after 24-hr cortisol administration, but the metoclopramide-induced PRL increase appeared to prevent the suppressive effects of ACTH on plasma T. A low-dose dexamethasone treatment did not modify testicular androgen levels. Experimentally induced hyperprolactinemia may have a stimulatory effect on testicular androgen secretion as well as a lowering action on 5 alpha reduction and oxidative T metabolism in man. On the other hand, ACTH-induced androgen suppression seems to be mediated through high circulating levels of corticosteroids; furthermore, PRL and corticosteroids might have reciprocal influences that modulate their effects on testicular function.
Subject(s)
Adrenocorticotropic Hormone/pharmacology , Androgens/blood , Prolactin/blood , Testis/physiology , Bromocriptine/pharmacology , Dexamethasone/pharmacology , Dihydrotestosterone/blood , Humans , Hydrocortisone/pharmacology , Hydroxyprogesterones/blood , Male , Metoclopramide/pharmacology , Testis/drug effects , Testosterone/bloodSubject(s)
Carbohydrate Metabolism , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus/metabolism , Lipid Metabolism , Adult , Age Factors , Aged , Blood Glucose/metabolism , Calorimetry, Indirect , Fatty Acids, Nonesterified/blood , Female , Glucose Tolerance Test , Humans , Insulin/blood , Male , Middle Aged , Oxidation-ReductionABSTRACT
The purpose of the study was to investigate the effect of hyperprolactinemia on the metabolism of androgens in man. A group of 6 normal men was treated for 4 consecutive days, on separate periods, with Sulpiride which is known to raise plasma prolactin (PRL) concentration. The effect of the treatment on plasma steroids was verified in basal conditions and under stimulation by HCG. In the controls, a parallel rise in testosterone (T) and dihydrotestosterone (DHT) was observed in response to HCG stimulation. In experimental hyperprolactinemia, the rise in T in response to HCG, similar to that of the controls, was accompanied by a markedly diminished rise in DHT. Similar results were observed in a patient with hyperprolactinemia following apparent accidental section of the pituitary stalk. These data demonstrate the interference of increased levels of PRL in the metabolism of testosterone into the active DHT form by 5alpha-reductase. They suggest that this mechanism could possibly impair the gonadal function in man.
