Role of testosterone and dihydrotestosterone in spontaneous gynecomastia of adolescents.

To test a possible hormonal mechanism of gynecomastia at puberty, a group of pubertal spontaneous gynecomastia (PSG) and healthy young volunteers (HYV), Tanner's stage II-V, were studied. Peripheral blood samples were obtained for measuring follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), dihydrotestosterone (DHT), estradiol (E-2) and estrone (E-1). No difference was established in steroids in pituitary hormonal concentration when both groups were compared on a sexual stage-matched control basis, except for T 2 SD in 5/9 subjects of PSG and DHT 2 SD in all of PSG. The T:DHT ratio varied from 5.0 to 15.4 in PSG and from 0.42 to 2.224 in HYV. Whether spontaneous gynecomastia might exist in an enzimatic blockade of 5 alpha-reductase and whether a decrease in the T:DHT ratio might favor the estrogen action for the progression of breast enlargement deserve further analysis.

Low plasma zinc and androgen in insulin-dependent diabetes mellitus.

Plasma zinc and pituitary and testicular hormone concentrations were measured in two groups of male adolescents. One group comprised insulin-dependent diabetes mellitus patients, aged 14-19 years; the other, as control, included 12 healthy youngsters aged 13-19 years. Plasma concentration of zinc, prolactin, testosterone, and dihydrotestosterone were lower in diabetics than in controls, whereas the ratios of androstenedione and androstenedione to testosterone + dihydrotestosterone were higher. Plasma FSH and LH were normal. These results suggest a diminished conversion of androstenedione to testosterone and relate zinc with the 17-beta-hydroxysteroid dehydrogenase enzyme activity.

Sindrome de sobreinsulinizacion cronica: metodo para prevenirlo. / Syndrome of chronic overdose of insulin: method to prevent it

El empleo de preparaciones de insulina de accion prolongada permitio mejorar el control de los diabeticos. Cuando la dosis se incrementa con el proposito de alcanzar un grado de control tal que la glucemia en ayunas no exceda los limites normales y la excrecion urinaria de glucosa se conserve y la excrecion urinaria de glucosa se conserve negativa, frecuentemente aparece un sindrome caracteristico. En este sindrome se encuentran mezclados con frecuencia signos y sintomas de hipoglucemia y de hiperglucemia, a causa de que el exceso de insulina produce hipoglucemias fugaces seguidas de hiperglucemias reactivas. Se ha denominado frecuentemente sindrome de sobreinsulinizacion. Puesto que las manifestaciones mas notables son los de hiperglucemia, frecuentemente es tratada con incrementos en la dosis de insulina. Se sugiere que para tratar a un diabetico con insulina se vigile que la dosis no exceda de 1 U/kg de peso, y que las decisiones clinico del paciente y no solamente en una determinacion de laboratorio. Nuestro grupo ha encontrado util tomar en consideracion las modificaciones del peso corporal y la excrecion urinaria de glucosa en 24 horas a fin de decidir los ajustes en la dosis de insulina

Cambios en las gonadotropinas (LH, FSH), prolactina, androgenos (testosterona, dihidrotestosterona) y estrogenos (estradiol y estrona) durante la pubertad masculina. / Changes in gonadotropins (LH, FSH), prolactin, androgens (testosterone, dihydrotestosterone) and estrogens (estradiol and estrone) during male pubescence

Esta investigacion se diseno para entender mejor la fisiologia del desarrollo puberal en el varon y obtener patrones de referencia normales. Se estudiaron 44 varones sanos con edades de 8 a 19 anos y desarrollo sexual entre los estadios I y V de Tanner.Se determinaron en el suero las concentraciones de LH, FSH, prolactina, testosterona (T) y dihidrotestosterona (DHT), estradiol (E2) y estrona (E1). Las concentraciones de FSH aumentaron a partir del estadio I, estabilizandose a partir del IV, mientras que las de LH aumentaron a partir de estadio III. Las hormonas gonadales (T, DHT, E1 y E2) aumentaron progresivamente a partir del estadio I hasta el V.Se observo un patron similar en la prolactina, con una disminucion durante el estadio V. La DHT predomino en la relacion T: DHT en el estadio I, mientras que en el estadio V la T fue la predominante. Se atribuyen a la capacidad de la FSH para aumentar las concentraciones de compuestos 5 alfa reducidos, los cambios observados en la relacion T:DHT

Hiperparatiroidismo primario en ninos Informe de dos casos y revision de la literatura. / Primary hyperthyroidism in childreen. Report of 2 cases and review of the literature

Se informa acerca de dos pacientes menores de 15 anos con hiperparatiroidismo primario de caracteristicas clinicas poco frecuentes: uno sufria tumores en el femur derecho y hemicara izquierda asociados a desnutricion grave y el otro artritis importante de ambas rodillas y poca repercusion osea. En este ultimo se localizo un adenoma paratiroideo por medio de la ultrasonografia. Se revisaron 67 casos publicados hasta 1981, 40 en ninos y 27 en ninas; 57 tenian adenomas y 10 hiperparasia-glandular. Los sintomas y signos referidos con mayor frecuencia en el nino son: fatigabilidad, anorexia, vomito, perdida de peso, detencion del crecimiento, osteoporosis y artritis, mientras que en los adultos, las manifestaciones clinicas se relacionan con litiasis de vias urinarias, trastornos oseos, ulcera peptica y pancreatitis. En ninos, la etiologia mas frecuente es un adenoma paratiroideo, con dimensiones mayores a 1.5 cms, histologicamente compuesto de celulas principales. Se Sugiere que el estudio ultrasonografico de cuello sea utilizado habitualmente para la localizacion del tumor

Body composition in hypopituitary dwarfs before and during human growth hormone therapy.

The clinical characteristics and body composition of eight hypopituitary dwarfs (10.2-21.6 yr) were analyzed before and after 6 and 12 mo of growth hormone therapy. 2 IU 3 times/wk. Before treatment, growth rate was 1.8 +/- 0.7 cm/yr, height age was 2.0-12.8 yr less, and bone age 2.0-11.1 yr less than chronologic age. Total body water (TBW), lean body mass (LBM), extracellular water (ECW), and intracellular water (ICW) were below normal for chronologic age, but normal for height. Muscle mass (MM) was below normal for age and height. During HGH therapy, growth rate was 7.1 +/- 1.6 cm/yr in the first 6 mo and 7.8 +/- 1.4 cm/yr during the next 6 mo; the ratio of change in height age to change in chronologic age was greater than or equal to 1.0 in all patients and the ratio of change in bone age to change in height age was 1.2 in one patient and less than or equal to 1.0 in the others. TBW, LBM, ECW, and ICW increased according to height increments; however, MM increased at a faster rate than expected from the height gains. Also, a relative or absolute loss of total body fat was recorded during the first 6 mo of therapy. It is suggested (1) that among the body composition parameters studied, muscle mass is the tissue most closely reflecting the lack of HGH and also its therapeutic benefits and (2) evaluation of body composition in hypopituitary dwarfs in response to HGH therapy shows striking changes not reflected by the determination of stature or weight alone.