Chronic renal failure and anterior hypophysial hormones.

Kidneys are not only organs with an excretory function but they produce their own endocrine factors which are involved in supporting homeostasis in the organism. The kidneys are the organs in which metabolism and biodegradation of many hormones take place. Together with the liver, the kidneys actively take part in the catabolism of hormones.

Influence of dopamine energic pharmacology drugs on secretion of the adrenocorticotropic hormone from the hypophysis.

To elucidate the role of dopamine as a neuromediator in the adrenocorticotropic hormone (ACTH) secretion, investigations were carried out with dopaminergic pharmacology drugs on male white Wistar rats. In the first series of experiments, the effects of 200 mg/kg body wt L-DOPA, of the combination of 200 mg/kg L-DOPA and 50 mg/kg body wt carbidopa, and of 2.5 mg/kg body wt bromocriptine, after a single intraperitoneal injection of ACTH in the serum of rats after 30, 90 and 120 min, following the injection, were studied. In the second series of experiments, the effect of 200 mg/kg body wt L-DOPA, of the combination of 200 mg/kg body wt L-DOPA and 50 mg/kg body wt carbidopa, of 1 mg/kg body wt bromocriptine, after intraperitoneal injection, on the concentration of ACTH in the serum within 7 days, were assessed. The inhibition of agonists of dopamine after ACTH secretion with repeated application has been shown. Using a radioimmunology assay with test kits, the amount of ACTH in the serum was determined.

[A comparative study of the effect of Zoladex treatment versus orchiectomy in patients with advanced prostatic cancer]. / Sravnitelno prouchvane efekta ot lechenieto sus Zoladex spriamo orkhiektomiiata pri bolni s naprednal rak na prostatnata zhleza.

The study entered sixty patients with advanced carcinoma of the prostate that were treated and followed-up by the authors. The median age was 70.3 years (range 58-83 years). In all patients a prostatic carcinoma has been morphologically proven. Orchiectomy was performed in 27 of them. Conservative treatment with Zoladex-monotherapy was applied in 21 patients and a combination of orchiectomy plus Zoladex-in 12 of the remaining. All patients were followed-up for the period of 3 months. Subjective and objective parameters were evaluated at 2, 4, 8 and 12 weeks during the treatment. Positive response to treatment was reported in 76% of the patients from the group of orchiectomy alone, 72% among the patients in the group of Zoladex depot and up to 80% in patients treated with orchiectomy plus Zoladex. The average time to achieve positive response was stated to be seven weeks for orchiectomy and Zoladex as a monotherapy and six weeks for the combination therapy.

[The formulation of the current management of patients with atypical hyperplasia (AH)]. / Izgrazhdane na suvremenno povedenie pri bolni s atipichna khiperplaziia (AKh).

The authors study is the receptor status of 16 patients with AH. The amount of ER and PR in patients with AH is compared to the amount of the same receptors in patients with highly differentiated adenocarcinoma. A progestin treatment is proposed for AH together with dynamic evaluation of the amount of ER and PR. In patients ER, PR, even if they have not complete their reproduction, hysterectomy is proposed. The cases ER+, PR+ are actively followed up. Every patients should undergo complex investigation and evaluation in which together with the receptor status extremely important is the routine biopsy.

[Progesterone receptors in patients with endometrial cancer]. / Prouchvane na progesteronovite retseptori pri bolni s rak na endometriuma.

The authors investigate the Prog. receptors in 62 women with carcinoma endometrii. They relate their findings to the age of the patients, clinical stage and the histological differentiation of the tumors. With advancing age, the cases of Prog. R+ increase and with Prog. receptors decrease. With stage advancement the Prog. R- cases increase. Patients with undifferentiated Ca usually are Prog. R-.

[The tumor markers CEA, AFP and CA125 in patients with endometrial carcinoma]. / Izsledvane na tumornite markeri CEA, AFP i CA125 pri bolni s endometrialen kartsinom.

The plasma concentration of CEA, AFP and CA125 in 54 women with endometrial carcinoma and 12 with atypical hyperplasias, were investigated. In 20 of the patients the tumor markers were studied again 11 months after the surgical treatment. Elevation of CEA, AFP and CA125 levels was found in the third, and especially in the forth phase of the illness. Essential similarities between the histological differentiation and the levels of the tumor markers were not observed. The supposition was that the study of the CEA, AFP and CA125 is not a reliable criterion for the early diagnosis of the endometrial carcinoma. They have a prognostic significance only in patients of the second clinical phase after a surgical treatment. It is recommended two of the markers to be used, mostly CEA and CA125 and the study to be performed several times.

[The effect of E2 and progesterone on the receptor status in endometrial carcinoma]. / Kum vuprosa za vliianieto na E2 i progesterona vurkhu retseptorniia status na endometrialniia kartsinom.

The authors study the plasma levels of E2 and progesterone in 62 women with EC. Parallelly the ER and PR in the same number of cases have been studied. The values of E2 in the plasma of ER+ are much lower than those of E2 in ER-. The quantity of E2 and progesterone influence the values of ER and PR in cancers of women in pre and postmenopausal age. In positive ER and PR patients the level of E2 and progesterone is lower in comparison of ER- and PR-.

[Estrogen and progesterone receptors as prognostic markers in endometrial carcinoma]. / Estrogenovi i progesteronovi retseptori kato prognostichni markeri pri endometrialniia kartsinom.

The authors examined the concentration of ER and PR in malignant endometrium and compared them to the survival of the patients with endometrial carcinoma. The results were 55.5% positive ER and 44.5% negative, PR-74.1% positive and 25.9% negative. From 54 women with EC-7 died during 3 years period of time. From these 7, only one was with elevated concentrations of both ER and PR. 5 women were with negative PR and in 3-negative both ER and PR. It's considered that negative PR are the most important prognostic signs for the survival of patients with EC.

[Clinical significance of analysis of estrogen and progesterone receptors in human uterine tissues]. / Klinicheskoe znachenie opredeleniia retseptorov éstrogenov i progesterona v tkaniakh matki cheloveka.

The action of steroid hormones in the target cell was found to be associated with the presence of specific receptors in the cytoplasm. Uterine, endometrial, and myometrial tissues obtained at hysterectomy for endometrial carcinomatosis and fibromyomas were used. In fibromyomas, the estrogen and progesterone receptors were found to be higher in the cytosol than in the normal myometrium. In endometrial carcinomatosis, the estrogen receptors were in varying quantities: normal, low, or nil in the cytosol, whereas the progesterone receptors were low or nil.

PIP: Estrogen (ER) and progesterone receptors (PR) in tumorous mammary gland tissues have been investigated for a long time. The clinical significance of measuring the amount of ER and PR in the normal and pathological endometrium and myometrium was assessed. Endometrial and myometrial tissue obtained by operation was placed in a vessel containing liquid nitrogen an dry ice. Homogenization was performed at 15, 5, and 45 seconds in a buffer solution. After ultracentrifugation at 105 g for 1 hour, cytosol fraction was separated and used for ER, PR, and protein analysis according to the method of Lowry. The ER content of normal endometrium was 4 times higher than that of normal myometrium, however, the PR content in normal endometrium was only 2 times higher than in normal myometrium. The ER content did not differ in cancerous endometrium, but the PR content decreased 1.5 times. ER and PR amounts in myomatous neoplasm tissue increased 3 times compared with healthy myometrium. Robel et al. showed the ER increased to 6000-10,000/cell after ovulation, while the number of PR reached 14,000/cell in the preovulation phase. IN 29 endometrial cancer patients a significant decrease of both were fund. The ratio of PR to ER was 7.9 in the endometrial tissues of healthy women compared with 2.28 in those with endometrial cancer. In the present investigation, the respective ratios were 3.6 and 1.8; this low index was attributed to women in postmenopause without estrogen stimulation. The number of PR seems to be directly influenced by estrogens being higher in women with cyclical activity of the ovaries, thus receptors in uterine tissue change depending on endocrine functions. Endometrium and myometrium are hormone-dependent tissues. The increase of Er and PR is characteristic of benign processes, while the decrease of PR and especially of the PR/ER index indicates the malignant nature of the disease.

[A parallel study between the magnitude of smooth-muscle contraction in vitro and the prostanoid content of the incubation medium of the preparation after the introduction of blood serum from women]. / Paralelno izsledvane mezhdu goleminata na gladkomuskulnoto sukrashtenie in vitro i sudurzhanieto na prostanoidi v inkubatsionnata sreda na preparata sled vuvezhdena na kruven serum ot zheni.

An attempt is made to establish dependence between stimulation of smooth-muscle contraction and the concentration of prostanoids in biologically active sera of women on the basis of two various methods: physiological test with smooth-muscle strips in vitro and radioimmunological determination of prostanoids. Three prostanoids are examined PgF2 alpha PgI2, TxA2 are examined and it is found that lineal dependence between the prostanoid concentration and activation of contraction (for the whole range) is observed only for PgF2 alpha, which allows graphic interpolation for this prostaglandin.

Stress-induced changes in the cyclic nucleotide concentrations and phosphorylase activity in the myocardium.

Restraint stress was produced by immobilizing rats in supine position for 6, 12 and 24h. Control rats were deprived of food and water for the same time intervals. Concentrations of cyclic AMP and cyclic GMP and activity of glycogen phosphorylase were studied in the ventricle myocardium of the animals. The cAMP concentrations in the myocardium of immobilized rats were significantly lower after 6 and 12h, but were higher after 24 h compared with control values. The cyclic GMP concentrations showed the same tendency though the differences were not significant. The concentrations of cAMP and cGMP in both restrained and control rats increased in the 12-hour experiment but decreased in the 24-hour experiment as compared to the 6 h values. Phosphorylase "a" and total phosphorylase activities were higher after 12-hour immobilization, but were lower after 24-hour restraint compared with control group. In the 6-hour experiment there were no differences between restrained and control rat. The percentage of phosphorylase "a" of the total activity was equal in immobilized and control animals. time related changes were also observed in the phosphorylase activity. The present results suggest that cyclic nucleotides and glycogen phosphorylase may improve myocardial metabolism by diminution of energy consumption and activation of glycogenolysis under trees conditions.

[Changes in the thromboxane B2 level of the blood plasma following partial resection of the pancreas]. / Promiana v nivoto na tromboksan B2 v kruvnata plazma sled partsialna rezektsiia na pankreasa.

The present study was devoted to the still poorly exploited aspect of pancreas surgery, from a standpoint of postoperative divergences in the plasma prostaglandin level. Experiments were carried out with dogs. The authors apply proximal (right) resection of pancreas and eliminate the exocrine function of the remaining part by occlusion of the pancreatic canal. Radioimmunologic investigations were carried out by extraction method for determining the plasma thromboxane B2 level. Postoperative rise in TxB2 level was found. The authors apply modern drugs, proceeding from recent report in the literature about correction of this abnormality aimed at optimal re-establishment of the functions of the remaining pancreas after the operative intervention.

[Changes in the ACTH and cortisol values of patients with acute myocardial infarct]. / Promeni v stoinostite na AKTKh i kortizol pri bolni s ostur infarkt na miokarda.

The plasma cortisol and adrenocorticotrophic hormone (ACTH) levels were studied in 12 patients with clinical, laboratory and ECG data for acute myocardial infarction. The changes were followed up during the 1, 3, 8 and 14 day after the onset of the chest pain attack. Increased ACTH and cortisol levels were established in these patients up to the 5 day. The regulatory principle of action of the opposite relation between these two hormones as well as their 24 hour rhythm were disturbed. These stress-induced hormonal changes should be kept in mind in determining the therapeutic conduct in the patients with acute myocardial infarction.

[The differential diagnosis of hairy virilism in polycystic ovaries from adrenal cortical hirsutism]. / Diferentsialna diagnoza na kosmeniia virilizum pri polikistozni iaichnitsi ot nadbubrechnokorov khirzutizum.

The hormones on the axis hypophysis-ovary and hypophysis-suprarenal gland were examined in 60 women with polycystic ovaries and hairy virilism, 53 women with hirsutism and 45 healthy women, all of the same age. The results show that in hairy virilism from ovarian origin the luteinizing hormone level (LH) is increased 100% and the follicle stimulating hormone level (FSH) is decreased 200%. The index LH/FSH is increased more than 3 times. The testosterone and androstanedione levels are increased, too. In patients with suprarenal-cortex hirsutism the levels of ACTH, androstanedione, dehydroepiandrosterone-sulfate, testosterone and cortisol are increased. A hirsutism from running with hyperprolactinemia is differentiated. The three hirsutism forms may appear as separate forms or in combination.

[The carcinoembryonic antigen in chronic pancreatitis]. / Kartsinoembrionalen antigen pri khronichen pankreatit.

The fasting carcinoembryonal antigen (CEA) concentrations in the serum and duodenal juice and after venous stimulation of the exocrine pancreas with the hormones CCK and secretin (Boots) were studied. Radioimmunologic test with a kit of the firm "Labimex"--PPR was used. 28 patients with clinically proved chronic pancreatitis and a control group of 27 healthy persons were examined. The fasting CEA serum concentrations in the patients with chronic pancreatitis were statistically significantly higher than those of the healthy persons--mean--16.5 ng/ml vs mean--8.2 ng/ml (p less than 0.001). In 14% of the healthy persons and 57% of of the patients with chronic pancreatitis the basic CEA concentrations were significantly increased. After stimulation with CCK and secretin the serum CEA concentration did not change substantially. The duodenal juice CEA concentrations after CCK and secretin stimulation were about 11 times higher than those in the serum--mean--113 ng/ml and mean--104 ng/ml for the control group vs mean--118 ng/ml and mean--110 ng/ml for the patients with chronic pancreatitis. No statistically significant difference between the patients with chronic pancreatitis and the control group of healthy persons was established. The results reveal the low specificity of the CEA as a "tumor marker".

[The concentration of carcinoembryonic antigen and carbohydrate antigen Ca-19-9 in the blood serum in cancerous diseases of the gastrointestinal tract]. / Kontsentratsiia rakovo-émbrional'nogo antigena i karbogidratnogo antigena Ca-19-9 v syvorotke krovi pri onkologicheskikh zabolevaniiakh zheludochno-kishechnogo trakta.

The results of comparative investigation of 266 cancer patients, 44 patients with benign G. I. tract diseases and 66 healthy subjects using 2 tumor markers (CEA and Ca-19-9) showed the diagnostic value of both methods, not exceeding 38-42%. The most informative were the data on patients with pancreatic and colorectal cancers as well as in patients with detected metastases. Significant differences in the sensitivity, specificity and diagnostic informative value between the two markers were undetectable.

[Hormonal aspects in the diagnosis of hirsutism]. / Khormonalni aspekti v diagnostikata na khirzutizma.

Hormones of hypophyseal-adrenal axes were determined in 135 girls with hirsutism. On the basis of changes in the hormonal levels it was established that the syndrome of Stein-Leventhal in 62 girls (54% of the patients) was dependent on luteinizing hormone (LH) and was characterized by an increased index of LH/FSH over 3.0 as well as by an increased level of testosterone; hirsutism in 73 girls (67% of the patients) was dependent on adrenocorticotropic hormone (ACTH) and was characterized by an increased level of ACTH and cortisol secretion; in the remaining patients hirsutism was a combination of both forms of dependence on LH and ACTH and an increase of hormones of both axes was present or was idiopathic with normal hormonal plasma levels, but with increased skin conversion and metabolic testosterone clearance.