Hormonal profile of men with premature balding.

OBJECTIVE: Premature androgenic alopecia has been suggested as a feature of the male equivalent of the syndrome of polycystic ovary. However, the hormonal pattern of men with premature balding has been investigated in only a few studies with inconsistent results. MATERIAL AND METHODS: We examined 37 men with premature balding (defined as frontoparietal and vertex hair loss before the age of 30 years with alopecia defined as grade 3 vertex or more on the alopecia classification scale of Hamilton with Norwood modification). The plasma concentrations of total testosterone, dihydrotestosterone, epitestosterone, androstenedione, cortisol, 17-OH-progesterone (17OHP), estradiol, LH, FSH, prolactin, SHBG and TSH and free thyroxine were measured. RESULTS: The frequency of subnormal values in SHBG, FSH, testosterone and epitestosterone (but not in free androgen index) was significant in the balding men. A borderline significant trend was recorded with respect to increased levels in 17OH-P and prolactin. CONCLUSIONS: The hormonal pattern of a substantial number of men with premature balding resembles in some respects the hormonal pattern of women with polycystic ovary syndrome.

[Hormonal profile in men with premature androgenic alopecia]. / Hormonální profil muzu s predcasnou androgenní alopecií.

Androgenetic alopecia especially that with premature onset can be a cause of serious psychic trauma. As far as the treatment with antiandrogens, inhibitors of 5 alpha-reductase or hair transplantation represents a heavy economic burden for the patient, we tried to exclude other hormonal causes or to find a criterion for the apt candidates for the treatment in 15 young men with premature androgenetic alopecia. Hormonal analysis discovered a significantly lower plasma level of sexual binding globulin (SHBG) and FSH and nearly significantly higher concentration of 17 alpha-hydroxyprogesterone. These data resemble those in the hormonal pattern of women suffering from the syndrome of polycystic ovaries (PCOS). The finding of premature balding as the possible male phenotype hormonal equivalent of polycystic ovaries is in concordance with several pedigree studies in kindreds with PCOS, which have suggested a genetic basis of this syndrome in some families in which balding and pilosity was frequent in male members.

Unexpected gastrointestinal complications in severely burned children.

The authors refer to the frequently difficult diagnosis of gastrointestinal complications of major burns, particularly in childhood, to weight the factors co-responsible for the development of those complications and to stress the importance of the patient's history. They report on the case of three and a half year-old child to demonstrate the fatal course of a late diagnosed complications -- perforating cholecystitis. Autopsy showed the chronic nature of the disease with acute exacerbation in the course of treatment. No case similar to this one has yet been seen at the Prague Burns Centre in any age category.

Natural killer cell activity following thermal injury.

The role of natural killer cell activity in immunosurveillance following thermal injury remains unknown. We utilize a chromium-51-release assay of K562 targets to monitor NK activity. NK activity of peripheral blood mononuclear cells of severely burned patients (BSA greater than 20%) was determined once a week until the convalescence period was completed. From the second week after thermal injury, impairment of NK activity was demonstrated, but the differences did not reach statistical significance. However, a correlation was found between decline of NK activity and incidences of septic complications. Surprisingly, no decline in NK activity was observed in the first week after thermal injury.

Immunoglobulin E (IgE) in patients with severe burns.

The concentrations of immunoglobulin E (IgE) were measured serially in 30 patients with severe burn injury. A characteristic finding was a rapid and dramatic increase of IgE in the serum of all patients, some of whom showed up to 20-fold increases. IgE was also found in considerable amounts in blister fluid and pleural effusions. In some patients raised IgE values were the only indicator of an anamnestic immediate allergic state. No correlation was found between the IgE levels and clinical characteristics of individual patients but significant changes seemed to be present only in patients with a burn covering more than 20 per cent of the body surface area.

Effect of human recombinant interleukin (IL-2) on peripheral blood mononuclear cells of burned patients.

Interleukin-2 (IL-2) has been suggested to play a key role in the immune response. To investigate the effect of human recombinant IL-2 on proliferative and cytotoxic responses in burn patients, peripheral blood mononuclear cells from 20 severely burned patients (body surface area (BSA) greater than 20 per cent) were studied in this way. Proliferative response measured by tritiated thymidine uptake was impaired from week 2 following injury. IL-2-activated cytotoxicity to NK-resistant target T24 was significantly impaired from week 2. To clarify if the defect in cytotoxic response is due to a decreased number of cell precursors or due to reduced responsiveness to IL-2, a limiting dilution assay was introduced. However, there was no reduction in precursor cell numbers. These data suggest that, in addition to impaired IL-2 production, there is an endogenous defect in IL-2 responsiveness. This may be of clinical importance since it is not possible to reverse this defect, at least in vitro.