The relationship of antibody levels to the clinical spectrum of human neurocysticercosis.

One hundred proven cases of cerebral cysticercosis were studied with an enzyme linked immunoassay (ELISA) employing cyst fluid as antigen, with a view to detecting specific antibodies in serum and cerebrospinal fluid (CSF). Antibody levels were correlated with the clinical presentation of the patients, the type and number of cysts detected on their brain scans, the anatomical position of these cysts and the presence of lymphocytes in the CSF. Patients could be divided into two distinct categories, one with low levels of antibody in the serum and absent antibody in the CSF, and the other with high levels in both the serum and the CSF. This differentiation matched the clinical presentation of a benign and a malignant group. Antibody levels could not be related to the type of cysts as observed on the brain scan, but depended on the anatomical position of the cyst, being lower if the cysts were confined to the cerebral cortex. A correlation of antibody levels with the number of cysts was only found in the benign group.

Sexual behavior of men with isolated hypogonadotropic hypogonadism or prepubertal anterior panhypopituitarism.

Sexual behavior of men with secondary hypogonadism was studied. Seven of the thirteen subjects presented with hypogonadism secondary to isolated gonadotropin (Gn) deficit, whereas the other six had idiopathic prepubertal anterior panhypopituitarism. Testosterone (T) levels were low and did not differ between the two groups. All subjects were evaluated both during replacement therapy (Gn in the first group; Gn plus cortisone and thyroxine in the second group) and 2 months after withdrawal of Gn therapy. During and after withdrawal of Gn administration, men with isolated deficit of Gn retained sexual activity and nocturnal penile tumescence, although they were partially compromised compared with a control group; on the other hand, panhypopituitarics reported compromised sexual function during Gn treatment and no sexual function when Gn therapy was not given. We conclude that different lesions of the hypothalamus-pituitary axis were accompanied by varying degrees of sexual impairment in the two groups of men presenting both secondary hypogonadism and very low T levels.

Effects of androgen treatment in impotent men with normal and low levels of free testosterone.

The relation between sexual function and serum free testosterone (fT) levels, which represent the active fraction of circulating testosterone, was evaluated. Two groups of impotent male subjects with mild hypogonadism were treated with oral testosterone undecanoate (TU); these men presented with tT/luteinizing hormone (LH) ratio and tT levels at the lower limits of normal. The first group had serum fT below 6.6 ng/ml, considered the lower normal value, according to our laboratory method, whereas the second group had normal fT limits. Administration of TU improved sexual function only in impotent men with low fT levels, but not in subjects with normal fT levels, even though the tT levels and the tT/LH ratio of the two groups were not significantly different. The results of our study suggest the presence of a minimum serum fT threshold, lying near the lower normal range, which determines the male sexual function. Moreover, serum fT levels were a more sensitive index than tT for identifying impotent men who can be successfully treated with androgens.

Changes in the bioactivity to immunoreactivity ratio of circulating luteinizing hormone in impotent men treated with testosterone undecanoate.

Testosterone undecanoate was administered orally (80 mg twice daily) for 30 days to 10 impotent men with mild Leydig cell failure, age 28 to 42 years. Placebo was administered for 30 days both before and at the end of testosterone undecanoate therapy. Serum levels of bioactive LH, immunoreactive LH and testosterone were determined in basal conditions (day zero), 30 days after the first placebo administration, at the 15th and 30th day of testosterone undecanoate therapy, and at the end of the second treatment with placebo (90th day). Bioactive LH was measured by a sensitive and specific in vitro bioassay based on testosterone production by mechanically dispersed mouse Leydig cell preparations. Immunoreactive LH and testosterone were determined by a double-antibody RIA technique. The results were compared with those obtained in 30 untreated normal young men. In the basal state, serum concentrations of immunoreactive LH were significantly higher in the patients (P less than 0.02) than in control subjects, whereas testosterone levels were significantly lower (P less than 0.001) in the impotent men. In contrast, bioactive LH levels and the bioactive LH to immunoreactive LH ratios were similar in the two groups. In the patients, at the 15th day of treatment with testosterone undecanoate, serum levels of testosterone and bioactive LH were significantly higher (P less than 0.01) than basal values, whereas immunoreactive LH concentrations showed no significant changes. Consequently, the bioactive LH to immunoreactive LH ratios rose significantly (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of cyproterone acetate, LHRH agonist and ovarian surgery in McCune-Albright syndrome with precocious puberty and galactorrhea.

We have studied the endocrinological pattern in a girl with McCune-Albright syndrome. The young patient showed: normal prepubertal serum levels of gonadotropins, fluctuating estrogen concentrations, which sometimes were similar to the levels in adult women of fertile age, hyperprolactinemia with galactorrhea, ovarian cysts. The effects of treatment with antiandrogen drug, cyproterone acetate, and of a LHRH agonist, buserelin (less than D-Ser[TBU(8)6-des-gly NH2.10 greater than LHRH ethylamide), were studied. Cyproterone acetate with or without buserelin did not fully suppress estradiol concentrations. On the other hand, surgical resection of these cysts resulted in both clinical and endocrinological remission. It is likely that in this case of McCune-Albright syndrome precocious puberty was a result of ovarian estrogen secretion, while pubertal activation of the hypothalamus-pituitary axis was absent. Hyperprolactinemia, which appeared after the beginning of the combined therapy with buserelin and cyproterone acetate, was probably due to the elevated estrogen levels.

Species-specific immunodiagnosis of Taenia solium cysticercosis by ELISA and immunoblotting.

A combination of ELISA and immunoblotting was evaluated for immunodiagnosis of human T. solium cysticercosis. The sensitivity of ELISA for diagnosis of European, Latin-American, Asian and South African patients with cysticercosis was 75% for serum and 55% for cerebrospinal fluid specimen. Antigens originating from cysticerci in pigs from Mexico and South Africa were of adequate applicability. A species-specific confirmation of T. solium cysticercosis by immunoblotting (detection of antibody activity to the 26 K and 8 K bands) was achieved in 92% (serum) and 100% (CSF) of samples positive in ELISA. No antibodies from 147 patients with other helminth infections reacted with the 26 K and the 8 K band in immunoblotting, resulting in a specificity of 100%.

Further acquisitions on gonadal function in bromocriptine treated hyperprolactinemic male patients.

The diurnal variation of plasma total and free testosterone (tT and fT) and the gonadotropinemic response to LH-RH were evaluated in a group of hyperprolactinemic impotent males with pituitary microprolactinoma before and during therapy with bromocriptine, a well known dopamine agonist drug. Before treatment, basal levels not only of tT but also of fT were decreased and the diurnal variation of both tT and fT was absent. Moreover, the LH-RH test showed a delay in the LH response peak, together with normal basal levels of LH. Bromocriptine therapy caused normalization of both the secretion response of LH to LH-RH and of the secretion pattern of tT and of fT (basal levels and diurnal variation) besides a significant decrease in PRL levels and an improvement in sexual function. The possible effects of high plasma levels of PRL at various levels of the hypothalamus-pituitary-testicular axis are discussed.

Further studies on the effects of heroin addiction on the hypothalamic-pituitary-gonadal function in man.

The effects of chronic heroin addiction on LH biological and immunological activity, as well as on total and free testosterone concentrations, were investigated in 8 active young male addicts. The results were compared with those obtained in 33 normal young men. In addition, the effects of naloxone (N) administration on LH bio- and immuno-potency were studied in 3 normal men. LH biological activity (bLH) was assessed by a specific and sensitive "in vitro" bioassay, based upon testosterone production by mechanically dispersed mouse Leydig cell preparations. Double antibody radioimmunoassay methods were employed to assess serum levels of immunoreactive LH (iLH), total testosterone (T) and morphine (M). Free testosterone (FT) concentrations were determined by RIA after an ultrafiltration procedure. Mean basal values of bLH, iLH, T and LH bio/immuno (b/i) ratio observed in heroin addicts were similar to those obtained in the control group. In contrast, serum levels of FT and the mean FT/T ratio were significantly reduced in heroin addicts. A significant decrease of LH b/i ratio was observed during N infusion in the normal subjects.

Sexual behavior of male rats: influence of short- and long-term adrenalectomy.

Adult male rats (3 months old) were tested for their copulatory behavior: those satisfying the criterion of sexual vigor in the last three out of five weekly tests were randomly divided into two groups and adrenalectomized or sham operated, and their copulatory activity was retested 35 and 420 days after surgery. Short-term adrenalectomy did not modify any of the parameters of sexual behavior. On the other hand, a higher percentage of adrenalectomized than of sham-operated rats still had successful sexual performance when 18 months old (420 days after surgery); moreover, blood levels of testosterone were higher in adrenalectomized than in sham-operated old rats. The possibility that adrenal steroids may play a role in the age-linked decline in male sexual activity in mammals is discussed.

Circadian rhythm of testosterone and prolactin in the ageing.

The role which testicular hormones have on the decrease of sexual function in ageing men is still uncertain, but of primary interest. Previously, it has been known that the impairment of Leydig cell activity is a causal factor in the decreasing sexual function in ageing men. The present study is an evaluation of some chronobiological aspects, which directly or indirectly concern the 'Gonadostat' in ageing men, in order to determine of any change of the hypothalamic-pituitary axis occurs during the ageing process. The results from a group of 18 young men aged between 21 and 37 were compared with the results from a group of 28 older men between the ages of 67 and 98. The daily variations of testosterone (T) levels were determined in both groups of men as its circadian rhythm is well known in adult men. Moreover, the nocturnal secretory pattern of prolactin (PRL) was studied in 6 of the 28 elderly men. When comparing the usual increase of T levels in adult men, which occurs in the morning, there were no significant differences found in the older group of men between early morning and evening. The PRL levels showed no nocturnal increase in 4 of the 6 men. A hormonal impairment in the central nervous system may, in fact, be associated with the testicular deficiency leading to the decrease in sexual function of ageing men.