الملخص
Leydig cell tumors are rare ovarian steroid cell neoplasms. More than 75% of patients show signs of virilization due to overproduction of testosterone. We report a case of an 8-year-old woman with progressive signs of virilization, and presenting vaginal bleeding. Clinical analyses revealed high levels of serum testosterone, delta 4-androstenedione and estradiol, and also inappropriate low levels of gonadotrophins for a post-menopausal woman. Transvaginal ultrasound showed no evidence of ovarian tumor, but pelvic and abdominal computerized axial tomography imaging revealed a left ovarian solid nodule, and no evidence of alteration in the adrenal glands. Total hysterectomy and bilateral salpingoophorectomy were performed. Histopathology and immunohistochemistry confirmed the diagnosis of Leydig cell tumor. After surgery, androgen levels returned to normal, and there was regression of the signs of virilization.
Tumores ovarianos de células de Leydig são neoplasias raras de células ovarianas esteroidogênicas. Mais de 75% dos pacientes apresentam sinais de virilização devido à produção excessiva de testosterona. Relatamos aqui o caso de uma mulher de 81 anos de idade com sinais progressivos de virilização e ocorrência de sangramento vaginal. As análises clínicas mostraram altos níveis de testosterona sérica, delta 4-androstenediona e estradiol, além de níveis inadequadamente baixos de gonadotrofinas para uma mulher em pós-menopausa. O ultrassom transvaginal não apresentou evidências de tumor ovariano, mas a tomografia axial computadorizada da região pélvico-abdominal mostrou um nódulo sólido no ovário esquerdo e nenhuma evidência de alteração nas adrenais. Foi feita uma histerectomia total e salpingooforectomia bilateral. Os exames histopatológicos e a imuno-histoquímica confirmaram o diagnóstico de tumor de células de Leydig. Após a cirurgia, os níveis de androgênios voltaram ao normal, e os sinais de virilização regrediram.
الموضوعات
Aged, 80 and over , Female , Humans , Leydig Cell Tumor/complications , Ovarian Neoplasms/complications , Virilism/etiology , Androstenedione/blood , Estradiol/blood , Gonadotropins/blood , Hyperandrogenism/blood , Hyperandrogenism/etiology , Leydig Cell Tumor/blood , Magnetic Resonance Imaging , Ovarian Neoplasms/blood , Postmenopause/blood , Tomography, Emission-Computed , Testosterone/blood , Virilism/bloodالملخص
FUNDAMENTOS: As glândulas sebáceas são suscetíveis à ação dos hormônios androgênios e apresentam proliferação benigna com a idade, ou seja, hiperplasia. OBJETIVOS: Estudo piloto para verificar se há correlação entre a taxa de hormônios masculinos circulantes e o aumento da incidência da hiperplasia das glândulas sebáceas. MÉTODOS: 16 pacientes do sexo feminino, com diagnóstico de hiperplasia sebácea cutânea, foram comparados a um grupo-controle de mesmo gênero e idades semelhantes, sem a doença. Ambos os grupos foram submetidos a testes de dosagem sanguínea para avaliação das taxas de hormônios androgênios circulantes (testosterona livre e total, androstenediona). Os resultados foram tabulados e analisados estatisticamente. RESULTADOS: Os dados demonstraram não haver mudanças nos níveis de hormônios masculinos circulantes dos pacientes com hiperplasia sebácea cutânea, quando comparados ao grupo-controle. CONCLUSÃO: Os dados sugerem que não há alterações estatisticamente significantes nas taxas dos hormônios circulantes (testosterona livre e total, androstenediona, deidroepiandrosterona, sulfato de deidroepiandrosterona) dos pacientes com hiperplasia sebácea cutânea.
BACKGROUND: The sebaceous glands are susceptible to the effects of androgens. A benign proliferation of these hormones, i.e. hyperplasia, occurs with age. OBJECTIVES: This was a pilot study to demonstrate whether any correlation exists between circulating androgen levels and an increase in the incidence of sebaceous hyperplasia. METHODS: Sixteen female patients with a diagnosis of sebaceous hyperplasia were compared to a control group of females of a similar age without the disease. Blood tests were performed on participants of both groups to measure circulating androgen levels (free and total testosterone and androstenedione levels). Results were tabulated for statistical analysis. RESULTS: These data showed no statistically significant differences in circulating androgen levels between the patients with sebaceous hyperplasia and the control group. CONCLUSION: These data suggest that no significant changes occur in circulating androgen levels [free and total testosterone, androstenedione, dehydroepiandrosterone (DHEA) and DHEA sulfate] in patients with sebaceous hyperplasia.
الموضوعات
Adult , Aged , Female , Humans , Middle Aged , Androstenedione/blood , Dihydrotestosterone/blood , Sebaceous Gland Diseases/pathology , Sebaceous Glands/pathology , Testosterone/blood , Biomarkers/blood , Case-Control Studies , Hyperplasia/blood , Hyperplasia/pathology , Pilot Projects , Prospective Studies , Sebaceous Gland Diseases/bloodالملخص
A single measurement of serum 17alpha-hydroxyprogesterone (17OHP) level can be unreliable because of its marked diurnal variation. We investigated the relationship of serum level of 17OHP with that of androstenedione (AD), which shows a smaller diurnal variation. And we tested whether the responses of these two hormones to low-dose ACTH stimulation are correlated in patients with 21-hydroxylase deficiency. Baseline serum 17OHP and AD levels were measured in 87 patients and a low-dose ACTH stimulation test was performed in 41 patients. The basal 17OHP level correlated positively with the basal AD level independently of sex, type of 21-hydroxylase deficiency, and the time of day of blood sampling (n = 87, R2 = 0.75, P < 0.001). The area under the curve of 17OHP and AD correlated positively with their respective basal levels. The fold-change increase in 17OHP after ACTH injection correlated negatively with the basal 17OHP level, but that of AD did not correlate with the basal AD level. The random serum 17OHP level, used in the clinic, is a reliable guide and a low-dose ACTH stimulation test provides no extra benefit for assessing the treatment adequacy in patients with 21-hydroxylase deficiency.
الموضوعات
Adolescent , Female , Humans , Male , Young Adult , 17-alpha-Hydroxyprogesterone/blood , Adrenal Hyperplasia, Congenital/diagnosis , Adrenocorticotropic Hormone , Androstenedione/blood , Circadian Rhythm , Steroid 21-Hydroxylase/metabolismالملخص
To determine the frequency of raised serum androgen levels in hirsute women and their relationship to the pattern and severity of hair growth in patients presenting at private cosmetic center at Hyderabad. In this cross-sectional study, conducted in a private cosmetic and aesthetic centre, Hyderabad, from January, 2007 to December, 2007, 65 consecutive patients of hirsutism attending the centre were enrolled. Twenty normal women of similar ages [mean age 23.60 +/- 2.90 years] without signs of hirsutism and with normal menstrual cycle were also included as control group. Informed consent was obtained from all patients. Duration, pattern, and severity of hair growth [Ferriman-Gallwey score], weight, body mass index, acne and sebhorrhea were also evaluated. Serum testosterone, serum androstenedione and dehydroepiandrosterone sulphate levels were assessed in all patients and controls. Correlation between serum androgen levels and pattern and severity of hair growth was determined. Chisquare test was applied to determine p value. A total of 65 patients were enrolled in study. Their ages ranged from 16 to 45 years [mean age 24.49 +/- 6.44 years]. Thirty nine [60%] patients had normal androgen levels without evidence of significant endocrine abnormality. These were assigned idiopathic category. 26 [40%] patients had modest elevations of serum androgens. Among them, 21 had polycystic ovaries. Patients having modest to greatly elevated androgen levels [serum testosterone] had severe hirsutism with Ferriman-Gallwey scores [F-G score] >/= 8. [p = .005]. Patients with mild elevation of hormone levels had mild hirsutism with an F-G score of less than 8 [p = 0.005]. There is correlation between serum androgen levels and severity of hair growth. Serum androgen levels are greatly raised in patients with modest to severe hirsutism
الموضوعات
Humans , Female , Androgens/blood , Hair , Cross-Sectional Studies , Polycystic Ovary Syndrome , Testosterone/blood , Androstenedione/blood , Dehydroepiandrosterone/bloodالملخص
In order to explore the effects of metformin combined with cyproterone acetate (CPA) on the clinical features, endocrine and metabolism of the patients with polycystic ovarian syndrome (PCOS), 50 cases of non-obese PCOS were randomly subjected to CPA (CPA treatment group, n = 25) and CPA+ metformin (n = 25) treatment for 6 months. Before and after treatment the body mass index (BMI), waist : hip ratio (WHR), ovarian volume, serum gonadotrophin, androgen and sex hormone-binding globulin (SHBG) levels, and fasting lipid, glucose and insulin levels were measured. The results showed that all of the parameters in two groups were similar before treatment. After treatment for 6 months in the CPA+ metformin group, BMI and WHR were significantly decreased, while insulin sensitivity was significantly decreased as Compared with those before treatment. In CPA group, no significant changes were found before and after treatment. Combined use of CPA and metformin could result in the reduction of serum androstenedione and increases of serum SHBG levels as compared with the CPA treatment alone. It was concluded that combined use of CPA and metformin could improve the insulin sensitivity, and further suppress the hyperandrogenism in non-obese women with PCOS.
الموضوعات
Androgen Antagonists/therapeutic use , Androstenedione/blood , Body Mass Index , Cyproterone Acetate/therapeutic use , Drug Therapy, Combination , Hypoglycemic Agents/therapeutic use , Insulin Resistance , Metformin/therapeutic use , Polycystic Ovary Syndrome/drug therapyالملخص
The purpose of this study was to determine the age-specific reference ranges for some important male sex steroid hormones, prostate-specific antigen [PSA], insulin-like growth factor-1 [IGF-1], and IGF binding protein-3 [IGFBP-3], for the Kuwaiti population. Blood samples were taken from 398 consenting, fasting, healthy Kuwaiti males aged 15-80 years between 8.00 a.m. and 12.00 noon. The serum concentrations of total testosterone [TT], dehydro-epiandrosterone sulfate [DHEAS], androstenedione [ADT], sex hormone binding globulin, luteinizing hormone [LH], follicle-stimulating hormone [FSH], prolactin, PSA, IGF-1 and IGFBP-3 were determined. A distribution curve was plotted and age-specific reference levels were determined for each analyte. The reference interval for parameters with a normal distribution [Gaussian] was mean +/- 2 SD, while for the non-normal distribution [non-Gaussian], it was 2.5-97.5 percentile. The reference intervals for the analytes obtained from this study were compared with those suggested by the kit manufacturers and currently used by the Ministry of Health, Kuwait Laboratories [MOHKL]. Serum IGFBP-3 and ADT had normal distribution while other analytes had non-normal distribution. The reference intervals from this study, manufacturers kit and MOHKL were as follows: TT 3-31, 9-60, 8-35 nmol/l; DHEAS 0.9-11, 1.0-7.3, 2.2- 15.2 micro mol/l; ADT 0.5-4.3, 0.8-2.8, 2.0-9.2 nmol/l; LH 1-11, 0.8-7.6, 0.4-5.7 mIU/l; FSH 0.5-11, 0.7-11.1, 1.1-13.5 mIU/l; prolactin 42-397, 53-360, 80-230 nmol/l; IGF-1 41-542, 78-956, 71-261 ng/ml; IGFBP-3 88- 2,090, 900-4,000, 900-4,000 ng/ml, and PSA 0-3.1, 0-4, 0-4 ng/ml, respectively. These data indicate that for Kuwaitis lower reference ranges must be used for serum TT, DHEAS, ADT, IGFBP-3 and PSA. There is no need to change the currently used reference interval for FSH whereas higher values must be used for LH, prolactin, and IGF-1
الموضوعات
Humans , Male , Gonadal Steroid Hormones/blood , Prostate-Specific Antigen/blood , Insulin-Like Growth Factor I/blood , Insulin-Like Growth Factor Binding Protein 3/blood , Testosterone/blood , Dehydroepiandrosterone/blood , Androstenedione/blood , Prolactin/blood , Follicle Stimulating Hormone, Human/blood , Luteinizing Hormone/bloodالملخص
Measurement of adrenocortical steroids at birth is of paramount importance especially for early diagnosis and treatment of some grave diseases including congenital adrenal hyperplasia and adrenocortical insufficiency. To determine the serum levels of 17 alpha -hydroxyprogesterone [17 alpha -OHP], 4 delta -androstenedione and cortisol in normal full-term neonates. The level of the above-mentioned corticosteroids were measured at the time of delivery, and 12 and 24 hours after birth in 15 healthy neonates by use of specific radioimmunoassays [RIA]. The present study indicated that there are no significant differences between the adrenocortical steroid levels of the two sexes. The level of each corticosteroid declined in the first 24 hours of life. The mean and standard deviation of the above-mentioned corticosteroids are higher [but not statistically significant] in comparison to studies conducted in different geographical areas, perhaps due to difference in race, consanguinity and high frequency of congenital adrenal hyperplasia in Iran
الموضوعات
Humans , Male , Female , Hydroxyprogesterones/blood , Hydrocortisone/blood , Androstenedione/blood , Gestational Ageالملخص
O objetivo deste trabalho foi avaliar a eficácia do tratamento com antiandrógenos em mulheres com alopécia androgenética (AA). Realizamos dosagens de testosterona total (T), testosterona livre (TL), sulfato de deidroepiandrosterona (DHEA-S), androstenediona (A), proteína ligadora dos hormônios sexuais (SHBG), androstanediol glucuronídeo (3alpha-diol G), TSH, anticorpo antimicrossomal e as relaçöes T/SHBG (x100) e 3alpha-diol G/SHBG em 30 mulheres com AA, idades entre 14 e 46 anos, e comparamos com grupo controle, constituído por 11 mulheres, idades entre 16 e 27 anos. Quatro pacientes tiveram diagnóstico de doença endócrina: hipotireoidismo primário (n=2), síndrome dos ovários policísticos e hirsutismo idiopático. Nas demais 26 pacientes, a relaçäo 3alpha-diol G/SHBG foi maior (p<0,05), sem diferença na concentraçäo dos androgênios, quando comparamos com o grupo controle. Sete pacientes utilizaram acetato de ciproterona (50mg/dia) associado com etinilestradiol (AC+E) e cinco pacientes utilizaram espironolactona (100mg/dia) por 6 meses. Houve diminuiçao estatisticamente significativa nas dosagens de 3alpha-diol G, SHBG e da relaçäo T/SHBG somente nas pacientes que utilizaram AC+E. Todas as pacientes relataram melhora da queda do cabelo. Observamos, através do tricograma, um aumento estatisticamente significativo dos pêlos anágenos nas pacientes que utilizaram AC e espironolactona (p<0,05) e diminuiçao de pêlos anágenos disäo androgênica que ocorre em mulheres geneticamente predispostas. O tratamento com AC+E acarreta uma melhora no perfil hormonal e na análise do tricograma sendo necessário tratamento mais prolongado para que seja observado aumento na quantidade do pêlo.
الموضوعات
Humans , Female , Adolescent , Adult , Middle Aged , Alopecia/drug therapy , Androgen Antagonists/therapeutic use , Cyproterone Acetate/therapeutic use , Lynestrenol/therapeutic use , Spironolactone/therapeutic use , Alopecia/blood , Androstenedione/blood , Dehydroepiandrosterone/blood , Testosterone/blood , Treatment Outcomeالملخص
En publicaciones recientes se han evaluado varios factores que pueden influir en las hormonas de la reproducción durante el climaterio. En nuestro medio no existen investigaciones sobre esta problemática, razón por la cual se diseñó este estudio con el objetivo de conocer la relación entre los niveles hormonales posmenopáusicos y la actividad en los círculos de abuelos. Se seleccionó una muestra simple aleatoria de 134 mujeres posmenopáusicas, estratificada según participaran o no en el círculo de abuelos (67 en cada estrato), de un área de salud urbana. Se determinaron por radioinmunoanálisis las siguientes hormonas: FSH, LH, prolactina, testosterona, estradiol 17 beta, androstenediona y 17 hidroxiprogesterona (17 OH-P). La prolactina fue mayor en las mujeres que no participan en las actividades del círculo de abuelos, mientras que la testosterona y la 17 OH-P fueron menores con respecto al grupo que participa en el círculo de abuelos. El resto de las hormonas no mostró diferencias entre los 2 grupos. Según estos resultados, las actividades realizadas por estas mujeres en el círculo de abuelos influyen en los niveles de algunas de las hormonas de la reproducción, lo que pudiera tener efectos favorables para la salud, al disminuir el estrés y en particular sobre la osteoporosis que se desarrolla en esta época de la vida
الموضوعات
Humans , Female , Middle Aged , Androstenedione/blood , Estradiol/blood , Follicle Stimulating Hormone/blood , Hydroxyprogesterones/blood , Luteinizing Hormone/blood , Prolactin/blood , Radioimmunoassay , Testosterone/blood , Exercise , Health of the Elderly , Postmenopause/bloodالملخص
O glicuronídeo de androstanediol (3alpha-diol G) é considerado um bom marcador da açäo periférica dos androgênios e da atividade da 5alpha-redutase, relacionando-se com a presença do hirsutismo. O objetivo deste estudo foi demonstrar a utilidade da determinaçäo do nível sérico do 3alpha-diol G na avaliaçäo do hirsutismo e na resposta ao tratamento. Realizamos dosagens do 3alpha-diol G, testosterona total (TT), testosterona livre (TL), androstenediona (A) e SDHEA em 27 mulheres com hirsutismo devido a hiperandrogenismo e/ou anovulaçäo crônica de causa näo definida (HACND), e comparamos com 11 mulheres sem clínica de hiperandrogenismo e com ciclos regulares. Iniciamos tratamento com etinilestradiol 35 mg + 2 mg de acetato de ciproterona e/ou espironolactona 100 mg/d, com reavaliaçäo clínico-hormonal após 6 meses. Para avaliaçäo da resposta ao tratamento consideramos: 1) melhora objetiva: diminuiçäo do escore do hirsutismo; 2) melhora subjetiva: apenas diminuiçäo da freqüência depilatória e, 3) ausência de melhora clínica. Na avaliaçäo inicial encontramos que as pacientes hirsutas com ciclos irregulares apresentaram TT e/ou A maior do que as pacientes com ciclos regulares e o grupo controle (p<0,05). O único marcador da atividade androgênica nas pacientes com ciclos regulares foi o 3alpha-diol G (p<0,0001). Nas pacientes que completaram 6 meses de tratamento (n=13) observamos que a mudança dos níveis do 3alpha-diol G foi a mais concordante com a resposta clínica, diferente dos outros androgênios. Portanto, o 3alpha-diol G é um bom marcador da atividade androgênica em mulheres com hirsutismo, principalmente nas que näo apresentam aumento da produçäo androgênica, podendo sua variaçäo estar relacionada com a resposta clínica ao tratamento.
الموضوعات
Humans , Female , Adolescent , Adult , Androstane-3,17-diol/blood , Hirsutism/metabolism , Hirsutism/therapy , Androstenedione/blood , Anovulation , Dehydroepiandrosterone Sulfate/blood , Hirsutism/diagnosis , Hyperandrogenism , Biomarkers , Prospective Studies , Testosterone/bloodالملخص
Se seleccionó una muestra aleatoria triste de 134 mujeres posmenopáusicas de un área de salud urbana, para conocer algunas características generales, así como las concentraciones de la hormonas de la reproducción (gonadotropinas hipofisarias y sexoesteroides), en este período de la vida. Se determinaron por radioinmunoanálisis las siguientes hormonas : FSH, LH, estradiol (E2), testosterona (T), androstenediona (A'd), prolactina (PRL) y el precursor 17 hidroxiprogesterona (17 OH-P). La edad cronólogica media de las mujeres fue de 56,3 años y un promedio de 8,4 años desde la menopausia. La edad de la menopausia fue 48,1 ñ 4,7 años, fue poco frecuente después de los 55 años (2,2 por ciento) y antes de los 40 (7,5 por ciento); no se presentó ningún caso de menopausia precoz. La obesidad y el hábito de fumar son hallazgos comunes en la mujer posmenopáusica, ambos son factores de riesgo de trastornos de alta prevalencia en estas mujeres como son las cardiopatías isquémicas y la hipertensión arterial, por lo cual se obvia la necesidad de insistir e eliminar o disminuir el riesgo. El patrón de las hormonas de la producción en las mujeres posmenopáusicas se caracterizó por niveles elevados de gonadotropinas (FSH y LH), índice LH/FSH normal, niveles disminuidos de E2 y niveles normales de PRL, 17 OH-P y andrógenos (Ty A'd)
الموضوعات
Humans , Female , Androstenedione/blood , Body Mass Index , Body Weight , Estradiol/blood , Hydroxyprogesterones/blood , Luteinizing Hormone/blood , Menotropins/blood , Prolactin/blood , Smoking , Testosterone/blood , Obesity , Radioimmunoassayالملخص
Retrospectiva: O citrato de clomifene tem sido utilizado em pacientes ovuladoras com a intençao de melhorar os índices de gravidez. Objetivo: O objetivo do presente trabalho foi comparar as variaços hormonais (LH e androstenediona), as respostas ovariana (número de folículos dominantes e índice de ovulaçao) e endometrial (espessura) e os índices de gravidez obtidos por diferentes doses de citrato de clomifene e em ciclos espontâneos, em pacientes com ciclos ovulatórios. Casuistica e Metodos: Foram estudadas 38 pacientes com esterilidade sem causa aparente, tratadas de 4 maneiras: citrato de clomifene 25 mg/dia (1O pacientes), citrato de clomifene 50 mg/dia (9 pacientes), citrato de clomifene 100 mg/dia (3 pacientes) e ciclo espontâneo (1O pacientes). Resultados: Houve somente diferença estatisticamente significativa em relaçao à espessura do endométrio (pالموضوعات
Humans
, Female
, Adult
, Citrates/pharmacology
, Clomiphene/pharmacology
, Ovulation
, Androstenedione/blood
, Endometrium
, Luteinizing Hormone/blood
, Ovarian Follicle
, Ovulation Induction
, Pregnancy
, Prospective Studies
الملخص
Este trabalho objetiva a montagem e padronizaçäo doradioimunoensaio para dosagem da androstenediona utilizando-se o éter etílico para extraçäo do plasma. A sensibilidade do método foi de 6,8 pg/tubo, a repordutibilidade (erro inter ensaio) foi de 15,6 por cento e a precisäo (erro intra ensaio) 5,2 por cento. Como controle biológico, 20 mulheres com ciclos ovulatórios mostraram valores medianos plasmáticos de 1.250 pg/ml e 24 mulheres com Síndrome dos Ovários Policísticos (SOP) apresentaram valores medianos plasmáticos de 2.037 pg/ml
الموضوعات
Humans , Female , Androstenedione/administration & dosage , Androstenedione/blood , Ether , Ovulation , Radioimmunoassay , Polycystic Ovary Syndrome/blood , Plasma , Statisticsالملخص
Adrenal androgen hypersecretion either produced by genetic defects or reticular disfunction, is reduced by exogenous glucocorticoid administration and as with any suppression therapy, it should relapse when the therapy is discontinued. However, prolonged remissions of adrenal androgen hypersecretion after discontinuing glucocorticoids have been described. We report 15 patients with adrenal hyperandrogenism and elevated levels of dehydroepiandrosterone sulfate that received treatment with dexamethasone. After 1 month of treatment with dexamethasone 0.5 mg/day, dehydroepiandrosterone sulfate levels returned to normal and remained so during a mean of 19 months receiving dexamethasone 0.25 mg/day. One year after discontinuing therapy, hormone levels continued within normal range in all patients. It is concluded that a long remission period of adrenal hyperandrogenism was achieves after discontinuing glucocorticoid therapy
الموضوعات
Humans , Female , Adolescent , Adult , Hyperandrogenism/drug therapy , Glucocorticoids/administration & dosage , Testosterone/blood , Acne Vulgaris/etiology , Dehydroepiandrosterone/blood , Hirsutism/etiology , Androgen Antagonists/administration & dosage , Androstenedione/blood , Menstruation Disturbances/etiologyالملخص
Frente a controvérsia existente na literatura sobre qual a característica do sêmen que mais influencia seu poder de fertilizaçäo de ovócitos, procuramos neste trabalho avaliar 1) os espermogramas realizados para investigaçäo do casal infértil, 2) o resultado das capacitaçöes do sêmen realizadas para teste de capacitaçäo e fertilizaçäo assistida (IUI e FIVETE) e 3) a correlaçäo entre os diversos parâmetros de avaliaçäo do sêmen e a fertilizaçäo de ovócitos. Para isto, foram avaliados 385 espermogramas, 101 capacitaçöes de sêmen e 30 procedimentos de fertilizaçäo assistida (FIVETE), realizados no Setor de Reproduçäo Humana do Depto. de Ginecologia e Obstetrícia-HC-FMRP-USP. Observou-se maior freqüência da associaçäo entre as alteraçöes de motilidade e morfologia (41,6 por cento) nos espermogramas avaliados; o índice de recuperaçäo de espermatozóides após capacitaçäo obteve mediana no valor de 110 por cento e as taxas de fertilizaçäo de ovócitos foram melhores quando o número de sptz/ml foi maior de que 20 milhöes e quanto maior a motilidade progressiva. Os resultados permitem concluir que a concentraçäo de espermatozóides é o parâmetro mais importante a ser observado na amostra pré-capacitaçäo estando relacionado diretamente com o percentual de motilidade progressiva e com o índice de recuperaçäo.
الموضوعات
Humans , Male , Infertility, Male/diagnosis , Semen , Androstenediol , Androstenedione/blood , Estradiol/blood , Estrone/blood , Fertilization in Vitro , Follicle Stimulating Hormone/blood , Infertility/therapy , Insemination, Artificial , Luteinizing Hormone/blood , Prognosis , Sperm Capacitation , Sperm Count , Sperm Motility , Steroids/blood , Testosterone/bloodالملخص
We studied 13 children with 21-hydroxyalse deficiency to explore the immediate potential suppressive effect of hydrocortisone dose schedule on the adrenal cortex. They were given 20 mg/m2 daily in a controlled trial. After random administration of a greater dose in the morning (7 patients) or at night (6 patients), we measured plasma levels of 17-hydroxyprogesterone, testosterone, and androstenedione at times-24, 0, 2, 4, and 6h. Considerable fluctuation of the steroid levels, unrelated to the drug intake, was observed. There was no statistically significant differences between the "morning dose" and "night dose" groups for any steroid. We conclude that; (i) the greater night dose did not avoid the 17-hydroxyprogesterone morning peaks, and (ii) the variation in plasma steroid levels is so marked that a single morning sample is unreliable to reflect the degree of adrenal suppression.
الموضوعات
17-alpha-Hydroxyprogesterone , Adrenal Cortex/drug effects , Adrenal Hyperplasia, Congenital/drug therapy , Androstenedione/blood , Child , Child, Preschool , Circadian Rhythm , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Hydrocortisone/administration & dosage , Hydroxyprogesterones/blood , Infant , Male , Testosterone/bloodالملخص
Com o objetivo de avaliar o perfil dos esteróides sexuais e gonadotrofinas na Síndrome dos Ovários Policísticos (SOP), foram estudadas 24 pacientes com SOP e comparadas a 20 mulheres normais, na fase folicular precoce do ciclo menstrual. As pacientes com SOP, quando comparadas as mulheres normais, apresentavam níveis plasmáticos basais significantemente elevados de LH, A, T, E1 e E2 e similares de FSH e DHEA-S. A relaçäo LH/FSH estava significantemente elevada e a relaçäo A/T, significantemente diminuída no grupo SOP, enquanto que as relaçöes A/E1 T/E2 estavam elevadas e E1/E2 diminuída, mas sem significado estatístico. No grupo de pacientes com SOP, observou-se correlaçäo positiva entre A e E1.
الموضوعات
Humans , Female , Androgens/blood , Estrogens/blood , Gonadotropins/blood , Polycystic Ovary Syndrome/blood , Steroids/blood , Androstenedione/blood , Estradiol/blood , Estrone/blood , Follicle Stimulating Hormone/blood , Luteinizing Hormone/blood , Testosterone/bloodالملخص
Six patients with Cushing's disease received ketoconazole for 7-10 weeks following ketoconazole challenge test. Clinical and hormonal alterations in circulating cortisol, 17 OH progesterone, androstenedione and testosterone were assessed during the therapy. There was significant clinical improvement which corresponded to a fall in cortisol, androstenedione and testosterone. The rise in 17 OH progesterone and the fall in cortisol suggest a blockade at 17,20 desmolase and 11 B-hydroxylase in the cortisol bio-synthetic pathway.
الموضوعات
17-alpha-Hydroxyprogesterone , Adolescent , Adult , Androstenedione/blood , Cushing Syndrome/blood , Female , Humans , Hydrocortisone/blood , Hydroxyprogesterones/blood , Ketoconazole/administration & dosage , Middle Aged , Testosterone/blood , Time Factorsالملخص
Circulating levels of cortisol, 17 alpha hydroxy progesterone and delta 4 androstenedione were analysed by specific radioimmunoassays in 11 patients with Cushing's disease before and at 2, 4, 6, 12 and 24# h following an oral dose of 400 mg ketoconazole. A significant fall in cortisol (26 - 79.6%, 59.8 +/- 18.7 SEM), delta 4 androstenedione (21.5 - 63.3%, 47.8 +/- 4.87) with a concomitant rise in 17 alpha hydroxy progesterone (113 - 218%, 116 +/- 11.43) were noted, suggesting inhibition of 17, 20 desmolase and 11 beta-hydroxylase enzymes in cortisol biosynthetic pathway.
الموضوعات
17-alpha-Hydroxyprogesterone , Aldehyde-Lyases/antagonists & inhibitors , Androstenedione/blood , Cushing Syndrome/blood , Cytochrome P-450 Enzyme System/antagonists & inhibitors , Female , Humans , Hydrocortisone/blood , Hydroxyprogesterones/blood , Ketoconazole/pharmacology , Male , Steroid 11-beta-Hydroxylase/antagonists & inhibitors , Steroid 17-alpha-Hydroxylaseالملخص
En el presente trabajo, hemos desarrollado una prueba de estimulación testicular simplificada y de aplicación clínica. Además, se correlacionó la respuesta esteroidogénica a la hCG, con las alteraciones espermatogénicas en hombres con infertilidad asintomática. Los niveles circulantes de testosterona (T), estradiol (E2), 17OH-Progesterona (17OHP) fueron determinados en condiciones basales (3 muestras de sangre tomadas en intervalos de 15 min) y a las 2, 4, 24 y 48 h después de la inyección i.m. de 5.000 UI de hCG, en 420 pacientes oligoastenospérmicos normoprolactinémicos con niveles normales de LH y FSH. Las respuestas de T y 17OHP a la hCG, en el grupo control, mostraron un patrón bifásico con un pico agudo a las 4 h y un pico más sostenido y retrasado luego de las 24 h. Los pacientes infértiles mostraron 2 tipos de respuesta de la T a la hCG: grupo 1) (n = 290), con una respuesta disminuida entre las 2 y 4 h, pero en el rango de los valores de los hombres normales entre las 24 y las 48 h, y un grupo 2 (n = 130) con una respuesta de T similar al grupo control. Las respuestas de E2 en los pacientes del grupo 1 y 2 fueron similares a las del grupo control. La hCG indujo un crecimiento significativo en la relación 170HP/T en los pacientes del grupo 1. En 22 pacientes: 16 del grupo 1 y 6 del grupo 2, se administró aminoglutetimida-hidrocortisana (AGT-HC), un inhibidor de la aromatasa, durante 90 días. Díez pacientes del grupo 1 normalizaron el espermograma (5 de los cuales lograron embarazos, en 5 se obtuvo un incremento significativo de los espermatozoides grado 3 y en 1 no se observaron cambios. Por otro lado, sólo 1 paciente del grupo 2 presentó una leve mejoría en la calidad del semen. La AGT disminuyó la concentración de E2 y aumentó las gonadotrofinas y la relación T/E2. En los pacientes del grupo 1 se incrementó la respuesta aguda de T a la hCG, durante el tratamiento. Nuestros resultados sugieren que 1), el E2 podría estar involucrado, tanto en la etiología de algunos casos de oligoazoospermia, como en la falta de respuesta aguda de T a la hCG, induciendo, posiblemente, un bloqueo parcial de la 17,20 desmolasa; 2) la mejoría de la calidad del semen inducida por el AGT-HC podría estar relacionada a un incremento en la relación T:E2, a una disminución intratesticular de E2, a un incremento de gonadotrofinas o a la suma de cambios hormonales; 3) solamente los pacientes con una respuesta aguda disminuidas de T a la hCG serían posibles para el tratamiento