Urinary steroid measurements in some endocrine and psychiatric diseases.

In 1990, the worldwide accepted Shackleton method, which provides a possibility of determining the steroid metabolites from urine, was adopted in our laboratory. The procedure is very useful in the diagnosis of different endocrine diseases and in the recognition of dysfunction or absence of enzymes with an important role in steroid metabolism, and it gives possibility to control the treatment in patients with these diseases. Besides the proximate clinical application, the method gives a convenient tool to study the steroid background of these disorders, helping us understand the mechanism of their development. In the last few years, we have examined the steroid profile of patients with hair (androgen alopecia /AA/, effluvium /E/), psychiatric problems (major depression /MD/, eating disorders /EDS/, especially anorexia nervosa and bulimia) and osteoporosis (OP). In all of the examined hair loss diseases, the levels of main androgen metabolites were increased, and elevated 5alpha-reductase activity were found. We could observe the alteration of the activity of 11beta-hydroxysteroid dehydrogenase (11beta-HSD) enzyme and marked gender differences in the changes of the steroid metabolism in patients with major depression (MD). In women with OP, the significantly decreased level of certain metabolites points to the role of testosterone, androstenedione and DHEA in postmenopausal bone loss in women. Our experiences contribute to the knowledge of the nature and steroid background of some endocrine and psychiatric diseases.

Urinary steroids in men with male-pattern alopecia.

Enzyme hydrolysis, solid phase extraction, methoxym-silyl derivatization and capillary gas chromatographic analysis were used to examine the changes in urinary steroid metabolites in men with androgenic alopecia. A total of 23 men with androgenic alopecia and 7 age-matched control healthy men collected 24-h urine. Significantly increased values were found in the metabolites of testosterone (T): androsterone (A) (p<0.02), and etiocholanolone (E) (p<0.05) in patients with androgenic alopecia, compared to the control values. Elevated levels of 16-hydroxy-dehydroepiandrosterone (16-OHD) (p<0.03) and cortisol (F) (P<0.05) were found, but the levels of cortisol metabolites were unchanged. Calculating the ratio of total 5 alpha/5 beta metabolites provided information on the activity of 5 alpha-reductase. The ratio of total 5 alpha/5 beta metabolites was increased in the patients showing the increased 5 alpha-reductase activity. The elevated 16-OHD level could be indicative of patients who had mild hyperadrenal activity.

Urinary steroids in women with androgenic alopecia.

OBJECTIVES: To determine the nature of the hormonal overproduction in androgenic alopecia. DESIGN AND METHODS: Urinary steroid metabolites were measured after enzyme hydrolysis and methoxym-silyl derivatization by capillary gas chromatography in 56 women with androgenic alopecia and in 17 control healthy laboratory women workers. RESULTS: Elevated C19 metabolites of testosterone and androstendione, hyperandrogenemia (p < 0.01), and increased cortisol (p < 0.01) and corticosterone metabolite, aTHB (p < 0.01) were found in patients with androgenic alopecia compared to normal control. Normal 11beta-hydroxylase activity and increased 5alpha-reductase activity were experienced. CONCLUSION: We propose that in addition to the increased excretion of almost all steroid metabolites, the enhanced activity of 5alpha-reductase is the primary defect in the majority of androgenic alopecia.

[Use of argon laser in dermatology]. / Argonlézer alkalmazása a bórgyógyászatban.

The authors have been using an argon laser at the Department of Dermatology of Pécs Medical University School for two years. They summarise their cosmetically good therapeutical effects on the 373 patients treated with different dermatological diseases. They refer to that the different laser instruments have their own indications, in well defined diagnoses, but slight coincidences are known. After the correct diagnose and so the correctly chosen type of the laser instrument good result could be reached.

[Facial granuloma]. / Granulome facial.

INTRODUCTION: The aim of this case report is to show the results of therapeutical procedures in the facial granuloma. CASE: A 48 year old male patient had multiple facial granulomas persisting for at least 8 years. They were unresponsive to dapsone. The surgical removal of two lesions and the liquid nitrogen cryotherapy of the remaining lesions were efficient without recurrence in a follow-up time of 6 months. COMMENTS: Lesions of facial granuloma do not spontaneously regress; they are easily recognized and differentiated from other conditions occurring on the face. New therapeutical approaches are welcome, even if they are empirical, in so far as they are efficient and reproducible.

Study of circulating immune complexes in atopic dermatitis.

The authors examined sera from 92 patients (78 adults, 14 children) with atopic dermatitis (AD), for the presence of circulating immune complexes (CIC). Using the PEG precipitation technique they found an increase in CIC total protein. In the quantity of precipitated proteins, elevated IgA and IgG levels and decreased C3 in CIC were measured. Neither the acute nor the subacute stage of the disease, nor skin involvement, correlated with CIC. In increased content of CIC was found in patients who had AD with associated disease recurrent infections, recurrent conjunctivitis, asthma, allergic rhinitis) and especially with pustulosis varicelliformis Kaposi, i.e. eczema herpeticatum. The T lymphocytes, together with other surface complement receptor-positive cells, are able to induce CIC production and keep them in solution.