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Journal Article 2002; 23(2): 155-160 PubMed PMID: 12011802 Citation  Keywords:  Aged, Aged, 80 and over, Alzheimer Disease:blood, Estradiol:blood, Estrone:blood, Female, Folic Acid:blood, Humans, Logistic Models, Mental Status Schedule, Testosterone:blood,.   

OBJECTIVES: In vitro and in vivo animal studies suggest that sex steroids, such as estrogens and testosterone, could protect the brain. However, estrogen replacement therapy (ERT) for Alzheimer's disease (AD) in women has not been successful. We hypothesised that the lack of effect of ERT might be related to an interaction between estrogens and some other factor(s) associated with AD.

DESIGN, SETTING AND METHODS: We analysed total estrogen (TE) and testosterone (TT) levels in women diagnosed with AD and controls of the Oxford Project To Investigate Memory and Ageing. Because estradiol (TE2) after the menopause is largely derived from estrone (TE1), we computed the ratio TE2/(TE1+TE2) and a total steroid index (TT+TE2+TE1).

RESULTS: Women with AD (n=66) had significantly higher levels of TE2 (27+/-13 vs. 21+/-13) and a higher TE2/(TE1+TE2) ratio. Stepwise logistic regression analyses showed that the TE2/(TE1+TE2) ratio was the main sex steroid predictor for AD (O.R.=1.06, 95% C.I.=1.01-1.11, p<0.01). Multiple regression analyses revealed that dementia severity was associated with an interaction between the TE2/(TE1+TE2) ratio and serum folate (B=4.59 (SE=1.48), beta=1.22, 95% C.I.=1.62-7.56, p<0.005). None of the other potential mediators of this association (body mass index, sex hormone binding globulin, homocysteine levels, ApoE genotype, smoking, diabetes, blood pressure) was significant.

MAIN FINDINGS: A high ratio of estradiol to total estrogens is associated with AD but, in subjects with a high ratio, the dementia severity was lower in those with high serum folate levels.

CONCLUSIONS: If this association is causal, then supplementation with folic acid might be considered in future studies on ERT in AD....

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Journal Article 2001; 22(5): 332-336 PubMed PMID: 11600882 Citation  Keywords:  17-alpha-Hydroxyprogesterone:blood, Adolescent, Adrenal Hyperplasia, Congenital, Adrenocorticotropic Hormone, Adult, Dehydroepiandrosterone Sulfate:blood, Estradiol:blood, Fasting, Female, Follicle Stimulating Hormone:blood, Follicular Phase, Humans, Hype.   

OBJECTIVES: To determine melatonin production in hyperandrogenic women.

MATERIAL AND METHODS: Seventeen women with late onset adrenal hyperplasia due to 21-hydroxylase deficiency (LOCAH) and 15 control women were studied in early follicular phase of the menstrual cycle. Fasting serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E(2)), testosterone, dihydroepiandrosterone sulfate (DHEA-S), 17-hydroxyprogesterone (17-OHP) as well as the peak 17-OHP response to ACTH (250 microg IV) and 24h urinary 6-sulfatoxymelatonin (aMT6s) were determined in all participants.

RESULTS: All 17 hyperandrogenic women were carrying mutations of the CYP21 gene. Women with LOCAH had significantly higher serum testosterone, DHEA-S, 17-OHP and ACTH stimulated 17-OHP values compared with controls. Their aMT6s values (44.6+/-20.3 microg/24h) were significantly higher than the values in control women (31.5+/-20.3) (p<0.03). The urinary aMT6s values were positively correlated with testosterone (p<0.04), DHEA-S (p<0.02) and peak 17-OHP (p<0.04).

CONCLUSIONS: Women with LOCAH have increased melatonin production. There is a relationship between adrenal androgens and melatonin in these women....

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Journal Article 2001; 22(5): 349-355 PubMed PMID: 11600877 Citation  Keywords:  Animals, Appetite Regulation:drug effects, Energy Metabolism:drug effects, Estradiol:blood, Female, Follicle Stimulating Hormone:blood, Galanin:blood, Hormones:blood, Leptin:analysis, Luteinizing Hormone:blood, Neuropeptide Y:blood, Neuropeptides:blood, P.   

OBJECTIVES: Some hormonal disturbances were demonstrated in starvation. Leptin, NPY and galanin play an important role in the control of appetite and in the mechanism of hormone release.

METHODS: In order to evaluate the effect of starvation on the relationship between leptin, neuropeptide Y (NPY) galanin and pituitary and gonadal hormones release, plasma leptin, NPY and galanin as well as serum LH, FSH, prolactin (PRL), estradiol, progesterone levels in non-starved female rats (in diestrus) and after 72 hrs of starvation were measured with RIA methods. Effects of leptin, NPY and galanin administration on pituitary and gonadal hormones were investigated in vivo and in vitro experiments.

RESULTS: Plasma leptin, NPY and galanin as well as serum estradiol and progesterone concentrations were significantly lower in starved rats as compared with non-starved rats. However serum prolactin level was significantly higher in starved rats. Opposite effects after leptin and NPY administration on hormone release in vivo and in vitro experiments were observed in non-starved rats. However, in starved rats we did not find changes in pituitary and gonadal hormones release after leptin, NPY and galanin injection or the hormonal response was blunted.

CONCLUSIONS: 1) The disturbances in neuropeptides activity and in hormones release were observed in starvation. 2) Leptin, NPY and galanin have direct and indirect effects on pituitary and gonadal hormones release. 3) In starvation the hormonal response to leptin, NPY and galanin is impaired....

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Journal Article 2001; 22(2): 93-99 PubMed PMID: 11335885 Citation  Keywords:  Alcoholism:complications, Animals, Autoradiography, Cell Division:drug effects, Ethanol:administration & dosage, Leydig Cells:drug effects, Male, Rats, Rats, Sprague-Dawley, Seminiferous Tubules:drug effects, Spermatogonia:drug effects, Testicular Disease.   

OBJECTIVES: Considering the possibility that alcoholism induces gonadal dysfunction, the present work was designed to investigate the morphophysiology of rat testes submitted to experimental alcoholism.

METHODS: Male Sprague-Dawley rats weighing 150+/-5 gm were chronically given 40% ethanol solution at a dose of 3 g/kg body weight for 30 days. (3)H-thymidine autoradiographic investigations and histological studies were carried out to determine the proliferative activity and/or different stages of spermatogenesis in the seminiferous tubule cycle and Leydig cells.

RESULTS: The 3H-thymidine autoradigraphic investigation revealed that there was a significant inhibition in the proliferative activity of the spermatogonia in all stages of the seminiferous tubule cycle in the alcohol-treated rats versus controls as indicated by the values of (3)H-labelling indices. The histological and numerical investigations indicated that the alcohol-treated rats presented testicular lesions including a significant decrease in the diameter of the seminiferous tubules, the number of different germ cells in all stages of the seminiferous tubule cycle and the presence of degenerative germ cells. In addition, there was a significant decrease in the number of Leydig cells.

CONCLUSION: The present work suggests the deleterious effects of alcohol on the testes. These effects may be due to the effect of alcohol on the gonadotrophic cells of the pituitary gland and/or directly on the seminiferous tubules and Leydig cells....

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Journal Article 2018; 39(3): 219-225 PubMed PMID: 30431736 Citation  Keywords:  Adolescent, Adult, Body Mass Index, Estradiol:blood, Female, Humans, Menstruation Disturbances:blood, Obesity:blood, Oligomenorrhea:blood, Overweight:blood, Risk Factors, Sex Hormone-Binding Globulin:metabolism, Testosterone:blood, Vitamin D:analogs & der.   

INTRODUCTION: Vitamin D (VD) plays a crucial role in calcium metabolism as well as immunological and endocrine homeostasis. Previous studies revealed strong inverse correlation between VD levels and insulin resistance, parathyroid dysfunctions and autoimmune thyroid disease. Insufficient evidence concerns its dependency of ovarian hormones. Malfunctioning of the ovaries results in menstrual disorders that are one of the most common endocrine impairments in young women of reproductive age. MATERIAL AND METHODS: The study was aimed to evaluate the correlation between 25(OH)D serum concentration and estradiol, testosterone as well as body mass index (BMI) in women with oligomenorrhea. 134 women of reproductive age with oligomenorrhea were eligible for the study. 25-hydroxyvitamin D [25(OH)D], estradiol, testosterone and sex hormone-binding globulin (SHBG) were measured using chemiluminescence immunoassay. Free androgen index (FAI) and body mass index (BMI) were calculated. RESULTS: Critical 25(OH)D deficiency (<10 ng/ml) was found in 13.4% of women, the risk of deficiency (<30 mg/dl) was diagnosed in 69.4%, while sufficient level of VD (>30 mg/ml) in 17.2% of them. Significant negative correlation was detected between 25(OH)D and estradiol serum concentrations (r=-0.2; p=0.049), as well as BMI levels (r=-0.22; p=0.01). However, no significant correlation was found between 25(OH)D and testosterone (r=-017; p=0.055), SHBG (r=0.08; p=0.4) and FAI (r=-0.1; p=0.24). CONCLUSIONS: Thorough assessment of vitamin D deficiency/insufficiency is required among patients with menstrual disorders, especially those overweighed and obese. Early screening and VD supplementation in women with estrogen-dependent disorders may become a part of routine management in order to optimize endocrine health....

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Journal Article 2018; 39(4): 281-287 PubMed PMID: 30531701 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Brain Neoplasms:radiotherapy, Female, Glioblastoma:radiotherapy, Humans, Male, Middle Aged, Neoplasm Recurrence, Local:radiotherapy, Palliative Care, Radiosurgery, Retrospective Studies, Survival Rate, Treatment.   

OBJECTIVE: Local recurrence of glioblastoma is observed in most patients after standard oncologic treatment (surgery, chemotherapy and radiotherapy). Stereotactic radiosurgery with the Leksell Gamma Knife (SRS with LGK) was used to treat recurrent tumors in selected cases, and retrospective analysis of treatment outcome was performed. METHODS: Altogether 126 patients were treated for glioblastoma at our center from 1992-2014. Sixty-nine patients (55%) were male and 57 (45%) female, with a median age of 56 years (range 17-80 years). Prior to LGK radiosurgery, 123 (98%) underwent surgery, 126 (100%) radiotherapy and 116 (92%) chemotherapy. The median Karnofsky score before LGK radiosurgery was 90% (range 50-100), and the median time from GBM diagnosis to LGK radiosurgery was 12 months (range 1-96 months). The median tumor volume was 3.75 cm3 (range 0.04-37.10 cm3). LGK radiosurgery was performed in a single fraction with a median minimal tumor dose of 12 Gy (range 10-25 Gy) on a median 50% (range 40-86%) isodose line. Two and more LGK radiosurgeries were performed in 19 (15%) cases, a median interval of 9.6 months (range 2-45 months) from the initial LGK radiosurgery. The median prescribed dose in these patients was 12.6 Gy (range 10-15 Gy), and the median volume 5.8 cm3 (range 0.1-13.7 cm3). RESULTS: The median survival from GBM diagnosis was 20 months (range 6-237 months). The median survival after LGK radiosurgery was 7 months (range 1-223 months). The one year survival after LGK radiosurgery was 27%, 2 years 8%, and more than 3 years 4%. Tumor regression on MR images was observed in 17% of patients at a median interval of 7 months. The median interval to tumor progression on MR images after LGK treatment was 8.5 months. No treatment-related radionecrosis with expansive behaviour was detected after radiosurgery. CONCLUSION: We show that LGK radiosurgery is a safe palliative treatment modality in patients with recurrent GBM....

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