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Biomedical subjects

D A Adamopoulos

Publications and source records attributed to D A Adamopoulos.

At least 19 recordsLinked to original sources
PubMed2000

Sex steroids in cervical mucus of spontaneous or induced ovulatory cycles.

Evaluation of sex steroids in cervical mucus was performed at different phases of spontaneous or clomiphene-citrate-induced ovulatory cycles. To this end, 11 women with normal ovulatory cycles and 9 subjects with polycystic ovary syndrome of comparable age and body mass index were investigated. Serum and cervical mucus samplings were assessed for 17beta-estradiol (E2), progesterone, testosterone, and sex hormone binding globulin levels at the pre-, peri-ovulatory, and mid-luteal phases of the cycle. The cervical mucus maturation index also was estimated in all women. Measurable amounts of E2 were found in most mucus samples with a cyclic variation in all cases. The highest E2 and mucus maturation index values coincided, but both lagged by 24 h behind the serum mid-cycle peak of this steroid. Detectable amounts of progesterone were found in the luteal phase, testosterone was present at low levels throughout the cycle, but sex hormone binding globulin was undetectable in all cervical mucus samples. Differences between spontaneous or drug-induced ovulatory cycles were not found. It is concluded that sex steroids are present in human cervical mucus, showing variations similar to those in peripheral blood. The significance of these findings is not clear at present, but it is probably related to the cyclic changes of cervical epithelium and gland secretion. An important implication of the absence of measurable sex hormone binding globulin amounts in cervical mucus is that the free fraction of sex steroids present in that fluid are presumably higher, and therefore, expected to exert greater biologic activity than in peripheral blood.

Adult↗
PubMed2000

Present and future therapeutic strategies for idiopathic oligozoospermia.

The effectiveness of medical treatment for idiopathic oligozoospermia (IO) has been at best doubtful until now and a logical consequence of this unsatisfactory situation has been the partial displacement of this approach by assisted reproduction techniques. This state of affairs has resulted from insufficient investigation, inappropriately designed clinical trials and consistent disregard for the principles of evidence-based medicine. Protocol-related shortcomings and wrong interpretation of the data available have also been some of the all too frequent problems encountered in this therapeutic approach. In this rather misty situation, it appears that, of the therapeutic agents used so far, follicle stimulating hormone (FSH) (mainly FSH-secretagogues) may exert some beneficial effects on a number of biological endpoints related to spermatogenesis and sperm maturation. The short and medium term prospects of medical treatment for IO rest mainly with improvement of investigative procedures to a higher degree of sophistication, with emphasis placed on identifying the causes rather than the results of dysfunction so that a better selection of candidates can be made. Moreover, the introduction of prognostic indices for evaluation of the beneficial effects of a therapeutic agent may be of paramount importance. Finally, a better assessment of the preparations available and, possibly, the introduction of new more specific agents may also be an important step forward in this field. This type of large-scale effort should not be left to individual investigators or special centres working independently, but it may come under the auspices of a central regulating agency so that undisputed results from large, multicentre and uniform studies might be obtained, if medical treatment is to remain a good option. In this context, it may also be emphasized that andrology's main task should always be to treat the male with the problem rather than his healthy female partner, whenever this is possible.

Clinical Trials as Topic↗
PubMed2000

The role of carotid atherosclerosis in the distinction between ischaemic and non-ischaemic cardiomyopathy.

AIM: Sometimes ischaemic cardiomyopathy is a result of severe coronary artery disease of an occult course, without typical symptoms or evidence of myocardial infarction. This form of presentation is usually indistinguishable from non-ischaemic dilated cardiomyopathy. Carotid bifurcation atherosclerosis and coronary artery disease have been shown to be strongly associated. We prospectively examined the value of extracranial carotid atherosclerosis in the distinction between ischaemic and non-ischaemic aetiology in patients with clinically unexplained cardiomyopathy. METHODS AND RESULTS: Seventy-eight patients with undetermined dilatation and diffuse impairment of the left ventricular contraction were studied within 28 months. They underwent carotid scan and coronary arteriography. Carotid atherosclerosis was found to be very common in ischaemic and rare in non-ischaemic cardiomyopathy. The presence of at least one abnormal carotid finding (intima-media thickness >1 mm, plaques, severe carotid stenosis) was 96% sensitive and 89% specific for ischaemic cardiomyopathy. CONCLUSION: Carotid scanning may be a useful screening and decision making tool in patients with cardiomyopathy of indecisive cause. Patients with carotid atherosclerosis are likely to suffer from severe coronary artery disease. Coronary angiography and subsequent myocardial viability studies, when indicated, could be considered early during their evaluation. In contrast, a negative carotid scan predicts non-ischaemic cardiomyopathy.

Adult↗
PubMed2000

Medical treatment of idiopathic oligozoospermia and male factor subfertility.

Pharmaceutical treatment for the so-called idiopathic oligozoospermia (I. O.) is possible and effective in a fair proportion of patients with the syndrome provided that appropriate investigative procedures may identify the major disorder or its level of disruption, this abnormality is reversible and appropriate prognostic indices for the treatment's success are devised and validated. According to the evidence available, minimal evaluation and prognostic indices for treatment eligibility in normogonadotropic men with I. O. include a routine work-up but, mainly, microscopical assessment of spermatogenesis and appraisal of Sertoli cell's functional capacity. Published data indicate that men with hypospermatogenesis without maturational arrest, respond favorably to agents stimulating Sertoli cells and germinal epithelium with increased sperm production. Furthermore, Sertoli cell activity as judged by cell-specific indices such as inhibin B secretion, may provide additional discriminating power to the microscopical picture of the testis. In this context, precise identification of the causative factor(s), together with the establishment of prognostic indices are the most important criteria on which the decision, for or against medical treatment in I. O., should be based. Obviously, further basic research and clinical trials are urgently needed in this particular field, and this should be a major task for clinical andrologists.

Humans↗
PubMed1997

The combination of testosterone undecanoate with tamoxifen citrate enhances the effects of each agent given independently on seminal parameters in men with idiopathic oligozoospermia.

OBJECTIVE: To evaluate the effects of combined tamoxifen citrate and T undecanoate treatment on seminal parameters in men with idiopathic oligozoospermia. DESIGN: Prospective randomized clinical study. SETTING: A state hospital tertiary clinic. PATIENT(S): Eighty oligozoospermic men were included in the protocol. INTERVENTION(S): Patients were randomized to receive placebo, T undecanoate (40 mg three times per day), tamoxifen citrate (10 mg two times per day), or T undecanoate plus tamoxifen citrate. RESULT(S): Tamoxifen citrate plus T undecanoate treatment produced a satisfactory improvement of total sperm number, motility, and functional sperm fraction after 3 and 6 months. Comparisons with other active treatment groups showed significantly higher increment values for motility and functional fraction, whereas aniline, acrosine, and free L-carnitine also were markedly better in the combination treatment group. CONCLUSION(S): These results indicate that the combination of tamoxifen citrate with T undecanoate not only improves significantly important seminal parameters but also compares favorably with the single treatments used. Therefore, this combination deserves a place as a first line of treatment in idiopathic oligozoospermia.

Acrosin↗
PubMed1996

Seminal volume and total sperm number trends in men attending subfertility clinics in the greater Athens area during the period 1977-1993.

The trends for such important parameters of male fertility as seminal volume and total sperm number were assessed in men living permanently in the Greater Athens area over a prolonged period of time. To this end, the records of three andrological laboratories employing the same method for semen evaluation were analysed retrospectively. Out of 23,850 men examined from 1977 to 1993 (17 years) for couple subfertility, a total of 2385 (10%) were selected for evaluation by a randomization procedure. Analysis of the data included (i) estimation of mean seminal volume and total sperm number per year, (ii) assessment of percentage frequency distribution of each seminal parameter and (iii) evaluation of seminal volume and total sperm number changes in relation to the year of observation and age of the subjects. A significant decrease (P < 0.01) of total sperm number was observed over the years with a mean (+/-SEM) of 154.3 +/- 19.2 x 10(6) at the beginning (1977), dropping to 130.1 +/- 13.3 x 10(6) in the final year (1993). Mean seminal volume was lower in the final year of observation, but its difference from the initial year value was not significant. Frequency distribution analysis showed a marked decline in the 240-400 x 10(6) sub-set of the range of sperm number values from 16.9 +/- 4.5% (1977) to 10.6 +/- 1.6% in the final year (P < 0.01). Multiple regression analysis of seminal volume, total sperm number, age and year of assessment revealed a significant decline of the two seminal parameters along the years of observation (P < 0.05 and P < 0.0001 respectively). Over the same period, a marked deterioration of some air pollution indices was observed in that area. It is concluded that in this racially and ethnically homogeneous sample of men, living under the same environmental conditions, a significant decline in seminal volume and total sperm number occurred over the 17 years of observation.

Adult↗
PubMed1995

Endocrine effects of testosterone undecanoate as a supplementary treatment to menopausal gonadotropins or tamoxifen citrate in idiopathic oligozoospermia.

OBJECTIVE: To evaluate the effects of T undecanoate given as a supplementary treatment with tamoxifen citrate (TAM) or hMG on pituitary and Leydig cell function in men with idiopathic oligozoospermia. DESIGN: A total of 48 normogonadotropic men with idiopathic oligozoospermia were allocated in to six groups (n = 8 per group) treated with placebo, 40 mg T undecanoate three times per day, 10 mg TAM two times per day, T undecanoate and TAM, 75 IU/d hMG, and T undecanoate and hMG. All groups were evaluated with standard GnRH, thyrotropin-releasing hormone, and hCG tests before and on the final day of 3 months on treatment with measurements of FSH, LH, thyroid-stimulating hormone (TSH), PRL, T, E2, 17-hydroxyprogesterone, sex hormone-binding globulin, and seminal analyses (at least twice each time). RESULTS: Basal and stimulated concentrations and incremental FSH and LH values showed no differences among TAM or hMG and TAM + T undecanoate or hMG + T undecanoate treated groups. Basal, stimulated, and incremental values for TSH and PRL were elevated markedly during treatment in most groups in comparison to placebo. Basal, stimulated, and incremental T and E2 values were similar in active treatment groups except that higher T concentration was found in TAM + T undecanoate as compared with T undecanoate only treated men. Finally, significant improvements were noted in important seminal parameters and particularly in the functional sperm fraction of the TAM + T undecanoate group as compared with single treatment with TAM. CONCLUSION: These results indicate that T undecanoate in combination with TAM or hMG not only had no adverse effects on pituitary and Leydig cell activity but also seemed to improve important seminal parameters and signify that androgens may be tried as a supplementary treatment to conventional regimes in idiopathic oligozoospermia.

Adult↗
PubMed1994

Testicular secretion after pulsatile human menopausal gonadotropin therapy in gonadotropin-releasing hormone agonist desensitized dysspermic men.

OBJECTIVE: To evaluate Leydig and Sertoli cell response to prolonged pulsatile stimulation with hMG after pituitary desensitization with the GnRH agonist (GnRH-a) triptoreline in normogonadotropic men with abnormal semen analyses. DESIGN: A group of four oligozoospermic men were investigated in the following manner: [1] basal and GnRH-hCG stimulated activity were assessed in all volunteers; [2] a long-acting form of the GnRH-a triptoreline (3.75 mg every month for 3 months) was given, and its effectiveness was evaluated on day 20; and [3] on that day hMG pulsatile administration was introduced (150 IU per 24 hours in 90-minute pulses) with serial hourly sampling (6 to 7 hours) for measurement of FSH, LH, T, E2, and inhibin on days 20, 41, and 90 from the first GnRH-a injection. RESULTS: Initial evaluation showed normal basal, GnRH, and hCG-stimulated hormone concentrations. Pituitary and gonadal activity were effectively suppressed by GnRH-a when tested on day 20. Pulsatile hMG had no immediate stimulatory effect on gonadal activity (day 20). However, on middle and final evaluations (days 41 and 90), basal T, E2, and inhibin had risen to pre-GnRH-a levels, and, moreover, distinct secretory pulses were seen for these hormones. CONCLUSION: These findings indicate that suppression of pituitary gonadotropin activity with triptoreline combined with pulsatile hMG stimulation offers a new, useful tool for investigation of the male reproductive system in oligozoospermic men.

Adult↗
PubMed1992

Effects of induced peripheral anosmia on gonadal maturation in prepubertal male rabbits.

The effect of induced peripheral anosmia on gonadal development and maturation was investigated in sexually immature male rabbits. Furthermore, the effect of agents promoting gonadal maturation (LHRH, hMG or methyl testosterone) on testicular development was examined in anosmic rabbits. Peripheral anosmia was induced by spraying the olfactory mucosa with 5% ZnSO4 solution; its effects were evaluated after a 45-day period, corresponding to the duration of spermatogenesis. Evaluation was based on measurement of body-weight, testicular size, testicular biopsy score count (TBSC) and a standard LHRH test (0 and 30 min) involving measurement of the blood levels of FSH, LH and testosterone before and at the end of the test. Markedly lower final and incremental values were noted in anosmic, compared to intact, animals for body-weight (P less than 0.001), TBSC (P less than 0.001), FSH (P less than 0.01) and LH (P less than 0.05). On the other hand, treatment of the anosmic rabbits with 0.9% saline, resulted in lower FSH, TBSC and testicular size increments than in rabbits treated with LHRH, hMG or testosterone, while testosterone levels and body-weight increments were similar in all groups. These findings indicate that induced peripheral anosmia is probably responsible for the inadequate gonadal maturation in prepubertal anosmic male rabbits. This relationship was confirmed by the observed stimulatory effect of administration of agents activating pituitary gonadotrophin secretion or gonadal function in anosmic animals.

Animals↗
PubMed1988

Effects of antiandrogen-estrogen treatment on sexual and endocrine parameters in hirsute women.

Sexual activity was evaluated in 51 women with hirsutism associated with increased levels of circulating androgens before and while on combined treatment with the antiandrogen cyproterone acetate (CA) and ethinyl estradiol (EE2) and compared to a reference group of 52 subjects. The percentage of unbound testosterone (T) was higher (p less than 0.001), the coital frequency lower (p less than 0.05), and the masturbation frequency higher (p less than 0.04) in hirsute women. Mean frequency of total activity (coitus plus masturbation) was similar in the two groups. Treatment with combination of CA and EE2 resulted in a decline of unbound T (p less than 0.001). There was no change of total sexual activity, but coital frequency increased (p less than 0.05) and masturbation frequency declined (p less than 0.04). It is concluded that raised levels of circulating androgens, as judged by free T concentration, are not of crucial importance in the expression of sexual behavior in hirsute women.

Adolescent↗
PubMed1987

Raised sodium, potassium, and urea concentrations in spermatic venous blood: an additional causative factor in the testicular dysfunction of varicocele?

The concentrations of Na, K, Cl, HCO3, LA, and urea, with calculation of the AG, as indirect indices of electrolyte balance and metabolic conditions prevailing in testicular environment, were determined in PB and SVB of 24 men with varicocele and 15 men with inguinal hernia. Significantly higher concentrations of Na, K, and urea were found in SVB as compared with PB values (P less than 0.001 for all) of patients with varicocele, but not in control subjects. The SVB concentrations of Na, K, and urea in varicocele patients were higher than SVB and PB concentrations of the control group (P less than 0.001 for all). It is concluded that urea, Na, and K concentrations are raised in SVB of patients with varicocele; this imbalance may be related, among other factors, to the pathogenesis of dyspermia in varicocele.

Adult↗
PubMed1986

Thyroid disease in patients with benign and malignant mastopathy.

The incidence of thyroid disease was examined prospectively in 97 consecutive patients with breast cancer (Group I) and was compared with that of 61 women with cystic breast disease (Group II) and that of 60 control women (Group III) with no breast problems. Thyroid enlargement was found in 47%, 49%, and 22% of those in Groups I, II, and III, respectively, and treatment with thyroid hormones was taken by 9.3% (I), 8.2% (II), and 5.0% (III) of the cases. The mean thyroid-stimulating hormone (TSH) concentration in those in Group I (5.4 +/- 2.2 microU/ml) was significantly higher than in Groups II (3.9 +/- 1.9, P less than 0.01) and III (4.0 +/- 1.8, P less than 0.001), whereas thyroid microsomal antibodies were detected in 13.4% (I), 9.1% (II), and 1.7% (III); mean triiodothyronine (T3) and thyroxin (T4) concentrations were similar in the three groups. When both TSH and T3 concentrations were taken into account, 24% and 17% of the patients, respectively, from Group I were no longer in the Group III range; the corresponding figures for Group II were 13% and 23%, respectively. These results indicate that breast cancer and thyroid disease are probably related, but not in a specific way, since benign mastopathy also seems to be associated with thyroid disturbances.

Adult↗
PubMed1984

Prolactin concentration in milk and plasma of puerperal women and patients with galactorrhea.

Prolactin (PRL) concentration was estimated in milk and blood of women with various types of galactorrhea (n = 53) and was compared with lactating (n = 17) and normally menstruating women (n = 36). Mean milk (+/- SD) PRL concentration in lactating women (160 +/- 66 micrograms/l) was similar to that of galactorrhea due to pituitary adenoma (149 +/- 87 micrograms/l, n = 24), thyroid dysfunction (193 +/- 72 micrograms/l, n = 8), functional causes (192 +/- 91 micrograms/l, n = 10) or recent pregnancy (198 +/- 44 micrograms/l, n = 2), but higher than that of sex steroid-induced galactorrhea (85 +/- 53 micrograms/l, n = 9). Plasma PRL concentration in lactating women (208 +/- 102 micrograms/l) was higher than in normal control women (14 +/- 5 micrograms/l) and patients with galactorrhea due to thyroid dysfunction (36 +/- 15 micrograms/l), functional causes (16 +/- 8 micrograms/l), drugs (20 +/- 4 micrograms/l), recent pregnancy (22 +/- 3 micrograms/l) or pituitary adenoma (145 +/- 53 micrograms/l). The milk to plasma PRL concentration ratio was 0.8 +/- 0.4 in lactating women and 1.1 +/- 0.7 in patients with adenoma but significantly higher (p = 99% two-sided) in galactorrhea due to thyroid dysfunction (4.4 +/- 2.1), drugs (3.4 +/- 1.1) or functional causes (12.3 +/- 4.3). Bromocriptine administration reduced PRL in both fluids. It is concluded that in women with galactorrhea milk PRL concentration is similar to that of nursing mothers, but plasma levels of this hormone are significantly lower than that of the latter group in all but the pituitary adenoma related galactorrheas.

Adenoma↗
PubMed1982

Pituitary function in young women in a reformatory institution.

Pituitary function was assessed by measuring serum prolactin thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH) and luteinizing hormone (LH) before and after LH releasing hormone (LH-RH) (100 mg intravenously) and sulpiride (100 mg intramuscularly) administration in 13 young women in a reformatory institution, and in six employees of the same establishment with regular cycles, serving as control group. Ovarian endocrine activity was assessed with basal oestradiol estimations. Seven out of the 13 restricted women had secondary amenorrhea that began shortly after their imprisonment and six had regular cycles. Basal oestradiol concentration was similar in the three groups, but prolactin response to sulpiride was significantly higher in the control group than that in either group of inmates. Basal FSH, LH and TSH concentrations as well as FSH and TSH responses were not different in the three groups, but the LH response to LH-RH was significantly higher in the group of inmates with amenorrhea than that in the two remaining groups.

Adolescent↗
PubMed1982

Gastrin secretion in the menstrual cycle and pregnancy.

Gastrin (1--17) concentration was estimated under basal conditions in 12 menstruating women, and 42 women with normal pregnancy. In 10 women with normal pregnancy this hormone was also measured 10 days after delivery. In addition, gastrin was determined after stimulation with a standard protein meal in 7 menstruating women, 12 women with normal pregnancy and 14 women with complicated pregnancies. Umbilical vein blood levels of gastrin were also determined in 5 cases while, in 3 women serial hormone estimations were carried out for 24 hours after normal delivery. The mean (+/- SEM) basal gastrin concentration was 36.1 +/- 2.9 pg/ml in the productive and 45.4 +/- 2.0 in the secretory phase of the cycle (p less than 0.02). The mean basal concentration in normal pregnancy (60.4 +/- 5.4) was higher than that of the normal cycle as a whole (p less than 0.001), showed no significant variations related to the progress of pregnancy, and fell to normal cycle levels after delivery (42.1 +/- 2.9). In complicated pregnancies the mean hormone concentration (47.0 +/- 2.3) was lower than that of normal pregnancies (p less than 0.05) and similar to that of the secretory phase of the cycle. Gastrin responses to protein meal were similar in all 3 groups studied, with maximal concentration at 30 min, and a gradual decline thereafter. Umbilical vein blood levels of gastrin were generally higher than in maternal circulation but not significantly so. Serial estimations of gastrin after delivery failed to show any uniform pattern of changes. It is concluded that variations of gastrin secretion related to the phase of the menstrual cycle or the reproductive state may occur in women.

Adolescent↗
PubMed1981

The effect of clomiphene citrate on sex hormone binding globulin in normospermic and oligozoospermic men.

The effect of clomiphene citrate (CG) on sex hormone binding globulin (SHBG) was studied in 10 oligozoospermic patients with varicocele and 6 normospermic men. Plasma SHBG, testosterone (T), oestradiol (E2), FSH, LH, Prolactin (Prl), thyroxine (T4) and 17-OH-progesterone (17-OH-P) were determined before and during medication. SHBG concentration rose from 38.1 +/- 18.3 to 54.3 +/- 16.0 nmol/l (P less than 0.01), while T and E2 showed significant increases from 31.2 +/- 10.8 nmol/l and 24.6 +/- 5.4 pg/ml to 52.0 +/- 3.6 and 43.3 +/- 14.9, respectively in the oligozoospermic patients, with similar rises noted in the normospermic men. FSH, LH and 17-OH-P were markedly elevated while on CC, but Prl and T4 remained unchanged. The findings of this study indicated the CC causes an increase of SHBG concentration, which is probably related to the rise of E2 concentration. This SHBG change, combined with the intrinsic oestrogenic activity of CC might be one of the factors responsible, through a decrease of free T and a T to E2 imbalance, for the lack of significant effect on parameters of seminal quality in so treated patients.

Clomiphene↗