[Use of the method of determination of tetrahydroaldosterone in the study of clinical cases].
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Biomedical subjects
Publications and source records attributed to D Drafta.
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The authors have investigated the presence of oestrogenic and progesteronic receptors in 38 patients with breast cancer. It was noted that these receptors were present in 20 patients, and that the hormone-dependent tumours are more frequent in patients which are in the post-menopausal stage. The level of circulating oestrogens was also investigated, as well as the amount of oestrogens in the cytosol of tumor cells, and in the normal cells from the diseased breast. In patients with oestrogen-positive tumors, and/or progesteron-positive tumors, a rise was noted in the amount of circulating oestradiol, an increased contents of cytosolic oestradiol, especially in the tumoral cells as compared with the normal ones in the same breast. On the basis of these data patients were selected, with hormone-dependent breast tumors in view of ovarectomy. The indications are discussed, as well as the advantages of surgical ovarectomy.
The dynamics of urinary and plasma steroids (CPB and RIA) were simultaneously studied in a 36-yr-man with Cushing's syndrome due to adrenal carcinoma. The markedly increased basal excretion of 5-pregnenetriol, PG, PGT, DHA, THS and corticosteroids with nonsignificant changes during the endocrine tests decreased to normal levels after tumour removal. The basal low level of plasma testosterone, with nonsignificant changes during the endocrine tests, rose progressively after surgery. The steroid content of adrenal carcinoma tissue determined by CPB and RIA after LH-20-Sephadex CC separation revealed important proportion of unconjugated 17-OH-P.
Plasma testosterone (T), 5 alpha-dihydrotestosterone (DHT), T/DHT ratio, estrone (E1), estradiol (E2), E2/T ratio and 17-hydroxyprogesterone (17-OH-P) were measured in 70 patients with prostatic carcinoma (PCA) (T34, N01, M01), after endocrine therapy including: steroidal estrogens (polyestradiol phosphate = Estradurin monthly in injections of 80 mg; estradiol - 17 beta: 5 mg/d), nonsteroidal synthetic estrogens (DES: 5 mg/d; chlorotrianisene = TACE: 24 mg/d; DES-diphosphate = Honvan: 360 mg/d), orchidectomy and their combinations. All these forms of treatment lowered T, DHT, T/DHT ratio and 17-OH-P, the maximal suppression being observed after castration. No further decrease of the mentioned parameters was achieved by estrogen treatment of castrated patients, as compared with castration alone. In the noncastrated patients, steroidal estrogens were less effective than nonsteroidal ones, in terms of lowering T, DHT and T/DHT ratio. Significant decreases in estrone (p less than 0.05) and estradiol (p less than 0.01) levels were observed after nonsteroidal estrogen treatment and castration respectively, and extremely high values of circulating estrogens were found after steroidal estrogen administration.
Plasma cortisol, 17-hydroxyprogesterone (17-OH-P), progesterone, FSH, LH and prolactin were determined by RIA, in 14 cancer patients without metastases aged between 40 and 74 years (6 cases of breast cancer: T123, N01, M0 and 8 with other forms of cancer). The cancer patients were investigated: (A) under basal conditions, (B) after three days' adrenal suppression by dexamethasone, 3 mg/day and (C) immediately after local radiation therapy (4500 rads). The basal mean hormonal values in these patients showed increased cortisol, decrease 17-OH-P and normal values of progesterone, FSH, LH and prolactin. Plasma cortisol was significantly reduced by adrenal suppression with a percentage reduction of 19.44 without differences between breast cancer patients and patients with other forms of cancer; adrenal suppression induced an increase of 17-OH-P only in male cancer patients. The only significant hormonal changes after local radiation therapy were increased plasma 17-OH-P values in both female and male cancer patients. A second group investigated in the present study consisted of 11 patients (6 castrated and 5 postmenopausal women) with metastatic breast cancer and presented increased plasma cortisol values, decreased 17-OH-P values, and a great scatter in the estrone values, some of them being very high.
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