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Biomedical subjects

D L Loriaux

Publications and source records attributed to D L Loriaux.

At least 217 records · Page 12Linked to original sources
PubMed1984

The effects of temperature on the activity of testicular steroidogenic enzymes.

Decreased sperm counts and impaired sperm motility are present in a substantial proportion of men with varicocele. Elevations in the temperature of the affected testis, and increased spermatic vein estradiol (E2) concentrations have been found in some of these patients. To investigate the possibility that increases in temperature lead to a pattern of testicular steroidogenesis that results in increased E2 synthesis, we have examined the effects of temperature changes on the activities of four important testicular steroidogenic enzymes. 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD), 17-hydroxylase (17-OH), 17,20-desmolase (17,20-D) and aromatase activities were measured in the microsomal fraction of rat, pig and horse testes. Incubations were performed at 34 degrees C, 36 degrees C, and 38 degrees C. The activities of all 4 enzymes increased with each 2 degrees C temperature elevation in roughly proportional amounts. We conclude that minor elevations in incubation temperature are associated with increases in the in vitro activity of four key testicular steroidogenic enzymes.

Aldehyde-Lyases↗
PubMed1984

Caloric balance, brain to body ratio, and the timing of menarche.

Caloric availability regulates female reproductive function. Menses do not normally occur until the amount of stored fat is sufficient to meet the nutritional requirements of pregnancy. Unusual energy drains such as heavy exercise cause a reversible cessation of menses. The brain appears to monitor the balance between the availability of calories and their utilization, and reproduction is suppressed when the balance is unfavorable. We postulate that the juvenile human brain, with its unique metabolic requirements, constitutes an important energy drain in the premenarchal girl, and that caloric utilization by the brain may explain the delay of reproductive competence in man. It follows that the changing energy requirements of the brain relative to the body during normal premenarchal growth may play a key role in the timing of menarche. Pathological examples of altered brain to body ratios support this hypothesis: an increase of the brain to body ratio has been observed to delay menarche, a decrease of the brain to body ratio to advance menarche. We explore several clinical implications of this hypothesis and present suggestions for its experimental evaluation.

Adolescent↗
PubMed1984

Ocular findings in Turner syndrome. A prospective study.

We performed complete ophthalmological examinations of 30 consecutive patients with Turner syndrome. Twenty-three had 45XO and 7 had 45XO/46XX karyotypes (mosaicism). Non-familial strabismus was the most prominent ocular abnormality and was present in 33% of the patients. Other eye findings included ptosis (16%), hypertelorism (10%), epicanthus (10%), and antimongoloid slants (10%). Red-green color deficiency was found in 10% of the patients. One patient had congenital periodic alternating nystagmus.

Adolescent↗
PubMed1984

Effects of the luteinizing hormone-releasing hormone (LHRH) analog D-Trp6-Pro9-NEt-LHRH on the pituitary-gonadal axis of prepubertal rhesus monkeys.

To elucidate whether the luteinizing hormone-releasing hormone (LHRH) analog D-Trp6-Pro9-NEt-LHRH (LHRHa) decreases plasma testosterone levels in male primates solely by inhibiting gonadotropin secretion or, in addition, by inhibiting testicular testosterone biosynthesis, we have investigated the effects of this drug on 6 infant male rhesus monkeys. Three animals received LHRHa (12 micrograms . kg . day s.c., experimental group), and 3 animals received saline injections (control group) during the first 2 mo of life. Mean plasma testosterone was significantly lower in the experimental group compared to the control group (54 +/- 7 ng/dl vs. 501 +/- 52 ng/dl, P less than 0.001). The experimental group also had significantly lower mean follicle-stimulating hormone (FSH; 5.1 +/- 0.2 microgram/ml vs. 9.6 +/- 0.7 microgram/ml, P less than 0.001), and bioactive luteinizing hormone (LH; 2.0 +/- 0.08 microgram/ml vs. 3.5 +/- 0.2 microgram/ml, P less than 0.001). To study whether LHRHa influences testicular function directly, all animals were treated with human chorionic gonadotropin (hCG; 100 mIU . kg . day i.m.) for 28 days beginning at 8 mo of age. During Days 15 through 28 we administered LHRHa 12 micrograms . kg . day s.c. to the experimental animals and saline injections to the control group. Plasma testosterone increased to 5827 +/- 557 ng/dl in the experimental group and 4440 +/- 897 ng/dl in the control group after 14 days of hCG treatment. Plasma testosterone concentrations decreased in both groups of animals from Days 15 to 28 fo the study. All steroid intermediates were similar in both groups of animals on Days 14 and 28.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Petrosal sinus sampling for Cushing syndrome: anatomical and technical considerations. Work in progress.

ACTH-producing microadenomas of the pituitary gland drain unilaterally into the adjacent cavernous sinus; therefore, petrosal sinus sampling to distinguish pituitary from ectopic-ACTH syndromes must always be performed bilaterally. A negative finding from a unilateral petrosal sinus sample does not exclude the presence of a contralateral ACTH-producing microadenoma. Hemiresection of the pituitary gland based on results of bilateral sampling can be performed if the adenoma is too small to be recognized at surgery. Large pituitary adenomas produce elevated ACTH levels in the petrosal sinuses bilaterally. However, if plain radiographs or CT scans provide unequivocally positive findings in Cushing syndrome (less than 20%), inferior petrosal sinus sampling is not indicated.

Adenoma↗
PubMed1984

Psychiatric implications of basic and clinical studies with corticotropin-releasing factor.

Corticotropin-releasing factor (CRF) is a newly sequenced neuropeptide thought to be a principal stimulus to pituitary corticotropin (ACTH) secretion. Evidence obtained from laboratory animals and primates is reviewed which indicates that CRF not only stimulates the pituitary-adrenal axis but also influences several aspects of CNS function which may be of relevance to psychiatric illness. Clinically, experience in administering ovine CRF to more than 150 individuals shows that CRF can be helpful in resolving differential diagnostic dilemmas in patients with various disorders of the hypothalamic-pituitary-adrenal axis and in furthering an understanding of the pathophysiology of conditions such as Cushing's disease and depression.

Adrenocorticotropic Hormone↗
PubMed1984

Adaptation of the mineralocorticoid target tissues to the high circulating cortisol and progesterone plasma levels in the squirrel monkey.

Many New World primate species have elevated circulating free plasma cortisol concentrations, target tissue resistance to cortisol, and no evidence of sodium retention. A representative New World primate, the squirrel monkey (Saimiri sciureus), has plasma cortisol concentrations above those necessary to cause complete suppression of the renin-angiotensin-aldosterone axis in an Old World primate, the cynomolgus monkey (Macaca fascicularis). Despite this, the arterial blood pressure as well as the plasma sodium, potassium, and bicarbonate levels of the squirrel monkey are similar to those of the cynomolgus monkey, and its plasma aldosterone concentrations are approximately 2-fold higher. These findings suggest that cortisol has minimal sodium-retaining effects in this species. Renal cytosol aldosterone receptor concentrations are about 2- to 3-fold lower in the squirrel monkey than in the cynomolgus, whereas the receptor affinities for [3H]aldosterone are similar in the two monkeys. Higher concentrations of cortisol are needed to displace [3H]aldosterone from the mineralocorticoid receptor in the squirrel monkey than from the renal receptor in the cynomolgus [apparent equilibrium dissociation constant (Ki) = 7.8 X 10(-7) vs. 2.9 X 10(-8) M, respectively]. In addition, in contrast to man and presumably other Old World primates, plasma aldosterone concentrations in the female squirrel monkey do not increase during the reproductive cycle or pregnancy when progesterone concentrations are 10- to 20-fold higher than those of the male or the reproductively quiescent female. This suggests that progesterone is a poor aldosterone antagonist in this species. We conclude that a low concentration of mineralocorticoid receptors in New World Primates is compensated for by higher aldosterone levels, with a concomitant increase in receptor occupancy. The salt-retaining potency of cortisol is low, presumably because of a decrease in the affinity of the aldosterone receptor for glucocorticoids in New World primates.

Adrenal Cortex Hormones↗
PubMed1984

Plasma cortisol transport and primate evolution.

Primates have diverged into three major evolutionary groups: prosimians, Old World primates, and New World primates; the last group is distinguished by high circulating cortisol concentrations and resistance to the action of glucocorticoids. We have studied a large spectrum of primate species within these groups to characterize the phylogenetic relationships of cortisol-binding globulin (CBG) among them. The CBG in each species was found to be glycosylated, as judged from lectin interactions, and to exhibit an electrophoretic mobility similar to that of human CBG. Although the CBG affinity for cortisol differed among species, the effects of changes in temperature on the CBG affinity were similar. Strikingly, the CBG-binding capacity of plasma in the New World primates was 1/10th to 1/100th those in the Old World primates and prosimians, while the CBG-binding affinity for cortisol was lower. The reduced capacity and affinity of CBG result in a markedly higher fraction of unbound plasma cortisol in the New World primates than in the Old World primates or the prosimian species examined. This evolutionary pattern of CBG may be a compensatory mechanism for the target organ resistance to glucocorticoids that characterizes the New World monkeys.

Animals↗
PubMed1984

Corticotropin-releasing factor: pharmacokinetics in man.

Corticotropin-releasing factor (CRF), a 41-amino acid peptide isolated and sequenced from ovine hypothalami, has potential clinical application as a provocative test of the hypothalamic-pituitary-adrenal axis. To define its pharmacokinetic parameters in man, we measured the MCR and plasma half-life of immunoreactive CRF (IR-CRF) by the pulse injection and continuous infusion methods. Synthetic ovine CRF was given to 12 normal men as a bolus injection (1 microgram/kg; n = 6) or as a continuous infusion (0.51 +/- 0.05 micrograms/kg X h; n = 6) over 8 h. The disappearance curve of IR-CRF from plasma was biexponential. The plasma half-life of IR-CRF was 11.6 +/- 1.5 min (mean +/- SE) for the fast component and 73 +/- 8 min for the slow component. The MCR using the pulse injection technique was 95 +/- 11 liters/m2 X day, and the volume of distribution was 6.2 +/- 0.5 liters. Continuous infusion of CRF gave approximately the same MCR (88 +/- 7 liters/m2 X day). A small percentage of IR-CRF (approximately 0.03%) was found in the urine at the end of the continuous infusion. The relatively low MCR of CRF may explain its prolonged biological action in primates and man.

Adult↗
PubMed1984

Potency and specificity of a growth hormone-releasing factor in a primate and in vitro.

The potency and specificity of the 44-amino acid human pancreatic tumor GRF were tested in six adult female rhesus monkeys and in a perifusion system containing a suspension of rat pituicytes. In vivo, plasma GH levels were elevated in a dose-dependent fashion, with an ED50 of approximately 5 micrograms/kg, a value of the same order of magnitude as other hypothalamic releasing hormones. The magnitude of the GH response after GRF treatment was similar to that observed during insulin-induced hypoglycemia, with peak plasma GH concentrations occurring 5-15 min after GRF administration. High doses of GRF slightly stimulated PRL release, but had no effect on arterial blood pressure, heart rate, or plasma cortisol or glucose concentrations. In vitro, GRF released GH in a dose-dependent manner, but no PRL was released even at the highest GRF concentrations employed (100 nM). It thus appears that stimulation of PRL in vivo may be an indirect effect of GRF. Alternatively, there may be species differences in responsiveness to GRF.

Animals↗
PubMed1984

Isosexual precocious pseudopuberty secondary to a feminizing adrenal tumor.

We report a 2 10/12-yr-old girl with precocious pseudopuberty due to a feminizing adrenal carcinoma without Cushing's syndrome. The patient had marked elevation of plasma concentrations of the delta 5 adrenal steroids dehydroepiandosterone and dehydroepiandrosterone sulfate and increased levels of androstenedione, estrone, estradiol, and testosterone. Adrenal microsomal 3 beta-hydroxysteroid dehydrogenase-isomerase 17-hydroxylase, 17,20-desmolase, and 21-hydroxylase activities in the tumor and adjacent normal adrenal gland were measured. The tumor had approximately normal levels of 17-hydroxylase and 17,20-desmolase activity, with low levels of 21-hydroxylase and 3 beta-hydroxysteroid dehydrogenase-isomerase activities. This combination of enzyme activity may explain the absence of Cushing's syndrome and the high levels of delta 5 adrenal steroids. This patient demonstrates that adrenal neoplasms arising in girls may mimic isosexual true precocious puberty and should be included in the differential diagnosis of precocious puberty.

Adrenal Gland Neoplasms↗
PubMed1984

Uterine estrogen and progesterone receptors in an estrogen- and progesterone- "resistant" primate.

The squirrel monkey, a New World primate, has elevated plasma estradiol and progesterone concentrations compared to those in the cynomolgus macaque, an Old World primate. We previously reported that uterine progesterone receptor concentrations examined in ovariectomized squirrel monkeys 2 days after estrogen treatment were about one eighth those in identically treated cynomolgus macaques. To examine this in greater detail, we gave estradiol (10 micrograms/kg X day) to ovariectomized squirrel and cynomolgus monkeys for various lengths of time (0, 2, 4, 7, and 14 days), followed by measurement of uterine estrogen and progesterone receptors and assessment of endometrial histology (including glycogen and peroxidase strains), vaginal histology, and cytology. Endometrial and vaginal morphologies showed adequate estrogen effects, as did glycogen and peroxidase stains. Two days of treatment were sufficient to induce both estrogen and progesterone receptors to maximal binding of [3H]moxestrol and [3H]R5020, respectively, in both species. Squirrel monkeys had about one third and one eighth the estrogen and progesterone uterine receptor concentrations, respectively, of cynomolgus monkeys. Receptor affinities in both species were similar. Neither [3H]moxestrol nor [3H]R5020 bound to uterine cytosols from untreated monkeys. We conclude that the increased plasma concentrations of estradiol and progesterone in the squirrel monkey compensate for the decreased estrogen and progesterone receptors in this species.

Animals↗
PubMed1984

The effects of sex steroids on ulnar growth during adolescence.

To investigate the relative effects of androgens and estrogens on long bone growth, we evaluated the 3-week ulnar growth velocities of 10 boys before and after the iv administration of testosterone (T; 15 mg/day), dihydrotestosterone (DHT; 7 mg/day), and estradiol (E2; 90 micrograms/day) for 4 days. Ulnar growth is a sensitive index of short term growth in children. Mean 3-week ulnar growth velocities increased from 0.49 +/- 0.11 (+/- SEM) to 1.09 +/- 0.14 mm/3 weeks after the T infusion (P less than 0.005), from 0.42 +/- 0.09 to 0.84 +/- 0.13 mm/3 weeks after the DHT infusion (P less than 0.02), and from 0.67 +/- 0.07 to 0.96 +/- 0.26 mm/3 weeks after the E2 infusion (P = NS). The mean T level was 2555 +/- 234 ng/dl during the T infusion. Mean E2 levels were 53 +/- 4 pg/ml during the T infusion and 102 +/- 7 pg/ml during the E2 infusion. Mean DHT levels were 73 +/- 7 ng/dl during the T infusion and 1115 +/- 124 ng/dl during the DHT infusion. Mean somatomedin-C levels increased to a similar degree during all infusions, but were significantly higher only during the E2 infusion (P less than 0.01). We conclude that T and DHT given for 4 days stimulated ulnar growth, while E2 at concentrations greater than those derived from T did not cause a significant increase in ulnar growth. None of the ulnar growth rates after T, DHT, or E2 treatment, however, differed significantly.

Adolescent↗
PubMed1984

True precocious puberty complicating congenital adrenal hyperplasia: treatment with a luteinizing hormone-releasing hormone analog.

Congenital adrenal hyperplasia (CAH) is a recognized cause of precocious pseudopuberty. Some children with CAH also develop true precocious puberty with early maturation of the hypothalamic-pituitary-gonadal axis. We have seen four such children (three boys and one girl) who had the diagnosis of CAH made between the ages of 3 and 6 yr. These patients were treated with standard doses of hydrocortisone and fludrocortisone. A diagnosis of true precocious puberty was made because of testicular enlargement in the boys, breast development in the girl, progressive pubic hair development, rapid growth, and rapid bone age maturation. Plasma steroid levels were elevated for age, and gonadotropin levels were within the normal pubertal range, both basally and in response to LHRH stimulation. We treated these children with daily sc injections of a LHRH analog (LHRHa) for 6-18 months in addition to the standard hydrocortisone and fludrocortisone therapy for CAH. LHRHa significantly decreased basal plasma LH and FSH, peak LH and FSH responses to native LHRH, and testosterone levels. Testis size decreased in the males, and breast development regressed in the female. LHRHa therapy led to significant decreases in linear growth rate, ulnar growth rate, and rate of bone age advancement. These results suggest that LHRHa is an effective adjunct to hydrocortisone and fludrocortisone in the treatment of true precocious puberty complicating CAH.

Adrenal Hyperplasia, Congenital↗
PubMed1984

The corticotropin-releasing hormone stimulation test: a possible aid in the evaluation of patients with adrenal insufficiency.

Ten patients with adrenal insufficiency receiving chronic glucocorticoid therapy were studied. All had subnormal plasma cortisol responses to ovine corticotropin-releasing hormone ( CRH ) (1 microgram/kg as an iv bolus) 12-60 h after discontinuation of steroid treatment. Plasma ACTH responses to CRH fell into three different patterns. The first three patients with primary adrenal insufficiency had high basal ACTH levels and augmented ACTH responses to CRH . A fourth such patient, however, treated with pharmacologic doses of prednisone, had a low normal ACTH response. Patients with secondary adrenal insufficiency had either low basal ACTH levels and diminished responses to CRH or low basal ACTH values but prolonged and augmented plasma ACTH responses to CRH with a delayed peak. We postulate that the group of patients with the former pattern have pituitary gland destruction whereas the patients with the latter pattern have hypothalamic CRH deficiency. Thus, CRH may be useful in differentiating between hypothalamic and pituitary causes of adrenal insufficiency.

Adolescent↗
PubMed1984

Absence of pubertal gonadotropin secretion in girls with McCune-Albright syndrome.

Precocious puberty in girls with McCune-Albright syndrome has been attributed in some cases to early activation of the hypothalamic-pituitary-gonadal axis and in other cases to sex steroid secretion by apparently autonomous ovarian cysts. We evaluated serum gonadotropins and sex steroids in six girls (aged 1-9 yr) with McCune-Albright syndrome. The children had Tanner stage II-IV pubertal development. In five patients, nocturnal gonadotropin concentrations and the gonadotropin response to LHRH were within the normal range for prepubertal children. Thus, the precocious puberty in these patients could not be explained by activation of the hypothalamic-pituitary-ovarian axis. One child had high amplitude nocturnal pulses of serum LH and a LH-predominant response to LHRH. She was the oldest of the six girls and had a bone age of 13.5 yr which is within the range in which hypothalamic-pituitary-ovarian activation normally occurs. The children all had ovarian enlargement and ovarian cysts determined by ultrasound. It appears that precocious puberty in McCune-Albright syndrome may result from ovarian estrogen secretion in the absence of normal pubertal activation of the hypothalamic-pituitary-ovarian axis.

Adolescent↗
PubMed1984

Dissociation of cortisol and adrenal androgen secretion in the hypophysectomized, adrenocorticotropin-replaced chimpanzee.

We tested the hypothesis that adrenal androgen production is supported by a pituitary factor distinct from ACTH. Six adult male chimpanzees who had completed adrenal maturation (adrenarche) were castrated and either hypophysectomized or sham hypophysectomized. Hypophysectomized animals received synthetic ACTH-(1-24) and T4 to prevent adrenal insufficiency and hypothyroidism. Adrenal function was evaluated with a 3-h ACTH infusion before and 7, 21, 40, 120, and 180 days after hypophysectomy. Plasma cortisol (F), dehydroepiandrosterone (DHA), DHA sulfate (DHAS), and androstenedione (delta 4A) were measured at six time points during the ACTH infusions. The mean ratios of DHA to F, DHAS to F and delta 4A to F during ACTH infusion were calculated as indices of the relative activity of the androgen pathway compared to that of the cortisol pathway. The DHA to F ratio during ACTH infusion was 31% of the pretreatment level 40 days after hypophysectomy (P less than 0.01 compared to the sham-hypophysectomized controls). The DHAS to F ratio during ACTH infusion, which paralleled the DHA to F ratio, also fell significantly (P less than 0.025). Hypophysectomy did not alter the delta 4A to F ratio. None of the ratios was altered by sham hypophysectomy. MCRs for F and DHA, which were measured before and 180 days after hypophysectomy or sham hypophysectomy, did not change significantly. Additionally, plasma corticosteroid-binding globulin levels remained unchanged throughout the study for both groups of chimpanzees. Thus, the changes in the DHA to F ratio cannot be explained by alterations in the MCRs of DHA or F or in the plasma transport protein for F. These data suggest that ACTH maintained normal F and delta 4A secretion after hypophysectomy but failed to maintain normal DHA and DHAS secretion. This is consistent with the hypothesis that normal delta 5-adrenal androgen secretion is dependent upon a non-ACTH pituitary factor or with the hypothesis of different ACTH requirements for the maintenance of F and delta 5-adrenal androgen secretion.

Adrenal Cortex↗