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Biomedical subjects

D Vanderschueren

Publications and source records attributed to D Vanderschueren.

At least 55 records · Page 3Linked to original sources
PubMed1996

Pregnancy after electroejaculation in combination with intracytoplasmic sperm injection in a patient with idiopathic anejaculation.

OBJECTIVE: To assess the possibility of achieving a pregnancy in the wife of a patient suffering from idiopathic anejaculation who failed to respond to therapeutical modalities such as psychotherapy, sex therapy, and vibrostimulation. DESIGN: Case report. SETTING: The IVF program at the Leuven University Fertility Centre. PATIENT(S): A patient suffering from idiopathic anejaculation. INTERVENTION(S): Intracytoplasmic sperm injection (ICSI) in combination with electroejaculation. MEAN OUTCOME MEASURE(S): Fertility rate, cleavage rate, clinical pregnancy. RESULT(S): Two IVF procedures were performed of which the second resulted in an ongoing pregnancy and the delivery of a healthy boy. CONCLUSION(S): Electroejaculation may offer fertility chances in a patient suffering from idiopathic anejaculation resistant to conventional treatment modalities. When sperm quality shows very low motility, ICSI should be offered to improve pregnancy chances.

Ejaculation↗
PubMed1995

Androgens and bone.

Androgen receptors are present at low densities in osteoblasts. Androgens are also metabolized in bone. (Non)aromatizable androgens probably induce proliferation of osteoblasts and differentiation. A direct effect of androgens on osteoclasts has not been demonstrated. Androgens may however inhibit bone resorption indirectly, by an inhibition of the recruitment of osteoclast precursors from bone marrow, by decreased secretion of interleukin-6 and/or prostaglandin E2, and/or by an increased sensitivity of marrow cells or osteoblasts for bone resorption stimulating factors such as PTH. The recent demonstration of androgen receptors in bone marrow stromal and osteoclast-like cells opens new perspectives in this respect. During puberty, androgens stimulate bone growth both directly and indirectly. Observations in androgen-resistant animals clearly demonstrated that the sexual dimorphism of bone depends on the presence of a functional androgen receptor. Optimal peak bone mass seems related to an appropriately timed androgen secretion. In adults, androgens are also involved in maintenance of the male skeleton. Androgen replacement may prevent further bone loss in hypogonadal men, however, it seems difficult to fully correct bone mass in these men.

Androgens↗
PubMed1995

The effects of stress and coping upon the diagnostic intracavernous injection in men with erectile dysfunction.

The diagnostic intracavernous injection (ICI) can be considered to be a stressful situation because it may exacerbate worries about the 'sexual' function and because it is an invasive procedure. The individual's primary appraisal (harm or pain caused by the injection, performance anxiety, fear of success as well as fear of failure) and his secondary appraisal (general coping style as well as the (in)effectiveness of this function) could influence the ICI. Therefore, coping style and anxiety levels were assessed in men with erectile dysfunction. These psychometric characteristics were correlated with the subsequent ICI with prostaglandin E1 (PGE1): the individual's anxiety level does not, but the coping style does explain a significant part of the variation in ICI response. Indeed, avoidance and palliative coping have a negative impact on the penile response following ICI. The present study suggests that coping style should be included in further psychophysiological studies of the ICI response.

Adaptation, Psychological↗
PubMed1995

A study in patients with erectile dysfunction comparing different formulations of prostaglandin E1. Alprostadil Study Group.

PURPOSE: Prostaglandin E1 sterile powder and sterile solution are 2 new formulations of exogenous prostaglandin E1 that are more convenient for auto-injection therapy for erectile dysfunction than the presently used pediatric sterile solution. Therefore, the pharmacodynamic profiles of intracavernous prostaglandin E1 sterile powder and nonalcohol sterile solution were compared with the pediatric sterile solution in men with erectile dysfunction who were known to be stable responders to intracavernous prostaglandin E1. MATERIALS AND METHODS: Based on the dose used at home, patients were randomized to 1 of 5 dose groups: 0 microgram. (placebo), 2.5 micrograms., 5 micrograms., 10 micrograms. or 20 micrograms. Each patient received a single injection of the same dose of each of the 3 formulations. The primary pharmacodynamic end points were clinical evaluation of erectile response, RigiScan real-time evaluation of erectile response and patient evaluation of erectile response. RESULTS: No significant differences were identified among the formulations for any of these end points, either by comparison among all active doses or by comparison at each prostaglandin E1 dose level. There was also little or no intra-patient variation in dose response and the inter-dose variation in response between patients was not significant. Pharmacodynamic end points were well intercorrelated, although assessment of erectile response by the patients tended to be more positive than that by RigiScan or clinical evaluation. There were no major side effects. Penile pain on injection and/or during erection occurred in 9 to 17% of the patients according to the formulations. However, penile pain was also reported by 11% of the placebo-treated patients. CONCLUSIONS;: The 3 formulations of prostaglandin E1 showed equivalence and were safe for the treatment of erectile dysfunction with respect to side effects.

Alprostadil↗
PubMed1994

Androgen resistance and deficiency have different effects on the growing skeleton of the rat.

Mature male, female, and androgen-resistant testicular feminized (Tfm) male rats of the same strain were sacrificed at the age of 120 days. Young male and Tfm rats were orchidectomized (orch) at 1 month of age and sacrificed at 120 days. The right femora were dissected, cleaned, defatted, and scanned with the Hologic QDR-1000. Orch and Tfm rats had similar body weights that were intermediate between body weights of their normal male and female littermates. Serum IGF-I concentrations were lowest in Tfm rats; IGF-1 concentrations in orch rats were not lower than in males. Dual-energy X-ray absorptiometry yielded the following results: Total femoral mass and area were lower in female, Tfm rats and in both orch groups compared with intact male rats. Femoral bone density was, however, only decreased in orch rats. Bone density measured in an area containing only cortical bone was not different between groups. However, the density was lower in orch rats in an area containing both cancellous and cortical bone. This finding is consistent with a +/- 50% decrease of cancellous bone volume in orch rats compared with all other groups at the proximal tibial metaphysis (an area containing mainly cancellous bone). These data show that Tfm rats, despite having lower IGF-I levels in serum, low body weight, and decreased femoral areas, manage--in contrast with orchidectomized rats--to maintain similar trabecular bone densities and volumes during growth. We conclude that trabecular bone densities can be preserved in androgen-resistant male rats independent of bone or body growth velocity or IGF-I secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1994

Cauda equina syndrome complicating ankylosing spondylitis: role of computed tomography and magnetic resonance imaging.

We present two cases of cauda equina syndrome in ankylosing spondylitis. Cauda equina syndrome is a rare complication of ankylosing spondylitis, the pathogenesis of which is not well understood. The onset is insidious with pain and sensory symptoms; sphincter disturbances are common. After a period of increasing neurological symptoms, the condition tends to stabilize. The degree of nerve involvement is variable and can be accurately defined by electromyography. The diagnosis has to be confirmed by computed tomography (CT) or magnetic resonance imaging (MRI); myelography must be avoided. There is no specific treatment, except for pain control. The different clinical presentations and the role of new imaging techniques, CT and MRI, are demonstrated.

Cauda Equina↗
PubMed1994

Time-related increase of biochemical markers of bone turnover in androgen-deficient male rats.

Bone loss during androgen deficiency has been associated with accelerated bone turnover and imbalance between bone formation and resorption but the relative increase of both phenomena is not well described. Serum osteocalcin as marker of bone formation and urinary excretion of pyridinoline (PYD) and deoxypyridinoline (DPD) as markers of bone resorption were measured in both orchidectomized (ORCH, n = 8) and sham-operated (SHAM, n = 8) aged (12-month-old) male rats from 2 days before until 66 days after surgery. PYD and DPD were significantly higher in the ORCH group compared to the SHAM group starting from 21 days after surgery until the end of the experiment. Serum osteocalcin was only significantly increased in the ORCH group at 30 and 40 days. The maximal increase of serum osteocalcin was also smaller than the increase in PYD and DPD (30% versus 74% and 112%, respectively). The two markers of bone resorption were correlated with osteocalcin (r = 0.63 for PYD and r = 0.71 for DPD). Based on these results, we conclude that (1) bone resorption, as measured by PYD and DPD, increased during androgen deficiency; (2) moreover, the increase of bone resorption, as measured by DPD and PYD, was followed by a more moderate increase in bone formation as measured by serum osteocalcin, supporting the hypothesis that androgen deficiency causes accelerated bone turnover and imbalance between bone resorption and bone formation.

Amino Acids↗
PubMed1993

Bone and mineral metabolism in the androgen-resistant (testicular feminized) male rat.

Androgens have important effects on bone in vivo, possibly by direct activation of the androgen receptors in osteoblasts. To test this hypothesis, calcium homeostasis, bone mass, and bone turnover were evaluated in mature (4-month-old) androgen-resistant (testicular feminized, TFM) male rats. Data were compared with data from both female and male littermates of the same age and strain. Compared to normal males, TFM had similar serum testosterone, twofold higher estradiol and estrone, and sixfold higher androstenedione concentrations. Compared to normal females, TFM rats showed lower estradiol but also elevated concentrations of androstenedione and estrone. Despite similar free 1,25-(OH)2D3 concentrations, both TFM and male rats maintained higher serum calcium and phosphate concentrations than their female littermates. Serum IGF-I concentrations in TFM rats were decreased compared to male rats (-12%) or female rats (-27%). Serum osteocalcin concentrations, however, were twofold higher in TFM rats than in females but not significantly different from males. Femoral length, diameter, and cortical thickness were intermediate between those of males and females. The cancellous bone density of the femur and cancellous bone volume of the proximal metaphysis of the tibia, however, were not significantly different between groups. The ash weight of the tibia was also not significantly different, and the ash weight of the four distal lumbar vertebrae ranged between male and female values. Bone mechanical properties as measured by torsional strength and energy absorption of the femur were lower in TFM than in females but not different from males.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgen-Insensitivity Syndrome↗
PubMed1993

The aged male rat as a model for human osteoporosis: evaluation by nondestructive measurements and biomechanical testing.

Effects of androgen deficiency and androgen replacement on bone density, as measured with dual-energy X-ray absorptiometry (DXA) and single photon absorptiometry (SPA), cortical ratio (cortical thickness/outside bone diameter x 100), and biomechanical properties were evaluated in 14-month-old (1 month after orchiectomy (orch) or sham-operation) and in 17-month-old (4 months after orch or sham) male rats. Whole femoral bone mineral content (BMC) and density (BMD) measured with DXA were not significantly decreased 1 month after orch. Whole femoral BMC and BMD were 10% and 8% lower in 4 months after orch (P < 0.01 and P < 0.001, respectively). This decrease was prevented by testosterone replacement. There was an excellent correlation (R = 0.99) between whole femoral BMC and femoral ash weight. Selective scanning of cortical and cancellous sites of the femur showed that both cancellous and cortical BMC and BMD were significantly decreased 4 months after orch. SPA of the right tibia confirmed a 7% decrease in cancellous BMC and BMD 4 months after orch (preventable by testosterone) but not in cortical BMD and BMC. Femoral cortical ratio decreased with age (47 +/- 2 in 14-month-old and 40 +/- 2 in 17-month-old sham rats versus 63 +/- 1 in 6-month-old male rats) due to a continuously enlarging femoral shaft. Androgen deficiency resulted in an even greater decrease of the cortical ratio 4 months after orch (36 +/- 2 in 17-month-old orch rats) that was again prevented by testosterone (47 +/- 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1993

Effects of sex steroids on hepatic and lipoprotein lipase activity and mRNA in the rat.

In humans, sex steroids have been implicated in the regulation of hepatic and lipoprotein lipase activity. Therefore, the effects of orchidectomy and subsequent androgen or estrogen administration on hepatic lipase (HL) and adipose tissue and heart lipoprotein lipase (LPL) were examined. Relative to intact controls, orchidectomy of male rats resulted in no significant change in HL activity and mRNA, or in heart and adipose tissue LPL activity and mRNA levels. Subsequently, a subcutaneous silastic tubing, delivering either testosterone, dihydrotestosterone, nandrolone, or 17 beta-estradiol, was implanted for 5 weeks. All substitution treatments had a tendency to reduce HL activity and to induce HL mRNA levels. This effect was, however, only significant for testosterone which resulted in a decrease in HL activity (238 +/- 15 vs. 328 +/- 31 mU/g tissue; p vs. control < 0.05) and an increase in HL mRNA (166 +/- 11 vs. 100 RAU; p vs. control < 0.01). No significant effects of androgens on LPL expression either in heart or adipose tissue were observed. Adipose tissue LPL activity (20 +/- vs. 35 +/- 4 mU/g; p vs. control < 0.05) and mRNA (28 +/- 4 vs. 100 RAU; p vs. control < 0.001) levels, but not heart LPL, however, were diminished substantially after 17 alpha-estradiol treatment. In conclusion, rat HL is influenced by testosterone, while adipose tissue, but not heart LPL, is reduced after estrogen administration.

Adipose Tissue↗
PubMed1992

Bone and mineral metabolism in the adult guinea pig: long-term effects of estrogen and androgen deficiency.

The effects of androgen and estrogen deficiency on skeletal homeostasis were studied in the guinea pig. Male and female adult (7 months old) guinea pigs were either sham operated (9 females and 7 males) or gonadectomized [9 ovariectomized (OVX) females and 6 orchidectomized (ORX) males] and sacrificed 4 months later for evaluation of bone mass, bone turnover, and serum calcium homeostasis. Parameters of bone turnover, calcium homeostasis, and vitamin D metabolites were similar in all groups except for increased serum IGF-I concentrations (+30%) in males compared to females. Gonadectomy resulted in a 50% decrease in serum IGF-I concentrations in males only (p < 0.001). Volume, total calcium content, and cortical density of the tibia were significant higher in males than in females. Estrogen deficiency had no effect on bone volume or calcium content. Androgen deficiency resulted in a significant lower volume and calcium content of the tibia and in a lower calcium content of the distal lumbar vertebrae. Single-photon absorptiometry of the tibia showed that only cortical, not trabecular bone density of the tibia was decreased after ORX. Histomorphometric studies of the tibial metaphysis also did not show significant differences in trabecular bone volume between sham-operated and ORX males. We conclude that in adult male guinea pigs androgen deficiency results in a decrease in (cortical) bone volume and content concomitant with decreased IGF-I levels. In female guinea pigs of the same age, estrogen deficiency did not affect total or regional bone mass.

Absorptiometry, Photon↗
PubMed1992

Bone and mineral metabolism in aged male rats: short and long term effects of androgen deficiency.

Both short and long term effects of androgen deficiency and steroid replacement therapy on skeletal homeostasis were investigated in aged (13-month-old) male rats. The animals were either sham operated (n = 28) or orchidectomized (orch; n = 89). The orch animals were divided into 5 groups; 26 rats received an empty sc Silastic implant (orch), all others received an implant containing testosterone (T), 5 alpha-dihydrotestosterone (DHT), 17 beta-estradiol (E2), or nandrolone (Nandro; 15-16 rats in each group). Half of the rats were killed 1 month (short term experiment) after implantation; the others were killed 4 months after implantation (long term experiment). Short term androgen deficiency caused a significant increase in both serum osteocalcin and histomorphometric parameters of bone turnover measured at the proximal tibial metaphysis, but not in a significant decrease in bone mass at this site. This increase in bone turnover was prevented not only by T and DHT, but also by E2 and Nandro. Long term androgen deficiency resulted in a decrease in the calcium content of both tibia and lumbar vertebrae. Cancellous bone volume in the proximal tibial metaphysis was +/- 50% lower in the orch group (P less than 0.001) 4 months after orchidectomy. At the same time, cortical bone was lost in orch rats; femoral cortical thickness was reduced by 12% (P less than 0.01), and cortical density tended to be lower. T, DHT, E2, or Nandro treatment completely prevented this decrease in cortical thickness and density. T and Nandro were also able to prevent the cancellous bone loss. DHT could only partly prevent cancellous bone loss. E2 treatment resulted not only in a sustained decrease in both serum osteocalcin concentrations and histomorphometric indices of bone turnover, but also in a net gain of cancellous bone volume (P less than 0.05 vs. sham). No significant differences in serum concentrations of vitamin D metabolites or nephrogenous cAMP were observed between groups in both short and long term experiments. We conclude that bone mass in aged male rats was significantly decreased 4 months after orchidectomy, preceded by an early increase in bone turnover. Both the early increase in bone turnover and the later decrease in bone mass were prevented by aromatizable and nonaromatizable androgens by estrogen and by nandralone.

Aging↗
PubMed1992

Homologous radioimmunoassay of human osteocalcin.

Osteocalcin or bone gamma-glutamic acid-containing protein (GLA protein) was isolated from human bone and used to develop a homologous radioimmunoassay of human osteocalcin. The effect of age on serum osteocalcin was studied in 380 normal children and adolescents and 330 normal adults. The mean (+/- SD) values in adults were higher in men [25 +/- 5 micrograms/L (4.3 +/- 0.8 nmol/L)] than in premenopausal women [20 +/- 6 micrograms/L (3.4 +/- 1.0 nmol/L); P < 0.01], but both were lower than in postmenopausal women [29 +/- 2 micrograms/L (5.0 nmol/L)]. The highest concentrations were seen in girls [ages 10-12 years: 99 +/- 38 micrograms/L (17.0 nmol/L)] and boys [ages 14-16 years: 107 +/- 57 micrograms/L (18.4 nmol/L)]. These mean values were substantially higher than those previously reported for results of heterologous osteocalcin radioimmunoassays but the correlation (r = 0.87, n = 77, P < 0.001) between both sets of results was excellent. In patients with metabolic bone diseases characterized by high or low bone turnover, the increase or decrease in serum osteocalcin observed was as expected. This homologous radioimmunoassay of human osteocalcin thus reflects bone turnover but reports serum concentrations higher than previously suspected.

Adolescent↗
PubMed1991

Short-term course of 1,25(OH)2D3 stimulates osteoblasts but not osteoclasts in osteoporosis and osteoarthritis.

We investigated the effect of short-term, 1,25-dihydroxyvitamin D3 therapy (4 micrograms/day for 4 days) on calcium metabolism in 27 postmenopausal women (11 cases with osteoporosis and 16 cases with osteoarthritis). Bone mass at the axial and appendicular skeleton was higher in osteoarthritis than in osteoporosis. Initial values of calcium metabolism were similar. Osteoporotic and osteoarthritic patients responded with a similar significant increase in serum osteocalcin (+61% and +54%, respectively), fasting urinary calcium excretion (+178% and +124%, respectively) and 24 hour calcium excretion (+148% and +142%, respectively). Parathyroid hormone (PTH) levels decreased significantly in both groups (-30% and -18%, respectively). Osteoclastic bone resorption, evaluated by urinary hydroxyproline excretion, was not stimulated in either group. We conclude that in osteoporosis and also in osteoarthritis (1) 1,25-dihydroxy-vitamin D3 (1,25(OH)2D3) stimulation of osteoblast function is similar in production of osteocalcin; (2) the vitamin D target tissues react adequately to 1,25(OH)2D3 stimulation; (3) short-term high dose of 1,25(OH)2D3 does not stimulate bone resorption; and (4) the differences in bone mass between osteoarthritis and osteoporosis are not related to an alteration of the responsiveness to stimulation by 1,25 (OH)2D3.

Aged↗
PubMed1991

Seasonal variation in bone metabolism in young healthy subjects.

Serum vitamin D metabolites and urinary calcium excretion; parameters of bone formation (serum alkaline phosphatase, serum osteocalcin); parameters of bone resorption (24 hour hydroxyprolinuria, 2 hour fasting urinary hydroxyproline/creatinine ratio); and parameters of cortical and trabecular bone density, parathyroid hormone (iPTH, COOH terminal assay), and serum minerals (calcium, phosphorus) were followed serially in 55 young adults (21 women and 34 men) from December 1985 until January 1987 at four different times during the year. The effect of a low-dose cyclooxygenase inhibitor (piroxicam 5 mg daily) on the same parameters of bone density and bone turnover when given from December until May, was also evaluated in this study. At the end of the treatment period parameters of bone turnover and bone density were comparable between placebo and piroxicam-treated groups. Therefore, the results of all subjects were pooled in order to investigate seasonal variation. In both sexes, seasonal variation was found not only for 250HD3 but also for 1,25(OH)2D3, serum calcium and phosphorus, urinary calcium excretion, and for bone density at the lumbar spine. Parameters of bone formation (serum osteocalcin and alkaline phosphatase), bone resorption (24 hour urinary hydroxyprolinuria and fasting urinary hydroxyproline/creatinine ratio) and PTH were influenced by this seasonal variation. We conclude that in young adults, a significant seasonal variation occurs, with low winter and high summer values, for serum 25 and 1,25(OH)2D3 for urinary calcium apparently without important influence on parameters of bone turnover or parathyroid activity and for lumbar spine density. Treatment with a low-dose cyclooxygenase inhibitor was without influence on the observed changes.

Adult↗
PubMed1991

1,25-Dihydroxyvitamin D3 stimulation test and the effect of a prostaglandin synthesis inhibitor (piroxicam) in young adults.

This study was performed to assess whether the 1,25(OH)2 vitamin D3 stimulation test for osteoblastic function is influenced by a prostaglandin synthesis inhibitor (piroxicam). Thirty-four healthy male young adults had a 1,25(OH)2 vitamin D3 (Rocaltrol) stimulation test. After a baseline day, the subjects received 2 micrograms Rocaltrol every 12 h for 4 days. Serum and urinary parameters of bone turnover were assessed before and after stimulation. The subjects were randomly allocated to placebo or piroxicam 5-, 10- and 20-mg treatment groups. After stimulation, serum and urinary calcium increased significantly, and immunoreactive PTH decreased significantly in the control group. In the piroxicam group, serum calcium, phosphate, osteocalcin and urinary calcium increased significantly, and PTH and glycosaminoglycan excretion significantly decreased. The piroxicam treatment group did not differ from controls, except for a nonsignificant minor increase in serum calcium and phosphorus after calcitriol stimulation. Since the major effect of nonsteroidal anti-inflammatory drugs is to decrease prostaglandin synthesis, these data suggest that prostaglandins do not mediate the effects of calcitriol on bone and other target tissues, because no alteration in intestinal calcium absorption, calcium-phosphorus-PTH interaction, bone turnover and renal handling of calcium and phosphorus in normal subjects was found.

Adult↗
PubMed1990

Sex- and age-related changes in bone and serum osteocalcin.

We measured bone osteocalcin concentrations in EDTA extracts from iliac crest cortical bone specimens obtained postmortem from 63 men and 71 women (age range 19-90 years), and serum osteocalcin levels in healthy blood donors, 49 men and 49 women (age range 21-65 years). Bone and serum osteocalcin concentrations were higher in men than in women, and an age-related decline was observed in both sexes. In women, however, a temporary increase in serum (P less than 0.05) osteocalcin was seen in the sixth decade. This study shows sex- and age-related changes in bone osteocalcin consistent with changes in serum osteocalcin, confirming that serum measurement of osteocalcin reflects bone levels. As osteocalcin reflects osteoblastic activity and thus bone formation, the overall decline in bone and serum osteocalcin in men and women, and the increase in serum osteocalcin in the sixth decade in women, indicate that aging is associated with a decrease in bone formation and turnover and that osteoblastic activity and bone turnover are stimulated at the menopause.

Adult↗