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Biomedical subjects

H E Kulin

Publications and source records attributed to H E Kulin.

At least 73 records · Page 4Linked to original sources

Spironolactone stimulation of gonadotropin secretion in boys with delayed adolescence.

Spironolactone (Aldactone) acts as an antiandrogen by blocking testosterone synthesis and competing with testosterone for the androgen receptor. These properties of the mineralcorticoid antagonist were used in an attempt to interrupt the gonadal-pituitary-hypothalamic negative feedback axis and thereby stimulate LH and FSH in 7 boys with delayed puberty. Following administration of aldactone (5 mg/kg) daily for one week, there was a significant (P less than .01) mean increase in serum LH of 60%. In all 7 boys an absolute rise in LH was observed, but these changes were statistically significant in only 5 individuals. While mean FSH levels increased by 60% in this group of boys, the individual responses were variable. No rise in gonadotropin levels occurred in 2 patients with Kallmann's syndrome, who also received 5 mg/kg of spironolactone daily for 1 week. Large doses of the drug appeared necessary to stimulate gonadotropin secretion since a dose of 3 mg/kg per day did not cause LH or FSH increments in 2 additional patients with delayed puberty. Progesterone and 17alpha-hydeoxyprogesterone levels increased to a greater extent than LH and FSH in response to spironolactone, reflecting either adrenal or testicular enzyme inhibition. Spiornolactone is the first drug shown to be capable of stimulating gonadotropin secretion by interrupting negative feedback inhibition in boys with delayed puberty.

Adolescent↗

Plasma testosterone response to short-term human chorionic gonadotropin administration in men with follicle-stimulating hormone suppressed by exogenous estrogen.

In order to investigate the role of FSH in Leydig cell function, six men were given four daily injections of HCG (4,000 IU) while receiving oral ethinyl estradiol. The peak testosterone levels in these subjects were contrasted to the results obtained in seven men who received HCG without additional exogenous steroid treatment. Urinary and plasma FSH was suppressed to 26% and 50%, respectively, of basal values by the estrogen treatment. Peak plasma testosterone determinations following HCG did not differ in the two groups of subjects. Additionally, an early pubertal boy had a normal HCG-induced testosterone rise while his urinary FSH was suppressed by estradiol to lower than prepubertal levels. The data indicate the short-term FSH suppression does not alter testicular responsivity to short-term HCG administration. A role for FSH in Leydig cell testosterone production in men has yet to be demonstrated.

Administration, Oral↗

Integration of pulsatile gonadotropin secretion by timed urinary measurements: an accurate and sensitive 3-hour test.

The integration of pulsatile gonadotropin secretion by the radioimmunoassay of an acetone precipitation from a short-term urine sample was evaluated. FSH and LH excretion over a 3-h period was compared to the mean level of 10 blood samples obtained every 20 min for a similar time period from 71 patients. A highly significant correlation existed between blood and urine results. In addition, the gonadotropin levels obtained from a 3-h sample correlated well with the 24 h excretion of FSH and LH from the same individual. A 3-h urine collection can provide a simple, sensititve, and accurate means of assessing circulating FSH and LH levels.

Adolescent↗

Changing sensitivity of the pubertal gonadal hypothalamic feedback mechanism in man.

Clomiphene citrate in doses which stimulate gonadotropin production in the adult suppresses urinary follicle stimulating hormone (FSH) excretion and plasma testosterone concentration in prepubertal children. Such results indicate that feedback between gonad and hypothalamus is operative and highly sensitive in prepubertal humans. Puberty in man, as in the rat, is accompanied by a decrease in the sensitivity of the feedback mechanism.

Adolescent↗