C19O2-Steroid transformations in the human normal, hyperplastic and cancerous prostate.
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Biomedical subjects
Publications and source records attributed to J F Charles.
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Perineal punch biopsy specimens of human prostate with benign hyperplasia (BPH), well- and poorly-differentiated adenocarcinoma and transitional-cell carcinoma were incubated with testosterone-1,2-3H and 5alpha-dihydrotestosterone-1,2-3H. Incubations were carried out using a single tissue-radiosubstrate ratio and time point. Resulting radiosteroid patterns were related to histologic and ultrastructural features of these tissues. Well differentiated neoplasms had ultrastructural characteristics closely resembling hyperplastic epithelia. Both in BPH and in well differentiated carcinomas the C19-steroids were mainly metabolized by the 17beta-hydroxysteroid pathway. In contrast, cells in poorly-differentiated adenocarcinoma and transitional-cell carcinoma lacked the cytoplasmic organelles responsible for secretion; formation of 5alpha-reduced 17beta-hydroxysteroids was decreased in these carcinomas, while conversion to 17-oxosteroid radiometabolites remained unchanged or was greatly increased. These results indicate that loss of prostatic differentiation is attended by a trend from reductive toward oxidative radiotestosterone metabolism. Even in NAPDH-supplemented preparations of the majority of poorly-differentiated tumors, there was diminished transformation to 5alpha-dihydrotestosterone, the key intracellular hormone in the expression of androgenic activity in the prostate. These findings may explain why poorly-differentiated prostatic neoplasms are frequently unresponsive to anti-androgenic therapy.
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The original method of continuous low rate enteral feeding is used in cases of nutritious deficiencies and is found to be of value in view of its scientific and technical advantages. Its value is demonstrated by 95% satisfactory results. Furthermore, its low cost, handiness and ease of operation make it accessible to any medical or surgical center where it may have a preferential if not exclusive place.
Prostatic adenoma develops at the site of the periurethral glands. The concentration of 5alpha-dihydrotestosterone seems greater at the center of the adenoma than in the overlying prostate. This suggests that medical treatment of prostatic adenoma might be feasible using substances inhibiting the 5alpha-reduction of testosterone.
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Hormono-dependent epithelial cells of the prostate gland loose their histologic and cytologic differentiation when becoming neoplastic. Such loss of differentiation is related to a change in testosterone metabolism measured by the testosterone metabolites ratio (17 beta-hydroxy/17-oxometabolites). This ratio decreases with differentiation losses and increasing independence from androgenic steroids. Knowledge of that ratio is suggested, prior to the starting of antiandrogenic therapies.