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J H Davies

Publications and source records attributed to J H Davies.

16 recordsLinked to original sources

Identification of 4-hydroxyandrost-4-ene-3,17-dione metabolites in prostatic cancer patients by liquid chromatography-mass spectrometry.

Liquid chromatography with thermospray mass spectrometry has proved to be an invaluable technique for the study of metabolic degradation of xenobiotics in complex biological fluids. This paper describes the detection of 4-hydroxyandrost-4-ene-3,17-dione and its metabolites in urinary extracts from prostatic cancer patients. Several metabolites were detected including 4 beta,5 alpha-dihydroxyandrostan-3,17-dione, 3,17-dihydroxyandrostan-4-ones and 3 alpha-hydroxy-5 beta-androstan-4,17-dione.

Androstenedione

Aromatase inhibition: 4-hydroxyandrostenedione (4-OHA, CGP 32349) in advanced prostatic cancer.

We report the use of the steroidal aromatase inhibitor, 4-hydroxyandrostenedione (4-OHA, CGP 32349), in the management of patients with advanced, hormone resistant, prostatic cancer. Eighteen of 25 patients (72%) showed a subjective response, mainly in the form of pain relief and increased performance. There were no objective improvements. A tumour flare occurred in 17/25 (68%). Detailed endocrine studies were performed during treatment. These showed that suppression of serum oestradiol levels occurred in 19/25 (76%) of patients during treatment with 4-OHA. Serum levels of androstenedione increased in 9/14 patients (64%). Concentration of serum testosterone and 5 alpha-dihydrotestosterone were elevated in 3/14 (21%) and 2/11 (18%) patients respectively. There appeared to be no correlation between response or tumour flare and changes in steroid levels during treatment with 4-OHA. The mechanism of action of 4-OHA in palliating patients with advanced prostatic cancer remains obscure. 4-OHA or its metabolites may be acting on metastatic bone metabolism via effects on oestrogen related osteoclastic and osteoblastic activity. Further investigation of the effects of aromatase inhibitors on prostatic biology, and bone metabolism in patients with metastatic prostate cancer, would appear worthwhile.

Aged

Hormonal cytoreduction and radiotherapy for carcinoma of the prostate.

We report the effect on prostatic volume of the administration of the luteinising hormone-releasing hormone (LHRH) analogue goserelin in 22 patients with locally advanced carcinoma of the prostate; 20 achieved a significant reduction in volume, the median volume being 66 ml before treatment (range 40-130) and 30 ml after 17 weeks (range 13-47). If used before external beam radiotherapy (RT), volume reduction will permit smaller boost fields and thus potentially reduce adverse radiotherapy effects. In addition, reducing tumour volume before RT may lead to an increase in local control. We discuss the possible role of hormonal volume reduction in the management of prostatic cancer.

Buserelin

Effects of 4-hydroxyandrost-4-ene-3,17-dione and its metabolites on 5 alpha-reductase activity and the androgen receptor.

The steroidal aromatase inhibitor, 4-hydroxyandrost-4-ene-3,17-dione (4OHA) and its metabolites, 4-hydroxytestosterone (4OHT), 3 beta,17-dihydroxy-5 alpha-androstan-4-one (metabolite A) and 3 alpha, 17-dihydroxy-5 beta-androstan-4-one (metabolite B) were evaluated as inhibitors of the human prostatic 5 alpha-reductase enzyme and for binding to the rat prostatic androgen receptor. 4OHA and 4OHT were weak inhibitors of 5 alpha-reductase with IC50 values of 15-29 microM. Metabolites A and B had no significant inhibitory activity. 4OHA and metabolites A and B bound weakly to the androgen receptor. The binding affinities (RBA) relative to mibolerone (RBA = 100) were 0.085, 0.485 and 0.016, respectively. However, 4OHT (RBA = 75) was a more potent binder than the endogenous androgen 5 alpha-dihydrotestosterone (RBA = 66). The ability of these metabolites, in particular 4OHT, to bind to the androgen receptor may explain the in vivo androgenic activity of 4OHA.

5-alpha Reductase Inhibitors

Should urologists wear spectacles for transurethral resection of the prostate?

Contamination of the eyes by irrigation fluid during transurethral resection (TUR) of the prostate was assessed by measuring droplet splashes on to spectacles worn by 2 surgeons. During 30 consecutive operations, droplet splash contamination occurred during every procedure. The number of splashes increased with time. The use of spectacles during TUR will reduce the risks of eye contamination from droplet splashes and therefore the possibility of transmission of the human immunodeficiency virus from infected patients.

Eye Protective Devices

Comparison of aromatase activity in human prostatic, testicular and placental tissues.

The aromatase enzyme was quantified by the release of tritiated water from [1 beta-3H] androstenedione. Tritiated water was released by the crude homogenates in 4 of 18 samples of benign prostatic hyperplasia tissue and one of 5 samples of prostate carcinoma tissue. However, this apparent aromatase activity was not inhibited by 4-hydroxyandrostenedione (0.5 and 5.0 microM), and none of the particulate fractions (100,000 g pellet) prepared from each of the prostatic tissues exhibited aromatase activity. Particulate fractions from rat ovary (n = 3) and human testes (n = 6) displayed significant aromatase activity (mean values of 9.9 and 0.033 nmol estrone formed/g protein/h, respectively). The testicular aromatase was inhibited by aminoglutethimide, 4-hydroxyandrostenedione and CGS 16949A with IC50 values of 6.4, 0.17 and 0.0017 microM, respectively. These are of a similar order to values obtained with the aromatase enzyme from human placental microsomes (14, 0.43 and 0.0075 microM, respectively).

Androstenedione

Aromatase inhibition in advanced prostatic cancer: preliminary communication.

We report the results of the first use of a steroidal aromatase inhibitor, 4-hydroxyandrostenedione (4-OHA, CGP 32349), in the palliation of patients with advanced, hormone resistant, prostatic cancer. Twelve of 19 patients (63%), who had relapsed following castration and other therapies, gained significant pain relief following weekly intramuscular injections of 4-OHA. Five patients (31%) experienced a transient 'tumour flare', represented by an increase in bone pain soon after commencing treatment. The mechanism of action of 4-OHA in palliating patients with advanced prostatic cancer is obscure at present, but may represent an important new treatment modality which may lead to greater insight into prostatic biology.

Aged

Adenomatoid tumours of the male genital tract. Review of 5 men presenting with an intrascrotal swelling subsequently diagnosed as an adenomatoid tumour.

Adenomatoid tumours of the male genital tract are not commonly diagnosed pre-operatively and there is some controversy regarding their management. We reviewed the case notes of 5 men who presented between 1980 and 1987 with an intrascrotal swelling subsequently diagnosed as an adenomatoid tumour. 3 had a testicular swelling and 2 of these underwent an orchidectomy. 2 had epididymal swellings and local excision was performed. The histopathology and management of adenomatoid tumours are discussed.

Adult

Metabolic consequences of forced diuresis following prostatectomy.

The efficacy and metabolic consequences of a standardised forced diuresis regime following prostatectomy were studied in three parts. A retrospective review of 372 patients. A detailed prospective study of blood and urine electrolyte changes in 25 patients. A prospective study of urinary oxalate levels in 15 patients. The regime was effective in safely preventing post-operative clot retention. In 54% of patients the plasma sodium fell below 135 mmol/l. Hypokalaemia was mild and transient except in patients on long-term diuretics. There was a significant per-operative fall in serum calcium levels. It was concluded that forced diuresis is a safe and effective method of reducing clot retention following prostatectomy. The high incidence of post-operative hyponatraemia suggests that absorption of glycine solution at transurethral prostatectomy is a common occurrence.

Creatinine

The influence of physical and chemical restraint on the physiology of the chacma baboon (Papio ursinus).

The chacma baboon (Papio ursinus) is extensively used in South Africa for biomedical research. Being a large primate, it is always necessary to apply some measure of chemical or physical restraint. The physiological effects of placing an animal in a restraint chair are compared with the effects of various chemical agents, such as ketamine, halothane, and ketamine/xylazine combination over 90 min. It was found that ketamine and thiopentone infusion were a satisfactory chemical restraint agent that gave a stable physiological state over 90 min.

Acid-Base Equilibrium

Inhibition of fly head acetylcholinesterase by bis-[(m-hydroxyphenyl)-trimethylammonium iodide] esters of polymethylenedicarbamic acids.

A series of bis-[(m-hydroxyphenyl)trimethylammonium iodide] esters of polymethylenedicarbamic acids and a number of (m-hydroxyphenyl)trimethylammonium iodide esters of straight-chain N-alkylcarbamic acids have been examined as inhibitors of acetylcholinesterase from fly head. Evidence is presented suggesting that inhibition of acetylcholinesterase by the bis-carbamates is due to carbamoylation of the enzyme, as is generally thought to be the case with esters of N-alkylcarbamic acids. Inhibition is irreversible. The (m-hydroxyphenyl)trimethylammonium iodide ester of N-hexylcarbamic acid also inhibits fly head acetylcholinesterase irreversibly. There is therefore no need to implicate a second functional group in bis-carbamate esters to explain the irreversible inhibition of the enzyme. An unusual feature of the inhibition is that inhibition lines do not pass through 100% enzyme activity at t=0, except for rather low concentrations of inhibitor (<10mum for the octamethylene compound). Also, inhibition lines tend towards a maximum slope as inhibitor concentration is increased. The first observation indicates complex-formation, even in the presence of high concentrations of substrate, and by using measurements of inhibition at relatively high inhibitor concentrations, affinity constants K'(a) have been calculated. K'(a) varies from 0.1mum for the dodecamethylene compound to 10mum for the tetramethylene compound, in the presence of 3.75mm-acetylthiocholine, indicating high affinity for the enzyme. The second observation shows that, owing to this high affinity, the enzyme becomes saturated with inhibitor under the experimental conditions employed, and from the limiting slope values of the carbamoylation rate constant (k(2)) have been calculated. k(2) varies from 0.15min(-1) for the tetramethylene compound to 1min(-1) for the decamethylene compound. Variations of potency in this series are therefore mainly due to changes in affinity (100-fold) rather than in carbamoylation rate (sevenfold). The observation that large molecules may acylate the enzyme raises certain problems, which are discussed.

Animals