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Biomedical subjects

K Carlström

Publications and source records attributed to K Carlström.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Intramuscular depot estrogens (Estradurin) in treatment of patients with prostate carcinoma. Historical aspects, mechanism of action, results and current clinical status].

More than 50 years ago, orally given estrogen was already used in the treatment of prostate cancer. Due to cardiovascular side-effects with a high morbidity of 25%, this treatment has not become standard. Recent investigations show that parenteral application reduces the risk of cardiovascular side-effects, because it avoids the first passage through the liver with high concentrations of estrogen which normally occur after oral application. Therefore, an increased synthesis of so-called "steroid-sensitive" liver proteins, such as coagulation factors (especially factor VII) can be avoided. This newer parenteral estrogen application shows encouraging results of a cheap and effective hormonal therapy with a low rate of side-effects in patients with prostate cancer.

Antineoplastic Agents, Hormonal↗
PubMed1995

Altered adrenal steroid metabolism underlying hypercortisolism in female endurance athletes.

OBJECTIVE: To explore possible changes in adrenal steroid metabolism and androgenic-anabolic status in female endurance athletes as a mechanism for their hypercortisolism. DESIGN: Adrenal steroids and androgenic-anabolic factors were studied during basal conditions and in response to ACTH stimulation related to menstrual status. SETTING: Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden. PARTICIPANTS: Thirteen female elite middle to long distance runners (six eumenorrheic, seven oligoamenorrheic) and seven regularly menstruating controls. INTERVENTIONS: Blood samples were collected before and after an injection of 250 micrograms IV synthetic ACTH 1-24. Body weight, height, and body fat were measured. MAIN OUTCOME MEASURES: Basal serum concentrations of cortisol, androstenedione (A), DHEA, DHEAS, 17 alpha-hydroxyprogesterone (17-OHP), T, steroid-binding proteins, and insulin-like growth factor I and ACTH-induced response (area under the curve) of cortisol, DHEA, and 17-OHP. RESULTS: Oligoamenorrheic athletes had higher basal cortisol and A concentrations compared with healthy controls, whereas basal levels of DHEA and DHEAS were normal. Important findings in the oligoamenorrheic athletes were a significantly lower ratio between the ACTH-induced increments of DHEA and 17-OHP and an increased ratio between basal A and DHEAS. Insulin-like growth factor I was correlated negatively to sex hormone-binding globulin and to the amount of body fat in the combined material. CONCLUSIONS: The results indicate a redistribution of adrenal steroid metabolism in favor of glucocorticoid production in female endurance athletes. We suggest that hypercortisolism in female endurance athletes is a physiological adaptation to maintain adequate blood glucose levels during a condition of energy deficiency.

17-alpha-Hydroxyprogesterone↗
PubMed1994

Loss of neurones after long-term adrenalectomy in the adult rat hippocampal formation.

The effects of long-term adrenalectomy (ADX) on hippocampal neurones were investigated 5 months after surgery in male Sprague-Dawley rats. Cells in Nissl-stained sections from ADX rats were counted and compared with those in sections from sham-operated rats. The ADX rats had a significantly reduced number of dentate granule cells. A novel finding was a significant reduction in the number of pyramidal cells in CA1, CA2, CA3 and CA4 regions of the hippocampus. Thus long-term adrenalectomy causes loss of dentate granule cells and pyramidal neurones of the hippocampus.

Adrenalectomy↗
PubMed1994

Plasma atrial natriuretic peptide concentration and renin activity during overhydration with 1.5% glycine solution in conscious sheep.

We estimated the changes of fluid compartment volumes and concomitant effects on plasma atrial natriuretic peptide (ANP) and plasma renin activity (PRA) for up to 4 hr after intravenous infusion of 57 ml/kg of 1.5% glycine solution over 40 min in six conscious ewes. Infusions of the same volumes of isotonic saline served as controls. Glycine infusions resulted in a four-fold increase and saline in a doubling of the plasma ANP concentration, despite a more pronounced volume expansion from saline. The ANP level remained significantly elevated for 2 hr after glycine infusion. This result suggests that glycine has a specific ANP-stimulating effect which may contribute to the hypovolemia, hypotension, and natriuresis seen in the "transurethral resection (TUR) syndrome." The PRA decreased by about 50% in response to both infusions. However, PRA returned to the baseline level at the end of the glycine infusion, whereas it remained depressed during the entire follow-up period after saline infusion. This is in accordance with a pure volumetric influence on renin release, since calculations of fluid distribution between different compartments suggested that, in contrast to the effect of saline, only a small amount of irrigant water remained in the extracellular fluid after glycine administration. The urea and creatinine clearances increased only in response to isotonic saline. Glycine infusion was even followed by reduction of the creatinine clearance.

Analysis of Variance↗
PubMed1994

Catecholamine resistance in fat cells of women with upper-body obesity due to decreased expression of beta 2-adrenoceptors.

Upper-body obesity is an important risk factor for developing non-insulin dependent diabetes. To investigate the possibility that a lipolysis defect is present in this form of obesity, we examined the adrenergic regulation of lipolysis in abdominal subcutaneous fat cells from 25 women with upper-body obesity and 24 non-obese women. Lipolytic noradrenaline sensitivity (but not the maximum rate of lipolysis) was reduced by 10-fold in obese women (p < 0.01). The noradrenaline resistance could be ascribed to a 10-fold decrease in lipolytic beta 2-adrenoceptor sensitivity (p < 0.01). The lipolytic sensitivity of beta 1- and alpha 2-adrenergic receptors was normal in the obese women. A 70% reduction in the cell surface density of beta 2-adrenoceptors was observed compared to the control subjects (p < 0.01). However, beta 1-receptor density as well as steady-state mRNA levels for beta 1- and beta 2-receptors were normal in obese women. Lipolytic noradrenaline sensitivity correlated inversely with BMI (adjusted r2 = 0.76 together with fat cell volume in stepwise regression analysis). The fasting plasma level of free cortisol was 30% lower in obese compared to non-obese women (p < 0.05) but obesity did not influence resting plasma catecholamine levels. Thus, lipolytic catecholamine resistance is present in abdominal obesity, due to low density of beta 2-adrenoceptors, which in its turn may be caused by a post-transcriptional defect in beta 2-receptor expression.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1994

Reduced serum cholecystokinin response to food intake in female athletes.

Strenuous training in women has been shown to cause menstrual dysfunction and decreased bone mineral density. These endocrine and metabolic complications are associated with an insufficient dietary intake and decreased body fat content in female athletes. The present investigation was undertaken to study serum levels of cholecystokinin (CCK), insulin, gastrin, and cortisol in 14 female long-distance runners and 15 sex- and age-matched control subjects during intake of a standardized meal (500 kcal). The athletes showed a decreased response of the "satiety peptide" CCK to the meal and reported increased hunger compared with the control group. Meal-related insulin response was also decreased in the athletes, whereas gastrin levels were comparable to those of controls. Basal levels of glucose were increased in the athletes, but there was no difference in postprandial levels between the groups. Cortisol levels were clearly elevated in the female runners. We conclude that insufficient food intake in female athletes cannot be explained by increased CCK secretion and satiety. Since the athletes reported a larger caloric intake of a normal daily breakfast than the control subjects, the decreased CCK response may instead be explained by an adaptation to increased food intake. The decreased meal-related insulin response may be a reflection of increased insulin sensitivity as an adaptation to physical exercise. However, an impaired peptide secretion cannot be excluded. The role of elevated cortisol levels in the gastrointestinal hormone response needs further investigation.

Adult↗
PubMed1994

Metabolism of estrone sulfate by normal breast tissue: influence of menopausal status and oral contraceptives.

The metabolism of [3H]estrone sulfate ([3H]E1S) was studied in normal breast tissue from 10 premenopausal women without oral contraceptives (OC), in 12 OC users and in 9 untreated postmenopausal women. [3H]E1S was converted into estrone ([3H]E1) and estradiol-17 beta ([3H]E2) by tissue samples from all three groups of women, with only minor formation of other unconjugated compounds. The rate of [3H]E2 formation was significantly higher in premenopausal women without OC than in postmenopausal women. Among premenopausal women, OC users had a significantly lower rate of total hydrolysis and of [3H]E1 formation than non-users. The rate of total hydrolysis of [3H]E1S in normal breast tissue from all three groups of women was similar to that in muscle, but the rate of [3H]E2 formation was ten times higher. Both total hydrolysis rate and rate of [3H]E2 formation were significantly lower in normal breast tissue than in breast carcinoma and in normal and neoplastic endometrium. The specific ability of normal breast tissue to convert E1S into the terminal biologically active estrogen E2 may be important for estrogenic stimulation of the breast in subjects with low circulating E2 levels. The lower rate of E1 formation in OC users may reflect an inhibitory effect of the progestagen compound in such preparations.

Adolescent↗
PubMed1994

Estramustine binding protein in primary tumours and metastases of malignant melanoma.

The presence of estramustine binding protein (EMBP), a 54 kD cytosolic glycoprotein, which is distinct from the estrogen receptor, was investigated in a pilot study of primary malignant melanomas and their metastases. In 11 primary melanomas EMBP was demonstrated by immunohistochemistry. The percentage of positive melanoma cells ranged between 11-91% with a mean of 57%. Radioimmunoassay on metastatic tissue revealed significant amounts of EMBP, with values ranging between 0.6-4.2 with a mean of 1.6 ng/mg protein. A high number of cells with a positive stain for EMBP in the primary tumours was significantly correlated to a short interval between diagnosis and the occurrence of metastases. Presence of EMBP in malignant melanoma may have prognostic significance and the role of hormone-linked cytostatic drugs in the treatment of this disease needs further investigation.

Adult↗
PubMed1994

Acute volume expansion in normal pregnancy and preeclampsia. Effects on plasma atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) concentrations and feto-maternal circulation.

OBJECTIVE: To compare normal pregnancy with pregnancy-induced hypertension (PIH)/preeclampsia with respect to the effects of acute volume expansion on plasma atrial natriuretic peptide (ANP), cyclic guanosine monophosphate (cGMP) and fetal-maternal circulation. DESIGN: Observational study. SETTING: University hospital. SUBJECTS: Fifteen women with PIH/preeclampsia and 15 healthy pregnant controls. INTERVENTIONS: Before and after 30 minutes' infusion of a crystalloid solution (15 ml/kg), maternal venous blood was sampled for ANP and cGMP analysis and echocardiographic and Doppler investigations were performed. RESULTS: Basal median (range) ANP and cGMP levels were significantly higher in the PIH/preeclampsia group compared to the controls: 6.5 (3.8-30.4) compared to 3.9 (2.0-6.7) pmol/l, p < 0.01 and 5.8 (2.4-11.6) compared to 4.0 (2.3-10.8) nmol/l, p < 0.05. The response to volume load was enhanced: 4.6 (-4.5-21.8) compared to 0.7 (-4.1-8.8), p < 0.05 and 2.9 (0.1-10.9) compared to 1.2 (-5.0-6.0), p < 0.05, respectively. Systemic vascular resistance was initially higher in the patient group, 22.3 (14.1-36.7) compared to 15.6 (10.0-25.5) peripheral resistance units, p < 0.01 but the response to volume load was similar in both groups (12-13% decrease). The pulsatility index of the uterine artery, 0.85 (0.46-1.38) compared to 0.72 (0.49-1.26) and umbilical artery 0.89 (0.66-1.57) compared to 0.97 (0.74-1.31) did not differ between the groups. Volume expansion did not affect any of these variables. CONCLUSIONS: The pulsatility index of the uterine artery remained unaffected in both preeclamptic patients and healthy controls despite an increase of ANP and cGMP concentration and a systemic vasodilatation during acute volume expansion. This finding may indicate the absence of a vasodilation of the uteroplacental vascular bed.

Atrial Natriuretic Factor↗
PubMed1993

Is there an altered steroid profile in patients with endometrial carcinoma?

BACKGROUND: Besides the well-known association between endometrial carcinoma (EC) and unopposed estrogen, androgens also may play a role in this respect; however, previous studies on endogenous estrogens and androgens in patients with EC and control subjects have yielded mostly divergent results, probably because of the use of poorly defined control groups. METHODS: Circulating steroid and pituitary hormones and sex hormone-binding globulin were measured in patients with EC and matched control groups of either patients with nonmalignant postmenopausal bleeding (hospital control subjects) and healthy, symptom-free women (nonhospital control subjects). RESULTS: Patients with EC had higher serum levels of adrenal C21 and C19 steroids, estrogens, and biologically active testosterone than nonhospital control subjects, whereas the hospital control subjects constituted an intermediate group in this respect. CONCLUSIONS: The results clearly indicate an altered steroid homeostasis, probably reflecting an increased "adrenal drive" in patients with EC. The results also stress the necessity of using strictly defined, healthy, symptom-free control subjects instead of the frequently used hospital control subjects when studying more subtile endocrine aberrations.

Adenocarcinoma↗
PubMed1993

Basal concentrations of anabolic and catabolic hormones in relation to endurance exercise after short-term changes in diet.

This study aimed to use a classical model to analyse whether alterations in performance due to short-term changes in diet are reflected in peripheral basal anabolic and catabolic hormone concentrations. Six healthy students (two women and four men) performed a cross-over study including three test situations. The reference test was preceded by each subject's normal unrestricted diet of western type (N). After this, three of the subject's were provided a carbohydrate-rich diet (CHO) for 3 days followed by the second test. Following this test, a carbohydrate deficient, protein/fat rich diet (F) was provided for another 3 days followed by the third test. The remaining three subjects had these diets in reverse order. Basal concentrations of cortisol (C), sex hormone-binding globulin (SHBG), insulin-like growth factor (IGF-I), total-testosterone and non-SHBG-bound-testosterone (NST), the NST:C ratio and an ergometer cycle endurance test with measurements of submaximal as well as measurements of maximal oxygen uptake, heart rate, respiratory exchange ratio (R), free fatty acids (FFA), glycerol and lactate were investigated. All the subjects were involved in athletics for recreation and during the study they performed daily physical exercise according to their normal routine. After the F diet only two of the subjects completed the test. One woman dropped out after 16 min, two men dropped out after 14 min and one after 13 min of cycling. After the CHO diet all six subjects completed the ergometer cycle test. Considering the whole group, there were no significant differences in lactate or glycerol concentrations during the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Oestrogenic effects of adjuvant tamoxifen in postmenopausal breast cancer.

Oestrogenic influence of the non-steroidal anti-oestrogen tamoxifen may have consequences for the morbidity pattern among women on long-term adjuvant treatment. Subclinical oestrogenic effects of adjuvant tamoxifen on the tissue level was studied among 16 postmenopausal women in three different organ systems: the pituitary, the liver and bone. After 3 months of adjuvant tamoxifen prolactin levels decreased 66% (P < 0.001) in comparison with pretreatment levels. There was an 80% increase in basal growth hormone after 3 months of treatment in comparison with pretreatment levels, which did not reach statistical significance (P = 0.07). Sex hormone binding globulin levels increased 39% (P < 0.01) and IGF-1 (somatomedin C) levels decreased 20% (P < 0.05). The levels of bone GLA protein (BGP; osteocalcin), a marker of bone osteoblastic activity, decreased 28% (P < 0.01). In 13 of the patients bone mineral density (BMD) was measured before treatment and after 1 year. No significant change in BMD was observed. The results thus suggest a clear oestrogenic effect of tamoxifen on the pituitary, liver and bone in postmenopausal women.

Aged↗
PubMed1993

Hormone anabolic/catabolic balance in female endurance athletes.

The anabolic/catabolic hormone balance in 13 female endurance athletes was studied during basal conditions by comparing their serum concentrations of androgenic and catabolic steroids, growth hormone, insulin-like growth factor 1 (IGF-1) and insulin with corresponding values in 15 matched sedentary controls. Higher cortisol and lower levels sex hormone-binding globulin (SHBG) were found in the athletes, and these differences were enhanced depending on the degree of menstrual disorders. There was a negative correlation between cortisol and SHBG levels. No differences were found in concentrations of androgens, IGF-1 and insulin. The results indicate a normal anabolic activity in oligomenorrheic athletes, but due to their distinct hypercortisolism, the anabolic/catabolic hormone balance is changed to a predominantly catabolic state.

Adult↗
PubMed1993

Subnormal androgen and elevated progesterone levels in women treated for congenital virilizing 21-hydroxylase deficiency.

Clinical, anthropometric, and endocrine data were examined in 22 corticosteroid-treated, prenatally virilized women with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency and in 22 matched healthy controls. In view of the androgen excess, limited growth, and subfertility associated with CAH, the investigation focused on androgenic/anabolic status and circulating progesterone levels. CAH patients were shorter and had a significantly higher body mass index than the controls. One pregnancy was reported in the CAH group compared to 15 in the controls. Five of the CAH patients were judged as undersubstituted based on greatly elevated circulating levels of 17 alpha-hydroxyprogesterone. These five patients had elevated serum levels of progesterone (P) and testosterone (T) and elevated ratios between T and sex hormone-binding globulin, but subnormal levels of dehydroepiandrosterone (DHA) and its sulfate. The remaining 17 well substituted patients had elevated follicular phase levels of P, but subnormal levels of all androgens (4-androstene-3,17-dione, T, DHA, and DHA sulfate) and subnormal T/sex hormone-binding globulin ratios. Contrary to the apprehension that normally guides the treatment of CAH, well substituted patients may be considered hypoandrogenic rather than hyperandrogenic. The elevated levels of P may have a minipill-like effect, which may be one of the causes of the differences in fertility between salt-wasting and simple virilizing CAH.

Adolescent↗
PubMed1993

Elective ovarian removal and estrogen replacement therapy--effects on sexual life, psychological well-being and androgen status.

Conflicting data have been reported on the psychosexual impact of hysterectomy combined with bilateral oophorectomy. Three age-matched, hysterectomized groups of women were investigated: Group A (n = 33): oophorectomized, not receiving estrogen replacement therapy (ERT); Group B (n = 33): oophorectomized, receiving ERT; and Group C (n = 35): ovaries preserved and not receiving ERT. The McCoy Sexual Rating Scale and the Psychological General Well-Being Index as well as a semi-structured interview were used to assess postoperative experience with respect to libido, vaginal lubrication, ability of getting pleasure from intercourse, and ability to achieve orgasm. Serum concentrations of total and free testosterone, insulin-like growth factor I (IGF-I), sex hormone binding globulin, dehydroepiandrosterone sulfate and 4-androstene-3,17-dione were determined. In oophorectomized women sexual life was impaired as compared to those with intact ovaries and these women complained about less pleasure from coitus, impaired libido and lubrication. Regardless of whether estrogens were administered or not a similar pattern was found, indicating that estrogens are of little value in treating these specific sexual dysfunctions. Oophorectomized women receiving ERT reported less anxiety and depression and more well-being similar to women whose ovaries had been preserved. No correlation was found between psychosexual variables and biochemical androgen markers. However, the IGF-I levels were strongly correlated to sexual activity and responsiveness.

Adaptation, Psychological↗
PubMed1993

Liver metabolism during treatment with estradiol and natural progesterone.

Serum concentrations of sex hormone-binding globulin (SHBG), corticosteroid binding globulin (CBG), ceruloplasmin, lipoprotein A and liver enzymes were measured in 30 postmenopausal women treated with 2 mg micronized 17 beta-estradiol daily and micronized progesterone orally in doses of 50, 100 and 200 mg daily, as progestogen supplementation. The treatment lasted for 4 months. The serum levels of SHBG and CBG increased during treatment and a weak association between progesterone dosage and CBG was observed. Levels of lipoprotein A and liver enzymes did not change. It is concluded that micronized natural progesterone is an attractive means of progesterone supplementation in postmenopausal hormone replacement therapy without any liver-related side-effects.

Adult↗