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Biomedical subjects

O Kletzky

Publications and source records attributed to O Kletzky.

12 recordsLinked to original sources
PubMed1991

Ten-year follow-up of patients with secondary amenorrhea and normal prolactin.

A group of 46 patients with secondary amenorrhea without galactorrhea or hyperprolactinemia were studied retrospectively after being clinically categorized into four groups with the use of progesterone-induced uterine bleeding and measurement of serum gonadotropins and prolactin levels. The ability to have regular spontaneous menstrual cycles and to conceive was assessed after a follow-up period of 10 years. Patients who had been classified as having hypothalamic pituitary "failure" (hypoestrogenic amenorrhea) with low levels of circulating estradiol had a greater rate of recovery of spontaneous ovulation and menses when compared with patients who had been classified as having only hypothalamic pituitary dysfunction (euestrogenic amenorrhea). The patients with diagnosis of hyperandrogenic chronic anovulation or polycystic ovary syndrome generally required clomiphene citrate for induction of ovulation and almost all the patients with premature ovarian failure (hypergonadotropic amenorrhea) remained estrogen-deficient and unable to ovulate. Hyperprolactinemia or an identifiable pituitary adenoma has not developed in any of the patients to date.

Adolescent↗
PubMed1991

Nocturnal growth hormone secretion does not affect diurnal variations in arginine and glucose-stimulated insulin secretion.

There is a diurnal variation in insulin secretion, with higher values in the morning (AM) than in the afternoon (PM). This study tested the hypothesis that nocturnal human growth hormone (hGH) secretion might be the mechanism producing this diurnal variation in insulin secretion. Six healthy normal-weight men were studied on four occasions: twice in the early morning (AM) and twice in the afternoon (PM). Oral methscopolamine (Pamine), an anticholinergic agent that blocks hGH release, was administered at bedtime prior to the AM study or before breakfast for the PM study. An index of insulin secretion in all four tests was obtained from measurement of the acute release of insulin in response to two intravenous (IV) boluses of arginine, one given basally and the other given after raising glucose levels to approximately 150 mg/dL above the baseline. Insulin secretion was significantly greater in the morning than in the afternoon in both control and methscopolamine-pretreated subjects. The mean peak hGH was reduced in subjects pretreated with oral methscopolamine. Drug treatment reduced insulin secretion proportionally in the morning and afternoon. These results suggest that the diurnal insulin response to stimulation with arginine during a hyperglycemic clamp persists despite complete suppression of hGH by anticholinergic blockade, and that the diurnal insulin secretion is not caused by sleep- or meal-induced GH secretion.

Adult↗
PubMed1986

The effect of laparoscopic follicular aspiration on ovarian steroidogenesis during the early preimplantation period.

Seventeen patients were studied for the first 72 hours of the luteal phase after spontaneous ovulation or follicle aspiration. Nine patients (group I) underwent follicle aspiration after clomiphene citrate (CC) administration, three women were studied after CC for ovulation induction (group II), and five spontaneous ovulating subjects served as controls (group III). Serum progesterone (P) concentrations were significantly elevated in stimulated cycles with or without follicle aspiration, compared with subjects. Moreover, when aspirated subjects were compared with nonaspirated stimulated subjects, a significant difference in P concentration was identified. It can be concluded that with follicle aspiration, P decreases can be observed, but with multiple follicle development, inadequate P levels are not seen in these stimulated subjects. On the contrary, with such elevated P levels, endometrial advancement may play a role in poor implantation success with human in vitro fertilization procedures.

Clomiphene↗
PubMed1985

Seminal prolactin concentration and sperm reproductive capacity.

Prolactin (PRL) levels in the seminal plasma were determined in 63 men, all partners from infertile marriages. For comparison of seminal PRL concentration and semen quality, a sperm concentration and motility were studied in all men. Also, for determination of the fertilizing capacity of the semen, a zona-free hamster ovum penetration test was done in 49 men, while 14 men were studied by determination of the fertilization of human oocytes in vitro. Significantly higher levels of semen PRL were found in those individuals with low sperm concentration and motility as well as in those individuals that showed an abnormal hamster ovum penetration test. This suggests that high seminal PRL levels have a negative impact on sperm functional capacity.

Animals↗
PubMed1983

Natural history of microprolactinomas: six-year follow-up.

A 6-year follow-up of patients harboring microprolactinomas suggests that few patients (3 of 27) demonstrate significant growth of their tumor during this time. The major hazard for such patients who are not treated seems to be their risk for the development of premature osteoporosis in the face of sustained hyperprolactinemia. The risks of this complication may exceed the risks of early surgical intervention in selected patients. This short term risk of tumor growth (about 10%) must be weighed in the decision about therapeutic endeavors.

Adolescent↗
PubMed1978

The significance of galactorrhea in patients with normal menses, oligomenorrhea, and secondary amenorrhea.

Thyroid-stimulating hormone and prolactin (PRL) were measured in a group of 149 women with galactorrhea. Three of these patients were found to have primary hypothyroidism. In the remaining 146 patients, the PRL assay was correlated with the menstrual history and the results of hypocycloidal polytomography. Sixty-two per cent of these patients had hyperprolactinemia and 35 per cent had abnormal tomograms. Nine patients with abnormal x-rays had normal prolactin levels. None of the patients with normal menses and normal PRL was found to have an abnormal x-ray. Fourteen of the 15 patients with PRL levels greater than 200 ng. per milliliter had abnormal tomograms. Almost 70 per cent of patients with secondary amenorrhea and low estrogen status had abnormal x-rays. In patients with oligomenorrhea and secondary amenorrhea with normal estrogen status, it was not possible to differentiate between patients with normal or abnormal tomograms based on the level of serum PRL. Polytomography remains the single most important diagnostic test in establishing the presence of a pituitary tumor.

Adolescent↗
PubMedDate not supplied

Pituitary gonadal function in diabetic male patients with and without impotence.

Assessment of pituitary function was undertaken in diabetic male patients with and without impotence, and in normal subjects, using a combined gonadotropin releasing hormone (GnRH) and thyrotropin releasing hormone (TRH) test. Basal plasma levels of testosterone, gonadotropins, PRL and TSH were similar in the diabetic patients and controls. Following the administration of I.V. GnRH 150 microgram and TRH 500 microgram, diabetic patients with impotence demonstrated a lower LH response at 30 and 150 minutes and an increased PRL response at 20 minutes, which was statistically significant when compared to controls. FSH and TSH were similar in the diabetic patients and controls. The GnRH and TRH test was repeated in impotent diabetic patients while receiving 0.8-1 mU/kg/hr of insulin through an infusion pump. No difference in LH and PRL response could be demonstrated. These results demonstrate that following GnRH and TRH test, diabetic patients with impotence have a significantly different LH and PRL response than controls. In these patients acute control of hyperglycemia using an insulin infusion pump did not reverse the abnormal response.

Adult↗