Biomedical subjects

R Tomić

Publications and source records attributed to R Tomić.

At least 19 recordsLinked to original sources

PubMed1992

Sexual function in men after radical cystectomy with or without urethrectomy.

Sexual function was evaluated in 21 patients with bladder carcinoma who had undergone radical cystectomy either with (n = 9) or without (n = 12) excision of the urethra. All patients received preoperative radiotherapy, and the cystectomy was done by a nerve-sparing surgical technique. At follow-up all patients reported normal sexual desire and tactile sexual activity. Eight of the 12 patients in whom the urethra was preserved could achieve penile erection and orgasm to tactile stimulation, and five of them had sufficient strength and duration of erection for sexual intercourse. Two of the nine patients in whom the urethra was removed-had weak erections insufficient for intercourse; three could experience orgasm. These results show that when cystectomy is done by a nerve-sparing technique and without urethrectomy there is more chance of preserving sexual function than when simultaneous urethrectomy is done.

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PubMed1991

Treatment of rat prostatic adenocarcinoma with medroxyprogesterone acetate (MPA): effects on growth and morphology.

Rats bearing the Dunning R3327H prostatic carcinoma were castrated and supplemented with testosterone propionate. These rats were then treated with estradiol benzoate or medroxyprogesterone acetate alone or in combination with estradiol. During the treatment period of six weeks, the growth rate of the prostatic tumors was measured. At the end of the treatment period the morphology of the tumors was also studied. It was found that medroxyprogesterone acetate is as effective as estradiol in inhibiting the growth of the Dunning prostatic carcinoma and that the combination of medroxyprogesterone acetate and estradiol was more efficient in that respect than estradiol alone. Morphometric evaluation of the tumor epithelium and stroma showed a decrement of epithelial growth in all treatment groups, while the groups treated with medroxyprogesterone acetate, both alone or in combination with estradiol, also showed an inhibited growth of the tumor stroma. It was concluded that medroxyprogesterone acetate probably has direct inhibitory effects on prostatic tumor cells in the Dunning model and that medroxyprogesterone acetate may act in an additive manner with estradiol.

Adenocarcinoma↗

PubMed1989

Deoxyribonucleic acid content and medroxyprogesterone acetate treatment in metastatic renal cell carcinoma.

High dose medroxyprogesterone treatment was given to 20 patients with metastatic renal cell carcinoma. Distant metastases occurred before the perifascial nephrectomy in 11 patients and following nephrectomy in 9. Tumor deoxyribonucleic acid content was analyzed by flow cytometry in 8 fresh samples from each primary tumor. Four patients had homogeneously diploid primary tumors, 5 had tumors with diploid and aneuploid samples, and all 8 tumor samples were aneuploid in 10 patients. Deoxyribonucleic acid analysis was unsuccessful in 1 patient. One patient with a diploid primary tumor died of an intercurrent disease. Three patients (16 per cent) had objective remissions and 1 had a long-lasting stable disease. Of the 4 patients with any response to medroxyprogesterone acetate treatment 3 had diploid primary tumors, and 1 had 8 diploid and 2 aneuploid samples in the primary tumor. The remaining 14 patients showed no response to treatment and had progressive disease (11 of these patients died within 14 months). All 14 patients had aneuploid primary tumors. The results indicate that tumor ploidy might be related to response to medroxyprogesterone acetate treatment. Deoxyribonucleic acid content seems to be an important parameter to consider in planning treatment of metastatic renal cell carcinoma.

Aneuploidy↗

PubMed1988

Depressed testosterone release from testicular tissue in vitro after withdrawal of oestrogen treatment in patients with prostatic carcinoma.

Bilateral orchiectomy was performed in patients with prostatic carcinoma after oestrogen treatment for different periods of time. Testicular slices were incubated in vitro to examine the effect of previous oestrogen treatment on testosterone production. After short-term treatment, the testicular tissue responded to human chorionic gonadotrophin by testosterone production. This was in contrast to long-term administration of oestrogen which induced arrest of testosterone synthesis. The results suggest irreversible changes of Leydig cell function after long-term oestrogen treatment.

Chorionic Gonadotropin↗

PubMed1988

Hormonal effects of high dose medroxyprogesterone acetate treatment in males with renal or prostatic adenocarcinoma.

In 18 patients, 12 with renal and 6 with prostatic carcinoma, the gonadal, pituitary and adrenal functions were studied by measurements of steroid hormones and gonadotrophins, before and after six weeks treatment with medroxyprogesterone acetate (MPA), injected intramuscularly 500 mg per day for 5 days each week. The testosterone-oestradiol-binding globulin (TeBg) was measured and the amount of albumin and TeBg bound and unbound testosterone was calculated. Treatment with high doses of MPA caused a profound decrease in serum concentrations of testosterone, dehydroepiandrosterone sulphate (DHEAS), cortisol and TeBg. There were significant decreases in serum concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH) and oestradiol-17 beta. The serum concentration of prolactin was significantly elevated. The protein unbound testosterone fraction was lowered by MPA treatment but less than total testosterone. In conclusion, MPA therapy in high dose alters the gonadal, pituitary and adrenal functions suppressing serum concentrations of androgens, gonadotrophins, cortisol and TeBg but elevating prolactin concentration.

Adenocarcinoma↗

PubMed1988

Endocrine effects of oestrogen withdrawal in long-term treated patients with prostatic adenocarcinoma.

Eighteen patients with prostatic adenocarcinoma, treated with oestrogen for 45 months or more, were followed-up after withdrawal of oestrogen treatment. Serum concentrations of testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), oestradiol-17 beta, testosterone-oestradiol-binding globulin (TeBg) and prolactin were measured at different intervals between 3 and 42 months after cessation of treatment. Serum testosterone concentrations after cessation of oestrogen treatment were low (range 71.4 +/- 6.3 to 120.8 +/- 23.7 nmol/100ml), whereas the concentrations of LH (range 21.8 +/- 3.6 to 32.6 +/- 9.1 U/1) and FSH (range 31.2 +/- 5.5 to 54.7 +/- 9.5 U/1) were within or higher than the reference range. Prolactin (range 6.0 +/- 85.3 to 7.9 +/- 68.2 micrograms/1) was within the reference range. No significant changes in serum concentrations of testosterone, LH, FSH and prolactin occurred during the follow-up period. The serum concentrations of both oestradiol-17 beta and TeBg, found between 13 and 36 months after oestrogen cessation (range 43.8 +/- 4.6 to 46.2 +/- 5.9 and 64.0 +/- 2.5 to 86.0 +/- 10.0, respectively) were significantly lower than the concentrations found between 3 and 12 months (range 71.9 +/- 10.4 to 99.8 +/- 12.9 and 124.1 +/- 15.5 to 140.2 +/- 13.7, respectively). It is concluded that in patients with prostatic adenocarcinoma, long-term oestrogen treatment causes an irreversible impairment of Leydig cell function and consequently a reduced testosterone secretion after cessation of oestrogen treatment.

Adenocarcinoma↗

PubMed1987

Pituitary function after orchiectomy in patients with or without earlier estrogen treatment for prostatic carcinoma.

Testosterone, FSH, LH and prolactin were measured before, and up to 36 months after orchiectomy in 62 patients with prostatic carcinoma; 36 were treated by primary orchiectomy, 10 by orchiectomy after prior estrogen treatment for less than 3 yr (short-term) and 16 for more than 3 yr (long-term). Before orchiectomy serum levels of testosterone, FSH and LH were significantly lower in estrogen-treated than in untreated patients. Following orchiectomy serum FSH and LH increased in all patients studied. However, long-term estrogen-treated patients had significantly lower FSH and LH both before orchiectomy and during the follow-up period than those treated by primary orchiectomy or orchiectomized after short-term estrogen treatment. In addition, in those long-term estrogen-treated patients, serum testosterone did not significantly decrease after orchiectomy, whereas in patients treated by primary orchiectomy or orchiectomized after short-term estrogen treatment serum testosterone fell significantly. At follow-up comparable levels of testosterone were found in the three patient groups studied. Prolactin levels did not differ significantly between the patient groups and were not elevated either before or after orchiectomy. It is suggested that patients with carcinoma of the prostate treated with estrogen for more than 3 yr have impaired, but slowly increasing, pituitary gland function, possibly caused by long-term effect of estrogen on the pituitary gland.

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PubMed1987

Hormonal effects of cessation of estrogen treatment for prostatic carcinoma.

Serum concentrations of testosterone, luteinizing hormone and follicle-stimulating hormone were measured before, and at 1, 12 and 24 months after cessation of long-term estrogen treatment (mean 8.7 years, range 4.3 to 13.1 years) in 14 patients with prostatic carcinoma but without metastases. In addition, the same hormones were measured before and up to 24 months after orchiectomy in 14 age-matched, previously untreated patients also without metastases. In long-term estrogen-treated patients serum concentrations of testosterone found at 1, 12 and 24 months after cessation of estrogen did not differ significantly either from the value before estrogen withdrawal or from the corresponding values found in age-matched patients after orchiectomy. The concentrations of luteinizing and follicle-stimulating hormones increased significantly in the estrogen-treated patients after cessation of estrogen and in the age-matched patients after orchiectomy. However, luteinizing and follicle-stimulating hormones were significantly lower in the patients after estrogen treatment than in the age-matched patients after orchiectomy. During the study period only 1 patient from the estrogen-treated group had clinical progression and he died of prostatic carcinoma. We conclude that long-term estrogen treatment causes impairment of Leydig cell function in patients with prostatic carcinoma and, as a result, the serum testosterone concentrations do not increase when that treatment is discontinued.

Adenocarcinoma↗

PubMed1987

Effect of orchidectomy performed after cessation of estrogen therapy on serum testosterone concentrations in patients with prostatic carcinoma.

Serum concentrations of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were determined before and after orchidectomy performed at different intervals (2-29 months) after withdrawal of estrogen therapy in patients with prostatic carcinoma. Patients previously treated with estrogen for more than 3 years had low testosterone concentrations after estrogen withdrawal and the values were not significantly changed by orchidectomy. In contrast, in patients treated with estrogen for less than 3 years, the testosterone concentrations were below or within the normal values after estrogen cessation and following orchidectomy, the values were significantly decreased. In both groups of patients the LH and FSH values were within or above the normal range both before and after orchidectomy, but FSH was significantly lower in patients previously treated with estrogen for more than 3 years. In conclusion, orchidectomy performed after cessation of long-term estrogen therapy in patients with prostatic carcinoma is without value, since testosterone levels do not change despite cessation of estrogen treatment or after orchidectomy.

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PubMed1987

Effect of medroxyprogesterone acetate, alone or in combination with epirubicin hydrochloride, on the growth of the Dunning R3327H prostatic adenocarcinoma.

Rats bearing the Dunning R3327H prostatic adenocarcinoma were castrated and supplemented with testosterone propionate. Some of the testosterone-supplemented rats were treated with medroxyprogesterone acetate (MPA) alone or in combination with epirubicin hydrochloride. During the treatment period of 4 weeks, the growth rate of the prostatic tumors was measured. The testosterone-supplemented rats showed a tumor growth rate similar to that found in intact control rats. It was found that MPA has an inhibitory effect on the tumor growth rate in castrated testosterone-supplemented animals. This effect was more pronounced if the MPA treatment was combined with epirubicin hydrochloride, where the tumor growth rate was slower than that found in rats castrated as the only treatment.

Adenocarcinoma↗

PubMed1986

Some effects of treatment with ethinyl oestradiol with or without polyoestradiol phosphate in patients with prostatic carcinoma.

Eleven patients with prostatic carcinoma were treated with ethinyl oestradiol (Etivex) 50 micrograms three times daily with and 10 patients without 80 mg polyoestradiol phosphate (Estradurin) monthly. Both forms of treatment produced a significant decrease in the serum testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) and a significant increase in the testosterone-oestradiol-binding globuline (TeBg). Serum prolactin was significantly higher at 1, 3 and 6 months after treatment, in all patients studied, but the concentrations found at 12 and 18 months did not differ from those before treatment. One out of 10 patients treated with ethinyl oestradiol had congestive heart failure. Five out of 11 patients treated with ethinyl oestradiol-polyoestradiol phosphate had cardiovascular or liver complications. Three of the 5 had thromboembolic complications. It is concluded that ethinyl oestradiol given in combination with polyoestradiol phosphate, was not superior in decreasing serum testosterone when compared to ethinyl oestradiol given alone. Furthermore, the oestrogens used, elevated prolactin only, during the first 6 months of treatment. There were fewer complications using ethinyl oestradiol alone than when using ethinyl oestradiol combined with polyoestradiol phosphate.

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PubMed1985

Prognostic significance of transrectal fine-needle aspiration biopsy findings after orchiectomy for carcinoma of the prostate.

In 48 patients with prostatic carcinoma two types of cell patterns were found at fine-needle aspiration biopsy at follow-up 6 and 12 months after orchiectomy: (1) unmodified carcinoma cells or (2) carcinoma cells with regressive changes. Objective clinical regression at 36 months was significantly more frequent in patients with regressively transformed cancer cells at 6 and/or 12 months than in patients with unmodified carcinoma cells: 73 and 32%, respectively. Ten percent of the patients with regressively transformed carcinoma cells and 41% of the patients with unmodified cancer cells died of prostatic carcinoma. The cytologic findings at 6 and/or 12 months after orchiectomy is thus of importance for predicting the prognosis.

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PubMed1984

Sexual function in prostatic cancer patients treated with radiotherapy, orchiectomy or oestrogens.

Sexual function in prostatic carcinoma patients was studied in 12 patients from each of three treatment groups: radiotherapy, orchiectomy and oestrogen treatment. Significant deterioration occurred in all groups. Although erectile potency was preserved in 9 of 12 patients treated with radiotherapy, 7 of these had a marked reduction in the frequency of sexual activity. Men subjected to orchiectomy or oestrogen treatment were seldom capable of having intercourse or of experiencing orgasm. However, oestrogen-treated men continued sexual activity with their partner more often than orchiectomised subjects. Patients receiving oestrogen treatment scored significantly higher for mental depression than those in the other two treatment groups.

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PubMed1983

Binding capacity of testosterone-estradiol-binding globulin (TeBG), total and calculated unbound concentrations of testosterone in patients with carcinoma of the prostate treated with orchidectomy or estrogens.

Testosterone-estradiol-binding globulin (TeBG) binding capacity, total estradiol-17 beta and total testosterone were measured in patients with carcinoma of the prostate treated with orchidectomy or estrogens. Comparisons were made with a control group. There was a significant increase in TeBG binding capacity in the group treated with estrogens. Both orchidectomy and estrogen-treatment decreased total testosterone significantly and to the same degree. The concentration of free testosterone was calculated using a new method, and was found to be lower in orchidectomized and estrogen treated patients when compared with the control group. When the two groups under treatment were compared, the calculated free testosterone concentration was significantly lower in the estrogen treated group.

Adenocarcinoma↗

PubMed1983

Effects of external radiation therapy for cancer of the prostate on the serum concentrations of testosterone, follicle-stimulating hormone, luteinizing hormone and prolactin.

Testosterone, luteinizing hormone, follicle-stimulating hormone and prolactin were analyzed in serum from 31 patients with carcinoma of the prostate treated primarily with megavoltage radiation therapy. The total tumor dose varied between 58 and 71 gray (mean 63.5 gray). Absorbed doses to the testes were measured at approximately 1 to more than 10 gray. We investigated retrospectively 17 patients 3 to 60 months (mean 20 months) after therapy and found significantly lower serum testosterone concentrations and significantly higher luteinizing and follicle-stimulating hormone concentrations than in age-matched controls. Of the patients 14 were followed before and after radiation treatment. Testosterone concentrations were reduced significantly 1 week as well as 3 months after treatment but pre-treatment values were found on analysis 6 and 12 months after treatment. The values for luteinizing and follicle-stimulating hormones were significantly higher 3, 6 and 12 months after radiation treatment compared to pre-treatment values. The follicle-stimulating hormone value already increased after 1 week. The greatest observed testosterone alteration occurred 1 week after treatment in patients who received more than 10 gray over the gonads. The use of lead shields protecting the testes reduced the dose absorbed to the gonads by approximately 50 per cent.

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PubMed1983

Testicular endocrine function after withdrawal of oestrogen treatment in patients with carcinoma of the prostate.

The serum concentration of testosterone, luteinising hormone (LH), follicle stimulating hormone (FSH) and prolactin were determined at different intervals after withdrawal of oestrogen treatment in patients with prostatic carcinoma. Oestrogen therapy had been stopped in all patients because of the side effects of oestrogens. There was a negative correlation (r = -0.64) between serum testosterone concentrations and the duration of oestrogen treatment in patients investigated for more than 6 months after withdrawal of hormones. However, the decrease in testosterone concentration seems to be time-dependent. Thus patients who were treated for less than 3 years had normal testosterone concentrations approximately 6 months after withdrawal of the oestrogen therapy. This group of patients had a positive correlation (r = 0.49) between serum testosterone concentration and time elapsed after cessation of therapy. In contrast, patients treated for more than 3 years retained low testosterone concentrations even after 6 months. The other hormones did not vary between the groups. It is concluded that patients with carcinoma of the prostate treated with oestrogens for more than 3 years have an impaired Leydig cell function which might be irreversible.

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PubMed1983

Some effects of orchiectomy, oestrogen treatment and radiation therapy in patients with prostatic carcinoma.

In patients treated for prostatic carcinoma with oestrogen, orchiectomy or external radiation, serum concentrations of testosterone, LH, FSH, prolactin, TeBG and oestradiol-17 beta as well as changes in sexual behaviour and mental mood were studied. Oestrogen treatment as well as orchiectomy reduced serum testosterone concentration to similar values. Neither totally nor subcapsularly orchiectomized patients responded to HCG stimulation. The free testosterone was 68% lower in oestrogen treated than in orchiectomized patients, probably due to a high TeBG concentration induced by oestrogens. patients oestrogen treated for less than 3 years and in whom the treatment had been withdrawn had normal serum testosterone and LH at follow-up. In contrast, low serum testosterone concentration and normal LH were found after oestrogen cessation in patients oestrogen treated for more than 3 years indicating reduced Leydig cell, and/or hypothalamic-hypophyseal function. In patients oestrogen treated for more than 3 years the serum testosterone concentration neither increased after oestrogen cessation nor decreased after orchiectomy. Absorbed testes doses during radiation treatment were measured from a few to more than 10 Gy but were reduced by about 50% if the gonads were protected by lead shields during anterior and posterior treatment sessions. Radiation may affect gonadal function as decreased serum testosterone concentration and increased LH, FSH were found after treatment. Sexual function was altered after oestrogen, orchiectomy and radiation treatment. Sexual activity and capability were distinctly better maintained after radiation than after orchiectomy or oestrogen treatment. Sixty-seven percent of the patients had coitus or masturbated after radiation treatment, all experiencing orgasm. Patients on oestrogen treatment or after orchiectomy had coitus/masturbation less often (17% in both groups). They also experienced orgasm less often (8% and 17% respectively). The group of patients on oestrogen treatment had a higher average score for depression than those treated with orchiectomy or radiation treatment.

Adenocarcinoma↗

PubMed1982

Effects of total and subcapsular orchidectomy on serum concentrations of testosterone and pituitary hormones in patients with carcinoma of the prostate.

22 men with carcinoma of the prostate were consecutively subjected to either total or subcapsular orchidectomy at random. Serum concentrations of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone and testosterone-estrogen-binding globulin were followed. No differences were found between the two groups during the 6-month follow-up period. Orchidectomy reduced testosterone concentration in all cases and none responded to human chorionic gonadotrophin stimulation 6 months postoperatively. The concentrations of free and bound testosterone were calculated but did not vary between the two types of operation, which were considered equally efficient in reducing testosterone concentration. However, doubts about the completeness of the operation might possibly arise in cases with cancer progress and therefore we prefer total orchidectomy as the first choice, but perform subtotal orchidectomy on those men preferring this type of operation psychologically.

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