Diego Turner

Effect of the Phosphodiesterase Inhibitor Pentoxyfylline on Human Sperm Motility

Einfluß des Phosphodiesterase‐Inhibitors Pentoxyphyllin auf die Motilität menschlicher Spermatozoen

Plasma levels of norepinephrine during the periovulatory period in normal women

Abstract Eleven normally cycling women in whom laparotomy was indicated for benign gynecologic pathology were studied. Surgery was performed on day 0 (expected day of ovulation). Blood samples were drawn daily from day −8 to day −4, and every 8 hours from day −3 to day +2; estradiol (E 2 ), progesterone (P), norepinephrine (NE), and LH were determined by RIA. Ovulation was certified by ovarian visualization and biopsy during laparotomy. In nine ovulatory patients mean E 2 peak was found 48 hours before LH peak. Mean NE levels showed minimal variations until 48 hours before LH peak; 8 hours after E 2 peak mean NE values increased significantly, fell 8 hours later, and rose immediately again, reaching maximal levels 24 hours after E 2 peak. These values remained high until 16 hours before the LH peak and decreased gradually, thereafter reaching basal levels 32 hours after LH peak. Two anovulatory patients showed an atypical pattern of ovarian steroids and LH secretion and NE showed large variations without any correlation with estradiol or LH levels. This study confirms previous findings in women and experimental work in animals regarding the existence of a noradrenergic trigger mechanism to the LH ovulatory discharge.

Response of Luteinizing Hormone and Follicle-Stimulating Hormone to Different Doses of Synthetic Luteinizing Hormone-Releasing Hormone by Intramuscular Administration in Normal and Oligospermic Men: Preliminary Report

The response of LH and FSH levels to intramuscularly administered synthetic LH-RH was studied in two healthy volunteers and three oligospermic patients. Four tests with 50, 100, 250, and 500 mug of LH-RH, respectively, were carried out on each subject at 8 am; the interval between tests was one week. The serum levels of LH and FSH were determined by radioimmunoassay (double-antibody method) before each injection, and 60, 120, 180, and 240 minutes after each injection. No differences in the basal values of either hormone were observed. In both oligospermic and normal men, maximal responses were obtained with doses between 100 and 250 mug. With 500 mug, levels decreased rather than increased. Maximal peaks occurred between 60 and 180 minutes after injection. In the two normal subjects, the responses of LH and FSH were similar. Two of the three oligospermic patients showed discordant responses. From the results, we can assume that LH-RH doses between 100 and 250 mug should be used as a basis for chronic treatment.

Bromocriptine in the Treatment of Hyperolactinemic Amenorrhea

Thirty women with secondary amenorrhea and hyperprolactinemia were studied; galactorrhea was present in 25 of them, and 18 were infertile. Serum prolactin (PRL) levels were high in all cases, between 26 and 120 ng/ml. All women were treated with bromocriptine in increasing doses from 2.5 to 5.0 or 7.5 mg daily, according to the response obtained, for 4 months. In 27 patients a PRL determination was performed during treatment; values returned to normal (up to 20 ng/ml) in 23 women and remained high in 4. Galactorrhea disappeared in 21 of 25 women. Ovulatory menses were re-established in 17 patients (56.6%). Seven women became pregnant (38.8%), one of them after bromocriptine and clomiphene were given simultaneously in the same cycle. According to our results and a literature review the following conclusions may be drawn: (1) bromocriptine is a useful therapeutic tool for re-establishing menstruation and inducing ovulation in patients with the hyperprolactinemic-amenorrhea syndrome; (2) the association of bromocriptine and clomiphene could be the next step in the treatment of patients who fail to ovulate with bromocriptine alone.

PLASMA LEVELS OF NOREPINEPHRINE DURING THE PERIOVULATORY PERIOD IN NORMAL WOMEN

Eleven normally cycling women in whom laparotomy was indicated for benign gynecologic pathology were studied. Surgery was performed on day 0 (expected day of ovulation). Blood samples were drawn daily from day -8 to day -4, and every 8 hours from day -3 to day +2; estradiol (E2), progesterone (P), norepinephrine (NE), and LH were determined by RIA. Ovulation was certified by ovarian visualization and biopsy during laparotomy. In nine ovulatory patients mean E2 peak was found 48 hours before LH peak. Mean NE levels showed minimal variations until 48 hours before LH peak; 8 hours after E2 peak mean NE values increased significantly, fell 8 hours later, and rose immediately again, reaching maximal levels 24 hours after E2 peak. These values remained high until 16 hours before the LH peak and decreased gradually, thereafter reaching basal levels 32 hours after LH peak. Two anovulatory patients showed an atypical pattern of ovarian steroids and LH secretion and NE showed large variations without any correlation with estradiol or LH levels. This study confirms previous findings in women and experimental work in animals regarding the existence of a noradrenergic trigger mechanism to the LH ovulatory discharge.

Niveles Plasmáticos de Insulina y Glucosa en Diabéticos Tratados con Glibenclamida y Clorpropamida

RiassuntoSono stati studiati due gruppi di pazienti con diabete stabile dell’età matura, ciascuno costituito da 4 soggetti: il primo (gruppo « A ») era stato trattato con glibenclamide durante 20,0 ± 1,1 mesi, il secondo (gruppo « B »), con clorpropamide durante 44,2 ± 15,4 mesi. Dopo 3 determinazioni preliminari della glicemia (metodo di Somogyi-Nelson) e dell’insulinemia (metodo di Meade e Klitgaard) in condizioni di base, è stata praticata una prova di carico orale con glucosio (100 g), con dosaggio dei livelli ematici di insulina e di glucosio a 0, 60, 120 e 180 min. Dopo l’esecuzione di tale prova, i farmaci sono stati scambiati: ai pazienti del gruppo « A » è stata somministrata clorpropamide e a quelli del gruppo « B » glibenclamide, in dosi equivalenti. Un secondo esperimento simile al primo è stato effettuato dopo 60 giorni di trattamento. Dai dati ottenuti con la glibenclamide si rileva che questo farmaco provoca una risposta insulinica più attiva, con un rapporto insulina/glucosio più prossimo a quello osservato in un gruppo di soggetti sani di età comparabile. Il significato dei risultati ottenuti viene discusso.RésuméOn a étudié deux groupes de patients avec diabète stable de l’âge mûr, chacun se composant de 4 individus: le premier (groupe « A ») avait été traité avec glibenclamide pendant 20,0 ± 1,1 mois, le deuxième (groupe « B »), avec chlorpropamide pendant 44,2 ± 15,4 mois. Après 3 déterminations préliminaires de la glycémie (méthode de Somogyi-Nelson) et de l’insulinémie (méthode Meade et Klitgaard) sous des conditions de base, on a procédé à un essai de chatgment oral avec du glucose (100 g), avec dosage des niveaux hématiques d’insuline et de glucose à 0, 60, 120 et 180 min. Après avoir exécuté cet essai, les médicaments ont été changés: les patients du groupe « A » ont reçu chlorpropamide alors que ceux de groupe « B » ont pris glibenclamide par doses équivalentes. Une deuxième expérience pareille à la première a été menée après 60 jours de traitement. Les résultats obtenus avec la glibenclamide ont relevé que ce médicament provoque une reponse plus active à l’insuline, avec un rapport insuline/glucose plus proche de celui vérifié chez un groupe d’individus sains d’âge comparable. On discute sur la signification des résultats obtenus.ResumenEn dos grupos de cuatro pacientes diabéticos adultos y estables, tratados con glibenclamida durante 20,0 ± 1,2 meses el primero (grupo « A ») y con clorpropamida durante 44,2 ± 15,4 meses el segundo (grupo « B »), se llevó a cabo el siguiente estudio: luego de 3 determinaciones basales previas de glucemia (método de Somogyi-Nelson) y de insulinemia (método de Meade y Klitgaard), se efectuó prueba de tolerancia glúcidica (100 g de glucosa oral) dosándose insulina y glucosa a los 0, 60, 120 y 180 min. A continuación las sulfodrogas fueron permutadas en el grupo « A » a clorpropamida y en el « B » a glibenclamida, a dosis equivalentes. Al cabo de 60 días de este tratamiento se efectuó un segundo estudio similar al primero. Los resultados obtenidos mostraron una mayor respuesta secretora de insulina y un patrón de interrelación insulina/glucosa más cercano al de un grupo de sujetos normales de la misma edad que la del grupo de diabéticos bajo glibenclamida. Se discuten las implicancias de los resultados obtenidos.ZusammenfassungEs wurden zwei Gruppen von je vier Patienten mit Erwachsenen-Diabetes untersucht. Die eine (Gruppe « A ») war seit 20,0 ± 1,1 Monaten mit Glibenclamid behandelt worden, die andere (Gruppe « B ») seit 44,2 ± 15,4 Monaten mit Chlorpropamid. Nach dreimaliger Bestimmung des basalen Blutzuckers (Somogyi-Nelson) und Insulins (Meade und Klitgaard) wurde eine Belastungsprobe mit 100 g Glukoseper os durchgeführt, wobei Insulin und Blutzucker nach 0, 60, 120 und 180 Minuten bestimmt wurden. Danach wurde die Behandlung ausgewechselt, indem Gruppe « A » mit Chlorpropamid und Gruppe « B » mit Glibenclamid in äquivalenter Dosierung behandelt wurde. Nach 60 Tagen wurde die oben beschriebene Untersuchung wiederholt. Es zeigte sich, dass unter Glibenclamid ein höherer Plasmainsulinspiegel und ein normaleres Insulin/Glukose Verhältnis (im Vergleich mit einer Gruppe von gleichaltrigen Normalpersonen) erzielt werden. Die Bedeutung dieser Ergebnisse wird besprochen.SummaryTwo groups, each consisting of four maturity-onset diabetics, were studied. This first group (group « A ») had been under glibenclamide treatment for 20.0 ± 1.1 months; the second group (group « B ») had received chlorpropamide for 44.2 ± 15.4 months before the beginning of the present study. After 3 preliminary basal blood (Somogyi-Nelson) and insulin (Meade and Klitgaard) determinations, a 100 g oral glucose tolerance test was performed, with insulin and glucose assays at 0, 60, 120 and 180 min. Medication was then crossed-over: group « A » was switched to chlorpropamide and group « B » to glibenclamide, both at equivalent dose levels. The study described above was repeated 60 days later. The findings with glibenclamide included a higher insulin response and an insulin/glucose ratio closer to normal parameters (as determined in a group of healthy subjects in the same age range as the diabetics). The implications of these results are discussed.