Low-dose aminoglutethimide therapy without glucocorticoid administration. Clinical and hormonal findings

Eleven postmenopausal patients with advanced breast cancer were assessed for their response and endocrine changes to low-dose aminoglutethimide (250 mg twice a day) therapy without steroid administration. In 7 cases an objective response was registered; 1 patient had a stabilization of the disease lasting for 9 months. Significant falls in plasma estrogen and rises in plasma androgen levels were observed, while those of cortisol and ACTH remained essentially unchanged. No serious side effects occurred.

[Management of tibial fractures with Ender nailing]

Authors have performed in 1984-1986 46 Ender nailings based on definite indications as treatment of lower leg fractures in the Department of Traumatology, Arpád Hospital, Ujpest. In their clinical study they stress the criteria of the choice of this method, underline the advantages and disadvantages of the stabilization with elastic nails. This treatment used especially for fractures of the distal third lightens the care, the mobilization, shortens the stay in the hospital, diminishes the number of the septic complications. In many cases authors recommend it as a good alternative method, based on own experiences and results, to surgeons forced to accept a compromise.

Correlation between human lactoferrin binding and colicin susceptibility in Escherichia coli

Escherichia coli H10407 demonstrated low 125I-human lactoferrin (HLf) binding (7%) and was insusceptible to group A (A, E1, E2, E3, E6, and K) and group B (B, D, Ia, Ib, and V) colicins. Conversely, a spontaneous HLf high-binding (44%) variant, H10407(Lf), demonstrated an increase susceptibility to both colicin groups. Colicin-insusceptible E. coli wild-type strains 75ColT, 84ColT, and 981ColT showed a low degree of HLf binding, i.e., 4, 8, and 10%, respectively. The HLf binding capacity was high in the corresponding colicin-susceptible mutants 75ColS (43%), 84ColS (32%), and 981ColS (43%). Furthermore, HLf low- (less than 5%) and high- (greater than 35%) binding E. coli clinical isolates (10 in each category) were tested for susceptibility against 11 colicins. Colicin V susceptibility did not correlate with HLf binding in either categories. However, with the remaining colicins, three distinct HLf-binding, colicin susceptibility patterns were observed; (i) 10 of 10 HLf low-binding strains were colicin insusceptible, (ii) 6 of 10 HLf high-binding strains were also colicin insusceptible, and (iii) the remaining HLf high binders were highly colicin susceptible. Certain proteins in the cell envelope and outer membrane of wild-type H10407 (HLf low binder, colicin insusceptible) showed a lower mobility in sodium dodecyl sulfate-polyacrylamide gel electrophoresis compared to the corresponding proteins of mutant H10407(Lf) (HLf high binder, colicin susceptible). These mobility differences were also associated with HLf-binding proteins in Western blot (ligand blot) analysis. The wild type showed a smooth form of lipopolysaccharide (LPS) with a distinct ladder of O-chains, compared to the rough LPS of the mutant.(ABSTRACT TRUNCATED AT 250 WORDS)

[Simultaneous occurrence of selective ACTH deficiency , achalasia, alacrimia and hyperlipoproteinemia]

An extremely rare clinical syndrome on a 7-year-old girl is presented. Besides isolated glucocorticoid insufficiency, achalasia and alacrimia disturbance of the lipid metabolism was also detected--this is a special feature of this case. The details of the endocrine workup is discussed, providing clues for the possible pathomechanism. The correct diagnosis and specific therapy is of utmost importance in the everyday life of the patient.

[Parenteral-enteral feeding and monitoring of patients with protein-calorie malnutrition in pharyngeal-laryngeal tumors]

The authors nourished artificially patients with stage III.--IV. pharyngeal and laryngeal tumors in the preoperative phase at the Department of Head and Neck Surgery, Postgraduate Medical School. The courses were monitored with biochemical and antropometrical measurements. The good results of wound healing advocate the use of the described method.

[Increased androgen-binding capacity and decreased free androgen index in male alcoholics with liver disease]

Androgen binding capacity in the serum of 30 male patients under 51 years of age suffering from chronic alcoholic liver disease was investigated with tritiated 5 alpha-dihydrotestosterone. The result received by saturation analysis is regarded as an indicator of the SHBG (sex hormone binding globulin) content of the blood. Testosterone was measured simultaneously and the free androgen index (FAI) was calculated. The diagnosis of liver disease was based on case histories, physical symptoms and laboratory abnormalities, in some cases on liver biopsy too. Age-matched control group consisted of 18 healthy males. The results showed markedly elevated androgen binding capacities (SHBG contents), testosterone values in the normal range and significantly decreased FAI, indicating insufficient amounts of biologically active testosterone.

High-dose ketoconazole treatment in advanced prostatic cancer

For purposes of testosterone suppression, high doses of ketoconazole were administered to 18 patients with advanced cancer of the prostate for an average of 6 months. A well-evaluable response was observed both objectively and subjectively. The blood levels of the steroid hormones were measured during the treatment period and it was found that testosterone biosynthesis was blocked. Mild gastrointestinal symptoms occurred in the minority of the cases, and administration of the drug had to be stopped in one case because of jaundice. The possibility of the use of smaller doses is being investigated, which may lead to the development of an alternative to the endocrine treatment methods.

Curing of plasmid pE194 with novobiocin and coumermycin A1 in Bacillus subtilis and Staphylococcus aureus

Plasmid pE194 determining macrolide-lincosamid-streptogramin B resistance could be eliminated with novobiocin and coumermycin A1 in Bacillus subtilis and Staphylococcus aureus. In both organisms the curing effect depended on the temperature. In the case of Staphylococcus aureus it increased very much at high temperatures, while in the case of Bacillus subtilis only a moderate increase could be observed. The curing activity of coumermycin was substantially weaker than that of novobiocin in both bacteria. This difference decreased at higher temperatures only in Staphylococcus aureus. In Bacillus subtilis the curing with novobiocin could be antagonized with coumermycin in accordance with the growth experiments reported previously.

Investigations on the chemistry of berbanes. 10. Synthesis of raunescinone analogues with hypotensive and antihypertensive activity

The pharmacologically active (methylenedioxy)- and diethoxyepialloberbane keto esters I have been synthesized with use of the readily available keto esters 2 as starting material. By choice of the appropriate reaction sequence both antipodes of keto ester 2a can be employed to provide any enantiomer of the desired raunescinone analogue 1a. Hypotensive, antihypertensive, and central depressant effects of 1a are described. The principle effect observed for 1a was a potent hypotensive and antihypertensive effect of long duration without depression of the central nervous system.

Formation and concentration of dehydroepiandrosterone sulphate in the abdominal skin of healthy individuals and patients with endocrine disease

In vitro incubation studies demonstrated that abdominal skin slices from healthy females and males converted 1.05-2.73% (mean 1.75%) and 0.64-2.06% (mean 1.32%), respectively of [4-14C]dehydroepiandrosterone (DHA) to [4-14C]dehydroepiandrosterone sulphate (DHA-S) and that the delta 5-3 beta-hydroxysteroid sulphokinase(delta 5-3 beta-HSS) activities were almost identical in female and male abdominal skin. DHA-S formation in the skin of females with hirsutism of adrenocortical, ovarial or idiopathic origin was shown not to differ from that in healthy females; the hyperandrogenism in the skin of hirsute females is thus not a consequence of a delta 5-3 beta-HSS deficiency. In vitro synthesis of DHA-S in the abdominal skin of patients with complete testicular feminization or 46XY pure gonad dysgenesis and anorchia was similar to that in healthy subjects. Addition of synthetic human alpha 1-39-ACTH and natural (porcine) ACTH to in vitro incubates of abdominal skin slices from healthy females or females with various types of hirsutism increased the formation of DHA-S, revealing thereby a further extra-adrenal effect of ACTH. In the abdominal skin of healthy females and males the DHA concentration did not differ, but the concentration of DHA-S was much higher in males. The DHA-S concentration in the abdominal skin of idiopathic hirsutism patients was pathologically high in spite of the blood DHA-S level being normal. The considerable accumulation of DHA-S in the abdominal skin of healthy males and hirsute females cannot be explained by the normal delta 5-3 beta-HSS activity; thus, it is assumed that either the DHA-S elimination mechanism may be changed in the abdominal skin slices, or the DHA-S binding proteins might be multiplied.

Cyproterone acetate treatment of females with hyperandrogenism

Five females with idiopathic hirsutism, ten with adrenogenital syndrome, four with acne vulgaris, and three with Stein-Leventhal syndrome were treated for nine months with large or small doses of cyproterone acetate (100 or 2 mg daily, respectively) in combination with oestrogen. The drug had a good effect on the acne vulgaris and moderated the hirsutism. In the various patient groups the serum testosterone level was decreased to between 58.6% (+/- 28.7% S.E.) and 10.8% (+/- 8.2% S.E.) of the basal value. No essential difference in effectiveness was observed between the large and small doses. Based on study of the side-effects, it is recommended that laboratory liver tests are used for control.

Attempts at localizing calcium in relation to synaptic transmission: an X-ray microanalytical study

1. In view of the importance of calcium in triggering the transmitter secretion during nerve stimulation or depolarization, the localization of calcium binding sites was studied in stimulated nerve endings that were fixed in calcium-containing s-collidine buffered paraformaldehyde solution. 2. In cholinergic synapses, such as the superior cervical ganglion of cat, the myoneural junction of rat diaphragm and the electric organ of Torpedo marmorata, a stimulation-dependent accumulation of calcium was found in the mitochondria of presynaptic nerve endings. 3. In synaptosomes prepared from rat cerebral cortex, the activity-dependent accumulation of calcium in mitochondria of pinched off nerve endings was also observed. The mitochondrial accumulation of calcium in synaptosomes was dependent on ATP, temperature and could be inhibited by quercetin. 4. In stimulated synapses, only the mitochondria seemed to accumulate calcium in appreciable amounts, whereas other intra-terminal structures, such as the smooth endoplasmic reticulum and synaptic vesicles were devoid of calcium.

Clinical trials with MTDQ /6,6'-methylene-bis (2,2,4-trimethyl-1,2-dihydroquinoline)/ an antioxidant with radiation sensitizing effect

Daily doses of 1320 mg MTDQ have been administered orally to 7 patients for 100 subsequent days. Biological half-life and serum concentration measurements were performed. Function of vital organs, as well as routine laboratory findings revealed that MTDQ did not induce any toxic changes. The effect of MTDQ on the radiosensitivity of hypoxic tumor cells was studied in a combined treatment modality including 12 patients. The action on tumor regression was found encouraging. It has been found remarkable, too, that due to the effect of MTDQ and radiotherapy some of the nonspecific and general symptoms (e. g. pruritus) also disappeared.