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Clinical Trial 2005; 26(6): 811-814 PubMed PMID: 16380700 Citation  Keywords:  Acromegaly:blood, Adult, Cardiovascular Diseases:complications, Female, Glucose Tolerance Test, Growth Hormone:blood, Homocysteine:blood, Humans, Hyperhomocysteinemia:blood, Male, Middle Aged, Risk Factors, Statistics, Nonparametric,.   

: Acromegaly is associated with a two to three-fold increase in mortality related predominantly to cardiovascular disease. The excess mortality is associated most closely with higher levels of growth hormone (GH). Survival in acromegaly may be normalized to a control age-matched rate by controlling GH levels; in particular, GH levels less than 2.5 ng/mL are associated with survival rates equal to those of the general population. Hyperhomocysteinemia has also been recognized as a risk factor for cardiovascular disease, yet there are limited data on the prevalence of hyperhomocysteinemia in patients with acromegaly. Eighteen acromegaly patients (7 male, 11 female, mean age 42.8 +/- 11.0 years) in our endocrine clinic consented to having the following tests performed: complete blood count (CBC), thyroid hormones, folic acid, vitamin B12, plasma homocysteine levels, uric acid, fibrinogen, CRP, fasting glucose, insulin, C-peptide, total serum cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, GH, insulin-like growth factor-1 (IGF-1) and GH levels after an oral glucose tolerance test (OGTT). By history, fourteen had macroadenomas and four had microadenomas; eight had hypertension; two had glucose intolerance, and four had diabetes. Fifteen had had transsphenoidal or transfrontal surgery: two had been cured, but 13 others were taking long-acting octreotide. Five patients had undergone radiotherapy and the acromegaly in two was treated primarily with long-acting octreotide. CBC, thyroid hormone, folic acid, and vit B12 levels were normal in all patients. We divided the patients into two groups according to mean GH levels after an OGTT: Group 1 (GH<2.5 ng/mL, n=10), and Group 2 (GH<2.5 ng/mL, n=8). Comparison of the two groups using Mann-Whitney U testing revealed statistically significant lower levels in Group 1 of the following parameters: GH (1.91 +/- 0.90 vs. 8.58 +/- 5.55 ng/mL, p=0.002), IGF-1 (338.30 +/- 217.90 vs. 509.60 +/- 293.58 ng/dL, p=0.06), GH after an OGTT (1.42 +/- 0.81 vs. 9.01 +/- 4.53 ng/mL, p=0.001), plasma homocysteine (12.85 +/- 4.47 vs. 18.20 +/- 4.99 micromol/L, p=0.05), total cholesterol (164.0 +/- 20.81 vs. 188.0 +/- 22.26 mg/dL, p=0.05) and LDL cholesterol (81.0 +/- 9.64 vs. 116.70 +/- 13.03 mg/dl, p=0.01). Differences between the other parameters were not significantly different. Acromegaly patients with high GH levels after an OGTT have much higher levels of homocysteine than patients with lower GH levels. The role of elevated homocysteine levels as an independent cardiovascular risk factor in the mortality of acromegaly patients should be determined in future studies....

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Clinical Trial 2005; 26(6): 752-756 PubMed PMID: 16380699 Citation  Keywords:  Biomechanical Phenomena, Female, Foot:anatomy & histology, Humans, Imaging, Three-Dimensional, Models, Anatomic, Postpartum Period:physiology, Pregnancy:physiology, Stress, Mechanical, Weight-Bearing,.   

OBJECTIVES: The aim is data detection and finding some load consequences generated by various mechanical or physiological changes in the interaction of the end segment of the body--the foot--and the environment.

DESIGN: Shape instability of the foot caused by e.g. loading of the foot by long-term frequency loads--walking, by extreme loads--sport, by hormonal changes--pregnancy, by aging, by pathologies, etc. The footprint surface was numerically described in 3D by means of stereo-photo-gram-metrical method--DMR digital relief model. Density of discrete points--250-400 per one print.

SETTING: Detailed DMR was constructed by means of triangular web including contour picture with the use of Atlas program. The specified generated web is characterized by triangles with a cca 1 mm side in the number of up to 4,500 elements per one footprint model.

RESULTS: The results enable us to deduce shape characteristics of DMR--the shape of the interactive boundary of the foot--the rest surface, to solve foot arch straining, to solve issues of discomfort and distribution of the pressure at the boundary of the foot--the rest surface, the shoe, etc. The gained findings can be interpreted in the field of prevention, therapy, orthopedics, podology, and enable us to come up with recommendations for the orthopedic practice and industrial use in the footwear production, etc. THE MAIN FINDINGS: The difference between volume reductions of the space under the foot arch characterizes the level of "fall" of the arch. This criterion is independent of the foot size, and is in 3D.

CONCLUSIONS: Shape characteristics of footprints in pregnant women and in the period after childbirth were calculated on the basis of the defined criterion. The results of the group of four women tested in three periods suggest that there is no clear tendency towards the foot arch falling/increasing of the foot arch "fall" during the pregnancy period....

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Clinical Trial 2005; 26(6): 830-834 PubMed PMID: 16380698 Citation  Keywords:  Adult, Analysis of Variance, Energy Metabolism:physiology, Exercise:physiology, Heart Rate:physiology, Humans, Male, Physical Exertion, Reference Values, Statistics, Nonparametric, Thyrotropin:blood, Thyroxine:blood, Triiodothyronine:blood,.   

BACKGROUND: Physical activity influences energy metabolism in human subjects by increasing activity-induced energy expenditure and resting metabolic rate for several hours after exercise. Effects of exercise on circulating thyroid hormone values remain controversial. We have investigated the effect of acute aerobic exercise on thyroid hormone values.

MATERIALS/METHODS: The effect of different intensity levels of acute aerobic exercise on thyroid hormones was investigated in 60 male well-trained athletes by performing bicycle ergometer at 45% (low intensity), 70% (moderate intensity), and 90% (high intensity). These intensities were selected according to their maximum heart rate (MHR). At each intensity level, heart rate, blood lactic acid, serum total thyroxine (T4), free thyroxine (fT4), total triiodothyronine (T3), free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) values were measured.

RESULTS: The results of this study show that exercise performed at the anaerobic threshold (70% of maximum heart rate, lactate level 4.59 +/- 1.75 mmol/l) caused the most prominent changes in the amount of any hormone values. While the rate of T4, fT4, and TSH continued to rise at 90% of maximum heart rate, the rate of T3 and fT3 started to fall.

CONCLUSIONS: Maximal aerobic exercise greatly affects the level of circulating thyroid hormones....

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Controlled Clinical Trial 2005; 26(6): 653-656 PubMed PMID: 16380697 Citation  Keywords:  Adult, Circadian Rhythm:physiology, Down-Regulation, Female, Humans, Kidney Failure, Chronic:blood, Male, Melatonin:blood, Middle Aged, Reference Values, Renal Dialysis, Reproducibility of Results,.   

OBJECTIVES: In spite of broad interest, intensive studies on function of melatonin have not yielded much information about relationships between this hormone and kidneys in health, and particularity, in disease. There are only a few studies dealing with melatonin concentrations in renal diseases, mainly performed in hemodialyzed patients with end-stage renal disease (ESRD). Moreover, the most melatonin assays were performed during the daytime, and the results are conflicting. Therefore, the aim of the present study was to determine the circadian melatonin profiles in patients ESRD before and after hemodialysis.

MATERIAL AND METHODS: Thirty patients (19 males and 11 females) with ESRD undergoing dialysis, aged 22 to 64 years (mean+/-SEM: 49.1.0+/-1.9 years) were included in the study. The control group consisted of 20 healthy volunteers (13 males and 7 females) aged 35 to 55 years (mean+/-SEM: 46.2+/-1.4 years) matched according to sex and age. Blood samples were collected on the day preceding hemodialysis and one day following dialysis at 08:00, 12:00, 16:00, 20:00, 24:00, 02:00, 04:00, and 08:00 h. Melatonin concentration was measured by enzyme immunoassay.

RESULTS: In patients with renal insufficiency undergoing dialysis mean melatonin nocturnal concentrations were significantly lower then those in healthy volunteers. The presence of the circadian rhythm in melatonin concentrations (although of significantly lower nocturnal amplitude) was detected only in 8 patients with renal failure undergoing hemodialysis, whereas in remaining 22 patients no such rhythm was found. Hemodialysis did not influence melatonin concentrations.

CONCLUSIONS: The mechanism of depressed melatonin concentrations in hemodialyzed patients observed in our study remains unclear. However, it seems possible that decline in melatonin levels is due to impairment in adrenergic function that occurs in renal failure. Because the studies on the melatonin secretion in chronic renal failure bring about conflicting results, the relationship between renal diseases and melatonin secretion needs further investigations....

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Clinical Trial 2005; 26(6): 709-712 PubMed PMID: 16380696 Citation  Keywords:  Adrenocorticotropic Hormone:blood, Adult, Dexamethasone:therapeutic use, Down-Regulation, Female, Humans, Hydrocortisone:blood, Middle Aged, Nelson Syndrome:blood, Somatostatin:therapeutic use, Treatment Outcome, Valproic Acid:therapeutic use,.   

OBJECTIVE: Pituitary tumours occurring in patients bilaterally adrenalectomized because of Cushing's disease (Nelson's syndrome) are frequently invasive and a complete their resection is not possible in most of them. Administration of the drugs decreasing ACTH secretion could be helpful in such unresectable tumours. We tried to evaluate the influence of somatostatin and valproic acid, compared to dexamethasone, in short-term studies, on plasma ACTH levels in Nelson's syndrome (NS).

MATERIAL AND METHODS: Basal ACTH levels were determined within 18 h after last dose of hydrocortisone and next, 1 and 2 hours following oral administration of 20 mg of hydrocortisone. Somatostatin was injected s.c. in two patients with NS while sodium valproate and dexamethasone were administered orally for three days in three patients with NS (two with an invasive pituitary tumour and one with a localized, intrasellar adenoma). The blood for ACTH and cortisol determination was drawn before the tests (two hours after 20 mg of hydrocortisone ingestion) as well as 1 and 2 hours following somatostatin injection and after 3 days of valproic acid or dexamethasone administration.

RESULTS: High plasma ACTH levels were found before the tests. Somatostatin lowered ACTH levels in both patients, more effectively in the patient with non-invasive pituitary adenoma. Valproic acid decreased moderately ACTH concentration in two patients, while following dexamethasone administration a fall in ACTH levels was observed in all three patients, the most evident in the patient with a non-invasive Nelson's adenoma.

CONCLUSION: Somatostatin seemed to be more effective in its inhibitory action on ACTH secretion than valproic acid, thus its administration in invasive cases of NS could be tried as a supplementary method to neurosurgery. The response to dexamethasone administration indicates that a feed-back regulation, although impaired, exists in these cases....

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Journal Article 2005; 26(6): 663-666 PubMed PMID: 16380693 Citation  Keywords:  Adult, Apoptosis:physiology, Endometrium:metabolism, Female, Humans, Immunohistochemistry, Menstrual Cycle:metabolism, Metallothionein:metabolism, Middle Aged, Statistics, Nonparametric,.   

OBJECTIVES: Molecular changes observed in endometrium with respect to menstrual cycle changes seem to be crucial for the reproductive function. Accumulation of cytotoxic cells increases the exposure of endometrial cells to apoptosis. Protection against apoptosis may be reached by endometrial cells by self molecular regulation. Metallothionein was suggested to participate in this process. The aim of our study was to evaluate endometrial MT immunoreactivity with respect to the menstrual cycle phases.

MATERIALS AND METHODS: MT expression was assessed using immunohistochemistry method in 47 endometrial tissue samples derived from randomly selected patients with respect to the menstrual cycle phases--proliferative and secretory with distinguishing early, mid and late subphases in each.

RESULTS: MT expression changes were observed respectively to hormonal fluctuations with the highest level during mid secretory phase and its respective decrease during the early, late secretory and mid proliferative menstrual cycle phases. The lowest MT immunoreactivity level was disclosed during early proliferative phase.

CONCLUSION: Significant differences in MT expression observed in endometrium with respect to menstrual cycle changes might suggest MT participation in endometrial cells protection against apoptosis....

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Clinical Trial 2005; 26(6): 771-774 PubMed PMID: 16380685 Citation  Keywords:  Adaptation, Psychological, Adolescent, Adult, Analysis of Variance, Cultural Evolution, Female, Hierarchy, Social, Homosexuality, Humans, Male, Psychological Theory, Reproduction, Sex Factors, Sexual Behavior:psychology, Social Behavior,.   

OBJECTIVES: The alliance theory holds that homosexual behavior in humans may have evolved because it reinforced same-sex alliances which contributed to survival and reproduction. The present study was designed to test this evolutionary hypothesis in view of the strongly negative perception of homosexual behavior. It was predicted that targets who engaged in homosexual behavior would be perceived as likely to achieve greater social status and reproductive opportunities when the behavior reinforced an alliance that led to increased social opportunities.

METHODS: Three hundred sixteen men and women read scenarios in which a target engaged in homosexual behavior and then answered questions about the target's future social status and reproductive opportunities as measured by number of sexual partners. The data were analyzed in two 3 (social outcome: positive vs. neutral vs. negative) x 2 (gender of target) x 2 (gender of participant) analyses of variance.

RESULTS: The results supported the predictions and demonstrated that targets were perceived as likely to have the greatest social status and reproductive opportunities in the positive outcome condition.

CONCLUSION: The alliance theory of homosexual behavior may have heuristic value for the evolutionary study of homosexual behavior and its perception....

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Clinical Trial, Phase I 2005; 26(6): 685-689 PubMed PMID: 16380684 Citation  Keywords:  Adult, Antipsychotic Agents:therapeutic use, Benzodiazepines:therapeutic use, Brain Mapping, Cerebrovascular Circulation:drug effects, Cysteine:analogs & derivatives, Frontal Lobe:blood supply, Humans, Male, Middle Aged, Organotechnetium Compounds, Psychi.   

OBJECTIVES: Altered regional cerebral blood flow (r-CBF) is mentioned as one of possible etiological factors or as a consequence of schizophrenia. Perfusion scintigraphic brain studies with SPECT (Single Photon Emission Computed Tomography) and PET (Positron Emission Tomography) can detect areas of the brain with altered perfusion during the disease. Conflicting data exist on follow-up after treatment. The aim of our study was to evaluate r-CBF in acute first-episode schizophrenia and early effect of antipsychotic drugs on r-CBF.

DESIGN AND SETTING: Clinical criteria for schizophrenia were met according to International Classification of Diseases-10th Edition (ICD-10). Psychic status and severity of the disease in each patient were evaluated with psychiatric interview, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) on the same day as the scintigraphic study. Brain perfusion SPECT was performed 20 minutes after 99mTc-ECD application. R-CBF was measured in 9 first-episode schizophrenic male patients 2-7 (median 6) days after the beginning of antipsychotic treatment and 8-15 (median 9) weeks later. Semiquantitative analysis of r-CBF was performed with cerebellum as the reference region. R-CBF was evaluated for 12 regions in each study.

RESULTS: Decrease in perfusion in comparison to cerebellum was detected in left (90%) and right (93%) frontal lobes. Increase in perfusion between the first (t1) and the second (t2) investigation was significant (p<0.05) for both frontal regions (left 94%, right 97%). Significant decrease in PANSS (p<0.05) and CGI (p<0.001) scores was noted and correlated well with the increase of r-CBF.

CONCLUSIONS: Our findings implicate that patients with first-episode schizophrenia have significant left hypoperfusion relative to the right in dorsolateral frontal lobes. Increased blood flow was observed bilaterally in dorsolateral frontal lobes after 10 weeks of antipsychotic medication. Significant amelioration of r-CBF correlated with clinical improvement....

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