EFFECTS OF GENERAL ANAESTHESIA AND SEVERITY OF SURGICAL STRESS ON SERUM LH AND TESTOSTERONE IN MALES

1975 ◽  
Vol 78 (2) ◽  
pp. 258-269 ◽  
Author(s):  
A. Nakashima ◽  
K. Koshiyama ◽  
T. Uozumi ◽  
Y. Monden ◽  
Y. Hamanaka ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Surgical Stress ◽  
Fiberoptic Bronchoscopy ◽  
Serum Testosterone ◽  
Major Surgery ◽  
Succinylcholine Chloride ◽  
Serum Luteinizing Hormone ◽  
Serum Lh ◽  
Rate Of Increase ◽  
Male Patients

ABSTRACT Significantly decreased levels of serum testosterone from the pre-anaesthesia level were found during and up to 7 days following major surgery under general anaesthesia (nitrous oxide, oxygen and halothane following induction with thiopental and succinylcholine chloride) in 18 male patients. On the other hand, in the same patients, the serum luteinizing hormone (LH) increased significantly from the pre-anaesthesia level 30 min and 1 h after the beginning of anaesthesia. A slight increase in LH level was also noted on the 7th post-operative day. The determinations of serum testosterone and LH in fiberoptic bronchoscopy under the same general anaesthesia as that used in surgery or local anaesthesia in 26 male patients, revealed that the change in the serum LH during and following surgery seemed to be mainly induced by the general anaesthesia and that the rate of decrease in the serum testosterone may be related to the severity of surgical stress including the anaesthesia. The rate of increase in serum testosterone following the injection of gonadotrophin in 20 males on the 6th post-operative day was similar to that in 10 pre-operative males. The effects of pulmonary lobectomy on serum testosterone and urinary steroids were also studied in 6 males under adrenal suppression with dexamethasone. On the 6th post-operative day, the urinary aetiocholanolone plus androsterone and serum testosterone were found to be half the level of those on the pre-operative day, while the urinary 5β-pregnane-3α,17α,20α-triol remained unchanged. These observations in human are not inconsistent with the report of Tcholakian & Eik-Nes (1971) in dogs namely that a shift in androgen biosynthetic pathway is present in the testis under surgical stress.

PITUITARY-GONADAL FUNCTION IN MALE PATIENTS WITH MYOTONIC DYSTROPHY - SERUM LUTEINIZING HORMONE, FOLLICLE STIMULATING HORMONE AND TESTOSTERONE LEVELS AND HISTOLOGICAL DAMAGE OF THE TESTIS

1977 ◽  
Vol 84 (2) ◽  
pp. 382-389 ◽  
Author(s):  
Ryoyu Takeda ◽  
Misao Ueda
Keyword(s):  
Myotonic Dystrophy ◽  
Serum Testosterone ◽  
Serum Levels ◽  
Seminiferous Tubules ◽  
Reciprocal Relation ◽  
Logarithmic Scale ◽  
Serum Luteinizing Hormone ◽  
Serum Lh ◽  
Male Patients ◽  
Lh Rh

ABSTRACT Variations in serum levels of LH and FSH after administration of synthetic LH-RH, and basal levels of serum testosterone were studied in 9 male patients with myotonic dystrophy. The degree of testicular damage, as determined histologically on biopsy specimens, was also studied. Results were as follows: 1) it was observed that both the basal and stimulated (maximal) levels of serum LH and FSH were significantly higher than levels found in 9 sex- and age-matched normal controls. 2) The basal level of serum testosterone was consistently lower in the patient group. One patient, however, showed a low normal level, which represented a statistically significant reciprocal relation to both LH and FSH levels as expressed on a logarithmic scale. 3) There was a significant trend which indicated that the higher the serum LH, FSH levels, or the lower the basal levels of serum testosterone, the more extensive was the damage to the seminiferous tubules. From these findings it was concluded that hypogonadism in patients with myotonic dystrophy, is characterized by the development of lesions in the seminiferous tubules.

Hypergonadotropism in Peripubertal Boys with Chronic Renal Failure

PEDIATRICS ◽  
1983 ◽  
Vol 72 (3) ◽  
pp. 384-389
Author(s):  
Harold K. Marder ◽  
Laxmi S. Srivastava ◽  
Stephen Burstein
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Elevated Serum ◽  
Serum Testosterone ◽  
Normal Serum ◽  
Adult Men ◽  
Testicular Dysfunction ◽  
Serum Luteinizing Hormone ◽  
Serum Lh ◽  
Serum Gonadotropin

Serum gonadotropin and testosterone concentrations were measured in ten peripubertal boys to assess the effects of uremia on pubertal maturation. Serum luteinizing hormone (LH) concentrations were elevated for stage of puberty in eight boys, whereas in most boys serum follicle-stimulating hormone and testosterone concentrations were normal. Serum LH concentrations correlated with the severity of uremia. LH levels declined when measured 1 year after the initial measurements in four boys who received renal allografts, but were further elevated in two boys who were treated conservatively. Elevated serum LH concentrations in the presence of normal serum testosterone concentrations imply limited testicular sensitivity to the effects of LH in these peripubertal boys, as has been documented for adult men with chronic renal failure. Alternatively, there may be accumulation of an immunoreactive LH molecule that lacks bioactivity. A testicular dysfunction may explain the pubertal delay experienced by some uremic adolescent boys.

INFLUENCE OF MAJOR SURGICAL STRESS ON PLASMA TESTOSTERONE, PLASMA LH AND URINARY STEROIDS

1972 ◽  
Vol 69 (3) ◽  
pp. 542-552 ◽  
Author(s):  
Y. Monden ◽  
K. Koshiyama ◽  
H. Tanaka ◽  
S. Mizutani ◽  
T. Aono ◽  
...  
Keyword(s):  
Marked Decrease ◽  
Surgical Stress ◽  
Major Surgery ◽  
Plasma Testosterone ◽  
Pulmonary Lobectomy ◽  
Adrenal Androgens ◽  
Testosterone Secretion ◽  
Urinary Steroids ◽  
Post Operative Period ◽  
Male Patients

ABSTRACT Plasma testosterone levels were determined in 42 male patients both before 1, 2, 3, 4, 6, 8 and 12 weeks following pulmonary lobectomy. The plasma LH was measured in 13 of the 42 patients. There was a significant fall in the plasma levels of testosterone 1, 2 and 3 weeks after the pulmonary lobectomy but the levels returned to the control values from the fourth post-operative week onward. On the other hand, the level of plasma LH increased significantly one week after the operation when the plasma testosterone showed the most marked decrease. The urinary 17-KS and 17-OHCS were measured in 27 of the 42 male patients, both before and 1, 4, 8 and 12 weeks after the operation. The total 17-KS was found to be significantly decreased 1, 4 and 8 weeks after the operation. The post-operative decrease resulted from a significant decrease in the excretion of C19O2-17-KS on the seventh postoperative day but thereafter the decrease mainly resulted from a decrease in C19O3-17-KS. It is suggested that testosterone secretion from the testes seems to decrease for 3 weeks after major surgery. The decrease in the excretion of 17-KS observed after this post-operative period is caused by a decrease in the excretion of metabolites from adrenal androgens.

PLASMA TESTOSTERONE LEVELS FOLLOWING SURGICAL STRESS IN MALE PATIENTS

1970 ◽  
Vol 65 (1) ◽  
pp. 11-17 ◽  
Author(s):  
K. Matsumoto ◽  
K. Takeyasu ◽  
S. Mizutani ◽  
Y. Hamanaka ◽  
T. Uozumi
Keyword(s):  
Postoperative Period ◽  
Plasma Levels ◽  
Surgical Stress ◽  
Control Level ◽  
Major Surgery ◽  
Plasma Testosterone ◽  
Blood Samples ◽  
Testosterone Levels ◽  
Competitive Protein Binding ◽  
Male Patients

ABSTRACT Plasma testosterone levels were determined by the competitive protein binding method of Mayes & Nugent (1968) with slight modifications, in 20 male patients in whom moderate or major surgery had been performed. Preoperative (control) and postoperative blood samples were obtained at 8 a. m. except for immediate postoperative samples. There was a significant decrease in the plasma levels of testosterone immediately and 2 days after moderate and major surgery. The level of testosterone returned toward the control level on the sixth postoperative day after moderate surgery, while after major surgery, the decreased plasma testosterone was maintained for at least 6 days. It is suggested that testicular secretion of testosterone seems to decrease during the postoperative period.

Effect of Long-Acting Thyroid Stimulator on Serum Concentration of Luteinizing Hormone in the Rat

1975 ◽  
Vol 48 (3) ◽  
pp. 231-233
Author(s):  
P. Dandona ◽  
D. J. El Kabir ◽  
F. Naftolin ◽  
P. C. B. MacKinnon
Keyword(s):  
Luteinizing Hormone ◽  
Serum Concentration ◽  
Pituitary Gland ◽  
Immunoglobulin G ◽  
Adrenocorticotrophic Hormone ◽  
Serum Concentrations ◽  
Serum Luteinizing Hormone ◽  
Serum Lh ◽  
Long Acting ◽  
Dexamethasone Suppression

1. The effect of long-acting thyroid stimulator (LATS) on the serum luteinizing hormone (LH) levels of the rat in pro-oestrus has been studied. 2. The injection of three out of four LATS-containing immunoglobulin G fractions caused an increase in amounts of serum LH. 3. Adrenalectomy and dexamethasone suppression did not alter this response. 4. Injection of large doses of adrenocorticotrophic hormone did not produce any increase in serum concentrations of LH. 5. It is postulated that LATS may have a direct effect on the release of LH from the pituitary gland.

scholarly journals Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Martin Hübner ◽  
Styliani Mantziari ◽  
Nicolas Demartines ◽  
François Pralong ◽  
Pauline Coti-Bertrand ◽  
...  
Keyword(s):  
Stress Response ◽  
Pilot Study ◽  
Clinical Outcomes ◽  
Surgical Stress ◽  
Major Surgery ◽  
Surgical Trauma ◽  
Once Daily ◽  
Reactive Protein ◽  
Estimated Blood Loss ◽  
Postoperative Stress

Background. Surgical stress during major surgery may be related to adverse clinical outcomes and early quantification of stress response would be useful to allow prompt interventions. The aim of this study was to evaluate the acute phase protein albumin in the context of the postoperative stress response.Methods. This prospective pilot study included 70 patients undergoing frequent abdominal procedures of different magnitude. Albumin (Alb) and C-reactive protein (CRP) levels were measured once daily starting the day before surgery until postoperative day (POD) 5. Maximal Alb decrease (Alb Δ min) was correlated with clinical parameters of surgical stress, postoperative complications, and length of stay.Results. Albumin values dropped immediately after surgery by about 10 g/L (42.2±4.5 g/L preoperativelyversus33.8±5.3 g/L at day 1,P<0.001). Alb Δ min was correlated with operation length (Pearsonρ=0.470,P<0.001), estimated blood loss (ρ=0.605,P<0.001), and maximal CRP values (ρ=0.391,P=0.002). Alb Δ min levels were significantly higher in patients having complications (10.0±5.4versus6.1±5.2,P=0.005) and a longer hospital stay (ρ=0.285,P<0.020).Conclusion. Early postoperative albumin drop appeared to reflect the magnitude of surgical trauma and was correlated with adverse clinical outcomes. Its promising role as early marker for stress response deserves further prospective evaluation.

ENDOCRINE STUDIES AND SUCCESSFUL TREATMENT IN A PATIENT WITH TRUE HERMAPHRODITISM

1979 ◽  
Vol 91 (1) ◽  
pp. 184-192
Author(s):  
Evangelina Valdés ◽  
Carlos Fernández del Castillo ◽  
Raul Gutiérrez ◽  
Fernando Larrea ◽  
Martha Medina ◽  
...  
Keyword(s):  
Chromosome Complement ◽  
Reproductive Function ◽  
External Genitalia ◽  
Serum Testosterone ◽  
Serum Levels ◽  
Normal Children ◽  
Serum Lh ◽  
Genital Ambiguity ◽  
And Gender ◽  
Lh Rh

ABSTRACT A 12-year old, 46 XX true hermaphrodite born with genital ambiguity was studied and successfully treated. The serum LH and FSH profile resembled that of a pubertal normal individual, and LH-RH administration induced a normal LH response. Baseline testosterone serum levels were within the range for normal children. Exogenous HCG stimulation induced a significant serum testosterone increase up to values similar to those observed in normal post-pubertal males. Surgical examination disclosed the presence of bilateral ovotestis, normal Mullerian derivatives, epididymis, and vas deferens. A complete ovotestis with testicular predominance and the testicular portion of the contralateral ovotestis as well as the Wolffian derivatives, were removed. A further HCG stimulation 3 months after surgery, failed to induce serum testosterone increase. Spontaneous menarche was observed 6 months after surgery and ovulation was well documented. At present the patient has several characteristics of female sex including those of chromosome complement, gonad, internal and external genitalia, hormone levels and gender identity, thus demonstrating that treatment was successful and that reproductive function could be obtained. The finding of spontaneous ovulation following removal of the testicular portion suggests normal cyclic gonadotrophic release implying a difference between animal models and man in regard to hypothalamic virilization.

Altered Fibrinolysis during and after Surgery

2021 ◽  
Author(s):  
Maria J. Colomina ◽  
Esther Méndez ◽  
Antoni Sabate
Keyword(s):  
Surgical Stress ◽  
Point Of Care ◽  
Vena Cava ◽  
Coagulation Factors ◽  
Major Surgery ◽  
Fibrinogen Concentration ◽  
Tissue Destruction ◽  
Inflammatory Reactions ◽  
Hematological Disorders ◽  
Number Of Patients

AbstractMajor surgery induces hemostatic changes related to surgical stress, tissue destruction, and inflammatory reactions. These changes involve a shift of volume from extravascular space to intravascular and interstitial spaces, a “physiologic” hemodilution of coagulation proteins, and an increase of plasmatic fibrinogen concentration and platelets. Increases in fibrinogen and platelets together with a simultaneous dilution of pro- and anticoagulant factors and development of a hypofibrinolytic status result in a postoperative hypercoagulable state. This profile is accentuated in more extensive surgery, but the balance can shift toward hemorrhagic tendency in specific types of surgeries, for example, in prolonged cardiopulmonary bypass or in patients with comorbidities, especially liver diseases, sepsis, and hematological disorders. Also, acquired coagulopathy can develop in patients with trauma, during obstetric complications, and during major surgery as a result of excessive blood loss and subsequent consumption of coagulation factors as well as hemodilution. In addition, an increasing number of patients receive anticoagulants and antiplatelet drugs preoperatively that might influence the response to surgical hemostasis. This review focuses on those situations that may change normal hemostasis and coagulation during surgery, producing both hyperfibrinolysis and hypofibrinolysis, such as overcorrection with coagulation factors, bleeding and hyperfibrinolysis that may occur with extracorporeal circulation and high aortic-portal-vena cava clamps, and hyperfibrinolysis related to severe maintained hemodynamic disturbances. We also evaluate the role of tranexamic acid for prophylaxis and treatment in different surgical settings, and finally the value of point-of-care testing in the operating room is commented with regard to investigation of fibrinolysis.

RESTORATION OF OESTROGEN POSITIVE FEEDBACK EFFECT ON LH RELEASE BY BROMOCRIPTINE IN HYPERPROLACTINAEMIC PATIENTS WITH GALACTORRHOEA-AMENORRHOEA

1979 ◽  
Vol 91 (3) ◽  
pp. 591-600 ◽  
Author(s):  
Toshihiro Aono ◽  
Akira Miyake ◽  
Takenori Shioji Motoi Yasuda ◽  
Koji Koike ◽  
Keiichi Kurachi
Keyword(s):  
Luteinizing Hormone ◽  
Follicle Stimulating Hormone ◽  
Serum Prolactin ◽  
Serum Luteinizing Hormone ◽  
Serum Lh ◽  
Lh Release ◽  
The Mean ◽  
Lh Rh ◽  
Lh Releasing Hormone ◽  
Positive Feedback Effect

ABSTRACT Five mg of bromocriptine was administered for 3 weeks to 8 hyperprolactinaemic women with galactorrhoea-amernorrhoea, in whom the response of serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) to 100 μg of iv LH-releasing hormone (LH-RH) had been evaluated. Twenty mg of conjugated oestrogen (Premarin®) was injected iv any day between the 10th and 12th day from the initiation of the treatment, and serum LH levels were serially determined for 120 h. Hyperresponse of LH with normal FSH response to LH-RH was observed in most patients. Bromocriptine treatment for 10 to 12 days significantly suppressed mean (± se) serum prolactin (PRL) levels from 65.1 ± 23.0 to 10.4 ± 2.0 ng/ml, while LH (12.6 ± 2.1 to 24.8 ± 5.9 mIU/ml) and oestradiol (40.1 ± 7.6 to 111.4 ± 20.8 pg/ml) levels increased significantly. Patients on bromocriptine treatment showed LH release with a peak at 48 h after the injection of Premarin. The mean per cent increases in LH were significantly higher than those in untreated patients with galactorrhoea-amenorrhoea between 32 and 96 h after the injection. The present results seem to suggest that the restoration of LH-releasing response to oestrogen following suppression of PRL by bromocriptine may play an important role in induction of ovulation in hyperprolactinaemic patients with galactorrhoea-amenorrhoea.

HYPOTHALAMIC, PITUITARY AND TESTICULAR FUNCTION DURING SEXUAL MATURATION OF THE MALE RAT

1977 ◽  
Vol 72 (1) ◽  
pp. 17-26 ◽  
Author(s):  
A. H. PAYNE ◽  
R. P. KELCH ◽  
E. P. MURONO ◽  
J. T. KERLAN
Keyword(s):  
Dehydrogenase Activity ◽  
Sexual Maturation ◽  
Hydroxysteroid Dehydrogenase ◽  
Male Rat ◽  
Releasing Hormone ◽  
Isomerase Activity ◽  
Serum Lh ◽  
Rate Of Increase ◽  
Gonadotrophin Releasing Hormone

SUMMARY Hypothalamic content of gonadotrophin-releasing hormone (GnRH), serum LH and FSH, capacity of the testis to synthesize testosterone in vitro, and testicular 5-ene-3β-hydroxysteroid dehydrogenase-isomerase and 17β-hydroxysteroid dehydrogenase were measured in groups of rats at approximately 5 day intervals from birth to day 64 and at days 74 and 89. The capacity of the testes to synthesize testosterone in vitro was measured in the presence of a saturating dose of rat LH. Gonadotrophin-releasing hormone increased steadily from 0·17 ng per hypothalamus at birth to a maximum of 7 ng at day 52 and then remained constant. LH concentrations were highly variable and often exceeded adult values between days 10 and 32. After day 32 a steady rise was observed which reached adult values between days 37 and 42. FSH concentrations markedly increased from 255 ng/ml observed at birth and day 10 to a peak value of 1000 ng/ml at day 32. Subsequently there was a steady decline in FSH values until day 74 when the concentration returned to values found at birth. 5-ene-3β-Hydroxysteroid dehydrogenase-isomerase activity exhibited a rapid increase between days 12 and 19 followed by an even greater rate of increase between days 19 and 32 when adult levels were attained. 17β-Hydroxysteroid dehydrogenase activity was very low between birth and day 22. Enzyme activity began to increase at day 22 with a rapid increase in activity observed between days 37 and 58. The increase in capacity to synthesize testosterone closely followed the increase in 17β-hydroxysteroid dehydrogenase activity. The study demonstrates that during sexual maturation in the male rat, changes in serum LH and FSH do not reflect changes in hypothalamic GnRH. The appearance of Leydig cells as monitored by 5-ene-3β-hydroxysteroid dehydrogenase-isomerase activity precedes by approximately 20 days the increase in testicular capacity to synthesize testosterone in vitro. The latter coincides with the increase in 17β-hydroxysteroid dehydrogenase activity. These results suggest that 17β-hydroxysteroid dehydrogenase is a limiting factor in the ability of the testis to respond to LH stimulation.

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