The assessment of testosterone and radioisotopic index of bone metabolism and bone mineral density in men with testosterone deficiency after one year of testosterone therapy

Background: Testosterone deficiency in men is characterized by typical symptoms of hypogonadism and negative influence on the preservation of bone mass. In this study, we analysed the relationship between testosterone concentration and bone metabolism. Moreover, we assessed the impact of one-year compensation of testosterone deficiency in elderly men on bone metabolism and bone mineral density. Radioisotopic methods of bone metabolism assessment provide new research opportunities. Materials and methods: Men with total testosterone concentration (TT) ≤ 3 ng/ml were included into this study. Patients with disorders or injuries of bone system, elevated prostate-specific antigen (PSA), enlarged prostate, disorders of thyroid and liver, diabetes mellitus or a history of chemotherapy as well as those treated for a long time with antibiotics were excluded from this study. The results of 50 men aged 57.52 ± 6.71 years obtained before the treatment (I test) and after one year of oral testosterone supplementation (test II) were analysed in this study. The following examinations and analyses were performed: interview and physical examination, orthopaedic, neurological and urological consultations, blood biochemistry, determination of hormones levels, assessment of Testosterone Deficiency Syndrome (TDS), densitometric and radioisotope assessment of bone metabolism. Moreover, radioisotopic index of bone metabolism was calculated. Testosterone therapy with oral preparation Undestor Testo Caps (Organon) containing 40 mg of testosterone lasted for 12 months. Statistical analysis was performed using Statistica 12 and Excel 2010 programs. Correlations between results before and after treatment were analysed. Results: After 12 months of treatment, testosterone concentration increased by mean 78% and the level of luteinizing hormone (LH) decreased by 62%. TDS index increased from 0.53 ± 0.21 (in test I) to 1.91 ± 0.60 (in test II). After the therapy this index was significantly higher in all men (p < 0.0001). Moreover, BMD was also improved following therapy, however, the difference between test I and II was statistically insignificant. The greatest change was found in case of IBM (Index of Bone Metabolism). We observed a positive correlation between IBM and BMD before treatment (r = 0.7991), however, its strength decreased after one-year therapy (r = 0.6757). Conclusions: In our opinion, IBM is more sensitive than other methods of the assessment of changes occurring in bone system under the influence of testosterone therapy. The observed changes in IBM were proportional to changes in testosterone concentration. Testosterone level, TDS and radioisotopic assessment of bone metabolism may be used as prognostic and therapeutic factors of osteoporosis and bone fractures in elderly men.  BACKGROUND: Testosterone deficiency in men is characterized by typical symptoms of hypogonadism and negative influ­ence on the preservation of bone mass. In this study, we analysed the relationship between testosterone concentration and bone metabolism. Moreover, we assessed the impact of one-year compensation of testosterone deficiency in elderly men on bone metabolism and bone mineral density. Radioisotopic methods of bone metabolism assessment provide new research opportunities. MATERIALS AND METHODS: Men with total testosterone concentration (TT) ≤ 3 ng/ml were included into this study. Patients with disorders or injuries of bone system, elevated prostate-specific antigen (PSA), enlarged prostate, disorders of thyroid and liver, diabetes mellitus or a history of chemotherapy as well as those treated for a long time with antibiotics were excluded from this study. The results of 50 men aged 57.52 ± 6.71 years obtained before the treatment (I test) and after one year of oral testosterone supplementation (test II) were analysed in this study. The following examinations and analyses were performed: interview and physical examination, orthopaedic, neurological and urological consultations, blood biochemistry, determination of hormones levels, assessment of Testosterone Deficiency Syndrome (TDS), densitometric and radioisotope assessment of bone metabolism. Moreover, radioisotopic index of bone metabolism was calculated. Testosterone therapy with oral preparation Undestor Testo Caps (Organon) containing 40 mg of testosterone lasted for 12 months. Statistical analysis was performed using Statistica 12 and Excel 2010 programs. Correlations between results before and after treatment were analysed. RESULTS: After 12 months of treatment, testosterone concentration increased by mean 78% and the level of luteinizing hormone (LH) decreased by 62%. TDS index increased from 0.53 ± 0.21 (in test I) to 1.91 ± 0.60 (in test II). After the therapy this index was significantly higher in all men (p &lt; 0.0001). Moreover, BMD was also improved following therapy, however, the difference between test I and II was statistically insignificant. The greatest change was found in case of IBM (Index of Bone Metabolism). We observed a positive correlation between IBM and BMD before treatment (r = 0.7991), however, its strength decreased after one-year therapy (r = 0.6757). CONCLUSIONS: In our opinion, IBM is more sensitive than other methods of the assessment of changes occurring in bone system under the influence of testosterone therapy. The observed changes in IBM were proportional to changes in testosterone concentration. Testosterone level, TDS and radioisotopic assessment of bone metabolism may be used as prognostic and therapeutic factors of osteoporosis and bone fractures in elderly men.

The own method and program of isotope quantitatively assessment of perfusion in muscles of upper limbs (initial report)

BACKGROUND: The issue of blood flow in muscles has been dealt with for many years. However, most often it was assessed qualitatively with standard vascular examinations. The quantitatively perfusion assessment is indispensable in the normal and pathological conditions. Some diseases impair the perfusion mainly in the area of upper limbs. It can be observed in Raynaud’s disease, vascular occlusive diseases, neurological disturbances, and thermal injuries. Hyperhidrosis of upper limbs after sympathectomy of thoracic part of sympathetic trunk may bring closer the diagnosis statement. Nuclear medicine has the markers and methods that allow for the assessment of the volume of perfusion in muscles. The aim for creating this method and program was the development of radioisotope method allowing for quantitative assessment of perfusion in muscles of upper limbs. This should lead to calculating the perfusion index and its range of normal values in a greater group of patients and to using this method both in the healthy and pathological conditions. MATERIAL AND METHODS: 20 patients, age 30.4 ± 7.1 years, who underwent following examinations: qualification to the group, medical history, subject examinations, USG of upper limb vessels, anthropometric examinations, biochemical and hormonal blood tests, the assessment of upper limbs with USG Doppler and FMD (flow mediated dilatation), radioisotope examinations with gamma camera BrightView XCT by own program RAPUL (Radioisotope Assessment Perfusion of Upper Limb). Acquisitions were started five minutes after intravenous injection of 99mTc-MIBI (metoxyisobutylnitrite). The whole body scintigram and scintigrams of arm and forearm muscles in A-P projections were taken. RESULTS: In the examined patients, the results of anthropometric, biochemical and hormonal test were within the range of normal values. In radioisotope quantitative assessment of perfusion, perfusion indexes of left arm were 20 &lt; PI_left &lt; 11.90 and of the right arm 7.00 &lt; PI_right &lt;12.30. The dependency correlation PI_left vs. PI_right was strong r = 0.92036. The values of perfusion symmetry index (IPS) had a normal distribution and were within the following range: 0.9231 &lt; IPS &lt; 1.1019. CONCLUSIONS: The RAPUL method and program allow for quantitative assessment of perfusion in muscles of upper limbs. Developed program has a high repeatability of results. The results in the bigger group will allow for defining the range of normal values of perfusion index in muscles of upper limbs at rest. These will be diagnostically used both in healthy (sports medicine, military services) and pathological conditions.BACKGROUND: The issue of blood flow in muscles has been dealt with for many years. However, most often it was assessedqualitatively with standard vascular examinations. The quantitatively perfusion assessment is indispensable in the normal andpathological conditions. Some diseases impair the perfusion mainly in the area of upper limbs. It can be observed in Raynaud’sdisease, vascular occlusive diseases, neurological disturbances, and thermal injuries. Hyperhidrosis of upper limbs after sympathectomyof thoracic part of sympathetic trunk may bring closer the diagnosis statement. Nuclear medicine has the markersand methods that allow for the assessment of the volume of perfusion in muscles. The aim for creating this method andprogram was the development of radioisotope method allowing for quantitative assessment of perfusion in muscles of upperlimbs. This should lead to calculating the perfusion index and its range of normal values in a greater group of patients and tousing this method both in the healthy and pathological conditions.MATERIAL AND METHODS: 20 patients, age 30.4 ± 7.1 years, who underwent following examinations: qualification to thegroup, medical history, subject examinations, USG of upper limb vessels, anthropometric examinations, biochemical andhormonal blood tests, the assessment of upper limbs with USG Doppler and FMD (flow mediated dilatation), radioisotopeexaminations with gamma camera BrightView XCT by own program RAPUL (Radioisotope Assessment Perfusion of UpperLimb). Acquisitions were started five minutes after intravenous injection of 99mTc-MIBI (metoxyisobutylnitrite). The whole bodyscintigram and scintigrams of arm and forearm muscles in A-P projections were taken.RESULTS: In the examined patients, the results of anthropometric, biochemical and hormonal test were within the range ofnormal values. In radioisotope quantitative assessment of perfusion, perfusion indexes of left arm were 20 &lt; PI_left &lt; 11.90 andof the right arm 7.00 &lt; PI_right &lt;12.30. The dependency correlation PI_left vs. PI_right was strong r = 0.92036.The values of perfusion symmetry index (IPS) had a normal distribution and were within the following range: 0.9231 &lt; IPS &lt;1.1019.CONCLUSIONS: The RAPUL method and program allow for quantitative assessment of perfusion in muscles of upper limbs.Developed program has a high repeatability of results. The results in the bigger group will allow for defining the range of normalvalues of perfusion index in muscles of upper limbs at rest. These will be diagnostically used both in healthy (sports medicine,military services) and pathological conditions

Light Emission from the Fe2+-EGTA-H2O2 System: Possible Application for the Determination of Antioxidant Activity of Plant Phenolics

Oxidative reactions can result in the formation of electronically excited species that undergo radiative decay depending on electronic transition from the excited state to the ground state with subsequent ultra-weak photon emission (UPE). We investigated the UPE from the Fe2+-EGTA (ethylene glycol-bis(β-aminoethyl ether)-N,N,N′,N′-tetraacetic acid)–H2O2 system with a multitube luminometer (Peltier-cooled photon counter, spectral range 380 to 630 nm). The UPE of 92.6 µmol/L Fe2+—185.2 µmol/L EGTA—2.6 mmol/L H2O2 reached 4319 ± 755 relative light units during 2 min measurement and was about seven times higher (p &lt; 0.001) than the UPE of incomplete systems (Fe2+-H2O2, EGTA-H2O2) and medium alone. Substitution of Fe2+ with Cr2+, Co2+, Mn2+ or Cu2+ as well as of EGTA with EDTA (ethylenediaminetetraacetic acid) or citrate completely abolished UPE. Experiments with ROS scavengers revealed the dependence of UPE on hydroxyl radicals suggesting occurrence of oxidative attack and cleavage of the ether bond in EGTA backbone structure and formation of triplet excited carbonyl groups with subsequent light emission. Plant phenolics (ferulic, chlorogenic and caffec acids) at concentration 87 µmol/L and ascorbate at 0.46 mmol/L inhibited UPE by 90 ± 4%, 90 ± 5%, 97 ± 2% and 92 ± 1%, respectively. Quenching of UPE from Fe2+-EGTA-H2O2 system can be used for evaluation of antioxidant activity of phytochemicals

Concentration Dependence of Anti- and Pro-Oxidant Activity of Polyphenols as Evaluated with a Light-Emitting Fe2+-Egta-H2O2 System

Hydroxyl radical (&bull;OH) scavenging and the regeneration of Fe2+ may inhibit or enhance peroxidative damage induced by a Fenton system, respectively. Plant polyphenols reveal the afore-mentioned activities, and their cumulative net effect may determine anti- or pro-oxidant actions. We investigated the influence of 17 phenolics on ultra-weak photon emission (UPE) from a modified Fenton system (92.6 &micro;mol/L Fe2+, 185.2 &micro;mol/L EGTA (ethylene glycol-bis(&beta;-aminoethyl-ether)-N,N,N&prime;,N,-tetraacetic acid) and 2.6 mmol/L H2O2 pH = 7.4). A total of 8 compounds inhibited (antioxidant effect), and 5 enhanced (pro-oxidant effect) UPE at all studied concentrations (5 to 50 &micro;mol/L). A total of 4 compounds altered their activity from pro- to antioxidant (or vice versa) along with increasing concentrations. A total of 3 the most active of those (ferulic acid, chlorogenic acid and cyanidin 3-O-glucoside; mean UPE enhancement by 63%, 5% and 445% at 5 &micro;mol/L; mean UPE inhibition by 28%, 94% and 24% at 50 &micro;mol/L, respectively) contained catechol or methoxyphenol structures that are associated with effective &bull;OH scavenging and Fe2+ regeneration. Most likely, these structures can determine the bidirectional, concentration-dependent activity of some phenolics under stable in vitro conditions. This is because the concentrations of the studied compounds are close to those occurring in human fluids, and this phenomenon should be considered in the case of dietary supplementation with isolated phenolics

Effect of Physiological Concentrations of Vitamin C on the Inhibitation of Hydroxyl Radical Induced Light Emission from Fe2+-EGTA-H2O2 and Fe3+-EGTA-H2O2 Systems In Vitro

Ascorbic acid (AA) has antioxidant properties. However, in the presence of Fe2+/Fe3+ ions and H2O2, it may behave as a pro-oxidant by accelerating and enhancing the formation of hydroxyl radicals (•OH). Therefore, in this study we evaluated the effect of AA at concentrations of 1 to 200 µmol/L on •OH-induced light emission (at a pH of 7.4 and temperature of 37 °C) from 92.6 µmol/L Fe2+—185.2 µmol/L EGTA (ethylene glycol-bis (β-aminoethyl ether)-N,N,N′,N′-tetraacetic acid)—2.6 mmol/L H2O2, and 92.6 µmol/L Fe3+—185.2 µmol/L EGTA—2.6 mmol/L H2O2 systems. Dehydroascorbic acid (DHAA) at the same range of concentrations served as the reference compound. Light emission was measured with multitube luminometer (AutoLumat Plus LB 953) for 120 s after automatic injection of H2O2. AA at concentrations of 1 to 50 µmol/L and of 1 to 75 µmol/L completely inhibited light emission from Fe2+-EGTA-H2O2 and Fe3+-EGTA-H2O2, respectively. Concentrations of 100 and 200 µmol/L did not affect chemiluminescence of Fe3+-EGTA-H2O2 but tended to increase light emission from Fe2+-EGTA-H2O2. DHAA at concentrations of 1 to 100 µmol/L had no effect on chemiluminescence of both systems. These results indicate that AA at physiological concentrations exhibits strong antioxidant activity in the presence of chelated iron and H2O2