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In 4 clinical studies of a biological tissue isolate (BTI) similar to Rellidep, the majority of subjects reported improved well-being and mood. Based on these reports of positive effect on mood in trials, an antidepressant pilot study was undertaken with the BTI Rellidep.
Twenty-three subjects (14 women and 9 men; mean age, 44.8 years) with major d...
The use of puberty-delaying or blocking hormonal treatment of adolescents with gender identity disorder (GID) has become increasingly common. In the present study, we examined demographic, behavior problem, and psychosexual measures to see if any of them correlated with the clinical decision to recommend, or not recommend, puberty-blocking hormonal...
It is well-established that total testosterone (TT) in men decreases with age and that bioavailable testosterone (bio-T) falls to an even greater extent. The clinical relevance of declining androgens in the aging male and use of testosterone replacement therapy (TRT) in this situation is controversial. Most studies have been short term and there ar...
The prevalence of thyroid abnormalities among 831 sexual, violent, and non-violent non-sex offenders was found to be greater than found in the general population. Thyroid abnormalities were most common among violent offenders and among sex offenders who victimized children. Thyroid disorders were associated with psychotic diagnoses, delusions, mani...
Sexual desire and activity continue well into later life, and advanced age alone is not a deterrent to a happy and healthy sex life; however, clinicians should be aware that the normal sexual response of men and women may change with aging. When sexual dysfunction occurs, studies show that men and women tend to view sexual dysfunction differently....
Sexuality and sexual activity do not end when a person reaches a certain age. Sexual desire and activity continue well into later life, and age is not a deterrent to a happy and healthy sex life. However, clinicians should be aware that the normal sexual response of men and women may change with aging. When sexual dysfunction occurs, studies show t...
The prevalence of diabetes among 915 sexual, violent, and non-violent non-sex offenders was found to be more than twice the prevalence in the general population. Diabetes was most common among violent offenders and among sex offenders who victimized children. The older diabetics presented significantly more often with cognitive impairment and young...
In 2004, the Ontario Society of Clinical Chemists (OSCC) held an invitational multidisciplinary workshop to establish the most reliable, cost-effective approach to the biochemical assessment of hypogonadism in men.
Specialists across Canada in clinical biochemistry, endocrinology, family medicine and urology were invited to participate in this work...
Introduction:
Testosterone treatment of older symptomatic men with reduced testosterone availability is increasing. There is an expanding body of literature to support such treatment in a large subset of aging men, but there has not yet been a long-term placebo-controlled double-blind study of several thousand men to confirm the efficacy and safet...
Testosterone is more than a "male sex hormone". It is an important contributor to the robust metabolic functioning of multiple bodily systems. The abuse of anabolic steroids by athletes over the years has been one of the major detractors from the investigation and treatment of clinical states that could be caused by or related to male hypogonadism....
This study examines three hypotheses: (1) there is an association of parental and offspring substance abuse for sex offenders and paraphilics; (2) there is a higher occurrence of substance abuse among the parents of sex offenders and paraphilics than seen in the general population; (3) substance abuse among the parents will be associated with a hig...
To evaluate a recently published algorithm for calculation of serum "Bioavailable" Testosterone (BAT) using serum Total Testosterone (TT), Sex Steroid Binding Globulin (SSBG) [also commonly known as Sex Hormone Binding Globulin (SHBG)] and albumin concentrations as parameters, in comparison with a locally available "salting-out" BAT method. If sati...
To review the rationale for treating symptomatic aging men whose testosterone levels are mildly reduced or low-normal with testosterone replacement therapy.
Large-scale multicentre prospective studies on the value of treating andropausal men with hormone therapy do not exist because the whole area of hormone therapy is barely 10 years old. Evidence...
The goal of this study was to determine if cleric-sex offenders differed significantly from other sex offenders when compared to a control group and assessed with standard instruments that examine the major factors important in sexual offenses.
Twenty-four male clerics accused of sexual offenses were compared to 24 male sex offender controls, match...
Objective: The goal of this study was to determine if cleric-sex offenders differed significantly from other sex offenders when compared to a control group and assessed with standard instruments that examine the major factors important in sexual offenses.Method: Twenty-four male clerics accused of sexual offenses were compared to 24 male sex offend...
To determine if physician sex offenders differ significantly from other sex offenders by using a control group and assessing both groups with reliable and valid instruments.
Nineteen male physician sex offenders were compared with 19 male sex offender control subjects, matched on offence type, age, education, and marital status. Both groups were co...
Solitary hyperfunctioning nodules of the thyroid gland are usually viewed as benign. They may present with autonomous euthyroidism but are of concern for potential progression to hyperthyroidism. Various methods of treatment are worthy of consideration.
Forty-five patients with solitary hot thyroid nodules verified by radioisotope scintiscanning we...
Background: Secondary cancer of the thyroid gland is widely acknowledged as infrequent but is a persistent problem requiring ongoing awareness, particularly with respect to clinical recognition and treatment.
Methods: From 1978 to 1993, a 15-year period, patients demonstrating secondary involvement of the thyroid gland as a surgical problem were co...
The successful diagnosis and surgical treatment of primary hyperparathyroidism due to parathyroid adenoma benefits significantly, in our experience, from a process of pre-operative imaging localization of the parathyroid adenoma. This prospective study evaluates a window of 25 consecutive patients who underwent pre-operative imaging localization pr...
To determine whether folk myths regarding the relationships of penile size to body height and foot size have any basis in fact, 63 normally virilized men were studied. Height and stretched penile length were measured; shoe size was recorded and converted to foot length. Penile length was found to be statistically related to both body height and foo...
Thirteen diabetic male sex offenders were compared to 13 nondiabetic sex offenders matched on age, education and offense type. A standard battery of tests administered in the assessment of sex offenders was used to compare the two groups. The tests examine sexual history and preference, substance abuse, violence, personality, and neuropsychological...
Surgical decision making is essentially based on experience, augmented by a management philosophy. In this manuscript we review concepts of thyroid and parathyroid surgical decision making in relation to diagnostic imaging input. These two endocrine glands have crucial anatomic associations, but very different pathologic conditions; it is the speci...
Thirteen diabetic male sex offenders were compared to 13 nondiabetic sex offenders matched on age, education and offense type. A standard battery of tests administered in the assessment of sex offenders was used to compare the two groups. The tests examine sexual history and preference, substance abuse, violence, personality, and neuropsychological...
the elementary physiology of sex hormone production in humans will be outlined, followed by a review of the effects of these hormones on normal human sexual development, adult sexual behavior, and aggressiveness
the evidence for endocrinological abnormalities in individuals who have committed various types of nonsexual as well as sexually motivat...
Sixteen male genital exhibitionists were compared to nonviolent nonsex offender controls with respect to 9 serum hormones: cortisol, prolactin, dehydroepiandrosterone, estradiol, luteinizing hormone, follicle stimulating hormone, androstenedione, testosterone, sex hormone binding globulin, and two indices of free testosterone. There were group diff...
Twenty-six pedophiles and 16 nonviolent nonsex offenders were compared on baseline values of Luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, estradiol, dehydroenpiandrosterone sulphate (DHEAS) and cortisol. Pedophiles had significantly higher levels of LH and FSH but lower levels of testosterone. There were no significan...
Twenty-six pedophiles and 16 nonviolent nonsex offenders were compared on baseline values of Luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, estradiol, dehydroenpiandrosterone sulphate (DHEAS) and cortisol. Pedophiles had significantly higher levels of LH and FSH but lower levels of testosterone. There were no significan...
Fifty-one men charged with or convicted of sexual assault on an adult female were compared with thirty-six controls consisting of nonviolent, nonsex offenders using the Luria-Nebraska Neuropsychological Test Battery, WAIS and CT scans. The sexual assaulters were classified as twenty-two sadists and twenty-one nonsadists on the basis of clinical int...
Endocrine functioning in sadists, nonsadistic sexual aggressives and criminal controls was examined in two studies. In Study 1 baseline values for 8 hormones and 2 indices of free testosterone were compared. There were no statistically significant group differences, although some cases showed abnormalities. In Study 2, the ACTH test was performed....
The behavior of sadists is bizarre and poorly understood. There are gross endocrine and brain abnormalities in a small number of these men. Approximately two-fifths show subtle temporal lobe brain abnormalities that are logically linked to sexual behavior and require further exploration. It would be interesting to explore the interface of the endoc...
The result of the hormone concentration of one blood sample was used to determine the accuracy of predicting not only the hormone concentrations of a second and third sample drawn 15 minutes apart, but also the mean value of the three samples. Three blood specimens from 73 men involved in two previously reported studies (A and B) were assayed indiv...
The result of the hormone concentration of one blood sample was used to determine the accuracy of predicting not only the hormone concentrations of a second and third sample drawn 15minutes apart, but also the mean value of the three samples. Three blood specimens from 73 men involved in two previously reported studies (A and B) were assayed indivi...
A sample of 100 men accused of sexual assault on a child and referred to a forensic clinic were approached for assessment and treatment in a double blind study of MPA (Provera). A total of 48 men completed assessment and 18 agreed to participate in the drug trial. Only 11 completed a 3-month course of MPA or placebo therapy. Those refusing treatmen...
Endocrine functioning in sadists, nonsadistic sexual aggressives and criminal controls was examined in two studies. In Study 1 baseline values for 8 hormones and 2 indices of free testosterone were compared. There were no statistically significant group differences, although some cases showed abnormalities. In Study 2, the ACTH test was performed....
A study of hormonal levels of violent and nonviolent offenders failed to establish any significant differences among murderers, assaulters, and controls. While the results do not suggest a contributory role for random blood hormone levels in facilitating aggressive behavior, further study of complex interactions is necessary to rule out endocrinolo...
Explores whether an abnormality in androgen metabolism may be linked with aberrant sexual behavior in the male. The relationship between testosterone and libido and potency, its effect on sexual behavior, and the merit of an anti-testosterone approach to the therapy of men who have committed sexually aggressive acts are discussed. Possible sites of...
Compared 15 heterosexual, 14 homosexual, and 10 bisexual male pedophiles (mean age 39 yrs) to 14 nonviolent nonsex offenders (mean age 25 yrs), using the Halstead-Reitan Neuropsychological Test Battery, the Luria-Nebraska Neuropsychological Battery, the Wechsler Adult Intelligence Scale (WAIS), and computerized tomography scans. Ss were classified...
The gonadal function of 18 women who were treated for childhood nephrotic syndrome at a mean age of 10.7 years with cyclophosphamide (mean dosage, 28 gm; mean duration of therapy, 354 days) was evaluated at a mean of 14.5 years after treatment by means of detailed questionnaires. Menstrual patterns were normal in all except two, who were still rece...
Ejaculatory incompetence is a relatively uncommon cause of infertility but a potentially treatable one. We report on 11 men with anejaculation, 2 of whom presented with complaints of sexual dysfunction and 9 with infertility. Psychologic factors were considered the major cause in all patients. Sexual counseling was carried out in four couples; in t...
Thirty men treated in childhood with cyclophosphamide for a mean of 280 days were assessed at a mean of 12.8 years after treatment for hormone concentrations and spermatogenesis. Four were azoospermic, nine oligospermic, and 17 normospermic. There was a significant inverse correlation of sperm density with cyclophosphamide dosage and duration of tr...
Twenty-three men who participated in a 15-month clinical trial to assess the potential effectiveness of using a combination of varying doses of medroxyprogesterone acetate (MPA) and methyltestosterone (MT) as a male contraceptive agent, completed a "sexual problem checklist" every two weeks. The study was divided into three phases: pre-treatment (3...
Retrospective review was carried out of 124 patients with nodular disease of the thyroid gland and a history of radiation exposure who had undergone needle aspiration biopsy. Latency period from time of radiation varied from 2 to 50 years; but in 92 patients it exceeded 2 decades. Our patient group included those with occupational exposure and a pa...
The authors studied functional secondary amenorrhea in young women. There was a high incidence of weight disturbance. Hormone assays demonstrated a diminution of hypothalamic-pituitary function in the underweight group. The findings from psychiatric interviews and psychological testing revealed the prevalence of psychopathology with disorders of se...
The Y chromosome directs the primitive gonad to develop into a testis. Without a Y chromosome an ovary will develop, but that ovary will not be normal unless two X chromosomes are present. Active intervention is needed for male differentiation; internal male structures will not be found unless sufficient and effective testosterone is secreted by th...
This study suggests that the syndrome of isolated premature gonadal failure is immunogenetically heterogeneous. It is likely that the subgroup characterized by the presence of HLA-DR3 is autoimmune in origin, and it appears to be distinct from that subgroup in which B35 is increased. Considering the strong association of B35 with subacute thyroidit...
Therapy of infertility in the male still remains problematic. Despite increased knowledge of normal physiology, our understanding of the pathophysiology of male reproductive failure is sparse, with the consequence that there are no treatment modes that are known to have a high success rate. There is a multiplicity of therapies, many of them describ...
In this book we have been treated to a potpourri of therapeutic approaches to the difficult problem of male infertility. In the “olden” days there were therapies (used even now) that were hailed as being important tools in our treatment armamentarium. These included vitamin E, triiodothyronine, and others. We have since learned that vitamin E doesn...
Our insight into the mechanisms of the physiology of reproduction has experienced a swift and constant development these last few years. The advent of more sophisticated diagnostic methods and their relatively easy clinical application allow for the incorporation of that knowledge into the evaluation of the infertile couple. These facts, together w...
We report the third case of renal hemangiopericytoma associated with spontaneous hypoglycemia. The clinical and pathological features suggest that excessive glucose storage by the tumor is an important factor in the pathogenesis of the hypoglycemia. Other possible mechanisms producing hypoglycemia associated with mesenchymal tumors are reviewed.
A male contraceptive trial was undertaken in 23 men using a combination of oral medroxyprogesterone acetate (MPA) and oral methyltestosterone (MeT). The men were divided into four groups according to varying drug dosages and were followed for 15 months (control - 3 months, treatment - 6 months, follow-up - 6 months). The parameters assessed include...
The effects of an initial oral 2.5 mg dose of bromocriptine and of a similar dose after treatment with 2.5--5 mg daily for one week on plasma concentrations of ACTH, cortisol, LH, FSH, testosterone, and dihydrotestosterone were studied in normal men. In addition to its suppressive effects on plasma concentrations of prolactin and catecholamines whi...
The aim of research into chemical male contraception is to find an agent or combination of agents that will induce infertility effectively, safely, cheaply, and reversibly. The search for such an agent first had to take into consideration the mode by which this aim could be accomplished; the next step was to be assured of the safety of using the ag...
About 10% or more of all couples find themselves confronted by the problem of infertility (Mac Naughton, 1973), which is said to exist if pregnancy has not been achieved after one year of unprotected intercourse. Pure female factors account for approximately one-third of human infertility, pure male factors for one-third and a combination of male a...
Despite the increasing number of andrological pub opment of basic and clinical research in andrology, lications, the diagnostic aspects of andrology have to analyze modern techniques for the evaluation of received relatively little attention. In the last decade male infertility, to stimulate the development of substantial progress has been made in...
Analysis of semen from 16 patients treated with cyclophosphamide for nephrotic syndrome showed azoospermia in three and oligospermia in seven. Analysis was normal in the other six. Prolonged treatment, particularly with larger total dosage, was associated with a higher incidence of gonadal dysfunction. Recovery was not evident at follow-up, 2 years...
Administration of a single oral 2.5 mg dose of bromocriptine (Brc), a dopamine (DA) receptor agonist, to normal male volunteers results in comparable marked decreases in resting supine plasma concentrations of DA (decrement 2 h after drug administration was 67 +/- 5%; mean +/- SE), norepinephrine (NE; 63 +/- 3%) and epinephrine (E; 65 +/- 5%); decr...
A radioimmunoassay previously described for serum T and DHT was adapted for use in the measurement of these hormones in seminal plasma. The seminal plasmas of 273 semen specimens were assayed for T and DHT concentration. Mean levels of these hormones for various sperm count and sperm motility categories were determined. We found that: (1) the DHT l...
A 51-year-old woman presented with a painful, rapidly enlarging thyroid gland. The serum concentrations of the thyroid hormones were initially at the upper limit of normal, and the uptake of radioactive iodine by the thyroid was completely depressed. Although subacute thyroiditis was suspected, a biopsy specimen from the thyroid showed malignant di...
Six patients with thyroid cancer presented with clinical and, in most cases, biochemical features of subacute or chronic thyroiditis. Pathologic study revealed all types of cancer, including metastatic and neighborhood parathyroid malignancy. Confusion in diagnosis lead to a delay of diagnosis of one month to ten years. When thyroiditis is diagnose...
Eleven normal women, between the ages of 19 and 28, were examined at the same time of day, every day of a complete menstrual cycle. Measurements of intraocular pressure, anterior chamber depth, corneal thickness, and tear production were obtained. Tonographic values were obtained on eight days during the cycle. The results for ten of the women who...
In this article we discuss some basic principles of thyroid physiology and control mechanisms and thyroid gland dysfunction and indicate an approach to the investigation and management of abnormalities of thyroid structure.
In three cases of cancer (arising in the pancreas, the breast and the lung) that had metastasized to the thyroid an unusual primary thyroid lesion was the presenting problem. While reputedly rare, metastases in the thyroid gland are not infrequently encountered at necropsy. These cases illustrate the varied causes of goitre, the value of needle asp...
GnRH was administered to 34 men (8 normospermic, 8 moderately oligospermic, 10 severely oligospermic and 8 azoospermic) and the responsiveness of serum LH and FSH determined. For LH, basal levels were not different among each group, nor was there any difference in response to GnRH at any point in time after injection; however, there was a trend for...
Diagnostic ultrasounds is a simple, rapid, harmless and painless method to visualize intrascrotal contents. It may provide information that is difficult to obtain on clinical examination. Abnormalities such as testicular neoplasms, inflammation and hydroceles are discussed herein.
Hyperparathyroidism due to a hyperfunctioning parathyroid adenoma developed in a 57-year-old woman exposed to radiation for facial hirsutism, in whom other tumors of the head and neck had occurred. The details of history and the implications of causal relationship are presented.
Excerpt
Department of Medicine, Mount Sinai Hospital and University of Toronto, Toronto, Ontario M5G 1X5, Canada
(Received 2 December 1974)
It has been postulated that testicular tubules are responsible for the production of a substance, inhibin, which selectively inhibits or modulates the secretion of follicle-stimulating hormone (FSH) by the pitu...
This study is being carried out to determine the potential value of B-Mode ultrasonography in the identification and diagnosis of intratesticular disorders, information heretofore onlv obtainable through biopsy. Fifty-six cases have been examined to date. Fifty-three were referred from an infertility clinic and include Oligospermic and azoospermic...
Varying doses (1, 3, 10 and 30 μg/100 g body wt) of NIH LH B7 were administered intraperitoneally to groups of male rats, 10, 21, 41 and 62 days of age. Serum testosterone (T) was quantified by radioimmunoassay 1 hr later, the time when the LH induced testosterone rise was maximal. The 1 μg dose did not significantly increase serum T concentrations...
This study was carried out to determine the potential value of B-mode ultrasonography in the identification and diagnosis of intratesticular disorders, information heretofore obtainable only through biopsy. Fifty-nine cases have been examined to date. Fifty-three were referred from an infertility clinic and include oligospermic and azoospermic subj...
In an attempt to find a preferential inhibitor of serum FSH, a number of C18, C19 and C21 steroids were evaluated for suppressive effects on LH and FSH and stimulatory effects upon ventral prostate weight in the acutely castrate adult male rat. C21 steroids had no effect. The C19 steroids were listed in order of potency with regard to suppressing L...
The LH producing cell of the human adenohypophysis has been identified by the immunofluorescent technique followed by aldehyde thionin-periodic acid Schiff-orange G (AT-PAS-OG) staining. It is a basophilic subtype with sparse granularity which is both PAS and aldehyde thionin-positive. These cells occur singly throughout the gland and are found in...
Short and longer term studies of the antidiuretic effect of chlorpropamide have been undertaken in 5 patients with diabetes insipidus secondary to a known hypothalamic or pituitary lesion (Group 1), 6 patients with idiopathic diabetes insipidus (Group 2), and 1 patient with familial nephrogenic diabetes insipidus. Of the 11 patients in Groups 1 and...
