Papers by Bruno Lunenfeld
Human Reproduction, 1993
This study was designed to investigate the basic concentrations of different hormones in obese an... more This study was designed to investigate the basic concentrations of different hormones in obese and non-obese patients with polycystic ovarian disease (PCOD). Eight women with PCOD, of whom four were obese with body mass index (BMI, kg/m2) of > 25 and four were non-obese with BMI < 25, volunteered to participate in this study. Serum samples were taken every 20 min over an 8 h period, starting at 2300 h, on day 5 of a spontaneous or gestagen-induced cycle. Basic insulin concentration was found to be significantly higher in the obese women compared with their non-obese counterparts (P < 0.0001). Serum concentrations of insulin-like growth factor binding protein (IGFBP-I) and sex hormone binding globulin (SHBG) were found to be significantly lower (P < 0.001 for both hormones) in the obese compared with the non-obese women. Serum concentrations of insulin-like growth factor I (IGF-I) did not differ between the two groups. The non-obese women had significantly higher serum concentrations of luteinizing hormone (LH) (P < 0.001) and of growth hormone (GH) (P < 0.002) than their obese counterparts. Based on these results, two models of the development of PCOD were suggested. In obese women, hyperinsulinaemia causes an excessive production of androgens through the enhancement of IGF-I receptors which, in synergism with LH, causes increased activity of cytochrome P-450c 17a. In non-obese patients, relative increase of GH concentration stimulates excessive ovarian IGF-I production. At this point synergism with LH results in excessive production of androgens by the same mechanism as in obese patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Human Reproduction, 1991
The incidence of polycystic ovarian disease (PCOD) varies from 0.6 to 92%, depending on the param... more The incidence of polycystic ovarian disease (PCOD) varies from 0.6 to 92%, depending on the parameters analysed, PCOD has been reported to appear in association with Cushing's Syndrome, adrenal hyperplasia, hypothyroidism, adrenal and ovarian tumours and some genetic abnormalities. The controversy regarding the pathophysiological mechanism underlying the disease still persists. Critical evaluation of old data, assessment of new findings concerning the possible role of insulin, growth factors and their binding proteins, and extrapolation of neuroendocrinological experiments enabled the construction of a concise hypothesis of the pathophysiology of PCOD. According to this hypothesis, PCOD is a multifactorial disease. The sequence of events finally leading to clinical manifestation of the disease (hyperandrogenism, abnormal luteinizing hormone pulsatility pattern and ovulation disturbances) may originate in different organs or be triggered by different mechanisms. It may stem from the adrenals, the hypothalamus or higher central nervous system centres, or from the ovary itself; it may originate from excess of fat tissue usually combined with hyperinsulinism; or may be the result of a net increase in active growth factors. Each of the above disturbances probably appears early in life, much before the clinical signs of the disease are evident. Predisposing factors such as gestational diabetes of the mother, childhood obesity, borderline adrenal hyperplasia and late menarche have to be looked for as early as possible in order to prevent the late consequences of the disease, such as increased risk of infertility, endometrial and breast cancer and cardiovascular disease.
British Journal of Cancer, 1987
A Textbook with Special Reference to Etiology, Diagnosis and Treatment
GnRH Analogues in Reproduction and Gynecology, 1990
The ovulatory cycle is governed and accompanied by characteristic protein and steroid hormonal le... more The ovulatory cycle is governed and accompanied by characteristic protein and steroid hormonal levels that are reflected by typical changes in the reproductive organs. To enable grouping, super-imposition, recording and comparison of various parameters of the ovulatory cycle, to define and characterize abnormalities and to plan rational therapeutic approaches, its span is divided into several phases. Each phase reflects a characteristic, easily definable hormonal or organic change. Depending on the criteria on which the division is based, several different phases of the ovulatory cycle may be recognized. In the following discussion the simple division into follicular, ovulatory and luteal phases will be used.
Archives of Andrology, 1987
The in vitro penetration ability of human sperm into bovine cervical mucus after washing and susp... more The in vitro penetration ability of human sperm into bovine cervical mucus after washing and suspension of the sperm in Earl's medium was compared with that of untreated sperm. The extent of penetration was found to be significantly lower in sperm washed and suspended in Earl's medium than in the unwashed sperm (p < 0.0001); it increased to some extent on resuspension of the washed sperm in the seminal plasma but still remained significantly lower than that of intact sperm QJ < 0.009). The introduction of caffeine into the Earl's medium resulted in an increased penetration of the washed sperm into bovine cervical mucus, but this was still significantly lower than the penetration of the unwashed sample (p < 0.02). The data point to the effectiveness of the seminal plasma as a medium facilitating sperm penetration through bovine cervical mucus.
Pediatric Research, 1978
In an Israeli nationwide screening program for neonatal hypothyroidism using blood spots on filte... more In an Israeli nationwide screening program for neonatal hypothyroidism using blood spots on filter paper 42071 newborns were screened. The screening program detected 10 infants - an incidence of almost 1:4000. 9 infants had primary hypothyroidism and 1 secondary hypothyroidism. The 4 last newborns were detected by thyroxine and confirmed by thyrotropin radioimmunoassay using the same original filter paper blood spots. Another 5 infants were diagnosed as thyroid-binding globulin deficient. In 3 infants reverse T3 was measured in serum taken at the day of the filter paper spotting: in 1 infant the levels were high and in 2 low. In 2 infants born to mothers suffering from thyroid disease, a transient state of hypothyroidism was diagnosed. Whereas serum reverse T3 estimation did not seem helpful in neonatal screening of hypothyroidism, the T4 and TSH spot assay combined system reduced the number of infants to be recalled.
Obstetrical & Gynecological Survey, 1987
The Journal of Clinical Endocrinology & Metabolism, 1977
Thyroxine (T4) concentrations were measured by RIA in 37 milk samples from 19 healthy eutryroid m... more Thyroxine (T4) concentrations were measured by RIA in 37 milk samples from 19 healthy eutryroid mothers, obtained between 3-165 days postpartum. The mean milk T4 concentration in the first week postpartum was 0.38 +/- 0.07 microgram/100 ml (mean +/- SEM). The mean T4 concentrations between 8 and 48 days rose to 4.27 +/- 0.50 microgram/100 ml (mean +/- SEM), and decreased to 1.11 +/- 0.25 microgram/100 ml (mean +/- SEM) after 50 days postpartum. The data suggest that human milk can provide a significant exogenous source of T4 to the infant. In the hypothyroid infant, the amount of T4 in human milk may delay clinical recognition of the disease. Although this exogenous source of T4 may alleviate the disease, it is insufficient to prevent the detrimetal effects of hypothyroidism.
The Journal of Clinical Endocrinology & Metabolism, 1962
ABSTRACT. Injection into the rabbit of a highly purified human chorionic gonadotropin preparation... more ABSTRACT. Injection into the rabbit of a highly purified human chorionic gonadotropin preparation evoked production of an antiserum that neutralized hormonal (biologic) activity of the preparation and produced a visible precipitin reaction in vitro. Immunoelectrophoretic analysis demonstrated the heterogeneity of the purified gonadotropin preparations. The quantitative estimation of HCG in a mixture of HCG and HMG has been achieved by the use of immunologic inhibition of the HMG in the mixture and a subsequent bio-assay of the HCG.
International Journal of Gynecology & Obstetrics, 1993
Acta Endocrinologica, 1966
A method is described for the quantitative estimation of urinary androsterone, aetiocholanolone a... more A method is described for the quantitative estimation of urinary androsterone, aetiocholanolone and dehydroepiandrosterone which employs enzymatic hydrolysis for glucuronide conjugates, solvolysis for sulphate esters, ascending thin-layer chromatography, elution and spectrophotometric quantitation of the eluted steroids as Zimmermann chromogens. The reliability of the method was established by recovery experiments and by duplicate assays. Its specificity was confirmed by u. v. and i. r. spectral analysis of the urinary components eluted from the thin-layer chromatograms and by gas-liquid chromatography of these components and their trimethyl-silyl derivatives. Since the method is relatively rapid and requires small samples of urine it has the advantage of being suitable for large-scale clinical determinations.
Andrologia, 2009
patients, 4 months to five years following unilateral torsion of the testis were evaluated as to ... more patients, 4 months to five years following unilateral torsion of the testis were evaluated as to semen quality and hormonal status. In patients operated within 12 hours of the onset of pain 44% had normal semen quality while in those operated following more than 12 hours only 20% had normal semen analysis. FSH, LH and testosterone levels were normal in 14 of the 16 patients. One patient had a low testosterone level and slightly elevated FSH, another patient had slightly elevated levels of both FSH and LH. Spermaqualitat und Hormonstatus bei Patienten nach Hodentorsion Zuammenfassung: 16 Patienten wurden 4 Monate bis 5 Jahre nach einseitiger Hodentorsion in Hinsicht auf Spermaqualitat und Hormonstatus untersucht. Bei Patienten, die innerhalb von 12 Stunden nach Einsetzen der Schmerzen openert wurden, hatten 44% normale Samenqualitat, wahrend diejenigen, die mehr als 12 Stunden danach openert wurden, nur in 20% normale Samenanalysen aufwiesen. Die FSH-, LH-und TestosteronSpiegel waren normal bei 14 der 16 Patienten. Ein Patient hatte einen niedrigen Testosteron-Spiegel und ein gering erhohtes FSH, ein weiterer Patient hatte gering erhohte Spiegel bei FSH und LH.
Gynecological Endocrinology, 1987
The hypothalamic pituitary axis was studied in patients with an abnormal pattern of gonadotropin ... more The hypothalamic pituitary axis was studied in patients with an abnormal pattern of gonadotropin release during chronic treatment with LH-RH agonist. T w o patients had PCOD and the third demonstrated the early luteinization phenomenon. Following a well-defined gonadotropin rise with initiation of LH-RH treatment, no further response was noted. Stabilization of the LH:FSH ratio in PCOD patients was noted after 4 weeks of treatment. Administration of both native LH-RH (100 pg) and intravenous pulsatile LH-RH did not evoke any rise in LH. In addition to the above LH-RH challenges, the positive feedback was examined by administration of estradiol benzoate (EB). The study demonstrated that, although the pituitary did not respond to any LH-RH challenge, it may still respond by a rise in LH following EB administration. Both functions of the hypothalamic pituitary axis should be examined in order to determine the state of medical hypophysectomy.
The Japanese Journal of Urology, 2004
Best Practice & Research Clinical Obstetrics & Gynaecology, 2000
ABSTRACT
Frontiers in Immunology, 2021
Sepsis continues to be a major cause of morbidity, mortality, and post-recovery disability in pat... more Sepsis continues to be a major cause of morbidity, mortality, and post-recovery disability in patients with a wide range of non-infectious and infectious inflammatory disorders, including COVID-19. The clinical onset of sepsis is often marked by the explosive release into the extracellular fluids of a multiplicity of host-derived cytokines and other pro-inflammatory hormone-like messengers from endogenous sources (“cytokine storm”). In patients with sepsis, therapies to counter the pro-inflammatory torrent, even when administered early, typically fall short. The major focus of our proposed essay is to promote pre-clinical studies with hCG (human chorionic gonadotropin) as a potential anti-inflammatory therapy for sepsis.
Fertility and Sterility, Apr 1, 1987
Monitoring of human menopausal gonadotropin (hMG) treatment for induction of ovulation according ... more Monitoring of human menopausal gonadotropin (hMG) treatment for induction of ovulation according to either preovulatory estrogen levels or the presence of a dominant ovarian follicle was found insufficient to prevent ovarian hyperstimulation syndrome (OHS). In 65 infertile patients treated with hMG and human chorionic gonadotropin (hCG), a possible correlation between the number and size of all ovarian follicles on the day of assumed ovulation and the occurrence of OHS was evaluated in order to assess the value of ultrasonography in predicting OHS. It was found that patients with OHS had significantly more follicles at the time of hcrr than patients without OHS. Mild OHS was characterized by the presence of eight to nine follicles, 68.7% of which were of intermediate size (9 to 15 mm).In moderate to severe OHS 95% of the preovulatory follicles were < 16 mm, most of them (54.7%) < 9 mm in diameter. It can be concluded that a specific preovulatory follicular configuration characterizes mild and severe hyperstimulation. This is important information before heG administration and emphasizes the value of ovarian ultrasonography in
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Papers by Bruno Lunenfeld