Endometriosis is defined as the presence of functional endometrial tissue outside the uterus, causing diverse progressive symptoms such as infertility, pelvic pain, and dysmenorrhea. Although endometriosis has been described since the 1800s, the mechanisms responsible for its pathogenesis and progression remain poorly understood. It is well established that endometriosis grows and regresses in an estrogen-dependent fashion and the disease can be effectively cured by definitive surgery. However, prolonged medical therapy may be needed in most of the cases since conservative surgery is usually performed especially in young women. This treatment modality is often associated with only partial relief and/or recurrence of the disease. In the present review, up-to-date findings on the treatment of endometriosis will be briefly summarized. The outcomes of surgery in patients with endometriosis will be reviewed in terms of pelvic pain relief as well as infertility treatment largely based on recent Cochrane reviews and clinical reports. The efficacy of newer drugs including aromatase inhibitor, anti-tumor necrosis factor-alpha, and dienogest will be also reviewed based on recent clinical studies.
Aromatase ; Dysmenorrhea ; Endometriosis ; Female ; Humans ; Infertility ; Nandrolone ; Necrosis ; Pelvic Pain ; Recurrence ; Uterus

BACKGROUND: Recombinant human erythropoietin (rHuEPO) has become attractive option of anemia therapy in chronic hemodialysis patients, but the use of rHuEPO is primarily limited by its high cost. So, the current cost-containment policy renders valuable any strategies that enhances the erythropoietic response to rHuEPO, thus resulting in lower rHuEPO dosing. Before the widespread availability of rHuEPO, androgen was the mainstay of nontransfusional therapy for the anemia of end-stage renal failure. However, previous studies that used androgen to enhance the response to rHuEPO showed variable results. METHODS: We carried out a prospective study to examine the effect of adjuvant androgen on anemia and nutritional parameters in chronic hemodialysis patients using low-dose rHuEPO. Studies were performed in seventeen hemodialysis patients previously treated with low-dose rHuEPO (1,000 U rHuEPO subcutaneously three times a week), mean hemoglobin < 9.0 g/dL for 6 months (group A: before adjuvant androgen therapy). Same patients received the same dose of rHuEPO plus nandrolone decanoate 100 mg intramuscularly weekly for 6 months (group B: after adjuvant androgen therapy). RESULTS: Transferrin saturation, serum ferritin, intact serum parathyroid hormone, plasma aluminium, ALT, ESR, albumin, PCRn and Kt/V were not significantly changed before and after adjuvant androgen therapy. The increase in hemoglobin and hematocrit in the group B was statistically greater than in the group A, respectively (8.99+/-1.39 g/dL vs 7.75+/-0.90 g/dL; p=0.001, 26.66+/-3.91% vs 23.68+/-2.85%; p= 0.003, respectively). With the exception of mild discomfort at the injected site, there were no significant side effects from nandrolone decanoate. CONCLUSION: Adjuvant androgen in patients treated with low-dose rHuEPO is effective treatment for the anemia of poor responsive patients to low-dose rHuEPO and lower the economical cost compared with the higher dose rHuEPO treatment alone.
Anemia* ; Erythropoietin* ; Ferritins ; Hematocrit ; Humans ; Humans* ; Kidney Failure, Chronic ; Nandrolone ; Parathyroid Hormone ; Plasma ; Prospective Studies ; Renal Dialysis* ; Transferrin

To evaluate the effect of anabolic steroid(AS) on body composition and protein metabolism in malnourished CAPD patients, 7 CAPD patients who were proved to be malnourished by subjective global assessment received 200mg of AS, nandrolone decanoate, by intramuscular route monthly for 5 months. We analyzed the body composition, biochemical nutritional markers, plasma and dialysate amino acids(AA) before and after administration of AS. The mean age was 53.6+/-11.5 years, the sex ratio was 2:5, and the duration of CAPD was 28.5+/-18.7 months. Two patients were diabetics. Five months after AS administration, %lean body mass seemed to increase from 52.6+/-11.7 to 57.3+/-11.0%(P>0.05), but there were no significant changes in body weight and body mass index. Serum insulin-like growth factor-I (172.4+/-88.5 vs. 204.1+/-85.8ng/ml, P<0.05) and transferrin(213.6+/-55.4 vs. 239.0+/-55.3mg/dl, P<0.05) were significantly increased, and serum total CO2(31.1+/-4.5 vs. 25.9+/-2.5mM/L, P<0.05) were significantly decreased. Urea nitrogen appearance(4.0+/-2.0 vs. 3.6+/-1.6g/ day) seemed to be decreased. Both plasma essential AA(EAA) level(738.3+/-206.5 vs. 492.5+/-187.2micromol/L, P<0.05) and peritoneal EAA loss(565.0+/-186.1 vs. 377.4+/-113.9micromol/day, P<0.05) decreased significantly after administration. Plasma total and non- essential amino acids(NEAA) level tended to be increased and peritoneal total and NEAA loss seemed to be decreased without statistical significance. In conclusion, AS seems to have anabolic effect and be useful in the correction of malnutrition in CAPD patients.
Amino Acids ; Anabolic Agents ; Body Composition* ; Body Mass Index ; Body Weight ; Humans ; Malnutrition ; Metabolism* ; Nandrolone ; Nitrogen ; Peritoneal Dialysis, Continuous Ambulatory* ; Plasma ; Sex Ratio ; Urea

Recombinant human erythropoietin(r-HuEPO) is the mainstay of anemia therapy in patient with end stage renal disease(ESRD), but the use of r-HuEPO is primarily limited by its high cost. So, it encourages any strategies that potentially enhance the erythropoietic response. However, studies designed to assess whether androgens would enhance the response to r-HuEPO were inconclusive. While androgens may be less expensive and may improve several nutritional parameters, their potential adverse effects discourage usage. We carried out a prospective study to examine the effect of low-dose androgen in combination with subcutaneous r-HuEPO on anemia and nutritional paramenters in hemodialysis patients. Twenty-four hemodialysis patients with hematocrit <24% or hemoglobin <8.0g/dL were randomly assigned into two groups. Group A(n=12) received 2000U r-HuEPO subcutaneously twice a week for six months. Group B(n=12) received the same dose of r-HuEPO plus nandrolone decanoate 100mg intramuscularly biweekly. Anthropometry, albumin, cholesterol, prealbumin, and transferrin were measured as nutritional parameters. The groups showed no differences in baseline levels of the followings : Hemoglobin, hematocrit; transferrin saturation; serum ferritin; intact serum parathyroid hormon, Kt/V; vitamin B12, folate; nutritional parameters. At the completion of the study, both groups showed significant increase in hematocrit compared with baseline levels(group A 20.7+/-2.2% to 26.0+/-3.8%; group B : 21.5+/-3.5% to 30.1+/-2.8%). The mean hematocrit in group B was significantly higher than in group A after 4 month study period(p<0.05). Ten of 12 patients in group B achieved a target hematocrit of 30%, as compared with four of 12 patients in group A. Both groups didn't show significant changes in any nutritional parameters. No significant side effects of androgen were noted during this short-term study. We conclude that low-dose androgen in combination with subcutaneous r-HuEPO is effetive treatment on anemia in hemodialysis patients, but does not improve nutritional status.
Androgens ; Anemia* ; Anthropometry ; Cholesterol ; Erythropoietin* ; Ferritins ; Folic Acid ; Hematocrit ; Humans* ; Nandrolone ; Nutritional Status ; Prealbumin ; Prospective Studies ; Renal Dialysis* ; Transferrin ; Vitamin B 12

A method was evaluated for determination of twenty-one doping (including nandrolone, boldenone and methandienone) in human urine by gas chromatography-high resolution mass spectrometry. Samples were prepared by liquid-liquid extraction, concentrated, TMS derivatization and limit of detection at ng x mL(-1) by MID/GC/HRMS. According to the code of the World Anti-Doping Agency (WADA), precision and recoveries of the procedure were evaluated by replicate analysis (n = 6), the recoveries in the range of 66%-103%, with the RSD below 10.0%. The precision within the day of the method with three different concentrations was also determined RSD were less than 9.5%, 10.0% and 9.7%.
Anabolic Agents ; urine ; Doping in Sports ; Gas Chromatography-Mass Spectrometry ; Humans ; Methandrostenolone ; urine ; Nandrolone ; urine ; Substance Abuse Detection ; methods ; Testosterone ; analogs & derivatives ; urine

AIMTo investigate the reversibility of the effect of nandrolone decanoate (ND) on sperm parameters after discontinuing the drug.

METHODSThree groups of rats received peanut oil (control), low and high doses of ND for 14 weeks, respectively. Each group was divided into subgroups A and B, in which rats were killed 14 and 28 weeks after initiating the injection, respectively.

RESULTSSperm count and motile sperm fraction were decreased in the subgroups A and B that received low and high doses of ND in comparison with the controls A and B, respectively. The sperm count and motile sperm fraction increased in the subgroups B that received low and high doses of ND in comparison with their corresponding subgroups A. The number of normal morphology sperm was decreased significantly in subgroups A receiving low and high doses of ND in comparison with the control subgroup A. However, this parameter was not decreased in subgroups B receiving low and high doses in comparison with the control subgroup B. The normal sperm morphology did not show any significant differences in the subgroups B in comparison with their corresponding subgroups A.

CONCLUSIONThe 14-week injection of low and high doses of ND decreases sperm quality and quantity in rats. These parameters were improved after discontinuing ND, but not recovered completely even when they are left untreated for 14 weeks.

Anabolic Agents ; administration & dosage ; Animals ; Male ; Nandrolone ; administration & dosage ; analogs & derivatives ; Rats ; Sperm Count ; Sperm Motility ; drug effects ; Spermatozoa ; drug effects ; ultrastructure

OBJECTIVETo produce anti-19-Nortestosterone (NT) monoclonal antibodies and identify their immunological characteristics.

METHODSHybridomas were prepared by fusing NS0 mouse myeloma cells with splenocytes isolated from immunized BALB/c mice. Noncompetitive and competitive indirect ELISA were employed to screen positive cell clones. A caprylic acid ammonium sulphate (CAAP) method was used to purify NT mAb, and the Batty saturation method was used to determine the affinity constant (Kaff).

RESULTSFive hybridoma cell lines, named NT-1, NT-2, NT-3, NT-4, and NT-5, were identified and their corresponding mAbs were of the IgG(1) isotype with a k light chain. The Kaffs of all mAbs were between 2.6 and 4.7 × 10(9) L/mol. The titers and IC(50) values of purified ascite fluids were in the range of (0.64-2.56) × 10(5) and (0.55-1.0) ng/mL, respectively. Of all the cross-reacting steroids, (-NT was the most reactive with the mAbs at 62% with NT-1 mAb and 64% with NT-2 mAb. Negligible cross-reactivity (<0.01%) with other steroids was observed.

CONCLUSIONThe establishment of these hybridomas allows the potential development of a rapid test kit, and may provide an alternative method for the detection of NT residues in food producing animals.

Animals ; Antibodies, Monoclonal ; Antibody Affinity ; Antibody Specificity ; Cell Line ; Female ; Hybridomas ; Mice ; Mice, Inbred BALB C ; Molecular Structure ; Nandrolone ; chemistry ; immunology ; Plasmacytoma ; Reagent Kits, Diagnostic ; Spleen ; cytology

Protein-energy malnutrition is frequently observed in CAPD patients and is closely correlated with morbidity and mortality. We investigated the effects of AS on nutritional parameters in malnourished CAPD patients. Eleven CAPD patients who were proved to be malnourished by biochemical and anthropometric measurements, not admitted for 2 months recently, received intramuscularly 200mg of Nandrolone Decanoate, monthly. After AS was administered for more than 12 weeks, the nutritional parameters were checked. The mean age of patients was 53.5+/-9.8(SD) years, the sex ratio was 4:7. The mean duration of CAPD was 34.5+/-23.2 months. Three patients were diabetics. The mean duration of AS administered was 22.0+/-3.6 weeks. Eight of eleven patients improved their subjective symptoms such as appetite and muscle strength. There were significant increases in hemoglobin(7.0+/-0.9 vs. 7.8+/-1.1g/dl), hematocrit(20.3+/-2.8 vs. 23.0+/-2.8%), insulin-like growth factor I(165.9+/-71.6 vs. 207.1+/-69.5ng/ml), prealbumin(30.1+/-11.0 vs. 39.3+/-9.1mg/dl), transferrin(205.4+/-48.8 vs. 239.6+/-47.7mg/dl) and nPCR(0.75+/-0.15 vs. 0.84+/-0.15g/kg/day)(P<0.05). There were no changes in albumin, total lymphocyte, cholesterol, weeklky Kt/Vurea, weekly creatinine clearance and urea nitrogen appearance. On anthropometric measurements, midarm muscle circumference(21.8+/-3.2 vs. 22.7+/-3.5cm, P<0.05) and % lean body mass(57.6+/-12.7 vs. 60.5+/-11.4%, P<0.05) were increased, but triceps skinfold thickness, and body mass index were not changed. Edema was observed in 8 patients and acne was noted in a patient. Severe edema and ultrafiltration failure were observed in 2 patients. The mean time that edema developed was 17.6 4.6 weeks. In conclusion, AS seems to be useful in correcting malnutrition with their protein anabolic effect in malnourished CAPD patients.
Acne Vulgaris ; Anabolic Agents ; Appetite ; Body Mass Index ; Cholesterol ; Creatinine ; Edema ; Humans ; Lymphocytes ; Malnutrition ; Mortality ; Muscle Strength ; Nandrolone ; Nitrogen ; Peritoneal Dialysis, Continuous Ambulatory ; Protein-Energy Malnutrition ; Sex Ratio ; Skinfold Thickness ; Ultrafiltration ; Urea

Nandrolone decanoate(ND), one of the anabolic steroids, has been used by athletes to build muscle mass and enhance weight-lifting performance and has also shown to be useful in malnourished ESRD patients. However, ND has several adverse effects including edema. After we experienced a case of severe edema and transient ultrafiltration failure(TUF) requiring more frequent number of dialysis during ND treatment, we prospectively studied the incidence and clinical characteristics of TUF during ND treatment. Among 30 ND-treated patients, 7 patients developed TUF. All TUF+ patients were female and had sigificantly higher number of patients with congestive heart failure, more use of minoxidil and moderate to severe malnutrition than TUF- patients. There were no significant differences in age, duration of dialysis, and number of diabetics between TUF+ and TUF- group. In ND-treated male patients, the number of patients with CHF and moderate to severe malnutrition and with use of minoxidil were significantly lower than TUF+ ones. Body weight and serum albumin concentrations were significantly increased 2-3 months after ND treatment in TUF+ patients. But there were no differences in body weight and serum albumin in TUF-patients. In TUF+ patients, frequency of HD increased from 3 times to 4 to 6 times a week. CAPD patients with TUF+ had more frequently used 4.25% dialysate and number of exchanges were increased. In most TUF+ patients, severe edema and TUF were disappeared about 2 weeks after treatment. Most TUF+ patients returned to previous schedle of dialysis. In conclusion, ND seems to induce TUF in ESRD patients who had risk for volume regulation such as CHF, hypoalbuminemia, or the use of minoxidil.
Athletes ; Body Weight ; Dialysis* ; Edema ; Female ; Heart Failure ; Humans ; Hypoalbuminemia ; Incidence ; Kidney Failure, Chronic* ; Male ; Malnutrition ; Minoxidil ; Nandrolone* ; Peritoneal Dialysis, Continuous Ambulatory ; Prospective Studies ; Renal Dialysis ; Serum Albumin ; Steroids ; Ultrafiltration*

OBJECTIVESTo evaluate the effects of 19-nortestosterone (NT) on the growth and development of the ventral prostate (VP), epididymis, and seminal vesicles (SV) in hypogonadal (hpg) mice.

METHODSThe silastic tube filled with NT was implanted subdermally into mature hpg mice (n = 7) for five weeks. Similar silastic tubes without NT were implanted into both of hpg mouse control group (n = 7) and normal mouse group (n = 10) instead. The weights of sex accessory glands and the branch tip number of VP from all mice were evaluated.

RESULTSThe weights of VP, SV, and epididymis in NT treated hpg group were significantly higher than those of hpg control group (P < 0.005); and the branching morphology of the VP showed a tendency to be normal and the development of prostate ductal tip was improved significantly. Especially, the weight of SV in NT treated hpg mice was equal to that of normal mice, while the weights of VP, epididymis and branching tip number in NT treated hpg group was still significantly lower than that of normal mice (P < 0.005).

CONCLUSIONSThe NT treatment significantly stimulates the growth and development of the sex accessory gland in mature hpg mouse.

Animals ; Epididymis ; drug effects ; growth & development ; Genitalia, Male ; drug effects ; growth & development ; Hypogonadism ; drug therapy ; physiopathology ; Male ; Mice ; Nandrolone ; therapeutic use ; Prostate ; drug effects ; growth & development ; Seminal Vesicles ; drug effects ; growth & development