Self-administration of 3α-androstanediol increases locomotion and analgesia and decreases aggressive behavior of male hamsters

Androgens, such as testosterone (T), can have reinforcing effect, which may be due in part to actions of T's metabolite, 3alpha-androstanediol (3alpha-diol). To investigate rewarding effects of 3alpha-diol, gonadally intact adult male hamsters were given a two-bottle choice test to determine the amount of 3alpha-diol that would be self-administered over 4 days of exposure. After 2 days of habituation and 4 days of monitoring of consumption, hamsters were tested in an activity monitor and the open field (locomotion/exploration), paw lick (analgesia) and resident-intruder (aggression) tasks. Hamsters consumed significantly more 3alpha-diol than vehicle in the two-bottle choice test. Hamsters that were allowed to self-administer 3alpha-diol made significantly more beam breaks and total entries in the open field had increased latencies to pawlick, and engaged in significantly fewer attacks, than did hamsters with access to vehicle alone. Hamsters that self-administered 3alpha-diol had higher levels of 3alpha-diol in serum, hippocampus, prefrontal cortex, striatum and midbrain than did hamsters with access to vehicle alone. Together, these data suggest that 3alpha-diol may have rewarding effects.

The androgen 5alpha-dihydrotestosterone and its metabolite 5alpha-androstan-3beta, 17beta-diol inhibit the hypothalamo-pituitary-adrenal response to stress by acting through estrogen receptor beta-expressing neurons in the hypothalamus

Estrogen receptor beta (ERbeta) and androgen receptor (AR) are found in high levels within populations of neurons in the hypothalamus. To determine whether AR or ERbeta plays a role in regulating hypothalamo-pituitary-adrenal (HPA) axis function by direct action on these neurons, we examined the effects of central implants of 17beta-estradiol (E2), 5alpha-dihydrotestosterone (DHT), the DHT metabolite 5alpha-androstan-3beta, 17beta-diol (3beta-diol), and several ER subtype-selective agonists on the corticosterone and adrenocorticotropin (ACTH) response to immobilization stress. In addition, activation of neurons in the paraventricular nucleus (PVN) was monitored by examining c-fos mRNA expression. Pellets containing these compounds were stereotaxically implanted near the PVN of gonadectomized male rats. Seven days later, animals were killed directly from their home cage (nonstressed) or were restrained for 30 min (stressed) before they were killed. Compared with controls, E2 and the ERalpha-selective agonists moxestrol and propyl-pyrazole-triol significantly increased the stress induced release of corticosterone and ACTH. In contrast, central administration of DHT, 3beta-diol, and the ERbeta-selective compound diarylpropionitrile significantly decreased the corticosterone and ACTH response to immobilization. Cotreatment with the ER antagonist tamoxifen completely blocked the effects of 3beta-diol and partially blocked the effect of DHT, whereas the AR antagonist flutamide had no effect. Moreover, DHT, 3beta-diol, and diarylpropionitrile treatment significantly decreased restraint-induced c-fos mRNA expression in the PVN. Together, these studies indicate that the inhibitory effects of DHT on HPA axis activity may be in part mediated via its conversion to 3beta-diol and subsequent binding to ERbeta.

The nucleus accumbens as a site of action for rewarding properties of testosterone and its 5alpha-reduced metabolites

Testosterone (T)'s positive hedonic effects may be mediated by actions of its metabolites, dihydrotestosterone (DHT) or 3alpha-androstanediol (3alpha-diol), in the nucleus accumbens (NA). In Experiment 1, adult, intact, male rats were systemically administered 1 mg of T, DHT, 3alpha-diol or vehicle, at different time points to examine concentrations of androgens in the NA. Rats administered 3alpha-diol had significantly increased concentrations of 3alpha-diol in the region of the brain encompassing the NA. These data are consistent with previous data from our laboratory demonstrating that 3alpha-diol elicits a conditioned place preference (CPP) more effectively than either T or DHT, when administered systemically. In Experiment 2, rats received implants of T, DHT or 3alpha-diol to the NA immediately prior to placement in the CPP apparatus on conditioning days. Implants of T, DHT or 3alpha-diol, but not vehicle, significantly increased time spent on the non-preferred side of the chamber on the test day. This effect was only produced by androgenic stimulation of the shell of the NA and not the core of the NA. Thus, androgen regimens we have previously found to enhance CPP produced the greatest increases in 3alpha-diol concentrations in the NA region and direct implants of T, DHT or 3alpha-diol to the shell, but not the core, of the NA enhanced CPP. These data are consistent with the hypothesis that the hedonic effects of T may be due to actions of its metabolites in the NA.

Effects of long-term administration of androgens and estrogen on rhesus monkey prostate: possible induction of benign prostatic hyperplasia

Rhesus monkeys were used to investigate the role of androgenic steroids and estradiol in the induction of hyperplastic changes in stromal and glandular prostate tissues. Adult male rhesus monkeys were procured from the wild and, after routine quarantine procedures, were randomly divided into 5 groups of 5 animals each. Gluteus maximus muscles were injected with 2.5 mg of androstenedione (Group II), 2.5 mg of dihydrotestosterone (DHT) or 0.25 mg of estradiol (Group II), 2.5 mg androstanediol (Diol; Group IV), or Diol in combination with 0.25 mg of estradiol (Group V). Group I consisted of untreated controls. Animals were injected with steroids 3 times a week for 2 years. Treatment with androstenedione (Group II) resulted in stromal hyperplasia in the caudal lobe and an increase in epithelial cell height in all zones except in the central zone of the caudal lobe. In monkeys treated with DHT and estradiol (Group III), stromal hyperplasia in both lobes, a decrease in tubular size, and degranulation and vacuolation of epithelial cells were noticed. Injection of Diol alone (Group IV) or in combination with estradiol (Group V) resulted in a widening of stroma in the central and peripheral zones of cranial and caudal lobes, whereas the tubular size decreased. Diol also induced epithelial cell hypercellularity in the central and peripheral zones of the caudal lobe and in the peripheral zone of the cranial lobe. Prostate-specific antigen levels in Group IV animals gradually increased from 6 months of treatment and were maximal after 18 months of injections. Serum estradiol levels increased to detectable levels in all groups except Group IV. Serum testosterone levels decreased to very low or undetectable levels in all groups, whereas prostate-specific acid phosphatase increased in all treated groups. Prolactin levels were elevated in all treated groups except in animals injected with androstenedione. These results indicate that repeated long-term injections of androstenedione or DHT and estradiol induced stromal hyperplasia, which may be an estrogen-related effect. Androstanediol-induced hypercellularity and stratification of glandular epithelium is comparable to human prostatic intraepithelial neoplasia. These results also suggest that the rhesus monkey is a suitable animal model for experimental induction of prostate diseases.

Estradiol causes a dose-dependent stimulation of prostate growth in castrated beagle dogs

BACKGROUND

Previous studies have shown that chronic treatment of castrate dogs with androgen and estrogen results in significant prostate growth. Estrogen treatment of castrate dogs in the absence of androgen has resulted in conflicting data as reported by several authors. The purpose of this experiment was to evaluate the effect of a physiological dose of estradiol on prostate growth in dogs, using ultrasound to study size changes over time.

METHODS

Dogs (n = 25) were randomly divided into groups (n = 5) and treated as follows: castration alone (CC), castration plus low dose estradiol (E(2) low), castration plus high estradiol (E(2) high), castration plus estradiol and androstanediol (E(2)A), or no treatment (normal controls, NC). Silastic implants containing 5alpha-androstan-3alpha-17beta-diol (3alphadiol), and/or 17beta-estradiol were used for continous delivery of steroids. Prostate volume was measured by transrectal ultrasonography, and blood was drawn for hormone and sex hormone binding globulin (SHBG) determinations.

RESULTS

Results show that serum estradiol and SHBG levels were fairly constant over 12 weeks in all groups. Estradiol-treated groups had mean serum estradiol values of approximately 40 and 60 pg/ml, respectively. Initially, all groups had similar prostate volumes. Over 12 weeks the castrate dogs had a decline in prostate volume, whereas the intact dogs and those treated with E(2) and 3alpha-diol maintained a constant prostate volume. Estradiol treatment caused a large, late onset (week 7), dose-dependent increase in prostate volume relative to the intact group (P < 0.01). At 12 weeks, animals were euthanized and prostates weighed. The mean prostate weights in each group were: NC 14.8 +/- 2. 9, CC 2.4 +/- 0.5, E(2)A 9.7 +/- 2.0, E(2) low 21.7 +/- 4.3, and E(2) high 63.6 +/- 12.6 g (geometric mean +/- SEM). Histologically, prostates of estrogen-treated dogs showed metaplastic squamous epithelium.

CONCLUSIONS

These results demonstrate that estradiol causes marked dose-dependent stimulation of prostate growth in the castrate dog.

Efficacy of various natural and synthetic androgens to induce ductal branching morphogenesis in the developing anterior rat prostate

The studies presented herein quantitated ductal branching morphogenesis in the anterior prostate (AP) of the newborn rat. Four parameters were measured: epithelial area, epithelial perimeter, node number, and form factor. Nine natural and synthetic androgens were tested for their effectiveness in inducing postnatal prostatic development using 808 newborn rat APs in 68 dose-response experiments. Based on these studies it was shown that testosterone (T) was slightly more effective than dihydrotestosterone (DHT) in supporting ductal branching morphogenesis in the developing rat AP. Furthermore, the activity of T could not be accounted for simply by conversion of T to DHT. Synthetic androgens, 7alpha-methyl-19-nortestosterone and methyltrienolone (R1881), which cannot be 5alpha-reduced to DHT, also induced extensive ductal branching and elicited responses less than those to T and not statistically different from those to DHT. This suggests that although DHT is sufficient for prostatic development, it is not necessary for postnatal ductal branching morphogenesis and growth of the prostate. 5Alpha-androstan-3alpha,17beta-diol was particularly potent in inducing ductal branching, eliciting a response greater than or comparable to those of T and DHT. Androsterone, androstanedione, 5alpha-androstan-3beta,17beta-diol and 5beta-androstan-3alpha,17beta-diol induced ductal branching, but to a lesser extent than either T or DHT. These studies challenge the assumption that DHT is essential for prostatic development, specifically during ductal branching morphogenesis of the neonatal rat prostate.

Progesterone and 3 alpha-androstanediol conjugated to bovine serum albumin affects estrous behavior when applied to the MBH and POA

Ovariectomized rats with cannula over the medial basal hypothalamus (MBH) received implants of 3 alpha-diol conjugated to bovine serum albumin (BSA; 3 alpha-diol:BSA), free 3 alpha-diol diluted with BSA (3 alpha-diol&BSA), progesterone (P) conjugated to BSA (P:BSA), free P diluted with BSA (P&BSA), or BSA alone. 3 alpha-diol:BSA or 3 alpha-diol&BSA facilitated receptivity within 90 min. Other estradiol-treated rats received steroid implants in the preoptic area (POA); those receiving P:BSA or P&BSA showed significant elevations in lordosis in 5 min. When systemic P was given, 3 alpha-diol:BSA and 3 alpha-diol&BSA applied to the MBH or POA inhibited receptivity. When 3 alpha-diol was given systemically, 3 alpha-diol:BSA implants to the MBH and POA produced facilitatory effects. These data suggest 3 alpha-diol can act at the membrane and that these effects are influenced by circulating steroids; yet membrane-mediated actions do not account for all of P-facilitated sexual behavior in the MBH and POA.

Analgesic effects of the neurosteroid 3 alpha-androstanediol

The efficacy of 5 alpha-androstane-3 alpha,17 beta-diol (3 alpha-Androstanediol; 3 alpha-Diol) and 4-pregnen-3,20-dione (progesterone; P) in promoting analgesia was investigated. Ovariectomized rats received daily injections of 3 alpha-Diol (0.6, 3.0, 6.0 and 7.5 mg/kg) or vehicle and twice daily injections of estradiol-17 beta (E2: 1 microgram) for 2 days. Progesterone (0.5, 1.0, 2.0 and 4.0 mg/kg) or its vehicle was given on the third day and nociceptive testing using the radiant heat tailflick method was carried out 4 h later. In Expt. 1, P and 3 alpha-Diol both produced analgesia and had biphasic dose-response effects when administered singly. 3 alpha-Diol (3.0 mg/kg) elevated tailflick latencies in E2-primed animals above those following vehicle, 6.0 or 7.5 mg/kg 3 alpha-Diol; 6.0 and 7.5 mg/kg produced elevations that were greater than vehicle but less than 3.0 mg/kg. Progesterone (0.5 and 1.0 mg/kg) also elevated tailflick latencies above vehicle controls, while 2.0 and 4.0 mg/kg produced intermediate effects. In Expt. 2, 3 alpha-Diol (3 alpha-Diol:BSA) and P (P:BSA) conjugated to bovine serum albumin (BSA) were applied to the medial basal hypothalamus (MBH) and preoptic area (POA) to ascertain whether the steroids' analgesic actions were mediated by membrane actions in these sites. Free P and P:BSA both increased tailflick latencies when applied to the MBH, while 3 alpha-Diol and 3 alpha-Diol:BSA elevated latencies when applied to the POA, suggesting the steroids' effects occur in part at the neuronal membrane. In Expt. 3, free P or P:BSA applied to the MBH did not increase tailflick latencies if systemic P was given concurrently. Similarly, free 3 alpha-Diol and 3 alpha-Diol:BSA implants into the POA failed to increase tailflick latencies if s.c. 3 alpha-Diol was co-administered. These data indicate that P and 3 alpha-Diol at moderate doses have analgesic effects in part via membrane actions within the MBH and POA, respectively.

[Pharmaceutic development of injectable Arduan]

As a consequence of the presence of two ester groups in its molecule the main decomposition route of pipecuronium bromide (active ingredient of Arduan injection) is hydrolysis. In addition to this, autoxidation can also take place. In order to obtain a stable dosage form liophylized ampoules containing mannitol were prepared. Mannitol is not only a filling material but its role is also to decrease the dielectric constant of the solvent water thus increasing the stability of the drug substance before and during the liophylization procedure and after the dissolution of the content of the ampoules for administration. In order to protect the drug molecule against oxidation inert gas atmosphere was used during the production of the ampoules. The preparation is compatible with basic infusion solutions.

Myasthenia gravis and pipecuronium--report of two cases

The use of pipecuronium in two patients with myasthenia gravis undergoing thymectomy is described. Neuromuscular function was monitored throughout using the train-of-four (TOF) mechanical twitch response. The cumulative dose-response to pipecuronium was determined in both patients during nitrous oxide-oxygen-narcotic anaesthesia. Both patients were sensitive to pipecuronium. The ED50 doses of pipecuronium were 11.6 and 11.1 micrograms.kg-1 and the ED95 doses were 35 and 33.3 micrograms.kg-1 in patients #1 and 2 respectively. Edrophonium 1 mg.kg-1 and neostigmine 0.06 mg.kg-1 were administered to patients #1 and 2 respectively for antagonism of residual neuromuscular blockade at 25 per cent spontaneous recovery of first twitch (T1) of the TOF stimulation. As with other non-depolarizing muscle relaxants pipecuronium in reduced dosage and with careful neuromuscular monitoring can be used to provide surgical relaxation safely in patients with controlled myasthenia gravis.

Clinical evaluation of different doses of pipecuronium bromide during nitrous-oxide-fentanyl anaesthesia in adult surgical patients

The neuromuscular and cardiovascular effects of three different doses of pipecuronium were studied in 60 adult patients. Neuromuscular blockade was measured using electromyographic activity of the adductor pollicis muscle after supramaximal stimulation of the ulnar nerve at 0.1 Hz and 2 Hz. Three subgroups (A, B, C) of 20 patients received pipecuronium doses of 60, 80 and 100 micrograms kg-1, respectively, as an intubating dose and, when necessary, maintenance doses were administered at 25% single twitch recovery in a dose of one-quarter of the initial one. The onset time was 5.4 +/- 2.0 min for 60 micrograms kg-1 and similar for 80 and 100 micrograms kg-1 (3.9 +/- 1.1 and 3.6 +/- 1.1 min). The duration of action was 45 +/- 10 min for 60 micrograms kg-1, 74 +/- 25 and 94 +/- 21 for 80 and 100 micrograms kg-1, respectively. The recovery indices were measured in all patients after neostigmine administration (Groups B and C) and after neostigmine and edrophonium (Subgroup A, 10 patients each). TOF ratio was significant only 2 min after edrophonium administration in Group A patients. Variations of heart rate and blood pressure were not significant.

Intubating conditions after pipecuronium bromide: the influence of dose and time

STUDY OBJECTIVE

To determine the intubating conditions following the administration of pipecuronium bromide in doses of two (0.07 mg/kg) or three (0.1 mg/kg) times ED95 (average dose that gives 95% block of the first twitch).

DESIGN

To compare intubating conditions at 11/2 and 21/2 minutes in 41 patients receiving balanced anesthesia.

SETTING

Surgical patients at Thomas Jefferson University Hospital.

PATIENTS

Forty-one patients undergoing surgical procedure who received general anesthesia.

INTERVENTIONS

After obtaining a stable baseline of train-of-four (TOF), 41 patients randomly received either 0.07 mg/kg or 0.1 mg/kg of pipecuronium as a single intravenous (IV) bolus dose, and the trachea was intubated either at 11/2 or 21/2 minutes.

MEASUREMENTS AND MAIN RESULTS

Intubating conditions at 21/2 minutes appeared significantly better than those at 11/2 minutes, regardless of the pipecuronium dose. The mean time for T1 (first twitch of TOF) to reach 50% and 90% suppression was 1.36 +/- 0.51 minutes and 2.29 +/- 0.8 minutes, respectively, for the 0.07 mg/kg dose and 1.07 +/- 0.27 minutes and 1.72 +/- 0.45 minutes, respectively, for the 0.1 mg/kg dose. This did not make a significant difference in intubating conditions at either time. The time to 25% recovery of T1 was 68.2 +/- 22 minutes for the 0.07 mg/kg dose and 121.5 +/- 49 minutes for the 0.1 mg/kg dose. In patients who had spontaneous recovery of T1 to between 10% and 25% of control, administration of neostigmine or edrophonium resulted in identical recovery in 10 minutes. However, in patients with less than 10% spontaneous recovery of T1, neostigmine appeared to be superior to edrophonium.

CONCLUSION

Pipecuronium has a relatively rapid onset. The trachea could be intubated successfully in 11/2 minutes with a dose of either 0.07 mg/kg or 0.1 mg/kg. If the clinical situation requires perfect relaxation with no movement or bucking, we recommend waiting at least 21/2 minutes.

Comparison of cardiovascular effects of pipecuronium versus vecuronium in patients receiving sufentanil anesthesia for myocardial revascularization

This study was designed to compare the cardiovascular effects of pipecuronium bromide (PIP) to vecuronium (V) when combined with sufentanil (SF) in patients undergoing coronary artery bypass surgery. Eighty-two patients were studied; 40 were normotensive and 42 had hypertension currently controlled by pharmacological therapy. All patients were randomly assigned to receive either intravenous V, 0.12 mg/kg, or PIP, 0.10 mg/kg. Anesthesia was induced with SF, 6 micrograms/kg, while breathing 100% oxygen. Hemodynamic data including heart rate, mean arterial pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac index, systemic vascular resistance, pulmonary vascular resistance, and left ventricular stroke work index were collected at five points: prior to induction, 3 and 6 minutes after the complete administration of PIP or V, and 3 and 6 minutes after intubation. There were no statistical differences in hemodynamic changes associated with either PIP or V. In addition, there were no statistical differences in the hemodynamic parameters measured at the five time points between the normotensive and hypertensive patient groups. This study demonstrates that there are no significant hemodynamic changes between SF/PIP and SF/V when used during coronary artery surgery. Due to its associated stable hemodynamics, as well as its long duration of action, PIP could become a commonly used muscle relaxant for anesthesia for cardiac surgery.

Neuromuscular effects of pipecuronium bromide

The neuromuscular effects of pipecuronium bromide have been evaluated in 90 adult patients anaesthetized with thiopentone, nitrous oxide in oxygen and intravenous fentanyl with or without halothane. Eighty patients received pipecuronium 45 micrograms kg-1 and the remaining ten 70 micrograms kg-1. A separate group of 10 patients received pancuronium in a dose of 60 micrograms kg-1 (equipotent to pipecuronium 45 micrograms kg-1). Neuromuscular block was measured using a single-twitch or train-of-four mode of stimulation. The time to onset of maximum block with pipecuronium 45 micrograms kg-1 varied between 3.5 and 5.7 min depending on the mode of stimulation and the anaesthetic technique used. The time to 25% recovery of this dose varied between 41 and 54 min. The recovery index (time from 25 to 75% recovery) averaged 29 min. These values were generally similar in the group receiving pancuronium 60 micrograms kg-1. The time to onset of complete block with 70 micrograms kg-1 of pipecuronium averaged 2.5 min and the duration to 25% recovery 95 min. There were no significant changes in heart rate and arterial pressure with the use of pipecuronium. The results show pipecuronium to be a drug resembling pancuronium in its neuromuscular effects when used in equipotent doses.

Dose requirements and plasma concentrations of pipecuronium during bilateral renal exclusion and orthotopic liver transplantation in pigs

We have studied five pigs undergoing bilateral clamping of the renal pedicles, seven pigs undergoing orthotopic liver transplantation and three control animals without surgery in order to examine the roles of the kidney and liver in the plasma clearance of pipecuronium. An i.v. infusion of pipecuronium was controlled to maintain a constant 90-95% twitch depression throughout the investigation. The right sciatic nerve was stimulated continuously with supramaximal stimuli at 0.1 Hz and the force of the corresponding evoked isometric muscle contraction was recorded continuously. Control pigs needed an infusion rate of pipecuronium 8-10.7 micrograms kg-1 min-1. In the renal group, it was necessary to reduce the infusion rate of pipe-curonium by about 25% after clamping both renal vascular pedicles (P less than 0.05 compared with controls); in pigs undergoing liver transplantation, it was necessary to reduce the rate by approximately 80% after clamping hepatic vessels (P less than 0.05 compared with controls and from the period after clamping of renal vessels). After hepatic recirculation, the infusion rate of pipecuronium was increased progressively to a rate which corresponded to 50% of baseline values (P less than 0.05 compared with the anhepatic phase and from controls). Plasma concentrations of pipecuronium were comparable in the three animal groups and did not change significantly during the study. These data suggest that the liver plays a more important role than the kidney in the plasma clearance of pipecuronium in pigs.

[A pharmacodynamic study of pipecuronium bromide (Arduan) in newborn infants, infants and children]

The purpose of the study was to measure the neuromuscular effects of pipecuronium bromide (Arduan) and to determine its dosage in paediatric anaesthesiology by recording dose-effect curves in children, infants and newborn babies during diazepam, ketamine, fentanyl, nitrous oxide anaesthesia. These investigations were performed by electromechanographic method. In connection with the pharmacodynamic evaluation, literature on the pipecuronium bromide and on the administration of the muscle relaxants in paediatric anaesthesiology is summarized. From the investigations it can be ascertained that infants are more sensitive and neonates prove to be even more sensitive to pipecuronium than children; therefore it is advisable to administer 80-90 micrograms.kg-1 of Arduan for children, 50-60 micrograms.kg-1 for infants and 40-50 micrograms.kg-1 for newborn babies to ensure appropriate relaxation for surgery.

Interaction between nondepolarizing neuromuscular blocking agents and inhalational anesthetics

Although many studies have presented data based on administration of nondepolarizing neuromuscular blocking agents to patients given inhalation anesthesia for 30-45 min, no data exist on the interaction in a clinical situation where the relaxant is administered immediately after the start of anesthesia. We therefore studied the effect of the commonly used inhalation anesthetics, halothane and enflurane, on the clinical pharmacology of atracurium, vecuronium, pipecuronium, and pancuronium. No significant influence of the anesthetic technique on the onset time of the various neuromuscular blocking agents was observed. The duration of action of atracurium, pipecuronium, and pancuronium was significantly prolonged during enflurane anesthesia as compared with the other two anesthetic techniques. The duration of vecuronium blockade was not significantly influenced by enflurane. Halothane, in contrast to enflurane, did not significantly prolong the blockade induced by these agents. The prolongation of atracurium blockade was clinically irrelevant. A fact that is statistically significant but clinically irrelevant is that a cumulative effect with atracurium and vecuronium was only seen during enflurane anesthesia and after the fourth maintenance dose. We conclude that there is no clinical indication that the dosage of atracurium and vecuronium during inhalation anesthesia should be reduced, but the doses of pipecuronium and pancuronium should be reduced when prolonged paralysis is not desired.

A dose-response evaluation of pipecuronium bromide in elderly patients under balanced anesthesia

Pipecuronium bromide is a new steroidal non-depolarizing muscle relaxant currently under investigation. It is similar to pancuronium with respect to the duration of action, but lacking its cardiovascular side effects. We examined the dose-response relation of pipecuronium in 27 patients, ages 66-79 years, utilizing the incremental dose method under balanced anesthesia. The ED50, ED90 and ED95 were 22.42 (5.2) mcg/kg, 31.81 (6.9) mcg/kg and 35.12 (7.8) mcg/kg, respectively (log probit method). Our recovery data also demonstrate that residual neuromuscular blockade due to pipecuronium can easily be antagonized with neostigmine as long as spontaneous recovery of T1- at the time of reversal administration is greater than 13%. The authors conclude that under balanced anesthesia the cumulative dose-response of pipecuronium in the elderly patients is consistent with those previously described for younger population. Therefore, no dose adjustment appears necessary for the elderly. However, as with all medications, careful administration is appropriate.

Effects of aromatizable and nonaromatizable androgen treatments on luteinizing hormone receptors and ovulation induction in immature rats

The effects of androgen pretreatment on follicle-stimulating hormone (FSH)-stimulated luteinizing hormone (LH) receptor induction in ovarian granulosa cells was examined. Immature female rats were treated with various doses (0.1-5 mg/rat) of testosterone (T), 5 alpha-dihydrotestosterone (DHT), 5 alpha-androstane-3 alpha,17 beta-diol (3 alpha-diol), or 5 alpha-androstane-3 beta,17 beta-diol (3 beta-diol). Subsequent follicular development was stimulated by treatment with ovine FSH. LH receptor induction in granulosa cells and ovulatory responses to 10 IU human chorionic gonadotropin (hCG) were examined. Since LH receptor induction requires the synergistic action of both FSH and estradiol, the effects of the androgen pretreatment on FSH-stimulated estradiol production were also examined. Dihydrotestosterone treatment at doses greater than 1 mg inhibited LH receptor induction by approximately 70%, which resulted in absent ovulatory responses. Treatment with 1 mg or more of T or 3 alpha-diol had no effect on LH receptor induction, yet the hCG-stimulated ovulation rate was reduced to 40% of that seen in vehicle-treated controls. 3 beta-Diol, at a dose of 1 mg/rat, did not affect LH receptor induction but did reduce hCG-stimulated ovulation responses. No significant effects of androgen treatment on ovarian or uterine weight or FSH-stimulated estradiol production were observed. These results suggest that androgens can act at multiple sites to inhibit ovarian follicular development and function. In addition these studies demonstrate that, although LH receptor induction is necessary, it may not be a sufficient condition to ensure ovulation of ovarian follicles.

Differential actions of testosterone and its metabolites on mice submandibular gland

Submandibular glands from male mice castrated at 21 days of age and killed 60 days thereafter exhibited impaired development of the granular ducts (GD), an effect which is directly related to its androgen-dependent feature. Testosterone and other related steroids of natural occurrence were given to these animals in order to determine the mechanism by which those compounds bring about recovery of their glandular histophysiology. The size and number of GD were reconstituted by the steroids in the following order of potency: 5 alpha-androstane-3 alpha, 17 beta-diol greater than testosterone propionate greater than 5 alpha-dihydrotestosterone greater than or equal to testosterone greater than 5 alpha-androstane-3 beta, 17 beta-diol. All of the drugs stimulated protein synthesis, but only 3 alpha-diol was also able to increase DNA synthesis. Results support the assumption that 3 alpha-diol exerts both proliferative and hypertrophic effects on mice SMG, possibly through some receptor-independent pathway(s); the action of the other steroids is essentially hypertrophic in nature.

Interaction of androgens and estrogens in the control of sexual behavior in male Japanese quail

A series of 4 experiments was performed to study the relative contribution of androgens and estrogens in the activation of sexual behavior in castrated male quail. The synthetic androgen methyltrienolone (R 1881) which is not metabolized in androgen target tissues activated sexual behavior in castrated birds and at the dose level of 0.5-1 mg/day/animal had the same potency as testosterone (T). However R 1881 was much more active than T in the induction of cloacal gland growth and activation of crowing, two typically androgen-dependent responses. This suggests that sexual behavior is not controlled by exactly the same mechanism as crowing or cloacal gland growth. In another experiment, estradiol (E2) alone activated sexual behavior but it is only at very high doses which had clear toxic effects that a significant behavioral activation could be observed. This questions the role of E2 as the physiological agent stimulating copulation in intact birds unless it is assumed that centrally administered E2 would be much more active compared to peripheral E2 which is exposed to a very intense peripheral catabolism. In the last two experiments, a clear synergism could be detected between 5 alpha-dihydrotestosterone (5 alpha-DHT) and E2 in the activation of sexual activity and doses of hormones could be defined which had almost no activity by themselves but significantly stimulated sexual behavior when given simultaneously. It was however impossible to define a hormonal treatment with T metabolites which restored behavior to its precastration level, a result very easily achieved with T treatments. Taken together, these data suggest that activation of sexual behavior in quail does not depend only on E2, nor 5 alpha-DHT nor even on their combined action. Considering that specific T receptors which probably do not bind 5 alpha-DHT are present in the brain, it would seem justified to reconsider the possible role played by T itself in the activation of behavior.

[Comparison of morphological and biochemical indicators of prostatic growth and function in castrated rats receiving separately and simultaneously 5 alpha-dihydrotestosterone and 5 alpha-androstane-3 beta, 17 beta-diol]

Experiments in vito showed that indicators of prostatic growth (organ mass, protein content, DNA) and function (acid phosphatase activity) of castrated rats regenerated under the influence of 5 alpha-dihydrotestosterone. The morphological structure of this organ showed a pronounced activation of the glandular epithelium proliferation by this metabolite without a significant effect on the connective tissue. The other testosterone metabolite 5 alpha-androstan-3 beta, 17 beta-diol did not influence biochemical indicators but according to the morphological data it stimulated the secretory activity of the glandular epithelium and connective tissue formation. As a result of a combined effect of the metabolites the influence of 5 alpha-dihydrotestosterone on the proliferative processes in the prostate was limited, and the response of the connective tissue to 5 alpha-androstan-3 beta, 17 beta-diol preserved. The results obtained were not in accord with a hypothesis that 5 alpha-dihydrotestosterone is the only physiologically active testosterone metabolite in the rat pancreas, and confirmed the idea of androgen functional interrelationship.

Administration of constant low doses of androgens to steers by silastic implant. Suppression of gonadotropins and peripheral conversion of androgens

Yearling Hereford calves approximately 300 kg in weight were castrated and assigned to one of six treatment groups receiving subcutaneous implants (3 implants, 0.5 cm diameter by 10 cm length, 10% steroid by weight) of either androstenedione (D); testosterone (T); 5 alpha-androstane-3 beta, 17 beta-diol (3 beta-diol); dihydrotestosterone (DHT); androsterone (A); or control (no steroid). Blood samples were obtained at half-hour intervals for eight hours one day prior to, and one week after, castration. The castration-induced elevation in FSH secretion was suppressed or modified by the DHT, T, and 3 beta-diol implants. LH levels were not significantly suppressed. The T implants elevated serum T concentrations; DHT implants elevated serum 5 alpha-androstane-3 alpha, 17 beta-diol (3 alpha-diol) and 3 beta-diol, but not DHT concentrations; 3 beta-diol implants elevated serum 3 beta-diol concentrations. The effects of D and A implants upon serum androgen concentrations were not statistically significant, although observations in vitro suggested an adequate release rate. These data imply that T and DHT, or metabolites of DHT, suppress FSH secretion and suggest that extensive peripheral androgen metabolism occurs.

[Role of 5-alpha-androstane-3-beta, 17-beta-diol in establishing feedback between the gonads and hypothalamo-hypophyseal system of orchidectomized adult rats]

Concentration of luteinizing hormone and content of luliberine were estimated, respectively, blood serum and in hypothalamic arccuate nucleus and median eminence of adult castrated rats after administration of testosterone, 5 alpha-androstane 3 beta, 17 beta diol and 5 alpha-androstane 3 alpha, 17 beta diol. Effect of testosterone and of its derivatives on hypothalamo-hypophysial system was distinctly dissimilar both in the intensity of the action and in the rate of its realization. 5 alpha-androstane 3 beta, 17 beta diol as well as testosterone and 5 alpha-androstane 3 alpha, 17 beta diol were shown to be active in the negative feedback mechanism between gonads and hypothalamo-hypophysial system; the effect of androgenes was dose-dependent.

Comparison of spontaneous and experimentally induced canine prostatic hyperplasia

Spontaneous prostatic hyperplasia in the beagle appears to progress with age from a glandular to a cystic histological appearance. Prostatic hyperplasia can be induced in young beagles with intact testes by treatment for 4 mo with either dihydrotestosterone or 5 alpha-androstane-3 alpha, 17 beta-diol, alone, or with either of these steroids in combination with 17 beta-estradiol. In contrast, the induction of prostatic hyperplasia in young castrated beagles, in which the gland had been allowed to involute for 1 mo, requires the administration of both 17 beta-estradiol and either 5 alpha-androstane-3 alpha, 17 beta-diol or dihydrotestosterone. Testosterone and 17 beta-estradiol, either singly or in combination, did not produce the hyperplastic condition in intact or castrated beagles. The experimentally induced prostatic hyperplasia is identical in pathology to the glandular hyperplasia that occurs naturally in the aging dog with intact testes. However, cystic hyperplasia was not produced by any of the treatments tested in young animals.

Comparison of effects of C19 (androstene or androstane) steroids on serum gonadotrophin concentrations and on accessory reproductive organ weights in gonadectomized, adult male rats

The effects of subcutaneous administration of graded doses of C19 (androstene or androstane) steroids on serum levels of LH and FSH and on weights of accessory reproductive organs in gonadectomized, adult male rats were investigated. The C19 steroids were administered during 7 days in doses of 100, 50, 25, 12.5 or 6.25 mug per 100 g body weight per day. With the amounts of steroids used, 5alpha-dihydrotestosterone and 5alpha-androstane-3alpha, 17beta-diol had a high potency in preventing the rise of serum gonadotrophin concentrations and in curbing the decrease weights of ventral prostates and seminal vesicles following orchidectomy. 5alpha-Androstane-3beta, 17beta-diol showed no such effects. Positive feedback effects on serum gonadotrophins in castrates were observed following injection of certain doses of some steroids. Effects of steroids on accessory reprosuctive organs did not always correlate with those on gonadotrophic function of the hypothalamic-pituitary unit.