New advances in the treatment of hypogonadism in the aging male

The signs and symptoms of low testosterone in the aging male include erectile dysfunction, decreased libido, mood disturbances such as depression, loss of muscle mass, osteoporosis, and increase in body fat. Many of these signs and symptoms were previously believed to be part of the normal aging process, and only recently has treatment of low testosterone in the aging male been shown to provide long-term physical and mental improvement. In the past, oral and injectable testosterone delivery methods had disadvantages that limited their use, but the introduction of transdermal testosterone patches has allowed testosterone to be delivered into the circulation in a consistent fashion. Long-term use of these patches over the last 3 to 10 years has been effective in maintaining sexual function and bone and muscle mass, and from short-term studies it does not appear that testosterone treatment puts men at risk for the development of prostate cancer. A new topical gel formation (Testim) has been designed to provide consistent transdermal absorption of testosterone over 24 hours after a single dose.     

Androgen treatment of male hypogonadism in older males

The treatment of primary and secondary hypogonadism with testosterone is well established. Recently, there has been increased awareness that low testosterone levels also occur in chronically ill persons and aging males. Because of sex hormone binding globulin changes, it is more appropriate to make the diagnosis using either free or bioavailable testosterone. A small number of controlled studies have suggested that testosterone replacement in older men improves libido, quality of erections, some aspects of cognition, muscle mass, muscles strength, and bone mineral density. It also decreases fat mass and leptin levels. A number of screening questionnaires for the andropause have been developed. Insufficient numbers of older men have been treated with testosterone to characterize the true incidence of side effects. There is a desperate need for well designed, large controlled trials to establish the value or otherwise of testosterone treatment in older males.     

合成生物学在基础生命科学研究中的应用

合成生物学作为一门新兴的交叉学科,吸引了来自生物学、数理科学和工程学等不同学科的研究人员以及产业界的广泛关注和参与。它旨在通过从头创造全新的或改造已有的生物系统,实现天然生物系统不具备的功能与特性。合成生物学研究不仅具有广阔的生物产业应用前景,更为基础科研提供了全新的手段和思路。本文着眼于合成生物学―建物致知‖的理念,跟踪合成生物学研究在回答生命科学基础问题方面取得的相关成果,简述了其在细胞内分子调控网络、细胞生理学、多细胞群体形态与行为以及多物种微生态学等研究中的应用。     

Fundamental symmetry aspects of chirality

Physical systems which exhibit distinguishable enantiomers under space inversion are not necessarily chiral. A new definition of chirality is proposed that enables true and false chirality to be distinguished. Although spatial enantiomorphism is sufficient to guarantee chirality in a stationary object, enantiomorphous systems are not necessarily chiral when motion is involved. Only a truly chiral influence can induce absolute asymmetric synthesis in a reaction mixture at thermodynamic equilibrium, but false chirality might suffice if equilibrium is not attained. Parity violation lifts only the degeneracy of enantiomers of truly chiral systems, the true enantiomers (i.e. strictly degenerate) being interconverted by space inversion together with charge conjugation. The time-independence of optical activity arising from parity violation is contrasted with the time-dependence of that arising from spontaneous parity breaking.     

Fertility and the aging male

In the United States since 1980, the birth rate in women aged > 35 years has increased by nearly 60%, whereas the birth rate for women aged 20 to 34 years has increased by only 10%. The trend in parenthood at an older age has also been seen in men. Since 1980, the fertility rate for men in their 30s has increased by 21% and for men aged 40 years and older, the rate has increased nearly 30%. In contrast, the fertility rate in men younger than age 30 years has decreased by 15%. Age-related infertility will continue to be a problem. A basic understanding of the issues is critical for health care professionals so that they can effectively counsel patients who are considering a delay in childbearing for social reasons or for those seeking fertility treatments. This review details the changes in fertility seen in the aging male.     

Androgen replacement therapy in the aging male

Beginning around age 40 years, men experience a decrease in testosterone level-referred to as "andropause"-and the pathophysiologic changes that accompany this decrease. Androgen replacement therapy, typically used for the treatment of senile hypogonadism, is evolving as a potential treatment of various other conditions related to testosterone loss, such as osteoporosis, sarcopenia, and even psychological symptoms. As with any treatment modality, certain patient factors are more predictive of success with minimal adverse effects, and consideration must be given to concomitant conditions. This article will provide a review of recent studies examining the effects of androgen supplementation and evaluate the purported benefits and potential risks of this therapy. Further research is anticipated to elucidate the most appropriate candidates, as well as other potential indications, for this treatment.     

Some aspects of aging in the lumbar spine

I measured the bodies of vertebrae L3 and L4 of 338 skeletons from the Terry collection in the Smithsonian Institution, including Blacks and Whites, males and females, aged from 20 to 90 years. Transverse breadths of the upper and lower endplates (excluding osteophytes) and minimum transverse breadths all increase with age. In general, the greater broadening occurs in the endplates, but the middle of the body also broadens to such a degree that there is no demonstrable increase in vertebral “flaring” with age. In males, posterior body height decreases relative to anterior height, so that the lumbar bodies become more wedge-shaped with age, but females show essentially no change. Anterior height decreases in proportion to minimum breadth, so that the lumbar bodies become relatively lower and broader, and this change is significantly correlated with age in all groups. Midbody height decreases relative to anterior height, so that Nordin's biconcavity index is reduced with age. The increase in biconcavity remains evident even when average anterior-posterior height is used to calculate the index. At all age levels a high percentage of individuals have biconcavity indices of 80% or less, indicating that Nordin's standard of normality for this index, established from measurement on radiographs of the living, should be revised downward for use in evaluating osteoporosis in skeletal populations.     

Osteoporosis in male hypogonadism: responses to androgen substitution differ among men with primary and secondary hypogonadism

BACKGROUND: No randomized study exists comparing the effects of different modes of androgen substitution on bone mineral density (BMD). METHODS: We performed a prospective, randomized, trial assigning 53 hypogonadal men to the following treatment groups: mesterolone 100 mg p.o. daily, testosterone undecanoate 160 mg p.o. daily, testosterone enanthate 250 mg i.m. every 21 days, or a single subcutaneous implantation of 1,200 mg crystalline testosterone. The BMD was determined by peripheral quantitative computed tomography. RESULTS: At baseline, men with secondary hypogonadism (n = 33) had a lower BMD (-1.52 +/- 0.23 SDS; Z-scores) than men with primary hypogonadism (n = 20, -0.87 +/- 0.23 SDS, p < 0.01). In men with primary hypogonadism, the BMD increased dose dependently (crystalline testosterone +7.0 +/- 1.3%, testosterone enanthate +4.8 +/- 0.2%, testosterone undecanoate +3.4 +/- 2.5%, mesterolone +0.8 +/- 1.6%) after 6 months of therapy. Only secondary hypogonadal men treated with testosterone enanthate experienced an increase of the BMD. CONCLUSIONS: In primary hypogonadal men the BMD responds dose dependently to testosterone substitution, whereas in secondary hypogonadism only testosterone enanthate treatment significantly increased the BMD.     

Cholinergic binding in the hippocampus of the aging male rat

1. M1 muscarinic (3H-pirenzepine) and 3H-L-nicotine binding were measured in the hippocampus of male Wistar rats aged 3-4, 10-11 and 24-25 months. 2. The maximal number of M1 binding sites did not differ between age groups. 3. The dissociation constant of M1 binding was higher in old rats than in young rats. 4. The binding of 3H-L-nicotine did not differ between age groups. 5. The number of postsynaptic muscarinic receptors may be preserved, but the conformation of these receptors in the rat hippocampus may be altered during aging.