RESUMEN
This study aimed to evaluate associations between exposure to a group of persistent organic pollutants, measured in both adipose tissue and serum samples from breast cancer patients, and a set of tumor prognostic markers. The study population comprised 103 breast cancer patients recruited in Granada, Southern Spain. Data for tumor prognostic markers were retrieved from hospital clinical records and socio-demographic information was gathered by questionnaire. Persistent organic pollutants were quantified by gas chromatography with electron capture detection. Exposure levels were categorized in quartiles, and associations were evaluated using unconditional logistic regression. Adipose tissue HCB concentrations were associated positively with ER and PR expression (p-trends=0.044 and 0.005, respectively) and negatively with E-Cadherin and p53 expression (p-trends=0.012 and 0.027, respectively). PCB-180 adipose tissue concentrations were positively associated with HER2 expression (p-trend=0.036). Serum PCB-138 concentrations were positively associated with ER and PR expression (p-trends=0.052 and 0.042, respectively). The risk of p53 expression was higher among women in the lowest quartile of serum PCB-138 concentrations, but no significant trend was observed (p-trend=0.161). These findings indicate that human exposure to certain persistent organic pollutants might be related to breast cancer aggressiveness. We also highlight the influence on exposure assessment of the biological matrix selected, given that both serum and adipose tissue might yield relevant information on breast cancer prognosis.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Exposición a Riesgos Ambientales , Contaminantes Ambientales/metabolismo , Hidrocarburos Clorados/metabolismo , Plaguicidas/metabolismo , Tejido Adiposo/química , Adulto , Anciano , Biomarcadores/sangre , Biomarcadores/metabolismo , Contaminantes Ambientales/sangre , Femenino , Humanos , Hidrocarburos Clorados/sangre , Persona de Mediana Edad , Plaguicidas/sangre , Bifenilos Policlorados/sangre , Bifenilos Policlorados/metabolismo , Pronóstico , Receptor ErbB-2/sangre , Receptor ErbB-2/metabolismo , Receptores de Estrógenos/sangre , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/sangre , Receptores de Progesterona/metabolismoRESUMEN
We aim to study the SCN5A gene in a cohort of Brugada syndrome (BS) patients and evaluate the genotype-phenotype correlation. BS is caused by mutations in up to 10 different genes, SCN5A being the most frequently involved. Large genomic rearrangements in SCN5A have been associated with conduction disease, but its prevalence in BS is unknown. Seventy-six non-related patients with BS were studied. Clinical characteristics and family risk profile were recorded. Direct sequencing and multiplex ligation-dependent probe amplification (MLPA) of the SCN5A gene for identification of mutations and larger rearrangements were performed, respectively. Eight patients (10.5%) had point mutations (R27H, E901K, G1743R (detected in three families), V728I, N1443S and E1152X). Patients with mutations had a trend toward a higher proportion of spontaneous type I Brugada electrocardiogram (ECG) (87.5% vs 52.9%, p = 0.06) and had evidence of familial disease (62.5%, vs 23.5%, p = 0.03). The symptoms and risk profile of the carriers were not different from wild-type probands. There were non-significant differences in the prevalence of type I ECG, syncope and history of arrhythmia in carriers of selected polymorphisms. None of the patients had any deletion/duplication in the SCN5A gene. In conclusion, 10.5% of our patients had mutations in the SCN5A gene. Patients with mutations seemed to have more spontaneous type I ECG, but no differences in syncope or arrhythmic events compared with patients without mutations. Larger studies are needed to evaluate the role of polymorphisms in the SCN5A in the expression of the phenotype and prognosis. Large rearrangements were not identified in the SCN5A gene using the MLPA technique.
Asunto(s)
Síndrome de Brugada/genética , Predisposición Genética a la Enfermedad/genética , Mutación , Canal de Sodio Activado por Voltaje NAV1.5/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Síndrome de Brugada/patología , Niño , Preescolar , Estudios de Cohortes , Análisis Mutacional de ADN , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Lactante , Modelos Logísticos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa Multiplex , Fenotipo , Adulto JovenRESUMEN
Objetivo: El dolor irruptivo es una necesidad clínica desconocida que todavía se diagnostica poco y, por lo tanto, se evalúa y se trata de modo inadecuado. Concretamente, en los pacientes oncológicos se puede presentar un dolor rectal irruptivo defecatorio debido al tumor, los efectos secundarios de los tratamientos administrados (cirugía, radioterapia y/o quimioterapia) o ambos. Recientemente, ha aparecido un sistema de administración transmucosa oral, citrato de fentanilo oral transmucosa (CFOT) (Actiq®) como método de alta eficacia para un inicio rápido de la analgesia. El objetivo de este trabajo es valorarla eficacia de CFOT como analgésico en este subgrupo tan específico de pacientes oncológicos. Pacientes y métodos: Entre enero de 2006 y julio de 2009 hemos revisado retrospectivamente un total de 10 pacientes tratados en nuestro servicio con CFOT por dolor rectal irruptivo defecatorio no premedicados con opiáceos. Cuando los pacientes referían en consulta dolor rectal se les valoraba con una escala visual analógica (EVA) (0-10). Resultados: La puntuación media premedicación con CFOT de dolor irruptivo defecatorio con la EVA fue de 7 (rango: 5-9). La puntuación media tras el tratamiento pasó a ser 1,9 (rango: 1-3). Todos refirieron controlar el dolor con dosis de 200 μg de CFOT, salvo 2 pacientes que precisaron dosis progresivas de 400 y 600 μg, respectivamente. El grado de satisfacción de los pacientes fue excelente-bueno en el 90% de los casos. Ningún paciente refirió efectos indeseables relacionados con el uso de CFOT. Conclusiones: Aunque nuestra serie es corta y, por lo tanto, sus resultados son muy preliminares, podemos recomendar el CFOT como analgésico ideal por su rapidez y seguridad para el tratamiento del dolor rectal irruptivo defecatorio. Es de fácil y cómoda administración, y de corta duración..(AU)
Objective: Breakthrough pain is a little-known entity that is infrequently diagnosed and consequently inadequately evaluated and treated. In particular, cancer patients can experience rectal defecation breakthrough pain due to the tumor, the side effects of treatment (surgery, radiotherapy and/or chemotherapy) or both. Recently, a new system of administration has been developed, oral transmucosal fentanyl citrate (OTFC; Actiq®), which is a highly efficient method for rapid onset of analgesia. The aim of this study was to evaluate the efficiency of OTFC as an analgesic for a highly specific subgroup of cancer patients. Patients and methods: We retrospectively reviewed 10 cancer patients treated with OTFC for rectal defecation breakthrough pain not previously treated with opioids between January 2006 and July 2009 in our Radiotherapy Service. Patients reporting rectal pain in consultations were evaluated by a Visual Analog Scale (VAS) (0-10). Results: The mean breakthrough pain VAS score was reduced from 7 (range 5-9) before OTFC to 1.9 (range 1-3) after the treatment. All patients reported pain control with a dose of 200 μg of OTFC except two patients who required progressive doses of 400 and600 μg, respectively. The degree of patient satisfaction was excellent-good in 90% of the patients. No patients reported undesirable effects related to the use of OTFC. Conclusions: Although our series is small and our results are therefore preliminary, we can recommend OTFC as the ideal analgesic due to its speed of onset and safety in the treatment of rectal defecation breakthrough pain. OTFC is easy and comfortable to administer and is short lasting. This option can be used by patients outside the home, thus preserving their independence. OTFC can be considered for the relief of breakthrough pain of other etiologies (oncological and non-oncological) in outpatients (AU)
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Fentanilo/uso terapéutico , Neoplasias del Recto/complicaciones , Neoplasias del Recto/terapia , Satisfacción del Paciente , Adyuvantes Anestésicos/administración & dosificación , Adyuvantes Anestésicos/uso terapéutico , Estudios Retrospectivos , Aceptación de la Atención de Salud , /métodosAsunto(s)
Remodelación Ósea/fisiología , Huesos/fisiología , Proteínas Portadoras/fisiología , Citocinas/fisiología , Glicoproteínas/fisiología , Glicoproteínas de Membrana/fisiología , Osteoclastos/fisiología , Receptores Citoplasmáticos y Nucleares/fisiología , Animales , Humanos , Ligandos , Osteoprotegerina , Ligando RANK , Receptor Activador del Factor Nuclear kappa-B , Receptores del Factor de Necrosis TumoralRESUMEN
No disponible
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Animales , Humanos , Citocinas , Receptores Citoplasmáticos y Nucleares , Glicoproteínas de Membrana , Osteoclastos , Huesos , Proteínas Portadoras , Remodelación Ósea , Ligandos , GlicoproteínasRESUMEN
The role of circulating tumor markers in providing prognostic information has not been widely studied. In the current study, serum levels of the carbohydrate antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) were determined preoperatively in 364 breast cancer patients with no clinical signs of metastasis. The prognostic relevance of these markers for recurrence (175/364) and death of disease (104/175) was determined by Cox multivariate analysis, including the comparison with classical prognostic factors. High levels of both tumor markers were associated with aneuploid tumors with high S-phase fraction and high ornithine decarboxylase activity. CA 15-3 was highly associated with the number of positive lymph nodes and peritumoral lymphatic or blood vessel invasion. No significant associations were found between CEA or CA 15-3 levels and histologic grade, necrosis and steroid receptor status. In univariate analysis, preoperative values, using optimum cutoff values of CA 15-3 (40 U/ml) and CEA (6 ng/ml), were statistically significant for relapse-free survival and overall survival. In multivariate analysis, only node status, DNA ploidy and ornithine decarboxylase activity were independent predictors for relapse-free survival; the estrogen receptor status was a predictor of overall survival. In node-negative patients, ornithine decarboxylase activity was the only factor selected for relapse-free survival. In node-positive patients, the number of lymph nodes and DNA ploidy were the only variables selected for relapse-free survival or overall survival. Estrogen receptor and ornithine decarboxylase activity were excluded for relapse-free survival, but were significant prognostic factors for overall survival.
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Neoplasias de la Mama/cirugía , Antígeno Carcinoembrionario/sangre , Mucina-1/sangre , Adulto , Anciano , Aneuploidia , Biomarcadores de Tumor/sangre , Neoplasias de la Mama/sangre , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Ciclo Celular , ADN de Neoplasias/análisis , ADN de Neoplasias/genética , Diploidia , Femenino , Citometría de Flujo , Humanos , Metástasis Linfática , Menopausia , Persona de Mediana Edad , Análisis Multivariante , Necrosis , Ornitina Descarboxilasa/análisis , Pronóstico , Receptores de Estrógenos/análisis , Receptores de Progesterona/análisis , Recurrencia , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
BACKGROUND: The influence of prognostic factors in breast cancer may change during follow-up. Our aim was therefore to look for time-related changes in hazard ratios for steroid receptor status and the risk of relapse. PATIENTS AND METHOD: We studied 455 patients with operable primary breast cancer during a mean follow-up period of 72 months (range, 42-130 months). Clinical and histological characteristics were assessed and estrogen receptor (ER) and progesterone receptor (PgR) status were determined and compared to disease-free survival (DFS) and overall survival (OS). Analysis of DFS included fitting a multivariate Cox proportional hazards model, testing for non-proportionality, and examining diagnostic plots. RESULTS: A total of 66.8% of the tumors were ER positive and 54.7% PgR positive. Receptor status is highly associated with menopausal status, histological grade, peritumoral lymphatic or blood vessel invasion and mitotic index. No correlation was found between steroid receptor status and tumor size, node status or tumor stage. In univariate analysis, ER/PR vs ER+/PR+ display a hazard ratio of 2.15 (IC del 95%, 1.59-2.99) for DFS (p = 0.001) and 1.95 (IC del 95%, 1.38-2.59) for OS (p = 0.0043). In multivariate analysis, steroid receptor status, node status and mitotic index were independent prognostic factors for DFS and OS. By using Cox regression time-dependent covariates model, we show that the steroid receptor status hazard ratio is 5.6 at diagnosis, decreases after 4 years, and loses its significance after 10 years of follow-up. CONCLUSION: In patients with breast cancer the status steroid receptor have a relatively limited prognostic value and is lost within the first years.
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Neoplasias de la Mama/genética , Receptores de Esteroides/genética , Adulto , Anciano , Neoplasias de la Mama/química , Neoplasias de la Mama/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Análisis Multivariante , Fenotipo , Pronóstico , Receptores de Esteroides/análisis , Factores de TiempoRESUMEN
OBJECTIVE: The purpose of the study is to identify biochemical tests that are good predictors for the diagnosis of pheochromocytoma in patients at hypertension. SETTING: Review of data from of 3826 patients studied over a 5-year period, between 1994 and 1998, at the University Hospital Virgen de la Arrixaca, Murcia, Spain. DESIGN AND METHODS: A retrospective study for the diagnosis of pheochromocytoma of 24-h urinary free catecholamines (norepinephrine, epinephrine, and dopamine) measured by high-performance liquid chromatography (HPLC)-electrochemical detector (ECD), total metanephrines (MNt), and vanillylmandelic acid measured by spectrophotometric methods. RESULTS: During this period, 57 patients were found to have pheochromocytoma, being 47 sporadic, 9 with multiple endocrine neoplasia type 2A, and 1 with neurofibromatosis. In all patients multiple endocrine neoplasia type 2A the tumor were bilateral but only in four of the sporadic tumor group (p < 0.0001, Fisher's exact test). MNt was determined to be the best discriminator of hypertension and pheochromocytoma. It scored a sensitivity of 94.7% (95% confidence interval, 88.3-99.9%), a specificity of 95.3% (89.5-99.9%), and thus had the best negative predictive value of 99.9% (99.8-99.9%), and this biochemical test also had the best positive predictive value of 23.3% (10.8-59.9%). When combining both MNt and norephinephrine, the positive predictive value to increases to 85.6% (65.3-95.6%). CONCLUSION: Urinary 24-h MNt excretion level is the best single biochemical test for screening and, in combination with norephinephrine, is diagnostic of the presence of pheochromocytoma.
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Neoplasias de las Glándulas Suprarrenales/diagnóstico , Catecolaminas/orina , Metanefrina/orina , Feocromocitoma/diagnóstico , Adolescente , Neoplasias de las Glándulas Suprarrenales/complicaciones , Neoplasias de las Glándulas Suprarrenales/orina , Adulto , Anciano , Niño , Cromatografía Líquida de Alta Presión , Femenino , Humanos , Hipertensión/etiología , Masculino , Persona de Mediana Edad , Feocromocitoma/complicaciones , Feocromocitoma/orina , Valor Predictivo de las Pruebas , Valores de Referencia , Estudios Retrospectivos , Sensibilidad y Especificidad , Espectrofotometría , Ácido Vanilmandélico/orinaRESUMEN
The polyamines putrescine, spermidine, and spermine and ornithine decarboxylase (ODC), the rate-limiting enzyme in their biosynthetic pathway, play an important role in cell proliferation, differentiation, and transformation. In the present study, we have analyzed polyamine concentrations and ODC activity in samples from benign breast diseases (n = 36), benign breast tissue adjacent to the primary carcinoma (n = 19), and breast carcinoma (n = 104). ODC activity in primary carcinoma was significantly higher (2.42 +/- 0.22 nmol CO2/h g; P < 0.001) than that found in benign breast (0.62 +/- 0.15 nmol CO2/h g) or in breast tissue adjacent to the primary carcinoma (0.52 +/- 0.16 nmol CO2/h g). The total polyamine content of breast cancer tissues was higher than in benign breast diseases (704.3 +/- 38.3 nmol/g wet weight versus 295.8 +/- 27.4 nmol/g wet weight) and correlated well with ODC activity (Pearson, r = 0.42; P < 0.001). ODC activity correlated with histological grade, peritumoral lymphatic or blood vessel invasion, S-phase fraction, and cathepsin D. Total polyamine concentration increased with S-phase fraction, cathepsin D, and aneuploidy. No significant correlation was found between ODC or polyamines and tumor size, lymph node involvement, or steroid receptor status. A major finding in our study was that ODC activity was an independent prognostic factor for recurrence and death. The results indicate that the estimation of ODC activity and polyamines in human breast carcinoma might be useful to determine tumor aggressiveness and suggest that ODC may have a potential value as both a prognostic factor and a chemoprevention target in human breast cancer.
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Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/metabolismo , Carcinoma/diagnóstico , Carcinoma/metabolismo , Ornitina Descarboxilasa/metabolismo , Poliaminas/metabolismo , Adolescente , Adulto , Anciano , Enfermedades de la Mama/metabolismo , Neoplasias de la Mama/genética , Neoplasias de la Mama/mortalidad , Carcinoma/genética , Carcinoma/mortalidad , Catepsinas/metabolismo , Supervivencia sin Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Análisis Multivariante , Ploidias , Posmenopausia/metabolismo , Valor Predictivo de las Pruebas , Premenopausia/metabolismo , Pronóstico , Fase S , Tasa de SupervivenciaRESUMEN
BACKGROUND: Following extracorporeal cardiac surgery, transient myocardial dysfunction (stunning) and cellular damage may develop in relation, among other mechanisms, to the production of free radicals (FR) during reperfusion. The purpose of this study is to evaluate whether captopril (CTP), an angiotensin converting enzyme inhibitor with a thiolic group, which has been shown to be useful as an antioxidant agent both in in vitro and in vivo studies, can prevent emergence of those problems when used as pretreatment within 24 hours in patients undergoing valvular cardiac surgery. EXPERIMENTAL DESIGN: prospective and randomized study. Comparison of data pre-ischemic (pre-aortic clamping) and post-reperfusion (post-cardiac rewarming) was performed. Ejection fraction was compared pre-surgery, after surgery and after 3 months. SETTING: cardiology and cardiovascular surgery services in a general hospital. PATIENTS OR PARTICIPANTS: thirty patients who had to undergo valvular replacement surgery were randomly allocated to two similar groups, one group pretreated with captopril (CTP group, n = 15) and the other group without it (CON group, n = 15). Exclusion criteria (left ventricular ejection fraction <40%, evidence of angiographic coronary disease or prior myocardial infarction and peroperative myocardial infarction). INTERVENTION: in CTP group, the dose of captopril administered was 12.5 mg every 8 hours orally, from 24 hours before. MEASURES: using electron microscopy of myocardial biopsies taken prior to aortic clamping and post-reperfusion, a semi-quantitative analysis was performed on the degree of myocytic damage (MD), mitochondrial swelling (MS), sarcoplasmic reticulum swelling (SRS) and content in glycogen granules (GLY). Left ventricular ejection fraction was evaluated isotopically at three timepoints, preoperatively (EF1), at 2-3 days (EF2) and at 3 months (EF3). Also, analytical data were collected from the coronary sinus to determine creatine phosphokinase (CPK) and activity of the angiotensin converting enzyme (ACE). RESULTS: We noted that, in general, cellular damage resulting from valvular surgery is low, the degree of MS and SRS being lower in the CTP group. In the CTP group, however, there is a stunning phenomenon (EF1: 54.9+/-6.9%; EF2: 50.8+/-8.5%; EF3: 57.7+/-7.7%) which does not occur in the CON group (EF1: 58.0+/-8.3%; EF2: 60.8+/-10.9%; EF3: 63.0+/-9.3%). CONCLUSIONS: We conclude that the cellular damage caused during valvular replacement surgery is small, and emphasize that pretreatment with CTP further minimizes both MS and SRS; however, for reasons as yet unknown, CTP pretreatment may induce myocardial stunning, an indication that at these low rates of cellular damage, CTP has no beneficial effect, either because it is ineffective as an antioxidant agent or because FR formation has little repercussion in human beings, pointing out to the likely existence of other mechanisms that may induce an appearance of postsurgical myocardial stunning.
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Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Captopril/uso terapéutico , Enfermedades de las Válvulas Cardíacas/cirugía , Implantación de Prótesis de Válvulas Cardíacas , Aturdimiento Miocárdico/prevención & control , Miocardio/patología , Anciano , Válvula Aórtica/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Válvula Mitral/cirugía , Estudios ProspectivosAsunto(s)
Epidídimo/fisiología , Semen/química , alfa-Glucosidasas/análisis , Biomarcadores , Humanos , MasculinoRESUMEN
INTRODUCTION AND OBJECTIVES: After the ischemia-reperfusion process in extracorporeal cardiac surgery there are, among several phenomena, some reperfusion arrhythmias which are influenced by a varied series of mechanisms. These arrhythmias have been related to the release of oxygen-derived free radicals during the first moments of reperfusion. Thus, a previous administration of free-radical scavengers might be beneficial, among which captopril has been included with good results in human studies in vitro and in animals in vivo. The aim of this study was to evaluate the influence of pretreatment with captopril on the prevention of reperfusion arrhythmias in patients undergoing valvular cardiac surgery. METHODS: 30 patients were randomly allocated to pretreatment with either captopril (CTP group, n = 15) or without captopril (CON group, n = 15). Exclusion criteria (left ventricular ejection fraction < 40%, evidence of angiographic coronary disease, prior myocardial infarction and preoperatory myocardial infarction). The dose of captopril administered was 12.5 mg every 8 hours orally, from 24 hours before surgery. A Holter register was used to analyze the ventricular arrhythmias (extrasystoles, salvos, tachycardia and fibrillation) during the first hour of reperfusion. The need for cardioversion was examined and the number of shocks needed. These events were related to changes in blood analyses from coronary sinus samples to determine creatine phosphokinase, activity of the angiotensin converting enzyme and cyclic adenosine monophosphate, before aortic clamping and after the heart was rewarmed. RESULTS: No significant differences were found in the number of ventricular arrhythmias. 60% of the patients with captopril and only 40% of the patients without it (non significant) had spontaneous defibrillation without electric shock; in those cases in which it was necessary, the number of shocks was less in the captopril group (p < 0.05). Excepting the significant correlation (p < 0.01) that we have found between ventricular fibrillation and the cyclic adenosine monophosphate increase, there is no significant correlation between the other arrhythmias and the analytical data studied. CONCLUSIONS: These data suggest that captopril, given before cardiac surgery, has little or no protector effect on reperfusion ventricular arrhythmias in extracorporeal cardiac surgery, though in patients treated with captopril there is a greater possibility of spontaneous defibrillation and fewer shocks necessary for defibrillation, without negative effects.
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Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Captopril/uso terapéutico , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Daño por Reperfusión Miocárdica/prevención & control , Arritmias Cardíacas/etiología , Arritmias Cardíacas/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Daño por Reperfusión Miocárdica/etiologíaRESUMEN
Basic semen tests nowadays contain no variables that may allow to certify that a man is fertile. Starting from this premise it could be clinically very useful, for the diagnosis of male infertility, to evaluate a parameter that may be related to sexual maturity and be specific of the germinal tissue, such as the C4-lactate dehydrogenase isoenzyme (C4-LDH), which could indicate the activity of the germinal epithelium and the quality of the spermatozoa. In our experience, C4-LDH activity in seminal plasma discriminates between fertile and non-fertile males; also, their testicular study has a good correlation both with histologically diagnosed disease and the seminal plasma levels. All of which suggest the diagnostic validity of plasma C4-LDH in male infertility, as a routine test which thus precludes the use of invasive techniques in the patient.
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Infertilidad Masculina/diagnóstico , Infertilidad Masculina/enzimología , L-Lactato Deshidrogenasa/metabolismo , Testículo/enzimología , Adulto , Biopsia , Humanos , Isoenzimas , Masculino , Testículo/patologíaRESUMEN
We followed weekly the evolution of serum lipid concentrations in two bodybuilders undergoing a cycle of treatment with anabolic steroids. These drugs caused maximum depression of high-density lipoprotein cholesterol concentrations by 69.1% in the fifth week after the beginning of the cycle for subject 1, and by 72.4% in the fourth week for subject 2. Maximum increases in low-density lipoprotein cholesterol concentrations were 144% and 156%, respectively. Total cholesterol and apolipoprotein (apo) B were highly increased with anabolic steroid use. We also saw depression of apo A-I by 84% and 91%, and lipoprotein(a) decreased to undetectable amounts in both cases. These effects were reversed 10 weeks after the end of the steroid cycle in subject 1, but subject 2 still presented abnormal concentrations of serum lipids 13 weeks after drug cessation. The periods until reversibility of anabolic steroid effects on lipids were longer than those reported in previous studies.