Growth hormone treatment affects plasma LH pulsatile release in women with secondary amenorrhoea

OBJECTIVE Since growth hormone (GH) is administered as a co-gonadotrophic factor in ovulation induction, this study aimed to assess the action of GH on the episodic pulsatile release of LH and FSH in amenorrhoeic patients. PATIENTS AND DESIGN Nineteen patients affected by hypothalamic amenorrhoea were enrolled for this study: group A, 9 patients with normal gonadotrophins; group B, 10 patients with low gonadotrophins. Both groups were studied during GH infusion (0015 IU/min for 4 hours) and after 7 days of GH administration (0 1 IU/kg/day). Patients underwent a 4-hour pulsatility study, with blood sampling every 10 minutes. A standard GnRH test (10 μ g i.v. bolus) was performed immediately after the pulsatility evaluation. MEASUREMENTS LH and FSH were assayed with an IFMA method; oestradiol and IGF-I were assayed by RIA and IRMA, respectively. PULSE DETECTION Time series were analysed with Detect program. RESULTS All patients showed similar LH and FSH pulsatile characteristics both under baseline conditions and during GH infusion. After 7 days of GH administration, episodic FSH release showed no change in either group. On the contrary, LH pulse frequency (mean ± SE) significantly increased in group A (4 0±0 2 peaks/4h, P&kt;0 05), while putse amplitude (baseline, 3.9± 0 6 IU/I; after 7 days, 2.9±0.3 IU/I, P<0 05), and integrated LH plasma concentrations (baseline, 7.6 ±1–1 IU/I; after 7 days, 5±0 8 IU/I, P<0 05) were significantly decreased. No significant changes were observed for LH pulse frequency, amplitude or integrated LH plasma concentrations in hypogonado-trophinaemic patients (group B). Plasma oestradiol levels were significantly increased only in group A (baseline, 154 18±23 8 pmoI/I; after 7 days, 380 3±110 1 pmoI/I, P < 005), while IGF-I levels were significantly increased in both groups after 7 days of GH administration (P<0 05). No significant differences were observed in the gonadotropin responses to GnRH test before and after GH administration. CONCLUSIONS The present study showed that the administration of GH in amenorrhoeic patients determines the significant changes in episodic LH release in those subjects with normal LH plasma levels and suggests that the action of GH may be dependent upon the ovarian-pituitary feedback action.     

Focal Adhesion Kinase in Rat Central Nervous System

Focal adhesion kinase (pp125^FAK, FAK) is a 125 kDa non-receptor tyrosine kinase enriched in focal adhesions of various cell types, where it is thought to transduce signals triggered by contact with the extracellular matrix. We have studied the expression and localization of FAK in rat CNS. Immunoblotting, immunohistochemistry and in situ hybridization revealed the presence of FAK in all regions of the adult brain and demonstrated its enrichment in specific neuronal populations of the cerebral and cerebellar cortex, as well as in the hippocampus. During development, FAK protein levels were highest around birth in cerebral cortex and caudate putamen and decreased in the adult. In situ hybridization revealed enrichment of FAK mRNA in the ventricular germinative and external layers during the last period of embryonic growth. In primary cultures FAK immunoreactivity was localized in focal adhesions in astrocytes, whereas in developing neurons the highest levels were found in growth cones and perikarya. In the growth cone, FAK immunoreactivity colocalized with actin filaments. In mature neurons FAK appeared to be distributed in the whole cytoplasm, with no enrichment in any cellular compartment. Our results demonstrate the presence of high levels of FAK in rat CNS, maximal during development but persistent in the adult. Its enrichment in growth cones suggests that it may play a role in neurite outgrowth, as well as in plasticity in the adult.     

Diode laser treatment of posterior retinopathy of prematurity

AIMS: To study the efficacy of infrared diode laser for the treatment of posterior retinopathy of prematurity (ROP). METHODS: 48 eyes of 25 premature babies (mean birth weight 779 (SD 127.7) g; mean gestational age 25.5 (SD 1.47) weeks) with threshold ROP in zone I and posterior zone II were treated by the indirect infrared (810 nm) diode laser. Confluent burns were applied to the avascular retina. In 18 eyes, an additional row of laser burns was added posterior to the ridge. RESULTS: Favourable anatomical results were noted in 41 eyes (85.4%). ROP stage 5 developed in two eyes, ROP stage 4A developed in four eyes, and ROP stage 4B in one eye. Three of the eyes with stage 4A eyes were successfully buckled; the fourth was not operated on and remained demarcated by laser scars. No complications were noted. CONCLUSION: In this series, the diode laser was found to be a safe and effective treatment for posterior ROP.     

Roles of compatible osmolytes and heat shock protein 70 in the induction of tolerance to stresses in porcine endothelial cells

Studies of the responses of porcine pulmonary endothelial cells to acute hypertonic stress have been extended by examining the induction and underlying mechanisms of cell tolerance to both osmotic and heat stresses. Preliminary adaptation of these cells to 0.4osmol (kg H₂O)⁻¹ rendered them tolerant either to subsequent severe osmotic stress (0.7osmol (kg H₂O)⁻¹) or to subsequent severe heat shock (50 min at 49°C). In contrast, preliminary exposure of the cells to mild heat shock (44°C for 30 min) induced tolerance only to severe heat shock, not to hyperosmotic stress. Induction of tolerance to heat shock by either procedure correlated with the induced expression of heat shock protein 70 (HSP70). Induction of tolerance to hyperosmotic stress, on the other hand, was associated with the cellular accumulation of osmolytes, such as amino acids, betaine and myo -inositol, and did not correlate with the induced expression of HSP70. It also required a reduction in the final change of osmotic pressure applied to the cells, such that maximum cell shrinkage would not be much more than 40%. In general, therefore, HSP70 and compatible osmolytes have distinct roles in cellular adaptation to these stresses.     

Commingling Analysis of Intraocular Pressure and Glaucoma in an Older Australian Population

Purpose : To test the hypothesis of a major genetic determinant of intraocular pressure (IOP) under the mixed genetic model in a defined population, and to elucidate the relationship between IOP and glaucoma. Methods : IOP was measured in 3654 persons attending the Blue Mountains Eye Study. A commingling analysis on IOP was performed using a new program, SKUDRIVER. The goodness of fit of 1‐, 2‐ and 3‐distribution models was measured. This was repeated after the glaucoma cases had been removed from the dataset, and further repeated on the glaucoma cases in the dataset. Results : The best model was 3‐distribution with no evidence for Hardy‐Weinberg disequilibrium. The proportion of variance explained by this major effect was 0.18. When glaucoma cases were removed, the best model had 2 distributions. There was no evidence of admixture in glaucoma patients. Conclusions : The findings of this study are consistent with the presence of a major gene accounting for 18% of the variance of IOP, which could therefore influence the risk of glaucoma, in this population. These findings suggest methods of optimizing strategies for family and association studies to identify quantitative trait loci for IOP. No evidence for distinct IOP‐dependent and IOP‐independent subgroups of glaucoma was found.     

Fish consumption (hair mercury) and nutritional status of Amazonian Amer-Indian children.

Fish are abundant and important dietary items for the Amer‐Indians, and total hair‐Hg (HHg) concentration is a reliable marker of fish consumption. We studied the impact of fish consumption (HHg) on the nutritional status of Indian children of Eastern Amazonia. Weight‐for‐height Z score (WHZ) was measured, and HHg was determined in 203 children younger than 10 years of age in three villages. There was significantly higher fish consumption in Kayabi children (16.55 μg Hg/g; SD, 11.44) than in children of the Munduruku villages of Missão‐Cururu (4.76 μg Hg/g; SD, 2.09) and Kaburua (2.87 μg Hg/g; SD, 2.13). Anthropometric indices showed WHZ means of ?0.27, ?0.22, and 0.40, respectively, for Kayabi, Missão‐Cururu and Kaburua villages. Despite a different pattern of fish‐protein consumption between tribes, there was no significant correlation between WHZ and HHg concentrations (r² = 0.0079; P < 0.2021). Dietary differences among Amazonian tribes can be traced and used in measuring health outcomes. Higher fish consumption, although important for Kayabis, was compensated by other protein sources by the Kaburua villagers. Am. J. Hum. Biol. 17:507–514, 2005.© 2005 Wiley‐Liss, Inc.     

Indices of mercury contamination during breast feeding in the Amazon Basin

Mercury pollution, due to gold mining has spread through the Amazon ecosystem reaching the food chain and affecting the indigenous people of the region. We studied the mercury contamination of 47 mothers and infants and the role of breast feeding in indices of mercury body burden in both groups, by measuring hair and milk Hg levels. Total mercury concentration of breast milk ranged from 0.0 to 24.8 (5.85, 5.2 S.D.) ng/g. Calculated levels of mercury exposure of breast fed babies indicated that 53% were above tolerable daily intakes (0.5 μg/kg body weight) recommended for adults by WHO. Mercury concentration in maternal hair was higher than in hair from breast-fed babies. Correlation analysis showed that mercury hair concentration in infants was significantly affected by maternal mercury contamination during pregnancy, but not during the post-natal breast-feeding period. The mercury concentration in milk was not significantly correlated with maternal or infant's hair Hg. A statistically significant correlation was found only between maternal and infant's hair mercury concentration (r=0.675; P=0.0001).     

Multidisciplinary approach to "accidental" falls in the elderly: A case report

Falls in the elderly are commonly and often wrongly identified as "accidental". We report a case of an elderly woman admitted to first aid for a trauma due to an accidental fall. Geriatric multidisciplinary evaluation revealed mild cognitive impairment associated with depressive symptoms; both findings made the anamnesis uncertain. Syncope algorithm was applied and "tachy-brady form of sick sinus syndrome" was diagnosed. Differential diagnosis between "accidental" and "apparently accidental" falls in elderly patients is very difficult but a multidisciplinary geriatric evaluation can clarify the correct diagnosis.     

Her-2/neu evaluation in Sister Mary Joseph's nodule from breast carcinoma: a case report and review of the literature

Sister Mary Joseph's nodule (SMJN) involving the umbilicus can often be a clinical sign of metastatic cancer, but rarely cancer originating from the breast. We report a rare case of umbilical metastases from breast cancer and reviewed the literature. A 54-year-old woman was referred to a pre-surgery clinic for an examination of an umbilical nodule. The patient had a history of ductal breast carcinoma. Cytological smear from fine needle aspiration showed epithelial neoplastic cells resembling those of breast carcinoma. Neoplastic cells from tissue were positive for cytokeratin 8–18, estrogen and progesterone receptor and negative for E-cadherin and had a low proliferative index. Her-2/neu immunodetection showed a 2+ equivocal positive rate, but Her-2/neu gene amplification was found on the cytological smear by fluorescence in situ hybridization analysis. Similar results were obtained within a tissue section. Concordant findings have been obtained when comparing the recent American Society of Clinical Oncology/College of American Pathologists scoring system. Fine needle aspiration from the SMJN is a useful tool for the diagnosis of metastatic breast cancer. Furthermore, the predictive biomarkers for tumors of the breast, hormonal receptors and Her-2/neu not only assist with the identification of the source of the metastatic disease but also provide clinical information for patient management.