The effect of chronic treatment with GH on gonadal function in men with isolated GH deficiency

Eleven adult males, previously submitted to neurosurgery because of a pituitary lesion (three with craniopharyngioma, three with clinically non-functioning adenoma and five with macroprolactinoma) were treated with recombinant GH for 12 months after the diagnosis of GH deficiency was made. Circulating FSH, LH, prolactin, testosterone, 17 beta-estradiol (E2), dehyroepiandrosterone (DHEA-S), androstenedione. 17-OH-progesterone (17OHP), IFG-I, and steroid hormone-binding protein (SHBG) levels were assayed before and after CG test at study entry and 6 and 12 months after GH treatment. A significant increase in plasma IGF-I levels was obtained after 6 and 12 months of GH treatment. In addition, CG-stimulated, but not baseline, testosterone levels showed a significant increase after 6 and 12 months of GH treatment when compared with study entry (9.6 +/- 0.5 and 9.9 +/- 0.5 vs 7.9 +/- 0.5 ng/ml; P < 0.05). Baseline, but not CG-stimulated, serum 17OHP levels were significantly increased only after 12 months of GH treatment (1.7 +/- 0.1 vs 1.4 +/- 0.1 ng/ml; P < 0.05). No significant difference was found as far as both basal and CG-stimulated E2, androstenedione, DHEA-S and SHBG were concerned. With regards to the semen analysis, only seminal plasma volume was significantly increased after 12 months of GH treatment (2.9 +/- 0.3 vs 1.7 +/- 0.3 ml; P < 0.05). No significant change in sperm count, motility and abnormal forms was observed. These data show that GH treatment displays a clear-cut effect upon Leydig cell function and increases the production of seminal plasma volume in fertile adult males with isolated GH deficiency.     

Endoscopic septostomy through a standard precoronal ventricular access: feasibility and effectiveness

Background  

Although endoscopic septostomy is widely adopted in the treatment of unilateral or specific types of hydrocephalus, there is no consensus on surgical indications, technical aspects and postoperative outcome. In particular, the choice of the ventricular access has been recently debated. We investigated the results of endoscopic septostomy performed through a standard precoronal ventricular access using a rigid endoscope.     

Complications of delayed cranial repair after decompressive craniectomy in children less than 1 year old

Background  

Decompressive craniectomy is an effective treatment option in case of refractory intracranial hypertension after severe head injury. The incidence of complications following cranial repair after decompressive craniectomy for traumatic brain injury is not negligible, particularly in infants and young toddlers. However, only a few dedicated papers can be found in the literature.     

Sudden paraplegia in a case of apparently isolated frontal embryonal tumour with abundant neuropil and true rosettes

The exceptional case of a 19-month-old boy with an apparently isolated frontal lesion and a huge holocord neoplastic involvement, presenting with a subtly indolent preoperative course and a particularly tumultuous evolution, is reported. The diagnosis of embryonal tumour with abundant neuropil and true rosettes was posed.     

MDL 72222, a selective 5-HT3 receptor antagonist, suppresses voluntary ethanol consumption in alcohol-preferring rats

The effect of the selective 5-HT3 receptor antagonist MDL 72222 on voluntary ethanol consumption was examined in Sardinian ethanol-preferring (SP) rats in a free choice (10% ethanol and water) experiment. SP rats consumed 8.1 +/- 1.1 g/kg ethanol daily. MDL 72222 treatment (3.0, 5.0 and 7.0 mg/kg i.p. 3 times daily for 6 days) inhibited ethanol consumption during the 6 days of treatment by 25%, 50% and 75%, respectively, without modifying total fluid intake. We suggest that 5-HT3 receptor activation plays a permissive role in alcohol preference.     

Prevalence and clinical correlates of disinhibition in dementia.

OBJECTIVE AND METHODS: The phenomenology, main clinical correlates, and long-term evolution of disinhibition in dementia are not well known. To examine this issue, we studied a consecutive series of 272 patients with probable Alzheimer disease using a comprehensive psychiatric and neuropsychological evaluation that included the Disinhibition Scale. A subset of patients was reexamined with the same instruments between 1 and 4 years after the initial evaluation. RESULTS: A factor analysis of the Disinhibition Scale demonstrated 4 factors: (1) abnormal motor behavior, (2) hypomania, (3) loss of insight and egocentrism, and (4) poor self-care. Disinhibition was significantly associated with major and dysthymic depression, more severe negative symptoms, and loss of awareness. Most patients with disinhibition at the initial evaluation still showed disinhibition at follow-up, whereas 23% of patients without disinhibition at the initial evaluation developed disinhibition at follow-up. CONCLUSIONS: Disinhibition is a frequent and long-lasting problem in dementia. Our study demonstrates that the construct of disinhibition consists of 4 independent subsyndromes, each of which may have specific underlying mechanisms.     

Chagasic Granulomatous Encephalitis in Immunosuppressed Patients; Computed Tomography and Magnetic Resonance Imaging Findings

American trypanosomiasis (Chagas' disease), a zoonosis caused by Trypanosoma cruzi with a high incidence in Latin America, may induce an uncommon form of localized encephalitis termed “chagoma,” found in few immunocompromised patients. The computed tomography (CT) and magnetic resonance imaging (MRI) findings of brain chagoma are reported for 3 males (ages 32, 32, and 9 yr), the first 2 infected with human immunodeficiency virus (HIV) and the third with acute lymphoblastic leukemia. Diagnosis was confirmed by biopsy. CT disclosed a single, supratentorial, nodular-shaped lesion that substantially enhanced with contrast material, localized in parietal or frontal lobes. T1-weighted MRI showed hypointense lesions that enhanced with gadolinium-diethylenetriaminepentaacetic acid, corresponding to extensive hyperintense areas on T2-weighted images, producing mass effect. The imaging pattern of brain chagoma presented here is similar to that of cerebral toxoplasmosis and should be considered in the differential diagnosis of an intracerebral mass lesion in immunocompromised patients.     

Hub Colonization as the Initial Step in an Outbreak of Catheter-Related Sepsis Due to Coagulase Negative Staphylococci during Parenteral Nutrition

A prospective study was carried out to determine the pathogenesis of coagulase negative staphylococci catheter-related sepsis during parenteral nutrition. Forty-three catheters were cultured by semiquantitative and quantitative methods. The skin around the puncture site was cultured at the time of catheter removal and three segments of the catheter were cultured apart: the hub, the proximal subcutaneous segment, and the tip. Skin cultures were negative (89%) or yielded different coagulase negative staphylococci from those recovered in catheter and/or blood. Seventeen catheters were the source of sepsis. In 15 cases an infected hub was associated with an infected tip. In two cases the hub was negative (one sepsis due to mixture contamination and the other due to hematogenous seeding of the catheter tip). Sixteen cases of sepsis were due to coagulase negative staphylococci. Staphylococcus epidermidis has been the species most commonly isolated, followed by Staphylococcus haemolyticus, Staphylococcus saprophyticus, and Staphylococcus hominis. In our patients most catheter sepsis have their origin in an infected hub and are not due to migration of skin bacteria along catheter subcutaneous tunnel. (Journal of Parenternal and Enteral Nutrition 8:668–672, 1984)