Abnormal melatonin secretion in male patients with hypogonadism.

Recently we have demonstrated that melatonin secretion is increased in untreated male patients with GnRH deficiency. Testosterone administration to these patients decreased melatonin secretion to normal levels. These data, however, did not exclude a gonadotropic effect on melatonin secretion.

Fracture of the penis: results of an immediate surgical approach.

Fracture of the penis is a rare and probably under-reported entity. We present 7 patients with this type of trauma. All the patients were treated operatively immediately on presentation with good morphologic and functional results.

Population analysis of mesothelium in situ and in vivo exposed to bicarbonate-buffered peritoneal dialysis fluid.

Population analysis of mesothelium (PAM) done using the in vivo and almost in situ technique of mesothelial cell imprints revealed that lactate-buffered solutions had detrimental effects upon cell viability, that high glucose concentration affected cytokinesis, whereas the association of both components led to a decreased density population of cells showing a larger surface area. In the present study, PAM was done on mesothelium of mice exposed to bicarbonate-buffered peritoneal dialysis fluid (BBF) with glucose concentrations of 1.5 and 4.

Prevalence of cognitive dysfunction and hypothyroidism in an elderly community population.

Cognitive function was assessed in 801 elderly subjects (aged 65-92 years) using the Mini Mental State Examination (MMSE). The mean (+/- SD) MMSE score in the age group 65-70 years was 27.8 +/- 5.

Use of cordocentesis in the management of preterm or growth-restricted fetuses with abnormal monitoring.

The dilemma of when to deliver preterm or growth-restricted fetuses with abnormal monitoring is faced by all those treating such patients. Current noninvasive tests for fetal well-being have relatively high false-positive rates. Cordocentesis allows the clinician to directly analyze fetal blood and determine whether the fetus is truly in distress, is suffering from aneuploidy, or is plagued by infection.

Comparison of the proteins of middle ear effusion with human mast cell proteins.

In order to clarify the role of mast cells in the aetiology of secretory otitis media (SOM), we compared the protein components of middle ear effusion (MEE) with human mast cells using acrylamide gradient gel electrophoresis and electrofocusing methods. This first direct comparison between the proteins of MEE and human mast cells has been made possible by a method developed in our laboratory for cultivation of human mast cells in tissue culture. On electrophoresis, we found that out of 12 bands of MEE proteins that were different from the serum, seven (58 per cent) had a similar electrophoretic migration rate (Rx) to mast cells.

Recovery of ovarian function after laparoscopic detorsion.

In an attempt to preserve ovarian function, we managed 58 women with adnexal torsion by laparoscopic detorsion. Follow-up ultrasound examinations were performed on 54 of the women. Follicular development was evident in 49 of 52 (94.

A random single Doppler study of the umbilical artery in the evaluation of pregnancies complicated by diabetes.

To evaluate a random single Doppler study of the systolic to diastolic ratio of the umbilical artery as a predictor of perinatal outcome in diabetic pregnancies, a prospective double-blind study was performed in 92 diabetic pregnant women between 28 and 40 weeks of gestation. Main outcome measures were perinatal outcome: group A, normal outcome; group B, poor outcome. The sensitivity and specificity of the Doppler studies as a predictor of poor perinatal outcome were 39% and 92%, respectively.

Pseudo-precocious puberty in a male patient and the melatonin-testosterone relationship.

We describe a 14 year-old boy with a pineal germ cell tumor which secreted beta HCG. Serum testosterone levels were markedly elevated with concomitant decreased LH secretion. 24-h serum melatonin levels were suppressed and lacked the normal nocturnal rise.

Foreign-body appendicitis.

The authors report the case of a 9-year-old boy who had a needle in his appendix. The contrast between absence of clinical symptoms and clear inflammatory changes of the appendix is noted. The authors recommend appendectomy for patients with pointed foreign bodies in the appendix to avoid inflammation and perforation.

Gonadotrophin-releasing hormone agonist compared with human chorionic gonadotrophin for ovulation induction after clomiphene citrate treatment.

The objective of this study was to compare hormonal response, luteal phase adequacy and pregnancy and abortion rates in patients randomized to receive human chorionic gonadotrophin (HCG) or gonadotrophin-releasing hormone agonist (GnRHa) during ovulation cycles stimulated by clomiphene citrate. Anovulatory patients received either one s.c.

Induction of pre-ovulatory gonadotrophin surge with gonadotrophin-releasing hormone agonist compared to pre-ovulatory injection of human chorionic gonadotrophins for ovulation induction in intrauterine insemination treatment cycles.

The clinical outcome of intrauterine insemination (IUI) treatment cycles employing a gonadotrophin-releasing hormone agonist [GnRHa, triptorelin (Decapeptyl)] or human chorionic gonadotrophin (HCG) for ovulation induction was compared. A group of 48 patients presenting with amenorrhoea, oligomenorrhoea or unexplained infertility were all treated with human menopausal gonadotrophins (HMG) from day 5 of the cycle, on an individualized schedule. They were then randomly divided into two groups to receive either a single s.

Increased nocturnal melatonin secretion in male patients with hypogonadotropic hypogonadism and delayed puberty.

Hypogonadotropic hypogonadism (IGD) and constitutional delayed puberty (DP) share a common pathophysiologic process, i.e. GnRH deficiency.

Can an educational program improve the diagnosis and treatment of pharyngotonsillitis in the ambulatory care setting?

The influence of an educational program on the diagnosis and treatment of pharyngotonsillitis was evaluated in three outpatient clinics in northern Israel during two periods. During both periods--1 January to 31 March 1988 (baseline phase) and 1 January to 31 March 1989 (study phase)--clinical data of all patients for whom antibiotics were prescribed were recorded on special forms, which included the patient's diagnosis and the antibiotic prescribed. In November 1988, 2 months before the study phase, two 1 h sessions on pharyngitis were given by the study physicians to the entire medical staff of two clinics (Clinics B and C), and written material was distributed.

Oral ciprofloxacin for treatment of infection following nail puncture wounds of the foot.

From January 1990 to December 1993, 23 adults were hospitalized at our institution for treatment of foot infections that occurred following nail puncture wounds. All 23 patients had cellulitis, and 14 had signs of osteochondritis on a roentgenogram or a 99mTc bone scan. After undergoing surgical intervention that consisted of debridement, drainage of the pus, and exploration of the bones, patients received intravenous ciprofloxacin (400 mg b.

Decreased incidence of severe ovarian hyperstimulation syndrome in high risk in-vitro fertilization patients receiving intravenous albumin: a prospective study.

The administration of human serum albumin has been reported to prevent severe ovarian hyperstimulation syndrome (OHSS) while undergoing ovarian stimulation protocols for in-vitro fertilization (IVF). This prospective, randomized study investigated the effectiveness of a single dose of human serum albumin (20 g) administered i.v.

Syncytial variant of nodular sclerosing Hodgkin's disease presenting as a thyroid nodule. A case report.

The fine needle aspiration cytology of a thyroid nodule in a 19-year-old female showed Reed-Sternberg (RS) cell variants in clusters, thereby suggesting the possibility of syncytial variant of nodular sclerosing Hodgkin's disease (NSHD). A similar picture was observed on imprint smears of an excised cervical lymph node, the histology of which confirmed the original diagnosis. Following chemotherapy, the nodule disappeared.

Comparison of 12- and 72-hour expectant management of premature rupture of membranes in term pregnancies.

Objective: To compare 12-hour and 72-hour expectant management of premature rupture of membranes (PROM) in singleton term pregnancies.

Methods: In a prospective, nonrandomized study, 566 low-risk women with singleton term pregnancies presenting with PROM were assigned to either 12-hour or 72-hour expectant management. Patients who had not entered labor at the end of the assigned period were induced with oxytocin.

Endocytosis and transcytosis of albumin gold through mice peritoneal mesothelium.

The present transmission electron microscopy (TEM) study was designed to investigate whether mesothelial cells of mice diaphragmatic, parietal and mesenteric peritoneum are actively coupled to the mechanisms involved in the transerosal absorption of albumin gold complexes (Alb-Au). Five albino mice were injected intraperitoneally with 0.5 ml of a suspension of Alb-Au.

High prevalence of vitamin D deficiency among Ethiopian women immigrants to Israel: exacerbation during pregnancy and lactation.

A population of 125 adult Ethiopian women immigrants to Israel was screened for serum levels of calcium, phosphorus, and alkaline phosphatase. Five women (prevalence of 4%) had hypocalcemia and in one of them osteomalacia was found. In the other 120 subjects normal values were recorded.

Goiter prevalence in children immigrating from an endemic goiter area in Ethiopia to Israel.

A survey study was performed to assess the prevalence of goiter and thyroid dysfunction in a population of 534 Ethiopian children, one year after arrival in Israel. The overall prevalence of goiter was 43.6%.

Treatment of surgical and non-surgical septic multiorgan failure with bicarbonate hemodialysis and sequential hemofiltration.

Objective: Hospital mortality of patients with septic multiorgan failure (MOF) is still around 95%. The present study investigates whether this high mortality could be significantly reduced by the addition of sequential hemofiltration (SH) with bicarbonate hemodialysis (HD) to the currently used life supportive measures.

Design: 35 (18 surgical and 17 nonsurgical) patients, with 3 or more organ failures, had daily sessions of zero balance SH, for periods ranging from 2-22 days.