Adrenarche does not occur in treated patients with congenital adrenal hyperplasia resulting from 21-hydroxylase deficiency.

Objective: There have been few studies of adrenarche in patients with congenital adrenal hyperplasia (CAH). We have therefore sought to detect the onset of adrenarche in CAH patients and to investigate whether its evolution was influenced by the severity of the disease, the age at the onset of substitution therapy, or both.

Design And Patients: Sixteen female CAH patients were studied longitudinally for 4-11 years.

Daudi lymphoma killing triggers the programmed death of cytotoxic V gamma 9/V delta 2 T lymphocytes.

A common feature of human V gamma 9/V delta 2 gamma delta T lymphocytes is their ability to kill Daudi lymphoma cells. We show here that during this killing a substantial fraction of cytotoxic gamma delta T cells dies as well. Their death has morphologic, cytometric, and biochemical features of apoptosis and depends on TCR triggering.

Warm heart surgery in cold haemagglutinin disease.

Continuous warm retrograde blood cardioplegia and systemic normothermia are a promising method for heart surgery in patients with cold autoimmune disorders in order to avoid the adverse effects of both systemic and coronary hypothermia during cardiac arrest and cardiopulmonary bypass. A 59-year-old white man with cold haemagglutinin disease who underwent coronary surgery using continuous retrograde normothermic blood cardioplegia and systemic normothermia is reported.

A new approach using local combined microwave hyperthermia and chemotherapy in superficial transitional bladder carcinoma treatment.

For some time hyperthermia, alone or in combination with radiotherapy or chemotherapy, has proved to be a promising method for treating several kinds of solid tumors. After intensive laboratory investigations a new device, based on a microwave source delivering local bladder hyperthermia together with intravesical mitomycin C chemotherapy has been clinically tested as a neoadjuvant approach in 44 patients suffering from superficial cancer of the bladder. The combined approach was administered on an outpatient basis without major complications and with acceptable local toxicity.

Bovine factor VIII derivative in the treatment of non-proliferative diabetic retinopathy.

The complexity of the pathogenesis of diabetic retinopathy (DR) makes it difficult to produce effective drugs for its treatment. Among the active principles recently suggested, the peptide fraction of bovine factor VIII of the clotting cascade deserves particular attention. Bovine factor VIII derivatives (vascular factor, VF) have been shown to have significant effects on the capillary basement membrane and on vascular endothelium and they are able to stabilise vessel walls.

Imaging of renal cell carcinoma with gadolinium-enhanced magnetic resonance: radiological and pathological study.

The use of gadolinium-DTPA enhanced MR imaging (Gd-MR) in detecting and staging of large and small renal neoplasm was investigated in 61 patients with 66 renal cell carcinoma confirmed at surgery. The purpose of the study was also to evaluate the signal intensity of the lesions and to correlate the contrast-enhanced pattern to the pathological components and architecture of the surgical specimens. Forty-four tumors were larger than 3 cm and 22 lesions were smaller than 3 cm.

Radioimmunoguided surgery using iodine-125-labeled biotinylated monoclonal antibodies and cold avidin.

Unlabelled: One of the limitations of intraoperative tumor detection with radiolabeled monoclonal antibody (Mab), by means of a gamma-detecting probe (GDP), is the long time interval needed between Mab injection and surgery to obtain low blood-pool activity. Such an interval can be shortened considerably, exploiting the high affinity between avidin and biotin.

Methods: Twenty patients with colorectal cancer were injected with 1 mg of biotinylated 125I monoclonal antibodies followed, 48 hr later, by a chase of cold avidin.

Peripheral and abdominal adiposity in childhood obesity.

The aim of this work was to evaluate peripheral and abdominal adipose tissue (AT) content detected by MRI in normal weight and obese children, to compare MRI data with simple anthropometric indexes and to estimate intrabdominal adipose tissue (IAT) influence on cardiovascular risk factors. The subjects were 23 obese and 21 normal weight children aged 10 to 15 years. The following measurements were carried out: MRI analysis at lumbar level with definition of subcutaneous adipose tissue (SAT) area and IAT area; arm fat area (AFA); thigh fat area (TFA) and waist/hip ratio from anthropometry.

Detubularized sigmoid colon for bladder replacement after radical cystectomy.

During the last 6 years 24 sigmoid colon neobladders were constructed at our institute according to a surgical technique that provides for an optimal spherical configuration of the orthotopic reservoir. All patients underwent radical cystectomy for locally advanced or superficial recurrent bladder cancer. The surgical complication rate was minimal.

Simultaneous determination of plasma levels of alpha-ketoisocaproic acid and leucine and evaluation of alpha-[1-13C]ketoisocaproic acid and [1-13C]leucine enrichment by gas chromatography-mass spectrometry.

A sensitive method for the simultaneous analysis of plasma alpha-ketoisocaproic acid (KIC) and leucine using GC-MS is described. Plasma was deproteinized after addition of both alpha-ketovaleric acid and norleucine as internal standards. Derivatization of the compounds involved protection of the keto groups with methoxyamine and tert-butyldimethylsilylation under optimized conditions.

Open-chain peptides obtained by acidic hydrolytic cleavage of cyclosporin A.

Hydrolysis of cyclosporin A (CsA) was studied in order to clarify the still undefined point of attack of the acidic degradation. Among ether extractable and water-soluble products formed from CsA in HCl, two open-chain peptides were isolated by high-performance liquid chromatography which were identified as the deca- and nonapeptides deriving from CsA through the hydrolytic cleavage of amino acid residue 11 and both residues 11 and 10, respectively. Identification was carried out by fast atom bombardment tandem mass spectrometry.

Fast gas chromatographic-mass spectrometric method for the evaluation of plasma fatty acid turnover using [1-13C]palmitate.

Turnover of plasma free fatty acids (FFAs) can be determined from the palmitate enrichment of plasma after administration of analogues labeled with stable isotopes. We studied the conditions to measure both the concentration and the 13C enrichment of plasma palmitate by gas chromatography-mass spectrometry (GC-MS) using crude extracts. The method used plasma extraction after addition of heptadecanoic acid as internal standard and methylation with diazomethane.

Endophotocoagulation through perfluorodecalin in rabbit eyes.

Retinal laser endophotocoagulation through perfluorodecalin was studied in six eyes of three Dutch-belted rabbits after vitrectomy. Both the energy density threshold (EDT/50) and the energy threshold necessary to obtain a therapeutic lesion were evaluated. Both argon and semiconductor diode laser endophotocoagulators were used.

Persisting functional connection in growth-hormone-deficient patients with a transected stalk.

Prolactin response after domperidone (DOM) stimulus was used to investigate the functional status of the hypothalamo-hypophyseal axis in 57 congenital growth-hormone-deficient (GHD) children with and without magnetic resonance imaging (MRI) abnormalities. Response to DOM was significantly lower in the GHD children compared with controls, using maximum peak (p < 0.0001), increase (p < 0.

Echographic diagnosis of Drusen of the optic nerve head in patients with angioid streaks.

A total of 58 patients (116 eyes) with angioid streaks, referred to this department over 2 years (1990-1992), underwent a thorough ophthalmic examination, retinal fluorescein angiography, dermatological visit with skin biopsy, and a series of other examinations (blood and biochemistry, skull X-ray, vascular echo Doppler, abdominal ultrasound) and eye ultrasonography. Fifty patients (100 eyes, 86.2%) had pseudoxanthoma elasticum (PXE).

Corneal autofluorescence in diabetic and normal eyes.

Corneal autofluorescence has been lately studied as a predictor of retinopathy severity in diabetic patients. We measured corneal autofluorescence in 138 eyes of 69 diabetic patients and 64 eyes of 32 healthy controls. Diabetic patients were subdivided by the severity of retinopathy according to the Modified Airlie House Classification (stage 1: no or minimal retinopathy; stage 2: minimal background retinopathy; stage 3: background retinopathy; stage 4: (pre-) proliferative retinopathy.

Updating on intraoperative light-induced retinal injury.

We are presenting the state of knowledge concerning intraoperative light-induced retinal injury, considered to be a combination of photic retinopathy and retinal photocoagulation. It may arise from retinal light exposure to the operating microscope or to the fiberoptic endoilluminator. Ultraviolet and short-wavelength visible light are more dangerous than longer wavelength light.

Biomicroscopy versus fluorescein angiography of the iris in the detection of diabetic iridopathy.

Iris fluorescein angiography is not commonly employed in clinical practice, but it is the most sensitive technique for the evaluation of iris vessel abnormalities. We used iris fluorescein angiography as the gold standard against which to test the ability of iris biomicroscopy to demonstrate diabetic iridopathy (DI). One hundred and fourteen eyes of 63 diabetic patients affected by preproliferative or proliferative diabetic retinopathy (DR) (the DR groups at high risk of developing DI) were considered.

Capillary electrophoresis for protein analysis: separation of human growth hormone and human insulin molecular forms.

The capillary zone electrophoresis (CZE) technique was evaluated for separation and quantification of human growth hormone (hGH), human insulin (hI), and proinsulin. Three different molecular forms of biosynthetic hGH (20K, 22K, 44K), methionyl-hGH, biosynthetic hI, and proinsulin, were studied. The hormones were separated with uncoated capillaries, and various analytical conditions were tested (different buffers, ionic strength, pH).

Progressive dysphasic dementia with bucco-facial apraxia: a case report.

A patient with progressive dementia, prominent non-fluent aphasia and signs of frontal lobe involvement, was evaluated by neuropsychological testing, magnetic resonance imaging (MRI) and high resolution single photon emission tomography (SPET). The presence of severe bucco-facial apraxia, associated with spared imitation of limb movements, correlated well with a marked reduction of cerebral perfusion in the left fronto-temporal cortex. This case emphasizes the usefulness of SPET as a valuable alternative to PET for the diagnosis of conditions, such as progressive neuropsychological syndromes, where a coupled reduction of metabolism and blood flow can be expected.

Laser treatment of iris vascular tufts.

We describe a case of iris vascular tufts which came to our attention because of a hyphaema. Laser treatment was carried out for the vascular anomalies. After a period of 3 months, fresh vascular anomalies had appeared in different locations.

Diabetes-induced alteration of HMGCoA reductase forms in rat livers.

The effects of streptozotocin-induced diabetes on the various forms of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCoA reductase), phosphorylated/dephosphorylated and thiolic/disulphide, were studied in rat liver. Animals were treated twice with 65 mg/kg intraperitoneally of streptozotocin to induce diabetes and sacrificed after 5 days. The relative amounts of the four possible forms of the enzyme were determined in control and diabetic rats.

Peripheral retinal changes and axial myopia.

The relationship between the presence of peripheral chorioretinal changes and axial myopia in 513 eyes (513 patients) 24 mm or more in length, or beyond the upper range of normal axial length, is studied. Axial length was measured with A-scan ultrasonography (immersion technique) and retinal periphery was studied by biomicroscopic examination and scleral indentation. The presence of lattice degeneration, pavingstone degeneration, pigmentary degeneration, white with or without pressure (WWP), retinal holes, tears, or both (RHT), retinal detachment, and posterior vitreous detachment was reported.

Minimal models of glucose disappearance: lessons from the labelled IVGTT.

In this paper the domain of validity of the unlabelled and labelled minimal models of glucose disappearance is studied. Labelled intravenous glucose tolerance tests were performed in six normal subjects using 3-3H-glucose as the tracer. Insulin and unlabelled glucose data were analysed with the minimal model of glucose disappearance.