No abstract

We investigated the effect of aging on glucose uptake, glucose-induced O2 consumption, glucose-induced 45Ca movements, and calmodulin content to elucidate age-related impairment of glucose-induced insulin release in pancreatic islets of Wistar rats. Intact pancreatic islets from old (24-month-old) rats showed impaired glucose-induced insulin release; glucose uptake and O2 consumption were lower in old than in young (2-month-old) or adult (12-month-old) rats. Moreover, 45Ca uptake and calmodulin content were decreased in pancreatic islets from older rats, which explained the impairment in glucose-induced insulin release in aging. No major differences between the 3 age groups in glucose-induced 45Ca efflux in pancreatic islets were observed.

Forty-one women with oligo-menorrhoea and/or galactorrhoea were subjected to hypothalamic pituitary-thyroid testing in an attempt to establish the presence or absence of an underlying pituitary microadenoma. They were divided into two groups in accordance with the serum level of prolactin (PRL): Group I (N = 25, mean +/- SE 17.6 +/- 1.5 ng/ml) and Group II (N = 16, 102.8 +/- 29.7 ng/ml). The dynamic tests performed were a TRH test, a stimulation test with metoclopramide (MCP) and a suppression test with bromocriptine. The results of these tests were compared with those obtained in nine normal women and eleven patients with surgically proved pituitary microadenoma. Radiologically abnormal pituitary fossas were found in ten subjects from Group I and in fourteen from Group II. All patients were euthyroid. A persistently elevated serum TSH in response to TRH was observed in patients of Group II suggesting an hypothalamic abnormality and a progressive decrease in the 120-min use of serum T3 was noted with increasing evidence of the existence of a pituitary tumour. A negative correlation was found between the basal serum PRL and the rise of serum PRL with TRH. Patients from Group II showed a lower PRL response to MCP when compared to Group I and again a negative correlation between basal level of serum PRL and the change after MCP was observed. No clear difference in the 4-h response to bromocriptine was found between the different groups of subjects. In conclusion, none of the three tests analysed permitted us to establish which of the patients had an underlying pituitary microadenoma.

Weaning female rats were fed for 13–14 months with a low iodine diet (LID) and compared with age matched controls on KIO3 supplemented LID (C). At sacrifice the LID rats had large goitres, low plasma PBI and thyroidal 127I content, a rapid thyroidal-131I (*I) turnover and increased *MIT/*DIT and *T3/*T4 ratios. Body weights were slightly higher in LID and pituitary growth hormone like protein bands were the same in both groups. There were no differences between LID and C, whether fed or fasted for 48 h with regard to plasma insulin, glucose and ketone bodies. In vitro disposition of trace or 10−2 m alanine-U-14C by liver slices were the same as measured by 14C incorporation into CO2, glucose and lactic acid. The response of these parameters to fasting was normal: plasma insulin and glucose decreased and ketone bodies and in vitro gluconeogenesis increased. The lack of alteration in the intermediary metabolism of rats, sufficiently iodine deficient to develop goitre, has been interpreted as indicating either that: 1) thyroid hormones have no direct effect on the parameters of intermediary metabolism studied, or 2) there is enough hormone available to the tissues to keep a normal metabolism but not to suppress TSH secretion, thus suggesting different sensitivities to the hormone.

No abstract

Ten cases of the empty sella syndrome are presented. In four a pituitary adenoma had been treated by surgery with or without radiotherapy. In three women there was a close relation pregnancy, and two boys had congenital malformations. Five cases presented with appearances of pseudotomour, and the remainder had cerebrospinal fluid (CSF) fistula. Four fistulas were spontaneous, one was post-traumatic aggravated by the intrasellar implantation of YT-90. Two were occult CSF fistulas causing recurrent meningitis. Gamma cisternography and iodocisternography proved to be good diagnostic tests, both for the empty sella and for CSF fistulas. Nine cases were operated on. In four na intrasellar cyst was present. In the other five an empty sella with deficient or absent diaphragm was found. Treatment of most cases consisted of covering the floor of the sella with lyophilized dura, which was fixed in place with biological glue.

To study the effect of a sudden loss of body weight on the beta-cell function of aging rats, basal and glucose-induced insulin secretion was measured in pancreatic islets obtained from young (2-month-old), adult (12-month-old) and aging (24-month-old) rats, either fed ad libitum or fed a restricted diet (50% caloric restriction). Basal insulin secretion was similar in islets of young, adult and older rats. Glucose stimulated insulin release was significantly reduced in aging rats as compared to young animals. Animals fed a restricted diet showed a prolonged and higher secretory rate during first phase release when compared to animals fed ad libitum.

Objective: to evaluate reintervention rates after primary aortic arch reconstruction according to patch material. Methods: Patients undergoing primary surgical repair from October 2004 to December 2021 were identified. Univentricular physiology anatomies were excluded. Comparative analysis was performed between Homograft (81%), and Bovine pericardium (19%). The primary outcome was surgical or catheter-based reintervention. Kaplan-Meier function and Cox-regression analysis were used. Results: we included 160 patients with a median age and weight of 14 days (IQR 7-53) and 3.3 kg (IQR 2.9 - 4.2). The median follow-up time was 6.4 years (IQR 2.8 - 10.4). The clinical breakdown was Hypoplastic Aortic Arch/Aortic Coarctation in 89% (n=142) and Interrupted Aortic Arches in 10% (n= 17) (Table 1). Overall, 25% patients (n= 40) underwent a reintervention; 80% (n= 32) were balloon dilation angioplasties. After 1-, 5-, and 10-years post op, 78%, 74%, 72% of patients survived without reintervention, respectively. No differences were observed in the cumulative hazard between homograft and Bovine pericardium patch repairs (Figure 1). Multivariable cox regression showed an increased hazard for reintervention for bovine pericardium patches (HR 2.9, 95% CI 1.1 - 8.0) after controlling for age, weight, diagnosis, aortic arch, and aortic isthmus Z-Scores. Conclusion: Intermediate term outcomes after aortic arch reconstruction are favorable in a single center. Patch material is likely to be an important determinant for the risk of early restenosis requiring reintervention after aortic arch reconstruction.