The frequency of detection of serum antibodies against pituitary cells was determined in 32 patients with the primary empty sella syndrome. Antibodies reacting with corticotropin-secreting mouse AtT20 and PRL-secreting rat GH3 cells were found in 24 (75%) and 15 (47%), respectively, of the 32 patients; 14 patients (44%) had antibodies reacting with both cell lines. In patients with pituitary adenomas, the prevalence of antipituitary antibodies was significantly lower than in those with the empty sella syndrome; 1 of 9 acromegalic patients had antibodies reacting with GH3 cells, and 2 of 9 prolactinoma patients and 1 of 7 patients with nonfunctioning adenomas had antibodies reacting with both AtT20 and GH3 cells. Among 6 patients with idiopathic diabetes insipidus, 1 patient had antibodies reacting with AtT20 and GH3 cells, and 2 patients had antibodies reacting with either AtT20 or GH3 cells. None of 5 patients with established autoimmune diseases (3 with systemic lupus erythematosus and 2 with autoimmune adrenal failure) had antipituitary antibodies in their serum. These results suggest that pituitary antibodies may be related to the development of pituitary atrophy and the primary empty sella syndrome, and that the test may be clinically useful as a screening test for the empty sella syndrome.

OBJECTIVE -To clarify mortality and morbidity of intensively managed elderly diabetic individuals and to explore factors predicting mortality and diabetes-related end points. RESEARCH DESIGN AND METHODS-A total of 390 elderly (Ն65 years of age) outpatients with type 2 diabetes ( 173 men and 217 women, mean age 73.0 years) were analyzed. The mean HbA 1c upon entry was 6.8% (332 receiving oral hypoglycemics and/or insulin) and blood pressure upon entry was 136/74 mmHg (219 receiving antihypertensive drugs). The patients have been followed-up for 3 years with HbA 1c Ͻ7.0% and blood pressure Ͻ145/80 mmHg as targets, with mortality and an aggregate of fatal and nonfatal diabetes-related events as end points. Mortality rate and causes of mortality, as well as risk factors for mortality and morbidity, were determined. RESULTS -The mortality rate, 2.9% per year, was comparable to that of the age-and sex-matched general population. Stroke was a leading cause of mortality after malignancy. By the univariate Cox proportional hazards model, only high serum creatinine and prior stroke were highly significant and strong risks for both end points. In those without prior stroke and receiving antihypertensive agents, the incidence of the diabetes-related end point based on their systolic blood pressure (SBP) quartile was U-shaped, with the nadir at the 3rd (SBP,(137)(138)(139)(140)(141)(142)(143)(144)(145)(146)(147) and the peak at the 1st (SBP Յ 125 mmHg) quartile.CONCLUSIONS -In well-controlled elderly diabetic subjects, there was no excessive mortality compared to the age-and sex-matched general population. Renal dysfunction and prior stroke were independent risks for mortality and morbidity. In those without prior stroke, a risk of too much lowering of blood pressure was suggested. Diabetes Care 26:638 -644, 2003

The effects of two weeks of reduced activity on gastrointestinal transit time were studied in nine healthy elderly subjects, who had engaged in regular recreational exercise for ten years. Physical inactivity was achieved by a restriction of all kinds of physical exercise and by staying at home. Mouth-to-cecum transit time was measured by a breath hydrogen method and mean total and segmental colonic transit times by a radiopaque marker method. The mouth-to-cecum transit time did not change during the period of physical inactivity. The mean total colonic transit time (10.9 +/- 2.7 h) was significantly prolonged to 19.5 +/- 2.9 hours during the physical inactivity (p < 0.01). This prolongation was due to slowed transit through the right and the left segments of the colon. The transit time of the rectosigmoid segment of the colon was not affected. In conclusion, the period of physical inactivity prolonged the colonic transit time in active elderly subjects.

In elderly patients under intensive control for DM, the outcome of microangiopathy is favorable. Modifiable risk factors were hyperglycemia for development of retinopathy and hypertension and hypercholesterolemia for development or worsening of nephropathy; prior stroke was an unmodifiable risk factor for development of nephropathy.

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Aneurysms of the interatrial septum are uncommon lesions that are often accompanied by other cardiac anomalies or systemic thrombosis. The authors report 1 case of atrial septum aneurysm that was diagnosed by two-dimensional contrast echocardiography. At surgery a membrane-like, fenestrated aneurysmal protrusion to the right atrium without thrombosis was seen. The atrial septum was closed without using an artificial patch after some of the aneurysm with fenestrations was resected.

risk to human health which can be directly used for informing decisions about how to manage those risks. Prerequisite of regulatory risk assessment is a clear causal association and exposureresponse-relationship. Risk quantification should be based on absolute measures instead of relative measures. Lifetime (excess) risk estimation is the most suitable effect measure in regulatory risk assessment. It provides the estimated probability of disease occurrence due to life long exposure to a special occupational hazard under certain exposure level. Methods on the quantification of Lifetime (excess) risk estimations are going to be introduced based on examples of silica related health issues, such as silicosis and lung cancer. Interpretation of risk estimations should be made carefully, especially regarding the biological plausibility of the estimated exposure-response-relationship, change of exposure patterns over working time, consideration of disease latency and comparability of exposure assessment methods used in various studies or countries.