A systematic review of symptomatic outcomes used in oesophagitis drug therapy trials

Symptoms are an important outcome for measurement in clinical trials into gastro-oesophageal reflux disease, but the optimal approach to symptom assessment has not been formally evaluated. The authors conducted a systematic review to assess how reflux symptoms have been evaluated and how well these correlate with oesophagitis healing and relapse.

Modeling the dynamics of cardiac action potentials

The nonlinear dynamics of cardiac action potentials is explained via simple model equations describing the membrane potential and the inward and outward currents through the membrane. The equations approximate ionic models, yet are expressed as polynomial functions, and robustly capture the phase-space dynamics of action potentials.

Leptin binding activity (LBA) in plasma of nondiabetic and diabetic adolescents and obese children: relation to auxologic and hormonal data

Leptin circulates in serum bound to high molecular weight proteins. Hypothesizing that leptin binding proteins may regulate the functional efficiency of leptin, we characterized auxologic and hormonal factors that influence leptin binding in three disparate groups: normal adolescents, obese children, and teenagers with type I diabetes mellitus (IDDM). Specific leptin binding activity (sLBA) was assessed by column chromatography after incubation of serum with 125I-leptin in the presence and absence of excess unlabeled leptin. Mean sLBA was 17.0 +/- 7% (SD) in the healthy adolescents (n=41), 6.6 +/-4.3% in the obese children (n=26), and 14.9 +/-7.3% in the diabetic teenagers (n=17). At any value of sLBA, obese children had higher serum leptin levels than non-obese adolescents or diabetic teenagers, consistent with "leptin resistance" in the obese group. sLBA was higher in males than in females only in those with diabetes (18.6 +/- 7.3 vs 10.9 +/- 5.1%, p<0.05). sLBA correlated inversely with serum insulin-like growth factor-I values in the normal group (r= -0.45, p<0.01) and with insulin in the obese children (r= -0.53, p<0.01). There was no correlation between sLBA or serum leptin values and HbA1c, in the diabetic group. The serum leptin concentration was the principal determinant explaining the total variability of sLBA in all three cohorts. However, body mass index (BMI = weight/ height2) accounted for more of the total variability of percent specific binding in the healthy adolescents than in the other groups. We conclude that sLBA reflects circulating leptin levels, body composition, and hormonal milieu. Thus, in addition to leptin, qualitative and quantitative characteristics of leptin binding may play a physiological role in the regulation of appetite and in the "leptin resistance" of obesity.

A spun-column assay for determination of leptin binding in serum

Serum collected from 27 patients was assayed simultaneously using a spun-column assay (SPC) and a traditional exclusion gel-filtration assay (GFC) to determine specific leptin binding. The levels of serum leptin binding determined by either assay correlated inversely with serum leptin levels (SPC, r = 0.63, P < 0.001; GFC, r = 0.79, P < 0.0001). Although specific leptin binding as determined by the traditional exclusion gel-filtration assay was generally higher than that obtained by the spun-column assay (mean = 18.3% vs 14.0%, P < 0. 02, respectively); the values obtained between the two assay methods were highly correlative (r = 0.89, P < 0.0001). By varying either the amount of 125I-leptin or the amount of competitor, analysis was carried out using the spun-column assay to determine the intrinsic properties of serum leptin binding. Results yielded a Kd = 0.3 nM, where each variable amount of leptin or competitor was carried out in duplicate. The complete analysis was carried out in the time that it typically takes for a single sample determination by the traditional exclusion gel-filtration assay. We conclude that the "spun-column" assay is a useful method for rapid and accurate quantification of leptin binding in serum.

Demonstration of a leptin binding factor in human serum

Serum leptin levels are elevated in subjects with exogenous obesity, indicating that obesity is associated with leptin resistance. Since in man no abnormalities have yet been found in either the genes for leptin or its receptor, the mechanism of leptin resistance in obesity remains unknown. To determine if resistance might be related to leptin binding by a serum component, we assessed the carrier status of leptin in serum. The presence of a specific leptin binding factor in human serum has been established by (1) demonstrating [125I]-leptin binding to a serum component that is saturable and specifically displaceable only by unlabeled leptin and not by human growth hormone, pork insulin, insulin-like growth factors I and II, luteinizing or follicle stimulating hormones, transforming growth factor-beta 1, interleukin-6, or leukemia inhibiting factor; (2) fractionating the leptin bound serum complex and the serum leptin binding component on a molecular sieving column revealing a mass of approximately 450 kDa; and (3) identifying an inverse correlation between the concentration of serum leptin and the quantity of the leptin binding component. It is suggested that binding of leptin by this serum component may influence the physiologic response to leptin.

Effects of short-term growth hormone therapy in rats undergoing 75% small intestinal resection

Thirty 250-g male rats underwent 75% small intestinal resection and received s.c. injections of water [short gut (SG)-control], human growth hormone (hGH) at 0.1 mg/kg/dose [SG-low-dose (LD) GH], or hGH at 1.0 mg/kg/dose [SG-high-dose (HD) GH] every other day for 28 days. Ten additional rats underwent sham operation and received water injections (sham control). After 28 days, SG-control and SG-LDGH rats weighed significantly less than the sham control group; the mean weight of the SG-HDGH group was not different from other groups. Weight per centimeter of the distal ileum was greater in all SG groups compared to the sham control group, and was greater in the SG-HDGH than in the SG-control group. Mean mucosal height of the distal ileum was greater in both SG groups receiving GH than in sham controls. No differences in ileal mucosal DNA content or ileal insulin-like growth factor-1 (IGF-1) content were identified between groups. Mucosal sucrase activity was not increased in hGH-treated rats. Serum calcium and phosphorus concentrations were higher in SG-HDGH rats than in SG-control animals. HDGH increased body weight, distal ileal weight/cm, and mucosal height in rats undergoing 75% small bowel resection. A trend toward normalization of serum calcium, phosphorus, and plasma IGF-1 concentrations was also observed. Further longer-term studies are indicated to learn if GH has a beneficial effect upon gut growth and function in the SG syndrome.

Serum concentrations of growth hormone, insulin, free thyroxine, thyrotropin, and cortisol in very-low-birth-weight infants receiving total parenteral nutrition

Serum concentrations of growth hormone, insulin, free thyroxine, thyrotropin, cortisol, and glucose were measured during four time periods (0 to 4, 5 to 11, 12 to 18, and greater than or equal to 19 days of life) in 16 mechanically ventilated very-low-birth-weight infants (mean [+/- SD] birth weight, 1017 +/- 196 g) receiving total parenteral nutrition and in 21 very-low-birth-weight infants not requiring mechanical ventilator support (mean [+/- SD] gestational age, 30 +/- 1.7 weeks; mean [+/- SD] birth weight, 1149 +/- 210 g) fed enterally. There were no significant differences in the serum concentrations of the hormones or in the glucose levels between the two groups at any time interval. Present data demonstrate no significant difference in the serum concentration of glucose, insulin, growth hormone, cortisol, free thyroxine, and thyrotropin between very-low-birth-weight infants fed enterally and those maintained on a regimen of total parenteral nutrition.

Age-related differences in the growth hormone secretory response to hGHRH 1-44 in male rats from infancy through puberty. In vivo and in vitro studies

The GH secretory response to varying doses (15, 30, 60 micrograms/kg) of sc administered hGHRH 1-44 (or normal saline) was measured in vivo in 10, 20, 30, 40, 50, 60 and 130 days old pentobarbital-anaesthetized, male rats. The 10-min GH level and delta GH were in general significantly greater in older rats (50, 60, 130 days old) than in younger rats (10, 20 days old) following all doses hGHRH. Ten-day-old animals had no significant GH response to any dose of hGHRH tested. delta GH correlated significantly with age (r = 0.36; P less than 0.0001) and Sm-C level (r = 0.29; P less than 0.01) but not with serum testosterone concentrations. Monolayer pituitary cell cultures were established in rats aged 10 to 130 days and were incubated with varying concentrations of hGHRH 1-44 (0.05, 0.5, 5.0, 50 nmol/l or incubation medium). Cultures from 10- and 20-day-old animals had a greater percentage increase over basal GH secretion than other groups at all concentrations of hGHRH tested (P less than 0.05). Age-related differences in the GH secretory response to hGHRH are present in male rats from 10 to 130 days. The in vitro results reported here suggest that the increase in magnitude and sensitivity of the GH response to hGHRH observed in pubertal animals in vivo under pentobarbital anaesthesia is likely due to influences above the level of the somatotrope receptor.

Effect of estrogen on the growth hormone (GH) secretory response to GH-releasing factor in the castrate adult female rat in vivo

Five groups (n = 11) of 250-g female rats were oophorectomized and immediately thereafter received daily sc injections of estradiol benzoate (EB; 0.05, 0.5, 5.0, and 50.0 micrograms) or vehicle for 28 days. A sixth group underwent sham operation and received injections of vehicle. Somatomedin-C (SmC) concentrations were determined before EB administration. After 4 weeks of EB treatment, the GH response to human GH-releasing factor (1-44) (GRF; 5 micrograms/kg, iv) was determined under pentobarbital anesthesia in seven animals from each group. Serum PRL, LH, and estradiol and plasma SmC concentrations were also measured. The GH secretory response to GRF (delta GH) was greatest in castrated animals receiving vehicle (P less than 0.05) and was significantly blunted in animals receiving 5.0 and 50.0 micrograms EB (P less than 0.05) compared to that in sham-operated animals. A significant negative correlation was observed between delta GH and serum PRL concentrations (r = -0.53; P less than 0.0001). SmC concentrations after treatment were significantly lower in animals receiving 5.0 and 50.0 micrograms EB (P less than 0.01), than in sham-operated animals and were elevated compared to those in sham-operated controls in the group receiving the lowest dose of EB (0.05 microgram; P less than 0.01). Posttreatment SmC levels correlated positively with delta GH (r = 0.58; P less than 0.001) and negatively with serum estradiol concentrations (r = -0.47; P less than 0.01). Pituitary glands from the remaining animals in each group (n = 4) were weighed and assayed for GH, PRL, and LH content. Pituitary PRL content increased with increasing doses of EB replacement and correlated strongly (r = 0.82; P less than 0.0001) with pituitary weight. In the castrated adult female rat, high doses of estrogen inhibited the GH secretory response to GRF in vivo and decreased SmC concentrations. Low dose estrogen increased SmC concentrations, although the GH secretary response to GRF in this group was similar to that in sham-operated rats. The latter observation suggests that the rise in SmC levels associated with low dose estrogen may not be mediated through a change in GH secretion.

[Inflammatory aneurysm of the aorta. Value of x-ray computed tomography and ultrasonography in the diagnosis of a case and review of the literature]

Until recently inflammatory aneurysm of the aorta was discovered only at the time of surgery and confirmed by the pathologist. New imaging modalities, such as ultrasound and CT-scan now enable the radiologist to diagnose this entity before surgery, thus leading to a better surgical planning and reducing the operative morbidity. The authors report a case of inflammatory aneurysm of the aorta and review the literature on this entity.

Effects of drug and alcohol abuse upon pituitary-testicular function in adolescent males

To assess the effects of drug and alcohol abuse (DAA) on the physical changes and hormones of puberty in adolescents, 26 males (13 5/12-22 years) enrolled in a drug rehabilitation program were examined. In 22 subjects four timed blood samples were obtained sequentially at 15 minute intervals for measurement of serum concentrations of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and dehydroepiandrosterone sulfate (DHAS). The mean duration of DAA was 3.7 years, with marijuana and alcohol being the most frequently abused substances. The study subjects were compared to a matched control group of non-substance-abusing teenagers. All heights and weights of the DAA subjects fell within two standard deviations of the mean on the Tanner Growth Charts and no statically significant differences in the Tanner stages of sexual maturation were found between the DAA and control groups. The mean (+/- SD) testosterone level of the DAA group (221 +/- 109 ng/dl) was less than half that of the control group (477 +/- 193 ng/dl, p less than 0.001). Mean LH concentration in the DAA group (3.9 +/- 3.0 mIU/ml) was significantly less than that of the control group (10 +/- 4.9 mIU/ml, p less than 0.01). In both the DAA and control populations there was a significant (p less than 0.01) correlation between serum concentrations of LH and testosterone. The mean FSH level of the DAA group (3.3 +/- 1.1 mIU/ml) was significantly less (p less than 0.02) than that of the control group (4.7 +/- 1.9 mIU/ml). To assess the effects of treatment, six boys underwent repeat blood sampling 7-12 months after drug and alcohol withdrawal.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of zinc deficiency upon pituitary function in sexually mature and immature male rats

Serum pituitary levels of growth hormone (GH), thyrotropin (TSH), prolactin (PRL), luteinizing hormone (LH) and follicle stimulating hormone (FSH) were measured in sexually mature (adult) and sexually immature (juvenile) male rats who had been deprived of dietary zinc for 15 and 7 weeks, respectively. When compared to pair-fed control rats receiving a zinc supplemented diet, both the adult and juvenile zinc deficient rats had significantly lower body weights, tail lengths and ventral prostate weights. The testes of the sexually immature rats were also smaller than those of the pair-fed animals. In sexually mature, zinc deficient rats serum concentrations of GH and testosterone were significantly lower and serum LH levels significantly higher than in ad libitum fed control rats. Pituitary and hypothalamic levels of other hormones did not differ from values recorded in control animals. In sexually immature zinc deficient rats serum concentrations of GH were also significantly depressed; pituitary content and concentration of LH and pituitary and serum levels of FSH were significantly increased over control values. No discernible effects of zinc deficiency upon hyplthalamic content of LH-releasing hormone or serum concentrations of PRL or TSH were recorded in juvenile rats. Zinc deficiency has minimal effects upon the hypothalamic-pituitary axis of sexually mature rats. In sexually immature males, zinc deprivation leads to impairment of gonadal growth and increased synthesis and/or secretion of the pituitary gonadotropins.

Synthesis of 1,25-dihydroxyvitamin D in the nephrectomized pregnant rat

Pregnant rats were maintained on diets either adequate or deficient in vitamin D. On the 20th day of gestation, animals were either nephrectomized bilaterally or sham operated. Immediately therafter, four groups of nephrectomized or sham-operated pregnant rats received iv [26,27-3H]25-hydroxyvitamin D3 ([26,27-3H]25OHD3), while two groups received [1,2-3H,4-14C]D3. The animals were sacrificed 10-24 h later. The distribution of the radiolabeled metabolites of vitamin D3 was determined in extracts of maternal plasma, maternal intestinal tract, placentae, and fetuses after Sephadex LH-20 column chromatography. Both vitamin D3 and 25OHD3 crossed the placenta and entered the fetus. In anephric animals receiving [26,27-3H]-25OHD3, 24,25-dihydroxyvitamin D and a polar peak eluting in the position of 1,25-dihydroxyvitamin D [1,25(OH)2D] and 25,26-dihydroxyvitamin D were identified in extracts of maternal plasma and intestinal tracts and of placentae and fetuses. The identities of 24,25-dihydroxyvitamin D and 1,25 (OH)2D were confirmed by high pressure liquid chromatography. In rats receiving [1,2-3H,4-14C]D3, approximately 50% of the polar metabolite consisted of 1,25(OH)2D. We conclude that the anephric pregnant rat is able to synthesize 1,25(OH)2D, that the fetal portion of the feto-placental unit is the most likely site of production of this hormone, and that this metabolite of vitamin D is able to cross the placenta from the fetus to the mother.

Pituitary hormone secretion in the genectically male rat pseudohermaphrodite

Pituitary content or concentration of follicle-stimulating hormone (FSH), prolactin and growth hormone in the genetically androgen insensitive male rat pseudohermaphrodite is intermediate between normal male and female rats, while pituitary luteinizing hormone (LH) concentration and serum FSH levels are the same as in the normal male. The concentration of serum LH, prolactin and growth hormone indicated no sexual dimorphism. Although the pseudohermaphrodite is genetically male with a female phenotype, our results suggest some degree of masculinization of the hypothalamic-pituitary system.

Effect of testosterone propionate on th release of FSH from the pituitary gland

On the basis of a study of changes in follicle stimulating hormone (FSH) levels in rat pituitary glands, obtained at various times after orchiectomy, it has been previously suggested that the Leydig cell secretions may regulate the release of FSH from the pituitary gland (Steinberger & Duckett 1966). This hypothesis was put to test in the present study. FSH levels have been determined in the pituitary gland and plasma of normal, testosterone-treated, orchiectomized, and orchiectomized testosteronetreated rats. A marked drop of pituitary FSH levels, associated with an elevation of plasma FSH levels, was observed in orchiectomized rats. Administration of testosterone to orchiectomized rats prevented the drop in pituitary FSH levels and rendered the blood levels undetectable. These results are interpreted as supporting the hypothesis that testosterone has an inhibitory effect on the release of FSH from the pituitary gland.