The functional statue of the thyroid in old age and its role in the genesis of some manifestations of senescence have been subjects of speculation tor many years. Numerous studies have been done but few, if any, conclusions based on sound evidence have been reached. The ovary has a life span shorter than that of the total organism, and concomitant with a decline in ovarian function undesirable physical and emotional disturbances may occur. Some features of human senescence are similar to those of the hypothyroid states for example, one sees in both diminished motor activity, impaired muscle strength, dryness or the skin, diminished cold tolerance, and falling of the hair.

The earliest documentary evidence of hypertensive disease associated with adrenal cortical tumours has been ascribed to Neusser in 1897 by Perera. The presser properties of the medullary extracts from the suprarenal glands had already been described by Oliver and Schaefer in 1895. With this background hyperepinephrinemia was cautiously suggested as/ possible cause of hypertension by several authors around the turn of the present century, but it was Vaquez in 1904, who propounded it as a theory based on the observation that suprarenal hyperplasia was frequently seen in patients with hypertension.

Note: Missing Page 288. / It has been estimated that of the total deaths due to heart disease one-third may be attributed to primary coronary artery insufficiency related to atherosclerosis as the dominant factor, one third to primary coronary insufficiency associated with cardiac hypertrophy and increased work arising from valvular lesions and hypertension, and one-third to primary myocardial insufficiency. In other words, two-thirds of the deaths from heart disease may be traced directly or indirectly to coronary artery insufficiency (Rowe 1960). Wearn in 1933 described arterioluminal vessels running from the coronary arteries through the myocardium to the ventricular cavities, arterioluminal sinusoids passing deviously through the myocardium, connecting the arterial lumen to the ventricular cavity and the Thebesian veins communicating with the coronary venous system and ventricular lumen.

Background: NAFLD is one of the most common causes of liver disease worldwide. It is a spectrum of disease characterized by macrovesicular steatosis of the liver that ranges from simple fatty liver (steatosis), to non-alcoholic steatohepatitis (NASH). NASH may eventually evolve to cirrhosis and end stage complication. Liver biopsy has long been considered the gold standard of reference to diagnose NAFLD but it is costly and invasive. Recently, non-invasive methods have been proposed. Aims and methods: The aim of this study was to investigate the accuracy of non-invasive methods including (Ultrasound, computed tomography scan, Xenon-133 scan, Hepatic steatosis index, Fibroscan, NAFLD fibrosis score, APRI index, and FIB-4 index) and their combination to diagnose steatosis and to diagnose significant liver fibrosis (>F2) and cirrhosis (F4) as compared to liver biopsy. We conducted a retrospective study of 114 NASH patients (79 males, mean age 49.6±10.6). All had adequate liver histology. Results: The distribution of fibrosis stage was as follows: F0-F1= 50%, F2=16.8%, F3=19.2%, F4=14%. The distribution of steatosis grade was as follows: grade 0-1=16%, grade2=53.3%, grade3=30.7%. The following tests correlated with fibrosis: APRI index (r=0.554), FIB-4(r=0.555), NAFLD fibrosis score (r=0.473), Fibroscan(r=0.586) and Hepatic Steatosis Index (HSI) (r=0.245). The FIB-4 and APRI index showed the best diagnostic accuracy for significant fibrosis as indicated by an Area Under the Curve (AUC) of 0.801 and 0.782, respectively. The FIB-4 showed the best AUC= 0.886 for cirrhosis. None of the following tests US, CT, HSI, and xenon-133 scan were considered correlated significantly. The best combination algorithm for the detection of cirrhosis was gender and FIB-4 with an AUC of 0.8937. Conclusion: this study demonstrates that non-invasive methods for liver fibrosis are accurate to diagnose >F2 and F4. Severe steatosis cannot be reliably diagnosed by non-invasive methods. Notably, a combination of FIB-4 and gender significantly improves the performance of the single method for cirrhosis. These methods may help reducing the number of liver biopsies stratifying NASH patients that should start a screening program for HCC and esophageal varices. / Contexte : La stéatose hépatique non alcoolique (SHNA) est l'une des causes les plus répandues des maladies du foie à l'échelle mondiale. Il s'agit d'un spectre de maladies qui se caractérise par une stéatose hépatique macrovésiculaire allant de la stéatose hépatique simple (stéatose) à la stéatohépatite non alcoolique (NASH). La NASH peut éventuellement évoluer vers une cirrhose et des complications en phase terminale. La biopsie du foie a longtemps été considérée comme la norme de référence par excellence pour le diagnostic de la SHNA, mais elle est coûteuse et invasive. Des méthodes non invasives ont récemment été proposées. Objectifs et méthodes : La présente étude avait pour objectif d'évaluer la précision de certaines méthodes non invasives (notamment les ultrasons [US], la tomographie par ordinateur [TO], la scintigraphie au xénon 133, l'indice de stéatose hépatique (ISH), la technique Fibroscan, le score de fibrose de SHNA, l'indice de ratio entre l'aspartate aminotransférase et les plaquettes [APRI] et l'indice FIB-4) et de l'utilisation combinée de ces méthodes pour le diagnostic de la stéatose et pour le diagnostic d'une fibrose hépatique significative (> F2) et de la cirrhose (F4), par comparaison à la biopsie du foie. Nous avons réalisé une étude rétrospective sur 114 patients atteints de NASH (79 patients de sexe masculin, âge moyen de 49,6 ans ± 10,6). Tous ces patients présentaient une histologie hépatique adéquate.Résultats : La répartition des stades de fibrose était la suivante : F0 F1 = 50 %, F2 = 16,8%, F3 = 19,2 %, F4 = 14 %. La répartition des stades de stéatose était la suivante : stade 0-1 = 16 %, stade 2 = 53,3 %, stade 3 = 30,7 %. Les tests suivants ont été mis en corrélation avec la fibrose : l'indice APRI (r = 0,554), l'indice FIB-4 (r = 0,555), le score de fibrose de SHNA (r = 0,473), la technique Fibroscan (r = 0,586) et l'indice de stéatose hépatique (r = 0,245). L'indice FIB-4 et l'indice APRI ont offert la meilleure précision diagnostique en ce qui concerne la fibrose significative, comme l'indiquent la surface sous la courbe (SSC) de 0,801 et la SSC de 0,782 respectivement. L'indice FIB-4 a présenté la meilleure SSC, soit 0,886, pour ce qui est de la cirrhose. Aucun des tests suivants, c'est à dire les tests aux US, la TO, l'ISH, et la scintigraphie au xénon 133, n'était considéré comme étant corrélé significativement. Le meilleur algorithme de combinaison pour le dépistage de la cirrhose était le sexe et l'indice FIB-4 avec une surface sous la courbe de 0,8937. Conclusion: cette étude démontre que les méthodes non invasives de diagnostic de la fibrose hépatique sont précises en ce qui concerne les stades > F2 et F4. La Stéatose sévère ne peut être diagnostiqué de façon fiable par des méthodes non invasives Notamment, une combinaison de l'indice FIB-4 et du sexe améliore considérablement le rendement de la méthode unique en ce qui a trait à la cirrhose. Ces méthodes pourraient aider à réduire le nombre de biopsies du foie visant à stratifier les patients atteints de NASH qui devraient entreprendre un programme de dépistage du carcinome hépatocellulaire (CHC) et des varices œsophagiennes.

Background: There is evidence to show that varicocele repair can improve conventional sperm parameters and sperm DNA integrity in infertile men with a clinical varicocele. Objective: To further examine the effect of varicocelectomy on sperm quality, specifically, sperm nuclear chromatin integrity, distribution of nuclear sulfhydryl groups and sperm maturation. Design, Setting and Participants: We prospectively evaluated a consecutive series of infertile men (n=29) presenting to Ovo clinic with one year or more history of infertility, a clinically palpable varicocele and abnormal semen parameters. Six sperm donors with normal sperm parameters served as controls. Surgical Procedure: Microsurgical sub-inguinal varicocelectomy. Outcome Measures: (1) Conventional sperm parameters, (2) aniline blue staining (AB is specific to histone lysines), (3) iodoacetamide fluorescein (IAF targets free protamine sulfhydryl groups) and (4) sperm chromatin structure assay (SCSA) with the results expressed as % DNA fragmentation index (%DFI) and percent high DNA stainability (%HDS) before and 4 months after microsurgical varicocelectomy. Results: The sperm %DFI, %HDS (a measure of chromatin compaction), % 5-IAF staining (diffuse head staining), % AB staining (dark blue) were all significantly lower in the control group compared to infertile men with varicocele (8 vs. 20%, 4.0 vs. 9.6%, 1.7 vs. 16.3%, and 2.5 vs. 13.5% respectively). The %5-IAF and %AB staining decreased significantly after surgery (from 16.3 to 5.4%, and from 13.5% to 5.4%, respectively). Similarly, the %HDS and %DFI also decreased significantly after surgery (from 10% to 6% and from 20% to 13%, respectively). The only notable relationships were between aniline blue staining and %HDS post varicocelectomy (r= 0.57, P <0.05), and both %IAF staining and %DFI were inversely correlated with motility (r=-0.44 and -0.43, respectively). Conclusion: The data show that varicocelectomy is associated with a consistent improvement in sperm DNA integrity and chromatin compaction using three different assays of sperm chromatin integrity (SCSA, IAF, Aniline Blue). / Contexte: Il y a la preuve(l'évidence) pour montrer que la réparation de varicocele peut améliorer des paramètres de sperme conventionnels et l'intégrité d'ADN de sperme dans des hommes infertiles avec varicocele clinique. Objectif: Examiner l'effet de varicocelectomy sur la qualité de sperme, spécifiquement, le sperme l'intégrité chromatin nucléaire, la distribution de groupes sulfhydryl nucléaires et la maturation de sperme. Schéma, environnement et participants : Nous avons éventuellement évalué une série consécutive d'hommes infertiles (n=29) présentant à la clinique Ovo avec un an ou plus d'histoire d'infertilité, varicocele cliniquement palpable et des paramètres de sperme anormaux. Six donneurs de sperme avec des paramètres de sperme normaux ont servi de contrôles. Intervention chirurgicale: Microchirurgie sous-inguinale varicocelectomie.Mesures des résultats: (1) Des paramètres de sperme conventionnels, (2) l'aniline bleu teintant(tachant) (d'AB est spécifique à histone lysines), (3) iodoacetamide fluorescein (libère protamine sulfhydryl des groupes) et (4) le sperme chromatin l'essai de structure (SCSA) avec les résultats (DFI) de fragmentation d'ADN de % et le pour cent haut ADN stainability (%HDS) auparavant et 4 mois après varicocelectomy microchirurgical Résultats: Le pourcentage de spermatozoïdes avec le sperme de DFI%, HDS%, positif de 5-IAF coloration, une coloration positive AB (bleu foncé) étaient significativement inférieure dans le groupe témoin par rapport aux hommes infertiles ayant une varicocèle (8 vs 20%, 4,0 vs 9,6%, 1,7 vs 16,3%, et 13,5 vs 2,5% respectivement). Le pourcentage de spermatozoïdes avec positifs 5-IAF coloration et AB nucléaire positif diminué de façon significative après la chirurgie (de 16,3 à 5,4%, et de 13,5% à 5,4%, respectivement). Les HDS% et DFI% également diminué de façon significative après la chirurgie (de 10% à 6% et de 20% à 13%, respectivement). Les seules relations entre les notables étaient coloration au bleu d'aniline et varicocélectomie après HDS (r = 0,57, P <0,05), et les deux taches IAF et DFI% ont été inversement corrélée avec la motilité (r = -0,44 et de -0,43, respectivement).Conclusion: Les données montrent que varicocélectomie est associée à une amélioration constante de l'intégrité d'ADN de sperme et compaction de la chromatine en utilisant trois différents dosages cytochimiques de l'intégrité chromatine des spermatozoïdes (SCSA, l'IAF, le bleu d'aniline).

<p> Objective: Inpatient protocols for glycemic control</p><p> Research Design and Methods: This retrospective observational study analyzed the adult admissions to a Teaching Hospital from October 2010 to February 2013. The association between the protocol using insulin Glargine/Lispro vs NPH/regular and rates of hypoglycemia (glucose &le; 70 mg/dl), severe hypoglycemia (&le; 550 mg/dl), severe hyperglycemia (&ge; 300 mg/dl), and average glucose per patient-day were evaluated. The effect on these outcomes of being hospitalized on the week/weekend and the personnel shift (7-3, 3-11, 11-7) were also analyzed. </p><p> Results: The rates of hypoglycemia (severe or not) were lower in the analog insulin protocol after multivariate logistic modeling. The rate of hyperglycemia was higher on the analog insulin protocol, but this association disappeared after multivariate modeling. The outcomes were not affected by the weekend, but the rate of hypoglycemia was lower in the 3-11 shift, and the rate of hyperglycemia was lower in the 11-7 shift. </p>

No description available.

The recently developed method of nuclear magnetic resonance spectroscopy allows for continuous monitoring of high energy phosphate compound (ATP and Phosphocreatine) and intracellular pH of tissues or whole organs. In other to better understand why ex-vivo hearts can be preserved for longer periods when perfused with oxygenated crystalloid solutions under hypothermic conditions, two groups of canine hearts were studied with nuclear magnetic resonance spectroscopy. / Group 1 = Canine hearts preserved for 4 hours by immersion into a 4$ sp circ$C saline solution. / Group 2 = Canine hearts preserved for 24 hours by continuous coronary perfusion with a modified oxygenated Krebs solution at 4$ sp circ$C. / The longer preservation of ATP and phosphocreatine, as well as the slower decrease of intracellular pH in Group II hearts are hypothesized to be the reasons why perfused hearts can be preserved for longer periods of time.

Lipid is a major fuel in trauma and sepsis. Previous in vitro studies have demonstrated an increased $ beta sb1$-adrenergic stimulated lipolysis in the adipose tissue of trauma patients. With sepsis there was a decrease in $ beta sb1$ stimulated lipolysis. Subsequent in vitro studies have shown that E. coli endotoxin decreases $ beta sb1$-stimulated lipolysis and that this effect may be occurring at the level of the G-protein, a component of the $ beta$-adrenergic receptor mechanism. The object of this study is to demonstrate the effect of E. coli endotoxin on lipid metabolism in vivo and to correlate this with in vitro receptor data obtained using adipose tissue biopsies.

No description available.