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Objective: to evaluate the degree of exposure to PCB in a population resident in the lower Susa Valley and its effects on general and endocrine homeostasis. DESIGN, SETTING, PARTICIPANTS AND MAIN OUTCOME MEASURES: in the lower Susa Valley (Piedmont, Italy), there is a steel secondary casting plant (i.e. by fusion of scrap iron), active since the '50s. The emissions of PCB and dioxin coming from the furnace were found in samples of herb, pulse and ground in a preliminary environmental characterisation study. During 2005-2006 we run an epidemiologic study of biomonitoring (measuring as outcome common haematochemical parameters, hormonal parameters, haematic PCB) on a sample of subjects resident in the municipalities with higher levels of PCB and dioxin contamination (exposed subjects), that was compared with another sample (unexposed) of subjects residing in other areas of the Susa Valley., Results: the final sample consisted of 244 subjects (119 unexposed and 125 exposed), balanced by gender, age, education and representative of the Susa Valley population. The greater part of hormonal and toxic parameters showed worse values among exposed than among unexposed, including PCB median value (2.30 μg/l among exposed vs. 1.90 μg/l among unexposed). The difference however was not statistically significant and the values were lower than the population reference values (7.2 μg/l). Haematic PCB values were significantly and positively correlated with age and alcohol consumption and not significantly with male gender. The distribution of the principal haematochemical parameters (hemochrome, total, LDL and HDL cholesterol, triglycerides, glucose, creatinine, bilirubin, transaminases, gamma-glutamiltranspeptidase, proteine electrophoresis) showed also, on the whole, worse values among exposed compared to unexposed, even if the difference was not statistically significant for single values., Conclusions: the exposed population showed higher values of PCB haematic values and alterations of the hormonal and common heamatochemical parameters compared to unexposed population, even if within reference limits.

Congenital chylothorax is a rare condition characterized by the accumulation of lymph fluid in the pleural space that causes respiratory and circulatory dysfunctions, immune deficiencies, hypoalbuminemia, electrolyte imbalance and alterations of the coagulation. Mortality rates are elevated and can rise to 50%. Therapy consists in conservative treatment based on thoracic drainage combined with total parenteral nutrition or use of low-fat high-protein diet supplemented with medium chain triglycerides. In case of failure surgical intervention may be considered. During the last years some authors have experienced the use of octreotide with doubtful results. In no case the drug impact on insulin, GH and cortisol secretion in neonatal age has been investigated and only in one case the effect on thyroid hormones has been assessed. We report the case of a 36-week baby with congenital chylothorax treated with octreotide for 42 days. The drug was well tolerated but hormonal level measurements showed a deep depression of insulin secretion unaccompanied by alterations of glucose levels. Levels of GH and TSH showed only a transitory decrease. ACTH and cortisol remained normal. At 5 months, the measurements of hormonal levels did not show significant alterations. It is not possible to determine if such a drug played an essential role in the solution of the pleural effusion, but it is important to emphasize that a prolonged treatment with octreotide has not caused, in our case, persistent hormonal alterations.

Aim: The effects of steroid hormones on the periodontium are most prominent at certain stages of a woman's life especially during the menstrual cycle when there is an increase in the secretion of sex hormones or a significant fluctuation in their concentration. The deterioration of existing periodontal conditions can be attributed to a fluctuation in the steroid hormones in circulation. By contributing to our understanding of periodontal changes caused by variation in hormone concentrations, this study aims to encourage the implementation in dental practice of the most suitable forms of treatment for hormone-related pathologies., Methods: Tartar was removed from the teeth of five young women and four biopsies and blood tests were carried out on them at regular intervals. The information gathered was used to monitor periodontal changes arising from variation in hormone concentrations., Results: The histological analysis of the test samples under an optical microscope did not reveal signs of inflammation, hyperaemia or oedema at any stage of the menstrual cycle in the patients examined. The extent of gingival Keratinization was found to be comparable to that present in the follicular phase., Conclusion: The occurrence of ovulation could not be shown in the pilot study. The histological analysis and the analysis of hormone concentrations show primarily the absence of surges in estradiol and LH which normally accompany ovulation; the levels recorded are similar to those found in the follicular phase.

Purpose: The authors assessed mammographic and ultrasound (US) features and histological and biological characteristics of male breast carcinomas observed in five men (mean age 57.8 years) in a single year and compared the findings with the literature., Materials and Methods: All patients underwent history taking and bilateral mammography and US examination extended to the axillary region and complemented with colour Doppler US., Results: Three out of five patients had a family history of breast cancer, and all of them had an altered energy balance (mean body mass index 30.8). All subjects had a palpable mass, which was associated with bloody nipple discharge in two cases. Mammography identified all lesions as opacities with irregular margins (mean size 1.98 cm); in one case, it also revealed a nonpalpable contralateral lesion. US demonstrated the presence of inhomogeneously hypoechoic nodules with irregular margins and centrifugal vascular spots in 4/6 lesions. Histology diagnosed invasive ductal cancer (IDC) in 5/6 lesions (83.3%) and ductal carcinoma in situ (DCIS) in the contralateral lesion only., Conclusions: The presence of symptoms warrants mammography, which is an accurate method for identifying male breast cancer. The frequency of invasive disease observed in our study was consistent with the literature (80%-90% IDC). The hormonal alterations induced by excess fat in our series appear to be correlated with the development of carcinomas with positive receptor status for both oestrogen and progesterone.

Unlabelled: Aim of the study is to explore in shiftworkers: a) blood pressure and hormonal variations; b) dyslipidemia and blood glucose levels; c) insulin resistence syndrome. We have assessed 48 male workers employes in Amsa SpA, a large municipal enterprise in charge of street cleaning and domestic waste collection, in permanent day and night work as hand sweepers, motor sweepers and delivery tricar drivers. 24 of those workers (daily and nightly) were normotensive and 24 were hypertensive. Our medical checks were: physical examination: BMI; laboratory findings (blood): glucose, total cholesterol, triglycerides, endothelin, insulin, FFA, HOMA S, HOMA B, HOMA R; assay of salivary cortisol and urinary cortisol in 24 h; 24 h pressure monitoring., Results: Nightly hypertensive: increased consumption in wine and coffee, weight and BMI, total cholesterol and FFA and endothelin. Nightly normotensive: increased consumption in cigarettes and salivary cortisol. Daily hypertensive: increased total cholesterol; 24 h pressure monitoring showed more pronounced variations of pressure in night workers both normotensive and hypertensive in working time., Conclusions: Night shiftwork looks like more stressfull than day shiftwork. Insuline resistance isn't noticed in all four groups.

Background: In this study, the level and the variation of a number of hormone and metabolic parameters during brain death treatment in potential organ donors have been monitored., Methods: Thirty-nine consecutive brain-dead patients were enrolled in 3 Intensive Care Units of Regional Hospitals of the North of Italy. All patients were potential organ donors and free from diseases before the accident leading to death. The levels of ADH, ACTH, TSH, prolactin, cortisol, aldosterone, FT3, FT4, renin, serum lactate and plasma osmolality were measured immediately after the diagnosis of brain death (T0), certified following the Italian law of December 29, 1993, n. 578, and after 6 hours (T6)., Results: Hormone levels were normal in the majority of subjects, and there was no significant variation during the 6 hours of the observation period. No correlation was found between the hormone levels considered and the metabolic parameters; ADH levels were not correlated with plasma osmolality. FT3 levels were below the normal range in the majority of subjects, but were not associated with a higher lactate level, which is used as a marker of a shift toward tissue anaerobic metabolism., Conclusions: In conclusion, triiodothyronine administration to improve metabolic order and thus the function of organs for transplantation is not justified in brain-dead patients.

268 patients (age 16-47 years) affected with idiopathic varicocele, submitted to surgery, have been studied. Semen analysis, pampiniphorm plexus doppler examination and testosterone, estradiol, D4 androstenedione, DHEA-S, HPRL, 17-OH-P, FSH and LH (basal and after LH-RH) evaluation, before and 6 months after surgery, were performed. The patients were divided in 3 groups (A, B and C) according to sperm count. Pre-surgery seminal parameters in A group were significantly reduced in comparison with control group. Six months after surgery, a significant increase of total and forward progression, Swelling test, Acridine Orange and in vitro penetration (CMPT) was observed. Sperm count showed an increase, although being still significantly reduced in comparison with normal controls. In B group, before surgery, sperm count, viability, Acridine Orange and CMPT were significantly reduced in comparison with controls. Six months after surgery, viability, Acridine Orange and CMPT resulted significantly improved. In C group, before surgery, CMPT resulted significantly reduced in comparison with controls. After surgery, semen framework improved without significant differences in comparison with normal controls. No significant differences were observed for hormonal patterns before and after surgery.

Well known is the need to treat "acute onset" Anorexia Nervosa in care units. Nevertheless even the "successfully treated" patients show a very high percentage of relapse. The aim of our study has been to revalue different clinical, nutritional (hemoglobin, transferrin, IGF1), hormonal (thyroid function, gonadotropins) and psychiatric (EDI: Eating Disorder Inventory Test) parameters in a group of nineteen women aged 20-34 years (median 27 years) admitted to our department 1-11 years (median 6 years) before for anorexia nervosa treatment. On admission their weight loss was -33% +/- 10% according to Ideal Body Weight (IBW); a "low T3 syndrome" was present and all the patients not treated with estro-progestins were amenorrhoic. After a long hospitalization (median 51 days) the patients showed a significant decrease in weight loss (25% +/- 6%; p < 0.01). At follow-up seventeen patients had a weight better than at discharge (13% +/- 12%; p < 0.01) and 9/17 patients non treated with estro-progestins had spontaneous menses. Nutritional (hemoglobin*: 13 +/- 0.2 g%, transferrin*: 313 +/- 57 mg%, IGF-1: 187 +/- 15 ng/ml) and hormonal (LH*: 9.4 +/- 1 mUI/ml, FSH*: 15 +/- 1.3 mUI/ml, T3: 1 +/- 1 ng/ml) parameters were significantly improved (*p < 0.01, p < 0.05) compared to those at admission (hemoglobin: 12 +/- 0.2 g%, transferrin: 218 +/- 58 mg%, IGF-1: 154 +/- 21 ng/ml, LH: 5.6 +/- 0.8 mUI/ml, FSH: 9.5 +/- 1 mUI/ml, T3: 0.8 +/- 1 ng/ml). The EDI test has shown a persistence of anorexic condition ("overt" or latent) in 2/3 of patients. This study confirms the endocrine and nutritional modifications of anorexia nervosa and underlines the persistence of psychiatric ones in a great number of patients including the "clinically cured", justifying long-term follow-up and the high percentage of disease relapse.

We report the effect of "intravenous gamma-globulin treatment" (IVIG) in a patient with autoimmune polyglandular syndrome type II, with circulating organ specific autoantibodies, preclinical hypothyroidism, amenorrhea and Addison syndrome. During IVIG treatment we observed a normalization of thyroid function, the appearance of some non ovulatory menses, reduction of thyroglobulin, thyroidal microsomal, anti-parietal cell, adrenal and ovary antibodies. These data confirm that intravenous immunoglobulin may represent a new tool for treatment of autoimmune disorders and show, for the first time, an immunosuppressive effect of intravenous gammaglobulin treatment in immunological phenomena direct against ovary, adrenal and gastric mucosa.

To investigate the sex hormone status of women with polycystic ovary syndrome (PCO) and to relate this to serum levels of glucose, insulin, lipids and lipoproteins, 90 women with PCO (30 obese: BMI greater than 30 kg/m2; 30 overweight: BMI greater than 25- less than 30 kg/m2; 30 non obese: BMI less than 25 kg/m2) and 60 normal ovulatory women (20 obese; 20 overweight; 20 non obese) were studied. The women with PCO had significantly increased LH, FSH and androgen levels and significantly decreased SHBG levels compared to the normal women. Obese women with PCO had higher concentrations of fasting glucose, fasting insulin, incremental glucose area, incremental insulin area and lipid than overweight and non obese women with PCO and overweight and non obese control subjects, but were similar in obese normal women. There were decreases in high-density lipoproteins levels in both the obese groups (obese PCO and obese control women). Lipid and lipoprotein concentrations did not differ in the obese, overweight and non obese PCO women compared to the normal groups while HDL cholesterol were decreased in obese PCO and obese control women. The correlations between hormone, glucose, insulin, lipid and lipoprotein levels were different among the six groups. Non obese PCO women had: inverse correlations between free testosterone and incremental glucose area (r = -0.5128, P = 0.03); positive correlations between SHBG and alpha-lipoproteins (r = 0.9159, P = 0.001). Non obese normal women had: positive correlations between fasting insulin and total testosterone (r = 0.5272, P = 0.043) and between SHBG and beta-lipoproteins (r = 0.7445, P = 0.014) and LDL cholesterol (r = 0.7360, P = 0.010).(ABSTRACT TRUNCATED AT 250 WORDS)

Five children (3 boys and 2 girls) ranging in age form 5-12 years and suffering from Prader-Willi syndrome have been evaluated. In each subject the Authors have examined auxological parameters and the following hormonal values: GH after two pharmacological stimuli tests, gonadotropins after LHRH, TSH and prolactin after TRH, cortisol rhythm, testosterone after hCG in males, thyroid hormones and steroids. The results have shown a height less than 3 degrees centile only in a subjects and ranging from 10 degrees-50 degrees in the others, a weight greater than 97 degrees centile for the height age in all, a low response in GH to both stimuli in two subjects, an increased response to LHRH in FSH in two subjects. All other endocrine evaluations were in the normal range with the exception of insulin that resulted augmented in spite of normal glycaemic values. In conclusion, our data would suggest the existence of an eventual alteration of the hypothalamus-pituitary structures.

To determine whether obesity associated with "primary empty sella" (PES) had a characteristic hormonal pattern, we evaluated the hormonal profile in 24 simple obese and 19 obese-PES women. The latter group showed a significant delta-GH and LH impaired levels as well as plasma beta-EP significantly higher. Hence, the beta-EP measurement could be used to predict the hormonal response in these women.

The change in the eating behaviour of anorexic individuals has been studied with particular attention to the case of two biovular heterozygotic twins. It is observed that dietetic treatment backed by careful psychiatric therapy is a decisive factor in the resolution of the pathology.

The authors report 20 cases of primary empty sella syndrome (ESS) observed during the last 5 years in their Department of Internal Medicine. Clinical data and particular syndromes are discussed and compared with data of partially reviewed literature. The authors discuss the classification of primary and secondary ESS with their possible endocrine, ophthalmological and neurological symptoms, or--on the contrary--without clinical signs as more frequently observed. The usual diagnostic and therapeutic procedures are also reported.

After synthesizing modifications to hormonal and humoral factors following shock, a number of minor endocrine resonances detectable during and after ECC, or during cardiogenic shock of infarction genesis are considered. In small series of patients, renin activity, aldosterone, cortisol and 18-hydroxy-11-desoxycorticosteroid plasma levels were evaluated, the results providing interesting guidelines for extending hormonal researches into the above sector.

Four obese patients were given a single-meal diet for two periods of three days each. Blood samples were drawn every four hours for serum determinations of growthormone, cortisol and insulin. At same times urinary samples for urinary cathecholamines determination were collected. Cortisolemia showed a firm circadian rhythm in both regimens: there was a marked over-lap of the two confidences ellipsis so we could conclude for the independence of cortisol rhythm whith both regimes, but there occurred a significant difference in the acrofases between the two regimens. This could mean that meal-timing can play a major role in syncronizing catecholamines urinary excretion as far as subjects in supine position are concerned. No circadian rhythm was detected either in serum insulin or in HGH values.

The activity of bromocriptin has been clinically tested on 18 patients suffering from psoriasis. The plasma levels of Human Growth Hormone (HGH), Human Adrenocorticotropic Hormone (ACTH), Thyroid Stimulating Hormone (TSH), Prolactin (PL), Aldosterone and Cortisol were investigated in these 18 patients along with 35 untreated psoriatic patients and 19 normal subjects. Bromocriptin was shown to be effective in 13 of our 18 psoriatic patients. Plasma levels of HGH, ACTH, and Aldosterone, measured in all 53 psoriatic patients, were found to be higher than normal in 11, 26 and 40 patients respectively (HGH and Aldosterone: p less than 0,005; ACTH: p less than 0,001).