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There is a large body of experimental evidence showing benefits of deliberate mild hypothermia (33-35 degrees C) on the injured brain as well as an improvement of neurological outcome after cardiac arrest in humans. However, the clinical evidence of any benefit of hypothermia following stroke, brain trauma and neonatal asphyxia is still lacking. Controversial results have been published in patients with brain trauma or neonatal asphyxia. Hypothermia can reduce the elevation of intracranial pressure, through mechanisms not completely understood. Hypothermia-induced hypocapnia should have a role on the reduction of intracranial pressure. The temperature target is unknown but no additional benefit was found below 34 degrees C. The duration of deliberate hypothermia for the treatment of elevated intracranial pressure might be at least 48 hours, and the subsequent rewarming period must be very slow to prevent adverse effects.

An original radioimmunoassay for quantitation of circulating autoantibodies (aAb) to thyroperoxidase (TPO) proved to be well suited for large scale routine testing. The present study was aimed to assess the prevalence of aAb to TPO in patients with various thyroid and autoimmune disease and, for comparison, in women referred for reproductive disorders and indication of in vitro fertilization. Anti-TPO aAb were measured in sera from 32 healthy subjects and 262 patients thoroughly investigated for thyroid dysfunction. As determined in healthy subjects, the normal level of aAb to TPO in serum ranged from 0.30 to 3.07 mg/l (of affinity-purified) anti-TPO aAb. Anti-TPO and anti-MIC aAb levels were both normal in 115 patients and correlated well (r = 0.835, P less than 0.001) in the remaining 147 patients. Coexistence of normal level of anti-TPO aAb and abnormal level of anti-MIC aAb was found in 4 patients and ascribed to a lack of specificity or sensitivity of the test for anti-MIC aAb. Coexistence of abnormal level of anti-TPO aAb and normal level of anti-MIC aAb was found in 67 patients of whom 62 presented only slightly elevated (3.1 to 10.0 mg/l) anti-TPO aAb concentration; the 5 remaining patients, all with overt thyroid autoimmune disease, showed anti-TPO levels between 10.7 to 100.7 mg/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Thyrotoxicosis may be held responsible for osteoporosis. The question is whether a very slight subclinical hyperthyroidism, as is desirable in the post-operative treatment of differentiated thyroid carcinoma, can in the long run be detrimental to bone tissue. In a series of 37 patients, aged 50.9 +/- 11.1 years, presenting with the features of subclinical hyperthyroidism of 8.0 +/- 4.8 years duration, the authors have been unable to find any change in paraclinical parameters of bone and calcium-phosphate metabolism. Thirty-six of these 37 patients showed no abnormal decrease of vertebral bone density measured by dual photon absorptiometry.

An adrenal mass without any clinical or biological symptom was accidentally discovered in thirteen patients. All patients underwent surgical exploration. After surgery, pathological studies showed lesions of corticosuprarenaloma (5 considered benign, 1 malignant and 1 uncertain) myelolipoma (2 cases), adrenal cyst, ganglioneuroma, haemangioma and lymphangioma (1 case each). Since no reliable preoperative investigations are yet available to assess the nature of adrenal masses, and since these may be due to benign or malignant endocrine tumours, their surgical removal is indicated.

The spermatogenesis of a sterile male carrying a Y long arm deletion was analyzed by meiotic techniques and by light and electron microscopy on testicular biopsies. R-, Q- and C- banding techniques have shown that the Y long arm deletion included the entire heterochromatin and a part of the euchromatic region, with breakpoint between q11.21 and q11.23. The seminiferous tubules showed a sharp decrease in spermatogonia, degenerative phenomena in their nuclei and a spermatogenic block. Abnormal meiotic aspects were observed: pairing failure with atypical diakinesis configurations. These findings confirm the presence of spermatogenesis controlling factors on the distal euchromatic region of the Y long arm.

The ultra-structural of a C-cell carcinoma of the thyroid confirms previous data: the cells are slender, with a large nucleus. The Golgi apparatus is well developed. Granules in striking abundance are seen in every part of the cytoplasm: their diameter is 85 - 250 mmu.

Malignant hypercalcemia due to the association of hyperthyroidism and hyperparathyroidism is rare. We report a case with a fatal course in spite of surgical treatment of both lesions. Death occurred seven days after the operation due to ventricular tachycardia, in spite of return to normal of the calcemia, the serum phosphorus, the serum electrolytes and relief of the thyro-toxicosis. There is a great deal of histopathological evidence for the association of a toxic parathyroid carcinoma and a thyroid adenoma.

Somatostatin levels have been determined by radioimmunoassay in hypophysial portal blood of pentobarbital-anesthetized male rats. In euthyroid rats, the mean level was 158 +/- 27 pg/ml (n = 8); somatostatin was undetectable (less than 30 pg/ml) in systemic blood of these rats. Thyroidectomy and excess of T4 did not modify the levels of somatostatin in hypophysial portal blood.

In order to elucidate the physiological role of the 41 amino-acid residue corticotropin-releasing factor (41-CRF) on the secretion of ACTH, B-Endorphin and alpha-MSH, plasma levels of these peptides were measured by radioimmunoassay in intact and adrenalectomized rats, two hours after the injection of either 41-CRF antiserum (CRF-AS) or normal rabbit serum for controls. The administration of CRF-AS strikingly lowered the plasma ACTH levels in both intact and adrenalectomized rats. A statistically significant reduction of plasma levels of B-Endorphin was also observed in the same rats. However, the effect of CRF-AS on B-Endorphin release was less pronounced than the effect on ACTH release. No changes in plasma alpha-MSH levels were observed after passive immunization with CRF-AS. We conclude that, in the rat, 41-CRF plays a physiological role in the regulation of ACTH and B-Endorphin secretion, but is not involved in the regulation of alpha-MSH release from the pituitary gland.

Radioimmunoassay (RIA) for plasma T3 has been proposed in the diagnosis of thyroid disease. 1 171 simultaneous determination (RIA) of plasma Thyrotropin-Stimulating Hormone (TSH), triiodothyronine (T3) and thyroxine (T4) have been performed in unselected patients under suspicion of a thyroid disease. 81.8% of the cases showed a good agreement between T3 and T4 levels. The remaining 18.2% can be divided into 6 groups: 1. High T3-normal T4 : 51% of the discrepancies: Graves disease untreated (16%) or treated (4%); sporadic goiter (13%); growth failure (8%); hypothyroidism under treatment (6%); thyroiditis, Graves ophtalmopathy, toxic adenoma (4%); 2. High T3-low T4 : 6.5%; sporadic goiter (3%); hypothyroidism (3%); 3. Normal T3-low T4 : 22%: Graves disease under treatment (6%); sporadic goiter (4.5%); subacute thyroiditis (3%); hypothyroidism (3%); miscellaneous (5.5%); 4. Normal T3-High T4 : 9.5%; thyroidectomized patients for cancer well-substituted with T4 (6%); miscellaneous (3.5%) including 1 case of Graves disease; 5. Low T3-normal T4 : 8% 8%: sporadic goiter (4%); hypothyroidism (2%); treated hyperthyroidism (2%); 6. Low T3-high T4 : 3% : including 1 case of hyperthyroidism and 2 cases of thyroidectomized patients well-substituted with T4. In conclusion discrepancies between T3 and T4 levels have been observed mainly in untreated or treated Graves disease (high T3-normal or low T4) and in hypothyroidism (normal or high T3-low T4). The basal TSH and TSH peak after I.V. injection of TRH (65 cases) are in better agreement with T4 level than with T3 level. Indeed, both TRS values are high when T4 is low while T3 is normal of high.

Experimental diabetes in animals induces marked alterations of gonadal androgenic functions: reduction in testis weight, morphological alterations of Leydig cells, decrease of plasma testosterone levels and reduction of the ability of the Leydig cells to secrete testosterone in vitro. hCG treatment restores the testicular endocrine function; in addition several morphological and functional changes are observed in the hypothalamic-hypophyseal-gonadal axis which are probably responsible for the testicular lesions found in untreated experimental diabetes mellitus. In diabetic men, the hypothalamic-hypophyseal-gonadal axis seems to be normal (with exception of individual cases); Mean plasma levels of testosterone, LH, FSH and the responses of the gonadal axis to hCG and LHRH are normal.

Basal plasma dopamine (DA), Norépinephrine (NE) and Epinephrine (E) were determined in controls (n = 15) essential hypertension (n = 19) and Pheochromocytoma (n = 9). Plasma NE was significantly higher in essential hypertension than in control and in 5 cases, plasma NE or E was 3 SD above mean control values. In 8/9 pheochromocytomas DA, E or NE were significantly elevated. In 1 case, catecholamine levels were within normal range during normotensive period. When a provocative glucagon test (1 mg I.V) was performed in controls, there was no change in blood pressure DA and NE levels, but a significant increase in plasma E 2.5 and 5 min. after injection. Similar results were obtained in 8/10 cases of labile hypertension. However in 2 cases plasma NE or E increased significantly without elevation in blood pressure. In 3/4 pheochromocytomas under normotensive phase, blood pressure and plasma catecholamines increased significantly; however in 1 case, no change was observed.