Fausto Zuccato

Comparative Effect of Galanin and Pyridostigmine on the Growth Hormone Response to Growth Hormone-Releasing Hormone in Normal Aged Subjects

The aim of our study was to investigate the effects of aging on the growth hormone (GH) response to growth hormone-releasing hormone (GHRH) alone and in combination with either the neuropeptide galanin or the acetylcholinesterase inhibitor pyridostigmine (PD) in normal subjects. In protocol 1 (GHRH/galanin), 9 old healthy volunteers, ranging in age from 68 to 97 years, and 6 young subjects, ranging in age from 25 to 31 years, received: (a) human GHRH (1-29)NH2, 100 micrograms in 1 ml saline, as an intravenous bolus, and (b) porcine galanin, 500 micrograms in 100 ml saline, as an intravenous infusion from -10 to 30 min combined with GHRH, 100 micrograms i.v. at time 0. In protocol 2 (GHRH/PD), 14 old healthy volunteers, ranging in age from 65 to 91 years, and 11 young subjects, ranging in age from 19 to 34 years, received: (a) GHRH (1-29)NH2, 100 micrograms in 1 ml saline, as an intravenous bolus, and (b) PD, 120 mg administered per os 60 min before GHRH, 100 micrograms as an intravenous bolus. Blood samples for GH were drawn at -75, -60 (time of PD administration), -45, -30, -15, -10 (time of beginning of galanin infusion), 0 (time of GHRH injection), 15, 30, 45, 60, 90, and 120 min. The GH response to GHRH was significantly (< 0.05) enhanced either by galanin or PD pretreatment both in young and old subjects. However, the GH response to GHRH alone or combined with either galanin or PD was significantly greater in the young subjects as compared to the old subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

SMS 201-995 Improves Glucose Tolerance in Insulin-Treated Type II Diabetic Patients

cardiac routing of several drugs can be useful in cardiac arrest when peripheral or central drip are ineffective. In our patient, intracardiac insulin puncture, an undescribed type of treatment, was presumptively effective to locally decrease K levels so that myocardial membrane depolarizations reverted and sinusal rhythm could be restored. After this experience, we consider that intracardiac injection of regular insulin may be an additional treatment of cardiac arrest due to hyperkalemia, especially if it coexists with hyperglycemia.

Pregnancy in Sheehan's syndrome corrected by adrenal replacement therapy. Case report.

A 23-year-old woman was referred to our Institute in October 1981 for assessment of fatigue, weight loss and postpartum amenorrhoea. The patient, who had had her first pregnancy in 1978 with normal labour and lactation, gave birth a t term after a sccond uncomplicated pregnancy in March 1981. The patient noticed a much heavier blood loss at the second delivery than during her first, but she denied loss of consciousness and no blood transfusion was given. lmmediately after delivery, the patient complained of intense fatigue with drowsiness, depression and anorexia. Afterwards, lactation failed and the patient did not resume her menses, which had always been regular. In the subsequent 7 months, there was an involuntary weight loss from 53 to 45 kg, and she continued to complain of diminished vigour, lethargy and apathy. On admission to our Institute, the clinical features were dominated by a depressive state and remarkable thinness. Her height was 1.60 m and her weight 42 kg. Blood pressure was 90160 mmHg, and the pulse rate 48, otherwise physical examination was not noteworthy; in particular pubic and axillary hair was normal, and she had no signs of hypothyroidism. Routine studies demonstrated a haematocrit of 28.5%, with a haemoglobin of 9.9 &dl, and fasting blood glucose level of 60 mgidl (3.3 mmolil). Several baseline pituitary hormonal levels were reduced (Table 1 shows normal ranges for our laboratory): serum prolactin (PRL) was 2.2ngidl: growth hormone (GH) was 1.4 ng/dl; ACTH was 8 ngidl; but gonadotrophin levels (LH 6 m IUiml and FSH 11 m IUlml) were within the normal range. An early morning plasma cortisol concentration was 1.2 pg/dl, and