Background: Klinefelter's syndrome (KS) is characterized by extra X chromosomes and features of primary hypogonadism including osteopenia and osteoporosis. Testosterone therapy (TTh) is widely used to treat men with KS and low serum testosterone/hypogonadal symptoms, though studies on its efficacy in improving bone density show varied outcomes. Materials and Methods: We studied the effects of TTh, bisphosphonates, and vitamin D/calcium in 38 men with KS and low testosterone, hypogonadal symptoms, and T-scores consistent with osteoporosis. Our aim was to investigate at the end of follow-up (median: 87 months, range: 27-147 months), associations between age, baseline total testosterone, and T-scores, and change in T-scores after treatment. Results: At final assessment, all men had T-score values outside the osteoporotic range (À1.1 standard deviation [SD], À1.8 SD). Baseline age but not median baseline testosterone appeared associated with change in T-score and T-score at final assessment. All men had dual-energy X-ray absorptiometry every 6 months and demonstrated continued improvement in T-scores after 3 months and up to 72 months. Baseline age and T-scores (stratified by median) were associated with change in T-score at final assessment. Compared with men ‡51 years, those aged <51 years showed significantly greater improvement in T-scores between 6 and 30 months. Men with worse T-score values (<3.7 SD) showed significantly greater improvement at every time point up to 36 months. Our results indicate that TTh, bisphosphonates, and vitamin D/calcium improve osteoporosis although there is a need to better understand the effects of the individual therapies, age, and baseline T-score on treatment efficacy.

Hormonal involvement in the control of blood glucose level of Poecilobdella viridis was tested by performing debraining, supra-and sub-oesophageal ganglionectomy, followed by injections of the extract of neuroendocrine tissues in operated leeches.Anatomically, the brain ring. through which the oesophagus passes, of this leech is composed of two separate ganglia, the supra-oesophageal and sub-oesophageal. connected to each other by circum-oesophageal connectives. In normal leeches blood glucose level was found to be 10·2~g%. Removal of complete brain and only the supra-oesophageal portion of the brain produced after 24 h a significant (P < 0·0I) decrease in the blood glucose concentration. Suboesophageal ganglionectomy produced no effect. Injections of brain and supra-oesophageal ganglion extracts into 24 h debrained and supra-oesophageal and sub-oesophageal ganglionectomized leeches increased the blood glucose level significantly, but the injections of suboesophageal ganglion homogenates had no effect. These data indicate that supraoesophageal ganglionic portion of the brain of Poecilobdella viridis may be the production site of hyperglycemic hormone.

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