We have previously reported an impaired growth hormone (GH) response and abnormal prolactin release to insulin-hypoglycaemia in obesity. We suggested that obese women with an absent prolactin response to hypoglycaemia ('non-responders') have a disorder of hypothalamic function. We have now investigated the GH response to i.v. growth hormone releasing factor, GHRF (1-29)NH2, in 14 obese women and nine age-matched normal-weight women. We found a significantly reduced GH response to GHRF in the obese women as compared with controls (mean peak +/- SEM: obese 8.9 +/- 2 mu/l, controls 28 +/- 2 mu/l; P less than 0.01). When the obese women were divided on the basis of their prolactin response to insulin-hypoglycaemia (seven 'non-responders', mean weight 102 +/- 5 kg; seven responders, mean weight 108 +/- 8 kg) a similar GH response to GHRF was found between the two groups but the GH response to hypoglycaemia was significantly less in the 'non-responder' women (mean peak 'non-responders' 10.5 +/- 3 mu/l, responders 27 +/- 4 mu/l; P less than 0.05). We conclude that obesity may be characterized by an impaired GH response to both i.v. GHRF and insulin-hypoglycaemia, which suggests altered hypothalamic-pituitary function. The finding that the GH response to hypoglycaemia is significantly less in the obese prolactin 'non-responder' women supports the hypothesis for a hypothalamic disorder.

In this relatively small sample, the addition of a DA to SC for women with POP does not significantly decrease the level of decisional conflict in making treatment-related decisions.

Promising methods have been developed recently for the determination of selenium (Se) and tellurium (Te) in geological materials at ng g−1 and lower levels, using hydride generation‐inductively coupled plasma‐mass spectrometry. Here we report on a new isotope dilution‐hydride generation‐inductively coupled plasma‐mass spectrometry (ID‐HG‐ICP‐MS) method for the simultaneous determination of Se and Te, which is applied to basalts, and modified compared to previous work. The basalts were attacked and dissolved with hydrofluoric and nitric acid, spiked with enriched isotopes, and passed through a cation exchange column (AG 50‐X8 100–200 mesh) to separate the major cations that interfere with Se and Te detection (e.g., Fe). The detection limits of this method were 0.010 ng g−1 for Se and 0.0030 ng g−1 for Te, well below the concentrations of Se and Te expected in basalts. The precision of the method for Se was 12.2 to 15.1% and for Te was 4.6 to 7.2% RSD from replicate analyses of basalt reference samples. The accuracy for Se determinations was 61 to 94% and for Te 28 to 100% of values previously reported in the literature for selected USGS reference materials.

The absence of blood flow in the testis on ultrasound examination is the gold standard for diagnosis of testicular torsion. This imaging finding is seen in the vast majority of patients with testicular torsion, except in patients with partial torsion. Patients with partial testicular torsion may have reversal of arterial diastolic flow on spectral Doppler, decreased amplitude of the spectral Doppler waveform (parvus tardus wave), or monophasic waveforms. However, it is important to consider that not all absence of blood flow or reversal of diastolic flow in testis represents testicular torsion, as other conditions may have a similar appearance, including rare detection of such a pattern in normal asymptomatic patients. Conditions that commonly mimic testicular torsion include incarcerated inguinal hernias and complications following hernia repair,thrombotic phenomena, vasculitis, complicated epididymo-orchitis, asymptomatic variants, and technical limitations of ultrasonography. It is important for a practicing radiologist to be familiar with such cases to avoid unnecessary surgical interventions.We present a pictorial essay of cases in which the absence of testicular blood flow on color flow Doppler or abnormal waveforms on spectral Doppler are identified, without the presence of testicular torsion.

Inflammatory pseudotumor is a relatively rare, nonneoplastic lesion composed of inflammatory cells and myofibroblastic spindle cells that can be identified on sonographic evaluation of the genitourinary system. These lesions are thought to be an inflammatory response to insults such as surgery, trauma, infection, or malignancy. Such lesions need to be distinguished from true neoplasms and other benign lesions, including inflammatory responses and infectious processes. Identification of inflammatory pseudotumors and its mimics is important for radiologists to guide patient treatment and follow-up. This pictorial essay presents sonographic features of inflammatory pseudotumors of the genitourinary tract and its mimics with cross-sectional imaging and histopathology, where available.