Structural differences in the rotator cuff muscles alter the direction of the humeral head forces on the developing glenoid fossa and can lead to osseous deformities. Glenohumeral deformities are significantly greater with a C5-C6 (C7) lesion than with a complete brachial plexus lesion in which the large internal rotators are also affected. Reducing the muscular imbalance that occurs with a C5-C6 (C7) lesion could diminish glenohumeral joint incongruency and may improve the outcome of subsequent soft-tissue release or tendon transfer surgery.

. Retention of estradiol negative feedback relationship to LH predicts ovulation in response to caloric restriction and weight loss in obese patients with polycystic ovary syndrome. Am J Physiol Endocrinol Metab 286: E615-E620, 2004. First published December 16, 2003 10.1152/ajpendo.00377.2003.-The present study tests the hypothesis that specific endocrine, metabolic, and anthropometric features distinguish obese women with polycystic ovary syndrome (PCOS) who resume ovulation in response to calorie restriction and weight loss from those who do not. Fifteen obese (body mass index 39 Ϯ 7 kg/m 2 ) hyperandrogenemic oligoovulatory patients undertook a very low calorie diet (VLCD), wherein each lost Ն10% of body weight over a mean of 6.25 mo. Body fat distribution was quantitated by magnetic resonance imaging. Hormones were measured in the morning at baseline, after 1 wk of VLCD, and after 10% weight loss. To monitor LH release, blood was sampled for 24 h at 10-min intervals before intervention and after 7 days of VLCD. Responders were defined a priori as individuals exhibiting two or more ovulatory cycles in the course of intervention, as corroborated by serum progesterone concentrations Ն18 nmol/l followed by vaginal bleeding. At baseline, responders had a higher sex hormonebinding globulin (SHBG) concentration but were otherwise indistinguishable from nonresponders. Body weight, the size of body fat depots, and plasma insulin levels declined to a similar extent in responders and nonresponders. Also, SHBG increased, and the free testosterone index decreased comparably. However, responders exhibited a significant decline of circulating estradiol concentrations (from 191 Ϯ 82 to 158 Ϯ 77 pmol/l, means Ϯ SD, P ϭ 0.037) and a concurrent increase in LH secretion (from 104 Ϯ 42 to 140 Ϯ 5 U⅐l Ϫ1 ⅐day Ϫ1 , P ϭ 0.006) in response to 7 days of VLCD, whereas neither parameter changed significantly in nonresponders. We infer that evidence of retention of estradiol-dependent negative feedback on LH secretion may forecast follicle maturation and ovulation in obese patients with PCOS under dietary restriction. fertility; ovarian cycle; sex hormones; body fat distribution; gonadotropins POLYCYSTIC OVARY SYNDROME (PCOS) is a heterogeneous disorder of female reproduction characterized by hyperandrogenism and chronic oligo-or anovulation in the absence of specific disease of the adrenal glands, ovaries, or pituitary gland (41). If these criteria are applied to establish the diagnosis, PCOS occurs in 4-8% of premenopausal women (2,5,19).The etiology of the disease remains uncertain. It is thought that various environmental factors interact with genes that predispose women to the development of PCOS (8, 21). A number of features that are often, but not always, present in PCOS may provide mechanistic clues: obesity, peripheral insulin resistance, and chronic hyperinsulinemia (6, 11). More than 30% of women with PCOS are obese (body mass index Ͼ30 kg/m 2 ), reflecting primarily visceral adiposity (11). Intraabdominal obesity is freque...

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Aims/hypothesis. Large quantities of pure viable donor islets are necessary for clinical transplantation. At present, low yields and low viability of pancreatic islets after transplantation necessitate the use of multiple donors for a single recipient. In this study an improved method for obtaining large quantities of pure viable islets of Langerhans for transplantation was developed in the rat. Methods. Islets of Langerhans were isolated from Albino Oxford rats. The donor pancreata were perfused in situ with iron oxide, which resulted in entrapment of iron particles in the capillaries of the islets. Subsequently, the islets were isolated by magnetic retraction. Islets obtained with this method were compared with islets obtained by density gradient-isolated islets with respect to yields, purity, and insulin production capacity. Islets isolated with the magnetic retraction method were transplanted under the renal capsule of streptozotocin-induced diabetic recipients. Blood-glucose levels in the recipients were monitored for 2 months after transplantation.Results. This method yielded more pure and viable islets than the conventional protocol. No contamination of exocrine tissue was observed after isolation. Furthermore, the islets isolated by magnetic retraction stained strongly positive for insulin during the entire observation period in vitro, and produced high amounts of insulin upon a challenge with glucose. The islets that were obtained by this new protocol were suitable for safe and effective transplantation. Conclusions/interpretation. We have shown that both the quantity and quality of islets obtained with this method were sufficient to induce insulin independence in a diabetic recipient using islets from only one donor. [Diabetologia (2004) 47:55-61]