Expression of leptin receptor isoforms and effects of leptin on the proliferation and hormonal secretion in human pituitary adenomas.

OBJECTIVE: To pursue whether leptin regulates anterior pituitary cells, we studied the ex vivo expression of several isoforms of the leptin receptor (OB-R) as well as the in vitro effects of leptin administration in human pituitary adenomas. METHODS: OB-R mRNA expression and in vitro response to leptin were studied in 39 pituitary macroadenomas. RESULTS: All 4 OB-R subtypes were expressed in most adenomas. The expression was significantly more pronounced in GH-secreting adenomas as compared to non-functioning tumor cells (p < 0.05). Leptin administration in vitro did not significantly influence cell proliferation or the secretion of GH, FSH, LH or alpha-subunit. CONCLUSIONS: (1) Several isoforms of the OB-R, including the signal transducing full-length receptor, are expressed in most human pituitary adenomas. (2) This expression ex vivo is not associated with significant effects of leptin in vitro.

Influence of cuff size on blood pressure among schoolchildren.

In 236 schoolchildren aged 7-15 years arm blood pressure was measured using a semiautomatic technique. Three different cuffs were chosen among four cuffs with bladder sizes of either 6 x 20 cm, 9 x 27 cm, 12 x 35 cm or 15 x 43 cm. Ideal cuff size in each pupil was defined as the one in which the width of the bladder was closest to 40% of arm circumference. In all subjects ideal cuffs were tested along with two cuffs bigger or smaller than the ideal one. The study showed that "normal blood pressure" in relation to age depended on the cuff used. Using the ideal one, systolic blood pressure increased from 105 mmHg at 7 years of age to 117-119 mmHg at age 11, with no further increase at higher ages, while diastolic blood pressure was almost unchanged in the different age groups. Normal blood pressure curves constructed using the same cuff in all children showed a steeper increase in both systolic and diastolic blood pressure in relation to age compared to the curve based on the ideal cuff in all children. It is strongly recommended that future studies should take the best-suited cuff problem into consideration when planning studies among children. Some of the differences between previous published studies may be explained by the differences introduced by different cuff sizes.

Strategic planning for optometric education: the Georgetown Conference.

In 1991, the American Optometric Association (AOA) and the Association of Schools and Colleges of Optometry (ASCO) committed to the joint sponsorship of a national Summit on Optometric Education. The decision began a 3-year effort which will have an impact on both the academic and political arms of the profession for years to come. The purpose of this discussion is to consider the specific parameters and the process involved in a nationally based strategic planning process for optometric education. The planning process began with The Georgetown Conference in April 1992 and will continue through a series of 6 focus conferences ending in November 1993.

Blood pressure measurement in childhood and adolescence. International recommendations and normal limits of blood pressure.

BLOOD PRESSURE MEASUREMENTS IN CHILDREN SHOULD BE BASED ON THE FOLLOWING RULES: 1. Resting period prior to readings should be about 5-10 minutes. In children under 5 years of age, lying position should be used. In older children sitting position is most suitable. 2. Either flush method or ultrasound technique should be used in newborn. Auscultatory blood pressure is suitable in other children. 3. Width of cuff should be based on circumference of the arm, and not on arm-length: (width = 120% of diameter = 40% of circumference, i.e., 3, 6, 9, 12, or 15 cm). Length of cuff-bladder = circumference or more. 4. Diastolic blood pressure should be read at muffling of Korotkoff sounds (phase IV). 5. Although some agreement exists between different studies, it is obvious, that definition of "normal blood pressure" in children is dependent on the methodological factors involved in the measurement of blood pressure.

The cost effectiveness of selected optometric procedures.

As funding of optometric care by the government and third parties increases, more regulation of vision care is anticipated. Utilization of cost effectiveness studies may largely determine the level of optometric care acceptable to these providers. Consequently, a method of determining cost effectiveness of optometric procedures has been developed and applied to three models of optometric care. Data taken from a review of patient records are used to develop quantifiable cost criteria for a specified patient group. These criteria include actual cost, patient acceptance (satisfaction), and professional acceptance of prescribed therapy. These criteria are then applied to each model of patient care to determine which is most cost effective.