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Approximately 11% of patients with breast cancer (bca) are diagnosed before menopause, and because in most of those patients the tumour expresses a hormone receptor, treatment with endocrine interventions can be applied in any setting of disease (early or advanced). In the past, hormonal treatment consisted only of the estrogen receptor modulator tamoxifen, associated with luteinizing hormone&ndash, releasing hormone (lhrh), more recently, aromatase inhibitors (ais) have come into widespread use. The ais interfere with the last enzymatic step of estrogen synthesis in which androgens are converted into estrogens. Initially, the ais were used alone in postmenopausal patients to prevent disease recurrence, but together with lhrh analogs, they can be used in premenopausal patients to produce better estrogen suppression than can be achieved with tamoxifen plus a lhrh analog. Using a systematic review of the scientific literature (prospective and retrospective studies), we set out to assess the efficacy of ais compared with other endocrine therapy in various disease settings (neoadjuvant, adjuvant, metastatic).

L'identità di genere è una dimensione dell'identità sessuale e si riferisce alla persistente concezione personale di sé come maschio o femmina. Lo sviluppo delle identità di genere non è sempre conforme al sesso biologico, quindi anche in tenera età alcuni bambini non si identificano con il genere assegnato alla nascita (varianza di genere). In alcuni casi questa condizione può essere accompagnata da disagio (disforia di genere). I pediatri sono spesso il primo contatto che questi bambini / adolescenti hanno con il sistema sanitario, quindi dovrebbero essere in grado di rispondere alle domande delle famiglie e quando individuano un'eventuale disforia di genere dovrebbero affrontare la questione semplicemente, ricercando gli eventuali problemi psicosociali associati.

Permintaan ikan belida cukup tinggi untuk memenuhi kebutuhan konsumsi dan bahan baku olahan makanan yang masih mengandalkan tangkapan dari alam. Tingginya eksploitasi mengakibatkan populasi ikan dari tahun ke tahun semakin berkurang dan terancam punah. Teknologi pembenihan ikan belida dengan penggunaan hormon diduga dapat meningkatkan produksi larva untuk keperluan budidaya. Penelitian dilakukan untuk mengevaluasi performasi pemijahan ikan belida secara alami dan buatan melalui induksi hormon HCG dan LHRH analog. Pemijahan alami dan buatan dilakukan menggunakan induk betina sebanyak enam ekor dan jantan tiga ekor (rasio 2:1). Induk yang digunakan berukuran panjang 46 ± 5 cm dan bobot 2.209 ± 623 g. Pemijahan buatan dilakukan dengan induksi hormon HCG dosis 500 IU/kg dan LHRH analog dosis 0,5 mL/kg. Penyuntikan HCG dan LHRH diberikan dengan interval 24 jam. Hasil penelitian menunjukkan pada pemijahan buatan (induksi hormon) diperoleh induk yang memijah sebanyak dua ekor dengan nilai diameter telur (3,1 ± 0,3 mm); fekunditas (282-907 butir); derajat pembuahan (21%-40%); derajat penetasan (56%-75%); dan sintasan (30%-50%); sedangkan pada pemijahan alami diperoleh satu ekor induk yang memijah dengan nilai diameter telur (3,5 ± 0,3 mm); fekunditas (1.616 butir); dan derajat pembuahan (86,7%); selama tiga bulan pengamatan secara intensif dengan frekuensi pemijahan enam kali. Aplikasi teknologi pemijahan dengan menggunakan induksi hormon dapat menghasilkan produk larva pada ikan belida.The demand for fish consumption of Clown Knifefish is considerably high. However, the fish supply for consumption and processed food still relies on wild-caught. Such exploitation has decreased the population of Clown Knifefish to a point that it can become an endangered species. Efforts on the breeding technology of Clown Knifefish through natural and artificial propagation using of hormones have shown promising results. The current study was conducted to evaluate the performance of Clown Knifefish in natural and artificial spawning conditions using the induction of HCG hormone and LHRH analogues. The natural and artificial spawning treatments were conducted using six fish females and three fish males (a ratio of 2:1). The average Broodstocks’ size was 46 ± 5 cm in length and 2,209 ± 623 g in weight. The artificial spawning was conducted with HCG hormone induction (dose of 500 IU/kg body weight) and LHRH analogue (dose: 0.5 mL/kg). HCG and LHRH injections were given within 24 hours interval. The results showed that the artificial spawning (hormone induction) had successfully caused two broodstock to spawn producing eggs with the diameter of 3.1 ± 0.3 mm; fecundity of 282-907 eggs; fertilization rate of 21%-40%; hatching rate of 56%-75%; and survival rate of 30%-50%. In the natural spawning, one broodstock had spawned with the egg diameter of 3.5 ± 0.3 mm; fecundity of 1,616 eggs; and fertilization rate of 86.7%. This study concludes that spawning technology applications using hormonal induction can increase the production larvae of Clown Knifefish broodstock.

To investigate histidine racemization in the synthesis of a LHRH analog, (D-Trp)6-LHRH2-10 was built up by stepwise elongation of the sequence 3-10 using the solid phase technique on a 1% cross-linked chloromethyl polystyrene. For the whole synthesis the tert.-butyloxycarbonyl (BOC) group was used for temporary N-terminal protection. To protect the pi-nitrogen in histidine the benzyl-oxymethyl (BOM) group was utilized. The condensation position in the (D-Trp)6-LHRH analog was chosen so as to be able to investigate the racemization of histidine. We coupled BOC-His(BOM) with the (D-Trp)6-LHRH3-10 fragment using three different activating agents, mixed anhydride, carbonyldiimidazole (1 equiv.)/1-hydroxybenzotriazole (2 equiv.) and dicyclohexylcarbodiimide/1-hydroxybenzotriazole. The racemization was investigated by enzymatic digestion and by HPLC. For HPLC, (D-His(BOM)2-(D-Trp)6-LHRH2-10 was also synthesized. It could be proved that practically no racemization occurs during the actual peptide synthesis. The small amount (1%) of D-histidine found is due to racemization in the synthesis of BOC-His(BOM).

To improve the final height of short children who enter puberty at short stature, twenty-one boys who entered puberty shorter than 130 cm and twelve girls who entered puberty shorter than 125 cm were treated with a combination of GH and LHRH analog. Combined GST and GH treatment was started in boys and girls at a mean age of 11.78 (±0.82) years and 10.54 (±1.08) years, mean height of 130.0 (±4.4) cm and 122.6 (±3.2) cm, and mean height SD of -2.34 (±0.61) SD and -2.78 (±0.99) SD respectively. During the combination treatment, bone age decelerated after a bone age of 11.5 years in boys and 10 years in girls, and height velocity did not decelerate but remained at from 3 cm/year to 5 cm/year for a longer period. As a consequence of the treatment, the height SD score for bone age increased significantly. Seven boys and six girls discontinued LHRH analog treatment when the mean age was 17.11 (±1.15) years after a mean treatment period of 4.96 (±1.37) years for boys and when the mean age was 13.89 (±1.79) years after a mean treatment period of 3.21 (±1.52) years for girls. The mean height was 155.1 (±3.1) cm for boys and 143.3 (±3.0) cm for girls and their predicted adult height was 169.8 (±2.5) cm for boys and 155.8 (±3.1) cm for girls at the cessation of the combination treatment. All except one girl in our study will have achieved greater than the standard height gain during puberty. Although combined GH and LHRH analog treatment can improve the final height of short children by increasing pubertal height gain, the combination treatment seems more effective in boys than in girls.

The bone mineral density (BMD) of the 2nd metacarpal bone of the left hand was measured in 14 children with complete GH deficiency (CGHD) and 21 children with partial GH deficiency (PGHD) by the digital image processing (DIP) method. In the pretreatment patients, mean BMD in CGHD was significantly lower than that in normal children. The BMD standard deviation (SD) score in the patients with CGHD who had started the GH treatment before 10 years of age increased by approximately 1.5 SD during GH treatment, while that in the patients with PGHD did not change significantly. Since BMD did not show a pubertal increase in the patients who received combined GH and LHRH analog treatment, their BMD SD score decreased by approximately 1.5 SD. The data demonstrate that GH influences BMD, and the level of BMD in patients with GHD should be followed in a longitudinal observation.

Clinical variables that influence final height were analyzed in 27 girls with central precocious puberty treated with LHRH analog (TAP-144-SR: leuprorelin acetate). The patients were treated for a mean treatment period of 210.4 weeks. Plasma IGF-I levels did not change significantly during treatment. The predicted final height by projected height standard deviation score (SDS) for bone age at final estimation correlated positively with the average growth velocity during LHRH analog treatment. The mean growth velocity showed a significant negative correlation with the mean dose of LHRH analog; such a tendency was also clearly observed in patients who began to receive treatment after the age of 6 years. Although estradiol levels did not show any correlation with height velocity because of the low sensitivity of estradiol measurement, changes in plasma estradiol levels may contribute to changes in growth velocity, especcially in patients of pubertal bone age. To improve the final height prognosis in precocious puberty, it is recommended that LHRH analog be used at the minimum effective dose to maintain growth velocity during treatment.

It has been reported that the final height in short children is strongly related to the height at the onset of pubertal development, and pubertal height gain in GH-treated children is not exceed the gain in normal children. Therefore, it is now the consensus that insufficient height at the onset of puberty leads to short final height. We have already demonstrated that the final height in GH-deficient children with spontaneous puberty with gonadal suppression therapy by medroxyprogesterone or cyproterone acetate was significantly taller than GHD with spontaneous puberty without gonadal suppression therapy. In this study, we treated short boys who started puberty at height shorter than 130 cm with combined GH and LHRH analog. Final height was predicted by the height SD score for bone age. Although pubertal growth spurt was not recognized in short children on combination treatment, bone age maturation over 11.5 years decelerated significantly to the rate of one year in three or four years. Even during this slow bone maturation period, growth velocity remained at 4 cm/year due to GH treatment. Therefore, height SDS for bone age was improved in combination with the elongation of treatment period by the slow bone maturation. Some investigators recommend not to delay induction if puberty much beyond the normal age to avoid psychological problems and ennuchoid proportion in these children. When we explained to our Japanese patients the chance of increasing the final height with gonadal suppression treatment and the risk of delaying the pubertal development, almost all children preferred taller final height to pubertal development and they did not experience much psychological trouble. The differences in social and cultural circumstances do, however, influence patients' preferences.

TPS5086Background: Adjuvant ADT with an LHRH analog (LHRHA) given before during and after radiotherapy (RT) is standard of care for high risk localised prostate cancer (PC). Enzalutamide is more ef...

Turner's syndrome (TS) is clinically characterized by reduced growth, ovarian dysgenesis and infertility. The majority of patients with TS do not undergo spontaneous pubertal development. We report two patients with mosaic Turner karyotype who experienced precocious pubertal development. The first patient responded well to LHRH analog treatment and now has regular menses and has nearly achieved her target height. The second patient was treated with both LHRH analog and recombinant growth hormone. LHRH analog delayed puberty for the patient and the recombinant growth hormone increased the patient's predicted height from 145 cm to 158 cm. This report emphasizes that the treatment goals and modalities of patients must be tailored to the individual to optimize pubertal and growth outcomes.

A survey by the WHO on heavy uterine bleeding reported a stable prevalence of menorrhagia in 19% of the 5322 women interviewed in 14 different countries. Menorrhagia can be invalidating and its limitations on active, social and family life for the concerned women are severe. It is a common cause for anemia by iron loss in women.

e16077 Background: LHRH analogs (LHRHa) are standard of care in the treatment of advanced and metastatic prostate cancer (PCa). The most widely prescribed LHRHa leuprorelin acetate is in clinical u...

LBA505 Background: Premature ovarian failure (POF) is a common toxicity of CT. Risk depends on type and amount of CT, age, and perhaps ovarian cycling at the time of CT. POEMS is a SWOG-coordinated phase III randomized study to evaluate whether LHRH analog administration with CT for early-stage breast cancer (BC) would reduce POF. Methods: Premenopausal patients (PT) age .05). POF rates were 22% in the standard arm and 8% in the GN arm (OR=0.30, 95% CI: 0.10-0.87, p=.03 [unadjusted analysis]; OR=0.36, 95%CI: 0.11-1.14, p=0.08 [adjusted logistic regression analysis]). In a sensitivity analysis defining 2-year POF more liberally as either amenorrhea or elevated FSH, 45% in the standard arm and 20% in the GN arm had POF (OR=0.29, 95% CI: 0.12-0.70, p=.006). There were 13 pregnancies in the standard arm and 22 in the GN arm (OR=2.22, 95% CI: 1.00-4.92, p=.05). DFS and OS were better in the GN arm (Cox regression, including stage: HR=0.49, 95% CI: 0.24-0.97, p=.04; HR=0.43, 95% CI: 0.18-1.00, p=.05, respectively). Conclusions: LHRH analog administration with CT was associated with less POF and more pregnancies. In an exploratory analysis, GN use in premenopausal ER-negative BC was associated with improved DFS and OS. Clinical trial information: NCT00068601.

Part I. Biomaterials and Biocompatibility Studies. Biomaterials and Their Biocompatibilities, Luigi Ambrosio, Gianfranco Peluso, and Patricia A. Davis. Bacterial Adhesion to Biomaterial Surfaces, Yuehuei H. An, Richard J. Friedman, Robert A. Draughn, Edwin A. Smith, and Joseph F. John. Fine Structure-Property Relationships of Biomedical Ion-Containing Polymers, Huiying Chen, Yuankang He, and Di Qiang. Part II. Case Studies of Orthopedic Biomaterials. Bone-Inducing Factors in Osteoinductive Implants, Kunio Takaoka, Hideki Yoshikawa, Shimpei Miyamoto, Jun Hashimoto, Masashi Matsui, and Keiro Ono. Biopolymer Alloy for Surgical Plates, Joseph D. Gresser, Debra J. Trantolo, Donald L. Wise, David E. Altobelli, Michael J. Yaszemski, and Gary E. Wnek. Biological Response to Particulate Debris from Nonmetallic Orthopedic Implants, Michael A. Pappas, Christopher C. Schmidt, Arun S. Shanbhag, Theresa A. Whiteside, Harry E. Rubash, and James H. Herndon. Calcium Hydroxyapatite in Total Joint Arthroplasty, Kjeld Soballe and Richard J. Friedman. Bone Cement, Part 1, Joseph D. Gresser, Debra J. Trantolo, Hisanori Nagaoka, Donald L. Wise, David E. Altobelli, Michael J. Yaszemski, and Gary E. Wnek. Bone Cement, Part 2, Donald L. Wise, Debra J. Trantolo, Hisanori Nagaoka, Joseph D. Gresser, David E. Altobelli, Michael J. Yaszemski, and Gary E. Wnek. Part III. Biomedical Applications of Biomaterials. Biomaterial Considerations for Cardiac Prostheses, Yukihiko Nose, Yukio Ohashi, Kimitaka Tasai, and Michael E. DeBakey. Plastic Materials for External Prostheses and Orthoses, Allan G. A. Coombes, Christopher D. Greenwood, and John J. Shorter. Biomaterials in Vascular Surgery, Martin R. Back and Rodney A. White. Biomaterials in Ophthalmology, Giovanni G. Giordano and Miguel F. Refojo. Multiphasic or 'Pulsatile' Controlled Release System for the Delivery of Vaccines, Otute Akiti, A. Ganiyu Jimoh, Donald L. Wise, Gilda A. Barabino, Debra J. Trantolo, and Joseph D. Gresser. Part IV.Functional Biomaterials. Skin Repair with Cultured Cells and Biopolymers, Steven T. Boyce. Slow Release of an LHRH Analog to Reduce Serum Testosterone, Debra J. Trantolo, Joseph D. Gresser, A. Ganiyu Jimoh, Donald L. Wise, Richard C. Rhodes III, and Janet E. Hall. Regulation of Vascular Graft Healing by Induction of Tissue Incorporation, Howard P. Greisler. Tissue Regeneration by Use of Analogs of Extracellular Matrix, Diane L. Ellis and Ioannis V. Yannas. In Vitro and In Vivo Release of Naltrexone from Two Types of Poly(lactide-co-glycolide) Matrices, Joseph D. Gresser, Debra J. Trantolo, Charles H. Lyons, Hisanori Nagaoka, Louis Shuster, Robert M. Swift, and Donald L. Wise. Index.