Comparative drug treatment of endocrine exophthalmos

The degree of exophthalmos and the width of the palpebral fissure were studied serially in 58 previously thyrotoxic patients, who were divided into 6 treatment groups: 1. guanethidine eye drops; 2. oral thyroxine; 3. guanethidine eye drops and oral thyroxine; 4. guanethidine and prednisolone eye drops; 5. napththazoline nitrate 0.1% and zine sulfate 0.5% eye drops; and 6. metronidazole orally. Exophthalmos increased significantly in the first and third group, and the palpebral fissure decreased in the first group. It was concluded that guanethidine eye drops should be given when there is marked lid retraction with minimal exophtalmos; that prednisolone eye drops are not indicated in endocrine exophthalmos; and that the combination of guanethidine eye drops with oral thyroxine in different dosages is worth further study. © 1970 Springer-Verlag

The expression of Omental 11β-HSD1 is not increased in severely obese women with metabolic syndrome

Objective: Plasma cortisol in obese subjects does not differ from that in normoweight subjects. Extra-adrenal cortisol production by 11β- hydroxysteroid dehydrogenase type 1 (11β-HSD1) can result in local hypercortisolemia. The aim of the present study was to examine the role of visceral hypercortisolemia in the development of metabolic syndrome in severe obesity. Methods: Eight lean women during hysterectomy (controls) and 19 severely obese women during bariatric surgery were studied, 8 without metabolic syndrome (OM- group) and 11 with it (OM+ group). Biopsies of omental and subcutaneous fat were performed in the severely obese women during surgery, but only omental biopsies in the controls. Expression of 11β-HSD1, glucocorticoid receptor α (GRα) and glucocorticoid receptor β (GRβ) was evaluated using real-time PCR.Results: Omental 11β-HSD1 expression was different between groups (one-way ANOVA, p < 0.01). Post-hoc analysis revealed that mean omental 11β-HSD1 mRNA levels were higher in the OM- group compared to controls, whereas they were similar when comparing the OM+ group with lean controls. Expression of 11β-HSD1 in subcutaneous fat was not different between OM+ and OM- groups. GRα expression in omental fat did not differ among groups or between omental and subcutaneous fat in severely obese patients. An expression of GRβ was not detected.Conclusion: Contrary to our original hypothesis, omental 11β-HSD1 expression is not increased in the OM+ group. Copyright © 2012 S. Karger GmbH, Freiburg