Classification of secondary amenorrhea based on distinct hormonal patterns

Patients with secondary amenorrhea have been classified into 4 clincal groups. In order to further investigate these 4 groups, LH, FSH, and estradiol (E2) were measured at 15 min intervals for 4 h in 21 patients with secondary amenorrhea. Patients within each group had similar hormonal patterns, but there was a distinct variation among the groups. Three patients in group 1 (polycystic ovaries [PCO]) had elevated basal levels of only LH with marked irregular fluctuations. Seven patients in group II (hypothalamic-pituitary dysfunction) had normal basal levels of LH, FSH, and E2. Only LH showed oscillations of varying mahnitude and frequency. Eight patients in group III (hypothalamic-pituitary failure) had low or low-normal levels of LH, FSH, and low E2 with minimal or absent fluctuations. Three patients in group IV (ovarian failure) had high basal levels of FSH and LH and irregular fluctuations. This study confirmed the rationality of separating patients with secondary amenorrhea into 4 different groups. In addition, it was found that in group III patients, the total amount of LH secreted in a 4-hour period of time appears to be insufficient to stimulate E2 production from the ovary even when a single sample was found to be in the normal range.

[Atypical juvenile neurolipidosis. Ultrastructural study of a cerebral biopsy]

Electron-microscopic findings on a brain biopsy in a 9-year-old male affected by juvenile lipidosis are reported. Two types of neuronal cytosomes were discribed: lamellar concentric bodies, resembling membranous cytoplasmic bodies, and polymorphous complex bodies, unit membrane bound including various material, mostly resembling lipofuscin. The same storage was found in glial and endothelial cells. Neurochemical data failed to pin-point any specific abnormalities. The present case cannot be classified in the category of neuronal ceroid-lipofuscinosis but seems similar to certain reported cases of atypicalneurolipidosis.

Morphologic approaches to the nosology of nervous system defects

Recent technologic advances demonstrate that the morphologic approach to the nosologic delineation of nervous system disorders is often inadequate. This tenet is exemplified by the hopeless confusion which neuropathology has imparted on the problem of amaurotic familial idiocy. The delineation of nosologic entities involving the nervous system may depart from morphologic studies but requires rigid confirmation by genetic and biochemical observations.

Biochemical approaches to the nosology of nervous system defects, III

In an ever larger number of neurologic conditions, the diagnosis depends on biochemical procedures. These range in complexity from simple screening tests on urine or blood, to analyses of nervous tissue lipids or metabolic studies or explants of brain tissue. Examples of each these are provided.

The nosological position of concentric lacunar leucoencephalopathy

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