bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of diabetic pregnant women with monocomponent insulins
Authors: Gargiulo P. , Di Mario U. , Zuccarini O. , Troili F. , Tiberti C. , Nicolini U. , Pachi A. , Gerlini G. , Fallucca F. 
Published: October 2009

Abstract. Very little immunological research has been undertaken in pregnant diabetic women in relation to insulin therapy.
We investigated the relations between treatment with insulins of varied immunogenic character and the presence of immune factors such as insulin antibodies, immune complexes and insulin antiinsulin complexes as well as some maternal and neonatal complications of diabetic pregnancy.
128 insulin treated diabetic pregnant women and 121 of their newborns were included in the study.
The incidence of insulin antibodies, immune complexes and insulin antiinsulin complexes was lower in patients treated with highly purified insulins than in those treated with conventional insulins.
The insulin antibody levels were significantly related to the occurrence of maternal and neonatal morbibity.
The presence of insulin antiinsulin complexes in the cord blood of infants of diabetic mothers was related to the presence of these complexes in their mothers.
Our results seem to indicate that the use of highly purified insulin could favour the outcome of diabetic pregnancy.
Fetal lung maturation in diabetic pregnancy
Authors: Tydén Olof , Eriksson Ulf J. , Berne Christian 
Published: October 2009

Abstract. The increased incidence of the idiopathic respiratory distress syndrome (IRDS) in infants of diabetic mothers may be explained by preterm delivery and asphyxia but the metabolic derangement per se may also be responsible for the inadequate production of surfactant.
Experimental studies of the underlying mechanisms in the lungs of fetuses of pregnant diabetic rats have shown a decreased formation of the two major surfactant phospholipids disaturated phosphatidyl choline and phosphatidyl glycerol. In addition, the activities of key enzymes responsible for the production of these phospholipids are decreased in the fetal lung tissue. Inadequate utilization of pulmonary glycogen for surfactant biosynthesis has also been observed. Furthermore, experimental studies support that other changes than fetal hyperinsulinaemia are needed to produce a state of disturbed surfactant production.
In human diabetic pregnancy strict metabolic control allows the fetal lungs to mature in a near-normal fashion. The presence of phosphatidyl glycerol in the amniotic fluid seems to be the best available predictor of lung maturity in diabetic pregnancy, in which both the lecithin/sphingomyelin ratio and amniotic fluid cytology may result in false-positive and false-negative values. The trend towards extension of delivery to term will undoubtedly diminish the need for estimation of fetal lung maturity by amniocentesis. Avoiding preterm delivery and adhering to strict metabolic control of the maternal diabetes would be expected to decrease the neonatal respiratory problems in diabetic pregnancy.
Relationship between ultrasound findings in pregnancy and neonatal morbidity
Authors: Pachi A. , Fallucca F. , Gerlini G. F. , Maggi E. , Torre R. La 
Published: October 2009

Abstract. In 142 diabetic pregnancies fetal biparietal diameter (BPD), transverse abdominal diameter (TAD) and abdominal circumference (AC) were estimated by means of serial ultrasound examinations. An accurate evaluation of fetal growth was obtained in 85% of the cases. AC was found to have the highest degree of reliability in predicting macrosomia (71%) followed by TAD (60%) and BPD (17%).
Placental morphology was estimated at the last scanning before delivery in 85 of the patients. In pregnancies resulting in macrosomic infants the placental maturation seemed to be retarded.
In 26 patients a third trimester amniocentesis was performed. A mature (grade III) placenta was always associated with a lecithin-sphingomyelin (L/S) ratio> 2, indicating fetal lung maturity but there was no constant relation between placental maturity and the L/S ratio.
In conclusion, ultrasound examination during diabetic pregnancy offers valuable information concerning the prenatal diagnosis of macrosomia and could serve as a guidance in the determination of the optimal time and route of delivery. The grading of placental maturity might help to identify fetuses at risk, but further studies in this area are needed before final conclusions can be drawn.
Growth hormone response to thyrotropin-releasing hormone in children and adolescents: a reappraisal
Authors: THEINTZ G.E. , TANG J.Z. , MARTI C. , BISCHOF P. , SIZONENKO P.C. 
Published: October 2009

ABSTRACT
In normal subjects, thyrotropin-releasing hormone (TRH) is not involved in the control of growth hormone secretion. Paradoxical growth hormone (GH) responses to TRH have been described in acromegalic subjects and, recently, in some constitutionnally tall children. To confirm this finding, we have examined the GH response to combined LHRH-TRH tests performed to assess the pituitary function of children with GH deficiency, tall stature before and during bromocriptine therapy, precocious or delayed puberty as well as in a group of patients of average height and normal bone age. Unlike prolactin, the GH "response" to TRH, in children followed longitudinally, is particularly heterogeneous with an unpredictable pattern of secretion in repeated tests. Over 90% of children display peaks of GH (≥5ng/ml), of which 38% occur twice during the test period. Amplitude and frequency of GH peaks appear to be independent of height, chonological age or bromocriptine therapy. Secretory rate estimated by integrated surface area increases in parallel to sex steroids impregnation. The pattern of GH secretory episodes, the increase in mean GH secretion in parallel to the production of gonadal sex steroids and the failure of bromocriptine to affect GH secretion in constitutionnally tall children allow to speculate that what is measured after TRH injection is normal spontaneous GH rhythm rather than a direct effect of TRH on GH secretion.
Sex hormone priming prior to the combined hypoglycaemia test
Authors: HAMILTON WILLIAM , KHATTAB MOHSEN M. 
Published: October 2009

Abstract
The insulin hypoglycaemia test (IHT) was performed on 3 groups of short statured children. One group was unprimed with sex steroid hormones, a second group received 17β-oestradiol, while a third group received testosterone. The dosage of insulin was adjusted to produce a nadir in blood glucose of ⇋ 1 mmol/L. When this level is achieved plasma growth hormone (GH) responses less than 10 mU/L are not improved by either priming procedure. It is suggested from the data that there is no place for a diagnosis of a partial GH deficiency state.
When the IHT is combined with Gn-RH and TRH infusion the data derived may indicate GH-RH deficiency alone or additionally a CRF deficiency. Alternatively a pituitary insensitivity to these releasing substances or a pituitary synthetic failure of all trophic hormones may be adduced. Unless a releasing hormone is deficient and the pituitary is shown to be able to respond to its synthetic analogue, treatment with the available analogues will fail to give the desired clinical response.
Treatment of Silver-Russell type dwarfism with human growth hormone: Effects on serum somatomedin-C levels and on longitudinal growth studied by knemometry
Authors: PARTSCH C.-J. , HERMANUSSEN M. , SIPPELL W. G. 
Published: October 2009

Abstract. Two patients, aged 5 and 12 years, with Silver-Russell type dwarfism are presented. As shown by standard tests and examination of the spontaneous nocturnal hGH secretion, there was only mild regulative hGH deficiency. HGH treatment was started with daily subcutaneous injections at age 5.5 years (height 90.3 cm, −6.1 SDS, bone age 2.75 years) and 12.6 years (height 125.7 cm, −3.7 SDS, bone age 8.75 years), respectively. Treatment was monitored by serial somatomedin-C (SM-C) determinations and by knemometry (lower leg measurement).
SM-C values increased in both patients by 10.5 and 4.8 fold, respectively, and remained above the prepubertal range (>2.5 U/ml) during the treatment periods of 1.5 years. Pretreatment knemometric growth rate was high (after a somatomedin generation test) in patient 1 (0.7 mm/week) and low in patient 2 (0.31 mm/week). It remained at the same level in patient 1 (0.67 mm/week) and increased markedly in patient 2 (0.46 mm/week). During a treatment interruption, in both patients, knemometric growth rates fell to 0.33 and 0.30 mm/week, respectively. After resumption of treatment, now with biosynthetic hGH, growth rates increased again in patients 1 and 2 to 0.64 and 0.48 mm/week, respectively. This lower leg growth pattern was parallelled by similar changes in total body growth velocity. Even after the relatively short treatment period of 14 to 16 months, a slight net gain in statural height could be observed, as standard deviation scores for bone age increased.
Observations on the role of GH/IGF-1 and sex hormone binding globulin (SHBG) in the pubertal development of growth hormone deficient (GHD) children
Authors: RUDD B.T. , RAYNER P.H.W. , THOMAS P.H. 
Published: October 2009

Abstract
SHBG concentrations in GHD and non GHD children of both sexes were studied in relation to their weight and androgen status. SHBG was inversely related to age in short and control children, but not for GHD. Correction for body weight restored the inverse relationship in these children and improved the correlation for the other groups. DHAS concentrations were similar in GHD and short children, suggesting GH per se does not influence adrenal androgen synthesis. The mean free testosterone in GHD children 12.7 pmol/L, was similar to that in short children, 14.3 pmol/L, and lower than controls 21.2 pmol/L, but consistent with their pubertal status.
The Linear regression of SHBG on IGF-1 was r = -0.605 (P <0.01). It was postulated that IGF-1 and free testosterone may regulate SHBG synthesis.
Administration of native and synthetic GH to prepubertal GHD children lowered SHBG without a significant change in TBG, albumin or free testosterone.
The fall in SHBG concentration after HGH in GHD children is suggested as a selective mechanism which may lead to improved pubertal development.
It is now recognised that many of the biochemical actions of administered human growth hormone (HGH), notably linear growth, protein synthesis and turnover, recorded in the classical studies of Prader et al. (1964), Hubble (1966) and Brown et al. (1967) are mediated by the generation of somatomedin C (IGF-1) (Van Wyk et al., 1974). Less certain is the role that IGF-1 may play in the timing of the growth spurt and subsequent pubertal development. It is documented however, (Laron and Sarel, 1970), that clinical signs of poor genital development in male patients with growth hormone deficiency may be reversed by HGH therapy, but the mechanism is unknown.
A specific carbohydrate rich dimeric binding protein, sex hormone binding globulin, with a high Ka for testosterone and oestradiol-17β is present in serum (Anderson, 1974). Levels are raised prepubertally and fall progressively in both sexes as puberty advances (Lee et al., 1985).
This fall is a trigger for increased levels of free testosterone and oestradiol-17β which may play a part in the activation of the hypothalamic-pituitary-gonadal axis. Preliminary reports (Rudd et al., 1985), have shown that some GHD children had raised SHBG values for chronological and bone age.
These observations suggested that concentrations of non-protein bound sex steroids may be inappropriately low because of a raised In this paper, the weight and the androgen status of GHD SHBG. children is studied in relation to compared to similar data for short addition, the effect of native and Sweden) GH on SHBG and non-protein GHD patients, is examined. their SHBG concentrations and is children and controls. In synthetic (Somatonorm S - Kabi, bound testosterone in the serum of
Growth, growth hormone secretion and somatomedin C after cranial irradiation for acute lymphoblastic leukemia
Authors: BRAUNER R. , PREVOT C. , ROY MP. , RAPPAPORT R. 
Published: October 2009

Abstract
In a large group of 74 patients irradiated with 2400 rad for acute lymphoblastic leukemia an unusually high frequency of complete GH deficiency was observed (40 %). Only 11 out of 46 prepubertal children had growth retardation and seven children received hGH treatment. On the contrary 11 other prepubertal cases had normal growth rates in spite of lack of response to AITT. Plasma SmC values were correlated with growth rates but were discrepant with GH responses to AITT in somecases. Because of this high frequency of GH dysregulation further growth at time of puberty should be carefully documented.
Endogenous opioid inhibitory tone on LH secretion in normal puberty and in several pubertal disturbances
Authors: BERNASCONI S. , PETRAGLIA F. , IUGHETTI L. , FACCHINETTI F. , MARCELLINI C. , GIOVANNELLI G. , GENAZZANI A.R. 
Published: October 2009

Abstract
To further evaluate the role exerted by endogenous opioids on LH secretion a naloxone challenge (0.08 mg/Kg b.w. i.v.) was performed in 23 healthy children at different stages of puberty, in 5 adolescents in different period of menstrual cycle, in 3 case of idiopathic precocious puberty (PP), in 7 cases of delayed puberty (DP), in 4 females affected by hypogonadotropic hypogonadism (HH) and in 6 patients affected by polycystic ovary disease (PCOD). Naloxone does not induce any significant change on LH plasma levels in prepubertal helathy children and in all the cases of PP and DP. Similarly there was no LH response in healthy adolescents neither in HH nor in PCOD, the response to naloxone appears only in preovulary and luteal phases. These data indicate that the central opioid system regulating LH secretion in humans is active only at more advanced stages of puberty and it does not seem to play a role in the beginning of sexual maturation. Moreover gonadal steroids seem to play a fundamental modulatory role on opioid-controlled LH secretion.
Gynaecomastia and premature thelarche in a schoolchildren population of northern Italy
Authors: Nizzoli G , Del Corno G , Fara G M , Chiumello G 
Published: October 2009

Abstract
The prevalence and incidence of gynaecomastia and thelarche have been studied in pre-school children and school children belonging to different socio economical classes in two Northern Italian Cities: Milano and Mantova. The child ren selected underwent three clinical examinations in their own school by the same examinator. The highest prevalence (36.6%) of breast enlargement was observed in nursery children until 2 years of age in Milano. Age and sex specific incidence rates were higher in Milano than in Mantova except in boys 11-14 years old. Assumption of drugs which might induce gynaecomastia thelarche was excluded. Relative risks calculated for veal and chicken must suggest that these are not relevant in the ethiology of breast enlargement.
Is heterozygosity for the steroid 21-hydroxylase deficiency responsible for hirsutism, premature pubarche, early puberty, and precocious puberty in children?
Authors: KNORR D. , BIDLINGMAIER F. , HÖLLER W. , KUHNLE U. , MEILER B. , NACHMANN A. 
Published: October 2009

Abstract
We applied the ACTH-stimulation test developed in our laboratory for the detection of heterozygous carriers of the 21-hydroxylase deficiency gene to patients suffering from hirsutism (n=89), premature pubarche (n=75), early puberty (n=37), and precocious puberty (n=22). While, in the general population, this test is positive in less than 2%, we found in 33% of hirsute patients, in 41% of patients with premature pubarche, and in 33% of patients with early puberty a hormonal response similar to the one seen in heterozygous carriers for the 21-hydroxylase defect. In contrast, only 18% of patients with precocious puberty responded abnormally. Thus we speculate that, at least in some patients with hirsutism, premature pubarche, and early puberty, heterozygosity for the 21-hydroxylase defect plays a major role in the pathogenesis of these disorders.
Annual progression of retinopathy in conventionally treated children and adolescents with type I diabetes mellitus
Authors: BURGER W. , WEBER B. , HARTMANN R. , HÖVENER G. 
Published: October 2009

ABSTRACT
In a cohort of 268 type I diabetic patients, aged 19.6 ± 4.1 years (Mean ± 1 SD), with a diabetes duration of 10.4 ± 4.9 years, treated by the same team, using the same conventional treatment regime during the total observation period, the progression rate of early retinopathy within the first two decades of diabetes was deduced from observed transitions of the retinal status from one stage of retinopathy (as defined by fluorescein angiography) to a higher one (Malone et al., 1977) within one year. A total number of 83 such events were evaluated.
After a gradual development of earliest changes within the fifth year of diabetes, the median annual rate of progression was found to be 12 - 13%, independent of the previous duration of diabetes and the actual retinal state.
Long-term treatment with diazoxide in childhood hyperinsulinism
Authors: GRANT D. B. , DUNGER D. B. , BURNS E. C. 
Published: October 2009

Abstract
This paper reviews the outcome in 12 children with hyperinsulinaemic hypoglycaemia who first developed symptoms between the ages of 2 and 8 months and who were treated with diazoxide (5 - 20 mg/kg/day) for 2-13 years. Two cases required subtotal pancreatectomy at the ages of 5 and 10 years because of recurrent hypoglycaemia and one girl with severe retardation died at the age of 6 years while still on diazoxide therapy. Two patients aged 3.5 and 9 years are still on treatment and in 7 cases diazoxide was discontinued between the ages of 2.5 and 14 years, indicating that spontaneous remission can be expected in a high proportion of children with post-neonatal hyperinsulinaemic hypoglycaemia. Of the 9 children who started diazoxide within 3 months of the onset of symptoms, 5 are of normal intelligence and 4 are moderately retarded (IQs 63-71). In 3 children diazoxide was started 8 months to 3 years after the onset of symptoms; two are retarded (IQs 60-70) and the third was severely retarded and died aged 6 years.
Juvenile thyrotoxicosis
Authors: PETER F. 
Published: October 2009

ABSTRACT
The incidence of juvenile thyrotoxicosis has not exceeded one case per 100,000 population per year in Hungary during the past decades. From more than 200 simultaneous determinations of serum thyroid hormones (T3, T4, FT4) it was concluded that increased FT4 concentrations are the most frequent findings in thyrotoxicosis, even when both or one of the other thyroid hormone concentrations (T3, T4) are normal,-TSH and prolactin responses to TRH were studied in 18 patients; TSH remained always undetectable whereas prolactin increased in half of the patients. A significant negative relationship was found between the prolactin response and the level of circulating thyroid hormone. Although the pituitary lactotrophin is controlled by thyroid hormones, thyrotrophin is more sensitive to thyroid hormone levels in juvenile thyrotoxicosis.-In 56 TRH tests during antithyroid drug therapy this test was not found to be useful in predicting the likelihood of long-term remission. - The low maintenance dose of antithyroid treatment (2.5-5.0 mg/day) without thyroid hormone addition seems to be a favourable mode of therapy in juvenile thyrotoxicosis.
The subcellular defects in the androgen insensitivity syndrome
Authors: SWOBODA W. , HERKNER K. 
Published: October 2009

ABSTRACT
The androgen insensitivity syndrome (AIS) was studied with consideration of the complexity of mechanisms involved on the intracellular level: testosterone (T) and dihydrotestosterone (DHT) receptors and the androgen-5α-reductase (A5R). Five children with "normal" female external genitalia (group A) and three patients with variable forms of ambiguity (group B), ages 1 to 18 years, were studied. Tissue specimens from genital skin were analysed for the Kd- and Nmaxvalues of the cytosolic and nuclear T- and DHT-receptors, as well as for the Km- and Vmax-data of the tissue specific A5R. The enzyme analyses were performed with a kinetic method.
Results show that patients from group A mainly lack action of the nuclear DHT receptor, combined with reduces binding capacity in the cytosol. T binding was poor in both, cytosolic and nuclear fractions, respectively. Results of group B proved to be more inhomogenous, ranging from total absence of a DHT receptor to normal binding capacities in the nuclear fractions, accompanied by decreased cytosolic Nmax values for that ligand. T binding was poor in all patients of group B in the cytosolic and nuclear fractions, respectively. A5R was qualitatively normal in all patients examined, except one, but decreased enzyme activities could be observed in a wide range. In summary, the study confirms the complex mechanisms, presenting as AIS clinically. Moreover a close relationship between abnormalities of androgen receptor function and changes in A5R activity could be evaluated, thus confirming the recent theories about intracellular androgen action.
The role of regulatory peptides in postnatal metabolic adaptation
Authors: Aynsley-Green A 
Published: October 2009

Abstract
Major changes occur after the umbilical cord is cut at birth in the structure and function of several physiological systems which enable the newborn baby to adapt from an intrauterine milieu of continuous intravenous nutrition via the placenta to a postnatal environment of intermittent enteral feeding with milk. The secretion of regulatory peptides from the gut and pancreas in response to enteral milk feeding may have a fundamental role in initiating and regulating the cascade of developmental changes needed for the utilization of food which occur after birth.
Urinary arginine-vasopressin (AVP) excretion in cystic fibrosis (CF)
Authors: Stegner H. , Caspers S. , Niggemann B. , Commentz J. 
Published: October 2009

Abstract
Free water handling is impaired in chronic obstructive lung disease (COLD). We studied the role of AVP in this mechanism with a sensitive urinary AVP radioimmunoassay (RIA) in 13 patients with CF. The mean age was 14.7 ± 1.27 SE years. The control group was age and sex matched. While the 24-hour urine volume was not significant different in both groups, urine osmolality was higher in CF (788 mosmol/kg ± 182 SE vs. 622 mosmol/kg ± 218 SE; p = 0.05).
The 24-hour urinary AVP excretion in CF patients was found to be significantly elevated (174 ng/day ± 99 SE vs. 74 ng/day ± 48 SE; p = 0.01). This difference becomes even greater if these values are corrected for body weight (4.4 ng/(kg × day) ± 2.1 SE vs. 1.5 ng/(kg × day) ± 0.9 SE; p = 0.005).
Lung function studies were available in 8 patients. We used a body plethysmograph to measure FEV1 (1 sec forced exspiratory volume) and MEF25 (forced exspiratory flow at 25% of vital capacity) as sensitive indices of airway obstruction. There was a significant negative correlation between urinary AVP excretion and MEF25 (r =.76) and FEV1 (r =.65): the more pronounced the airway obstruction the higher the AVP excretion. We conclude that AVP plays a major role in the impaired water handling in COLD. Increased AVP secretion is already present under clinically stable conditions and is dependent on the degree of airway obstruction. In treating those patients one has to be aware of the possibility of water intoxication.