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31.
Forty-two GH deficient patients (14 isolated GH deficiency (IGHD), 28 multiple pituitary hormone deficiencies (MPHD), 23 males and 19 females) were evaluated after termination of hGH therapy and achievement of final height. IGHD patients were found to score higher in intelligence quotients (IQ) than the MPHD patients. The educational and occupational achievements of all patients positively correlated with their IQ level. Three patients achieved only elementary education, 26 completed high school and 13 had higher education. Thirty patients who had completed their education were employed, whereas 12 continued to study. Seventeen of the male patients and five females served in the Army. Eight patients were married and half of the single patients reported having a stable relationship with the opposite sex. The hypopituitary patients did not differ in five out of seven subscales of the human services rehabilitation scale when compared to a normal control group. These results which vary from those previously reported demonstrate the importance of long-term psychosocial counselling initiated at the time of diagnosis as part of the therapeutic approach in hypopituitary patients.  相似文献   
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AIM: Dismembered pyeloplasty is the treatment of choice for significant ureteropelvic junction obstruction in children. In the present study, we review our experience in 103 pediatric patients and present the clinical characteristics, the surgical treatment and its complications and the long term results. METHODS: We have reviewed the medical charts of 103 consecutive patients who underwent dismembered pyeloplasty in a 5-year period, from 1997 to 2002. Preoperative data, short- and long-term complications and outcome were recorded. Imaging studies included urinary tract sonography and dynamic renal scans, the results of which were compared pre- and postoperatively. RESULTS: Most of our patients were boys (81%), diagnosed prenatally (78%). We had no major complications and acceptable incidence of minor complications. Postoperative outcome was excellent, with decreased hydronephrosis (81%), improved renal drainage (87%) and preserved or improved renal function (89%). CONCLUSION: Dismembered pyeloplasty can be performed with a low incidence of minor complications, no major complications and excellent long-term outcome.  相似文献   
34.
The stimulation of growth hormone release in children by L-dopa has been studied. An oral dose of 0.5 g L-dopa was administered to fourteen children with, and to fifteen children without, hypothalamic-pituitary insufficiency. In the control group, L-dopa induced a release of pituitary growth hormone, the peak of which occurred from 30 to 60 min after ingestion. Nine out of fifteen control subjects showed peak levels of plasma growth hormone greater than 8 ng/ml. None of the patients with hypothalamic-pituitary insufficiency showed levels greater than 5 ng/ml. In five out of six children with measurable amounts of plasma HGH, and in fourteen children with a lack of HGH, there was a good correlation between the HGH response after L-dopa, insulin hypoglycaemia and arginine infusion. It is concluded that the administration of one oral dose of L-dopa can be used as a provocative test of growth hormone secretion.  相似文献   
35.
Substance P content was determined by radioimmunoassay in colonic mucosa from 24 patients with chronic severe constipation, 16 with active ulcerative colitis, and 28 normal controls. In patients with chronic severe constipation, the mean concentration of substance P (19.9±8.2 pg/mg) was significantly lower than in normal subjects (71±18 pg/mg). In patients with ulcerative colitis, colonic substance P concentration in inflamed mucosa (170±46 pg/mg) was significantly higher than its levels in normal subjects. Substance P may therefore have a role in the pathogenesis of clinical conditions associated with diarrhea and constipation.  相似文献   
36.
Basal fasting values of plasma C-peptide (CP), plasma insulin and 24 h urine CP were determined in 224 normal non-obese subjects of both sexes ranging in age from 1 to 20 years. Analysis of the results by age, pubertal rating, sex and bone age (BA) during childhood showed that mean +/- SD plasma CP levels in both sexes rose from 0.07 +/- 0.08 pmol/ml at the age of 1-2 years to 0.21 +/- 0.11 pmol/ml at 8-10 years. Mean +/- SD plasma insulin levels in both sexes rose from 3.2 +/- 4.3 microU/ml at the age of 1-2 years to 5.9 +/- 4.5 microU/ml at 8-10 years. Mean +/- SD urine CP levels rose from 6.5 +/- 2.8 pmol/mg creatinine per 24 h at the age of 2-8 years to 7.7 +/- 3.5 pmol/mg creatinine per 24 h at 8-11 years in both sexes. During puberty, plasma and urine CP and plasma insulin levels rose further to peak at pubertal stage P3, the values in females being higher (CP = 0.32 +/- 0.06 pmol/ml) than those in males (CP = 0.22 +/- 0.06 pmol/ml) (P less than 0.005). Plasma insulin levels in females were 13.2 +/- 6.9 microU/ml and 6.4 +/- 3.1 microU/ml in males (P less than 0.05). Urine CP levels were 14.5 +/- 5.7 pmol/mg creatinine per 24 h and 10.8 +/- 5.4 pmol/mg creatinine per 24 h in females and males respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   
37.
Abstract. Pertzelan, A., Adler-Bier, M., Kauli, R., Josefsberg, Z., Grunebaum, M., Horodniceanu, Ch. and Laron, Z. (Institute of Pediatric and Adolescent Endocrinology and Pediatric Radiology Unit, Beilinson Medical Center, Petah Tikva, and Sackler School of Medicine, Tel Aviv University, Israel). Linear growth in hypopituitary patients treated with hGH after age 15. Paediatr Scand, Suppl. 277: 69, 1979. Two groups of hHG deficient adolescents (isolated growth hormone deficinecy: 11 patients and multiple pituitary hormone deficiency: 20 patients) receiving hGH therapy were analyzed for their linear growth response. It was found that even at a chronological age of 15 years or more, growth can be markedly enhanced, depending upon the bone age and pubertal stage in the IGHD patients and upon optimal balance between hGH and sex hormones in the MPHD patients.  相似文献   
38.
During treatment of girls with oestrogen deficiency we observed different patterns of breast development in response to therapy. The forty-five girls studied fell into four groups: Group A, gonadal dysgenesis; Group B, isolated gonadotrophin deficiency; Group C, multiple pituitary hormone deficiencies; Group D, congenital adrenal hyperplasia (17-alpha-hydroxylase deficiency). Treatment with oestrogen was given in an identical manner to all. In the patients with gonadal dysgenesis, in whom the hypothalamic-pituitary function was normal, treatment led to full breast development. In isolated gonadotrophin deficiency and multiple pituitary hormone deficiency breast development was incomplete even after 3 years or more of oestrogen treatment. The conspicuous difference in the hormonal status is that the latter two groups lack gonadotrophins, while in gonadal dysgenesis these hormones are grossly elevated. Our conclusion is that gonadotrophins play an important role in mammary gland development, a finding not previously described. In the girl with 17-alpha-hydroxylase deficiency we observed that cortisol was necessary, in addition to sex hormones, for normal breast development.  相似文献   
39.
ABSTRACT. Data obtained during long-term follow-up of 68 girls with premature thelarche were analysed. In 85 % onset was before the age of 2 years, in 30.8 % being present at birth. In 44.1 % there was a regression after 32/12±28/12 12years (SD). Basal levels of plasma FSH and response to LH-RH were significantly higher than prepubertal controls (1.93± 1.56 vs. 0.8±0.1 mU/ml and peaks 12.3±5.4 vs. 7.9±1.0 mU/ml respectively; p <0.001). Twenty-seven of 52 patients tested had increased plasma estradiol and in 27 of 40 patients tested, urocytograms or vaginal smear showed estrogenization. Basal levels of LH and response to LH-RH were prepubertal. The girls with premature thelarche were significantly taller than normal controls of the same age ( p <0.001). These results suggest that premature thelarche is an incomplete form of precocious sexual development probably due to derangement in the maturation of the hypothalamo-pituitary-gonadal axis which results in a higher than normal secretion of FSH, as well as a defect in the peripheral sensitivity to the sex hormones.  相似文献   
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