Oestradiol increases baseline growth hormone levels in the male rat: possible direct action on the pituitary*

The effect of oestradiol treatment on the secretion of growth hormone (GH) was investigated in normal unrestrained male rats with chronic i. v. cannulae and in hypophysectomized male rats with autotransplanted pituitaries. The effect of gonadectomy of normal rats on the plasma GH secretory pattern was also evaluated. Baseline plasma GH levels were elevated following estradiol treatment of normal male rats (1.5 mg kg^-1 per 15 days). Gonadectomy of male rats also resulted in increased baseline GH levels, although the effect was less apparent than after oestradiol administration. The pulse height was not influenced by gonadectomy or oestradiol administration. In male rats with the pituitary autotransplanted to the kidney capsule, oestradiol caused a dose-dependent increase in plasma GH levels, while there was no such effect of testosterone. These results suggest that the stimulatory influence of oestradiol on baseline GH levels is, at least partly, due to a direct effect on the pituitary. Plasma prolactin levels were elevated in rats with pituitary transplants receiving oestradiol. It is concluded that oestrogen administration to normal male rats increases baseline plasma GH levels, possibly by an effect exerted directly at the pituitary level.     

Dyspnoea in a cross-sectional and a longitudinal study of middle-aged men: The Study of Men Born in 1913 and 1923

In a longitudinal population study, 855 men, born in 1913 andinitially examined when 50 years old, were followed for 17 yearswith measurements of dyspnoea and other variables performedat ages 50, 54, and 67 years. In addition a sample of 226 menborn in 1923 was followed from 50 to 57 years of age. At thelatest examination, four different methods for measuring dyspnoeawere used, one based on questionnaire, one on interview, andtwo on visual analogue scales. The estimates from these methodswere highly intercorrelated, and correlated with measures ofcardiopulmonary function as well. The prevalence of dyspnoeagrade 2 (shortness of breath when walking with someone of thesame age on the level) or more, not counting the mildest formof dyspnoea in these populations, was 2.8%, 3.0%, 5.2% and 10.3%at 50, 54, 57 and 67 years of age, respectively. Dyspnoea gradel (shortness of breath when walking quickly on the level oruphill) was less well related to age. A scoring system to differentiatevarious possible causes of dyspnoea was applied. About one thirdof the dyspnoeic men had signs and symptoms of cardiac disease,one quarter had pulmonary disease, and a quarter had a combinationof both causes. The remaining 20% had no signs or symptoms indicatingcardiopulmonary disease but in the majority of the cases otherplausible causes were found.     

USE OF POST-TETANIC COUNT IN ASSESSMENT OF A REPETITIVE VECURONIUM-INDUCED NEUROMUSCULAR BLOCK

In order to evaluate the use of the post-tetanic count (PTC)method during repetitive administration of vecuronium, we studied20 patients allocated randomly to one of two groups: 10 patientsreceived droperidol-fentanyl anaesthesia (control group); 10other patients were given droperidol-fentanyl anaesthesia modifiedsubsequently by addition of 0.5% isoflurane (isoflurane group).Before tracheal intubation, a bolus dose of vecuronium 0.08mg kg^–1 was given i. v. followed by repeated doses of0.03 mg kg^–1. The twitch response of adductor polliciswas recorded after supramaximal stimulation of the ulnar nerveat the wrist using a Myograph 2000 neuromuscular transmissionanalyser. In the control group, a close correlation was foundbetween PTC and time to first reaction to train-of-four (TOF)nerve stimulation. This relationship was unchanged when comparingthe bolus dose and each of eight consecutive maintenance doses.Further, the degree and the duration of intense block were unchangedafter each of the eight maintenance doses. In the isofluranegroup, the relationship between PTC and time to first reactionto TOF stimulation remained unchanged after addition of isoflurane.However, isoflurane caused a significant prolongation of theduration of intense block and a corresponding lower PTC in allpatients. We conclude that PTC is a reliable method to evaluateintense neuromuscular block caused by vecuronium, even afterrepetitive administration of the drug and in combination with0.5% isoflurane. Presented in part at the annual meeting of the American Societyof Anesthesiologists, San Francisco, October 1988.     

Oral health programme for preschool children: a prospective, controlled study

Background.  New perspectives are needed for oral health programmes (OHPs). The aim was to evaluate the preventive effect of a risk-based OHP in comparison with a traditional programme.
Design.  An age cohort of 794 Finnish children, 446 in the intervention group and 348 in the control group, was followed from 18 months to 5 years of age. The children were screened for mutans streptococci (MS) in the dental biofilm. The main outcome measure was the proportion of children with dental caries (decayed, missing, or filled primary teeth > 0) at the age of 5 years. The intervention, targeted to MS-positive subjects in the intervention group only, was based on repeated health education to the caretakers and xylitol lozenges for the child. Dental hygienists carried out the programme.
Results.  OHP was effective in white-collar families [numbers needed to treat (NNT) = 3, 95% CI 2–11]. Factors significantly associated with caries at 5 years were MS colonization at 18 months, occupation of caretaker, but also gender when incipient carious lesions were included in the index.
Conclusion.  Early risk-based OHP, targeted to the families of MS-positive children, can reduce the risk for caries in white-collar families. For blue-collar families, different kinds of methods in caries prevention and support are needed.     

SEVERE NEONATAL ASPHYXIA

ABSTRACT. In Sweden during the 1970's the incidence of severe asphyxia (an Apgar score of 3 or less at 5 min) has decreased significantly from 3.22 to 2.56 per 1000 infants. A follow-up study was undertaken concerning 116 infants (40 preterm, 76 full-term) admitted to St. Göran's Children's Hospital during a 7-year period (1973–79). The mortality rate was 48% in preterm and 21% in full-term infants. Significant sequelae were present in 27% of the surviving full-term and 14% of the preterm infants. The three severely-handicapped preterm infants had other serious diseases as well whereas this applied to only one full-term infant. The predictors of sequelae included perinatal complications, late onset of spontaneous ventilation (>20 min) and postnatal symptoms, such as seizures. Only two of 9 infants with regular breathing after 20 min and three of 16 infants with seizures were considered normal at follow-up.     

Tumour-induced hypoglycaemia in a patient with insulin-dependent diabetes mellitus

We report on a case of malignant insulinoma occurring in a patient with genuine insulin-dependent diabetes mellitus (IDDM). A review of cases concerning patients with diabetes mellitus and insulinomas is presented, and reveals only patients with non-insulin-dependent diabetes mellitus (NIDDM). Our case appears to be the first in showing the combination of IDDM and a functioning malignant insulinoma.