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Biomedical subjects

D A Price

Publications and source records attributed to D A Price.

At least 217 records · Page 12Linked to original sources

Studies on the growth of the fetal guinea pig. Effects of reduction in uterine blood flow on the plasma sulphation-promoting activity and on the concentration of insulin-like growth factors-I and -II.

The effects of prenatal growth restriction caused by uterine artery ligation at midgestation has been studied in pregnant guinea pigs. Ligation of a uterine artery at day 30 of pregnancy commonly caused a reduction in fetal growth of greater than 45% by days 40-65 of gestation. This was associated with substantial delays in the development of a number of fetal tissues and in particular that of the skeleton which remained cartilagenous for longer than normal. Hence normally by day 50 of pregnancy clear evidence of epiphyseal ossification in the long bones of the fore- and hindlimbs was present, but in growth retarded fetuses of less than 50% of normal size such evidence was sparce. Delayed skeletal development and the slowing of fetal growth rate correlated well with marked depression of plasma sulphation-promoting activity. Indeed plasma from fetuses that were less than 40% of normal size inhibited sulphate incorporation into pig costal cartilage. This indicated the presence of inhibitory factors in the plasma of such fetuses, an interpretation that was re-inforced by the observation that plasma IGF-II concentrations were 2-4 times above normal. In contrast plasma IGF-I concentration was depressed upto 50% by growth retardation in line with the fall in fetal plasma insulin concentration. The changes in plasma sulphation-promoting activity and of IGF-I are consistent with slowing of DNA, RNA and protein synthesis and of gene expression in tissues of the growth-retarded fetus. The elevated fetal plasma IGF-II concentration provided further evidence that in the fetal guinea pig this hormone has a potentially glyconeogenic action and maintains essential glycogen stores.

Animals↗

Somatomedin C deficiency in Asian sisters.

Two sisters of Asian origin showed typical clinical and biochemical features of primary somatomedin C (SM-C) deficiency (Laron dwarfism). Abnormalities of SM-C binding proteins were observed, one sister lacking the high molecular weight (150 Kd) protein.

Carrier Proteins↗

Emotional difficulties in diabetes mellitus.

Sixty children and adolescents with diabetes aged between 9 and 18 years were investigated for emotional difficulties in association with their diabetic control. Seventeen (28%) had appreciable emotional or behavioural difficulties according to parental report, and seven (12%) considered themselves 'possibly depressed'. These latter patients had a mean glycosylated haemoglobin concentration below 10%, poorer self esteem, and a greater external locus of control. Three were considered not to have pronounced emotional difficulties according to parental report.

Adolescent↗

Cross-phyletic bioactivity of arthropod neurohormones and molluscan ganglion extracts: evidence of an extended peptide family.

Two structurally related arthropod neuropeptides, red pigment concentrating hormone (RPCH) and adipokinetic hormone (AKH), are potent excitors of the heart of the clam Mercenaria mercenaria. The response is bimodal: whereas the threshold for affected hearts is 1-3 X 10(-9) M, about 40% of the preparations are virtually unresponsive. Aqueous extracts of Mercenaria ganglia contain a substance which concentrates the red pigment in the erythrophores of intact destalked Uca pugilator and even of its isolated legs. This substance is retained on Sephadex G-15 and co-elutes with synthetic shrimp RPCH. The active fractions also concentrate the erythrophores and the leucophores of destalked shrimp (Penaeus). Neither dopamine nor the molluscan neuropeptide FMRFamide had any chromatophorotropic effect in these assays. The activity of the ganglion extracts was abolished by digestion with chymotrypsin. In conclusion, molluscan ganglion extracts contain a peptide factor, possibly an analog of RPCH, that concentrates the pigments of crustacean chromatophores by a direct action on the cells.

Animals↗

Renal function in diabetes mellitus.

Glomerular filtration rate, day and night-time albumin excretion, and blood pressure were estimated in 83 children with diabetes mellitus and compared with measures of glycaemic control, age, and duration of disease. Careful attention was paid to definition of normal values in age matched controls. The glomerular filtration rate was greater than normal, and correlated with duration of disease, but not with albumin excretion or blood pressure. Daytime albumin excretion correlated with duration of disease and glycosylated haemoglobin, but not with age, glomerular filtration rate, or blood pressure. Night-time albumin excretion was significantly raised and correlated with duration of disease, glycosylated haemoglobin, mean blood sugar concentration, and M value but not with age, glomerular filtration rate, or blood pressure. Diastolic blood pressure was significantly raised but was not correlated with any other measured variable. We have confirmed abnormalities of renal function in a children's diabetic clinic. The measurement of overnight albumin excretion rates may provide a sensitive early indicator of renal damage.

Adolescent↗

Steroid biochemistry of virilising adrenal tumours in childhood.

Steroid excretion in urine of 12 infants with virilising adrenal tumours has been determined using gas chromatography. In six children, (Group A, five female, one male) aged 2.8-5.3 years, very high urinary excretions of 17 oxosteroids (greater than 40 mumol/24 h) were largely accounted for by dehydroepiandrosterone (DHA). In one of the girls, the pattern of steroids excreted in urine was similar to that of newborn infants, with high excretions of 16-oxygenated derivatives of DHA. The histology of this tumour suggested a neoplasia of fetal-type adrenocortical cells. Very large tumours were found in three of the infants, two of whom have died and one has multiple metastases. From the other three children, small, well-encapsulated adenomas were successfully removed. Six children (Group B), had moderately elevated 17-oxosteroid excretions (8-17 mumol/24 h). In five of these cases (four female, one male) aged 0.8-5 years, 11 beta-hydroxyandrosterone was a consistently prominent urinary steroid. In one boy, aged 7.7 years, 17-oxosteroid excretion was 15 mumol/24 h and the major steroids in urine were metabolites of pregnenolone. These six children have survived with no clinical evidence of recurrent tumour. The in vivo functional activities of the tumours can be deduced from the different profiles of steroids in urine. These have revealed heterogeneous patterns of steroid biosynthesis.

17-Ketosteroids↗

Plasma somatomedin activity after injury in man and its relationship to other hormonal and metabolic changes.

Plasma somatomedin activity was measured in 12 patients who had sustained non-fatal musculo-skeletal injuries. It was depressed for 2-3 d after injury, but this depression bore no relationship to the catabolic response to injury which, as judged by urinary nitrogen excretion, was maximal at about one week. The depression of somatomedin activity may have been related to the high plasma cortisol concentrations observed during the first few days after injury. Plasma growth hormone concentrations were high acutely after injury but rapidly returned to normal. The changes in plasma somatomedin activity were thus unrelated to those in growth hormone, but were very similar to those in plasma insulin concentrations. A marked positive relationship was observed between plasma insulin concentrations and urinary nitrogen excretion, indicating unresponsiveness of protein metabolism to the normal anabolic effects of insulin. The study showed, however, that this was not as a result of low somatomedin activity.

Adolescent↗

Gonadotrophin responses to GnRH in precocious puberty treated with GnRH analogue.

The gonadotrophin releasing hormone analogue Buserelin was given by intranasal spray to 13 children with precocious puberty. The LH responses to GnRH reverted to prepubertal levels in the boys on 200-400 micrograms daily of the analogue while doses of 400-1200 micrograms daily were needed to suppress the girls. The significance of this apparent sex difference is uncertain.

Buserelin↗

Short stature caused by obstructive apnoea during sleep.

A 5 year old girl presented to a growth clinic with short stature. Obstructive sleep apnoea was diagnosed. After tonsillectomy her symptoms were alleviated and her rate of growth increased from 4.0 cm/year to 13.6 cm/year.

Body Height↗

Subcutaneous emphysema: a new form of self abuse.

Subcutaneous emphysema is usually the result of trauma or surgery. We report an unusual case of a disturbed adolescent who presented with cervicofacial emphysema as a result of self abuse.

Adolescent↗

Continuous subcutaneous insulin infusion in diabetes mellitus. A year's prospective trial.

Thirteen children aged between 8 and 16 years were entered into a 12 month prospective trial comparing continuous subcutaneous insulin infusion with intensified conventional treatment. Two of seven children on insulin infusion withdrew after eight and nine weeks, and three of six children on conventional treatment withdrew after four to eight weeks. Withdrawals in both groups were related to dissatisfaction with the techniques. The group on insulin infusion treatment achieved a mean plasma glucose of 9.8 mmol/l (176.4 mg/100 ml), a median M value of 50 mmol/l (900 mg/100 ml) and a mean glycosylated haemoglobin of 9.1% during the year. This represents a significant improvement compared with the previous values, and also when compared with the conventional treatment group whose trial values of a mean plasma glucose of 15.5 mmol/l (279 mg/100 ml), median M value of 167 mmol/l (3006 mg/100 ml), and glycosylated haemoglobin of 10.4% were not significantly different from those before the trial. Two children on insulin infusion developed subcutaneous abscesses in the early months. There was an increased incidence of diabetic ketoacidosis in this group, but no difference in the incidence of serious hypoglycaemia between the two groups. The children reported improved well-being when using insulin infusion and continued with the technique after the trial finished. Insulin infusion offers an acceptable means of improving glycaemic control for some diabetic children.

Adolescent↗

Objective structured clinical examination compared with other forms of student assessment.

Two hundred and twenty nine final year medical students were assessed in paediatrics using an objective structured clinical examination (OSCE) and a traditional viva voce examination, and the results were compared with other assessments of the students made during and at the end of the undergraduate course. Results of the OSCE correlated positively with other forms of assessment and more strongly than the viva voce examination. There was little correlation between the OSCE and viva results. Eighty per cent of students felt the OSCE to be a fairer system than other examinations and all external examiners commented favourably on it. An OSCE is an acceptable alternative to traditional means of examination in paediatrics and may be superior in certain aspects.

Education, Medical, Undergraduate↗

Urinary albumin excretion in school children.

Concentrations of albumin were measured by an enzyme linked immunoassay in 24 hour urine collections (divided into day and night-time samples) from 183 boys and 191 girls aged 4 to 16 years. The 24 hour albumin excretion rate and day and night-time albumin excretion rates all increased with age in both girls and boys. Albumin excretion during the day exceeded that at night in both girls and boys. Albumin excretion rates were higher in girls than boys during the day but there was no significant difference at night-time. The urinary albumin creatinine ratio showed no change with age, but was greater in girls than boys during the day and at night, and was also greater during the day than at night in both sexes. Graphs of normal values of albumin excretion rates and albumin creatinine ratios are provided.

Adolescent↗