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Biomedical subjects

H E Harrison

Publications and source records attributed to H E Harrison.

18 recordsLinked to original sources

Growth hormone therapy in a poorly growing child with hypophosphatemic rickets.

We treated a 10 6/12 year old prepubertal male with hypophosphatemic rickets, who was growing poorly despite appropriate treatment with calcitriol and phosphate, with exogenous growth hormone (for an initial trial period of 4 months, followed by 14 months of continuous treatment at a dose of 4 IU three times weekly) even though his growth hormone testing proved to be normal. His growth rate increased significantly during treatment with synthetic growth hormone (from a basal rate of 3.9 cm/yr to 9 cm/yr during the first 4 months of therapy and from 2.7 cm/yr to 6.0 cm/yr during next 14 months of treatment) and his predicted adult height increased as well. Slight metabolic changes were detected in this patient during treatment, with an increase in serum phosphorus and a decrease in twenty-four hour urine calcium concentrations. It would seem reasonable to evaluate the growth hormone status of children with hypophosphatemic rickets who are growing poorly despite appropriate therapy with calcitriol and phosphate and to consider a trial period of therapy with growth hormone in some of them.

Body Height

Transfer from animal insulins to semisynthetic human insulin: a study in four centres.

The effects of transfer from animal insulin to semisynthetic human insulin on glycaemic control, insulin dose and anti-insulin antibodies were investigated in a total of 108 patients at four centres in a double-blind controlled study of eight months duration. Six months after transfer from porcine to human insulin there was a mean (+/- SE) increase in pre-breakfast blood glucose of 1.1 +/- 0.6 mmol l-1 (vs a reduction of 1.6 +/- 0.7 mmol l-1 in controls) (p less than 0.01), and a mean increase of pre-lunch blood glucose of 0.9 +/- 0.7 mmol l-1 (vs a reduction of 1.14 +/- 0.7 mmol l-1 in controls) (p less than 0.05). Six months after transfer from bovine to human insulin, there were no significant changes in blood glucose. Glycated haemoglobin showed no significant change six months after transfer from either bovine or porcine to human insulin. Hypoglycaemic symptoms, the total daily insulin dose, and the ratio of short- to intermediate-acting insulin did not change significantly after transfer from either bovine or porcine to human insulin. Transfer from bovine to human insulin resulted in a significant decline in anti-human insulin antibodies (mean (range): 50.5(14.8-125)% of initial levels), vs controls (113(43.4-234)% of initial levels; p = 0.034), and a non-significant decline in anti-bovine insulin antibodies (52.2(25.8-111)% vs 81.7(42.5-128)%; p = 0.082).

Adult

Recent advances in calcium metabolism. I. Mechanisms of calcium homeostasis.

Within recent years newly acquired knowledge has provided a clearer understanding of some aspects of the complex mechanisms that collectively maintain calcium homeostasis within body fluids and it is our intent to define current concepts of the interrelationship of these various factors to the end that fuller understanding may be available concerning the maintenance of calcuim homeostasis in health as well as features which result in its disruption and the consequent effects of imbalances of calcium in various disease states. In this first section dealing with the physiologic state, there are included descriptions of: (1) the metabolism of vitamin D, the synthesis of its active metabolites, 25 OHD3 and1.25(OH)2D3, and the metabolic actions of the active vitamin D metabolite and analogues upon gastrointestinal, bone, and kidney functions; (2) the synthesis, secretion, and metabolic activity of parathyroid hormone and the difficulties with the radioimmunoassay of PTH related to the number of PTH-like peptides in the circulation; and (3) the chemistry, metabolism, and biologic activities of calcitonin, a hypocalcemic principle derived from the parafollicular cells of the thyroid gland. It is emphasized that under normal circumstances these humoral mechanisms act in an integrated manner to maintain serum concentrations of total and ionized calcium within narrowly defined limits.

Adolescent

Recent advances in calcium metabolism. II. Disorders of calcium homeostasis.

Abnormalities of calcium and mineral metabolism are described in relation to the differential diagnosis, clinical characteristics, diagnostic procedures, and treatment of infants and children with hypocalcemia, hypercalcemia, rickets, chronic renal insufficiency, and other disorders of calcium metabolism. Understanding of the basic pathogenesis of each abnormality of calcium homeostasis is essential for the rational management of affected patients.

Adolescent

Rickets.

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Animals

Fanconi syndrome following bowel surgery and hepatitis reversed by 25-hydroxycholecalciferol.

A permature male infant required intravenous alimentation for six weeks following extensive surgery for ileal and cecal necrosis. At 3 months he developed evidence of hepatitis. Subsequently osteoporosis and the Fanconi syndrome appeared. Urine phosphate clearance was 83 percent of creatinine clearance at a serum phosphate concentration of 1.6 mg/dl. Concentration of plasma immunoreactive parathyroid hormone was elevated at 550 pg/ml. 25-Hydroxycholecalciferol was given at 240 mug/day. Aminoaciduria disappeared and bone healing occurred. Serum phosphate rose to 6.5 mg/dl and phosphate clearance fell to 2 percent of creatinine clearance. Upon cessation of 25-OHCC therapy, the Fanconi syndrome recurred despite administration of vitamin D2. 25-OHCC was then administered at 40 mug/day, and the urine abnormalities were reversed. The patient probably developed hyperparathyroidism, secondary malabsorption, and hepatitis. The Fanconi syndrome was the consequence of the hyperparathyroidism. 25-OHCC therapy was more effective than vitamin D in reversing the disordered state, possibly because of impaired hepatic metabolism of vitamin D2.

Cecal Diseases

Aldose reductase in the etiology of diabetic complications: 2. Nephropathy.

The progression of diabetic nephropathy can be arrested by an improvement in diabetic control. High glucose concentrations increase the flux through the aldose reductase pathway, and it has been proposed that this may contribute to renal damage. Aldose reductase is present in both the glomerulus and the renal tubule. Biochemical changes associated with increased sorbitol production have been demonstrated in animal models, including myo-inositol depletion, reduced Na+-K+ ATPase activity, and activation of the pentose phosphate and glucuronate-xylose pathways. Selective inhibition of aldose reductase reverses these biochemical changes and prevents some of the structural and functional abnormalities in diabetic rats. The potential beneficial effects of aldose reductase inhibitors on diabetic kidney disease in man are at present being investigated.

Aldehyde Reductase