Growth hormone treatment of short stature. State-of-the-art 1989.
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Adult↗
Biomedical subjects
K Hall
Publications and source records attributed to K Hall.
Depression, hopelessness, and suicidal behavior in Chinese and American psychiatric patients.
The authors compared 37 patients in the People's Republic of China and 46 patients in the United States who were having difficulty with suicidal thinking or behavior. Hopelessness, reasons for living, and suicidal efficacy showed none of the expected relationships with suicidal intent among the Chinese patients, but the two groups were similar on many variables theoretically related to suicidality. Chinese patients were less likely to communicate suicidal intent and rated suicide as less effective at solving problems. The authors examine such variations in the light of possibly different cultural approaches to suicidal behavior.
Adult↗
The effects of altered nutritional status upon insulin-like growth factors and their binding proteins in neonatal rats.
To investigate the role of nutrition in the regulation of IGFs during the perinatal period, 10-d-old rats were infused intravenously with various concentrations of nutrients for 24 h. Breast-fed litter mates served as controls. The effect of caloric intake on concentrations of IGF-I and IGF-II as well as IGF-binding proteins in serum, liver, and brain of neonatal rats was studied. A total of 45 rats from 10 litters was infused with solutions ranging from a caloric intake of 0 (saline) to 75% (glucose, amino acids, and lipids) of the estimated intake of control rats. In serum, both IGF-I and -II concentrations fell markedly in response to fasting. Serum IGF-II levels were linearly related to caloric intake in the pooled data from all groups. Concentrations of IGF-II, but not IGF-I, in liver and brain were depressed by caloric restriction. In contrast to the fall in IGF concentrations, activity of IGF-associated binding proteins rose in serum and in liver cytosol 2- to 4-fold in response to decreased nutrient intake. In serum, but not liver, the rise in binding protein activity was inversely related to to caloric intake. In liver, cytosol, but not serum, the rise in binding protein activity was inversely related to total serum amino acid concentration. Thus, IGF concentrations in preweanling rats change in response to alterations of nutrient intake. The fasting induced decrements in IGF levels, as well as the elevations in IGF-associated binding protein activity, may serve as a protective mechanism to depress growth in times of caloric restriction.
Animals↗
The role of computed tomography and coronal plane tomography in radiotherapy for laryngeal cancers.
The results of a study undertaken prospectively in 1983 and 1984 to assess the value of computed tomography (CT) and conventional tomography in the planning of radiotherapy for laryngeal cancer are presented. Of 32 cases treated in 1983, 23 had both CT scans and coronal plane tomography prior to radiotherapy. At the end of 1983 these radiographs were reviewed and an assessment made of their value in treatment planning. As a result of this review it was decided that cancers of the larynx confined to the vocal cords should routinely have conventional coronal plane tomograms rather than CT scans. All other cases were to have CT scans and not tomograms. The results of following this policy in 1984 confirm that it is effective. There was no detriment to patients with early vocal cord cancers in performing coronal plane tomograms rather than CT scans. The survival at 24 months of both cohorts was 93%. In the more invasive cancers of the larynx, greater information about the extent of the disease was obtained using CT scans, and improved treatment plans resulted. When compared with a historical group, there appears to be an advantage for local control, 27.3% of the study group suffering local recurrence as opposed to 53.6% of the historical group.
Follow-Up Studies↗
Lack of diurnal rhythm of low molecular weight insulin-like growth factor binding protein in patients with Cushing's disease.
A specific radioimmunoassay with antibodies raised against the 25 kD insulin-like growth factor binding protein (25 kD IGFBP) in amniotic fluid was used to measure levels of cross-reacting protein in human serum and plasma. Plasma samples collected continually at 20-min intervals during 24-h in 6 healthy adults revealed a distinct diurnal rhythm in the concentration of 25 kD IGFBP. The lowest levels (9-13 micrograms/l) were found between 13.00 and 24.00 h with a rise after midnight to maximum levels (23-71 micrograms/l) between 03.00 and 09.00 h. There was no relation between the patterns of GH and 25 kD IGFBP. In 3 patients with active Cushing's disease, the levels of 25 kD IGFBP in plasma samples collected during 12 h, 19.00-07.00 h, were generally low and without nocturnal variations. One of the patients studied after extirpation of a pituitary adenoma displayed a nocturnal rhythm with maximum levels of 25 kD IGFBP between 03.00 and 07.00 h. Eight patients treated with stereotactic pituitary irradiation owing to Cushing's disease also showed a distinct nocturnal increase of 25 kD IGFBP. The results indicate the existence of a diurnal rhythm of 25 kD IGFBP in adults. Further, low levels and lack of diurnal rhythm of 25 kD IGFBP are demonstrated in Cushing's disease.
Adult↗
On the nomenclature of the IGF binding proteins.
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Animals↗
Clinical evaluation of a desktop robotic assistant.
A desktop vocational assistant robotic workstation was evaluated by 24 high-level quadriplegics from the Palo Alto Veterans Affairs Spinal Cord Injury Center. The system is capable of performing daily living and vocational activities for individuals with high-level quadriplegia via voice control. Subjects were asked to use the robot to perform a repertoire of daily living activities, including preparing a meal and feeding themselves, washing their face, shaving, and brushing teeth. Pre- and post-test questionnaires, interviews, and observer assessments were conducted to determine the quality of the robot performance and the reaction of the disabled users toward this technology. Results of the evaluations were generally positive and demonstrated the usefulness of this technology in assisting high-level quadriplegics to perform daily activities and to gain a modicum of independence and privacy in their lives.
Activities of Daily Living↗
Intravenous methylprednisolone in the treatment of Graves' ophthalmopathy.
Eleven euthyroid patients with severe Graves' eye disease were treated with intravenous methylprednisolone and followed up for six months or more by ophthalmological assessment, orbital computed tomography (CT), photographs, and antibody measurements. Papilloedema resolved in the single patient in whom it was present; visual acuity was abnormal in seven eyes initially and in only one eye after treatment; the intraocular pressure differential, which reflects muscle dysfunction, was initially abnormal in 18 eyes but showed a progressive and distinct improvement; nine patients showed substantial improvement in inflammatory signs. Exophthalmos improved early after treatment, but this improvement was not maintained. Orbital CT showed a pronounced reduction in the bulk of eye muscles after treatment in eight of nine patients. Autoantibodies to the thyroid stimulating hormone receptor declined. Adverse effects were trivial. Thus eight patients showed a clear response to intravenous methylprednisolone as judged by ophthalmic assessment and CT scan. The two patients who showed little response and one who had none all had a long history (more than a year) of ophthalmopathy. Results were better than those with oral steroids and adverse effects less. Treatment of Graves' eye disease is more likely to be effective if given early; patients should be referred promptly to specialist centres, where treatment with intravenous methylprednisolone should be considered.
Adult↗
Oxygen-17 nuclear magnetic resonance spectroscopic studies of carbonmonoxyperoxidases.
We have obtained oxygen-17 (17O) nuclear magnetic resonance (NMR) spectra of C17O ligands bound to ferrous horseradish peroxidase isozyme A, isozyme C, and ferrous chloroperoxidase, as a function of pH. Our results show that the peroxidases exist in two distinct states, the acidic and alkaline forms, which undergo reversible acid-base-induced transitions characterized by a single pK value. The two forms are characterized spectroscopically in much the same way in all three proteins, suggesting a similar structural origin for the transition process. In particular, the 17O NMR signal of the acidic form is approximately 7 ppm more shielded than that of the alkaline form, and the CO ligand in the acidic form appears to have a smaller 17O nuclear quadrupole coupling constant than that of the alkaline form. We have also obtained the pK values and exchange rates for all three peroxidases. The results indicate that a similar structural change may be involved in the transition process in all three peroxidases.
Carbon Monoxide↗
Characterization of a new glucose-6-phosphate dehydrogenase variant: G6PD Central City.
Glucose-6-phosphate-dehydrogenase deficiency is the most common disease-producing enzyme deficiency in man. This paper describes a new glucose-6-phosphate-dehydrogenase variant discovered during the evaluation of an episode of acute hemolytic anemia in a 62-year-old black male, which was temporally related to the ingestion of Tolbutamide. The hemolysis resolved within 10 days despite continuation of Tolbutamide. The erythrocyte glucose-6-phosphate-dehydrogenase activity was significantly decreased, and its electrophoretic mobility was indistinguishable from wild type enzyme, though faster on starch gel with tris, borate, and phosphate buffers. The enzyme had a biphasic pH optimum reduced Km for G-6-P and NADP, decreased utilization of deamino-NADP, and reduced Ki for NADPH. Because the kinetic properties of this enzyme were unique, we have designated it as G6PD Central City.
Alabama↗
G6PD Viangchan: a new glucose 6-phosphate dehydrogenase variant from Laos.
We describe a previously unreported glucose-6-phosphate dehydrogenase-(G6PD) variant. G6PD Viangchan was found in a Laotian immigrant to Calgary, Canada, and was characterized by severe enzyme deficiency, normal electrophoretic mobility, increased pH optimum, and abnormal kinetics for the natural substrates G6PD and NADP, as well as the artificial substrates 2-deoxy G6PD and deamino NADP. The inhibition constant for NADPH was decreased. The subject has no evidence suggesting chronic or episodic hemolysis.
Child↗
G6PD Huntsville: a new glucose-6-phosphate dehydrogenase associated with chronic hemolytic anemia.
We describe a previously unreported glucose-6-phosphate dehydrogenase (G6PD) variant. G6PD Huntsville was found in a Caucasian male, resident of Huntsville, Alabama who was investigated for otherwise unexplained chronic hemolytic anemia. An unusual feature of this unique, apparently hemolytic, G6PD mutant is that its red cell enzymatic activity has not been decreased. The mutant enzyme is unstable. Additionally, the enzyme variant is characterized by normal electrophoretic mobility, biphasic and slightly alkaline pH optimum, and abnormal kinetics for the natural substrates G6PD and NADP as well as the artificial substrates deamino NADP. Its activity for another artificial substrate 2-deoxy G6PD is normal. The inhibition constant for NADPH is normal. The subject has had no evidence of episodic jaundice.
Aged↗
Insulin regulates the 35 kDa IGF binding protein in patients with diabetes mellitus.
The serum levels of the low molecular form of insulin-like growth factor binding protein (IGFBP) was determined in 56 outpatients with diabetes mellitus by a radioimmunoassay developed for amniotic 35 kDa IGFBP. The mean level of 35 kDa IGFBP was found to be threefold higher in insulin dependent diabetes mellitus (IDDM), 112 +/- 13 ng/ml, than in age matched controls, 37 +/- 2 ng/ml, while the mean level in non-insulin dependent diabetes mellitus (NIDDM), 16 +/- 2 ng/ml, was decreased. In hospitalized IDDM patients there was a significant correlation (r = 0.91, p less than 0.01) between fasting blood-glucose and 35 kDa IGFBP levels, not found in NIDDM patients. During insulin infusion the 35 kDa IGFBP levels declined with a half-life of 60-120 min. The decline in IGFBP continued even after the establishment of steady state B-glucose at 4.7 mmol/l. In conclusion, the elevated 35 kDa IGFBP levels in IDDM can be attributed to insulin deficiency and may reflect a reduced bioavailability of the IGFs at the target cells.
Adult↗
Two apparent glucose-6-phosphate dehydrogenase variants in normal XY males: G6PD Alabama.
A six-year-old black boy who had transient hemolysis after a viral infection was found to have mildly decreased red cell glucose-6-phosphate dehydrogenase (G6PD) activity (1.25 IU/g hemoglobin). Two G6PD bands, both slightly faster than normal G6PD B, were seen on electrophoresis in both the propositus as well as in his maternal grandfather. This is an unexpected finding, since the G6PD gene is located on the long arm of the X chromosome that is subject to X-chromosome inactivation, and available evidence indicates that it is present as a single functional copy in the human genome. The obvious possibility of duplication of the X chromosome was eliminated by cytogenetic analysis with G-banding. G6PD duplication is unlikely, since peripheral blood granulocytes, platelets, and lymphocytes; cultured skin and bone marrow fibroblasts; and Epstein-Barr virus-stimulated lymphocytes yielded only a single electrophoretic band with mobility identical to the slower band seen in crude red blood cell hemolysate. Study of partially purified red blood cell hemolysate G6PD also yielded a single band with identical mobility. Kinetic studies of the enzyme in the propositus and in three generations of his family identified a unique, previously unpublished G6PD mutant that is herein designated G6PD Alabama. Red blood cells were separated by density gradient into a reticulocyte-enriched, an intermediate, and a dense, older portion. Two distinct enzyme bands were identified on electrophoresis of hemolysate from the reticulocyte-enriched portion, but not from the other two portions. It is postulated that two transcriptional products of the mutant G6PD gene exist; one with a short half-life and detectable only in young red blood cells, and another with a longer half-life present in all cells. The existence of two distinct mutant genes in the genome or a unique post-translational form of the mutant G6PD detected only in reticulocytes cannot be excluded.
Blood Protein Electrophoresis↗
Posttraumatic stress disorder in a Central American refugee.
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Adolescent↗
Somatosensory evoked responses to dermatomal stimulation in cervical spinal cord injured and normal subjects.
This exploratory study investigates dermatomal evoked potential patterns in the upper extremities of normal and spinal cord injured subjects. Fifteen normal subjects without neurologic deficits and twelve patients with partial or complete spinal cord injuries were tested at dermatomal levels C5, C6, C7, C8, and T1, and also at median and ulnar nerve sites. Responses were recorded at the scalp. Analyses of evoked response patterns included measurement and comparison of peak and interpeak latencies and amplitudes as well as blind ratings of the degree of abnormality of evoked potential waveforms. Analyses were also made of relationships between evoked potential data and neurological findings on clinical examination. There appeared to be a fairly consistent SEP response among normals when dermatomes C6 through C8 are stimulated. Less consistent responses are observed when C5 and T1 are stimulated. In general, spinal cord injured subjects as compared to normal subjects had evoked responses with less consistent peaks, more amplitude diminution, and greater diffuseness and overall pattern abnormality even at dermatomal levels that were intact on clinical neurologic examination. There was also a distinct progression of overall SEP abnormality in dermatomes with impaired vibration, light touch, and position sense. There were no consistent differences in interpeak latencies between SEPs of normal and spinal cord injured subjects at intact dermatomes, but there were significant differences in EP abnormalities (EPA scores). Possible reasons for the differences in the SEP responses between normals and spinal cord injured subjects include spinal cord injury not detectable by clinical exam. Difficulty in obtaining objective and accurate sensory reports also contributes to data unreliability. In conclusion, we believe that stimulation of specific sensory dermatomes merits further study, as it has a number of possible clinical uses. These include: (1) surgical monitoring at more specific levels than monitoring with mixed nerve root stimulation, (2) for study of specific nerve root injury, and (3) as an aid in examining the neurological status in acutely injured spinal cord patients who are unable to cooperate adequately during examination, such as the very young or those with lowered levels of awareness associated with head injury. Additional information which could be useful to obtain is cervical dermatomal stimulation with spinal recording sites.
Adolescent↗
The effects of biosynthetic insulin-like growth factor-1 supplementation on somatic growth, maturation, and erythropoiesis on the neonatal rat.
Somatomedins are anabolic hormones that may stimulate growth during the perinatal period. To test this hypothesis, neonatal rats were injected with a biosynthetic somatomedin, insulin-like growth factor 1 (IGF-1) twice daily for the first 2 wk of life. Two biosynthetic IGF-1 preparations of different potency were tested as well as a preparation of human growth hormone in five litters of rats. When compared to saline-injected rats, IGF-1 injected rats had increased body weight and tail length as well as specific increases in weights of liver, brain, heart, and testes. In addition, significant increases in bone marrow erythropoietic cell precursors were apparent after IGF-1 injection. IGF-1-treated neonatal rats also exhibited precocious eye opening as a sign of epithelial cell differentiation. Five additional litters of rats received similar injections but were exposed to postnatal nutritional deprivation via artificially increasing litter size. Although IGF-1 caused stimulation of bone marrow erythropoiesis and precocious eye opening, no effects of IGF-1 on somatic or organ growth could be documented. This represents the first demonstration in vivo of the anabolic effects of IGF-1 in rapidly growing neonatal rats but suggests that nutritional sufficiency may also be necessary for the full expression of somatomedin effects.
Animals↗
Serum levels of the low molecular weight form of insulin-like growth factor binding protein in healthy subjects and patients with growth hormone deficiency, acromegaly and anorexia nervosa.
The low molecular weight form of insulin-like growth factor binding protein (35 kD IGFBP), determined in serum by radioimmunoassay during non-fasting conditions, was high at birth and declined with increasing age during childhood and adolescence (N = 149). Inverse correlation was found between chronological age and 35 kD IGFBP values (r = -0.61, P less than 0.001) during childhood and adolescence, but no age dependency was found in adult subjects aged 20-66 years (N = 73). The mean and 95% confidence limits of immunoreactive 35 kD IGFBP were 34 micrograms/l and 15-79 micrograms/l, respectively, in healthy adults (N = 73) in whom the blood samples were drawn after a one-night fast. The mean level of the 35 kD IGFBP in patients with acromegaly (19 micrograms/l, N = 23) was decreased by 50% in comparison with healthy adults, whereas a 2-fold elevation of the mean levels was found in both anorexia nervosa patients (70 micrograms/l, N = 13) and adult patients with GH deficiency (69 micrograms/l, N = 22). In patients with anorexia nervosa, the 35 kD IGFBP levels were inversely related to the body mass index (r = -0.65, P less than 0.02).
Acromegaly↗