[Disorders of sexual differentiation and sexual development].
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Biomedical subjects
Publications and source records attributed to L Lisá.
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No significant differences in the acetylene-reducing activity and evolution of H2 and CO2 from nodulated roots of Pisum sativum inoculated with soil Rhizobium populations from two soils with different acidities (Ruzynĕ soil 7.6; Lukavec soil 4.9) were observed. Rhizobium population from Lukavec soil formed nodules, exhibiting a higher H2 evolution. Co-inoculation with the Hup+ strain 128C30 (7 x 10(7) cells per seedling) eliminated, to some extent, the effect of soil populations on physiological activity.
In growth disorders it is important to consider carefully all causes which may lead to growth retardation. Therefore possible factors and diagnostic possibilities are listed. The importance of the prognosis of the affected child is emphasized.
The authors defined a uniform classification of abnormal positions of the testes. They recommend also a uniform therapeutic procedure: after the first year of life treatment with human chorionic gonadotropin in one or two curves, if orchiopexy fails.
The authors describe six patients, female phenotype with karyotype 45X/46XY. Two girls suffered from pure gonadal dysgenesis, four from mixed gonadal dysgenesis. The authors emphasize the intact axis hypothalamus-pituitary gonads. In the above diagnoses the authors recommend revision and extirpation of the gonads with regard to possible malignant growth in the dysgenetic gonad.
The authors divided forty children and adolescents with inborn adrenal hyperplasia caused by a block of 21-hydroxylase of steroids (CAH) according to clinical criteria into adequately and inadequately treated. Substitution treatment with hydrocortisone or hydrocortisone combined with fludrocortisone was administered three times a day in individual doses. In order to find an adequate indicator of the adequacy of therapy, the authors assessed in addition to total urinary 17-oxosteroids also 17 alpha-hydroxyprogesterone, androstenedione and 11 beta-hydroxyandrostenedione in serum. The values of urinary 17-oxosteroids did not correspond to the clinical condition of the children; in younger children three was a high percentage of falsely positive and in older children of falsely negative results. As to serum steroids, the most suitable indicator for monitoring was 17-hydroxyprogesterone. The authors consider its levels above 30 nmol/l as a basis for consideration of raising therapeutic doses, while levels below 2.2 nmol/l signalize possible overdosage of the drug. Concurrently elevated levels of 17-hydroxyprogesterone and androstenedione are found in particularly inadequately treated children. 11 beta-hydroxyandrostenedione is not a useful indicator for monitoring of CAH treatment. In any case it is necessary, when controlling CAH therapy, to select an individual procedure and to evaluate results in the context with the patient's clinical condition.
The authors followed up 59 children with congenital adrenal hyperplasia. They compared the somatic development of these children in the group treated with hydrocortisone only and in the group treated with fludrocortisone. They evaluated their growth, bone maturity, sexual maturing. The results of the clinical investigation are in favour of combined therapy.
For screening of obese children and marginal obesities the authors elaborated tables for boys and girls aged 6 to 18 years. The tables are based on height and body weight of the Czechoslovak population examined in 1985.
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