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Biomedical subjects

P Stubbe

Publications and source records attributed to P Stubbe.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Excessive gynecomastia in boys. Effective medical treatment using danazol (Winobanin)].

The purpose of this study was to provide a medical alternative to mastectomy in boys with excessive breast development. Eleven boys with bilateral gynecomastia, ranging in size between 9 X 7 cm and 3 X 3 cm in diameter, were treated with 200 mg of Danazol daily for 6 months. This therapy led to a reduction in breast size between 3 X 3 cm and 1,5 X 1,5 cm. The antigonadotropic action of Danazol was documented by inhibition of basal gonadotropin secretion, by disappearance of normal sleep dependent rhythms and by a reduced pituitary response to stimulation. Simultaneously, plasma testosteron secretion was suppressed without reduction of testicular volumes. In all patients the hypothalamo-pituitary gonadal axis normalized within 67 months after termination of therapy and no relapse was observed over a control period up to 26 months. The continuing regression after Danazol treatment emphasizes the effectiveness of drug therapy as an alternative regimen to surgical intervention.

Adolescent↗
PubMed1983

Turner syndrome: spontaneous growth in 150 cases and review of the literature.

The spontaneous growth of 150 patients with Turner syndrome from three German centers--90 with 45,X0 constitution, 60 with other chromosomal abnormalities--has been analyzed. The mean adult height was found to be (n = 14) 146.8 cm. It was observed that growth in these patients can be divided into four phases: (1) Intrauterine growth, which is retarded; (2) Height development, which is normal up to a bone-age of about 2 years; (3) Between a bone-age of 2 and 11 years when stunting of growth is most marked; (4) After a bone-age of 11 years--the time at which puberty should normally start--the growth phase is prolonged, but total height gain is only little below normal levels. No difference in height could be observed between cases with X0 karyotype and other chromosomal variants. The data are compared with those in the literature.

Adolescent↗
PubMed1983

Sleep-related gonadotropin rhythms in children following treatment of acute leukemia: recovery of the hypothalamo-pituitary-gonadal axis after chemotherapy and CNS-irradiation.

Twelve children (5 girls and 7 boys, between the ages of 6 and 20 years) in complete remission from previous ALL who had completed their entire anti-leukemic treatment program and who had been off all chemotherapy for at least one year, were included in a study of sleep-related prolactin and gonadotropin rhythms. All the patients had received prophylactic CNS-irradiation. The patients in early puberty showed a sleep-dependent FSH rhythm. Patients in middle-to-late puberty had sleep-related FSH and LH rhythms, and estradiol and testosterone plasma concentrations were normal for their pubertal stage, suggesting recovery of the hypothalamo-pituitary-gonadal feedback system. We conclude that the neuro-endocrine axis is not permanently injured by CNS-irradiation and anti-leukemic therapy.

Adolescent↗
PubMed1983

[Familial hypogonadism with anosmia: Kallmann Syndrome].

The familial occurrence of hypogonadism and anosmia (Kallmann-Syndrome) is reported in a 15 5/12 year old boy and his 20 7/12 year old sister, who in addition has a ventricular septal defect. To establish the diagnosis it is important to examine the patient with hypogonadism for anosmia since voluntary information is rarely obtained. Quite often there are additional, associated anomalies which have to be searched for carefully.

Adolescent↗
PubMed1982

Iodine-induced hypothyroidism and goiter following lipiodolTM lymphography.

Hypothyroid goiter is a rare but well recognized complication following long term administration of iodine containing expectorants and disinfectants in children. Only few reports exist on iodine-induced hypothyroidism after a single injection of the iodized radiopaque dye Lipiodol. A 15-year-old boy with previously normal thyroid function is described who developed hypothyroid goiter within six weeks following bipedal lymphography. Urinary iodine excretion was extremely elevated up to 18 mg/day while serum concentrations of total thyroxine were below the euthyroid range and thyrotropin levels were elevated. After oral L-thyroxine treatment the goiter disappeared. Thyroid function remained normal when treatment was discontinued after five months although iodine excretion was still 50 times higher (2.5 mg/day) than in normal age matched children. The observed alterations of the thyroid gland were caused by a long lasting Wolff-Chaikoff effect with a delayed adaptation to high iodide concentrations.

Adolescent↗
PubMed1982

Endocrinological studies of the hypothalamo-pituitary gonadal axis during danazol treatment in pubertal boys with marked gynecomastia.

The present paper evaluates the variations of the hypothalamo-pituitary gonadal axis during Danazol treatment in pubertal boys with marked gynecomastia (breast size more than 6 cm in diameter). Before treatment a normal sleep-dependent gonadotropin increase was found together with a normal response to LHRH stimulation. Plasma prolactin increased at sleep as well. Plasma testosterone values were normal for pubertal age. During Danazol treatment 200 mg daily for 6 months basal gonadotropin levels, the sleep related hormone increases as well as the response to luteinizing-hormone releasing hormone (LHRH) stimulation were blunted. Concomitantly, testosterone values decreased to values seen in pubertal stage II-III. After 6 months of therapy, 4 of 5 boys treated so far, demonstrated a reduction of the gynecomastia to a maximum of 3 cm in diameter. In 1 boy Danazol treatment was finished after 3 months. Because of increased psychological problems a mastectomy was performed. 6 months after cessation of Danazol treatment a normal sleep dependent gonadotropin rhythm and a normal response to LHRH was found again demonstrating a normalization of the physiologic sleep-related gonadotropin rhythms. Plasma testosterone levels nearly increased to values seen before treatment. From the clinical aspect there were no signs of a recurrence of the marked pubertal gynecomastia in all boys treated with Danazol. These results indicate that Danazol is a specific gonadotropin inhibitor acting at the hypothalamo-pituitary level. No side effects on other hormones or on the development of secondary sex characteristics were noted during and after Danazol treatment.

Adolescent↗
PubMed1981

[Misinterpretation of thyroid function caused by alteration in thyroxine binding globulin concentration (author's transl)].

Two children with undiagnosed TBG alteration were incorrectly treated for hyperthyroidism and hypothroidism, respectively. The first child exhibited hyperthyroxinemia and hypertriiodothyroninemia caused by an increase of TBG. The unoccupied binding sites of serum for thyroid hormones measured by T3-uptake were elevated as usually seen in hypothyroidism. In contrast thyroxine and triiodothyronine were extremely low in the serum of the second patient due to inherited TBG deficiency. T3-uptake was decreased to a value normally found in hyperthyroidism. The paradoxical results of T3-uptake and thyroxine levels indicated changes of concentrations of thyronine binding proteins. The quantitative determination of TBG established the correct diagnosis of TBG elevation and TBG deficiency, respectively.

Child↗
PubMed1980

Transient congenital hypothyroidism after amniofetography.

A newborn infant who presented with giotrous congenital hypothyroidism is described. Thyroid dysfunction was due to amniofetography performed 4 days before delivery, during which a total of 5.22 g of iodine as water- and lipid-soluble contrast medium was injected. After oral L-thyroxine treatment hypothyroidism disappeared rapidly. Thyroid function remained normal when treatment was withdrawn after 28 days, underlining the transient character of hypothyroidism.

Adult↗
PubMed1980

Endocrine studies in Blackfan-Diamond anemia: evidence for hypothalamic-pituitary dysfunction under frequent transfusion therapy.

A 13 year old boy with Blackfan-Diamond anemia treated with frequent transfusions was investigated for endocrine abnormalities. Prepubertal plasms LH and FSH values, lack of sleep-related hormone rhythms of the gonadotropins, as well as prepubertal responses of LH and FSH to acute stimulation with LHRH strongly suggests that a hypothalamic-pituitary abnormality is the cause of the hypogonadotropic hypogonadism observed in this patient. As a result of impaired stimulation of the gonads plasm testosterone was prepubertal. A three-to fourfold increase of basal plasma PRL values was found without any signs of a typical sleep-dependent increase. Values obtained ranged between 21 ng/ml and 24 ng/ml (normal range 5-8 ng/ml). A normal response to TRH stimulation was found. These results suggest that hemosiderosis may be responsible for the hyperprolactinemia as a result of hypothalamic-pituitary dysfunction. Furthermore, dysfunction is demonstrated by prepubertal responses of LH and FSH to LHRH stimulation.

Adolescent↗
PubMed1980

[Physiology and disease of the endocrine function of the pancreas (author's transl)].

Qualitative and quantitative immunocytochemistry, electronmicroscopy and radio-immuno-assays led to the discovery of 5 pancreatic polypeptide hormones under physiological conditions. The active endocrine cells and the produced hormones are termed A, B, D, D1, and PP cell and glucagon, insulin, somatostatin, vasoactive intestinal polypeptide (VIP) and pancreatic polypeptide (PP) respectively. Beside the physiology of secretion and action a survey of pathological conditions in the paediatric age group is given. Insulin is the most important of pancreatic hormones in childhood. Therefore diagnosis and treatment of hyperinsulinism are described in extension.

Child↗
PubMed1979

[Cytological diagnosis of thyroiditis (author's transl)].

In 2347 patients fine needle aspiration of the thyroid gland was performed. In 49 cases (2.1%), a final diagnosis of thyroiditis was established. Non-specific granulomatous thyroiditis occurred most frequently (n = 24), followed by lymphocytic hypertrophic thyroiditis Hashimoto (n = 18), focal lymphocytic (n = 5), atrophic lymphocytic (n = 1) and chronic fibrosing thyroiditis (n = 1). Fine needle aspiration biopsy is most suited to diagnose granulomatous thyroiditis. In Hashimoto's thyroiditis cytological investigations are superior to estimation of thyroglobulin antibodies. The cytological method is of little value for the diagnosis of atrophic lymphocytic and chronic fibrosing thyroiditis.

Biopsy, Needle↗
PubMed1979

[Juvenile goitre (author's transl)].

Clinical, cytological, serological and endocrinological examinations were performed on 50 previously untreated children and adolescent with goitre. Three girls were found to have the cytological picture of Hashimoto's thyroiditis, in one instance associated with Turner's syndrome and hyperthyroidism. Two other girls presented with hyperthyroidism. In the remaining 45 patients thyroid aspirates and thyroid hormone levels were normal. The girl with Turner's syndrome, hyperthyroidism and Hashimoto's thyroiditis had thyroglobulin antibodies. It is the authors' experience that the diagnosis of Hashimoto's thyroiditis can be made only by needle biopsy of the thyroid. If iodination of cooking and table salt were to become widespread in the Federal Republic of Germany, and increased incidence of Hashimoto's thyroiditis is to be expected amount children with goitre.

Adolescent↗
PubMed1979

[Hypothyroid, iodine-deficient goitre in neonates (author's transl)].

Within one year 1750 mature neonates were examined for congenital hypothyroidism. The region of Göttingen is known to be an iodine-deficient one. Sixteen goitrous, hypothyroid neonates with a low total thyroxine, and raised serum TSH concentration were first diagnosed through this screening programme. As a result of the intra-uterine iodine deficiency, serum triiodothyronine concentration was elevated while urinary iodine excretion was reduced compared with euthyroid neonates. During iodine treatment the size of the thyroid became normal within eight days, TSH after 3.8 days and serum thyroxine after three days. Serum triiodothyronine concentration remained elevated for several weeks, presumably as a result of the persisting iodine deficiency. The results indicate that a neonatal screening programme for hypothyroidism is as essential as adding iodine to table salt for avoiding neonatal and foetal maldevelopment.

Congenital Hypothyroidism↗
PubMed1979

Prolactin-producing pituitary adenoma in a 9 year old boy.

A boy aged 9 years and 8 months was evaluated for headache and an enlarged sella. His neurological status and visual fields were normal. After injection of radiographic contrast agent, computerized axial tomography showed evidence of an intrasellar tumor. The most striking endocrine abnormalities were growth hormone insufficiency after arginine infusion and after insulin-induced hypoglycemia, and excessively elevated prolactin levels ranging between 1220 ng/ml and 1560 ng/ml. A slightly granulated, acidophilic pituitary adenoma was selectively removed by the trans-sphenoidal approach. The function of the anterior pituitary improved post-operatively. Growth hormone secretion after insulin-induced hypoglycemia returned to normal, and the basal serum prolactin levels decreased, but are still three times higher than normal.

Adenoma, Acidophil↗
PubMed1979

[Cryptorchidism (author's transl)].

The treatment of cryptorchidism should start at the age of two years because of pathological and anatomical studies. Ectopic testicles, inguinal hernias and postoperative situations associated with a wrong position of the testicle are primary indications for surgical corrections. Fixed inguinal, retractile or abdominal testicles may be primarily treated with human chorionic gonadotropin (HCG). The success rate after medical treatment averages 50%. The intranasal application of the releasing hormone of luteotropic hormone (LH-RH) may represent an alternative approach to the treatment of cryptorchidism. If treatment with LH-RH is to obtain the same success rate as HCG in larger series it may combine the advantage of painlessness with no androgenic side effects.

Administration, Intranasal↗
PubMed1979

[The radiolucent esophageal foreign body in children (author's transl)].

The symptoms of radiolucent esophageal foreign bodies in small children may be predominantly respiratory with stridor and dyspnea. In a 1 3/12 years old girl who suffered from inspiratory stridor and only later from dysphagia as well this diagnosis was delayed for 2.5 months. Air in the upper part of the esophagus was the first striking roentgenologic symptom of the foreign body which was then clearly outlined by a barium swallow examination. The foreign body was a plastic lid of a candy tube.

Age Factors↗