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Biomedical subjects

F Waldhauser

Publications and source records attributed to F Waldhauser.

71 records · Page 4Linked to original sources
PubMed1984

Diminished prolactin response to thyrotropin and insulin in anorexia nervosa.

Although patients with anorexia nervosa (AN) have a variety of endocrine disturbances, it generally is believed that the PRL response to stimulation is not altered in this disorder. We measured basal serum PRL values and serum PRL values after stimulation either with TRH (200 micrograms/m2) or with insulin (4 IU/m2) in 27 women with AN and 9 normal women. Basal values in anorexic women and normal women did not differ significantly, whereas all stimulation variables (mean PRL stimulation values, maximum PRL values, sum of increments, and area under the stimulation curve) were significantly lower in AN patients than in normal women. Furthermore, after TRH stimulation most of these variables correlated positively with the percentage of ideal body wt of the patients, indicating that the diminished PRL response was wt dependent. This diminished PRL response in the patients may accompany starvation and low estradiol values. Both conditions per se are known for their association with diminished PRL responses. Hence, no hypothesis which posits hypothalamic dopamine excess as the basic disturbance in AN seems justified. Moreover, diminished PRL responses in AN are not consistent with an assumption of hypothalamic dopamine depletion in this disorder.

Adolescent↗
PubMed1982

Gonadotropin responsiveness to luteinizing hormone releasing hormone in prepubertal and pubertal patients with growth hormone deficiency.

Gonadotropin response to 100 microgram/m2 LHRH was determined in 31 patients with growth hormone deficiency. According to their bone ages the patients were divided into a "prepubertal" (n = 18) and a "pubertal" (n = 13) group. The results were compared with the LHRH tests from 16 healthy prepubertal boys and girls and 32 healthy adult probands, respectively. The maximum increment of LH and FSH was evaluated. In the "prepubertal" group five patients had an insufficient rise of LH and FSH, four of them having additional anterior pituitary hormone deficiencies. In the "pubertal" group nine patients were found to be gonadotropin deficient, all of them had additional hormone deficiencies, TSH being the most frequently affected hormone. Only one of 14 gonadotropin-deficient patients had no other than growth hormone deficiency in addition. An isolated decreased FSH increment without LH deficiency was found in 6 male and 2 female patients and is not thought to be of diagnostic value. No influence of growth hormone treatment or growth velocity on the gonadotropin responsiveness was found. Patients with an additional thyreotropic defect could be classified as pituitary or hypothalamic disorder due to their reaction in the TRH test. These groups could not be differentiated by a single bolus LHRH test, indicating the need of prolonged stimulation to recover the pituitary hyporesponsiveness. Due to methodological problems the diagnosis of gonadotropin deficiency in an individual patient of the prepubertal age group might be questioned. However, a normal gonadotropin response to LHRH can be expected in prepubertal patients with growth hormone deficiency and may indicate a normal gonadotropin function.

Adolescent↗
PubMed1982

Prolactin and thyrotrophin response to thyrotrophin-releasing hormone in growth hormone deficiency.

Basal and thyroid-releasing hormone-stimulated (200 micrograms/m2) prolactin and thyroid-stimulating hormone (TSH) levels were measured in 31 patients with hypopituitarism (13 isolated growth-hormone deficiencies and 18 multiple pituitary hormone deficiencies). The results were compared with the prolactin response in 76 healthy prepubertal children. Normal prolactin concentrations were found in 13 patients whereas 11 had increased levels. TSH levels were either normal or increased in patients who were considered to have hypothalamic disorders. Decreased prolactin response was present in 7 children, 6 of whom had multiple pituitary deficiencies. Their TSH response was decreased as well, indicating pituitary failure. There was good overall correlation of peak prolactin with peak, TSH concentrations. Some patients with 'isolated' growth hormone deficiency had an abnormal prolactin response indicating an additional hormonal deficiency. All patients with low levels of serum thyroxine had abnormal prolactin or TSH levels, high in some, low in others. Two euthyroid patients with increased prolactin stimulation became hypothyroid during treatment with growth hormones, thus questioning whether prolactin is a more sensitive indicator of early thyroid insufficiency than thyroxine or TSH levels.

Adolescent↗
PubMed1982

[Transient vitamin-D dependent rickets? a case report differential diagnosis (author's transl)].

The clinical course of a 9-month-old boy with Vit. D resistant rickets receiving treatment course 1-Alpha-hydroxycholecalciferol is described. Patient's response to therapy was excellent, after regression of bone changes and normalization of serum parameters drug treatment was discontinued for differential diagnostic considerations. Even several months later no relapse occurred. Due to this fact and the high concentration of serum 1,25-dihydroxycholecalciferol concentration during therapy the very rare pseudovitamin-D-deficiency type II, which is characterized by a bone receptor defect, was assumed. In contrast, successful treatment with low-dose 1 Alpha-OHCCF indicates that the underlying defect is pseudovitamin-D-deficiency rickets type I, however this form would require lifelong therapy. The differential diagnosis based on recent knowledge of Vitamin-D-metabolism is discussed.

Calcifediol↗
PubMed1981

[Hypothalamic endocrinopathy in histiocytosis X (author's transl)].

Histiocytosis X in a 2-year-old boy with mainly skull manifestations was treated with radiotherapy and cytostatic drugs. Diabetes insipidus and growth retardation followed. Secretory capacity of GH was variable, periods of normal and insufficient secretion alternating during the 15-year observation period; there was a satisfactory response to GH therapy for one year. Thyrotropin and ACTH deficiency were diagnosed 3 1/2, and again 9 years after termination of histiocytosis therapy. Since there was no relapse of histiocytosis, this hypothalamic endocrinopathy is interpreted as being a late sequela of radiotherapy.

Adolescent↗
PubMed1981

A combination of spastic paraparesis, polyneuropathy and adrenocortical insufficiency-a childhood form of adrenomyeloneuropathy.

This report describes a combination of spastic paraparesis and symmetrical sensory motor polyneuropathy with a pathological response to the ACTH test in the case of a 16 year-old boy and a borderline response to the ACTH test in the case of his 8-year-old sister. Another sister, aged 14, showed only a pathological response to ACTH testing, the neurological status being unremarkable. The EEG was normal in all three children examined. Visually evoked potentials were borderline in the case of the boy and normal in the case of the clinically involved sister. Although on examination by light microscopy the sural nerve proved to be normal, the clinical diagnosis of adrenomyeloneuropathy (AMN) in its juvenile form may be assumed, in view of the clinical symptoms and the evidence of adrenocortical insufficiency revealed by the ACTH test.

Adolescent↗
PubMed1981

Pulsatile secretion of gonadotropins in early infancy.

In adults, luteinizing hormone (LH) and follicle stimulating hormone (FSH) are secreted in a pulsatile manner. Prior to puberty gonadotropin (GN) levels are low and show only small fluctuations. The following investigation was performed to elucidate the type of GN secretion in infants. LH and FSH were determined every 30 min over a period of 8 h in three different groups: Group 1:2 male and 2 female adults; Groups 2:2 male and 2 female prepubertal children; Group 3:3 male and 3 female infants, aged 6-12 weeks. Group 1 showed a clear pulsatile secretion of LH (4.5-23.5 mIU/ml [range]) and FSH (6.9-16.0 mIU/ml). Group 2 demonstrated a rather constant secretion of LH (less than 1.5-2.3 mIU/ml) and FSH (1.6-4.9 mIU/ml). Group 3: In male infants pulsatile secretion of LH (3.6-34.7 mIU/ml)--and to a lesser degree of FSH (1.8-4.6 mIU/ml)--were found. In female infants the pulsatile secretion of FSH (6.5-22.7 mIU/ml) was more pronounced than that of LH (less than 1.5-4.7 mIU/ml). The secretory pattern in early infancy is of a pulsatile type.

Adult↗
PubMed1981

[Subclinical hypothyroidism in infancy (author's transl)].

Clinical symptoms of hypothyroidism (constipation, macroglossia, umbilical hernia, typical face hyperbilirubinaemia) were found in a 4 months old infant. Body height and activity were normal and the skin did not show the typical dryness. Total-thyroxin (T4) level was normal as well as basal thyrotropin (TSH), only after stimulation with thyrotropin releasing hormone (TRH) an exaggerated response was observed. These hormonal findings are typical for subclinical hypothyroidism, a well known disturbance in adults. The clinical as well as therapeutic considerations are discussed in this patient.

Child, Preschool↗
PubMed1979

[Chronic fetomaternal bloodtransfusion with signs of heart failure (author's transl)].

A case of chronic fetomaternal bloodtransfusion with signs of heart failure is described. More than 200 ml blood were lost into the mother's circulation. Heartfailure did not fully account for the marked enlargement of the liver and the slight splenomegoly, so that reactivation of the extramedullary erythropoesis presumably was an additional causative factor for it.

Anemia, Neonatal↗
PubMed1978

[Value and incidence rate of the inflammation of the bowels in a general children's autopsy material during twenty years (author's transl)].

The acute enteritis in the postneonatal period with or without dyspepsia appeared with an incidence ranging from 18,9% to 27,6% during twenty years period (1956--1975) observations in a general children's autopsy material. Bacteriological and serological analysis may be of success and complete the pathologic-anatomical diagnoses. Infective enteritis often is accompanied by pneumonia and/or otitis media. The acute enteritis can always be detected as an important feature in regard to the cause of death. Most children die within less than twenty-four hours from hospital admission. The hemorrhagic, ulcerous and necrotic form of the enterocolitis predominate the perinatal and neonatal period, frequently combined with peritonitis and bowel perforation. Bacteriological examinations should be obtained. This form of the acute enteritis and enterocolitis of the newborns must be taken into consideration of the ileus symptoms differential diagnosis.

Adolescent↗
PubMedDate not supplied

Influence of glucose fluctuations on alkaline phosphatase activity.

It has been suggested previously that non-enzymatic glycosylation of certain enzymes results in decreased enzymatic activity. In order to examine the role of high blood glucose concentrations (BG) on serum alkaline phosphatase (AP) activity, we determined BG and serum AP in 32 healthy children during an oral glucose tolerance test (OGTT) and in 10 type I diabetic children at 30-min intervals for at least 150 min. A significant negative correlation was noted for BG and AP during the oral glucose load (r = -0.57, p less than 0.01). In diabetics, however, only children with marked BG fluctuations showed this inverse relationship between BG and AP. These observations could be explained by the formation of a Schiff base as the initial step of non-enzymatic glycosylation of AP. This assumption was further confirmed by in vitro experiments, in which AP was incubated with glucose resulting in decreased enzymatic activity. The dialyzable aldimine formed initially is subsequently stabilized as ketoamine after long-term incubation.

Adolescent↗
PubMedDate not supplied

Age-related changes in melatonin levels in humans and its potential consequences for sleep disorders.

Prior to three months of age there is little melatonin (MLT) secretion in humans. MLT production then commences, becomes circadian, and reaches its highest nocturnal blood levels between the ages of one to three years. During the remainder of childhood, nocturnal peak levels drop progressively by 80%. In adults, these levels show an additional drop of some 10%, mainly during senescence. The large drop in serum MLT during childhood is probably the result of the increase in size of the human body, despite a constant MLT production after infancy. The additional decline of MLT with higher age may be due to a yet unidentified physiological mechanism accompanying senescence. The biological significance of these MLT alterations remains unknown. Since the discovery of MLT, an immediate sedative action of this hormone has been known. A number of recent studies have demonstrated that MLT indeed exerts a sleep-promoting action by accelerating sleep initiation, improving sleep maintenance, and marginally altering sleep architecture. The potential of MLT in the treatment of insomnia is being explored, and the results are promising. Although in most of these studies pharmacological dosages of MLT have been used, preliminary data suggest that similar effects can also be achieved by physiological hormone concentrations. The latter observation raises the question of whether MLT might be involved in the physiological control of sleep.

Aging↗
PubMedDate not supplied

[Reduction of body height in tall girls by estrogen treatment].

Twenty-six girls with constitutional tall stature were treated with 0.5 mg ethinyloestradiol daily po and 10 mg norethisteronacetate from day 21 to 25 of the cycle for 1.4 +/- 0.4 years. Height, weight, bone age according to Greulich-Pyle (GP) and Tanner (RUS), height predictions according to Bayley Pinneau (BP) and Tanner Whitehouse (TW) were recorded at the onset of therapy, at the end of treatment and 7.4 years later. The mean chronological age at start of treatment was 12.6 +/- 1.1 years, bone age (GP) 12.4 +/- 0.7 years, (RUS) 13.5 +/- 0.7 years. The initial height prediction according to BP was 186.2 +/- 4.1 cm, which was 3.5 cm higher than the prognosis according to Tanner Whitehouse. Depending on the method used for height prediction, the height reduction by treatment was 4.6 +/- 3.0 cm (BP) or 1.4 +/- 2.2 cm (TW), respectively. The reduction of predicted height was more pronounced in girls with a bone age (GP) < 12.5 years at the initiation of therapy (n = 13), than in girls with a bone age > or = 12.5 years (n = 13). Final height was measured 7.4 years after the end of treatment. Chronological age: 21.3 +/- 3.7 years, final height 181.8 +/- 3.7 cm. Mean final height after therapy was 7.7 cm above target height, or, after allowance for the secular trend, 3.8 cm above target height. Body weight, recorded in centiles of body mass index, increased from the 38.5 +/- 26 to the 58.1 +/- 22 centile, weight gain was more pronounced in younger girls. At follow up investigation 18/19 girls, who answered a questionnaire, had a positive view of the previous treatment.

Adolescent↗
PubMedDate not supplied

[Anorexia nervosa in male adolescents. I: Clinical findings].

In six male patients with anorexia nervosa (a.n.) we describe the anamnestic data, the course of disease and progress in therapy. We also present the results of psychological testing and organic investigations. The mean weight loss at the time of first investigation at the clinic was 70% of ideal body weight. The mean time between first symptoms of a.n. and the first admission at the clinic was 19 months. The psychopathological status showed in all six patients symptoms of obsessive, in two patients additional of depressive behavior. This finding is in contradiction to the result in 61 female patients with a.n., where hysteriformic and depressive symptoms predominated (36). The follow up time reached from 18 to 84 months (mean 49 months). At the time of last control-investigation we found only one patient restored to health, two patients showed a positive progression. In two patient the psychiatric situation was nearly unchanged, one patient committed suicide. The three patients without positive therapeutic effect were three times respectively six times at the inpatient department and discontinued two times or also three times the psychotherapy. In our experience the course of disease in male patients with a.n. seems to be more serious and more resistant to therapy than in female patients.

Adolescent↗
PubMedDate not supplied

[Anorexia nervosa in male adolescents. II. Psychoneuroendocrinologic findings].

Female patients with anorexia nervosa (a.n.) are characterized by distinct endocrine features probably due to hypothalamic pituitary dysfunctions. There is only a limited number of case reports available on patients with a.n.; mostly with few data on hormones. In six male patients with a.n. we examined basal and stimulation values of several hormones performing three pituitary function tests. Basal and stimulated values of luteinizing hormone (LH) and of follicle stimulating hormone (FSH) after LHRH were low comparable to results in prepuberal boys. Similarly, testosterone levels in serum were also markedly reduced. By exploring the pituitary-thyroidal axis total T4 was diminished in one patient and at the lower limit in two patients; concentration of free T4 was in the normal range, while five of six subjects had reduced total T3 concentration and two of six patients showed increased reversed T3 levels; TBG concentration was always in the normal range. Basal TSH was normal, while in two patients the TSH stimulation levels after TRH were diminished; in all patients the TSH stimulation levels were found to be delayed. The basal levels of growth hormone were normal, but the growth hormone response after insulin was diminished in four patients. In all six patients basal prolactin (PRL) and PRL concentration after TRH stimulation was in the normal range. The neuroendocrine results in the six patients with a.n. confirm in males a similar hypothalamic-pituitary dysfunction as it is already known for female patients.

Adolescent↗