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Biomedical subjects

R Müller-Hess

Publications and source records attributed to R Müller-Hess.

8 recordsLinked to original sources
PubMed1978

Glucocorticosteroids and growth hormone secretion under physiological conditions and in states of steroid excess.

Cortisol and growth hormone (GH) secretion (spontaneous variations at night and the release induced by insulin hypoglycaemia) were investigated in 69 children and adolescents. Statistical analysis of approximately 600 pairs of cortisol and GH values in this study demonstrated that physiological fluctuations of cortisol do not alter GH secretion. A review of the literature shows that GH secretion is consistently depressed in Cushing's disease of central origin and in Cushing's syndrome due to adrenal carcinoma. When acutely administered, doses higher than 100 mg of cortisol (or equivalent amounts of other steroids) per adult are necessary to block GH secretion and the hormones have to be given several hours previously. In long-term steroid treatment, suppression of GH is observed in only 1 out of 3 patients. The effect apparently does not persist beyond elimination of the last dose, i.e. generally not longer than 12 to 24 h. These data can be taken as a rationale for intermittent or alternating dosage schedules, and for the use of short acting derivatives if long-term, high-dose steroid treatment is necessary in children. It remains to be established whether growth deficiency in exogenous hypercortisolism is due to suppression of GH secretion, decreased production of somatomedins, direct antagonism of the action of somatomedins on growing cartilage, or a combination of these mechanisms.

Adolescent↗
PubMed1977

Endocrine function after antineoplastic therapy in 22 children with acute lymphoblastic leukaemia.

In 22 children who were in complete remission after acute lymphoblastic leukaemia endocrinological investigations were performed 5-12 weeks after cessation of therapy. The children had received central nervous system irradiation (tele-Co60, 850-1800 rad), and long term, aggressive cytostatic drug therapy during 21 to 36 months. Growth hormone, TSH, thyroxine, LH, FSH, cortisol secretion, and urinary concentrating capacity were found to be normal, with a few exceptions where borderline results were obtained.

Adolescent↗
PubMed1977

[Outpatient management of diabetic children and adolescents: control of fractional 24-h glucosuria (author's transl)].

The optimal ambulatory treatment of diabetic children requires the cooperation of the patient and his family. Following a careful and extensive information about the course of diabetic mellitus, its management, and its possible complications, the patients and their parents have to take charge of an important part of the metabolic control. Fractionating 24-h-urines in three portions and estimation of the glucose excretion using the Clinitest-method proved to be a valuable tool to judge the metabolic control and to adjust the insulin doses. The comparison of the glucose excretion in 595 fractionated urines of 30 juvenile diabetics estimated with both the Clinitest-method and polarimetry in the clinical laboratory showed good agreement for low glucose conentrations. The discrepancies between the two methods increased with rising glucose concentrations and increasing urine volumes. 139 insulin-dependent diabetic children and adolescents were presented to the Children's Hospital outpatient clinic every 6-7 weeks for a physical examination and measurements of the 24-h-glucose excretions as well as the postprandial blood glucose concentrations. The average glucose excretion in two groups of patients with one or two daily injections of insulin was 24 and 30 g/day, respectively, which is higher than the recommended limit of 20 g/day. The glucose excretion was not significantly influenced by the frequency of insulin administration (one or two injections per day), by the age of the patient or by the duration of the diabetes mellitus. The good agreement of the evaluations of the 24-h-glucosuria using Clinitest on one side and polarimetry on the other proves regular controls at home by the patients and their parents to be useful and to facilitated the outpatients management of juvenile diabetics. Measuring the 24-h-glucose excretion at least 2-3 times a week seems desirable.

Adolescent↗
PubMed1975

Effects of oral xylitol administration on carbohydrate and lipid metabolism in normal subjects.

Oral tolerance tests with 30 and 50 g of xylitol were performed in 10 normal subjects adapted to taking this pentitol. A 50 g oral glucose tolerance test served as control. Continuous indirect calorimetry was carried out in 7 of these subjects to measure the effects on the metabolic rate and on the oxidation rates of carbohydrate and fat. A small and short rise in serum xylitol and low quantitites of xylitol excretion in urine were observed in both xylitol tests. Xylitol caused a small but statistically significant increase in blood glucose and plasma insulin concentrations. Plasma free glycerol diminished significantly. After xylitol the metabolic rate rose throughout the test period but the total increase was only half of that after glucose administration. There was no significant influence of xylitol on the oxidation rates of carbohydrate and lipids. The total increase in carbohydrate oxidation during 2 1/2 hours amounted to one fourth of that caused by glucose. It is suggested that xylitol, during the first two hours after ingestion, charges the body's metabolism much less than equal amounts of glucose. Therefore, the use of xylitol as a sweetener in the diet of diabetic patients seems to be justified.

Administration, Oral↗
PubMed1975

Interactions of insulin and epinephrine in human metabolism: their influence on carbohydrate and lipid oxidation rate.

Two groups of normal male subjects were given an infusion of insulin and an infusion of epinephrine + insulin respectively. Blood glucose, plasma free fatty acids (FFA), insulin, growth hormone, cortisol, and urinary catecholamines were determined. Continuous indirect calorimetry was used to measure metabolic rate and oxidation rates of carbohydrate and lipids. The first group (n equals 7) received a 30-minute insulin infusion (0.1 IU/kg). While blood glucose and plasma FFA decreased, carbohydrate oxidation and metabolic rate significantly increased after some delay, whereas lipid oxidation decreased. The increase in carbohydrate oxidation amounted to 5 g/120 min. The decrease in blood glucose during insulin administration did not correlate with the increase in carbohydrate oxidation. In the second group (n equals 7), a 150-minute epinephrine infusion (900 mug in 500 ml saline) was administered, and superimposed upon it, a similar insulin infusion initiated after 60 min. Epinephrine alone increased blood glucose and plasma FFA levels, and decreased insulinemia. The rise in the metabolic rate was sharp and significant. After a short but significant increase the oxidation rate of carbohydrate decreased, whereas that of lipids markedly rose. This increase significantly correlated with that in FFA. Addition of insulin markedly decreased the elevated FFA levels and lowered blood glucose. After some delay this was followed by a marked increase in carbohydrate oxidation and a decrease in lipid oxidation. In this test the total increase in carbohydrate oxidation was 11 g/120 min. In comparison with the insulin test, this double amount seems to correlate well with the higher blood glucose levels measured before insulin administration. The results suggest that insulin indirectly stimulates carbohydrate oxidation by facilitating glucose transport into the cells and lowering FFA levels, and that epinephrine favours lipid oxidation through its lipolytic effects and its suppression of insulin release.

Adult↗