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Biomedical subjects

S Suwa

Publications and source records attributed to S Suwa.

At least 19 recordsLinked to original sources

Standards for growth and growth velocity in Turner's syndrome.

Turner-specific natural growth and growth velocity curves based on the retrospectively surveyed growth data of 704 Japanese patients in a mixed cross-sectional and longitudinal mode are reported. There was no significant difference in growth between the patients with karyotype 45,X and non-45,X. Twenty-three patients had a history of genital bleeding between the ages of 11 and 14 years (12 years +/- 9 months). The mean height of the patients with genital bleeding did not differ significantly from that without bleeding from birth until 1 year 3 months of age but thereafter the former were always significantly taller than the latter. The former ceased growing after 18 years; on the other hand the latter were still growing after 18 years and then the final height of each group of patients became almost the same (139.6 +/- 3.5 cm in the former and 139.1 +/- 5.6 cm in the latter). A slight and gentle growth spurt was observed during the expected adolescent period in both groups, with and without genital bleeding. However, the mean height of peak (1.3 +/- 0.95 cm/year) and the mean peak velocity (5.2 +/- 1.1 cm/year) in the patients with genital bleeding were significantly higher than those (0.7 +/- 0.36 and 3.8 +/- 0.6 cm/year, respectively) in the patients without genital bleeding.

Adolescent

A dose finding study of a super long-acting luteinizing hormone-releasing hormone analog (leuprolide acetate depot, TAP-144-SR) in the treatment of central precocious puberty. The TAP-144-SR CPP Study Group.

The effect of leuprolide acetate (D-Leu6-[des-Gly10-NH2]-LH-RH ethylamide acetate) for depot suspension (TAP-144-SR), a synthetic analog of luteinizing hormone-releasing hormone, was examined in three doses in 36 patients (34 girls, 2 boys) with central precocious puberty. TAP-144-SR was injected subcutaneously every four weeks for twelve weeks, and clinical symptoms and plasma and urinary levels of various hormones were followed every four weeks. Eleven girls given 10 micrograms/kg showed a significant decrease in peak plasma LH and FSH responses to LH-RH test, but basal plasma LH and FSH did not change significantly. In 13 patients (11 girls and 2 boys) given 30 micrograms/kg and 12 girls given 90 micrograms/kg, both basal and peak LH and FSH were significantly suppressed. Urinary excretion of LH decreased significantly in all groups except in the 10 micrograms/kg group. Urinary excretion of FSH did not change significantly in the 10 and 30 micrograms/kg groups, but it decreased significantly in the 90 micrograms/kg group. In girls, plasma and urinary estradiol also fell greatly, but the difference was insignificant except in the 90 micrograms/kg group. Regression of sexual characteristics was observed in almost half of the patients at the 12th week of the treatment. Side effects were minimal. A dose of more than 30 micrograms/kg of TAP-144-SR is effective in suppressing gonadotropins and causing improvement of clinical symptoms, and appears to be useful in treating children with central precocious puberty.

17-Hydroxycorticosteroids

Quantitation of urinary gonadotropins in normal children.

A simple and improved method for the quantification of urinary LH and FSH was developed. Urinary gonadotropin concentrations were determined by polyclonal double antibody RIA after ammonium sulfate extraction. Urinary LH and FSH concentrated by ammonium sulfate were coeluted with an iodinated LH and FSH tracer. Gel chromatography of the urine revealed that the majority of immunoreactive LH and FSH were eluted coincident with 125I-LH and 125I-FSH. Good correlation was observed between urinary gonadotropin/creatinine ratios in first morning voided and full 24-h urine collections. Age-dependent changes in urinary LH excretion were significant in normal boys and girls 6-17 y of age. Urinary FSH excretion in these children did not change in an age-dependent fashion.

Adolescent

Monthly urinary LH and FSH secretory patterns in normal children and patients with sexual disorders.

Urinary gonadotropin concentrations were determined by polyclonal double antibody RIA after ammonium sulfate extraction. Good correlation was observed between urinary gonadotropin/creatinine ratios in first morning voided and full 24-h urine collections. Using consecutive 30-d first morning voided urine specimens from normal children and from patients with sexual disorders, we have studied the monthly patterns of nighttime gonadotropin secretion. In normal prepubertal girls, the levels of urinary LH were low with few variations and those of urinary FSH were higher with episodic fluctuations. In early pubertal girls, the levels of urinary LH increased with striking, rhythmic fluctuations. The same changes were seen in urinary FSH. A single big surge of urinary gonadotropins was observed in postmenarcheal girls. In normal boys, the secretory patterns of urinary gonadotropins were similar to those of normal girls, but varied less. In patients with idiopathic precocious puberty, the patterns of urinary gonadotropins were similar to those of normal subjects matched for sexual stage. The measurement of 30-d first morning voided urinary gonadotropins can provide a simple and physiologic test of gonadotropin function in children.

Adolescent

Isolated human growth hormone deficiency due to the hGH-I gene deletion with (type IA) and without (the Israeli-type) hGH antibody formation during hGH therapy.

Three Japanese patients with isolated growth hormone deficiency from two different families were shown to be homozygous for deletion of the structural gene for human growth hormone (hGH-I gene). These three patients had the same restriction fragment length polymorphism haplotypes. In patient No. 1, the growth rate initially responded well to pituitary human growth hormone, but growth rapidly ceased concomitantly with the development of high levels of anti-hGH antibodies. He again responded well to recombinant methionyl hGH and recombinant hGH without the methionine residue, even though having high hGH antibodies. Two siblings (Patients No. 2 and 3) showed a rather good response to pituitary hGH treatment without hGH antibodies ever being detected (the Israeli-type). hGH-I gene deletions may not necessarily result in hGH antibody formation. Heterogeneity has been observed in isolated hGH deficiency due to hGH-I gene deletion. hGH-I gene analysis should not be limited to patients with hGH antibody formation and subnormal growth responses to hGH therapy.

Adolescent

C26 sterol in a human urine.

A new C26 sterol, 22-trans-27-norcholesta-5,22-dien-3 beta-ol, was found in the urine of a 6-year-old girl, with a clinical diagnosis of congenital adrenal hyperplasia of the salt losing type, accompanied by symptoms of mixed sex anatomy and skin pigmentation. The structure of the sterol was determined by comparison with the synthetic compound. The sterol was also detected in ther serum. This appears to be the first case in which a C26 sterol has occurred in mammalia.

Adrenocortical Hyperfunction

A new method of urea removal using urease and expanded polytetrafluoroethylene membrane.

A new method for urea removal using a gas membrane is introduced along with some preliminary results. The membrane used was expanded polytetrafluoroethylene (E-PTFE) which is highly permeable to gaseous substances, while at the same time it is highly resistant to water permeation. In in vitro experiments using 10 mmol/L ammonia solution it was revealed that the single-pass reduction rate was approximately 95% at 30 degrees C at a flow rate of 200 ml/min. In animal experiments using four dogs, the extraction rate of urea was 40.4 +/- 4.4% after four hours of dialysis using 5 L dialysate. However, elevation of blood ammonia was observed in all dogs tested. Removal of ammonia by means of a gas membrane is considered to be feasible and has the possibility of being used for maintenance hemodialysis in combination with urease and charcoal.

Ammonia

The effect of alpha adrenergic receptor blockade on the glucagon-induced growth hormone response.

The effect of a alpha adrenergic blockade (phentolamine) on glucagon induced growth hormone response was tested in five normal men. There was no significant difference in growth hormone concentrations between the glucagon test and the glucagon-phentolamine test (mean maximum level, 23.4 +/- 3.7 ng/ml and 23.1 +/- 5.9 ng/ml, respectively). Insulin secretion was significantly higher (P less than 0.025) 30 and 60 min after an injection of glucagon in the glucagon-phentolamine test. The results suggest that the stimulation of growth hormone secretion by glucagon is not mediated through an alpha adrenergic mechanism.

Adult

Neonatal hypophosphatasia with elevated serum parathyroid hormone.

Two cases of neonatal hypophosphatasia are described. In case 1, hypercalcemia developed at 2 1/2 months of age and continued until death at 10 1/2 months of age. Serum calcium levels decreased transiently in response to phosphate supplementation, prednisolone, and calcitonin. Significantly elevated levels of PTH were detected at 2 1/2 months of age. At autopsy, no parathyroid glands were found. In case 2, hypercalcemia was not detected in his course. Elevated level of serum PTH was recorded on the 17th day of life. A post-mortem examination revealed the presence of one normal parathyroid gland.

Autopsy

A case of McCune-Albright syndrome with hyperthyroidism and vitamin D-resistant rickets.

A girl aged 1 11/12 year with the unusual combination of McCune-Albright syndrome (polyostotic fibrous dysplasia, cutaneous pigmentation and precocious puberty), hyperthyroidism and vitamin D-resistant rickets is described. Urinary estrogens are increased, while serum LH and FSH responses to LH-RH are subnormal. Thyroid hormone levels in serum and 131I thyroidal uptake are increased, while TSH response to TRH is decreased. Serum phosphorus level is low and phosphate clearance high, while PTH is within normal range. Basal GH level and GH responses to various stimulations are high, but high basal GH is suppressed by oral glucose. The oral glucose tolerance test shows normal blood glucose with hypersecretion of insulin. These data suggest that the common pathogenesis of the various aspects of the syndrome is a hypersensitivity of the target organs, which include the pituitary, the thyroid, the gonads, the pancreatic islet cells and the proximal tubules of the kidney.

Female