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This study was undertaken to investigate the prevalence of coeliac disease in children and adolescents with Turner syndrome. Eighty-seven children and adolescents with Turner syndrome were screened for IgA-antiendomysium antibodies (EMA) and IgA-antigliadin antibodies (AGA), 5% (4/87) being found to be EMA-positive, and 15% (13/87) to have AGA levels above normal. Of the 10 patients who were either AGA- or EMA-positive and further investigated with intestinal biopsy, four manifested villous atrophy (i.e. all three of the EMA-positive patients, but only one of the seven AGA-positive patients). The results suggest EMA-positivity to be a good immunological marker for use in screening for coeliac disease, and such screening to be justified in patients with Turner syndrome. [ABSTRACT FROM AUTHOR]

Twenty children, aged 4-9 years, underwent adeno/tonsillectomy because of unequivocal anamnestic nocturnal obstructive breathing. Preoperatively, apnea-hypopnea index was >5 in 10 cases only, AI>1 in 17. Nineteen children had signs of increased respiratory labour in movement recordings and inspiratory EMG-activity. Oxygen desaturation index was 0 in 7 children, and nadir SaO[sub 2] was ≥90% in 10. Cephalometry and dentition study models initially revealed significant changes, chiefly lateral cross-bite (n=11) and vertical growth direction of the mandible. Tonsillar size or duration of disease was not correlated with the severity of polysomnographic findings, nor were orthodontic variables. Symptoms disappeared promptly postoperatively. After one year, respiratory recordings were normalized or improved in the majority of children, and orthodontic variables normalized or improved in all children. Conclusion: Oximetry and airflow recordings may be normal in children who benefit from treatment of anamnestic nocturnal obstruction. Craniofacial deformities are common and improve significantly with surgical treatment of the airway obstruction. [ABSTRACT FROM AUTHOR]

Albertsson Wikland K, Alm F, Aronsson S, Gustafsson J, Hagenas L, Hager A, Ivarsson S, Kristrom B, Marcus C, Moe11 C, Nilsson KO, RitzCn M, Tuvemo T, Westgren U, Westphal 0, Aman J. Effect of growth hormone (GH) during puberty in GH-deficient children: preliminary results from an ongoing randomized trial with different dose regimens. Acta Pxdiatr 1999; Suppl 428:80-4. Stockholm. ISSN 0803-5326 This paper reports results from an ongoing, randomized, multicentre national trial. The aim is to elucidate whether a dose of growth hormone (GH) of 0.2 IUkg (0.07 mgkg), given either as once-daily or twice-daily injections during puberty, is more effective than a once-daily dose of 0.1 IU/kg/day (0.03 mg/kg/day) in improving final height in children with GH deficiency (GHD). The twice-daily regimen comes closer to the spontaneous GH secretion pattern in puberty. Ninety-two children with GHD who had been receiving GH therapy for at least 1 year, and with spontaneous puberty or who were prepubertal and due to be started on replacement therapy to induce puberty, were randomly assigned to receive GH as follows: group A, 0.1 IU/kg/day (0.03 mg/kg/day), administered once daily; group B, 0.2 IU/kg/day (0.07 mg/kg/day), administered once daily; and group C, 0.2 IUkg/day (0.07 mg/kg/day), divided into two equal injections given at 12-hour intervals. Pubertal height gain was 0.7, 0.7 and 1.3 SDS for groups A, B and C, respectively. The gain in height during puberty was thus most marked in group C. Mean final height, when corrected for parental height, was between 0 and 1 SDS in all treatment groups. All but seven children reached a final height within 2 SD of the general population. There was a wide range of final heights in all three treatment groups. This variation in response suggests the need to individualize treatment in order to achieve an appropriate final height for most individuals. □ Dose, final height, growth hormone treatment, puberty, randomized treatment trial [ABSTRACT FROM AUTHOR]

Chronic limb-threatening ischemia (CLTI) has a major impact on patients' lives and is associated with a heavy health care burden with high morbidity and mortality. Treatment by endovascular intervention is mostly based on macrocirculatory information from angiography and does not consider the microcirculation. Despite successful endovascular intervention according to angiographic criteria, a proportion of patients fail to heal ischemic lesions. This might be due to impaired microvascular perfusion and variations in the supply to different angiosomes. Non-invasive optical techniques for microcirculatory perfusion and oxygen saturation imaging have the potential to provide the interventionist with additional information in real-time, supporting clinical decisions during the intervention. This study presents a novel multimodal imaging system, based on multi-exposure laser speckle contrast imaging and multi-spectral imaging, for continuous use during endovascular intervention. The results during intervention display spatiotemporal changes in the microcirculation compatible with expected physiological reactions during balloon dilation, with initially induced ischemia followed by a restored perfusion, and local administration of a vasodilator inducing hyperemia. We also present perioperative and postoperative follow-up measurements with a pulsatile microcirculation perfusion. Finally, cases of spatial heterogeneity in the oxygen saturation and perfusion are discussed. In conclusion, this technical feasibility study shows the potential of the methodology to characterize changes in microcirculation before, during, and after endovascular intervention., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

The aim of the study was to investigate the effects of alpha-melanocyte-stimulating hormone (alpha-MSH), a tridecapeptide derived from proopiomelanocortin (POMC), on the neurodegeneration following global cerebral ischemia and reperfusion in the rat. The biological activities of alpha-MSH include inhibition of inflammatory responses and anti-pyretic effects. Male Sprague-Dawley rats were subjected to four-vessel occlusion (4-VO) global cerebral ischemia followed by reperfusion, and treated with alpha-MSH (intraperitoneally, i.p.) at 30 min, and 24, 48, 72 and 96 h post-ischemia. Stereological quantification of the pyramidal cells in the CA1 area of the hippocampus showed that the number of viable neurons in ischemic rats was 96,945+/-18,610 (means+/-SD) as compared to 183,156+/-49,935 in sham-operated rats (P<0.05). The number of viable neurons after treatment of ischemic rats with alpha-MSH was 162,829+/-34,757, i.e. significantly different from the number of viable neurons in ischemic rats injected with saline (P<0.01). Astrocyte proliferation due to the ischemic insult was markedly reduced by the treatment with alpha-MSH, and the loss in body weight was reduced by alpha-MSH. In conclusion, post-ischemic administration of alpha-MSH was found to provide neuroprotection in the CA1 pyramidal cell layer in the hippocampus, concomitant with a reduction in glial activation, indicating that alpha-MSH or mimetics thereof may have a potential in the treatment of stroke or other neurodegenerative diseases. Further studies will be required to define the post-ischemic time window for administration of alpha-MSH.

In the Rana temporaria tadpole, the part of the infundibular floor that eventually becomes the eminentia mediana is very thin throughout premetamorphosis; the supply of aminergic and neurosecretory nerves is poor, and the area is covered by a few fenestrated capillaries. The organ begins to thicken around mid-prometamorphosis owing to a marked invasion of nerves. At this stage it is also penetrated by capillaries and perivascular space extensions, which together form the neurovascular link structures. These become more pronounced during metamorphic climax, when the eminentia mediana attains the adult appearance. Development of the organ is arrested at the premetamorphic stage after thyroidectomy in the young premetamorphic tadpole. Removal of the adenohypophysial primordium from the embryo of the tailbud stage prevents the vascular-but not the neural-component of the eminentia from developing beyond the premetamorphic stage. By contrast, in the American Rana-species investigated the neural component also fails to develop after hypophysectomy.

The quantitative distribution of mutans streptococci and lactobacilli in saliva of insulin-dependent diabetic children was compared with a group of healthy children and related to the metabolic control of the disease. The study group, consisting of 94 boys and girls (age 4-19) with type 1 diabetes was matched by sex and age with a non-diabetic control group. Stimulated whole saliva was collected and flow rate, buffer capacity and the levels of mutans streptococci and lactobacilli were analysed in all children. In the diabetic group, total salivary proteins and glucose content of saliva were determined. Data on caries experience were recorded from the dental cards of all children. There were no difference in the distribution or number of mutans streptococci between the groups, but significantly (p less than 0.05) lower levels of lactobacilli were found among the diabetic children. The number of lactobacilli was positively correlated (p less than 0.05) to glucose concentration in saliva. There was no difference in the prevalence of caries between the groups. The present findings suggest that the dietary treatment of young insulin dependent diabetics gives rise to a reduced number of lactobacilli in saliva but does not affect the mutans streptococci.

With the aid of lesion experiments and the Falck-Hillarp fluorescence technique, it is shown that the aminergic nerves of the hypophysis, including pars distalis, originate in the caudal hypothalamus and reach the gland via a fibre tract in the floor of tuber cinereum. However, some contribution to the eminentia mediana from the preoptic area could not be excluded. A vasomotor function of the pars distalis nerves is unlikely. Based on a comparative survey the hypothesis is put forward, that the pars distalis nerves, which disappear during the metamorphic climax, are remnants of an aminergic innervation existing together with a hypophyseal portal system as a functional link between brain and pituitary in the fish-like ancestor of amphibians. Aspects are given on the problem of why a direct pars distalis innervation has neither been retained nor evolved during evolution of tetrapods.

In Rana temporaria tadpoles, fluorescent fibres appear in the prospective eminentia mediana, the pars intermedia and the pars distalis at Gosner's stage 25. During prometamorphosis the amount of fluorescent material increases around the developing primary capillary plexus in the eminentia mediana. In the pars intermedia the fibres form a dense fluorescent network but in the pars distalis the fibres are few and delicate. At stages 42-43, the onset of climax, the pars distalis fibres disappear. The possible functional significance of the pars distalis fibres is discussed. The background adaptation ability appears at stages 28-29, while the fluorescent pars intermedia innervation is observable at stage 25.