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Diffuse esophageal spasm: a malfunction that involves nitric oxide?

https://arctichealth.org/en/permalink/ahliterature11329
Source
Scand J Gastroenterol. 1995 Nov;30(11):1041-5
Publication Type
Article
Date
Nov-1995
Author
J W Konturek
A. Gillessen
W. Domschke
Author Affiliation
Dept. of Medicine B, University of Münster, Germany.
Source
Scand J Gastroenterol. 1995 Nov;30(11):1041-5
Date
Nov-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Arginine - diagnostic use
Esophageal Spasm, Diffuse - metabolism - physiopathology
Esophagus - physiopathology
Female
Humans
Male
Manometry
Middle Aged
Muscle Contraction
Nitric Oxide - metabolism - physiology
Nitroglycerin - diagnostic use
Abstract
OBJECTIVE: As recently suggested, nitric oxide (NO) may play an important role in the regulation of esophageal motility, being partly responsible for the latency period and latency gradient between the onset of a swallow and contractions of esophageal circular smooth muscles. Diffuse esophageal spasm appears to be a classical example in which the mechanisms normally responsible for the physiologic timing of the contractions occurring in the esophageal body after swallowing are disturbed. METHODS: Five patients (one male and four female; age, 18-48 years) with symptomatic esophageal spasm were give glyceryl trinitrate (GTN) intravenously in gradually increasing doses or L-arginine on two separate occasions and underwent manometric measurements of esophageal motility after wet swallows, using a multilumen perfused catheter system (Synetics Medical, Stockholm, Sweden). The amplitude, duration, and propagation of the contractions and the latency period were analyzed, using specially designed software. Additionally, during the GTN infusion period arterial blood pressure was measured every 5 min, RESULTS: GTN infusion given at a dose of 100 to 200 micrograms/kg-h intravenously caused the occurrence of and a dose-dependent elongation of the latency period after swallowing. The mean amplitude of the contractions did not show any significant alterations, whereas the mean duration of the contractions decreased significantly, from 11.2 +/- 4.8 sec to 5.4 +/- 0.8 sec. These effects were accompanied by significant alleviation of symptoms during swallowing. Interestingly, no adverse side effects such as headache or flush were observed at any dose of GTN. The blood pressure did not show any changes during the studies in any of the five patients. Administration of L-arginine (300 mg/kg-h intravenously) did not cause any significant alterations of motility pattern or alleviation of dysphagia. CONCLUSIONS: 1) NO may play an important role in the control of human esophageal motility, being involved in the mechanisms responsible for the timing of propulsive contractions in the body after swallowing; 2) GTN may to be of benefit in the treatment of diffuse esophageal spasm in symptomatic patients; and 3) patients with diffuse esophageal spasm may have a malfunction in endogenous NO synthesis and/or degradation.
PubMed ID
8578161 View in PubMed
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Glucose intolerance is predicted by low insulin secretion and high glucagon secretion: outcome of a prospective study in postmenopausal Caucasian women.

https://arctichealth.org/en/permalink/ahliterature196082
Source
Diabetologia. 2000 Feb;43(2):194-202
Publication Type
Article
Date
Feb-2000
Author
H. Larsson
B. Ahrén
Author Affiliation
Department of Medicine, Lund University, Malmö, Sweden.
Source
Diabetologia. 2000 Feb;43(2):194-202
Date
Feb-2000
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Arginine - diagnostic use
Body constitution
Cohort Studies
European Continental Ancestry Group
Female
Follow-Up Studies
Glucagon - blood - secretion
Glucose Intolerance - epidemiology - physiopathology
Glucose Tolerance Test
Humans
Insulin - blood - secretion
Middle Aged
Postmenopause
Predictive value of tests
Prospective Studies
Regression Analysis
Sweden
Time Factors
Abstract
To study the pathophysiological importance of changes in insulin sensitivity and islet function over time for alterations in glucose tolerance in a randomly selected large group of non-diabetic women aged 57-59 years over a 3-year period.
At baseline and at the 3-year follow-up, glucose tolerance (WHO 75 g oral glucose), insulin sensitivity (euglycaemic, hyperinsulinaemic clamp) and insulin and glucagon secretion (2 to 5-min responses to 5 g i.v. arginine at fasting, 14 and > 25 mmol/l glucose) were measured.
At baseline, women with impaired glucose tolerance (IGT, n = 28) had lower insulin sensitivity (p = 0.048) than normal women (NGT, n = 58). The arginine-induced insulin responses (AIR) were inversely associated with insulin sensitivity (r > or = -0.55, p
PubMed ID
10753041 View in PubMed
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Pituitary size and function in children and adolescents with shunted hydrocephalus.

https://arctichealth.org/en/permalink/ahliterature34237
Source
Clin Endocrinol (Oxf). 1997 Jun;46(6):691-9
Publication Type
Article
Date
Jun-1997
Author
T. Löppönen
E. Pääkkö
J. Laitinen
A L Saukkonen
W. Serlo
P. Tapanainen
A. Ruokonen
P. Pirttiniemi
A. Poikela
M. Knip
Author Affiliation
Department of Paediatrics, University of Oulu, Finland.
Source
Clin Endocrinol (Oxf). 1997 Jun;46(6):691-9
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Arginine - diagnostic use
Body Height
Body mass index
Cerebrospinal Fluid Shunts
Child
Child, Preschool
Cross-Sectional Studies
Female
Follicle Stimulating Hormone - blood
Follow-Up Studies
Growth Hormone - blood
Humans
Hydrocephalus - pathology - physiopathology - surgery
Insulin - diagnostic use
Luteinizing Hormone - blood
Magnetic Resonance Imaging
Male
Pituitary Gland - pathology - physiopathology
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: Most previous reports of endocrine disorders in children with shunted hydrocephalus have been case reports and there is a lack of systematic information on pituitary anatomy and function among these children. We have obtained these data in a large group of individuals with shunted hydrocephalus. DESIGN: A controlled cross-sectional study. PATIENTS: Fifty-four children and adolescents with shunted hydrocephalus were studied for pituitary anatomy and function. They had 54 age- and sex-matched controls (group I). The mean age of the patients and controls was 12.6 years and the mean shunting period 10.6 years. There was a second control group (II) for the magnetic resonance imaging (MRI) and a third control group (III) for the radiography of the sella turcica. MEASUREMENTS: The anatomy was visualized by MRI of the pituitary gland and by radiography of the sella turcica. The functional evaluation included an arginine-insulin test and a combined stimulation test with corticotrophin releasing factor (CRF), GnRH and TRH. RESULTS: The patients were shorter (height 148.4 cm vs 153.7 cm, P
PubMed ID
9274699 View in PubMed
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Prediction of the growth response of short prepubertal children treated with growth hormone. Swedish Paediatric Study Group for GH treatment.

https://arctichealth.org/en/permalink/ahliterature35512
Source
Acta Paediatr. 1995 Jan;84(1):51-7
Publication Type
Article
Date
Jan-1995
Author
B. Kriström
J. Karlberg
K. Albertsson-Wikland
Author Affiliation
Department of Paediatrics, University of Umeå, Sweden.
Source
Acta Paediatr. 1995 Jan;84(1):51-7
Date
Jan-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Arginine - diagnostic use
Body Height - drug effects
Child
Child, Preschool
Female
Growth - drug effects
Growth Disorders - blood - drug therapy - physiopathology
Growth Hormone - blood - therapeutic use
Humans
Insulin - diagnostic use
Male
Predictive value of tests
Puberty
Regression Analysis
Research Support, Non-U.S. Gov't
Sweden
Abstract
The aim of this study was to identify predictors of the growth response to growth hormone (GH) during the first 2 years of GH treatment, using auxological data and the maximum GH response (GHmax) to provocation tests. The patients were 169 prepubertal short children (27F, 142M), with Gmax values ranging from 0 to 65 mU/l. Their mean age (+/- SD) was 8.3 +/- 2.4 years (range 3-13 years), mean height SDS -3.0 +/- 0.7 (range -1.5 to -6.0 SDS) and mean pretreatment height velocity was normal (+/- 0.0 SDS) (range -1.6 to +0.9 SDS). The increase in height SDS during the first 2 years of GH treatment (0.1 U/kg/day) varied from 0.10 to 3.75 SDS, with younger children having a better growth response. Individual growth responses correlated (p
PubMed ID
7734899 View in PubMed
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Prediction of the outcome of growth hormone provocative testing in short children by measurement of serum levels of insulin-like growth factor I and insulin-like growth factor binding protein 3.

https://arctichealth.org/en/permalink/ahliterature34391
Source
J Pediatr. 1997 Feb;130(2):197-204
Publication Type
Article
Date
Feb-1997
Author
A. Juul
N E Skakkebaek
Author Affiliation
Department of Growth and Reproduction (GR 5064), National University Hospital, University of Copenhagen, Denmark.
Source
J Pediatr. 1997 Feb;130(2):197-204
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Arginine - diagnostic use
Biological Markers - blood
Body Height - drug effects
Child
Child, Preschool
Clonidine - diagnostic use
Denmark
Female
Human Growth Hormone - blood - deficiency - drug effects
Humans
Infant
Infant, Newborn
Insulin-Like Growth Factor Binding Protein 3 - blood
Insulin-Like Growth Factor I - analysis
Longitudinal Studies
Male
Prognosis
Reference Values
Sensitivity and specificity
Abstract
Serum levels of insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3) reflect the secretion of endogenous growth hormone (GH) in healthy children and exhibit little diurnal variation, which makes them potential candidates for screening of GH deficiency (GHD). We evaluated serum IGF-I and IGFBP-3 levels in relation to the outcome of GH provocative testing in 203 children and adolescents (111 boys and 92 girls) in whom GHD was suspected. A total of 1030 children served as control subjects. In children less than 10 years of age, IGF-I levels were below the cutoff limit in 8 of 15 children with GHD (sensitivity 53.3%) and above the cutoff limit in 47 of 48 children with a normal GH response (specificity 97.9%). Similarly, IGFBP-3 levels were below the cutoff limit in 9 of 15 children with GHD (sensitivity 60%) and above the cutoff limit in 47 of 48 children with a normal GH response (specificity 97.9%). Consequently the predictive value of a positive test result in prepubertal children was 88.8% for IGF-I and 90% for IGFBP-3. In children and adolescents between 10 and 20 years of age, IGF-I levels were below the cutoff limit in 34 of 46 children with GHD (sensitivity 73.9%) and above the cutoff limit in 63 of 94 children with normal GH response (specificity 67%). IGFBP-3 levels were below the cutoff limit in 26 of 46 children with GHD (sensitivity 56.5%) and above the cutoff limit in 74 of 94 children with a normal GH response (specificity 78.7%). Accordingly the positive predictive value and in 10- to 20-year-old children was 52.3% for IGF-I and 56.5% for IGFBP-3. Combination use of IGF-I and IGFBP-3 gave additional diagnostic information. We conclude that a subnormal IGF-I level, and especially a subnormal IGFBP-3 level, are highly predictive of a subnormal GH response to a provocative test in prepubertal children in whom GHD is suspected. On the other hand, a normal IGF-I or IGFBP-3 level does not exclude GHD. The predictive value of IGF-I and IGFBP-3 in pubertal children is diminished in comparison with that in prepubertal children. We believe that IGF-I and IGFBP-3 are valuable tools in the evaluation of childhood GHD.
Notes
Comment In: J Pediatr. 1997 Feb;130(2):172-49042114
PubMed ID
9042120 View in PubMed
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6 records – page 1 of 1.