The perioperative management of pheochromocytoma in children.

The perioperative experiences of 15 children and adolescents who underwent a total of 18 surgical procedures for resection of a pheochromocytoma were analyzed to determine clinical or hemodynamic events associated with intraoperative or postoperative complications. Of the pre- and intraoperative factors assessed, only preoperative resolution of symptoms and normalization of blood pressure were predictive of uncomplicated outcome. No intraoperative factors were statistically associated with outcome, but the four patients with complicated outcomes had had aggressively administered intraoperative fluids.

Assessment of growth hormone (GH) axis in Turner's syndrome using 24-hour integrated concentrations of GH, insulin-like growth factor-I, plasma GH-binding activity, GH binding to IM9 cells, and GH response to pharmacological stimulation.

The GH axis was studied in Turner's syndrome (TS) patients. Thirty-seven prepubertal TS patients and 42 normally growing girls (NGG; 5.5-16.

Predictors of growth response to growth hormone in otherwise normal short children.

Sixty prepubertal short children (39 boys) with heights less than 2 SD for age and gender were treated daily for 1 year with recombinant human growth hormone (GH), either 0.1 IU/kg (group 0.1, n = 32) or 0.

Risk factors for small-for-gestational-age birth in a preterm population.

Objective: The objective of this study was to discovery any distinct risk factors for small-for-gestational-age birth among premature infants.

Study Design: Demographic and obstetric risk factors were compared for 136 small-for-gestational-age prematures and 636 appropriate-for-gestational-age premature infants.

Results: Three significant risk factors for growth retardation among premature infants were found: black maternal race (odds ratio 2.

Cigarettes, coffee, and preterm premature rupture of the membranes.

Premature (prior to 37 completed weeks of gestation) rupture of the membranes (preterm PROM) is one of the most common underlying causes of preterm delivery. However, there have been few epidemiologic studies of this obstetric complication. The authors studied the relation of maternal cigarette smoking and coffee consumption to both preterm PROM and spontaneous preterm labor not complicated by premature rupture of the membranes (preterm NONPROM) in a large cross-sectional data base.

Association of intrauterine cigarette smoke exposure with indices of fetal lung maturation.

The timing of fetal lung maturation is regulated, at least in part, by the fetal endocrine milieu, which in turn may be influenced by environmental factors. Infants of smoking mothers are at decreased risk of neonatal respiratory distress syndrome (RDS), a disease of lung immaturity. Therefore, we measured fetal lung maturity and cigarette smoke exposure to determine whether the lungs of smoke-exposed fetuses mature more quickly and whether changes in maturation are associated with alterations in amniotic fluid (AF) cortisol levels.

Mechanisms of glutamate activation of axon-to-Schwann cell signaling in the squid.

Membrane potentials from Schwann cells associated with giant axons of the small squid (Alloteuthis and Loliguncula) and the large squid (Loligo) were monitored with glass microelectrodes following 100 Hz/15 s axonal stimulation, or the application of 10(-7) M glutamate and ion substitutions, in the presence or absence of 10(-7) M d-tubocurarine. Glutamate or stimulation caused the membrane of the Schwann cell to depolarize to approximately -32 mV. This was rapidly replaced by a transient hyperpolarization to approximately -55 mV; the potential returning to the resting level (-40 mV) in approximately 7 min.

Clinicopathologic description of myocarditis.

Histologic evidence of myocarditis was demonstrated in 35 of 348 patients submitted to endomyocardial biopsy over 5 years. Analysis of the histologic findings and clinical course of these patients resulted in a new clinicopathologic classification of myocarditis in which four distinct subgroups are identified. Patients with fulminant myocarditis become acutely ill after a distinct viral prodrome, have severe cardiovascular compromise, multiple foci of active myocarditis by histologic study and ventricular dysfunction that either resolves spontaneously or results in death.

Risk factors for abruptio placentae.

The authors studied the relation of sociodemographic, medical, and life-style factors and abruptio placentae in a large cross-sectional data base. The 143 cases of abruption identified in the Delivery Interview Program, conducted in Boston from 1977 to 1980, were compared with 1,257 randomly selected controls. The authors used multiple logistic regression techniques to derive maximum likelihood estimates of the adjusted odds ratios and 95% confidence intervals as measures of the association between exposure factors and abruption.

Adverse infant outcomes associated with first-trimester vaginal bleeding.

We assessed the association between first-trimester vaginal bleeding and singleton infant outcomes in a hospital-based population of 11,444 nondiabetic women. Low birth weight (LBW), shortened gestation, LBW at term, and neonatal death occurred more often in women reporting first-trimester bleeding than in those who never bled. These relationships remained statistically significant after adjusting for confounding factors.

Cigarette smoking during pregnancy in relation to placenta previa.

To evaluate the relationship between cigarette smoking and the occurrence of placenta previa, we used interview and medical record data to conduct a case-control analysis of 69 placenta previa cases and 12,351 controls. The unadjusted relative risk estimate of placenta previa for women reported to have "ever smoked" during pregnancy relative to nonsmoking mothers was 1.9 (95% confidence interval, 1.

S-nitrosocysteine inhibition of human platelet secretion is correlated with increases in platelet cGMP levels.

Platelet inhibition by exogenous and endogenous nitrovasodilators has been shown to be associated with increases in cGMP, but proof of a role for cGMP in this process is lacking. We therefore studied the effects of cGMP and guanylate cyclase stimulation on human platelet secretion by pharmacologically modulating intraplatelet cGMP levels. The endothelium-derived relaxing factor (EDRF)-like activator of guanylate cyclase, S-nitrosocysteine (SNOC), led to a dose-dependent inhibition of secretion in intact human platelets (IC50 = 10(-6) M).

Determination of the membrane potential of cultured mammalian Schwann cells and its sensitivity to potassium using a thiocarbocyanine fluorescent dye.

The membrane potential of cultured rat sciatic nerve Schwann cells was determined with conventional microelectrode and voltage-sensitive fluorescent dye, Di-S-C3(5), optical techniques. The value for membrane potential obtained with microelectrodes was -42.1 +/- 4.

Axon-glia interactions in the crayfish: glial cell oxygen consumption is tightly coupled to axon metabolism.

Oxygen consumption (QO2) of single isolated axons and their associated glial cell sheath was investigated under a variety of conditions to determine the contribution of each cell type to whole tissue QO2. It was found that the QO2 of the sheath, in the absence of a functional axon, represented approximately 30% of the total tissue QO2. When the axon was injected with carboxyatractyloside, an inhibitor of mitochondrial oxidative phosphorylation that is membrane impermeant, electrophysiological properties of the axon were not affected and glial sheath respiratory activity was stimulated by 1.

Chronic growth hormone administration does not suppress endogenous growth hormone secretion in patients with neurosecretory growth hormone dysfunction.

Short children who respond normally to growth hormone (GH) stimulation, but have a subnormal spontaneous secretion of GH (neurosecretory GH dysfunction, NSD) are treated with exogenous GH which might suppress their endogenous GH secretion. The effect of chronic administration of GH (8-24 months) on plasma GH responses to GHRH, clonidine and spontaneous GH secretion were studied in 17 NSD patients. The diagnosis of NSD was based on a normal GH response to clonidine (greater than 10 micrograms/l) and an integrated concentration of (IC-GH) GH less than 3.

Persistent hyperinsulinemic hypoglycemia of infancy ("nesidioblastosis"): autosomal recessive inheritance in 7 pedigrees.

Persistent Hyperinsulinemic Hypoglycemia of Infancy (PHHI) is a rare disease characterized clinically by persistent hypoglycemia with inappropriately elevated circulating insulin concentrations. Here we report on 7 pedigrees including 21 cases. The pedigrees are derived from 3 distinct ethnic groups, and include a very large Bedouin family, and Arab family, and 5 smaller pedigrees of Jewish families all of Eastern European origin.

Age, sex, and road-use patterns of motor vehicular trauma in Rhode Island: A population-based hospital emergency department study.

Population-based hospital emergency department data on motor vehicle traffic trauma in Rhode Island, 1984-85, are analyzed by age, sex, and road-use status. Annualized rates of overall and severe trauma were 1,195 cases (95% confidence interval [CI] = 1,164, 1,225) and 102 cases (95% CI = 94, 111) per 100,000 population, respectively. Overall and severe rates peaked at ages 15-24 years.

Soft tissue calcification in pediatric patients with end-stage renal disease.

Soft tissue calcification is a recognized complication of uremia in adult patients and has been implicated as a cause of ischemic necrosis, cardiac arrhythmias, and respiratory failure. However, soft tissue calcification has been regarded as rare in pediatric renal patients. Following a sudden death due to pulmonary calcinosis in an adolescent after renal transplantation, we retrospectively reviewed clinical, biochemical and autopsy data of 120 patients with uremia, on dialysis, or following renal transplantation cared for at Childrens Hospital of Los Angeles from 1960 to 1983.

Interpregnancy interval and risk of preterm labor.

In 1977-1980, over 12,000 pregnant women being followed at the Boston Hospital for Women were interviewed and had their medical records reviewed. The effect of interpregnancy interval on the risk of preterm labor was estimated in 4,467 of these women whose previous pregnancy had resulted in a full-term live birth. The rate of preterm birth after the spontaneous onset of labor in this cohort was 3.