Cholinergic impact on neuroplasticity drives muscarinic M1 receptor mediated differentiation into neurons.

Objectives: Increasing evidence indicates that canonical neurotransmitters act as regulatory signals during neuroplasticity. Here, we report that muscarinic cholinergic neurotransmission stimulates differentiation of adult neural stem cells in vitro.

Methods: Adult neural stem cells (ANSC) dissociated from the adult mouse hippocampus were expanded in culture with basic fibroblast growth factor (BFGF) and epidermal growth factor (EGF).

Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children.

Context: Animal data suggest that adverse early experiences may affect endocrine and immune functioning in later life.

Objective: Our objective was to assess the impact of preterm delivery on hypothalamus-pituitary-adrenal axis functioning, heart rate responses, and immune function.

Participants: Former preterm children [aged 8-14 yr (n = 18)], sex and age-matched full-term born control children (n = 18), data on birth weight, gestational age, birth weight for gestational age (in sd units), actual body weight, height, and body mass index were assessed.

Increased responsiveness of the hypothalamus-pituitary-adrenal (HPA) axis to stress in newborns with atopic disposition.

In previous studies, atopic patients showed attenuated cortisol responses to psychosocial stress which is suggestive of a hyporeactive hypothalamus-pituitary-adrenal (HPA) axis in this patient group. Regarding the anti-inflammatory role of glucocorticoids, reduced responsiveness of the HPA axis under stress may be one potential explanation of stress-induced exacerbation of atopic symptoms. The present study evaluated whether hyporeactivity of the HPA axis is a feature related to the disposition of atopy rather than a consequence of an ongoing chronic allergic inflammatory process.

Blunted cortisol responses to psychosocial stress in asthmatic children: a general feature of atopic disease?

Objective: Atopy is defined by the individual predisposition to develop a group of inflammatory disorders in response to certain food or environmental substances that are otherwise innocuous for the host. In previous studies we could demonstrate a reduced responsiveness of the hypothalamus-pituitary-adrenal (HPA) axis to psychosocial stress in young and adult patients with atopic dermatitis (AD), a chronic atopic skin disorder. With respect to the important immunoregulatory role of the HPA axis, especially under stress, this observation could be of clinical relevance and may at least partly explain stress-induced exacerbation of AD.

Delayed appearance of bilateral morgagni herniae in a child with Down's syndrome.

This case report describes the delayed presentation of bilateral Morgagni herniae in a 4 1/2-year-old boy with Down's syndrome. The authors emphasize the difficulties in establishing the diagnosis, although ultrasonography appears to be valuable. A review of the literature suggests an association between Morgagni hernias and trisomy 21.

Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis.

Objective: Atopic dermatitis (AD) is an inflammatory skin disease characterized by a hyperactivity of the humoral immune system with an onset in infancy or early childhood. Although most of the research has focused on the pathophysiological role of the immune system in AD, the impact of endocrine signals in the pathology of AD has received only little attention. However, because the endocrine system may play a regulatory role in immune functioning, it might be of major interest to study endocrine reactivity in AD patients.

Clinical experience of a tricomponent acellular pertussis vaccine combined with diphtheria and tetanus toxoids for primary vaccination in 22,505 infants.

Objectives: To assess the safety and tolerability of 12 lots of SmithKline Beecham Biologicals' diphtheria-tetanus-tricomponent acellular pertussis vaccine (DTaP) in a large cohort of 22,000 vaccinees, with detailed analyses of reactivity, immunogenicity, and immune response to pertussis toxin in subsets.

Methods: In a prospective, double-blind, multicenter trial in Germany, 22,505 healthy infants received three vaccinations of DTaP at age 3, 4, and 5 months. Serious adverse events were followed for 1 month after each vaccination, and neurologic events for 1 year or longer.

Efficacy of acellular pertussis vaccine in early childhood after household exposure.

Objective: To evaluate the efficacy of a three-dose primary vaccination with a diphtheria-tetanus tricomponent acellular pertussis vaccine against "typical" pertussis, defined as a spasmodic cough of 21 days or longer with confirmation of Bordetella pertussis infection by culture or serology.

Design: Passive monitoring for suspected first household (index) cases of typical pertussis in six areas in Germany comprising 22,505 children vaccinated with study vaccine at 3, 4, and 5 months of age. Blinded, prospective follow-up of household contacts of index cases for incidence and progression of pertussis.

[Blunt abdominal trauma caused by child abuse].

We report about 3 boys under 4 years of age with abdominal blunt trauma following child abuse admitted to our clinic with different diagnoses. Common were fresh or older haematomas, burn wounds, for which the parents had no plausible explanation. The children had no skeletal or intracranial lesions, but they developed abdominal pain, which became worse in the absence of the parents.

[Reduction of table salt and diuretic therapy in arterial hypertension in childhood].

Experimental, epidemiological and clinical evidence indicates that salt plays a major role in the pathogenesis of arterial hypertension. Endocrine and membrane ion transport studies suggest a genetic disposition with regard to salt susceptibility. In the industrialized countries sodium intake in children probably exceeds the physiological needs.

[Nocturnal hypoglycemias and cortisol excretion in overnight urine].

In 20 juvenile diabetic inpatients the relationship between nocturnal hypoglycemia and overnight urinary cortisol excretion was studied. Cortisol was expressed as absolute quantity per kg body weight because the cortisol/creatinine ratio does not always yield reliable results in diabetic patients. Comparison between different patients yielded no significant difference between posthypoglycemic and non-posthypoglycemic cortisol values.

Determinants of plasma arginine-vasopressin in children.

Plasma concentration of arginine-vasopressin (AVP) was measured in 145 healthy subjects aged one day to 18 years of age. AVP decreased with age immediately after birth. Above one year of age values of children did not significantly differ from those in adults.

[Endocrine and neurogenic hypertension in childhood].

Endocrine and neurological diseases are rare causes of arterial hypertension in childhood. They represent less than 5% of all cases of secondary hypertension. Inflammatory, traumatic, and tumorous disorders of the central nervous system rarely result in chronic hypertension but may frequently be associated with acute hypertensive crisis.

Hypothalamo-pituitary-gonadal axis in children with chronic renal failure.

Delayed puberty in children with chronic renal failure (CRF) may be due to gonadal dysfunction, increased plasma binding of gonadal hormones, or changes of the hypothalamo-pituitary axis. Plasma androgens were studied in 17 prepubertal boys with preterminal CRF. In addition, the response of luteinizing and follicle-stimulating hormones (LH, FSH) to luteinizing-releasing hormone (LHRH) was followed in the plasma of these boys and of 12 prepubertal girls with CRF.

Vasoactive hormones in children with chronic renal failure.

Plasma renin activity (PRA), aldosterone, vasopressin and catecholamines were measured in 15 children (ages 7.3 to 16.2 years) with chronic renal failure (CRF) before and after one session of hemodialysis and in 15 control children.

Progressive adrenal failure in polyglandular autoimmune disease.

We describe the clinical course of a boy who developed progressive adrenal failure, beginning with failure of the zona glomerulosa, as part of polyglandular autoimmune disease. Initially the patient presented with hypoparathyroidism and mucocutaneous candidiasis. ACTH tests at ages 8 and 11 yr resulted in a normal response of both mineralo- and glucocorticoids.

Adrenal glomerulosa function in patients with dexamethasone-suppressible hyperaldosteronism.

The response of the adrenal glomerulosa to renin stimulation was determined in 10 patients with dexamethasone-suppressible hyperaldosteronism. The patients were treated continuously with 2 mg/day dexamethasone (DEX) and were studied on a regular sodium diet (87 meq/m2 . day) and on a 10 meq/day sodium diet.

Quantitative enzymatic histophotometry of morphologic alterations caused by urologically relevant tubular kidney damages using computed image analysis device technique.

The tissue concentration of tubular marker enzymes were evaluated in sections of kidneys from 86 patients with various underlying diseases such as hydronephrosis, interstitial nephropathies, ischemia due to renal arterial stenosis and chronic allograft rejection. In addition, as an experimental model, kidney tissue sections of 166 Wistar rats were analyzed due to hydronephrosis caused by ureteral obstruction, ischemia and obstruction of the renal vein. The tissue concentration of indicator enzymes, such as alkaline phosphatase (AP) and alanine-aminopeptidase (AAP), was considered as a parameter describing the extent of kidney tubule damage.

Aldosterone response to prolonged ACTH infusion in juvenile hypertension.

The effects of a continuous 5-day ACTH infusion (40 units/24 hr) on plasma aldosterone (aldo) concentration and urinary excretion of aldosterone pH 1 conjugate, tetrahydroaldosterone and free aldo were investigated in 6 normotensive children, and 7 children with hypertension of unknown origin. In both groups, an initial rise of plasma aldo and all urinary aldo metabolites and a subsequent fall were observed during the ACTH test. The decline in plasma aldo correlated significantly with a decrease in plasma renin activity and serum K+.