Natural occurrence of the diamond hexagonal structure in silicon nanowires grown by a plasma-assisted vapour-liquid-solid method

Silicon nanowires have been grown by a plasma-assisted vapour-liquid-solid method using tin as the catalyst. Transmission electron microscopy in the [12[combining macron]10] zone axis shows that the diamond hexagonal (P6₃/mmc) crystal structure is present in several nanowires. This is the first unambiguous proof of the natural occurrence of this metastable phase to our knowledge.

Synthesis engineering of iron oxide raspberry-shaped nanostructures

Magnetic porous nanostructures consisting of oriented aggregates of iron oxide nanocrystals display very interesting properties such as a lower oxidation state of magnetite, and enhanced saturation magnetization in comparison with individual nanoparticles of similar sizes and porosity. However, the formation mechanism of these promising nanostructures is not well understood, which hampers the fine tuning of their magnetic properties, for instance by doping them with other elements. Therefore the formation mechanism of porous raspberry shaped nanostructures (RSNs) synthesized by a one-pot polyol solvothermal method has been investigated in detail from the early stages by using a wide panel of characterization techniques, and especially by performing original in situ HR-TEM studies in temperature. A time-resolved study showed the intermediate formation of an amorphous iron alkoxide phase with a plate-like lamellar structure (PLS). Then, the fine investigation of PLS transformation upon heating up to 500 °C confirmed that the synthesis of RSNs involves two iron precursors: the starting one (hydrated iron chlorides) and the in situ formed iron alkoxide precursor which decomposes with time and heating and contributes to the growth step of nanostructures. Such an understanding of the formation mechanism of RSNs is necessary to envision efficient and rational enhancement of their magnetic properties.

Clinical and Pathological Analysis of Two Cases of Cutaneous Malignant Melanoma

The purpose of this study was the clinical and histo-immunohistochemical analysis of two cases: a cutaneous pigmented facial malignant melanoma and a lumbar congenital nevus with malignant transformation. A series of clinical elements raised the suspicion of some malignant melanocytic lesions and the histopathological analysis through the paraffin embedding technique confirmed the clinical suspicion. The immunohistochemical analysis using the streptavidin-biotin-peroxydase method of the facial malignant melanoma showed: S100 protein intense and diffuse positive, Tyrosinase diffuse positive, HMB45 strong and focal positive, Cyclin D1 positive in approximately 40% and Ki-67 positive in almost 70% of the tumor cells. The malignant melanoma developed on the nevocellular nevus displayed: S100 protein intense and diffuse positive, both in the nevus cells and in the malignant melanocytes as well, Tyrosinase intense and diffuse positive in the malignant melanocytes, poor and focal positive in the nevus cells and HMB45 intense and focal positive in the malignant cells and positive in the isolated nevus cells. Cyclin D1 was positive in about 70% of the malignant cells, but negative in the nevus area and Ki-67 was found positive in relatively 30% of the malignant melanocytes, also in less than 1% of the nevus cells. The pattern and the intensity of the Tyrosinase and HMB45 immunoexpression are important in the differentiation of the nevus cells from the malignant melanocytic cells. The immunoexpression of Cyclin D1 does not correlate directly with the proliferating activity of the malignant melanocytic cells in all types of malignant melanomas.

[Adult onset Still's disease with normal level of serum ferritin]

We present a case of an adult onset Still's disease: a 51 year old men presented with one month history of high spiking fever, asymmetric migratory polyarthritis and a previous history of pharyngitis. The diagnostic was based upon clinical criteria and laboratory findings, and necessitated the exclusion of infectious, neoplastic, and other "autoimmune" disease. The systemic involvement in our case induced us to comment therapy with corticosteroid. Patients with systemic disease have a favorable prognosis, with only rare serious complications from the disease (pericarditis, tamponade, diffuse intravascular coagulation, amyloidosis, hepatic disease, and respiratory failure) or the treatment (infections, gastrointestinal bleeding etc.).

A comparative study of the efficacy of acute and continuation treatment with escitalopram versus duloxetine in patients with major depressive disorder

OBJECTIVE

This study evaluated the efficacy and tolerability of escitalopram and duloxetine in the treatment of major depressive disorder (MDD).

RESEARCH DESIGN AND METHODS

Patients were randomised to 24 weeks of double-blind treatment with fixed doses of escitalopram (20 mg) (n = 143) or duloxetine (60 mg) (n = 151). The primary analysis of efficacy was an analysis of covariance (ANCOVA) of change from baseline to endpoint (week 24) in MADRS total score (last observation carried forward). MAIN OUTCOME MEASURES;

RESULTS

At week 8, the mean change from baseline in total MADRS score was -19.5 for patients treated with escitalopram (n = 141) and -17.4 for patients treated with duloxetine (n = 146), a difference of 2.1 points (p < 0.05). At week 8, the proportion of responders (> or = 50% decrease in MADRS) was 69% (escitalopram) and 58% (duloxetine) (p < 0.05) and remission (MADRS < or = 12) rates were 56% (escitalopram) and 48% (duloxetine) (NS). For the primary endpoint, the mean change from baseline in total MADRS score at week 24 was -23.4 for patients treated with escitalopram and -21.7 for patients treated with duloxetine, a difference of 1.7 points (p = 0.055, one-sided). The difference in mean change from baseline in MADRS total score favoured escitalopram at weeks 1, 2, 4, 8, 12 and 16 (p < 0.05). The overall withdrawal rates were 22% (escitalopram) and 25% (duloxetine) (NS). The withdrawal rate due to adverse events was lower for escitalopram (9%) compared to duloxetine (17%) (p < 0.05) and significantly more patients treated with duloxetine reported insomnia (12.6% vs. 4.9%) and constipation (8.6% vs. 2.8%).

CONCLUSION

Escitalopram was superior to duloxetine in acute treatment and at least as efficacious and better tolerated in long-term treatment of MDD.

Effect of a variable hepatic insulin clearance on the postprandial insulin profile: insights from a model simulation study

The liver plays a pivotal role in determining postprandial insulin levels because it is responsible for the extraction of a large (approximately 50%) fraction of the newly secreted insulin by the pancreas. Evidence exists that hepatic insulin extraction is not constant during a meal, but is inhibited because of saturable receptor-mediated mechanisms and/or increase in hepatic blood flow. The aim of the present study was to exploit the ability of mathematical model simulation to shed light on the role of a variable hepatic insulin extraction during a meal. Mathematical models of insulin secretion and kinetics were coupled to provide predictions for the concentration of insulin in plasma following a meal under the assumptions of either a constant or a time-varying hepatic insulin clearance. Our results indicate that a 20% inhibition in hepatic clearance is able to remarkably enhance the plasma insulin level following a meal. These results emphasise the need for simple and accurate methods to measure the time course of hepatic insulin extraction under nonsteady-state conditions.

A comparative study of the efficacy of long-term treatment with escitalopram and paroxetine in severely depressed patients

OBJECTIVE

This randomised, double-blind, fixed-dose study evaluated the efficacy of escitalopram and paroxetine in the long-term treatment of severely depressed patients with major depressive disorder (MDD).

RESEARCH DESIGN AND METHODS

Patients with a primary diagnosis of MDD and baseline Montgomery-Asberg Depression Rating Scale (MADRS) >or= 30 were randomised to 24 weeks of double-blind treatment with fixed doses of either escitalopram (20 mg) (n = 232) or paroxetine (40 mg) (n = 227). The primary analysis of efficacy was an analysis of covariance (ANCOVA) of change from baseline to endpoint (Week 24) in MADRS total score (last observation carried forward, LOCF). MAIN OUTCOME MEASURES;

RESULTS

At endpoint (24 weeks), the mean change from baseline in MADRS total score was -25.2 for patients treated with escitalopram (n = 228) and -23.1 for patients with paroxetine (n = 223), resulting in a difference of 2.1 points (p < 0.05). The difference in the change in the MADRS total score (LOCF) was significantly in favour of escitalopram from Week 8 onwards. The proportion of remitters (MADRS <or= 12) after 24 weeks was 75% for escitalopram and 67% for paroxetine (p < 0.05). The results on the primary efficacy scale were supported by significantly greater differences in favour of escitalopram on the Hamilton Anxiety, Hamilton Depression and Clinical Global Impression-Improvement and -Severity scales. For very severely depressed patients (baseline MADRS >or= 35), there was a difference of 3.4 points at endpoint in the MADRS total score in favour of escitalopram (p < 0.05). The overall withdrawal rate for patients treated with escitalopram (19%) was significantly lower than with paroxetine (32%) (p < 0.01). The withdrawal rate due to adverse events was significantly lower for escitalopram (8%) compared to paroxetine (16%) (p < 0.05). There were no significant differences in the incidence of individual adverse events during treatment.

CONCLUSION

Escitalopram is significantly more effective than paroxetine in the long-term treatment of severely depressed patients.

[The therapeutical strategy for locally advanced breast cancer]

As for the other cancers, the strategy of therapy of breast cancers is going to a unitary standardization. In our department between 1984-1999 we are operated 1040 patients with breast cancers, which means 25.3% of all cancers treated. 688 (64.3%) were CMLA, 646 (96.7%) of them were in patients women and 22 (3.3%) men. The mean age was 52.4 years (3-84 years). All patients were divided into two trials and analyzed: retrospectively (A) 312 (46.7%) and prospectively (B) 356 (53.3%) patients, 51.2% of patients was in III and IV TNM stage. The patients from trial B were treated concerning with specific therapeutically protocol, adapted by age, anatomopathological form, volume of tumor, skin or thoracic wall invasion, inflammatory lesions, lymph node invasion and physiological period. The results were: the increase of number of radical surgical interventions, the decrease of the morbidity, the increase of survival and a better quality of life.

[Strategy and tactic in the treatment of local advanced rectal cancer]

In local advanced rectal cancer (LARC) was defined at the work group in rectal cancer as a tumour what invade the serosa or neighbouring organs, associated with invaded perirectal or mezorectal nodes, with internal fistulae, peritoneal carcinomatosis and locoregional recidives. On a trial of 97 patients, the authors present personal experience, in comparison with literature data regarding therapeutic strategy and tactic of parameters: operability and the moment of operation, indication of preoperative radiotherapy, the type of operation, excision of the metastasis, adjuvant therapy and attitude of locoregional recidives. The survival of the patients was 21.6% at 3 years and 15.4% at 5 years.

[Considerations on 988 breast cancers]

AIM

Therapy schedule improvement.

MATERIAL & METHOD

The study includes 988 patients (which 16 men) with breast cancer who underwent surgery between 1984-1998. Out of them 63.2% were in advanced stages. The patients were divided in 2 homogenous groups: trial A = 520 patients treated between 1984-1991 (in stade: I = 2, II = 240, III = 246, IV = 32) studied retrospectively, and trial B = 468 patients treated between 1992-1998 (in stade I = 3, II = 212, III = 235, IV = 18) studied prospectively. In trial B the complex therapy schedule was improved according to disease's stade, local breast aspect and patient's biological status, straining on neoadjuvant therapy. To the entire group 945 radical mastectomies (95.6%) were performed. Only 628 (63.5%) could be properly followed up.

RESULTS

Global 5 years survival rate was 72% (improved from 69% in trial A to 72% in trial B). The survival rate varied according the stage from 100% (stade I), 88% (stade II), to 22% (stade III) and 2% (stade IV). In the advanced states, the local recurrencies at 5 years were of 22% and the methastases of 17%.

CONCLUSIONS

The neoadjuvant therapy, selectively applied upon stade and patient improves the 5 year survival rate. Every patient with an advanced breast cancer can benefit of a complex, differentiated and well guided treatment. The adequate operation earn the important role in powering the neoadjuvant and adjuvant therapies. Further results improvement requires restarting the collectivities and high risk persons screening.

[Vulvar cancer. The therapeutic aspects]

Even though it has a low frequency (4 - 5%) compared to genital cancers, it has certain biological features represented by the possibility of multicentric localisation what performs on the dystrophic lesions, the presence of the inguinal nodes, the sensibility of the irradiation of the cancer and nodes and the efficacity of the treatment of the treatment of the bleomicine which request many therapeutical problems. Between 1985-1994, in Colţea Surgery Clinic there were operated 13 vulvar carcinoma, in women between 45-69 years old, in stages II (6), III (4) and IV b (3). Primary lesion was on labia major (11), labia minor (1) and posterior fourchette (1). Preoperative radiotherapy was made in 9 patients. At 3 patients, valvar lesion represents the second cancer--in all cases were syndrome neoplasia, after cervix neoplasia (2) or ano-rectal neoplasia (1) which were operated. At histopathological exam all cancers were spinocellular epithelium keratosis in 10, non-keratosis in 2 or trabecular in 1. The surgical treatment was selective and consisted in total vulvectomy (9), vulvectomy with inguinal lymphadenectomy (3) and left colostomy (1) after ano-rectal invasions and intestinal obstruction. The postoperative mortality and complications were zero. Postoperative treatment consisted in radiotherapy in association with chemotherapy 93) or only chemotherapy (8). The survival rates at 3 years (2), 5 years (30, 7 years) (3) and 10 years (2), justify the complex treatment. In conclusion, vulvectomy represents the specific treatment associated with inguinal lymphadenectomy in case of lymph nodes metastasis. Postoperative radiotherapy and postoperative chemotherapy seem to increase the survival rate.

Growth deficiency with high circulating growth hormone levels: the insulin stimulation test in 39 children

Thirty nine patients with abnormal high basal hGH levels were selected and analysed as a part of a retrospective study of the results of 1,500 insulin stimulation tests (IST), applied in children and adolescents with growth deficiency. Their height, weight, and bone age were lower than their corresponding chronological age. Both in girls and in boys groups, responders and nonresponders subgroups were detected as judging by the results of the secretagogue action of insulin on hGH. The hGH basal levels were 43.88 +/- 18.27 microU/ml (X +/- SD) in boys (no = 22) and 56.61 +/- 35.21 microU/ml in girls (no = 17). It is to be noted that the hGH nonresponder group had deeper hypoglycemia at 30 minutes post-insulin injection than the responder group: 53.6 +/- 13.0 mg/100 ml (X +/- SD) vs 66.0 +/- 11.5 mg/100 ml respectively (p less than 0.01). Two siblings, a girl and a boy, had the highest basal and stimulated hGH, either during the IST or starvation. One of them, the boy, during the starvation test, had a paradoxical fall of about two orders of magnitude of the serum hGH 4 hr after basal sample collection. These two siblings are similar to the familial Laron type dwarfism. The possible mechanisms of growth deficiency in children with constant high but variable hGH values are discussed, as well as the aspects concerning the therapeutic ways to improve their linear growth.

Sleep-induced GH release in otherwise GH deficient children having short stature; a possibly new variant of GH neurosecretory dysfunction (GHND)

Sleep and exercise are considered physiologic stimuli of growth hormone (GH) release from the pituitary. They were used to some extent for the assessment of GH reserve in growth disorders of supposedly pituitary origin. In order to better establish the diagnostic value of the sleep test, we studied 34 children of both sexes aged 6-14 having various degrees of shortness of stature associated with bone age retardation (range of the latter: 3-10 years). Eight healthy controls of the same age were also subjected to the sleep test. The latter was begun at 10:00-11:00 a.m. generally in a dark room under polygraphic control. The subjects were fed a standard breakfast at 8:00-8:30 a.m. After thirty minutes of steep or after reaching the IVth stage of slow-wave sleep, the children were awakened and samples of venous blood for GH determinations were drawn. Two other GH reserve tests were also performed in other days, usually insulin-induced hypoglycemia and glycine intravenous loading. Except sleep, no other GH provocative tests were performed in controls. In normal GH reserve children (21/34) according to other tests, the sleep test was positive (i.e. peak values greater than 15 microU/ml) in 7 cases and the mean GH response was not significantly smaller than the peak recorded after insulin-induced hypoglycemia. In abnormal GH reserve, presumably hypopituitary children (13/34) according to other tests, the sleep confirmed the other tests in 8 cases. In five cases of clinically and endocrinologically "hypopituitary" dwarfism, the sleep test revealed a normal response.(ABSTRACT TRUNCATED AT 250 WORDS)

Morphotypic aspects in the cryptorchidic child

The morphotype of 40 children with cryptorchidism (18 bilateral, 22 unilateral), selected by complex endocrine examination, was assessed in relation to age and clinical form of cryptorchidism. The morphotype was established on the basis of 9 anthropometric parameters (weight, stature, pube-ground distance, a-a, thr-thr, thoracic, abdominal, hips and cephalic circumferences). The malformed lot consists of 28 children with common and 12 with symptome cryptorchidism (5 adiposogenital, 3 male Turner's syndrome and 3 with gonadal dysgenesis). In the child with symptom cryptorchidism, the morphogram reveals, irrespective of age, a morphotype which corresponds in point of absolute dimensions and proportions, to the somatotype in which cryptorchidism as a symptome is included. The child with common cryptorchidism has irrespective of age, a normal or short stature and is underweight. Compared to the stature, the head is small, the lower limbs are short, the trunk is long and the hips are well developed. In our series of common cryptorchid child, the most marked statural deficit was found between 11 and 15 years as well as under the age of 6.

Secretion of basal gonadotropins after LRH decapeptide and tripeptide. Stimulation in hypogonadotropic hypogonadism

Sixteen females with pubertary delay of the isolated hypogonadotropic hypogonadism type (mean age 19 years, age range 14-25 years) were studied by radioimmunoassay of LH and FSH. The mean values +/- SE were compared to the values obtained from 10 girls in the B 5 Tanner stage and 15 normal adult women investigated on the 14th and 21st day of their ovarian cycle. Two females were given the LRH decapeptide and LRH-LA tripeptide stimulation test. In one case the daily variations of circulating serum LH and FSH were followed up. The fluctuations found suggest an ovarian rhythm which is present in the normal adult woman.

Somatotype of children with gonadal dysgenesis and structural anomalies of genitalia

The somatotype of 92 children with sexual structural anomalies of whom 28 with female Turner's syndrome, 22 with Klinefelter's syndrome, 20 with adreno-genital syndrome, 14 with hypospadias, 2 with Reinfenstein's syndrome and 6 with feminizing testis was established on the basis of biometric and genetically determined morphologic characteristics (dermatoglyphics, pigment complex). A morphogram utilizing 12 anthropometric and 5 dermatoglyphic parameters was constructed; it can be used in phenotypical differentiation of the anatomo-clinical variants of structural anomalies of the genitalia and gonads. The 12 anthropometric parameters were: weight, stature, height of the head + neck segment, the sternum-symphysis distance, length of arms and legs, the biacromial and bitrochanterian diameters, the circumference of the thorax, abdomen, hips and head. The dermatoglyphic parameters were: the digital delta index, TFRC, a-b ridge count, the ATD angle and the A line obliquity. For longitudinal assessment of the phenotype of children with structural anomalies of genitalia and gonads, the authors propose utilization of the percentile diagrams regarding weight, stature, pubes to floor distance, and the biacromial and bitrochanterian diameters.

Results of 131I therapy in hyperthyroidism at 7-18 years of age

Twenty-seven patients aged 7-18 years, with hyperthyroidism and diffuse goite received 131I and 125I in doses of 200-350 muCi/gm of gland. The drug was given in a unique dose to 14 patients and fractioned (maximum 4 doses) to the rest. The total maximum dose was 15 mCi. Doubtless recovery was obtained in 25 cases and probable improvement in another 2 (the patients were lost track of). Exophthalmometric values did not increase in any of the patients and in 2 cases of edematous exophthalmos the protrusion and edema disappeared after this treatment. Clear improvement in the nutritional state occurred and puberty followed a normal course. The incidence of both early and late transient hypothyroidism was 1/25, while permanent hypothyroidism occurred in 5/25. In 5 cases administration of 125I in doses of 500 muCi/gm of gland was not effective and necessitated 131I readministration. It was concluded that radioactive iodine (131 isotope) is an effective radiopharmaceutical for radical treatment of hyperthyroidism in children and adolescents. The therapeutical innocuity of 131I was perfect and the dose of 200-350 muCi/gm of gland was the most adequate. A follow-up of the functional status is however advocated in these patients for detection of late hypothyroidism.

Somatotyping in the obese children and adolescents

Age-related somatic variability studied by 15 anthropometric parameters was assessed in 278 subjects (138 boys and 140 girls) aged between 5 and 20 years. Of these, 30% had simple obesity, 10.0% obesity associated with hypothyroidism, 10.0% obesity with diabetes, 25% obesity with adrenocortical reaction, 23.5% functional adiposo-genital syndrome and 1.5% Cushing's syndrome. The peculiarities related to the somatic development as a whole, the degree of bone development, and adiposity are interpreted in the main clinical forms of obesity, on the basis of the morphogram.

The effect of combined administration of L-proline and glycine on GH and IRI release in healthy prepuberal children

Proline (100 mg/kg b.w.) was given per os and after 30 minutes 10% glycine was i.v. injected to 25 healthy children of both sexes. A positive response (an increase of over 5 ng/ml of serum level of GH) was found in 21 of the 25 children. The insulin test showed a positive response in 24 of the 25 children. It was concluded that the decrease in glycine dosage from 250 mg/kg b.w. (earlier reports by the same authors) to 100 mg/kg b.w. (present data) is generally compensated by l-proline priming. The IRI serum levels were almost unchanged. By l-proline priming, the glycine test can also be applied to subjects with body weight over 40 kg, in doses of 100 mg/kg b.w. for exploring the secretory reserve of the somatotropic axis.

Release of growth hormone, prolactin, LH, FSH and IRI in serum through orally administered 1-proline in high dosage

Orally given 1-proline in high dosage (500 mg/kg b.w.) resulted in growth hormone (GH) release in 9 healthy, sexually immature children investigated (5 boys and 4 girls). A slight, unsignificant decrease of the mean prolactin level was also noted. Serum immunoreactive insulin (IRI), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) concentrations in serum were not influenced. The possible use of proline loading in high dosage for the detection of GH deficiency especially in small children and in infants is suggested.

L-proline loading for the assessment of pituitary GH reserve

Intravenous insulin (0.1 U/kg body weight) and oral 1-proline (100 mg/kg body weight) tolerance tests were performed in 22 healthy and 30 short-statured children and adolescents and blood glucose, serum immunoreactive growth hormone (GH), immunoreactive insulin (IRI) and 1-proline were determined. The peak level of serum GH was significantly higher following insulin than after 1-proline. The proline loading correctly identified the normality of GH axis in 12 out of 22 controls and in 3 out of 7 normopituitary short-statured patients. The serum 1-proline levels consideration did not improve much the ability of 1-proline load to detect either the normal GH responsiveness or the pituitary insufficiency. The mechanism of GH stimulatory properties of 1-proline in some healthy subjects is not known.

Clinical assessment of cryptorchid boys by determination of urinary testosterone glucuronide following large doses of human chorionic gonadotropin (hCG)

Urinary TG and fractionated 17-ketosteroid (Drosdowsky) determinations were performed before and after the intramuscular administration of 15,000 IU of human chorionic gonadotropin (hCG) in 10 sexually immature healthy boys and in 12 bilaterally cryptorchid boys. The same basal determinations were made in 11 gonadless girls. Basal serum FSH and LH were determined (by radioimmunoassay) in controls and also in cryptorchid boys. If 15mug/24 h (three SD's of basal excretion in controls) is considered the smallest adequate response, the TG but not the fractionated 17-KS determination assessed fairly well either the presence or the functional capacity of the Leydig cell-containing tissue. Agonadic girls had significantly higher basal excretion of steroids and this is presumably due to their greater absolute body size and to their more advanced bone age.

Immunoreactive insulin (IRI) dynamics in GH-deficient patients following intravenous glycine loading

In hypopituitary short-statured patients glycine intravenous injection (250 mg/kg of body weight) provokes a mild and inconstant stimulation of IRI release followed by a significant fall down. Though insiginificant (P 0.064), the prevalence of IRI responsive individuals to glycine in the patients group of idiopathic etiology could be of pathophysiological importance.

Mild stimulation of serum immunoreactive insulin (IRI) release following large doses of intravenously given glycine to children of normal pituitary function

In healthy, sexually immature children of both sexes serum IRI levels rose more than expected from random inter-individual variation (i.e. more than 3 standard deviations of the basal level) in 10 out of 21 subjects loaded by glycine. The IRI release by glycine though moderate and not constant is, however, unquestionable. The growth hormone (GH) secretory response to glycine did not change according to the occurrence and/or magnitude of IRI release. It was concluded that GH and IRI stimulatory properties of glycine given intravenously in large doses are completely unrelated.

Clinical use of glycine intravenous load for diagnosis of growth hormone deficiency

Intravenous glycine injection (250 mg/kg of body weight) resulted in growth hormone release in normal children but not in those with growth hormone deficiency diagnosed by insulin-induced hypoglycaemia. In the latter significantly higher peak concentrations of serum alpha-amino nitrogen were also found. False negative responses to glycine (no GH release) were observed in two patients of short stature but normal pituitary function. In them the peak levels of serum alpha-amino nitrogen were lower than in those with hypopituitarism. We propose the clinical use of glycine as an inexpensive and innocuous procedure for the detection of GH deficiency in children. A post-glycine GH peak greater than 10-0 mu/l seems to be a good index of an intact GH reserve.

Growth hormone release by glycine injected intravenously in 22 healthy sexually immature children

A solution of 10% glycine (250 mg/kg of body weight) was injected in within 5-10 minutes in 22 healthy, sexually immature children who were previously tested for insulin-induced hypoglycemia. Blood specimens were collected before, 10, 30, 60 and 120 minutes after injection for glucose, HGH and total alpha-amino nitrogen determination. The mean peak post-glycine level of serum HGH was 11.47 +/- 1.558 ng/ml (+/- SEM) and did not differ significantly from the corresponding post-insulin mean value (15.63 +/- 0.247 ng/ml). The highest post-stimulatory mean value (8.88 +/- 1.694 ng/ml) was observed 30 minutes after the end of the injection of glycine. Glycine is a reliable GH stimulating agent, which may be tentatively used for detection of hyposomatotropism in children.