A comparison of renal size, expressed as ultrasonographic renal parenchymal volume and urographic renal parenchymal area, and renal function, measured as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), was made in two groups of children: (1) 21 patients with normal urograms and no signs of current disease and (2) 26 children with recurrent urinary tract infections or asymptomatic bacteriuria. Renal parenchymal volume was calculated using a water delay ultrasonographic device (Octoson). Renal parenchymal area was measured urographically. GFR and ERPF were determined from the clearances of inulin and PAH, respectively. In both groups a good correlation was found between both GFR and ERPF and total renal parenchymal volume as well as renal parenchymal area. The determination of renal parenchymal volume could possibly replace the determination of GFR and ERPF in healthy children and in children with urinary tract infections with normal and abnormal urograms.
A comparison of the relationship that might exist between ultrasonographically calculated renal parenchymal volume and renal parenchymal area assessed from urography and also between renal parenchymal volume and kidney function was conducted in a series of 26 children with recurrent urinary tract infection or asymptomatic bacteriuria. Glomerular filtration rate (GFR) was determined by the clearance of inulin, renal parenchymal area was measured from urography and renal parenchymal volume was calculated from sequential longitudinal scans of the kidney using an automated water-delay ultrasonographic equipment (Octoson). High correlation was found between 1) renal parenchymal volume and GFR, 2) renal parenchymal volume and renal parenchymal area and 3) renal parenchymal area and GFR. Octoson ultrasonographic determination of renal parenchymal volume is a reliable method to evaluate glomerular filtration rate and renal parenchymal area in children with recurrent urinary tract infections and asymptomatic bacteriuria.
Objectives: To study the effect of 12 months of growth hormone (GH) treatment on bone markers, bone mineral density (BMD), lean body mass (LBM) and body fat mass (BF) in postmenopausal osteoporotic women. Design: Sixteen patients were randomised to a double-blind randomised placebo-controlled one-year study with daily s.c. injections of GH or placebo. After the first year 14 patients (8 placebo treated, 6 GH treated) were recruited to GH treatment during the second year. All patients were also supplemented with 0.5 g calcium per oral. Methods: Bone mineral density and body composition were assessed by dual energy X-ray absorptiometry. Biochemical bone markers were analysed by RIA or HPLC techniques. Diurnal GH profiles were performed with continuous venous blood sampling. Results: Sixteen patients started in the placebo-controlled study. In all, twelve patients completed one year and only four patients completed two years of GH treatment. At baseline 3 patients had serum insulin-like growth factor-I (S-IGF-I) levels below -2 S.D. for age. Maximal diurnal GH levels tended to correlate negatively with S-IGF-I (P = 0.076). S-IGF-I was unrelated to BMD. Serum IGF-binding protein-1 (S-IGFBP-1) correlated negatively with femoral neck BMD (r = ¹0.61, P = 0.012). The intended GH dose of 0.05 U/kg/day or a maximum of 3 U/day s.c. was reduced to 0.024 Ϯ 0.004 U/kg/day, equal to 0.5-2.7 U/day due to frequent side effects, and four patients were excluded. After one year of GH treatment BF increased slightly, LBM and BMD in total body and lumbar spine were unchanged but femoral neck BMD had decreased 3.4 Ϯ 1.6% (P < 0.05). The mean S-IGF-I increase was 32% (range ¹38-138%). Mean levels of the bone formation markers S-osteocalcin and S-procollagen type I propeptide increased maximally by 88 and 36% respectively after 9-12 months while the bone resorption markers were unchanged. In the placebo-treated group there were no significant alterations.
Conclusions:The effects on S-IGF-I, bone markers and LBM were small although GH-related side effects were common. The reason for this apparent partial resistance to the anabolic effects of GH is not clear but nutritional deficits may be involved. Assessment of the effects of GH on bone mass and fracture rate requires longer study periods than one year.
Histologically classified benign breast disorder was present in 163 breast of 158 symptomatic women. The results of diaphanography (DPG) were correlated with those obtained by clinical examination (CE), mammography (M) and cytology (C). A tumour was palpable in 108 cases (66.3%). A false positive diagnosis, i.e. possibly malignant, probably malignant or malignant was made in 15 cases (9.2%) with DPG, and in 33 cases (20.2%) with M. Use of both M and DPG reduced the number of false positives to 1.8 per cent. In 8 cases (4.9%) false positive diagnosis was made with C. During a mean observation time of 58.5 months (range 44-72 months, one case of breast carcinoma was diagnosed.
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