Shoichi Kusano

Growth-hormone-induced changes in postheparin plasma lipoprotein lipase and hepatic triglyceride lipase activities.

A comparison of treated and untreated patients with growth hormone deficiency revealed that administration of growth hormone reduced lipoprotein lipase and hepatic lipase activities, total cholesterol, and high-density lipoprotein cholesterol concentrations. The possible significance of these results is discussed.

Low-dose particulate polyvinylalcohol embolization in massive small artery intestinal hemorrhage. Experimental and clinical results.

The branches of the superior mesenteric artery were embolized with polyvinylalcohol (PVA) particles 149 to 250 mu (small), 420 to 590 mu (medium), and 590 to 1000 mu (large), respectively, in three groups of dogs. In the small PVA particle group, all three dogs died. In the medium and the large PVA particle groups, nine of the 11 dogs showed no significant ischemic change and the remaining two (one dog in the medium PVA group and one in the large PVA group) had a superficial ulcer. This study suggests that PVA embolization can be performed safely if particles of 420 mu or larger are used. In clinical studies, large PVA particles were used in embolization therapy for massive intestinal hemorrhage from small arteries in five patients. All had the hemorrhage from ulcer disease in the small bowel (four patients) and the ascending colon (one patient). Three patients were completely controlled with no recurrence of hemorrhage. The remaining two experienced rebleeding after embolization. No major complication was found in this series. It is concluded that low-dose large PVA particles are suitable as an embolic material for transcatheter occlusion of small-artery intestinal hemorrhage.

Postheparin plasma lipoprotein lipase and hepatic triglyceride lipase activities in children with idiopathic pituitary dwarfism

Recent studies have demonstrated the low prevalence of atherosclerosis despite the high incidence of hyperlipidemia in pituitary dwarfs, while the physiologic role of growth hormone (GH) in lipid metabolism remains to be clarified. The aim of this study is to investigate the effects of GH deficiency and of hGH administration to deficient children on the activities of lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL). Twenty-five euthyroid children with idiopathic pituitary dewarfism, aged 7 to 21 years, were studied. Each patient was shown to lack immunoreactive GH after at least 2 provocative stimuli for GH secretion. Seventeen patients, who were studied 4 days after the last hGH injection, were treated with conventional therapeutic dose of hGH (0.33kO. 12 IU/kg/week; twice a week), while 8 had not received hGH treatment for at least 6 months. Thirty nonobese and normolipidemic children, aged 2 to 15 years, served as controls. Postheparin plasma was collected 5 minutes after heparin (1 0 U/kg body weight) administration. The activities of LPL and HTGL were measured by an immunochemical method, utilizing antiserum against HTGL. The serum HDL-cholesterol (HDL-C) level was measured enzymatically after precipitation by heparin-MnCI, . Nine of 25 patients had the serum triglyceride level higher than 100 mg/dl, while 16 had the serum total cholesterol level higher than 200 mg/dl. The serum HDL-C level was normal in the untreated patients, and was decreased in the GHtreated patients (p < 0.01). The untreated patients had a normal LPL activity and an increased (p < 0.02) HTGL activity, while the GH-treated patients had a decreased (p < 0.05) LPL activity and a normal HTGL activity. Both lipase activities in the untreated patients were higher than those in the GH-treated patients (LPL, p < 0.05; HTGL, p < 0.005). There was. a positive correlation between the serum HDL-C level and the LPL activity in the patients. This results is in accordance with the view that the formation of HDL related to the catabolism of TG-rich lipoprotein by the action of LPL. The HTGL activity in the patients was not related to the serum lipid levels. We have observed that mild hyperlipidemia, which was not affected by hGH treatment, was common in children with pituitary dwarfism even in euthyroid states. A decrease in LPL activity, which may be responsible for the decrease in serum HDL-C level in the GH-treated patients, may be accounted for by the lipolytic action of GH. Thus, GH may be a factor to the development of atherosclerosis.

Priming effect of LH‐RH on the release of gonadotropins in puberty

appears almost simultaneously in the right and left heart chambers. In our case, there was a delay in appearance of echoes in the left heart chambers (Fig. 2), and there was no significant findings in pulmonary angiography; so we diagnosed that the shunt was intrapulmonary and dispers telangictatic type. 5 cases of diffuse pulmonary AVF were reported in Japan. Onset was various, and both sexes were affected. (male 3, female 2) We found possibly co-existing RenduOsler-Weber disease only in one case. Cardiac catheterization with angiography was of relatively little value, and diagnosis was made by contrast echocardiography in 4 out of the 5 patients. Defect of IVC (2/5), azygos or hemiazygos drainage (3/5), liver dysfunction (2/5), skin telangiectasis (2/5) were co-existed, and pathogenetically very interesting. (Acta Paediatr Sep. 24(3):399 1982)