[Early-onset eating disorders: a review of the literature]. / Vroeg ontstane eetstoornissen: literatuuroverzicht.

BACKGROUND: The incidence of anorexia nervosa (AN) in adolescents has increased significantly in recent years. In several studies and in the media it has been suggested that AN has recently become more prevalent in the pre-adolescence. In view of the impact that an eating disorder can have on a child, it is important to diagnose and start treating the illness as early as possible. AIM: To review the literature on the characteristics and susceptibilities of patients with eating disorders because this information can be important for early diagnosis, prevention and identification of susceptibilities to early-onset eating disorders. METHOD: We searched the literature for articles relating to early-onset eating disorders. We based our search on PubMed and on related relevant articles listed in the references. We selected 34 relevant articles published between 1987 and 2014. RESULTS: The literature lists characteristics and susceptibilities at various levels. Many types of factors are involved; examples of 'biological' factors are prior streptococcal infection, previous consultations with GP and a patients medical history; psychological factors include comorbidity, temperament, a particular personality profile, maturation-anxiety; environmental factors such as family history, family functioning and/or stressful events can play a role in the development of eating disorders. CONCLUSION The literature indicates that the early development of AN in children is related to a complex combination of etiological factors. However, there is a need for more research into this group of patients.

[Efficiency after radical surgery for bronchectasis (author's transl)]. / Untersuchungen zur Leistungsreserve des Organismus nach Radikaloperation im Kindesalter wegen Brochiektasen.

The maximally possible efficiency as well as the O2-supply (VO2 max) necessary for this purpose comes in patients with resection of 1 to 5 segments to 25 to 30% less than in healthy persons. The loss of 6 to 10 segments lowers the capacity of compensation by 40%. Persisting bronchitis decreases this mechanism for 10 to 12% more.

Possible role played by monoamines in the control of puberty onset in female rats.

The effect of pargyline on 5 HT concentration in a combined forebrain and midbrain section ( FMB ) have been investigated in female rats which were temporarily deprived from their dams in postnatal life and daily injected with the monoamine oxidase inhibitor. Two hours after the last pargyline injection a marked increase in 5 HT concentration could be observed both in 12 and 30 days-old rats. The question is raised whether 5 HT may be involved in neuroendocrine mechanisms which are responsible for controlling the onset of puberty, since a significant advance of puberty could be achieved by this pargyline treatment in normal and deprived female rats.

Gene- and environment-dependent neuroendocrine etiogenesis of homosexuality and transsexualism.

Sexual brain organization is dependent on sex hormone and neurotransmitter levels occurring during critical developmental periods. The higher the androgen levels during brain organization, caused by genetic and/or environmental factors, the higher is the biological predisposition to bi- and homosexuality or even transsexualism in females and the lower it is in males. Adrenal androgen excess, leading to heterotypical sexual orientation and/or gender role behavior in genetic females, can be caused by 21-hydroxylase deficiency, especially when associated with prenatal stress. The cortisol (F) precursor 21-deoxycortisol (21-DOF) was found to be significantly increased after ACTH stimulation in homosexual as compared to heterosexual females. 21-DOF was increased significantly before and even highly significantly after ACTH stimulation in female-to-male transsexuals. In view of these data, heterozygous and homozygous forms, respectively, of 21-hydroxylase deficiency represent a genetic predisposition to androgen-dependent development of homosexuality and transsexualism in females. Testicular androgen deficiency in prenatal life, giving rise to heterotypical sexual orientation and/or gender role behavior in genetic males, may be induced by prenatal stress and/or maternal or fetal genetic alterations. Most recently, in mothers of homosexual men--following ACTH stimulation--a significantly increased prevalence of high 21-DOF plasma values and 21-DOF/F ratios was found, which surpassed the mean + 1 SD level of heterosexual control women. In homosexual men as well--following ACTH stimulation--most of the 21-DOF plasma values and 21-DOF/F ratios also surpassed the mean + 1 SD level of heterosexual men. In only one out of 9 homosexual males, neither in his blood nor in that of his mother increased 21-DOF values and 21-DOF/F ratios were found after ACTH stimulation. In this homosexual man, however, the plasma dehydroepiandrosterone sulfate (DHEA-S) values and the DHEA-S/1000 x A (A = androstenedione) ratio were increased before and after ACTH stimulation. Furthermore, highly significantly increased basal plasma levels of dehydroepiandrosterone sulfate were found in male-to-female transsexuals as compared to normal males, suggesting partial 3 beta-ol hydroxysteroid dehydrogenase deficiency to be a predisposing factor for the development of male-to-female transsexualism.

Effects of tamoxifen on the levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), 17 beta-oestradiol (E2), total and free testosterone (T) and total and free dihydrotestosterone (DHT) in blood of patients with benign prostatic hyperplasia.

Treatment of 9 patients with benign prostatic hyperplasia with 20 mg tamoxifen daily for 6 weeks resulted in a significant increase of LH (211%), FSH (215%), E2 (231%), total T (157%), free T (148%) and total DHT (148%) levels in blood. The increase of plasma free DHT (152%) levels was not significant and PRL concentrations in serum were unchanged during treatment. Comparison of the increases between total T and free T, total T and total DHT as well as free T and free DHT failed to reveal any significant differences. These results imply (1) a marked anti-oestrogenic effect of tamoxifen at the level of hypothalamo-hypophysial axis (2) no effect at the hepatic oestrogen receptor sites indicated by unchanged SHBG-bound T and DHT in plasma and (3) no significant inhibitory effect of tamoxifen on 5 alpha-reductase activity concluded from the T/DHT ratio in peripheral circulation. In view of these findings tamoxifen appears to be unsuitable for therapy of benign prostatic hyperplasia.

Pyridostigmine administration in newborn rats prevents permanent mental ill-effects produced by maternal deprivation.

Maternal deprivation from Day 3 to Day 14 of life, i.e., separation of the pups from their mother animals during this developmental period for 16 hours each day, gave rise to highly significantly decreased learning capability and memory capacity in adulthood associated with significantly decreased acetylcholinesterase activity in the brain. These permanent ill-effects of the brain, produced by maternal deprivation of newborn rats, could be prevented by the acetylcholinesterase inhibitor pyridostigmine when administered from Day 1 to Day 14 of life. In view of these findings, teratogenic mental ill-effects, produced by psychosocial and/or nutritional deprivation during brain development, appear to be preventable by correcting abnormal neurotransmitter concentrations during this critical period of brain organization.

The synthesis and pharmacological activity of two new derivatives of benzazocine.

Two new derivatives of benzazocine of anticipated analgesic action were synthesized. Pharmacological investigations were carried out to confirm their analgesic activity, affinity to the opiate receptor and potential antagonistic properties.

Short- and long-term effects of perinatal interleukin-1 beta-application in rats.

Nervous, endocrine and immune systems are regarded as a complex functional unit, interacting by their specific chemical messengers-neurotransmitters, systemic hormones and hormone-like mediators of immune cells (cytokines). Cytokines are known to affect several endocrine axes. Interleukin-1 beta (IL) was administered in rats intraperitoneally twice daily from day 17 to 21 of pregnancy. Some of the IL-treated mothers were rapidly decapitated 1.5 h after the last injection. The fetuses were delivered by cesarean section. Maternal plasma CRF, ACTH and corticosterone were found to be significantly elevated. Fetal adrenal and thymus weights were lower, and plasma corticosterone did not differ from controls. Fetal plasma testosterone was decreased in males, androstenedione was increased in females. Open-field testing revealed a higher total locomotor activity of IL offspring than of controls. IL offspring showed worse results in Skinner box learning than controls. Sexual behavior was only affected in males, showing a higher percentage of female-type lordosis behavior after castration and estrogen treatment compared to controls. At the age of 6 months responsiveness to 'novel-environment stress' of IL groups was significantly lower than that of controls in terms of plasma corticosterone. These results indicate that prenatal treatment with IL-1 beta results in long-lasting alterations in psychomotor development, behavior as well as in the neuroendocrine system.

Molecular mass and carbohydrate structure of prostate specific antigen: studies for establishment of an international PSA standard.

Despite the widely accepted use of prostate specific antigen (PSA) as a marker of prostate cancer, this molecule has not yet been completely characterized. Past studies have well established, however, using both amino acid and cDNA sequencing techniques, that PSA contains 237 amino acids, with a molecular mass of 26,079 Da for the peptide moiety of the molecule. The present study reports analysis of this protein by ion spray mass spectrometry (ISMS) and analysis of its carbohydrate moiety by NMR spectroscopy. The predominant PSA molecular species detected by ISMS was at relative molecular mass (M(r)) of 28,430, indicating that PSA contains a carbohydrate residue of M(r) 2,351, for a total percentage of carbohydrate of 8.3%. Analysis of PSA by SDS-PAGE, however, showed a M(r) of 32,000 to 33,000, suggesting an overestimation of the molecular weight by the latter technique. The complete primary structure of the PSA carbohydrate chain was determined by NMR spectroscopy in combination with carbohydrate composition analysis. The experimentally determined carbohydrate content of PSA confirms that only one N-glycosylation site is occupied in the protein. The proposed carbohydrate structure is a diantennary N-linked oligosaccharide of the N-acetyllactosamine type, with a sialic acid group at the end of each of the two branches. In addition, our data indicate that approximately 70% of the PSA molecules contain a fucose group in the core chitobiose moiety. The calculated molecular weight of this carbohydrate structure (M(r) 2,351.8) is in excellent agreement with the predicted molecular weight of the carbohydrate group, based on the M(r) 28,430 for PSA measured by ion spray mass spectrometry and M(r) 26,079 calculated from the consensus sequence for the peptide portion of the molecule. ISMS of PSA is thus proposed as a convenient and reliable method of quality control, an indispensible step towards international standardization of this very important tumor marker for detection and monitoring of prostatic diseases, especially prostate cancer.