[Relationship between immunoreactive insulin and plasma somatomedin-C/insulin-like growth factor-I concentration in childhood obesity]. / Osszefüggés a szérum immunreaktív insulin (IRI) és a plazma somatomedin-C/insulin-like growth factor-I (SM-C/IGF-I) koncentrációk között gyermekkori elhízásban.

Childhood obesity may be characterised by basal and reactive hyperinsulinemia, reduced growth hormone (HGH) responses to various provocative stimuli and increased plasma concentration of somatomedine-C/insulin-like growth factor-I (SM-C/IGF-I). For this reason the relationship between the degree of obesity (i. e. BMI), serum immunoreactive insulin (IRI) and plasma SM-C/IGF-I was investigated in children with obesity (n = 26, age: 13.0 +/- 0.97 years, BMI: 32.8 +/- 5.3 kg/m2). SM-C/IGF-I was increased in obese children compared to the normal range of this age. Significant positive correlations were found between BMI and IRI, between BMI and SM-C/IGF-I, and between IRI and SM-C/IGF-I. These results suggest that SM-C/IGF-I production in obesity is regulated by IRI dependent on BMI and this regulating effect of insulin may be important in obesity since HGH production to provocative stimuli is reduced.

[Insulin resistance in childhood obesity]. / Inzulin-rezisztencia a gyermekkori elhízásban.

Insulin binding to erythrocytes (IB) and serum immunoreactive insulin concentration (IRI) were measured and relationships between these parameters and body mass index (BMI) were investigated in obese children and age matched controls with normal body weight. IRI was increased and IB was decreased significantly in the obese group compared to data of the controls. The decreased IB was due to a decrease in insulin receptor number since it was not accompanied by alteration of half maximal inhibition dose (ID50). Strong negative correlations were found between BMI and IB and between IRI and IB while a positive association was seen between BMI and IRI. These results prove an interrelationship between weight excess, hyperinsulinism and insulin resistance in childhood obesity.

[The myelodysplastic syndrome]. / A myelodysplasiás szindrómáról.

Clinical data of 70 patients, treated and observed with myelodysplastic syndrome between 1977 and 1989 were analysed. Two-thirds of the patients belonged to the elder age-group and a mild female predominance was registered. With the application of complex cytochemical-histological and cytogenetical methods, correct diagnosis could be established. The clinical material included patients from different morphologic subtypes: 19 with refractory anaemia (with a longer course of the illness). 20 with sideroblastic anaemia, 26 with chronic myelomonocytic leukaemia and the remaining 5 with refractory anaemia with excess of blasts (a more progressive type of the myelodysplastic syndrome, with a short duration). The mean survival of all patients were 42 months. 45 (69%) died during this period and 12 (18.5%) among them in acute myelogenous leukaemia (mean survival: 16 month). Megakaryoblastic leukaemic transformation was observed in three patients with sideroblastic refractory anaemia. Haemorrhage and infection-sepsis, due to thrombocytopenia and/or granulocytopenia, was fatal in 30 cases. In the treatment of the myelodysplastic syndrome an appropriate supportive therapy (blood transfusion, antibiotics) has a decisive importance. A more aggressive treatment with cytostatic drugs is suggested in the progressive form of the disease of younger patients and in patients with overt acute leukaemia.