[TSH receptor antibodies determined by the Thybia test in children with hyperthyroidism]. / TSH-receptor antitela odredjena Thybia-testom kod dece sa hipertireozom.

Using a radioreceptor assay Thybia-test, we studied 22 girls with Graves' disease, aged 4.0 to 20.4 years (mean = 13.8 years). Sera of 9 girls were obtained before therapy, 20 during treatment with methimazole, 4 in remission and 2 relapse. The total number of tested sera was 113. Control sera were obtained from 19 age-matched controls. The results of Thybia-test were positive in 7 of 9 girls with Graves' disease before treatment (77.8%) and in both girls in relapse. Of 89 samples of sera taken during drug therapy Thybia-test was positive in 51. Only 3 of 13 sera taken in remission gave positive results. The highest mean values of Thybia-test were detected in patients in relapse (46.2%), and in patients before therapy (23.9%). During treatment mean values became lower (14.4%) and were the lowest in remission of the disease (6.9%). The results of Thybia-test in controls ranged from 0% to 7.5% (mean = 1.93 +/- 2.78%). Significant differences were noticed between mean values of Thybia-test of patients before therapy and controls as well as between patients during therapy and controls. Six girls were studied after discontinuation of thyreosuppressive therapy. In 5 results of Thybia-test were negative. Three of them are still in long remission. Two were in short remission and relaps in both of them was followed by convertion of Thybia-test to positive. At the end of treatment the only patient with positive Thybia-test was in remission and Thybia-test was-later converted to negative. Our study shows that Thybia-test is a valuable method in addition to others used to correlate the natural history of the disease with the results of therapy. We are still unable to make a definite statement on the significance of this method in prediction of relapse and remission of Graves' disease.

[Treatment of unstable diabetes mellitus in children and adolescents using insulin administered by a semi-automated syringe, NovoPen]. / Lecenje nestabilonog dijabetes melitusa kod dece i adolescenata insulinom uz pomoc poluautomatske brizgalice-NovoPen.

An insulin device, NovoPen, incorporating human actrapid insulins was used in a group of 6 poor--controlled diabetic adolescents, aged 15 years (mean 8-18.7) with duration of diabetes 8.2 +/- 4.8 years (mean +/- S.D). The study was carried out in insulin-dependent diabetic young-people, to test the efficacy and acceptance of an intensified insulin therapy (an injection of short-acting insulin before each of the three meals using NovoPen plus an evening injection of human ultratard insulin from a conventional syringe) in the hope of achieving the improved control. All patients completed a 6-months NovoPen-therapy and preferred to continue with the multiple injection regimen in the long term. Metabolic control was improved, the values of haemoglobin A1c decreased from 16.8% to 13.4% (statistically significant) during the study. The use of the NovoPen injection device proved to be a safe and acceptable method of therapy; it offered the patients a marked freedom and liberalization of everyday life.

Adrenal cysts in the newborn.

We report on 2 newborns with adrenal cysts who were treated successfully with an operation. One patient had been well after birth with no adrenal insufficiency. However, 2 large and 2 small cysts were found, all of which were attached to the adrenal gland without a clear vascular stalk. The other patient had adrenal cortical insufficiency. His mother had had gestational diabetes and hypertension during pregnancy. The adrenal cyst was partially resected. Both patients were in good condition 5 years postoperatively.