Hormone researchPub Date : 2009-01-01Epub Date: 2009-06-30DOI: 10.1159/000224335
Rossana Roman, German Iniguez, Juan Javier Lammoglia, Alejandra Avila, Teresa Salazar, Fernando Cassorla
{"title":"The IGF-I response to growth hormone is related to body mass index in short children with normal weight.","authors":"Rossana Roman, German Iniguez, Juan Javier Lammoglia, Alejandra Avila, Teresa Salazar, Fernando Cassorla","doi":"10.1159/000224335","DOIUrl":"https://doi.org/10.1159/000224335","url":null,"abstract":"<p><strong>Aim: </strong>We investigated whether the insulin-like growth factor (IGF)-I response to growth hormone (GH) is regulated by body mass index (BMI) in short children with normal weight.</p><p><strong>Methods: </strong>We studied 37 prepubertal children with idiopathic short stature (ISS), comparing children with high-normal BMI (standard deviation scores, SDS 1.23 +/- 0.11, n = 20) and low-normal BMI (SDS -0.93 +/- 0.12, n = 17). The IGF-I response to GH was determined with an abbreviated IGF-I generation test, by measuring serum IGF-I concentrations at baseline and 24 h after the administration of GH (0.033 mg/kg).</p><p><strong>Results: </strong>Children with high- and low-normal BMI had similar age (8.5 +/- 0.7 vs. 8.7 +/- 0.7 years) and height (-2.0 +/- 0.1 vs. -2.2 +/- 0.2 SDS). However, children with high-normal BMI exhibited higher mean basal IGF-I (191 +/- 15 vs. 139 +/- 11 ng/ml, p < 0.05), higher mean IGF-I levels 24 h after GH administration (261 +/- 22 vs. 164 +/- 14 ng/ml, p < 0.05) and a higher IGF-I percent increase after GH administration (37 +/- 5 vs. 17 +/- 4%, p < 0.05) compared with children with normal-low BMI.</p><p><strong>Conclusion: </strong>BMI modulates the IGF-I response to GH, suggesting that GH sensitivity may be influenced by the nutritional status in children with ISS and normal body weight.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"72 1","pages":"10-4"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000224335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28356074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-10-19DOI: 10.1159/000245933
Katja Dumic, Nevena Krnic, Veselin Skrabic, Gordana Stipancic, Katarina Cvijovic, Vesna Kusec, Katarina Stingl
{"title":"Classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency in croatia between 1995 and 2006.","authors":"Katja Dumic, Nevena Krnic, Veselin Skrabic, Gordana Stipancic, Katarina Cvijovic, Vesna Kusec, Katarina Stingl","doi":"10.1159/000245933","DOIUrl":"https://doi.org/10.1159/000245933","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the incidence, gender, symptoms and age at diagnosis among patients with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency in Croatia.</p><p><strong>Methods: </strong>Data were collected retrospectively for all classical CAH patients born or electively aborted following prenatal diagnosis between 01.01.1995 and 31.12.2006 and were compared with the data of the previously conducted study evaluating CAH patients discovered between 1964 and 1984.</p><p><strong>Results: </strong>During a 12-year period, 34 classical CAH patients were born. There were 20 salt-wasting (SW) (12 females/8 males) and 14 simple virilizing (SV) patients (7 females/7 males). If 3 female fetuses, electively aborted, were added, that would be a total of 37 CAH patients. With 532,942 live births and 34 CAH patients born over this period, incidence of classical CAH was estimated to 1:15,574 or 1:14,403 if 3 electively aborted fetuses were included. The lower incidence of SW boys compared to SW girls (8:12) and similar number of SW and SV boys (8:7) indicate that substantial proportion of SW boys die unrecognized. Owing to better health care, diagnosis was established significantly earlier in SW and SV girls compared to the period of 1964-1984 (p < 0.003). During 1995-2006, none of the patients died following the diagnosis of CAH, and there was no erroneous sex assignment.</p><p><strong>Conclusion: </strong>Despite of improvement in health care, diagnosis of CAH in Croatia is still delayed and some of the patients go unrecognized or die. Therefore, we think that the results of our study support the need for the introduction of newborn screening.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"72 5","pages":"310-4"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245933","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28448217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Triiodothyronine is an indicator of nutritional status in adolescent girls with eating disorders.","authors":"Ingemar Swenne, Mats Stridsberg, Barbro Thurfjell, Agneta Rosling","doi":"10.1159/000208800","DOIUrl":"https://doi.org/10.1159/000208800","url":null,"abstract":"<p><strong>Aim: </strong>Circulating thyroid hormone concentrations are influenced by nonthyroidal disease and changes in nutritional status. We studied thyroid hormones as possible indicators of nutrition in adolescent girls with eating disorders.</p><p><strong>Method: </strong>Blood samples for analyses of thyroid hormones were obtained at 360 assessments of 298 patients and biweekly during 42 treatment periods in 36 patients.</p><p><strong>Results: </strong>At assessment, when most of the girls were on a weight losing course, serum triiodothyronine (T3) concentrations were low. Great weight loss and rapid rate of weight loss were the most important predictors of low T3 concentrations. Serum free thyroxine concentrations were in the lower normal range. In premenarcheal girls, weight loss was the most important predictor of free thyroxine but this relationship was weaker in postmenarcheal girls. Serum TSH concentrations were within the normal range and only weakly related to weight changes. During treatment, T3 increased in parallel with weight but was also influenced by the short-term weight trend.</p><p><strong>Conclusion: </strong>Serum T3 concentration is an indicator of nutritional status in adolescent girls with eating disorders. It is sensitive to short-term weight changes and could be used to monitor progress throughout nutritional rehabilitation.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"71 5","pages":"268-75"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000208800","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28088851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-01-21DOI: 10.1159/000178058
C de Bruin, B P Meij, H S Kooistra, J M Hanson, S W J Lamberts, L J Hofland
{"title":"Cushing's disease in dogs and humans.","authors":"C de Bruin, B P Meij, H S Kooistra, J M Hanson, S W J Lamberts, L J Hofland","doi":"10.1159/000178058","DOIUrl":"https://doi.org/10.1159/000178058","url":null,"abstract":"<p><strong>Background: </strong>Cushing's disease (CD) is a common endocrinological disorder in dogs with an estimated incidence of 1 to 2 cases/1,000 dogs/year. This is in contrast to humans in whom CD is rare. The clinical presentation of CD, however, is highly similar between dogs and humans, with characteristic signs, such as abdominal obesity, weight gain, fatigue, muscle atrophy and skin changes. Canine CD may therefore serve as an animal model for human CD, especially since therapeutic canine hypophysectomy can generate substantial amounts of primary corticotroph adenoma tissue for in vitro research purposes. In a recent study, we found that dopamine (DA) D(2) and somatostatin (SS) receptor subtypes are well expressed in canine corticotroph adenomas, but there are some distinct differences compared with the expression profile observed in human CD. These differences need to be considered when using canine CD as a model to evaluate the efficacy of novel DA/SS compounds for potential use in human CD.</p><p><strong>Case report: </strong>This case involves an 8-year-old female dog that developed signs of exercise intolerance, muscle weakness and polyuria/polydipsia due to an adrenocorticotropic hormone-secreting pituitary adenoma. The dog underwent curative transsphenoidal hypophysectomy and has remained in complete remission in the 3.5 years since surgery.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"71 Suppl 1 ","pages":"140-3"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000178058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27932033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-01-21DOI: 10.1159/000178032
Michelangela Barbieri, Virginia Boccardi, Michela Papa, Giuseppe Paolisso
{"title":"Metabolic journey to healthy longevity.","authors":"Michelangela Barbieri, Virginia Boccardi, Michela Papa, Giuseppe Paolisso","doi":"10.1159/000178032","DOIUrl":"https://doi.org/10.1159/000178032","url":null,"abstract":"<p><strong>Background: </strong>The process of aging is associated with progressive remodeling. The age-dependent remodeling process mainly affects anthropometrics and endocrine function, which subsequently impact metabolic factors. In some individuals, e.g., the very select group of healthy centenarians, the remodeling process is successful. The reasons why centenarians are able to reach the extreme limits of human life span are still largely unknown; however, several studies in humans have shown that longevity is associated with a significant improvement in glucose handling - mainly, a rise in insulin sensitivity and a decline in plasma insulin-like growth factor I levels.</p><p><strong>Conclusions: </strong>Caloric restriction seems to be the best positive modulator of metabolism to achieve longevity. Other specific metabolic adaptations, even those genetically induced, might also play a role in the health of centenarians.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"71 Suppl 1 ","pages":"24-7"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000178032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27932281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-09-29DOI: 10.1159/000236083
Paula van Dommelen, Floor K Grote, Wilma Oostdijk, Sabine M P F de Muinck Keizer-Schrama, Jan Bouquet, Johannes J E Hendriks, Jan Kouwenberg, Paul H Verkerk, Stef van Buuren, Jan M Wit
{"title":"Growth monitoring to detect children with cystic fibrosis.","authors":"Paula van Dommelen, Floor K Grote, Wilma Oostdijk, Sabine M P F de Muinck Keizer-Schrama, Jan Bouquet, Johannes J E Hendriks, Jan Kouwenberg, Paul H Verkerk, Stef van Buuren, Jan M Wit","doi":"10.1159/000236083","DOIUrl":"https://doi.org/10.1159/000236083","url":null,"abstract":"<p><strong>Background/aims: </strong>Cystic fibrosis (CF) in infancy and childhood is often associated with failure to thrive (FTT). This would suggest that in countries without a newborn screening program for CF, FTT could be used as a clinical screening tool. The aim of this study is to assess the diagnostic performance of FTT for identifying children with CF.</p><p><strong>Methods: </strong>Longitudinal length and weight measurements up to 2.5 years of age were used from CF patients (n = 123) and a reference group (n = 2,151) in The Netherlands. Growth measurements after diagnosis were excluded. We developed five potential screening rules based upon length, weight and body mass index (BMI) standardized by age and gender (SDS). Outcome measures were sensitivity, specificity and positive predictive value (PPV).</p><p><strong>Results: </strong>BMI SDS had the highest sensitivity at low false-positive rates. An efficient scenario is a BMI SDS below -2.5 SD in combination with a decrease in BMI SDS of at least 0.5 SD. This scenario had a sensitivity of 32%, a specificity of 98.3% and a PPV of 0.75%.</p><p><strong>Conclusion: </strong>In the absence of a newborn screening program, young children with FTT for BMI are candidates to consider testing for CF.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"72 4","pages":"218-24"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000236083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40040531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-02-03DOI: 10.1159/000197872
S Shalitin, M Yackobovitch-Gavan, M Phillip
{"title":"Prevalence of thyroid dysfunction in obese children and adolescents before and after weight reduction and its relation to other metabolic parameters.","authors":"S Shalitin, M Yackobovitch-Gavan, M Phillip","doi":"10.1159/000197872","DOIUrl":"https://doi.org/10.1159/000197872","url":null,"abstract":"<p><strong>Aim: </strong>To establish the prevalence of elevated thyroid-stimulating hormone (TSH) levels in obese children and adolescents, and identify the relationship between changes in TSH levels and other metabolic and hormonal variables before and after weight reduction.</p><p><strong>Methods: </strong>207 obese participants aged 5-18 years were evaluated for anthropometric, biochemical, metabolic and hormonal variables before and after a weight reduction.</p><p><strong>Results: </strong>At baseline, 46 participants (22.2%) had hyperthyrotropinemia (> or =4.0 mIU/l). Free T(4) levels were normal in all cases. Triglyceride levels were significantly higher in participants with hyperthyrotropinemia than in those with normal thyroid function (p = 0.011). Baseline TSH was significantly correlated with triglyceride levels (r = 0.261, p < 0.001), but not with age, anthropometric, or laboratory variables. Of the 142 participants who completed the intervention, 27 (19 %) had hyperthyrotropinemia. There was no significant relationship between changes in TSH level and changes in body mass index-standard deviation score. A significant correlation was found between the final TSH level and triglyceride level (r = 0.167, p = 0.045), and between the decrease in TSH level and the decrease in waist circumference (r = 0.291, p = 0.013).</p><p><strong>Conclusions: </strong>In obese children, hyperthyrotropinemia with normal free T(4) levels appears to be frequent. The correlation of hyperthyrotropinemia with waist circumference and higher triglyceride levels raises the question of the necessity to treat the elevated TSH levels.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"71 3","pages":"155-61"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000197872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27962028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-02-03DOI: 10.1159/000197876
Juan Javier Lammoglia, Veronica Mericq
{"title":"Familial tumoral calcinosis caused by a novel FGF23 mutation: response to induction of tubular renal acidosis with acetazolamide and the non-calcium phosphate binder sevelamer.","authors":"Juan Javier Lammoglia, Veronica Mericq","doi":"10.1159/000197876","DOIUrl":"https://doi.org/10.1159/000197876","url":null,"abstract":"Hyperphosphatemic familial tumoral calcinosis (HFTC) is an uncommon disease characterized by periarticular calcifications produced by the deposition of amorphous extraosseous calcifications of hydroxyapatite. It is associated with hyperphosphatemia due to increased tubular phosphate reabsorption, despite normal renal function and normal plasma PTH levels. The disease can be caused by inactivating mutations in either the fibroblast growth factor 23 (FGF23) gene, the UDP-N-acetyl-D-galactosamine:polypeptide N-acetylgalactosaminyltransferase 3 (GALNT3) gene or in human KLOTHO (KL) gene. Herein, we describe a Caucasian 3-year-old girl with tumoral calcinosis who presented with elevated serum phosphorus levels and a large calcified mass at her left elbow which led to ulceration of the skin. Treatment with the phosphate binder sevelamer and the carbonic anhydrase inhibitor acetazolamide successfully reduced the serum phosphate levels and led to a reduction of the calcified mass. This medical management has not been described previously. Her 7-month-old sister also had elevated serum phosphate levels, but did not have ectopic calcifications. Sequencing analysis revealed a novel homozygous FGF23 missense mutation (c.367G>T, p.Gly123Trp) in both siblings while the parents were carriers of the mutation.","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"71 3","pages":"178-84"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000197876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27962032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-10-19DOI: 10.1159/000245929
R A M Garcia, C A Longui, C Kochi, M Arruda, C D C Faria, L E P Calliari, O Monte, P R Pachi, P Saenger
{"title":"First two years' response to growth hormone treatment in very young preterm small for gestational age children.","authors":"R A M Garcia, C A Longui, C Kochi, M Arruda, C D C Faria, L E P Calliari, O Monte, P R Pachi, P Saenger","doi":"10.1159/000245929","DOIUrl":"https://doi.org/10.1159/000245929","url":null,"abstract":"<p><strong>Background: </strong>Growth hormone (GH) is a therapeutic option for small for gestational age (SGA) children without spontaneous catch-up. There are few reports on preterm SGA children. Prematurity is an additional risk factor for adult short stature.</p><p><strong>Aim: </strong>To describe GH efficacy in preterm SGA patients.</p><p><strong>Methods: </strong>Twenty-five preterm SGA patients, 2-4 years old, treated with GH 0.066 mg/kg/day, were compared with 14 age-matched preterm SGA historical controls. Height, weight, IGF-I, IGFBP-3, fasting glucose and insulin were measured every 6 months.</p><p><strong>Results: </strong>At start of GH treatment, mean height and weight were -2.4 and -2.4 SDS, respectively. There was a significant increment in height SDS of 1.3 and 2.1 during the 1st and the 2nd year of GH therapy, respectively. There was no significant difference between the progression of chronological and bone ages. A significant increase in IGF-I, IGFBP-3 and molar ratio was observed during GH therapy. There was no difference in glucose, insulin or HOMA-IR index.</p><p><strong>Conclusion: </strong>We showed for the first time that the height increment of preterm SGA with GH treatment is similar to that described in other studies with term SGA patients. Therefore, short-term GH treatment in a subset of preterm SGA patients between 2-4 years of age was able to promote adequate growth recovery with no excessive bone age acceleration or adverse effects on carbohydrate metabolism.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"72 5","pages":"275-80"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000245929","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28076087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hormone researchPub Date : 2009-01-01Epub Date: 2009-04-01DOI: 10.1159/000208797
Tsutomu Ogata, Jocelyn Laporte, Maki Fukami
{"title":"MAMLD1 (CXorf6): a new gene involved in hypospadias.","authors":"Tsutomu Ogata, Jocelyn Laporte, Maki Fukami","doi":"10.1159/000208797","DOIUrl":"https://doi.org/10.1159/000208797","url":null,"abstract":"<p><p>MAMLD1 (mastermind-like domain containing 1), previously known as CXorf6 (chromosome X open reading frame 6), has been shown to be a causative gene for hypospadias. This is primarily based on the identification of nonsense mutations (E124X, Q197X, and R653X), which undergo nonsense-mediated mRNA decay, in patients with penoscrotal hypospadias. Subsequent studies have shown that (1) the mouse homolog is transiently expressed in fetal Sertoli and Leydig cells around the critical period of sex development; (2) transient knockdown of MAMLD1 results in significantly reduced testosterone production in murine Leydig tumor cells; (3) MAMLD1 protein shares homology to mastermind-like 2 (MAML2) protein that functions as a co-activator in canonical Notch signaling; (4) MAMLD1 localizes to the nuclear bodies and transactivates the promoter activity of a non-canonical Notch target gene hairy/enhancer of split 3 (Hes3), rather than the canonical Notch target genes such as Hes1 and Hes5, without demonstrable DNA-binding capacity, and (5) MAMLD1 is regulated by steroidogenic factor 1. These findings suggest that the MAMLD1 mutations cause hypospadias primarily because of compromised testosterone production around the critical period of sex development, and provide useful information for the molecular network involved in fetal testosterone production.</p>","PeriodicalId":13225,"journal":{"name":"Hormone research","volume":"71 5","pages":"245-52"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000208797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28088366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}