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OBJECTIVE: To evaluate clinical, hormonal, and auxologic features in a group of girls with central precocious puberty during and after long-term treatment with luteinizing hormone—releasing hormone analogue nasal spray. DESIGN: Clinical survey, before-after trial. SETTING: Pediatric Clinic, Endocrinological Center, University of Bologna (Italy). PATIENTS: Forty-one girls with central precocious puberty were treated for 28 months (range, 12 to 60 months); 25 of them discontinued therapy at a mean chronological age of 10.0±0.9 years and were followed up for 25 months (range, 6 to 50 months). Twelve patients achieved adult height. INTERVENTION: Buserelinacetate (D-Ser [TBU] LHRH Al-9EA) nasal spray; 1800 μg/d subdivided into six intranasal administrations of 300 μg each. MEASUREMENTS/MAIN RESULTS: Basal follicle-stimulating hormone, peak gonadotropin values (fluoro-immunoenzymatic method, Eurogenetics, Tessenderlo, Belgium; sensitivity was 0.5 IU/L for luteinizing hormone and 1IU/L for follicle-stimulating hormone), and estradiol (radioimmunoassay method, DPC Kit, Los Angeles, Calif; sensitivity was 11.01 pmol/L were significantly suppressed (P<.0001) as of the third month of treatment and increased significantly (P<.01) to pretreatment levels 6 months after discontinuation of therapy. Uterine and mean ovarian volumes, which were stable throughout treatment, appeared significantly higher (P<.05) than before treatment at only 6 months after stopping therapy. In patients with more advanced bone age (according to Greulich and Pyle) at onset of treatment, we observed a more significant improvement of SD score for height (Tanner). Mean adult height in our patients was 159.5±6.1 cm, and the variables that were significantly associated with final height were height age/bone age ratio at onset and target height (according to Tanner). CONCLUSIONS: Long-term buserelin treatment administered nasally is effective because of completeness of inhibition, quick reversibility after treatment is stopped, and lack of side effects. Its auxologic results are different depending on bone age advancement at onset, which represents a predictor of "therapeutic success." Further follow-up would be useful.(Arch Pediatr Adolesc Med. 1994;148:1194-1199)

A systematic multidisciplinary survey on the coasts of the Ionian Islands, founded on 26 new radiocarbon accelerator mass spectrography (AMS) dates, has revealed the occurrence of sectors which were uplifted (seismo)tectonically during the late Holocene. In Corfu, two uplift movements of about 0.8m each took place in the central part of the island: one of them around 790-400 cal. BC, and also at a more recent, undetermined date. In Levkas, up-and-down tectonic movements of metric order governed late-Holocene relative sea-level changes, at least in the northern part of the island; submergence of at least 2.5 m occurred since 2400 years ago, with a possible spasmodic subsidence around cal. AD 500-700. In Cephalonia, two vertical displacements affected most of the island, around cal. AD 350-710 and in AD 1953; both movements resulted in uplift in the southeastern part of the island. Submergence seems to predominate round Ithaca. Lastly, in Zante, clear evidence of a Holocene crustal block movement is limited to the southeastern peninsula, where an uplift of 0.95 ± 0.15 m took place, probably coseism ically, around the period cal. AD 200-500. The time ranges of uplift in Cephalonia and Zante, and of possible subsidence in Levkas, correspond with a period of regional tectonic paroxysm, between the middle of the fourth century AD and the middle of the sixth century AD; this has already been documented in several areas of the eastern Mediterranean, notably in the Gulf of Corinth, the southern Hellenic arc, Turkey, Cyprus, the Lebanon and Syria.

IGF-I, testosterone and estradiol levels were evaluated in 8 girls with androgen insensitivity immediately before and from 1 to 3 months after bilateral gonadectomy. In 6 patients GH secretion was evaluated before and after gonadectomy by means of an arginine test and in 3 a sleep test was also performed. Mean IGF-I level before surgery was significantly higher than that of normal controls (2850 ± 1230 vs 1680 ± 1040 U/l, p < 0.025). After gonadectomy a significant decrease was evident for testosterone, estradiol and IGF-I levels. A positive correlation between IGF-I and estradiol levels was present before surgery (p < 0.005). The presence of a correlation with estradiol, but not with testosterone, and the knowledge that this syndrome is due to an insensitivity to androgens, but not to estradiol, support the hypothesis that the estradiol level is the major determinant for the control of IGF-I values in these patients. After gonadectomy, a substantial decrease of the 12-h nocturnal GH secretion was evident. Comparison of the nocturnal GH levels before surgery of the 3 patients with those of normal subjects of the same age showed hormonal values higher than 1 sdover the mean values of control subjects. Even if the number of patients studied is too small to draw any definitive conclusion, these data may suggest that sex hormones play a role in the control of IGF-I levels, a function which seems to be mediated through GH secretion.

In 22 normal boys, 33 unilateral and 14 bilateral cryptorchids, a gonadal function test (2000 IU of HCG im each a day for three days and assays of plasma testosterone and plasma oestradiol-17β before and after the HCG administration) as well as an LH-RH test were carried out.In 60% of the cases, both normal and cryptorchid boys, plasma oestradiol-17β (both in basal conditions and after stimulus) were found to be less than the sensitivity (5 pg/ml) of the method. While the plasma testosterone was similar under basal conditions in the three groups of children, after HCG it was significantly lower than the mean value of the control group only in the bilateral cryptorchids. The testosterone levels, both under basal conditions and after stimulus, are correlated to bone age only in the normal boys and in the unilateral cryptorchids. There were no significant differences among the various groups for either LH and FSH both under basal conditions and after LH-RH. The LH curve area during the LH-RH test is in correlation with bone age only in the normal children.

Four raised shorelines, between +1.1 m and +3.5 m, have been identified at two localities on the Perachora Peninsula and were dated by AMS 14C to between 6400 and 1500 calibrated years ago. Uplift movements seem to have occurred in increments of 0.8 ± 0.3 m, with a return period of about 1600 years. The last uplift coincided with a regional tectonic paroxysm, which has already been documented in several areas of the eastern Mediterranean. The average uplift rate was probably faster during the Holocene than the average since the Last Interglacial period. No important vertical displacement occurred in this area at the time of (or after) the 1981 earthquake, but a new episode of coseismic uplift may be in preparation.

A field survey along the coasts of Calabria has found little evidence of Holocene emergence, the greatest being no more than 1.0–1.5 m in elevation. A former shoreline (a thick crust of calcareous algae in growth position at about + 0.6 m, capping an elevated beachrock slab) was dated 2990 ± 60 yr B.P. This emergence is recent, if compared to the time of the Climatic Optimum, and relatively slight, if Late Pleistocene uplift rates, which in some cases exceed 1 mm/yr, are considered. This apparent discrepancy can be explained by taking into account glacio- and hydroisostatic effects of the last glaciation, which have produced subsidence at decreasing rates during the late Holocene in a wide area around the former Scandinavian ice sheet which includes most of the Mediterranean. According to isostatic modelling, the average subsidence rate during the last 6000-5000 years was between 0.4 and 1 mm/yr near the coasts of Calabria. If global sea-level changes can be neglected, it is only when the subsidence rate of glaciohydro-isostatic origin became slower than the local uplift that emergence at a slower rate than that of the tectonic uplift trend could have begun. Such emergence is therefore a recent phenomenon, in the Holocene, and its rate is still much slower than that of tectonic uplift predominating in Calabria over a longer time scale.

In dieser Arbeit sind mehr als 700 Daten über das Untertauchen und Aufsteigen von Küsten für die letzten 2000 Jahre in bezug auf ihre geographische Verbreitung analysiert worden. Die Befunde variieren von einer Region zur anderen, und es gibt keinen generellen Trend. Untertauchen herrscht vor an den Küsten der USA und Westeuropas innerhalb breiter Gürtel, die an die ehemaligen Eisschilde anschließen. Es überwiegt außerdem in den meisten Mittelmeeren. Andererseits erscheinen Anzeichen für ein Aufsteigen hauptsächlich an den Küsten der Arktis, des Indischen und Pazifischen Ozeans. Diese Unterschiede werden auf isostatische und tektonische Phänomene zurückgeführt. Die wichtigste Schlußfolgerung ist: Keine Küstenregion der Welt kann a priori als völlig stabil angesehen werden. Der daraus folgende Mangel eines absoluten Bezugspunktes läßt es derzeit unsicher erscheinen, irgendwelche präzisen Angaben über ein „eustatisches“ Meeresspiegelniveau zu machen. Mögliche Fluktuationen scheinen die Größenordnung von Dezimetern nicht überschritten zu haben.

Nine cases of adrenocortical tumor are presented, six were males. Four were less than three years and five were between 5 and 10 years of age. Clinical virilization was found in 8 children, one had only signs of hypercortisolism and another showed signs of virilization and hypercortisolism simultaneously. Urinary 17-KS and 17-OHCS were high in all patients. Plasma levels of testosterone and of the other adrenal androgens were high in all the cases tested. Plasma level of cortisol was elevated only in few cases. In two out of five cases steroids were only partially suppressed by dexamethasone. Computed tomography and abdominal sonography have been useful tods for the localization of the tumour. The resection of the tumour, indipendent of hystopathological diagnosis, led to a complete normalization of the clinical and hormonal picture in eight cases evaluated at a distance of 2 months 10 years after surgery. In one case a hepatic metastasis was observed and removed three years after surgery.Adrenocortical tumours are rare (Javadpour et al., 1980) and the vast majority of them are hormone secreting. Although cases have been described which showed feminilization and hyperaldosteronism (Bacon & Lowrey, 1965; Bhettay & Bormici, 1977; Crane et al., 1961; Gauguly et al., 1980), virilization and hypercortisolism are most commonly found (Hayles et al., 1966).This paper illustrates our experience with nine cases of adrenocortical tumour, eight of whom showed inappropriate virilization with or without hypercortisolism and one of whom was a classic case of Cushing's syndrome.

Signs of up to eight stepped Holocene shorelines, which have been reported in a previous study on the east coast of Rhodes Island, have been reinvestigated in detail on the basis of a new geomorphological survey, identification and petrological analysis of many new samples of exposed marine organic crusts and over 30 radiocarbon datings.

Field surveys of several sea-level indicators (exposed in situreef framework, conglomerates, coral colonies and Tridacnashells in a growth position, sea-corrosion notches) carried out on six atolls from the NW Tuamotus (Mataiva, Rangiroa, Arutua, Kaukura, Apataki and Takapoto) and data from four subsurface boreholes drilled through Mataiva show that during the late Holocene mean sea level (MSL) reached a maximum elevation at approximately + 0.9 m. It remained above the present MSL from between 6000 and 5500 yr B.P. until at least 1200 yr B.P. Human settlements on the atolls were extremely unlikely and probably impossible throughout this time. The area investigated seems to have been tectonically quite stable during the late Holocene. A local curve of MSL variations may be representative of the regional eustatic pattern.

Evidence of Holocene sea levels higher than the present level have often been reported from the Northwest Pacific. Eustatic interpretations have been propounded, but age and level of the maximum transgression vary with each new analysis. In this investigation, after an inventory of approximately 250 items of data, some of which are new, a tentative synthesis transcending local scale is advanced. The highest levels are reported from Taiwan, where they often reach several tens of meters in altitude. In the Ryûkyûs and in the main islands of the Japanese Archipelago, evidence of recent emergence is found along most of the coasts. Elevation increases towards the oceanic trenches, but former sea levels at above 6 m and even higher may also be recognized along the coasts of the Sea of Japan. In a few areas, such as in the Niigata Plain, marks of Holocene sea levels higher than at present are lacking. On the other hand, in other basins regarded as subsiding, such as those in the Nôbi and the Kantô plains, evidence of recent emergence is quite frequent. In many places, marks of several sea levels indicate that a step-by-step uplift has occurred. All the investigated insular arcs, therefore, seem to be situated in epeirogenic areas formed by several more or less large blocks affected by relative movements. The blocks are larger in the Outer Zone of Southwestern Japan; in the Inner Zone, an intricate network of fault lines marks the boundaries of many smaller independent blocks. During great earthquakes, relative movements of uplift, subsidence, tilting, or undulation occur in one or several blocks, depending on the position of the epicentres. Subsidence, however, must often be simply of a temporary nature, because a long-term uplift trend seems to prevail in most regions, even if it occurs at different rates. This interpretation may explain the cause of the great variety of ages and elevations of the former sea levels (with the oldest ages corresponding to the highest elevations) and the great number of indicators of step-by-step sea-level change. The inference, drawn by several authors, that the Holocene sea level in the Northwest Pacific was higher than at present, is, therefore, reasonable on a local scale, but does not define an eustatic sea level.

This paper is concerned with the tectonic trends that can be deduced from the Holocene raised shorelines between Ch'eng-kung and Hsin-she, along a 65-km long coastal sector in the eastern Coastal Range of Taiwan. Sequences of up to eight superimposed shorelines have been identified in a single section. Twelve new radiocarbon dates (six of which were obtained by accelerator mass spectrometry) of in-situ marine samples (up to 40 m in altitude) have confirmed a Holocene age. However, it is difficult to define clearly the upper marine boundary in the highest Holocene coastal terraces, which have been uplifted to 65–70 m, but have been capped by, and often also interfingered with, alluvial deposits. High uplift rates, ranging from 2.5–3.0 to over 8 mm/yr, have been inferred along the coast, providing evidence of differential uplift. In some cases uplift movements appear to have occurred by steps, probably spasmodically. Recurrence periods of fast uplifts seem to be of the order of at most 1000 yr. This means that a new spasmodic movement may be imminent, because the last displacement (4–6 m) has been dated about 1000 yr BP.

On the reefs of the central Pacific, emerged coral conglomerates give evidence of ancient sheets of reefal debris deposited above reef flats, which were subsequently lithified and exposed by a fall in the relative sea level. Such spreadings of debris, which contribute to the strengthening of the reef framework structure, are generally produced by high-energy waves, often during storm surges. Examples are described of former spreadings which occurred in the sublittoral, intertidal, and partially supralittoral zones. According to the distribution of coral conglomerates over the reefs, it is possible to identify the areas which were most exposed to storm waves and therefore to specify locally the trajectory of ancient tropical cyclones. In the Leeward Islands of the Society Archipelago, the most significant cyclones came mostly from the west between 3000 and 1600 yr B.P., when the relative sea level was almost 1 m above the present one.

The site of Qal'at al-Ṣuḥâr on the coast of the Sultanate of Oman, has been excavated by the French archaeological team in Baḥraîn and Oman conducted by Monique Kervran from 1980 to 1982. The fortress was built in the 13th-14th century above a residential quarter of 9th-11th century Ṣuḥâr. The fort was later constantly altered and partly rebuilt right up until the present century. The Chinese material presented here comes from surveys (1980), the excavation of the fort itself, stratigraphic soundings made perpendicular to the outside of the wall. The sherds have been grouped in series and only some pieces, representatives of each series, are illustrated and described in the catalogue. A study of the Chinese ceramics excavated shows that the Chinese sherds are very abundant, varied and of a rather high quality (white and qingbaiwares, Yue ware, Changsha, Xicun...) for the period of the second half of the 9th century until the beginning of the 12th century, which corresponds to the most flourishing period of Ṣuḥâr, when the port, like Sîrâf, traded with China, India and the Oriental coast of Africa. Very few specimens were found from the 14th century (celadon and qingbai) to the beginning of 17th century (kraakporselein). The site yielded a huge quantity of coarse export ware, mainly 19th century. The gap (12th-18th century) noted in the Chinese material could correspond to the decline of Ṣuḥâr's international status. [ABSTRACT FROM AUTHOR]

Statistical analysis of a data base with ride-gauge and meteorological records from the French Atlantic coast enables to define recent and present-day trends of variation for MSL, surges and the related meteorological contribution. Climate variability is for the moment in favour of a decrease in the frequency and severity of coastal flooding. However the highest storm surges of the last decades did not occur at the time of spring high tide and such a chance may not necessarily continue in the near future.