Body Surface Area Group Research Articles

A survey of iodine intake and thyroid volume in Dutch schoolchildren: reference values in an iodine-sufficient area and the effect of puberty.

Iodine deficiency and endemic goiter have been reported in the past in The Netherlands, especially in the southeast. To evaluate iodine intake and thyroid size in Dutch schoolchildren, contrasting those living in a formerly iodine-deficient region in the east (Doetinchem) with those living in an iodine-sufficient region in the west (Amsterdam area). Cross-sectional survey of 937 Dutch schoolchildren aged 6--18 years, of whom 390 lived in the eastern and 547 in the western part of the country. Thyroid size was assessed by inspection and palpation as well as by ultrasound. Iodine intake was evaluated by questionnaires on dietary habits and by measurement of urinary iodine concentration. Eastern and western regions were similar with respect to median urinary iodine concentration (15.7 and 15.3 microg/dl, NS, Mann-Whitney U test), goiter prevalence by inspection and palpation (0.8 and 2.6%, P=0.08, chi-squared test), and thyroid volumes. The P97.5 values of thyroid volumes per age and body surface area group were all lower than the corresponding sex-specific normative WHO reference values. Iodized salt was not used by 45.7% of households. Daily bread consumption was five slices by boys and four slices by girls. Weekly milk consumption was 3 liters by boys and 2 liters by girls. Seafish was consumed once monthly. From these figures we calculated a mean daily iodine intake of 171 microg in boys and 143 microg in girls, in good agreement with the measured median urinary concentration of 16.7 microg/dl in boys and 14.5 microg/dl in girls. The sex difference in iodine excretion is fully accounted for by an extra daily consumption of one slice of bread (20 microg I) and one-seventh of a liter of milk (8.3 microg I) by boys. Thyroid volume increases with age, but a steep increase by 41% was observed in girls between 11 and 12 years, and by 55% in boys between 13 and 14 years, coinciding with peak height velocity. Girls have a larger thyroid volume at the ages of 12 and 13 years, but thyroid volume is larger in boys as of the age of 14 years. (1) Iodine deficiency disorders no longer exist in The Netherlands. (2) Bread consumption remains the main source of dietary iodine in The Netherlands; the contribution of iodized table salt and seafish is limited. (3) The earlier onset of puberty in girls renders their thyroid volume larger than in boys at the age of 12--13 years, but boys have a larger thyroid volume as of the age of 14 years.

Urine Flow in Childhood: A Study of Flow Chart Parameters Based on 1,361 Uroflowmetry Tests

We attempted to analyze the parameters of the urine flow chart in children. We evaluated 1,361 uroflowmetry tests of healthy boys and girls, analyzed voided volume in relation to age and body surface area, and made a descriptive study of flow chart parameters. Analysis of variance was used for comparative study of these parameters in sex, age and body surface area groups. Mean values of maximum and average flow increased with voided volume, patient age and body surface, and they were higher in girls. However, mean values of flow time and time to maximum flow were higher in boys. Flow time increased with volume, and decreased with age and body surface, although time to maximum flow increased slightly with volume and did not change with age in boys or girls. Generally, we noted significant differences in maximum and average flow, and flow time and time to maximum flow in the different age groups and in both sexes. Regarding flow curve shape, a normal flow pattern (bell-shaped curve) was noted in more than 90% of cases. The plateau curve was apparent in 5.2 and 0.7% of boys and girls, respectively.

Maximum and average urine flow rates in normal children‐the Miskolc nomograms

To establish normal reference ranges of urinary flow rates in children. From a screening programme, 200 healthy children (96 girls and 104 boys, between 3 and 18 years old) with no renal, urological, psychological or neurological disorders were selected, and they provided 433 micturitions for analysis. The children were divided into those with body surface areas of < 0.92 m2, between 0.92 and 1.42 m2 and > 1.42 m2. The voided volume, maximum and average flow rates of urine were measured. Data were fitted by several mathematical functions and goodness-of-fit determined. The relationship between maximal or average flow rates and voided volume was best fitted by a logarithmic function. The maximal and average urine flow rate nomograms are given in centile form for each body surface area group in both girls and boys. Flow rates showed a close relationship with voided volumes in both sexes and for all body sizes. The average maximal and average flow rates were higher in girls than in boys. Normal nomograms of maximal and average urine flow rates of girls and boys at three different body surfaces are presented in centile form. These may be useful for diagnosing lower urinary tract disturbances in children over a wide range of body size and voided volumes.

Maximum and average urine flow rates in normal children‐the Miskolc nomograms

Objective To establish normal reference ranges of urinary flow rates in children.Subjects and methods From a screening programme, 200 healthy children (96 girls and 104 boys, between 3 and 18 years old) with no renal, urological, psychological or neurological disorders were selected, and they provided 433 micturitions for analysis. The children were divided into those with body surface areas of &lt; 0.92 m2, between 0.92 and 1.42 m2 and &gt; 1.42 m2. The voided volume, maximum and average flow rates of urine were measured. Data were fitted by several mathematical functions and goodness‐of‐fit determined.Results The relationship between maximal or average flow rates and voided volume was best fitted by a logarithmic function. The maximal and average urine flow rate nomograms are given in centile form for each body surface area group in both girls and boys. Flow rates showed a close relationship with voided volumes in both sexes and for all body sizes. The average maximal and average flow rates were higher in girls than in boys.Conclusion Normal nomograms of maximal and average urine flow rates of girls and boys at three different body surfaces are presented in centile form. These may be useful for diagnosing lower urinary tract disturbances in children over a wide range of body size and voided volumes.

Internal mammary artery grafting in patients with smaller body structure

The results of internal mammary artery grafting in 50 patients with a body surface area less than 1.6 m2 were compared with those in 54 patients with a larger body surface area. Age (58.8 +/- 8.2 versus 54.9 +/- 10.3 years old) and prevalence of female gender (28% versus 4%) were significantly different between the group of patients with a small body surface area and the group with a large body surface area, respectively. However, the prevalence of unstable angina, previous myocardial infarction, extent of coronary artery disease, and preoperative ejection fraction was not significantly different between the two groups. The mean number of distal anastomoses was 3.0 and 2.8, and the mean duration of aortic occlusion was 65.6 +/- 23.0 minutes and 59.5 +/- 21.7 minutes in the small and large body surface area groups, respectively (not significant). The mean free flow rate of the internal mammary artery was 65.6 +/- 16.8 ml/min in the small body surface area group and 78.0 +/- 21.6 ml/min in the large body surface area group (p less than 0.05). The diameters of the anterior descending and the circumflex arteries were significantly smaller in the small body surface area group. Two patients (4%) died within 30 days of operation and one patient died later in the small body surface area group, whereas no death was noted in the large body surface area group (not significant). No significant differences were found in the incidence of aortic balloon pumping, perioperative myocardial infarction, and serious postoperative complications between the two groups. Symptomatic relief was equally good in both groups (92% and 96%). The patency rate of the internal mammary artery was 95% (42/44) in the small body surface area group and 100% (48/48) in the large body surface area group within 1 year, mean 2.3 +/- 2.4 months. In conclusion, internal mammary artery grafting can be performed safely and effectively even in patients with small body structure. Though the blood flow of the internal mammary artery and the size of the coronary arteries were smaller in patients with small body structure, excellent patency of the internal mammary artery graft and satisfactory symptomatic relief can be expected.

An evaluation of five indices of physical working capacity in children.

The purposes of this study were 1) to analyze race, sex, and body surface area (BSA) differences in the mean work to exhaustion index, maximal endurance index, rate-pressure product, maximum power, and physical working capacity index (PWC) of 383 healthy children, ages 5-16 yr, by using an alternative method of statistical analysis than has been used in previous studies of this type; and 2) to determine which index best measures relative physical working capacity in children. As a result of a three-way analysis of variance test, strong interaction effects were found among race, sex, and BSA on all but one of the indices. In general, the results indicated that the differences between males and females and between blacks and whites in physical working capacity were not consistent across all BSA groups. This suggests that normal values for these indices should be separated into race, sex, and BSA groupings. Based on correlation coefficients, it was also found that all the indices except PWC were biased by age and height differences. In addition, PWC was the only working capacity index to discriminate properly among underweight, normal, and overweight children. It was concluded that of the five indices tested, PWC was the best index of relative physical working capacity for use with children.

108 BLOOD PRESSURE AND HEART RATE RESPONSES TO EXERCISE IN HEALTHY CHILDREN-BLACK vs WHITE

To determine whether responses to dynamic exercise differed between healthy black and white children, we tested 220 white and 182 black children between the ages of 6 and 15 on a cycle ergometer. We analyzed the following variables in relation to race, sex, age, and body surface area: resting systolic blood pressure (SBP); maximum (max) SBP; resting heart rate (HR); HR max. Among the boys, there were no consistent differences between black and white children for resting HR, HR max, or resting SBP. The BP max values were statistically significantly higher in black males in seven of the ten age groups (6,8,9,10, 11,12, and 13 years). When analyzed by surface area, all groups of black males had higher BPmax. Among the girls, no consistent differences were seen for HRmax, and resting BP. Resting HR was lower in the 9 and 10 year old blacks; it was lower in all body surface area groups. BPmax was higher in the 9 and 10 year old blacks; it was higher in blacks over 1.05m2. These data suggest that black males have increased peripheral vascular resistance in comparison to their age-matched or surface-area matched white counterparts. The black girls tested may have been more fit (as reflected by decreased resting HR) but still had higher BPmax than white girls. This suggests that possible precursors for the early onset of hypertension in the black population may be demonstrated as early as six years of age.

Plasma cortisol concentrations and circadian rhythm in healthy young Japanese and caucasians (author's transl)

We report herein a method of solid-phase radioimmunoassay (RIA) for assessment of plasma cortisol concentration using 125I-labeled ligand [CORTCTK-125]. Plasma cortisol concentrations and its circadian rhythm in healthy young Japanese and American whie women were also evaluated using CORTCTK-125. Nineteen Japanese women, of an average age of 20.3 +/- 0.1 years, and 12 Caucasians of mixed ethnic origin (Minnesota), average 20.0 +/- 0.5 years, were studied using a similar protocol. The distribution of the menstrual stage of the two groups was similar. Blood was drawn from each subject into EDTA containers at 4-hour intervals starting at 0800 on one day and was continued for the ensuing 24 hours. The samples were immediately placed in a refrigerated centrifuge at 4 degrees C, and then stored at -20 degrees C until the assay. The samples from Minnesota were packed in dry ice and brought by air to Japan. Determinations of plasma cortisol concentration in samples from both groups were carried out at Kyushu University. Advantages of the solid-phase RIA method are as follows: (1) 0.05 ml of plasma or serum was sufficient for determination of plasma cortisol concentrations, (2) no other solvents or solutions for the extraction or purification were required, (3) the procedure was simple and readily facilitated, and (4) the concentration of cortisol in heparin-plasma was somewhat higher than that in serum or EDTA-plasma, but there was no statistical difference. Plasma cortisol concentrations in the samples from the Japanese (19.73 +/- 1.44 on the first and 18.94 +/- 1.32 microgram/dl on the second day) and that of the American group (17.48 +/- 2.38 and 19.37 +/- 2.16 microgram/dl, respectively) at 0800 was similar. The average value of 7 determinations at 4-hour intervals was 11.01 +/- 2.00 microgram/dl in the Japanese and 10.29 +/- 1.05 microgram/dl in the American group. A remarkable and similar circadian rhythm was observed in both groups with a peak at 0800 and with nadirs at 2000 in the Japanese (4.80 +/- 0.45 microgram/dl) and 2400 in the American group (5.18 +/- 0.83 microgram/dl). There were statistically significant differences between the values at the peak and the nadir. The related subjects were then classified into Group-F (9 subjects) and Group-T (9); the former included high body mass index [BMI: body weight(kg)/body height(m)2] of more than 24.0, and the latter included a relatively lower BMI of less than 21.5. The circadian rhythm of both groups revealed a similar pattern, whereas plasma cortisol concentration was always higher in Group-F than in Group-T, at all 7 determinations. There were no significant differences except for the value at 0400. Furthermore, the average values of plasma cortisol concentration and circadian rhythm were compared; the group with a larger body surface area (BSA) (Group-L) and the group with a smaller BSA (Group-S). No difference was found in the plasma cortisol concentration of Group-L and -S, and the circadian rhythm was similar in both groups...