In this era of proliferation of synthetic growth hormone in the marketplace, there is a parallel and accentuated interest in growth hormone in the scientific arena. Because many more people can be treated with available growth hormone, clinicians must be prepared to answer hard questions regarding appropriate therapeutic usage and their decisions should be based on substantiated research in growth hormone. In June 1987, an international group of basic and clinical inves­ tigators gathered in Tampa, Florida, to address these issues and to further explore the very nature of growth hormone. The presentations contained within this book bring together their most current and vital research related to growth hormone. Section I deals with an examination of the molecular and biochemical events which define the growth hormone process. In Section II the neuroregulation of growth hormone secretion is highlighted from contrasting perspectives. The third section emphasizes and defines methods of diagnosis of growth hormone deficiency states. Section IV reviews the physiology, biochemistry and molecular actions of growth hormone and somatomedin. Section V represents an assessment of growth hormone treatment for various disorders, and the sixth section expands current uses of growth hormone therapy as it evolves into the next decade. The symposium upon which this book is based proved to be a dynamic blending of scholarly interaction between basic and clinical scientists. I am indebted to the participants whose worthy contributions are reflected in these pages.

Inhalt

I. Processing of Growth Hormone.- 1. Growth Hormone Gene Expression: Hormonal Regulation and Tissue-Specific Expression.- 2. Heterogeneity of Growth Hormone.- 3. Some Aspects on the Biochemistry of Growth Hormone.- 4. Multiple Forms of Growth Hormone.- 5. Genetic Defects in Processing Growth Hormone.- 6. Summary of Session I: Processing of Growth Hormone.- II. Neuroendocrine Regulation of Growth Hormone Secretion.- 7. Interactions Between Growth Hormone Releasing Hormone, Somatostatin and Galanin in the Control of Growth Hormone Secretion.- 8. The Role of Neurotransmitters in Growth Hormone Secretion.- 9. Acromegaly.- 10. Summary of Session II: Neuroendocrine Regulation of Growth Hormone Secretion.- III. Assessment of Growth Hormone Secretion in Children.- 11. Dynamics of GH Secretion in Children.- 12. Growth Hormone Neurosecretory Dysfunction: Update.- 13. Growth Hormone Secretion and Growth in Central Nervous System Irradiated Children.- 14. Age and Sex-Related Neurosecretion of Growth Hormone.- 15. Chronobiology of Growth Hormone Secretion.- 16. Summary of Session III: Assessment of Growth Hormone Secretion in Children.- IV. Growth Hormone Action.- 17. Growth Hormone Receptors in Rat Adipocytes.- 18. Direct Action of GH.- 19. Comparison of Growth Effects of rhIGF-I in Diabetic and Hypox Rats with Those of Insulin and Growth Hormone.- 20. Biological Action of Insulin-Like Growth Factor-I In Vivo.- 21. Insulin-Like Growth Factors in Fetal Growth.- 22. Organization and Expression of the Genes Encoding the Human Somatomedins.- 23. Summary of Session IV: Growth Hormone Action.- V. Therapeutic Effects of Growth Hormone.- 24. Assessing Selected Aspects of Adequacy of the Growth Hormone-Somatomedin Axis in Short Children with Quantitatively Normal Growth Hormone Secretion.- 25. Therapeutic Effects of Growth Hormone Releasing Hormone.- 26. Improvement in Growth Rate and Mean Predicted Height During Long-Term Treatment with Growth Hormone in Children with Non-Growth Hormone Deficient Short Stature.- 27. Constitutional Delay of Growth and Adolescent Development.- 28. Dose-Response Relationship of Growth Hormone Therapy.- 29. Effects of Human Growth Hormone in Normal Short Children and in Patients with Intrauterine Growth Retardation, Glucocorticoid-Induced Stunting of Growth, Osteochondrodystrophies and Other Disorders.- 30. Summary of Session V: Therapeutic Effects of Growth Hormone..- VI. New Applications of Growth Hormone Treatment.- 31. Growth Hormone Therapy in Turner's Syndrome.- 32. Use of Growth Hormone in Surgery.- 33. Interaction of Growth Hormone and Nutritional Intake in Facilitating Nitrogen Conservation and Promoting Lipolysis.- 34. Assessment of the Risks of Treatment with Human Growth Hormone.- 35. Summary of International Growth Hormone Symposium.- Author Index.