bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum FSH and testicular morphology in male infertility
Authors: Bergmann Martin , Behre Hermann M. , Nieschlag Eberhard 
Published: March 2008

SummaryOBJECTIVE In patients with azoospermia serum FSH helps to differentiate between obstruction or spermatogenetic dysfunction as the possible cause of this condition. The role of FSH in the diagnosis of infertile men with oligoasthenoteratozoospermia is less clearly defined. In order to evaluate the diagnostic significance of serum FSH in the management of male infertility, serum FSH levels were related to testicular morphology from bilateral biopsies of infertile men.DESIGN AND PATIENTS Testicular biopsies were obtained from 213 infertile men and evaluated in semi‐thin sections. Biopsies were performed either in order to distinguish between obstructive and non‐obstructive azoospermia or because of subnormal semen variables when history, clinical investigation and hormone levels failed to explain infertility. Serum FSH was measured by fluoroimmunoassay.RESULTS Patients were divided into five groups on the basis of morphological criteria. The mean serum FSH value of patients with obstructive azoospermia and normal histology (group 1, n= 14) was normal (3.0 (2.2–4.1) IU/I) (mean (95% confidence limits)). Serum levels of FSH in non‐obstructive oligo or azoospermia were as follows: group 2: mixed atrophy of tubular tissue without focal Sertoli cell only syndrome (SCO) (n= 104) (4.5 (4.0–5.1) IU/I), group 3: mixed atrophy with unilateral focal Sertoli cell only (n= 39) (7.4 (6.1–90) IU/I), group 4: mixed atrophy with bilateral focal SCO (n= 36) (107 (8.7–13.0) IU/I). Group 5: bilateral or unilateral total Sertoli cell only (n= 20) (16 0 (12 1–20 9) IU/I). Mean serum FSH levels were significantly different between all groups (P<0.05).CONCLUSIONS Elevation of serum FSH correlates with the appearance of Sertoli cell only tubules. Elevated FSH serum levels make testicular biopsies superfluous for diagnostic purposes, but normal FSH does not exclude severe derangement of spermatogenesis in individual cases.
Prolactin, growth hormone and insulin‐like growth factor‐l in newborn children of smoking mothers*
Authors: Beratis Nicholas G. , Varvarigou Anasiasia , Makri Maria , Vagenakis Apostolos G. 
Published: March 2008

SummaryOBJECTIVE Since maternal smoking causes fetal circulatory abnormalities, as well as disturbances of the maternal endocrine equilibrium, we measured the PRL, hGH and insulin‐like growth factor‐l (IGF‐I) concentrations in the cord and venous blood of neonates of smoking mothers to determine whether or not the tobacco smoke affects the endocrine status of the neonate.DESIGN The above hormones were measured in the cord blood of the newborns of both smoking and non‐smoking mothers. Also, PRL and hGH were determined at 24 and 72 hours after birth in newborns of both groups.PATIENTS Fifty‐three newborns of smoking and 47 newborns of non‐smoking mothers were investigated. Seventeen of the newborns of the smoking and 21 of the nonsmoking mothers were preterm. The remainder were full‐term.MEASUREMENTS PRL was measured with a solid‐phase immunoradiometric assay, hGH with a solid‐phase two‐site immunoradiometric assay and IGF‐I with a solid‐phase radioimmunoassay after extraction with acid‐etha‐nol.RESULTS The median value of PRL in the 17 preterm newborns of smoking mothers was 4941 mU/l (range 1322‐7230), whereas in the 21 preterm newborns of nonsmoking mothers it was 2013 mU/l (range 243‐4740) (P = 0 0002). The median hGH value in the above subjects was 1020 mU/l (range 35 2‐208 4) and 59 8 mU/l (range 11 6‐134‐2), respectively (P = 0 0039). The median IGF‐I was 580 7 U/l (range 253 2‐4851 1) and 530 6 U/l (range 239 6‐3591 5), respectively (P = 0 429). In the 36 full‐term newborns of smoking mothers the median PRL value was 5171 mU/l (range 2074‐7530), whereas in the 26 full‐term newborns of non‐smoking mothers it was 5081 (range 244‐6540) (P = 0 048). The median hGH was 69 6 mU/l (range 42 3‐280 0) and 32 2 mU/l (range 6 2‐200 0), respectively (P = 0 0031). Also, the median IGF‐I value was 926 3 U/l (range 348 5‐5344 7) and 462 1 U/l (range 250 2‐1578 7), respectively (P = 00024). On the 3rd day the PRL in the preterm neonates of both smoking and non‐smoking mothers showed the same 16‐5% drop, and thus the difference between the groups was maintained. A similar reduction in the hormone levels was observed in the full term neonates.CONCLUSIONS The findings indicate that the maternal tobacco‐smoking causes disturbances of the endocrine status of the fetus, as shown by the increased levels of PRL, hGH and IGF‐I, which are more pronounced between 30 and 37 weeks of gestation than at term.
The neuroendocrine effects of sumatriptan, a specific ligand for 5‐HT 1‐like receptors
Authors: Facchinetti Fabio , Nappi Rossella E. , Sances Grazia , Fioroni Loredana , Nappi Giuseppe , Genazzani Andrea R. 
Published: March 2008

SummaryOBJECTIVE A relationship between the serotoninergic and the opiatergic system in the pathogenesis of head pain is supported by several data. This study was carried out to investigate the neuroendocrine effects of sumatriptan, a specific serotonin agonist used in the treatment of migraine, on hypothalamic‐pituitary‐adrenal axis (PHA) hormones.DESIGN Two consecutive studies were performed. In study A, eight subjects received a subcutaneous (s.c.) injection of sumatriptan (6 mg). In study B, a further six subjects were randomized to receive either sumatriptan or placebo.SUBJECTS Healthy volunteers recruited within the staff (eight males and six females) were studied.MEASUREMENT In study A, plasma Cortisol and PRL were measured by direct RIA and β‐endorphin after extraction and chromatography. Samples were collected from 60 minutes before to 120 minutes after the administration of the drug, at 15‐minute intervals. According to the data of the first study, in study B, in addition to Cortisol and β‐endorphin, ACTH was also measured.RESULTS Significant increases in the mean β‐endorphin and Cortisol concentrations were found in every subject receiving sumatriptan, while no significant changes were observed in prolactin plasma levels. Study B confirmed the activation of the pituitary‐adrenal axis, additionally demonstrating the release of ACTH, and indicated that placebo has no effects.CONCLUSION Acute s.c. stimulation with sumatriptan activates the pituitary‐adrenal axis.
Immunological findings and thyroid function of untreated Graves' disease patients with undetectable TSH‐binding inhibitor immunoglobulin
Authors: Mukuta T. , Tamai H. , Oshima A. , Morita T. , Matsubayashi S. , Fukata S. , Kuma K. 
Published: March 2008

SummaryOBJECTIVE TSH‐binding inhibitory immunoglobulin (TBII) is undetectable in about 10% of untreated Graves' disease patients, but the clinical characteristics and immunological significance of this finding are unknown. In this study we evaluated the clinical characteristics of TBII negative Graves' disease.PATIENTS We examined TBII in 1048 untreated patients at Kuma hospital from 1986 to 1990 and found 69 TBII undetectable patients (12 men and 57 women, mean age ± SEM 35 ± 2 years, group A).MEASUREMENTS We compared the clinical characteristics and immunological findings of group A with 57 untreated TBII detectable Graves' patients who were selected randomly (11 men and 46 women, mean age ±SEM 40 ±2 years, group B). T4, TSH, FT4, FT3, 1231 thyroid uptake, TBII, thyroid stimulating antibodies (TSAb) and the volume of the thyroid using ultrasonography were measured at the first visit.RESULTS Serum T4, FT4 and FT3 levels in group A were significantly lower than those in group B (P<0 001). The values of TSAb in group A were significantly lower than those in group B (593±67 (mean±SE) vs 2143±280%, respectively, P < 0001). The 1231 thyroid uptake in group A was significantly lower than that in group B (53 1 ±11 vs 61 ‐4±14%, respectively, P<0.01).The thyroid volume in group A was significantly smaller than that in group B (391 ±3 0 vs 51 3±3 3 ml, respectively, P<0 01). TSAb was undetectable in about 10% (6) of the TBII negative untreated Graves' patients at their first visit.CONCLUSION In the present study, untreated TBII negative patients with Graves' disease were characterized by mild elevation of thyroid hormones, mildly elevated 123l uptake, weak TSAb activities and small goitres. The finding of both TBII and TSAb negative titres in untreated Graves' disease patients was also confirmed.
α2‐Adrenergic activity is normal in patients with thyroid disease
Authors: Del Rio Graziano , Zizzo Giuseppe , Marrama Paolo , Venneri Maria Grazia , Casa Luciano Delia , Velardo Antonino 
Published: March 2008

SummaryOBJECTIVE Several studies indicate an inverse relationship between the sympathetic nervous system activity and thyroid function. Altered adrenoceptor sensitivity, particularly α and β, have been described in hypothyroid and hyperthyroid patients. No information in patients with thyroid disease is available on the main mechanism regulating sympathetic nervous system outflow, i.e. the α2‐adrenoceptor pathway. In our study we evaluated α2‐adrenergic activity in patients with thyroid disease by the assessment of cardiovascular and catecholamine response to clonidine, a central a2 adrenergic agonist.PATIENTS Ten patients with hypothyroidism, six patients with hyperthyroidism before and during adequate therapy, and ten healthy subjects.MEASUREMENTS After three blood samples for the basal determination of noradrenaline and adrenaline, the subjects swallowed 4 μg/kg body weight of clonidine. Blood pressure and pulse rate were measured 30,60,90,120,130 and 140 minutes after clonidine administration; blood samples for determination of catecholamines were drawn at 120,130 and 140 minutes.RESULTS At presentation the decrease in plasma noradrenaline after clonidine in the patients was similar to that of the control group (hypothyroids: 1.07 ± 0.23 nmol/l mean±SEM; hyperthyroids: 0.54 ± 0 06 nmol/l; controls: 0.36±0.10 nmol/l; F=1.2, P=NS). No differences were detected in the fall in adrenaline and mean arterial pressure (MAP) after clonidine. The adequate therapy induced in hypothyroid patients a decrease in the basal levels of noradrenaline (1.88±0.28 vs 0.67±0.10 nmol/l; P <0.05) and a lesser fall in mean arterial pressure after clonidine (AMAP 20 4 ± 2 0 vs 9.7 ±2.8 mmHg; P < 0.05). No variations were detected in hyperthyroid patients after therapy either in basal hormones levels or in the magnitude of decrement in MAP and noradrenaline induced by clonidine.CONCLUSIONS We conclude that in spite of the previously reported abnormalities in α1 and β‐adrenergic receptor activity, the inhibitory α2‐receptor pathway is normal in patients with altered thyroid function.
Prospective evaluation of insulin resistance and lipid metabolism in women receiving oral contraceptives
Authors: Sheu Wayne Huey‐Herng , Hsu Chih‐Hsueh , Chen Yan‐Shiun , Jeng Chii‐Yuang , Fuh Martin Mao‐Tsu 
Published: March 2008

SummaryOBJECTIVES It has been suggested that normal women receiving oral contraceptives (OC) may develop a series of metabolic side‐effects which relate to the risk of cardiovascular disease. These metabolic disturbances include changes in glucose and insulin metabolism, raised serum lipid and lipoprotein concentrations and elevated blood pressure. All these changes indicate that OC might cause insulin resistance. We have prospectively examined the effect of OC on insulin resistance and lipid metabolism including Lp(a) values.PATIENTS The study group comprised 13 normally menstruating Chinese women.DESIGN The study subjects were given a combined triphasic oral contraceptive which was administered on a 21‐day on, 7‐day off medication cyclic regimen, the first pill being administered on day 5 from the beginning of menses. The metabolic investigations were carried out during luteal phase before OC and again the third week of the third month of OC administration.MEASUREMENTS Metabolic evaluation including insulin secretion and insulin‐mediated glucose uptake were evaluated by oral glucose tolerance test and the modification of insulin suppression test. Fasting triglyceride, cholesterol, HDL‐cholesterol and Lp(a) concentrations were also measured.RESULTS The plasma glucose and insulin responses during a 75‐g oral glucose challenge increased significantly (P<0 05 and P<003, respectively). The steady‐state plasma glucose (SSPG) concentrations achieved during constant infusion of glucose, insulin and somatostatin increased significantly after 3 cycles of OC administration (glucose 7–5±08 vs 124±07 mmol/l, P<0001) while the steady‐state plasma insulin (SSPI) concentrations were relatively similar (410±14 vs 391 ±7 pmol/l, NS). Plasma triglyceride levels increased significantly (0 81 ±012 vs 1 09±0 19 mmol/l, P<0 03) following OC administration. Fasting plasma cholesterol, HDL cholesterol and calculated LDL cholesterol concentrations did not change as compared with baseline values, nor did the ratio of total cholesterol to HDL cholesterol. The Lp(a) concentrations did not change during the administration of OC (81 ±25 vs 71 ±21 mg/l, NS).CONCLUSIONS These data indicated that intake of OC for 3 cycles induced glucose intolerance, hyperinsulinaemia and insulin resistance in normal menstruating Chinese women. These changes occurred in association with elevated plasma triglyceride concentrations and no alteration in Lp(a) or other lipid values.
Glucocorticoid responsive ACTH secreting bronchial carcinoid tumours contain high concentrations of glucocorticoid receptors
Authors: Florkowski C. M. , Wittert G. A. , Lewis J. G. , Donald R. A. , Espiner E. A. 
Published: March 2008

SummaryCushing's syndrome due to a bronchial ACTH secreting carcinoid tumour may be difficult to distinguish from a pituitary microadenoma (corticotrophinoma) causing Cushing's disease, since in both disorders ACTH secretion may be responsive to glucocorticoids. Why some bronchial carcinoid tumours are responsive is unknown but it could be because of co‐secretion of corticotrophin releasing factor (CRF) and/or expression of glucocorticoid receptors. We report two patients with glucocorticoid responsive ACTH secreting bronchial carcinoid tumours, neither of whom produced or responded to CRF. Significant glucocorticoid receptor binding capacity (92 and 102 pmol/g protein), compared with control lung tissue, was found in extracts from both tumours. These findings suggest that corticotrophinoma‐like responses to glucocorticoids observed in some ACTH secreting bronchial carcinoids result from expression of glucocorticoid receptors and are not necessarily related to the production of CRF.
The value of inferior petrosal sinus sampling in diagnosis and treatment of Cushing's disease
Authors: Landolt Alex M. , Schubiger Othmar , Maurer Robert , Girard Jürg 
Published: March 2008

SummaryOBJECTIVE While microsurgical selective adenomectomy is the best method available at present for the treatment of Cushing's disease, its success depends to a large degree on precise preoperative intrapituitary microadenoma localization. This study compares the results of intrapituitary adenoma localization obtained with inferior petrosal sampling, computerized tomography and magnetic resonance imaging with the adenoma localization as found at surgery.DESIGN The results of inferior petrosal sampling for intrapituitary localization of ACTH‐producing pituitary adenomas were compared in a retrospective study with the results of computerized tomography, magnetic resonance imaging, surgical and pathological findings. Special attention was paid to the intersinus ACTH relation.PATIENTS Thirty‐eight patients (33 women and 5 men) of 11‐68 years of age suffering from pituitary‐dependent Cushing's disease were studied. Patients with ectopic ACTH‐secreting tumours and and recurrent pituitary adenomas were excluded.MEASUREMENTS Blood samples were obtained simultaneously from both inferior petrosal sinuses and a peripheral vein before and 5, 10, 15 and 20 minutes after stimulation with 60 /μg/m2 human corticotrophin‐releasing hormone (hCRH).RESULTS of the adenomas in our series, 42% had a diameter of 3 mm or less. Only 6 of 20 adenomas examined by computerized tomography and 11 of 29 examined by magnetic resonance imaging were identified correctly. Inferior petrosal sinus sampling produced significantly better results, particularly when combined with a stimulation test with hCRH: for 29 of 38 adenomas examined, the location was predicted correctly with these techniques. Analysis of the intersinus adrenocorticotrophin concentration ratio showed that the best right‐central‐left discrimination was obtained with values of 1.3 and 1.4.CONCLUSIONS We conclude that inferior petrosal sinus ACTH sampling after hCRH stimulation is the best method available for the intrapituitary localization of microadenomas causing Cushing's disease provided that the appropriate technique of blood sampling is used meticulously.
Plasma corticotrophin releasing hormone, vasopressin, ACTH and Cortisol responses to acute myocardial infarction
Authors: Donald R. A. , Crozier I. G. , Foy S. G. , Richards A. M. , Livesey J. H. , Ellis M. J. , Mattioli L. , Ikram H. 
Published: March 2008

SummaryOBJECTIVES We assessed the magnitude and duration of the response of hypothalamic‐pituitary‐adrenal hormones to the stress of myocardial infarction, in the presence and absence of angiotensin converting enzyme inhibitors. In particular, we wished to analyse the interrelationships between peripheral plasma levels of corticotrophin releasing hormone (CRH), vasopressin (AVP) and adrenocorticotrophin (ACTH), and also between ACTH and Cortisol, during a prolonged medical stress.DESIGN All hormones were measured within 6 hours of the onset of an acute myocardial infarction. Patients were randomly allocated to three different study groups according to a double blind procedure.PATIENTS Group 1 (10 patients) received placebo treatment, Group 2 (13 patients) received a maintenance dose of captopril 25 mg three times daily, Group 3 (11 patients) received enalapril 5 mg three times daily.MEASUREMENTS Peptide hormones were measured by radioimmunoassay, and Cortisol by ELISA. Reference ranges for all hormones were obtained from 40 or more volunteers from the electoral roll.RESULTS At the start of the study, mean±SEM plasma AVP (27.9 ± 4.6 pmol/l) was significantly (P<0 001) raised above the mean for the reference range (1.82 ± 0.09 pmol/ I), and 12 patients had values >50 pmol/l. Mean plasma Cortisol (960 ± 89.6 nmol/l) was also raised above the reference range mean (554±28 nmol/l, P<0.001), as was mean plasma CRH (4.97 ± 0.5 pmol/l, reference mean 1.52± 0.09 pmol/l, P<0001). By contrast, mean ACTH (3.88 ± 0.66 pmol/l) was significantly less than the reference mean (10.7 ± 0.7 pmol/l, P<0.001). During the 72‐hour observation period there was a highly significant fall (P<0.001) in plasma CRH, AVP and Cortisol. By contrast, plasma ACTH rose, and the change with time of ACTH was significantly different from the fall in plasma CRH, AVP or Cortisol (P<0.001 for each comparison). No significant differences in plasma CRH, AVP, ACTH or Cortisol responses to placebo, captopril or enalapril were observed.CONCLUSIONS Within 6 hours of a myocardial infarction, mean plasma CRH, AVP and Cortisol values were very significantly raised above mean control values, while ACTH was very significantly reduced. During the 3 days following an acute myocardial infarction, plasma CRH, AVP and Cortisol fell substantially, and this pattern was not influenced by angiotensin converting enzyme inhibitors. By contrast, plasma ACTH showed a significant increase with time. This suggests that the usual relationships between CRH, AVP and ACTH, and between ACTH and Cortisol are disturbed in patients admitted to hospital with myocardial infarction. Maximum levels of AVP observed in 12 patients exceeded 50 pmol/l, which may be sufficiently high to interfere with tissue perfusion. It is postulated that V1, AVP receptor antagonists may have a therapeutic application in limiting infarct size.
The renin‐aldosterone axis in patients with diabetes insipidus
Authors: Antaraki Aspasia , Rangou Despina , Chlouverakis Constantino 
Published: March 2008

SummaryOBJECTIVE The objective of the present study was to investigate the renin‐aldosterone axis in neurogenic diabetes insipidus in man, in view of the fact that profound abnormalities of this axis have been described in experimental animals with congenital neurogenic diabetes insipidus.DESIGN AND PATIENTS Nine patients with neurogenic diabetes insipidus and 11 healthy subjects (controls) were examined under basal conditions, following the standard 8‐hour water deprivation test and 1 hour after a subsequent oral rehydration.MEASUREMENTS Plasma and urine osmolalities were determined by freezing point depression, plasma sodium and potassium by a method using an ion‐selective electrode, plasma AVP, Cortisol, aldosterone and plasma renin activity by radioimmunoassay.RESULTS Plasma renin activities under basal conditions were significantly higher in patients with diabetes insipidus than in controls (mean ± SEM 23.4 ± 6.6 vs 7.8 ± 1.2 ng/ I min). In the diabetes insipidus group, water deprivation caused a twofold Increase in plasma renin activities (48 ± 13.8 ng/l min), while in the control group plasma renin activity levels were not significantly altered (10.2 ± 1.2 ng/l min). Rehydration did not alter plasma renin activity levels in either group (patients 50.4 ± 13.2, controls 9.0 ± 2.4 ng/l min). Plasma aldosterone concentrations under basal conditions did not differ between the two groups (patients 302.4 ± 37, controls 326.4 ± 36.5 pmol/l) and did not change in patients with diabetes insipidus after water deprivation or rehydration (307.5 ± 67.2 and 385.5 ± 91 pmol/l, respectively). Conversely, controls showed a significant decrease in plasma aldosterone levels after dehydration (201 ± 27.9 pmol/l), which was attributed to the circardian variation in aldosterone secretion, as shown by a parallel decrease in plasma Cortisol levels.CONCLUSIONS Patients with diabetes insipidus are hyper‐reninaemic, probably because of chronic volume contraction. There is a dissociation between renin and aldosterone in patients with diabetes insipidus under basal conditions, which is exaggerated during water deprivation.