bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREDICTION OF THERAPEUTIC RESPONSE TO RADIOACTIVE IODINE IN GRAVES’DISEASE USING TSH‐RECEPTOR ANTIBODIES AND HLA‐STATUS
Authors: DAVIES T. F. , PLATZER M. , FARID N. R. 
Published: March 2008

SUMMARYWe have examined the combined usefulness of TSH‐receptor antibody detection and HLA status on the therapeutic response to standard doses of radioactive iodine (RAI) in forty‐three hyperthryoid Graves’patients. Twenty‐three patients had detectable TSH‐receptor antibodies as measured by 125I‐TSH binding‐inhibition (TBI) prior to administration of 7 mCi RAI. Eighteen (78%) of these patients were rendered euthyroid within 3 months. In contrast, twenty patients were TBI negative prior to RAI and sixteen (80%) of these individuals remained hyperthyroid at 3 months and required two, or more, doses of RAI to control their thyroid function. DR3 status alone was not strongly associated with resistance to RAI. However, of sixteen patients without detectable TBI activity and who required two or more doses of RAI, ten patients were DR3 positive (62%) compared with 25% in a control population. Only one patient who was both TBI and DR3 negative required more than one dose of RAI.These data indicate that TBI may be an accurate predictor of the therapeutic response to RAI in patients with hyperthyroid Graves’disease. Investigation of HLA status alone was of limited value, although it appeared that the combination of TBI and DR3 may be of additional help in developing an overall strategy for the treatment of hyperthyroid Graves’disease.
TRH INJECTION DURING LABOUR: EFFECT ON MATERNAL AND FETAL PROLACTIN SECRETION
Authors: MESSINIS I. E. , LOLIS D. E. , KANELLOPOULOS N. , DALKALITSIS N. , KANARIS C. 
Published: March 2008

SUMMARYThe effect of TRH injection on PRL levels in maternal serum and in serum of umbilical vein (UV) and artery (UA) was investigated in forty‐six women. Twenty‐two of them, with normal singleton term pregnancy, were given i.v. either saline solution (nine women, control group 1) or 200 μg of synthetic TRH (thirteen women, group 2) 30–45 min before normal delivery. Group 1 PRL values (mean ± SE) (ng/ml) in UV (428 ± 41) and UA serum (434 ± 45) were significantly higher than in maternal serum either before (285 ± 39) or after saline injection (331 ± 14) (P < 0·05). In group 2, TRH induced a marked increase in maternal serum PRL (544 ± 33 v. 285 ± 39, P < 0·001) (difference from corresponding maternal serum PRL of group 1 significant, P < 0·001) but not in UV (409 ± 41) and UA (406 ± 48) PRL values (difference from the corresponding PRL values in UV and UA serum of group 1 non‐significant, P > 0·1). Group 2 maternal serum PRL values after TRH were significantly higher than in UV and UA serum (P < 0·05). A significant positive correlation was found between UV and UA serum PRL values in both group 1 (r=0·858, P < 0·01) and group 2 (r=0·870, P < 0·001). Twelve of the remaining twentyfour women were given TRH either 10–20 min (four women), 60–75 min (four women), or 90–110 min (four women) before delivery. UA serum PRL values did not differ significantly from corresponding controls (twelve women). It is suggested, from these findings in women, that TRH injected into the mother in a single dose of 200 μg stimulates maternal but not fetal pituitary in late pregnancy during labour. This is possibly due to inability of TRH to cross the human placenta.
METABOLIC CLEARANCE AND PRODUCTION RATES OF 3,3′‐DIIODOTHYRONINE, 3′,5′‐DIIODOTHYRONINE AND 3′‐MONOIODOTHYRONINE IN HYPER‐ AND HYPOTHYROIDISM
Authors: FABER J. , LUMHOLTZ I. B. , KIRKEGAARD C. , SIERSBæK‐NIELSEN K. , FRIIS T. 
Published: March 2008

SUMMARYComplete turnover studies of thyroxine (T4), 3,5,3′‐triiodothyronine (T3), 3,3′,5′‐triiodothyronine (rT3), 3,3′‐diiodothyronine (3,3′‐T2), 3′,5′‐diiodothyronine (3′,5′‐T2) and 3′‐monoiodothyronine (3′‐T1) were performed in each of eight healthy subjects, eight hyperthyroid and eight hypothyroid patients, using the single injection, non‐compartmental approach. The median metabolic clearance rate (litre per day per 70 kg) in controls was, T4 1·19; T3 19·7. rT3 147; 3,3′‐T2 1073; 3′,5′‐T2 256 and 3′‐T1 518. Hyperthyroid patients had increased and hypothyroid patients reduced values. The median production rate (PR) (nmol per day per 70 kg) in controls was, T4 117, T3 39, rT3 52, 3,3′‐T2 35, 3′,5′‐T2 14 and 3′‐T1 27. The PR of all iodothyronines studied was increased in hyperthyroidism, the increase in PR of T3 being the most pronounced. Hypothyroid patients had reduced PRs, a reduction which was relatively less pronounced for T3. Assuming thyroidal secretion contributes little rT3 and 3′,5′‐T2, the conversion rates (CRs) of T4 to rT3 and further to 3′,5′‐T2 were calculated. CR of T4 to rT3 in controls was in median 34%. By comparison the CR in hyperthyroid patients was increased to 56% (P < 0·05). In contrast the CR of rT3 to 3′,5′‐T2 was similar in controls and hyperthyroid patients, 26% v. 31%.Our data demonstrate, that quantitatively important amounts of 3,3′‐T2, 3′,5′‐T2 and 3′‐T1 are produced in man, and that deiodination of T4, the T3s and the T2s is a major metabolic pathway both in eu‐, hyper‐ and hypothyroidism. The daily production of all six iodothyronines studied is influenced by hyper‐ and by hypothyroidism. The activity of the 5‐deiodination of T4 seems to be enhanced during hyperthyroidism, possibly tending to counteract the hypermetabolic state. In contrast the 5‐deiodination of rT3 is unaltered in hyperthyroidism, thus suggesting the existence of more than one 5‐deiodinase in man.
RELATIONSHIP OF ALTERED THYROID HORMONE INDICES TO SURVIVAL IN NONTHYROIDAL ILLNESSES
Authors: KAPTEIN ELAINE M. , WEINER JOHN M. , ROBINSON WILLIAM J. , WHEELER WILLIAM S. , NICOLOFF JOHN T. 
Published: March 2008

SUMMARYAlthough alterations of serum thyroid hormone indices are frequent in nonthyroidal illnesses, their relationship to survival is poorly defined. Consequently, the prevalence and prognostic relevance of alterations in thyroidal indices were evaluated prospectively in 195 patients requiring intensive medical therapy and in 75 critically ill patients with serum total T4 (TT4) levels below 3 μg/dl. In the 195 patients, serum total T3 (TT3) and TT4 levels were reduced in 69% and 43% respectively. Decreased TT4 levels had the highest correlation with mortality (P < 0·001) and correctly predicted outcome in 70% of patients. Other thyroidal indices, which were significantly different between survivors and nonsurvivors, correlated with TT4 and did not contribute independently to prediction accuracy when assessed by discriminant function analysis.In seventy‐five patients with TT4 levels below 3 μg/dl, the nadir TT4 level appeared a median of 9 days (range 1–28) after hospital admission. The nonsurvivors lived a median of 6 days (range 0–42) and the survivors were discharged a median of 20 days (range 4–55) after the TT4 nadir. Only an increased free fraction of T4 (FFT4) was found to correlate significantly with mortality and contribute to prediction accuracy.An inhibition of serum T4 binding to carrier proteins could account for both the decreased serum TT4 and the increased FFT4 values. Serum TT4 and/or FFT4 levels may be useful in assessing the severity and predicting the clinical outcome of acute critical nonthyroidal illnesses.
MENSTRUAL FUNCTION AND SERUM PROLACTIN LEVELS AFTER LONG‐TERM BROMOCRIPTINE TREATMENT OF HYPERPROLACTINAEMIC AMENORRHOEA
Authors: BERGH TORBJÖRN , NILLIUS SVEN JOHAN , WIDE LEIF 
Published: March 2008

SUMMARYLong‐term bromocriptine treatment was discontinued in thirty‐seven women with hyperprolactinaemic amenorrhoea. After cessation of therapy thirty of the thirty‐seven women became hyperprolactinaemic again with amenorrhoea or anovulatory bleeding. Seven of the women continued to have regular ovulatory menstruation but only three were normoprolactinaemic 3 months after stopping treatment. Two of the seven women had evidence of pituitary tumour regression. After the discontinuation they had nearly normal prolactin levels but during 2 years of follow up the serum prolactin levels slowly increased. In the twenty‐seven women with pre treatment prolactin levels below 100 μg/l there was no difference between the prolactin levels before starting and 1 month after stopping treatment, while the women with pretreatment prolactin levels above 100 μ/l had lower levels after therapy. Bromocriptine treatment seldom results in permanent cure of hyperprolactinaemic amenorrhoea.
SALIVARY TESTOSTERONE: RELATIONSHIP TO UNBOUND PLASMA TESTOSTERONE IN NORMAL AND HYPERANDROGENIC WOMEN
Authors: BAXENDALE P. M. , JACOBS H. S. , JAMES V. H. T. 
Published: March 2008

SUMMARYA sensitive radioimmunoassay (RIA) was used to measure salivary testosterone levels in normal women, in patients with polycystic ovaries (PCO), and in women with hirsutism. There was a highly significant correlation (r= 0·79, P<0·001) between the concentration of testosterone in saliva [12·3 ± 7·8 (SD) pg/ml] and the concentration of unbound testosterone in plasma (5·2 ± 3·1 pg/ml) in matched samples collected from 56 women including normals, patients with clinical signs of hyperandrogenism, and women treated with a combination of cyproterone acetate (CA) and ethinyl oestradiol (EE). The unbound plasma testosterone was measured in the dialysate directly using a sensitive RIA. Salivary and plasma testosterone levels in patients with PCO (20·6 ± 8·5 and 626 ± 187 pg/ml respectively, n= 14) and in those with hirsutism (13·9 ± 5·6 and 421 ± 170 pg/ml, n= 30) were significantly higher (P<0·001) than levels in normal women (7·7 ± 2·6 and 196 ± 68 pg/ml, n= 36). Treatment for 3 months with CA and EE resulted in a decrease (mean 68%) in salivary testosterone levels in all patients studied (n= 15), but the suppression of plasma testosterone (mean 34%) was not observed in all cases. It is concluded that measurement of salivary testosterone gives a useful indication of levels of biologically available androgen in hyperandrogenic women, before and during CA/EE therapy.
FAILURE OF FSH TO INFLUENCE AROMATIZATION IN HUMAN ADIPOSE TISSUE
Authors: FOLKERD E. J. , JACOBS H. S. , VAN DER SPUY Z. , JAMES V. H. T. 
Published: March 2008

SUMMARYSince gonadotrophins are known to influence aromatase activity in gonadal tissue, an attempt was made to correlate serum gonadotrophin concentrations with the activity of aromatase enzyme in adipose tissue. No relationship between in‐vitro measurements of adipose tissue aromatase activity and FSH or LH levels in serum was found. Four of five women studied with premature ovarian failure had low levels of aromatase activity despite having post‐menopausal levels of serum gonadotrophins. In addition, FSH receptors could not be demonstrated on whole adipose tissue, isolated fat cells or stromal‐vascular tissue.
PRIMARY HYPOTHYROIDISM WITH GROSSLY ELEVATED PLASMA TOTAL THYROXINE AND TRIIODOTHYRONINE LEVELS
Authors: BECKETT G. J. , TODD J. A. , HUGHES G. J. , CAMPBELL I. W. 
Published: March 2008

SUMMARYIn an elderly patient with clinical primary hypothyroidism and a raised basal TSH, the serum free thyroxine (fT4), total thyroxine (TT4) and triiodothyronine (TT3) were consistently and paradoxically grossly elevated when measured by radioimmunoassay. In part these hormone levels were due to a high titre of endogenous IgG immunoglobulins which bound T4, T3 and reverse T3 (rT3) and thus caused gross interference in the radioimmunoassays. However, when this methodological interference was removed by using a methanolic extract of the patient's serum, the concentrations of TT4 and TT3 were still grossly elevated. It was only when basal TSH and the concentration of fT4 and fT3 were measured by equilibrium dialysis that these hormone levels were found to be consistent with primary hypothyroidism.
MICROHETEROGENEITY OF LUTEINIZING HORMONE IN PITUITARY GLANDS FROM WOMEN OF PRE‐ AND POSTMENOPAUSAL AGE
Authors: READER S. C. J. , ROBERTSON W. R. , DICZFALUSY E. 
Published: March 2008

SUMMARYLuteinizing hormone from the pituitaries of women of premenopausal (Pre‐M) and postmenopausal (Post‐M) age has been studied to further understand the variations in the quality of plasma LH in women of different ages. The median and range for bioactive LH was 101: 85–155 IU/mg protein and 83: 52–201 IU/mg protein for the Pre‐ and Post‐M groups respectively. The ratios of LH bioactivity/immunoreactivity (B:I) were 1·04 ± 0·13 (Pre‐M) and 0·97 ± 0·02 (Post‐M). Broad range isoelectrophoretic profiles of the pituitary extracts revealed a heterogeneous population of coincident bioactive and immunoreactive LH peaks. Recoveries from the columns were similar in both groups and B:I values of the LH material throughout the columns were between 0·5 and 2·0 in over 90% of the fractions. Between 31·8 and 36·6% of the LH from both groups appeared between pH 7 and pH 8. The most striking difference between the two groups was that > 34% of the bioactive LH from the Post‐M pituitaries, but <6% of the LH from the other group had migrated as a major discrete peak to an acidic region of pH < 6. We conclude that although there is no difference in total LH activity in the pituitaries from the two groups, substantially more ‘acidic’ LH material is stored in the postmenopausal pituitaries. These observations are consistent with the recent finding of greater circulating levels of acidic LH in plasma from post‐menopausal women.
THE CLINICAL PRESENTATION OF HYPOTHYROID MYOPATHY AND ITS RELATIONSHIP TO ABNORMALITIES IN STRUCTURE AND FUNCTION OF SKELETAL MUSCLE
Authors: KHALEELI A. A. , GRIFFITH D. G. , EDWARDS R. H. T. 
Published: March 2008

SUMMARYClinical assessment for the presence of myopathy was performed in fifteen untreated hypothyroid patients. In many of these patients plasma creatine kinase (CK) activities, tests of skeletal muscle function and vastus lateralis needle biopsies were performed. Muscle symptoms were extremely common, occurring in thirteen patients. Proximal muscle weakness, preferentially affecting the legs, muscle pains or cramps and delayed tendon jerk relaxation represented the commonest features of hypothyroid myopathy. Detailed descriptions are given of patients with muscle hypertrophy, muscle atrophy and developmental failure to illustrate the wide clinical spectrum.If examination revealed signs of myopathy, in particular if there was delayed relaxation of tendon jerks, biochemically severe hypothyroidism (serum thyroxine < 20 nmol/1) was likely (P < 0·01). The latter was a frequent finding in six patients with serous effusions (P <0·01). This subgroup also had a mean plasma CK activity of 1339 IU/1 compared to 679 IU/1 (normal 10–120 IU/1) for the whole hypothyroid group, and all five patients in this subgroup in whom vastus lateralis needle biopsies were performed showed abnormalities.Quadriceps force measurements and ankle jerk relaxation times were more sensitive than clinical examination in detecting muscle weakness and delayed relaxation. A reduced maximum relation rate (MRR) of the quadriceps, vastus lateralis needle biopsy abnormalities, and myopathic features on electromyography were characteristic.
DOPAMINE BLOCKADE INHIBITS STARVATION KETOSIS IN MAN
Authors: JOHNSTON D. G. , BLESA‐MALPICA G. , BURRIN J. M. , WAUGH C. , COOK D. , ØRSKOV H. , ALBERTI K. G. M. M. 
Published: March 2008

SUMMARYThe effects of dopamine blockade on the endocrine and metabolic response to starvation have been investigated by administration of metoclopramide, 30 mg daily, or placebo to five normal subjects fasted for sixty hours on two occasions. Blood glucose and alanine concentrations fell with starvation and metoclopramide had no further effect. Concentrations of the other gluconeogenic precursors, lactate and pyruvate, were also unaffected by metoclopramide. The rise in circulating ketone body concentrations with fasting was impaired by metoclopramide, significantly from 44 h onwards (blood total ketone body concentration at 60 h, 3·42·0±94 mmol/1 with placebo; 2·08 ± 0·67 mmol/1 with metoclopramide, P < 0·05). Blood glycerol and plasma non‐esterified fatty acids (NEFA) levels rose with starvation, and metoclopramide had no further effect. Serum insulin concentrations remained low with fasting, while circulating glucagon and growth hormone levels rose. Similar changes were noted with both metoclopramide and placebo. Serum prolactin concentrations during starvation were elevated two to four fold by metoclopramide.The inhibitory effect of dopamine blockade on ketosis thus occurred despite hyperprolactinaemia, and did not result from measurable alterations in insulin, glucagon or growth hormone secretion. The data suggest a stimulatory role for endogenous dopamine on starvation ketonaemia in man.
STUDIES OF INSULIN‐LIKE GROWTH FACTOR ‐I AND ‐II BY SPECIFIC RADIOLIGAND ASSAYS IN UMBILICAL CORD BLOOD
Authors: GLUCKMAN P. D. , JOHNSON‐BARRETT J. J. , BUTLER J. H. , EDGAR B. W. , GUNN T. R. 
Published: March 2008

SUMMARYSomatomedin concentrations in human umbilical sera (n= 206) were measured using a specific radioimmunoassay for insulin‐like growth factor (IGF)‐I and a specific radioreceptor assay for IGF‐II following acid‐ethanol extraction of the sera to remove the somatomedin binding proteins. IGF‐I concentrations were lower (P< 0·001) than adult values and correlated with gestational age (P< 0·001) and birth weight (P< 0·0001). Multiple regression analysis demonstrated that both birth weight expressed independently of gestational age as the standard deviate score (P< 0·0001) and gestational age (P< 0·002) had effects on umbilical cord IGF‐I concentrations. IGF‐II concentrations were similar to adult values and did not correlate with gestational age, birth size or IGF‐I values. IGF‐II concentrations were higher (P< 0·005) in male than female fetuses. These data support a role for IGF‐I in influencing fetal growth and suggest the independent regulation of the secretion of IGF‐I and II in the perinatal period. These was no evidence to suggest a distinct perinatal form of somatomedin.
NATURAL HISTORY OF THYROID FUNCTION IN DIABETICS WITH IMPAIRED THYROID RESERVE: A FOUR YEAR CONTROLLED STUDY
Authors: GRAY R. S. , BORSEY D. Q. , IRVINE W. J. , SETH J. , CLARKE B. F. 
Published: March 2008

SUMMARYAn attempt was made to compare the natural history of thyroid function in 80 diabetics having raised serum TSH concentrations (median 8·9 mU/l, range 5·8–46·3 mU/l) but serum T4 concentrations within the normal range (Group 1), and in 59 diabetics having normal serum TSH (median 1·9 mU/l, range 0·8–4·7 mU/l) and T4 concentrations (Group 2). Thyroid microsomal antibodies were present initially in 65% of patients in Group 1 and 15% of patients in Group 2. By 1981, 59 patients (74%) in Group 1 and 47 patients (80%) in Group 2 had been followed for a mean ± SD duration of 4·2 ± 1·8 and 4·2 ± 1·5 years, respectively.Hypothyroidism developed in 9 patients in Group 1, but none from Group 2. Of patients in Group 1, hypothyroidism developed at a rate of 5% per annum in those with thyroid microsomal antibodies, but only 1% per annum in those without antibodies. Therefore, the risk of development of hypothyroidism is greatest in diabetics having both elevated serum TSH concentrations and thyroid microsomal antibodies and such patients should have regular review of thyroid function. Either risk factor alone appears to be a poor predictor of development of hypothyroidism.
CORRECTION BY BROMOCRIPTINE OF HYPOTHALAMIC DYSFUNCTION AND POST‐PRANDIAL HYPOGLYCAEMIC SYMPTOMS IN A 31‐YEAR‐OLD WOMAN
Authors: CORCOS A. P. , WEIDENFELD J. , LEVY J. , BARASH V. , SIEGEL R. A. , GUTMAN A. , CHOWERS I. 
Published: March 2008

SUMMARYA 31‐year old female presented with recurrent episodes of post‐prandial hypoglycaemic symptoms. Basal serum levels of ACTH, cortisol, GH, insulin and glucagon were normal. An adrenaline test demonstrated a normal peripheral response. An exercise test failed to produce ACTH, cortisol or FFA responses. Insulin (0·1 u/kg)‐induced‐hypoglycaemia failed to elevate serum ACTH, cortisol or GH. Metyrapone and ACTH tests were normal, demonstrating adequate hypophyseal and adrenal function. These findings suggested that the patient suffered from hypothalamic dysfunction. Brornocriptine (Parlodel, 7·5 mg/d for 5 weeks) resulted in an improved general condition, accompanied by a decrease in sugar consumption. Following treatment, FFA, ACTH and cortisol responses to exercise test were normal, as were ACTH, cortisol and GH responses to insulin‐induced hypoglycaemia. It is concluded that bromocriptine may be useful in the treatment of post‐prandial hypoglycaemic symptoms associated with hypothalamic dysfunction.
EFFECT OF TREATMENT OF CUSHING'S SYNDROME ON SKELETAL MUSCLE STRUCTURE AND FUNCTION
Authors: KHALEELI A. A. , BETTERIDGE D. J. , EDWARDS R. H. T. , ROUND J. M. , ROSS E. J. 
Published: March 2008

SUMMARYThe time course of recovery in the myopathy of Cushing's syndrome was studied before and after removal of a pituitary adenoma at hypophysectomy in three patients and an adrenal adenoma in another. Serial measurements were performed of quadriceps force, total muscle mass/body weight, individual fibre size on needle biopsies of the lateral muscle mass of the thigh and skeletal muscle cross‐sectional area (CSA) and force/unit CSA on computed (CT) scans of thighs and calves. All patients were weak, and recovery was slow but substantial except in one patient who had persistent Cushing's syndrome. An accompanying increase in overall and type II mean fibre area (MFA) occurred after surgery in the patients with a pituitary adenoma, as did an increase in skeletal muscle CSA and force/unit CSA in both patients having CT scans. The only patient with pronounced muscle wasting showed severe type II fibre atrophy with a reduced total muscle mass/body weight, but muscle morphology and total muscle mass were normal in the other patients. Only in this patient was a significant increase in total muscle mass/body weight noted after surgery. These findings suggest that the increase in muscle mass which may follow hypophysectomy in Cushing's syndrome is due to an increase in individual cell size.
SHOULD ONE MEASURE SERUM THYROGLOBULIN IN THE PRESENCE OF ANTI‐THYROGLOBULIN ANTIBODIES?
Authors: BLACK E. G. , HOFFENBERG R. 
Published: March 2008

SUMMARYThyroglobulin auto‐antibodies (anti‐Tg) may affect measurement of serum thyroglobulin (Tg). We have assayed sera for Tg by RIA regardless of presence or absence of anti‐Tg, and this study was designed to assess the influence of anti‐Tg on the results. Binding of human anti‐Tg by the second antibody in our RIA (sheep anti‐rabbit immunoglobulin) is very low and sera containing anti‐Tg of varying titres do not systematically affect assay of Tg regardless of concentration. In our follow‐up study of patients with thyroid cancer, correlation between clinical state and Tg concentration is greater than 97% whether anti‐Tg is present or absent. These results indicate that in our assay anti‐Tg positive sera do not need to be excluded.
SUSTAINED GONADAL SUPPRESSION IN FERTILE WOMEN WITH THE LHRH AGONIST BUSERELIN
Authors: HARDT W. , SCHMIDT‐GOLLWITZER M. 
Published: March 2008

SUMMARYNine fertile women were treated with the luteinizing‐ hormone‐releasing hormone agonist buserelin (seven women received 800 ųg, two women 1200 ųg intranasally for up to 24 weeks). Both doses produced sustained suppression of ovarian function, accompanied by hot flushes. In five women chemical castration was established within 1 to 5 weeks, whereas in the other four volunteers transient peaks of serum oestradiol occurred between the 6th and 19th weeks. Thereafter low postmenopausal oestradiol levels persisted. Chemical castration was confirmed by hormonal parameters and endometrial biopsies (inactive endometrium). After cessation of treatment normal cyclical function occurred immediately. This reversible chemical castration may be useful for new therapeutical approaches in sexual hormone dependent diseases (endometriosis, precocious puberty, metastatic breast cancer).