bluuebunny/crossref_metadata_2025_split huggingface dataset:
The diagnosis of polycystic ovaries in women with oligo‐amenorrhoea: predictive power of endocrine tests
Authors: Fox Robert , Corrigan Elizabeth , Thomas Paul A. , Hull Michael G. R. 
Published: March 2008

SummaryThe ability of several endocrine tests to distinguish between women with and without polycystic ovaries (PCO) has been studied prospectively in a series of 65 patients with functional oligo‐amenorrhoea using ultrasonography as a reference test. In terms of overall diagnostic accuracy, the free androgen Index (FAI) (94%) and the progestogen challenge (89%) gave similar results (CI =–5 to 15%) but both were significantly better than all the other tests including measurement of serum LH (69%), total testosterone (71%) and androstenedlone (74%) (minimum CI = 6 to 23%). The FAI together with LH measurement was the most accurate of the combinations (97%) but this was not significantly better than the best of the combinations Incorporating the progestogen challenge (92%; CI =–3% to 13%). Given the limited availability of the assay for SHBG, these results show that assessment of oestrogen state is a useful method for categorizing patients with functional oligo‐amenorrhoea
High permanent plasma adrenaline levels: a marker of adrenal medullary disease in medullary thyroid carcinoma
Authors: Visteile R. , Grulet H. , Gibold C. , Chaufour‐Higel B. , Delemer B. , Fay R. , Delisie M. J. , Caron J. 
Published: March 2008

Summary Increases in urinary, plasma and tumour adrenaline have been previously observed In MEN II patients with phaeochromocytoma. However, the sensitivity of adrenaline for early detection of adrenal medullary disease has not been accurately evaluated. Twenty‐five patients with medullary thyroid carcinoma (MTC) histologically confirmed but without clinical or biological evidence of phaeochromocytoma have been studied. Medullary adrenal status was evaluated by adrenal CT‐scan. MIBG scintigraphy, determination of urinary VMA, metanephrines and total catecholamine levels, measurement of nyctohemeral plasma adrenaline or noradrenaline concentrations (every 2 h during 24 h) and clonidine suppression test. Four of the 25 patients had evidence of adrenal medullary disease In view of the coexistence of CT‐scan, MIBG scintigraphy and plasma adrenaline abnormalities. Moderate adrenal enlargement (unilateral, n= 3; bilateral, n= 1) was observed on scans together with a high adrenal MIBG uptake (bilateral, n= 4). Among the urinary parameters studied, a minor MN increase was observed In only one of the four patients. Plasma adrenaline levels were significantly (P > 0·01) different from those of the other 21 patients (mean + SD 115 + 110 pmol/I). This plasma adrenaline increase is reproducible and not suppressed by clonidine. Unilateral adrenalectomy performed in one patient confirmed a phaeochromocytoma and induced normalization of plasma adrenaline levels. In contrast, the plasma noradrenaline levels of the four patients were not statistically different from those of the other 21 patients. These data suggest that persistent high plasma adrenaline levels may be selectively increased in MTC patients together with a moderate adrenal CT‐scan enlargement and a high adrenal MIBG uptake, despite a normal urinary excretion of total catecholamines and catecholamines metabolites. These preliminary results allow us to propose that the determination of plasma free adrenaline concentrations be used for the early detection of adrenal medullary disease.
Withdrawal of bromocriptine after long‐term therapy for macroprolactinomas; effect on plasma prolactin and tumour size
Authors: Van't Verlaat Johanna W. , Croughs Ronald J. M. 
Published: March 2008

Summary The present study describes the effect on plasma prolactin values and tumour size of bromocrlptine withdrawal in 12 patients who had been treated for macroprolactinomas for a period of 3·5–7 (mean 4·9) years. Pretreatment plasma prolactin values ranged from 12000 to 210000 (mean: 66000) mU/I. Immediately before bromocriptine withdrawal plasma prolactin values were In the normal range (> 350 mU/I for men; > 450 mU/I for women). Bromocriptine treatment was associated with tumour reduction in all cases. The following observations were made upon withdrawal of bromocrlptlne:(1) In 11 patients hyperprolactinaemia redeveloped although plasma prolactin levels remained below 600 mU/I In two of these patients during a follow‐up period of 1 year. In the other nine patients bromocriptine treatment was reinstituted after 4–12 weeks(2) Hyperprolactinaemla was associated with tumour re‐expansion In one case and Increased density of the tumour in two cases(3) In one patient plasma prolactin remained undetectable during a follow‐up period of 1 year and no tumour re‐expansion was foundIt Is concluded that tumour regrowth is uncommon and of small extent after cessation of long‐term bromocriptine treatment for macroprolactinomas
Role of peripherally infused angiotensin II on the human hypothalamic–pituitary–adrenal axis
Authors: Calogero Aldo E. , Fornito Marla C. , Aiiffl Antonia , Vicarl Enzo , Moncada Marla L. , Mantero Franco , Polosa Pietro , D'Agata Rosario 
Published: March 2008

SummaryAlthough angiotensin II (All), a potent vasoconstrictor agent, has been reported to stimulate the hypothalamicpituitary‐adrenal (HPA) axis of laboratory animals, Its role In the regulation of this axis In humans appears to be controversial. To examine this question, All (Val5‐All amide) was Infused Intravenously Into 19 male normal volunteers at the doses of 0, 1, 3·3 and 10 ng/kg/mln for 30 min. All had no effect on plasma ACTH, cortical, corticotrophin‐releasing hormone, arginine vasopressin, and atrial natriuretic factor concentrations, nor did it increase systolic or diastolic arterial blood pressure. On the other hand, All caused a dose‐dependent Increase of plasma aldosterone concentrations, suggesting that the doses and the mode of All Infusion were effective. Thus, our data show that peripherally Infused All has no detectable effect on the HPA axis function in humans, at doses capable of stimulating plasma aldosterone secretion, Its specific target hormone.
Induction of c‐fos and c‐myc mRNA expression by immunoglobulin G from patients with Graves’ disease in thyrotrophin‐dependent rat thyroid cell line (FRTL5)
Authors: Hatabu H. , Kasagl K. , Lida Y. , Nosaka T. , Misaki T. , Hidaka A. , Tokuda Y. , Endo K. , Mori T. , Lee K. , Tsubol K. , Hatanaka M. , Konishl J. 
Published: March 2008

Summary The present study was conducted to evaluate effects of autoantlbodles In patients with Graves’ disease on Induction of c‐fos and c‐myc mRNA expression In rat thyroid cell line (FRTL5). IgG fractions were Isolated from 11 patients with Graves’ disease, and six healthy subjects, with protein A‐Sepharose. FRTL5 cells which had been grown to subconfluency and deprived of TSH for a week were exposed to the IgG for an hour. Expression of c‐fos and c‐myc mRNAs was examined by the Northern blot method using nick‐translated v‐fos and c‐myc probes. C‐fos and c‐myc transcripts were Induced by IgGs from two patients with Graves’ disease, which displayed much higher activities In assays for TSH binding Inhibitor Immuno‐globullns, thyroid stimulating antibodies and thyroid growth‐stimulating Immunoglobullns, assessed by measuring Inhibition of 125I‐TSH binding to the TSH‐receptor, cAMP production and 3H‐thymldine Incorporation In FRTL5 cells, respectively, compared with those In the remaining patients. The Induction of c‐fos and c‐myc mRNAs by IgG from a patient with Graves’ disease was suppressed by prelncubatlon with IgGs from two patients with primary myxoedema who were known to have a blocking type TSH‐receptor antibody. These data suggest that the binding of the antibodies to the TSH–receptor followed by cAMP production Is related to the induction of c‐fos and c‐myc mRNAs and, thus, to the growth of FRTL5 cells. To our knowledge, this Is the first report demonstrating that autoantibodies Induce proto‐oncogene mRNA expression.
The effect of lithium therapy on parameters thought to be involved in the development of autoimmune thyroid disease
Authors: Wilson R. , McKlllop J. H. , Crocket G. T. , Pearson C. , Jenkins C. , Burns F. , Burnett A. K. , Thomson J. A. 
Published: March 2008

Summary This study has considered the effects of primary affective disorders and lithium therapy on a number of factors thought to be Important In the development of autoimmune thyroid disease. These factors were examined In (a) controls with no history of any such disorders; (b) patients with primary affective disorders treated with drugs other than lithium and (c) patients with primary affective disorders treated with lithium alone. Eight of 40 patients who were receiving lithium therapy were found to be positive for thyroid microsomal and/or thyroglobulin antibodies, compared to only 3/40 patients who were receiving some other form of treatment for their depression. Peripheral blood mononuclear ceils from patients receiving lithium were found to have significantly reduced numbers of suppressor/cytotoxlc T cells (p>0.05). In addition, suppressor T cells from these patients showed a significantly reduced response to stimulation with concanavalin A (p>0.01). These effects were greatest In patients found to be antibody positive. Increased B cell activity, as measured by Increased IgG and IgM release following mltogen stimulation, was seen in patients receiving lithium and in those patients receiving other forms of treatment for their depression. This would suggest that the Increase Is a feature of primary affective disorders and is not due specifically to lithium treatment. It would appear from this study that lithium therapy induces antibody formation In susceptible Individuals and this may ultimately lead to the development of thyroid disease.
Histological and biochemical distinctiveness of atypical aldosterone‐producing adenomas responsive to upright posture and angiotensin
Authors: Tunny Terry J. , Gordon Richard D. , Klemm Shelley A. , Cohn David 
Published: March 2008

Summary Fifteen patients with primary aldosteronism were classified as anglotensin II‐unresponsive aldosterone‐producing adenoma (All‐U APA, n = 9), or anglotensin II‐responsive aldosterone‐producing adenoma (All‐R APA, n= 6), based on the responsiveness of aldosterone to upright posture and to anglotensin II infusion. Lack of aldosterone response to anglotensin II Infusion immediately post‐operatively In the All‐R APA subtype was consistent with previous responsiveness residing solely within the adenoma. Cortisol levels In five of the six patients with All‐R APA failed to suppress normally with dexamethasone consistent with some autonomous production of cortisol by the adenoma. In contrast, cortisol levels suppressed normally during dexamethasone administration In all patients with All‐U APA. This biochemical distinction can be added to the previously described overproduction of 18‐oxo cortisol in All‐U APA but not in All‐R APA. Histological examination of adenoma sections revealed predominantly (±‐50%) zone fascicuiata type cells in All‐U APA. In contrast, All‐R APA contained less than 20% zona fasciculata type. Thus, biochemical differences between All‐U APA and All‐R APA subtypes of primary aldosteronism may be due to underlying differences In cellular composition of the aldosterone‐producing adenomas.
Physiological growth hormone secretion in adult growth hormone deficiency: comparison with normal controls
Authors: Whitehead Helen M. , Aikent Brenda , Lewis Stuart , Sheridan Brian , Haddon David R. 
Published: March 2008

Summary A comparison was made between the pulsatile pattern of growth hormone secretion In 14 growth hormone deficient adults (serum growth hormone less than 7 mU/l following insulin‐stimulated hypoglycaemia) and 14 age and sex matched controls. The 24‐h secretory profile was generated by 2‐hourly sampling from 0800 to 2200 h, and 30‐min sampling from 2200 to 0600 h. Plasma GH in each sample was measured using a double antibody radloimmunoassay. The profiles were analysed using a computer program (Pulsar). Sleep‐electroencephalography was recorded In all subjects. The total amount of GH secreted In a 24‐h period (area under the curve over baseline) was significantly less In the growth hormone deficient group (P > 0·002). The pulse frequency, amplitude, height and percentage GH secreted in peaks were also significantly less in the growth hormone deficient group (P > 0± 002 respectively). We conclude that adults deficient In GH, as defined by conventional pharmacological stimuli, are in addition physiologically deficient of pulsatile GH secretion.
HLA Associations with Hashimoto's thyroiditis
Authors: Tendon N. , Zhang L. , Weetman A. P. 
Published: March 2008

Summary There Is disagreement over the HLA‐DR associations of Hashimoto's (goitrous) thyroiditis. We have studied 86 English Caucasian patients with this condition whose DR types were determined by restriction fragment polymorphism analysis. HLA‐DR3 was significantly more frequent In these patients than in 100 controls (χ2= 7·09; P > 0·01). The relative risk was 2·23 and aetiological fraction 0·29. HLA‐DPB and DOB alleles were analysed in a proportion of these subjects by enzymatic DNA amplification and oligonucleotide probing. The only significant finding was an excess of HLA‐DQw2 (In linkage disequllibrium with DR3) In the Hashimoto group (χ2=7·43, P > 0·007). These results do not support a difference between goitrous and atrophic thyroiditis based on respective associations with HLA‐DR5 and DR3, but confirm a recent study in which HLA‐DR3 was associated with Hashimoto's thyroiditis. However, It Is possible that genes telomeric to DR3 may be Involved in determining which type of thyroiditis a patient with autoimmune hypothyroidism develops.
Production of calcitonin gene related peptide, calcitonin and PTH‐related protein by a prostatic adenocarcinoma
Authors: Shulkes A. , Fletcher D. R. , Rubinstein C. , Ebelingt P. R. , Martint T. J. 
Published: March 2008

Summary PTH and calcitonln are the two major hormones controlling calcium metabolism. Recently two new substances related to these hormones have been Isolated: calcitonln gene related peptide (CGRP) and PTH‐related protein (PTHrP). CGRP Is a potent vasodilator and stimulant of intestinal secretion while PTHrP Is probably the agent responsible for humoral hypercalcaemla of malignancy. We report here a patient with a prostatlc tumour presenting with vasodilatlon, diarrhoea and hypercalcaemia. Our investigations revealed that the primary prostatic and liver secondary tumour contained CGRP, calcitonln and PTHrP. Most of the immunoreactive CGRP in the tumour and plasma co‐eluted with the biologically active form of CGRP. The circulating levels of CGRP correlated with the presence of the diarrhoea. PTHrP concentration In the tumours was one of the highest reported for any tumour although previous studies may have utilized less than optimal extraction procedures. The somatostatin analogue, octreotide (SMS 201–995), did not reduce the plasma CGRP or the diarrhoea, a finding similar to that seen in patients with medullary thyroid carcinoma and high plasma CGRP. The hypercalcaemla was also unaffected by octreotide administration. This is the first report of a prostatic tumour associated with over‐production of calcltonin, PTHrP and CGRP. The major life‐threatening effects of this unusual case of prostatic carcinoma were diarrhoea and hypercalcaemia. Both these effects could be tentatively ascribed to newly discovered substances, CGRP and PTHrP. With the greater availability of assays to measure CGRP and PTHrP in plasma, a detailed examination of the incidence of over‐production of these substances In various cancers will be possible.
Megavoltage pituitary irradiation in the management of prolactinomas: long‐term follow‐up
Authors: Tsagarakis S. , Grossman A. , Plowman P. N. , Jones A. E. , Touzel R. , Rees L. H. , Wass J. A. H. , Besser G. M. 
Published: March 2008

Summary
objective To determine the long‐term effects of external beam megavoltage radiotherapy (RT: 4500 cGy via three portals at 180 cGy or less total daily dose) on endocrine function in prolactinomas.
design Longitudinal study following radiotherapy with periodic re‐assessment at regular Intervals, at least 2 months off dopamine agonist therapy.
patients Thirty‐six female patients, age range 19–50 years, with either macroprolactlnomas (12 patients) or macroprolactinomas (24 patients), but without significant suprasellar extensions.
measurements Clinical appraisal, and anterior and posterior pituitary assessment: basal levels at yearly intervals or less, with dynamic screening with TRH, LHRH and hypoglycaemic stimulation every 2–3 years.
results Before RT, serum prolactin (PRL) levels ranged from 1150 to 34 000 mU/l; after RT (mean 8·5 years, range 3–14), serum PRL fell to normal (l.e. >360 mU/l) in 18 of the 36 patients (50%), and to just above the normal range (378–780 mU/l) in a further 10 (28%). Two patients had PRL levels at their last follow‐up higher than those at presentation, with one patient showing evidence of tumour recurrence on CT scan. A total of eight of the 36 patients (23%) developed post‐RT gonadal deficiency by the end of follow‐up at 8 ± 3·1 years (± SD, range 3–11), but six were aged over 40 years at that time. GH deficiency was frequent, occurring in 94% of patients, usually from 2 to 3 years post‐RT, while TSH deficiency and reduced ACTH reserve was uncommon (each 14%), and occurred later. In the subgroup of 12 patients with macroprolactinomas, results were broadly comparable.
conclusions Megavoltage RT produces a progres‐sive fail in serum prolactin in the great majority of patients with prolactinomas, with a relatively low incidence of TSH or ACTH deficiency. As it Is now clear that dopamine agonist therapy alone provides suff iclent management for microprolactinomas, RT may be used for the long‐term control of macroprolactlnomas, together with interim dopamine agonist therapy. It allows pregnancy to be safely undertaken but, in view of the delayed onset of gonadal deficiency, Its administration should be tlmed with respect to the desired onset of conception In women.
Primary localized cutaneous amyloidosis and familial medullary thyroid carcinoma
Authors: Ferrer Jorge P. , Halperin Irene , Conget J. Ignacio , Alsina Mercé , Martinez‐Osaba Maria J. , Palou Josep , Bombs Josep A. , Vilardell Enric 
Published: March 2008

SUMMARYWe have studied a family with an autosomai dominant Inheritance of primary localized cutaneous amyloidosis (PLCA) and familial medullary thyroid carcinoma (MTC). Ten family members were screened for multiple endocrine neoplasia (MEN) 2; five were found to have MTC and two had C‐cell hyperplasia. None had evidence of phaeochromocytoma or parathyroid abnormalities. Five of these seven patients presented characteristic inter‐scapular hyperpigmented lesions, showing dermal amylold deposits In two of the four patients In which a biopsy was performed. The data are analysed In the light of two recent reports of MEN 2A associated with Identical lesions. We conclude that PLCA should be sought in MTC patients, even If no other endocrinopathies are present. This may be Informative of the familial character of MTC in Index cases and also of the tumour gene status in family members who are being screened
Plasma growth hormone (GH)‐releasing hormone levels in patients with lung carcinoma
Authors: Schopohl Jochen , Lose Marco , Frey Chris , Wolfram Gernot , Huber Rudolf , Permanetter Willibald , von Pawel Joachim , Müller O. Albrecht , von Werder Klaus 
Published: March 2008

SUMMARY objective The aim was to investigate the serum levels of growth hormone releasing hormone and GH in patients with lung carcinoma design After an overnight fast a plasma sample was collected for determination of growth hormone releasing hormone and GH patients The investigation was performed in 28 patients with non small cell lung carcinoma, in 44 patients with small cell lung carcinoma, and 10 patients with non malignant lung disease. A group of 37 normal subjects served as control measurements Growth hormone releasing hormone and GH were determined by radloimmunoassay
results Patients with small cell lung carcinoma showed higher plasma growth hormone releasing hormone levels (49·9±4 ng/l) than control subjects (16·3±2·1 ng/l; p>0·05), patients with non small cell lung carcinoma (23·9± 8·8 ng/l; p>0·05), and patients with non malignant lung disease (12·7±5·5; P > 0·05). Basal GH level was lower than 5 μ g/l In all patients except five patients with small cell lung carcinoma and one patient with non small cell lung carcinoma. conclusions The higher plasma growth hormone releasing hormone levels in patients with small cell lung carcinoma compared to normal controls and patients with non small cell lung carcinoma and patients with non malignant lung disease, confirm the frequent neuroendocrine activity of this particular tumour
Changes in skeletal muscle and body composition after discontinuation of growth hormone treatment in growth hormone deficient young adults*
Authors: Rutherford O. M. , Jones D. A. , Round J. M. , Buchanan C. R. , Preece M. A. 
Published: March 2008

SUMMARY objectives The aim of this study was to determine whether there are any changes in skeletal muscle strength and size and body composition following growth hormone (GH) withdrawal in GH deficient young adults design A longitudinal, 1‐year, open, uncontrolled study of the changes in skeletal muscle and body composition following GH withdrawal was performed. Endocrine status was reassessed at the end of the study period during an insulin tolerance test. Some measurements were repeated after 2 years off treatment patients Twelve (11 male, one female; age range 14–21) patients who had been diagnosed during childhood as growth hormone deficient took part in the study. Four of the 12 patients were found to have a normal GH response on retesting at the end of the study and their results were analysed as a separate group measurements Quadriceps and forearm flexor maximum voluntary isometric strength, body fat content and serum IGF‐1 were measured at 3‐monthly intervals over 1 year. Every 6 months muscle size was measured from computerized tomography scans and fibre area from quadriceps needle biopsy samples results For the growth hormone deficient group the 12 month quadriceps strength, size and fibre areas were 94·0%±8·5 (mean±SD), 94·5%±6·3 and 85·6%±17·7 respectively of control (baseline) values. Forearm flexor strength and size were 101·4%±7·9 and 92·0%±9·2 of control. Body fat percentage had Increased from 19·5%±8·6 to 24·1%±9·5. No change was seen In the non‐growth hormone deficient group conclusions Although the changes measured were relatively small they suggest a role for GH In the maintenance of muscle integrity and body composition in the young adult with growth hormone deficiency