bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ACUTE CHANGES IN THYROID STIMULATING IMMUNOGLOBULINS, THYROGLOBULIN AND THYROGLOBULIN ANTIBODIES FOLLOWING SUBTOTAL THYROIDECTOMY*
Authors: BECH KARINE , FELDT‐RASMUSSEN ULLA , BLIDDAL H. , DATE J. , BLICHERT‐TOFT M. 
Published: March 2008

SUMMARYThe acute changes in thyroid adenylate cyclase stimulating immunoglobulins (TACSI), TSH binding inhibiting immunoglobulins (TBII), thyroglobulin (Tg) and thyroglobulin antibodies (TgAb) in serum after subtotal thyroidectomy were studied in thirteen patients with Graves' disease (GD) and thirteen patients with non‐toxic goitre (NG).Prior to operation eight patients with GD were TACSI positive (mean ± SEM: 135·18%) and within 8 h following surgery TACSI increased and became positive in all thirteen patients (mean 172 ± 20%). There was a parallel increase in Tg and a decline in TgAb. A secondary rise in TACSI was observed 3–4 days after operation followed by a gradual fall which was associated with an increase in TgAb reaching a maximum 10 days after surgery. TACSI were still detectable 1 month postoperatively, but had disappeared by 3 months.In four of nine patients with GD TBII were present prior to operation. Immediately after surgery TBII decreased significantly (P < 0·05) and two of the four patients who were TBII positive became permanently negative, while the other two patients remained positive. A transient increase of the mean TBII levels was observed 5 days after surgery.Two of thirteen patients with NG were TACSI positive before operation and no significant changes were observed after surgery. The mean levels were significantly lower than in GD. Tg was measurable in eleven patients and showed a lower increase than in GD following surgery. TgAb were present in two patients prior to operation but disappeared in one and in the other one the changes following surgery were similar to the changes in GD.
SIZE HETEROGENEITY OF IMMUNOREACTIVE PROLACTIN IN HYPERPROLACTINAEMIC SERUM
Authors: SOONG Y. K. , FERGUSON K. M. , McGARRICK G. , JEFFCOATE S. L. 
Published: March 2008

SUMMARYThirty‐five samples of serum with levels of immunoreactive prolactin greater than 500 mu/l have been fractionated by gel filtration. In samples from seven normal subjects with elevated prolactin levels following TRH or insulin stimulation and samples from twelve patients with prolactin levels greater than 1500 mu/l, over 80% of the immunoreactive material eluted in the position of native or ‘little’ prolactin. In eleven out of sixteen samples containing 500 to 1500 mu/l the proportion of ‘little’ prolactin was less than 80% and more than 20% eluted as ‘big‐big’ prolactin. It appears therefore that patients with moderately elevated levels of immunoreactive prolactin may not have genuine hyperprolactinaemia.
SERUM THYROGLOBULIN IN NORMAL AND HYPOTHYROID NEONATES
Authors: BLACK E. G. , BODDEN S. J. , HULSE J. A. , HOFFENBERG R. 
Published: March 2008

SUMMARYThyroglobulin (Tg) is secreted only by the thyroid gland and its presence in serum should therefore indicate the presence of functioning thyroid tissue. We have measured Tg in cord and heelprick serum samples from 230 newborn infants with no thyroid disease and in forty‐seven infants with suspected neonatal hypothyroidism. In the euthyroid group, well full‐term infants showed an increase in Tg post‐natally which was not seen in ill full‐term or pre‐term neonates. Thyroid hormones were lower and TSH higher in the ill and pre‐term groups, which, in conjunction with the lack of increase in Tg, suggests impaired thyroid secretion in these groups.Of the forty‐seven hypothyroid infants (low T4 with raised TSH) thirty‐five had measurable Tg; twenty‐eight of these had thyroid scans, and twenty‐seven showed the presence of thyroid tissue. Of twelve infants without measurable Tg seven were scanned; four showed no thyroid uptake, in the other three thyroid tissue was demonstrable; two of these had a positive family history of goitrous hypothyroidism.It appears that many infants with biochemical hypothyroidism (low T4 and high TSH) have functioning thyroid tissue (measurable Tg and positive scan). Adequate thyroid hormone replacement therapy should be instituted in all cases, but assessment of therapy at a later stage of childhood may establish whether the prognosis for the group with functioning thyroid tissue, especially for mental impairment, is different from those without demonstrable thyroid function.
CUSHING'S SYNDROME IN PREGNANCY—TREATMENT WITH METYRAPONE
Authors: GORMLEY M. J. J. , HADDEN D. R. , KENNEDY T. L. , MONTGOMERY D.A.D. , MURNAGHAN G. A. , SHERIDAN B. 
Published: March 2008

SUMMARYA 23‐year‐old female presented with severe Cushing's syndrome in the 23rd week of pregnancy. Investigations showed plasma cortisol 770 nmol/l (08.00 h) and 850 nmol/l (23.00 h); plasma ACTH was 10 ng/l (08.00 h) and 27 ng/l (23.00 h); urinary free cortisol excretion was 2460 nmol/24 h. Dexamethasone 2 mg 6‐hourly for 48 h suppressed the 08.00 h plasma cortisol only to 680 nmol/l. Abdominal C.T. scan showed a right adrenal adenoma. The patient was treated with metyrapone and a good clinical improvement ensued. Plasma cortisol was reduced to 300–500 nmol/l. Despite ultrasonographic evidence of normal fetal growth, urinary oestriol excretion was markedly deficient. Prior to the spontaneous onset of labour, there was a marked rise in plasma cortisol despite continuous metyrapone treatment. A normal female infant was born at 37 weeks' gestation. The maternal adrenal adenoma was subsequently removed. The deficiency of oestriol synthesis during the pregnancy may be explained by metyrapone‐induced inhibition of C19‐hydroxylation.
A COMPARATIVE STUDY OF THE EFFECT OF OESTROGEN SUBSTITUTION THERAPY ON BREAST DEVELOPMENT IN GIRLS WITH HYPO—AND HYPERGONADOTROPHIC HYPOGONADISM
Authors: PERTZELAN A. , YALON L. , KAULI R. , LARON Z. 
Published: March 2008

SUMMARYDuring treatment of girls with oestrogen deficiency we observed different patterns of breast development in response to therapy.The forty‐five girls studied fell into four groups: Group A, gonadal dysgenesis; Group B, isolated gonadotrophin deficiency; Group C, multiple pituitary hormone deficiencies; Group D, congenital adrenal hyperplasia (17‐alpha‐hydroxylase deficiency).Treatment with oestrogen was given in an identical manner to all. In the patients with gonadal dysgenesis, in whom the hypothalamic‐pituitary function was normal, treatment led to full breast development. In isolated gonadotrophin deficiency and multiple pituitary hormone deficiency breast development was incomplete even after 3 years or more of oestrogen treatment. The conspicuous difference in the hormonal status is that the latter two groups lack gonadotrophins, while in gonadal dysgenesis these hormones are grossly elevated. Our conclusion is that gonadotrophins play an important role in mammary gland development, a finding not previously described.In the girl with 17‐alpha‐hydroxylase deficiency we observed that cortisol was necessary, in addition to sex hormones, for normal breast development.
THE EFFECT OF PUBERTY AND SHORT‐TERM ORAL ADMINISTRATION OF TESTOSTERONE UNDECANOATE ON GH TESTS AND SEX‐STEROID RELATED PLASMA COMPOUNDS IN GH DEFICIENT PATIENTS
Authors: DROP S. L. S. , SABBE‐CLAUS L. , VISSER H. K. A. 
Published: March 2008

SUMMARYIn twelve boys and two girls, with idiopathic (partial) growth hormone deficiency diagnosed at prepubertal age, we studied the effect of spontaneous puberty (six patients) as well as the effect of sex‐steroid priming (eight patients). Six boys received testosterone undecanoate and two girls ethinyloestradiol for 5 days.Two pubertal patients showed a normal GH response, the patients primed with testosterone or oestrogen did not, despite a distinct effect on sex‐steroid related plasma compounds.Reevaluation of GH status appears to be worthwhile in GH deficient patients presenting with short stature, growth deceleration at an early pubertal age and delayed sexual maturation. Sex‐steroid priming is unlikely to alter the outcome of GH testing, whenever marked growth deceleration is evident at prepubertal age.
STEROIDOGENESIS IN VITRO BY HUMAN OVARIAN FOLLICLES DURING THE PROCESS OF ATRESIA
Authors: MORI TAKAHIDE , FUJITA YASUHIKO , NIHNOBU KENJI , EZAKI YOJIRO , KUBO KIYOSHI , NISHIMURA TOSHIO 
Published: March 2008

SUMMARYSlices of each of the six antral follicles at different stages of atresia isolated from ovaries of six patients with or without pretreatment with HCG before laparotomy, were incubated with [1–14C] acetate. Incorporation into progestins, androgens and oestrogens was assessed by the reverse dilution technique with recrystallization to constant specific activity.The greatest incorporation into androstenedione without any incorporation into progesterone was commonly observed throughout the morphologically denned three stages of atresia. In the first stage atretic follicles, characterized by coexistence of normally developed thecal cells with degenerating granulosa cells, a minute incorporation into oestradiol was identified. In the second stage atretic follicles, showing hyperplasia and hypertrophy of thecal cells without granulosa cells, an increased incorporation into androgens was shown. Treatment with HCG induced similar but much pronounced changes in function and morphology. In the third stage atretic follicles, with subsiding thecal cells, a diminished incorporation into androstenedione was observed with 17‐hydroxyprogesterone being the only other steroid formed in this stage. The observed qualitative and quantitative changes of steroidogenesis in vitro may be functional reflections of structural changes during the atretic process.
HYPERPARATHYROIDISM DUE TO A CYSTIC PARATHYROID ADENOMA AFTER IRRADIATION OF THE NECK
Authors: VALENTA LUBOMIR J. , EISENBERG HARVEY , FISHMAN ARNOLD , ELIAS ALAN N. , PEZZLO FRANK , GORDON MARVIN 
Published: March 2008

SUMMARYA 48‐year‐old female with hypercalcaemia diagnosed 3 years prior to admission is described. The patient underwent x‐ray therapy of the neck for keloid scars 35 years prior to the diagnosis of hypercalcaemia. The hypercalcaemia was found to be the result of primary hyperparathyroidism. A cystic parathyroid adenoma was identified during surgery and was, on microscopic examination, composed of oxyphil cells rich in mitochondria. The cystic fluid contained 360 times higher C‐terminal PTH than peripheral serum and almost 4000 times higher PTH as intact 1–84 amino acid residue species. We concluded that previous X‐ray irradiation was related to the pathogenesis of the patient's parathyroid adenoma. The mild nature of the patient's hyperparathyroidism was possibly related to the composition of the tumour of oxyphil cells, known to be a poorly functioning variant of the parathyroid cell. Since parathyroid‘cysts’are obviously necrotic parathyroid adenomas, aspiration of the cysts alone cannot be expected to be curative and, therefore, it is recommended to treat cystic parathyroid adenomas by surgical extirpation.
PLASMA STEROID CONCENTRATIONS IN PATIENTS WITH HYPOPITUITARISM AND KALLMAN'S SYNDROME: EFFECTS OF TESTOSTERONE REPLACEMENT THERAPY
Authors: SAGEL J. , LEVINE J. H. , MATHUR R. S. , ROSEBROCK G. , GONZALEZ J. , VILLIER C. DE , NAIR R. M. G. 
Published: March 2008

SUMMARYTo determine the adrenal contribution to plasma concentrations of steroids potentially derived from both the adrenal and the testes, plasma levels of pregnenolone (Δ5P), progesterone (P), dehydroepiandrosterone and its sulphate (DHA and DHAS) and androstenedione (Δ4A) were measured in four men with isolated gonadotrophin deficiency and anosmia (Kallman's syndrome). A comparison of these levels with those seen in ten patients with both adrenal and testicular failure (hypopituitarism) and in sixteen normal age‐matched men was made.As expected, the basal plasma levels of most steroids were low in patients with hypopituitarism. An exception was the normal Δ5P levels in most patients. In the patients with Kallman's syndrome both DHA and Δ5P were elevated whereas Δ4A and P were low.When expressed as ratios, Δ5P/P was increased in both groups. DHA/Δ4A was increased in Kallman's syndrome but not in hypopituitarism. Following ACTH infusion, no significant changes in these ratios were observed.To determine whether testosterone deficiency was in part responsible for the abnormal Δ5/Δ4 ratios, three patients with hypopituitarism and two with Kallman's syndrome were treated for 3 months with intramuscular testosterone. A decrease in the DHA/Δ4A ratio was seen in all patients and a decrease in Δ5P/P in all but one patient. In most cases these changes were produced by a fall in the Δ5 steroids as well as an increase in Δ4 steroids.These findings suggest that a defect in the metabolism of Δ5 steroids exists in patients with hypopituitarism and Kallman's syndrome. In hypopituitarism the defect involves the metabolism of Δ5P to both DHA and P. In Kallman's syndrome only the metabolism of Δ5P to P is defective. Testosterone therapy alone or in combination with other appropriate hormonal replacement increases the metabolism of Δ5 to Δ4 steroids.
EFFECT OF METOCLOPRAMIDE AND LISURIDE ON HYPOPHYSEAL AND GONADAL FUNCTION IN MEN
Authors: GRÄF K.‐J. , SCHMIDT‐GOLLWITZER M. , HOROWSKI R. , DOROW R. 
Published: March 2008

SUMMARYThe effects of chronic treatment over 7 weeks with metoclopramide and lisuride alone as well as the combination of both drugs were studied on basal and TRH/LHRH stimulated serum PRL, testosterone, LH, FSH, GH, and TSH concentrations. The study was conducted under double‐blind placebo‐controlled conditions and included twenty‐four healthy male volunteers. In addition, repeated seminal fluid analyses were performed before, during and after treatment. While the known PRL‐stimulatory effect of metoclopramide and the PRL‐lowering effect of lisuride could be confirmed, we were unable to demonstrate any substance‐related effects on the other hypophyseal or gonadal hormones. In contrast to previously published data no adverse effects of metoclopramide on sperm analysis could be demonstrated.
THE EFFECT OF IODIZED OIL ON GOITRE SIZE, THYROID FUNCTION AND THE DEVELOPMENT OF THE JOD BASEDOW PHENOMENON*
Authors: MABERLY G. F. , CORCORAN J. M. , EASTMAN C. J. 
Published: March 2008

SUMMARYIn the Lubok Antu district of Sarawak, Malaysia, 240 subjects with 75% prevalence of goitre were studied before and at intervals of 1 and 2 years following iodized oil injection. After 1 year the prevalence of goitre was reduced to 33%, but 2 years after injection, goitres had regrown in fourteen subjects (6%). The mean urinary iodine concentration was low initially at 0±17±0±08 (SD) μmol/l, consistent with iodine deficiency, and rose to a level of 2±6 ± 2±5 μmol/l at 1 year, before falling to 0±46 ± 0±38 μmol/l, again consistent with deficiency. Such a rapid depletion of iodine may be related to the high consumption of cassava. Before injection serum TSH concentrations showed a wide scatter from normal up to 62 mU/l and at 1 year, serum TSH concentrations were undetectable. At 2 years serum TSH was again detectable in 50% of subjects with levels up to 8±6 mu/l. During the 2 years, there was a progressive rise in the mean serum T4 concentration from 92 ± 22 (SD) nmol/l to 110 ± 22 nmol/l (P < 0±05). Serum T3 concentrations rose serially in all subjects from a pre‐injection mean of 1±9 ± 0±3 nmol/l to 2±5 ± 0±9 nmol/l (P < 0±001) and then fell significantly below the baseline level to a mean of 1±7 ± 0±6 nmol/l 2 years after injection (P < 0±01). The mean serum rT3 levels followed the same trend. At 1 or 2 years following injection, eight subjects were clinically hyperthyroid. Four of these consented to venesection and hyperthyroidism was confirmed biochemically. These data reveal that:

goitres decreased rapidly in size in response to iodized oil injection;
2 significant though incomplete depletion of the iodine stores occurred within 2 years of injection;
the consistent increase in serum T3 was associated with a fall in serum TSH to undetectable levels;
the prevalence of the Jod Basedow phenomenon was l±7%.

These data suggest the need for closer biochemical monitoring of subjects receiving massive doses of iodine and a reappraisal of the use of iodized oil in the treatment of endemic goitre.
OPIATE MODULATION OF THE PITUITARY‐ADRENAL AXIS: EFFECTS OF STRESS AND CIRCADIAN RHYTHM
Authors: GROSSMAN A. , GAILLARD R. C. , McCARTNEY P. , REES LESLEY H. , BESSER G. M. 
Published: March 2008

SUMMARYThe opiate control of the pituitary‐adrenal axis has been investigated in normal subjects. The infusion of 1 mg of the met‐enkephalin analogue, DAMME, led to a fall in circulating cortisol in spite of a fall in blood pressure. Conversely, 16 mg of the opiate antagonist, naloxone led to brisk and pronounced elevations in plasma ACTH, lipotrophin (LPH) and cortisol. The rise above basal levels was consistent, irrespective of whether the infusion was given at 09.00, 18.00, or 23.00 h; the peak response obtained was significantly less at 23.00 h than at either 09.00 or 18.00 h. Finally, insulin‐induced hypoglycaemia (0.15 u/kg) or naloxone (25 mg) produced a similar rise in plasma cortisol which was no different when the two stimuli were combined.It is suggested that there is a constant tonic inhibition of the pituitary‐adrenal axis by endogenous opiates throughout 24 h, and that the circadian rhythm of ACTH/LPH secretion is not due to changes in opiate tone. However, disinhibition of this tone is likely to be responsible, at least in part, for the rise in cortisol in response to hypoglycaemic stress.
HYPERMINERALOCORTICISM WITHOUT EXCESSIVE ALDOSTERONE SECRETION: AN ADRENAL CARCINOMA PRODUCING DEOXYCORTICOSTERONE
Authors: KELLY WILLIAM F. , O'HARE MICHAEL J. , LOIZOU SOZOS , DAVIES DEREK , LAING IAN 
Published: March 2008

SUMMARYA 51‐year‐old female was thought to have Conn's syndrome because she had hypertension, hypokalaemia and low plasma renin activity. The cause was not aldosterone excess, but there was an adrenal cortical carcinoma producing 11‐deoxycorticosterone (DOC) in extremely large quantities, with ineffective 1 l/?‐steroid hydroxylation. Plasma and urinary aldosterone levels were within the normal range. Blood levels of other steroids including those on the pathways of formation of glucocorticoids and sex steroids were unaffected. The tumour was cultured in vitro and shown by high performance liquid chromatography (HPLC) to produce predominantly DOC from tritiated pregnenolone, with no detectable aldosterone, in agreement with the in vivo results.
CHANGES IN CIRCULATING SOMATOMEDIN‐C LEVELS IN BROMOCRIPTINE‐TREATED ACROMEGALY
Authors: WASS J. A. H. , CLEMMONS D. R. , UNDERWOOD L. E. , BARROW I. , BESSER G. M. , WYK J. J. VAN 
Published: March 2008

SUMMARYTo determine whether the improvement in clinical status of patients with active acromegaly correlates with a reduction of circulating somatomedin‐C, serum immunoreactive somatomedin‐C was measured in twenty‐seven patients before and during bromocriptine therapy. The patients were assessed using a clinical and metabolic score which included both subjective criteria of improved sweating and facial features, and objective criteria of a reduction in ring circumference and the area under the glucose tolerance curve. Using this, together with the change in GH levels before and during bromocriptine therapy, the patients could be divided into three groups. In one group, there was no clinical improvement, a less than 30% decline in somatomedin‐C, and in four of six patients no significant decline in GH. In both the other groups there was clinical improvement and a greater than 30% decrease in somatomedin‐C. In one of these two groups, however GH did not decline, while in the other it was reduced significantly. The results suggest that during bromocriptine treatment of acromegaly, serum somatomedin‐C concentrations correlate better with clinical status than does serum GH. Since some patients have no significant fall in GH but show both clinical improvement and a reduction in somatomedin‐C, it seems likely that in some patients bromocriptine may improve acromegaly by a mechanism other than a simple decrease in total immunoreactive GH secretion.
PRODUCTION OF NON‐STIMULATORY IMMUNOGLOBULINS THAT INHIBIT TSH BINDING IN Graves' DISEASE AFTER RADIOIODINE ADMINISTRATION
Authors: BECH KARINE , BLIDDAL HENNING , SIERSBÆK‐NIELSEN KAJ , FRIIS THORKILD 
Published: March 2008

SUMMARYThe effect of a single dose of 131I upon thyroid stimulating immunoglobulins has been studied in twenty‐two patients with Graves' disease. The thyroid stimulating immunoglobulins were assessed by parallel measurements of thyrotrophin receptor binding inhibitory immunoglobulins (TBII) and of thyroid adenylate cyclase stimulating immunoglobulins (TACSI) in serum by radioreceptor assay and stimulation of adenylate cyclase respectively.Prior to 131I therapy TBII were present in fourteen and TACSI in sixteen patients; seventeen were positive in one of the assays and thirteen in both assays. After radioiodine the level of both TACSI and TBII increased in most patients, but in six patients 131I therapy appeared to lead to a dissociation between the TBII and TACSI. After 12 months, nine patients were still positive in both assays, and twenty‐one in one of the assays.In total, five patients developed hypothyroidism within 1 year after radioiodine. The TBII levels were significantly higher both before and 3 months after therapy in these patients than in those who remained euthyroid. Two of the hypothyroid patients developed non‐stimulatory TSH binding inhibitory antibodies.The present study thus confirms that radioiodine therapy is followed by an increase of TBII and TACSI in most patients with Graves' disease. The level of TBII can probably provide a marker for development of hypothyroidism following 131I therapy and might be involved in its pathogenesis.
AN IMPROVED RADIORECEPTOR ASSAY FOR TSH RECEPTOR ANTIBODIES
Authors: SHEWRING G. , SMITH B. REES 
Published: March 2008

SUMMARYAn improved receptor assay for TSH receptor antibodies is described in which detergent‐solubilized TSH receptors and 125I‐labelled TSH are used. Normal human serum and immunoglobulin concentrates from normal serum showed little effect on the interaction between labelled TSH and detergent‐solubilized receptors whereas immunoglobulin concentrates from some Graves' sera caused marked inhibition of TSH binding. Precipitation with polyethylene glycol was the most convenient way of preparing immunoglobulin concentrates and using this technique the assay could be completed in a few hours. The coefficient of inter assay variation at 51% inhibition of labelled TSH binding was 3.7% and analysis of serum samples from patients with Graves' disease (n= 42), Hashimoto's disease (n= 26), multinodular goitre (n= 9), rheumatoid arthritis (n= 10) and normal donors (n= 35) suggested that the assay could detect TSH receptor antibodies in about 80% of patients (treated and untreated) with Graves' disease.