bluuebunny/crossref_metadata_2025_split huggingface dataset:
USE OF COMBINED ORAL CONTRACEPTIVE PREPARATIONS ALTERS THE INSULIN SENSITIVITY OF FATTY ACID AND KETONE METABOLISM
Authors: SINGH B. M. , NATTRASS M. 
Published: March 2008

SUMMARYEight women taking low‐dose‐oestrogen combined oral contraceptive preparations were compared to eight women in the luteal phase of the menstrual cycle during hourly incremental insulin infusions of 0 (basal), 0.005, 0.01 and 0.05 U/kg/h short‐acting insulin.Dose‐response relationships between insulin and intermediary metabolites were sought by analysis of variance applied to regression. For insulin (log) and glucose the slope of the relationship was significantly shallower in the oral contraceptive group.For insulin (log) and non‐esterified fatty acids the slopes of the regression lines were not different between groups but lines were significantly displaced. For insulin (log) and total ketone bodies (log) slopes of the regression lines were not different but significant displacement was observed. At identical insulin concentrations women taking an oral contraceptive had higher non‐esterified fatty acids (NEFA) (difference between groups +0.15 mmol/l, P > 0.001) and total ketone bodies (log; −0.26 mmol/l, P > 0.001). The potency of insulin action in oral contraceptive users versus the luteal group was 0.47 (P > 0.01) for NEFA and 0.38 (P > 0.001) for total ketone bodies.The results demonstrate, for the first time, in‐vivo insulin resistance of NEFA and ketone bodies’ metabolism induced by oral contraceptive use.
COMPARISON OF THE EFFECTS OF ORAL AND TRANSDERMAL OESTRADIOL ADMINISTRATION ON OESTROGEN METABOLISM, PROTEIN SYNTHESIS, GONADOTROPHIN RELEASE, BONE TURNOVER AND CLIMACTERIC SYMPTOMS IN POSTMENOPAUSAL WOMEN
Authors: SELBY PETER L. , MCGARRIGLE H. H. G. , PEACOCK MUNRO 
Published: March 2008

We compared the effect of administering oestradiol via the transdermal or oral routes in six and eight postmenopausal women respectively. Although both treatments achieved similar plasma levels of oestradiol, oral administration led to much greater increases in plasma levels of oestrone and the sulphates and glucuronides of oestradiol, oestrone and oestriol than transdermal treatment (P < 0.001).Both treatments reduced plasma FSH; from 42 ± 10 (SE) IU/1 to 30 ± 2 IU/1 with oral and from 46 ± 7 IU/1 to 28 ± 6 IU/1 with transdermal treatment. Urine calcium excretion fell from 0.41 ± 0.06 (molar ratio to creatinine) to 0.17 ± 0.02 with oral and from 0.25 ± 0.06 to 0.13 ± 0.02 with transdermal treatment. Patients' symptoms were improved by both treatments. These changes were related to the plasma oestradiol concentration but not to that of oestrone.Oral, but not transdermal, treatment stimulated hepatic protein synthesis as shown by increased plasma levels of both vitamin‐D‐binding globulin and sex‐hormone‐binding globulin.We conclude that although both oral and transdermal oestradiol reduce postmenopausal bone loss, gonadotrophin secretion and symptoms, oral treatment also leads to hepatic stimulation and extensive metabolism of oestradiol, both of which may increase side‐effects without conferring additional benefit.
TSH BINDING‐INHIBITING ANTIBODIES IN HYPERTHYROIDISM: RELATIONSHIP TO CLINICAL SIGNS AND HORMONE LEVELS
Authors: BENKER G. , KOTULLA P. , KENDALL‐TAYLOR P. , EMRICH D. , REINWEIN D. 
Published: March 2008

SUMMARYTSH binding‐inhibiting antibody (TBIAb) activity was measured in 809 European patients with different forms of hyperthyroidism. Distribution of these TBIAb was skewed, with a peak in the range of normal controls, and an ill defined, not clearly separated peak at higher levels of TSH displacement. There was no unequivocal separation of two possible subgroups of hyperthyroidism (immunogenic and non‐immunogenic). TBIAb distributions of patients with and without endocrine ophthalmopathy (EO) overlapped considerably. Although patients with Graves' disease, arbitrarily defined by the presence of endocrine ophthalmopathy or diffuse nuclide uptake by thyroid scanning, had mostly elevated TBIAb activity, 24.3% had values within the range of normal controls (mean + 2SD). Patients with diffuse thyroid uptake had significantly higher TBIAb levels than patients with nodular scan findings. In Graves' disease, TBIAb activity was positively correlated with the severity of endocrine ophthalmopathy, the size of the thyroid, and the serum levels of total and free triiodothyronine. There was no influence of age, sex, pretreatment, or regional iodine supply. These results suggest (1) that the clinical manifestations of Graves' disease are statistically related to TBIAb activity and (2) that separation of immunogenic and non‐immunogenic forms of hyperthyroidism by means of TBIAb determination is unsatisfactory. The almost continuous distribution of TBIAb points to insufficient sensitivity of the present technique and raises doubts as to whether TBIAb values can be reliably classified as ‘positive’ or ‘negative’.
METABOLIC PROFILES IN PATIENTS WITH INSULINOMA
Authors: HALE PETER J. , NATTRASS MALCOLM 
Published: March 2008

SUMMARYTwelve‐hour metabolic profiles have been measured in six patients with insulinoma and results compared with normal subjects of similar age and weight. Fasting blood glucose was lower (mean ± SEM 2.9 ± 0.3 mmol/l vs 50 ± 0.2 mmol/l) and plasma insulin higher (20.0 ± 3.9 mU/l vs 7.2 ± 1.6 mU/l) in insulinoma patients. Over the 12‐h period blood glucose, pyruvate and glycerol were significantly lower, and plasma insulin, blood lactate, alanine and plasma non‐esterified fatty acids (NEFA) significantly higher in insulinoma patients. Overall the concentration of blood total ketone bodies was significantly higher in insulinoma patients. Values were higher in the early part of the day but lower later in the day and did not show the marked pre‐meal rise observed in the normal subjects. The raised NEFA and ketone bodies are of particular interest as they may be a source of fuel supply in the presence of relative glucose deficiency.
RHYTHMS OF SERUM MELATONIN IN PATIENTS WITH SPINAL LESIONS AT THE CERVICAL, THORACIC OR LUMBAR REGION
Authors: LI Y. , JIANG D. H. , WANG M. L. , JIAO D. R. , PANG S. F. 
Published: March 2008

SUMMARYThe neural pathway essential for the diurnal rhythm of serum melatonin was studied in humans. Blood samples from 17 patients with chronic lesions of cervical (n= 8), low thoracic or lumbar (n= 9) spinal cord were collected at 0200, 0400,1000 and 1400 h of their normal light‐dark cycle. Blood samples were also collected from eight control subjects at 0200 and 1400 h. No special treatment of food, drug or photoperiod was implemented. Serum melatonin was extracted by dichloromethane and determined by radioimmunoassay. In patients with cervical spinal lesions (C3‐C7), it was found that serum melatonin levels were low and no diurnal rhythm was observed. Conversely, diurnal rhythm of circulating melatonin with significantly higher levels (P< 0.01) in the dark period were observed in individuals with injuries at the low thoracic or lumbar regions (T9‐L2). In the second experiment, blood samples from two other patients were collected for three consecutive days during acute period of spinal injuries (cervical or upper thoracic region) and serum melatonin concentrations were determined. Again, there were low levels of serum melatonin with no observable diurnal rhythm in the patient with cervical lesion (C4–5). However, diurnal rhythms were maintained with high levels in the dark period in the patient with upper thoracic spinal (T2–3) transection. Our data suggest that the cervical region of the spinal cord is part of the neural pathway essential for the diurnal rhythm of pineal melatonin secretion in human beings.
SIMULTANEOUS ASSAY OF THYROID ADENYLATE CYCLASE‐ AND GROWTH‐STIMULATING ANTIBODIES USING FRTL‐5 CELLS. EVIDENCE SUGGESTING THEIR IDENTITY IN PATIENTS WITH GRAVES' DISEASE
Authors: MARCOCCI C. , VITTI P. , LOPEZ G. , SANTINI F. , MAMMOLI C. , FENZI G. F. , PINCHERA A. 
Published: March 2008

SUMMARYThe relationship between thyroid growth‐stimulating antibodies (TGSAb) and thyroid adenylate cyclase‐stimulating antibodies (TSAb) in patients with Graves' disease is still a matter of controversy. To investigate this problem, we have developed an assay for the simultaneous measurement of TSAb and TGSAb using FRTL‐5 cells. TSAb was detected by its ability to stimulate iodide (I−) uptake and TGSAb by the 3H‐thymidine ([3H]‐Tdr) incorporation assay. Thirty‐four immunoglobulin G (IgG) preparations from patients with active Graves' disease were selected from a previous series in order to include both TSAb‐negative IgGs (n = 9) and TSAb‐positive IgGs (n= 25) by the cAMP stimulation assay, with a wide range of stimulatory activity. With one exception, the TSAb‐positive IgGs produced a significant stimulation of I− uptake; 20 of them were also TGSAb‐positive. The nine IgGs negative in the cAMP assay, were also negative in the I− uptake and the [3H]‐Tdr incorporation assays. The majority of samples had a similar potency in the two assays and a significant positive correlation was found (r=0.76; P < 0.001). Two IgGs previously shown to inhibit TSH‐stimulated adenylate cyclase in FRTL‐5 cells produced an almost complete inhibition (80–90%) of both TSH‐ and Graves' IgG‐stimulated I‐ uptake and [3H]‐Tdr incorporation. In conclusion, using a simultaneous assay for thyroid growth and adenylate cyclase stimulation, TGSAb in Graves' patients were found only in TSAb‐positive IgGs; both Graves' IgG‐stimulated activities were inhibited by antibodies blocking the TSH‐dependent adenylate
BILATERAL TESTICULAR TUMOURS IN CONGENITAL ADRENAL HYPERPLASIA: A CONTINUING DIAGNOSTIC AND THERAPEUTIC DILEMMA
Authors: CUNNAH D. , PERRY L. , DACIE J. A. , GRANT D. B. , LOWE D. G. , SAVAGE M. O. , BESSER G. M. 
Published: March 2008

SUMMARYBilateral testicular tumours are a rare but well described complication of congenital adrenal hyperplasia (CAH). It can be extremely difficult to distinguish histologically between Leydig cell tumours and adrenocortical rest hyperplasia which may lead in some cases to unnecessary orchidectomy in young men. A 26‐year‐old male in whom CAH had been diagnosed neonatally, was referred for further investigation of a craggy mass in the left testis. Six months earlier, right orchidectomy had been performed after presentation with bilateral enlarged, hard testes and azoospermia. The tumour was interpreted to be a malignant interstitial cell tumour of the testis. Our investigations revealed that his CAH was inadequately controlled and that the hormonal secretion from the remaining left testicular mass was ACTH dependent. Percutaneous venous sampling revealed high concentrations of Cortisol and other adrenocortical hormones coming from the gonadal vein. Dexamethasone suppressed these adrenal hormones and reduced the size and softened the consistency of the testicular mass. Total disappearance of the mass was achieved by using dexamethasone, given in a reverse circadian rhythm regimen. Spermatogenesis returned and the patient's wife became pregnant after 6 months; she gave birth to a normal male infant. To our knowledge, this is the first time in this clinical setting that fertility has been achieved. This case highlights the need for both a functional and histological assesement of such ‘tumours’ in CAH prior to orchidectomy.
BILATERAL INFERIOR PETROSAL SINUS SAMPLING AS A ROUTINE PROCEDURE IN ACTH‐DEPENDENT CUSHING'S SYNDROME
Authors: McCANCE DAVID R. , McILRATH EDWARD , McNEILL AVRIL , GORDON DEREK S. , HADDEN DAVID R. , KENNEDY LAURENCE , SHERIDAN BRIAN , ATKINSON A. BREW 
Published: March 2008

SUMMARYBilateral inferior petrosal sinus sampling was successfully performed in 12 of 13 consecutive patients with ACTH‐dependent Cushing's syndrome. Ten of the patients subsequently had transsphenoidal pituitary microsurgery. Eight patients in whom the inferior petrosal sinus to peripheral vein ACTH level ratio was 1.5 or greater were found to have a pituitary adenoma. One of the remaining two patients who had ratios < 1.5 had pituitary hyperplasia while the other had no identified abnormality. In five of the patients with pituitary tumour a ratio above 1.5 was present on only one side. Bilateral petrosal sampling is therefore always necessary. Tumour localization within the pituitary was only poorly predicted by either petrosal sinus sampling (four of eight) or computed tomography scanning (three of eight). If petrosal sinus sampling is used early in the differential diagnosis of ACTH‐dependent hypercortisolism, then the use of other differential diagnostic tests may not always be necessary.
QUANTITATIVE AND QUALITATIVE CHANGES IN LH SECRETION FOLLOWING PULSATILE GnRH THERAPY IN A MAN WITH IDIOPATHIC HYPOGONADOTROPHIC HYPOGONADISM
Authors: TSATSOULIS A. , SHALET S. M. , TALBOT A. , ROBERTSON W. R. 
Published: March 2008

SUMMARYThe pattern of bioactive and immunoreactive LH secretion before and during pulsatile GnRH therapy (18 μg/90 min) in a hypogonadotrophic hypogonadal male has been studied. Before treatment the patient was azoospermic and had low testosterone (1.2 nmol/1) with low and apulsatile immunoreactive LH (1.9 ± 0.2 IU/1) and FSH (1.4±1.9 IU/1) levels. There was no detectable LH bioactivity. During the first 24 h of GnRH therapy there was a small increase in immunoreactive (5.4±0.8 IU/1) and bioactive (6.7±1.3 IU/1) LH, with an irregular pattern and little effect on testosterone production (2.2 nmol/I). Within 1 week of treatment both bioactive (30.5±6.8 IU/1) and immunoreactive (13.6±1.5 IU/1) LH levels were above the normal range and the pattern of secretion was pulsatile. The bioactive to immunoreactive (B:I) LH ratios within the pulses (2.6±0.3) were higher (P < 0.01) than between pulses (1.97 ± 0.1) and the testosterone concentration (17.8 ± 2.1 nmol/1) was now normal. At one month LH secretion was similar and testosterone pulses of high amplitude were evident corresponding to high‐amplitude bioactive LH pulses. By 3 months mature spermatozoa (1.3 × 106/ml) were seen in the patient's semen. The pattern of LH secretion was pulsatile but the levels of bioactive (131 ± 36 IU/1) and immunoreactive (9.5±1.3 IU/1) LH decreased towards the normal range reflecting maturation of the testicular feedback control at the pituitary level. This effect was more pronounced on bioactive rather than immunoreactive LH secretion (57%vs 32% relative decrease). At 6 months LH levels were similar and the sperm count was normal (34 × 106/ml).
OPIOIDERGIC REGULATION OF LH PULSATILITY IN WOMEN WITH POLYCYSTIC OVARY SYNDROME
Authors: BERGA S. L. , YEN AND S. S. C. 
Published: March 2008

SUMMARYWomen with polycystic ovary syndrome (PCO) display disordered patterns of LH pulsatility and may have an impairment of opioidergic regulation of GnRH‐LH. In order to ascertain if these patterns reflect an inherent hypothalamic abnormality or a functional state consequent to the acyclicity of sex steroids, LH pulsatility and gonadotrophin responses to naloxone were examined in six PCO women before and after treatment with incremental daily doses of a progestogen, medroxyprogesterone acetate (MPA), for 10 days to determine (i) if progestogen treatment would alter the LH pulse pattern to resemble that of the luteal phase; and (ii) if the conversion to a luteal phase LH pulse pattern by MPA would involve the induction of opioidergic regulation.LH pulsatility and FSH levels were determined by blood sampling at 10 min intervals for 8 h before and after MPA treatment during a saline infusion on the control day and during a naloxone infusion (1.6 mg/h) on the following day. Basal levels of oestradiol, oestrone. androstenedione, testosterone, and dehyd‐roepiandrosterone‐sulphate were measured before and after MPA. All six PCO women responded to MPA administration with a significant reduction in LH pulse frequency (P<0.005), an increase in LH pulse amplitude (P<0.0025), and an increase in LH pulse duration (P<0.025), without changes in mean LH, mean FSH, androgen, or oestrogen levels. Thus, a luteal phase LH pulse pattern was induced by MPA. Naloxone reversed the MPA‐induced changes in LH pulsatility, indicating that these responses involved the induction of central opioidergic activity. These results suggest that progestogen modulation of LH pulsatility in PCO women is similar to that of cycling women. The establishment by MPA treatment of opioidergic regulation of GnRH‐LH pulsatility implies that the opioidergic impairment seen in PCO women is a functional state
OBSERVER VARIATION IN THE SCINTIGRAPHIC DIAGNOSIS OF SOLITARY COLD THYROID LESIONS
Authors: JARLØV ANNE E. , GJØRUP THOMAS , HEGEDÜS LASZLO , HVID‐JACOBSEN KELD , MARVING JENS , HANSEN JENS M. 
Published: March 2008

SUMMARYIn order to evaluate the reproducibility of the diagnosis of solitary cold thyroid lesions, two specialists in nuclear medicine and two specialists in endocrinology independently twice read 240 thyroid 99mTc pertechnetate scintigrams. No significant difference or interaction between the results obtained from the right and the left lobe was found. A solitary cold lesion was diagnosed in 100 of the 480 lobes; however, in only 30 did all four observers agree upon the diagnosis. Interobserver variation was determined by pairwise comparison of observers. The observed agreement was between 0.91 and 0.94. After adjusting for expected chance agreement, kappa values between 0.57 and 0.70 were found. Intraobserver variation was smaller than interobserver variation, revealing agreement rates of 0.93–0.96 and kappa values between 0.71 and 0.77. Agreement was related to large lesions, lesions located centrally in the lobe, and ovoid‐shaped lesions. Clinicians should be aware to what extent they can rely on the information they use in their decisions. The considerable inconsistency in the evaluation of cold lesions on thyroid scintigrams should be taken into consideration, and calls in question the value of using thyroid scintigrams for deciding whether a patient should be referred for operation or biopsy.
THE OVERNIGHT DEXAMETHASONE TEST IS A WORTHWHILE SCREENING PROCEDURE
Authors: CRONIN C. , IGOE D. , DUFFY M. J. , CUNNINGHAM S. K. , MCKENNA T. J. 
Published: March 2008

SUMMARYThe overnight low‐dose dexamethasone test is a convenient screening procedure for Cushing's syndrome. Claims that the test is associated with a high incidence of ‘false positives’, rendering it of little value particularly in obese and hospital in‐patients, have been investigated in the present study. The data from 100 consecutive subjects undergoing overnight low‐dose dexamethasone tests to examine for the possibility of Cushing's syndrome, were reviewed. Cushing's syndrome was identified in four patients, normal suppression of cortisol values occurred in 84 patients and 12 patients exhibited false positive results. Differences in body weights, body mass indices or in‐patient status did not distinguish between those subjects with normal suppression of plasma cortisol and those subjects who yielded false positive results. These data indicate that the simple overnight dexamethasone test substituted for the more cumbersome traditional 48‐h dexamethasone test in 84 of 96 patients who did not have Cushing's syndrome. Thus the overnight test provides a useful screening procedure but a small percentage of patients, approximately 12.5%, will require additional procedures to exclude Cushing's syndrome.
URINARY GLYCOSAMINOGLYCANS IN Graves'OPHTHALMOPATHY*
Authors: KAHALY G. , SCHULER M. , SEWELL A. C. , BERNHARD G. , BEYER J. , KRAUSE U. 
Published: March 2008

SUMMARYAn increased accumulation of glycosaminoglycans (GAG) in retrobulbar tissues has been reported in patients with thyroid eye disease. We examined the quantitative urinary GAG excretion in 101 patients with Graves'ophthalmopathy of different classes, 36 patients with Graves'hyperthyroidism without ophthalmopathy, 14 patients with toxic nodular goitre and 103 control subjects. Glycosaminoglycans were isolated from 24‐h urine collections by precipitation with cetylpyridinium chloride and ethanol followed by photometrical quantification of hexuronic acids after reaction with carbazole. In comparison with the control group (15.8, 10.4, 21.6 mg/24 h; median, 25th, 75th percentile) a significant (P < 0.005) elevation of urinary GAG excretion was found in patients with ophthalmopathy (192, 12.2, 28.7 mg/24 h), whereas patients with Graves'hyperthyroidism and no ophthalmopathy (16.2, 11.9, 21.7 mg/24 h) and patients with toxic nodular goitre (15.8, 11.5, 21.2 mg/24 h) exhibited no markedly increased values. Especially, patients with active, untreated ophthalmopathy showed on average a twofold increase (36.7, 28.1, 48.4 mg/24 h) in urinary GAG excretion. In contrast, high values were not found in patients with inactive ophthalmopathy and elevated values decreased under treatment, which correlated with clinical findings. Further, relapses were also accompanied by high GAG excretion. Thus, using a simple laboratory method, quantitative determination of urinary GAG excretion appears to present an effective parameter for the activity of Graves'ophthalmopathy.
REDUCED FOREARM BONE MINERAL CONTENT AND BIOCHEMICAL EVIDENCE OF INCREASED BONE TURNOVER IN WOMEN WITH EUTHYROID GOITRE TREATED WITH THYROID HORMONE
Authors: TAELMAN P. , KAUFMAN J. M. , JANSSENS X. , VANDECAUTER H. , VERMEULEN A. 
Published: March 2008

SUMMARYWe used single‐photon absorptiometry to assess forearm bone mineral content (BMC/BW) (arbitrary units normalized for bone width) at a proximal site (PBMC/BW) and at a more distal site (DBMC/BW) in 60 women treated with 25–50 μg T3 or 50–100 μg T4 for euthyroid goitre, in 13 untreated goitre patients, and in 2 controls matched for age and menopausal state for each goitre patient. BMC/BW was not significantly different between untreated goitre patients and controls. In 36 premenopausal patients, treated for 5.8 |Mp 5.4 years (mean |Mp SD) a slight decrease in PBMC/BW of about 5% compared to controls was observed (PBMC/BW 1.42 |Mp 0.19 vs 1.49 |Mp 013, P< 0.05). In 24 postmenopausal patients, treated for 10.0 |Mp 5.8 year, a 20% deficit in BMC/BW compared to controls was found (DBMC/BW 0.80 |Mp 0.18 vs 1.06 |Mp 0.20, P < 0.001 and PBMC/BW 1.14 |Mp 0–20 vs 1.42 |Mp 0.19, P < 0.001). Biochemical indices of bone metabolism in 43 pre and post‐menopausal patients and 43 controls showed in the patients a higher serum alkaline phosphatase activity (AP) (P < 0.01 and P < 0.05) and serum osteocalcin (NS and P < 0.05). AP was negatively correlated with TSH levels and, in postmenopausal patients, with DBMC/BW and PBMC/BW. Our results suggest that treatment of euthyroid women with moderate doses of thyroid hormone increases bone turnover with clear adverse effects on bone mineral status in postmenopausal patients.