bluuebunny/crossref_metadata_2025_split huggingface dataset:
RESTORATION OF DEXAMETHASONE SUPPRESSION BY INCOMPLETE ADENOMECTOMY IN CUSHING'S DISEASE
Authors: JEFFCOATE W. J. , DAUNCEY S. , SELBY C. 
Published: March 2008

SUMMARYTwo cases of pituitary‐dependent Cushing's disease are described. Selective transphenoidal adenomectomy was attempted in each, but proved incomplete. Although both patients had persistent Cushing's disease after the operation, both were shown to have been rendered fully dexamethasone suppressible. The pathophysiological basis of partial suppressibility is discussed, as are the criteria for the diagnosis of cure in Cushing's disease treated by selective adenomectomy.
GLUCOCORTICOID DEFICIENCY WITH ACHALASIA OF THE CARDIA AND LACK OF LACRIMATION
Authors: POMBO M. , DEVESA J. , TABORDA A. , IGLESIAS M. , GARCIA‐MORENO F. , GAUDIERO G. J. , MARTINÓN J. M. , CASTRO‐GAGO M. , PEÑA J. 
Published: March 2008

SUMMARYFour recent reports describe a multisystem disorder in which ACTH insensitivity is associated with achalasia and alacrima. We report studies on a male patient with this rare triad. The patient had alacrima from birth; isolated glucocorticoid deficiency had been diagnosed at 3·5 years of age and achalasia at age 6. The possibility that this syndrome could be due to a parasympathetic degeneration has already been proposed; the cause of the glucocorticoid deficiency, however, remains unclear. Parasympathetic function in other areas was investigated to determine whether there might be a more generalized abnormality. Specific cardiac tests of parasympathetic function showed that parasympathetic input to the heart was affected in the patient, while the same tests in an Addisonian child were normal. We show, then, a hitherto undetected parasympathetic abnormality in a patient with this syndrome, suggesting a generalized disturbance of this system. On this basis we may hypothesize that the glucocorticoid failure may be a consequence of the loss of parasympathetic input to the adrenal gland, although this remains to be demonstrated experimentally.
ASSOCIATION OF HLA ANTIGENS WITH THYROTOXIC GRAVES’ DISEASE AND PERIODIC PARALYSIS IN HONG KONG CHINESE
Authors: HAWKINS B. R. , MA J. T. C. , LAM K. S. L. , WANG C. C. L. , YEUNG R. T. T. 
Published: March 2008

SUMMARYThe HLA‐A and ‐B antigen distribution in 132 Hong Kong Chinese patients with Graves’ disease, including 24 with thyrotoxic periodic paralysis, was compared with that in 110 controls. The HLA‐DR antigen distribution in 68 patients was compared with that in 47 controls. The prevalence of Bw46 was significantly increased in patients with Graves’ disease and with periodic paralysis. The prevalence of DRw9 was also slightly increased but not at a statistically significant level. The high prevalence of Bw46 related to patients with early age at onset whereas patients with later age at onset had a significantly increased prevalence of HLA B5. It is suggested that Graves’ disease in Chinese is due to two HLA‐associated mechanisms in which early‐onset disease is associated with Bw46 and late‐onset disease with B5.
MULTIPLE INTRACRANIAL METASTASES FROM A PROLACTIN SECRETING PITUITARY TUMOUR
Authors: GASSER R. W. , FINKENSTEDT G. , SKRABAL F. , TWERDY K. , GRUNERT V. , MAYR U. , FROMMHOLD H. , ZUR NEDDEN D. , FEICHTINGER J. , HOFSTAEDTER F. 
Published: March 2008

SUMMARYA 28 year old man presented with partial hypopituitarism and signs of a pituitary tumour. A chromophobe adenoma was partially removed by right frontal craniotomy. Seven years later complete hypopituitarism and hyperprolactinaemia were documented, at which time there was no evidence of tumour recurrence on CT scan. The patient was treated with bromocriptine but the pituitary tumour redeveloped a year later. Nine years after the original operation the first metastasis was demonstrated together with very high prolactin levels. The intracranial metastasis, and the pituitary tumour were removed at a second craniotomy following which the prolactin concentration fell. Further metastases developed subsequently and the patient died 12 years after the initial diagnosis. At autopsy multiple metastases were found in the brain, tumour cells were present in the subarachnoid space and in cerebral veins. The pituitary tumour and secondaries were shown by immunocytochemistry to contain prolactin but not ACTH or growth hormone. This appears to be the third well documented case of a metastasizing, prolactin secreting pituitary tumour.
THE ABSENCE OF ANY EFFECT OF METHIMAZOLE ON IN VITRO CELL‐MEDIATED CYTOTOXICITY
Authors: WEETMAN A. P. , GUNN CATHERINE , HALL R. , McGREGOR A. M. 
Published: March 2008

SUMMARYTwo recent studies have reported that antithyroid drugs inhibit killer (K) and natural killer (NK) cell function in vitro, which could be relevant to the changes in these cell populations during treatment of GRAVES' disease. In contrast to these reports we have found no in vitro effect of pharmacologically relevant concentrations of methimazole (MMI) (100 μmol/l) on (i) NK cell function using K562 cells or MOLT‐4 cells as targets, (ii) K cell function using antibody‐dependent cytotoxicity assays with L929 cells or thyroid‐antigen‐coated chick red cells, or (iii) monocyte‐dependent cytotoxin‐mediated killing of L929 cells. Enhanced cytotoxicity was found with 1 mmol/l MMI in some of these assays but this was not consistent since it occurred only in certain individual cultures. Since we have shown previously that 100 μmol/l MMI inhibits oxygen radical generation, the present results add to the evidence that these radicals are not directly involved in cell‐mediated cytotoxicity and do not support the concept that antithyroid drugs have a significant effect on antibody‐dependent cell‐mediated cytotoxicity in GRAVES' disease.
BIOACTIVE FORMS OF SERUM LACTOGENS: EFFECTS OF TREATMENT OF PROLACTINOMA PATIENTS WITH BROMOCRIPTINE
Authors: RENNIE P. S. , PRIOR J. C. , BRUCHOVSKY N. , GOUT P. W. 
Published: March 2008

SUMMARYAn in vitro bioassay for lactogenic hormones, based on the specific mitogenic effects of lactogens on cultured Nb2 node rat lymphoma cells, was used to measure the levels of lactogens in whole serum and in fractionated serum samples from three patients with prolactin (PRL) secreting pituitary adenomas. Under basal conditions, after pituitary stimulation, and following treatment with bromocriptine which greatly decreased the serum PRL levels, the bioassay (BA) results closely paralleled fluctuations in the sum of radioimmunoassay (RIA) estimates of serum PRL and growth hormone concentrations. The extreme sensitivity (10 pg/ml) of the BA facilitated measurement of PRL in fractions obtained after Sephadex G‐100 chromatography of only 0·1 to 0·3 ml of sera from both untreated and bromocriptine‐treated prolactinoma patients. In both types of samples, similar heterogenous patterns of bioactive PRL were observed, although most of the recovered activity appeared to be due to monomeric PRL. BA and RIA of fractions obtained after DEAE cellulose chromatography of sera from untreated prolactinoma patients revealed two PRL peaks, the first one containing 75% of the activity. Therapy with bromocriptine led to a reduction in the total serum PRL activity and, in particular, in the activity of the second peak.
ALTERATION IN THE NOCTURNAL PULSATILE RELEASE OF GH DURING THE INDUCTION OF PUBERTY USING LOW DOSE PULSATILE LHRH: A CASE REPORT
Authors: STANHOPE R. , PRINGLE P. J. , BROOK C. G. D. 
Published: March 2008

SUMMARYA 16.4 year old girl with idiopathic hypogonadotrophic hypogonadism had successful induction of puberty by administration of low dose LHRH by pulsatile subcutaneous infusion at night. Peak serum GH was increased with therapy but more importantly, pulsatile secretion of GH which was minimal before treatment, was restored after one week of LHRH treatment.
PARATHYROID HORMONE‐LIKE BIOACTIVITY IN A PATIENT WITH SEVERE OSTEITIS FIBROSA CYSTICA DUE TO MALIGNANCY: RENOTROPIC ACTIONS OF A TUMOUR EXTRACT AS ASSESSED BY CYTOCHEMICAL BIOASSAY
Authors: LOVERIDGE N. , KENT G. N. , HEATH D. A. , JONES E. L. 
Published: March 2008

SUMMARYA patient is described with malignancy, hypercalcaemia and radiological evidence of severe parathyroid bone disease but undetectable concentrations of circulating immunoreactive PTH. Autopsy showed the tumour to be a metastatic bronchial carcinoid with no evidence of primary parathyroid disease. Extracts of the tumour had no PTH immunoreactivity but had high concentrations of a substance with identical activity to PTH in a cytochemical bioassay. The biological activity of the extract was not inhibited by PTH antibodies but was inhibited by an antagonist to PTH bioactivity.
PITUITARY CUSHING'S DISEASE ARISING FROM A PREVIOUSLY NON‐FUNCTIONAL CORTICOTROPHIC CHROMOPHOBE ADENOMA
Authors: VAUGHAN N. J. A. , LAROCHE C. M. , GOODMAN I. , DAVIES M. J. , JENKINS J. S. 
Published: March 2008

SUMMARYSevere pituitary Cushing's disease of sudden onset after 18 years of unsuccessful treatment for a previously non‐functioning chromophobe adenoma is described in a middle‐aged woman. Initial presentation with symptoms of optic nerve compression had been preceded by two years of amenorrhoea. Transfrontal resection of a chromophobe adenoma followed by radiotherapy, performed both at this time and again after a recurrence eight years later, failed to eradicate the tumour. Ten more years elapsed before she rapidly developed florid features of Cushing's syndrome. Plasma ACTH levels were markedly elevated and were only partially reduced by further transfrontal surgery, complete removal of the tumour proving impossible. Subsequent bilateral adrenalcctomy was performed to control her hypercortisolism and a course of cytotoxic chemotherapy was administered in an attempt to treat the tumour recurrence. Immunocyto‐chemical staining of tumour obtained at surgery demonstrated ACTH immunoreactivity both before and after the development of Cushing's disease. Although silent corticotrophic adenomas of the human pituitary, including chromophobic tumours, have been previously described, this is the first report of such a tumour becoming functional, sufficient to cause clinically evident Cushing's disease.
T‐CELL SENSITIZATION TO AUTOLOGOUS THYROID CELLS AND NORMAL NON‐SPECIFIC SUPPRESSOR T‐CELL FUNCTION IN GRAVES' DISEASE
Authors: DAVIES T. F. , BERMAS B. , PLATZER M. , ROMAN S. H. 
Published: March 2008

SUMMARYWe have employed a syngeneic system utilizing thyroid cell monolayers initiated following thyroid surgery co‐cultured with autologous T cells to demonstrate T cell autosensitization in patients with GRAVES' disease. Antigen‐induced blasto‐genesis was monitored using 24 h [3H]thymidine uptake. Control experiments with 5 d cultured normal human thyroid cells from tissue around benign adenomata showed no evidence of syngeneic T cell autosensitization. Human thyroid cells alone were unable to incorporate [3H]thymidine in the presence of bTSH. In three of four experiments with GRAVES' thyroid cells there was significant induction of autologous T cell blastogenesis with a mean stimulation index of 220%. In parallel experiments we explored the non‐specific helper and suppressor T cell function of these and similar patients with GRAVES' disease. In normal controls (n= 6) increasing numbers of T cells added to a constant number of B cells (consisting of a T cell depleted peripheral mononuclear cell preparation) showed a marked helper effect measured as increasing IgG secretion. As the ratio of T:B cells increased above 4:1 there was a suppression of IgG secretion. One of two hyperthyroid GRAVES' patients was observed to have deficient T cell function as demonstrated by lack of IgG suppression. The remaining five patients (all but one of whom were euthyroid at the time of testing) had results similar to the controls indicating normal suppressor T cell function in this disease. Such data showed that patients with GRAVES' disease possessed circulating T cells which exhibited autosensitization to syngeneic thyroid cell surface antigens, a phenomenon not demonstrable in control individuals. Furthermore, this specific T cell autosensitization did not interfere with non‐specific T cell function as judged by its influence on IgG secretion.
COMPARATIVE STUDY OF NURSING MOTHERS IN AFRICA (ZAIRE) AND IN EUROPE (SWEDEN): BREASTFEEDING BEHAVIOUR, NUTRITIONAL STATUS, LACTATIONAL HYPERPROLACTINAEMIA AND STATUS OF THE MENSTRUAL CYCLE
Authors: HENNART P. , HOFVANDER Y. , VIS H. , ROBYN C. 
Published: March 2008

SUMMARYA total of 1036 nursing mothers were investigated for their nursing behaviour, status of nutrition and menstrual cycle, serum prolactin and progesterone; 61 in Sweden, 457 in an urban area of Zaïre (Bukavu, Kivu) and 518 in a rural area of the same region (Kabare, Kivu). Lactational hyperprolactinaemia is influenced by the frequency but not by the duration of suckling. The return of luteinization of follicles, but not that of menstrual bleeding, was inversely related to the degree of lactational hyperprolactinaemia. Significant luteinization took place in only some 10% of the mothers during the first three months of lactation in Sweden and within the first year in Zaïre. In these mothers with luteinized follicles the average progesterone was only slightly above 1·0 ng/ml indicating poor luteinization. Lactational hyperprolactinaemia, the return of menstruation and luteinization during lactation were not related to the nutritional status as evaluated by the body weight indices and serum albumin. However, suckling and hyperprolactinaemia do not appear to be the only factors involved in the control of fertility during lactation. When serum prolactin levels were equally low, i.e. below 500 μU/ml, twice the number of lactating mothers with signs of luteinization were found in the urban than in the rural population of Zaïre.
THE EFFECT OF A NEW ERGOLINE DERIVATIVE, CU 32‐085, IN THE TREATMENT OF ACROMEGALY. A CONTROLLED STUDY
Authors: ESKILDSEN P. C. , HOMMEL E. , BUCHHAVE J. 
Published: March 2008

SUMMARYThe effect of a new dopamine agonist, CU 32‐085 (8α‐amino‐ergoline), on pituitary function in acromegaly was evaluated by a controlled, single blind study of 12 acromegalics. The study included a single dose placebo/drug (0·5 mg CU 32‐085) trial and a long‐term crossover trial with 3 month periods (placebo/CU 32‐085 8 mg daily). The patients were evaluated clinically and biochemically (oral glucose tolerance (OGTT), TRH‐ and LHRH‐tests) before and after each 3 month period. Nine patients completed this long‐term trial; one died from myocardial infarction during the placebo period, and two dropped out because of side effects. The release of GH, judged from more than 9 h suppression of serum GH following the single dose, and from the response to OGTT after the long‐term treatment, was significantly inhibited by CU 32‐085. Serum GH reached normal values in 4 of 9 patients. Serum PRL was also markedly suppressed, to subnormal values after the 3 months in all but one hyperprolactinemic patient. Serum TSH, cortisol, FSH and LH were generally unaffected. Glucose tolerance was not significantly altered, although an improvement was found in six of nine patients. A semiquantitative evaluation of subjective symptoms showed a significant improvement following the long‐term treatment, while objective signs of acromegaly were unaffected. The blood pressure was slightly lowered, both after a single dose and after 3 months' treatment. Seven patients experienced nausea and dizziness, two of them with vomiting, after a single dose of the drug. Four of these had similar symptoms initially during the long‐term treatment, which forced two to interrupt the trial. We conclude that CU 32‐085 caused a marked suppression of the release of GH and PRL and an improvement of the major symptoms of acromegaly, a therapeutic effect that is comparable to the previous experience with bromocriptine.
FOLLOW‐UP OF PROLACTIN LEVELS IN LONG‐TERM OESTROGEN‐TREATED MALE‐TO‐FEMALE TRANSSEXUALS WITH REGARD TO PROLACTINOMA INDUCTION
Authors: GOOREN L. J. G. , HARMSEN‐LOUMAN W. , VAN KESSEL H. 
Published: March 2008

SUMMARYAs in laboratory animals, long‐term oestrogen treatment in the human male might induce prolactinomas. We here report on PRL levels in 142 male‐to‐female transsexuals, treated with 100 mg cyproterone acetate and 100 μg ethinyloestradiol per day for 6–108 months (median 52). PRL levels varied markedly between individuals. No relation with age and length of treatment period was found. In 42 subjects in whom PRL levels were followed serially, a slight fall was measured after 12–15 months of treatment. Galactorrhoea, present in 10 of 142 subjects, was unrelated to PRL levels. In 34 subjects in whom PRL levels were measured during treatment and 3 weeks after withdrawal, PRL levels fell significantly. Dopamine in doses of 0·1 μg/kg/min and 1·0 μg/kg/min was administered to six subjects with PRL levels > 1000 mU/l and six subjects with PRL levels < 500 mU/l. No difference in the percentage decrease of PRL levels was found between these two groups. However, administration of monoiodotyrosine, an inhibitor of central dopamine synthesis, to these two groups, induced a significantly smaller release of PRL (expressed as percentage change) in subjects with PRL > 1000 mU/l than in those with PRL < 500 mU/l possibly indicating a loss of control of central dopaminergic regulation. These findings suggest that the risk of inducing prolactinomas through cross‐gender hormone treatment is likely to be small.
ENDOCRINE EFFECTS OF LOW DOSE AMINOGLUTETHIMIDE AS AN AROMATASE INHIBITOR IN THE TREATMENT OF BREAST CANCER
Authors: STUART‐HARRIS R. , DOWSETT M. , D'SOUZA A. , DONALDSON A. , HARRIS A. L. , JEFFCOATE S. L. , SMITH I. E. 
Published: March 2008

SUMMARYThe endocrine effects of low dose (62·5 mg, twice a day) aminoglutethimide (AG), without hydrocortisone (HC), escalating at monthly intervals to a conventional dose of AG (500 mg twice a day) combined with HC, were studied in 33 postmenopausal breast cancer patients. Pretreatment serum concentrations of oestrone (E1) and oestradiol (E2) were significantly suppressed by 62·5 mg of AG twice a day. Although further suppression of E1 appeared to occur with 125 mg of AG twice a day, this was not statistically significant. For E1 and E2, higher doses of AG or combined AG and HC failed to cause further significant suppression compared with that obtained at 125 mg of AG twice a day. Significant rises in serum androstenedione were found with all doses of AG alone, although pretreatment concentrations of androstenedione were not significantly altered by combined AG and HC treatment. Mean pretreatment concentrations of dehydroepiandrosterone sulphate (DHA‐S) were significantly suppressed by 62·5 mg of AG twice a day and further marked suppression occurred on combined AG and HC therapy. Serum cortisol, aldosterone and plasma ACTH concentrations showed no significant alterations throughout treatment. Aminoglutethimide is as effective at 125 mg twice a day without HC in its suppression of oestrogen levels as at 500 mg twice a day with HC, and its use in this form warrants clinical evaluation.
THE ASSAY FOR THYROID STIMULATING IMMUNOGLOBULINS USING CULTURED HUMAN THYROID CELLS
Authors: GRANT S. J. B. , LUTTRELL B. M. , HALES I. B. 
Published: March 2008

SUMMARYRecent reports have shown that thyroid‐stimulating immunoglobulins (TSI) may be detected by measuring cyclic AMP increases in cultures of isolated thyroid cells in response to added patient immunoglobulins (Ig). We have compared the frequency that TSI may be detected in the Ig fraction of 114 sera from 112 patients with a variety of thyroid disorders, to the presence of thyrotrophin binding inhibitor Ig (TBII). Whereas the sera of 46 out of 48 (95·6%) patients with untreated thyrotoxic Graves' disease had detectable TSI, only 26 out of 48 (54·2%) had detectable TBII. We did not find any significant correlation between TSI and TBII for these patients but there was a significant correlation between TSI and both serum T3 (r=+0·55, P < 0·01) and T4 (r=+0·50, P < 0·01). Twelve patients were studied at the time of relapse of thyrotoxicosis due to Graves' disease. All sera contained detectable TSI whereas only one contained detectable TBII. Of the sera from 20 patients in remission after antithyroid drug therapy three were positive for TSI. One of these samples as well as two others had detectable TBII. The two samples with TBII in the absence of TSI came from patients who had developed hypothyroidism. TSI were detected in the serum of one out of nine patients with Hashimoto's thyroiditis but not in the sera of 20 other patients with a variety of non‐autoimmune thyroid disorders including five patients with thyrotoxicosis not due to Graves' disease. However TSI was found in the sera of three out of five patients with exophthalmos and no history of hyperthyroidism. In conclusion using this technique, TSI can be detected in the majority of sera from thyrotoxic Graves' disease patients. It offers information more relevant to the study and management of thyrotoxicosis than is provided by the more widely used TBII assay.
FREE THYROID HORMONE LEVELS AND TSH RESPONSE TO TRH IN PATIENTS WITH AUTONOMOUS THYROID ADENOMATA AND NORMAL T3 AND T4
Authors: LERRO S. , LOSA M. , TRISORIO M. T. , LIUZZI A. 
Published: March 2008

SUMMARYFree thyroid hormone levels together with basal and TRH stimulated TSH levels, have been determined in 50 patients with autonomous thyroid adenomata, who had normal serum total T3 and T4 values. Similar measurements were made in 33 healthy subjects. FT3 and FT4 plasma levels were significantly higher (P < 0·01 and P < 0·05 respectively), and basal and TRH stimulated TSH were significantly lower (P < 0·05 and P < 0·001 respectively) in the patients than in the controls. The TSH response to TRH was decreased in spite of normal free thyroid hormones in 25 patients and in a further ten both the ΔTSH after TRH and the free fractions were normal. Eighteen patients were studied over periods from 4‐37 months by repeating thyroid hormone levels and TRH tests. In six of them a change of these parameters toward toxicity was observed. The data obtained in the longitudinal study indicate that the values of free thyroid hormones and the result of the TRH test obtained by a single determination may represent different steps in the evolution of autonomous thyroid adenomata rather than a distinct pathophysiological condition.
AN ANALYSIS OF THYROTROPHIN RECEPTOR BINDING AND THYROID STIMULATING ACTIVITIES IN A SERIES OF Graves' SERA
Authors: CREAGH FIONUALA , TEECE MICHELLE , WILLIAMS SUSAN , DIDCOTE SUZANNE , PERKINS W. , HASHIM F. , SMITH B. REES 
Published: March 2008

SUMMARYImproved receptor and bioassays have been used to compare TSH receptor binding and thyroid stimulating activities in unextracted sera from 110 patients with Graves' disease. The two parameters showed a significant correlation (r= 0·65; P < 0·001) although there were some clear discrepancies. Dose‐response studies in 17 sera showed that both receptor binding and thyroid stimulating responses always increased with increasing doses of serum. In patients who were in relapse or remission following antithyroid drug treatment, the results of both bio‐ and receptor assays correlated well with disease activity with only one clear discrepancy which could have been attributable to the coexistence of autoimmune stimulation and destruction of the thyroid.