bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous ethanol injection treatment of autonomous thyroid adenoma: hormonal and clinical evaluation
Authors: Monzanl Fablo , Golettl Orlando , Caracclo Nadla , Del Guerra Paolo , Ferdeghinl Marco , Puccl Enrico , Baschieri Lldlo 
Published: March 2008

OBJECTIVE We have evaluated the efficacy of percutaneous ethanol Injection as an alternative to surgery and iodlne‐131 treatment in solitary autonomous thyroid adenoma.DESIGN Percutaneous ethanol Injection (0.5–2.8 ml ethanol/ml nodular tissue) was performed under sonographic guidance in 3–5 (1–2 weekly) sessions; a 7.5 MHz linear real‐time scanner (Toshiba, mod. 32B) was used for sonographic studies. The thyroid hormone profile was assessed during treatment and for the next 6 months.PATIENTS Fifty‐six patients (40 females, 16 males, mean age 46.SD 9 years; 30 pretoxic, 26 toxic) were included in the study: their pretreatment technetlum‐99 m thyroid scan showed a single hot nodule with total suppression of extranodular tissue in 45 and near‐total suppression in 11.MEASUREMENTS Thyroid hormones, antithyroglobulin and antiperoxidase antibodies were measured by specific radloimmunoassay, while thyrotrophin was evaluated by ultrasensitive Immunoradiometric assay.RESULTS Apart from a case of transient pyrexia, no relevant adverse effects were observed. A slight thyrold hormone increase was seen in both groups immediately following a treatment. Six months after therapy a biochemical and clinical remission of hyperthyroldism was observed in 18 out of 22 toxic patients (81.8%); a significant increase of TSH levels was seen in both groups (P<0.01). With follow‐up, significant volume shrinkage (P< 0.001) as well as structural alterations of the nodule were consistently recorded at sonography; a linear relationship (r= 0.98; P<0.0001) between pretreatment volume and volume reduction was found. At scintiscan, functional activity of extranodular parenchyma was found In 40 out of 56 patients (71.4%), 16/26 (61.5%) In the hyperthyrold group, 24/30 (80.0%) In the pretoxic group.CONCLUSIONS These data confirm that percutaneous ethanol Injection is effective in obtaining functional ablation and in Inducing remission of hyperthyroldism, when present; adverse effects seem infrequent.
The role of 1,25‐dihydroxyvitamin D in the mechanism of acquired vitamin D deficiency
Authors: Clements M. R. , Davies M. , Hayes M. E. , Hlckey Claire D. , Lumb G. A. , Mawer E. Barbara , Adams P. H. 
Published: March 2008

OBJECTIVE We wished to assess the effect of changes In the plasma concentration of 1,25‐dihydroxyvitamin D on the plasma elimination half‐time for 25‐hydroxyvitamin D In man.DESIGN The turnover of 25‐hydroxyvltamin D in plasma was Investigated after intravenous doses of the radioac‐tively labelled metabolite had been given to a group of patients (n= 17) with disorders of bone and mineral metabolism before and after oral treatment with calcium or 1,25‐dihydroxyvitamin D.PATIENTS Seven patients with post‐menopausal osteoporosis, five with hypoparathyroidlsm, three with hypo‐phosphataemic osteomalacia, one with renal osteodystro‐phy and one patient with coeliac disease were studied.MEASUREMENTS Intravenous injections of 3H‐labelled 25‐hydroxyvitamin D were given and plasma elimination half‐time assessed over periods of 4–14 days during which frequent measurements of plasma calcium, phosphate, parathyroid hormone, 25‐hydroxyvltamln D and 1,25‐dihydroxyvitamin D were made. Changes in the plasma elimination half‐time for 3H‐25‐hydroxyvltamin D before and after treatment with calcium and 1,25‐dlhydroxyvitamin D were evaluated by non‐parametric statistical analysis.RESULTS The elimination half‐time for 3H‐25‐hydroxyvita‐min D in plasma was significantly shortened by raising the circulating concentration of 1,25‐dihydroxyvitamin D. Conversely, in a patient with intestinal malabsorption of calcium, the metabolic clearance of 3H‐25‐hydroxyvitamln D was prolonged when the concentration of 1,25‐dlhydroxy‐vitamln D In plasma was decreased by suppressing secondary hyperparathyroldism with large calcium supplements. In the longer‐term studies (n= 10) there was a highly significant Inverse relation (r= 0.88, P <0.001) between the change in the plasma concentration of 1,25‐dlhydroxyvitamin D and the Induced change in the elimination half‐time of 3H‐25‐hydroxyvitamin D. There was also a significant correlation (r= 0.66, p < 0.0025) between the observed fall in the plasma concentration of unlabelled 25‐hydroxyvitamin D and the predicted fall calculated from the measured value for the half‐time of the 3H‐labelled metabolite. In acute studies in patients with post‐menopausal osteoporosis (n= 7), enhanced metabolic Inactlvatlon of 3H‐25‐hydroxyvitamln D was detectable within 24 hours of oral administration of 1,25‐dihydroxyvitamin D.CONCLUSIONS The effect of 1,25‐dlhydrhyvltamln D on the catabolism of 25‐hydroxyvltamin D can contribute to the development of vitamin D deficiency in many clinical disorders. When the natural supply of vitamin D is limited by sunlight deprivation, a sustained Increase in the plasma concentration of 1,25‐dihydroxyvitamin D due to primary or secondary hyperparathyroidlsm will lead to accelerated depletion of vitamin D stores.
Peripheral bone density in women with untreated multinodular goitre
Authors: Mudde A. H. , Reijnders F. J. L. , Kruseman A. C. Nieuwenhuijzen 
Published: March 2008

OBJECTIVES We wished to determine whether women with multinodular goitre and spontaneous subclinical hyperthyroidism have decreased bone density.DESIGN AND SUBJECTS Bone density was measured at the distal and proximal forearm. Data were expressed as Z‐scores relative to the mean values out of 125 control subjects matched for age and menopause. The Z‐scores of 23 women with subclinical hyperthyroid goitre (TSH<0.1 mU/l and normal values for FT4 and total T3) and of 54 women with euthyroid goitre were compared.MEASUREMENTS Bone density was measured by single photon absorptiometry. TSH was measured by IRMA, FT4 by RIA.RESULTS Relative to the euthyroid goitre subjects the mean±SEM Z‐scores of both the distal and proximal forearm density were lower (‐ 0.69±0.17 vs ‐ 0.1 ± 0.18, P <0.05 and ‐0.5±0.18 vs 0.07±0.18, P <0.05, respectively). Median (range) FT4 in the subclinical hyperthyroid goitre subjects was significantly higher than euthyroid goitre subjects (15.6 (11–23.2) pmol/l vs 11.9 (8.3–18.3) pmol/l, P <0.001) although still within the normal range. FT4 correlated inversely with Z‐scores of both distal and proximal forearm bone density in the subjects with subclinical hyperthyroidism (r= ‐0.42, P <0.05 and r= ‐0.43, P <0.05, respectively), but not in the euthyroid goitre subjects.CONCLUSION These findings indicate that women with untreated multinodular goitre and subclinical hyperthyroidism have reduced bone density in the forearm.
Frequency of prolactin pulsatile release in normal men and in agonadal patients is neither coupled to LH release nor influenced by androgen modulation
Authors: Genazzani A. D. , Forti G. , Guardabasso V. , Maggi M. , Milloni M. , Clanfanelli F. , Serio M. 
Published: March 2008

OBJECTIVE We wished to examine and characterize the prolactin pulsatile secretory pattern In both normal and agonadal males in order to assess whether there was any concordance with LH secretion.DESIGN Patients were sampled every 5 minutes for 12 hours.PATIENTS We studied five normal and four agonadal men, the latter group before and on testosterone enanthate (TE) (200 mg l.m. every 15 days) treatment.MEASUREMENTS Prolactin and luteinizing hormone plasma levels were determined using commercial RIA systems. Pulse detection was performed using the DETECT program and the degree of concordance between luteinizing hormone and prolactin was established computing the specific concordance Index.RESULTS We demonstrated the presence of a frequent PRL secretory pattern in normal men (22.8±1.8 peaks/12h; mean±SEM) and in agonadal patients, both in basal conditions and during testosterone treatment (20.5±2.8 and 18±1.6 peaks/12h, respectively). The testosterone treatment in agonadal men significantly reduced luteinlzing hormone pulse frequency (baseline: 27.5±2, testosterone administration: 18.1±3 peaks/12h, P <0.01) but did not affect pulsatile prolactin release. Using a 10 and 15 minute sampling protocol, we observed that prolactin pulse frequency significantly decreased (P <0.01) and was similar to the frequencies estimated In previous reports. When lutelnizing hormone and prolactin time series were studied to evaluate the possible presence of a specific concordance (SC) between the secretory events of the two hormones, no significant degree of concomitancy was observed neither using the specific concordance index or the cross‐correlation analysis.CONCLUSONS This report demonstrates (a) the presence of frequent pulsatile release of prolactin in both controls and agonadal patients (baseline and on testosterone enanthate), (b) the use of an appropriate sampling Interval (5 minutes) to unmask the prolactin pulsatile release, (c) that in men, lutelnizing hormone secretory events are not temporally linked to prolactin secretion, and (d) that androgens, even if reducing luteinlzing hormone pulse frequency in agonadal patients, do not significantly affect prolactin pulsatile secretion, suggesting that testosterone and its metabolites do not affect lactotroph activity.
Effectiveness of computer‐assisted perimetry in the follow‐up of patients with pituitary microadenoma responsive to medical treatment
Authors: Cannavó S. , Natale R. De , Curtó L. , Calzi L. Li , Trimarchl F. 
Published: March 2008

DESIGN Patients were studied before and after 1 year of bromocriptine or 6 months of SMS 201–995 treatment, for prolactinomas or GH‐secreting adenomas, respectively. PATIENTS Seventeen patients with intrasellar pituitary tumour (ten prolactinomas, all females; seven GH‐secreting adenomas, four males and three females) and the presence of relative or absolute scotomas, were examined.MEASUREMENTS We used computed tomodensitometry, Goldman perimeter and computer‐assisted perimetry.RESULTS The patients were divided into three groups according to their response to medical treatment as proved by computed tomodensitometry which revealed the disappearance of the tumour in four prolactinomas (group 1), a reduction < 40% in three prolactinomas and in three acromegalics (group 2) and no significant variation in the diameter of the adenoma in three prolactinomas and in four acromegalics (group 3).Comparison by the paired t‐test of the visual fields before and after treatment revealed a significant positive change (P < 0.01) for all patients in groups 1 and 2 and for one patient in group 3, with disappearance of the scotomas in all cases in group 1 and in two cases in group 2.Visual field defects were detected by means of the Goldman perimeter in only one patient with prolactinoma and in two acromegalics, although the computer‐assisted perimetry showed that, in 15 out of 17 patients, visual impairment was unilateral and in all cases the presence of relative scotomas was concentrated in the upper temporal quadrant.The visual defects observed with computer‐assisted perimetry and the pituitary tumour dimension evaluated with computed tomodensitometry did not show significative correlations (r= 0.059, P NS).CONCLUSIONS Computer‐assisted perimetry was most useful in the diagnosis and follow‐up of patients with pituitary adenoma, especially in the evaluation of small masses without subjective symptoms of visual loss, when the Goldman perimeter does not usually allow us to recognize minimal chiasmatic involvements or the improvement of visual field as a result of the medical therapy.
Serum levels of growth hormone‐binding protein and insulin‐like growth factor‐I during puberty*
Authors: Massa Guy , Bouillon Roger , Vanderschueren‐Lodeweyckx Magda 
Published: March 2008

OBJECTIVE The aim was to investigate the effect of pubertal development on serum levels of growth hormone binding protein (GHBP) and IGF‐I, and to study the relationship between GHBP levels and height standard deviation score (SDS), nutritional state and IGF‐I levels. DESIGN AND PATIENTS The investigation was performed on serum samples from 72 healthy adolescents of different pubertal stage. Results were compared to those obtained in 46 prepubertal children.MEASUREMENTS Serum levels of GHBP were measured by HPLC gel filtration and IGF‐I levels were measured by RIA after acid‐ethanol extraction.RESULTS No effect of pubertal stage on serum levels of GHBP was found. A positive relationship was found between serum levels of GHBP and height SDS (r= 0.38; P < 0.005) and weight expressed as percentage of median weight for height age (r= 0.46; P < 0.0005). Serum levels of IGF‐I increased during puberty and were not correlated with height SDS or weight for height age. In pubertal subjects, no relationship existed between serum levels of GHBP and IGF‐I. In prepubertal subjects, however, a significantly positive relationship between GHBP and IGF‐I levels (r= 0.66; P < 0.0005) was found.CONCLUSIONS Pubertal development does not seem to influence serum levels of GHBP. Height SDS and nutritional state are related to the concentration of GHBP. Before puberty, the level of GHBP is positively related to IGF‐I levels; during puberty, however, the increase in serum IGF‐I levels is not accompanied by changes in the amount of circulating GHBP.
Growth hormone secreting pituitary carcinoma: a case report and literature review
Authors: Stewart P. M. , Carey M. P. , Graham C. T. , Wright A. D. , London D. R. 
Published: March 2008

Only five cases of growth hormone secreting pituitary carcinoma have been documented. We present a 49‐year‐old West Indian male with grossly elevated plasma growth hormone (760–10 400 mU/l), and a large aggressive pituitary tumour that continued to grow despite repeated pituitary surgery, radiotherapy and medical therapy (bromocriptine and somatostatin analogue). Thirteen years after diagnosis the patient died secondary to left ventricular failure. A post‐mortem revealed a large locally invasive pituitary tumour, but in addition numerous tumour seedlings within the cerebrospinal fluid space, and a solitary intraparenchymal tumour deposit within the right temporal lobe, clearly separate from the primary tumour.Pituitary carcinoma should be considered in any acromegalic with grossly elevated plasma growth hormone levels who falls to respond to conventional therapy.
Prevalence of gastritis in patients with acromegaly: untreated and during treatment with octreotide
Authors: Anderson J. V. , Catnach S. , Lowe D. G. , Fairclough P. D. , Besser G. M. , Wass J. A. H. 
Published: March 2008

OBJECTIVE It has previously been suggested that acromegalic patients treated with the somatostatin analogue octreotide invariably have chronic gastritis. We have examined the prevalence of gastritis in a large group of acromegalic patients, untreated and during treatment with octreotide.DESIGN We studied three groups of acromegalic patients: (A) untreated; (B) octreotide‐treated; (C) a subgroup of these studied both before and during octreotide therapy. PATIENTS Forty‐eight patients, grouped as above, with active acromegaly were examined for the presence of gastritis.MEASUREMENTS Gastroscopy and histological examination of gastric biopsies for the presence of gastritis and Helicobacter organisms were undertaken. The principal outcome was quantification of the prevalence of gastritis in the various study groups.RESULTS Group A: 10 of the 33 patients (30%) had gastritis before any therapy with octreotide. Group B: 17 of 36 patients (47%) on octreotide treatment for 6–59 months (mean 20.5) had gastritis, and this was present in five out of the sub‐group of eight patients (62%) treated for over 3 years. Group C: three of 21 patients (14%) developed gastritis during treatment with octreotide for between 6 and 23 months (mean 12.4). There was a highly significant association between the presence of gastritis and the presence of Helicobacter pylori organisms.CONCLUSIONS Octreotide therapy of acromegaly may predispose to the development of gastritis, but this remains statistically unproven. Certainly, gastritis is not an invariable consequence of octreotide therapy, even after prolonged periods of treatment. The presence of gastritis is associated with H. pylori infection.
The pulsatile GH secretion in acromegaly: Hypothalamic or pituitary origin?*
Authors: Riedel M. , Günther T. , von zur Mühlen A. , Brabant G. 
Published: March 2008

OBJECTIVE We studied the effects of different modes of octreotide therapy on the pulsatile pattern of GH release in an attempt to define better its regulation by growth hormone‐releasing hormone (GHRH) and somatostatin and its effects on IGF‐I plasma levels in acromegaly.DESIGN In six acromegalic patients not cured by previous treatment we compared the 24‐hour GH secretion profiles under basal conditions with subcutaneous (s.c.) bolus injections of 100 μg octreotide every 8 hours and with continuous s.c. Infusions of the same daily dose. Blood samples were taken every 10 minutes over 24 hours followed by a GHRH test (100 μg GHRH i.v.) with blood sampling every 15 minutes for another 2 hours. After a 4‐week interval all patients were treated either by the bolus or continuous mode of octreotide application in a randomized cross‐over design. On day 4 of treatment blood sampling and GHRH test were repeated. Octreotide treatment was withdrawn for another 4 weeks; all patients then received the alternate application mode and were measured under similar conditions.MEASUREMENTS Serum GH and plasma IGF‐I concentrations were analysed by serial array averaging. IGF‐I levels were measured in two different assays with and without previous protein extraction. For GH pulse detection three different algorithms (Cluster, Pulsar, Desade) were applied.RESULTS With both treatments, the initially elevated basal 24‐hour mean serum GH concentrations (58.0 ± 9.7 mU/l mean.SEM) decreased significantly (bolus: 11.5 ± 4.9 mU/l, P < 0.001 vs basal; continuous Infusion: 7.6 ± 1.9 mU/l, P < 0.001 vs basal) after 4 days. GH suppression was significantly more pronounced following continuous infusion than bolus (P < 0.05). IGF‐I plasma concentrations were lowered significantly (P < 0.05) with both forms of treatment which did not differ between themselves. Bolus and continuous infusion treatment significantly inhibited (P < 0.05) the amplitudes of pulsatile GH release, but did not change the pulse frequency. In two of the patients, GHRH stimulation did not increase GH serum levels suggesting a constitutive activation of adenylyl cyclase.CONCLUSION Continuous subcutaneous octreotide treatment in acromegaly suppresses mean GH levels better than bolus injection. The number of GH pulses remains unaffected by both modes of treatment providing evidence against a somatostatinergic mechanism of pulsatile GH secretion in these patients. The unchanged frequency of pulsatile GH release in the patients unresponsive to exogenous GHRH indicates that this pattern might be independent of hypothalamic GHRH and somatostatin and suggests a pituitary‐derived mechanism for GH pulse generation in acromegaly.
Effect of growth hormone on the low level of growth hormone binding protein in idiopathic short stature
Authors: Fontoura Manuel , Mugnier Elizabeth , Brauner Raja , Rappaport Raphael , Postel‐Vlnay Marie‐Catherine 
Published: March 2008

OBJECTIVE Growth hormone receptor status was assessed in children with idiopathic short stature by evaluating plasma growth hormone‐binding protein before and under GH therapy.DESIGN Among 22 children presenting idiopathic short stature, 15 were randomly selected to be treated with GH (1.2 IU/kg/week); they were studied before and under GH therapy. Untreated patients served as a control group for age and GH effect.PATIENTS Twenty‐two prepubertal children, aged 5–11 years, were studied. They presented growth retardation of ‐2.8±0.1 SDS (mean . SEM). All had normal GH secretion and their mean IGF‐I plasma level was normal.MEASUREMENT Growth hormone‐binding protein was measured using high pressure liquid chromatography gel filtration. The specific binding of 125I‐hGH to the growth hormone‐binding protein was expressed as a percentage of the total radioactivity.RESULTS Specific binding of 125I‐hGH to the high affinity growth hormone‐binding protein was low with a mean . SEM value of 11.1 . 0.9% of radioactivity. In the treated group, growth hormone‐binding protein increased significantly after 3 months of treatment; It reached 21.1 . 1.0% of radioactivity (mean . SEM) in the eight children who have been treated for 18 months. In the seven untreated children, the growth hormone‐binding protein value Increased to 16.2.1.1% after 18 months; this value is significantly lower than that found in the GH‐treated children, demonstrating that the GH effect Is greater than the age‐related increase in the growth hormone‐binding protein. A positive correlation was found between IGF‐I plasma levels and growth hormone‐binding protein and also between growth velocity and growth hormone‐binding protein.CONCLUSIONS The low growth hormone‐binding protein and the response to high doses of GH suggest partial GH resistance at the receptor level, in this group of children with idiopathic short stature.
The early mineralocorticoid effector mechanism, the sodium—proton exchanger, is sensitized in lymphocytes from patients with Cushing's syndrome
Authors: Wehling M. , Käsmayr J. , Christ M. , Sippell W. , Thelsen K. , Müller O.‐A. 
Published: March 2008

OBJECTIVE In‐vitro binding of aldosterone to mineralocorticoid receptors on human mononuclear leucocytes and its effects on the intracellular sodium and potassium concentrations, the sodium‐proton exchanger and cell volume of human mononuclear leucocytes have been described for normals. In the present paper this easily accessible human cell model was studied in Cushing's syndrome to detect abnormalities of the mineralocorticoid effector mechanism.DESIGN The rate of cell swelling in isotonic sodium propionate reflecting the activity of the sodium‐proton exchanger and the stimulatory activity of 1.4 nM aldosterone were determined in a Coulter Channelyzer.PATIENTS Nine female patients with pituitary‐dependent (7) and adrenal hypercortlsollsm (2) were included in the study.MEASUREMENTS Compared with controls from matched normals, the cell volume of human mononuclear leucocytes in a physiological buffer was significantly increased in the patients. The increment of cell size in isotonlc sodium propionate was elevated in the presence of 1.4 nM aldosterone only.RESULTS These findings are equivalent to an excess stimulation of the sodium‐proton exchanger by aldosterone in these patients. Plasma cortlsol was inversely correlated with the cell swelling In propionate.CONCLUSIONS These data indicate that the early mineralocorticoid effector mechanism in human mono‐nuclear leucocytes from patients with Cushing's syndrome has an increased sensitivity to aldosterone compared with that from normals. This could reflect an adaptation of the cellular electrolyte metabolism to the decreased mineralocorticoid activity balancing the increased glucocorticold activity. If representative of other cell systems, e. g. renal tubular cells, these findings would identify accompanying electrolyte disorders in these patients not as a side‐effect of glucocortlcolds, but as a result of an increased sensitivity to endogenous mlneralo‐corticolds.