bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum levels of free and bound testosterone in hyperthyroidism
Authors: Ford H. C. , Cooke R. R. , Kelghtley E. A. , Feek C. M. 
Published: March 2008

SUMMARY objective The aim of this study was to improve knowledge about the relationships between free and bound forms of testosterone in serum and the major testosterone‐binding proteins during hyperthyroidism design nine men and 11 women were studied when hyperthyroid due to Graves' disease and again after at least 3 months of euthyroidism measurements The serum concentrations of free T3, free T4, TSH, sex hormone‐binding globulin (SHBG), LH, progesterone and free, non‐SHBG bound and total testosterone were determined results For both sexes, hyperthyroidism was associated with significant elevations of the mean totat testosterone and sex hormone‐binding globulin (SHBG) levels and significant depressions of the mean percentage and concentration of non‐SHBG‐bound testosterone and the mean percentage of free testosterone. For women, the mean free testosterone concentration was significantly lower during hyperthyroidism than during euthyroidlsm; no Significant difference in mean free testosterone concentration was observed between hyperthyroid and euthyroid men. When the experimentally derived data were analysed according to a model based on the binding constants of testosterone with SHBG and albumin, the simulated results for each patient when hyperthyroid and euthyroid paralleled the actual results. However, the model consistently overestimated the actual amounts of non‐SHBG‐bound testosterone. There was a significant correlation between SHBG concentration and the severity of thyrotoxlcosis as measured by the change in thyroid hormone levels between eukhyroidlsm and hyperthyroldism conclusions Our results support the following pathogenetic sequence: thyrotoxicosis leads to a rise in serum SHBG concentration which Is accompanied by an increase In testosterone concentration, a fall In the concentration of non‐SHBG‐bound testosterone and little or no change in the concentration of free testosterone
Contraceptives containing desogestrel or levonorgestrel have different effects on serum lipoproteins and post‐heparin plasma lipase activities
Authors: Kaupplnen‐Makelln Rltva , Kuusl Timo , Ylikorkala Olavl , Tlkkanen Mattl J. 
Published: March 2008

SUMMARY objective We examined the effects of mono and polyphasic oral contraceptives containing desogestrel or levonorgestrel on serum lipoproteins, sex hormone binding globulin and post‐heparln plasma lipase activities design The women took either desogestrel or levonorgestrel during the first menstrual cycle on days 15–28. They then received monophasfc ethlnyloestradiol plus either desogestrel or levonorgestrel for three cycles. After this, the women took sequential pills containing ethlnyloestradiol plus either desogestrel or levonorgestrel for the three following cycles. Fasting blood samples were drawn pretreatment and at the end of each treatment patients The study group consisted of 30 apparently healthy women, aged 18–35. They were randomly divided Into desogestrel and levonorgestrel groups, each consisting of 15 women measurements Cholesterol, triglyceride and phosphollplds were determined in whole serum and In all lipoprotein fractions (following isolation of lipoproteins by ultracentrifugatlon). Plasma apolipoproteln A‐l concentration, post‐heparln plasma lipase activities and serum sex hormone binding globulin were also measured results Desogestrel (150 μ g/day) did not change serum total triglyceride concentration, whereas levonorgestrel (150 μ g/day) decreased it. Except for monophasic ethinyloestradiol plus levonorgestrel, the oestrogen‐containing combinations increased serum triglyceride level. Low density lipoprotein (LDL) cholesterol remained stable with all treatments, but the cholesterol/triglyceride ratio of LDL decreased during all combinations with ethinyloestradiol. Levonorgestrel reduced total high density lipoprotein (HDL) cholesterol and both progestins reduced HDL2 cholesterol concentration. Addition of ethlnyloestradiol reversed this change in the desogestrel but not in the levonorgestrel group. The polyphaslc ethinyloestradiol plus levonorgestrel combination did not change total HDL cholesterol. Hepatic lipase was activated with either progestln when administered alone but Its activity was suppressed below the baseline level when ethlnyloestradiol was added. Conversely, both progestins suppressed sex hormone binding globulln levels, but addition of ethlnyloestradiol caused marked Increases above baseline. These increases were greater in women taking desogestrel than in those taking levonorgestrel. No treatment affected lipoprotein lipase activity significantly. conclusions Monophasic or polyphaslc combinations of ethlnyloestradiol and desogestrel do not have deleterious effects on serum lipoproteins. If levonorgestrel is used as the progestln component, polyphaslc ethlnyloestradiol plus levonorgestrel appears more favourable than monophasic ethlnyloestradiol plus levonorgestrel
Assessment of the risk of post‐menopausal osteoporosis using clinical factors
Authors: Ribot C. , Pouilles J. M. , Bonneu M. , Tremollieres F. 
Published: March 2008

SUMMARY obfective We wished to assess the predictive value of the main clinical risk factors for osteoporosis over a low vertebral bone mineral density design A cross‐sectional study was made of a cohort of peri and post‐menopausal women (mean age, 54 years) patients One thousand, five hundred and sixty‐five normal white women were selected from among the women referred to our menopause clinic for screening and prevention of osteoporosis measurements Each woman had replied to a detailed standardized questionnaire including the main clinical risk factors and had her bone density measured using dual photon absorptiometry results The predictive value for a low vertebral bone mineral density (2 SD below the normal young adult value) was assessed for 15 historical and anthropometric vari‐ables. Among these, age, age at menarche, weight, height, menopause and its duration, were independant predictors of a low bone mineral density, in a multiple logistic regression analysis. Odds ratios were calculated for each of these variables, weight, menopause and its duration being the three most influential variables. At best this model makes it possible to correctly classify 73% of women with a low bone mineral density and 66% of those with a normal bone mineral density. If this model Is used for screening, it could possibly save 25% of bone denslto‐metry examinations conclusions Direct bone densitometry remains indispensable to assess osteoporosis risk, since risk factors alone are not sufficient for accurate delineation of either low or normal bone mineral density
Functional properties of a novel mutant thyroid hormone receptor in a family with generalized thyroid hormone resistance syndrome
Authors: Adams M. , Nagaya T. , Tone Y. , Jameson J. L. , Chatterjee V. K. K. 
Published: March 2008

SUMMARY objective We wished to ascertain whether a mutation in the thyroid hormone receptor β gene was present in a family with generalized thyroid hormone resistance syndrome and to characterize the functional properties of this mutant receptor. design Blood samples were obtained from family members for hormone assays and genomic DNA was isolated from leucocytes for genetic analyses patients Three members (B, C, E) of a family with possible thyroid hormone resistance and two normal family members (A, D) were studied measurements Basal thyroid function tests together with serum sex hormone binding globulin (SHBG) levels were measured. The thyroid hormone receptor β gene was amplified using the polymerase chain reaction and the receptor mutation identified by sequence analysis. The ability of mutant receptor to bind T3, interact with a specific DNA sequence and to modulate target gene expression was tested. The effects of mutant receptor on co‐expressed wild type receptor action were determined. results Patients with resistance had raised levels of T4 and T3 together with inappropriately normal serum TSH and SHBG whereas unaffected individuals had a normal hormone profile. A single nucleotide substitution corresponding to a giycine to serine mutation at codon 340 (G340S) in the hormone binding domain was identified in one of the two β receptor gene alleles in patients with resistance, but not in the normal family members. When expressed in vitro, this receptor protein (G340S), as well as a related (G340R) mutant identified in another family, retained the ability to bind to a specific DNA sequence but were unable to bind ligand or to activate or repress target gene expression. in addition both receptor mutants were capable of Inhibiting the function of wlld type thyroid hormone receptor in a co‐expression assay but differed In their inhibitory potential. conclusions We report a second type of mutation (Gly to Ser) in codon 340 of hTRβ in a family with generalized thyroid hormone resistance. Mutations at thls slte ellminate T3 blndlng, causing a loss of hormone‐stimulated receptor functlon. However, the mutant receptors retain the abllity to block normal receptor action. The occurrence of different mutations at the same site suggests that alterations in this region of the receptor may be Important for generatlng the clinical phenotype of thls disorder.
Preserved thyroidal secretion of thyroxione in acromegalic patients with suppressed hypophyseal secretion of thyrotrophin
Authors: Yoshinari Motolaka , Tokuyama Takashi , Kuroda Takeo , Sato Kaori , Okazawa Kaeko , Mizokami Tetsuya , Okamura Ken , Fujishima Masatoshi 
Published: March 2008

SUMMARY objective We have assessed the mechanisms which maintain euthyroidism in acromegalic patients despite the suppression of thyrotrophin (TSH) secretion materials Fourteen untreated patients with acromegaly were analysed. Ten patients were also studied after pituitary surgery methods Thyroid hormones, growth hormone (GH), Insulin‐like growth factor‐I (IGF‐I) and thyroidal uptake of radioactive iodine, thyrotrophin releasing hormone (TRH) test and basal metabolic rate (BMR) were measured before and after pituitary surgery results Nine patients had paipable goitres. The TSH response to TRH stimulation was suppressed in eight patients, who maintained normal serum levels of total T3, T4 and free T4. The patients with normal TSH response had lower levels of free and total T4 than controls. The response of TSH to TRH correlated inversely with the serum level of total and free T4, and also with the plasma level of IGF‐I (r=–0·74, P > 0·05, n= 9). After pituitary surgery, the serum levels of total and free T4 were elevated for at least up to 6 months, with a decrease in the T3/T4 ratio and the BMR. conclusion GH may have a direct stimulatory action on the thyroid secretion of T4 possibly via increased IGF‐I, despite suppressed TSH secretion. The post‐operative elevation of serum T4 suggests the persistent secretion of T4 from the thyroid gland, in spite of instantaneous normalization of the accelerated conversion of T4 to T3, even after reduction of excess GH secretion
The incidence of late‐onset congenital adrenal hyperplasia due to 3β‐hydroxysteroid dehydrogenase deficiency among hirsute women
Authors: Mathieson J. , Couzinet B. , Wekstein‐Noel S. , Nahoui K. , Turpin G. , Schaison G. 
Published: March 2008

SUMMARY objective The present study was designed to determine the incidence of 3β‐hydroxysteroid dehydrogenase deficiency (3β‐HSD) in adult women with hyperandrogenism. design and patients In 78 hirsute patients and 30 normal women in the same age range, an ACTH stimulation test was performed on day 5 of the cycle by administration of a single bolus of 0·25 mg ACTH‐(1– 24) at 0800 h measurements The following steroids were measured before, 30 and 60 minutes after ACTH Injection: Δ5‐pregnenolone (Δ5‐P), 17‐hydroxy‐Δ5‐pregnenolone (17‐OHΔS‐P), dehydroeplandrosterone (DHEA), Δ5‐androstenediol, progesterone (P), 17‐hydroxyprogesterone (17‐OHP), androstenedione (A), testosterone (T) and cortisol results Maximum ACTH‐stimulated values of ΔS‐steroids were in excess of the 90% confidence limits of the control group in 19 hirsute women. Ten patients had an isolated increase in Δ5‐P, 17‐OHΔ5‐P, DHEA or Δ5‐androstenediol. Nine patients had an increase in two Δ5 steroids and none had increased values of three or four Δ5 steroids. The ratios of 17‐OHΔ5‐P to 17‐OHP, DHEA to A, Δ5‐P to P and Δ5‐androstenediol to T were increased in 5, 1, 1 and 1 patients respectively. No patient had elevated values of more than one ratio conclusions Using stringent diagnostic criteria, partial 3 β‐HSD deficiency was excluded in all 78 patients and therefore appears to be a rare disorder.
Investigation of adrenal function in women with oligomenorrhoea and hirsutism (clinical PCOS) from the north‐east of England using an adrenal stimulation test*
Authors: Turner Elaine I. , Watson Malcolm J. , Perry Leslie A. , White Michael C. 
Published: March 2008

SUMMARY objective To determine the prevalence of adrenal enzyme dysfunction in women presenting with oligomenorrhoea and hirsutism, two clinical features of polycystic ovary syndrome (PCOS) design A prospective study of women attending outpatient clinics with these complaints. Androstenedione, dehydroepiandrosterone (DHEA), 17‐hydroxyprogesterone (17‐OHP), 11 ‐deoxycortisol and cortlsol were measured before and after overnight dexamethasone suppression and at 60 minutes after adrenal stimulation by ACTH injection subjects Fifty women with clinical features of PCOS and 37 control women with regular cycles and normal hair distribution from the catchment area of the Royal Victoria infirmary which includes Newcastle upon Tyne, Co. Durham, Cleveland, Cumbria and Northumberland measurements Number of women with steroid responses to ACTH beyond the normal range, as defined by the responses of the control group and in previous studies results Nineteen women (38%) were found to have some abnormality. One woman (2%) was identified with 21‐hydroxylase (21‐OHase) deficiency and a second (2%) had an increase in 17‐OHP compatible with the heterozygote state for 21‐OHase deficiency. Four women (8%) had isolated elevations in the DHEA response consistent with minimal 3β‐hydroxysterold dehydrogenase (3β‐HSD) deficiency. Thirteen women (26%) showed increases in both androstenedione and DHEA, or androstenedione alone, compatible with enhanced 17–20 lyase activity. conclusions Twelve per cent of the group showed evidence consistent with an adrenal enzyme deficiency; 26% had results in keeping with increased adrenal androgen production without an enzyme deficiency. These findings may be of relevance both in the pathogenesis of the features of PCOS and in determining appropriate treatment for individual patients
Nelson's syndrome following partial pituitary microadenomectomy and pregnancy
Authors: Igoe D. , Pidgeon C. , Dlnn J. , McKenna T. J. 
Published: March 2008

SUMMARYWe report for the first time the development of Nelson's syndrome in a patient who had previously undergone unsuccessful pituitary microadenomectomy and subsequently bilateral adrenalectomy. The removal of a 3‐mm portion of a microadenoma did not protect against the development of Nelson's syndrome within 3 years which was closely related to pregnancy, a previously noted association. This report suggests that the development of Nelson's syndrome depends not on the size of the initial pituitary tumour but rather on its individual potential for proliferating once free of the inhibitory effects of glucocorticold excess
Circadian rhythm and pulsatility of parathyroid hormone secretion in man
Authors: Herfarth Klaus , Schmidt‐Gayk Heinrich , Graf Stefanie , Maier Andreas 
Published: March 2008

SummaryOBJECTIVE We wished to investigate the circadian rhythm and pulsatility of parathyroid hormone (PTH) secretion in man, as conflicting results have been published.DESIGN and PATIENTS To investigate the circadian rhythm during daytime, we sampled (a) peripheral blood at hourly intervals in 12 healthy young men from 0900 h until 1700 h. For observation of pulsatility, we sampled (b) peripheral blood at 1‐minute intervals for 1 hour in three healthy men and three healthy women (mean 27 7 years, range 21– 56 years) and (c) at 1‐minute intervals for 30 minutes in 21 patients with surgically confirmed primary hyperparathyroidism (pHPT).MEASUREMENTS The serum levels of intact PTH were measured by two‐site immunoradiometric assay and special care was taken to reduce intra‐assay variability, especially at the normal PTH concentration. In series (a), ionized calcium, total calcium and phosphate were also determined.RESULTS A circadian rhythm during daytime was found for intact PTH in healthy men and women with a nadir at 0930 h and a peak in the afternoon. Ionized calcium and total calcium (protein‐adjusted) decreased and phosphate increased in the afternoon. These changes were all statistically significant (P < 0– 02).Pulsatility of PTH: Statistical cluster analysis of the data showed no pulsatility either in healthy persons or in patients with primary hyperparathyroidism. In two healthy women and one healthy man slight changes of longer duration were discovered, but no complete pulses. In five patients with primary hyperparathyroidism, larger differences between the highest and lowest concentrations of intact PTH were found, but no complete pulses.CONCLUSIONS Our data show a significant circadian rhythm during daytime of intact PTH and only minor changes from minute to minute. The alterations in PTH‐levels occurred at longer time intervals in healthy persons. In some patients with primary hyperparathyroidism, decreases of PTH‐levels were found. The circadian rhythm of PTH may be due to slight changes in calcium or phosphate concentration.
The empty sella: results of treatment in 76 successive cases and high frequency of endocrine and neurological disturbances
Authors: Gallardo Enrique , Schächter Dina , Caceres Edith , Becker Pedro , Colin Enrique , Martinez Carlos , Henriquez Camilo 
Published: March 2008

SummaryOBJECTIVE We assessed the frequency of endocrine or neurological disturbances and the results of surgery in patients with empty sella, diagnosed with cisternography and/or computerized tomography scanning.DESIGN AND PATIENTS Analysis of hospital records of 76 successive patients (73 primary, three secondary empty sella) from a single institution.MEASUREMENTS Clinical and neuro‐ophthalmological evaluation. Serum PRL, GH, TSH, LH, FSH, T4, T3 by radioimmunoassay. Diagnosis of empty sella with cisternography and/or computerized tomography scanning (n = 69), or discovered at surgery (n = 7).RESULTS Patients with empty sella had: headache (69 7%), visual disturbances (34 2%), cerebrospinal fluid rhinorrhoea (11 8%), endocrine disturbances (51 4%, including hyperprolactinaemia, acromegaly, Cushing's syndrome). A pituitary tumour was discovered in two patients, in seven other ones it was suspected but not found at surgery. Transsphenoidal packing of empty sellas was done in 56 cases, with 71% post‐operative complications. With surgery there was improvement of headache in 71%, of visual disturbances in 46%. Cerebrospinal fluid rhinorrhoea (discovered at surgery in four other patients) was not resolved by the first operation in six out of 13 patients. In 20 patients without surgery, headache improved in 64 6%.CONCLUSIONS The empty sella is frequently associated with a variety of neurological and endocrine disturbances, which is contrary to conventional belief. Cerebrospinal fluid rhinorrhoea is not a rare complication and it may be difficult to treat. Some cases of empty sella may be due to partial pituitary apoplexy. Autoimmunity may have existed in other cases. Surgery may be useful in many patients, but a judicious selection is needed because it entails complications and non‐operated patients may improve spontaneously.
Non‐autonomy of parathyroid hormone secretion in acute primary hyperparathyroidism
Authors: Schachter Pinhas P. , Christy Mark D. , Avigad Itamar S. , Shabtay Moshe , Leight George S. 
Published: March 2008

SummaryA patient with acute primary hyperparathyroidism treated with mithramycin preoperatively, underwent neck exploration and two enlarged parathyroid glands were excised: one huge adenoma (6g) and another smaller gland. Mithramycin was administered preoperatively to lower life‐threatening hypercalcaemia, and parathyroid slices from the huge adenoma removed at surgery were submitted in vitro to various calcium concentrations in the media to determine the influence of calcium on parathyroid adenoma secretory pattern in acute primary hyperparathyroidism. Mithramycin induced a significant decline in calcium levels and significant elevations of calciotrophic hormones (intact PTH, mid‐region specific PTH, calcitonin and calcitriol). Significant suppression in PTH output in vitro was achieved by increasing calcium levels in the media. These results exclude autonomous PTH secretion (non‐calcium dependent) as a possible aetiology of acute primary hyperparathyroidism. We suggest that a sudden increase in the set‐point of the diseased parathyroid cells in the presence of a huge cell mass accounts, in large part, for both the marked hypercalcaemia and elevated PTH levels in this patient.
Thyroid abscess complicating subacute thyroiditis: A consequence of steroid therapy?
Authors: Quin J. D. , Gray H. W. , Baxter J. N. , Thomson J. A. 
Published: March 2008

SummaryA patient with subacute thyroiditis developed a thyroid abscess after drainage of a pilonidal abscess. An infective focus in a patient with subacute thyroiditis on steroids should be treated aggressively with adequate antibiotic cover.
Hypothalamic abnormalities in patients with pituitary‐dependent Cushing's syndrome
Authors: Stewart P. M. , Penn R. , Gibson R. , Holder R. , Parton A. , Ratcliffe J. G. , London D. R. 
Published: March 2008

OBJECTIVE We aimed to investigate the pattern of 24‐hour ACTH and cortisol secretion in pitultary‐dependent Cushing's syndrome and to evaluate the pituitary and hypothalamic contributions to the disease.PATIENTS Five women with Cushing's disease (mean age 35±5 (SEM) years) and five normal female controls (mean age 25±2 years) were studied.DESIGN AND MEASUREMENTS Plasma ACTH and cortisol levels were measured every 15 minutes for 24 hours using established IRMA and RIA respectively. ACTH and cortisol mean and trough levels, pulse number and amplitude were calculated using established computer software, programmed to identify ACTH and cortisol peaks.RESULTS Patients with Cushing's disease had a twofold increase in 24‐hour mean cortisol levels and a threefold increase in 24‐hour mean ACTH levels (Cushing's 5.9±1.0, controls 1.9±0.2 pmol/l, P<0.01). This was predominantly mediated by an increase in ACTH pulse amplitude. However, 24‐hour ACTH pulse number was also increased (Cushing's 15±2±2±6, controls 10±6±1±7, P<0±05) due to an increase in pulse number between 1800 and 2400 h. ACTH trough levels were also higher in patients with Cushing's disease (Cushing's 5±3±1±3, controls 2±3±0±2 pmol/I, P<0±05).CONCLUSION Twenty‐four‐hour mean plasma cortisol and ACTH levels are elevated two to three‐fold in patients with Cushing's disease. The Increase in ACTH pulse amplitude suggests a pituitary abnormality in patients with Cushing's disease. However, the increased ACTH pulse frequency together with elevated trough levels is interpreted as Indicating coexisting hypothalamic stimulation (or loss of inhibition).