bluuebunny/crossref_metadata_2025_split huggingface dataset:
EVALUATION OF A SENSITIVE CHEMILUMINESCENT ASSAY FOR TSH IN THE FOLLOW‐UP OF TREATED THYROTOXICOSIS
Authors: DAVIS J. R. E. , BLACK E. G. , SHEPPARD M. C. 
Published: March 2008

SUMMARYWe have studied 21 patients treated for thyrotoxicosis to evaluate a highly sensitive chemiluminescent thyrotrophin (TSH) assay in the assessment of changing thyroid status. Serum TSH was generally suppressed with high serum thyroid hormone concentrations and invariably rose when free T4 and T3 fell substantially below the normal range. However TSH values in 14 of the 21 patients remained undetectable or subnormal for variable periods despite normal or even slightly subnormal free T4 and T3 values. The level of free T4 and T3 at which TSH concentrations rose was highly variable, suggesting differing degrees of hypothalamo‐pituitary suppression. Sensitive T S H assays are likely to provide useful information regarding physiological regulation of TSH secretion in man, but our data indicate that in certain circumstances these assays used alone will be inadequate for biochemical assessment of thyroid status.
EFFECT OF BROMOCRIPTINE ON LH PULSATILITY IN THE POLYCYSTIC OVARY SYNDROME
Authors: CHAPMAN A. J. , WILSON M. D. , OBHRAI M. , SAWERS R. S. , LYNCH S. S. , ROYSTON J. P. , CLAYTON R. N. 
Published: March 2008

SUMMARYThe effects were studied of bromocriptine, 10 mg daily for 1 year, on luteinizing hormone (LH) pulse characteristics in patients with classical polycystic ovarian syndrome (PCOS). All patients were hirsute, had been oligomenorrhoeic since menarche, had LH: FSH ratios of > 3:1, and either elevated serum testosterone (T) or dehydroepiandrosterone sulphate (DHAS) concentrations. In 10 subjects who completed the study menstrual frequency increased from an average of 3‐6 to 8 per year but few of the cycles were ovulatory. Mean (SE) serum testosterone fell from 4‐4 (0‐5) nmol/1 pretreatment to 2‐8 (0‐3) nmol/1 (P<001) and DHAS from 7‐9 (1‐1) μmol/1 to 5‐4 (1‐1) μmol/1 (P<0‐05). Serum A4 androstenedione and oestradiol did not change with bromocriptine treatment. Mean serum LH fell from 17‐4 (2‐4) IU/l to 11‐2 (1‐8) IU/l (P<0‐03) after 12 months of bromocriptine. No pattern of LH pulsatility specific to PCOS was detected during 10 min sampling for an 8 h period prior to dopamine agonist treatment. LH interpeak interval (58 (5‐2) min) and peak amplitude (156 (7‐2%) of mean nadir) in untreated PCOS were similar to that of the mid‐follicular stage of ovulatory cycles, and bromocriptine for 1 year did not alter these variables. We conclude that while bromocriptine reduces serum androgen levels and increases menstrual frequency it has no effect centrally to modify hypothalamic GnRH secretion. The reduction in LH levels by bromocriptine may be the result of diminished gonadotroph sensitivity to GnRH or reduced pituitary stores of LH available for release. Despite the return towards normal of various hormonal characteristics of PCOS, bromocriptine has little place in the management of this condition.
CLINICAL EXPERIENCE WITH KETOCONAZOLE AS A THERAPY FOR PATIENTS WITH CUSHING'S SYNDROME
Authors: MCCANCE D. R. , HADDEN D. R. , KENNEDY L. , SHERIDAN B. , ATKINSON A. B. 
Published: March 2008

SUMMARYSix consecutive patients with Cushing's disease were treated with the broad spectrum antifungal drug ketoconazole. Urinary Cortisol levels rapidly fell to within the normal range in five of the six patients. Acute hypoadrenalism occurred in one patient, and nausea and pyrexia in three. Our experience with hepatotoxicity was different from that reported by others in that reversible hepatotoxicity was demonstrated in three patients within 7 to 12 days of treatment. Further work is required before ketoconazole can be recommended as a standard primary therapy for patients with Cushing's syndrome. Continuing vigilance for both hypoadrenalism and hepatotoxicity is essential in any patient being treated with this drug either for hypercortisolism or for other reasons.
SIPPLE'S SYNDROME ASSOCIATED WITH A LARGE PROLACTINOMA
Authors: BERTRAND J.‐H. , RITZ P. , REZNIK Y. , GROLLIER G. , POTIER J.‐C. , EVRAD C. , MAHOUDEAU J. A. 
Published: March 2008

SUMMARYA 26‐year‐old male presented with the symptoms and signs of acute congestive heart failure and hypertension. The left ventricle was shown to be thickened and displayed reversible hypokinesia. Further investigations revealed the underlying pathology of a phaeochromocytoma, bilateral medullary thyroid carcinoma (MTC), parathyroid adenoma and macro‐prolactinoma. There was a family history of MTC. The echocardiographic features of catecholamine‐induced cardiomyopathy were important in this diagnosis. Our research revealed no previous report of Sipple's syndrome associated with a macroprolactinoma. This case, along with the other 13 reports of mixed (type I and II) multiple endocrine neoplasia (MEN), are not within the classical subsets of MEN.
IN‐VITRO CONVERSION OF BLOCKING TYPE ANTI‐TSH RECEPTOR ANTIBODY TO THE STIMULATING TYPE BY ANTI‐HUMAN IgG ANTIBODIES
Authors: AMINO N. , WATANABE Y. , TAMAKI H. , IWATANI Y. , MIYAI K. 
Published: March 2008

SUMMARYWe examined the relationship between blocking type anti‐TSH receptor antibody (TRAb) and stimulating type TRAb by trying to convert blocking type TRAb to the stimulatory type in vitro. Immunoglobulins (IgGs) purified from sera of six patients with primary hypothyroidism blocked bovine TSH (100 μU/ml)‐induced cAMP production (58‐3‐82‐1% inhibition) in cultured porcine thyroid cells. None of these IgGs showed stimulating activity even after their dilution. In the conversion experiment, thyroid cells were first incubated with these IgGs at 34°C for 30 min and then washed with incubation buffer. They were then incubated with various kinds of anti‐human IgG antibodies first for 1 ‐5 h at 4°C and then for 18 h at 34°C, and the cAMP concentrations in the supernatants were measured. All six IgGs showed strong, dose‐dependent thyroid‐stimulating activity after addition of antibodies against human whole IgG, or Fab or Fc fragments of IgG. The Fab or F(ab')2 fragments of goat anti‐human IgG antibody also had these converting activities, although less than whole IgG. Addition of normal IgG in the first incubation or anti‐human IgG antibody alone had no thyroid‐stimulating activity. Anti‐human IgA or IgM antibodies did not have these converting activities. These results show that blocking type anti‐TSH receptor antibodies can be converted to the stimulating type by anti‐human IgG antibodies in vitro. The results suggest that the blocking and stimulating types bind to the same epitope(s) of TSH‐receptor related antigens. The same anti‐TSH receptor antibody may act as a stimulator or blocker by the influence of other factors, such as anti‐idiotype antibody.
EFFECTS OF LONG TERM DEXAMETHASONE TREATMENT IN ADULT PATIENTS WITH CONGENITAL ADRENAL HYPERPLASIA
Authors: HORROCKS P. M. , LONDON D. R. 
Published: March 2008

SUMMARYWe have followed nine adult patients with congenital adrenal hyperplasia (CAH) for between 7‐77 months on dexamethasone (DXM) 0.5 mg mane and 0.25 mg nocte, reducing to 0.5 mg mane. Twenty‐four hour profiles of ACTH, 17‐hydroxyprogesterone (17OHP), and androstenedione were performed; the areas under the curves (AUC) and the heights of the morning peaks were used to assess biochemical control. Comparisons were made between treatment before DXM (pre‐DXM), 0.75 mg for 2 weeks (DXM‐ST), 0.75 mg for at least 3 months (DXM‐LT), and 0.5 mg for at least 3 months (DXM‐0.5). None of the three males suffered any significant side‐effects. All women had menstrual disturbance but in three ovulation was induced. One female developed Cushing's syndrome and two developed hirsutism which resolved on stopping DXM. Overall there was no significant difference between DXM‐ST and DXM‐LT (mean AUCs for ACTH: DXM‐ST 660, DXM‐LT 383, for 170HP: DXM‐ST 1177, DXM‐LT 587, for androstenedione DXM‐ST 232, DXM‐LT 121). Reduction of the dose from 0‐75 mg to 0‐5 mg led to significant deterioration in control (Mean AUCs for ACTH DXM‐0 5,1123 (P < 0‐02), for 170HP DXM‐0‐5, 2068 (P < 0‐002), for androstenedione DXM‐05, 213 (P < 0‐5). We conclude that DXM is a satisfactory regime but the dose must be adjusted for each patient.
PLASMA AND CYST FLUID LEVELS OF A5 AND A4 STEROID HORMONES IN WOMEN WITH GROSS CYSTIC BREAST DISEASE
Authors: INAUDI P. , BERNABEI A. , GIOFFRÉ W. , FRANCHI F. , MAZZULLO G. , de LEO V. , D'ANTONA N. 
Published: March 2008

SUMMARYΔ5 and Δ4 steroid levels were studied in the plasma and cyst fluid of women with gross cystic breast disease (GCBD). In luteal phase a significant increase in plasma levels (mean + SEM) of DHA (11.2 ± 2.4 ng/ml), DHAS (1.45 ± 0.6 fig/ ml) and Cortisol 277 ± 15.7 ng/ml) was found; in follicular phase the mean levels were 4.09 ± 0.47 ng/ml for DHA, 0.65 ± 0.08 μg/ml for DHAS and 190 ± 46.3 μg/ml for Cortisol. The DHA/DHAS and cortisol/androstenedione ratios were significantly higher in the plasma and lower in the cyst fluid of GCBD patients, than in the plasma of controls; the androstenedione/DHA ratio was higher in the cyst fluid than in the plasma of controls. The hormonal situation of the GCBD patients thus differed from that of the controls both in the plasma and cyst fluid, particularly as regards the Δ5 steroids.
SLEEP APNOEA AND DAYTIME SLEEPINESS IN ACROMEGALY: RELATIONSHIP TO ENDOCRINOLOGICAL FACTORS
Authors: PEKKARINEN T. , PARTINEN M. , PELKONEN R. , IIVANAINEN M. 
Published: March 2008

SUMMARYSleep history and pituitary function were studied and sleep polygraphy performed in 11 acromegalic patients before and after pituitary surgery. Excessive daytime sleepiness or habitual snoring or both together, as well as an elevated fasting level of serum GH occurred in all the patients. In five men but in none of the women an abnormal number of episodes of sleep apnoea were observed. Pituitary adenomectomy improved the apnoea frequency in one patient, whereas in the others the abnormality was still present 1 year later. After operation the fasting level of serum GH became normal in eight patients, two of them with persisting sleep apnoea. The sleep apnoea syndrome is common and clinically important in acromegaly. Its early diagnosis using polygraphic monitoring is emphasized, as it is a treatable disorder.
GROWTH HORMONE RESPONSES TO PYRIDOSTIGMINE IN NORMAL ADULTS AND IN NORMAL AND SHORT CHILDREN
Authors: GHIGO E. , MAZZA E. , IMPERIALE E. , MOLINATTI P. , BERTAGNA A. , CAMANNI F. , MASSARA F. 
Published: March 2008

SUMMARYThere is evidence indicating that the cholinergic system positively modulates GH release probably by inhibiting somatostatinergic tone. In the present study, the effects of cholinergic enhancement by pyridostigmine, (PD), a cholin‐esterases inhibitor, on GH release in normal adults (n= 14) (NA) and in both normal (n = 5) (NC) and short children (n = 19) (SC) with familial short stature (n =7) or constitutional growth delay (n= 12) were studied. In SC the insulin hypoglycaemia (IH)‐induced GH increase was also studied. In both NC and SC 60 mg orally PD induced a significant GH increase with mean peak at 90 min (mean ± SEM 11.0 ± 2.2 ng/ml in NC and 11.2 ± 2.3 ng/ml in SC). The GH areas under response curve (AUC) were 379.3 ± 76.6 and 327.8 ±43.2 ng/ml/h in NC and SC respectively. In NA 120 mg orally PD induced a significant GH increase with mean peak at 120 min (5.1 ± 11 ng/ml) which was significantly lower (P < 0.05) than that observed in both NC and SC. This statistical difference was strengthened by evaluating AUC (NA: 205.6 ± 33.7 ng/ml/h, P < 0.05 vs NC and SC). The correlation of drug dosage with body area ruled out that this difference could be related to the different PD dose in adults and children. In SC, IH induced a GH increase significantly lower than that observed after PD (GH peak 7.8 ± 0.6 vs 16.4 ± 1.9 ng/ml P<0.001). Our data show that cholinergic enhancement by PD induces a higher GH increase in both normal and short children than that observed in adults. This could be related to a variation of somatostatinergic tone. The higher PD‐induced GH response compared to the IH‐induced one indicates that PD test may be considered a more potent GH provocative stimulus than insulin hypoglycaemia.
GROWTH HORMONE RELEASING FACTOR STIMULATES and SOMATOSTATIN INHIBITS PROLACTIN RELEASE FROM HUMAN MIXED SOMATOTROPH‐LACTOTROPH ADENOMAS IN PERIFUSION
Authors: SERRI O. 
Published: March 2008

SUMMARYThe effects of human growth hormone‐releasing factor (hGRF) and somatostatin on growth hormone (GH) and prolactin (PRL) secretion in perifusion of dispersed cells of human GH‐secreting adenomas, obtained from seven acromegalic patients with hyperprolactinaemia, were examined. Six adenomas stained for both GH and PRL on immunohistochemical examination, and one contained only GH. GH release was consistently stimulated in a dose‐dependent manner by hGRF (0.01, 0.1 and 1.0 nM) in all seven adenomas studied. PRL release was undetectable in two adenomas. In the other five, hGRF stimulated PRL release and the response was dose related. Furthermore, the PRL response was significantly correlated with the GH response to hGRF. When cells were perifused with somatostatin (1 nM), GH and PRL secretion induced by hGRF was completely antagonized. We also evaluated the effect of hGRF pretreatment on the subsequent GH response to hGRF in two adenomas. hGRF pretreatment (1 nM) for 210 min reduced the GH response to a subsequent hGRF challenge (100 nM) in one tumour but not in the other. In conclusion, the PRL response is similar to the GH response in mixed GH and PRL‐secreting adenomas after exposure to GH release‐stimulating and inhibiting hormones. After prolonged exposure to hGRF, some adenomas remain responsive to further stimulation with hGRF, whereas others do not.
OVARIAN SUPPRESSION IN POLYCYSTIC OVARIAN DISEASE DURING 6 MONTH ADMINISTRATION OF A LUTEINIZING HORMONE‐RELEASING HORMONE (LH‐RH) AGONIST
Authors: FAURE N. , LEMAY A. 
Published: March 2008

SUMMARYThis study was designed to evaluate the long‐term effect (6 months) of the luteinizing hormone‐releasing hormone (LH‐RH) agonist buserelin on pituitary and ovarian function in a group of 14 patients presenting with the polycystic ovarian (PCO) syndrome. Buserelin was given subcutaneously 200 μg three times daily for the first 7 days followed by 500 μg once daily. Blood samples were taken weekly for the first month and then every month for radioimmunoassay of LH, FSH and sex steroids. While LH levels were stimulated during the first 2 weeks and then declined towards baseline, serum FSH levels were reduced after only 1 week (P < 0.05). Serum oestradiol levels were maximally suppressed to the menopausal range after 1 month and testosterone levels were also significantly inhibited (P < 0.05) after 2 weeks of therapy. Dehydroepiandrosterone (DHEA) sulphate did not show any significant change while 17‐hydroxyprogesterone was suppressed after the first month of buserelin administration (P < 0.01). The apparent divergent response of the gonadotrophins and the reduction of ovarian steroids in spite of a lack of suppression of LH levels can be explained by the marked inhibition of the bioactivity of LH assessed by dispersed mouse Leydig cells assay. The clinical evaluation of hirsutism did not detect any change during the 6 month period. No patient had any menstrual bleeding or spotting after the sixth week of buserelin. The monthly incidence of hot flushes varied between 50 to 66%. This study shows that LH‐RH agonist administration can selectively inhibit ovarian function and could be an interesting approach to evaluate the respective contribution of the ovary and adrenal on the pathophysiology of the polycystic ovarian disease.
(RAPID COMMUNICATION) PLASMA LEVELS OF ATRIAL NATRIURETIC PEPTIDE IN HYPERTHYROIDISM
Authors: WOOLF A. S. , MOULT P. J. A. 
Published: March 2008

SUMMARYWe measured plasma atrial natriuretic peptide (ANP) levels in 17 patients with newly diagnosed thyrotoxicosis. ANP was elevated compared to a group of healthy controls and fell to normal after treatment. Plasma cyclic guanosine monophosphate was also raised in untreated patients. Elevated circulating levels of ANP may play a part in the haemodynamic changes of hyperthyroidism.
EFFECTS OF ALPHA‐1 ADRENERGIC BLOCKADE ON THE HORMONAL RESPONSE TO HYPOGLYCAEMIC STRESS IN NORMAL MAN
Authors: CUNEO R. C. , LIVESEY J. H. , NICHOLLS M. G. , ESPINER E. A. , DONALD R. A. 
Published: March 2008

SUMMARYIn order to evaluate the effect of alpha‐1 adrenoreceptor regulation of ACTH release during insulin‐induced hypoglycaemia, we studied the response to hypoglycaemia with and without prazosin premedication in eight normal men. Prazosin pretreatment did not affect basal or peak plasma ACTH, Cortisol or GH during hypoglycaemic stress. However basal plasma levels of noradrenaline were increased (P < 0.02) as were responses of AVP, angiotensin II (P < 0.05) and noradrenaline (P < 0.05) to hypoglycaemia after prazosin. Though it is possible that these augmented responses masked an inhibitory effect of prazosin, we were unable to demonstrate a major role for alpha‐1 adrenergic receptors in mediating the ACTH response to hypoglycaemic stress in normal man.
INFLUENCE OF NIFEDIPINE AND ENALAPRIL ON OSMOREGULATION OF VASOPRESSIN
Authors: FAVRE L. , VALLOTTON M. B. 
Published: March 2008

SUMMARYTo determine whether calcium fluxes and angiotensin II influence osmoregulation of vasopressin (AVP) secretion, the effects of the calcium antagonist nifedipine and of the converting enzyme inhibitor enalapril on the AVP response to an osmotic load were compared to those of a placebo in seven normal female subjects. Plasma and urinary AVP were measured before and during a 3‐h infusion of 2.5% hypertonic saline. Nifedipine (10 mg orally 2 h before and 10 mg at the start of the infusion) increased heart rate but did not change blood pressure. The changes in free water clearance and in urinary AVP induced by hypertonic saline under nifedipine were greater than in the control test, but the slope and the intercept of the regression line of plasma AVP upon plasma osmolality were not significantly different. Enalapril (10 mg 3 h before the infusion) did not change heart rate or blood pressure. Free water clearance and urinary AVP did not differ from the control test, but the slope of the regression line was less steep. These slight modifications of the response to an osmotic load suggest that calcium fluxes and angiotensin II only exert a limited influence on AVP osmoregulation in normal females.
DURATION OF ANTITHYROID ACTION OF METHIMAZOLE ESTIMATED WITH AN INTRAVENOUS PERCHLORATE DISCHARGE TEST
Authors: McCRUDEN D. C. , HILDITCH T. E. , CONNELL J. M. C. , McLELLAN A. R. , ROBERTSON J. , ALEXANDER W. D. 
Published: March 2008

SUMMARYWe have used a method based on a perchlorate discharge test to estimate the duration of antithyroid effect of two doses of methimazole (MMI). Six patients with diffuse toxic goitre took 5 mg MMI twice daily and six took 20 mg twice daily over the study period of 12 weeks. Biochemical control of hyperthyroidism was achieved in all patients and thyroid hormone supplementation was required by all of the patients in the higher dose group to avoid hypothyroidism. Discharge of radioiodine from the thyroid by perchlorate diminished in both groups with time after MMI. After 5 mg MMI, perchlorate discharge as a percentage of the 30‐min uptake (mean ± SD), was 81.7 ± 3.3% at 2.2 h, 69.3 ± 18.9% at 5.9 h, 22.6–23.4% at 13.4 h and 2.7–6.7% at 25.1 h. After 20 mg MMI, the discharge was 92.5 ± 1.9% at 2.2 h, 84.3 ± 8.8% at 6.3 h, 64.8 ± 24.1 % at 13.3 h and 26.9–29.4% at 25.1 h. Only four patients (one in the lower dose group) showed a detectable discharge at 25 h and one of the patients treated with the lower dose showed no discharge at 13 h. These estimates of the effect of MMI on thyroidal iodide organification are not in keeping with published thyroidal MMI concentrations which do not show a fall between 3–6 h and 17–20 h after carbimazole. The explanation for this disparity is not clear but may be based on a redistribution of thioureylenes within the thyroid with time after dosage. The present data suggest that once daily is not the optimum dosage interval for MMI with respect to its effect on the organification of iodide.
RE‐EVALUATION OF THE CLINICAL VALUE OF THE 30 MIN ACTH TEST IN ASSESSING THE HYPOTHALAMIC‐PITUITARY‐ADRENOCORTICAL FUNCTION
Authors: LINDHOLM J. , KEHLET H. 
Published: March 2008

SUMMARYThe insulin hypoglycaemia test has been widely used for assessing the hypothalamic‐pituitary‐adrenocortical function. The outcome of this test has been compared to that of the 30 min ACTH test in 200 consecutive patients with proven or suspected hypothalamic‐pituitary disorder. A significant correlation (R= 0.83, P < 0.001) between the results of the two tests was found. In patients in whom blood glucose levels fell to 2.2 mmol/l (40 mg/dl) or below, the ratio between the peak plasma Cortisol concentration during hypoglycaemia and plasma Cortisol concentration 30 min after ACTH was 1.002. In patients in whom blood glucose concentration declined to 2.3–30 mmol/l (41–54 mg/dl) the ratio was significantly lower (0.828). In eight patients discordant results between the two tests were found. In two patients the ACTH test was normal despite impaired response to insulin. They were studied shortly after acute symptoms of a pituitary adenoma necrosis. Two patients had subnormal responses to insulin despite the fact that pituitary‐adrenal function appeared to be intact. In both cases relative insufficiency of the hypoglycaemic stimulus was the likely cause of the discrepancy. In the remaining four patients results of one test was marginally below, and that of the other test marginally above the lower limit of normal. It is concluded that the 30 min ACTH test is reliable for assessing integrated hypothalamic‐pituitary‐adrenal function (except shortly after acute ACTH deprivation).