bluuebunny/crossref_metadata_2025_split huggingface dataset:
MANAGEMENT OF CRANIAL DIABETES INSIPIDUS WITH ORAL DESMOPRESSIN (DDAVP)
Authors: CUNNAH D. , ROSS G. , BESSER G. M. 
Published: March 2008

SUMMARYThe effect of oral administration of desmopressin (DDAVP) solution was investigated in six patients with cranial diabetes insipidus of varying aetiology. All patients experienced a prompt and prolonged antidiuresis. Nine patients have been managed with oral DDAVP tablets for up to 5 months and all preferred this route of administration to intranasal application using a rhinyle. Oral DDAVP gives excellent and convenient control in cranial diabetes insipidus.
BIOACTIVE LUTEINIZING HORMONE IN PLASMA OF URAEMIC MEN AND MEN WITH PRIMARY TESTICULAR DAMAGE
Authors: HANDELSMAN D. J. , JENNIFER A. , SPALIVIERO  , TURTLE J. R. 
Published: March 2008

SUMMARYElevation of immunoreactive LH and reduced testosterone production are consistent features of Leydig cell dysfunction in uraemic hypogonadism. To investigate further Leydig cell regulation in uraemia, we measured plasma bioactive LH (B‐LH) and immunoreactive LH (I‐LH), as well as FSH, testosterone, creatinine, urea and albumin in seven uraemic men before and after haemodialysis and compared them to levels both in eugonadal controls (n = 10) and in men with primary testicular damage (n= 10). Plasma B‐LH was increased in uraemic men compared with both nonuraemic control groups. Plasma I‐LH and FSH were increased and testosterone decreased in uraemic men compared to eugonadal controls. In comparison with nonuraemic men with primary testicular damage, plasma I‐LH levels were similar but FSH and testosterone lower in uraemic men. As a consequence, the ratio of B‐LH to I‐LH (LH:B/I ratio) was decreased in men with primary testicular damage but normal in uraemic men. A single session of haemodialysis decreased creatinine (50–5%) and urea (58.5%) and increased B‐LH (47.7%), I‐LH (32.9%), FSH (24.4%), testosterone (15.8%) and albumin (17.8%) levels, but the LH:B/I ratio was unchanged. Increases in gonadotrophin levels were greater than could be accounted for by haemoconcentration suggesting that dialysis may also ameliorate uraemic suppression of the hypothalamus and pituitary. Ultrafiltrates of human uraemic plasma (mol wt < 25000) had no inhibitory effect on in‐vitro steroidogenesis by isolated rat Leydig cells making circulating uraemic‘middle‐molecule’‐type toxins unlikely to be involved in causing lowered testosterone levels in uraemic men. These qualitative abnormalities of plasma LH in uraemia indicate that the pathogenesis of uraemic testicular dysfunction involves additional defects in regulation of Leydig cell function beyond that of primary testicular damage.
ACTH AND CRF‐PRODUCING BRONCHIAL CARCINOID ASSOCIATED WITH CUSHING'S SYNDROME
Authors: ZÁRATE A. , KOVACS K. , FLORES M. , MORÁN C. , FÉLIX I. 
Published: March 2008

SUMMARYA young female patient, with clinical and biochemical manifestations of severe hypercorticism and with the presence of a pituitary adenoma shown by computerized tomography, was thought to have Cushing's syndrome of hypophysial origin. However, the surgically‐removed pituitary adenoma contained no ACTH, by immunocytology, and hypercorticism persisted after transsphenoidal adenomectomy. The patient died and autopsy demonstrated an ACTH and corticotrophin releasing factor (CRF)‐containing bronchial carcinoid. It can be concluded that bronchial carcinoids can produce ACTH and CRF and can mimic the clinical and biochemical manifestations of pituitary Cushing's syndrome. Thus, the localization of the primary site of hypercorticism can be extremely difficult in patients who have an insidious, occult extrapituitary tumour. Further work is required to establish whether CRF plays a role in the causation of Cushing's syndrome and whether the simultaneous secretion of this peptide can modify the clinical and biochemical manifestations of the ectopic ACTH syndrome.
OVULATION AND NORMAL LUTEAL FUNCTION DURING LHRH TREATMENT OF WOMEN WITH HYPERPROLACTINAEMIC AMENORRHOEA
Authors: POLSON D. W. , SAGLE M. , MASON H. D. , ADAMS J. , JACOBS H. S. , FRANKS S. 
Published: March 2008

SUMMARYFive patients with hyperprolactinaemic amenorrhoea who had been resistant to, or intolerant of bromocriptine were treated with pulsatile LHRH therapy. Ovulation was induced in 9 of 12 treatment cycles. In one patient hyperstimulation occured in the first cycle of treatment but subsequently she ovulated normally on a reduced dose of LHRH. The gonadotrophin and ovarian responses to treatment in ovulatory cycles were normal despite prolactin concentrations that remained elevated throughout treatment and rose still further with resumption of ovarian activity. The length of the luteal phase and the mid‐luteal serum progesterone concentrations were also normal. Pulsatile secretion of progesterone in response to LHRH pulses was observed. These data show that ovulation and normal luteal function can be induced by physiological LHRH replacement in women with persistent hyperprolactinaemia. This confirms that the mechanism of anovulation in hyperprolactinaemic amenorrhoea is disordered LHRH secretion.
NOCTURNAL PULSATILE GROWTH HORMONE RELEASING HORMONE TREATMENT IN GROWTH HORMONE DEFICIENCY
Authors: SMITH P. J. , BROOK C. G. D. , RIVIER J. , VALE W. , THORNER M. O. 
Published: March 2008

SUMMARYWe have treated five GH‐deficient prepubertal children (4 M, 1 F) with GH releasing hormone1–40 (GHRH1–40) in two dosage regimens over 9 months. Profiles of serum GH concentrations were obtained over 24 hours before treatment and nocturnal profiles were obtained serially throughout the study. GHRH was administered subcutaneously at night for four pulses using 1 μg/kg/pulse in the first 3 months and 2 μg/kg/pulse for a further 6 months. All subjects demonstrated pituitary responsiveness to i.v. GHRH before treatment and at 3 and 6 months. GH secretion was induced in a pulsatile fashion in response to subcutaneous GHRH in three children from the first night of treatment. A self priming effect to successive GHRH pulses was evident and the response augmented with time and with the higher dose regimen. The growth velocity of these three children increased from a mean of 3.7 cm/year (range 3.7–3.8) before treatment to 5.5 cm/year (range 4.1–7.2) over the first 3 months and to 7.2 cm/ year (range 4.8–9.2) over the following 6 months. In one subject entrainment of GH secretion to GHRH did not occur until the higher dose regimen and this was associated with a modest increase in growth velocity. One subject did not respond to treatment. Pulsatile administration of GHRH1–40 is effective in inducing GH secretion and promoting growth acceleration in some children with idiopathic GH deficiency. The optimal dose and mode of administration of GHRH have yet to be established.
ALTERATIONS IN THE HYPOTHALAMIC‐PITUITARY‐THYROID AXIS AFTER PROLONGED RESIDENCE IN ANTARCTICA
Authors: REED H. L. , BURMAN K. D. , SHAKIR K. M. M. , O'BRIAN J. T. 
Published: March 2008

SUMMARYThe human population which lives and works in polar environments has been increasing steadily over the last 15 years. Very little is known about how these residents adjust to their environment. Cold adaptation in man is a poorly understood phenomenon. Euthermic mammals maintain body temperature during cold exposure via non‐shivering thermogenesis, a process which is hormonally mediated. We studied prospectively the response of the hypothalamic‐pituitary‐thyroid axis in 17 euthyroid men before, during and after assignment to duty in the Antarctic. Serum total and free T4 levels fell slightly but not significantly after very prolonged Antarctic residence. Serum total and free T3 decreased significantly from basal levels of 170 ± 3 ng/dl and 388 ± 19 pg/ dl to 155 ±5 ng/dl and 319±14 pg/dl respectively after Antarctic duty. Serum T3 levels increased after 42 weeks of polar living, the end of the observation period, but the change did not attain statistical significance. The integrated TSH response to TRH administration increased by 50% to 734 ± 58 μIU.min/ml over warm climate basal response levels of 456 ± 33 μIU.min/ml by the end of the study. The daily circadian rhythm of serum Cortisol was maintained throughout the study period. The alterations in thyroid hormones which we describe, are apparently related to the chronic cold exposure which our subjects experienced in this polar environment.
THE EFFECT OF TRANSDERMAL OESTROGEN ON BONE, CALCIUM‐REGULATING HORMONES AND LIVER IN POSTMENOPAUSAL WOMEN
Authors: SELBY P. L. , PEACOCK M. 
Published: March 2008

SUMMARYTransdermal oestradiol, 100 μg/d, was used to treat 11 women suffering from postmenopausal symptoms. After 3 weeks therapy there was a significant rise in the plasma oestradiol into the premenopausal range and a significant fall in plasma FSH level and symptom score. Bone resorption, assessed by urinary excretion of calcium and hydroxyproline, decreased significantly while plasma alkaline phosphatase activity remained constant. There was a significant fall in plasma calcium and phosphate but the plasma concentrations of PTH, calcitonin and calcitriol and the urinary excretion of cAMP were unchanged. Plasma levels of vitamin D binding protein, albumin and globulin were unaltered, and blood pressure did not rise. These effects were similar to those found in postmenopausal women with oral ethinyloestradiol, 30 μg/d, (Selby et al., 1985), apart from those on plasma vitamin D binding protein, total calcitriol, albumin, globulin, tubular reabsorption of phosphate and blood pressure, changes which probably arise from a direct action of oral oestrogen on the liver.
ROLE OF ENDOGENOUS OPIOIDS IN REDUCING THE FREQUENCY OF PULSATILE LUTEINIZING HORMONE SECRETION INDUCED BY PROGESTERONE IN NORMAL WOMEN
Authors: STEELE P. A. , JUDD S. J. 
Published: March 2008

SUMMARYIt is well‐established that the frequency of LH pulses varies during the normal menstrual cycle with a significant reduction in frequency in the luteal phase. Previous studies have indicated that both progesterone and opioids are able to reduce the frequency of LH pulses and in this study we sought to clarify the possible interaction between progesterone, endogenous opioids and GnRH neurons. Sixteen normal women in the mid‐follicular phase (days 8–12) were randomly allocated to a control or treatment group and LH pulsatility assessed on one or two occasions by taking blood samples at 15 min intervals over 8 h. For the control women, LH pulsatility was assessed on one occasion during a saline infusion. The treated women received progesterone (50–100 mg/d for 7 d) at the end of which LH pulsatility was assessed before and after a naloxone infusion (2 mg/h for 8 h). Mean±SEM LH pulse frequency in the control women was 4.9 ± 0.5 pulses/8 h which was significantly decreased to 3.0 ± 0.3 pulses/8 h (P < 0.01) in the progesterone treated women but not different from 5.5 ± 0.3 pulses/8 h in those also treated with naloxone. Mean ± SEM LH pulse amplitude in the control women was 2.3 ± 0.3 IU/l, which was significantly increased to 4.8 ± 0.7 IU/l (P < 005) in the progesterone treated group, and to 3.7 ± 0.4 IU/l (P < 005) in the progesterone‐treated women after naloxone. We conclude that progesterone slows the frequency of LH pulsatility by increasing endogenous opioid activity in the hypothalamus which may in turn inhibit the firing rate of the GnRH neurons.
BASAL AND STIMULATED RELEASE OF CALCITONIN GENE‐RELATED PEPTIDE (CGRP) IN PATIENTS WITH MEDULLARY THYROID CARCINOMA
Authors: MASON R. T. , SHULKES A. , ZAJAC J. D. , FLETCHER A. E. , HARDY K. J. , MARTIN T. J. 
Published: March 2008

SUMMARYCalcitonin gene‐related peptide (CGRP) is a recently discovered peptide whose existence was first predicted following sequence analysis of the rat calcitonin gene. In the present study, plasma levels of CGRP were measured in patients with medullary thyroid carcinoma, both basally and following calcium or pentagastrin stimulation. Using a sensitive radioimmunoassay for CGRP, 19 of 21 patients with medullary thyroid carcinoma had elevated plasma levels of immunoreactive CGRP (median value 114 pmol/l) while 23 normal subjects had plasma CGRP levels below the detection limit of the assay (< 10 pmol/l). Calcium or pentagastrin infusion in medullary thyroid carcinoma patients were potent stimuli to CGRP release, increasing plasma levels two‐to five‐fold. Chromatographic characterization using high pressure liquid chromatography of the CGRP immunoreactivity in plasma from two patients with medullary carcinoma of the thyroid demonstrated the presence of two molecular forms, neither of which co‐eluted with synthetic human CGRP. The role of CGRP in the pathophysiology of medullary thyroid carcinoma is not clear but it may contribute to some of the clinical features associated with the disease. Furthermore, measurement of CGRP in conjunction with calcitonin could help in determining the prognosis of these patients.
CORTICOTROPHIN‐RELEASING FACTOR‐TEST USED WITH BILATERAL, SIMULTANEOUS INFERIOR PETROSAL SINUS BLOOD‐SAMPLING FOR THE DIAGONOSIS OF PITUITARY‐DEPENDENT CUSHING'S DISEASE
Authors: LANDOLT A. M. , VALAVANIS A. , GIRARD J. , EBERLE A. N. 
Published: March 2008

SUMMARYBilateral, simultaneous inferior petrosal sinus blood‐sampling for determinations of ACTH levels has improved the ability to establish a differential diagnosis of Cushing's disease, particularly in patients whose endocrinological studies show equivocal results and whose computed tomography scans yield negative or inconclusive findings. Individual anatomical variations in the configuration of the sinus and insignificant differences between the ACTH levels obtained from its two sides may be a problem. Seven patients with clinically and biochemically typical Cushing's disease and one with atypical Cushing's disease were examined. An alternative approach for catheterization of the inferior petrosal sinus through the deep vertebral venous plexus was used in those patients who did not have direct connections between the sinus and the internal jugular vein. In two of the eight patients, only ACTH secretion stimulated with corticotrophin‐releasing factor could unmask a significant difference between the ACTH levels on the two sides which was not obvious from the basal ACTH levels. Beta‐lipotrophin values showed a behaviour similar to that of ACTH values, but because of a slower turn‐over rate, the CRF‐induced peaks were better visible. The aetiology of Cushing's disease was established from the results of this examination and corresponded with the surgical findings in this series, with the exception of one in which the patient had a highly atypical form of the disease. The abnormal ACTH source was found later to be a thymus carcinoid.
GONADOTROPHIN‐SECRETING PITUITARY ADENOMAS MASQUERADING AS PRIMARY OVARIAN FAILURE
Authors: COOK D. M. , WATKINS S. , SNYDER P. J. 
Published: March 2008

SUMMARYThree women, 20–35 years old, appeared on initial presentation to have primary ovarian failure, because each had amenorrhoea or oligomenorrhoea and markedly supranormal serum concentrations of gonadotrophins. On further evaluation, however, each had ovaries that could secrete oestradiol normally, and one had normal oestradiol secretion without any treatment. Another secreted oestradiol normally only after reduction of her gonadotrophins following partial excision of a pituitary adenoma. The third secreted oestradiol normally only after exogenous oestrogens were administered to reduce her gonadotrophins and were then withdrawn. Each had an enlarged, contrast‐enhancing pituitary gland by computed tomographic scan and a markedly supranormal serum concentration of glycoprotein alpha subunit. We conclude that each of these women had a gonadotrophin‐secreting pituitary adenoma that masqueraded as primary ovarian failure. Their persistently supranormal serum gonadotrophins appear to have inhibited ovarian function.
METOCLOPRAMIDE‐INDUCED HYPERPROLACTINAEMIA: EFFECTS ON CORPUS LUTEUM FUNCTION, ENDOMETRIAL STEROID RECEPTOR CONCENTRATIONS AND 17β‐HYDROXYSTEROID DEHYDROGENASE ACTIVITY
Authors: KAUPPILA A. , ISOTALO H. , KIRKINEN P. , MÄKILÄ U.‐M. , ORAVA M. , VIHKO R. 
Published: March 2008

SUMMARYInduced hyperprolactinaemia impairs ovarian follicular development, especially during the recruitment period. The consequences of hyperprolactinaemia during the luteal phase alone on corpus luteum. function have not been characterized, nor have the actions of excessive circulating PRL on the endometrium. In this study, postovulatory 5‐d administration of metoclopramide (MC) increased serum concentrations of PRL and decreased those of pregnenolone and progesterone indicating inhibition of steroidogenesis in the corpus luteum. This effect may partly explain the relatively common failure of implantation in association with induced ovulation using regimens leading to transient hyperprolactinaemia. In contrast to this, MC‐induced hyperprolactinaemia during the mid‐follicular (4 d) or early luteal phase of the cycle did not alter the concentrations of cytosol or nuclear oestrogen and progestin receptors or the activity of 17β‐hydroxysteroid dehydrogenase in endometrial tissue. Thus, transiently elevated circulating PRL does not seem to have direct effects on female sex steroid receptors or their function in the proliferative or secretory endometrium.
EFFECTS OF NALOXONE ON THE PITUITARY‐ADRENAL AXIS IN PATIENTS WITH DEXAMETHASONE‐SUPPRESSIBLE HYPERALDOSTERONISM
Authors: FALLO F. , BOSCARO M. , SONINO N. , MANTERO F. 
Published: March 2008

SUMMARYEndogenous opioids may normally modulate the function of the hypothalamopituitary‐adrenal axis. We investigated whether opioid peptides play any role on aldosterone secretion in dexamethasone‐suppressible hyperaldosteronism (DSH). Clinical and hormonal effects of i.v. administration of naloxone (10 mg as a bolus) in two siblings affected by this disease and in eight normal volunteers were studied. In normals, naloxone caused a significant increase in plasma Cortisol compared with placebo, an insignificant increase in ACTH and no change in plasma renin activity (PRA) and aldosterone level. In DSH patients there was a slight increase in plasma Cortisol, no change in PRA and a marked rise of aldosterone level. In five normals retested after dexamethasone 2 mg, baseline ACTH and Cortisol were reduced and no response to naloxone was observed compared to naloxone alone. After dexamethasone, aldosterone levels were suppressed in DSH patients and unchanged in normals, and did not respond to naloxone in any case. In conclusion, naloxone may increase the responsiveness of adrenal zona fasciculata to physiological levels of ACTH in normals, since the slight increase in ACTH seems inadequate to explain per se the marked Cortisol elevation. The marked aldosterone rise after naloxone indicates an underlying adrenal rather than pituitary abnormality in patients with DSH, and possibly implicates endogenous opioids.
NORMAL GROWTH AND PUBERTAL DEVELOPMENT DURING BROMOCRIPTINE TREATMENT FOR A PROLACTIN‐SECRETING PITUITARY MACROADENOMA
Authors: DALZELL G. W. , ATKINSON A. B. , CARSON D. J. , SHERIDAN B. 
Published: March 2008

SUMMARYAn 11 ‐year‐old male presented with a 2‐year history of headache and lethargy. Serum PRL was elevated at 14 000 mU/1 and computerized tomography showed a pituitary macroadenoma. Visual fields and fundi were normal and the testes showed early pubertal changes. There was normal responsiveness of serum Cortisol but absence of GH response to hypoglycaemia. After bromocriptine therapy for 4 months serum PRL had fallen to 90 mU/1 and the tumour was not visible on repeat computerized tomography. After 7 months treatment, repeat pituitary function testing showed restoration of GH response to hypoglycaemia. Treatment with bromocriptine was continued and there was spontaneous progression of normal puberty; the serum testosterone continued to rise, and height maintained the 50th centile. Bromocriptine therapy should be considered as initial therapy in the management of prolactinomas in prepubertal patients.
PLASMA OXYTOCIN, ARGININE VASOPRESSIN AND ATRIAL NATRIURETIC PEPTIDE RESPONSES TO INSULIN‐INDUCED HYPOGLYCAEMIA IN MAN
Authors: FISHER B. M. , BAYLIS P. H. , FRIER B. M. 
Published: March 2008

SUMMARYThe changes in blood glucose, plasma oxytocin, plasma vasopressin, plasma atrial natriuretic peptide, serum osmolality, haematocrit and blood pressure were measured in response to acute insulin‐induced hypoglycaemia in six normal male subjects. After the i.v. administration of insulin (015 U/kg), plasma concentrations of oxytocin and vasopressin increased rapidly in all subjects and were maximal 15 min after the acute hypoglycaemic reaction (R). Haematocrit increased at the time of the hypoglycaemic reaction, but there was no change in serum osmolality. Systolic blood pressure rose and diastolic blood pressure fell, but mean arterial blood pressure remained unchanged. No changes were demonstrated in plasma concentrations of atrial natriuretic peptide. The release of oxytocin and vasopressin in response to acute hypoglycaemia in man is probably caused by stimulation of the posterior pituitary gland via hypothalamic activation, and not by stimulation of osmoreceptors or baroreceptors.
OVULATION OF A SINGLE DOMINANT FOLLICLE DURING TREATMENT WITH LOW‐DOSE PULSATILE FOLLICLE STIMULATING HORMONE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME
Authors: POLSON D. W. , MASON H. D. , SALDAHNA M. B. Y. , FRANKS S. 
Published: March 2008

SUMMARYTen women with clomiphene‐resistant chronic anovulation associated with polycystic ovary syndrome were treated with purified urinary FSH (urofollitro‐phin). The gonadotrophin was given s.c. by pulsatile infusion pump starting at a low dose (1 ampoule or 75 U/d) and increasing by 37‐5 U/d at weekly stages in an attempt to induce ovulation of a single follicle. Seventy percent of the 33 cycles were ovulatory and in 18 of these (78%) a single dominant follicle developed and ovulated. Each of the 10 women ovulated when the optimum dose was reached and five of these women became pregnant. The maximum dose of FSH in uniovulatory cycles was 150 U/d or less. Endogenous LH concentrations which were raised at the onset of treatment were suppressed in the late follicular phase. The rate of follicular growth and gonadal steroid concentrations were consistent with those observed in spontaneous ovulatory cycles. This study demonstrates that by using low‐dose gonadotrophin therapy it is possible to find the‘threshold’ dose of FSH to promote maturation of a single dominant follicle. The high rate of ovulation and pregnancy suggest that this approach is of practical importance in treatment of infertile patients with polycystic ovaries.
SUPPRESSION OF OVARIAN ACTIVITY BY ZOLADEX DEPOT (ICI 118630), A LONG‐ACTING LUTEINIZING HORMONE RELEASING HORMONE AGONIST ANALOGUE
Authors: WEST C. P. , BAIRD D. T. 
Published: March 2008

SUMMARYA long‐acting LHRH agonist, Zoladex depot 3–6 mg, was administered as a monthly s.c. injection to seven premenopausal volunteers for a maximum of 6 months, starting in the luteal phase of the cycle. Transient stimulation of gonadotrophin release was observed 24 h after the initial depot, followed by sustained suppression of plasma LH, while FSH levels returned to the normal range. Plasma oestradiol concentrations fell to early follicular phase values within 14 d. Twice‐weekly monitoring of urinary oestrone‐3‐glucuronide and pregnanediol demonstrated inhibition of ovulation and almost complete suppression of ovarian follicular activity throughout therapy. All the subjects became amenorrhoeic. Mean plasma testosterone concentrations were also significantly reduced while androstenedione remained within the pretreatment range. SHBG concentrations were not significantly reduced. After cessation of therapy, postovulatory menstruation occurred within 80 d of administration of the last depot.