bluuebunny/crossref_metadata_2025_split huggingface dataset:
INDIRECT EVIDENCE THAT THE ACTION OF CYPROTERONE ACETATE ON THE SKIN IS DUE TO A METABOLITE
Authors: LYONS F. , SHUSTER S. 
Published: March 2008

SUMMARYCyproterone acetate, applied as 1% solution in ethanol or isopropyl myristate, did not decrease the sebum excretion rate (SER) when applied to forehead skin of patients with acne, although SER is decreased when the drug is given systemically. The probable explanation is that cyproterone acetate owes its local action to a metabolite formed systemically. The present study shows this is unlikely to be the 17β‐hydroxy cyproterone acetate.
ADRENAL PROGESTERONE, 17α‐HYDROXYPROGESTERONE AND CORTISOL RESPONSES TO SYNACTHEN IN NORMAL WOMEN AND WOMEN WITH VARIOUS GYNAECOLOGICAL DISORDERS
Authors: CONWAY D. I. , ANDERSON D. C. , GORDON M. T. , BU'LOCK D. E. , HILLIER V. F. 
Published: March 2008

SUMMARYIn apparently normal subjects there is marked heterogeneity in the adrenal's capacity to produce the progestogens progesterone (Po) and 17α‐hydroxyprogesterone (17Po). We have now screened for the possibility that adrenal progestogens might be an aetiological factor in some patients with hitherto unexplained gynaecological disorders by measuring the responses to acute stimulation with ACTH after overnight dexamethasone suppression. Plasma progesterone (Po), 17α‐hydroxyprogesterone (17Po), and cortisol were assayed in 65 gynaecologically normal women and in 187 with a variety of gynaecological problems including dysfunctional uterine bleeding, unexplained primary infertility, endometriosis, polycystic ovaries, idiopathic hirsutism, and premenstrual syndrome. Responses to ACTH were compared with those in normal subjects according to predominant diagnostic category or categories. There was a wide spectrum of progestogen response to Synacthen in all groups with close agreement between the 30‐ and 60‐min increments in the serum levels for any one steroid. The test was reproducible from one cycle to the next for 17Po (a relatively weak progestogen) and cortisol but much less so for the strong progestogen Po. This variability was not due to spontaneous fluctuation in dexamethasone‐suppressed serum Po levels and remains unexplained. The 60‐min Po and 17Po increments tended to increase slightly with age. Overall, the 60‐min Po increments were a little higher amongst the patients with unexplained primary infertility than amongst controls. There were no significant differences in 17Po increments between normal women and patients, with an equal incidence of marked hyperresponse (exceeding 6 nmol/l increment) in both populations. Unexpectedly, the 18 patients complaining of severe premenstrual symptoms had significantly lower cortisol responses than other groups. We conclude that except in overt 21‐hydroxylase deficiency, adrenal progestogens are unlikely to be a major factor in causing gynaecological disorders.
THYROID FUNCTION AND IMMUNOLOGICAL ACTIVITY DURING AND AFTER MEDICAL TREATMENT OF GRAVES' DISEASE
Authors: GOSSAGE A. A. R. , CRAWLEY J. C. W. , COPPING S. , HINGE D. , HIMSWORTH R. L. 
Published: March 2008

SUMMARYThe variable clinical course of Graves' disease has been followed in 27 patients each studied for 2 years from the time of diagnosis. Thyroid hormone synthesis was blocked with large doses of antithyroid drugs for the first 12 months while euthyroidism was maintained with triiodothyronine. The latter was given alone from 12 to 18 months, and for the last 6 months the patients received no treatment. The activity of the disease was determined by repeated measurements of thyroid uptake of pertechnetate and by assay of thyrotrophin receptor antibodies (TSH binding inhibitory immunoglobulins).Retrospectively there were no features on presentation which singly or in combination indicated the clinical outcome: 16 patients remained in remission (Group 1) whilst in 11 hyperthyroidism had recurred before the end of the study (Group 2). Both measures of disease activity (thyroid uptake and antibody levels) fell during the first 12 months in patients of both groups. Recurrence of Graves' disease could be predicted in some but not all patients of Group 2 at 12 months by higher thyroid uptakes and levels of thyrotrophin receptor antibodies. There was, however, evidence of abnormal thyroid function, from which we infer continuing activity of the disease, 12 to 18 months after diagnosis in all patients of Group 1, even though these patients had normal TRH tests during the last phase of the study.The difference in the course of Graves' disease 12 to 24 months after diagnosis between those patients who remained in remission and those who did not was relative: in no patient was completely normal physiological control of thyroid function re‐established. Clinical remission from hyperthyroidism at this time is a level of disease activity at which the normal physiological output of thyroid hormones is not exceeded.
CONSISTENCY AND VARIABILITY IN THE CHARACTER OF THYROTROPHIN RECEPTOR ANTIBODIES IN GRAVEs' DISEASE
Authors: GOSSAGE A. A. R. , CRAWLEY J. C. W. , COPPING S. , HINGE D. , HIMSWORTH R. L. 
Published: March 2008

SUMMARYAt diagnosis there was no correlation between the uptake of pertechnetate by the thyroid and thyrotrophin receptor antibodies (TRAb) measured as TSH binding inhibitory immunoglobulins in a series of 27 patients with Graves' disease. TRAb were detectable initially in 19 patients, in 11 of these there was a significant positive correlation (P > 0·05) between serial measurements of pertechnetate uptake and TRAb made during 2 years following diagnosis. In five patients pertechnetate uptake fell with time whilst TRAb levels were maintained or fluctuated. In the remaining three of the 19 patients both measurements were low and did not change during treatment.We conclude that TRAb in any individual patient are a mixture of immunoglobulins of variable effectiveness as thyroid stimulators. In a majority of patients the composition of this mixture remains constant during the course of the illness and the clinical state reflects the levels of TRAb in the blood. In a minority, however, the character of these antibodies may alter with time or there is a change in the responsiveness of the thyroid gland. The general lack of correlation between measurements of thyroid stimulating activity and TSH binding inhibitory immunoglobulins in groups of patients is due to differences between patients in the composition of TRAb.
TRACKING OF INDIUM‐111‐OXINE LABELLED LYMPHOCYTES IN AUTOIMMUNE THYROID DISEASE
Authors: POZZILLI P. , POZZILLI C. , PANTANO P. , NEGRI M. , ANDREANI D. , CUDWORTH A. G. 
Published: March 2008

SUMMARYPeripheral lymphocytes (∼108) from 4 subjects affected by autoimmune thyroid disease (2 Hashimoto's thyroiditis, 1 primary myxoedema, 1 Graves' disease) and 4 normal subjects were labelled in vitro with 40 μCi of indium‐111‐oxine and, following autologous injection, the distribution of the cells in the body was investigated by gamma camera imaging.Lymphocytes in the thyroid were observed 24 h after injection in both patients with Hashimoto's thyroiditis and in the patient with primary myxoedema, but not in the patient with Graves' disease or in any of the controls. To our knowledge, this is the first report using this method to try and demonstrate lymphocytes in the thyroid gland, and supports the concept that cell‐mediated immunity may be playing an important role in the pathogenesis of Hashimoto's thyroiditis and primary myxoedema.
A MIXED LONGITUDINAL STUDY OF ADRENAL STEROID EXCRETION IN CHILDHOOD AND THE MECHANISM OF ADRENARCHE
Authors: KELNAR C. J. H. , BROOK C. G. D. 
Published: March 2008

SUMMARYTwenty four‐hour urine samples have been collected 6 monthly for 18 months from 127 normal boys aged between 7·5 and 17 years. Urinary steroid metabolites have been measured by gas‐liquid chromatography and ratios of steroid metabolites used to draw conclusions about likely enzymic activities at each step in the adrenal biosynthetic pathway.DHA excretion rose throughout the study, especially between 7·5 and 11 years. Metabolites of cortisol and corticosterone did not increase when related to surface area. During adrenarche there were changes consistent with a decrease in 3β‐hydroxysteroid dehydrogenase activity, a slight rise in 17α hydroxylase activity, a marked rise in 17,20 lyase activity, and a fall in 11β hydroxylase activity.These data are compatible with the hypothesis that a small reduction in the ability to synthesize cortisol requires a marginal increase in the secretion of ACTH and/or other CRF‐induced peptides to maintain cortisol production rate. ACTH itself or a dexamethasone‐suppressible CRF‐induced peptide would in such a case control the growth of the zona reticularis at adrenarche, which thus appears to be primarily an adrenal event.
THE EFFECT OF MINOR INCREMENTS IN PLASMA THYROXINE ON HEART RATE AND URINARY SODIUM EXCRETION
Authors: BELL G. M. , SAWERS J. S. A. , FORFAR J. C. , DOIG A. , TOFT A. D. 
Published: March 2008

SUMMARYWe studied day/night (D:N) patterns of urinary sodium excretion and the 24 hour ambulatory electrocardiogram in seven normal subjects before and during the administration of T4. Thyroxine increased thyroid hormone levels within the normal range and inhibited the plasma TSH response to TRH. This was associated with a significant decrease in D:N sodium excretion (P < 0·01) and D:N urine flow (P < 0·01), a significant increase in mean nocturnal heart rate (P < 0·01), and a lesser increment in mean daytime heart rate (P < 0·05).These responses to small changes in thyroid hormone levels suggest that the anterior pituitary is not alone in recognising minor thyroid hormone excess. The clinical implication is that some patients with a normal T3 and T4 but an impaired TSH response to TRH might benefit from antithyroid treatment.
LH PULSE FREQUENCY IN RELATION TO POSITIVE OESTROGEN‐GONADOTROPHIN FEEDBACK IN AMENORRHOEA
Authors: EL SHEIKH M. A. A. , MOLLOY B. G. , OAKEY R. E. , CHAPMAN C. , HANCOCK K. W. , GLASS M. R. 
Published: March 2008

SUMMARYThe relationship between the pattern of pulsatile LH release and the response to oestrogen provocation was studied in twenty amenorrhoeic or oligomenorrhoeic subjects. In 12 subjects with positive oestrogen‐gonadotrophin feedback a definite pulsatile pattern of LH release was demonstrated with a pulse frequency of 60–80 min and an increase from nadir to peak ranging between 30 and 58%. The mean basal LH concentration was significantly higher in this group (P < 0·001).Of eight subjects who had absence of positive feedback, five showed infrequent pulses, 1–2 during the four‐hour period. These were of low amplitude and with a percentage increase of 45–70 from nadir to peak. The remaining three did not have a pulsatile pattern of LH release.Positive feedback, as demonstrated by an oestrogen provocation test was thus found only in patients having 3 or more LH pulses in the 4 h study period; an LH pulse frequency similar to that in the early follicular phase in regularly menstruating women.
ACTH FUNCTION IN WOMEN WITH THE POLYCYSTIC OVARIAN SYNDROME
Authors: HORROCKS P. M. , LONDON D. R. , KANDEEL F. R. , BUTT W. R. , LYNCH S. S. , HOLDER G. , LOGAN‐EDWARDS R. 
Published: March 2008

SUMMARYSerum androgen levels, including dehydroepiandrosterone sulphate (DHAS) which is thought to be solely of adrenal origin, are elevated in women with the polycystic ovarian syndrome. We have investigated the possibility that this may be due to a mild form of congenital adrenal hyperplasia by measuring basal and stimulated levels of ACTH in women with this condition and have compared them to levels in normal women. We found no difference in the diurnal rhythm of ACTH between patients and normal subjects nor any difference in stimulated levels achieved after a single‐dose oral metyrapone test. Thus there is no evidence from this study to support the idea that these patients might have congenital adrenal hyperplasia. There are two alternative hypotheses to explain the elevated DHAS levels. They may be associated with the high oestrogen levels, which interfere with the enzyme 3β‐hydroxysteroid dehydrogenase, or there may be alteration of the factors controlling adrenal androgen secretion.
24 HOUR MELATONIN SECRETORY PATTERN IN CUSHING'S SYNDROME
Authors: FEVRE‐MONTANGE M. , TOURNIAIRE J. , ESTOUR B. , BAJARD L. 
Published: March 2008

SUMMARYThe concentrations of plasma melatonin and cortisol were determined every 20 min during a 24 h period in 6 women aged 24 to 45 years with Cushing's syndrome of differing aetiologies (4 adrenal adenomas, 2 adrenal hyperplasia). Melatonin was assayed after chloroform extraction according to the method of Rollag and Niswender (1976). Abnormal melatonin secretory patterns were found in all the patients; 24 h melatonin concentration means varied from 130 to 413 pg/ml and were not significantly higher than the 24 h mean in 4 controls (215 ± 126 pg/ml). All six subjects however showed a significant increase of melatonin during the day period (302 ± 109 as compared with controls 129 ± 65 mg/ml, mean ± SD; P<0.005). No relationship could be found between abnormal melatonin levels and the sexual status of the patients (4 with amenorrhoea, 2 normally menstruating women). An alteration of melatonin secretory pattern is present in Cushing's syndrome, whatever the aetiology. It is suggested that hypercortisolism, by itself, may modify the pattern of melatonin secretion.
A HIGHLY SENSITIVE CYTOCHEMICAL BIOASSAY FOR PLASMA ANGIOTENSIN II
Authors: JONES JULIA C. , MACGREGOR G. A. , SAGNELLA G. A. , MORTON J. J. , ALAGHBAND‐ZADEH JAMSHID 
Published: March 2008

SUMMARYA highly sensitive cytochemical bioassay has been developed for measuring angiotensin II in human plasma. The assay depends on the ability of angiotensin II to alter the reducing potency of the zona glomerulosa as measured by Prussian blue staining and microdensitometry. An inverse correlation between the intensity of the stain and the logarithm of concentration existed over the range 0.05‐5.0 fmol/l of angiotensin II. The limit of sensitivity of the assay in plasma was 50 fmol/l; the index of precision was 0.07 ± 0.04 (mean ± SD; n = 15); and the coefficient of variation of a quality control sample was 34%. The response was specific for angiotensin II; approximately 102 times more angiotensin III and approximately 106 times more ACTH was required to produce a similar effect. Angiotensin I had no significant activity. A significant inverse relationship existed between sodium intake and bioactive angiotensin II in 5 normal subjects studied on low, normal and high sodium diets. Extremely low levels of angiotensin II were detected in anephric subjects.
DIMINUTION OF PROLACTIN AND INCREASE OF THYROTROPHIN RESPONSE TO THYROTROPHIN RELEASING HORMONE OCCURRING INDEPENDENTLY OF CHANGES IN BASAL LEVEL OF THESE HORMONES DURING TREATMENT OF HYPOTHYROIDISM
Authors: VAN GROENENDAEL J. H. L. M. , FISCHER H. R. A. , HACKENG W. H. L. , SCHOPMAN W. , SILBERBUSCH J. 
Published: March 2008

SUMMARYIn order to study the effect of rising thyroid hormone levels in hypothyroidism upon prolactin responses to TRH, in relation to changes in basal prolactin concentration and to changes in TSH responses, we followed 18 patients by performing TRH tests before and after 14, 28, 42 and 56 d on gradually increasing levothyroxine dosages, plus a final test when euthyroidism was achieved.Basal prolactin rose initially, at day 14, followed by a return on days 28, 42 and 56 to a level similar to the pretherapeutic value, while at euthyroidism prolactin had fallen below the original value. The area under the prolactin response curve on TRH stimulation was unchanged at 14 d, notwithstanding the rise of basal prolactin concentration. At 28, 42 and 56 d the responses declined progressively along with basal prolactin concentrations that remained equivalent to the pretreatment level.The TSH response to TRH rose at 14, 28, and 42 d along with a continuous downward course of basal TSH.Thus, substitution with L‐thyroxine inhibited the responsivity of prolactin but enhanced that of TSH to TRH. The fact that these changes occurred in opposite directions, appears to rule out a negative feed‐back effect of T4 on hypothalamic TRH secretion.The effects on responses were shown to occur independently of those on basal secretion of prolactin and TSH.
PREVALENCE OF SALT‐LOSING AMONG CONGENITAL ADRENAL HYPERPLASIA PATIENTS
Authors: FIFE D. , RAPPAPORT ELIZABETH B. 
Published: March 2008

SUMMARYAmong clinic patients with congenital adrenal hyperplasia (CAH) the observed frequency of salt‐losing has increased significantly over the past 30 years. Comparing estimates from various clinics, older estimates of the frequency of salt‐losing are lower than estimates cited in more recent literature. Within the patient population of a single long‐established clinic, an increase in the frequency of salt‐losing can also be observed. It is likely that the increase in the frequency of salt‐losing CAH reflects improved case finding and survival of salt‐losing patients. Based on reports of recent populations of CAH patients, the frequency of salt‐losing among CAH patients is approximately 66%.
THE RENIN–ANGIOTENSIN SYSTEM AND TOTAL BODY SODIUM AND POTASSIUM IN HYPERTENSIVE WOMEN TAKING OESTROGEN–PROGESTAGEN ORAL CONTRACEPTIVES
Authors: McAREAVEY D. , CUMMING A. M. M. , BODDY K. , BROWN J. J. , FRASER R. , LECKIE B. J. , LEVER A. F. , MORTON J. J. , ROBERTSON J. I. S. , WILLIAMS E. D. 
Published: March 2008

SUMMARYMeasurements of total body sodium and potassium, and of components of the renin–angiotensin–aldosterone system, were made in a group of women who developed hypertension while taking oestrogen–progestagen oral contraceptives. The results were compared with similar measurements made in age‐matched women with essential hypertension. Total body sodium and potassium were normal in both groups. Plasma renin‐substrate was significantly elevated in the women taking oral contraceptives, while concentrations of active renin were similar and normal in both groups. Thus plasma angiotensin II was significantly elevated in the pill users; overall the product of renin and renin substrate concentrations correlated significantly with angiotensin II. The rise in plasma angiotensin II in conjunction with normal total body sodium could therefore contribute to the increase in blood pressure induced by oestrogen–progestagen oral contraceptives.
PLASMA CALCITONIN AND ACTH RESPONSES TO LYSINE VASOPRESSIN, CALCIUM AND PENTAGASTRIN IN A PATIENT WITH MEDULLARY THYROID CARCINOMA ASSOCIATED WITH CUSHING'S SYNDROME
Authors: SHIMATSU AKIRA , KATO YUZURU , TANAKA ISSEY , NAKAI YOSHIKATSU , FUKUNAGA MASAO , IMURA HIROO 
Published: March 2008

SUMMARYIn a case study of medullary thyroid carcinoma (MTC) associated with Cushing's syndrome, elevated levels of urinary 17‐hydroxycorticosteroids, plasma ACTH, cortisol, calcitonin (CT) and somatostatin (GHRIH) were documented. Lysine vasopressin administration further increased the levels of plasma ACTH, cortisol and CT, whereas the administration of calcium and pentagastrin increased only the level of plasma CT. Immunoreactive ACTH, CT and GHRIH were highly concentrated in the tumour tissues. Basal plasma ACTH levels were more progressively increased than plasma CT during the postoperative course when the patient was treated with o,p′‐DDD, since the tumour was not completely resected. These findings suggest that the secretion of ACTH and CT from MTC were regulated in a different manner.
THE EFFECTS OF PROLONGED BROMOCRIPTINE ADMINISTRATION ON PRL SECRETION GH AND GLYCAEMIC CONTROL IN STABLE INSULIN‐DEPENDENT DIABETES MELLITUS
Authors: SCOBIE I.N. , KESSON C.M. , RATCLIFFE J.G. , MACCUISH A.C. 
Published: March 2008

SUMMARYPlasma glucose, PRL and GH concentrations were measured at hourly intervals over a 24‐h period before and after oral bromocriptine administration in a dosage of 7±5 mg/day for 6 weeks in nine stable insulin‐dependent diabetic men. The pattern of PRL secretion was noted to be normal in stable diabetes (with a mean concentration of 205 mu/l ± 23 SEM) and was effectively suppressed by bromocriptine (to a mean concentration of 51 mu/l ± 2 SEM). This suppression of PRL secretion caused no major alteration in glycaemic control, mean plasma glucose for the group was 10±6 mmol/l ± 3± 4 SD before and 9±6 mmol/l ± 3·1 SD after bromocriptine administration. Bromocriptine produced no change in plasma glucose or GH profiles. It is concluded that PRL secretion is not a major influence on carbohydrate metabolism in stable diabetics.
PERIPHERAL K CELLS IN GRAVES’DISEASE AND HASHIMOTO'S THYROIDITIS IN RELATION TO CIRCULATING IMMUNE COMPLEXES
Authors: ENDO Y. , ARATAKE Y. , YAMAMOTO I. , NAKAGAWA H. , KURIBAYASHI T. , OHTAKI S. 
Published: March 2008

SUMMARYA plaque assay was employed to quantify the number of peripheral K cells in autoimmune thyroid diseases. The percentages of peripheral K cells determined were 3·1 ± 2·2% and 3·3 ± 1·3% (mean ± SD) in forty‐one patients with Graves’disease and twenty‐two patients with Hashimoto's thyroiditis, respectively, which were significantly lower than 5·3 ± 2·5% in 22 normal subjects. Circulating immune complexes (ICs) were measured by three different methods. The positivity of these ICs was investigated in relation to the level of peripheral K cells. The percentage of peripheral K cells in the patients positive for ICs was found to be lower than that in the patients negative for any ICs. Moreover, it was observed that the number of detectable K cells from a normal subject was significantly decreased by incubating the K cells with sera of patients positive for ICs. These results suggest that the decrease of peripheral K cells in the patients with autoimmune thyroid diseases may be due to saturation of K cell Fc receptors by binding ICs.
INCREASED SERUM CONCENTRATION OF T4‐BINDING GLOBULIN IN PATIENTS WITH HYPOGAMMAGLOBULINAEMIA
Authors: LEVER A. , BIRD DAPHNE , BYFIELD P. G. H. , LALLOZ M. R. A. , WEBSTER A. D. B. , HIMSWORTH R. L. 
Published: March 2008

SUMMARYPatients with hypogammaglobulinaemia have been regularly found to have abnormal conventional thyroid function test results. The abnormality is due to an increased plasma concentration of T4‐binding globulin (TBG). As the prevalence of autoimmune thyroid disease is probably increased in hypogammaglobulinaemia this further abnormality in the plasma proteins may lead to diagnostic confusion. Administration of gammaglobulin by infusion causes a rapid but transient fall in plasma concentrations of TBG and T4 which is probably due to a temporary redistribution of the plasma proteins.
EXTERNAL PITUITARY IRRADIATION AS A CAUSE OF TRH DEFICIENCY IN PATIENTS WITH PITUITARY ADENOMAS*
Authors: MACFARLANE I. A. , SHALET S. M. , BEARDWELL C. G. , APPLEGATE G. , ROBINSON E. L. , SUTTON M. L. 
Published: March 2008

SUMMARYThe influence of external pituitary irradiation (XRT) on thyrotroph function and PRL secretion was studied in twenty‐five patients with pituitary adenomas, of whom eight had acromegaly. Twenty‐one patients had undergone subtotal operative removal of their adenomas 8–190 weeks (median 12 weeks) before XRT. Following irradiaton there was a significant reduction in peak serum TSH levels in response to i.v. TRH (P < 0·05, compared with before XRT). Peak TSH levels returned to normal at 3 months. Similarly a transient reduction in TRH‐stimulated β‐TSH release was observed. Serum T3 and T4 concentrations also fell after XRT, the levels at 3 months being significantly lower than control values (P<0·02), though no difference was seen at 6 and 12 months. A delayed (hypothalamic) serum TSH response to TRH (60 > 20‐min level) developed at 6 months. In contrast, PRL concentrations (basal and TRH stimulated) were not altered during the 12 months following XRT. These findings demonstrate that thyrotroph function can be transiently impaired following external pituitary irradiation. None of the patients studied required T4 replacement therapy. The development of a delayed TSH response to i.v. TRH may indicate endogenous TRH deficiency. It was not associated with supra‐sellar tumour enlargement in our patients and may be due to hypothalamic damage by irradiation.