bluuebunny/crossref_metadata_2025_split huggingface dataset:
The short Synacthen test in acute hospital admissions
Authors: Patel S. R. , Selby C. , Jeffcoate W. J. 
Published: March 2008

Summary. objective We wished to define the cortisol response to 250 μg intramuscular tetracosactrin (Synacthen) in acute hospital admissions, using a modern Immunoassay for cortisol.design We performed a prospective study of, as near as possible, a consecutive series of 161 admissions to a single unit.patients We studied 50 patients (age range 67–98, mean 80.3 years, 31‐female, 19‐male) admitted as an emergency, from whom it was possible to obtain informed consent, and whom it was possible to study within 24 hours of admission.measurementsWe measured baseline, increment and peak serum cortisol following administration of 250 μg intramuscular tetracosactrin between 0800 and 0900 hours.results Baseline cortisol concentrations ranged from 288 to 1585 nmol/I (mean 706; median 665). Peak cortisol concentrations ranged from 602 to 2265 nmol/I (mean 1076; median 999). Baseline and peak cortisol concentrations showed a significant correlation (P < 0.001). Increment varied from 10 to 747 nmol/I (mean 374; median 336) and did not correlate with baseline.conclusions In acute hospital admissions, baseline serum cortisol between 0800 and 0900 hours should exceed 250 nmol/I. Peak serum cortisol after 250 μg intramuscular tetracosactrin should exceed 600 nmol/I. Calculation of the increment is of no value.
Antisperm antibodies in the polyglandular autoimmune (PGA) syndrome type I: response to cyclical steroid therapy
Authors: Tsatsoulis A. , Shalet S. M. 
Published: March 2008

Summary. objective To determine if cyclical intermediate dose steroid therapy could Improve semen parameters In an Infertile man with sperm autolmmunity associated with the polyglandular autolmmune (PGA) syndrome.design Sperm agglutination studies performed before, during and after three courses of cyclical intermediate dose prednisolone therapy.patient A twenty‐six‐year old man with polyglandular autolmmune syndrome, consisting of Addison's disease, hypoparathyroidism, chronic mucocutaneous candidiasis and alopecia totalis, presented with Infertility. He had normal endocrine testicular function but severe exocrine failure evidenced by a low sperm count (4.5 ± 104/ml), zero motility and universal sperm agglutination.measurements Sperm agglutination tests.results At presentation the gelatin agglutination test (GAT) was strongly positive in serum (1/1204) and seminal plasma (1/64) as was the tray agglutination test (TAT) (1/32). The patient's wife had a regular menstrual cycle with normal luteal phase progesterone levels.Following three courses of cyclical prednisolone (20 mg twice daily on days 1–10 of wife's cycle, and 5 mg on days 11 and 12), sperm quantity and motility Improved consider‐ably (12 ± 106/ml, 40% respectively) and sperm agglutination tests became negative. After a fourth course of therapy the patient's wife became pregnant. Three months post‐treatment sperm motility was very low again and agglutinating activity in serum and seminal plasma increased.conclusions This is the first case of male infertility due to sperm autoimmunity in association with the PGA syndrome type 1. The Immunosuppressive action of cyclical intermediate dose steroid therapy led to a significant quantitative and qualitative Improvement in semen parameters.
Cholesterol fractions and apolipoproteins during endometriosis treatment by a gonadotrophin releasing hormone (GnRH) agonist implant or by danazol
Authors: Lemay André , Brideau Natalie‐Anne , Forest Jean‐Claude , Dodin Sylvie , Maheux Rodolphe 
Published: March 2008

Summary. objective The evaluation of cholesterol fractions and apoproteins during ovarian suppression by a GnRH agonist implant vs danazol in the treatment of endometriosisdesign A randomized study in 33 patients comparing goserelin (3.6 mg/4 weeks s.c., n= 20) with danazol (2 ± 400 mg/day p.o., n= 13) in patients with a laparoscopic diagnosis of endometriosis and treated for 6 months.measurementsTriglycerides, cholesterol (C), LDL‐C, HDL‐C subtractions and apoproteins A‐1 and B were measured at admission, at months 2, 4 and 6 of treatment and at month 2 post‐treatment.results After 1 month of therapy, serum oestradiol levels were maintained in the menopausal range with goserelin and in the early follicular phase range with danazol. Goserelin induced a significant elevation in HDL‐C (by 31.4%), in HDL2‐C (24.6%) and in HDL3‐C (45.7%) but no significant change in LDL‐C or in ApoA‐1 and ApoB. By contrast, danazol caused significant diminutions in HDL‐C (23.9%), HDL,‐C (56.6%) and ApoA‐1 (35.6%). Moreover, danazol increased LDL‐C (10.5%) and ApoB (29.0%, P < 0.05). The lipoprotein changes during goserelin had a favourable effect on the atherogenic index (cholesterol/HDL‐C) and ApoA‐1/ApoB ratio whereas those of danazol had opposite effects. These changes reverted 2 months after danazol while HDL was still elevated after goserelin.conclusions In relation to cholesterol, goserelin is a safe medication. The significance of temporary adverse changes in cholesterol fractions due to danazol Is still unknown.
The secretory granule peptides 7B2 and CCB are sensitive biochemical markers of neuro‐endocrine bronchial tumours in man
Authors: Vieau D. , Rojas‐Miranda' A. , Verley' J. M. , Lenne F. , Bertagna And X. 
Published: March 2008

Summary. Objective Bronchial tumours are the most frequent cause of the ectopic ACTH syndrome. Two types of tumours are classically responsible: the relatively benign carcinoids and the highly aggressive small cell carcinomas. Both have neuro‐endocrine features and are thought to originate from the endocrine component of the bronchial tree. Our objective was to assess the sensitivity of 7B2 and secretogranin 1 as new biochemical markers of neuro‐endocrine differentiation in these tumours In comparison with gastrin releasing peptide.Methods Tissue concentration of 7B2, secretogranin 1 fragments (GAWK and CCB), gastrin releasing peptide and 8‐endorphin were measured in normal human lung (n=4), bronchial carcinoid tumours with (n=5) and with‐out (n=15) the ectopic ACTH syndrome, small cell carcinomas (n=2), squamous cell carcinomas (n=11) and adenocarcinomas (n=6). Molecular weight forms of Immunoreactive ‐ACTH, ‐GAWK, ‐gastrin releasing peptide, and ‐7B2 were also examined using gel exclusion chromatography and Western blot analysis.Results We detected 7B2 immunoreactivity in 19 of 22 neuro‐endocrine lung tumours (with values ranging from <5 to 555 fmol/mg wet weight tissue), CCB immunoreactivity in 20 of 22 tumours with neuro‐endocrine features (with values ranging from <5 to 19 875 fmol mg wet weight tissue) and gastrin releasing peptide immunoreactivity In 10 of 22 neuro‐endocrine lung tumors (with values ranging from <5 to 11132 fmol/mg wet weight tissue). Immunoreactive 7B2 and CCB were detected neither In tumours with non‐endocrine features, nor in the four normal lung specimens. Differing molecular weight forms of Immuno‐reactive 7B2 in two bronchial carcinoids associated with the ectopic ACTH syndrome showed a predominant signal corresponding to a molecular weight of 22 kDa; in addition, a second signal of 19 kDa was also present. The differing molecular weight forms of Immunoreactive ACTH related peptides In the five tumours responsible for the ectopic ACTH syndrome showed, in addition to ACTH1‐35, the constant presence In variable proportions of corticotrophin‐like Intermediary lobe peptide (or ACTH15‐39). The differing molecular weight forms of Immunoreactive GAWK showed heterogeneous results with materials eluting at Kav of 0, 0.3 and 0.4 respectively. In the three bronchial carcinoids studied, two immunoreactive gastrin releasing peptide molecular weight forms were always found at Kav of 0.5 and 0.85 corresponding to gastrin releasing peptide and its fragment 14‐27 respectively.Conclusion Our results show that 7B2 and the two fragments of secretogranin 1 (GAWK and CCB) are the best biochemical markers of neuro‐endocrine differentiation in human lung tumours.
Inhibin and age in men
Authors: MacNaughton Judith A. , Bangah' Mohan L. , McCloudt Philip I. , Burger Henry G. 
Published: March 2008

Summary. objective Normal elderly men are reported to have decreased testicular function despite elevated gonadotrophin levels. We wished therefore to determine If changes in testicular function occur over the age range 19–80 years.design Single fasting blood samples were obtained between 0800 and 0900 h.patients Working men In a large Industrial company between the ages of 19 and 60 years participated in the study.measurements fsh,serum immunoreactive Inhibin and total testosterone were measured, the latter two as measurements of Sertoll and Leydig cell function respectively.resultsThe mean baseline serum Immunoreactive inhibin level was significantly lower in men from the older age groups, 31–40 years (479 U/I), 41–50 years (439 U/I) and 51–60 years (415 U/I) than in men from the youngest age group, 21–30 years (613 U/I) while serum FSH was higher in men from the older age groups, 41–50 years (3.7 IU/I) and 51–60 years (6.1 IU/I) than In men from the youngest age group, 21–30 years (2.6 IU/I). There appears to be a change in both FSH and inhibin production, consistent with a primary decline In testicular function.There was no significant difference in testosterone levels between the older age group, age 51–60 years and the younger age group, age 21–30 years. However, testosterone levels were significantly lower in the 41–50 year age group, when compared with the 21–30 year, this significance levelling out at about age 45 years.conclusionThe data are consistent with the hypothesis that Immunoreactive inhibin reflects Inhibin bioactivity, and that inhibin plays a role in the feedback control of FSH secretion in men.
Levels of GH binding activity, IGFBP‐1, insulin, blood glucose and cortisol in intensive care patients
Authors: Ross Richard J. M. , Miell John P. , Holly Jeff M. P. , Maheshwari Hlralal , Norman Mike , Abdulla A. Farhana , Buchanan Charles R. 
Published: March 2008

Summary. objective To Investigate levels of serum GH binding activity, Insulin‐like growth factor binding protein‐1 (IGFBP‐1), blood glucose, serum insulin, and cortisol in patients on the Intensive Therapy Unit.design Case‐control study of severely Ill patients admitted to the Intensive Therapy Unit.patients Six critically ill patients (51–78 years) who required ventilatory and nutritional support and six healthy age, sex, height and weight matched controls.measurements Patients and controls were studied for two 24‐hour periods; the patients before and after commencing parenteral nutrition, the controls whilst fasted and on a second occasion when fed a diet equal In protein and calories to that of the patients' parenteral nutrition. Samples were taken hourly for measurement of IGFBP‐1, blood glucose, serum Insulin and cortisol. Growth hormone binding activity was measured at 0 hours.results Blood glucose levels were higher in the patients than controls in both the fasted (mean SEM 5.1 ±0.5 vs 3.8± 0.2 mmol/1, p= 0.04) and fed states (10.1 ± 1.6 vs 5.0±0.1 mmol/1, p= 0.02) and patients' insulin levels were also higher when fed (81.5±31.6 vs 24.2±4.8 mU/1, p=0.046) although there were no significant differences between patients and controls when fasted. IGFBP‐1 levels were Inversely related to insulin levels in both the patients and controls; mean IGFBP‐1 concentrations were higher In fasted patients than In controls (123.38 vs 52.9, p=0.046) but when fed, both groups had similar mean levels. Serum GH binding activity was low in the patients and did not change with feeding. Mean 24‐hour cortisol levels were higher in the patients than In controls, whether fasted or fed, and showed no nyctohemeral rhythm.conclusions We have previously reported that critically patients have low levels of 1GF‐1 with augmented basal levels of GH. The present results demonstrate that these changes in the GH–IGF‐1 axis are associated with insulin resistance with respect to blood glucose and high levels of IGFBP–1 when patients are fasted. However, when fed, the Inverse relationship of IGFBP–1 to insulin is preserved. Patients have low levels of GH binding activity and Increased mean cortisol levels. Interventional studies in this patient group with GH and IGF‐1 must take account of these changes in binding protein and cortisol levels.
β‐Endorphin and adrenocortical function in obesity
Authors: Zelissen P. M. J. , Koppeschaar H. P. F. , Erkelens D. W. , Thijssen J. H. H. 
Published: March 2008

Summary. objective To test the hypothesis that the hyperendorphinaemia In obesity originates from outside the pituitary.design Intravenous administration of corticotrophin‐releasing hormone (CRH) after overnight suppression with 2 mg of dexamethasone in normal‐weight controls and in obese subjects before and after weight reduction.patients Eleven obese females, age (mean±SEM) 30.21 years, body mass index (BMI) 41.2±1.9 kg/m2. Eight normal‐weight females served as controls, age 26.2.1 years, BMI 21.4±0.5 kg/m2. Five obese subjects were also studied after weight loss of 18.4±1.0% of original weight.measurements Plasma β‐endorphin, ACTH and cortlsol. Cortisol production rate In 24‐hour urine. Basal (without dexamethasone suppression) plasma β‐endorphin levels.results Basal (without dexamethasone suppression) β‐endorphin levels were 7.7±0.8 pmol/1 In the obese and 3.8±0.5 pmol/1 in the control subjects (p<0.005). The degree of suppression of β‐endorphin after dexamethasone was similar in the obese (23.2±3.7%) and In the control subjects (28.2 ±012%). Administration of CRH following dexamethasone suppression resulted in a small but significant increase of plasma β‐endorphin In both obese (from 1.55.0.12 to 2.32±0.28 pmol/1) and control subjects (from 0.98 ± 0.24 to 1.69± 0.33 pmol/1). The groups did not differ regarding this response, nor regarding the release of ACTH and cortisol after CRH. Cortisol production rate was higher (p<0.001) In the obese (68.7±3.3 μmol/24 h) than In the controls (40.0± 3.0 μmol/ 24 h). No correlation between cortisol production rate and basal β‐endorphin levels was found. Weight loss appeared to have no influence on cortisol production rate, basal β‐endorphin levels, or on the responses to dexamethasone or CRH.conclusions Plasma β‐endorphin in obese subjects can be affected by manipulations of the hypothalamicpituitary‐adrenocorticai axis; the hypothesis that the hyperendorphinaemia of obesity originates from outside the pituitary cannot be confirmed.
The effect of subcutaneous injection site on absorption of human growth hormone: abdomen versus thigh
Authors: Beshyah Salem A. , Anyaoku Victor , Niththyananthan Rathnam , Sharp Patrick , Johnston Desmond G. 
Published: March 2008

Summary.objectivesTo investigate whether growth hormone (GH) absorption is site dependent.design and measurementsHuman growth hormone (hGH, Norditropin) 4 IU, was injected subcutaneously on two separate occasions: into the thigh on one occasion and into the abdomen on a second occasion. Blood was sampled for GH, insulin, glucose, non‐esterified fatty acids and glycerol at baseline and hourly for 12 hours. Serum insulin‐like growth factor I was measured at baseline, and after 12 and 24 hours.subjectsEleven healthy young adults (8 M, 3 F).resultsFollowing the injection serum GH had risen by 1 hour and peaked by 3–6 hours. The peak GH and growth hormone area under the curve were significantly higher after injection in the abdomen compared with the thigh (GH peak (mean±SEM) 103.20 vs 41 .8 mU/l,P= 0.002 and GH area 528.88 vs 239.34 mU/l h,P= 0.003 respectively). Serum insulin‐like growth factor I at 12 and at 24 hours showed a significant rise from the baseline level, but no significant difference was observed between the two injection sites. No significant difference in plasma insulin, glucose, non‐esterified fatty acids or glycerol was observed between the two methods of injection.conclusionSubcutaneously injected GH is better absorbed from the abdominal site than from the thigh.
Rapid preoperative preparation in hyperthyroidism
Authors: Baeza A. , Aguayo J. , Barria M. , Pineda G. 
Published: March 2008

Summary. objective We have evaluated an alternative method of preparation of hyperthyroid patients for surgery, using betamethasone, lopanoic acid and propranolol.design Betamethasone (0.5 mg every 6 hours), lopanoic acid (500 mg every 6 hours) and propranolol (40 mg every 8 hours) were given orally for 5 days; thyroidectomy was performed on the 6th day. We analysed patient acceptability, clinical and hormonal effects, ease of surgery and final outcome.patients Thirteen females and 1 male, aged 16–59 years, ten with diffuse goitre and four with nodular goitre were submitted to subtotal thyroidectomy because antithyrold drugs had failed to control thyrotoxicosis or because hyperthyroidism coexisted with other conditions (pregnancy, hypertensive disease).measurementsDaily clinical assessments were made together with T3, T4 and rT3 serum concentrations before and while on drug treatment, during the surgical procedure and post‐operatively.results Daily assessment showed progressive clinical improvement so that on day 5 the patients were considered clinically euthyroid. Serum levels of T3 (mean ± SD) showed significant decrease (by 38.2±24.9%, P < 0.01) as early as 24 hours after medication was started, reaching almost euthyroid levels on day 3; on the day of operation T3 had diminished by 64.5±16.6% (P < 0.0001). Serum T4 concentration showed a slight but significant decrement only from day 4 on and never reached euthyrold levels. Serum rT3 values exhibited a brisk Increment at 24 hours (+ 333.194%, P < 0.0001) and remained elevated between 8 and 10 nmol/l until medication was stopped. Drug tolerance was considered as excellent since no serious side‐effects were noted, even in pregnant patients. There were no anaesthetic incidents or post‐operative complications and patients were discharged 48–72 hours after operation. The final outcome has been satisfactory and pregnant patients continued their pregnancies without Incident, bearing normal children.conclusions Pharmacological combination of betamethasone, lopanoic acid and propranolol has proved to be safe and effective and is of low cost. Provided there Is adequate supervision of the patients, it may be used in patients requiring urgent thyroidectomy or In those who for reasons of non‐compliance need a short preoperative regime.
The relation between pharmacokinetics and endocrine effects of buserelin implants in patients with mastalgia
Authors: Klijn Jan G. M. , van Geel Bert , de Jong Frank H. , Sandow Jurgen , Krauss Birgit 
Published: March 2008

SummarySix patients with mastalgia were treated with polylactide/ glycolide SO: 50 implants containing 6 6 mg buserelin once every 4 weeks, to study the relationship between buserelin pharmacokinetics and suppression of pituitary‐ovarian function. On the first treatment day there was an initial rise in plasma and urinary buserelin levels followed by a rapid fall during the next 2 days. After a plateau phase (60–80 μg/g creatinine) urinary buserelin/creatinine ratios decreased slowly to a mean value of 25 μg/g creatinine 4 weeks after Implantation. Plasma oestradiol concentrations dropped to castrate values within 2 weeks of treatment reaching a mean concentration of 17 pmol/l compared to 27 pmol/l (P<0.01) determined In 680 postmenopausal control women. After the last implant injection urinary buserelin/creatinine ratios remained relatively high (> 5 μg/g creatinine) during more than 8 weeks followed by an exponential decrease (half‐life of buserelin release: 15 days) to undetectable buserelin levels at 16–22 weeks after the last implantation. A rise of suppressed plasma oestradiol concentrations to above castrate levels was found 15–20 weeks after the last buserelin Implantation, at a time when urinary buserelin excretion had decreased below 0.2 μg/g creatinine. It Is concluded that after initial suppression of pituitary‐ovarian function only very low concentrations of buserelin are needed to maintain suppression of ovarian activity by using slow release preparations.
A cluster of male pseudohermaphrodites with 5α‐reductase deficiency in Papua New Guinea
Authors: Imperato‐McGinley J. , Miller M. , Wilson J. D. , Peterson R. E. , Shackleton C. , Gajdusek D. C. 
Published: March 2008

SummaryWe report a cluster of male pseudohermaphrodites from the Simbari Anga linguistic group in the Eastern Highlands of Papua New Guinea. These subjects are born with a rudimentary clitoral‐like penis and pseudovaginal perineoscrotal hypospadias. At puberty, the penis enlarges with concurrent growth of pubic and axillary hair and significant muscular development. There is significant facial hair, but it is less than that of their normal male siblings or other male relatives. Plasma collected from four adult subjects revealed elevated plasma testosterone levels, low to low normal dihydrotestosterone levels, and elevated testosterone/dihydrotestosterone ratios. All subjects had high urinary aetiocholanolone/androsterone ratios, and C12 and C21 5β/5α metabolite ratios. Decreased 5ot‐reductase activity was demonstrated in fibroblasts cultured from genital skin. The data indicate a phenotypic and biochemical profile similar to patients studied in the Dominican Republic, except tor a greater abundance of facial and body hair. The phenotypic variability, as pertains to facial and body hair, may be related to differences in familial expression, as well as the degree of enzyme deficiency. Infants, thought to be females at birth, were reared as girls until puberty in a society practising one of the strictest gender segregations known. At puberty, these ‘girls’ were discovered to be boys, and a switch of gender roles was instituted. Recently, however, some Muniri, Dunkwi and northern Simbari hamlets recognize these individuals as male in infancy and rear them as boys, calling them ‘kwalatmala’ to distinguish them from normal males, accepting them as an intersex destined to occupy male adult roles.
The effects on anterior pituitary hormone secretion of salmon calcitonin in healthy volunteers
Authors: Trainer P. J. , Kirk J. M. W. , McLoughlln L. , Touzel R. J. , Perry L. , Rees L. H. , Besser G. M. 
Published: March 2008

SummaryThe reports of the effect of calcitonin on pituitary function are confusing and often refer to uncontrolled studies. We have now carried out a double‐blind placebo‐controlled trial of Intravenous and subcutaneous salmon calcitonin on anterior pituitary function in 17 healthy volunteers. Visual analogue scores for the nausea and vomiting seen after salmon calcitonin correlated with the rise in ACTH and, secondarily, Cortisol. Calcitonin had no effect on growth hormone, prolactin, thyrotrophin, luteinizing hormone or follicle stimulating hormone. It is concluded that the stimulation of ACTH secretion following a single dose of salmon calcitonin Is probably the result of the stress of nausea rather than a direct effect on the pituitary.