bluuebunny/crossref_metadata_2025_split huggingface dataset:
ADRENOCORTICOTROPHIN (ACTH) DEFICIENCY UNDETECTED BY STANDARD DYNAMIC TESTS OF THE HYPOTHALAMIC‐PITUITARY‐ADRENAL AXIS
Authors: TSATSOULIS A. , SHALET S. M. , HARRISON J. , RATCLIFFE W. A. , BEARDWELL C. G. , ROBINSON E. L. 
Published: March 2008

SUMMARYSix patients (four females, two males; aged 18–65 years), previously treated by external pituitary irradiation (2000–4000 cGY in 8–15 fractions over 10–20 days) for pituitary tumours, presented with the symptoms of excessive and inappropriate tiredness suggestive of ACTH deficiency, despite a normal peak cortisol response to an insulin tolerance test (four cases) or to a glucagon stimulation test (two cases). These six patients were found to have significantly lower mean 24 h urinary free cortisol levels (100 ± 40 nmol; mean ± SD) compared with the mean value of 31 normal controls (210 ± 70.8 nmol; P<0.01). In addition serum cortisol profiles based on a series of four timed samples between 0900–2300 h were subnormal (mean 130 nmol/l) in comparison with profiles obtained from 12 normal controls (mean 270 nmol/l) (P <0.001). Glucocorticoid replacement therapy promptly abolished their symptoms. These results suggest that a discordance between ACTH secretion under basal circumstances and ACTH response to pharmacological tests may exist in patients with ACTH deficiency. We speculate that defective endogenous corticotrophin‐releasing hormone (CRF) secretion, due to radiation‐induced damage at hypothalamic level, is one cause of this phenomenon.
CHANGES IN SERUM PROLACTIN LEVELS DURING THE FOLLICULAR PHASE AND THE ENDOGENOUS LUTEINIZING HORMONE SURGE OF CYCLES HYPERSTIMULATED WITH FOLLICLE STIMULATING HORMONE
Authors: MESSINIS I. E. , TEMPLETON A. 
Published: March 2008

SUMMARYThe pattern of serum PRL levels during superovulation induction with pulsatile ‘pure’ FSH was investigated in 10 normally ovulating women. They were studied in two consecutive cycles, i.e. an untreated spontaneous and an FSH stimulated cycle. An endogenous LH surge occurred in all 10 spontaneous cycles and in five of the FSH cycles. Midcycle PRL levels were significantly higher in the FSH stimulated than in the spontaneous cycles (P < 0.01). In both groups of cycles, circadian periodicity of serum PRL levels during the LH surge was different from that during the late follicular phase with higher levels at midnight, although in the FSH cycles PRL secretion showed a sustained increase over 24 h. A nadir of PRL levels was found between 0900 h and 1200 h. In contrast, progesterone secretion during the LH surge showed a nocturnal increase with the highest value between 0600 h and 1200 h and the lowest at midnight. In the FSH cycles without an LH surge, PRL levels increased as long as FSH administration was continued and showed a significant positive correlation with the increasing serum oestradiol levels (r= 0.77). We conclude that ovarian hyperstimulation is a potent stimulus of PRL secretion in women. It is suggested that the midcycle endogenous LH surge facilitates the evening PRL secretion, while induction of multiple folliculogenesis amplifies the 24 h pattern of PRL secretion.
HYPERTHYROIDISM AND THYROID CANCER
Authors: EDMONDS C. J. , TELLEZ M. 
Published: March 2008

SUMMARYTen of 502 patients presenting with thyroid cancer were hyperthyroid due to Graves' disease (4 patients), multinodular goitre (3), an autonomous functioning nodule (1) and a large functioning tumour (2). In addition eight patients had a past history of Graves' disease and four of hyperthyroidism associated with multinodular goitre. Mortality in patients with Graves' disease and with multinodular goitre appeared similar to that of other patients of comparable age. Both patients with large functioning tumours died from progressive disease. Concentration 131I by tumour metastases was present in one patient with active Graves' disease who had a high serum concentration of TSH‐receptor binding antibodies, indicating that these antibodies may chronically stimulate tumour function. The potential for 131I concentration by tumour when TSH secretion is suppressed should therefore be determined in patients with Graves' disease and if demonstrable tumour function is present, reflecting stimulation by Graves' immunoglobulins, then elimination of tumour remnants is particularly important.
DEVELOPMENT OF HYPERTHYROIDISM FOLLOWING PRIMARY HYPOTHYROIDISM: A CASE REPORT WITH CHANGES IN THYROID‐RELATED ANTIBODIES
Authors: TAKEDA K. , TAKAMATSU J. , KASAGI K. , SAKANE S. , IKEGAMI Y. , ISOTANI H. , MAJIMA T. , MAJIMA M. , KITAOKA H. , IIDA Y. , IKEKUBO K. , KONISHI J. , MOZAI T. 
Published: March 2008

SUMMARYWe report a 48‐year‐old woman who developed hyperthyroidism following primary hypothyroidism. The serum T4 level was initially low and serum TSH level was high with clinical signs of hypothyroidism. The thyroid gland was not enlarged. Therapy with L‐T4 was started. Three years later she developed hyperthyroidism; serum free T4 increased to 29–1 pmol/l after cessation of L‐T4 therapy. The 123I thyroid uptake was increased with no suppression by exogenous T3. When she was hypothyroid, the activity of thyroid stimulating antibodies (TSAb) in serum measured by cyclic AMP production in cultured porcine thyroid cells were negative at 93.4% (normal < 140%), while thyroid stimulation‐blocking antibodies (TSBAb) determined by inhibition of TSH‐induced cyclic AMP increase were positive at 96.1% (normal < 40%). When hyperthyroidism subsequently occurred, TSBAb became negative (30.%), while TSAb became positive (163.3%). The findings indicate that hypothyroidism due to the potent TSBAb activity is not always persistent, but can be changed when various types of thyroid‐relating antibodies change in the course of the disease.
GROWTH HORMONE DEFICIENCY AND THE MEASUREMENT OF SOMATOMEDIN C/IGF‐I: THE INFLUENCE OF SEXUAL MATURATION
Authors: RAYNER P. H. W. , RUDD B. T. , THOMAS P. H. , WILLIAMS J. W. 
Published: March 2008

SUMMARYFifty‐nine short children 2–19 years, 25 females and 34 males, were studied for clinical and biochemical evidence of growth hormone deficiency (GHD). Group 1 (n= 32), mean height SDS — 3.26 ± 1.5, mean retardation of bone age 2 years, had a mean peak GH of 6.1 ± 3.7 mIU/l during tests of GH release, and were classified as GHD. Group 2 (n= 27), had a mean height SDS of ‐ 2.65 ± 1, mean bone age retardation of 1.7 years and had a mean peak GH during provocation tests of 24.3 ± 11.1 mIU/l and were classified as non‐GHD. Basal IGF‐I concentrations were correlated with height and bone age, for both groups and for GHD children, with pubertal score. Neither peak GH values nor integrated GH concentrations in a provocative test were correlated with IGF‐I values. The minimum IGF‐I concentrations occurred at a bone age of 8 years, the reference point that was taken as the average expected time of maturational change. IGF‐I concentrations rose in five GHD children when their bone age exceeded 8 years and when their free testosterone was greater than 10 pmol/l. Eighty‐nine per cent of the GHD children with a bone age at or below 8 years were identified as GHD from their basal IGF‐I values, but for, all bone ages this fell to 62.5%. Basal IGF‐I values appear to be less discriminatory for identification of GHD as sexual maturity and bone age advance.
THE REGULATION AND INTEGRATION OF THYROID FOLLICULAR DIFFERENTIATION AND FUNCTION
Authors: BIDEY S. P. , TOMLINSON S. 
Published: March 2008

SUMMARYAs in a number of other endocrine tissues in which expression of differentiated function is dependent upon a stable cellular architecture, the control of differentiation of the thyroid follicle requires a coordination between the ultrastructural and morphological responses to a number of endocrine growth factors, which may ultimately involve autocrine or paracrine‐mediated effects within the immediate follicular microenvironment. Through analogy with other cell types, expression of appropriate differentiation characteristics within the thyroid follicle may involve the activation of specific c‐oncogenes within each of the component cells. With the recent development and application of oncogene transfection technology, application of such procedures to the thyroid follicular cell should prove to be a particularly fruitful area for future research within the thyroid gland, leading to elucidation of the mechanisms whereby the cellular responses to growth and tissue‐differentiating factors are mediated. Clearly however, further consideration must also be made of the roles played in maintaining follicular stability by both physical and chemical interactions between the component cells and the immediate extracellular environment. The contributory roles played by basement membrane and cell‐surface components in cellular recognition, together with the physical effects imposed upon the apical surfaces of the follicle by luminal thyroglobulin have already been identified as fundamental factors in this respect. It is also reasily apparent that morphological differentiation of the follicle bears critically upon the chemical characteristics of the microenvironment through the ability of the latter to promote expression of specific apical/basal recognition characteristics of the component cells, and thus maintain the unidirectional polarity upon which the functional capacity of the thyroid follicle is so critically‐dependent.
REVERSIBLE REPRODUCTIVE DYSFUNCTION IN MEN WITH OBSTRUCTIVE SLEEP APNOEA
Authors: SANTAMARIA J. D. , PRIOR J. C. , FLEETHAM J. A. 
Published: March 2008

SUMMARYA central, reversible decrease in male sexual function appears related to some aspect of obstructive sleep apnoea (OSA). Lower serum testosterone (T) levels were documented in 15 men with OSA versus nine snorers (no OSA), (9.18 ± 0.92 vs 11.55 ± 0.90 nmol/l, mean ± SEM), P < 0.05 in a consecutive case series of 24 men referred for diagnostic overnight sleep studies. Gonadotrophins did not differ between the two groups. Although the men with OSA did not differ in body mass index (BMI) or weight from the snorers, they were older (51 ± 3.9 vs 44 ± 3.1 years), P < 0.02. Serum T did not correlate with age, but was correlated with minimum nocturnal arterial oxygen saturation (Min SaO2) (r=0.589), P < 0.02. A prospective controlled trial of uvulopalatopharyngo‐plasty therapy (UPP) for OSA in 12 subsequent subjects showed reproductive improvement which was parallel with improved apnoea at 3 months post‐surgery. T increased (13.31 ± 1.07 to 16.59 ± 0.72 nmol/l), P<0.02, without significant changes in BMI, serum PRL, LH or FSH. All seven of the men who reported decreased sexual interest prior to surgery felt their libido and sexual functioning had returned to normal 3 months following UPP. Some aspect of OSA in men appears to produce a reversible hypothalamic‐pituitary reproductive dysfunction.
ABNORMAL PUBERTAL DEVELOPMENT IN PRIMARY HYPOTHYROIDISM
Authors: PRINGLE P. J. , STANHOPE R. , HINDMARSH P. , BROOK C. G. D. 
Published: March 2008

SUMMARYWe have studied three patients (1M, 2F), age range 10.9 to 15.5 years, who had abnormal sexual maturation secondary to primary hypothyroidism. The boy had inappropriately large testes for his stage of puberty, the girls had isolated breast development and there was absence of pubertal growth acceleration. FSH, LH, TSH and GH secretion, pituitary imaging and ovarian ultrasound morphology were studied before and during thyroxine treatment. In the hypothyroid state, FSH levels were elevated with abnormal pulsatility and LH: FSH concentrations were reversed.
ENDOGENOUS OPIOIDS INHIBIT OXYTOCIN RELEASE DURING NICOTINE‐STIMULATED SECRETION OF VASOPRESSIN IN MAN
Authors: SECKL J. R. , JOHNSON M. , SHAKESPEAR C. , UGHTMAN S. L. 
Published: March 2008

SUMMARYThe effects of the opioid antagonist naloxone on the vasopressin (AVP) and oxytocin (OT) responses to nicotine were studied in male non‐smokers (21–30 years old). Either saline (n= 6) or naloxone (4 mg bolus 4.6 mg/h, n= 6) was infused i.v. during the study. After 60 min infusion the subjects smoked one high‐nicotine content cigarette. Naloxone infusion for 60 min did not alter basal plasma AVP or OT levels. Smoking led to a significant rise in plasma vasopressin in both saline and naloxone‐infused subjects (P < 0.05). There was no significant difference in the plasma AVP response to smoking between the two groups. Saline‐infused subjects did not show any change in plasma OT in response to smoking. Naloxone infusion was associated with a significant rise in OT from 1.3 ± 0.1 pmol/l to 4.3 ± 2.4 pmol/l 5 min after smoking (P < 0.05). We conclude that there is endogenous opioid‐mediated inhibition of OT which prevents its release when AVP is secreted in response to nicotine in man.
A STUDY ON THE FEASIBILITY OF SUPPRESSING OVARIAN ACTIVITY FOLLOWING THE END OF POSTPARTUM AMENORRHOEA BY INCREASING THE FREQUENCY OF SUCKLING
Authors: DIAZ S. , MIRANDA P. , BRANDEIS A. , CARDENAS H. , CROXATTO H. B. 
Published: March 2008

SUMMARYThe aim of the study was to test the effect of increasing the frequency of breastfeeding upon ovarian function following the end of postpartum amenorr‐hoea. Women exclusively breastfeeding (n= 14) who experienced their first postpartum menstruation between the third and fifth month after delivery were randomly allocated to an experimental (n= 7) and a control (n= 7) group and studied during the next two cycles. Women in the experimental group agreed to increase the number of breastfeeding episodes per day throughout the second cycle. Blood samples were drawn twice a week from the first to the third postpartum menstruation for prolactin, oestradiol and progesterone determinations. The number of breastfeeding episodes per day and night and the length of each episode were recorded daily. An average frequency of 11 nursing episodes per 24 h was reported during the first study cycle in both groups. The experimental group increased by 50% the breastfeeding frequency after the second menstruation while the control group kept its spontaneous feeding pattern. The increase of suckling frequency occurred mainly during day hours. The total breastfeeding time per 24 h was not increased. The length of the menstrual cycle was not altered by the increased suckling frequency. The endocrine pattern differed neither between the first and second cycle of the experimental group nor between the experimental and control group, with the exception of PRL levels which were higher in the experimental group throughout both cycles. Twenty cycles (71%) showed progesterone values compatible with ovulation (> 9.5 nmol/l). The highest progesterone values and the highest oestradiol values observed in the ovulatory cycles of lactating women were within the range found in non‐nursing fertile women. Plasma levels of PRL were significantly elevated in all cycles but one, in comparison with PRL levels in non‐nursing women. It is concluded that if cyclic ovarian function is reestablished early in fully nursing women, a mere increase in the number of breastfeeding episodes, without augmenting total suckling time and the frequency of nocturnal episodes, does not provide a sufficient stimulus to re‐suppress the pituitary‐ovarian axis.
LONG‐LASTING LOWERING OF SERUM GROWTH HORMONE AND PROLACTIN LEVELS BY SINGLE AND REPETITIVE CABERGOLINE ADMINISTRATION IN DOPAMINE‐RESPONSIVE ACROMEGALIC PATIENTS
Authors: FERRARI C. , PARACCHI A. , ROMANO C. , GEREVINI G. , BOGHEN M. , BARRECA A. , FORTINI P. , DUBINI A. 
Published: March 2008

SUMMARYCabergoline, the new long‐acting dopaminergic ergoline derivative, was given orally in single doses of 0.3 and 0.6 mg to eight dopamine‐responsive acromegalic patients. Serum GH and PRL levels were determined before treatment, 3,4, and 6 h and 1, 3, 5, 7 and 14 days after treatment. A control test with a single oral dose of 2.5 mg of bromocriptine was also performed. Cabergoline induced a marked fall in seurm PRL level, starting within 3 h and continuing for 7 days after administering 0.3 mg, and for 14 days after 0.6 mg. The mean maximal decrease was 49% after 0.3 mg and 63% after 0.6 mg and occurred after 24 h in both cases. The latter was of similar magnitude to that induced by bromocriptine (67% at 4 h). Serum GH levels did not change after 0.3 mg of cabergoline, but decreased significantly from 3 h to 3 days after 0.6 mg of the compound with a mean maximal decrease of 42% after 24 h, and from 3 to 6 h after giving bromocriptine (mean maximal decrease 63% at 4 h). Once a week repeated administration of 0.3–0.6 mg of cabergoline was carried out in six patients, five of whom had completed the acute study; a normalization of serum GH and insulin‐like growth factor I (IGF‐I) levels occurred iri three patients, one of whom had very high pretreatment values. In three poorly or non‐responsive patients, a better response, as assessed by both GH and IGF‐I levels, was induced by increasing the dose up to 0.6 mg twice or 0.4 mg three times a week; in one case this was associated with marked tumour shrinkage. Sustained normalization of PRL levels was achieved in all cases. These data indicate that a single dose of 0.6 mg of cabergoline inhibits GH as well as PRL secretion in dopamine‐responsive acromegalic patients and suggests that doses of 0.3–0.6
IMMUNOREACTIVE HUMAN CHORIONIC GONADOTROPHIN FROM THE CYST FLUID AND CSF OF PATIENTS WITH CRANIOPHARYNGIOMA
Authors: HARRIS P. E. , PERRY L. , CHARD T. , CHAUDRY L. , COOKE B. A. , TOUZEL R. , COATES P. , LOWE D. G. , AFSHAR F. , WASS J. A. H. , BESSER G. M. 
Published: March 2008

SUMMARYA specific radioimmunoassay for the beta‐chain of human chorionic gonadotropin irHCGβ has demonstrated HCG‐like material to be present in craniopharyngioma cyst fluid in nine consecutive patients with craniopharyngioma. There was no detectable LH/HCG bioactivity as assessed using testosterone production from isolated Leydig cells from rat testis in seven samples tested. One patient was also found to have measureable irHCGβ in the cerebrospinal fluid (CSF), which fell to undetectable levels following surgery; in this patient, there was clinical evidence that the cyst fluid had leaked into the CSF pre‐operatively. Immunocytochemical staining for HCGβ and intact HCG was positive in five of the tumours. irHCGβ was not measurable in the serum of any of the patients.
WEIGHT GAIN AND REPRODUCTIVE FUNCTION: ULTRASONOGRAPHIC AND ENDOCRINE FEATURES IN ANOREXIA NERVOSA
Authors: TREASURE J. L. , WHEELER M. , KING E. A. , GORDON P. A. L. , RUSSELL G. F. M. 
Published: March 2008

SUMMARYPelvic ultrasonographic measurements and reproductive hormone levels in 36 patients with anorexia nervosa were followed as they gained weight during inpatient treatment. In 24 patients who were severely malnourished (69% of premorbid weight) the ovaries were small and amorphous and the levels of LH, FSH and oestfadiol were very low. Weight gain led to the appearance of multifollicular ovaries when levels of LH and oestradiol remained low but FSH levels had increased resulting in an LH: FSH ratio of less than 1. The emergence of a dominant follicle in 19 patients after weight gain (to 97% of premorbid weight) was accompanied by an increase in uterine area and associated with increased levels of LH and oestradiol and an LH: FSH ratio greater than 2. Among these patients with a dominant follicle at peak weight, 11 menstruated within a month of discharge.The weight at which normal ovarian morphology returned was related to premorbid weight (P< 0.002) whereas body mass index (BMI) was poorly related. Our findings suggest that pelvic ultrasonography is probably the best indicator of the weight required for full endocrine recovery and offers advantages over sequential hormonal measurements, and is valuable in the management of patients with anorexia nervosa.
STRESSFUL LIFE EVENTS IN THE PATHOGENESIS OF CUSHING'S SYNDROME
Authors: SONINO N. , FAVA G. A. , GRANDI S. , MANTERO F. , BOSCARO M. 
Published: March 2008

SUMMARYSome clinical observations suggested that stressful life events may play an aetiological role in Cushing's syndrome. However, there are no controlled investigations using standardized methods of life events assessment to substantiate this hypothesis. Events in the year before the first signs of disease onset were investigated in 30 consecutive patients with Cushing's syndrome (26 with a pituitary‐dependent form, three with an adrenal adenoma, and one with an adrenal carcinoma) and 30 control subjects matched for sociodemographic variables by means of Paykel's Interview for Recent Life Events. Patients with Cushing's syndrome reported significantly more stressful life events than a normal control group (P<0001) and had significantly more of the following: exits (P<005), undesirable (P<001) and uncontrolled (P<001) events. M ore events that had an objective negative impact (P<0.001) and more independent events (unlikely to be a consequence of the illness; (P<0001) were also reported. Such ratings were carried out by an independent rater unaware whether the event had occurred in patients or controls.The results are suggestive of a causal relationship between stressful life events and Cushing's syndrome. Such relationship largely pertains to the hypothalamic‐pituitary forms of the illness. This is in agreement with a multifactorial model of pathogenesis in Cushing's disease and with current understanding of the complex interdependence of neurophysiological, biochemical and behavioural factors.
METABOLIC AND HORMONAL RESPONSES TO EXOGENOUS HYPERTHERMIA IN MAN
Authors: MØLLER N. , BECKWITH R. , BUTLER P. C. , CHRISTENSEN N. J. , ØRSKOV H. , ALBERTI K. G. M. M. 
Published: March 2008

SUMMARYTo study whether hyperthermia reproduces hormonal and metabolic responses seen in stress states such as mild infections, six normal male subjects underwent (i) a 3‐h hot bath and (ii) a 3‐h thermoneutral control period. During the hot bath body temperature rose by 1.2 ± 0.03°C (mean ± SEM) and significant peaks of circulating growth hormone (56 ± 9 vs 7 ± 4 mu/l), adrenaline (310 ± 34 vs 152 ± 39 pmol/l), glucagon (19.2 ± 4.3 vs 11.8 ± 2.3 pmol/l) and cortisol were recorded together with slight hyperinsulinaemia (6.5 ± 1.3 vs 5.3 ± 1.0 mU/l, P > 0.05). Hyperthermia was also accompanied by significant increases in circulating levels of free fatty acids (0.93 ± 0.1 vs 0.46 ± 0.1 mmol/l), 3‐hydroxybutyrate (196 ± 67 is 50 ± 18 μmol/l), glycerol (102 ± 10 vs 48 ± 5 μmol/l) and lactate. Blood alanine decreased and blood glucose remained constant. When an intravenous glucose tolerance test was performed during the last hour of hyperthermia signs of impaired first phase and enhanced second phase insulin responses were recorded. Calculated values for glucose disappearance also deteriorated (1.34 ± 0.19 vs 2.04 ± 0.50 %/min, P > 0.05). We conclude that hyperthermia mimics most major metabolic and hormonal changes observed during mild infection and could provide a model to study these conditions.