bluuebunny/crossref_metadata_2025_split huggingface dataset:
Growth hormone and lean tissue catabolism during long‐term glucocorticoid treatment
Authors: Bennet William M. , Haymond Morey W. 
Published: March 2008

SUMMARY objectives The aim of the study was to determine whether growth hormone (GH) treatment decreased net protein catabolism of lean tissues in patients receiving chronic glucocorticoid treatment design Whole body leuclne kinetics were measured In post‐absorptive conditions using a 1‐14C‐leucine infusion before and during GH administration (0·0125 mg/kg/day; 0·033 U/kg/day) for 7 days. patients We studied four patients (age range 31–71 years) who had taken prednisone (mean ± SEM 0·21·0±03 mg/kg/day, total dose 10–27·5 mg/day) for longer than 5 months for various lung diseases results During GH treatment leucine oxidation decreased (baseline 0·44·0±07 vs GH 0·37·0±05 μ mol/kg lean body mass/min, P= 0·01) and non‐oxidative leuclne disposal increased (1·95·0±10 vs 2·05·0±09 μ mol/kg lean body mass/min, P= 0·02) but leuclne appearance was unaltered. conclusions We conclude that GH decreased amino acid catabolism and improved protein synthesis without altering protein breakdown in patients receiving chronic glucocorticoid treatment. There may be a role for GH in mitigating the protein catabolic side‐effects of prolonged glucocorticoid treatment
Rate of change (modulation) of serum growth hormone concentrations is a more important factor in determining growth rate than duration of exposure
Authors: Hlndmarsh P. C. , Matthews D. R. , Stratton I. , Prfngle P. J. , Brook C. G. D. 
Published: March 2008

SUMMARY objective To determine whether duration of exposure to GH and/or rate of change of serum GH concentration are Important factors In determining the growth rate of short children design An analysis of parameters of occupancy percentage and rate of change of serum GH concentration was performed as part of a prospective study Investigating the relationship between growth and GH In childhood patients Sixty‐four short prepubertal children (48 male, 16 female) aged between 4·7 and 11·9 years were studied. Thirty‐one children were growing with a height velocity standard deviation score between 0 and – 0·8 and were defined as short normal. Thirty‐three children were growing with a height velocity standard deviation score less than – 0·8 and were defined as short slowly growing measurements Twenty‐four hour serum GH concentration profiles were constructed by withdrawing samples at 20‐minute intervals. Analysis of occupancy percentage was performed on each data array by determining cumulative distributions and plotting these as linear problts against log serum GH concentration. Estimates of peak (OC45), Intermediate (OC50) and trough (OC5) occupancies were calculated. A first‐order derivative of the concentration‐time data array was determined for each profile as a measure of rate changes. results First‐order derivative values were significantly greater In the short normal group than In the short slowly growing children (short normal median 1·41 mU/l/min; short slowly growing median 0·72 mU/l/min; P > 0·001). OC56 values were significantly higher in the short normal group (median 19·31 mU/l) than the short slowly growing group (median 7·69 mU/l) (P > 0·001). There was no difference In OC50 values. OC5 values were lower In short normal children (median 0·20 mU/l) than in the short slowly growing children (0·55 mU/l) (P > 0·003).The most Important factor In determining growth rate was the rate of change In serum GH concentration (FOD). Occupancy percentage played no part In the relationship. The regression equation wasHeight velocity SDS =1·16 (In FOD) – 1·03; r= 0·75; P > 0·001 conclusions These data suggest that the pattern of presentation of GH In the circulation Is an Important factor in determining target organ response. Although occupancy percentages at differing serum GH concentrations differ between short slowly growing and short normal children, it Is the rate of change of the hormone in the circulation which appears to be the more Important ‘signal’ In terms of modulating growth
Long‐term treatment with the dopamine agonist CV 205–502 of patients with a clinically non‐functioning, gonadotroph, or α‐subunit secreting pituitary adenoma
Authors: Kwekkeboom D. J. , Lamberts S. W. J. 
Published: March 2008

SUMMARY objective We aimed to assess the effects of prolonged treatment with the dopamine agonist CV 205–502 on tumour volume, visual field defects, and serum gonadotrophin and α‐subunit concentrations in patients with gonadotroph, α‐subunit secreting, or clinically non‐functioning pituitary adenomas. design The patients were treated with CV 205–502 in a final daily dose of 300 μ g for at least 1 year. The patients were seen at 2 or 3‐week intervals during the first 3 months of treatment, and thereafter every 1 or 2 months. Computerized tomography and Goldmann perimetry were performed before treatment and during follow‐up. Blood samples were drawn before treatment and at each out‐patient visit. patients One patient with gonadotroph, two with α‐subunit secreting, and two with clinically non‐functioning pituitary adenomas were studied. results Computerized tomography showed tumour shrinkage in one patient. In two other patients an improvement of visual field defects was observed. In four patients, a significant decrease in serum FSH and/or α‐subunit concentrations occurred within the first 3 months of treatment. In the remaining patient, a significant decrease of serum FSH and α‐subunit concentrations was found after more than 3 months of treatment. conclusions In patients with clinically non‐functioning, gonadotroph, or α‐subunit secreting pituitary tumours, long‐term treatment with the dopamine agonist CV 205–502 decreases serum FSH and/or α‐subunit concentrations. This decreased secretory activity from the pituitary tumour may be accompanied by an improvement of visual field defects, or tumour shrinkage on computerized tomography. Therefore, treatment with CV 205–502 may be useful in patients with clinically non‐functioning, gonadotroph, or α‐subunit secreting pituitary tumours, who cannot be operated upon.
The tubular maximum for calcium reabsorption: a normal range in children
Authors: Shaw N. J. , Wheeldon J. , Brocklebank J. T. 
Published: March 2008

SUMMARY objective We aimed to establish a normal range for the tubular maximum rate of reabsorption of calcium corrected for glomerular filtration rate design A prospective survey was used patients One hundred and ten normal children aged 2–14 years were studied measurements Total plasma calcium, ultrafiltrable calcium and parathyroid hormone. Urinary calcium, sodium and creatlnlne excretion results The normal range was found to be 1·87–3·39 mmol/l of glomerular filtrate with a geometric mean value of 2·40 mmol/l. There was a significant Inverse relationship between the tubular maximum for calcium and the urinary sodium excretion. No significant relationship was found between the tubular maximum for calcium and the level of parathyroid hormone In this group of normal children conclusions The normal range seen In children is higher than that seen in adults with a higher mean value. This normal range should be useful in the assessment of renal calcium handling In children with disorders of calcium homeostasls
Lack of linear relationship between hyperinsulinaemia and hyperandrogenism
Authors: Toscano V. , Bianchi P. , Balducci R. , Guglielmi R. , Mangiantlnl A. , Lubrano C. , Sclarra F. 
Published: March 2008

SUMMARY objective Because of continued debate about the role of Insulin in the development of hirsutism and in the induction of the polycystic ovary syndrome, we have evaluated the hormonal pattern in a group of hirsute patients patients Fifty‐four hirsute patients (age range 18–39 years) of whom 26 patients were obese (O) (BMI 28–53 kg/m2 and W/H < 0·85), 12 with ultrasonographic evidence of polycystic ovaries (O PCO) and 14 with normal ovaries. Twenty‐eight patients were within normal weight range, and, of these, 14 presented ultrasonographic evidence of polycystic ovaries and 14 had normal ovaries. Two groups of age‐matched subjects (obese and normal weight), normally menstruating, without hirsutism or history of endocrinopathies or ultrasonographic evidence of polycystic ovaries, served as controls. measurements Androstenedione and testosterone were evaluated in all patients by RIA, following ether extraction, DHEAS, LH, FSH and insulin were evaluated directly by RIA. SHBG was evaluated by the concanavalin method. Free testosterone (FT%) was calculated according to the formula FT = 4·038–1·607 log SHBG. integrated areas under the response curve were calculated for LH and insulin respectively following i.v. administration of GnRH (100 μ g) or oral administration of glucose (75 g). results Results (mean ± standard deviation) showed comparable values of androstenedione in all groups of obese patients and in obese controls (7·3 ± 2·6 in patients with polycystic ovaries, 7·1 ± 2·9 in non‐polycystic ovary patients and 7·4 ± 2·6 nmol/l in obese controls, respectively), regardless of baseline and area insulin, the presence or absence of polycystic ovaries, or hirsutlsm. SHBG levels showed a similar pattern (24 ± 10, 23·8 ± 7·9 and 36 ± 19 nmol/l) as did the percentage of free testosterone, regardless of the presence or absence of hirsutism. Regression analysis of the insulin and LH values (baseline and area) against the androgens and SHBG plasma levels showed that only LH area correlated positively with testosterone (r= 0·36, P > 0·03), androstenedione (r= 0·44, P > 0·02), % free testosterone (r= 0·53, P > 0·001), testosterone/SHBG ratio (r= 0·39, P > 0·03) and inversely with SHBG (r=– 0·57, P > 0·001). conclusions These results showed (1) no linear relationship between high levels of insulin, ovarian androgen production or free hormone availability, and (2) make it very doubtful that insulin plays a primary role in polycystic ovarian syndrome or hirsutlsm
Normal bone mineral density following cure of Cushing's syndrome
Authors: Manning Patrick J. , Evans Margaret C. , Reid Ian R. 
Published: March 2008

SUMMARY objective Both endogenous and exogenous glucocorti‐cold excess are well established as causes of osteoporosis. However, there are few data describing bone mineral density in these subjects following the restoration of normal steroid levels. The present study addresses this issue design A cross‐sectional assessment of bone mineral density in patients cured of Cushing's syndrome, and comparison of each with four normal subjects matched by age, sex, weight, menopausal status and race, was used patients Seventeen adults cured of Cushing's syndrome 8·6±1·6 years (mean ± SEM) took part measurements The bone mineral density of the lumbar spine and proximal femur was measured by dual energy X‐ray absorptiometry results Bone mineral densities, relative to control, were 100·16, 98·14, 97·19 and 98·16% (mean ± SD), in the lumbar spine, femoral neck, Ward's triangle and trochanteric regions, respectively. There was a positive relationship between bone density and time since cure (r= 0·24–0·59, in the four regions). In contrast, bone density was significantly reduced in five subjects with active Cushing's disease when similarly matched (BMD = 87·4, 83·4, 75·6 and 82·6%, in the respective regions; 0·01 > P > 0·05). conclusions Bone density is reduced in subjects with Cushing's syndrome but not in those having undergone cure some years previously. This Implies that steroid‐induced osteoporosis is substantially reversible, though long‐term prospective studies will be necessary to estab‐lish this definitively
The effects of the specific serotonin antagonist ICI 169, 369 on the pituitary hormone response to insulin‐induced hypoglycaemia in humans
Authors: Thompson C. J. , Jones I. R. , Walker M. , Baylis P. H. , Kendall‐Taylor P. 
Published: March 2008

SUMMARY objective To examine the role of serotonin in pitultary hormone release by studying the effect of a specific 5HT2 receptor antagonist, ICI 169,369, on the ACTH, prolactin, growth hormone and AVP response to insulin‐Induced hypoglycaemia in healthy humans. design A double‐blind, within‐subject trial using a cross‐over design to compare the effect of placebo with two doses of ICI 169,369 on pituitary hormone responses to insulin‐induced hypoglycaemia patients Ten healthy subjects were studied In the low‐dose (30 mg × 2) limb and 11 healthy volunteers in the high‐dose (80 mg × 2) limb measurements Plasma concentrations of prolactin, growth hormone, ACTH, cortisol and AVP, and blood glucose results In the low‐dose study, pretreatment with 30 mg ICI 169,369, 10 and 2 hours before the study, had no effect on the fall in blood glucose or the rise in plasma ACTH, prolactin, growth hormone, AVP or plasma cortisol following insulin injection, when compared with placebo. In the high‐dose study the effect of a higher dose (80 mg) of ICI 169,369 on the pituitary hormone response to hypoglycaemia was compared with that of placebo. Although the fall in blood glucose was similar following drug (4·3±0·1 to 1·5±0·5 mmol/l, mean ± SEM, P > 0·001) and placebo (4·3±0·1 to 1·4±0·4 mmol/l, P > 0·001), the rise in plasma AVP was lower (P > 0·05) following pretreatment with drug (0·5±0·2 to 2·1±0·6 pmol/l, P > 0·05) than with placebo (0·7±0·2 to 3·4±0·9 pmol/l, P > 0·01). conclusions The ACTH, prolactin, growth hormone and cortisol responses were unaffected by ICI 169,369. The data are compatible with an Inhibitory effect of the serotonin antagonist ICI 169,369 on the AVP, but not the ACTH, proiactin or growth hormons to insulln‐induced hypoglycasmia in humans
Half‐life of exogenous growth hormone following suppression of endogenous growth hormone secretion with somatostatin in type I (insulin‐dependent) diabetes mellitus
Authors: Mullis Primus E. , Rani Pal B. , Matthews David R. , Hindmarsh Peter C. , Phillips Paula E. , Dunger David B. 
Published: March 2008

SUMMARY objective To estimate the half‐life of growth hormone In young adult patients with type I (insulin‐dependent) diabetes mellitus following bolus injection and prolonged exposure for the purpose of deconvolution analysis of plasma growth hormone profiles to determine growth hormone secretory rates design In the bolus study, an intravenous bolus injection of 100 mU of biosynthetic human growth hormone was given while endogenous growth hormone was suppressed by a continuous Infusion of somatostatin under three different glucose clamp conditions: normoglycae‐mla (5 mmol/l) with normoinsulinaemla (65 pmol/l); hyperglycaemia (12 mmol/l) with normofnsulinaemia; and normoglycaemia with hyperlnsullnaemia (360 pmol/l). In the infusion study, the effect of prolonged and repeated growth hormone exposure upon the growth hormone half‐life was estimated. Three pulses of 60 minutes growth hormone infusion (6 mU/kg/pulse) two hours apart under euglycaemic somatostatin suppression were applied. PATIENTS Six young adult patients with type I (insulin‐dependent) diabetes mellitus were studied in both the bolus and the infusion study results Mean GH half‐lives by mono‐exponential analysis were not significantly different remaining unaltered by the short‐term metabolic changes of hyperglycaemia and hyperinsullnaemla. Data were therefore pooled yielding an overall mean GH half‐life of 13·6 minutes (range 11·9–19·4). Applying a bl‐exponentlal model mean GH half‐lives were 3·1 minutes (range 2·5–5·9) for the rapid phase of distribution of the hormone and 13·4 minutes (range 9·6–16·9) for the decay of GH from the circulationThe GH half‐life during the infusions studies did not vary with repeated exposure but was Significantly longer (mean half‐life of 25·7 minutes; range 19·4–37·1) than during the bolus studies (P > 0·001). conclusions The half‐life of exogenous r‐hGH is not affected by glucose or insulin concentrations but increases after prolonged GH exposure in young adults with type I (Insulin‐dependent) diabetes mellitus
Cyclical Cushing's syndrome first diagnosed after pituitary surgery: a trap for the unwary
Authors: Atkinson A. B. , McCance O. R. , Kennedy L. , Sheridan B. 
Published: March 2008

SUMMARYThree patients were studied after transsphenoldal microsurgery for Cushing's disease because their symptoms and signs were slow to settle and/or because they had variable endocrine results. All were established as having cyclical Cushing's syndrome, first diagnosed post‐operatively. This may be a much more common finding than previously realized and emphasizes the need for detailed and ongoing endocrlnologlcal Investigation after transsphenoldal surgery for Cushing's disease
IGF binding protein 3 in patients with Laron type dwarfism: effect of exogenous rIGF‐I
Authors: Laron Z. , Klinger B. , Blum W. F. , Silbergeld A. , Ranke M. B. 
Published: March 2008

SUMMARY objective The aim of the study was to investigate the serum levels of IGFBP‐3, the major IGF‐I binding protein, in patients with Laron type dwarfism (LTD) before and after IGF‐I treatment design and patients Eight Laron type dwarfism patients (four children and four adults) were treated for 7 days by one daily s.c. injection of blosynthetic IGF‐I In doses of 120 or 150 μ g/kg/day. measurements Blood was sampled in the fasting state before and 1 and 7 days after the last Injection results It was found that IGF‐I administration significantly reduced plasma hGH levels with recovery after one week of no treatment. Serum IGFBP‐3 was abnormally low (0·70·0±37 mg/l) and decreased significantly further during IGF‐I treatment (to 0·48·0±28 mg/l) (P > 0·065). conclusions The finding that serum IGFBP‐3 is low in Laron type dwarfism, a disease due to molecular defects in the GH receptor, is compatible with the hypothesis that this IGF binding protein is GH‐dependent. On the other hand the decrease during IGF‐I administration and concomitant suppression of GH secretion may denote either that GH activity is not completely blocked in this syndrome or that there are additional mechanisms regulating IGFBP‐3 synthesis
The evaluation of patients with a suspected pituitary microadenoma: computer tomography compared to magnetic resonance imaging
Authors: Johnson Mark R. , Hoare Richard D. , Cox Tim , Dawson John M. , Maccabe Jeffery J. , Huw Llewelyn D. E. , McGregor Alan M. 
Published: March 2008

SUMMARY objectives To perform a prospective study to compare the ability of magnetic resonance Imaging (MRI) and computer assisted tomography (CT) to predict the position of a tumour within the pituitary fossa and to assess the clarity of the image generated by the two modalities in patients with suspected pituitary microadenomas design Nineteen patients were investigated with CT and MRI scans and underwent trans‐sphenoldal exploration of the pituitary fossa. Both scans were assessed blind and independently by three neuroradiologists, A, B, and C; A and B examined the CT scans and B and C the MRI scans. The predicted site was then compared to the size and position of the tumour at surgery patients Twenty‐five patients were recruited and had both CT and MRI scans, 19 subsequently underwent trans‐sphenoldal exploratiom of the pituitary fossa and formed the study population results The Joint opinions of A and B of the CT scans were correct in 10/19, and those of B and C of the MRI scans were correct in 17/19 cases, P= 0·008. Observer agreement was used to assess the clarity of the image. A and B agreed about the site of the tumour on the CT scan in 14 of 19 cases (Kappa statistic 0·556); B and C agreed on the MRI scans in 19/19 cases (Kappa statistic 1), P= 0·025. After the exclusion of five cases found to be macroadenomas at surgery, the joint opinions of A and B of the CT scans were correct in 8/14, and those of B and C of the MRI scans were correct in 12/14 cases, P= 0·133. A and B agreed about the site of the tumour on the CT scan in 12/14 cases (Kappa statistic 0·653), B and C agreed on the MRI scans in 14/14 cases (Kappa statistic 1, no significant difference). conclusions In the assessment of suspected pituitary mlcroadenomas MRI is the imaging technique of choice in view both of its greater diagnostic accuracy and the avoidance of radiation exposure
Growth hormone binding protein in Werner's syndrome
Authors: Hattori Naokl , Hino Megumu , Ikekubo Katsuji , Ishihara Takashi , Moridera Kunisaburo , Kurahachi Hiroyuki 
Published: March 2008

SUMMARY objective GH and growth hormone binding protein in Werner's syndrome were investigated to elucidate their relation to the short stature design The levels of GH binding protein and GH response to insulin‐induced hypoglycaemla were determined. GH binding protein levels and its Scatchard analysis in Werner's syndrome were compared with those in normal subjects patients Three patients with Werner's syndrome (one man aged 45 years and two women aged 39 and 38 years) and 41 normal subjects (18 men and 23 women aged 39·3±5·5 years, mean±SD) were studied measurements GH binding protein levels were determined using an Ultrogel AcA44 minicolumn and GH levels were measured by a highly sensitive enzyme immunoassay results Two out of three patients with Werner's syndrome had GH binding protein levels above the mean + 2SD value in normal subjects. GH secretion was impaired in Werner's syndrome as judged by the low GH response to insulin‐induced hypoglycaemia conclusions Elevated GH binding protein levels may lead to an increase in the bound form of GH, which is probably less bloactive, resulting in growth failure In association with the impaired GH secretion in Werner's syndrome
Failure of somatostatin analogue to control Cushing's syndrome in two cases of ACTH‐producing carcinoid tumours
Authors: Cheung N. W. , Boyages S. C. 
Published: March 2008

SUMMARY objective To determine the effectiveness of somatostatin analogue (octreotide) in controlling hypercortisolism in two patients with ectopic ACTH‐producing carcinoid tumours, and to review the literature design The two patients were treated with octreotide administered by subcutaneous injection, for 5 days with 150 μ g three times daily and for 7 days with 100 μ g three times daily respectively. They were subsequently treated with oral metyrapone 250 mg three times daily. patients Patient 1 had a metastatic carcfnoid tumour but the primary was not identified. Patient 2 had a pulmonary carcinoid. Cushing's syndrome due to ectopic ACTH syndrome was established by demonstration of failure of cortisol suppression by dexamethasone, elevated ACTH levels, and immunoperoxidase staining for ACTH within the tumours measurements Urinary free cortisol (UFC) was measured on consecutive days during treatment with octreotide. Serum cortisol and ACTH levels were taken daily in patient 2, and on days 0 and 3 in patient 1 results Patient 1 had a baseline 24‐hour urinary free cortisol of 5340 nmol/24 h, serum cortisol of 915 nmol/l, and serum ACTH of 163 ng/l (ACTH ng/l X 0·23 = pmol/l). After 3 days of octreotide, serum cortisol was 782 nmol/l and ACTH 164 ng/l. Twenty‐four hour urinary free cortisol was 4136 nmol/24 h after 7 days of treatment. Metyrapone, however, resulted in a rapid fall in urinary free cortisol to 290 nmol/24 h, with marked clinical improvementPatient 2 had a baseline 24‐hour urinary free cortisol of 2520 nmol/24 h, serum cortisol of 747 nmol/l, and ACTH of 103 ng/l. Urinary free cortisol rose to 2970 nmol/24 h on day 6 of treatment with octreotide. Serum cortisol and ACTH levels fell slightly to 611 nmol/l and 70 ng/l respectively. On changing to metyrapone, the urinary free cortisol fell to 821 nmol/24 h in 4 days conclusions Octreotide failed to significantly reduce 24‐hour urinary free cortisol, serum cortisol and ACTH in the two patients reported. We conclude that it should probably not be regarded as primary treatment for control of hypercolisolism in patients with ACTH‐producing carcinolds, but reserved as adjunctive therapy