bluuebunny/crossref_metadata_2025_split huggingface dataset:
PITUITARY SURGERY FOR ENDOCRINE DISORDERS
Authors: NABARRO J. D. N. 
Published: March 2008

SUMMARYThe use of pituitary surgery for patients with over‐production of growth hormone, corticotrophin and prolactin is reviewed. The value of specialized neuroradiological techniques is discussed including computerized tomography, air‐encephalography and cavernous sinus venography. The indications for transcranial as opposed to trans‐sphenoidal surgery are considered.The place of trans‐sphenoid surgery in the treatment of acromegaly is emphasized and the indications for surgical treatment are reviewed.The two syndromes due to over‐production of ACTH are considered—Cushing's disease and Nelson's syndrome. The increasing use of pituitary surgery for the treatment of Cushing's syndrome due to increased ACTH production is noted, but a warning is given about the small ACTH‐secreting pulmonary carcinoid tumour that may closely mimic Cushing's disease. The difficulties encountered in trying to treat patients with Nelson's syndrome are stressed. It is recommended that in the rare case where total adrenalectomy is required in Cushing's disease, pituitary irradiation should be given before or shortly after adrenalectomy.The present position relating to the surgical treatment of the small prolactin‐secreting pituitary tumour is reviewed. Published data and personal experience suggests that for many of these patients, treatment with bromocriptine is preferable to trans‐sphenoidal surgery. Large prolactinomas usually need trans‐frontal surgery and X‐ray therapy, sometimes followed by bromocriptine treatment.The need for steroid cover for pituitary surgery is discussed and it is suggested that a glucocorticoid with less salt‐retaining action than cortisol should be used. The importance of post‐operative endocrine assessment is emphasized and a convenient method suggested. The incidence of complications after trans‐sphenoidal surgery is low, although panhypopituitarism occurred in 14% of the cases reported.
AN IMPROVED METHOD FOR THE DETECTION OF HETEROZYGOSITY OF CONGENITAL VIRILIZING ADRENAL HYPERPLASIA
Authors: LEJEUNE‐LENAIN C. , CANTRAINE F. , DUFRASNES M. , PREVOT F. , WOLTER R. , FRANCKSON J. R. M. 
Published: March 2008

SUMMARYA modified short ACTH test for the detection of heterozygote carriers of 21‐hydroxylase deficiency (21‐OHD) was applied to twenty‐one controls and fourteen parents of children with 21‐OHD. The following modifications were introduced: (1) Endogenous ACTH was suppressed by dexamethasone administration prior to the test, (2) Plasma 17‐hydroxyprogesterone (17‐OHP), cortisol (F), progesterone (P), corticosterone (B) and Δ4‐ androstenedione (A) were measured, (3) Variables studied were the ratio of plasma increments (A) between precursors and end products, (4) Data were analysed by a step‐wise discriminant analysis. Significant alterations in the metabolic pathway of F, B and A were demonstrated. The discriminant analysis showed that the addition of B pathway data did not improve the discrimination potency of the test performed on F pathway data. The combination of variates which provided the best discrimination was the logarithmic sum of Δ 170HP/ΔF at 15 and 30 min. It led to a 94% correct classification for normals and carriers.
LEYDIG CELL DYSFUNCTION AND GYNAECOMASTIA IN ADULT MALES TREATED WITH ALKYLATING AGENTS
Authors: FRIEDMAN N. M. , PLYMATE S. R. 
Published: March 2008

SUMMARYThree adult males presented with gynaecomastia, small testes and clinical features of androgen deficiency after treatment with alkylating agents. Laboratory evaluation revealed elevated serum follicle stimulating hormone and luteinizing hormone. Serum testosterone levels were in the low normal range. Treatment with testosterone oenanthate relieved the symptoms of androgen deficiency in addition to reducing the size and tenderness of the gynaecomastia. It is postulated that in addition to the well documented effects of alkylating agents on the seminiferous tubules, a state of ‘compensated Leydig cell dysfunction’ is induced. The relative decrease in serum testosterone and concomitant lowering of the testosterone to oestrogen ratio may act as a stimulus for breast development. Therefore, treatment with exogenous testosterone would be expected to be effective.
CIRCULATING SOMATOSTATIN AFTER FOOD AND GLUCOSE IN MAN
Authors: WASS J. A. H. , PENMAN ERICA , DRYBURGH JILL R. , TSIOLAKIS D. , GOLDBERG P. L. , DAWSON A.M. , BESSER G. M. , REES LESLEY H. 
Published: March 2008

SUMMARYUsing a recently validated radioimmunoassay, changes in circulating somatostatin have been measured in normal subjects after food (a standard breakfast), and oral and intravenous glucose. After the standard breakfast, a clear and sustained rise in plasma somatostatin was seen in all subjects from a mean value (± 1 SE) of 28 ± 7 pg/ml to a mean peak value, at 60 min of 57 ± 11 pg/ml. When glucose was taken by mouth a significant but smaller rise was seen, but intravenous glucose caused no significant change in plasma somatostatin. A rise in circulating somatostatin after feeding has not previously been demonstrated in normal man and it is suggested that somatostatin may have an important endocrine role in the gut.
CORTISOL, GROWTH HORMONE AND PROLACTIN RESPONSES TO INSULIN‐INDUCED HYPOGLYCAEMIA IN HYPERTHYROID PATIENTS BEFORE AND DURING β‐ADRENOCEPTOR BLOCKADE
Authors: NILSSON O. R. , ANDERBERG B. , KARLBERG B. E. , KAGEDAL B. 
Published: March 2008

SUMMARYTwo β‐adrenoceptor blocking agents, metoprolol (β‐1‐selective) and propranolol (non‐selective), were used in the treatment of hyperthyroid patients. The response of pituitary stress hormones to insulin‐induced hypoglycaemia was investigated before and during β‐adrenoceptor blockade. Treatment with metoprolol (n= 10) or propranolol (n= 10) produced no changes in the cortisol or prolactin responses to hypoglycaemia. Moreover the growth hormone response remained unaltered during treatment with metoprolol. A small, but statistically significant, augmentation of growth hormone response was obtained during treatment with propranolol. When twelve subjects, euthyroid after final conventional treatment (surgery, radioiodine or thyrostatic drugs), were re‐examined, the cortisol and prolactin responses were unchanged, although growth hormone concentrations reached a slightly higher maximum value (P > 0·01). It was concluded that treatment with β‐blocking agents in hyperthyroid subjects has no clinically important influence on the release of pituitary stress hormones during hypoglycaemia.
THE EFFECTS OF ARGININE, INSULIN AND METOCLOPRAMIDE ON GROWTH HORMONE, PROLACTIN AND CORTISOL RELEASE IN CHILDREN
Authors: IJAIYA K. , ROTH B. , SCHWENK A. 
Published: March 2008

SUMMARYThe growth hormone (GH) and prolactin (PRL) responses to metoclopramide (MCP) were compared to those with arginine and insulin‐induced hypoglycaemia in eight children. While a significant rise in GH release after stimulation with arginine and insulin occurred in all subjects (P > 0·05), no significant increase after MCP ingestion was observed. Metoclopramide, a dopamine antagonist, stimulated PRL release in all children, while arginine and insulin‐induced hypoglycaemia stimulation tests showed variable PRL responses. A statistically significant increase in cortisol secretion 5 h following MCP was observed (trend test, Cox & Stuart, 1955) (P > 0·05), but the plasma concentration at this time was still within the normal range. Metoclopramide stimulation is not a suitable test for growth hormone deficiency in children.
CONVERSION OF DEHYDROEPIANDROSTERONE SULPHATE TO OESTROGENS IN INTRAHEPATIC CHOLESTASIS AND OTHER COMPLICATIONS OF PREGNANCY
Authors: YLÖSTALO P. , KAUPPILA A. , REINILÄ M. , TUIMALA R. , YLIKORKALA O. 
Published: March 2008

SUMMARYThe aim of the present study was to determine whether pregnancy complications themselves influence the conversion rate of dehydroepiandrosterone sulphate (DHAS) to oestrogens during pregnancy. 100 mg of DHAS was given intravenously to seven women with intrahepatic cholestasis of pregnancy, nine women with preeclampsia, nine diabetics, ten with twins and eight women with normal pregnancy between 31–40 weeks of gestation. Serum oestradiol (E2) and oestriol (E3) were measured with specific radioimmunoassays before and 1–5 h after DHAS injections. A significant oestradiol elevation following DHAS was similar in each group. By contrast there was an oestriol elevation (P < 0·05) only in intrahepatic cholestasis of pregnancy. The results indicate that: (1) pregnancy complication itself does not affect the conversion rate of DHAS to oestradiol, (2) in patients with intrahepatic cholestasis there is a disturbed E3 metabolism which may be due to an increased placental permeability to exogenous DHAS or to a decreased metabolism of E3 by maternal liver.
ENDOCRINE INFLUENCES ON SERUM ACID‐ETHANOL SOLUBLE NON‐SUPPRESSIBLE INSULIN‐LIKE ACTIVITY (NSILA‐S)
Authors: FRANKLIN R. C. , RENNIE G. C. , BURGER H. G. , CAMERON D. P. 
Published: March 2008

SUMMARYSerum levels of the acid‐ethanol soluble component of non‐suppressible insulin‐like activity (NSILA‐S) have been measured by bioassay in patient with hyperprolactinaemia, hypothyroidism, thyrotoxicosis and diabetes mellitus, and in normal subjects administered prednisone, oestrogens or androgens. Hyperprolactinaemia per se did not influence serum NSILA‐S, however when GH was deficient prolactin hypersecretion may have maintanied serum NSILA‐S. Thyroid hormones, insulin and steroids did not appear to influence serum NSILA‐S. These results suggest that regulation of the serum concentration of NSILA‐S is not a common effector mechanism by which these hormones influence statural growth in man.
INSULIN‐LIKE GROWTH FACTOR AND ITS CARRIER PROTEIN IN HYPOPITUITARY AND HYPOTHYROID CHILDREN AND ADULTS
Authors: DRAZNIN B. , BURSTEIN P. J. , HEINRICH U. E. , JOHNSON CAROLYN B. , EMLER CAROL A. , SCHALCH D. S. 
Published: March 2008

SUMMARYUtilizing radioligand assays for the somatomedin, insulin‐like growth factor (IGF), and its carrier protein (CP), we have compared their serum levels in normal subjects with those in patients with hypopituitarism and hypothyroidism. The mean (±SEM) serum IGF concentration in children (n= 32, 2–13 yr, 929 ± 46 μU/ml) was virtually identical to that in adults (n= 20, 18–50 yr, 916·29 μU/ml), while CP levels in the former (1·8 ± 0·1 mg/ml) were significantly lower (P < 0·01) than in the latter (2·9 ± 0·1 mg/ml). Both serum IGF and CP were significantly decreased (P < 0·001) in hypopituitary children (n= 5, 6–8 yr, 377 ± 52 μU/ml and 0·9 ± 0·1 mg/ml respectively). Likewise, serum IGF and CP were significantly reduced (P < 0·05) in hypothyroid children (n= 10, 1–15 yr, 497 ± 24 μU/ml and 0·8 ± 0·1 mg/ml respectively) and adults (n= 12, 25–55 yr, 723 ± 40 μU/ml and 1·8 ± 0·2 mg/ml respectively). Growth hormone therapy (4 days) significantly increased (P < 0·05) serum IGF in hypopituitary children (336 ± 80 to 559 ± 59 μU/ml) but did not change the CP level (0·7 ± 0·2 to 0·7 ± 0·1 mg/ml). Thyroxine therapy (4–8 months) significantly increased (P < 0·05) both serum IGF and CP levels in hypothyroid children (497 ± 24 to 666 ± 38 μU/ml, and 0·8 ± 0·1 to 1·0 ± 0·1 mg/ml respectively) but had no effect in adults (723 ± 40 to 937 ± 132 μU/ml, and 1·8 ± 0·2 to 2·1 ± 0·2 mg/ml respectively). These studies indicate that growth retardation in children with hypopituitarism and hypothyroidism is associated with significant reductions in serum IGF and CP levels that are corrected, at least in part, by adequate hormone replacement therapy.
THYROTROPHIN BINDING INHIBITING IMMUNOGLOBULINS IN GRAVES' DISEASE BEFORE, DURING AND AFTER ANTITHYROID THERAPY, AND ITS RELATION TO LONG‐ACTING THYROID STIMULATOR
Authors: DOCTER R. , BOS G. , VISSER T. J. , HENNEMANN G. 
Published: March 2008

SUMMARYThyrotrophin binding inhibiting immunoglublins (TBII) were measured in twenty‐five patients with unequivocal hyperthyroid Graves' disease with a radioreceptor assay for TSH before, during and at the end of treatment with antithyroid drugs and triiodothyronine. To assess the outcome of this therapy patients were followed for 10–90 months (mean 63 months). Before treatment there was a significant correlation between TBII activity and serum thyroxine (r =−0·48, P < 0·05) and between TBII activity and 24 hour 131I thyroid uptake (r =−0·57, P < 0·01). No relationship was found between TBII activity and 20 min, 4 hour and 48 hour 131I thyroid uptakes before institution of therapy. During treatment a significant correlation between TBII index and 20 min 131I thyroid uptake was found (r =−0·55, P < 0·001). Both before and during treatment there was a significant correlation between TBII and LATS activity (r =−0·65, P < 0·001). From the magnitude of this correlation coefficient it can be concluded that related, although not the same immunoglobulins, are measured with the two assay techniques. It is not possible to predict the occurrence of a relapse from the presence or absence of TBII activity at the end of treatment in this group of patients. The relapse rate was four out of eight for patients without TBII activity in their serum at the end of treatment and five out of nine for patients with TBII activity. From the data presented it can be concluded that although there is a significant relation between TBII activity and some indices of thyroid function before and during treatment, the correlation coefficients are too small to conclude that TBII alone is responsible for the hyperfunction of the thyroid. The same conclusion can be drawn from the fact that TBII activity has no prognostic value in relation to a possible relapse.
HLA ANTIGENS AND THYROID AUTOANTIBODIES IN PATIENTS WITH GRAVES' DISEASE AND THEIR FIRST DEGREE RELATIVES
Authors: MATHER B. A. , ROBERTS D. F. , SCANLON M. F. , MUKHTAR E. D. , DAVIES T. F. , SMITH B. REES , HALL R. 
Published: March 2008

SUMMARYPatients with Graves' disease (n= 105) had an increased frequency of HLA‐B8 (40%) and a reduced frequency of HLA‐B12 (24·8%) when compared with random controls (n=117; 24·8% and 40·2% respectively). Comparison of patients with their first degree relatives (n= 118) shows the frequency deviations in these antigens to be characteristic of the families from which patients with Graves' disease are drawn, rather than of the disease itself. The haplotypes, identified in eighty‐six patients and 113 relatives, indicate that the excess of HLA‐B8 in patients and their relatives is primarily due to the haplotype 1–8. The relative risk for an HLA‐B8 individual of developing Graves' disease is 2·02, whilst the relative risk for an individual of haplotype 1–8 is 4·23. No significant associations were found between the incidence of any HLA antigen or combination thereof and the presence or absence of thyroglobulin and thyroid microsomal antibodies, or antibodies which interact with the TSH receptor.
EVIDENCE FOR DOPAMINE AS AN INHIBITOR OF VASOPROTEIN RELEASE IN MAN
Authors: LIGHTMAN S. L. , FORSLING MARY 
Published: March 2008

SUMMARYThe effect of dopamine on vasopressin release was studied by the infusion of L‐Dopa, a dopamine precursor that crosses the blood‐brain barrier. L‐Dopa suppressed resting levels of vasopressin and inhibited the rise of vasopressin produced by head‐up tilt. Carbidopa, a decarboxylase inhibitor that does not cross the blood‐brain barrier blocked the action of L‐Dopa. These results suggest that dopamine inhibits the release of vasopressin, either by an action at pituitary level or at the median eminence of the hypothalamus.
AN ASSESSMENT OF GLUCOSE INTOLERANCE IN ACROMEGALY AND ITS RESPONSE TO MEDICAL TREATMENT
Authors: WASS J. A. H. , CUDWORTH A. G. , BOTTAZZO G. F. , WOODROW J. C. , BESSER G. M. 
Published: March 2008

SummaryThe prevalence of abnormal carbohydrate tolerance has been assessed in sixty‐nine acromegalic patients using six different criteria for the definition of diabetes mellitus. Family history, HLA status and the incidence of pancreatic islet cell antibodies have been documented and the effect of 3 months therapy with bromocriptine on oral glucose tolerance has been assessed in sixty‐one patients.Thirteen patients (18–8%) had clinical diabetes and a total of twenty‐six patients (377%) had asymptomatic diabetes as defined by the British Diabetic Association criteria of 1964. Implementing the 1978 recommendations of the British Diabetic Association, 130% were defined as diabetic. The incidence of a positive family history of diabetes was the same in the diabetic and non‐diabetic acromegalics. There was no disturbance in respect of any of the HLA antigens when this was considered for the number of specificities tested for, and no patient had pancreatic islet cell antibodies.On treatment with bromocriptine, there was a highly significant improvement in the glucose tolerance of both the diabetic (P <0.0001) and the non‐diabetic (P < 0.005) acromegalics. However, in the group of eleven patients with no reduction of serum growth hormone on treatment, no improvement in glucose tolerance was seen.It is concluded that bromocriptine, by directly reducing serum growth hormone, has a significant effect on carbohydrate metabolism in acromegaly, irrespective of the initial level of glucose tolerance.
ANTIDIURETIC HORMONE IMMUNOACTIVITY IN TUMOUR TISSUE FROM PATIENTS WITH BRONCHOGENIC CARCINOMA: WITH AND WITHOUT HYPONATRAEMIA
Authors: KELLY P. , MORTON J. J. 
Published: March 2008

SummaryAntidiuretic hormone (ADH) immunoactivity (28–164 pg/mg wet weight) was detected in the tumour tissue of only three out of thirty‐two patients with carcinoma of the bronchus. All three patients had small oat‐cell tumours and two had persistent hyponatraemia prior to death. Serum sodium was not obtained in the third patient. Serum sodium was normal in the remaining twenty‐nine patients with undetectable ADH immunoactivity.
PLASMA ALDOSTERONE RESPONSE TO ANGIOTENSIN 11 AND POTASSIUM CHLORIDE INFUSIONS IN HYPOPITUITARY PATIENTS
Authors: LÓPEZ J. M. , RODRIGUEZ J. A. , MARUSIC ELISA T. 
Published: March 2008

SUMMARYThe acute adrenal response to potassium chloride and angiotensin II (A II) infusions was studied in hypopituitary patients and compared with normal subjects. The peripheral plasma levels of aldosterone (PAC), cortisol (F), potassium (K), and plasma renin activity (PRA), were measured at 09.00 h and after 60 and 120 min of infusion. All subjects were recumbent and under balance conditions, receiving a daily dietary intake of 180 mmol of sodium and 80 mmol of potassium. Basal PAC in hypopituitary patients was not significantly different from that observed in the control group. Both normal and hypopituitary patients respond to A II infusion with significant increments. Under potassium chloride stimulus the PAC response in hypopituitary patients was only observed when cortisol (20 mg) was given 2 h prior to the infusion. When cortisol replacement was omitted the response to KCl was not detected. These results suggest a permissive role of cortisol on glomerulosa response to potassium.
THE EFFECT OF OXPRENOLOL, ACEBUTOLOL AND PROPRANOLOL ON THYROID HORMONES IN HYPERTHYROID SUBJECTS
Authors: JONES M. K. , JOHN R. , JONES G. R. 
Published: March 2008

SUMMARYSerum thyroid hormone levels were measured before and during 10 days treatment with acebutolol (400 mg/day), oxprenolol (160 mg/day) and propranolol (160 mg/day) in eighteen hyperthyroid patients. A significant change in thyroid hormone concentrations was seen only in the group treated with propranolol. Propranolol should be used in preference to beta‐adrenoreceptor blocking drugs with partial agonist activity, in the treatment of hyperthyroidism.
PERICARDIAL EFFUSION IN HYPOTHYROIDISM
Authors: HARDISTY C. A. , NAIK D. R. , MUNRO D. S. 
Published: March 2008

SUMMARYThirty‐nine patients with untreated hypothyroidism have been examined using echocardiography for the presence of a pericardial effusion. Effusions were present in twelve patients who tended to be more severely hypothyroid. Plasma creatine phosphokinase and lactate dehydrogenase levels were higher in the presence of an effusion. Nine were reinvestigated during thyroxine replacement therapy and the effusions did not disappear until thyroid function tests had returned to normal. There were no specific electrocardiographic changes associated with the presence of an effusion which could be associated with a normal cardiac silhouette on a standard P.A. chest X‐ray.
FAILURE OF BOMBESIN TO ALTER ANTERIOR PITUITARY HORMONE SECRETION IN MAN
Authors: MORLEY J. E. , VARNER A. A. , MODLIN I. M. , CARLSON H. E. , BRAUNSTEIN G. D. , WALSH J. H. , HERSHMAN J. M. 
Published: March 2008

SUMMARYBecause of the stimulating effects of bombesin on growth hormone and prolactin secretion in the rat, we have studied the effects of bombesin infusions on anterior pituitary hormone secretion in man. Biological activity of the infused bombesin was confirmed by observing a brisk increase in serum gastrin concentrations and in gastric acid secretion during the lowest dose of bombesin infused. We could demonstrate no effect of bombesin in doses from 200 to 600 pmol.kg−1.h−1 on growth hormone, prolactin, thyrotrophin, luteinizing hormone and follicle stimulating hormone.
PLASMA ANGIOTENSIN II AND THE CONTROL OF DIABETES MELLITUS
Authors: SULLIVAN P. A. , GONGGRIJP HELGA , CROWLEY M. J. , FERRISS J. B. , O'SULLIVAN D. J. 
Published: March 2008

SUMMARYPlasma angiotensin II was measured in twenty patients with poorly controlled non‐ketotic diabetes mellitus, and again when blood glucose control improved. Plasma angiotensin II fell significantly with improved control, both when patients were supine and fasting overnight, and when studied after 4 h ambulation. The change occurred with improved short‐term and longer‐term control. It is concluded that the degree of blood glucose control is important when assessing the renin‐angiotensin system in diabetic patients.
OESTROGEN DYNAMICS IN ADRENAL VENOUS EFFLUENTS IN CONGENITAL VIRILIZING ADRENAL HYPERPLASIA
Authors: WAJCHENBERG B. L. , GOLDMAN J. , KYAN T. S. , ACHANDO S. S. , THOMSEN Y. L. , LIMA S. S. 
Published: March 2008

SUMMARYFour patients with untreated congenital virilizing adrenal hyper‐plasia (partial 21‐hydroxylase deficiency) were studied by bilateral adrenal vein catheterization. Simultaneous right and left adrenal and peripheral blood samples were collected for determination of oestrone (E1) and oestradiol (E2. The concentrations of both were higher in the adrenal effluents than in the peripheral blood samples, indicating their secretion by the adrenals. All patients were also studied during a sequential test of suppression (0.5 h after i.v. administration of 4 mg dexamethasone) and stimulation (5 min after i.v. administration of 250 μg ACTH 1–24; Synacthen). Mean peripheral E2 concentrations did not change significantly whereas E1 increased above control levels after stimulation. In contrast, suppression of adrenal venous blood concentrations with dexamethasone, and stimulation with ACTH, was demonstrated for every patient. The results indicate that in congenital adrenal hyperplasia the adrenal glands secrete significant amounts of E1 and E2.
FAILURE OF NALOXONE TO ALTER EXERCISE‐INDUCED GROWTH HORMONE AND PROLACTIN RELEASE IN NORMAL MEN
Authors: MAYER G. , WESSEL J. , KÖBBERLING J. 
Published: March 2008

SUMMARYGrowth hormone and prolactin levels during standardized exercise tests were measured in ten normal male volunteers, with and without previous intravenous administration of 4 mg naloxone. No significant influence of naloxone on hormone release could be observed. The lack of effect indicates that an opioid pathway is not involved in exercise‐induced growth hormone and prolactin release in humans, in contrast to that in rats.