bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of recovery of adrenocortical function after treatment for Cushing's syndrome due to pituitary or adrenal adenomas
Authors: Klose Marianne , Jørgensen Karsten , Kristensen Lars Østergaard 
Published: September 2004

Summaryobjective  Surgical cure of Cushing's syndrome (CS) is followed by adrenocortical insufficiency, which may be long‐lasting. The aim was to elucidate recovery of adrenocortical function, defined as a normal cortisol response to ACTH stimulation, and the relation to ACTH in patients cured for CS due to pituitary Cushing's disease (CD) or adrenal (AA) adenomas.design  A retrospective study including 32 patients considered surgically cured for CS (18 CD, 14 AA).results  Twelve (67%) patients with CD recovered within median 24 months (range 7 months−41/2 years) whereas six did not recover within 3–12 years. Plasma ACTH (p‐ACTH) at time of recovery was not different from p‐ACTH in patients not recovering (P = 0·9). Eleven (79%) patients with AA recovered within 24 months (10 months−4 years) whereas three did not recover within 4–10 years. p‐ACTH at time of recovery was higher compared to patients not recovering (P < 0·04). No differences were observed comparing CD and AA patients concerning preoperative 24‐h urinary free cortisol (UFC) excretion, postoperative unstimulated s‐cortisol or recovery time. By contrast, p‐ACTH measured at time of recovery was higher in AA compared to CD (median 12·3 vs. 4·6 pmol/l) (P < 0·001), whereas plasma dehydroepiandrosterone sulfate (p‐DHEAS) was lower in AA compared to CD (median 300 vs. 1500 nmol/l) (P = 0·02).conclusion  Recovery of secondary adrenal insufficiency is a slow process in both CD and AA. ACTH measured at time of recovery was significantly higher and DHEAS significantly lower in patients with AA compared to CD, which may suggest different mechanisms of the recovery process and different set points in the glucocorticoid feedback inhibition of ACTH secretion.
Changes in endothelium‐dependent arterial dilation before and after subtotal thyroidectomy in subjects with hyperthyroidism
Authors: Guang‐da Xiang , Hong‐yan Cao , Xian‐mei Zeng 
Published: September 2004

Summaryobjective  This case–control study was carried out to assess the alteration of endothelium‐dependent arterial dilation before and after subtotal thyroidectomy in subjects with hyperthyroidism.patients and methods  The study subjects included 12 patients with hyperthyroidism and 39 apparently healthy individuals. We performed a subtotal thyroidectomy on the hyperthyroid patients. The endothelium‐dependent arterial dilation was determined with a high‐resolution ultrasound method in each patient at the hyperthyroid stage before treatment (stage H), the euthyroid stage induced immediately before surgery (stage E), and the transient hypothyroid stage 1 or 2 months after surgery (stage L).results  The flow‐mediated arterial dilation decreased significantly from H to E and from E to L (P < 0·001). As compared with H, baseline blood flow decreased markedly at stages E and L (P < 0·001). The flow‐mediated arterial dilation and baseline blood flow in the control subjects were very close to those at stage E of the hyperthyroid patients. The absolute change in the flow‐mediated arterial dilation showed significant negative correlation with the changes in TSH (r =−0·86, P < 0·001), lipoprotein (a) [Lp(a)] (r =−0·77, P < 0·001) and low density lipoprotein (LDL) (r =−0·79, P < 0·001), and significant positive correlation with changes in fT3 (r =+0·88, P < 0·001). The absolute change in the baseline blood flow showed significant positive correlation with the change in fT3 (r =+0·85, P < 0·001) and significant negative correlation with the change in TSH (r =−0·63, P < 0·01).conclusion  The endothelium‐dependent arterial dilation increases significantly in untreated hyperthyroid patients, and decreases markedly after a subtotal thyroidectomy. Therefore, we conclude that the endothelium is more responsive to reactive hyperaemia in the hyperthyroid than the euthyroid state.
Rhythmogenesis in Vasopressin Cells
Authors: Brown C. H. 
Published: September 2004

AbstractMany neurones in the central nervous system possess intrinsic pattern‐generating properties, including vasopressin magnocellular neurosecretory cells. Synaptic input to vasopressin cells is not rhythmically patterned and yet these neurones fire action potentials in a ‘phasic’ activity pattern comprised of alternating periods of activity and silence that each last tens of seconds. This review describes the intrinsic and extrinsic mechanisms that generate phasic activity in vasopressin cells, highlighting recent work that has shown phasic activity to result from feedback modulation of synaptic inputs, and of intrinsic membrane properties, by peptides released from the dendrites of vasopressin cells.
Emerging Functions Of Gonadotropin‐Releasing Hormone II in Mammalian Physiology and Behaviour
Authors: Kauffman A. S. 
Published: September 2004

AbstractGonadotropin‐releasing hormone (GnRH) is the central neuroendocrine regulator of the hypothalamic‐pituitary‐gonadal axis. Multiple structural variants of GnRH are present in vertebrates. The first isoform isolated in the mammalian brain (GnRH I) was shown to regulate the release of pituitary gonadotropins. Recently, a second form has been discovered in mammals (GnRH II), both in the brain and periphery. Although it is unlikely to be a primary regulator of gonadotropin release, the highly conserved GnRH II variant appears to have a wide array of physiological functions. In the periphery, GnRH I and II have similar roles in regulating cell proliferation and mediating hormonal secretion from the ovary and placenta in an autocrine/paracrine manner. In the brain, GnRH I and II apparently modulate mammalian reproductive behaviours in different but complementary ways: GnRH I stimulates luteinizing hormone/follicle‐stimulating hormone secretion (and thus gonadal steroids) and promotes sexual behaviour in ad libitum fed animals. By contrast, GnRH II acts as a permissive regulator of female reproductive behaviour based on energy status, as well as a modifier of short‐term food intake. GnRH II has also been implicated in the regulation of calcium and potassium channels in nervous systems of amphibians, functions which may also be present in mammals. Increasing evidence suggests that the effects of GnRH II in both the periphery and brain may be mediated by GnRH receptor subtypes distinct from the type‐1 GnRH receptor. It is likely that this evolutionarily conserved peptide has been co‐opted over evolutionary time to possess multiple regulatory functions in a broad range of biological aspects, including, but not limited to, reproduction. Here, the proposed actions of both neural and peripheral GnRH II in affecting physiology and behaviour are summarized, and an outline of critical directions for future research is proposed.
Ageing and the Diurnal Expression of mRNAs for Vasoactive Intestinal Peptide and for the VPAC2 and PAC1 Receptors in the Suprachiasmatic Nucleus of Male Rats
Authors: Kalló I. , Kalamatianos T. , Piggins H. D. , Coen C. W. 
Published: September 2004

AbstractAgeing alters fundamental aspects of circadian rhythmicity in mammals; the effects include reduced rhythm amplitude and alterations in period length and in entrainment to the light/dark cycle. Such changes may reflect disruptions in cellular function within the suprachiasmatic nucleus (SCN), the site of the predominant circadian pacemaker. In the SCN, vasoactive intestinal peptide (VIP)‐synthesizing neurones receive various inputs, including retinohypothalamic projections containing pituitary adenylate cyclase activating peptide (PACAP). SCN VIP cells establish connections with local neurones and send efferents beyond the nucleus. Considerable evidence implicates VIP and PACAP in circadian rhythm maintenance and/or entrainment to photic Zeitgebers. These actions involve members of a distinct family of receptors; mRNAs for two such receptors, VPAC2 and PAC1, are present in the SCN. This study used isotopic in situ hybridization to examine the effects of ageing on expression of mRNAs for VIP, VPAC2 and PAC1 in the SCN of male rats under a 12 : 12 h light/dark cycle. Analysis of film autoradiographs from young adult (2–3 months) or aged (19–20 months) rats, at eight time points across the light/dark cycle, showed loss of diurnal rhythmicity and reduced levels for VIP mRNA in the aged group. A diurnal rhythm of VPAC2 receptor mRNA was present in both groups, but its levels were reduced in the aged rats. There were no differences between the two groups for PAC1 receptor mRNA expression. The present results indicate that ageing reduces VIP and VPAC2 receptor mRNA and eliminates diurnal expression of VIP mRNA within the SCN of aged male rats.
17β‐Oestradiol Modulates Glucocorticoid, Neural and Behavioural Adaptations to Repeated Restraint Stress in Female Rats
Authors: Lunga P. , Herbert J. 
Published: September 2004

AbstractSex steroids have a role in modulating responses that extends beyond reproduction. The current study investigated the influence of the sex steroid 17β‐oestradiol on hypothalamic‐pituitary‐adrenal (HPA) and behavioural responses to acute or repeated restraint stress. Ovariectomized rats treated with 17β‐oestradiol or peanut oil via a subcutaneous silastic capsule were subjected to daily handling (non stressed), acute (single, 1 h) or daily (10 days, 1 h/day) restraint stress. Blood collected at the end of stress revealed that 17β‐oestradiol treatment augmented the corticosterone response to acute restraint. After daily exposure to restraint, the corticosterone response was noticeably diminished in untreated females but 17β‐oestradiol‐treated rats still showed an exaggerated response compared to castrated, untreated females. Brain tissue collected 3 h after the end of restraint was probed using isotopic in situ hybridization for corticotropin‐releasing factor (CRF) and vasopressin gene expression in the paraventricular nucleus (PVN) of the hypothalamus. 17β‐oestradiol treatment at the higher dose (120 µg/ml) decreased basal CRF mRNA. Stress caused an increase in CRF mRNA expression in 17β‐oestradiol‐treated rats but not in the vehicle group. Repeated restraint stress caused an increase in PVN parvocellular vasopressin gene expression, which was more pronounced in 17β‐oestradiol‐replaced rats. Animals were exposed to the elevated plus maze for 5 min as a test for anxiety. Non‐stressed control rats with or without 17β‐oestradiol replacement spent the same percentage amount of time exploring the open arms of the maze. Previous exposure to acute restraint stress caused a marked reduction in the time spent exploring the open arms, indicating an increase in anxiety levels in these rats; this effect was observed in both vehicle and 17β‐oestradiol‐treated rats. After repeated restraint stress, 17β‐oestradiol‐replaced rats spent as much time exploring the open arms of the maze as controls, indicating adaptation. By contrast, nonreplaced rats were still showing a significant reduction in open arm exploration after repeated restraint. The present study presents novel data showing that the HPA axis remains reactive to repeated stress in 17β‐oestradiol‐treated ovariectomized rats, but stress‐induced anxiety behaviour is reduced.
Survey of asthma control in Thailand
Authors: BOONSAWAT Watchara , CHAROENPHAN Poonkasem , KIATBOONSRI Sumalee , WONGTIM Somkiat , VIRIYACHAIYO Vilaiwan , POTHIRAT Chaicharn , THANOMSIENG Nikom 
Published: September 2004

Objective:  The aim of the study was to determine whether asthma management in Thailand is succeeding in achieving the levels of control, specified in national and international asthma guidelines.Methodology:  Adults with asthma in Bangkok, Chiang Mai, Songkhla, and Khon Kaen were interviewed, and we have reported on their asthma severity, morbidity, control, perception of asthma, and healthcare use.Results:  A total of 466 asthma sufferers were interviewed. The burden of asthma was high, with 14.8% of respondents being hospitalized for their asthma in the past year. One‐quarter of those surveyed had lost workdays as a result of their asthma, and most patients felt that their lifestyle was limited. The majority of respondents had intermittent asthma (62.9%), 10.5% had mild persistent asthma, 17.6% had moderate persistent asthma, and 9.0% had severe persistent asthma; increasing severity was significantly associated with increased emergency healthcare use (P < 0.00001). Asthma sufferers greatly underestimated the severity of their condition. Only 36.0% used reliever medication, and use of inhaled corticosteroids was low at 6.7%. Understanding of the inflammatory basis of asthma was poor. Few patients underwent lung function tests or took peak flow meter readings.Conclusions:  The burden of asthma is high in Thailand, and guidelines are not being followed. Encouraging greater use of inhaled corticosteroids will be an important step towards improving asthma control.
Short‐ and long‐term hospital and community exercise programmes for patients with chronic obstructive pulmonary disease
Authors: ELLIOTT Mercedes , WATSON Carol , WILKINSON Eve , MUSK Arthur W. , LAKE Fiona R. 
Published: September 2004

Objective:  Pulmonary rehabilitation in patients with COPD has been shown to be beneficial but the optimal setting is not known. In the present study, the efficacy of a short‐term community‐based exercise programme was compared with a standard hospital outpatient programme. Additionally, the usefulness of community or home programmes in maintaining improvements in the longer term was studied.Methodology:  Forty‐three patients with moderate to severe COPD were randomized to one of the following three groups: a 3‐month hospital programme then a 9 month home programme (Hospital/Home); a 3‐month hospital programme then a 9‐month community programme (Hospital/Community); or a 12‐month community programme (Community/Community). The initial 3‐month programme was analysed by comparing the Hospital group (Hospital/Home plus Hospital/Community) with the Community group (Community/Community). Six‐minute walking distance (6MWD), quality of life (Guyatt chronic respiratory disease questionnaire, CRQ) and lung function were measured at 0, 3, 6 and 12 months and results were analysed using the Wilcoxon rank sum test.Results:  At 3 months, there was a significant improvement from baseline in 6MWD in the Hospital group (81.3 ± 18.3 m, P < 0.05, anova) but not the Community group (14.4 ± 28.5 m, not significant). The difference between the groups was not significant (P = 0.058). At 3 months, there was a significant improvement in quality of life in the Hospital group (CRQ +16.3 ± 3.1, P < 0.01, anova) and in the Community group (CRQ +10.2 ± 4.9, P < 0.05, anova) but the difference between the groups was not significant. Following the initial 3‐month programme, the dropout rate was high overall (73% by 12 months), and therefore data from the maintenance programme could not be analysed.Conclusions:  A 3‐month community‐based exercise programme for patients with COPD did not improve 6MWD. The long‐term retention rates in the programmes were poor.
Adult community‐acquired pneumonia in Malaysia: Prediction of mortality from severity assessment on admission
Authors: LOH Li‐Cher , KHOO Sert‐Kim , QUAH Soong‐Yuen , VISVALINGAM Vanitha , RADHAKRISHNAN Anuradha , VIJAYASINGHAM Pillai , THAYAPARAN Tarmizi 
Published: September 2004

Objectives:  Prediction of mortality in patients with community‐acquired pneumonia (CAP) can be assessed using clinical severity scores on admission to hospital. The clinical benefit of such tools is untested in Asian countries. The aim of this study was to determine the early adverse prognostic factors in patients hospitalized with CAP in Malaysia and to assess the usefulness of the British Thoracic Society (BTS) severity criteria.Methodology:  A prospective study was undertaken of all adult patients admitted between August 2002 and March 2003 in an urban‐based university teaching hospital.Results:  One hundred and eight patients (mean ± SD age 55 ± 20 years; 58% men) were eligible for the study. Thirteen patients (12%) died in hospital and 95 (88%) survived to hospital discharge. Older age, the presence of chronic illness, severity of comorbidity, reduced oxygen saturation and higher blood urea were associated with mortality during admission. Multivariate logistic regression of these variables identified reduced oxygen saturation as the only independently associated variable. BTS criteria fared poorly in predicting mortality compared with clinical assessment by attending clinicians (36‐fold increased risk of death by ‘clinical assessment’ vs two–threefold by ‘BTS criteria’).Conclusions:  In hospitalized patients with CAP, certain factors are adversely associated with mortality during admission. Severity criteria validated in specific countries might not be universally applicable.
Normal spirometric reference values for Omani children and adolescents
Authors: AL‐RIYAMI Bazdawi M. , AL‐RAWAS Omar A. , HASSAN Mohammed O. 
Published: September 2004

Objectives:  Normal lung function has been shown to be population specific. The aim of this study was to derive normal reference spirometric values for Omani children and adolescents.Methodology:  Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow and forced mid‐expiratory flow were measured in 837 healthy Omani school children aged 6–19 years. Multiple linear regression analysis was performed for each spirometric parameter against age, height and weight for boys and girls separately.Results:  All measured spirometric parameters increased with age and height and were significantly higher in boys than girls. Height explained the maximum variance for all parameters. After accounting for height in the prediction equations, the contribution of age and weight was minimal. The expiratory ratio (FEV1%FVC) was independent of age and height and its mean values (± standard deviation) were slightly higher in girls (91.1 ± 6.1%) than boys (86.5 ± 7.1%; P < 0.001). The predicted normal values of the subjects using the derived equations were between 5 and 10% lower than the respective values for subjects in Caucasian sample groups.Conclusion:  The developed prediction equations can be used in clinical practice in Oman and can be considered for use in neighbouring Arab countries.
Association between stress and asthma symptoms: A population‐based study
Authors: OH Yeon‐Mok , KIM Young Sam , YOO Se Hwa , KIM Sung Kyu , KIM Dong Soon 
Published: September 2004

Objective:  Although it is believed that stress contributes to asthma, there are no data from studies in the general population to support this belief. To determine whether stress influences asthma in the general population, a database from a nationwide survey to evaluate the relationship between stress and asthma symptoms was used in the present study.Methodology:  A database generated by the National Health and Nutrition Examination Survey I (in South Korea, 1998) was used for this cross‐sectional study. Stratified random samples of 9263 subjects, aged 20 years or older, were selected from the entire population of the country; 95% of these subjects responded. Among the responders, 5048 subjects aged 20–44 years were included in the study. Subjects were interviewed using a questionnaire. Multivariate analysis was performed using multiple logistic regression.Results:  The prevalence of wheeze and waking in the night because of cough or shortness of breath in the preceding 12 months was 12.9 and 13.5%, respectively. Multivariate analysis showed that the odds ratios for asthma symptoms increased according to the severity of stress reported by the subjects. When stress levels were classified into four categories of little, some, much and very much stress, the odds ratios for wheeze in the preceding 12 months were 1.7 (95% confidence interval (CI) 1.1, 2.5), 2.6 (95% CI 1.7, 4.0) and 3.6 (95% CI 2.1, 5.9) for subjects reporting some, much and very much stress, respectively, relative to those reporting little stress. Using the same stress‐level classifications, the odds ratios for waking in the night because of cough or shortness of breath in the preceding 12 months were 1.5 (95% CI 1.0, 2.3), 2.4 (95% CI 1.6, 3.6) and 4.0 (95% CI 2.5, 6.4), respectively.Conclusion:  This cross‐sectional study shows an association between stress and asthma symptoms in the general population of South Korea.
Clinical phenotypes of COPD: Results of a Japanese epidemiological survey
Authors: TATSUMI Koichiro , KASAHARA Yasunori , KUROSU Katsushi , TANABE Nobuhiro , TAKIGUCHI Yuichi , KURIYAMA Takayuki ,   THE RESPIRATORY FAILURE RESEARCH GROUP IN JAPAN
Published: September 2004

Objective:  The Global Initiative for Obstructive Lung Disease characterizes COPD as airflow limitation caused by parenchymal destruction and/or small airway disease. This report characterizes the clinical features of these two phenotypes of COPD in Japan.Methodology:  COPD was diagnosed by spirometric airflow limitation (FEV1/FVC < 70%), and all subjects underwent chest CT scanning. Patients with diffuse low attenuation areas (LAA) on CT scan were categorized as the emphysema‐dominant phenotype; those with little LAA were categorized as the airway disease‐dominant phenotype. The two groups were compared to identify significant clinical or demographic differences.Results:  Of the 1438 patients analysed, 1294 (90%) were classified as having an emphysema‐dominant phenotype and 144 (10%) as having an airway disease‐dominant phenotype. The airway disease‐dominant phenotype was: more common than the emphysema‐dominant phenotype in women (15%vs. 7%, P < 0.01) and in non‐smokers (6%vs. 2%, P < 0.05); was more commonly complicated by asthmatic features (35%vs. 21%, P < 0.01); and had higher IgE and eosinophil levels (P < 0.05) and less lung function impairment.Conclusion:  This analysis is the first to clinically define two phenotypes of COPD in a Japanese epidemiological survey. There appear to be striking differences as well as overlap between these two groups. Further research is warranted to determine the significance of COPD phenotypes.
Does addition of inhaled steroid to combined bronchodilator therapy affect health status in patients with COPD?
Authors: YILDIZ Fusun , BASYIGIT Ilknur , YILDIRIM Elif , BOYACI Hasim , ILGAZLI Ahmet 
Published: September 2004

Objective:  Withdrawal of corticosteroid is associated with a deterioration of health status in COPD. In this study the aim was to determine whether high dose inhaled corticosteroid improves quality of life in patients with COPD.Methodology:  In total, 38 male patients with moderate COPD were included in the study. Baseline quality of life scores were determined using a Turkish version of the St George's Respiratory Questionnaire (SGRQ). Patients were randomly divided into two groups. Group 1 consisted of 20 patients who received existing bronchodilator therapy plus inhaled corticosteroid (800 µg budesonide) for 12 weeks, while 18 patients in group 2 received bronchodilator and placebo. The SGRQ was repeated after the treatment period.Results:  All patients were male and mean age was 67 ± 8.2 years. Symptom, activity, impact, and total scores were assessed and a difference of four units with treatment was considered to be clinically significant. Total score and activity score were decreased by six units and eight units, respectively, in the placebo group while symptom and impact scores did not change significantly. Total scores and the three component scores improved significantly in the corticosteroid group compared to the placebo group (Δtotal score: −22 in corticosteroid group, −6 in placebo group, P < 0.01).Conclusion:  Inhaled corticosteroid improved quality of life scores in patients with COPD, without significant improvement in airflow obstruction parameters. Since improvement of health status is one of the important aims in COPD treatment, use of inhaled corticosteroids should be considered from this perspective.