bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three years of GH treatment in Turner's syndrome: complex effect of GH dosage on growth parameters
Authors: Bertrand A. M. , Chaussain J. L. , Job B. , Mariani R. , Ponte C. , Rappaport R. , Rochiccioli P. , Chatelain P. 
Published: November 2003

OBJECTIVE There have been few studies of GH dose responses in Turner's syndrome. We have therefore compared the growth effect of two doses of subcutaneous rGH: 0.45 (D1) or 0.90 (D2) IU/kg/week. DESIGN Multicentre study with two parallel randomized groups treated with D1 or D2 dose for one year, then with D2 for the second and third years in both groups. PATIENTS Ninety‐seven girls with Turner's syndrome aged from 4.8 to 16.5 years. RESULTS The first mean height velocity (HV) was significantly higher with D2. At one year the girls changed from D1 to D2 showed a further acceleration in HV. During second and third years HV remained above the mean for untreated Turner girls, in both groups. Mean cumulative height gains over the 3 years were 1.06 and 1.17 SDS/CA (Ranke's Turner standard) in groups G1 and G2 respectively. Bone maturation, over 36 months, was 33.7 (G1) and 31.9 (G2) months. CONCLUSION These results suggest that, if a higher initial GH dose is associated with a greater net initial height gain, the duration of treatment might affect the long‐term results. Intermittent treatment should be considered.
Insulin‐like growth factor‐I raises serum procollagen levels in children and adults with Laron syndrome
Authors: Klinger B. , Jensen L. T. , Silbergeld A. , Laron Z. 
Published: November 2003

OBJECTIVE Recombinant IGF‐I is now available for the treatment of GH insensitivity (Laron syndrome). We have determined the effects of IGF‐I on soft connective tissue and bone metabolism in a group of patients with this disorder. PATIENTS AND DESIGN Thirteen patients with Laron syndrome (LS) (8 children and 5 adults) were included in the study. The children with LS were treated with IGF‐I for 3 years with daily doses of 150–200 μg/kg. The adult LS patients were treated for 9 months with daily doses of 50–120 μg/kg. Blood samples for procollagens were collected before, during and at the end of IGF‐I treatment. MEASUREMENTS Serum levels of the carboxyterminal propeptide of type I procollagen (PICP), the aminoterminal propeptide of type III procollagen (PIIINP) and of the pyridinoline cross‐linked carboxyterminal telopeptide of type I collagen (ICTP) were determined before and during IGF‐I administration. RESULTS Untreated patients with LS had lower than normal serum levels of PICP and PIIINP for age. IGF‐I treatment increased significantly the PIIINP levels in children from 7.2 ± 2.8 (SD) to 12.5 ± 2.2 μg/l (P < 0.001), and in adults from 2.7 ± 1.0 to 8.4 ± 3.6 μg/l (P < 0.001); serum PICP increased from 243 ± 123 to 384 ± 190 μg/l (P < 0.087) in children, and in adults from 43.4 ± 8.1 to 135.8 ± 41.9 μg/l (P < 0.001). ICTP levels in children increased from 9.7 ± 3.7 to 14.3 ± 5.9 μg/l (P < 0.001) and in adult patients levels increased from 3.6 ± 0.9 to 5.5 ± 2.2 μg/l (P < 0.001) during treatment and returned to basal values after stopping IGF‐I administration. CONCLUSIONS Low procollagen levels in untreated Laron syndrome patients and their rise during replacement therapy with IGF‐I provide evidence that IGF‐I plays an important role in bone and soft connective tissue metabolism and that serum procollagen may serve as a marker to reflect some of the biochemical changes induced by IGF‐I in connective tissue in the initial periods of treatment.
Effects of FSH on serum immunoreactive inhibin levels in the luteal phase of the menstrual cycle
Authors: Burger Henry , Hee Jennifer , Bangah Mohan , Prince Mirella , McCloud Philip , Ohara Akira , Iwai Toshiko , Mori Takahide 
Published: November 2003

OBJECTIVE FSHcauses a dose‐related increase in circulating immunoreactive inhibin (INH) in the follicular phase of the menstrual cycle, while LH is the major stimulus to INH secretion by the corpus luteum. The present study was undertaken to assess whether FSH can also stimulate INH production during the luteal phase. DESIGN Normal volunteers were treated with a single injection of LH‐free FSH (Metrodin, 150 units) or saline as control, during the early, mid‐ or late luteal phase of the cycle, with subsequent hormone measurements. PATIENTS The 21 volunteers were aged 19–29. Seven subjects given FSH and 8 controls were studied in the early luteal phase, 1–4 days post ovulation. Eight FSH treated subjects and 10 controls were studied in the mid‐luteal phase, 5–9 days post ovulation, and 6 each, respectively, were studied in the late luteal phase. MEASUREMENTS Oestradiol (E2), progesterone (P), and INH were measured by previously described radioimmunoassays. RESULTS In both the early and mid‐luteal phases, FSH caused a significant rise in INH (early, from 778 to 922 U/l, mid‐luteal 1553 to 2090 U/l) and E2 (early 371 to 545 pmol/l, mid‐luteal 528 to 636) while there was no significant change in P. No significant changes occurred in the saline treated subjects. In the late luteal phase FSH prevented the significant fall in INH seen in the controls, whilst there was no effect on E2 or P. CONCLUSIONS It was concluded that both FSH and LH are capable of modulating inhibin production during the luteal phase of the menstrual cycle. FSH may exert its actions on the corpus luteum or alternatively on developing follicles. The present study cannot clearly distinguish between these possibilities.
A comparison of the overnight and the standard metyrapone test for the differential diagnosis of adrenocorticotrophin‐dependent Cushing’s syndrome
Authors: Avgerinos Peter C. , Nieman Lynette K. , Oldfield Edward H. , Cutler Jr Gordon B. 
Published: November 2003

OBJECTIVE We wished to develop optimal criteria for interpreting the single‐dose overnight metyrapone test and to compare the diagnostic efficiency of the overnight and the standard 6‐dose metyrapone tests for the differential diagnosis of ACTH‐dependent Cushing’s syndrome. DESIGN Retrospective pilot study based on all patients who completed both metyrapone tests and whose diagnoses were subsequently confirmed surgically. PATIENTS Sixty‐three patients, 57 with pituitary tumours and 6 with ectopic ACTH syndrome, were studied. MEASUREMENTS The sensitivity and specificity were determined using stimulation of plasma 11‐deoxycortisol and suppression of plasma cortisol as endpoints for the overnight test and stimulation of urine 17‐hydroxysteroid and plasma 11‐deoxycortisol as endpoints for the standard test. The test response that gave the highest sensitivity for the diagnosis of Cushing’s disease, with 100% specificity, was determined for each test endpoint. RESULTS Both the stimulation of plasma 11‐deoxycortisol and the suppression of plasma cortisol were expressed as the ratio of the post‐metyrapone value to baseline. A plasma 11‐deoxycortisol ratio > than 220 or a plasma cortisol ratio > 0.6 was associated with 100% specificity for diagnosis of Cushing’s disease by the overnight test. When these two criteria were combined, the sensitivity was 65%, which was significantly higher than that obtained using either steroid alone: 42% for both plasma 11‐deoxycortisol and plasma cortisol. The sensitivity of 65% for the overnight test, at 100% specificity, was nearly identical to that of the standard test in the same patients: 67% for the combined criterion of > 70% stimulation of urine 17‐hydroxysteroid or > 480‐fold increase of plasma 11‐deoxycortisol. When the criteria for both the overnight and standard tests were combined, the sensitivity increased to 84%, which was higher than that obtained using the criteria for either test alone (P < 0.02). CONCLUSION The single‐dose overnight metyrapone test, which can be performed in 24 hours and which avoids the disadvantages associated with timed urine collections, has a nearly identical sensitivity (for a specificity of 100%) as the 6‐dose standard metyrapone test for the diagnosis of Cushing’s disease. Furthermore, the diagnostic performance of a criterion that combines the results of both tests is significantly better than the best criterion for either test alone.
In vivo imaging of pituitary tumours using a radiolabelled dopamine D2 receptor radioligand
Authors: De Herder W. W. , Reijs A. E. M. , Kwekkeboom D. J. , Hofland L. J. , Nobels F. R. E. , Oei H. Y. , Krenning E. P. , Lamberts S. W. J. 
Published: November 2003

OBJECTIVE Knowledge of the dopamine D2 receptor status of pituitary tumours may play a predictive role in differential diagnosis and therapeutic decisions. This study was performed to evaluate the value of pituitary dopamine D2 receptor scintigraphy with (S)‐2‐hydroxy‐3‐123I‐iodo‐6‐methoxy‐N‐[(1‐ethyl‐2‐pyrrolidinyl)methyl]benzamide (123I‐IBZM) in the diagnostic evaluation of patients with pituitary tumours. DESIGN AND PATIENTS Scintigraphy using 123I‐IBZM was performed in 5 patients with PRL‐secreting macroadenomas, 2 patients with PRL‐secreting microadenomas, 17 patients with clinically non‐ functioning pituitary adenomas (NFPAs), 12 patients with GH‐secreting adenomas and 1 patient with a TSH‐secreting macroadenoma. RESULTS Single‐photon emission tomography (SPECT) showed significant uptake of 123I‐IBZM in the pituitary region in 3/5 macroprolactinoma patients. These results closely correlated with the response of plasma PRL levels to the dopamine D2 receptor agonist quinagolide. In two scan‐positive prolactinoma patients, repeated SPECTs during therapy with quinagolide showed a reduction in the pituitary uptake of 123I‐IBZM. Pituitary SPECT was negative in the 2 microprolactinoma patients, who responded to quinagolide administration. In 4/17 patients with NFPA, significant uptake of the radioligand in the pituitary region was observed. In 2/3 scan‐positive NFPA patients, who were treated with quinagolide, shrinkage of the pituitary tumours was observed. Treatment with quinagolide resulted in stabilization of tumour growth in the other scan‐ positive patients. Four out of 17 patients with NFPA and a negative SPECT were treated with quinagolide. Tumour growth was observed in 1 patient, and tumour size did not change in the other 3 patients. The pituitary region of none of the 12 acromegaly patients showed significant uptake of 123I‐IBZM. Sensitivity of the GH‐secreting adenomas to quinagolide was demonstrated in 8/12 patients in vivo by an acute test, and in 6/9 of the tumours in vitro. Pituitary SPECT was negative in the patient with the TSH‐secreting macroadenoma and this tumour also showed no sensitivity to quinagolide in vivo or in vitro. CONCLUSIONS We conclude that 123I‐IBZM is a ligand for in vivo imaging of dopamine agonist‐ sensitive macroprolactinomas, but not for microprolactinomas or GH‐secreting adenomas. The technique potentially provides a means of predicting the dopamine agonist‐responses of non‐functioning pituitary adenomas in vivo.
Effect of magnetostriction on fracture of a soft ferromagnetic medium with a crack‐like flaw
Authors: WAN Y. P. , FANG D. N. , SOH A. K. , HWANG K. C. 
Published: November 2003

ABSTRACTThe magnetic‐induction field in the vicinity of an elliptical inclusion embedded in an infinite soft ferromagnetic medium is determined based on complex potential theory. By using a constitutive relation of magnetostriction for isotropic materials, the stress field in the vicinity of an elliptical flaw is obtained. Furthermore, the stress field at the tip of a slender elliptical crack is determined for the case in which only an external magnetic field perpendicular to the major axis of the ellipse is applied at infinity. The results indicate that the stress field in the neighbourhood of the tip is governed by the magnetostriction and permeability of the soft ferromagnetic material. The induction magnetostrictive modulus is a key parameter in determining which of the two mechanisms, i.e., magnetostriction and magnetic‐force‐induced deformation, is dominant in determining the stress field in the neighbourhood of the tip of a crack‐like flaw. With regard to the influence of the magnetic field on the apparent toughness of a soft ferromagnetic body with a crack‐like flaw, soft ferromagnetic materials can be roughly divided into two categories: one possesses a large induction magnetostrictive modulus and the other has a small modulus. An approximate criterion for categorizing the materials is presented. For the benefit of engineering design, the expressions of the stress‐intensity factor for these two categories of soft ferromagnetic materials are presented. The results show that the stress‐intensity factor is affected not only by the flaw geometry, but also by the permeability of the medium inside the flaw.
Improvement in quality of colorectal cancer pathology reporting with a standardized proforma – a comparative study
Authors: Beattie G. C. , McAdam T. K. , Elliott S. , Sloan J. M. , Irwin S. T. 
Published: November 2003

AbstractBackground  Histopathological evaluation is a critical component in the management of patients with colorectal cancer (CRC). It is the single most powerful prognostic indicator in CRC and determines if adjuvant chemotherapy is indicated. The aim of this study was to assess if the introduction of a comprehensive standardized pathology proforma improved the quality of histopathology reporting.Methods  A standardized pathology proforma, based on the 1996 minimum dataset for colorectal histopathology reporting, was introduced in our pathology department in 1998. Pathology reports for all colonic resection specimens for 1996 (n = 85) and 2000 (n = 86) were identified, retrieved and entered on to database. Comparison was made with the minimum dataset published in the 1996 guidelines for the management of colorectal cancer.Results  Demographic details were complete in all cases. Clinical data was incomplete in 57 (67%) patients in 1996 and 63 (73%) in 2000 (ns; χ2). There were 24 (28%) (7 Abdomino‐perineal resections (APER)) and 40 (47%) (17 APER's) rectal specimens for 1996 and 2000, respectively. The presence or absence of pathological background abnormalities were commented on in 18 (21%) reports in 1996 and 80 (93%) reports in 2000 (P < 0.01; Fishers exact test (Fisher)). Histological differentiation was commented on in 73 (86%) and 86 (100%) in 1996 and 2000, respectively (P < 0.01; Fisher). Dukes' stage was stated in 33 (39%) reports in 1996 and 86 (100%) in 2000 (P < 0.01; Fisher) but Dukes' stage was calculable in 84 (99%) in 1996 and 86 reports (100%) for 2000 (ns; Fisher). The apical node was commented on in 34 (40%) reports in 1996 and 85 (99%) reports in 2000 (P < 0.01; Fisher). The median (IQR) number of nodes assessed in 1996 was 8 (5–12) compared to 12 (8–17) in 2000 (P < 0.001; Mann–Whitney (MW)). Complete resection was mentioned in 74 (87%) reports in 1996 and 86 (100%) in 2000 (P < 0.01; Fisher). Regarding rectal specimens, the circumferential resection margin (CRM) was commented on in 19 of 24 specimens in 1996 and 38 of 40 specimens in 2000 (ns; Fisher). Relationship to the peritoneal reflection was commented on in 1 (1%) rectal specimen in 1996 and 30 (35%) in 2000 (P < 0.001; Fisher).Conclusion  The introduction of a standardized proforma for reporting CRC resection specimens improves the quality of histopathological reporting. This aids decision‐making regarding adjuvant chemotherapy or radiotherapy and further surveillance.
The proportional decrease in prostate specific antigen level best predicts the duration of survival after hormonal therapy in patients with metastatic carcinoma of the prostate
Authors: Evans C.P. , Gajendran V. , Tewari A. , Aslam K. , Juster R. , Gange S. , Eason A. , Narayan P. 
Published: November 2003

Objective To examine the usefulness of a test for prostate specific antigen (PSA) to predict survival in hormonally treated patients with metastatic prostate cancer. Patients and methods The study comprised 49 patients (mean age 72 years, sd 6) who underwent orchidectomy for metastatic prostate cancer. PSA was measured before orchidectomy and after 6 months, and the absolute, differential and proportional decreases calculated. A Cox proportional hazards regression model, which controlled for patient age, tumour (Gleason) grade and the number of skeletal metastases, was then used to evaluate these estimates of PSA as predictors of survival. Results The 6‐month proportional decrease in PSA from the pre‐operative level was the most accurate predictor of patient survival (P=0.006) after hormonal therapy for metastatic prostate cancer. Conclusion This information may help to direct appropriate patients to new and experimental therapies for metastatic disease.
Wegener's granulomatosis involving the urogenital tract
Authors: Davenport A. , Downey S.E. , Goel S. , Maciver A.G. 
Published: November 2003

Objective To report eight cases of limited Wegener's granulomatosis (WG) affecting the urogenital tract (testis, ureter, bladder, urethra and penis) and to emphasize the importance of the anti‐neutrophil cytoplasm antibody (ANCA) test in establishing the diagnosis. Patients and methods Eight patients (six men and two women, aged 41–77 years) were diagnosed with WG, based on their previous medical history, the ANCA test and by biopsy. Results In each case, there were difficulties and delay in establishing the diagnosis of WG and starting appropriate treatment. The ANCA test was positive in seven cases and helped in establishing the diagnosis, in conjunction with the confirmation of vasculitis and granulomata by biopsy. Conclusion We advocate ANCA testing in patients presenting with limited urogenital disease in association with a past or present relevant history of arthritis, skin vasculitis and/or biopsies showing necrosis or non‐specific inflammation.
The role of the Sertoli cell in active immunosuppression in the human testis
Authors: Turek P.J. , Malkowicz S.B. , Tomaszewski J.E. , Wein A.J. , Peehl D. 
Published: November 2003

Objective To define the involvement of Sertoli cells in immune suppression within the testis by identifying surface receptor molecules that describe or communicate with cells of the immune system. Materials and methods Ten pairs of human testes obtained from orchidectomy were stained immunohistochemically with established monoclonal antibodies that identify common cells of the immune system. Results Patterns of staining were similar in all testes. Class I major histocompatibility complex (MHC) antigen, important for self/non‐self recognition, was found on Sertoli cells. Class II MHC antigen, important for immune cell interaction and limited to immune cells, was absent. Leu M3, characteristically found on macrophages, was also seen on Sertoli cells but no receptor antigens defining basic T cell types (CD4, CD8), B cells (Leu 12) or natural killer cells (Leu 11) were seen on Sertoli cells. Conclusions The Sertoli cell membrane lacks lymphocyte‐cell surface markers but harbours somatic cell and macrophage markers. This suggests that immunosuppression within the testis is not maintained through classic lymphocyte receptors. The presence of a macrophage marker is consistent with the known phagocytic activity of the Sertoli cell.
Six chromophobe cell carcinomas and one mixed renal
Authors: Usubütün A. , Uygur M.C. , Ayhan A. , Özen H. , Remzi D. 
Published: November 2003

Objective To determine the incidence and clinical and pathological features of chromophobe cell carcinoma (CCC) among renal cell carcinomas (RCCs).Materials and methods The records and nephrectomy samples from 166 patients who were operated on and followed up thereafter with a diagnosis of RCC were re‐evaluated. New sections were cut and specific staining performed when deemed necessary.Results Of 166 patients with RCC, six were diagnosed as having CCC and, unusually, one patient had a mixed RCC with areas of CCC. Neither the symptoms nor radiological features of these seven patients differed from those of the patients with RCC; the serum ferritin levels of these seven patients were also within the normal range. These patients appeared to have a favourable clinical course.Conclusion Chromophobe cell carcinoma is a distinct entity and must be distinguished particularly from oncocytoma and other variants of RCC. Although it seems to have a low malignant potential, metastatic CCC may have a worse prognosis.
Impact of the prostatic apex on continence and urinary flow in patients with intestinal neobladders
Authors: Koraitim M.M. , Atta M.A. , Foda M.K. 
Published: November 2003

Objective To determine the impact of preserving the prostatic apex on continence and urinary flow in patients with post‐cystectomy intestinal bladder substitutes. Patients and methods A total of 38 male patients underwent radical cystectomy for bladder carcinoma and construction of a neobladder from ileum [9], sigmoid [9] or an ileocaecal segment [20]. The intestinal reservoir was anastomosed to the membranous urethra in 25 patients and to the apical prostatic capsule in 13. A subjective evaluation of urinary continence, uroflowmetry and urethral pressure profilometry were performed 1–3 years after surgery. Results The only variable which showed a significant difference between patients with and without preservation of the prostatic apex was the functional profile length (P<0.05). Conversely, there was no statistically significant difference in the continence result, peak flow rate and maximum urethral pressure between these two groups. However, there was a significant difference (P<0.05) in peak flow rate among the three versions of neobladder in patients with a preserved prostatic apex (9.4 mL/s in ileal vs 15.8 mL/s in sigmoid and ileocaecal segments). Conclusion Preservation of the prostatic apex does not improve urinary continence in patients with intestinal neobladders and may present an element obstructing the evacuation of ileal bladders.
Local staging of prostate cancer by endorectal MRI using fast spin‐echo sequences: prospective correlation with pathological findings after radical prostatectomy
Authors: Cornud F. , Belin X. , Flam T. , Chrétien Y. , Deslignieres S. , Paraf F. , Casanova J.M. , Thiounn N. , Hélénon O. , Debré B. , Dufour B. , Moreau J.F. 
Published: November 2003

Objective To evaluate the accuracy of endorectal magnetic resonance imaging (MRI) with fast spin‐echo sequences in the local staging of clinically localized prostate cancer. Patients and methods Seventy‐one patients with a clinical T1 (18 patients) or T2 tumour (53 patients) underwent endorectal MRI 2–12 weeks before radical prostatectomy. Extraprostatic tumour was diagnosed if MRI showed signs of capsular penetration and/or invasion of the seminal vesicle and/or distal urethra or bladder neck. If the pathological examination showed a single positive margin with no periprostatic tissue, the tumour was classified as indeterminate and not as a T3 tumour. Results Of the 25 cases of capsular penetration, MRI correctly identified 10 (sensitivity 42%, specificity 100%). Of the 14 cases with seminal vesicle invasion, MRI correctly identified six (sensitivity 43%, specificity 100%), but showed other signs of extraprostatic tumour spread in seven of the eight unidentified cases. Overall, MRI identified 16 of the 30 patients (53%) with occult extraprostatic spread of tumour; there was only one false‐positive result. The sensitivity, specificity and accuracy of MRI were 53, 96 and 74%, respectively. Conclusion Endorectal MRI can reduce the rate of pre‐operative understaging from 42% to 22% and it can be used for a given individual because it can detect extraprostatic invasion with 96% specificity, ensuring that very few, if any, patients will be deprived of curative surgery.