bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperprolactinaemia in hypothyroidism: clinical significance and impact of TSH normalization
Authors: Raber Wolfgang , Gessl Alois , Nowotny Peter , Vierhapper Heinrich 
Published: March 2003

Summaryobjectives Menstrual irregularities in hypothyroidism have been reported to occur less frequently than previously described. We therefore studied the influence of serum PRL in patients with newly diagnosed subclinical and overt hypothyroidism and in hyperprolactinaemic patients treated with T4 to distinguish the impact of hypothyroidism from that of confounding drugs on hyperprolactinaemia and menstrual irregularities.patients and methods PRL was determined in 1003 consecutive hypothyroid patients (TSH > 4·0 mU/l) at referral, and after TSH normalization in 84 (8%) initially hyperprolactinaemic (female, > 480 mU/l; male, > 432 mU/l) subjects. Medical history (psychotropic drugs and oestrogens) and menstrual patterns were assessed at referral and after 8 ± 5 (mean ± SD) months of T4 therapy. Pituitary magnetic resonance imaging (MRI) was offered to patients with persistently elevated PRL.results Menstrual disturbancies (oligomenorrhoea/secondary amenorrhoea, O/A) were not more common (P = NS) in hyper‐ than in normoprolactinaemic women (26% and 16%, respectively). We observed no galactorrhoea and no correlation between PRL and TSH or O/A except in pregnant or lactating women (N = 11). Oestrogens or antidepressants (including selective serotonin reuptake inhibitors) did not cause hyperprolactinaemia but antipsychotic drugs did. PRL decreased with T4 therapy (P < 0·01) in patients not using confounding drugs (from 720 ± 288 to 360 ± 192 mU/l) but menstrual irregularities persisted. PRL remained unchanged in patients receiving antipsychotic treatment. PRL was also unchanged in patients with pituitary abnormalities (seven micro‐, one macroadenoma).conclusions Hyperprolactinaemia was not an important feature in patients with newly diagnosed hypothyroidism. Neuroleptic drugs may cause persisting hyperprolactinaemia after TSH normalization. In addition, menstrual disturbancies do not relate to hyperprolactinaemia in hypothyroidism.
Bone mineral density, biochemical and hormonal profiles in suboptimally treated children and adolescents with β‐thalassaemia disease
Authors: Mahachoklertwattana Pat , Chuansumrit Ampaiwan , Sirisriro Rojana , Choubtum Lulin , Sriphrapradang Arporn , Rajatanavin Rajata 
Published: March 2003

Summaryobjective Thalassaemia/haemoglobinopathy is a hereditary disease causing increased erythropoiesis and expansion of the bone marrow cavity. As a consequence, there is a reduction in trabecular bone tissue resulting in osteopenia/osteoporosis. The present study was performed to assess bone mineral density (BMD) in children and adolescents with β‐thalassaemia disease and to determine biochemical and hormonal changes that may affect BMD.methods Forty‐eight children and adolescents with β‐thalassaemia were divided into two groups, transfusion‐dependent (TD) (n = 16) and transfusion‐independent (TI) (n = 32). All patients were treated suboptimally. BMD was determined by dual‐energy X‐ray absorptiometry. Bone maturation was assessed by radiographic bone age (BA). Blood and urine samples were obtained for the determination of biochemical and hormonal profiles, which included PTH, 25‐hydroxyvitamin D (25‐OHD), osteocalcin, bone‐specific alkaline phosphatase, IGF‐1, fT4, TSH and urine deoxypyridinoline.results Most of the patients were short and underweight, and they had delayed BA with mean Z‐scores of −2·77 in the TD and −2·04 in TI groups. The mean Z‐scores of BMD in the TD vs. TI groups of total body, radius, femoral neck and lumbar spine were −2·09 vs.−1·49, −0·73 vs. −0·54, −1·93 vs.−1·17 and −3·45 vs.−2·43, respectively. Although the means BMD values in the TD group were lower than those in the TI group, they were not significantly different. Mean serum IGF‐1 levels were lower in the TD than the TI groups, 11·6 and 24·9 nmol/l, respectively (P < 0·05). Other biochemical and hormonal profiles did not differ between these two groups.conclusions Patients with undertransfused severe β‐thalassaemia had more bone marrow expansion, lower serum IGF‐1 levels and more delayed bone age than did patients with untransfused moderately severe β‐thalassaemia. Therefore, the severity of the disease appeared to be a primary factor for low bone mineral density in undertransfused patients in association with bone age delay and low serum IGF‐1.
The regulation of growth in glycogen storage disease type 1
Authors: Mundy Helen R. , Hindmarsh Peter C. , Matthews David R. , Leonard James V. , Lee Philip J. 
Published: March 2003

Summaryobjective To study endocrine and metabolic variables that affect growth in patients with glycogen storage disease type 1 (GSD‐1) receiving standard dietary therapy.design Observational study.patients and measurements Thirty‐eight patients with GSD‐1, age range 0·6–32·9 years, were investigated on their usual dietary regimens. Data on height, height velocity in prepubertal children, endocrine and metabolic responses to oral glucose load, 24‐h serum cortisol and GH concentration profiles and serum IGF‐1 concentrations were collected.results The population studied was shorter than average, with a median height standard deviation score (SDS) of −1·60, but significantly taller than a historical population studied at the same institution that had not received dietary therapy at the time of study. A wide range of height SDS was encountered (−5·28 to 1·21) and a subset still exhibit marked growth failure. Median body mass index (BMI) SDS was 0·72 (range −1·34 to 3·96). Those patients with the greatest BMI SDS had the lowest serum GH concentrations but serum IGF‐1 concentrations were within the normal range. Patients with the poorest growth exhibit low serum insulin concentration responses to glucose load, GH insensitivity and higher mean 24‐h plasma cortisol levels when compared to those patients who were better grown.conclusion This study shows that overall the growth of this group of patients with glycogen storage disease type 1 has improved compared to that of a historical control group. There remains a subset of this population with poor growth despite therapy. The measured endocrine responses in this subset are similar to those reported for untreated patients. To improve the growth further in these individuals it will be necessary to understand whether this is failure of prescribed therapy or failure to comply with therapy.
Fat distribution in non‐obese girls with and without precocious pubarche: central adiposity related to insulinaemia and androgenaemia from prepuberty to postmenarche
Authors: Ibáñez Lourdes , Ong Ken , De Zegher Francis , Marcos Maria Victoria , Del Rio Luis , Dunger David B. 
Published: March 2003

Summaryobjective Precocious pubarche (PP) in girls is associated with hyperinsulinaemia and dyslipidaemia of prepubertal onset, and with ovarian hyperandrogenism and ovulatory dysfunction in adolescence, particularly if they also had prenatal growth restraint and postnatal growth acceleration. Hyperinsulinaemia may be the pathogenic key factor, possibly amplified by hyperandrogenaemia. While such PP girls do not have increased body mass index (BMI), we hypothesized that body fat mass and fat distribution may differ between PP girls and matched controls, and may relate to insulin and androgen levels.patients and design Sixty‐seven PP girls (age range 6·0–18·0 years) and 65 control girls matched for age and pubertal stage (5·9–18·0 years) had height, weight, waist and hip circumferences measured, and dual‐energy X‐ray absorptiometry (DXA) assessment of total body fat mass, and fat mass in abdominal and truncal regions. All girls had fasting plasma glucose, serum insulin, lipids, testosterone and SHBG levels measured; PP girls also had a standard 2‐h oral glucose tolerance test (oGTT).results Despite no differences in BMI, PP girls had significantly larger waist circumference, waist‐to‐hip ratio, total fat mass, percentage fat mass, abdominal fat mass, and truncal fat mass vs. controls in each pubertal stage. Overall, fasting insulin levels, free androgen index (FAI) and blood lipid levels were more closely related to central fat than to total body fat mass. In a multiple regression analysis, truncal fat mass was independently related to both fasting insulin (P = 0·009) and FAI (P < 0·0001). Abdominal fat mass was inversely related to birthweight (r = −0·25, P = 0·001). In PP girls, central fat mass was positively related to insulin levels after oGTT (truncal fat vs. 30 min insulin; r = 0·46, P < 0·0005).conclusions Precocious pubarche girls had excess total body and central fat mass throughout all pubertal stages, and increased central fat was related to hyperinsulinaemia and hyperandrogenaemia. It remains to be verified whether body composition in PP girls can be normalized by insulin‐sensitization and/or antiandrogen therapy.
Wall motion abnormalities in male elite orienteers are aggravated by exercise
Authors: Damm  , Andersson  , Henriksen  , Niklasson  , Jonason  , Ahrén  , Wesslén  , Nyström‐Rosander  , Rolf  , Hedenstierna  , Ringqvist  , Friman  
Published: March 2003

During the period 1979–92, 16 (15 men and one woman) sudden unexpected cardiac deaths occurred among young Swedish orienteers. This finding indicated a sharp increase in the death rate of orienteers, and necropsy demonstrated that myocarditis was a common histopathological finding. Therefore, an extensive non‐invasive cardiac investigation was performed. A total of 59 male élite orienteers (mean age 23 years) and 36 cross‐country skiers and middle‐distance runners (mean age 22 years), serving as controls, were examined by both echocardiography at rest and radionuclide ventriculography at rest and during exercise.Wall motion abnormalities were found in eight orienteers using echocardiography. The purpose of this study was to examine whether the group of orienteers with wall motion abnormalities found using echocardiography had a smaller increase in ejection fraction from rest to exercise using radionuclide ventriculography than the rest of the orienteers and the controls, indicating an aggravation of the wall motion abnormalities during exercise. There were no significant differences in the ejection fraction at rest between the groups. In the orienteers with wall motion abnormalities (group 1), 62% (five out of eight) had less than a 0·05 unit increase in left ventricular ejection fraction compared with 27% (14 out of 51) of the remaining orienteers (group 2) and 19% (7 out of 36) of the controls (group 3). A comparison of athletes in group 1 with those in groups 2 and 3 combined revealed a statistically significant difference (P < 0·05). The divergent response in left ventricular ejection fraction during exercise suggests an aggravation of the wall motion abnormalities with exercise. Both the echocardiographic and the radionuclide ventriculographic findings indicate that the orienteers in group 1 had concealed left ventricular damage.
Immunocytochemical detection of prognostic markers in breast cancer; technical considerations
Authors: Kuenen‐Boumeester V. , Timmermans A. M. , de Bruijn E. M. C. A. , Henzen‐Logmans S. C. 
Published: March 2003

Immunocytochemical detection of prognostic markers in breast cancer; technical considerationsThe purpose of this study was to establish a good technical procedure for immunocytochemical (IC) staining of prognostic markers in breast cancer specimens. The influence of various preparation, fixation and storage methods on ER, P53 and Ki‐67 IC staining was assessed, using cells of two breast cancer cell lines T47D (ER/P53+) and ZR‐75‐ER (ER+, P53−). In addition we searched for a suitable transport medium. Depending on the technical procedure, great variations in expression of the tested antigens were found. Cytospins fixed and stored according to the Abbott method gave the best results. Histocon appeared to be the medium of choice. A good concordance of IC and immunohistochemical (IH) results was found when the adopted method was tested on material of 10 breast cancers. This study underlines the importance of quality controlled standardization of cell processing, fixation and storage of fine needle aspiration (FNA) aspirates in order to obtain reproducible and consistent IC results.
Screening for the 21st century: learning from the past
Authors: Raffle A. E. 
Published: March 2003

IntroductionIn 1986 I took on the public health responsibility for the cervical screening service in Avon. Like many others, I understood screening to be a simple, highly effective, and inexpensive way of stopping people getting cancer. The only problem so far as I was aware was in making sure those most at risk took up the opportunity to be screened. The more involved I became with screening, however, the more I was obliged to modify this view. In summary, I was confronted with two problems. The Avon cervical screening service—thanks to contributions from many individuals over the previous two decades—was already well organized and population coverage was already high. Why then were women still dying from cancer of the cervix? Why also was there a substantial and rising number of women requiring colposcopic investigation for screen‐detected abnormality when, according to screening theory, the ‘prevalence’ pool should have been cleared and the rate of newly detected ‘incident’ abnormalities should equate to the incidence of serious disease?
Are women sufficiently well informed to provide valid consent for the cervical smear test?
Authors: Slater D. N. 
Published: March 2003

Are women sufficiently well informed to provide valid consent for the cervical smear test?Three hundred women attending colposcopy for the first time, following an abnormal cervical smear, were invited to fill in a questionnaire. This covered aspects of their understanding of the cervical smear test and the NHS Cervical Screening Programme (NHSCSP). In addition, it covered aspects of consent to the test. The response rate was 83%. Seventy percent thought that the NHSCSP is working well and 72% were aware that probably over 3000 cases of cervical cancer per year are being saved by the NHSCSP. However, 55% did not know that the death rate from cervical cancer is decreasing. 96% were aware that the main reason for a cervical smear is to prevent the development of cervical cancer, by finding early treatable abnormalities. Similarly, 94% were aware that the presence of abnormal cells on a cervical smear indicated a possible but not definitive indication of cervical precancer or cancer. Disappointingly, only 5% had seen the new NHSCSP information poster on the cervical smear test and only 44% had been given written information about the test. Consent for the test in 59% of women had been implied rather than expressed and 30% of women providing expressed consent had signed to that effect. In 42% of women, the smear taker or a doctor had failed to discuss the reason for having a cervical smear and had not explained about its advantages and limitations. In 72%, the smear taker or doctor had not explained that the cervical smear test can never be 100% accurate and that some laboratory errors are unavoidable. It is likely that women attending for colposcopy are a highly motivated cohort in relation to their understanding of the cervical smear test and the NHSCSP. Accordingly, understanding in the more general female population is likely to be considerably less. It would appear that women are often suboptimally informed to provide valid consent for the cervical smear test.
Quantitative cytological assessment of Ki67 and AgNORs using computer‐digitized image analysis of four clinicopathological breast lesions
Authors: Zaitoun A. M. , Ebbs S. R. 
Published: March 2003

Quantitative cytological assessment of Ki67 and AgNORs using computer‐digitized image analysis of four clinicopathological breast lesionsAnalysis of silver‐stained proteins associated with nucleolar organiser regions (AgNORs) is proposed as a marker of cellular proliferation. This study describes the application of AgNORs and Ki67 in breast lesions.Sixty‐one cases including fibroadenoma (FA), fibrocystic disease (FCD), ductal carcinomain situ(DCIS) and invasive carcinoma (IC) were studied by image analysis to evaluate quantitative changes in AgNORs in both Ki67‐positive, and Ki67‐negative smears. The Ki67 index was assessed. Morphometric features of cell nuclei and AgNORs were determined by digitized computer image analysis (Prodit 5.2).The growth fraction was 5.08 for FA, 5.71 for FCD, 16.75 for DCIS and 23.26 for IC. The mean nuclear area was significantly higher in malignant cells than those of fibroadenoma and fibrocystic disease.In Ki67‐positive cells the total area, long axis and number of AgNORs increased progressively across disease groups. Eccentricity of AgNORs and AgNORs: nuclear area ratios were significantly increased in malignant breast lesion in comparison with benign lesion in Ki67 positive cells.In Ki67 negative cells, the highest value of AgNORs was observed in DCIS. The AgNORs: nuclear area ratio demonstrated a statistically significant trend across the disease groups.This study demonstrates that the growth fraction, mean nuclear area and selected AgNORs features have potential for differentiating benign from malignant breast tumours.
p53 Protein expression and proliferative activity in ductal breast carcinomas
Authors: Ioakim‐Liossi A. , Safioleas M. , Karakitsos P. , Athanassiadou P. , Athanassiades P. , Gogas J. , Nakopoulou L. 
Published: March 2003

p53 Protein expression and proliferative activity in ductal breast carcinomasThe immunocytochemical expression of p53 protein and Ki‐67 labelling index in tumour cells of 100 ductal breast carcinomas of different histological grade and stage was evaluated in cytological material. In order to investigate p53 expression and Ki‐67 expression an avidin‐extravidin immunocytochemical technique was applied to imprints. Monoclonal antibody (MoAb) DO‐p53 and proliferating cell monoclonal antibody were used as primary antibodies. A statistically significant difference was observed between p53 protein expression and grade of malignancy and clinical stage (P = 0.001, P < 0.001, respectively). A statistically significant difference was also observed between Ki‐67 LI and histological grade and stage of the tumours (P < 0.001, P < 0.001 correspondingly). A correlation was observed between p53 protein expression and Ki‐67 LI (P < 0.001). The immunocytochemical study of p53 protein and Ki‐67 expression in cytological material represents a simple method which can be applied in routine cytological laboratories for the investigation of potential malignancy of ductal breast cancer.
The usefulness of a panel of immunostains in the diagnosis and differentiation of metastatic malignancies in pericardial effusions
Authors: Gupta R. K. , Kenwright D. N. , Fauck R. , Lallu S. , Naran S. 
Published: March 2003

The usefulness of a panel of immunostains in the diagnosis and differentiation of metastatic malignancies in pericardial effusionsPericardial effusions are not uncommon in patients with an advanced malignancy. Rarely malignancies may present initially with a pericardial effusion. Cytological examination of pericardial fluid may be valuable in differentiation of these cases. However, a metastatic tumour in serous effusion may not always show the functional differentiation of the primary tumour. In such a situation, although a wide range of special studies have been suggested for the diagnosis of malignancy we have found the use of a panel of a few common immunostains to be useful in confirming or suggesting the site of a primary tumour. The material for this study consisted of 76 pericardial fluids obtained between January 1991 and October 1998 from 46 males (mean age 59 years) and 30 females (mean age 52 years). Metastatic malignancy was diagnosed in 22 of the 76 patients and in 7/22 cases pericardial effusions were the initial presentation. The subsequent follow‐up in the seven cases revealed adenocarcinoma of lung (n = 2), small cell anaplastic carcinoma of lung (n = 1), squamous cell carcinoma lung (n = 1), melanoma leg (n = 1), non‐Hodgkin’s lymphoma retroperitoneal lymph nodes (n = 1) and carcinoma of the breast (n = 1). Of the remaining 15 cases with a known history of malignancy, eight had cancers (three adeno; two small cell; one poorly differentiated, and two squamous cell types) of the lung; breast (n = 3); colon (n = 1); melanoma (n = 2) and non Hodgkin’s lymphoma (n = 1). Immunostains which were useful in the diagnosis were EMA, CEA, cytokeratin, B72.3, HMB45, vimentin, S100, LCA, L26 and kappa and lambda light chains.
Immunophenotypic analysis of simultaneous specimens from different sites from the same patient with malignant lymphoma
Authors: Bangerter M. , Hildebrand A. , Griesshammer M. 
Published: March 2003

Immunophenotypic analysis of simultaneous specimens from different sites from the same patient with malignant lymphoma The assumption that immunophenotypic characteristics of different specimens obtained simultaneously from the same patient remain unchanged has rarely been evaluated. Using flow cytometry, we reviewed our experience of 29 patients with non Hodgkin’s lymphoma (NHL). From these patients, 60 simultaneous specimens taken from the peripheral blood, bone marrow, effusions, fine needle aspirates from lymph nodes or cerebrospinal fluid were studied. In 26 out of 29 patients, the immunophenotype in the different specimens was identical. In one patient with unclassifiable low‐grade B‐NHL, immunophenotyping showed additionally a CD38 expression in the effusion which was not seen in the bone marrow. In one patient with mantle cell lymphoma, expression of CD10 in the lymph node was noted which was lacking in the peripheral blood. In the remaining patient with unclassifiable low‐grade B‐NHL, CD23 expression was noted in the lymph node but not in the peripheral blood. This retrospective study suggests that discordant antigen expression in samples from different body sites within the same patient is a rare event.
Reasons for variation in coverage in the NHS cervical screening programme
Authors: McGAHAN C. E. , BLANKS R. G. , MOSS S. M. 
Published: March 2003

Reasons for variation in coverage in the NHS cervical screening programme In order to investigate reasons for variation in coverage of cervical screening, data from standard Department of Health returns were obtained for all Health Authorities for 1998/1999. Approximately 80% of the variation between health authorities is explained by differences in age distribution and area classification. Considerable differences between Health Authority and Office of National Statistics (ONS) population figures in City and Urban (London) areas for the age group 25–29 years and for City (London) for age group 30–34 years, suggest an effect of list inflation in these groups. Coverage as a performance indicator may be more accurately represented using the age range 35–64 years. Using this narrower age range, the percentage of health authorities meeting the 80% 5‐year coverage target increases from 87% to 90%.