bluuebunny/crossref_metadata_2025_split huggingface dataset:
Confirmation of severe GH deficiency after final height in patients diagnosed as GH deficient during childhood
Authors: Attanasio Andrea F. , Howell Simon , Bates Peter C. , Blum Werner F. , Frewer Paul , Quigley Charmian , Shalet Stephen M. 
Published: March 2003

Summaryobjective Human GH treatment of patients with childhood‐onset (CO) growth hormone deficiency (GHD) ceases when they reach final height; this provides an opportunity to retest GH status in all patients before determining whether GH therapy will be required in adult life. At present, the diagnostic approach to these patients is not fully standardized. This study aimed to characterize a large group of previously GH‐treated CO GHD patients and establish their GH status.patients and methods The multinational study included 167 patients diagnosed as GH deficient and treated with hGH to final height during childhood. Mean age was 19·2 years and mean height standard deviation score (SDS) was –1·08. Peak serum GH concentrations were determined in standard GH stimulation tests. IGF‐I and IGFBP‐3 concentrations were determined at a central laboratory and converted to SDS values by reference to a normal population.results Using only a peak GH value of less than 3 µg/l (1 mg = 3 U) in stimulation tests as the cut‐off, 133 (79·6%) patients would be classed as GH deficient. Using only an IGF‐I value less than –2 SDS as the cut‐off, 134 (80·2%) patients would be classed as GH deficient. However, by using both criteria there were 120 (71·9%) patients who were definitely severely GH deficient (group 1) and 20 (12·0%) who were not GH deficient (group 2), leaving 14 (8·4%) classed as GH deficient from IGF‐I SDS only (group 3) and 13 (7·8%) classed as GH deficient from stimulation test only (group 4). There was no difference between the groups in height SDS or body mass index (BMI), but the GH‐deficient patients tended to have been diagnosed at a younger age (group 1, 8·2 ± 3·9; group 2, 10·0 ± 4·0; P = 0·052). For patients classed as GH deficient compared with those not GH deficient, the percentage of males was lower (group 1, 64·2%; group 2, 90·0%; P = 0·022) and the percentage with multiple pituitary hormone deficiencies was higher (group 1, 81·7%; group 2, 20·0%; P < 0·001), with the other two groups being intermediate in each case. Only the group classed as GH deficient by both criteria had a mean IGFBP‐3 less than –2 SDS and both IGF‐I SDS and IGFBP‐3 SDS increased steadily across the four groups.conclusions A high percentage (71·9%) of these childhood‐onset GH‐deficient patients were still GH deficient in adult life and are likely to require further hGH treatment. While 12·0% could be classed as definitely no longer GH deficient, there are some patients who are intermediate (16·2%) and may be classed as GH deficient by one criterion but not the other. When GH stimulation test results and IGF‐I concentration are discordant, the IGFBP‐3 level does not establish diagnosis and the hGH treatment requirement of such patients remains a dilemma.
The treatment of a thyrotropin‐secreting pituitary macroadenoma with octreotide in twin pregnancy
Authors: Blackhurst G. , Strachan M. W. , Collie D. , Gregor A. , Statham P. F. X. , Seckl J. E. R. 
Published: March 2003

SummaryTSH‐secreting pituitary tumours are rare but difficult to treat due to a combination of refractory hyperthyroidism and low surgical cure rates. We describe the case of a 21‐year‐old woman who, despite twin pregnancy, became euthyroid and had dramatic tumour shrinkage on octreotide treatment. To our knowledge, this is the first description of the use of octreotide for a TSH‐secreting pituitary adenoma throughout pregnancy.
Cerebrovascular mortality in patients with pituitary adenoma
Authors: Brada M. , Ashley S. , Ford D. , Traish D. , Burchell L. , Rajan B. 
Published: March 2003

SummaryObjective To assess cerebrovascular mortality in a UK cohort of patients with pituitary adenoma known to have increased incidence of cerebrovascular accidents (CVA).Methods A total of 334 patients treated at the Royal Marsden Hospital (RMH) between 1962 and 1986 with surgery and postoperative radiotherapy were followed up via the NHS Central Register (NHSCR) to identify deaths and emigrations. The causes of death were assessed by NHSCR‐based death certificates and coded according to the 9th revision of ICD. Follow‐up was censored at age 85, on emigration or cancellation of NHSCR. Thirteen patients could not be traced. A total of 4982 person‐years was accumulated in the cohort. Expected numbers of deaths were computed from the national age‐, sex‐ and period‐specific mortality rates for England and Wales.Results In the pituitary adenoma cohort, 128 deaths were observed compared to 80·9 expected [relative risk (RR) of death 1·58 (95% CI: 1·32–1·90)]. There were 33 cerebrovascular deaths compared with 8·04 expected (RR 4·11, 95% CI 2·84–5·75). Three deaths were from subarachnoid haemorrhage compared to 0·54 expected (RR 5·51, 95% CI 1·14–16·09). There was an increased cerebrovascular mortality in women (RR 6·93, 95% CI 4·29–10·60) compared to men (RR 2·4, 95% CI 1·24–4·20; P = 0·002) and in patients having debulking surgery (RR 5·19, 95% CI 3·50–7·42) compared to biopsy/no surgery (RR 1·33, 95% CI 0·27–3·88; P = 0·02). The RR in patients with nonsecretory tumours was 3·65 (95% CI 2·26–5·58), compared with 5·23 (95% CI 2·25–10·30) in secretory tumours (P = 0·4). The effect of age at radiotherapy was not significant (P = 0·4).Conclusion Patients with pituitary adenoma treated with surgery and radiotherapy have an increased risk of cerebrovascular mortality compared to the general population, which mirrors the increased incidence of CVA. The possible risk factors include hypopituitarism, radiotherapy and extent of surgery but none are at present proven causes. The evaluation of new treatment strategies should not only assess intermediate end‐points of tumour and endocrine control but should concentrate on long‐term survival with particular emphasis on CVA incidence and mortality.
Size at birth, gestational age and cortisol secretion in adult life: foetal programming of both hyper‐ and hypocortisolism?
Authors: Kajantie Eero , Phillips David I. W. , Andersson Sture , Barker David J. P. , Dunkel Leo , Forsén Tom , Osmond Clive , Tuominen Juha , Wood Peter J. , Eriksson Johan 
Published: March 2003

Summaryobjective Recent studies have suggested that lifelong programming of the hypothalamic–pituitary–adrenal (HPA) axis in utero is an important mechanism in explaining the link between small size at birth and adult cardiovascular disease. However, direct evidence from human birth cohorts has so far been contradictory. We set out to study reasons for this discrepancy by examining the relationship between adult HPA axis function and birthweight and body proportions at birth in a group of elderly subjects with detailed birth records.design Birth cohort study.subjects Four hundred and twenty‐one men and women (mean age 69·5 years, range 65·1–75·8 years) born at term in Helsinki, Finland, during 1924–33, with body size and gestational age at birth recorded.measurements Fasting serum cortisol and cortisol‐binding globulin concentrations. The concentration of free cortisol was estimated by their ratio.results There was no significant correlation between fasting cortisol concentrations and birthweight in either men or women. However, there was a weak inverse association between fasting cortisol and length at birth in women but not in men. There was also a significant positive association between cortisol and ponderal index in both genders. We found that the association between foetal growth on fasting total and free cortisol concentrations differed in subjects born at different gestational ages. In subjects born before 39 weeks of gestation, both total and free cortisol showed inverse correlations with birthweight (P = 0·02 and P = 0·09, respectively) and length at birth (P = 0·001 and P = 0·02), whereas in subjects born after 40 weeks of gestation there were positive correlations with birthweight (P = 0·06 and P = 0·002) and ponderal index at birth (P = 0·003 and P = 0·003). The interactions between birthweight and gestational age were statistically significant (P = 0·01 for total and P = 0·003 for free cortisol).conclusions These data suggest that the relationship between size at birth and cortisol concentrations in adult life is different in subjects born at different gestational ages: both hyper‐ and hypocortisolism may arise as a consequence of foetal programming of the hypothalamic–pituitary–adrenal axis during intrauterine life.
Atrioventricular plane displacement correlates closely to circulatory dimensions but not to ejection fraction in normal young subjects
Authors: Carlhäll C.‐J. , Lindström L. , Wranne B. , Nylander E. 
Published: March 2003

Aims Mitral atrioventricular plane displacement (AVPD) provides information about left ventricular systolic function. M‐mode of systolic annulus amplitude or tissue Doppler imaging of systolic annulus velocity are the current methods of evaluating AVPD. A correlation to ejection fraction (EF) has been demonstrated in patients with coronary artery disease and left ventricular dysfunction. Our aim was (i) to investigate the mitral AVPD of normal subjects with different physical work capacities and (ii) to further evaluate AVPD as an index of left ventricular systolic function. Methods and results Twenty‐eight healthy men mean age 28 years (20–39) were included: endurance trained (ET) (n=10), strength trained (ST) (n=9) and untrained (UT) (n=9). The systolic AVPD was recorded at four sites, septal, lateral, anterior and posterior, using M‐mode. Left ventricular volumes were calculated according to Simpson’s rule. Systolic AVPD was higher in endurance trained, 16·9 ± 1·5 mm, as compared with both strength trained, 13 ± 1·6 (P<0·001) and untrained, 14 ± 1·6 (P<0·001). Left ventricular systolic AVPD correlated strongly with end‐diastolic volume (r=0·82), stroke volume (r=0·80) and maximal oxygen consumption per body weight (r=0·72). The correlation between AVPD and EF was poor (r=0·22). Conclusion In the subjects studied, with a range of normal cardiac dimensions, AVPD correlated to stroke volume, end‐diastolic volume and maximal oxygen consumption per body weight, but not to EF. On theoretical grounds, it also seems reasonable that a dimension like AVPD is related to other cardiac dimensions and volumes, rather than to a fraction, like EF. AVPD is one parameter that is useful for evaluation of left ventricular systolic function but is not interchangeable with other measurements such as EF.
The accuracy of endometrial cytology in the diagnosis of endometrial adenocarcinoma
Authors: TAJIMA  , INAMURA  , NAKAMURA  , SUDO  , YAMAGISHI  
Published: March 2003

tajima m., inamura m., nakamura m., sudo y. and yamagishi k. (1998) Cytopathology9, 369–380The accuracy of endometrial cytology in the diagnosis of endometrial adenocarcinomaWe have examined 62 234 cytological samples of endometrium to establish the accuracy and false‐positive rate for the diagnosis of endometrial adenocarcinoma. The patients were either attending the gynaecological out‐patients clinic with symptoms or were asymptomatic women attending for routine population screening as part of our cancer detection programme, the numbers from these two sources being equal. Out of 138 cases identified as endometrial adenocarcinoma by cytology 126 (91.3%) were confirmed histologically in our hospital. Twelve cases (8.7%) were shown to be false‐positives. Re‐examination of these led to the same false‐positive diagnosis in all 12 cases. This was attributable to similarities of nucleo–cytoplasmic ratio, irregular arrangement of nuclei, variation in nuclear shape and in the numbers of nucleoli in repair cells and hyperplastic cells compared with the carcinoma cases. Most of the false‐negative reports were due to insufficient material, pale staining in malignant cells or diagnostic error. Refraction measurement of the density of nuclei of cancer cells using equipment for which the patent is pending enabled objective measurement of nuclear density which indicated that the nuclei were not stained darkly enough in false‐negative cases.
Assessment of cell proliferation by Ki‐67 staining and flow cytometry in fine needle aspirates (FNAs) of reactive lymphadenitis and non‐Hodgkin's lymphomas
Authors: Schmitt F. , Tani E. , Tribukait B. , Skoog L. 
Published: March 2003

Assessment of cell proliferation by Ki‐67 staining and flow cytometry in fine needle aspirates (FNAs) of reactive lymphadenitis and non‐Hodgkin's lymphomasThis study was undertaken to assess cell proliferation in FNAs from a series of 57 non‐Hodgkin's lymphomas (NHL) and 11 cases of reactive lymphadenitis using Ki‐67 staining and flow cytometry (FCM). The results were compared and correlated to the cytomorphological subgrouping according to Kiel classification. The mean percentages of Ki‐67 positivity were 16.6% and 61.1% for low and high grade lymphomas, respectively (P < 0.001). The mean S‐phase fraction (SPF) determined by FCM was 4.6% for low grade and 12.9% for high grade lymphomas (P < 0.001). The figures for Ki‐67 positivity and S‐phase fraction in reactive lymphadenitis were 16.8% and 4%, respectively. We observed a strong correlation in low grade lymphomas between Ki‐67 and SPF. A good correlation was also found in reactive lymphadenitis. In high grade lymphomas, however, with highly scattered Ki‐67 and S‐phase values, this correlation was lost. In some cases this discrepancy can be explained by a rich admixture of non‐neoplastic, non‐proliferating cells in aspirates from diploid tumours. In addition, the existence of a minor aneuploid tumour cell population of high proliferation such as that in Ki‐1 lymphomas will not be accurately analysed by FCM but is easily assessed by Ki‐67 staining. However, the main reason seems to be a high variability between the fraction of cells in S‐phase and the total number of cells in G1, S and G2 in individual tumours.
Diagnosis of fibromatosis colli by fine needle aspiration (FNA) cytology
Authors: Pereira S. , Tani E. , Skoog L. 
Published: March 2003

Diagnosis of fibromatosis colli by fine needle aspiration (FNA) cytologyThis study presents eight cases of fibromatosis colli accurately diagnosed by FNA cytology. Fibromatosis colli is a rare fibroblastic lesion that manifests in the sternocleidomastoid muscle during the first to second months after birth. The tumours varied in size from 1 to 3 cm and engaged the lower, middle as well as the upper part of the sternocleidomastoid muscle. The FNA cytology smears showed mostly mature fibroblasts in a background of pink granular material and fragments of striated muscle fibres with degeneration. The cytological presentation together with the typical clinical setting will allow a definitive and accurate diagnosis, avoiding surgery.
Fluorescence microscopy of mycobacteria in pleural effusions
Authors: Küpper TH. , Gore C. , Gore R. , Wehle K. , Marzahn S. , Pfitzer P. 
Published: March 2003

Fluorescence microscopy of mycobacteria in pleural effusionsThe diagnostic advantage of fluorescence microscopy (FM) of Papanicolaou‐stained cytological specimens obtained by bronchoscopy has been described previously. This study was designed to evaluate the method's diagnostic benefit in cytological pre‐ parations of pleural effusions in cases of active pulmonary tuberculosis. In contrast to bronchial material there is no advantage in cytological evaluation of pleural effusions by FM.
Evaluation of histochemical methods for the detection of intracytoplasmic mucin in serous effusions
Authors: Yu G. H. , DE Frias D. V. S. , Horcher A. M. 
Published: March 2003

Evaluation of histochemical methods for the detection of intracytoplasmic mucin in serous effusionsWe have studied 25 serous effusions containing definitive morphologic evidence of adenocarcinoma to evaluate the ability of two mucin stains (Mayer's mucicarmine, D‐PAS) to detect intracytoplasmic mucin in both cytologic (cytospin) and corresponding histological (cell block) preparations. Mucicarmine stain was positive in six of 25 (24%) cytospins and 13 of 25 (52%) cell blocks. D‐PAS was positive in 19 of 25 (76%) cytospins and 20 of 25 (80%) cell blocks. Eight cases were identified which showed mucicarmine positivity in the cell block but not the corresponding cytospin; prolonging incubation time resulted in a positive mucicarmine in cytospin preparations for seven of these cases. We conclude that: (i) D‐PAS is a more sensitive stain for the detection of intracytoplasmic mucin in all preparations; (ii) mucicarmine shows preferential staining for cell blocks; (iii) alterations in the staining protocol may permit mucin detection by mucicarmine staining in cytologic preparations in a significant number of cases.
The utility of transbronchial (Wang) fine needle aspiration in lung cancer diagnosis
Authors: Siddiqui M. T. , Saboorian M. H. , Gokaslan S. T. , Lindberg G. , Ashfaq R. 
Published: March 2003

The utility of transbronchial (Wang) fine needle aspiration in lung cancer diagnosis We evaluated our experience with transbronchial fine needle aspiration (TBNA) in cancer diagnosis over a period of 1 year. A total of 51 aspirates were performed by specialist chest physicians in the presence of a cytopathologist who made on spot evaluation of Diff‐Quik smears for adequacy and guided the aspirator for additional sampling if necessary. Two clusters of at least 10 malignant cells were required on the Diff‐Quik smears to render an on the spot positive diagnosis of malignancy. Aspirates showing atypical cells or few malignant cells not fulfilling the above criteria were placed in a suspicious category and additional material was requested. The TBNA results were correlated with the transbronchial biopsy when available.
Is there a better way to assess performance in breast cytology?
Authors: Robinson I. A. , Blackham R. B. 
Published: March 2003

Is there a better way to assess performance in breast cytology? Results generated from a series of breast fine needle aspirates (BrFNA) are semi‐qualitative and therefore sensitivity, specificity and accuracy are not necessarily the best measures of effectiveness. This paper considers the likelihood ratio of cancer (LR +), which can provide the probabilities for cancer being present or absent for cancer across the range of diagnostic categories used in the National Health Service Breast Screening Programme (NHSBSP), i.e. C1 to C5. Using LR +, receiver operating characteristic (ROC) curves can be generated and used to compare performance between pathologists, laboratories or years. These are illustrated using test results from 1997 to 1999 for the Derbyshire Royal Infirmary. LR + and ROC are meaningful measures. They could replace the 12 calculations currently used for the evaluation of effectiveness of BrFNA in the National Health Service Breast Screening Programme (NHSBSP) and for validation of pathologists’ performance.
Conjunctival impression cytology in contact lens wearers
Authors: Anshu  , Munshi M. M. , Sathe V. , Ganar A. 
Published: March 2003

Conjunctival impression cytology in contact lens wearersThe upper tarsal conjunctiva is in constant friction with the surface of the contact lens. The conjunctival surfaces of 80 soft and gas‐permeable contact lens wearers (40 each) and 20 controls were studied using biomicroscopy and impression cytology. A filter dissolution technique was used to process the conjunctival imprints. Biomicroscopic and cytologic grading of the conjunctivae was performed using four‐tier grading systems. Impression cytology is a non‐invasive, painless procedure. The altered technique of processing yielded better cellularity and excellent cellular detail. On biomicroscopy and cytology, all controls showed Grade 1 appearances. Soft lens wearers who were symptomatic were found to have a significant increase in both biomicroscopic and cytologic grades, when compared with their asymptomatic counterparts. No correlation was found between duration of lens use and biomicroscopic or cytologic grades. All changes were found to be more severe in soft lens wearers.
Reducing predation of orb‐web spiders by controlling common wasps (Vespula vulgaris) in a New Zealand beech forest
Authors: TOFT RICHARD J. , REES JOANNA S. 
Published: March 2003

1. Introduced common wasps (Vespula vulgaris) reach high densities in the beech forests (Nothofagus spp.) of the northern South Island, New Zealand, and may be having a severe impact on populations of native invertebrates. An experimental approach was used to test whether reducing the abundance of common wasps increases the probability of native invertebrates surviving. Garden orb‐web spiders (Eriophora pustulosa) were used because they were easy to collect and could be trained to build webs on a standard frame. Thirty orb‐web spiders were placed out on web‐frames in each of four study sites in beech forest during periods of low, medium and high wasp abundance, and their rate of removal was measured over a 4‐h period. Wasp numbers were reduced by poisoning in two study sites. Using wasp‐abundance data from weekly Malaise trap samples in the poisoned and non‐poisoned sites, the probability of spider survival over the entire wasp season was modelled and the level of wasp control necessary to protect natural populations of orb‐web spiders was estimated.2. Wasp abundance and the probability of spider survival were negatively correlated, and smaller spiders were likely to survive longer than larger spiders. At the peak of the wasp season, significantly more spiders survived in the poisoned areas than in the non‐poisoned areas.3. The probability of a spider surviving to the end of the wasp season was virtually nil in the non‐poisoned sites (5.08 × 10–18), but was also very unlikely in the poisoned areas (3.47 × 10–5).4. The survival model predicts that wasp abundance would need to be reduced by 80–89.5% over the entire wasp season to protect populations of orb‐web spiders.5. Extrapolation from the model predicts that the invertebrate taxa most vulnerable to wasp predation may have already been removed from the beech forest ecosystem during the 40 years of wasp occupation.
Behavioural fever in the Senegalese grasshopper, Oedaleus senegalensis, and its implications for biological control using pathogens
Authors: BLANFORD SIMON , THOMAS MATTHEW B. , LANGEWALD JÜRGEN 
Published: March 2003

1. Thermoregulatory behaviour of the Senegalese grasshopper, Oedaleus senegalensis (Krauss), was investigated in the field following a spray application of an oil‐based formulation of Metarhizium flavoviride Gams and Rozsypal in Niger, West Africa.2. Measurements of environmental temperature, wind speed and solar radiation were made in conjunction with measurements of internal body temperatures of grasshoppers from a control (unsprayed) and treated plot using microthermocouples and hand‐held thermometers. Grasshoppers were monitored for 4 days from the third day after application.3. Oedaleus senegalensis utilized a range of thermoregulatory behaviours to maximize body temperatures during periods of low insolation and ambient temperature, and to minimize excessive heat loading during the hottest periods. Preferred body temperature of uninfected grasshoppers was 39 °C, with a range from 24 °C in the early morning to a high of 46 °C during periods of high insolation and ambient temperature.4. Infected grasshoppers altered their thermoregulatory behaviour and showed a behavioural fever response to the pathogen. Preferred body temperatures of infected individuals were raised to a new set point of ≈ 42 °C. This is believed to be the first evidence for a behavioural fever in response to a microbial infection for any natural population. In the present study, its effects appeared to provide little therapeutic advantage to hosts infected following application. Preliminary evidence from other studies, however, indicates that modifications to host thermoregulation could be a significant constraint to the pathogen and may limit its impact under certain conditions.