bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endocrine responses to ghrelin in adult patients with isolated childhood‐onset growth hormone deficiency
Authors: Aimaretti Gianluca , Baffoni Claudia , Broglio Fabio , Janssen Joop A. M. , Corneli Ginevra , Deghenghi Romano , Van Der Lely Aart Jan , Ghigo Ezio , Arvat Emanuela 
Published: March 2003

Summaryobjective Ghrelin, a 28 amino acid acylated peptide, is a natural ligand of the GH secretagogues (GHS) receptor (GHS‐R), which is specific for synthetic GHS. Similar to synthetic GHS, ghrelin strongly stimulates GH secretion but also displays significant stimulatory effects on lactotroph and corticotroph secretion. It has been hypothesized that isolated GH deficiency (GHD) could reflect hypothalamic impairment that would theoretically involve defect in ghrelin activity.patients In the present study, we verified the effects of ghrelin (1 µg/kg i.v.) on GH, PRL, ACTH and cortisol levels in adult patients with isolated severe GHD [five males and one female, age (mean ± SEM) 24·7 ± 2·6 years, BMI 25·7 ± 2·7 kg/m2]. In all patients, the GH response to insulin‐induced hypoglycaemia (ITT, 0·1 IU regular insulin i.v.) and GH releasing hormone (GHRH) (1 µg/kg i.v.) + arginine (ARG, 0·5 g/kg i.v.) was also studied. The hormonal responses in GHD were compared with those in age‐matched normal subjects (NS, seven males, age 28·6 ± 2·9 years, BMI 22·1 ± 0·8 kg/m2).results IGF‐I levels in GHD were markedly lower than in NS (69·8 ± 11·3 vs. 167·9 ± 19·2 µg/l, P < 0·003). Ghrelin administration induced significant increase in GH, PRL, ACTH and cortisol levels in all GHD. In GHD, the GH response to ghrelin was higher (P < 0·05) than that to GHRH + ARG, which, in turn, was higher (P < 0·05) than that to ITT (9·2 ± 4·1 vs. 5·3 ± 1·7 vs. 1·4 ± 0·4 µg/l). These GH (1 µg/l = 2 mU/l) responses in GHD were markedly lower (P < 0·0001) than those in NS (ghrelin vs. GHRH + ARG vs. ITT 92·1 ± 16·7 vs. 65·3 ± 8·9 vs. 17·7 ± 3·5 µg/l). In GHD, the highest individual peak GH response to ghrelin was markedly lower than the lowest peak GH response in NS (28·5 vs. 42·9 µg/l). GHD and NS showed overlapping PRL (1 µg/l = 32 mU/l) (10·0 ± 1·4 vs. 14·9 ± 2·2 µg/l), ACTH (22·3 ± 5·3 vs. 18·7 ± 4·6 pmol/l) and cortisol responses (598·1 ± 52·4 vs. 486·9 ± 38·9 nmol/l).conclusions This study shows that ghrelin is one of the most powerful provocative stimuli of GH secretion, even in those patients with isolated severe GHD. In this condition, however, the somatotroph response is markedly reduced while the lactotroph and corticotroph responsiveness to ghrelin is fully preserved, indicating that this endocrine activity is fully independent of mechanisms underlying the GH‐releasing effect. These results do not support the hypothesis that ghrelin deficiency is a major cause of isolated GH deficiency but suggest that ghrelin might represent a reliable provocative test to evaluate the maximal GH secretory capacity provided that appropriate cut‐off limits are assumed.
Chromogranin ‘A’ in normal subjects, essential hypertensives and adrenalectomized patients
Authors: Giampaolo Bernini , Angelica Moretti , Antonio Salvetti 
Published: March 2003

Summaryobjective Chromogranin A (CgA) is an acidic glycoprotein co‐stored in vesicles and co‐released with catecholamines. Although currently used as a humoral marker of endocrine tumours, several aspects of CgA secretion still need to be clarified in humans.patients Fifty‐four controls, 83 essential hypertensive and six adrenalectomized patients were studied.design In the controls and hypertensive patients, CgA and catecholamines were measured before (supine position) and after changes in posture (2′ upright position), insulin‐induced hypoglycaemia (0·15 IU/kg i.v.) and glucagon injection (1 mg i.v.). In addition, blood samples were taken in the morning (0800 h) and in the afternoon (1800 h), and every 5 h for 24 h. In the adrenalectomized patients, blood samples were obtained in the morning and in the afternoon.measurements CgA was measured by an immunoradiometric assay, and noradrenaline and adrenaline by high‐performance liquid chromatography.results In controls, posture slightly increased plasma catecholamines without affecting CgA levels. Hypoglycaemia evoked a rise in noradrenaline (P < 0·04), adrenaline (P < 0·01) and CgA (79·6 ± 11·8 vs. 46·1 ± 10·1 µg/l, P < 0·03). Glucagon injection increased plasma adrenaline (P < 0·01) but not noradrenaline or CgA levels. At variance with blood pressure and catecholamines, CgA increased significantly in the afternoon (51·1 ± 4·0 vs. 45·0 ± 3·9 µg/l, P < 0·05); it also had a circadian rhythm, with peak values during the night (at 2300 h, 65·4 ± 9·0 µg/l) and a nadir in the morning (at 0800 h, 43·1 ± 6·6 µg/l). In hypertensives, basal and stimulated CgA levels as well as diurnal/circadian variations of this peptide were similar to those in normal subjects. In adrenalectomized patients plasma CgA in the morning (34·3 ± 6·5 µg/l) was lower (P < 0·03) than in all controls and hypertensives studied, but also showed an afternoon increment (46·4 ± 6·6 µg/l, P < 0·003). No correlation was found between CgA and catecholamines or blood pressure in all subjects or in the subgroups.conclusions In normal humans, chromogranin A and catecholamines are not always co‐secreted, and co‐secretion occurs only for marked exocytotic adrenergic stimuli, such as hypoglycaemic stress. In addition, chromogranin A has a circadian rhythm unrelated to plasma catecholamines. Basal plasma concentrations and the secretory pattern of chromogranin A in hypertensives do not differ from the findings in controls. Finally, the adrenal glands contribute partially to circulating chromogranin A and are not involved in the circadian rhythm of this peptide in humans.
West syndrome and mitochondrial diabetes: relationship or coincidence?
Authors: Bouhanick B. , Reynier P. , Salle A. , Ilhouz F. , Coutant R. , Pouplard F. 
Published: March 2003

SummaryWest syndrome occurs in infancy and in early childhood. It is characterized by intractable seizures occurring almost daily, severe psychomotor retardation, poor prognosis and EEG abnormalities, known as hypsarrhythmia. We report here the case of a 28‐year‐old patient, who was diagnosed with West syndrome when he was 8 months old and with diabetes mellitus when he was 25 years old. Sequencing analyses and restriction analyses were suggestive of mitochondrial diabetes. Four years after the diagnosis of diabetes, this patient's diabetes is still controlled by diet and biguanides.
A case of primary mucoepidermoid carcinoma of the thyroid: molecular evidence of its origin
Authors: Minagawa Akinobu , Iitaka Makoto , Suzuki Miho , Yasuda Shigemitsu , Kameyama Kaori , Shimada Shio , Kitahama Shinji , Wada Seiki , Katayama Shigehiro 
Published: March 2003

SummaryPrimary mucoepidermoid carcinoma (MEC) of the thyroid is very rare, and its origin has not been fully determined. We report a case of MEC, the origin of which was demonstrated by thyroid specific genes expressed in a metastatic lymph node. A 52‐year‐old male presented with chest pain, weight loss and diffuse goitre. Ultrasonography showed the thyroid to be diffusely enlarged with numerous small calcifications. The tumour was found to be infiltrating the thyroid, lung, lymph nodes and first thoratic vertebra. A variant type of papillary thyroid carcinoma was suspected by fine needle aspiration cytology of the thyroid. An open biopsy specimen from an axillary lymph node revealed the tumour to be composed of three distinct cell types: mucin‐producing cells, intermediate cells and a small amount of epidermoid cells with scattered psammoma bodies. Immunohistochemical studies showed the tumour cells to be negative for thyroglobulin and calcitonin, but positive for CEA. To examine the primary origin of the tumour, the expression of thyroid specific genes in the lymph node specimen was examined by RT‐PCR. TTF‐1, TTF‐2, Pax‐8, Na‐I symporter and thyroid peroxidase mRNA were detected. The presence of these thyroid‐specific mRNAs indicates that this MEC originated from thyroid follicular epithelium. This is the first molecular evidence of dedifferentiation from thyroid follicular cells to MEC.
Glucocorticoids as prophylaxis against acute mountain sickness
Authors: Basu M. , Sawhney R. C. , Kumar Surender , Pal K. , Prasad R. , Selvamurthy W. 
Published: March 2003

SummaryObjective Acute mountain sickness (AMS) characterized by presence of symptoms including headache, nausea, excessive fatigue, loss of appetite, irritability and insomnia is a major impediment to work performance in human subjects who are rapidly inducted to high altitude (HA) during the initial phase of induction. The present study aims at to evaluate the efficacy of prophylactic administration of low dose glucocorticoids in prevention of AMS in normal healthy men who are inducted to HA by air.Design Fifty healthy men were randomly divided into five groups of 10 each. Group I received prednisolone (Pred) 10 mg, Group II Pred 20 mg, Group III Pred 40 mg, Group IV dexamethasone 0·5 mg, Group V received placebo once a day in the morning for 2 days at sea level (SL) and for 3 days on arrival at an altitude of 3450 m by air.Measurements The severity of AMS was assessed using Lake Louise AMS scoring system. Physiological parameters like blood pressure, respiratory rate, peripheral blood O2 saturation and heart rate were measured at sea level and on arrival at HA. Circulatory levels of cortisol and adrenocorticotropic hormone (ACTH) were measured by radioimmunoassay (RIA) and immunoradiometreic assay (IRMA), respectively.Results In the placebo group, significant AMS could be detected at 12 h of arrival at HA, peaked by day 1 or 2 of stay and started declining thereafter. As compared to the placebo group, the steroid treated groups showed a significant (P < 0·01) reduction in daily AMS score. When compared with prednisolone 10 mg, 40 mg and dexamethasone groups, the prednisolone 20 mg group showed an optimal response in reduction of AMS symptoms. The O2 saturation showed a significant decline (P < 0·001) on arrival at HA, but the pattern of O2 saturation in placebo and glucocorticoid groups was identical. Similarly, the rise in heart rate and blood pressure and on day 3 of stay at HA was similar in placebo and glucocorticoid‐treated groups. An increase in plasma cortisol in placebo group was observed on day 3 of stay at HA and continued to rise till day 8 of observations. The cortisol levels in Pred 10 mg and Pred 20 mg groups on day 1 and 3 of arrival at HA were not significantly different than the SL post‐treatment values but were found to be significantly higher on day 8 of stay. Plasma cortisol in Pred 40 mg and dexamethasone groups was significantly lower (P < 0·01) on day 1 and 3 of stay but showed an increase by day 8 of stay. The ACTH levels were increased at HA in placebo group but did not show any significant change till day 3 of stay in steroid treated subjects and were found to be higher in all groups on day 8 of observations.Conclusion These observations suggest that administration of low‐dose glucocorticoids can curtail acute mountain sickness significantly without influencing the normal adreno cortical response to hypoxia.
Comparisons of leptin, incretins and body composition in obese and lean patients with hypopituitarism and healthy individuals
Authors: Mersebach H. , Svendsen O. L. , Holst J. J. , Astrup A. , Feldt‐Rasmussen U. 
Published: March 2003

Summaryobjective To identify possible abnormalities specific for obesity in hypopituitary patients.study design Cross‐sectional case–control study.measurements and study subjects Body composition (DEXA) and measurements of fasting plasma levels of glucose‐dependent insulinotropic polypeptide (GIP), glucagon‐like peptides (GLPs), insulin, C‐peptide, glucose, leptin and lipids were performed in 25 hypopituitary patients (15 obese, 10 normal weight) and 26 BMI and age‐matched healthy controls (16 obese, 10 normal weight). All hypopituitary patients had GH deficiency and received adequate substitution therapy on this and other deficient axes (3 ± 1).results Fasting GIP‐levels were significantly higher in obese hypopituitary patients compared to lean hypopituitary patients (P < 0·01), while the fasting concentrations of GLP‐1 and GLP‐2 were comparable between obese and lean hypopituitary patients. The same trend was seen in obese healthy controls vs. lean controls. No differences were observed in glucose, insulin or C‐peptide between the hypopituitary patients and the controls. Leptin levels were increased in obese hypopituitary patients compared to lean hypopituitary patients when adjusted for gender. At least a 2‐fold higher level of leptin was observed in women compared to men in both patient groups and healthy controls. Lean female hypopituitary patients had higher leptin levels than matched controls.conclusions Fasting levels of GIP were elevated in obese substituted hypopituitary patients, while fasting concentrations of GLPs were similar. Obese hypopituitary patients had the same degree of hyperinsulinaemia, affected glucose tolerance, dyslipoproteinaemia and central obesity as obese healthy controls. Further studies are required to identify the possible biochemical reasons for obesity in patients with apparently well‐substituted hypopituitarism.
Methodological aspects of the evaluation of endothelium‐dependent vasodilatation in the human forearm
Authors: Lind  , Sarabi  , Millgård  
Published: March 2003

The present study, involving 56 healthy subjects from a health screening, was undertaken to address some methodological questions regarding the measurement of endothelial function using local intra‐arterial infusions of metacholine (2 and 5 μg min−1) to evaluate endothelium‐dependent vasodilatation, and sodium nitroprusside (SNP, 5 and 10 μg min−1) to evaluate endothelium‐independent vasodilatation. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. The ratio of FBF during the highest dose of metacholine to FBF during the highest dose of SNP was used as an index of endothelial function. In 10 young volunteers the procedure was repeated after 2 h and again after 3 weeks in order to study short‐term and long‐term reproducibility of the method.Neither the vasodilatatory response to metacholine (r = 0·006) nor that to SNP (r = 0·08) was related to resting FBF. Neither the circumference nor the length of the arm was related to endothelial function (r = 0·01−0·11), as evaluated by the FBF on metacholine to nitroprusside ratio (mean 1·3 ± 0·3 SD).The use of a wrist cuff to exclude hand circulation, or not, did not influence the evaluation of endothelial function significantly.Maximal FBF after 3 min of arterial occlusion of the forearm was significantly related to blood flow during both metacholine (r = 0·53, P < 0·01) and nitroprusside infusion (r = 0·36, P < 0·05), but not to the FBF on metacholine to nitroprusside ratio (r = 0·01).The short‐term and long‐term reproducibility of FBF during vasodilatation with metacholine and SNP was good (r = 0·89−0·97, P < 0·001), while the individual measurements for resting FBF were less reproducible when repeated after 3 weeks (r = 0·34).In conclusion, endothelial function was not related to resting FBF, nor to the arm circumference or length. No major difference was seen whether endothelial function was evaluated with or without exclusion of the hand circulation. Maximal FBF during reactive hyperaemia was not related to endothelial function.
The diagnostic value of oesophageal radionuclide transit in patients admitted for but without acute myocardial infarction
Authors: Jørgensen  , Fruergaard  , Launbjerg  , Aggestrup  , Elsborg  , Hesse  
Published: March 2003

The use of radionuclide transit (RT) as a screening test for chest pain of oesophageal origin has been debated. The aim of this study was to determine the value of RT as a screening test for oesophageal disorders in comparison with oesophageal manometry in patients admitted with acute chest pain but without acute myocardial infarction (non‐AMI patients), and to assess the frequency of oesophageal disease present in these patients. A total of 222 non‐AMI patients entered the study. An extensive examination programme comprised noninvasive cardiac studies, pulmonary studies, a careful physical examination of the musculoskeletal system, and oesophago‐gastric examinations including endoscopy, pH monitoring of the oesophagus and a Bernstein test. In 91% of the patients one or more diagnoses were obtained.Based on clinical and laboratory data a `consensus' diagnosis was made. With manometry as the reference RT had a poor sensitivity (35%) but an acceptable specificity (82%). With the consensus diagnosis as the gold standard the sensitivities of both manometry and RT were poor (29%), whereas the specificity of RT, but not of manometry, was very high (97%). Gastrointestinal diagnoses were found in 57% of the patients. In conclusion, none of the applied oesophageal examinations are valuable as single screening tests. Both RT and manometry have low sensitivities. RT may be used as a cheap, noninvasive and rapid supplementary examination. When positive, it strongly supports further invasive studies of the oesophagus in non‐AMI patients with unexplained chest pain.
Cytological changes of the respiratory tract in young adults related to high levels of air pollution exposure
Authors: DJURIČIĆ  , PLAMENAC  
Published: March 2003

djuričić s. and plamenac p. (1998) Cytopathology 9, 23–28Cytological changes of the respiratory tract in young adults related to high levels of air pollution exposureSeveral histopathological and cytological studies have shown that lesions of the respiratory tract epithelium become increasingly severe with duration of exposure to high levels of urban air pollution as well as with ageing of studied population groups. In this study we investigated and compared findings of cytological abnormalities in sputa of young adults (21–25 years of age) exposed to high levels of air pollution since birth with those who were exposed in the last 2–3 years only. All subjects were non‐smokers and were clinically healthy at the time of sampling. No significant differences in the incidence or severity of any of the cytological findings were found. The fact that even 10 times longer exposure to air pollution resulted in no major respiratory tract epithelial changes is, in our opinion, a result of the extremely efficient defence mechanisms and enormous regenerative potential of the respiratory tract of younger people.
Personal performance profiles: a useful adjunct to quality assurance in cervical cyt_logy
Authors: HOULISTON  , BOYD  , NICHOLAS  , SMITH  
Published: March 2003

houliston d. c., boyd c. m., nicholas d. s. and smith j. a. (1998) Cyt_pathology,9, 162–170Personal performance profiles: a useful adjunct to quality assurance in cervical cyt_logyIn our laboratory, which processes approximately 40 000 smears annually, the reporting patterns of each individual primary screener have been continuously monitored over a 6‐year period. The detection rates for minor abnormalities (borderline/mild dyskaryosis) and major abnormalities (moderate dyskaryosis and worse) are published quarterly in the laboratory. Individual continuous monitoring rapidly identifies screeners with low detection rates. It is a useful adjunct to existing methods of quality assurance; rescreening can be more appropriately directed to smears reported by screeners with low detection rates. It also identifies training needs and may be used to assess the value of update courses for each screener. It is a faster method of identifying poor performance than rapid review of all smears. The reporting rate of inadequate smears is also calculated and published on a quarterly basis. This promotes a degree of uniformity within the laboratory in the rate at which smears are reported as inadequate, and also reduces the inadequate rate.
Quality procedures in non‐gynaecological cytology laboratories in England and Wales
Authors: Egan M. , Gray J. 
Published: March 2003

Quality procedures in non‐gynaecological cytology laboratories in England and WalesAll non‐gynaecological cytology laboratories in England and Wales (n = 212) were surveyed by telephone. The aim was to investigate what concepts of quality applied in this context and to establish what tools and techniques of quality improvement were used. The overall response was 146 (69%). The respondents mainly comprised NHS Trusts and University Departments. The study showed that there was a diverse approach to quality. All types of quality assurance and customer focus procedure questioned were undertaken but to a varied extent; three laboratories (2%) used a complete range and three (2%) used no procedure at all. Accreditation was associated with staffing adequacy and use of surveys, but not quality assurance (QA) or user focus. Laboratories with a high priority for quality performed more QA and reported a higher staffing adequacy. Critical incident analysis was dependent on workload. Computerization did not affect quality procedures and involvement in the Breast Screening Programme did not result in different quality measures. The time since last update was independent of all factors and external quality assurance (EQA) was not widely available. The study suggested that an integrated approach to quality had not been adopted in English and Welsh cytology laboratories and that there may be a need for a more strategic approach with greater availability of EQA, guidelines on quality tools, closer linkage of accreditation and quality procedures and the production of minimum and ideal standards. The ideal standard could be the complete range of procedures, and the minimum standard could comprise those processes in most frequent use, i.e. critical incident analysis, correlation methods, action on information, analysis of what is done with diagnostic information, a complaints procedure and customer surveys.
Prospective study of PAPNET: review of 25656 Pap smears negative on manual screening and rapid rescreening
Authors: Halford J. A. , Wright R. G. , Ditchmen E. J. 
Published: March 2003

Prospective study of PAPNET: review of 25 656 Pap smears negative on manual screening and rapid rescreeningIn this prospective study, 27014 Pap smears were selected for PAPNET review on the request of the referring practitioner or patient. Smears that were negative on routine manual screening were submitted for rapid rescreening. Smears considered normal after these two manual screens (n = 25656) were reviewed using the PAPNET testing system. Routine manual screening identified 1340 (4.96%) of the smears as abnormal, and a further 18 (0.07%) abnormalities were detected by rapid rescreening. PAPNET review identified an additional 102 (0.4%) abnormal smears, including 10 histologically confirmed high grade lesions. The use of PAPNET testing following routine manual screening and rapid rescreening in tandem, enables cytologists to detect additional diagnostically significant abnormalities and reduce the rate of false‐negative smears.
A survey of biomedical scientists and consultant pathologists involved in the cervical screening programme
Authors: Brown D. C. , Griffiths D. 
Published: March 2003

A survey of biomedical scientists and consultant pathologists involved in the cervical screening programmeThe past decade has seen a transformation in the National Health Service Cervical Screening Programme (NHSCSP) largely driven by responses to various screening scandals. Independent inquiries into these laboratory failures have identified a number of contributing factors. The aim of this postal survey was to determine how widespread these factors are throughout screening laboratories in England. The results indicate that issues around recruitment and retention of staff, the training of pathologists and low morale appear to be widespread. However, the results do not indicate a widespread breakdown in working relationships between consultants and biomedical scientists, although there is room for improvement in their relationships with hospital management. Finally, there seem to be mixed messages about the commitment of consultants to the screening programme.