bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oestrogen supplementation attenuates responses to psychological stress in elderly men rendered hypogonadal after treatment for prostate cancer
Authors: Komesaroff Paul A. , Fullerton Meryl , Esler Murray D. , Jennings Garry , Sudhir Krishnankutty 
Published: March 2003

Summarybackground We have shown previously that oestrogens attenuate cardiovascular and hormonal responses to stress in perimenopausal women. The cardiovascular role of oestrogens in men is uncertain, despite preliminary evidence that endogenous oestrogens produced by aromatization of androgenic precursors are of physiological importance; hypogonadal men have very low levels of circulating oestrogen.methods We therefore studied the haemodynamic and hormonal responses to a standardized laboratory mental stress test in 12 men (mean age 68·9 ± 2·6 SEM years) rendered hypogonadal as a result of treatment for prostatic cancer, before and after 8 weeks of oestrogen supplementation (oestradiol valerate 1 mg daily, n
= 7) or placebo (n = 5). The stress was administered as a standard mental arithmetic test of 10 minutes’ duration. Blood pressure, cortisol and ACTH were measured at baseline, and following 5 minutes and 10 minutes of stress, and ACTH again at 25 minutes on both days. Noradrenaline and adrenaline responses to mental stress, as well as changes in total body and forearm spillover of noradrenaline and noradrenaline clearance, were also measured.results Oestrogen supplementation was well tolerated, with minimal adverse effects. Mean oestradiol levels increased from < 30 pmol/l to 308 ± 65 pmol/l after oestrogen treatment. Oestradiol significantly attenuated the mental stress‐induced increase in both systolic and diastolic blood pressures. Oestradiol also attenuated mental stress‐induced increases in ACTH, cortisol and adrenaline, but did not influence either total body or forearm spillover of noradrenaline. Responses to stress were unchanged after administration of placebo.conclusions We conclude that oestrogen supplementation in men rendered hypogonadal as a result of treatment for prostate cancer is well tolerated and significantly attenuates blood pressure and hormonal responses to psychological stress. These findings suggest the need for further studies to examine a possible clinical role for oestrogen treatment in hypogonadal men.
Serum leptin concentrations of patients with sequential thyroid function changes
Authors: Hsieh Ching‐Jung , Wang Pei‐Wen , Wang Shan‐Tair , Liu Rue‐Tsuan , Tung Shih‐Chen , Chien Wen‐Yen , Lu Yung‐Chuang , Chen Jung‐Fu , Chen Chen‐Hsiong , Kuo Ming‐Chun 
Published: March 2003

Summarybackground Leptin, a recently discovered protein produced in adipocytes, regulates body weight by suppressing food intake and/or increasing energy expenditure. Thyroid hormones, which increase the basal metabolic rate and thermogenesis, have been reported to be one of leptin's regulating factors because alternations in thyroid status might lead to compensatory changes in circulating leptin.objective The aim of this study was to assess the influence of sequential changes in thyroid function on serum leptin levels.patients and methods The thyroid function status of 65 patients (55 women and 10 men, aged 40·6 ± 15·2 years, mean ± SD) with differentiated thyroid cancer who had received near‐total thyroidectomy was studied before I‐131 ablation therapy and after 2–4 and 6 months of levo‐thyroxine suppressive therapy. Thirty‐three (26 women, seven men; aged 41·0 ± 10·4 years, mean ± SD) of them were found to have become hypothyroid, then euthyroid and subsequently subclinically hyperthyroid. Their body mass index (BMI), body fat (%BF) by electrical bioimpedance, thyroid function and fasting serum leptin in these states were assessed and compared to those of 38 controls (30 women, eight men, aged 40·2 ± 11·3 years, mean ± SD). The controls had no past history or family history of thyroid diseases, and had the same range of BMI, between 20 and 30 kg/m2, as the patients.results No difference in serum leptin levels was found between patients and controls with comparable age, sex, and BMI distribution in the euthyroid state. Using a repeated measures anova, tests of TSH, free T4 (FT4), BMI,%BF and leptin were performed on the 33 patients with sex as a grouping factor and thyroid state as a time factor. The sex difference for %BF and leptin proved to be statistically significant (P < 0·0001, and P = 0·0003, respectively). Serum leptin levels increased significantly from the hypothyroid to the subclinical hyperthyroid state (P < 0·0001) with a more pronounced increase found in females than in males (P = 0·03). Change of BMI during sequential thyroid function alterations was significant (P = 0·04) while change in %BF was not significant (P = 0·09). Pearson correlation analysis showed that serum leptin levels significantly correlated with BMI, %BF, FT4, and TSH (all P < 0·05). Using the generalized estimating equations, multivariate regression analysis revealed that FT4 was a statistically independent predictor for serum leptin (P < 0·0001). While other parameters were held constant, the mean serum leptin level increased by 1·47 units when serum FT4 was increased by one unit.conclusion In conclusion, our data indicate that circulating thyroid hormone plays a relevant role in regulating leptin metabolism independent of BMI and body fat.
Detection of low titre TBII in patients with Graves’ disease using recombinant human TSH receptor
Authors: Morgenthaler Nils G. , Nagata Atsuo , Katayama Shigehiro , Bergmann Andreas , Iitaka Makoto 
Published: March 2003

Summaryobjectives We evaluated thyrotropin‐binding inhibitor immunoglobulin (TBII) in sera from patients with Graves’ disease (GD) by using the new human recombinant TSH receptor (TSH‐R) assay to determine if it is useful for the diagnosis and follow‐up of GD.patients Serum samples from 25 patients with untreated GD, 24 with relapsing GD, 15 with GD in remission and 197 treated GD patients were examined. TBII was also measured in sera from healthy individuals (n = 69).design and measurements TBII was retrospectively measured by using the conventional porcine TBII assay (pTBII) and the human recombinant TBII assay (hTBII). Specificity was adjusted at 97·5% for both assays by receiver‐operating characteristic (ROC) plot analysis, resulting in cut‐offs at 10·5% inhibition (hTBII) and 9·9% (pTBII). Sensitivity was 87% for hTBII compared to 52% for pTBII (P < 0·0001).results Even in pTBII‐positive patients, hTBII values (57·6 ± 26·1%) were significantly (P < 0·0001) higher than pTBII values (34·2 ± 27·6%). When 139 pTBII‐negative serum samples from patients with treated GD were examined, 97 samples (69·8%) were positive for hTBII. hTBII values (23·9 ± 17·0%) were significantly (P < 0·0001) higher than pTBII values (4·1 ± 3·3%). hTBII was positive in 13 of 13 patients who were taking antithyroid drugs but had normal serum TSH levels. When 19 serum samples from pTBII‐negative untreated patients with GD were examined, 15 out of 19 (79%) were positive for hTBII. We also examined 24 patients with relapsing GD. hTBII was positive in 16 (64%) patients, whereas seven (16%) were positive for pTBII (P < 0·01). Positivity of hTBII in these untreated or relapsing GD patients was significantly higher than that of thyroid stimulating antibodies. We then examined TBII levels in 15 patients with GD in remission who had normal serum TSH values. hTBII was positive in seven patients at the time of blood withdrawal, and GD subsequently relapsed in three hTBII‐positive patients in 6 months.conclusions Low TBII titres can now be followed more accurately during the course of treatment, which will also allow better longitudinal studies on the importance of TBII for the diagnosis as well as the prognosis of GD with respect to remission or relapse.
Relationship between plasma free fatty acids and uncoupling protein‐3 gene expression in skeletal muscle of obese subjects: in vitro evidence of a causal link
Authors: Sbraccia Paolo , D’Adamo Monica , Leonetti Frida , Buongiorno Angela , Silecchia Gianfranco , Basso Maria Sole , Tamburrano Guido , Lauro Davide , Federici Massimo , Di Daniele Nicola , Lauro Renato 
Published: March 2003

Summaryobjective To investigate whether skeletal muscle uncoupling protein‐2 (UCP2) and uncoupling protein‐3 (UCP3) gene expression is altered in massive obesity and whether it correlates with in vivo insulin sensitivity and with metabolic and hormonal status.design Quantification of UCP2 and UCP3 gene expression in skeletal muscle of obese and lean subjects displaying different degrees of insulin sensitivity.patients Fourteen obese and 10 age‐ and sex‐matched healthy control subjects with a mean body mass index (BMI) of 43·6 ± 1·4 and 22·8 ± 1·8 (± SEM), respectively.measurements Insulin sensitivity by glucose clamp, body composition by bio‐impedance, fasting plasma glucose, insulin, leptin and free fatty acids (FFA). Skeletal muscle UCP2 and UCP3 mRNA levels by quantitative reverse transcription polymerase chain reaction (RT–PCR).results No significant differences in UCP2 or UCP3 mRNA levels were found between obese and control subjects. No significant correlation was observed, in both groups, between UCP2 or UCP3 mRNA levels and both anthropometrical and metabolic parameters. In contrast, a highly significant correlation was observed between skeletal muscle UCP3, but not UCP2, mRNA levels and plasma FFA in the obese, but not in the lean, group. Furthermore, exposure of human myocytes to FFA for 24 h strongly induced both UCP3 and peroxisome proliferator‐activated receptor‐γ (PPARγ) but not UCP2 gene expression.conclusions FFA levels correlate strongly with skeletal muscle UCP3 mRNA levels in obese, but not in lean, subjects; in addition, in human myocytes, high FFA concentrations promote UCP3 expression. Our studies therefore provide evidence that supports a role for increased plasma FFA concentrations in the regulation of human skeletal muscle UCP3 gene expression.
A single growth hormone (GH) determination is sufficient for the diagnosis of GH‐deficiency in adult patients using the growth hormone releasing hormone plus growth hormone releasing peptide‐6 test
Authors: Leal A. , Lage M. , Popovic V. , Torres E. , Koppeschaar H. P. F. , Paramo C. , Micic D. , Garcia‐Mayor R. V. , Dieguez C. , Casanueva F. F. 
Published: March 2003

Summarybackground The diagnosis of GH deficiency in adults is based on the provocative testing of GH secretion. When testing a patient with suspected GH deficiency, clinicians assess the whole secretory curve and select the GH peak as an index of secretory capability. This procedure is time consuming and the determination of GH in several samples is necessary. The combined administration of growth hormone releasing hormone (GHRH) plus growth hormone releasing peptide‐6 (GHRP‐6) is an effective test of GH secretion, and it has been unambiguously demonstrated that the elicited GH peak is capable of segregating normal GH secretion subjects from GH deficient patients on an individual basis. The GHRH + GHRP‐6 test biochemically classifies patients into three groups; those with a stimulated GH peak ≥ 20 µg/l are considered normal and those with peaks at ≤ 10 µg/l as GH deficient. The group comprising individuals between these parameters is considered uncertain, and the results are further interpreted according to clinical information, or by other tests.objective  As the GHRH + GHRP‐6 test induces GH peaks consistently in the first 30 minutes, the working hypothesis assessed in this study was whether a single determination of GH 30 minutes after stimulus could provide the same clinical classification as the whole secretory curve.patients and methods  Three hundred and forty‐nine adult subjects (146 patients with organic pituitary disease and 203 healthy subjects) were studied. All were administered GHRH 1 µg/kg i.v. plus GHRP‐6 1 µg/kg i.v. at 0 minutes, and blood samples were obtained at regular intervals. GH was determined in all samples.results  GHRH + GHRP‐6‐evoked GH peaks in controls and patients were not correlated with GH basal values, making this determination useless for test validation. In contrast, an excellent correlation was observed between GH values at 30 minutes and the GH peaks (r = 0·994, P < 0·0001). When comparing the 30‐minute GH values against the peaks, the biochemical classification changed from normal toward uncertain in only five out of 203 control subjects, which is without clinical relevance according to Bayes theorem. Similarly, when the 30‐minute value was used instead of the peak in GH deficient patients, only two out of 146 patients moved from the uncertain area toward the GH deficient one. Thus, better diagnostic classification was provided for patients.conclusions The GHRH + GHRP‐6 test is a convenient, safe and reliable, provocative test of GH reserve in adults, which can be reduced to a single fixed GH determination 30 minutes after stimulus.
Hodgkin's disease masquerading as fibrous thyroiditis: potential role of cytokines in in vivo and in vitro studies
Authors: Bercovici Jean Pierre , Machelon Veronique , Gaudin‐Nome Françoise , Roudaut Nathalie , Conan‐Charlet Virginie , Leroy Jean Paul , Sensebe Luc , Kerlan Veronique 
Published: March 2003

SummaryHodgkin's disease appearing as, or associated with, fibrous thyroiditis has only been described rarely. We report the observation of a patient presenting with a goitre, fibrosis of the thyroid and adjacent structures, and hypothyroidism. The histological examination was compatible with fibrosclerotic thyroiditis. This diagnosis was reviewed 6 months later when the biopsy of a supraclavicular nodule that had subsequently appeared led to the diagnosis of a nodular‐sclerosis type of Hodgkin's disease. The plasmatic levels of interleukin 6 (IL‐6) and tumour necrosis factor alpha (TNF‐α) were very high compared to the levels in healthy subjects (12 and 40 IU/l vs. 0·05 and 2·0 IU/l, respectively). These cytokine levels decreased when the initial illness was treated, and their normalization was associated with the disappearance of the cervical and thyroidal fibroses. A parallel in vitro study of these cytokines and of TNF‐α receptors and IL‐13 was performed. The results suggest a possible cause‐and‐effect relationship between IL‐6 and IL‐13 produced locally by the tumoral tissue and the development of cervical fibrosis.
Final height outcome and value of height prediction in boys with constitutional delay in growth and adolescence treated with intramuscular testosterone 125 mg per month for 3 months
Authors: Kelly Brian P. , Paterson Wendy F. , Donaldson Malcolm D. C. 
Published: March 2003

Summaryobjectives Constitutional delay in growth and adolescence (CDGA) is common in boys, some of whom request treatment to accelerate growth and attainment of secondary sexual characteristics. The aims of this study were to confirm that a 3‐month course of intramuscular testosterone oenanthate does not impair final height in boys with CDGA, and to determine the accuracy of height prediction in this condition.design and patients Boys with CDGA who had attended the growth clinic, who were now at or close to final height and who had received either testosterone or declined treatment, were identified by retrospective case note analysis. Bone age assessment was carried out by a single observer, using the RUS (TW2) method of Tanner and Whitehouse.measurements The following auxological data were extracted from the case records: age, bone age, height, pubertal stage, parental heights and predicted final height. All subjects were then measured at age 19 years or greater. The main outcome measures were comparison of final height in treated and untreated boys; final height comparison with mid‐parental height and with height prediction [RUS (TW2) method] at initial assessment and at subsequent review.results Sixty‐four boys met the inclusion criteria, of whom 41 subjects had received testosterone and 23 were untreated. There were no significant differences between the groups (treated mean/SD vs. untreated mean/SD; P‐value) in age (14·3/0·7 vs. 14·0/1·1; 0·13), height (144·7/6·2 vs. 144·2/6·2; 0·79), mid‐parental heights (170·4/5·5 vs. 171·1/4·5; 0·59), and bone age (12·0/1·2 vs. 12·3/1·3; 0·36). Final heights in both groups (168·9/6·0 vs. 168·2/3·5; 0·65) were closely related to predicted final heights (170·0/5·0 vs. 168·1/4·1; 0·15) and only slightly less than mid‐parental heights. Only three subjects had final heights below the initial height prediction range.conclusions Our data support the hypothesis that this treatment regime does not adversely affect the final height achieved in constitutional delay of growth and adolescence and that height prediction, assessed by a single observer, is a useful and accurate tool.
Carriers for type II 3β‐hydroxysteroid dehydrogenase (HSD3B2) deficiency can only be identified by HSD3B2 genotype study and not by hormone test
Authors: Pang Songya , Carbunaru Goldy , Haider Anzar , Copeland Kenneth C. , Chang Ying Tai , Lutfallah Chantal , Mason J. Ian 
Published: March 2003

Summaryobjective We investigated adrenal steroidogenic function relevant to 3β‐hydroxysteroid dehydrogenase (HSD3B2) activity in vivo and HSD3B2 genotype in clinically normal family members of patients with HSD3B2 genotype‐proven HSD3B2 deficiency congenital adrenal hyperplasia (CAH) to determine whether genotype‐proven carriers for HSD3B2 deficiency exhibit decreased enzyme activity analogous to the mildly decreased adrenal 21‐hydroxylase activity in the carriers of CYP21 gene mutation.design/patients Nineteen adult family members (ages median/range: 37/19–56 years) including 13 females and six males of six unrelated patients with HSD3B2 genotype‐proven HSD3B2 deficiency were studied.measurements All family members had HSD3B2 DNA analysis and an ACTH stimulation test (Cortrosyn 0·25 mg IV bolus) for determination of adrenal HSD3B activity.results Ten of 13 females and five of six males were carriers of a proven or predictably deleterious mutation in one allele of the HSD3B2 gene, which was identified in the probands. ACTH‐stimulated levels of 17‐hydroxypregnenolone (Δ5‐17P), 17‐hydroxyprogesterone (17‐OHP), cortisol (F), dehydroepiandrosterone (DHEA) and androstenedione (Δ4‐A) and ratios of Δ5‐17P to 17‐OHP, Δ5‐17P to F and DHEA to Δ4‐A, as well as increments of Δ5‐17P and DHEA values (ACTH‐stimulated − baseline) in the genotype‐proven female carriers (age, mean ± SD: 36 ± 6·7 years) and male carriers (age, mean ± SD: 37 ± 6·7 years) did not differ significantly from age‐matched normal females (35 ± 5·4 years, n = 20) and normal males (35 ± 6 years, n = 10), respectively. There were no significant differences in any of the ACTH‐stimulated hormonal levels or ratios between the female carriers with a seriously deleterious genotype (n = 5) and the female carriers with mildly deleterious genotypes (n = 5). These hormonal levels and ratios in three genotype‐normal females and one genotype‐normal male overlapped with those of the carriers.conclusion These data suggest that normal adrenal HSD3B2 activity is maintained in the genotype‐proven carriers because heterodimers of mutant and wild‐type HSD3B2 enzymes may be stable and exhibit similar activity compared to homodimers of wild‐type enzymes, possibly by a relatively rate‐unlimited effect of haplo‐wild‐type enzyme activity. However, we cannot preclude entirely the possibility of a limited expression of another HSD3B activity under ACTH stimulation contributing to the normal adrenal HSD3B activity in vivo in the HSD3B2 genotype‐proven heterozygotes. Which mechanism plays a role in maintaining normal enzyme activity in the heterozygotes remains to be elucidated. The hormone findings in the genotypic‐proven carriers for HSD3B2 deficiency also indicate that carriers for this disorder cannot be detected by a hormone test and can only be detected by HSD3B2 genotype study.
A new method to quantify postexercise ST‐deviation – the ST‐deficit. A study in men at high and low‐risk for coronary heart disease
Authors: Suurküla Madis , Arvidsson Anders , Fagerberg Björn , Bjurö Thorvald , Wikstrand John 
Published: March 2003

Background Quantitative heart rate adjusted exercise ST criteria like μV/beats per minute (bpm) improve the diagnostic accuracy of the exercise ECG. However, there are few quantitative HR adjusted postexercise variables available. The aim of the present exercise study was to evaluate a new such variable from computerized averaging of the postexercise ECG. Methods The presence of possible myocardial ischaemia in a population based sample of 74 elderly male hypertensives at high‐risk of coronary heart disease, and in 42 age‐matched clinically healthy males (reference group) at low‐risk was assessed by exercise ECG. All men had a normal resting ECG without signs of ischaemia. Variables studied: standard ST‐criteria, ST/HR slope ≤–2·4 μV · bpm–1, shape of the rate‐recovery loop, the latter also with a new quantitative variable, the ST‐deficit. Results In spite of a normal resting ECG many subjects showed an abnormal ST/HR slope during exercise, 43% in the hypertension group and 26% in the reference group. An abnormal rate‐recovery loop (ST‐deficit) also contributed substantially to identify patients with possible myocardial ischaemia, 30 vs. 10%, respectively (P<0·02); cumulatively for the two HR adjusted criteria 53% vs. 29%, respectively (P<0·02). Mean ST‐deficit was significantly lower in the high‐risk group. Conclusions Effort‐related myocardial ischaemia is frequently silent in elderly high‐risk hypertensives and necessitates testing, preferably with computerized exercise ECG and heart rate adjusted ST criteria. A new quantitative variable to assess the postexercise rate‐recovery loop in the time domain, the ST‐deficit is described. This variable seems to effectively discriminate between subjects with low and high‐risk for coronary heart disease and thus provides new information. Further studies are warranted to validate this variable against myocardial perfusion scintigraphy and coronary angiography.
Fine needle aspiration (FNA) biopsy of primary cutaneous meningioma: report of two cases
Authors: KALFA M. , DASKALOPOULOU D. , MARKIDOU S. 
Published: March 2003

Fine needle aspiration (FNA) biopsy of primary cutaneous meningioma: report of two casesTwo cases of primary cutaneous meningioma are described. A male and a female patient, aged 56 and 61 years, respectively, presented each with a solitary subepidermal nodule. The initial diagnosis was established in both patients by application of FNA biopsy. The subsequent histologic examination confirmed the cytologic diagnosis. Extensive investigation of the patients by computed tomography (CT) and nuclear magnetic resonance imaging (MRI) scans failed to reveal any primary meningioma of the neuraxis. Neurologic examination and routine laboratory test results were all normal. The microscopic features, immunocytological study and histology, which all gave a similar pattern to that seen in intracranial meningiomas, are discussed. Distinction from other cutaneous lesions that may be considered in the differential diagnosis is made. A brief review of the literature is also presented.