bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipid profiles in untreated severe congenital isolated growth hormone deficiency through the lifespan
Authors: Gleeson Helena K. , Souza Anita H. O. , Gill Matthew S. , Wieringa Gilbert E. , De A. Barretto Elenilde S. , Barretto‐Filho J. A. S. , Shalet Stephen M. , Aguiar‐Oliveira Manuel H. , Clayton Peter E. 
Published: March 2003

Summaryobjective Growth hormone deficiency (GHD) is associated with adverse changes in lipid profile. However, changes in lipids through life in a homogeneous group of GHD subjects have not been defined.patients and measurements We examined lipid levels in a group of untreated severely GHD patients with a mutation in the GHRH receptor gene from a rural community in North‐east Brazil. Lipid profiles in 15 GHD subjects [eight children and adolescents (one male), age (median [range]) 13·2 (5·4–19·9) years; seven adults (one male), age 47 (33–66) years] were compared with those in 29 indigenous controls from the same extended kindred [17 children and adolescents (six male), age 10·2 (5·3–18·4) years; 12 adults (eight male), age 54·5 (33–80) years]. All GHD subjects had a peak GH response of < 0·5 ng/ml in response to an insulin tolerance test and extremely reduced IGF‐1 levels (median 5·5 ng/ml). Data were compared between cohorts and with an age‐ and sex‐matched white American reference population.results Abnormalities were confined to plasma total cholesterol (TC) and low‐density lipoprotein cholesterol (LDL‐C) levels. More GHD children had levels of plasma TC and LDL‐C above the 95th percentile for our reference population (3/8 and 4/7, respectively) compared to controls (0/17 and 1/15, respectively) (P < 0·05). In the adults, median TC and LDL‐C levels were higher in the GHD than controls (P < 0·05) (6·3 vs. 4·1 mmol/l; 4·4 vs. 2·7 mmol/l, respectively). Median Z‐scores, calculated using values from the reference population, were not different between GHD children and adults for both TC (+0·8 vs.+0·4) and LDL‐C (+1·4 vs.+0·7).conclusions The lipid profile in children as well as in adults with very severe GHD is adversely modified. There would appear to be no significant worsening of the lipid abnormality with duration of GHD or achievement of adulthood.
Genetics of type 2 diabetes and insulin resistance: knowledge from human studies
Authors: McIntyre E. A. , Walker M. 
Published: March 2003

SummaryBoth type 2 diabetes mellitus (T2DM) and insulin resistance are complex traits in which multiple gene effects and metabolic and environmental factors combine to contribute to the overall pathogenesis of these conditions. This complexity has complicated the search for susceptibility genes and has led to different but complementary approaches being used for the detection of gene effects. These include the study of monogenic cases of insulin resistance and T2DM, association studies of candidate genes and genome‐wide scans. The peroxisome proliferator‐activated receptor gamma (PPARγ) and calpain‐10 (CAPN10) genes have recently been identified as T2DM susceptibility genes, and the lessons learnt from these studies are helping to shape future strategies to search for additional susceptibility genes in T2DM and insulin resistance.
Influence of antihypertensive medication on aldosterone and renin concentration in the differential diagnosis of essential hypertension and primary aldosteronism
Authors: Seifarth C. , Trenkel S. , Schobel H. , Hahn E. G. , Hensen J. 
Published: March 2003

Summaryobjective Antihypertensive drugs influence the neurohumoral cardiovascular system and the concentration of hormones involved in blood pressure regulation. Little is known, however, about the extent to which various antihypertensive drugs influence cardiovascular hormone concentrations and thus disturb the differential diagnosis of hypertension in clinical practice. In this study we compare the impact of different antihypertensive medicaments on the renin–angiotensin–aldosterone system in patients with essential hypertension who are screened for primary aldosteronism.design and subjects We analysed serum aldoster‐one (SAC) and plasma renin concentration (PRC) in 37 normotensive controls, 144 hypertensive patients with essential hypertension, and 19 patients with primary aldosteronism. Patients were on different treatment regimens such as single drug or combination therapy with β‐blockers, angiotensin‐converting enzyme (ACE) inhibitors or angiotensin II subtype 1 (AT1) receptor antagonists, calcium channel blockers, spironolactone and no treatment.results In patients with essential hypertension, β‐blocker therapy (n = 47) led to a highly significant suppression of renin, whereas serum levels of aldosterone were not significantly altered. ACE inhibitors and AT1 receptor antagonists (n = 55) decreased aldosterone levels only to a minor extent. Calcium channel blockers (n = 23) had no significant influence on SAC or PRC. In patients with primary aldosteronism treated with spironolactone (n = 8), renin escaped suppression and reached very high levels.conclusion β‐blockers and aldosterone antagonists have the strongest impact on the renin–angiotensin system. The decrease in renin concentration by β‐blockers leads to an increase in the ratio of aldosterone to renin, and thus to false‐positive results in patients with essential hypertension. Calcium channel blockers, and probably also ACE inhibitors and AT1 receptor antagonists alone or in combination, may be continued during screening for primary aldosteronism by determination of renin and aldosterone concentration.
A signal peptide mutation of the arginine vasopressin gene in monozygotic twins
Authors: Boson Wolfanga L. , Sarubi Juliana C. , D’Alva Catarina B. , Friedman Eitan , Faria Daniela , De Marco Luiz , Wajchenberg Bernardo 
Published: March 2003

SummaryFamilial neurohypophysial diabetes insipidus (FNDI) is a rare autosomal dominant syndrome stemming from the absence of arginine vasopressin (AVP). More than thirty‐five different germline mutations in the arginine vasopressin‐neurophysin II gene have been reported. These mutations are either in the signal peptide or scattered throughout the neurophysin II domain. A missense mutation altering alanine at position −1 to either valine or threonine in the signal peptide domain has previously been found in ten unrelated families. In the present report, Brazilian female monozygotic twins with clinically typical central DI in whom biochemical and molecular characterization were carried out are described. Direct mutational analysis by sequencing of the vasopressin gene in germline DNA revealed a heterozygous missense mutation (G→A) at nucleotide 279, predicting the substitution of alanine by threonine at position −1 of the signal peptide moiety. In summary, we present an extremely rare case of familial central diabetes insipidus in monozygotic Brazilian twins with a seemingly common missense mutation in the AVP gene.
Diagnosis of growth hormone deficiency after pituitary surgery: the combined acipimox/GH‐releasing hormone test
Authors: Van Dam P. Sytze , Dieguez Carlos , Cordido Fernando , De Vries Wouter R. , Veldhuyzen Bernard F. E. , Van Thiel E. , F. Casanueva Felipe , Koppeschaar Hans P. F. 
Published: March 2003

Summaryobjective Reduction of plasma free fatty acids leads to enhanced GH response after stimulation by GH‐releasing hormone (GHRH). We studied the clinical usefulness of combined administration of acipimox and GHRH for the diagnosis of GH deficiency.design We evaluated 35 patients [mean age 53·0 years; mean body mass index (BMI) 26·7 kg/m2] after pituitary surgery. We compared GH responses after acipimox and GHRH with the GH response during an insulin tolerance test (ITT) and, in a subgroup of 12 patients, with the GHRH/arginine test. The acipimox/GHRH test was additionally performed in 21 control subjects (mean age 53·8 years; mean BMI 24·7 kg/m2).results In the patients, the mean (± SEM) peak GH was almost four‐fold higher after acipimox/GHRH (6·94 ± 1·07 µg/l, range 0·46–23·1; P < 0·001) and after GHRH/arginine (8·32 ± 1·23 µg/l, range 1·1–49·2; P < 0·001) than after ITT (1·84 ± 0·46 µg/l, range 0·01–11·9). According to the ITT, 29 patients were severely GH deficient (peak GH < 3·0 µg/l). Peak GH levels after acipimox/GHRH in controls ranged from 7·5 to 78·4 µg/l (mean 29·3 ± 3·5). GH peak values during the acipimox/GHRH test were significantly correlated with values from the ITT (r = 0·63, P < 0·01) and GHRH/arginine test (r = 0·87, P < 0·001). Areas under the curve were also correlated. According to generally accepted cut‐off peak GH levels for the ITT and GHRH/arginine test, a GH peak exceeding 11·2 µg/l excludes severe GH deficiency after acipimox/GHRH. Our control data indicate that the cut‐off level is lower at older age.conclusions The acipimox/GHRH test leads to GH responses similar to those of the GHRH/arginine test, and to higher peak GH values if compared with the ITT. The acipimox/GHRH test is a potential additional tool to detect GH deficiency in patients with pituitary disease, in particular in patients with a perturbation of fatty acid metabolism.
Increased serum reverse triiodothyronine levels at diagnosis of hepatocellular carcinoma in patients with compensated HCV‐related liver cirrhosis
Authors: Sorvillo Francesca , Mazziotti Gherardo , Carbone Antonella , Morisco Filomena , Cioffi Michele , Rotondi Mario , Stornaiuolo Gianfranca , Amato Giovanni , Gaeta Giovanni B. , Caporaso Nicola , Carella Carlo 
Published: March 2003

Summaryobjective The aim of this study was to investigate changes in thyroid hormone metabolism in relation to the development of hepatocellular carcinoma (HCC) in patients with HCV‐related liver cirrhosis.materials and methods The study group (Group A) comprised 31 patients (25 M, 6 F; median age 62·1 years, range 54·0–81·5 years) affected by HCV‐related liver cirrhosis with superimposed HCC. Acute and chronic systemic disease, other than cirrhosis, inducing ‘euthyroid sick syndrome’ was excluded in all patients. Serum TSH, FT4, FT3, rT3, and thyroxine‐binding globulin (TBG) levels were retrospectively evaluated in frozen aliquots drawn at the time of tumour diagnosis and every 6 months for 3–7 years before HCC diagnosis. The control group (Group B) comprised 29 patients affected by HCV‐related liver cirrhosis without HCC, matched for sex, age and grade of liver dysfunction.results At the time of HCC diagnosis, all patients in Group A were euthyroid with serum TSH, FT4, FT3 and TBG values not significantly different from those of cirrhotic patients of Group B. However, at diagnosis Group A patients had serum rT3 values that were significantly higher than those in Group B (35·0 ng/dl, range 12·0–162·0 vs. 19·0 ng/dl, range 10·0–51·0; Group A vs. Group B; P < 0·001). Serum rT3 values above the normal range were found in 12 patients in Group A (38·7%) but in only one of the patients from Group B (3·4%) (χ2 10·2; P = 0·001). The serum rT3 levels were not significantly correlated to the Child grade of liver cirrhosis (rho 0·1; P = 0·5). The intrasubject analysis demonstrated that a significant increase in serum rT3 levels occurred at the time of HCC diagnosis but serum FT4, FT3 and TSH values did not change significantly. A receiver operating curve (ROC) demonstrated that a 6‐monthly increase in serum rT3 levels of at least +22·5% identified patients with HCC with a diagnostic accuracy of 81·7%.conclusions Our study has demonstrated that development of hepatocellular carcinoma is accompanied by a significant increase in serum rT3 levels in patients with low‐grade HCV‐related liver cirrhosis who had no other illness causing the ‘euthyroid sick syndrome’.
Fine needle aspiration biopsy of the spleen in pyrexia of unknown origin
Authors: Rajwanshi A. , Gupta D. , Kapoor S. , Kochhar R. , Gupta† S. , Varma† S. , Gupta S. 
Published: March 2003

Fine needle aspiration biopsy of the spleen in pyrexia of unknown originTo evaluate the diagnostic utility, value and potential risk of fine needle aspiration biopsy of spleen (sFNAB) in patients with splenomegaly in pyrexia of unknown origin (PUO), a retrospective analysis of medical records and cytological material of 31 patients on whom FNAB was performed between April 1994 and October 1997 was done. The patients were HIV− and presented with PUO. All other relevant investigations were negative. The spleen was either palpable or detected to have space‐occupying lesions on ultrasonography (USG). The splenic aspirates showed tuberculosis in 11 patients (35.4%) and inconclusive or reactive changes in nine patients (25.8%). One case out of this group proved to be Kaposi's sarcoma on autopsy. The other diseases encountered were leishmaniasis (n = 3), non‐Hodgkin's lymphoma (n = 4), fungal infections (n = 2), Hodgkin's lymphoma (n = 1). The patients who were diagnosed as having tuberculosis had epithelioid cells, giant cells, necrosis and inflammatory cells in various combinations. AFB positivity was 63.6%. The other cases which showed granulomas but no AFB were diagnosed on empirical grounds and all responded to the anti‐tuberculosis therapy. No complications were encountered with the procedure. Therefore the authors conclude that sFNAB is rewarding in patients where all other non‐invasive modalities of diagnosis have failed.
Improved fine needle aspiration (FNA) cytology results with a near patient diagnosis service for breast lesions
Authors: Dray M. , Mayall F. , Darlington A. 
Published: March 2003

Improved fine needle aspiration (FNA) cytology results with a near patient diagnosis service for breast lesionsThis study is a review of the quality of FNA cytology results for breast lesions approximately 18 months before and 10 months after a change from a rapid diagnosis FNA service with consultant pathologist aspirators to a conventional FNA service with clinician aspirators of varied experience. The setting was symptomatic breast clinic in a large hospital in rural New Zealand acting as a tertiary referral centre for a population of 550000. The results were collected retrospectively and prospectively. The quality of results for pathologist aspirators (total 810) and clinician aspirators (total 403) was compared using the definitions of the NHS Breast Screening Program Guidelines for Cytology Procedures and Reporting in Breast Cancer Screening. There were statistically significant differences in specificity (biopsy cases only) with 73% for pathologists and 49% for clinicians, specificity (full) with 74% and 56%, inadequate rate with 23% and 37%, and complete sensitivity with 76% and 67%. The use of pathologist aspirators allowed the specimens to be reported in a few minutes. Specimens taken by clinicians took at least 30 min to report. The financial aspects of the two approaches are discussed. When compared with clinician aspirators, pathologist aspirators obtained better quality results and these were reported more quickly.
Exact Touch: a new device for cervical cytology. Comparison with Ayre spatula plus Cytobrush
Authors: De Palo G. , Stefanon B. , Alasio L. , Polotti S. 
Published: March 2003

Exact Touch: a new device for cervical cytology. Comparison with Ayre spatula plus CytobrushExact Touch® is a new plastic device for the collection of cells from the ectocervix and endocervix. A total of 189 consecutive women were evaluated, 94 with the Ayre/cytobrush and 95 with Exact Touch®. Sampling was performed by only one clinician, and the slides were analysed by only one cytotechnologist, who had no information about the sampling method. Our results showed that more endocervical and metaplastic cells were collected by Exact Touch® than by Ayre/cytobrush.
Educational Case Report Cervical cytology through the looking glass
Authors: Smith J. H. F. 
Published: March 2003

Educational Case Report—Self‐AssessmentA 25‐year‐old woman underwent a routine cervical smear that was reported as showing borderline change. Six months later when 6 months pregnant she had a repeat smear. This is shown in Figure 1 (Pap., original mag. × 600.)What is your opinion? For the correct answer please read the Educational Case Report (page 54).
Cervical screening: how often should women be screened?
Authors: Herbert A. 
Published: March 2003

IntroductionAs a result of major improvements that have been made to cervical screening during the last 15 years, and implementation of call and recall to invite all women aged 20–64 for screening, the incidence of cervical carcinoma has fallen by 42% since 19901. Cervical cancer is now a rare disease, largely thanks to the widespread uptake of screening by the women at risk. Despite the manifest success of the NHS Cervical Screening Programme (NHSCSP), there is pressure on one hand to improve its sensitivity by the introduction of new technology, including human papillomavirus (HPV) testing2, and on the other hand to reduce the cost of the programme, which is more than £130m per year. The main method suggested to reduce costs is the restriction of routine screening to an interval of 5 years3–5.
Scrape cell‐block technique for fine needle aspiration cytology smears
Authors: Kulkarni M. B. , Prabhudesai N. M. , Desai S. B. , Borges A. M. 
Published: March 2003

Scrape cell block technique for fine needle aspiration cytology smearsAn inconclusive diagnosis on fine needle aspiration cytology (FNAC) may be due to poor spreading and presence of thick tissue fragments despite aspiration of adequate material. Repeat aspiration may not be possible especially when aspirates of deep seated organs have been obtained by image guided techniques. We have resorted to a ‘scrape cell‐block’ (SCB) technique in such cases. In this technique the cellular material on the slides which had already been fixed and stained, was carefully removed by scraping following destaining and then processed as a cell block. SCB interpretation was then compared with the smear diagnosis and histological diagnosis, wherever available. A total of 27 cases were studied. In 12 cases SCB slides added information to the FNAC smears. In 14 cases SCB did not offer any additional information. SCB was inconclusive in one case. Final histological correlation was available in eight cases and the SCB diagnosis was confirmed in six cases, whereas in two cases SCB failed to identify the tumour. Immunocytochemistry (ICC) was done in one case. SCB is a useful technique to make the best use of the available material when reaspiration is difficult.
Fine needle aspiration cytodiagnosis of secretory carcinoma of the breast
Authors: Gupta R. K. , Kenwright D. , Naran S. , Lallu S. , Fauck R. 
Published: March 2003

Fine needle aspiration cytodiagnosis of secretory carcinoma of the breastSecretory carcinoma (SC) of the breast is a rare variant of breast malignancy and its cytological features in fine needle aspirates have only recently been described. In this communication, our experience with four cases of SC of the breast is presented in which the diagnosis was established on fine needle aspiration cytology (FNAC). In all cases, the samples were cellular and featured diffuse, prominent, intracytoplasmic vacuoles and secretion in malignant cells and occasional signet‐ring like forms. The cytodiagnosis of SC in all the cases correlated with subsequent examination of cell blocks of the aspirate and tissue. Cytochemical stains showed diffuse positivity for mucin by alcian blue stain in the vacuolated cells which was periodic acid–Schiff positive and resistant to diastase digestion. Oil‐red O staining was negative. Immunopositivity to carcinoembryonic antigen, cytokeratin (CAM 5.2), B72.3 and epithelial membrane antigen was found in malignant cells. The cytodiagnostic criteria for SC of the breast, characteristic cytological features which are useful in a correct FNAC diagnosis and differentiation from other pertinent breast carcinomas, are discussed.
Survey of smear taking practice in the former North Thames region
Authors: Al Awadhi R. , Coleman D. V. 
Published: March 2003

Survey of smear taking practice in the former North Thames regionOne hundred and seventy‐seven doctors and 161 nurses from 230 clinics responded to a questionnaire on smear taking practice. The responses show that 66% of smear takers use the Aylesbury spatula and 30% use the Ayre spatula. A total of 53% use a cytobrush for selected cases. Training of smear takers and preparation of smears was satisfactory. Most (but not all) smear takers routinely record clinical information on the request form. Only 20 cytology laboratories in the North Thames region (70%) provide additional feedback to the smear takers about the quality of their smears apart from the information on the request form. Our study shows that feedback is an area where interaction between the laboratory and smear taker could be encouraged.
Cytological evaluation of angiogenesis in endometrial aspirates
Authors: Ono M. , Shiina Y. 
Published: March 2003

Cytological evaluation of angiogenesis in endometrial aspirates We conducted a comparative study of angiogenesis observed in endometrial aspirates according to histological type. Cytological specimens from 14 cases of proliferative phase endometrium, 21 cases of endometrial hyperplasia and 18 cases of well‐differentiated endometrial adenocarcinoma were used in the investigation. Immunohistochemical staining was performed according to standard methods using CD34 monoclonal antibody, and new vessels were examined. New vessels were identified in all of the histological types, but no morphological differences were seen. New vessels were observed in more cases of adenocarcinoma than in cases of normal tissue or hyperplasia, and the differences were significant. The difference between the maximum and minimum rates of occurrence of cell clusters possessing new vessels tended to be greater in adenocarcinoma than in the other tissue types (P < 0.05). Based on the above findings, examination of new vessels appearing in aspirated endometrial specimens appeared to be of help in differential diagnosis, but it also seemed necessary to take changes due to the menstrual cycle etc. into consideration.
The Lepidoptera fauna associated with Calluna vulgaris: effects of plant architecture on abundance and diversity
Authors: Haysom K. A. , Coulson J. C. 
Published: March 2003

Abstract.1. The effects of plant architecture on the Lepidoptera assemblage associated with heather Calluna vulgaris were studied at four locations in northern England and southern Scotland in 1992 and 1993. The study areas were Calluna vulgaris–Vaccinium myrtillus heaths, where management by rotational burning had created a mosaic of stands of different‐aged Calluna. Lepidoptera were sampled in the larval stage.2. Larval abundance was considered in relation to Calluna age, height, cover, green shoot density, and flower density. For most study areas and species, multiple regression selected Calluna height as the variable that explained most variation in larval density, although the explanatory variables were intercorrelated.3. After compensating for the effects of different study locations, the slope of the regression between the logarithm of larval density and the logarithm of Calluna height was common to the macrolepidoptera, microlepidoptera, geometrid, and noctuid larval groups.4. There was a significant progressive increase in larval diversity with increase in Calluna height, due to the presence of uncommon moth species in the samples from taller Calluna, and a change in the contribution of common species to the community in different height zones.5. The significance of these results is discussed in relation to other heathland invertebrate studies and management practices.