bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity, rather than menstrual cycle pattern or follicle cohort size, determines hyperinsulinaemia, dyslipidaemia and hypertension in ageing women with polycystic ovary syndrome
Authors: Elting Mariet W. , Korsen Ted J. M. , Schoemaker Joop 
Published: March 2003

OBJECTIVE The aim of this study was to investigate if ageing women with polycystic ovary syndrome (PCOS) who gained regular menstrual cycles differed from women who continued to menstruate irregularly with regard to risk factors for developing diabetes mellitus and atherosclerosis.DESIGN AND PATIENTS In the original study of a population of 346 PCOS patients, defined in the past as having oligo‐ or amenorrhoea and elevated LH concentrations, we had sent out a questionnaire to investigate changes in the pattern of their menstrual cycles while ageing. From this cohort of patients, a significantly older group of 53 women (mean age: 41·3 years, range: 33·3–49·4) who were not using oral contraceptives or other hormones visited the outpatient clinic. These women did not differ from the non‐participating group in BMI, ethnic origin, the proportion with regular menstrual cycles by age group, parity or the use of clomiphene citrate or gonadotrophins in the past.MEASUREMENTS A physical examination and a transvaginal ultrasound were performed. The size of the follicle cohort was determined by counting the number of small follicles in the ovaries. Thirty‐four women were also willing to give two fasting blood samples for measuring their glucose, insulin and lipid status.RESULTS Forty‐one of the 53 (77·4%) women had a regular menstrual cycle (shorter than 6 weeks) and 12 (22·6%) had an irregular cycle (longer than 6 weeks). The body mass index (BMI), waist : hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and prevalence of diabetes (1·9%) and hypertension (11·3%) did not differ between the two menstrual cycle groups. Also, the fasting glucose, insulin, glucose/insulin ratio, total cholesterol, HDL‐c, and LDL‐c concentrations did not show any significant difference between the two groups. Instead, these parameters all were significantly higher in women with a BMI > 27 kg/m2 compared to women with a BMI ≤ 27 kg/m2. Regularly menstruating PCOS women were older (P < 0·01), showed less follicles in their ovaries (n = 48, P < 0·01) and had lower androgens (n = 34, P < 0·05) than the irregularly menstruating women. Logistic regression analysis showed a second significant influence, after age, of the BMI on the menstrual cycle pattern (age, P < 0·01; BMI, P < 0·05). If age was excluded from the analysis, only the follicle count significantly predicted the menstrual cycle pattern (P < 0·02).CONCLUSIONS We conclude that hyperinsulinaemia, dyslipidaemia and hypertension in our population of ageing women with polycystic ovary syndrome are not related to the menstrual cycle pattern but rather to obesity. Age and the size of the follicle cohort are the main factors determining the menstrual cycle pattern in ageing women with polycystic ovary syndrome, although an association with the BMI was also found.
Postpartum thyroid dysfunction and postpartum depression: are they two linked disorders?
Authors: Lucas Anna , Pizarro Eduarda , Granada María Luisa , Salinas Isabel , Sanmartí Anna 
Published: March 2003

OBJECTIVE Postpartum has been considered as a period of risk for developing postpartum depression (PD) by some but not all authors, and this PD has been linked with postpartum thyroid dysfunction (PPTD). The major aim of this study was to evaluate the relation between the presence of PPTD and PD.DESIGN and PATIENTS Six hundred and forty‐one healthy Caucasian women recruited between their 36th week of pregnancy and fourth day postpartum underwent clinical and laboratory evaluation and were checked again at 1 (n = 605), 3 (n = 552), 6 (n = 574), 9 (n = 431), and 12 (n = 444) months postpartum.MEASUREMENTS At baseline and at each clinical evaluation, Beck Depression Inventory (BDI) was administered to screen PD. The definitive diagnoses of PD was performed by a psychiatrist according to the DSM‐III‐R criteria. At each visit, we determined serum free T4 and TSH concentrations. Thyroperoxidase and thyroglobulin antibodies were determined only in patients with abnormal hormone concentrations. Postpartum thyroiditis (PPT) was considered to be present in women with overt or subclinical transient hyperthyroidism between 1 and 3 months postpartum and/or overt or subclinical hypothyroidism between 3 and 6 months postpartum.RESULTS Fifty‐six women developed postpartum thyroid dysfunction (PPTD), corresponding to an incidence rate of 11%: 45 with PPT [incidence rate 7·8%; confidence interval (CI) 5·6–10%], eight with Graves' disease (incidence rate 1·5%; CI 0·5–2·5%) and three with nonpalpable toxic thyroid adenoma (incidence rate 0·5%; CI 0–1·5%). Five hundred and eighty of the evaluated women (incidence rate 90·5%; CI 95% 88·2–92·8) presented BDI scores below 21 and therefore the PD diagnoses was excluded. In 50 cases (incidence rate 7·8%; CI 95% 5·7–9·8), we detected a BDI score over 21 in some evaluations, but the PD diagnosis was not confirmed. Another 11 (incidence rate 1·7%; CI 95% 0·7–2·7) were diagnosed as having PD and required psychiatric treatment. None of the PPTD was diagnosed as having PD. The BDI scores frequency over 21 was similar between healthy women and those with PPTD. Patients with a previous history of depression developed PD more often (P < 0·0001). One hundred and ninety women breast fed their babies for more than 2 months, without observing a higher PD rate or BDI scores over 21 (P = 0·5).CONCLUSIONS We found a general PD incidence rate of 1·7% in our group of patients. This figure is not higher in women with hormone abnormalities caused by PPTD. Women with a past history of depression present a higher risk of PD while those who breast fed did not have an increased risk.
A novel bioassay for human somatogenic activity in serum samples supports the clinical reliability of immunoassays
Authors: Rowland Jennifer E. , Marshall Nicholas J. , Leung Kin‐chuen , Ho Ken K. Y. , Cotterill Andrew M. , Rowlinson Scott W. , Waters Michael J. 
Published: March 2003

Summaryobjective Because there is discordance between different immunoassay values for serum hGH, and because clinical state may not correlate with immunoreactive hGH, we have developed an assay to accurately measure serum hGH somatogenic bioactivity. The results of this assay were compared with the Elegance two‐site ELISA assay across 135 patient samples in a variety of clinical states.design The somatogenic assay was based on stable expression of hGH receptor in the murine BaF line, allowing these cells to proliferate in response to hGH. To eliminate interference by other growth factors in serum, we created a specific antagonist of the hGH receptor (similar to Trovert or Pegvisomant) which allowed us to obtain a true measure of hGH somatogenic activity by subtraction of the activity in the presence of the antagonist. The assay was carried out in microtiter plates over 24 h, with oxidation of a chromogenic tetrazolium salt (MTT) as the endpoint.patients These encompassed a number of different clinical conditions related to short stature, including idiopathic short stature, neurosecretory dysfunction and renal failure, as well as obese patients on dietary restriction and normal volunteers.measurements In addition to the colourimetric (MTT) response to hGH, we measured free hGH by stripping out GHBP‐bound hGH using beads coupled to a monoclonal antibody to the GHBP (GH binding protein). All samples were measured in both bioassay and ELISA assay.results This bioassay was sensitive (5 mU/l or 2 µg/l) and precise, and not subject to interference by the GHBP. There was a good correlation (r = 0·95) between bioactivity and immunoactivity across clinical states. There was, however, an increased bioactivity during secretory peaks (over 25 mU/l), which has been reported previously for the Nb2 bioassay. Free hGH did not correlate with clinical state.conclusions Because the results of the Elegance ELISA and the bioassay correlate well, even though there is greater bioactivity at higher hormone concentrations, it is evident that an appropriate immunoassay is able to act as a reliable indicator for clinical assessment. In those rare cases where bio‐inactive GH exists, our bioassay should provide an appropriate means to demonstrate this.
MRI findings of the pituitary gland in short children born small for gestational age (SGA) in comparison with growth hormone‐deficient (GHD) children and children with normal stature
Authors: Arends N. J. T. , V.d. Lip W. , Robben S. G. F. , Hokken‐Koelega A. C. S. 
Published: March 2003

SummaryBackground Disturbances in the GH/IGF‐I axis are reported in 25–60% of short children born small for gestational age (SGA). We hypothesized that these abnormalities might be related to abnormalities in the pituitary region. Therefore, the results of magnetic resonance imaging (MRI) of short SGA children were compared to MRI results of other groups of short children and to normal controls.Patients and Methods MRI was performed in four groups of short children: SGA children without GH deficiency (SGA group; n = 17), SGA children with isolated GH deficiency (SGA + IGHD group; n = 10), non‐SGA children with isolated GH deficiency (IGHD group; n = 24) and non‐SGA children with multiple pituitary hormone deficiencies (MPHD group; n = 15). MRI was also performed in children with normal stature (control group; n = 13). Pituitary height (PH) and thickness of the pituitary stalk (PS) were measured and their relationship with the maximum GH peak during a GH stimulation test, serum IGF‐I and IGFBP‐3 levels was evaluated.Results Short SGA children either with or without IGHD did not show major anatomical abnormalities in the hypothalamic‐pituitary region in contrast to 58% of the non‐SGA IGHD children and 87% of the MPHD children who had anatomical abnormalities. PH in SGA children without GHD was normal whereas it was significantly lower in SGA children with IGHD. The lowest PHs were measured in non‐SGA children with MPHD. A moderate decrease in PH was associated with significantly lower maximum serum GH peaks and lower serum IGF‐I and IGFBP‐3 levels.Conclusion Measuring PHs in children with less severe GHD, who underwent MRI as part of the diagnostic process, might support the diagnosis of GHD even in the absence of anatomical abnormalities. Our study demonstrates that there is no indication to perform MRI of the pituitary region in short children born SGA without GHD.
Antiangiogenic effects of somatostatin analogues
Authors: De La Torre N. García , Wass J. A. H. , Turner H. E. 
Published: March 2003

SummaryInhibition of angiogenesis has become a target for antineoplastic therapy and for treatment of retinal neovascularization. The presence of somatostatin receptors on tumour cells and on the proliferating vascular endothelium has led to several in vitro and in vivo studies to investigate the antiproliferative and antiangiogenic effects of somatostatin analogues. Currently available data suggest that somatostatin analogues might inhibit angiogenesis directly through somatostatin receptors present on endothelial cells and also indirectly through the inhibition of growth factor secretion such as IGF‐I and vascular endothelial growth factor (VEGF) and reducing monocyte chemotaxis. However, beneficial effects on inhibition of neovascularization have been questioned by some studies. More work is therefore required to firmly establish the role of somatostatin analogues as potential antiangiogenic therapy. The currently available somatostatin analogues have high affinity for somatostatin receptor subtype 2 (sst2) and, to a lesser extent, sst5 and sst3. However, because vascular endothelial cells express several types of somatostatin receptors, it will be important to investigate somatostatin analogues with different receptor subtype affinities, which might increase the spectrum of available therapy for tumours.
Oxidative stress and normal pregnancy
Authors: Toescu V. , Nuttall S. L. , Martin U. , Kendall M. J. , Dunne F. 
Published: March 2003

Summaryobjective To determine whether, in normal pregnancies, there is evidence of oxidative stress that is related to the lipid changes observed in pregnancy.design Longitudinal study of healthy women having a normal pregnancy. Samples were obtained towards the end of each trimester and after 8 weeks postpartum.patients Seventeen healthy women during a normal singleton pregnancy were compared with 12 healthy, non‐pregnant women.measurements Oxidative stress was determined by measuring total antioxidant capacity (TAC), uric acid and lipid hydroperoxides (LHP). Lipid status was evaluated by measuring total and high‐density lipoprotein cholesterol, triglycerides and low‐density lipoprotein (LDL) subfractions.results Pregnancy was associated with decreased TAC and uric acid in the first trimester, which gradually increased during pregnancy, reaching normal values during the postpartum period. LHP significantly increased towards the end of pregnancy. The changes observed in LHP were significantly correlated with increases in LDL subfraction profile.conclusions Late pregnancy was associated with the formation of susceptible, oxidisable particles (high LDL score) and an increase in oxidative damage. These biochemical changes may be relevant for the long‐term cardiovascular health of women, especially those of high parity or those who are at high risk for cardiovascular disease (e.g. women with diabetes).
Peripheral amino acid and fatty acid infusion for the treatment of necrolytic migratory erythema in the glucagonoma syndrome
Authors: Alexander Erik K. , Robinson Malcolm , Staniec Maryjane , Dluhy Robert G. 
Published: March 2003

SummaryNecrolytic migratory erythema (NME), the characteristic rash associated with the glucagonoma syndrome, is a cause of substantial morbidity among patients with this rare malignancy. Treatment options are suboptimal, and often useful for only short or moderate durations. We report the effective, long‐term (> 1 year) use of intermittent infusions of amino acids (AA) and fatty acids (FA) administered via peripheral intravenous access for the treatment of NME in the glucagonoma syndrome. Despite resolution of the NME, serum amino acid (initially subnormal) and fatty acid (initially normal) levels remained unchanged. Tumour growth and other symptoms related to the glucagonoma syndrome appear unaffected by such infusions.
The Arg16Gly polymorphism of human β2‐adrenoreceptor is associated with type 2 diabetes in Taiwanese people
Authors: Chang Tien‐Jyun , Tsai Ming‐Han , Jiang Yi‐Der , Lee Borheng , Lee Kuan‐Ching , Lin Jin‐Yu , Chiu Ken C. , Tai Tong‐Yuan , Chuang Lee‐Ming 
Published: March 2003

Summaryobjective  The significance of the association of amino terminal polymorphisms in β2‐adrenoreceptor (ADRB2) with obesity and type 2 diabetes is controversial and differs among ethnic groups. In this study, the association of ADRB2 with risk and age of onset of type 2 diabetes has been examined in a Taiwanese population.design The study design is a case–control study to investigate the impact of the two amino acid polymorphisms in ADRB2.patients and measurements  This study includes 130 patients with type 2 diabetes [female : male = 1 : 1, age: 52·4 ± 10·0 years; body mass index (BMI): 24·2 ± 2·9 kg/m2; mean ± SD] and 130 controlled subjects matched for gender, age and BMI with normal glucose tolerance (female : male = 1 : 1, age: 51·7 ± 10·6 years; BMI: 23·9 ± 2·7 kg/m2). The Arg16Gly and Gln27Glu polymorphisms of ADRB2 were determined by polymerase chain reaction‐restriction fragment length polymorphism (PCR–RFLP) assays. The genotypic and allelic frequencies between two groups were compared and the relationship between the genotypes and clinical phenotypes was examined.results A difference in genotypic frequency in the Arg16Gly polymorphism was noted between groups in this gender‐, age‐ and BMI‐matched case–control study (P = 0·039). Multivariate regression analysis revealed that the Arg16Gly polymorphism was the only independent factor for development of type 2 diabetes (P = 0·021). In addition, we utilized the log‐rank test to compare the differences in age of onset between wild‐type and nonwild‐type polymorphisms. The Arg16Gly polymorphism was independently associated with age of onset in type 2 diabetes (P = 0·017). There was no difference in the Gln27Glu polymorphism between diabetic and control groups in this study.conclusions In a Taiwanese population, homozygosity of Arg16 in the ADRB2 gene was associated with a higher frequency (odds ratio 1·87, 95% confidence interval 1·34–2·40) for development of type 2 diabetes. Moreover, this polymorphism was also associated with an earlier onset of type 2 diabetes. However, the Glu27Gln polymorphism had no impact on either BMI or type 2 diabetes in a Taiwanese population.
Reversal of acromegalic cardiomyopathy in young but not in middle‐aged patients after 12 months of treatment with the depot long‐acting somatostatin analogue octreotide
Authors: Colao Annamaria , Marzullo Paolo , Cuocolo Alberto , Spinelli Letizia , Pivonello Rosario , Bonaduce Domenico , Salvatore Marco , Lombardi Gaetano 
Published: March 2003

Summarybackground Cardiovascular disease is the most frequent cause of death of patients with acromegaly.aim To investigate whether young patients with a presumed short disease duration are more likely to reverse the acromegalic cardiomyopathy than older patients with longer disease duration.design An open prospective design.patients Ten young (aged < 40 years), and 12 middle‐aged (41–59 years) patients with active acromegaly well controlled after 12 months of treatment with the depot formulation of octreotide (OCT‐LAR); 22 sex‐ and age‐matched healthy subjects as controls.methods Left ventricular (LV) mass (LVM) by echocardiography and performance by equilibrium radionuclide angiography were measured before and after 12 months of OCT‐LAR treatment.results At study entry, none of the controls and 14 patients (63·4%) of whom six were young (χ2 = 17·7; P < 0·0001) had LV hypertrophy (LVH); none of the controls and four patients of whom one was young had insufficient LV ejection fraction (LVEF) at rest (< 50%); one control and 13 patients (59·1%) of whom five were young (χ2 = 12·7; P < 0·0001) had inadequate LVEF at peak exercise (ΔLVEF; < 5% increase of baseline). After 12 months, no change in haemodynamic and diastolic parameters was observed in both groups, except for a significant decrease in heart rate at peak exercise in young patients (P < 0·0001). The LVM index decreased significantly in both young (124·4 ± 5·8 vs. 103·4 ± 3·9 g/m2; P = 0·01) and middle‐aged patients (140·9 ± 7·9 vs. 117·8 ± 6·6 g/m2; P = 0·03). LVH disappeared in 10 of 14 patients (71·4%): all six young and four of eight middle‐aged patients (50%). LVEF at rest and at peak exercise increased significantly in both groups but ΔLVEF increased significantly only in young patients (1·5 ± 2·9 vs. 13·7 ± 5·2%, P = 0·04); it normalized in nine of 13 patients (69·2%), four of five young (80%) and four of eight middle‐aged patients (50%). Exercise capacity (82·5 ± 5·3 vs. 110·0 ± 5·5 W, P = 0·005) and duration (7·3 ± 0·3 vs. 9·9 ± 0·4 min, P = 0·0003) also increased only in young patients.conclusions The acromegalic cardiomyopathy is reversed in most young patients with short disease duration and achieving disease control after OCT‐LAR treatment for 12 months, indicating that early diagnosis and effective treatment are essential.
An unusual presentation of fine needle aspiration (FNA) cytology from the syncytial variant of nodular sclerosing Hodgkin's disease
Authors: Stephen M. R. , Mallon E. A. 
Published: March 2003

IntroductionOpen access breast clinics are now widely available and immediate reporting of FNAs of the breast has become an established part of the triple approach to the management of breast disease1.We report the unexpected findings of a case of Hodgkin's disease at such a clinic. The patient was a young woman who initially was thought by both her general practitioner and surgeon to have a fibroadenoma in the axillary tail region of her right breast. The FNA of this lump showed the features of Hodgkin's disease but with widespread necrosis, which was unusual and potentially misleading and which we wish to highlight. A lymph node biopsy confirmed the diagnosis and showed that the patient was suffering from the syncytial variant of nodular sclerosing Hodgkin's disease (NSHD).This variant probably accounts for about 5% of cases of Hodgkin's disease2. Necrosis is a common feature of NSHD; it can range from minute scattered foci to more extensive necrosis of nodules or even involve the entire lymph node.
Aspergillus in the Papanicolaou stain: morphology, fluorescence and diagnostic feasibility
Authors: HETTLICH  , KÜPPER  , WEHLE  , PFITZER  
Published: March 2003

hettlich c., küpper th., wehle k. and pfitzer p. (1998) Cytopathology9, 381–388Aspergillus in the Papanicolaou stain: morphology, fluorescence and diagnostic feasibilityAspergillus species exhibit a distinct and clear fluorescence in Papanicolaou‐stained cytological samples. The Papanicolaou (PAP) stain enhances the autofluorescence of cultured aspergilli and allows better cytological recognition of the fungus by fluorescence microscopy when it is not easily discerned from its surroundings by light microscopy. Morphological properties can be better distinguished and facilitate the differentiation of aspergillus organisms from other filamentous fungi. Neither light nor fluorescence microscopy, the cytological quality nor the presence of phagocytosed hyphae in alveolar macrophages allow distinction between infection and contamination with Aspergillus species. Only the presence of eosinophilic inflammation permits a tentative diagnosis of an Aspergillus infection. In conclusion, PAP fluorescence reduces the need for special stains, is superior to and quicker than other investigative techniques and enhances the sensitivity and specificity of cytological investigation when a rapid and reliable identification of Aspergillus is needed.
Argyrophilic nucleolar organizer region (AgNOR) technique: a helpful tool for differential diagnosis in urinary cytology
Authors: CIA E. M. M. , TREVISAN M. , METZE K. 
Published: March 2003

Argyrophilic nucleolar organizer region (AgNOR) technique: a helpful tool for differential diagnosis in urinary cytologyThe aim of this study was to investigate whether the AgNOR technique could be helpful for the cytologic diagnosis of neoplastic and non‐neoplastic urinary tract lesions. We analysed the AgNOR pattern in urinary cytology in samples from 70 patients. In every case the average number of silver precipitations per nucleus was counted and the range between the minimum and maximum AgNOR value calculated. Furthermore we noted whether the AgNOR precipitations had a homogeneous or heterogeneous distribution. The diseases were classified in three groups: non‐neoplastic lesions, low grade and high grade carcinoma. Linear discriminant analysis (with jack‐knife procedure) was performed with the AgNOR parameters as independent variables. The final diagnosis of each patient had been established by histological analysis of bladder biopsies. We obtained a correct classification in 84.3% of the cases. All patients with normal or reactive lesions were correctly classified and only two cases of low grade malignancy were erroneously diagnosed as non‐malignant. Five high grade neoplasms had been classified as low grade and four low grade carcinomas had been over‐diagnosed as high grade neoplasms. We conclude that a combined qualitative and quantitative AgNOR analysis can be useful in the differential diagnosis of urinary cytology.