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Biomedical subjects

S C Boyages

Publications and source records attributed to S C Boyages.

At least 37 records · Page 2Linked to original sources
PubMed1997

Increased incidence of neoplasia in females with acromegaly.

OBJECTIVE: Some studies have indicated an increased incidence of neoplasia, particularly breast and colon, in acromegaly. We have determined the incidence of benign and malignant neoplasms in an Australian population of patients with acromegaly. DESIGN: Retrospective review, with comparison against cancer data for the local population obtained from a State Cancer Registry. PATIENTS: Fifty patients with documented acromegaly. RESULTS: There were 7 cases of malignancy (2 in men, 5 in women) in the period of follow-up (435 patient years). With logistic regression analysis, there was a relative risk of malignancy, of 1.2 (95% confidence interval 0.31-5.0) for men (P = 0.8) and 4.3 (95% confidence interval 1.7-10.5) for women (P = 0.001), when compared to the local population. There were 2 cases of breast and renal carcinoma, and one each of prostatic, colonic and parotid carcinoma. Of the most common benign tumours 35% of patients had thyroid nodules, 10% had colonic polyps and 6% had nasal polyps. CONCLUSION: The incidence of malignancy was found to be increased in female patients with acromegaly in this series. Routine screening procedures for malignancy, particularly in female patients, should therefore be considered.

Acromegaly↗
PubMed1997

An audit of long-term octreotide therapy for acromegaly.

BACKGROUND: Octreotide has been successfully used for the treatment of acromegaly, but little long-term data are available. AIMS: To determine the long-term efficacy and safety of octreotide in the treatment of acromegaly. METHODS: Twenty-seven patients with acromegaly were treated with octreotide in a non randomised study. Six patients had not had previous surgery or radiotherapy, and were treated with octreotide alone. Symptoms of acromegaly, IGF-I levels, growth hormone suppression by glucose, pituitary tumour size, and side effects were monitored. The median duration of treatment was 44 months (range six-102). RESULTS: Symptom control was excellent. Twenty (74%) patients had a reduction of IGF-I into the normal range. IGF-I levels fell after one year from 94.2 +/- 6.1 nmol/L (mean +/- SEM) to 50.0 +/- 2.7 nmol/L (p < 0.0001). Ten of 13 (77%) patients had normal IGF-I levels after four years. These reductions have persisted for up to nine years of octreotide therapy. The GH response to glucose was normalised in 14 of 16 (88%) subjects. Eleven of 25 (44%) patients had a reduction in pituitary gland height. Side effects were common, but usually of a minor nature. Cholelithiasis occurred in 39% of patients. Two patients ceased octreotide because of side effects. CONCLUSIONS: We conclude that octreotide is an effective and safe long-term treatment for acromegaly. It is a useful adjunct to surgery, and may be offered as sole therapy for patients with smaller adenomas.

Acromegaly↗
PubMed1997

Amiodarone induces a different pattern of ultrastructural change in the thyroid to iodine excess alone in both the BB/W rat and the Wistar rat.

Amiodarone (AMD)-induced toxicity can be a life-threatening complication which limits the use of amiodarone as an anti-arrhythmic agent. The aim of the present study was to determine the nature of AMD toxicity by comparing ultrastructural changes induced by AMD and equivalent amounts of iodide in two animal models, the Wistar and the autoimmune BB/W rat. Rats were divided into control (water), AMD- (30 mg AMD/kg) or iodide-treated (10 mg/kg) groups. Thyroids were removed at 15 weeks and processed for electron microscopy. We found that AMD induced specific ultrastructural changes of thyroid cytotoxicity in both rat models, which were distinct compared with changes induced by excess iodide alone. Specific changes included marked distortion of thyroid architecture, evidence of necrosis and apoptosis, inclusion bodies, lipofuscinogenesis and markedly dilated endoplasmic reticulum (ER). Our data indicate that AMD is directly cytotoxic to the thyroid an effect mediated by disruption of subcellular organelle function. ER dilatation is suggestive that AMD cytotoxicity may be mediated through disruption of the protein sorting pathways leading to a drug-induced form of ER storage disease. The predilection of the thyroid to AMD may be explained by the additive effects of excess iodine and AMD drug toxicity on protein sorting pathways.

Amiodarone↗
PubMed1996

Detection of extended distribution of beta2-thyroid hormone receptor messenger ribonucleic acid (RNA) in adult rat brain using complementary RNA in situ hybridization histochemistry.

In situ hybridization histochemistry using a complementary RNA probe, directed at the entire length of the thyroid hormone receptor beta2 (TRbeta2)-specific region (-56 to 495 bp), was used to evaluate expression of TRbeta2 messenger RNA (mRNA) in coronal sections of adult rat brain. An extended distribution and intense expression of TRbeta2 mRNA was found in several regions of rat brain, including regions where TRbeta2 mRNA had not been previously identified using PCR or in situ hybridization histochemistry. These areas included hippocampus (dentate gyrus and C1, -2, and -3), cerebral cortex (predominantly layer 3), arcuate nucleus, median eminence, medial geniculate nucleus, tegmental bundle, medial and lateral lemniscus, Purkinje layer of the cerebellum, and several brain stem nuclei. In conclusion, we have developed a highly sensitive and specific method to demonstrate TRbeta2 mRNA expression in adult rat brain. The present findings are in agreement with immunoreactive TRbeta2 studies of rat brain and argue against the presence of an unidentified T3-binding protein to explain the previous discordant results of TRbeta2 mRNA and protein studies. In addition, the specificity of distribution of TR beta2 mRNA to certain brain nuclei, particularly those involved in hearing, implies a specific functional role of this receptor subtype and provides a physiological basis to understand the effects of hypothyroidism on brain development.

Animals↗
PubMed1996

Growth hormone does not increase thyroid size in the absence of thyrotropin: a study in adults with hypopituitarism.

Goiter is a frequent clinical finding in patients with acromegaly, an effect mediated by chronically elevated insulin-like growth factor I (IGF-I) levels. It is unclear, however, whether the presence of TSH is a prerequisite for the growth-promoting actions of IGF-I on the human thyroid. We, therefore, studied a group of subjects with hypopituitarism, who were deficient in both TSH and GH, examining the effects of GH replacement therapy on thyroid size and function. GH replacement was initiated in 14 subjects with hypopituitarism. After 6 months of recombinant human GH therapy at 0.25 IU/ kg week, IGF-I levels increased from 11.5 +/- 6.0 to 32.4 +/- 15.4 nmol/L (P = 0.002). Thyroid volume, as determined by ultrasound, did not change significantly over this period. Similarly, there was no change in thyroglobulin levels after treatment with GH, but there was a decrease in the free T4/free T3 ratio (P = 0.043). Pretreatment thyroid size in subjects with hypopituitarism was also compared to that in a group of age- and sex-matched controls. The size of thyroid glands in the hypopituitarism group was smaller than that in controls (P = 0.015). We found that GH therapy did not increase thyroid size in patients with hypopituitarism. From these data we conclude that in vivo, IGF-I does not independently stimulate thyroid growth, but promotes thyroid cell proliferation by potentiating the mitogenic action of TSH.

Adult↗
PubMed1996

Growth hormone treatment increases cytochrome P450-mediated antipyrine clearance in man.

We used the antipyrine clearance test (APC) to examine the effect of growth hormone (GH) therapy on hepatic cytochrome P450 (CYP) enzyme activity. Eleven GH deficient adults were randomized to receive GH or placebo for 6 months, all subjects subsequently received GH. Before treatment, APC was below the normal range in six subjects. We found an increase in APC in the subjects randomized to receive GH compared to those on placebo (median change +0.14 ml/min/kg [range + 0.04 to + 0.20]vs -0.04 ml/min/kg [range -0.07 to + 0.04], p = 0.011). The stimulatory effect of GH on drug metabolism was confirmed by the data for 3 months GH treatment in all 11 subjects, with APC increasing from 0.33 ml/min/kg (range 0.22 to 0.69) to 0.50 ml/min/kg (range 0.27 to 0.83), p = 0.018). These data indicate that GH modulates hepatic CYP activity. This has important clinical implications, as the hepatic metabolism of drugs and hormones may be altered in patients undergoing GH therapy.

Adult↗
PubMed1995

Goitre in Australia.

Goitre due to nodular thyroid disease is common. Most patients present with benign disease and are euthyroid at presentation, but careful clinical evaluation (thyroid function tests and fine needle biopsy) is essential to determine appropriate therapy. Thyroid hormone therapy should be reserved for hypothyroid patients and those with Hashimoto's thyroiditis. Iodine supplements are not beneficial. Indications for surgery are a malignant or atypical finding on fine needle biopsy, a recurrent cyst larger than 4 cm in diameter, or a goitre causing obstruction.

Goiter↗
PubMed1995

Thyroid dysfunction following radiotherapy for head and neck cancer.

PURPOSE: To determine the frequency of hypothyroidism (both subclinical and clinical) following external beam radiotherapy to the whole of the thyroid gland in the treatment of squamous cell cancers of the head and neck. METHODS AND MATERIALS: One hundred and four patients who had completed radiotherapy 30 days to 5 years earlier (84 patients) or who were scheduled for radiotherapy (20 patients) had a single measurement of serum-free thyroxine and thyroid stimulating hormone levels between August 1991 and May 1992. RESULTS: None of the 20 patients assessed prior to treatment showed thyroid dysfunction. Twenty of 84 (23.8%) previously treated patients had subclinical (9.5%) or clinical (14.3%) hypothyroidism. By 5 years, up to 40% of patients may become hypothyroid. Thyroid underactivity was significantly more common in patients having both laryngectomy (including hemi-thyroidectomy) and radiotherapy compared to radiotherapy alone (p < 0.001). Hypothyroidism had not been suspected clinically in any patient tested. CONCLUSION: In view of the frequency and potential morbidity of this complication, thyroid function testing should become a routine part of posttreatment follow-up for these patients.

Female↗
PubMed1995

Screening for PIT1 abnormality by PCR direct sequencing method.

PIT1 abnormality is defined as a genetic abnormality in the PIT1 gene, which encodes a pituitary specific transcription factor Pit-1/GHF-1.PIT1 abnormality has been reported in several patients displaying either complete or incomplete deficiency of thyrotropin (TSH), growth hormone (GH), and prolactin (PRL) in either familial or sporadic cases. To see if there are abnormalities in the PIT1 gene in patients with incomplete TSH, GH, and PRL deficiency, we utilized a PCR direct sequencing method to determine the Pit-1/GHF-1 coding sequence. A total of 15 patients, 1 patient from a family with TSH and GH deficiency, 3 patients with TSH, GH, and PRL deficiency, and 11 patients treated with both human GH (hGH) and thyroid hormone were studied. In one patient of combined pituitary hormone deficiency, the Arg-271-Trp mutation was detected. Since both of the parents did not harbor this mutation, it is a de novo germ line mutation. No mutation was detected in the other patients, showing that PIT1 abnormality is not a frequent cause of GH deficiency.

Base Sequence↗
PubMed1995

The G2M arrest caused by iodide is unrelated to the effects of iodide at adenylate cyclase.

Previously, we have shown that the iodide was able to inhibit TSH induced thyrocyte proliferation by arresting the cell cycle at G0G1 and G2M, suggesting that the iodide may be exerting its effects through more than the TSH-adenylate cyclase-cAMP system. To confirm the effects of iodide on the adenylate cyclase (AC) system, forskolin- and dibutyryl-cyclic-AMP (dBcAMP)-stimulated FRTL5 thyroid cells were exposed to inhibitory concentrations of iodide and the resultant effects on the cell cycle were compared to the effects observed with TSH, using flow cytometric DNA analysis. Forskolin stimulated the proliferation of FRTL5 cells in a dose-dependent manner. Cell numbers rose from baseline by 169 +/- 4% to peak at 10 microM forskolin. Interestingly, 100 microM forskolin inhibited cell proliferation, causing cell numbers to fall by approximately 50%. Iodide inhibited forskolin-induced proliferation to baseline levels. However, the pattern of cell cycle perturbation was different to that with TSH-stimulated cells. There were no differences in the proportion of cells in G0G1 between forskolin alone and forskolin + NaI, while there was a marked fall in the proportion of cells in S phase, indicating possible partial arrest at G0G1. Furthermore, there was a marked accumulation of cells in G2M over and above that found with TSH + NaI, indicating arrest at G2M. dBcAMP maximally stimulated cell numbers to rise from baseline by 125% with 1 mM dBcAMP. Again, higher concentrations of the mitogen had an inhibitory effect on proliferation. The addition of NaI inhibited dBcAMP stimulated cell proliferation.

Adenylyl Cyclases↗
PubMed1995

Somatostatin-14 and its analog octreotide exert a cytostatic effect on GH3 rat pituitary tumor cell proliferation via a transient G0/G1 cell cycle block.

Somatostatin (SRIF) and its analogs exert potent inhibitory effects on hormonal hypersecretion. In addition, they have been demonstrated to inhibit the proliferation of various cell lines as well as the growth of some endocrine tumors in vivo. To evaluate the action of SRIF and its analog octreotide on the proliferation and cell cycle kinetics of endocrine cells, we investigated their effect on GH3 rat pituitary tumor cells, a GH-producing cell line. Using flow cytometric DNA analysis with propidium iodide staining, we found that octreotide inhibits the proliferation of synchronized GH3 cells, achieving a maximal reduction, compared to controls, of 19.4 +/- 5.3% and 22.4 +/- 5.1% with 100 ng/ml and 1000 ng/ml octreotide, respectively (P < 0.05). This effect was demonstrated to be due to a block in progression from the G0/G1 phase to the S phase of the cell cycle. This was most evident after 24 h of exposure to 100 ng/ml octreotide, at which time there was a 7.1 +/- 1.4% increase in cells in G0/G1 (P < 0.01) and a 6.6 +/- 1.3% decrease in cells in S phase (P < 0.01). However, unless octreotide was replenished, this effect was transient and overcome by 36-48 h. No apoptosis was seen, and trypan blue studies confirmed that cell death by necrosis did not occur. A single exposure to native SRIF-14 had little effect, but a G0/G1 cell cycle block and inhibition of proliferation were seen if SRIF was regularly replenished. We conclude that SRIF and octreotide exert a cytostatic effect on GH3 cells by causing a partial G0/G1 cell cycle block. These findings suggest that the actions of SRIF and octreotide occur through signal transduction pathways that act predominantly on downstream regulators.

Animals↗
PubMed1995

Excess iodine induces the expression of thyroid solid cell nests in lymphocytic thyroiditis-prone BB/W rats.

Previous epidemiological studies have suggested that lymphocytic thyroiditis and/or an increased iodine intake may be risk factors for the development of thyroid cancer. We previously reported that excess iodine accelerated the development of thyroid lymphocytic infiltration (LI) in the autoimmune BB/W rat model. We also found that excess iodine increased thyroid cell proliferation in a disordered manner. The present study was designed to further explore these observations and to address the question as to whether excess iodine under certain conditions predisposes the thyroid gland to neoplasia. To test this hypothesis, the lymphocytic thyroiditis-prone BB/W rat was exposed to excess iodine in drinking water. Ten BB/W rats at 4 weeks of age were given iodine water (NaI 0.05%) for 10 weeks, whilst another 10 BB/W rats were given tap water and served as controls. Eighteen normal Wistar rats were also divided into excess iodine and control groups, served as a comparison to the BB/W rats. We found that an excess iodine intake accelerated the development of LI in the BB/W rat. Severe LI was usually accompanied by prominent thyroid cell proliferation, evident as numerous microfollicles and cell masses, not forming normal thyroid follicles. Numerous lymphocytes and plasma cells often encroached on these areas of increased cellular proliferation. The surprising feature, and a possible indicator of activated thyroid cell proliferation, was the high incidence of thyroid solid cell nest-like lesions (SCN) in the iodine treated BB/W rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Iodide induced lymphocytic thyroiditis in the BB/W rat: evidence of direct toxic effects of iodide on thyroid subcellular structure.

A high dietary iodine intake accelerates the development of lymphocytic thyroiditis (LT) in the BB/W rat. Our previous studies have defined the temporal sequence of the immunological events triggered by excess iodide intake in these animals. It was still not clear, however, whether these observed immunological changes were a direct effect on immune effector cells, or whether they represented a secondary response to a toxic effect of iodine on thyroid tissue. In the present study, the effect of excessive iodine intake on the subcellular structure of the BB/W rat thyroid gland, particularly, whether iodide had a toxic effect independent of its immune response has been examined. BB/W rats were exposed, prenatally through maternal drinking water, to excessive iodide at two doses (Moderate 3 x 10(-6) M iodide/l; High 3 x 10(-3) M iodide/l); a third group of BB/W rats was given tap water; till 12 weeks postnatal age. Two groups of Wistar rats received high dose iodide water or tap water for the same period of time and served as controls. Thyroid gland ultrastructure was determined by electron microscopic (EM) examination. Thyroid 125I uptake and perchlorate discharge tests were also performed in separate experiments. We found that thyroid glands of non-iodine supplemented Wistar rats were morphlogically normal under EM. There were no overt changes in the iodide treated Wistar rats. By contrast, iodide treated BB/W rats exhibited marked accumulation of secondary lysosomes and lipid droplets; markedly swollen and disrupted mitochondria and extreme dilatation of rough endoplasmic reticulum (RER).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Endemic cretinism: toward a unifying hypothesis.

Based on our data, the clinical picture of endemic cretinism results from the product of two pathophysiological events. Both events share a common feature, namely iodine deficiency, but act at different points in time. The first event occurs in all cretins and represents the prenatal action of thyroid hormone deficiency on brain development, transmitted vertically from mother to fetus, resulting in the neurological disorder of endemic cretinism. A consistent pattern and intensity of neurological, intellectual, and audiometric deficit is common to and equally present in all types of endemic cretin. The nature of these deficits points to an intrauterine insult to the developing fetal nervous system around the time of the midtrimester. The second event represents the postnatal action of thyroid hormone deficiency on somatic as well as brain development. Whereas previous workers had attributed the differences in the clinical presentation of endemic cretinism to the presence or absence of neurological features (i.e. prenatal hypothyroidism), the distinction between the types of endemic cretin can be related to the length and severity of postnatal thyroid hormone deficiency. Endemic cretins with predominant neurological features have had only transient hypothyroidism in the postnatal period, evidenced by their near normal thyroid function and by a lack of hypothyroid clinical features. By contrast, cretins with marked myxedematous features were characterized by permanent and severe postnatal thyroid hormone deficiency. These cretins, in addition to signs of neurological damage, were typically dwarfed, sexually immature, with marked clinical features of myxedema. This second event, influenced by the thyroid gland's morphologic response to its environment (goiter or thyroid atrophy), dictates the final clinical outcome. In conclusion, our hypothesis states that the clinical expression of endemic cretinism is determined by the sum of two pathophysiologic processes. The first process is fetal hypothyroidism which results in the neurological damage of the disorder and the second process is the duration and magnitude of postnatal hypothyroidism which dictates the final clinical appearance.

Animals↗