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PubMed1989

Effects of thyrotropin-releasing hormone and gonadotropin-releasing hormone on inositol phospholipid turnover in endocrinologically inactive pituitary adenomas and prolactinomas.

We examined the effects of GnRH and TRH on inositol phospholipid turnover in 11 endocrinologically inactive pituitary adenomas and 5 prolactinomas. In 9 of the 11 nonsecreting adenomas, GnRH induced a significant increase in inositol phospholipid turnover; of those that responded, increased inositol phospholipid turnover in response to TRH occurred in 6. Neither of the 2 prolactinomas exposed to GnRH responded to GnRH, whereas all 5 prolactinomas responded to TRH. These findings demonstrate the presence of functional GnRH receptors on endocrinologically inactive pituitary adenomas. The phosphatidyl inositol-linked receptor status of these tumors differs from that of prolactinomas. These receptors may offer a possible target for therapeutic intervention in endocrinologically inactive adenomas.

Adenoma↗

PubMed1990

Five-year cimetidine maintenance trial for peptic ulcer disease. A clinical and endocrinologic approach.

A multicentre maintenance trial was conducted in 63 peptic ulcer patients to investigate the efficacy and safety of continuous cimetidine maintenance therapy for up to 5 years. In Amsterdam the male patients were investigated yearly for possible endocrinologic changes and to monitor gastric acid secretory capacity. Patients with healed ulcers entered maintenance treatment with a 400-mg bedtime dose of cimetidine. The yearly relapse rates decreased from 20% to 6% from year 1 to year 4. Adverse reactions observed in this study were not different from those previously reported with cimetidine. Endocrinologic studies in 10 male patients showed a small but consistent increase in basal gastrin in the 3rd and 4th year, stabilizing in the 5th year. Prolactin levels showed a gradual increase during the first 3 years but remained well within the normal range. In the 4th and 5th year they decreased again; however, the changes noted were rather modest. It is concluded from this study that weak nocturnal acid inhibition with cimetidine maintenance treatment not only continues to be effective and safe beyond 1 year but also reduces the risk of relapse over time. No relevant endocrinologic abnormalities are to be expected with this regimen of modest nocturnal acid suppression.

Adult↗

PubMed2001

Effect of glycemia status on endocrinological parameters of impotent and infertile patients.

OBJECTIVE: To identify the effects of glycemia status on hormone levels, we evaluated the effects of hypo and hyperglycemia on endocrinological parameters of patients with erectile dysfunction, infertility, varicocele and compared the results with control subjects. MATERIALS AND METHODS: Twenty patients with erectile dysfunction, 20 infertile patients with oligo-azoospermia, 20 patients with normozoospermic left varicocele and 15 healthy control subjects constitute our study population. Plasma follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and prolactin (PRL) levels were measured both in patients in hypoglycemia and hyperglycemia status. Statistical analysis were done by Wilcoxon test. RESULTS: All endocrinological parameters did not show any statistically significant difference between the hypoglycemia and hyperglycemia status. Also, no abnormalities in the endocrinological parameters were observed. CONCLUSION: We showed that the glycemia status of the patient (either hypo or hyperglycemia) did not effect the results of endocrine profile. Also, endocrine evaluation is unnecessary in impotence and infertility.

Adult↗

PubMed2006

Endocrinological markers for assessing hyperandrogenemia in women classified as having polycystic ovary syndrome (PCOS) according to the revised 2003 diagnostic criteria.

The aim of this study was to investigate whether free testosterone estimated by calculation from total testosterone and sex hormone-binding globulin or free androgen indexes were more appropriate markers for assessing hyperandrogenemia in patients with polycystic ovary syndrome (PCOS). 107 Caucasian women were presented at our Division of Gynecological Endocrinology and Reproductive Medicine because of their infertility and hirsutism. Hirsutism was quantitatively assessed using a modified Ferriman-Gallwey score; oligo-ovulation or/and anovulation were assessed; polycystic ovaries were assessed; afterwards women were classified as having PCOS according to the revised 2003 consensus on diagnostic criteria for PCOS or classified as controls; endocrinological parameters were assessed using commercial immunoassays or were calculated. 50 women were classified as having PCOS; 57 women were classified as controls because they did not fulfill the criteria of PCOS. Calculated free and bioavailable testosterone, FAI, total testosterone, free testosterone assessed by immunoassay and DHEAS were significantly increased in women classified as having PCOS. All endocrinological markers for assessing hyperandrogenemia were elevated in the PCOS group regardless if they were assessed using commercial immunoassays or were calculated. Calculated values showed no diagnostic advantage in this study.

Adult↗

PubMed1991

[Two cases of TSH-secreting pituitary adenoma; endocrinological, diagnostic and therapeutic approach to the disease].

Two cases of TSH-secreting pituitary adenoma were reported. Endocrinological and immunohistochemical features of these cases were described and problems in diagnosis and treatment of the rare disease are discussed. [case 1] A 28 year-old woman suffered from hyperthyroidism with a relatively high value of serum TSH (T3; 350 ng/dl, T4; 10.0 micrograms/dl, TSH; 24.5 microU/ml). She was treated with antithyroid drug and then underwent subtotal thyroidectomy. Although the levels of serum T3 and T4 were lowered to within normal range, the level of serum TSH still remained high. One month later, she developed frontal headache, amenorrhea and bitemporal hemianopsia. A CT scan showed an enhanced mass in the sellar and suprasellar region. Preoperative endocrinological studies showed elevated values of TSH (47 microU/ml) and its alpha-subunit (9.0 ng/ml). The levels of both T3 (190 ng/dl) and T4 (10.0 micrograms/dl) were near the upper normal limit. Serum TSH was suppressed by administration of exogenous T3, but did not respond to exogenous TRH, l-Dopa nor bromocriptine. Under the diagnosis of TSH-secreting pituitary adenoma, the patient was operated on by craniotomy and received local radiation therapy (50 Gy). In 1990, 12 years after the treatment, she is well and endocrinologically normal. Immunohistochemical study revealed that most tumor cells were positive for TSH. [case 2] A 28 year-old woman visited our hospital for examination of hyperthyroidism. Serum level of TSH was detectable (4.5 microU/ml). A CT scan performed at that time disclosed no pituitary tumor. Thyroid function was normalized by antithyroid drug, but the level of TSH was still high and progressively increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗

PubMed1980

Light microscopical and fluorescence histochemical observations on the endocrinological activity of human pulmonary neoplasia.

Light microscopical histochemical methods known to demonstrate the hormone storage granules of the hypophyseal ACTH/MSH cells were applied to study 14 oat cell carcinomas of human lung with special reference to assessment of the applicability of these techniques in the detection of the reported endocrinological activity of these tumors. Lead-hematoxylin, masked metachromasia and PAS reactions gave negative results for hormone storage granules in all cases studied. Argyrophilic granules were found in two tumors. The above methods, thus, were interpreted to be far too insensitive to be applicable for the demonstration of endocrinological activity. Fluorescence histochemical demonstration of the NH2-terminal tryptophyl-peptides, shown to be present in the hormone storage granules of the hypophyseal ACTH/MSH cells, yeilded positive results in three of the five studied cases. Two of these positive cases were found to have a pronounced adrenal hyperplasia. Conclusion was drawn that the used fluorescence histochemical technique for the demonstration of the NH2-terminal tryptophyl-peptides might offer new possibilities in the diagnosis of obscure human lung tumors, and it might be a valuable aid in the demonstration of the endocrinological activity in general.

Adrenocorticotropic Hormone↗

PubMed1993

[Alcoholic liver injury accompanied with various metabolic and endocrinological disorders--a case report].

We report a young female case of alcoholic liver injury accompanied with various metabolic and endocrinological disorders. A 29 year-old woman was admitted because of general fatigue and hyperlipidemia. She was a heavy drinker. Laboratory data on admission revealed liver dysfunction and hyperlipidemia (type II b) with a quite high serum gamma-glutamyltranspeptidase (gamma GTP) level. The microscopic finding of the liver biopsy specimen showed fatty metamorphosis and ballooning of hepatocytes, and she was diagnosed as heavy alcoholic liver injury. The endocrinological examination revealed the elevated plasma cortisol level, though the urinary 17-hydroxycorticoids (17-OHCS) and 17-ketosteroids (17-KS) excretion and the plasma adrenocorticotropic hormone (ACTH) level were reduced. Cortisol secretion showed the normal circadian rhythm and the normal response to ACTH provocation. The levels of plasma triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) were also reduced. These endocrinological and metabolic disorders were normalized in company with recovery of the liver function by temperance, diet therapy and nutritional education. Thus, these abnormalities were considered to be resulted from the alcoholic liver injury and the effect of the ethanol to the hypothalamic-pituitary system.

Adult↗

PubMed1996

[Follow-up studies and disorders of endocrinologic function in MELAS syndrome].

The clinical course of MELAS syndrome (mitochondrial myopathy, encephalopathy, lactic acidosis, stroke-like episodes) is described in five cases. The age of onset was 9.2 years on average. Cerebral symptoms occurred at an age of 24.6 years on average. The diagnosis was only made later. Three patients died during the follow-up period. The mean age at death was 33.3 years, the average duration of the disease, 19.6 years. All patients suffered from progressive hearing loss, multiple strokes, and complex-partial and generalized seizures. They all had short stature, normal early development and 'ragged red fibers' in the muscle biopsy. Imaging studies (CT and MRI) showed bilateral calcification of basal ganglia and multiple strokes. One patient, admitted with epileptic status as initial symptom, showed lymphocytic pleocytosis in the cerebrospinal fluid; thus, in her case the differential diagnosis included encephalitis. Four patients were studied by dynamic endocrinological testing. Endocrinological disturbances were detected in three patients. Two of them suffered from hypothalamic-pituitary failure and one patient exhibited hyperprolactinemia. Endocrinological disturbances were considered an expression of the underlying cytopathy. Cerebral symptoms occurred rather late in the course of the disease and indicated poor prognosis.

Adolescent↗

PubMed1996

[Endocrinologic and pathologic findings in ornamental birds with polyostotic hyperostosis].

Polyostotic hyperostosis is a finding that is often seen on x-rays in companion birds. Hyperestrogenism might be a causative for polyostotic hyperostosis. The purpose of this study was to compare endocrinologic and pathologic findings in birds with polyostotic hyperostosis. Thirty-five affected and three control birds were examined. Blood samples were taken for endocrinologic statement (estrone, estradiol, testosterone and estrone sulfate) and the values were compared with the pathologic findings. In the present study the comparison of endocrinologic and pathologic findings did not reveal any significant results supporting the hypothesis that polyostotic hyperostosis was caused by hyperestrogenism.

Animals↗

PubMed2006

[Clinical pathways in endocrinology and diabetology].

Endocrinology and diabetology are disciplines with an interdisciplinary approach. Patients with diabetes or endocrine disorders are diagnosed and treated by multiple disciplines both in an outpatient or in-hospital setting. Additional diabetes-specific professions also participate in the care of diabetic patients. The development of clinical pathways and case-management in institutionalized "Diabetes Centers" and "Endocrinology Centers" as platforms of cooperation is one way to improve patient care and to pool resources. In such centers an interdisciplinary decision support within the diagnostic and therapeutic process is important. E. g., interdisciplinary case conferences expediate and intensify the necessary flow of information. This guarantees the implementation of a rational and concerted treatment according to guidelines and finally optimize the clinical pathways in a continuous process improvement.

Communication↗

PubMed2004

The development of a computer-assisted curriculum in reproductive endocrinology and infertility for residents.

UNLABELLED: OBJECTIVE This study was undertaken to determine the features of an effective computer-based residency curriculum in reproductive endocrinology and infertility. STUDY DESIGN: A review of the literature to determine those features that have been used by training programs in medicine. Reproductive endocrinology and infertility division directors, current obstetrics and gynecology residents, and obstetrics and gynecology practitioners in the community were surveyed to evaluate critical subjects for study. RESULTS: Programs most successful in using computers in training health care providers use a case-based approach that prioritizes important subjects. Areas of greatest importance to the 3 groups surveyed include infertility, dysfunctional uterine bleeding, and management of the climacteric, and several other areas were also deemed critical. CONCLUSION: Benefits of computer-based learning include consistency, the ability to develop problem solving skills for life-long learning, and a self-paced approach, but its validity as a teaching tool will require rigorous appraisal.

Computer-Assisted Instruction↗

PubMed2005

Assisted reproductive technology has been detrimental to academic reproductive endocrinology and infertility: depth of the problem and possible solutions.

Dr. Soules' editorial points out some, but not all, of the detrimental effects of assisted reproductive technology on the subspecialty of academic reproductive endocrinology and infertility. This response adds to the list of problems (i.e., discussing the loss of pure endocrinology) but points out an example of a creative solution (i.e., merging academic units with private practices).

Decision Making, Organizational↗

PubMed2004

Microbial endocrinology and infectious disease in the 21st century.

More than 70 years ago, a new age in endocrinology was just beginning with the first purification of a hormone, adrenaline. As early as 1930, almost immediately following its first use, cases of adrenaline-associated sepsis were reported. From this time, there have been reports associating the elaboration of neuroendocrine hormones, such as adrenaline, with infectious disease. The most widely accepted theory to explain the ability of hormones to influence the course of infection involves the suppression of the immune system. The theory that the infectious microorganism itself might be equally responsive to the host's neuroendocrine environment has not been considered. It is the intent of this article to introduce a new perspective to the current understanding of the factors that mediate the ability of bacteria to cause disease, and to demonstrate that neuroendocrinology and microbiology intersect to form the interdisciplinary field of microbial endocrinology.

Bacteria↗

PubMed2005

Ethology and the origins of behavioral endocrinology.

The neurosciences embrace many disciplines, some long established, others of more recent origin. Behavioral endocrinology has only recently been fully acknowledged as a branch of neuroscience, distinctive for the determination of some of its exponents to remain integrative in the face of the many pressures towards reductionism that so dominate modern biology. One of its most characteristic features is a commitment to research at the whole-animal level on the physiological basis of complex behaviors, with a particular but by no means exclusive focus on reproductive behavior in all its aspects. The search for rigorously defined principles of behavioral organization that apply across species and the hormonal and neural mechanisms that sustain them underlies much of the research. Their aims are much like those put forth in the classical ethology of Lorenz and Tinbergen, one of the roots from which behavioral endocrinology has sprung. But there are others that can be traced back a century or more. Antecedents can be found in the work of such pioneers as Jakob von Uexküll, Jacques Loeb, Herbert Spencer Jennings, and particularly Charles Otis Whitman who launched a tradition that culminated in the classical contributions of Robert Hinde and Daniel Lehrman. William C. Young was another pioneer. His studies revolutionized thinking about the physiological mechanisms by which hormones influence behavior. An earlier potent influence was Karl Lashley who helped to shape the career of Frank Ambrose Beach who, more than anyone, has played a leading role in launching this new field.

Animals↗

PubMed1996

AN electronic bulletin board for instruction in reproductive endocrinology in a residency in obstetrics and gynecology.

OBJECTIVE: To explore the role of an electronic bulletin board as a means of computer-based learning in reproductive endocrinology for residents in obstetrics and gynecology. DESIGN: An electronic bulletin board was networked to all residents to present a formal lecture series in reproductive endocrinology and an informal question, answer, and discussion session after each lecture. Ten lectures were presented, one each month, throughout the academic year followed by question, answer, and discussion sessions. All lectures could be stored in an electronic file folder or printed as hard copy for review. A questionnaire was distributed at the conclusion of the project to assess previous resident experience with computers, resident response to, and utilization of the bulletin board. SETTING: A residency program in obstetrics and gynecology in a major medical center. PARTICIPANTS: Twenty-four residents in a 4-year program. MAIN OUTCOME MEASURES: Previous computer experience, ease of use, resident participation, and satisfaction with the bulletin board. RESULTS: Sixty-five percent of the residents considered themselves computer literate and 33 percent previously had taken a course in computer technology. Computer experience in word processing, spreadsheet, and database management was related by 55 percent, 40 percent, and 25 percent of the residents, respectively. Ninety-five percent of the residents accessed the bulletin board for the lectures and found this system a convenient means of review. Sixty percent reviewed the lectures and stored them in an electronic file folder for later review. Forty percent printed the lecture on hard copy. On a scale of 1 to 5 (1 = lowest; 5 = highest), overall resident satisfaction was high at 4.5. CONCLUSION: Our data suggest a potential role for electronic bulletin boards as a complement to standard teaching protocols in resident education. The relative ease of use and satisfaction suggest that these techniques are feasible and offer an effective method of on-line instruction.

Computer Communication Networks↗

PubMed1997

Decision analysis in endocrinology and metabolism.

Decision analysis is a powerful tool for synthesizing and analyzing clinical decisions in the practice of endocrinology and metabolism. The technique involves defining strategies for comparison, choosing a time horizon, constructing a decision tree and model, selecting outcomes and assigning probabilities, taking into account the value of time, calculating the net clinical and cost outcomes, and performing sensitivity analysis. This technique and its utility for different populations and changing health care settings are illustrated for the decision of screening for mild thyroid failure with a thyroid-stimulating hormone assay at the periodic health examination. The strengths and limitations of decision analysis and future applications in endocrinology and metabolism are explored.

Cost-Benefit Analysis↗

PubMed2001

Computer assisted learning is an effective way of teaching endocrinology.

OBJECTIVES: Computers are a part of everyday life and offer an exciting way of learning. The aim of our study was to determine the effectiveness of teaching undergraduate endocrinology using a Computer Assisted Learning (CAL) programme. DESIGN AND SUBJECTS: One hundred and eighty-five first year clinical medical students were randomly assigned either to attend a series of conventional lectures (n = 77) or to have the same material available through a CAL programme. MEASUREMENTS: A multiple choice question examination was performed before and after the course. Lecture attendance and individual usage of the computer system were recorded. Students were asked to fill in an evaluation form at the end of the study. RESULTS: There was no significant difference in the first examination scores between the groups. Both groups improved their scores after the course. Students spent longer performing CAL than attending lectures. Those who scored lowest in the first examination spent the most time on the CAL course. Those who spent the most time on the CAL course showed the largest improvement in examination score. Thirty-six out of the 42 students, who completed an evaluation of the CAL programme, rated it better than the standard lectures. CONCLUSIONS: Computer assisted learning is an effective way of increasing knowledge in teaching undergraduate endocrinology. The course was easy to run and was valued more highly than conventional lectures. The module is now running routinely in the year 3 clinical firms at St Thomas' and has resulted in an increase in knowledge in the end of firm assessment.

Computer-Assisted Instruction↗

PubMed1994

Charles-Edouard Brown-Séquard: double-hyphenated neurologist and forgotten father of endocrinology.

This year is the Centenary of the death of Brown-Séquard who, although remembered today only for his eponymous syndrome, was as well known in the Victorian medical world as Robert Maxwell was to newspaper readers in the past decade. His position in the history of endocrinology is paradoxical; a good case can be made for saying that he invented the doctrine of internal secretion. Yet, the excesses of the organotherapy movement he founded at the end of his life discredited endocrinology and probably delayed the discovery of insulin.

Diabetes Mellitus↗