Bailliere's clinical endocrinology and metabolism最新文献_第9页

Treatment of Graves' disease: The American way 格雷夫斯病的治疗:美国方式

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80798-7

MD Elliot G. Levy (Clinical Professor of Medicine)

引用次数: 24

Thyroxine suppression therapy in Graves' disease 甲状腺素抑制治疗Graves病

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80753-7

MD, FRCP Anthony Toft (Consultant Physician)

{"title":"Thyroxine suppression therapy in Graves' disease","authors":"MD, FRCP Anthony Toft (Consultant Physician)","doi":"10.1016/S0950-351X(97)80753-7","DOIUrl":"10.1016/S0950-351X(97)80753-7","url":null,"abstract":"<div><p>A recent Japanese report of a novel ‘block-and-replace’ regime for Graves' hyperthyroidism in which thyroxine was continued alone after the combination therapy was stopped was associated with a negligible relapse rate of less than 2%. Such a finding has the potential to revolutionize the management of Graves' disease but a similarly large study from Scotland failed to confirm any benefit from the new treatment. Apart from obvious differences in race and dietary iodine there is no adequate explanation for the discrepant results. In all studies reporting a fall in thyrotropin (TSH) receptor antibodies (TRAb) and/or relapse rates following conventional or novel ‘block-and-replace’ regimes, serum TSH concentrations were often elevated in the control groups treated with antithyroid drugs alone. Theoretically, this could lead to continued expression of thyroid cell surface antigen, increased production of TRAb and an adverse effect on remission rates. This, however, fails to explain the extraordinary low remission rates of the original study from Japan and, in the meantime, there is no good reason to adopt the novel regime, at least in Caucasians.</p></div>","PeriodicalId":77027,"journal":{"name":"Bailliere's clinical endocrinology and metabolism","volume":"11 3","pages":"Pages 537-548"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-351X(97)80753-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20456055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Cytokines and Graves' disease 细胞因子和格雷夫斯病

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80708-2

MD, DSc, FRCP A.P. Weetman (Professor of Medicine), MD, MMedSci Ramzi A. Ajjan (Research Fellow), PhD P.F. Watson (Lecturer)

引用次数: 23

Previous issues 以前的问题

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80633-7

引用次数: 0

Index 指数

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80813-0

引用次数: 0

Prevention and treatment of postpartum Graves' disease 产后Graves病的防治

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80768-9

MD, FRCP John H. Lazarus (Senior Lecturer Department of Medicine), PhD Marian E. Ludgate (Research Fellow Department of Pathology)

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引用次数: 18

Understanding the thyrotropin receptor function—structure relationship 了解促甲状腺激素受体功能与结构的关系

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80693-3

BSc, PhD Jane Sanders (Senior Molecular Biologist), MD, PhD Yasuo Oda (Visiting Research Fellow) , BSc Sara-Anne Roberts (Scientific Assistant), MD Masayuki Maruyama (Visiting Research Fellow) , MD, PhD Jadwiga Furmaniak (Laboratory Director and Honorary Lecturer) , BSc, PhD, DSc Bernard Rees Smith (Managing Director and Honorary Senior Lecturer)

{"title":"Understanding the thyrotropin receptor function—structure relationship","authors":"BSc, PhD Jane Sanders (Senior Molecular Biologist), MD, PhD Yasuo Oda (Visiting Research Fellow) , BSc Sara-Anne Roberts (Scientific Assistant), MD Masayuki Maruyama (Visiting Research Fellow) , MD, PhD Jadwiga Furmaniak (Laboratory Director and Honorary Lecturer) , BSc, PhD, DSc Bernard Rees Smith (Managing Director and Honorary Senior Lecturer)","doi":"10.1016/S0950-351X(97)80693-3","DOIUrl":"10.1016/S0950-351X(97)80693-3","url":null,"abstract":"<div><p>The thyrotropin (TSH) receptor (TSHR) is a key protein in the control of thyroid function and a major thyroid autoantigen. Recently, molecular cloning of the receptor has been carried out and we now review the impact of this work on our understanding of the physiology and pathophysiology of the TSHR. Analysis of recombinant TSHR proteins expressed in prokaryotic and eukaryotic systems has indicated that post-translational processing is important for the formation of active receptors. Studies of TSHR glycosylation have shown that a ‘mature’ form of the receptor containing mainly complex-type sugar residues is principally involved in TSH and TSHR autoantibody (TRAb) binding. In addition, the processing of the TSHR peptide chain into two subunits observed with native TSHR has been confirmed using recombinant TSHR. However, despite considerable efforts in many laboratories, the binding site(s) for TSH and TRAb on the TSHR have not been well characterized as yet and lessons learned from the discovery of naturally occurring amino acid mutations of the TSHR confirm the complexity of the hormone and autoantibody binding sites. Future progress in producing large amounts of pure TSHR as well as monoclonal TRAbs, followed by crystallographic analysis of TSHR-TSH complexes and TSHR-TRAb complexes, should be helpful in providing a better insight into the relationship between TSHR structure and function.</p></div>","PeriodicalId":77027,"journal":{"name":"Bailliere's clinical endocrinology and metabolism","volume":"11 3","pages":"Pages 451-479"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-351X(97)80693-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20456138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 49

Treating severe Graves' ophthalmopathy 治疗严重格雷夫斯眼病

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-10-01 DOI: 10.1016/S0950-351X(97)80738-0

MD Luigi Bartalena (Assistant Professor of Endocrinology), MD Claudio Marcocci (Assistant Professor of Endocrinology), MD Aldo Pinchera (Professor of Endocrinology)

{"title":"Treating severe Graves' ophthalmopathy","authors":"MD Luigi Bartalena (Assistant Professor of Endocrinology), MD Claudio Marcocci (Assistant Professor of Endocrinology), MD Aldo Pinchera (Professor of Endocrinology)","doi":"10.1016/S0950-351X(97)80738-0","DOIUrl":"10.1016/S0950-351X(97)80738-0","url":null,"abstract":"<div><p>Most patients with Graves' disease have some evidence of ocular involvement, but this is commonly mild, requiring only local measures. A minority of patients (3–5%) have severe Graves' ophthalmopathy, for which the three main treatment procedures are represented by high-dose glucocorticoids, orbital radiotherapy and orbital decompression. Favourable results with medical treatment have been reported in approximately 60% of patients, with particular regard to inflammatory changes, newly developed eye muscle dysfunction and optic neuropathy. Orbital decompression is indicated in severe eye disease not responsive to glucocorticoids and/or irradiation, particularly in the presence of marked proptosis and optic neuropathy. Not conclusive or unsatisfactory results have been obtained with other medical treatment procedures, including immunosuppressive drugs, intravenous immunoglobulins and plasmapheresis. Recently favourable responses have been reported with somatostatin analogues. Rehabilitative surgery involving either the eye muscles or the eyelids is not infrequently required after medical treatment or decompression. Permanent control of thyroid hyperfunction by radioiodine or thyroidectomy is advisable when severe ophthalmopathy is present. Exacerbation of ophthalmopathy following radioiodine may occur but can be prevented by concomitant administration of glucocorticoids. Smoking deleteriously influences the course of ophthalmopathy and its response to treatment.</p></div>","PeriodicalId":77027,"journal":{"name":"Bailliere's clinical endocrinology and metabolism","volume":"11 3","pages":"Pages 521-536"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-351X(97)80738-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20456054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 86

Growth hormone secretion in the elderly: Ageing and the somatopause 老年人的生长激素分泌:衰老与躯体暂停

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-07-01 DOI: 10.1016/S0950-351X(97)80257-1

MD, MSc, FRCP Finbarr C. Martin (Consultant Physician and Senior Lecturer, UMDS Department of Elderly Care), MA, MRCP Ai-Lyn Yeo (Research Registrar Department of Elderly Care), MD, FRCP Peter H. Sonksen (Honorary Consultant Physician and Professor of Endocrinology UMDS)

{"title":"Growth hormone secretion in the elderly: Ageing and the somatopause","authors":"MD, MSc, FRCP Finbarr C. Martin (Consultant Physician and Senior Lecturer, UMDS Department of Elderly Care), MA, MRCP Ai-Lyn Yeo (Research Registrar Department of Elderly Care), MD, FRCP Peter H. Sonksen (Honorary Consultant Physician and Professor of Endocrinology UMDS)","doi":"10.1016/S0950-351X(97)80257-1","DOIUrl":"10.1016/S0950-351X(97)80257-1","url":null,"abstract":"<div><p>The syndrome associated with lack of growth hormone (GH) in adults can be reversed by treatment with recombinant human GH (rhGH) with apparently beneficial clinical effects. This syndrome is strikingly similar to the characteristics of normal older adults which are known as the somatopause. GH secretion and insulin-like growth factor I levels are reduced in healthy older people and it has been suggested that the somatopause is an age-related GH deficiency state.</p><p>This review describes the physiological control of GH secretion in adults and seeks an explanation for the age-related decline, considering the impact of other factors such as nutrition and mobility, and particularly whether exercise offers a physiological approach to changing both the GH decline and the somatopause. The benefits and side-effects of treatment with rhGH for normal older people or older patients facing catabolic stresses are reviewed together with alternative approaches to stimulate GH such as GH-releasing hormone and the new pharmaceutical GH secretagogues.</p></div>","PeriodicalId":77027,"journal":{"name":"Bailliere's clinical endocrinology and metabolism","volume":"11 2","pages":"Pages 223-250"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-351X(97)80257-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20331015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 67

Ageing and adrenal cortical function 衰老与肾上腺皮质功能

Bailliere's clinical endocrinology and metabolism Pub Date : 1997-07-01 DOI: 10.1016/S0950-351X(97)80287-X

MD, PhD Frank Svec (Professor of Medicine and Chief)

引用次数: 12