Endocrine Abstracts

Seaweed consumption results in high levels of iodine intake in Asian populations and influences the presentation of thyroid and perhaps extrathyroidal disorders. The relationship of seawater to seaweed is analogous to that between the bloodstream and the thyroid. However, seaweed has a dramatically more efficient uptake system than the thyroid, concentrating iodide from seawater by a factor of up to 106 compared to 40-50 for the thyroid. The ability of seaweeds to b...

PTTG is tumourigenic in vivo and transactivates fibroblast growth factor-2 (FGF-2). We have previously identified expression of PTTG and FGF-2 as potential prognostic indicators for differentiated thyroid cancer. Critical to PTTG function is a double PXXP motif, forming a putative SH3-interacting domain. We employed cDNA array approaches to identify further genes regulated via this region. MCF12A cells were transiently transfected with vector-only (VO) control, wild-type (WT)-...

T3, GH and IGF-1 are essential for skeletal development. GH acts directly on growth plate chondrocytes and also via a local paracrine pathway involving IGF-1, but it is unclear whether T3 stimulates bone formation directly or indirectly. To address this, we determined expression of GH-receptor, IGF-1 and IGF-1 receptor (IGF-1R) by in situ hybridisation and activation of downstream STAT5 and AKT signalling by immunohistochemistry in growth plates from four T3-receptor (TR) muta...

Introduction:There is a great need for targeted and tailored treatment strategies in anaplastic thyroid cancer patients.The current conventional treatment strategies consisting of surgery,chemo- or radiotherapy have a palliative effect leading to short survival periods.The failure of tumor cells to undergo apoptosis may cause resistance to chemoradiological therapies due to overexpression of antiapoptotic oncogenes and transcriptionally repressed apoptotic tumour suppressor ge...

Objective: To evaluate the psychometric properties of two new condition-specific questionnaires: (1) the 18-item ThyDQoL, an individualised patient-centred measure of perceived impact of hypothyroidism on QoL, and (2) the 15-item ThySC symptom checklist in which patients provide 'bother' ratings for common hypothyroid symptoms.Method: A cross-sectional survey was conducted with 110 adults with clinical or subclinical hypothyroidism [mean age: 55.1 plus/m...

In vitro human thyroid follicular cells have been shown to secrete vascular endothelial growth factors (VEGFs). VEGFs transduce their effects by binding to their receptors, VEGFRs, leading to receptor phosphorylation and recruitment of downstream signalling molecules. Using RT-PCR we found that normal human thyroid follicular cells in culture express VEGFR-1, VEGFR-2 and VEGFR-3. Western blotting using antisera specific for phosphotyrosine at 1214 of the GRB2 SH2 bindin...

The plasminogen activator (PA) system plays a central role in biological processes that involve extracellular proteolysis including tissue remodelling, blood clotting, angiogenesis and metastases. The thyroid gland is highly vascular and undergoes extensive remodelling in goitre. We found that primary cultures of human thyroid follicular cells secrete large amounts of PAs (2.5-110 U per ml per day per 105 cells), both urokinase-like (uPA) and tissue-type (tPA), and ...

Acetylation of DNA can result in gene silencing. In the thyroid such phenomena can lead to the loss of ability to accumulate radioiodide. The aim of this study was to examine the effects on the rat thyroid cell line FRTL-5 and human thyroid follicular cancer cell line FTC-133 of Trichostatin A (TSA), a histone deactylase inhibitor. A concentration of TSA was selected using MTT cell viability assays for use in uptake, efflux and expression studies. Cells were incubated with TSA...

Connective tissue growth factor (CTGF aka CCN2), is known to be up-regulated by transforming growth factor beta (TGF beta) and plays important roles in cell cycle control, growth, differentiation, cell adhesion, migration, angiogenesis and ECM production. CTGF is overexpressed in fibrotic disease e.g in kidney, lung, heart as well as in tumours. We have examined expression of CTGF in thyroid tissue because TGF beta is known be an autocrine factor, regulated by iodide. Immunohi...

Graves' disease (GD) is caused by genetic and environmental factors. To date only the HLA class II region on chromosome 6p21 and the CTLA-4 gene on chromosome 2q33 have been consistently associated with disease. A recent study has indicated the most likely position of the aetiological variant in the CTLA-4 locus to be in a 6.1kb region of the 3' untranslated region of the gene. However the same degree of mapping resolution has not been achieved for the HLA class II region due ...

Thyroid dysfunction is common, particularly in the elderly, and has an important impact on morbidity and mortality, especially in this age group.Aim: We have investigated associations between thyroid function, presence of atrial fibrillation and cognitive function in a large general practice-based study conducted from December 2002-November 2004. Subjects with a previous history of thyroid disease or currently taking thyroxine or anti-thyroid drugs were ...

Introduction:Anaplastic thyroid carcinoma has a very poor prognosis because it is a highly aggressive and extremely lethal human cancer with poor therapeutic responses due to intrinsic resistance to chemotherapy.One of the reasons is DNA methylation which causes silencing of tumour suppressor genes (TSGs).To improve the prognosis of patients with anaplastic thyroid Ca,a better understanding of the molecular changes involved in its pathogenesis is essential.<p class="abstex...

Background: Maternal hyperthyroidism (MH) during late pregnancy is associated with adverse neonatal outcomes but the effects of MH in early gestation when managed in a specialised joint obstetric endocrine clinic setting is unclear. Objectives: To evaluate the obstetric and neonatal outcomes of maternal hyperthyroidism presenting during early gestation. Methods: Endocrine and obstetric record of 40 pregnancies with active hyperthyroidism managed in the antenatal endocrine clin...

It has been claimed that the use of the TRH test and the nocturnal TSH surge test might uncover the diagnosis of the so-called 'hidden' central hypothyroidism, in a substantial proportion of euthyroid cranially irradiated children. In our study of 37 euthyroid adult cancer survivors and 34 matched normal controls, patients had significantly (P<0.05) higher basal and stimulated TSH levels and a slightly slower TSH decline between 20 and 60 min during the TRH test; none had b...

IntroductionAntithyroid drugs are widely used in the therapy of hyperthyroidism. This review (update of Cochrane review: Antithyroid drug regimen for treating Graves' hyperthyroidism. In: The Cochrane Library, Issue 4, 2003; with 4 additional trials) assesses the effects of dose, regimen and duration of antithyroid drug therapy for Graves' hyperthyroidism.MethodsThe Cochrane Controlled Trials Register, MEDLIN...

Background and aims: Maternal subclinical hypothyroidism during early pregnancy has been shown to be associated with impaired neuropsyhological developement of children.Recent consensus guidelines have recmmended aggressive case finding for thyroid or other autoimmune disorders.We have examined the efficacy of these criteria in identifying women with thyroid dysfunction during early pregnancy.Subjects and methods:During july 2002 to june 2003,we propecti...

ObjectiveDoes subclinical hypothyroidism (SCH)cause increased cardiovascular risk and how does treatment affect cardiac and vascular function in patients with SCH?MethodsCardiac function and central arterial stiffness(CAS)were measured in 20 females (mean age 50.1 plus/minus 4.1 years)with SCH (mean free T4 12.2 plus/minus 0.2 picomol per litre [normal range 9.8-22.1],median TSH 8.8 milliunits per litre[norma...

Objective: To assess perceived health status in people with sub-clinical hypothyroidism (SCH) who may have physical and psychological symptoms of hypothyroidism, which could affect their health perceptions.Method: A cross-sectional survey was conducted involving 71 adults with SCH and no other chronic disease, age range 18 - 64 years. Patients completed the eight scales of the Short Form 36 Health Survey questionnaire version 2 (SF-36v2), a widely used t...

Objective: Assessment of the accuracy of physical examination performed by thyroid surgery team doctors at thyroid clinic.Method: Random review of 120 new referrals to thyroid clinic, with review of clinical findings on physical examination on first attendance to clinic and compare the clinical findings with subsequent ultrasound scan findings.Results: Of total number of 120 patients, 63 had solitary nodule on physical examination,...

ObjectivesBoth glucose insulin potassium (GIK) and tri-iodothyronine (T3) may improve cardiovascular performance following cardiac surgery. The effects of combined treatment are unknown.MethodsAfter obtaining local research ethics committee approval, we performed a randomised double-blind placebo-controlled trial on patients undergoing first time elective/urgent isolated CABG. Between January 2000 ...

ObjectiveThyroid replacement therapy needs careful titration, and recently there has been discussion regarding the bioavailability of different thyroxine preparations [1]We have taken the opportunity of comparing thyroid function in 18 females who were enrolled in a trial studying the effects of thyroxine therapy on subclinical hypothyroidism [SCH].MethodsThese patients (at entry to tri...

Agranulocytosis complicating carbimazole (CBZ) therapy occurs in <1% of treated patients and generally presents in a charachteristic way. A 72 year old female presented with thyrotoxicosis (FT4 44.9 pmol/l, NR 12.5-20.5), confirmed as Graves disease on investigation. Treatment was commenced with carbimazole. 4 weeks after beginning therapy she complained of a painful red eye, nausea, anorexia and weight loss. Examination confirmed iritis. Subsequent investigations revealed ...

High dose steroids are effective in treating active thyroid-associated ophthalmopathy (TAO), however the side effects are considerable. This study aimed to establish whether long term response to intravenous methylprednisolone can be predicted by a detailed ophthalmological assessment 1 to 2 weeks after the first dose of steroid.45 patients with moderate to severe, active TAO (including 31 with optic neuropathy), treated with intravenous methylprednisolo...

IntroductionPrediction of the efficacy of antithyroid medication in Graves' disease would be of great value. There is no consensus if TSH levels at the end of treatment accurately predict relapse. Previous studies have not carefully defined Graves' disease nor used the same treatment protocol in all patients.AimTo study patients with Graves' disease treated with antithyroid medication to confirm or refute an ...

Objective: To assess quality of life (QoL) in people on therapy for hypothyroidism (T4 group) and to compare it with people with untreated sub-clinical hypothyroidism (SCH group).Method: A newly designed and validated tool, the 18-item ThyDQoL, measuring hypothyroid-specific QoL was completed in a cross sectional survey of the T4 group [n=103, mean age (SD) 55 (14.2) years, 17.5% males], which was similar in age and sex to the SCH group [n=100, mean age ...

The hypothalamic-pituitary-thyroid axis can be affected following therapy for brain tumours. Primary thyroid damage is frequent following craniospinal irradiation(CSI). Central hypothyroidism is less commonly reported following cranial irradiation(CI), however, some investigators have argued it is underdiagnosed and may be more prevalent than growth hormone deficiency(GHD). Utilising thyroid function tests(TFT) for the diagnosis of central hypothyroidism is notoriously difficu...

In Europe the trace element selenium has been shown to be diminished on farmland and consequently in the food chain. Selenoproteins play a major role in the redox-systems of the body; glutathion-peroxidase is important for the enzymatic reduction of hydroperoxides in the thyroid gland. Furthermore, various forms of dejodases contain selenium, which convert thyroxin into triiodthyronin.We investigated the incidence and the extent of selenium deficiency in...

Clinical outcome and Implications for training in thyroid surgery in a district general HospitalAuthors: Rajashekhar Rao, Kanagaraj Marimuthu, and Paul ThomasObjective: To assess the volume of work outcome and training opportunity in adistrict general Hospital and compare with the BAES recommendationsMethods: Retrospective study, Patients identified by theatre records, pathology<p c...

BackgroundRadioiodine therapy (RAI) is an effective treatment for hyperthyroidism, being used with increasing frequency. There is no consensus as to the correct use of radioiodineThe aim is to compare our practice to the standards recommended by the working group of the Royal College of Physicians and Society for Endocrinology and to measure the outcome at one year of using a fixed dose of RAI (555 Mbq) .Meth...

While iodine deficiency goitre is common worldwide, it is rarely described in the U.K. Vegan diet is the only real way for this deficiency to occur in the U.K. A MEDLINE search from 1966 revealed 1 reported case (Shaikh et al. Transient neonatal hypothyroidism due to a maternal vegan diet; Journal of Pediatric Endocrinology & Metabolism Jan 2003). We have identified 3 cases, which we will describe here.Case 1A 21-year-ol...

Natriuretic peptides BNP and NTpro-BNP have been suggested as being useful for the diagnosis of congestive heart failure, and have been shown to have excellent negative predictive value for excluding severe systolic left ventricular dysfunction.We have shown previously that changes in thyroid function are associated with changes in concentrations of other low molecular weight molecules through the changes on renal function. Therefore, the aim of this stu...

A 76 year old woman was referred in December 1997 to the Endocrine clinic at Luton & Dunstable Hospital following admission with atrial fibrillation which was managed by digoxin, flecainide and warfarin.Investigations initiated by her GP included reduced TSH at 0.18 milliUnits/Litre (0.32-5.00) despite normal free T4 of 14 picomols/Litre (9-24) and normal free T3 of 4.4 picomols/Litre (2.5-5.3). Ultrasound scan was in favour of multinodular goitre an...

Physical examination in thyroid diseases, should it be relied on?M Sadri, C Y Yiangou, A. DhandaDepartment of thyroid surgery Queen Alexandra Hospital, PortsmouthObjective: Assessment of the accuracy of physical examination performed by thyroid surgery team doctors at thyroid clinic.Method: Random review of 120 new referrals to thyroid clinic, with review of clinical findings on physica...