FT Measurements Research Articles

Financial Toxicity Experiences of Patients With Cancer in Indonesia: An Interpretive Phenomenological Analysis

ObjectivesFinancial toxicity (FT) is an important adverse effect of cancer. Recent systematic reviews have shown that FT may lead to treatment nonadherence and impaired health-related quality of life, both of which may adversely influence the survival rates of patients. However, less is known about how patients endure FT, particularly in low- and middle-income countries. The purpose of this study was to explore how patients with cancer experience and cope with FT in Indonesia. MethodsSemistructured in-depth interviews were conducted to explore the experiences of Indonesian patients with cancer. Qualitative data were analyzed using interpretive phenomenological analysis approach. We purposefully recruited 8 patients undergoing active treatment (aged 27-69 years) who had been diagnosed of cancer over 5 years before and possessed health insurance at the time of diagnosis. ResultsWe identified 2 main themes: (1) the experienced financial burden, with subthemes underinsurance, out-of-pocket nonhealthcare cancer-related costs, and negative income effect from employment disruption, and (2) the financial coping strategies, with subthemes reallocating household budget, seeking family support, rationalizing treatment decisions, and topping up insurance for family members. ConclusionsThis is the first interpretive phenomenological study on FT in the literature and the first qualitative FT study in Indonesia. Our findings provide insight into the occurrence of FT and coping strategies used by Indonesian patients with cancer. The subjective experiences of patients may be considered to further improve oncology care, support the need for measurement of FT, and provide mitigation programs for patients.

Practical parameters for assessing starch digestion and feeding value of steam-flaked corn in finishing diets for feedlot cattle

ABSTRACT Six Holstein steers (153 kg ± 11) with cannulas in the rumen and proximal duodenum were used in a 6 × 6 Latin square design experiment to compare flake density (FD, kg/L), flake thickness (FT, mm), amyloglucosidase reactivity (AGR, % DM) and faecal starch (FS, % DM) as predictors of ruminal (RSD, %) and total tract (TSD, %) starch digestion. Dietary treatments consisted of a finishing diet containing 77% corn. The six corn processing treatments consisted of dry-rolled corn (DRC) with a density of 0.54 kg/L, and steam-flaked corn (SFC) processed to obtain densities of 0.46, 0.41, 0.36, 0.31 and 0.26 kg/L. Compared with DRC, steam flaking enhanced postruminal (34.2%, P < 0.01) and TSD (7.8%, P < 0.01). Measures of FS were the best single predictor of both ruminal (r 2 = 0.97) and TSD (r 2 = 0.98). Whereas AGR was a good predictor of RSD (r 2 = 0.94), it was less effective than FS for estimation of TSD (r 2 = 0.91). We conclude that compared with dry rolling, stream flaking markedly enhances the feeding value of corn. To evaluate the consistency of the flaking process, we recommend in addition to the determinations of FD, measurements of FT, starch enzymatic reactivity and FS are useful indicators.

Validation of body condition score based on subcutaneous fat thickness measurements in primiparous Gyr cows

Context The body condition score (BCS) is an easily measured, fast, inexpensive, and non-invasive tool to estimate the amount of body fat and to evaluate the nutritional status of dairy cows. Aims The aim of this study was to validate BCS in primiparous Gyr cows by using ultrasound measurements of subcutaneous fat (FT). Methods Body weight, BCS (score of 1–9) and FT measured at five body sites (FT1–FT5) were recorded during the prepartum and postpartum periods. Linear regression of FT on BCS and Pearson’s correlations were used. Key results The correlations between body weight and FT measures ranged from 0.49 to 0.63 and from 0.51 to 0.64 during the pre- and postpartum periods respectively, while the correlations between BCS and FT ranged from 0.69 to 0.82 and from 0.67 to 0.78 in the two periods. The BCS better reflected the variation in FT before and after calving than did body weight. Linear regression models were used to explore the relationship between BCS and FT measurements considering the former as the predictor variable. The coefficients of determination (R2) obtained for the prepartum variables ranged from 0.48 to 0.67. The highest R2 was obtained for the model that included FT measured in the lumbar region midway between the last rib and tuber coxae (hook; FT4) as the response variable. The R2 of the models whose response variables were obtained during the postpartum period ranged from 0.45 to 0.60. The highest R2 was observed when the pelvic region midway between the tuber coxae (hook) and tuber ischii (pin; FT2) was used as a response variable. Conclusions The correlations between BCS and FT validate the use of BCS obtained by visual assessment as a tool for evaluating fat reserves in Gyr dams before calving and during first lactation. Among the FT measurements, FT2 and FT4 are interesting because both are easy to measure and showed higher correlations and coefficients of determination with BCS before calving and lactation. Implications The BCS is an accessible tool for producers that requires only training of the evaluator and that is economically viable since no special equipment is needed.

Effect of Exercise on Oxidant and Antioxidant Systems in Rat Kidney Tissue with Hyperthyroidism

Oxidative stress is involved in the pathogenesis of many diseases. Hyperthyroidism is associated with increased oxidative tissue damage. The aim of this study is to investigate whether if there is any protective effect of a regular endurance exercise on oxidative stress in kidney tissues of rats with experimental hyperthyroidism. Twenty-three male Spraque Dawley rats were divided into four groups: Control, hyperthyroid, exercise and, hyperthyroid with exercise. Hyperthyroid was induced in rats by subcutaneous injections at a dosage of 250 µg L-thyroxine per kg body weight and hyperthyroidism was confirmed by the measurements of TSH, FT 3 and FT 4 in serum. Endurance training lasted 8 weeks and consisted of 45 minutes daily treadmill running at a speed of 23 m/minute for 5 days a week. The levels of MDA, GSH and, GSH-Px activity were measured in kidney homogenates. MDA level of the hyperthyroid group was significantly higher than those of the control group(p=0.022). On the other hand, the MDA level of the exercise group was significantly lower than the MDA level of the hyperthyroid group (p=0,001). GSH level and GSH-Px activities were lower in the hyperthyroid group comparing the control group (p<0.05). GSH level and GSH-Px activity in the exercise group were higher than compared with the hyperthyroid group (p<0.05). The results of our study show that L-thyroxine injection may increase oxidative stress by causing lipid peroxidation at kidney tissues and endurance training may decrease oxidative stress. Keywords: Endurance training, glutathione, glutathione peroxidase, hyperthyroidism, kidney tissue, malondialdehyde DOI: 10.7176/JMPB/70-05 Publication date: April 30 th 2021

Six-Axis Force Torque Sensor Model-Based In Situ Calibration Method and Its Impact in Floating-Based Robot Dynamic Performance

A crucial part of dynamic motions is the interaction with other objects or the environment. Floating base robots have yet to perform these motions repeatably and reliably. Force torque sensors are able to provide the full description of a contact. Despite that, their use beyond a simple threshold logic is not widespread in floating base robots. Force torque sensors might change performance when mounted, which is why in situ calibration methods can improve the performance of robots by ensuring better force torque measurements. The Model-Based in situ calibration method with temperature compensation has shown promising results in improving FT sensor measurements. There are two main goals for this paper. The first is to facilitate the use and understanding of the method by providing guidelines that show their usefulness through experimental results. Then the impact of having better FT measurements with no temperature drift are demonstrated by proving that the offset estimated with this method is still useful days and even a month from the time of estimation. The effect of this is showcased by comparing the sensor response with different offsets simultaneously during real robot experiments. Furthermore, quantitative results of the improvement in dynamic behaviors due to the in situ calibration are shown. Finally, we show how using better FT measurements as feedback in low and high level controllers can impact the performance of floating base robots during dynamic motions. Experiments were performed on the floating base robot iCub.

Assessment of Thyroid Function in Early Pregnancy

&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Thyroid disorders are commonly observed in pregnancy. Thyroid hormones play an important role in embryogenesis and fetal development. The fetus is completely dependent on the mother for thyroid hormone in first trimester. About 10% of all pregnant women can be affected by thyroid disorders during pregnancy. Thyroid function abnormalities in pregnancy are a challenge for the concerned physicians. The objective of this study was to assess the maternal thyroid function in first trimester of pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and Methods: &lt;/strong&gt;A descriptive cross sectional study was carried out at the Combined Military Hospital (CMH), Dhaka over a period of one year from January 2013 to December 2013 to see the serum FT&lt;sub&gt;3&lt;/sub&gt;, FT&lt;sub&gt;4&lt;/sub&gt;, TSH, thyroid antibodies level and common thyroid disorders in pregnancy. A total of 138 pregnant women in their first trimester (up to 12 weeks) of pregnancy with an age range of 18-35 years were enrolled in this study. Pregnant women with known thyroid disorder and on treatment and pregnancy more than three months were excluded. Measurement of serum FT&lt;sub&gt;3&lt;/sub&gt;, FT&lt;sub&gt;4&lt;/sub&gt;, TSH, Anti TPO-Ab and Anti TG-Ab were done in each patient at the time of enrolment. Ultrasonography of each patient was done for confirmation of pregnancy and correlation of gestational age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 138 pregnant women, subclinical hypothyroidism was detected in 10 (7.2%) patients and subclinical hyperthyroidism was detected in 3 (2.2%) patients. Mean difference of the investigation findings were not statistically significant among primi and multi gravida. TPO-Ab and TG-Ab difference were statistically significant between two age groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Subclinical thyroid disorders are fairly high among pregnant women. Correct diagnosis in early pregnancy and prompt treatment will bring an excellent prognosis for both mother and offspring.&lt;/p&gt;&lt;p&gt;Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016&lt;/p&gt;

Mass screening of newborns for congenital hypothyroidism of central origin by free thyroxine measurement of blood samples on filter paper

To evaluate the effectiveness of mass screening of newborns for congenital hypothyroidism of central origin (CH-C) by measurement of free thyroxine (FT(4)) and thyroid-stimulating hormone (TSH). Questionnaire-based survey of CH-C patients born between 1999 and 2008 in Kanagawa prefecture, Japan. TSH and FT(4) levels in dried blood spots on filter paper were measured using ELISA kits, and CH-C was diagnosed at FT(4) levels below a cutoff of 0.7 ng/dl (9.0 pmol/l). Survey results were collated with the database created by the screening organizer. Twenty-four CH-C patients (18 males) were identified, 14 of whom had multiple pituitary hormone deficiencies (group M), eight had isolated CH-C (group I), and two had undetermined pituitary involvement (group U). In groups M, I, and U, the number of patients with FT(4) levels below the cutoff value at screening was five (36%), seven (88%), and one (50%) respectively; other patients had been diagnosed clinically. Thus, 13 patients were true positives, while nine were false negatives, yielding screening sensitivity of 59.1% and positive predictive value of 11.5%. The calculated sensitivity was 81.8% at a higher cutoff value of 0.9 ng/dl (11.6 pmol/l). The overall incidence of CH-C was estimated at 1 in 30, 833 live births, while that of CH of thyroidal origin (CH-T) is 1 in 3472 live births in Kanagawa prefecture (CH-T/CH-C, 8.9). Newborn screening with combined FT(4) and TSH measurements can identify a significant number of CH-C patients before manifestation of clinical symptoms, but a more appropriate FT(4) cutoff value should be considered.

Underestimation of Effect of Thyroid Function Parameters on Morbidity and Mortality due to Intra-Individual Variation

Thyroid dysfunction is associated with several diseases and mortality. Due to the within-individual variation of TSH and free T(4) (FT(4)) levels, the association between thyroid function and disease or mortality rates might be underestimated in studies based on one single measurement of TSH and/or FT(4). This kind of bias is called regression dilution bias. The aim of this study was to examine the within-individual variability of TSH and FT(4) measurements several years apart in different study cohorts and to determine the magnitude of the underestimation of the association between thyroid function and disease rates in population-based studies using only one baseline measurement. We used a pair of measurements of serum TSH and FT(4) levels of subjects of the Nijmegen Biomedical Study (NBS) and the Rotterdam Study (RS) to calculate the regression dilution ratio (RDR) with a nonparametric method, the MacMahon's method. Risk estimates could be corrected for regression dilution bias by dividing them by the RDR. The RDR of serum TSH in the NBS and RS were 0.74 and 0.78, respectively. The RDR of serum TSH were similar for women and men, 0.75 and 0.74 in the NBS and 0.80 and 0.77 in the RS. The RDR of serum FT(4) in subjects in the NBS was 0.77. The relationship between thyroid function and disease rates is underestimated by studies using only one measurement of TSH and FT(4). The true association will be about 33% (1/0.75) higher for studies with a follow-up time of 2-4 yr.

The Type 2 Deiodinase ORFa-Gly3Asp Polymorphism (rs12885300) Influences the Set Point of the Hypothalamus-Pituitary-Thyroid Axis in Patients Treated for Differentiated Thyroid Carcinoma

Iodothyronine deiodinases D1, D2, and D3 play an important role in synthesis and degradation of T(3). The relationship between serum TSH and free T(4) (FT(4)) levels is determined by an individual set point of the hypothalamus-pituitary-thyroid axis. Several polymorphisms have been described in D1 and D2 of which some are associated with serum TSH and iodothyronine levels. In this study we investigate whether polymorphisms of D1 and D2 influence the set point of the hypothalamus-pituitary-thyroid axis. We collected 1905 serum FT(4) and TSH measurements during 11.5 ± 8.8 yr of follow-up in patients treated for differentiated thyroid carcinoma (DTC). We determined these polymorphisms: D1-rs11206244, D1-rs12095080, D2-rs225014, and D2-rs12885300. Effects of these polymorphisms on the set points of the hypothalamus-pituitary-thyroid axis were analyzed with a linear mixed model. The study was conducted at Leiden University Medical Center, a tertiary referral center for DTC. One hundred fifty-one consecutive patients were treated and cured for DTC. Slopes and intercepts of regression equations representing the relationship between InTSH and FT(4) were measured for all polymorphisms. DTC patients homozygous for the D2-rs12885300 T allele have an altered set point of the hypothalamus-pituitary-thyroid axis. The slope of the regression line (corrected for age, body mass index, and gender) for wild-type patients was -0.32 ± 0.028 (ln[TSH(mU/liter)]/[FT(4)(pmol/liter)]), the intercept, 4.95. For heterozygous patients, the slope was -0.30 ± 0.028 (ln[TSH(mU/liter)]/[FT(4)(pmol/liter)]), the intercept, 4.23. The slope of the homozygous patients was -0.35 ± 0.026 (ln[TSH(mU/liter)]/[FT(4)(pmol/liter)]) and the intercept, 6.07 (P = 0.036 compared with wild-type and heterozygous patients). Our data suggest that the negative feedback of FT(4) on TSH is weaker in patients homozygous for the D2-rs12885300 T allele than in wild-type and heterozygous subjects.

Pretransplantation Serum FT 3 Concentration in Kidney Recipients is Useful to Identify Higher Risk of Graft Failure

Background Free triiodothyronine (FT 3) is a marker of comorbidity in end-stage renal disease and in many acute and chronic diseases. The objective of the present study was to investigate the effects of pretransplantation FT 3 concentration on graft function. Materials and Methods Between 2003 and 2008, the study enrolled 86 patients who underwent renal transplantation. Twenty-six patients were women, and 60 were men, with overall mean (SD) age of 38 (10) years. In all patients, serum FT 3, free thyroxine, and thyroid-stimulating hormone concentrations were determined before transplantation. Demographic data and laboratory values were evaluated at 2 years posttransplantation. Results The overall graft survival rate at 2 years was 82.1%. Pretransplantation serum FT 3 concentration was inversely correlated with 2-year serum creatinine concentration ( r = −0.29; P = .01) and proteinuria ( r = −0.37; P < .00). Linear regression analysis demonstrated that serum FT 3 ( r 2 = 0.63; 95% confidence interval, 0.52–0.74; P = .00) was a statistically significant risk factor for increased serum creatinine concentration. No correlation was observed for thyroid-stimulating hormone or free thyroxine and posttransplantation data. Conclusion Patients with end-stage renal disease with low pretransplantation serum FT 3 concentration are at greater risk of subsequent graft failure. Measurement of pretransplantation serum FT 3 concentration could be a clinically useful method of identifying patients at increased risk of graft failure.

Opioid Analgesics Suppress Male Gonadal Function, but Opioid Use in Men and Women Does Not Correlate with Symptoms of Sexual Dysfunction

Opioid analgesia impairs gonadal function in men and women, but the correlation with symptoms and hormonal measurements of hypogonadism is not well established. To determine the frequency of impaired gonadal function in men and women using opioids for chronic pain, and to determine the correlation of symptoms with hormonal measurements of gonadal function. A prospective study of patients attending a multidisciplinary pain clinic was conducted. A total of 65 women (47 opioid users and 18 nonopioid analgesic controls) and 32 men (26 opioid users and six controls) were enrolled. Histories of sexual dysfunction and hormonal testing (men: total testosterone [TT], free testosterone [FT], prolactin and luteinizing hormone; women: FT, TT, prolactin, dehydroepiandrosterone sulphate, sex hormone- binding globulin, progesterone, luteinizing hormone and follicle- stimulating hormone, and estradiol) were obtained. In men, a low FT level was more common in opioid users (20⁄26; P=0.04). In men with abnormal hormone levels, there was no difference in the frequency of sexual dysfunction compared with men with normal hormone levels, and no difference in the frequency of opioid versus nonopioid use. In women, opioid users had lower FT levels (P=0.02). Low dehydroepiandrosterone sulphate was more frequent in women on opioids (P=0.03) in the menopausal group only (P=0.046). Premenopausal women taking opioids more frequently had a low TT level (P=0.03). The frequency of female sexual dysfunction was the same in opioid users (32⁄47) and controls (13⁄18; P=0.75), and also did not relate to any hormone abnormality. Men taking opioids had lower FT and higher prolactin levels, and women taking opioids had lower FT levels. Frequency of sexual dysfunction did not correlate with hormone levels in either men or women taking opioids. Opioids frequently cause low FT levels in men, but there is no relationship between abnormal hormone levels and symptoms of sexual dysfunction. Therefore, all men should be screened for low FT levels. Women on opioids had lower FT levels, but this did not correlate with sexual dysfunction symptoms. Therefore, measurements of FT or other hormones were not considered to be useful in women.

Thyroid Hormone Level Positively Regulates NOS and cGMP in the Developing Rat Cerebellum

Thyroid hormones and nitric oxide/cyclic guanosine monophosphate (NO/cGMP) signaling play a significant role in the structural development of the cerebellum, respectively. In the present study, the possible contribution of neuronal NO synthase (NOS) and cGMP in the thyroid hormone-induced structural changes was investigated in the cerebella of postnatal rats at different hormone levels. Animals were treated from postnatal day 4 until days 7, 14, and 21, by i.p. injection of 1 μg thyroxine (T₄)/10 g body weight/4 days, or p.o. with 100 μg 6-n-propyl-2-thyouracil (PTU)/10 g body weight/day. Control groups consisted of i.p. and p.o. vehicle controls and PTU/T₄-treated animals. Measurement of serum fT₄, TSH as well as total T₃ and T₄ concentration of the cerebellar tissue indicated the changed thyroid status. nNOS extensively expressed in growing parallel fibers revealed by quantitative Western blot and layer analysis of immunohistochemically labeled coronal sections. Simultaneously, the cGMP concentration increased and the distribution of cGMP-immunoreactive (cGMP-IR) material in Purkinje cell perikarya and in the molecular layer expanded during cerebellar development. T₄ increased nNOS and cGMP level, and accelerated the development of nNOS-IR parallel fibers and cGMP-IR molecular layer. In contrast, PTU retarded the development by decreasing nNOS and cGMP concentration and slowing down layer formation. A single dose of T₄ could rescue the PTU-induced changes. Results suggest that the contribution of nNOS- NO/cGMP signaling in thyroid hormone regulated structural maturation of the cerebellum. The possible involvement of neurotrophins, calcium, and apoptotic events in this process was discussed.

Are the adverse effects of glitazones linked to induced testosterone deficiency?

BackgroundAdverse side-effects of the glitazones have been frequently reported in both clinical and animal studies, especially with rosiglitazone (RGZ) and pioglitazone (PGZ), including congestive heart failure, osteoporosis, weight gain, oedema and anaemia. These led to consideration of an evidence-based hypothesis which would explain these diverse effects, and further suggested novel approaches by which this hypothesis could be tested.Presentation of hypothesisThe literature on the clinical, metabolic and endocrine effects of glitazones in relation to the reported actions of testosterone in diabetes, metabolic syndrome, and cardiovascular disease is reviewed, and the following unifying hypothesis advanced: "Glitazones induce androgen deficiency in patients with Type 2 Diabetes Mellitus resulting in pathophysiological changes in multiple tissues and organs which may explain their observed clinical adverse effects." This also provides further evidence for the lipocentric concept of diabetes and its clinical implications.Testing of the hypothesisClinical studies to investigate the endocrine profiles, including measurements of TT, DHT, SHBG, FT and estradiol, together with LH and FSH, in both men and women with T2DM before and after RGZ and PGZ treatment in placebo controlled groups, are necessary to provide data to substantiate this hypothesis. Also, studies on T treatment in diabetic men would further establish if the adverse effects of glitazones could be reversed or ameliorated by androgen therapy. Basic sciences investigations on the inhibition of androgen biosynthesis by glitazones are also warranted.Implications of the hypothesisGlitazones reduce androgen biosynthesis, increase their binding to SHBG, and attenuate androgen receptor activation, thus reducing the physiological actions of testosterone, causing relative and absolute androgen deficiency. This hypothesis explains the adverse effects of glitazones on the heart and other organs resulting from reversal of the action of androgens in directing the maturation of stem cells towards muscle, vascular endothelium, erythroid stem cells and osteoblasts, and away from adipocyte differentiation. The higher incidence of side-effects with RGZ than PGZ, may be explained by a detailed study of the mechanism by which glitazones down-regulate androgen biosynthesis and action, resulting in a state of androgen deficiency.

The Implications of Proteolytic Background for Shotgun Proteomics

The analysis by liquid chromatography coupled to tandem mass spectrometry of complex peptide mixtures, generated by proteolysis of protein samples, is the main proteomics method used today. The approach is based on the assumption that each protein present in a sample reproducibly and predictably generates a relatively small number of peptides that can be identified by mass spectrometry. In this study this assumption was examined by a targeted peptide sequencing strategy using inclusion lists to trigger peptide fragmentation attempts. It was found that the number of peptides observed from a single protein is at least one order of magnitude greater than previously assumed. This unexpected complexity of proteomics samples implies substantial technical challenges, explains some perplexing results in the proteomics literature, and prompts the need for developing alternative experimental strategies for the rapid and comprehensive analysis of proteomes.

Predicting beef carcass retail products of Mediterranean buffaloes by real-time ultrasound measures

Twenty eight Mediterranean buffaloes bulls were scanned with real-time ultrasound (RTU), slaughtered, and fabricated into retail cuts to determine the potential for ultrasound measures to predict carcass retail yield. Ultrasound measures of fat thickness, ribeye area and rump fat thickness were recorded three to five days prior to slaughter. Carcass measurements were taken, and one side of each carcass was fabricated into retail cuts. Stepwise regression analysis was used to compare possible models for prediction of either kilograms or percent retail product from carcass mesaurements and ultrasound measures. Results indicate that possible prediction models for percent or kilograms of retail products using RTU measures were similar in their predictive power and accuracy when compared to models derived from carcass measurements. Both fat thickness and ribeye area were over-predicted when measured ultrasonically compared to measurements taken on the carcass in the cooler. The mean absolute differences for both traits are larger than the mean differences, indicating that some images were interpreted to be larger and some smaller than actual carcass measurements. Ultrasound measurements of REA and FT had positive correlations with carcass measures of the same traits (r=.96 for REA and r=.99 for FT). Standard errors of prediction currently are being used as the standard to certify ultrasound technicians for accuracy. Regression equations using live weight (LW), rib eye area (REAU) and subcutaneous fat thickness (FTU) between 12th and 13 th ribs and also over the biceps femoris muscle (FTP8) by ultrasound explained 95% of the variation in the hot carcass weight when measure immediately before slaughter.

Hypogonadism in male patients with cancer

Patients with cancer often develop anorexia, fatigue, and decreased muscle mass. These signs and symptoms are nonspecific, and they frequently occur in other conditions, including hypogonadism. The objectives of this study were 1) to measure testosterone levels in patients with cancer and 2) to examine the correlations between testosterone, tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), insulin-like growth factor-1 (IGF-1), ghrelin levels, and appetite in patients with cancer patients and in a noncancer control group. This was designed as a cross-sectional study in the setting of a university-affiliated Veterans Affairs Medical Center. The study population included 31 male patients with cancer and 25 gender-matched noncancer controls of similar age. The variables total testosterone (TT), calculated free testosterone (cFT), calculated bioavailable testosterone (cBT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), TNF-alpha, IL-6, IGF-1, and active ghrelin were measured in fasting morning plasma samples. Appetite was measured according to a visual analog scale. The main outcome measures were cFT and cBT. Cancer patients had mean TT levels similar to levels in the noncancer control group but significantly lower levels of cFT, cBT, IGF-1, and appetite. SHBG, LH, TNF-alpha, IL-6, and ghrelin levels were increased in patients with cancer compared with the control group. cFT and cBT levels were correlated inversely with IL-6 and ghrelin levels and were correlated directly with IGF-1 levels and appetite. Patients with cancer had lower levels of biologically active testosterone. TT was not adequate for the evaluation of hypogonadism, because SHBG levels were increased. A reliable measurement of FT and/or BT should be used. LH was elevated in the patients with cancer, indicating that low FT levels were caused by primary testicular dysfunction. The authors postulated that high IL-6 or ghrelin levels inhibit testosterone synthesis, although a secondary effect at the hypothalamic-pituitary levels cannot be excluded.

Evaluation of plasma testosterone: Which test and when?

Biochemical evaluation of androgenicity in men and women requires the determination of plasma testosterone (T). Because essentially only nonspecifically bound T appears to be available to tissues and to be bioactive (Bio-T), it may be required, in some instances, to determine the Bio-T fraction (free T [FT] and albumin-bound T). Surprisingly, a very important interlaboratory variation in T levels does exist and the lack of precision of current methods does not allow accurate measurement of T levels in women or prepubertal boys. Thus, each laboratory should establish its own range of normal values. As to parameters of FT or Bio-T, kits for direct measurement of FT are unreliable. Equilibrium dialysis, the gold standard of FT, is not suited for clinical routine, whereas the FT index (T/sex hormone-binding globulin [SHBG]) is a reliable parameter of FT in women only; calculation of FT and Bio-T (from T, SHBG, and albumin concentration) yields reliable results, but the absolute values depend on the association constants of SHBG and albumin for T used. In men (F)T is mainly used to confirm the clinical diagnosis of hypogonadism or to modulate androgen treatment. In otherwise healthy hypogonadal men, measurement of total T will suffice, but in patients with conditions affecting binding proteins (eg, thyroid or liver pathology, nephrotic syndrome, obesity) measurement of Bio-T may be required. In women, androgen measurement is generally required to evaluate androgen excess (eg, polycystic ovary syndrome, ovulatory dysfunction, hirsutism).

Ist die Bestimmung des «freien Androgenindexes» zum Hormonscreening bei polyzystischen Ovarien sinnvoll?

In 82 females with hyperandrogenism and polycystic ovaries, the sensitivity and diagnostic accuracy of the free-androgen index (FAI) were compared with those of testosterone (T), free testosterone (fT), androstenedione (A), LH and the LH/FSH ratio. Normal ranges for each parameter were derived as 95th percentile in 53 healthy controls of similar age. T, fT, A, FAI, LH and LH/FSH were significantly (p < 0.001) higher in patients than controls. The sensitivity and diagnostic accuracy of the FAI (0.46 and 0.64) were lower than those of T (0.67 and 0.78) and A (0.56 and 0.73) and similar to those of fT and LH/FSH. The overall variance of the FAI was highest among all parameters. The FAI was significantly (p = 0.05) elevated in a subgroup with obesity (n = 34), whereas T and fT did not differ in obese and nonobese subjects with polycystic-ovary syndrome. We cannot recommend the routine measurement of the FAI in the rational laboratory evaluation of female hyperandrogenism for the following reasons. (1) The adequate normal range for the FAI (< 8.7) is substantially higher than previously thought in normal individuals, which has serious consequences for the accuracy of the test. (2) The values of the FAI showed the widest overlap with controls. (3) The significant positive correlation between FAI and fT allows the prediction of the FAI from the measurement of fT, rendering the determination of a second parameter for the free bioactive T unnecessary. (4) The FAI as well as sex-hormone-binding globulin are influenced by body weight, whereas T and fT are markers for hyperandrogenism independent of obesity.

Electron saturation velocity in Ga0.5Inp0.5P measured in a GaInP/GaAs/GaInP double-heterojunction bipolar transistor

The first (not necessarily typical) performance measurements on Ga0.5In0.5P/GaAs/Ga0.5In0.5P double-heterojunction bipolar transistors are reported. The measured cutoff frequency and maximum oscillation frequency are 25 and 35GHz, respectively. From various measurements of fT under various bias conditions, the value of the electron saturation velocity in GaInP is determined to be 4.4 × 106cm/s.

Experimental aspects of Fourier transform Raman spectroscopy

Using a commercial Fourier transform infrared spectrometer and the 1.064μm line of a CW Nd∶YAG laser, we have measured the Raman spectra of a wide variety of materials. The Raman scattered light, Stokes shifted toward the mid-infrared, is collected, using a 90° lens geometry, and focused through the emission port of the spectrometer. After passing through the Michelson interferometer, the light is detected by a thermoelectrically-cooled high-sensitivity germanium detector. The Fourier transform of the resulting interferogram gives the Raman spectrum. This new technique allows spectra to be obtained of samples which were previously completely masked by competing fluorescence. In addition, FT-Raman also allows moieties, such as hydrocarbon chains, which are not present in resonance enhanced spectra, to be investigated. We will discuss our approach toward FT-Raman, which is compatible with traditional Raman spectroscopy, present representative spectra of liquids and solids, and draw some comparisons and contrasts between dispersive and FT measurements.