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Polycystic ovary syndrome

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Liquid chromatography–mass spectrometry ( LC–MS ) is an analytical chemistry technique that combines the physical separation capabilities of liquid chromatography (or HPLC ) with the mass analysis capabilities of mass spectrometry (MS). Coupled chromatography – MS systems are popular in chemical analysis because the individual capabilities of each technique are enhanced synergistically. While liquid chromatography separates mixtures with multiple components, mass spectrometry provides spectral information that may help to identify (or confirm the suspected identity of) each separated component. MS is not only sensitive, but provides selective detection, relieving the need for complete chromatographic separation. LC–MS is also appropriate for metabolomics because of its good coverage of a wide range of chemicals. This tandem technique can be used to analyze biochemical, organic, and inorganic compounds commonly found in complex samples of environmental and biological origin. Therefore, LC–MS may be applied in a wide range of sectors including biotechnology , environment monitoring, food processing , and pharmaceutical , agrochemical , and cosmetic industries. Since the early 2000s, LC–MS (or more specifically LC– MS/MS ) has also begun to be used in clinical applications.

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144-710: Polycystic ovary syndrome , or polycystic ovarian syndrome ( PCOS ), is the most common endocrine disorder in women of reproductive age. The syndrome is named after cysts which form on the ovaries of some women with this condition, though this is not a universal symptom, and not the underlying cause of the disorder. Women with PCOS may experience irregular menstrual periods , heavy periods , excess hair , acne , pelvic pain, difficulty getting pregnant , and patches of thick, darker velvety skin . The primary characteristics of this syndrome include: hyperandrogenism , anovulation , insulin resistance , and neuroendocrine disruption. A review of international evidence found that

288-513: A DiGeorge-like syndrome . Malformations in the GCM2 gene have resulted in hypoparathyroidism . Studies on SOX3 gene mutations have demonstrated that it plays a role in parathyroid development. These mutations also lead to varying degrees of hypopituitarism. The human fetal pancreas begins to develop by the fourth week of gestation. Five weeks later, the pancreatic alpha and beta cells have begun to emerge. Reaching eight to ten weeks into development,

432-402: A macronutrient -matched healthy diet. Reducing intake of food groups that cause inflammation, such as dairy, sugars and simple carbohydrates, can be beneficial. A mediterranean diet is often very effective due to its anti-inflammatory and anti-oxidative properties. Vitamin D deficiency may play some role in the development of the metabolic syndrome , and treatment of any such deficiency

576-870: A pelvic ultrasound is a major diagnostic tool, it is not the only one. The diagnosis is fairly straightforward using the Rotterdam criteria, even when the syndrome is associated with a wide range of symptoms. Other causes of irregular or absent menstruation and hirsutism, such as hypothyroidism , congenital adrenal hyperplasia (21-hydroxylase deficiency) (which may cause excessive body hair, deep tone voice and others symptoms similar to hyperandrogenism ), Cushing's syndrome , hyperprolactinemia (leading to anovulation ), androgen-secreting neoplasms, and other pituitary or adrenal disorders, should be investigated. Some other blood tests are suggestive but not diagnostic. The ratio of LH ( luteinizing hormone ) to FSH ( follicle-stimulating hormone ), when measured in international units ,

720-984: A 1995 study of 1,741 women with PCOS, mean testosterone levels were 2.6 (1.1–4.8) nmol/L (75 (32–140) ng/dL). In a 1998 study which reviewed many studies and subjected them to meta-analysis, testosterone levels in women with PCOS were 62 to 71 ng/dL (2.2–2.5 nmol/L) and testosterone levels in women without PCOS were about 32 ng/dL (1.1 nmol/L). In a 2010 study of 596 women with PCOS which used liquid chromatography–mass spectrometry (LC–MS) to quantify testosterone, median levels of testosterone were 41 and 47 ng/dL (with 25th–75th percentiles of 34–65 ng/dL and 27–58 ng/dL and ranges of 12–184 ng/dL and 1–205 ng/dL) via two different labs. If testosterone levels are above 100 to 200 ng/dL, per different sources, other possible causes of hyperandrogenism , such as congenital adrenal hyperplasia or an androgen -secreting tumor , may be present and should be excluded. Warning signs may include

864-586: A 50% chance of inheriting the predisposing genetic variant(s) from a parent, and, if a daughter receives the variant(s), the daughter will have the disease to some extent. The genetic variant(s) can be inherited from either the father or the mother, and can be passed along to both sons (who may be asymptomatic carriers or may have symptoms such as early baldness and/or excessive hair) and daughters, who will show signs of PCOS. The phenotype appears to manifest itself at least partially via heightened androgen levels secreted by ovarian follicle theca cells from women with

1008-461: A LC–MS interface capable of handling high flow rates (1 ml/min) and avoiding the flow split in DLI interfaces. The TSP interface was composed of a heated probe, a desolvation chamber, and an ion focusing skimmer. The LC effluent passed through the heated probe and emerged as a jet of vapor and small droplets flowing into the desolvation chamber at low pressure. Initially operated with a filament or discharge as

1152-468: A cavity of ectodermal cells of the oropharynx , forms between the fourth and fifth week of gestation and upon full development, it gives rise to the anterior pituitary gland. By seven weeks of gestation, the anterior pituitary vascular system begins to develop. During the first 12 weeks of gestation, the anterior pituitary undergoes cellular differentiation. At 20 weeks of gestation, the hypophyseal portal system has developed. The Rathke's pouch grows towards

1296-428: A change in appearance. But there are also manifestations of mental health problems, such as anxiety, depression, and eating disorders. A diagnosis of PCOS suggests an increased risk of the following: The risk of ovarian cancer and breast cancer is not significantly increased overall. PCOS is a heterogeneous disorder of uncertain cause. There is some evidence that it is a genetic disease . Such evidence includes

1440-430: A computer. The mass spectrum can be used to determine the mass of the analytes, their elemental and isotopic composition, or to elucidate the chemical structure of the sample. MS is an experiment that must take place in gas phase and under vacuum (1.33 * 10 to 1.33 * 10 pascal). Therefore, the development of devices facilitating the transition from samples at higher pressure and in condensed phase (solid or liquid) into

1584-443: A critical site such as the thyroid ( toxic multinodular goitre ). Hypofunction of endocrine glands can occur as a result of loss of reserve, hyposecretion, agenesis , atrophy, or active destruction. Hyperfunction can occur as a result of hypersecretion, loss of suppression, hyperplastic or neoplastic change, or hyperstimulation. Endocrinopathies are classified as primary, secondary, or tertiary. Primary endocrine disease inhibits

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1728-419: A duct. The major glands of the endocrine system include the pineal gland , pituitary gland , pancreas , ovaries , testes , thyroid gland , parathyroid gland , hypothalamus and adrenal glands . The hypothalamus and pituitary gland are neuroendocrine organs . The hypothalamus and the anterior pituitary are two out of the three endocrine glands that are important in cell signaling. They are both part of

1872-410: A fetus reaches 12 weeks of development, the thyrotrophs begin expression of Beta subunits for TSH, while gonadotrophs being to express beta-subunits for LH and FSH. Male fetuses predominately produced LH-expressing gonadotrophs, while female fetuses produce an equal expression of LH and FSH expressing gonadotrophs. At 24 weeks of gestation, prolactin-expressing lactotrophs begin to emerge. A hormone

2016-554: A gynecological problem, with the ovaries being the primary organ affected. However, recent insights show a multisystem disorder, with the primary problem lies in hormonal regulation in the hypothalamus , with the involvement of many organs. The term PCOS is used due to the fact that there is a wide spectrum of symptoms possible. It is common to have polycystic ovaries without having PCOS; approximately 20% of European women have polycystic ovaries, but most of those women do not have PCOS. PCOS may be related to or worsened by exposures during

2160-452: A history of sexually transmitted diseases. For overweight anovulatory women with PCOS, weight loss and diet adjustments, especially to reduce the intake of simple carbohydrates, are associated with resumption of natural ovulation. Digital health interventions have been shown to be particularly effective in providing combined therapy to manage PCOS through both lifestyle changes and medication. Endocrine system The endocrine system

2304-557: A lack of physical exercise, and a family history of someone with the condition. Diagnosis is based on two of the following three findings: anovulation , high androgen levels, and ovarian cysts . Cysts may be detectable by ultrasound . Other conditions that produce similar symptoms include adrenal hyperplasia , hypothyroidism , and high blood levels of prolactin . The genetic component appears to be inherited in an autosomal dominant fashion with high genetic penetrance but variable expressivity in females; this means that each child has

2448-427: A liquid phase technique (HPLC) with a continuously flowing eluate, and a gas phase technique carried out in a vacuum was difficult for a long time. The advent of electrospray ionization changed this. Currently, the most common LC–MS interfaces are electrospray ionization (ESI), atmospheric pressure chemical ionization (APCI), and atmospheric pressure photo-ionization (APPI). These are newer MS ion sources that facilitate

2592-447: A mass spectrometer are the ion source , the mass analyzer , the detector, and the data and vacuum systems. The ion source is where the components of a sample introduced in a MS system are ionized by means of electron beams , photon beams ( UV lights ), laser beams or corona discharge . In the case of electrospray ionization, the ion source moves ions that exist in liquid solution into the gas phase. The ion source converts and fragments

2736-467: A metal capillary kept at 3 to 5 kV and is nebulized by a high-velocity coaxial flow of gas at the tip of the capillary, creating a fine spray of charged droplets in front of the entrance to the vacuum chamber. To avoid contamination of the vacuum system by buffers and salts, this capillary is usually perpendicularly located at the inlet of the MS system, in some cases with a counter-current of dry nitrogen in front of

2880-448: A more favorable side effect profile. The United Kingdom's National Institute for Health and Clinical Excellence recommended in 2004 that women with PCOS and a body mass index above 25 be given metformin when other therapy has failed to produce results. Metformin may not be effective in every type of PCOS, and therefore there is some disagreement about whether it should be used as a general first line therapy. In addition to this, metformin

3024-449: A nano HPLC system and an electron ionization equipped mass spectrometer. ESI interface for LC–MS systems was developed by Fenn and collaborators in 1988. This ion source/ interface can be used for the analysis of moderately polar and even very polar molecules (e.g., metabolites, xenobiotics, peptides, nucleotides, polysaccharides). The liquid eluate coming out of the LC column is directed into

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3168-500: A nervous system and all vertebrates have a hypothalamus–pituitary axis. All vertebrates have a thyroid, which in amphibians is also crucial for transformation of larvae into adult form. All vertebrates have adrenal gland tissue, with mammals unique in having it organized into layers. All vertebrates have some form of a renin–angiotensin axis, and all tetrapods have aldosterone as a primary mineralocorticoid . Liquid chromatography%E2%80%93mass spectrometry In addition to

3312-614: A normal weight before and after diagnosis. "Lean" women still face the various symptoms of PCOS with the added challenges of having their symptoms properly addressed and recognized. Lean women often go undiagnosed for years, and usually are diagnosed after struggles to conceive. Lean women are likely to have a missed diagnosis of diabetes and cardiovascular disease, these women also have an increased risk of developing insulin resistance, despite not being overweight. Lean women are often taken less seriously with their diagnosis of PCOS, and also face challenges finding appropriate treatment options. This

3456-589: A protease, urea to denature the tertiary structure, and iodoacetamide to modify the cysteine residues. After digestion, LC–MS is used for peptide mass fingerprinting , or LC–MS/MS ( tandem MS ) is used to derive the sequences of individual peptides. LC–MS/MS is most commonly used for proteomic analysis of complex samples where peptide masses may overlap even with a high-resolution mass spectrometry. Samples of complex biological (e.g., human serum) may be analyzed in modern LC–MS/MS systems, which can identify over 1000 proteins. However, this high level of protein identification

3600-482: A regular weight-loss diet. A scientific review in 2013 found similar improvements in weight, body composition and pregnancy rate , menstrual regularity, ovulation, hyperandrogenism, insulin resistance, lipids, and quality of life to occur with weight loss, independent of diet composition. Still, a low GI diet , in which a significant portion of total carbohydrates is obtained from fruit, vegetables, and whole-grain sources, has resulted in greater menstrual regularity than

3744-403: A specific complement of genes, such as follistatin and multiple cyclin kinase inhibitors are involved in ovarian development. An assortment of genes and proteins - such as WNT4, RSPO1, FOXL2, and various estrogen receptors - have been shown to prevent the development of testicles or the lineage of male-type cells. The pituitary gland is formed within the rostral neural plate. The Rathke's pouch,

3888-399: A thin, flask-like diverticulum of the median anlage develops. At approximately 24 to 32 days of gestation the median anlage develops into a bilobed structure . By 50 days of gestation, the medial and lateral anlage have fused together. At 12 weeks of gestation, the fetal thyroid is capable of storing iodine for the production of TRH , TSH , and free thyroid hormone. At 20 weeks, the fetus

4032-414: A two-stage process that begins at eight weeks of gestation and continues through the middle of the third trimester. During the transabdominal stage (8 to 15 weeks of gestation), the gubernacular ligament contracts and begins to thicken. The craniosuspensory ligament begins to break down. This stage is regulated by the secretion of insulin-like 3 (INSL3), a relaxin-like factor produced by the testicles, and

4176-561: A vacuum system has been essential to develop MS as a potent tool for identification and quantification of organic compounds like peptides. MS is now in very common use in analytical laboratories that study physical, chemical, or biological properties of a great variety of compounds. Among the many different kinds of mass analyzers, the ones that find application in LC–MS systems are the quadrupole , time-of-flight (TOF) , ion traps , and hybrid quadrupole-TOF (QTOF) analyzers. The interface between

4320-531: A wide range of highly polar metabolites, oligosaccharides , amino acids , amino sugars , and sugar nucleotides from Cucurbita maxima phloem tissues. Another example of LC–MS in plant metabolomics is the efficient separation and identification of glucose , sucrose , raffinose , stachyose , and verbascose from leaf extracts of Arabidopsis thaliana . LC–MS is frequently used in drug development because it allows quick molecular weight confirmation and structure identification. These features speed up

4464-509: Is a medication commonly used in type 2 diabetes mellitus to reduce insulin resistance, and is used off label (in the UK, US, AU and EU) to treat insulin resistance seen in PCOS. In many cases, metformin also supports ovarian function and return to normal ovulation. A newer insulin resistance medication class, the thiazolidinediones (glitazones), have shown equivalent efficacy to metformin, but metformin has

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4608-425: Is a messenger system in an organism comprising feedback loops of hormones that are released by internal glands directly into the circulatory system and that target and regulate distant organs . In vertebrates , the hypothalamus is the neural control center for all endocrine systems. In humans , the major endocrine glands are the thyroid , parathyroid , pituitary , pineal , and adrenal glands , and

4752-583: Is a strong risk factor for insulin resistance, although insulin resistance is a common finding among women with PCOS in normal-weight women as well. Elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic–pituitary–ovarian axis that lead to PCOS. Hyperinsulinemia increases GnRH pulse frequency, which in turn results in an increase in the LH/FSH ratio increased ovarian androgen production; decreased follicular maturation; and decreased SHBG binding. Furthermore, excessive insulin increases

4896-408: Is a well developed chemical analysis strategy dating back from the 1950s. Gas chromatography (GC)–MS was originally introduced in 1952, when A. T. James and A. J. P. Martin were trying to develop tandem separation – mass analysis techniques. In GC, the analytes are eluted from the separation column as a gas and the connection with electron ionization ( EI ) or chemical ionization ( CI ) ion sources in

5040-399: Is able to implement feedback mechanisms for the production of thyroid hormones. During fetal development, T 4 is the major thyroid hormone being produced while triiodothyronine (T 3 ) and its inactive derivative, reverse T 3 , are not detected until the third trimester. A lateral and ventral view of an embryo showing the third (inferior) and fourth (superior) parathyroid glands during

5184-620: Is added to the mobile phase or the nebulizing gas to promote a reaction of charge-exchange between the dopant molecular ion and the analyte. The ionized sample is later transferred to the mass analyzer at high vacuum as it passes through small orifice skimmers. The coupling of MS with LC systems is attractive because liquid chromatography can separate delicate and complex natural mixtures, which chemical composition needs to be well established (e.g., biological fluids, environmental samples, and drugs). Further, LC–MS has applications in volatile explosive residue analysis. Nowadays, LC–MS has become one of

5328-409: Is also used in plant metabolomics, but this technique can only detect and quantify the most abundant metabolites. LC–MS has been useful to advance the field of plant metabolomics, which aims to study the plant system at molecular level providing a non-biased characterization of the plant metabolome in response to its environment. The first application of LC–MS in plant metabolomics was the detection of

5472-504: Is another LC–MS ion source/ interface for the analysis of neutral compounds that cannot be ionized using ESI. This interface is similar to the APCI ion source, but instead of a corona discharge, the ionization occurs by using photons coming from a discharge lamp. In the direct-APPI mode, singly charged analyte molecular ions are formed by absorption of a photon and ejection of an electron. In the dopant-APPI mode, an easily ionizable compound (Dopant)

5616-429: Is any of a class of signaling molecules produced by cells in glands in multicellular organisms that are transported by the circulatory system to target distant organs to regulate physiology and behaviour . Hormones have diverse chemical structures, mainly of 3 classes: eicosanoids , steroids , and amino acid / protein derivatives ( amines , peptides , and proteins ). The glands that secrete hormones comprise

5760-559: Is associated with several unpleasant side effects: including abdominal pain, metallic taste in the mouth, diarrhoea and vomiting. Metformin is thought to be safe to use during pregnancy ( pregnancy category B in the US). A review in 2014 concluded that the use of metformin does not increase the risk of major birth defects in women treated with metformin during the first trimester. Liraglutide may reduce weight and waist circumference in people with PCOS more than other medications. The use of statins in

5904-484: Is because most treatment options are limited to approaches of losing weight and healthy dieting. Testosterone levels are usually elevated in women with PCOS. In a 2020 systematic review and meta-analysis of sexual dysfunction related to PCOS which included 5,366 women with PCOS from 21 studies, testosterone levels were analyzed and were found to be 2.34 nmol/L (67 ng/dL) in women with PCOS and 1.57 nmol/L (45 ng/dL) in women without PCOS. In

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6048-416: Is characterized by the hypersecretion of the adrenocorticotropic hormone (ACTH) due to a pituitary adenoma that ultimately causes endogenous hypercortisolism by stimulating the adrenal glands. Some clinical signs of Cushing's disease include obesity, moon face, and hirsutism. Addison's disease is an endocrine disease that results from hypocortisolism caused by adrenal gland insufficiency. Adrenal insufficiency

6192-413: Is considerable debate as to the optimal treatment. One of the major factors underlying the debate is the lack of large-scale clinical trials comparing different treatments. Smaller trials tend to be less reliable and hence may produce conflicting results. General interventions that help to reduce weight or insulin resistance can be beneficial for all these aims, because they address what is believed to be

6336-424: Is contrasted both to exocrine glands , which secrete hormones to the outside of the body, and to the system known as paracrine signalling between cells over a relatively short distance. Endocrine glands have no ducts , are vascular, and commonly have intracellular vacuoles or granules that store their hormones. In contrast, exocrine glands, such as salivary glands , mammary glands , and submucosal glands within

6480-412: Is elevated in women with PCOS. Common cut-offs to designate abnormally high LH/FSH ratios are 2:1 or 3:1 as tested on day 3 of the menstrual cycle. The pattern is not very sensitive; a ratio of 2:1 or higher was present in less than 50% of women with PCOS in one study. There are often low levels of sex hormone-binding globulin , in particular among obese or overweight women. Anti-Müllerian hormone (AMH)

6624-402: Is from the thickening of the pharyngeal floor, which serves as the precursor of the thyroxine (T 4 ) producing follicular cells. The other part is from the caudal extensions of the fourth pharyngobranchial pouches which results in the parafollicular calcitonin-secreting cells. These two structures are apparent by 16 to 17 days of gestation. Around the 24th day of gestation, the foramen cecum ,

6768-520: Is increased in PCOS, and may become part of its diagnostic criteria. PCOS diagnosis is categorized into four different types; PCOS has no cure. Treatment may involve lifestyle changes such as weight loss and exercise. Recent research suggests that daily exercise including both aerobic and strength activities can improve hormone imbalances. Birth control pills may help with improving the regularity of periods, excess hair growth, and acne. Combined oral contraceptives are especially effective, and used as

6912-614: Is indicated. However, a systematic review of 2015 found no evidence that vitamin D supplementation reduced or mitigated metabolic and hormonal dysregulations in PCOS. As of 2012, interventions using dietary supplements to correct metabolic deficiencies in people with PCOS had been tested in small, uncontrolled and nonrandomized clinical trials; the resulting data are insufficient to recommend their use. Medications for PCOS include oral contraceptives and metformin . The oral contraceptives increase sex hormone binding globulin production, which increases binding of free testosterone. This reduces

7056-469: Is involved in controlling the secretion of hormones from the anterior pituitary. Anterior Pituitary : The main role of the anterior pituitary gland is to produce and secrete tropic hormones . Some examples of tropic hormones secreted by the anterior pituitary gland include TSH, ACTH, GH, LH, and FSH. There are many types of cells that make up the endocrine system and these cells typically make up larger tissues and organs that function within and outside of

7200-508: Is needed to assess the role that endocrine disruptors may play in disrupting reproductive health in women and possibly triggering or exacerbating PCOS and its related symptoms. Polycystic ovaries develop when the ovaries are stimulated to produce excessive amounts of androgenic hormones, in particular testosterone, by either one or a combination of the following (almost certainly combined with genetic susceptibility): A majority of women with PCOS have insulin resistance and/or are obese , which

7344-409: Is not possible to directly pump the eluate from the LC column into the MS source. Overall, the interface is a mechanically simple part of the LC–MS system that transfers the maximum amount of analyte, removes a significant portion of the mobile phase used in LC and preserves the chemical identity of the chromatography products (chemically inert). As a requirement, the interface should not interfere with

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7488-500: Is possible only after separating the sample by means of SDS-PAGE gel or HPLC-SCX. Recently, LC–MS/MS has been applied to search peptide biomarkers. Examples are the recent discovery and validation of peptide biomarkers for four major bacterial respiratory tract pathogens ( Staphylococcus aureus , Moraxella catarrhalis ; Haemophilus influenzae and Streptococcus pneumoniae ) and the SARS-CoV-2 virus. LC–MS has emerged as one of

7632-459: Is possible to acquire alternate positive and negative mode spectra rapidly within the same LC run . While most large molecules (greater than MW 1500–2000) produce multiply charged ions in the ESI source, the majority of smaller molecules produce singly charged ions. The development of the APCI interface for LC–MS started with Horning and collaborators in the early 1973. However, its commercial application

7776-447: Is responsible for increasing glucose uptake and lipogenesis during the stages leading up to birth. Fetal cells contain a higher amount of insulin receptors in comparison to adults cells and fetal insulin receptors are not downregulated in cases of hyperinsulinemia . In comparison, fetal haptic glucagon receptors are lowered in comparison to adult cells and the glycemic effect of glucagon is blunted. This temporary physiological change aids

7920-569: Is significant because it is correlated with decreased ability to maintain blood pressure and blood sugar, a defect that can prove to be fatal. Graves' disease involves the hyperactivity of the thyroid gland which produces the T3 and T4 hormones. Graves' disease effects range from excess sweating, fatigue , heat intolerance and high blood pressure to swelling of the eyes that causes redness, puffiness and in rare cases reduced or double vision. A neuroendocrine system has been observed in all animals with

8064-507: Is the use of tandem MS–MS , where the detector may be programmed to select certain ions to fragment. The measured quantity is the sum of molecule fragments chosen by the operator. As long as there are no interferences or ion suppression in LC–MS , the LC separation can be quite quick. LC–MS is used in proteomics as a method to detect and identify the components of a complex mixture. The bottom-up proteomics LC–MS approach generally involves protease digestion and denaturation using trypsin as

8208-459: Is used by some in whom other measures are not effective. Certain cosmetic procedures may also help alleviate symptoms in some cases. For example, the use of laser hair removal, electrolysis, or general waxing, plucking and shaving are all effective methods for reducing hirsutism. The primary treatments for PCOS include lifestyle changes and use of medications. Goals of treatment may be considered under four categories: In each of these areas, there

8352-451: Is widely used in the field of bioanalysis and is specially involved in pharmacokinetic studies of pharmaceuticals. Pharmacokinetic studies are needed to determine how quickly a drug will be cleared from the body organs and the hepatic blood flow. MS analyzers are useful in these studies because of their shorter analysis time, and higher sensitivity and specificity compared to UV detectors commonly attached to HPLC systems. One major advantage

8496-553: The HOX15 gene can cause parathyroid gland aplasia , which suggests the gene plays an important role in the development of the parathyroid gland. The genes, TBX1 , CRKL , GATA3 , GCM2 , and SOX3 have also been shown to play a crucial role in the formation of the parathyroid gland. Mutations in TBX1 and CRKL genes are correlated with DiGeorge syndrome , while mutations in GATA3 have also resulted in

8640-511: The gastrointestinal tract , tend to be much less vascular and have ducts or a hollow lumen . Endocrinology is a branch of internal medicine . The human endocrine system consists of several systems that operate via feedback loops . Several important feedback systems are mediated via the hypothalamus and pituitary. Endocrine glands are glands of the endocrine system that secrete their products, hormones , directly into interstitial spaces where they are absorbed into blood rather than through

8784-456: The hypothalamic–pituitary–adrenal axis . In addition to the specialized endocrine organs mentioned above, many other organs that are part of other body systems have secondary endocrine functions, including bone , kidneys , liver , heart and gonads . For example, the kidney secretes the endocrine hormone erythropoietin . Hormones can be amino acid complexes, steroids , eicosanoids , leukotrienes , or prostaglandins . The endocrine system

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8928-415: The nervous system . Autocrine signaling is a form of signaling in which a cell secretes a hormone or chemical messenger (called the autocrine agent) that binds to autocrine receptors on the same cell, leading to changes in the cells. Some endocrinologists and clinicians include the paracrine system as part of the endocrine system, but there is not consensus. Paracrines are slower acting, targeting cells in

9072-451: The ovaries become morphologically visible by the 8th week of gestation. The absence of testosterone results in the diminution of the Wolffian structures. The Müllerian structures remain and develop into the fallopian tubes, uterus, and the upper region of the vagina. The urogenital sinus develops into the urethra and lower region of the vagina, the genital tubercle develops into the clitoris,

9216-411: The plasma membranes of target cells to act within their nuclei . The typical mode of cell signalling in the endocrine system is endocrine signaling, that is, using the circulatory system to reach distant target organs. However, there are also other modes, i.e., paracrine, autocrine, and neuroendocrine signaling. Purely neurocrine signaling between neurons , on the other hand, belongs completely to

9360-586: The prenatal period , epigenetic factors, environmental impacts (especially industrial endocrine disruptors, such as bisphenol A and certain drugs) and the increasing rates of obesity. Endocrine disruptors are defined as chemicals that can interfere with the endocrine system by mimicking hormones such as estrogen . According to the NIH (National Institute of Health) , examples of endocrine disruptors can include dioxins and triclosan . Endocrine disruptors can cause adverse health impacts in animals. Additional research

9504-405: The (male) testis and (female) ovaries . The hypothalamus , pancreas , and thymus also function as endocrine glands, among other functions. (The hypothalamus and pituitary glands are organs of the neuroendocrine system . One of the most important functions of the hypothalamus—it is located in the brain adjacent to the pituitary gland—is to link the endocrine system to the nervous system via

9648-412: The 6th week of embryogenesis Once the embryo reaches four weeks of gestation, the parathyroid glands begins to develop. The human embryo forms five sets of endoderm -lined pharyngeal pouches. The third and fourth pouch are responsible for developing into the inferior and superior parathyroid glands, respectively. The third pharyngeal pouch encounters the developing thyroid gland and they migrate down to

9792-406: The DLI interface was the frequent clogging of the diaphragm orifices. The DLI interface was used between 1982 and 1985 for the analysis of pesticides, corticosteroids, metabolites in horse urine, erythromycin, and vitamin B 12 . However, this interface was replaced by the thermospray interface, which removed the flow rate limitations and the issues with the clogging diaphragms. A related device

9936-522: The FAB based interfaces were able to handle liquid flow rates of only 1–15 μl and were also restricted to microbore and capillary columns. In order to be used in FAB MS ionization sources, the analytes of interest had to be mixed with a matrix (e.g., glycerol) that could be added before or after the separation in the LC column. FAB based interfaces were extensively used to characterize peptides, but lost applicability with

10080-461: The HPA axis which is known to play a role in cell signaling in the nervous system. Hypothalamus: The hypothalamus is a key regulator of the autonomic nervous system. The endocrine system has three sets of endocrine outputs which include the magnocellular system, the parvocellular system, and autonomic intervention. The magnocellular is involved in the expression of oxytocin or vasopressin. The parvocellular

10224-489: The INSL3 G-coupled receptor, LGR8. During the transinguinal phase (25 to 35 weeks of gestation), the testicles descend into the scrotum. This stage is regulated by androgens, the genitofemoral nerve, and calcitonin gene-related peptide. During the second and third trimester, testicular development concludes with the diminution of the fetal Leydig cells and the lengthening and coiling of the seminiferous cords . For females,

10368-430: The LC system is pumped through a capillary and there is also nebulization at the tip, where a corona discharge takes place. First, the ionizing gas surrounding the interface and the mobile phase solvent are subject to chemical ionization at the ion source. Later, these ions react with the analyte and transfer their charge. The sample ions then pass through small orifice skimmers by means of or ion-focusing lenses. Once inside

10512-550: The MS system was a technically simpler challenge. Because of this, the development of GC-MS systems was faster than LC–MS and such systems were first commercialized in the 1970s. The development of LC–MS systems took longer than GC-MS and was directly related to the development of proper interfaces. Victor Talrose and his collaborators in Russia started the development of LC–MS in the late 1960s, when they first used capillaries to connect an LC column to an EI source. A similar strategy

10656-511: The action of downstream glands. Secondary endocrine disease is indicative of a problem with the pituitary gland. Tertiary endocrine disease is associated with dysfunction of the hypothalamus and its releasing hormones. As the thyroid , and hormones have been implicated in signaling distant tissues to proliferate, for example, the estrogen receptor has been shown to be involved in certain breast cancers . Endocrine, paracrine, and autocrine signaling have all been implicated in proliferation, one of

10800-419: The activity of 17α-hydroxylase , which catalyzes the conversion of progesterone to androstenedione , which is in turn converted to testosterone. The combined effects of hyperinsulinemia contribute to an increased risk of PCOS. Adipose (fat) tissue possesses aromatase , an enzyme that converts androstenedione to estrone and testosterone to estradiol . The excess of adipose tissue in obese women creates

10944-491: The adrenal glands have been encapsulated and have formed a distinct organ above the developing kidneys. At birth, the adrenal glands weigh approximately eight to nine grams (twice that of the adult adrenal glands) and are 0.5% of the total body weight. At 25 weeks, the adult adrenal cortex zone develops and is responsible for the primary synthesis of steroids during the early postnatal weeks. The thyroid gland develops from two different clusterings of embryonic cells. One part

11088-465: The advent of electrospray based interfaces in 1988. Liquid chromatography is a method of physical separation in which the components of a liquid mixture are distributed between two immiscible phases, i.e., stationary and mobile. The practice of LC can be divided into five categories, i.e., adsorption chromatography , partition chromatography , ion-exchange chromatography , size-exclusion chromatography , and affinity chromatography . Among these,

11232-415: The allele. The exact gene affected has not yet been identified. In rare instances, single-gene mutations can give rise to the phenotype of the syndrome. Current understanding of the pathogenesis of the syndrome suggests, however, that it is a complex multigenic disorder. Due to the scarcity of large-scale screening studies, the prevalence of endometrial abnormalities in PCOS remains unknown, though women with

11376-455: The alpha cells. The insulin concentration within the fetal pancreas is 3.6 pmol/g at seven to ten weeks, which rises to 30 pmol/g at 16–25 weeks of gestation. Near term, the insulin concentration increases to 93 pmol/g. The endocrine cells have dispersed throughout the body within 10 weeks. At 31 weeks of development, the islets of Langerhans have differentiated. While the fetal pancreas has functional beta cells by 14 to 24 weeks of gestation,

11520-422: The amount of insulin that is released into the bloodstream is relatively low. In a study of pregnant women carrying fetuses in the mid-gestation and near term stages of development, the fetuses did not have an increase in plasma insulin levels in response to injections of high levels of glucose. In contrast to insulin, the fetal plasma glucagon levels are relatively high and continue to increase during development. At

11664-549: The analysis of drugs , metabolites, conjugates, nucleosides , peptides , natural products , and pesticides . The introduction of TSP marked a significant improvement for LC–MS systems and was the most widely applied interface until the beginning of the 1990s, when it began to be replaced by interfaces involving atmospheric pressure ionization (API). The first fast atom bombardment ( FAB ) and continuous flow-FAB (CF-FAB) interfaces were developed in 1985 and 1986 respectively. Both interfaces were similar, but they differed in that

11808-399: The analysis of drugs, pesticides, steroids, alkaloids, and polycyclic aromatic hydrocarbons . This interface is no longer used because of its mechanical complexity and the difficulties associated with belt renewal (or cleaning) as well as its inability to handle very labile biomolecules. The direct liquid-introduction (DLI) interface was developed in 1980. This interface was intended to solve

11952-521: The atmospheric pressure interfaces such as electrospray and APCI which provide a broader range of compound coverage and applications. The thermospray (TSP) interface was developed in 1980 by Marvin Vestal and co-workers at the University of Houston. It was commercialized by Vestec and several of the major mass spectrometer manufacturers. The interface resulted from a long-term research project intended to find

12096-405: The capillary inlet interface, the evaporation of the mobile phase inside the capillary was one of the main issues. Within the first years of development of LC–MS, on-line and off-line alternatives were proposed as coupling alternatives. In general, off-line coupling involved fraction collection, evaporation of solvent, and transfer of analytes to the MS using probes. Off-line analyte treatment process

12240-480: The cells can usually be between only 2 and 4 nm. Diseases of the endocrine system are common, including conditions such as diabetes mellitus , thyroid disease, and obesity . Endocrine disease is characterized by misregulated hormone release (a productive pituitary adenoma ), inappropriate response to signaling ( hypothyroidism ), lack of a gland ( diabetes mellitus type 1 , diminished erythropoiesis in chronic kidney failure ), or structural enlargement in

12384-488: The collection of the medioventral region of the urogenital ridge . At the five-week point, the developing gonads break away from the adrenal primordium. Gonadal differentiation begins 42 days following conception. For males, the testes form at six fetal weeks and the sertoli cells begin developing by the eight week of gestation. SRY , the sex-determining locus, serves to differentiate the Sertoli cells . The Sertoli cells are

12528-420: The condition may be at increased risk for endometrial hyperplasia and carcinoma as well as menstrual dysfunction and infertility. The severity of PCOS symptoms appears to be largely determined by factors such as obesity. PCOS has some aspects of a metabolic disorder , since its symptoms are partly reversible. Even though considered as a gynecological problem, PCOS consists of 28 clinical symptoms. Even though

12672-415: The disease are non-obese or "lean" women. However, obese women that have PCOS have a higher risk of adverse outcomes, such as hypertension , insulin resistance , metabolic syndrome , and endometrial hyperplasia . Even though most women with PCOS are overweight or obese, it is important to acknowledge that non-overweight women can also be diagnosed with PCOS. Up to 30% of women diagnosed with PCOS maintain

12816-526: The disturbed ovarian function. The follicles may be oriented along the ovarian periphery, appearing as a 'string of pearls' on ultrasound examination. PCOS may be associated with chronic inflammation , with several investigators correlating inflammatory mediators with anovulation and other PCOS symptoms. Similarly, there seems to be a relation between PCOS and an increased level of oxidative stress . Not every person with PCOS has polycystic ovaries (PCO), nor does everyone with ovarian cysts have PCOS; although

12960-455: The dorsal gradient of pituitary morphogenesis is dependent on neuroectodermal signals from the infundibular bone morphogenetic protein 4 (BMP4). This protein is responsible for the development of the initial invagination of the Rathke's pouch. Other essential proteins necessary for pituitary cell proliferation are Fibroblast growth factor 8 (FGF8), Wnt4, and Wnt5. Ventral developmental patterning and

13104-422: The endocrine system. The fetal endocrine system is one of the first systems to develop during prenatal development . The fetal adrenal cortex can be identified within four weeks of gestation . The adrenal cortex originates from the thickening of the intermediate mesoderm . At five to six weeks of gestation, the mesonephros differentiates into a tissue known as the genital ridge. The genital ridge produces

13248-612: The endocrine system. The term hormone is sometimes extended to include chemicals produced by cells that affect the same cell ( autocrine or intracrine signalling ) or nearby cells ( paracrine signalling ). Hormones are used to communicate between organs and tissues for physiological regulation and behavioral activities, such as digestion, metabolism , respiration , tissue function, sensory perception , sleep , excretion , lactation , stress , growth and development , movement , reproduction , and mood . Hormones affect distant cells by binding to specific receptor proteins in

13392-453: The entrance through which ions are directed by the electric field. In some sources, rapid droplet evaporation and thus maximum ion emission is achieved by mixing an additional stream of hot gas with the spray plume in front of the vacuum entrance. In other sources, the droplets are drawn through a heated capillary tube as they enter the vacuum, promoting droplet evaporation and ion emission. These methods of increasing droplet evaporation now allow

13536-481: The expression of transcription factors is influenced by the gradients of BMP2 and sonic hedgehog protein (SHH). These factors are essential for coordinating early patterns of cell proliferation. Six weeks into gestation, the corticotroph cells can be identified. By seven weeks of gestation, the anterior pituitary is capable of secreting ACTH. Within eight weeks of gestation, somatotroph cells begin to develop with cytoplasmic expression of human growth hormone. Once

13680-436: The external and internal surfaces of irregularly or spherically shaped 5 μm diameter porous silica particles. In HPLC, typically 20 μl of the sample of interest are injected into the mobile phase stream delivered by a high pressure pump. The mobile phase containing the analytes permeates through the stationary phase bed in a definite direction. The components of the mixture are separated depending on their chemical affinity with

13824-457: The familial clustering of cases, greater concordance in monozygotic compared with dizygotic twins and heritability of endocrine and metabolic features of PCOS. There is some evidence that exposure to higher than typical levels of androgens and the anti-Müllerian hormone (AMH) in utero increases the risk of developing PCOS in later life. It may be caused by a combination of genetic and environmental factors. Risk factors include obesity ,

13968-405: The fetal pancreatic alpha and beta islet cells have fully developed and are capable of hormone synthesis during the remaining fetal maturation, the islet cells are relatively immature in their capacity to produce glucagon and insulin. This is thought to be a result of the relatively stable levels of fetal serum glucose concentrations achieved via maternal transfer of glucose through the placenta. On

14112-498: The first used a porous frit probe as connecting channel, while CF-FAB used a probe tip. From these, the CF-FAB was more successful as a LC–MS interface and was useful to analyze non-volatile and thermally labile compounds. In these interfaces, the LC effluent passed through the frit or CF-FAB channels to form a uniform liquid film at the tip. There, the liquid was bombarded with ion beams or high energy atoms (fast atoms). For stable operation,

14256-410: The first-line of treatment to reduce acne and hirsutism, and regulate menstrual cycle. This is especially the case in adolescents. Metformin , GLP-1 , and anti-androgens may also help. Other typical acne treatments and hair removal techniques may be used. Efforts to improve fertility include weight loss, metformin , and ovulation induction using clomiphene or letrozole . In vitro fertilization

14400-545: The following: Women with PCOS tend to have central obesity, but studies are conflicting as to whether visceral and subcutaneous abdominal fat is increased, unchanged, or decreased in women with PCOS relative to non-PCOS women with the same body mass index . In any case, androgens, such as testosterone , androstanolone (dihydrotestosterone), and nandrolone decanoate have been found to increase visceral fat deposition in both female animals and women. Although 80% of PCOS presents in women with obesity, 20% of women diagnosed with

14544-418: The high vacuum region, the ions are subject to mass analysis. This interface can be operated in positive and negative charge modes and singly-charged ions are mainly produced. APCI ion source can also handle flow rates between 500 and 2000 μl/min and it can be directly connected to conventional 4.6 mm ID columns. The APPI interface for LC–MS was developed simultaneously by Bruins and Syage in 2000. APPI

14688-590: The hormones necessary for regular ovulation. PCOS might also increase the risk of miscarriage or premature delivery. However, it is possible to have a normal pregnancy. Including medical care and a healthy lifestyle to follow. For women that do, anovulation or infrequent ovulation is a common cause and PCOS is the main cause of anovulatory infertility. Other factors include changed levels of gonadotropins , hyperandrogenemia , and hyperinsulinemia . Like women without PCOS, women with PCOS that are ovulating may be infertile due to other causes, such as tubal blockages due to

14832-725: The increased rate of fetal development during the final trimester. Poorly managed maternal diabetes mellitus is linked to fetal macrosomia , increased risk of miscarriage, and defects in fetal development. Maternal hyperglycemia is also linked to increased insulin levels and beta cell hyperplasia in the post-term infant. Children of diabetic mothers are at an increased risk for conditions such as: polycythemia , renal vein thrombosis , hypocalcemia , respiratory distress syndrome , jaundice , cardiomyopathy , congenital heart disease , and improper organ development. The reproductive system begins development at four to five weeks of gestation with germ cell migration. The bipotential gonad results from

14976-466: The ionizing efficiency and vacuum conditions of the MS system. Nowadays, most extensively applied LC–MS interfaces are based on atmospheric pressure ionization (API) strategies like electrospray ionization (ESI), atmospheric-pressure chemical ionization (APCI), and atmospheric pressure photoionization (APPI). These interfaces became available in the 1990s after a two decade long research and development process. The coupling of chromatography with MS

15120-657: The length of chromatography columns can be shorter (30–50 mm) with 3–5 μm diameter packing particles. In addition to the conventional model, other LC columns are the narrow bore, microbore, microcapillary, and nano-LC models. These columns have smaller internal diameters, allow for a more efficient separation, and handle liquid flows under 1 ml/min (the conventional flow-rate). In order to improve separation efficiency and peak resolution, ultra performance liquid chromatography (UHPLC) can be used instead of HPLC. This LC variant uses columns packed with smaller silica particles (~1.7 μm diameter) and requires higher operating pressures in

15264-405: The liquid chromatography and mass spectrometry devices, an LC–MS system contains an interface that efficiently transfers the separated components from the LC column into the MS ion source. The interface is necessary because the LC and MS devices are fundamentally incompatible. While the mobile phase in a LC system is a pressurized liquid, the MS analyzers commonly operate under high vacuum. Thus, it

15408-454: The lower poles of the thyroid lobes. The fourth pharyngeal pouch later encounters the developing thyroid gland and migrates to the upper poles of the thyroid lobes. At 14 weeks of gestation, the parathyroid glands begin to enlarge from 0.1 mm in diameter to approximately 1 – 2 mm at birth. The developing parathyroid glands are physiologically functional beginning in the second trimester. Studies in mice have shown that interfering with

15552-740: The management of underlying metabolic syndrome remains unclear. It can be difficult to become pregnant with PCOS because it causes irregular ovulation . Medications to induce fertility when trying to conceive include the ovulation inducer clomiphene or pulsatile leuprorelin . Evidence from randomised controlled trials suggests that in terms of live birth, metformin may be better than placebo, and metform plus clomiphene may be better than clomiphene alone, but that in both cases women may be more likely to experience gastrointestinal side effects with metformin. Not all people with PCOS have difficulty becoming pregnant. But some individuals with PCOS may have difficulty getting pregnant since their body does not produce

15696-412: The mid-stage of gestation, the glucagon concentration is 6 μg/g, compared to 2 μg/g in adult humans. Just like insulin, fetal glucagon plasma levels do not change in response to an infusion of glucose. However, a study of an infusion of alanine into pregnant women was shown to increase the cord blood and maternal glucagon concentrations, demonstrating a fetal response to amino acid exposure. As such, while

15840-436: The mobile and stationary phases. The separation occurs after repeated sorption and desorption steps occurring when the liquid interacts with the stationary bed. The liquid solvent (mobile phase) is delivered under high pressure (up to 400 bar or 5800 psi) into a packed column containing the stationary phase. The high pressure is necessary to achieve a constant flow rate for reproducible chromatography experiments. Depending on

15984-426: The most commonly used techniques in global metabolite profiling of biological tissue (e.g., blood plasma, serum, urine). LC–MS is also used for the analysis of natural products and the profiling of secondary metabolites in plants. In this regard, MS-based systems are useful to acquire more detailed information about the wide spectrum of compounds from a complex biological samples. LC–nuclear magnetic resonance ( NMR )

16128-408: The most widely used chemical analysis techniques because more than 85% of natural chemical compounds are polar and thermally labile and GC-MS cannot process these samples. As an example, HPLC–MS is regarded as the leading analytical technique for proteomics and pharmaceutical laboratories. Other important applications of LC–MS include the analysis of food, pesticides , and plant phenols . LC–MS

16272-435: The most widely used variant is the reverse-phase (RP) mode of the partition chromatography technique, which makes use of a nonpolar (hydrophobic) stationary phase and a polar mobile phase. In common applications, the mobile phase is a mixture of water and other polar solvents (e.g., methanol, isopropanol, and acetonitrile), and the stationary matrix is prepared by attaching long-chain alkyl groups (e.g., n-octadecyl or C 18 ) to

16416-415: The name suggests that the ovaries are central to disease pathology, cysts are a symptom instead of the cause of the disease. Some symptoms of PCOS will persist even if both ovaries are removed; the disease can appear even if cysts are absent. Since its first description by Stein and Leventhal in 1935, the criteria of diagnosis, symptoms, and causative factors are subject to debate. Gynecologists often see it as

16560-433: The neutral sample molecules into gas-phase ions that are sent to the mass analyzer. While the mass analyzer applies the electric and magnetic fields to sort the ions by their masses, the detector measures and amplifies the ion current to calculate the abundances of each mass-resolved ion. In order to generate a mass spectrum that a human eye can easily recognize, the data system records, processes, stores, and displays data in

16704-464: The other hand, the stable fetal serum glucose levels could be attributed to the absence of pancreatic signaling initiated by incretins during feeding. In addition, the fetal pancreatic islets cells are unable to sufficiently produce cAMP and rapidly degrade cAMP by phosphodiesterase necessary to secrete glucagon and insulin. During fetal development, the storage of glycogen is controlled by fetal glucocorticoids and placental lactogen . Fetal insulin

16848-425: The pancreas starts producing insulin , glucagon , somatostatin , and pancreatic polypeptide . During the early stages of fetal development, the number of pancreatic alpha cells outnumbers the number of pancreatic beta cells . The alpha cells reach their peak in the middle stage of gestation. From the middle stage until term, the beta cells continue to increase in number until they reach an approximate 1:1 ratio with

16992-485: The paradox of having both excess androgens (which are responsible for hirsutism and virilization ) and excess estrogens (which inhibit FSH via negative feedback ). The syndrome acquired its most widely used name due to the common sign on ultrasound examination of multiple (poly) ovarian cysts . These "cysts" are in fact immature ovarian follicles . The follicles have developed from primordial follicles, but this development has stopped ("arrested") at an early stage, due to

17136-431: The partitioning between the mobile and stationary phases, the components of the sample will flow out of the column at different times. The column is the most important component of the LC system and is designed to withstand the high pressure of the liquid. Conventional LC columns are 100–300 mm long with outer diameter of 6.4 mm (1/4 inch) and internal diameter of 3.0 – 4.6 mm. For applications involving LC–MS,

17280-510: The pituitary gland.) Other organs, such as the kidneys , also have roles within the endocrine system by secreting certain hormones. The study of the endocrine system and its disorders is known as endocrinology . The thyroid secretes thyroxine , the pituitary secretes growth hormone , the pineal secretes melatonin , the testis secretes testosterone , and the ovaries secrete estrogen and progesterone . Glands that signal each other in sequence are often referred to as an axis, such as

17424-555: The point of origin for anti-Müllerian hormone . Once synthesized, the anti-Müllerian hormone initiates the ipsilateral regression of the Müllerian tract and inhibits the development of female internal features. At 10 weeks of gestation, the Leydig cells begin to produce androgen hormones. The androgen hormone dihydrotestosterone is responsible for the development of the male external genitalia. The testicles descend during prenatal development in

17568-939: The prevalence of PCOS could be as high as 26% among some populations, though ranges between 4% and 18% are reported for general populations. According to the World Health Organization (WHO), PCOS affects over 8-13% of reproductive-aged women. The exact cause of PCOS remains uncertain, and treatment involves management of symptoms using medication. Two definitions are commonly used: Signs and symptoms of PCOS include irregular or no menstrual periods , heavy periods , excess body and facial hair , acne , pelvic pain, difficulty getting pregnant , and patches of thick, darker, velvety skin , ovarian cysts, enlarged ovaries, excess androgen, and weight gain. Associated conditions include type 2 diabetes , obesity , obstructive sleep apnea , heart disease , mood disorders , and endometrial cancer . Common signs and symptoms of PCOS include

17712-452: The problem of evaporation of liquid inside the capillary inlet interface. In DLI, a small portion of the LC flow was forced through a small aperture or diaphragm (typically 10 μm in diameter) to form a liquid jet composed of small droplets that were subsequently dried in a desolvation chamber. The analytes were ionized using a solvent-assisted chemical ionization source, where the LC solvents acted as reagent gases. To use this interface, it

17856-438: The range of 310000 to 775000 torr (6000 to 15000 psi, 400 to 1034 bar). Mass spectrometry (MS) is an analytical technique that measures the mass-to-charge ratio ( m/z) of charged particles (ions). Although there are many different kinds of mass spectrometers, all of them make use of electric or magnetic fields to manipulate the motion of ions produced from an analyte of interest and determine their m/z. The basic components of

18000-429: The required steps of oncogenesis . Other common diseases that result from endocrine dysfunction include Addison's disease , Cushing's disease and Graves' disease . Cushing's disease and Addison's disease are pathologies involving the dysfunction of the adrenal gland. Dysfunction in the adrenal gland could be due to primary or secondary factors and can result in hypercortisolism or hypocortisolism . Cushing's disease

18144-542: The same tissue or organ. An example of this is somatostatin which is released by some pancreatic cells and targets other pancreatic cells. Juxtacrine signaling is a type of intercellular communication that is transmitted via oligosaccharide, lipid, or protein components of a cell membrane, and may affect either the emitting cell or the immediately adjacent cells. It occurs between adjacent cells that possess broad patches of closely opposed plasma membrane linked by transmembrane channels known as connexons . The gap between

18288-715: The solvent vapours under reduced pressure in two vacuum chambers. After the liquid phase was removed, the belt passed over a heater which flash desorbed the analytes into the MS ion source. One of the significant advantages of the MBI was its compatibility with a wide range of chromatographic conditions. MBI was successfully used for LC–MS applications between 1978 and 1990 because it allowed coupling of LC to MS devices using EI, CI, and fast-atom bombardment (FAB) ion sources. The most common MS systems connected by MBI interfaces to LC columns were magnetic sector and quadrupole instruments. MBI interfaces for LC–MS allowed MS to be widely applied in

18432-559: The source of ions (thereby acting as a CI source for vapourized analyte), it was soon discovered that ions were also observed when the filament or discharge was off. This could be attributed to either direct emission of ions from the liquid droplets as they evaporated in a process related to electrospray ionization or ion evaporation, or to chemical ionization of vapourized analyte molecules from buffer ions (such as ammonium acetate). The fact that multiply-charged ions were observed from some larger analytes suggests that direct analyte ion emission

18576-450: The source. Drying the droplets outside of the source volume, and using a jet separator to pump away the solvent vapour, allowed the particles to enter and be vapourized in a low-pressure EI source. As with the MBI, the ability to generate library-searchable EI spectra was a distinct advantage for many applications. Commercialized by Hewlett Packard , and later by VG and Extrel, it enjoyed moderate success, but has been largely supplanted by

18720-403: The steroidogenic cells for both the gonads and the adrenal cortex. The adrenal medulla is derived from ectodermal cells . Cells that will become adrenal tissue move retroperitoneally to the upper portion of the mesonephros. At seven weeks of gestation, the adrenal cells are joined by sympathetic cells that originate from the neural crest to form the adrenal medulla . At the end of the eighth week,

18864-428: The symptoms of hirsutism caused by high testosterone and regulates return to normal menstrual periods . Anti-androgens such as finasteride , flutamide , spironolactone , and bicalutamide do not show advantages over oral contraceptives, but could be an option for people who do not tolerate them. Finasteride is the only oral medication for the treatment of androgenic alopecia , that is FDA approved. Metformin

19008-439: The target cell resulting in a change in cell function. This may lead to cell type-specific responses that include rapid changes to the activity of existing proteins, or slower changes in the expression of target genes. Amino acid–based hormones ( amines and peptide or protein hormones ) are water-soluble and act on the surface of target cells via signal transduction pathways; steroid hormones , being lipid-soluble, move through

19152-571: The third ventricle and fuses with the diverticulum. This eliminates the lumen and the structure becomes Rathke's cleft. The posterior pituitary lobe is formed from the diverticulum. Portions of the pituitary tissue may remain in the nasopharyngeal midline. In rare cases this results in functioning ectopic hormone-secreting tumors in the nasopharynx. The functional development of the anterior pituitary involves spatiotemporal regulation of transcription factors expressed in pituitary stem cells and dynamic gradients of local soluble factors. The coordination of

19296-493: The transition from a high pressure environment (HPLC) to high vacuum conditions needed at the MS analyzer. Although these interfaces are described individually, they can also be commercially available as dual ESI/APCI, ESI/APPI, or APCI/APPI ion sources. Various deposition and drying techniques were used in the past (e.g., moving belts) but the most common of these was the off-line MALDI deposition. A new approach still under development called direct-EI LC–MS interface , couples

19440-681: The underlying cause. As PCOS appears to cause significant emotional distress, appropriate support may be useful. Where PCOS is associated with being overweight or obesity, successful weight loss is the most effective method of restoring normal ovulation/menstruation. The American Association of Clinical Endocrinologists guidelines recommend a goal of achieving 10–15% weight loss or more, which improves insulin resistance and all hormonal disorders . Still, many women find it very difficult to achieve and sustain significant weight loss. Insulin resistance itself can cause increased food cravings and lower energy levels, which can make it difficult to lose weight on

19584-425: The urogenital folds develop into the labia minora, and the urogenital swellings develop into the labia majora. At 16 weeks of gestation, the ovaries produce FSH and LH/hCG receptors . At 20 weeks of gestation, the theca cell precursors are present and oogonia mitosis is occurring. At 25 weeks of gestation, the ovary is morphologically defined and folliculogenesis can begin. Studies of gene expression show that

19728-514: The use of liquid flow rates of 1 - 2 mL/min to be used while still achieving efficient ionisation and high sensitivity. Thus while the use of 1 – 3 mm microbore columns and lower flow rates of 50 - 200 μl/min was commonly considered necessary for optimum operation, this limitation is no longer as important, and the higher column capacity of larger bore columns can now be advantageously employed with ESI LC–MS systems. Positively and negatively charged ions can be created by switching polarities, and it

19872-411: The way to the modern atmospheric-pressure ionization interfaces, and are described for historical interest. The moving-belt interface (MBI) was developed by McFadden et al. in 1977 and commercialized by Finnigan. This interface consisted of an endless moving belt onto which the LC column effluent was deposited in a band. On the belt, the solvent was evaporated by gently heating and efficiently exhausting

20016-495: Was introduced at the beginning of the 1990s after Henion and collaborators improved the LC–APCI–MS interface in 1986. The APCI ion source/ interface can be used to analyze small, neutral, relatively non-polar, and thermally stable molecules (e.g., steroids, lipids, and fat soluble vitamins). These compounds are not well ionized using ESI. In addition, APCI can also handle mobile phase streams containing buffering agents. The liquid from

20160-453: Was investigated by McLafferty and collaborators in 1973 who coupled the LC column to a CI source, which allowed a higher liquid flow into the source. This was the first and most obvious way of coupling LC with MS, and was known as the capillary inlet interface. This pioneer interface for LC–MS had the same analysis capabilities of GC-MS and was limited to rather volatile analytes and non-polar compounds with low molecular mass (below 400 Da). In

20304-419: Was necessary to split the flow coming out of the LC column because only a small portion of the effluent (10 to 50 μl/min out of 1 ml/min) could be introduced into the source without raising the vacuum pressure of the MS system too high. Alternately, Henion at Cornell University had success with using micro-bore LC methods so that the entire (low) flow of the LC could be used. One of the main operational problems of

20448-465: Was occurring under at least some conditions. The interface was able to handle up to 2 ml/min of eluate from the LC column and would efficiently introduce it into the MS vacuum system. TSP was also more suitable for LC–MS applications involving reversed phase liquid chromatography (RT-LC). With time, the mechanical complexity of TSP was simplified, and this interface became popular as the first ideal LC–MS interface for pharmaceutical applications comprising

20592-418: Was the particle beam interface (PBI), developed by Willoughby and Browner in 1984. Particle beam interfaces took over the wide applications of MBI for LC–MS in 1988. The PBI operated by using a helium gas nebulizer to spray the eluant into the vacuum, drying the droplets and pumping away the solvent vapour (using a jet separator) while the stream of monodisperse dried particles containing the analyte entered

20736-450: Was time-consuming and there was an inherent risk of sample contamination. Rapidly, it was realized that the analysis of complex mixtures would require the development of a fully automated on-line coupling solution in LC–MS. The key to the success and widespread adoption of LC–MS as a routine analytical tool lies in the interface and ion source between the liquid-based LC and the vacuum-base MS. The following interfaces were stepping-stones on

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