ACTA ENDOCRINOLOGICA (BUC)

OBJECTIVES: This study was carried out on 1290 patients, whose choroids plexus and pineal gland were examined on computed tomography. Aim: To check the correspondence between the choroid plexuses and the pineal gland calcifications along age groups and sex; and the connections between these calcifications and associated pathology.\r\nMATERIALS AND METHODS: The study group consisted of patients of both sexes, within six age intervals.\r\nRESULTS: In order to classify the calcification variants, eight types of combinations were ordered and can be seen in CT: two refer to extreme variants: totally uncalcified (type 1) and totally calcified (type 8); bilateral, symmetrical variants (types 4 and 5); the other four types include the asymmetrical calcifications (2, 3, 6 and 7). After the anthropological study the results demonstrate that there are significant differences between calcification of the choroids plexus and those of the pineal gland with the two sexes, on age groups and pathological ground. For type 1-totally uncalcified the maximum frequency is around 70% with ages under 19. For type 8 - totally calcified, bilateral, the maximum frequency is around 50% with age groups 48-59 and 60-71. For type 4 - calcification only of choroid plexus, one finds a continuous increase from about 10% at the first age group to about 25% at the last group, while for type 5- calcification only of the pineal gland the frequency is 10%−20%. We started from the hypothesis that the presence of these calcifications is physiological, and has an active adaptative metabolic part depending on many factors, among which the individual constitutional ground is also present.\r\nCONCLUSIONS: The age is not the main cause of the calcification types, but a process of adaptative-reactive variability of interface type, playing an integrating mediating part.

The blood-CSF barrier (BCB), as a component of the blood-brain barrier, is protective for the maternal brain. This study assesses estradiol, prolactin, glycoproteic hormones (hCG, FSH, LH, TSH) and thyroxine across the BCB in pregnancy after 38 weeks. Method. 35 pregnant women were simultaneously sampled in serum and CSF during caesarian section and compared to 27 non-pregnant fertile women undergoing surgery for benign gynecological disorders. The study was approved by the local Ethics Committee. Results were analysed as nonparametric variables. Compared to non-pregnant controls, we found high serum estradiol levels at term, also reflected in the CSF, while the CSF/serum ratio was non-significantly modified (median ratio 0.1 versus 0.1, p=NS). Prolactin showed a similar proportional increase in serum and CSF levels at term, with unmodified CSF/serum ratio (median ratio 0.14 versus 0.18, p=NS). hCG showed a similar profile across the BCB. FSH was significantly lower at term, but still conserved the CSF/ serum ratio. LH was undetectable in pregnancy. In peripartum TSH showed a unique profile across the BCB as it was the only one showing an increased CSF/serum ratio compared to non-pregnant controls (median ratio 0.11 versus 0.04, p<0.0001). Thyroxine was significantly increased in both serum and CSF, and showed a CSF/serum ratio unmodified from non-pregnant women (median ratio 0.02 versus 0.02, p=NS). Conclusion. There is an increase of BCB permeablity for TSH in term pregnancy. The peripartum increase in estradiol and decrease in HCG could be involved. We suggest that the unique TSH profile maintains the necessary thyroxine levels in pregnancy at term.

effects of Ultrasonic Coagulation (UC), Bipolar Energy Sealing System (BESS), Intra Operative Nerve Monitoring (IONM) and surgical experience on the complications of thyroid surgery. Method. The data of 1627 patients who underwent thyroid surgery for various indications in our department between 2009 and 2018 were analyzed retrospectively and the effects of different technological devices on complications were investigated. Results. Transient recurrent laryngeal nerve (RLN) palsy was higher between 2009 and 2013, when IONM was not in routine use (p=0.029). There were no significant differences between two energy devices (UC and BESS) in terms of transient or permanent RLN palsy, bleeding, and transient or permanent hypocalcemia. Multivariate analysis showed that young age (0.006), female gender (0.016), surgery type (p<0.001), and lateral neck dissection (p=0.026) are independent risk factors for transient hypocalcemia. Conclusion. The results indicate that there is no superior hemostatic device. IONM and specific branching decrease transient RLN palsy. Female gender, young age, completion thyroidectomy, and lateral neck dissection were independent risk factors for the development of transient hypocalcemia.

Introduction. Even if the last decade brings new information about the existence of the local pulmonary renin-angiotensin system (RAS), published results about its involvement in the progression of various pulmonary diseases remain contradictory. Methods. Using an experimental model of pulmonary allergic disease induced by ovalbumin (OVA) sensitization we studied effects of intratracheal (i.t.) administrated AT1 receptor blocker losartan (LOS) on inflammatory processes supposed to be mediated by pulmonary RAS. Alterations in bronchoalveolar lavage fluid (BALF) cellularity and variations of airway reactivity from OVA sensitized and challenged rats after LOS or vehicle i.t. instillation were comparatively assessed. Results. Blocking of RAS decreased the total BALF cellularity and polymorphonuclear cell count. LOS instillation also reduced the increases in specific airway resistance (sRaw) induced by inhalation of allergen (with 20%) or acetylcholine (with at least 15%). Conclusions. Our data suggest that expressly blocking of local RAS by i.t. administration of LOS have inhibitory effects on allergen - induced lung inflammation and sustain the participation of pulmonary RAS, activated by local or systemic factors, in lung diseases.

In this study we aimed to evaluate and quantify optic nerve damage caused by long standing compressive pituitary macroadenomas with conventional (ophthalmoscopy) and modern techniques such as fundus camera, confocal scanning laser tomography for quantitative measurements of the thickness of retinal layers as well as visual evoked potentials (VEP) for electrophysiological quantification. Seven patients with large, long standing pituitary macroadenomas were submitted to ophthalmologic evaluation, including a visual field (VF), visual acuity (VA) and eye fundus (F). Heidelberg retinal tomography (HRT) was used for retinal thickness and evaluation of nerve fibers loss, and VEP were measured by pattern reversal and flash stimulus. In addition, all patients underwent tumor imaging (MRI/CT) and specific endocrine evaluation. All cases presented with macroadenomas with suprasellar extension and residual or progressive optic chiasma syndrome; all but one (prolactinoma) were nonfunctioning adenomas, after radical treatment (surgery ? radiotherapy). Adrenal and thyroid substitutive treatment was instituted in all cases due to associated pituitary failure. Evaluation of VF showed 9 eyes with temporal hemianopia, 2 with nasal islands of vision and 1 with nasal hemianopia in a homonymous hemianopia case; another case presented for left 3rd nerve palsy due to a cavernous sinus syndrome, therefore the visual field was not measurable in 2 eyes. Visual acuity was very low (counting fingers) in 4 eyes, while in the rest the VA was between 0.5-0.9. The fundus revealed total atrophy in 2 eyes, band atrophy in 4, temporal pallor in 5 and global pallor in 1. Cup/disk ratio in the case with 3rd nerve palsy was 0.5 (RE) and 0.3 (LE). HRT II stereometric analysis of the optic nerve head showed abnormal values, documenting retinal nerve fiber layer (RNFL) loss that correlated with fundus appearance and visual field defects. Mean RNFL thickness had abnormal values in 8 eyes (from 0.074 to 0.173 &#956;m), correlated with RNFL cross sectional area in 7 eyes (from 0.362 to 0.846 &#956;m2) and 1 eye with low limit values (1000 &#956;m2). In agreement with these data, VEP&#8211;P100 presented increased latency over 120 ms in 8 eyes, borderline (100-120 ms) in 5 and 97.5 ms in only 1 eye. In conclusion, HRT can document the papilla and nerve fiber layer more objective, permitting quantification of the disc&#8217;s alterations due to compressive pituitary macroadenomas. HRT is useful in quantifying RNFL loss in other conditions than glaucoma, when other optic disc imaging tools are not available.

Objective. Data about iodine status in pregnant women in Turkey is not sufficient. We aimed to determine the iodine status, goiter prevalence, iodized salt consumption among first trimester pregnant women living in Edirne. Design and Setting. Cross-sectional study was performed on pregnant women living in Edirne. Subjects and Methods. A total of 275 pregnant women in their first trimester were examined regarding iodized salt use, median urinary iodine concentration (UIC), presence or absence of goitre and thyroid function. Goitre status was determined by palpation. Participants filled out a questionnaire, which included questions regarding sociodemographic features, iodized salt consumption, knowledge, and behavior regarding iodine deficiency. UIC was measured using colorimetric method based on Sandell–Kolthoff reaction. Thyroid hormones and TSH were measured by chemiluminescence immunoassays. Results. While the proportion of iodized salt use was 96.6%, UIC was below 150 μg/L in 88.4 % of the women. The median UIC was 77 μg/L, indicating insufficient iodine intake. Total goitre rate was 19.3%. Conclusions. Our study shows that iodine deficiency is a serious problem among pregnant women in Edirne. We suggest that pregnant women living in Edirne should be supplemented by iodine-containing preparations in addition to iodized salt.

Context. Oxytocin has been investigated as a potential medication for psychiatric disorders. Objective and design. This study prospectively investigates correlations between oxytocin and other neuropeptides plasma levels in patients with autism spectrum disorders (ASD) according to severity and treatment, as compared to controls. Subjects and methods. Thirty-one children (6 neurotypical as control) participated in this study. The patients were classified into mildly and severely-affected, according to Autism Diagnostic Observation Schedule (ADOS) scores. Oxytocin, orexin A and B, α-MSH, β-endorphins, neurotensin and substance P were investigated using a quantitative multiplex assay or a competitive-ELISA method. Results. Plasma oxytocin levels differed between the groups (F (2, 24) =6.48, p=0.006, η2=0.35, observed power=86%): patients with the mild ASD had higher values of plasma oxytocin than those with the severe form (average difference=74.56±20.74pg/mL, p=0.004). Conclusions. These results show a negative correlation between plasma levels of oxytocin and the severity of ASD and support the involvement of oxytocinergic mechanisms in ASD.

Context. Chronic stress is characterized by increased release of catecholamines, glucocorticoids and other neurohumoral factors, predisposing individuals to obesity, insulin resistance and vascular disease, pathologies considered priority health problems. Study of alterations induced by stress on metabolism in association with food intake modulatory hormones (insulin, leptin and ghrelin) is mandatory. Objective. This research studied temporal course during 60 days of chronic unpredictable mild stress (CUMS) on glucose and lipids metabolism, and on the neuroendocrine system that regulates appetite-satiety balance. Materials and Methods. Wistar rats were exposed to CUMS for 20, 40 and 60 days. Corticosterone stayed high during 60 days of CUMS; after 40 days, body weight, cholesterol and triglycerides decreased and glucose intolerance was evident at day 60; insulin and ghrelin increased at 20 and 40 days, respectively; leptin decreased after day 20. Data suggest that 60 days of CUMS progressively disturb metabolism of carbohydrates and lipids as well as food intake regulatory hormones, affecting the metabolism, and can lead to the development of chronic degenerative diseases, such as cardiovascular disease, metabolic syndrome and type 2 diabetes.

Objective. The aim of the study was to investigate the role of Hepatocyte Growth Factor (HGF)/c-Met pathway in testicular damage provoked by streptozotocin (STZ)- induced diabetes and the effects of insulin treatment on the HGF/c-Met pathway. Methods. Total 21 paraffin-embedded testicular tissues of control (n=7), streptozotocin (STZ)-induced diabetic (n=7) and insulin-treated diabetic (n=7) Wistar albino rats were used in this study. Testicular damage was examined histologically and by Johnsen’s score was also evaluated. Immunohistochemical stainings of HGF and c-Met were analysed by using antibodies against HGF and c-Met. Results. We found the degeneration in seminiferous tubule epithelium and disorganization of spermatogenetic cell series in testis tissues of diabetic rats. We also determined decrease both in seminiferous tubule diameter and Johnsen’s scores in diabetic group. The expressions of HGF and c-Met in seminiferous tubule epithelium and in spermatogenic cells (especially spermatocytes and spermatids) were significantly increased in diabetic rats compared to those of control. Insulin treatment significantly reduced the diabetes-induced morphological changes and HGF/c-Met over expressions in the diabetic rat testis. Conclusion. HGF/c-Met pathway might have a role in diabetes- induced testicular damage. Drugs acting on this pathway might be effective to prevent or delay the testicular damage induced by diabetes.

Context. Diverse physiological or pathological events which are stimulated or contributed by HGF/c-Met pathway overlap by processes that play roles in etiopathogenesis of diabetes. Objective. In this study, it was aimed to analyse hepatocyte growth factor (HGF) and its receptor c-Met by immunohistochemistry in the heart and aorta tissues of diabetic and insulin-treated diabetic rats. Subjects and Methods. Accordingly, 21 rats were (equally) divided into three groups: Control (C), Diabetic (D), and Insulin-treated Diabetic (D + I). Rats were treated with Streptozotocin (STZ) (45 mg/kg, i.p.) to induce diabetes. Rats in the control group were given saline once a day for 8 weeks, while rats in the D + I group received 6 U/kg NPH insulin once daily for 8 weeks. The heart and aorta tissues were examined with immunohistochemistry, using antibodies against HGF and c-Met. Results. HGF and c-Met expressions were observed to be increased both in heart and aorta tissues in group D, whereas they decreased in group D+I. Conclusions. As a result, insulin treatment was determined to have a reducing effect on the increased expression of HGF and c-Met in diabetic heart and aorta. According to our results, increased HGF ve c-Met values observed in the myocardium and aorta in diabetes, are shown to increase in parallel to tissue damage and decrease by insulin treatment which is an effective therapy method.