ACTA ENDOCRINOLOGICA (BUC)

Context/Objective. The standard approach is to perform repeat FNAB (rFNAB) in thyroid nodules with nondiagnostic (ND) / insufficient (UNS) cytology. However, due to the nature of these nodules, recurrent FNABs may also be insufficient. Therefore, by comparing the clinicalradiological- pathological parameters of nodules with a definite diagnosis of excision, we questioned the possibility of patient management without rFNAB. Methods. Clinical-radiological parameters of 275 nodules belonging to 264 patients in the ND/UNS aspiration group with definite pathological diagnosis after surgery were determined. Under the guidance of these parameters, those with and without rFNAB were compared. Results. The incidence of malignancy was found to be significantly higher in nodules without rFNAB compared to nodules with rFNAB (p = 0.036). In addition, the incidence of malignancy in BC-1 nodules without rFNAB was significantly higher than in nodules with rFNAB result also BC-1 (p = 0.009). In all cases, nodule size smaller than 10 mm and border irregularity were found to be statistically significant for malignancy (p <0.020, p <0.002). When looking at the distribution of rFNAB results, a significant correlation was observed with female gender, solid component, hypoechogenicity, border irregularity and halo loss around the nodule in patients with BC-4,5,6 cytology results (respectively, 0.005 / 0.031 / 0.001 / 0.012 / 0.004). Conclusion. rFNAB did not show the expected effect in ND / UNS nodules. We recommend direct surgical excision without rFNAB for nodules with border irregularity, solid structure, halo loss and hypoechogenicity, which should be considered more important in female patients.

Context. Studies indicate a decrease in spatial memory across species as they age. Moreover, consistent administration of Gonadotropin-releasing hormone (GnRH) improves learning abilities in older rats that have undergone gonadectomy. Objective. The aim of this study was to investigate the effects of the GnRH agonist, leuprolide acetate (LA) on spatial memory in aged intact male rats and the expression of proteins associated with hippocampal plasticity. Subjects and methods. Aged male rats were injected with LA or saline every three days for nine weeks to assess the effects of LA on spatial memory. The aged rats were trained in the Morris Water Maze for four days, and the evaluation took place on the fifth day. Additionally, the Y-maze test was used to investigate short-term spatial memory. The expression of spinophilin and microtubule-associated protein 2 (MAP2) in the hippocampus was measured. Results. Behavioral tests revealed that LA improves spatial memory in aged rats. Additionally, we observed increased expression of spinophilin and MAP2 in the hippocampus of aged male rats following LA treatment. Based on these results, the administration of LA holds is a potential treatment for restoring cognitive function in aged individuals.

We present the case-report of a 56 years-old woman with hypothyroidism due to autoimmune thyroiditis. The family history was positive for biopsy proven celiac disease (CD) in her daughter. The patient declared gluten-containing diet and was completely asymptomatic regarding gastrointestinal tract. The serological screening for CD reflected an activity of the disease by the presence of antiendomysial antibodies (EMA). Consequently, an upper gastrointestinal endoscopy was performed and biopsy specimens were obtained. The standard histopathological examination was unremarkable for a defined CD. However, the results of immunohistological techniques showed intestinal IgA deposits compatible with early developing CD. In patients with family history of CD, even without any suggestive symptoms, high index of suspicion regarding CD should be kept even more in those associating other autoimmune disease.

Objective: The goal of this research is to investigate whether melatonin, a circadian informant, is implicated in idiopathic oligospermia in men.\r\nSubjects and methods: 12 men (mean age 30.5 yr) with normal sexual function diagnosed with idiopathic oligospermia and 8 healthy men were included. In urine 6-sulfatoxymelatonin (aMT6s), a reliable index of melatonin secretion and gonadotropins, LH and FSH were assayed. In plasma LH, FSH, DHEA-S, 17-OH progesterone, testosterone, free testosterone, SHBG were measured at 08:00.\r\nResults: As expected, in the infertile group reproductive hormones were within normal limits but persisted low testosterone and high gonadotropins. Estimated bioavailable testosterone also showed a significant decrease (p=0.03). Evaluation of individual differences in circadian production of both melatonin and gonadotropins exhibited substantial changes in their secretion pattern from the phase shifts to loss of rhythm for aMT6s. The reduced amplitudes (p=0.04) of aMT6s were associated with a longer duration of melatonin secretion (p< 0.001) as estimated from onset/offset time and a reduced ratio between night- and daytime; the mean 24h amount of aMT6s tended to decrease at significant limit (p=0.05); no significant correlation between aMT6s and gonadotropins was observed compared with the control group. The amplitudes of gonadotropins were lower while their mean 24 h amount showed a moderate increase.\r\nConclusions: The present findings suggest that the significant increase in the duration of melatonin secretion may contribute to the imbalance of reproductive hormones that affect spermatogenesis; aMT6s, urinary metabolite of melatonin may be a sensitive predictor in circadian disorders of reproductive axis.

Introduction. Menopause increases the risk of cardiovascular disease in women. The aims of the present study were to evaluate the effects of swimming training on cardiac histology and expression of miR-29 and IGF-1 in the ovariectomized rats. Materials and methods. Thirty female Wistar rats were divided into sham and ovariectomized groups: sedentary control (OVX) and trained with 8 weeks exercise (OVX.E). On 57th day, blood was collected and used for lipid profile measurement. In addition, heart tissue was analyzed by reverse transcription–polymerase chain reaction for IGF- 1 mRNA and miR-29, and studied for histopathological changes. Results. Ovariectomy significantly decreased miR- 29 and IGF-1 expression in the heart compared to sham animals group (p<0.05). Exercise training increased miR-29 and IGF- 1 expression in the trained rats and improved histology and lipid profile compared with OVX group (p<0.05). Conclusion. Estrogen deficiency could lead to cardiac fibrosis through deregulation miR-29 and IGF-1 expression. The findings of the current study suggests a protective effect of exercise on heart against fibrotic changes in ovariectomized rats and support a potential preventive value of exercise in improving cardiac function after menopause.

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Vertebrate nonapeptide neurohormones constitute an evolutionarily conserved family, involved in vital functions, such as hydro-osmotic balance regulation, reproduction and social behaviour. Two human members of this family are known, vasopressin (AVP) and oxytocin (OXT), with their highly homologous genes closely located on Chr 20p13. Presence of vasotocin (AVT) in man has been suggested, but remains controversial, and genetic evidence is lacking. AVT activity could be explained by the presence of a third distinct gene for AVT or an RNA-processing mechanism involving products of AVP and/or OXT genes. To test the first hypothesis, we developed bioinformatics and experimental approaches using genomic DNA and fetal tissues mRNAs. Family-specific primers for AVT and neurophysin were designed based on CODEHOP strategy and used in our experiments. Results of bioinformatics and genomic DNA experiments (family-specific and Alu step-out PCR) suggest there is no evidence for an AVT gene in the genome. RNA-based techniques 3?-RACE and Family-Specific Domain Restriction Fragment RTPCR provided evidence for new transcript species that could code for AVT. Further experiments will be needed to characterize them. We discuss potential mechanisms of AVT mRNA generation based on AVP and OXT mRNAs, by alternative splicing, heterologous transsplicing or RNA-editing. While all methods we developed proved feasible, current results suggest there is no AVT gene in the genome, but specific mRNAs could be present in fetal tissues. Their full characterization may potentially allow identification of vasotocin mRNA and shed light on a subject of fundamental scientific interest.

The development of cancer in humans involves genetic and epigenetic changes that\r\nlead to cell cycle progression, inhibition of apoptosis, cell immortalisation, angiogenesis and\r\nthe ability to metastasise. One signalling pathway common to these events is the activation\r\nof phosphatidylinositol-3-kinase (PI3K) that affects downstream molecules involved in\r\nmalignant transformation. The article reviews the present data on the PI3K signalling, its\r\nderegulation in endocrine tumours, and new therapeutic strategies targeting this pathway in\r\nhuman neoplasia.

Background. Null cell adenoma (NCA) of the pituitary gland, once considered a distinct subtype of nonfunctioning pituitary tumors, has been substantially redefined with the advent of transcription factor (TF) immunostaining. The updated WHO classifications emphasize cell lineage differentiation, significantly narrowing the true spectrum of NCAs. Objective. To underscore the diagnostic challenges and potential misclassification of NCAs by presenting two illustrative cases and reviewing the evolving diagnostic approach. Methods. We describe two diagnostically complex cases initially classified as NCAs due to negative anterior pituitary hormone and TF immunostaining. Both demonstrated atypical clinical features, such as rapid progression and elevated Ki-67 indices, prompting further pathological reassessment. Results. In the first case, follow-up surgeries and additional immunohistochemistry revealed a posterior pituitary tumor—spindle cell oncocytoma. In the second, reevaluation identified hepatocellular carcinoma (HCC) metastasis to the pituitary. These findings highlight the necessity of considering posterior pituitary tumors and metastases in the differential diagnosis of NCAs, especially when clinical or imaging findings suggest alternative etiologies. Conclusion. NCAs must be regarded as a diagnosis of exclusion. Accurate classification depends on thorough clinicopathological correlation, multidisciplinary collaboration, and the use of expanded immunohistochemical panels. Recognition of rare mimickers is crucial for guiding appropriate treatment and improving outcomes.

Aims. To provide growth references for school-aged children in western Romania, to compare them with other national and\r\ninternational growth charts and evaluate the prevalence of overweight and obesity.\r\nMethods. A total of 3731 children, aged 7-19 years, from Timis county, were examined by medical students, between\r\nFebruary 2010-June 2011. Growth references for height, weight, and body mass index (BMI) were constructed with LMS method and LMSChartMaker software. The Romanian 3rd, 50th and 95th percentile for height and BMI were compared with national and international growth references. The prevalence of overweight and obesity was determined with IOTF definition.\r\nResults. Crude and smoothed percentiles for weight, height and BMI were shown for this population. The comparison\r\nprovided data regarding the variation of growth models in different populations. Our results demonstrated a high prevalence of overweight (18.2%) and obesity (7.2%) in our\r\npopulation, higher in boys versus girls.\r\nConclusions. Our study constructed growth references for a Romanian population. The comparison with other growth references reflected the regional differences in growth\r\npatterns between populations.