Search NEL Online

Journal Article 2008; 29(6): 852-856 PubMed PMID: 19112398 Citation  Keywords:  Contraception:methods, Endometrial Hyperplasia:etiology, Female, Genital Diseases, Female:etiology, Genital Neoplasms, Female:immunology, Humans, Immunosuppression, Immunosuppressive Agents:adverse effects, Menstruation Disturbances:chemically induced, Or.   

: Organ transplantation has become universally accepted treatment of end-stage organ failure. The main problem focuses on preventing the graft from rejection with the use of immunosuppressive agents. High incidence of infection is the most frequent adverse effect of immunosuppressive therapy. Symptoms of inflammation are often reduced in immunosuppressed patients. All invasive diagnostic and therapeutic procedures should be associated with the increase in dose of steroids and prophylactic antibiotics. Ovarian and menstrual function is usually restored in transplanted women. Function of the hypothalamus-pituitary-ovary axis in transplanted women is believed to be normal. Most common abnormal uterine bleeding in graft recipient are: prolonged and profuse menstruation and inter-menstrual bleeding or spotting. Among the underlying diseases are lesions of the uterus (fibroids, endometrial or cervical polyps), infections of sex organs or hormonal disturbances. Higher rate of endometrial hyperplasia (without atypia) is reported in renal graft recipients. Organ transplantation results in the restored fertility thus effective family planning method is necessary in women of reproductive age who do not want to conceive. Vaginal diaphragms are not advised and intrauterine device are contradicted. Observational studies indicate for safety and high rate of acceptance of oral and transdermal hormonal contraception in transplanted women. Over ten-year experiences of HRT administration in graft recipient have proved the benefits of the therapy. Patients after organ transplantation have three to four-fold increased incidence of malignancy compared with general population. All transplant women must undergo regular gynecological screening for premalignant and malignant lesions of sex organs and breast....

Read abstract  Full text PDF

Case Reports 2008; 29(6): 871-873 PubMed PMID: 19112397 Citation  Keywords:  Abscess:complications, Anti-Bacterial Agents:therapeutic use, Cesarean Section, Female, Humans, Pregnancy, Pregnancy Complications, Infectious:drug therapy, Pregnancy Outcome, Treatment Outcome, Uterine Diseases:complications, Uterus:abnormalities, Young .   

: A 20 year old primigravida with a double uterus was admitted with a viable fetus in the right uterus and pus oozing from the left one. Management consisted of a regimen of intravenous antibiotics and intravaginal antibiotic tablets. Tocolysis was used to arrest imminent preterm labor. In the course of pregnancy IUGR was diagnosed. At 38 weeks of pregnancy a SGA baby boy of 2,440 g was delivered by cesarean section. The mother and the baby were discharged from the hospital in good general condition....

Read abstract  Full text PDF

Journal Article 2008; 29(6): 831-836 PubMed PMID: 19112396 Citation  Keywords:  Adolescent, Adolescent Development, Age of Onset, Brain:growth & development, Child, Child Development, Critical Period (Psychology), Humans, Neuronal Plasticity:physiology, Neuropsychology, Schizophrenia:physiopathology, Schizophrenic Psychology,.   

: Schizophrenia is a disorder characterized by delay in neurodevelopment and by a central disorder of recognition (i.e. with generalized cognitive deficit). Connectivity impairments in the areas of the social brain and cerebellum are the "messenger" of abnormal CNS development in schizophrenia. Processes of neuronal reorganization in cortical and subcortical structures, aberrant forms of pruning, sprouting, and myelinization may play a major role in the pathogenesis of a schizophrenic breakdown. Models of neuroplasticity during adolescence can be connected with models of neurodevelopmental vulnerability and models of neurotoxicity to form an integrated approach in order to better understand premorbid adjustment, onset, and course of schizophrenia. The loss of plasticity and aberrant myelinization lead to a deterioration in cognitive functions, social dysfunction and, in individuals with specific genetic vulnerability, to expression of schizophrenia. This article discusses brain development in relation to the diagnosis of schizophrenia and the basic symptoms of childhood schizophrenia (with early and very early onset) and of adolescent schizophrenia....

Read abstract  Full text PDF

Case Reports 2008; 29(6): 877-878 PubMed PMID: 19112394 Citation  Keywords:  Adult, Antidepressive Agents:therapeutic use, Asperger Syndrome:complications, Child, Child Development Disorders, Pervasive:complications, Depressive Disorder, Major:complications, Female, Humans, Sensation Disorders:complications, Serotonin Uptake Inhib.   

: It is a case report of improvement of tactile defensiveness after taking sertraline in a woman with major depressive disorder and Asperger's syndrome....

Read abstract  Full text PDF

Journal Article 2008; 29(6): 1033-107 PubMed PMID: 19112393 Citation  Keywords:  ACTH-Secreting Pituitary Adenoma:metabolism, Adenoma:classification, Adult, Apoptosis Regulatory Proteins:metabolism, Female, Growth Hormone-Secreting Pituitary Adenoma:metabolism, Humans, Inhibitor of Apoptosis Proteins, Male, Microtubule-Associated Prot.   

OBJECTIVES: Survivin is a member of the inhibitor of apoptosis protein family, which was recently showed to be expressed by different benign and malignant human tumors. Still very little is known about survivin expression in pituitary tumors. In spite of the fact that pituitary tumors in histological examination are usually benign, in the clinical process a certain number of pituitary adenomas is capable of aggressive growth, recurrence and invasion of the surrounding structures. The aim of the present study was to assess the presence of survivin transcripts and protein in different types of pituitary tumors and to evaluate survivin expression levels in invasive and non-invasive pituitary tumors.

DESIGN AND METHODS: The analyzed material consisted of tumor tissue samples obtained during standard neurosurgical removal of the tumor from 23 patients in whom acromegaly (n=14), non-functioning pituitary tumor (n=6), prolactinoma (n=2) and corticotropinoma (n=1) were diagnosed. As a control of the study normal pituitary tissue obtained at autopsy was used. Amplification of survivin gene using sequence specific primers and qRT-PCR method and immunohistochemical staining with primary polyclonal antibodies against human survivin were performed.

RESULTS: Our study demonstrated the presence of survivin mRNA in all 23 analyzed pituitary tumors. Survivin expression was also observed in normal pituitary, but the level of its expression was 6-fold lower than in tumors tissue when studied by real time RT-PCR. The difference between the levels of survivin expression in invasive and non-invasive tumors was not statistically significant. Immunohistochemical analyses revealed the presence of the protein in both normal and tumor tissue of pituitary. Immunostaining of tumor tissue was not uniform. Survivin was observed mainly in the nuclei of cells collected in clusters. The presence of the protein in normal pituitary was restricted to small population of cells.

CONCLUSIONS: The present study showed that overexpression of survivin is characteristic for pituitary tumors. Further analysis of this protein expression profile should demonstrate whether survivin might be use as a prognostic marker in diagnosis and therapy of pituitary adenomas....

Read abstract  Full text PDF

Journal Article 2008; 29(6): 995-998 PubMed PMID: 19112392 Citation  Keywords:  Adult, Age Distribution, Aged, Aged, 80 and over, Antipsychotic Agents:adverse effects, Basal Ganglia Diseases:chemically induced, Cohort Studies, Czech Republic:epidemiology, Dyskinesia, Drug-Induced:epidemiology, Female, Humans, Incidence, Male, Middle .   

BACKGROUND: The second generation antipsychotics (SGA) is considered to have contributed to the decrease of the risk of TD in comparison with the first generation antipsychotics (FGA). Using the multiple regression analysis, we compared the predictive strength of the FGA/SGA distinction with the predictive strength of the duration of treatment, patients' age and sex. The difference between sedative (sed) and incisive (inc) antipsychotics was added as the fifth predictor.

METHOD: A cohort of patients treated with antipsychotic drugs for less than 5 years and who were free from TD was followed for one year and examined regularly by the abnormal involuntary motor scale (AIMS).

RESULTS: From a sample of 98 patients, 6 patients developed TD after six months. The duration of treatment, age and sex of the patients were the main determinants of its emergence. The drugs used did not play a statistically significant role. After one year, 15 patients developed TD. Age and sex lost their statistically provable influence on its emergence. The difference between the treatment with sedative or incisive antipsychotics became the variable with the highest statistical significance. The relationship of the risk of TD to the FGA/SGA distinction was not statistically significant. 14.4% of the variability in the increase of the risk of TD during the second half of the one year observational period could be explained by the predictors. The stepwise regression showed that both, SG/FG and sed/inc distinction remained statistically significant....

Read abstract  Full text PDF

Comparative Study 2008; 29(6): 971-976 PubMed PMID: 19112391 Citation  Keywords:  Adolescent, Adult, Amyloid beta-Peptides:cerebrospinal fluid, Biomarkers:cerebrospinal fluid, Case-Control Studies, Demyelinating Diseases:cerebrospinal fluid, Female, Humans, Male, Middle Aged, Multiple Sclerosis:cerebrospinal fluid, Peptide Fragments:ce.   

OBJECTIVES: The presented study focuses on the importance of measurement of beta-amyloid42 (Abeta-42) levels, total tau protein, and phosphorylated tau (p-tau) protein in the cerebrospinal fluid (CSF) of cerebrospinal multiple sclerosis (MS) and clinically isolated syndrome (CIS) which represents an early phase of multiple sclerosis.

METHODS: A total of 23 patients with clinically isolated syndrome and suspected MS were enrolled into the study. Of this number, 14 patients met the criteria for definitive MS according to McDonald. The control group consisted of 40 patients examined for the possibility of organic damage to the brain, which was not confirmed. We used method of enzyme immunoanalysis to examine concentrations of tau protein, p- tau protein, and beta amyloid42. Differences between the respective groups were examined by test statistics. In addition, dependence of the total tau protein, p-tau protein, and beta-amyloid42 levels on demographic variables, diagnosis and duration of disease was examined by correlation analysis. Correlation of the concentrations obtained in the measurements was evaluated based on the calculated correlation coefficient (r) and level of significance (p).

RESULTS: Compared to the control group, no statistically significant difference was found in the levels of tau protein and p-tau protein between the CIS group and definitive MS group. A significant increase was found only for beta-amyloid42 levels in patients with diagnosed MS vs. control group. We demonstrated no correlation between the beta-amyloid42 and tau protein levels, p-tau protein and age of patients and duration of disease in patients with MS, CIS and the control group.

CONCLUSION: Results of our study show that use of tau protein, p-tau protein and beta-amyloid42 in the diagnosis of multiple sclerosis seems to be non-beneficial. We confirmed no importance for the differential diagnosis of an early stage MS....

Read abstract  Full text PDF

Comparative Study 2008; 29(6): 929-938 PubMed PMID: 19112387 Citation  Keywords:  Adenoma:classification, Gene Expression Regulation, Neoplastic:physiology, Ghrelin:genetics, Humans, Immunohistochemistry, Pituitary Neoplasms:classification, RNA, Messenger:analysis, Somatotrophs:metabolism,.   

OBJECTIVES: It has been suggested that ghrelin synthesized locally in pituitary regulates the function and growth of pituitary cells in autocrine/paracrine way and might be an important factor of pituitary tumorogenesis. The expression of ghrelin receptor in neoplastic cells of pituitary adenomas has also been demonstrated. In vitro studies confirmed that ghrelin stimulates the proliferation of somatotroph cells in GH3 cell line. The presence of both ghrelin mRNA and protein was detected in a number of benign and malignant neoplasms as well as in neoplastic cells of the tissues which do not express ghrelin in physiological conditions. This study showed the presence of ghrelin mRNA and its protein in different types of pituitary adenomas.

DESIGN: The samples of 37 pituitary adenomas were obtained during standard neurosurgical tumor removal. The study tissues included 20 somatotroph tumors (15 patients treated and 5 patients untreated with octreotide LAR before the surgery), 12 nonfunctioning adenomas, 4 prolactinomas and 1 ACTH-secreting tumor. The control included samples of normal mucous membrane of the stomach and normal pituitaries. Expression of ghrelin mRNA was studied in 28 pituitary adenomas by RT-PCR. Immunohistochemical evaluation of ghrelin presence was performed in 34 tumors.

RESULTS: The presence of ghrelin gene transcripts was demonstrated in 10 out of 15 examined somatotroph tumors (obtained from patients treated with octreotide LAR before the surgery) and also in 2 out of 4 samples of prolactinomas, 7 out of 8 of nonfunctioning tumors and in 2 samples of normal pituitary. Immunohistochemical analyses revealed the presence of the protein in all 5 examined somatotroph tumors obtained from patients not treated prior to the surgery and in 10 out of 15 tumors obtained from patients treated with octreotide LAR. The peptide was detected also in 10 out of 12 examined nonfunctioning tumors and in 2 examined PRL-secreting tumors. The immunostaining for ghrelin was not shown in normal pituitaries.

CONCLUSIONS: The study demonstrated that ghrelin gene is expressed in somatotroph adenomas, both treated and untreated with octreotide LAR before the surgery, and also in other types of pituitary adenomas (prolactinomas and nonfunctioning adenomas)....

Read abstract  Full text PDF