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Journal Article 2008; 29(3): 292-294 PubMed PMID: 18580844 Citation  Keywords:  Abnormalities, Multiple:surgery, Adult, Amoxicillin:therapeutic use, Anti-Bacterial Agents:therapeutic use, Cesarean Section, Female, Humans, Infant, Newborn, Infant, Premature, Ischium:abnormalities, Kidney Function Tests, Laparotomy, Male, Pelvis:abnorm.   

: We present a case of a pregnancy in a 24 year old woman who was born with ectopia vesicae, split pelvis and hypoplasia of ischial bones. From childhood to adulthood she had undergone reconstructive surgeries of the abdomen and perineum, as well as urine diversion surgery. During pregnancy she experienced recurrent urinary tract infections which were treated with antibiotics. In spite of tocolysis, she delivered by cesarean section a premature baby boy at 35th week of gestation due to premature uterine contractions. The postoperative period was uneventful and they were discharged from the hospital in a good general condition....

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Case Reports 2008; 29(3): 295-302 PubMed PMID: 18580843 Citation  Keywords:  Antidepressive Agents, Tricyclic:therapeutic use, Bipolar Disorder:drug therapy, Brain:pathology, Clomipramine:therapeutic use, Depression:drug therapy, Electroencephalography, Humans, Magnetoencephalography, Male, Middle Aged, Parietal Lobe:physiology, R.   

BACKGROUND: QEEG cordance and low-resolution electromagnetic tomography (LORETA) are relatively new applications of QEEG. Four small-scale studies have shown that decreases of QEEG prefrontal theta cordance after the first week on new antidepressants predict clinical response to treatment in patients with unipolar depression.

METHODS: We calculated prefrontal theta cordance and changes in 3D distribution of brain electrical activity using LORETA in the case of a 54-year old man experiencing his third depressive episode.

RESULTS: We did not detect a decrease of prefrontal theta cordance after one week of new treatment and the patient did not respond to this therapy after four weeks. However, we observed a decrease of prefrontal theta cordance after the first week of clomipramine therapy. Manic symptoms emerged after two weeks of clomipramine treatment. A decrease of prefrontal theta cordance preceded the clomipramine induced switch to hypomania during the next episode of depression also. LORETA before and during clomipramine therapies detected a significant increase of theta in the right postcentralis gyrus in the parietal lobe, and a borderline increase of alfa2 in the right middle frontal gyrus.

DISCUSSION: In a patient with bipolar spectrum disorder we found that a treefold change in theta prefrontal cordance preceded mood changes in a similar way as in patients with unipolar depression. We speculate that the changes detected by LORETA can attributed to the anticholinergic activity of clomipramine and the specific effects of a mood switch. Our data suggest that the new applications of QEEG can be sensitive to mood changes and have potential in bipolar disorder research....

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Journal Article 2008; 29(3): 287-291 PubMed PMID: 18580840 Citation  Keywords:  Animals, Anti-Inflammatory Agents:pharmacology, Antidepressive Agents:pharmacology, Biomarkers, Brain Chemistry:drug effects, Cytokines:physiology, Depression:drug therapy, Humans, Inflammation:drug therapy, Intestinal Absorption:physiology, Intestinal Mu.   

: This paper hypothesizes that inflammatory, oxidative and nitrosative (IO&NS) pathways, and an increased translocation of LPS from gram-negative bacteria are causally related to depression following external (psychological) and internal (organic) stressors and that IO&NS pathways are novel targets for antidepressant development. We review that depression is accompanied by an inflammatory reaction as indicated by an increased production of pro-inflammatory cytokines, such as interleukin-1beta (IL-1beta), IL-6, tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN)-gamma. These cytokines are stress-sensitive and may cause depressive behaviors. The latter may be induced by an increased catabolism of tryptophan, the precursor of serotonin, to neurotoxic TRYCATs (tryptophan catabolites along the indoleamine oxidase pathway). Inflammatory biomarkers are detected in animal models of depression. Newly developed animal models of depression are based on induced inflammation. Most if not all antidepressants have specific anti-inflammatory effects. Anti-inflammatory compounds may augment the clinical efficacy of antidepressants. Depression is also accompanied by an IgM-related (auto)immune response directed against disrupted lipid membrane components, such as phosphatidyl-inositol, by-products of lipid peroxidation, e.g. azelaic acid and malondialdehyde, and NO-modified amino-acids, which are normally not detected by the immune system but due to damage caused by O&NS have become immunogenic. Increased translocation of lipopolysaccharide from gram-negative bacteria, which may be induced by internal and external stressors, may further aggravate the induced IO&NS pathways....

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Journal Article 2008; 29(3): 347-350 PubMed PMID: 18580839 Citation  Keywords:  ACTH-Secreting Pituitary Adenoma:metabolism, Adenoma:metabolism, Adrenocorticotropic Hormone:metabolism, Adult, Cushing Syndrome:blood, Female, Humans, Immunohistochemistry, Ki-67 Antigen:blood, Male, Nelson Syndrome:blood, Paraffin Embedding, Pituitary H.   

OBJECTIVES: The aim of the study was to evaluate the ACTH-immunopositive pituitary adenomas, especially those without manifestation of Cushing's disease

MATERIAL AND METHODS: 148 pituitary adenomas removed surgically in years 1994--2007 were studied. The paraffin sections were immunostained with antibodies against the pituitary hormones. In 79 adenomas the immunostaining with anti-ACTH antibody was performed Additionally, 23 tumors were also immunostained with anti-Ki-67 (MIB-1) antibody. Visualization of reactions was done by means of streptavidin-biotin-peroxidase technique with use of 3,3'-diaminobenzidine as chromogen.

RESULTS: ACTH immunopositivity was found in 34 cases (23%). Fourteen ACTH-immunopositive tumors manifested themselves as Cushing's disease (including 1 case of Nelson's syndrome). In the remaining 20 cases in spite of the positive immunostaining for ACTH of the tumor cells, no features of hypercortisolism were observed (in several cases even hypocortisolism was found). Thus, those tumors represented so-called "silent" corticotropinomas. Over one third (37%) of "clinically" nonfunctioning pituitary adenomas, when immunostained with anti-ACTH antibody, showed ACTH immunopositivity. Three adenomas in patients with Cushing's disease (21.4%) and 7 "silent" corticotropinomas (35%) were recurrent tumors. In contrast, the recurrence rate in the group of ACTH-immunonegative clinically nonfunctioning pituitary adenomas was 14.7%. The "silent" corticotropinomas exhibited a tendency towards the higher expression of a proliferation marker, Ki-67 antigen as compared to the "active" corticotropinomas.

CONCLUSIONS: (i) "Silent" corticotropinomas are rather frequent. (ii) This adenoma type should be considered as aggressive. (iii) It is hypothetized that--like in Nelson's syndrome--the lack of hypercortisolism or even presence of hypocortisolism favorizes the exaggerated growth of tumoral corticotrophs....

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Clinical Trial 2008; 29(2): 252-255 PubMed PMID: 18404138 Citation  Keywords:  Alendronate:pharmacology, Bone Density Conservation Agents:pharmacology, Diphosphonates:pharmacology, Female, Humans, Lipid Metabolism:drug effects, Lipids:blood, Middle Aged, Osteoporosis, Postmenopausal:blood,.   

OBJECTIVES: Bisphosphonates are widely used for the treatment of metabolic bone disorders and their effects on lipid metabolism have also been investigated. Some studies reported that bisphosphonates have beneficial effects on serum cholesterol levels. In this study we aimed to assess the effects of bisphosphonates on lipid levels in hyperlipidemic patients who received bisphosphonates because of osteoporosis.

METHODS: 49 female patients (age: 54.2+/-7.2 years) with diagnosis of osteoporosis and hyperlipidemia were enrolled. Patients received alendronate 10 mg/day and they were followed up for 6 months. Pretreatment total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, apolipoprotein A1 and apolipoprotein B levels were measured and compared with post-treatment levels.

RESULTS: Pretreatment and post-treatment levels of total cholesterol were 255.2+/-34.3; 233.02+/-37.0 mg/dL, triglyceride levels were 153.0+/-57.3; 129.1+/-54.4 mg/dL, and LDL levels were 170.7+/-30.5; 160.0+/-34.2 mg/dL, respectively. Reductions in total cholesterol, triglyceride and LDL-cholesterol levels were statistically significant; whereas differences in HDL-cholesterol, apolipoprotein-A1 and apolipoprotein-B levels were not significant.

CONCLUSIONS: Data from our study suggest that alendronate therapy may have beneficial effects on lipid metabolism. Thus, when hyperlipidemia is detected in patients receiving bisphosphonates, it is considered reasonable to follow the patient for a while before initiating antihyperlipidemic agent to prevent unnecessary use of drugs....

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Journal Article 2008; 29(2): 246-251 PubMed PMID: 18404133 Citation  Keywords:  Attention Deficit Disorder with Hyperactivity:genetics, Case-Control Studies, Child, DNA Mutational Analysis, Dopamine Plasma Membrane Transport Proteins:genetics, Dopamine beta-Hydroxylase:genetics, Female, Gene Frequency, Genetic Predisposition to Disea.   

BACKGROUND: Pharmacological approach is the most effective way of treatment of ADHD and its early application prevents from the progress of secondary disorders. The study on present neurotransmitter systems in pathology of ADHD can be helpful in selecting appropriate drug, since there are used various substances with different mechanisms of functioning in treatment of the hyperkinetic syndrome.

METHOD: Within our study there were selected the genes of dopaminergic (DRD2, DRD3, DAT1), noradrenergic (DBH) and serotoninergic (5-HTT) systems. With the use of molecular-genetic methods based on association strategy "case-control" there were analysed genes including 11 polymorphisms. The presence of risk alleles was examined in comparison of the sample of 100 ADHD children to a control group of another 100 subjects, who were checked by child psychiatrists and examined with the Conners test in order to exclude eventual cases with ADHD symptoms.

RESULTS: Our research suggests the association of some genes with ADHD. It could be concluded: 1) the risk of ADHD is significantly increased in the presence of one risk allele in genes DRD2 (O.R.=7,5), 5-HTT (O.R.=2,7) and DAT1 (O.R.=1,6). 2) The risk of ADHD is significantly increased at homozygotes for risk alleles in genes DRD2 (O.R.=54,8), 5-HTT (O.R.=6,7) and DAT1 (O.R.=6,6). For polymorphisms G444A and C1603T in DBH, which were detected by univariant analysis, haplotype analysis was performed and resulted in conclusion that: 3) the risk of ADHD is significantly increased in the presence of allele DBH +444A as well as in the presence of allele DBH +1603T (O.R.=15)....

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Journal Article 2008; 29(2): 230-234 PubMed PMID: 18404132 Citation  Keywords:  Animals, CHO Cells, Cells, Cultured, Corticotropin-Releasing Hormone:genetics, Cricetinae, Cricetulus, Estradiol:pharmacology, Humans, Promoter Regions, Genetic:drug effects, RNA, Messenger:metabolism, Receptors, Estrogen:antagonists & inhibitors, SUMO-1 .   

OBJECTIVES: Human corticotrophin-releasing hormone (CRH) plays a pivotal role in the stress response. Its expression is under the control of various steroid hormones, such as estrogens. The transcriptional activity of the estrogen receptor (ER) may be modified by small-ubiquitin related modifier (SUMO1). In the present study, we aim to reveal the role of SUMO1 in the regulation of ER-mediated CRH promoter activation.

METHODS: CHO-K1 cells were transfected with human ER and SUMO1 expressing plasmids together with the CRH promoter reporter gene. CRH mRNA was detected in BE(2)C cells by real time PCR.

RESULTS: We found that estradiol could elevate CRH promoter activity to a much higher level in cells co-transfected with ER and SUMO1 than that with ER alone, and that the enhancement was blocked by the ER inhibitor, ICI182,780. Furthermore, the endogenous CRH mRNA expression was also increased when the BE(2)C cell were transfected with ERalpha and SUMO1 in contrast to the transfection with ERalpha alone.

CONCLUSIONS: Our results indicate that SUMO1 participates in the modulation of ER-mediated CRH mRNA expression which may be important for the regulation of the stress response....

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Journal Article 2008; 29(1): 11-15 PubMed PMID: 18283270 Citation  Keywords:  Adolescent, Age Factors, Child, Child, Preschool, Endoscopy:methods, Female, Genital Diseases, Female:diagnosis, Genitalia, Female:abnormalities, Humans, Hysteroscopy, Laparoscopy,.   

: Early proper diagnostics and treatment of developmental age pathologies in most cases facilitate correct sex organ development, as well as reproductive functions formation. To make the foregoing possible, it is necessary to apply minimally invasive and safest methods like vaginoscopy, hysteroscopy and laparoscopy. The main application field of vaginoscopy and hysteroscopy in pediatric and adolescent gynecology is the diagnosis and treatment of vulvar and vaginal pathologies and developmental anomalies of sex organ. The laparoscopy is becoming a more and more popular method in the treatment of adnexal tumors in children, due to its little invasiveness, quick recovery and less severe pain complaints after the surgery. The application of these endoscopic procedures should always be preceded by the complex noninvasive diagnostics, such as ultrasonography and magnetic resonance imaging. The endoscopic procedures facilitate wide-ranging diagnostics and simultaneously therapeutic management, ensuring minimal invasion and high safety of the surgery. They should be considered diagnostics and treatment of choice in the pathology of vulva, vagina, developmental anomalies of sex organ and adnexal tumors in patients of the developmental age....

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