Search NEL Online

Case Reports 2013; 34(3): 173-176 PubMed PMID: 23685414 Citation  Keywords:  Amino Acid Substitution:genetics, Chromosomes, Human, X, Female, Humans, Insulin Receptor Substrate Proteins:genetics, Middle Aged, Schizophrenia, Paranoid:genetics, Signal Transduction:genetics,.   

: This report deals with a female patient with schizophrenia who was found to have a mutation in the insulin receptor substrate-4 gene that is located on chromosome Xq22.3. Since this mutation is expected to change amino acid coding from histidine to tyrosine and cause an altered insulin receptor substrate-4 protein, and the insulin receptor substrate-4 protein may be involved in neuronal growth and function in the brain, it is possible that it is this insulin receptor substrate-4 gene mutation that underlies this patient's schizophrenia development....

Read abstract  Full text PDF

Journal Article 2013; 34(2): 143-153 PubMed PMID: 23645312 Citation  Keywords:  Animals, Circadian Rhythm:physiology, Male, Photoperiod, Pineal Gland:metabolism, Pituitary Gland:metabolism, Rats, Rats, Sprague-Dawley, Seasons, Testis:metabolism, Testosterone:metabolism,.   

BACKGROUND: Photoperiodic changes mediate certain physiological or pathological alterations in organisms. Solstices represent either the longest or shortest photoperiod of a year.

OBJECTIVES: Intact and pinealectomized rats were used to investigate the potential changes of reproductive hormones in the hypothalamus-pituitary-testis (HPT) axis including GnRH, FSH, LH, testosterone and melatonin, and their receptors at summer solstice (SS) and winter solstices (WS).

METHODS: The levels of reproductive hormones in HPT axis and the binding characteristics of their receptors were examined using radioimmunoassay and radioreceptor assay techniques, respectively.

RESULTS: The results indicate that in the intact male rat, GnRH, LH and testosterone are higher at the SS than at the WS. However, FSH exhibited no significant seasonal changes. In the testis, Bmax and Kd of LH receptors are higher at the WS than at the SS while those of FSH receptors are higher at the SS than at the WS. In addition, the melatonin in HPT axis appeared significant differences between WS and SS. Bmax and Kd of melatonin receptors in the hypothalamus and pituitary also showed higher at the WS than at the SS. Moreover, reproductive hormone production lost their seasonal rhythms after pinealectomy.

CONCLUSION: The most important discovery in this study is that we first reported that pinealectomy had profound effects on the binding characteristics of melatonin with its subtype receptors. Especially at the hypothalamus, the dominated melatonin receptors shifted from MT1 to MT2 after pinealectomy at the two solstices....

Read abstract  Full text PDF

Journal Article 2013; 34(2): 135-142 PubMed PMID: 23645311 Citation  Keywords:  Aged, Cross-Over Studies, Diabetic Neuropathies:psychology, Double-Blind Method, Electric Stimulation Therapy:methods, Female, Humans, Male, Middle Aged, Pain:physiopathology, Pain Measurement:methods, Prospective Studies, Psychiatric Status Rating Scales.   

OBJECTIVE: Aim of the study was to verify the efficacy of "mesodiencephalic" modulation (MDM), as named by the commercial promoters, in reducing symptoms accompanying painful diabetic neuropathy and in improving mental health.

METHODS: 32 patients with type 1 and 2 diabetes mellitus, with painful neuropathy, were enrolled in the prospective, double-blind, placebo-controlled, cross-over study. The modulation was performed using MDM electrotherapeutic device (ZAT a.s), sham modulation was used as a placebo. Pain relief (visual analogue scale-VAS; total symptom score-TSS) and changes in mental state (Beck Depression Inventory-BDI-II; OSWESTRY and SF-36 questionnaires) were evaluated.

RESULTS: The study was completed by 30 patients. Pain evaluation: VAS: pain relief was statistically insignificantly higher after real (R) compared to sham (S) modulation (-0.7 vs. -0.3; p=0.06), effect of both modulations was equal after 1 month (-0.4 vs. 0.0; p=0.46). TSS: the effect of R and S modulation did not differ immediately after the procedure (-1.3 vs. -1.0; p=0.27), nor after 1 month (-1.5 vs. -0.34; p=0.9). Psychological tests: according to SF-36, the physical health improved considerably after R compared to S (2.5 vs. -2.0; p<0.01), however, changes in the mental health were equal (-1.5 vs. 0.0; p=0.78). Oswestry (0 vs. 0; p=0.95) and BDI-II (-0.5 vs. -1.0; p=0.42) were comparable after R and S modulation. Order of the procedures (R vs. S) did not affect results.

CONCLUSION: The study did not demonstrate any positive effect of MDM on painful diabetic neuropathy compared to placebo, relative to pain or mental state evaluations. The study emphasizes the need of using placebo-controlled studies, especially when testing a new analgesic drug or a method for pain modulation....

Read abstract  Full text PDF

Journal Article 2013; 34(2): 124-128 PubMed PMID: 23645309 Citation  Keywords:  Aged, Aged, 80 and over, Biomarkers:blood, Brain Ischemia:blood, Diabetes Mellitus, Type 2:blood, Female, Humans, Hypertension:blood, Middle Aged, Neuropeptide Y:blood, Obesity:blood, Radioimmunoassay:methods, Stroke:blood,.   

OBJECTIVE: It has been reported that plasma NPY levels were increased in obesity, type 2 diabetes mellitus and hypertension. The symptoms of metabolic syndrome frequently appear in patients with acute ischemic stroke. The association between plasma NPY levels and metabolic markers in women with acute ischemic stroke was investigated in the current study.

METHODS: Plasma NPY concentrations were determined using radioimmunoassay in 58 women aged 60-85 (mean age: 76.5±0.8) with acute ischemic stroke and in 24 women aged 63-67 (mean age: 65.6±0.6) of the control group. Stroke was defined according to the NIHSS (National Institute of Health Stroke Scale) and was confirmed using CT or MR scan.

RESULTS: The prevalence of type 2 diabetes, hypertension and insulin resistance was higher in the group of patients with stroke. Plasma NPY levels measured during the 1st day and 10 days after the acute phase of stroke were significantly lower (p<0.001) compared to the control group.

CONCLUSION: In women with acute ischemic stroke plasma NPY concentrations were decreased in spite of higher frequency of the occurrence of the symptoms of metabolic syndrome....

Read abstract  Full text PDF

Journal Article 2013; 34(2): 118-123 PubMed PMID: 23645308 Citation  Keywords:  Amygdala:metabolism, Animals, Brain:metabolism, Cyclic AMP Response Element-Binding Protein:metabolism, Estrogens:metabolism, Female, Male, Neurons:metabolism, Phosphorylation, Proto-Oncogene Proteins c-fos:metabolism, Rats, Rats, Wistar,.   

OBJECTIVE: We examined whether female pheromone, which would be contained in female-soiled bedding, affected the expression of phosphorylated cAMP response element-binding protein-like (pCREB) immunoreactive cells in the extended amygdala.

METHODS: Male rats were exposed to following conditions: maintained in their home cage (home cage group), or relocated to a cage containing clean bedding (clean-bedding exposed group), ovariectomized (OVX) rat-soiled bedding (OVX-bedding exposed group) or estrogen-treated OVX rat-soiled bedding (OVX+E2-bedding exposed group). Rats were sacrificed 10-20 min after exposure and brain sections were subject to immunocytochemical processing.

RESULTS: In the medial subdivision of the bed nucleus of the stria terminalis (BST) and the central amygdala (CeA), the number of pCREB immunoreactive (pCREB-ir) cells in the clean-bedding exposed group was significantly larger than in the home cage group, while the number of pCREB-ir cells in the OVX+E2-bedding exposed group did not differ from that in the home cage group. The bedding soiled by OVX rats was less effective. No significant difference in the number of pCREB-ir cells was detected in the other regions of the extended amygdala among all groups.

CONCLUSIONS: The present study suggests that the exposure of clean bedding to male rats induces the expression of pCREB-ir in the medial BST and the CeA; exposure to female pheromone attenuates this expression....

Read abstract  Full text PDF

Case Reports 2013; 34(2): 111-117 PubMed PMID: 23645307 Citation  Keywords:  Brain Edema:diagnosis, Female, Humans, Magnetic Resonance Imaging:methods, Meningeal Neoplasms:diagnosis, Meningioma:diagnosis, Middle Aged, Neurosurgical Procedures:methods, Skull Base Neoplasms:complications, Treatment Outcome,.   

: Meningiomas are very common neurosurgical problem. Their histological appearance, different size and localization, adherence to vital neural and vascular structures or extensive peritumoral brain edema (PTBE), especially in deep seated tumors, may lead to severe, life-threatening complications. We report a case of tuberculum sellae meningioma (TSM). A 48-year old female presented with 7-month history of blurred vision and progressive visual impairment. Intracranial tumor was confirmed by magnetic resonance imaging (MRI). After ophtalmological and endocrinological evaluation, the patient underwent surgical removal of the tumor. She immediately recovered from her visual disturbances and no tumor recurrences were seen during follow-up. Pathological diagnosis showed a meningioma of the secretory subtype (MS). We discuss the role of immunohistochemical staining in the diagnosis and the role of different factors in the PTBE formation. Selection of surgical route to the TSM is discussed, as well. Review of the literature is presented....

Read abstract  Full text PDF

Journal Article 2013; 34(1): 75-80 PubMed PMID: 23524628 Citation  Keywords:  Adolescent, Adult, Cardiotocography, Female, Fetal Distress:diagnosis, Heart Rate, Fetal:physiology, Humans, Hypoxia:diagnosis, Middle Aged, Oxygen:blood, Predictive Value of Tests, Pregnancy, Pregnancy Complications:diagnosis, Sensitivity and Specificity.   

OBJECTIVES: The evaluation of hypoxia index (HI) in the prediction of abnormal fetal heart rate at delivery in uncomplicated pregnancies.

MATERIAL AND METHODS: The study group included 148 pregnant patients at term (69 patients with and 79 without brain sparing effect). The value of C/U ratio and HI was determined. Next, its value in predicting abnormal fetal heart rate during labor was evaluated. Then the predictive value of the HI index, C/U and last abnormal values of PI and RI in the MCA and the UA were compared in relation to the analyzed parameters. Evaluation included signs of fetal distress in CTG and abnormal fetal outcome. Then selected parameters, characterizing pregnancy course and fetal outcome with abnormal Doppler indices, were compared.

RESULTS: The designated value of hypoxia index characterized by abnormal neonatal outcome was >10 for sHI and >14 for HI. Low prognostic value of MCA PI and RI, and UA PI and RI has been shown. The highest predictive value was marked by C/U and HI. There were no statistically significant differences in prediction of abnormal fetal heart rate during labor between C/U ratio, HI and sHI.

CONCLUSIONS: The C/U ratio showed the highest sensitivity in the prediction of fetal abnormal heart rate. The C/U ratio, as a easier test, should be recommended as a first-line test in the prediction of abnormal CTG recordings in uncomplicated pregnancies....

Read abstract  Full text PDF

Journal Article 2013; 34(1): 71-74 PubMed PMID: 23524627 Citation  Keywords:  Acromegaly:epidemiology, Adult, Colonoscopy, Female, Humans, Incidence, Irritable Bowel Syndrome:diagnostic imaging, Male, Middle Aged, Pilot Projects, Quality of Life, Ultrasonography,.   

BACKGROUND: In acromegaly, the gastrointestinal system is under the influence of excessive growth hormone (GH) and insulin like growth factor-1 (IGF-I). Increased bowel length and delayed transit time may cause functional disturbance of the bowel. The objective of the current study is to evaluate the frequency of irritable bowel syndrome (IBS) in cases with acromegaly.

PATIENTS AND METHODS: Twenty-three active cases with acromegaly newly diagnosed between 2010-2011 were included in the study. The control group consisted of ninety gender and age-matched healthy controls (HC). All cases were questioned for presence of IBS using Rome III criteria. Abdominal ultrasonography and colonoscopy results of acromegalic patients were obtained. In addition, cases with acromegaly were evaluated for their quality of life and status of depression by using the Acromegaly Quality of Life Questionnaire (AcroQoL) and Beck Depression Inventory (BDI), respectively.

RESULTS: The median GH and IGF-1 levels of cases with acromegaly were 5.72 [IQR: 2.2-34] ng/ml and 753 [IQR: 503-1050] ng/ml, respectively. The median AcroQoL score of patients with acromegaly was 56 [IQR: 43-71.5] and the median BDI score was 16 [IQR: 11-21]. Rome III diagnostic criteria were positive in 2 of 23 acromegaly patients and in 3 of 90 HC (p=0.26). IBS was present in 1 of 23 of the acromegaly patients compared to 3 of 90 HC (p=0.81).

CONCLUSION: Although acromegaly and IBS may cause similar gastrointestinal symptoms, acromegaly is not associated with a greater incidence of true IBS....

Read abstract  Full text PDF