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Clinical Trial 2008; 29(1): 100-106 PubMed PMID: 18283260 Citation  Keywords:  Adolescent, Adult, Aged, Aging:blood, Blood Glucose:metabolism, Body Weight:physiology, Dehydroepiandrosterone Sulfate:blood, Estradiol:blood, Ghrelin:blood, Growth Hormone:blood, Humans, Insulin:blood, Insulin-Like Growth Factor I:metabolism, Leptin:bloo.   

OBJECTIVES: Ghrelin, a natural ligand of the growth-hormone secretagouges receptor is the peptide known because of its growth hormone (GH)-releasing as well as orexigenic actions. THE AIM of the study was to examine the relationship between ghrelin levels and age, weight, glucose metabolism markers, GH, IGF-1 and androgens in men.

PATIENTS AND METHODS: The study included 19 healthy men aged 16-73 yrs, mean 46,8 +/-18,5 (mean +/- SD). The height, weight, and body mass index (BMI) of the study subjects were assessed and serum concentration of fasting ghrelin, leptin, GH, IGF-1, glucose, insulin, estradiol, testosterone and DHA-S were measured.

RESULTS: The negative correlation between age and serum ghrelin levels (r=-0,52; p<0,04) in men was found. In men under 30 years old serum ghrelin levels were significantly higher compared to men over 60 years old (p<0,02). Serum ghrelin levels in men were significantly lower compared to healthy women aged 43,5 +/- 12 years old (p<0,008). Serum insulin levels correlated negatively with ghrelin levels (r= -0,87; p<0,0006) and serum testosterone concentrations correlated with ghrelin levels (r= 0,69; p<0,00006).

CONCLUSION: Our findings demonstrate that the serum ghrelin levels in men decline with age, is lower than in women and correlate negatively with fasting insulin levels. We demonstrated, for the first time, that serum testosterone levels in men correlate with total ghrelin levels....

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Case Reports 2008; 29(1): 51-54 PubMed PMID: 18283258 Citation  Keywords:  Adolescent, Dose-Response Relationship, Drug, Growth Hormone:adverse effects, Hair Diseases:chemically induced, Humans, Hypopituitarism:drug therapy, Insulin-Like Growth Factor I:metabolism, Male, Neoplasm Recurrence, Local:chemically induced, Pilomatrixo.   

: Pilomatricoma is usually a solitary subcutaneous nodule. Recurrence of the nodule after surgical excision is very rare. Pilomatricoma occurrence in patients with growth hormone (GH) deficiency has not been reported, yet. We report a 14-year-old boy with pilomatricoma and panhypopituitarism. After GH therapy had been started, we observed two relapses of previously completely excised pilomatricoma in the same location and a new pilomatricoma formation on the chin....

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Journal Article 2008; 29(1): 163-167 PubMed PMID: 18283255 Citation  Keywords:  Female, Gynecologic Surgical Procedures:adverse effects, Humans, Laparoscopy:adverse effects, Leiomyoma:surgery, Retrospective Studies, Treatment Outcome, Uterine Neoplasms:surgery,.   

OBJECTIVES: To analyze the indications, safety and feasibility of laparoscopic myomectomies performed during the last 10 years.

MATERIAL AND METHODS: The studied material consisted of 187 typically performed laparoscopies, mostly due to uterine myomas. All the patients underwent an ultrasound examination at the time of admission and those with the maximum of 3 tumors, where the largest tumors were less than 10cm in diameter, were qualified for endoscopic surgery.

RESULTS: Out of 187 women, 39 patients had laparoscopy performed twice, with a 3-4 months interval for GnRH analogues treatment. Among 164 operative laparoscopies myomas were enucleated in 132 of the women (80.5%). In the case of 18 patients (9.6%) there was a need for laparoconversion resulting from the difficulties with enucleation, adhesions, and the size or localization of the tumor. There were also 62 cases of diagnostic laparoscopy, where myomas were either too large or too small to be enucleated. On analyzing the number and size of the tumors it occurred that a single myoma was the most frequent finding, while more than half of all the enucleated uterine tumors found during diagnostic and operative endoscopies were up to 2cm in diameter.

CONCLUSIONS: Laparoscopic myomectomy is a safe and reliable surgical alternative for women suffering from symptomatic myomas and is a method of choice in young patients of reproductive age. Beside skillful surgical techniques, a proper qualification for the operation is essential for the desired outcome....

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Case Reports 2008; 29(1): 41-43 PubMed PMID: 18283254 Citation  Keywords:  Adult, Anticoagulants:therapeutic use, Female, Heparin:therapeutic use, Humans, Hypothyroidism:complications, Intracranial Hypertension:diagnosis, Sinus Thrombosis, Intracranial:diagnosis, Thyroxine:therapeutic use,.   

: Several cases of hypothyroidism have been reported to develop idiopathic intracranial hypertension not directly precisely linked with cerebral venous sinus thrombosis (CVT). A 31-year-old Chinese woman presented with bilateral blurred vision and paroxysmal amaurosis for about 6 months without headache. Neurological examination revealed normal expect for the sixth cranial nerve palsy and bilateral papilledema. Laboratory tests showed pronounced hypothyroidism and greatly increased serum triglyceride. Cerebral spinal fluid showed the increased opening and closing pressure. Digital subtraction angiography (DSA) disclosed a filling defect in the adjunction of bilateral transverse sinuses and sigmoid sinuses. Her symptoms gradually improved with levothyroxine, mannitol and anticoagulants treatment. In presenting the rare case of lateral sinus thrombosis associated with primary hypothyroidism, we wish to alert physicians that patients presenting with papilledema and hypothyroidism may require investigations of DSA for CVT, even in the absence of headache....

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Case Reports 2008; 29(1): 44-46 PubMed PMID: 18283253 Citation  Keywords:  Adrenergic beta-Antagonists:adverse effects, Amnesia, Transient Global:diagnosis, Humans, Male, Middle Aged, Migraine Disorders:drug therapy, Recurrence, Substance Withdrawal Syndrome, Vasomotor System:physiopathology, Vasospasm, Intracranial:complication.   

: The etiology of Transient Global Amnesia (TGA) is not yet clear. A small part of TGA has a familiar occurrence. We report a case of recurrent, long-lasting familiar amnesia occurring after betablocker treatment withdrawal in a migrainous patient. We suggest that familiar TGA could be caused by the mechanism of vasospasm rather than venous congestion and that the abnormal cerebral vasomotor control could be the hereditary substrate in this condition....

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Case Reports 2008; 29(1): 67-68 PubMed PMID: 18283251 Citation  Keywords:  Brain:blood supply, Creutzfeldt-Jakob Syndrome:diagnostic imaging, Diagnosis, Differential, Female, Fluorodeoxyglucose F18:metabolism, Humans, Middle Aged, Positron-Emission Tomography:methods, Radiopharmaceuticals:metabolism, Regional Blood Flow, Tomogra.   

: Creutzfeldt-Jakob disease (CJD) is a subacute spongiform encephalopathy. This fatal prion disease is characterized by rapidly progressive dementia with a variety of neurological disorders. Diagnostic methods provided by nuclear medicine might be helpful for evaluation of patients with probable CJD as additional diagnostic tools to MRI and cerebro-spinal fluid evaluation. The experience with FDG-PET and brain perfusion SPECT is presented....

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Journal Article 2008; 29(1): 29-36 PubMed PMID: 18283249 Citation  Keywords:  Hearing Loss:genetics, Humans, Membrane Transport Proteins:genetics, Mutation:genetics, Phenotype, Syndrome, Vestibular Aqueduct:abnormalities,.   

: This paper presents the current views, regarding the pathomechanisms, which lead to the development of pathological symptoms in the enlargement of the vestibular aqueduct syndrome (EVAS) and the Pendred syndrome (PS). Associated phenotypes have been discussed and an attempt has been undertaken to correlate them with a corresponding genotype. Mutations of SLC26A4 gene are one of the factors, which are at the base of congenital hearing losses. Inherited hearing loss occurs in these cases either as an isolated phenomenon with anatomical anomalies of the labyrinth in the background (EVAS) or with endocrine disorders (PS). The official name of SLC26A4 gene is "solute carrier family 26, member 4". Pendrin, the product of its expression, transports iodine beyond thyroid follicular cells, where it is linked with thyroglobulin and, then, used in hormone synthesis. Abnormal expression of SLC26A4 gene results in disturbance of iodine organification. In the internal ear, pendrin transports bicarbonates to the endolymph, taking in this way an active part in pH control of the endolymph and providing proper functioning of KCNJ10 potassium channels and TRP5 calcium channels. Disorders of homeostasis in labyrinth fluids are responsible for abnormalities of its structure, such as enlargement of the vestibular aqueduct and of the endolymph sac. At present, the Human Gene Mutations database provides 124 recessive mutations of SLC26A4 gene. In EVAS and PS, two missense mutations are most frequently observed: L236P and T416P, as well as the mutation, regarding abnormal splicing process, i.e., IVS8+1G-A, in a total of 55% of the patients with recognised mutation of SLC26A4 gene; the remaining 45% of changes of this gene are unique mutations....

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Journal Article 2008; 29(1): 75-79 PubMed PMID: 18283248 Citation  Keywords:  Aged, Aged, 80 and over, Alzheimer Disease:blood, Amyloid beta-Peptides:blood, Biomarkers:blood, Case-Control Studies, Female, Humans, Interleukin-10:blood, Interleukin-6:blood, Middle Aged, Tumor Necrosis Factor-alpha:blood,.   

: Alzheimer's disease (AD) belongs to a group of neurodegenerative disorders. It is characterized by irreversible and progressive memory loss accompanied with decline in other cognitive functions. At a microscopic level, the typical neuropathologic features, senile plaques and neurofibrillary lesions are found. The pathological processes lead to neuronal loss, synaptic dysfunction and inappropriate activity of neurotransmitters. The major constituent of senile plaques is abnormally aggregated beta amyloid protein. Beta amyloid (Abeta) is a short (40-42 amino acid) product of proteolysis of the transmembrane amyloid precursor protein (APP). Extracellular depositions of Abeta 1-42 may initiate a wide range of pathological processes including glia activation, neuroinflammation and neuronal apoptosis. There is convincing evidence that inflammatory response to accumulation of beta amyloid plays a pivotal role in the progression of neuropathological changes found in AD. Current research was directed at assessing beta amyloid, cytokines (IL-6, IL-10 and TNF alpha) plasma levels in women with AD. Hundred and twenty four women, aged between 59 to 86 years, were enrolled in the study. Amongst them 57 were diagnosed with AD (29 subjects in early stage and 28 subjects with moderate to severe stadium of disease) and 67 women without dementia were investigated as a control group. The lowest values of Abeta 1-42 were found in AD subjects in moderate to severe stage of disease as compared with the early stage of AD (p< 0.05) and the control group (p<0.01). Change in IL-6 values was significantly different between groups with the lowest values found in women without dementia. Both subset of AD patients demonstrated statistically enhanced IL-6 levels when compared with the control group (p<0.001, p<0.01 respectively for early and moderate/severe stage of AD). Moreover, our study revealed a trend to increase in TNF alfa and IL-10 values in AD. However, those differences were not statistically significant. In addition, we did not detect any correlations between plasma beta amyloid and investigated cytokines....

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