ACTA ENDOCRINOLOGICA (BUC)

Objective. To investigate clinicopathologic feature, diagnosis and differential diagnosis of gangliocytic paraganglioma (GP). Methods. Clinical data, histologic findings of one GP case in our hospital were reported and we reviewed the published literature on GP. Results. GP is composed of three types of cells: spindle cells, ganglion-like cells, and epithelioid cells. Several kinds of antibodies were used to evaluate and identify tumor cells immunohistochemically. Epithelioid cells showed positive results with antibodies for NSE , CgA, Syn, Ck and negative results with antibodies for S-100 protein, CD117.Spindle cells showed positive results with antibodies for S-100 protein, CD34 and negative results with antibodies for CD117, NSE, CgA, Syn, CK. Ganglion-like cells showed positive results with antibodies for NSE, CgA, Syn, CD117 and negative results with antibodies for S-100 protein and CK . In some cases, metastatic spread to regional lymph nodes or recurrence has been reported. Conclusions. GP is a rare true neuroendocrine tumor of potential metastatic capacity.

This study was performed to search the effect of a fiber rich dietary product on anthropometric measurements and some biochemical parameters of obese adult women. A total of 25 adult women (12 were in study and 13 were in control group, all randomly selected) volunteered in this study. At the beginning of the study, height, weight, waist and hip circumferences of all women were measured, and blood samples were collected for fasting blood glucose (FBG), insulin, triglycerides (TG), total cholesterol, HDL-C, LDL-C, VLDL-C levels. Patients having endocrine and metabolic disturbances and who need to use anti-obesity medications were not enrolled. A low calorie weight losing diet consisting of 50-55% carbohydrate, 15-20% protein and <30% fat was given to all cases, but women in the study group were given a specific dietary product rich in apple and wheat fiber as an exchange of one slice of bread every day. Patients were checked monthly with respect to their weight loss and diet adhesion during the three months of treatment period. Although biochemical parameters did not show any significant differences between the two groups at the beginning of the study, FBG and insulin levels were significantly lower in the study group than in the control group at the end of the treatment period. There were also significant decreases in insulin, triglyceride, total cholesterol and VLDL-C levels in the study group after 3 months of treatment, but not in the control group. Women in both groups lost weight, and their waist and hip circumferences decreased significantly. This concludes that the fiber rich, fat, sugar and salt free dietary product could be a useful dietary treatment not only in obesity, but also in dislipidemia and insulin resistant states.

Background. Intraabdominal obesity is considered a low level chronic proinflammatory state. The adipocyte is the central element that integrates multiple metabolic and endocrine signals.\r\nObjectives. This study monitors the metabolic effects of the administration of melatonin or melatonin associated with estrogen in surgically castrated female rats.\r\nMaterial and method. Experiments were performed in white female Wistar rats, with a weight of 160-200 g. At 14 days postovariectomy, a time period required for the postoperative validation of ovarian failure, with the experimental induction of artificial\r\nmenopause in the studied animals, estrogen replacement treatment and combined treatment of estrogen and melatonin were initiated. The duration of the administered treatment, with the products and the doses recommended for veterinary use, was of 12 consecutive weeks.\r\nResults. Food consumption (p=0.60), glycemia (p=0.053) and TG (p=0.34) did not significantly differ between the groups. The comparison of weight and intra-retroperitoneal\r\nfat between the groups in the last week showed that groups which did not receive estrogen had a significantly higher weight and higher intra-retroperitoneal fat than groups to which estrogen was administered (p<0.001). Groups which received estrogen associated with melatonin had a lower weight and a lower intra-retroperitoneal fat compared to groups, which received estrogen alone (p<0.001). Melatonin administred alone (without estrogens)does not show any effects on weight or lipid metabolism in ovarectomised rats.\r\nConclusion. In ovarectomised rats, the associated administration of estrogen and melatonin is correlated with: a less important increase in the body weight, under the conditions of unchanged food consumption, a decrease in intra-retroperitoneal fat, a decrease in total cholesterol, an increase in HDL-cholesterol levels.

Context. 18F-fluorocholine (FCH) has been used as a positron emission tomography (PET) tracer in the localization of hyper-functioning parathyroid glands (HPGs). Objective. We performed this methodological study to evaluate the diagnostic performance of 18F-FCH PET/computerized tomography (CT) and repeated ultrasonography (USG) in detecting unidentified lesions in patients with primary hyperparathyroidism (PHPT). Design. In this retrospective methodological study, we studied the diagnostic performance of 18F-FCH PET/CT and a repeated USG in detecting unidentified parathyroid lesions. Subjects and Methods. Twenty-eight patients who were diagnosed with PHPT, had an indication for surgery following the current guidelines and had no identified lesion on 99mTc-MIBI SPECT/CT, USG, or other imaging methods than 18F-FCH PET/CT, included in the study. Results. While lesions were detected in 26 patients via 18F-FCH PET/CT among 28 patients [92.9% (95% CI: 76.6%-99.1%)], the lesion detection rate was 95.7% (95% CI: 78.1%-99.9%) in 23 patients who underwent a repeated USG. The sensitivity and the accuracy of both 18F-FCH PET/CT and repeated USG were 95.2% (95% CI: 76.2%- 99.9%) and 95.0 (95% CI: 75.1%-99.9%), respectively. Conclusions. This study supports that the combination of 18F-FCH PET/CT and repeated USG has promising potential for being an imaging technique for early detection and localization of HPGs.

Context. The variety of tumor-seeking radiopharmaceuticals, which are currently in clinical use, may have a potential role as imaging agents for adrenal gland tumors, due to physiological characteristics of this organ. Objective. The purpose of this study was to evaluate the diagnostic potential of 99mTc-HYNIC-TOC, 99mTc(V)- DMSA, and 99mTc-MIBI in the assessment of adrenal tumors, by correlating with imaging findings and histopathologic results. Design. The research is designed as a crosssectional prospective study. Patients and method. The study included 50 patients with adrenal tumors (19 hormone-secreting and 31 nonfunctioning) and 23 controls without adrenal involvement. In all patients, single-photon emission computed tomography (SPECT) was performed, using qualitative and semiquantitative analysis. The tumor to nontumor tracer uptake was conducted by using a region-ofinterest technique. Adrenal to background (A/B) ratio was calculated in all cases. Results. 99mTc-HYNIC-TOC scintigraphy showed a high statistical significance between A/B ratios, while other two tracers resulted in a lower sensitivity, specificity and accuracy. Futhermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumors (the receiveroperating- characteristic curve analysis, A/B ratio cut-off value of 8.40). Conclusion. A semiquantitative SPECT analysis showed that 99mTc-HYNIC-TOC is a highly sensitive tumorseeking agent for the accurate localization of adrenal tumors.

important role in insulin signaling and the common Gly971Arg polymorphism is related to type 2 diabetes (T2D). IRS-1 Gly971Arg polymorphism can modify tyrosine phosphorylation at a specific site of IRS-1 and may have a critical role in the development of insulin resistance (IR). Objective. The purpose of this study was to investigate the association between this polymorphism and IR in Iranian patients with newly-diagnosed type 2 diabetes. Design. The study was conducted on 114 individuals with newly-diagnosed T2D and 118 healthy matched controls, aged 20-80 years. Fasting blood glucose and insulin were measured by the enzymatic method and enzyme-linked immunosorbent assay, respectively. Insulin-resistance was calculated by homeostasis model assessment estimatedinsulin resistance (HOMA-IR). The gene polymorphism was examined by polymerase chain reaction-restriction fragment length polymorphism. Results. There are significant differences between IRS1 Gly971Arg polymorphism and studied individuals (P<0.0001). The findings showed that the risk of developing T2D in individuals who had R-alleles was 3.74 folds higher than those without R-alleles. However, IRS1 Gly971Arg polymorphism was not associated with high HOMA-IR, high BMI and familial history of diabetes. Conclusions. Even though there was not a significant relationship between IRS-1 G971R polymorphism with insulin resistance and high BMI, this polymorphism was correlated to newly-diagnosed diabetic patients. Thus, the evaluation of IRS-1 G971R polymorphism may be helpful for predicting T2D new cases.

Background. Primary hyperparathyroidism and vitamin D deficiency are both associated with increased prevalence\r\nof anemia. Relationship of hemoglobin and parathyroid hormone in normal ranges were not investigated appropriately.\r\nMethods. We analysed laboratory data of 476 patients without primary hyperparathyroidism. The patients had concurrent measurements of calcium, phosphorus, alkaline phosphatase, parathyroid hormone, 25-OH vitamin D and hemoglobin.\r\nResults. Parathyroid hormone was negatively correlated with hemoglobin (p=0.01), the correlation persisted after\r\ncorrection for vitamin D levels (p=0.045), and in sub-group of normal (>20 ng/mL) 25-OH vitamin D levels (p=0.005). Parathyroid hormone was also correlated negatively with\r\nferritin (p=0.02), correlation persisted after being adjusted to vitamin D (p=0.021). In anemic patients, these with low ferritin (<12 ng/mL) had higher PTH levels than these with higher ferritin despite having similar calcium\r\nand vitamin D levels (p=0.014).\r\nConclusion. Interaction of parathyroid hormone and erythropoiesis seems to be present in normal ranges where\r\nerythropoietin may mediate key roles regulating both.

Background and Aim. The house sparrow (Passer domesticus) is a seasonal breeder\r\nforming monogamous pairs like majority of the sub-tropical birds. Less is known about its\r\nreproductive endocrinology during different phases of the breeding cycle. In the present\r\nstudy, the house sparrows were analysed to shed light onto their breeding physiology.\r\nMethods. Seasonal changes in body weight, gonad morphology and plasma\r\nconcentration of testosterone and progesterone (by ELISA) were evaluated in 40 males and\r\n40 females respectively, using 10 birds for each season.\r\nResults. Testosterone in males was minimal during the non-breeding phase at 0.41 ? 0.17\r\nng/mL increasing at 2.35 ? 0.12 ng/mL during the onset of the pre-breeding phase,increased in the\r\nbreeding period at 5.65 ? 0.16 ng/mL, while in the post-breeding phase it was 3.83 ? 0.20 ng/mL.\r\nIn females, testosterone levels during the non-breeding phase were 0.11 ? 0.07 ng/mL, which rose\r\nsignificantly during the pre-breeding phase to 0.45 ? 0.10 ng/mL, a level equivalent to the one in\r\nmales during the non-breeding phase. During the breeding phase the values increased to 1.25 ?\r\n0.09 ng/mL, which later decreased in the post-breeding phase to 0.96 ? 0.12 ng/mL.\r\nProgesterone basal levels in females during the non-breeding phase were maintained at\r\n1.80 ? 0.10 ng/mL. A significant increase (p<0.001) is seen with the onset of pre-breeding\r\nphase which continues in the breeding phase at 2.20 ? 0.13 ng/mL and 6.23 ? 0.12 ng/mL,\r\nrespectively. During the post-breeding phase the levels significantly (P<0.001) decreased to\r\n4.73 ? 0.10 ng/mL. In males, the levels of this hormone vary less during all the phases of\r\nbreeding. The progesterone titres during the non-breeding phase were 0.85 ? 0.17 ng/mL\r\nincreasing with the onset of the pre-breeding season at 1.12 ? 0.13 ng/mL and continued to rise\r\nin breeding phase at 2.76 ? 0.16 ng/mL. Later during the post-breeding phase the levels\r\ndecreased significantly 1.45 ? 0.18 ng/mL (p<0.001).\r\nConclusion. The present study reveals cyclicity in the breeding and cyclic changes taking\r\nplace in the titers of the two hormones during different phases of the breeding in both sexes.

The pathogenesis of type 1 diabetes became a history longer and longer. There are 40 years since the immunogenetic theory of type 1 diabetes has been launched. Near this anniversary a challenge of this theory was recently published. We give here our interpretation of primary cause of type 1 diabetes which must be connected with the pathogenesis of other phenotypes of diabetes which has a main similar mechanism: the β-cell dysfunction.

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