ACTA ENDOCRINOLOGICA (BUC)

Introduction. The pituitary gland serves as the center of the endocrine system. Stem cells are typically found in a specialized microenvironment of the tissue, called the niche, which regulates their maintenance, self-renewal, fate determination, and reaction to external influences. The aim of this study is to elucidate the role of stem cells in the initiation, invasion, and progression of pituitary adenomas. Materials and methods. All specimens were collected between January 2007 and April 2015. Radiological classification (invasiveness) for all cases was performed according to the Wilson-Hardy classification system. Immunohistochemical staining was performed to all specimens for CD133, Oct4, Sox2 and nestin. Results. The study included 48 patients. Of 48 patients, 17 (35.4%) were male and 31 (64.6%) were female. Mean age is 47.10±14.14 (17–86 yrs.). According to the Wilson-Hardy classification system, 27 (56.3%) were noninvasive adenomas. There was no statistical significance between the expression of pituitary stem cell markers (CD133, OCT4, SOX2, nestin) and invasiveness. Conclusion. All stem cell markers are stained extensively in pituitary adenomas, except for SOX2 which was stained weakly. However, there is no effect of stem cells on invasiveness of pituitary adenomas because we cannot find a difference of the staining level between invasive and non-invasive adenomas. Nestin was stained extensively in functional adenomas, especially for GH, PRL, and gonadotropin secreting adenomas. SOX2 was stained extensively for ACTH-secreting adenomas.

Context. Exercise and anabolic steroids are anticipated to promote fat mass reduction and so to decrease the number of comorbidities related to excessive weight. Objective. The aim of this study was to verify the influence of aerobic exercise and the use of steroids on the accumulation of adipose tissue and on the biochemical limitations of Wistar rats nourished by a hypercaloric diet. Methods. Forty, young male Wistar rats were split into four groups: obese control (n=10), obese under treatment (n=10), obese under aerobic exercise (n=10) and obese under aerobic exercise and treatment (n=10). All animals were fed with a hypercaloric diet and animals under treatment received intramuscular testosterone. Body (weight and visceral fat) and blood (lipidogram, glucose, and liver enzymes) parameters were assessed. Results. The group treated with aerobic exercise and testosterone revealed a reduction in body weight and visceral, perirenal, retroperitoneal and epididymal fats, accompanied by the blood levels of glucose, lactate, LDLcholesterol, HDL-cholesterol, and lactate dehydrogenase; following high-intensity physical activity. Conclusion. The results support the theory that the combination of steroids and physical activity reduces the side-effects of androgenic-anabolic hormones and conveys benefits to some constraints

Context. Ghrelin, in both its acylated and desacylated forms, and leptin can modulate fetal energy balance and development. Objective. The aim of our study is to assess desacylated ghrelin (DAG) and leptin values and influence on intrauterine and postnatal growth in infants with intrauterine growth restriction. Design, subjects and methods. We performed a prospective study on 39 infants recruited over five months, 20 appropriate - for - gestational - age (AGA) infants and 19 small-for-gestational-age (SGA) infants, in which we measured DAG and leptin in the umbilical cord blood and we compared their respective values between the two groups, along with auxological parameters at birth and at 10 months of postnatal age. Results. Our results show that both DAG and leptin have lower values in SGA infants and correlate with most of the anthropometrical parameters at birth. Both hormones correlate with weight at 10 months in SGA infants, but this correlation lacks in AGA infants. Whereas DAG in the cord blood can be considered a predictor for weight at 10 months (β=0.207, p=0.001), the same cannot be stated about leptin (β=0.078, p=0.195). Conclusion. DAG and leptin are involved in both intrauterine and postnatal development, but the extent of their role is still to be determined.

Background. The potential measures of preventing environmental pollutants-induced reproductive toxicity in mammals require adequate investigations. \r\nAim. The protective role of vitamin C against gasoline vapors?induced reproductive toxicity was assessed in male rats. \r\nAnimals and Methods. Vitamin C (200mg/kg body weight) was daily administered orally to albino Wistar rats concomitantly exposed to 17.8cm3h-1m-3 of Premium Motor Spirit (PMS) blend unleaded gasoline vapors(UGV) for 6 hr/day, 5days/week for 10 weeks. \r\nResults and Discussion. No significant changes (P ≥ 0.05) in the serum FSH and LH levels were observed to be associated with exposure to UGV. However, the results showed that UGV caused a significant decrease (P ≤ 0.05) in serum testosterone level and distortions in the architectural structure of the testicular tissues in male rats, compared to the control. This suggests that the gonads may be the target tissue of interaction for UGV reproductive toxicity in male rats. Also, treatment of the exposed rats with vitamin C was observed to produce a significant increase in the level of serum testosterone to a mean value within the range obtained for the control. Moreover, the distorted architectural structure of the testicular tissues observed to be associated with exposure to UGV was significantly prevented by the administration of vitamin C. \r\nConclusion. These observations indicated that vitamin C can be effective in the protection of UGV-induced reproductive toxicity in male rats.

Context. The androgen/androgen receptor interaction plays a critical role in the development of the male genital system, and investigations around these receptors can expand our knowledge about mechanisms of some male abnormalities such as hypospadias. Objective. In the present study, the expression of androgen receptor (AR), fibroblast growth factor-10 (FGF10), and fibroblast growth factor receptor-2 (FGFR2) genes were investigated in prepuce tissue of healthy and hypospadic children. Design. It was a case-control study with follow-up about up to eight months after operation. Subjects and Methods. Patients’ tissue samples (n=20) and controls tissue samples (n=20) were collected after surgery and circumcision. After RNA extraction and cDNA synthesis, the Real time PCR was performed to evaluate and compare the levels of gene expressions. Both groups were checked until eight months after surgery. Results. The results showed that FGFR2 gene expression had significantly decreased in prepuce tissue of patients compared with healthy children (p-value <0.05). Patients and healthy children follow up showed that 20% of hypospadic patients who needed reoperation had AR gene upregulation along with FGF10 and FGFR2 downregulation. Conclusions. Taken together, interestingly, FGF10/ FGFR2 signaling has an important role in external genital system development and wound healing process.

Objective. We analyzed the correlation between glycemic variability and psychological problems such as depression, anxiety disorder, and low self-esteem in pregnant and non-pregnant (excluding gestational diabetes) patients with diabetes. Besides its originality, this study might contribute to better / earlier diagnosis of these psychological conditions, with a special interest in pregnant diabetic women. Better management and cost reduction of care could be a consequence. Methods. We compared diabetic pregnant and non-pregnant women from the perspective of the glycemic variability (for a period of 15 days prior inclusion in the study) and their results on the standardized questionnaires: Beck depression inventory, Hamilton anxiety scale – HRSA, Rosenberg self-esteem test. Results and Conclusions. A statistically significant correlation was identified in both groups between the glycemic oscillation and depression, anxiety, and low selfesteem. Diabetic pregnant women had a higher statistical significance for the correlation between the glycemic oscillation and depression, as well as between the glycemic oscillation and anxiety than non-pregnant diabetic patients. The present data justify further research. Our results could be developed into a preliminary intervention protocol, using the daily glycemic values measurements, collected by patients.

Introduction. Pheochromocytoma is a rare clinical finding during pregnancy. Due to the variable clinical presentation it may be mistaken for preeclampsia or primary hypertension. The early antenatal diagnosis is crucial, because it reduces possible maternal and fetal complications. Pheochromocytomas are usually benign, but may also present as or develop into a malignancy. Malignancy requires evidence of metastases at non-chromaffin sites distant from that of the primary tumor. Large tumor size and malignant disease are not necessarily associated. Case. The patient, a 39 years old multipara presented at 30 weeks of gestation with labile hypertension, headache and palpitations. She had a 6 years history of chronic hypertension controlled during the pregnancy with methyldopa. Using this treatment blood pressure was maintained at 140/100 mmHg. Further biochemical and radiological investigations confirmed the diagnosis of pheochromocytoma. The patient was invasively monitored and treated with alpha-adrenoblockers. Childbirth was performed by elective cesarean section at 34 weeks with simultaneous right-sided adrenalectomy. Postoperative period was uneventful. Histological examination of 12 cm encapsulated tumor revealed trabecular type pheochromocytma with focal capsular invasion. Although the usual criteria for malignancy, such as mitotic activity, nuclear pleomorphism, are not suitable to discern benign from malignant pheochromocytomas, we considered this large tumor presumably malignant in order to provide systematic longterm follow-up. Postoperative biochemical and imagistic screening was planned to detect and treat local recurrence or metastatic tumors. Conclusions. A multidisciplinary team to diagnose and treat pheochromocytoma during pregnancy is mandatory. Careful postoperative monitoring of recurrent disease is necessary indefinitely.

Aims: Prolonged exposure to a glucocorticoid excess leads to cognitive impairment in experimental animals as well as humans. The present study tries to identify the cognitive deficits in patients with Cushing’s syndrome and to evaluate the possible residual deficits in patients after treatment. Materials and methods: 19 patients (women) with a history of chronic endogenous hypercortisolemia were investigated for etiology using clinical and biochemical criteria. Cognitive functions were evaluated using a battery of psychometric tests: the Rey Auditory Verbal Learning Test (RAVLT), the BCR2 battery for general intellectual potential and the Prague test, for divided attention and resistance to psychic fatigue. The patients were divided into two groups (before surgical treatment– Cushing and after surgical treatment – postCushing) without differences in age or duration of studies between groups (p = ns). The controls were considered to belong to the general population for which the psychometric tests were standardized. Results: Both groups showed an altered pattern of incremental learning - scores below standard in the last two trials of the RAVLT (one sample t test, one tailed, p<0.05), and the total score (p<0.05 for PostCushing, p=0.07 for Cushing); both had very low total scores in the battery for intellectual potential. The PostCushing scores were significantly better than those of the Cushing group for only one nonverbal test (complex perceptual analysis), p<0.02. There appears to be no significant effect of cortisol exposure on distributive attention; there is however an alteration in the resistance to psychic fatigue. Daily average cortisol exposure was positively correlated with the number of errors in learning for both groups (r=0.65, p=0.058 for Cushing; r=0.85, p<0.005 for PostCushing) Duration of illness was negatively correlated with the total learning score in the PostCushing group (r=-0.68, p<0.05). For the Cushing group there was a strong negative correlation between the duration of illness, general performance (r=-0.81, p<0.05) and verbal scores (r=-0.77, p<0.07).

Context. Polycystic ovarian syndrome is the most common endocrine disorder in women of reproductive age. Objective. The purpose of the present study is to investigate the role of progesterone on survival, in vitro growth and in vitro maturation of follicles and the maturation of oocytes derived from mouse polycystic ovary. Subjects and Methods. To induce polycystic ovary (PCO) female NMRI mice 21 days old were injected daily with testosterone enanthate 1 mg/100g body weight dissolved in sesame oil for 4 weeks (PCO group), while non- PCO group were injected only with vehicle. Follicles were derived from both groups and cultured in MEM-α medium either with progesterone or without progesterone. Sizes of follicles were measured in days 1, 3, 6, 9 and 12. After 12 days follicles were transferred to mature medium, follicles from two groups were cultured for 24 and 48 h and the in vitro maturation of oocytes was assessed. Results. In PCO groups with progesterone, survival and in vitro growth of follicles, significantly increased as compared with PCO groups without progesterone (p<0.05). The in vitro maturation rate in PCO group with progesterone was significantly higher than in those not treated by progesterone (p<0.05). Conclusions. This study demonstrated that progesterone can improve survival, in vitro growth and in vitro maturation of follicles derived from mouse polycystic ovary.