ACTA ENDOCRINOLOGICA (BUC)

Endemic goiter and primary hyperparathyroidism are two common endocrine disorders, and, consequently, they could coexist in many European countries. The prevalence of nodular goiters is increased in the patients with primary hyperparathyroidism, ranging widely between 22 to 70%, with higher prevalence in endemic goiter areas.\r\nRomania is a country having both endemic goiter and a high prevalence of vitamin D deficiency. Coexisting vitamin D deficiency is associated with more cases of symptomatic primary hyperparathyroidism or may mask a primary hyperparathyroidism, serum calcium being in the normal range.\r\nBecause of the frequent association of parathyroid adenomas with thyroid nodules, the optimal imaging combination is 99mTc-sestamibi and ultrasonography. Thyroid nodules can give false positive results at preoperative scintigraphy because they trap and retain 99mTc-sestamibi similarly as parathyroid adenomas.\r\nBilateral neck exploration (vs minimally invasive parathyroidectomy) is probably necessary in the treatment of primary hyperparathyroidism associated with nodular goiter, because nodular goiters increases the difficulty of preoperative localization of parathyroid lesion(s).

Objective: The goal of this research is to investigate whether melatonin, a circadian informant, is implicated in idiopathic oligospermia in men.\r\nSubjects and methods: 12 men (mean age 30.5 yr) with normal sexual function diagnosed with idiopathic oligospermia and 8 healthy men were included. In urine 6-sulfatoxymelatonin (aMT6s), a reliable index of melatonin secretion and gonadotropins, LH and FSH were assayed. In plasma LH, FSH, DHEA-S, 17-OH progesterone, testosterone, free testosterone, SHBG were measured at 08:00.\r\nResults: As expected, in the infertile group reproductive hormones were within normal limits but persisted low testosterone and high gonadotropins. Estimated bioavailable testosterone also showed a significant decrease (p=0.03). Evaluation of individual differences in circadian production of both melatonin and gonadotropins exhibited substantial changes in their secretion pattern from the phase shifts to loss of rhythm for aMT6s. The reduced amplitudes (p=0.04) of aMT6s were associated with a longer duration of melatonin secretion (p< 0.001) as estimated from onset/offset time and a reduced ratio between night- and daytime; the mean 24h amount of aMT6s tended to decrease at significant limit (p=0.05); no significant correlation between aMT6s and gonadotropins was observed compared with the control group. The amplitudes of gonadotropins were lower while their mean 24 h amount showed a moderate increase.\r\nConclusions: The present findings suggest that the significant increase in the duration of melatonin secretion may contribute to the imbalance of reproductive hormones that affect spermatogenesis; aMT6s, urinary metabolite of melatonin may be a sensitive predictor in circadian disorders of reproductive axis.

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Introduction. Menopause increases the risk of cardiovascular disease in women. The aims of the present study were to evaluate the effects of swimming training on cardiac histology and expression of miR-29 and IGF-1 in the ovariectomized rats. Materials and methods. Thirty female Wistar rats were divided into sham and ovariectomized groups: sedentary control (OVX) and trained with 8 weeks exercise (OVX.E). On 57th day, blood was collected and used for lipid profile measurement. In addition, heart tissue was analyzed by reverse transcription–polymerase chain reaction for IGF- 1 mRNA and miR-29, and studied for histopathological changes. Results. Ovariectomy significantly decreased miR- 29 and IGF-1 expression in the heart compared to sham animals group (p<0.05). Exercise training increased miR-29 and IGF- 1 expression in the trained rats and improved histology and lipid profile compared with OVX group (p<0.05). Conclusion. Estrogen deficiency could lead to cardiac fibrosis through deregulation miR-29 and IGF-1 expression. The findings of the current study suggests a protective effect of exercise on heart against fibrotic changes in ovariectomized rats and support a potential preventive value of exercise in improving cardiac function after menopause.

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Context. Large variations in thyroid volume (TV) have been reported in Hashimoto’s thyroiditis (HT). The need for long-term levo-thyroxine (L-T4) administration in order to control TV, as well as to normalise thyroid function, has not been well defined. Subjects and Methods. Retrospective data on TV in 94 adult women with HT were analysed in an ambulatory setting in Liguria, an area of moderate iodine sufficiency. TV was evaluated by means of ultrasonography (US). Thyroid function, anthropometric data, smoking habits and pharmaceutical drugs were registered at each examination. Results. At the baseline, an atrophic gland was noted in 16% of the women, and goitre in 13%. The women were evaluated 56 and 102 months after the baseline examination. At the time of each examination, 50%, 78% and 83% of women, respectively, were on L-T4 treatment. Baseline TV was not significantly different in women on/off L-T4 treatment. However, in those on L-T4, TV decreased significantly over the period of follow-up, while in those without L-T4 treatment, it did not change. By the end of the study, the percentage of L-T4-treated women with an atrophic gland had increased to 27%, and that of women with goitre had dropped to 6%; in untreated women, only minor changes were noted. There was a significant negative correlation between TV% change and baseline TSH levels in HT women on L-T4 treatment. Conclusion. The majority of HT women living in an area of moderate iodine sufficiency have normal TV. Moreover, long-term L-T4 treatment can be used to control TV, as well as to maintain normal thyroid parameters.

Uncontrolled chronic gout can lead to deposition of monosodium urate crystals, better known as tophi. Such depositions can involve several organ systems, including unusual locations such as the vertebrae. Nevertheless, certain complications, such as hypercalcemia, can arise because of tophi. Despite an aggressive intervention, hypercalcemia might not resolve spontaneously, as long as an ongoing inflammatory process secondary to gouty tophi is taking place. Herein, we present the case of a 62-year-old man with a long history of gouty tophi who presented for back pain and was found to have spinal cord involvement with PTH-independent hypercalcemia which only resolved with pegloticase therapy.

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Vertebrate nonapeptide neurohormones constitute an evolutionarily conserved family, involved in vital functions, such as hydro-osmotic balance regulation, reproduction and social behaviour. Two human members of this family are known, vasopressin (AVP) and oxytocin (OXT), with their highly homologous genes closely located on Chr 20p13. Presence of vasotocin (AVT) in man has been suggested, but remains controversial, and genetic evidence is lacking. AVT activity could be explained by the presence of a third distinct gene for AVT or an RNA-processing mechanism involving products of AVP and/or OXT genes. To test the first hypothesis, we developed bioinformatics and experimental approaches using genomic DNA and fetal tissues mRNAs. Family-specific primers for AVT and neurophysin were designed based on CODEHOP strategy and used in our experiments. Results of bioinformatics and genomic DNA experiments (family-specific and Alu step-out PCR) suggest there is no evidence for an AVT gene in the genome. RNA-based techniques 3?-RACE and Family-Specific Domain Restriction Fragment RTPCR provided evidence for new transcript species that could code for AVT. Further experiments will be needed to characterize them. We discuss potential mechanisms of AVT mRNA generation based on AVP and OXT mRNAs, by alternative splicing, heterologous transsplicing or RNA-editing. While all methods we developed proved feasible, current results suggest there is no AVT gene in the genome, but specific mRNAs could be present in fetal tissues. Their full characterization may potentially allow identification of vasotocin mRNA and shed light on a subject of fundamental scientific interest.