ORBITAL PSEUDOTUMOR CAN MIMIC GRAVES' OPHTHALMOPATHY.

CONTEXT: Orbital pseudotumor (OP) is a benign inflammatory process of the orbit with a large polymorphous lymphoid infiltrate, associated with fibrosis in variable amounts, localized or diffuse. Graves' ophthalmopathy (GO) is the most common cause of proptosis, unilateral or bilateral. CASE REPORT: We report a patient with unilateral proptosis who was initially treated with antithyroid drugs for an euthyroid Graves disease, but the extension of the investigation infirmed this. The MRI findings (inflammation of fat, muscle and the left lacrimal gland) in conjunction with the biopsy infirmed the initial diagnostic and confirmed the OP. CONCLUSIONS: Orbital pseudotumor is a rare disorder that can image and clinically mimics some inflammatory disease especialy Graves' ophthalmopathy. Orbital MRI represents the most important test for diagnostic. A negative TRAb in euthyroid cases of proptosis can be a serious starting point for investigating an OP.

ASSOCIATION BETWEEN LOW BONE MINERAL DENSITY, METABOLIC SYNDROME AND SEX STEROIDS DEFICIENCY IN MEN.

OBJECTIVE: To analyze the association between low bone mineral density (BMD), metabolic syndrome (MS) and sex hormones deficiency in men. METHODS: We included in this retrospective study 199 men with osteoporosis or osteopenia and 167 men with normal BMD as controls, aged between 55-85 years old. Patients' evaluation included: medical history and physical examination, X-ray of thoracic and lumbar spine, measuring BMD at hip and lumbar spine, serum glucose and lipid profile, serum levels of total testosterone (tT), free testosterone (fT) and estradiol (E2). RESULTS: The results revealed a significant association between low BMD and MS (p=0.011). Vertebral fractures were more frequently associated with MS (p=0.041). Patients with MS had lower vertebral BMD (p=0.037) and lower E2 levels (p=0.024) compared with those without MS. In men with MS, E2 deficiency can predict the value of vertebral and hip BMD. fT deficiency can predict only the value of hip BMD. CONCLUSIONS: A significant association between MS, low BMD, vertebral fractures and sex steroids deficiency, in particular E2 and fT was found. The presence of MS and sex hormones deficit can predict the reduction of BMD.

CORRELATIONS BETWEEN THE PRESENCE OF HÜRTHLE CELLS AND CYTOMORPHOLOGICAL FEATURES OF FINE-NEEDLE ASPIRATION BIOPSY IN THYROID NODULES.

INTRODUCTION: The presence of Hürthle cells (HC) in fine needle thyroid biopsy (FNAB) is a real concern for a cytologist and also for an endocrinologist. We aimed to demonstrate if the presence of HC is associated with specific cytological features in FNAB results. MATERIAL AND METHODS: This retrospective study analyzed 89 patients diagnosed with thyroid nodules, with FNAB; were two groups of patients: the study group A (HC+) (22 patients) with HC and control group B (HC-) (67 patients) with no HC; for both groups we analyzed the presence of 9 cytomorphologic features: overall cellularity, background colloid, lymphocyte infiltration, chronic inflammation, large nucleoli, small nucleoli, syncytial infiltration, nuclear pleomorphism/atypia, cellular pleomorphism. RESULTS: We found no statistical differences between age and gender. Nodules with diameter greater than 2 cm were present, more frequently in the group without HC, 43 (64.18%). The presence of HC is correlated with cellular pleomorphism (p=0.042) and nuclear pleomorphism (p < 0.0001) with no correlation between the other investigated parameters. The presence of colloid was correlated with the absence of HC (p= 0.014). In group with HC was a positive correlation with cellular pleomorphism and fibrosis. In the presence of fibrosis, HC was correlated with nuclear pleomorphism (p=0.03). In the group with HC without fibrosis there are more characteristic the sets with positive nuclear pleomorphism, positive large nucleoli and negative small nucleoli (p= 0.002). CONCLUSIONS: The presence of HC in FNAB results is associated with colloid in small amounts, associated with nodules smaller than 2 cm, correlated with cellular pleomorphism and nuclear pleomorphism. Fibrosis can be a protective feature against malignancy because cellular parameters were not significantly associated with HC except the cellular pleomorphism.

Phosphorylated cAMP response element binding protein in the mouse brain after fear conditioning: relationship to Fos production.

Phosphorylation of the cAMP response element binding protein (pCREB) triggered by associative learning was monitored immunohistochemically in different areas of the mouse brain during a 6-h interval, starting immediately after training. One trial context-dependent fear conditioning was employed as a learning paradigm. Training consisted of contextual exposure followed by shock. Control groups consisted of naïve mice, mice exposed to the context alone and mice exposed to an immediate shock in the context. For all trained mice, the time course of CREB phosphorylation in hippocampus, parietal cortex and amygdaloid nuclei exhibited a biphasic pattern. The early phase was between 0 and 30 min, and the late phase was between 3 and 6 h after training. The animals exposed to context followed by an electric shock, as well as those exposed to an immediate electric shock, exhibited significantly higher pCREB levels than the mice subjected to context alone. During the late phase, the pCREB levels were highest in the mice exposed to the context followed by shock. It was observed that CREB phosphorylation and Fos production followed different regional and stimulus-dependent patterns. It is suggested that the early phase of pCREB increase may be related to stress-related behaviors, whereas the late phase may rather relate to memory consolidation.

Persistent activation of ERK contributes to glutamate-induced oxidative toxicity in a neuronal cell line and primary cortical neuron cultures.

Oxidative stress can trigger neuronal cell death and has been implicated in several chronic neurological diseases and in acute neurological injury. Oxidative toxicity can be induced by glutamate treatment in cells that lack ionotrophic glutamate receptors, such as the immortalized HT22 hippocampal cell line and immature primary cortical neurons. Previously, we found that neuroprotective effects of geldanamycin, a benzoquinone ansamycin, in HT22 cells were associated with a down-regulation of c-Raf-1, an upstream activator of the extracellular signal-regulated protein kinases (ERKs). ERK activation, although often attributed strictly to neuronal cell survival and proliferation, can also be associated with neuronal cell death that occurs in response to specific insults. In this report we show that delayed and persistent activation of ERKs is associated with glutamate-induced oxidative toxicity in HT22 cells and immature primary cortical neuron cultures. Furthermore, we find that U0126, a specific inhibitor of the ERK-activating kinase, MEK-1/2, protects both HT22 cells and immature primary cortical neuron cultures from glutamate toxicity. Glutamate-induced ERK activation requires the production of specific arachidonic acid metabolites and appears to be downstream of a burst of reactive oxygen species (ROS) accumulation characteristic of oxidative stress in HT22 cells. However, inhibition of ERK activation reduces glutamate-induced intracellular Ca(2+) accumulation. We hypothesize that the precise kinetics and duration of ERK activation may determine whether downstream targets are mobilized to enhance neuronal cell survival or ensure cellular demise.

Possible role of Ca2+ dependent ATPase in determining the relationship between stimulation frequency and action potential duration in the myocardial fibre.

At present, action potential duration (APD) is considered to be dependent on the activation of the transient outward current. We applied a stimulation frequency (SF) pattern which was continuously and linearly increased (from the third stimulus on, every stimulus was applied 40 ms earlier than the previous one). Our previous results (Stanciu and Stanciu, 1995) have shown both a decrease of APD--in the interval between 0.5 Hz and 2 Hz, and in the one between 4 Hz and 8 Hz, and an increase of APD--in the interval between 2 Hz and 4 Hz. Triiodothyronine, which stimulates Ca2+ dependent ATPase, has positive effects on APD for all SF, ranging from 0.5 Hz to 6 Hz. On the contrary, increasing the pH value (from 7.4 to 8.6), which prevents Ca2+ binding to membrane proteins, determines a decrease of APD for the same SF levels. Therefore, we advance the assumption that there should be some attached protein molecules, having a role in Ca2+ storage, on the external side of the sarcolemmal membrane. In this case, it is the sarcolemmal Ca2+ dependent ATPase which performs the loading of those stores. The loading up to saturation state is accomplished during a time lapse that depends on the working rate of the Ca2+ dependent ATPase. The premature occurrence of a stimulus finds the store only partially loaded with Ca2+, which may explain the decrease in APD associated with the increase in SF. The continuous and linear increase of SF results in a high internal Ca2+ concentration and--consequently--in the stimulation of Ca2+ dependent ATPase. That explains the APD increase for SF ranging between 2 Hz and 4 Hz. The same pattern of SF increase (continuos and linear), but using frequencies higher than 4 Hz, results in an overflow of the maximal operating capacity of the Ca2+ dependent ATPase and also in the reduction of APD amplitude.

The block of central vasopressin V1 but not V2 receptors suppresses grooming behavior and hypothermia induced by intracerebroventricular vasopressin in male rats.

The role of central vasopressin V1 receptors in grooming behavior induced by vasopressin and oxytocin was studied in male rats of the Wistar strain. The intracerebroventricular (ICV) injection of vasopressin (3 micrograms/5 microliters) induced hypothermia and enhanced novelty-induced grooming behavior. Enhanced grooming but not hypothermia was also induced by ICV injection of oxytocin (3 micrograms/5 microliters). The central administration of a selective vasopressin V1 receptor antagonist prevented the stimulating action of vasopressin on novelty-induced grooming and its hypothermic effect. The ICV injection of a selective vasopressin V2 receptor antagonist failed to affect vasopressin-induced grooming and hypothermic effect. An increase in core temperature was observed in oxytocin-injected animals pretreated with the vasopressin V1 receptor antagonist. Furthermore, pretreatment with the antagonist did not affect grooming induced by oxytocin. These results suggest that enhancement of grooming behavior and influence on thermoregulation are differently regulated by central receptors for vasopressin and oxytocin.

Ethyl alcohol and dilative cardiomyopathy.

The ethanol-induced dilative cardiomyopathy has a complex clinical and paraclinical picture because of the direct action of the alcohol and the indirect action of its metabolites on human myocardium and neuroendocrine system. Ventricular arrhythmias, atrial arrhythmias, and heart failure are significant and show a great sensitivity of the conduction system. Working myocardium is also affected, which is proved by the impaired systolic and diastolic function of the heart and by the nitroglycerine-resistant isovolumetric relaxation time.

MRI of intracranial subependymomas.

OBJECTIVE: We report imaging features of two cases of subependymoma, a relatively rare benign intraventricular neoplasm. MATERIALS AND METHODS: The first case was a lateral ventricular tumor, which grew to a large size before becoming symptomatic. The second case was a fourth ventricular subependymoma with extensive cisternal spread. RESULTS: In Case 1, absence of postcontrast enhancement suggested the correct diagnosis. However, in Case 2 heterogeneous enhancement made the diagnosis uncertain. In both cases, pre- and postoperative MRI was superior to other modalities in defining tumor extent and delineating the surrounding anatomy. CONCLUSIONS: Magnetic resonance imaging is the modality of choice for studying subependymomas. The diagnosis should be placed among differential considerations for intraventricular tumors.

The "involuntary postcontraction" mechanism or the postcontractile elastic restitution.

Unquestionable experimental proofs are brought forward in support of the non-cortical origin of "involuntary postcontraction". The mechanism of this phenomenon is purely passive and it originates in the elastic component of the muscular organ. Far from inducing the postcontractile event, cortical induction brakes it. The results obtained up to now enable the authors to consider that the analysis of postcontraction provides quantifiable information of great practical importance on the type and momental functional state of human nervous system.