International Journal of Endocrinology and Metabolism
Volume:9 Issue: 2, Mar 2011

Parathyroid adenomas account for most cases of primary hyperparathyroidism. Parathyroid adenomas rarely attain huge proportions and since they are usually small in size, preoperative localization using sestamibi scanning or ultrasonography is required to avoid unnecessary bilateral neck exploration. We report herein the case of a 47 year old woman who was diagnosed as having a parathyroid tumor after she presented with bone pain. Detected by clinical findings, ultrasonography and parathyroid scintigraphy by 99m Tc-MIBI, her tumor was found to be a huge adenoma of the parathyroid, measuring 5.5×3.5×2 cm and weighing approximately 30 grams. This size and weight of tumor is a very rare finding in parathyroid adenomas, and deserves documentation

Pituitary diseases are often associated with changes in quality of life. Hypopituitarism and radiotherapy may negatively affect quality of life, causing depression and anxiety and resulting in cognitive disorders. To comparatively evaluate cognitive function and quality of life in patients with pituitary adenomas who developed hypopituitarism after surgery, with or without radiotherapy.Patients and Out of a total of 36 patients enrolled in the study, 25 (70%) received conformal radiotherapy as an adjuvant treatment. The mean age was 47 ± 13 years in the radiotherapy group and 48 ± 12 years in the non-radiotherapy group. All the patients had hypopituitarism and had undergone hormone replacement therapy, with the exception of the growth hormone, for the entire axes. Tests to assess cognitive function, anxiety, depression, and quality of life were performed on an outpatient basis. There were no differences between the groups, with respect to gender, educational level, and presence of deficit in the adrenal, gonadal, somatotropic, or thyroid axis. Mean time since surgery and that since radiotherapy was 10 ± 5 years and 10 ± 6 years, respectively. All the patients had some degree of anxiety and depression on the basis of their Beck Anxiety and Depression Inventory scores. There was a trend toward greater depression severity in the group undergoing radiotherapy (p = 0.058). With respect to the health-related quality of life, a significant difference was detected in social relationships, with lower scores observed in the radiotherapy group. Irradiated hypopituitary patients showed impairment in the social relationship aspect of their quality of life and greater depression severity.

Cardiovascular disorders constitute the major causes of morbidity and mortality among diabetic patients. The effect of chronic sesamolin administration was studied on aortic reactivity of rats with streptozotocin (STZ)-induced diabetes One week after induction of diabetes, male rats received sesamolin for 7 weeks. The contractile responses to KCl and phenylephrine (PE) and the relaxation response to acetylcholine (ACh) were measured in aortic rings. The maximum contractile response to PE of endothelium-intact aortic rings was significantly lower in sesamolin-treated diabetic rats than in untreated diabetic rats. Removal of the endothelium from the aortic rings abolished this difference. The endothelium-dependent relaxation response to ACh was significantly higher in sesamolin-treated diabetic rats than in untreated diabetic rats. Pretreatment of aortic rings with the nitric oxide synthase inhibitor N(G) -nitro-L-arginine methyl ester (L-NAME) significantly attenuated the observed response. A 2-month course of diabetes also resulted in elevated malondialdehyde (MDA) and decreased superoxide dismutase (SOD) activity; sesamolin treatment reversed the increased MDA level and reversed the reduced SOD activity We conclude that chronic treatment of diabetic rats with sesamolin can prevent abnormal changes in vascular reactivity via nitric oxide regulation and attenuation of oxidative stress in aortic tissue. Furthermore, endothelial integrity is necessary for sesamolin’s beneficial effect.

We wished to assess bone mineral density (BMD) values and factors that contribute to bone mineral accrual among preschool children in Sri Lanka. Currently, this information is not available. To measure BMDs of spine and hip, using a central-type DXA, in a representative sample of preschool children in Southern Sri Lanka and to study their anthropometry and micronutrient status in order to study the associations of such measurements with bone mineral status.Patients and We measured BMD of the spine and hip using dual-energy absorptiometry in 105 preschool children (52 boys) aged 3–5 years in Southern Sri Lanka. We also studied their anthropometric characteristics and micronutrient status (iron, zinc, calcium, ceruloplasmin, free thyroxine, and vitamins A and D). Although spine BMD showed no sex difference (mean BMD 0.451 g/cm2 and 0.447 g/cm2 in boys and girls, respectively; p = 0.70), proximal femur BMD values were significantly higher (p = 0.02) among boys (0.594 g/cm2) than among girls (0.557 g/cm2). Boys had significantly higher bone area in the spine, compared to girls (mean 25.58 vs. 24.05 cm2; p = 0.02). After controlling for other independent variables studied (anthropometry and biochemistry), weight and serum calcium accounted for 26% of the BMD variation (R2 = 0.26). One unit change in body weight (1 kg) or serum calcium level (1 mmol/L) was associated with a change in spine BMD of 0.051 g/cm2 or 0.016 g/cm2, respectively. In addition to higher BMD in the proximal femur boys have broader bones, particularly in the spine. Among different indices of body measurements and multiple nutritional factors, body weight and serum calcium appear to be the main determinants of BMD accrual.

Pheochromocytoma develops in 0.1–0.5% of the hypertensive population between the ages of 30–50 years and is classically characterized by either sustained or paroxysmal hypertension, flushing, sweating, palpitations, and severe anxiety.

To demonstrate the safety and usefulness of bilateral adrenal venous sampling (BAVS) in patients with pheochromocytoma, but with negative imaging resultsPatients and

We used BAVS with glucagon stimulation (1 mg, IV bolus) and measured stimulated fractionated catecholamines (norepinephrine [NE] and epinephrine [EPI]).

We performed BAVS with glucagon stimulation on 41 patients who presented with signs and symptoms highly suggestive of the presence of pheochromocytoma, and also had equivocal imaging results. Twenty patients were diagnosed with unilateral pheochromocytoma. The minimum predictive cut-off value for the EPI ratio of affected vs. unaffected sides in diagnosing a unilateral pheochromocytoma was 6.8 (sensitivity; 88.9%, specificity, 87.5%, P = 0.001). The minimum predictive cut-off value for the norepinephrine (NE) ratio of affected vs. unaffected sides was 3.8 (sensitivity; 90%, specificity; 81.2%, P = 0.001). The 2-min post glucagon-stimulated levels of affected versus unaffected adrenals were: EPI; 29,162 ± 8,756 vs. 1,136 ± 546 pg/ml (ratio = 25.7) and NE; 7,156 ± 1,399 vs. 760 ± 228 pg/ml (ratio = 9.4). The EPI:NE ratio on the affected side was significantly higher (4.1 vs. 1.5, P < 0.001). During the follow-up period, patients who did not require post-operative medication were those who had a shorter duration of hypertension (4.8 ± 3 vs. 10 ± 10.8 years).

BAVS with glucagon stimulation is a safe and useful approach for early diagnosis of pheochromocytoma.

Chamomile plant extracts contain phytoestrogen compounds. These compounds act as agonist or antagonist estrogen receptors and as aromatase enzyme inhibitors, thus affecting the level of steroid hormones. In traditional medicine, chamomile is used to relieve menstrual pain and as a housing drug. The aim of this study was to investigate the effects of a hydroalcoholic extract of Matricaria chamomilla flowers on the pituitary-gonadal axis and on the ovaries of rats. In the present study, 45 female Wistar rats were divided into 5 groups of 9: the control, sham, and experimental groups I, II, and III; rats in the experimental groups I, II, and III received intraperitoneal injections of 10, 20, and 40 mg/kg of a hydroalcoholic extract of chamomilla flowers for 14 days, respectively. Twenty-four hours after the last treatment, blood samples were obtained from the heart, centrifuged, and then the sera were evaluated for determining the concentration of gonadotropins, estrogen, and progesterone by radioimmunoassay. In addition, the ovaries were removed and fixed, and ovarian sections were studied stereologically. No significant changes in body weight were detected for the different groups, except experimental group III, which showed a decrease. Furthermore, varying the amount of chamomilla extract had no effect on the amount of the luteinizing hormone and follicle-stimulating hormone. In experimental group I that received 10 mg/kg chamomilla extract, the serum concentration of estrogen showed a significant decrease, while that of progesterone showed a meaningful increase. The mean number of secondary follicles and corpora lutea were not significantly different for the different groups, but a significant decline was observed in the mean number of primary and graafian follicles in the experimental group treated with 20 and 40 mg/kg hydroalcoholic extract of the chamomilla flower. The phytoestrogen present in the hydroalcoholic extract of chamomilla causes a decrease in the serum level of estrogen.

hCG is a generic name for 5 biologically active molecules that share a common α and ß-subunit amino acid sequence. These 5 molecules have key biological function in human pregnancy and human cancer. This review examines these molecule in detail. These 5 molecules, hCG, sulfated hCG, hyperglycosylated hCG, hCG free ß and hyperglycosylated free ß are produced by placental syncytiotrophoblast cells and pituitary gonadotrope cells (group 1), and by placental cytotrophoblast cells and human malignancies (group 2). Group 1 molecules are both hormones that act on the hCG/LH receptor. These molecules are central to human menstrual cycle and human pregnancy. Group 2 molecules are autocrines that act by antagonizing a TGFß receptor. These molecules are critical to all advanced malignancies.The hCG groups are molecules critical to both the molecules of pregnancy or human life, and to the advancement of cancer, or human death.

Muscle infarction is an uncommon complication of long-standing diabetes mellitus. Here, we report the case of a 62-year-old diabetic male patient with acute pain and swelling of the right thigh with signs of mild inflammation but no evidence of infection or myopathy. Initial magnetic resonance imaging (MRI) revealed diffuse swelling and edema of quadriceps muscles with blurred margins. The clinical symptoms showed significant improvement after 1 month of symptomatic treatment. Follow-up MRI performed after 3 months showed remarkable improvement in inflammatory changes with mild residual swelling and edema of the vastus lateralis muscle. In the absence of any systemic signs of infection and laboratory diagnostic markers, the detection of typical features such as hyperintense signal on T2 weighted images or hypo- to isointense signals on T1 weighted images, without localized fluid collection, remains the most useful investigative tool for diagnosing diabetic muscle infarction and obviates the need for invasive procedures like muscle biopsy. Diabetic muscle infarction is a rare complication with distinct clinical presentation, laboratory findings, and MRI features, and can be resolved over a period only by administering adequate supportive treatment. Clinicians should be aware of this complication and always consider it in the differential diagnosis of diabetic patients presenting with acute onset of pain and swelling of the extremities.