Struma ovarii complicating pregnancy. Case report and literature review.

A 19-year-old woman at 12th week of pregnancy was referred to our hospital with severe acute abdominal pain, nausea and vomiting. Patient's abdomen was untreatable. Routine examinations, except neutrophilic leukocytosis, were normal. Ultrasound imaging showed the presence of intrauterine pregnancy corresponding to amenorrhea and a right complex ovarian mass, with well defined margins without papillary projection, 14x12 cm in diameter. No free fluid was evident. Due to untreatable abdomen and suspecting torsion of the ovarian tumor the patient underwent laparotomy under general anesthesia. The pregnant uterus was normal. The right ovary had increased volume for a cystic-solid mass of the size of 14 cm with smooth surface and twisted on the vascular peduncle. A right adnexectomy was performed. Intraoperative frozen section was negative for malignancy and postoperative histological examination revealed a struma ovarii without atypia of the follicular cells. Postoperative course was normal. The patient was discharged after three days and she delivered at term a normal baby. Mostly struma ovarii represents an incidental finding during cesarean section, but in rare case it may be cause of complications such as torsion, rupture, hypertiroidism and rarely may be a malignant tumor. The AA describe literature data on struma ovarii diagnosed in pregnancy.

[Clinical effects of treatment with phytoestrogens in postmenopausal women]. / Effetti clinici del trattamento con fitoestrogeni in donne in post-menopausa.

AIM AND METHODS: Phytoestrogens are plant substances that have estrogenic properties; they haven't steroid structure but they are heterocyclic phenols and for this reason are similar to 17 ß estradiol from the functional and structural point of view; they compete for the same receptor sites of endogenous estrogens, but with an activating capacity a thousand times lower. For this reason, the isoflavones are an alternative to hormone-replacement treatment: they are prescribed to all those women who cannot be treated with HRT for several contraindications, such as thrombosis or breast tumor familiarity. The aim of our study was to demonstrate the effectiveness of soy isoflavones on menopausal symptoms. RESULTS AND CONCLUSION: In our experience, literature data were confirmed, with a 40% reduction of the vasomotor symptoms after 6 months of treatment. Associated with this improvement, there is also the reduction in the degree of insomnia and depressive symptoms. The musculoskeletal pains, however, are not reduced significantly as no positive change was found on vaginal dryness, a major cause of dyspareunia in postmenopausal period.

Metabotropic glutamate receptors 1 and 5 differentially regulate CA1 pyramidal cell function.

The activation of group I metabotropic glutamate receptors (mGluRs) produces a variety of actions that lead to alterations in excitability and synaptic transmission in the CA1 region of the hippocampus. The group I mGluRs, mGluR1 and mGluR5, are activated selectively by (S)-3,5-dihydroxyphenylglycine (DHPG). To identify which of these mGluR subtypes are responsible for the various actions of DHPG in area CA1, we took advantage of two novel subtype-selective antagonists. (S)-(+)-alpha-amino-a-methylbenzeneacetic acid (LY367385) is a potent competitive antagonist that is selective for mGluR1, whereas 2-methyl-6-(phenylethynyl)-pyridine (MPEP) is a potent noncompetitive antagonist that is selective for mGluR5. The use of these compounds in experiments with whole-cell patch-clamp recording and Ca(2+)-imaging techniques revealed that each group I mGluR subtype plays distinct roles in regulating the function of CA1 pyramidal neurons. The block of mGluR1 by LY367385 suppressed the DHPG-induced increase in intracellular Ca(2+) concentration ([Ca(2+)](i)) and the direct depolarization of CA1 hippocampal neurons. In addition, the increase in the frequency of spontaneous IPSCs (sIPSCs) caused by the DHPG-induced depolarization of inhibitory interneurons also was blocked by LY367385, as was the DHPG-induced inhibition of transmission at the Schaffer collateral-->CA1 synapse. On the other hand, the block of mGluR5 by MPEP antagonized the DHPG-induced suppression of the Ca(2+)-activated potassium current (I(AHP)) and potentiation of the NMDA receptor. Finally, antagonism of the DHPG-induced suppression of evoked IPSCs required the blockade of both mGluR1 and mGluR5. These data suggest that mGluR1 and mGluR5 play distinct roles in the regulation of the excitability of hippocampal CA1 pyramidal neurons.