Vestibular function in panic disorder patients: a vestibular-evoked myogenic potentials and video head impulse test study.

PURPOSE: To evaluate the function of the utriculus and sacculus and their central connections by ocular and cervical vestibular-evoked myogenic potentials (oVEMPs and cVEMPs), and the function of high-frequency VOR of the semicircular canals by video head impulse test (vHIT) in patients with panic disorder (PD). METHODS: Forty-eight patients with PD (21 with agoraphobia) and 20 sex- and age-matched healthy controls took part in the investigation. The vestibulo-ocular reflex (VOR) gains and latencies and peak-to-peak amplitudes of sound-induced VEMPs were measured and compared with those of healthy controls. RESULTS: Any statistical differences in the parameters of cVEMP and oVEMP responses between both PD patients groups and between patients and healthy controls were not observed. Also, significant differences between VOR in patients and healthy controls were not found. The VOR gain, bilaterally in the three semicircular canals was within normal limits (0.8-1.2) for 67%, and higher for 33% of the patients with PD. Overt and covert saccades were not observed. The relationship between higher VOR gains and the increase of postural instability when a sensory conflict exists (standing on foam pad with eyes closed) for patients with PD was established. CONCLUSION: The VEMPs and vHIT tests demonstrated that there is no evidence of hypofunction of the semicircular canals in the high-frequency spectrum of VOR functioning. Nor are there any indications of impairment of the otolith system in patients with PD, regardless of their subjective vestibular sensations. The findings of the current study confirm the proposed link between anxiety, panic symptoms and postural instability in PD patients.

EPIDEMIOLOGICAL REGISTRY OF NEUROENDOCRINE TUMORS IN BULGARIA--A PILOT SURVEY.

The National registry of patients with neuroendocrine tumors (NET) in Bulgaria was established in 2013 as a joint initiative of the Bulgarian Surgical Society and the Institute for Rare Diseases. The register aims to explore the epidemiology of NET in Bulgaria, as well as the different diagnostic and treatment approaches for the disease throughout the country. This the first of its kind retrospective study of NET in the country is covering the period January 2012 - January 2013. A total of 127 patients with NET were identified. At the time of the survey the average age of patients with NET was 58.61 ± 15.59 years. The data show almost equal distribution between the genders with a slight predominance of women. The largest relative part of NET is those of NET located in the gastrointestinal tract (54.10 ± 4.51%), followed by those located in the pancreas (12.30 ± 2.97%) and in the lungs (10.66 ± 2.79%). In 72.44 ± 3.96% of the patients a immunohistochemical diagnosis was performed. The study confirmed the leading role of the surgery method of the NET management. In 65.83 ± 4.33% of the patients a radical removal of the tumor was conducted, while the relative part of the undertaken partial resection was 7.50 ± 2.40%. A statistically significant association between the type of surgical treatment and during the follow-up of patients was found. An update of the information in the register will allow a more precise determining of the distribution and management of NET in Bulgaria.

[A case of 11 operation because of genitourilal abnormalites and cervical carcinoma].

A case of young woman with 11 operation because of genitourinal abnormalities and cancer of the uterine cervix. The patient was with bladder exstrophy and 2nd stage cervical cancer, treated operatively and with chemotherapy. Because local recurrence she was operated 3 times. The patient died 3 years after initial treatment of the cervical cancer.

Relationship of asymmetric dimethylarginine with flow-mediated dilatation in subjects with newly detected severe hypercholesterolemia.

BACKGROUND: Little is know about the relationship between asymmetric dimethylarginine (ADMA) and percent flow-mediated dilatation (%FMD) in subjects with severe hypercholesterolemia (HH). AIM: The aim of the present study was the evaluation of the relationship of ADMA to %FMD, as well as to lipid parameters and other markers of endothelial dysfunction in newly detected subjects with severe HH. METHODS: One hundred and twenty asymptomatic patients with severe, newly detected HH and 100 controls were evaluated. The plasma level of ADMA was tested by ELISA and total homocysteine (tHcy) - through fluid chromatographic analysis. The %FMD was evaluated by the diameter of brachial artery with 7.5 MHz transducer of HP SONOS 5500. RESULTS: Significant difference was found between patients and controls, (P<0.05) regarding lipid total cholesterol, triglycerides, high-density lipoprotein, low-dencity lipoprotein, atherogenic indices) and non-lipid markers (ADMA, sICAM-1, sVCAM-1), as well as the endothelium dependent %FMD in contrast to flow independent vasodilation. (P>0.05) No significant difference was found between the groups with respect to tHcy, P-selectine and E-selectine. (P>0.05) A strong negative correlation was found between %FMD and ADMA. (r(xy) = -0.895; P<0.001), Apolipoprotein-B (r(xy )= -0.687; P<0.0001, tHcy (r(xy) = -0.560; P<0.001) and Apolipoprotein index -B/A1 (r(xy) = -0.518; P<0.001). The subsequent linear and multiple regression analysis selected ADMA as the most significant factor in relation to %FMD. CONCLUSION: It is concluded that ADMA is the basic modulator of %FMD among all tested atherogenic risk biomarkers in in newly detected subjects with severe HH.

Expression of galanin in hypothalamic magnocellular neurones of lactating rats: co-existence with vasopressin and oxytocin.

Lactation is a physiological condition known to upregulate the expression of the hypothalamic neurohormones, oxytocin and vasopressin, in the rat supraoptic and paraventricular nuclei. Other neuropeptides such as galanin are co-localized in the same magnocellular neurones and their expression has been demonstrated to be regulated by different experimental and physiological conditions. In the present study, we investigated the possible changes in galanin expression during lactation, using in situ hybridization and immunohistochemistry separately or in combination. Galanin messenger RNA concentrations decreased on day 3 of lactation in both the supraoptic and paraventricular nuclei and remained low on day 7 of lactation, but no differences were observed between control and 14-day lactating rats. In parallel, immunopositive cell bodies were almost undetectable on day 7 of lactation and immunoreactivity remained weak after 14 days of lactation, whereas galanin immunoreactive profiles in the supraoptic nucleus were more numerous than in the control group. Moreover, the subcellular distribution of immunostaining changed on day 14 of lactation. Galanin immunoreactivity was confined around the nucleus in the control females, but it became weaker and more homogenously distributed throughout the cytoplasm in the lactating rats. Electron microscopy using a pre-embedding technique confirmed that galanin immunoreactivity was no longer restricted to the Golgi complex, but was apparent throughout in the cytoplasm. Multiple labellings showed galanin and galanin messenger RNA to be co-localized with oxytocin messenger RNA in neurones of the dorsomedial part of the supraoptic nucleus during lactation. Some of those doubly labelled cells also expressed vasopressin messenger RNA in the same conditions as revealed by a triple-labelling procedure. As these co-localizations have not been observed in female control rats, lactation provided an example of a physiological condition inducing oxytocin and galanin co-synthesis in a subpopulation of magnocellular neurones. In conclusion, we have demonstrated plasticity of galanin expression during lactation in the hypothalamic magnocellular neurones. This plasticity could be caused by changes in galanin expression or in galanin processing in magnocellular neurones.

Ring chromosome 14 without deletion.

A new case of a male infant with ring chromosome 14 is reported. The G banding characteristics of early metaphase chromosomes did not reveal visible deletions in the long and short arms. The present report discusses the basic symptoms characteristic of the ring 14 chromosome and also points to a certain clinical polymorphism.

Reproductive failure in a carrier of inv dupl l(q21.4----q12).

High resolution analysis of the early metaphase and prometaphase chromosomes of the father of a child with malformations and mental retardation revealed inv dupl l(q21.4----q12). Almost the same was the aberration in the propositus but with a deletion of the band lq11.2 : 46,XX, inv dupl l(q21.4----q12)del lq11.2. This suggested that the malformations and mental retardation in the child were probably due to the microchromosome anomaly in the euchromatin, connected with the heterochromatin block in the father.