Precise long-range migration results from short-range stepwise migration during ring gland organogenesis.

Many organs are specified far from the location they occupy when functional, having to migrate long distances through the heterogeneous and dynamic environment of the early embryo. We study the formation of the main Drosophila endocrine organ, the ring gland, as a new model to investigate in vivo the genetic regulation of collective cell migration. The ring gland results from the fusion of three independent gland primordia that migrate from the head towards the anterior aorta as the embryo is experiencing major morphogenetic movements. To complete their long-range migration, the glands extend filopodia moving sequentially towards a nearby intermediate target and from there to more distal ones. Thus, the apparent long-range migration is composed of several short-range migratory steps that facilitate reaching the final destination. We find that the target tissues react to the gland's proximity by sending filopodia towards it. Our finding of a succession of independent migration stages is consistent with the stepwise evolution of ring gland assembly and fits with the observed gland locations found in extant crustaceans, basal insects and flies.

Frecuencia de Patologías Tiroideas con Tratamiento Quirúrgico / Frequency of Thyroid Diseases with Surgical Treatment

Introducción: La cirugía desempeña un papel fundamental en el tratamiento de las afecciones de la glándula tiroides. Tener noción de la frecuencia real de sus diferentes patologías en la población a la que se le brinda atención en salud es de gran importancia para el buen manejo médico-quirúrgico. Objetivo: Determinar la frecuencia de patologías tiroideas con tratamiento quirúrgico en el Servicio de Cirugía General del Hospital Central "Dr. Emilio Cubas" del Instituto de Previsión Social, de enero de 2008 a diciembre de 2013. Metodología: Estudio retrospectivo, observacional descriptivo de corte transversal, basado en datos secundarios colectados de las historias clínicas, fechas operatorias e informes de anatomía patológica. Resultados: El 2,1% correspondió a patología tiroidea, promedio de 104,5 casos/año, estadía hospitalaria de 3,4 días, predominio del sexo femenino 15:1 y un rango mayor de presentación a los 41-50 años. El 67,3% procedió de las Regiones Sanitarias: Central y Distrito capital. El motivo de consulta más frecuente (77,2%) fue por el aumento de la glándula tiroides. La distribución por agrupación histopatológica fue: Bocio (60,0%), Cáncer (22,8%), Autoinmunes (9,4%) y Adenoma (7,8%). La Tiroidectomía Total (41,8%) fue la técnica quirúrgica más empleada. Conclusión: Las patologías tiroideas con tratamiento quirúrgico fueron más frecuentes en mujeres. La mayor parte procedió del Departamento Central del Paraguay. El Bocio Coloide Multinodular es la patogenia más frecuente entre las Patologías Benignas y el Cáncer Papilar en las Patologías Malignas. Existe un aumento progresivo de casos quirúrgicos tiroideos por año. La Tiroidectomía Total es la técnica más utilizada como tratamiento quirúrgico. La estancia hospitalaria es elevada. Palabras clave: Epidemiología - Glándula Tiroides -Patología Quirúrgica - Tiroidectomía - Paraguay

Introduction: Surgery plays a fundamental role in the treatment of the thyroid glands diseases. Knowing the actual frequency of its different diseases in the population receiving health care service is of great importance in order to offer a proper medical and surgical treatment. Objective: Determine the frequency of thyroid diseases with surgical treatment in the Department of General Surgery, at the Central Hospital "Dr. Emilio Cubas" of the Institute of Social Security, from January 2008 to December 2013. Methodology: A retrospective, observational, descriptive, cross-sectional study of secondary data collected from medical records, surgery records and pathological anatomy reports. Results: Thyroid disease represented 2,1% of the surgeries, averaging 104,5 cases/year, 3,4 days of hospitalization, 15:1 female predominance and a higher incidence at ages 41-50. 67,3% of cases were from the Central and Capital District Health Regions. In 77,2% of cases, the reason for consultation was the enlargement of the thyroid gland. The distribution by histopathological groups was: Goiter (60,0%), Cancer (22,8%), Autoimmune Disease (9,4%) and Adenoma (7,8%). Total Thyroidectomy was the preferred surgical technique (41,8%). Conclusion: Thyroid diseases with surgical treatment are more common in women. Most patients come from the Central Department of Paraguay. Multinodular colloid goiter is the most common pathogenesis among the benign diseases, and papillary cancer among the malignant ones. There is a steady increase in thyroid surgical cases per year. The total thyroidectomy is the most frequently used surgical treatment. The hospitalization period is elevated. Keywords: Epidemiology - Thyroid Gland ­Surgical Pathology- Thyroidectomy - Paraguay

Diagnóstico e tratamento das massas adrenais clinicamente silenciosas - revisão sistemática de literatura / Diagnoses and treatment of clinically unapparent adrenal masses - systematic literature review

Introdução: Massas adrenais clinicamente silenciosas, diagnosticadas sem intenção, incidentalmente, durante exame de imagem realizado para outras condições clínicas ("incidentaloma") têm sido cada vez mais encontradas devido ao constante progresso dos métodos de imagem e de sua indicação relativamente elástica. São inúmeras as causas, diagnósticos e tratamentos dessas massas, levando o médico a definir se a massa é hormonalmente ativa e se há risco de a lesão ser maligna. Entretanto os métodos para esclarecimento dessas questões ainda não estão bem definidos. Objetivo: Avaliar as melhores formas de diagnóstico, tratamento e seguimento da lesão incidental de adrenal. Método: Foi realizada uma revisão sistemática da literatura até outubro de 2004, analisando seu grau de evidência. Resultados: Foram encontrados dois trabalhos de revisão sistemática que selecionaram e estudaram artigos até setembro de 2003 e, então, adicionados ao estudo mais 28 artigos provenientes de revisão bibliográfica sistemática até outubro de 2004. Conclusões: Em geral os "incidentalomas" são não funcionantes, mas a avaliação endócrina demonstrou que não é raro o achado de hiperfunção hormonal subclínica, reforçando a necessidade de dosagem de certas substâncias, como metanefrinas, realização do teste de supressão de dexametasona em baixas dosagens e mensuração da relação da aldosterona plasmática/atividade plasmática da renina. "Incidentalomas" não funcionantes menores de 4cm devem ser observados entre 4 e 6cm devem ser analisados por suas características de imagem maiores de 6 cm devem ser operados. "Incidentalomas" funcionantes devem ser submetidos à adrenalectomia. Massas adrenais não operadas devem ser acompanhadas por dois anos, por meio de exames de imagem e de função.

Management of neonatal endocrinopathies--best practice guidelines.

Neonatal emergencies are uncommon, but may lead to significant morbidity and mortality if not recognised and managed promptly. Disorders of sex development, hypoglycaemia, thyrotoxicosis and calcium balance are discussed, with emphasis on the clinical assessment, investigations and management of these disorders in the acute setting.

Experimental designs to assess endocrine disrupting effects in invertebrates. A review.

In order to gain basic understanding of the ecological effects of vertebrate Endocrine Disrupting Chemicals (EDCs), many research groups are currently testing these chemicals using aquatic invertebrates. Small crustaceans, such as cladocerans and copepods, are of particular interest since they are ecologically important and their short life cycles allow obtaining information on demographic parameters. Despite the existence of diverse literature on the development, growth and reproductive effects of EDCs on these crustaceans, only a few studies have unambiguously assessed a truly endocrine disrupting effect. This review discusses new experimental designs to differentiate between endocrine disruption and other causes of reproductive and developmental impairment. Our findings clearly illustrate that many studies may have falsely concluded that chemicals have endocrine disrupting modes of action when in fact a much simpler explanation was not previously ruled out (e.g., egg mortality, feeding inhibition). This means that there is an urgent need for integration of toxic effects on energy intake to toxicity assessments. Such an approach would permit different ectotoxicological models of action, including endocrine disrupting effects, to be distinguished and their relative roles in the overall toxic response to be clarified.

Autopsy case of multiple anomalies with hypoplastic cerebrum, eyes, and endocrine organs, mimicking Micro syndrome.

We report an autopsy case of multiple anomalies with severe micrencephaly, bilateral microphthalmos, and hypoplastic endocrine organs. We examined expressions of calcium-binding proteins and hypothalamic and pituitary hormones. A female proband presented with microcephaly, microphthalmia, and psychomotor development delay. At the age of 23 years, she died of cardiorespiratory failure. The endocrine organs demonstrated severe underdevelopment, and the hypoplastic eyeballs had remnant lens, vitreous hemorrhage, and retinal detachment. The brain weighed 260 g; the cerebrum, cerebellum, and brain stem were extremely small; and the tertiary sulci were absent in the cerebral surface. The cross-sectional area of cerebral cortex was reduced to about one third of those in the control, although six-layered lamination, density of pyramidal neurons, and expressions of calcium-binding proteins were comparatively preserved in the cerebral cortex. The third ventricle was hypoplastic, and the bilateral thalami appeared to be fused and the hippocampus was unrolled, whereas the corpus callosum was preserved. In the hypothalamus, the paraventricular nucleus was only identified, and the adenohypophysial somatotrophs were reduced. This may be the first autopsy report of Micro syndrome, which is characterized by microcephaly, brain malformations, optic atrophy, and hypogenitalism, although the case lacked agenesis of the corpus callosum.

Function of the retinoic acid receptors (RARs) during development (II). Multiple abnormalities at various stages of organogenesis in RAR double mutants.

Compound null mutations of retinoic acid receptor (RAR) genes lead to lethality in utero or shortly after birth and to numerous developmental abnormalities. In the accompanying paper (Lohnes, D., Mark., M., Mendelsohn, C., Dollé, P., Dierich, A., Gorry, Ph., Gansmuller, A. and Chambon, P. (1994). Development 120, 2723-2748), we describe malformations of the head, vertebrae and limbs which, with the notable exception of the eye defects, were not observed in the offspring of vitamin A-deficient (VAD) dams. We report here abnormalities in the neck, trunk and abdominal regions of RAR double mutant mice, which include: (i) the entire respiratory tract, (ii) the heart, its outlow tract and the great vessels located near the heart, (iii) the thymus, thyroid and parathyroid glands, (iv) the diaphragm, (v) the genito-urinary system, and (vi) the lower digestive tract. A majority of these abnormalities recapitulate those observed in the fetal VAD syndrome described by Joseph Warkany's group more than fourty years ago [Wilson, J. G., Roth, C. B. and Warkany, J. (1953) Am. J. Anat., 92, 189-217; and refs therein]. Our results clearly demonstrate that RARs are essential for vertebrate ontogenesis and therefore that retinoic acid is the active retinoid, which is required at several stages of the development of numerous tissues and organs. We discuss several possibilities that may account for the apparent functional redundancy observed amongst retinoic acid receptors during embryogenesis.

Three additional cases of the congenital hypothalamic "hamartoblastoma" (Pallister-Hall) syndrome.

The cause of this syndrome remains unknown. Epidemiologic studies should be done by experts. The first two cases above gave a "muddy" history for possible teratogens--a "recall bias"--one of a vaginal foam spermicide, one of exposure over several days to a heavy residue of aviation diesel fuel exhaust. We do not think these are pertinent but they do point to the problem of getting a meaningful history. In addressing this problem (in a letter of 5/27/82) R.J. Berry, M.D., medical epidemiologist, Centers for Disease Control, Atlanta, Georgia, wrote "... a designed study providing standardized interview forms with controls could be designed if cases continue to appear." Since this seems to be the case, perhaps this approach should be embraced. A teratogen(s) appears to be a good bet since the condition was recognized suddenly with the first Montana case in February, 1978. Even though no record has been found in the files of the Armed Forces Institute of Pathology, Children's Hospital Automated Medical Programs (CHAMP), Montreal or Wisconsin and one or two other places, it might be worthwhile to look back at all cases of imperforate anus which have come to autopsy for possible associated CNS lesions. We may be deluding ourselves in considering the condition as "new." Chromosomes were usually studied in lymphocytes, once on the tumor and once or twice on marrow. It might be well to do more than one tissue in all new cases. Once again there appears to be no "obligatory" finding for any one syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum levels of gonadotropins, prolactin, and testosterone in oligo/azoospermic Nigerian males.

To determine the frequency of hormonal abnormalities in a Nigerian population of male partners of infertile relationships, serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, and testosterone were estimated using radioimmunoassay techniques in 454 oligo/azoospermic male partners of infertile marriages. Of these men, 272 (59.9%) had an abnormal serum level of one or more of the hormones. Hyperprolactinemia, found in 144 patients, was the most common hormonal disorder in the group. Elevated serum gonadotropins associated with low serum testosterone were found in 120 (26.4%) patients, while 32 (7%) had a reduced serum testosterone concentration in association with low serum gonadotropins. Since hyperprolactinemic, hypogonadotropic, and normogonadotropic testicular failures are amenable to treatment, routine hormonal evaluation of male partners of infertile marriages is suggested in Nigeria and other places where this practice is uncommon at present.