Phenolics and Antioxidant Activity of Mushroom Leucopaxillus giganteus Mycelium at Different Carbon Sources

This article reports the first approach to the antioxidant potential evaluation of the edible mushroom Leucopaxillus giganteus mycelium obtained in the presence of four different carbon sources: glucose, sucrose, fructose and mannitol. Despite the use of Leucopaxillus mushroom species in chemical industry for extraction of clitocybin antibiotic, the production of its mycelium for pharmacological applications has not been explored. The concentration of antioxidant compounds increased along the growth time as a response to the oxidative stress and therefore free radicals production. The aldohexose glucose proved to be the most appropriate carbon source to increase antioxidant activity, leading to the highest phenols content and lowest EC50 values. Significant negative linear regressions were established between phenols and flavonoids contents, and antioxidant activity, which support that the extracts mechanism of action for the different antioxidant activity assays may be identical, being related with the content in those compounds and their free radical scavenging activity.

[Acute thyroiditis]

We review the pathophysiology, clinical features and therapy of acute thyroiditis. Four cases are reported stressing the role of fine needle aspiration for the diagnosis of this clinical entity.

Mutational analysis of Portuguese families with multiple endocrine neoplasia type 1 reveals large germline deletions

OBJECTIVE

To determine the spectrum of MEN1 mutations in Portuguese kindreds, and identify mutation-carriers.

PATIENTS, DESIGN AND RESULTS

Six unrelated MEN1 families were studied for MEN1 gene mutations by single-strand conformational polymorphism (SSCP) and DNA sequence analysis of the coding region and exon-intron boundaries of the MEN1 gene. These methods identified 4 different heterozygous mutations in four families: two mutations are novel (mt 1539 delG and mt 655 ims 11 bp) and two have been previously observed (mt 735 del 46p and mt 1656 del C) all resulting in a premature stop codon. In the remaining two families, in whom no mutations or abnormal MEN1 transcripts were detected, segregation studies of the 5' intragenic marker D11S4946 and codon 418 polymorphism in exon 9 revealed two large germline deletions of the MEN1 gene. Southern blot and tumour loss of heterozygosity analysis confirmed and refined the limits of these deletions, which spanned the MEN1 gene at least from: exon 7 to the 3' untranslated region, in one family, and the 5' polymorphic site D11S4946 to exon 9 (obliterating the initiation codon), in the other family. Twenty-six mutant-gene carriers were identified, 6 of which were asymptomatic.

CONCLUSIONS

These results emphasize the importance of the detection of MEN1 germline deletions in patients who do not have mutations of the coding region. Important clues indicating the presence of such deletions may be obtained by segregation studies using the intragenic polymorphisms D11S4946 and at codon 418. The detection of these mutations will help in the genetic counselling of clinical management of the MEN1 families in Portugal.

Clinical outcome of Crohn's disease: analysis according to the vienna classification and clinical activity

The aim of this study was to describe the clinical course of Crohn's disease (CD) in a well-defined, homogeneous groups of patients. A total of 480 patients with CD were followed up from diagnosis up to 20 years. Definitions of patient subgroups were made according to the Vienna Classification. Markov chain analysis was used to estimate the probabilities of remissions and relapses during the disease course. Both age at diagnosis and behavior were associated with different disease locations. Patients with ileal disease had a greater need for surgical and a lesser need for immunosuppressive treatment; patients with ileocolonic disease were diagnosed at an earlier age and showed a lower probability of remaining in remission during the disease course; patients with colonic disease needed less surgical or steroid treatments; patients with intestinal penetrating disease were frequently submitted to abdominal surgery, whereas those with anal-penetrating disease often needed immunosuppressive treatment. Approximately 40% of the patients were in clinical remission at any time, but only about 10% maintained a long-term remission free of steroids after their initial presentation. A more benign clinical course could be predicted in patients who stay in remission in the year after diagnosis. The grouping of patients with CD according to the Vienna Classification and/or the clinical activity in the year after diagnosis is useful in predicting the subsequent course of disease.

The hyperparathyroidism-jaw tumour syndrome in a Portuguese kindred

The hyperparathyroidism-jaw tumour (HPT-JT) syndrome is an autosomal dominant disease characterized by the occurrence of parathyroid tumours and fibro-osseous tumours of the jaw bones. Some HPT-JT patients may also develop renal abnormalities, which include Wilms' tumours, hamartomas and polycystic disease. The HPT-JT gene has been mapped to chromosome 1q25-q31, and we report the clinical and genetic findings in a kindred from central Portugal. HPT-JT was observed in six members from three generations; all had primary hyperparathyroidism (five had parathyroid adenomas, one a parathyroid carcinoma). Ossifying jaw fibromas affecting the maxilla and/or mandible were observed in 5/6. Renal cysts (<2.5 cm) were observed in four. Genetic studies using 18 polymorphic loci from chromosome 1q25-q31, together with leukocyte DNA from 11 family members and tumour DNA from three parathyroids (two adenomas and one carcinoma), revealed loss of tumour heterozygosity in the parathyroid carcinoma only, and the retained haplotype was found to cosegregate with the disease in the six affected members. A new Portuguese kindred with the HPT-JT syndrome that maps to chromosome 1q25-q31 has been identified, and these findings will help in the further characterization of this inherited disorder.

[deficiency of growth hormone in children. Re-evaluation after therapeutic completion]

OBJECTIVE

To assess GH secretion in young adults treated with GH replacement therapy in childhood.

PATIENTS AND METHODS

From the 38 patients who concluded treatment with GH, we studied 20 (52.6%), 9 girls and 11 boys. Thirteen had Growth Hormone Deficiency (GHD)-65%, while 7 had Multiple Pituitary Hormone Deficiency (MPHD)-35%. The patients were retested within 6 months to 6 years after completing GH therapy. The mean age (+/- SD) at retesting was 18.1 +/- 2.6 years for those with GHD and 20.8 +/- 2.8 for those with MPHD. At reassessment we performed two provocative tests: insulin tolerance test (ITT) and clonidine test.

RESULTS

Seven of the 20 patients retested, retained GH deficiency. Of the 13 patients with GHD, only one maintained the deficiency, while of the 7 patients with MPHD, 6 maintained the deficiency.

CONCLUSION

Young adults with GH deficiency treated with this hormone should be retested in order to identify those who are truly GH insufficient adults and may benefit from replacement therapy.

[Kidney transplantation in patients with type I and type II diabetes mellitus]

A total of 618 patients with end-stage renal disease received kidney transplants between 1980 and September 1996. Twenty eight of them were diabetics. Better results were achieved for type 1 diabetic patients than for type 2 (mortality: 5.9% vs 27.3%; functioning graft: 88.2% vs 72.7%). The morbility was also higher in those patients (infections: 81.8% vs 29.4%; vascular complications: 45.5% vs 17.6%). Actuarial patient and graft survival were lower for type 2 than for non diabetic patients. For type 1 diabetics the results are similar to those for non diabetics. Better results can probably be achieved by restricting the selection criteria. The decision to transplant or maintain on dialysis should be made on a case by case basis.

[Pituitary apoplexy followed by endocrine remission. Report of two cases]

Pituitary apoplexy is rare and endocrine remission in patients with apopletic secreting pituitary adenomas is even rarer. This study reports on two patients with pituitary macroadenomas (one with Cushing's disease and the other with acromegaly) in whom endocrine remission occurred after apoplexy. The first patient had Cushing's disease and had an ictus of headache and vomiting after which she started a progressive remission of hypercortisolism. A post-apoplexy MRI disclosed persistence of a sellar and supra-sellar mass. She was submitted to transesphenoidal surgery. An hypertensive hemorrhagic cyst was found with no tumor. The second patient had acromegaly. While performing a LHRH-stimulation test he had an ictus of headache, vomiting, no visual loss and appearance of diabetes insipidus. A CT scan disclosed an intrasellar hematoma. Despite the size of the tumor and since there was no visual impairment, this patient was followed up without surgery. Imaging follow-up showed a progressive shrinkage and disappearance of the mass, which was corroborated by endocrine remission. A high rate of recurrence is reported in such patients in the literature. Both patients are being currently followed-up on a long-term basis.

[Prevalence of arterial hypertension in Cushing's syndrome]

OBJECTIVE

To determine the prevalence of hypertension (HT) in patients with Cushing's syndrome.

PATIENTS AND METHODS

We studied 23 patients with Cushing's syndrome, 17 women (mean +/- SD age = 42.8 +/- 15.6 years) and 6 men (mean +/- SD age = 34.8 +/- 10.2 years). The etiologies were: 16-Cushing's disease, 3-suprarenal adenoma, 2-suprarenal carcinoma and 2-iatrogenic. Blood pressure (BP) was measured at least three times and we consider hypertension when systolic BP > or = 140 mmHg and/or diastolic BP > or = 90 mmHg.

RESULTS

The prevalence of HT, at diagnosis, was 73.9% (64.7% in women and 100% in men) and the mean BP was 163 +/- 25/100 +/- 16 mmHg (158 +/- 26/97 +/- 15 mmHg in women and 182 +/- 5/114 +/- 10 mmHg in men). From the 16 patients with Cushing's disease, 13 (81%) had HT; all the patients (n = 3) with suprarenal adenoma had HT; none with suprarenal carcinoma (n = 2) had HT and only 1 of the 2 patients with iatrogenic Cushing's syndrome had HT. After treatment, 14 patients entered remission, 6 persisted with active disease and 1 was missed during the follow-up. In the group of patients that entered remission, the prevalence of HT at diagnosis was 78.5% (n = 11), 57.1% (n = 8) being after treatment.

CONCLUSIONS

In this study, we found a high prevalence of HT at diagnosis (73.9%). After treatment and in the patients that entered remission, the prevalence of HT remained high (78.5% vs 57.1%). The high prevalence of HT in Cushing's syndrome, suggests its importance as a morbidity factor and also as an important diagnostic indicator, when present.

ACGT and vicilin core sequences in a promoter domain required for seed-specific expression of a 2S storage protein gene are recognized by the opaque-2 regulatory protein

The expression of Brazil nut storage albumin genes is highly regulated during seed development. Several sequences in the promoter of one of these genes show homologies with the target sites of the maize O2 bZIP regulatory protein. We therefore asked whether the O2 protein would recognize these promoter sequences. We show that the O2 protein binds to three different sequences (F1, F2 and F3). F1 and F3 are hybrid C/G and A/G boxes, respectively, that are homologous to the O2-binding site of a maize alpha-zein gene. F2 is a new O2-binding sequence related to the O2 target sites of the Coix alpha-coxin, the maize b-32 genes and the AP-1 pseudopalindrome. Molecular modelling showed that an Asn and a Ser in the 02 DNA binding domain make different base-specific contacts with each operator. 5' Promoter deletions of the be2S1 gene showed that the domain containing the O2 target sites F1 and F2 is required for detectable reporter gene expression in transgenic tobacco seeds. Moreover, the homologous coix O2 protein was shown to in situ transactivate the promoter region encompassing the three O2-binding sites F1, F2 and F3. Thus, these sites may be in vivo regulatory sequences mediating activation by bZIP regulatory proteins.

[Craniocerebral imaging in children with short stature]

OBJECTIVE

To analyse the type and frequency of cranial CT and NMR imaging anomalies in children of short stature.

PATIENTS AND INTERVENTIONS

We studied 57 children of short stature with a mean age (+/-SD) of 10.1 +/- 3.8 years, 34 boys and 23 girls, all of them with auxometric criteria of GH deficiency. After studying the pituitary function and determination of karyotype in the girls, the children were classified in to five groups:-Isolated GHD (IGHD) (n = 32), multiple pituitary hormone deficiency (MPHD) (n = 6), neurosecretory dysfunction (NSD) (n = 8), Turner syndrome (n = 7) and idiopathic short stature (ISS) (n = 4). The imaging methods used were cranial CT or NMR.

RESULTS

Of the 57 children studied the CT/NMR was abnormal in 37(64.9%) children. We found anomalies in 65.6% of IGHD patients, 62.5% of NSD patients, 100% of MPHD patients and 57.1% and 25% in the Turner s. patients and ISS patients respectively. The most frequent anomaly was hypoplastic pituitary found in 50% of IGHD patients, 37.5% of NSD patients and 33.3% of MPHD patients. None of the cases of Turner s. or ISS had hypoplastic pituitary. An empty sella was the second most frequent anomaly found in 7 patients (IGHD-3, MPHD-3, DNS-1). Of the 25 children in which NMR was performed, 8 had hypoplastic pituitary and stalk and 2 had interruption of the pituitary stalk and ectopic neurohypophysis.

CONCLUSION

These results strengthen the necessity for CT/NMR imaging in children of short stature which, besides allowing identification of tumors, also permits the diagnosis of idiopathic GHD because of its frequent association with cranial imaging anomalies, mainly hypoplastic pituitary.

[The prevalence of hypertension in acromegaly]

AIM

To estimate the prevalence of hypertension (HT) in a group of patients with acromegaly at the moment of diagnosis and after treatment.

PATIENTS AND METHODS

Fifty-seven patients, 43 females and 14 males with a mean age of 45.19 +/- 11.9 years were studied retrospectively. In the last visit 9 patients (15.7%) were in remission and 47 (84.2%) had active acromegaly. We considered hypertensive the patients with systolic BP > or = 140 and/or diastolic BP > or = 90 mmHg. Hypertension was classified in four stages:- mild, moderate, severe and very severe.

RESULTS

The prevalence of hypertension at the moment of diagnosis was 35%. The hypertensive patients had a mean age of 51.75 +/- 9.3 years and normotensive patients 41.65 +/- 11.6 years (p < 0.001). In females the prevalence of HT was 27.9% and in males it was 57% (p = NS). In hypertensive patients (n = 20), the mean BP was 159 +/- 15 (syst.)/97.2 +/- 9.8 (diast.), 16 patients (80%) had mild to moderate HT and the remainder had severe (n = 2) and very severe (n=1) HT. In the last visit, 22.2% of patients were cured and 46.8% of those with active acromegaly were hypertensive. None of the patients cured and initially normotensive developed HT; among those that were hypertensive (n = 3), 2 remained hypertensive and 1 became normotensive. Among patients with active acromegaly and initially normotensive, 7 developed HT 4.85 +/- 2.03 years later; of those hypertensive at diagnosis (n = 16), only one became normotensive. The last case was 27 years old. The patients that remained hypertensive had a mean age of 53.8 +/- 6.85 years (41-62 years).

CONCLUSIONS

The prevalence of hypertension at the moment of diagnosis was 35%, similar to the majority of studies published and higher than the general population. The hypertensive patients were significantly older the normotensive patients and most of them had mild to moderate HT. We observed an increase in the prevalence of HT over the years in the cases that maintained active acromegaly. In our series only one of the three patients cured became normotensive, therefore, we concluded that HT in acromegaly is frequently irreversible. The chances of normalization seems higher in younger patients and probably with a shorter duration of acromegaly.

[24-hour arterial pressure study and diabetic neuropathy and angiopathy of the lower limbs]

AIMS

To study the circadian variation of BP in diabetics with chronic late complications (autonomic neuropathy, peripheral neuropathy and macroangiopathy of the lower limbs).

PATIENTS AND METHODS

We studied 35 NIDDM patients, 22 male and 13 female, with a mean age of 62.17 +/- 8.66 years, all with hypertension (HBP) or with BP levels close to normal, many of them under anti-hypertensive therapy (mean BP in clinical measurements: 164 +/- 23.16 mmHg systolic and 92.14 +/- 11.06 mmHg diastolic). Twenty-four suffer from autonomic neuropathy, 23 from peripheral neuropathy and 11 from macroangiopathy of the lower limbs. The control group is composed of 10 patients with essential HBP without other observable pathology, with a mean age of 68.5 +/- 3.63 years and BP in clinical measurements: systolic 192 +/- 15.49 mmHg and diastolic 88 +/- 4.21 mmHg (without any previous therapy). The record of the BP circadian profile was made, with the use of a Spacelab monitor, model 90207, 5 days after anti-hypertensive therapy was suspended.

RESULTS

The mean BPs in 24 hours were: control group-systolic BP 152.6 +/- 13 mmHg and diastolic 79.8 +/- 13 mmHg; diabetics-systolic BP 136.82 +/- 15 mmHg and diastolic 77.4 +/- 8 mmHg. The daily and nocturnal mean BPs were 158.5 +/- 8.5 and 146 +/- 8.4 mmHg (systolic) and 82.8 +/- 5.7 and 70.9 +/- 5.1 mmHg (diastolic) in the control group, while they were, in diabetics, 141.3 +/- 15.7 and 135.6 +/- 16.6 mmHg (systolic) and 79.6 +/- 7.1 and 72 +/- 8.2 mmHg (diastolic). In diabetic patients, considering the groups with and without autonomic neuropathy, the difference between daily and nocturnal mean BP was 1.6 vs 9.4 mmHg systolic and 4.9 vs 9.4 mmHg, diastolic.

CONCLUSIONS

In both groups, the mean BP levels in 24 hours were notoriously lower than those obtained from the clinical measurements: the differences were 40 mmHg (control group) and 27.2 mmHg (diabetics) for systolic BP and 8.2 mmHg (control group) and 14.7 mmHg (diabetics) for diastolic. The BP circadian profiles show a lower variability, with absence of the nocturnal reduction, specially evident in diabetic patients with autonomic neuropathy versus other groups.

[Diabetes mellitus after renal transplant]

Posttransplant Diabetes Mellitus (PTDM) has traditionally been attributed to therapy with steroids, however with the introduction of Cyclosporine (cya) into clinical practice, an increase in the incidence of PTDM was noted. We studied the prevalence of PTDM in Renal transplant recipients and its clinical characteristics.

MATERIALS AND METHODS

355 patients were submitted to a renal transplant between 30/06/80 and 31/12/92. After stabilization of the doses of the immunosuppressive therapy we considered diabetic patients those with fasting glycemic values > or = 140 mg/dl and those with glycemic values between 100-140 mg/dl were given to an oral glucose tolerance test (WHO criteria 1985).

RESULTS

Posttransplant diabetes mellitus occurred in 28 patients (7.9%), 11 females with a mean age of 53.36 +/- 12.75 years and 17 males with a mean age of 51.05 +/- 10.60 years.

DISCUSSION

Due to the great prevalence of alterations in glucose tolerance and their adverse effects on the cardio-vascular system, we think that all renal transplant recipients should be screened.

Acute effect of intracerebroventricular administration of zinc on the drinking behavior of rats induced by dehydration or central cholinergic and angiotensinergic stimulation

1. Zinc is a metal important for several biological functions including neuromodulation and neurotransmission in the central nervous system. 2. In the present paper we studied the acute effects of third ventricle injections (2 microliters) of minute amounts of zinc acetate on the water intake of male, adult, Wistar rats (N = 7-14) under three conditions: water deprivation (14 h, overnight) and after third ventricle injections of carbachol (11 nmoles/rat in 2 microliters) or angiotensin II (AII, 9.6 pmoles/rat in 2 microliters). 3. Central injections of zinc acetate in different doses (0.3 and 3.0 nmoles/rat) induced a partial blockade of water intake of rats under all three conditions studied. Water intake after 120 min in control dehydrated rats (those receiving NaAc instead of Zn(Ac)2) was 7.89 +/- 0.47 ml while dehydrated animals receiving Zn(Ac)2 in the highest dose employed (3.0 nmoles/rat) was 2.90 +/- 0.75 ml. Carbachol-induced water intake after 45 min was 5.49 +/- 0.83 ml. This value was significantly reduced in zinc-treated (3.0 nmoles/rat) animals receiving carbachol (2.41 +/- 0.84 ml). Angiotensin-treated animals exhibit a water intake of 3.85 +/- 0.48 ml after 45 min, a value reduced to 1.13 +/- 0.6 ml in those animals receiving angiotensin II plus zinc (3.0 nmoles/rat). 4. It is suggested that zinc alters the functional integrity of cholinergic and angiotensinergic systems in the central nervous system mediating water-intake behavior in rats.