Genetic, andrological and clinical characteristics of patients with congenital bilateral absence of the vas deferens

The possibility of retrieving spermatozoa from the epididymis allows patients with congenital bilateral absence of the vas deferens (CBAVD) to father a child by means of assisted reproduction techniques. This has, however, increased the chance of transmitting a mutated allele of the cystic fibrosis transmembrane conductance regulator (CFTR) gene which increases the risk of generating offspring with cystic fibrosis (CF). Because of the increased heterogeneity of the CFTR locus, the study of a discrete number of mutations, as usually carried out in a diagnostic work-up, is unable to ascertain the presence of a mutation in a relatively high proportion of the patients screened. In an attempt to increase the chance of detecting the presence of CFTR gene abnormalities, 37 patients with CBAVD and one patient with congenital unilateral agenesis of the vas deferens (CUAVD) underwent an enlarged diagnostic protocol, which included screening for the most expected mutations of the CFTR gene in our population, evaluation of the five thymidine (5T) allelic variant, sweat test, respiratory function tests, evaluation of steatocrit, and an accurate evaluation of the history of the patient to search for symptoms commonly found in patients with CF. A single CFTR gene mutation was found in 18 patients (48.6%) with CBAVD and in the patient with CUAVD. The most frequent mutation observed was the Delta F508. Eleven patients (45.8%) had the 5T variant and in five of them it was not associated with any detectable mutation of the CFTR gene. Two female partners were found to be carriers of a mutation, whereas 5 (18.5%) had the 5T variant. As many as 71% of CBVAD patients had the simultaneous presence of at least two signs and/or symptoms suggestive of CF, albeit they were of mild intensity and the patients felt fit and healthy. In conclusion, these results suggested that some patients with CBAVD without CFTR gene mutation or 5T variant, even when their sweat test is negative, may show clinical suspicion of carrying a CFTR gene mutation and therefore are at risk of generating children affected by CF if the partner carries a mutation as well. The screening for mutations and a careful clinical examination may contribute to better identification of patients with CFTR-related CBAVD.

[Hürthle-cell thyroid neoplasms: a clinical enigma]

Hürthle cell neoplasms represent a pathological entity whose diagnosis and therapy are still not defined. These neoplasms constitute from 1.5% to 10% of all thyroid tumors. Hürthle cell nodule is clinically indistinguishable from other nodular thyroid diseases and histologic features of the tumors do not always allow us to distinguish benign nodules from malignant ones. The authors, analyzing a segment of their own experience (335 surgical thyroid diseases), observed nine cases of Hürthle cell adenomas (0.03%). Because of concomitant presence of heterolobar thyroid disease, seven cases were treated with a total thyroidectomy, and two cases were treated with a lobo-isthmectomy. In a long-term follow-up study, there were not signs of Hürthle cells neoplastic disease. The authors suggest that the treatment of choice for patients with "surely benign" Hürthle cell nodule is lobo-isthmectomy. For malignant Hürthle cell tumors, total thyroidectomy is the most rational treatment associated with cervical lymphadenectomy in presence of metastatic nodes. In all cases, a long-term periodical check-up proves to be the best solution, also for patients treated for benign pathological Hürthle cell.

Effect of serotonin on protein phosphorylation in the central nervous system of the leech Hirudo medicinalis

1. Phosphoproteins of different regions of the Hirudo medicinalis central nervous system have been analysed by means of two-dimensional electrophoresis. 2. Serotonin, 8-Br-cAMP and phorbol 12,13-dibutyrate stimulate phosphorylation of a number of proteins whose isoelectric points and molecular weights are presented. 3. A group of proteins of 78 kDa and pI = 6-6.5, whose level of phosphorylation increases in the presence of serotonin, 8-Br-cAMP and phorbol ester, is observed only in segmental but not in cephalic or caudal ganglia. 4. The putative roles of these phosphoproteins are discussed.

Effect of phorbol ester on protein phosphorylation in the central nervous system of the leech Hirudo medicinalis: a two-dimensional electrophoretical analysis

1. Proteins of different regions of the Hirudo medicinalis central nervous system have been analyzed by means of two-dimensional electrophoresis. 2. Subcellular distribution of phosphoproteins has been studied in leech segmental ganglia. 3. Phorbol 12,13-dibutyrate, a protein kinase C activator, stimulates the phosphorylation of a number of proteins whose isoelectric points and mol. wts are presented. 4. Putative roles for these phosphoproteins are discussed.