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Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate the levels of protein C, protein S, fibrinogen, antithrombin 3 and platelet function analysis in patients with acromegaly. Thirty-nine patients with active acromegaly and 35 healthy subjects were included in the study. Plasma glucose and lipid profile, fibrinogen levels, GH and IGF-1 levels and protein C, protein S and antithrombin III activities were measured in all study subjects. Also, platelet function analysis was evaluated with collagen/ADP and collagen–epinephrine-closure times. Demographic characteristics of the patient and the control were similar. As expected, fasting blood glucose levels and serum GH and IGF-1 levels were significantly higher in the patient group compared with the control group (pglc: 0.002, pGH: 0.006, pIGF-1: 0.001, respectively). But lipid parameters were similar between the two groups. While serum fibrinogen and antithrombin III levels were found to be significantly higher in acromegaly group (pfibrinogen: 0.005 and pantithrombin III: 0.001), protein S and protein C activity values were significantly lower in the patient group (pprotein S: 0.001, pprotein C: 0.001). Also significantly enhanced platelet function (measured by collagen/ADP- and collagen/epinephrine-closure times) was demonstrated in acromegaly (pcol-ADP: 0.002, pcol-epinephrine: 0.002). The results did not change, when we excluded six patients with type 2 diabetes in the acromegaly group. There was a negative correlation between serum GH levels and protein S (r: –0.25, p: 0.04)) and protein C (r: –0.26, p: 0.04) values. Likewise, there was a negative correlation between IGF-1 levels and protein C values (r: –0.39, p: 0.002), protein S values (r: –0.39, p: 0.001), collagen/ADP-closure times (r: –0.28, p: 0.02) and collagen/epinephrine-closure times (r:-0.26, p: 0.04). Also, we observed a positive correlation between IGF-1 levels and fibrinogen levels (r: 0.31, p: 0.01). Acromegaly was found to be associated with increased tendency to coagulation and enhanced platelet activity. This hypercoagulable state might increase the risk for cardiovascular and cerebrovascular events in acromegaly.

Objective: To evaluate the risk of developing endocrine hyperactivity and carcinoma during a period of up to 5 yr in patients with apparently benign and non-functioning adrenal incidentalomas. Patients and methods: Thirty-two patients (mean age: 57.0±8.3 yr) were investigated in a prospective follow-up study for a median time of 24 months. Twentyeight patients had unilateral and 4 had bilateral masses. Initial avarage mass diameter was 17.47±6.60 mm. All patients were followed up yearly by physical examination, metabolic parameters, hormonal evaluation [morning cortisol after 3-mg dexamethasone suppression, urinary metanephrines, and upright aldosterone/plasma renin activity (PRA)]. Results: Among the clinical characteristics, 48% of patients were obese, 20% were hypertensive, 13 had Type 2 diabetes and impaired glucose tolerance. During follow-up period no significant change in the functional status was observed and no malignant transformation occured. Only 1 patient developed subclinical Cushing’s syndrome at the end of the 1styear and referred to surgery. Change in mass size was correlated with homeostasis model assessment of insulin resistance (p=0.002), upright aldosterone/PRA (p=0.041), cortisol after dexamethasone suppression (p=0.048) and 24-h urinary normetanephrine (p=0.005) levels. Gender, body mass index, glucose metabolism, and blood pressure were not found to be correlated with change in mass size and functional status. Conclusions: Due to the extremely low risk of developing malignancy during up to 5 yr of follow-up, conservative approach for the management of adrenal incidentalomas is thought to be appropriate. However, possibility of evolution to hormonal hypersecretion makes long-term follow-up of 2-to-5 yr seems to be obligatory.

Abstract The aim of this experimental study was to investigate the possible role of nitric oxide (NO) levels, and activities of adenosine deaminase (ADA) and xanthine oxidase (XO) in the pathogenesis of methotrexate-induced nephrotoxicity, and was the effect of caffeic acid phenethyl ester (CAPE), the potent free radical scavenger, in decreasing the toxicity. A total of 19 adult male rats were divided into three experimental groups, as follows: control group, MTX-treated group, and MTX+CAPE treated group. MTX were administered intraperitoneally (i.p.) with 20 mg/kg for single dose. CAPE was administered i.p. with a dose of 10 μmol//kg once daily for 7 days. The injection of MTX induced a significant increase in the activities of ADA and XO, and NO levels in renal tissue of rats (p < 0.0001). Co-treatment with CAPE caused a significantly decrease activities of ADA and XO, and the levels of NO in renal tissue (p < 0.0001). The results of this study revealed that NO, XO and ADA may play an important role in the pathogenesis of MTX-induced oxidative renal damage. CAPE may have protective potential in this process and it will become a promising drug in the prevention of this undesired side effect of MTX.

AbstractBackground: To evaluate the ability of topical ibopamine 2% to detect outflow resistance by comparing it with the tonography test in eyes with ocular hypertension (OHT). Methods: 62 eyes with OHT and 33 control eyes were included in this prospective study. Tonography was done manually as a standard outflow facility measurement. We used a C value of 0.18 μl/min/mm Hg or less and a Po/C value of 100 and above as a positive tonographic test. The ibopamine test performed on the following day was considered positive if there was an intraocular pressure (IOP) change of at least 3 mm Hg. Results: The sensitivity of the tonography and ibopamine tests was 69 and 53%, respectively, in eyes with OHT. The specificity of both tests was 97%. Although the sensitivity of the tonography test is higher than that of the ibopamine test, the difference between both was not statistically significant in these eyes (p = 0.409). Positive results in tonography were associated with higher IOP, while the results were not dependent on the IOP in the ibopamine test. Both tests together were positive in 33.87% (21 eyes) and negative in 11.29% (7 eyes) in 62 eyes with OHT. Conclusion: This study revealed that the ibopamine provocation test can detect outflow system resistance in eyes with OHT comparable with tonography which is a traditional outflow facility measurement. Ibopamine, however, can detect the eye with outflow impairment by a different and IOP-independent way, while tonography depends on IOP.Copyright © 2005 S. Karger AG, Basel

N-(2-pyridil)-salicylidene (1) and N-(2-pyridil)-2-oxo-1-naphthylidene-methylamine (2) were studied by elemental analysis, IR, 1H NMR and UV–visible techniques and the structure of compound (2) was examined crystallographically. The UV–visible spectra of 2-hydroxy Schiff bases are investigated in different solvents, acidic and basic media. Compound (2) is in tautomeric equilibrium (phenol–imine, O–H⋯N⇌keto–amine, O⋯H–N forms) in polar and non-polar solvents. These tautomers are not observed in polar and non-polar solvents for (1) as also supported by 1H NMR and UV–visible data. The keto–amine form of compound (2) was observed in basic solutions of DMSO, ethanol, chloroform, benzene, cyclohexane and in acidic solutions of chloroform and benzene, but not in acidic solutions of DMSO and ethanol. On the contrary, this form for compound (1) was not observed in the same solutions. The asymmetric unit of compound (2) contains two independent molecules of (C16H12N2O) which constitute a tautomeric pair. The observed differences in the related CN (1.317(4) and 1.330(4)Å) and C–O (1.279(4) and 1.263(4)Å) bond lengths in the two crystallographically independent molecules indicate that the phenol–imine and the keto–amine forms coexist in the solid state. Intramolecular hydrogen bond lengths (O–H⋯N) are 2.586(4)Å and 2.518(4)Å for the two individual tautomers. It crystallizes in the monoclinic space group P21/nwith a=5.837(2), b=17.476(2), c=24.295(3)Å,β=91.95(4)°, V=2476.9(6)Å3,Z=4 and Dx=1.3315gcm−3.