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Biomedical subjects

M Alevizaki

Publications and source records attributed to M Alevizaki.

At least 37 records · Page 2Linked to original sources
PubMed1998

High serum cholesterol levels in persons with 'high-normal' TSH levels: should one extend the definition of subclinical hypothyroidism?

OBJECTIVE: The association between established hypothyroidism and high cholesterol levels is well known. The aim of the present study was to investigate the effect of thyroxine (T4) administration on cholesterol levels in hypercholesterolemic subjects with TSH levels within the normal range ('high-normal' TSH compared with 'low-normal' TSH). DESIGN AND METHODS: We determined TSH levels in 110 consecutive patients referred for hypercholesterolemia (serum cholesterol >7.5 mmol/l). Those with 'high-normal' TSH (2.0-4.0 microU/ml) as well as those with 'low-normal' TSH (0.40-1.99 microU/ml) were randomly assigned to receive either 25 or 50 microg T4 daily for two months. Thus, groups A and B (low-normal TSH) received 25 and 50 microg T4 respectively and groups C and D (high-normal TSH) received 25 and 50 microg T4 respectively. Serum T4, tri-iodothyronine (T3), TSH, free thyroxine index, resin T3 uptake and thyroid autoantibodies (ThAab) as well as total cholesterol, high and low density lipoprotein cholesterol (HDL, LDL), and triglycerides were determined before and at the end of the two-month treatment period. RESULTS: TSH levels were reduced in all groups. The most striking effect was observed in group D (TSH levels before: 2.77+/-0.55, after: 1.41+/-0.85 microU/ml, P < 0.01). Subjects in groups C and D had a higher probability of having positive ThAabs. A significant reduction in total cholesterol (P < 0.01) and LDL (P < 0.01) was observed after treatment only in group D. In those subjects in group D who were ThAab negative, there was no significant effect of thyroxine on cholesterol levels. CONCLUSIONS: Subjects with high-normal TSH levels combined with ThAabs may, in fact, have subclinical hypothyroidism presenting with elevated cholesterol levels. It is possible that these patients might benefit from thyroxine administration.

Adult↗
PubMed1998

Impaired endothelium-dependent vasodilatation in women with previous gestational diabetes.

OBJECTIVE: To assess whether otherwise healthy women with a history of gestational diabetes mellitus (GDM) may have abnormalities in endothelial function at a very early stage, before glucose intolerance occurs. RESEARCH DESIGN AND METHODS: A total of 33 women with previous GDM (17 nonobese [BMI < 27] and 16 obese [BMI > or = 27]) and 19 healthy nonobese women were examined. A 75-g oral glucose tolerance test was performed, and insulin levels and biochemical parameters were also measured. Using high-resolution ultrasound, we measured vasodilatory responses of the brachial artery during reactive hyperemia (endothelium-dependent vasodilatation), and after nitroglycerin administration, an endothelium-independent vasodilator. RESULTS: Flow-mediated dilatation (FMD) was significantly and equally decreased in both groups of women with previous GDM, compared with control subjects (1.6 +/- 3.7% in the nonobese GDM group and 1.6 +/- 2.5% in the obese GDM group vs. 10.3 +/- 4.4% in control subjects, P < 0.001). FMD correlated inversely with serum uric acid levels, BMI, serum total cholesterol, and basal insulin resistance (homeostasis model assessment). Nitrate-induced dilatation was significantly decreased only in the obese GDM group compared with control subjects, (21.4 +/- 5.1 vs. 27.9 +/- 9.5, P < 0.05). CONCLUSIONS: Endothelial dysfunction, which is considered as a very early index of atherogenesis, is already present in both obese and nonobese women with a history of GDM, even when they have normal glucose tolerance.

Adult↗
PubMed1998

Neuroendocrine differentiation in follicle-cell thyroid carcinoma: correlation to prognostic factors in papillary carcinoma.

The presence of NE-differentiation in the follicle-cell thyroid carcinoma has been investigated by immunohistochemical detection of chromogranin A in the neoplastic cells. It has been found that NE-differentiation was present in a significant percentage in the papillary Ca alone (46.60%) whereas all Huerthle-cell neoplasms and the large majority of follicular and undifferentiated carcinomas showed non reactivity for Chromogranin A. Moreover, we have correlated the presence of NE-differentiation to well known prognostic factors in papillary Ca. We found a statistically significant correlation between the neuroendocrine differentiation and some unfavourable factors such as old age of the patient, size of the tumor, invasion of thyroid capsule and lymphnode involvement. We suggested that NE-differentiation could be considered as an index of poor prognosis.

Adenocarcinoma, Follicular↗
PubMed1997

Genetic screening for RET mutations in families with multiple endocrine neoplasia 2 syndromes.

Mutations in the RET proto-oncogene have recently been recognized to be responsible for the inherited multiple endocrine neoplasia type 2 syndrome. As expected, Greek patients with MEN2 and FMTC carry RET mutations similar to those of other ethnic groups. In those regions of the gene that were analyzed, mutations were detected in six out of six families with classical MEN2A, three out of five of the families with familial MTC, and one case with MEN2B. Presymptomatic screening using DNA analysis has now replaced calcitonin stimulation tests in the offspring of families where the mutation has been characterized. The use of these methods will improve the prognosis in MEN2 patients and will also reduce the psychological burden of risk for a potentially lethal disease on family members.

Drosophila Proteins↗
PubMed1997

Endothelial dysfunction of conduit arteries in insulin-dependent diabetes mellitus without microalbuminuria.

OBJECTIVE: Previous studies have shown that endothelial dysfunction, an early sign of atherosclerosis, occurs in animal models of diabetes mellitus and in resistance vessels of patients with insulin-dependent diabetes. In the present study we examined whether young patients with insulin-dependent diabetes without microalbuminuria present abnormal endothelial function of large peripheral arteries. METHODS: Twenty-six patients with insulin-dependent diabetes without microalbuminuria were compared with 26 normal controls and 5 patients with insulin-dependent diabetes with microalbuminuria. Brachial artery diameter was measured at rest, during reactive hyperaemic flow (endothelium-dependent dilatation) and after sublingual isosorbide dinitrate (endothelium-independent dilatation). RESULTS: Baseline artery diameter and flow as well as the degree of reactive hyperaemia were similar in all groups compared to controls. Flow-mediated dilatation was lower in patients with diabetes without microalbuminuria (5.8 +/- 7 vs 11 +/- 7%. P = 0.01) as well as in patients with diabetes without microalbuminuria (0.75 +/- 2.5 vs 11 +/- 7%, P = 0.003); nitrate-induced dilatation was normal in patients without microalbuminuria and attenuated in patients with microalbuminuria. In the group of diabetes patients without microalbuminuria, those with disease duration > 10 years and HbAlc > 6% had the worse endothelial function. CONCLUSIONS: Our results demonstrate that endothelial dysfunction of conduit arteries can be detected in patients with insulin-dependent diabetes mellitus without microalbuminuria, probably contributing to the high prevalence of atherosclerosis in these patients.

Adolescent↗
PubMed1997

Flow-mediated, endothelium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values.

Patients with hypothyroidism are considered to have an increased risk of developing atherosclerosis; because endothelial dysfunction is an early sign of atherosclerosis, we investigated whether endothelial dysfunction is present in patients with hypothyroidism. Thirty-five subjects with various TSH levels were investigated by high-resolution ultrasound imaging of the brachial artery to assess endothelial and smooth muscle responses. Flow-mediated, endothelium-dependent vasodilatation was significantly higher in subjects with TSH 0.4-2 microIU/mL (11.8 +/- 2.7%), compared with subjects with TSH 2.01-4 microIU/mL (6.8 +/- 2.9%), 4.01-10 microIU/mL (5.2 +/- 6.3%) and >10 microIU/mL (4.0 +/- 4.4%); TSH levels correlated inversely to endothelium-dependent dilatation. Thus, flow-mediated vasodilatation, a marker of endothelial function, is impaired not only in patients with mild hypothyroidism but also in subjects with "high-normal" serum TSH levels (ie, 2.01-4.0 microIU/mL) that may be characterized as possibly abnormal.

Adult↗
PubMed1997

Islet amyloid polypeptide (amylin) does not seem to be directly involved in the development of gestational diabetes mellitus.

In order to define the islet amyloid polypeptide (IAPP) levels in gestational diabetes mellitus (GDM) and their interrelationship with the insulin levels, we studied (1) the placental RNA from 10 women (5 with GDM and 5 normals) for IAPP expression by Northern blotting and (2) 10 women with GDM during a 100-gram oral glucose tolerance test and compared these with 11 normal women matched for obesity and age. Plasma levels of glucose, IAPP, insulin, and C peptide were determined. No IAPP expression was detected in any of the placentae after a long exposure. We could not demonstrate any differences in plasma IAPP levels (basal or stimulated) between the two groups of pregnant women. However, in women with GDM we found a lower IAPP/insulin ratio (p < 0.05) and a lower maximal IAPP/maximal insulin response ratio during the oral glucose tolerance test (p < 0.05) than in normal women. Therefore, IAPP does not appear to be directly involved in the development of GDM. The peripheral levels of IAPP relative to insulin are lower in GDM, a finding similar to that described in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus). This observation further confirms that GDM resembles the early stages of type 2 diabetes mellitus.

Adult↗
PubMed1997

Simultaneous occurrence of a medullary and a papillary thyroid carcinoma in the same patient.

We present the case of a patient in whom we diagnosed two different thyroid carcinomas (one on each lobe) of distinct histologic type: one derived from the follicular cells (papillary) and one from the C cells (medullary). They were both diagnosed preoperatively by fine needle aspiration (FNA), and the diagnosis was confirmed with histologic examination. "Inappropriate" staining with neuroendocrine markers was observed in the papillary tumor. Analysis of tumor tissue for the RET oncogene mutations, commonly found in the MEN2 syndromes, was negative. This case supports the view of a common origin for these two tumor types.

Biopsy, Needle↗
PubMed1995

Increased incidence of medullary carcinoma of the thyroid in rural regions in Greece.

A role of environmental factors for the development of Medullary Carcinoma of the Thyroid (MTC) has been shown for animals, but has only been speculated for humans. In the present study we analyzed our registry of 58 sporadic MTCs for the place of origin and place of residence and compared these with 408 other thyroid carcinomas of different histology who are attending the same Endocrine Clinics in the Athens area. Clustering of sporadic MTCs was observed in the Ionian islands, where an increased incidence of familial cases has previously been observed. Patients with sporadic MTCs originated more frequently from rural areas (p = 0.0006), where the main occupation is agriculture. No important differences were observed concerning the place of residence. We speculate that exposure to sunshine, which is greater in rural areas, may be one factor which, through vitamin D, could be involved in the development of C-cell tumors in predisposed individuals.

Adult↗
PubMed1995

Partial disomy of Xp and the presence of SRY in a phenotypic female.

We present a study of a mentally retarded and mildly dysmorphic female in whom initial cytogenetic studies identified the karyotype 46,X, + mar. Further characterisation of the structurally abnormal chromosome by fluorescence in situ hybridisation (FISH) showed that it is composed of both X and Y chromosome material with a centromere originating from the Y chromosome. The presence of the DMD gene and the absence of the XIST gene was shown by FISH using locus specific probes. The Y segment included the SRY and ZFY genes. Based on these findings, the karyotype was defined as 46, X,der(Y)t(X;Y) (p21.1;q11). This case illustrates male to female sex reversal owing to a partial duplication of the short arm of the X chromosome in the presence of SRY.

Chromosome Banding↗
PubMed1994

Amylin/islet amyloid polypeptide expression in medullary carcinoma of the thyroid: correlation with the expression of the related calcitonin/CGRP genes.

OBJECTIVE: The amylin/islet amyloid polypeptide (IAPP) gene is the third member of the calcitonin (CT)/calcitonin gene related peptide (CGRP) gene family, which includes the alpha CT/CGRP (CALC-I) and beta CGRP (CALC-II) genes. CT is predominantly expressed in thyroid C cells, alpha and beta CGRP (CGRP-I and II) in neural tissue and amylin/IAPP in pancreatic beta cells. Both the detailed tissue distribution and the physiological role of amylin are subjects of current research. We sought to characterize the RNAs transcribed from the IAPP gene in normal human pancreas and to investigate possible ectopic expression of this gene in neuroendocrine tumours. DESIGN AND TISSUES: RNA was extracted from normal human pancreas, five phaeochromocytomas and 12 medullary thyroid carcinomas (MTCs) and studied by Northern blotting. RESULTS: We found that in normal human pancreas the IAPP gene transcripts differ in size from those reported for human insulinoma. Expression of the amylin/IAPP gene was detected in seven of the MTCs, while it was not detected in phaeochromocytomas. There were no apparent clinical or histological differences between IAPP positive and IAPP negative MTCs. The relative expression levels of the four mRNAs of the CT/CGRP gene family varied between the different tumours. CONCLUSIONS: Our findings are consistent with the view that ectopic hormone production may occasionally be causally related to the common origin of related genes. The possibility that IAPP may constitute a minor component of MTC amyloid should be considered.

Amyloid↗
PubMed1992

A complex pattern of antigen receptor gene rearrangements in a case of Philadelphia positive acute lymphoblastic leukaemia.

The paper describes a case of Philadelphia (Ph) positive acute lymphoblastic leukaemia (ALL) presenting with high white cell count and central nervous system involvement. Immunophenotypically the case was characterized as common ALL. The t(9;22) abnormality corresponded to a rearrangement within the breakpoint cluster region gene, while antigen receptor gene studies showed multiple rearrangements of the immunoglobulin heavy chain gene (IGH) concomitant with a single rearrangement of the T cell receptor beta chain gene (TCR beta). We speculate that this case represents the neoplastic transformation of a stem cell, the Ph abnormality being involved in the early steps of transformation. It is conceivable that the IGH but not the TCR beta gene was accessible to recombination within the malignant clone, thus generating the multiple rearrangements observed. If this is the case, these findings would appear to be compatible with the hypothesis that antigen receptor gene rearrangements may be partly dependent on the accessibility of the corresponding genetic loci.

Adult↗
PubMed1989

Altered calcitonin gene in a young patient with osteoporosis.

To assess whether calcitonin is important in maintaining the integrity of bone the calcitonin gene of a young male patient with osteoporosis and no detectable plasma concentrations of calcitonin was studied. Genomic Southern blots with various restriction enzymes showed no large abnormalities in his calcitonin gene. Genomic clones representing his calcitonin gene were then analysed. His gene encoded normal precursor polypeptides for calcitonin and calcitonin gene related peptide; the only abnormality identified was a single base insertion in the intron separating exons IV and V of the gene. The affected sequence is homologous with an intron sequence from beta globin that is implicated in splicing and forming a crucial intermediate structure during the maturation of messenger RNA. The change observed may be responsible for the patient's calcitonin deficiency and consequently for his condition, suggesting that calcitonin is important in preventing bone loss.

Base Sequence↗
PubMed1987

Calcitonin and the peptides from the calcitonin gene.

The alpha-calcitonin gene encodes a small family of peptides: calcitonin, katacalcin, and calcitonin gene-related peptide (CGRP). Calcitonin and katacalcin are produced from one precursor and CGRP from another. Calcitonin and katacalcin come mainly from the thyroid, while CGRP is present in both the thyroid and the central nervous system. Calcitonin is concerned with skeletal integrity, while the function of katacalcin, if any, is unknown. The secretion of calcitonin is, in part, estrogen dependent, and it appears likely that a postmenopausal decline in calcitonin secretion is a factor in the development of postmenopausal osteoporosis. It is possible that calcitonin may prove useful in the prevention and perhaps the treatment of this condition. CGRP, conversely, is one of the most potent vasodilators known and probably plays an important physiologic role in the control of vessel tone and blood flow. CGRP may also have a role as neurotransmitter or neuromodulator.

Amino Acid Sequence↗
PubMed1986

The calcitonin-like sequence of the beta CGRP gene.

We have identified a region within the beta CGRP gene which has the potential to encode a novel calcitonin-like peptide. The gene is located on the short arm of chromosome 11 (11p 12-14.2) and we suggest that it resulted from a local duplication of the alpha gene. We have been unable to detect the corresponding mRNA in a variety of tissues which express alpha-calcitonin. It is not clear whether this sequence can be expressed in man.

Base Sequence↗
PubMed1983

A familial X/Y translocation in a boy with ichthyosis, hypogonadism and mental retardation.

A 14-year-old boy is described with hypogonadism, ichthyosis and mental retardation. His karyotype was 46,Y, der(X),t(X;)(p22;q11). His mother's karyotype was 46,X,der(X),t(X;Y)(p22;q11). Thus the son is nullisomic for the region Xp22 leads to pter and the mother is monosomic for the same region. The steroid sulfatase activity in this boy is discussed in relationship to the enzyme's locus on the X chromosome and the manifestation of ichthyosis.

Adolescent↗