Recidivirajući hiperparatiroidizam: prikaz slučaja

A 57-year-old man with a history of primary hyperparathyroidism, consequential chronic renal failure and associated chronic Hashimoto.s thyroiditis presented with recurrent hypercalcemia. Hypercalcemia persisted despite three resections of enlarged parathyroid glands and multiple sclerosations of the remaining parathyroid tissue. The possible causes of persisting hypercalcemia include unrecognized asymmetric parathyroid hyperplasia, multiple parathyroid adenomas, however, parathyromatosis as a complication of parathyroid resection could not be ruled out. Dispersion of parathyroid tissue and growth of multiple parathyroid nodules could lead to primary hyperparathyroidism. With intermittent parenteral pamidronate normocalcemia was temporarily achieved, although fourth resection of parathyroid tissue and subtotal thyroidectomy eventually led to normocalcemia and normal parathyroid hormone levels in this patient.Prikazuje se 57-godišnji bolesnik s recidivirajućim primarnim hiperparatiroidizmom i posljedičnom kroničnom bubrežnom insuficijencijom.U tri navrata učinjena je ekstirpacija povećanih paratiroidnih žlijezda i višekratna sklerozacija preostalog paratiroidnog tkiva, uz i dalje prisutnu hiperkalcemiju. Moguća objašnjenja su da se kod bolesnika radilo o višestrukim adenomima paratiroidnih žlijezda koji su se razvili metakrono ili se od samog početka radilo o neprepoznatoj asimetričnoj hiperplaziji svih paratiroidnih žlijezda. Ne može se, međutim, isključiti niti paratiromatoza kao posljedica poslijeoperacijske rupture kapsule adenoma, što je dovelo do rasapa i ponovnog rasta višestrukih paratiroidnih čvorova i recidiva primarnog hiperparatiroidizma. Bolesnik je uz intermitentnu parenteralnu terapiju pamidronatom bio u prolaznoj normokalcemiji, a nakon ponovne pojave hiperparatiroidizma učinjena je radikalna disekcija paratiroidnog tkiva i subtotalnalna resekcija štitne žlijezde, čime je uspostavljena normokalcemija i postignuta uredna razina paratiroidnog hormona

Autoimuni poliglandularni sindrom tip II. - prikaz slučaja

Presentation is made of a 41-year-old man with Addison’s disease and coexistent Hashimoto’s thyroiditis and hypothyroidism. The two diseases are presumed to be of autoimmune etiology and to manifest as part of the autoimmune polyglandular syndrome type II, as also suggested by tissue typing for HLA B8 locus. Inadequate TSH suppression with standard levothyroxine substitution therapy for a one-year period or with higher substitution doses of 200 mg during TRH stimulation, with FT4 which showed no major increase but remained within lower normal limits, indicated partial hypophyseal resistance to thyroxin and/or possible development of autoantibodies to peripheral thyroid hormones.Prikazan je 41-godišnji bolesnik s Addisonovom bolešću i pridruženim Hashimotovim tireoiditisom i hipotireozom. Za pretpostaviti je da su ove dvije bolesti autoimune etiologije i da se javljaju u okviru autoimunog poliglandularnog sindroma tipa II., na što upućuje i tipizacija tkiva u smislu HLA B8 lokusa. Nedovoljna supresija TSH standardnom nadomjestnom terapijom levotiroksinom kroz dulje vremensko razdoblje od godinu dana, kao i većim nadomjestnim dozama od 200 mg tijekom stimulacije TRH, uz FT4 koji se nije značajnije povisio, nego je ostao u nižem normalnom rasponu, ukazivala je na djelomičnu rezistenciju hipofize na tiroksin i/ili mogućnost razvoja autoantitijela na periferne hormone štitnjače

Reaktivna i klonska trombocitoza: citokini i reaktanti akutne faze

Platelets are acute phase reactants that increase in response to various stimuli, including systemic infections, inflammatory conditions, bleeding, and tumors. This is called reactive or secondary thrombocytosis, which is a benign form of thrombocytosis. Clonal thrombocytosis is an unregulated abnormality of platelet production due to clonal expansion of bone marrow progenitor cells. Secondary thrombocytosis may be due to the overproduction of proinflammatory cytokines such as interleukin-1 (IL-1), IL-6, and IL-11, which occurs in chronic inflammatory, infectious and malignant states. The presence of elevated IL-1, IL-6, C-reactive protein and granulocyte-macrophage colony-stimulating factor in individuals with this condition suggests that these cytokines may be involved in reactive thrombocytosis.Trombociti su reaktanti akutne faze i njihov se broj povećava kao odgovor na različite podražaje, uključujući sistemske infekcije, upalna stanja, krvarenja i tumore. To se naziva reaktivnom ili sekundarnom trombocitozom, što je benigni oblik trombocitoze. Esencijalna trombocitoza je nenormalna proizvodnja trombocita uzrokovana klonskom ekspanzijom progenitorske stanice koštane srži. Sekundarna trombocitoza može biti uzrokovana prekomjernom proizvodnjom proupalnih citokina, kao što su interleukin 1 (IL-1), IL-6, IL-11, koji se javljaju u kroničnim upalnim, infektivnim i malignim stanjima. Prisutnost povišenih vrijednosti IL-1, IL-6, C-reaktivnog proteina i granulocitno-makrofagnog faktora stimulacije rasta u pojedinaca s ovim stanjem ukazuje kako bi ovi citokini mogli biti upleteni u reaktivnu trombocitozu

Sputtered Ge-on-Si heteroepitaxial pn junctions: Nanostructure, interface morphology and photoelectrical properties

Ge thin films are epitaxially grown onto (1 0 0) Si substrates by DC-Pulsed Magnetron Sputtering. Relaxed single crystalline layers, with slightly misoriented domains are identified by XRD, TEM and HREM. Planar defects and threading dislocations are the relevant lattice imperfections. As-deposited Ge films are p-type without the need for intentional doping, even in the absence of grain boundaries. A pronounced flatness in the near IR absorption spectra is evident, in the absence of strong interfacial strain. This could be traced to a bandgap narrowing effect due to intragap states related to defects in the interfacial region. Photoconductive response around λ = 1.5 μm is flat and an equivalent responsivity Reff|Vbias = −1V = 1.0088 A/W at λ = 1.5 μm has been estimated

Superlattice approach to doping infinite layer nickelates

The recent observation of superconductivity in infinite layer Nd1 amp; 8722;xSrxNiO2 thin films has attracted a lot of attention, since this compound is electronically and structurally analogous to the superconducting cuprates. Due to the challenges in the phase stabilization upon chemical doping with Sr, we synthesized artificial superlattices of LaNiO3 embedded in insulating LaGaO3, and we used layer selective topotactic reactions to reduce the nickelate layers to LaNiO2. Hole doping is achieved via interfacial oxygen atoms and tuned via the layer thickness. We used electrical transport measurements, transmission electron microscopy, and x ray spectroscopy together with ab initio calculations to track changes in the local nickel electronic configuration upon reduction, and we found that these changes are reversible. Our experimental and theoretical data indicate that the doped holes are trapped at the interfacial quadratic pyramidal Ni sites. Calculations for electron doped cases predict a different behavior, with evenly distributed electrons among the layers, thus opening up interesting perspectives for interfacial doping of transition metal oxide

H-1 and C-13 Nmr-Studies of Aminoglycoside Antibiotics

H-1 NMR spectroscopy was used to determine the conformations of the aminoglycoside antibiotic N-demethylclindamycin and two of its cyclic derivatives. The conformational features of these systems were determined by consideration of vicinal coupling constants and, in some cases, nuclear Overhauser enhancement (NOE) effects. H-1 and C-13 chemical shifts are reported and compared with previous results for the related antibiotic lincomycin. The stability of the two cyclized derivatives in aqueous solution was examined. Both cyclizations involved formation of a 4-imidazolidinone ring. It was found that the ring system based on cyclization with formaldehyde was stable in aqueous solution, whereas that based on benzaldehyde was not