bluuebunny/crossref_metadata_2025_split huggingface dataset:
MON-500 Cell Adhesion Molecules mRNA Expression in Thyroid Tumors
Authors: Teodoro Larissa , Peres Karina Colombera , Nascimento Matheus , Teixeira Elisangela Souza , Barreto Icleia Siqueira , Geraldo Murilo Vieira , Assumpção Ligia Vera Montalli , Tincani Alfio José , Maximo Valdemar , Bufalo Natassia Elena , Ward Laura Sterian 
Published: May 2020

Abstract
Thyroid cancer biology is extremely diverse. While some cases never progress clinically or do so indolently, others evolve aggressively and may even lead to death. Cell adhesion molecules are glycoproteins present in the cell membrane and play an important role in inflammatory and neoplastic diseases by recruiting immune cells to these sites. The aim of the present study was to investigate the role of mRNA expression of SELL, ICAM1 and ITGAL in thyroid tumors and their relationship with lymphocyte infiltration. We evaluated by RT-qPCR technique 191 thyroid nodules including 97 benign (79 females, 17 males; 49.8±12.5 years old) and 94 malignant (71 females, 23 males; 48.3±15.5years old) cases. Clinical and pathology data were obtained from 47 goiters; 50 follicular adenomas (FA); 74 papillary thyroid carcinomas (PTC), including: 29 classic papillary thyroid carcinomas (CPTC), 21 follicular variant of PTC (FVPTC), 12oxifilic variant of PTC (OVPTC), 12 tall cell papillary thyroid carcinomas (TCPTC); and 20 follicular thyroid carcinomas (FTC). All patients were managed according to a standard protocol based on current guidelines and followed-up for 78.7±54.2 months. SELL was more expressed in malignant (0.85±1.54 UA) than in benign (0.54±0.71 UA, p=0.0027) nodules. The same occurred with ICAM1 (0.99±1.41 vs. 0.46±0.85, p=0.0001), but not with ITGAL gene expression (1.04±1.63 vs. 0.76±1.21, p=0.2131). In addition, the expression of SELL was different when we compared PTC with FA (0.94±1.62 UA vs. 0.47±0.72 UA, p=0.0018) and FTC with FA (0.82±2.38 UA vs. 0.47±0.72 UA, p=0.0078). ICAM1 expression was lower in goiters (0.46±0.90 UA) when compared with PTC (0.93±1.22 UA, p=0.0030) and FTC (1.03±3.30 UA, p=0.0207). Higher expression of ICAM1 (1.16±3.04 UA vs. 0.52±0.96 UA, p=0.0064) and ITGAL (1.17±1.54 UA vs. 0.49±1.39 UA, p=0.0244) was observed in tumors with lymphocyte infiltrate. Also, ITGAL gene expression was higher in tumors that had distant metastasis at diagnosis (1.53±2.18 UA vs. 0.57±1.10 UA, p=0.0217). We were not able to demonstrate any association between any of the investigated molecules and patients’ outcome. In conclusion, our data suggest that cell adhesion molecules may play an important role in neoplastic thyroid cells proliferation. In addition, our findings show that gene expression of SELL and ICAM1 may assist in the histological characterization of follicular patterned thyroid nodules.
SUN-192 Spontaneous Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome on Rivaroxaban: A Potentially Fatal Complication
Authors: DiCenso Daniela Maria , Penaherrera Carlos A , Ayala Alejandro 
Published: May 2020

Abstract
Introduction: Primary Adrenal insufficiency is an uncommon complication of antiphospholipid syndrome, with an incidence of 0.4% [2]. It is often secondary to bilateral adrenal hemorrhage. We present a case of bilateral adrenal hemorrhage in a patient with APLS on anticoagulation with rivaroxaban. Case: 46-year-old m with a history of antiphospholipid syndrome, recently transitioned from warfarin to rivaroxaban for anticoagulation, who presented to the ED after a syncopal episode following a prior episode of abdominal pain with an unremarkable work-up. He subsequently developed severe fatigue, dizziness, headaches, nausea and 15 lbs weight loss. On presentation, the patient was hypotensive(72/45 mmHg) and tachycardic. Intravenous hydration was started with minimal response. Initial laboratory testing showed serum sodium of 121mmol/L, potassium of 5.5mmol/L and random cortisol of 0.8mcg/dL. The patient was admitted to the intensive care unit where he was started on vasopressors and hydrocortisone 50 mg IV every 8 hours. A non-contrast CT of the abdomen and pelvis showed thickening of the adrenal glands with decreased attenuation. MRI of the abdomen showed hyper-intensity of the adrenal glands bilaterally (T1 images), without post-contrast enhancement suggestive of bilateral adrenal hemorrhage. His electrolytes normalized, and he was successfully discharged home on hydrocortisone and fludrocortisone replacement with outpatient follow-up. Discussion: Atraumatic bilateral adrenal hemorrhage is rare, but remains one of the most common endocrine-related complications of antiphospholipid syndrome (APLS). The venous anatomical configuration of the adrenal gland increases risk of thrombotic hemorrhagic infarction[1]. Patients with APLS are commonly anticoagulated to prevent thrombosis. The ideal anticoagulation regimen remains controversial. Only three other cases of spontaneous bilateral adrenal hemorrhage on patients with APLS using new oral anticoagulants (NOACs) were reported. The use of NOACs seem to increase the already-elevated risk of adrenal hemorrhage seen in patients with APLS.
References:
1. Aldaajani, H. et al. Bilateral adrenal hemorrhage in antiphospholipid syndrome: Anticoagulation for the treatment of hemorrhage. Saudi Med J. 2018; 39(8): 829-833.
2. Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT, et al. Antiphospholipid syndrome: Clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum. 2002;46:1019-27.
SAT-030 The Barnsley Diabetes Hypogonadal Questionnaire (BDHQ) - Validation for the Clinical Use to Support the Diagnosis of Testosterone Deficiency in Men with Type 2 Diabetes (T2D)
Authors: Mumdzic Enis , Rao Preethi Mohan , Jones Thomas Hugh 
Published: May 2020

Abstract
The Aging Males’ Symptoms (AMS) scale is used to assess health-related quality of life (HRQOL) and erectile dysfunction (ED) in hypogonadal men. However, this questionnaire hasn’t been validated specifically for use in hypogonadal men with T2D. BDHQ was developed using data collected in the Barnsley Type 2 Diabetes Cohort Longitudinal Study based on AMS, The International Index of Erectile Function Questionnaire, and The Short Form (36) Health Questionnaire. Statistical analysis identified the 19 most sensitive and specific questions for identifying men with hypogonadism in a T2D population.
Objectives: To assess the significance of AMS and BDHQ in hypogonadal men with T2D.
Methods: The research data from a study involving men with T2D was used. All men were divided into 2 groups according to their baseline total testosterone (TT) status: group 1 (n = 82) - men with low TT (&lt;10.4nmol/l; 300ng/dl), and group 2 (n = 64) - men with normal TT (≥10.4nmol/l; 300ng/dl). Data was also assessed using calculated freeT and bioavailableT. The statistical analysis was carried out using SPSS software and the data analysed using General Linear Model Univariate analysis of variance and Receiver Operating Characteristic (ROC) curve.
Results: Mean age for group 1 was 59.4 ± 10.1 years (range 25 - 77) and for group 2 was 61.5 ± 9.8 years (range 30 - 80). Mean TT for group 1 was 7.9 ± 1.8 nmol/l (range 1.3 - 10.3); for group 2TT was 14.9 ± 4.1 nmol/l (range 10.4 - 29.5). There was statistically significant difference in the scores in both questionnaires between the groups (AMS, p=0.012; BDHQ, p=0.035). Area under the curve (AUC) by ROC analysis showed no significant difference in sensitivity and specificity between the two questionnaires (AMS, AUC=0.623; BDHQ, AUC=0.606). To achieve sensitivity of 80%, it showed that the cut-off for positive test should be 40 out of 85 for AMS, and 44 out of 95 for BDHQ.
Conclusion: The BDHQ can be used to support a diagnosis of hypogonadism in the presence of persistent testosterone deficncy when TT is &lt;10.4nmol/l. Whilst AMS is well-recognised tool for assessing HRQOL and ED in hypogonadal men in general population, the cut-off for positive test should be lower in diabetic population. In addition, this study showed that BDHQ is not inferior test to AMS in assessing HRQOL and ED in hypogonadal men with T2D.
SUN-352 The Effects of Acute Hyponatremia on Bone Remodeling Markers in Patients with Subarachnoid Hemorrhage
Authors: Garrahy Aoife , Galloway Iona , Hannon Anne Marie , Dineen Rose , Gan K J , Javadpour Mohsen , Tormey William T , Twomey Patrick J , McKenna Malachi J , Kilbane Mark , Sherlock Mark , Crowley Rachel K , Thompson Chris J 
Published: May 2020

Abstract
Animal data and cross-sectional human studies have established that chronic hyponatremia predisposes to osteoporosis; the effects of acute hyponatremia on bone remodeling are unknown. Serum markers of bone remodeling (total procollagen type 1 amino-terminal propeptide (P1NP), bone specific alkaline phosphatase (bone ALP), N-mid-osteocalcin (OCI) and C-terminal teleopeptides of type I collagen (CTX-1)) were assessed in a cohort of patients admitted with subarachnoid hemorrhage (SAH), who were prospectively studied over seven days. The ratio of P1NP:CTX-1 was calculated to report a bone formation index.
Twenty-two patients (13 women), median (IQR) age 53 (47, 62) years were recruited. Patients who developed post-SAH ACTH deficiency and those treated with glucocorticoids, or continuous enteral feeding were excluded. All patients were eunatremic on initial assessment. Eight patients developed acute hyponatremia, median nadir plasma sodium concentration (pNa) 131 (128, 132) mmol/L, and 14 remained eunatremic, nadir pNa 136 (133, 137) mmol/L. The groups were matched for age, 25-hydroxy Vitamin D, PTH, WFSS and Fischer scores. Serum cortisol concentration was greater in the hyponatremic group, 571 (504, 671) nmol/L, than the eunatremic group, 449 (400, 501) nmol/L, p=0.008. Bone remodeling markers and bone formation index (P1NP:CTX-1 ratio) were similar in the two groups at baseline.
There was a significant rise in CTX-1 in both hyponatremic patients, +0.15 (0.09, 0.37) μg/l, p = 0.009, and patients who remained eunatremic, +0.11 (-0.02, 0.23) μg/l, p = 0.04, with no significant difference between the groups. There was, however, a significant fall in P1NP:CTX-1 ratio in patients with acute hyponatremia, p = 0.02, but no significant change in eunatraemic patients, with significant between group difference, p = 0.02.
Changes in P1NP and OCI correlated positively with nadir pNa; r = 0.43, p = 0.04 and r = 0.61, p = 0.001 respectively. In addition, there was a positive correlation between change in P1NP:CTX-1 ratio and nadir pNa, r = 0.43, p = 0.04. There was no correlation between change in OCI or CTX-1 and nadir pNa. Serum cortisol was strongly negatively correlated with change in P1NP (r = -0.64, p = 0.001) but not with change in other bone remodeling markers.
Acute hyponatremia following SAH is associated with a fall in bone formation index; physiological hypercortisolemia may contribute to this. Further analysis with larger numbers will help us determine whether hyponatremia is an independent risk factor.
MON-305 Clinical Features in Patients with Hypercorticism
Authors: Negmatova Gulzoda Shuhratovna , Norshodieva Rukhangiz Utkurovna , Mirsaidova Umida Akmalovna 
Published: May 2020

Abstract
Cushing’s disease is a severe multimorbid pathology affecting mainly people of young working age. In most cases, the diagnosis of the disease is acute and the patient is observed for a long time by doctors of different specialties with complications of hypercorticism.
Purpose: To identify the most frequent clinical manifestations of hypercorticism at the time of diagnosis of Cushing’s disease, to analyze the relationship of clinical manifestations of hypercorticism with the main clinical and laboratory indicators.
Material and methods: 25 patients were examined, including 15 women and 10 men with Cushing’s disease, registered in Samarkand Endocrinology Clinic.
Results: Majority of patients (68%) were in age 25-40, the average age was 37. The median duration of the disease was 35,5 months. Matronism, the most characteristic manifestation of hypercortisolism was observed in 36% (9 patients). This is most often associated with hypercorticism symptoms were striae and acne, which were found in 56% (14 patients), osteoporosis 40% (10). The most frequent complaints were weight gain, fatigue, headache, menstrual disturbances. A number of symptoms had a positive correlation with cortisol levels.
Conclusion: Clinical manifestations of hypercorticolism are mainly nonspecific. Striae and acne were found in high frequency. Therefore these key features, namely a change in facial appearance, weight gain, elevation of BMI and the presence of genital virilisation should alert the clinician to the possibility of Cushing’s disease and initiate laboratory evaluation
MON-161 Body Weight Reduction Not Always Reduced Adrenal Gland Volume in Obese Patients
Authors: Chen Tao 
Published: May 2020

Abstract
Recent studies have shown that obesity is a major risk factor for idiopathic hyperaldosteronism (IHA). IHA patients have greater AGV than normal controls. However, it is unclear whether such changes are caused by obesity and whether losing weight could reverse the morphological and functional abnormalities of the adrenal gland. This study was to investigate the association of obesity with adrenal gland volume (AGV) and the effects of weight loss on AGV. This study recruited obese patients (N=25) who underwent sleeve gastrectomy and age- and sex-matched normal-weight (N=25) and overweight healthy volunteers (HV) (N=21). Thin-slice computed tomography was used to evaluate adrenal morphological changes. AGV was measured semiautomatically based on the digital imaging and communications in medicine (DICOM) image. The effects of weight loss on AGV were evaluated in patients for one year or more after sleeve gastrectomy. The results showed that left, right and total AGV were larger in obese patients than those in overweight and normal- weight HVs (6.77±0.36, 5.76±0.31, and 12.53±0.64 cm3 vs. 3.88±0.14, 3.09± 0.13 and 6.97± 0.24 cm3 vs. 3.38±0.23, 2.67±0.15 and 6.04±0.36 cm3). No statistically significant difference was identified between overweight and normal-weight HVs. Sleeve gastrectomy significantly reduced body weight (-27.1±2.5 kg), left AGV (-0.80±0.26 cm3), and right AGV (-0.88±0.20 cm2). However, the adrenal volume in five patients was not reduced, despite significant weight loss postsurgery. In brief, obesity leads to increased AGV, and in some cases, this effect seems to be irreversible. We speculate that obesity causes permanently adrenal morphological changes (increased volume or hyperplasia), and under certain circumstances, it results in excessive aldosterone secretion via altered adipokines (leptin, CTRP1, etc.).
MON-598 Vitamin B12 Deficiency Leads to Fatty Acid Metabolism Dysregulation and Increased Pro-Inflammatory Cytokine Production in Human Adipocytes and Maternal Subcutaneous and Omental Adipose Tissue
Authors: Samavat Jinous , Adaikalakoteswari Antonysunil , Boachie Joseph , McTernan Philip , Christian Mark , Saravanan Ponnusamy 
Published: May 2020

Abstract
Vitamin B12 (B12) is an essential micronutrient required for optimal hematopoietic, neurologic and other several metabolic reactions. Animal and clinical studies show that B12-deficiency is associated with maternal obesity, insulin resistance, and metabolic syndrome. Given the key metabolic role of adipose tissue, we investigated whether B12 deficiency may affect triglyceride synthesis and lipid metabolism leading to adipose tissue inflammation. The AbdSc pre-adipocyte cell line (Chub-S7) and human AbdSc primary pre-adipocytes were differentiated under different B12 concentrations (25pM,100pM,1nM,500nM). Human Om, Sc-AT and blood samples were collected from 106 pregnant women at delivery. SerumB12 and relevant metabolic risk factors were measured. Gene expression was performed by q-RTPCR, de novo triglyceride synthesis was quantified by radioactive tracing, ß-oxidation and palmitate-induced oxygen consumption rate was determined using seahorse-XF analyser. Adipocytes cultured in low-B12 conditions showed significantly increased expression (P&lt;0.01) of triglyceride biosynthesis genes (ELOVL6,SCD,GPAT,LPIN1 and DGAT2), a significantly decreased expression (P&lt;0.01) of ß-oxidation genes (FAT/CD36,CPT1-ß,ACADL,ECHS1 andACAA2) and an increased expression (P&lt;0.01) of pro-inflammatory cytokines (IL-1, IL-6,IL-8,IL-18,TGF-β,TNF-α and MCP-1). These data were also confirmed in the AT of B12-deficient pregnant women. Additionally, real-time fatty acid flux synthesis and fatty-acid-oxidation induced by palmitate were significantly altered (P&lt;0.05) in B12-deficient adipocytes. Our data highlights that B12-deficiency has profound effects on adipocyte dysfunction, opening new insights into the pathogenesis of maternal obesity and the relevance of micronutrient supplementation for pregnant mothers.
SAT-708 The Effect of Soybean Isoflavones in Developing Cerebellum
Authors: Ariyani Winda , Miyazaki Wataru , Amano Izuki , Koibuchi Noriyuki 
Published: May 2020

Abstract
Abstract ENDO 2020
The effect of soybean isoflavones in developing cerebellum
Thyroid hormone (TH) receptor (TR) and estrogen receptor (ER) play crucial roles in cerebellar development. TR and ER are involved in Purkinje cells dendrite growth, spines and synapse formation. They also regulate the functional maturation, intracellular metabolism, and migration of neuron and glial. Soybean isoflavones especially genistein, daidzein, and daidzein metabolite, S-equol were known to exert their action through TR, ER, and GPR30, that is a G-protein-coupled ER. However, the mechanisms of soybean isoflavone action on cerebellar development and function have not yet been extensively studied. We evaluated the effects of soybean isoflavone, such as genistein, daidzein, and S-equol, using mouse primary cerebellar culture, astrocyte-enriched culture, and C6 clonal cells. Soybean isoflavone augmented TH- or estradiol (E2)-mediated dendrite arborization of Purkinje cells. Such augmentation was suppressed by G15, a selective G-protein coupled ER (GPR30) antagonist, and ICI 182.780, an antagonist for ERs in both cultures. It also increased mRNA expression level of TH-responsive genes including Mbp, Bdnf, Rc3, Ntf3, Camk2b, and Hr. Moreover, genistein and daidazein also increased mRNA expression level of Syn1, Syp and Psd95 that are involved in synaptic plasticity.
On the other hand, in astrocytes, soybean isoflavone activated cell migration and F-actin rearrangements. Such effects were suppressed by G15, but not by ICI 182.780. Knockdown of GPR30 by RNAi also suppressed the cells migration. Protein expression levels of p-Akt (Ser473), p-Rac1/cdc42 (Ser71), RhoA, Rac1/2/3, and cdc42 also increased by soybean isoflavone. Co-exposure with Rhosin HCl, a selective RhoA inhibitor, reduced the cells migration and formation of stress fibers. These findings indicate that sobybean isoflavone may affect cerebellar development by acting to both neurons and astrocytes through several signaling pathways, including TR, ER, and GPR30.
Keywords:
EDC, ER, TR, GPR30, Neuron, Astrocyte
SUN-571 The Associations Between p,p’-DDE Levels and Serum Levels of Lipoproteins and Their Subclasses in an Elderly Population Determined by Lipidomics Analysis
Authors: Jugan Juliann Amela , Lind P Monica , Salihovic Samira , Stubleski Jordan , Kärrman Anna , Lind Lars , Merrill Michele La 
Published: May 2020

Abstract
Low biodegradability and high lipophilicity of p,p’-dichlorodiphenyldichloroethylene (DDE), a metabolite of the insecticide DDT, leads to transport with lipids and accumulation in adipose tissue. This persistence allows for DDE to effect adipose tissue and lipid metabolism. A few small human studies have shown an association between DDE and blood lipids, although with some inconsistent conclusions. The aim of this study was to investigate the association between DDE exposure and altered levels of circulating lipids in a large human cohort. To evaluate the associations between DDE and human lipid profiles, plasma was collected from a subset of elderly Swedes in the Prospective Investigation of the Vasculature of Uppsala Seniors (PIVUS) cohort who were free from lipid lowering medication (n = 571). DDE concentrations in plasma were measured using high-throughput solid phase extraction and gas chromatography-high resolution mass spectrometry. Lipidomic analysis of plasma was performed with nuclear magnetic resonance spectroscopy. Linear models of lipids and DDE were statistically adjusted for sex and body mass index. Detectable levels of DDE were found in the plasma samples of all subjects. With elevated DDE levels, the comprehensive lipoprotein profile showed an elevation in total concentration of all diameters of very low density lipoprotein (VLDL) (p&lt;0.001), low density lipoprotein (LDL) (p&lt;0.008), intermediate density lipoprotein (IDL) (p&lt;0.02), and in small high density lipoprotein (HDL) (p&lt;0.05). Triglycerides and DDE were associated to varying degrees in lipoproteins (IDL &gt; VLDL &gt; LDL &gt; HDL) and within total serum (p&lt;0.005). DDE levels were positively associated with cholesterol and cholesterol ester levels only in VLDL and LDL (p&lt;0.05) and with apolipoprotein B (p&lt;0.0009). The positive associations observed between each lipoprotein class and elevated DDE support previous data suggesting that DDE interacts with lipoproteins within plasma. We speculate that both physio-chemical and biological mechanisms may explain why DDE does not uniformly associate with lipids across lipoproteins.
SUN-176 A Case of Aldosterone-Producing Adenoma with Preoperative Use of a Novel Mineralocorticoid Receptor Antagonist Esaxerenone
Authors: Yamanami Hiroaki 
Published: May 2020

Abstract
Background: Esaxerenone is a novel mineralocorticoid receptor antagonist (MRA) with nonsteroidal structure and high selectivity to MR, which became clinically available in Japan in 2019.
Clinical Case: A 57-year-old woman showed a left adrenal incidentaloma (15mm) on MRI. Serological tests confirmed a diagnosis of primary aldosteronism: baseline plasma aldosterone concentration (PAC) was elevated (47.3 ng/dL, n &lt; 15.9 ng/dL), and plasma renin activity (PRA) below sensitivity. PAC after saline infusion was 43.2 ng/dL. Overnight 1mg dexamethasone suppression test was negative. Her blood pressure had been well-controlled with amlodipine 5mg daily. Despite of large amount of potassium supplementation (96 mmol/day orally and 50 mmol/day intravenously), the level of serum potassium remained low (3.2 mmol/L). Adrenal venous sampling (AVS) was performed successfully, showing laterality index of 45.8 on left. Segmental AVS supported aldosterone hypersecretion from the tumor. After diagnosis, esaxerenone was introduced and the patient became normokalemic without potassium supplementation after a week. No adverse effect occurred in a period of two months before surgery. She underwent laparoscopic left total adrenalectomy. The tumor was positive for CYP11B2, consistent with aldosterone producing adenoma (APA). She became normotensive and normokalemic without any medications.
Conclusion: This case illustrates the preoperative effectiveness of esaxerenone on blood pressure and hypokalemia in patients with APA.
Key words: Esaxerenone; mineralocorticoid receptor antagonist; case report; adrenal venous sampling; primary aldosteronism; aldosterone producing adenoma