Regulatory peptides: the molecular aspects of biological mechanism

摘要

Therefore, we provide a powerful tool to manipulate mice to SWS with high temporal precision, even in some particular sit- uation that mice are naturally not easy to fall asleep. Multiple endocrine neoplasia with psychiatric involvement: A case report and literature review He is a 48 years old male, diabetic, hypertensive, arteriopathic, followed at our service for a multiple endocrine neoplasia type 2. The discovery of the adrenal mass was fortuitous, and the diagno- sis of pheochromocytoma was suspected on symptoms dominated by the frequent occurrence of panic attacks leading to consult in psychiatry and put on symptomatic treatment. The evolution was marked by the imbalance of his diabetes and blood pres- sure and the occurrence of paroxysmal hypertension associated with a weight loss and the MENARD triad (headache, palpitations, sweating). A pheochromocytoma was confirmed after determina- tion of the urinary-methoxylated-derivatives which was positive at 10 times normal and with CT:2 adrenal masses of 6 cm(left) and 5 cm(right)with MIBG scintigraphy in favor of bilateral pheochro- mocytoma without signs of secondary localization. The patient had left adrenalectomy with histological confirmation of multin- odular pheochromocytoma and a 50% drop in postoperative DMU levels. In postoperative, the patient presented an acute adrenal insufficiency, in the setting of multi-organ failure by a septic shock with pulmonary starting-point, which was explained by hemorrhagic necrosis of the right adrenal gland, requiring corti- costeroid treatment with good evolution. The operative indication was asked but refused by the patient. As part of screening for NEM, primary hyperparathyroidism was eliminated. The diagnosis of a CMT was suspected by the presence of 2 nodules on thy- roid ultrasound with a calcitonin assay at 152 ng/l (VN<10ng/l) and confirmed by cytology. The patient had a total thyroidectomy with bilateral lymphadenectomy complicated by the occurrence of postoperative hypoparathyroidism undergoing vitamin-calcium replacement therapy. A scintigraphic control after 2 years showed a stable appearance of right pheochromocytoma without secondary localization, DMUs were stable at around 4 times normal. The genetic study is in progress. It is a research about psychiatric disor- ders that can reveal organic diseases and particularly abnormalities of the neuroendocrine system. The discovery of a tumor requires the investigation of other disorders that may be associated with multiple endocrine neoplasia.