Calprotectin as a marker of inflammation in cystic fibrosis

Calprotectin is an abundant neutrophil cytosolic protein released during neutrophil activation or death. The use of plasma calprotectin concentration as a marker of pulmonary inflammation was tested in 31 children with cystic fibrosis, none of whom was acutely unwell or pyrexic. Twenty three were receiving antibiotics, 21 had positive sputum cultures, but none of the traditional tests clearly diagnosed ongoing infection. Plasma calprotectin was significantly higher in the cystic fibrosis group than in matched controls. Sixteen children with cystic fibrosis had values above the control range (320-1570 micrograms/l). Their chest radiograph Northern score, an index of accumulated pulmonary involvement, and their plasma copper, an index of acute phase response, both correlated with plasma calprotectin. Plasma gamma-glutamyltransferase also correlated weakly with plasma calprotectin: thus, hepatic pathology may be a confounding variable. However, the data still suggested that plasma calprotectin is a better index of inflammation than the traditional indices in general use.     

Growth Hormone and Prolactin Secretion after External Cranial Irradiation for Extrasellar Tumours

Background

Deficiency of one or more anterior pituitary hormones may follow treatment with external radiation when hypothalamo-pituitary axis lies within the field of radiation. Patients with brain tumours who are treated with radiation frequently have growth hormone (GH) deficiency, other neuro-endocrine abnormalities are presumed to be uncommon. The present study has been undertaken with the aim to study GH and prolactin secretion, their relationship with dose of radiotherapy and duration after radiotherapy in patients who have received extracranial radiation for extrasellar tumours.

Method

In this study, 96 patients who underwent cranial radiation before 12 months, were evaluated. Basal 8 a.m. venous blood samples were taken for estimation of prolactin and GH. Insulin tolerance test was performed for stimulated GH levels.

Result

GH deficiency was present in 59% patients. Isolated GH deficiency was present in 12 (21%) cases, whereas others had associated hormone deficiency. Height percentiles of prepubertal and pubertal patients were 10^th to 25^th (-1.5 to -0.5SD). Patients with isolated GH deficiency had received significantly higher radiation dose than normal pituitary function (5795 ± 24 vs 4908 ± 71, p=0.001). Proportion of patients with GH deficiency increased with increasing dose of radiation (p=0.12), fractional dose of radiation (p=0.08) and increasing duration after radiotherapy (p=0.038). GH levels among all decreased significantly with increasing dose of radiation (p=0.02). Hyperprolactinemia was present in 21% of cases. GH deficiency is more common with lower (<5ng/ml) and higher (>15ng/ml) prolactin levels.

Conclusion

GH deficiency is common after extracranial radiation for extrasellar tumours. GH deficiency is related to dose of radiation, fraction of radiation, and duration after radiotherapy. All prepubertal and pubertal patients with GH deficiency had their height percentile within normal range. Relation of prolactin and GH deficiency indicates that radiation affects both hypothalamus and pituitary.Key Words: Cranial radiation, Growth hormone deficiency, Hyperprolactinemia     

Target Gland Dysfunction Following External Cranial Radiation for Extrasellar Tumours

Background

Diseases of the pituitary gland manifest as increased or decreased production of one or more of these hormones that in turn trigger a series of secondary hormonal changes in target glands (Thyroid, Adrenal and Gonad). Dysfunction of target glands may follow treatment with external radiation when hypothalamo-pituitary axis lies within the field of radiation. The present study has been undertaken with the aim to study target gland dysfunction and their relationship with dose of radiotherapy and duration after radiotherapy in patients who have received extracranial radiation for extrasellar tumours.

Methods

In this study, 96 patients who underwent cranial radiation 12 months ago were evaluated. Basal 8 am venous blood samples were taken for estimation of triiodothyronine (T₃), thyroxin (T₄), thyrotropin stimulating hormone (TSH) and basal cortisol estimation. Pooled samples (three samples taken 20 minutes apart and pooled together) were taken for LH, FSH and testosterone (TE) estimation. Insulin tolerance test was performed for stimulated cortisol levels.

Results

Target gland dysfunction was present in 72 (75%) patients. Hypogonadism was present in 48 (53%) of post-pubertal patients. 36% of male patients had hypogonadism whereas 100% of female patients had hypogonadism. Patients with hypogonadism were older, received higher doses of radiation and evaluated earlier after radiotherapy than without hypogonadism. Serum testosterone level declined significantly with increasing doses of radiation. Hypoadrenalism was present in 44 patients (46%). There was no significant difference of age, radiation dose and radiation fraction among patients with or without adrenal insufficiency. Proportion of patients with hypoadrenalism increased with increasing duration after radiotherapy. Hypothyroidism was present in 12 patients (13%). Proportion of patients with hypothyroidism doubled with increasing dose of radiation. Serum T₃ level declined significantly with increasing doses of radiation. Patients with hypothyroidism had significantly low T₃ and T₄ level, but significantly higher TSH and basal and peak cortisol levels than patients without hypothyroidism.

Conclusion

Target gland dysfunction is common after extracranial radiation for extrasellar tumours. Hypogonadism was the commonest followed by hypoadrenalism and hypothyroidism. Target gland dysfunction was related to age, radiation dose and duration after radiotherapy, but not with fraction of radiation.Key Words: Adrenal insufficiency, Cranial radiation, Hypogonadism, Hypothyroidism     

姜黄素促进损伤骨骼肌修复

目的:研究姜黄素促进损伤骨骼肌修复的功能.方法:制作小鼠胫骨前肌实验性损伤模型,实验小鼠分别肌注和口服姜黄素,以组织学指标观察姜黄素体内促进损伤骨骼肌的修复功能.采用MTT和流析细胞分析技术观察姜黄素对骨骼肌成肌细胞的作用及可能的信号传导通路.结果:实验的小鼠肌肉伤口区新生肌纤维显著多于对照组.姜黄素无明显促C2C12细胞增殖,但能促进C2C12细胞融合而分化成肌纤维;姜黄素能抑制C2C12细胞NFκB反应因子的转活,而对c-Myc和CRE通路反应因子没有显著影响.大剂量使用姜黄素未见急性毒性反应.结论:姜黄素能通过促进骨骼肌干细胞的分化而促进损伤骨骼肌的修复.     

含巨菊形团的玻璃样变梭形细胞肿瘤--附3例报告及电镜分析

含巨菊形团的玻璃样变梭形细胞肿瘤 (ＨＳＣＴＧＲ)是近年来才被命名的间叶性肿瘤 ,光镜下类似低度恶性纤维粘液肉瘤。作者观察了 3例ＨＳＣＴＧＲ的光镜、电镜及免疫组化表现。3例中男性 2例 ,分别为 41和 5 4岁 ,女性 1例 ,6 2岁。肿瘤位于深部软组织 ,2例在下肢 ,1例在上臂。大体上 ,最大径 3～ 13 3ｃｍ不等 ,境界清楚 ,呈棕红色或黄白色 ,质实 ,可伴囊性变 ,其中发生于小腿的 1例合并有股骨骨肉瘤 ,小腿部肿块仅做了活检。光镜下 3例图像相似 ,均有纤维粘液样区 ,2例伴有玻璃样变 ,1例有灶性骨化。肿瘤细胞为温和的卵圆形至梭形细胞 ,…     

Percutaneous transluminal angioplasty and valvectomy in a failing in situ saphenous graft

A patient is described who experienced increasing ischemia in the follow-up period of femoral-peroneal artery graft surgery. Transcatheter angiographic management was successful in improving the long-term patency of the graft. The procedure is described, and the applications are discussed.     

Vitamin E analogues reduce the incidence of ventricular fibrillations and scavenge free radicals

Summary— The aim of our study was to analyse the protective effects of different α-tocopherol analogues 1) against fibrillations induced by an ischemia-reperfusion sequence, and 2) to further investigate in vitro the radical scavenging properties of these analogues by two sensitive methods. Concerning 1: isolated rat hearts underwent 10 min of coronary ligation followed by reperfusion and the α-tocopherol analogues were infused IS min before occlusion. Functional parameters including heart rate and fibrillations were recorded. Concerning 2: the β-phycoerythrin assay was utilised to determine the oxygen radical absorbing capacity (ORAC) of these vitamin E analogues against peroxyl radicals. Electron paramagnetic resonance (EPR) was used to measure their scavenger abilities on hydroxyl radical and superoxide anion production. Concerning 1: ventricular fibrillation times were reduced for all analogues treated hearts at concentrations of 1 μM and 5 μM, with Trolox being the most efficacious. Concerning 2: in our experimental conditions of intense production of free radicals, scavenging IC₅₀ values for hydroxyl radical were 1.15, 2.17 and 4.04 mM for Trolox, MDL 74270 and MDL 74366 respectively. Superoxide anion IC₅₀ values were 1.0 and 6.75 mM for Trolox and MDL 74270.
Our results show that water-soluble analogues of vitamin E are effective in the prevention of coronary ligation induced reperfusion arrhythmia, under our experimental conditions. Moreover, our data demonstrate that these vitamin E analogues are effective scavengers for a variety of radicals. Our studies support the view that compounds that can either inhibit the formation or scavenge free radicals can protect the heart against arrhythmia associated with ischemia-reperfusion.     

Assessment of the immune system in 55 Iranian patients with vitiligo

BACKGROUND: Vitiligo is an acquired idiopathic hypomelanotic disorder characterized by circumscribed depigmented macules resulting from the loss of cutaneous melanocytes. OBJECTIVE: In order to evaluate the immune system of Iranian patients with vitiligo, this study was accomplished. METHODS: Fifty-five Iranian patients with vitiligo and 60 healthy persons as control were investigated in this study. The laboratory techniques were included: antimelanocyte antibody (AMA) and antinuclear antibody (ANA) with indirect immunoflorescent test, C3 and C4 levels with single radial immunodiffusion (SRID), and rheumatoid factor (RF) with enzyme-linked immunosorbent assay (ELISA). RESULTS: AMA was positive in 17 patients (30.9%) and was negative in the entire control group (P < 0.0001). ANA was positive in 4 patients (7.3%), which was insignificantly higher than control group (1.7%). IgM-RF was positive in 6 patients (10.8%) while it was negative in the entire control group (P = 0.027). C3 and C4 values decreased in 14 patients (25.5%), which was significantly higher than control group (P < 0.001). CONCLUSION: The important role of the immune system in the pathogenesis of vitiligo could be suggested. In addition, the autoimmune hypothesis of vitiligo could be confirmed based on the results of this study.     

Identifying targets for COPD treatment through gene expression analyses

Despite the status of chronic obstructive pulmonary disease (COPD) as a major global health problem, no currently available therapies can limit COPD progression. Therefore, an urgent need exists for the development of new and effective treatments for COPD. An improved understanding in the molecular pathogenesis of COPD can potentially identify molecular targets to facilitate the development of new therapeutic modalities. Among the best approaches for understanding the molecular basis of COPD include gene expression profiling techniques, such as serial analysis of gene expression or microarrays. Using these methods, recent studies have mapped comparative gene expression profiles of lung tissues from patients with different stages of COPD relative to healthy smokers or non-smokers. Such studies have revealed a number of differentially-regulated genes associated with COPD progression, which include genes involved in the regulation of inflammation, extracellular matrix, cytokines, chemokines, apoptosis, and stress responses. These studies have shed new light on the molecular mechanisms of COPD, and suggest novel targets for clinical treatments.     

Cerebrovascular disease: evaluation with transbrachial intraarterial digital subtraction angiography using a 4-F catheter

Three hundred sixty-one patients underwent intraarterial digital subtraction angiography for definite or probable occlusive vascular disease of the carotid arteries. Examinations were performed with 65-cm-long, 4-F aortic catheters. A transbrachial approach was used. Images were good or excellent in nearly all cases. No postprocedural neurologic deficits or hematomas occurred. Permanent pulse deficit occurred in two patients, and temporary deficit occurred in three patients, an improvement over the frequency found in previous transbrachial series using 6-8-F catheters. While these results establish the efficacy of this technique, they also indicate a possible greater relative safety in men than in women.