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.     

Freshwater cyanobacterium Microcystis aeruginosa (UTEX 2385) induced DNA damage in vivo and in vitro

Microcystins are a family of potent hepatotoxins and liver tumor promoters produced by several genera of cyanobacteria including Microcystis, Nodularia, Anabena, Nostoc, etc. They are chemically very stable and represent a public health threat when they occur in water used for human consumption. We investigated the DNA damage effects of M. aeruginosa UTEX 2385 in mouse liver in vivo and also in mammalian cells in vitro. The DNA damage effect is compared with purified toxin microcystin-LR (MCLR) in non-hepatic cells viz. baby hamster kidney cells (BHK-21) and mouse embryo fibroblasts primary cells (MEF). Cell-free extracts of UTEX 2385 induced significant DNA fragmentation at 0.5, 1 and 2 LD(50) (32.7, 65.4 and 130.8 mg/kg, respectively) and it was also time dependent. M. aeruginosa UTEX 2385 and MCLR induced significant DNA fragmentation in BHK-21 and MEF cells at 100 and 1.0 μg/ml concentration. Electrophoretic analysis revealed necrotic DNA damage by UTEX 2385 in vivo. Both the toxins caused smear in agarose gel electrophoresis indicating the necrotic DNA damage in MEF cells, whereas, multiple DNA fragments in BHK-21 cells. The DNA damage effect of the toxin is supported by data on hepatotoxicity in vivo and cytotoxicity in vitro.     

Development and evaluation of SYBR Green I-based one-step real-time RT-PCR assay for detection and quantification of Chikungunya virus.

The development of a one-step SYBR Green I-based real-time RT-PCR assay is reported for detection and quantification of Chikungunya virus (CHIKV) in acute-phase patient serum samples by targeting the E1 structural gene. A linear relationship was obtained between the virus concentration and cycle threshold (C(t)) value over a range of 10(7)-0.1PFU/ml. The reported assay was found to be 10-fold more sensitive compared to conventional RT-PCR with a detection limit of 0.1PFU/ml. The feasibility of this reported assay system for clinical diagnosis was validated with 51 suspected acute-phase serum samples of the recent CHIKV epidemic in southern India, 2006. The comparative evaluation with acute-phase patient serum samples revealed the higher sensitivity of real-time RT-PCR assay by picking up six additional samples with low copy number of template. None of the healthy serum samples analyzed in this study showed amplification. The quantification of the viral load in the acute-phase serum samples was also determined employing the standard curve, which varies from 0.1 to 10(7)PFU/ml. These findings demonstrated that the reported assay has the potential usefulness for clinical diagnosis due to simultaneous detection and quantification of Chikungunya virus in acute-phase patient serum samples.     

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 ,…     

Case series of scleral patch grafts during COVID-19 pandemic

Scleral graft is done for clinical conditions as scleral melt post pterygium surgery, immune or infection related scleral melt, for covering the tubes of Ahmed glaucoma valve implant, for covering the orbital implants post enucleation, etc. A review of literature revealed the use of sclera for corneal perforations in the past, but became obsolete after the cornea being used for patch grafts. Now in this COVID-19 time, due to scarcity of corneal tissue, this technique of scleral patch grafts can be considered as an alternative to corneal patch grafts, which serves well the tectonic/therapeutic purpose and helps salvage the eye.     

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.