Growth and puberty after growth hormone treatment after irradiation for brain tumours

The impact of treatment with either cranial or craniospinal irradiation with or without cytotoxic chemotherapy for a brain tumour distant from the hypothalamic-pituitary axis was assessed in 29 children who had reached final height. All had received growth hormone treatment for radiation induced growth hormone deficiency. Final height, segmental growth during puberty, and duration of puberty were studied. Both craniospinal irradiation and the use of chemotherapy resulted in a significant and equal reduction in final height; this effect in those children who received both craniospinal irradiation and chemotherapy was additive. The degree of height loss was related to the age at irradiation, the most profound effect on final height occurring in the youngest at irradiation. The mean duration of puberty from G2-G4/B2-B4 (1.97 years) was not significantly different from the duration of puberty in normal children. Growth hormone increases growth velocity in children with radiation induced growth hormone deficiency but their final height is significantly less than their mid-parental height. The use of spinal irradiation and chemotherapy in the original treatment of brain tumours has a marked effect on growth which is not overcome with the use of growth hormone treatment in current doses. Early puberty of normal duration contributes to poor growth.     

Clinical patterns of × linked agammaglobulinemia in Malaysian children

X linked agammaglobulinemia (XLA) is rarely reported from developing countries especially from South East Asia. It appears that × linked agammaglobulinemia is less common in certain ethnic groups. It is very uncommon in black people in USA and South Africa. In multiracial Malaysia we have documented five XLA in Malays and Indians but not in the Chinese that constitute about 31% of the population. First degree relatives afflicted with XLA or other primary immunodeficiencies occurred more often in our study. All showed lung involvement although the etiologic organisms involved were atypical, being Gram negative.     

Microbiota modification by probiotic supplementation reduces colitis associated colon cancer in mice

AIM To investigate the effect of probiotic supplementation during the development of an experimental model of colitis associated colon cancer(CAC). METHODS C57 BL/6 mice received an intraperitoneal injection of azoxymethane(10 mg/kg), followed by three cycles of sodium dextran sulphate diluted in water(5% w/v). Probiotic group received daily a mixture of Lactobacillus acidophilus, Lactobacil us rhamnosus and Bifidobacterium bifidum. Microbiota composition was assessed by 16 Sr RNA Illumina Hi Seq sequencing. Colon samples were collected for histological analysis. Tumor cytokines was assessed by Real Time-PCR(Polymerase Chain Reaction); and serum cytokines by Multiplex assay. All tests were two-sided. The level of significance was set at P 0.05. Graphs were generated and statistical analysis performed using the software Graph Pad Prism 5.0. The project was approved by the institutional review board committee. RESULTS At day 60 after azoxymethane injection, the mean number of tumours in the probiotic group was 40% lower than that in the control group, and the probiotic group exhibited tumours of smaller size( 2 mm)(P 0.05). There was no difference in richness and diversity between groups. However, there was a significant difference in beta diversity in the multidimensional scaling analysis. The abundance of the genera Lactobacillus, Bifidobacterium, Allobaculum, Clostridium XI and Clostridium XVⅢ increased in the probiotic group(P 0.05). The microbial change was accompanied by reduced colitis, demonstrated by a 46% reduction in the colon inflammatory index; reduced expression of the serum chemokines RANTES and Eotaxin; decreased p-IKK and TNF-α and increased IL-10 expression in the colon. CONCLUSION Our results suggest a potential chemopreventive effect of probiotic on CAC. Probiotic supplementation changes microbiota structure and regulates the inflammatory response, reducing colitis and preventing CAC.     

S-甲基异硫脲抑制梗塞兔心肌诱导型一氧化氮合酶的表达

目的　研究S 甲基异硫脲 (SMT)对梗塞兔心肌组织内诱导型一氧化氮合酶 (iNOS)活性的抑制作用。方法　对左房心耳和心尖中间弯曲的冠状动脉前外侧枝进行结扎 ,建立心肌梗塞模型。应用L 精氨酸转换为L 胍氨酸法测定家兔心肌梗塞区和非梗塞区诱导型一氧化氮合酶的活性 ,同时观察S 甲基异硫脲和NW 硝基 L 精氨酸 (L NNA)对诱导型一氧化氮合酶活性的抑制作用。结果　冠状动脉结扎后 48h、72h和 96h ,心肌梗塞区诱导型一氧化氮合酶活性比非手术组显著增加 (P <0 0 1) ,并在 72h达到峰值 ;梗塞后 72h左室壁cGMP含量也明显增加 (P <0 0 1) ;同时SMT能明显降低梗塞区心肌诱导型一氧化氮合酶的活性 (P<0 0 1)。结论　SMT能明显抑制梗塞兔心肌iNOS的活性 ,提示SMT对改善心脏功能和治疗急性心肌梗塞具有一定的临床效果。     

Initial experience in 115 patients with the retrievable Cook Celect vena cava filter

The aim of this study was to evaluate our experience with the retrievable Cook Celect inferior vena cava (IVC) filter (William Cook, Europe) with regard to insertion, efficiency, ease of retrieval, and any associated complications. A retrospective review was performed of 115 patients (41 female, 74 male, mean age 47.97 years) who underwent Cook Celect IVC filter insertion between December 2005 and October 2007. Filter insertion was successful in all patients. Of the 115 filters inserted, 57 have been successfully retrieved (49.6%) to date. The successful retrieval rate from attempted retrieval was 93.4%. The mean dwell time of successfully retrieved filters was 114.9 days (range 14–267 days). Failed retrievals were due to a thrombosed vena cava (n = 1) and endothelialisation of the filter (n = 3). In the failed retrieval group the mean implantation time was 142 days (range 78–211 days). While this is the first retrospective clinical study on the Cook Celect filter, results to date are promising. We demonstrated an efficacious filter with a high successful retrieval rate of 93.4% and a low complication rate. The filter was assessed with extended dwell times (range 14–267 days). Failed retrieval secondary to hook endothelialisation continues to be an issue with this filter. We recognize that a limitation of our study was the lack of systematic follow‐up for clinically silent complications. Further studies to evaluate longer term outcomes and effectiveness of this filter are warranted.