Polymyositis Presenting as Rhabdomyolysis After the Initiation of Omeprazole

Pump proton inhibitors display anti-tumour potential in glioma

OBJECTIVES

Glioma is one of the most aggressive brain tumours with poor overall survival despite advanced technology in surgical resection, chemotherapy and radiation. Progression and recurrence are the hinge causes of low survival. Our aim is to explain the concrete mechanism in the proliferation and progression of tumours based on tumour microenvironment (TME). The main purpose is to illustrate the mechanism of proton pump inhibitors (PPIs) in affecting acidity, hypoxia, oxidative stress, inflammatory response and autophagy based on the TME to induce apoptosis and enhance the sensitivity of chemoradiotherapy.

FINDINGS

TME is the main medium for tumour growth and progression. Acidity, hypoxia, inflammatory response, autophagy, angiogenesis and so on are the main causes of tumour progress. PPIs, as a common clinical drug to inhibit gastric acid secretion, have the advantages of fast onset, long action time and small adverse reactions. Nowadays, several kinds of literature highlight the potential of PPIs in inhibiting tumour progression. However, long-term use of PPIs alone also has obvious side effects. Therefore, till now, how to apply PPIs to promote the effect of radio-chemotherapy and find the concrete dose and concentration of combined use are novel challenges.

CONCLUSIONS

PPIs display the potential in enhancing the sensitivity of chemoradiotherapy to defend against glioma based on TME. In the clinic, it is also necessary to explore specific concentrations and dosages in synthetic applications.

Bone Scan in Identification, Assessment of Initial Extent and Response to Therapy in Polymyositis

This is a 51-year-old male who presented with abdominal pain, bilateral proximal upper and lower extremities pain and weakness, and decreased urine output with abnormal kidney function test; Urea and creatinine levels were elevated at 231.5 mg/dl and 11.05 mg/dl, respectively. Initial bone scan showed increased uptake within several muscles suspicious for polymyositis, this was confirmed by biopsy of the right triceps, identified by bone scan as the best superficial biopsy site. Pelvis and thigh MRI demonstrated diffuse hyperintense signal on fluid sensitive sequences involving several muscles. Renal biopsy showed acute tubular injury. He was treated with steroids resulting in significant improvement. A repeat bone scan showed near complete resolution of the muscular uptake seen at presentation. This case nicely illustrates the role of bone scanning in the initial recognition and determination of the extent of polymyositis with identification of a suitable biopsy site as well as assessment of response to treatment.