Correlation between Thyroid Radiation Dose and Thyroid Function after Adjuvant Hypofractionated Locoregional Radiotherapy in Breast Cancer Patients

PURPOSE/OBJECTIVE(S)

Radiotherapy (RT) is used quite often among breast cancer patients, and because these patients now live longer than they used to, long-term treatment-related adverse effects, such as hypothyroidism, are becoming increasingly relevant. Radiation-induced hypothyroidism is a late side effect of radiation to the thyroid gland, which could develop months to years after radiotherapy. However, there is no sufficient data on hypothyroidism in patients with breast cancer who receive locoregional RT, which usually affects a portion of the thyroid gland. In this prospective study, we tried to correlate between the radiation dose received by the thyroid gland and the incidence of thyroid dysfunction in breast cancer patients treated with hypofractionated locoregional radiotherapy, as well as establishing potential planning objectives that could help in sparing the thyroid gland.

MATERIALS/METHODS

Our study included 109 women who received 3-D conformal loco-regional breast radiotherapy, these patients had normal thyroid function prior to start of radiotherapy. Patients had follow-up thyroid function tests 6 months after finishing radiotherapy. Based on dose volume histograms (DVH), the percentages of the thyroid volume, and ipsilateral thyroid lobe, receiving 5, 10, 15, 20, 25, 30, 35, and 40 Gy (V5, V10, V15, V20, V25, V30, V35, and V40 respectively), in addition to the mean and maximum thyroid doses, were estimated.

RESULTS

Follow-up assessment of thyroid function and statistical analysis unveiled incidence of radiotherapy induced hypothyroidism to be 8.3%. Possible risk factors included high maximum radiation dose and V40 to the thyroid gland and the ipsilateral thyroid lobe, as well as high mean dose and smaller volume of the ipsilateral thyroid lobe.

CONCLUSION

The likelihood of hypothyroidism was significantly increased with V40 of >5% of the thyroid gland, and V40 of >11% of the ipsilateral thyroid lobe. Further study is recommended for larger populations and longer follow-up periods.

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Association of ficolin-2 gene polymorphisms and susceptibility to systemic lupus erythematosus in Egyptian children and adolescents: a multicenter study

BACKGROUND

Pediatric-onset SLE (pSLE) is a multisystem autoimmune disease. Recently, the ficolin-2 (FCN2) gene has emerged as a potential candidate gene for susceptibility to SLE.

OBJECTIVES

The objective of this study was to evaluate the association of the FCN2 gene polymorphisms at positions -986 (G/A), -602 (G/A), -4 (A/G) and SNP C/T (rs3124954) located in intron 1, with susceptibility to pSLE in Egyptian children and adolescents.

METHODS

This was a multicenter study of 280 patients diagnosed with pSLE, and 280 well-matched healthy controls. The FCN2 promoter polymorphisms at -986 G/A (rs3124952), -602 G/A (rs3124953), -4 A/G (rs17514136) and SNP C/T (rs3124954) located in intron 1 were genotyped by polymerase chain reaction, while serum ficolin-2 levels were assessed using enzyme-linked immunosorbent assay.

RESULTS

The frequencies of the FCN2 GG genotype and G allele at -986 and -602 positions were significantly more represented in patients with pSLE than in controls (p < 0.001). Conversely, the FCN2 AA genotype and A allele at position -4 were more common in patients than in controls (p < 0.001). Moreover, patients carrying the FCN2 GG genotype in -986 position were more likely to develop lupus nephritis (odds ratio: 2.6 (95% confidence interval: 1.4-4.78); p = 0.006). The FCN2 AA genotype at position -4 was also identified as a possible risk factor for lupus nephritis (odds ratio: 3.12 (95% confidence interval: 1.25-7.84); p = 0.024).

CONCLUSION

The FCN2 promoter polymorphisms may contribute to susceptibility to pSLE in Egyptian children and adolescents. Moreover, the FCN2 GG genotype at position -986 and AA genotype at position -4 were associated with low serum ficolin-2 levels and may constitute risk factors for lupus nephritis in pSLE.

Identifying demographic, social and clinical predictors of biologic therapy effectiveness in psoriasis: a multicentre longitudinal cohort study

Background

Biologic therapies have revolutionized the treatment of moderate‐to‐severe psoriasis. However, for reasons largely unknown, many patients do not respond or lose response to these drugs.

Objectives

To evaluate demographic, social and clinical factors that could be used to predict effectiveness and stratify response to biologic therapies in psoriasis.

Methods

Using a multicentre, observational, prospective pharmacovigilance study (BADBIR), we identified biologic‐naive patients starting biologics with outcome data at 6 (n = 3079) and 12 (n = 3110) months. Associations between 31 putative predictors and outcomes were investigated in univariate and multivariable regression analyses. Potential stratifiers of treatment response were investigated with statistical interactions.

Results

Eight factors associated with reduced odds of achieving ≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) at 6 months were identified (described as odds ratio and 95% confidence interval): demographic (female sex, 0·78, 0·66–0·93); social (unemployment, 0·67, 0·45–0·99); unemployment due to ill health (0·62, 0·48–0·82); ex‐ and current smoking (0·81, 0·66–0·99 and 0·79, 0·63–0·99, respectively); clinical factors (high weight, 0·99, 0·99–0·99); psoriasis of the palms and/or soles (0·75, 0·61–0·91); and presence of small plaques only compared with small and large plaques (0·78, 0·62–0·96). White ethnicity (1·48, 1·12–1·97) and higher baseline PASI (1·04, 1·03–1·04) were associated with increased odds of achieving PASI 90. The findings were largely consistent at 12 months. There was little evidence for predictors of differential treatment response.

Conclusions

Psoriasis phenotype and potentially modifiable factors are associated with poor outcomes with biologics, underscoring the need for lifestyle management. Effect sizes suggest that these factors alone cannot inform treatment selection.

What's already known about this topic?

Biologic therapy used in the treatment of moderate‐to‐severe psoriasis differs in its effectiveness across patients.

Previous research has indicated that patients with a higher body mass index, who smoke or who have smoked, and with a lower baseline Psoriasis Area and Severity Index (PASI) are less likely to have a good outcome with biologic therapy for the treatment of moderate‐to‐severe psoriasis.

What does this study add?

This large‐scale study in a real‐world setting confirms that weight, smoking status and baseline PASI are associated with effectiveness of biologic therapy.

There is evidence that non‐white ethnicity, female sex, unemployment, psoriasis of the palms and soles and the presence of small chronic plaques are associated with poor outcomes with biologics.

There is some evidence that men have a comparatively worse response to etanercept, relative to adalimumab, than women. Otherwise, most factors do not appear to be predictors of differential treatment response.

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Protective effects of sea cucumber (Holothuria atra) extract on testicular dysfunction induced by immune suppressant drugs in Wistar rats

The current study was aimed to evaluate the protective effect of Holothurian atra (HA) extract; naturally occurring marine resource, against methotrexate (MTX) induced testicular dysfunction. Mature rats received either MTX (20 mg/kg, intraperitoneally) or saline on the 7th day of experiment al design. Seven days prior and after MTX-injection, rats received HA at dose of 300 mg/kg intragastrically (HA + MTX group; HA group alone). Serum was extracted and testicular tissues were examined for the changes in serum biochemistry (liver & kidney biomarkers, testicular hormones and antioxidants), molecular and histopthological alterations using RT-PCR and immunohistochemistry. MTX-injected rats induced alteration in all testicular parameters. Prior administration of HA ameliorated the MTX-induced oxidative stress. HA administration normalised MTX-induced decrease in serum levels of interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ), reproductive hormones (FSH, LH and testosterone) and antioxidants GST, SOD and catalase. MTX-injected rats down-regulated mRNA expression of GST, SOD, steroidogenesis associated genes, IFN-γ, Bcl2 and NFKB. MTX up-regulated BAX expression and caspase 9 immunoreactivity that were ameliorated in HA + MTX group. Collectively, HA ameliorated and restored all altered genes. In conclusion, HA is a promising supplement that is helpful in protection against testicular cytotoxicity and dysfunction induced by methotrexate.

Species-specific control of hepatocyte growth factor expression and production in adipocytes in a differentiation-dependent manner

Hepatocyte growth factor (HGF) is a mesenchymal cell-derived factor that regulates cell growth, cell motility, and morphogenesis. Since there are conflicting reports on HGF-producing cells, we herein examined HGF activity in conditioned medium (CM) of bovine and mouse preadipocytes before and after adipogenic differentiation. CM of bovine adipocytes and mouse preadipocytes induced the morphogenesis of mammary epithelial cells that was inhibited by an NK4 HGF antagonist, whereas CM of bovine preadipocytes and mouse adipocytes did not. HGF mRNA expression was increased by a treatment with dexamethasone and isobutylmethylxanthine in bovine as well as human cells, whereas it was decreased in rodent cells. It was unfortunate that HGF gene promoter activity failed to reflect HGF mRNA expression in these cells. After actinomycin D treatment, expression of HGF mRNA remained stable in pre- and differentiated bovine adipocytes and mouse preadipocytes, whereas rapidly decreased in mouse-differentiated adipocytes. These results indicate that expression and production of HGF are regulated in a species-specific adipogenic differentiation-dependent manner and suggest that the decrease in HGF mRNA in mouse differentiated adipocytes is, at least in part, mediated by differentiation-dependent loss of its stability.

Diurnal variations of serum leptin in dogs: effects of fasting and re-feeding

Leptin is a protein synthesized and secreted primarily by adipocytes, and plays a key role in the regulation of energy balance. We have reported that serum leptin is elevated in obese dogs. In the present study, we examined diurnal variations of serum leptin in the dog, with special references to feeding and fasting cycles. Four male beagles were accustomed to feed once a day at 10:00 h, and blood samples were taken every 3 h for 24-36 h. Serum leptin concentration showed clear diurnal variations, being lowest before food intake (2.3+/-0.5 ng/mL) at 09:00 h, and highest (10.5+/-2.4 ng/mL) at 18:00 h. Such diurnal variations disappeared when the dogs were fasted. Serum insulin also showed diurnal variation with higher levels at 12:00-15:00 h. When insulin or glucose was injected in the fasted dogs to mimic the post-prandial insulin rise, serum leptin concentration was significantly increased in 4-8 h, but in both cases to a lesser extents than those after food intake. The results indicate that serum leptin concentrations change diurnally in association with feeding-fasting cycles in the dog, partially due to changes in insulin secretion.

Comparison of serum antibody responses to Giardia lamblia of symptomatic and asymptomatic patients

The circulating anti-parasite antibody response against Giardia lamblia in symptomatic and asymptomatic Egyptian children with confirmed giardiasis was examined. Symptomatic patients were identified using the following criteria: presence of only G. lamblia cysts in the feces, and one or more of the following symptoms, diarrhea, abdominal pain, loss of weight, vomiting and/or nausea, and abdominal distention. The anti-parasite humoral response was measured using indirect immunofluorescence (IFA), ELISA, and immunoblotting. There was a significant difference in the anti-parasite antibody response measured by IFA of asymptomatic and symptomatic patients, in which more than 34% of the asymptomatic patients had a titer equal to or less than 1:500, and more that 29% of the symptomatic patients had a titer of 1:8,000 or higher. The circulating anti-parasite total IgM and IgA but not IgG, measured by ELISA, was significantly higher in symptomatic than in asymptomatic patients, and were related to higher cyst output observed in symptomatic individuals. Although total anti-parasite IgG response was similar in symptomatic and asymptomatic patients, the analysis of the IgG isotype responses revealed that both IgG1 and IgG3 were significantly higher in symptomatic patients. The antigen recognition by anti-parasite IgM, IgA, IgG1, and IgG3 of symptomatic and asymptomatic individuals, determined by immunoblotting, was heterogeneous and revealed only minor differences in the response of the two groups.

Selenium and cadmium induced pulmonary functional impairment and cytotoxicity

Ovalbumin-sensitized (50 mg/kg, i.p.) male Hartley-guinea-pigs (550-610 g; n = 6) were treated 14 days later intratracheally with saline, cadmium (Cd 0.3 mg), selenium (Se 0.3 mg or 0.06 mg) or Se (0.06 mg) with Cd (0.3 mg). After 24 h, baseline dynamic-lung-compliance (Cdynl) and pulmonary-resistance (Rp), and percent change after ovalbumin-aerosol-challenge (10 mg/ml, 60 s) were assessed. Cadmium or Se (0.3 mg), Se (0.06 mg) and/or Cd (0.3 mg) decreased Cdynl (P < 0.05). Selenium (0.3 mg) increased Rp (P < 0.05). Ovalbumin-challenge decreased Cdynl and increased Rp in all groups. Analysis of bronchoalveolar-lavage-fluid (BALF) displayed increased activities of lactate-dehydrogenase (LDH), beta-glucuronidase (beta-G), alkaline-phosphatase (AP), and protein due to 0.3 mg Se, 0.3 mg Cd alone or with 0.06 mg Se (P < 0.05). Findings indicated that, 0.3 mg Se is more detrimental than 0.3 mg Cd to lung-dynamics despite a modest protection by 0.06 mg Se against Cd illustrated by an ameliorated Cdynl and lower protein in BALF.

Oral manifestations and histochemical studies of the gingiva in Down syndrome

Down syndrome is the most frequent of the aneuploids observed in newborn infants whose major manifestations are mental and growth retardation. The purpose of this work was to study the oral manifestations, histological and histochemical changes in gingiva of Egyptian Down syndrome children and to correlate the noted histochemical changes with the intelligence quotient and the karyotype. The study comprised 29 cases (19 males and 10 females) with a mean age of (4.673 + 2.406) and 30 control children (19 males and 11 females) with a mean age of (4.632 + 2.568). 27 cases had pure trisomy 21 and 2 cases was mosaics. General clinical and orodental examination confirmed the developmental variability of Down syndrome patients. The orodental examination showed: 1--A high susceptibility to periodontal disease. 2--Bad oral hygiene. 3--High arched palate, macroglossia, hypocalcification, fissured tongue, underdeveloped maxilla delayed eruption of the primary teeth. The histological and histochemical changes were: 1--Increased inflammatory signs in the epithelium and connective tissue of the gingiva. 2--Amorphous amyloid deposits in lamina propria of Down syndrome children, while it was absent in that of control children. It was more in low I.Q. children with fair gingival index than those with better I.Q. 3--Neutral glycoprotein was stronger in Down syndrome than that in controls. 4--Reduction in the highly acidic MPS. 5--Total protein content was increased in Down syndrome children that of their controls. 6--Acid phosphatase activity was stronger in Down syndrome than of their controls. 7--Alkaline phosphatase activity was less in Down syndrome than of their controls. These changes point to a correlation which needs further investigation in a larger number of cases.

Matrix solid phase dispersion (MSPD) extraction and gas chromatographic screening of nine chlorinated pesticides in beef fat

A multiresidue technique is presented for the extraction and quantitative gas chromatographic screening of 9 insecticides (lindane, heptachlor, aldrin, heptachlor epoxide, p,p'-DDE, dieldrin, endrin, p,p'-TDE, and p,p'-DDT) as residues in beef fat. Beef fat was fortified by adding the 9 insecticides, plus dibutyl chlorendate as internal standard, to 0.5 g portions of beef fat and blending with 2 g C18 (octadecylsilyl)-derivatized silica. The C18/fat matrix blend was fashioned into a column by adding the blend to a 10 mL syringe barrel containing 2 g activated Florisil. The insecticides were then eluted from the column with 8 mL acetonitrile, and a 2 microL portion of the acetonitrile eluate was then directly analyzed by gas chromatography with electron capture detection. Unfortified blank controls were treated similarly. The acetonitrile eluate contained all of the pesticide analytes (31.25-500 ng/g) and was free of interfering co-extractants. Correlation coefficients for the 9 extracted pesticide standard curves (linear regression analysis, n = 5) ranged from 0.9969 (+/- 0.0021) to 0.9999 (+/- 0.0001). Average relative percentage recoveries (85 +/- 3.4% to 102 +/- 5.0%, n = 25 for each insecticide), inter-assay variability (6.0 +/- 1.0% to 14.0 +/- 6.7%, n = 25 for each insecticide), and intra-assay variability (2.5-5.1% n = 5 for each insecticide) indicated that the methodology is acceptable for the extraction, determination, and screening of these residues in beef fat.

Heated fats. Part 3. Biological effect and effect of heating and tempering oils on fatty acid composition of liver, heart and serum lipids of rats

The study deals with the biological effect caused by changes in fats during heating. The study includes feeding experiments and extraction of serum, liver, and heart from the animals tested. The biological study reveals that animals fed heated oil showed retardation of growth, poor efficiencies, rough, greasy mottled coats, and shortened life span.

Renal amyloidosis and schistosomiasis

A retrospective study of 60 renal biopsies obtained from nephrotic subjects with schistosomiasis showed amyloid deposits in 10 cases. Distribution was usually segmental, mainly mesangial and overlapped with the conventional mesangio-proliferative lesions of schistosomiasis. The invariable clinical presentation was proteinuria with generalized oedema of insidious onset and a slowly progressive or intermittent course. Differences from conventional schistosomal nephropathy are described. Response to anti-schistosomal treatment was very poor. Repeat renal biopsies showed no regression of the lesions. The possible links between schistosomiasis and amyloidosis are discussed and causes of amyloid deposition suggested.