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de Villedon de Naide V, Maes JD, Villegas-Martinez M, Ribal I, Maillot A, Ozenne V, Montier G, Boullé T, Sridi S, Gut P, Küstner T, Stuber M, Cochet H, Bustin A. Fully automated contrast selection of joint bright- and black-blood late gadolinium enhancement imaging for robust myocardial scar assessment. Magn Reson Imaging 2024; 109:256-263. [PMID: 38522623 DOI: 10.1016/j.mri.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE Joint bright- and black-blood MRI techniques provide improved scar localization and contrast. Black-blood contrast is obtained after the visual selection of an optimal inversion time (TI) which often results in uncertainties, inter- and intra-observer variability and increased workload. In this work, we propose an artificial intelligence-based algorithm to enable fully automated TI selection and simplify myocardial scar imaging. METHODS The proposed algorithm first localizes the left ventricle using a U-Net architecture. The localized left cavity centroid is extracted and a squared region of interest ("focus box") is created around the resulting pixel. The focus box is then propagated on each image and the sum of the pixel intensity inside is computed. The smallest sum corresponds to the image with the lowest intensity signal within the blood pool and healthy myocardium, which will provide an ideal scar-to-blood contrast. The image's corresponding TI is considered optimal. The U-Net was trained to segment the epicardium in 177 patients with binary cross-entropy loss. The algorithm was validated retrospectively in 152 patients, and the agreement between the algorithm and two magnetic resonance (MR) operators' prediction of TI values was calculated using the Fleiss' kappa coefficient. Thirty focus box sizes, ranging from 2.3mm2 to 20.3cm2, were tested. Processing times were measured. RESULTS The U-Net's Dice score was 93.0 ± 0.1%. The proposed algorithm extracted TI values in 2.7 ± 0.1 s per patient (vs. 16.0 ± 8.5 s for the operator). An agreement between the algorithm's prediction and the MR operators' prediction was found in 137/152 patients (κ= 0.89), for an optimal focus box of size 2.3cm2. CONCLUSION The proposed fully-automated algorithm has potential of reducing uncertainties, variability, and workload inherent to manual approaches with promise for future clinical implementation for joint bright- and black-blood MRI.
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Affiliation(s)
| | - Jean-David Maes
- CHU de Bordeaux, Department of Cardiovascular Imaging, INSERM, U 1045, F-33000 Bordeaux, France
| | | | - Indra Ribal
- Université de Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, F-33000 Bordeaux, France
| | - Aurélien Maillot
- Université de Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, F-33000 Bordeaux, France
| | - Valéry Ozenne
- Université de Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, F-33000 Bordeaux, France
| | - Géraldine Montier
- CHU de Bordeaux, Department of Cardiovascular Imaging, INSERM, U 1045, F-33000 Bordeaux, France
| | - Thibaut Boullé
- CHU de Bordeaux, Department of Cardiovascular Imaging, INSERM, U 1045, F-33000 Bordeaux, France
| | - Soumaya Sridi
- CHU de Bordeaux, Department of Cardiovascular Imaging, INSERM, U 1045, F-33000 Bordeaux, France
| | - Pauline Gut
- Université de Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, F-33000 Bordeaux, France; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Küstner
- Medical Image and Data Analysis (MIDAS.lab), Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, 72076 Tübingen, Germany
| | - Matthias Stuber
- Université de Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, F-33000 Bordeaux, France; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Hubert Cochet
- Université de Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, F-33000 Bordeaux, France; CHU de Bordeaux, Department of Cardiovascular Imaging, INSERM, U 1045, F-33000 Bordeaux, France
| | - Aurélien Bustin
- Université de Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, F-33000 Bordeaux, France; CHU de Bordeaux, Department of Cardiovascular Imaging, INSERM, U 1045, F-33000 Bordeaux, France; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Pra AD, Zwahlen D, Liu V, Hayoz S, Spratt D, Davicioni E, Liu Y, Proudfoot J, Schär C, Hölscher T, Gut P, Polat B, Hildebrandt G, Mueller A, Plasswilm L, Feng F, Pollack A, Thalmann G, Aebersold D, Ghadjar P. Prognostic and Predictive Performance of a 24-Gene Post-Operative Radiation Therapy Outcomes Score (PORTOS) in a Phase 3 Randomized Trial of Dose-Intensified Salvage Radiotherapy after Radical Prostatectomy (SAKK 09/10). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pra AD, Ghadjar P, Hayoz S, Liu V, Spratt D, Thompson D, Davicioni E, Huang HC, Zhao X, Liu Y, Schär C, Gut P, Plasswilm L, Hölscher T, Polat B, Hildebrandt G, Müller AC, Pollack A, Thalmann G, Zwahlen D, Aebersold D. Validation of the Decipher Genomic Classifier in Patients receiving Salvage Radiotherapy without Hormone Therapy after Radical Prostatectomy – An Ancillary Study of the SAKK 09/10 Randomized Clinical Trial. Ann Oncol 2022; 33:950-958. [DOI: 10.1016/j.annonc.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 12/19/2022] Open
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Zörner B, Hostettler P, Meyer C, Killeen T, Gut P, Linnebank M, Weller M, Straumann D, Filli L. Prognosis of walking function in multiple sclerosis supported by gait pattern analysis. Mult Scler Relat Disord 2022; 63:103802. [DOI: 10.1016/j.msard.2022.103802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/18/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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Pra A, Ghadjar P, Hayoz S, Spratt D, Liu V, Todorovic T, Davicioni E, Huang H, Schär C, Hölscher T, Gut P, Polat B, Hildebrandt G, Mueller A, Plasswilm L, Thalmann G, Zwahlen D, Aebersold D. Performance of a Genomic Classifier (GC) Within a Phase 3 Randomized Trial of Dose Escalated Salvage Radiotherapy (SRT) After Radical Prostatectomy (RP). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gut P, Krieger M, Lomax T, Weber DC, Hrbacek J. Combining rescanning and gating for a time-efficient treatment of mobile tumors using pencil beam scanning proton therapy. Radiother Oncol 2021; 160:82-89. [PMID: 33839206 DOI: 10.1016/j.radonc.2021.03.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/04/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Respiratory motion during proton therapy can severely degrade dose distributions, particularly due to interplay effects when using pencil beam scanning. Combined rescanning and gating treatments for moving tumors mitigates dose degradation, but at the cost of increased treatment delivery time. The objective of this study was to identify the time efficiency of these dose degradation-motion mitigation strategies for different range of motions. MATERIALS AND METHODS Seventeen patients with thoracic or abdominal tumors were studied. Tumor motion amplitudes ranged from 2-30 mm. Deliveries using different combinations of rescanning and gating were simulated with a dense dose spot grid (4 × 4 × 2.5 mm3) for all patients and a sparse dose spot grid (8 × 8 × 5 mm3) for six patients with larger tumor movements (>8 mm). The resulting plans were evaluated in terms of CTV coverage and time efficiency. RESULTS Based on the studied patient cohort, it has been shown that for amplitudes up to 5 mm, no motion mitigation is required with a dense spot grid. For amplitudes between 5 and 10 mm, volumetric rescanning should be applied while maintaining a 100% duty cycle when using a dense spot grid. Although gating could be envisaged to reduce the target volume for intermediate motion, it has been shown that the dose to normal tissues would only be reduced marginally. Moreover, the treatment time would increase. Finally, for larger motion amplitudes, both volumetric rescanning and respiratory gating should be applied with both spot grids. In addition, it has been shown that a dense spot grid delivers better CTV dose coverage than a sparse dose grid. CONCLUSION Volumetric rescanning and/or respiratory gating can be used in order to effectively and efficiently mitigate dose degradation due to tumor movement.
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Affiliation(s)
- Pauline Gut
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Miriam Krieger
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Tony Lomax
- Department of Physics, ETH Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland
| | - Damien C Weber
- Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland; Department of Radiation Oncology, University Hospital of Zurich, Zurich, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Jan Hrbacek
- Center for Proton Therapy, Paul Scherrer Institute (PSI), Villigen PSI, Switzerland.
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Czarnywojtek A, Zgorzalewicz-Stachowiak M, Czarnocka B, Sawicka-Gutaj N, Gut P, Krela-Kazmierczak I, Ruchala M. Effect of lithium carbonate on the function of the thyroid gland: mechanism of action and clinical implications. J Physiol Pharmacol 2020; 71. [PMID: 32633237 DOI: 10.26402/jpp.2020.2.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Lithium carbonate, a drug known for more than 100 years, has been successfully used as a psychiatric medication. Currently, it is a commonly used drug to treat patients with unipolar and bipolar depression, and for the prophylaxis of bipolar disorders and acute mania. Lithium salts may cause the development of goiter, hypothyroidism, or rarely hyperthyroidism. The present review examined the current state of knowledge on the effect of lithium carbonate on the thyroid gland. The Pubmed database and Google Scholar were searched for articles related to the effects of lithium therapy on the thyroid gland function published up to February 2020. Studies that examined the mechanism of action of lithium at the molecular level, including pharmacokinetics, and focused on its effects on the thyroid gland were included. Lithium as a mood-stabilizing drug has a complex mechanism of action. Because of the active transport of Na+/I- ions, lithium, despite its concentration gradient, is accumulated in the thyroid gland at a concentration 3 - 4 times higher than that in the plasma. It can inhibit the formation of colloid in thyrocytes, change the structure of thyroglobulin, weaken the iodination of tyrosines, and disrupt their coupling. In addition, it reduces the clearance of free thyroxine in the serum, thereby indirectly reducing the activity of 5-deiodinase type 1 and 2 and reducing the deiodination of these hormones in the liver. Taken together, this review provides recommendations for monitoring the thyroid gland in patients who require long-term lithium therapy. Prior to the initiation of lithium therapy, thyroid ultrasound should be performed, and the levels of thyroid hormones (fT3 and fT4), TSH, and antithyroid peroxidase and antithyroglobulin antibodies should be measured. If the patient shows normal thyroid function, TSH level measurement and thyroid ultrasound should be performed at 6- to 12-month intervals for long term.
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Affiliation(s)
- A Czarnywojtek
- Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland.,Chair and Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - M Zgorzalewicz-Stachowiak
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, University of Medical Sciences, Poznan, Poland
| | - B Czarnocka
- Department of Biochemistry and Molecular Biology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - N Sawicka-Gutaj
- Chair and Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
| | - P Gut
- Chair and Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - I Krela-Kazmierczak
- Department of Gastroenterology Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - M Ruchala
- Chair and Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
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Weger M, Diotel N, Weger BD, Beil T, Zaucker A, Eachus HL, Oakes JA, do Rego JL, Storbeck KH, Gut P, Strähle U, Rastegar S, Müller F, Krone N. Expression and activity profiling of the steroidogenic enzymes of glucocorticoid biosynthesis and the fdx1 co-factors in zebrafish. J Neuroendocrinol 2018; 30:e12586. [PMID: 29486070 DOI: 10.1111/jne.12586] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 02/06/2018] [Accepted: 02/22/2018] [Indexed: 01/23/2023]
Abstract
The spatial and temporal expression of steroidogenic genes in zebrafish has not been fully characterised. Because zebrafish are increasingly employed in endocrine and stress research, a better characterisation of steroidogenic pathways is required to target specific steps in the biosynthetic pathways. In the present study, we have systematically defined the temporal and spatial expression of steroidogenic enzymes involved in glucocorticoid biosynthesis (cyp21a2, cyp11c1, cyp11a1, cyp11a2, cyp17a1, cyp17a2, hsd3b1, hsd3b2), as well as the mitochondrial electron-providing ferredoxin co-factors (fdx1, fdx1b), during zebrafish development. Our studies showed an early expression of all these genes during embryogenesis. In larvae, expression of cyp11a2, cyp11c1, cyp17a2, cyp21a2, hsd3b1 and fdx1b can be detected in the interrenal gland, which is the zebrafish counterpart of the mammalian adrenal gland, whereas the fdx1 transcript is mainly found in the digestive system. Gene expression studies using quantitative reverse transcriptase-PCR and whole-mount in situ hybridisation in the adult zebrafish brain revealed a wide expression of these genes throughout the encephalon, including neurogenic regions. Using ultra-high-performance liquid chromatography tandem mass spectrometry, we were able to demonstrate the presence of the glucocorticoid cortisol in the adult zebrafish brain. Moreover, we demonstrate de novo biosynthesis of cortisol and the neurosteroid tetrahydrodeoxycorticosterone in the adult zebrafish brain from radiolabelled pregnenolone. Taken together, the present study comprises a comprehensive characterisation of the steroidogenic genes and the fdx co-factors facilitating glucocorticoid biosynthesis in zebrafish. Furthermore, we provide additional evidence of de novo neurosteroid biosynthesising in the brain of adult zebrafish facilitated by enzymes involved in glucocorticoid biosynthesis. Our study provides a valuable source for establishing the zebrafish as a translational model with respect to understanding the roles of the genes for glucocorticoid biosynthesis and fdx co-factors during embryonic development and stress, as well as in brain homeostasis and function.
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Affiliation(s)
- M Weger
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - N Diotel
- INSERM, UMR 1188, Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Université de La Réunion, Saint-Denis de La Réunion, France
| | - B D Weger
- Nestlé Institute of Health Sciences SA, Lausanne, Switzerland
| | - T Beil
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | - A Zaucker
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - H L Eachus
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Department of Biomedical Science, The Bateson Centre, Sheffield, UK
| | - J A Oakes
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Department of Biomedical Science, The Bateson Centre, Sheffield, UK
| | - J L do Rego
- Plateforme d'Analyse Comportementale (SCAC), Institut de Recherche et d'Innovation Biomédicale, Inserm U1234, Université de Rouen, Rouen Cedex, France
| | - K-H Storbeck
- Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa
| | - P Gut
- Nestlé Institute of Health Sciences SA, Lausanne, Switzerland
| | - U Strähle
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | - S Rastegar
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | - F Müller
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - N Krone
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Department of Biomedical Science, The Bateson Centre, Sheffield, UK
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Ghadjar P, Gut P, Hölscher T, Hildebrandt G, Müller A, Nadjafi Y, Kohler G, Kranzbühler H, Aebersold D, Sassowsky M. Use of EORTC Target Definition Guidelines for Dose Intensified Salvage Radiation Therapy for Recurrent Prostate Cancer: Results of the Quality Assurance Program of the Randomized Trial Sakk 09/10. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Baczyk M, Milecki P, Pisarek M, Gut P, Antczak A, Hrab M. A prospective randomized trial: a comparison of the analgesic effect and toxicity of 153Sm radioisotope treatment in monotherapy and combined therapy including local external beam radiotherapy (EBRT) among metastatic castrate resistance prostate cancer (mCRPC) patients with painful bone metastases. Neoplasma 2013; 60:328-33. [PMID: 23374004 DOI: 10.4149/neo_2013_044] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bone metastases in prostate cancer constitute the most frequent cause of systemic failure in treatment, which results in numerous complications and finally leads to patient's death. Pain is one of the first and most important clinical symptoms of bone metastases and can be found among more than 80% of patients. Therefore, the most analgetic effective and simultaneously the least toxic treatment is an important point of therapeutic management in this group of patients. The aim of this prospective clinical trial was a comparison of analgetic effectiveness and toxicity of monotherapy with 153Sm isotope to combined therapy (153Sm + EBRT) among patients diagnosed with multiple painful bone metastases due to CRPC (mCRPC). 177 patients with mCRPC were included into the prospective randomised clinical trial in which 89 patients were assigned to the 153Sm isotope monotherapy, while 88 patients were assigned to the combined therapy including 153Sm isotope therapy and EBRT. All patients were diagnosed (bone scan and X-ray or/and CT or/and MRI) with painful bone metastases (bone pain intensity >= 6 according to VAS classification). The following additional inclusion criteria were established: histologically confirmed adenocarcinoma of prostate, multifocal bone metastases, no prior chemotherapy or palliative radiotherapy to bone. All patients signed informed consent.The combination of the isotope therapy with EBRT was more effective analgetic treatment than isotope therapy alone. The highest pain decline was noticed in the first weeks after treatment termination. In the whole group, a total or partial analgesic effect was observed among 154 (87%) patients while among 23 (13%) patients there was a lack of analgesic effect or even pain intensification. The results of this clinical trial demonstrated that for patients with multiple mCRPC it is recommended to combine the 153Sm isotope therapy with local EBRT because of a greater analgetic effect. It is important to note that combined therapy did not intensify the toxicity of treatment.
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Affiliation(s)
- M Baczyk
- Department of Nuclear Medicine, Poznan University of Medical Sciences, Poland
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Gut P, Greiner R, Leiser D, Kothbauer K, Seiler R, Thum P. PO-0656: Dose intensified irradiation to brain metastases or resection cavity and low dose prophylactic cranial irradiation. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fichna M, Zurawek M, Gut P, Sowiński J, Nowak J. Adrenal hypoplasia congenita - an uncommon reason of primary adrenal insufficiency. Ann Endocrinol (Paris) 2010; 71:309-13. [PMID: 20542258 DOI: 10.1016/j.ando.2010.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Revised: 04/02/2010] [Accepted: 04/14/2010] [Indexed: 11/30/2022]
Abstract
Adrenal hypoplasia congenita (AHC) is a rare inherited condition characterised by primary adrenal failure and hypogonadotropic hypogonadism. Most cases arise from mutations in the NR0B1 gene (Xp21.3), which encodes an orphan nuclear receptor DAX-1. A 20-year-old patient was recently diagnosed with AHC. Adrenal failure had been recognized and treated since his infancy. During adolescence, gradual decrease in growth velocity and low body mass were noted. Lack of puberty and skeletal immaturity were observed. Serum DHEA-S and testosterone were undetectable. Low gonadotropin levels failed to rise after stimulation. Neither dysfunction of the somatotropic nor pituitary-thyroid axis was found and no hypothalamo-pituitary pathology was visible on MRI. Androgen replacement therapy induced the development of secondary sexual characteristics, remarkably improved patient's growth and advanced his bone age. NR0B1 mutation screening revealed nucleotide transversion C>A, resulting in premature stop codon (Y399X). Same mutation was previously identified in a Scottish family, however, phenotypic differences suggest the role of additional factors modifying the disease course. Although it does not change therapeutic strategy, accurate molecular diagnosis allows genetic counselling in family members. Autoimmunity remains the major cause of adrenal failure; however, other rare conditions should always be considered.
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Affiliation(s)
- M Fichna
- Department of Endocrinology and Metabolism, Poznań University of Medical Sciences, 49 Przybyszewskiego, 60355 Poznań, Poland.
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Kukolowicz P, Dąbrowski A, Gut P, Chmielewski L, Wieczorek A, Kędzierawski P. 3/Evaluation of set-up deviations during the irradiation of patients suffering from breast cancer treated with two different techniques. Rep Pract Oncol Radiother 2004. [DOI: 10.1016/s1507-1367(04)70835-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gut P, Luginbühl A, Nicolet J, Boerlin P, Burnens AP. [The necrotizing enteritis by Clostridium perfringens type C in piglets: II. Molecular epidemiology study]. SCHWEIZ ARCH TIERH 2002; 144:275-81. [PMID: 12125238 DOI: 10.1024/0036-7281.144.6.275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Investigations were performed on shedding of C. perfringens in sows from four different pig farms. In two farms where no outbreaks of necrotizing enteritis had been observed, no strains of C. perfringens producing beta-toxin were detected in the faeces of sows. In contrast, C. perfringens strains producing beta-toxin were detected in sows on both farms suffering outbreaks of acute necrotizing enteritis. Strains of C. perfringens producing beta-toxin were invariably positive for the beta 2-toxin gene. However, strains carrying the beta 2-toxin gene only (i.e. negative for beta-toxin) were present in animals on all farms with roughly similar frequencies (mean 28.2% carriers). Some sows carried C. perfringens strains of both toxin genotypes simultaneously. Whereas these data further support the role of betatoxin as a cause of necrotizing enteritis, the role of beta 2-toxin in intestinal disease of piglets remains unclear. To establish the role of faecal shedding vs. environmental contamination as reservoirs of C. perfringens type C, strains were isolated from teats and feedlot trough swabs (toxin genotype beta/beta 2), as well as from fodder (genotype beta 2). However, sows carried this pathogen intermittently and in small numbers. This renders an individual, reliable diagnosis of carrier sows very difficult. Ribotyping of 34 C. perfringens isolates of different toxin genotypes showed five distinct profiles. Different toxin genotypes can belong to the same ribotype, and the same toxin genotype can be present in different ribotypes. Thus, even if a majority (79.4%) of strains investigated in a limited geographic region belonged to ribotype 1, ribotyping offered discrimination of strains beyond toxin typing.
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Affiliation(s)
- P Gut
- Institut für Veterinär-Bakteriologie der Universität Bern
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Gut P, Kukołowicz P, Chmielewski L, Dąbrowski A. 25. Assessment of the accuracy of radiotherapy by digital superposition of portal and rference images. Rep Pract Oncol Radiother 2001. [DOI: 10.1016/s1507-1367(01)70395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gut P, Grennan Jones F, Sullivan A, Ziemnicka K, Smith S, Jaskólski D, Furmaniak J, Rees Smith B. Recombinant human thyroid peroxidase produced in insect cells has similar properties to native human thyroid peroxidase. Thyroid 2000; 10:543-50. [PMID: 10958306 DOI: 10.1089/thy.2000.10.543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purified native human thyroid peroxidase (nTPO) isolated from thyroid tissue and recombinant (r)TPO produced in High Five insect cells have been compared. nTPO and rTPO were purified to about 95% homogeneity and showed similar UV and visual spectra and similar 412 nm per 280 nm absorbance ratios (0.4 for nTPO and 0.4 for rTPO). The nTPO and rTPO guaiacol oxidation enzyme activities were about 1,000 guaiacol units per milligram of protein. TPO autoantibody binding characteristics of nTPO and rTPO were analyzed in an assay based on 125I-labeled nTPO and precipitation with protein A. In the assay, the effect of unlabeled nTPO or rTPO on TPO autoantibody binding from 25 patients sera was studied. Unlabeled nTPO or rTPO (from 0 to 160 ng/mL) inhibited the binding of TPO autoantibodies in a dose-dependent manner in the case of each serum studied (from 100% in the absence of unlabeled TPO to 5%-10% in the presence of 160 ng/mL of TPO). The inhibition profile for each serum was essentially identical in the case of both TPO preparations. The effect of TPO autoantibodies on enzyme activity of rTPO was analyzed after incubation of rTPO with TPO autoantibody-positive serum immunoglobulin G (IgG) (n = 12), TPO monoclonal antibodies reactive with two different epitopes on the TPO, IgG (n = 3) from glutamic acid decarboxylase autoantibody positive patient sera, and IgG (n = 3) from healthy blood donors. Effective complexing of TPO by TPO autoantibodies was tested by precipitating the complexes with solid phase protein A and measuring the TPO enzyme activity in the resulting supernatants. These studies showed that the TPO enzyme activity was not affected by incubation with TPO autoantibody-positive IgG or monoclonal antibodies despite effective complexing of the autoantibodies with TPO. Overall, our studies demonstrate that nTPO and rTPO produced in insect cells are very similar in terms of enzyme activity, UV and visible spectra, and reactivity with autoantibodies. Furthermore, in our study, TPO autoantibodies did not appear to inhibit TPO enzyme activity.
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Affiliation(s)
- P Gut
- FIRS Laboratories, RSR Ltd. Parc Ty Glas, Llanishen, Cardiff, United Kingdom
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Sawicka J, Gryczyńska M, Baumann-Antczak A, Gut P, Polańska A, Kosowicz J. [Detection of pituitary autoantibody in patients with pituitary tumors and hypopituitarism]. Pol Arch Med Wewn 1999; 101:123-9. [PMID: 10723226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
UNLABELLED In 80 patients, 73 cases of pituitary tumours and 7 cases of hypopituitarism, we performed pituitary autoantibodies assays in serum samples because in our previous studies we had found a high prevalence of pituitary autoantibodies in several autoimmune endocrine disorders. To detect the presence of pituitary autoantibodies we applied 2 methods, radioimmunoassay (RIA) and immunoblotting. The RIA was performed by solid phase technique in human pituitary microsome-coated polyethylene tubes. Following incubation with diluted sera of the patients labelled 125I-protein A was added to the tubes to detect the retained antibodies. In the sera of 33 patients we detected the presence of antibodies; in the other 47 patients no antibodies were found. The majority of the patients with positive antibody results were previously treated by pituitary irradiation. To evaluate the molecular weights of pituitary autoantigens the microsomal proteins were separated on SDS PAGE, then electrophoretically transferred to nitrocellulose membranes and reacted with diluted sera of 30 antibody-positive patients. The nitrocellulose strips were incubated with labelled 125I-protein A and autoradiographed. Using immunoblotting, 13 out of these 30 patients we found autoantibodies reacting with pituitary microsomal antigens of different molecular weights, most frequently reacting with a 68 kDa autoantigen. CONCLUSIONS The prevalence of pituitary autoantibodies in patients with pituitary diseases is 41% lower than in autoimmune endocrine diseases. Pituitary autoantibodies usually appear in patients after pituitary irradiation or after neurosurgery followed by irradiation, but occur rarely in untreated patients with pituitary adenomas.
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Affiliation(s)
- J Sawicka
- Klinika Endokrynologii Instytutu Chorób Wewnetrznych AM w Poznaniu
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