Nephritis Syndrome Tubulo-Intertitial and Uveitis (Tinu Syndrome): About 2 Cases

Introduction: Tubular and interstitial nephropathy syndrome with uveitis or TINU syndrome is a rare association. Patients and methods: We have listed cases in which the clinical-biological picture and histology were consistent with this syndrome. Results: Two cases were retained: These were two female patients whose mean age at diagnosis was 16 years. The inaugural symptoms were bilateral anterior uveitis in two cases. The time to onset of renal signs: was 4 to 2 weeks months. Acute kidney failure was reported in both cases with a mean creatinine of 36.4 mg/l. An average proteinuria of 1.1 g/24 h associated with aseptic leukocyturia in one case/2 and glycosuria normoglycemic in 1 case/2. Non inflammatory syndrome specific with inflammatory anemia is reported in both cases. Kidney puncture biopsy confirmed the diagnosis with nephropathy diffuse polymorphic tubulointerstitial and immunofluorescence negative in both cases. Oral corticosteroid therapy (1 mg/kg per day) was started for 4 to 6 months. Both patients received initial local corticosteroid therapy for uveitis. The outcome was favorable under treatment with remission complete. Kidney function recovered after 6 months with an average serum creatinine of 6 mg/l. Discussion: The incidence of TINU syndrome appears to be underestimated in the literature. It is believed to be an autoimmune disease. The positive diagnosis is based on clinical, biological and histological. An etiological investigation in search of disease systemic is necessary before making the diagnosis. There is no codified treatment. The prognosis is favorable in the majority of cases. Conclusion: Investigation of renal function is necessary for any patient.

Hypofractionated Radiation Therapy for the Treatment of Breast Cancer: Experience of National Institute of Oncology, Rabat, Morocco

Hypofractionated radiation therapy has proven effective on locoregional control and tolerance in the adjuvant treatment of breast cancer. The aim of this study is to compare the results of hypofractionated radiation therapy versus conventional radiation therapy in terms of local control and tolerance. It was a retrospective study of patients observations collected from January 2007 to December 2008 in Department of Radiation Therapy in Institut National d’Oncologie de Rabat. The treatment results were evaluated by the rate of locoregional recurrence, distant recurrence and research of late toxicities. Radiotherapy was delivered using the same technique in both groups, by gamma photons of cobalt 60 with an energy of 1.25 MeV. They were 2 groups: the first group treated with standard dose rate and the second group treated by hypofractionated radiation therapy. The mean age of the patients was 42.8 ± 6.9 years old in the standard group and 43.22 ± 7.2 years old in the hypofractionation group. We noted a predominance of infiltrating ductal carcinoma. The majority of patients were pT2, pN0 and pN1. The majority of patients had radical surgery and chemotherapy with anthracyclines in both groups. We noted a statistically significant difference in the irradiation of chest wall between the standard (89.2%) and hypofractionated group (70.3%), with p = 0.043. The median duration of radiation therapy was statistically different in both groups: 39 days in the standard and 23 days in the hypofractionated group (p 0.001). The local recurrences were statistically identical to 12 and 24 months (p = 0.999). Concerning toxicities, the frequency of adverse event was similar in both groups. Hypofractionated radiation therapy with a total dose of 42 Gy at 2.8 Gy per fraction in 5 fractions weekly is comparable to standard radiotherapy in terms of local control and tolerance and is therefore a very good alternative to standard treatment.

Corticosurrenaloma: About a Pediatric Case

Introduction: This study aims to describe the outcome of adrenocortical cancer in children through observation. Observation: A 10-year-old girl with no previous pathological history. She presented headaches and severe hypertension with clinical and biological signs of hyperandrogenism for 6 months. An abdominal CT scan showed an encapsulated left adrenal mass without local or regional invasion or secondary location. A pheochromocytoma or adrenal neuroblastoma was first suspected. The blood pressure was stable at 130/65 mmHg under antihypertensive drugs. She underwent a complete tumor resection without any intraoperative incident. The pathologic study confirmed the adrenocortical carcinoma scored Weiss 7. The severe high blood pressure reappeared 2-year later despite antihypertensive drugs. The thoracic abdominal and pelvic CT scan showed a locally advanced tumor recurrence in the left adrenal gland with parenchymal nodes in the lungs and liver. The outcome was fatal despite medical and surgical management. Conclusion: Adrenocortical cancer is a rare tumor. It is important to hormonal testing in the presence of Cushing’s syndrome in children. It can give a strong indication of the diagnostic possibilities. Histology confirms the diagnosis. The evolution is covered by complications, in particular recurrence with life-threatening metastases.

A Rare Cause of Hemiparesis: Intracranial Mycotic Aneurysm—A Case Report, and Review of the Literature

Background: The intracranial mycotic aneurysm is known to be a rare complication of infective endocarditis and it is more clinically challenging to get this diagnosis right when it happened to be in a patient without a past medical history of heart diseases. We report a documented case of mycotic aneurysm revealed by isolated left hemiparesis and our management with the collaboration of the cardiology department. Case Description: A 48-year-old male patient with a history of teeth loss, a chronic smoker presented with sudden heaviness in the left upper and lower limbs. No fever. Physical examination revealed a left hemiparesis of 3/5 on the muscle tone scale without the stiffness of the neck. The CT-Scan and the MRI conclude of subarachnoid and cerebral hemorrhage with right temporal hematoma being most probably a vascular malformation. The cerebral arteriography concluded of a right Sylvian mycotic distal aneurysm in the M4 segment. Transesophageal echocardiography was performed and concluded of infectious endocarditis with mitral and aortic valvular disease grade II. Positive blood culture for staphylococcus coagulase-negative. The patient was managed with antibiotic therapy and clinically stable after 28 days. He was then transferred to the cardiology department for follow-up. Six (6) months later a CT-angiography was done for a check-up and shows no further changes in the aneurysm. The patient underwent surgery, two (2) months later, for clipping the aneurysm because the aneurysm did not regress in size. The aneurysm was then excluded with an eventless post-operative period, confirmed by controlled cerebral arteriography. The patient was discharged five (5) days later and he is doing well. Conclusion: Mycotic aneurysm is a rare consequence of infective endocarditis. The distal sites of the middle cerebral artery are commonly found, and conservative treatment with a long course of antibiotics like amoxicillin 12 g/24h for 6 weeks or direct surgical clipping or excision can manage it.

黏附素5胞外区克隆、转染及抗人乳腺癌细胞生长的研究

目的:克隆和转染黏附素5胞外区,并研究其对人乳腺癌MDA-MB435细胞株生长的影响。方法:RT-PCR技术克隆黏附素5胞外区(称为CED1-4),将其插入pMSCV质粒载体,在大肠杆菌XL-blue扩增,提取和纯化pMSCV-CED1-4,酶切、电泳和测序检测CED1-4序列。CED1-4基因转染MDA-MB435细胞株,RT-PCR和Western blotting检测MDA-MB435细胞表达CED1-4。细胞增殖实验和乳腺癌裸小鼠致瘤实验检测CED1-4对MDA-MB435细胞体内外生长的影响。结果:构建了重组体pMSCV-CED1-4,电泳显示CED1-4条带在1636bp-1018bp区间,测序显示CED1-4基因长1452bp,编码484氨基酸。经PCR和Western blotting证实,CED1-4基因转染的MDA-MB435细胞在mRNA和蛋白质水平表达CED1-4。细胞增殖实验结果表明,实验组MDA-MB435细胞增殖低于实验对照组和空白对照组(P<0.05)。乳腺癌裸小鼠致瘤实验显示,实验组移植瘤平均体积和重量低于实验对照组和空白对照组(P<0.05)。结论:黏附素5胞外区CED1-4能在体内外抑制人乳腺癌MDA-MB435细胞株的生长。

Young footballers, assessed by deep breathing test, have a higher vagal response

Parasympathetic function can be assessed by the deep breathing test (DB) as a simple and reproducible cardiovascular reflex. The aim of this study is to use this test to compare the vagal response of a young footballers group to of age-matched untrained normal subjects. Deep breathing test was performed in 2 groups: one of 20 adult young footballers (average age of 19.3 ± 0.6 years), and a second age-matched group of 20 untrained subjects (average age of 19.6 ± 0.6 years). Subjects underwent the DB test after 30 min resting in supine position, and responses were expressed as a percentage of variation of heart rate during the stimulation. Student’s t-test was used to evaluate statistical differences among the two groups for all parameters (vagal response, heart rate, VO2max….) and considering p < 0.05 as a significant difference. The results showed that vagal response to deep breathing test was significantly higher in the young footballers when compared to the untrained controls (72.6% ± 16.2% vs 55.0% ± 12.8%, respectively, p = 0.03). The basal heart rate was significantly lower in footballers than in the controls group (52.1 ± 7.4 bat/min vs 69.8 ± 14.3 bat/min, p < 0.01). The use of the simple test of deep breathing allowed us to demonstrate that adult young footballers have a significantly lower basal HR and higher parasympathetic response in comparison to untrained subjects.

POLYPHENOLS, CYTOTOXICITY AND ENZYMATIC ACTIVITIES OF THREE ERIACEAE SPECIES FROM ALGERIA

In Algerian traditional medicine,Erica arborea(EA),Erica multiflora(EM)and Arbutus unedo(AU)are reported as antiseptic,diuretic,astringent,depurative,and to treat scalds and wounds.The methanolic extracts of their leaves and aerial parts were screened for enzyme inhibitory and cytotoxic activities.TLC and HPLC chromatographic profiles based on flavonoids allowed to easily distinguish between the three investigated species.Inhibitory