Kinetics of intracolloidal iodine in thyroid of iodine-deficient or equilibrated newborn rats. Direct imaging using secondary ion mass spectrometry.

The most significant impact of the Chernobyl accident is the increased incidence of thyroid cancers among children. In order to accurately estimate the radiation dose provided by radioiodines, it is important to examine how the distribution of newly incorporated iodine varies with time and if this distribution varies according to the iodine status. The kinetic distribution of intra colloidal newly organified iodine in the rat immature thyroid was recorded and analysed using the ionic nanoprobe NanoSims50. Our observations imply that in case of radioiodine contamination, the energy deposits vary (i) with time, (ii) from one follicle to another, and (iii) from one cell to another inside the same follicle regardless the iodine status. The kinetic heterogeneity of iodine distribution must be take in account in thyroid dose evaluation.

[Isolated carcinoid tumor of the ovary disclosed by tricuspid insufficiency]. / Une tumeur carcinoïde isolée de l'ovaire révélée par une insuffisance tricuspide.

A 68-year old woman was hospitalised because of isolated right heart failure. Doppler echocardiography revealed severe tricuspid regurgitation with thickened, shortened, hypomobile leaflets. Pulmonary valve was thickened with mild pulmonary regurgitation. Mitral and aortic valves were normal. The patient was finally diagnosed with carcinoid heart disease from an isolated ovarian carcinoid cancer without hepatic metastases. Ovarectomy was performed and the patient was considered cured of her cancer. Because of refractory right heart failure, she underwent tricuspid valve replacement with a bioprosthesis. Such cardiovascular manifestations are rarely the presenting symptoms of carcinoid disease. Carcinoid heart disease from ovarian primary cancer is exceptional. In this circumstance, carcinoid cardiac lesions may develop in the absence of hepatic metastases because the venous blood from the ovaries drains into the inferior vena cava without hepatic first past effect. Surgical resection of primary ovarian carcinoid tumor is often curative and the prognosis depends mainly on the cardiac condition. The diagnosis of carcinoid syndrome should be discussed in patients with organic tricuspid regurgitation without left valvular disease.

Analysis of the distribution of MRI contrast agents in the livers of small animals by means of complementary microscopies.

BACKGROUND: Magnetic resonance imaging (MRI) contrast agents contain magnetic molecules such as iron (Fe) or gadolinium (Gd) that are injected in vivo into rats or mice to study their distribution inside the liver. Fluorescent europium (Eu) can be used as a model of Gd to obtain comparable information of this distribution of corresponding contrast agents. In a similar approach, Fe can be attached to Texas Red and used as a model of ferumoxides and be detected by fluorescence. METHODS: To combine and compare the advantages of different microscopic imaging modes, characterization studies were carried out by means of a confocal laser scanning microscope (CLSM), a secondary ion mass spectrometric (SIMS) microscope, and an electron energy loss spectrometric (EELS) microscope. In the case of CLSM, the locations of fluorescent signals inside preparations were determined by factor analysis of biomedical image sequences (FAMIS) and selection of image sequences at emission. RESULTS: By CLSM and FAMIS, we distinguished chelated Eu and Texas Red attached to Fe. By SIMS microscopy, we distinguished Eu and Gd of chlorides and chelates and Fe of a ferumoxide. By EELS microscopy, we distinguished Eu and Gd of chlorides. CONCLUSIONS: Analysis of compounds inside correlative specimens by means of CLSM, SIMS, and EELS microscopes provided complementary results.

Early ultrastructural injuries in the thyroid of the normal rat radioinduced by diagnostic and/or therapeutic amounts of iodine-131.

After irradiation, two principal mechanisms of cytolytic cell death can be involved: apoptosis and necrosis. By using morphological criteria, cells undergoing apoptosis can be distinguished from cells dying by necrosis. In nuclear medicine 131I is used to ablate thyroid remnants or to treat well differentiated thyroid carcinoma. The aim of study was to describe the progressive morphological thyroid changes induced by a diagnostic and/or therapeutic amounts of 131I in the rat using electron microscopy, in an attempt to determine which is the cell death pathway and to analyse "stunned" thyroid tissue to elucidate this effect. Tissular and ultrastructural examinations show that damages induced by 131I irradiation of the normal thyroid gland are heterogeneous. Thyroid cells die by necrosis after this metabolic irradiation, and no signs of apoptosis were observed by electron microscopy. In the other hand, stunning effect did not seem to impair the effectiveness of 131I treatment.

In vitro irradiation of blood with 99mTc: evaluation of dose and chromosome aberrations in irradiated lymphocytes.

The use of ionizing radiation for diagnostic or therapeutic purposes in medicine represents the principal source of artificial radiation to humans. Calculation of radiation dose is essential to the analysis of risks (biological effects) and benefits in any application, including nuclear medicine. The dose assessment in many cases is not necessarily straightforward. Many radiopharmaceuticals are labelled with radionuclides that undergo not only gamma-emission but also emission of Auger and internal conversion electrons. A typical example is technetium-99m (99mTc), which is used in more than 80% of nuclear medicine applications. In this work, in vitro studies have been carried out to evaluate the dose delivered to lymphocytes by human serum albumin microspheres (HSAM) labelled with 99mTc. Experiments were performed in order to score unstable chromosomal aberrations induced by 99mTc-HSAM, using conventional cytogenetic techniques. Henceforth, the relationship between activities introduced into blood samples and induced chromosomal aberrations were evaluated. To assess the dose absorbed in lymphocytes, electron and photon transport was performed in a simple model representing the system used for irradiating the cells using the MCNP Monte Carlo code. In this report, analysis of dose-effect curve demonstrates a linear quadratic response for unstable chromosome aberrations.

Biological consequences of irradiation by low doses of technetium 99m: ultrastructural studies, p53 protein expression and cytogenetic effects.

Few studies concerning the potential genetic effects of diagnostic radionuclides used in nuclear medicine have been reported. The aim of this study was to evaluate the biological and cytogenetic consequences of two technetium 99m-labelled radiopharmaceuticals. Ultrastructural modifications of pulmonary cells were first investigated after injection of 99mTc labelled microspheres in the rat. On the same irradiated cells, nuclear expression of p53 protein was assessed using immunohistochemistry. Despite very high previously calculated doses delivered to pulmonary cells, no morpholological cell damage and no significant increase of nuclear expression of the p53 were noted. There was no correlation between the calculated dose and the ultrastructural biological damage. Secondly, a specific in vitro curve, activity/number of unstable chromosomal aberrations, corresponding to physical characteristics of 99mTc, was established to verify the potentiality of 99mTc to induce such aberrations. In vivo, cytogenetic effects were assessed on blood samples of 5 patients with various arthrosic and periarthrosic diseases obtained after bone scintigraphy. Aberration frequencies of both in vitro and in vivo irradiated lymphocytes were determined using the classical Fluorescence Plus Giemsa technique. No cytogenetic effects appeared with the routinely 99mTc injected activities as predicted by the in vitro curve.

Extensive phenotypic analysis of a family with growth hormone (GH) deficiency caused by a mutation in the GH-releasing hormone receptor gene.

GH secretion and release are complex phenomena depending on activation of several genes, including those encoding GH, GHRH, and its receptor (GHRH-R). The GH gene, which is the most extensively analyzed sequence in patients with familial GH deficiency (GHD), represents the main known target of mutations. To test the involvement of the GHRH-R gene in this disease phenotype, we investigated one candidate Tamoulean family originating from Sri Lanka. Two brothers, with extremely short stature (< -4 SD) and no dysmorphy, were diagnosed as having complete GHD, unresponsive to exogenous GHRH and associated with PRL levels within the lower normal range. Magnetic resonance imaging examination showed anterior pituitary hypoplasia with a normal pituitary stalk. Both patients increased their growth rate while under GH therapy. Molecular investigations revealed a homozygous GHRH-R gene mutation that introduces a stop codon at residue 72. This mutation, which predicts a severely truncated receptor lacking the seven membrane spanning domains, is identical to that recently reported in one Indian Moslem family, raising the possibility of a founder effect. There was no clear evidence for height reduction in the three heterozygous individuals studied. This observation, which underlines the phenotypic criteria associated with a loss of GHRH-R function, raises the question of the frequency of GHRH-R abnormalities among GHD patients.

Heterogeneous distribution of technetium-99m-labeled microspheres in rat lungs: microautoradiographic evidence and dosimetric consequences.

UNLABELLED: The heterogeneity of 99mTc-labeled microspheres distribution within rat lung was visualized and quantified using a microautoradiographic "track" method (MAR). METHODS: MAR was used to study the uptake of radioactivity by individual microspheres, thereby enabling calculation of the range of particle activity. MAR was also used to visualize in rat lung sections the intrapulmonary distribution of the microspheres within the lungs after intravenous administration. The mean doses delivered to the cells in close contact with the labeled microspheres were calculated taking only the 99mTc electron emissions into account. RESULTS: All the microspheres were labeled. Nevertheless, the spectrum of visible tracks varied by a factor of 10, inducing a variable activity per microsphere from < 36 Bq to 325 Bq (mean activity-94 Bq/microsphere). No correlation existed between the radioactivity uptake and the size of microspheres. A very heterogeneous tridimensional distribution of the microspheres within the lungs were demonstrated with interparticle distances ranging from 57-4400 microns. On the other hand, only 1 of 2000 rat lung capillaries was obstructed. Using the mean activity, calculated delivered doses were found to reach approximately 6 Gy for the closest endothelial cells and 2 Gy for epithelial cells. However, such high doses were delivered to only a few cells. CONCLUSION: The number of obstructed capillaries in human lungs is lower than in rat lungs; the distances between microspheres should be larger. Nevertheless, the individual doses absorbed by the pulmonary cells closest to the microspheres should be very important.

[Radio-isotope assays of vitamin B 12: value of the Kappa test in a multicenter evaluation]. / Dosages radio-isotopiques de la vitamine B12: intérêt du test Kappa dans une évaluation multicentrique.

Owing to the lack of a reference technique and of an international cobalamin (vitamin B12) standard, and the large discrepancy between laboratory norms, the authors performed a multicentric study to compare five RIA kits usually used. First, classical tests were used to evaluate the analytical performances of each kit. Results did not demonstrate any superiority of one kit over another. Secondly, B12 values were classified among three categories (low, normal and high) characterized by laboratory and then manufacturer norms. The concordance between these two "judgments" was evaluated with the Kappa coefficient. In addition, the Kappa index proved that the norms supplied by the manufacturer were better than those of laboratories. But mean Kappa coefficient established for each norm gave us an unsatisfactory result. Third, clinical informations allowed to improve the classification of the patients. New limits were defined for each technique and should be tested further, routinely in each laboratory.

Pharmacokinetics and biodistribution of technetium 99m labelled standard heparin and a low molecular weight heparin (enoxaparin) after intravenous injection in normal volunteers.

For a better understanding of low molecular weight heparin pharmacokinetics, 99m technetium labelled heparin and enoxaparin were injected intravenously to four normal volunteers, after approval by the Ethics Committee and preliminary animals studies. In vitro and in vivo, the labelled products proved to be stable and identical to the non-labelled drugs. Radioactivity curves in blood, organs and urines were similar for both products. Anti Xa plasma half-life was 3 times longer for enoxaparin than for heparin. Anti IIa plasma half-lives were similar. However, radioactivity persisted much longer than biological activities for both products. After chromatography, most of the radioactivity was bound to AT III, where an anti Xa activity peak was also detected. The anti Xa activity peak seen after adding AT III to plasma was much higher with heparin than with enoxaparin. In urine, biological activities, measured with AT III supplementation, were higher with enoxaparin than with heparin. These results suggest that phenomena other than biodistribution are responsible for the differences in pharmacokinetics observed between these two products. The two most likely explanations are differences in metabolism and/or a release of an endogenous factor.

[Bilateral diaphyseal hyperostosis of the leg bones in adults. Apropos of a case]. / Hyperostose diaphysaire bilatérale des os de la jambe de l'adulte. A propos d'un cas.

A new case of bilateral, diaphyseal hyperostosis of the leg bones is reported. Strictly unilateral symptoms appeared when the patient was 35 years old consisting of unbearable pain in the middle section of the antero-medial side of the left leg. Diagnosis was based on X-rays and a pre-operative bone scintiscan, showing localised hyperfixation opposite the pain site. Preoperative locating using a radioactive marker enabled circumscribed but complete excision of the hyperfixation site. This diagnosis was confirmed by the pathologist examination. The patient, who experienced immediate relief after surgery, has remained pain-free for one year to date. The relationship between this case and Camurati-Engelmann disease (diaphyseal dysplasia) is discussed.

Pharmacokinetics and tissue distribution of 99mTc-labelled enoxaparin in the rat: evaluation of dosimetry parameters.

A low molecular weight heparin, enoxaparin, was labelled with 99mTc and the characteristics of the labelled compound determined. In vitro the stability, and labelling efficiency (98%) of the labelled drug were excellent. Rats were injected with 99mTc-enoxaparin to study pharmacokinetics and distribution. The results were used to calculate dosimetric estimates which are a prerequisite for pharmacokinetic studies on labelled LMWH (low molecular weight heparin) in human subjects. Biodistribution studies showed preferential liver and spleen accumulation. But the doses absorbed by these target organs remained below the upper limits of the dose received by a patient undergoing hepatic scintigraphy.

Beta-endorphin levels after intrathecal infusion of iodinated contrast media.

Modifications in beta-endorphin levels in cerebrospinal fluid have been described following lumbar puncture and metrizamide injection. Cerebrospinal fluid (CSF) samples were obtained from 19 patients before and after lumbar myelography. Two radioimmunoassays were used. One was a commercial kit; and the other one (developed in our laboratory) used a chromatographic removal from beta-lipotrophin. No definite variation of beta-endorphin was observed after myelography, using either the commercial kit or a more sophisticated procedure. Some controls were prepared by adding metrizamide or Iopamidol in vitro to CSF samples in order to evaluate a non specific effect of these contrast media. The results obtained with these controls suggest that the discrepancy of results may be explained simply by assay artifacts due to drug interferences when using the commercial methods.

Thallium uptake in fasted and nonfasted rats.

Thallium uptake was studied in selected organs in two groups of rats: fasted and nonfasted. A significant increase in thallium uptake was found in the stomach and the small intestine after eating while a significant decrease was found in the lung.