Intérêt de la scintigraphie parathyroïdienne de soustraction dans la prise en charge de l’hyperparathyroïdie secondaire. À propos de 33 cas

Aim^99mTc-Sestamibi is used in the imaging of hyperparathyroidism in order to guide the surgical procedure and to propose methods of less invasive surgery. The aim of our study was to evaluate the efficiency of preoperative subtraction parathyroid scintigraphy (Sestamibi-^99mTc/Pertechnetate) in the management of secondary hyperparathyroidism.Patients and methodsThe records of 33 patients with renal impairment consecutively operated from 2009 to 2011 for secondary hyperparathyroidism were retrospectively reviewed. We collected data on parathyroid function, results of parathyroid scintigraphy, intraoperative findings and pathological findings.ResultsScintigraphy was positive in 32 patients by disclosing a total of 75 hyperplastic parathyroid glands. The surgical exploration of all parathyroid glands revealed 99 hyperplastic glands confirmed by histological analysis. The sensitivity of parathyroid scintigraphy was 70.7% with a specificity of 85%. Positive predictive value was 93.3%, while negative predictive value was 50%. No correlation was found between the values of parathyroid hormone (PTH) and calcemia measured preoperatively and scintigraphic results.Discussion and conclusionIn our study, the correlation of scintigraphic data with PTH and serum calcium is not statistically significant. However, owing to a high positive predictive value, the parathyroid scan should be indicated. Value of parathyroid scintigraphy extends to searching ectopic or supernumerary glands and especially in cases of persistent or recurrent hyperparathyroidism.     

Fixation extraosseuse du radiotraceur lors de la réalisation d’une scintigraphie du squelette chez un patient atteint de bêta-thalassémie : à propos d’un cas

Red blood cell transfusion, main therapeutic modality of beta-thalassemia, leads to iron overload which may perturb several metabolic ways. The aim of this paper is to illustrate the uptake abnormalities observed on bone scan of thalassemic patients and to discuss mechanisms of extraosseous accumulation of the radiopharmaceutical in this pathology. We report a 16-year-old child suffering from beta-thalassemia major undergoing transfusion therapy. A bone scan was indicated to look for osseous infection. This study revealed a little skeletal uptake and abnormal liver, splenic and renal accumulation. A repeat bone scan, performed three weeks later showed a better skeletal uptake which enabled the discovery of focal abnormalities and made the diagnostic easier. The effect of iron overload on radiopharmaceuticals's uptake in bone scan is known since 1975. Dissociation of ^99mTc from the carrier ligand due to the presence of iron excess seems the most plausible hypothesis. Free ^99mTc can be bound to other tissular substrates which can explain extraosseous uptake. The normally available pool for bone is reduced and then the skeletal uptake decreased. This report limits considerably the sensitivity of the bone scan. A well-led iron chelation and eventually the use of diuretic drug may guarantee a better quality of bone scan images.     

Chloroplast DNA analysis in Tunisian fig cultivars (Ficus carica L.): Sequence variations of the trnL-trnF intergenic spacer

We investigated the nucleotide variation of a non-coding, chloroplast DNA (cpDNA) region to infer relationships among Tunisian fig cultivars. In this study, we examine the level of genetic diversity and its distribution using sequences of the trnL and trnF genes intergenic spacer. The non-coding region displays 28 substitution sites. Insertions and deletions involving 6 sites were found. By using the Kimura-2 method, nucleotide sequences have been aligned using the MEGA program to calculate pairwise divergence of trnL-trnF spacer sequences between cultivars. The size of this non-coding region varied from 430 to 464 bases. The relatively high A + T values (63.7–64.4%) of trnL-trnF intergenic spacer in Ficus carica may explain the high proportion of the identified transversions (t_i/t_v = 0.9). These results suggest the occurrence of nucleotide diversity with a large variation level of chloroplast non-coding region. The analysed data illustrate a considerable level of variability in the genetic pool of the local germplasm. In fact, relationships inferred from the cpDNA analysis suggest several clades, which do not show geographical correspondence. Fourteen haplotypes were detected among 20 individuals examined, yielding a haplotype diversity of 0.983 and a high level of nucleotide diversity (0.0100). The observed variation pattern of plastid DNA provides evidence that the fig germplasm has been undergoing rapid expansion. Neutrality tests rejected the neutrality assumption in the total sample. The cytoplasm variability indicates a narrow genetic base in the cultivated common fig. Despite the high level value of the apparent diversity, we may conclude that fig chloroplast genome provides a new conceptual and practical opportunity to evaluate genetic diversity and to identify local cultivars, making it a valuable source to include into potential breeding programs.     

The DNA-methylation state regulates virulence and stress response of Salmonella

The DNA methylation is a post-replicative event that provides secondary information to that formed by DNA. Addition of this information involves DAM methyltransferase, which methylates DNA on specific sites (5'-GATC-3'). This modification of DNA may play a role in regulating various processes in eukaryote or prokaryote cells. It was well understood that deoxyadenosine methyltransferase (DAM) methylates the adenine of the GATC sequence. Following DNA replication, however, DNA is transiently hemimethylated, and the new strand is then methylated by DAM. In Escherichia coli, removing the dam gene produces several phenotypes indicating multiple functions of methylation: (i) modulation of gene expression, (ii) DNA repair, (iii) initiation of replication, and (iv) stabilising the chromosome.     

Sarcome d’Ewing agressif apparaissant comme une lésion froide sur la scintigraphie osseuse

Ewing's sarcoma classically presents as a hot spot on bone scan as a result of increased vascularity of the tumor and new bone formation.PurposeWe report and analyze an uncommon pattern of a “cold” lesion in Ewing's sarcoma on bone scan and its physiopathologic significance.Case reportA 15-year-old boy complaining of thigh pain. CT scan evocated Ewing's sarcoma or osteitis. MRI evocated chronic osteitis. Scintigraphy showed a fairly intense and heterogeneous uptake on the femoral lesion and no abnormal uptake elsewhere. Biopsy showed none pathologic pattern. Three months later, a second biopsy concluded to Ewing's sarcoma. Bone scan showed a larger lesion with peripheral intense uptake centered by enlarged “cold” area in the left femoral diaphysis and no evident bone metastasis. The patient underwent chemotherapy and surgery. Three months later, bone scan showed extensive skeletal metastasis.ConclusionEwing's sarcoma appears usually as an intense lesion on bone scan. Nevertheless, decreased radiopharmaceutical uptake or “cold” lesion may be seen in aggressive Ewing's sarcoma with lytic tumor, growth of which is very rapid and bony reaction is minimal.     

Tyrosine phosphorylation of the Janus kinase 2 activation loop is essential for a high-activity catalytic state but dispensable for a basal catalytic state

The phosphorylation of an "activation loop" within protein kinases is commonly associated with establishing catalytic competence, and phosphorylation of the Tyr(1007) residue in the activation loop of Janus kinase 2 (JAK2) has been shown to be essential for intracellular propagation of cytokine-initiated signaling. We provide evidence for the presence of a basal activity state of JAK2, which was observed in the absence of activation loop phosphorylation. Phosphorylation of the JAK2 activation loop was essential for conversion to the high-activity state, characterized by high-efficiency ATP utilization during autophosphorylation. Mutagenesis of activation loop tyrosine residues Tyr(1007/1008) to phenylalanine residues impaired, but did not abolish, the enzyme's ability to autophosphorylate. The activation loop mutant JAK2 could also transphosphorylate an inactive JAK2 fragment coexpressed in Sf21 cells, providing evidence of exogenous substrate phosphorylation. The mutant enzyme remained in a basal activity state characterized by low-efficiency ATP utilization during autophosphorylation. Mutagenesis of a critical Lys(882) residue to a glutamate residue abolished all evidence of kinase activity, confirming that the observed activity of Tyr-to-Phe mutants was not due to another kinase. Our data are consistent with the proposal that JAK2 is an inefficient but active enzyme in the absence of activation loop phosphorylation and is capable of conversion to a high-activity state by autophosphorylation under physiological ATP concentrations. This theoretically precludes the need for an upstream activating kinase. The activation process of JAK2 may be envisioned as a multistate process involving at least two kinetically distinct states of activity.     

Analysis of Genetic Diversity and Relationships in a Tunisian Fig （Ficus carica） Germplasm Collection by Random Amplified Microsatellite Polymorphisms

The random amplified mirosatellite polymorphism method was performed in a set of Tunisian fig landraces using eighteen primer combinations. A total of sixty three random amplified microsatellite polymorphism （RAMPO） markers were scored and used either to assess the genetic diversity in these cultivars or to detect cases of mislabeling. Opportunely, data proved that the designed procedure constitutes an attractive and fast method with low costs and prevents radio exposure. As a result, we have identified the primer combinations that are the most efficient to detect genetic polymorphism in this crop. Therefore, the derived unweighted pair-group method with arithmetic averages （UPGMA） dendrogram illustrates the genetic divergence among the landraces studied and exhibits a typically continuous variation. Moreover, no evident correlation between the sexes of trees was observed. In addition, using these markers, discrimination between landraces has been achieved. Thus, random amplified mirosatellite polymor- phism is proved to be powerful for characterizing the local fig germplasm.     

Molecular evolution of chloroplast DNA in fig (Ficus carica L.): Footprints of sweep selection and recent expansion

Here, we report the nucleotide variation in two non-coding regions of the chloroplast DNA (cpDNA) to construct a possible evolutionary scenario in Ficus carica L. Our results suggest the occurrence of haplotypic and nucleotide diversity with a large variation level of chloroplast non-coding regions. Furthermore, our results demonstrated an explicit rejection of the null hypothesis that within F. carica the intron trnL and the spacer trnL-trnF evolved under a strictly neutral model of molecular evolution. Although, recent population expansion could serve as one alternative explanation for the detected excess of singleton, our results imply a positive selection and the genetic hitchhiking effect is unlikely. Parameters performed supported scenario of sweep selection and recent expansion of F. carica across Tunisia. Our results indicate that both positive selection and demographic histories have jointly contributed to the observed patterns of nucleotide diversity and haplotypes structure. Based on the results, we characterize the fig resources and provide several suggestions for effective conservation and improvement programs.