Fadhel Guermazi

A Comparative Study of the Oxidative Profile in Graves’ Disease, Hashimoto’s Thyroiditis, and Papillary Thyroid Cancer

The aim of this study was to evaluate and compare the oxidative profiles of three thyroid disorders: Graves’ disease (GD), Hashimoto thyroiditis (HT), and papillary thyroid cancer (PTC). Malondialdehyde levels (MDA), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) activities were examined in the plasma of 52 patients (29 untreated HT, 16 untreated GD, and 7 PTC who underwent surgical therapy). Results were compared with those of 30 healthy controls and among the three groups of patients. The GD, HT, and PTC patients exhibited increased plasma MDA levels and SOD activities compared with the controls (p < 0.05, p < 0.05, and p < 0.001, respectively). CAT activities significantly increased only for the PTC and HT patients (p < 0.001 and p < 0.05, respectively), whereas GPx activities significantly decreased only in the GD and PTC (p < 0.05 and p < 0.01, respectively). The comparison among the three groups of patients has shown increased MDA level and SOD activity for the PTC patients as compared to the GD patients (p < 0.01 and p < 0.001, respectively). Compared with HT, PTC patients exhibited significant higher MDA level, SOD, and CAT activities and a significant lower GPx activity (p < 0.01, p < 0.001, p < 0.05, and p < 0.05, respectively). No significant discrepancies were noted between the GD and HT patients. Our results have clearly shown an oxidative profile that is highly disturbed for the PTC patients as compared to those of autoimmune disorders. Future studies are needed to determine whether or not the oxidative stress has a prognostic value in this pathology.

Changes in growth rate and thyroid- and sex-hormones blood levels in rats under sub-chronic lithium treatment

Lithium therapy, mainly used in curing some psychiatric diseases, is responsible for numerous undesirable side effects. The present study is a contribution to the understanding of the pathophysiological mechanisms underlying lithium toxicity. Male and female mature rats were divided into three batches and fed commercial pellets: one batch was the control and the second and third batches were given 2 g (Li1) and 4 g (Li2) of lithium carbonate/kg of food/day, respectively. After 7, 14, 21 and 28 days, serum levels of free tri-iodothyronine (FT3), thyroxine (FT4), testosterone and estradiol were measured. Attention was also paid to growth rate and a histological examination of testes or vaginal mucosa was carried out. In treated rats, a dose-dependent loss of appetite and a decrease in growth rate were observed, together with symptoms of polydypsia, polyuria and diarrhea. Lithium serum concentrations increased from 0.44 mM (day 7) to 1.34 mM (day 28) in Li1 rats and from 0.66 to 1.45 mM (day 14) in Li2 rats. Li2 treatment induced a high mortality after 14 days, reaching 50-60% in female and male animals. From these data, the LD50 (14 days Li2 chronic treatment) was calculated to be about 0.3 g/day per kilogram of animal, leading to Li serum concentrations of about 1.4 mM. A significant decrease of FT3 and FT4 was observed in treated rats. This effect appeared immediately for the highest dose and was more pronounced for FT3, resulting in an increase of the FT4/FT3 ratio. In males, testosterone decreased and spermatogenesis was stopped. Conversely, in females, estradiol increased in a dose-dependent manner as the animals were blocked in the diestrus phase at day 28. This finding supports a possible antagonistic effect of lithium on the estradiol receptors.

Analysis of Scintigraphic Renal Dynamic Studies: An Image Processing Tool for the Clinician and Researcher

The objective of this work is to develop a platform-independent tool for analysis of Scintigraphic renal dynamic studies. It allowing quantification kidney, from a series of Scintigraphic images in the format provided DICOM. This tool allows an automatic or manual drawing of regions of interest and the kidney in renal background even if small kidney and / or little functional kidney, drawing the isotopic nephrogram corrected for background noise (activity curves kidney) and determining the renal function on according to the method of the integral. This developed tool allows obtaining semi-automatic so reproducible results on page relevant information to the physician to assess the functional status of each kidney: the isotopic nephrogram, viewing dynamic images and the relative function that users can calculate renal function through the regions of both kidneys. This tool is a step forward towards standardization as a suitable tool for education, research, and for receiving distant expert’s opinions.

Lipid peroxidation, proteins modifications, anti-oxidant enzymes activities and selenium deficiency in the plasma of hashitoxicosis patients:

Objectives: The aim of this study was to explore the oxidative stress profile in hashitoxicosis (HTX) and to compare it with that of healthy subjects. Patients and methods: Spectrophotometric methods were used to evaluate the oxidative stress markers. The selenium level was investigated by atomic absorption. Results: High levels of thiobarbituric acid reactive species (TBARS) and conjugated dienes were found in HTX patients (p = 0.034 and p = 0.043, respectively) compared with healthy controls. For antioxidant enzymes, superoxide dismutase (SOD) and catalase activities increased, whereas that of glutathione peroxidase (GPx) decreased (p = 0.000, p = 0.014, p = 0.000, respectively) compared with controls. A reduction in the level of selenium (p = 0.029) and thiol groups (p = 0.008) were shown in patients; however, levels of carbonyl group and malondialdehyde (MDA) protein adducts decreased (p = 0.000) compared with controls. Positive correlation was shown between levels of free thyroxine (FT4) and TBARS (r = 0.711, p = 0.048) and between FT4 level and SOD activity (r = 0.713, p = 0.047). Conversely, GPx activity presented a negative correlation with FT4 and free triiodothyronine (FT3) levels (r = –0.934, p = 0.001; r = –0.993, p = 0.000, respectively). In addition, GPx activity showed positive correlation with selenium level (r = 0.981, p = 0.019) and the FT3 level correlated negatively with the level of thiol groups (r = –0.892, p = 0.017). Conclusions: This study shows the presence of an oxidative stress and selenium deficiency in HTX patients and suggests that the hyperthyroid state is strongly implicated in the establishment of this disturbed oxidative profile.

Métastases uvéales des carcinomes thyroïdiens. À propos de 3 cas

OBJECTIVE To study the characteristics of ocular metastases of thyroid carcinomas through three observations of patients. RESULTS Three patients aged respectively 41, 55 and 66 years were followed for thyroid carcinoma. All patients were treated by surgery followed by IRA therapy. They developed ocular metastases after a mean period of 10 years after thyroidectomy. They presented in addition multiple secondary sites such as bone, lungs and cerebrum. The uveal lesion was unilateral and localized at the choroid or iris. The predominant symptomatology was decreased visual acuity. The diagnosis was based on ophthalmoscopic examination and post-IRA therapy scan and was confirmed by anatomopathological study. Treatment options were respectively IRA therapy, sectoral iridectomy and enucleation. Evolution was fatal in 2 cases and towards aggravation for one case. CONCLUSION Uveal metastases of thyroid cancer are associated with a pejorative prognosis. Ophthalmologic follow-up is necessary when patient presents warning sign mainly with metastatic follicular carcinoma. Conversely, thyroid carcinoma should be considered in the differential diagnosis of a uveal mass of unknown origin.

Involvement of the Selenium Level in Plasma Glutathione Peroxidase Activity in Newly Diagnosed Patients with Graves’ Disease and Hashimoto Thyroiditis

1 Laboratory LR11ES45, Research Group “Biotechnology and Pathology”, National School of Engineers. Universisty of Sfax, Tunisia. malek.mseddi@gmail.com 2 Department of Endocrinology Inpatient and Outpatient Clinics, Hedi Chaker University Hospital of Sfax, Tunisia. bochragargouri@yahoo.fr 3 Department of Nuclear Medicine, Habib Bourguiba University Hospital of Sfax, Tunisia. fatmamnif05@yahoo.fr ABSTRACT

P178 L’acidocétose diabétique : cause d’embolie pulmonaire !

Introduction L’acidocetose diabetique est une complication frequente generalement d’evolution favorable. Des complications thromboemboliques peuvent etre observees dont l’embolie pulmonaire. A partir de cette observation clinique et d’une revue de la litterature, nous analysons la frequence de l’embolie pulmonaire au cours de l’acidocetose diabetique et sa physiopathologie. Observation Il s’agit d’un homme âge de 24 ans diabetique type 1 depuis 7 ans avec mauvaise observance du regime et du traitement. Son histoire remonte a 2 semaines avant son admission marquee par l’installation d’une asthenie, toux seche, douleur basithoracique bilaterale sans notion d’alitement. A l’examen : subfebrile a 37,8° ; bon etat de conscience, legerement deshydrate, tachycarde, TA 12/7, dyspneique avec tirage intercostal, FR a 26, des râles sibilants droits. Le reste de l’examen est sans particularite. Les examens biologiques trouvent : hyperglycemie avec acidocetose, hemoconcentration. A l’ECG : tachycardie sinusale, onde P pulmonaire en DII et DIII, aspect QS en V1 V2 et V3. La radio thorax revele une opacite parahilaire droite. Les D dimeres sont elevees, l’echodoppler des MI est normale, l’angio scanner thoracique note des foyers de condensation parenchymateux droits. La scintigraphie pulmonaire confirme le diagnostic d’embolie pulmonaire en montrant une discordance entre la perfusion et la ventilation au niveau basal droit. L’evolution est favorable sous heparinotherapie relaye par anti vitamine K. Par ailleurs, l’enquete etiologique de cette embolie pulmonaire est negative. Conclusion Des complications thromboemboliques sont decrites au cours de l’acidocetose diabetique tels que la thrombose du sinus veineux intra cerebral, thrombose de la veine axillaire, thrombose de l’aorte et de l’artere femorale exceptionnellement l’embolie pulmonaire. Ces complications sont dues a des troubles de la coagulabilite et a la depletion du volume intravasculaire.