978 resultados para ADRENAL MASSES


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La présence de disques circumstellaires signale la formation actuelle ou passée de systèmes planétaires, pour lesquels les processus de formation sont encore mal compris. Ce mémoire porte sur la détection et la caractérisation de disques circumstellaires autour d’étoiles de faibles masses (types spectraux > K5) et de naines brunes qui sont candidates ou membres d’associations cinématiques jeunes. Nous présentons ici les résultats de cette recherche ainsi que son implication pour la compréhension des processus de formation et d’évolution des systèmes planétaires. De l’échantillon initial composé de ∼ 1600 objets provenant des relevés BANYAN de Malo et al. ainsi que Gagné et al., dont seulement 600 satisfont nos critères de qualité sur les données, quatre nouveaux candidats de disque ont été découverts en détectant leur excès d’émission infrarouge dans les données d’archive de la mission WISE. Les données du relevé 2MASS ainsi que les spectres synthétiques BT-Settl ont été conjointement utilisés pour modéliser l’émission des étoiles. Les nouveaux candidats, dont les types spectraux sont tardifs (M4.5 à L0) et les masses se situent entre ∼ 13 et 120 M_Jup, ont des températures de disque de ∼ 135–520 K et des luminosités fractionnaires de 0,021–0,15. Pour deux des cibles, nous avons obtenu des spectres dans les longueurs d’onde visibles et infrarouges proches. Ces nouveaux spectres montrent respectivement des signes d’émission en Hα et Paβ, indiquant la présence d’accrétion, et ainsi de gaz, et renforçant l’hypothèse que ces objets sont réellement jeunes. Ces deux objets, vraisemblablement âgés de 40 Ma, pourraient représenter la première détection et caractérisation de disques porteurs de gaz plus vieux que 20 Ma.

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La présence de disques circumstellaires signale la formation actuelle ou passée de systèmes planétaires, pour lesquels les processus de formation sont encore mal compris. Ce mémoire porte sur la détection et la caractérisation de disques circumstellaires autour d’étoiles de faibles masses (types spectraux > K5) et de naines brunes qui sont candidates ou membres d’associations cinématiques jeunes. Nous présentons ici les résultats de cette recherche ainsi que son implication pour la compréhension des processus de formation et d’évolution des systèmes planétaires. De l’échantillon initial composé de ∼ 1600 objets provenant des relevés BANYAN de Malo et al. ainsi que Gagné et al., dont seulement 600 satisfont nos critères de qualité sur les données, quatre nouveaux candidats de disque ont été découverts en détectant leur excès d’émission infrarouge dans les données d’archive de la mission WISE. Les données du relevé 2MASS ainsi que les spectres synthétiques BT-Settl ont été conjointement utilisés pour modéliser l’émission des étoiles. Les nouveaux candidats, dont les types spectraux sont tardifs (M4.5 à L0) et les masses se situent entre ∼ 13 et 120 M_Jup, ont des températures de disque de ∼ 135–520 K et des luminosités fractionnaires de 0,021–0,15. Pour deux des cibles, nous avons obtenu des spectres dans les longueurs d’onde visibles et infrarouges proches. Ces nouveaux spectres montrent respectivement des signes d’émission en Hα et Paβ, indiquant la présence d’accrétion, et ainsi de gaz, et renforçant l’hypothèse que ces objets sont réellement jeunes. Ces deux objets, vraisemblablement âgés de 40 Ma, pourraient représenter la première détection et caractérisation de disques porteurs de gaz plus vieux que 20 Ma.

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The aim of the present study was to investigate the effects of the stimulation and inhibition of the ventral part of the medial prefrontal cortex (infralimbic cortex) on basal and stress-induced plasma levels of corticosterone and on the acquisition of aversive memory in animals maintained in control and environmental enrichment (EE) conditions. Intracortical microinjections of the GABAA antagonist picrotoxin and agonist muscimol were performed in male Wistar rats to stimulate and inhibit, respectively, the activity of the infralimbic cortex. Injections were performed 60 min before foot shock stress and training in the inhibitory avoidance task. Picrotoxin injections into the infralimbic cortex increased basal plasma levels of corticosterone. These increases were higher in EE rats which suggest that EE enhances the control exerted by infralimbic cortex over the hypothalamus-pituitary-adrenal (HPA) axis and corticosterone release. Muscimol injections into the infralimbic cortex reduced the stress-induced plasma levels of corticosterone and the retention latency 24 h after training in the inhibitory avoidance performance in control and EE animals, respectively. These results further suggest that the infralimbic cortex is required for the activation of the HPA axis during stress and for the acquisition of contextual aversive memories.

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Hypertension is the major risk factor for coronary disease worldwide. Primary hypertension is idiopathic in origin but is thought to arise from multiple risk factors including genetic, lifestyle and environmental influences. Secondary hypertension has a more definite aetiology; its major single cause is primary aldosteronism (PA), the greatest proportion of which is caused by aldosteroneproducing adenoma (APA), where aldosterone is synthesized at high levels by an adenoma of the adrenal gland. There is strong evidence to show that high aldosterone levels cause adverse effects on cardiovascular, cerebrovascular, renal and other systems. Extensive studies have been conducted to analyse the role that regulation of CYP11B2, the gene encoding the aldosterone synthase enzyme plays in determining aldosterone production and the development of hypertension. One significant regulatory factor that has only recently emerged is microRNA (miRNA). miRNAs are small non-coding RNAs, synthesized by a series of enzymatic processes, that negatively regulate gene expression at the posttranscriptional level. Detection and manipulation of miRNA is now known to be a viable method in the treatment, prevention and prognosis of certain diseases. The aim of the present study was to identify miRNAs likely to have a role in the regulation of corticosteroid biosynthesis. To achieve this, the miRNA profile of APA and normal human adrenal tissue was compared, as was the H295R adrenocortical cell line model of adrenocortical function, under both basal conditions and following stimulation of aldosterone production. Key differentially-expressed miRNAs were then identified and bioinformatic tools used to identify likely mRNA targets and pathways for these miRNAs, several of which were investigated and validated using in vitro methods. The background to this study is set out in Chapter 1 of this thesis, followed by a description of the major technical methods employed in Chapter 2. Chapter 3 presents the first of the study results, analysing differences in miRNA profile between APA and normal human adrenal tissue. Microarray was implemented to detect the expression of miRNAs in these two tissue types and several miRNAs were found to vary significantly and consistently between them. Furthermore, members of several miRNA clusters exhibited similar changes in expression pattern between the two tissues e.g. members of cluster miR-29b-1 (miR-29a-3p and miR-29b-3p) and of cluster miR-29b-2 (miR-29b-3p and miR-29c- 3p) are downregulated in APA, while members of cluster let-7a-1 (let-7a-5p and let-7d-5p), cluster let-7a-3 (let-7a-5p and let-7b-5p) and cluster miR-134 (miR- 134 and miR-382) are upregulated. Further bioinformatic analysis explored the possible biological function of these miRNAs using Ingenuity® Systems Pathway Analysis software. This led to the identification of validated mRNAs already known to be targeted by these miRNAs, as well as the prediction of other mRNAs that are likely targets and which are involved in processes relevant to APA pathology including cholesterol synthesis (HMGCR) and corticosteroidogenesis (CYP11B2). It was therefore hypothesised that increases in miR-125a-5p or miR- 335-5p would reduce HMGCR and CYP11B2 expression. Chapter 4 describes the characterisation of H295R cells of different strains and sources (H295R Strain 1, 2, 3 and HAC 15). Expression of CYP11B2 was assessed following application of 3 different stimulants: Angio II, dbcAMP and KCl. The most responsive strain to stimulation was Strain 1 at lower passage numbers. Furthermore, H295R proliferation increased following Angio II stimulation. In Chapter 5, the hypothesis that increases in miR-125a-5p or miR-335-5p reduces HMGCR and CYP11B2 expression was tested using realtime quantitative RT-PCR and transfection of miRNA mimics and inhibitors into the H295R cell line model of adrenocortical function. In this way, miR-125a-5p and miR-335-5p were shown to downregulate CYP11B2 and HMGCR expression, thereby validating certain of the bioinformatic predictions generated in Chapter 3. The study of miRNA profile in the H295R cell lines was conducted in Chapter 6, analysing how it changes under conditions that increase aldosterone secretion, including stimulation Angiotensin II, potassium chloride or dibutyryl cAMP (as a substitute for adrenocorticotropic hormone). miRNA profiling identified 7 miRNAs that are consistently downregulated by all three stimuli relative to basal cells: miR-106a-5p, miR-154-3p, miR-17-5p, miR-196b-5p, miR-19a-3p, miR-20b- 5p and miR-766-3p. These miRNAs include those derived from cluster miR-106a- 5p/miR-20b-5p and cluster miR-17-5p/miR-19a-3p, each producing a single polycistronic transcript. IPA bioinformatic analysis was again applied to identify experimentally validated and predicted mRNA targets of these miRNAs and the key biological pathways likely to be affected. This predicted several interactions between miRNAs derived from cluster miR-17-5p/miR-19a-3p and important mRNAs involved in cholesterol biosynthesis: LDLR and ABCA1. These predictions were investigated by in vitro experiment. miR-17-5p/miR-106a-p and miR-20b-5p were found to be consistently downregulated by stimulation of aldosterone biosynthesis. Moreover, miR-766-3p was upregulation throughout. Furthermore, I was able to validate the downregulation of LDLR by miR-17 transfection, as predicted by IPA. In summary, this study identified key miRNAs that are differentially-expressed in vivo in cases of APA or in vitro following stimulation of aldosterone biosynthesis. The many possible biological actions these miRNAs could have were filtered by bioinformatic analysis and selected interactions validated in vitro. While direct actions of these miRNAs on steroidogenic enzymes were identified, cholesterol handling also emerged as an important target and may represent a useful point of intervention in future therapies designed to modulate aldosterone biosynthesis and reduce its harmful effects.

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Background Echocardiography is the cornerstone in the evaluation of cardiac masses and provides accurate characterization. Despite, its accuracy in diagnosis of cardiac masses (CM) remains challenging and, up to date, no validated diagnostic algorithm is validated. Purpose The aim of our study was to evaluate the diagnostic accuracy of echocardiography, to identify the echocardiographic predictors of malignancy and to develop and then validate a multiparametric echocardiographic score that could be used to estimate the likelihood of the histological nature of a CM. Materials and methods The final sample consisted of 273 consecutive patients who had a 2D-echocardiographic evaluation and a histologic diagnosis. Logistic regression was performed to evaluate the ability of echocardiographic findings to discriminate benign versus malignant masses, then a scoring system was developed and validated in a separate test cohort. Results Of the 322 patients initially included in the Bologna Cardiac Masses Registry, 13 with a poor acoustic window, 27 with no histological examination patients and 9 extra-cardiac masses were excluded. In the remaining 273 patients, classical 2-D echocardiogram identified 249 masses with a diagnostic accuracy of 88%. A weighted score [Diagnostic Echocardiographic Mass (DEM) Score] ranging from 0 to 9 was obtained from 6 variables: infiltration, polylobate mass, moderate-severe pericardial effusion. The AUC for the score was 0.965 (95% CI [0.938-0.993]). In a logistic regression analysis using the DEM score as a predictor, the likelihood of malignant CM increased more than 4 times for a 1-unit increase in the score (OR=4.468; 95% CI 2.733-7.304). A score < 3 denoted a high probability of a benign diagnosis, and a score ≥ 5 points corresponded to a higher risk of malignancy. Conclusion 2D-Echocardiography provides a high diagnostic accuracy in identifying cardiac masses and our multiparametric echocardiographic score could be useful to predict the histological nature of cardiac masses.

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A three-dimensional Direct Finite Element procedure is here presented which takes into account most of the factors affecting the interaction problem of the dam-water-foundation system, whilst keeping the computational cost at a reasonable level by introducing some simplified hypotheses. A truncated domain is defined, and the dynamic behaviour of the system is treated as a wave-scattering problem where the presence of the dam perturbs an original free-field system. The rock foundation truncated boundaries are enclosed by a set of free-field one-dimensional and two-dimensional systems which transmit the effective forces to the main model and apply adsorbing viscous boundaries to ensure radiation damping. The water domain is treated as an added mass moving with the dam. A strategy is proposed to keep the viscous dampers at the boundaries unloaded during the initial phases of analysis, when the static loads are initialised, and thus avoid spurious displacements. A focus is given to the nonlinear behaviour of the rock foundation, with concentrated plasticity along the natural discontinuities of the rock mass, immersed in an otherwise linear elastic medium with Rayleigh damping. The entire procedure is implemented in the commercial software Abaqus®, whose base code is enriched with specific user subroutines when needed. All the extra coding is attached to the Thesis and tested against analytical results and simple examples. Possible rock wedge instabilities induced by intense ground motion, which are not easily investigated within a comprehensive model of the dam-water-foundation system, are treated separately with a simplified decoupled dynamic approach derived from the classical Newmark method, integrated with FE calculation of dam thrust on the wedges during the earthquake. Both the described approaches are applied to the case study of the Ridracoli arch-gravity dam (Italy) in order to investigate its seismic response to the Maximum Credible Earthquake (MCE) in a full reservoir condition.

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Grand Unification Theories (GUTs) predict the unification of three of the fundamental forces and are a possible extension of the Standard Model, some of them predict neutrino mass and baryon asymmetry. We consider a minimal non-supersymmetric $SO(10)$ GUT model that can reproduce the observed fermionic masses and mixing parameters of the Standard Model. We calculate the scales of spontaneous symmetry breaking from the GUT to the Standard Model gauge group using two-loop renormalisation group equations. This procedure determines the proton decay rate and the scale of $U(1)_{B-L}$ breaking, which generates cosmic strings, and the right-handed neutrino mass scales. Consequently, the regions of parameter space where thermal leptogenesis is viable are identified and correlated with the fermion masses and mixing, the neutrinoless double beta decay rate, the proton decay rate, and the gravitational wave signal resulting from the network of cosmic strings. We demonstrate that this framework, which can explain the Standard Model fermion masses and mixing and the observed baryon asymmetry, will be highly constrained by the next generation of gravitational wave detectors and neutrino oscillation experiments which will also constrain the proton lifetime

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Ultracold gases provide an ideal platform for quantum simulations of many-body systems. Here we are interested in a particular system which has been the focus of most experimental and theoretical works on ultracold fermionic gases: the unitary Fermi gas. In this work we study with Quantum Monte Carlo simulations a two-component gas of fermionic atoms at zero temperature in the unitary regime. Specifically, we are interested in studying how the effective masses for the quasi-particles of the two components of the Fermi liquid evolve as the polarization is progressively reduced from full to lower values. A recent theoretical work, based on alternative diagrammatic methods, has indeed suggested that such effective masses should diverge at a critical polarization. To independently verify such predictions, we perform Variational Monte Carlo (VMC) calculations of the energy based on Jastrow-Slater wavefunctions after adding or subtracting a particle with a given momentum to a full Fermi sphere. In this way, we determine the quasi-particle dispersions, from which we extract the effective masses for different polarizations. The resulting effective masses turn out to be quite close to the non-interacting values, even though some evidence of an increase for the effective mass of the minority component appears close to the predicted value for the critical polarization. Preliminary results obtained for the majority component with the Fixed-node Diffusion Monte Carlo (DMC) method seem to indicate that DMC could lead to an increase of the effective masses in comparison with the VMC results. Finally, we point out further improvements of the trial wave-function and boundary conditions that would be necessary in future simulations to draw definite conclusions on the effective masses of the polarized unitary Fermi gas.

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The aim was to analyse the physical growth and body composition of rhythmic gymnastics athletes relative to their level of somatic maturation. This was a cross-sectional study of 136 athletes on 23 teams from Brazil. Mass, standing height and sitting height were measured. Fat-free and fat masses, body fat percentages and ages of the predicted peak height velocity (PHV) were calculated. The z scores for mass were negative during all ages according to both WHO and Brazilian references, and that for standing height were also negative for all ages according to WHO reference but only until 12 years old according to Brazilian reference. The mean age of the predicted PHV was 12.1 years. The mean mass, standing and sitting heights, body fat percentage, fat-free mass and fat mass increased significantly until 4 to 5 years after the age of the PHV. Menarche was reached in only 26% of these athletes and mean age was 13.2 years. The mass was below the national reference standards, and the standing height was below only for the international reference, but they also had late recovery of mass and standing height during puberty. In conclusion, these athletes had a potential to gain mass and standing height several years after PHV, indicating late maturation.

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We compared the indication of laparoscopy for treatment of adnexal masses based on the risk scores and tumor diameters with the indication based on gynecology-oncologists' experience. This was a prospective study of 174 women who underwent surgery for adnexal tumors (116 laparotomies, 58 laparoscopies). The surgeries begun and completed by laparoscopy, with benign pathologic diagnosis, were considered successful. Laparoscopic surgeries that required conversion to laparotomy, led to a malignant diagnosis, or facilitated cyst rupture were considered failures. Two groups were defined for laparoscopy indication: (1) absence of American College of Obstetrics and Gynecology (ACOG) guideline for referral of high-risk adnexal masses criteria (ACOG negative) associated with 3 different tumor sizes (10, 12, and 14 cm); and (2) Index of Risk of Malignancy (IRM) with cutoffs at 100, 200, and 300, associated with the same 3 tumor sizes. Both groups were compared with the indication based on the surgeon's experience to verify whether the selection based on strict rules would improve the rate of successful laparoscopy. ACOG-negative and tumors ≤10 cm and IRM with a cutoff at 300 points and tumors ≤10cm resulted in the same best performance (78% success = 38/49 laparoscopies). However, compared with the results of the gynecology-oncologists' experience, those were not statistically significant. The selection of patients with adnexal mass to laparoscopy by the use of the ACOG guideline or IRM associated with tumor diameter had similar performance as the experience of gynecology-oncologists. Both methods are reproducible and easy to apply to all women with adnexal masses and could be used by general gynecologists to select women for laparoscopic surgery; however, referral to a gynecology-oncologist is advisable when there is any doubt.

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Chromatography combined with several different detection systems is one of the more used and better performing analytical tools. Chromatography with tandem mass spectrometric detection gives highly selective and sensitive analyses and permits obtaining structural information about the analites and about their molar masses. Due to these characteristics, this analytical technique is very efficient when used to detect substances at trace levels in complex matrices. In this paper we review instrumental and technical aspects of chromatography-tandem mass spectrometry and the state of the art of the technique as it is applied to analysis of toxic substances in food.

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X-linked adrenoleukodystrophy (X-ALD) is an inherited disease with clinical heterogeneity varying from presymptomatic individuals to rapidly progressive cerebral ALD forms. This disease is characterized by increased concentration of very long chain fatty acids (VLCFAs) in plasma and in adrenal, testicular and nervous tissues. Affected individuals can be classified in different clinical settings, according to phenotypic expression and age at onset of initial symptoms. Molecular defects in X-ALD individuals usually result from ABCD1 gene mutations. In the present report we describe clinical data and the ABCD1 gene study in two boys affected with the childhood cerebral form that presented with different symptomatic manifestations at diagnosis. In addition, their maternal grandfather had been diagnosed with Addison's disease indicating phenotypic variation for X-ALD within this family. The mutation p.Trp132Ter was identified in both male patients; additionally, three females, out of eleven family members, were found to be heterozygous after screening for this mutation. In the present report, the molecular analysis was especially important since one of the heterozygous females was in first stages of pregnancy. Therefore, depending on the fetus outcome, if male and p.Trp132Ter carrier, storage of the umbilical cord blood should be recommended as hematopoietic stem cell transplantation could be considered as an option for treatment in the future.

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Deficiency of the enzyme P450 oxidoreductase is a rare form of congenital adrenal hyperplasia with characteristics of combined and partial impairments in steroidogenic enzyme activities, as P450 oxidoreductase transfers electrons to CYP21A2, CYP17A1, and CYP19A1. It results in disorders of sex development and skeletal malformations similar to Antley-Bixley syndrome. We report the case of a 9-year-old girl who was born with virilized genitalia (Prader stage V), absence of palpable gonads, 46,XX karyotype, and hypergonadotropic hypogonadism. During the first year of life, ovarian cyst, partial adrenal insufficiency, and osteoarticular changes, such as mild craniosynostosis, carpal and tarsal synostosis, and limited forearm pronosupination were observed. Her mother presented severe virilization during pregnancy. The molecular analysis of P450 oxidoreductase gene revealed compound heterozygosis for the nonsense p.Arg223*, and the novel missense p.Met408Lys, inherited from the father and the mother, respectively. Arq Bras Endocrinol Metab. 2012;56(8):578-85

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Myxedema coma, a rare but fatal emergency, is an extreme expression of hypothyroidism. We describe a 51-year-old male patient who has discontinued hypothyroidism treatment 10 months earlier and developed lethargy, edema, and cold intolerance symptoms. He also had a previous diagnosis of neurofibromatosis. After admission, he progressed to respiratory insufficiency and coma. The prompt recognition of the condition, thyroid hormone replacement, and management of the complications (hypoventilation, cardiogenic shock associated with swinging heart, adrenal and renal insufficiency and sepsis), resulted in a favorable evolution.

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PURPOSE: To report an uncommon case of osteochondroma affecting the mandibular condyle of a young patient and to illustrate the important contributions of different imaging resources to the diagnosis and treatment planning of this lesion. CASE DESCRIPTION: A 24-year-old female patient with the chief complaint of an increasing facial asymmetry and pain in the left pre-auricular region, revealing a reduced mouth opening, mandibular deviation and posterior cross-bite over a period of 18 months. Panoramic radiography revealed an enlargement of the left condyle, whereas computed tomography (CT) sections and three-dimensional CT showed a well-defined bone growth arising from condylar neck. The scintigraphy exam showed an abnormal osteogenic activity in the left temporomandibular joint. The condyle was surgically removed and after 18 months follow-up the panoramic radiography and CT scans showed no signs of recurrence. CONCLUSION: Although osteochondroma is a benign bone tumor that rarely arises in cranial and maxillofacial region, it should be considered in the differential diagnosis of slow-growing masses of the temporomandibular area and the use of different imaging exams significantly contribute to the correct diagnosis and treatment planning of this pathological condition.