Usefulness of Somatostatin Receptor Scintigraphy (Tc-[HYNIC, Tyr3]-Octreotide) and 123I-Metaiodobenzylguanidine Scintigraphy in Patients with SDHx Gene-Related Pheochromocytomas and Paragangliomas Detected by Computed Tomography.

AIMS: The aim of this study was to assess the usefulness of somatostatin receptor scintigraphy (SRS) using (99m)Tc-[HYNIC, Tyr3]-octreotide (TOC) and 123I-metaiodobenzylguanidine (mIBG) in patients with SDHx-related syndromes in which paragangliomas were detected by computed tomography and to establish an optimal imaging diagnostic algorithm in SDHx mutation carriers. METHODS: All carriers with clinical and radiological findings suggesting paragangliomas were screened by SRS and 123I-mIBG. Lesions were classified by body regions, i.e. head and neck, chest, abdomen with pelvis and adrenal gland as well as metastasis. RESULTS: We evaluated 46 SDHx gene mutation carriers (32 index cases and 14 relatives; 28 SDHD, 16 SDHB and 2 SDHC). In this group, 102 benign tumors were found in 39 studied patients, and malignant disease was diagnosed in 7 patients. In benign tumors, the sensitivity of SRS was estimated at 77% and of 123I-mIBG at 22.0%. The SRS and mIBG sensitivity was found to be clearly region dependent (p < 0.001). The highest SRS sensitivity was found in head and neck paragangliomas (HNP; 91.4%) and the lowest was found in abdominal paragangliomas and pheochromocytomas (40 and 42.9%, respectively). The highest 123I-mIBG sensitivity was found in pheochromocytomas (sensitivity of 100%) and the lowest in HNP (sensitivity of 3.7%). In metastatic disease, SRS was superior to mIBG (sensitivity of 95.2 vs. 23.8%, respectively). CONCLUSION: SRS and 123I-mIBG single photon emission computed tomography (SPECT) sensitivity in SDHx patients is highly body region dependent. In malignant tumors, SRS is superior to 123I-mIBG SPECT.

[Oxidative stress and hypertensive arteriopathy in children with primary hypertension--preliminary results]. / Stres oksydacyjny a uszkodzenie tetnic u dzieci z nadcisnieniem tetniczym pierwotnym--wyniki wstepne.

UNLABELLED: Hypertensive arteriopathy and intima-media (IMT) thickening is observed already in adolescents with primary hypertension (PH) at diagnosis. The injury of arterial wall may cause also generation of free radicals and free radicals may by itself perpetuate arterial wall injury. The aim of the study was to verify the hypothesis that children with PH are exposed to oxidative injury (Sox) due to impaired antioxidant barrier, and that markers of Sox correlate with IMT and metabolic risk factors of arteriosclerosis. STUDY DESIGN: controlled, cross-sectional. PATIENTS: 76 children with untreated PH, aged 14.7 yrs (5-20): 23 girls, 53 boys. CONTROLS: 83 healthy children aged 13.4 yrs (4-23): 44 girls, 39 boys. METHODS: Sono-graphic assessment of IMT in common carotid (cIMT) and superficial femoral arteries (cIMT). Sox was assessed as thiobarbituric acid reactive substances plasma concentration (TBARS), glutathione plasma concentration (GSH) as well as, glutathione peroxidase activity (GPX) were tested to demonstrate free radical scavenger activity. RESULTS: PH pts had greater cIMT (p<0.0001), carotid wall cross sectional area (WCSA) (p<0.0001), fIMT (p<0.0001), lower HDL-cholesterol, apoA1/apoB than control group (p<0.05). GSH and GPX did not differ between groups but TBARS was significantly greater in PH pts (p <0.05). In control group fIMT significantly correlated with hCRP (r=0.30, p<0.01), homocysteine (r=0.3, p< 0.05), apoA1 (r=-0.2417, p<0.05), TBARS (r=0.329, p<0.01), GPX (r=-0.241, p<0.05) and with GSH (r=-0.22, p=0.05). In pts group, there were similar correlations between fIMT and hCRP (r=0.29, p<0.05), apoA1/apoB (r=-0.28, p<0.05). CONCLUSIONS: PH pts are exposed to significantly higher Sox than controls. The significant correlations between markers of Sox and biochemical parameters suggest that hypertensive arteriopathy is an effect of complex interplay between Sox, metabolic and hemodynamic insults.