Background
Testicular adrenal rest tumors (TARTs) leading to primary gonadal failure are the main etiology of infertility in congenital adrenal hyperplasia (CAH). We aimed at identifying the evolution of TART and related findings in young CAH patients.
Methods
Twelve male patients (3–23 years old) with 21-hydroxilase deficiency (11 with classic salt-wasting form) were included. Testicular ultrasonography (US) was performed in two moments, by a single blinded specialist in pediatric diagnostic imaging. Tumor progression was classified according to the Response Evaluation Criteria in Solid Tumors (RECIST). The clinical and laboratory data were retrieved from medical records. Serum 17-OH-progesterone (17OHP) and androstenedione concentrations were evaluated during the whole period of follow-up, from the CAH diagnosis. A logistic regression model with repeated measures was developed for the analysis.
Results
The prevalence of TART was 41.6% (n = 5) in the initial US evaluation and 66.6% (n = 8) after 6 years of follow-up. Tumor progression was detected in 4 of the 5 patients, and 1 presented with a stable tumor. Three patients presented with new tumors in the second evaluation. Most of the patients (n = 11) were pubertal, including a 7-year-old child with TART who presented with central precocious puberty. At regression analysis, it was observed that an inadequate hormonal control led to a 16 times greater chance of a patient to present with TART (OR = 16.08; confidence interval [CI] 95% = 2.38–108.81; p = 0.004).
Conclusions
We found a high prevalence of progressive TART in young pubertal subjects. US testicular screening should help in improving therapeutic optimization in CAH patients to reduce future impairment in fertility.
Proteases are enzymes which catalyze the hydrolysis of peptides bonds. These enzymes are applied in various industries such as food, pharmaceutical, cosmetics, leather and detergent. They are produced by animals, plants and microorganisms. Among its producers are the endophytic fungi, which are microorganisms that live inside plants symbiotically. Thus, the aim of this study was to isolate endophytic fungi of the Cerrado biome plants and evaluate the production of extracellular proteases for an industrial application. It was isolated 58 endophytic fungi from 13 different species of endemic plants. First, a screening was performed to evaluate fungi protease producing. 36 fungi has shown halo production using milk agar culture.Enzyme assay was performed using azocasein 0.5% as substrate to evaluate quantitatively the production of proteases. The best producers were endophytes encoded as BR, OH03, PT02, PEQ03 and KC01. Since then BR fungus stood out among them. BR showed 41 IU / mL of proteolytic activity, optimum pH 7.0 and optimum temperature of 60 °C and was chosen. To optimize protease production the medium were tested with different carbon and nitrogen sources. The best production of proteases occurred in a medium containing peptone, yeast extract and glucose. The best day of the enzyme production, based on growth curve curve, was the 9th day. The protease was partially purified using ion exchange chromatography. The partially purified fraction was characterized and showed highest activity at pH 7.0, 60 °C and maintained 100% stability at 60 °C for 1 hour. The enzyme was tested as stain remover detergent industry to improve the spot removal. When added to a commercial detergent, the enzyme demonstrated to be compatible with commercial brands of detergent clothes.
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