1. Pediatr Radiol. 2010 Feb 25. [Epub ahead of print]
MR urography in children. Part 2: how to use ImageJ MR urography processing
software.
Vivier PH, Dolores M, Taylor M, Dacher JN.
Department of Radiology, University Hospital of Rouen, 1 rue de Germont, Rouen,
76031, France.
MR urography (MRU) is an emerging technique particularly useful in paediatric
uroradiology. The most common indication is the investigation of hydronephrosis.
Combined static and dynamic contrast-enhanced MRU (DCE-MRU) provides both
morphological and functional information in a single examination. However,
specific post-processing must be performed and to our knowledge, dedicated
software is not available in conventional workstations. Investigators involved in
MRU classically use homemade software that is not freely accessible. For these
reasons, we have developed a software program that is freely downloadable on the
National Institute of Health (NIH) website. We report and describe in this study
the features of this software program.
PMID: 20182707 [PubMed - as supplied by publisher]
2. Pediatr Radiol. 2010 Feb 25. [Epub ahead of print]
MR urography in children. Part 1: how we do the F0 technique.
Vivier PH, Dolores M, Taylor M, Elbaz F, Liard A, Dacher JN.
Department of Radiology, University Hospital of Rouen, 1 rue de Germont, Rouen,
76031, France.
MR urography (MRU) has been widely accepted as a substitute to intravenous
urography for investigating children with a dilated urinary tract after
preliminary assessment by US and voiding cystourethrography. Hydronephrosis is by
far the main indication for MRU because upper tract dilatation is a frequent
condition in infants and children. Recent advances in technology have allowed MR
to go beyond morphology and to assess renal function parameters such as split
renal function and drainage. In this article we report our routine practice of
the F0 MRU technique. The main advantages of our protocol are no requirement for
general anaesthesia, no bladder catheterization, use of low-dose gadolinium-based
contrast agent (0.05-0.1 mmol/kg) and total acquisition time of 30 min or less.
PMID: 20182706 [PubMed - as supplied by publisher]
3. J Nutr. 2010 Feb 24. [Epub ahead of print]
A Diet Containing Whey Protein, Free Glutamine, and Transforming Growth
Factor-{beta} Ameliorates Nutritional Outcome and Intestinal Mucositis during
Repeated Chemotherapeutic Challenges in Rats.
Boukhettala N, Ibrahim A, Aziz M, Vuichoud J, Saudan KY, Blum S, Déchelotte P,
Breuillé D, Coëffier M.
Nutrition Unit, Rouen University Hospital, Rouen, France and ADEN-EA4311,
Institute for Biomedical Research and European Institute for Peptide Research,
Rouen University, Rouen F-76183, France.
Anticancer chemotherapy often induces side effects such as mucositis. Recent data
suggest that a diet, Clinutren Protect (CP), containing whey proteins, glutamine,
and transforming growth factor-beta (TGFbeta)-rich casein limits intestinal
mucositis and improves recovery after a single methotrexate (MTX) challenge in
rats. Chemotherapy consists of alternating periods of treatment and rest. Thus,
our study evaluated the effects of CP on nutritional outcome and intestinal
mucositis in rats receiving repeated chemotherapeutic challenges. Thirty-six
Sprague-Dawley rats received 3 cycles of MTX at 8-d intervals. Rats had free
access to CP or control diet (Co) from 7 d before the first MTX injection until
the end of the experiment at d 27. In Co, whey proteins and TGFbeta-rich casein
were replaced by TGFbeta-free casein. l-Glutamine was replaced by l-alanine. Body
composition was assessed by dual energy X-ray absorptiometry. Before MTX
challenges, food intake and body weight were similar in both groups but became
higher during MTX challenges in CP (P < 0.05). Fat mass decreased similarly in
both groups. In contrast, the decrease of fat free mass between d -1 and d 27 was
less pronounced in the CP group (-9.5 g) than in the Co group (-57.2 g) (P <
0.05). The intestinal damage score was lower in the CP group (0.6 +/- 0.3 vs. 2.1
+/- 0.6; P < 0.05). Fecal IgA increased over time in the CP group (P < 0.05) but
not in the Co group. A diet containing whey proteins, glutamine, and TGFbeta
improves nutritional outcome by limiting the reduction of fat free mass and
reduces intestinal mucositis during repeated chemotherapeutic challenges in rats.
PMID: 20181781 [PubMed - as supplied by publisher]
4. Rev Med Interne. 2010 Feb 16. [Epub ahead of print]
[Diffuse angioedema.]
[Article in French]
Leblanc C, Lahaxe L, Girszyn N, Levesque H, Marie I.
Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen
cedex, France.
PMID: 20167401 [PubMed - as supplied by publisher]
5. Encephale. 2010 Feb;36(1):33-38. Epub 2009 Apr 23.
[Psychoactive substance use during pregnancy: A review.]
[Article in French]
Lamy S, Thibaut F.
CHU de Rouen, 76031 Rouen, France; Inserm CIC 0204, Inserm U 614, UFR de
médecine, Rouen, France.
All around the world, the potential consequences of the increasing use of
psychoactive substances during pregnancy are a major public health concern. It is
estimated that 20 to 30% of pregnant women use tobacco, 15% use alcohol, 3 to 10%
use cannabis and 0.5 to 3% use cocaine. The estimation of tobacco consumption
during pregnancy is better known as compared with alcohol and substance use
prevalence during pregnancy, which remains under estimated or unknown. For
example, in France, the prevalence of cannabis and cocaine use during pregnancy
is unknown. In general, the prevalence of drug or alcohol use during pregnancy is
estimated by extrapolating data from epidemiological studies conducted in the
general population (in France or in other countries). However, drug or alcohol
use in the general population may dramatically vary from one country to another.
Even if some studies have reported the prevalence of alcohol or substance use in
different countries around the world, most of them were based on the mother's
interview. In most cases, the mother did not report exactly the amount of drugs
or alcohol used. Further studies measuring alcohol or substance use in the
mother's blood, hair or in the newborn's meconium are needed. In addition,
different methodologies have been used in the literature (different types of
interview, with or without biological measurements; different subjects included
(in- or out-pregnant women, psychiatric comorbidities or not, different economic
status, etc). Despite these methodological biases, the prevalence of drug or
alcohol use increases in pregnant women, and in most cases, several drugs are
associated. Most of the studies have used structured or semi-structured
interviews such as the addiction severity index (ASI) or the alcohol use
disorders identification test (AUDIT) to assess alcohol or drug consumption. In
addition, the identification of risk factors for substance or alcohol use during
pregnancy would allow the early detection of these high-risk pregnancies.
Environmental factors such as low economic status or marital status may play an
important role. Personality disorders may also contribute to substance or alcohol
use during pregnancy. In fact, in most studies the quality of the obstetrical
survey is lower in pregnant women using drugs or alcohol but it remains difficult
to describe a specific at-risk profile in these pregnant women. Consumption of
alcohol or of one or more psychoactive substances during pregnancy may have
serious consequences on the pregnancy and on the child's development. Fetal
alcoholism syndrome is the main etiology of mental retardation in France. We need
to improve our knowledge of alcohol and substance use during pregnancy in order
to target information for prevention campaigns and to implement specific mother
and child medical care in high-risk populations. Copyright © 2009 L’Encéphale,
Paris. Published by Elsevier Masson SAS. All rights reserved.
PMID: 20159194 [PubMed - as supplied by publisher]
6. Arch Otolaryngol Head Neck Surg. 2010 Feb;136(2):143-6.
Role of radiotherapy in the treatment of nasoethmoidal adenocarcinoma.
Choussy O, Ferron C, Védrine PO, Toussaint B, Liétin B, Marandas P, Babin E, De
Raucourt D, Reyt E, Cosmidis A, Makeieff M, Dehesdin D.
Otorhinolaryngology Department, Rouen University Hospital, France.
olivier.choussy@chu-rouen.fr
OBJECTIVE: To assess the efficacy of radiotherapy in the treatment of
nasoethmoidal adenocarcinoma. DESIGN: Multicenter, retrospective study. SETTING:
Eleven French hospitals. PATIENTS: The medical records of 418 patients who
presented with nasoethmoidal adenocarcinoma from January 1, 1976, through
December 31, 2001, were evaluated. A total of 324 patients were treated with a
combination of surgery and radiotherapy, and 55 were treated with surgery only.
MAIN OUTCOME MEASURES: Survival rates, disease recurrence, and postoperative
complications. RESULTS: The 5-year Kaplan-Meier survey revealed survival rates of
64.5% for the surgery-only group and 70.8% for the combined-treatment group. In
the surgery-only group, 28 patients (51%) had disease recurrence (24 local, 2
regional, and 2 distant). Of the 55 patients in the combined-treatment group, 31
patients (56%) had disease recurrence (29 local, 1 regional, and 1 distant).
Immediate postoperative complications in the combined-treatment group were
hemorrhages in 2 patients, meningitis in 3 patients, and cerebrospinal fluid
leakage in 4 patients, but no deaths occurred. In the surgery-only group, 1
patient had meningitis, 2 had cerebrospinal fluid leaking but no hemorrhage, and
5 died postoperatively. CONCLUSION: The results of this retrospective study
suggest that radiotherapy can be used to treat nasoethmoidal adenocarcinoma, but
its usefulness should be confirmed with further prospective studies.
PMID: 20157059 [PubMed - in process]
7. Rev Med Interne. 2010 Feb 10. [Epub ahead of print]
[Infectious aortic aneurysms. A case series of 10 patients.]
[Article in French]
Miranda S, Janvresse A, Plissonnier D, Levesque H, Marie I.
Département de médecine interne, CHU de Rouen-Boisguillaume, 76031 Rouen cedex,
France.
PURPOSE: Infectious aortic aneurysms are rare, being responsible of less than 3%
of aortic aneurysms. In this study, we report the clinical characteristics and
the outcome of patients presenting with infectious aortic aneurysms in an
internal medicine unit. METHODS: Diagnosis of infection-related aortic aneurysm
was obtained using: computed tomographic scan; and blood cultures, cultures and
molecular biology testing of aortic wall and intra-aneurismal thrombus. RESULTS:
The 10 consecutive patients included in this study consisted in eight men and two
women with a mean age of 61.7 years. Patients presented with fever (n=9),
asthenia (n=2), abdominal (n=4) or chest pain (n=1), lumbar pain (n=3). Computed
tomographic scan showed aneurysm involving both thoracic and abdominal aorta
(n=1), abdominal (n=8) or thoracic aorta (n=1). Isolated microorganisms were:
positive Gram cocci (70%) and negative Gram bacilli (30%). All patients underwent
both medical and surgical therapy. Outcome was favorable in nine patients; the
remaining patient died from aneurismal aortic rupture. CONCLUSION: Clinical
manifestations revealing infectious aortic aneurysms are variable, including
aneurysm rupture as well as atypical abdominal pain with inflammatory syndrome.
These latter presentations are more common in patients, who are hospitalized in
internal medicine. Our study underlines that this clinical pattern should not be
ignored, in order to avoid both diagnostic and therapeutic delay that could lead
to life-threatening complications and poor prognosis. Copyright © 2010 Société
nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All
rights reserved.
PMID: 20153092 [PubMed - as supplied by publisher]
8. J Nucl Cardiol. 2010 Feb 12. [Epub ahead of print]
Diagnostic and prognostic value of myocardial perfusion gated SPECT in orthotopic
heart transplant recipients.
Manrique A, Bernard M, Hitzel A, Bubenheim M, Tron C, Agostini D, Cribier A, Véra
P, Bessou JP, Redonnet M.
Department of Nuclear Medicine, Rouen University Hospital, Henri Becquerel
Center, Rouen, France, manrique@cyceron.fr.
BACKGROUND: Cardiac allograft vasculopathy (CAV) limits long-term survival after
heart transplantation. Diagnostic and prognostic value of gated single photon
emission computed tomography (gated SPECT) has not been documented in this
setting. METHODS AND RESULTS: We identified 110 consecutive heart transplant
recipients (with transplantation >18 months) who underwent stress-rest gated
SPECT and coronary angiography within 1 month, and were clinically monitored in a
single heart transplantation center. Visual scoring of perfusion and wall motion
images used a 16-segment model. Left ventricular function was automatically
calculated. Coronary angiography was normal in 64 patients (58%) and abnormal in
46 (any CAV, 42%), of whom 19 had severe stenoses. Sensitivity and negative
predictive (NPV) value were .63 and .75 for identification of any CAV, and .84
and .96 for severe CAV. Cox regression analysis showed that independent
predictors of cardiac death and retransplantation were the presence of any
angiographic CAV lesions (RR = 8.816, P = .043) and a stress perfusion defect >3
segments (RR = 5.607, P = .0053). A stress perfusion defect >3 segments predicted
the need for late coronary revascularization >2 months (RR = 6.11, P = .0002).
CONCLUSIONS: We conclude that perfusion gated SPECT is a useful noninvasive
screening test and may be proposed to help identify heart transplant recipients
with a high risk of poor clinical outcome. A normal gated SPECT was associated
with a low risk of cardiac hard event and might alleviate the need for coronary
angiography.
PMID: 20151240 [PubMed - as supplied by publisher]
9. J Card Surg. 2010 Feb 9. [Epub ahead of print]
Right Ventricular Perforation due to Migration of a Ventricular Lead.
Doguet F, Savouré A, Baste JM, Bessou JP.
Department of Thoracic and Cardiovascular Surgery, Rouen University Hospital,
Rouen, France.
(J Card Surg ****;**:**-**).
PMID: 20149012 [PubMed - as supplied by publisher]
10. Peptides. 2010 Feb 4. [Epub ahead of print]
Structural and pharmacological characteristics of chimeric peptides derived from
peptide E and beta-endorphin reveal the crucial role of the C-terminal YGGFL and
YKKGE motifs in their analgesic properties.
Condamine E, Courchay K, Rego JC, Leprince J, Mayer C, Davoust D, Costentin J,
Vaudry H.
European Institute for Peptide Research (IFRMP 23), University of Rouen, France;
CNRS UMR 6014, Laboratory of Organic Chemistry and Structural Biology, University
of Rouen, 76821 Mont-Saint-Aignan, France.
Peptide E (a 25-amino acid peptide derived from proenkephalin A) and
beta-endorphin (a 31-amino acid peptide derived from proopiomelanocortin) bind
with high affinity to opioid receptors and share structural similarities but
induce analgesic effects of very different intensity. Indeed, whereas they
possess the same N-terminus Met-enkephalin message sequence linked to a helix by
a flexible spacer and a C-terminal part in random coil conformation, in contrast
with peptide E, beta-endorphin produces a profound analgesia. To determine the
key structural elements explaining this very divergent opioid activity, we have
compared the structural and pharmacological characteristics of several chimeric
peptides derived from peptide E and beta-endorphin. Structures were obtained
under the same experimental conditions using circular dichroism, computational
estimation of helical content and/or nuclear magnetic resonance spectroscopy
(NMR) and NMR-restrained molecular modeling. The hot-plate and writhing tests
were used in mice to evaluate the antinociceptive effects of the peptides. Our
results indicate that neither the length nor the physicochemical profile of the
spacer plays a fundamental role in analgesia. On the other hand, while the
functional importance of the helix cannot be excluded, the last 5 residues in the
C-terminal part seem to be crucial for the expression or absence of the analgesic
activity of these peptides. These data raise the question of the true function of
peptides E in opioidergic systems. Copyright © 2010. Published by Elsevier Inc.
PMID: 20138196 [PubMed - as supplied by publisher]
11. J Clin Microbiol. 2010 Feb 3. [Epub ahead of print]
Evaluation of an upgraded version of the Roche COBAS(R) AmpliPrep/COBAS(R)
TaqMan(R) HIV-1 Test for HIV-1 viral load quantification.
Damond F, Avettand-Fenoel V, Collin G, Roquebert B, Plantier JC, Ganon A, Sizmann
D, Babiel R, Glaubitz J, Chaix ML, Brun-Vezinet F, Descamps D, Rouzioux C.
APHP, Laboratoire de Virologie, Hopital Bichat Claude Bernard, Paris, France;
APHP, Laboratoire de Virologie, Hopital Necker, Paris, France; EA3620, Université
Rene Descartes, Paris 5, France; EA4409, Université Denis Diderot, Paris 7,
France; Laboratoire de Virologie, Institut de Biologie Clinique, Hôpital Ch.
Nicolle, Rouen, France; Roche Molecular Diagnostics Ltd, Rotkreuz, Switzerland.
We evaluated the performance of the prototype COBAS(R) AmpliPrep/COBAS(R)
TaqMan(R) HIV-1 Test, v2.0, using prospective and archived clinical samples
initially underquantitated by the COBAS(R) AmpliPrep/COBAS(R) TaqMan(R) HIV-1
Test. The performance of the new test was significantly improved, the majority of
underquantitation observed with the first version test was eliminated.
PMID: 20129964 [PubMed - as supplied by publisher]
12. Gynecol Obstet Fertil. 2010 Feb;38(2):81-2. Epub 2010 Feb 8.
[Magnesium sulphate: An improvement in the field of preterm infant
neuroprotection.]
[Article in French]
Marret S.
Service pédiatrie néonatale et réanimation, EA 4309, Neovasc, institut
hospitalo-universitaire de recherche biomédicale et d'innovation, faculté de
médecine, CHU de Rouen, université de Rouen, 1, rue de Germont, 76031 Rouen,
France.
PMID: 20117034 [PubMed - in process]
13. Gynecol Obstet Fertil. 2010 Feb;38(2):154. Epub 2010 Jan 20.
[Capacity for debate or capacity for change?]
[Article in French]
Marpeau L.
Service de gynécologie-obstétrique, clinique Charles-Nicolle, CHU de Rouen, 1,
rue de Germont, 76031 Rouen cedex, France.
PMID: 20089435 [PubMed - in process]
14. J Neuropathol Exp Neurol. 2010 Feb;69(2):111-28.
Vascular endothelial growth factor and its high-affinity receptor (VEGFR-2) are
highly expressed in the human forebrain and cerebellum during development.
Sentilhes L, Michel C, Lecourtois M, Catteau J, Bourgeois P, Laudenbach V, Marret
S, Laquerrière A.
Neovasc, Rouen Institute for Medical Research and Innovation, Normandy, France.
Vascular endothelial growth factor (VEGF) is an angiogenic and neurotrophic
factor in both adult and neonatal animals, but its expression and role have been
incompletely studied in the developing human brain. We analyzed the distribution
of VEGF and its high-affinity receptor VEGFR-2 in the human forebrain and
cerebellum at developmental stages from 14 weeks' gestation (WG) to the13th
postnatal month. Tissue samples free of detectable neuropathologic abnormalities
were assessed by immunohistochemistry and confocal microscopy using anti-human
VEGF and VEGFR-2 antibodies. The VEGFR-2 was first expressed in the whole
cerebral mantle and in migrating cells in the intermediate zone, whereas VEGFwas
found in superficial layers of the cortical plate, in radial glia, and in the
cerebellar external germinal cell layer. From 23 WG, temporospatial VEGFR-2
expression was superimposable on that ofVEGF in the cortical plate, intermediate
zone, basal ganglia, limbicstructures, and external germinal cell layer. The
VEGF/VEGFR-2-positive astrocytes were observed during their generation and
migration from 23 WG to the first postnatal month. The VEGF-positive mature
oligodendrocytes were observed in myelinating structures in the forebrain from
birth and in the cerebellum from 24WG. These data suggest that VEGF and VEGFR-2
are likely involved in several aspects of human brain development.
PMID: 20084021 [PubMed - in process]
15. Neurochirurgie. 2010 Feb;56(1):67-72. Epub 2010 Jan 8.
[Aneurismal subarachnoid hemorrhage in the elderly subject. Should this patient
participate in a randomized clinical trial?]
[Article in French]
Proust F, Bracard S, Thines L, Leclerc X, Penchet G, Bergé J, Vignes JR, Irthum
B, Gabrillargues J, Chazal J, Bataille B, Drouinau J, Mourier K, Ricolfi F, Gay
E, Bessou P, Lonjon M, Sedat J, David P, Lajaunias P, Morandi X, Gauvrit JY,
Pelissou I, Turjman F, Roche PH, Dufour H, Levrier O, Emery E, Courthéoux P,
Laguarrigue J, Cognard C, Civit T, Lejeune JP.
Department of Neurosurgery, Rouen University Hospital, 1, avenue de Germont,
76031 Rouen cedex, France.
PMID: 20060549 [PubMed - in process]
16. Acta Obstet Gynecol Scand. 2010 Feb;89(2):223-9.
Treatment of concomitant prolapse and stress urinary incontinence via a
transobturator subvesical mesh without independent suburethral tape.
Sergent F, Sentilhes L, Resch B, Verspyck E, Medeiros R, Descamps P, Marpeau L.
Department of Obstetrics and Gynecology, Rouen University Hospital, 1, rue de
Germont-76031 Rouen Cedex, France. Fabrice.Sergent@chu-rouen.fr
OBJECTIVE: Evaluate the efficacy of a transobturator subvesical mesh for
cystocele in concomitant stress urinary incontinence (SUI). DESIGN: Longitudinal
observational study. SETTING: Tertiary referral urogynecology center. POPULATION:
One hundred and five women with at least an anterior vaginal wall prolapse and
concomitant SUI who underwent surgery. METHODS: After reduction of prolapse
elements, the intervention consisted of a non-absorbable monoprosthesis placement
with two transobturator expansions and, if necessary, associated hysterectomy or
infraccocygeal sacropexy. No specific procedure was performed for SUI. MAIN
OUTCOME MEASURES: All patients had a physical examination and a subjective
symptoms assessment via questionnaire in the preoperative period and at one-year
or more after surgery. The pelvic organ prolapse quantification system was used
for anatomical results. For SUI, Ingelman-Sundberg classification and cough test
were used. Loss of urine was measured by a one-hour pad test. Functional results
were evaluated by visual analog scale, quality-of-life questionnaires, including
the pelvic floor distress inventory and the pelvic floor impact questionnaire.
RESULTS: Median follow-up was 45 months (range: 12-72). A total of 102 women
(97%) were cured of their prolapse, of whom 72 (69%) were cured of their SUI and
13 (12%) showed improvement. Pad test, visual analogic scale and quality-of-life
questionnaires were all improved (p < 0.05). Complications consisted of one
rectal injury, one transitory urinary retention, and two hematomas. Of the
erosions 6% was observed for monofilament polypropylene prostheses. CONCLUSION:
Transvaginal monoprosthesis for the simultaneous correction of prolapse and SUI
represents an effective treatment for bulky or recurrent prolapse as well as
posthysterectomy vaginal vault prolapse.
PMID: 20059448 [PubMed - in process]
17. Schizophr Res. 2010 Feb;116(2-3):266-73.
Impaired decision making in schizophrenia and orbitofrontal cortex lesion
patients.
Larquet M, Coricelli G, Opolczynski G, Thibaut F.
Rouen University Hospital, INSERM U 614, Faculty of Medicine, 76031 Rouen,
France.
BACKGROUND: The aim of this study was to examine impaired decision making in
patients with schizophrenia and in patients with orbitofrontal cortex lesions.
METHODS: Schizophrenia patients (N=21), healthy controls (N=20) and an
independent group of orbitofrontal patients (N=10) underwent a computerized
version of the "Regret Gambling Task". Participants chose between two gambles,
each having different probabilities and different expected monetary outcomes, and
rated their emotional states after seeing the obtained outcome. Regret was
induced by providing information about the outcome of the unchosen gamble.
RESULTS: Healthy controls reported emotional responses consistent with
counterfactual reasoning between obtained and unobtained outcomes; they chose
minimizing future regret and were able to learn from their emotional experience.
In contrast, orbitofrontal patients and schizophrenia patients with prominent
positive symptoms did not report any regret and did not anticipate any negative
consequences of their choices. Our results demonstrate first the presence of very
different behavioural deficits within the spectrum of schizophrenia patients
which may have contributed to the discrepancies observed in previous studies.
Second, the results suggest that a subgroup of schizophrenia patients might have
an orbitofrontal dysfunction, in fact, schizophrenia patients with positive
symptoms have a behavioural dysfunction analogous to that of the orbitofrontal
patients. CONCLUSION: Schizophrenia patients with prominent positive symptoms
were unable to integrate cognitive and emotional components of decision making
which may contribute to their inability to generate adaptive behaviours in social
and individual environments. 2009 Elsevier B.V. All rights reserved.
PMID: 20022219 [PubMed - in process]
18. Ann Surg. 2010 Feb;251(2):275-80.
Prognostic value of circulating mutant DNA in unresectable metastatic colorectal
cancer.
Lefebure B, Charbonnier F, Di Fiore F, Tuech JJ, Le Pessot F, Michot F, Michel P,
Frebourg T.
Inserm U614, Institute for Medical Research, Rouen Northwest Canceropole, France.
benoit.lefebure@chu-rouen.fr
OBJECTIVE: No validated biologic prognostic marker is presently available in
metastatic colorectal cancer (MCRC). We prospectively evaluated the prognostic
value of circulating mutant DNA in 31 patients presenting an unresectable MCRC
treated by chemotherapy, and we used, as tumor markers, KRAS mutations and
methylation of the RASSF2A promoter. METHODS: Detection in the serum of KRAS
mutation and RASSF2A methylation were performed using sensitive methods,
respectively, real-time polymerase chain reaction (PCR) performed in the presence
of a peptide nucleic acid specific of the wild-type sequence and methyl-specific
PCR after bisulfite treatment. RESULTS: Among 29 MCRC patients for whom DNA from
the primary tumor was available, 23 (79%) presented at least one of the markers
in their primary tumor, and 12 of them presented the same alteration in serum.
For the 2 remaining patients, RASSF2A methylation was detected in serum
indicating that this alteration was present in the primary tumor. These 14
patients with a detectable tumor marker in their serum were designed sDNA+
patients. After 6 months of follow-up, 11/14 (79%) sDNA+ and 1/11 (9%) sDNA-
patients presented a progressive disease (P = 0.001). The median progression free
survival was 5 months in sDNA+ patients versus 14 months in sDNA- patients (P =
0.004). After 1 year of follow-up, 2 of 14 (14%) sDNA+ and 8 of 11 (73%) sDNA-
patients presented no signs of disease progression (P = 0.005). CONCLUSIONS: This
study suggests that the presence of circulating mutant DNA in unresectable MCRC
patients, which can be detected using simple methods such as methylation-specific
PCR or real-time PCR, is highly predictive of clinical outcome.
PMID: 20010083 [PubMed - indexed for MEDLINE]
19. Urology. 2010 Feb;75(2):249-50. Epub 2009 Nov 13.
Testicular metastasis of prostatic cancer.
Smaali C, Gobet F, Dugardin F, Pfister C.
Department of Urology, Rouen University Hospital, Rouen Cedex, France.
Secondary testicular tumors are rare, we report a case of a solitary testicular
metastasis of prostate cancer in 58-year-old man treated using hormonal therapy
associated with radiotherapy. Ultrasound is the imaging modality of choice, but
metastasis might be difficult to differentiate from primary tumors. The diagnosis
confirmed by histologic examination includes routine microscopic and
immunohistochemical findings, and therefore systemic treatment was required. 2010
Elsevier Inc. All rights reserved.
PMID: 19913885 [PubMed - in process]
20. Surg Radiol Anat. 2010 Feb;32(2):123-7. Epub 2009 Sep 24.
Late supra-diaphragmatic lymph node recurrence following resection of a
fibrolamellar hepatocarcinoma: an unusual case.
Tsilividis B, Huet E, Lubrano J, Lacaze L, Lestrat JP, François A, Riachi G,
Scotté M.
Department of Digestive Surgery, Rouen University Hospital, Rouen, France.
We report the case of a patient who presented with a supra-diaphragmatic lymph
node recurrence 8 years after resection of a right liver fibrolamellar carcinoma.
Treatment of this recurrence consisted of local excision by a right thoracotomy
approach. Postoperative course was uneventful and the patient did not experience
recurrence within 2 years. Based on this observation, we describe the major
lymphatic vessels of the liver, in order to explain this unusual metastatic site
occurrence.
PMID: 19777153 [PubMed - in process]
21. Arthritis Rheum. 2010 Jan 25. [Epub ahead of print]
Management of non-response to rituximab in rheumatoid arthritis: Predictors and
outcome of retreatment.
Vital EM, Dass S, Rawstron AC, Buch MH, Goëb V, Henshaw K, Ponchel F, Emery P.
Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine,
University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA,
UK.
OBJECTIVE:: A proportion of RA patients fail to respond to an initial cycle of
rituximab. Highly sensitive flow cytometry (HSFC) has shown that most patients
without a EULAR response have persistent circulating B cells at week 2. This
study examined whether in these patients a further cycle of rituximab would
improve depletion and clinical response. METHODS: 158 RA patients were treated
with a first cycle (C1) of 2 x 1g rituximab. Clinical response was determined
using EULAR criteria and patients were categorised as C1-responders (C1-R) and
non-responders (C1-NR). Baseline characteristics of 38 C1-NR and 65 C1-R with
complete data were compared. 25 C1-NR were treated with a second cycle of
rituximab (C2) at least 6 months after C1. HSFC was performed at baseline, after
each infusion of rituximab and then every 3 months for each cycle of rituximab. B
cell numbers below 0.0001 x 10(9)/ litre defined complete depletion. RESULTS:: At
baseline pre-plasma cell numbers were significantly higher in C1-NR compared to
C1-R (p=0.003). Following the first infusion of rituximab only 12% C1-NR had
complete depletion of B-lineage cells compared to 38% C1-R (p = 0.007). Following
C2, 38% of C1-NR had complete depletion. 26 weeks after C2 there was a
significant improvement in DAS28 at 26 weeks with 72% of patients now achieving a
EULAR response. CONCLUSION:: Patients with initial NR to rituximab have higher
circulating preplasma cell numbers at baseline and incomplete depletion. An
additional cycle of rituximab prior to full repopulation enhances depletion and
clinical responses.
PMID: 20131284 [PubMed - as supplied by publisher]
22. Clin Exp Rheumatol. 2009 Jul-Aug;27(4 Suppl 55):S74-9.
Early inflammatory clinics. Experience with early arthritis/back pain clinics.
Goëb V, Smolen J, Emery P, Marzo-Ortega H.
Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine,
University of Leeds, Leeds, UK.
There is a clear need to assess patients presenting with a new onset of
inflammatory peripheral arthritis and/or back pain early. Indeed, the clinical
presentation of rheumatoid arthritis (RA) is not always characteristic but its
early diagnosis is crucial to prevent irreversible structural damage. Likewise
low back pain is common in the general population but may be related to
ankylosing spondylitis (AS) and other axial spondyloarthritis (SpA) in up to 5%
of cases. Mounting evidence suggests that early intervention leads to improve
outcome both in RA and SpA which has important socioeconomic implications. Early
inflammatory clinics (EIC) should therefore be considered in every rheumatology
department to facilitate the early assessment and diagnosis of these patients
allowing for prompt and targeted therapeutic intervention. In addition the EICs
allow for a better focused follow-up of these patients in appropriate secondary
clinics. Since the sustained remission of inflammatory and autoimmune diseases
such as RA is highly dependent on how early treatment is instigated and its
efficacy regularly assessed, there is legitimacy for the EICs. Furthermore, there
is a clear research interest in building early inception cohorts that allow for
the characterization of the different disease phenotypes.
PMID: 19822050 [PubMed - indexed for MEDLINE]
