1. Rev Med Interne. 2010 May 24. [Epub ahead of print]
[Idiopathic inflammatory myopathies with anti-PM-Scl antibodies: Case series and
literature review.]
[Article in French]
Marie I, Lahaxe L, Tiev K, Duval-Modeste AB, Vittecoq O, Levesque H, Jouen F.
Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen
cedex, France.
PURPOSE: The objectives of this study were to evaluate: (1) the prevalence of
anti-PM-Scl antibodies within the framework of antinuclear antibodies detection;
and (2) the clinical features and outcome of patients with isolated
polymyositis/dermatomyositis. METHODS: Nine thousand and sixty-four consecutive
antinuclear testing data allowed us to evaluate anti-PM-Scl antibody prevalence.
Second, we also assessed the characteristics of patients with isolated
dermatomyositis/polymyositis and associated anti-PM-Scl antibody. RESULTS: Over
9064 consecutive antinuclear samples tested for antinuclear antibodies, 3263
(36%) were positive; anti-PM-Scl antibody were positive in nine patients: 0.1% of
all sera, 0.2% of sera positive for antinuclear antibodies, 1.2% of sera positive
for anti-ENA antibodies. Four of the nine patients with anti-PM-Scl antibody had
dermatomyositis (n=3) and polymyositis (n=1). Patients with
dermatomyositis/polymyositis and anti-PM-Scl antibody exhibited severe
complications, as follows: ventilatory insufficiency (n=2) requiring mechanical
ventilation in one case, esophageal involvement requiring enteral feeding (n=1);
also, two of these patients had cancer. CONCLUSION: Our case series suggests that
the presence of anti-PM-Scl antibody is not a favorable prognostic factor in
patients with dermatomyositis/polymyositis. This type of antibody appears to be
associated with lung and esophageal involvement; in addition, anti-PM-Scl
antibody may co-exist with malignancy in PM/DM patients. Taken together, we
suggest that patients with dermatomyositis/polymyositis and anti-PM-Scl antibody
require both initial evaluation for lung/digestive manifestations and cancer and
close surveillance. Copyright © 2010 Société nationale française de médecine
interne (SNFMI). Published by Elsevier SAS. All rights reserved.
PMID: 20510485 [PubMed - as supplied by publisher]
2. World J Biol Psychiatry. 2010 May 28. [Epub ahead of print]
Validation of the French version of SCOFF questionnaire for screening of eating
disorders among adults.
Garcia FD, Grigioni S, Chelali S, Meyrignac G, Thibaut F, Dechelotte P.
Nutrition and EA4311, Biomedical Research Institute, and Rouen University
Hospital, Rouen, France.
Abstract Objective. The aim of this study was to translate and validate a French
version of the English SCOFF questionnaire for the screening of eating disorders
(ED) in a student population. Methods. The translation and back-translation
method were employed for adaptation of the French version of SCOFF (SCOFF-F).
SCOFF-F paper questionnaire was given to female students attending yearly
evaluation in the University Preventive Medicine Department. After completing the
SCOFF-F, each student was evaluated by one ED specialist blinded to SCOFF-F
results. The validated French version of Mini International Neuropsychiatric
Interview (MINI) and DSM-IV criteria for ED were employed as diagnostic
references. Results. A total of 400 women were evaluated. ED were diagnosed in 37
(9.3%) of students: eight (2%) cases of anorexia nervosa (AN) and 29 (7.3%) of
bulimia nervosa (BN). Diagnostic threshold was fixed at two positive answers with
a sensitivity of 94.6%, a specificity of 94.8% and an area under the curve of
96.2%. Positive and negative predictive values for ED were 65 and 99%. Similar
figures were obtained separately for AN and BN. Conclusion. This study
demonstrates that the French version of SCOFF questionnaire is accurate and
reliable for the detection of women with EDs in this high-risk student
population.
PMID: 20509759 [PubMed - as supplied by publisher]
3. Rev Med Interne. 2010 May 20. [Epub ahead of print]
[Acute reactive arthritis after intravesical instillation of bacillus
Calmette-Guérin. Two case reports and literature review.]
[Article in French]
Miranda S, Vernet M, Héron F, Vittecoq O, Levesque H, Marie I.
Département de Médecine interne, CHU de Rouen-Boisguillaume, 1, rue de Germont,
76031 Rouen cedex, France.
INTRODUCTION: Intravesical bacillus Calmette-Guérin (BCG) therapy-associated
articular complications are uncommon, occurring in only 0.5 to 1% of the
patients. OBSERVATIONS: We report two patients who were given intravesical BCG
therapy for superficial bladder cancer. Both patients developed polyarthritis and
fever related to intravesical BCG instillation. The outcome of articular
manifestations was favorable after administration of nonsteroidal
anti-inflammatory therapy. CONCLUSION: Intravesical BCG therapy-associated
articular complications should not be overlooked, as they may result in high
morbidity. Nevertheless, the diagnosis of intravesical BCG therapy-related
reactive arthritis should be discussed after excluding infectious arthritis due
to Mycobacterium bovis. Therefore, joint fluid microbiological tests (cultures,
PCR) are required in the patients receiving intravesical BCG who develop
arthritis. Copyright © 2010 Société nationale française de médecine interne
(SNFMI). Published by Elsevier SAS. All rights reserved.
PMID: 20494494 [PubMed - as supplied by publisher]
4. Parkinsonism Relat Disord. 2010 May 19. [Epub ahead of print]
Whatever the disease duration, stimulation of the subthalamic nucleus improves
Parkin disease.
Lefaucheur R, Derrey S, Guyant-Maréchal L, Chastan N, Maltête D.
Department of Neurology, Rouen University Hospital and University of Rouen,
France.
PMID: 20493755 [PubMed - as supplied by publisher]
5. J Clin Endocrinol Metab. 2010 May 19. [Epub ahead of print]
Comparative Validation of the Growth Hormone-Releasing Hormone and Arginine Test
for the Diagnosis of Adult Growth Hormone Deficiency Using a Growth Hormone Assay
Conforming to Recent International Recommendations.
Chanson P, Cailleux-Bounacer A, Kuhn JM, Weryha G, Chabre O, Borson-Chazot F,
Dubois S, Vincent-Dejean C, Brue T, Fedou C, Bresson JL, Demolis P, Souberbielle
JC.
Unité Mixte de Recherche S693 (P.C.), Faculté de Médecine Paris-Sud, Université
Paris-Sud 11, and Institut National de la Santé et de la Recherche Médicale Unité
693 (P.C.), Le Kremlin Bicêtre F-94276, France; Service d'Endocrinologie et des
Maladies de la Reproduction et Centre de Référence des Maladies Endocriniennes
Rares de la Croissance (P.C.) and Unité de Recherche Clinique (P.D.), Assistance
Publique-Hôpitaux de Paris Hôpital de Bicêtre, Le Kremlin Bicêtre F-94275,
France; Department of Endocrinology and Institut National de la Santé et de la
Recherche Médicale CIC0204 (A.C.-B., J.-M.K.), Rouen University Hospital, Rouen
F-76031, France; Service d'Endocrinologie (G.W.), Centre Hospitalier
Universitaire de Nancy, Hôpital Brabois, Vandoeuvre les Nancy F-54511, France;
Service d'Endocrinologie (O.C.), Centre Hospitalier Universitaire de Grenoble,
Hôpital Michalon, La Tronche, F-38700 France; Service de Médecine Nucléaire
(F.B.-C.), Hospices Civils de Lyon, Hôpital Neurologique, Bron 7-69500, France;
Service d'Endocrinologie (S.D.), Centre Hospitalier Universitaire d'Angers,
Angers F-49033, France; Service d'Endocrinologie (C.V.-D.), Centre Hospitalier
Universitaire de Nantes, Hotel-Dieu, Nantes F-44093, France; Service
d'Endocrinologie (T.B.), Centre Hospitalier Universitaire de Marseille, Hôpital
La Timone, Marseille F-13385, France; Centre Hospitalier Universitaire de
Montpellier (C.F.), Hôpital Lapeyronie, Montpellier F-34295, France; Centre
d'Investigation Clinique (J.-L.B., J.-C.S.), Hôpital Necker-Enfants Malades,
Assistance Publique-Hôpitaux de Paris, Paris F-75015, France; and Faculté de
Médecine (J.-C.S.), Centre de Recherche Croissance et Signalisation (Institut
National de la Santé et de la Recherche Médicale Unité 845), Paris F-75015,
France.
Context: The GHRH plus arginine (GHRH+Arg) test is a promising alternative to the
insulin tolerance test (ITT) for diagnosis of adult GH deficiency (AGHD).
Objectives: The objectives of the study were to validate the GHRH+Arg test for
diagnosis of AGHD, using the ITT as comparator and a GH assay calibrated
according to recent international recommendations, and to study the repeatability
and tolerance of both tests. Design: This was a multicenter, randomized,
open-label, phase III study. Setting: The study was conducted at 10 French
university hospitals. Subjects: Sixty-nine subjects (38 and 15 with high and low
probability of GH deficiency, respectively, and 16 healthy controls) were
randomized: 35 to the GHRH+Arg-GHRH+Arg-ITT test sequence and 34 to the
ITT-ITT-GHRH+Arg test sequence. Interventions: Each subject underwent three tests
of GH secretion separated by 24 h or more. Main Outcome Measures: The primary
variable used for response assessments was serum peak GH response. Test results
were compared with the final AGHD diagnosis. Results: Peak GH responses in the
two tests were strongly correlated. A cutoff value of 7.89 mug/liter for GHRH+Arg
corresponding to 3 mug/liter for ITT was calculated. The cutoff value leading to
95% specificity with the GHRH+Arg test was measured at about 3.67 mug/liter
(sensitivity 79.0%). Intermethod agreement and repeatability were high. Both
tests were well tolerated. A preference for the GHRH+Arg test was expressed by
74% of subjects. Conclusions: The GHRH+Arg test demonstrated good accuracy and
repeatability, was at least as sensitive as the ITT, and was associated with
better subject acceptability. The GHRH+Arg test represents a good alternative to
the ITT for the diagnosis of AGHD.
PMID: 20484474 [PubMed - as supplied by publisher]
6. Endocr Relat Cancer. 2010 May 18. [Epub ahead of print]
Expression of trophic amidated peptides and their receptors in benign and
malignant pheochromocytomas: high expression of adrenomedullin RDC1 receptor and
implication in tumoral cell survival.
Thouënnon E, Pierre A, Tanguy Y, Guillemot J, Manecka DL, Guérin M, Ouafik L,
Muresan M, Klein M, Bertherat J, Lefebvre H, Plouin PF, Yon L, Anouar Y.
E Thouënnon, UNIVERSITY OF ROUEN, INSERM U982, MONT-SAINT-AIGNAN, France.
Pheochromocytomas are catecholamine-producing tumors which are generally benign,
but which can also present as or develop into malignancy. Molecular pathways of
malignant transformation remain poorly understood. Pheochromocytomas express
various trophic peptides which may influence tumoral cell behavior. Here, we
investigated the expression of trophic amidated peptides, including pituitary
adenylate cyclase-activating polypeptide (PACAP), neuropeptide Y (NPY) and
adrenomedullin (AM), and their receptors in benign and malignant
pheochromocytomas in order to assess their potential role in chromaffin cell
tumorigenesis and malignant transformation. PACAP, NPY and AM are expressed in
the majority of pheochromocytomas studied; NPY exhibiting the highest mRNA levels
relative to reference genes. Although median gene expression or peptide levels
were systematically lower in malignant compared to benign tumors, no
statistically significant difference was found. Among all the receptors of these
peptides that were analyzed, only the AM receptor RDC1 displayed a differential
expression between benign and malignant pheochromocytomas. This receptor
exhibited a 4-fold higher expression in malignant than in benign tumors. AM and
stromal derived factor-1 (SDF1), which has also been described as a ligand for
RDC1, increased the number of human pheochromocytoma cells in primary culture and
exerted anti-apoptotic activity on rat pheochromocytoma PC12 cells. In addition,
RDC1 gene silencing decreased the number of viable PC12 cells. This study shows
the expression of several trophic peptides and their receptors in benign and
malignant pheochromocytomas, and suggests that AM and its RDC1 receptor could be
involved in chromaffin cell tumorigenesis through pro-survival effects.
Therefore, AM and RDC1 may represent valuable targets for the treatment of
malignant pheochromocytomas.
PMID: 20483910 [PubMed - as supplied by publisher]
7. Ann Biol Clin (Paris). 2010 May-Jun;68(3):346-50.
[Li Fraumeni syndrome: a case with multiple primary cancers and presenting a
germline p53 mutation.]
[Article in French]
Landolsi S, Gharbi O, Zrig M, Gribaa M, Njim L, Zakhama A, Abid A, Frébourg T,
Ben Ahmed S.
Service de médecine carcinologique, CHU Farhat Hached, Sousse, Tunisie, Service
d'orthopédie, CHU Fattouma Bourguiba, Monastir, Tunisie, Laboratoire de
cytogénétique et de biologie de la reproduction, CHU Farhat Hached, Sousse,
Tunisie, Service d'anatomie et de cytologie pathologique, CHU Fattouma Bourguiba,
Monastir, Tunisie, Service de génétique, CHU Hôpitaux de Rouen, France.
Li Fraumeni Syndrome (LFS) is a rare autosomal disorder characterized by a
familial clustering of tumors. Analysis of several series of LFS families have
shown that 70% of such families are attributable to germ-line mutations in TP53.
We report the case of a patient who had a first degree family antecedent of
cancer in young ages. At the age of 31 years, the patient was operated of bladder
papillary superficial carcinoma; five years later, he was treated for a high
grade pleomorphe sarcoma of the left thigh and treated by surgery, adjuvant
chemotherapy and radiotherapy. At the age of 38 years, after abdominal pain,
radiologic examination reveled pancreatic tumor with bone and lymphatic
metastases. The patient died one month later from pulmonary embolism. Sequencing
revealed a germiline mutation of this patient that was confirmed in a member of
his family in codon 1009C>T, protein Arg337Cys, exon 10 of TP53 gene this
mutation was revealed in his nephew (died at the age of 20 from bone sarcoma).
PMID: 20478780 [PubMed - in process]
8. Prog Urol. 2010 May;20(5):382-4. Epub 2009 Aug 28.
[Renal angiomyolipoma with inferior vena cava extension]
[Article in French]
Galliot I, Albouy B, Houlle S, Secco M, Gobet F, Pfister C.
Service d'urologie, hôpital Charles-Nicolle, CHU de Rouen, 1 rue de Germont,
Rouen, France.
Angiomyolipoma is generally a benign and noninvasive tumor. We report a case of
angiomyolipoma with tumor thrombus from the renal vein into the inferior vena
cava suggesting a malignant disease. Copyright (c) 2009 Elsevier Masson SAS. All
rights reserved.
PMID: 20471584 [PubMed - in process]
9. J Clin Microbiol. 2010 May 12. [Epub ahead of print]
Geosmithia argillacea : an emerging pathogen in cystic fibrosis patients ?
Giraud S, Pihet M, Razafimandimby B, Carrère J, Degand N, Mely L, Favennec L,
Dannaoui E, Bouchara JP, Calenda A.
Groupe d'Etude des Interactions Hôte-Pathogène, UPRES-EA 3142, Université
d'Angers, Angers, France; Laboratoire de Parasitologie-Mycologie, Centre
Hospitalier Universitaire, 4 rue Larrey, Angers, France; Laboratoire de Biologie,
Hôpital Renée Sabran, Giens, France; Centre de Ressources et Compétences pour la
Mucoviscidose, Hôpital Renée Sabran, Giens, France; Laboratoire de
Parasitologie-Mycologie, Centre Hospitalier Universitaire Charles Nicolle, 1 rue
de Germont, Rouen, France; Centre National de Référence Mycologie et
Antifongiques, Institut Pasteur, Unité de Mycologie Moléculaire, CNRS URA3012,
Paris France; Unité de Parasitologie-Mycologie, Université Paris Descartes,
Faculté de Médecine, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.
We report eight cases of airway colonization by Geosmithia argillacea in patients
with cystic fibrosis. This filamentous fungus, resembling the genera Penicillium
and Paecilomyces, was identified by molecular analysis. All patients carried a
mutation on each CFTR (Cystic Fibrosis Transmembrane conductance Regulator)
allele with at least one copy of the F508del mutation. First isolation of this
fungus occurred from F508del-homozygous patients at a younger age than in
F508del-heterozygous patients. Before recovery of G. argillacea, all patients
were treated with itraconazole, two of whom had also received voriconazole, for
an Aspergillus fumigatus infection. However, antifungal susceptibility patterns
showed high minimum inhibitory concentrations (MICs) of voriconazole for all
isolates, and high MICs of amphotericin B and itraconazole for the majority of
them, but mostly low minimum effective concentrations (MECs) of caspofungin. The
appearance and persistence of G. argillacea in the airways were not associated
with exacerbation of the disease. However, the clinical implications of G.
argillacea, particularly in immunocompromised patients, remain a concern,
particularly given recent observations suggesting that this fungus may also cause
disseminated infections.
PMID: 20463155 [PubMed - as supplied by publisher]
10. Brain Res. 2010 May 8. [Epub ahead of print]
Filamin-A and Myosin VI colocalize with fibrillary Tau protein in Alzheimer's
disease and FTDP-17 brains.
Feuillette S, Deramecourt V, Laquerriere A, Duyckaerts C, Delisle MB, Maurage CA,
Blum D, Buée L, Frébourg T, Campion D, Lecourtois M.
Inserm U614, Institute for Biomedical Research, Faculty of Medicine, University
of Rouen, Rouen, France.
Tauopathies, including Alzheimer's disease (AD), fronto-temporal dementia with
parkinsonism linked to chromosome 17 (FTDP-17), Pick's disease and progressive
supranuclear palsy, are neurodegenerative disorders neuropathologically
characterized by the presence of intraneuronal fibrillary inclusions composed of
abnormally phosphorylated-Tau. Tau protein is a neuronal microtubule-associated
protein (MAP) involved in microtubules polymerization and stabilization. So far,
the molecular mechanisms underlying Tau-mediated cellular toxicity remain
elusive. To address the determinants of Tau neurotoxicity, we previously
performed a misexpression screening in a Drosophila tauopathy model to identify
genetic modifiers of the human Tau-induced neurodegeneration. We identified
several components of the actin network as modifiers of Tau V337M-induced
neurodegeneration, i.e. Filamin-A, Myosin VI, Paxillin and Transgelin-3. The aim
of this study was to assess whether these genetic interactions were associated
with a colocalization of the proteins (i) in the brains of patients with Tau
pathologies, and (ii) in the brain of transgenic mice overexpressing human mutant
Tau. We found that Filamin-A and Myosin VI indeed colocalize with fibrillary Tau
protein in AD and FTDP-17 and in Thy-Tau22 transgenic mice. Copyright © 2010.
Published by Elsevier B.V.
PMID: 20460118 [PubMed - as supplied by publisher]
11. Respiration. 2010;79(6):441-9. Epub 2010 May 12.
Bronchoscopic advances: on the way to the cells.
Thiberville L, Salaün M.
Clinique Pneumologique, Rouen University Hospital, and QuantIF-LITIS EA 4108,
Faculté de Médecine-Pharmacie, Rouen University, Rouen, France.
In the past 15 years, new endoscopic methods have been developed in order to
improve the detection of early bronchial cancers, with autofluorescence
bronchoscopy being the leading technique. However, autofluorescence bronchoscopy
is hampered by the low specificity of the fluorescence defect which ranges from
25 to 50%, and its limitation to the proximal bronchial tree from which arise
only half of the lung cancers that are currently diagnosed. To overcome these
limitations, other techniques emerge including video/autofluorescence
bronchoscopy, narrow band imaging, optical coherence tomography, and
'endomicroscopy' using confocal fluorescent laser microscopy. These emerging
techniques provide new insight into bronchology, extending the field of
exploration from the proximal bronchus down to the most distal part of the lungs,
and from macroscopy to in vivo cellular imaging. In the near future, they may
enable in vivo, minimally invasive, 'pathological grade' evaluation of abnormal
bronchial or parenchymal lung tissue. Whereas promising pioneer work has recently
been published, careful assessment is required before these methods find a place
in the evaluation strategy of early lung cancer and other lung diseases.
Copyright 2010 S. Karger AG, Basel.
PMID: 20431326 [PubMed - in process]
12. Am J Med Genet A. 2010 May;152A(5):1244-9.
Myoclonus dystonia plus syndrome due to a novel 7q21 microdeletion.
Saugier-Veber P, Doummar D, Barthez MA, Czernecki V, Drouot N, Apartis E, Bürglen
L, Frebourg T, Roze E.
Department of Genetics, University Hospital of Rouen, Rouen, France.
pascale.saugier-veber@chu-rouen.fr
Myoclonus dystonia (M-D) is a rare genetic movement disorder characterized by a
combination of myoclonic jerks and dystonia. It is usually due to mutations in
the SGCE gene. We report on a patient with a typical M-D syndrome, but also short
stature, microcephaly, and mental retardation. Molecular analysis showed no
mutations within the SGCE gene but a microdeletion encompassing the SGCE gene in
chromosome region 7q21. Array-CGH analysis showed that the deletion spanned
approximately 1.88 Mb. We suggest that M-D plus patients with mental retardation,
microcephaly, dysmorphism, or short stature, all frequently associated disorders,
should be screened for 7q21 microdeletion. By examining previously published
cases of mental retardation associated with pure 7q21 deletions, we identified
two distinct regions of respectively 455 and 496 kb that are critical for mental
retardation and growth retardation. Among the genes located within these regions,
LOC253012, also known as HEPACAM2, is a good candidate for both mental
retardation and microcephaly. Copyright 2010 Wiley-Liss, Inc.
PMID: 20425829 [PubMed - in process]
13. J Immunother. 2010 May;33(4):402-13.
HLA-A*0201-restricted CEA-derived peptide CAP1 is not a suitable target for
T-cell-based immunotherapy.
Fauquembergue E, Toutirais O, Tougeron D, Drouet A, Le Gallo M, Desille M,
Cabillic F, de La Pintière CT, Iero M, Rivoltini L, Baert-Desurmont S, Leprince
J, Vaudry H, Sesboué R, Frébourg T, Latouche JB, Catros V.
Inserm U614, Faculty of Medicine, Institute for Biomedical Research, University
Hospital, Rouen, France.
Carcinoembryonic antigen (CEA) is a potential target for antigen-specific
immunotherapy, as it is frequently overexpressed in human carcinomas. Moreover,
an epitope derived from CEA, designated CAP1 (YLSGANLNL), has been proposed as
naturally processed and presented by tumors in the human leukocyte antigen
(HLA)-A*0201 context. Our aim was to fully characterize and assess the clinical
relevance of the HLA-A*0201-restricted cytotoxic T lymphocyte (CTL) response
against CEA. Stable and potent artificial antigen presenting cells (AAPCs) were
used to evaluate T-cell response against CEA. These cells efficiently activate
CTLs against tumor-derived epitopes after transduction with the antigenic
peptides or full-length proteins. We found that AAPCs genetically modified to
express CAP1, the agonist peptide CAP1-6D, or the whole CEA protein were not able
to activate CAP1-specific CTLs from HLA-A*0201+ healthy donors or patients with
colorectal carcinoma, even after multiple stimulations. In addition, we showed
that a CAP1-specific T-cell clone, obtained after multiple stimulations of T
cells of a HLA-A*0201+ healthy donor in vitro with autologous antigen presenting
cells, recognized CEA(-) HLA-A*0201+ tumors transduced with a minigene encoding
CAP1 but failed to react against HLA-A*0201+ tumor cells expressing CEA. Finally,
AAPCs expressing the whole CEA protein did not induce any specific CTL response
against CEA+ HLA-A*0201+ tumor cells highlighting the potential difficulty of
mounting an efficacious T-cell response against this autoantigen. Altogether, our
data indicate that CAP1 is not efficiently processed and presented by CEA+ tumor
cells, and therefore, is not an appropriate target for T-cell-based
immunotherapy.
PMID: 20386466 [PubMed - in process]
14. Pediatrics. 2010 May;125(5):e1259-64. Epub 2010 Apr 12.
Bolus methylprednisolone efficacy for uncontrolled exacerbation of cystic
fibrosis in children.
Ghdifan S, Couderc L, Michelet I, Leguillon C, Masseline B, Marguet C.
CF Reference Centre, Charles Nicolle University Hospital, Rouen, France.
We present here the clinical course of 4 children with cystic fibrosis,
deltaF508/deltaF508, who were admitted with severe respiratory distress and in
whom no improvement was obtained by intensive antibiotic therapy and systemic
corticosteroids. Chest computed-tomography scans showed hyperinflation and
atelectasis. The severity of these exacerbations was explained neither by visible
mucus plugging nor by allergic bronchopulmonary aspergillosis. We hypothesized
that these clinical features were related to a severe inflammatory process in
small airways. Therefore, a high-dose short course of methylprednisolone (1
g/1.73 m(2) per day for 3 days) was given; all the patients' conditions were
dramatically improved, and the therapy was safe. To our knowledge, this is the
first reported use of bolus methylprednisolone in the treatment of uncontrolled
pulmonary exacerbation in children with cystic fibrosis.
PMID: 20385626 [PubMed - indexed for MEDLINE]
15. Rev Med Interne. 2010 May;31(5):353-60. Epub 2010 Apr 8.
[Non tuberculous anti-TNF associated opportunistic infections]
[Article in French]
Marie I, Guglielmino E.
Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen
cedex, France. isabelle.marie@chu-rouen.fr
Anti-TNFalpha agents have revolutionized the treatment of patients with
rheumatoid arthritis, spondylarthropathies and Crohn's disease. However, their
use is associated with an increased risk of infections. Pyogenic infections
(involving the lungs, skin and urinary tract) and tuberculosis are the more
commonly observed infectious complications in patients receiving anti-TNFalpha
agents. However, opportunistic infections have been increasingly reported in
anti-TNFalpha-treated patients, and include non tuberculous mycobacteria, fungi
(Pneumocystis jiroveci, Candida sp, Aspergillus, Cryptococcus, Histoplasma),
opportunistic bacterial (Nocardia), parasitic (Leishmania) and viral (e.g.
Cytomegalovirus, human herpes virus 8 [HHV 8]) infections. These infectious
complications usually occur within the first months of therapy and are important
causes of morbidity and mortality in anti-TNFalpha-treated patients. It is
recommended to rule out infections, especially latent or active tuberculosis,
before the initiation of anti-TNFalpha therapy. However, it is necessary to
follow-up closely these patients to detect the possible occurrence of
opportunistic infections. Copyright 2010 Société nationale française de médecine
interne (SNFMI). Published by Elsevier SAS. All rights reserved.
PMID: 20381217 [PubMed - in process]
16. J Clin Microbiol. 2010 May;48(5):1935-8. Epub 2010 Mar 17.
Should blood cultures be performed for patients with acute prostatitis?
Etienne M, Pestel-Caron M, Chapuzet C, Bourgeois I, Chavanet P, Caron F.
Department of Infectious Diseases, GRAM EA 2656, Rouen University Hospital,
F-76031 Rouen, France. manuel.etienne@chu-rouen.fr
The diagnostic and prognostic values of blood cultures (BC) for 347 acute
prostatitis inpatients were evaluated. BC were positive for 21% of patients and
contributed to the microbiological diagnosis for 5%. Fever duration, length of
hospitalization, use of an antibiotic combination, duration of antibiotic use,
and urine bacterial titers increased when BC were positive.
PMCID: PMC2863936 [Available on 2010/11/1]
PMID: 20237098 [PubMed - in process]
17. J Mol Endocrinol. 2010 May;44(5):295-9. Epub 2010 Mar 10.
Acute food deprivation reduces expression of diazepam-binding inhibitor, the
precursor of the anorexigenic octadecaneuropeptide ODN, in mouse glial cells.
Compère V, Lanfray D, Castel H, Morin F, Leprince J, Dureuil B, Vaudry H,
Pelletier G, Tonon MC.
Inserm U982, Laboratory of Neuronal and Neuroendocrine Communication and
Differentiation University of Rouen, European Institute for Peptide Research
(IFRMP 23), Regional Platform for Cell Imaging of Normandy, University of Rouen,
76821 Mont-Saint-Aignan, France.
In the central nervous system of mammals, the gene encoding diazepam-binding
inhibitor (DBI) is exclusively expressed in glial cells. Previous studies have
shown that central administration of a DBI processing product, the
octadecaneuropeptide ODN, causes a marked inhibition of food consumption in
rodents. Paradoxically, however, the effect of food restriction on DBI gene
expression has never been investigated. Here, we show that in mice, acute fasting
dramatically reduces DBI mRNA levels in the hypothalamus and the ependyma
bordering the third and lateral ventricles. I.p. injection of insulin, but not of
leptin, selectively stimulated DBI expression in the lateral ventricle area.
These data support the notion that glial cells, through the production of
endozepines, may relay peripheral signals to neurons involved in the central
regulation of energy homeostasis.
PMID: 20219854 [PubMed - in process]
18. J Neurochem. 2010 May;113(4):895-903. Epub 2010 Feb 27.
Drosophila models of human tauopathies indicate that Tau protein toxicity in vivo
is mediated by soluble cytosolic phosphorylated forms of the protein.
Feuillette S, Miguel L, Frébourg T, Campion D, Lecourtois M.
Inserm U614, Rouen Institute for Medical Research, Faculty of Medicine,
University of Rouen, Rouen Cedex, France.
Tau is a neuronal microtubule-associated protein involved in microtubules
assembly and stabilization. Tauopathies, including Alzheimer's disease and
fronto-temporal dementia with parkinsonism linked to chromosome 17, are a group
of neurodegenerative disorders characterized by the presence of intraneuronal
filamentous inclusions of abnormally and hyperphosphorylated Tau. Currently, the
molecular mechanisms underlying Tau-mediated cellular toxicity remain elusive. To
address the determinants of Tau neurotoxicity, we used Drosophila models of human
tauopathies to study the microtubule-binding properties of human Tau proteins in
vivo. We showed that, in contrast to endogenous Drosophila Tau, human Tau
proteins bind very poorly to microtubules in Drosophila, and are mostly recovered
as soluble cytosolic hyperphosphorylated species. This weak binding of human Tau
to microtubules is neither because of microtubules saturation nor competition
with endogenous Drosophila Tau, but clearly depends on its phosphorylation
degree. We also reported that accumulation of cytosolic hyperphosphorylated forms
of human Tau proteins correlates with human Tau-mediated neurodegeneration in
flies, supporting the key role of soluble cytosolic hyperphosphorylated Tau
proteins as toxic species in vivo.
PMID: 20193038 [PubMed - in process]
19. J Bacteriol. 2010 May;192(9):2373-84. Epub 2010 Feb 26.
Characterization of Acp, a peptidoglycan hydrolase of Clostridium perfringens
with N-acetylglucosaminidase activity that is implicated in cell separation and
stress-induced autolysis.
Camiade E, Peltier J, Bourgeois I, Couture-Tosi E, Courtin P, Antunes A,
Chapot-Chartier MP, Dupuy B, Pons JL.
Groupe de Recherche sur les Antimicrobiens et les Micro-organismes, UPRES EA
2656, IFR 23, Université de Rouen, 22 Boulevard Gambetta, F-76183 Rouen Cedex,
France.
This work reports the characterization of the first known peptidoglycan hydrolase
(Acp) produced mainly during vegetative growth of Clostridium perfringens. Acp
has a modular structure with three domains: a signal peptide domain, an
N-terminal domain with repeated sequences, and a C-terminal catalytic domain. The
purified recombinant catalytic domain of Acp displayed lytic activity on the cell
walls of several Gram-positive bacterial species. Its hydrolytic specificity was
established by analyzing the Bacillus subtilis peptidoglycan digestion products
by coupling reverse phase-high-pressure liquid chromatography (RP-HPLC) and
matrix-assisted laser desorption ionization-time of flight mass spectrometry
(MALDI-TOF MS) analysis, which displayed an N-acetylglucosaminidase activity. The
study of acp expression showed a constant expression during growth, which
suggested an important role of Acp in growth of C. perfringens. Furthermore, cell
fractionation and indirect immunofluorescence staining using anti-Acp antibodies
revealed that Acp is located at the septal peptidoglycan of vegetative cells
during exponential growth phase, indicating a role in cell separation or division
of C. perfringens. A knockout acp mutant strain was obtained by using the
insertion of mobile group II intron strategy (ClosTron). The microscopic
examination indicated a lack of vegetative cell separation in the acp mutant
strain, as well as the wild-type strain incubated with anti-Acp antibodies,
demonstrating the critical role of Acp in cell separation. The comparative
responses of wild-type and acp mutant strains to stresses induced by Triton
X-100, bile salts, and vancomycin revealed an implication of Acp in autolysis
induced by these stresses. Overall, Acp appears as a major cell wall
N-acetylglucosaminidase implicated in both vegetative growth and stress-induced
autolysis.
PMCID: PMC2863477 [Available on 2010/11/1]
PMID: 20190047 [PubMed - indexed for MEDLINE]
20. Neuroscience. 2010 May 19;167(3):716-23. Epub 2010 Feb 24.
Neuroprotective effects vary across nonsteroidal antiinflammatory drugs in a
mouse model of developing excitotoxic brain injury.
Leroux P, Hennebert C, Catteau J, Legros H, Hennebert O, Laudenbach V, Marret S.
Institute for Biomedical Research, Rouen University, Charles Nicolle University
Hospital, Rouen, France. philippe.leroux@univ-rouen.fr
Glutamate excitotoxicity is among the main cellular mechanisms leading to
perinatal insults in human newborns. We used intracerebral injection of the
glutamatergic glutamate N-methyl-D-aspartate-receptor agonist ibotenate to
produce excitotoxic lesions mimicking the acquired white matter lesions seen in
human preterm infants. We evaluated whether nonsteroidal antiinflammatory drugs
(NSAIDs) protected against glutamate excitotoxicity. Aspirin (0.01-100 microg/d),
indomethacin (0.1-10 microg/d), paracetamol (10-100 microg/d), or NS-398 (12.5
microg/d) was given daily before ibotenate (P1 to P5) or after ibotenate (P5 to
P9). Lesion size was measured on Cresyl Violet-stained brain sections collected
on P10. None of the drugs tested alone or in combination increased lesion size.
Pretreatment with low- or high-dose aspirin and post-treatment with paracetamol
or NS-398 protected against white matter lesions, whereas cortical lesions were
decreased by pretreatment with low- or high-dose aspirin or post-treatment with
NS-398. The corticosteroid betamethasone (0.18 microg/d) was neuroprotective when
given before or after ibotenate and this effect was reversed by concomitant
aspirin therapy (10 microg/d). In conclusion, perinatal NSAID administration may
have beneficial effects on brain injury if appropriately timed. Copyright 2010
IBRO. Published by Elsevier Ltd. All rights reserved.
PMID: 20188153 [PubMed - in process]
21. Pediatr Radiol. 2010 May;40(5):739-46. Epub 2010 Feb 25.
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.
Comment in:
Pediatr Radiol. 2010 May;40(5):669.
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 - in process]
22. Pediatr Radiol. 2010 May;40(5):732-8. Epub 2010 Feb 25.
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.
Comment in:
Pediatr Radiol. 2010 May;40(5):669.
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 - in process]
23. Peptides. 2010 May;31(5):962-72. Epub 2010 Feb 4.
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.
eric.condamine@ibs.fr
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 (c) 2010 Elsevier Inc. All rights
reserved.
PMID: 20138196 [PubMed - in process]
24. Biol Psychiatry. 2010 May 15;67(10):992-7. Epub 2010 Jan 27.
Impaired smooth pursuit in schizophrenia results from prediction impairment only.
Nkam I, Bocca ML, Denise P, Paoletti X, Dollfus S, Levillain D, Thibaut F.
Rouen University Hospital-Charles Nicolle and Le Rouvray Hospital, Rouen School
of Medicine, Rouen, France. tatomdjap2000@yahoo.fr
BACKGROUND: Oculomotor abnormality is one of the endophenotypes in schizophrenia.
The predictive component of smooth pursuit can be studied by comparing the gain,
i.e., the ratio of smooth eye position to target position, during predictable
(pure sinusoidal) and unpredictable (pseudorandom) target motions. The aim of
this experiment was to study predictive and nonpredictive components of smooth
pursuit in two groups of schizophrenia patients compared with control subjects.
METHODS: Fifty-one schizophrenia patients (40 nondeficit and 11 deficit) and 21
control subjects were studied. During a predictable task, subjects were asked to
track a sinusoidal target (.4 Hz). For the unpredictable task, the pseudorandom
target motion consisted of five superimposed sinusoidal waveforms (.1, .2, .4,
.6, and .8 Hz). The smooth eye position (eye position without saccades), gain,
and phase were calculated for each frequency in each participant and for both
tasks. RESULTS: The mean sinusoidal smooth eye position gain was significantly
lower in patients than in control subjects with no significant difference between
deficit and nondeficit patients. During the pseudorandom task, all groups had a
similar gain at .4 Hz. CONCLUSIONS: Our study reveals that patients have a normal
nonpredictive component of smooth pursuit, regardless of their level of negative
symptoms. In contrast, the predictive mechanisms involved in eye pursuit were
impaired in schizophrenia patients. These results indicate that poor pursuit
performance during smooth pursuit is primarily a consequence of a predictive
problem and is not related to the ability to generate an accurate pursuit
maintenance response. Copyright 2010 Society of Biological Psychiatry. Published
by Elsevier Inc. All rights reserved.
PMID: 20110087 [PubMed - in process]
25. Int J Gynaecol Obstet. 2010 May;109(2):131-5. Epub 2010 Jan 22.
Perioperative course and medium-term outcome of the transobturator and
infracoccygeal hammock for posthysterectomy vaginal vault prolapse.
Sergent F, Zanati J, Bisson V, Desilles N, Resch B, Marpeau L.
Department of Obstetrics and Gynecology, Rouen University Hospital and University
of Rouen, Rouen, France. Fabrice.Sergent@chu-rouen.fr
OBJECTIVE: To describe the perioperative course and medium-term anatomic and
functional outcomes of the transobturator-infracoccygeal hammock for
posthysterectomy vaginal vault prolapse repair. METHODS: A prospective
consecutive series of 52 women with a stage 2 vaginal vault prolapse or higher
that occurred after total hysterectomy who underwent surgery between 2003 and
2007. Principal outcome measures were anatomic cure (stage 1 or lower) and impact
on quality of life measured using the pelvic floor distress inventory (PFDI) and
pelvic floor impact self-reported questionnaire (PFIQ). Anatomical results were
analyzed using chi(2) and Fisher exact tests, and PFDI and PFIQ scores were
analyzed using the Wilcoxon test. RESULTS: With a median follow-up of 36months,
the anatomic cure rate was 96%. Significant improvements were noted in POPQ-S
scores after surgery (P<0.05). Stress urinary incontinence was cured in 73% of
patients and improved in 15% of patients. The PFDI and PFIQ scores were improved
(P<0.05). One mesh extrusion was observed. The rates of mesh contraction and new
cases of dyspareunia were 31% and 13%, respectively. CONCLUSION: The transvaginal
mesh hammock represents a useful treatment for recurrent and major vaginal vault
prolapse, and has few complications. Copyright 2009 International Federation of
Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights
reserved.
PMID: 20096834 [PubMed - in process]
26. Am J Gastroenterol. 2010 May;105(5):1181-8. Epub 2009 Dec 8.
Increased proteasome-mediated degradation of occludin in irritable bowel
syndrome.
Coëffier M, Gloro R, Boukhettala N, Aziz M, Lecleire S, Vandaele N, Antonietti M,
Savoye G, Bôle-Feysot C, Déchelotte P, Reimund JM, Ducrotté P.
Nutrition Unit, Rouen University Hospital, Rouen, France.
moise.coeffier@univ-rouen.fr
OBJECTIVES: Proteasome-mediated protein degradation may contribute to the
regulation of intestinal inflammation. At the same time, low-grade inflammation
and increased intestinal permeability seem to be involved in the pathophysiology
of irritable bowel syndrome (IBS). Thus, we aimed to evaluate proteasome
composition and activities in colonic mucosa of IBS patients and its putative
pathogenic role. METHODS: Proteasome activities and proteasome subunit expression
were measured in colonic mucosa of IBS, Crohn's disease (CD), and control
patients by fluorometric assays and western blot, respectively. Expression of
inhibitor of kappa B factor (IkappaB alpha) and occludin, a tight junction
protein, was also evaluated in colonic biopsies. The degradation of recombinant
occludin incubated with protein extracts from colonic mucosa was evaluated in the
presence or absence of proteasome inhibitor, MG132. RESULTS: Proteasome
trypsin-like activity was increased in IBS patients compared with CD and
controls, whereas chymotrypsin-like activity was upregulated in CD patients only.
Caspase-like activity was reduced both in IBS and CD patients. IkappaB alpha
expression was similar between IBS and controls. In contrast, occludin expression
was lower in IBS than in controls, but occludin mRNA level was similar. Protein
extracts from IBS patients but not from controls degraded recombinant occludin
(20% over 160 min), which was blocked by MG132. Although mast cell number was
increased in IBS patients, no correlation was found between this number and
proteasome alterations. CONCLUSIONS: Our study shows that proteasome alterations
are present in the colonic mucosa of IBS patients and may contribute to the
pathophysiology of IBS by increasing occludin degradation.
PMID: 19997094 [PubMed - in process]
27. Osteoporos Int. 2010 May;21(5):723-32. Epub 2009 Nov 17.
Treatment of osteoporosis: recognizing and managing cutaneous adverse reactions
and drug-induced hypersensitivity.
Musette P, Brandi ML, Cacoub P, Kaufman JM, Rizzoli R, Reginster JY.
Department of Dermatology and INSERM Unit 905, Charles Nicolle University
Hospital, Rouen, France.
Cutaneous adverse reactions are reported for many treatments including
antiosteoporotic agents. This position paper includes an algorithm for their
recognition. With early recognition and proper management, including immediate
and permanent withdrawal of the culprit agent, accompanied by hospitalization,
rehydration, and systemic corticosteroids, if necessary, the prognosis is good.
INTRODUCTION: Cutaneous adverse reactions are reported for many therapeutic
agents and observed in between 0% and 8% of treated patients depending on the
drug. The antiosteoporotic agents are reputed to be safe in terms of cutaneous
effects; however, there have been a number of case reports of cutaneous adverse
reactions, which merit consideration. This was the subject of a Working Group
meeting of the European Society for Clinical and Economic Aspects of Osteoporosis
and Osteoarthritis in April 2009, to focus on the impact of cutaneous adverse
reactions and drug-induced hypersensitivity in the management of postmenopausal
osteoporosis. We prepared this position paper following these discussions, and
include an algorithm for their recognition. METHODS: We reviewed cutaneous
adverse reactions observed with antiosteoporotic agents, including information
from case reports, regulatory documents, and pharmacovigilance. RESULTS: The
cutaneous adverse reactions range from benign reactions including exanthematous
or maculopapular eruption (drug rash), photosensitivity, and urticaria to the
severe and potentially life-threatening reactions, angioedema, drug rash with
eosinophilia and systemic symptoms (DRESS), Stevens Johnson syndrome (SJS), and
toxic epidermal necrolysis (TEN). Review of available evidence shows that
cutaneous adverse reactions occur with all commonly used antiosteoporotic agents.
Notably, there are reports of SJS and TEN for bisphosphonates, and of DRESS and
TEN for strontium ranelate. These severe reactions remain very rare (<1 in 10,000
cases). CONCLUSION: With early recognition and proper management, including
immediate and permanent withdrawal of the culprit agent, accompanied by
hospitalization and rehydration and systemic corticosteroids if necessary, the
prognosis is good.
PMID: 19921087 [PubMed - in process]
28. Cereb Cortex. 2010 May;20(5):1092-108. Epub 2009 Sep 16.
Dual effect of glutamate on GABAergic interneuron survival during cerebral cortex
development in mice neonates.
Desfeux A, El Ghazi F, Jégou S, Legros H, Marret S, Laudenbach V, Gonzalez BJ.
EA NeoVasc 4309, Laboratory of Microvascular Endothelium and Neonate Brain
Lesions, Rouen Institute for Biomedical Research, European Institute for Peptide
Research (IFR 23) University of Rouen, 76183 Rouen, France.
In term and preterm neonates, massive glutamate release can lead to excitotoxic
white-matter and cortical lesions. Because of its high permeability toward
calcium, the N-methyl-D-aspartic acid (NMDA) receptor is thought to play an
important role in excitotoxic lesions and NMDA antagonists therefore hold promise
for neuroprotection. We found that, in neonatal mouse cortex, a given NMDA
concentration exerted either excitotoxic or antiapoptotic effects depending on
the cortical layers. In layer VI, NMDA led to excitotoxicity, sustained calcium
mobilization, and necrosis of Gad67GFP neurons. In the immature layers II-IV,
NMDA decreased apoptosis and induced transient calcium mobilization. The NMDA
antagonist MK801 acted as a potent caspase-3 activator in immature layers II-IV
and affected gamma aminobutyric acid (GABA)ergic interneurons. The apoptotic
effect of MK801-induced BAX expression, mitochondrial potential collapse and
caspase-9 activation. In vivo Bax small interfering ribonucleic acid and a
caspase-9 inhibitor abrogated MK801-induced apoptosis and pyknotic nucleus
formation. Ketamine, an anesthetic with NMDA antagonist properties, mimicked the
apoptotic effects of MK801. These data indicate a dual effect of glutamate on
survival of immature and mature GABAergic neurons and suggest that ketamine may
induce apoptosis of immature GABAergic neurons.
PMID: 19759125 [PubMed - in process]
29. Acta Neurochir (Wien). 2010 May;152(5):793-802. Epub 2009 Jul 29.
Usefulness of multislice computerized tomographic angiography in the
postoperative evaluation of patients with clipped aneurysms.
Gerardin E, Tollard E, Derrey S, Langlois O, Dacher JN, Douvrin F, Freger P,
Proust F.
Department of Neuroradiology, Rouen University Hospital, 1 rue de Germont,
Rouen-cedex, France. emmanuel.gerardin@chu-rouen.fr
BACKGROUND: The aim of our study was to evaluate the diagnostic efficacy of
multislice computed tomographic angiography (MSCTA) regarding exclusion quality
after aneurysm clipping. METHODS: Sixty patients (74 aneurysms) underwent
microsurgical exclusion using titanium clips. The presence of aneurysm remnants
on MSCTA was compared by a neuroradiologist to 2D digital subtraction angiography
(DSA), which was considered as a reference examination. The contribution of 3D
DSA was assessed in a subpopulation of 29 patients (35 aneurysms). RESULTS: With
2D DSA, six aneurysm remnants (8%) were diagnosed, and only five (7%) by MSCTA.
The specificity and sensitivity were 98.5 and 83%, respectively. MSCTA failed to
demonstrate one large remnant (>2 mm) because of clip artifacts (six clips). With
3D DSA six supplementary remnants were diagnosed. Two were large remnants blinded
by vessel overlaps and clip artifacts. Four were small "dog-eared" remnants (< or
=2 mm). No additional treatment was required for small remnants. CONCLUSION: In
the postoperative period, MSCTA was considered a useful tool to evaluate the
large remnants as well as a non-invasive ulterior examination for suspected
bifurcation. Nevertheless, 3D DSA is still required for an accurate evaluation of
aneurysms treated by more than three clips.
PMID: 19639249 [PubMed - in process]
