Inner necrosis in grapevine rootstock mother plants in the Cognac area (Charentes, France)

The incidence and quantification of decline-associated inner necrosis in grapevine rootstock mother plants have rarely been studied. In an experimental vineyard planted in 1991 at Saintes (Charentes), susceptibility to esca was evaluated in eleven common rootstock varieties. Fifty vines per rootstock variety were used as mother plants producing long canes which were severely pruned every year. No foliar symptoms, typical of grapevine wood diseases, were seen in field inspections conducted in the summer of 1996, 2002, 2003 and 2006. In 2007, nine trunks per variety were randomly selected and were cross-sectioned at the point of greatest diameter. All sections revealed typical esca necrosis, central and/or sector-shaped, indicating that such necrosis is very common. Every section was photographed and the percentage of necrotic area was calculated by either visual assessment or image-analysis. No significant difference was detected between these two calculating methods. Based on the mean percent necrotic area, rootstock varieties were ranked in order of susceptibility from the least susceptible, ‘1103 Paulsen’ (33%), to the most susceptible, ‘101-14 MGT’ (71%). The percent of necrotic area was correlated significantly with i) the incidence of mortality and ii) the percentage of vine sections showing white rot, a type of necrosis indicating an advanced stage of wood deterioration. This study confirmed that necrosis in grapevine wood is not always associated with foliar symptoms, but that it is related positively with grapevine mortality. Furthermore, wood necrosis in mother-plants poses a risk of disseminating associated fungi through propagation material

Endoscopic spray cryotherapy for esophageal cancer: safety and efficacy

Few options exist for patients with localized esophageal cancer ineligible for conventional therapies. Endoscopic spray cryotherapy with low-pressure liquid nitrogen has demonstrated efficacy in this setting in early studies

Safety and efficacy of endoscopic spray cryotherapy for Barrett's esophagus with high-grade dysplasia

Endoscopic ablation to treat Barrett’s esophagus (BE) with high-grade dysplasia (HGD) is associated with a decreased incidence of esophageal adenocarcinoma. Endoscopic spray cryotherapy (CRYO) demonstrates promising preliminary data

Durability of Radiofrequency Ablation in Barrett's Esophagus With Dysplasia

Radiofrequency ablation (RFA) can eradicate dysplasia and intestinal metaplasia in patients with dysplastic Barrett’s esophagus (BE), and reduce rates of esophageal adenocarcinoma. We assessed long-term rates of eradication, durability of neosquamous epithelium, disease progression, and safety of RFA in patients with dysplastic BE

Clinical, imaging, endoscopic findings, and management of patients with CMV colitis: a single-institute experience

WOS: 000532194200005PubMed: 31955314Purpose To evaluate clinical, laboratory, imaging, endoscopic findings, treatment, and outcomes of patients with CMV colitis. Methods the electronic medical records of 652 patients who had an impression of colitis of unspecified etiology via endoscopic findings between 2011 and 2019 were retrospectively reviewed. There were 9 patients with biopsy-proven CMV colitis and associated CT imaging performed within 1 month of diagnosis. Demographic data, past medical history, symptoms, laboratory, imaging, endoscopic and biopsy findings, colitis-related adverse events, treatment, and management were recorded. Results Within the group of 9 patients (2 men; median age, 60 years), all were in an immunosuppressed state (8/9 on immunosuppressive medication regimen and 1/9 with untreated AIDS). Presenting symptoms of CMV colitis included bloody stools (9/9), abdominal pain (7/9), and diarrhea (7/9). the most common imaging findings were pericolonic stranding (9/9) and bowel wall thickening (9/9). Endoscopic evaluation noted inflammation (9/9), ulceration (9/9), and erythema (8/9) as the most prevalent impressions. As determined by both imaging and endoscopy, the sigmoid colon was most commonly affected. Patients were treated with valganciclovir alone (3/9) or ganciclovir followed by valganciclovir (6/9). Outcomes included perforated colon (1/9), persistent colitis (3/9), discharge to hospice (1/9), and resolution (4/9). Conclusions CMV colitis is generally associated with an immunosuppressed state. Imaging and endoscopic findings can mimic inflammatory, ischemic, and infectious colitides. However, CMV colitis should be included in the differential diagnosis in immunocompromised adults who present to emergency department with bloody stools, acute abdominal pain or diarrhea, and have bowel wall thickening and pericolonic stranding on imaging

Optimization of high-grade glioma resection using 5-ALA fluorescence-guided surgery: A literature review and practical recommendations from the neuro-oncology club of the French society of neurosurgery

cited By 0International audienceBackground: When feasible, the surgical resection is the standard first step of the management of high-grade gliomas. 5-ALA fluorescence-guided-surgery (5-ALA-FGS) was developed to ease the intra-operative delineation of tumor borders in order to maximize the extent of resection. Methods: A Medline electronic database search was conducted. English language studies from January 1998 until July 2018 were included, following the PRISMA guidelines. Results: 5-ALA can be considered as a specific tool for the detection of tumor remnant but has a weaker sensibility (level 2). 5-ALA-FGS is associated with a significant increase in the rate of gross total resection reaching more than 90% in some series (level 1). Consistently, 5-ALAFGS improves progression-free survival (level 1). However, the gain in overall survival is more debated. The use of 5-ALA-FGS in eloquent areas is feasible but requires simultaneous intraoperative electrophysiologic functional brain monitoring to precisely locate and preserve eloquent areas (level 2). 5-ALA is usable during the first resection of a glioma but also at recurrence (level 2). From a practical standpoint, 5-ALA is orally administered 3 hours before the induction of anesthesia, the recommended dose being 20 mg/kg. Intra-operatively, the procedure is performed as usually with a central debulking and a peripheral dissection during which the surgeon switches from white to blue light. Provided that some precautions are observed, the technique does not expose the patient to particular complications. Conclusion: Although 5-ALA-FGS contributes to improve gliomas management, there are still some limitations. Future methods will be developed to improve the sensibility of 5-ALA-FGS. © 2019 Elsevier Masson SA

Is fluorescence-guided surgery with 5-ala in eloquent areas for malignant gliomas a reasonable and useful technique?

Introduction. – High-grade gliomas surgery in eloquent areas must achieve two pivotal aims: oncological efficacy and preservation of unimpaired neurological functions or improvement of impaired neurological functions. Here, we evaluated the safety and the usefulness of 5-ALA fluorescence-guided surgery in eloquent areas. Material and methods. – Single center, retrospective and consecutive series of adult patients operated on for a supratentorial glioblastoma between November 2012 and November 2015. Results. – Fifty-one patients with a glioblastoma located within an eloquent area were included: 24 patients operated on with 5-ALA (5-ALA group), and 27 patients operated on under white light (con- trol group). Preoperative motor and language deficits were similar in the 5-ALA group (50%, 37.5%) as in the control group (59.3%, 55.6%) (P=0.510; P=0.200). Three-month postoperative motor and lan- guage deficits rates were similar in the 5-ALA group (12.5%, 12.5%) as in the control group (29.6%, 14.8%) (P = 0.180; P = 0.990). The extent of resection did not significantly vary between groups (P = 0.280). The overall survival did not significantly vary between groups (P = 0.080) but the progression-free survival was significantly higher in the 5-ALA group than in the control group (P = 0.020). The 12-month progression- free survival was significantly higher in 5-ALA group (60%) than in control group (21%; P = 0.006). In multivariate analysis, the 5-ALA was an independent prognostic factor associated with progression-free survival (P = 0.030). Conclusion. – 5-ALA fluorescence-guided surgery for glioblastoma located in eloquent areas is effective to improve progression-free survival. To preserve functional outcomes, it requires the routine use of intraoperative functional mapping to respect functional boundaries

Clinical imaging of choroid plexus in health and in brain disorders: a mini-review

The choroid plexuses (ChPs) perform indispensable functions for the development, maintenance and functioning of the brain. Although they have gained considerable interest in the last years, their involvement in brain disorders is still largely unknown, notably because their deep location inside the brain hampers non-invasive investigations. Imaging tools have become instrumental to the diagnosis and pathophysiological study of neurological and neuropsychiatric diseases. This review summarizes the knowledge that has been gathered from the clinical imaging of ChPs in health and brain disorders not related to ChP pathologies. Results are discussed in the light of pre-clinical imaging studies. As seen in this review, to date, most clinical imaging studies of ChPs have used disease-free human subjects to demonstrate the value of different imaging biomarkers (ChP size, perfusion/permeability, glucose metabolism, inflammation), sometimes combined with the study of normal aging. Although very few studies have actually tested the value of ChP imaging biomarkers in patients with brain disorders, these pioneer studies identified ChP changes that are promising data for a better understanding and follow-up of diseases such as schizophrenia, epilepsy and Alzheimer's disease. Imaging of immune cell trafficking at the ChPs has remained limited to pre-clinical studies so far but has the potential to be translated in patients for example using MRI coupled with the injection of iron oxide nanoparticles. Future investigations should aim at confirming and extending these findings and at developing translational molecular imaging tools for bridging the gap between basic molecular and cellular neuroscience and clinical research