Silicone migration to the contralateral axillary lymph nodes and breast after highly cohesive silicone gel implant failure: a case report

Highly cohesive silicone gel implants are advertised for aesthetic and safety advantages. Our case is the fourth report describing early implant rupture and contralateral migration of siliconoma. Despite the greater degree of gel cohesiveness, a continued vigilance for signs and symptoms of migration is highly recommended

Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review

Clinicians can use biomarkers to guide therapeutic decisions in estrogen receptor positive (ER+) breast cancer. One such biomarker is cellular proliferation as evaluated by Ki-67. This biomarker has been extensively studied and is easily assayed by histopathologists but it is not currently accepted as a standard. This review focuses on its prognostic and predictive value, and on methodological considerations for its measurement and the cut-points used for treatment decision. Data describing study design, patients’ characteristics, methods used and results were extracted from papers published between January 1990 and July 2010. In addition, the studies were assessed using the REMARK tool. Ki-67 is an independent prognostic factor for disease-free survival (HR 1.05–1.72) in multivariate analyses studies using samples from randomized clinical trials with secondary central analysis of the biomarker. The level of evidence (LOE) was judged to be I-B with the recently revised definition of Simon. However, standardization of the techniques and scoring methods are needed for the integration of this biomarker in everyday practice. Ki-67 was not found to be predictive for long-term follow-up after chemotherapy. Nevertheless, high KI-67 was found to be associated with immediate pathological complete response in the neoadjuvant setting, with an LOE of II-B. The REMARK score improved over time (with a range of 6–13/20 vs. 10–18/20, before and after 2005, respectively). KI-67 could be considered as a prognostic biomarker for therapeutic decision. It is assessed with a simple assay that could be standardized. However, international guidelines are needed for routine clinical use

Mutations in Arabidopsis YCF20-like genes affect thermal dissipation of excess absorbed light energy

Plants dissipate excess absorbed light energy as heat to protect themselves from photo-oxidative stress. The Arabidopsis thaliananpq6 mutant affected in thermal dissipation was identified by its partial defect in the induction of nonphotochemical quenching of chlorophyll fluorescence (NPQ) by excess light. Positional cloning revealed that npq6 contains a frameshift mutation caused by a single base-pair deletion in the At5g43050 gene, which encodes a member of the hypothetical chloroplast open reading frame 20 (YCF20) family of proteins with unknown function(s). The YCF20 protein family is mostly conserved in oxygenic photosynthetic organisms including cyanobacteria, eukaryotic algae, and plants. Amino acid sequence comparison identified two other genes in Arabidopsis that encode similar proteins to NPQ6: At1g65420 and At3g56830. These three Arabidopsis proteins have functional chloroplast-targeting transit peptides. Using reverse genetics, a mutant with a T-DNA insertion within the At1g65420 gene was identified and shown to exhibit a low NPQ phenotype similar to that of npq6; therefore, At1g65420 was named NPQ7. In contrast, a knockdown mutant in the At3g56830 gene with lower transcript levels showed wild-type levels of NPQ. The npq6 npq7 double mutant had an additive NPQ defect, indicating that the YCF20 family members in Arabidopsis have overlapping functions affecting thermal dissipation

Arabidopsis thaliana PGR7 Encodes a Conserved Chloroplast Protein That Is Necessary for Efficient Photosynthetic Electron Transport

A significant fraction of a plant's nuclear genome encodes chloroplast-targeted proteins, many of which are devoted to the assembly and function of the photosynthetic apparatus. Using digital video imaging of chlorophyll fluorescence, we isolated proton gradient regulation 7 (pgr7) as an Arabidopsis thaliana mutant with low nonphotochemical quenching of chlorophyll fluorescence (NPQ). In pgr7, the xanthophyll cycle and the PSBS gene product, previously identified NPQ factors, were still functional, but the efficiency of photosynthetic electron transport was lower than in the wild type. The pgr7 mutant was also smaller in size and had lower chlorophyll content than the wild type in optimal growth conditions. Positional cloning located the pgr7 mutation in the At3g21200 (PGR7) gene, which was predicted to encode a chloroplast protein of unknown function. Chloroplast targeting of PGR7 was confirmed by transient expression of a GFP fusion protein and by stable expression and subcellular localization of an epitope-tagged version of PGR7. Bioinformatic analyses revealed that the PGR7 protein has two domains that are conserved in plants, algae, and bacteria, and the N-terminal domain is predicted to bind a cofactor such as FMN. Thus, we identified PGR7 as a novel, conserved nuclear gene that is necessary for efficient photosynthetic electron transport in chloroplasts of Arabidopsis

Trade-offs between multifunctionality and profit in tropical smallholder landscapes

Land-use transitions can enhance the livelihoods of smallholder farmers but potential economic-ecological trade-offs remain poorly understood. Here, we present an interdisciplinary study of the environmental, social and economic consequences of land-use transitions in a tropical smallholder landscape on Sumatra, Indonesia. We find widespread biodiversity-profit trade-offs resulting from land-use transitions from forest and agroforestry systems to rubber and oil palm monocultures, for 26,894 aboveground and belowground species and whole-ecosystem multidiversity. Despite variation between ecosystem functions, profit gains come at the expense of ecosystem multifunctionality, indicating far-reaching ecosystem deterioration. We identify landscape compositions that can mitigate trade-offs under optimal land-use allocation but also show that intensive monocultures always lead to higher profits. These findings suggest that, to reduce losses in biodiversity and ecosystem functioning, changes in economic incentive structures through well-designed policies are urgently needed

Traitement conservateur du cancer du sein (Validation d'un atlas de techniques chirurgicales oncoplastiques par une série de 175 cas)

Les techniques de chirurgie oncoplastique sont une alternative aux tumorectomies standards dans le traitement conservateur du cancer du sein. Elles permettent l'exérèse large de tumeurs volumineuses et un remodelage immédiat. Une classification et un Atlas de ces techniques quadrant par quadrant ont récemment été proposés par l'équipe de l'institut du Sein (Paris). Le but de notre étude est de valider cet Atlas à l'aide d'une série de 175 cas en termes de qualité d'exérèse, de poids de résection, de complications, de suivi carcinologique et de résultats esthétiques. Au total, 175 cas de traitements conservateurs par technique oncoplastique de niveau Il ont été inclus rétrospectivement dans notre étude. Nous avons analysé les poids de résection, les taux de berges envahies, de mastectomie, de complications et de récidive en fonction des techniques utilisées, des types histologiques ou du recours à un traitement néoadjuvant. L'analyse statistique a été réalisée par des tests de X2 ou des tests exacts de Fisher lors de la comparaison de variables qualitatives. La comparaison de variables continues entre différents groupes a utilisé la loi de Student ou le test non paramétrique de Kruskall WaIlis. Dans notre série le poids moyen de résection était de 154 g pour une taille tumorale moyenne de 25 mm. Le volume de résection était plus important pour les techniques à cicatrice en T-inversé (p<10-3). Le taux de berges envahies était de 13% et le taux de mastectomies de 9%. Ces taux étaient statistiquement liés au type histologique avec 92% de berges saines pour les CCI contre 69% pour les CIC (p=0,002). L'utilisation d'une technique dédiée pour chaque quadrant a permis d'obtenir un faible taux de complications sans retard au traitement adjuvant. Aucune récidive précoce n'a été observée, et aucune patiente n'a du être réopérée pour correction esthétïque secondaire. Les techniques chirurgicales oncoplastiques de niveau Il appliquées selon les recommandations de l'Atlas permettent l'exérèse large de tumeurs volumineuses avec un taux de complications faible et une sécurité carcinologique comparable aux traitements standards. L'acquisiton de l'ensemble de ces techniques nécessite un apprentissage spécifique alors que leurs indications ne dépassent pas 10 % des cas de traitements conservateurs. Ainsi ces techniques resteront probablement préférentiellement réalisées, dans des centres référents en chirurgie du sein, disposant d'un fort volumeROUEN-BU Médecine-Pharmacie (765402102) / SudocSudocFranceF