Laser-supported partial laparoscopic nephrectomy for renal cell carcinoma without ischaemia time

BACKGROUND: To date, elective nephron-sparing surgery is an established method for the exstirpation of renal tumors. While open partial nephrectomy remains the reference standard of the management of renal masses, laparoscopic partial nephrectomy (LPN) continues to evolve. Conventional techniques include clamping the renal vessels risking ischaemic damage of the clamped organ. Thus, new techniques are needed that combine a sufficient tissue incision for exstirpation of the tumor with an efficient coagulation to assure haemostasis and abandon renal vessel clamping in LPN. Laser-excision of renal tumors during laparoscopic surgery seems to be a logical solution. METHODS: We performed nephron-sparing surgery without clamping of the renal vessels in 11 patients with a renal tumor in exophytic position (mean size 32 mm, ranging 8–45 mm) by laser-supported LPN. RESULTS: Regular ultrasound monitoring and insertion of a temporary drainage showed no evidence of postoperative hemorrhage. All tumors were removed with a histopathologically confirmed surrounding margin of normal renal tissue (R0 resection). Serum creatinine, hemoglobin, and hematocrit were nearly unaltered before and after surgery. CONCLUSIONS: The experience won in these patients have confirmed that laser-assisted LPN without clamping of the renal vessels could be a safe and gentle alternative to classic partial nephrectomy in patients with exophytic position of renal tumors

Virtual Reality Exposure to a Healthy Weight Body Is a Promising Adjunct Treatment for Anorexia Nervosa

Introduction/objective: Treatment results of anorexia nervosa (AN) are modest, with fear of weight gain being a strong predictor of treatment outcome and relapse. Here, we present a virtual reality (VR) setup for exposure to healthy weight and evaluate its potential as an adjunct treatment for AN. Methods: In two studies, we investigate VR experience and clinical effects of VR exposure to higher weight in 20 women with high weight concern or shape concern and in 20 women with AN. Results: In study 1, 90% of participants (18/20) reported symptoms of high arousal but verbalized low to medium levels of fear. Study 2 demonstrated that VR exposure to healthy weight induced high arousal in patients with AN and yielded a trend that four sessions of exposure improved fear of weight gain. Explorative analyses revealed three clusters of individual reactions to exposure, which need further exploration. Conclusions: VR exposure is a well-accepted and powerful tool for evoking fear of weight gain in patients with AN. We observed a statistical trend that repeated virtual exposure to healthy weight improved fear of weight gain with large effect sizes. Further studies are needed to determine the mechanisms and differential effects

In-vitro- and in-vivo-inhibition of the AKT-pathway in melanoma by a novel small-molecule inhibitor

Konstitutiv aktivierte Signalwege sind verantwortlich für die malignen Veränderungen in Melanozyten, die zur Entstehung des Melanoms beitragen. Im Mittelpunkt dieser Veränderungen stehen der PI3Kinase-AKT-Signalweg und der MAPK-ERK-Signalweg als wichtige Schlüsselwege in der Zellzykluskontrolle. Daher zielen viele neue Therapieversuche im Kampf gegen das Melanom auf die Kontrolle und Regulation dieser Wege. In dieser vorliegenden Arbeit wurden erstmals die Effekte eines neuen PI3K-Inhibitors, BAY-80-6946, und Wortmannin alleine und in Kombinationsbehandlungen mit den MEK1/2-Inhibitoren PD98059 und U0126 in vitro und in vivo untersucht. Zunächst wurden humane Melanomzellen auf konstitutiv aktivierte Signalwege in vitro per Western Blot untersucht und ihre Wachstumsraten im Mausmodell ermittelt. Die humane Melanomzelllinie LOX zeigte eine hohe konstitutive Expression von aktiviertem AKT und ERK, während A375 nur eine geringe Aktivität dieser beiden Signalwege aufwies. Dennoch besaßen diese beiden Zelllinien ein großes Wachstumspotential im Mausmodell im Vergleich zu anderen getesteten Zelllinien. A375 und LOX wurden in Zellkulturexperimenten mit den PI3Kinase-Inhibitoren Bay-80-6946 und Wortmannin sowie den MEK1/2-Inhibitoren PD98059 und U0126 behandelt und Tumor-relevante Zellfunktionen wie Proliferation und Apoptose gemessen. Die Zelllinien zeigten ein unterschiedliches Ansprechen auf die verschiedenen Inhibitoren und keine der Behandlungen wies eine zufriedenstellendes Ergebnis hinsichtlich der Anti-tumoralen Funktion auf. Bei dualer PI3Kinase- und MEK1/2-Hemmung zeigten sich jedoch deutliche synergistische Effekte, so dass diese Behandlungsform einen vielversprechenden Ansatz im Kampf gegen das Melanom darstellt

Antihypertensive Therapy Is Associated with Reduced Rate of Conversion to Alzheimer's Disease in Midregional Proatrial Natriuretic Peptide Stratified Subjects with Mild Cognitive Impairment

Background: Hypertension is a major risk factor of Alzheimer's disease (AD); however, controlled studies on the effect of antihypertensive treatment on the risk of dementia are inconclusive. Therefore, a biological marker that predicts individual response to antihypertensive treatment would be of high clinical relevance. Midregional proatrial natriuretic peptide (MR-proANP), an inactive surrogate molecule of the mature atrial natriuretic peptide, is related to circulatory function and hypertension. Methods: A sample population of 134 subjects with mild cognitive impairment (MCI) was followed for up to 6 years. Multivariable Cox regression analysis was conducted to predict conversion to AD based on all relevant variables. Results: Baseline MR-proANP was significantly increased in the AD converter group (p 74 pmol/L. Further subgrouping by age (>/<= 72 years at baseline) increased the positive correlation of antihypertensive treatment and MCI outcome for patients below the age of 72 years (conversion rate reduced by 74%, p = .016). Conclusions: These data seem to support the notion of a potential impact of circulatory function for the prognosis of AD at a prodromal stage. The MR-proANP levels may be useful to predict the effect of antihypertensive treatment on conversion rates to AD in subjects with MCI

Results from the French National Esophageal Atresia register: one-year outcome

International audienceBACKGROUND: The aim of the present national prospective population-based study was to assess the early morbidity of esophageal atresia (EA).METHODS: All 38 multidisciplinary French centers that care for patients with EA returned a specific questionnaire about the 1-year outcome for each patient. This information was centralized, checked, and entered into a database.RESULTS: From the total population of 307 EA patients born in 2008 and 2009, data about the 1-year outcome were obtained from 301 (98%) patients, of whom 4% were lost to follow-up and 5% died. Medical complications occurred in 34% of the patients: anastomotic leaks (8%), recurrent tracheoesophageal fistula (4%), and anastomotic stenosis (22%); all of the latter group needed dilation (median, 2 dilations/patient). A new hospitalization was required for 59% of patients (2.5 hospitalizations/patient) for digestive (52%) or respiratory (48%) reasons. Twelve percent of patients required antireflux surgery at a median age of 164 days (range, 33-398 days), and 1% underwent an aortopexy for severe tracheomalacia. The weight/age Z-score was -0.8 (range, -5.5 to 3.7 months) at 12 months. Fifteen percent of patients were undernourished at 12 months of age, whereas 37% presented with respiratory symptoms and 15% had dysphagia at the last follow-up. Significant independent factors associated with medical complications were anastomotic esophageal tension (p = .0009) and presence of a gastrostomy (p = .0002); exclusive oral feeding at discharge was associated with a decreased risk of complications (p = .007).CONCLUSIONS: Digestive and respiratory morbidities remain frequent during the first year of life and are associated with difficult anastomosis and lack of full oral feeding.</p

Fewer invited talks by women in evolutionary biology symposia

Lower visibility of female scientists, compared to male scientists, is a potential reason for the under-representation of women among senior academic ranks. Visibility in the scientific community stems partly from presenting research as an invited speaker at organized meetings. We analysed the sex ratio of presenters at the European Society for Evolutionary Biology (ESEB) Congress 2011, where all abstract submissions were accepted for presentation. Women were under-represented among invited speakers at symposia (15% women) compared to all presenters (46%), regular oral presenters (41%) and plenary speakers (25%). At the ESEB congresses in 2001–2011, 9–23% of invited speakers were women. This under-representation of women is partly attributable to a larger proportion of women, than men, declining invitations: in 2011, 50% of women declined an invitation to speak compared to 26% of men. We expect invited speakers to be scientists from top ranked institutions or authors of recent papers in high-impact journals. Considering all invited speakers (including declined invitations), 23% were women. This was lower than the baseline sex ratios of early-mid career stage scientists, but was similar to senior scientists and authors that have published in high-impact journals. High-quality science by women therefore has low exposure at international meetings, which will constrain Evolutionary Biology from reaching its full potential. We wish to highlight the wider implications of turning down invitations to speak, and encourage conference organizers to implement steps to increase acceptance rates of invited talks.