Cystic lymphangioma of the mesentery

peer reviewedCystic lymphangioma of the mesentery is a benign condition, probably of malformative origin, and frequently appearing in infancy. Its symptomatology can be very polymorphic. Its diagnosis is suspected by ultrasonography and computed tomography, and definitely confirmed by pathology. About a recent case of cystic lymphangioma of the mesentery diagnosed and operated on at the university hospital of Liege in an adult patient, the authors review its classification and its therapeutic strategy. Surgical resection is indicated in symptomatic cystic lymphangioma

Comparison of the sensitivity of culture, PCR and quantitative real-time PCR for the detection of Pseudomonas aeruginosa in sputum of cystic fibrosis patients

Background: Pseudomonas aeruginosa is the major pathogen involved in the decline of lung function in cystic fibrosis (CF) patients. Early aggressive antibiotic therapy has been shown to be effective in preventing chronic colonization. Therefore, early detection is important and sensitive detection methods are warranted. In this study, we used a dilution series of P. aeruginosa positive sputa, diluted in a pool of P. aeruginosa negative sputa, all from CF patients-to mimick as closely as possible the sputa sent to routine laboratories-to compare the sensitivity of three culture techniques versus that of two conventional PCR formats and four real-time PCR formats, each targeting the P. aeruginosa oprL gene. In addition, we compared five DNA-extraction protocols. Results: In our hands, all three culture methods and the bioMerieux easyMAG Nuclisens protocol Generic 2.0.1, preceded by proteinase K pretreatment and followed by any of the 3 real-time PCR formats with probes were most sensitive and able to detect P. aeruginosa up to 50 cfu/ml, i.e. the theoretical minimum of one cell per PCR mixture, when taking into account the volumes used in this study of sample for DNA-extraction, of DNA-elution and of DNA-extract in the PCR mixture. Conclusion: In this study, no difference in sensitivity could be found for the detection of P. aeruginosa from sputum between microbiological culture and optimized DNA-extraction and real-time PCR. The results also indicate the importance of the optimization of the DNA-extraction protocol and the PCR format

LA RADIOTHÉRAPIE DANS LE CANCER DU RECTUM : quand, comment et pourquoi ?

peer reviewedDepuis plusieurs décades, la radiothérapie préopéra - toire ou postopératoire joue un rôle important dans le contrôle local de l’adénocarcinome du rectum. Cette dernière décennie, avec la systématisation de la chirurgie d’exérèse en totalité du mésorectum (TME), le profil de récidive locale du cancer du rectum a été fortement modifié. Dans un tel contexte, la place de la radiothérapie doit être réévaluée en tenant compte de ces modifications. Dans cet article, nous proposons de faire la revue des différentes grandes études concernant les techniques et les indications d’un traitement de radiothérapie pré- ou post opératoire dans le contexte d’une chirurgie rectale TME

Deeper insights into long-term survival heterogeneity of Pancreatic Ductal Adenocarcinoma (PDAC) patients using integrative individual-and group-level transcriptome network analyses

peer reviewe

In situ study of the thermal stability of supported Pt nanoparticles and their stabilization via atomic layer deposition overcoating

Downscaling of supported Pt structures to the nanoscale is motivated by the augmentation of the catalytic activity and selectivity, which depend on the particle size, shape and coverage. Harsh thermal and chemical conditions generally required for catalytic applications entail an undesirable particle coarsening, and consequently limit the catalyst lifetime. Herein we report an in situ synchrotron study on the stability of supported Pt nanoparticles and their stabilization using atomic layer deposition (ALD) as the stabilizing methodology against particle coarsening. Pt nanoparticles were thermally annealed up to 850 degrees C in an oxidizing environment while recording in situ synchrotron grazing incidence small angle X-ray scattering (GISAXS) 2D patterns, thereby obtaining continuous information about the particle radius evolution. Al2O3 overcoat as a protective capping layer against coarsening via ALD was investigated. In situ data proved that only 1 cycle of Al2O3 ALD caused an augmentation of the onset temperature for particle coarsening. Moreover, the results showed a dependence of the required overcoat thickness on the initial particle size and distribution, being more efficient (i.e. requiring lower thicknesses) when isolated particles are present on the sample surface. The Pt surface accessibility, which is decisive in catalytic applications, was analyzed using the low energy ion scattering (LEIS) technique, revealing a larger Pt surface accessibility for a sample with Al2O3 overcoat than for a sample without a protective layer after a long-term isothermal annealing

The subaqueous landslide cycle in south-central Chilean lakes: the role of tephra, slope gradient and repeated seismic shaking

Subaqueous landslides are common features at active and passive ocean margins, in fjords and lakes. They can develop on very gentle slope gradients (<2) and the presence of sandy tephra layers seems to facilitate the development of translational failure. Despite numerous investigations, it remains elusive how different slope preconditioning factors act and interact over time and how different triggering mechanisms can lead to slope failure. In settings of low to moderate seismicity, stratigraphic sequences with sublacustrine mass-transport deposits (MTDs) have successfully been used for constructing prehistorical earthquake catalogs. In high seismicity areas, it is inferred that not all strong earthquakes succeed in triggering landslides on the investigated slope segments, and MTD records do not fully represent their complete recurrence pattern. Here, we present the spatio-temporal distribution of MTDs in two large glacigenic Chilean lakes (Villarrica and Calafquén) based on a detailed seismic-stratigraphic analysis and several radiocarbon-dated piston cores (up to 14m long). We find a strong influence of slope gradient on the occurrence and volume of landslide events; i.e. most (small) landslides take place on slopes of 5-20, whereas the few large (potentially tsunamigenic) landslides exclusively occur on slopes of <4. Liquefaction of sandy tephra layers facilitates the development of thin (<0.5m) in-situ deformations during earthquake shaking. When sandy tephra layers get progressively buried, liquefaction becomes unlikely, but repeated excess pore pressure transfer to overlying units facilitates the development of translational sliding. The occurrence of voluminous landslides seems to follow a “landslide cycle” which starts with the deposition of a tephra layer and the development of in-situ deformations directly on top. Once the slope sequence reaches a critical thickness, the end of the cycle is indicated by incipient scarp development, and subsequent major sliding event(s). The duration of the landslide cycle is defined by the rate of gradual sedimentation, but may be affected by sudden geological events (e.g., volcanic eruptions), expediting the end of the cycle. Despite the many methodological challenges inherent to the construction of a MTD stratigraphy, we propose that well-dated multiple MTD events can be used as positive evidence to strengthen and specify the regional paleoseismic record, concerning the largest events in a high-seismicity region. This method is most successful when targeting the base of relatively steep slopes (5-20) with frequent, minor landsliding, and complementing this with seismic-stratigraphic analysis of fluid-escape features and correlation with distal turbidite records.(VLID)3242017Submitted versio

The Rotterdam Study: 2012 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods

Pseudomonas aeruginosa Population Structure Revisited

At present there are strong indications that Pseudomonas aeruginosa exhibits an epidemic population structure; clinical isolates are indistinguishable from environmental isolates, and they do not exhibit a specific (disease) habitat selection. However, some important issues, such as the worldwide emergence of highly transmissible P. aeruginosa clones among cystic fibrosis (CF) patients and the spread and persistence of multidrug resistant (MDR) strains in hospital wards with high antibiotic pressure, remain contentious. To further investigate the population structure of P. aeruginosa, eight parameters were analyzed and combined for 328 unrelated isolates, collected over the last 125 years from 69 localities in 30 countries on five continents, from diverse clinical (human and animal) and environmental habitats. The analysed parameters were: i) O serotype, ii) Fluorescent Amplified-Fragment Length Polymorphism (FALFP) pattern, nucleotide sequences of outer membrane protein genes, iii) oprI, iv) oprL, v) oprD, vi) pyoverdine receptor gene profile (fpvA type and fpvB prevalence), and prevalence of vii) exoenzyme genes exoS and exoU and viii) group I pilin glycosyltransferase gene tfpO. These traits were combined and analysed using biological data analysis software and visualized in the form of a minimum spanning tree (MST). We revealed a network of relationships between all analyzed parameters and non-congruence between experiments. At the same time we observed several conserved clones, characterized by an almost identical data set. These observations confirm the nonclonal epidemic population structure of P. aeruginosa, a superficially clonal structure with frequent recombinations, in which occasionally highly successful epidemic clones arise. One of these clones is the renown and widespread MDR serotype O12 clone. On the other hand, we found no evidence for a widespread CF transmissible clone. All but one of the 43 analysed CF strains belonged to a ubiquitous P. aeruginosa “core lineage” and typically exhibited the exoS+/exoU− genotype and group B oprL and oprD alleles. This is to our knowledge the first report of an MST analysis conducted on a polyphasic data set

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge

There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. RESULTS: A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. CONCLUSIONS: The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo