Assessment of hydro-saline retention in bullous pemphigoid patients treated with super-potent topical corticosteroids.

INTRODUCTION: Super-potent topical corticosteroids (CS) are the mainstay of treatment for bullous pemphigoid. Since super-potent topical CS have systemic effects due to their transcutaneous absorption, we assessed whether super-potent CS were responsible for hydro-saline retention (HSR) in bullous pemphigoid patients. PATIENTS AND METHODS: From 2015 to 2017, patients with newly-diagnosed bullous pemphigoid treated using clobetasol propionate cream at a starting daily dose of 20 to 40 g were subsequently included in a prospective study. HSR was assessed by longitudinally measuring extracellular water (ECW) volume using bioimpedance analysis (BodyStat QuadScan 4000®) from Day 0 to Day 30 after the initiation of topical CS. Other parameters related to HSR such as weight, blood pressure, natriuresis and proteinuria, were also recorded. RESULTS: Twenty-nine patients (14 men and 15 women) of mean age 81.8 ±â€¯9.3 years were included and analysed. The mean ECW volume decreased from Day 0 to Day 7 (18.1 ±â€¯4.2 vs 16.7 ±â€¯2.7, p = 0.0094) and was maintained from Day 7 to Day 30 (16.8 ±â€¯2.8 vs 17.0 ±â€¯3.4 L; p = 0.8040). Patient weight loss at Day 30 (69.9 ±â€¯13.6 vs 72.5 ±â€¯14.2 kg, p = 0.0085) was closely correlated with the decrease in ECW volume (r = 0.6740, p < 0.0001). No significant changes in natriuresis, 24-hour proteinuria or blood pressure were observed from Day 0 to Day 30. CONCLUSION: We found no evidence of HSR in bullous pemphigoid patients treated with super-potent topical CS. Conversely, ECW volume decreased from Day 0 to Day 30, which was correlated with patient weight loss.

A specific prediction equation is necessary to estimate peak oxygen uptake in obese patients with metabolic syndrome.

PURPOSE: The aims were to: (1) compare peak oxygen uptake ([Formula: see text]peak) predicted from four standard equations to actual [Formula: see text]peak measured from a cardiopulmonary exercise test (CPET) in obese patients with metabolic syndrome (MetS), and (2) develop a new equation to accurately estimate [Formula: see text]peak in obese women with MetS. METHODS: Seventy-five obese patients with MetS performed a CPET. Anthropometric data were also collected for each participant. [Formula: see text]peak was predicted from four prediction equations (from Riddle et al., Hansen et al., Wasserman et al. or Gläser et al.) and then compared with the actual [Formula: see text]peak measured during the CPET. The accuracy of the predictions was determined with the Bland-Altman method. When accuracy was low, a new prediction equation including anthropometric variables was proposed. RESULTS: [Formula: see text]peak predicted from the equation of Wasserman et al. was not significantly different from actual [Formula: see text]peak in women. Moreover, a significant correlation was found between the predicted and actual values (p < 0.001, r = 0.69). In men, no significant difference was noted between actual [Formula: see text]peak and [Formula: see text]peak predicted from the prediction equation of Gläser et al., and these two values were also correlated (p = 0.03, r = 0.44). However, the LoA95% was wide, whatever the prediction equation or gender. Regression analysis suggested a new prediction equation derived from age and height for obese women with MetS. CONCLUSIONS: The methods of Wasserman et al. and Gläser et al. are valid to predict [Formula: see text]peak in obese women and men with MetS, respectively. However, the accuracy of the predictions was low for both methods. Consequently, a new prediction equation including age and height was developed for obese women with MetS. However, new prediction equation remains to develop in obese men with MetS.

Prenatal Detection of Coarctation of the Aorta in a Non-selected Population: A Prospective Analysis of 10 Years of Experience.

The objective of this study was to assess the ability of different parameters to identify fetuses requiring neonatal care for coarctation of the aorta (CoA). Between January 2003 and December 2012, 175 fetuses referred for great vessel disproportion were divided into two groups: group A (n = 51) with high risk of CoA and delivery planned in tertiary care referral center and group B (n = 124) with no increased risk of CoA. In group A, diagnosis of CoA was confirmed in 38/51 (74 %). In group B, 2/124 had CoA. Multiple logistic regression analysis identified the best combination as diffusely hypoplastic and/or angular aortic arches, ventricular septal defect and aortic valve diameter <5 mm at 36-week gestational age (GA). Positive predictive value was 75 % when vessel disproportion was noted before 28-week GA and 73 % in the third trimester. Postnatal diagnosis involved 38 cases of CoA which had not been referred. One case of CoA diagnosed after birth was referred prenatally for difficulty of screening without any defect. The results of our prospective study are in agreement with those of previous series, but our false positive rate was lower especially when the diagnosis of vascular disproportion was made at third trimester. The performance of fetal cardiac screening does not seem to be very good, but prenatal diagnosis is probably not always possible: Among our three false negative cases, two had isolated vascular disproportion and the third no risk factors.

[Prophylactic prescription of vitamin D in France: national multicenter epidemiological study of 3240 children under 6 years of age]. / Prescription prophylactique de la vitamine D en France : enquête épidémiologique multicentrique nationale chez 3240 enfants de moins de 6 ans.

AIMS: The aim of the study was to assess compliance with the current recommendations of prophylactic prescription of vitamin D via a multicentric cross-sectional epidemiological survey of 3240 children under 6 years of age. METHOD: Parent questionnaires and data from the health records of children presenting to the emergency departments of 25 teaching hospitals and hospital centers provided information on the children's characteristics, their prescriptions, and other vitamin D intake. Based on the currently applicable recommendations, intakes of 600-1,200 IU/day - 900-1500 IU/day for children with pigmented skin and/or premature and/or hypotrophic children - are considered adequate. RESULTS: In 1606 infants, 9.8% of the prescriptions were below and 23.7% were above the recommendations; in 1256 children between 18 months and 5 years of age, 53.4% of the prescriptions were below and 5.1% were above the recommendations. Children at risk, those from the southern half of France, and those between 18 months and 5 years of age were more likely to receive a prescription below the recommendations; their risk of receiving a prescription above the recommended guidelines was smaller. Of the children aged between 61 and 71 months, 85% had not received any prescription at all during the previous 12 months. These results were compared with the laboratory data collected from a subsample of children. There was a significant correlation between the adequacy of the prescription and the biological vitamin D status both for 25-hydroxyvitamin D (25-OH-D) serological concentrations and for calciuria. CONCLUSIONS: Only 66.6% of the prescriptions in children between 0 and 18 months of age and 41.5% in children between 19 months and 5 years of age comply with the recommendations; 53.4% of the prescriptions in the latter age group are below the current recommendations.

Novel inter-series hybrids in Solanum, section Petota.

Sexual hybrids between distantly related Solanum species can undergo endosperm failure, a post-zygotic barrier in inter-species hybridizations. This barrier is explained by the endosperm balance number (EBN) hypothesis, which states that parents must have corresponding EBNs for viable seed formation. Tests for inter-crossability were made involving the Mexican species Solanum pinnatisectum Dunal. (series Pinnatisecta, ApiApi, 1EBN), autotetraploids of this species, Solanum verrucosum Schlechtd. (series Tuberosa, AA, 2EBN), haploids (2x, 2EBN) of the South American S. tuberosum L. (series Tuberosa, A1A1A2A2, 4EBN), and F2 haploid-species hybrids with South American species (AA, 2EBN) S. berthaultii Hawkes, S. sparsipilum (Bitter.) Juz. and Bukasov and S. chacoense Bitter. The development of hybrid endosperms was investigated for these combinations by confocal microscopy with regard to cell-division timing and tissue collapse. Novel sexual diploid (AApi) and triploid (AApiApi) inter-series hybrids were generated from S. verrucosum x S. pinnatisectum crosses by using post-pollination applications of auxin. F1 embryos were rescued in vitro. The hybrid status of recovered plants was verified by microsatellite marker analysis, and the ploidy was determined by chromosome counting. The application of phytohormones in inter-ploidy S. pinnatisectum x S. tuberosum crosses, however, did not delay endosperm collapse, and embryos were not formed. Other diploid, 1EBN species tested in remote hybridizations with Group Tuberosum were S. cardiophyllum Lindl., S. trifidum Correll, and S. tarnii Hawkes and Hjert., series Pinnatisecta, and S. bulbocastanum Dunal., series Bulbocastana. Based on the analysis of post-zygotic reproductive barriers among isolated species of section Petota, we propose strategies to overcome such incompatibilities.

[Results of the surgical treatment of cancers of the supraglottic area]. / Les résultats du traitement chirurgical des cancers de l'étage sus-glottique.

The authors report a retrospective analysis of the results of surgery in 169 patients with supraglottic cancer referred to the Lille ENT clinic from 1976 to 1985. Partial surgery was performed in 53% of patients versus total laryngectomy in 47%. The 5 year survival rates in the patient groups treated by supraglottic laryngectomy and supracricoid laryngectomy with cricohyoidopexy were similar, 69.4% and 75.2%, respectively. The 5 year survival rate in the patient group treated by total laryngectomy or by total laryngectomy extended to the base of tongue was 62.8%.

[Subtotal laryngectomy in the treatment of extensive tumors of the larynx]. / La laryngectomie sub-totale dans le traitement des tumeurs étendues du larynx.

The authors assess the possibility to perform subtotal laryngectomy for extensive tumors of the endolarynx. They describe a particular variety of T3/T4 tumor extending anteriorly to the thyroid cartilage or to the pre-epiglottic space. Such tumors do not affect the arytenoid cartilages posteriorly, which makes functional subtotal laryngectomy with CHP or CHEP possible. This surgery was performed in 28 patients from 1972 to 1985, with 20 patients still living after 5 years, ie. 72% of all cases.

[Isolated ankylosis of the malleus]. / Les ankyloses isolées du marteau.

Certain cases of apparently isolated conductive deafness, the etiology of which remains uncertain after clinical examination and impedance measurement, can be found in younger patients and adults. Surgical exploration is necessary: this involves, first of all, an inspection of the anatomy of the ossicles and then precise study of their mobility at the level of the tympanic cavity and attic. Various forms of malleus ankylosis, due to blockage or malformation, are presented. Ossiculoplasty gives good auditory results.

[Medium-malignancy tumors of the parotid gland]. / Tumeurs à malignité intermédiaire de la parotide.

Among the 437 parotidectomies performed from 1966 to 1989, we observed 2 acinar-cell tumors and 11 mucoepidermoid carcinomas, ie. 3%. The acinar-cell tumors occurred in 2 men aged 45 and 71. A conservative complete parotidectomy was performed in both cases with a 6 and 7-year survival without local recurrence. The mucoepidermoid tumors affected 4 women and 7 men. The clinical appearance in 2 cases was highly suggestive of a malignant tumor, the picture including facial palsy, fixed gaze and adenopathy. In spite of excision completed by radiation therapy, the outcome soon was unfavorable. In the other 9 patients presenting with a limited tumor of the parotid gland, the facial nerve had to be partly sacrificed in 2 cases because no dissection was possible even under a microscope. The prognosis was generally favorable in the limited forms with 6/6 patients alive at more than 5 years and 3 patients alive at 3 years, 2 years and 1 year. Postoperative radiation therapy was not performed systematically, but only in 2/3 of cases (ill-delineated or ill-differentiated tumor).

cis-Diamminedichloroplatinum (II)-DNA adduct formation in renal, gonadal, and tumor tissues of male and female rats.

cis-Diamminedichloroplatinum(II) (cisplatin), a potent anticancer agent, is thought to exert its cytotoxic effects through DNA damage. Using a polyclonal rabbit antisera which recognizes intrastrand bidentate deoxy(ApG)- and deoxy(GpG)-N7-diammineplatinum adducts, an enzyme-linked immunosorbent assay has been developed to quantitate this adduct in cisplatin-exposed DNA. Cisplatin-DNA adducts were measured in renal, gonadal, and tumor (sarcoma) tissues of Sprague-Dawley rats following i.v. or i.p. administration of cisplatin. When drug was administered i.v. to animals fed ad libitum adduct levels were highest in kidneys, 50% lower in s.c. sarcoma, and substantially lower in gonads. Under these experimental conditions, a large interindividual variability in adduct formation was observed in renal and tumor tissues, and adduct levels in some samples were too low to measure. Higher values among individuals were obtained using tissues of animals fasted overnight and treated i.p. Adduct levels following i.p. injections of drug were higher in kidneys and gonads of male rats than in kidneys and gonads of female rats. Analysis of tissue platinum content demonstrated higher platinum levels in kidneys of male rats than in kidneys of female rats, but the magnitude of this gender difference in total tissue platinum was not as great as that observed for adduct formation. When the influence of castration on adduct formation was investigated, adduct levels in kidneys of castrated females were higher than those in sham-operated females, but adduct levels in kidneys of the castrated male animals were not substantively different from those seen in sham-operated male controls. We conclude that the route of drug administration, diet, and hormonal status of the animal are factors that may influence cisplatin-DNA adduct formation in the rat.

Antibodies elicited against cis-diamminedichloroplatinum(II)-modified DNA are specific for cis-diamminedichloroplatinum(II)-DNA adducts formed in vivo and in vitro.

Rabbit antiserum elicited against calf thymus DNA modified to 4.4% (Pt drug/nucleotide ratio = 0.044) with the antitumor drug cis-diamminedichloroplatinum(II) (cis-DDP) contains antibodies specific for the Pt-modified DNA immunogen as well as for Pt-DNA adducts formed in both cultured mouse leukemia L1210 cells and in L1210 cells from the ascites fluid of tumor-bearing mice exposed to cis-DDP. Pt-modified DNA was electrostatically complexed to methylated bovine serum albumin and injected into rabbits. Early bleedings of the derived antiserum were used to establish a competitive enzyme-linked immunosorbent assay (ELISA), which demonstrated specificity for the Pt-modified DNA but not for DNA or the Pt drug alone. In the ELISA, 50% inhibition occurred at a concentration of 0.5 nM Pt (on DNA) as determined by atomic absorption spectroscopy. This value corresponds to a lower limit of detectability of one adduct in 10(7) nucleotides, with 50 micrograms of sample DNA added per microtiter well. DNA isolated from cultured mouse L1210 cells exposed to increasing doses of the Pt drug was found by ELISA to contain from 0.2 to 10.0 fmol of Pt adduct per microgram of DNA. These levels remained stable for up to 4 hr after a 1-hr drug treatment, during which time DNA interstrand crosslinks developed. Thus, the antiserum appears not to be specific for DNA interstrand crosslinks. DNAs from L1210 cells exposed to trans-diamminedichloroplatinum(II) and L-phenylalanine mustard were not recognized in the ELISA. DNA prepared from the ascites cells of mice bearing the L1210 tumor 5 hr after injection of cis-DDP was found to contain about 2 fmol of Pt per microgram of DNA. This work establishes that cis-DDP-DNA adducts prepared in vitro are relevant to the in vivo binding of the Pt drug to its biological target, DNA, and opens new avenues for studying the mechanism of action of the Pt anticancer drugs.