[Umbilical endometriosis in women free of abdominal surgical antecedents]. / Endométriose ombilicale chez les femmes sans antécédents chirurgicaux.

Primary umbilical endometriosis represents a very rare localization of the disease and is represented by blue, papular, nodular or cystic lesions whose symptoms are related to ovarian cycle. We report the management of three women, free of surgical antecedents presenting with primary umbilical endometriosis. In each woman, abdominal laparoscopy revealed peritoneal pelvic endometriosis. The excision of umbilical lesions was performed with satisfactory esthetical outcomes. In our experience, umbilical endometriosis responsible for highly characteristic features appears playing the role of clinical marker for pelvic endometriosis.

[Influence of the size and the localization of metastases in melanoma sentinel lymph nodes on the results of lymphadenectomy]. / Influence de la taille et de la localisation des métastases dans les ganglions sentinelles de mélanome sur le résultat du curage, à propos de 35 cas.

AIM: Thirty-five cases of lymphadenectomy carried out in the context of positive sentinel lymph node for malignant melanoma have been reviewed to assess the prognostic value of certain metastatic charachteristics. We have checked wether the type (macro or micrometastasis) and localisation (subcapsular or intraparenchymal) in the sentinel lymph node had predictive value for the lymphadenectomy outcome and evolution of the case. MATERIAL AND METHODS: The retrospective study relates to 35 cases (with an average 2 years history) taken from a total of 87 sentinel lymph node protocols; average age 46.5 years, Breslow 2.5 mm with an history of 25 months. RESULTS: Among the 35 positive sentinel lymph nodes we have 19 cases (54.2%) of micrometastasis. Among the 35 lymphadenectomy 5 cases (14.28%) turned out positive, 3 of which concerned micrometastatic sentinel lymph nodes. In our cohort the micrometastatic nature of sentinel lymph nodes did not have statistically significant impact upon the lymphadenectomy result but showed more favourable short-term evolution with 68.42% metastatic free evolution as against 43.75% in case of initial macrometastasis. The subcapsular localisation of micrometastasis equally represents a factor of improved prognosis (69.2% of metastatic free evolution against of 30.8% in the case of intraparenchymal localistion). CONCLUSION: Unfortunately, none of the studied criteria justifies a modification of our present clinical attitude whereby a systematic lymphadenectomy in cases of positive sentinel lymph nodes is performed, whatever the type or localisation of the relevant metastases.

[Total abdominal wall reconstruction. Management of full-thickness losses of the abdominal wall after a long ischemic compression]. / Reconstruction par greffe de peau d'un cas inhabituel de perte de substance étendue de la paroi abdominale secondaire à une compression ischémique prolongée.

The authors report an original case of a 70-year-old male with large musculocutaneous necrosis area of the abdominal wall following a long ischemic compression. Initial treatment was done using a wide excision of the abdominal wall necrosis and insertion of synthetic prosthesis to protect bowels. After 4 weeks of further surgical revisions, two splits thickness skin grafting were performed. The grafts were placed directly on granulations around and over the mesh and the healing was complete. Postoperative course was uneventful. In our experience, this technique allowed a good cicatrisation and a good esthetical result.

Transcriptional and post-translational control of the plant plasma membrane H(+)-ATPase by mechanical treatments.

The activity of the plant plasma membrane (PM) H(+)-ATPase was studied with fresh, cut or aged tissues of sugar beet (Beta vulgaris L.) leaves. The rate of acidification of the medium by tissue samples was strongly stimulated by ageing, but unaffected by cutting. The proton-pumping activity and the specific activity of the vanadate-sensitive ATPase of purified PM vesicles prepared from aged tissues were much higher than that of fresh tissues, whereas cutting had no effect. Yet, both ageing and cutting increased the amount of PM H(+)-ATPase detected by enzyme-linked immunosorbent assays. Likewise, both ageing and cutting increased the levels of pma4 and pma2 ATPase transcripts, as assayed with the corresponding probes from Nicotiana plumbaginifolia. Ageing increases, within a few hours, the levels of the transcripts, the translation and the activity of several PM H(+)-ATPase families. Cutting, which represents a milder mechanical stress, only increases the levels of the transcripts and their translation, without detectable effect on the activity at the biochemical or physiological level, which suggests a post-translational control of this activity. Thus, upon mechanical stress, the activity of the H(+)-ATPase, a key enzyme of the plant PM is rapidly and tightly regulated by transcriptional and post-translational controls.

Low dose octreotide and tamoxifen in the treatment of adenocarcinoma of the pancreas.

BACKGROUND: Data from experimental studies suggest that a combination of octreotide, the long acting somatostatin analogue, octreotide, and tamoxifen improves the survival of animals with pancreatic cancer. METHODS: Twelve patients with a tissue diagnosis of ductal adenocarcinoma of the pancreas were treated with 100 micrograms of octreotide three times per day and tamoxifen 10 mg twice daily. The survival of the octreotide-tamoxifen group was compared with a historic cohort of 68 untreated patients with pancreatic cancer, matched for age, sex, and TNM stage. RESULTS: The median survival times for the octreotide-tamoxifen-treated group compared with the historic cohort were 12 and 3, months respectively. Actuarial one-year survival rates for the octreotide-tamoxifen-treated group compared with the historic cohort were 59% and 16%, respectively. CONCLUSIONS: In this study, patients with unresectable and resected ductal adenocarcinoma of the pancreas had an apparently increased survival when treated with a combination of octreotide and tamoxifen. A randomized controlled trial to examine this potential therapeutic benefit is now indicated.