Comparative analyses of the complete mitochondrial genomes of Cyathostomum pateratum and Cyathostomum catinatum provide new molecular data for the evolution of Cyathostominae nematodes.

The parasite Cyathostomum pateratum, which occurs in the large intestine of equines, is a common species of the subfamily Cyathostominae. Cyathostominae nematodes are a complex nematode group for which only limited genetic information has been reported. To re-examine the phylogenetic relationships among Cyathostominae nematodes, we sequenced the complete mitochondrial (mt) genome of Cy. pateratum and compared it with the mt genome of the congeneric species Cyathostomum catinatum. The complete mtDNA sequence of Cy. pateratum was 13,822 bp in length, 16 bp shorter than that of Cy. catinatum. The mtDNA sequences of both species contained 12 protein-coding genes, two rRNA genes and 22 tRNA genes, and all 36 genes were transcribed in the same direction and in the same strand. Pairwise comparisons of the 12 predicted amino acid sequences between Cy. catinatum and Cy. pateratum revealed differences of 0.4-3.1%; the least conserved sequence was that of cytochrome c oxidase subunit 3 (cox3). Phylogenetic analysis of the concatenated amino acid sequences using Bayesian inference and maximum likelihood methods showed that Cy. catinatum and Cy. pateratum clustered together with very high nodal support, and Cylicostephanus goldi was closer to the Cyathostomum nematodes than to other Cyathostominae nematodes. The mtDNA sequence of Cy. pateratum is reported here for the first time. The study will shed some light on the genetic evolution among parasitic nematodes in Cyathostomum.

[Atypical presentation of a breast cancer pituitary metastasis]. / Découverte fortuite d'une métastase hypophysaire d'un cancer du sein : cas clinique.

Pituitary metastasis occur in 1-5 % of patients with cancer. We report the discovery of a unique pituitary metastasis of breast cancer. A 67 years old woman was treated in 2003 for local adenocarcinoma. After bone metastatic relapse in 2008, the patient developed diplopia and diabetes insipidus. An MRI revealed a histologically proven metastatic pituitary nodule. Further explorations revealed failure of multiple endocrine axes. Pituitary metastases are relatively rare, but are probably under-diagnosed in the presence of advanced cancers with impaired general condition. This diagnosis should be considered in the context of cancer patients, with a recent history of diabetes insipidus, especially if the latter is associated with other neurological signs (ophthalmoplegia, cephallagia).

Les métastases hypophysaires surviennent chez 1 à 5 % des patients atteints de cancers. Nous rapportons ici la découverte fortuite d'une métastase hypophysaire d'un cancer du sein. Une patiente de 67 ans est prise en charge en 2003 pour un adénocarcinome mammaire localisé. Après une récidive métastatique osseuse en 2008, elle présente une diplopie et un diabète insipide. L'IRM cérébrale décèle une lésion hypophysaire dont l'origine métastatique est confirmée en anatomopathologie; une extension du bilan permet de diagnostiquer une insuffisance des multiples axes endocriniens. Les métastases hypophysaires sont des lésions relativement rares, mais qui restent probablement sous-diagnostiquées dans le contexte du cancer avancé avec altération majeure de l'état général. Ce diagnostic doit être évoqué en cas de découverte récente d'un diabète insipide, en particulier s'il est associé à des signes neurologiques (ophtalmoplégie ou céphalées).

[Prostate cancer of elderly patients: Place and role of geriatric assessment]. / Cancer de prostate des sujets âgés : place et rôle de l'évaluation gériatrique.

INTRODUCTION: The aim of this study was to appreciate the place and role of geriatric assessment in elderly patients with prostate cancer. MATERIALS AND METHODS: We performed a retrospective analysis of prostate cancer patients who underwent geriatric assessment during the therapeutic management from 2008 to 2014. Patient, tumor, treatment characteristics and their associated toxicity as well as the parameters of geriatric assessment were studied. The occurrence of geriatric assessment within the 3 months preceding a therapeutic decision was reviewed. RESULTS: Data of seventy-four patients were analyzed with a median follow-up of 15.6 years. The average age at diagnosis was 74.3 and 80.6 at the geriatric assessment. At the time of the geriatric assessment 64 patients had metastatic disease, 39 were in poor condition more than 50% of patients had walking ability disorders. Thirteen patients underwent radical surgery, 28 received radiotherapy, 30 patients had chemotherapy and hormonotherapy was prescribed for 72 patients. The geriatric assessment, requested on average 15 years after diagnosis, was not carried out within the 3 months preceding treatment decision for 55 patients. CONCLUSION: The recourse to geriatric assessment is predominantly used to endorse a decision of supportive care for elderly patients with prostate cancer. An early intervention by a geriatrician consultant for the initial management and then at each therapeutic event is a sine qua non condition for efficient personalized therapeutic management suitable to every patient according to physiological age. LEVEL OF EVIDENCE: 4.

Rare histologic types of rectal cancer: A monocentric cases series report.

PURPOSE: There is paucity of data on rectal cancer with uncommon histologic types. The objective was to describe managements of care and outcomes in patients with rectal cancer of histologic types other than adenocarcinoma. MATERIAL AND METHODS: This monoinstitutional retrospective study included all patients with rectal cancer undergoing rectal radiotherapy. RESULTS: From 2004 to 2015, 744 patients were treated for rectal cancer, and ten had a histologic type other than adenocarcinoma. The median age was 60.7 years (range: 34.6-80.4 years). Histologic types were neuroendocrine (four), adenosquamous (one), undifferentiated with large cell (one), clear cell (one), anaplastic with small cell (one), signet ring cell (one) and adenocarcinoma with choriocarcinomatous differentiation (one). Four patients were initially diagnosed with a stage IV rectal cancer, and two ultimately became metastatic. Six patients underwent surgery, with four neoadjuvant chemoradiotherapies. None experienced complete response and two had incomplete resections. First-line and concomitant chemotherapies were adapted to histology results, mainly with etoposide and platinum salts for neuroendocrine and small cells tumours. Four patients experienced progression before first line treatments were achieved. Median progression free survival and overall survival were 3.8 and 10.1 months respectively. Two patients were long survivors (22 and 54.7 months, both still alive). All other died of rectal cancer. CONCLUSION: The present study highlights the rarity and the specificities of uncommon histologic types of rectal cancer. We report the real-life management and outcome of rare histologic types of rectal cancers, with dismal prognosis of stage IV tumours. We also report that treatments were adapted to histology.

[Radiotherapy phase I trials' methodology: Features]. / Méthodologie des essais de phase I en radiothérapie : particularités.

In clinical research, biostatistical methods allow the rigorous analysis of data collection and should be defined from the trial design to obtain the appropriate experimental approach. Thus, if the main purpose of phase I is to determine the dose to use during phase II, methodology should be finely adjusted to experimental treatment(s). Today, the methodology for chemotherapy and targeted therapy is well known. For radiotherapy and chemoradiotherapy phase I trials, the primary endpoint must reflect both effectiveness and potential treatment toxicities. Methodology should probably be complex to limit failures in the following phases. However, there are very few data about methodology design in the literature. The present study focuses on these particular trials and their characteristics. It should help to raise existing methodological patterns shortcomings in order to propose new and better-suited designs.

Conflict of interests for radiation oncologists: Harnessing disclosures from policy to reality.

PURPOSE: An increasing attention is being paid to disclosures of conflicts of interests in the field of oncology. The purpose of this study was to examine how radiation oncologists report their conflicts of interests with pharmaceutical or technology industries. MATERIALS AND METHODS: We collected the data of conflicts of interests disclosures in the abstract books from the annual 2012 and 2013 meetings of the American Society for Radiation Oncology (ASTRO) in Miami (FL, USA), and in Atlanta (GA, USA), respectively. Geographic origins of abstracts as well other factors were examined. RESULTS: We identified a total of 4219 abstracts published in the past two years. The total number of involved authors was of 28,283. All of the published abstracts had conflicts of interests disclosures. Amongst them, 563 abstracts (13.4%) reported at least one potential conflict of interests, in which 1264 (4.5%) declared a potential conflict of interests in their disclosures. Geographic distribution of abstracts with financial relationship was as following: 67.9%, 15.5%, 7.7% and 7.7% for USA, Europe, Asia/Pacifica, and Canada, respectively. Abstracts with conflict of interest originated from North America in 75.6% of cases. USA distribution was 70.6% and 29.4% for Eastern and Western, respectively. CONCLUSIONS: The proportion of physicians declaring financial conflicts of interests remains extremely low, whichever geographic area authors are from. In comparison to the rest of the world, the US proved itself better at declaring potential links. Changes in medical culture and education could represent a significant step to improve the process of revealing conflicts of interest in medical journal as well as in international meetings.

[Carcinomatous meningitis: The radiation therapist's point of view]. / Méningite carcinomateuse: le point de vue de l'oncologue radiothérapeute.

Carcinomatous meningitis complicates 5 to 10% of cancers, essentially with breast cancers, lung cancers and melanomas. The incidence probably increased because of therapeutic advances in oncology. Treatment is based on external beam radiotherapy, systemic treatment, intrathecal chemotherapy and supportive care. The aim of this work was to review data on external radiation therapy and carcinomatous meningitis. There are few evidences on the subject, but it is a major topic of interest. A whole brain radiation therapy is indicated in case of brain metastases or clinical encephalitis. Focal radiation therapy is recommended on symptomatic, bulky or obstructive sites. The dose depends on performance status (20 to 40 Gy in five to 20 fractions), volume to treat and available techniques (classic fractionation or hypofractionation via stereotactic radiosurgery). The objective of radiation therapy is to improve quality of life. Association with systemic therapy improves overall survival. Administration of sequential intrathecal chemotherapy may also improve overall survival, but induces more toxicity. The use of new radiotherapy techniques and development of radiosensitizing molecules in patients with good performance status could improve survival in this frequent complication of cancer.

[Hyperbaric oxygen and radiotherapy: From myth to reality]. / Oxygénothérapie hyperbare et radiothérapie : entre mythe et réalité.

Worldwide, more than a million people receive each year a curative radiotherapy. While local control and overall survival are steadily increasing, 5 to 15% of patients still develop above grade 2 late toxicities. Late toxicities treatments are complex. Hyperbaric oxygenation was shown to induce revascularization and healing of injured tissues, but indications are still debated. Through a literature review, we summarized the hyperbaric oxygenation indications in radiation-induced late toxicities. We also studied the knowledge and practice of French local radiation therapists. It seems that hyperbaric oxygen therapy can be a conservative treatment of haemorrhagic cystitis and radiation-induced pain, in case of drug therapies failure. Often associated with a significant morbidity and mortality, surgery could be avoided. The risk of complications in case of tooth extraction in irradiated tissues is also reduced. However, the role of hyperbaric oxygenation for mandibular osteoradionecrosis, radiation-induced proctitis, enteritis, lymphoedema, brachial plexopathy, skin and neurological sequelae seems more questionable since studies results are conflicting. Future outcomes of phase III studies are expected to clarify the role of hyperbaric oxygenation in the management of radio-induced toxicities, including for head and necks complications.

Electron transfer between ferrocene-modified Au/octadecanethiol/lipid BLM electrode and redox couples in solution.

Bilayers incorporated with ferrocene consisting of self-assembled octadecanethiol and lipid monolayer on gold substrates were fabricated. Its electrochemical behaviors in solutions containing different redox couples were investigated by cyclic voltammetry and ac impedance. The transmembrane electron transfer reaction across octadecanethiol self-assembled film and an adsorbed phospholipid layer mediated by ferrocene have been observed in the solution of Fe(CN)6(3-/4-). The formal potential difference between mediator in bilayer lipid membrane (BLM) and redox couple in solution has a great impact on the transmembrane electron transfer behavior. The ferrocene-modified BLM electrodes might be useful for constructing a bilayer-based electrochemical current rectifying device.

Unmodified supported thiol/lipid bilayers: studies of structural disorder and conducting mechanism by cyclic voltammetry and AC impedance.

Supported thiol/lipid bilayer assembly, one of the most spectacular bilayer systems in recent years, has provided a good model to study biomembranes because of its high mechanical stability. In this work, the structural and conducting property of unmodified Au supported octadecanethiol/phosphatidylcholine bilayers were investigated using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The forming process of bilayer was monitored by capacitance plane plot. The normalized membrane capacitance of supported bilayer is 0.52 microF cm(-2). Kinetically controlled voltammograms determined by Butler-Volmer equation were obtained for both thiol monolayer and thiol/lipid bilayer in linear sweep voltammetry. Results of EIS experiment indicate that collapsed sites and pinhole defects exist in thiol monolayer and lipid monolayer, respectively. The difference between the values of experimental and theoretical standard electron transfer rate constant indicates that the conducting mechanism of Au supported thiol monolayer is electron tunneling at collapsed sites. The conducting mechanism of Au supported thiol/lipid bilayer is attributed as the following: the electroactive species could diffuse through pinholes in the lipid monolayer and reach collapsed sites in thiol monolayer, where electron transfer occurs via a tunneling process. The fractional coverage of the lipid monolayer measure by EIS experiments is about 0.98 or higher.