[Assessment of energy density during laser photoselective vaporisation of the prostate: A retrospective monocentric study]. / Évaluation de l'effet de la densité d'énergie délivrée lors d'une photovaporisation prostatique laser : étude rétrospective monocentrique.

INTRODUCTION: Greenlight XPS-180W® (AMS, San José, USA) photoselective vaporisation of the prostate (PVP) is considered as an alternative to transurethral resection of the prostate. The objective of this study was to assess the effect of energy density applied on adenoma during PVP treatment for benign prostate hyperplasia (BPH) on postoperative outcomes. METHODS: A single-centre retrospective study has been conducted in the department of Urology of Colmar Hospital, in patients with symptomatic BPH, treated by PVP, between January 2016 and January 2019. Patients were stratified into two groups according to energy delivered and prostate volume as determined preoperatively: Low density (<4kJ/mL) and high density (>4kJ/mL). Perioperative complications, PSA evolution and functional outcomes (International Prostate Symptom Score, quality of life, maximum urinary flow rate, post-void residual urine volume) were compared with a minimal delay of 6 months. The retreatment rate was similar in the two groups. RESULTS: A total of 215 patients were included with median follow-up of 25 months. High energy density was associated with less glandular volume. There were no statistically significant differences between the two groups concerning the perioperative complications and the functional outcomes. The postoperative reduction of the PSA level was more significant in the high-energy group (41% vs. 28%, P=0.03). CONCLUSION: The perioperative complications and functional outcomes of PVP with Greenlight XPS-180W® laser are equivalent depending on the energy density delivered. The greater decrease in postoperative PSA for high-energy density could nevertheless suggest better quality tissue destruction. LEVEL OF PROOF: 3.

Is there a volume-outcome relationship for partial nephrectomy?

OBJECTIVE: To investigate the impact of hospital volume on partial nephrectomy indications and outcomes. MATERIALS AND METHODS: Data were extracted from the National Observational Registry on the Practice and Hemostasis in Partial Nephrectomy registry. Four groups were created according to the number of partial nephrectomy (PN) performed: very high (VH, ≥ 19 PN), high (H, 10-18 PN), moderate (M, 4-9 PN) and low (L, <4 PN) PN activity. Indications and surgical outcomes were compared among all groups. The effect of hospital volume on postoperative complications and positive margin rate was examined by a multivariable analysis. RESULTS: Fifty-three centers included a total of 570 PN. There were 9 VH, 13 H, 12 M and 19 L volume centers which performed 270 (47.4 %), 179 (31.4 %), 74 (13 %) and 47 (8.2 %) PN, respectively. Patients in higher volume centers were significantly younger (p = 0.008), had a lower BMI (p = 0.002) and decreased ASA score (p < 0.001). PN was more frequently performed in higher volume centers (p = 0.006) particularly in case of renal masses <4 cm (p = 0.005). Open surgery was the most common approach in all groups, but laparoscopic PN was more frequent in M volume hospitals (p < 0.001). Positive margin (p = 0.06) and complications (p = 0.022) rates were higher in M group. In multivariable analysis, renal chronic disease was an independent predictor of positive margin rate (p < 0.001, OR 3.91). CONCLUSIONS: PN is more frequently performed in high volume institutions particularly for small renal masses. We observed increase positive margin and complication rates in moderate volume centers that might be explained by an increased use of laparoscopy.

[Primary renal synovial sarcoma]. / Synovialosarcome rénal primitif.

The primary renal synovial sarcoma is a rare tumor with a poor prognosis. It may be confused with other types of mesenchymal kidney tumors because of similarities in clinical and histological appearance. About 60 cases have been described in the literature. We report a case of a 66-year-old man presenting a primary synovial sarcoma of the right kidney with a vascular invasion of the inferior vena cava and right renal vein. The diagnosis was confirmed in molecular biology by reverse transcription polymerase chain reaction (RT-PCR) which demonstrated a unique chromosomal translocation t(X;18) with SYT-SSX2 fusion transcripts. We describe here the case with a brief review.

T-2 toxin inhibits the differentiation of human monocytes into dendritic cells and macrophages.

The aim of this work was to study the in vitro effect of T-2 toxin on human monocyte differentiation into macrophages and dendritic cells. Cytotoxicity of T-2 toxin on monocytes, on monocytes in differentiation process into macrophages or dendritic cells, and on immature dendritic cells and macrophages was evaluated to determine IC50. Monocytes are more sensitive to T-2 toxin than to differentiate cells. IC50 were equal to 0.11 nM for monocyte, to 45 and 30 nM for monocyte during differentiation process for 24 and 48 h of incubation, respectively, to 38 and 20 nM for immature dendritic cells after 24 and 48 h of incubation, and to 22 and 20 nM for macrophages after 24 and 48 h of incubation. T-2 toxin effects on monocyte differentiation process into macrophages have been explored: according to phenotypic expressions (CD71, CD14, CD11a, CD80, CD86, HLA-DR and CD64), endocytic capacity, phagocytosis, burst respiratory activity and TNF-alpha secretion. In the presence of 10 nM of T-2 toxin (no cytotoxic concentration), CD71 expression is downregulated compared to control. Endocytosis and phagocytosis capacities are less effective as burst respiratory activity and TNF-alpha secretion. Monocyte differentiation process into dendritic cells in the presence of 10 nM T-2 toxin is also markedly disturbed. Expression of CD1a (specific dendritic cells marker) is downregulated while that of CD14 (specific monocyte marker) is upregulated. CD11a, CD80, CD86, HLA-DR and CD64 expressions did not change. These results show that T-2 toxin disturbs human monocytes differentiation process into macrophages and dendritic cells. These results could significantly contribute to immunosuppressive properties of this alimentary toxin.

[Renal metastasis of an esophagus epidermoid carcinoma]. / Métastase rénale d'un carcinome épidermoïde de l'oesophage.

Renal metastases in the evolution of an esophagus epidermoid carcinoma are rare and are frequently bilateral or associated with many other metastases. The authors present an original article of a single metastasis. They discuss the importance of imagery and locoregional status in the management of patient.

Comparative anatomical study of sound production and reception systems in the common dolphin (Delphinus delphis) and the harbour porpoise (Phocoena phocoena) heads.

Magnetic resonance imaging (MRI) and computed tomography (CT) scans were used to analyse, respectively, the soft tissues and the bones of the heads of four common dolphins and three harbour porpoises. This imaging study was completed by an examination of anatomical sections performed on two odontocete heads (a subadult common dolphin and a subadult harbour porpoise). The three complementary approaches allowed to illustrate anatomical differences in the echolocation systems of the common dolphin and the harbour porpoise. We captured images confirming strong differences of symmetry of the melon and of its connexions to the MLDB (Monkeys Lips/Dorsal Bursae) between the common dolphin and the harbour porpoise. The melon of the common dolphin is asymmetrically directly connected to the right bursae cantantes at its right side, whereas the melon of the harbour porpoise is symmetrical, and separated from the two bursae cantantes by a set of connective tissues. Another striking difference comes from the bursae cantantes themselves, less deeply located in the head of the common dolphin than in the harbour porpoise.

Magnetic Resonance Imaging Study of Adipose Tissues in the Head of a Common Dolphin (Delphinus delphis): Structure Identification and Influence of a Freezing-Thawing Cycle.

Magnetic resonance imaging (MRI) was used to scan the head of a common dolphin (Delphinus delphis) in order to visualize the different adipose tissues involved in echolocation functioning and to precisely delineate their anatomical topology. MRI scans were performed on the head taken from a freshly stranded carcass and repeated after a 2-week freezing time followed by thawing. The main fatty organs of the head, that is the melon, the mandibula bulba, the bursae cantantes, and their different connections with surrounding tissues were identified and labelled. The nasal sacs, other organs of echolocation, were also identified and labelled thanks to different MRI acquisitions. The shape, the location, the type of MRI signal of each organ and of their different connections were successfully analysed on all images, and then, the images of the head fresh or after thawing were compared. No impacts of the freezing/thawing cycle on the fatty tissues of the head were identified. Different parts were distinguished in the melon on the basis of the MRI signal emitted, corresponding most likely to the internal and external melon already identified by other analytical approaches, and linked to differences in lipid composition. MRI is shown here to be a useful tool to study the functional anatomy of the organs responsible for echolocation in odontocetes, with a particularly high level of precision.

Sunflower (Helianthus annuus L.) Pathogenesis-Related Proteins (Induction by Aspirin (Acetylsalicylic Acid) and Characterization).

Sunflower leaf discs floated on a solution containing aspirin (acetylsalicylic acid) produced a set of new proteins extractable at pH 5.2 and excreted into the intercellular space. More than 80% of the proteins found in the intercellular fluids of induced leaf discs have been identified as pathogenesis-related (PR) proteins by their immunological relationship with tobacco PR proteins. Members of the four major classes of PR proteins have been characterized. Sunflower PR proteins of type 1 (PR1) and of type 3 (PR3) were found to have acidic isoelectric points, whereas the induced PR protein of type 2 (PR2) had a basic isoelectric point. Members of the type 5 PR proteins (PR5), known in tobacco as thaumatin-like proteins, showed a more complex pattern. Multiple sunflower PR5 isomers of similar molecular weight but of different isoelectric points were excreted from the cells in response to the aspirin treatment. PR2 and PR3 proteins were found at very low basal levels in untreated leaves, whereas PR1 and PR5 proteins could not be detected at all in the same extracts. Glucanase and chitinase activities were always associated with PR2 and PR3 proteins in partially purified sunflower extracts. All of these data indicate that, in response to aspirin treatment, sunflower plants produce a complete set of PR proteins characterized by an apparently exclusively extracellular localization.

[Simplified urinary diversion in colostomized patients]. / Dérivation urinaire simplifiée chez les patients colostomisés.

The authors report 3 cases of urinary diversion in patients with preexisting colostomy and operated by technique of Noble and Davis. The previous colostomy is used for urinary diversion and new colostomy is created for fecal diversion. This method is simple, time-saving and very beneficial for high risk patients. We found it very useful and had gave us satisfactory results.

[Adenocarcinoma developing on an ileal loop after augmentation cystoplasty]. / Adénocarcinome développé sur une anse iléale après cystoplastie d'agrandissement.

We report a case of adenocarcinoma arising in an ileal conduit 36 years after ring cystoplasty. The only presenting symptom was gross hematuria. Retrograde cystography ws useful in the diagnosis. Few primary bowel malignant neoplasms of this type have been described. Carcinogenesis is discussed.

[Esophageal metastasis of cancer of the bladder]. / Métastase oesophagienne d'un cancer de vessie.

The authors report a case of oesophageal metastasis of transitional cell carcinoma of the bladder. This lesion was responsible for hematemesis eight days after cystoprostatectomy. Treatment consisted of irradiation of the metastatic site and chemotherapy. The patient is in complete remission after a follow-up of 2 years.

[Technical approach to excision of renal cancers with venous thrombus extending to the right auricle. Apropos of 4 cases]. / Approche technique de l'exérèse des cancers du rein avec thrombus veineux étendu à l'oreillette droite. A propos de quatre observations.

The authors report four cases of renal neoplasm with associated thrombosis of the vena cava, extending to the right auricle. Three cases involved the right kidney. Three patients underwent operation with cardio-pulmonary bypass; two operations were successful and one had a fatal outcome. Although the technique of this operation has been considerably simplified, this operation is not performed routinely.

[Treatment of primary vesicorenal reflux in adults. Apropos of 71 case reports]. / Traitement du reflux vésico-rénal primitif de l'adulte. A propos de soixante et onze observations.

The authors report a series of seventy one cases of vesico-renal reflux in adults. Renal scarring was present in 76% of the cases, and in 11.5%, the kidneys were destroyed. The reflux was eliminated in 95.5% of the cases treated by the Leadbetter-Politano, Cohen and Glenn Anderson procedures, but a failure rate of 26% was registered with the Lich Grégoir technique. 26.5% of the patients presented with persistent urinary tract infection six months after the successful surgical correction of the reflux.

[Cystic lymphangioma of the spermatic cord. Report of a new case]. / Lymphagiome kystique du cordon spermatique. A propos d'un nouveau cas.

We report a new case of spermatic cord lymphangioma in a young patient. It is a rare tumor of the lymphatic system. Only eleven cases have been reported in literature. This lesion tends to recur despite surgical ablation. The pathogenesis of this lesion is still controversial.

[Prolapse of neovagina after anterior pelvic exenteration for urethral cancer]. / Prolapsus du néo-vagin après pelvectomie antérieure pour cancer de l'urèthre.

The authors report the case of a patient undergoing anterior pelvic exenteration for cancer of the urethra with sigmoid colon urinary diversion and vaginal reconstruction using a colonic segment. The postoperative course was marked by prolapse of the neovagina requiring reoperation via a transvaginal approach. The modalities of this prolapse repair are described and the various possibilities for urinary diversion and vaginal reconstruction after pelvic exenteration in women are then discussed.

[Value of estramustine phosphate in the treatment of estrogen-resistant prostatic adenocarcinoma]. / Intérêt de l'estramustine phosphate dans le traitement des adénocarcinomes prostatiques oestrogéno-résistants.

Estramustine phosphate ( Estracyt ) was used in 32 patients with a mean age of 73 and a half years suffering from oestrogen-resistant carcinoma of the prostate. These carcinomas were advanced and were divided into 26 stage D and 6 stage C. Treatment was given orally at a dose of 600 mg per day. Results were assessed on the basis of reliable subjective and objective selected criteria. Objective responses were obtained in 28,1% of cases and subjective responses in 40.6%. All the patients in whom there was an objective response showed a subjective response. Objective action was more marked on the primary tumour than on metastases. There was a decrease in bone pain, an improvement in general condition and disappearance of dysuria in more than a third of all cases. When there was a response, it always occurred before the end of the 2nd month and was maximal at 3 months. The mean duration of a response was 29.1 months for objective responses and 27.7 months for subjective responses. Survival of patients responding to treatment was markedly longer (by 15 months on average) than in patients who failed to respond. The low level of toxicity of the compound, even after prolonged use, makes its use possible in all patients. Thus Estracyt is felt to have a role in the treatment of the severe forms represented by hormone-resistant carcinomas of the prostate.

Visualisation of transgene expression at the single protoplast level.

Protoplasts are currently used to study the expression of genes following transformation. Expression is followed on a population of protoplasts after total protein extraction by conventional western blotting or measure of the enzymatic activity of the transgenic protein. We describe here a new method, called protoplast printing, allowing easy detection of the fraction of cells expressing a certain protein within a population of protoplasts. It consists of immobilization of the protoplast proteins on a nitrocellulose filter, so as to retain the outlines of the cell, followed by immunological detection of the protein of interest. The only special requirement is an antibody specific for the protein. We have studied the expression of the BNYVV coat protein after electroporation of Chenopodium quinoa protoplasts with viral RNAs, and the expression of the NPT II gene in protoplasts isolated from transgenic tobacco plants as well as after direct transfer of plasmid DNA into tobacco protoplasts. In both cases - infection with viral RNAs and transformation with plasmid DNA - expressing and non-expressing cells can be distinguished as early as 12h after transfer of the transgenes.

Unusual structure of the double-stranded RNA associated with the '447' cytoplasmic male sterility in Vicia faba.

The 16.7 kbp dsRNA specific to the '447' cytoplasmic male sterility (CMS) line of Vicia faba was labelled in vitro with [alpha-32P]ATP and poly(A) polymerase, and by T4 RNA ligase-mediated addition of [32P]pCp. Analysis of the reaction products under denaturing conditions revealed in both cases extensive labelling of a 4.5 kb ssRNA, already detected in previous experiments in which the RNA-dependent RNA polymerase associated with the dsRNA was allowed to pursue RNA synthesis on preinitiated complexes. Mobility shift analysis of total pCp-labelled dsRNA revealed not two but three different 3' termini. The most prominent sequencing pattern corresponded to the 4.5 kb ssRNA, indicating that this RNA species has a preferentially accessible, free 3' OH extremity. Northern blot analysis of the denatured dsRNA confirmed that the 4.5 kb ssRNA is a subgenomic mRNA and detected its counterpart of about 12 kb. Nearly all 16.7 kbp dsRNA molecules featured an interrupted positive-sense strand, indicating a marked prevalence of transcription over replication complexes. This unusual strategy of transcription by a strand displacement mechanism, following initiation at an internal discontinuity, is compared with that of other dsRNA viruses or defective viruses, and is discussed in relation to the expression of the CMS trait.