Polluter identification with spaceborne radar imagery, AIS and forward drift modeling.

This study defines and assesses a new operational concept to identify the origin of pollution at sea, based on Synthetic Aperture Radar, Automatic Identification System, and a forward drift model. As opposed to traditional methodologies where the SAR detected pollution is backtracked in the past, our approach assumes that all the vessels pollute all along their way. Based on all the AIS data flows, the forward-tracked simulated pollutions are then compared to the detected pollution, and the potential polluter can be finally identified. Case studies are presented to showcase its usefulness in a variety of maritime situations with a focus on orphan pollutions in a dense traffic area. Out of the identification of the suspected polluters, the age and eventually the type of the pollution can be retrieved.

[Evaluation of the immediate transfusion reaction incident reporting system at the Brest University Hospital Center]. / Evaluation du système de notification des incidents transfusionnels immédiats au CHU de Brest.

The Haemovigilance Unit of Brest University Hospital has had a reporting system of transfusion reactions since october 1994. Reporting "any unexpected or undesirable effect due or likely to be due to the administering of blood cell components" must be done on an answering machine immediately or in the next eight hours. The main goal of the evaluation of this epidemiological surveillance system was to assess its sensitivity, its positive predictive value, its acceptability, its timeliness and its simplicity, according to the Centers for Disease Control criteria. An exhaustive monitoring of the immediate transfusion reactions (ITR) occurring within the 24 hours following the procedure was conducted from April 1, to June 30, 1998. Two sources of information were used, the spontaneous notification to the Haemovigilance Unit using the answering machine, and a telephone survey of the nurse responsible for the transfusion or post-transfusion follow-up. During the survey, 19 ITR, among which 12 were reported to the Haemovigilance Unit on the answering machine, were recorded. The incidence rate of the I.T.R. was estimated at 5@1000 transfused blood cell components. The sensitivity of the notification system was estimated at 63% (95% confidence interval: 41-85) and the positive predictive value at 70% (95% confidence interval: 48-92). This notification system is operational. The function of sanitary alert is ensured at the primary level of the system surveillance. The undernotification of the ITR (37% of false negative) must be corrected by specific recommendations.

[Demonstration of clonal heterogeneity in adenocarcinomas on Barrett's esophagus by flow cytometric study of cellular DNA content]. / Mise en évidence d'une hétérogénéité clonale au niveau des adénocarcinomes sur endobrachyoesophage par l'étude cytofluorométrique du contenu cellulaire en ADN.

Flow cytometry was used to examine the spatial distribution of nuclear DNA content in Barrett's mucosa, in one patient with high grade dysplasia and in 6 patients with Barrett's adenocarcinoma. All tumors were aneuploid. Each adenocarcinoma but the most advanced seemed to arise from a single clone of aneuploid or near-tetraploid cells which was found in all biopsy specimens taken from the tumor. Multiple aneuploid populations of cells were seen in the larger tumors. Eight clones were individualized in the most advanced case of cancer. In all patients with carcinoma, the mucosa surrounding the tumor was aneuploid. Some areas were characterized by the same DNA index as in the tumor, others contained distinct aneuploid cell populations. The spatial distributions of aneuploid clones and dysplastic areas were not perfectly superimposed. These data suggest that neoplastic progression in Barrett's esophagus is associated with genomic instability preceding the development of malignancy. Clonal heterogeneity in Barrett's adenocarcinoma is more marked when compared to other tumors and suggests a majoration of genomic instability during tumor progression.

[Keratoconus, changes in corneal topography and allergy. Study of 3 groups of patients]. / Kératocône, modification de la topographie cornéenne et allergie. Etude de trois groupes de patients.

PURPOSE: To study the relation between keratoconus and atopy based on allergic prick tests, and the association of infraclinical keratoconus with atopy compared to "normal eyes". Simultaneously corneal topographic modifications have been researched to patients presenting an ocular atopy versus normal patients. MATERIAL AND METHOD: A videokeratoscope has been used for the selection of 22 keratoconic patients, 17 infraclinical keratoconic subjects and 22 patients with no ocular abnormality. Incidence of allergic phenomenon was assessed with two tests (Prick test, lacrymal total IgE dose). The videokeratoscopy was also performed in the research of corneal modifications in a group of 45 patients with an ocular atopy. RESULTS: The results of allergologic tests (positives Prick tests) showed a statistical significant difference between the keratoconus group (63.6%) and respectively the infraclinical keratoconus group (23.5%) and the normal eyes group (22.7%). No videotopographic picture of keratoconus and infraclinical keratoconus has been noted in patients with ocular atopy. CONCLUSION: Keratoconus is related to allergy. In this study, no association of allergy with infraclinical keratoconus was found. Further more, no videotopographic changes was observed in ocular allergic cases.

[A case of an accessory soleus muscle]. / Une observation de soléaire accessoire.

The authors describe a case of accessory soleus muscle they have seen. It caused the development of a painful swelling on the medial side of the lower third of the leg with progressive equinovarus deformity of the foot. The upper attachment of the accessory muscle was in front of the normal muscle and distally was attached to the inner aspect of the calcaneus. The case was treated by transferring the accessory tendon to the tendo Achillis. 7 other cases reported in the literature are discussed in detail.

[Immune evaluation in oncologic surgery]. / Le bilan immunitaire en chirurgie carcinologique.

Immunity-linked cells include the lymphocytes and phagocytes. The former can be counted by the rosette techniques or by monoclonal antibodies, while for the latter their function is determined mainly. Good correction has been demonstrated, for example, between the number of so-called E active rosettes and both tumor extension and patient survival. The surgical act itself exaggerates the satellite anomalies of the cancer, but in any case it is followed by immunotherapy which justifies a second application of immunologic techniques.

Predictive value of T-cell subset derangements in lung cancer.

The proportions of T-lymphocytes, T-lymphocyte subsets, NK cells, DR determinant and interleukin-2 receptor-bearing T-lymphocytes were enumerated in 39 patients with lung cancer prior to any chemotherapy. T-lymphocytes, suppressor/cytotoxic T-cells and interleukin-2 receptor-bearing T-cells were found to be significantly higher in patients responding than in those not responding to chemotherapy. Such mononuclear cell subset analysis by monoclonal antibodies might be additional information to consider before undertaking treatment.

Cytochrome P450 metabolic dealkylation of nine N-nitrosodialkylamines by human liver microsomes.

The metabolic dealkylation of nine nitrosodialkylamines, including five symmetrical (nitrosodimethylamine, nitrosodiethylamine, nitrosodipropylamine, nitrosodibutylamine and nitrosodiamylamine) and four asymmetrical nitrosodialkylamines (nitrosomethylethylamine, nitrosomethylpropylamine, nitrosomethylbutylamine and nitrosomethylamylamine), was investigated in 14 samples of human liver microsomes. All these nitrosodialkylamines were dealkytated to aldehydes that were separated by reversed phase HPLC and UV detected as dinitrophenylhydrazones. As the length of the alkyl chain increased from methyl to pentyl, dealkylation of symmetrical nitrosodialkylamines became less efficiently catalyzed by cytochrome P450. Conversely, oxidation of the methyl moiety of asymmetrical nitrosomethylalkylamines increased with the size of the alkyl moiety, while dealkylation of the longer alkyl group decreased. N-Dealkylase activities were significantly correlated with P450 activities measured in human liver microsomes. These catalytic activities involve CYP2A6 (coumarin 7-hydroxylation), CYP2C (mephenytoin 4-hydroxylation and tolbutamide hydroxylation), CYP2D6 (dextromethorphan O-demethylation), CYP2E1 (chlorzoxazone and p-nitrophenol hydroxylation) and CYP3A4 (nifedipine oxidation). By using 10 heterologously expressed P450s, it was shown that nitrosodimethylamine was mainly demethylated by CYP2E1. However, such enzyme specificity was lost with increasing size of the alkyl group. Therefore, the chain length of the alkyl group of nitrosodialkylamines determined the P450 involved in its oxidation. All these results emphasize that the catalytic site of P450 2EI has a geometric configuration such that only small molecules like nitrosodimethylamine fit favorably within the putative active site of the enzyme. Furthermore, there is good evidence that P450s other than P450 2E1, such as P450 2A6, 2C8/2C9/2C19 and 3A4, are involved in the metabolism of nitrosodialkylamines bearing bulky alkyl chains.

[Annular pancreas in the adult (author's transl)]. / Le pancréas annulaire de l'adulte.

Annular pancreas--a congenital malformation consisting of a ring of pancreatic tissue around the second part of the duodenum--is a rare surgical condition in adults. It may be responsible for occlusion in the newborn, but frequently remains latent or does not reveal itself until adulthood, usually around the age of 40. The only symptoms are ulcer-like epigastric pains; vomiting occurs at a late stage and jaundice irregularly. Hypotonic duodenography shows, at best, duodenal stenosis, the extrinsic origin of which is disclosed by fiberoscopy. Pre-operative investigations should aim at detecting a gastro-duodenal ulcer or an associated chronic pancreatitis. Owing to the presence of an excretory duct within the ring, section of the latter entails a risk of fistulisation. The best prospects of cure are offered by digestive tract derivation procedures: latero-lateral duodeno-duodenostomy, gastro-enterostomy and duodeno-jejunostomy on a Y-shaped excluded jejunal loop.

5-Fluorouracil and cisplatin as palliative treatment of advanced oesophageal squamous cell carcinoma. A multicentre randomised controlled trial. The French Associations for Surgical Research.

OBJECTIVE: To compare chemotherapy with no chemotherapy as palliative treatment for oesophageal squamous cell carcinoma. DESIGN: Randomised study. SETTING: Multicentre trial in France. SUBJECTS: Of 161 patients with histologically confirmed oesophageal squamous cell carcinoma located more than 5 cm from the mouth of the oesophagus, five were withdrawn because of protocol violation. The remaining 156 patients, 149 men and 7 women, mean (SD) age 58 (9) years range 36 to 77, were randomly allocated to either a control group without chemotherapy (n = 84) or a group treated by chemotherapy (n = 72). Patients were divided into four strata: I = complete resection of the tumour but with lymph node involvement (n = 62); II = incomplete resection of tumour leaving gross tumour behind (n = 58); III = no resection because of local or regional invasion (n = 22) ; and IV = no resection because of distant metastasis (n = 14). Exclusion criteria were histologically confirmed tracheobronchial involvement, oesophagotracheal fistula, Karnosky score < 50, cerebral metastases, or hepatic metastases occupying more than 30% of the liver, peritoneal carcinomatosis, associated or previously treated ear-nose-throat carcinoma, or complete resection of tumour without lymph node involvement. INTERVENTIONS: 5 fluorouracil (5FU) and cisplatin (CDDP) were given in 5-day courses, once every 28 days, for a maximum of eight cycles. 5 FU, 1 g/m2, was infused for 24 hours after a water overload, during five days. Cisplatin was given either in one dose of 100 mg/m2 at the beginning of the cycle or 20 mg/m2/day over three hours for five days. Duration of treatment ranged from 6-8 months. OUTCOME MEASURES: Median and actuarial survival. The subsidiary endpoint was quality of survival judged by complications of treatment, swallowing disorders, and the duration of ability to feed normally. RESULTS: There was no difference in survival, either overall (median = 12 months) or in any of the strata. There were however significantly more patients with neurological (p < 0.003), haematological (p < 0.0001), and renal (p < 0.0002) complications in the treated group compared with the control group. Four patients (6%) died of complications of chemotherapy. The course of swallowing disorders did not differ between the two groups. The duration of autonomous oral feeding was exactly the same in both groups (median = 10.5 months). CONCLUSION: The results suggest that 5FU and CDDP do not help in patients with squamous cell carcinoma of the oesophagus whether or not the tumour has been resected.

Expression of hepatitis C virus NS5A natural mutants in a hepatocytic cell line inhibits the antiviral effect of interferon in a PKR-independent manner.

The impact of hepatitis C virus NS5A protein mutations on interferon alfa (IFN-alpha) signaling pathway, cell proliferation, and viability is an important issue that is still under debate. We have therefore combined transient and stable expression in a human hepatocytic cell line (Huh7) of 3 full-length NS5A sequences, isolated from patients with or without response to IFN-alpha therapy. Expression of all 3 NS5A-reduced IFN-alpha global antiviral activity on both vesicular stomatitis virus (VSV) and encephalomyocarditis virus (EMCV) replication. We did not show, however, an effect of these 3 NS5A proteins on double-stranded RNA-dependent kinase (PKR) expression and activity as well as colocalization and coimmunoprecipitation between NS5A and PKR. We also failed to show an effect of the 3 NS5A mutants tested on cell proliferation and viability. Overall, our results support an important role of NS5A in controlling IFN-alpha antiviral activity; they show, however, that PKR-independent mechanisms are implicated, at least in liver-derived cells.

Chemoradiotherapy followed by surgery compared with surgery alone in squamous-cell cancer of the esophagus.

BACKGROUND: We conducted a multicenter, randomized trial to compare preoperative chemoradiotherapy followed by surgery with surgery alone in patients with stage I and II squamous-cell cancer of the esophagus. METHODS: The preoperative combined therapy consisted of two one-week courses; each involved radiotherapy, in a dose of 18.5 Gy delivered in five fractions of 3.7 Gy each, and 80 mg of cisplatin per square meter of body-surface area, administered 0 to 2 days before the first day of radiotherapy. The surgical plan included one-stage en bloc esophagectomy and proximal gastrectomy by the abdominal and right thoracic routes, to be performed immediately after randomization in the group assigned to surgery alone and two to four weeks after the completion of preoperative chemoradiotherapy in the group assigned to combined therapy. RESULTS: A total of 297 patients entered the study; 11 were found to be ineligible, and 4 were lost to follow-up. Of the remaining 282, 139 were assigned to surgery alone and 143 to combined therapy. After a median follow-up of 55.2 months, no significant difference in overall survival was observed; the median survival was 18.6 months for both groups. As compared with the group treated with surgery alone, the group treated preoperatively had longer disease-free survival (P=0.003), a longer interval free of local disease (P=0.01), a lower rate of cancer-related deaths (P=0.002), and a higher frequency of curative resection (P=0.017). However, there were more postoperative deaths (P=0.012) in the group treated preoperatively with chemoradiotherapy. Three prognostic factors were found to influence survival in a multivariate analysis: the disease stage, based on computed tomography; the location of the tumor; and whether the surgical resection was curative. CONCLUSIONS: In patients with squamous-cell esophageal cancer, preoperative chemoradiotherapy did not improve overall survival, but it did prolong disease-free survival and survival free of local disease.