Stauffer syndrome : a rare paraneoplastic complication of renal cell carcinoma to be kept in mind. Case report and literature survey.

The authors report the case of a 74-years-old woman treated by immunotherapy for a metastatic renal cell carcinoma and having developed an important cholestasis with thrombocytosis, increased CRP, leucocytosis and hypoalbuminemia. Liver remained free of metastases at medical imaging. The diagnosis of a Stauffer syndrome was confirmed by the hepatic biopsy. A complete response of liver disorders was obtained after nephrectomy. From literature survey, Stauffer syndrome should be kept in mind in cancer patients, especially those suffering from a renal cell carcinoma, presenting with cholestasis with no underlying cause.

Decellularized allografts as an alternative for reconstruction of large inferior alveolar nerve defects: a systematic review.

BACKGROUND: Inferior alveolar nerve (IAN) injuries are a clinical problem with devastating consequences, causing temporary or permanent paresthesia, significantly affecting the patient's quality of life. Despite morbidity, side effects and controversy regarding its results, autologous nerve grafting is still the main treatment for these type of lesions. However, due to advances in knowledge about nerve damage and with the aim of preventing the described problems of autografts, new treatment alternatives based on decellularized allografts have emerged. The aim of this systematic review was to evaluate the reported efficacy of decellularized allografts for the treatment of IAN damage. MATERIAL AND METHODS: We performed a systematic search in Pubmed, Scopus and Web of Science databases following the PRISMA guidelines. Cohort studies, randomized or non-randomized clinical studies, prospective or retrospective studies, without age limits and language restriction that included human subjects who received decellularized allograft as treatment for IAN damage were included. RESULTS: Six articles met the inclusion criteria and were included for data analysis. In all 6 articles, resolution of IAN damage was observed in more than 85% of patients after a 12-month follow-up period, and in 2 of them, complete resolution was observed in 100% of their patients at longer follow-ups. CONCLUSIONS: Decellularized allograft appears to be a promising alternative to resolve IAN lesions, without requiring a nerve autograft procedure. However, more randomized clinical trials are needed to validate adequate treatment modalities with decellularized allografts.

Both trait-neutrality and filtering effects are validated by the vegetation patterns detected in the functional recovery of sand grasslands.

Neutral theory of species assembly means that species assembly is governed by stochastic dispersal processes and fluctuations in established populations. An alternative theory suggests that assembly is strongly determined by functional trait filtering governed by abiotic and biotic filtering selecting species from the local species pool. To test these assumptions, in the current paper we analysed vegetation changes in the first 12 years of succession after heavy goose grazing on acidic sand. With trait-based analyses using permanent plots we addressed the following hypotheses: (i) High fluctuations in the trait values are typical in the first years; later a temporally divergent change in the trait patterns of sites with different vertical position became characteristic. (ii) In the functional diversity of regenerative and vegetative traits we expected different temporal patterns. We confirmed the first hypothesis, as in the first few years most traits displayed high fluctuations with no clear patterns. Our findings weakly supported the second hypothesis; while there were distinct patterns detected in the functional richness of traits, functional divergence and evenness displayed no clear distinctive patterns. We can conclude that both trait neutrality and filtering effects operate in the vegetation changes of the first period of secondary succession.

Trehalose sustains a higher post-thaw sperm motility than sucrose in vitrified human sperm.

One of the cryopreservation methods that best preserves sperm function is vitrification. However, comparative studies have not been performed to evaluate the effect of nonpermeable cryoprotectors on sperm function for prolonged periods of time post-devitrification. These times are necessary, especially in in vitro fertilisation and intrauterine insemination, for gamete interaction and then fertilisation to occur, while maintaining motility to arrive at the fertilisation site. In this study, sucrose (.25 m) and trehalose (.1 and .05 m) were compared in essential parameters like motility and plasma membrane integrity for 12 hr. Post-devitrification sperm motility using .1 m trehalose was 68.9%, higher than that obtained with .05 m trehalose (59.9%, p < .0081) and .25 m sucrose (57.9%, p < .0002). Similar results were obtained at 6 and 12 hr with .1 m trehalose (58.0% and 42.3% respectively) compared to .05 m trehalose (p < .0184 and p < .033) and .25 m sucrose (p < .0001 and p < .0012).There was no difference between .25 m sucrose and .05 m trehalose. Membrane integrity was best preserved at time 0 by .1 m trehalose (p < .05), but there was no significance at 6 and 12 hr compared to sucrose. Our results suggest that for assisted reproduction techniques that require motile spermatozoa for a longer period of time, use of .1 m trehalose is recommended in the sperm vitrification technique.

[A trans-hospital pilot programme for onco-geriatry. The experience of the CHC-Liege]. / Programme pilote trans-hospitalier d'onco-gériatrie.

The authors offered to 296 consecutive cancer patients aged > or = 70 to undergo a joint comprehensive geriatric and oncological assessment. After pluridisciplinary discussion, several reflections have emerged: the need in 15 - 32% of cases to reinforce the role of the paramedical staff; the correlation between age, low clinical indices, alteration of renal function as well as geriatric characteristics; 67% of evaluated cases presented a significant geriatric profile; recommendations for patients' management in relation to their pattern of frailty and health aging (standard, adapted or palliative treatment).

[Chronotherapy with 5-fluorouracil folinic acid and oxaliplatin delivered over 48 hours every second week in colorectal cancer. The CHC-Liège experience (Belgium)]. / Chronochimiothérapie à base de 5-fluorouracil, acide folinique et oxaliplatine administrée en deux jours toutes les deux semaines pour le cancer colorectal. L'expérience du CHC-Liège (Belgique).

One hundred and ten consecutive patients suffering from a colorectal cancer received chronotherapy infused over two days every two weeks. Each course comported 5 FU 3g/m(2), folinic acid (600 mg/m(2) - l. form or 1200 mg/m(2)--racemic form) and oxaliplatin (85/mg/m(2)--adjuvant indication or 100mg/m(2)--palliative indication). According to chronobiological concepts, 5 FU and folinic acid were infused from 10 pm to 10 am with a peak at 4 am while oxaliplatin was delivered from 10 am to 10 pm with a peak at 4 pm. The overall tolerance was excellent with a maximum of 17% patients experiencing a grade 3 toxicity. The toxicity was higher in women, in older patients (>=70) or in case of flat infusion. In adjuvant situation (60 cases), progression free and overall survivals established respectively at 76% (42+months) and 88% (45+months). Fifty-two percent response rate were recorded within the palliative group (50 cases) with an overall 68% disease control. Median progression free survival was seven months but median survival was not attained at 31+ months. Thirty percent patients could benefit from a curative surgery after chemotherapy. Older patients (>=70) experienced worsened survival. In conclusion, we think that our chrono-FOLFOX 2-12 should be proposed as standard treatment for colorectal cancer patients.

The role of seed bank in the dynamics of understorey in an oak forest in Hungary.

We studied the potential role of seed bank in the dynamics of the understorey in a turkey oak-sessile oak forest (Querceteum petraeae-cerris) in Hungary. We used long-term records of the herb layer (1973-2006) and the seed bank composition of 2006 to assess the role of seed bank in the regeneration of herb layer. The total cover of herb layer decreased from 22% (1973) to 6% (1988), and remained low (<10%) till 2006; coinciding with the increasing cover of secondary canopy dominated by Acer campestre. We found a low density seed bank (ca. 1300 seeds/m2). Altogether 33 species were germinated from the soil samples. A few generalist weed species composed the majority of seed bank. It was possible to assign a seed bank type for 19 species; 14 species out of 19 was long-term persistent. We found that the characteristic perennial forest herbs and grasses had only sparse seed bank. The Jaccard similarity between vegetation and seed bank was low (<30%). Our results suggest that the continuous establishment of forest herbs are not based on local persistent seed bank; it should be based on vegetative spreading and/or seed rain.

Leaf width, nrDNA and cpDNA its sequence variation within central European Bulbocodium vernum and B. versicolor (Colchicaceae) populations: are there really two taxa?

The taxonomy of the genus Bulbocodium, in which two European species, a smaller eastern (B. versicolor) and a more robust western (B. vernum) are included, has been controversial since the description of the eastern species in 1821. Nuclear encoded ribosomal DNA ITS1 and the entire chloroplast DNA ITS were sequenced from several European populations, from France to the Ukraine, and the leaf width of mature living individuals was measured and analysed by ANOVA and Tukey-test. Although the studied DNA regions proved to be invariable, leaf width shows extreme variability. We found no correlation between the leaf size of the individuals and the geographical position of the populations, and in addition, the sequenced DNA regions showed total uniformity. Thus, our results do not support the division of the genus Bulbocodium into two taxa, at least in the sampled area. The formerly described size variants can be treated taxonomically at the forma level.

[Cancer associated retinopathy (CAR). Two clinical cases and review of the literature]. / Cancer associated retinopathy (CAR). Présentation de deux cas cliniques et revue de la littérature.

The cancer associated retinopathy (CAR) is a paraneoplasic retinopathy in which an antigen-antibody reaction, due to retinal antigens, also expressed in tumours, leads to degeneration of retinal photoreceptor cells. We observed in CHL-Luxembourg, 2 clinical cases of non-Hodgkin's lymphoma with severe prognosis in whom we described the presence of anti-recoverin antibodies. The CAR is most frequently associated with small cell lung and ovarian carcinomas. Clinical symptoms (phosphenes, progressive loss of eyesight) sometimes, occur before the diagnostics of primary cancer. Retinal degeneration may be assessed by electroretinogram, visual field, fundus oculi. A crossed reactivity between tumour and retinal antigens may initiate an antigen-antibody reaction, that implicates optic lesions. Different antigenic proteins have been evidenced, the most frequent being the recoverin. This protein plays a role in the adaptation to light and darkness. It is expressed in more than 50% of different types of neoplastic cells and would play a role in tumour proliferation. The antigen-antibody reaction leads to death by apoptosis of photoreceptor and bipolar retinal cells. These antirecoverin antibodies are also observed in other retinal degenerative diseases. The diagnosis is confirmed by titration of antibodies in the serum by Western Blot, Elisa and immunohistochemical methods. However, this diagnosis is by exclusion (vs. brain metastasis, drug toxicity, demyelinating diseases, autoimmune non paraneoplastic retinopathies). Corticosteroids are the only therapy that can bring some benefit. There is no value in starting a therapy if the retinal degeneration has reached an advanced stage. Note that the CAR must be distinguished from the Melanoma Associated Retinopathy (MAR) which is a similar paraneoplastic syndrome, but with rapid evolution of its symptoms and different etio-pathogenesis.

[Adjuvant chemotherapy for Dukes B2 and C colon cancer combining 5-fluorouracil and folinic acid with or without carboplatin. Feasibility and comparison between standard and chronomodulated deliveries]. / Chimiothérapie adjuvante pour le cancer du colon de stades Dukes B2 et C comportant du 5-fluorouracile et de l'acide folinique, avec ou sans carboplatine. Faisabilité et comparaison d'une administration standard à une administration chronomodulée.

Thirty-seven patients operated from a Dukes B2-C colon cancer were randomised to receive as adjuvant infusional chemotherapy, nine 5 FU and folinic acid courses with or without carboplatin, as standard (de Gramont; 2 days every 2 weeks) or chronomodulated administration (4 days every 2 weeks). The overall tolerance was judged excellent with less than 7% courses with dose-adaptations. The two carboplatin arms presented an enhanced haematological toxicity, while some more cutaneous toxicity was observed in the chronomodulated arm with the three drugs.

[How I treat... refractory multiple myeloma with thalidomide]. / Comment je traite ... le myélome multiple réfractaire par thalidomide.

Despite the use of high-dose chemotherapy with autologous hematopoietic stem cell transplantation, multiple myeloma remains largely uncurable. Indeed complete remission rate is about 50% and median survival reaches 5 years without plateau. Recently thalidomide has been identified as a promising agent. We report the clinical story of 2 patients with refractory myeloma that we treated successfully with thalidomide.