Genome scans on experimentally evolved populations reveal candidate regions for adaptation to plant resistance in the potato cyst nematode Globodera pallida.

Improving resistance durability involves to be able to predict the adaptation speed of pathogen populations. Identifying the genetic bases of pathogen adaptation to plant resistances is a useful step to better understand and anticipate this phenomenon. Globodera pallida is a major pest of potato crop for which a resistance QTL, GpaVvrn , has been identified in Solanum vernei. However, its durability is threatened as G. pallida populations are able to adapt to the resistance in few generations. The aim of this study was to investigate the genomic regions involved in the resistance breakdown by coupling experimental evolution and high-density genome scan. We performed a whole-genome resequencing of pools of individuals (Pool-Seq) belonging to G. pallida lineages derived from two independent populations having experimentally evolved on susceptible and resistant potato cultivars. About 1.6 million SNPs were used to perform the genome scan using a recent model testing for adaptive differentiation and association to population-specific covariables. We identified 275 outliers and 31 of them, which also showed a significant reduction in diversity in adapted lineages, were investigated for their genic environment. Some candidate genomic regions contained genes putatively encoding effectors and were enriched in SPRYSECs, known in cyst nematodes to be involved in pathogenicity and in (a)virulence. Validated candidate SNPs will provide a useful molecular tool to follow frequencies of virulence alleles in natural G. pallida populations and define efficient strategies of use of potato resistances maximizing their durability.

[Assessment patient's sexuality after prolapse repair using the Elevate™ kit]. / Évaluation de la sexualité des patientes après pose de prothèse Elevate™ pour cure de prolapsus.

OBJECTIVES: The main aim of this study is to present the impact on the sexuality of patients after prolapse repair by a vaginal approach using the Elevate™ kit. Secondary objectives include the evaluation of the quality of life and presentation of anatomical results and complications. MATERIALS AND METHODS: This is a retrospective unicentric study of 177 patients with symptomatic urogenital prolapse, repair from 2009 to 2013, using anterior and/or posterior Elevate™ kit. Assessment sexuality was performed using a validated questionnaire, the PISQ-12. Anatomical outcomes and quality of life were assessed using the classification POP-Q and questionnaires PFDI20 and PFIQ-7 respectively. RESULTS: Response to the questionnaire was 53.1 % with a mean follow-up of 29 months (8-60). Forty-six patients were sexually (49 %) active after the procedure. The average score of postoperative questionnaire PISQ-12 was 34.5/48. De novo dyspareunia rate is 10.8 %. The anatomic success rate was 90 %, the exposure rate was 2.8 % and the retraction rate was 2.2 %. No patient with de novo dyspareunia had postoperative complication. CONCLUSION: The Elevate™ kit is associated with satisfactory functional and anatomical results. De novo dyspareunia rate is "acceptable" compared to the literature data.

[PROSPERE randomized controlled trial: laparoscopic sacropexy versus vaginal mesh for cystocele POP repair]. / Étude randomisée comparant la promontofixation cœlioscopique à la chirurgie prothétique par voie vaginale pour le traitement des cystocèles : PROSPERE (PROSthetic PElvic organ prolapse REpair).

BACKGROUND: Cystocele is a frequent and invalidating type of genital prolapse in woman. Sacropexy using synthetic mesh is considered the surgical gold standard, and the laparoscopic approach has supplanted the open abdominal route because it offers the same anatomical results with a lower morbidity. The use of mesh through the vaginal route may have many advantages: easiness to perform, shorter operative time and recovery, but may increase morbidity. In France, both laparoscopic sacropexy and vaginal mesh are commonly used to treat cystoceles. The French Haute Autorité de santé (HAS) has highlighted the lack of evaluation of safety assessment for vaginal meshes. METHOD/DESIGN: The main objective of the study is to compare the morbidity of laparoscopic sacropexy with vaginal mesh for cystocele repair. The primary endpoint will be the rate of surgical complications greater or equal to grade 2 of the Clavien-Dindo classification at 1-year follow-up. The secondary aims are to compare the functional results in the medium term (sexuality, urinary and bowel symptoms, pain), the impact on quality of life as well as anatomical results. PROSPERE is a randomized controlled trial conducted in 12 participating French hospitals. 262 patients, aged 45 to 75years old, with cystocele greater or equal to stage 2 of the POP-Q classification (isolated or not) will be included. Exclusion criterias are a previous surgical POP repair, and inability or contra-indication to one or the other technique. We have designed this study to answer the question of the choice between laparoscopic sacropexy and vaginal mesh for the treatment of cystocele. The PROSPERE trial aims to help better determine the indications for one or the other of these techniques, which are currently based on subjective choices or school attitudes. This is the reason why competent authorities have asked for such studies.

False positive lymph node activity on positron emission tomography (PET/CT) due to hemostatic compresses.

Combined positron emission tomography and computerized tomography (PET/CT) using 18-fluorodeoxyglucose (18-FDG) is the most effective study to identify invasion of pelvic and/or para-aortic lymph node chains in cancers of the uterine cervix. We report the case of a patient who underwent laparoscopic hysterectomy and cytoreductive surgery for endometrial cancer; postoperative PET/CT identified an intense localization of 18-FDG in the region of the right common iliac chain. This finding led to an open re-exploration at which the only finding was a granuloma arising in reaction to a hemostatic sponge.

Surgical treatment of recurring subareolar abscess using oncoplastic techniques.

PURPOSE: To evaluate the clinical and cosmetic results of our treatment of recurrent periareolar abscess. PATIENTS AND METHODS: Our technique was applied to 27 patients with recurrent periareolar abscess who had been previously surgically treated three or more times between January 2001 and December 2008. Our treatment combined resection of the fistula, the terminal milk ducts, and mammary gland involved in the inflammatory process. This was associated with glandular remodeling and a lift of the periareolar skin. Long-term clinical results and evaluation of cosmetic result are analyzed. RESULTS: The median age of patients was 36 years and the median course of disease was 5 years (2-11 years). The duration of follow-up was 37 months. Before being treated in our service, patients had a median of four prior surgeries for this condition (3-12). The average hospital stay was 3.2±0.6 days after surgery. One recurrence occurred among the 24 patients reviewed. She was treated by excision of the nipple and areola. Six patients (25%) rated their outcome excellent and 13 patients (54%) considered their results good. Five patients assessed their overall result as fair (21%), and no patients judged their results as poor. CONCLUSIONS: Our technique is simple and feasible and the results are encouraging. It can be used regardless of the location of the fistula around the periphery of the nipple-areola complex and it is perfectly suited to the management of chronic fistulous abscess.

[Peri-partum hemorrhage: surgical management]. / Hémorragies de la délivrance: prise en charge chirurgicale.

Surgeons must be aware of the surgical techniques necessary to control grave peri-partum hemorrhage which place the life of the mother in jeopardy; at times, surgery is the only life-saving solution in spite of all the medical, obstetrical, and interventional radiologic techniques which have been developed. Surgical indications and approaches must take into account several factors - the cause of the hemorrhage, the urgency defined by the hemodynamic status of the patient, the technical and human means available, and the obstetrical situation (vaginal versus caesarean delivery). When medical and obstetrical management along with fluid resuscitation prove inadequate, recourse to surgery is necessary. While hysterectomy and ligation of the hypogastric arteries are time-honored treatments of last recourse, newer techniques which are both simpler and less aggressive have been developed in recent years; these newer conservative techniques should be given first choice.

Improved characterization of FSHD mutations.

Facioscapulohumeral muscular dystrophy (FSHD) is caused by the shortest alleles of the 3.3kb-tandem repeat array D4Z4 at 4q35. Molecular diagnosis of FSHD depends upon the separation of unusually large alleles by pulse-field electrophoresis after EcoRI and EcoRI/BlnI digestion. The exact number of alleles could not however be directly inferred from the size of DNA fragments owing to polymorphisms in the telomeric region of the locus. Knowing the exact repeat number of disease causing alleles may benefit genetic counselling, help to understand the mechanism of this singular disease and the population dynamics of subtelomeric sequences variations. We present here a partial digestion mapping method giving the exact number of repeats for disease causing alleles, and we suggest that most inaccuracies induced by common polymorphisms could be reduced by using EcoRV in place of EcoRI. After studying more than 300 DNA samples with both the standard method and this new method, we show that alleles size can be evaluated with a precision of less than one half repeat, and that the variations in length of the truncated repeat in the telomeric region of the D4Z4 locus can be evaluated. The results suggest that at least one intact chromosome 4 type repeat at 4q35 is needed to cause FSHD.

Intra- and interspecific host discrimination by host-seeking larvae of coleopteran parasitoids.

Intraspecific host discrimination is widespread in solitary parasitoids whose adult females forage for and evaluate host suitability, whereas interspecific discrimination is less common. In some parasitoid species, mostly Diptera and Coleoptera, the larva performs the last step of host searching. It has been suggested that host discrimination will rarely occur in such host-seeking larvae because their low mobility results in a low host encounter rate. We determined the extent to which the larvae of Aleochara bilineata Gyllenhal (Coleoptera: Staphylinidae), a solitary parasitoid of aggregated Diptera pupae: (1) discriminated between unparasitized hosts and hosts parasitized by conspecifics; (2) used semiochemical cues to discriminate; (3) were influenced by life expectancy, presence of conspecifics and host availability in their host acceptance decision; and the extent to which (4) A. bilineata and A. bipustulata L., a species exploiting the same hosts and occurring sympatrically, showed interspecific host discrimination. A. bilineata larvae were able to discriminate between unparasitized hosts and hosts parasitized by conspecifics in a choice experiment. Such behavior has never previously been described for a coleopteran parasitoid or for a parasitoid species whose larvae perform host searching. Host discrimination in this species was not based on the presence of visual or tactile cues (e.g., entrance holes) but rather on chemical cues. The life expectancy of A. bilineata larvae was significantly shorter in the presence than in absence of hosts, and older larvae had lower parasitism success than young larvae in a 24-h experiment. However, the host acceptance decision of A. bilineata larvae was not influenced by larval age or the presence of conspecifics when the ratio of hosts per larva was greater than or equal to 1. When hosts were scarce, the degree of superparasitism increased significantly with the number of foraging conspecifics and the age of the larvae. Both species of Aleochara showed intra- and interspecific host discrimination in a choice experiment. In contrast to A. bipustulata, A. bilineata larvae more frequently parasitized hosts parasitized by A. bipustulata than those parasitized by conspecifics. We suggest that host discrimination will be frequent in solitary parasitoids with host-seeking larvae when hosts are aggregated.