Ecology of Scedosporium Species: Present Knowledge and Future Research.

The genus Scedosporium, which comprises at least five clinically relevant species, i.e. Scedosporium apiospermum, Scedosporium boydii, Scedosporium aurantiacum, Scedosporium dehoogii and Scedosporium minutisporum, ranks the second among the filamentous fungi colonizing the airways of patients with cystic fibrosis (CF). This colonization of the airways is thought to contribute to the inflammatory reaction leading to a progressive deterioration of the lung function. Additionally, these colonizing fungi may lead to severe disseminated infections in case of lung transplantation. Therefore, considering the low susceptibility of Scedosporium species to all current antifungal drugs, preventive measures should be defined to reduce the risk of exposure to these fungi for non-colonized CF patients. With this in mind, several studies have been conducted to elucidate the ecology of these fungi and to define possible sources of patient contamination. This review will summarize the major outcomes of those studies, including: the clear demonstration that ecological niches of Scedosporium species are strongly impacted by human activities, and the ability of Scedosporium species to degrade aliphatic and aromatic pollutants which supports the high occurrence of these species in contaminated soils and polluted waters and makes them promising candidates for bioremediation purposes. Finally, prospects for future research in this field are proposed.

Description of a regional anaesthesia technique for the dorsal cranium in the dog: a cadaveric study.

OBJECTIVE: To identify landmarks and to describe a technique for nerve blockade of the dorsal cranium in dogs. STUDY DESIGN: Anatomic cadaveric study. ANIMALS: A total of 39 dog cadavers, weighing 18.0 ± 9.7 kg (mean ± standard deviation). METHODS: The study was performed in three parts. In the initial part, cadavers were dissected to determine the location of the frontal, zygomaticotemporal, and major occipital nerves, and to identify prominent landmarks for their blockade. In the second part, one technique was developed to block each of the frontal and zygomaticotemporal nerves, and two techniques, rostral and caudal, were developed to block the major occipital nerve. Injection solution was 0.05% methylene blue in 0.5% bupivacaine. In the third part, cadavers were used to test the techniques developed in the second part with 0.04 mL kg-1 of the same injectate administered at each site (maximal volume 0.5 mL per site). The length of nerve stained was measured, with a length ≥6 mm considered successful. Confidence intervals were calculated using Fisher's exact test. RESULTS: Success rates (95% confidence interval) for the frontal, zygomaticotemporal, and rostral and caudal locations for the major occipital nerve were 94% (80-99%), 91% (76-98%), 74% (58-86%) and 77% (59-89%), respectively. With a combination of both locations, the success rate for the major occipital nerve was 100% (90-100%). CONCLUSION AND CLINICAL RELEVANCE: This study describes a simple regional anaesthesia technique using palpable anatomical landmarks that may provide analgesia for dogs undergoing craniotomy.

Pseudomonas aeruginosa septic trapezo-metacarpal arthritis after prostate laser vaporization.

Prostatic laser vaporization resection is a new and fast growing technique. Most publications compare this technique to the standard diathermic snare prostate resection without considering its particular complications. Septic arthritis of the trapezio-metacarpal joint is particularly rare if it has a haematogenous origin. We present here the case of a 65-year-old man with an isolated trapezio-metacarpal Pseudomonas aeruginosa arthritis with a haematogenous origin following a laser vaporization prostate resection.

Transcutaneous PCO2 monitoring in infants hospitalized with viral bronchiolitis.

UNLABELLED: Our objective was to assess within a feasibility study the correlation and agreement of transcutaneous carbon dioxide (PtcCO2) monitoring with venous carbon dioxide (PvCO2) in infants with bronchiolitis in the emergency room (ER) and pediatric department. Sixty infants (aged 3.6 ± 3.3 months) admitted to our ER with bronchiolitis were included. PtcCO2 measurements (SenTec Digital Monitoring System) collected prospectively were compared with simultaneous PvCO2 drawn for patient care. Analysis included 100 measurements. The correlation of PtcCO2 and PvCO2 (r = 0.71, p < 0.001) was good, and the agreement (mean difference ± standard deviation of the differences 1.9 ± 7.0 mmHg) was adequate; average PtcCO2 was slightly lower than PvCO2. Changes in PtcCO2 and PvCO2 for consecutive measurements within each patient correlated (r = 0.41, p < 0.01). The level of PtcCO2 correlated with disease severity clinical score (p < 0.001). CONCLUSIONS: PtcCO2 monitoring was feasible in the ER and pediatric department and was found to have a good correlation and adequate agreement with PvCO2 in infants with bronchiolitis. Because the standard deviation of the differences was relatively high, though comparable to the literature, we suggest that PtcCO2 should not replace blood gas but rather serve as a complementary tool for trending and for real-time continuous assessment of the CO2 levels.

Plant cell piercing by a predatory mite: evidence and implications.

Omnivorous arthropods can play an important role as beneficial natural enemies because they can sustain their populations on plants when prey is scarce, thereby providing prophylactic protection against an array of herbivores. Although some omnivorous mite species of the family Phytoseiidae consume plant cell-sap, the feeding mechanism and its influence on the plant are not known. Using scanning electron microscopy we demonstrated that the omnivorous predatory mite Euseius scutalis penetrates epidermal cells of pepper foliage and wax membranes. Penetration holes were teardrop shape to oval, of 2-5 µm diameter. The similarities between penetration holes in pollen grains and in epidermal cells implied that the same penetration mechanism is used for pollen feeding and plant cell-sap uptake. Variation in shape and size of penetration holes in leaves and a wax membrane were attributed to different mite life stages, depth of penetration or the number of chelicerae puncturing (one or both). Punctured stomata, epidermal and vein cells appeared flat and lacking turgor. When the mite penetrated and damaged a single cell, neighboring cells were most often intact. In a growth chamber experiment very large numbers of E. scutalis negatively affected the growth of young pepper plants. Consequently caution should be taken when applying cell-piercing predators to young plants. Further studies are needed to take advantage of the potential sustainability of plant cell-sap feeding predators.

[A new technique for ensuring negative surgical margins during partial nephrectomy: the ex vivo ultrasound control]. / Une nouvelle technique de contrôle des marges de résection au cours de la néphrectomie partielle : l'échographie ex vivo.

OBJECTIVE: To evaluate the feasibility and the efficiency of intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by urologist. PATIENTS AND METHODS: Patients undergoing partial nephrectomy from July 2010 to November 2012 for T1-T2 renal tumors were included in analysis. Tumor margin status was immediately determined by ex vivo ultrasound done by the surgeon himself. Results were compared with margin status on definitive pathological evaluation. RESULTS: A total of 26 men and 15 women with a median age of 61 (30-82) years old were included in analysis. Intraoperative ex vivo ultrasound revealed negative surgical margins in 38 cases and positive margins in two. Final pathological results revealed negative margins in all except one case. Ultrasound sensitivity and specificity were 100% and 97%, respectively. Mean ultrasound duration was 1minute±1. Mean tumor and margin sizes were 3.4±1.8cm and 2.38±1.76mm, respectively. CONCLUSION: Intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by a urologist seemed to be feasible, efficient and easy.

[Emergency nephrectomies: retrospective monocentric study, about eight cases]. / Néphrectomies réalisées dans un contexte d'urgence: étude rétrospective, monocentrique à propos de huit cas.

OBJECTIVE: Emergency nephrectomies are rare because of the improvement of the management of urinary tract infections and the development of radio-embolization. Few series of patients have been reported. The objective of our study is to assess the indication, the morbi-mortality and the outcome of the emergency nephrectomy performed in our hospital. PATIENTS: Between January 2011 and November 2012, eight patients underwent an emergency nephrectomy at the University Hospital Center of Caen. The present review reports the characteristics of this emergency nephrectomy and their morbi-mortality. RESULTS: Six women and two men were analyzed retrospectively between January 2011 and November 2012. All patients except one needed intensive care for a multiple-organ failure. All these eight emergency nephrectomies concerned a native kidney with a surgical approach as a lombotomy or subcostal laparotomy. Both patients survived. One patient need a renal dialysis support. CONCLUSION: Emergency nephrectomy are rare. Uncontrolled urinary sepsis represents the main indication. Identifying the population at risk of evolution to the toxic shock is indispensable for a better and faster care and to reduce the mortality bound to the sepsis.

[Botulinum toxin A intradetrusor injections in consultation: single center experience during 2 years]. / Injections intradétrusoriennes de toxine botulique A en consultation : expérience d'un centre pendant deux ans.

OBJECTIVES: In departments of urology, intradetrusor botulinum toxin injections are routinely performed in ambulatory outpatient clinic. The aim of the study was to assess the satisfaction level of patients treated with this technique. PATIENTS AND METHODS: A satisfaction questionnaire was carried out by telephone for all patients treated in ambulatory outpatient clinic from 2009 to 2010. RESULTS: Twenty-six patients were treated in consultation during the studied period for a total of 46 sessions of injections. The average age was 48.81 (±16.78) years. An injection programme containing 20 or 30 points was performed after a local anesthetic. Twenty patients answered the questionnaire. As regards the organization of the injections, 12 patients (60%) declared to have been satisfied and seven very satisfied (35%). Eight patients (40%) were very satisfied with the management of the pain and six (30%) satisfied versus only one (5%) not satisfied at all. For the time spent in the hospital during the injections, 10 (50%) were satisfied and seven (35%) very satisfied. Only 4 patients (20%) would have preferred to be hospitalized in an outpatient facility. In cases of new injections, 18 (90%) patients would have preferred an identical coverage. Finally, 17 (85%) would recommend this procedure to one of their close relations. CONCLUSION: Our results showed that the majority of patients were completely satisfied with the injection programme. However, as patients are not currently covered by the national health system for these injections, this might hinder the development of this procedure.

Protein sorting in the endomembrane system of plant cells.

Although many properties of the targeting of plant endomembrane proteins are similar to mammalian and yeast systems, several clear differences are found that will be stressed in this review. In the past year, significant advances in our understanding of storage protein segregation in the endoplasmic reticulum, compartmentation of Golgi, and the signals for vacuolar protein targeting have been made. This work will form the basis for determining the mechanism of these sorting phenomena.

[Treatment of benign prostatic hyperplasia by Prostiva(®): about a series of 76 cases]. / Traitement de l'hyperplasie bénigne de prostate par Prostiva(®) : à propos d'une série de 76 patients.

PURPOSE: To evaluate the efficacy and morbidity of BPH treatment by radiofrequency in the general population and attempt to identify factors of prognostic value for this technique. METHODS: This retrospective study examined 76 consecutive patients of mean age 68.9 years with symptomatic BPH in failure of medical treatment and treated at University Hospital of Caen between April 2004 and October 2008. Urine status was assessed before and after treatment with radiofrequency by the international prostate symptom score (IPSS), the quality of life (QOL) score related to urinary symptoms, the measurement of maximum urinary flow (Qmax) and residual postvoid volume (RPV). Erectile function was assessed by the International Index of Erectile Function (IIEF-5). The primary endpoint was treatment failure by radiofrequency regarded as the reintroduction of medical treatment or the need for surgical treatment. The secondary endpoints were the improvement of IPSS and QOL score, Qmax and RPV. Morbidity per and post-operative was also evaluated. RESULTS: A significant improvement in voiding status was observed with an average IPSS score from 24.7 to 15.1 (P<0.0001), and a QOL score from 5.2 to 2.9 (P<0,0001) in all patients. The Qmax and the RPV were significantly improved from 8.6 to 13.1ml/s (P<0.0001) and 177 to 100ml (P=0.0002) respectively. The IIEF-5 score was improved from 9.04 to 9.97 (P=0.0164). Twenty-five percent of acute urinary retention, 7.9% of haematuria and 1.3% of prostatitis were observed postoperatively. The overall retreatment rate was 46% after 14.6 months mean follow-up. When stratified into groups, patients with the inclusion criteria to this treatment showed a treatment rates of 34.8% after 16.2 months mean follow-up against 51% after 13.8 months of monitoring patients outside the inclusion criteria. Without showing significant difference between retentionist and no retentionist concerning subjective and objective parameters, the rate of retreat was more important for retentionist (51.2% after 11.8 months of mean follow against 39.4% after 18.4 months) with a significant difference on the actuarial cumulative survival curve without reprocessing. There was no significant difference found in patients with a median lobe. The results showed an improvement in Qmax significantly greater in the group with prostates less than 60 g without being able to demonstrate significant differences in other parameters. The retreatment rates in this group was 44.4% after 14.7 months of follow-up against 53.8% after 13.8 months of follow-up in the group of patients with prostate over 60 g. Moreover, the irritative component made a better initial response to treatment with a need for retreatment delayed compared to the group of patients with obstructive symptom, without noting significant differences in terms of improvement of objective and subjective parameters. The rate of retreatment was 63.6% after 16.4 months of mean follow and 51.6% after 11.2 months in the "obstructive" group. CONCLUSION: High rates of reprocessing are observed in the treatment of BPH by radiofrequency if inclusion criteria are not respected.

Pneumocystis exhalation by infants developing Pneumocystis primary infection: putative infectious sources in hospitals and the community.

Pneumocystis jirovecii DNA was detected using a polymerase chain reaction assay in air samples collected using an air-liquid impaction device at 1 m distance from three out of 14 infants who had developed Pneumocystis primary infection. P. jirovecii genotype identification was successful in one out of three pairs of air samples. Matching of P. jirovecii genotypes between the nasopharyngeal and air samples suggested that P. jirovecii was effectively exhaled by the infected infant. These original results represent a proof of concept of the role of infants with primary pneumocystis infection as infectious sources of P. jirovecii in hospitals and in the community.

[Transurethral needle ablation Prostiva for treating symptomatic benign prostatic hyperplasia: a review]. / Traitement de l'hyperplasie bénigne de la prostate par radiofréquence monopolaire type Prostiva.

Benign prostatic hyperplasia (BPH) is a common disease affecting a large proportion of men older than 50 years. There are multiple treatment options for BPH including medications, minimally invasive options such as transurethral needle ablation (Tuna) and transurethral microwave therapy (TUMT), and more invasive options such as transurethral laser vaporization and transurethral resection of the prostate (TURP). The minimally invasive options induce thermal injury to the BPH adenoma with a lower risk of permanent side effects than TURP. Tuna treatment is a minimally invasive technique of BPH which can be carried out in ambulatory surgery and which is effective for urinary symptoms with little risk of morbidity. It is an alternative to medical treatment and does not replace planned surgical treatment. Available evidence suggests that Tuna is a relatively effective and safe technique. It significantly improves BPH parameters but it does not reach the same level efficacy and long-lasting success as TURP. Also the Tuna procedure compares favourably to combination medical therapy for the treatment of BPH on a cost basis. α-Blocker monotherapy is less costly than Tuna for 5 years, while the cost of 5α-reductase inhibitor monotherapy is approximately equivalent to that of Tuna for 5 years. From the payer's perspective, the break-even point between the Tuna(®) procedure and combination medical management occurs after approximately 2 years 7 months of treatment.

[Input from a specialized nurse consultation in the management of detrusor overactivity treated with intradetrusor injections of botulinum toxin in urology department. Pilot study]. / Apports d'une consultation infirmière spécialisée dans la prise en charge de l'hyperactivité détrusorienne traitée par injections intradétrusoriennes de toxine botulique dans un service d'urologie. Expérience pilote.

OBJECTIVES: To adapt in daily practice, in a urology department, recommendations for good clinical practice for follow-up of neurological patients with neurogenic detrusor overactivity treated with injections of botulinum toxin type A by involving a referent nurse in neuro-urology. METHOD: A nurse consultation in neuro-urology has been created in June 2007 to intervene at each follow-up consultation at D0, D8, D45, then by phone until reappearance of functional signs to organize a new injection of botulinum toxin. This pilot study evaluated the faisability, the input on clinical workload, and the benefit on relationship between the patient and the caregiver. RESULTS: An improvement of the quality of care has been given to the patient since first contact to follow-up. The number of neurological patient transfers and waiting time between the recurrence of functional signs and new therapeutic care were reduced. The number of medical consultations has been reduced saving time to redistribute on other activities. Knowledge improvement and privileged relationship with the patient and the doctor were reported by the referent nurse. CONCLUSION: The participation of a referent nurse in neuro-urology has improved the quality of care of these patients from first contact to follow-up and has allowed adaptation of the recommendations in the practice of caring of an urology department.

The Long-Term Impact of Political Activism on Mental Wellbeing in the Context of Adult Immigrants Who Experienced Childhood Political Trauma.

There is limited literature on the long-term impact of political activism on mental wellbeing in the context of childhood political trauma and subsequent forced migration. Such information is important for developing mental health services suitable to this population. This qualitative study contributes to this gap by exploring the experience of an understudied population: adult Jewish Argentinian immigrants to Israel, who as children experienced the military dictatorship in Argentina (1976-1983). Thematic textual analysis of narrative interviews revealed that in the case of participants who escaped with their parents as political exiles to Israel, political activism during childhood and adulthood can be both a risk and protective factor and affect a range of positive and negative long-term mental health outcomes including resilience and symptoms that appear as Complex Post-Traumatic Stress Disorder.

Antifungal susceptibility testing practices in mycology laboratories in France, 2018.

A survey of mycology laboratories for antifungal susceptibility testing (AFST) was undertaken in France in 2018, to better understand the difference in practices between the participating centers and to identify the difficulties they may encounter as well as eventual gaps with published standards and guidelines. The survey captured information from 45 mycology laboratories in France on how they perform AFST (number of strains tested, preferred method, technical and quality aspects, interpretation of the MIC values, reading and interpretation difficulties). Results indicated that 86% of respondents used Etest as AFST method, with a combination of one to seven antifungal agents tested. Most of the participating laboratories used similar technical parameters to perform their AFST method and a large majority used, as recommended, internal and external quality assessments. Almost all the participating mycology laboratories (98%) reported difficulties to interpret the MIC values, especially when no clinical breakpoints are available. The survey highlighted that the current AFST practices in France need homogenization, particularly for MIC reading and interpretation.

Processing and lysosomal localization of a glycoprotein whose secretion is transformation stimulated.

The major excreted protein (MEP) of transformed mouse fibroblasts is a mannose 6-phosphate-containing glycoprotein whose synthesis and secretion are increased in malignantly transformed 3T3 cells and whose synthesis is increased by treatment of 3T3 cells with tumor promoters or growth factors. When pulse-labeled extracts from Kirsten virus-transformed NIH 3T3 (KNIH) cells were immunoprecipitated using an antibody against secreted MEP, one cellular protein was immunoprecipitated that had the same molecular weight and tryptic peptide map as the secreted protein. Pulse-chase labeling experiments showed that 50-60% of this 39,000-mol-wt form was secreted in transformed cells. Of the 40-50% remaining, approximately 5% was processed into two lower molecular weight forms (29,000 and 20,000) which are sequestered within the cell. Similar processing of these proteins was observed in the nontransformed parent NIH 3T3 (NIH) cells. However, in NIH cells, much less of the synthesized MEP was secreted. Measurements of steady-state levels of these three forms of cellular MEP by Western blot immunolocalization revealed approximately fourfold more MEP in KNIH cells than in NIH cells as well as differences in the relative distribution of MEP forms in transformed and nontransformed cells. Subcellular fractionation of KNIH cells on a Percoll gradient demonstrated a distribution of total MEP similar to that of several lysosomal enzymes. The light lysosomal/Golgi peak from these gradients contained both the precursor 39,000-mol-wt form of MEP and the 20,000-mol-wt form, whereas the heavy lysosomal peak was enriched in the 20,000-mol-wt form. The distribution of MEP forms was found to be similar in NIH cells except that the 29,000-mol-wt form was also seen to be enriched in the heavy lysosomal peak. This biochemical localization of MEP was confirmed by immunolocalization with light and electron microscopy. These data support the hypothesis that MEP is a lysosomal protein that is secreted by transformed cells.

An acid protease secreted by transformed cells interferes with antigen processing.

The major excreted protein of malignantly transformed mouse fibroblasts (MEP), which is the precursor to lysosomal cathepsin L, was used to study the effect of exogenous acid proteases on antigen processing. When MEP and native pigeon cytochrome c were added to Chinese hamster ovary (CHO) cells expressing transfected major histocompatability complex class II gene products, the antigen-specific T-cell hybridoma 2B4 did not respond to the antigen. MEP appears to destroy the antigen in an acid compartment of the presenting cell because: (a) MEP is only active as a protease under acid conditions; (b) mannose 6-phosphate inhibited the internalization of MEP and blocked its effect on antigen processing; (c) the destruction required the simultaneous entry of the antigen and MEP into the cells; and (d) cytochrome c fragment 66-104 which does not need to be processed stimulated 2B4 in the presence of MEP. These results support the hypothesis that antigen processing requires internalization of the antigen into an acidic compartment, and they provide a new model for the investigation of the contribution of acid proteases to the reduced immunocompetence of tumor-bearing animals.

[Treatment of benign prostatic hyperplasia by radiofrequency (TUNA): a monocentric study of 28 cases treated in ambulatory surgery]. / Traitement de l'hypertrophie bénigne de prostate par radiofréquence (TUNA) : étude monocentrique à propos de 28 cas traités en chirurgie ambulatoire.

AIM: To assess the feasibility of ambulatory surgery in the treatment of benign prostatic hyperplasia using radio frequency (TUNA) and evaluate its place in terms of efficiency among other minimally invasive surgical techniques. METHOD: Fifty-four patients suffering from benign prostatic hyperplasia and for whom medical treatment was ineffective, were treated with radio frequency between September 2004 and June 2007. Among them, 28 patients, whose average age was 65.8 (aged 52-82), were selected for Transurethral Needle Ablation (TUNA) as outpatients. Urine status was assessed before and after TUNA treatment using the International Prostate Score System, the Quality Of Life-score to urinary symptoms, the measures of the maximal flow rate and of the residual urine. The erectile function was assessed using the five-item version of the International Index of Erectile Function (IIEF-5). RESULTS: With an average regression of 12.14 months, a significant improvement in urine status was observed with an average IPSS score passing from 22.4 to 9.75 and an average quality of life score passing from 4.9 to 1.9. The maximum flow rate and average flow volume increased significantly from 8.66 to 14.6 ml/s and from 202 to 248.4 ml respectively. Average urine residue was reduced from 177.4 to 112.2 ml (p<0.05). The IIEF-5 score did not increase significantly (14.1 versus 12.8). There were no cases of patients being rehospitalised. One case of prostatitis and six cases of acute urinary retention were observed at the postoperative stage. The rate of retreat was 21.4%. CONCLUSION: TUNA treatment is a minimally invasive technique of benign prostatic hyperplasia which can be carried out in ambulatory surgery and which is effective for urinary symptoms with little risk of morbidity. It is an alternative to medical treatment and does not replace planned surgical treatment.

Inhibitory effects on mushroom tyrosinase by flavones from the stem barks of Morus lhou (S.) Koidz.

Five flavones displaying tyrosinase inhibitory activity were isolated from the stem barks of Morus lhou (S.) Koidz., a cultivated edible plant. The isolated compounds were identified as mormin (1), cyclomorusin (2), morusin (3), kuwanon C (4), and norartocarpetin (5). Mormin (1) was characterized as a new flavone possesing a 3-hydroxymethyl-2-butenyl at C-3. The inhibitory potencies of these flavonoids toward monophenolase activity of mushroom tyrosinase were investigated. The IC50 values of compounds 1-5 for monophenolase activity were determined to be 0.088, 0.092, 0.250, 0.135 mM, and 1.2 microM, respectively. Mormin (1), cyclomorusin (2), kuwanon C (4) and norartocarpetin (5) exhibited competitive inhibition characteristics. Interestingly norartocarpetin (5) showed a time-dependent inhibition against oxidation of L-tyrosine: it also operated under the enzyme isomerization model (k5 = 0.8424 min(-1), k6 = 0.0576 min(-1), K(app)(i) = 1.354 microM).