Diversity, distribution and multi-functional attributes of bacterial communities associated with the rhizosphere and endosphere of timothy (Phleum pratense L.).

AIMS: To characterize the bacterial communities of the rhizosphere and endosphere of the forage grass timothy (Phleum pratense L.) and evaluate the functional attributes with respect to growth promotion properties, antimicrobial and biosurfactant capacities. METHODS AND RESULTS: A total of 254 culturable bacteria were identified using 16S rRNA sequencing and grouped into 16 taxa that shared high homology of 98-99% with other known sequences. A majority of the isolates were recovered from the rhizosphere soil fraction and leaf and crown tissues. Bacillus genus was the most abundant in the bulk and rhizosphere soil fractions. Isolates belonging to the Methylobacterium genus were exclusively found in leaves making them tissue-specific. A majority of the bacterial isolates exhibited multi-functional growth promotion attributes and plant stress improvement related to the production of indole 3-acetic acid, VOC and siderophores and polymer-degrading enzymes and 1-aminocyclopropane-1-carboxylate (ACC) deaminase activities. Some demonstrated antimicrobial properties such as hydrogen cyanide and biosurfactant production and activities of fungal cell wall degrading enzymes. The internalization and spread of selected bacterial isolates in timothy seedlings under gnotobiotic conditions was confirmed using the culture-dependent method and SEM microscopy in proof-of-concept experiments. CONCLUSIONS: The attributes of some isolates with respect to growth promotion abilities, biocontrol potential and efficient colonization of timothy make them desirable for future development as potential biofertilizer tools. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides the first evidence of bacterial endophytes that have the necessary functional attributes to protect cool-season forage grasses against abiotic stress.

[A bulky lateral cervical mass]. / Une volumineuse tuméfaction cervicale latérale.

Branchial cysts are rare, benign cervical lesions that can mimic thyroid goiters, in particular in areas where goiters are endemic. This case describes an Ivorian patient who presented with what appeared to be a voluminous thyroid goiter. At surgery, it proved to be a cyst of the second pharyngeal arch.

The validity of circulating microRNAs in oncology: five years of challenges and contradictions.

MicroRNAs (miRNAs) in circulation have received an increasing amount of interest as potential minimal invasive diagnostic tools in oncology. Several diagnostic, prognostic and predictive signatures have been proposed for a variety of cancers at different stages of disease, but these have not been subjected to a critical review regarding their validity: reproducible identification in comparable studies and/or with different platforms of miRNA detection. In this review, we will critically address the results of circulating miRNA research in oncology that have been published between January 2008 and June 2013 (5.5 years), and discuss pre-analytical challenges, technological pitfalls and limitations that may contribute to the non-reproducibility of circulating miRNA research.

[Ultrasound-guided percutaneous insertion of implantable venous devices: a review of 102 patients]. / Pose de chambre implantable par abord percutané échoguidé : à propos d'une série de 102 patients.

Techniques of insertion of implantable venous devices have been widely described. The use of ultrasound guidance is part of the good practice recommendations of the SOR 2008 but there are few data in the literature and recommendations are based only on expert agreement. To this end we conducted a prospective, single-center study from January 2008 to August 2009 on percutaneous ultrasound-guided insertion of implantable devices. In addition to age, sex, the therapeutic indication and the site of implantation, we identified the operative time and number of venipunctures performed for each procedure. We then identified the infectious complications at three months and thromboembolic complications at 1 year and a half. Our study examined 102 consecutive patients. The mean age was 61.8 years (28-90); 71% of patients were men. For 101 patients, the internal jugular vein was punctured, the subclavian vein in one patient. In 86% of cases, the implantable venous device was inserted into the right vein. The average length of procedure was 30 minutes (18-60) for a single-vein puncture. Among the 102 patients, the overall morbidity was 7.8% with four infections (3.9%) and four thromboses (3.9%). There were no immediate perioperative complications (arterial puncture, hematoma, pneumothorax). In conclusion, percutaneous ultrasound-guided insertion of implantable venous devices in the internal jugular vein is a safe, minimally invasive technique which complies with the 2008 SOR recommendations by preventing the risk of venous thrombosis and avoiding repeated venous puncture. Less invasive than the open surgical approach, ultrasound-guided insertion is safer than puncture based solely on anatomical landmarks. In summary, this is a reliable, simple and easily reproducible technique which limits iatrogenic risks and improves patient comfort.

French experience in the management of hemorrhoids by HAL™ Doppler.

OBJECTIVE: The goal of this study was to prospectively evaluate the surgical management of hemorrhoids by Doppler-guided hemorrhoidal artery ligation (Doppler HAL™). PATIENTS AND METHODS: This study was conducted between April 2008 and September 2009. The Doppler HAL™ technique was performed in patients with grades II to IV, irrespective of whether they had previously undergone medical or instrumental management or not. The other demographics of the studied population, the operative and post-operative results as well as the functional outcome at one month and at one year were recorded prospectively and analyzed retrospectively. RESULTS: Sixty-one consecutive patients (mean age 45 [range 28-85]) underwent Doppler HAL™. The mean duration of operation was 26minutes [range 18-45]. The average number of ligations per patient was seven. Three patients left the hospital the same day, 51 patients were discharged on day 1 and five patients on day 2. Post-operative mortality was nil. The post-operative morbidity rate was 4.9%. Functional results evaluated at one month and one year showed that initial symptoms had disappeared in more than 78% of patients. The recurrence rate for hemorrhoidal related disease was 10.5% during the first year. CONCLUSION: Surgical treatment of hemorrhoids by the Doppler-guided hemorrhoidal artery ligation technique is mini-invasive, with low morbidity, and satisfactory short and medium term functional results. This technique represents a reliable surgical alternative to classical hemorrhoidectomy and hemorrhoidopexy in the therapeutic strategy of hemorrhoidal disease.

[Iatrogenic false aneurysm of the splenic artery after cephalic duodenopancreatectomy]. / Faux anévrisme iatrogène de l'artère splénique après duodénopancréatectomie céphalique.

Splenic artery aneurysms are rare entities with many causes. Rupture can be fatal and usually occurs when the aneurismal diameter is greater than 2 cm. Nevertheless, smaller aneurysms, especially false aneurysms, can also rupture. We report a case of iatrogenic, false aneurysm of the splenic artery subsequent to percutaneous drainage of a retrogastric collection after cephalic duodenopancreatectomy. Splenectomy enabled favorable recovery.

Delayed colo-anal anastomosis is an alternative to prophylactic diverting stoma after total mesorectal excision for middle and low rectal carcinomas.

BACKGROUND: After total mesorectal excision (TME), a low colorectal or colo-anal anastomosis is usually performed. A prophylactic covering stoma is often used, especially for patients receiving neoadjuvant chemo-radiotherapy. However, morbidity is high, mainly due to anastomotic leakage. METHODS: From May 2000 to October 2008, patients with middle or low rectal cancer who underwent a trans-anal pull-through procedure after TME were prospectively recorded. No covering stoma was performed in these patients. However, they all underwent a delayed colo-anal anastomosis (DCA), which was performed 6 days following the TME, on average. Both the surgical technique and follow-up were standardised. Patients with T3, T4 and/or N+ cancers were given preoperative radiotherapy. A retrospective analysis was done to assess post-operative mortality, morbidity, and oncologic and functional results. RESULTS: One hundred consecutive patients with rectal tumours at a median distance of 5 cm from the anal verge underwent DCA after TME. The 5-year overall and disease-free survival rates were 81% and 66%, respectively. The post-operative mortality rate was 3% and the overall post-operative morbidity rate was 36%, with only 3 anastomotic leakages. After two years, 73% of the patients had good functional outcomes. CONCLUSION: The trans-anal pull-through procedure after TME, followed by DCA seems to be a safe and efficient sphincter-preserving procedure to treat patients with middle or low rectal cancer while avoiding a prophylactic, diverting stoma.

[Parasitic infection causing appendicitis]. / Appendicite parasitaire.

Retrospective analysis of the medical records of patients who underwent acute appendectomy in the Gastrointestinal Surgery Department of the Desgenettes Military Hospital in Lyon, France from the 1st of November 2009 to the 21th of February 2011, turned up two cases of appendicular parasitosis for a prevalence of 3.3%. Both patients presented acute appendicular oxyuriasis caused by Enterobius vermicularis that was discovered inadvertently after appendectomy. This unexpected diagnosis raises questions about the exact role of parasites in the physiopathology of appendicitis. Though appendicitis is the most common surgical emergency in France, appendix vermicularis is rare. In comparison, developing countries and particularly endemic areas such as sub-Saharan Africa show considerably higher appendicular parasitosis prevalence rates and greater variety in the parasites involved. The purpose of this article is to describe the different parasites with potential to affect the appendix, to discuss the different pathophysiological mechanisms underlying acute appendicitis, and to recall the need for medical treatment after appendectomy.

Tubulovillous adenoma of the appendix: a case report and review of the literature.

We report the case of a young woman hospitalized for a chronic appendicular syndrome. The histological examination of the resected specimen revealed a rare tumor: tubulovillous adenoma, discovered in 0.02% of all appendectomy procedures. Treatment is most often limited to appendectomy, but in the event of incomplete excision or associated adenocarcinoma, right hemicolectomy may be required. After surgery, a follow-up colonoscopy is recommended due to the higher risk of second gastrointestinal neoplasms in patients with appendicular tumors.

[Laparoscopic management of median arcuate ligament syndrome]. / Traitement du syndrome du ligament arqué médian par voie coelioscopique.

Median arcuate ligament syndrome is a rare disorder resulting from luminal narrowing of the celiac trunk. The classic management of median arcuate ligament syndrome involves the surgical division of the median arcuate ligament fibers in order to decompress the celiac trunk. This has traditionally required an upper midline incision. A few authors have described a successful laparoscopic release of celiac artery compression syndrome. Laparoscopy provides a less invasive, but equally effective method for decompressing the celiac trunk.

A novel autosomal recessive limb-girdle muscular dystrophy with quadriceps atrophy maps to 11p13-p12.

Limb-girdle muscular dystrophies (LGMD) are a heterogeneous group of pathologies. We have identified a cohort of 14 French-Canadian patients from eight different families displaying a novel form of LGMD with an autosomal recessive inheritance. These patients share some features with previously described cases of 'quadriceps myopathy' that evolved into an LGMD. All demonstrate quadriceps femoris asymmetrical atrophy. Creatine kinase values were variable from normal to 6000 U/l. Clinical evaluations and MRI studies demonstrate a variable intrafamilial and interfamilial phenotype. Asymmetrical muscle involvement was clinically observed and confirmed by imaging. MRI studies suggest that the hamstrings and the adductor magnus are the first limb muscles to demonstrate fatty infiltration. Muscle pathology shows no sign of active inflammation but increased endomysial connective tissue associated with basal lamina duplication and collagen disorganization. A genome-wide scan using the two largest families uncovered linkage to marker D11S1360 on chromosome 11p12 [multipoint logarithm of the odds (LOD) score of 2.78]. Further genotyping for the eight families confirmed linkage to this new LGMD locus (multipoint LOD score of 4.56). Fine mapping subsequently defined a less than 3.3 cM candidate interval on 11p13-p12. Haplotype analysis of carrier chromosomes suggests that the most frequent mutation may account for up to 81.3% of French-Canadian mutations. In this study, we describe the chromosomal locus of a new form of recessive LGMD with prominent quadriceps femoris atrophy.