The A∞ Condition, ε-Approximators, and Varopoulos Extensions in Uniform Domains.

Suppose that Ω⊂Rn+1, n≥1, is a uniform domain with n-Ahlfors regular boundary and L is a (not necessarily symmetric) divergence form elliptic, real, bounded operator in Ω. We show that the corresponding elliptic measure ωL is quantitatively absolutely continuous with respect to surface measure of ∂Ω in the sense that ωL∈A∞(σ) if and only if any bounded solution u to Lu=0 in Ω is ε-approximable for any ε∈(0,1). By ε-approximability of u we mean that there exists a function Φ=Φε such that ‖u-Φ‖L∞(Ω)≤ε‖u‖L∞(Ω) and the measure µ~Φ with dµ~=|∇Φ(Y)|dY is a Carleson measure with L∞ control over the Carleson norm. As a consequence of this approximability result, we show that boundary BMO functions with compact support can have Varopoulos-type extensions even in some sets with unrectifiable boundaries, that is, smooth extensions that converge non-tangentially back to the original data and that satisfy L1-type Carleson measure estimates with BMO control over the Carleson norm. Our result complements the recent work of Hofmann and the third named author who showed the existence of these types of extensions in the presence of a quantitative rectifiability hypothesis.

Coexistence of EGFR mutation and ALK translocation in NSCLC: literature review and case report of response to gefitinib.

The coexistence of EGFR and ALK-EML4 gene mutations represents a rare event (about 1%) in patients with non small cell lung cancer (NSCLC) and the few cases described in the literature have all been treated by different methods. We present the case of a 52-year-old woman with adenocarcinoma of the lung whose tumor had this double genetic aberration. The patient was immediately treated with gefitinib because the tumor was judged inoperable, but after two months she obtained an important clinical remission and was submitted to radical surgery. She is currently undergoing adjuvant treatment with gefitinib. A review of the literature on this double genetic aberration highlighted that further research is needed to define the best therapeutic approach.

[Internal and external quality controls for Elisa techniques of aspergillosis serodiagnosis: proposals of the group "sérodiagnostic fongique" of the Société française de mycologie médicale]. / Contrôles internes et externes de qualité pour les techniques Elisa de sérodiagnostic aspergillaire: propositions du groupe «sérodiagnostic fongique¼ de la Société française de mycologie médicale.

In the end of May 2012, a meeting of the group "sérodiagnostic fongique" of the "Société française de mycologie médicale" had concerned quality controls to use, in particular, in the follow-up of Elisa techniques. A preliminary investigation showed that the internal quality controls (CIQ), according to the terms defined by the accreditation, were not systematically used. In June, was published the new guide of the COFRAC SH-GTA-06 on quality controls, this text being applicable on July 1st, 2012. It incited the working group to formulate proposals on the choice of the CIQ for antigen and antibody Elisa in the aspergillosis serodiagnosis. Informations on the external evaluations of the quality (EEQ) have also been given to better define for what we can expect from it. All these controls will allow every laboratory to better master the used techniques and their conditions of realization. A strengthened dialogue between the users and the manufacturers should incite these last actors to improve the supplied kits. It will drive later to an improvement of the reliability of the results obtained by these techniques and their interest in the aspergillosis diagnosis.

[State of the art and method validations: application to fidelity performance]. / Etat de l'art et validation de techniques: application aux performances de fidélité

Current events of clinical laboratories in France argue a lot about quality management. Setting up an assurance quality system can be realized in many approaches listed by increasing requirements: respect of reglementary Guide de bonne exécution des analyses (GBEA), BioQualite qualification, certification and at last accreditation. This last step corresponds to the recognition of the competence of the laboratory to execute specifics tasks. Validation of methods used in the laboratory is a key point when you realize an accreditation package. Fidelity (repetability and reproductibility) is one of the parameters to check in your lab for quantitative methods. These performances are validated in comparison with targets beforehand defined (according to biological variation or state of the art). This article reports fidelity performances obtained in 2000 and 2006 by the participants to ProBioQual internal quality controls. Considering these performances obtained in routine conditions, the different possible approaches to define acceptability limits were discussed.

[About the choice of acceptability limits in external quality assessment schemes]. / Réflexion sur le choix des limites acceptables dans les programmes d'évaluation externe de la qualité

Quality control schemes are a practical tool used in clinical laboratories and an essential element for any quality assurance process. In France, external quality assessment schemes (EQAS) can be mandatory (as national quality control organized by AFSSAPS) or voluntary as those suggested by French associations (ProBioQual, CTCB or Asqualab). These EQAS usually evaluate participants according to their performances: this ranking depends on acceptability limits which are here compared. Various examples based on ProBioQual's background illustrate difficulties to plan out analytical quality specifications. A comment is given about the best criteria (state of the art or biological variation mainly) to be considered to delimit analytic goals. This discussion includes approaches suggested by French committee on accreditation (Cofrac). All criteria could be criticized but it is important to compare oneself laboratory to peers and also to take account of biological variation.

Efficacy of two different platinum- or anthracycline-containing chemotherapy regimens for the treatment of small cell lung cancer.

The records of 190 consecutive patients referred to our department to be treated for small cell lung cancer were retrospectively evaluated, and the outcomes were compared on the basis of their first-line treatment. 113 patients were treated with 4-6 courses of cyclophosphamide, epidoxorubicin and etoposide (CEVP16), 77 with 4-6 courses of carboplatin and etoposide (CBE). 72 patients had limited disease and 118 extensive disease. Response rates were 58.4% for CEVP16 and 28.6% for CBE (p=0.0001), with no significant difference in the time to progression (255 vs 246 days, p=0.21). Overall survival was 334 days and 212 days, and the 1-year survival rate was 46% and 22.1%, respectively (p=0.0018). In patients with limited disease, overall survival was 434 days and 249 days (p=0.08) in both treatment group respectively and 281 and 208 days in those with extensive disease, respectively (p=0.02). No difference in side effects was observed between the two groups of patients. Our data suggest a role for anthracycline-containing regimens as first-line treatment of small cell lung cancer.

Cell proliferation of the duodenal mucosa in patients affected by familial adenomatous polyposis.

BACKGROUND & AIMS: Patients affected by familial adenomatous polyposis (FAP) are at increased risk of developing duodenal adenomas. In this study, cell proliferation of duodenal mucosa was analyzed to detect kinetic abnormalities related to cancer risk. METHODS: Duodenal biopsy specimens were collected in three groups of patients: group A, 9 hospital controls; group B, 14 patients with FAP without duodenal adenomas; and group C, 6 patients with FAP and duodenal adenomas. Proliferative cell nuclear antigen was assessed through immunohistochemistry. The main labeling parameters were (1) overall labeling index (LI) and (2) LI in the upper 40% of the crypts. RESULTS: Overall LI in groups B and C was higher than in group A (both P < 0.01). LI in group C was also significantly higher than in group B (P < 0.01). Similarly, the upper 40% LI was higher in groups B and C than in group A (both P < 0.01). This value was higher in group C than in group B (P < 0.05). CONCLUSIONS: These data suggest the presence of cell kinetics abnormalities in FAP and the existence of two subgroups of patients with FAP at different risks of duodenal neoplasia. These abnormalities could be used as an intermediate biomarker for chemoprevention studies of duodenal cancer in FAP.

[Microalbuminuria and pregnancy. Is microalbuminuria predictive of pregnancy toxemia?]. / Microalbuminurie et grossesse. La microalbuminurie est-elle prédictive d'une toxémie gravidique?

Several authors have suggested that estimating the levels of microalbuminuria will help in early screening for pre-eclampsia. The purpose of this work has been to look for the absence of microalbuminuria in normal pregnancies and to work out its predictive value for the risk of toxaemia of pregnancy when it does appear. The study was carried out on 257 women of whom 43 were controls and 214 women who were pregnant and had neither diabetes nor hypertension and had no kidney infections. The samples of urine were gathered in a 12 hour period of night and those that gave a positive reaction for albumin were rejected. RIA techniques were used to work out the levels of albuminuria and these were confirmed by immunoassay. We have compared microalbuminuria, the relationship between urine albumin and creatinine and the clearance of albumin in relationship to albuminuria (as defined by the relationship of albumin and creatinine clearance). We have calculated the sensitivity and the specificity and the prognostic value both positive and negative for these four parameters. Our results show that in a normal pregnancy there should not be any microalbuminuria, and on the other hand that if microalbuminuria does appear according to the four parameters studied, they are all equally sensitive for predicting pre-eclampsia. The relative clearance of albumin from the urine seems to be the most interesting parameter as far as we are concerned, and it could lead to early screening for toxaemia.