Mannose-6-phosphate receptor: a target for theranostics of prostate cancer.

The development of personalized and non-invasive cancer therapies based on new targets combined with nanodevices is a major challenge in nanomedicine. In this work, the over-expression of a membrane lectin, the cation-independent mannose 6-phosphate receptor (M6PR), was specifically demonstrated in prostate cancer cell lines and tissues. To efficiently target this lectin a mannose-6-phosphate analogue was synthesized in six steps and grafted onto the surface of functionalized mesoporous silica nanoparticles (MSNs). These MSNs were used for in vitro and ex vivo photodynamic therapy to treat prostate cancer cell lines and primary cell cultures prepared from patient biopsies. The results demonstrated the efficiency of M6PR targeting for prostate cancer theranostic.

[Polysplenia syndrome: two cases in adults revealed by biliary and pancreatic malformations]. / Syndrome de polysplénie: à propos de deux cas révélés chez l'adulte par des malformations biliaires et pancréatiques.

Polysplenia Syndrome (PS) associates multiple spleens with other malformations usually cardiac, vascular, visceral and biliary. The diversity of these malformations and their embryological mechanisms are described in relation to two cases of PS that were diagnosed in adults.

Mycophenolate mofetil in combination with reduction of calcineurin inhibitors for chronic renal dysfunction after liver transplantation.

UNLABELLED: The purpose of the study was to introduce mycophenolate mofetil (MMF) in liver transplant recipients with renal dysfunction to decrease calcineurin inhibitor (CNI) dosages without increasing rejection risk. In this prospective, multicenter, randomized study, chronic CNI-related renal dysfunction was defined by an increase in serum creatinine with values >140 micromol/L and <300 micromol/L. Patients were randomized in 2 groups. STUDY GROUP: combination of MMF (2 to 3 g/day) and reduced dose of CNI >or=50% of initial dose; control group: no MMF, but with the ability to reduce CNI doses, but not below 75% of initial dose. Fifty-six patients were included, 27 in the study group and 29 in the control group. In the study group, there was a significant decrease in serum creatinine values, from 171.7 +/- 24.2 micromol/L at day 0 to 143.4 +/- 19 micromol/L at month 12 and a significant increase in creatinine clearance, from 42.6 +/- 10.9 mL/min to 51.7 +/- 13.8 mL/min. No rejection episode was observed in the study group. In the control group, there was no improvement of renal function, assessed by the changes in serum creatinine values, from 175.4 +/- 23.4 micromol/L at day 0 to 181.6 +/- 63 micromol/L at month 12, and in creatinine clearance, from 42.8 +/- 12.8 mL/min to 44.8 +/- 19.7 mL/min. The differences between the 2 groups were significant: P = 0.001 for serum creatinine, and P = 0.04 for creatinine clearance. In conclusion, the introduction of MMF combined with the reduction of at least 50% of CNI dose allowed the renal function of liver transplant recipients to significantly improve at 1 year, without any rejection episode and without significant secondary effects.

[Managing the complications of cirrhosis]. / Principes de prise en charge des complications des malades cirrhotiques.

The main complications of cirrhosis are gastrointestinal bleeding related to portal hypertension, ascites, spontaneous peritonitis, hepato-renal syndrome, encephalopathy and hepatocellular carcinoma. The apparition of these complications constitutes a major event for the patient. In addition to the etiological treatment, take charge of complications can improve the prognosis of the patients.

Are preoperative patterns of alcohol consumption predictive of relapse after liver transplantation for alcoholic liver disease?

Predictive factors for alcoholic relapse after liver transplantation (LT) performed for alcoholic liver disease (ALD) have been assessed in numerous studies, often with contradictory results. The aim of the study was to assess pretransplantation alcohol consumption characteristics on alcoholic relapse after LT. Patients transplanted for ALD for at least 6 months were included. An anonymous questionnaire assessed socio-demographic characteristics, medical history, and alcohol consumption before and after LT. Relapse was defined as any alcohol use after LT. Severe relapse was defined by heavy drinking: more than 21 units/week for males and 14 units/week for females. A total of 61 patients were studied. The mean follow up after LT was 49 +/- 34 months. Alcoholic relapse occurred in 32 of 61 patients (52%) and severe relapse in eight of 61 patients (13%). Risk factors for severe relapse were: length of abstinence before LT (P = 0.0001), more than one alcohol withdrawal before LT (P = 0.001), alcohol dependence (P = 0.05), alcohol abuse in first relatives (P = 0.05), and younger age (P = 0.05). Information on previous alcohol consumption (dependence, number of withdrawals, family history) helps to predict severe relapse after LT in patients with ALD, allowing early awareness and specific postoperative care.

MRI thermodosimetry in laser-induced interstitial thermotherapy.

BACKGROUND AND OBJECTIVES: The aim of this study was to establish a correlation between a thermal measurement and a magnetic resonance imaging (MRI) signal during laser-induced interstitial thermotherapy (LITT) in liver. STUDY DESIGN/MATERIALS AND METHODS: Pig liver was irradiated for 15 minutes with a diode laser at two different powers, 0.5 W (450 J) and 1.5 W (1,350 J). Tissue temperature was monitored every 20 seconds using thermocouples. Thermosensitive MRI sequences (T(1)-weighted Turbo-Flash) were acquired with the same irradiation parameters. Correlation between MRI signals (SI) and temperature measures was defined at two different distances from the fiber (5 and 10 mm). RESULTS: At 0.5 W, temperatures rose progressively up to a maximum increase of 9.5 degrees C at 5 mm and 4 degrees C at 10 mm after 15 minutes. The corresponding MRI signal decreased progressively to -27.6 SI at 5 mm and -18.5 SI at 10 mm. At 1.5 W, temperatures rose dramatically at 5 mm, reaching a plateau. The temperature elevation measured at the end of the irradiation was of 30 degrees C whereas at 10 mm it was only 14.5 degrees C. The MRI signal varied accordingly, remaining inversely proportional to temperature (-76 SI at 5 mm and -35.5 SI at 10 mm). CONCLUSIONS: An inversely proportional relationship was observed between MRI signal in sequential Turbo-Flash and temperature. MRI should allow to analyze heat diffusion in the liver, and thus to monitor real-time LITT treatments.