Functional Rac-1 and Nck signaling networks are required for FGF-2-induced DNA synthesis in MCF-7 cells.

The effects of Fibroblast Growth Factor-2 (FGF-2) on breast cancer cell DNA synthesis are controversial. To elucidate the mechanisms by which FGF-2 stimulates or inhibits DNA synthesis, we analysed FGF-2 signaling pathways in breast cancer MCF-7 and MCF-7 cells overexpressing Ha-Ras (MCF-7ras). We found that FGF-2-induction of DNA synthesis correlates with Ras transient activation, FRS-2 tyrosine phosphorylation and low level of expression of p66Shc. In addition, Nck-associated proteins are highly tyrosine phosphorylated and JNK reaches a higher level of activation when FGF-2 triggers DNA synthesis. Interestingly upon FGF-2 treatment, JNK activation and DNA synthesis are dependent on Rac-1 activity. These results confirm that in MCF-7 cells, induction of DNA synthesis by FGF-2 requires a transient activation of the Ras/MAPK cascade and demonstrates for the first time that intact Rac-1 and Nck signaling networks are required.

Production and purification of active FGF2 via recombinant fusion protein.

Basic fibroblast growth factor (FGF2) is involved in both cell proliferation and differentiation processes. Heparin may interfere in the stability and biological activities of FGFs. However, it is difficult to obtain FGF preparation without traces of heparin since heparin affinity chromatographies are routinely used to prepare this growth factor. We have therefore devised a means of production of active recombinant FGF2 devoid of heparin traces. The bovine FGF2 gene was inserted into the pMAL-c prokaryotic expression vector and the recombinant protein was synthesised as a fusion product between the maltose binding protein (MBP) and FGF2. Purification of the FGF2 fusion protein was performed by an amylose affinity chromatography. Yields were similar to those obtained by using a traditional heparin affinity column purification procedure. The fusion protein (MBP-FGF2) and the cleaved-off FGF2 were tested for some of their biological properties and compared to recombinant FGF2 purified by heparin affinity chromatography. Mitogenic activity on Chinese hamster lung fibroblasts (CCL39) and neurite outgrowth on pheochromocytoma culture cells (PC12) were used as biological assays. The cleaved-off FGF2 was as active as commercially available recombinant FGF2 (ED50 at 0.16 and 0.04 nM respectively). However MBP-FGF2 was less active (ED50 at 0.9 nM) in both tests.

In situ grafting made easy. Modification of a technique.

In situ bypass grafting has come of age following a period of disenchantment. It has become, in some centers, the operation of choice for bypasses to the tibial and peroneal vessels. Two fundamentally different techniques for this procedure have evolved. The first, following the method of Hall, uses a retrograde valvulotome passed from the distal saphenous vein to the proximal vein; on withdrawal, it severs the valves. A second approach, that of Leather, uses microscissors and a right-angle valvulotome, along with a disposable valve stripper, to disrupt the valves. Proponents exist for both approaches. In 1983 we reported our protocol for in situ grafting using the Hall technique. A number of modifications have since been made to expedite the technique. We describe and provide illustrations of these modifications.

[Place of computed tomography in the diagnosis and assessment of the spread of malignant kidney tumors]. / Place de la tomodensitométrie dans le diagnostic et le bilan d'extension des tumeurs malignes du rein.

The value of computed tomography was assessed in 52 patients with malignant kidney tumors, of whom 34 had undergone nephrectomy. Findings on the CT scan in a small group of 9 patients, when it was employed mainly for diagnostic purposes, gave true results in 7 cases, its contribution being decisive in 3 of these 7 cases. Scanning replaced arteriography for evaluation of tumor spread in 40 patients, where it was found to be very effective for assessment of perirenal, pararenal and lymph node extension. A high percentage of doubtful results were obtained during the first few years of use of the CT scan for determining state of veins (renal vein and inferior vena cava). Subsequent refinements in technique markedly improved the incidence of positive results. Computed tomography should be employed as the method of first choice for determining the stage of malignant kidney tumors.

[Normal intrahepatic vessels. Remarks on their echographic image]. / Les vaisseaux intra-hépatiques normaux. Considération sur leur image échographique.

The sonographic appearances of intrahepatic vessels are demonstrated by the basic principles of ultrasonography. All intrahepatic vessels have a sonolucent lumen which may be blurred because of the slice-thickness effects. The vascular walls are detected only when they are perpendicularly struck by the ultrasound beam. The portal branches are visualized with satellite echoes which are reflections from the intraparenchymal hepatic arteries and/or biliary ducts, and from the collegenous sheath of the portal triad. These echoes are blended with the wall-echoes of the portal veins as to the major branches. For smaller branches they remain visible when the incidence of the ultrasound beam becomes less accurate, whereas the echoes from the portal veins tend to disappear. The echoes related to the hepatic veins only come from the walls of the veins, which are usually of medium size.

[X-ray computed tomography in the diagnosis of non-advanced stages of renal polycystosis in adults]. / Apport de la tomodensitométrie au diagnostic des stades non évolués de la polykystose rénale de l'adulte.

At early of non-advanced stages, the diagnosis of adult type polycystic disease may be very difficult using standard morphological techniques: IVU, echotomography. The CT scan is sometimes a decisive diagnostic feature when it shows diffuse invasion of parenchymal tissues by large numbers of cysts, certain measuring only millimetres. Its contribution is emphasised in five cases where the diagnosis was only suspected or envisaged by IVU and echotomography. In 4 of these cases the diagnosis of polycystic disease was confirmed by CT scan.

[Pseudo-ureterocele]. / Le pseudo-urétérocèle.

The authors describe nine cases of pseudo-ureterocele secondary to various obstructive lesions: bladder tumors, stones in the ureteral meatus, tuberculosis of the bladder. Certain radiological signs, such as asymmetrical swelling of the terminal ureter and the thick halo which surrounds the dilatation, can sometimes distinguish pseudo-ureteroceles from idiopathic ureteroceles, and associated radiological anomalies in the bladder are also of greater value for differentiation.

[Echographic aspects of intestinal invagination]. / Aspects échographiques de l'invagination intestinale.

Two cases of intestinal invagination were investigated by ultrasonography. The image in the first case was related to the palpable abdominal mass, suggesting a digestive tract lesion. In the second case, direct visualization of the invaginated but in the intestinal lamen appears to be a specific image which has not been reported previously.

[X-ray computed tomography and echography in the diagnosis of subcapsular hematoma of the kidney]. / Apports de la tomodensitométrie et de l'échographie dans le diagnostic des hématomes sous-capsulaires du rein.

Results and diagnostic value of computed tomography and ultrasound imaging in subcapsular hematoma of the kidney are discussed in relation to data from 9 cases. A positive diagnosis could be made in each case from CT scan images, but results of ultrasonography were less evident. An etiological diagnosis is difficult to establish and extreme caution is recommended before excluding a tumoral lesion, even in patients developing hematomas during anticoagulant treatment. Arteriography remains a valid examination since analysis of a large subcapsular hematoma by a CT scan is often risky, and a small cortical tumor may remain undetected.

[Multilocular cyst of the kidney. Characteristics of the imaging appearance]. / Kyste multiloculaire du rein. Particularités de l'imagerie.

Investigations in a patient with a multilocular cyst of kidney included urography, ultrasonography and computed tomography. Urography images showed a mass occupying the lower half of the left kidney with a lacunar image of pelvis, the association of these two elements suggesting a possible cancer of kidney. Ultrasound and computed tomography imaging demonstrated the fluid nature of the mass with absent partitioning. Findings were compared with data from the pathologic specimen which showed a main unilocular cyst with multiple satellite smaller cysts and a thick intrapyelic formation composed of microcystic aggregates. Pre-operative diagnosis of multilocular cyst was assisted by the use of modern imaging techniques: ultrasound and CT scan, which demonstrated a partitioned renal cystic lesion. Diagnosis is still difficult in atypical forms, however, and the relative frequency of an intrapyelic cyst protrusion is emphasized.

[Efficacy of modern imaging technics in the diagnosis of isolated angiomyolipoma of the kidney. Apropos of 11 cases]. / Efficacité de l'imagerie moderne dans le diagnostic des angiomyolipomes isolés du rein. A propos de 11 cas.

Ultrasound and computed tomography imaging techniques are very reliable methods of detection and diagnosis of renal angiomyolipoma not associated with the tuberous sclerosis of Bourneville's disease: results are considerably improved when compared with conventional investigations (IVU, arteriography). The series reported included 6 patients with large angiomyolipomas and 5 with lesions less than 2 cm in diameter discovered fortuitously on ultrasonography: all tumors were partially or totally hyperechogenic. The fatty tissue was detected in 9 of the 11 cases by computed tomography imaging.

[X-ray computed tomography in pheochromocytoma. Apropos of 20 cases]. / La tomodensitométrie dans les phéochromocytomes. A propos de 20 cas.

Study of 20 pheochromocytomas in 19 patients confirmed the remarkable sensitivity of computed tomography (100%) for the detection of their adrenal and juxtarenal localizations. However, ultrasonography was as effective as the CT scan in these same patients, and even detected latent tumors in several cases. Certain pheochromocytomas in this series presented unusual appearances, particularly two large tumors which were manifest as abdominal masses and a malignant form which provoked a total infarct of the homolateral kidney.

[Anterograde pyelography to assess morphology (author's transl)]. / La pyélographie antégrde à visée morphologique.

The use of anterograde pyelography to assess morphological changes revealed the presence of obstruction in the upper urinary tract, previously undetected by urography, in 61 patients studied. The technique, used almost exclusively to expose the pelvis over the last year, is described. Only in very rare cases was there a failure to puncture the renal pelvis, and no complications occurred. The relative indication of anterograde and retrograde pyelography are discussed, as well as the morphological data obtained by each method in different types of obstruction: complete, severe incomplete, and partial. The main indications for this procedure are reviewed as a function of the etiology.

[X-ray computed tomographic diagnosis of connective tissue tumors of the stomach of extrinsic development. Apropos of 6 cases]. / Le diagnostic tomodensitométrique des tumeurs conjonctives de l'estomac à développement extrinsèque. A propos de 6 observations.

Computed tomography findings appear to be very useful for the diagnosis of exogastric tumors on the basis of six cases: 4 leiomyosarcomas, 1 leiomyoblastoma and 1 schwannoma. The diagnosis of these usually large tumors arising within the gastric wall is often difficult through baryum opacification of the stomach (U.G.I.) owing to their exogastric growth. In the same way, endoscopy usually fails to evidence these tumors. Computed tomography permits to rule out an extrinsic tumor such as a hepatic or pancreatic one for instance and then to demonstrate the tumor originates within the gastric wall. The hypervascular pattern associated in most cases with central necrosis is demonstrated through contrast medium injection, what is a very typical and relatively constant-finding in these tumors.

[Pyelomanometry in obstructions of the upper urinary tract. Apropos of 26 cases]. / La pyélomanométrie dans les obstructions du tractus urinaire supérieur. A propos de vingt-six observations.

Pyelomanometry can be used in cases of ambiguous dilatation, to measure the pressure in the upper urinary tract during constant-flow perfusion through a percutaneous catheter (Whitaker's test). After recalling the principles of this method, and the technical procedure, the authors go on to discuss twenty six cases, analyzing the results, and comparing the advantages of this procedure with other methods of exploration.

Myofibroblastoma of breast--an appraisal of cytoskeletal phenotypes.

Myofibroblastoma of the breast is a recently described entity. Since its first description in 1987, less than 50 cases have been reported. We present the first (reported) myofibroblastoma to be detected as a non-palpable mass on a routine screening mammogram and emphasize the importance of not mis-diagnosing this rare cellular lesion as malignant on frozen section. Review of the literature demonstrates changes in the clinical presentation of myofibroblastomas. Once considered more common in men than in women, myofibroblastomas are now being reported with increasing frequency in women. The age at presentation is a decade earlier, and not surprizingly, the size of the earlier detected lesion is smaller. Recently four different cytoskeletal phenotypes (V, VA, VAD and VD) of myofibroblastomas have been described, depending upon the vimentin (V), actin (A), and desmin (D) immunoreactivity. Whereas vimentin reactivity is universal, actin and desmin immunoreactivity is variable, desmin being more frequently positive than actin. As more is known about the clinical behavior of myofibroblastomas, their rate of recurrence and malignant potential, if any, the relationship of the cytoskeletal content to prognosis may become clearer. Currently, complete immunohistochemical analysis and electron microscopic examination of this interesting breast lesion is recommended. List of abbreviations-Vimentin (V), actin (A), and desmin (D), vimentin and actin (VA), vimentin and desmin (VD), vimentin, actin and desmin (VAD).

[Early postoperative intestinal obstructions. Contribution of radiography to diagnosis of the type and to the indication for reoperation (experience in 84 cases)]. / Occlusions post-opératoires précoces. Apport de la radiographie au diagnostic de variété et à l'indication de réintervention. (Expérience de 84 observations)

The authors report 84 cases of post-operative intestinal obstruction and demonstrate the value of straight XRays and barium meal in the diagnosis of the variety of early post-operative obstruction and the indications for operation. In 74 cases out of 82, a precise diagnosis of the mechanical or paralytic nature of the obstruction was made and the operation always carried out under best possible conditions.

ACL reconstruction in children: a transphyseal technique.

The annual incidence of ACL tears is increasing steadily in pediatric patients. Chronic anterior instability causes meniscal lesions at a frequency that increases significantly with the injury-to-surgery interval. Conservative therapy, simple suturing, and isolated extra-articular tendon reconstruction are associated with high failure rates. Intra-articular arthroscopy-assisted tendon reconstruction is a good treatment method, although several different techniques have been described. We used a transphyseal technique with a hamstring tendon graft to treat 14 knees in 13 patients with a mean age of 13 years and 7 months. Mean injury-to-surgery interval was 6 months. Strict compliance with technical rules is required when using this technique. Bone tunnel diameter must not exceed 8 mm. Bone tunnels must be as vertical and central as possible. The fixation material must not bridge the physis (at the femur, cortical fixation; and at the tibia, fixation using a resorbable screw no longer than 25 mm combined with a staple). Meniscal lesions were present in half the knees and meniscal preservation considered mandatory. Conservative treatment of concomitant lesions was performed routinely. After a mean follow-up of 15 months, no recurrent tears or revision procedures for meniscectomy had been recorded. The IKDC grade was A or B in 93% of knees. The mean subjective IKDC score was 83.3 and the Lysholm score was in the excellent or good range in 93% of knees. Of the 14 knees, 2 exhibited signs suggesting femoral epiphysiodesis, with 4° of valgus deformity compared to the contra-lateral knee and no clinical consequences. Transphyseal reconstruction with open physes conducted in strict compliance with technical rules can be performed to control the instability and preserve the menisci. Nevertheless, this technique carries a risk of epiphysiodesis, chiefly at the femur.