Pelvic MRI for Endometriosis: A Diagnostic Challenge for the Inexperienced Radiologist. How Much Experience Is Enough?

PURPOSE: The purpose of this study was to investigate the impact of radiologist experience on diagnostic performance of pelvic magnetic resonance imaging (MRI) for the evaluation of endometriomas and different localisations of deep pelvic endometriosis (DPE). MATERIALS AND METHODS: In this prospective study all pelvic MRI examinations performed for pelvic endometriosis from December 2016 to August 2017 were evaluated by readers with different experience levels; junior resident (0-6 weeks of experience in female imaging), senior resident (7-24 weeks), fellow (6-24 months), and expert (10 years) in female imaging for the presence of endometriomas and DPE. Their evaluations were compared with surgery confirmed with pathology. Diagnostic performances of readers with different levels of experience were studied by the means of receiving operating characteristic curves and areas under the curve (AUC) were compared with the ones of the expert reader. RESULTS: Of 174 patients evaluated, the standard of reference was available for 59, consisting the final population of the study. The AUC for endometriomas, DPE for the posterior and anterior pelvic compartment, for rectosigmoid DPE and for overall evaluation were 0.983, 0.921, 0.615, 0.862, and 0.914 for the expert reader, 0.966 (p = 0.178), 0.805 (p = 0.001), 0.605 (p = 0.91), 0.872 (p = 0.317), and 0.849 (p = 0.0009) for the fellow level, 0.877 (p = 0.002), 0.757 (p < 0.001), 0.585 (p = 0.761), 0.744 (p = 0.239), and 0.787 (p = < 0.001) for the senior resident level and 0.861 (p = 0.177), 0.649 (p < 0.001), 0.648 (p = 0.774), 0.862 (p = 1), and 0.721 (p < 0.001) for the junior resident level. CONCLUSIONS: According to our results, interpretation of pelvic MRI for DPE should be performed by specialists as; even the performance of radiologists with up to 2 years of experience in female imaging was statistically inferior to that of experts.

Traumatic Obturator Hip Dislocation with Marginal Femoral Head Fracture in a 15-Year-Old Adolescent: A High-Energy Trauma-A Case Report and a Review of the Literature.

We report the case of a 15-year-old boy brought to the emergency department after a bike accident, complaining of an isolated left hip pain. The X-rays showed an obturator hip dislocation treated by closed reduction under general anaesthesia, followed by 6 weeks of discharge. The follow-up MRI performed 6 weeks after the trauma showed an avascular femoral head necrosis, for which we performed multiple retrograde femoral head drilling, completed by the injection of autologue stem cells from the iliaq crest. One year later, the patient has no hip pain, no joint limitation, and can practice BMX at a high level again. The purpose of this report is to make the physicians aware of this rare problem that may be damaging for hip function, especially in young people.

Talus fracture in a 4-year-old child.

Fracture of the talus is uncommon in childhood. We report a case of talar neck fracture that occurred in a 4-year-old girl. We present the radiological findings, the orthopaedic follow-up and the clinical outcome.

The grapevine genome sequence suggests ancestral hexaploidization in major angiosperm phyla.

The analysis of the first plant genomes provided unexpected evidence for genome duplication events in species that had previously been considered as true diploids on the basis of their genetics. These polyploidization events may have had important consequences in plant evolution, in particular for species radiation and adaptation and for the modulation of functional capacities. Here we report a high-quality draft of the genome sequence of grapevine (Vitis vinifera) obtained from a highly homozygous genotype. The draft sequence of the grapevine genome is the fourth one produced so far for flowering plants, the second for a woody species and the first for a fruit crop (cultivated for both fruit and beverage). Grapevine was selected because of its important place in the cultural heritage of humanity beginning during the Neolithic period. Several large expansions of gene families with roles in aromatic features are observed. The grapevine genome has not undergone recent genome duplication, thus enabling the discovery of ancestral traits and features of the genetic organization of flowering plants. This analysis reveals the contribution of three ancestral genomes to the grapevine haploid content. This ancestral arrangement is common to many dicotyledonous plants but is absent from the genome of rice, which is a monocotyledon. Furthermore, we explain the chronology of previously described whole-genome duplication events in the evolution of flowering plants.

Formation of the Arabidopsis pentatricopeptide repeat family.

In Arabidopsis (Arabidopsis thaliana) the 466 pentatricopeptide repeat (PPR) proteins are putative RNA-binding proteins with essential roles in organelles. Roughly half of the PPR proteins form the plant combinatorial and modular protein (PCMP) subfamily, which is land-plant specific. PCMPs exhibit a large and variable tandem repeat of a standard pattern of three PPR variant motifs. The association or not of this repeat with three non-PPR motifs at their C terminus defines four distinct classes of PCMPs. The highly structured arrangement of these motifs and the similar repartition of these arrangements in the four classes suggest precise relationships between motif organization and substrate specificity. This study is an attempt to reconstruct an evolutionary scenario of the PCMP family. We developed an innovative approach based on comparisons of the proteins at two levels: namely the succession of motifs along the protein and the amino acid sequence of the motifs. It enabled us to infer evolutionary relationships between proteins as well as between the inter- and intraprotein repeats. First, we observed a polarized elongation of the repeat from the C terminus toward the N-terminal region, suggesting local recombinations of motifs. Second, the most N-terminal PPR triple motif proved to evolve under different constraints than the remaining repeat. Altogether, the evidence indicates different evolution for the PPR region and the C-terminal one in PCMPs, which points to distinct functions for these regions. Moreover, local sequence homogeneity observed across PCMP classes may be due to interclass shuffling of motifs, or to deletions/insertions of non-PPR motifs at the C terminus.

GeneFarm, structural and functional annotation of Arabidopsis gene and protein families by a network of experts.

Genomic projects heavily depend on genome annotations and are limited by the current deficiencies in the published predictions of gene structure and function. It follows that, improved annotation will allow better data mining of genomes, and more secure planning and design of experiments. The purpose of the GeneFarm project is to obtain homogeneous, reliable, documented and traceable annotations for Arabidopsis nuclear genes and gene products, and to enter them into an added-value database. This re-annotation project is being performed exhaustively on every member of each gene family. Performing a family-wide annotation makes the task easier and more efficient than a gene-by-gene approach since many features obtained for one gene can be extrapolated to some or all the other genes of a family. A complete annotation procedure based on the most efficient prediction tools available is being used by 16 partner laboratories, each contributing annotated families from its field of expertise. A database, named GeneFarm, and an associated user-friendly interface to query the annotations have been developed. More than 3000 genes distributed over 300 families have been annotated and are available at http://genoplante-info.infobiogen.fr/Genefarm/. Furthermore, collaboration with the Swiss Institute of Bioinformatics is underway to integrate the GeneFarm data into the protein knowledgebase Swiss-Prot.

Genome-wide analysis of Arabidopsis pentatricopeptide repeat proteins reveals their essential role in organelle biogenesis.

The complete sequence of the Arabidopsis thaliana genome revealed thousands of previously unsuspected genes, many of which cannot be ascribed even putative functions. One of the largest and most enigmatic gene families discovered in this way is characterized by tandem arrays of pentatricopeptide repeats (PPRs). We describe a detailed bioinformatic analysis of 441 members of the Arabidopsis PPR family plus genomic and genetic data on the expression (microarray data), localization (green fluorescent protein and red fluorescent protein fusions), and general function (insertion mutants and RNA binding assays) of many family members. The basic picture that arises from these studies is that PPR proteins play constitutive, often essential roles in mitochondria and chloroplasts, probably via binding to organellar transcripts. These results confirm, but massively extend, the very sparse observations previously obtained from detailed characterization of individual mutants in other organisms.