[Evaluation of adverse events caused by intravesical BCG instillations: Has the strain used a potential implication?]. / Évaluation des effets indésirables des instillations endovésicales par BCG : implication potentielle de la souche utilisée ?

INTRODUCTION: Intravesical instillations of BCG represent an established treatment of high-risk non-muscle-invasive bladder cancer but also carry considerable toxicity. The aim of this work was to identify adverse effects, their impact on the treatment and the possible involvement of the BCG strain used. MATERIAL AND METHODS: To evaluate adverse events in terms of incidence, severity and moment of occurrence, we performed a retrospective analysis of all patients treated with BCG in our institution from 1998 to 2012. RESULTS: One hundred and forty-six patients were retained for analysis, 140 (95.9%) finished their first induction cycle. Thirty patients (20.6%) had to stop the treatment because of BCG-related adverse events, 80% of which happened during the first 3 BCG cycles (12 instillations). The strain used may have had a significant impact: 16 out of 42 patients (38.1%) treated with Connaught (Immucyst®) and 14 out of 104 patients (13.5%) treated with Tice (Oncotice®) had to stop treatment because of BCG related adverse events (P=0.0019) with an odds ratio of 2.83 (IC 95%: 1.52-5.23). CONCLUSION: BCG-related adverse events generally occur at the beginning of the treatment and therefore do not limit the use of BCG maintenance therapy. Good instillation practice and, in our series, the shift from Connaught to Tice strain enabled to significantly reduce BCG-related adverse events through time. The potential implication of the BCG strain used should be evaluated in prospective trials.

THE IMPACT OF SILICON ON TRANSCRIPTS RELATED TO CUCUMBER MOSAIC VIRUS INFECTION IN CUCUMBER.

The role of soluble silicon (Si) in alleviating viral plant infections is largely unknown. In order to analyse this gap in knowledge, this study provides insights into the relative gene expression data obtained from 1) control, 2) Cucumber mosaic virus (CMV)-infected and 3) sodium silica-treated, CMV-infected Cucumis sativus line B10 tissue cultures regenerated plants. The absence or presence of CMV was determined through RT-PCR, six days' post-inoculation. qRT-PCR was performed on five selected host genes related to CMV-defence (argonaute protein, WRKY transcription factor) and replication (chaperone, heat shock cognate protein, aquaporin). Relative gene expressions from Si-treated, CMV-infected clones were not significantly different from CMV-infected clones, but they were significantly different from the control plants. The upregulation of the chaperone, and heat shock cognate genes in Si-treated clones, is associated with enhanced virus replication, while the gene expression of the transcription factor increases and is related to defence, in contrast to decreased expression in CMV-infected clones. Aquaporin gene expression was downregulated and the argonaute expression was unaffected in both Si-treated, CMV-infected as well as CMV-infected clones. Since both alleviating and supportive gene shifts are observed in Si-treated plantlets for key genes related to the virus infection examined herein, sodium silica is suggested to have a neutral and limited impact on CMV infection in cucumber cultures.

FIRST REPORT OF 'CANDIDATUS PHYTOPLASMA ULMI' IN ULMUS LAEVIS IN GERMANY.

The wall-less bacteria of the provisory taxon 'Candidatus Phytoplasma' are obligate parasites and associated to diseases in many important crops and trees worldwide. 'Ca. Phytoplasma ulmi', assigned to 16SrV-A subgroup, is a quarantine pest and described to be associated to elm phloem necrosis, leaf yellowing, stunting, witches broom and decline in various elm species. Elm yellows phytoplasmas (EY) have been reported in several European countries but not in Ulmus laevis in Germany so far. Leaf samples from European white elms (Ulmus leavis PALL.) with and without chlorotic symptoms were investigated for EYs infection in Berlin and Brandenburg, Germany, through performing diagnostic nested PCR targeting partial rRNA operon of phytoplasmas. Specific PCR-products were obtained from 30 out of 59 samples. Partial 16S-rDNA sequences were assigned to 'Ca. P. ulmi' through sequence analysis, while sequence variation was observed. This is the first report of U. laevis infected with 'Ca. P. ulmi' in Germany.

LSD1 controls metastasis of androgen-independent prostate cancer cells through PXN and LPAR6.

Lysine-specific demethylase 1 (LSD1) was shown to control gene expression and cell proliferation of androgen-dependent prostate cancer (PCa) cells, whereas the role of LSD1 in androgen-independent metastatic prostate cancer remains elusive. Here, we show that depletion of LSD1 leads to increased migration and invasion of androgen-independent PCa cells. Transcriptome and cistrome analyses reveal that LSD1 regulates expression of lysophosphatidic acid receptor 6 (LPAR6) and cytoskeletal genes including the focal adhesion adaptor protein paxillin (PXN). Enhanced LPAR6 signalling upon LSD1 depletion promotes migration with concomitant phosphorylation of PXN. In mice LPAR6 overexpression enhances, whereas knockdown of LPAR6 abolishes metastasis of androgen-independent PCa cells. Taken together, we uncover a novel mechanism of how LSD1 controls metastasis and identify LPAR6 as a promising therapeutic target to treat metastatic prostate cancer.

Presacral ganglioneuroma with abnormal FDG uptake: a case report.

Ganglioneuromas are rare, benign, well-differentiated, slowgrowing tumors of the sympathetic nervous system, composed of large, mature neurons in a stroma composed of Schwann cells. Ganglioneuromas are derived from the neural crest cells and can arise anywhere from the base of the skull to the pelvis. The pre-sacral area is a very rare location for ganglioneuromas to develop. We describe the case of a 31 year old woman, who was incidentally found to have an abnormal pre-sacral mass. The following work-up, revealed the mass to be growing on imagery (computed tomography and magnetic resonance imagery) and fluorine-18 fluorodeoxiglucose avid. The mass was removed by assisted laparoscopy and was found to be a benign ganglioneuroma. This is the first described case of fluorine-18 fluorodeoxiglucose avid, pre-sacral, benign ganglioneuroma.

[Acute renal failure following rectosigmoidoscopy]. / Insuffisance rénale aiguë après rectosigmoïdoscopie.

We report the case of a 24-year old man with a past history of vesical extrophy and ureterosigmoidostomy in childhood, admitted with acute left flank pain and acute renal failure. The complaints started the day following the endoscopic resection of a sigmoid polyp. The stricture of the ureterosigmoid junction was diagnosed by intravenous urography. Conservative treatment with endo-ureteral dilatation was successfully performed. At 2 years of follow-up, the patient is still asymptomatic, without any residual hydronephrosis.

[Evaluation of quality of life following prosthetic replacement of the auricle]. / Untersuchungen zur Lebensqualität nach epithetischem Ohrmuschelersatz.

INTRODUCTION: The assessment of quality of life (QOL) of patients is becoming increasingly important in the evaluation of the quality of care. Therefore, we examined the quality of life of patients treated with prostheses following loss of an auricle using a questionnaire. PATIENTS AND METHODS: Of 18 patients (14 male, 4 female), 10 had lost an auricle due to a neoplasm, 2 traumatically, while 6 patients showed a congenital lack of an auricle. In order to measure the subjective quality of life we used a questionnaire compiled by the WHO (WHOQOL-BREF); we used a self-designed questionnaire for questions relating to the prostheses. RESULTS: Analysis of the data of all patients with prostheses in comparison with the age-based general population showed a lower score value for quality of life, indicating a poorer quality of life. However, none of the differences were statistically significant. Patients with neoplasms achieved higher values compared with the age-based standard value; in contrast, the other patients showed lower values in nearly every respect. The gender-related analysis of the results showed a poorer quality of life for females than for males. CONCLUSION: The reason for an auricle defect as well as patient gender influenced the subjective quality of life following prosthetic surgery. The overall acceptance of auricular prostheses can be considered good, especially among patients suffering from neoplasms. In order to be able to evaluate the results and compare the different working groups more sufficiently it would be desirable to use standardized test procedures and a larger patient collective.

Development of photosystem-II activity during irradiance of etiolated Helianthus (Asteraceae) seedlings.

Light-induced development of photosystem (PS)-II activity was followed during irradiance of etiolated Helianthus annuus (sunflower) cotyledons using chlorophyll a fluorescence. Cotyledons from seedlings grown in continuous darkness for 6 d were exposed to 100 µmol photons·m(-2)·s(-1) for time periods of 1, 3, 6, and 12 h. Associated with increased time of irradiance exposure were significant: (1) increases in concentration of PS II, (2) increases in quantum efficiency of PS II, (3) decreases in the ratio of PS-II quinone(B) (Q(B))-nonreducing centers to total PS-II centers (PS-II Q(B)-nonreducing centers + PS-II Q(B)-reducing centers), and (4) decreases in the ratio of slow PS-II Q(B)-reducing centers to total PS-II Q(B)-reducing centers (fast PS-II Q(B)-reducing centers + slow PS-II Q(B)-reducing centers). The results support the hypotheses that development of PS II involves assembly of complexes which initially cannot reduce Q(B) and that heterogeneous aspects of PS-II pools during chloroplast maturation may represent different developmental states.

Decision-making in end-stage coronary artery disease: revascularization or heart transplantation?

BACKGROUND: Left ventricular function is the most important predictor of survival in patients with coronary artery disease. It is also an important indicator for hospital and late mortality after operation for endstage coronary artery disease. METHODS: Between April 1986 and December 1994, 514 patients with end-stage coronary artery disease and left ventricular ejection fraction between 0.10 and 0.30 underwent coronary artery bypass grafting at the German Heart Institute Berlin. Two hundred twenty-five of these patients had been referred as possible candidates for heart transplantation. The prime criterion for bypass grafting was ischemia diagnosed by myocardial scintigraphy and echocardiography ("hibernating myocardium"). RESULTS: Operative mortality for the group was 7.1%. The actuarial survival rate was 90.8% after 2 years, 87.6% after 4, and 78.9% after 6. Left heart catheterizations performed 1 year after the operation showed that left ventricular ejection fraction had increased from a mean of 0.24 +/- 0.03 preoperatively to 0.39 +/- 0.06 postoperatively (p < 0.0001). Preoperatively 91.6% of the patients were in New York Heart Association (NYHA) class III or IV; 6 months postoperatively 90.2% of the surviving patients were in NYHA class I or II. Two hundred thirty-one patients with end-stage coronary artery disease and predominant heart failure underwent heart transplantation. Their actuarial survival rate was 74.9% after 2 years, 73.2% after 4, and 68.9% after 6. All of the patients could be recategorized into NYHA class I or II after the operation. CONCLUSIONS: We conclude that coronary artery bypass grafting and heart transplantation can be used successfully to improve the life expectancy of patients with end-stage coronary artery disease. Coronary artery bypass grafting leads to an excellent prognosis for these high-risk patients when the myocardium is preoperatively identified as being viable.

Rounded atelectasis and its association with asbestos-induced pleural disease.

Rounded atelectasis (RA) is an unusual form of peripheral lobar collapse which may present as a juxtapleural mass simulating a pulmonary neoplasm. Seven cases of RA were recently encountered in patients with asbestos-induced pleural disease. Since asbestos exposure is associated with mesothelioma, bronchogenic carcinoma, and other tumors, differentiation of RA from these neoplasms is essential in avoiding unnecessary thoracotomy. The radiographic features of RA are sufficiently characteristic, so that in the presence of chronic pleural thickening due to asbestos exposure, the diagnosis can be made with assurance and further work-up avoided.