The link between behavioural type and natal dispersal propensity reveals a dispersal syndrome in a large herbivore.

When individuals disperse, they modify the physical and social composition of their reproductive environment, potentially impacting their fitness. The choice an individual makes between dispersal and philopatry is thus critical, hence a better understanding of the mechanisms involved in the decision to leave the natal area is crucial. We explored how combinations of behavioural (exploration, mobility, activity and stress response) and morphological (body mass) traits measured prior to dispersal were linked to the subsequent dispersal decision in 77 roe deer Capreolus capreolus fawns. Using an unusually detailed multi-trait approach, we identified two independent behavioural continuums related to dispersal. First, a continuum of energetic expenditure contrasted individuals of low mobility, low variability in head activity and low body temperature with those that displayed opposite traits. Second, a continuum of neophobia contrasted individuals that explored more prior to dispersal and were more tolerant of capture with those that displayed opposite traits. While accounting for possible confounding effects of condition-dependence (body mass), we showed that future dispersers were less neophobic and had higher energetic budgets than future philopatric individuals, providing strong support for a dispersal syndrome in this species.

Pathological complete response and survival according to the level of HER-2 amplification after trastuzumab-based neoadjuvant therapy for breast cancer.

BACKGROUND: We analysed whether the level of human epidermal growth factor receptor-2 (HER-2) amplification significantly influenced either pathological complete response (pCR) or recurrence-free survival (RFS) and overall survival (OS) after trastuzumab-based neoadjuvant therapy. METHODS: In all, 99 patients with an HER-2-amplified breast tumour treated with trastuzumab-based neoadjuvant therapy were included. Tumours were classified as low amplified (LA; 6-10 signals per nuclei) or highly amplified (HA; >10 signals). Pathological response was assessed according to Chevallier's classification (pCR was defined as grade 1 or 2). Median follow-up lasted 46 months (6-83). Cox uni- and multivariate analyses were performed. RESULTS: In all, 33 tumour samples were LA and 66 were HA. The pCR in HA tumours was significantly higher than in LA tumours (55% vs 24%, P=0.005), whereas no association was found between the pCR rate and tumour stage, grade or hormone receptor status. In multivariate analysis, the pathological nodal status (P=0.005) and adjuvant trastuzumab (P=0.037) were independently associated with RFS, whereas the level of HER-2 amplification nearly reached statistical significance (P=0.057). There was no significant difference between LA and HA tumours for OS (P=0.22, log-rank). CONCLUSION: The level of HER-2 gene amplification significantly influenced pCR but not RFS or OS in non-metastatic breast cancer treated with trastuzumab-based neoadjuvant therapy. However, RFS in patients with HA tumours tended to be shorter.

Evaluation of quality of life after breast reconstruction using an autologous latissimus dorsi myocutaneous flap.

AIMS: To evaluate the patients' satisfaction with breast reconstruction using the autologous latissimus dorsi technique and the impact of the procedure on the quality of life and body image of women who had mastectomy for breast cancer. METHODS: A retrospective transversal study was conducted at the Georges François Leclerc Cancer Care Center in Dijon, France. From 1990 to 2008, 193 women underwent reconstruction (RW), among these, 141 were matched for age at diagnosis and the date of the mastectomy with women who did not undergo reconstruction (NRW) identified using data from the Côte d'Or breast cancer registry. Questionnaires concerning quality of life, body image and satisfaction (MBROS-S, MBROS-BI, EORTC QLQ-C30, EORTC QLQ-BR23) were sent through the post following surgery. RESULTS: The overall response rate was 77% and the mean (MBROS-S) satisfaction score was 3.36. The quality of life (EORTC QLQ-C30, EORTC QLQ-BR23) in RW was no better than that in NRW, but body image was better (p = 0.0247) especially before 60 years (p = 0.0192), in obese patients (p = 0.03) and when the breasts of RW were heavy (p = 0.0197). Moreover, when the time from the mastectomy was less than 4 years, body image (p = 0.0008) and the sexual activity score (p = 0.0078) were higher in RW. CONCLUSIONS: The level of satisfaction was higher in RW, and breast reconstruction made a strong contribution in terms of improvement in body image. A prospective study to evaluate quality of life in the long term is now necessary.

[Spontaneous acute intussusception in a pregnant woman]. / Invagination intestinale aiguë spontanée chez une femme enceinte.

Acute intussusception in adults is rare and particularly so in pregnant women (between 1 / 5000 and 1 / 68,000 deliveries). It is a life-threatening condition for both the mother and the fetus. In adults, such intussusceptions are mainly secondary to an intestinal disease and frequently a tumour. We describe here a case of spontaneous intussusception during pregnancy and surgical management of the condition. We also analyse the causes specific to pregnancy.

[Metastatic tumor implantation from a primary cancer of the base of the tongue at the site of placement of a central venous portacath]. / Métastase d'une tumeur de la base de langue sur un système d'accès veineux central totalement implantable.

Central venous catheter placement with an implanted port (portacath) is used to provide long-term venous access. We report a case of metastatic implantation at a port site from a primary cancer of the base of the tongue. Insertion of portacaths must be performed using full sterile precautions to avoid spread of tumor cells; in no case should the port site incisions be in contact with the surgical field in which the tumor resection was performed.

[Uterine artery embolization with resorbable material prior to myomectomy]. / Embolisation artérielle utérine par matériel résorbable avant myomectomie.

PURPOSE: Fibroids are a frequent cause of gynecology referral. Myomectomy is a conservative treatment alternative. The main risk from this procedure is hemorrhage. The main objective of this study was to demonstrate the efficacy of preoperative uterine artery embolization with resorbable agents to reduce blood losses and facilitate myomectomy. Secondary objectives were to evaluate morbidity and subsequent fertility. PATIENTS AND METHODS: Retrospective study of 21 patients with preoperative uterine artery embolization prior to myomectomy at the University Medical Center of Dijon over a 3 year period. RESULTS: Myomectomy after uterine artery embolization with resorbable agents was associated with only minimal blood loss. Mean preoperative and postoperative hemoglobin levels were comparable (p<0.0001). Uterine suturing was technically simpler. The number of resected fibroids (p=0.2824) and the presence of preoperative anemia (p=0.474) had no statistically significant impact on the duration of hospital stay. Uterine synechiae occurred in three patients after the procedure, and were easily treated. Two patients had normal subsequent pregnancies. CONCLUSION: Preoperative uterine artery embolization with resorbable agents was effective in reducing surgical blood losses. This technique reduces the number of hysterectomies and hemorrhagic complications (hematoma, infection, weaker scar tissue). It should be considered in patients wishing uterine preservation when the hemorrhagic risk is high. Its use in patients seeking subsequent pregnancy should be further assessed with larger series.

[Bone reconstruction, leg length discrepancy, and dislocation rate in 52 Wagner revision total hip arthroplasties at 44-month follow-up]. / Reconstruction osseuse, inégalité de longueur des membres, taux de luxation de 52 prothèses de Wagner, en révision d'arthroplasties totales de hanche au recul moyen de 44 mois.

PURPOSE OF THE STUDY: The primary and secondary stability of a revision implant is highly compromised in cases with important loss of bone stock from the proximal femoral after severe femoral loosening. Several methods using implants with or without cement have been proposed for reconstruction after femoral bone loss. The purpose of this study was to analyze mid-term clinical and radiological outcome with the Wagner prosthesis for revision surgery. MATERIAL AND METHODS: Fifty-two cases of aseptic femoral loosening were treated with this method in 36 women and 14 men, mean age 70 years (range 32-92 years). None of the patients was lost to follow-up; five who died after 18 months were retained for analysis. Mean follow-up was 44 months (range 18-88 months). The mean preoperative Postel Merle d'Aubigné (PMA) score was 10.5 +/- 0.4. These patients had major bone loss (5 grade II, 24 grade III, 23 grade IV in the SOFCOT classification). The transfemoral access was used in 17 cases and bone grafts in 32. Clinical outcome was assessed with the PMA score and leg length discrepancy was measured. Radiographically, stability was assessed by measuring stem impaction and progression of radiolucent lines. RESULTS: The overall functional score was significantly improved from 10.5 +/- 0.4 preoperatively to 14.6 +/- 0.5 (p<0.001). All items on the score improved but pain relief was the most notable. Improvement in the gait score was limited due to persistent limping in 39 patients. Leg length discrepancies were found in 8 patients with 6 shortenings and 2 lengthenings. The clinical situation remained stable after one year. The implant remained stable in 48 patients (92 p. 100) and stem impaction was observed in 4 before 12 months. Two of these cases required a second revision. Metaphyseal reconstruction was observed in 42 patients (81 p. 100), including 24 (46 p. 100) who exhibited homogeneous reconstruction with trabeculation. The reconstruction did not progress further after 18 months postoperatively. Complications included four dislocations and five revision procedures (three for cup loosening, two for femoral pivot instability). DISCUSSION: The functional outcome was similar to results reported in the literature, including the high frequency of limping that was caused by various factors (valgus prosthesis neck, leg length discrepancy, muscle deficits). Leg length discrepancies resulted from defective positioning or impaction at loading. Standard radiographic series allowed an assessment of stem impaction. Our low rate could be due to delayed weight bearing. La reconstruction of bone loss did not progress after 18 months and was independent of bone grafting, route of access, and the initial degree of loosening. The high frequency of dislocations with this type of implant can be prevented by horizontalization of the acetabulum and use of anti-dislocation inserts at the first intention revision. CONCLUSION: Our results with the Wagner prosthesis are satisfactory both clinically and radiographically. The two drawbacks of this implant (limping and dislocation), partly due to the design of the femoral stem, have led us to study a new implant that preserves good distal anchoring and optimizes the proximal biomechanics of the hip joint.

Development of feeding selectivity in roe deer.

The development of feeding behaviour in European roe deer (Capreolus capreolus) was studied using nine fawns, from birth to 1.5 months. They were offered individually, seven plant species in random order, one at a time, and their feeding behaviour recorded. The results were compared to the behaviour of eight adults offered the same plants, which were chosen to cover the whole range from preferred to strongly avoided plants. Fawns displayed selectivity towards the different plants from their first contact, and they appeared to respond initially to buccal, but not olfactory, stimuli. Thereafter consumption of the two preferred species increased, while use of the others remained at a very low level. For the two plant types most strongly avoided (and perhaps the most toxic), learning allowed the deer to distinguish and avoid the plants using olfactory (and perhaps also visual) stimuli. For the other three species, fawns continued to ingest small quantities which may have allowed them to learn to avoid these plants, using the association between taste and negative post-ingestive consequences. This process may also have been involved in the increases in the consumption of the two preferred species. The animals were able to discriminate to almost the same extent as adults by the time they were about 1 month old. These results underline the importance of learning, and identify some of the stimuli involved in the development and maintenance of the highly selective and flexible feeding behaviour of this herbivore.

Resorption kinetics of osseous substitute: natural coral and synthetic hydroxyapatite.

Coral and hydroxyapatite may be used as substitution biomaterials for bone grafts. In this work, we extracted the implants from the femora to study the kinetics of elementary mineral transformation of the osseous substitutes. The use of physical analysis methods such as PIXE (particle-induced X-ray emission) shows that coral and hydroxyapatite, after their implantation in vivo, reach a mineral composition comparable with that of bone. For the first time we have measured the concentration of mineral elements, at different time intervals after implantation, along a cross-section. The distribution according to mineral elements (Ca, P, Sr, Zn, Fe) in the implant, in the receiver site and also at the interface, showed that the kinetics of coral resorption was faster than that of hydroxyapatite; in the same way, the osseous attack was not global but, rather, centripetal.

Diffusion of mineral elements evaluated by PIXE at the bone-coral interface.

Substituting the tissue of human organs with biomaterials is problematic. However, its importance and relevance justify all the efforts made. An interdisciplinary approach is required. We report on our study of a product for bone substitution. Coral is a natural product, the interest of which we have already demonstrated in our previous work. Following sterilization, natural coral was implanted in sheep femurs. We regularly extracted the implants from the femurs to study the kinetics of elemental mineral transformation of the bone substitutes. For the first time ever, and thanks to the PIXE method (particles induced X-ray emission), we were able to measure the concentration of mineral elements at different time intervals after implantation over a whole cross-section. We found a discontinuity of the mineral elements (Ca, P, Sr, Zn, Fe) at the interface between the implant and the receiver. This shows that the osseous attack is not global but, on the contrary, centripetal. Moreover, the fit of the concentration time course indicates that the kinetics of ossification are different for each atomic element and characterize a distinct biological phenomenon. Our analyses confirm the biocompatibility and the ossification of the implanted coral.

Protein phosphotyrosine in mouse brain: developmental changes and regulation by epidermal growth factor, type I insulin-like growth factor, and insulin.

Using antiphosphotyrosine antibodies, we have investigated protein phosphorylation in mouse brain during development in intact animals and in reaggregated cerebral cultures. Under basal conditions, in vivo and in vitro, the levels of two main phosphoproteins, of Mr 120,000 and 180,000 (pp180), increased with development, reaching a maximum in the early postnatal period and decreasing thereafter. In adult forebrain, pp180 was still highly phosphorylated, but it was not detected in cerebellum or in peripheral tissues. In reaggregated cortical cultures, epidermal growth factor (EGF), type I insulin-like growth factor (IGF-I), and insulin enhanced protein tyrosine phosphorylation of several proteins, which were specific for EGF or IGF-I/insulin. In highly enriched neuronal or astrocytic monolayer cultures, some proteins phosphorylated in basal conditions, or in response to EGF and IGF-I, were found in both types of culture, whereas others appeared cell type specific. In addition, in each cell type, some proteins were phosphorylated under the action of both growth factors. These results indicate that tyrosine protein phosphorylation is maximal in mouse brain during development and is regulated by growth factors in neurons as well as in astrocytes.