Metastatic NSCLC: Clinical, molecular, and therapeutic factors associated with long-term survival.

BACKGROUND: Patients with metastatic non-small-cell lung cancer (NSCLC) who survive more than 2 years are considered long-term survivors (LTSs). The present study examined factors associated with long-term survival and collected information for future comparison. METHODS: Clinical, molecular, and therapeutic data were collected from patients followed for primary stage IV (7th TNM classification) NSCLC within 2 years from diagnosis in the respiratory medicine departments of 53 French non-teaching hospitals. LTS and non-LTS records were compared. Factors associated with long-term survival were examined by univariate and multivariate analyses using logistic regression models. RESULTS: Vital status at least 2 years after diagnosis was known for 1977 stage IV NSCLC patients; 220 (11.1%) were LTSs. On multivariate analysis, independent positive factors comprised: TTF-1(+) immunochemistry, EGFR-mutation, surgery, rescue radiotherapy, and targeted therapy. Independent negative factors comprised: prediagnosis weight loss>5kg, ECOG performance status>1, and primary radiotherapy. CONCLUSIONS: Molecular biology and targeted therapy were decisive for long-term survival. With their development and their widespread implementation in clinical practice, the percentage of LTSs is expected to grow. Factors determining long-term survival found in this study should be taken into account when considering treatment options for patients with stage IV NSCLC.

[Noninvasive ventilation for acute respiratory failure in a pulmonary department]. / Ventilation non invasive dans l'insuffisance respiratoire aiguë en service de pneumologie.

INTRODUCTION: Noninvasive ventilation (NIV) is considered as the first choice treatment for selected patients with acute respiratory failure (ARF), but many hospitals are forced to start NIV on medical wards. METHODS: The aim of this retrospective study was to assess the outcomes of NIV initiated for ARF on a respiratory ward and to find the criteria predictive of failure. All patients were treated in a four-bed ward specifically dedicated to NIV. Failure of NIV was defined as the need for intubation and transfer to ICU, or death. RESULTS: Among 105 admissions with ARF, 49 episodes needed NIV. These episodes were divided into 2 groups: PaCO2<45mmHg (10) and PaCO2>45mmHg (39). The overall failure rate of NIV and overall in-hospital mortality rate were 26.5% and 17% respectively. On multivariate analysis, SAPS II and respiratory acidosis with a pH less than 7.30 were significantly associated with failure of NIV. CONCLUSIONS: NIV is practicable and is effective in the management of mild to moderate ARF on a respiratory ward. However, patients with respiratory acidosis and a pH less than 7.30 are at risk of NIV failure.

[Noninvasive ventilation in palliative care and near the end of life]. / Place de la ventilation non invasive dans les soins palliatifs et en fin de vie.

INTRODUCTION: The occurrence of life threatening severe respiratory failure in patients with an incurable illness may be an indication for the use of noninvasive ventilation (NIV). STATE OF THE ART: Two approaches are associated with the use of NIV in palliative care settings. In the "palliative approach", NIV is proposed for patients with end stage of chronic respiratory failure and do-not-tracheostomize orders as a ceiling of care. In the "palliative and probably curative" approach, NIV may help patients with do-not-intubate orders or to forego endotracheal intubation. This review provides some guidelines for clinicians responsible for patients with incurable illness, to help to guide and anticipate the medical management if acute respiratory failure (ARF) develops. CONCLUSIONS AND PERSPECTIVES: NIV may palliate symptoms in patients near the end of life. In the case of severe ARF in patients with do-not-intubate orders, NIV may avoid the need for endotracheal mechanical ventilation, most often in patients with COPD or cardiogenic pulmonary oedema. NIV may help some patients to forego endotracheal intubation. Future studies are needed to examine the attitudes of patients and families to this intervention.

Field development of oil palms (Elaeis guineensis jacq) originating from cryopreserved stabilized polyembryonic cultures.

In this paper, the long term observation of plants originating from control and cryopreserved stabilized polyembryonic cultures (SPCs) of six elite oil palm clones was carried out. Survival of plantlets in the nursery was monitored, then a series of vegetative and floral characteristics of over 440 palms were studied for up to 12 years after field transfer in Côte D'Ivoire. The six clones tested showed an average recovery of 34% after freezing in liquid nitrogen. The average survival in the nursery of plantlets originating from pretreated and dehydrated and from cryopreserved SPCs was higher than that of control SPCs. Palm trees originating from control SPCs were found to flower earlier than those originating from pretreated and dehydrated and from cryopreserved SPCs. This delay in flowering disappeared progressively and all palms had flowered 3 years after planting regardless of the SPC treatment. Abnormal palms were observed in one clone only. With this clone, the percentage of abnormal palms originating from cryopreserved SPCs was significantly lower (5%) than that measured on palms originating from control SPCs (29%).

Histocytological analysis of callogenesis and somatic embryogenesis from cell suspensions of date palm (Phoenix dactylifera).

BACKGROUND AND AIMS: The date palm is a dioecious perennial species of the Arecaceae for which in vitro micropropagation is essential to ensure the renewal of palm plantations. This study presents a histocytological analysis of the traditional Mauritanian Amsekhsi cultivar beginning from the initial callogenesis and continuing up to the establishment of the cellular embryogenic cell suspensions. The formation of somatic embryos and their development into rooted plants are also described. METHODS: Foliar segments of seedlings cultured in the presence of 2,4-D produced primary calli that were chopped to produce fine friable granular calli that subsequently produced cellular suspensions when transferred to liquid medium. The somatic proembryos that developed after removal of the 2,4-D were plated on agar medium where they developed into rooted plants. Thin sections of tissue fragments taken at each stage of the process were stained using Periodic Acid Schiff and Naphthol Blue-Black. KEY RESULTS: The first cellular divisions were localized close to the vascular vessels of the leaf. The primary calli were obtained within 2 months. Fine friable granular calli grew quickly after the primary calli were chopped. Individual embryogenic cells were identified that rapidly started to divide and developed into globular proembryos. In addition, in the microcalli, breaking zones appeared in the thick pectocellulosic walls which delimited the pluricellular proembryos. The anatomy of somatic embryos is similar to that of zygotic embryos despite a deficit in the accumulation of intracellular proteins. When rooted with NAA, the vitroplants developed a strong orthotropic taproot. CONCLUSIONS: This study contributes to understanding the whole process of somatic embryogenesis, but two specific questions remain to be answered: what factors are involved in the reactivation of the somatic cells at the beginning of the initial callogenesis, and why do the somatic embryos not accumulate proteins in their tissues during maturation?

Comparative flow cytometric estimation of nuclear DNA content in oil palm (Elaeis guineensis Jacq) tissue cultures and seed-derived plants.

Flow cytometric analysis performed on two different crosses of dura×pisifera oil palm gave an accurate estimation of nuclear DNA content. The genome size of Elaeis guineensis was found to be 2C=3.76±0.09 pg and therefore ca. 3.4×109 bp. Embryogenic calli and plants showed the same ploidy level, but the measured 2C DNA values differed significantly. No variation in the ploidy level between three different types of calli originating from foliar explants, namely nodular compact callus, fast-growing callus and friable callus was observed. Since fast-growing callus (FGC), already identified as a source of `mantled' phenotype variants, did not show any difference in their ploidy level, these results are consistent with the hypothesis of an epigenetic origin for this type of somaclonal variant.

Cryopreservation of oil palm (Elaeis guineensis Jacq.) somatic embryos involving a desiccation step.

The standard cryopreservation process previously developed for oil palm clones using shiny white, finger-like somatic embryos could be applied in some cases to standard cultures. Its efficiency was markedly improved by completing the 7-day pregrowth period on 0.75 M sucrose by an additional dehydration period carried out either by placing the embryos in the air current of the laminar flow cabinet or in an air tight box containing silica gel. This improved process was successfully applied to 7 different clones. It will facilitate the routine uof cryopreservation for oil palm cultures.

Plant regeneration from embryogenic suspension cultures of oil palm (Elaeis guineensis Jacq.).

Suspension cultures of oil palm (Elaeis guineensis Jacq.) were established in a medium with 80 or 100 mg.l(-1) 2,4-dichlorophenoxyacetic acid and 1 g.l(-1) activated charcoal, from calli producing embryogenic cells and protruding proembryos. The suspension was composed of meristematic clumps, breaking away and giving rise to new smaller aggregates. Under the best conditions, the initial weight increased about 4 fold in one month. Embryo differentiation was achieved when plating the clumps either directly, or after a phase in hormone-free liquid medium. In the second case, early maturation occurred in liquid medium. Secondary embryogenesis was reduced, and up to 18.1 % embryos formed shoots. Rooted plants were sucessfully transferred to soil.

Colonization of tissue surfaces in the gastrointestinal tract of gnotobiotic animals by lactobacillus strains.

Eight strains of lactobacilli isolated from conventional mice, rats, fowls, and pigs were tested for their ability to colonize squamous epithelia in the gastrointestinal tracts of gnotobiotic animals. Two of the strains isolated from rodents could colonize the nonsecretory epithelium of the stomach of gnotobiotic rodents, and one strain isolated from a fowl could colonize the crop epithelium of gnotobiotic chickens. The specificity of colonization of squamous epithelia by lactobacilli was demonstrated by these in vivo studies; strains of lactobacilli isolated from rodents could only colonize rodent epithelium; the strain from a fowl could only colonize crop epithelium.

[Effect of age on permissive barrier effect against a strain of enterobacteria exerted by a complex bacterial flora in the digestive tract of mice reared in isolator (author's transl)]. / Influence du vieillissement de l'hôte sur l'effet de barrière permissif à l'égard d'une souche d'entérobactérie, exercé par une flore bactérienne complexe dans le tube digestif de souris maintenues en isolateur.

A permissive barrier effect against Escherichia coli was observed in the faeces of a first group of mice associated with a complex microbial flora. This effect was transmitted to 6 other groups of mice by inoculation of a fecal suspension originated from a mouse of group I. Although mice were kept in isolator in constant biotic and abiotic environmental conditions, the expression of the barrier effect was very variable during several days after inoculation, then became stabilized in every group, but more slowly in group I than in the others. The expression of this barrier effect was compared in male and female mice aged five weeks or 6 months. The barrier effect was significantly more efficient in older than in young mice whatever the sex.

Borate Exchanges of Lemna minor L. as Studied with the Help of the Enriched Stable Isotopes and of a (n,alpha) Nuclear Reaction.

Despite the lack of a convenient radioisotope of boron, it is possible to measure unidirectional fluxes of borate between cellular systems and their external medium. It was accomplished by using the two purified stable isotopes ((10)B and (11)B), with (10)B specifically detected by a (n,alpha) nuclear reaction. The method was applied to compartmental analysis of borate with intact plants of Lemna minor L. Four compartments were suggested. Three of them apparently correspond to the three classical ones: free space (including easily dissociable borate monoesters), cytoplasm, and vacuole. The fourth one was interpreted as corresponding to very stable borate diesters in the cell walls. The method allows the determination of the borate capacities of the various compartments and of the borate unidirectional fluxes between the different compartments, at borate flux equilibrium. Other physicochemical data (mono and diester mass action constants, turn over numbers) were evaluated. The results are consistent with what is known of pure substances.