A Chiral fNIRS Spotlight on Cerebellar Activation in a Finger Tapping Task.

Functional Magnetic Resonance Imaging (fMRI) has been so far the golden standard to study the functional aspects of the cerebellum. In this paper, a low-cost alternative imaging, i.e. functional Near-Infrared Spectroscopy (fNIRS) is demonstrated to achieve successful measurements of the cerebellar hemodynamics towards the challenging observation of motor and cognitive processes at the cerebellar level. The excitation and reception optodes need to be properly placed to circumvent a major hindering from the shielding by the neck muscles. A simple experimental protocol, i.e. finger tapping task, was implemented to observe the subject's engagement and the presence of functional asymmetries. Marked differences among subjects with different levels of lateralization were clearly noticed in terms of activation and latencies, together with peaks in the hemodynamic response following neural activation. These preliminary results suggest also differences in the hemodynamic behavior between the brain and the cerebellum and encourage future and extended analysis in this direction.Clinical Relevance-This establishes the possibility to use a novel technique (fNIRS) to study cerebellar hemodynamics instead of fMRI.

Single-Trial Detection of Event-Related Potentials with Integral Shape Averaging: An Application to the Elusive N400.

The estimation of Event-Related Potentials (ERPs) from the ambient EEG is a difficult task, usually achieved through the synchronous averaging of an extensive series of trials. However, this technique has some caveats: the ERPs have to be strictly time-locked with similar shape, i.e. emitted with the same latency and the same profile, with minor fluctuations of their amplitudes. Also, the method requires a huge number of valid trials (~100) to efficiently raise the ERPs from the EEG trials. In the case of cognitive ERPs, as with the N400, the delivered stimulus has to be different for each trial, the latencies are varying, and the number of available trials is usually low. In this paper, an alternative method, coined Integral Shape Averaging (ISA) and its derivatives are detailed. ISA is robust to varying latencies and affine transforms of shape. Furthermore, a new method coined ISAD can be derived to extract ERPs even from a single trial experiment. The aim here is to illustrate the potential of ISAD for N400 component extraction on real EEG data, with emphasis on its general applicability for ERPs computation and its major assets like reduced experimental protocol. Some insights are also given on its potential use to study ERP variability, through shape and latency.Clinical Relevance- The proposed algorithm aims to be a helpful tool in clinical practice to analyze and interpret evoked responses in real experimental settings, especially for particularities in neurology.

Effects of marine noise pollution on Mediterranean fishes and invertebrates: A review.

Marine noise pollution (MNP) can cause a multitude of impacts on many organisms, but information is often scattered and general outcomes difficult to assess. We have reviewed the literature on MNP impacts on Mediterranean fish and invertebrates. Both chronic and acute MNP produced by various human activities - e.g. maritime traffic, pile driving, air guns - were found to cause detectable effects on intra-specific communication, vital processes, physiology, behavioral patterns, health status and survival. These effects on individuals can extend to inducing population- and ecosystem-wide alterations, especially when MNP impacts functionally important species, such as keystone predators and habitat forming species. Curbing the threats of MNP in the Mediterranean Sea is a challenging task, but a variety of measures could be adopted to mitigate MNP impacts. Successful measures will require more accurate information on impacts and that effective management of MNP really becomes a priority in the policy makers' agenda.

Behavioural and biochemical alterations in gammarids as induced by chronic metallic exposures (Cd, Cu and Pb): Implications for freshwater biomonitoring.

In freshwater species, metal toxicity is usually assessed through short-term exposures, hence limiting the practical usefulness of biomarkers for monitoring long-term impacts on wildlife populations. This study investigates the biological alterations elicited by chronic metallic exposures in Gammarus fossarum using multi-level biomarkers. In aquaria, gammarids were exposed for 10 weeks to field-realistic concentrations of Cd, Cu or Pb (0.25, 1.5 or 5.0 µg/L). At the individual level, behavioural traits (respiration, locomotion and feeding) were compared between naive and chronically-exposed gammarids. At the cellular level, enzymatic activities involved in digestion, moult and cell stress were monitored after 2, 6 and 10 weeks of exposure in males and females to consider the temporal feature of their responses. Results showed that the inhibitory effects of Cd and Pb on respiration and locomotion disappeared in chronically-exposed gammarids, reflecting acclimation to maintain these processes, unlike Cu. Chronic Cu- and Pb-elicited feeding inhibition was associated with the inhibitions of digestion enzymes. Chitobiase was inhibited by Cu in males and, by Cd and Pb in females, suggesting gender-dependent disturbances in moulting. In both genders, Cd generated cellular stress by stimulating acidic phosphatase and peroxidase activities. To conclude, such cellular impairments and alterations in individual performances are likely to disturb individual growth, population dynamics and litter decomposition in the long-term. Besides, obtaining biological responses, common to metals or specific to a metal or a gender, supports the development of biomarkers highlighting long-term impacts of metals on the health of organisms and their associated ecological functions in natural environments.

[Sentinel node and breast cancer: A state-of-the-art in 2019]. / Ganglion sentinelle et cancer du sein : où en est-on en 2019 ?

Since 1994 and Giuliano's description of sentinel lymph node technique, this procedure has considerably improved and is nowadays, one of the essential pillars in the management of breast cancer. Neoadjuvant chemotherapy (NAC) is effective on regional control, especially on axillary lymph node. Various learned societies recommend that the initial proved GS can be realized before (CNGOF 2010, Saint-Paul de Vence 2013, ESMO 2015, St-Gallen 2015, NCCN 2016) or after (ASCO 2014, ESMO 2015, Saint-Gallen 2015) CNA when the patient is considered like N0. In patients with initial lymph node involvement, GS searching it is not yet recommended. SLN detection before NAC remains an important prognostic factor especially in N+ patients before surgery. The purpose of this article was a reviewing of medical literature regarding possible indications for SLN detection and axillary dissection in patients with NAC according to sentinel lymph node status. The secondary objective was to put forward different perspectives and studies dealing with this subject. The complete pathological response appears to be an important selection criterion for proposing SLN to these patients and avoiding a "useless" AD. It is important to include patients in the trials to make recommendations progress on SLN after NAC and avoid a rate of uninjured AD.

Endoprótesis GORE® EXCLUDER® con rama iliaca para el tratamiento de aneurismas aortoiliacos. Experiencia multicéntrica. Resultados a un año / Treatment of aorto-iliac aneurysms with GORE® EXCLUDER® iliac branch endoprosthesis. Multicentre experience. One year results

Introducción: En el tratamiento endovascular de los aneurismas de aorta abdominal, en el 20-40% de los casos el anclaje en la iliaca no es posible por afectación de la misma. Actualmente es posible el sellado de la endoprótesis en la iliaca externa preservando la permeabilidad de la arteria hipogástrica con dispositivos con ramas iliacas. Objetivo: Evaluar la eficacia y la seguridad del dispositivo IBE GORE® y sus resultados a un año para el tratamiento de los aneurismas aortoiliacos con dilatación de la arteria iliaca común. Material y métodos: Se trata de un estudio multicéntrico y retrospectivo con un seguimiento de 12 meses. Se incluyen 14 pacientes a los que se les han implantado 18 IBE GORE®. A todos se les ha practicado una TC antes de la cirugía y al menos una TC al mes y otra al año como protocolo de seguimiento. Resultados: El éxito técnico ha sido del 100%. A los 30 días, la mortalidad ha sido del 0%. Hubo una trombosis completa de un dispositivo que requirió un bypass cruzado y una oclusión de hipogástrica asintomática. Al año, el diámetro medio de la iliaca ha pasado de 37,3 a 31,4 mm (ha disminuido en el 87,5% de los casos) y no ha habido reintervenciones. La tasa global de endofugas tipo II de la serie ha sido del 21%, la permeabilidad del cuerpo del branch, del 94% (17/18), y la del componente de hipogástrica, del 89% (16/18). Conclusiones: El tratamiento de aneurismas aortoiliacos que afectan a la arteria hipogástrica con el dispositivo IBE GORE® es seguro, eficaz y permite preservar la permeabilidad de la hipogástrica (AU)

Introduction: In 20-40% of cases of endovascular aneurysm repair, the regular sealing in common iliac artery is not possible because of the severity of the disease. Nowadays, improved devices provide the possibility of a correct sealing in external iliac artery, preserving the hypogastric patency. Objective: The aim of this study is to evaluate the safety and efficacy of the IBE GORE® device and its one year results in the treatment of abdominal aorta-iliac aneurysms. Material and methods: A total of 14 patients treated with 18 IBE GORE® devices were evaluated in a multicentre and prospective study, and followed-up during a 12 month period. All of them had a CT scan prior to surgery, at one month, and at one year as required in the follow-up protocol. Results: There was 100% technical success. The 30 day follow-up mortality was 0%, with one complete occlusion of the iliac branch that needed a femoro-femoral bypass, and one asymptomatic hypogastric occlusion. The mean iliac artery diameter went from 37.3 to 31.4 mm after one year (decreased in 87.5% of patients), and no re-interventions were needed. The overall type II endoleak was 21%, the patency of the body of the branch was 94% (17/18), and the hypogastric component 89% (16/18). Conclusions: Endovascular treatment of aorto-iliac aneurysms affecting the internal iliac artery using the IBE GORE® device is safe, effective, and preserves hypogastric patency (AU)

Comparison in waterborne Cu, Ni and Pb bioaccumulation kinetics between different gammarid species and populations: Natural variability and influence of metal exposure history.

Kinetic parameters (uptake from solution and elimination rate constants) of Cu, Ni and Pb bioaccumulation were determined from two Gammarus pulex and three Gammarus fossrum wild populations collected from reference sites throughout France in order to assess the inter-species and the natural inter-population variability of metal bioaccumulation kinetics in that sentinel organism. For that, each population was independently exposed for seven days to either 2.5µgL-1 Cu (39.3nM), 40µgL-1 Ni (681nM) or 10µgL-1 Pb (48.3nM) in laboratory controlled conditions, and then placed in unexposed microcosms for a 7-day depuration period. In the same way, the possible influence of metal exposure history on subsequent metal bioaccumulation kinetics was addressed by collecting wild gammarids from three populations inhabiting stations contaminated either by Cd, Pb or both Pb and Ni (named pre-exposed thereafter). In these pre-exposed organisms, assessment of any changes in metal bioaccumulation kinetics was achieved by comparison with the natural variability of kinetic parameters defined from reference populations. Results showed that in all studied populations (reference and pre-exposed) no significant Cu bioaccumulation was observed at the exposure concentration of 2.5µgL-1. Concerning the reference populations, no significant differences in Ni and Pb bioaccumulation kinetics between the two species (G. pulex and G. fossarum) was observed allowing us to consider all the five reference populations to determine the inter-population natural variability, which was found to be relatively low (kinetic parameters determined for each population remained within a factor of 2 of the minimum and maximum values). Organisms from the population exhibiting a Pb exposure history presented reduced Ni uptake and elimination rate constants, whereas no influence on Ni kinetic parameters was observed in organisms from the population exhibiting an exposure history to both Ni and Pb. Furthermore Pb bioaccumulation kinetics were unaffected whatever the condition of pre-exposure in natural environment. Finally, these results highlight the complexity of confounding factors, such as metal exposure history, that influence metal bioaccumulation processes and showed that pre-exposure to one metal can cause changes in the bioaccumulation kinetics of other metals. These results also address the question of the underlying mechanisms developed by organisms to cope with metal contamination.

Resultados a corto y medio plazo en el tratamiento endovascular de aneurismas aortoiliacos o iliacos mediante el uso del dispositivo de rama iliaca / Short and medium-term outcomes in the endovascular treatment of aorto-iliac or iliac aneurysms with the use of an iliac branch device

Objetivo: El uso del dispositivo de rama iliaca (DRI) es una técnica para evitar complicaciones derivadas de la oclusión de las arterias hipogástricas (AH). Nuestro objetivo es analizar los resultados del uso del DRI a corto y medio plazo en nuestro centro. Material y métodos: Estudio descriptivo, 28 AH, 14 pacientes con aneurismas aortoiliacos tratados con DRI entre 2011 y 2015. Catorce (100%) aneurismas iliacos bilaterales, 11 (78,6%) aneurismas aórticos asociados y 4 (14,3%) con aneurisma hipogástrico. De 28 AH, 19 (67,8%) se trataron con DRI (5 bilaterales), 4 (14,3%) fueron cubiertas con endoprótesis, 2 (7,1%) embolizadas, 2 intactas y una con stent cubierto para tratar un aneurisma. En todos los casos quedó al menos una AH permeable. Analizamos mortalidad, permeabilidad del DRI, endofugas, claudicación glútea, disfunción eréctil e isquemia pélvica. Para realizar el seguimiento se utilizaron angio-TAC y ecodoppler. Resultados: El 100% eran varones, con una edad de 74,6 ± 13,6 años, permeabilidad al mes 94,7%, al año 80%, a los 2 años 77,8%, 0% de mortalidad, de endofugas, de claudicación glútea en el lado permeabilizado, de disfunción eréctil de nueva aparición y de isquemia pélvica. Hubo dos casos de claudicación glútea contralateral, un caso de trombosis arterial iliaca contralateral, resuelta mediante bypass femorofemoral, una trombosis del DRI intraoperatoria e isquemia aguda de la extremidad, resuelta mediante trombolisis y embolectomía, e imposibilidad para colocar el DRI por dificultad técnica en un caso. El seguimiento medio fue de 23,3 meses (rango 1-67), y hubo 2 pérdidas en el seguimiento. Conclusión: En nuestra experiencia, el DRI es una técnica eficaz y segura con pocas complicaciones y buena permeabilidad; no obstante, son necesarios estudios a largo plazo (AU)

Objective: An iliac branch device (IBD) is used as a technique to avoid or minimise the complications associated with the occlusion of the hypogastric artery (HA). The purpose of this paper is to analyse the short and medium-term outcomes with the use of an IBD in our centre. Material and methods: A descriptive study that included 28 HA of 14 patients with an aorto-iliac aneurysm treated with an IBD between 2011 and 2015. There were 14 (100%) bilateral iliac artery aneurysms, 11 (78.6%) associated with an aortic aneurysm, and 4 (14.3%) with HA aneurysm. Of the 28 HA, 19 (67.8%) where treated with an IBD (5 bilateral), 4 (14.3%) were covered with the endoprosthesis, 2 (7.1%) were embolised, 2 were not treated, and one was treated with a covered stent graft in order to treat the hypogastric aneurysm. In all of the cases one HA was patent. An analysis is presented of the mortality, patency, endoleaks, buttock claudication, erectile dysfunction, and pelvic ischaemia. CT angiogram and doppler ultrasound were used in the follow-up. Results: All (100%) the patients were male, with a mean age of 74.6 ± 13.6 years. Patency at one month was 94.7%, 80% at one year, and 77.7% at 2 years. There was 0% mortality, endoleaks, buttock claudication of the side treated, erectile dysfunction, and pelvic ischaemia. There were 2 cases of contralateral buttock claudication, one of contralateral iliac artery thrombosis, resolved through a femoro-femoral bypass, and one case of intra-operative IBD thrombosis that was treated favourably with thrombolysis. Mean follow-up was 23.3 months (range 1-67) with 2 losses in the study. Conclusion: In our experience, IBD is a safe and efficient technique, with few complications and good patency. Longer follow-up studies should be performed (AU)

Ecotoxicoproteomic assessment of the functional alterations caused by chronic metallic exposures in gammarids.

Very few ecotoxicological studies have been performed on long-term exposure under controlled conditions, hence limiting the assessment of the impact of chronic and diffuse chemical pressures on the health of aquatic organisms. In this study, an ecotoxicoproteomic approach was used to assess the integrated response and possible acclimation mechanisms in Gammarus fossarum following chronic exposures to Cd, Cu or Pb, at environmentally realistic concentrations (i.e. 0.25, 1.5 and 5 µg/L respectively). After 10-week exposure, changes in protein expression were investigated in caeca of control and exposed males. Gel-free proteomic analyses allowed for the identification of 35 proteins involved in various biological functions, for which 23 were significantly deregulated by metal exposures. The protein deregulation profiles were specific to each metal, providing evidence for metal-specific action sites and responses of gammarids. Among the tested metals, Cu was the most toxic in terms of mortality, probably linked with persistent oxidative stress. Moulting and osmoregulation were the major biological functions affected by Cu in the long-term. In Pb-exposed gammarids, significant deregulations of proteins involved in immune response and cytoskeleton were observed. Reproduction appears to be strongly affected in gammarids chronically exposed to Cd or Pb. Besides, modified expressions of several proteins involved in energy transfer and metabolism highlighted important energetic reshuffling to cope with chronic metal exposures. These results support the fact that metallic pressures induce a functional and energetic cost for individuals of G. fossarum with potential repercussions on population dynamics. Furthermore, this ecotoxicoproteomic study offers promising lines of enquiry in the development of new biomarkers that could make evidence of long-term impacts of metals on the health of organisms.

Environmental relevance of laboratory-derived kinetic models to predict trace metal bioaccumulation in gammarids: Field experimentation at a large spatial scale (France).

Kinetic models have become established tools for describing trace metal bioaccumulation in aquatic organisms and offer a promising approach for linking water contamination to trace metal bioaccumulation in biota. Nevertheless, models are based on laboratory-derived kinetic parameters, and the question of their relevance to predict trace metal bioaccumulation in the field is poorly addressed. In the present study, we propose to assess the capacity of kinetic models to predict trace metal bioaccumulation in gammarids in the field at a wide spatial scale. The field validation consisted of measuring dissolved Cd, Cu, Ni and Pb concentrations in the water column at 141 sites in France, running the models with laboratory-derived kinetic parameters, and comparing model predictions and measurements of trace metal concentrations in gammarids caged for 7 days to the same sites. We observed that gammarids poorly accumulated Cu showing the limited relevance of that species to monitor Cu contamination. Therefore, Cu was not considered for model predictions. In contrast, gammarids significantly accumulated Pb, Cd, and Ni over a wide range of exposure concentrations. These results highlight the relevance of using gammarids for active biomonitoring to detect spatial trends of bioavailable Pb, Cd, and Ni contamination in freshwaters. The best agreements between model predictions and field measurements were observed for Cd with 71% of good estimations (i.e. field measurements were predicted within a factor of two), which highlighted the potential for kinetic models to link Cd contamination to bioaccumulation in the field. The poorest agreements were observed for Ni and Pb (39% and 48% of good estimations, respectively). However, models developed for Ni, Pb, and to a lesser extent for Cd, globally underestimated bioaccumulation in caged gammarids. These results showed that the link between trace metal concentration in water and in biota remains complex, and underlined the limits of these models, in their present form, to assess trace metal bioavailability in the field. We suggest that to improve model predictions, kinetic models need to be complemented, particularly by further assessing the influence of abiotic factors on trace metal uptake, and the relative contribution of the trophic route in the contamination of gammarids.

A biodynamic model predicting waterborne lead bioaccumulation in Gammarus pulex: Influence of water chemistry and in situ validation.

Metals bioaccumulated in aquatic organisms are considered to be a good indicator of bioavailable metal contamination levels in freshwaters. However, bioaccumulation depends on the metal, the species, and the water chemistry that influences metal bioavailability. In the laboratory, a kinetic model was used to describe waterborne Pb bioaccumulated in Gammarus pulex. Uptake and elimination rate constants were successfully determined and the effect of Ca(2+) on Pb uptake was integrated into the model. Thereafter, accumulated Pb concentrations in organisms were predicted with the model and compared with those measured in native populations from the Seine watershed (France). The predictions had a good agreement with the bioaccumulation levels observed in native gammarids and particularly when the effect of calcium was considered. To conclude, kinetic parameters experimentally derived for Pb in G. pulex are applicable in environmental conditions. Moreover, the consideration of the water's chemistry is crucial for a reliable interpretation of bioaccumulation.

A transcriptionally active pRb-E2F1-P/CAF signaling pathway is central to TGFß-mediated apoptosis.

Transforming growth factor-ß (TGFß) modulates the expression of multiple apoptotic target genes; however, a common and central signaling pathway, acting downstream of TGFß and leading to cell death, has yet to be uncovered. Here, we show that TGFß-induced apoptosis in cancer cells requires the transcription factor E2F1 (E2 promoter-binding factor 1). Using the E2F1 knockout mouse model, we also found E2F1 to be required for TGFß-mediated apoptosis in normal cells. Moreover, we found TGFß to increase E2F1 protein stability, acting at the post-translational level. We further investigated the molecular mechanisms by which E2F1 contributes to TGFß-mediated apoptosis and found that TGFß treatment led to the formation of a transcriptionally active E2F1-pRb-P/CAF complex on multiple TGFß pro-apoptotic target gene promoters, thereby activating their transcription. Together, our findings define a novel process of gene activation by the TGFß-E2F1 signaling axis and highlight E2F1 as a central mediator of the TGFß apoptotic program.

Film-thickness-dependent conduction in ordered Si quantum dot arrays.

In recent years, silicon nanostructures have been investigated extensively for their potential use in photonic and photovoltaic applications. So far, for silicon quantum dots embedded in SiO(2), control over inter-dot distance and size has only been observed in multiple bilayer stacks of silicon-rich oxides and silicon dioxide. In this work, for the first time the fabrication of spatially well-ordered Si quantum dots (QDs) in SiO(2) is demonstrated, without using the multilayer approach. This ordered formation, confirmed with TEM micrographs, depends on the thickness of the initially deposited sub-stoichiometric silicon oxide film. Grazing incidence x-ray diffraction confirms the crystallinity of the 5 nm QDs while photoluminescence shows augmented bandgap values. Low-temperature current-voltage measurements demonstrate film thickness and order-dependent conduction mechanisms, showing the transition from temperature-dependent conduction in randomly placed dots to temperature-independent tunnelling for geometrically ordered nanocrystals. Contrary to expectations from dielectric materials, significant conduction and photocarrier generation have been observed in our Si QDs embedded in SiO(2) demonstrating the possibility of forming initial film-thickness-controlled conductive films. This conduction via the silicon quantum dots in thick single layers is a promising result for integration into photovoltaic devices.

Tratamiento endovascular del aneurisma de aorta abdominal / Endovascular treatment of the abdominal aortic aneurysm

La publicación de la primera reparación endovascular de un aneurisma de aorta abdominal ha cumplido 20 años, y los estudios aleatorizados que comparan la cirugía abierta con la endovascular han completado los 10 años de seguimiento.La experiencia en la reparación endovascular ha crecido notablemente, así como su uso ampliado a anatomías complejas mediante endoprótesis estándar en unos casos o con fenestradas y/o ramificadas en otros. El empleo para aneurismas rotos se ha difundido, aunque su uso sistemático para ello cuenta aún con dificultades y diversos puntos de controversia que motivan estudios no aceptados por todos. Las novedades en nuevas endoprótesis son continuas, y actualmente asistimos a un boom de ofertas comerciales, frente a un reducido grupo establecido en el mercado desde hace años que, no obstante, también ha implementado modificaciones que deben demostrar su efectividad a largo plazo. Sociedades científicas internacionales destacadas en el ámbito europeo y mundial han publicado actualizaciones de sus guías entre 2010 e inicios de 2011, en un intento de plasmar la actualidad de un campo tan cambiante.En este momento parece razonable poner al día el documento publicado en el capítulo de Cirugía Endovascular de la Sociedad Española de Angiología y Cirugía Vascular (SEACV), que pretende ser un documento de base que, manteniendo la esencia del original, incorpora novedades, puntos de debate y propuestas razonadas de mejora a partir de las que establecer un acuerdo global en la reparación endovascular de AAA, tanto en aspectos clínicos como técnicos.Por ello las recomendaciones son genéricas, a falta de un consenso explícito y recomendaciones oficiales emanadas de la sociedad científica que nos agrupa(AU)

It is now twenty years since the publication of the first endovascular repair of an abdominal aortic aneurysm, and randomised studies comparing open surgery with endovascular surgery have completed 10 years of follow-up.Experience in endovascular repair has markedly increased, as well its widened use in complex anatomies using standard endoprosthesis in some cases, or fenestrated and/or branched in others. The use for ruptured aneurysms has spread, although its systematic use still for this still has difficulties and several points of controversy due to studies not accepted by everyone. The innovations in new stents are continuous, and we are currently experiencing a boom in commercial offer, due to a reduced group established in the market for years. These, however, have also implemented changes that still are to show their effectiveness in the long term. International scientific groups in Europe and worldwide have published updates of their guidelines between 2010 and the beginning of 2011, in an attempt to reflect the current situation in such a changing field.Up to this point, it seems reasonable to update the document published by the Endovascular Chapter of the Spanish Angiology and Vascular Surgery (SEACV), which attempts to be a reference document, that while maintaining the essence of the original, includes innovations, points for debate and reasoned proposals for improvement, from which to establish an overall agreement on the repair of abdominal aortic aneurysms, in both the clinical and technical aspects.For this reason the recommendations are generic, lack a clear consensus and official recommendations by the Scientific Society to which we belong(AU)

Endotoxin-induced myeloid-derived suppressor cells inhibit alloimmune responses via heme oxygenase-1.

Inflammation and cancer are associated with impairment of T-cell responses by a heterogeneous population of myeloid-derived suppressor cells (MDSCs) coexpressing CD11b and GR-1 antigens. MDSCs have been recently implicated in costimulation blockade-induced transplantation tolerance in rats, which was under the control of inducible NO synthase (iNOS). Herein, we describe CD11b+GR-1+MDSC-compatible cells appearing after repetitive injections of lipopolysaccharide (LPS) using a unique mechanism of suppression. These cells suppressed T-cell proliferation and Th1 and Th2 cytokine production in both mixed lymphocyte reaction and polyclonal stimulation assays. Transfer of CD11b+ cells from LPS-treated mice in untreated recipients significantly prolonged skin allograft survival. They produced large amounts of IL-10 and expressed heme oxygenase-1 (HO-1), a stress-responsive enzyme endowed with immunoregulatory and cytoprotective properties not previously associated with MDSC activity. HO-1 inhibition by the specific inhibitor, SnPP, completely abolished T-cell suppression and IL-10 production. In contrast, neither iNOS nor arginase 1 inhibition did affect suppression. Importantly, HO-1 inhibition before CD11b+ cell transfer prevented the delay of allograft rejection revealing a new MDSC-associated suppressor mechanism relevant for transplantation.

Traumatismos arteriales intratorácicos y de troncos supraaórticos. Diagnóstico y tratamiento actual / Traumatic injury to the intrathoracic arteries and the supra-aortic trunks. Their diagnosis and current treatment

Objetivos. Exposición de los diferentes métodos de diagnóstico complementarios que se usan en la actualidad y valorar, con los datos de la literatura y la experiencia propia, los tipos de tratamiento: cirugía convencional y cirugía endovascular que se utilizan actualmente para tratar las lesiones traumáticas de la aorta torácica y la región cervical. Desarrollo. Datos de incidencia generales, causas y tipos de lesiones. Exposición diagnóstica (necesidad de la angiografía convencional) y pruebas necesarias para valorar y realizar las técnicas endovasculares. Exposición del tratamiento convencional y endovascular tanto técnico como resultados. Características que los diferencian y sus preferencias. Conclusiones. El análisis de los datos pone de manifiesto que la no necesidad de heparinización asociada a la posibilidad de diferir la intervención quirúrgica es la situación que mejores cifras de morbilidad y mortalidad ofrece. La lesión aguda con inestabilidad hemodinámica o sangrado activo debe ser intervenida urgentemente y la lesión estable permite realizar un estudio diagnóstico que orientará al tipo de tratamiento y características de las lesiones asociadas que presente el paciente, que en muchas ocasiones van a mediatizar el pronóstico

Aims. To describe the different complementary methods of diagnosis that are currently used and to evaluate, with data from the literature and our own experience, the types of treatment, that is conventional surgery and endovascular surgery, that are utilised nowadays to treat traumatic injuries to the thoracic aorta and the cervical region. Development. Data concerning general incidence, causes and types of injury. The diagnosis (need for conventional angiography) and tests required to appraise and perform endovascular techniques are described. Outline of the techniques and outcomes of conventional and endovascular treatment, as well as the characteristics that differentiate them and the preferences for each. Conclusions. An analysis of the data shows that the lack of a need for heparinisation in association with the possibility of delaying surgical intervention is the situation that offers the best morbidity and mortality rates, regardless of which surgical technique is used. Acute injury with haemodynamic instability or active bleeding requires urgent surgical intervention and a stable injury allows us to conduct a diagnostic study that will guide us as to the type of treatment and the characteristics of the associated injuries presented by the patient, which in many cases are going to affect the prognosis

Tratamiento endovascular de la patología aneurismática de la aorta abdominal / No disponible

No disponible

Calnexin-dependent regulation of tunicamycin-induced apoptosis in breast carcinoma MCF-7 cells.

The endoplasmic reticulum (ER) has evolved specific mechanisms to ensure protein folding as well as the maintenance of its own homeostasis. When these functions are not achieved, specific ER stress signals are triggered to activate either adaptive or apoptotic responses. Here, we demonstrate that MCF-7 cells are resistant to tunicamycin-induced apoptosis. We show that the expression level of the ER chaperone calnexin can directly influence tunicamycin sensitivity in this cell line. Interestingly, the expression of a calnexin lacking the chaperone domain (DeltaE) partially restores their sensitivity to tunicamycin-induced apoptosis. Indeed, we show that DeltaE acts as a scaffold molecule to allow the cleavage of Bap31 and thus generate the proapoptotic p20 fragment. Utilizing the ability of MCF-7 cells to resist tunicamycin-induced apoptosis, we have characterized a molecular mechanism by which calnexin regulates ER-stress-mediated apoptosis in a manner independent of its chaperone functions but dependent of its binding to Bap31.

Traumatismo cerrado de aorta torácica. Posibilidades diagnósticas y opciones de tratamiento / closed traumatic injury to the thoracic aorta. Diagnostic possibilities and therapeutic options

Objetivos. Exponer los diferentes métodos de diagnóstico complementarios que se usan en la actualidad y valorar, con los datos de la literatura y la experiencia propia, los tipos de tratamiento: cirugía convencional y cirugía endovascular, que se utilizan actualmente para tratar las lesiones traumáticas de la aorta torácica. Desarrollo. Datos de incidencia generales, causas y tipos de lesiones. Exposición diagnóstica (necesidad de la angiografía convencional) y pruebas necesarias para valorar y realizar las técnicas endovasculares. Exposición del tratamiento convencional y endovascular tanto técnico como de resultados. Características que los diferencian y preferencias de éste. Conclusiones. El análisis de los datos pone de manifiesto que la no necesidad de heparinización asociada a la posibilidad de diferir la intervención quirúrgica es la situación que mejores cifras de morbilidad y mortalidad ofrece, sea cual fuere la técnica quirúrgica empleada. En la actualidad, la cirugía convencional tiene unas cifras globales de mortalidad operatoria del 8-15%, sea cual sea la técnica quirúrgica utilizada o el sistema de protección. Por el contrario, la utilización de técnicas endovasculares presenta unas cifras inferiores al 2%. Sin embargo, la falta de seguimiento a largo plazo hace que no sepamos el comportamiento y la resistencia de estos materiales utilizados en las técnicas endovasculares. La evolución posterior nos tiene que poner de manifiesto la durabilidad de estas técnicas, hecho crucial para este tipo de paciente muy joven

Aims. To report on the different complementary methods of diagnosis that are currently in use and to evaluate, with data from the literature and our own experience, the types of treatment, namely conventional surgery and endovascular surgery, that are used nowadays to treat traumatic injuries to the thoracic aorta. Development. Data concerning general incidence, causes and types of injury. Outline of diagnosis (conventional angiography required) and tests needed to appraise and perform endovascular techniques.Outline of both the technique and outcomes of conventional and endovascular treatment. The characteristics that differentiate them and the preferences for the latter. Conclusions. Analysis of the data shows that the lack of a need for heparinisation associated to the possibility of delaying the surgical intervention is the situation that offers the best morbidity and mortality rates, no matter which surgical technique is used. The overall operative mortality rates in conventional surgery are currently around 8-15%, regardless of the surgical technique or the protection system that is utilised. In contrast, the use of endovascular techniques offers figures below 2%. Nevertheless, the lack of a long-term follow-up means that we do not know how the materials employed in endovascular techniques behave or how resistant they are. The progression following the intervention has to show us that these techniques are durable –a fact that is crucial for this kind of very young patient