[Robotic surgery in gynecologic oncology: Retrospective and comparative study with laparotomy and laparoscopy]. / Chirurgie robotique en cancérologie gynécologique: étude rétrospective comparative avec la laparotomie et la cœlioscopie traditionnelle.

OBJECTIVES: To compare robot-assisted laparoscopy with conventional laparoscopy and laparotomy in gynecologic oncology. PATIENTS AND METHODS: This is a monocentric retrospective study enrolling 92 patients who underwent a standard or radical hysterectomy (with parametrectomy) with or without pelvic lymphadenectomy between January 2008 and December 2010. All patients were diagnosed for a cervical or endometrial cancer. Laparotomy was performed for 33 patients, conventional laparoscopy for 20 patients, and robot-assisted laparoscopy for 39 patients. The main parameter was the length of hospital stay in the three groups. RESULTS: Length of hospital stay significantly decreased in the robotic group in comparison with the laparotomic group (median 5 and 8 days respectively, P<0.0001), but no differences were found between the robotic and laparoscopic groups (P=0.77). Intraoperative blood loss was lower in the robotic group. Intraoperative complications and lymph nodes removed were equal in the three groups. Regarding the data recorded, there were no significant differences between conventional and robotic laparoscopy. Hysterectomies performed after pelvic radiation, which were all made by laparotomy before the robot's arrival, were all performed with robotic laparoscopy since its arrival. CONCLUSION: Robotic surgery allows a reduced length of hospital stay and a lower blood loss in comparison with laparotomy, without any worse oncologic results. Robotic surgery changed our practice, especially hysterectomy after pelvic radiation, performed by laparotomy before.

The human growth factor-inducible immediate early gene, CYR61, maps to chromosome 1p.

Complementary DNA encoding the human CYR61 protein was isolated from human embryonic tissues and mapped to chromosome 1p22-p31. We show that CYR61 encodes a 381 amino acid protein rich in cysteine and proline residues that is strongly conserved with the mouse homologue. Sequence analysis reveals the presence of several distinct protein domains which confer a mosaic structure to this protein and makes human CYR61 a member of a recently described growth regulator family that includes several proto-oncogene products. From our results we hypothesize that this new immediate early gene may play a role in cell commitment during embryogenesis and more generally in the control of cell proliferation.

Characterization of the human jumonji gene.

While constructing a cDNA library of human embryos, we have isolated a clone homologous to jumonji, a mouse gene required for neural tube formation. We have determined the complete coding sequence of the human homologue (JMJ) and deduced the amino acid sequence of the putative protein. We show here that human and mouse jumonji putative proteins are homologous and present 90% identity. During human embryogenesis, JMJ mRNAs are predominantly expressed in neurons and particularly in dorsal root ganglion cells. They are also expressed in neurons of human adult cerebral cortex. In view of these observations, we propose JMJ as a candidate gene for developmental defects of the central nervous system in the human. The human JMJ gene maps at position 6p24-6p23.

Cloning of the human homologue of the TGF beta-stimulated clone 22 gene.

We have isolated the human homologue if the TGF beta-stimulated clone 22 gene from a human embryo cDNA library. This gene maps to the q14 region of chromosome 13. Its deduced amino acid sequence is almost 99% identical to that of mouse or rat proteins and includes a putative leucine zipper motif. An abundant major transcript of 1.8 kb and in some instances an additional 5 kb transcript were detected by Northern blotting of several human tissues. The TSC-22 protein has been shown to be well conserved across evolution as evidenced by the existence of a Drosophila homologue. These observations prompt discussion on the strong conservation of TSC-22 during evolution but also on its general function as a primary response gene expressed either when stimulated by several different factors during early human development, or in the adult in response to inducing differentiation signals.

The human SOX11 gene: cloning, chromosomal assignment and tissue expression.

The mammalian testis determining gene SRY contains an HMG box-related DNA binding motif. By analogy a family of genes related to SRY in the HMG domain have been called SOX (SRY box-related genes). We have cloned and characterized the human SOX11 gene using the partial cloning of both human and mouse SOX11 genes and mapped it to chromosome 1p25. The SOX11 sequence is strongly conserved with the chicken homologue and is related to SOX4. It contains several putative transcriptional either activator or repressor domains. SOX11 expression pattern is consistent with the hypothesis that this gene is important in the developing nervous system.

Postoperative pseudosarcomatous nodule: report of one case and review of the literature.

We present a case of a large postoperative pseudosarcomatous bladder tumour and review the literature for this exceptional benign tumour. Several lesions, especially leiomyosarcoma, must be discussed. Immunohistochemical studies are helpful. The evolution is always benign, even with an incomplete tumour ablation.

[The use of sulprostone (Nalador) in the evacuation of uterine contents. Apropos of 32 cases at the Department of Gynecology, University Hospital Center, Nîmes, over 2 years (a retrospective study)]. / Utilisation du sulprostone (Nalador) dans l'évacuation du contenu utérin. A propos de 32 observations du Service de Gynécologie CHU Nîmes sur deux années (étude rétrospective).

We have studied the use of sulprostone in evacuating uterine contents in 32 patients, the majority of whom were in the second trimester of their pregnancies. There are three ways to administer the drug (continuous intravenous, intermittent intravenous, and intramuscular); the best results were obtained when the drug was administered continuously intravenously. It was well tolerated, the use of Nalbuphine reducing pain. There were few side effects. The use of this product is discussed in connection with a few of the cases as well as the possible alternative treatments in difficult cases.

[Sub-capsular hematoma of the liver during pregnancy: a case report]. / Hématome sous-capsulaire du foie en cours de grossesse: un cas.

A sub-capsular haematoma of the liver is a rare but very serious complication of pregnancy. We report a case of a primipara whose pregnancy was first complicated by hypertension, then by a haematoma of the liver at the 28th week of amenorrhoea. It was diagnosed because of the clinical symptoms associated with the hypertension and a pain in the right hypochondrium and nausea. The diagnosis of haematoma of the liver was made before rupture and confirmed by ultrasound of the liver and by tomodensitometry made it possible to avoid operating on the liver during the laparotomy that was carried out to terminate the pregnancy. Regular X-ray follow-ups showed that the lesion had regressed in six months. MRI investigation of the parenchyma of the liver showed no cause of the lesions. If there is even the slightest suspicion of a haematoma of the liver in pregnancy, ultrasound nowadays should be carried out because it is indispensable to make the diagnosis.