[Primary epidermoid carcinoma of the colon].
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Carcinoma, Squamous Cell↗
Biomedical subjects
F Berger
Publications and source records attributed to F Berger.
[Late cryptococcal meningitis after liver transplantation].
We report a case of cryptococcal meningitis, eight years after liver transplantation for primary biliary cirrhosis. Detection of the cryptococcal antigen in serum and cerebrospinal fluid appears to be essential for initial diagnosis and follow-up. Oral fluconazole treatment alone can be effective, when given for a very long period to prevent relapse.
Female↗
Reversal of early acute rejection with increased doses of tacrolimus in liver transplantation: a pilot study.
BACKGROUND: In this pilot study, we present the results of treatment of early (3 months after liver transplantation) acute rejection episodes by increasing only the tacrolimus doses. METHODS: Ten patients who received tacrolimus as primary treatment experienced acute mild (one case), moderate (four cases), or severe (five cases) rejection episodes. Tacrolimus dosing was increased 1-2 mg every 1 or 2 days until hepatic enzymes started to improve. Steroid basic daily doses were kept unchanged. RESULTS: With the daily dose of tacrolimus increased by a median 1.89-fold (range: 1.2-5), alanine aminotransferase, bilirubin, and gamma-glutamyltranspeptidase levels rapidly reached normal values within the first month. During a median follow-up time of 19.5 months (range: 14-24), none of the 10 patients died or lost their graft. Control liver biopsies were done 13.5 months (range: 7-19) after rejection episode in all patients, and none demonstrated evidence of rejection or sequela. CONCLUSION: This pilot study suggests that increasing tacrolimus dosage could be considered as treatment against early acute rejection episodes including the severe grade.
Acute Disease↗
Nicotinic receptor-induced apoptotic cell death of hippocampal progenitor cells.
Nicotine has many effects on CNS functions, presumably through its action on neuronal nicotinic acetylcholine receptors (AChRs). One subclass of AChRs that binds the snake venom toxin alpha-bungarotoxin (alpha-Bgt-AChRs) has been shown to modulate neurotransmission in the brain. We now show that alpha-Bgt-AChR activation by low doses of nicotine results in apoptotic cell death of both primary and immortalized hippocampal progenitor cells. In HC2S2-immortalized hippocampal progenitors, nicotine is cytotoxic to undifferentiated cells, whereas it spares the same cells once differentiation has been induced. The activation of alpha-Bgt-AChRs by nicotine results in the induction of the tumor suppressor protein p53 and the cdk inhibitor p21. The cytotoxic effect of nicotine is dependent on extracellular calcium levels and is probably attributable to the poor ability of undifferentiated progenitors to buffer calcium loads. The major calcium buffer in these cells, calbindin D28K, is present only after differentiation has been induced. Furthermore transfection of undifferentiated cells with calbindin results in dramatic protection against the cytotoxic effects of nicotine. These results show that nicotine abuse could have significant effects on the survival of progenitor populations in the developing and adult brain and also suggest an endogenous role for alpha-Bgt-AChRs in neuronal development and differentiation.
Animals↗
Prognostic significance of T-cell phenotype in aggressive non-Hodgkin's lymphomas. Groupe d'Etudes des Lymphomes de l'Adulte (GELA).
Peripheral T-cell lymphomas (PTCL) have been generally reported to have a worse prognosis than B-cell lymphomas (BCL). Because of their heterogeneity and scarcity, the outcomes of the different histological subtypes have not been compared. From October 1987 to March 1993, 1,883 patients with diffuse aggressive non-Hodgkin's lymphomas (NHL) included in the LNH87 protocol could be assessed for both morphology and immunophenotyping. Among them, 288 (15%) had PTCL and 1,595 (85%) had BCL. According to the Kiel classification, most PTCL were classified as angioimmunoblastic (AIL; 23%), pleomorphic medium and large T-cell (PML; 49%), or anaplastic large cell (ALCL; 20%) lymphomas. Comparing PTCL with BCL patients, the former had more disseminated disease (78% v 58%), B symptoms (57% v 40%), bone marrow involvement (31% v 17%), skin involvement (21% v 4%), and increased beta2-microglobulin (50% v 34%), whereas BCL patients had more bulky disease (41% v 26%). According to the International Prognostic Index (IPI), PTCL and BCL scores were, respectively: 0 factors, 13% and 15%; 1 factor, 17% and 22%; 2 factors, 24% and 25%; >/=3 factors, 45% and 37% (P = .09). For BCL and PTCL, respectively, complete remission rates were 63% and 54% (P = .004); the 5-year overall survival (OS) rates were 53% and 41% (P = .0004) and event-free survival (EFS) rates were 42% and 33% (P < . 0001). Comparison of the different histological subtypes of lymphoma showed that the 5-year OS rate for T-ALCL (64%) was superior to those of other PTCL (35%) as well as diffuse large B-cell (53%) NHL. When multivariate analysis was applied using the IPI score as one factor, nonanaplastic PTCL remained an independent parameter (P = . 0004). Although the poor prognosis of non-ALCL PTCL could be due in part to the presence of adverse prognostic factors at diagnosis, this study shows that the T-cell phenotype is an independent significant factor, which should be incorporated into the definition of prognostic groups.
Adolescent↗
Positional information in root epidermis is defined during embryogenesis and acts in domains with strict boundaries.
BACKGROUND: Cell position rather than cell lineage governs most aspects of development in plants. However, the nature and the origin of positional information remains elusive. Animal epidermal patterning relies in many cases on positional information provided by cell-cell communication. The epidermal layer of the Arabidopsis root is made of alternating files of two cell types and thus presents a simple pattern to study positional mechanisms. RESULTS: Clonal analysis of the root epidermis in combination with molecular and morphological markers has shown that cell fate is determined by position relative to the underlying cell layer, the cortex. The epidermal pattern appears to be organised during embryogenesis. Fate is not fixed in the developing root, though, as cells that move into a position previously occupied by neighbour cells ablated using laser microsurgery change fate. In contrast, cell fate is not altered when communication with living neighbour cells is impaired. Precise mapping of the influence of the position of extracellular cues on cell fate has shown that domains of positional information are organised with well-defined boundaries. CONCLUSIONS: Cell-fate specification in the root epidermis relies on positional information that is organised in stable domains with sharp boundaries. The epidermal pattern is defined during embryogenesis and positional information remains active in the root until the initiation of cell morphogenesis. The origin of some positional cues might be extracellular.
Arabidopsis↗
Control of cell division in the root epidermis of Arabidopsis thaliana.
The formation of the root epidermis in Arabidopsis thaliana provides a simple model to study mechanisms underlying patterning in plants. In this paper we have analyzed the relationships between cell fate specification and the pattern of cell division that occur in the root epidermis. Using clonal analysis, the two cell types of the developing root epidermis, trichoblasts and atrichoblasts, were distinguished by different rates of cell division, highest in trichoblasts. This character appears to be dependent on TTG which controls epidermal cell fate specification. The ability of epidermal cells to undergo longitudinal divisions which are involved in the control of the radial symmetry was shown to be controlled in a cell-specific manner by TTG. The control of the rate and the orientation of cell division in the root meristem epidermal layer thus appear to be under the control of cell fate specification mechanisms.
Arabidopsis↗
Stomata patterning on the hypocotyl of Arabidopsis thaliana is controlled by genes involved in the control of root epidermis patterning.
Stomata complexes are epidermal specialized structures typical of the upper aerial part of plants (shoot). In the model plant Arabidopsis thaliana, we show that in the hypocotyl (the) junction between the shoot and the root), stomata are organized according to a clear pattern reminiscent of the root epidermis pattern. Although stomata complexes are typical of the shoot epidermis, their pattern on the hypocotyl is under the control of genes involved in root epidermis patterning. Moreover, we have isolated a GFP marker line for the hypocotyl epidermal cells which do not differentiate stomata complexes. In this line the root and the hypocotyl epidermal patterns are similar. Our data support the existence of interactions between developmental mechanisms involved in the control of the apical/basal polarity and the radial symmetry of the plant body.
Arabidopsis↗
Different inhibition patterns of tedisamil for fast and slowly inactivating transient outward current in rat ventricular myocytes.
Tedisamil has been described as a selective inhibitor of a fast inactivating transient outward current (i(to,f)) in rat ventricular myocytes. Because recent reports demonstrated the existence of a second slowly inactivating transient component (i(to,s)) we investigated i(to,s) and differentiated the effects of tedisamil on both transient outward current components and their influence on action potential duration. Standard electrophysiological techniques were used for whole cell recordings at 24-26 degrees C from enzymatically isolated myocytes. Inhibition of i(to,f) by tedisamil was the result of an acceleration of inactivation at positive test potentials with a concentration for half-maximal inhibition (EC50) of 4-7 micromol/l, which is confirmatory to reports from other investigators. Our new results show that i(to,s) is more sensitive to tedisamil with an EC50 of 0.5 micromol/l. Furthermore the pattern of i(to,s) inhibition is different compared with i(to,f), because inactivation of i(to,s) is not accelerated by tedisamil. Instead the amplitude of the steady state inactivation curve of i(to,s) is attenuated which indicates a reduction of maximally available current. I(to,s) was evaluated by three different methods as time-dependently inactivating current (7.5 s test pulse duration), voltage-dependently inactivated current and tedisamil-sensitive current. All approaches yield similar inactivation curves. The potential for halfmaximal inactivation of i(to,s) lies about 35 mV more negative than that for i(to,f) and the slope factor (K = -23 mV) is different to that of i(to,f) (K = -3 mV). Effectiveness of tedisamil-induced modulation of i(to,f) and i(to,s) on action potential repolarization was tested. Action potentials stimulated at 0.5 Hz were not prolonged by 1 micromol/l tedisamil (dominant i(to,s) block) at a repolarization level of 0 mV but prolonged to about 120% of control at -70 mV. This indicates that i(to,f) was sufficient to guarantee a regular early repolarization whereas decrease of i(to,s) delayed the final repolarization. In conclusion, the observation that tedisamil inhibits i(to,f) and i(to,s) differently supports the hypothesis that the two i(to)-components are related to two different channel populations expressed in rat ventricular myocytes.
Action Potentials↗
Split lung ventilation in a patient with differential pulmonary hemodynamics.
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Adult↗
[Initial clinical results with the Amplatzer septal occluder--a self-centering double disc for occlusion of atrial septal defects].
UNLABELLED: In recent years many different systems for transcatheter closure of an atrial septal defect (ASD) have been developed and tested. However, all systems presently available have some special disadvantages. The recently introduced Amplatzer Septal Occluder (ASO), though, appears promising. It is a self-expanding and self-centering double disc made from a Nitinol mesh, which is tightly woven to give mechanical strength. Both discs are separated by a connecting cylindrical portion. Its diameter may be chosen, so that it corresponds to that of the ASD. Discs of polyester patches are sewn into the retention discs as well as into the cylindrical portion of the device in order to augment thrombogenicity. After measuring the diameter of the ASD with a balloon, an appropriate ASO is selected and advanced into the left atrium through a 7 or 8 French sheath. Then the distal disc and part of the connecting cylindrical portion is developed in the left atrium and pulled against the atrial septum, so that the cylindrical portion is occluding the ASD. Thereafter, proximal disc is deployed and the delivery cable disconnected. As long as the cable is connected to the device repositioning is easily achieved by pulling the device back into the sheath. Within a time period of 4 months in 29 out of 31 patients (median age: 12.1 years, median weight: 45.0 kg) complete closure of the ASD with a mean diameter of 11.0 mm (6-20 mm) was achieved without complications, the average fluoroscopy time being 8.3 min (2.9-21.5 min). Mean Qp:Qs was 1.5 (0.9-2.2). During a mean follow-up period of 2.1 months post implantation fixed seating of the ASO without residual shunt, arrhythmias, thrombembolic events and impairment of A-V valves was observed in all patients. CONCLUSION: The Amplatzer septal occluder allows quick, safe, and complete closure of atrial septal defects without complications if one adheres to strict implantation criteria. For a final judgement, however, long-term follow-up studies are necessary.
Adolescent↗
[Medial pancreatectomy with pancreatogastric anastomosis in pancreatic neoplasms].
AIM OF THE STUDY: To report a personal series of ten patients who underwent a medial pancreatectomy with pancreaticogastrostomy for tumor of the pancreas. MATERIAL AND METHODS: An equal number of five patients had solid and cystic tumors. The solid tumors were all endocrine and included two cases of insulinoma and solitary cases of VIPoma, glucagonoma, and non-secreting tumor. Five patients had a cystic tumor which was in two cases a serous cystadenoma, and in the other cases, a mucinous cystadenoma, a solid pseudopapillary tumor, and a solitary hydatid cyst of the pancreas. The operative procedure included a middle segment pancreatectomy, a suture of the proximal pancreatic stump, an anastomosis of the distal pancreatic stump with the stomach and an external transgastric drainage of the distal main pancreatic duct. RESULTS: In the postoperative course, a sero-hematic collection close to the anastomosis occurred in four patients and required external drainage in three cases. All patients recovered without sequela of pancreatic dysfunction. CONCLUSION: This series confirms the place of medial pancreatectomy in resection of non-enucleable tumors of the middle part of the pancreas. It also shows that pancreaticogastrostomy is a technical simplification compared to Roux-en Y pancreaticojejunostomy in this particular modality of pancreatectomy.
Adolescent↗
A modified repair technique for tricuspid incompetence in Ebstein's anomaly.
OBJECTIVE: A modified technique for tricuspid valve repair in Ebstein's anomaly restructures the valve mechanism at the level of the true tricuspid anulus by using the most mobile leaflet for valve closure without plication of the atrialized chamber. Midterm results of this therapeutic approach for patients with Ebstein's anomaly and tricuspid valve incompetence are reported. METHODS: Between October 1988 and April 1997, the incompetent tricuspid valve was repaired with our technique in 19 patients (12 female, 7 male; 2 to 54 years, mean 21 years). The indication for operation was congestive heart failure of various degrees in all patients. Tricuspid incompetence was grade II in two patients, grade III in 14, and grade IV in three. Associated congenital malformations were simultaneously repaired (interatrial communication in 18, ventricular septal defect in two, pulmonary stenosis in two, mitral valve prolapse in one). Follow-up ranged between 10 and 103 months (median 28 months) and was complete for all patients. RESULTS: There were no operative deaths. One patient with active endocarditis and pulmonary abscess died 2 months after the operation of recurrent sepsis; there were no late deaths. During follow-up, New York Heart Association functional class improved from 2.8 before the operation to 1.9 without recurrent cyanosis, and tricuspid incompetence decreased from a mean grade of 3.1 to one of 0.9, without any echocardiographic deterioration of the tricuspid valve function or right ventricular dilation. CONCLUSIONS: Our technique allows tricuspid valve repair in patients with Ebstein's anomaly, even in cases usually reserved for primary valve replacement, without late functional deterioration.
Adult↗
Necrolytic migratory erythema, first symptom of a malignant glucagonoma: treatment by long-acting somatostatin and surgical resection. Report of three cases.
We report three cases of malignant glucagonoma with necrolytic migratory erythema as the first clinical symptom. Long-acting somatostatin analogue was the first step of a multimodal therapeutic strategy which included surgical resection of the primary tumour in every case. Liver metastases which were present in two patients were treated by hepatic arterial chemoembolization and systemic chemotherapy in one case and by liver resection for cytoreduction and hepatic arterial chemoembolization in another case. Skin lesions resolved in all three patients.
Aged↗
RLU and studies using the luciferase reporter gene.
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Calibration↗
Mantle cell lymphoma: a retrospective study of 121 cases.
Mantle cell lymphoma (MCL) patients represent a difficult problem, sometimes to establish the diagnosis but mostly because of their refractoriness to standard lymphoma treatments. Which treatments to apply and to whom is not yet defined. In this study, we attempted to analyze the clinical features, to identify the major prognostic factors, and to evaluate the outcome of 121 MCL patients treated in our institution between 1979 and 1997. Clinical data, treatment modalities, and International Prognostic Index (IPI) score were evaluated. Median age was 63 years. Patients usually presented with advanced stage disease (87%), disseminated lymph nodes (57%), bone marrow involvement (79%), but with a good performance status (PS) (81%). Lymphocytosis >4000/microl and/or peripheral blood involvement was present in 36% of cases, and gastrointestinal disease in 18%. The t(11;14)(q13;q32) and/or bcl-1 rearrangement was detected in 47/57 studied cases. Median overall survival (OS) was 3.12 years and a longer survival was significantly associated with younger age (<70 years), good PS (<2), localized disease (stage I-II), fewer than two extra-nodal sites, absence of spleen or peripheral blood involvement, normal serum LDH and beta2-microglobulin levels, and hemoglobin level greater than 12 g/dl. However, the IPI failed to identify patients with longer OS and in a multiparametric analysis, only older age, hemoglobin less than 12 g/dl, poor PS, and blood involvement were associated with a poorer outcome. Treatment modalities had no impact on survival with 75% of patients relapsing or progressing. Our data showed that the poor outcome of MCL patients is mainly related to adverse patient characteristics, a highly disseminated tumor, and some unknown parameters associated with the refractoriness to standard therapy.
Adult↗
Lymphomatoid granulomatosis--a report on four cases: evidence for B phenotype of the tumoral cells.
Four cases of lymphomatoid granulomatosis are reported, three of them involving the lung. Histological features included a true angiocentric and angiodestructive polymorphic cellular proliferation. This included histiocytes, plasma cells, many reactive T-cells and rare large, atypical cells which were of the B phenotype. Epstein-Barr virus was detected in the atypical cells by in situ hybridization in three cases, with expression of both latent membrane proteins (LMP)-1 and Epstein-Barr nuclear antigen-2 in two cases and expression of only LMP-1 in the third case. Expression of both of these proteins suggests a defect in the T-cell-mediated immunity and that Epstein-Barr virus is not only a silent passenger but may also be involved in the pathogenesis of the disease. This could have implications for therapy.
Adult↗
Burkitt-like lymphomas in AIDS patients: characterization within a series of 103 human immunodeficiency virus-associated non-Hodgkin's lymphomas. Burkitt's Lymphoma Study Group.
PURPOSE: Burkitt-like lymphoma (BLL) is a tumor with morphologic features intermediate between Burkitt's lymphoma (BL) and large-cell lymphoma, but its relationship with these lymphomas is currently unclear. We have therefore analyzed its characteristics within a large series of human immunodeficiency virus (HIV)-associated lymphomas. MATERIALS AND METHODS: Clinical, histologic, immunophenotypic, and molecular analyses were performed on 103 patients with AIDS lymphomas. RESULTS: Nineteen cases (18.4%) were identified as BLL. They were monoclonal B-cell proliferations, as evaluated by immunoglobulin (Ig) gene rearrangement analyses, and had rearrangement of the c-myc oncogene in 68% of cases but not the bcl-2 gene, in contrast to a previous study on non-HIV-associated BLL. This molecular pattern was therefore identical to that of typical BL, suggesting that they represented tumors of similar origin. However, some features could clearly differentiate BLL from BL and were similar to those seen in the diffuse large-cell immunoblastic lymphomas (DLC-IBL) group. These included a greater frequency of Epstein-Barr Virus (EBV) infection (79% v 48%, P = .04), an upregulation of CD39 (50% v 0%, P = .0007) and CD70 (75% v 15%, P = .003) activation antigens and of the CD11a/LFA-1 adhesion molecule (83% v30%, P = .05), and, finally, a lower CD4 count (mean, 119/microL v 270/microL, P = .04). CONCLUSION: BLL is a frequent entity among AIDS lymphomas and should be considered as a morphologic variant of BL in the context of severe immunodepression that occurs in HIV-infected patients.
Adult↗