A critical evaluation of secondary cancer risk models applied to Monte Carlo dose distributions of 2-dimensional, 3-dimensional conformal and hybrid intensity-modulated radiation therapy for breast cancer.

The comparison of radiotherapy techniques regarding secondary cancer risk has yielded contradictory results possibly stemming from the many different approaches used to estimate risk. The purpose of this study was to make a comprehensive evaluation of different available risk models applied to detailed whole-body dose distributions computed by Monte Carlo for various breast radiotherapy techniques including conventional open tangents, 3D conformal wedged tangents and hybrid intensity modulated radiation therapy (IMRT). First, organ-specific linear risk models developed by the International Commission on Radiological Protection (ICRP) and the Biological Effects of Ionizing Radiation (BEIR) VII committee were applied to mean doses for remote organs only and all solid organs. Then, different general non-linear risk models were applied to the whole body dose distribution. Finally, organ-specific non-linear risk models for the lung and breast were used to assess the secondary cancer risk for these two specific organs. A total of 32 different calculated absolute risks resulted in a broad range of values (between 0.1% and 48.5%) underlying the large uncertainties in absolute risk calculation. The ratio of risk between two techniques has often been proposed as a more robust assessment of risk than the absolute risk. We found that the ratio of risk between two techniques could also vary substantially considering the different approaches to risk estimation. Sometimes the ratio of risk between two techniques would range between values smaller and larger than one, which then translates into inconsistent results on the potential higher risk of one technique compared to another. We found however that the hybrid IMRT technique resulted in a systematic reduction of risk compared to the other techniques investigated even though the magnitude of this reduction varied substantially with the different approaches investigated. Based on the epidemiological data available, a reasonable approach to risk estimation would be to use organ-specific non-linear risk models applied to the dose distributions of organs within or near the treatment fields (lungs and contralateral breast in the case of breast radiotherapy) as the majority of radiation-induced secondary cancers are found in the beam-bordering regions.

Alps, genes, and chromosomes: their role in the formation of species in the Sorex araneus group (Mammalia, Insectivora), as inferred from two hybrid zones.

During the Pleistocene glaciations, the Alps were an efficient barrier to gene flow between isolated populations, often leading to allopatric speciation. Afterwards, the Alps strongly influenced the post-glacial recolonization of Europe and represent a major suture zone between differentiated populations. Two hybrid zones in the Swiss and French Alps between genetically and chromosomally well-differentiated species-the Valais shrew, Sorex antinorii, and the common shrew, S. araneus-were studied karyotypically and by analyzing the distribution of seven microsatellite loci. In the center of the Haslital hybrid zone the two species coexist over a distance of 900 m. Hybrid karyotypes, among them the most complex known in Sorex, are rare. F-statistics based on microsatellite data revealed a strong heterozygote deficit only in the center of the zone, due to the sympatric distribution of the two species with little hybridization between them. Structuring within the species (both F(IS) and F(ST)) was low. An hierarchical analysis showed a high level of interspecific differentiation. Results were compared with those previously reported in another hybrid zone located at Les Houches in the French Alps. Genetic structuring within and between species was comparable in both hybrid zones, although chromosomal incompatibilities are more important in Haslital, where a linkage block of the race-specific chromosomes should additionally impede gene flow. Evidence for a more restricted gene flow in Haslital comes from the genetically intermediate hybrid karyotypes, whereas in Les Houches, hybrid karyotypes are genetically identical to individuals of the pure karyotypic races. Genic and chromosomal introgression was observed in Les Houches, but not in Haslital. The possible influence of a river, separating the two species at Les Houches, on gene flow is discussed.

Genetic and karyotypic structure of a hybrid zone between the chromosomal races Cordon and Valais in the common shrew, Sorex araneus

Hybrid zones between genetically differentiated populations provide material to study evolutionary processes. Since the discovery of chromosomal races in Sorex araneus, contact zones have attracted attention of scientists. So far, studies on genetic markers in Sorex hybrid zones are missing. The acrocentric chromosomal race Cordon and the highly metacentric race Valais meet and hybridize at Les Houches in the Western Alps. On a transect through the hybrid zone, 273 shrews were caught at 15 localities over 4 years. Karyotype as well as the nuclear protein loci Alb and Pg were analyzed. F-st and F-is values were calculated by F-statistics. An analysis on pooled samples revealed the genetical differences between the hybridizing races as the only cause of population structuring. Genetical markers show dines with very strong frequency shifts at a mountain torrent, but behave differently through the zone. The performance of the torrent in maintaining the hybrid zone, selection against hybrids, possible assortative mating and linkage of the Valais Pg allele to a diagnostic chromosome arm, are discussed.

Estimating gene flow across hybrid zones: how reliable are microsatellites?

Due to their high polymorphism, microsatellites have become one of the most valued genetic markers in population biology. We review the first two published studies on hybrid zones of the common shrew based on microsatellites. Both reveal surprisingly high interracial gene flow. It can be shown that these are overestimates. Indeed, in classical population genetics models as F-statistics, mutation is neglected. This constitutes an acceptable assumption as long as migration is higher than mutation. However, in hybrid zones where genetic exchanges can be rare, neglecting mutation will lead to strong overestimates of migration when working with microsatellites which display mutation rates up to 10(-3). As there seems to be no straightforward way to correct for this bias, interracial gene flow estimates based on microsatellites should be taken with caution. This problem should however not conceal the enormous potential of microsatellites to unravel the genetics of hybrid zones.

Transjugular liver biopsy: prospective evaluation of the angle formed between the hepatic veins and the vena cava main axis and modification of a semi-automated biopsy device in cases of an unfavorable angle.

In cases of transjugular liver biopsies, the venous angle formed between the chosen hepatic vein and the vena cava main axis in a frontal plane can be large, leading to technical difficulties. In a prospective study including 139 consecutive patients who underwent transjugular liver biopsy using the Quick-Core biopsy set, the mean venous angle was equal to 49.6 degrees. For 21.1% of the patients, two attempts at hepatic venous catheterization failed because the venous angle was too large, with a mean of 69.7 degrees. In all of these patients, manual reshaping of the distal curvature of the stiffening metallic cannula, by forming a new mean angle equal to 48 degrees , allowed successful completion of the procedure in less than 10 min.

Interventions hybrides et malformations cardiaques congénitales [Hybrid procedures in congenital heart disease]

La complexité croissante de la prise en charge des malformations cardiaques congénitales impose des interventions chirurgicales et des cathétérismes cardiaques interventionnels fréquents. Chacune de ces techniques a ces limitations propres. Les interventions hybrides associent les avantages de la chirurgie cardiaque et du cathétérisme interventionnel. Dans notre expérience, les thérapies hybrides permettent de diminuer le temps de circulation extracorporelle, de diminuer la morbidité des interventions chirurgicales, de raccourcir le séjour du patient aux soins intensifs. Pour certaines malformations cardiaques congénitales complexes pour lesquelles il n'existe pas de chirurgie ou de thérapie interventionnelle idéale, les interventions hybrides sont en train de s'imposer comme la prise en charge incontournable. Increasing complexity in management of congenital heart disease imposes more frequent surgeries and interventions. Each technique has its own limitations, which could impair the anticipated result. Hybrid procedures join the advantages of cardiac surgery and interventions, creating a synergy in the management of these patients with cardiac anomalies. In our experience, hybrid procedures shorten cardiopulmonary bypass, reduce morbidity of surgery and reduce duration of stay in the intensive care unit. For some complex congenital heart diseases for which there are no ideal surgical or interventional options, hybrid procedures are becoming increasingly important in their management. Finally hybrid procedures allow surgeons and cardiologist to achieve complex procedures that could not be possible in another way

Monoclonal antibodies specific for carcinoembryonic antigen and produced by two hybrid cell lines.

Spleen cells from mice immunized with purified carcinoembryonic antigen (CEA), an important tumor marker of human carcinomas, were fused with the mouse myeloma cell line P3-NSI/1-Ag4. Out of the 400 hybrids obtained, 2 secreted antibodies reacting specifically with two different antigenic determinants present on CEA molecules. They were cloned and established as permanent hybridoma cell lines. These antibodies, which have relatively high-affinities and can be produced in unlimited amounts, will be useful both for the immunochemical characterization of CEA and as a standard reagent for the identification of this antigen in human tissues and body fluids.

Initial experience with hybrid surgery in congenital heart disease in a single center : P171

Introduction: A hybrid intervention is a joint procedure involving the interventional cardiologist and the cardiac surgeon. At our institution we have opted for this type of approach in congenital heart disease since 2005. We report here our initial experience. Cases: 1. A 3 year old boy with double aortic arch and multiple muscular ventricular septal defects (VSD),was readdressed for pulmonary band (PAB) removal and residual VSD closure after previous palliation. After surgical removal of the PAB, the surgeon provided a minimal transventricular access for placement of a 6mm Amplatzer® muscular VSD occluder by the cardiologist under transoesophageal guidance. The patient was extubated the same day and discharged after 5 days. 2. An 8 year old girl with Williams syndrome was followed for two large VSDs and severe peripheral pulmonary arteries (PA) stenosis. The membranous VSD was closed surgically, the muscular VSD during the same operation by direct placement of a 12 mm Amplatzer® muscular VSD occluder. During rewarming, balloon angioplasty of peripheral PA stenosis was achieved under fluoroscopy. Patient was extubated the following day and discharged after 8 days. 3. A 9 year old boy post tetralogy of Fallot repair had severe distal stenosis of the right ventricular to PA conduit.With patient on partial cardiopulmonary bypass, an incision was made on the conduit and a CP 8 Zig 16 stent placed on the stenosis. The child passed on full bypass and the definitive placement of the stent achieved. The child was extubated at the end of the intervention and discharged after 6 days. 4. A newborn presented at 2 days life with complex aortic arch anatomy: left aortic arch and right descending thoracic aorta perfused directly from a right arterial duct and left PA atresia. The arterial duct was stented with a Genesis XD stent dilated at 7mm. Two days later the cardiac surgeon made banded the right PA. The child was extubated after the operation and discharged a week later. Conclusion: Hybrid approach opens new ways of correction or palliation in congenital heart disease with encouraging results and less morbidity.

The Lin28/let-7 axis regulates glucose metabolism.

The let-7 tumor suppressor microRNAs are known for their regulation of oncogenes, while the RNA-binding proteins Lin28a/b promote malignancy by inhibiting let-7 biogenesis. We have uncovered unexpected roles for the Lin28/let-7 pathway in regulating metabolism. When overexpressed in mice, both Lin28a and LIN28B promote an insulin-sensitized state that resists high-fat-diet induced diabetes. Conversely, muscle-specific loss of Lin28a or overexpression of let-7 results in insulin resistance and impaired glucose tolerance. These phenomena occur, in part, through the let-7-mediated repression of multiple components of the insulin-PI3K-mTOR pathway, including IGF1R, INSR, and IRS2. In addition, the mTOR inhibitor, rapamycin, abrogates Lin28a-mediated insulin sensitivity and enhanced glucose uptake. Moreover, let-7 targets are enriched for genes containing SNPs associated with type 2 diabetes and control of fasting glucose in human genome-wide association studies. These data establish the Lin28/let-7 pathway as a central regulator of mammalian glucose metabolism.

Arabidopsis Basic Helix-Loop-Helix Transcription Factors MYC2, MYC3, and MYC4 Regulate Glucosinolate Biosynthesis, Insect Performance, and Feeding Behavior.

Arabidopsis thaliana plants fend off insect attack by constitutive and inducible production of toxic metabolites, such as glucosinolates (GSs). A triple mutant lacking MYC2, MYC3, and MYC4, three basic helix-loop-helix transcription factors that are known to additively control jasmonate-related defense responses, was shown to have a highly reduced expression of GS biosynthesis genes. The myc2 myc3 myc4 (myc234) triple mutant was almost completely devoid of GS and was extremely susceptible to the generalist herbivore Spodoptera littoralis. On the contrary, the specialist Pieris brassicae was unaffected by the presence of GS and preferred to feed on wild-type plants. In addition, lack of GS in myc234 drastically modified S. littoralis feeding behavior. Surprisingly, the expression of MYB factors known to regulate GS biosynthesis genes was not altered in myc234, suggesting that MYC2/MYC3/MYC4 are necessary for direct transcriptional activation of GS biosynthesis genes. To support this, chromatin immunoprecipitation analysis showed that MYC2 binds directly to the promoter of several GS biosynthesis genes in vivo. Furthermore, yeast two-hybrid and pull-down experiments indicated that MYC2/MYC3/MYC4 interact directly with GS-related MYBs. This specific MYC-MYB interaction plays a crucial role in the regulation of defense secondary metabolite production and underlines the importance of GS in shaping plant interactions with adapted and nonadapted herbivores.

Translation of polarity cues into asymmetric spindle positioning in "Caenorhabditis elegans"

Abstract: Asymmetric cell division is important to generate tissue diversity. The Caenorhabditis elegans embryo is well suited to study the mechanisms of asymmetric cell division. In wild type one-cell stage embryos, the spindle sets up along the anterior-posterior axis (AP). During anaphase, the spindle elongates. While the anterior spindle pole is relatively immobile, the posterior spindle pole moves towards the posterior cortex during anaphase leading to an asymmetric spindle position. As a result, the first cleavage gives rise to a large anterior blastomere and a smaller posterior one, which differs also in cell fate determinants. This posterior spindle displacement occurs in response to polarity cues set up along the AP axis by the PAR proteins and is due to imbalanced pulling forces acting on the two spindle poles, with net forces acting on the posterior spindle pole being more extensive than those at the anterior one. The project of my thesis was to characterize the involvement of two new components, gpr-1 and gpr-2, in spindle positioning. These genes encode essentially identical proteins containing a GoLoco motif characteristic of proteins interacting with α subunits of heterotrimeric G protein (Gα). In gpr-1/2(RNAi) embryos and in embryos lacking simultaneously two α subunits, goa-1 and gpa-16, (Ga(RNAi) embryos), there is a minimal posterior displacement of the spindle during anaphase, and the first division is equal. I found that the pulling forces acting on the two spindle poles is weak and equal in gpr-1/2(RNAi) and Gα (RNAi) embryos. I found that GPR-1/2 acts downstream of polarity cues for generation of pulling forces. Furthermore, I showed that GPR-1/2 distribution was enriched at the posterior cortex during metaphase whereas GOA-1 and GPA-16 were uniformly distributed at the cell cortex throughout the cell cycle. Gα subunits oscillate between GDP- and GTP-bound forms. Gα signaling is turned on by GDP/GTP exchange catalyzed by guanine nucleotide exchange factors (GEFs) and turned off by hydrolysis of GTP catalyzed by GTPase activating proteins (GAPs). A third class of proteins, the guanine dissociation inhibitors (GDIs), binds the GDP-bound form of Gα subunits and inhibits nucleotide exchange. I found that GPR-1/2 acts as a GDI for GOA-1. Taken together, my findings suggest a model in which differential activation of Gα subunits along the AP axis may translate into generation of differential pulling forces on the anterior and posterior spindle poles, and, thus, asymmetric cell division. Résumé L'embryon du nématode Caenorhabditis elegans est un modèle approprié pour étudier les mécanismes de la division asymétrique. Chez l'embryon précoce, le fuseau mitotique se forme le long de l'axe antéro-postérieur (A/P) et au centre de l'embryon, le pôle antérieur restant relativement immobile alors que le pôle postérieur du fuseau se déplace vers le cortex postérieur au cours de l'anaphase conduisant à une position excentrée du fuseau. 11 en résulte une première division qui génère un blastomère antérieur et postérieur de grande et petite taille respectivement et qui diffèrent en facteurs développementaux. Ce déplacement postérieur se produit en réponse de la polarité établie par la distribution polarisée des protéines PAR et est le résultat de la génération de forces inégales tirant sur les deux pôles du fuseau, les forces agissant sur le pôle postérieur du fuseau étant plus grandes. Le projet de ma thèse était d'identifier la fonction de deux nouveaux constituants, gpr-1 et gpr-2 dans le positionnement asymétrique du fuseau. Ces gènes codent essentiellement pour la même protéine qui contient un motif GoLoco, caractéristique des protéines interagissant avec la sous-unité alpha des protéines G hétérotrimériques. Chez l'embryon gpr-1/2(RNAi) et chez les embryons dépourvus d'activité de deux sous-unités alpha, goa-1 et gpa-16, (Gα(RNAi)), j'ai montré qu'il y avait un déplacement minimal du fuseau vers le pôle postérieur au cours de l'anaphase et la première division est symétrique en raison de forces faibles et égales agissant sur les deux pôles du fuseau. J'ai également montré que gpr-1/2 était requis en aval des signaux établissant la polarité pour générer les forces responsables du positionnement asymétrique du fuseau. De plus, j'ai montré que GPR-1/2 était enrichi au pôle postérieur lors de la métaphase alors que GOA-1 et GPA-16 étaient localisés de façon uniforme au cortex de l'embryon précoce. Gas oscillent entre une forme liée au GDP et une forme liée au GTP. La signalisation des Gas est activée par l'échange GDP/GTP qui est catalysé par des protéines GEFs. La signalisation des Gas est désactivée par l'hydrolyse du GTP qui est catalysée par des protéines GAPs. Une troisième classe de protéines, GDIs lie la forme GDP et inhibe l'échange de nucléotides. J'ai montré que GPR-1/2 agissait comme un GDI pour GOA-1. Mes résultats suggèrent un modèle dans lequel une activation différentielle des Gα le long de l'axe A/P pourrait générer des forces différentielles sur le pôle antérieur et postérieur du fuseau.