Expression of MYC, IgM, As Well As Non-Germinal Centre B-Cell Like Immunophenotype and Positive Immunofish Index Predict a Worse Progression Free Survival and Overall Survival in a Series of 670 De Novo Diffuse Large B-Cell Lymphomas Included in Clinical Trials: A GELA Study of the 2003 Program

Introduction: Diffuse large B-cell lymphomas (DLBCL) represent a heterogeneous disease with variable clinical outcome. Identifying phenotypic biomarkers of tumor cells on paraffin sections that predict different clinical outcome remain an important goal that may also help to better understand the biology of this lymphoma. Differentiating non-germinal centre B-cell-like (non-GCB) from Germinal Centre B-cell-like (GCB) DLBCL according to Hans algorithm has been considered as an important immunohistochemical biomarker with prognostic value among patients treated with R-CHOP although not reproducibly found by all groups. Gene expression studies have also shown that IgM expression might be used as a surrogate for the GCB and ABC subtypes with a strong preferential expression of IgM in ABC DLBCL subtype. ImmunoFISH index based on the differential expression of MUM-1, FOXP1 by immunohistochemistry and on the BCL6 rearrangement by FISH has been previously reported (C Copie-Bergman, J Clin Oncol. 2009;27:5573-9) as prognostic in an homogeneous series of DLBCL treated with R-CHOP. In addition, oncogenic MYC protein overexpression by immunohistochemistry may represent an easy tool to identify the consequences of MYC deregulation in DLBCL. Our aim was to analyse by immunohistochemistry the prognostic relevance of MYC, IgM, GCB/nonGCB subtype and ImmunoFISH index in a large series of de novo DLBCL treated with Rituximab (R)-chemotherapy (anthracyclin based) included in the 2003 program of the Groupe d'Etude des Lymphomes de l'Adulte (GELA) trials. Methods: The 2003 program included patients with de novo CD20+ DLBCL enrolled in 6 different LNH-03 GELA trials (LNH-03-1B, -B, -3B, 39B, -6B, 7B) stratifying patients according to age and age-adjusted IPI. Tumor samples were analyzed by immunohistochemistry using CD10, BCL6, MUM1, FOXP1 (according to Barrans threshold), MYC, IgM antibodies on tissue microarrays and by FISH using BCL6 split signal DNA probes. Considering evaluable Hans score, 670 patients were included in the study with 237 (35.4%) receiving intensive R-ACVBP regimen and 433 (64.6%) R-CHOP/R-mini-CHOP. Results: 304 (45.4%) DLBCL were classified as GCB and 366 (54.6%) as non-GCB according to Hans algorithm. 337/567 cases (59.4%) were positive for the ImmunoFISH index (i.e. two out of the three markers positive: MUM1 protein positive, FOXP1 protein Variable or Strong, BCL6 rearrangement). Immunofish index was preferentially positive in the non-GCB subtype (81.3%) compared to the GCB subtype (31.2%), (p<0.001). IgM was recorded as positive in tumor cells in 351/637 (52.4%) DLBCL cases with a preferential expression in non-GCB 195 (53.3%) vs GCB subtype 100(32.9%), p<0.001). MYC was positive in 170/577 (29.5%) cases with a 40% cut-off and in 44/577 (14.2%) cases with a cut-off of 70%. There was no preferential expression of MYC among GCB or non-GCB subtype (p>0.4) for both cut-offs. Progression-free Survival (PFS) was significantly worse among patients with high IPI score (p<0.0001), IgM positive tumor (p<0.0001), MYC positive tumor with a 40% threshold (p<0.001), ImmunoFISH positive index (p<0.002), non-GCB DLBCL subtype (p<0.0001). Overall Survival (OS) was also significantly worse among patients with high IPI score (p<0.0001), IgM positive tumor (p=0.02), MYC positive tumor with a 40% threshold (p<0.01), ImmunoFISH positive index (p=0.02), non-GCB DLBCL subtype (p<0.0001). All significant parameters were included in a multivariate analysis using Cox Model and in addition to IPI, only the GCB/non-GCB subtype according to Hans algorithm predicted significantly a worse PFS among non-GCB subgroup (HR 1.9 [1.3-2.8] p=0.002) as well as a worse OS (HR 2.0 [1.3-3.2], p=0.003). This strong prognostic value of non-GCB subtyping was confirmed considering only patients treated with R- CHOP for PFS (HR 2.1 [1.4-3.3], p=0.001) and for OS (HR 2.3 [1.3-3.8], p=0.002). Conclusion: Our study on a large series of patients included in trials confirmed the relevance of immunohistochemistry as a useful tool to identify significant prognostic biomarkers for clinical use. We show here that IgM and MYC might be useful prognostic biomarkers. In addition, we confirmed in this series the prognostic value of the ImmunoFISH index. Above all, we fully validated the strong and independent prognostic value of the Hans algorithm, daily used by the pathologists to subtype DLBCL.

Urgences vitales au cabinet médical: implications pour la formation et l'equipement du médecin de premier recours [Life-threatening emergencies at the office: implications for medical education and equipment of the primary care physician].

Every medical practitioner is confronted on a daily basis with emergencies. Among these, life-threatening emergencies can have disastrous consequences in term of morbidity and mortality; 22 cardiac arrests and 10 deaths were reported among the 1,650 Swiss practices during a 5 year period. The occurrence of life-threatening emergencies at the office necessitates, according to the type and place of the practice, the skills of the practitioner and the organization of his practice, the implementation of procedures, equipments (for example room equipped with a defibrillator, respiratory nebulizer, splints, emergency drugs) and specific continuous education programs that should be encouraged and made available to the whole medical corporation.

Remarques de grammaire sur Racine ([Reprod.]) / par M. l'abbé d'Olivet

Collection : Archives de la linguistique française ; 301

Traité de la prosodie françoise ([Reprod.]) / par M. l'abbé d'Olivet

Collection : Archives de la linguistique française ; 302

Produção de mudas de caramboleiras 'B-10' e 'Golden Star': II - marcha de absorção e acúmulo de nutrientes

A participação do Brasil no mercado externo de frutas tem aumentado consideravelmente e com potencial para crescer ainda mais. A constante ascensão dos dados de exportação brasileira é resultado da combinação de avanços tecnológicos do setor produtivo e de acesso a novos mercados consumidores. A caramboleira apresenta-se como uma excelente opção de cultivo de frutas exóticas, com grande potencial para atender ao mercado interno e às exportações. Assim, objetivou-se avaliar a marcha de absorção e de acúmulo de nutrientes em mudas de caramboleiras cultivadas em solução nutritiva. O experimento foi realizado em parcelas subdivididas, sendo utilizadas como parcela as duas cultivares de caramboleira ('B-10' e 'Golden Star') e, como subparcelas, cinco épocas de coleta de plantas, realizadas aos 208; 233; 258; 283 e 308 dias após o transplantio para a solução nutritiva. O delineamento foi inteiramente casualizado, com três repetições. As mudas foram cultivadas em vasos (8L) com solução nutritiva (pH=5,5 ± 0,5), com aeração. O experimento iniciou-se em 24-08-2005. Nos diferentes órgãos das mudas (folhas, caule e raízes), determinaram-se a marcha de absorção, o acúmulo de nutrientes e os índices nutricionais. Não houve diferenças no acúmulo de nutrientes entre as mudas de caramboleira de ambas as cultivares, sendo a ordem decrescente dos nutrientes em cada muda de 'B-10', no final do período experimental: N > K > Ca > Mg > S > P > Fe > Mn > B > Cu > Zn. Para a 'Golden Star', a ordem foi: N > K > Ca > Mg > P > S > Fe > Mn > B > Cu > Zn. Para as duas cultivares, o acúmulo médio foi maior nas folhas > caule > raízes. O período de maior exigência para 'B-10' foi entre 208 - 233 e, para 'Golden Star', entre 233 - 283 dias após o transplantio. As diferentes taxas de acumulação líquida dos nutrientes, nos diferentes órgãos da caramboleira, nem sempre acompanharam a taxa de acumulação de nutrientes do respectivo órgão.

Nutrient signature of Quebec (Canada) cranberry (Vaccinium macrocarpon Ait.)

Fertilizer recommendations for cranberry crops are guided by plant and soil tests. However, critical tissue concentration ranges used for diagnostic purposes are inherently biased by nutrient interactions and physiological age. Compositional data analysis using isometric log ratios (ilr) of nutrients as well as time detrending can avoid numerical biases. The objective was to derive unbiased nutrient signature standards for cranberry in Quebec and compare those standards to literature data. Field trials were conducted during 3 consecutive years with varying P treatments at six commercial sites in Quebec. Leaf tissues were analyzed for N, P, K, Ca, Mg, B, Cu, Zn, Mn and Fe. The analytical results were transformed into ilr nutrient balances of parts and groups of parts. High-yield reference ilr values were computed for cranberry yielding greater than 35 Mg ha-1. Many cranberry fields appeared to be over-supplied with K and either under-supplied with Mn or over-supplied with Fe as shown by their imbalanced [K | Ca, Mg] and [Mn | Fe] ratios. Nutrient concentration ranges from Maine and Wisconsin, USA, were combined into ilr values to generate ranges of balances. It was found that these nutrient ranges were much too broad for application in Quebec or outside the Quebec ranges for the [Ca | Mg] and the [Mn | Fe] balances, that were lower compared to those of high yielding cranberry crops in Quebec.

Directional and fluctuating asymmetry in finger and a-b ridge counts in psychosis: a case-control study

Background: Several studies have reported alterations in finger and a-b ridge counts, and theirderived measures of asymmetry, in schizophrenia compared to controls. Because ridges are fully formed by the end of the second trimester, they may provide clues to disturbed early development. The aim of this study was to assess these measures in a sample of patients with psychosis and normal controls.Methods: Individuals with psychosis (n = 240), and normal controls (n = 228) were drawn from a catchment-area case-control study. Differences in finger and a-b ridge count and Fluctuating Asymmetry were assessed in three group comparisons (non-affective psychosis versus controls; affective psychosis versus controls; non-affective psychosis versus affective psychosis). The analyses were performed separately for males and females. Results: There were no significant group differences for finger nor a-b ridge counts. While there were no group difference for Directional Asymmetry, for Fluctuating Asymmetry measures men with non-affective psychosis had significantly higher fluctuating asymmetry of the index finger ridge count (a) when compared to controls (FA-correlation score, p = 0.02), and (b) when compared to affective psychosis (adjusted FA-difference score, p = 0.04). Conclusion: Overall, measures of finger and a-b ridge counts, and their derived measures of directional and fluctuating asymmetry were not prominent features of psychosis in this sample. While directional asymmetry in cerebral morphology is reduced in schizophrenia, this is not reflected in dermatoglyphic variables.

Distribuição, probabilidade de ocorrência e período de retorno dos índices de erosividade EI30 e KE>25 em Seropédica - RJ

O presente trabalho foi desenvolvido com o objetivo de estudar as características da erosividade da chuva em Seropédica (RJ), quanto à sua distribuição, probabilidade de ocorrência e período de retorno. Para isso, foi utilizada uma série mensal de dados pluviométricos referente ao período de 1973 a 2002 e, com o auxílio de modelos ajustados para a região, foi possível obter os índices mensais e anuais de erosividade EI30 e KE>25. Com base nos resultados obtidos, foi possível concluir que: a) os valores médios anuais de EI30 e de KE>25 foram de 5.960,4 MJ mm ha-1 h-1 e de 99,2 MJ ha-1, respectivamente, e estão associados a períodos de retorno de 1,97 ano, com uma probabilidade de ocorrência de 50,82%; e b) valores anuais de EI30 da ordem de 5.995; 7.262; 7.684; 7.895; 8.022 e 8.064 MJ mm ha-1 h-1 e de KE>25 da ordem de 99,8; 122,7; 130,3; 134,1; 136,4 e 137,1 MJ ha-1, são esperados, em média, uma vez a cada 2; 5; 10; 20; 50 e 100 anos, respectivamente.

Traité de la prosodie françoise. (Avec) Une Dissertation... sur le même sujet ([Reprod.]) / par M. l'abbé d'Olivet ; de M. Durand...

Collection : Archives de la linguistique française ; 302

Comparative sequence analysis of the P-, M- and L-coding region of the measles virus CAM-70 live attenuated vaccine strain

Measles virus is a highly contagious agent which causes a major health problem in developing countries. The viral genomic RNA is single-stranded, nonsegmented and of negative polarity. Many live attenuated vaccines for measles virus have been developed using either the prototype Edmonston strain or other locally isolated measles strains. Despite the diverse geographic origins of the vaccine viruses and the different attenuation methods used, there was remarkable sequence similarity of H, F and N genes among all vaccine strains. CAM-70 is a Japanese measles attenuated vaccine strain widely used in Brazilian children and produced by Bio-Manguinhos since 1982. Previous studies have characterized this vaccine biologically and genomically. Nevertheless, only the F, H and N genes have been sequenced. In the present study we have sequenced the remaining P, M and L genes (approximately 1.6, 1.4 and 6.5 kb, respectively) to complete the genomic characterization of CAM-70 and to assess the extent of genetic relationship between CAM-70 and other current vaccines. These genes were amplified using long-range or standard RT-PCR techniques, and the cDNA was cloned and automatically sequenced using the dideoxy chain-termination method. The sequence analysis comparing previously sequenced genotype A strains with the CAM-70 Bio-Manguinhos strain showed a low divergence among them. However, the CAM-70 strains (CAM-70 Bio-Manguinhos and a recently sequenced CAM-70 submaster seed strain) were assigned to a specific group by phylogenetic analysis using the neighbor-joining method. Information about our product at the genomic level is important for monitoring vaccination campaigns and for future studies of measles virus attenuation.