Ex-Vivo Ultransonographic Control Of Resection Margin During Partial Nephrectomy

Introduction & Objectives: Surgery remains the treatment of choice for localized renal cell neoplasia. While radical nephrectomy was long considered as gold standard, partial nephrectomy (PN) has widened its indications over the past twodecades and has shown oncological results equivalent to radical nephrectomy for small tumors. Moreover, it is considered superior to radical nephrectomy in terms of non-cancer related mortality. The role of negative surgical margin has been widely debated. Intraoperative frozen section analysis has been shown to be unreliable, expensive, time-consuming and not well correlated to final pathology. The goal of the present study was to assess the correlation of intraoperative exvivo ultrasonographic (US) evaluation of resection margin to definitive pathology in patients undergoing PN.Materials & Methods: An observational study was carried out in ours 2 institutions from February 2008 to October 2010. Patients undergoing PN for T1-T2 renal tumors were included. Ex vivo US evaluation was performed. Considering availability of US engine, not all consecutive eligible patients were included. PN was undertaken either by open surgery or laparoscopic access in a standardized technique. The "minimal healthy tissue margin" technique was applied. Once resected, the specimen was kept in a saline solution and US determination of tumor margins was performed. Sequential images were captured in order to evaluate the whole capsule.Results: Twenty-two patients (9 women, age 63±11 years[46-78]) were included in the present analysis. Open or laparoscopic PN was performed in 19 and 3 patients, respectively. Intraoperative ex-vivo US showed negative surgical margin in all cases except one, needing a complementary renal parenchyma resection. US duration ranged from 1 to 4 minutes, with a median time of 1 minute. Definitive histological analysis confirmed the presence of 3 angiomyolipoma, 15 clear cell carcinoma (11 pT1a,3 pT1b,1 pT2), 3 chromophobe carcinoma (1 pT1a,1 pT1b,1 pT2) and 1 pT1a type II papillary tumor. Mean tumor size was 3,4±2.1 cm [0,6-7,2]. Final pathology revealed R0 margins in all cases.Conclusions: Intraoperative ex-vivo US evaluation of resection margin in patients undergoing PN is feasible, time-efficient, well correlated to definitive pathological examination, and should be evaluated in further prospective trials.

Ex vivo Pulsatile Perfusion of Human Saphenous Veins Induces Intimal Hyperplasia and Increased Levels of the Plasminogen Activator Inhibitor 1.

Vessel wall trauma induces vascular remodeling processes including the development of intimal hyperplasia (IH). To assess the development of IH in human veins, we have used an ex vivo vein support system (EVVSS) allowing the perfusion of freshly isolated segments of saphenous veins in the presence of a pulsatile flow which reproduced arterial conditions regarding shear stress, flow rate and pressure during a period of 7 and 14 days. Compared to the corresponding freshly harvested human veins, histomorphometric analysis showed a significant increase in the intimal thickness which was already maximal after 7 days of perfusion. Expression of the endothelial marker CD31 demonstrated the presence of endothelium up to 14 days of perfusion. In our EVVSS model, the activity as well as the mRNA and protein expression levels of plasminogen activator inhibitor 1, the inhibitor of urokinase-type plasminogen activator (uPA) and tissue-type plasminogen activator (tPA), were increased after 7 days of perfusion, whereas the expression levels of tPA and uPA were not altered. No major change was observed between 7 and 14 days of perfusion. These data show that our newly developed EVVSS is a valuable setting to study ex vivo remodeling of human veins submitted to a pulsatile flow.

chartularium monasterii sancti Vincentii Cenomanensis, ordinis sancti Benedicti ; quod confecit idem Rogerius de Gaignieres partim ex chartulariis, partim ex chartis ad idem monasterium pertinentibus, quas comperire potuit et describere.

Rogerii de Gaignieres

Usuardi martyrologium ex Flori aliorumque id genus scriptis contextum : praefixa illius ad Carolum Calvum epistola.

Puteanus

Ressenya de M. GLESSGEN (et al. ed.), 'Ex traditione innovatio. Miscellanea in honorem Max Pfister septuagenarii oblata'. Darmstadt: Wissenschaftliche Buchgesellschaft, 2002.

Certament ha de ser un motiu de satisfacció per a qualsevol mestre veure l"empremta deixada per l"obra pròpia juntament amb la que es reflecteix en la producció dels seus deixebles. En aquests volums editats en homenatge al professor Max Pfister amb motiu del seu setantè aniversari s"hi combinen encertadament aquestes dues facetes: els editors han estructurat aquest homenatge en dos volums. El primer recull escrits diversos del mateix Max Pfister de tema gal.loromànic o italoromànic; el segon articles de tema divers, però essencialment italoromànic, dels col.laboradors del LEI.

Lectotypification of Halymenia rodrigueziana J.Feldmann [= Sebdenia rodrigueziana (J.Feldmann) Codomier ex Athanasiadis (Sebdeniaceae, Rhodophyta)].

Here we designate as a lectotype of Halymenia rodrigueziana J. Feldmann the sheet JF2328 held in the Herbarium of J. Feldmann, included in the Herbarium of the Cryptogam Laboratory of the Muséum National d"Histoire Naturelle de Paris (PC). Also we present the correct citation of this species and for Sebdenia rodrigueziana (J. Feldmann) Codomier ex Athanasiadis.

L'aliança Polygonion avicularis Br.-Bl. ex Dich. 1933 als Pirineus Catalans

L'anàlisi de nombrosos inventaris procedents dels Pirineus centrals i orientals ens ha dut a realitzar una revisió de I'aliança Polygonion avicularis Br.-Bl. ex Dich 1933 en aquesta àrea. Reconeixem fins al moment sis associacions per a les quals donem la seva caracterització florística i ecologica, així com la seva distribució als Pirineus catalans. Descrivim, a més, una subass. scleranthetosum uncinatae del Rumici-Spergularietum rubrae, comunitat altimontana i subalpina pròpia dels sòls calcigats.

Omphalina Umbellifera (L. ex. Fr.)Quel. Novedad para la flora liquénica

Se da cuenta de la recolección en el Montseny, el Corredor y el Moixeró de varios basidiocarpos de Omphalina umbellifera(L. ex Fr. ) Quel. (= O. ericetorum (Pers.) M. Lange), en taludes y sobre madera en descomposición.

[Voyage en Italie : 1824-1830]. , Palais de la Chancellerie. Détails des ordres de la cour, au dixième de l'Ex[ecu]tion : [élévations partielles et profils des ordres inférieur et supérieur] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 573

Human melanoma-specific CD8(+) T-cells from metastases are capable of antigen-specific degranulation and cytolysis directly ex vivo.

The relatively low frequencies of tumor Ag-specific T-cells in PBMC and metastases from cancer patients have long precluded the analysis of their direct ex vivo cytolytic capacity. Using a new composite technique that works well with low cell numbers, we aimed at determining the functional competence of melanoma-specific CD8(+) T-cells. A multiparameter flow cytometry based technique was applied to assess the cytolytic function, degranulation and IFNγ production by tumor Ag-specific CD8(+) T-cells from PBMC and tumor-infiltrated lymph nodes (TILN) of melanoma patients. We found strong cytotoxicity by T-cells not only when they were isolated from PBMC but also from TILN. Cytotoxicity was observed against peptide-pulsed target cells and melanoma cells presenting the naturally processed endogenous antigen. However, unlike their PBMC-derived counterparts, T-cells from TILN produced only minimal amounts of IFNγ, while exhibiting similar levels of degranulation, revealing a critical functional dichotomy in metastatic lesions. Our finding of partial functional impairment fits well with the current knowledge that T-cells from cancer metastases are so-called exhausted, a state of T-cell hyporesponsiveness also found in chronic viral infections. The identification of responsible mechanisms in the tumor microenvironment is important for improving cancer therapies.

In vivo distribution and ex vivo permeation of cyclosporine A prodrug aqueous formulations for ocular application.

Cyclosporine A is a poorly water-soluble, immunosuppressive drug used to treat a variety of ocular diseases. Its limited solubility makes challenging the development of a cyclosporine A-based eye drop for ocular topical application. Based on the prodrug strategy, the practically insoluble cyclosporine A was converted into a freely soluble prodrug. Such a water-soluble prodrug made it possible to develop water-based concentrated eye drops. The prodrug formulations were tested for their ex vivo permeation and in vivo distribution at three concentrations (equivalent to 0.05%, 0.50% and 2.00% w/v cyclosporine A). The ex vivo permeation experiments were performed on corneal and conjunctival epithelia. The in vivo distribution evaluated the total cyclosporine A present in the ocular structures as well as in serum, spleen and cervical lymphatic ganglions. Each prodrug formulation was compared to conventionally used cyclosporine A eye drops at an equivalent concentration. The experimental results showed that the tested eye drops behaved differently. The prodrug formulation was characterized by the following: i) preferential conjunctival penetration, ii) an interesting capacity to create large tissue deposits and iii) a lower risk of systemic complications and immunosuppression. The prodrug aqueous eye drop was demonstrated to be a patient-friendly option for the treatment of ocular diseases requiring high ocular levels of cyclosporine A, pushing the boundaries of the current therapeutic arsenal.