Penetrating thorn in the heart complicated by infective endocarditis

A 3‐year‐old child presented with recurrent chest pain for 3 months, echocardiography showed a thorn inside the left ventricle, the patient was diagnosed with foreign body complicated with infective endocarditis and received proper treatment, and operation was performed after inflammatory reaction subsided.     

抗血管生成因子Angiostatin与Endostatin作用下肿瘤血管生成的二维数值模拟

目的数值模拟抗血管生成因子Angiostatin和Endostatin对肿瘤血管生成的影响。方法建立肿瘤内外血管生成的二维离散数学模型。模型耦合两种抗血管生成因子Angiostatin和Endostatin的抑制效应,数值模拟在促血管生成因子诱导下肿瘤微血管网生成,讨论血管生成抑制因子的影响。结果抗血管生成因子Angiostatin对肿瘤内外血管网络生成的速度和成熟度有抑制作用。抗血管生成因子Angiostatin和Endostatin耦合作用时,在肿瘤血管生成的早期有明显的抑制效应;在肿瘤血管生成的中后期,它们可以降低肿瘤血管化程度。结论本文模型能够较好的模拟抗血管生成因子Angiostatin和Endostatin对内皮细胞迁移和增殖的抑制作用。     

Ureteric complications in recipients of kidneys from donation after circulatory death donors

A large increase in the use of kidneys from donation after circulatory death (DCD) donors prompted us to examine the impact of donor type on the incidence of ureteric complications (UCs; ureteric stenosis, urinary leak) after kidney transplantation. We studied 1072 consecutive kidney transplants (DCD n=494, live donor [LD] n=273, donation after brain death [DBD] n=305) performed during 2008‐2014. Overall, there was a low incidence of UCs after kidney transplantation (3.5%). Despite a trend toward higher incidence of UCs in DCD (n=22, 4.5%) compared to LD (n=10, 3.7%) and DBD (n=5, 1.6%) kidney transplants, donor type was not a significant risk factor for UCs in multivariate analysis (DCD vs DBD HR: 2.33, 95% CI: 0.77‐7.03, P=.13). There was no association between the incidence of UCs and donor, recipient, or transplant‐related characteristics. Management involved surgical reconstruction in the majority of cases, with restenosis in 2.7% requiring re‐operation. No grafts were lost secondary to UCs. Despite a significant increase in the number of kidney transplants from DCD donors, the incidence of UCs remains low. When ureteric complications do occur, they can be treated successfully with surgical reconstruction with no adverse effect on graft or patient survival.     

Evaluation of tourists’ UV exposure in Paris

Background Ultraviolet (UV) exposure is one of the most important risk factor for skin cancers. If UV hazard has been evaluated in tropical countries or in some population – children, outdoor activities – little information is available about UV hazard in high latitude towns like Paris, considered as the most ‘charismatic city’ in the world. Objective To evaluate UV exposure in Paris in spring, in sun and shade, in real life conditions. Methods We evaluated erythemal UV exposure, during four sunny days in May‐June in eight Paris touristic sites during peak hours (2 days), and during two walks in touristic downtown of Paris. Measures were performed in sun and shade. UV radiation exposure was evaluated with UV index performed with a ‘Solarmeter ultraviolet index (UVI)’ and UV dose with ‘standard erythema dose’ (SED) and ‘minimal erythema dose’ (MED) calculations. Results Despite ‘average’ UVI in sunny conditions, a 4‐h sun exposure reaches 13–20 SED and 3–10 MED according to phototype. Clouds were inefficient to protect against UV. Shade of places reduces moderately UVI (50–60%) in forecourts. Exposure during 1‐h walk reach at least one MED in real life conditions for skin phototypes I–IV. Conclusions UV risk for tourist is quite high in spring in Paris. UVI remains high despite high cloud fraction. Shade reduces UVI, but UV protection factor is only 2–3 in large places such as Place Notre Dame and Place Charles de Gaulle. So sun protection campaigns should be proposed, and sun protective strategies could be integrated in urban planning.     

Validation of intensity modulated radiation therapy patient plans with portal images]

The goal of this study was to show the feasibility of step and shoot intensity-modulated radiation therapy pre-treatment quality control for patients using the electronic portal imaging device (iViewGT) fitted on a Sli+ linac (Elekta Oncology Systems, Crawley, UK) instead of radiographic films. Since the beginning of intensity-modulated radiation therapy treatments, the dosimetric quality control necessary before treating each new patient has been a time-consuming and therefore costly obligation. In order to fully develop this technique, it seems absolutely essential to reduce the cost of these controls, especially the linac time. Up to now, verification of the relative dosimetry field by field has been achieved by acquiring radiographic films in the isocenter plane and comparing them to the results of the XiO planning system (Computerized Medical Systems, Missouri, USA) using RIT113 v4.1 software (Radiological Imaging Technology, Colorado, USA). A qualitative and quantitative evaluation was realised for every field of every patient. A quick and simple procedure was put into place to be able to make the same verifications using portal images. This new technique is not a modification of the overall methodology of analysis. The results achieved by comparing the measurement with the electronic portal imaging device and the calculation with the treatment planning system were in line with those achieved with the films for all indicators we studied (isodoses, horizontal and vertical dose profiles and gamma index).     

Differential subcellular distribution of mitoxantrone in relation to chemosensitization in two human breast cancer cell lines.

The present work investigates the relationship between cancer cell chemosensitivity and subcellular distribution, molecular interaction, and metabolism of an anticancer drug. To get insights into this relationship, we took advantage of the differential sensitivity of two breast cancer cell lines, MDA-MB-231 and MCF-7, to anthracyclines, along with the property of docosahexaenoic acid (DHA, 22:6n-3), to differentially enhance their cytotoxic activity. The fluorescent drug mitoxantrone (MTX) was used because of the possibility to study its subcellular accumulation by confocal spectral imaging (CSI). The use of CSI allowed us to obtain semiquantitative maps of four intracellular species: nuclear MTX bound to DNA, MTX oxidative metabolite in endoplasmic reticulum, cytosolic MTX, and finally, MTX in a low polarity environment characteristic of membranes. MDA-MB-231 cells were found to be more sensitive to MTX (IC50 = 18 nM) than MCF-7 cells (IC50 = 196 nM). According to fluorescence levels, the nuclear and cytosolic MTX content was higher in MCF-7 than in MDA-MB-231 cells, indicating that mechanisms other than nuclear MTX accumulation account for chemosensitivity. In the cytosol, the relative proportion of oxidized MTX was higher in MDA-MB-231 (60%) than in MCF-7 (7%) cells. DHA sensitized MDA-MB-231 (approximately 4-fold) but not MCF-7 cells to MTX and increased MTX accumulation by 1.5-fold in MDA-MB-231 cells only. The DHA-stimulated accumulation of MTX was attributed mainly to the oxidative metabolite. Antioxidant N-acetyl-L-cysteine inhibited the DHA effect on both metabolite accumulation and cell sensitization to MTX. We conclude that drug metabolism and compartmentalization are associated with cell chemosensitization, and the related cytotoxicity mechanisms may involve oxidative stress.