First Report of Apricot pseudo-chlorotic leaf spot virus Infecting Plum (Prunus domestica) in the Czech Republic

Apricot pseudo-chlorotic leaf spot virus (APCLSV) is a novel, still poorly known Trichovirus in the family Betaflexiviridae. It is most closely related to Apple chlorotic leaf spot virus (ACLSV) (2,4) and infects stone fruit trees of the Prunus genus. Its presence has so far been detected in apricot, plum, Japanese plum, and peach trees in Italy, Spain, France, Hungary, Turkey, Jordan, and Australia (1,2,4). During the summers of 2008 and 2010, leaf samples of old Czech local plum cultivars were obtained from the Holovousy collection and assessed for the presence of viruses belonging to the Capillovirus, Trichovirus, and Foveavirus genera using the polyvalent degenerate oligonucleotides (PDO) nested reverse transcription (RT)-PCR test (3). Following amplification from total RNAs extracts, the amplicons were cloned and several clones were sequenced for each plant sample. In plum (Prunus domestica) cv. Babce, a mixture of amplicons was observed and BlastN and BlastX analyses of the obtained sequences revealed the presence of ACLSV and APCLSV. The 310-bp APCLSV amplicon (GenBank Accession No. JN790294) showed highest identity (82.9% in nucleotide sequence and 97.1% in amino acid sequence) with the Sus2 isolate of APCLSV (4) and clustered with APCLSV isolates in a phylogenetic analysis. APCLSV infection was further confirmed with an APCLSV-specific RT-PCR assay (4), which yielded a product of the expected 205-bp size (GenBank Accession No. JN653070) with closest homology again to the Sus2 APCLSV isolate (83.4 and 94.3% nucleotide and amino acid identity, respectively). To our knowledge, this finding represents the first detection of APCLSV in domestic plums in the Czech Republic, extending our vision of APCLSV diversity and its geographic distribution. For unknown reasons, APCLSV has almost always been reported in mixed infection with ACLSV (1,2,4) and the situation in cv. Babce does not deviate from this trend. This has greatly hindered the analysis of the pathogenicity of APCLSV, a situation further complicated in the current case because the Babce cultivar was also infected by Plum pox virus. References: (1) M. Barone et al. Acta Hortic. 781:53, 2008. (2) T. Candresse et al. Virus and Virus-Like Diseases of Pome and Stone Fruit Trees. A. Hadidi et al., eds. The American Phytopathological Society, St. Paul, MN, 2011. (3) X. Foissac et al. Phytopathology 95:617, 2005. (4) D. Liberti et al. Phytopathology 95:420, 2005.

First Report of Chrysanthemum stunt viroid in Various Cultivars of Argyranthemum frutescens in France

Described for the first time in Chrysanthemum indicum in the United States, Chrysanthemum stunt viroid (CSVd) was reported to naturally infect species in the Asteraceae family (1,3), as well a few hosts in other families. In May 2010 in a nursery in southwest France, the occurrence of stunted A. frutescens plantlets of cv. Butterfly showing yellow deformed leaves with terminal necrosis, which resembled the growth reduction, flower distortion or leaf necrosis symptoms reported for CSVd in Argyranthemum spp. (3), was reported. Mother plants from which the plantlets originated were asymptomatic. Reverse transcription (RT)-PCR with universal pospiviroid primers Pospi1-FW/RE (4) was performed on five symptomatic plants. A fragment of expected size (197 bp) was obtained in all cases. Viroid infection was confirmed by RT-PCR with two sets of primers: Vid-FW/RE using a 59°C annealing temperature instead of the recommended 62°C (4) and Vir-plus/minus that allows the amplification of the full-length viroid genome (2). Sequences of the three different uncloned amplicons were determined and a 355-nt contig was assembled (GenBank No. JF938538). A BLAST analysis of this full-length sequence revealed 99% identity with CSVd isolates from Chrysanthemum from Korea and Germany (GenBank Accession Nos. AF394452 and X16408). The Argyranthemum CSVd sequence differed from the Chrysanthemum ones by an A insertion at position 289 and substitutions (A to T) at positions 65 and 299. The insertion at position 289 is currently unique among CSVd sequences in GenBank. Thirty-five symptomless mother plants of A. frutescens cv. Butterfly were tested by PCR and all were shown to be infected. The difference in symptomatology observed between the mother plants and the commercial potting plants cannot be explained at this stage, but may reflect the different physiologies or growing conditions of the two kinds of plants, since these are known to affect CSVd symptoms in other hosts (1). To estimate the extent of CSVd contamination in A. frutescens, samples of 11 other cultivars originating from different nurseries were similarly analyzed. In addition to Butterfly, cvs. Sonnenstral, Maya Bofinger, Lili, Blanc Double, and Daisy Solenio were found to be infected by CSVd in the absence of clear symptomatology. The CSVd-free cultivars were Angelic Bordeaux, Dark Pink, Pink Delight, Angelic White, Dana, and Summer. The Pospi1-FW/RE amplicons from Blanc Double, Lili, and Daisy Solenio were identical to the Butterfly isolate sequence while the Maya Bofinger sequence showed one substitution (C to T) at position 256 and Sonnenstral had one substitution (T to A) at position 254. Although CSVd infection of Butterfly had been reported from Germany (3), to our knowledge, the results reported here represent the first report of CSVd in Argyranthemum for France and implicate a range of cultivars. CSVd being classified as a quarantine pest in Chrysanthemum spp. in the European Union, the finding of its significant prevalence in A. frutescens cultivars, frequently in the absence of clear symptomatology, raises the possibility that contaminated Argyranthemum may constitute a reservoir for future Chrysanthemum contamination. References: (1) I. Bouwnen and A. van Zaayen. Page 281 in: Viroids. Science Publishers, Enfield, NH, 2003. (2) T. Candresse et al. Plant Dis. 91:330, 2007. (3) W. Mentzel and E. Maiss. Z. Pflanzenk. Pfanzenschutz 107:548, 2000. (4) J. Th. J. Verhoeven et al. Eur. J. Plant Pathol. 110:823, 2004.

Basaloid squamous cell carcinoma of the head and neck: role of HPV and implication in treatment and prognosis

Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma (SCC) of the head and neck. Wain's criteria (peripheral palisading, association with SCC, high nuclear-cytoplasmic ratio, high mitotic rate, solid growth), anti-34BE12 and CK 5/6 staining, and absence of neuroendocrine markers are mandatory for the diagnosis of BSCC. Its increasing incidence parallels that of human papilloma virus (HPV)-positive tumours for the oropharyngeal subsite. On the other hand, BSCC is frequently considered a high-grade carcinoma of poorer prognosis than its SCC counterparts, mostly due to a higher rate of distant metastases. However, BSCC has similar or better locoregional control rates and a relatively better radiosensitivity than SCC. BSCC seems to have a dual behaviour depending, at least partly, on its recently described association with HPV. The basaloid subtype of SCC, owing to its particular behaviour, should be systematically investigated along with HPV and smoking status, as those factors may be determinant in the response to treatment.

Serotonin signaling is altered in irritable bowel syndrome with diarrhea but not in functional dyspepsia in pediatric age patients

BACKGROUND & AIMS

In adults, irritable bowel syndrome (IBS) and functional dyspepsia (FD) are chronic conditions that often start during childhood. We investigated mucosal serotonin (5-HT) signaling in children with the idea that data from subjects with a shorter history may improve our understanding of underlying pathophysiological mechanisms.

METHODS

Ninety-eight children undergoing gastroscopy or colonoscopy were studied prospectively. Biopsy specimens were evaluated for inflammation, enterochromaffin cell numbers, 5-HT content, and messenger RNA (mRNA) levels for the synthetic enzyme, tryptophan hydroxylase 1, and the serotonin transporter (SERT) were assessed by quantitative real-time reverse-transcription polymerase chain reaction.

RESULTS

Data from 12 children with IBS and 17 with FD were compared with age-matched controls (12 with rectal biopsies and 12 with gastric biopsies) and with subjects with organic disorders. In patients with FD, a small number of immune cells were observed in the gastric mucosa in half of the patients, but no abnormalities with respect to the 5-HT pathway were identified. In patients with IBS, no differences were detected between patients and controls regarding intraepithelial lymphocytes and CD3+ cells in the lamina propria although all patients showed at least a slight inflammatory infiltrate. In the IBS samples, higher 5-HT content (P < .01) and lower SERT mRNA (P < .05) were detected as compared with controls. Severe inflammation in the colonic mucosa had a high impact on 5-HT signaling with a significant decrease in enterochromaffin cells (P < .01) and 5-HT content (P < .01) and a high SERT mRNA expression (P < .01).

CONCLUSIONS

These results confirm the role of 5-HT signaling in IBS in children and argue against such a role in FD.

First Report of Nasturtium as a Natural Host of Cherry leaf roll virus on Amsterdam Island

Cherry leaf roll virus (CLRV) is a well-known virus belonging to the genus Nepovirus, but unlike most members of this genus, it is not known to be transmitted by nematodes but only through seeds and pollen. Since its first description in 1955 on Prunus avium L. in England (1), CLRV has been shown to have a worldwide distribution and a wide natural host range. During a survey of plant viruses in the French sub-Antarctic islands, samples from nasturtium plants (Tropaeolum majus), an introduced plant species, showing symptoms of leaf mosaic, deformation, and veinal necrosis were collected on Amsterdam Island. Upon mechanical transmission with sap extracts, necrotic ringspot and oak-leaf symptoms typical of Nepovirus infection were observed on the leaves of inoculated Nicotiana clevelandii and N. tabacum plants. Inoculation of healthy nasturtium plants resulted in mosaic and pin-point necrosis symptoms. Electron microscopy on negatively stained sap extracts revealed the presence of icosahedral virions, 28 to 30 nm in diameter, in the symptomatic Nicotiana leaves. Amplification by reverse transcription (RT)-PCR with a polyvalent test, which identifies viruses belonging to the family Comoviridae (2), yielded the expected 248-bp fragment. Sequencing of the cloned amplicon showed 80% nucleotide and 90% amino acid identity with a part of the RNA dependent RNA polymerase (RdRp) of CLRV (CAE83562). To confirm the presence of CLRV, an approximate 4.6-kbp cDNA fragment was PCR amplified from double-stranded RNAs purifed from infected Nicotiana plants using the sense primer 5'-GTGGGACTGCCATGCACCTACTC-3' and an oligo-T₂₅ as antisense primer. This PCR product (GenBank Accession No. GU167974) spans the region between the VPg gene and the polyA tail at the 3' end of the genome and thus provides approximately 2.8 kb of new internal sequence information on RNA1 of CLRV. The presence of CLRV in the initial nasturtium samples was confirmed with a CLRV-specific RT-PCR assay that amplifies the 3' non-coding region of the CLRV genome (3). Sequence of the amplified fragment showed it to be identical to the corresponding part of the 3' non-coding region of 4.6-kbp clone obtained from the CLRV isolate mechanically transmitted to the N. tabacum and N. clevelandii plants. Experimental infection of nasturtium by CLRV has been reported (4), but to the best of our knowledge these results represent the first report of natural infection of T. majus by CLRV. Given its seed transmissible character in many hosts, CLRV likely was introduced in infected seeds of T. majus imported to the remote sub-Antarctic Amsterdam Island. References: (1) R. Cropley. Ann. Appl. Biol. 49:524, 1961. (2) V. Maliogka et al. J. Phytopathol. 152:404, 2004. (3) K. Rebenstorf et al. J. Virol. 80:2453, 2006. (4) K. Schmelzer. Phytopathol. Z. 55:317, 1966.

Intraoperative near-infrared image-guided surgery for peritoneal carcinomatosis in a preclinical experimental model

Background

This study compared the quality of surgery performed under conventional light with near-infrared (NIR) image-guided surgery using a tumour-targeting probe and a portable clinical grade imaging device in a mouse model of peritoneal carcinomatosis.

Methods

Peritoneal carcinomatosis was induced by injection of luciferase-positive tumour cells, leading to the formation of small nodules in the peritoneal cavity. One day after intravenous injection of RAFT-c(RGDfK)4-Alexa Fluor® 700, a fluorescent tumour-targeting probe, the surgeon operated using the Fluobeam®, a portable device that illuminated the mouse with NIR light and allowed NIR vision. The quality of the surgery was evaluated using bioluminescence, a highly sensitive method that detected the remaining tumour cells, and operating time was measured.

Results

Under normal light, the surgeon detected and removed a mean(s.d.) of only 50·6(2·3) per cent of the nodules that were visible under NIR light. The duration of surgery was reduced from 19·5(3·3) min under normal light to 14·0(2·6) min when NIR light was used (P = 0·025). The sensitivity of the NIR system allowed the detection of nodules containing as few as 227 tumour cells.

Conclusion

NIR image-guided surgery improved the quality of surgery for peritoneal carcinomatosis by doubling the number of nodules detected and significantly reducing the duration of surgery.

Interobserver variability in antroduodenal manometry

Interobserver variability affects investigations involving assessment of complex visual data, such as histopathology, radiology and motility. This study assessed interobserver variation for interpretation of antroduodenal manometry (ADM), as this has not been previously investigated. Thirty-five ADM recordings from children aged 0.3-18 years were independently evaluated by five experienced paediatric gastroenterologists who were blinded to cases' clinical histories. Intra-class correlation (ICC) was analysed for detection and measurement of phase three of the migrating motor complex (MMC) and Cohen's kappa statistic was calculated between observer pairs for detection of specific motility features and final diagnosis. Observers were unanimous on the differentiation of normal and abnormal motility in 63% of cases. There was excellent interobserver agreement for the number of phase three of the MMC in fasting (ICC = 0.82, P < 0.0001) and for measurements of phase three of the MMC (ICC = 0.9999, P < 0.0001). Detection of other normal and abnormal motility patterns varied more. Objective findings such as the presence of phase three of the MMC correlated more closely than findings that involved the integration of several variables, such as final diagnosis. However, these data overall indicate that agreement between expert observers for the distinction of normal and abnormal antroduodenal motility compares favourably with other standard medical assessments.

Tolerance and consecutive patients adherence to hormonal treatment for early breast cancer

Abstract #1140

Body: For the past few years, Aromatase Inhibitors (AI) have been the standard hormonal treatment for menopausal women with breast cancer. Although the side effects described are as low as with Tamoxifen, tolerance is poor, and some patients wish to suspend treatment. A prospective observatory of patients under AI was initiated in our institution to assess patients' perception of side effects.&#x2028; Method: This monocentric prospective study was proposed to patients receiving AI treatment. After a medical visit, patients answered a specific questionnaire about their tolerance and including questions about their adherence to treatment: if necessary, reasons for stopping (either deliberate or not) were specified. The questionnaire was completed after the end of the medical visit and without the presence of the doctor. Medical evaluation of tolerance and cancer evolution was also collected. Statistical analyses were performed to test the correlation between patients' and physicians' perception according to side effects, patients' tolerance or desire to stop AI (Fischer test).&#x2028; Results: Of 450 post-menopausal patients included between Dec 2005 and Dec 2007, 300 were eligible for the adherence study. Median age was 59 years (range, 40-82) and cancer stages were: stage I: 40.5%, stage II: 46.8%, and stage III: 12.7%. Non menopausal women (2.3%) received gonadotropin-releasing hormone analogs. The three AI were Anastrozol (71.3% of cases), Letrozole (17.3%) and Exemestane (11.3%), Tamoxifen was initially prescribed to 30.8% of patients. Median follow-up was 23.1 months (range, 2.1-58.8) and the median number of questionnaires per woman was 1.46 (range, 1-5).&#x2028; Different side effects were reported; all declared symptoms were taken into account: insomnia (98.7%), arthralgia (85.3%), fatigue (72%), memory troubles (59.7%), concentration difficulties (55.3%), hot flushes (63.3%), decreased libido (56.7%), ocular troubles (50%), fracture (5%).&#x2028; Medical reports and patient responses were compared. Significant differences were seen in many items: arthralgia (85.3% vs. 49.3%, p&lt;0.001), fatigue (72% vs 17%, p=0.007), fracture (5% vs. 1%, p=0.04).&#x2028; Treatment adherence was high: at first medical visit (&gt; 3 months after the beginning of treatment) 81.4% of patients reported taking their treatment everyday (82.3% at second visit). But 6.1% decided to discontinue treatment (8.8% at the second visit). The main reasons were: bad tolerance (41.2%), recall of illness (17.6%) and lack of treatment information (17.6%).&#x2028; Discussion and Conclusions: Our results give evidence of the difficulty for the physicians to accurately determine patient's tolerance to a given treatment and consequently its observance. Adherence results appear better than in several previously published studies.&#x2028; This study was supported by grants from Astra Zeneca, Pfizer and Novartis.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1140.

Orbital apex syndrome following inferior turbinate radiofrequency

INTRODUCTION

We report a case of orbital apex syndrome following turbinate radiofrequency.

METHODS

The clinical features, investigations (nasofibroscopy, supra-aortic and trans-cranial vessels ultrasounds, CT- and MRI-scans) are described.

RESULTS

A forty-year-old man underwent radiofrequency volumetric tissue reduction (RFVTR) for bilateral inferior turbinate hypertrophy. No particular problems were reported during the procedure under general anaesthesia. Immediately after the general anaesthesia, the patient complained of right eyelid ptosis with right monocular blindness. The patient also had ophthalmoplegia and suffered from right corneal anaesthesia and right hypoaesthesia of the cheek. The CT-scan showed right ethmoidal and maxillary sinusitis with no bone or tissue lesions. MRI-scan showed an enlarged aspect of the subarachnoid membrane of the right optic nerve. Corticosteroid treatment was prescribed but did not produce any satisfactory result. No improvement in visual acuity was observed.

CONCLUSION

Turbinate radiofrequency may result in a definitive orbital apex syndrome.

Giant osteoma of the maxillary sinus--diagnosis and management

Osteomas are rare, slow-growing, benign bone tumors that preferentially develop in the paranasal sinuses. We report a case of a giant osteoma of the left maxillary sinus in a 29-year-old man which was diagnosed by imaging and endoscopy and treated surgically because of the patient's symptoms and maxillary sinus distortion. Given the large volume and location of the osteoma, resection was performed through an external sublabial approach, according to the Rouge-Denker technique. There were no postoperative complications. There was no sign of recurrence at 5 years follow-up. A review of the literature for maxillary sinus osteomas was performed. Indications for surgery and the different surgical approaches available are discussed.

First Report of Cherry virus A in Prunus mume in China

Natural infections of Cherry virus A (CVA) have been reported in sweet (Prunus avium) and sour cherry (P. cerasus) from a number of European countries, North America, and Japan. CVA has been detected occasionally in other Prunus hosts such as peach, plum, and apricot (1). In the spring of 2007, samples from four Japanese apricot (Prunus mume) trees from the Jiangsu Province of China were analyzed by a polyvalent reverse transcriptase-PCR assay that amplifies a short region of the polymerase gene of viruses from several genera in the family Flexiviridae (2). Sequencing of the amplified products identified CVA in three samples. Two isolates (GenBank Accession Nos. EU730949 and EU730950) were closely related and highly homologous (97.5 to 99.3% identity) to noncherry isolates of CVA (GenBank Accession Nos AY792509 and DQ445275 to DQ445292). The third isolate (GenBank Accession No. EU730951) was approximately 90% identical to the other P. mume isolates and showed the highest identity (92.3%) to a cherry isolate (GenBank Accession No AF413923). CVA infection of the P. mume samples was confirmed by two CVA-specific primer pairs targeting genomic regions corresponding to the movement or coat protein genes. Since the samples showed mixed infections with Plum pox virus (PPV) or Asian Prunus virus 1 (APV1), potential CVA symptomatology could not be evaluated. To our knowledge, these results are the first identification of CVA in China and in P. mume, extending the geographical distribution and natural host range of this virus. Additional work is needed to evaluate whether CVA poses a threat to P. mume production or whether, as in other identified hosts, CVA is largely latent. References: (1) M. Barone et al. Plant Dis. 90:1459, 2006. (2) X. Foissac et al. Phytopathology 95:617, 2005.

[Retinopathy of prematurity complicated by late glaucoma: a case report]

INTRODUCTION

We report the case of an acute rise in intraocular pressure occurring decades after the treatment for prematurity (ROP).

CASE REPORT

A 54-year-old preterm woman presented an acute rise in intraocular pressure in her right amblyopic eye. Prominent dilatation of iridal vessels was noted. Fundus was not visible at that time because of corneal edema. Ocular echography was normal. The fellow eye showed temporal attraction of temporal vessels suggestive of retinopathy of prematurity at the cicatricial stage. Neovascular glaucoma was postulated and pressure control was obtained after cyclodestruction and transscleral cryoapplication. After resolution of corneal edema, fundus examination revealed extensive peripheral retinal photocoagulation scars. Iridocorneal angle presented extensive iridocorneal synechias without true new vessels. Visual acuity remained limited to hand motion.

CONCLUSION

Prominent iris dilatation seen in some preterm patients can mimic rubeosis, and, in the present case, mislead to a diagnosis of neovascular glaucoma. Diagnosis can be difficult if the patient is not specifically asked for a history of prematurity. The case underlines the notion that ROP patients may present very late complications of the disease.

[Patients' preferences and decision-making: state of the art and applications in cancer]

BACKGROUND

This paper deals with the physician-patient encounter. In France, the current legal framework allows patients to be informed (patients' rights to health information) and to participate to decisions regarding their own health. In such a context, this paper aims to give the reader the broad key components of the so-called 'patient treatment preferences elicitation process' in breast cancer, our research area.

METHODS AND RESULTS

We first present the general context, with a definition of the different physician-patient models. We then present decision aids, tools that aim to provide high-quality information to patients in the decision-making process. Finally, based on our previous studies and on examples drawn from the international literature, we present the empirical process of patients' preferences elicitation, which not only increases patients' knowledge of and satisfaction with the decision made, but also allows patients to be part of their disease management.

CONCLUSION

Far from being a phenomenon in the air supported by a legal system, this method developed in the 90s allows patients and more generally healthcare users to be autonomous without constraining them to a choice.