The effect of Holstein-Friesian, Jersey × Holstein-Friesian, and Norwegian Red × (Jersey × Holstein-Friesian) cows on dry matter intake and production efficiencies in pasture-based systems

The objective of this study was to investigate the effect of cow genotype and parity on dry matter intake (DMI) and production efficiencies in pasture-based systems. Three dairy cow genotypes were evaluated over 3 yr; 40 Holstein-Friesian (HF), 40 Jersey × HF (JEX), and 40 Norwegian Red × JEX (3WAY) each year, with each genotype grazed in equal numbers on 1 of 4 grazing treatments in a 2 × 2 factorial arrangement of treatments [diploid or tetraploid perennial ryegrass (Lolium perenne L.) with or without white clover (Trifolium repens L.)]. A total of 208 individual cows were used during the experiment. The effect of parity (lactation 1, 2, and 3+) was also evaluated. Individual DMI was estimated 8 times during the study, 3 times in 2015 and in 2017, and twice in 2016, using the n-alkane technique. Days in milk at each DMI measurement period were 64, 110, and 189, corresponding to spring, summer, and autumn. Measures of milk production efficiency calculated were total DMI/100 kg of body weight (BW), milk solids (kg fat + protein; MSo)/100 kg of BW, solids-corrected milk (SCM)/100 kg of BW, and unité fourragère lait (net energy requirements for lactation equivalent of 1 kg of standard air-dry barley; UFL) available for standard (4.0% fat and 3.1% protein content) milk production after accounting for maintenance. During the DMI measurement periods HF had a greater milk yield (23.2 kg/cow per d) compared with JEX and 3WAY (22.0 and 21.9 kg/cow per d, respectively) but there was no difference in MSo yield. Holstein-Friesian and JEX, and JEX and 3WAY had similar DMI, but HF had greater total DMI than 3WAY (DMI was 17.2, 17.0, and 16.7 kg/cow per d for HF, JEX, and 3WAY, respectively). Jersey × Holstein-Friesian cows were the most efficient for total DMI/100 kg of BW, SCM/100 kg of BW, and MSo/100 kg of BW (3.63, 4.96, and 0.39 kg/kg of BW) compared with HF (3.36, 4.51, and 0.35 kg/kg of BW) and 3WAY (3.45, 4.63, and 0.37 kg/kg of BW), respectively. Unité fourragère lait available for standard milk production after accounting for maintenance was not different among genotypes. As expected, DMI differed significantly among parities with greater parity cows having higher DMI and subsequently higher milk and MSo yield. Although all 3 genotypes achieved high levels of DMI and production efficiency, JEX achieved the highest production efficiency. Some of the efficiency gains (SCM/100 kg of BW, MSo/100 kg of BW, and total DMI/100 kg of BW) achieved with JEX decreased when the third breed (Norwegian Red) was introduced.

The effect of Lolium perenne L. ploidy and Trifolium repens L. inclusion on dry matter intake and production efficiencies of spring-calving grazing dairy cows

The objective of this study was to investigate the effect of perennial ryegrass (Lolium perenne L.; PRG) ploidy and white clover (Trifolium repens L.) inclusion on milk production, dry matter intake (DMI), and milk production efficiencies. Four separate grazing treatments were evaluated: tetraploid PRG only, diploid PRG only, tetraploid PRG with white clover, and diploid PRG with white clover. Individual DMI was estimated 8 times during the study (3 times in 2015, 2 times in 2016, and 3 times in 2017) using the n-alkane technique. Cows were, on average, 64, 110, and 189 d in milk during the DMI measurement period, corresponding to spring, summer, and autumn, respectively. Measures of milk production efficiency were total DMI/100 kg of body weight (BW), milk solids (kg of fat + protein; MSo)/100 kg of BW, solids-corrected milk/100 kg of BW, and MSo/kg of total DMI. Perennial ryegrass ploidy had no effect on DMI; however, a significant increase in DMI (+0.5 kg/cow per day) was observed from cows grazing PRG-white clover swards compared with PRG-only swards. Sward white clover content influenced DMI as there was no increase in DMI in spring (9% sward white cover content), whereas DMI was greater in summer and autumn for cows grazing PRG-white clover swards (+0.8 kg/cow per day) compared with PRG-only swards (14 and 23% sward white clover content, respectively). The greater DMI of cows grazing PRG-white clover swards led to increased milk (+1.3 kg/cow per day) and MSo (+0.10 kg/cow per day) yields. Cows grazing PRG-white clover swards were also more efficient for total DMI/100 kg of BW, solids-corrected milk/100 kg of BW, and MSo/100 kg of BW compared with cows grazing PRG-only swards due to their similar BW but higher milk and MSo yields. The results highlight the potential of PRG-white clover swards to increase DMI at grazing and to improve milk production efficiency in pasture-based systems.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

An assessment of the production, reproduction, and functional traits of Holstein-Friesian, Jersey × Holstein-Friesian, and Norwegian Red × (Jersey × Holstein-Friesian) cows in pasture-based systems

Pasture-based production systems typically require highly fertile, healthy, and robust genetics, with greater emphasis on milk solids (MSo; kg of fat + protein) production as opposed to milk yield. This study assessed milk production, production efficiency, reproductive performance, body weight (BW), body condition score, and functional traits in 3 different dairy cow genotypes: Holstein-Friesian (HF), Jersey × Holstein-Friesian (JEX), and Norwegian Red × (Jersey × Holstein-Friesian) (3-way). The 3 genotypes were rotationally grazed on 4 different grazing treatments after calving in spring and were stocked at a rate of 2.75 cows/ha. Holstein-Friesian cows produced higher daily and total milk yields compared with JEX and 3-way cows (5,718 vs. 5,476 and 5,365 kg/cow, respectively). However, JEX and 3-way cows had higher milk fat and protein contents (4.86 and 4.75%, respectively, for JEX and 3.87 and 3.88%, respectively, for 3-way) compared with HF (4.52 and 3.72%), resulting in similar MSo yield for JEX and HF (469 and 460 kg/cow) and slightly lower MSo yield for 3-way (453 kg/cow) compared with JEX. As parity increased, milk and MSo yield per cow increased. Reproductive performance was not significantly different between the 3 genotypes, which had similar 24-d submission rates, 6-wk pregnancy rates, and overall pregnancy rates over the 4-yr period. No difference in calving difficulty, incidence of mastitis, or incidence of lameness was observed among the 3 genotypes. Body weight was significantly different among all 3 genotypes, with HF being the heaviest followed by 3-way and JEX (530, 499, and 478 kg, respectively), and 3-way cows had a higher body condition score throughout lactation compared with HF and JEX cows. The differences in BW coupled with similar MSo production resulted in JEX cows having the highest production efficiency (4.58 kg of MSo/kg of metabolic BW), 3-way cows being intermediate (4.30 kg of MSo/kg of metabolic BW), and HF cows having the lowest (4.16 kg of MSo/kg of metabolic BW). In conclusion, HF herds with poor reproductive performance and low milk fat and protein contents are likely to benefit considerably from crossbreeding with Jersey, and all herds are likely to benefit in terms of production efficiency. However, where herd performance, particularly in relation to reproductive performance, is comparable with HF in the current study, crossbreeding with Jersey or Norwegian Red is unlikely to lead to significant improvements in overall herd performance.

White clover incorporation at high nitrogen application levels: results from a 3-year study

Context High nitrogen (N)-fertiliser application levels and high stocking rates have been shown to optimise herbage dry-matter (DM) production in grass-only systems. Conversely, swards including white clover (Trifolium repens L.) are commonly suited to production systems at low N-fertiliser application levels (<150 kg N/ha) and low stocking rates (fewer than two livestock units (LU) per hectare). Despite this, the use of N fertiliser on grass–clover swards has generally increased during the past few decades, particularly in more intensively managed swards under dairy farming. Increasing inorganic N decreases sward white clover content in grass–clover swards, and increasing stocking rate on grass–clover swards can result in damage to white clover plants. However, under high N-application levels, a high stocking rate can also potentially minimise the negative effects of increased grass growth on sward white clover content. Aims The objective of the present study was to investigate the persistency of white clover in an intensive animal-grazing system, under a high N-fertiliser application level (250 kg N/ha) and at a high stocking rate (2.75 LU per hectare) over a 3-year period (2014–2016). Methods The study was a 2 × 2 factorial design, consisting of two perennial ryegrass ploidies (diploid, tetraploid) and two white clover treatments (grass-only, grass–clover). Four sward treatments (diploid-only, tetraploid-only, diploid + clover, tetraploid + clover) were evaluated over a full grazing season at a system scale. Sward measurements were taken at each grazing occasion for 3 years. Key results Over the 3 years, grass–clover swards produced an additional 1468 kg DM/ha when compared with grass-only swards. Sward white clover content decreased by 17% over the three study years. Conclusions This decrease in sward white clover content led to a decrease in contribution to cumulative herbage DM production. Implications Although the present study showed that white clover inclusion can increase herbage DM production at high N-fertiliser application levels, in association with high stocking rates, the initial extra herbage DM production on grass–clover swards decreased each year. Further studies should be undertaken to investigate whether the decline in white clover persistence observed is progressive over a longer time period.

Milk production per cow and per hectare of spring-calving dairy cows grazing swards differing in Lolium perenne L. ploidy and Trifolium repens L. composition

Grazed grass is the cheapest feed available for dairy cows in temperate regions; thus, to maximize profits, dairy farmers must optimize the use of this high-quality feed. Previous research has defined the benefits of including white clover (Trifolium repens L.) in grass swards for milk production, usually at reduced nitrogen usage and stocking rate. The aim of this study was to quantify the responses in milk production of dairy cows grazing tetraploid or diploid perennial ryegrass (Lolium perenne L.; PRG) sown with and without white clover but without reducing stocking rate or nitrogen usage. We compared 4 grazing treatments in this study: tetraploid PRG-only swards, diploid PRG-only swards, tetraploid with white clover swards, and diploid with white clover swards. Thirty cows were assigned to each treatment, and swards were rotationally grazed at a farm-level stocking rate of 2.75 cows/ha and a nitrogen fertilizer rate of 250 kg/ha annually. Sward white clover content was 23.6 and 22.6% for tetraploid with white clover swards and diploid with white clover swards, respectively. Milk production did not differ between the 2 ploidies during this 4-yr study, but cows grazing the PRG-white clover treatments had significantly greater milk yields (+596 kg/cow per year) and milk solid yields (+48 kg/cow per year) compared with cows grazing the PRG-only treatments. The PRG-white clover swards also produced 1,205 kg of DM/ha per year more herbage, which was available for conserving and buffer feeding in spring when these swards were less productive than PRG-only swards. Although white clover is generally combined with reduced nitrogen fertilizer use, this study provides evidence that including white clover in either tetraploid or diploid PRG swards, combined with high levels of nitrogen fertilizer, can effectively increase milk production per cow and per hectare.

Worms make risky choices too: the effect of starvation on foraging in the common earthworm (Lumbricus terrestris)

Species should avoid risks to protect accumulated fitness. However, when faced with starvation, organisms may accept risks to enhance future reproductive opportunities. We investigated the effect of starvation on risk-taking behaviour in the common earthworm (Lumbricus terrestris Linnaeus, 1758). Lumbricus terrestris are negatively phototactic annelids that feed on decaying plant matter at the soil surface. Feeding in high-light conditions is a potentially riskier choice, given the threats of visual predators and desiccation. We predicted that starvation in L. terrestris would increase risk-taking behaviour and decrease time taken (latency) to make choices. We manipulated the starvation level of L. terrestris individuals (nonstarved, half-starved, and fully starved) and presented them with a binary foraging choice. Lumbricus terrestris could choose either a low-food and dark condition (low-risk condition) or a high-food and light condition (high-risk condition). We found that starved individuals selected the high-risk condition more often than nonstarved individuals. Starved individuals also had a decreased latency to first choice. Risk-taking did not scale with level of starvation; there was no difference in foraging choice and latency between half- and fully starved individuals. Our results indicate that L. terrestris makes state-dependent foraging choices, providing insight into the importance of fundamental life-history trade-offs in this understudied species.

β-cell specific T-lymphocyte response has a distinct inflammatory phenotype in children with Type 1 diabetes compared with adults

AIM

To examine the hypothesis that the quality, magnitude and breadth of helper T-lymphocyte responses to β cells differ in Type 1 diabetes according to diagnosis in childhood or adulthood.

METHODS

We studied helper T-lymphocyte reactivity against β-cell autoantigens by measuring production of the pro-inflammatory cytokine interferon-γ and the anti-inflammatory cytokine interleukin-10, using enzyme-linked immunospot assays in 61 people with Type 1 diabetes (within 3 months of diagnosis, positive for HLA DRB1*0301 and/or *0401), of whom 33 were children/adolescents, and a further 91 were unaffected siblings.

RESULTS

Interferon-γ responses were significantly more frequent in children with Type 1 diabetes compared with adults (85 vs 61%; P = 0.04). Insulin and proinsulin peptides were preferentially targeted in children (P = 0.0001 and P = 0.04, respectively) and the breadth of the interferon-γ response was also greater, with 70% of children having an interferon-γ response to three or more peptides compared with 14% of adults (P < 0.0001). Islet β-cell antigen-specific interleukin-10 responses were similar in children and adults in terms of frequency, breadth and magnitude, with the exception of responses to glutamic acid decarboxylase 65, which were significantly less frequent in adults.

CONCLUSIONS

At diagnosis of Type 1 diabetes, pro-inflammatory autoreactivity is significantly more prevalent, focuses on a wider range of targets, and is more focused on insulin/proinsulin in children than adults. We interpret this as indicating a more aggressive immunological response in the younger age group that is especially characterized by loss of tolerance to proinsulin. These findings highlight the existence of age-related heterogeneity in Type 1 diabetes pathogenesis that could have relevance to the development of immune-based therapies.

New approach for a reliable in vitro sun protection factor method - Part II: Practical aspects and implementations

OBJECTIVE

Our previous paper (Part I: Principle and mathematical aspects) presented a new reliable in vitro sun protection factor (SPF) method and demonstrated it to be reproducible and correlated with the in vivo method. Nevertheless, the relevance of an international method should to be adaptable to all products on the market and demonstrated with a blind test. Thus, the aim of this second article was to focus on the practical aspects and implementation (Part II) of a large population of different commercially available sunscreen formulations to obtain similar in vivo SPF results for the purpose of labelling.

METHODS

The method uses the spectroradiometric measurement of residual ultraviolet (UV) through the sample that was applied on a substrate with a robotic appliance. The method has been demonstrated to be highly reliable, and it is based on a multisubstrate solution with a single UV pre-irradiation dose. Furthermore, different categories of the product were studied to identify a reliable and universal in vitro SPF method.

RESULTS

Based on different sunscreens products classified into 5 different groups (emulsion, oil, alcohol, stick and powder), it was demonstrated that our method has good reproducibility and accuracy compared with the clinical SPF method. Indeed, the mean coefficient of variation (CV%) was approximately 7%, and the coefficient of correlation reached approximately 0.8-1.0 for different types of tested products.

CONCLUSION

Our second paper concludes that the new in vitro SPF method (based on 113 sunscreen products from the Parts I and II) is clearly adaptable for the SPF labelling purpose on any product type because it is non-invasive, less expensive, more practical and more reliable if performed under strict conditions.

Characterization of RIPK3-mediated phosphorylation of the activation loop of MLKL during necroptosis

Mixed lineage kinase domain-like pseudokinase (MLKL) mediates necroptosis by translocating to the plasma membrane and inducing its rupture. The activation of MLKL occurs in a multimolecular complex (the 'necrosome'), which is comprised of MLKL, receptor-interacting serine/threonine kinase (RIPK)-3 (RIPK3) and, in some cases, RIPK1. Within this complex, RIPK3 phosphorylates the activation loop of MLKL, promoting conformational changes and allowing the formation of MLKL oligomers, which migrate to the plasma membrane. Previous studies suggested that RIPK3 could phosphorylate the murine MLKL activation loop at Ser345, Ser347 and Thr349. Moreover, substitution of the Ser345 for an aspartic acid creates a constitutively active MLKL, independent of RIPK3 function. Here we examine the role of each of these residues and found that the phosphorylation of Ser345 is critical for RIPK3-mediated necroptosis, Ser347 has a minor accessory role and Thr349 seems to be irrelevant. We generated a specific monoclonal antibody to detect phospho-Ser345 in murine cells. Using this antibody, a series of MLKL mutants and a novel RIPK3 inhibitor, we demonstrate that the phosphorylation of Ser345 is not required for the interaction between RIPK3 and MLKL in the necrosome, but is essential for MLKL translocation, accumulation in the plasma membrane, and consequent necroptosis.

Multi-parametric flow cytometric and genetic investigation of the peripheral B cell compartment in human type 1 diabetes

The appearance of circulating islet-specific autoantibodies before disease diagnosis is a hallmark of human type 1 diabetes (T1D), and suggests a role for B cells in the pathogenesis of the disease. Alterations in the peripheral B cell compartment have been reported in T1D patients; however, to date, such studies have produced conflicting results and have been limited by sample size. In this study, we have performed a detailed characterization of the B cell compartment in T1D patients (n = 45) and healthy controls (n = 46), and assessed the secretion of the anti-inflammatory cytokine interleukin (IL)-10 in purified B cells from the same donors. Overall, we found no evidence for a profound alteration of the B cell compartment or in the production of IL-10 in peripheral blood of T1D patients. We also investigated age-related changes in peripheral B cell subsets and confirmed the sharp decrease with age of transitional CD19(+) CD27(-) CD24(hi) CD38(hi) B cells, a subset that has recently been ascribed a putative regulatory function. Genetic analysis of the B cell compartment revealed evidence for association of the IL2-IL21 T1D locus with IL-10 production by both memory B cells (P = 6·4 × 10(-4) ) and islet-specific CD4(+) T cells (P = 2·9 × 10(-3) ). In contrast to previous reports, we found no evidence for an alteration of the B cell compartment in healthy individuals homozygous for the non-synonymous PTPN22 Trp(620) T1D risk allele (rs2476601; Arg(620) Trp). The IL2-IL21 association we have identified, if confirmed, suggests a novel role for B cells in T1D pathogenesis through the production of IL-10, and reinforces the importance of IL-10 production by autoreactive CD4(+) T cells.

[Analysis of clinical pathway in changing and disabling neurological diseases]

Neurological diseases are characterized by the complexity of care and by a constant and changing disability. More and more frequently, their impact on the clinical pathway remains unknown. Seven postgraduate rehabilitation students (Master coordination du handicap, université Pierre-et-Marie-Curie, Paris) reconstructed the clinical pathway of 123 patients with various neurological diseases: multiple sclerosis, Alzheimer disease, amyotrophic lateral sclerosis, spinal trauma, Parkinson disease and brain tumors. There was a significant correlation between disease duration and the number of specialists involved in care, the number of prescribed drugs and the number of short-term hospitalizations; there was no correlation with age. This result suggests that with time an increasing number of complications related to the initial neurological disease developed. Hospitalization in rehabilitation units was highly correlated with the degree of disability and also with the help received by the patients during the course of their disease. This result suggests that these hospitalizations were a direct consequence of burn out among relatives. General practitioners (GP) were highly involved only during the initial part of the pathway, and their involvement rapidly declined thereafter, suggesting a probable relation with the specificities and the complexity of care for neurological diseases which induces a progressive transfer of responsibilities from the GP to the hospital. Social care was always incomplete and occurred too late during the course of the disease. The feeling by the patients that their care pathway was chaotic was highly correlated with the quality of the information given to the patient at the time of the announcement of their disease. This study confirms that cares for neurological diseases is highly specific and that expert centers and coordination networks are in a key position to ensure an efficient care pathway.

Novel phytase from Pteris vittata resistant to arsenate, high temperature, and soil deactivation

Arsenate interferes with enzymatic processes and inhibits inorganic phosphorus (Pi) uptake in many plants. This study examined the role of phytase and phosphatase in arsenate tolerance and phosphorus (P) acquisition in the arsenic hyperaccumulator Pteris vittata . Enzyme-mediated hydrolysis of phytate in P. vittata extracts was not inhibited by arsenate at 5 mM or by heating at 100 °C for 10 min. Root exudates of P. vittata exhibited the highest phytase activity (18 nmol Pi mg(-1) protein min(-1)) when available P was low, allowing its growth on media amended with phytate as the sole source of P. Phosphorus concentration in P. vittata gametophyte tissue grown on phytate was equivalent to plants grown with inorganic phosphate at 2208 mg kg(-1), and arsenic was increased from 1777 to 2630 mg kg(-1). After 2 h of mixing with three soils, P. vittata phytase retained more activity, decreasing from ∼ 26 to ∼ 25 nmol Pi mg(-1) protein min(-1), whereas those from Pteris ensiformis and wheat decreased from ∼ 18 to ∼ 1 nmol Pi mg(-1) protein min(-1). These results suggest P. vittata has a uniquely stable phytase enabling its P acquisition in P-limiting soil environments. Furthermore, the P. vittata phytase has potential use as a soil amendment, a transgenic tool, or as a feed additive supplement, reducing the need for nonrenewable, polluting P fertilizers.

Borosilicate Nuclear Waste Glass Alteration Kinetics: Chemical Inhibition and Affinity Control

The objective of this work was to develop a more representative mathematical formulation of the alteration kinetics of the borosilicate SON68 glass by combining three approaches: (1) Compare extensive prior experimental static leaching results for SON68 glass with the first-order kinetic law in which silica is the predominant element, (2) Assess the exact role of dissolved silica on the alteration rate under conditions near and far from saturation, by means of dynamic leach tests and, (3) Compare the new data with the general kinetic law for silicates in which the reaction affinity, catalysis and inhibition are the three influencing factors.

Use of gene expression profiling to determine prognosis and therapeutic targets for patients with appendiceal carcinoma

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Background: Appendiceal carcinomas are rare neoplasms that often present as peritoneal surface malignancies. The tumors are treated similarly to primary colorectal metastases, despite having different biological environments. The aim of this study is to utilize genomic analyses to understand the underlying biology of appendiceal carcinoma in order to better guide prognosis and therapy.

Methods: Forty-one metastatic human tumors to the peritoneum (26 appendiceal carcinoma, 15 colorectal carcinoma) were subjected to global gene expression analysis. Unsupervised hierarchical clustering was used to differentiate phenotypes based on differential gene expression. Phenotypes were further analyzed to find differences in oncogenic pathway deregulation and findings were validated using gene specific inhibitors in vitro.

Results: Unsupervised hierarchical clustering revealed three distinct phenotypes, two consisting of predominantly low grade appendiceal samples (Cluster 1 and Cluster 2) and one consisting of predominantly colorectal samples (Cluster 3). Cluster 1 consisted of patients with good prognosis and Cluster 2 consisted of patients with poor prognosis (p = 0.046). Further characterization of Cluster 1 and Cluster 2 with oncogenic pathway signatures identified increased deregulation of the EGFR pathway in the poor prognosis cluster. Similarly, colon cancer cell lines with the poor prognosis phenotype were found to be more sensitive to gefitinib (EGFR inhibitor) (p = 0.038).

Conclusions: The use of geneexpression profiling can be used to identify prognosis and novel therapeutic targets for patients with appendiceal carcinoma. These methods can serve as models to understand the biology of appendiceal carcinoma and to assist in the design of future trials for patients with appendiceal cancer.

No significant financial relationships to disclose.

Resected pancreatic neuroendocrine tumors: Patterns of failure and disease-related outcomes with or without radiotherapy

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Background: Pancreatic neuroendocrine tumors (NET) are rare with improved prognosis compared to adenocarcinomas. Surgical resection remains the standard of care although many patients present with unresectable/metastatic disease. While many resected patients will fail distantly, little is known regarding the use of adjuvant radiotherapy. To define this and establish specific patterns of failure, an analysis of resected patients from a single institution was performed.

Methods: From 1994 to 2009, 33 patients with NET of the pancreatic head underwent resection with curative intent at Duke University. Sixteen patients were treated with surgical resection alone, and an additional 17 underwent resection with adjuvant (n=10) or neoadjuvant (n=7) radiation therapy, usually with concurrent fluoropyrimidine-based chemotherapy (CMT). Median radiation dose was 50.4 Gy and median follow-up 28 months.

Results: Patients receiving radiation therapy were more likely to have involved nodes (47% vs 19%, p=0.09), more mitoses per high power field (p=0.10) and involved margins (47% vs 31%, p=0.20) compared to surgery alone patients. Median survival for the whole cohort was 52 months. Two-year survival was 68% for the CMT group and 93% for the surgery alone group (p=0.03). Two-year local control was 85% for the CMT and 90% for the surgery group (p=0.49). Two-year metastasis-free survival was 45% and 69% for the CMT and surgery patients, respectively (p=0.02).

Conclusions: Patients receiving CMT were more likely to have adverse pathologic features compared to surgery-alone patients. Survival outcomes were high in both groups, although less so in the CMT group. Distant metastasis development dominated patterns of failure. Local failure following resection of NETs is uncommon, and the role of adjuvant radiotherapy in this setting remains unclear.

No significant financial relationships to disclose.

Surgical treatment of nasal obstruction in rhinoplasty

Often, rhinoplasty patients present not just for aesthetic correction, but for improvement of their nasal breathing due to functional abnormalities or problems. Because the aesthetic and functional problems must be addressed together, an understanding of both the internal and external anatomy is essential. In this article, the authors review the differential diagnosis of nasal obstruction and the important components of a thorough examination. In this article, medical treatment options are not discussed, but just as an exacting aesthetic analysis leads to an appropriate cosmetic rhinoplasty plan, a thorough functional analysis will dictate the appropriate medical or surgical treatment.

Metabolomics of temperature stress

Plants possess inducible tolerance mechanisms that extend the temperature range for survival during acute temperature stress. The inducible mechanisms of cold acclimation and acquired thermotolerance involve highly complex processes. These include perception and signal transduction of non-optimal temperatures or their physical consequences on cellular components that program extensive modification of the transcriptome, proteome, metabolome and composition and physical structure of the cytoplasm, membranes and cell walls. Therefore, a systems biology approach will be necessary to advance the understanding of plant stress responses and tolerance mechanisms. One promise of systems biology is that it will greatly enhance our understanding of individual and collective functions and thereby provide a more holistic view of plant stress responses. Past studies have found that several metabolites that could functionally contribute to induced stress tolerance have been associated with stress responses. Recent metabolite-profiling studies have refocused attention on these and other potentially important components found in the 'temperature-stress metabolome'. These metabolomic studies have demonstrated that active reconfiguration of the metabolome is regulated in part by changes in gene expression initiated by temperature-stress-activated signaling and stress-related transcription factors. One aspect of metabolism that is consistent across all of the temperature-stress metabolomic studies to date is the prominent role of central carbohydrate metabolism, which seems to be a major feature of the reprogramming of the metabolome during temperature stress. Future metabolomic studies of plant temperature-stress responses should reveal additional metabolic pathways that have important functions in temperature-stress tolerance mechanisms.

Glucan, water dikinase activity stimulates breakdown of starch granules by plastidial beta-amylases

Glucan phosphorylating enzymes are required for normal mobilization of starch in leaves of Arabidopsis (Arabidopsis thaliana) and potato (Solanum tuberosum), but mechanisms underlying this dependency are unknown. Using two different activity assays, we aimed to identify starch degrading enzymes from Arabidopsis, whose activity is affected by glucan phosphorylation. Breakdown of granular starch by a protein fraction purified from leaf extracts increased approximately 2-fold if the granules were simultaneously phosphorylated by recombinant potato glucan, water dikinase (GWD). Using matrix-assisted laser-desorption ionization mass spectrometry several putative starch-related enzymes were identified in this fraction, among them beta-AMYLASE1 (BAM1; At3g23920) and ISOAMYLASE3 (ISA3; At4g09020). Experiments using purified recombinant enzymes showed that BAM1 activity with granules similarly increased under conditions of simultaneous starch phosphorylation. Purified recombinant potato ISA3 (StISA3) did not attack the granular starch significantly with or without glucan phosphorylation. However, starch breakdown by a mixture of BAM1 and StISA3 was 2 times higher than that by BAM1 alone and was further enhanced in the presence of GWD and ATP. Similar to BAM1, maltose release from granular starch by purified recombinant BAM3 (At4g17090), another plastid-localized beta-amylase isoform, increased 2- to 3-fold if the granules were simultaneously phosphorylated by GWD. BAM activity in turn strongly stimulated the GWD-catalyzed phosphorylation. The interdependence between the activities of GWD and BAMs offers an explanation for the severe starch excess phenotype of GWD-deficient mutants.

High-resolution oligonucleotide array-CGH applied to the detection and characterization of large rearrangements in the hereditary breast cancer gene BRCA1

We have developed a new method for detecting and characterizing large rearrangements in the BRCA1 gene based on high-resolution oligonucleotide array-CGH technology. We designed a specific CGH array for the BRCA1 gene and its flanking regions. We then used this approach to analyze nine DNA samples known to contain large deletions and large duplications. When possible, the deleted or duplicated region was sequenced to identify the break point. All the large rearrangements were detected by the new method, and their size was estimated to be within 1--2 kb. This enabled us to develop a simple polymerase chain reaction screening test for other family members. A refined choice of oligonucleotides should improve the precision of the breakpoint determination. Finally, the high resolution of oligonucleotide array-CGH should help to detect new large rearrangements missed by other current methods.

Pentoxifylline : l'anti-TNF du pauvre ?

PURPOSE

Pentoxifylline (PTX) is a phosphodiesterase inhibitor drug used to improve peripheral vascular disease. In vitro studies demonstrated that PTX has anti-TNFalpha properties. We did a selective review of clinical trials which used PTX in patients with inflammatory rheumatic and non-rheumatic diseases.

CURRENT KNOWLEDGE AND KEY POINTS

Most of the identified clinical trials were uncontrolled and involved a low number of patients. Use of PTX in systemic lupus erythematous, Behçet's disease and sarcoidosis yielded significant preliminary results. Moreover, PTX markedly reduced proteinuria in several glomerulonephritis (lupus nephritis, membranous nephropathy, diabetic nephropathy).

FUTURE PROSPECTS AND PROJECTS

Further randomized and controlled clinical trials are required to examine whether PTX can improve outcome in patients with inflammatory diseases. Meanwhile, PTX should not be used for the treatment of these diseases.