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Abstract: Aim: The aim of this study was to assess the efficacy of Lanreotide Autogel 90 mg PR to prevent lymphorrhea after axillary dissection in breast cancer. Methods: A Phase III double-blind, randomized, placebo-controlled trial was performed between April 1st, 2008, and December 31st, 2010. The primary endpoint was the lymphorrhea volume (ml) in the axillary drain during the first four postoperative days. The secondary end points were the number of days until axillary drain removal, hospital stay duration (days), lymphorrhea volume (ml) up to days 15, 30 and 180, number of cases with seroma aspiration and number of seroma aspirations, evaluation of wound, arm pain and mobility on days 15, 30 and 180. Results: A total of 148 patients were recruited for the study. Altogether 145 patients were randomized and analysed on an intention-to-treat basis. On the day before surgery 73 patients received the placebo and 72 patients received lanreotide. At four postoperative days, there was a tendency towards a reduction of the lymphorrhea volume in the lanreotide group (median 292 ml, range 1–965 ml) as compared to the placebo group (median 337 ml, range 0–1230 ml), although it was not statistically significant (p = 0.18). There was no significant difference for the secondary end points. In the group with axillary dissection performed alone (n = 24), the lymphorrhea volume was shown to be significantly reduced in the lanreotide group, (p = 0.035) as compared to the placebo group. Conclusion: Our study did not identify any overall significant reduction of lymphorrhea on lanreotide. [Copyright &y& Elsevier]

BACKGROUND We investigated a novel allotransplantation model using an aortocava patch in ewes. METHODS AND RESULTS We carried out 10 uterine orthotopic allotransplantations in ewes with end-to-side anastomosis of the aortocava donor patch on the left external iliac vessel recipient. The immunosuppressive protocol was a combination of cyclosporine (10 mg/kg/day) and mycophenolic acid (3 g/day). An estimation of the immunosuppressive therapy exposure was performed by measuring the area under the curve (AUC) of immunosuppressive plasma concentrations. The graft was assessed by vaginoscopy, magnetic resonance imaging (MRI) and second look laparotomy at 6, 8 and 10 weeks, respectively. The median (range) times for cold and warm ischemia were 95 min (75–130) and 91 min (55–165), respectively. All the vascular anastomoses were patent at the end of the surgery. The median AUC of cyclosporine and mycophenolic acid were 1.24 mg h/l (0.34–3.85) and 18.40 mg h/l (3.76–42.35), respectively. Of the 10 ewes receiving a transplant, 6 could be assessed. Cervical biopsies showed signs of necrosis in all six ewes. The MRI results correlated with the macroscopic observations of the ‘second look’ laparotomy. The aortocava vascular pedicles were thrombosed, adding to the peripheral neovascularization. Graft histology showed endometrial tissue in two out of six ewes. CONCLUSIONS Mobility of the transplant within the pelvis, the length of the vascular pedicle and rejection can explain the high rate of transplant necrosis. The particular digestive anatomy and physiology of ruminants makes it difficult to administer an optimal immunosuppressive treatment. MRI appears to be a good non-invasive examination for graft estimation. [ABSTRACT FROM PUBLISHER]

Introduction: While increased oxidant stress is implicated in a variety of maternal and neonatal complications, the effects of tobacco-induced alterations in systemic redox status remains clinically unrecognized. We hypothesized that maternal smoking would increase systemic oxidant stress during pregnancy in the otherwise healthy female. Methods: We evaluated plasma samples from 212 post partum women as part of a larger parent investigation of mother-infant pairs. An extensive maternal interview noted tobacco, alcohol, cocaine or marijuana use throughout the pregnancy. The redox pairs of glutathione/oxidized GSSG and cysteine/oxidized cystine were measured in the plasma by high performance liquid chromatography. Results: Over 64.5% of the sample reported tobacco use during pregnancy. Tobacco-exposed newborns demonstrated lower birth weight, decreased head circumference and birth length. Maternal tobacco use decreased maternal cysteine by 10% and cysteine/cystine redox potential was dramatically oxidized by >20 mV, independent of alcohol, marijuana or cocaine use. Conclusion: Significant oxidation of maternal cysteine/cystine redox pair occurred before clinically apparent decreases in newborn birth weight. We concluded that tobacco use during pregnancy was associated with significant oxidation of the cysteine/cystine redox pair in the otherwise healthy post partum women. The implications of unrecognized derangements of systemic redox on the health of the mother and infant require evaluation. [ABSTRACT FROM AUTHOR]

erodynamic interference between high-speed slender bodies can detrimentally affect the force and moment characteristics. This is investigated through a wind tunnel study using pressure sensitive paint and force measurements on a receiver body placed adjacent to a generator body. The aim of this paper is to understand both the force and moment changes as well as the underlying aerodynamics of the interference loads which are induced by the disturbance flowfield. The impact of receiver incidence and the strength of the disturbance field are also assessed. The observed interference loads primarily depend on a complex balance of static pressure footprints and tend to be bespoke to each configuration. As a result, overall trends are difficult to extract, but in general the magnitude of the interference loads increases when the receiver is at incidence and also when the strength of the imposed disturbance flowfield increases. [ABSTRACT FROM AUTHOR]

Abstract: Traditionally, stroke risk stratification has centred on the degree of internal carotid artery stenosis, and the presence of focal neurological symptoms. However, degree of stenosis alone is a relatively poor predictor of future stroke in asymptomatic patients; the Asymptomatic Carotid Surgery Trial highlighting the need to identify a subgroup of asymptomatics that may benefit from intervention. Attempting to define this subgroup has inspired imaging research to identify, in vivo, high-risk plaques. In addition to pre-operative risk stratification of carotid stenosis, contrast enhanced ultrasound (CEUS) may be employed in monitoring response to plaque-stabilising therapies. Unlike most contrast agents used for computed tomography and magnetic resonance imaging, microbubbles used in CEUS remain within the vascular space and can hence be used to study the vasculature. In addition to improving current carotid structural scans, CEUS has potential to add extra information on plaque characteristics. Furthermore, by targeting microbubbles to specific ligands expressed on vascular endothelium, CEUS may have the ability to probe plaque biology. This review describes the current carotid ultrasound examination and the need to improve it, rationale for imaging neovascularisation, use of CEUS to image neovascularisation, microbubbles in improving the structural imaging of plaque, potential problems with CEUS, and future directions. [Copyright &y& Elsevier]

Abstract: Hydroconversion reactivity of an Athabasca vacuum residue (VR) has been studied in a batch autoclave reactor, as part of a work dedicated to the study of detailed hydroconversion mechanisms. In this work, as a first step, a detailed analytical study was performed on several vacuum residues. Saturates, Aromatics, Resins and Asphaltenes (SARA) composition strongly varies for different feeds, but SAR fractions analyses show strong similarities (13C NMR distribution and molecular weight). Therefore, SARA compositions may explain feed hydroconversion differences. The reactivity of the whole Athabasca vacuum residue has been studied under deep hydroconversion conditions in a batch autoclave. Process severity was adjusted varying by temperature from 395 up to 420°C. Catalytic effect was also evaluated. As expected, results show that VR conversion increases with temperature. Product yields were obtained and depend mostly on residue conversion. The results also confirm that cracking reaction mechanisms are initiated thermally and that radicals formed are stabilized by catalytic hydrogenation. In order to better understand feedstock effects on reactivity, we have also conducted a dedicated study in order to separate the Athabasca vacuum residue in different families, each of them containing mainly asphaltenes, resins or an aromatics/saturates mixture. The reactivity of those cuts will be studied in a next step to highlight feed composition effects. [Copyright &y& Elsevier]

Abstract: The procedure known as sentinel lymph node biopsy (SLNB) under local anesthesia (LA) allows surgical teams to avoid the uncertainties of frozen tissue examination and to perform axillary dissection on patients who have been informed of the risks of lymph node invasion prior to the procedure. Objective: In the absence of studies that assess the risk of obtaining false negatives during SLNB under LA, we believed it would be relevant to do a study of the safety of SLNB under LA to ensure that the risk of axillary recurrence is as low as with SLNB carried out in the traditional manner under general anesthesia. Through the experience of the Department of Gynecological Surgery at the Limoges CHU, we were able to assess the risk of axillary recurrence after SLNB under LA. Materials and methods: Between July 2001 and November 2008, 319 SLNB under LA was performed in cases of invasive breast cancer. Axillary dissection was done in 125 cases. In total, 194 patients underwent SLNB with no lymph node invasion and without additional axillary dissection. Follow-up was monitored until May 30, 2008. Results: With a median follow-up period of 39.5 months, there were no patients with axillary recurrence. We recorded 6 local recurrences and 3 distant metastases. Conclusion: With an experienced team, SLNB under LA is a procedure that does not expose patients to a greater risk of axillary recurrence than SLNB carried out in the traditional manner under general anesthesia. [Copyright &y& Elsevier]

Many cases of not life saving transplanted organs were described with the aim of improving quality of life. Uterus graft could be an alternative solution to adoption or surrogacy for women who have uterine factor infertility. Different animals’ studies with mouse, sheep or monkey showed feasibility of the surgical technique with large vessels patch. One case of human uterine transplant has been reported but failed. Cold storage of the uterus in protective solution has been explored with mouse, sheep and human. Only pregnancy after uterus graft by syngenic mouse has been published. Results about pregnancy after allograft with sheep or monkey are necessary before pregnancy after human uterus graft becomes a reality. [Copyright &y& Elsevier]