Patients with primary hyperparathyroidism (pHPT) can develop persistent (P-pHPT) or recurrent (R-... more Patients with primary hyperparathyroidism (pHPT) can develop persistent (P-pHPT) or recurrent (R-pHPT) disease after parathyroidectomy. Before recommending reoperation, recurrence must be accurately identified because of the high risk of complications. Our study evaluates 18F-fluorocholine (18F-FCH) PET/CT and 4D-CT integrated in PET/4D-CT in patients with P-pHPT/R-pHPT. Patients with P-pHPT/R-pHPT investigated by 18F-FCH PET/4D-CT between May 2018 and March 2021 were retrospectively included. Forty-two patients were included, 37 of whom underwent 4D-CT. The sensitivity and detection rate (DR%) were 95% and 88% for 18F-FCH PET/CT and 70% and 63% for 4D-CT, respectively. PET/CT and 4D-CT were concordant in 18/24 glands and concordant and positive in 15/24 (63%) glands. Discordant results were obtained for 6/24 glands. The surgical success rate was 65%. PET/CT showed significantly higher sensitivity than 4D-CT. Dynamic CT allowed the identification of no additional glands missed by PE...
Supplemental Material, sj-pdf-1-sri-10.1177_15533506211001236 for Original Preoperative Localizat... more Supplemental Material, sj-pdf-1-sri-10.1177_15533506211001236 for Original Preoperative Localization Technique of Parathyroid Adenomas by 3-Dimensional Virtual Neck Exploration by Mihaela Ignat, Madeleine Pérouse, François Lefebvre, Deborah Kadoche, Alessio Imperiale, Lee Swanstrom, Michel Vix and Didier Mutter in Surgical Innovation
False negative results in microCT scan imaging in two mice. A, B, C. Aspects corresponding to the... more False negative results in microCT scan imaging in two mice. A, B, C. Aspects corresponding to the first animal. A, B. Axial and frontal view of microCT scan imaging of an isodense, poorly delineated right liver lobe tumor. Prospective and retrospective interpretation of images could only identify an enlargement of the right liver lobe. The border between normal and pathological tissue could not be identified on the microCT scan rendering. C. Gross appearance of the poorly delineated right liver lobe tumor, depicted in A and B. D, E, F. Aspects corresponding to the second animal. D. Retrospective interpretation of microCT scan rendering with identification of a centroabdominal in-homogeneous, isodense tumor (arrowheads). E. Gross appearance of the centroabdominal tumor which was not identified at the prospective interpretation of the microCT scan images. F. Histological assessment of the presence of a hepatocellular carcinoma (HE, x240). (JPG 3580 kb)
Fenestra™ toxicity. Table: Liver function tests, expressed as average ± standard deviation, in a ... more Fenestra™ toxicity. Table: Liver function tests, expressed as average ± standard deviation, in a 20 mice group (16 wild types and 4 mice Trim24 L2/L2Alb-Cre) receiving a total dose of up to 22 μl/g Fenestra™) controlled by five wild type mice receiving no Fenestra™ ASAT: aspartate transaminase, ALAT: alanine transaminase, GGT: gamma-glutamyl transferase. Alkaline phoshpatase levels were not different. Serological measurements (ASAT, ALAT, bilirubin, GGT, alkaline phoshpatase) were performed on blood samples collected by direct cardiac puncture under general isoflurane anaesthesia before animal euthanasia. Standard techniques (ADVIA 2400, Siemens and immune-nephelometry BNII) were employed. Figure: Micrographs of histological structure of the liver (A, B, C) and kidney (D) in mice with acute toxicity after 22 μl/g Fenestra™ administration. HE staining, original magnifications x1500 (A, B) and x240 (C, D). Red arrows: leucocyte adhesion and diapedesis; Arrowheads: hepatocyte necrosis;...
Follow-up of hepatocellular carcinoma (HCC) growth by 3D reconstruction. Follow-up of hepatocellu... more Follow-up of hepatocellular carcinoma (HCC) growth by 3D reconstruction. Follow-up of hepatocellular carcinoma (HCC) growth by 3D reconstruction of micro-CT rendering. Micro-CT imaging was performed at 12, 15, and 21 months of age respectively in hepatocyte specific Trim24-null mice. A, B, C Exponential growth of unifocal HCC. A. Micro-CT-scan rendering in coronal slides (strips indicate vertical diameter of HCC). B. 3D reconstruction of the micro-CT-scan (HCC is depicted in green). C. Macroscopic appearance of the liver and HCC at dissection at 22 months old (black arrow indicates tumor). D, E, F. Multifocal growth of HCC. D. Micro-CT scan rendering in coronal slides (strips indicate vertical diameters of the HCCs). E. 3D reconstruction of the micro-CT-scan (HCCs are depicted in green). F. Macroscopic appearance of the liver and HCCs at dissection at 23 months old (black arrows indicate tumors). (JPG 4259 kb)
Long-term results on sleeve gastrectomy (SG) with more than 10 years report patients needing slee... more Long-term results on sleeve gastrectomy (SG) with more than 10 years report patients needing sleeve revision for weight loss failure, de novo gastroesophageal reflux (GERD), or sleeve complications. The aim of this study was to analyze the results of laparoscopic conversion of failed SG to Roux-en-Y gastric bypass (RYGB). Retrospective review of a prospectively institutional maintained database to identify patients who underwent conversion of SG to RYGB between 2012 and June 2020. Sixty patients(50 females) underwent conversion to RYGB. Average time to conversion was 5.6 years (2–11). Mean %WL and TWL after SG were respectively 26±8.8% and 33.2±14.1kg. Mean BMI at the time of RYGB was 38.1±7.1 kg/m2. Mean follow-up was 30.4±16.8 months (6–84). Available patients at each time of follow-up: 1 year 59 (98.3%); 2 years 47 (78.3%); 3 years 39 (71.6%); and 5 years 33 (55%). Patients were divided according to indication for revision in weight regain/insufficient weight loss (30 patients) g...
While radiochemotherapeutic protocols have improved treatment outcomes in several types of human ... more While radiochemotherapeutic protocols have improved treatment outcomes in several types of human cancers, they remain unsatisfactory as malignant cells continue to resist to their destruction by ionising radiation in many cases. Radiation therapy with high linear energy transfer (LET) accelerated particles (fast neutrons and carbon ions), called hadrontherapy, has been shown to overcome radioresistance against standard low-LET radiation. Combining these two approaches is therefore a possible strategy to increase killing of highly radioresistant cancer cells. Previously, we reported that fast neutrons (p(65)+Be) (produced at the Cyclotron Research Center, Louvain-la-Neuve, Belgium) could induce autophagy, an alternative mode of programmed cell death, when combined with oxaliplatin (Ox) in radioresistant U-87 glioblastoma cells. In the present study, we further investigated the effects of fast neutron irradiation combined with Ox in the human hepatocellular carcinoma cell line SK-Hep1...
The problematic nature of social change is evidenced by the diversity of the conceptions held by ... more The problematic nature of social change is evidenced by the diversity of the conceptions held by the earliest sociologists as well as by the wide variety of theories they generated. The opinions expressed in specialist literature, including those aimed at clarifying concepts, do not overlap completely. On the contrary, beyond the areas of contact and interchange, there exist different points of view, ranging from nuanced positions on the same issue to contrasts that can overshadow the understanding of phenomena and processes at the core of social change. Generally, we speak of social change when referring to modernisation, globalisation, regional development, and urbanisation and additionally when considering the human resources side, more exactly the behaviours and attitudes of groups of people. This article does not delve into the details of each theory, but rather aims to group them according to two perspectives, i.e. the systemic and the modern. The research has a documentation ...
The aim of the present study was to determine the cytotoxic consequences of high-linear energy tr... more The aim of the present study was to determine the cytotoxic consequences of high-linear energy transfer (LET) irradiation in the presence of oxaliplatin on hepatocellular carcinoma (HCC) cells in vitro. We attempted to correlate the induction of apoptosis and autophagy with the formation of DNA double-strand breaks (DSBs). SK-Hep1 cells were irradiated by 65 MeV neutrons in the presence of oxaliplatin and/or the poly(ADP-ribose) polymerase (PARP) inhibitor PJ34. DSBs were measured by the formation of gammaH2AX foci. Results show that in SK-Hep1 cells exposed to fast neutrons in the presence of oxaliplatin, DSBs occurred and persisted with time after irradiation. While apoptosis remained low in co-treated cells, autophagy was considerably increased after irradiation and augmented by the addition of oxaliplatin. Thus, autophagic cell death appears to play a prominent role in the cytotoxicity of the combined treatment and may be linked to the generation of heavy damage to DNA.
Objective. Preoperative imaging in primary hyperparathyroidism (PHPT) is essential for planning o... more Objective. Preoperative imaging in primary hyperparathyroidism (PHPT) is essential for planning of parathyroidectomy—particularly for selection of a minimally invasive approach. The objective of this cohort study was to evaluate the diagnostic precision of 3D virtual neck exploration (3D-VNE), to evaluate its impact on choice of surgical approach, and to document the correlation with long-term outcomes. Methods. 235 consecutive patients with PHPT were studied (January 2014 to December 2018), with 6-month follow-up. 220 patients had a preoperative computed tomography (CT), 172 of these had a 3D-VNE based on the CT, and 226 patients had a Tc-99m sestamibi scan. Results. Sensitivity of exact, per gland, adenoma localization was 57.09% (95% CI: 50.85–63.10%) for nonspecialized radiologist interpretation of CT scan, 58.17% (95% CI: 51.99–64.10%) for Tc-99m sestamibi scan, and 90.21% (95% CI: 85.21–93.64%) for 3D-VNE, and thereby favoring 3D-VNE compared to CT scan alone (OR 34.5, 95% CI:...
Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide and a major heal... more Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide and a major health problem since the choice of treatment is limited due to chemo- and radio-resistance. It was previously reported that high linear energy transfer (LET) radiation induced massive autophagic cell death in the human HCC SK-Hep1 cell line in vitro. This study analyzed the effects of high-LET radiation on the same HCC tumor model, orthotopically transplanted into nude mice. For this purpose, after surgical xenograft in the liver, animals were irradiated with fast neutrons and cell death occurring in the tumors was assessed with various techniques, including electron microscopy and probe-based confocal laser endomicroscopy. Results indicate that considerable autophagy and only limited apoptosis took place in the tumor xenografts after high-LET irradiation. These data confirm the previous in vitro results, suggesting that autophagy may act as a predominant mode of cell death in the efficacy o...
L’obtention de substrats „cyto-favorables”, aptes a soutenir la regeneration tissulaire, impose l... more L’obtention de substrats „cyto-favorables”, aptes a soutenir la regeneration tissulaire, impose l’utilisation de biomateriaux qui portent des domaines de reconnaissance cellulaire, comme par exemple les scleroproteines et certains polysaccharides. La membrane des cellules specifiques aux tissus conjonctifs dispose de mecanismes qui facilitent l’ancrage aux substrats solides ou a l’etat de gel ou se retrouvent des macromolecules ou des fibrilles de (atelo) collagene, associees ou non a l’acide hyaluronique. On peut generer de tels substrats par des techniques de rassemblement moleculaire spontane ordonne (tout comme dans le cas de la restructuration du collagene quasi-natif pour former des fibrilles), ou induite physico-chimiquement ensuite stabilise morphologiquement (tout comme dans le cas de la preparation des hydrogels mixtes, atelocollagene–hyaluronate de sodium, diversement reticules ensuite transformes en cryo- ou vitri-gels). Dans le cadre de la these, nous etudions les moyen...
PURPOSE Thyroid nodules frequently coexist with primary hyperparathyroidism (pHPT). Because of th... more PURPOSE Thyroid nodules frequently coexist with primary hyperparathyroidism (pHPT). Because of the increasing use of 18F-fluorocholine (18F-FCH) PET/CT in patients with pHPT, evaluation of its clinical utility for thyroid nodules characterization in this population is of paramount importance. Herein, we investigate the value of dual-point 18F-FCH PET/CT in the diagnosis of thyroid cancer in patients referred for pHPT imaging who have thyroid nodules. PATIENTS AND METHODS All pHPT patients who underwent a dual-time point 18F-FCH PET/CT (at 5 and 60 minutes postinjection) between July 2019 and December 2020 were analyzed. Only those with a thyroid nodule greater than 10-mm and pathological analysis (criterion standard) were included. Nodule-to-thyroid SUVmax ratio was calculated at the 2 study points, as well as the 18F-FCH washout index (WO%). RESULTS Twenty-seven patients (32 nodules) were included in this study. The final diagnoses were as follows: 27 benign nodules including 2 NIFTPs (noninvasive follicular thyroid neoplasm with papillary-like nuclear features) and 5 cancers of follicular origin. Early uptake ratio was significantly higher in malignant lesions than in benign nodules (P = 0.0008). Thyroid cancers were also characterized by a marked 18F-FCH washout index (WO% benign vs cancer: 2.9% ± 4.1% vs 45.5% ± 13.4%, P = 0.0001). Using a WO% threshold of 22.1%, 25/27 benign nodules and 5/5 malignant lesions were accurately classified (sensitivity of 100%, specificity of 92.6%, positive predictive value of 71.4%, and negative predictive value of 100%). The false-positive findings were related to the 2 NIFTPs that share similarities with thyroid cancer. CONCLUSIONS Our preliminary results suggest to perform a dual-time-point PET/CT acquisition protocol in pHPT patients with uncharacterized centimeter thyroid nodules. However, the real impact of these promising results should be assessed by prospective studies on a larger cohort of patients.
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
The present retrospective study evaluates the diagnostic value of integrated 18F-Fluorocholine po... more The present retrospective study evaluates the diagnostic value of integrated 18F-Fluorocholine positron emission tomography/four-dimensional contrast-enhanced computed tomography (18F-FCH PET/4D-CT) as second-line imaging in preoperative work-up of primary hyperparathyroidism (pHPT), and compares 18F-FCH PET with 4D-CT. Patients with pHPT and negative/discordant first-line imaging addressed for integrated 18F-FCH PET/4D-CT were retrospectively selected. Sensitivity and detection rate (DR%) of 18F-FCH PET/CT, 4D-CT, and PET/4D-CT were calculated according to the per patient and per lesion analyses, and afterwards compared. Histology associated with a decrease more than 50% of perioperative parathyroid hormone (PTH) blood level was used as a gold standard. Persistent high serum PTH and calcium levels during a 6-month follow-up was considered as presence of pHPT in both operated and non-operated patients. 50 patients (55 glands) were included. 44/50 patients (88%) were surgically treat...
Patients with primary hyperparathyroidism (pHPT) can develop persistent (P-pHPT) or recurrent (R-... more Patients with primary hyperparathyroidism (pHPT) can develop persistent (P-pHPT) or recurrent (R-pHPT) disease after parathyroidectomy. Before recommending reoperation, recurrence must be accurately identified because of the high risk of complications. Our study evaluates 18F-fluorocholine (18F-FCH) PET/CT and 4D-CT integrated in PET/4D-CT in patients with P-pHPT/R-pHPT. Patients with P-pHPT/R-pHPT investigated by 18F-FCH PET/4D-CT between May 2018 and March 2021 were retrospectively included. Forty-two patients were included, 37 of whom underwent 4D-CT. The sensitivity and detection rate (DR%) were 95% and 88% for 18F-FCH PET/CT and 70% and 63% for 4D-CT, respectively. PET/CT and 4D-CT were concordant in 18/24 glands and concordant and positive in 15/24 (63%) glands. Discordant results were obtained for 6/24 glands. The surgical success rate was 65%. PET/CT showed significantly higher sensitivity than 4D-CT. Dynamic CT allowed the identification of no additional glands missed by PE...
Supplemental Material, sj-pdf-1-sri-10.1177_15533506211001236 for Original Preoperative Localizat... more Supplemental Material, sj-pdf-1-sri-10.1177_15533506211001236 for Original Preoperative Localization Technique of Parathyroid Adenomas by 3-Dimensional Virtual Neck Exploration by Mihaela Ignat, Madeleine Pérouse, François Lefebvre, Deborah Kadoche, Alessio Imperiale, Lee Swanstrom, Michel Vix and Didier Mutter in Surgical Innovation
False negative results in microCT scan imaging in two mice. A, B, C. Aspects corresponding to the... more False negative results in microCT scan imaging in two mice. A, B, C. Aspects corresponding to the first animal. A, B. Axial and frontal view of microCT scan imaging of an isodense, poorly delineated right liver lobe tumor. Prospective and retrospective interpretation of images could only identify an enlargement of the right liver lobe. The border between normal and pathological tissue could not be identified on the microCT scan rendering. C. Gross appearance of the poorly delineated right liver lobe tumor, depicted in A and B. D, E, F. Aspects corresponding to the second animal. D. Retrospective interpretation of microCT scan rendering with identification of a centroabdominal in-homogeneous, isodense tumor (arrowheads). E. Gross appearance of the centroabdominal tumor which was not identified at the prospective interpretation of the microCT scan images. F. Histological assessment of the presence of a hepatocellular carcinoma (HE, x240). (JPG 3580 kb)
Fenestra™ toxicity. Table: Liver function tests, expressed as average ± standard deviation, in a ... more Fenestra™ toxicity. Table: Liver function tests, expressed as average ± standard deviation, in a 20 mice group (16 wild types and 4 mice Trim24 L2/L2Alb-Cre) receiving a total dose of up to 22 μl/g Fenestra™) controlled by five wild type mice receiving no Fenestra™ ASAT: aspartate transaminase, ALAT: alanine transaminase, GGT: gamma-glutamyl transferase. Alkaline phoshpatase levels were not different. Serological measurements (ASAT, ALAT, bilirubin, GGT, alkaline phoshpatase) were performed on blood samples collected by direct cardiac puncture under general isoflurane anaesthesia before animal euthanasia. Standard techniques (ADVIA 2400, Siemens and immune-nephelometry BNII) were employed. Figure: Micrographs of histological structure of the liver (A, B, C) and kidney (D) in mice with acute toxicity after 22 μl/g Fenestra™ administration. HE staining, original magnifications x1500 (A, B) and x240 (C, D). Red arrows: leucocyte adhesion and diapedesis; Arrowheads: hepatocyte necrosis;...
Follow-up of hepatocellular carcinoma (HCC) growth by 3D reconstruction. Follow-up of hepatocellu... more Follow-up of hepatocellular carcinoma (HCC) growth by 3D reconstruction. Follow-up of hepatocellular carcinoma (HCC) growth by 3D reconstruction of micro-CT rendering. Micro-CT imaging was performed at 12, 15, and 21 months of age respectively in hepatocyte specific Trim24-null mice. A, B, C Exponential growth of unifocal HCC. A. Micro-CT-scan rendering in coronal slides (strips indicate vertical diameter of HCC). B. 3D reconstruction of the micro-CT-scan (HCC is depicted in green). C. Macroscopic appearance of the liver and HCC at dissection at 22 months old (black arrow indicates tumor). D, E, F. Multifocal growth of HCC. D. Micro-CT scan rendering in coronal slides (strips indicate vertical diameters of the HCCs). E. 3D reconstruction of the micro-CT-scan (HCCs are depicted in green). F. Macroscopic appearance of the liver and HCCs at dissection at 23 months old (black arrows indicate tumors). (JPG 4259 kb)
Long-term results on sleeve gastrectomy (SG) with more than 10 years report patients needing slee... more Long-term results on sleeve gastrectomy (SG) with more than 10 years report patients needing sleeve revision for weight loss failure, de novo gastroesophageal reflux (GERD), or sleeve complications. The aim of this study was to analyze the results of laparoscopic conversion of failed SG to Roux-en-Y gastric bypass (RYGB). Retrospective review of a prospectively institutional maintained database to identify patients who underwent conversion of SG to RYGB between 2012 and June 2020. Sixty patients(50 females) underwent conversion to RYGB. Average time to conversion was 5.6 years (2–11). Mean %WL and TWL after SG were respectively 26±8.8% and 33.2±14.1kg. Mean BMI at the time of RYGB was 38.1±7.1 kg/m2. Mean follow-up was 30.4±16.8 months (6–84). Available patients at each time of follow-up: 1 year 59 (98.3%); 2 years 47 (78.3%); 3 years 39 (71.6%); and 5 years 33 (55%). Patients were divided according to indication for revision in weight regain/insufficient weight loss (30 patients) g...
While radiochemotherapeutic protocols have improved treatment outcomes in several types of human ... more While radiochemotherapeutic protocols have improved treatment outcomes in several types of human cancers, they remain unsatisfactory as malignant cells continue to resist to their destruction by ionising radiation in many cases. Radiation therapy with high linear energy transfer (LET) accelerated particles (fast neutrons and carbon ions), called hadrontherapy, has been shown to overcome radioresistance against standard low-LET radiation. Combining these two approaches is therefore a possible strategy to increase killing of highly radioresistant cancer cells. Previously, we reported that fast neutrons (p(65)+Be) (produced at the Cyclotron Research Center, Louvain-la-Neuve, Belgium) could induce autophagy, an alternative mode of programmed cell death, when combined with oxaliplatin (Ox) in radioresistant U-87 glioblastoma cells. In the present study, we further investigated the effects of fast neutron irradiation combined with Ox in the human hepatocellular carcinoma cell line SK-Hep1...
The problematic nature of social change is evidenced by the diversity of the conceptions held by ... more The problematic nature of social change is evidenced by the diversity of the conceptions held by the earliest sociologists as well as by the wide variety of theories they generated. The opinions expressed in specialist literature, including those aimed at clarifying concepts, do not overlap completely. On the contrary, beyond the areas of contact and interchange, there exist different points of view, ranging from nuanced positions on the same issue to contrasts that can overshadow the understanding of phenomena and processes at the core of social change. Generally, we speak of social change when referring to modernisation, globalisation, regional development, and urbanisation and additionally when considering the human resources side, more exactly the behaviours and attitudes of groups of people. This article does not delve into the details of each theory, but rather aims to group them according to two perspectives, i.e. the systemic and the modern. The research has a documentation ...
The aim of the present study was to determine the cytotoxic consequences of high-linear energy tr... more The aim of the present study was to determine the cytotoxic consequences of high-linear energy transfer (LET) irradiation in the presence of oxaliplatin on hepatocellular carcinoma (HCC) cells in vitro. We attempted to correlate the induction of apoptosis and autophagy with the formation of DNA double-strand breaks (DSBs). SK-Hep1 cells were irradiated by 65 MeV neutrons in the presence of oxaliplatin and/or the poly(ADP-ribose) polymerase (PARP) inhibitor PJ34. DSBs were measured by the formation of gammaH2AX foci. Results show that in SK-Hep1 cells exposed to fast neutrons in the presence of oxaliplatin, DSBs occurred and persisted with time after irradiation. While apoptosis remained low in co-treated cells, autophagy was considerably increased after irradiation and augmented by the addition of oxaliplatin. Thus, autophagic cell death appears to play a prominent role in the cytotoxicity of the combined treatment and may be linked to the generation of heavy damage to DNA.
Objective. Preoperative imaging in primary hyperparathyroidism (PHPT) is essential for planning o... more Objective. Preoperative imaging in primary hyperparathyroidism (PHPT) is essential for planning of parathyroidectomy—particularly for selection of a minimally invasive approach. The objective of this cohort study was to evaluate the diagnostic precision of 3D virtual neck exploration (3D-VNE), to evaluate its impact on choice of surgical approach, and to document the correlation with long-term outcomes. Methods. 235 consecutive patients with PHPT were studied (January 2014 to December 2018), with 6-month follow-up. 220 patients had a preoperative computed tomography (CT), 172 of these had a 3D-VNE based on the CT, and 226 patients had a Tc-99m sestamibi scan. Results. Sensitivity of exact, per gland, adenoma localization was 57.09% (95% CI: 50.85–63.10%) for nonspecialized radiologist interpretation of CT scan, 58.17% (95% CI: 51.99–64.10%) for Tc-99m sestamibi scan, and 90.21% (95% CI: 85.21–93.64%) for 3D-VNE, and thereby favoring 3D-VNE compared to CT scan alone (OR 34.5, 95% CI:...
Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide and a major heal... more Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide and a major health problem since the choice of treatment is limited due to chemo- and radio-resistance. It was previously reported that high linear energy transfer (LET) radiation induced massive autophagic cell death in the human HCC SK-Hep1 cell line in vitro. This study analyzed the effects of high-LET radiation on the same HCC tumor model, orthotopically transplanted into nude mice. For this purpose, after surgical xenograft in the liver, animals were irradiated with fast neutrons and cell death occurring in the tumors was assessed with various techniques, including electron microscopy and probe-based confocal laser endomicroscopy. Results indicate that considerable autophagy and only limited apoptosis took place in the tumor xenografts after high-LET irradiation. These data confirm the previous in vitro results, suggesting that autophagy may act as a predominant mode of cell death in the efficacy o...
L’obtention de substrats „cyto-favorables”, aptes a soutenir la regeneration tissulaire, impose l... more L’obtention de substrats „cyto-favorables”, aptes a soutenir la regeneration tissulaire, impose l’utilisation de biomateriaux qui portent des domaines de reconnaissance cellulaire, comme par exemple les scleroproteines et certains polysaccharides. La membrane des cellules specifiques aux tissus conjonctifs dispose de mecanismes qui facilitent l’ancrage aux substrats solides ou a l’etat de gel ou se retrouvent des macromolecules ou des fibrilles de (atelo) collagene, associees ou non a l’acide hyaluronique. On peut generer de tels substrats par des techniques de rassemblement moleculaire spontane ordonne (tout comme dans le cas de la restructuration du collagene quasi-natif pour former des fibrilles), ou induite physico-chimiquement ensuite stabilise morphologiquement (tout comme dans le cas de la preparation des hydrogels mixtes, atelocollagene–hyaluronate de sodium, diversement reticules ensuite transformes en cryo- ou vitri-gels). Dans le cadre de la these, nous etudions les moyen...
PURPOSE Thyroid nodules frequently coexist with primary hyperparathyroidism (pHPT). Because of th... more PURPOSE Thyroid nodules frequently coexist with primary hyperparathyroidism (pHPT). Because of the increasing use of 18F-fluorocholine (18F-FCH) PET/CT in patients with pHPT, evaluation of its clinical utility for thyroid nodules characterization in this population is of paramount importance. Herein, we investigate the value of dual-point 18F-FCH PET/CT in the diagnosis of thyroid cancer in patients referred for pHPT imaging who have thyroid nodules. PATIENTS AND METHODS All pHPT patients who underwent a dual-time point 18F-FCH PET/CT (at 5 and 60 minutes postinjection) between July 2019 and December 2020 were analyzed. Only those with a thyroid nodule greater than 10-mm and pathological analysis (criterion standard) were included. Nodule-to-thyroid SUVmax ratio was calculated at the 2 study points, as well as the 18F-FCH washout index (WO%). RESULTS Twenty-seven patients (32 nodules) were included in this study. The final diagnoses were as follows: 27 benign nodules including 2 NIFTPs (noninvasive follicular thyroid neoplasm with papillary-like nuclear features) and 5 cancers of follicular origin. Early uptake ratio was significantly higher in malignant lesions than in benign nodules (P = 0.0008). Thyroid cancers were also characterized by a marked 18F-FCH washout index (WO% benign vs cancer: 2.9% ± 4.1% vs 45.5% ± 13.4%, P = 0.0001). Using a WO% threshold of 22.1%, 25/27 benign nodules and 5/5 malignant lesions were accurately classified (sensitivity of 100%, specificity of 92.6%, positive predictive value of 71.4%, and negative predictive value of 100%). The false-positive findings were related to the 2 NIFTPs that share similarities with thyroid cancer. CONCLUSIONS Our preliminary results suggest to perform a dual-time-point PET/CT acquisition protocol in pHPT patients with uncharacterized centimeter thyroid nodules. However, the real impact of these promising results should be assessed by prospective studies on a larger cohort of patients.
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
The present retrospective study evaluates the diagnostic value of integrated 18F-Fluorocholine po... more The present retrospective study evaluates the diagnostic value of integrated 18F-Fluorocholine positron emission tomography/four-dimensional contrast-enhanced computed tomography (18F-FCH PET/4D-CT) as second-line imaging in preoperative work-up of primary hyperparathyroidism (pHPT), and compares 18F-FCH PET with 4D-CT. Patients with pHPT and negative/discordant first-line imaging addressed for integrated 18F-FCH PET/4D-CT were retrospectively selected. Sensitivity and detection rate (DR%) of 18F-FCH PET/CT, 4D-CT, and PET/4D-CT were calculated according to the per patient and per lesion analyses, and afterwards compared. Histology associated with a decrease more than 50% of perioperative parathyroid hormone (PTH) blood level was used as a gold standard. Persistent high serum PTH and calcium levels during a 6-month follow-up was considered as presence of pHPT in both operated and non-operated patients. 50 patients (55 glands) were included. 44/50 patients (88%) were surgically treat...
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Papers by Mihaela Ignat