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To prospectively evaluate the safety and efficacy of embolization using ethylene vinyl alcohol copolymer (OnyxThis prospective study was approved by the institutional ethics review board. Ten clinical parameters were retained for evaluation of PeVD (pelvic pain, dyspareunia, post-coital pain, menstruation pain, lower limbs pain, difficulty walking, aesthetic discomfort, impact on daily working life, psychological impact and impact on daily life), measured on a visual analogue scale (VAS) between 0 and 10, and a global score out of 100 was noted before embolization, after 3 months during the imaging follow-up, and at the end of follow-up by phone call. The main criterion was clinical efficacy of embolization defined by an impairment score40/100 and a 50% decrease in overall score. Complications were recorded. Visualization of OnyxBetween July 2017 and May 2019, 73 consecutive women (mean age ± SD [range]: 41 ± 11 years [25-77]) treated by embolization with OnyxEmbolization using Onyx• Embolization using Onyx

Copper-sulfides within carbonatites and phoscorites of the Phalaborwa Igneous Complex, South Africa, have been investigated since the middle of the 20th Century. However, aspects of ore formation have remained unclear. This study examines the mechanisms involved in Cu-sulfide mineralisation by micro-focus X-ray computed tomography as applied to sulfide-rich drill core samples. Several texturally distinct assemblages of magmatic sulfides can be identified, including: (1)

Purpose The purpose of this study was to identify anatomical findings at magnetic resonance imaging (MRI) associated with successful percutaneous embolization in women with pelvic venous insufficiency (PVI). Material and methods Between 2008 and 2018, 168 consecutive women (mean age, 39 ± 9 [SD] years; range: 21–69 years) who underwent percutaneous embolization for PVI confirmed by MRI and phlebography were included. Clinical efficacy of embolization was evaluated by patients’ opinion or visual analogue scale. Associated factors of success of embolization were searched by comparing MRI findings in women with successful embolization with those in women with failed embolization using univariate analyses. Results The mean follow-up was 36 ± 29 (SD) months (range: 12–138 months). Clinical efficacy of embolization was obtained in 126/168 women (75%), complete symptom improvement in 33/168 women (20%) and significant partial improvement in 92/168 women (55%). No symptom improvement and symptoms exacerbation were observed in 17/168 (10%) and 2/168 (1%) women, respectively. At univariate analysis, right ovarian vein diameter ≤ 7 mm and vulvar varicosities were associated with successful embolization (P = 0.04 and P = 0.01, respectively) and left ovarian vein diameter ≤ 7 mm was associated with a complete improvement of symptoms (P = 0.03). At multivariate analysis, a small right ovarian vein diameter was the single MRI variable associated with clinical efficacy of embolization (P = 0.04). Conclusion Small ovarian vein diameters on MRI are associated with best clinical efficacy of percutaneous embolization in PVI. Right ovarian vein diameter > 7 mm should warrant further phlebography to exclude venous insufficiency.

Although Cu-sulfide mineralization within the Loolekop pipe of the Phalaborwa Igneous Complex has been extensively studied, certain aspects of the sulfide metallogenesis remain unclear. This research aims to constrain the relative timing and processes involved in Cu-sulfide mineralization within the Loolekop pipe through textural analysis and trace element composition of the three different types of sulfide assemblages in this intrusion. The first primary magmatic mineralization phase contains dispersed bornite with chalcopyrite exsolution and local traces of chalcocite and covellite related to fluid alteration, whereas the second primary phase is characterized by veins of chalcopyrite with cubanite exsolution. The third mineralization phase relates to leaching of primary sulfide assemblages by oxidizing fluids, resulting in desulfurization and the formation of valleriite [(Fe2+,Cu)4(Mg,Al)3S4(OH,O)6] and magnetite. Whole-rock ICP-MS analyses of platinum-group elements (PGE) indicate a mantle origin of the primary Cu-sulfides (bornite-chalcopyrite assemblages). In situ trace element analyses of sulfide assemblages also show evidence of external material input, most likely of crustal origin, during magma and sulfide liquid ascent, before decoupling of the sulfide liquid and the melt, although the exact source is unclear. The enrichment of Pd-group PGE (PPGE: Pd, Pt) over Ir-group PGE (IPGE: Os, Ir, Ru) in Cu-sulfide phases suggests the presence of an intermediate solid solution (iss)-monosulfide solid solution (mss) system. It is proposed that a Cu- and PPGE-enriched sulfide liquid fractionated from an IPGE-enriched mss, followed by the formation of an iss, and finally the extraction of a PPGE-rich Cu-liquid from the iss forming the bornite-chalcopyrite assemblages. Sulfide textures and the presence of chalcopyrite veins suggest that the iss was leached by high-temperature hydrothermal fluids at depth that remobilized and precipitated Cu along the fractures within the intrusion. Subsequently, all the primary magmatic phases were affected by late-stage fluids, which triggered their alteration into valleriite, also precipitating along fractures within the Loolekop pipe.

The measurement of the magneto-elastic impedance enables the magneto-mechanical coefficient of amorphous tapes, for example, to be accurately estimated. We first propose an analytical model describing the principle of a resonator based on magnetostrictive ribbons. We show how, from the impedance described by a circle in the complex plane, the characteristics of a magnetostrictive resonator can be established and estimated from the evolution of the impedance as a function of frequency. This method, which is entirely implemented with an amorphous metal ribbon (Metglas™ 2826), is perfectly adapted to estimate the magneto-mechanical coupling coefficient k33 and thus establish the magnetostriction curves λ(H) of amorphous ribbons. However, application to thick nickel foil shows that the current method is restricted to magnetic materials in a thin ribbon form (

To compare intervention duration and fluoroscopy time for proximal embolization of splenic arteries in acute trauma using the Penumbra occlusion device (POD ® ), coils or Amplatzer™ vascular plug (AVP). A total of 29 patients with splenic injury without vascular injury who were treated by proximal splenic artery embolization using POD ® (n=12), coils (n=9) or AVP (n=8) were retrospectively included. There were 25 men and 4 women with a median age of 34 years (range: 10-69 years). To overcome bias in treatment choice, a propensity score was used using inverse probability weighting. Intervention duration and fluoroscopy time, treatment success and complications were compared. The median intervention duration was significantly shorter using POD ® (30min) or AVP (47min) than using coils (60min) (P=0.0001 and 0.004, respectively). The median fluoroscopy time was significantly lower using POD ® (11.5min) than using coils (23.6min) (P=0.0076) or AVP (16.5min) (P=0.049). The primary efficacy rate was 100% with POD ® and AVP and 89% with coils (P=0.586). Six complications occurred with a mean follow-up of 12 months for POD ® , 32 months for coils and 40 months for AVP, consisting in 2 abscesses treated by anti-biotherapy with POD ® , one abscess with AVP, 2 material migrations with coils and 1 coil dismantled without consequence. POD ® and AVP allow proximal embolization of splenic artery in acute trauma with shorter intervention duration by comparison with conventional metallic coils with similar technical success. POD ® allows a shorter fluoroscopy time than coils or AVP.

Objectifs Evaluer le traitement endovasculaire du syndrome post-thrombotique (SPT) lie a une occlusion veineuse chronique iliofemorale ou cave inferieure et determiner les facteurs influencant la permeabilite prothetique. Methodes Dans cette etude multicentrique retrospective realisee dans 15 centres francais specialises en radiologie interventionnelle vasculaire, tous les dossiers des patients traites par stenting endovasculaire pour un SPT lie a une occlusion veineuse chronique proximale entre 2009 et 2019 ont ete retrospectivement analyses. Les taux de permeabilite primaire, primaire assistee et secondaire etaient determines par echographie-Doppler et/ou phleboscanner. L’efficacite clinique etait evaluee grâce aux scores de Villalta et CIVIQ-20. Les resultats du traitement endovasculaire etaient compares a la severite preoperatoire des lesions, a l’extension distale du stenting, a la presence d’une thrombophilie, aux antecedents de recidive thrombotique et au delai avant traitement. Resultats Au total, 698 patients (419 femmes) ont ete inclus. Un succes technique immediat a ete obtenu chez 668/698 (95,7 %) patients, avec un taux de morbidite de 3,9 %. Apres un suivi moyen de 20,7 mois, une permeabilite primaire, primaire assistee ou secondaire a ete obtenue respectivement chez 537/668 (80,4 %) patients, 566/668 (84,7 %) patients et 616/668 (92,2 %) patients. Pour les patients presentant des lesions post-thrombotiques absentes ou minimes, les taux de permeabilite secondaires en fin de suivi etaient respectivement de 96,0 % (216/225) et 92,9 % (131/141), chutant a 88,4 % (168/190) pour les patients avec lesions severes et a 78,9 % (30/38) pour ceux avec des lesions majeures (p = 0,0008). Il n’y avait pas de correlation entre la permeabilite veineuse et l’extension distale du stenting, la presence d’une thrombophilie, l’antecedent de recidive thrombotique ou le delai avant traitement. Les ameliorations moyennes des scores de Villalta et CIVIQ-20 etaient respectivement de 7,0 ± 4,7 points (p Conclusion Le traitement par recanalisation puis stenting endovasculaire peut etre propose dans le traitement du SPT lie a une occlusion veineuse chronique proximale, permettant des taux eleves de permeabilite et d’amelioration clinique a moyen terme, pour un taux de morbidite faible. La permeabilite veineuse apparait par ailleurs fortement correlee a la severite des lesions post-thrombotiques des veines de la cuisse.

Purpose The purpose of this study was to determine retrospectively the safety and technical success rate of embolization using ethylene vinyl alcohol copolymer (Onyx ® ) for persistent type 1A endoleaks after chimney endovascular aneurysm repair (EVAR) for complex aortic aneurysms. Material and methods Nine consecutive patients (6 men, 3 women) with a mean age of 78.6 years (range: 62–87 years) presenting with persistent type IA endoleaks after chimney EVAR and an increase of aneurysm size were treated using transarterial embolization with Onyx ® . Results Technical success was obtained in all patients (100%) and no complications were observed. Mean follow-up was 16 months (range: 3–35 months). Primary clinical efficacy was obtained for 8/9 patients (89%) and primary technical efficacy for 6/9 patients (67%). Secondary clinical efficacy was 100%, and secondary technical efficacy was 78%. Conclusion Our results suggest that arterial embolization using Onyx ® appears as a feasible and safe endovascular procedure of type IA endoleaks after chimney EVAR, although further validation is now required.

Purpose To retrospectively evaluate the safety and efficacy of embolization of persistent type II endoleaks occurring after abdominal endovascular aneurysm repair (EVAR) using ethylene vinyl alcohol copolymer (Onyx ® ). Material and methods Between 2008 and 2016, 28 consecutives patients (25 men, 3 women) with a mean age of 75.3 years ± 9 (SD) (range: 59–90 years) were treated for 29 persistent type II endoleaks with increasing aneurysm size > 5 mm occurring after EVAR. A total of 35 embolization procedures were performed using Onyx ® , via a transarterial route ( n = 25) or direct puncture ( n = 10), with or without additional metallic coils. The endpoints were to evaluate the clinical efficacy, corresponding to the stabilization or decrease of aneurism size, and the technical efficacy, corresponding to the ability to complete the embolization. Results No severe complications were observed during and after embolization. The primary and secondary clinical efficacies were 75% (21/28) and 96.4% (27/28), respectively. Overall primary technical efficacy rate was 58.6% (17/29), greater for transarterial technique (72.8%) than for direct puncture (14.3%) ( P = 0.01). Secondary technical efficacy was 72.4% (21/29), with no differences between transarterial (81.8%) and direct puncture (42.8%) ( P = 0.06). Conclusion Embolization with Onyx ® of type II endoleaks after EVAR appears a safe and effective procedure.

STUDY QUESTION Is the noncoding transcriptional landscape during spermatogenesis conserved between human and rodents? SUMMARY ANSWER We identified a core group of 113 long noncoding RNAs (lncRNAs) and 20 novel genes dynamically and syntenically transcribed during spermatogenesis. WHAT IS KNOWN ALREADY Spermatogenesis is a complex differentiation process driven by a tightly regulated and highly specific gene expression program. Recently, several studies in various species have established that a large proportion of known lncRNAs are preferentially expressed during meiosis and spermiogenesis in a testis-specific manner. STUDY DESIGN, SIZE, DURATION To further investigate lncRNA expression in human spermatogenesis, we carried out a cross-species RNA profiling study using isolated testicular cells. PARTICIPANTS/MATERIALS, SETTING, METHODS Human testes were obtained from post-mortem donors (N = 8, 51 years old on average) or from prostate cancer patients with no hormonal treatment (N = 9, 80 years old on average) and only patients with full spermatogenesis were used to prepare enriched populations of spermatocytes, spermatids, Leydig cells, peritubular cells and Sertoli cells. To minimize potential biases linked to inter-patient variations, RNAs from two or three donors were pooled prior to RNA-sequencing (paired-end, strand-specific). Resulting reads were mapped to the human genome, allowing for assembly and quantification of corresponding transcripts. MAIN RESULTS AND THE ROLE OF CHANCE Our RNA-sequencing analysis of pools of isolated human testicular cells enabled us to reconstruct over 25 000 transcripts. Among them we identified thousands of lncRNAs, as well as many previously unidentified genes (novel unannotated transcripts) that share many properties of lncRNAs. Of note is that although noncoding genes showed much lower synteny than protein-coding ones, a significant fraction of syntenic lncRNAs displayed conserved expression during spermatogenesis. LARGE SCALE DATA Raw data files (fastq) and a searchable table (.xlss) containing information on genomic features and expression data for all refined transcripts have been submitted to the NCBI Gene Expression Omnibus under accession number GSE74896. LIMITATIONS, REASONS FOR CAUTION Isolation procedures may alter the physiological state of testicular cells, especially for somatic cells, leading to substantial changes at the transcriptome level. We therefore cross-validated our findings with three previously published transcriptomic analyses of human spermatogenesis. Despite the use of stringent filtration criteria, i.e. expression cut-off of at least three fragments per kilobase of exon model per million reads mapped, fold-change of at least three and false discovery rate adjusted P-values of less than WIDER IMPLICATIONS OF THE FINDINGS For the first time, this study has led to the identification of a large number of conserved germline-associated lncRNAs that are potentially important for spermatogenesis and sexual reproduction. In addition to further substantiating the basis of the human testicular physiology, our study provides new candidate genes for male infertility of genetic origin. This is likely to be relevant for identifying interesting diagnostic and prognostic biomarkers and also potential novel therapeutic targets for male contraception. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by l’Institut national de la santé et de la recherche médicale (Inserm); l’Université de Rennes 1; l’Ecole des hautes études en santé publique (EHESP); INERIS-STORM to B.J. [N 10028NN]; Rennes Métropole ‘Défis scientifiques émergents’ to F.C (2011) and A.D.R (2013). The authors have no competing financial interests.

To retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD). From October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10–86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up. To produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess. The POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.

Resume La pathologie abdominale non traumatique est l’un des motifs les plus frequents de consultation dans les services d’accueil d’urgences. Une douleur abdominale peut reveler de tres nombreuses pathologies, dont certaines necessitent une prise en charge urgente. Le recours a l’imagerie est habituellement necessaire dans la mesure ou l’anamnese et l’examen clinique sont rarement suffisants. Le choix des examens, oriente par le contexte clinique, est guide par la performance des examens disponibles, dans un souci d’innocuite et de moindre cout. Les cliches standard n’ont plus de place dans l’exploration de l’abdomen aigu. La disponibilite encore insuffisante de l’imagerie par resonance magnetique circonscrit le choix a l’echographe et au scanner. Aucune evidence scientifique ne permet d’imposer une strategie unique. Il existe actuellement une alternative entre la realisation systematique d’une echographie completee par un scanner lorsqu’elle n’est pas concluante, et la realisation d’un scanner en premiere intention sauf en cas de douleur de la fosse iliaque droite ou de l’hypochondre droit ainsi que chez la femme enceinte ou l’echographie est l’examen de premiere intention.

To report the mid-term outcomes of percutaneous cryoablation (PCA) performed as second-line therapeutic option of venous malformations (VM). From 2011 to 2015, PCA was offered in 24 patients (mean age: 31 years, range: 12–64) as second-line treatment for recurrence of symptoms after sclerotherapy and when resection was not possible (due to lesion location or previous failure) or refused by the patient. Adverse effects were recorded, disease-free survival (DFS) and local tissue control (LTC) rates were calculated based on symptoms and volume evolution. Mean follow-up was 18.7 months (6–48). Nine (37.5%, 9/24) adverse effects occurred and three (12.5%, 3/24) were severe. Mean pain assessed by visual analog scale (VAS) was 41.7 mm (0–80) before treatment and 20.3 mm (0–80) (p=0.01) after. Mean volume decreased significantly after treatment from 22.4 cm3 (0.9-146) to 8.35 cm3 (0–81.3) (p 10 cm3 was associated with a higher risk of local recurrence (p=0.05). PCA as second-line treatment appears to be safe and effective for local control of VM according to mid-term results. • Percutaneous cryoablation of venous malformations appeared well tolerated. • Size of venous malformations decreased significantly after percutaneous cryoablation (p

To retrospectively evaluate the ability of magnetic resonance (MR) imaging to differentiate low from high Fuhrman grade renal cell carcinoma (RCC).MR images from 80 consecutive pathologically proven RCC (57 clear cell, 16 papillary and 7 chromophobe) were evaluated. Double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps were reviewed independently. Signal intensity index (SII), tumour-to-spleen SI ratio (TSR), ADC ratio, wash-in (WiI) and wash-out indices (WoI) between different phases were calculated and compared to pathological grade and size. The Fuhrman scoring system was used. Low grade (score ≤ 2) and high grade (score ≥ 3) tumours were compared using univariate and multivariate analyses.No associations between grade and imaging factors were found for papillary and chromophobe RCCs. For clear cell RCCs, there was a significant association between the grade and parenchymal WiI (WiI2) (P = 0.02) or ADCr (P = 0.03). A significant association between tumour grade and size (P = 0.01), WiI2 (P = 0.02) and ADCr (P = 0.05) remained in multivariate analysis.Multiparametric MRI can be used to accurately differentiate low Fuhrman grade clear cell RCC from high grade. High Fuhrman grade (≥ 3) RCCs were larger, had lower parenchymal wash-in indices and lower ADC ratios than low grade.• Fuhrman grade of clear cell RCC can be differentiated with multiparametric MR imaging. • Fuhrman grade significantly differed for size, parenchymal wash-in index and ADC ratio. • No significant associations were found for papillary and chromophobe renal cell carcinoma.

To evaluate the efficacy of selective arterial embolization (SAE) of angiomyolipomas based on the percentage volume reduction after embolization and to identify predictive factors of volume decrease. Patients receiving prophylactic SAE of renal angiomyolipomas were included retrospectively over 3 years. The volume change after SAE and haemorrhagic or surgical events were recorded. Initial tumour volume, percentage tumour fat content, mean tumour density, embolic agent used, number of angiomyolipomas and tuberous sclerosis disease were evaluated as predictive factors of volume decrease. A total of 19 patients with 39 angiomyolipomas were included with median follow-up of 28 months (interquartile range 21–37 months). All treatments were technically successful (92 % primary and 8 % secondary). No distal bleeding or any increase in size or surgical nephrectomy after SAE was recorded. Mean volume reduction was 72 % (±24 %). Volumes before SAE (R 2 = 0.276; p = 0.001), percentage fat content (R 2 = 0.612; p

Resume Objectif Evaluation de l’efficacite du traitement par embolisation veineuse du syndrome de congestion pelvienne (SCP). Patientes et methodes Etude retrospective de 33 patientes ayant eu une embolisation veineuse pelvienne entre janvier 2008 et mai 2012 a Bordeaux. Les criteres d’inclusion etaient une symptomatologie clinique de SCP documentee par une echographie Doppler transabdominale et/ou une imagerie par resonnance magnetique pelvienne. Les patientes ayant des varices pelviennes alimentant des varices saphenes etaient exclues. L’efficacite du traitement etait jugee par l’echelle visuelle analogique (EVA). Resultats Trente-trois patientes ont ete incluses avec un suivi moyen de 26 mois (3–59 mois). L’EVA etait de 7,37 (ecart-type : 0,99) avant embolisation et de 1,36 (ecart-type : 1,73) apres embolisation (p Conclusion Notre serie montre l’efficacite du traitement par embolisation avec une diminution significative de l’EVA chez les patientes presentant un SCP.

The purpose of this preliminary study was to report the short-term local control of percutaneous image-guided cryoablation of localized symptomatic abdominal scar endometrioma. Four consecutive patients (mean age 34.5 years) with a total of ten lesions were included, with mean preoperative pain of 7 (range 5–9) on the visual analog scale. Cryoablation was performed in a single session under general anesthesia. Postoperative superficial edema disappeared within 2 weeks for all patients. No severe complications (>grade 2 according to the CTCAE classification) were reported. Mean postoperative pain was 1.7 at 6 months (range 0–5) and magnetic resonance imaging demonstrated a significant volume decrease for all patients (range 72.2–100 %; p = 0.028). Percutaneous cryoablation shows promising local control in patients with symptomatic abdominal wall endometriosis.

Functional imaging of the kidney using radiological techniques has a great potential of development because the functional parameters, which can be approached non-invasively, are multiple. CT can provide measurement of perfusion and glomerular filtration but has the inconvenient to deliver irradiation and potentially nephrotoxicity due to iodine agents in this context. Sonography is able to evaluate perfusion only but quantification remains problematic. Therefore, MR imaging shows the greatest flexibility measuring blood volume and perfusion as well as split renal function. The main applications of perfusion imaging of the kidney are vascular diseases, as renal artery stenosis, renal obstruction and follow-up of renal tumors under antiangiogenic therapy. However, full clinical validation of these methods and the evaluation of their clinical impact are still often worthwhile.

Resume L’incidence et la prevalence de la maladie renale chronique (MRC) sont en augmentation dans les pays occidentaux, du fait principalement des nephropathies associees au diabete sucre et a l’hypertension. La MRC peut conduire a une insuffisance renale terminale, responsable d’une morbidite et d’une mortalite tres importantes et d’une augmentation des couts medicaux. La prevention primaire et secondaire exige une meilleure connaissance des mecanismes qui sont a l’origine de la sclerose renale et necessite la mise au point de therapies specifiques visant a ralentir l’evolution de la maladie et d’outils diagnostiques non invasifs permettant de caracteriser le processus. L’elastographie ultrasonore (US) est une nouvelle technique d’imagerie en cours de developpement qui fournit des informations sur la « durete » du tissu renal. Les mesures de l’elasticite renale par ultrasons requierent une technique quantitative, comme l’imagerie d’onde de cisaillement. Cependant, la durete du tissu renal n’est pas liee exclusivement a la fibrose ; elle est egalement sensible a des parametres mecaniques et fonctionnels tels que l’anisotropie, la vascularisation, l’hydronephrose et la pression externe. Nous analysons dans cet article les techniques actuelles d’elastographie US appliquees au rein, sachant que sa place pour la caracterisation du tissu renal est en cours de validation.

To evaluate survival and outcomes after percutaneous radiofrequency ablation (RFA) of malignant renal tumours in high-risk patients with long-term follow-up.Between 2002 and 2009, 62 patients (71 tumours), with a median age of 73.5 years (20-87), consecutively treated with RFA under ultrasound or computed tomography guidance for malignant renal tumours were retrospectively selected and prospectively followed until 2012, including 25 patients (40.3 %) with solitary kidney and 7 cystic cancers. Maximal tumour diameters were between 8 and 46 mm (median: 23 mm).Radiofrequency ablation was technically possible for all patients. Mean follow-up was 38.8 months (range: 18-78 months). Primary and secondary technique effectiveness was 95.2 % and 98.4 % per patient respectively. The rates of local tumour progression and metastatic evolution were 3.2 % and 9.7 % per patient and were associated with tumour size4 cm (P = 0.005). The disease-free survival rates were 88.3 % and 61.9 % at 3 and 5 years. No significant difference in glomerular filtration rates before and after the procedure was observed (P = 0.107). The major complications rate was 5.9 % per session with an increased risk in the case of central locations (P = 0.006).Percutaneous renal RFA appears to be safe and effective with useful nephron-sparing results.• Radiofrequency ablation (RFA) is a well-tolerated technique according to mid-term results. • RFA for malignant renal tumours preserved renal function in high-risk patients. • Mid-term efficacy of RFA was close to that of formal conservative surgery. • Tumour size and central location limit the efficacy and safety of RFA.

To report the safety and short-term efficacy of percutaneous image-guided cryoablation performed as second-line therapy of venous vascular malformations (VVM) of extremities. In this non-blinded, no-randomized trial, cryoablation was proposed in 14 patients presenting with symptomatic VVM for recurrences after treatment. Eligibility criteria were: cryoablation feasible, localization at least 5 mm from skin and nerves, absence of contra-indication for anesthesia. Safety was evaluated by the common terminology criteria for adverse events (AE). Clinical response was assessed by evaluating pain at day 7, month 2 and 6 using visual analog scale; quality of life before cryoablation and at 2 and 6 months after using questionnaire. Evolution of volume was evaluated by MRI at 6 months. Comparison was performed using the Wilcoxon test. A technical success was observed in all cases. While 11 patients (78.6%) presented AE (13 grade 1–2 and 3 grade 3), only two severe AE (grade 3) related to cryoablation occurred in two patients (14.3%) during the 6-month follow-up: one immediate sciatic paralysis and one delayed paresthesia. A clinical response was observed in 12 patients (85.7%) at 6 months. Pain decreased significantly from 42.5 ± 14.2 mm before the intervention to 11.8 ± 17.9 mm at 6 months (P = 0.002). A significant decrease in the mean volume from 12.8 ± 14.3 to 3 ± 2.7 cm3 was observed at 6 months (P = 0.002). Percutaneous cryoablation is a promising alternative treatment for sclerotherapy-resistant venous malformations. However, to improve safety, careful patient selection and treatment planning will be mandatory.

To retrospectively evaluate the safety and efficacy of embolization of persistent type II endoleaks occurring after abdominal endovascular aneurysm repair (EVAR) using ethylene vinyl alcohol copolymer (OnyxBetween 2008 and 2016, 28 consecutives patients (25 men, 3 women) with a mean age of 75.3years±9 (SD) (range: 59-90years) were treated for 29 persistent type II endoleaks with increasing aneurysm size5mm occurring after EVAR. A total of 35 embolization procedures were performed using OnyxNo severe complications were observed during and after embolization. The primary and secondary clinical efficacies were 75% (21/28) and 96.4% (27/28), respectively. Overall primary technical efficacy rate was 58.6% (17/29), greater for transarterial technique (72.8%) than for direct puncture (14.3%) (P=0.01). Secondary technical efficacy was 72.4% (21/29), with no differences between transarterial (81.8%) and direct puncture (42.8%) (P=0.06).Embolization with Onyx

Resume Les techniques de thermo-ablation des tumeurs renales se sont imposees chez les patients a risque pour la chirurgie. Ces traitements percutanes sont efficaces localement, notamment pour les tumeurs de moins de 4 cm. Les tumeurs plus volumineuses peuvent aussi etre traitees en adaptant technique et strategie. Une concertation pluridisciplinaire est indispensable avant toute decision, afin de choisir la technique la plus appropriee. La radiofrequence (RF) est simple, efficace et peu couteuse. La cryotherapie est plus complexe et a privilegier en cas de tumeur volumineuse ou presentant un contact vasculaire ou urinaire. Les micro-ondes permettent de traiter des tumeurs plus volumineuses. La morbidite associee est faible, mais requiert la connaissance de ces techniques, associee a celle de la dissection, permettant d’eviter de leser les structures digestives ou urinaires de voisinage.

Thermal ablation techniques for renal tumours have become the norm in surgically at-risk patients. These percutaneous treatments are locally effective, particularly for tumours measuring less than 4 cm. Larger tumours may be treated by adapting the technique and strategy. Multidisciplinary discussion is essential before any decision, in order to decide on the most appropriate technique. Radiofrequency is simple, effective and inexpensive. Cryotherapy is more complex and should be preferred when the tumour is large or there is vascular or urinary tract contact. Microwaves can be used to treat larger tumours. Morbidity is low, but good knowledge of these techniques and of dissection is required to avoid injury to neighbouring digestive or urinary structures.

In autosomal polycystic kidney disease, nephrectomy is required before transplantation if kidney volume is excessive. We evaluated the effectiveness of transcatheter arterial embolization (TAE) to obtain sufficient volume reduction for graft implantation. From March 2007 to December 2009, 25 patients with kidneys descending below the iliac crest had unilateral renal TAE associated with a postembolization syndrome protocol. Volume reduction was evaluated by CT before, 3, and 6 months after embolization. The strategy was considered a success if the temporary contraindication for renal transplantation could be withdrawn within 6 months after TAE. TAE was well tolerated and the objective was reached in 21 patients. The temporary contraindication for transplantation was withdrawn within 3 months after TAE in 9 patients and within 6 months in 12 additional patients. The mean reduction in volume was 42% at 3 months (p = 0.01) and 54% at 6 months (p = 0.001). One patient required a cyst sclerosis to reach the objective. The absence of sufficient volume reduction was due to an excessive basal renal volume, a missed accessory artery and/or renal artery revascularization. Embolization of enlarged polycystic kidneys appears to be an advantageous alternative to nephrectomy before renal transplantation.

Two abalone species were described in Senegal by Linnaeus in 1758: Haliotis tuberculata and Haliotis marmorata. The present study investigates differences at the molecular level by comparing 18S rDNA – ITS1 and mitochondrial sequences, in addition to making a morphological description of 35 OTUs from the Senegalese coast. A comparison was made between the two sympatric sub-species: Haliotis tuberculata tuberculata, present throughout Northern Europe, and H. t. coccinea, present in the Canary Islands and on Northern Atlantic coasts. Although shell morphology cannot be used to easily differentiate Senegalese specimens, the number of open respiratory pores in the shells was significantly lower. Nuclear 18S rDNAs showed 0.6% differences and ITS1 0.37% between H. marmorata and H. tuberculata sub-species. The divergence of the coding genes of mitochondrial DNA ranged from 4.5 to 13.3%, between H. tuberculata and H. marmorata whilst it ranged from 1.2 to 5.5% between H. tuberculata sub-species. These variations are lower for tRNAs. A phylogenetic analysis using three different markers (ITS1, COI and 16S) from Haliotidae revealed a robust cluster for the species complex H. tuberculata and H. marmorata. Seven different haplotypes were found inside the 35 OTUs from Senegal, by using COI, that are unrelated to the defined H. tuberculata sub-species haplotypes. The ancient geographical isolation during the Quaternary period may explain their allopatric speciation. From our results we consider these two species as sister species but, other studies are necessary to verify their status.

Non-traumatic abdominal pathology is one of the most common reasons for consultation in emergency care services. Abdominal pain is the presenting symptom for many diseases, which often requires urgent care. Clinical history and physical examination are rarely sufficient to establish a definite diagnosis and imaging is usually necessary. The choice of imaging modality is oriented by the clinical context and guided by the institutional capabilities, safety and cost-effectiveness of the available tests. Plain radiographs have little or no place in the evaluation of the acute abdomen. Magnetic resonance imaging (MRI) still has limited availability in many hospitals, thus narrowing the imaging choice to ultrasound (US) and computerized tomography (CT). No scientific evidence exists to allow the imposition of one single strategy. At the present time, the clinician may choose either routine US evaluation complemented by CT in case the US is inconclusive or first-line CT (except for the evaluation of right lower quadrant [RLQ] pain, right upper quadrant [RUQ] pain and in pregnant women where ultrasound is the first-line study).

Purpose To retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD).

We aimed to retrospectively assess the long-term safety and efficacy of embolization of renal arteries (ERA) in patients with polycystic kidney disease (PKD) before renal transplantation. Between January 2008 and November 2013, 82 ERA procedures were performed on 76 kidneys in 73 patients (mean age 53 years, range: 34–72). All patients had terminal-stage PKD and were under dialysis and on the renal transplant waiting list with a temporary contraindication due to excessive renal volume. ERA was considered successful in 89.5 % (68/76) of embolized kidneys, meaning that the temporary contraindication for transplantation could be withdrawn for 65 patients (on average 5.6 months, range: 2.8-24.3, after ERA). Mean volume reduction was 40 (range: 2–69) at 3 months and 59 % (35–86) thereafter (both p

AimTo assess the efficacy of venous embolization treatment for the pelvic congestion syndrome (PCS).Patients and methodsRetrospective study of 33 female patients undergoing pelvic venous embolization between January 2008 and May 2012 in Bordeaux. The inclusion criteria were clinical symptoms of PCS documented by transabdominal Doppler ultrasound and/or pelvic magnetic resonance imaging. Patients with pelvic varicose veins feeding saphenous varicose veins were excluded. The efficacy of treatment was assessed on a Visual Analog Scale (VAS).ResultsThirty-three patients were included and the mean follow up period was 26months (3–59months). The VAS was 7.37 (standard deviation: 0.99) before embolization and 1.36 (standard deviation: 1.73) after embolization (P

Whereas diagnosis and prognosis of prostate carcinoma is assessed by biopsy in patients with abnormal digital rectal examination and/or elevated PSA levels, the conventional sextant approach yields approximately a 25 % cancer detection rate. Subsequently, to increase the detection rate of prostate cancer, some authors have proposed to use contrast-enhanced ultrasound (CEUS) due to the hypervascular nature of prostate cancer compared to surrounding healthy tissue.

To retrospectively evaluate the ability of multiparametric magnetic resonance (MR) imaging to differentiate renal tumours. MR images from 100 consecutive pathologically proven solid renal tumours without macroscopic fat [57 clear cell, 16 papillary and 7 chromophobe renal cell carcinomas (RCCs), 16 oncocytomas and 4 minimal fat angiomyolipomas (AMLs)] between 2009 and 2012 were evaluated. Two radiologists blinded to pathology results independently reviewed double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps. Signal intensity index (SII), tumour-to-spleen SI ratio (TSR), ADC ratio, wash-in (WiI) and wash-out indices (WoI) between different phases were calculated. There were significant differences between papillary RCCs and other renal tumours for arterial WiI (P

An increased use of peripherally inserted central catheters (PICC) in French hospitals has been observed in recent years. We report complications having occurred following the placement of PICC in a teaching hospital. Patients and methods A prospective study was made for 7 months, between October 2010 and April 2011, including all patients having undergone PICC placement in interventional radiology. Results Two hundred and sixty-seven PICC were inserted in 222 patients for intravenous antibiotic therapy (68%), parenteral nutrition (13%), or chemotherapy (9%). The median duration of PICC use was 17 days (min–max: 1–140) for the 200 PICC monitored until removal. The most common complication was obstruction ( n = 41), 16 of which motivated PICC removal (8%). Five cases of vein thrombosis (2.5%) and 20 infectious complications (10%) led to removal. There were 14 accidental removals (7%). The overall infection rate was 2.3 per 1000 catheter-days with 0.86 per 1000 catheter-days for central line-associated bloodstream infection. Thirty-four percent of PICC were removed without any complications without any difference according to use. Conclusion PICC are a simple alternative to standard central venous catheter but the rate of complications is high and could be decreased by a stringent management and training for this type of catheter.

International audience; PURPOSE: To evaluate the agreement and diagnostic accuracy of Contrast enhanced magnetic resonance angiography (CE-MRA), Doppler ultrasound (DUS) and Digital subtraction angiography (DSA) in the assessment of carotid stenosis. METHODS: DUS, CE-MRA and DSA were performed in 56 patients included in the Carotide-angiographie par résonance magnétique-échographie-doppler-angioscanner (CARMEDAS) multicenter study with a carotid stenosis ≥ 50%. Three readers evaluated stenoses on CE-MRA and DSA (NASCET criteria). Velocities criteria were used for stenosis estimation on DUS. RESULTS: CE-MRA had a sensitivity and specificity of 96-98% and 66-83% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 94% and 76-84% respectively for carotid stenoses ≥ 70%. The interobserver agreement of CE-MRA was excellent, except for moderate stenoses (50-69%). DUS had a sensitivity and specificity of 88 and 75% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 83 and 86% respectively for carotid stenoses ≥ 70%. Combined concordant CE-MRA and DUS had a sensitivity and specificity of 100 and 85-90% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 96-100% and 80-87% respectively for carotid stenoses ≥ 70%. The positive predictive value of the association CE-MRA and DUS for carotid stenoses ≥ 70% is calculated between 77 and 82% while the negative predictive value is calculated between 97 and 100%. CE-MRA and DUS have concordant findings in 63-72%, and the overestimations cases were recorded only for carotid stenosis ≤ 69%. CONCLUSION: Combined DUS-CE-MRA is excellent for evaluation of severe stenosis but remains debatable in moderate stenosis (50-69%) due to the risk of overestimations.

International audience; During the transfer of rainbow trout from freshwater to seawater, the gills have to switch from an ion-absorption epithelium to an ion-secretion epithelium in order to maintain equilibrium of their hydromineral balance. After a change to ambient salinity, several gill modifications have already been demonstrated, including ion transporters. In order to identify new branchial mechanisms implicated in seawater acclimation, we carried out an extensive analysis of gene expression in gills using microarray technology. This strategy allowed us to show that CYP1A gene expression was up-regulated in the gills after salinity transfer. This increase was confirmed by real-time reverse transcription PCR. Furthermore, measurements of CYP1A enzyme activity (EROD) showed a significant increase after transfer to seawater. Immunohistochem-istry analysis in the gills revealed that cells with a higher expression of CYP1A protein were principally pillar cells and those in the primary lamellae not in contact with the external medium. The results of this study suggest for the first time that CYP1A may be implicated in the seawater acclimation of the gills of rainbow trout.

En presence d’une d’urgence arterielle ou veineuse, l’echo-Doppler est le premier complement de l’examen clinique qui va permettre de conforter un diagnostic clinique et d’orienter vers une prise en charge therapeutique ou vers d’autres explorations complementaires. Par sa mise en oeuvre rapide et non invasive, cet examen permet egalement d’evaluer la severite de certaines affections arterielles. Ses principales indications sont le diagnostic et l’evaluation d’une ischemie de membre en cas d’occlusion arterielle aigue — quelle que soit sa cause — et le diagnostic de thrombose veineuse.

Les hemorragies d’origine renale sont dominees par la pathologie traumatique (accidentelle et iatrogene) et les accidents des anticoagulants. En troisieme position viennent les hemorragiques d’origine tumorale. Elles peuvent etre soit exteriorisees par le biais d’une hematurie macroscopique, soit internes, soit les deux.

We report a patient with a papillary fibroelastoma arising from the left ventricular posterior wall. The tumor was detected incidentally during echocardiography undertaken to evaluate aortic stenosis. Possible complication from tumor embolization was avoided by surgical resection during aortic valve replacement.