Molecular Characterization of Gastrointestinal Stromal Tumors (Gist) and Contribution of Immunohistochemistry in Congolese from Kinshasa

Introduction: The differentiation of digestive tumors very often requires the use of techniques currently not widely in use in the Democratic Republic of Congo (DRC), such as immunohistochemistry. This is perfectly verified for GISTs whose precise, or at least highly certain, diagnosis can only be made using immunohistochemical markers. This underuse of these techniques due to lack of equipment and human skills explains the limited epidemiological data available to date, thus leading to untargeted and too often late treatment of patients. Research question: What contribution can immunohistochemical markers make to the diagnosis of digestive tract tumours? Objective: Discuss the contribution of immunohistochemical markers in the diagnosis of GIST and provide basic data on the epidemiology of these nosological entities in Kinshasa. Methodology: This was a retrospective study carried out at the LEBOMA private anatomy and pathological cytology centre. The main inclusion criterion was any digestive tract block or slide whose diagnosis of GIST had been requalified after review by at least 2 pathologists. An immuhistochemical study was performed using an automated technique (with a Ventana XT machine) using a panel of antibodies: CD-117 and DOG-1 which are listed in the literature as strongly correlated with the occurrence of GIST, all slides were made at Hj Hospital using an OLYMPUS BX41 co-observation microscope. Results: Of 601 cases of digestive tumors recorded during the concerned period, 32 (5.32%) concerned GIST. This prevalence was confirmed by our immunohistochemical results where the expression of CD117 and that of DOG-1 were positive in 90.6% and 100% of cases which prevalence is high compared with the worldwide prevalence according to the literature, respectively. The distribution of the patients concerned was made with a sex ratio of 1.6 women/men with a median age of 53 years. Most cases (81%) had a gastric location and were fusiform GISTs. Conclusion: Gastrointestinal stromal tumours, although rare and underestimated, account for 5.32% of cases in the DRC. This is a considerable and high prevalence compared with the world average. To the best of our knowledge, no studies have been carried out on these aspects in the DRC, which explains the importance of this study. The results of this research demonstrated the contribution of these 2 markers as specific and effective biomarkers for optimal and differential diagnosis in GIST. In view of the above, it is therefore more than necessary to popularise the use of these biomarkers in order to contribute effectively to improving the overall management of gastrointestinal tumours by improving their identification.

Atypical presentation and localization of granulosa cell tumor—A case report and review of the literature

Introduction: Extraovarian granulosa cell tumor (GCT) is a very uncommon tumor, assumed to arise from the ectopic gonadal tissue along the embryonal route of the genital ridge. Case report: We report the case of a 25 year-old woman who was presented at the emergency unit with a severe abdominal pain focused on the left iliac fossa. The patient had delivered normally 2 months before. An ovarian mass of 79 × 67 × 89 mm was shown in vaginal ultrasound as well as at the abdominal scan. Exploratory laparoscopy was performed and a torsion of the fallopian tube and an hemato-salpinges was visualized. Re-vascularisation was not achieved and a left salpingectomy took place. The immuno-histopathology report revealed an extra-ovarian GCT deriving from the fimbriae of the tube. Follow-up surgery was discussed. The case is presented for its rarity.

Lethality of Imidacloprid and Fipronil on Apis mellifera: A Retrospective Analysis on the French Case

The aim of this study was to draw a retrospective analysis on the lethality of Imidacloprid(Gaucho®)and Fipronil(Régent TS®)on Apis mellifera between 1992 and 2016 in France.Early monitoring reports in the 1992-2002 period notified these two embedded insecticides to be at the origin of massive colony collapse disorders.Ecotoxicological analyses based on the LD50 of Imidacloprid and Fipronil highlighted their differential lethality by both contact(Imidacloprid:81 ng/honeybee vs.Fipronil:5.9 ng/honeybee)and ingestion(Imidacloprid:3.7 ng/honeybee vs.Fipronil:4.2 ng/honeybee),but failed to point Imidacloprid’s high solubility as a higher lethal agent.Chemical properties and action mode of these two insecticides originated neural disfunction in the case of Imidacloprid,and honeybee brood immune depression for Fipronil.Despite the conduction of these monitoring reports and laboratory researches,Fipronil was completely banned in 2005 but Imidacloprid only in 2016.

Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

Background:The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)presence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal infection.This study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and mortality.Methods:This was a secondary analysis of an international observational study(“AbSeS”)investigating ICU patients with intra-abdominal infection.Only patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the ICU.Relationships with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95%confidence interval(CI).Results:The overall mortality was 35.2%(n=58).The independent risk factors for mortality included older age(OR=1.03,95%CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95%CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95%CI:3.8 to 23.9,P<0.001)or after the implementation of additional source control interventions within the first week(OR=4.0,95%CI:1.3 to 12.2,P=0.013).Gramnegative bacteria were most frequently isolated(n=58,49.2%)without clinically relevant differences in microbial etiology between survivors and non-survivors.Conclusions:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term outcome.In this limited series,essentials of the AbSeS-classification,such as the setting of infection onset,diffuse peritonitis,and severity of disease expression,were not associated with an increased mortality risk.

Optical–digital joint design of refractive telescope using chromatic priors

The conventional optical system design employs combinations of different lenses to combat aberrations, which usually leads to considerable volume and weight. In this Letter, a tailored design scheme that exploits state-of-the-art digital aberration correction algorithms in addition to traditional optics design is investigated. In particular, the proposed method is applied to the design of refractive telescopes by shifting the burden of correcting chromatic aberrations to software. By enforcing cross-channel information transfer in a post-processing step, the uncorrected chromatic aberrations are well-mitigated. Accordingly, a telescope of F-8, 1400 mm focal length, and 0.14° field of view is designed with only two lens elements. The image quality of the designed telescope is evaluated by comparing it to the equivalent designs with multiple lenses in a traditional optical design manner, which validates the effectiveness of our design scheme.

China’s Three Level Game in the Middle East

How has China responded to regional tensions and conflicts in the Middle East?Broadly,it has done so in the form of a threelevel game,at the global level(involving powerful outside parties like the US,Russia and the Europeans),at the regional level(and specifically the main regional powers like Saudi Arabia,Iran,Israel and Turkey)and at the sub-regional level where smaller and weaker states are based.The existence of this multipolar and competitive environment in which no one state or group of states is sufficiently capable to overcome another means that China’s relations with the region involve a range of sometimes contrary responses,including cooperation with these states while avoiding being caught up in their differences.This strategy may be summarised as‘strategic ambiguity’or‘hedging’and while it has served China well,it may be reaching the endpoint of its current utility.