Search

La syphilis est une infection sexuellement transmissible (IST) liée au Treponema pallidum. La syphilis secondaire correspond à la diffusion systémique hématogène du tréponème.

Résumé Introduction La syphilis est une infection sexuellement transmissible (IST) liée au Treponema pallidum . La syphilis secondaire correspond à la diffusion systémique hématogène du tréponème. Observation Nous rapportons un cas de syphilis secondaire chez une patiente sans facteur de risque d’IST. Le tableau clinique a commencé par une atteinte génitale suivie d’érosions et d’ulcérations buccales et d’une uvéite antérieure, puis postérieure. La sérologie a établi le diagnostic et le traitement par pénicilline G par voie intra-veineuse a permis la guérison. Discussion Dénommée la grande simulatrice du fait de son polymorphisme clinique, la syphilis secondaire peut entraîner des complications neurologiques et ophtalmologiques redoutables. Le diagnostic sérologique repose sur l’utilisation d’un test tréponémique et d’un test non tréponémique. La pénicilline G reste le traitement de choix et doit être adapté en fonction de l’atteinte clinique. Summary Introduction Syphilis is a sexually transmitted infection (STI) related to Treponema pallidum . Secondary syphilis is the blood-borne systemic spread of Treponema. Observation We report the case of secondary syphilis in a patient without risk of STIs factor. The clinical picture began with a genital affection followed by oral erosions and ulcers and an anterior and then posterior uveitis. Serology established the diagnosis and intravenous penicillin G treatment allowed for healing. Discussion Called the “great pretender” because of its clinical polymorphism, secondary syphilis can lead to formidable neurological and ophthalmological complications. Serological diagnosis is based on the use of treponemal and a nontreponemal tests. Penicillin G remains the treatment of choice and must be adapted according to the clinical damage. [ABSTRACT FROM AUTHOR]

Collecter des données épidémiologiques, étiopathogéniques, cliniques, histologiques et thérapeutiques concernant la leucoplasie verruqueuse proliférative (LVP) et rapporter trois nouveaux cas de cette affection.

De mars 2003 à avril 2004, 1 289 patientes ayant un carcinome canalaire in situ(CCIS) du sein ont été colligées au cours d’une enquête nationale multicentrique prospective. Pour chaque cas, les données clinicoradiologiques, histopathologiques et les modalités de traitement ont été recueillies. L’âge médian était de 56 ans. Le diagnostic a été réalisé par mammographie dans 87,6 % des cas. Les patientes ont eu une mastectomie (M), une chirurgie conservatrice (CC) exclusive et une CC avec radiothérapie (RT) dans 30,5, 7,8 et 61,7 % des cas. Un prélèvement du ganglion sentinelle (GAS) et un curage ont été réalisés dans 21,3 et 10,4 % des cas et une hormonothérapie délivrée chez 13,4 % des patientes. Le grade nucléaire était bas, intermédiaire et élevé dans 21, 38,5 et 40,5 % des cas. L’exérèse a été considérée complète dans 92 et 88,3 % des cas (groupe CC et CC + RT). On note d’importantes variations régionales dans les traitements, avec des taux de M entre 20 et 37 % des taux de RT après CC entre 84 et 96 % et une hormonothérapie entre 6 et 34 % des cas. Cette étude a permis une évaluation des modalités de prise en charge des CCIS en France, avec des corrélations précises entre les facteurs histopathologiques et les traitements ; elle montre une variabilité interrégionale, comme dans les pays anglo-saxons.

In this paper, we present the SHARE-it approach to the integration of agent technology with other existing technologies to build specific intelligent and semi-autonomous assistive devices for older persons and people with disabilities (both cognitive and/or motor). In particular, we explored the benefits of the concept of situated intelligence to build mobility platforms and other artefacts that enhance the autonomy of the target user group in their daily life so that they can be self-dependent enough to autonomously live in their preferred environment.

Abstract: Two copper powders were deposited with CGT3000 cold-gas dynamic spray system on aluminum substrates. Mechanical properties have been studied using microhardness, nanoindentation, and bond strength measurements. The deposition efficiency has also been studied. The x-ray diffraction patterns allow the characterization of the microstructure such as grain size, strain in the coating, and dislocation densities. Both powders and coatings have been fully characterized. Three methods have been used to interpret the x-ray patterns: the Warren-Averbach method, the Hall-Williamson (H-W) method, and the modified H-W method. A comparison between the state of the powders before and after deposition will give an insight on the metallurgical processes that take place during the formation of the coating. The influence of the grain size distribution will also be discussed.

Abstract. Let f an endomorphism of of degree >1. We show how to obtain a bound (depending only on n) on the number of codimension-two subspaces in which are completely invariant for f (where “L is completely invariant for f” means that f-1(L)=L set-theoretically).

Fibrosis following breast radiotherapy for mammary cancer is a frequent undesired effect with objective (esthetic) and subjective (pain) consequences. Forty‐four patients with clinical radiofibrosis following conservative treatment of breast cancer were evaluated for the local antifibrosis effect of copper zinc superoxide dismutase [SOD(Cu/Zn)]. Extracted SOD(Cu/Zn) in a concentration of 3,600 units/mg was applied as ointment to the fibrotic affected area, b.i.d. for 90 days, in a total dose of 40 mg. The radiofibrosis intensity was scored on the basis of clinical criteria (pain and the fibrosis area) before and after SOD(Cu/Zn) treatment. SOD(Cu/Zn) was found to be effective in reducing radiation induced fibrosis by a lowering pain score in 36/39 patients and a decrease of the fibrotic area size in half cases, after 6 months. The intensity and changes of breast fibrosis were assessed also by mammography and, for the topographical distribution of subcutaneous temperature, by infrared thermography. Mammography density suggested decreased fibrosis in one third of patients. Thermography showed that fibrosis was accompanied by two zones clinically indistinctive: a central area with maximum thermal activity, called “Maximal Thermic zone” (MTZ) and a peripheral area with less thermal activity but higher than in the surrounding normal tissue, “Transitional Thermic Zone” (TTZ). Both MTZ and TTZ were significantly decreased in 36/44 patients after SOD(Cu/Zn) treatment. Clinical changes persisted all along the study. Treatment was well tolerated except for one case of local allergic reaction, and no important side effects. Molecular mechanisms involved are discussed. Further studies are running to confirm and explain these results.

Medullary breast carcinoma (MBC) is a rare pathological type of breast cancer. The rate of p53 protein accumulation is higher in MBC than in common invasive ductal carcinoma. Whether this particular feature of MBC influences the outcome after treatment is unknown. We retrospectively analyzed the characteristics, treatment and outcome of 71 patients with MBC treated between 1981 and 1996. The median age was 51 years (range 27–81) and the median clinical tumor size was 25 mm (range 0-70 mm). Breast-conserving treatment was offered when possible: 55 patients had undergone a tumorectomy and radiotherapy while 16 patients had undergone a mastectomy. p53 protein accumulation was determined by immunohistochemistry on paraffin-embedded tumor specimens from 58/71 samples available for this study. The median follow-up for the 56 survivors was 113 months (range 30–241). The 10-year survival and metastasis-free survival rates were 81% and 81.4%, respectively. The local recurrence rate was 16.4%. The two factors predicting outcome were pathological axillary node involvement in the 60 patients who underwent axillary dissection and adjuvant chemotherapy. p53 accumulation was found in 33/58 patients (57%). p53 status was not predictive of survival nor of distant or local recurrences. We confirm that medullary breast carcinoma has a favorable prognosis despite its aggressive pathological features. p53 protein accumulation, found in the majority of MBCs, was not related to outcome.

Lang's conjectures link the geometric, hyperbolic, and arithmetic properties of projective complex varieties of general type. We propose here an extension of these conjectures to arbitrary projective varieties X. This extension rests on the notion of ‘special’ variety. This class contains manifolds either rationally connected or with vanishing Kodaira dimension. We further construct for any Xits ‘core’, which is a fibration cX: X→C(X) with general fibre special and orbifold base of general type. This fibration seems to permit us to decompose Xaccording to the dichotomy ‘special’ vs ‘general type’, and not only leads to the above-mentioned extension of Lang's conjectures but also to a simple global view of classification theory.

The existence is proved and an explicit algebraic description is given for sections of a fibration over a curve whose general fibre is a Fano complete intersection in a product of weighted projective spaces. It is proved also that a fibration whose general fibre is a smooth Fano threefold is rationally connected.

Whether or not young age at diagnosis is an adverse prognostic factor in breast cancer has long been controversial, in part because much previous work has not taken due account of menopausal status and confounding factors. We have analysed the influence of age on prognosis in a consecutive series of 1703 patients with stage I-III breast cancer. All were premenopausal and all were treated in one centre (Institut Curie, Paris) between 1981 and 1985. Mean age was 44 years (range 23-55) and median follow-up was 82 months.

This retrospective study presents the diagnostic, prognostic and therapeutic problems raised by axillary recurrences (AR). 15S9 cases of breast cancer measuring less than 3 cm, treated at the Institut Curie between 1981 and 1987, were studied by a combination of surgery and radiotherapy. Treatment of the breast always included wide local excision associated with irradiation. The axilla was treated either by dissection (865 cases) or by irradiation (724 cases) and 159 patients received chemotherapy. 26 patients (2%) developed AR, confirmed by fine needle aspiration cytology in 92% of cases. None of these 26 patients had initially received chemotherapy. The treatment of the AR was variable, adapted to the initial treatment. 22 patients retained their breast during treatment of the AR and none subsequently developed a local recurrence. 4 mastectomies were performed and histological examination revealed a subclinical local recurrence in 2 cases. The TNM classification, menopausal status, size of the tumour and hormonal receptor status were not risk factors for AR. Young age (P= 0.01) and high histological grade (P= 0.03) were significant risk factors for AR. The AR rate was similar whether axillary dissection or axillary irradiation had been performed. The overall 5-year survival after initial treatment was 85% for AR and 95% for the reference population. The overall 4-year survival after recurrence was 69% and the incidence of metastasis was markedly increased (P= 0.002). 2 of the 26 patients developed lymphoedema of the arm after treatment of AR. We confirm that AR worsens the prognosis, but not significantly more than local recurrence. Young age and the modified histological grading of Scarff Bloom and Richardson were risk factors for AR. Although excision of the AR is necessary to ensure local control, mastectomy is unnecessary when clinical examination and mammography are normal.

Abstract.: In [K2] Moishezon twistor spaces over the connected sum (), which do not contain effective divisors of degree one, were constructed as deformations of the twistor spaces introduced in [LeB]. We study their structure for by constructing a modification which is a conic bundle over . We show that they are rational. In case n = 4 we give explicit equations for such conic bundles and use them to construct explicit birational maps between these conic bundles and .

Introduction: Oral lichen is a chronic inflammatory disease for which diagnostic management and follow-up are heterogeneous given the absence of specific guidelines in France. Our objective was to develop French multidisciplinary guidelines for the management of oral lichen.

Without Abstract:

Les localisations cutanées et gingivales font partie des atteintes extra-médullaires les plus fréquentes des leucémies aiguës myéloïdes (LAM). Bien que les données disponibles soient encore contradictoires, elles sont en général considérées comme des facteurs de plus mauvais pronostic. Leurs spécificités cytogénétiques ou mutationnelles restent non établies à ce jour.

Chronicles of sieges to castles or fortresses, using "machinae", can often be found in historical sources. Moreover, archaeological excavations of castles or fortresses has brought to light rocks or projectiles whose carving suggests a military usage. Nevertheless, chronicles and discoveries alone, are seldom enough to propose a faithful reconstruction of these machines. Therefore, the aim of this research is the development of methodologies for reconstructing virtual scenarios of sieges, starting from the scarce information available. In order to achieve it, a procedure for the virtual reconstruction of the siege machine has been set up, focusing on typology and dimensions of the machines, also investigating possible fire positions according to topography. The entire procedure has been developed using the siege of Cervara di Roma's Rocca as a case study. Late medieval chronicles (end of 13th Century) report the siege brought by the papal army in order to restore the jurisdiction on the Cervara's stronghold, following the insurrection of a group of vassals headed by a monk named Pelagio. The discovery, in the area of the Rocca, of a stone that could have been used as a projectile confirms what reported. The proposed methodology is composed of two parts. The first one is connected to the study of the "internal ballistics", to understand the performances and to build virtual models of siege machines. The second part is the study of the "external ballistics", then to the positioning and shooting ability of possible machines, analysing the topography of the area. In this paper, we present the feasibility of this methodology through the preliminary results achieved correlating internal and external ballistics.