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International audience; For this workshop, participants will take part in the fine-tuning of a handwritten text recognition (HTR) model with eScriptorium. Fine-tuning a model means retraining an initial generic model with a new dataset in order to specialize it in a particular domain.; Cet atelier proposera aux participant-es de prendre part à la production d'un modèle affiné de reconnaissance d'écriture manuscrite (REM) à partir de l'application eScriptorium/Kraken et de découvrir une méthodologie pour l'évaluation des performances des modèles de transcription. Un modèle affiné résulte du ré-entraînement d'un premier modèle générique à partir d'un autre jeu de données, avec comme objectif de le spécialiser dans un domaine particulier.

National audience

International audience

Les fonds judiciaires de la Section ancienne des Archives nationales nous ont conservé quelques affaires d’inscription en faux d’actes de notaires de Paris. Les actes en question sont datés de 1603 à 1787. L’article se propose d’examiner l’aspect matériel sous lequel se présente ces documents, conservés dans des petits sacs de jute, de déterminer ce que les caractéristiques matérielles et intellectuelles communes à ce petit corpus nous permettent d’inférer quant aux affaires et aux procédures qu’elles suivent. Enfin, il est intéressant d’étudier l’attitude prudente quoique combattive adoptée par la compagnie des notaires du Châtelet face à ces affaires d’inscription en faux qui remettent en cause les fondements mêmes de la profession et dans lesquelles le degré d’implication de ses membres est variable.

Le discrimen veri ac falsi appartient depuis les Temps modernes à l’art de l’historien. Récemment le couple vrai/faux est entré uni dans le langage de l’historien qui a cherché ce que le faux lui apprenait de vrai sur la société qui l’avait vu naître, prospérer et souvent demeurer indétecté. Il est peu fréquent cependant que l’on se penche sur les circonstances qui ont déterminé un faux à être repéré et dénoncé, puis que l’on s’attarde sur la manière dont ce dernier était saisi, discuté, éventuellement puni par la justice. Les contributions rassemblées ici prennent le faux comme point de départ et non comme point d’arrivée, autrement dit s’intéressent moins à sa fabrication, à ses modèles ou aux motivations de son faussaire qu’à l’aval de son histoire, depuis la découverte ou la dénonciation jusqu’à son jugement ou sa condamnation, en passant par les moyens et les hommes qui permettent d’établir son caractère falsifié. Ce livre constitue un élément d’une plus vaste enquête engagée autour de l’écrit comme moteur, et non plus seulement symptôme ou instrument, de la construction de l’État et de ses rapports avec la société.

INTRODUCTION : Les internes de médecine générale sont amenés à réaliser des gardes d’étages dès leur premier semestre. À la Faculté de Médecine de Nancy, un séminaire d’urgence leur est dispensé afin de les préparer les internes à leurs premières gardes où ils se retrouvent souvent seuls. Mais quelle est la réalité des motifs d’appels durant les gardes ? MATERIEL ET MÉTHODE : Étude descriptive analytique sur deux périodes en décembre 2016 et juin 2017 par un questionnaire en ligne comprenant pour chaque appel : la description du motif d’appel, l’urgence ressentie, le ressenti sur la gestion de la situation (formuler une hypothèse diagnostique, prescrire des examens complémentaires, proposer une thérapeutique) et les recours utilisés. RÉSULTATS : 106 appels ont été recensés. En semestre d’hiver les motifs d’appels les plus fréquents concernaient les pathologies respiratoires, puis les entrées en service et les troubles du comportement. En semestre d’été, les motifs d’appels les plus fréquents concernaient les régularisations de prescription et les tâches administratives. Seulement 38% des appels étaient considérés comme « médical urgent ». CONCLUSION : Les internes de premier semestre ont eu plus de difficulté à proposer une hypothèse diagnostique, notamment face aux dyspnées et aux troubles du comportement. Ce constat pourrait permettre d’adapter le contenu du séminaire d’urgence à la réalité des motifs d’appels durant les gardes.

International audience

International audience

International audience

International audience

Des communes et des départements jusqu’à Bruxelles, en passant par les régions, le Parlementet l’exécutif national, s’élève la même clameur : il faut investir dans les infrastructures ! Lesobjectifs poursuivis sont variés. Certains veulent relancer la croissance, dans une logique degrands travaux. D’autres souhaitent adapter nos infrastructures aux nouveaux usages avec, parexemple, le déploiement de la fibre optique. D’autres encore cherchent à développer leur territoireen le rendant plus attractif pour les ménages comme pour les firmes. Relayant cesdemandes, le nouveau président de la Commission européenne annonce des investissementsde 300 Md€ à l’échelle de l’Union pour les cinq prochaines années. Mais l’Europe ne peut pastout. M. Juncker propose des financements communautaires à hauteur de 21 Md€ seulement.Il espère combler la différence entre 300 et 21 avec des financements nationaux et un appelaux capitaux privés. Or, cet effet de levier ne peut fonctionner que pour des projets rentables.

International audience

Studien zum Schriftgut im privaten Bereich haben dessen große Vielfalt, die einen persönlichen Ausdruck wiedergibt, herausgestellt. Um die Bedeutung, die das geschriebene Wort für einen Einwohner von Paris im 19. Jahrhunderts und vor allem für die Anonymen, die keine persönlichen Archive hinterließen, besaß, zu verstehen, untersuchten der Minutier central des notaires de Paris (Archives nationales) und die École nationale des chartes die von Pariser Notaren in der ersten Hälfte des 19. Jahrhunderts nach dem Tod einer Person erstellten Inventare. Als Gegenstand derUntersuchung wurde der Faubourg Saint-Germain ausgewählt, ein Bezirk von großer sozialer Vielfalt, in dem zu Beginn der Julimonarchie noch alle Schichten vertreten sind, bevor das begüterte Bürgertum in diesem Stadtteil einen bemerkenswerten Aufstieg erfährt. Der Beitrag geht zunächst auf die angewandte Methode und den juristischen Gehalt eines im 19. Jahrhundert nach dem Tod aufgestellten Inventars ein, bevor er die ersten Ergebnisse dieses Forschungsprojekts vorstellt. Wenngleich die Suche nach privatem Schriftgut weniger erfolgreich war als erwartet, da die Inventare nur die für die Erbfolge bestimmten Schriften auflisten, hat diese Untersuchung es doch ermöglicht, die Arbeit desNotars und die durch den Code Civil ausgelöste Rechtsentwicklung besser zu verstehen., Recent research on writing in the private sphere has brought to light many varieties of textual self-expression. In order to assess the importance of writing in the lives of nineteenth-century Parisians, especially individuals who left no personal papers and are otherwise unknown, the Minutier central des notaires de Paris (housed in the ArchivesNationales) and the École nationale des chartes have undertaken a survey of post-mortem inventories by Paris notaries, 1800-1850, focusing on the Faubourg Saint-Germain : a diverse neighbourhood where all social strata were found at the beginning of the JulyMonarchy, before the wealthy bourgeoisie took it over. This article outlines the methodology employed in the study and describes the nineteenth-century post-mortem inventory in legal terms, before presenting the first results of the survey. The search for private writings proved less fruitful than expected, since the inventories list only those writings related to inheritance. Nonetheless, the survey casts light on the work of notaries and on new legal developments resulting from the introduction of by the Civil Code., Les études sur le for privé ont montré la grande variété d’écrits témoignant d’une expression personnelle. Pour tenter d’appréhender la place de l’écrit chez le Parisien du XIXe siècle et notamment chez les anonymes qui n’ont pas laissé d’archives personnelles constituées, le Minutier central des notaires de Paris et l’École nationale des chartes se sont penchés sur les inventaires après décès dressés par les notaires parisiens de la première moitié du XIXe siècle. Le choix de l’enquête s’est porté sur le faubourg Saint-Germain, quartier de grande diversité sociale où toutes les strates sont encore représentées au début de la Monarchie de Juillet, avant une hausse remarquable de la bourgeoisie aisée dans ce secteur. Après l’exposé de la méthodologie suivie et une présentation juridique de l’inventaire après décès au XIXe siècle, la présente contribution livre les premiers résultats de cette recherche. Si la quête d’écrits privés a porté moins de fruits qu’escompté, l’inventaire après décès ne recensant que les écrits servant à la succession, cette enquête a permis de mieux comprendre le travail du notaire et les évolutions juridiques apportées par le Code civil., Limon Marie-Françoise, Nougaret Christine. L’écrit dans l’écrit : papiers d’affaires et papiers personnels dans les inventaires après décès dressés dans le quartier Saint-Germain-des-Prés (première moitié du XIXe siècle). In: Bibliothèque de l'école des chartes. 2014, tome 172. pp. 421-445.

International audience; Bien qu'essentiellement agricole, l'usage des pesticides est varié et les sources d'exposition de la population aux pesticides sont multiples. Les niveaux d'imprégnation de la population générale aux pesticides sont méconnus en France et dans la majorité des pays européens. La mesure de l'exposition par des biomarqueurs d'exposition a l'avantage d'intégrer toutes les voies possibles d'exposition. Compte-tenu de la sensibilité particulière des fœtus aux toxiques, évaluer l'exposition des femmes enceintes est une question majeure de santé publique. La cohorte Pélagie a inclus près de 3 500 femmes enceintes en Bretagne entre 2002 et 2006. La collecte d'échantillons urinaires en début de grossesse et des dosages chimiques de pesticides pour 546 échantillons urinaires ont été réalisés. L'objectif était d'évaluer le niveau et l'étendue de l'imprégnation des femmes enceintes aux pesticides, en particulier aux herbicides de la familles des triazines, interdits d'usage en France depuis fin 2003 mais toujours présents dans l'environnement, et aux insecticides organophosphorés, d'usages agricoles et non agricoles. Les résultats indiquent la présence de traces de pesticides dans la majorité des urines des femmes enceintes, certaines molécules étant des produits de dégradation persistants dans l'environnement de molécules-mères. Ces résidus de pesticides sont généralement multiples et leurs impacts, individuels ou conjoints, sur le foetus et son développement sont encore incertains dans la littérature épidémiologique. Ils seront évalués prochainement dans la cohorte Pélagie.

Catalogue d'exposition de documents insolites conservées aux Archives départementales des Vosges : reliques, objets, remploi de manuscrits médiévaux, etc.

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The aim of this monocentric, randomized, comparative, open study was to evaluate the safety of Amukine 0.06% solution (an isotonic hypochloride sodium solution) versus a 5% povidone iodine solution (Bétadine 5% solution for ocular irrigation) in antisepsis before cataract surgery.One hundred and thirteen patients, aged between 49 and 90 years, were included and split, after randomization, into two groups: one testing Amukine 0.06%, the other testing a 5% povidone iodine solution. For each group, after local anesthesia, the antiseptic procedure consisted of an antisepsis of periocular teguments followed by an eye antisepsis through the instillation of two drops of the tested product in the conjunctival fornices. The safety evaluation was performed by grading superficial punctate keratitis 24 hours after surgery (slit lamp examination after fluorescein instillation). Conjunctival hyperemia scores by examination of the bulbar conjunctiva before the first instillation, immediately before surgery, and 24 hours after surgery were also compared.One hundred and seven reports were analyzed. Concerning the presence of corneal superficial punctate keratitis 24 hours after surgery, mean scores were not different (0.27 for the Amukine 0.06% group and 0.38 for the povidone iodine group; p=0.27 Mann Whitney test). The observations did not show a different progression of conjunctival hyperemia depending on the treatment group (p=0.65 (immediately after application) and p=0.52 (after 24 hours); Mann Whitney test).In this study, the ocular safety of Amukine 0.06% solution was not different from a 5% povidone iodine solution. Therefore, Amukine 0.06% is a new interesting approach to surgical antisepsis in ophthalmology and an alternative in case of iodine allergy.

To assess the results of the first procedures of endoscopic endonasal dacryocystorhinostomy (ENL DCR). To study the efficiency of diode laser in this operation versus electrocautery instruments (ECI).Prospective study; comparative study.Intraoperative comparison between ECI and diode laser is based on 422 ENL DCR achieved between June 1997 until June 2000. Three hundreds and sixty three procedures were diode laser assisted and 59 procedures were done with the use of an ECI. The diode laser was only used to vaporize nasal mucosa laying on the osteotomy site, to realize partial turbinectomy and to vaporize polyps and synechiae. Intraoperative comparison was based on the followings: frequency and extent of bleeding, quality of visibility, perception of pain during the use of the instrument and duration of the operation. Postoperative comparison is based on 318 procedures. Comparison was based on: frequency of granuloma formation in the nasal mucosa at the site of the osteotomy, frequency of acquired nasal synechiae, frequency of important crusting reaction of the nasal mucosa; success rates after a minimum follow up of 6 months.Intraoperative haemorrhages were fewer and smaller in the diode laser assisted procedures than in ECI assisted procedures; visibility was better with the diode laser; the use of the diode laser was painless versus 24% of patients complaining of pain during the use of electro-cautery. The duration of the procedure was shorter with the diode laser (29'30 vs 37'). In the postoperative follow-up frequency of granuloma formation was equal with the two instruments, synechiae were fewer with the diode laser (11% vs 22%) just like crusting reaction of the nasal mucosa (7% vs 36%). Success rates were similar (diode laser: 91.94% vs EC: 86.66%).Because of the effeciency of the vaporization and coagulation, the diode laser, in comparison with the ECI, allows to shorten mean operative time, to improve the visibility and to decrase bleeding. Contrary to EC it's use is painless. Fewer important crusting reactions and fewer synechiae after diode laser assisted procedures tend to prove than postoperative inflammation and surgical trauma are smaller than with ECI. There is no statiscally signifant difference between the success rates of ENL laser diode assisted procedures and ENL ECI assisted procedures.

To assess the efficacy of transcanalicular dacryocystorhinostomy for the revision of other procedures. The results are analyzed following the use of two different types of laser: the Neodymium: YAG (Nd: YAG) laser and the Holmium: YAG (Ho: YAG) laser. To study the efficacy of using two antimetabolite drugs in this context: mytomycin-C (MMC) and 5-fluoro-uracile (5-FU).One hundred and fourteen patients were operated on. Of these, 88 had already undergone one procedure, 25 two procedures, and 5 three procedures. The Nd: YAG laser was used in 78 procedures, the Ho: YAG in 30 procedures, and both lasers in 10 procedures. Twenty patients were treated with an application of MMC and 25 patients with an application of 5-FU.The results are based on 106 procedures. The total success rate was 49.06% after one revision and 58.49% after two or three revisions. There is no statistically significant difference between the Nd: YAG and Ho: YAG lasers. The use of antimetabolites did not improve the success rate.Transcanalicular dacryocystorhinostomy is a very useful method because it does not cause cutaneous scarring and it has a low rate of morbidity given that it causes very little surgical traumatism. The revision of other dacryocystorhinostomy methods using the transcanalicular approach is theoretically a positive indication because it does not dissect scarring tissues and because the osteotomy has already been performed. However, the success rate is lower than for the external and endonasal approaches. The success rate is not modified by the use of antimetabolites or by the type of laser.

The appearance of ocular pathological outcomes following an hepatitis B vaccination is uncommon. Among them, acute multiple posterior placoid pigment epitheliopathy has been noticed after injections of Engerix B recombinant vaccine. We describe the case of an 11-year-old child who presented this affection following a Genhevac B recombinant vaccine injection.

Optical Coherence Tomography (OCT) is a novel noninvasive and noncontact imaging technique providing cross-sectional representations of the eye structures. OCT is analogous to Ultrasound B-scan, except that it analyzes the reflection of a 850 nm light wave. The aim of this study was to assess the potential of ocular coherence tomography for diagnosing and monitoring macular diseases.Cross-sectional images were performed with the Zeiss-Humphrey OCT. Over one year period, we examined approximately 300 patients with idiopathic full thickness macular hole, lamellar hole, cystoid macular edema, choroidal new vessels, epiretinal membrane, diabetic maculopathy, and central serous chorioretinopathy.OCT can provide new information concerning the posterior pole diseases mentioned above. OCT can also be useful in thickness measurements.OCT allows tomographic analysis of macular diseases. The information obtained is different from that obtained by histologic study which is sometimes hard to interprete. OCT is mostly useful in studying internal layers of the retina. Further applications may be developed.

We reported a case of pigmentary glaucoma in an elderly black patient, treated surgically with phacoemulsification associated with automatised trabeculectomy. The patient was implanted with a silicone foldable lens introduced in the capsular bag. Three months post-operatively, visual acuity, well restored after surgery, decreased progressively and, biomicroscopic exam revealed a pigmented cellular membrane. Pathogeny of this membrane is discussed.

In 2 clinical cases of bilateral optic disk oedema, the optic disk oedema was part of a so-called benign, or rather idiopathic, intracranial hypertension. Aetiological investigations were unable to detect any intracranial or systemic anomaly, except the fact that both patients had been on a long-term treatment. The first, a 35-year-old man, was taking Roaccutane (isotretinoin) for acne, for at least 5 years, Supradyne (containing vitamin A) minimum 1 pill per day. The second patient, aged 16 years, had also been treated for acne with Roaccutane and Mynocine (minocyclin) for several months. Minocyclin and vitamin A, contained in these substances, are likely to have induced the idiopathic intracranial hypertension, and consequently the optic disk oedema. Indeed, discontinuing the treatment and rachicentesis led to a significant resolution of symptoms. A good history of the clinical cases thus remains a key-element in the process of diagnosis-making and should be strictly conducted in cases with bilateral optic disk oedema, particularly when seen in young patients.

We describe a new technique of dacryocystorhinostomy (DCR) and we present our first clinical cases. The principle of this technique is to create a fistula between the lacrimal sac and the nose with a quartz fibre advanced through a canaliculus and connected to a Neodymium:YAG.An 800 microns outer diameter metallic pipe was inserted through a lacrimal canaliculus up to bone contact. An optical fibre light probe was inserted through the pipe in order to locate the lacrimal sac in the nasal fossa by translumination using a nasal video-endoscope. The optical fibre light probe was then replaced with a laser fibre and a lacrimo-nasal fistula (approximately 5 mm diameter) was created in a few minutes by juxtaposition of twenty or more 10 watt energy pulses. Finally, a silicone stent was positioned for 6 months.We have operated 41 DCR using this transcanalicular method with the Nd:YAG laser. Our mean follow-up was 6 months (max 16 months). Indications were stenosis of the naso-lacrimal duct, failed classical DCR, abscesses of the lacrimal sac uncurable by antibiotherapy and canaliculary stenosis.Success rate was 75%, both for primary procedures and for operations after failed classical DCR.The advantages of this method are its simplicity, its atraumatic feature, minimal bleeding, the absence of scar and its ability to treat obstructions located at all levels of the excretory lacrimal system. Minimal operating traumatism makes it a very convenient method for out patient clinic.

Since the demonstration that imidazoline and guanidinium alpha-2 adrenergic agonists induce some of their functional effects by a "nonadrenergic" mechanism, many efforts have been done to identify an imidazoline receptor. Binding studies have allowed to characterize two classes of potential imidazoline receptors: the "(p-amino)clonidine" and the "idazoxan" binding sites. These last, that we named "imidazoline-guanidinium receptive sites" (IGRS) on the basis of their ligand-recognition properties, have been identified, for the first time, in the proximal tubule from rabbit and human kidney. In the present report we will summarize the studies that led us to the characterization of IGRS.

In various models of hypertension of genetic origin, a hypersensitivity of phospholipase C has been demonstrated to participate in the hyperreactivity of platelets toward a variety of vasoactive agents. Since this abnormality could not be observed in the absence of cell stimulation, it could not account for the increase in free Ca2+ which has been reported in resting platelets in primary hypertension. Likewise, in hypertensive subjects, platelets behave hyperactive when stimulated by ADP, although the stimulus has been demonstrated to be a poor activator of phospholipase C. In order to gain insight into the membrane alteration that could account for the cellular hyperactivity which characterizes hypertensive subjects, we investigated, in resting platelets, the kinetics of radioactive labeling of major membrane phospholipids. Isolated platelets were prepared from SHR (4w and 17w of age), SHR-SP, Dahl salt-resistant and salt-sensitive rats fed either a low or a high salt diet, DOCA-salt hypertensive rats and from the appropriate normotensive controls. Irrespective of the radioactive precursor used (32P-orthophosphate, 3H-glycerol, 3H-choline), the labeling of phosphatidylcholine (PC) was markedly (up to 20 fold) enhanced in SHR (whichever their age) and SHR-SP compared with WKY. This increase, specific of PC, could not be accounted for by differences either in the actual amount of PC or in the uptake of various labels, suggesting an increased PC turnover. Such an increase was also observed in platelets of Dahl hypertensive rats but not in those of DOCA-salt hypertensive rats.(ABSTRACT TRUNCATED AT 250 WORDS)

In primary hypertension, phospholipase C (PLC) is hypersensitive in several target tissues (platelets, vascular smooth muscle cells, aortic fibroblasts). Protein kinase C (PKC) and myosin light chain kinase (MLCK), which are physiologically activated by PLC-triggered second messengers (diacylglycerol and Ca2+ ions, respectively), phosphorylate specific proteins closely involved in the cell functional responses. In this study, we have examined and compared between platelets of spontaneously hypertensive rats (SHR) and their normotensive controls Wistar-Kyoto (WKY), the patterns of protein phosphorylation obtained either with the receptor-mediated agonist thrombin (i.e. which acts via PLC) or with direct activators of the protein kinases, PKC and MLCK. Activation by thrombin of 32P-prelabeled platelets induced incorporation of radioactivity into two proteins, P20 (myosin light chain) and P47. The curves obtained when platelets were challenged with either increasing doses of thrombin (0.025-0.3 U/ml) for 20 sec or with a low dose of the agent (0.1 U/ml) for up to 1 min, revealed that phosphorylation of the target proteins of PKC (P47) and of MLCK (P20) were significantly enhanced in platelets of SHR compared to WKY. In contrast, direct activation of PKC by phorbol ester and of MLCK by the calcium ionophore A23187 evoked the selective phosphorylation of the respective target proteins, P47 and P20, to a similar extent in platelets of SHR and WKY. Taken together, these results demonstrate that a physiological agonist (thrombin) induces an enhanced phosphorylation of intracellular proteins in platelets of SHR.(ABSTRACT TRUNCATED AT 250 WORDS)

Can vitrectomy help to understand the vitreous role in intermediate uveitis and Behçet's disease with vitritis without retinal detachment? 400 vitrectomies were decided because of vitreous changes but, over all, if macular changes were seen clinically or on the angiogram in 58 Behçet's disease and 342 intermediate uveitis including 59 children cases. Visual acuity, clinical, angiographical and visual field controls, recurrences, reduction of the medical treatment and growth were followed during 1 to 9 years. The vitrectomy products were compared to those of other inflammatory origin vitreous, the both representing 149 cases. Vitrectomy at the early stage of only posterior interface changes prevent the macular edema but this one is irreversible. The preexisting angiographical lesions have not regressed but they are generally quiet. The RD incidence is lower even if it is possible after vitrectomy, in 1.2% of the cases (1% in late vitrectomies). Recurrences and further medical treatment are reduced. This psychological point of view is important. Thus, vitrectomy at alone posterior interface change stage avoid ocular complications. Its pathogenic role in intermediate uveitis is not demonstrated; it seems more a secondary than a primary process.