Search

Resume Il n’existe a l’heure actuelle aucun traitement neuroprotecteur permettant de reduire la progression de la maladie de Parkinson (MP). Au debut du vingtieme siecle, trois grandes caracteristiques neuropathologiques ont ete decrites : la degenerescence des neurones dopaminergiques, les corps de Lewy, et l’accumulation en fer au niveau de la substance noire (SN). Cette accumulation en fer ainsi que sa grande toxicite ont ete confirmees dans toutes les formes de MP. Par crainte d’induire une anemie, aucune strategie therapeutique basee sur la chelation du fer n’avait ete developpee chez l’humain. Cependant, grâce au concept de chelation conservatrice du fer, nous avons etabli une nouvelle strategie de neuroprotection utilisant la molecule prototype deferiprone et mis en place des essais cliniques actuellement en phase II et III. La decouverte recente d’un nouveau mecanisme de mort cellulaire programmee non apoptotique dependante du fer, appelee ferroptose, qui predomine dans la MP, permettrait a la fois d’expliquer le mecanisme d’action de la chelation du fer tout en ouvrant de nouvelles perspectives therapeutiques de molecules anti-ferroptotiques.

The percutaneous aortic valve replacement (TAVI) is the most recent and promising procedure in the area of interventional cardiology with a rapidly growing number of interventions worldwide. The transfemoral approach being less invasive, it has become the predominant access for the device delivery. The prevention of vascular complications by an optimal risk stratification using appropriate imaging techniques (vascular CT scan and angiography), optimised techniques for femoral puncture (active control of the arterial punction, crossover...) and skilled teams for peripheral angioplasty and percutaneous arterial closure devices (Prostar) has become mandatory given the fragile target population for TAVI. Vascular complications remain indeed one of the most frequent complication although the trend toward reduced sheeths size led to significant reduction This is mandatory regarding the needed size of the vascular arterial access - itself with constant improvement by minimising the initial 24 French with mandatory real chirurgical closure to the actual 18-19 French and soon 16 French. The improvement of the implanted devices is due to the recent evidence of the promising future of this technique and the important technological effort realised by the industry not only on the implanted aortic prosthesis but also on their delivering catheters.

Le pseudo-anevrisme arteriel (PAA) de la femorale superficielle (FS) sur fracture de stent est une entite rare selon notre revue de la litterature. Nous rapportons le cas d’un homme de 73 ans qui consultait en urgence pour claudication a la marche d’apparition recente du membre inferieur droit. Antecedent de pose de stent de la FS en 2008. Au Doppler, on enregistrait un flux typiquement alternant de la femorale commune. Decouverte d’un PAA partiellement thrombose developpe aux depens de la jonction femorale superficielle (FS)–poplitee sus-articulaire (PSA) en regard du stent. Un angioscanner en urgence confirmait la presence d’un volumineux PAA mesurant 7 cm de hauteur, 6 cm de large et 5 cm d’epaisseur partiellement thrombose. Il etait situe au niveau d’une zone de discontinuite du stent avec visualisation d’une breche sur son versant posterieur. La prise en charge fut chirurgicale avec mise a plat greffe femoro-poplitee sus-articulaire prothetique SILVER® de 8 mm. Le choix de la chirurgie a ete fait par necessite d’un abord chirurgical pour evacuer la compression liee a l’anevrisme et egalement en l’absence de stent couvert de taille correspondante dans le contexte d’urgence. Les suites operatoires ont ete simples et le controle au scanner fut satisfaisant avec un retour du patient a son domicile au 4e jour postoperatoire.

Whether in person or in the guise of some fictional character, the figure of Eugène-François Vidocq appears regularly in the literature of the nineteenth century. In the present article, I study the figure's literary posterity and examines how the ex-convict who rose to the rank of chief of police was treated by some French and English authors of the time, including Jerrold, Balzac and Collins. By doing so I establish the various processes involved in the making of a legend and explore the different stages in the development of the adventurer as a social type in the nineteenth century.

Background The clinical significance of moderate coronary stenosis is a fundamental to the choice of treatment. The gold standard is invasive fractional flow reserve (FFR) studying by quantitative coronary angiography (QCA). The role of 256 slices coronary computed tomography angiography (CCTA) one-beat acquisition is insufficiently studied and may be an important factor to predict the clinical significance of moderate coronary stenosis. Purpose To identify morphological CCTA predictors for the clinical significance of moderate coronary artery stenosis. Methods A total of 61 arteries (43 consecutive patients) underwent CCTA and QCA associated with a lesion-specific FFR measurement were retrospectively analyzed. CCTA was performed on a 256-slices CT one-beat acquisition, three-phase injection protocol by using smart shot dual injector. Stenosis from 50–69% were considered as moderate. FFR ≤ 0.80 was considered as functionally significant. Results The mean age was 67.9 ± 10.1, BMI 27.3 ± 4.4 kg/m2 and 75% were males. Twenty-nine percent patients (18 arteries) have clinically significant moderate stenosis with FFR ≤ 0.8; 23% (n = 14) have moderate but not clinically significant stenosis (FFR > 0.80) and 48% (n = 29) were presented by 30–49% stenosis. All of stenosis 0.8 (P Conclusion CCTA plays an important role for noninvasive assessment of clinical significance of moderate coronary stenosis. Moderate stenosis are clinically significant (FFR ≤ 0.8) if their length is more than 16 mm in calcified arteries, particularly in culprit arteries with multiple stenosis.

Resume La tuberculose neonatale ou congenitale est une manifestation meconnue de l'infection a Mycobacterium tuberculosis . Observations Cas 1. Un nouveau-ne premature et hypotrophique souffrait a j45 et en dehors de tout contact maternel d'une bronchopneumopathie bilaterale. Alors que la grossesse et l'accouchement s'etaient deroules sans incident notable, la mere a developpe une miliaire tuberculeuse. Sous rifampicine, isoniazide et pyrazinamide, elle decedait d'une insuffisance renale. Malgre le traitement, l'enfant decedait a j52 d'une defaillance multiviscerale. Apres quelques semaines, la culture des secretions tracheales a confirme le diagnostic de tuberculose. Cas 2. Un nouveau-ne premature et hypotrophique montrait a j22 une detresse respiratoire (miliaire), un ictere et une hepatosplenomegalie. Alors que la grossesse et l'accouchement s'etaient deroules sans incident, la mere avait 18 jours apres l'accouchement une miliaire et une pleuresie tuberculeuses. Malgre l'association de rifampicine, d'isoniazide et de pyrazinamide debutee a j22, l'enfant decedait a j27 dans un tableau de defaillance multiviscerale. Les biopsies hepatiques post mortem confirmaient le diagnostic de tuberculose. Cas 3. Un nouveau-ne a terme est hospitalise a j4 pour un ictere. Grossesse et accouchement s'etaient deroules sans incident. La mere developpait a j 10 une pleuresie tuberculeuse. L'allaitement etait interrompu. Devant la presence d'opacites pulmonaires, un traitement par rifampicine, isoniazide et pyrazinamide etait debute chez l'enfant. Une hepatomegalie et une mauvaise prise ponderale etaient observees jusqu'a j25, suivies d'une amelioration secondaire. Conclusion La tuberculose congenitale est une pathologie probablement sous-estimee. Un diagnostic precoce est indispensable, mais souvent delicat car les premiers signes sont retardes. Un meilleur depistage des femmes a risques ainsi qu'une sensibilisation du corps medical sont necessaires.

Resume La neurocysticercose est la parasitose du systeme nerveux central (SNC) la plus frequente dans le monde. Son extension, l'importance des flux migratoires depuis les pays d'endemie et la proximite de certains foyers font qu'il n'est plus exceptionnel d'avoir a envisager ce diagnostic en France metropolitaine. L'epilepsie en est la forme de revelation habituelle. Le diagnostic repose sur l'imagerie (tomodensitometrie et resonance magnetique) et la serologie (Elisa et Western Blot) qui doivent etre demandees devant tout signe clinique evocateur d'une atteinte du SNC chez un sujet ayant sejourne en region d'endemie cysticerquienne. L'evolution est tres variable, de la latence clinique complete a l'encephalopathie convulsivante avec regression psychomotrice. Le traitement specifique repose sur deux antiparasitaires de classe differente: le praziquantel (Biltricide®) et l'albendazole (Zentel®). Les indications de la corticotherapie sont encore discutees mais les symptomes de la neurocysticercose sont tres corticosensibles a la phase aigue de la maladie. Les formes racemeuses et les localisations intraventriculaires peuvent necessiter le recours a la neurochirurgie. Les espoirs therapeutiques dans les pays d'endemie reposent principalement sur les campagnes de prevention et les progres de la vaccination.

Summary In order to improve elm resistance to dutch elm disease by genetic engineering, woody internodes of field grown elms Commelin were tested for regeneration capacity and susceptibility to Agrobacterium tumefaciens . After a drastic surface disinfection (especially burning), the explants were introduced in vitro on a medium containing cef otaxime (500 mg - L ∔1 ). Budding took place within 2 weeks on the cambial part of the explants. After 1-2 months, the number of rootable shoots per explant was 3 -6, increasing up to 13 by shoot excision. Shoot rooting (70 %) and acclimatization (survival 80 %) were easy. Agrobacterium tumefaciens wild strains (Ach5, T37, C58, 82-139) were either inoculated on shoots or cocultivated on internodes. Octopine/agropine type Ach5 induced tumors (> 50 %) where agropine was often detected. Efficiency of 82-139 was lower. However, it was very effective in improving budding ability of internodes up to 11. A strategy to obtain transgenic elm based on these results is now in progress.

The objective of the study was to determine the concordance of emergency physicians' and cardiologists' interpretations of emergency department (ED) electrocardiograms (ECG), to evaluate the impact of ECG misinterpretation on patient management, and to determine error rates as a function of the level of physician training and the specific ECG diagnoses. ECG interpretations were registered prospectively using a programmed-response data sheet. A second blinded interpretation by a staff cardiologist was assumed to be correct. Only ECG discrepancies with potential or probable clinical importance were considered as errors. The ED management of patients with ECG misinterpretations was reviewed by the investigators. The study was performed at an urban university hospital using 300 consecutive ED ECGs. The analysis found 154 errors of interpretation of which nine had probable clinical significance, and 56 had indeterminant significance. The concordance was weak at 0.69 (Kappa = 0.32, weighted Kappa = 0.30) with a significant discordance (McNemar Chi 2:P < 0.05). Error rates did not differ significantly between the diverse categories of physicians. In two cases, interpretation errors impacted patient management decisions but not patient outcomes. The most frequent errors involved repolarization abnormalities, ventricular hypertrophy and hemi-blocks. While discordance was significant, errors in ECG interpretation rarely impacted patient management. Prospective evaluation of ECG interpretation may be a useful means of gauging physician skills. It can also serve to focus educational activities on problem areas in electrocardiography.

We introduce an automated and accurate system for registering pre-operative 3D MR and CT images with intraoperative 3D ultrasound images based on the vessels visible in both. The clinical goal is to guide the radio-frequency ablation (RFA) of liver lesions using percutaneous ultrasound even when the lesions are not directly visible using ultrasound. The lesions locations and desired RFA sites are indicated on pre-operative images, and those markings are made to appear within the intra-operative 3D ultrasound images. We present our current implementation, provide analyses of its components, and demonstrate its performance.

The relevance of WHO criteria for severe and complicated malaria has been debated for a while, especially as regards children. Recent data led WHO experts to modify the definition of severe malaria. The objective of this study was to evaluate retrospectively the significance of the new definition on severity, lethality and intensive care distribution in children admitted with falciparum malaria (in 1997-99) to Hopital Principal de Dakar, Senegal. We used the paediatric risk of mortality score (PRISM) to compare the 2 definitions, WHO 2000 and WHO 1990. Finally, we evaluated the impact of the new definition in terms of major therapeutic interventions (MTIs): mechanical ventilation, haemodynamic support, transfusion, haemodialysis, and the use of sedatives. Among 311 patients, the frequencies of severe malaria cases and case-fatality rates thereof were 52% (n = 161) and 17% (n = 28) respectively using the 1990 WHO criteria, and 75% (n = 233) and 12% (n = 28) using the 2000 WHO criteria. Mean PRISM score among severe cases decreased with the new definition (6.5 versus 8.6). Both definitions predicted neurological sequelae and deaths with 100% sensitivity. One or more MTIs were required in severe malaria cases in 86% (n = 139) under the 1990 criteria and 73% (n = 170) under the 2000 criteria. In this area of low and seasonal transmission, the 2000 WHO definition of severe malaria proved broader and less specific, but was easier to apply and retained the high sensitivity of the earlier definition in identifying life-threatening infections.

Three unknown di- and tricarboxylic acids were characterized in the fine size fraction of aerosols which were collected during the wet season in the Amazon basin (Rondonia, Brazil). For the structural characterization of the methyl esters of these unknown compounds, mass spectrometry with electron ionization (EI) and tandem mass spectral techniques combined with gas chromatographic (GC) separation were employed. Fragment and parent ion spectra were recorded during elution of the GC peaks by linked scanning of the B and E sectors in combination with high-energy collision-induced dissociation. The fragmentation patterns of significant ions in the first-order EI spectra were also obtained for nonanedioic acid, which was examined as a model compound. The compounds were tentatively identified as 4-acetyloxyheptanedioic acid and cis and trans isomers of 5-hexene-1,1,6-tricarboxylic acid. Since there were indications of biomass burning during the aerosol sampling the di- and tricarboxylic acids characterized in the present work could be markers for biomass burning. Furthermore, the characterization of di- and tricarboxylic acids in the fine size fraction of atmospheric aerosols may be important for assessing the effects of organic aerosols in cloud formation.

Dynamic simulation solver codes are now extensively used by industry for the design verification of vehicle crashworthiness and for the process simulation of sheet metal forming. The logical next step is to use these by now proven codes for the optimization of the vehicle crash design and of metal forming processes. A step towards this goal has been taken by PSI, and an optimization code, PAM-OPT™, has been written for calling dynamic FE codes of the PAM-SOLID™ family in design and process optimization loops. The code interacts with the user via input, signalling and output files and it calls an interface that interacts with the FE solvers. The paper briefly outlines the properties and various flow charts of the optimizer, depending on single or multiple solvers used in the loop, single or parallel calls and fast solvers. Then the paper reports various applications of PAM-OPT™ in conjunction with the PAM-SFE™, PAM-CRASH™, PAM-SAFE™ and PAM-STAMP™ solvers. An outlook on how to replace the user-written interface with a general keyword-driven interface concludes the paper.

Neurocysticercosis (i.e. cerebral localization of the metacestode larvae of Taenia solium) is believed to be a major cause of late onset epilepsy in non-Muslim developing countries. To define its role in childhood epilepsy in Madagascar, analysis of serological markers of cysticercosis was performed in 256 children with unexplained epilepsy and in 113 controls. Sera were considered positive when high titres in ELISA were present together with at least one of the bands 13, 14, 18, 21, 24 or 32 kD on Western blot. Altogether, 17.6% of the patients versus none of the controls were seropositive using these criteria. When analysing the bands of the Western blot, those of 13, 14 and 18 were significantly more frequently detected in sera of epileptic children than in sera of controls. Neurocysticercosis can be considered the main cause of secondary childhood epilepsy in our country, Madagascar being one of the most important foci in the world.

Agrobacterium tumefaciens strains harboring octopine- or agropine-type Ti-plasmids induce crown gall tumors on Kalanchoe tubiflora , sunflower or carrot, that contain agropine, mannopine, mannopinic acid, and agropinic acid. Since oxidation of these compounds on electrophoretograms by an alkaline silver nitrate reagent yields darkly stained spots due to reduction of the silver ions, they are called ‘silver nitrate-positive’. These silver nitrate-positive compounds are not present in normal plant tissues nor in tumors induced by A. tumefaciens strains that contain a nopaline-type Ti-plasmid. All four compounds are opines since octopine- and agropine-type Ti-plasmids, but not nopaline-type Ti-plasmids, confer on the bacterial host the ability to catabolize them for growth. Silver nitrate-positive opines were always present in primary octopine- or agropine-type crown gall tumors. However, cultured crown gall tumors frequently did not contain detectable silver nitrate-positive opines even though other types of opines, such as octopine, were usually present.

Des mesures du temps de retournement en regime impulsionnel ont ete faites et mettent en evidence, a faibles champs, un retournement en deux temps. D'autre part, de nouvelles mesures du champ coercitif sont egalement presentees. Measurements of the switching current and switching time are made. At low fields, the switching takes place in two stages. New measurements of the coercive field are presented.

A reproducible switching device has been fabricated from thin-film VO 2 with a delay time of several microseconds, and has operated over 108cycles without degradation. Using the same technology, a dichromic display with a low operating voltage will be described.

The aerosol characterization experiment performed within the Large-Scale Biosphere-Atmosphere Experiment in Amazonia-Smoke, Aerosols, Clouds, Rainfall and Climate (LBA-SMOCC) field experiment carried out in Rondonia, Brazil, in the period from September to November 2002 provides a unique data set of size-resolved chemical composition of boundary layer aerosol over the Amazon Basin from the intense biomass-burning period to the onset of the wet season. Three main periods were clearly distinguished on the basis of the PM(10) concentration trend during the experiment: (1) dry period, with average PM(10) well above 50 mu g m(-3); (2) transition period, during which the 24-hour-averaged PM(10) never exceeded 40 mu g m(-3) and never dropped below 10 mg m(-3); (3) and wet period, characterized by 48-hour-averaged concentrations of PM(10) below 12 mu g m(-3) and sometimes as low as 2 mu g m(-3). The trend of PM(10) reflects that of CO concentration and can be directly linked to the decreasing intensity of the biomass- burning activities from September through November, because of the progressive onset of the wet season. Two prominent aerosol modes, in the submicron and supermicron size ranges, were detected throughout the experiment. Dry period size distributions are dominated by the fine mode, while the fine and coarse modes show almost the same concentrations during the wet period. The supermicron fraction of the aerosol is composed mainly of primary particles of crustal or biological origin, whereas submicron particles are produced in high concentrations only during the biomass-burning periods and are mainly composed of organic material, mostly water-soluble, and similar to 10% of soluble inorganic salts, with sulphate as the major anion. Size-resolved average aerosol chemical compositions are reported for the dry, transition, and wet periods. However, significant variations in the aerosol composition and concentrations were observed within each period, which can be classified into two categories: (1) diurnal oscillations, caused by the diurnal cycle of the boundary layer and the different combustion phase active during day (flaming) or night (smouldering); and (2) day-to-day variations, due to alternating phases of relatively wet and dry conditions. In a second part of the study, three subperiods representative of the conditions occurring in the dry, transition, and wet periods were isolated to follow the evolution of the aerosol chemical composition as a function of changes in rainfall rate and in the strength of the sources of particulate matter. The chemical data set provided by the SMOCC field experiment will be useful to characterize the aerosol hygroscopic properties and the ability of the particles to act as cloud condensation nuclei.