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Noise-induced hearing loss (NIHL) affects the ability of an individual to communicate and can negatively impact quality of life. The risk to orthopaedic surgeons of developing NIHL as a result of occupational exposures in the operating room (OR) is currently unknown. Hearing protection is recommended for levels of85 decibels (dB), irrespective of length of exposure. The primary goal of the present study was to determine whether orthopaedic surgeons are exposed to harmful noise levels in the OR that puts them at risk for developing NIHL.A prospective review was conducted with use of intraoperative audio recordings across 6 orthopaedic subspecialties. Recordings were made in ORs prior to the surgical start time to serve as baseline controls. Decibel levels were reported as the maximum dB level (MDL), defined as the highest sound pressure level during the measurement period, and as the time-weighted average (TWA), defined as the average dB level projected over an 8-hour time period. Noise doses were reported as the percentage of maximum allowable daily noise (dose) and as the measured dose projected forward over 8 hours (projected dose).Three hundred audio recordings were made and analyzed. The average MDL ranged from 96.9 to 102.0 dB, with noise levels for all subspeciality procedures being significantly greater compared with the control recordings (p0.001). Overall, MDLs were85 dB in 84% of cases and100 dB in 35.0% of cases. The procedure with the highest noise dose was a microdiscectomy, which reached 11.3% of the maximum allowable daily noise and a projected dose of 104.1%. Among subspecialties, adult reconstruction had the highest dose and projected dose per case among subspecialties.The present results showed that orthopaedic surgeons are regularly exposed to damaging noise levels (i.e.,85 dB), putting them at risk for permanent hearing loss. Further investigation into measures to mitigate noise exposure in the OR and prevent hearing loss in orthopaedic surgeons should be undertaken.Orthopaedic surgeons are at risk for NIHL as a result of occupational exposures in the OR.

The identification of transcription factor (TF) target genes is central in biology. A popular approach is based on the location by pattern matching of potential cis-regulatory elements (CREs). During the last few years, tools integrating next-generation sequencing data have been developed to improve the performance of pattern matching. However, such tools have not yet been comprehensively evaluated in plants. Hence, we developed a new streamlined method aiming at predicting CREs and target genes of plant TFs in specific organs or conditions. Our approach implements a supervised machine learning strategy, which allows decision rule models to be learnt using TF ChIP-chip/seq experimental data. Different layers of genomic features were integrated in predictive models: the position on the gene, the DNA sequence conservation, the chromatin state and various CRE footprints. Among the tested features, the chromatin features were crucial for improving the accuracy of the method. Furthermore, we evaluated the transferability of predictive models across TFs, organs and species. Finally, we validated our method by correctly inferring the target genes of key TFs controlling metabolite biosynthesis at the organ level in Arabidopsis. We developed a tool—Wimtrap—to reproduce our approach in plant species and conditions/organs for which ChIP-chip/seq data are available. Wimtrap is a user-friendly R package that supports an R Shiny web interface and is provided with pre-built models that can be used to quickly get predictions of CREs and TF gene targets in different organs or conditions in Arabidopsis thaliana, Solanum lycopersicum, Oryza sativa and Zea mays.

The diversity of vaccination modalities and infection history are both variables that have an impact on the immune memory of individuals vaccinated against SARS-CoV-2. To gain more accurate knowledge of how these parameters imprint on immune memory, we conducted a long-term follow-up of SARS-CoV-2 spike protein–specific immune memory in unvaccinated and vaccinated COVID-19 convalescent individuals as well as in infection-naïve vaccinated individuals. Here, we report that individuals from the convalescent vaccinated (hybrid immunity) group have the highest concentrations of spike protein–specific antibodies at 6 months after vaccination. As compared with infection-naïve vaccinated individuals, they also display increased frequencies of an atypical mucosa-targeted memory B cell subset. These individuals also exhibited enhanced T H 1 polarization of their SARS-CoV-2 spike protein–specific follicular T helper cell pool. Together, our data suggest that prior SARS-CoV-2 infection increases the titers of SARS-CoV-2 spike protein–specific antibody responses elicited by subsequent vaccination and induces modifications in the composition of the spike protein–specific memory B cell pool that are compatible with enhanced functional protection at mucosal sites.

The generation of antibodies against donor-specific major histocompatibility complex (MHC) antigens, a type of donor-specific antibodies (DSAs), after transplantation requires that recipient’s allospecific B cells receive help from T cells. The current dogma holds that this help is exclusively provided by the recipient’s CD4+T cells that recognize complexes of recipient’s MHC II molecules and peptides derived from donor-specific MHC alloantigens, a process called indirect allorecognition. Here, we demonstrated that, after allogeneic heart transplantation, CD3ε knockout recipient mice lacking T cells generate a rapid, transient wave of switched alloantibodies, predominantly directed against MHC I molecules. This is due to the presence of donor CD4+T cells within the graft that recognize intact recipient’s MHC II molecules expressed by B cell receptor–activated allospecific B cells. Indirect evidence suggests that this inverted direct pathway is also operant in patients after transplantation. Resident memory donor CD4+T cells were observed in perfusion liquids of human renal and lung grafts and acquired B cell helper functions upon in vitro stimulation. Furthermore, T follicular helper cells, specialized in helping B cells, were abundant in mucosa-associated lymphoid tissue of lung and intestinal grafts. In the latter, more graft-derived passenger T cells correlated with the detection of donor T cells in recipient’s circulation; this, in turn, was associated with an early transient anti–MHC I DSA response and worse transplantation outcomes. We conclude that this inverted direct allorecognition is a possible explanation for the early transient anti-MHC DSA responses frequently observed after lung or intestinal transplantations.

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Pulmonary mucormycosis (PM) is a life-threatening invasive fungal infection mostly affecting immunocompromised patients. We aimed to study the influence of underlying conditions on disease presentation and diagnostic strategy during PM. Methods All PM cases from six French teaching hospitals between 2008 and 2019 were retrospectively reviewed. Cases were defined according to EORTC/MSG 2019 criteria with the addition of diabetes and traumatism as host factors and positive serum or tissue PCR as mycological evidence. Thoracic CT scans were reviewed centrally. Results Among 114 cases of PM, 52 (46%) were proven and 62 (54%) were probable, including 12 cases with a positive serum qPCR as the sole mycological criterion. Hematological malignancy was the most common risk factor (49%), followed by allogeneic hematopoietic stem-cell transplantation (21%), and solid organ transplantation (SOT, 17%). Fever was the first symptom for 66% patients and was more frequent in patients with neutropenia than in those without (97% vs 52%, P Chest radiological presentation included consolidation (58%), pleural effusion (52%), reversed halo sign (26%), halo sign (24%), vascular abnormalities (26%), and excavation (23%). The excavation was more frequently reported in SOT patients (64%, P A total of 83 (73%) patients had a positive fungal culture from any type of respiratory sample. Serum qPCR was positive for 42/53 patients (79%) and respiratory fluid qPCR for 16/21 (76%) patients. In neutropenic patients, BAL culture was less often positive (30% vs 66%, P 3 cm in diameter (91% vs 62%, P = .02). Rhizomucor spp. Was identified in 31 patients (32%), Rhizopus spp. In 29 patients (30%), Lichtheimia spp. In 24 patients (25%), Mucor spp. In 10 patients (10%) and Cunninghamella spp. In 4 patients (4%). Neutropenic patients were more frequently infected with Rhizomucor (43% vs 13%, P Conclusion Underlying conditions significantly influenced clinical and radiological presentation and diagnostic tools’ contribution. Neutropenic patients present more frequently with dissemination, fever, reversed halo sign, pathological angioinvasion, the negativity of BAL culture, the positivity of serum qPCR, and Rhizomucor infection.

La Fondation Alexander von Humboldt, l’une des principales institutions scientifiques allemandes, joue un rôle crucial dans les échanges scientifiques en favorisant le séjour de chercheurs et en particulier de chercheurs étrangers d’excellence dans les laboratoires allemands, ainsi que le séjour de scientifiques allemands dans des équipes à l’étranger. Corine Defrance présente quelques-unes de ses caractéristiques en introduction de deux articles consacrés à son histoire. One of the main German scientific institutions, the Alexander von Humboldt Foundation plays a leading role in scientific exchanges by promoting research fellowships of scientists and in particular of foreign highly-qualified scientists in German laboratories, as well as fellowships of German scientists in teams abroad. Introducing two articles devoted to its history, Corine Defrance presents some of its current characteristics.

Transplant recipients, who receive therapeutic immunosuppression to prevent graft rejection, are characterized by high coronavirus disease 2019 (COVID-19)–related mortality and defective response to vaccines. We observed that previous infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but not the standard two-dose regimen of vaccination, provided protection against symptomatic COVID-19 in kidney transplant recipients. We therefore compared the cellular and humoral immune responses of these two groups of patients. Neutralizing anti–receptor-binding domain (RBD) immunoglobulin G (IgG) antibodies were identified as the primary correlate of protection for transplant recipients. Analysis of virus-specific B and T cell responses suggested that the generation of neutralizing anti-RBD IgG may have depended on cognate T-B cell interactions that took place in germinal center, potentially acting as a limiting checkpoint. High-dose mycophenolate mofetil, an immunosuppressive drug, was associated with fewer antigen-specific B and T follicular helper (TFH) cells after vaccination; this was not observed in patients recently infected with SARS-CoV-2. Last, we observed that, in two independent prospective cohorts, administration of a third dose of SARS-CoV-2 mRNA vaccine restored neutralizing titers of anti-RBD IgG in about 40% of individuals who had not previously responded to two doses of vaccine. Together, these findings suggest that a third dose of SARS-CoV-2 mRNA vaccine improves the RBD-specific responses of transplant patients treated with immunosuppressive drugs.

Summary Background Standardization of aortic valve repair by the external ring annuloplasty approach is an alternative to valve replacement to avoid prosthetic valve-related events. Although the benefit of exercise training to improve postoperative exercise tolerance has been demonstrated in many conditions after cardiac surgery, it has never been described after aortic valve repair. Objectives To evaluate the feasibility of an early exercise training programme after aortic valve repair. Methods Consecutive patients were prospectively included in 13 postoperative centres. Patients underwent an exercise training programme for approximately 3–5 weeks. Transthoracic echocardiography and a cardiopulmonary exercise test were performed before and after the exercise training programme. Results Fifty patients (mean ± standard deviation [SD] age: 50 ± 13 years) were included a mean of 13.6 ± 12.0 days after aortic valve repair. The preoperative degree of aortic insufficiency was moderate to severe in 35 patients (70%) and the aortic valve was bicuspid in 24 patients (48%). Valve-sparing root replacement and isolated aortic valve repair (including 10% supracoronary aorta replacement) were performed in 64% and 36% of patients, respectively. We found no aortic insufficiency occurrence or worsening and no adverse clinical events after the exercise training programme. Mean left ventricular ejection fraction increased significantly (from 54% ± 8% to 57% ± 9%; P = 0.0007). Mean peak oxygen consumption and first ventilatory threshold increased from 17.0 ± 5.3 to 22.5 ± 7.8 mL/kg/min (32% increase) and from 12.0 ± 3.9 to 14.3 ± 5.2 mL/kg/min (19% increase), respectively (both P Conclusion Exercise training early after aortic valve repair is safe and seems to significantly improve exercise capacity.

Le film réalisé par Marina de Van sur un scénario de Bertrand Santini est une adaptation globalement fidèle du conte de Perrault « Le petit Poucet ». Les auteurs du film ont exploré sa richesse fantasmatique, notamment à travers la figure régressive de l’ogre, support symbolique de multiples transgressions (anthropophagie, inceste, pédophilie). Leur lecture met en lumière l’atemporalité du conte tout autant qu’elle l’ancre dans la modernité, en tissant des rapprochements entre plusieurs types de violence, dont la violence contre les animaux, qui emblématise celle du monde d’aujourd’hui. Partant d’une comparaison avec deux adaptations antérieures du conte (Le Petit Poucet de Michel Boisrond puis celui d’Olivier Dahan), l’étude s’intéresse à la tension entre naturalisme et stylisation qui travaille ce film, y compris dans les scènes où le merveilleux est convoqué, et analyse le jeu de cache-cache que le film entretient avec le conte. The film directed by Marina de Van on a script by Bertrand Santini is an overall faithful adaptation of Perrault’s tale “Le petit Poucet”. The authors of this film explored the fantasmatic dimension of the tale, especially through the regressive character of the ogre, symbolic support of multiple transgressions (anthropophagy, incest, paedophilia). Weaving connections between several types of violence, including against animals which exemplifies the violence of today’s world, this original and powerful adaptation highlights the timelessness of the tale and it anchors it in modernity. Starting from a comparison with two previous adaptations of the tale (Michel Boisrond’s, then Olivier Dahan’s “Le Petit Poucet”), this study is interested in the tension between naturalism and stylization at work in this last adaptation, including in the scenes where the marvelous is summoned, and analyzes the game of hide-and-seek that the film maintains with the tale.

Objective: The magnitude and direction of effects on pregnancy outcomes of the lockdown imposed during COVID-19 have been uncertain and debated. Therefore, we aimed to quantify delivery and perinatal outcomes during the first nationwide lockdown due to the COVID-19 pandemic compared with the same durations of time for the pre- and post-lockdown periods. Study design: This was a retrospective cohort study of six university hospital maternity units distributed across France, each of which serves as the obstetric care referral unit within its respective perinatal network. Maternal and perinatal outcomes were compared between the lockdown period and same-duration (i.e., 55-day) periods before and after the 2020 lockdown (pre-lockdown: 22 January–16 March; lockdown: 17 March–10 May; post-lockdown: 11 May–4 July). We compared the overall rates of Caesarean delivery (CD), pre-labor CD, labor induction, operative vaginal delivery, severe postpartum hemorrhage (≥1 L), severe perineal tear, maternal transfusion, and neonatal mortality and morbidity (1- and 5-min Apgar scores < 7), hypoxia and anoxia (umbilical arterial pH < 7.20 or

Post-traumatic stress disorder is an adjustment disorder combining psychological and physical symptoms. Faced with the pain associated with post-traumatic stress disorder, it is important to know how to differentiate between the pain linked to the physical injury at the time of the traumatic event and the psychogenic pain. Identifying these pains and studying their aetiology, combined with an assessment of the patient's psychological state and life history, enables multi-disciplinary care to be put in place to improve the patient's prognosis and can help to improve recognition of these disorders.

Objective: The effect of lockdowns during the coronavirus (COVID-19) pandemic on pregnancy outcomes remains uncertain. We aimed to evaluate the association between the COVID-19-related lockdown and pregnancy outcomes in maternity hospitals in France. Study design: This was a retrospective cohort study from six tertiary referral hospitals in different regions of France. Three 55-day periods were compared: pre-lockdown from 22 January 2020, lockdown from 17 March 2020, and post-lockdown from 11 May 2020 to 4 July 2020. We included all women who delivered singleton or multiple pregnancies, who delivered at ≥24 weeks of gestation and with birthweights ≥500 g. We documented gestational ages at the delivery of liveborn and stillborn infants (‘stillbirths’). These were categorized as having a very low birthweight (VLBW, +6 weeks, between weeks 28+0 and 31+6, and between 32+0 and weeks 36+6 were 1.0%, 1.9%, and 4.4%, respectively. After adjustment, these rates were stable between periods 1 and 2 (adjusted odds ratio, aOR 0.90; 95% confidence interval, CI 0.69–1.19) and between periods 2 and 3 (aOR 1.04; 95% CI 0.80–1.36). Although more VLBW neonates were born during lockdown (3.5% vs. 2.6%, p = 0.03), this difference did not persist after adjustment (aOR 0.84, CI 95% 0.64–1.10). The LBW rates were similar during the three periods at 12.5% overall. The stillbirth rate was unaffected by the lockdown. Conclusion: The pregnancy outcomes (preterm birth, LBW, VLBW, and stillbirth rates) were not modified by the COVID-19 lockdown in our cohort study in France. Considering the discrepancies in results and methodological issues in previous published studies, there is not sufficient evidence to conclude that such lockdowns have any impact on perinatal outcomes.

Study objectives By modifying the apneic threshold, the antiplatelet agent ticagrelor could promote central sleep apnea hypopnea syndrome (CSAHS). We aimed to assess the association between CSAHS and ticagrelor administration. Methods Patients were prospectively included within 1 year after acute coronary syndrome (ACS), if they had no heart failure (and left ventricular ejection fraction ≥ 45%) and no history of sleep apnea. After an overnight sleep study, patients were classified as “normal” with apnea hypopnea index (AHI) Results We included 121 consecutive patients (mean age 56.8 ± 10.8, 88% men, mean body mass index 28.3 ± 4.4 kg/m2, left ventricular ejection fraction 56 ± 5%, at a mean of 67 ± 60 days (median 40 days, interquartile range: 30–80 days) after ACS. In total, 49 (45.3%) patients had AHI ≥ 15 (27 [22.3%] CSAHS %, 22 [18.2%] OSAHS). For 80 patients receiving ticagrelor, 24 (30%) had CSAHS with AHI ≥ 15, and for 41 patients not taking ticagrelor, only 3 (7.3%) had CSAHS with AHI ≥ 15 (chi-square = 8, p = 0.004). On multivariable analysis only age and ticagrelor administration were associated with the occurrence of CSAHS, (p = 0.0007 and p = 0.0006). Conclusion CSA prevalence after ACS is high and seems promoted by ticagrelor administration. Results from monocentric study suggest a preliminary signal of safety. Clinical trials.gov id NCT03540459.

Background: Blood-retinal barrier cells are known to exhibit a massive phenotypic change during experimental autoimmune uveitis (EAU) development. In an attempt to investigate the mechanisms of blood-retinal barrier (BRB) breakdown at a global level, we studied the gene regulation of total retinal cells and retinal endothelial cells during non-infectious uveitis. Methods: Retinal endothelial cells were isolated by flow cytometry either in Tie2-GFP mice (CD31+ CD45- GFP+ cells), or in wild type C57BL/6 mice (CD31+ CD45- endoglin+ cells). EAU was induced in C57BL/6 mice by adoptive transfer of IRBP1-20-specific T cells. Total retinal cells and retinal endothelial cells from naïve and EAU mice were sorted and their gene expression compared by RNA-Seq. Protein expression of selected genes was validated by immunofluorescence on retinal wholemounts and cryosections and by flow cytometry. Results: Retinal endothelial cell sorting in wild type C57BL/6 mice was validated by comparative transcriptome analysis with retinal endothelial cells sorted from Tie2-GFP mice, which express GFP under the control of the endothelial-specific receptor tyrosine kinase promoter Tie2. RNA-Seq analysis of total retinal cells mainly brought to light upregulation of genes involved in antigen presentation and T cell activation during EAU. Specific transcriptome analysis of retinal endothelial cells allowed us to identify 82 genes modulated in retinal endothelial cells during EAU development. Protein expression of 5 of those genes (serpina3n, lcn2, ackr1, lrg1 and lamc3) was validated at the level of inner BRB cells. Conclusion: Those data not only confirm the involvement of known pathogenic molecules but further provide a list of new candidate genes and pathways possibly implicated in inner BRB breakdown during non-infectious posterior uveitis., SCOPUS: ar.j, info:eu-repo/semantics/published

Background With the recent opioid epidemic in the United States, measures by both government and medical providers are being taken to decrease the opioid dependence rate. Different methods have been proposed, including patient education and multimodal pain therapies. The purpose of this study was to determine whether preoperative opioid education reduces the risk of opioid dependence at 2 years following arthroscopic rotator cuff repair (ARCR). Methods This study was a 2-year follow-up of the 2018 Neer Award study that demonstrated the use of preoperative opioid education as a means to reduce postoperative opioid consumption after ARCR at 3-month follow-up. This was a prospective, single-center, single-blinded, parallel-group, 2-arm, randomized clinical trial with a 1:1 allocation ratio. To study the effect of preoperative opioid education on opioid dependence at 2 years, we randomized patients into 2 cohorts, a study cohort and a control cohort. Data were obtained with a review of prescription data–monitoring software and a patient telephone interview. Results Opioid education (P = .03; odds ratio, 0.37; 95% confidence interval, 0.14-0.90) was found to be an independent factor that is protective against opioid dependence. Study patients had a lower rate of opioid dependence (11.4%, 8 of 50) than control patients (25.7%, 18 of 50) (P = .05). Significantly fewer prescriptions were filled by study patients (mean, 2.9) than by control patients (mean, 6.3) (P = .03). Additionally, fewer pills were consumed by study patients (median, 60; interquartile range [IQR], 30, 132) than by control patients (median, 120; IQR, 30, 340) (P = .10). Finally, fewer morphine milligram equivalents were consumed by study patients (median, 375; IQR, 199, 1496) than by control patients (median, 725; IQR, 150, 2190) (P = .27). Conclusion Our study found that patients who were preoperatively educated on opioid use were less likely to become opioid dependent at 2-year follow-up. Therefore, we demonstrated that opioid education does impart significant long-term benefits to patients undergoing ARCR.

Introduction: A lung assist device, which acts as an artificial placenta, can provide additional gas exchange for preterm and term newborns with respiratory failure. The concept of the lung assist device requires a large bore access via umbilical vessels to allow pumpless extracorporeal blood flow rates up to 30 mL/kg/min. After birth, constricted umbilical vessels need to be reopened for vascular access. The objective is to study the impact of umbilical vessel expansion on vessel integrity for achieving large bore access. Methods: Umbilical cords from healthy term deliveries were cannulated and dilatated with percutaneous transluminal angioplasty catheters in 1 mm increments from 4 to 8 mm for umbilical artery and from 4 to 15 mm for umbilical vein, n = 6 per expansion diameter. Paraffin-embedded transverse sections of dilated and control samples were HE & Van Gieson stained. Effects of dilatation, shown by splitting, were measured. Results: Umbilical vessel expansion led to concentric splitting, shown by areas devoid of extracellular matrix and nuclei in the tunica intima and media. No radial splitting was observed. Results suggest an expansion threshold of umbilical artery at 6 mm and umbilical vein at 7 mm, while maximal splitting was observed above this threshold (3.6 ± 0.8%, p = 0.043 for umbilical artery 7 mm and 6.3 ± 1.8%, p = 0.048 for umbilical vein 8 mm). Endothelial cell sloughing was present in all dilated samples but not in the control samples. Conclusion: The suggested thresholds for safe expansions are similar to in utero umbilical vessel diameters and demonstrate a proof of concept for attaining large bore access for the lung assist device.

Si la « Grande Guerre » – comme ses contemporains l’ont qualifiée – constitue un temps spécifique, une unité historique pourrait-on dire, elle s’organise autour de grands moments : l’entrée en guerre ; la mobilisation des soldats et des sociétés ; les grandes « batailles » sur les différents fronts ; les contestations en première ligne comme à l’arrière ; les négociations diplomatiques, secrètes ou non ; les demandes et signatures d’armistices… Ainsi, chacune des cinq années de la guerre a so...

Introduction Le syndrome de Wolfram est une maladie neurodegenerative rare, autosomique recessive. Il associe un diabete insulinodependant des l’enfance et une atrophie optique bilaterale. Le diabete insipide et la surdite de perception completent la tetrade connue sous le nom du syndrome de DIDMOAD (Diabetes Insipidus, Diabetes Mellitus,Optic Atrophy and Deafness). Observation Patiente de 53 ans, vue a l’âge de 41 ans avec un diabete etiquete de type 1 diagnostique a l’âge de 17 ans avec une atrophie optique connue depuis l’âge de 19 ans. Association a une neuropathie peripherique, deficience sensorielle avec agueusie et anosmie, syndrome vestibulaire et dystonie vegetative: hypotension orthostatique, tachycardie, probable gastroparesie et vessie neurologique documentee. Presence de troubles cognitifs et syndrome depressif. Devant ce tableau atypique comportant un diabete insulinotraite et atrophie optique, le syndrome de Wolfram est evoque. L’etude genetique a la recherche de mutation du gene WFS1 revient positive. Le tableau clinique est domine par l’atteinte neurologique ayant cause la perte d’autonomie et l’atteinte vesicale cause d’infections urinaires recidivantes. Une prise en charge multi-disciplinaire a ete instauree. Discussion L’association diabete et atrophie optique doit faire evoquer le syndrome de Wolfram independamment de la tetrade classique retrouvee dans 53 % des cas. Le diabete represente la premiere manifestation. Les manifestations urinaires sont frequentes (environ 90 % des patients). Le diagnostic precoce permet une prise en charge globale multidisciplinaire pour une meilleure insertion sociale et un depistage systematique des autres atteintes neurosensorielles pouvant engendrer un handicap et urologiques susceptibles d’impacter le pronostic vital des patients.

Joseph Rovan a ete l’un des premiers et des plus importants mediateurs entre la France et l’Allemagne ainsi qu’un grand Europeen. En octobre 1945, il livra a la revue Esprit un article intitule « L’Allemagne de nos merites », manifeste a la lumiere duquel se lit son engagement. Comment cet exile allemand engage dans la resistance francaise, survivant de Dachau, a-t-il tire parti de ces experiences extremes de la guerre pour repenser les relations franco-allemandes en Europe et œuvrer au rapprochement ? Son originalite consiste a avoir agi a la fois comme intellectuel analysant les evolutions en cours, comme acteur de la societe civile (notamment a « Peuple et Culture ») et agent de l’Etat (au cabinet du ministre des Armees, charge des prisonniers de guerre allemands ; puis au bureau de l’education populaire du gouvernement militaire francais), alternativement depuis la France (1945-1947) et l’Allemagne (1947-1951). La reference a Dachau, encore bien presente en 1945, s’efface ensuite devant les urgences de la guerre froide et la necessite d’une nouvelle solidarite franco-allemande dans un cadre europeen. Elle reviendra bien plus tard, a partir de la seconde moitie des annees 1980. Au debut des annees 2000 Rovan ferait de Dachau le lieu symbolique de la solidarite transnationale des resistants au nazisme et d’une communaute franco-allemande et europeenne de destin fondee dans l’epreuve.

L’ouvrage de Marion Aballea, issu d’une these de doctorat en cotutelle (Strasbourg/Geneve), constitue une contribution importante au renouvellement de l’histoire des relations internationales. L’auteure a pris pour objet ce qui, au premier regard, pourrait paraitre comme un element de l’histoire diplomatique traditionnelle, mais loin de faire une histoire de plus des relations diplomatiques franco-allemandes, elle mene une « histoire totale » d’une ambassade consideree dans son ancrage local ...

In mouse embryo gastrulation, epiblast cells delaminate at the primitive streak to form mesoderm and definitive endoderm, through an epithelial-mesenchymal transition. Mosaic expression of a membrane reporter in nascent mesoderm enabled recording cell shape and trajectory through live imaging. Upon leaving the streak, cells changed shape and extended protrusions of distinct size and abundance depending on the neighboring germ layer, as well as the region of the embryo. Embryonic trajectories were meandrous but directional, while extra-embryonic mesoderm cells showed little net displacement. Embryonic and extra-embryonic mesoderm transcriptomes highlighted distinct guidance, cytoskeleton, adhesion, and extracellular matrix signatures. Specifically, intermediate filaments were highly expressed in extra-embryonic mesoderm, while live imaging for F-actin showed abundance of actin filaments in embryonic mesoderm only. Accordingly, Rhoa or Rac1 conditional deletion in mesoderm inhibited embryonic, but not extra-embryonic mesoderm migration. Overall, this indicates separate cytoskeleton regulation coordinating the morphology and migration of mesoderm subpopulations., eLife digest As an embryo develops, its cells divide and specialize to form different tissues and organs. Early in development the cells arrange into so-called germ layers, which each produce particular types of tissue. One of these layers, called the mesoderm, develops into the muscles, bones and circulatory system of the embryo. It also contributes to the support structures that feed and protect the embryo, such as the placenta, umbilical cord and yolk sac. If these ‘extra-embryonic’ structures do not develop correctly, the embryo may not grow properly. Much of what we know about how the cells of the mesoderm move around to form different tissues comes from studies of species that lay eggs; for example, chicks, frogs and fish. The initial steps of embryo development in these animals are similar to how mammals develop, but bigger differences emerge as the extra-embryonic tissues start to form. Recent methodological advances are now making it possible to dynamically study this later stage of development in live mouse embryos. Saykali et al. studied mouse embryos whose mesoderm cells contained a ‘reporter’ that allowed them to be identified when viewed using a microscopy technique known as two-photon live imaging. This approach allows cells to be tracked as they move through living tissue. Saykali et al. found that the mesoderm cells change shape depending on which region of the embryo they are in, and on which germ layer they are next to. The cells that become extra-embryonic are larger and longer, and develop small protrusions. Instead of moving directly to their destinations, they tend to zigzag. Further experiments revealed that embryonic and extra-embryonic mesoderm cells produce different amounts of several proteins, including the distinct types of filaments that act as the cell’s internal skeleton. Mesoderm cells that are destined to become extra-embryonic depend less on signaling proteins called Rho GTPases to move around. Knowing how mesoderm cells form extra-embryonic structures will help researchers to understand how problems with these structures can affect how embryos grow. The techniques used by Saykali et al. will also help to design new ways to cultivate mesoderm cells in the laboratory for future experiments. These could, for example, investigate whether human mesoderm cells develop in the same way as mice mesoderm cells.

Although transcatheter aortic valve implantation (TAVI) has been indicated for patients with high surgical risk, indications for or against the procedure become more difficult as vascular access becomes more proximal and/or invasive in order to accommodate patients with even higher risks. We compared preoperative factors including the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Society of Thoracic Surgeons Predicted Risk of Mortality (STS) score with postoperative survival in 195 patients undergoing TAVI during 2.5 years (January 2010 to June 2012), when vascular access routes were developed from iliofemoral (IL/Fm access, n = 149), axillo-clavicular, apical, and direct aortic approaches (alternative access, n = 46). Logistic regression analyses showed that alternative access was associated with reduced 30-day survival (P = 0.024), while high surgical risk (>15% in both EuroSCORE and STS score) was associated with reduced 1-year survival (P = 0.046). Thus, patients treated via IL/Fm access had acceptable outcome regardless of preoperative risk levels while patients with low surgical risk ( 15%) requiring alternative access, had a prohibitive risk in our experience, they might have been considered untreatable or not amenable even to TAVI and offered medical or alternative managements.

International audience; Background:Iodinated and gadolinium-based contrast media (ICM; GBCM) induce immediate hypersensitivity (IH) reactions. Differentiating allergic from non-allergic IH is crucial; allergy contraindicates the culprit agent for life. We studied frequency of allergic IH among ICM or GBCM reactors.Methods:Patients were recruited in 31 hospitals between 2005 and 2009. Clinical symptoms, plasma histamine and tryptase concentrations and skin tests were recorded. Allergic IH was diagnosed by intradermal tests (IDT) with the culprit CM diluted 1:10, "potentially allergic" IH by positive IDT with pure CM, and non-allergic IH by negative IDT.Findings:Among 245 skin-tested patients (ICM = 209; GBCM = 36), allergic IH to ICM was identified in 41 (19.6%) and to GBCM in 10 (27.8%). Skin cross-reactivity was observed in 11 patients with ICM (26.8%) and 5 with GBCM (50%). Allergy frequency increased with clinical severity and histamine and tryptase concentrations (p 50% of life-threatening ones. GBCM and ICM triggered comparable IH reactions in frequency and severity. Cross-reactivity was frequent, especially for GBCM. We propose considering skin testing with pure contrast agent, as it is more sensitive than the usual 1:10 dilution criteria.

Cytotoxic CD4 (CD4CTX) T cells are emerging as an important component of anti-viral and anti-tumor immunity but the molecular basis of their development remains poorly understood. In the context of human cytomegalovirus infection, a significant proportion of CD4 T cells displays cytotoxic functions. We observed that the transcriptional program of these cells was enriched in CD8 T cell lineage genes despite the absence of ThPOK downregulation. We further show that establishment of CD4CTX-specific transcriptional and epigenetic programs occurred in a stepwise fashion along the Th1-differentiation pathway. In vitro, prolonged activation of naive CD4 T cells in presence of Th1 polarizing cytokines led to the acquisition of perforin-dependent cytotoxic activity. This process was dependent on the Th1 transcription factor Runx3 and was limited by the sustained expression of ThPOK. This work elucidates the molecular program of human CD4CTXT cells and identifies potential targets for immunotherapy against viral infections and cancer., SCOPUS: ar.j, info:eu-repo/semantics/published

Pulmonary mucormycosis (PM) is a life-threatening infection and the diagnosis can be challenging. The objective was to retrospectively explore the value of the RHS in our cohort of 27 patients with mucormycosis and its relation to neutropenia. This was a retrospective study including all patients with a diagnosis of probable or proven invasive PM according to the 2008 EORTC/MSG criteria between September 2003 to April 2016. Fisher's exact test and Mann-Whitney test, with a P-value statistically significant under .05 (P

International audience; Background: Preterm birth (PB) is an important predictor of childhood morbidity and educational performance. Beyond the known risk factors, environmental factors, such as air pollution and noise, have been implicated in PB. In urban areas, these pollutants coexist. Very few studies have examined the effects of multi-exposure on the pregnancy duration. The objective of this study was to analyse the relationship between PB and environmental chronic multi-exposure to noise and air pollution in medium-sized cities.Methods: A case-control study was conducted among women living in the city of Besançon (121 671 inhabitants) or in the urban unit of Dijon (243 936 inhabitants) and who delivered in a university hospital between 2005 and 2009. Only singleton pregnancies without associated pathologies were considered. Four controls were matched to each case in terms of the mother’s age and delivery location. Residential noise and nitrogen dioxide (NO2) exposures were calculated at the mother’s address. Conditional logistic regression models were applied, and sensitivity analyses were performed.Results: This study included 302 cases and 1204 controls. The correlation between noise and NO2 indices ranged from 0.41 to 0.59. No significant differences were found in pollutant exposure levels between cases and controls. The adjusted odds ratios ranged between 0.96 and 1.08. Sensitivity analysis conducted using different temporal and spatial exposure windows demonstrated the same results.Conclusions: The results are in favour of a lack of connection between preterm delivery and multi-exposure to noise and air pollution in medium-sized cities for pregnant women without underlying disease.

Type 1 diabetes (T1D) is due to the loss of both beta-cell insulin secretion and glucose sensing, leading to glucose variability and a lack of predictability, a daily issue for patients. Guidelines for the treatment of T1D have become stricter as results from the Diabetes Control and Complications Trial (DCCT) demonstrated the close relationship between microangiopathy and HbA1c levels. In this regard, glucometers, ambulatory continuous glucose monitoring, and subcutaneous and intraperitoneal pumps have been major developments in the management of glucose imbalance. Besides this technological approach, islet transplantation (IT) has emerged as an acceptable safe procedure with results that continue to improve. Research in the last decade of the 20th century focused on the feasibility of islet isolation and transplantation and, since 2000, the success and reproducibility of the Edmonton protocol have been proven, and the mid-term (5-year) benefit-risk ratio evaluated. Currently, a 5-year 50% rate of insulin independence can be expected, with stabilization of microangiopathy and macroangiopathy, but the possible side-effects of immunosuppressants, limited availability of islets and still limited duration of insulin independence restrict the procedure to cases of brittle diabetes in patients who are not overweight or have no associated insulin resistance. However, various prognostic factors have been identified that may extend islet graft survival and reduce the number of islet injections required; these include graft quality, autoimmunity, immunosuppressant regimen and non-specific inflammatory reactions. Finally, alternative injection sites and unlimited sources of islets are likely to make IT a routine procedure in the future.

L’année 1974 et la mise en place du gouvernement Schmidt ne constituent pas une césure, ni même un tournant majeur dans le mouvement de réforme de la politique culturelle de la RFA qui est alors à l’œuvre. 1990 constitue en revanche un tournant plus net, la (ré-)unification de l’Allemagne et la fin de la guerre froide contraignant la RFA à repenser les enjeux et les modalités de sa politique culturelle extérieure. Sur la période considérée, il convient donc davantage d’interroger la volonté de poursuivre ou non les réformes et les conséquences de la mise en pratique de la réforme entreprise pendant les années Brandt. Afin de saisir ce cœur politique d’une politique culturelle extérieure renouvelée, la présente contribution traite dans un premier temps de la nécessité et des grands principes de la réforme de l’Auswärtige Kulturpolitik, puis, dans un second temps, des avatars et remises en cause de cette réforme jusqu’en 1990. En conclusion, elle aborde l’enjeu crucial de la politique culturelle extérieure de la République fédérale : dans quelle mesure a-t-elle servi l’œuvre de rapprochement et de réconciliation de l’Allemagne avec ses voisins après « l’effondrement civilisationnel » de la période nazie et de la Seconde Guerre mondiale ? Corine Defrance is a researcher specializing in the history of Franco-German relations in the 20th and 21st centuries and in the process of reconciliation throughout Europe. At the beginning of her analysis of Germany’s foreign policy starting from 1974, she recalls the main principles of the reform undertaken under Brandt’s government on the broader understanding of culture (Erweiterter Kulturbegriff). Her goal is to question the purpose and consequences of the reform. She examines the changes up until 1990, under Cold War rivalry between West Germany and East Germany that led to a retreat into more traditional options. In conclusion, the author questions the crucial issue of a foreign policy, which served the German work of rapprochement and reconciliation with its neighboring countries after the "civilizational collapse" of the Nazi period and in World War II. Corine Defrance gilt als Expertin in der Geschichte der deutsch-französischen Beziehungen im zwanzigsten und einundzwanzigsten Jahrhundert. Am Anfang ihrer Analyse der Außenpolitik in der Bundesrepublik Deutschland seit 1974 wird an die Hauptgrundlagen der Reform erinnert, die mit dem „Erweiterten Kulturbegriff“ unter Brandts Regierung eingeführt wurden. Im weiteren Verlauf versucht C. Defrance, die Initiative für diese Reform der Außenpolitik sowie die Frage nach deren Weiterführung bis 1990 auf den Grund zu gehen. Sie untersucht die Folgen der Reform im Rahmen der deutsch-deutschen Konkurrenz, die zu einer Art Rückzug in traditionellere Wege führten. Zum Schluss wird gefragt, ob die Außenpolitik der Bundesrepublik im Dienst der Aussöhnung mit den Nachbarländern diente – nach dem zivilisatorischen Zusammenbruch im Dritten Reich und im Zweiten Weltkrieg.

BACKGROUND The tumor immune response is increasingly associated with better clinical outcomes in breast and other cancers. However, the evaluation of tumor-infiltrating lymphocytes (TILs) relies on histopathological measurements with limited accuracy and reproducibility. Here, we profiled DNA methylation markers to identify a methylation of TIL (MeTIL) signature that recapitulates TIL evaluations and their prognostic value for long-term outcomes in breast cancer (BC). METHODS MeTIL signature scores were correlated with clinical endpoints reflecting overall or disease-free survival and a pathologic complete response to preoperative anthracycline therapy in 3 BC cohorts from the Jules Bordet Institute in Brussels and in other cancer types from The Cancer Genome Atlas. RESULTS The MeTIL signature measured TIL distributions in a sensitive manner and predicted survival and response to chemotherapy in BC better than did histopathological assessment of TILs or gene expression-based immune markers, respectively. The MeTIL signature also improved the prediction of survival in other malignancies, including melanoma and lung cancer. Furthermore, the MeTIL signature predicted differences in survival for malignancies in which TILs were not known to have a prognostic value. Finally, we showed that MeTIL markers can be determined by bisulfite pyrosequencing of small amounts of DNA from formalin-fixed, paraffin-embedded tumor tissue, supporting clinical applications for this methodology. CONCLUSIONS This study highlights the power of DNA methylation to evaluate tumor immune responses and the potential of this approach to improve the diagnosis and treatment of breast and other cancers. FUNDING This work was funded by the Fonds National de la Recherche Scientifique (FNRS) and Televie, the INNOVIRIS Brussels Region BRUBREAST Project, the IUAP P7/03 program, the Belgian "Foundation against Cancer," the Breast Cancer Research Foundation (BCRF), and the Fonds Gaston Ithier.

The spectrum of adipose tissue diseases ranges from obesity to lipodystrophy, and is accompanied by insulin resistance syndrome, which promotes the occurrence of type 2 diabetes, dyslipidemia and cardiovascular complications. Lipodystrophy refers to a group of rare diseases characterized by the generalized or partial absence of adipose tissue, and occurs with or without hypertrophy of adipose tissue in other sites. They are classified as being familial or acquired, and generalized or partial. The genetically determined partial forms usually occur as Dunnigan syndrome, which is a type of laminopathy that can also manifest as muscle, cardiac, neuropathic or progeroid involvement. Gene mutations encoding for PPAR-gamma, Akt2, CIDEC, perilipin and the ZMPSTE 24 enzyme are much more rare. The genetically determined generalized forms are also very rare and are linked to mutations of seipin AGPAT2, FBN1, which is accompanied by Marfan syndrome, or of BANF1, which is characterized by a progeroid syndrome without insulin resistance and with early bone complications. Glycosylation disorders are sometimes involved. Some genetically determined forms have recently been found to be due to autoinflammatory syndromes linked to a proteasome anomaly (PSMB8). They result in a lipodystrophy syndrome that occurs secondarily with fever, dermatosis and panniculitis. Then there are forms that are considered to be acquired. They may be iatrogenic (protease inhibitors in HIV patients, glucocorticosteroids, insulin, graft-versus-host disease, etc.), related to an immune system disease (sequelae of dermatopolymyositis, autoimmune polyendocrine syndromes, particularly associated with type 1 diabetes, Barraquer-Simons and Lawrence syndromes), which are promoted by anomalies of the complement system. Finally, lipomatosis is currently classified as a painful form (adiposis dolorosa or Dercum's disease) or benign symmetric multiple form, also known as Launois-Bensaude syndrome or Madelung's disease, which are sometimes related to mitochondrial DNA mutations, but are usually promoted by alcohol. In addition to the medical management of metabolic syndrome and the sometimes surgical treatment of lipodystrophy, recombinant leptin provides hope for genetically determined lipodystrophy syndromes, whereas modifications in antiretroviral treatment and tesamorelin, a GHRH analog, is effective in the metabolic syndrome of HIV patients. Other therapeutic options will undoubtedly be developed, dependent on pathophysiological advances, which today tend to classify genetically determined lipodystrophy as being related to laminopathy or to lipid droplet disorders.

Introduction L’hyperparathyroidie primaire est souvent infra clinique, parfois symptomatique et alors revelee par une complication de type fracture, lithiase urinaire ou hypercalcemie aigue. Nous rapportons le cas d’une patiente dont l’hyperparathyroidie s’est revelee par un hematome cervical anterieur. Observation La patiente, âgee de 67 ans ayant pour seul antecedent une colectomie partielle pour pathologie benigne a presente un malaise qui amene a la prescription d’un anti-aggregant plaquettaire. Deux mois plus tard, elle presente une douleur avec dysphagie et ecchymose cervicale anterieure. Le scanner et l’echographie montrent une image retrothyroidienne gauche avec deviation tracheale vers la droite, sans compression. Le bilan phosphocalcique initial etait normal. Un mois plus tard, il montre un tableau d’hyperparathyroidie primaire avec calcemie corrigee a 107 mg/L (85–105), phosphoremie a 24 mg/L (25–45), PTH 185 pg/mL (10–65), 25OH vit D 23 ng/mL (> 30). L’echographie cervicale confirme un aspect d’hypertrophie parathyroidienne inferieure gauche, confirme en scintigraphie au MIBI-Tc. Le bilan de retentissement montrant des lithiases urinaires, une chirurgie est decidee. La patiente a eu une cervicotomie laterale gauche montrant un nodule semblant d’origine parathyroidienne, confirmee par l’examen anatomopathologique. Le caractere adenomateux ou hyperplasique n’etait pas precisable compte tenu des sequelles de l’hemorragie. En post-operatoire, la calcemie est corrigee a 99 mg/L, phosphoremie 28 mg/L. Le bilan reste stable avec un recul de 10 mois maintenant. Discussion L’hemorragie d’un adenome parathyroidien est une complication exceptionnelle mais deja decrite, elle peut reveler ou guerir l’adenome, un peu comme l’apoplexie d’un adenome hypophysaire.

Introduction La maladie de Basedow est une cause frequente d’hyperthyroidie, de tableau souvent typique et traitement bien codifie. Nous rapportons le cas d’une patiente, dont le diagnostic, l’evolution, la prise en charge ont ete difficiles. Observation La patiente, âgee de 68 ans presente un coma febrile avec fibrillation auriculaire, hyperthermie, par crise aigue thyrotoxique justifiant une prise en charge initiale en reanimation, et traitee par betabloquants, cholestyramine et propylthio-uracile (PTU). Il existait un goitre multinodulaire volumineux (110 mL), hypervasculaire avec TBII a 116 UI/L. L’hyperthyroidie initialement majeure s’est normalisee en quelques mois sous PTU (8 cp/j) ensuite associe au levothyrox poursuivis 2 ans a forte dose en raison de la normalisation tardive de la vascularisation thyroidienne et des TBII, puis une diminution progressive etait initiee pour preparer une thyroidectomie. En cours de decroissance, le PTU est arrete apres 3 ans de traitement devant une anemie puis une insuffisance renale, en rapport avec une vascularite a ANCA a un titre de 1/1280 de type anti-MPO, confirmee par une biopsie renale. Celle-ci est traitee par corticotherapie et immunosuppresseurs (cyclophosphamide) avec une amelioration partielle de la fonction renale. A distance de l’immunosuppression majeure, une thyroidectomie est realisee sans complication. Discussion La maladie de Basedow peut avoir une presentation grave. Ici, la crise thyrotoxique avait fait preferer le PTU, probablement responsable de la vascularite a ANCA. Malgre les facteurs pejoratifs (goitre volumineux, hypervascularisation, TBII tres eleves), la chirurgie a pu debarrasser la patiente de sa maladie thyroidienne, mais l’insuffisance renale persiste.

Introduction Le goitre rapidement evolutif et compressif peut etre difficile a prendre en charge. Nous rapportons le cas d’une patiente presentant un goitre atypique qui avait fait evoquer un lymphome thyroidien. Observation La patiente, âgee de 68 ans etait adressee en consultation specialisee pour goitre compressif evolutif en 3 mois, avec dyspnee, voix rauque. Ce goitre etait globuleux, dur, avec signes compressifs (cornage, manœuvre de Pemberton, dyspnee), associe a une thyroidite franche (ATPO > 8000 UI/L, N En echographie, il etait extremement hypoechogene et heterogene, globuleux, sans nodule franc, predominant a droite, sans adenopathie, volumineux (130 mL). On notait par ailleurs une calcitonine negative, β2 μglobuline 2,9 mg/L ( Malgre la normalisation de la TSH sous levothyrox, ni le volume du goitre ni les signes compressifs n’etaient modifies, justifiant une thyroidectomie apres corticotherapie. Les suites ont ete simples et l’anatomopathologie a confirme une « simple » thyroidite lymphocytaire. Discussion Ce cas illustre la potentielle severite clinique des thyroidites d’Hashimoto qui peuvent amener a une indication de thyroidectomie quand elles sont d’evolution rapide, compressives, ou en cas de doute concernant un lymphome (80 % de thyroidite associee), entite rare heterogene, pour laquelle on connait le faible apport de la cytoponction.

BACKGROUND Both dopamine and norepinephrine are recommended as first-line vasopressor agents in the treatment of shock. There is a continuing controversy about whether one agent is superior to the other. METHODS In this multicenter, randomized trial, we assigned patients with shock to receive either dopamine or norepinephrine as first-line vasopressor therapy to restore and maintain blood pressure. When blood pressure could not be maintained with a dose of 20 μg per kilogram of body weight per minute for dopamine or a dose of 0.19 μg per kilogram per minute for norepinephrine, open-label norepinephrine, epinephrine, or vasopressin could be added. The primary outcome was the rate of death at 28 days after randomization; secondary end points included the number of days without need for organ support and the occurrence of adverse events. RESULTS The trial included 1679 patients, of whom 858 were assigned to dopamine and 821 to norepinephrine. The baseline characteristics of the groups were similar. There was no significant between-group difference in the rate of death at 28 days (52.5% in the dopamine group and 48.5% in the norepinephrine group; odds ratio with dopamine, 1.17; 95% confidence interval, 0.97 to 1.42; P = 0.10). However, there were more arrhythmic events among the patients treated with dopamine than among those treated with norepinephrine (207 events [24.1%] vs. 102 events [12.4%], P

BACKGROUND: The toxicities of pyrethrins + rapeseed oil, pyrethrins + piperonyl butoxide (PBO), potassium salts of fatty acids and linseed oil were assessed in the laboratory on the parasitic wasp Aphidius rhopalosiphi (Destefani-Perez), the ladybird Adalia bipunctata (L.), the rove beetle Aleochara bilineata (Gyll.) and the carabid beetle Bembidion lampros (Herbst.). The methods selected were residual contact toxicity tests on inert and natural substrates. RESULTS: Both the pyrethrin products led to 100% mortality in the adult parasitic wasps and ladybird larvae on glass plates and plants. The pyrethrins + PBO formulation was toxic for B. lampros on sand and natural soil, but the pyrethrins + rapeseed oil formulation was harmless for this species. Insecticidal soaps were harmless for all these beneficial species. None of the tested products significantly affected the parasitism of the onion fly pupae by A. bilineata. CONCLUSION: The results indicated the potentially high toxicity of natural pyrethrins for beneficial arthropods. Although this toxicity needs to be confirmed in field conditions, the toxicity levels obtained in the laboratory were similar to or higher than those of several synthetic insecticides known to be toxic in the field. Insecticidal soaps could be considered as an alternative for aphid control in organic farming in terms of selectivity. Copyright © 2010 Society of Chemical Industry

Purpose: To assess whether fusion of multislice computed tomography (CT) images with electroanatomical (EA)-mapping data using a new image integration module (CartoMerge TM ) is feasible and accurate to navigate ablation catheters in right and left atrial catheter ablation. Material and methods: Twenty-four patients were examined with ECG-gated cardiac multislice CT (64 mm × 0.6 mm, 0.33 s) 1 day before left atrial (LA) (15 patients) radiofrequency or right atrial cavotricuspid isthmus ablation (9 patients). CT data were fused with the non-fluoroscopic EA-mapping data by using dedicated software (CartoMerge TM ) and the value of CT was analysed. Results: In 23/24 (96%) patients, CT images could be fused with the EA-map. The alignment error was 2.16 ± 0.35 mm. In 15/15 (100%) patients, CT added relevant anatomical information regarding the course of the esophagus or the pulmonary veins before LA-ablation. CT added useful information in only 3/8 (37.5%) of patients undergoing right atrial cavotricuspid isthmus ablation. Conclusion: 3D-navigation of RF-ablation catheters in the atria assisted by image fusion of multislice CT with EA-mapping data is feasible and accurate. CT added relevant anatomical information about the left atrium and the pulmonary veins before LA-ablation, CT also provided information about the course of the esophagus which might help to avoid thermal injury. CT image fusion might be of minor value before right atrial cavotricuspid isthmus catheter ablation. © 2007 Elsevier Ireland Ltd. All rights reserved.

TSH-secreting adenomas are rare tumors, representing only 0.5 to 2.5% of pituitary adenomas. Their main clinical characteristics include signs of thyrotoxicosis, diffuse goiter and a compressive syndrome. Biologically, free T4 and T3 serum levels are elevated, contrasting with inadequate serum TSH levels and increased alpha chains. Magnetic resonance (MR) imaging shows a pituitary tumor, the main differential diagnosis being resistance to thyroid hormones. Treatment is based on surgery, possibly associated with somatostatin analogs and radiotherapy. Though the long-term evolution of this rare pathology seems to have improved, some clinical situations are still a challenge to treat. We report one such case that was resistant to both stereotactic radiotherapy and somatostatin analogs, but surprisingly improved with cabergoline. We suggest that cabergoline should be considered as an alternative treatment in cases of pituitary adenomas that resist traditional treatments.