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Objective: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft., Methods: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described., Results: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients. Forty-five collective strategic MEDEVAC courses were delivered to 91 intensivists, 130 anesthetic nurses, 79 flight surgeons, 55 flight nurses, and 89 nurses. Five sessions of tactical MEDEVAC courses were performed for 14 flight surgeons, 6 flight nurses, and 17 other nurses. Ten sessions of individual strategic MEDEVAC courses were delivered to 17 intensivists, 10 flight surgeons, 21 flight nurses, and 7 other nurses. Between 2006 and 2015, 818 (± 68) individual strategic MEDEVACs were performed per year. Thirty-three (± 19) concerned critical care patients. Five missions of collective strategic MEDEVAC were performed for 56 patients., Conclusion: The FMHS has developed specific courses for the MEDEVAC of critical care patients, allowing the training of numerous MEDEVAC teams., (Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.)

An amorphous reduced form of oxide ion conductor La2Mo2O9 had been proposed as sulfur-tolerant anode material for solid oxide fuel cell, but its oxygen content was not known. In this paper, we investigate the reduction kinetics by diluted hydrogen of La2Mo2O9 to amorphous, and the oxygen range of the amorphous form. The reduction kinetics is studied as a function of the powder specific surface area and of the temperature, on powders synthesized by solid state reaction and by polyol process using two different solvents. The reduction process was carried out by TGA under 10% H2 diluted in argon, and its kinetics is analyzed and modeled. As expected, small particles and high temperature lead to higher reduction rates. Several reduction steps were identified by XRD during the process. At 700 °C La2Mo2O9 is directly reduced into the amorphous phase La2Mo2O7-y, whereas at 760 °C reduction occurs through an intermediate crystallized La7Mo7O30 (≅ La2Mo2O8.57) phase before amorphization. In both cases, further reduction of La2Mo2O6.2 amorphous phase leads to an exsolution of metallic molybdenum and a molybdenum deficiency in the amorphous phase. Reoxidation of amorphous La2Mo2O7-y was studied by TGA, DTA and XRD. At low temperature in air, the reduced compounds are reoxidized while remaining amorphous. The annealing for 60 h at 350 °C in air of reduced La2Mo2O6.66, obtained beforehand by solid state reaction, gives an amorphous phase with composition La2Mo2O8.85. The existence domain of the reduced amorphous phase in terms of oxygen content therefore ranges at least from O6.2 to O8.85, thus including the composition La2Mo2O8.50 of the amorphous surface layer at the origin of a huge increase of ionic conductivity recently reported in nanowires of La2Mo2O9.

Thyroid storm is a life-threatening condition that occurs secondary to an uncontrolled hyperthyroid state. Atrial fibrillation is a cardiovascular complication occurring in up to 15% of patients experiencing thyroid storm, and if left untreated this condition could have up to a 25% mortality rate. Thyroid storm with stroke is a rare presentation. This case report details a left middle cerebral artery (MCA) stroke with global aphasia and thyroid storm in a 53-year-old Hispanic male patient. Although uncommon, this combination has been reported in multiple case series. Although it is well documented that dysfunctional thyroid levels promote a hypercoagulable state, available guidelines from multiple entities are unclear on whether anticoagulation therapy is appropriate in this situation.

In France, approximately 3000 people are repatriated every year, either in a civil situation by insurers. Repatriation also concerns French army soldiers. The literature is scarce on the topic of venous thromboembolic risk and its prevention during repatriation for medical reasons, a common situation. Most studies have focused on the association between venous thrombosis and travel, a relationship recognized more than 60 years ago but still subject to debate. Examining the degree of venous thromboembolic risk during repatriation for medical reasons must take into account several parameters, related to the patient, to comorbid conditions and to repatriation modalities. Appropriate prevention must be determined on an individual basis., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Objectives: The aim of this study was to evaluate the capacity of a traditional stethoscope versus an electronically amplified one (expected to reduce background and ambient noise) to assess heart and respiratory sounds during medical transport., Materials and Methods: It was a prospective, double-blinded, randomized performed study. One traditional stethoscope (Littmann Cardiology III; 3M, St Paul, MN) and 1 electronically amplified stethoscope (Littmann 3200, 3M) were used for our tests. Heart and lung auscultation during real medical evacuations aboard a medically configured Falcon 50 aircrafts were studied. The quality of auscultation was ranged using a numeric rating scale from 0 to 10 (0 corresponding to "I hear nothing" and 10 to "I hear perfectly"). Data collected were compared using a t-test for paired values., Results: A total of 40 comparative evaluations were performed. For cardiac auscultation, the value of the rating scale was 4.53 ± 1.91 and 7.18 ± 1.88 for the traditional and amplified stethoscope, respectively (paired t-test: P < .0001). For respiratory sounds, quality of auscultation was estimated at 3.1 ± 1.95 for a traditional stethoscope and 5.10 ± 2.13 for the amplified one (paired t-test: P < .0001)., Conclusions: This study showed that practitioners would be better helped in hearing cardiac and respiratory sounds with an electronically amplified stethoscope than with a traditional one during air medical transport in a medically configured Falcon 50 aircraft., (Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.)

Lysyl oxidase enzymes are reported to be involved in patho-physiological process such as tumorigenesis. β-Aminopropionitrile (BAPN) is an irreversible inhibitor of lysyl oxidase activity, suggesting a potentially useful therapeutic of interest in oncology. This paper describes the first assay concerning the quantification of BAPN by mass spectrometry. A high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS) assay was developed for the quantification of BAPN in plasma and tumor of mice. This method combines dansyl chloride (Dns) derivatization and extraction using a solid-phase extraction Oasis Max column. Deuterated BAPN was used as internal standard (IS). Separation was achieved using an C₁₈ column HypersylGold, (ThermoElectron), 3.0 µm (100 × 2.1 mm i.d.). Gradient elution with water containing 0.1% acetic acid (A) and acetonitrile containing 0.1% acetic acid (B) was applied. Detection was performed with an electrospray ionization interface operating in negative ion mode. Selected reaction monitoring was used with ion transitions m/z 302 → 249 for BAPN-Dns and m/z 306 → 250 for the IS. The method was fully validated in plasma and was linear and sensitive in the range of 10-500 ng/mL. The lower limit of quantification in plasma was 2.5 ng/mL. This validated assay was successfully applied to a kinetic study of BAPN in mouse plasma and demonstrates that BAPN reaches the tumoral tissue., (Copyright © 2014 John Wiley & Sons, Ltd.)

Osteonecrosis of the jaw (ONJ) is a clinical condition associated with long-term exposure to inhibitors of bone resorption, mainly bisphosphonates. Denosumab (DMab) is a human monoclonal antibody of the receptor activator of nuclear factor kappa-B ligand. It prevents osteoclast-mediated bone resorption and is widely prescribed for the management of postmenopausal osteoporosis. Whereas ONJ has already been reported in women treated with DMab, we report for the first time the development of ONJ, following tooth extraction, in a male patient treated for idiopathic osteoporosis with DMab. Due to the constant increase in DMab prescription, for the management of osteoporosis, in both genders, physicians should be made aware of this potential risk.

Background: Recent studies have identified new candidate polymorphisms in the genes related to CYP3A activity or calcineurin inhibitor dose requirements in kidney transplant recipients. These genes and polymorphisms are CYP3A4 (cytochrome P450, family 3, subfamily A, polypeptide 4) (rs35599367-C>T; *22); POR [P450 (cytochrome) oxidoreductase] (rs1057868-C>T; *28); and PPARA (peroxisome proliferator-activated receptor alpha) (rs4253728-G>A). We investigated the impact of these polymorphisms on sirolimus (SRL) in vitro hepatic metabolism, SRL trough concentrations (C0), and SRL adverse events in kidney transplant recipients., Methods: The clinical study included 113 stable kidney transplant patients switched from a calcineurin inhibitor to SRL (SRL C0 measured at 1, 3, and 6 months thereafter). We investigated SRL metabolism in vitro using human liver microsomes derived from individual donors (n = 31). Microsomes and patients were genotyped by use of Taqman® allelic discrimination assays. The effects of polymorphisms and covariates were studied using multilinear regression imbedded in linear mixed-effect models or logistic regressions., Results: In vitro, the CYP3A4*22 allele resulted in approximately 20% lower metabolic rates of SRL (P = 0.0411). No significant association was found between CYP3A4, CYP3A5, or PPARA genotypes and SRL dose, C0, or C0/dose in kidney transplant patients. POR*28 was associated with a minor but significant decrease in SRL log-transformed C0 [CT/TT vs CC, β = -0.15 (0.05); P = 0.0197] but this did not have any impact on the dose administered, which limited the relevance of the finding. After adjustment for nongenetic covariates and correction for false discovery finding, none of the single-nucleotide polymorphisms tested showed significant association with SRL adverse events., Conclusions: These recently described polymorphisms do not seem to substantially influence the pharmacokinetics of SRL or the occurrence of SRL adverse events in kidney transplant recipients.

Background: The purpose of this study was to assess the feasibility of hemodynamic monitoring by bioreactance during the air evacuation of war casualties., Methods: From June 2011 to January 2012, the French Air Force used a noninvasive bioreactance monitor during the aeromedical evacuation of patients with severe battle injury. Patients were continuously monitored from takeoff (baseline) until arrival. Cardiac index, quality, and viability of signal and fluctuations in values were assessed during the entire flight., Results: Eighteen patients were included, and monitoring was possible for 16 patients. The implementation of the monitoring was found to be straightforward for both doctors and paramedics, and we observed no loss of signal or interference during the flights. Cardiac index decreased significantly during the takeoff and returned to baseline value after the 50th minute of flight., Conclusion: The application of noninvasive bioreactance hemodynamic monitoring is feasible and pertinent in the specific environment of aeromedical evacuation. This monitoring can be particularly useful during the strategic evacuation of patients with severe injury from field hospital to tertiary centers., Level of Evidence: Care management study, level V.

Objectives: The ability to auscultate during air medical transport is compromised by high ambient noise levels. The aim of this study was to assess the capabilities of a traditional and an amplified stethoscope (which is expected to reduce background and ambient noise) to assess heart and breath sounds during medical transport in a Falcon 50 plane., Methods: A prospective, double-blind, randomized study was performed. We tested 1 model of traditional stethoscope (Littman cardiology III) and 1 model of amplified stethoscope (Littman 3100). We studied heart and lung auscultation during real medical evacuations aboard Falcon 50 (medically configured). For each, the quality of auscultation was described using a numeric rating scale (ranging from 0 to 10, with 0 corresponding to "I hear nothing" and 10 corresponding to "I hear perfectly"). Comparisons were accomplished using a t test for paired values., Results: A total of 32 comparative evaluations were performed. For cardiac auscultation, the value of the rating scale was 5.8 ± 1.5 and 6.4 ± 1.9, respectively, for the traditional and amplified stethoscope (P = .018). For lung sounds, quality of auscultation was estimated at 3.3 ± 2.4 for traditional stethoscope and at 3.7 ± 2.9 for amplified stethoscope (P = .15)., Conclusions: Practicians in Falcon 50 are more able to hear cardiac sounds with an amplified than with a traditional stethoscope, whereas there is no significant difference concerning breath sounds auscultation., (Copyright © 2011 Elsevier Inc. All rights reserved.)

The maintenance in the long run of a positive carbon balance under very low irradiance is a prerequisite for survival of tree seedlings below the canopy or in small gaps in a tropical rainforest. To provide a quantitative basis for this assumption, experiments were carried out to determine whether construction cost (CC) and payback time for leaves and support structures, as well as leaf life span (i) differ among species and (ii) display an irradiance-elicited plasticity. Experiments were also conducted to determine whether leaf life span correlates to CC and payback time and is close to the optimal longevity derived from an optimization model. Saplings from 13 tropical tree species were grown under three levels of irradiance. Specific-CC was computed, as well as CC scaled to leaf area at the metamer level. Photosynthesis was recorded over the leaf life span. Payback time was derived from CC and a simple photosynthesis model. Specific-CC displayed only little interspecific variability and irradiance-elicited plasticity, in contrast to CC scaled to leaf area. Leaf life span ranged from 4 months to >26 months among species, and was longest in seedlings grown under lowest irradiance. It was always much longer than payback time, even under the lowest irradiance. Leaves were shed when their photosynthesis had reached very low values, in contrast to what was predicted by an optimality model. The species ranking for the different traits was stable across irradiance treatments. The two pioneer species always displayed the smallest CC, leaf life span, and payback time. All species displayed a similar large irradiance-elicited plasticity.

The care of elderly patients suffering from multiple pathologies requires a real continuity of care, and consequently, close cooperation between shifts. These principles must be applied by the different structures caring for elderly people as well as, and especially, within a single institution, between the day shifts and the night shifts.

New developments concerning the synthesis of oxide and non oxide nanoparticles by laser pyrolysis are reported here. In order to be able to study the relations between the host and the guest in doped nanostructured luminescent oxide matrix, tetragonal ZrO2 nanoparticles were synthesized with sizes as low as 3 nm in weighable amounts. Y2O3 nanoparticles doped with Ce were also prepared with grains in the 10-20 nm size range. Concerning the non-oxide materials, TiC, TiN, and TiC(x)N(y) nanopowders were obtained from simple annealing treatments performed on TiO2/C nanocomposites grown by laser pyrolysis. The final crystalline phase was controlled by the initial C content and the annealing atmosphere. Once sintered, these materials will allow the study of the mechanical properties of nanostructured carbonitride ceramics.

Background: Developmental stressors are consistently reported to increase risk for certain neuropsychiatric disorders including schizophrenia, depression, and post-traumatic stress disorder. Recent clinical evidence supports a "double-hit" hypothesis of genetic vulnerability interacting with developmental challenges to modulate this risk. Early life stressor effects on behavior may be modulated in part by alterations in corticotropin releasing factor (CRF) signaling via two known receptors, CRF(1) and CRF(2). One extant hypothesis is that CRF(2) activation may modulate long-term adaptive responses after homeostatic challenge. As such, loss of CRF(2) activity via genetic variance may increase sensitivity to the long-term effects of developmental stress., Methods: We tested the hypothesis that CRF(2) function may mitigate the behavioral effects of isolation rearing, predicting that loss of CRF(2) function increases sensitivity to this developmental challenge. Using the behavioral pattern monitor (BPM), we examined exploratory behavior and locomotor patterns in adult CRF(2) wild-type (WT) and gene knockout (KO) mice reared socially or in isolation., Results: Isolation housing produced robust increases in the amount of locomotor activity and investigatory holepoking, and altered the temporal distribution of activity in CRF(2) KO but not CRF(2) WT mice. Isolation housing significantly increased rearing behavior and altered spatial patterns of locomotor activity regardless of genotype., Conclusions: Loss of CRF(2) function increased sensitivity to the effects of chronic social isolation on exploratory locomotor behavior. Thus, CRF(2) activation appears to mitigate isolation rearing effects on exploratory behavior. Further research assessing the interaction between CRF(2) function and developmental challenges is warranted., (Published by Elsevier Ltd.)

Falls are common causes of hospitalisation in geriatrics. Over time they can become a major factor for admission to an institution. Supporting "fallers" requires specific, and in particular, multi-disciplinary care.

Post-weaning social isolation of rodents is used to model developmental stressors linked to neuropsychiatric disorders including schizophrenia as well as anxiety and mood disorders. Isolation rearing produces alterations in emotional memory and hippocampal neuropathology. Corticotropin releasing factor (CRF) signaling has recently been shown to be involved in behavioral effects of isolation rearing. Activation of the CRF(2) receptor is linked to stress-induced alterations in fear learning and may also be involved in long-term adaptation to stress. Here we tested the hypothesis that CRF(2) contributes to isolation rearing effects on emotional memory. At weaning, mice were housed either in groups of three or individually in standard mouse cages. In adulthood, isolation-reared mice exhibited significant reductions in context-specific, but not cue-specific, freezing. Isolation-reared mice exhibited no significant changes in locomotor exploration during brief exposure to a novel environment, suggesting that the reduced freezing in response to context cues was not due to activity confounds. Isolation rearing also disrupted context fear memory in mice with a CRF(2) gene null mutation, indicating that the CRF(2) receptor is not required for isolation effects on fear memory. Thus, isolation rearing disrupts hippocampal-dependent fear learning as indicated by consistent reductions in context-conditioned freezing in two separate cohorts of mice, and these effects are via a CRF(2)-independent mechanism. These findings may be clinically relevant because they suggest that isolation rearing in mice may be a useful model of developmental perturbations linked to disruptions in emotional memory in a variety of neuropsychiatric disorders.

Airport malaria is a particular form of autochthonous malaria: it happens when the Plasmodium infected Anopheles genus mosquito travels from an endemic area to a malaria free airport. Since 1969, 30 cases of airport malaria have been reported in France, 2 during summer 2008. The severity of airport malaria is explained by the frequency of Plasmodium falciparum infecting non immune individuals and an often important diagnosis delay. It is a compulsory notification disease in France. The International Health Regulations (IHR) require states to check that airplanes coming from malaria or arboviral endemic area are systematically disinsected. Vector control measures have to be implemented within a distance of at least 400 meters around the perimeter of airports in malaria or arboviral endemic areas. In France, this measure applies to all airports of French overseas territories, except for the island of Saint-Pierre and Miquelon.

Corticotropin-releasing factor (CRF) peptides and their receptors have crucial roles in behavioral and endocrine responses to stress. Dysregulation of CRF signaling has been linked to post-traumatic stress disorder, which is associated with increased startle reactivity in response to threat. Thus, understanding the mechanisms underlying CRF regulation of startle may identify pathways involved in this disorder. Here, we tested the hypothesis that both CRF1 and CRF2 receptors contribute to fear-induced increases in startle. Startle responses of wild type (WT) and mice with null mutations (knockout, KO) for CRF1 or CRF2 receptor genes were measured immediately after footshock (shock sensitization) or in the presence of cues previously associated with footshock (ie fear-potentiated startle, FPS). WT mice exhibited robust increases in startle immediately after footshock, which was dependent upon contextual cues. This effect was completely absent in CRF1 KO mice, and significantly attenuated in CRF2 KO mice. In contrast, CRF1 and CRF2 KO mice exhibited normal potentiation of startle by discrete conditioned cues. Blockade of both receptors via CRF1 receptor antagonist treatment in CRF2 KO mice also had no effect on FPS. These results support an additive model of CRF1 and CRF2 receptor activation effects on potentiated startle. These data also indicate that both CRF receptor subtypes contribute to contextual fear but are not required for discrete cued fear effects on startle reactivity. Thus, we suggest that either CRF1 or CRF2 could contribute to the increased startle observed in anxiety disorders with CRF system abnormalities.

Miglustat (OGT 918) is an iminosugar recently introduced in therapeutic as potential alternative therapy in disorders found in several diseases such as Tay-Sachs, Gaucher or Niemann-Pick diseases. A highly sensitive liquid-chromatography-electrospray tandem mass spectrometry (LC-MS/MS) assay was developed for the quantification of miglustat in human plasma and cerebrospinal fluid (CSF). The sample preparation consists in a simple protein precipitation with a mixture of acetonitrile/methanol (75/25) which yields 100% recovery. The isocratic separation utilizes an Atlantis Hilic (3 microm, 150 mm x 2.1 mm) column, with a mobile phase of acetonitrile/water/ammonium acetate buffer (75/10/15, v/v/v) delivered at 230 microl/min. Selected reaction monitoring (SRM) mode was used with the transitions m/z 220-->158 for the miglustat and m/z 208-->m/z 146 for the miglitol (internal standard). Good linearity was observed in a range from 125 to 2500 ng/ml and from 50 to 1000 ng/ml, for plasma and CSF, respectively. The within-run precision of the assay was less than 6%, and the between-run run precision was less than 6.5%, for six replicates at each of three concentrations and evaluated on three separated days for both plasma and CSF mediums. Assay accuracy was in the range of 98-106.5%. Stability of miglustat was reported under a variety of storage conditions. The miglustat concentrations in two children are presented to demonstrate the clinical interest of this new method.

Homogeneous, transparent, and mechanically rigid gels have been successfully synthesized in the tellurium isopropoxide-isopropanol-citric acid and water system. The sol to gel transition and the gels microstructure have been studied by using small angle X-ray scattering (SAXS) experiments. For any value of the two key synthesis parameters, which are the citric acid ratio and the alkoxide concentration, very small Te-rich elementary particles, about 1-1.5 nm in radius, form immediately when the water is added, leading to colloidal sols. During gelation, these elementary particles stick progressively together to build up fractal aggregates by a pure hierarchical aggregation process which has been identified as a reaction-limited cluster aggregation (RLCA) mechanism. The SAXS curve analysis, based on scaling concepts, shows that the gelling network exhibits a time and length scale invariant structure factor characterized by self-similarity. This self-similarity is also displayed for a wide range of chemical compositions and the gel microstructures only differ in their fractal aggregate size according to the tellurium isopropoxide concentration as well as the citric acid ratio.

It is shown that the onset temperature and the magnitude of thermal events observed during DSC analyses of alpha-lactose monohydrate can be strongly affected by various treatments such as ageing, manual grinding and preheating (cycle of preliminary dehydration and rehydration). In the case of grinding and preheating, the change of dehydration pathways was further investigated by using a suitable combination of characterization techniques, including X-ray powder diffraction (XRPD) performed with a synchrotron source (allowing an accurate Rietveld analysis), scanning electron microscopy (SEM), laser particle size measurements, FTIR spectroscopy and (1)H NMR for the determination of beta-lactose contents in samples. It appeared that the dehydration mechanism is affected not only by a smaller particle size distribution, but also by residual anisotropic lattice distortions and by the formation of surface defects or high energy surfaces. The fusion-recrystallization process occurring between anhydrous forms of alpha-lactose at ca. 170 degrees C is not significantly affected by grinding, whereas a preheating treatment induces an unexpected large increase of the enthalpy associated with this transition. Our observations and interpretations confirm the important role of water molecules in the crystal cohesion of the title compound and illustrate the necessity to consider the history of each sample for a satisfactory understanding of the physical properties and the behaviour of this important pharmaceutical excipient.

The optical rotation sign/absolute configuration relationships of several alpha-methyl-alpha-arylglycines have been reinvestigated by crystallographic methods, as they have been found to be inconsistent in recent literature. Assignments previously made by enzymatic resolution, by analogy with natural tertiary aminoacids were found to be erroneous in the case of these quaternary aminoacids.

In beech (Fagus sylvatica L.), the number of leaf primordia preformed in the buds determines the length and the type (long versus short) of annual growth units, and thus, branch growth and architecture. We analyzed the correlation between the number of leaf primordia and the hydraulic conductance of the vascular system connected to the buds. Terminal buds of short growth units and axillary buds of long growth units on lower branches of mature trees were examined. Buds with less than four and more than five leaf primordia formed short and long growth units, respectively. Irrespective of the type of growth unit the bud was formed on, the occurrence of a large number of leaf primordia was associated with high xylem hydraulic conductance. Xylem conductance was correlated to the area of the outermost annual ring. These results suggest that organogenesis and primary growth in buds correlates with secondary growth of the growth units and thus with their hydraulic architecture. Possible causal relationships between the variables are discussed.

Despite important health benefits, the presence of depressive symptoms may decrease the prevalence of breastfeeding. The current study assessed the relationship between depressive symptoms and breastfeeding at 6 and 12 weeks postpartum. Participants were recruited from a cohort completing a clinical trial of calcium for prevention of preeclampsia. At 6 weeks postpartum, the Edinburgh Postnatal Depression Scale (EPDS) was completed by mail. At 12 weeks postpartum, the EPDS was completed at an outpatient visit. There was an inverse relationship between depressive symptoms and breastfeeding at 6 weeks postpartum (P<.001) but not at 12 weeks. This relationship persisted even after controlling for prior history of depression, increased life stress, and current psychoactive medication. The results suggest that depressive symptoms early in the postpartum period may lower the prevalence of breastfeeding.

Variability of leaf traits related to photosynthesis was assessed in seedlings from 14 tree species growing in the tropical rain forest of French Guiana. Leaf photosynthetic capacity (maximum rate of carboxylation and maximum rate of electron transport) was estimated by fitting a biochemical model of photosynthesis to response curves of net CO2 assimilation rate versus intercellular CO2 mole fraction. Leaf morphology described by leaf mass per unit leaf area (LMA), density and thickness, as well as area- and mass-based nitrogen (N) and carbon (C) concentrations, were recorded on the same leaves. Large interspecific variability was detected in photosynthetic capacity as well as in leaf structure and leaf N and C concentrations. No correlation was found between leaf thickness and density. The correlations between area- and mass-based leaf N concentration and photosynthetic capacity were poor. Conversely, the species differed greatly in relative N allocation to carboxylation and bioenergetics. Principal component analysis (PCA) revealed that, of the recorded traits, only the computed fraction of total leaf N invested in photosynthesis was tightly correlated to photosynthetic capacity. We also used PCA to test to what extent species with similar shade tolerances displayed converging leaf traits related to photosynthesis. No clear-cut ranking could be detected among the shade-tolerant groups, as confirmed by a one-way ANOVA. We conclude that the large interspecific diversity in photosynthetic capacity was mostly explained by differences in the relative allocation of N to photosynthesis and not by leaf N concentration, and that leaf traits related to photosynthetic capacity did not discriminate shade-tolerance ranking of these tropical tree species.

A selective, efficient, and fast access to (Z,E)-2,7-bis(4-cyanobenzylidene)cycloheptan-1-one (BCBCH), precursor of the synthetic antagonist of tissue-plasminogen activator (t-PA), is reported using a solid/solid aldolisation-crotonisation reaction on a supramolecular complex under microwave irradiation. The underlying mechanism is investigated from the crystal structure of the intermediate host-guest complex formed between permethylated gamma-cyclodextrin and (Z)-2-(4-cyanobenzylidene)cycloheptan-1-one.

Background: The current study examined the relationship between calcium supplementation during pregnancy and blood pressure (BP) in the mother and offspring at 3 months and at 2 years postpartum., Methods: Nulliparous pregnant women were assigned to either receive 2 g of calcium or placebo daily beginning between weeks 13 to 21 of gestation and continuing until delivery. Blood pressure was measured in children and their mothers at 3 months (n = 260) and (n = 57) at 2 years postpartum. Systolic BP was measured in the infants using a sphygmomanometer with ultrasonic amplification. For the toddlers, three supine BP measurements were taken from the right arm using a Critikon automated sphygmomanometer just after measurement of left ventricular wall thickness., Results: Systolic BP in the calcium-supplemented infants was 2.2 mm Hg lower than in the placebo group (P >.05). At 2 years of age, systolic BP was 4.8 mm Hg lower in the calcium supplemented group (P <.05), whereas diastolic BP was 3 mm Hg lower (P >.05). There was no difference in left ventricular mass index between groups, although there was a significant correlation between systolic BP and wall thickness (P <.05). Maternal BP was positively correlated with circulating 1,25(OH)(2)D3 (P <.001) but did not differ between calcium groups at 3 months postpartum., Conclusions: The data on BP in the children are in agreement with previous studies and argue strongly for additional research into the effects of prenatal calcium supplementation on BP regulation in the offspring.

Objectives: To quantify the morphologic changes of temporopolar structures to better understand the pathophysiology of anterior temporal white matter increased T2 signal observed in temporal lobe epilepsy (TLE)., Methods: MRI was performed in 30 patients with TLE and in 30 normal control subjects and independently assessed by visual analysis and quantitative measurements. Specifically, the temporal pole (TP) volume, as well as its gray and white matter components, was measured using three-dimensional T1 MR images and a semiautomatic protocol. The authors tested whether the presence of an increased T2-weighted signal in the anterior temporal white matter was associated with significant TP atrophy. The associations between the TP volume and MRI signs of hippocampal sclerosis, age at onset, seizure frequency, duration of illness, and a history of febrile convulsions were also studied., Results: Both right and left TLE populations demonstrated a reduction of the temporopolar white and gray matter volumes ipsilateral to seizure onset (p < 0.02 in right TLE; p < 0.0001 in left TLE). Twenty-two patients (72%) exhibited significantly abnormal TP volume measurements, which correctly lateralized the epileptogenic zone in all cases. The presence of an increased T2-weighted signal in the anterior temporal white matter (ISWM), but not that of hippocampal sclerosis, was associated with a greater TP volume asymmetry index (p < 0.05)., Conclusions: The temporal pole is frequently atrophic ipsilateral to seizure onset in refractory TLE. The association between TP atrophy and ISWM suggests that both abnormalities might derive from a common pathologic process.

We report the results of 105 intracortical electrical stimulations of the temporo-polar cortex performed in 30 patients during stereo-electroencephalography (SEEG) investigation of drug-resistant temporal lobe epilepsy. Clinical responses were elicited in 50% of the patients during 26 of the 105 stimulations. Responses are coherent with data found in the literature with mostly psychic, viscero-sensitive, autonomic and viscero-motor phenomena being elicited. Nearly all responses were evoked by stimulation of the antero-medial part of the temporo-polar cortex whereas only once was a clinical response elicited during stimulation of the lateral part of the temporo-polar cortex. Induced auras were more frequently reported when there was an afterdischarge associated to the clinical response (60 and 75% of the stimulation followed by a localized or a diffusing after-discharge, respectively) then when there wasn't any after-discharge following stimulation. The clinical responses evoked during stimulation of the temporo-polar cortex only have a limited topographic specificity since they closely resemble symptoms elicited by stimulation of other limbic or paralimbic areas. Nonetheless these results do suggest that the antero-medial part of the temporo-polar cortex is included in the symptomatogenic zone in so-called "temporo-limbic" epilepsies.

Magnetic resonance imaging (MRI) demonstrates an abnormal aspect of the temporo-polar region in 1/3 to 2/3 of patients suffering from cryptogenic temporal lobe epilepsy. This abnormal aspect is described as a white matter increased T2 signal, resulting in a loss of gray-white matter demarcation, often associated with atrophy, as recently confirmed by quantitative volumetric measurements. These temporo-polar MRI findings appear to correctly lateralize the epileptogenic temporal lobe with a very high specificity, and have never been reported in extra-temporal lobe epilepsy nor in control subjects. They are usually associated with MRI signs of hippocampal sclerosis, but the two conditions seem to be partly distinct from a pathophysiological point of view. Pathological correlates of temporo-polar white matter increased T2 signal are controversial, but the role of an abnormal myelin seems more likely than that of ectopic neurons. A myelin dysfunction would also be consistent with the correlation observed between lateral temporal hypometabolism and temporo-polar MRI abnormalities. Whether or not these MRI findings are associated with a better seizure outcome following temporal lobectomy remains a debated issue.

A 36-year-old woman presented acute polyradiculoneuropathy following Chlamydia pneumoniae infection. Although electrophysiologic studies were normal, clinical features were typical of Guillain-Barré syndrome (GBS). Anti-ganglioside GM1 antibodies were positive. Two other cases of GBS following Chlamydia pneumoniae infection have been reported, but no specific feature emerges. Outcome was good in our patient after intravenous globulin then antibiotic therapy. Our case supports the notion that Chlamydia pneumoniae infection can induce GBS. The association is probably underestimated.

Ground studies indicate that spaceflight may diminish vascular contraction. To examine that possibility, vascular function was measured in spontaneously hypertensive rats immediately after an 18-day shuttle flight. Isolated mesenteric resistance arterial responses to cumulative additions of norepinephrine, acetylcholine, and sodium nitroprusside were measured using wire myography within 17 h of landing. After flight, maximal contraction to norepinephrine was attenuated (P < 0.001) as was relaxation to acetylcholine (P < 0.001) and sodium nitroprusside (P < 0.05). At high concentrations, acetylcholine caused vascular contraction in vessels from flight animals but not in vessels from vivarium control animals (P < 0.05). The results are consistent with data from ground studies and indicate that spaceflight causes both endothelial-dependent and endothelial-independent alterations in vascular function. The resulting decrement in vascular function may contribute to orthostatic intolerance after spaceflight.

To determine the influence of dietary calcium on spaceflight-induced alterations in calcium metabolism and blood pressure (BP), 9-wk-old spontaneously hypertensive rats, fed either high- (2%) or low-calcium (0.02%) diets, were flown on an 18-day shuttle flight. On landing, flight animals had increased ionized calcium (P < 0.001), elevated parathyroid hormone levels (P < 0.001), reduced calcitonin levels (P < 0.05), unchanged 1,25(OH)(2)D(3) levels, and elevated skull (P < 0.01) and reduced femur bone mineral density. Basal and thrombin-stimulated platelet free calcium (intracellular calcium concentration) were also reduced (P < 0.05). There was a tendency for indirect systolic BP to be reduced in conscious flight animals (P = 0.057). However, mean arterial pressure was elevated (P < 0.001) after anesthesia. Dietary calcium altered all aspects of calcium metabolism (P < 0.001), as well as BP (P < 0.001), but the only interaction with flight was a relatively greater increase in ionized calcium in flight animals fed low- compared with high-calcium diets (P < 0.05). The results indicate that 1) flight-induced disruptions of calcium metabolism are relatively impervious to dietary calcium in the short term, 2) increased ionized calcium did not normalize low-calcium-induced elevations of BP, and 3) parathyroid hormone was paradoxically increased in the high-calcium-fed flight animals after landing.

We report on a case of Hodgkin's disease, revealed in a 52 year-old woman by isolated neurological signs. Sciatica is an uncommon pattern of discovery that is particularly misleading. It may lead to a delayed diagnosis all the more prejudicial since it discloses an advanced stage of the disease. The neurological involvement is always associated with a bone lesion. This latter can be discovered at an early stage through magnetic resonance imaging.