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Triage nurses are important in pain management and in early relief of pain among patients admitted to the emergency department (ED).To assess a new nurse-initiated pain management protocol, without the requirement for medical prescription, wich was implemented in October 2016 for patients with moderate or severe pain in the ED. It allows the administration of oral acetaminophen and oral oxycodone chlorydrate during the first evaluation of the patient by a nurse and eliminates the use of codeine or tramadol.We conducted a comparative, single-center, retrospective study that looked at the outcomes of a new nursing protocol for patients aged ≥16 years with moderate to severe pain. The primary outcome was the percentage of increase of analgesics delivered by the nurse.A total of 756 patients were included: 377 before and 379 after protocol implementation. Oral analgesic use on admission increased from 44.3% to 57.8% (p .001), and from 50.2% to 76.6% among patients with severe pain (p .001). Strong opioid analgesic administration increased from 2.1% to 41.2%. This increase was also observed among those with moderate pain (1.4% to 13.3%; p .001) and those with severe pain (2.6% to 62.6%; p .001). Analgesic prescriptions added by the clinician decreased from 28.6% to 21.4% (p = .028).We observed an increase in analgesic administration after the implementation of a new nurse-initiated pain treatment protocol, especially an increase in oral opioid analgesics, for patients with moderate to severe pain.

Background Although mortality due to acute heart failure has decreased, its prevalence in France is still high. The aim of this study was to examine the quality of acute heart failure treatment in French emergency departments (EDs) with reference to subsequently published European Society of Cardiology (ESC) recommendations. Methods The medical records of patients with acute pulmonary oedema (as a marker for acute heart failure) admitted to the EDs of 11 French hospitals in 2013 were reviewed retrospectively. Results A total of 834 patients were included (median [interquartile range] age 84 [78–89] years; 48.6% male). Rates of compliance of initial management in 2013 to subsequently published 2015 recommendations were as follows: (1) thoracic ultrasound was performed in 17.3%; (2) loop diuretics were given in 75.9%; at a correct dose (among those for whom this was calculable) in 40.0% (3); intravenous nitrates were given in 21.7% of patients with systolic blood pressure > 110 mmHg; (4) non-invasive ventilation was initiated in 22.0% of patients with respiratory distress. Discharge summaries most often lacked a scheduled cardiologist follow-up (89.4%) and discharge patient weight (78.9%). Conclusions The early management of patients with acute pulmonary oedema (as a marker of acute heart failure) in France in 2013 was quite different to recommendations published in 2015. A programme to implement the new recommendations is in place, and a repeat evaluation will be conducted in 2017.

Resume La prise en charge des patients porteurs d’une embolie pulmonaire diagnostiquee aux urgences depend du risque de mortalite precoce. Une prise en charge ambulatoire est envisageable chez les patients a faible risque. Nous presentons ici les differents scores de risque existants, et la strategie proposee par le reseau Nord-Alpin des urgences, qui utilise le score PESI (Pulmonary Embolism Severity Index) dans sa version simplifiee pour selectionner les patients a bas risque, candidats a une prise en charge ambulatoire.

Supplemental Digital Content is available in the text, In France, one in eight patients with acute ST-segment elevation myocardial infarction (STEMI) is admitted direct to an emergency department (ED) in a hospital without percutaneous coronary intervention (PCI) facilities. Guidelines recommend transfer to a PCI center, with a door-in to door-out (DI–DO) time of ≤30 min. We report DI–DO times and identify the main factors affecting them. RESURCOR is a French Northern Alps registry of patients with STEMI of

Background In 2015, the European Society of cardiology published guidelines on the pre-hospital and early hospital management of acute cardiac failure (ACF), which included: – use of intravenous vasodilators (nitrates) when systolic blood pressure is > 110 mmHg; – non-invasive ventilation if oxygen saturation is 25/min despite nasal oxygen; – using a reduced dose of intravenous furosemide (20–40 mg or equivalent of the oral morning dose if already on chronic diuretic therapy) and; – early performance of echocardiography. We sought to compare the gap between these recommendations and clinical practices in French emergency departments (EDs). Methods We undertook a retrospective evaluation of clinical practices in 834 consecutive patients with ACF admitted in 2013 to the EDs of 16 French hospitals. Data, including patient characteristics and practices were collected from the medical records. Results Patients’ mean ± standard deviation age was 82 ± 10 years and 49% were men. Clinical practices in relation to the guideline recommendations are shown in the Table 1 . Conclusions These initial data which precede publication of the current guidelines, show that use of nitrates, non-invasive ventilation, reduced diuretic dose and early echocardiography were relatively infrequent at the first point of medical care for patients presenting with ACF. These findings indicate the need for a sizable shift in practice in order to meet the new guideline recommendations. We will conduct a repeat evaluation in 2016, after implementation of a programme aimed to improve practices at these sites.

In the emergency department, the management of patients with pulmonary embolism depends on the early mortality risk. Outpatient care is possible in low-risk patients. We present the existing scores and the strategy proposed by the North Alps Emergency Network, which uses the simplified PESI score (Pulmonary Embolism Severity Index) to select those low-risk patients, candidates for early discharge.

Summary Different studies performed in rodents revealed that Bisphenol-A (BPA), an environmental compound, altered early embryonic development. However, little is known concerning the direct effects of BPA on human implantation process. Thus, we decided to study in vitro BPA's effects on proliferative capacities of the human trophoblastic cell line, JEG-3. For this purpose, we first have shown that JEG-3 cells express the specific BPA receptor, namely estrogen-related receptor γ1 (ERRγ1). Secondly, once the non-toxic effect of BPA on JEG-3 cell viability was verified, [3H]-thymidine incorporation experiments were performed and revealed that BPA significantly reduced cell proliferation. The results also showed that BPA induced JEG-3 apoptosis as reflected by DNA fragmentation experiments. In conclusion, we describe here the direct impact of BPA on trophoblastic cell number mediated through both antiproliferative and proapoptotic effects and could then participate in the impact of BPA on placental development.

The objective of the review is to provide fundamental knowledge on the chemical composition and structural characteristics of flax fibres. These are long and multinucleate cells without septum or partition (average length 2–5 cm) and have a secondary wall of very large thickness (5–15 μm). Fibres are gathered in bundles of one to three dozen cells that encircle the vascular cylinder. The bundle cohesion is insured by pectins, accumulating in the primary wall and cell junctions. In contrast, lignin, which is present in very low amount, does not seem to play a major role in bundle cohesion. At maturity, secondary wall is characterised by (i) a high level of cellulose with microfibrils locked into an almost axial direction and (ii) 5–15% non-cellulosic polysaccharides (NCPs). The chemical composition of NCPs depends on growth stage, indicating important cell wall remodelling, fibre position and variety. Despite the large disparity of the results reported in the literature, galactose appears to be the predominant sugar of NCPs, and β-1-4-galactan together with rhamnogalacturonan of type I (RG-I) and polygalacturonic acid (PGA) become, with fibre maturity, the most abundant tightly bound NCPs. Glycine-rich proteins (GRPs) and arabinogalactan-proteins (AGPs), also present in flax fibres, are both characterised by appreciable levels of glycine and acidic amino acid and are deficient in hydroxyproline, and may contribute to the cross-linking of pectins. (Galacto)glucomanans/glucans rather than xylans consist of cross-linking polymers in fibre secondary wall. A model is proposed where cellulose microfibrils, tethered by cross-linking (galacto)glucomanans/glucans, are embedded in a pectic matrix.

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Well-characterized pectin samples with a wide range of degrees of esterification (39–74%) were incubated with the solubilized pure α and γ isoforms of pectinmethylesterase, from mung bean hypocotyl (Vigna radiata). Enzyme activity was determined at regular intervals along the deesterification pathway at pH 5.6 and pH 7.6. It has been demonstrated that the distribution of the carboxyl units along the pectin backbone controls the activity of the cell wall pectinmethylesterases to a much greater extent than the methylation degree, with a random distribution leading to the strongest activity. Polygalacturonic acid was shown to be a competitive inhibitor of the α isoform activity at pH 5.6 and to inhibit the γ isoform activity at both pH 5.6 and pH 7.6. Under these conditions, the drop in enzyme activity was shown to be correlated to the formation of deesterified blocks of 19 ± 1 galacturonic acid residues through simulations of the enzymatic digestion according to the mechanisms established previously (Catoire, L., Pierron, M., Morvan, C., Herve du Penhoat, C., and Goldberg, R. (1998) J. Biol. Chem.273, 33150–33156). However, even in the absence of inhibition by the reaction product, activity dropped to negligible levels long before the substrate had been totally deesterified. Comparison of α and γ isoform cDNAs suggests that the N-terminal region of catalytic domains might explain their subtle differences in activity revealed in this study. The role of pectinmethylesterase in the cell wall stiffening process along the growth gradient is discussed.

To study the in vitro release of PRL isoforms, anterior pituitary glands from medium white turkeys at various physiological stages were stimulated by cVIP in a perifusion system. Pituitaries were cut into hemi-pituitaries after collection and placed into separate perifusion chambers. Medium (M199) was continuously perifused through the system and pituitaries were stimulated with cVIP (10 −7 M). Total PRL content was monitored by RIA and, the ratio of immunoreactive PRL isoforms in the perifusate was estimated by Western blotting. After exposure to X-ray film for autoradiography, the relative intensity of the bands was analyzed by densitometry. All the perifused pituitaries responded to cVIP stimulation by increasing the release of PRL. Two immunoreactive bands with relative molecular weights of 24 and 27 kDa were detected by Western blotting. The immunoreactive band corresponding to the glycosylated isoforms of PRL (27 kDa) was predominant in samples from egg-laying and incubating hens and the band corresponding to the nonglycosylated isoform (24 kDa) was predominant in samples from out-of-lay and molting stages. No changes in the ratio of isoform released were detected during cVIP stimulation. Our data clearly show that glycosylated and nonglycosylated PRL isoforms are released by the pituitary gland in vitro in the same relative proportion that was previously observed in pituitary extracts and thus are likely to reflect the secreted forms of PRL in the blood during various physiological stages. In addition, the PRL-releasing activity of VIP does not affect the ratio of isoforms secreted by the pituitary gland in vitro .

1. The proportion of patients coming for cast versus shoe brace has changed over the time but the work organisation did not follow this evolution 2. The clinic cannot meet all the needs of the population. In Nov 2013, there were 50 patients on the waiting list. Therefore the clinic does not advertise and works in relative isolation 3. For security and financial reasons access to services remains difficult for the patients 4. Physiotherapist compliancewith Ponseti protocol of treatment is good but the provision and quality of shoe braces is not satisfactory 5. Collection of data is good but not routinely analysed 6. Clinic services are not evaluated on regular basis which hampers proper monitoring 7. Patient feed-back has never been recorded.

The activity of pectin methyltransferases (PMT) from endomembranes of flax cells (Linum usitatissimum L.) was enhanced in the presence of exogenous pectins. The value of optimal pH increased from 5.5 to 7.0 with the degree of methylesterification (DE from 0.00 to 0.50) of pectins. We showed, using size exclusion chromatography, that methylesterification had principally occurred onto exogenous pectins. PMT activity, measured in vitro at pH 7.0 and in the presence of highly methylated pectins, was maximum when tested during the fast growth-phase of cells. In contrast, a major peak occurred at pH 5.5 in the presence of lowmethylated pectins over the maturation phase. Two successive sucrose-gradient centrifugations led to the fractionation of low-density membranes (density 1.08) with PMT activity only detected at pH 5.5 and in the presence of lowmethylated pectins (DE 0.10). On the other hand, membranes of density 1.12-1.14 were enriched in PMT with a maximum of activity that happened at pH 7.0 and in the presence of highly methylated pectins (DE 0.50). These experiments indicated two types of pectin methyltransferase activities. However, their apparent A"m(s) for the donor of methyl, S-adenosyl methionine (about 20 //M), and for the pectic substrate (1 mM galacturonic acid or 0.25 mg ml" 1 ) were similar.

The present study aimed at analyzing the structural features of seed mucilage and cell-wall polysaccharides which accounted for 41% of the mass of flax meal (FM). A combination of high molar-mass mucilage-like polysaccharides (rhamnogalacturonan and arabinoxylan) was released from FM in water, together with arabinogalactan proteins and glucans. About half of FM homogalacturonans was extracted using a calcium chelator and boiling water. Hemicellulosic xyloglucans and xylans were further extracted with 1M KOH, in ∼13% FM-sugars yield. Structural characterization of the xyloglucan using specific enzyme hydrolysis, ion exchange chromatography (HPAEC) and matrix assisted laser desorption ionization-time-of-flight (MALDI-TOF) mass spectroscopy showed the presence of XXXG type xyloglucan, but also that of XXGG-structure, possibly characteristic of flax seeds. Hydrolysis of xylans with endo-(1→4)-β-D-xylanase, and analysis of the neutral and acidic oligosaccharides by MALDI-TOF-MS showed that xylan consisted of β-(1→4)-linked-D-xylopyranose backbone with some zones (DP 5-7) substituted with 4-O-MeGlcA\GlcA\Glc residues.

With a view to investigating the role of encapsulation of indomethacin within modified β-cyclodextrin (βCD-C6) nanocapsules, we prepared nanocapsules with indomethacin as a model drug. These particles had an average size of 194 nm and encapsulated approximately 99% of indomethacin. The encapsulation of indomethacin within orally administered βCD-C6 nanocapsules protected against both gastric and intestinal ulceration is compared with an oral administration of an aqueous solution of Indocid®. The relative bioavailability was also increased by this encapsulation.

Background Many patients with acute ST-segment elevation myocardial infarction (STEMI) are admitted to emergency departments (EDs) of centres without percutaneous coronary intervention (PCI) facilities. The 2012 European Society of Cardiology guidelines recommend transfer to a PCI centre with a “door in - door out” (DI-DO) time ≤ 30 min. Purpose To report DI-DO times in a registry of patients with acute STEMI. Methods The RESeau des Urgences CORonarienne (RESUCOR) is a permanent registry of patients admitted with acute STEMI in 16 hospitals in the north French Alps since 2002. In patients admitted to a non-PCI centre, the DI-DO times were split into “diagnostic time” (from admission to transfer decision) and “logistical time” (from transfer decision to discharge). Results Of 2081 patients included in the registry from 2012 to 2014, 493 were admitted directly into an ED (254 PCI centre and 239 non-PCI centre). Of those admitted into an ED of a non-PCI centre, 228 were immediately transferred to a PCI centre (76 treated with thrombolysis and 132 with primary PCI). The proportions of patients with DI-DO ≤ 30 min and median (interquartile range [IQR]) DI-DO times are reported in the Table 1 . Median (IQR) DIDO times were 90.5 (69–118) min for patients treated with thrombolysis and 88 (62–147) min for primary PCI. Conclusions DI-DO times were longer than recommended. Efforts to decrease these delays are required. Transfer with a non-PCI centre ambulance is preferable.

Successive extraction of mechanically-isolated flax fibres with ethylene-diaminetetraacetic acid partially neutralized with NAOH EDTA-Na 2 and NaOH solubilized about 25% of the mass of fibres. The cation exchange capacity (CEC) of the fibres decreased from 0.100 ± 0.025 meq g −1 to 0.035 ± 0.015 meq g −1 after EDTA-Na2 extraction and then was reduced to virtually nil by extraction with NaOH. This final reduction in CEC by alkali was accompanied by the extraction of small charge molecules, notably phenolic acids. These may influence the binding selectivity of the fibre towards monovalent cations. Polymers solubilized by this extraction procedure included two main types of galactans; the first type consisted of β-1→4 galactans attached to a rhamnogalacturonan I-like polymer and the second type was β-1→3, β-1→6 linked galactans attached to proteins in some unknown manner. In addition, some β-1→3 glucan, β-1→4 glucan and glucomannan-like polymers were detected.

Polymers extracted with CDTA-Na2 (trans-diaminocyclohexane-a-tetra-acetic acid partially neutralized with NaOH) after a boiling water treatment from cell walls of 3-day-old seedlings of flax, germinated on water and in darkness, contained three main components: (1) rhamnogalacturonan I (RG-I)-like polymers with ratios of rhamnose to galacturonic acid which increased with their molecular mass; (2) neutral polysaccharides including galactans as well as arabinans; and (3) galacturonic-acid enriched polymers. High degrees of acetylation were estimated for most of the rhamnogalacturonans but a minor RG-I-like fraction with a ratio of rhamnose to galacturonic acid of unity was acetylated (29%) as well as methylesterified (40%). However, the calcium activity coefficients of the fractionated polymers measured in solution were quite high which implies that these polyelectrolytes did not behave like linear ones. These polymers which reacted in solution as well as in situ not only with ruthenium red but also with ferric hydroxylamine, and which contained large amounts of acetylated RG-I-like blocks might be considered as early markers of the differentiation of the cellulosic fibre cells in flax.

Summary Cotyledonary protoplasts of two French fibre flax ( Linum usitatissimum ) cultivars (Ariane and Viking) were isolated and cultured. The optimal conditions for high yield were from 4-5 day old seedlings, where 6-6.5x10 6 and 6.7-7.4x10 6 protoplasts were released from cv. Ariane and cv. Viking respectively. Culture in glutamine (20mM) containing medium led to first divisions after 2 days with an efficiency of 19% or 21.9% (cv. Ariane) and 49.3% or 44% (cv. Viking) of divided cells, when plating densities were 10 5 versus 5 x 10 4 protoplasts per mL. Rhizogenesis occurred on protoplast derived calli at high frequency 4 weeks after transfer onto solid medium supplemented with 0.5 μM 2.4 dichlorophenoxyacetic acid. Variations of cell wall sugar composition during culture on inducing and non-inducing media expressed some significant differences. The percentage of galacturonic acid increased on non-inducing medium, but remained constant on root-inducing medium. Glucose presented a peak of accumulation concomitant of the emergence of the root meristems 4 weeks after transfer onto 2,4-D containing medium. On the contrary galactose and arabinose variations were not characteristic of the rhizogenic process.

Physicochemical and enzymic approaches were used to characterize highly methylated pectins isolated from mung bean hypocotyl cell walls. Young cell walls were particularly rich in rhamnogalacturonan-1-like polysaccharides, the galacturonic units of which might be fully methylated. Short, smooth, homogalacturonan blocks separated these hairy regions. The homogalacturonans included acidic and highly methylated blocks, the structures of which have been investigated through computer simulations. Such complex carbohydrates were also detected in the older parts of the hypocotyls but to a lesser extent. Mature cells were characterized by the presence of pure, sparsely methylated homogalacturonan with randomly distributed methyl groups.

Genetic variation at eight polymorphic enzyme loci was investigated in 13 populations of the scallop Pecten maximus (L.) from a number of sites in Scotland, UK and Brittany, France. Two of the populations had initially been transplanted, as spat, to Brittany from Scottish and Irish collection sites. In common with other studies of marine bivalves, an overall deficiency of heterozygotes was observed, but genotype frequencies of transplanted populations were generally in agreement with the Hardy-Weinberg model indicating little post-transplant selection. There was high genetic similarity among all the populations surveyed and no overall differences between the Scottish and Brittany samples. The results are discussed in relation to contrasting evidence, derived from studies on the reproductive cycle of P. maximus and the genetics of Aequipecten (Chlamys) opercularis (L.), which suggests that the Scottish and Brittany scallop populations are, nevertheless, genetically distinct.

Cell walls of Linum usitatissimum calli exhibited ca 1 μkat g−1 of pectin methylesterase activity (EC 3.1.1.11). Ion exchange and size exclusion chromatography gave three active fractions. The major one, representing 20% of the initial activity, with a chromatographic Mr of 100 000, and a SDS-PAGE one of 43 000 consisted of three isoforms with pIs of 5.5, 7.3 and 7.8, respectively. The second fraction, 3.5% of the initial activity, had a chromatographic Mr of 110 000, and was separated into five isoforms with pIs of 5.5, 7, 7.3, 7.8 and 8.8. The minor active fraction, 1 % of the initial activity, revealed one isoform (pI close to 10) but was contaminated with non-active proteins. The major active fraction had a Km of 0.147 mg ml−1 for a specific activity of 3.3 mkat g−1 and a complex behaviour in the presence of NaCl.

An endo-polygalacturonase was purified from a commercial preparation of Aspergillus by cation exchange and size exclusion chromatographies. It degraded a polysaccharide extracted from under-retted flax into three general size classes. The first product was a polysaccharide of high molecular weight (close to 100 000), enriched in galactose and characterized by a ratio of galacturonic acid:rhamnose 2:1. The second product was an acidic polysaccharide (the molecular weight of which was close to 10 000) enriched in glucose and rhamnose, which reacted little with the usual colorimetric methods for uronic acids and gave a negative circular dicroism bond. The last and major products were oligomers rich in galacturonic acids.

Efficacy and safety of an alpha-tocopherol-enriched emulsion incorporating soybean, coconut, olive, and fish oils (SMOF) are compared in terms of biologic parameters to those of soybean oil-based emulsion (LIPOVEN).Twenty stressed patients were randomly assigned in a double-blind study to receive at least a 5-day course of total parenteral nutrition. Plasma activities of liver enzymes, C-reactive protein, antioxidant capacity, alpha-tocopherol, retinol, and low density lipoprotein (LDL)-alpha-tocopherol levels were determined. LDL-lipid oxidation is measured after incubation of the LDL in the presence of a prooxidant.The plasma activities of liver enzymes and the phospholipids/apo A1 ratio were increased in both groups. However, in the SMOF group the increases were lower than in the LIPOVEN group and non-significant for the CRP plasma level and the alanineamino-transferase activity. Before parenteral nutrition, the plasma antioxidant status was markedly reduced in both groups. After parenteral nutrition discontinuation, the antioxidant capacity and the amount of LDL-derived oxidation by-products formed were comparable in both groups. There was a significant improvement in plasma lipophilic antioxidant vitamins and LDL-alpha-tocopherol levels only in the SMOF group.The lower increase of plasma liver enzymes and phospholipids/apo A1 ratio in the SMOF group suggest a better liver function than in the LIPOVEN group. This beneficial effect results in a higher liver mobilization and plasma levels of lipophilic antioxidants. They could, together with higher delivery of omega-3 fatty acids to peripheral tissues, contribute positively to survival rate of stressed patients.

The Lupme3 flax (Linum usitatissimum) gene encodes a putative pectin methylesterase (PME). A cDNA was generated by RACE-PCR using two consensus sequences to generate primers. PMEs are encoded by numerous genes (more than 60 ORFs in Arabidopsis contain PME consensus sequences) and little information is available on their expression regulation, and the role of the different isoforms in the plant, except for those that are active in fruits.

The Arabidopsis thaliana sam1 gene encoding S-adenosylmethionine synthetase (EC 2.5.1.6) was transferred to flax (Linum usitatissimum) cells via Agrobacterium tumefaciens. This enzyme catalyses the conversion of methionine to S-adenosylmethionine (SAM), the major methyl group donor in living cells. The aim of this work was to study the consequences of an increased SAM-synthetase (SAM-S) activity in transgenic cell lines on both the production of mono- and dimethoxylated lignin monomers and the degree of methylesterification of pectins. Hypocotyls were cocultivated with Agrobacterium tumefaciens strain GV3101 (pGV2260) harbouring the pO35SSAM binary vector carrying the sam1 gene under the control of the 35S promoter and the nptII gene for selection of putative transformed cells. Most of the transgenic cell lines exhibited a significant (up to 3.2-fold) increase in SAM-S activity compared to the controls. The results showed that for the cell lines analysed this transformation had no effect on caffeic acid O-methyltransferase (COMT, EC 2.1.1.68) in vitro activity, degree of methoxylation of lignin precursors or lignin deposition, pectin methyltransferase (PMT, EC 2.1.1) in vitro activity, but led to an increase of pectin methylesterification in friable and fast-growing transgenic cell lines.

The sleep analysis and scoring program WSCORE was developed under the European Neurological Network (ENN) project. The purpose was to implement an analysis and scoring system for ambulatory and standard polysomnography. In addition to visual RechtschaffenKales scoring the program offers a possibility of free form visual scoring. It contains also analysis modules for Periodic Leg Movement Disorder, Hjort parameters, heart rate and EMG amplitude. A FTP client module was built into the program so that it can be used as a telemedicine application.

Sleep laboratory have long waiting lists due to the high prevalence of sleep disorders and the low availability of centers. One possibility for improving patient care is an ambulatory recording at home or in a distributed center. Then the data recorded must be transferred for analysis in the specialized center. Similarly, an application is needed for the transfer of raw data when the recordings are made by a health care provider sending sleep technologists to set-up the equipment in the patient's home. It is ethically preferable that the analysis be made by a physician from an independent organization from the provider to avoid any conflict of commercial interest with the provider whose main purpose is delivering therapeutic equipment (CPAP, oxygen...). The objectives were to set-up and test the transfer of sleep data files by ISDN lines between a health care provider and an expert sleep center. The application had to take into account a wide geographical dispersion of patients, general practitioners and medical experts. For that reason, it was decided to use existing Internet Web technology to facilitate portability and interoperability, reduce design time and costs and speed up deployment. The healthcare provider is the collecting site of ambulatory sleep recordings performed at the patient's home by the sleep technician of the provider. The raw data are sent to the sleep center for expert analysis. The methods used were: a PC set-up with a Gazel pro 2B PCI board, a commercially available file transfer software (DT Winstutel from ORSENNA) and an ISDN connection at 128 Kbps. The transfer security needs a set-up to maintain the confidentiality of the personal data transmitted: this is ensured through an identification sequence with several encrypted passwords. The duration of the transfer between Paris and Clamart has been tested for a 44 Moctets file: it took 66 min instead of a theoretical duration of 50 min. This difference was explained by a slower transfer rate (93 Kbps) instead of 128 Kbps. The cost of the transfer has been estimated at 5.4 Euro. This cost can be reduced by subscribing higher transfer tariffs. It amounts to 4.5% of the total cost of the ambulatory procedure at a value of 0.12 Euro per Moctet.

Well-characterized pectin samples with a wide range of degrees of esterification (39-74%) were incubated with the solubilized pure alpha and gamma isoforms of pectinmethylesterase, from mung bean hypocotyl (Vigna radiata). Enzyme activity was determined at regular intervals along the deesterification pathway at pH 5.6 and pH 7.6. It has been demonstrated that the distribution of the carboxyl units along the pectin backbone controls the activity of the cell wall pectinmethylesterases to a much greater extent than the methylation degree, with a random distribution leading to the strongest activity. Polygalacturonic acid was shown to be a competitive inhibitor of the alpha isoform activity at pH 5.6 and to inhibit the gamma isoform activity at both pH 5.6 and pH 7.6. Under these conditions, the drop in enzyme activity was shown to be correlated to the formation of deesterified blocks of 19 +/- 1 galacturonic acid residues through simulations of the enzymatic digestion according to the mechanisms established previously (Catoire, L., Pierron, M., Morvan, C., Herve du Penhoat, C., and Goldberg, R. (1998) J. Biol. Chem. 273, 33150-33156). However, even in the absence of inhibition by the reaction product, activity dropped to negligible levels long before the substrate had been totally deesterified. Comparison of alpha and gamma isoform cDNAs suggests that the N-terminal region of catalytic domains might explain their subtle differences in activity revealed in this study. The role of pectinmethylesterase in the cell wall stiffening process along the growth gradient is discussed.

The content of prolactin mRNA as well as total prolactin content and type of isoforms of prolactin were measured in single pituitary glands from turkey embryos and poults. Levels of mRNA and pituitary content of prolactin remained low until 5 days before hatching, while plasma concentrations remained low until 2 days before hatching. Levels of prolactin mRNA then increased until the day of hatch, stayed stable during the 3 first days of age, and significantly increased until 2 wk of age. Similar changes were observed in pituitary content and plasma levels of prolactin. Two immunoreactive bands of apparent molecular masses of 24 and 27 kDa, corresponding to the nonglycosylated and glycosylated form of prolactin, respectively, were visualized on Western blots. In pituitary glands from embryos at 22 days of incubation, 31.5% of the protein was glycosylated, whereas in embryos at 27 days of incubation and poults at 1 and 7 days of age, 48.6%, 48.0%, and 56. 0% of prolactin was glycosylated, respectively. The results indicate that the increases in the synthesis and the release of prolactin occur mainly around and after the time of hatching in the turkey embryo. Higher percentages of glycosylated isoforms were associated with increasing levels of total prolactin in the pituitary gland. Thus, the synthesis of prolactin and its post-translational modifications may be important factors involved in the physiologic changes occurring around the time of hatching.

Well characterized pectin samples were incubated with cell wall-bound and -solubilized pure isoforms of pectinmethylesterase from mung bean hypocotyls (Vigna radiata). Both enzyme activity and average product structure were determined at intervals along the deesterification pathway at pH 5.6 and 7.6. The latter analyses were performed by 13C NMR spectroscopy, and the degree of esterification was probed by both 13C NMR and potentiometric measurements. A dichotomy was observed in the behavior of the alpha and gamma isoforms when compared with that of the beta isoenzyme. Ideal blockwise deesterification mechanisms reproduced the experimental average structures (methylester distribution) throughout the course of the reaction. In the case of the alpha and gamma isoforms, a single chain mechanism associated with a free carboxyl group at the second nearest neighbor position could be postulated at pH 5.6, whereas some multiple attack character was required to reproduce the data at pH 7.6. Several mechanisms that differed from the preceding ones were compatible with the data for the beta isoform at the two pH values. Both the nature of the polysaccharides produced in these reactions and the role of pectinmethylesterase in the cell wall-stiffening process along the growth gradient are discussed.

The consequences of active immunization against prolactin on expression of incubation, reproductive performance and hormonal profiles were evaluated in turkey hens. Hens were injected weekly for 4 wk starting 8 wk before being submitted to a stimulatory photoperiod and 3 times thereafter at intervals of 4 to 5 wk. The hens were injected i.d. with 0.5 mL of a mixture diluted half in Freund's adjuvant. The mixture was prediluted in .9% saline and contained 100 micrograms of a fusion protein (GST-tPRL), GST, oPRL or vehicle. The results indicate that active immunizations with GST-tPRL or oPRL both induce production of specific prolactin antibodies. The onset of egg production was unaffected but higher egg production was observed for the GST-tPRL immunized hens. No GST-tPRL immunized hens expressed incubation behavior, whereas 20 to 30% of hens in the other experimental groups did so. Apparent hyperprolactinemia was detected by RIA for the GST-tPRL immunized groups starting before photostimulation and lasting until Week 10 of egg production but not in other groups. No significant differences were observed in either plasma LH or estradiol concentrations of immunized and nonimmunized turkey hens. In conclusion, both GST-tPRL or oPRL induced the production of antibodies against prolactin in turkey hens. However, only active immunization using GST-tPRL induced higher antibody titers as well as full prevention of incubation behavior expression. Such a pharmacological approach is of great practical interest, although its uses need to be carefully evaluated under commercial conditions.

The inhibition of lipoprotein catabolism after triton WR-1339 intravenous administration is associated with an impressive modification in the balance between plasma peroxidable substrates and antioxidants. Treated rat plasma and membrane lipids become peroxiaable when they are incubated with phenylhydrazine in standardized conditions and the production of thiobarbituric acid-reactive substances (lipoperoxidation markers) significantly increases. An accumulation of native lipoproteins which present a decreased alpha-tocopherol on triglycerid ratio and a modification in the plasmatic balance between alpha-tocopherol and ascorbate could explain these observations.

Chronic urticaria results from multiple interactive causes. For certain authors dythyroidism is significantly more frequent in patients with chronic urticaria, often associated with other autoimmune disorders.This study included 45 patients with chronic urticaria (29 men and 16 women, mean age 45.6 years). All underwent clinical examination for thyroid disease with assay of free T3 and T4, ultrasensitive TSH and antimicrosome and antithyroperoxidase antithyroid antibodies.Among the 45 patients, 8, all women, had an autoimmune thyroid disease: Graves' disease (n = 1), juvenile chronic thyroiditis (n = 1), autoimmune disease n = 6). All had goiter but most had no clinical sign suggestive of hypothyroidism or hyperthyroidism. Other clinical features or laboratory findings suggested autoimmune disorders in 3.These results suggest that a complete thyroid examination with hormone assay, especially in women, should be performed in patients with chronic urticaria. TSH and antiperoxidase antibodies appear to be the most sensitive and specific assays in patients with autoimmune thyroid disease.

The characteristic features of the pectins present in the walls of immature fibre cells of the hypocotyl of flax seedlings have been studied by a combination of three subtractive methods (treatment with boiling water, calcium chelator, and free endopolygalacturonase), three staining reactions (periodic acid-thiocarbohydrazide-silver, Ruthenium Red, and ferric hydroxylamine) and labelling with an endopolygalacturonase-gold probe. The primary wall and the periphery of the tricellular junctions were shown to contain pectic molecules made of blocks either with free acidic functions or methyl-esterified, these molecules being removed from the wall by splitting alpha (1-4) linkages. On the contrary, the pectic molecules in the core of the tricellular junctions were mainly with free acidic groups, but with an appreciable acetylesterification of their hydroxyl groups; and they were linked with one another chiefly by calcium bonds. This unexpected constitution of the core of the tricellular junctions may be considered to be an early marker of the cells destined to give rise to the fibre bundles of the mature plant.

During the first stage of flax growth, stem elongation reaches 2.4 cm per day and the percentage of cell wall remains quite constant (4–15%). Cellulosic fibres develop principally during capsule formation and seed maturation. During the latter stage, the proportion of walls increases from 15 to 60% and the elongation is diminished to 0.5 cm per day. The lowering of the cation exchange capacity and of the pectin content of the cell walls during growth results principally from increased cellulose deposition in the fibre cells. The changes in the cation exchange capacity and in the percentage of cell wall show that when cellulose biosynthesis predominates, there is a continuous synthesis of pectins (10–15%) during the development of the plant. Methylated pectins are synthesized during the elongation phase. During maturation, the relative amounts of highly and less methylated pectins remain the same and thus it is not possible to determine what type of pectin is preferentially synthesized.

From this brief review it appears that the interactions between calcium ions and cell walls play a key role in plant physiology. Calcium ions are involved in many mechnisms: for example, stabilization of cell wall structures, acidic growth, ion exchange properties, control of the activities of wall enzymes. All these properties originate from the tight binding of calcium ions to the pectins present in the cell walls. The factor most important for controlling wall behaviour is the density of non-diffusible charges and, due to its high affinity, calcium can significantly affect this factor. We also discuss the theoretical ion exchange models in relation to the specific role of calcium ions.