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Levamisole (an increasingly frequent contaminant of cocaine) can cause antineutrophil cytoplasmic antibody-associated vasculitis. Dermatologists should consider a diagnosis of cocaine/levamisole-associated cutaneous vasculopathy syndrome in cases of purpura of the ears and/or extensive retiform purpura in drug users. We report a case of particularly severe levamisole-induced necrotic purpura and immunological abnormalities in a 40-year-old woman. [ABSTRACT FROM AUTHOR]

Abstract: Ozone treatment (10g/kg) of common wheat grains with a new patented process, Oxygreen®, used before milling was found to significantly reduce (by 10–20%) the required energy at breaking stage whatever the grain hardness and without changes in the flour yield. Detailed study of each of the milling steps undertaken on a hard type cultivar showed that both the breaking and the reduction energy were decreased. Reduction of the coarse bran yield was also observed concomitantly with an increase in the yield of white shorts. Biochemical characterization of the milling fractions pointed out changes in technological flour properties as starch damage reduction, aleurone content enrichment and increase of insoluble glutenin polymers. Measurement of wheat grain tissue mechanical properties showed that ozone treatment leads to reduction of the aleurone layer extensibility and affects the local endosperm resistance to rupture. These data as well as the direct effect of ozone oxidation on biochemical compounds could explain the observed changes in milling energy, bran and shorts yield and flour composition. [Copyright &y& Elsevier]

Abstract: 2-Chloro-N-S-phenyl 2S-piperidin-2-yl methyl]-3-trifluoromethyl benzamide, monohydrochloride (SSR504734) is a potent and selective inhibitor of the glycine transporter type 1, which increases central N-methyl-d aspartate glutamatergic tone. Since glutamate has been shown to play a role in the regulation of the dopaminergic system in dopamine-related disorders, such as schizophrenia, we investigated the possibility that SSR504734 may modify the basolateral amygdala-elicited stimulation of dopamine release in the nucleus accumbens via an augmentation of glutamate receptor-mediated neurotransmission. First, our data confirmed that SSR504734 is an inhibitor of GlytT1. In the nucleus accumbens of anesthetized rat, SSR504734 (10mg/kg, i.p.) induced an increase of extracellular levels of glycine as measured by microdialysis coupled with capillary electrophoresis with laser-induced fluorescence detection. Second, the data demonstrated that SSR504734 (10mg/kg, i.p.) enhanced the facilitatory influence of glutamatergic afferents on dopamine neurotransmission in the nucleus accumbens. Using an electrochemical technique, we measured dopamine release in the nucleus accumbens evoked by an electrical stimulation of the basolateral amygdala. SSR504734 facilitated dopamine release evoked by a 20 or a 40Hz frequency basolateral amygdala stimulation. This facilitatory effect was dependent on glutamatergic tone, as intra-nucleus accumbens application of 6-7-dinitroquinoxaline-2,3-dione (10−3 M) or dl-2-amino-5-phosphonopentanoic acid (10−3 M), α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid and N-methyl-d aspartate receptors antagonists, respectively, inhibited dopamine release evoked by basolateral amygdala stimulation. Furthermore dl-2-amino-5-phosphonopentanoic acid co-administrated with SSR504734 hampered the dopamine-evoked release facilitation. These data underline the in vivo implication of the glycine uptake mechanism in the control of subcortical glutamate/dopamine interactions. [Copyright &y& Elsevier]

La guidance interactive est une technique de psychothérapie parent–enfant. Initialement développée par Susan Mc Donough aux États-Unis, pour soutenir l'alliance auprès des parents en grandes difficultés. Elle a ensuite montré sont efficacité auprès de dyades dont les bébés présentaient des troubles fonctionnels du nourrisson, dans l'étude Princeps du Geneva Group. Cette technique choisit comme porte d'entrée dans l'interaction parent–enfant, la dimension interpersonnelle, et la lecture des comportements interactifs, pour ensuite aborder les pensées et cognitions et les émotions en lien avec le symptôme de l'enfant ou de la dyade. Le visionnement de séquences de jeu libre est au cœur du dispositif thérapeutique, permettant une co-construction de la lecture de l'interaction, entre le thérapeute et le parent concerné. Nous proposons une description des grands principes de cette technique et son illustration par deux cas cliniques. Le premier décrit une interaction dont la lecture fut un moment clé dans une thérapie mère–bébé auprès d'une patiente présentant une dépression périnatale. Le second illustre la création d'une alliance thérapeutique forte, dans une situation de parentalité à haut risque, par la description et soutien des compétences parentales à travers le visionnement de moments positifs de l'interaction. Ces situations illustrent le processus thérapeutique et les liens qui se font entre la symptomatologie maternelle et la synchronie de l'interaction. Nous discuterons cette technique au regard d'autres interventions utilisant le vidéo feed-back. Interactive guidance is a parent-child psychotherapy technique, which was initially developed by Susan Mc Donough in the United States to support parental alliance in high-risk families. Later the Geneva Group Study showed its effectiveness in dyads whose babies had functional disorders. This technique chooses as a gateway in the parent–child interaction the interpersonal dimension, and the reading of the Interactive behaviors, to then approach thoughts, cognitions, and emotions related to the symptom of the child or of the dyad. The viewing of free play sequences is at the heart of the therapeutic device allowing a co-construction of the interaction reading between the therapist and the concerned parent. We propose a main principles description of this technique and its illustration by two clinical cases. The first one describes an interaction whose reading was a key moment in a mother–baby therapy with a mother suffering from perinatal depression. The second illustrates the creation of a strong therapeutic alliance in a situation of high-risk parenting through the description and support of parenting skills by means of viewing positive moments of interaction. These situations illustrate the therapeutic process and the links that arise between the maternal symptomatology and the synchrony of the interaction. We will discuss this technique in conceptual contrast to some other interventions using video feedback. [ABSTRACT FROM AUTHOR]

Objectif discuter et illustrer les signes de torsion d’annexe en IRM dans la population pédiatrique. Evaluer son intérêt. Matériels et méthodes étude rétrospective de 19 cas, d’âge moyen 13 ans, opérés après diagnostic de torsion d’annexe à l’IRM. Relecture des données cliniques, échographiques, des IRM, des comptes-rendus opératoires, histologiques et comparaison des deux groupes. Résultats le diagnostic de torsion à l’IRM a été confirmé en chirurgie dans 13 cas, dont 2 étaient des torsions tubaires isolées. 6 cas étaient des faux positifs de torsion en IRM dont 4 kystes hémorragiques de l’ovaire, une péritonite appendiculaire associée à un kyste ovarien, et un ovaire normal. L’IRM a redressé le diagnostic de torsion, non vu en échographie dans 8 cas dont 3 ovaires ont pu être sauvés par détorsion. Les signes IRM les plus fréquents en cas de torsion étaient les signes tubaires (oedème, tour de spire) et les signes d’ischémie. L’hémorragie intraovarienne en cas de torsion était corrélée en anatomopathologie à de l’infarcissement hémorragique. 38% des torsions étaient associées à une masse ovarienne. Conclusion l’IRM réalisée en urgence présente un intérêt diagnostic et pronostic dans les suspicions de torsion d’annexe en pratique pédiatrique. [ABSTRACT FROM AUTHOR]

Aims: To describe the sources of interindividual variability of bevacizumab and trastuzumab pharmacokinetics in early-stage breast cancer, and to study the relationship between exposure and both early clinical response and specific adverse events. Patients and methods: Patients (n = 86) received 6 cycles of docetaxel + trastuzumab. Early tumour response was assessed by determination of the maximum standard uptake value (SUVmax) variation (ΔSUVmax) after 1 cycle using [18F]-fluorodeoxyglucose (FDG) PET. Early poor responders (ΔSUVmax < 70%) also received bevacizumab from cycle 3 to cycle 6. Sources of interindividual variability in pharmacokinetics of both antibodies were studied by population compartment modelling. Exposure as assessed by area under the concentration-versus-time curve (AUC) was compared between responders and non-responders and between patients experiencing specific adverse events or not. Results: A two-compartment model described the pharmacokinetics of both antibodies satisfactorily. Their central volume of distributions (Vc) increased with body surface area and their elimination half-lives were shorter (~14 days) than previously reported (~26–28 days). There was a time-dependent increase in trastuzumab Vc, positively correlated to baseline SUVmax. Bevacizumab elimination rate (k10) was positively correlated with ΔSUVmax measured at the end of the first cycle. Bevacizumab had no significantly influence on trastuzumab pharmacokinetics. No relationship between exposure and clinical response or occurrence of adverse events was found. Conclusion: Tumour uptake as assessed by SUVmax influences the pharmacokinetics of bevacizumab and trastuzumab. In early-stage breast cancer, elimination half-lives of these therapeutic monoclonal antibodies may be shorter than those previously reported in more advanced disease. [ABSTRACT FROM AUTHOR]

To evaluate the efficiency of laser thermocoagulation under computed tomography (CT) guidance in the treatment of osteoid osteoma within a strictly pediatric group. Twenty-five patients aged 4 to 17 years were treated under CT by laser thermocoagulation. The nidus measured on average 10.1 mm. Pain relief was the main item for evaluation of the effectiveness of our treatment. Follow-up ranged from 3 months to 61 months (mean, 26 months). Technical success was achieved in 100%. Thermocoagulation proved to be initially effective in 24 of 25 children (96%) and had a positive long-term effect in 23 of 25 children (92%). We had four minor complications and one severe complication (partial osteonecrosis of the talus). Laser thermocoagualation is an effective treatment for osteoid osteoma in pediatric patients. [ABSTRACT FROM AUTHOR]

Abstract: Arginine vasopressin and corticotropin-releasing factor are two neuroactive peptides that regulate hypothalamic–pituitary-axis and associated stress response. While the potential antidepressant and anxiolytic profiles of corticotropin-releasing factor 1 antagonists have been well studied, the concept of blockade of vasopressin system as another approach for the treatment of emotional processes has only been made available recently by the synthesis of the first non-peptide antagonist at the V1b receptor, SSR149415. In the present study SSR149415 has been compared with the corticotropin-releasing factor 1 antagonist SSR125543 and with anxiolytic and antidepressant drugs on the response of hippocampal cholinergic and cortical noradrenergic systems to the anxiogenic benzodiazepine receptor inverse agonist FG 7142. Acute (0.3–10 mg/kg, i.p.) and long-term administration (10 mg/kg, i.p., 21 days) of SSR149415 and SSR125543 reduced the FG 7142-induced increase in extracellular concentrations of acetylcholine in the hippocampus of anesthetized rats measured by microdialysis. By contrast acute and long-term administration of SSR149415 failed to reduce the FG 7142-induced increase in the release of norepinephrine in the cortex of freely moving rats. The present results demonstrate that the two compounds have similar profiles in a model of activation by an anxiogenic drug of the hippocampal cholinergic system and they suggest that SSR149415 and SSR125543 may have anti-stress anxiolytic and antidepressant effects via a mechanism of action different from classical benzodiazepine ligands and noradrenergic antidepressants. [Copyright &y& Elsevier]

Introduction: In the literature, data on the effect of renal impairment on the pharmacokinetics of anticancer drugs are scarce. Here, we report a 68-year-old metastatic osteosarcoma patient with impaired renal function due to prior chemotherapy, who was treated on compassionate use basis with 400 mg/m cetuximab. Material and methods: Pharmacokinetic parameters after the first dose, including dose-normalised AUC from time zero to day 7, clearance, elimination half-life ( t), were estimated using trapezoidal non-compartmental methods and compared to pharmacokinetic data from a study population with normal kidney function. Results: The results showed that the pharmacokinetics of cetuximab in this patient with renal failure was similar to that with adequate renal function. Conclusion: This study suggests that cetuximab can be safely used in cancer patients with renal impairment without dose adjustment. [ABSTRACT FROM AUTHOR]

Background: Preoperative diffusion-weighted MRI (DW-MRI) has been described as an efficient method to differentiate good and poor responders to chemotherapy in osteosarcoma patients. A DW-MRI performed earlier during treatment could be helpful in monitoring chemotherapy. Objective: To assess the accuracy of DW-MRI in evaluating response to chemotherapy in the treatment of osteosarcoma, more specifically at mid-course of treatment. Materials and methods: This study was carried out on a prospective series of adolescents treated for long-bone osteosarcoma. MR examinations were performed at diagnosis (MRI-1), at mid-course of chemotherapy (MRI-2), and immediately before surgery (MRI-3). A DW sequence was performed using diffusion gradients of b0 and b900. The apparent diffusion coefficients (ADC1, ADC2, ADC3, respectively), their differentials (ADC2 − ADC1 and ADC3 − ADC1), and their variation (ADC2 − ADC1/ADC1 and ADC3 − ADC1/ADC1) were calculated for each of these three time points. Results: Fifteen patients were included. Patients with no increase in ADC showed a poor response to chemotherapy on their histology results. At mid-course, the three calculated values were significantly different between good and poor responders. ADC2 − ADC1 enabled us to detect, with 100% specificity, four out of seven of the poor responders. There was no significant difference in the values at MRI-3 between the two groups. Conclusion: DW-MRI performed both at baseline and mid-course of neoadjuvant chemotherapy is an efficient method to predict further histological response of osteosarcoma. This method could be used as an early prognostic factor to monitor preoperative chemotherapy. [ABSTRACT FROM AUTHOR]

Abstract: SR58611A is a selective β3-adrenoceptor (Adrb3) agonist which has demonstrated antidepressant and anxiolytic properties in rodents. The present study confirmed the detection of Adrb3 mRNA transcript in rodent brain sub-regions and evaluated the effect of SR58611A on serotonergic and noradrenergic transmission in rats and mice in an attempt to elucidate the mechanism(s) underlying these properties. SR58611A (3 and 10 mg/kg, p.o.) increased the synthesis of 5-HT and tryptophan (Trp) levels in several rodent brain areas (cortex, hippocampus, hypothalamus, striatum). Moreover, SR58611A (10 mg/kg, p.o.) increased the release of 5-HT assessed by in vivo microdialysis in rat prefrontal cortex. Systemic (3 mg/kg, i.v.) or chronic administration of SR58611A (10 mg/kg, p.o.), in contrast to fluoxetine (15 mg/kg, p.o.), did not modify the activity of serotonergic neurons in the rat dorsal raphe nucleus. The increase in 5-HT synthesis induced by SR58611A was not observed in Adrb3s knockout mice, suggesting a selective involvement of Adrb3s in this effect. SR58611A (3 and 10 mg/kg, p.o.) did not modify norepinephrine synthesis and metabolism but increased its release in rat brain. Repeated administration of SR58611A (10 mg/kg, p.o.) did not modify basal norepinephrine release in rat prefrontal cortex whereas it prevented its tail-pinch stress-induced enhancement similarly to reboxetine (15 mg/kg, p.o.). Finally SR58611A increased the firing rate of noradrenergic neurons in the rat locus coeruleus following systemic (3 mg/kg, i.v.) or local (0.01 and 1 μM) but not chronic (10 mg/kg, p.o.) administration. These results suggest that the anxiolytic- and antidepressant-like activities of SR58611A involve an increase of brain serotonergic and noradrenergic neurotransmissions, triggered by activation of Adrb3s. [Copyright &y& Elsevier]

Abstract: Management of cystic lymphangioma necessitate for optimal diagnosis and treatment the expertise of a trained multidisciplinary team including dermatologists, radiologists, plastic and vascular surgeons. An initial imaging work-up of these lesions by ultrasound Doppler examination and MR imaging are necessary before treatment planning. Depending of the size, the location, the risk for the adjacent organs, a therapeutic decision may be mandatory. Percutaneous sclerotherapy is a safe and efficient treatment. It is the treatment of choice that must be proposed in first intention. [Copyright &y& Elsevier]

In vivo microdialysis was used to investigate the interactions between dopamine (DA), glutamate (Glu) and aspartate (Asp) in anaesthetised-rat striatum. The combination of brain microdialysis and capillary electrophoresis with laser-induced fluorescence detection (CE-LIFD) allows the simultaneous monitoring of the efflux of these neurotransmitters up to every 10 s. DA and Glu reuptake inhibitors, nomifensine and L-trans-pyrrolidine-2,4-dicarboxylic acid (PDC) and, dopaminergic and glutamatergic receptor agonists, apomorphine and NMDA respectively, were administered by reverse dialysis.Reverse dialysis of 20 μM nomifensine induced a rapid and marked increase (+3200% at 5 min) in extracellular DA, while a decrease in Glu and Asp (–11 and -25%, respectively) was observed simultaneously. Reverse dialysis of 10 μM apomorphine led to progressive changes: −63% decrease in DA and +25% Glu increase at 36 min. Reverse dialysis of 1 mM NMDA induced a simultaneous increase in DA, Glu and Asp which peaked at +2 min (+840%, +40% and +150%, respectively). Surprisingly, a second increase in Glu was observed 5 min after the end of NMDA perfusion. Reverse dialysis of PDC (1 mM and 10 mM) induced a rapid increase in Glu and Asp levels, while DA increased with a 26-s delay.These findings indicate that, in the striatum, endogenous DA and Glu may act in opposition to regulate each other’s efflux. These results have been obtained due to unique features offered by microdialysis coupled with CE-LIFD. [Copyright &y& Elsevier]

Objectif: Étudier la capacité de l’IRM fœtale de détecter une malrotation intestinale. Matériel et Méthodes: Étude rétrospective sur 5 ans de notre base de données d’IRM fœtales non cérébrales. Résultats: Quatre cent une IRM fœtales furent analysées. Dans 34 cas (8,5%), le jéjunum proximal était considéré en position anormale, càd ailleurs que dans le flanc gauche sous l’estomac sur les séquences pondérées en T2. Dans 22 cas (65%), le jéjunum était situé dans l’hémi-thorax gauche dans le cadre d’une hernie diaphragmatique gauche (groupe A). Dans 7 cas (20%) il était en position extra-abdominale dans le cadre d’un laparoschisis (group B). Dans 5 cas (15%) il était anormalement situé dans l’abdomen, en position médiane ou dans le flanc droit, avec un estomac en position normale (group C). Tous les cas des groupes A et B ont été confirmées en période post-natale ou à l’autopsie. Dans 4 cas du groupe C (syndrome de Prune-Belly, poche colonique, atrésie digestive, cardiopathie) la malrotation n’était pas suspectée en échographie et était confirmée après la naissance. Dans le dernier cas, l’intestin était refoulé à droite par une duplication digestive géante, et le TOGD post-natal était normal. Conclusion: Grâce à son excellente résolution en contraste en pondération T2, l’IRM fœtale identifie avec précision une position anormale du jéjunum, en dehors de toute suspicion échographique, avec une excellente corrélation postnatale. [ABSTRACT FROM AUTHOR]