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International audience; Objective: To determine the consumption pattern of selected households consuming traditional green leafy vegetables (TGLVs) during three seasons and potential contribution to recommended nutrient intakes. Design: Repeated household survey using food frequency questionnaire to obtain consumption pattern of selected TGLVs. Setting and Subjects: Selected households in a small rural farming community: pre-rainy (n = 43), rainy (n = 36) and post-rainy seasons (n = 40). Results: Corchorus olitorius and A. hybridus were the most consumed by > 70% of households across three seasons. A. esculentus and A. viridis were the least consumed TGLVs through all the seasons. Uncultivated and cultivated TGLVs could contribute between 26–> 100% and 18–96%, respectively, of recommended intake for vitamin A for children and women. For young children, both the cultivated and uncultivated TGLVs could contribute more than 50% of their RDA for iron. Conclusion: seasonal availability, and preference for certain species, determine the consumption pattern of the TGLVs studied. Uncultivated and less utilised vegetables have the potential to make significant contributions to the micronutrient requirements of women and children, especially vitamin A and iron if frequently used.

Resume Introduction Pour la semaine de la securite des patients (SSP) 2018, axee sur les erreurs medicamenteuses (EM), notre etablissement a souhaite developper un outil de simulation en sante innovant, ludique et pragmatique. L’objectif etait de creer un jeu d’evasion (escape game) medicamenteux alliant reflexion sur les EM et travail collaboratif. Methodologie Un groupe de travail pluridisciplinaire a cree un scenario de prise en charge medicamenteuse (PECM) d’un patient necessitant une pose rapide d’antibiotherapie. Le groupe a defini quatre enigmes successives reprenant les principaux risques lies aux EM identifies dans notre etablissement. La seance de 45 minutes permettait d’immerger les equipes de 3 a 5 personnes suivant le format : instructions, mise en situation, analyse critique et evaluation de satisfaction. Resultats Soixante professionnels repartis en 14 equipes ont participe au jeu : 40 % d’infirmieres, 32 % d’aides-soignants, 18 % d’autres professionnels. Les equipes ont reussi le jeu en 21 min et 23 s et ont eu besoin de sept indices, en moyenne. Le niveau de difficulte a ete juge difficile (50 %) ou intermediaire (38 %) et le scenario decrit comme pertinent pour tous les participants. L’outil a repondu aux attentes de 88 % des participants et 81 % d’entre eux disent avoir acquis des connaissances. Conclusion Le jeu d’evasion medicamenteux permet de reprendre de facon ludique et pedagogique des erreurs pertinentes retrouvees dans le circuit de la PECM du patient. Apres un premier retour d’experience positif, ce format pedagogique sera integre a notre plan de formation 2019.

The aim of the study was to quantify the folate content of eight samples (seven raw and boiled traditional leafy vegetables and one fruit vegetable). The analysis of folate in the raw and cooked vegetable samples followed the process of extraction, deconjugation using chicken pancreas deconjugase, and derivatization. Through this process, all folate forms in the deconjugated sample extracts were converted to 5-methyltetrahydrofolic acid (THF-5CH3) monosodium glutamate and/or diglutamate. Purii¬cation was done by afi¬nity chromatography with Folate Binding Protein and Reversed-phase high performance liquid chromatography (RP-HPLC) equipped with i¬‚uorimetric detection was used to quantify folate. Folate content in the raw samples ranged from 21.5 µg/100 g (FW) in Solanum macrocarpon leaves to 183.4 µg/100 g (FW) in Corchorus olitorius and in the boiled samples values ranged from 8.5 µg/100 g (FW) in S. macrocarpon to 48.6 µg/100 g (FW) in Launaea taraxacifolia leaves. Loss of folate in the boiled vegetables varied from 46.6% in L. taraxacifolia to 88.4% in Adansonia digitata. The difference in folate content of the raw and boiled vegetables were found to be significantly different (p

International audience; Objective: To determine the micronutrient composition of fresh and boiled traditional green leafy vegetables (TGLVs). Design: Sixteen TGLVs categorised into cultivated and uncultivated vegetables were analysed for vitamin C (ascorbic acid [AA] and dehydroascorbate [DHAA]), β-carotene, lutein and minerals. Results: Basella alba had the highest AA (72 mg/100 g) content; Vernonia amygdalina (unwashed), had the highest β-carotene and lutein concentrations (14.1 and 29.0 mg/100 g, respectively); Amaranthus hybridus had the highest AA (43 mg/100 g) and β-carotene (9.3 mg/100 g) content, for cultivated sp. Celosia argentea had the highest Fe content; Zn content of all the vegetables was low, 0.4–2.6 mg/100 g. Cooking resulted in significant losses in AA content in all the samples, 19% in B. alba to 100% in Crassocephalum crepidioides. Carotenoid losses were observed in 10 samples and six samples had increased values of β-carotene (12% to 183%) and lutein (64% to double). Conclusion: Traditional green leafy vegetables studied were found to be rich in the micronutrients of interest, especially in carotenoids. Boiling of leafy vegetables, as traditionally done, led to considerable losses of the micronutrients. The micronutrient content of uncultivated leafy vegetables compared well with commonly cultivated species.

The dangers of the blue light are the object of numerous publications, for both the scientific community and the general public. The new prolific development of light sources emitting potentially toxic blue light (415-455nm) ranges from LED (Light Emitting Diodes) lamps for interior lighting to television screens, computers, digital tablets and smartphones using OLED (Organic Light Emitting Diode) or AMOLED (Active-Matrix Organic Light Emitting Diode) technology. First we will review some technical terms and the main characteristics of light perceived by the human eye. Then we will discuss scientific proof of the toxicity of blue light to the eye, which may cause cataract or macular degeneration. Analysis of the light spectra of several light sources, from natural light to LED lamps, will allow us to specify even better the dangers related to each light source. LED lamps, whether used as components for interior lighting or screens, are of concern if they are used for extended viewing times and at short distance. While we can protect ourselves from natural blue light by wearing colored glasses which filter out, on both front and back surfaces, the toxic wavelengths, it is more difficult to protect oneself from LED lamps in internal lighting, the use of which should be restricted to "white warmth" lamps (2700K). As far as OLED or AMOLED screens are concerned, the only effective protection consists of using them occasionally and only for a short period of time.

Raw, heated and frozen–thawed apple parenchyma of the ‘Golden Delicious’ and ‘Granny Smith’ varieties were subjected to leaching and phenolic compounds were analysed by high performance liquid chromatography (HPLC). Fick’s second law was applied for the determination of the apparent diffusivity ( D e ) of individual polyphenols. Further information was obtained histochemically by means of toluidine blue O staining and image analysis. No difference in phenolic quantification existed between the biochemical and histochemical approaches. The histochemical analysis revealed cell structure changes and the interaction of procyanidins with the cell wall during the leaching process. The D e values of the total polyphenols were 0.30 and 0.26 × 10 −9 m 2 s −1 for the ‘Golden Delicious’ and ‘Granny Smith’ raw apple matrix, respectively. The D e values (and leaching yields) increased after treatments that degraded the plant tissue matrix. After freeze–thaw, the D e values became 0.39 and 0.40 × 10 −9 m 2 s −1 , while after heating they were 0.92 and 0.38 × 10 −9 m 2 s −1 . There was also an influence of the phenolic compound nature.

1. The quantitative determination of quality traits requiring spectral and classical data. In the work, the accuracy of the mid-infrared spectroscopy was investigated to predict internal quality traits in purees of fresh tomatoes. In a first time, the models of prediction were established using 50 representative samples and then these models were used to evaluate the quality traits of a large diversity of tomatoes through an experiment. Mid-infrared spectroscopy showed a good ability to estimate not only soluble solids (error of 4%) and titratable acidity (error of 5%) but also individual compounds such as glucose, fructose and citric acid (error of 4%). For malic acid, the high error of prediction (20%) was probably in relation with its low level in the studied tomatoes. Using these models, the tomato quality has been shown to depend on the following factors listed in descending importance as field/greenhouse cultivation > genotype > harvesting date > post-harvest duration. 2. The discrimination of different processed tomato matrices by the direct exploitation of spectral data. The analyses of principal components (PCA) performed on some specific spectral areas allowed the sample discrimination. A clear separation was shown between tomato purees prepared at 20, 40 and 70°C from those prepared at 90°C. An important change happened at around 70°C.

For a real-time video application such as a remote learning session, the main difficulty is to keep the latency low while providing a video stream to viewers with different devices over a variety of bandwidth restricted networks. This Letter proposes an optimisation to dynamically select a subset of predefined different video representations, such that with a limited number of encoders, the largest possible group of viewers receives a decodable video stream at a low latency. This optimisation outperforms the static encoder approach by achieving a fairness of 98.2% with an average client bandwidth utilisation of 84.1% to provide higher quality video.

THERE are many changes for estimating erosion by water in RUSLE, the revised universal soil loss equation. The changes include the following: Computerizing the algorithms to assist with the calculations. New rainfall-runoff erosivity term values (R) in the western United States, based on more than 1,200 gauge locations. Some revisions and additions for the eastern United States, including corrections for high R-factor areas with flat slopes to adjust for splash erosion associated with raindrops falling on ponded water. Development of a seasonally variable soil erodibility term (K). A subfactor approach for calculating the cover-management term (C), with the subfactors representing considerations of prior land use, crop canopy, surface cover, and surface roughness. New slope length and steepness (LS) algorithms reflecting rill to interrill erosion ratios. The capacity to calculate LS products for slopes of varying shape. New conservation practice values (P) for rangelands, stripcrop rotations, contour factor values, and subsurface drainage. History of the USLE Although the universal soil loss equation (USLE) is a powerful tool that is widely used by soil conservationists in the United States and many foreign countries, research and experience since the 1970s have provided improved technology that is incorporated in the …

Resume Introduction Le glaucome chronique par fermeture de l’angle (GCFA) est un probleme de sante publique reconnu en Asie mais il n’est pas suspecte chez les blancs, les myopes, les patients ayant une chambre anterieure profonde ou les sujets normotones. Le diagnostiquer precocement permettrait de traiter le mecanisme causal par une iridotomie peripherique (IP). Patients et methodes Etude retrospective de patients ayant eu une IP dont l’indication a ete posee sur les resultats d’une gonioscopie « photodynamique » (GPD) realisee dans l’obscurite et montrant des signes en faveur de contacts irido-trabeculaires nocturnes. L’indication de la GPD a ete posee sur l’existence d’anomalies de structure des fibres nerveuses retiniennes (FNR) meme minimes au GDxVCC ou sur l’existence du classique signe de Van Herick (VH). Resultats Cent trois yeux de 103 patients ont eu une IP au laser et un suivi d’au moins 1 an (recul moyen de pres de 2 ans). L’âge moyen etait de 63,7 ± 11,8 ans avec une predominance feminine (63,1 %). Pour 78,6 % des patients, il n’y avait pas de glaucome ni meme d’hypertonie oculaire. Il y avait 60,1 % d’hypermetropes et 39,9 % de myopes. Plus de la moitie (57 %) avaient une chambre anterieure profonde voire tres profonde. L’IP a entraine une augmentation immediate de la profondeur de la chambre anterieure au limbe dans 100 % des cas. Apres 1 an, la pression intra-oculaire (PIO) avait baisse de 1,3 ± 2,4 mmHg (p Discussion Notre etude retrouve des fermetures chroniques de l’angle frequentes dans notre population tout-venant de patients caucasiens malgre des chambres anterieures profondes ou tres profondes. L’absence de signe de VH ne suffit pas a ecarter cette eventualite. La gonioscopie photodynamique doit etre faite dans l’obscurite et au verre a 3 miroirs pour eviter d’indenter involontairement ces yeux strictement normotones. L’IP est un traitement efficace du mecanisme causal et gagne a etre pratiquee precocement.

The three major symptoms of the irido-corneo-endothelial syndrome are the alterations of the corneal endothelium and of the iris with a loss of the regulation of the cell cycle, and the progressive obstruction of the irido-corneal angle. This rare pathology attacks mainly young adult women. Most of the symptoms and complications originate from the excessive proliferation of the corneal endothelial cells accompanied by the evolution of their phenotype towards that of the epithelial cells. In normal conditions the corneal endothelial cells do not divide, they are blocked in the G1 stage of the cell cycle, mainly because of the action of the inhibitors of cyclin-dependent kinases. Still these cells retain a good capacity for proliferation, which can be induced by the down-regulation of the expression of the inhibitors of the cyclin-dependent kinases. This proliferative capacity declines with age and is also different according to the localization of the cells: it is more intense with those originating from the central area then in those from the peripheral area of the cornea. The age-related decline of the proliferative capacity is not due to the shortening of the telomers, but to the stress-induced accelerated senescence of the cells.

Resume Introduction Nous avons souhaite etudier l’epidemiologie, la microbiologie et l’evolution clinique de keratites bacteriennes severes afin d’en actualiser les facteurs de risque et le pronostic. Patients et methodes Au travers d’une etude retrospective monocentrique, de janvier 2005 a janvier 2011, nous avons analyse les donnees epidemiologiques et cliniques des patients hospitalises pour keratite severe d’origine bacterienne prouvee. Resultat Nous avons recense 268 abces corneens unilateraux. Nous avons identifie au moins un facteur de risque local et/ou general chez 255 patients sur 268 (95 %). Les principaux facteurs de risque locaux etaient le port de lentilles de contact (n = 129), une keratopathie sous-jacente (n = 50) et une chirurgie corneenne prealable (n = 47). Les acuites visuelles moyennes (AV) initiale et finale etaient respectivement de 0,06 et 0,2 (1,20 et 0,72 LogMAR), avec un pronostic moins defavorable et une duree moyenne de sejour plus courte pour les porteurs de lentilles (p Conclusion Des facteurs de risques specifiques doivent etre recherches lors de l’observation d’une keratite bacterienne severe. Le port de lentilles est le plus frequent mais de pronostic moins defavorable que les keratopathies, antecedents de chirurgie corneenne et facteurs de risque generaux. Le type de germe responsable ne semble plus modifier clairement le pronostic final de ces abces corneens.

The dangers of the blue light are the object of numerous publications, for both the scientific community and the general public. The new prolific development of light sources emitting potentially toxic blue light (415-455nm) ranges from LED (Light Emitting Diodes) lamps for interior lighting to television screens, computers, digital tablets and smartphones using OLED (Organic Light Emitting Diode) or AMOLED (Active-Matrix Organic Light Emitting Diode) technology. First we will review some technical terms and the main characteristics of light perceived by the human eye. Then we will discuss scientific proof of the toxicity of blue light to the eye, which may cause cataract or macular degeneration. Analysis of the light spectra of several light sources, from natural light to LED lamps, will allow us to specify even better the dangers related to each light source. LED lamps, whether used as components for interior lighting or screens, are of concern if they are used for extended viewing times and at short distance. While we can protect ourselves from natural blue light by wearing colored glasses which filter out, on both front and back surfaces, the toxic wavelengths, it is more difficult to protect oneself from LED lamps in internal lighting, the use of which should be restricted to "white warmth" lamps (2700K). As far as OLED or AMOLED screens are concerned, the only effective protection consists of using them occasionally and only for a short period of time.

Hydrologists are concerned with high-intensity rainfall and peak runoff rates for stormwater infrastructure designs, post-event assessments, and mitigation of environmental impacts. In the southwestern United States the need for accurate information about these rates is increasingly important as population growth and associated development are projected to exceed national averages. Design storm totals for various durations and return period frequencies are routinely derived from the National Oceanic and Atmospheric Administration (NOAA) Atlas 14 and are commonly used as input to hydrologic models to estimate peak runoff rates and runoff volumes. For the southwestern United States during the North American Monsoon, NOAA relies on sparse rain gauge networks to measure rainfall from limited area convective storms primarily at daily time steps and estimates of subdaily event intensities are derived by temporal downscaling from a few point locations. The USDA, Agricultural Research Service, Southwest W...

Resume Objectif Analyser objectivement l’aspect de la cicatrice cutanee apres dacryocystorhinostomie par voie faciale et comparer le resultat esthetique d’une incision sur l’aile du nez a celle palpebrale inferieure. Patients et methodes Tous les patients operes consecutivement de dacryocystorhinostomie par voie faciale entre janvier 2007 et decembre 2009 ont ete convoques. La cicatrice a ete photographiee et analysee de visu par les deux auteurs qui ont attribue la note suivante ; 20 : aucune cicatrice visible ; 10 : cicatrice visible mais jugee esthetiquement non prejudiciable ; 0 : cicatrice visible jugee inesthetique. Resultats Dix-huit patients sur les 60 convoques sont revenus en consultation. Cent pour cent des dix patients operes par voie palpebrale etaient cotes a 20 pour 25 % des huit patients operes par incision nasale. Parmi ceux-ci, 62,5 % etaient cotes a 10. Seul un patient presentait une cicatrice cotee 0 (voie nasale). Conclusion L’incision realisee dans le pli palpebral inferieur nous a semble considerablement minimiser le prejudice cicatriciel.

Yellow passion fruit processing in Brazil releases large amounts of waste (300,000 metric tons per year) that could be used as an alternative raw material for extracting potentially 2,000 metric tons of pectin. Valorization of pectin extracted from passion fruit rind demands the establishment of a proper protocol to maintain a high standard of product quality. In this work, a central composite experimental design of 23 was used to verify the influence of different conditions on the molecular characteristics and rheological behavior of extracted pectin. The extraction conditions were time (5–45 min), temperature (63–97C) and nitric acid concentration (8–92 mM). The responses significantly influenced (P

Resume Introduction La repetition des keratoplasties transfixiantes (KT) augmente le risque de rejet. Les chirurgiens sont souvent reticents a realiser une troisieme KT lorsqu’il y a deja eu deux rejets de greffe. L’objectif de cette etude etait d’evaluer le pronostic d’une troisieme KT chez des patients traites par l’association de ciclosporine A 2 % et de dexamethasone 0,1 % en collyre. Patients et methodes Dans cette etude, 15 yeux de 15 patients traites et suivis dans le service d’ophtalmologie de l’hopital Hotel-Dieu a Paris entre 2006 et 2009 pour une troisieme KT ont ete evalues de maniere retrospective. Resultats Apres un suivi moyen de 20,5 ± 2 mois, le risque de rejet de greffe etait de 13,33 %, La duree du suivi correspondait chez tous les patients a la duree du traitement par ciclosporine collyre. Aucun patient n’avait arrete le traitement en raison de probleme de tolerance. Conclusion Nous observons dans cette etude un taux de succes legitimant l’indication d’une troisieme keratoplastie sous ciclosporine locale 2 % classiquement consideree comme discutable.

Resume Les keratoconjonctivites virales a adenovirus sont le fait de tres nombreuses souches de virus et vont donner des tableaux cliniques varies, domines en frequence par les keratoconjonctivites epidemiques, meme si les conjonctivites folliculaires et la fievre pharyngoconjonctivale ne sont pas exceptionnelles. C’est un virus tres resistant dont la transmission se fait essentiellement par contact. Au niveau de la conjonctive, il va provoquer un tableau non specifique de conjonctivite. Au niveau de la cornee, il va laisser des depots de proteines virales sur la couche de Bowman. La reaction immunitaire contre ces depots sera a l’origine des infiltrats sous-epitheliaux. Le diagnostic est essentiellement clinique, le laboratoire n’apportant que rarement une aide rapide. Il n’y a pas de traitement autre que symptomatique. Les sequelles sont les opacites sous-epitheliales corneennes dont le traitement est difficile, malgre l’apport du laser excimer. Le role et l’utilisation des corticoides sont discutes a tous les stades de l’infection. La prevention est l’action la plus importante que l’ophtalmologiste puisse appliquer dans cette maladie.

Hyaluronan, as most macromolecules of the extracellular matrix, are produced by the differentiated mesenchymal cells. These cells produce also enzymes degrading hyaluronan. This results in the presence of several hyaluronan pools of different molecular weights, all capable of interacting with surrounding cells, mediated by hyaluronan binding proteins and receptors. These interactions modulate cell phenotype and produce a variety of effects conditioning the specific functions of tissues. We shall discuss here several examples studied in our laboratory, concerning skin, cornea and the venous wall. Some of these actions might even be harmful, and could play an important role in aging of connective tissues with loss of function. Some of these age-dependent modifications mediated by hyaluronan will be reviewed and commented, especially the upregulation of matrix degrading enzymes as MMP-2 and MMP-9. We shall also mention some of our experiments for finding molecules capable of counteracting the harmful effects mediated by hyaluronan.

Summary Objective To study the behavior of a “pushed” monocanalicular stent by means of nasal endoscopy. Patients and Methods Four children (six affected sides) with congenital nasolacrimal duct obstruction were treated with monocanalicular intubation with an anchoring plug . The children's mean age at the time of the operation was 33 months (range, 30–37 months). The procedure began with probing in order to verify (a) dacryostenosis (simple or extensive nasolacrimal duct impatency) and (b) the metal-to-metal contact in the lower nasal meatus. The stent was similar to a Monoka TM , but the guide (a malleable stainless steel probe) is located inside the silicone stent rather than projecting from it. The silicone's total length is 40 mm and the external diameter 0.96 mm. Simultaneously, the guide acts to catheterize the nasolacrimal duct by pushing the silicone through the upper and lower parts of the outflow system. The guide is removed via a punctal approach. This mode of intubation dispenses with the nasal recovery step. Nasal endoscopy was used to monitor (a) the position of the stent in the lower nasal meatus (free or submucosal), (b) mucosal damage and bleeding, and (c) the behavior of the silicone tube during removal of the guide. Results Because of the complexity of nasolacrimal ducts, two of the six sides were treated with the classical Monoka intubation method of pulling the silicone tubing out from the nasal exit of the duct (the pull technique). The pushed intubation method was used for the four simple nasolacrimal stenoses, with no problems whatsoever. In all four cases, endoscopic examination showed (a) no submucosal tunneling (false passage), (b) no noteworthy mucosal damage, and (c) no retraction (bunch-up) of the silicone tube during the metal guide removal. No particular complications were reported during the procedure or the intubation period, which lasted an average of 3 weeks. The stents were removed in the consulting room. Tearing ceased during the 1 st week in two cases, during the intubation period. Tearing persisted throughout the intubation period in the other two cases, but ceased during the week following stent removal. The follow-up lasted 2 months. Conclusions The pushed procedure simplifies monocanalicular nasal intubation. Its indications remain to be determined.

Resume Introduction En 2009, en France, les patients operes de chirurgie de la cataracte sont revus par leur chirurgien le lendemain. L’interet d’une visite a J1 apres chirurgie de la cataracte est clairement remis en question depuis quelques annees mais cette visite reste largement pratiquee. Le but de cette etude est d’evaluer si cette visite modifie la prise en charge therapeutique. Patients et methodes Cent trois patients (106 yeux) consecutifs operes de chirurgie de la cataracte par phacoemulsification ont ete inclus de maniere prospective dans notre service (82 % etaient pris en charge en ambulatoire). Les complications per-operatoires ont ete notees. Ont ete analyses a J1 : tonus oculaire, examen du segment anterieur et du pole posterieur. Tout changement de prescription par rapport a une ordonnance « standard » a ete note. Resultats Des complications per-operatoires sont survenues dans 8 cas. A l’examen du J1, six patients ont eu une hypertonie oculaire superieure a 24 mmHg, 14 un œdeme corneen, 6 une erosion corneenne, 2 un seidel, 1 une subluxation anterieure d’une haptique, 1 seul un decollement de retine. Dans 26 cas (24,5 %), il y a eu un changement de prescription par rapport a l’ordonnance standard. Discussion Un grand nombre d’etudes ont montre que la visite du J1 apres phacoemulsification n’etait pas obligatoire. Le principal objectif de cette visite est de detecter une hypertonie oculaire. Plus rarement, elle permet de detecter un seidel, une malposition de l’implant, un decollement de retine, complications pouvant necessiter une reprise chirurgicale. Conclusion La visite a J1 apres phacoemulsification reste necessaire, car des complications parfois imprevisibles peuvent survenir et potentiellement compromettre le resultat de la chirurgie. Elle a egalement un interet d’education therapeutique des patients (reexplication des symptomes devant faire consulter en urgence).

Resume Introduction Le pronostic de la keratite a Fusarium est souvent trop sombre. Le but est d’apporter une demarche therapeutique. Observation Nous rapportons le cas d’un homme porteur de lentilles souples ayant presente une keratite a Fusarium solani. Le traitement par amphotericine B collyre et voriconazole intraveineux a permis une amelioration. Il y a eu une rechute a l’instauration des corticoides avec aggravation et effraction de chambre anterieure malgre l’arret des corticoides et la reprise du traitement initial. La guerison a ete obtenue sans chirurgie avec voriconazole collyre, amphotericine B liposomale collyre, natamycine collyre, voriconazole intraveineux et amphotericine B liposomale intraveineuse. Conclusion La prise en charge rapide et l’apparition de nouvelles molecules devraient changer les resultats a venir. Le voriconazole associant voies locale et generale est interessant pour une concentration minimale inhibitrice autour de 2 μg/ml. L’amphotericine B liposomale semble etre la molecule la plus sure pour tous les stades. Le posaconazole represente une alternative a explorer.

A 59-year-old man presented with Terrien's marginal degeneration associated with keratoconus of his left eye. Penetrating keratoplasty of the left eye permitted an evaluation under optical microscopy, as well as transmission and scanning electron microscopy. An anatomical-pathological evaluation confirmed the co-existence of a central lesion due to keratoconus and a peripheral lesion due to Terrien's marginal degeneration. An absence of the knowledge of the etiology of either afflication does not allow one to define whether there exists one or two active degenerative processes.

Corneal tattooing. A series of 14 case studies N. Rocher, L. Hirst, G. Renard, M. Doat, J.-L. Bourges, E. Mancel Aims Evaluate the efficacy of a little-used surgical method: corneal tattooing, using a dermograph to hide unsightly corneal scars on nonfunctional eyes. Patients and methods Retrospective study of 14 eyes of 13 patients treated by tattooing the corneal surface, by directly introducing the pigments into the corneal stroma using a dermograph. The effectiveness of tattooing was evaluated by pigmentation homogeneity and patient satisfaction. Tolerance was evaluated by the scarring at the 7th day and ocular inflammation. The average follow-up was 18 months. Results: Fourteen eyes presented an unaesthetic, neovascularized major corneal edema (79 % traumatism). In 12 eyes, the treatment was homogeneous with a very satisfactory aesthetic result for the patient. One eye presented minor complications of pigmentary migration. One eye presented a corneal perforation 40 days after the procedure on a very pathological cornea. Conclusion: Corneal tattooing using a dermograph is a little-used technique since changes in corneal transplantation indications but is also a simple and inexpensive alternative for corneal scar treatment on nonfunctional eyes

Relevance of traditional hospitalizations in an ophthalmology department T. Gaujoux, O. Offret, G. Renard, Y. Santini, D. Chauvaud, J.-L. Bourges. Introduction: Ophthalmological indications for traditional hospitalizations are not clearly established and should be updated with respect to both healthcare quality and economic considerations. We therefore analyzed the data of patients hospitalized in an ophthalmology department. Patients and method: We prospectively analyzed the medical and socioeconomic charts of all patients hospitalized during a 2-month period (December 2006 and January 2007) in a single ophthalmology department. Results: Over the 2 months, 349 patients were admitted (mean stay, 3 days), 324 of whom were operated. The main causes of admission were retinal detachments (n=103), injuries (n=33), endothelial cell failure (n=27), cataract (n=27), high ocular pressure (n=23), and corneal abscess (n=17). Admission was mainly guided by the surgeon’s habits (n=135, 39%) and was not medically relevant but was generally motivated by financial considerations. Other hospital admissions were medically justified (intravenous injections, head positioning) but the hospitalization of patients living far from the hospital (n=46; 13%) could be limited by the development of housing made available to patients. Conclusion: Ophthalmological hospitalization is not always medically relevant and often is based on financial or housing constraints. More than half of the classical admissions should be switched to ambulatory patient care by adapting financial compensations to surgical costs or providing outpatient housing.

Corneal keratocytes are often confounded with fibroblasts, although their matrix-synthetic phenotype is quite different as shown by the nature and relative amount of the different collagens and proteoglycans-glycosaminoglycans synthesized. In these experiments, we compared the concentration of collagens excreted in the culture medium by human corneal keratocytes and skin fibroblasts at three consecutives passages. Although the keratocytes excreted less collagen at earlier passages, they approached and reached fibroblasts at later passages. This can be taken as an indication of the progressive loss of a specific keratocyte phenotype with increasing passages (in vitro aging). The effect of rhamnose-rich oligo- and polysaccharides on collagen secretion also confirmed the subtle differences between these two cell-types, as well as the difference between saturation density of both cell types at confluence and the proportion of dead cells floating on top of the culture medium. These differences were also attenuated with passage number without disappearing completely. The significance of these findings will be discussed in the light of previous results in our and other laboratories on matrix-secreting phenotypes and aging.

La dysplasie ectodermique anhidrotique est une dermatose congenitale atteignant surtout le garcon (sa transmission etant le plus souvent liee a l’X), chez qui elle est responsable d’une dysmorphie faciale, d’un retard staturo-ponderal et d’une blepharite severe. Elle associe une atteinte des phaneres, de l’epiderme et des glandes du derme, en particulier des glandes sudoripares, mettant en jeu le pronostic vital. Les atteintes ophtalmologiques sont dominees par les anomalies palpebrales avec une diminution, voire une absence, des glandes de Meibomius, un dysfonctionnement des glandes de Moll et de Zeis aboutissant a une blepharite ciliaire squameuse et un retrecissement, voire une stenose, des points lacrymaux. Ces anomalies palpebrales conduisent a de severes atteintes de la surface oculaire se developpant a partir de la deuxieme decennie, souvent invalidantes, necessitant un suivi rigoureux pour eviter des complications corneennes.

Purpose To quantify the visual outcome obtained in patients operated on for penetrating keratoplasty for keratoconus (KC) after 1 and 2 years. Patients and methods The files from consecutive keratoconus patients operated on for PKP after more than 2 years of follow-up were retrospectively studied. The demographic charts, the KC stage, and the surgical features were noted. The best corrected visual acuities (BSCVA) were analyzed at the initial examination and after 1 and 2 years of follow-up. Results One hundred and two eyes from 98 patients were analyzed, including 83 grade 4 (81%) and 19 grade 3 (18%) cases of KC. The mean preoperative BSCVA was 0.08 on the decimal chart, which increased to 0.5 and 0.6 1 and 2 years after penetrating keratoplasty (p Conclusion One and 2 years after penetrating keratoplasty, a mean BSCVA of 0.5 and 0.6 could reasonably be expected in keratoconus patients and three-quarters of patients can be expected to see better than 0.5 after 2 years.

La glycosylation non-enzymatique (glycation) des proteines a ete decrite par Louis Camille Maillard en 1912. Cette reaction aboutit a la formation de produits avances de la glycation (AGE-s : Advanced Glycation End products) qui representent un facteur de risque dans le vieillissement tissulaire. En pathologie oculaire, leur role a ete demontre dans la rigidification de la cornee, ou dans la pathologie du vitre susceptible de favoriser le detachement de la retine. Les AGE-s interviennent egalement dans la pathologie des vaisseaux retiniens et dans la degenerescence maculaire liee a l'âge (DMLA). L'etude comparative de la susceptibilite aux AGE-s des fibroblastes de la peau humaine et des keratocytes a montre que les keratocytes sont nettement moins endommages par ces produits que les fibroblastes. Au contact des AGE-s, en culture cellulaire, on trouve beaucoup moins de cellules mortes et une nettement meilleure conservation de la capacite de proliferation chez les keratocytes que chez les fibroblastes. L'origine de cette difference de phenotype entre fibroblastes et keratocytes pourrait etre l'exposition frequente de ces derniers aux rayons UV, ce qui pourrait favoriser l'apparition chez les keratocytes, au cours de l'evolution, d'une meilleure resistance contre des effets cytotoxiques declenches par des mecanismes radicalaires.

Extended Abstract. Hydrologists are concerned with high intensity rainfall and peak runoff rates for stormwater infrastructure designs, post-event assessments and mitigation of environmental impacts. In the Southwestern US the need for accurate information about these rates is increasingly important as population growth and associated development is projected to exceed national averages. Design storm totals for various durations and return period frequencies are routinely derived from NOAA Atlas 14 and are commonly used as input to hydrologic models to estimate peak runoff rates and runoff volumes. For the Southwestern US during the North American Monsoon, NOAA relies on sparse rain gauge networks to measure rainfall from limited area convective storms primarily at daily time steps and estimates of sub-daily event intensities are derived by temporal down-scaling from a few point locations. The US Department of Agriculture, Agricultural Research Service, Southwest Watershed Research Center (SWRC) operates the Walnut Gulch Experimental Watershed (WGEW) in the vicinity of Tombstone, Arizona. SWRC maintains a database of 60 years of sub-daily, high temporal-precision rainfall intensities and runoff rates for WGEW (Goodrich et al., 2008). Updated, temporally-extended, rainfall intensity-duration-frequency relations for WGEW are presented. The current analysis includes intensity-duration-frequency relations for July, August and September for 53 years, 1961-2013, for 2-, 5-, 10-, 15-, 30- and 60-minute durations and 2-, 5-, 10-, 25-, 50-, 100- and 1000-year return periods. The 149 km 2 WGEW is large enough to select groups of four rain gauges whose event totals are independent. This allows combining of the four independent gauges’ 53-year time series into a longer time series of 212 years. A comparison of WGEW-generated intensity-duration-frequency curves to those of NOAA Atlas 14 indicated good agreement. However, across the range of durations, many observed events on WGEW from gauges not used in the frequency analysis are much greater than the estimated 100-year event.

Introduction Nous rapportons le cas d’une injection intravitreenne accidentelle de lidocaine au cours d’une anesthesie locale palpebrale. Nous evoquons la prise en charge de cette rare complication et discutons de la toxicite retinienne de la lidocaine en situation intravitreenne. Observation Un homme, âge de 29 ans, se plaignit l’exerese d’une baisse brutale d’acuite visuelle droite lors d’une injection intrapalpebrale d’anesthesique precedant l’exerese d’un chalazion. L’examen retrouvait une acuite visuelle reduite a une perception lumineuse, une hypertonie, une effraction de la cristalloide posterieure, une bulle d’air dans la cavite vitreenne ainsi qu’un spasme de l’artere centrale de la retine. L’electroretinogramme initial objectivait une diminution de l’amplitude de l’onde b. La levee de l’hypertonie en urgence permit de supprimer le spasme de l’artere centrale de la retine. Vingt-quatre heures apres, l’acuite visuelle etait chiffree a 6/10e et l’electroretinogramme montrait une onde b plus ample. Aucune toxicite retinienne n’a ete cliniquement observee. Seule une cataracte sous-capsulaire limitait l’acuite visuelle. Conclusion Cette observation confirme la relative bonne tolerance retinienne de la lidocaine en situation intravitreenne, et nous rappelle que les risques de blessures oculaires existent aussi lors d’anesthesies palpebrales superficielles.

The effect of high glucose concentration (3 g/l) on bovine corneal total protein and collagen biosynthesis was studied, using 3H-proline incorporation in explant cultures with protein and collagen determinations. The high glucose concentration increased the incorporation of 3H-proline in total corneal proteins as well as in collagens. The specific radioactivity of stromal collagens was strongly increased in these conditions. Mannitol was used to control the osmotic effect of the high glucose concentration, both at 1 and 3 g/l concentrations. Mannitol did not increase the incorporation of 3H-proline in total proteins or collagens, but on the contrary decreased it. The high glucose concentration decreased the excretion of neosynthesized proteins and collagens in the culture medium, but did not affect the total protein or collagen content of the corneas. The strong increase in the specific radioactivity of corneal collagens in the presence of 3 g/l glucose suggests an increased turnover of collagens in diabetic corneas. The increased biosynthesis of collagens together with their decreased elimination in the extracellular compartment can create the conditions for the formation and accumulation of advanced glycation endproducts by the Maillard reaction. This can induce and stimulate the liquefaction of the vitreous body leading to sight-threatening disorders such as diabetic retinopathy, retinal detachment, glaucoma, cataract formation and age-related macular degeneration.

Dans cet article, nous discuterons de la physiopathologie des embolies arterielles retrogrades compliquant les chirurgies faciales a travers l’observation d’une patiente qui a presente une ischemie oculaire apres traitement de rides glabellaires par injection de graisse autologue centrifugee (lipostructure). Ces complications encore peu connues sont en recrudescence en raison de la multiplication des injections de substances visqueuses a visee esthetiques pourtant considerees comme peu risquees. Nous expliquerons comment se produisent pendant l’acte chirurgical, les embolies arterielles retrogrades jusqu’a l’artere ophtalmique du fait de ses anastomoses avec les arteres faciales et faisons une revue de la litterature.

Introduction La precocite de la prise en charge des keratites amibiennes conditionne le pronostic visuel final. Le but de ce travail a ete d’etudier les keratites stromales amibiennes prises en charge dans le departement d’urgences ophtalmologiques de l’Hotel-Dieu de Paris sur une periode de 3 ans pour preciser l’incidence et les facteurs conduisant a cette complication grave. Patients et methodes Tous les cas de keratite stromale amibienne confirmes par un examen parasitologique et pris en charge dans le service des urgences entre janvier 2000 et decembre 2002 ont ete recenses. Durant cette periode, huit patients ont presente cette affection. Leurs caracteristiques generales, biomicroscopiques, therapeutiques et evolutives ont ete relevees. Resultats Tous les patients consultaient pour un second ou troisieme avis. Un seul patient n’etait pas porteur habituel de lentille souple. Six patients presentaient un abces bacterien associe. L’infiltrat annulaire amibien typique n’a ete observe qu’une seule fois. Trois patients ont recu un traitement anti-amibien efficace dans les 15 jours suivant les premiers symptomes et cinq patients seulement un mois apres. Une keratoplastie a chaud a ete necessaire chez l’un des patients. L’acuite visuelle finale etait inferieure a 5/10 e dans tous les cas. Les patients traites dans les 15 premiers jours avaient la meilleure acuite visuelle finale. Discussion Les lentilles souples hydrophiles sont encore responsables de la majorite des graves complications corneennes amibiennes. L’errance diagnostique reste actuellement la cause principale de ces keratites stromales amibiennes graves, particulierement en l’absence d’antecedents contactologiques, a cause du retard therapeutique induit. Conclusion Le pronostic visuel final est fonction de la precocite d’un traitement amibien efficace. La gravite de cette affection justifie un traitement probabiliste anti-amibien efficace en cas de doute diagnostique.

Introduction L’huile de silicone est utilisee dans le traitement du decollement de la retine rhegmatogene, en cas de risque de proliferation vitreoretinienne postoperatoire. Ce type de tamponnement peut determiner des complications secondaires. Le retrait du silicone est necessaire pour assurer un resultat fonctionnel durable. Cette etude a pour but d’evaluer les resultats du tamponnement par huile de silicone apres son retrait. Patients et methodes Nous avons retrospectivement analyse l’evolution des patients traites par tamponnement interne par huile de silicone pour le decollement de la retine idiopathique entre le 1er janvier et le 31 decembre 2001. Les donnees suivantes ont ete etudiees : le type de dehiscence initiale, les traitements entrepris avant tamponnement par silicone, l’indication du tamponnement par silicone, les procedures chirurgicales employees et leurs resultats, les causes des recidives du decollement de la retine et l’acuite visuelle finale. Le succes anatomique est defini par une retine a plat apres retrait de l’huile de silicone. Resultats 93 patients etaient inclus dans cette etude. Au terme des procedures, la retine etait a plat et le silicone ote chez 71 patients (76,3 %). Le nombre moyen d’interventions en cas de recidive etait de 2,6. Apres la chirurgie initiale, le taux de recidive a l’ablation de l’huile de silicone etait de 17,0 % ; le taux de recidive de decollement de retine sous silicone etait de 45,1 %, la cause de recidive etant la PVR dans 97,6 % des cas. Le tamponnement interne par huile de silicone, dont la duree moyenne est de 6,7 mois, n’a ete responsable d’aucune complication severe. Les meilleurs resultats ont ete obtenus en l’absence de recidive sous silicone : l’acuite visuelle etait superieure a 4/200 dans 84,6 % des cas, superieure a 20/200 dans 61,5 % des cas et superieure a 80/200 dans 20,5 % des cas. En cas de recidive sous silicone, 70,4 % des cas de succes anatomique avaient une acuite visuelle finale superieure a 4/200 et 25,9 % une acuite visuelle superieure a 20/200. Conclusions Les resultats de cette etude sont comparables a ceux des etudes ou l’analyse est faite apres ablation de silicone. La proliferation vitreoretinienne demeure le seul facteur de risque de recidive du decollement de la retine sous silicone (p

Objectif Explorer des tumeurs du limbe en microscopie confocale in vivo et comparer les images aux coupes histologiques traditionnelles. Materiel et methodes Nous avons etudie chez trois patients, trois tumeurs du limbe en microscopie confocale (Heidelbergh Retina Tomograph II, Rostock Cornea Module). Chaque patient eu une biopsie-exerese chirurgicale completee d’une cryotherapie. Un examen anatomopathologique a ensuite ete effectue. Resultats L’histologie a identifie deux dysplasies et un carcinome in situ . Les images de microscopie confocale ont permis d’observer plusieurs caracteres morphologiques des neoplasies intra-epitheliales : les atypies cytonucleaires, les interdigitations de la proliferation dans un chorion inflammatoire et richement vascularise, les fins vaisseaux perpendiculaires a la surface, la limite nette avec l’epithelium sain, l’architecture papillomateuse, la keratinisation anormale. Conclusion Cette etude preliminaire a montre que les tumeurs du limbe sont explorables en microscopie confocale in vivo. Cette technique ne nous a pas permis cependant de repondre a la question cruciale de la micro-invasion ou non du tissu conjonctif sous-jacent. Elle pourrait etre une aide au diagnostic en cas de tumeur du limbe atypique et pour la recherche postoperatoire des frequentes recidives. D’autres etudes sont necessaires pour confirmer nos hypotheses.

It is well recognized that near-wellbore formation damage can dramatically reduce well productivities, especially for open hole completed horizontal wells. The economic impact of poor productivity of these wells has pushed toward significant efforts in recent years to study laboratory testing techniques and numerical modeling methods for predicting and controlling drilling-induced formation damage. This paper presents an integrated approach, combining a near-wellbore modeling with laboratory experiments for data acquisition as input for the model, to evaluate the performance of oil and gas wells after drilling-induced formation damage.

Nous presentons le cas anatomo-clinique d’une femme de 74 ans venue consulter pour « larmes de sang ». L’etiologie se revela etre un volumineux melanome nodulaire conjonctival cache dans le cul-de-sac superieur gauche. Il s’etait developpe a bas bruit sur une melanose acquise primitive meconnue. Les donnees cliniques et histologiques ainsi que le traitement sont presentes. Un arbre decisionnel resume la conduite a tenir face a une melanose conjonctivale.

Corneal wound healing often leads to the development of scar tissue with loss of transparency. Reconstitution of transparent corneal stroma depends on the regulation of the biosynthetic activities of postlesional keratocytes and also to a large extent on the limitation of matrix degradation, attributed essentially to the upregulation of matrix metalloproteases and especially MMP-9. Using a standardized method for the production of reproducible corneal lesions by burning with iodine vapors, we could show that the local application of 0.5 mg/ml L-fucose reduced significantly MMP-9 upregulation and accelerated the recovery of the epithelial layer of the cornea. The iodine vapor used in the experiments produces a rapid loss of epithelium with no or slight effect below the basement membrane. A relatively rapid regrowth of epithelium was observed. The speed of this reepithelialization was stimulated by the local application of fucose. At 48 h after burn, there was a difference between fucose-treated and control corneas (epithelial thickness was about 50 µm for fucose-treated corneas and 37 µm for control corneas). Culture media of in vivo fucose-treated corneas showed an important decrease of MMP-9 activity (–51%, n = 6, p < 0.01). It appears that the in vivo fucose treatment reduced the MMP-9 activity released in the media. This effect is significant 24 h after iodine vapor burn. In order to study the effect of fucose on normal corneas, it was added to rabbit as well as human cornea explant cultures, and the production and release of MMP-9 was determined by zymography. Fucose at a concentration of 0.5 mg/ml produced a 70% decrease of MMP-9 activity released in the medium by corneal explant cultures. Other mono- and oligosaccharides were also tested. Besides lactose, fucose-rich oligosaccharides also produced significant inhibition. Galactose, melibiose, mannose and glucose were inactive. These results justify the use of fucose for the local treatment of corneal wounds.

Eye burns are frequent among eye traumas. They induce different effects on the ocular structures, depending on the type of burn: chemical, with an important difference between acids and bases, thermal, or ionizing rays. The physiopathology of eye burns reflects the different stages of progression, with a first stage of destruction, a second stage of cleaning and inflammation, and a last stage of reconstruction and scarring. The final prognosis depends on the initial lesions, not only involving the eye ball, but also the conjunctiva and eyelids. Chemical burns by basic fluids have the worst prognosis because they are able to penetrate the tissues quickly. Burns by acids have a better prognosis and thermal burns are located only at the injured area. Treatment is most effective at the initial stage of destruction and can dramatically change the prognosis. The secondary phase of cleaning includes the entire biochemical cascade of inflammation and the production of proteases. At this stage, treatment can be effective but must be closely monitored because it can inhibit progression to the last stage of scarring. At the scarring stage, neovascularization begins, induced by initial ischemia, the reconstruction of epithelium with a probable role of stem cells, the reconstruction of nerve fibers depending on the nerve growth factor (NGF), and the reconstruction of extracellular matrix in which matrix metalloproteinases (MMPs) are essential. At this stage, therapy can only be surgery of functional after effects and esthetic anomalies.

Nous rapportons le cas d’une patiente de 56 ans qui vint consulter pour une masse de la glande lacrymale principale gauche avec signes inflammatoires, discrete exophtalmie et douleurs. L’imagerie au scanner montra une hyperdensite dans la loge lacrymale gauche. Une surveillance de 9 mois fut effectuee ; aucun traitement anti-inflammatoire ne put etre applique en raison d’ulceres digestifs en evolution. Au terme de cette surveillance, une exerese monobloc par voie anterolaterale permit l’analyse histologique de la piece qui conclut a un adenome pleomorphe. Ce cas demontre l’interet d’une approche chirurgicale suffisamment large de toute masse de la glande lacrymale pour eviter toute effraction capsulaire, source potentielle de recidive tumorale.

Introduction Il est difficile d’introduire un implant orbitaire poreux biocolonisable de volume suffisant apres une evisceration classique. Nous proposons une modification de la technique permettant une optimisation des resultats. Materiel et methodes Quatre carres de sclere restant pedicules sur l’insertion des muscles droits sont decoupes et sutures deux a deux en avant de la bille. Resultats Quinze patients ont ete operes. Aucune complication n’a ete decelee avec un recul moyen de 12,4 mois. Discussion La conjonctive et la couche de Tenon etaient protegees de la bille par deux couches de sclere vascularisees. Le diametre de l’implant etait de 18 mm pour 3 patients, de 20 mm pour 8 patients, et de 22 mm pour les 4 autres. La duree operatoire etait considerablement raccourcie par rapport a une enucleation avec evisceration sur table. Conclusion L’evisceration avec la technique des « quatre carres » est une technique sure et rapide pouvant, en dehors d’un contexte oncologique, etre proposee dans la majorite des cas.