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Resume Introduction L’atteinte respiratoire liee a la maladie associee aux IgG4, proteiforme et d’intensite variable, peut etre grave. Nous rapportons un cas de maladie associee aux IgG4 revelee par une pneumopathie infiltrante diffuse d’aggravation rapidement progressive. Observation Il s’agit d’un homme âge de 69 ans, ancien fumeur, hospitalise initialement pour enquete etiologique d’une pneumopathie interstitielle diffuse revelee par une toux, une dyspnee febrile et une alteration de l’etat general evoluant depuis 3 mois. L’aggravation rapide de l’hypoxemie imposait un transfert en soins intensifs respiratoires pour instauration d’une ventilation non invasive (VNI) et d’une oxygenotherapie a haut debit. Le scanner thoracique revelait des condensations lobaires inferieure droite et moyenne, des plages de verre depoli diffuses, un epaississement des septa inter-lobulaires ainsi que des adenomegalies mediastinales et une pleuresie bilaterale de faible abondance. Une maladie associee aux IgG4 etait suspectee devant une augmentation des IgG4 seriques. La confirmation diagnostique fut obtenue par une biopsie renale montrant une glomerulonephrite aigue avec une infiltration lympho-plasmocytaire, une fibrose d’aspect storiforme et plus de 60 plasmocytes IgG4+ par champ a fort grossissement. L’evolution etait rapidement favorable sous corticotherapie systemique. Conclusion Habituellement au second plan, l’atteinte respiratoire de la maladie associee aux IgG4 peut egalement se reveler par une insuffisance respiratoire severe avec ou sans atteinte extra-thoracique.

Ressenya del llibre Mireia Freixa i Mar Léniz, El Park Güell i els seus orígens, 1894-1926, Barcelona, Museu d’Història de Barcelona - Ajuntament de Barcelona, 2019.

En este articulo se describen las protesis usadas en las personas adultas que han sufrido una amputacion del miembro inferior, por causa vascular (la gran mayoria), traumatica, neoplasica, infecciosa o congenita, pero sin incluir las protesis que no se ajustan a las «normas» y que se pueden utilizar en causas congenitas. Esta escrito desde el punto de vista del protesico y del rehabilitador. En la primera parte, se describen las distintas protesis que se utilizan en la actualidad. Despues, se detalla la colocacion de las mismas, enumerando distintas tecnicas y ofreciendo los consejos del rehabilitador sobre varios aspectos. Como conclusion, los autores presentan de un modo critico, pero constructivo, algunos sistemas protesicos avanzados.

Resume Introduction Les anticorps anti programmed death-1 (PD-1) et programmed death-ligand 1 (PD-L1) sont des immunotherapies utilisees dans le traitement de nombreuses tumeurs solides. Des cas de pneumopathies interstitielles induites par les anti PD-1 ont largement ete decrits, mais les donnees sont moins nombreuses avec les anti PD-L1. L’avelumab est une nouvelle immunotherapie de la classe des anti PD-L1. Observation Il s’agit d’une femme de 66 ans, tabagique sevree, traitee par avelumab et axitinib depuis le 15 novembre 2016 pour un cancer renal a cellules claires. Elle presente une pneumopathie interstitielle decouverte fortuitement 4 mois apres le debut du traitement avec des lesions scannographiques de verre depoli, des reticulations intra-lobulaires et une adenopathie de la zone 4R. Le bilan exhaustif ne met pas en evidence de retentissement fonctionnel respiratoire, ni d’etiologie infectieuse ou immunologique. Les anomalies radiologiques regressent spontanement apres l’arret du traitement, permettant de retenir le diagnostic de pneumopathie medicamenteuse. Conclusion L’avelumab peut induire une pneumopathie interstitielle. Son mecanisme incertain necessite des etudes complementaires. Une surveillance des explorations fonctionnelles respiratoire et du scanner thoracique est necessaire pour une prise en charge precoce.

Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension. Heritable and sporadic forms have been distinguished. Hypoxemia, profound reduction in the diffusion of carbon monoxide and haemodynamic confirmation of pre-capillary pulmonary hypertension are the major diagnostic criteria. Thoracic CT scanning and a response to pharmaceutical therapy provide additional information to confirm the diagnosis. A 52-year-old patient, three of whose siblings had pulmonary hypertension, was admitted with dyspnoea, malaise and palpitations. Right heart catheterisation confirmed pre-capillary pulmonary hypertension. A search for an EIF2AK4 mutation was carried out, and this showed a composite biallelic heterozygous mutation compatible with the diagnosis of familial PVOD, identical to that showed in one of his brothers. Given the signs of severity of the disease and the diagnosis of PVOD, whose response to pharmaceutical therapy is often poor, the patient was placed on a waiting list for lung transplantation. Despite a similar diagnosis in 3 brothers and follow-up proposed 11 years before the diagnosis, pulmonary hypertension appeared within a few weeks and led immediately to a severe clinical situation. Annual clinical and echocardiographic monitoring had been strongly advised to the patient, but had not allowed diagnosis at a mild or moderate stage of the disease. This clinical case shows that the identification of factors predicting the development of heritable PVOD at a pre-symptomatic stage is an important issue for clinical research.

Resume Introduction Les pneumopathies a eosinophiles sont caracterisees par une alveolite a polynucleaires eosinophiles. Elles peuvent etre idiopathiques ou relever de differentes causes. L’origine medicamenteuse doit etre toujours evoquee. Observation Nous rapportons le cas d’une femme de 57 ans, fumeuse, atteinte d’un trouble bipolaire, traitee par divalproate de sodium depuis plus de 2 ans, qui presentait une dyspnee non febrile depuis 5 mois. Les explorations realisees montraient une hypoxemie severe, un trouble ventilatoire obstructif severe, de multiples images en verre depoli avec un aspect de crazy paving au scanner thoracique, une hypereosinophilie sanguine et une alveolite a eosinophiles au lavage broncho-alveolaire. Le diagnostic de pneumopathie a eosinophiles au divalproate de sodium etait retenu apres un bilan etiologique exhaustif, et l’amelioration radio-clinique etait rapide apres l’arret du medicament, sans recours a la corticotherapie systemique. Conclusion Le divalproate de sodium peut induire une pneumopathie a eosinophiles plusieurs annees apres son introduction. Un diagnostic rapide et un arret du traitement ont permis une guerison complete dans le cas rapporte.

The intrathoracic manifestations of IgG4-related disease include a range of conditions and severity, and can on occasion cause acute respiratory failure as reported in the case described here.A 69-year-old male former smoker, was admitted to our hospital with dyspnea, fever, cough, fatigue, and a 3-month history of weight loss. He received high flow oxygen therapy and non-invasive ventilation for severe respiratory failure. Chest computed tomography revealed multifocal condensations and ground glass opacities, accompanied by thickening of the perilymphatic interstitium, mediastinal lymphadenopathy and bilateral pleural effusion. Elevated serum concentrations of IgG4 suggested an IgG4-Related Disease. He developed renal failure and underwent a renal biopsy. Histopathological analysis of which supported the diagnosis by showing dense lymphocytic infiltrate with a count of IgG4+ cells/hpf higher than 60, and storiform fibrosis - a swirling, "cartwheel" pattern of fibrosis which may have a patchy distribution. The patient responded well to steroid therapy.Although respiratory symptoms are usually mild in IgG4-relatd disease, thoracic features can evolve into acute respiratory failure with few extra thoracic manifestations.

Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension. Heritable and sporadic forms have been distinguished. Hypoxemia, profound reduction in the diffusion of carbon monoxide and haemodynamic confirmation of pre-capillary pulmonary hypertension are the major diagnostic criteria. Thoracic CT scanning and a response to pharmaceutical therapy provide additional information to confirm the diagnosis. A 52-year-old patient, three of whose siblings had pulmonary hypertension, was admitted with dyspnoea, malaise and palpitations. Right heart catheterisation confirmed pre-capillary pulmonary hypertension. A search for an EIF2AK4 mutation was carried out, and this showed a composite biallelic heterozygous mutation compatible with the diagnosis of familial PVOD, identical to that showed in one of his brothers. Given the signs of severity of the disease and the diagnosis of PVOD, whose response to pharmaceutical therapy is often poor, the patient was placed on a waiting list for lung transplantation. Despite a similar diagnosis in 3 brothers and follow-up proposed 11 years before the diagnosis, pulmonary hypertension appeared within a few weeks and led immediately to a severe clinical situation. Annual clinical and echocardiographic monitoring had been strongly advised to the patient, but had not allowed diagnosis at a mild or moderate stage of the disease. This clinical case shows that the identification of factors predicting the development of heritable PVOD at a pre-symptomatic stage is an important issue for clinical research.

Simplifying the encoding of a simulation conceptual model representation reduces the number of errors that will be detected in the verification phase. In this paper, we present a mapping between Petri nets, a well-known formalism, and FlexSim, a well-known simulation tool. The proposal is illustrated through an example of how a model specified in a Petri net can be encoded easily, reducing the time needed to understand and verify the model. In the proposed methodology, the mapping must be defined at the initial stage of the encoding, starting from (in this case) a Petri net conceptual model, and ending at the encoding tool (FlexSim in this case). The main advantages of the proposed methodology are discussed.

Wildfire simulation tools focus on how fire spreads in the natural environment. Simulation of fire containment operations can provide managers with a tool that combine wildfire evolution with suppression operations. Combined simulation tools are useful to evaluate different strategies and tactics in firefighting wildfires. This paper presents the modelling and simulation of aerial containment operations integrated into a wildfire spread simulator. A continuous space wildfire spread simulator has been used for fire spread simulation. This simulator called GisFIRE integrates aerial operations and uses QGIS geographical information system to integrate both simulation tools with geographical information. The information system combines air facilities locations, usable bodies of water, and other relevant geo-information with the simulation procedures. Open source software is a requirement to allow integration of different software packages and usage of OGC standards to represent geographical information.

PURPOSE Prophylactic radiotherapy to prevent procedure-tracts metastases from malignant pleural mesothelioma remains controversial and clinical practice varies. The purpose was to assess the efficacy of local radiotherapy in a single fraction of 10Gy in preventing malignant seeding at intervention pleural site in patients with malignant pleural mesothelioma. MATERIAL AND METHODS This is a retrospective cohort study, including patients with histological confirmed malignant pleural mesothelioma treated by prophylactic irradiation to prevent interventional site metastases with a unique fraction of 10Gy with 6 to 18MeV, from January 1990 to December 2013 in the institut de cancerologie de Lorraine (Nancy, France). RESULTS Ninety-one patients were treated by irradiation in intervention site, involving 120 intervention pleural sites, 91 thoracoscopies, 17 thoracotomies with chest drain and 12 CT or ultrasound guided needle biopsies. The median follow-up was 7 months (interquartile between 3 and 15 months). The overall survival was 43.5% at 12 months. The local progression free survival was 43.7% at 12 month. The incidence of local recurrence was 8% at 12 months. The median interval from radiotherapy to local recurrence was 4 months (2; 32). No grade II or higher toxicity was observed. CONCLUSION Irradiation of pleural intervention sites with a single fraction of 10Gy is effective, well tolerated, simple, fast and cost effective.

The first reports of hepatic steatosis following pancreaticoduodenectomy (PD) were published several years ago; however, clear risk factors remain to be identified. Therefore, the aim of this study was to identify the risk factors for hepatic steatosis post-PD. We studied 90 patients who had undergone PD between September 2005 and January 2015. The inclusion criteria were as follows: available unenhanced CT within one month before PD and at least one unenhanced CT acquisition between PD and chemotherapy initiation. Using scanners, we studied the liver and spleen density as well as the surface areas of visceral (VF) and subcutaneous fat (SCF). These variables were previously identified by univariate and multivariate analyses. Hepatic steatosis occurred in 25.6% of patients at 45.2 days, on average, post-PD. Among the patients with hepatic steatosis, the average liver density was 52 HU before PD and 15.1 HU post-PD (p

Eosinophilic pneumonias are characterized by an increase in lung eosinophils. These disorders can be induced by drug reactions.A 57-year-old woman suffering from bipolar disorder and treated by sodium divalproate for more than 2 years was hospitalised in the department of respiratory medicine for dyspnoea and cough. The investigations showed severe hypoxaemia, airflow limitation, multiple ground-glass opacities and crazy paving on the chest CT-scan and a blood eosinophilia. A significant alveolar eosinophilia was found in the broncho-alveolar lavage. A complete assessment of possible causes was made. Finally, we made the diagnosis of eosinophilic pneumonia secondary to sodium divalproate. The treatment was stopped and systemic corticosteroid therapy was not introduced. The patient showed an improvement of her dyspnoea in a few days. Lung function and the CT-scan were normal within a few months.Sodium divalproate, frequently used in the treatment of bipolar disorder, is a rare cause of eosinophilic lung disease, even years after its introduction. Rapid diagnosis and withdrawal of treatment led to complete resolution in the reported case.

Resume Introduction L’histoire naturelle des maladies pulmonaires orphelines est rarement connue. Nous presentons l’evolution a long terme d’une forme bronchectasiante de la maladie a depots de chaines legeres (MDCL) d’immunoglobulines non amyloides. Observation Il s’agit d’une femme fumeuse chez qui le diagnostic de dilatation des bronches d’etiologie indeterminee est porte a l’âge de 50 ans. Dix ans apres, l’hypothese d’une MDCL pulmonaire est evoquee devant l’aspect caracteristique des bronchectasies, l’apparition de kyste pulmonaires, l’augmentation du taux serique des chaines legeres Kappa. La confirmation diagnostique est obtenue par biopsie pulmonaire chirurgicale. Aucune hemopathie maligne n’est retrouvee. Durant les 12 ans de suivi, l’aggravation de la dyspnee d’effort est lente et concomitante a l’extension des bronchectasies et des kystes realisant un aspect de pneumopathie multikystique. Les EFR montrent une preservation des volumes pulmonaires et une diminution moderee de la capacite de diffusion du monoxyde de carbone (DLCO). Conclusion Nous decrivons l’evolution d’une presentation rare de la MDCL pulmonaire isolee sous la forme de bronchectasies kystiques diffuses, a parois fines, non secretantes, s’associant a une destruction kystique du parenchyme pulmonaire. L’hypothese d’une MDCL pulmonaire doit etre evoquee devant des bronchectasies atypiques d’etiologie indeterminee.

Poor storage of cereals, such as maize can lead to both nutritional losses and mycotoxin contamination. The aim of this study was to examine the respiration of maize either naturally contaminated or inoculated with Aspergillus flavus to examine whether this might be an early and sensitive indicator of aflatoxin (AF) contamination and relative storability risk. We thus examined the relationship between different interacting storage environmental conditions (0.80-0.99 water activity (a

International audience; PURPOSE:To describe the multidetector row computed tomography (MDCT) imaging features of HCC that develops in patients who are free from underlying liver cirrhosis and to determine if the MDCT presentation of this specific tumor differs from that of the more common HCC that develops in patients with liver cirrhosis using a retrospective case-control study.PATIENTS AND METHODS:The MDCT examinations of 38 patients with HCC in non-cirrhotic liver (group 1) were quantitatively and qualitatively analyzed and compared to those obtained in 38 patients with HCC in cirrhotic liver (group 2) matched for age and gender. Quantitative and qualitative characteristics of HCC of both groups were compared using univariate analysis.RESULTS:HCCs were significantly larger in group 1 (81.5mm±55.5) than in group 2 (44.5mm±39.1 SD; P=0.0015). In group 1, HCCs were more frequently single tumors (87%) than in group 2 (37%) (P

The anti programmed death-1 (PD-1) and the programmed death ligand 1 (PD-L1) antibodies are used as immunotherapies in the treatment of many solid tumours. Cases of interstitial pneumonitis induced by anti PD-1 have been widely described, but there are fewer data with anti PD-L1. Avelumab is a new immunotherapy of the anti PD-L1 class.A 66-year-old woman, ex-smoker, had been treated with avelumab and axitinib since November 2016 for renal cell cancer. Interstitial pneumonitis was discovered accidentally 4 months after the beginning of the treatment, with ground glass opacities, intra-lobular crosslinking and adenopathy of the 4R zone on the CT scan. An exhaustive assessment did not reveal any respiratory function defect or an infectious or immunological cause. The radiological abnormalities regressed spontaneously after cessation of treatment confirming the diagnosis of drug-induced pneumonitis.Avelumab can induce interstitial lung disease. The mechanism is uncertain and requires further studies. Monitoring of respiratory function and CT scanning are necessary for its early management.

Resume Les atteintes infectieuses du foie sont extremement variables en raison de la multiplicite des agents infectieux. Cet article fait le point sur l’apport de l’imagerie : celle-ci peut etre sensible et specifique, par exemple dans les abces a germes banaux, comme peu performante, par exemple en cas de lesion virale. L’imagerie a aussi un interet dans la prise en charge therapeutique permettant le traitement percutane des lesions collectees. L’ensemble de ces situations seront abordees dans ce travail.

Resume La radioembolisation est une forme de radiotherapie interne selective consistant en l’administration de microparticules impregnees d’Yttrium-90 au sein des arteres hepatiques. Elle repose sur le fait que les neoplasies hepatiques primitives et secondaires sont vascularisees principalement par un flux arteriel a l’inverse des hepatocytes sains dont l’apport sanguin est majoritairement issu du reseau portal. Cela permet de delivrer des doses importantes en epargnant relativement le parenchyme sain adjacent. Les principales complications sont liees a la diffusion des spheres radioactives dans le tractus gastro-intestinal par les branches issues du pedicule hepatique. La connaissance de ce reseau arteriel hepatique, ses variations et les considerations techniques qu’il engendre sont un pre-requis necessaire a la preparation du traitement. Ce travail detaille les particularites anatomiques et techniques de cette anatomie a la lumiere de la litterature recente en l’illustrant par des cas tires de notre experience personnelle.

Radioembolization (RE) is a selective internal radiotherapy technique in which yttrium-90 blended microspheres are infused through the hepatic arteries. It is based on the fact that primary and secondary hepatic tumors are vascularized mostly by arterial blood flow whereas healthy hepatocytes obtain their blood supply mostly from the portal network. This enables high radiation doses to be delivered, sparing the surrounding non-malignant liver parenchyma. Most of the complications are caused by unexpected particles passing into the gastrointestinal tract through branches originating from the main hepatic arterial supply. Knowledge of this hepatic arterial network and of its variations and the technical considerations this raises are required in preparation for treatment. This work describes the specific anatomical features and techniques for this anatomy through recent literature illustrated by cases from our own experience.

The natural history of orphan lung diseases is often unclear. We report the long-term follow-up of a case of bronchiectasis due to pulmonary non amyloid light chain deposition disease (LCDD).A 50-year-old woman who was a smoker, was diagnosed with diffuse thin walled bronchiectasis of uncertain origin after presenting with a respiratory tract infection. Ten years later, the combination of bronchiectasis, the appearance of pulmonary cysts and the identification of increased kappa free light chains evoked the diagnosis of pulmonary LCDD. The diagnosis was confirmed by lung biopsy. No immunoproliferative disorder was identified. During the 12 years follow-up, dyspnea worsened progressively and bronchiectasis and lung cysts extended leading to multicystic lung disease. Pulmonary function tests did not show any ventilatory defect but a small decrease in carbon monoxide transfer factor occurred.We describe the evolution of a rare presentation of isolated pulmonary LCDD, characterized by cystic diffuse atypical bronchiectasis with thin walls, associated with progressive cystic destruction of the lung parenchyma. The possibility of pulmonary LCDD should be considered in cases of atypical bronchiectasis of unknown etiology.

Prophylactic radiotherapy to prevent procedure-tracts metastases from malignant pleural mesothelioma remains controversial and clinical practice varies. The purpose was to assess the efficacy of local radiotherapy in a single fraction of 10Gy in preventing malignant seeding at intervention pleural site in patients with malignant pleural mesothelioma.This is a retrospective cohort study, including patients with histological confirmed malignant pleural mesothelioma treated by prophylactic irradiation to prevent interventional site metastases with a unique fraction of 10Gy with 6 to 18MeV, from January 1990 to December 2013 in the institut de cancérologie de Lorraine (Nancy, France).Ninety-one patients were treated by irradiation in intervention site, involving 120 intervention pleural sites, 91 thoracoscopies, 17 thoracotomies with chest drain and 12 CT or ultrasound guided needle biopsies. The median follow-up was 7 months (interquartile between 3 and 15 months). The overall survival was 43.5% at 12 months. The local progression free survival was 43.7% at 12 month. The incidence of local recurrence was 8% at 12 months. The median interval from radiotherapy to local recurrence was 4 months (2; 32). No grade II or higher toxicity was observed.Irradiation of pleural intervention sites with a single fraction of 10Gy is effective, well tolerated, simple, fast and cost effective.

La Plaça Reial de Barcelona que avui coneixem és el resultat d’un procés que arrenca a fi nals del segle xviii i pren forma a partir de 1822 amb la cessió del convent dels caputxins per construir-hi una plaça dedicada als herois de la Guerra del Francès. Però els diferents canvis de règim que se succeeixen al llarg del segle infl uencien decisivament en el concepte de la plaça, que tendeix a convertir-se en un espai més comercial que representatiu. Tot i això, en alguns dels diferents projectes que es presenten en el concurs de 1848, la idea patriòtica es manté amb força, però abordada des de diferents perspectives, des de la glorifi cació de l’Imperi Espanyol fi ns a la reivindicació catalanista. A partir de les diferents memòries dels projectes podrem analitzar els interessants programes iconogràfi cs proposats, la qual cosa ens permetrà mostrar l’ampli ventall d’opcions ideològiques dominants a Barcelona en el trànsit del Romanticisme al Realisme., Today’s Plaça Reial square in Barcelona is the result of a process that started in the late eighteenth century, and took shape from 1822 when the Capuchin convent was relocated to the city in order to build a square dedicated to the heroes of the Napoleonic Wars. But various regime changes throughout the century decisively infl uenced the ideological concept of the square, which gradually became a commercial rather than a representative site. Nevertheless, some of the projects presented at the 1868 competition retained patriotic ideas, although they were considered in many diff erent ways, from the glorifi cation of the Spanish Empire to the vindication of the Catalan state. Based on several reports on these projects, we will analyse the interesting iconographic programmes proposed, allowing us to illustrate the wide range of ideologies present in Barcelona at the time between Romanticism and Realism.

Aquest article tracta de l’edifici de la Central Catalana de Electricidad, construit per Pere Falques a Barcelona a finals del segle xix, el qual es concebut d’una manera molt diferent, donant una importancia a l’aspecte estetic i simbolic que no trobem en construccions contemporanies similars, com ara la central electrica del Paral·lel de l’empresa rival, la Compania Barcelonesa de Electricidad, de linies senzilles.A mes d’analitzar la complexa genesi constructiva de l’edifici, volem destacar que Falques hi conjuga els valors de funcionalitat amb la voluntat de crear una arquitectura que «expressi» el que significa l’electricitat com a paradigma de modernitat en el tombant de segle, i alhora que satisfaci la necessitat de representativitat de la nova companyia, entrant en competencia amb els majestuosos edificis on s’havien instal·lat les seus corporatives d’altres empreses d’energia com ara la Compania de Gas Lebon i la Catalana de Gas.

Many thermal sensors are already used, for many years, to better understand and control material forming processes, especially polymer processing. Due to technical constraints (high pressure, sealing, sensor dimensions…) the thermal measurement is often performed in the tool or close its surface. Thus, it only gives partial and disturbed information. Having reliable information about the heat flux exchanges between the tool and the material during the process would be very helpful to improve the control of the process and to favor the development of new materials. In this work, we present several sensors developed in labs to study the molding steps in forming processes. The analysis of the obtained thermal measurements (temperature, heat flux) shows the required sensitivity threshold of sensitivity of thermal sensors to be able to detect on-line the rate of thermal reaction. Based on these data, we will present new sensor designs which have been patented.

Aquest article tracta de l’edifici de la Central Catalana de Electricidad, construït per Pere Falqués a Barcelona a finals del segle xix, el qual és concebut d’una manera molt diferent, donant una importància a l’aspecte estètic i simbòlic que no trobem en construccions contemporànies similars, com ara la central elèctrica del Paral·lel de l’empresa rival, la Compañía Barcelonesa de Electricidad, de línies senzilles.A més d’analitzar la complexa gènesi constructiva de l’edifici, volem destacar que Falqués hi conjuga els valors de funcionalitat amb la voluntat de crear una arquitectura que «expressi» el que significa l’electricitat com a paradigma de modernitat en el tombant de segle, i alhora que satisfaci la necessitat de representativitat de la nova companyia, entrant en competència amb els majestuosos edificis on s’havien instal·lat les seus corporatives d’altres empreses d’energia com ara la Compañía de Gas Lebon i la Catalana de Gas., This article is focussed on the power plant building of the new electric company Catalana de Electricidad, built by the architect Pere Falqués in Barcelona in the late nineteenth century. This building was conceived in a very original way, as the aesthetic and symbolic aspects have an outstanding importance not seen in other similar buildings of that time, such as the power plant that the Compañía Barcelonesa de Electricidad had built in the Avinguda del Paral·lel a few years previously.Thus, we not only analyse the complex building process, but also highlight how Pere Falqués, the architect, was able to combine the functional and aesthetic aspects, with the aim of creating an architecture that expressed the meaning of electricity as a symbol of modernity at the end of the nineteenth century, and an architecture that fulfilled the new company’s necessity of representativeness, and that rivaled the monumental corporate buildings of the gas companies in the very centre of Barcelona.

Nestorone® (NES) is a potent nonandrogenic progestin being developed for contraception. NES is a synthetic progestin that may possess neuroprotective and myelin regenerative potential as added health benefits. In receptor transactivation experiments, NES displayed greater potency than progesterone to transactivate the human progesterone receptor (PR). This was confirmed by docking experiments where NES adopts the same docking position within the PR ligand-binding domain (LBD) as progesterone and forms additional stabilizing contacts between 17α-acetoxy and 16-methylene groups and PR LBD, supporting its higher potency than progesterone. The analog 13-ethyl NES also establishes similar contacts as NES with Met909, leading to comparable potency as NES. In contrast, NES is not stabilized within the human androgen receptor LBD, leading to negligible androgen receptor transactivation. Because progesterone acts in the brain by both PR binding and indirectly via binding of the metabolite allopregnanolone to γ-aminobutyric acid type A receptor (GABAAR), we investigated if NES is metabolized to 3α, 5α-tetrahydronestorone (3α, 5α-THNES) in the brain and if this metabolite could interact with GABAAR. In female mice, low concentrations of reduced NES metabolites were identified by gas chromatography/mass spectrometry in both plasma and brain. Electrophysiological studies showed that 3α, 5α-THNES exhibited only limited activity to enhance GABAAR-evoked responses with WSS-1 cells and did not modulate synaptic GABAARs of mouse cortical neurons. Thus, the inability of reduced metabolite of NES (3α, 5α-THNES) to activate GABAAR suggests that the neuroprotective and myelin regenerative effects of NES are mediated via PR binding and not via its interaction with the GABAAR.

Resume Nous avons mene une etude sur le devenir d’enfants victimes de rhinoconjonctivite pollinique desensibilises au pollen de graminees reevalues au moins trois ans apres l’arret de leur traitement. Ce travail a concerne 46 enfants d’âge median en debut de traitement de 10,46 ans. Parmi eux, (32) 69,57 % ont recu une desensibilisation par voie sous-cutanee (SC), (11) 23,61 % par voie sublinguale (SL) et (3) 6,52 % par voie SC puis SL. La duree moyenne de la desensibilisation etait de 4,41 ans. Un asthme etait associe dans 84,78 % des cas et 50 % etaient polysensibilises. L’evolution des scores symptomatiques restait en dessous des scores cliniques moyens avant desensibilisation ( p p = 0,001). A l’inverse, la toux seche et/ou les crises d’asthme, ne recidivaient pas lors de la saison pollinique. Il n’a pas ete observe d’augmentation significative de la prise de medicaments de secours au cours de la saison pollinique a l’exception d’antihistaminiques lors du pic pollinique ( p = 0,001). En fin d’etude, 82 % de la population trouvaient la desensibilisation toujours efficace du point de vue de l’asthme, contre 71 % pour la rhinite et 76 % pour la conjonctivite. L’efficacite de la desensibilisation reste prononcee apres arret prolonge. La persistance de symptomes mineurs justifie un suivi clinique adapte.

Objectif L’objectif de ce travail est de presenter la validation technique et la mise en place de 100 000 dosages sanguins annuels d’immunosuppresseurs (IS), ciclosporine, tacrolimus, everolimus et sirolimus, doses avec le kit MassTox ® Immunosuppressants (Chromsystems) sur 3 systemes LC-MS/MS en miroir (SCIEX API TQ 4500MD) avec une preparation entierement automatisee sur 2 Tecan EVO 150. Methodes Performances analytiques: les coefficients de variation (CV) de repetabilite et de fidelite intermediaire (FI) ont ete etablis, sur respectivement 15 et 30 points, avec les 4 niveaux de controles de chromsystems (CQ1, CQ2, CQ3 et CQ4) pour chaque LC-MS/MS (MS1, MS2 et MS3). Comparaisons de methodes/correlations des LC-MS/MS en miroir : 35 echantillons ont ete doses sur MS1, MS2 et MS3 et compares, par methode de regression lineaire, a la technique immuno-enzymatique sur RXL ® SIEMENS pour la ciclosporine, et au dosage sur Architect ® (ABBOTT) pour le tacrolimus. La correlation des trois LC-MS/MS en miroir a ete faite pour chaque IS sur 35 echantillons dont les resultats couvrent le domaine de mesure. Seuil de quantification/domaine de linearite : un seuil de quantification et un domaine de linearite ont ete etablis pour chaque IS sur les trois LC-MS/MS. Resultats Performances analytiques : Les CV de repetabilite sont compris entre 3,63 % et 10,93 % pour les 4 IS sur MS1, MS2 et MS3. Les CV de FI sont compris entre 4,61 % et 12,69 % pour les 4 IS sur MS1, MS2 et MS3. Ces CV ne sont pas significativement differents entre les 3 LC-MS/MS. Comparaisons de methodes/correlations des LC-MS/MS en miroir : les comparaisons de methodes entre LC-MS/MS et dosages immuno-enzymatiques pour la ciclosporine et le tacrolimus sont mediocres, respectivement : y = 0,8321 x – 12,471 et y = 0,68 x + 0,83 sur MS1 (resultats comparables sur MS2 et MS3). Ces resultats etaient previsibles et s’expliquent par la moins bonne specificite des dosages immuno-enzymatiques, ainsi que l’indique la litterature [1] . La correlation des 3 LC-MS/MS en miroir est acceptable quelque soit l’IS et le couple MS. Exemple de correlation: MS1/MS2 pour la ciclosporine: y = 0,9670 x + 1,9892. Seuils de quantification (LOQ)/limite haute de linearite : un seuil de quantification (LOQ) et une limite haute de linearite ont ete etudies pour la ciclosporine et les 3 autres IS sur MS1, MS2 et MS3 : les resultats respectifs sont 10 μg/L a 2000 μg/L pour la ciclosporine, et 0,5 μg/L a 100 μg/L pour le tacrolimus, l’everolimus et le sirolimus. Conclusion Apres 2 annees d’activite, nous pouvons confirmer la robustesse de la technique et la qualite des performances analytiques attendues. Sur les 100 000 dosages annuels, 75 % sont rendus le jour meme du dosage et 25 % le lendemain.

Resume L’evaluation du pronostic a long terme de l’asthme du nourrisson est une question essentielle compte tenu de sa frequence. La persistance de l’asthme a l’adolescence est d’origine multifactorielle. Objectif principal de l’etude Comparer la frequence de l’asthme a l’adolescence selon l’origine geographique des enfants. Objectif secondaire Determiner les principaux facteurs de risque de persistance. Type d’etude Retrospective, transversale, menee dans deux centres hospitalo-universitaires (centre de l’Asthme, hopital Trousseau, Paris ; unite de pneumologie et allergologie infantile, CHU-Estaing, Auvergne, Clermont-Ferrand). Criteres d’inclusion Enfants âges de moins de 36 mois presentant un asthme du nourrisson selon la definition de l’HAS et ayant beneficie d’une exploration standardisee. Les symptomes d’asthme ont ete reevalues apres l’âge de 12 ans. Deux cent vingt-sept patients ont ete inclus (148 a Clermont-Ferrand, 79 a Paris). Resultats Il n’existe pas de difference evolutive (persistance de l’asthme a l’adolescence) selon l’origine geographique des patients (32,26 % a Clermont-Ferrand vs 25 % a Paris, p = 0,27). Les enfants suivis en Auvergne sont plus sensibilises a l’adolescence que les Parisiens (26,16 % de sensibilisations a deux pneumallergenes vs 11,11 % a Paris, p = 0,03). Les risques de persistance de l’asthme dans les deux groupes sont: la sensibilisation multiple aux pneumallergenes (OR 4,6), l’antecedent de dermatite atopique (OR 3,4), la severite initiale (OR 2,3) et une eosinophilie superieure a 470/mm3 (OR 2,2). L’existence d’une rhinite allergique est associee de facon significative a la gravite de l’asthme actuel. Conclusions La dermatite atopique et la multisensibilisation allergenique constituent des facteurs de risque evolutif. Le fait de vivre dans une region fortement urbanisee ou non ne modifie pas de facon significative le devenir a long terme, a l’exception de la sensibilisation allergenique.

Questo articolo presenta la protesizzazione delle persone, in eta adulta, amputate di arto inferiore, per una causa vascolare (la grande maggioranza), traumatica, neoplastica, infettiva o congenita, ma senza mostrare le protesi «fuoriserie» che si possono trovare in quest’ultima situazione. Esprime il punto di vista del tecnico ortopedico e il punto di vista del rieducatore. In un primo tempo, sono esposte le differenti protesi che si costruiscono attualmente, con la presa in carico dei costi. Quindi, e spiegata l’applicazione delle protesi enumerando diverse tecniche e offrendo il parere del rieducatore su alcune concezioni. In conclusione, gli autori presentano, con occhio critico ma costruttivo, alcuni sistemi protesici all’avanguardia.

Resume Certaines inquietudes ayant recemment ete rapportees sur les couples de frottement metal–metal (M–M) des arthroplasties totales de hanche, le but de ce travail etait de faire le point sur les connaissances actuelles concernant le relargage d’ions metalliques et ses consequences potentielles. Chaque implant M–M presente des proprietes tribologiques differentes. Les techniques de dosage sont performantes et les taux d’ions Co circulant semblent acceptables jusqu’a 2 μg/L. Une reaction d’hypersensitivite retardee de type IV (ALVAL) peut etre a l’origine d’un echec de l’arthroplastie. Idiosyncrasique, elle est impredictible avec des tests cutanes et apparemment rare (0,3 %). Il n’existe a ce jour aucune donnee scientifique ou epidemiologique en faveur de risques de carcinogenese ou teratogenese lies a l’usage d’un couple M–M. Les pseudotumeurs solides concernent quasi exclusivement les resurfacages, avec un taux de revision annuel important chez les femmes de moins de 40 ans, survenant surtout en cas de malposition acetabulaire et avec l’usage d’alliages de Cr–Co coule. L’osteolyse se manifeste par des liseres globaux et evolutifs ou par des lesions cavitaires qui ont pour etiologie des alterations type ALVAL ou des problemes de conflit ou d’incompatibilite d’implants. La formation de debris excedant la tolerance biologique est a craindre en cas de malposition des implants, de subluxation et grippage de la tete en cas de deformation de la cupule acetabulaire. Dans l’etat actuel des connaissances, les couples M–M sont contre-indiques en cas d’allergie aux metaux ou de dysfonction renale severe et les resurfacages de petite taille sont a utiliser avec prudence.

Antifreeze proteins (AFPs) are found in different species from polar, alpine and subarctic regions, where they serve to inhibit ice-crystal growth by adsorption to ice surfaces. Recombinant North Atlantic ocean pout (Macrozoarces americanus) AFP has been used as a model protein to develop protocols for amino-acid-specific hydrogen reverse-labelling of methyl groups in leucine and valine residues using Escherichia coli high-density cell cultures supplemented with the amino-acid precursor alpha-ketoisovalerate. Here, the successful methyl protonation (methyl reverse-labelling) of leucine and valine residues in AFP is reported. Methyl-protonated AFP was expressed in inclusion bodies, refolded in deuterated buffer and purified by cation-exchange chromatography. Crystals were grown in D(2)O buffer by the sitting-drop method. Preliminary neutron Laue diffraction at 293 K using LADI-III at ILL showed in a few 24 h exposures a very low background and clear small spots up to a resolution of 1.80 A from a crystal of dimensions 1.60 x 0.38 x 0.38 mm corresponding to a volume of 0.23 mm(3).

Introduction Le recours a la radiotherapie prophylactique afin de prevenir les metastases des sites d’intervention pleurale dans le mesotheliome pleural malin demeure controverse et les pratiques cliniques variees. L’objectif de notre etude est d’evaluer l’efficacite de la radiotherapie externe en une fraction unique de 10 gray en prevention de l’ensemencement des sites d’intervention pleurale des patients atteints de mesotheliome pleural malin. Methodes Il s’agit d’une etude epidemiologique descriptive retrospective de cohorte, incluant les patients atteints d’un mesotheliome pleural malin histologiquement prouve, irradie en regard des sites d’intervention pleurale en une seance unique de 10 gray avec des electrons de 6 a 18 MeV, entre janvier 1990 et decembre 2013 a l’institut de Cancerologie de Lorraine (ICL). Resultats Quatre-vingt-onze patients ont ete traites par radiotherapie prophylactique des sites d’intervention pleurale a l’ICL, soit 120 sites d’intervention pleurale irradies : 91 thoracoscopies, 17 thoracotomies avec drainage pleural et 12 ponctions-biopsies scanno ou echoguidees. Le suivi median etait de 7 mois (intervalle interquartile entre 3 et 15 mois). La survie sans progression locale des patients a 6, 12 et 24 mois etait respectivement de 63,3 % (52,2 % ; 72,4 %), 43,7 % (32,9 % ; 53,9 %) et 17,9 % (10,2 % ; 27,3 %) en regard d’une survie globale a 6, 12 et 24 mois respectivement de 65,5 % (54,4 % ; 74,4 %), 43,5 % (32,7 % ; 53,8 %) et 19,1 % (11,1 % ; 28,6 %). L’incidence de la progression locale etait de 8 % a 12 mois. Le recours a une autre chimiotherapie que l’association sels de platine – pemetrexed etait un facteur de mauvais pronostic de la progression locale (HR 11,9 (1,17 ; 122,40), p = 0,036). Toutes les progressions locales interessaient des sites d’intervention pleurale a type de thoracoscopie. Le delai median entre l’irradiation et la progression locale etait de 4 mois (2 ; 32). Il n’y avait pas d’effet secondaire precoce ou tardif de grade superieur ou egal a deux. Conclusion L’irradiation des sites d’intervention pleurale en une fraction unique de 10 gray est efficace, bien toleree, simple, rapide et peu couteuse. Ce resume fera l’objet d’un poster lors du congre annuel de la SFRO.