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Resume Depuis que l’etre humain a developpe une pensee philosophique, deux questions existentielles l’obsedent : pourquoi vieillissons-nous ? Pourquoi mourrons-nous ? Cela a bien entendu fait surgir la question suivante : comment pourrions-nous rester jeune indefiniment et indemne de toute maladie ? Mais, malgre les avancees technologiques en biologie moleculaire et en genetique, a ce jour aucune de ces questions n’a encore trouve sa reponse et les vrais mecanismes du vieillissement sont encore bien mal precises. Au travers de cet article, nous presentons les grands mecanismes supposes de notre senescence et decrivons ce que sont a l’echelle des populations les trois grands modes de vieillissement.

Resume Le but de ce travail etait d’evaluer les resultats cliniques et radiologiques de differents types de reconstruction ligamentaire pour instabilite laterale de cheville et leur retentissement articulaire au long terme. Materiel et methodes Il s’agit d’une etude multicentrique et retrospective portant sur 310 cas de reconstructions laterales de cheville, revus au recul moyen de 13 ans avec un minimum de cinq ans. On notait une majorite d’hommes (53 %) et de traumatismes sportifs (78 %) ; la duree moyenne de l’instabilite etait de 92 mois pour un âge moyen a l’operation de 28 ans. L’articulation subtalaire participait au syndrome d’instabilite dans 28 % des cas. Quatre classes (C) techniques ont ete individualisees : C1 (retente capsuloligamentaire isolee) ; C2 (retente associee a un renfort) ; C3 (plastie utilisant partiellement un tendon stabilisateur-everseur ; exemple : court fibulaire) ; C4 (plastie utilisant la totalite d’un tendon stabilisateur-everseur). L’evaluation clinique et fonctionnelle se basait sur les scores de Karlsson et de Good-Jones-Livingstone ; l’evaluation radiographique regroupait les cliches centres de face et profil, les cliches cercles en charge selon Meary et les cliches dynamiques (technique manuelle, Telos ® ou autovarus) pour la laxite residuelle. Resultats On retrouvait une majorite de resultats satisfaisants (92 %). Le score de Karlsson moyen etait de 90 (19–100), soit 87 % de bons et tres bons resultats ; il etait correle au resultat subjectif ; il n’evoluait pas dans le temps. Les complications postoperatoires (20 %), en particulier nerveuses, etaient correlees a un moins bon resultat. Les controles radiographiques confirmaient une faible progression de l’arthrose et une amelioration de la stabilite, mais il n’y avait pas de correlation entre le resultat fonctionnel et la laxite residuelle radiographique. Les chevilles instables et douloureuses avaient de moins bons resultats cliniques et plus d’arthrose secondaire. Les resultats analytiques selon la technique employee montraient significativement de moins bons resultats pour les plasties de type C4 et un moins bon controle de la laxite radiographique pour les retentes type C1. Discussion Ces resultats confirment l’interet des ligamentoplasties laterales de cheville dans le traitement de l’instabilite et la protection face au risque d’arthrose secondaire, et l’importance d’un bilan lesionnel precis (scanner/IRM) pour adapter la technique operatoire aux lesions ligamentaires et associees. Type d’etude Retrospective. Niveau IV.

Resume Introduction La luxation anterieure d’epaule est frequente avec un taux eleve de recidives. L’immobilisation en rotation externe semblerait ameliorer les resultats. Cependant, peu de travaux le demontrent. Nous avons etudie, a l’IRM, l’incidence de la rotation externe sur les lesions labrales et capsuloligamentaires post primo luxation. Materiel L’etude prospective etait debutee le 1 er janvier 2007. Les criteres d’inclusion etaient la survenue d’un premier episode de luxation antero-interne d’epaule sans antecedent traumatique. On denombrait 24 patients de 37 ans de moyenne d’âge. Methodes Une IRM etait realisee precocement selon le protocole suivant : une acquisition en rotation interne (RI), suivie d’une acquisition en rotation externe (RE). Les criteres etudies etaient : l’hemarthrose, la mesure de la RE, la coiffe des rotateurs, les lesions osseuses, le labrum : type lesionnel (classification d’Habermeyer) et deplacement (criteres d’Itoi). Resultats Nous retrouvions 12 epaules droites et 12 epaules gauches. Le delai moyen d’obtention de l’IRM etait de 3,7 jours. Nous notions trois ruptures de la coiffe des rotateurs, aucune lesion de la glene et 14 encoches humerales. L’hemarthrose etait quasi constante, avec une repartition modifiee par la RE dans 75 %. Trois n’avaient pas d’hemarthrose posterieure quelle que soit la rotation. La rotation externe moyenne obtenue etait de 37°. Selon la classification d’Habermeyer, nous avions retrouve 12 types 1, dix types 2. Deux patients n’avaient pas de lesion labrale. Tous les labrums separes s’etaient reduits en RE dont cinq (21 %) totalement. A six reprises, la mesure du deplacement labral s’etait modifiee selon la rotation. La reduction de la poche capsulaire anterieure en RE etait constante dont trois completement. Discussion Pour Itoi et al., la diminution du taux de recidives passe par l’immobilisation en RE. Nous retrouvons comme dans la litterature, une reductibilite constante du labrum lors de la mise en RE, mais la reduction reste souvent incomplete. Il semblerait que la RE reduise d’avantage la separation. Notre etude confirme egalement la diminution du volume capsulaire anterieur lors de la mise en RE, facteur de recidives. Conclusion La RE permet une reduction de l’hemarthrose, du decollement capsulaire anterieur, des lesions labrales. Elle ne les majore jamais. L’interet de l’immobilisation en RE dans la prevention de l’instabilite scapulo humerale doit etre confirme par des etudes cliniques a long terme. Nous prolongeons donc notre etude IRM par une etude clinique en immobilisant en RE l’ensemble des patients ayant une reduction significative de la lesion labrale. Niveau de preuve IV. Etude therapeutique retrospective.

ERMA

Organized neuronal firing is crucial for cortical processing and is disrupted in schizophrenia. Using rapid amplification of 5' complementary DNA ends in human brain, we identified a primate-specific isoform (3.1) of the ether-a-go-go-related K(+) channel KCNH2 that modulates neuronal firing. KCNH2-3.1 messenger RNA levels are comparable to full-length KCNH2 (1A) levels in brain but three orders of magnitude lower in heart. In hippocampus from individuals with schizophrenia, KCNH2-3.1 expression is 2.5-fold greater than KCNH2-1A expression. A meta-analysis of five clinical data sets (367 families, 1,158 unrelated cases and 1,704 controls) shows association of single nucleotide polymorphisms in KCNH2 with schizophrenia. Risk-associated alleles predict lower intelligence quotient scores and speed of cognitive processing, altered memory-linked functional magnetic resonance imaging signals and increased KCNH2-3.1 mRNA levels in postmortem hippocampus. KCNH2-3.1 lacks a domain that is crucial for slow channel deactivation. Overexpression of KCNH2-3.1 in primary cortical neurons induces a rapidly deactivating K(+) current and a high-frequency, nonadapting firing pattern. These results identify a previously undescribed KCNH2 channel isoform involved in cortical physiology, cognition and psychosis, providing a potential new therapeutic drug target.

Summary Introduction Anterior knee instability caused by anterior cruciate ligament (ACL) deficiency results in meniscal as well as chondral femorotibial and/or femoropatellar damages over a more or less long duration delay. This study's objectives were, in chronically deficient ACL patients, to assess onset delay for developping chondral patella lesions and also analyse these lesions characteristics in relation to laxity duration. Hypothesis Chondral patellar lesions in ACL deficient knees get worse with time. Material and methods We reviewed 250 charts of patients who had undergone arthroscopically assisted surgery for knee anterior laxity. The arthroscopic procedures were conducted between January 1995 and January 2005. Chondral damages were evaluated at surgery according both to International Cartilage Repair Society (ICRS) and Bauer and Jackson classifications. The data were analyzed using the Kruskal-Wallis test and the Fisher exact test. Results Of the 250 analysed charts, 72 patients (28.8%) were found to present chondral patella lesions. The majority of these lesions were superficial and involved the lateral facet area. We observed a statistically significant ICRS worsening grade in relation to laxity duration. Discussion Few publications in the literature report patellar involvement in anterior laxity of the knee. However, our results are comparable to those of the rare series found. The pathomechanics of these lesions has not yet been precisely identified and requires further biomechanical studies. Conclusion Patellar damage is frequent with anterior laxity (28.8% in our series) and duration is correlated with statistically significant aggravation of these lesions. Currently, the assessment of these patellar lesions is considered less important than meniscal and femorotibial lesions, even though the natural history of ACL disruption seems to be evolving toward degeneration of all the compartments of the knee, including the femoropatellar compartment. Level of evidence: level IV. Diagnostic study.

ERMA; La prise en charge des fractures articulaires complexes de l'extrémité distale de l'humérus (FEDH) chez le sujet âgé demeure, malgré les progrès thérapeutiques, un des grands challenges de la chirurgie traumatologique. Ces fractures relativement rares ont une incidence qui ne cesse d'augmenter. Cette étude multicentrique a permis de colliger deux cent trente-huit dossiers : 205 pour la série rétrospective, 33 pour la série prospective (recul minimum de six mois). Les critères d'analyse des patients regroupaient les suivants : l'âge, le sexe, l'état général (selon score ASA), le statut fonctionnel (selon score de Katz et lieu de vie), le statut osseux (ostéoporose par score OST, radio/ostéodensitométrie). Les critères d'analyse du traitement regroupaient les suivants : les techniques thérapeutiques, les complications précoces et tardives. Les résultats ont été évalués cliniquement selon le Mayo Elbow Performance Score (MEPS) (Morrey) et le Quick Disability of the Arm-Shoulder-Hand (DASH), et radiographiquement par les critères habituels de consolidation, de réduction et d'évolution arthrosique secondaire (selon Bröberg-Morrey) pour les ostéosynthèses et le positionnement, les complications mécaniques des implants et l'étude du scellement pour les arthroplasties. L'étude statistique a fait appel aux tests de comparaison de variables qualitatives et de variables quantitatives et de corrélation paramétrique. On retrouve une grande majorité de femmes (plus de 80 %), en bon état général selon la cotation ASA (plus de 70 % ASA 1-2), autonome et vivant à domicile dans plus de 80 % des cas. Le traitement est dominé par les ostéosynthèses (172 patients), contre 44 prothèses totales de coude (PTC) représentées en majorité par les prothèses de Coonrad-Morrey. Les patients ayant bénéficié d'une ostéosynthèse sont moins âgés (moy. 77 ans) que ceux opérés par prothèse (moy. 81 ans). Le recul moyen de révision était de deux ans huit mois. Les ostéosynthèses ont donné 77 % d'excellents et bons résultats ; le taux de complications était de 20 % dont 13 % de réintervention. Les arthroplasties ont donné 83 % d'excellents et bons résultats ; le taux de complications était de 14 % dont 6 % de réintervention. S'il semble exister un léger avantage pour les PTC avec un score moyen de la Mayo Clinic de 84 points et de 95 points pour les études rétrospective et prospective versus 77 points et 75 points pour les ostéosynthèses, l'étude statistique ne permet pas de conclure de façon formelle. Les indications doivent être basées sur le statut fonctionnel du patient et non sur le seul âge chronologique, ainsi que sur le degré de comminution, au mieux évalué par examen tomodensitométrique. Schématiquement, l'ostéosynthèse reste de règle en première intention chez le patient au statut fonctionnel indépendant avec l'objectif d'un montage stable ; à l'inverse, l'arthroplastie semble indiquée chez les patients dépendants ou fragilisés par des facteurs de comorbidité ou lors d'une reconstruction techniquement non fiable de par l'état osseux et/ou le degré de comminution.

Resume Les auteurs rapportent les resultats de 36 osteosyntheses de la palette humerale d’une population âgee. L’objectif etait de comparer ces resultats aux autres series d’osteosyntheses, mais aussi aux series d’arthroplasties de coudes fractures. L’etude retrospective a ete realisee sur 34 patients, dont la moyenne d’âge etait de 77,6 ans, avec un recul moyen de 35 mois. Les fractures se repartissaient en 8 types C1, 10 types C2 et 18 types C3. Les patients ont ete evalues par un critere social, un critere clinique (Mayo elbow score), un critere radiologique (classification de Broberg) et un critere subjectif. Le Mayo elbow score moyen etait de 73,3 : 13 excellents resultats, 8 bons, 5 moyens et 10 mauvais. Les meilleurs resultats etaient obtenus par double plaque d’osteosynthese. Vingt-trois patients etaient douloureux. L’arc moyen de mobilite etait de 80°. L’indice de satisfaction restait positif. Dix patients ne purent retrouver leur autonomie preoperatoire. Soixante-quinze pour cent des patients presentaient des signes radiologiques d’arthrose et 32 % une pseudarthrose du foyer de fracture humerale. Nous retrouvions 3 infections superficielles et 4 lesions neurologiques.

The γ-ray de-excitations following the β-decay of 83Ga and the β-n decay of 84Ga have been studied. The radioactive species were produced using the PARRNe on-line mass-separator installed at the IPN Orsay Tandem accelerator. Two γ-lines were attributed to 83Ge with the aid of β-γ and γ-γ coincidences. The Z identification of the γ-lines was provided by time analysis of a buid-up/decay cycle. The excited levels of 83Ge can be explained by the coupling of the single neutron state ν2d 5/2 to the first 2+ excitation of the 82Ge core.

Traumatic lesions of the colon associated with fracture of the acetabulum occurs in less than 2% of the cases. Direct perforation of the colon by a bony spike, which occurred in our patient, is even more exceptional. We were unable to find any other case reported in the literature. This case illustrates the importance of looking for intestinal lesions in all patients with pelvic injury presenting an unexplained infectious syndrome. Imaging provides clear evidence for avoiding late diagnosis and life-threatening situations.

The PARRNe (Production d'Atomes Radioactifs Riches en Neutrons) experimental program has been part of the recent R&D efforts for the design of the SPIRAL2 project at GANIL. The PARRNe2 set-up installed at IPNOrsay allows the use of the Tandem as a deuteron driver in order to produce mass separated fission fragment beams. The measured fission fragment yields proved to be high enough to undertake a series of beta-decay experiments dedicated at studying the structure of proton-deficient nuclei close to N=50. We report here on two such experiments, the first being dedicated at the observation of the decay of 83Ga->83Ge (Z=32, N=51), 84Ga->84Ge (Z=32, N=52) and the second of the decay of 81Zn->81Ga (Z=31, N=50) allowing for the fist time the identification of a few gamma lines with transitions in the daughter nuclei thus providing the material for a preliminary glimpse of their structure.

The PARRNe facility has been used to produce neutron-rich isotopes 83,84Gaby the ISOL method. Their decay has been studied, and β-γ coincidence and γ-γ coincidence data were collected as a function of time. The first two excited levels in 83Ge and the first excited level in 84Ge have been measured for the first time.

In the framework of the PARRNe program (Production d’Atomes Radioactifs Riches en Neutrons) of IPN Orsay, various techniques are currently used to characterize the release properties of elements of interest from a UCX target. On-line studies have been carried out with two plasma ion sources: a Nier–Bernas and a hot plasma ISOLDE-type (the ISOLDE collaboration kindly supplied us a MK5 ion source for these studies). In parallel, the analysis of the chemical and structure properties of some UCX samples as function of heating conditions has been carried out. Such data are essential to determine optimal conditions for the production of isotopes by the isotope separator on-line (ISOL) technique. First results are presented here for Kr and Ag. Investigations for other kinds of fission targets are planned.

In order to probe neutron rich radioactive noble gases produced by photo-fission, a PARRNe-1 experiment (Production d’Atomes Radioactifs Riches en Neutrons) has been carried out at CERN. The incident electron beam of 50 MeV was delivered by the LIL machine: LEP Injector Linac. The experiment allowed us to compare under the same conditions two production methods of radioactive noble gases: fission induced by fast neutrons and photo-fission. The obtained results show that the use of the electrons is a promising mode to get intense neutron rich ion beams. After the success of this photo-fission experiment, a conceptual design for the installation at IPN Orsay of a 50 MeV electron accelerator close to the PARRNe-2 device has been worked out: ALTO Project. This work has started within a collaboration between IPNO, LAL (Laboratoire de l’Accelerateur Lineaire) and CERN groups.

The release properties of UCx and molten U thick targets associated with a Nier–Bernas ion source have been studied. Two experimental methods are used to extract the release time. Results are presented and discussed for Kr, Cd, I and Xe.

Experimental results concerning neutron distributions from thick Be and U targets bombarded by deuterons at 200 MeV incident energies and from a thick C target bombarded by 36Ar at 95 MeV/u are reported. The measurements were performed with the activation technique using an improved set of detectors. A comparison was carried out with theoretical results in the framework of the Serber model for deuteron beams and using a schematic fireball model for Ar beams.

The latest results of the research and development program Production d'Atomes Radioactifs Riches en Neutrons (PARRNe) at Institut de Physique Nucleaire (IPN) Orsay are presented. The production of neutron rich isotopes by fast neutron induced fission in a liquid depleted uranium target was measured. A comparison of the production rates with a uranium carbide (UCx) target is given.

Despite the repeatedly observed impaired proliferative response of T lymphocytes from aged donors, the precise molecular basis underlying such a defect is still poorly understood. The aim of this study was to determine whether cyclin-dependent kinase 1 (cdk1), a serine-threonine kinase required for entry into mitosis, is implicated in this age-associated dysregulation of the cell cycle. T lymphocytes derived from young and elderly donors were blocked in S phase by hydroxyurea after a 48-h activation by anti-CD3 Abs. Under these experimental conditions, only the cells that were already located beyond the S phase were able to complete the cell cycle, decreasing their DNA content from 4n to 2n chromosomes. Using this procedure, a delay in the accomplishment of mitosis could be observed in cells from elderly individuals, as evidenced by propidium iodide staining. In this age group, only a minimal cdk1 activity could be immunoprecipitated from cells sorted in G2/M after nocodazole block. The decrease in cdk1 activity observed in T lymphocytes from aged donors could be accounted for by at least three mechanisms: 1) a failure of these cells to express a sufficient amount of cdk1, 2) a reduced level of the associated cyclin B1, and 3) an incomplete dephosphorylation of the kinase on tyrosine. This low cdk1 activity is likely to postpone the progression through the G2/M transition and participates in the dysfunction of the cell cycle during the process of aging.

We recently showed that mature T lymphocytes derived from elderly humans were more susceptible to activation-induced cell death than similar cells from young individuals. Because this excessive apoptosis is unrelated to either the age-associated decrease in IL-2 production, a differential Bcl-2 expression or to a modification of the antioxidant pathway, we examined the possibility that the Fas receptor (FasR) is directly implicated in the generation of the unwarranted death signal. We investigated the expression and the function of FasR on T lymphocyte populations from healthy young and elderly individuals. We found that the frequency of FasR+ T cells increases as a function of age. The FasR expressed at the surface of freshly isolated T lymphocytes from elderly donors appear to be fully functional since their ligation by a cytocidal IgM anti-Fas mAb leads to a significant increase in DNA fragmentation in this cell population. Conversely, exposure of T cells derived from aged individuals to an antagonistic anti-FasR mAb partially prevents the age-related increase in apoptotic cell death. The population of FasR+ T lymphocytes is essentially constituted of previously activated CD45RO+ cells and also includes recently activated lymphocytes bearing the CD25 and CD69 activation markers. The accumulation of chronically and recently in vivo activated T-cells with age probably contributes to the amplification of the process of Fas-mediated cell death in T lymphocytes isolated from senescent organisms.

We present here a study of the thermal and physical properties of graphite targets for the SPIRAL project. The main objective was to develop an optimized set-up both mechanically and thermally resistant, presenting good release properties (hot targets with thin slices). We show here the results of irradiation tests concerning the mechanical and thermal resistance of the first prototype of SPIRAL target with conical geometry. We also study the micro-structural properties of the graphite target in order to check that the release properties are not deteriorated by the irradiation. Finally, we present the results concerning the latest pilot target internally heated by an electrical current. This setup has been especially designed to be used in case of low power primary beams.

The aging of populations represents a tremendous challenge for the 21st century, all the more since it is known that men are more often confronted with periods of disability in later life than in other periods of their life span. To meet this concern, actions should be taken in the medical field and in this regard, the geriatrician has an essential role to play. Geriatrics, as an innovative discipline, should become a widely-recognized and strengthened speciality on the academic plane, also through promoting high-level research, on which high-quality teaching in turn depends. There is a need, therefore, to arm family doctors, because they are in charge of following up the population's aging; indeed, they, better than anyone else, know the difference between normal aging and pathology, and thereby are the very first to make interventions aimed at facilitating the aging process.

This paper presents the results of two different treatments using pteridines in Drosophila melanogaster larvae: injection of pteridines alone; and injection of extracts from diapaused Pieris brassicae chrysalids treated with pteridines. Genetic analysis reveals first the induction of lethal or visible recessive mutations that give rise mostly to developmental mutants with variable phenotypes, and second the induction of genetic recombinations. Both treatments disturb genetic recombination in F1 female female issued from the treated larvae. This disturbance is evidenced by the increase in the rate of recombination particularly in the centromere region, and induces in F1 female female and male male clusters of mitotic recombinations of premeiotic origin. These two observations present an analogy with hybrid dysgenesis in the P-M system. This suggests that the treatments either promote the mobility of transposons in female and male larvae and their progeny, or affect the system controlling transposon mobility and integration at specific chromosomal sites. We used in situ hybridization to test our hypotheses, using P, I and copia-like probes. P yields a positive response both at the level of gonadal sterility (gonadal dysgenesis test) and in situ hybridization: after treatment, Oregon K and the wing-altered mutant bspw exhibit a normal number of P elements whereas the maternal strain Oregon K is totally devoid of P. This mutant bspw carries the neutral strain Q (a variant of P), which cannot produce P-M dysgenesis. The implication of these findings for understanding the mode of action of pteridines is twofold: (1) pteridines may be mutagenic agents which perturb meiotic and mitotic recombination; and (2) pteridines disturb the system regulating the mobility and insertion of P elements.

ERMA; International audience; INTRODUCTION: Anterior dislocation of the shoulder is frequent, with high rates of recurrence. Immobilization in external rotation (ER) seems to improve results, although few studies have actually demonstrated this. The present MRI study examined the impact of ER on labral and capsular ligamentous complex lesions after primary dislocation. MATERIAL: A prospective study was started up on January 1st, 2007. Inclusion criteria were: acute initial anteromedial dislocation of the shoulder, without past history of shoulder trauma. There were 23 such patients, with a mean age of 37 years. METHODS: Early MRI scan used the following protocol: one acquisition in internal rotation followed by one in ER. Study criteria were: hemarthrosis, ER amplitude, rotator cuff status, bone lesion, and labral lesion stage (Habermeyer's classification) and displacement (Itoi criteria). RESULTS: There were 12 right and 11 left shoulders. Mean time to MRI was 3.7 days. There were three rotator cuff tears, no glenal lesions, and 14 humeral notches. Hemarthrosis was almost systematically present, with its distribution modified by ER in 75% of cases; three patients showed no posterior hemarthrosis, in whatever rotation. Mean ER was 37 degrees. On Habermeyer's classification, there were 12 stage-1 lesions, and 10 stage-2; one patient had no labral lesion. All separated labra were reduced in ER, five (21%) totally. In six cases, labral displacement changed according to rotation. All anterior joint effusion was reduced in ER, in three cases totally. DISCUSSION: According to Itoi among others, immobilization in ER is the way to reduce recurrence of anterior dislocation. The present study confirmed that labral reduction was systematic with ER, but it was by no means always complete. ER seemed more effective in reducing the separation. Results further confirmed that ER reduced anterior capsule volume, a recurrence factor. CONCLUSION: ER reduced hemarthrosis, anterior capsule detachment and labral lesions, and never the contrary. The interest of immobilization in ER to prevent shoulder instability needs confirming by long-term clinical studies; we are therefore extending the present MRI study by a clinical study of ER immobilization in all patients showing significant labral lesion reduction. LEVEL OF EVIDENCE: Level IV. Retrospective therapeutic study.

ERMA; International audience; UNLABELLED: The present study sought to assess the clinical and radiological results and long-term joint impact of different techniques of lateral ankle ligament reconstruction. MATERIAL AND METHODS: A multicenter retrospective review was performed on 310 lateral ankle ligament reconstructions, with a mean 13-year-follow-up (minimum FU: 5 years). Male subjects (53%) and sports trauma (78%) predominated. Mean duration of instability was 92 months; mean age at surgery was 28 years. Twenty-eight percent of cases showed subtalar joint involvement. Four classes of surgical technique were distinguished: C1, direct capsular ligamentous complex reattachment; C2, augmented repair; C3, ligamentoplasty using part of the peroneus brevis tendon and C4, ligamentoplasty using the whole peroneus brevis tendon. Clinical and functional assessment used Karlsson and Good-Jones-Livingstone scores; radiologic assessment combined centered AP and lateral views, hindfoot weight-bearing Méary views and dynamic views (manual technique, Telos or self-imposed varus). RESULTS: The majority of results (92%) were satisfactory. The mean Karlsson score of 90 [19-100] (i.e., 87% good and very good results) correlated with the subjective assessment, and did not evolve over time. Postoperative complications (20%), particularly when neurologic, were associated with poorer results. Control X-ray confirmed the very minor progression in degenerative changes, with improved stability; there was, however, no correlation between functional result and residual laxity on X-ray. Unstable and painful ankles showed poorer clinical results and more secondary osteoarthritis. Analysis by class of technique found poorer results in C4-type plasties and poorer control of laxity on X-ray in C1-type tension restoration. DISCUSSION: The present results confirm the interest of lateral ankle ligamentoplasty in the management of instability and protection against secondary osteoarthritis, and of precise lesion assessment (CT-scan/MRI) to adapt surgery to the ligamentary and associated lesions. LEVEL OF EVIDENCE: Level IV. Retrospective therapeutic study.

The purpose of this paper is the genetic visualization by in situ hybridization of 130 sex-linked recessive lethals plus a non-lethal induced by I-R dysgenesis. This collection of lethals involves inducer strains which differ in the position of the I elements on the X chromosomes. The I-R interaction was strong. Our previous results have shown that about 30% of the induced recessive lethals are associated with cytologically visible chromosomal rearrangements. 1. (1) The rearrangements induced by I-R-type hybrid dysgenesis often exhibit homology with the I factor at the level of one or both junction points, depending on the types of chromosome rearrangements. These results suggest that the chromosome rearrangements arise directly from the transposition of I elements. However, the breakpoints of some types of cytologically non-visible deficiencies and of 2 small cytologically visible deficiencies do not present detectable homology with the I factor. 2. (2) The majority of rearrangements do not involve the I elements already present on the paternal X chromosome. 3. (3) The hybridization signal distributions on the X chromosome are not uniform. They present peaks of various heights which may correspond to specific anchoring areas of copies of I in the course of integration. 4. (4) The data presented here agree with the literature with respect to the mean number of copies of I per X chromosome and to the excess of copies of I at locus 1A. Two rearrangement formation mechanisms are envisaged: crossing-over and ‘target’ exchanges.

The mammalian homologue of the cdc2 gene of the fission yeast Schizosaccharomyces pombe encodes a p34cdc2 cyclin-dependent kinase that regulates the cell cycle of a wide variety of cell types. Resting murine T lymphocytes contained no detectable p34cdc2 protein, histone kinase activity, or specific mRNA for the cdc2 gene. Activation of the T cells by immobilized anti-CD3 resulted in the expression of specific mRNA late in the G1 phase of the cell cycle, and p34cdc2 protein was detectable at or near G1/S. At this point in the cell cycle, the protein was phosphorylated at tyrosine and displayed no H1 histone kinase activity. As the cells progressed through the cycle, the amount of specific mRNA and p34cdc2 increased, and H1 histone kinase activity was detectable when the cells were blocked at G2/M by nocodazole. The activation of T cells by phorbol dibutyrate induced the expression of IL-2R but failed to induce the synthesis of IL-2 or the expression of cdc2-specific mRNA. Under these conditions, the activated cells failed to enter the S phase of the cell cycle. Because the presence of IL-2 added exogenously during activation by phorbol dibutyrate resulted in the expression of cdc2-specific mRNA and progression through the cell cycle, either IL-2 or the interaction with IL-2R may be involved in the expression of cdc2 and regulation of the G1/S transition.

Resume Introduction L’instabilite anterieure du genou entraine la survenue de lesions meniscales et femorotibiales, mais peut egalement entrainer des lesions osteochondrales patellaires dont le demembrement reste au second plan. Hypothese Le but de ce travail etait d’evaluer la survenue de lesions de chondropathies patellaires chez les patients presentant une rupture du LCA et d’en etudier les caracteristiques en fonction du delai de laxite. Materiel et methode Dans une etude retrospective, nous avons revu 250 dossiers de patients âges en moyenne de 32 ans, operes entre janvier 1995 et janvier 2005 d’une laxite anterieure du genou sous arthroscopie (photographies arthroscopiques, comptes-rendus operatoires et fiches de renseignement arthroscopiques). Les lesions chondrales ont ete etudiees a l’intervention selon les classifications de Bauer et Jackson et de l’International Cartilage Repair Society (ICRS). Les analyses statistiques ont ete realisees au moyen du test de Kruskal-Wallis et du test exact de Fischer. Resultats Soixante-douze patients (28,8 %) presentaient une atteinte chondrale patellaire. Le versant lateral etait touche dans 41 cas (56,9 %). Les lesions se situaient majoritairement au tiers moyen de la patella. Il s’agissait de lesions superficielles (stade 1 et 5 de Bauer et Jackson ; grade 1 de l’ICRS) dans deux tiers des cas. Nous avons pu mettre en evidence une aggravation statistiquement significative du grade ICRS en fonction de la duree de laxite preoperatoire. Discussion Peu de publications dans la litterature concernent l’atteinte patellaire lors de laxite anterieure du genou ; cependant, nos resultats sont comparables a ceux des rares series retrouvees. Les mecanismes lesionnels ne sont pas encore precisement identifies et necessiteraient des etudes biomecaniques. Conclusion La presence de lesions patellaires est frequente en cas de laxite anterieure (28,8 % dans notre serie) et le delai est correle a une aggravation statistiquement significative de ces lesions. A l’heure actuelle, l’evaluation de ces lesions patellaires reste au second plan par rapport aux lesions meniscales et femorotibiales, cependant, l’histoire naturelle de la rupture du LCA semble evoluer vers une atteinte degenerative de tous les compartiments du genou, y compris du compartiment femoropatellaire.

Resume L’immobilisation en rotation externe (RE) des luxations anterieures d’epaule semble diminuer leur taux eleve de recidives. Notre etude IRM evalue l’incidence de la RE sur les lesions labrales et capsuloligamentaires postprimoluxation. Tout premier episode de luxation antero-interne sans antecedent traumatique beneficiait d’une IRM en rotation interne (RI), puis en RE pour etudier l’hemarthrose, le degre de RE, la coiffe des rotateurs, les lesions osseuses, le labrum. On denombrait 24 patients d’âge moyen, 37 ans. Le delai moyen d’obtention de l’IRM etait de 3,7 jours. La RE moyenne de 37°, modifiait l’hemarthrose dans 75 %, reduisait les labrums separes et la poche capsulaire anterieure. Nous retrouvons comme dans la litterature, une reductibilite constante mais incomplete du labrum en RE ainsi qu’une diminution du volume capsulaire anterieur. Des etudes cliniques a long terme confirmeront l’interet de cette immobilisation dans la prevention de l’instabilite scapulohumerale.

Some applications of Mossbauer spectroscopy to the study of insulating neptunium compounds are reported here. After a short introduction to hyperfine parameters useful for the chemist, some correlations between isomer shift, electric field gradient and neptunium bonding or crystallographic structure are discussed. A review of selected examples of recent studies regarding local order and isomer shift of neptunium in crystallized or amorphous compounds for each charge state of Np(III–VII) follows. Finally, an attempt is made to correlate the electronic structure and bonding in insulating neptunium compounds to isomer shift and electric field gradient with calculations using the relativistic extended Huckel method.

Although interleukin 2 (IL 2) clearly up-regulates the expression of the p55 chain of the IL 2 receptor (IL 2R) little is known about its role in the induction of the high-affinity IL 2R. Resting T lymphocytes were induced to express IL 2R under experimental conditions in which IL 2 production was not induced or was prevented. Under these conditions high- and low-affinity IL 2R were easily demonstrated by Scatchard analysis. Northern blot analysis confirmed the accumulation of p55 specific mRNA and the absence of the IL 2 transcript. High-affinity IL 2R induced in the complete absence of IL 2 were unable to transmit a proliferative response unless exposed to extremely high concentrations of IL 2. The addition of picomolar amounts of recombinant IL 2 or the initiation of endogenous IL 2 production during the induction period restored the functionality of high-affinity IL 2R. Also, T cells induced to generate IL 2 displayed functional high-affinity IL 2R even in the presence of monoclonal antibodies blocking extracellular IL 2 and IL 2R. These results indicate that the presence of IL 2 during the early phase of T cell activation is an absolute requirement for the induction of fully operational high-affinity IL 2R and that low amounts of intracellular IL 2 are sufficient to confer functional properties to these receptors. The data also suggest that an intracellular as well as an extracellular high-affinity structure, expressed as a consequence of cell activation, is responsible for conferring competence to the high-affinity IL 2R involved in IL 2-dependent proliferation.

Treatment of comminuted intra-articular fractures of the distal humerus in elderly patients remains a challenge in trauma surgery. These fractures are rare, but their frequency increases. Our multicenter studies collected 238 cases of comminuted intra-articular fractures of the distal humerus in patients older than 65: two hundred and five cases for the retrospective study, 33 for the prospective study with a minimum follow-up of six months. The following criterias were studied: age, sex, state of health (with ASA score), functional scores (with Katz score), osteoporosis by the OST score and dual X-ray absorptiometry. The results were evaluated according to the Mayo Elbow Performance Score (Morrey) and the Quick DASH. X-ray studies were performed in order to assess both results for prosthesis and osteosynthesis. The following criteria were studied: bone healing, quality of reduction, signs of arthritis (Broberg-Morrey), prosthetic position, mechanical complications, prosthesis fixation. There were 80% of women in good health according to the ASA score (more than 70% of ASA 1 or 2). Most of them (80%) were self-governing and living at home. Hundred and seventy-two patients had an osteosynthesis and 44 had a prosthetic reconstruction (like Coonrad-Morrey prosthesis). Patients treated with osteosynthesis were younger (mean age was 77) than those treated with prosthetic reconstruction (mean age 81). Mean follow-up was 32 months. Results of osteosynthesis were good and excellent for 77% of the patients. Complications occurred for 20% of patients with a reoperation rate of 13%. Results of prosthetic reconstruction were good and excellent for 83% of the patients with 14% of complications and 6% of reoperation. Prosthetic reconstruction seemed to be better than osteosynthesis according to the Mayo Clinic score (84 points versus 77 points for the retrospective study and 95 points versus 75 points for the prospective study). However, the statistical analysis was not significant. Treatment of these fractures must be discussed according to the physiological status of the patient and the fracture patterns (scan evaluation). In conclusion, osteosynthesis remains the standard treatment when stable fixation is feasible. However, prosthetic reconstruction should be discussed for dependant patients or with comorbidity factors, bad bone quality leading to poor osteosynthesis or complex fracture.

This is a retrospective analysis of patients aged over 60 years treated in a single center for intra-articular fractures of the distal humerus. Outcomes were compared with published results for osteosynthesis and arthroplasty.The cohort included 34 patients (36 fractures) reviewed at mean 35 months. Mean age was 77.6 years. Fracture types were: C1: 8, C2: 10, C3: 18. The transtricipital posteromedial approach was used in the majority of patients. Fixation was achieved with a prebent lateral plate (n=11 fractures), a Y-plate (n=9), two plates (n=4), pins or screws (n=9) and an external fixator (n=3). Outcome was assessed with the Mayo elbow score, the Bröberg radiographic score and patient satisfaction. The social impact was also noted.The mean Mayo elbow score was 73.3; outcome was excellent (n=13), good (n=8), fair (n=5) and poor (n=10). Pain persisted in 23 patients. The mean range of movement was 80 degrees . Patient satisfaction remained good. Ten patients did not recover their preoperative level of autonomy. Radiological signs of osteoarthritis were noted for 75% of patients and nonunion of the humeral fracture in 32%. There were three superficial infections and four neurological lesions.Good and very good outcome was noted for 59% of the osteosyntheses in this series, compared with 71% in the literature. The rate for arthroplasty is 95%. The mean range of motion is 101 degrees , 17% of patients with a prosthesis complain of pain, 5% develop a superficial infection and 6.5% suffer neurological injury. The estimated rate of revision for arthroplasty is 11% at 7 years.Beyond the age of 65 years and based on evidence reported in the literature, it would be advisable to prefer another mode of treatment for these intra-articular fractures, for example elbow arthroplasty, particularly for comminutive fractures on osteoporotic bone.

This paper presents results of the genetic and cytological analysis of 144 sex-linked recessive lethals, plus 1 non-lethal. All of them were induced by I-R hybrid dysgenesis. This collection of mutants was pooled from experiments involving inducer chromosomes that differ in the chromosomal position of their I elements. Our results show that 30% of the recessive lethals are associated with chromosomal rearrangements which depend on the strength of the I-R interaction. These lethals are induced on both inducer- and reactive-origin chromosomes, and their frequency is dependent on the structure of the inducer chromosome used. The I-R-induced lethals occur along the entire length of the X chromosome. These sites probably correspond to specific loci which are more or less homologous with I. The complementation relationships showed that some specific loci were more frequently involved in all the lethal mutations tested. The most sensitive loci are, in order of observation: l(1)J1, ct, f, ma1 and m. Among induced recessive lethals considered to be point mutation, complementation tests showed that many of them are in fact multilocus deficiencies which can be detected only at the molecular level. It seems that the production of I-R rearrangements (cytologically visible or not) may be the most important mechanism leading to lethal mutations. These mutations probably occur during the transposition of I elements, hence their importance from an evolutionary standpoint.

Following modifications on the beam line at the Orsay Protontherapy Center, dose measurements were performed in order to make a dose map in the treatment rooms and in the delimited radiation-controlled area around beam line. Measurements were performed using tissue-equivalent proportional counters and rem-counters. Analysis of TEPC single event measurements showed that high LET components (>10 keV.microm(-1)) represent 90 to 99% of total dose equivalent in the treatment rooms and 50 to 90% in the controlled area and quality factors range, respectively between 2 and 15. A fast neutron component was identified in the treatment rooms, where dose equivalent rate varied between few microSv.h(-1) to some dozen of mSv.h(-1). In high-energy radiation field rem-counters underestimated TEPC values for neutron component. The variation between instruments response according to the location is linked to energetic spectrum variations and instrument characteristics.

NESTER ACC; The release properties of a UCx thick target associated with a hot plasma ion source have been studied. Measurements have been performed for various elements: Kr, Ag, Sn, I and Xe. The analysis is made assuming pure diffusion or pure effusion as the release processes. The results obtained are compared to the data available in the literature.

The state, electrical and dilatational rheological properties of surface films formed at air-water interface from lipid nanocapsules (LNC) with various compositions as well as model monolayers formed by the LNC constituents-Labrafac, Solutol and Lipoid are investigated. These nanocapsules constitute potential drug delivery systems where lypophilic drug will be loaded in their core. The study of the model Labrafac/Solutol (Lab/Sol) mixed monolayers shows behavior close to the ideal. Small negative deviations in the mean molecular areas a and dipole moments mu are observed. All studied monolayers have elastic behavior during the small continuous compressions. The comparison between the properties of surface films formed from LNC with those of the model monolayers confirms the idea developed in the kinetic study that the surface films formed after a rapid disaggregation of the unstable nanocapsule fraction (LNC I) contains mainly Labrafac and Solutol. The Labrafac molar part (xLab) in the formed Lab/Sol mixed layer is established.

The action of the hydrolytic enzymes humicola lanuginosa lipase (HLL) and pancreatic phospholipase A2 (PLA2) on monolayers formed from lipid nanocapsules (LNC) and model monolayers containing their components, Labrafac, Solutol and Lipoid, is studied by simultaneous measuring the changes in the film area and the surface potential in the "zero order" trough at constant surface pressure (pi). The kinetic models describing the hydrolysis by HLL of the Labrafac, Solutol and their mixtures have been proposed. By using the developed theoretical approach together with the experimental results the surface concentrations of the substrates, hydrolysis products and values of the global kinetic constants were obtained. The comparison between the global kinetic constants in the case of HLL hydrolysis of pure Labrafac, Solutol monolayers and those of the model mixed Labrafac/Solutol monolayers, shows that the rates of hydrolysis are of the same order of magnitude, i.e. an additively of the HLL enzyme action is observed. The composition of the mixed Labrafac/Solutol monolayer, formed after the interfacial LNC destabilization, was estimated.

Traumatic lesions of the colon associated with fracture of the acetabulum occurs in less than 2% of the cases. Direct perforation of the colon by a bony spike, which occurred in our patient, is even more exceptional. We were unable to find any other case reported in the literature. This case illustrates the importance of looking for intestinal lesions in all patients with pelvic injury presenting an unexplained infectious syndrome. Imaging provides clear evidence for avoiding late diagnosis and life-threatening situations.

The size, the electrical properties and the behaviour at air-water interface of lipid nanocapsules (LNC) with various compositions were investigated. Two populations of LNC are presented in the suspension after the preparation: with (LNC II) and without (LNC I) phospholipid molecules. After the spreading at air-water interface, a rapid disaggregation of LNC I, located in the vicinity of interface, occurs leading to formation of surface film. The phospholipid molecules stabilize the structure of nanocapsules and LNC II are more stable at the interface in comparison with LNC I. The formation of a surface film was followed after by measuring the evolution of the surface pressure, relative surface area change and surface potential. A kinetic approach describing the various processes during the surface film formation was proposed. The corresponding kinetic constants were estimated.

There is a general consensus concerning the clinical and radiological approach to diagnosis and proper management strategy in patients with sciatalgia subsequent to disk herniation. Recurrent herniation is the most probable diagnosis when pain recurs the same territory long after surgery. Despite advances in computed tomographic and magnetic resonance imaging, it may be difficult to identify the real source of the pain in some patients. We report a patient with renal cell cancer who developed recurrent sciatic pain which did not respond to disk surgery. This case illustrates the need for an extensive work-up before implicating the spine as the cause of recurrent sciatalgia.

A source of neutron rich ions can be conceived through the photo-fission process. An exploratory study of such a source is realized. A survey of the radiative electron energy loss theory is reported in order to estimate numerically the bremsstrahlung production of thick targets. The resulted bremsstrahlung angular and energy theoretical distributions delivered from W and UCx thick converters are presented and compared with previous results. Some quantities as the number of fission events produced in the fissionable source and the energy loss in the converters are also reported as function of the geometry of the combination and the incident electron energy. An attempt of comparison with experimental data shows a quantitative agreement. This study is focussed on initial kinetic energies of the electron beam included in the range 30–60 MeV, suitable for the production of large radiative γ-ray yields able to induce the 238 U fission through the giant dipole resonance. A confrontation with the number of fission events produced in the frame of the fast neutron induced fission method indicates that the photo-fission can be a competitive concept.

The aim of this paper is to present a user's point of view of a mechatronics platform considered as a framework for the design of a mechatronic system. Emphasis is placed on the reusability of validated component models which is the core of the proposed approach. It is hoped that new products allowing the storage and management of these models will be developed, thereby providing the necessary support to integrated design of mechatronics systems. A first attempt to develop such a product is performed within the ongoing ESPRIT III/OLMECO project conducted by PSA. >