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Resume Objectif Evaluer a court et moyen terme le succes de la sphincterotomie endoscopique (SE) dans la dyssynergie vesico-sphincterienne chez l’homme neurologique. Methode Etude retrospective, monocentrique, conduite chez 51 patients ayant eu une premiere SE entre janvier 2003 et juin 2018 avec au moins deux ans de suivi. Le critere de jugement principal etait le succes defini par le maintien du mode mictionnel reflexe au terme du suivi. Les criteres de jugement secondaires etaient les complications postoperatoires, le taux de reinterventions, le retentissement fonctionnel, le suivi urodynamique et le retentissement sur le haut appareil urinaire. Resultats L’âge median etait de 50,6 ans et le suivi median de 4,6 ans. Le taux de succes etait de 80 % (n = 41). Dix patients ont change de mode mictionnel dont 5 lies a une diminution de la contractilite detrusorienne. Le taux de reintervention etait de 39 %. Au terme du suivi, il est observe une amelioration significative des hyperreflexies autonomes (HRA) (26 vs 7 patients, p Conclusion La SE permet de maintenir un mode mictionnel reflexe chez 80 % des patients. Elle ameliore significativement les episodes d’HRA et d’IUF avec cependant un taux de reintervention de 39 %. Un suivi neuro-urologique regulier a long terme est necessaire afin de ne pas meconnaitre la recidive d’un obstacle sous vesical ou une diminution de la contractilite detrusorienne pouvant justifier d’une reintervention ou d’un changement de mode mictionnel. Niveau de preuve III.

The cyclization of a series of nonheterocyclic allenyl aryl ketones was examined using boron trifluoride etherate and indium triflate to mediate the reaction. Yields with BF3 were low in most instances due mainly to competitive destruction of the substrates. With In(OTf)3, there was less decomposition, and the yields of the cyclized product were much higher, but only for substrates with electron-donating substituents. Cyclization did not occur without those substituents. A computational study using the ωB97X-D/6-311+G(2d,p)//ωB97X-D/6-31+G(d,p) method confirmed better stability of the σ-complexed substrate by indium(III) and that meta-substituents on the phenyl ring of the substrate significantly influenced the activation barrier of the cyclization, whereas the effect of para-substituents was almost negligible. The computational results supported the idea that the cyclization is a 4π-electrocyclization and not a 5-endo-dig ring closure as had been proposed in the literature.

To assess the efficacy and morbidity of percutaneous nephrolithotomy (PNLT) in the treatment of renal stones in patients with neurogenic lower urinary tract dysfunction (NLUTD).Retrospective, monocentric study including all patients with NLUTD who had undergone PNLT between 2005 and 2017. Pre-operative clinical data (neurological condition, voiding mode, preoperative urine culture…), peri-operative and post-operative data (success and morbidity) were collected from the patients' charts. Success was defined by the absence of residual fragment (RF), on imaging or intraoperative endoscopy. Partial efficacy was defined by the presence of RF lower than 4mm. Early complications were reported according to the Clavien-Dindo classification.In all, 53 PNLTs were performed, in 35 patients, mostly with spinal cord injury. The success and partial efficacy rates were 66.0% and 71.7% respectively. The failure rate was correlated with increased stone burden (P=0.03), increased size of the largest stone (P=0.02), and the presence of complex stones (P0.02). The rate of early complications was 41.5%, with 27.3% major, mostly septic, and bleeding. The retreatment rate within 3 years was 41.5%.In patients with NLUTD, PNLT allows a high success rate, but with a significant rate of retreatment and infectious complications. However, NLPC remains the gold standard in this population, especially for renal stones larger 20mm, allowing a higher success rate than ureteroscopy and a lower retreatment rate.

Rapid progress in technologies such as calcium imaging and electrophysiology has seen a dramatic increase in the size and extent of neural recordings. Even so, interpretation of this data requires considerable knowledge about the nature of the representation and often depends on manual operations. Decoding provides a means to infer the information content of such recordings but typically requires highly processed data and prior knowledge of the encoding scheme. Here, we developed a deep-learning framework able to decode sensory and behavioral variables directly from wide-band neural data. The network requires little user input and generalizes across stimuli, behaviors, brain regions, and recording techniques. Once trained, it can be analyzed to determine elements of the neural code that are informative about a given variable. We validated this approach using electrophysiological and calcium-imaging data from rodent auditory cortex and hippocampus as well as human electrocorticography (ECoG) data. We show successful decoding of finger movement, auditory stimuli, and spatial behaviors – including a novel representation of head direction - from raw neural activity.

Summary Flexible navigation relies on a cognitive map of space, thought to be implemented by hippocampal place cells: neurons that exhibit location-specific firing. In connected environments, optimal navigation requires keeping track of one’s location and of the available connections between subspaces. We examined whether the dorsal CA1 place cells of rats encode environmental connectivity in four geometrically identical boxes arranged in a square. Rats moved between boxes by pushing saloon-type doors that could be locked in one or both directions. Although rats demonstrated knowledge of environmental connectivity, their place cells did not respond to connectivity changes, nor did they represent doorways differently from other locations. Place cells coded location in a global reference frame, with a different map for each box and minimal repetitive fields despite the repetitive geometry. These results suggest that CA1 place cells provide a spatial map that does not explicitly include connectivity., Highlights • Rats flexibly navigate in a four-room maze where connectivity changes • Place cell firing fields are not specifically altered by changes in connectivity • Single or ensemble place cell activity does not encode changes in connectivity • Place cells can uniquely map identical connected compartments, Hippocampal place cells are thought to underlie a “cognitive map” of space. Duvelle and Grieves et al. show that the place cells of rats discriminate four connected rooms and rats learn changes in their connectivity. However, such changes do not affect place cell activity, suggesting that other brain regions or mechanisms encode this information.

Flexible navigation relies on a cognitive map of space, thought to be implemented by hippocampal place cells: neurons that exhibit location-specific firing. In connected environments, optimal navigation requires keeping track of one’s location and of the available connections between subspaces. We examined whether the dorsal CA1 place cells of rats encode environmental connectivity in four geometrically-identical boxes arranged in a square. Rats moved between boxes by pushing saloon-type doors that could be locked in one or both directions. While rats demonstrated knowledge of environmental connectivity, their place cells did not respond to connectivity changes, nor did they represent doorways differently from other locations. Importantly, place cells coded the space in a global frame, expressing minimal repetitive fields despite the repetitive geometry (global coding). These results suggest that CA1 place cells provide a spatial map that does not explicitly include connectivity.

To evaluate in the short and mid-term the success of external sphincterotomy (ES) in neurological patients with detrusor sphincter dyssynergia (DSD).Retrospective, monocentric study, conducted in 51 patients who had a first ES between January 2003 and June 2018, with at least two years of follow-up. The success of ES was defined by maintenance of reflex voiding mode at the end of follow-up. Secondary outcomes were early postoperative complications, rate of revision, functional impact, urodynamic follow-up and upper urinary tract impact.The median age was 50.6 years and the median follow-up was 4.6 years. The success rate was 80% (n=41). Ten patients had to change their voiding mode. For 5 patients, it was related to secondary detrusor low contractility. A second ES was required for 39% of patients. At the end of follow-up, there was a significant improvement in Autonomic Dysreflexia (AD) (26 vs 7 patients, P0.001), urinary tract infections (UTI) (31 vs 15 patients, P0.001) and a significant decrease in post-voiding residuals (200 vs 50mL, P0.001).ES allowed to maintain reflex voiding in 80% of our patients. It significantly improves AD and UTI despite a high rate of re-operation (39%). A long-term follow-up is mandatory in order not to ignore a recurrence of bladder outlet obstruction and/or decrease in detrusor contractility, which may justify a re-operation or an alternative bladder management.III.

One of the goals of nanomedicine is targeted delivery of therapeutic enzymes to the sub-cellular compartments where their action is needed. Endothelial caveolae-derived endosomes represent an important yet challenging destination for targeting, in part due to smaller size of the entry aperture of caveolae (ca. 30–50 nm). Here, we designed modular, multi-molecular, ferritin-based nanocarriers with uniform size (20 nm diameter) for easy drug-loading and targeted delivery of enzymatic cargo to these specific vesicles. These nanocarriers targeted to caveolar Plasmalemmal Vesicle-Associated Protein (Plvap) deliver superoxide dismutase (SOD) into endosomes in endothelial cells, the specific site of influx of superoxide mediating by such pro-inflammatory signaling as some cytokines and lipopolysaccharide (LPS). Cell studies showed efficient internalization of Plvap-targeted SOD-loaded nanocarriers followed by dissociation from caveolin-containing vesicles and intracellular transport to endosomes. The nanocarriers had a profound protective anti-inflammatory effect in an animal model of LPS-induced inflammation, in agreement with the characteristics of their endothelial uptake and intracellular transport, indicating that these novel, targeted nanocarriers provide an advantageous platform for caveolae-dependent delivery of biotherapeutics.

Objectifs Les patients avec vessie neurologique sont plus a risque de developper des calculs renaux. Les etudes sur la Mini-Nephrolithotomie percutanee (Mini-NLPC) chez ces patients sont limitees. L’objectif de notre etude etait de comparer l’efficacite et la morbidite de la Mini-NLPC a la NLPC et a l’Ureterorenoscopie souple (URSS) pour le traitement des calculs renaux de plus de 15 mm chez les patients avec vessie neurologique. Methodes Nous avons mene une etude retrospective, monocentrique entre 2005 et 2020 dans notre centre de neuro-urologie tertiaire. Les patients inclus etaient tous porteurs d’une vessie neurologique et ont ete traites pour calculs renaux de taille superieure a 15 mm, ou 10 mm s’ils etaient situes dans le calice inferieur, par l’une des trois techniques chirurgicales etudiees. Le succes etait defini par l’absence de fragment residuel (sans fragment residuel = SFR) sur le scanner de controle a 3 mois, et les complications etaient rapportees selon la classification de Clavien-Dindo. Resultats 98 patients ont ete inclus sur la periode d’etude. Les techniques operatoires se repartissaient comme suit : 76 NLPC, 46 URSS et 25 Mini-NLPC. Le taux de succes de la Mini-NLPC (SFR 37,5 %) etait comparable a la NLPC (SFR 38,2 %) et a l’URSS (SFR 37 %) (p > 0,05) pour des tailles moyennes de calculs respectivement de 30,32 mm, 52,55 mm et 25,57 mm, c’est a dire des tailles de calculs significativement plus elevees pour la NLPC(p Tableau 1 ). Conclusion Chez les patients avec vessie neurologique, la Mini-NLPC semble avoir une efficacite comparable a la NLPC avec moins de complications et des durees d’hospitalisation plus courtes, pour des tailles de calculs plus petites. La mini-NLPC apparait comme une alternative seduisante a la NLPC pour le traitement des calculs renaux entre 15 et 30 mm chez les patients porteurs d’une vessie neurologique.

Flexible navigation relies on a cognitive map of space, thought to be implemented by hippocampal place cells: neurons that exhibit location-specific firing. In connected environments, optimal navigation requires keeping track of one's location and of the available connections between subspaces. We examined whether the dorsal CA1 place cells of rats encode environmental connectivity in four geometrically-identical boxes arranged in a square. Rats moved between boxes by pushing saloon-type doors that could be locked in one or both directions. While rats demonstrated knowledge of environmental connectivity, their place cells did not respond to connectivity changes, nor did they represent doorways differently from other locations. Importantly, place cells coded the space in a global frame, expressing minimal repetitive fields despite the repetitive geometry (global coding). These results suggest that CA1 place cells provide a spatial map that does not explicitly include connectivity.

Rodents are the main animal model to study sleep. Yet, in spite of a large consensus on the distinction between rapid-eye-movements sleep (REM) and non-REM sleep (NREM) in both humans and rodent, there is still no equivalent in mice of the NREM subdivision classically described in humans.Here we propose a classification of sleep stages in mice, inspired by human sleep scoring. By using chronic recordings in medial prefrontal cortex (mPFC) and hippocampus we can classify three NREM stages with a stage N1 devoid of any low oscillatory activity and N3 with a high density of delta waves. These stages displayed the same evolution observed in human during the whole sleep or within sleep cycles. Importantly, as in human, N1 in mice is the first stage observed at sleep onset and is increased after sleep fragmentation in Orexin-/- mice, a mouse model of narcolepsy.We also show that these substages are associated to massive modification of neuronal activity. Moreover, considering these stages allows to predict mPFC neurons evolution of firing rates across sleep period. Notably, neurons preferentially active within N3 decreased their activity over sleep while the opposite is seen for those preferentially active in N1 and N2.Overall this new approach shows the feasibility of NREM sleep sub-classification in rodents, and, in regard to the similarity between sleep in both species, will pave the way for further studies in sleep pathologies given the perturbation of specific sleep substages in human pathologies such as insomnia, somnambulism, night terrors, or fibromyalgia.

Cerebellar activity supported by PKC-dependent long-term depression in Purkinje cells (PCs) is involved in the stabilization of self-motion based hippocampal representation, but the existence of cerebellar processes underlying integration of allocentric cues remains unclear. Using mutant-mice lacking PP2B in PCs (L7-PP2B mice) we here assess the role of PP2B-dependent PC potentiation in hippocampal representation and spatial navigation. L7-PP2B mice display higher susceptibility to spatial map instability relative to the allocentric cue and impaired allocentric as well as self-motion goal-directed navigation. These results indicate that PP2B-dependent potentiation in PCs contributes to maintain a stable hippocampal representation of a familiar environment in an allocentric reference frame as well as to support optimal trajectory toward a goal during navigation., It is known that Purkinje cell PKC-dependent depression is involved in the stabilization of self-motion based hippocampal representation. Here the authors describe decreased stability of hippocampal place cells based on allocentric cues in mice lacking Purkinje cell PP2B-dependent potentiation.

We report on the development and investigation of standardized, nurse-delivered discharge information to women after same-day hysterectomy, including the relationships among discharge information, self-care confidence, perceived recovery, and satisfaction. Fifty-one women reported high levels of self-care confidence and various levels of perceived recovery 48 to 72 hours after surgery. They were satisfied to highly satisfied with their experiences and with the discharge information provided. The important role of standardized patient discharge information is highlighted.

Introduction La ventilation non invasive (VNI) est le traitement de reference de l’insuffisance respiratoire chronique hypercapnique, notamment en cas de bronchopneumopathie obstructive (BPCO) et de syndrome obesite-hypoventilation (SOH). L’usage de systemes d’humidification pour lutter contre la secheresse buccale est repandu. Cependant, il n’existe aucune donnee sur la potentielle colonisation microbienne de ces systemes. L’objectif de notre etude etait d’evaluer la prevalence de la contamination microbiologique des reservoirs des ventilateurs non invasifs de domicile, de determiner la prevalence de germes potentiellement pathogenes chez les patients BPCO et SOH. L’objectif secondaire etait d’evaluer le lien la presence de pathogenes et la survenue eventuelle d’une exacerbation dans les 12 mois precedant. Methodes Etude prospective, monocentrique et observationnelle ( NCT03809832 ) incluant les patients appareilles par ventilation non invasive depuis plus de 6 mois, ayant un systeme d’humidification et une observance superieure a 4 heures/jour. Lors de l’evaluation, etaient realises des prelevements microbiologiques de maniere standardisee sur les systemes d’humidification. Un questionnaire systematise sur l’entretien de la ventilation etait administre. Resultats Cinquante-trois patients ont ete inclus: 38 (72%) avec BPCO et 15 (28%) avec SOH. Les analyses microbiologiques ont montre que 50 (94% [95%CI: 84 to 99]) reservoirs etaient contamines par au moins un germe, sans difference entre les deux populations BPCO et SOH (p = 0.55). Un total de 22 (42% [95%CI: 28 to 56]) reservoirs etaient contamines par au moins un germe potentiellement pathogene sur le plan respiratoire, sans difference entre les patients atteints de BPCO et ceux atteints de SOH (p = 0.36). Le score moyen d’observance des mesures d’entretien etaient de 4.9 ± 1.7 sur 7 sans difference entre les deux groupes (p = 0.36). Dans la population BPCO, l’isolement d’un germe potentiellement pathogene dans le reservoir n’etait pas associe a une augmentation du taux d’exacerbations: IRR: 1.17 [95%CI: 0.72 to 1.88] (p = 0.53). Conclusion La contamination microbiologique des reservoirs de ventilateurs non invasifs est extremement frequente. Dans notre etude, nous avons retrouve un taux significatif de germes potentiellement pathogenes sur le plan respiratoire. L’impact clinique de la presence de ces pathogenes reste a determiner.

Does the body play an active role in emotions? Since the original James/Cannon controversy this debate has mainly been fueled by introspective accounts of human experience. Here, we use the animal model to demonstrate a physiological mechanism for bodily feedback and its causal role in the stabilization of emotional states. We report that during fear-related freezing mice breathe at 4Hz and show, using probabilistic modelling, that optogenetic perturbation of this feedback specifically reduces freezing maintenance without impacting its initiation. This rhythm is transmitted by the olfactory bulb to the prefrontal cortex where it organizes neural firing and optogenetic probing of the circuit demonstrates frequency-specific tuning that maximizes prefrontal cortex responsivity at 4Hz, the breathing frequency during freezing. These results point to a brain-body-brain loop in which the initiation of emotional behavior engenders somatic changes which then feedback to the cortex to directly participate in sustaining emotional states.

Capture of the cyclic oxyallyl cation intermediates from the BF3-mediated Nazarov reactions of three allenyl vinyl ketones with various dienes was accomplished by (3+2)- and (4+3)-cycloaddition. The relative amounts of these types of products were dependent on the substitution on the diene, and this could be linked to steric hindrance. Treatment of the (3+2)-cycloaddition products with BF3·Et2O led mainly to decomposition but also to ring-opened molecules and ring-enlarged structures. The computed Gibbs energies of the (3+2)-cycloaddition products, the products of the acid treatment and of some transition states leading to rearranged products were compared.

SIXTH INTERNATIONAL SYMPOSIUM OF SRC, Rome, ITALY, JUL 03-04, 2014; International audience; The contribution of the cerebellum to the non-motor aspects of spatial navigation is now established, but the mechanisms of its participation remain unclear. The L7-PKCI mouse model, in which inhibited PKC activity suppresses parallel fiber-Purkinje cell long-term depression (LTD), provides the opportunity to study their spatial abilities in the absence of any motor impairment. L7-PKCI mice are deficient in the spatial but not the cued version of the watermaze task. Their performances are preserved when alleys guide their trajectories in the starmaze task, suggesting that cerebellar PKC-dependent mechanisms are required for the production of an optimal trajectory toward a goal. Furthermore, electrophysiological recordings in freely moving L7-PKCI mice revealed that their hippocampal place cell properties are affected when they have to rely on self motion information: in the absence of external information as well as in a conflicting situation between self-motion and external information. This suggests that the cerebellum is involved in the processing of self-motion information and is required for the construction of the spatial representation in the hippocampus.

It has long been thought that sleep scoring could not be achieved with brain signals alone despite the deep neuromodulatory transformations that accompany sleep state changes. Here we demonstrate using multi-site electrophysiological LFP recordings in freely moving mice that gamma power in the olfactory bulb (OB) allows for clear classification of sleep and wake. Coupled with hippocampal theta activity, it allows the construction of a sleep scoring algorithm that relies on brain activity alone. This method reaches over 90% homology with classical methods based on muscular activity (EMG) and video tracking. Moreover, contrary to EMG, OB gamma power allows correct discrimination between sleep and immobility in ambiguous situations such as fear-related freezing. We use the instantaneous power of hippocampal theta oscillation and OB gamma oscillation to construct a 2D phase-space that is highly robust across mice and days. Dynamic analysis of trajectories within this space yields a novel characterization of sleep/wake and wake/sleep transitions as deeply divergent phenomena. Whereas waking up is a fast and direct transition, falling asleep is best described as stochastic and gradual change. Altogether this methodology opens the avenue for multi-timescale characterization of sleep states with high temporal resolution based on brain signals only.

The incidence of post-traumatic syringomyelia (PTS) is estimated according to recent studies at 25 to 30% of patients with traumatic spinal cord injuries in magnetic resonance imaging (MRI), which remains the gold standard exam for syringomyelia diagnosis and monitoring. Syringomyelia is translated by an increased cord signal (similar to CSF) with low-density T1-weighted image and high-density T2-weighted image, which extends beyond site of initial lesion at least to two vertebral segments. Two conditions are required for development of PTS: traumatic spinal cord injury and blocked the flow of CSF epidural. The mean interval from spinal cord injury to diagnosis SPT was 2.8years (range, 3months to 34years). The commonest symptoms are pain and sensory loss. PTS should be suspected if the patient has new neurological symptoms above level of injury, such as dissociated sensory injuries, reflexes abolition, and motor deficit, after the neural function becomes stable for certain time. In urologic practice, new neurological symptoms could be bladder and/or erectile dysfunction. The medical management based on prevention efforts with closed-glottis pushing, which could aggravate the syrinx cavity. In urology, extracorporeal shockwave lithotripsy, and laparoscopic or robotic surgery could extend the syrinx cavity for the same reason (increase abdominal pressure). The indications for surgical intervention and optimal surgical treatment technique for patients with PTS are not consensual. The literature demonstrated that surgery PTS is effective at arresting or improving motor deterioration, but not sensory dysfunction or pain syndromes.

Resume Objectif Etudier la precision obtenue dans l’estimation de la lumiere et de la distensibilite aortiques en utilisant des sequences d’IRM : « steady-state free-precession » (SSFP) et de contraste de phase (PC). Sujets et methodes Les lumieres arterielles systolique et diastolique de l’aorte ascendante et descendante de 50 sujets, recueillies avec les deux sequences d’acquisition, ont ete extraites par une methode de segmentation automatique 2D + t. Resultats Alors que l’analyse statistique indique des resultats tres similaires pour l’aire de la lumiere aortique estimee avec les sequences SSFP et PC (pente = 1, r = 0,99), les valeurs correspondantes de distensibilite sont moins bien correlees (r = 0,54). La comparaison entre les valeurs de distensibilite dans l’aorte ascendante et descendante et l’etude de leur evolution au cours du vieillissement montrent une plus grande coherence avec le comportement physiologique attendu de l’aorte lorsque les images SSFP sont utilisees. Discussion La presence d’artefacts de flux plus importants sur les images PC peut expliquer, en partie, les meilleurs resultats obtenus avec les acquisitions SSFP. Conclusion L’estimation de la rigidite aortique locale est plus precise a partir des sequences d’images SSFP qu’a partir des sequences d’images PC.

The cationic intermediate of the Lewis acid-initiated Nazarov cyclization of an allenyl vinyl ketone (AVK) was trapped by pyrroles and indoles. The yields ranged from modest to high (up to 93%), and in both cases, only two of the three possible products were produced. Cyclopent-2-enones substituted at the 5-position were predominantly produced, however with increasing alkyl substitution or placement of an electron-withdrawing group on the nitrogen, an alternative regioisomer could also be formed. The results of this study suggest that a position α to the oxygen of the oxyallyl cation is the electronically preferred trapping site, whilst an exocyclic position is preferred for more sterically encumbered reacting partners.

Nitrous acid, HONO, is an important trace gas in tropospheric photochemistry, because it is a source of OH radicals. In order to obtain HONO concentrations from spectroscopic measurements, the knowledge of accurate absorption cross-sections is essential. Furthermore, the ultraviolet absorption cross-sections of HONO determine its atmospheric photolysis rates, which are still being debated. In particular, in a recent field study focusing on the photolysis frequency of HONO, the absolute values of the ultraviolet absorption cross-sections have been proposed as a potential source for systematic errors. For these reasons, we have compared the absorption cross-sections for HONO in the infrared (IR) and ultraviolet (UV) by performing simultaneous measurements in both spectral regions. Assuming that the IR cross-sections (that show good agreement between different studies) are correct, our study shows a good agreement between the consistent infrared studies and some selected accurate UV spectra published previously (about 6%) while a rather large disagreement (about 22%) is observed when using other UV data sets.

Resume Objectifs Les injections de toxine sont un traitement efficace dans la prise en charge de l'hyperactivite vesicale neurologique. L'effet du renouvellement des injections est peu documente. L'objectif est d'evaluer l'efficacite de l'administration repetee de toxine dans le detrusor, chez des patients presentant une hyperactivite vesicale. Materiel et methodes Il s'agit d'une etude retrospective chez des patients recevant des injections de 300 UI de Botox ® . L'analyse des donnees cliniques comporte l'obtention d'une continence, la duree d'efficacite sur les fuites, les modifications dans la prise d'anticholinergiques ou le port de protection et la satisfaction des patients. Les donnees urodynamiques analysees sont la capacite cystomanometrique maximale, l'existence d'une contraction et la pression de contraction detrusorienne. Les donnees ont ete analysees a l'aide des tests de Wilcoxon et Kruskal-Wallis. Resultats–discussion Quarante-deux patients ont ete inclus (30 hommes et 12 femmes), presentant les lesions medullaires traumatiques, des scleroses en plaques ou des myelopathies d'etiologies diverses. Les patients ont recu une a six injections. La duree d'efficacite est de six mois en moyenne. Il n'existe pas de difference significative de ce delai entre les injections successives. Les anticholinergiques sont arretes chez 43 % des patients et les protections chez 48 % d'entre-deux. Quatre-vingts pour cent des patients sont satisfaits. La contraction vesicale disparait dans 70 % des cas et la capacite cystomanometrique maximale est augmentee de 144 ml en moyenne. Conclusion L'administration repetee de toxine intradetrusorienne reste un traitement actif cliniquement et urodynamiquement. La duree d'efficacite sur la continence se maintient au fil des injections.

Une compression chronique du nerf pudendal dans un site d’etroitesse anatomique (syndrome canalaire) peut etre a l’origine de douleurs perineales invalidantes. Ce type d’atteinte doit etre diagnostique de facon specifique, car cela peut constituer une indication de neurolyse chirurgicale. Dans ce cadre, il est usuel de demander un examen electroneuromyographique (ENMG) du perinee, qui sera base sur l’etude de l’activite electromyographique de muscles perineaux, des reflexes sacres et des conductions motrices du nerf pudendal. Differentes considerations physiopathologiques et techniques expliquent certaines limites de l’ENMG qu’il faut connaitre. C’est ainsi que les methodes utilisees n’evaluent pas les anomalies fonctionnelles a l’origine des douleurs, mais plutot les alterations structurelles du nerf pudendal (demyelinisation ou perte axonale). De plus, seule l’innervation motrice directe ou reflexe est evaluee, alors que l’etude specifique des conductions sensitives serait sans doute plus sensible a objectiver une compression nerveuse. Enfin, il n’est pas possible de distinguer l’atteinte compressive des nombreuses autres causes de lesion nerveuse pudendale (chirurgicales, obstetricales, liees a une constipation chronique…). Ainsi, l’ENMG perineal a une sensibilite et une specificite limitees dans le diagnostic de syndrome canalaire pudendal et ne renseigne pas directement sur le phenomene douloureux. Le diagnostic de nevralgie pudendale repond en fait a des criteres cliniques precis et l’ENMG ne peut que donner des arguments supplementaires, mais non formels en faveur de ce diagnostic. L’ENMG perineal permet surtout de faire un « etat des lieux » de l’innervation perineale en prevision d’un geste chirurgical de decompression, et pourrait eventuellement fournir certains elements predictifs de l’interet de l’intervention. En revanche, l’ENMG ne permet generalement pas de localiser precisement le site de compression et n’a, dans tous les cas, aucune utilite dans la surveillance peroperatoire.

This paper uses macroscopic and radiological examinations to provide differential diagnoses of pathological lesions in the skeleton of a young woman, 20–25 years of age, which triggered the Danish palaeopathologist Vilhelm Moller-Christensen's interest in leprosy. The skeleton was incomplete, but the majority of bones of the upper body, as well as the skull, were present. The pathological changes consisted of medullary and cortical lytic foci, periosteal reaction and enhanced cortical density. The lesions were most extensive on the left side, especially around the elbow, wrist and scapula. Treponematosis, leprosy, smallpox, ergotism, rheumatoid arthritis, tuberculosis and sarcoidosis are all reviewed with regard to bone and joint pathology and their likelihood of being the correct diagnosis. We concluded that the most plausible diagnosis is treponematosis, but neither sarcoidosis nor smallpox can be completely excluded. Copyright © 2007 John Wiley & Sons, Ltd.

An oxyallyl cation, generated by Nazarov reaction of an allenyl vinyl ketone, is trapped by regioselective cycloaddition with 2-siloxy-1,3-butadienes to give bicyclo[4.2.1]nonane derivatives.

Introduction The management of pressure sores in neuro-injured patients at the Nantes University Hospital was organized for 30 years in a medical-surgical care chain. The last ten years of this activity are traced in this retrospective study. Patients and methods All records of patients who had a surgical flap to cover pressure sore between 1 January 2004 and 31 December 2014 were analysed to synthesize results. Results One hundred and thirteen men and 49 women (n = 162) were operated of 250 flaps. This was mainly spinal cord injured patients (78%). Patients were divided into two groups: pressure ulcer(s) single or multiple (several lesions operated at the same time or later). There were 67% of ischial lesions, 20% of sacral lesions and 12% trochanteric lesions. The most used flap was that of gluteus maximus (82%) for the ischial and sacral lesions, then comes the tensor fascia lata (12%) for trochanteric lesions. Feature of our series (unlike others [1] ), the hamstring's flap is only used as a last resort (6%) in multirecidivist patients. The complication rate delaying delivery to the chair in theoretical time of six weeks is 35%, to be analysed according to age, general health, the size and number of initial lesions. However, the rate of recurrence after healing of the flap is only 10%. Discussion A medical and surgical management, long and sometimes complex [2] , but our long-term results are satisfactory regarding to the low recurrence rate.

Capture of the cyclic oxyallyl cation intermediates from the BF3-mediated Nazarov reactions of allenyl vinyl ketones with various dienes is accomplished by (3+2)- and (4+3)-cycloaddition.

The oxyallyl cation intermediate from the Lewis acid mediated Nazarov reaction of an allenyl vinyl ketone was intercepted by acyclic, 2-silyloxy-substituted butadienes by highly regioselective (4 + 3) cycloadditions. Stereoselectivity was often modest, but in some instances steric interactions were responsible for high selectivity. The results are consistent with concerted (4 + 3) cycloadditions. In many instances, the (4 + 3) products were susceptible to fragmentation or rearrangement in the presence of the Lewis acid.

International audience; The cerebellum has already been shown to participate in the navigation function. We propose here that this structure is involved in maintaining a sense of direction and location during self-motion by monitoring sensory information and interacting with navigation circuits to update the mental representation of space. To better understand the processing performed by the cerebellum in the navigation function, we have reviewed: the anatomical pathways that convey self-motion information to the cerebellum; the computational algorithm(s) thought to be performed by the cerebellum from these multi-source inputs; the cerebellar outputs directed toward navigation circuits and the influence of self-motion information on space-modulated cells receiving cerebellar outputs. This review highlights that the cerebellum is adequately wired to combine the diversity of sensory signals to be monitored during self-motion and fuel the navigation circuits. The direct anatomical projections of the cerebellum toward the head-direction cell system and the parietal cortex make those structures possible relays of the cerebellum influence on the hippocampal spatial map. We describe computational models of the cerebellar function showing that the cerebellum can filter out the components of the sensory signals that are predictable, and provides a novelty output. We finally speculate that this novelty output is taken into account by the navigation structures, which implement an update over time of position and stabilize perception during navigation.

International audience; Spatial navigation calls upon mnemonic capabilities (e.g. remembering the location of a rewarding site) as well as adaptive motor control (e.g. fine tuning of the trajectory according to the ongoing sensory context). To study this complex process by means of behavioral measurements it is necessary to quantify a large set of meaningful parameters on multiple time scales (from milliseconds to several minutes), and to compare them across different paradigms. Moreover, the issue of automating the behavioral analysis is critical to cope with the consequent computational load and the sophistication of the measurements. We developed a general purpose Navigation Analysis Tool (NAT) that provides an integrated architecture consisting of a data management system (implemented in MySQL), a core analysis toolbox (in MATLAB), and a graphical user interface (in JAVA). Its extensive characterization of trajectories over time, from exploratory behavior to goal-oriented navigation with decision points using a wide range of parameters, makes NAT a powerful analysis tool. In particular, NAT supplies a new set of specific measurements assessing performances in multiple intersection mazes and allowing navigation strategies to be discriminated (e.g. in the starmaze). Its user interface enables easy use while its modular organization provides many opportunities of extension and customization. Importantly, the portability of NAT to any type of maze and environment extends its exploitation far beyond the field of spatial navigation.

Recent surveys suggest more than one third of patients utilize the Internet to seek information about chronic pain (CP) and that 60% of patients feel more confident in the information provided online than provided by their physician. Unfortunately, the quality of online information is questionable. For example, some Websites make unsubstantiated claims while others may have covert motives (i.e., product advertisement). This article presents two studies that utilized a well-validated tool to evaluate the quality of online CP-related information.A Website search was conducted by entering the most commonly used pain-related search terms into the three most commonly used search engines in North America. In study 1, the first 50 Websites from each search were evaluated using a consumer-focused evaluation tool-the DISCERN. In study 2, 21 clients with CP used the DISCERN to rate a random selection of Websites from among the 10 highest scoring and five lower scoring sites from Study 1, and answered open-ended questions regarding the DISCERN and Websites.Ratings indicated that Websites ranged substantially in quality, with many providing incomplete and incorrect information, and others providing accurate and detailed information. The majority of the Websites provided low-quality information. Client ratings of the Websites were consistent with those of the researchers.Overall, these findings speak to the risks associated with clients making CP-related treatment choices based on information obtained online without first evaluating the Website.

International audience; Early investigations of cerebellar function focused on motor learning, in particular on eyeblink conditioning and adaptation of the vestibulo-ocular reflex, and led to the general view that cerebellar long-term depression (LTD) at parallel fiber (PF)-Purkinje cell (PC) synapses is the neural correlate of cerebellar motor learning. Thereafter, while the full complexity of cerebellar plasticities was being unraveled, cerebellar involvement in more cognitive tasks-including spatial navigation-was further investigated. However, cerebellar implication in spatial navigation remains a matter of debate because motor deficits frequently associated with cerebellar damage often prevent the dissociation between its role in spatial cognition from its implication in motor function. Here, we review recent findings from behavioral and electrophysiological analyses of cerebellar mutant mouse models, which show that the cerebellum might participate in the construction of hippocampal spatial representation map (i.e., place cells) and thereby in goal-directed navigation. These recent advances in cerebellar research point toward a model in which computation from the cerebellum could be required for spatial representation and would involve the integration of multi-source self-motion information to: (1) transform the reference frame of vestibular signals and (2) distinguish between self- and externally-generated vestibular signals. We eventually present herein anatomical and functional connectivity data supporting a cerebello-hippocampal interaction. Whilst a direct cerebello-hippocampal projection has been suggested, recent investigations rather favor a multi-synaptic pathway involving posterior parietal and retrosplenial cortices, two regions critically involved in spatial navigation.

International audience; Automated extraction of quantitative parameters from Cardiac Magnetic Resonance Images (CMRI) is crucial for the management of patients with myocardial infarct. This work proposes a post-processing procedure to jointly analyze Cine and Delayed-Enhanced (DE) acquisitions in order to provide an automatic quantification of myocardial contraction and enhancement parameters and a study of their relationship. For that purpose, the following processes are performed: 1) DE/Cine temporal synchronization and 3D scan alignment, 2) 3D DE/Cine rigid registration in a region about the heart, 3) segmentation of the myocardium on Cine MRI and superimposition of the epicardial and endocardial contours on the DE images, 4) quantification of the Myocardial Infarct Extent (MIE), 5) study of the regional contractile function using a new index, the Amplitude to Time Ratio (ATR). The whole procedure was applied to 10 patients with clinically proven myocardial infarction. The comparison between the MIE and the visually assessed regional function scores demonstrated that the MIE is highly related to the severity of the wall motion abnormality. In addition, it was shown that the newly developed regional myocardial contraction parameter (ATR) decreases significantly in delayed enhanced regions. This largely automated approach enables a combined study of regional MIE and left ventricular function.; L'extraction automatisée de paramètres quantitatifs à partir d'images par résonance magnétique cardiaque (CMRI) est cruciale pour la prise en charge des patients atteints d'infarctus du myocarde. Ce travail propose une procédure de post-traitement pour analyser conjointement les acquisitions d'IRM Ciné et de rehaussement tardif (RT) afin de fournir une quantification automatique des paramètres de contraction et de rehaussement du myocarde et une étude de leur relation. À cette fin, les processus suivants sont effectués : 1) synchronisation temporelle RT/Ciné et alignement spatial 3D, 2) recalage rigide RT/Ciné 3D dans une région autour du cœur, 3) segmentation du myocarde sur Ciné IRM et superposition des contours épicardiques et endocardiques sur les images RT, 4) quantification de l'étendue de l'infarctus du myocarde (EIM), 5) étude de la fonction contractile régionale à l'aide d'un nouvel indice, le rapport amplitude/temps. L'ensemble de la procédure a été appliqué à 10 patients présentant un infarctus du myocarde cliniquement prouvé. La comparaison entre le EIM et les scores de fonction régionaux évalués visuellement a démontré que le EIM est fortement lié à la gravité de l'anomalie du mouvement de la paroi. En outre, il a été démontré que le paramètre de contraction myocardique régional nouvellement développé diminue de manière significative dans les régions rehaussées retardées. Cette approche largement automatisée permet une étude combinée de l'étendue de l'infarctus du myocarde régional et de la fonction ventriculaire gauche.

We investigated polysaccharide films obtained by simultaneous and alternate spraying of a chitosan (CHI) solution as polycation and hyaluronic acid (HA), alginate (ALG), and chondroitin sulfate (CS) solutions as polyanions. For simultaneous spraying, the film thickness increases linearly with the cumulative spraying time and passes through a maximum for polyanion/CHI molar charge ratios lying between 0.6 and 1.2. The size of polyanion/CHI complexes formed in solution was compared with the simultaneously sprayed film growth rate as a function of the polyanion/CHI molar charge ratio. A good correlation was found. This suggests the importance of polyanion/polycation complexation in the simultaneous spraying process. Depending on the system, the film topography is either liquid-like or granular. Film biocompatibility was evaluated using human gingival fibroblasts. A small or no difference is observed in cell viability and adhesion between the two deposition processes. The CHI/HA system appears to be the best for cell adhesion inducing the clustering of CD44, a cell surface HA receptor, at the membrane of cells. Simultaneous or alternate spraying of CHI/HA appears thus to be a convenient and fast procedure for biomaterial surface modifications. journal article research support, non-u.s. gov't 2012 Jun 05 2012 05 23 imported

The incidence of post-traumatic syringomyelia (PTS) is estimated according to recent studies at 25 to 30% of patients with traumatic spinal cord injuries in magnetic resonance imaging (MRI), which remains the gold standard exam for syringomyelia diagnosis and monitoring. Syringomyelia is translated by an increased cord signal (similar to CSF) with low-density T1-weighted image and high-density T2-weighted image, which extends beyond site of initial lesion at least to two vertebral segments. Two conditions are required for development of PTS: traumatic spinal cord injury and blocked the flow of CSF epidural. The mean interval from spinal cord injury to diagnosis SPT was 2.8years (range, 3months to 34years). The commonest symptoms are pain and sensory loss. PTS should be suspected if the patient has new neurological symptoms above level of injury, such as dissociated sensory injuries, reflexes abolition, and motor deficit, after the neural function becomes stable for certain time. In urologic practice, new neurological symptoms could be bladder and/or erectile dysfunction. The medical management based on prevention efforts with closed-glottis pushing, which could aggravate the syrinx cavity. In urology, extracorporeal shockwave lithotripsy, and laparoscopic or robotic surgery could extend the syrinx cavity for the same reason (increase abdominal pressure). The indications for surgical intervention and optimal surgical treatment technique for patients with PTS are not consensual. The literature demonstrated that surgery PTS is effective at arresting or improving motor deterioration, but not sensory dysfunction or pain syndromes.

Our purpose, in this prospective clinical study, was to identify the best predictors of 2-month return to work or retraining for a group of low back injured subjects (n = 40) who completed at least 8 weeks of a community-based rehabilitation program that combined aerobic and flexibility exercise conducted in the water (aquafitness) with muscle strength and endurance training. Baseline demographic characteristics and changes in physical fitness, pain, disability, and psychological well-being during the course of program participation were compared between two groups of low back injured subjects: those who returned to work (RTW) [n = 24], and those who did not (N-RTW) [n = 16]. Subjects in both groups showed comparable improvement in measures of physical fitness at 8 weeks. However, multivariate analyses showed significant between-group differences in self-report measures. The RTW group showed significant improvement in measures of pain, disability, anxiety, and vigor while self-esteem and affect remained stable. The N-RTW group displayed no change in pain and disability variables and had significant deterioration in mean overall psychological well-being over time. The best predictors of return to work using logistic regression analyses were a first injury rather than a repeat injury to the lower back, and stability in self-esteem. Suggestions are offered for further research to examine the benefits of aquafit exercise for the low back injured, for additional interventions for those with a reinjury, and for maintaining or enhancing self-esteem as a treatment goal.

The efficiency of a new transit time (Δt) estimator (MSeg) for Pulse Wave Velocity (PWV) estimation is compared with three previously described methods (MUpslope, MFoot, MPoint), in terms of correlation with aging and reproducibility. SSFP and PC acquisitions from 40 subjects (42±15 year), recorded at the level of the aortic arch were studied. Δt was defined as the time shift between the flow curves in the ascending (CA) and descending (CD) aorta and calculated with: 1) MSeg, by minimizing the area delimited by two sigmoid curves fitted to the systolic up-slope of CA and CD, 2) MUpslope, by minimizing the area between the systolic up-slope of CA and the CD curve, 3) MFoot using CA and CD feet, 4) MPoin,t using the half maximum of CA and CD. The MSeg estimator resulted in a higher reproducibility (6%), better correlation of pulse wave velocity with aging (r=0.85), and less overlap between the

Associative olfactory learning increased survival of adult born granule interneurons in the olfactory bulb at regions which are specific to the learned odorant. However, the mechanism shaping this odor-specific distribution of newborn neurons and its temporal relationship with the learning process are unknown. In the present study, using Bromodeoxyuridine or activated caspase3 labeling, newborn and apoptotic cells respectively were mapped in the granule cell layer of the olfactory bulb, just before, during and at the end of odor conditioning or pseudo-conditioning in adult mice. Results indicate that before and during training, when the task is not yet acquired, conditioned and pseudo-conditioned animals displayed the same density of newborn neurons. However, at the end of the conditioning, when the animals mastered the task, the density of newborn cells remained elevated in conditioned animals while it decreased in pseudo-conditioned animals suggesting newborn cell death in that group. Indeed, using Activated Caspase3/BrdU co-labeling, we found that the proportion of newborn cells among dying cells was reduced in conditioned animals mastering the task compared to non expert conditioned or pseudo-conditioned animals. The overall level of cell death did not change across training and was similar in conditioned and pseudo-conditioned groups, indicating that BrdU-positive cells were spared to the detriment of non-labeled cells. In addition, a fine analysis of cell distribution showed an uneven distribution of apoptotic cells, with lower densities in the medial part of the GCL where the density of newborn cells is high in conditioned animals. We conclude that acquisition of the task triggered the rescue of newborn neurons by a targeted regulation of cell death.

BackgroundTransposition of the great arteries (TGA) is the consequences of abnormal aorticopulmonary septation. Animal embryonic data indicate that septation and elastogenesis are related events. It was showed that carotid artery is markedly and constitutionally stiffer in patients with TGA.Objectiveto assess aortic dimensions and aortic elasticity in patients with TGA using magnetic resonance imaging (MRI).MethodsMRI was performed in 29 patients with simple TGA operated by an atrial switch procedure (22 male; mean age 29 ± 4 years) and 29 age and gender-matched healthy subjects.ResultsTGA patients showed aortic root dilatation (7.7±2.1 vs 6.2±1.2cm∑, p = 0, 0018, in systole, and 6.8±2.1 vs 5.0±1.2cm∑, p = 0.0003, in diastole, at tubular level), reduced aortic root distension (13.5±5.9 vs 24.3±11.7, p