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A perfect maze is a maze where any two cells can be joined by a unique path. In the literature, there exist eleven maze generation algorithms as compiled by Buck in 2015 in his book “Mazes for Programmers”. Each algorithm creates mazes differently. Our aim is to analyze how perfect mazes are generated. For this, we use the simple measures introduced by Buck, as well as the physical based measures introduced by McClendon in 2001. We introduce a new measure that helps us establish a ranking for perfect mazes. We also propose two new maze generation algorithms, called Prim & Kill and Twist & Merge . According to our measure, these two algorithms generate mazes differently than the existing algorithms do.

Study question To observe real-world utilization of algorithm-based dosing of follitropin delta in women naïve to ovarian stimulation (OS) and undergoing either in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Summary answer Individualized dosing of follitropin delta in real-world clinical practice results in predictable ovarian response while minimizing risk of ovarian hyperstimulation syndrome (OHSS). What is known already Follitropin delta (REKOVELLE, Ferring Pharmaceuticals, Switzerland), is the first recombinant human follicle-stimulating hormone (FSH) to be produced in a human cell line. The algorithm-based individualized dosing regimen for follitropin delta was developed to target an ovarian response of 8–14 oocytes while reducing the risk of extreme ovarian hypo- and hyper-response as compared with conventional dosing strategies. The efficacy and safety of follitropin delta has been demonstrated in randomized controlled trials (RCTs) compared with a standard daily starting dose of 150 IU recombinant FSH. Real-world implementation of individualized follitropin delta dosing using the algorithm in OS cycles is currently unknown. Study design, size, duration PROFILE was a prospective, open-label, non-interventional, multinational study conducted between March 2018 and October 2020 in which 1258 women were screened, 1013 met the inclusion/exclusion criteria and 944 women initiated their first OS cycle. No study drugs were reimbursed or provided by the study sponsor. All IVF/ICSI treatment protocols were conducted according to routine clinical practice, including how to prescribe follitropin delta and undertaking fresh/frozen transfers. Participants were followed for up to three OS cycles. Participants/materials, setting, methods All participants met inclusion criteria: ≥18 years, were naïve to IVF/ICSI treatment and the decision had made before enrolment to use follitropin delta for OS. Main exclusion criteria were any contraindication(s) preventing prescription of follitropin delta, and undergoing OS for oocyte donation or fertility preservation. The main outcomes were use of dosing algorithm, follitropin delta dosing patterns, ovarian response and pregnancy for first OS cycle, and adverse drug reactions (ADRs) for up to three cycles. Main results and the role of chance Baseline demographics for 944 women who initiated Cycle 1 were: age, 33.5±4.7 years; bodyweight, 67.1±13.6 kg; anti-Müllerian hormone, 20.3±16.1 pmol/L (2.84 ng/mL) (mean±standard deviation). Cycles 2 and 3 were initiated by 156 and 29 women, respectively. In Cycle 1, clinicians used the dosing algorithm to calculate the follitropin delta starting dose for 893/944 women (94.5%), although some clinicians adjusted the prescribed daily starting dose. The difference between the calculated and prescribed daily dose was small (0.2±1.40 µg); most women (822/944, 87.1%) were prescribed a daily dose of follitropin delta within 0.33 µg (1 click of pen) of the algorithm-calculated dose. The mean daily starting dose was 10.4 µg and mean total dose administered was 104 µg over 10.1 days. A mean of 10.1±7.03 oocytes were retrieved per woman. A fresh transfer was performed for 592/944 women (62.7%) and subsequent positive β-human chorionic gonadotropin (βhCG) reported for 352/944 women (37.3%). Ongoing pregnancy rate after fresh transfer was 27.0% (n = 255) and cumulative ongoing pregnancy rate after fresh/frozen transfer was 36.4% (n = 344). Four women discontinued follitropin delta due to ADRs. OHSS was reported for 37 women (3.9%); 12 (1.3%) OHSS events were reported as serious ADRs. No new safety signals were reported. Limitations, reasons for caution There may be bias towards IVF/ICSI treatment protocols used in countries with highest enrolment. Reasons for prescribing follitropin delta as part of a mixed FSH regimen in 33/944 women (3.5%) were not reported. Wider implications of the findings In real-world clinical practice, nearly all clinicians use the dosing algorithm to calculate individualized daily follitropin delta dose. Despite some women being prescribed dose deviations, first cycle ovarian response was predictable with good ongoing pregnancy rates. OHSS incidence was within expected range. PROFILE confirms efficacy and safety from pivotal RCTs. Trial registration number NCT03393780

Peripheral arterial disease is a result of atheroma. This disease is frequent in subjects with vascular risk factors. This disease is also frequent in low income countries. The detection and the diagnosis of peripheral arterial disease is obtained by calculating the ankle brachial index. Patients with peripheral arterial disease are not always symptomatic thus explaining how this disease is under diagnosed. The symptoms can be absent, and especially in case of diabetes or in women. In case of peripheral arterial disease, atheroma often involves other arterial vascular networks especially the coronaries. An adapted treatment reduces the morbi-mortality linked to this disease. This treatment is based on the correction of the vascular risk factors and especially tobacco cessation, walking rehabilitation and drugs (antiplatelet agent, statin, renin angiotensin system blocker). In case of rest or critic ischemia, the first-line treatment is a revascularisation. In peripheral arterial disease, management of patients is often non optimal and therapeutic targets fairly often obtained.

La crise sanitaire de la Covid-19 du printemps 2020 a peu touché les enfants avec peu d’hospitalisations dans les hôpitaux pédiatriques. Le défi a été d’apporter une aide aux hôpitaux adultes avec un personnel principalement formé à la pédiatrie tout en maintenant la permanence des soins urgents pour les enfants atteints ou non de la Covid-19. À l’hôpital universitaire Armand-Trousseau, nous avons créé des unités dédiées pour les enfants atteints de la Covid-19, identifié les spécificités des enfants atteints de la Covid-19 et notamment les formes de Kawasaki like ou PIMS (paediatric multisystem inflammatory syndrome), créé une unité de réanimation adulte au pic de l’épidémie pour augmenter les capacités en lits de réanimation dans notre région, mutualisé notre centre de dépistage pour le personnel d’hôpitaux adultes. Enfin, nous avons envoyé plus de 140 personnels médicaux et paramédicaux dans les hôpitaux adultes de notre groupe hospitalier. Cette aide a pu être organisée grâce aux liens étroits établis par des cellules de crises communes avec les hôpitaux adultes de notre groupe hospitalier. Nous rapportons ainsi un retour d’expérience d’un hôpital pédiatrique au cours de la crise de la Covid-19 en Île-de-France.

Peripheral arterial disease is a result of atheroma. This disease is frequent in subjects with vascular risk factors. This disease is also frequent in low income countries. The detection and the diagnosis of peripheral arterial disease is obtained by calculating the ankle brachial index. Patients with peripheral arterial disease are not always symptomatic thus explaining how this disease is under diagnosed. The symptoms can be absent, and especially in case of diabetes or in women. In case of peripheral arterial disease, atheroma often involves other arterial vascular networks especially the coronaries. An adapted treatment reduces the morbi-mortality linked to this disease. This treatment is based on the correction of the vascular risk factors and especially tobacco cessation, walking rehabilitation and drugs (antiplatelet agent, statin, renin angiotensin system blocker). In case of rest or critic ischemia, the first-line treatment is a revascularisation. In peripheral arterial disease, management of patients is often non optimal and therapeutic targets fairly often obtained.

To meet the international biodiversity targets of the 2011–2020 Global Strategy for Plant Conservation, it is important to assess the success of coordinated ex situ plant conservation initiatives such as the European Native Seed Conservation Network (ENSCONET), which operated during 2005–2009, and the ENSCONET Consortium, which was established in 2010. In particular, analysis of the ENSCONET database (ENSCOBASE) indicates that ex situ seed banks have been making significant progress towards meeting targets 8 (at least 75% of threatened plant species in ex situ collections, preferably in the country of origin, and at least 20% available for recovery and restoration programmes) and 9 (70% of the genetic diversity of crops, including their wild relatives and other socio-economically valuable plant species, conserved, while respecting, preserving and maintaining associated indigenous and local knowledge) for native European species. However, the infraspecific diversity of threatened species stored in ENSCONET seed banks needs to be increased to meet research and conservation objectives.

Fibrogenesis is a universal and ubiquitous process associated with tissue healing. The impairment of tissue homeostasis resulting from the deregulation of numerous cellular actors, under the effect of specific cytokine and pro-oxidative environments can lead to extensive tissue fibrosis, organ dysfunction and significant morbidity and mortality. This situation is frequent in internal medicine, since fibrosis is associated with most organ insufficiencies (i.e. cardiac, renal, or hepatic chronic failures), but also with cancer, a condition with common pathophysiological mechanisms. Finally, fibrosis is a hallmark of numerous systemic autoimmune diseases such as connective tissue disorders (in particular systemic sclerosis), vasculitides, granulomatoses, histiocytoses, and IgG4-associated disease. Although the process leading to tissue fibrosis may be in part irreversible, new pharmacological approaches or cell therapies bring hope in the field of fibrotic conditions.

The contribution of the European Native Seed Conservation Network (ENSCONET, 2004-2009) and the ENSCONET Consortium (since 2010) towards meeting the 2020 Global Strategy for Plant Conservation (GSPC) target 8 was assessed in 2017. While the outcome was positive (62.7% of European threatened species already conserved ex situ in seed banks), the analysis showed that it was essential to provide guidance on which European native threatened species should be collected as a priority if the target was to be reached by 2020. In this paper we present a priority-setting method and its result, designed to guide collecting strategies across Europe to meet the 2020 GSPC target 8. The result of our study is a country-based checklist of European threatened taxa to be collected and stored ex situ across the seed banks of the ENSCONET Consortium by 2020. After discussing the results of the applied method, the ENSCONET Consortium Steering Committee has identified some key action points to support the implementation of such a collecting strategy across Europe in order to meet the 2020 GSPC target 8 for Europe.

Introduction Nous rapportons une observation de malformations capillaires-malformations arterioveineuses (MC-MAV) de type 2 a type de telangiectasies hereditaires benignes (THB), illustrant, a partir de la revue de la litterature, le caractere desormais obsolete de la terminologie « THB ». Observation Une femme de 19 ans etait adressee pour des telangiectasies asymptomatiques presentes depuis la naissance et d’extension progressive. Ses antecedents etaient marques par l’absence d’epistaxis et la presence de telangiectasies faciales similaires chez son pere, sans atteinte connue de sa mere. L’examen attestait de telangiectasies majoritairement punctiformes et cernees d’un halo anemique, parfois lineaires ou arborescentes distribuees electivement sur le visage, plus particulierement la region medio-faciale, les paupieres superieures et les levres au niveau de leur bordure vermillon, le dos des mains, les faces externes des membres superieurs et le V du decollete. Une macule angiomateuse confluente et telangiectasique de 3 cm, de forme dechiquetee, de couleur inhomogene rouge a brun clair, situee sur un bras, et de multiples taches de Bier des membres inferieurs etaient notees. L’analyse genetique moleculaire mettait en evidence une mutation pathogene a l’etat heterozygote p.Tyr306* du gene EPHB4, permettant de poser le diagnostic de MC-MAV de type 2. Discussion Le tableau clinique de telangiectasies hereditaires photodistribuees, de debut precoce, avec atteinte des bordures vermillon des levres, sans antecedent d’epistaxis est caracteristique des THB de Ryan et Wells. La revue exhaustive de la litterature sur la soixante-dizaine d’observations de THB documentees avant la decouverte des genes RASA1 et EPHB4 permet de distinguer schematiquement deux types de presentations cliniques plus ou moins intriquees suivant le caractere predominant : – de macules telangiectasiques confluentes rondes ou ovalaires sans topographie elective comme au cours des MC-MAV de type 1 (RASA1) ; – ou de telangiectasies punctiformes, lineaires ou arborescentes avec halo anemique photodistribuees avec atteinte telangiectasique du bordure vermillon des levres comme au cours des MC-MAV de type 2 (EPHB4). La presence d’une MAV cerebrale et de MAV cutanees superficielles ou profondes precedemment decrites au cours des THB plaident egalement pour considerer les THB comme des formes phenotypiques de MC-MAV, rendant la terminologie de « benignes » obsolete et trompeuse et justifiant la realisation initiale systematique d’une imagerie cerebrale ou medullaire. Conclusion Nous rapportons une observation de MC-MAV-2 caracteristiques des THB. Cette derniere terminologie apparait desormais obsolete. La presence d’un tableau evocateur de THB justifie une recherche de mutation des genes RASA1 et EPHB4 et la recherche radiologique systematique de MAV cerebro-medullaire associee.

Acid sphingomyelinase deficiency (ASMD) is an autosomal recessive disease with a clinical spectrum ranging from a neurovisceral infantile form (Niemann-Pick disease type A) to a chronic visceral form also encountered in adults (Niemann-Pick disease type B, NP-B).Retrospective multicentric analysis of French adult patients with ASMD over the period 1985-March 2015. Clinical, biological, and imaging data were analyzed.Twenty-eight patients (19 males, 9 females) were analyzed. Diagnosis was made before the age of 10 years in 16 cases. Main symptoms at diagnosis were spleen/liver enlargement and interstitial lung disease. Biological abnormalities included: thrombocytopenia (platelet count150 000/mmASMD in adulthood (NP-B) associates spleen/liver enlargement and interstitial lung disease. Early diagnosis and appropriate management are essential for reducing the risk of complications, improving quality of life, and avoiding inappropriate procedures such as splenectomy. To date, only symptomatic therapy is available. A phase 2/3 therapeutic trial with IV infusion of recombinant enzyme is on-going.

To analyse in the general population the prevalence and predictors of symptomatology consistent with post-traumatic stress disorder (S-PTSD) 18 months after an industrial explosion.Cross-sectional survey.A random sample of 1191 city inhabitants, including an oversample of the immediate area (3 km). S-PTSD was measured by the self-administered Impact of Event Scale-Revised. The relation between S-PTSD and individual vulnerability factors, immediate exposure and post-trauma factors was analysed by gender.S-PTSD was more prevalent in the immediate area than in the peripheral area (women 19% vs 8%; men 8% vs 2%, p0.01). In the immediate area, S-PTSD was independently associated with birth outside France (men: OR(a) = 13.9, 95% CI 3.7 to 52.8; women: OR(a) = 2.1, 95% CI 1.0 to 4.2), age more than 40 years (men: OR(a) = 4.3, 95% CI 1.01 to 18.2; women: OR(a) = 2.3, 95% CI 1.1 to 4.5), previous psychotropic treatment (men: OR(a) = 11.5, 95% CI 2.4 to 53.6), proximity to the explosion (less educated men only) (OR(a) = 9.3, 95% CI 1.9 to 44.7), rescue efforts (men: OR(a) = 5.2, 95% CI 1.5 to 18.2), temporarily uninhabitable home (men: OR(a) = 5.8, 95% CI 1.9 to 18.1), personal injury (women: OR(a) = 3.7, 95% CI 1.7 to 8.4), financial difficulties (men: OR(a) = 17.4, 95% CI 4.2 to 72.1; women: OR(a) = 3.4, 95% CI 1.7 to 7.1) and inconvenience due to closure of public services (women: OR(a) = 4.1, 95% CI 1.6 to 9.9).Individual vulnerability, exposure and post-trauma factors were associated with S-PTSD. Vulnerable subgroups, defined by low socioeconomic characteristics may warrant focused screening after such disasters.

Resume La mesure des resistances peripheriques au niveau des axes arteriels des membres inferieurs n’est jamais abordee en pratique clinique, alors que sa determination par des methodes non invasives apparait simple a mettre en œuvre. L’objectif de notre etude a ete d’evaluer l’apport de ce parametre dans la realisation du « portrait robot » des lesions arterielles. Materiel et methode Le recueil prospectif des donnees hemodynamiques non invasives [Index systolique de pression a la cheville (IPSc), Pic Systolique de Velocite (PSV), Vitesse telediastolique (VTD) et score du lit d’aval jambier] effectue chez l’arteriopathe a ete compare au calcul d’un index de resistance peripherique (IR) mesure au niveau de l’artere femorale commune et etabli d’apres la formule d’Arbeille [IR = VTD/PSV]. Resultats Entre le 1er fevrier 2003 et le 30 avril 2003, 150 mesures de l’IR ont ete realisees chez 99 patients au stade d’ischemie d’effort ; (Hommes 69 %, femmes 31 %, âge moyen 64,8 ± 15,2 ans). Quarante et une fois (27 %) la mesure de l’IR a ete effectuee chez des patients presentant des facteurs de rigidite parietale (mediacalcose du diabetique ou de l’insuffisant renal dialyse). La mesure de l’IR apparait correlee a la vitesse telediastolique [r = - 0,76 ; DDL = 148 ; p Conclusion Ces resultats laissent envisager la possibilite de realiser une evaluation plus precise des repercussions hemodynamiques chez les patients diabetiques ou insuffisants renaux dialyses, chez qui la plupart des parametres hemodynamiques sont difficilement interpretables compte tenu de la rigidite parietale. Des etudes prospectives apparaissent cependant indispensables pour determiner l’apport de l’IR dans le suivi de ces patients et son interet par rapport a la simple mesure de la vitesse telediastolique.

La mere joue encore un role central dans l'alimentation de l'enfant, tout au moins jusqu'a l'adolescence, ou le jeune commence a prendre une certaine autonomie alimentaire. C'est ainsi que l'on peut considerer que la mere conditionne fortement les habitudes alimentaires du futur adulte, habitudes qui joueront un role-cle sur l'etat de sante actuel et futur. Cependant, avec les evolutions recentes du mode de vie, parmi lesquelles l'augmentation de la population active feminine, le marketing directement cible vers les enfants et la place toujours grande de la restauration scolaire, l'alimentation de l'enfant echappe de plus en plus au controle de la mere. Une etude psychosociale menee en parallele sur les meres de famille, qui devrait etre publiee prochainement, avait pour objectif de mettre au jour les attitudes et les representations de celles-ci vis-a-vis de l'alimentation enfantine et de la cantine. Dans ce premier volet de l'etude, nous avons analyse en profondeur l'equilibre nutritionnel d'un echantillon d'enfants âges de 6 a 8 ans, provenant de differents milieux sociaux, en nous interessant a l'influence de la restauration scolaire.

Morbid obesity is an emerging condition in the general population. Bariatric surgery, which has demonstrated its effectiveness for weight loss, mortality and morbidity related to obesity, is required in some patients. However, it may be associated with various adverse effects, including vitamin deficiencies.We report a 33-year old man who presented central and peripheral neurological deficits and cardiac manifestations related to multiple vitamin deficiencies, following "sleeve" gastrectomy. The vitamin deficiencies were related to insufficient ingesta secondary to psychogenic anorexia. The patient improved with vitamins, antidepressant drugs and atypical neuroleptics.Post-operative complications of "sleeve" gastrectomy include vitamin deficiencies that can develop in the context of psychogenic anorexia and ingesta reduction, in the absence of any digestive malabsorption.

Using Brewster angle microscopy we have studied the low-temperature region of the phase diagram of Langmuir monolayers of long-chain fatty acids. We have shown that the transitions between the three tilted phases, ${\mathit{L}}_{2}$, ${\mathit{L}}_{2}^{\ensuremath{'}}$, and ${\mathit{L}}_{2}^{\mathrm{\ensuremath{''}}}$ are first order, and have located the triple point precisely. We have observed a radical change of the tilt-azimuth texture at the ${\mathit{L}}_{2}$-${\mathit{L}}_{2}^{\mathrm{\ensuremath{''}}}$ phase transition, even though the tilt direction with respect to the lattice is the same in the two phases. The transition between the tilted phase ${\mathit{L}}_{2}^{\mathrm{\ensuremath{''}}}$ and the crystalline untilted phase CS is also studied. Its character possibly changes from second order below the ${\mathit{L}}_{2}$-${\mathit{L}}_{2}^{\ensuremath{'}}$-${\mathit{L}}_{2}^{\mathrm{\ensuremath{''}}}$ triple point to first order above. \textcopyright{} 1996 The American Physical Society.

Pulmonary hypertension (PH) is a complex disorder resulting from many etiologies that cause disturbances of normal pulmonary haemodynamics. Recent breakthroughs have led to a better understanding of the pathophysiology of the disease. In PH, haemodynamic disturbances are closely linked to structural changes and excessive remodeling of pulmonary vessels, leading to progressive narrowing of the pulmonary vascular lumen. Imbalances between pulmonary vasoconstrictors and vasodilators on the one hand, and factors favoring cell proliferation and apoptosis on the other hand, probably account for most cases of PH. This review aims to update readers with the current knowledge on the molecular physiopathology of PH and how this can progress the therapeutic of this disorder.

We report the cases of two patients treated with anti-TNF-alpha for uveitis. The first patient developed visceral leishmaniasis and the second cutaneous leishmaniasis.an 8-year-old girl was treated with corticosteroids and intravenous infliximab for juvenile idiopathic arthritis with bilateral anterior uveitis. After 12 months of treatment, she presented with fever, hepatosplenomegaly and thrombocytopenia. Visceral leishmaniasis was diagnosed, and she was treated successfully with parenteral liposomal Amphotericin-B (Ambisome(®)). Upon resolution, we re-instituted her treatment with infliximab. Second case: a 48-year-old man consulted us for severe panuveitis of the left eye with a serous retinal detachment. He was diagnosed with seronegative ankylosing spondylitis. His uveitis and arthritis were treated successfully with infliximab for 20 months, after which two cutaneous lesions appeared. The diagnosis of cutaneous leishmaniasis without visceral involvement was based on the presence of Leishmania in the skin scraping of a lesion. Intravenous infusions of infliximab were discontinued, and local treatment consisting of intralesional injections of meglumine antimonate salts (Glucantime(®)) was initiated, leading to rapid improvement. Anti-TNFα drugs are used frequently now. They appear promising in terms of efficacy, but one must carefully monitor patients for possible side effects, including infection.

Although giant cell arteritis (GCA) is a rare cause of ophthalmoplegia, swift diagnosis and treatment are necessary to avoid other complications. We report here a case of GCA in a 59-year-old woman with a history of hypertension and thyroid lobectomy. Diagnosis resulted from binocular diplopia, although classical GCA symptoms had been present a few days before. Oral corticotherapy led to a rapid disappearance of headaches and normal ocular motility in 1 month. We discuss the ophthalmological signs of the disease and the place of temporal artery biopsy and treatment.

Posterior reversible encephalopathy (PRES) represents an uncommon entity related to multiple pathologies, the most common of which is hypertensive crisis. PRES is classically characterized as symmetrical parieto-occipital edema, but may affect other areas of the brain. Diffusion-weighted magnetic resonance imaging (DWI) is important for differentiating between vasogenic and cytotoxic edema. We present here the case of a 43-year-old woman, known to suffer from arterial hypertension and severe renal failure, who developed PRES with restricted apparent diffusion coefficients (ADC) in various cerebral areas, suggesting irreversible tissue damage. Nevertheless, follow-up cranial MRI revealed complete remission, indicating that restricted diffusion does not always lead to cell death in this pathology. The underlying pathophysiological mechanism is not well understood. Such reversibility of diffusion anomalies has already been reported with transient ischemia, vasospasm after subarachnoid hemorrhage and epilepsy but, to our knowledge, never before in PRES.

We report the first case of cutaneous leishmaniasis in a patient treated with infliximab. The species was Leishmania infantum, agent of both cutaneous leishmaniasis and visceral leishmaniasis. Cutaneous leishmaniasis occurred after the 9th infusion of infliximab in a patient who was suffering from ankylosing spondylitis.

Introduction De nombreuses interactions existent entre l'etat nutritionnel et les capacites olfactives, sous le controle des hormones impliquees dans la regulation de l'homeostasie energetique. A l'heure actuelle, les consequences sur l'olfaction de perturbations metaboliques induites par l'alimentation ne sont pas connues. Alors que certains patients diabetiques font preuve d'aptitudes olfactives anormales, les consequences du diabete sur le systeme olfactif sont peu connues. Nous avons etudie les effets precoces d'un regime enrichi en fructose (connu pour induire rapidement un diabete de type 2 chez le rongeur) sur le systeme olfactif murin. Materiels et methodes Des souris mâles ont ete alimentees pendant 8 semaines avec un regime enrichi en fructose (HFruD pour High Fructose Diet ). Nous avons mesure l'etat metabolique des animaux (glycemie, insulinemie, poids, prise alimentaire et ipGTT) et teste leur comportement olfactif par deux mesures comportementales: test d'habituation/deshabituation et test de la nourriture enfouie (pour evaluer respectivement les capacites olfactives pour les odeurs neutres et les odeurs de nourriture). Enfin, nous avons quantifie l'effet du regime sur la muqueuse olfactive par des mesures de la reponse globale en potentiel de champ local (EOG pour electro-olfactogrammes). Resultats Les animaux HFruD font preuve d'une hyperglycemie, d'une hyperinsulinemie et d'une intolerance au glucose des 4 semaines de HFruD. En termes de reponse comportementale, les animaux sous HFruD ne peuvent plus discriminer les deux odorants testes et mettent plus de temps a retrouver la nourriture enfouie que les animaux temoins. Ces effets persistent apres 8 semaines de HFruD. Enfin, les amplitudes des reponses EOG apres stimulations odorantes ont ete partiellement reduites et leurs cinetiques modifiees chez les animaux HFruD par rapport aux animaux controles. Conclusion La consommation d'un regime diabetogene enrichi en fructose entraine rapidement une diminution des capacites olfactives, tant au niveau comportemental que fonctionnel. Declaration d’interet Les auteurs declarent ne pas avoir d'interet direct ou indirect (financier ou en nature) avec un organisme prive, industriel ou commercial en relation avec le sujet presente.

Adult-Onset Still's disease (AOSD) is a rare condition of unknown origin with various presentations and unpredictable outcome. The aim of this study was to analyse clinical and biological presentation, and outcome of patients admitted to an internal medicine service.A retrospective cohort design with prospective follow-up was used. All the patients admitted to our internal medicine service for AOSD between January 1998 and March 2004 were included.According to Yamaguchi's classification criteria, 17 patients were analysed with a mean age at onset of 37.3 years and a 2.4 sex-ratio (female/male). Mean follow-up length was 52.1 months. Eight patients developed a monocyclic systemic form, 8 a polycyclic systemic form and 1 a chronic articular form. Arthralgia (87%) and arthritis (53%) were less frequent than in other series. Sixteen patients were treated: 14 by corticosteroids, 6 by non-steroid anti-inflammatory drugs, 5 by methotrexate, 2 intravenous polyglobulin and one by anti-TNF drug. Patients with a corticodependant or corticoresistant form had more polyarthritis at the onset of the disease (3/6 vs 0/11, P=0.029).In internal medicine activity, AOSD without oligo- or polyarthritis may be more frequent than expected according to the literature. Corticotherapy alone is often efficient in these AOSD form without synovitis, and methotrexate use is uncommon.

Peripheral resistance of lower limb arteries is not a common clinical measurement despite easy-to-apply non-invasive techniques. The aim of our trial has been to test this new parameter as a marker of arterial lesions.In this prospective study, hemodynamic data acquired non-invasively [Ankle brachial index (ABI), peak systolic velocity (PSV), end-diastole velocity (VTD) and peripheral artery quality] in patients with lower limb arterial disease were compared with the resistance index measured in the common femoral artery (Arbeille index: IR=VTD/PSV).Between February 1, 2003 and April 30, 2003, 150 measurements of resistance index were made in 99 individuals with ischemia following a strain (69% men, 31% women, average age 64.8+/-15.2 years). Forty-one of the resistance measurements (27%) were also made in patients with arterial disease factors (diabetics, renal replacement therapy). The resistance index was closely associated with end-diastole velocity. (r=-0.76; DDL=148; p0.01) as well as peripheral artery quality (r=0.81; DDL=148; p0.01); on the contrary the resistance index was not affected by the arterial disease factors (0.3+/-0.1 vs 0.33+/-0.12; p=NS).These findings suggest that the hemodynamic impact might be evaluated more precisely diabetics and renal replacement therapy patients whose hemodynamic parameters are difficult to assess due to their arterial disease factors. Prospective studies are needed to determine the role of the resistance index in the follow up of these patients, and its contribution in comparison with the measurement of end-diastole velocity.

Central nervous system manifestations are rare clinical features of Wegener's granulomatosis, and occur in 4-8% of the patients, but few studies were dedicated to them.This retrospective study (1988-2001) include 14 consecutive patients suffering from Wegener's granulomatosis. Involvement of central nervous system was defined as follows: suggestive neurological signs, compatible cerebral imaging, efficacy of the specific treatment of the granulomatosis.Four patients had a central nervous system manifestation (29%), including three women (average age 51 years). The signs were inaugural in a case. The manifestations were the following: sensibility disturbance (three cases), motor weakness (two cases), aphasia (one case), and mood disorders (two cases). Cranial nerves were constantly involved. Cerebral magnetic resonance imaging findings were: pachymeningitis and venous thrombosis (one case), vasculitis (two cases). Under steroid therapy associated with cyclophosphamide, in spite of a recurrence at 27 months in one patient, all patients had a complete remission. There was no death, with a median follow-up of 66 months. Except the ocular signs, that were more common (three cases), these patients had the usual characteristics of the Wegener's granulomatosis: rhinosinusitis (four cases), pulmonary (three cases), renal (three cases), and peripheral nervous system involvement (three cases).Our study, based on precise criteria, indicates that the frequency of the central neurologic manifestations of Wegener's granulomatosis is probably under estimated. Cranial nerves involvement is highly evocative. The long-term prognosis seems good, in spite of the associated multivisceral disorder.

Spinal cord lesions are an uncommon mode of discovering acquired immunodeficiency syndrome because they usually appear at a later stage.We report a 58-year-old patient who had a spastic paraparesia and sphincter dysfunction. The spinal cord magnetic resonance imaging showed spontaneous hypersignals on T2-weighted images at the cervical and thoracic levels, enhanced with gadolinium, and without swelling. No cause was found. The HIV serology was positive and allowed us to consider an HIV-associated myelopathy. The antiretroviral therapy led to functional recovery.An HIV serology is suggested whenever an unexplained intramedullary lesion is discovered. Indeed, the diagnosis of HIV-associated myelopathy implies a specific therapeutic approach.

International audience; We present a Brewster angle microscopy study of the domains of liquid condensed phase (L2) in the liquid expanded phase (L1) in a Langmuir monolayer of a long-chain fatty acid. A strong deformation of the domains is observed when they are close to each other, indicating the presence of long-range repulsive dipolar interactions between them. The line tension of the L1/L2 interface is deduced from the balance between the line tension and the electrostatic forces. The latter were deduced from surface potential measurements.

Using Brewster angle microscopy to study Langmuir monolayers of fatty acids at the air-water interface, we have observed a boojum pattern in two-dimensional drops of a tilted liquid condensed phase. In a boojum, the in-plane molecular orientation turns continuously and points with the same molecular orientation are located on straight lines, crossing at a defect point expelled from the drop. We have observed a distortion of the drops in the neighborhood of these points. We have studied the distortion of the drops and the distance of the defect point to the drop boundary, and deduced several ratios between elastic constants, anisotropic line tension, and elastic constants of the medium.

International audience; Brewster angle microscopy (BAM) and polarized fluorescence microscopy (PFM) are used to observe the distinctive textures of and the transitions between condensed phases in Langmuir monolayers of n‐alkanoic acids. BAM is sensitive to film anisotropy even when the molecules are not tilted as long as the unit cell is anisotropic. Every transition is visible with one or both of the techniques, either as a dramatic change in the degree of contrast or as a sudden alteration of the mosaic domain texture. The two techniques are generally consistent, although the presence of the fluorescent probe impurity (for PFM) causes a subtle difference in the appearance of one transition and small shifts in transition surface pressures.