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Sansilvestri-Morel P, Bertin F, Lapret I, Neau B, Blanc-Guillemaud V, Petit-Dop F, Tupinon-Mathieu I, Delerive P. S62798, a TAFIa inhibitor, accelerates endogenous thrombolysis in a murine model of pulmonary thromboembolism. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Pulmonary embolism (PE) is the third leading cause of cardiovascular death in western countries. The enhancement of fibrinolysis constitutes a promising approach to treat thrombotic diseases. In patients, venous thrombosis and thromboembolism risks are associated with increased plasma levels of TAFI (Thrombin Activatable Fibrinolysis Inhibitor) antigen as well as the active form TAFIa. S62798 is a competitive, selective and potent human TAFIa inhibitor (IC50±SD=11.2±0.4nM). It is however less potent on mouse TAFIa (IC50±SD=270±39nM). Here, we tested the ability of S62798 to enhance endogenous fibrinolysis in a mouse model of pulmonary thromboembolism.
Human Tissue Factor (TF) was injected in C57Bl6 male mice. Ten minutes later, mice (n=4 to 14 per group) were treated (IV) with S62798 (from 0.01 to 100mg/kg) or vehicle (0.9% NaCl). Ten or twenty minutes (min) later, mice were anesthetized and lungs were collected, homogenized and pulmonary fibrin was quantified by ELISA. Results are expressed as ratio of geometric mean of pulmonary fibrin (μg/mL): tested treatment/ vehicle [95% confidence interval (CI)].
Ten minutes after S62798 treatment, pulmonary fibrin deposition was dose-dependently decreased with a Minimal Effective Dose of 0.04mg/kg [90% prediction interval 0.037 - 0.051] and an ED50 of 0.03mg/kg [95% CI: 0.01; 0.06]. Mice were then treated with 0.1mg/kg S62798 or vehicle (10 min after TF induction) and fibrin deposition in lungs was quantified 10 and 20 minutes post S62798 treatment. The level of pulmonary fibrin deposition was significantly decreased (p<0.0001) compared to vehicle group (ratio 0.31 [0.21; 0.45] at 10 min; 0.35 [0.24; 0.51] at 20 min). Finally, the effect of S62798 (1mg/kg) in combination with heparin was evaluated (n=10/group). When administered 10 min before TF injection, heparin (2000IU/kg) significantly (p<0.0001) decreased pulmonary fibrin level (20 min post TF: ratio 0.03 [0.01; 0.05]). When treatment was done in a curative setting (10 min post TF), heparin alone had no effect (p=0.85) on fibrin deposition (ratio 0.96 [0.65; 1.43]) whereas a similar significant (p<0.0001) decreased pulmonary fibrin deposition was observed in response to S62798 alone or associated with heparin (ratio 0.27 [0.18; 0.40] (S62798 alone) and 0.29 [0.20; 0.43] (S62798+heparin)).
In this model, curative S62798 treatment, alone or associated to heparin, accelerated clot degradation by potentiating endogenous fibrinolysis and thus decreased pulmonary fibrin deposition. Due to its capacity to enhance endogenous fibrinolysis, S62798, which has completed phase I studies, is expected to be a therapeutic option for intermediate high risk PE patients on top of anticoagulants. With early recanalization, S62798 should rapidly reduce pulmonary artery pressure and resistance, with concomitant improvement in right ventricular function, preserving cardiac function, and reducing acute PE-related morbidity and mortality in these patients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - F Bertin
- Servier Research Institute, Suresnes, France
| | - I Lapret
- Servier Research Institute, Suresnes, France
| | - B Neau
- Servier Research Institute, Suresnes, France
| | - V Blanc-Guillemaud
- Servier International Research Institute, Cardiovascular and Metabolic Diseases, Suresnes, France
| | - F Petit-Dop
- Servier International Research Institute, Cardiovascular and Metabolic Diseases, Suresnes, France
| | - I Tupinon-Mathieu
- Servier International Research Institute, Cardiovascular and Metabolic Diseases, Suresnes, France
| | - P Delerive
- Servier Research Institute, Suresnes, France
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Denes E, Tricard J, Chermat A, El Balkhi S, Bertin F. Utilisation d’une céramique chargée en antibiotique pour le traitement des destructions sternales post-médiastinites et outrepasser les résistances bactériennes. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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3
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Tricard J, Chermat A, Denes E, Bertin F. Antibiotic-loaded ceramic sternum for sternal replacement in a patient with deep sternal wound infection. Interact Cardiovasc Thorac Surg 2020; 29:973-975. [PMID: 31365090 DOI: 10.1093/icvts/ivz182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/27/2019] [Accepted: 06/30/2019] [Indexed: 11/12/2022] Open
Abstract
A 68-year-old man presented with destruction of his sternum after cardiac surgery. Classical management with multiple debridements, vacuum dressings and antibiotics failed. A replacement of his sternum was performed using an antibiotic-loaded porous alumina ceramic sternum. Despite the infected wound, the ceramic sternum did not get infected due to the high antibiotic concentration obtained locally. Two years after the surgery, no relapse occurred and the pulmonary function tests improved.
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Affiliation(s)
- Jeremy Tricard
- Thoracic and Cardiovascular Surgery Department, Limoges teaching Hospital, Limoges, France
| | - Anaëlle Chermat
- Thoracic and Cardiovascular Surgery Department, Limoges teaching Hospital, Limoges, France
| | - Eric Denes
- R&D Department, I.Ceram, Limoges, France.,Infectious Diseases Department, Clinic Chénieux, Limoges, France
| | - François Bertin
- Thoracic and Cardiovascular Surgery Department, Limoges teaching Hospital, Limoges, France
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4
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Denes E, Bertin F, Barraud O, El Balkhi S. Mediastinitis due to highly resistant bacteria treated with the help of locally delivered antibiotics to optimize local antibiotic concentrations. Clin Microbiol Infect 2020; 26:1099-1100. [PMID: 32120040 DOI: 10.1016/j.cmi.2020.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 10/24/2022]
Affiliation(s)
- E Denes
- R&D Department, I.Ceram, Limoges, France; Infectious Diseases Department, Limoges Polyclinique, France.
| | - F Bertin
- Thoracic Surgery Department, CHU Limoges, Limoges, France
| | - O Barraud
- Bacteriology-Virology-Hygiene Department, CHU Limoges, Limoges, France
| | - S El Balkhi
- Pharmacology-Toxicology and Pharmacovigilance Department, CHU Limoges, Limoges, France
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5
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Abstract
Background After its destruction during refractory deep sternal wound infection (DSWI), current sternum reconstructions mainly rely on muscle flaps technique, but such technique have pitfalls and limits. To tackle the limited possibilities to use device implantation because of the risk of infection, we developed a self-protected device allowing its implantation in an infected area. Methods We used gentamicin alone or in combination with vancomycin loaded in a porous ceramic sternum to replace sternums destroyed during DSWI. The aim was to mechanically replace the sternum and to secure the implantation by killing the remaining bacteria in the wound thanks to the loaded antibiotic. Results This device was implanted in four infected patients during DWSI with sternal dehiscence. No complication occurred during surgeries, and wound healing was obtained quickly. Local antibiotic concentrations largely exceeded the ones needed for their efficacy while no antibiotic was found in the blood. All patients are well-being. However previously unknown gentamicin resistant bacteria, present in the surgical wound at the time of positioning, required sternal implant removal for one patient after 19 months. For all patients, pulmonary function tests (PFT) improved after implantation. Conclusions The ceramic sternum played its role consolidating the thoracic cage without stiffening. The antibiotic loaded in the sternum allowed a secure implantation, killing bacteria before the colonization of the implant even in this infected area. These four implantations are promising for patients with sternal destruction after DSWI.
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Affiliation(s)
- Jeremy Tricard
- Thoracic and Cardiovascular Surgery Department, Limoges Teaching Hospital, Limoges, France
| | - Anaëlle Chermat
- Thoracic and Cardiovascular Surgery Department, Limoges Teaching Hospital, Limoges, France
| | | | - Eric Denes
- R&D Department, I.Ceram, Limoges, France.,Infectious Diseases Department, Polyclinique de Limoges, Limoges, France
| | - François Bertin
- Thoracic and Cardiovascular Surgery Department, Limoges Teaching Hospital, Limoges, France
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Fouilloux V, Bertin F, Peltier E, Jouve JL. First Sternal Cleft Repair Using a Porous Alumina Ceramic Prosthesis in a 9-Year-Old Child. European J Pediatr Surg Rep 2019; 7:e20-e23. [PMID: 31463174 PMCID: PMC6710092 DOI: 10.1055/s-0039-1688775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/31/2019] [Indexed: 11/21/2022] Open
Abstract
Sternal cleft is a rare congenital abnormality, often associated with other congenital defects. We present the case of a 9-year-old child with complete sternal cleft, treated with an innovative sternal prosthesis. Surgery was performed to protect the heart and also, as pulsations was visible, leading to serious esthetical concerns, to enhance school integration, which was difficult. The porous alumina device used was initially designed for sternal reconstruction after refractory deep sternal wound infection or carcinoma. Surgery and early follow-up were simple. There was no complication and the follow-up of more than 1 year reveals a good healing without breath discomfort and a correct development of the chest wall. In this rare indication, the alumina ceramic sternal prosthesis offers a reliable alternative to classical methods, such as muscle flap, autogenous tissue transfer, costal homograft, and other prosthetic materials like mesh or synthetic patch.
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Affiliation(s)
- Virginie Fouilloux
- Department of Cardiac Surgery, Timone Children's Hospital, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - François Bertin
- Department of Thoracic and Vascular Surgery, Dupuytren University Hospital, Limoges, France
| | - Emilie Peltier
- Faculty of Medicine, Aix-Marseille University, Marseille, France.,Department of Orthopaedics, Timone Children's Hospital, Marseille, France
| | - Jean-Luc Jouve
- Faculty of Medicine, Aix-Marseille University, Marseille, France.,Department of Orthopaedics, Timone Children's Hospital, Marseille, France
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Isabelle M, Harouki N, Bertin F, Lecomte M, Ragonnet C, Butin S, Gransagne D, Laurent I, Villeneuve N. Relevant preclinical model of heart failure in rat: Impact of myocardial infarction and hypertension. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.02.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Bertin F, Deluche E, Tricard J, Piccardo A, Denes E. First case of sternum replacement with a bioceramic prosthesis after radio-induced sarcoma. ACTA ACUST UNITED AC 2018; 25:e351-e353. [PMID: 30111981 DOI: 10.3747/co.25.4020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives To date, no "gold standard" technique has been developed for sternum replacement in cases of radioinduced sarcoma, which is a rare and aggressive disease. Current techniques rely on metallic prostheses, meshes, or bone grafts-procedures that that are associated with several complications. We therefore tried a new solution that might simplify and optimize this surgery. Methods We used a porous alumina ceramic prosthesis (Ceramil: i.ceram, Limoges, France) that has several interesting characteristics, such as osseointegration, biocompatibility, radiolucency, and high mechanical strength. Results We report the first case of sternal replacement surgery involving the implantation of a ceramic prosthesis after radio-induced sternal sarcoma. In 2005, a 54-year-old woman was diagnosed with local breast cancer for which she underwent all appropriate treatment. Ten years later, she developed radio-induced sarcoma of the sternum. A complete sternal replacement was performed on 24 April 2015, with no postoperative complications. Imaging by 18F-flurodeoxyglucose positron-emission tomography-computed tomography performed 26 months after the surgery showed no local recurrence. The patient seems to have fully recovered and has resumed normal activity. Conclusions This new technique is promising. For the first time, we highlight the feasibility, safety, and efficacy of sternal replacement using a porous alumina ceramic prosthesis.
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Affiliation(s)
- F Bertin
- Department of Cardiothoracic Surgery, University Hospital
| | - E Deluche
- Department of Medical Oncology, University Hospital, and
| | - J Tricard
- Department of Cardiothoracic Surgery, University Hospital
| | - A Piccardo
- Department of Cardiothoracic Surgery, University Hospital
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Denes E, Fiorenza F, Bertin F, El Balkhi S. Administration locale osseuse d’antibiotique via une céramique d’alumine poreuse. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Abstract
CONTEXT: To date, there is no gold standard technique for sternum replacement. Current techniques rely on metallic prosthesis, meshes and bars, or bone grafts. However, they have several pitfalls. AIMS: The aim of this article is to report the results of sternal replacement with a porous alumina ceramic sternum. SETTINGS AND DESIGN: Surgeries were performed in two teaching hospitals in France. METHODS: We designed a porous alumina ceramic prosthesis which possesses interesting characteristics for this surgery such as great biocompatibility, a certain level of bacterial resistance, radiolucency, and compatibility with radiotherapy. The implant is stitched to the ribs with suture thread and does not require osteosynthesis material. RESULTS: Six patients with a mean age of 60.6 years received this prosthesis. Indication was tumor in five cases and mediastinitis in one case. The mean follow-up is 20 months (3–37 months). No major complication occurred and healing was fine for all patients. Patients did not complain of breathing discomfort or pain related to the prosthesis. CONCLUSIONS: This new technique is promising even if there are only six patients in this study.
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Affiliation(s)
- François Bertin
- Department of Cardiothoracic Surgery, Limoges Teaching Hospital, Limoges, France
| | - Alessandro Piccardo
- Department of Cardiothoracic Surgery, Limoges Teaching Hospital, Limoges, France
| | - Eric Denes
- Department of R and D, I.Ceram, Limoges, France
| | - Gonzagues Delepine
- Department of Cardiothoracic Surgery, Reims Teaching Hospital, Reims, France
| | - Jeremy Tricard
- Department of Cardiothoracic Surgery, Limoges Teaching Hospital, Limoges, France
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Al-Akhrass H, Naves T, Vincent F, Magnaudeix A, Durand K, Bertin F, Melloni B, Jauberteau MO, Lalloué F. Sortilin limits EGFR signaling by promoting its internalization in lung cancer. Nat Commun 2017; 8:1182. [PMID: 29084952 PMCID: PMC5662760 DOI: 10.1038/s41467-017-01172-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 08/24/2017] [Indexed: 01/27/2023] Open
Abstract
Tyrosine kinase receptors such as the epidermal growth factor receptor (EGFR) transduce information from the microenvironment into the cell and activate homeostatic signaling pathways. Internalization and degradation of EGFR after ligand binding limits the intensity of proliferative signaling, thereby helping to maintain cell integrity. In cancer cells, deregulation of EGFR trafficking has a variety of effects on tumor progression. Here we report that sortilin is a key regulator of EGFR internalization. Loss of sortilin in tumor cells promoted cell proliferation by sustaining EGFR signaling at the cell surface, ultimately accelerating tumor growth. In lung cancer patients, sortilin expression decreased with increased pathologic grade, and expression of sortilin was strongly correlated with survival, especially in patients with high EGFR expression. Sortilin is therefore a regulator of EGFR intracellular trafficking that promotes receptor internalization and limits signaling, which in turn impacts tumor growth.
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Affiliation(s)
- Hussein Al-Akhrass
- EA3842 Homéostasie Cellulaire et Pathologies and Chaire de Pneumologie Expérimentale, Université de Limoges, Faculté de Médecine, 2 Rue du Dr. Raymond Marcland, 87025, Limoges CEDEX, France
| | - Thomas Naves
- EA3842 Homéostasie Cellulaire et Pathologies and Chaire de Pneumologie Expérimentale, Université de Limoges, Faculté de Médecine, 2 Rue du Dr. Raymond Marcland, 87025, Limoges CEDEX, France.
| | - François Vincent
- EA3842 Homéostasie Cellulaire et Pathologies and Chaire de Pneumologie Expérimentale, Université de Limoges, Faculté de Médecine, 2 Rue du Dr. Raymond Marcland, 87025, Limoges CEDEX, France.,Service de Pathologie Respiratoire, Centre Hospitalier et Universitaire de Limoges, 87042, Limoges CEDEX, France
| | - Amandine Magnaudeix
- EA3842 Homéostasie Cellulaire et Pathologies and Chaire de Pneumologie Expérimentale, Université de Limoges, Faculté de Médecine, 2 Rue du Dr. Raymond Marcland, 87025, Limoges CEDEX, France
| | - Karine Durand
- EA3842 Homéostasie Cellulaire et Pathologies and Chaire de Pneumologie Expérimentale, Université de Limoges, Faculté de Médecine, 2 Rue du Dr. Raymond Marcland, 87025, Limoges CEDEX, France.,Service d'Anatomie Pathologique, Centre Hospitalier et Universitaire de Limoges, 87042, Limoges CEDEX, France
| | - François Bertin
- Service de Chirurgie Thoracique et Cardio-vasculaire, Centre Hospitalier et Universitaire de Limoges, 87042, Limoges CEDEX, France
| | - Boris Melloni
- Service de Pathologie Respiratoire, Centre Hospitalier et Universitaire de Limoges, 87042, Limoges CEDEX, France
| | - Marie-Odile Jauberteau
- EA3842 Homéostasie Cellulaire et Pathologies and Chaire de Pneumologie Expérimentale, Université de Limoges, Faculté de Médecine, 2 Rue du Dr. Raymond Marcland, 87025, Limoges CEDEX, France.,Service d'Immunologie, Centre Hospitalier et Universitaire de Limoges, 87042, Limoges CEDEX, France
| | - Fabrice Lalloué
- EA3842 Homéostasie Cellulaire et Pathologies and Chaire de Pneumologie Expérimentale, Université de Limoges, Faculté de Médecine, 2 Rue du Dr. Raymond Marcland, 87025, Limoges CEDEX, France
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Verusio C, Ratti M, Bertin F, Portaluppi A, Rossi A, Sarno L, Marconi M. Patient relationship training in an integrated perspective: guidelines for psychological intervention. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx434.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Ratti M, Bertin F, Rossi A, Portaluppi A, Marconi M, Sarno L, Verusio C. Evaluation OF psychological aspects of taking care cancer patients: a multicentre study on a sample of caregivers. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx434.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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14
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Bertin F, Tricard J, Eveno C, Denes E, Piccardo A. P-159POROUS ALUMINA CERAMIC STERNUM AS AN OPTION FOR STERNAL REPLACEMENT: A REPORT OF 7 CASES. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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15
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Piccardo A, Regesta T, Le Guyader A, Di Lorenzo N, Bertin F, Pesteil F, Cornu E. Outcomes after surgery for acute type A aortic dissection in “non-Marfan syndrome” patients with long life expectancy: A 24-year follow-up. Arch Cardiovasc Dis 2017; 110:14-25. [DOI: 10.1016/j.acvd.2016.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 02/27/2016] [Accepted: 05/12/2016] [Indexed: 10/20/2022]
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Lacroix P, Aboyans V, Criqui MH, Bertin F, Bouhamed T, Archambeaud F, Laskar M. Type-2 diabetes and carotid stenosis: a proposal for a screening strategy in asymptomatic patients. Vasc Med 2016; 11:93-9. [PMID: 16886839 DOI: 10.1191/1358863x06vm677oa] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of this prospective observational study was to establish the prevalence of carotid atherosclerosis in an asymptomatic diabetic population and to determine predictive factors for a screening optimization. A total of 300 consecutive type-2 diabetic subjects (166 males, 134 females) underwent a physical examination and duplex carotid scanning. Patients with a recent cerebrovascular event (±6 weeks) or previous carotid surgery were excluded. The prevalence of carotid stenosis ≥60% or occlusion was 4.7%; the prevalence of carotid atherosclerosis was 68.3%. Risk factors for stenosis ≤60% or occlusion were the presence of diabetic retinopathy (OR: 3.62; 95% CI: 1.12-11.73), ankle-brachial index (ABI) <0.85 (OR: 3.94; 95% CI: 1.21-12.84) and a personal history of neurological disorders (OR: 4.54; 95% CI: 1.16-17.81). Being female was a protective factor (OR: 0.09; 95% CI: 0.01-0.78). The two factors in the analysis limited to the male population were an ABI < 0.85 (OR: 3.66; 95% CI: 1.04-12.84) and a personal history of coronary heart disease (OR: 3.34; 95% CI: 1.01-11.01). If male diabetics without either of these two factors are excluded, the negative predictive value for carotid stenosis is 96.6%. In conclusion, the prevalence of atherosclerotic carotid disease in diabetic patients is high. In these patients, the probability of finding >60% stenosis is highest among men with a history of coronary heart disease or an ABI <0.85.
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Affiliation(s)
- P Lacroix
- Department of Cardiovascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges, France.
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Le Coustumier EM, Vandeix E, Delage-Corre M, Bertin F, Melloni B. [Hypoglycaemic coma revealing a malignant recurrence during Doege-Potter syndrome]. Rev Mal Respir 2015; 32:530-4. [PMID: 26072009 DOI: 10.1016/j.rmr.2014.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/07/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The Doege-Potter syndrome is a rare paraneoplastic syndrome, first described by Doege and Potter in 1930, that usually involves solid fibrous pleural tumours. Hypoglycaemia is a rare complication of these tumours, due to secretion of insulin-like growth factors, and it can be the presenting symptom. The incidence of malignancy is low, about 12-15 %. CASE REPORT An 81-year-old Caucasian man, operated on 20 years previously for a benign pleural fibroma, presented with several episodes of loss of consciousness due to profound hypoglycaemia and a history of increasing dyspnea. The chest X-ray revealed an intrathoracic mass. Following excision histological examination confirmed recurrence with malignant transformation to a high-grade sarcoma. CONCLUSION The Doege-Potter syndrome is a rare condition but it should be suspected in episodes of hypoglycaemia associated with a history of dyspnea. These patients should be followed up postoperatively because of the risk of tumour recurrence.
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Affiliation(s)
- E-M Le Coustumier
- Service de pathologie respiratoire et d'allergologie, hôpital du Cluzeau, CHU de Limoges, 23, avenue Dominique-Larrey, 87042 Limoges cedex, France.
| | - E Vandeix
- Service d'oncologie médicale, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - M Delage-Corre
- Service d'anatomopathologie et de cytologie, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - F Bertin
- Service de chirurgie thoracique et cardiovasculaire, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - B Melloni
- Service de pathologie respiratoire et d'allergologie, hôpital du Cluzeau, CHU de Limoges, 23, avenue Dominique-Larrey, 87042 Limoges cedex, France
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Dubos M, Da Silva C, Bézanahary H, Bertin F, Darodes N, Liozon E, Fauchais A, Ly K. Péricardite chronique constrictive : un diagnostic et une prise en charge difficile : à propos de trois cas. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grenier A, Duguay S, Barnes J, Serra R, Haberfehlner G, Cooper D, Bertin F, Barraud S, Audoit G, Arnoldi L, Cadel E, Chabli A, Vurpillot F. 3D analysis of advanced nano-devices using electron and atom probe tomography. Ultramicroscopy 2014; 136:185-92. [DOI: 10.1016/j.ultramic.2013.10.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 09/17/2013] [Accepted: 10/08/2013] [Indexed: 10/26/2022]
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Grenier A, Duguay S, Barnes JP, Serra R, Haberfehlner G, Cooper D, Bertin F, Barraud S, Audoit G, Arnoldi L, Cadel E, Chabli A, Vurpillot F. 3D analysis of advanced nano-devices using electron and atom probe tomography. Ultramicroscopy 2014. [PMID: 24189616 DOI: 10.1016/i.ultramic.2013.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The structural and chemical properties of advanced nano-devices with a three-dimensional (3D) architecture have been studied at the nanometre scale. An original method has been used to characterize gate-all-around and tri-gate silicon nanowire transistor by combining electron tomography and atom probe tomography (APT). Results show that electron tomography is a well suited method to determine the morphological structure and the dimension variations of devices provided that the atomic number contrast is sufficient but without an absolute chemical identification. APT can map the 3D chemical distribution of the atoms in devices but suffers from strong distortions in the dimensions of the reconstructed volume. These may be corrected using a simple method based on atomic density correction and electron tomography data. Moreover, this combination is particularly useful in helping to understand the evaporation mechanisms and improve APT reconstructions. This paper demonstrated that a full 3D characterization of nano-devices requires the combination of both tomography techniques.
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Affiliation(s)
- A Grenier
- CEA, LETI, MINATEC Campus, 17 rue des Martyrs, 38054 Grenoble Cedex 9, France.
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Pham Dang A, Fourcade L, Bertin F, Mameli A, Arhip S, Gardet E. [MacLeod syndrome and pneumothorax: don't be fooled]. Rev Mal Respir 2012. [PMID: 23200584 DOI: 10.1016/j.rmr.2012.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION MacLeod syndrome, also known as Swyer-James syndrome, is a rare syndrome characterized by unilateral lung hyperlucency. It is a form of constrictive bronchiolitis which is caused by repeated acute bronchiolitis and/or pulmonary infections during infancy. CASE REPORT The patient was a 26-year-old man who had had a first left pneumothorax at the age of 21. He smokes tobacco. When he was 1-year-old he had experienced repeated episodes of acute bronchiolitis. At age 26, he suffered from a second left pneumothorax which was wrongly diagnosed as a recurrent drain-resistant pneumothorax. Misdiagnosed, he underwent a chemical pleurodesis during thoracoscopy. As a hyperlucency remained in the left upper part of the lung on chest X-ray, further investigations were undertaken and a diagnosis of MacLeod syndrome was made. CONCLUSIONS MacLeod syndrome is rare. It can be associated with pneumothorax which can be a source of misdiagnosis and error in the management of these patients. Therefore, the diagnostic criteria and therapeutic indications are reiterated. The probable mechanism of association between pneumothorax and Macleod syndrome is also discussed.
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Affiliation(s)
- A Pham Dang
- Service de chirurgie infantile, hôpital Mère-Enfant, 8 avenue Dominique-Larrey, Limoges cedex, France.
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Gauthier T, Bertin F, Fourcade L, Maubon A, Saint Marcoux F, Piver P, Marquet P, Pommepuy I, Plainard X, Couquet C, Cornuejols MJ, Essig M, Aubard Y. Uterine allotransplantation in ewes using an aortocava patch. Hum Reprod 2011; 26:3028-36. [DOI: 10.1093/humrep/der288] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- François Bertin
- Service de Chirurgie Thoracique et Cardiovasculaire, CHU Dupuytren, Limoges, France
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Gardet E, Fouilloux V, Guerlin A, Bertin F. [Subcutaneous fistula from a pneumatocele: surgical treatment]. Rev Mal Respir 2010; 27:1105-8. [PMID: 21111286 DOI: 10.1016/j.rmr.2010.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Accepted: 03/01/2010] [Indexed: 11/15/2022]
Abstract
INTRODUCTION A pneumatocele is an air containing cavity, without a wall. It is a rare complication of thoracic trauma. CASE REPORT The patient was a 46-year-old drug addict, positive for the human immunodeficiency virus. Following a fall in which he fractured the posterior parts of the right 7th and 8th ribs, he developed a subcutaneous fistula and a pneumatocele of the right lower lobe. It did not resolve spontaneously and surgery was undertaken. The pneumatocele and the subcutaneous cavity were drained and the rib fractures were stabilized with Judet struts. CONCLUSIONS Pneumatocele is a classical but rare complication of thoracic trauma, resulting from a tear of the lung. The differential diagnosis includes localised pneumothorax, an intrathoracic gastric hernia and pneumomediastinum. The usual treatment is surveillance but in this case, surgery was necessary for drainage of the cavities and stabilization of the rib fractures.
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Affiliation(s)
- E Gardet
- Service de chirurgie thoracique et cardiovasculaire, CHU Dupuytren, 22 bis, rue Petiniaud-Beaupeyrat, 87000 Limoges, France.
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Monteil J, Vergnenègre A, Bertin F, Dalmay F, Gaillard S, Bonnaud F, Melloni B. Randomized follow-up study of resected NSCLC patients: conventional versus 18F-DG coincidence imaging. Anticancer Res 2010; 30:3811-3816. [PMID: 20944175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of this study was to compare the utility of gamma camera using a coincidence detection system imaging (CDET) with 18-fluorodeoxyglucose to conventional imaging techniques in the detection of recurrence of non-small cell lung cancer. Sixty-nine patients were randomized into two groups for follow-up after surgery from October 2000 to December 2002. Each patient was evaluated every 6 months by conventional technique imaging in group A (n=33) or CDET imaging in group B (n=36) over two years. The direct costs of each procedure were evaluated. The major endpoint was the number of recurrences or new tumours detected. The two groups were similar. A total of 25 recurrences was detected (9 in group A and 16 in group B). Overall survival was similar in the two groups. CDET imaging was more expensive. CDET imaging provides earlier detection of recurrence, but does not modify survival outcome. Further studies are necessary to demonstrate the impact, if any, of 18-FDG imaging.
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Affiliation(s)
- J Monteil
- Departement of Nuclear Medicine, University Hospital, Limoges, 87042 Limoges Cedex, France.
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Cohen-Bacrie S, Bertin F, Gassiot AS, Prère MF. Rapid molecular genetic assay for direct identification of Bordetella from patients specimens. ACTA ACUST UNITED AC 2009; 58:52-4. [PMID: 19892481 DOI: 10.1016/j.patbio.2009.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 07/12/2009] [Indexed: 11/18/2022]
Abstract
Biological diagnosis of whooping cough is increasingly necessary to confirm respiratory tract infection. Indeed, clinical symptoms are variable especially in adolescents and adults who contaminate newborns too young to be vaccinated. The PCR assay was proven highly sensitive for the diagnosis of pertussis. In this study, we reported the use of a new test (GenoQuick Bordetella [GQB], Hain Life Science, Germany) which permits the fast molecular genetic identification of Bordetella pertussis and parapertussis directly from patients specimens, i.e. swabs from nose or throat. The test was performed over a three months period on 40 specimens from patients (1 month to 65 years old), most of them were young children admitted in paediatric emergency with paroxysmal cough or prolonged cough.
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Affiliation(s)
- S Cohen-Bacrie
- Unité de Bactériologie Pédiatrique, IFB, CHU de Toulouse, France
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Servanton G, Pantel R, Juhel M, Bertin F. Two-dimensional quantitative mapping of arsenic in nanometer-scale silicon devices using STEM EELS–EDX spectroscopy. Micron 2009; 40:543-51. [DOI: 10.1016/j.micron.2009.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 04/03/2009] [Accepted: 04/04/2009] [Indexed: 10/20/2022]
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Bertin F, Labrousse L, Gazaille V, Vincent F, Guerlin A, Laskar M. New Modality of Collapse Therapy for Pulmonary Tuberculosis Sequels: Tissue Expander. Ann Thorac Surg 2007; 84:1023-5. [PMID: 17720428 DOI: 10.1016/j.athoracsur.2007.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 03/29/2007] [Accepted: 04/02/2007] [Indexed: 11/21/2022]
Abstract
Classical collapse therapy with extrapleural Lucite balls placement used for tuberculosis sequelae is associated with long term complications, such as migration of the foreign body. We report a new modality of collapse therapy for tuberculosis cavitation which may avoid this complication and which uses percutaneous tissue expanders. Postoperative course was uneventful and mid term follow-up confirmed the functional improvement without recurrence of the infection. This new modality of post-tuberculosis collapse therapy may allow treatment with fewer physical and physiologic sequelae of the residual cavities, and should reduce long term complications such as migration.
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Affiliation(s)
- François Bertin
- Department of Thoracic and Cardiovascular Surgery and Angiology, Centre Hospitalier Universitaire Limoges, Limoges, France.
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Bernard C, Aimé JP, Marsaudon S, Levy R, Bonnot AM, Nguyen C, Mariolle D, Bertin F, Chabli A. Drying nano particles solution on an oscillating tip at an air liquid interface: what we can learn, what we can do. Nanoscale Res Lett 2007; 2:309-318. [PMCID: PMC3246374 DOI: 10.1007/s11671-007-9065-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Accepted: 05/19/2007] [Indexed: 05/30/2023]
Abstract
Evaporation of fluid at micro and nanometer scale may be used to self-assemble nanometre-sized particles in suspension. Evaporating process can be used to gently control flow in micro and nanofluidics, thus providing a potential mean to design a fine pattern onto a surface or to functionalize a nanoprobe tip. In this paper, we present an original experimental approach to explore this open and rather virgin domain. We use an oscillating tip at an air liquid interface with a controlled dipping depth of the tip within the range of the micrometer. Also, very small dipping depths of a few ten nanometers were achieved with multi walls carbon nanotubes glued at the tip apex. The liquid is an aqueous solution of functionalized nanoparticles diluted in water. Evaporation of water is the driving force determining the arrangement of nanoparticles on the tip. The results show various nanoparticles deposition patterns, from which the deposits can be classified in two categories. The type of deposit is shown to be strongly dependent on whether or not the triple line is pinned and of the peptide coating of the gold nanoparticle. In order to assess the classification, companion dynamical studies of nanomeniscus and related dissipation processes involved with thinning effects are presented.
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Affiliation(s)
- Charlotte Bernard
- Université Bordeaux-1, CPMOH 351 cours de la Libération, Talence cedex, 33405, France
| | - Jean-Pierre Aimé
- Université Bordeaux-1, CPMOH 351 cours de la Libération, Talence cedex, 33405, France
| | - Sophie Marsaudon
- Université Bordeaux-1, CPMOH 351 cours de la Libération, Talence cedex, 33405, France
| | - Raphaël Levy
- Center for Nanoscale Science, Bioscience Building and Department of Chemistry, University of Liverpool, Liverpool, l69 7zb, UK
| | | | - Cattien Nguyen
- ELORET Corporation/NASA Ames Research Center, MS 229-1 Moffett Field, Mountain View, CA, 94035-1000, USA
| | - Denis Mariolle
- CEA-LETI, MINATEC, 17 rue des Martyrs, Grenoble Cedex 9, 38054, France
| | - François Bertin
- CEA-LETI, MINATEC, 17 rue des Martyrs, Grenoble Cedex 9, 38054, France
| | - Amal Chabli
- CEA-LETI, MINATEC, 17 rue des Martyrs, Grenoble Cedex 9, 38054, France
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Melloni B, Gazaille V, Bertin F, Gaillard S, Monteil J. [Diagnosis of lung cancer. Role of PET/CT fusion scan in lung cancer]. Rev Mal Respir 2006; 23:16S11-16S16. [PMID: 17268330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Whole-body positron emission tomography (PET) with radiolabeled [18F]-fluoro-2-deoxy-D-glucose (18FDG) plays an important role in the diagnosis, staging, and management of lung cancer. The preferential accumulation of FDG in malignant cells assists in the differentiation of benign and malignant tissue. However, PET alone does not allow an accurate anatomic localisation of FDG uptake. The combination of PET with CT images improves the spatial resolution, sensitivity and specificity of the test. PET/CT, as with PET alone, is indicated for the diagnosis of pulmonary nodules as well as the locoregional and extrathoracic staging of non-small-cell lung cancer (NSCLC). In many published studies, PET/CT has been shown to be superior to CT alone, to PET alone, or to both imaging techniques used separately to evaluate pulmonary nodules or for staging NSCLC. Now, PET/CT imaging is being investigated in the staging and management of small-cell lung cancer, in radiation treatment planning, in response prediction following treatment and in the detection of lung cancer recurrence in NSCLC. PET/CT is likely to have an important role in the management of lung cancer. New machines are in development and new radiopharmaceutical agents must be assessed.
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Affiliation(s)
- B Melloni
- Service de Pneumologie, Hôpital du Cluzeau, CHU Limoges, France.
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Jai C, Aimé JP, Mariolle D, Boisgard R, Bertin F. Wetting an oscillating nanoneedle to image an air-liquid interface at the nanometer scale: dynamical behavior of a nanomeniscus. Nano Lett 2006; 6:2554-60. [PMID: 17090090 DOI: 10.1021/nl0619599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The dynamical behavior of a nanomeniscus is investigated with a oscillating nanoneedle recording information on the change of the shape and viscous contribution. At the air-glycerol interface, the dynamical properties exhibit a nonlinear behavior making the nanomeniscus evolution similar to a first-order phase transition. Also shown is the capability to record height images of the liquid interface with resolutions at nanometer scale. At the air-water interface, evaporation leads to more complex dynamical properties. The viscous damping first increases as a consequence of a thinning effect, then, when the contact angle reaches zero, the nanomeniscus is unable to sustain the dissipation.
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Affiliation(s)
- C Jai
- CPMOH, Université Bordeaux 1, 351 Cours de la Libération, 33405 Talence, France
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34
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Gazaille V, Bertin F, Delage M, Decroisette C, Labrousse F, Sturtz F, Melloni B, Bonnaud F. 047 MRP1 and -3 protein expression in non-small cells carcinomas and survey. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bertin F, Guerlin A, Laskar M. [Clinical types of thoracic cancer. Treatment of pancoast tumours]. Rev Mal Respir 2006; 23:16S164-16S169. [PMID: 17268354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- F Bertin
- Service de Chirurgie Thoracique et Cardio-Vasculaire CHU Dupuytren, Limoges, France.
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Azorin JF, Bertin F, Martinod E, Melloni VB, Laskar M, Marquette CH, Wurtz A. [Surgery of the trachea: old problem, new possibilities]. Rev Mal Respir 2006; 23:10S103-10S105. [PMID: 17127979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- J-F Azorin
- Service de Chirurgie Thoracique et Vasculaire, Hôpital Avicenne, Bobigny, Université Paris XIII.
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Decroisette C, Melloni B, Moldovan D, Gazaille V, Fermeaux V, Bertin F, Bonnaud F. [Pleural metastases of sclerosing epithelioid fibrosarcoma]. Rev Pneumol Clin 2006; 62:179-82. [PMID: 16840996 DOI: 10.1016/s0761-8417(06)75435-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Sclerosing epithelioid fibrosarcoma is a rare tumor recently described. The histological presentation can be confused with certain soft tissue benign tumors and certain sarcomas. Metastatic spread is usually late in the natural course of the disease. We report a case of recurrent sclerosing epithelioid fibrosarcoma with pleural metastases which developed ten years after surgical resection of the primary tumor. The tumor was formed by small uniform round epithelioid cells with a clear cytoplasm. The tumor cells were strongly positive for vimentin. This clinical case is discussed in light of other cases reported in the literature.
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Affiliation(s)
- C Decroisette
- Service de Pneumologie, Hôpital du Cluzeau - CHU, 23, avenue Dominique-Larrey, 87042 Limoges.
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Gazaille V, Delage M, Bertin F, Decroisette C, Chable H, Fajac A, Sturtz F, Melloni B, Bonnaud F. 060 MRP1, -3 and -5 protein expression in non-small cells carcinomes and survey after adjuvant chemotherapy. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)92472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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Bertin F, Gazaille V, Sturtz F, Laskar M, Melloni B. P-007 Vascular endothelial growth factor-A as a predicting factor of clinical outcome in non-small cell lung cancer. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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40
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Lacroix P, Aboyans V, Bertin F, Laskar M, Cornu E. [Management of acute leg ischemia]. Rev Prat 2005; 55:1205-10. [PMID: 16164066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Nowadays acute limb ischemia (ALI) is still a tremendous complication that may compromise local or general prognosis. Every practician might be able to diagnose this situation in order to transfer in emergency the patient in a vascular unit. The main determinants of outcome of the leg are the severity of the ALI and a prompt treatment. The severity is evaluated according the SCV/ISCVS classification. Patients with a sensitive-motor neurologic deficit are at high risk; they require urgent therapy. The main causes are embolism and thrombosis. In case of classical presentation of embolism, immediate embolectomy will be done under local anesthetic. But this presentation is rare; often the picture is much more complex; the majority of ALI patients are elderly with atherosclerotic vessels. In such situation a team approach is mandatory to decide optimal management. The treatment may combine thrombolytic therapy or aspiration thrombectomy and percutaneous or surgical revascularisation. Finally, atrial fibrillation is now the most common cause of embolism, and appropriate anticoagulation would prevent this complication.
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Affiliation(s)
- Philippe Lacroix
- Service de chirurgie thoracique, cardiovasculaire et angiologie, hôpital Dupuytren, 87042 Limoges.
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Melloni B, Monteil J, Vincent F, Bertin F, Gaillard S, Ducloux T, Verbeke S, Maubon A, Vandroux JC, Bonnaud F. Assessment of 18F-fluorodeoxyglucose dual-head gamma camera in asbestos lung diseases. Eur Respir J 2005; 24:814-21. [PMID: 15516678 DOI: 10.1183/09031936.04.00004504] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of this study was to evaluate the performance of 18F-fluorodeoxyglucose (18FDG) imaging via coincidence detection emission tomography (CDET) in identifying malignant lesions in subjects exposed to asbestos. A total of 30 patients exposed to asbestos underwent 18FDG-CDET between January 2000 and June 2003. A CDET scan of the thorax and abdomen was performed 60 min after injection of 18FDG in fasting patients, and results were obtained in slices in three axes. The CDET results were compared to those from computed tomography (CT), and pleural or surgical biopsy in patients with positive 18FDG-CDET results. All primary malignant mesotheliomas accumulated 18FDG (n=6), and, in two patients, CDET findings were superior to those of CT, allowing early detection. In two cases, lung carcinomas with malignant pleural effusion were also detected. There were five false positive CDET results: three unilateral pleural thickening, one rounded atelectasis, and one benign lung nodule. All patients with pleural plaques showed no significant 18FDG uptake. Malignant diseases were detected by 18FDG-CDET imaging with a sensitivity of 89% and specificity of 71%. Coincidence detection emission tomography can identify malignant mesothelioma in selected subjects exposed to asbestos. Coincidence detection emission tomography appears to be a useful noninvasive method for the follow-up of subjects with exposure risk of asbestosis.
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Affiliation(s)
- B Melloni
- Dept of Pneumology, Centre Hospitalier et Universitaire de Limoges, Limoges, France.
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Aboyans V, Lacroix P, Jeannicot A, Guilloux J, Bertin F, Laskar M. A New Approach for the Screening of Carotid Lesions: A ‘Fast-track’ Method with the Use of New Generation Hand-held Ultrasound Devices. Eur J Vasc Endovasc Surg 2004; 28:317-22. [PMID: 15288637 DOI: 10.1016/j.ejvs.2004.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2004] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We assessed the usefulness of fast-track neck sonography with a new-generation hand-held ultrasound scanner in the detection of > or =60% carotid stenosis. DESIGN Patients with a past history of atherosclerotic disease or presence of risk factors were enrolled. All had fast-track carotid screening with a hand-held ultrasound scanner. METHODS Initial assessment was performed with our quick imaging protocol. A second examiner performed a conventional complete carotid duplex as gold-standard. RESULTS We enrolled 197 consecutive patients with a mean age of 67 years (range 35-94). A carotid stenosis >60% was detected in 13 cases (6%). The sensitivity, specificity, positive and negative predictive value of fast-track sonography was 100%, 64%, 17% and 100%, respectively. Concomitant power Doppler imaging during the fast-track method did not improve accuracy. CONCLUSIONS The use of a fast-track method with a hand-held ultrasound device can reduce the number of unnecessary carotid Duplex and enhance the screening efficiency without missing significant carotid stenoses.
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Affiliation(s)
- V Aboyans
- Department of Thoracic and Cardiovascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges, France
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Bertin F, Vincent F, Guerlin A, Le Guyader A, Melloni B, Laskar M. 113 Risques de l’utilisation de la ventilation à percution intrapulmonaire en post-opératoire de la chirurgie pulmonaire. Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71739-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Etobou C, Bachy A, Bertin F, Salmin E. [Radiological quiz of the month]. Arch Pediatr 2002; 9:1280-2. [PMID: 12564436 DOI: 10.1016/s0929-693x(02)00128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C Etobou
- Service de pédiatrie, centre hospitalier Notre-Dame et Reine-Fabiola, Cherleroi, Belgique
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Melloni B, Monteil J, Bertin F, Ducloux T, Gaillard S, Vincent F, Vergnenegre A, Laskar M, Vandroux JC, Bonnaud F. [Value of 18FDG-CDET in the evaluation of operable bronchial cancer]. Rev Mal Respir 2001; 18:599-606. [PMID: 11924180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The purpose of this study was to investigate the utility of 18fluorodeoxyglucose (FDG) coincidence detection position emission tomography (CDET) in the evaluation of metastatic mediastinal lymph nodes in patients with potentially operable non-small-cell lung cancer (NSCLC). A prospective study was performed in thirty patients with newly suspected NSCLC. Thoracic computed tomography (CT), FDG CDET, and invasive surgical staging were performed in patients. Blinded prospective interpretation was performed for each test and compared to pathological staging obtained by mediastinoscopy and/or by thoracotomy. Patients were followed for six months to detect occult metastases. The sensitivity and specificity of CDET for the detection of mediaStinal lymph nodes were 75% and 94.4% respectively. The corresponding value for CT were 50% and 80.9%. Three patients with N1 disease were classified as N0 by CDET. With regard to definitive surgical node staging, CDET could identify nodal disease in 26 patients and CT only in 18 patients (n = 30). FDG full-ring positron emission tomography (PET) is the most accurate non-invasive method for the detection and staging of lung cancer. In addition, FDG CDET shows high accuracy for the detectability of pulmonary lesions with a diameter at least 2 cm and the evaluation of lymph node in NSCLC.
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Affiliation(s)
- B Melloni
- Service de Pathologie Respiratoire et d'Allergologie, Universitaire de Limoges.
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46
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Abstract
This report describes the case of a 37-year-old man who fell from 6 m height and presented an isolated rupture of the right pulmonary vein. The patient had a low blood pressure without any sign of intrathoracic injury. An echocardiogram revealed a tamponade with hemodynamic intolerance. The repair was made using cardiopulmonary bypass which made the inspection and total repair of the lesions easier. This case is unusual because of the isolated lesion and the few articles about similar reports founded in an extended literature review. Mechanisms and generation of blunt chest trauma lesions are discussed.
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Affiliation(s)
- A Le Guyader
- Department of Thoracic and Cardiovascular Surgery, Dupuytren's University Hospital, Limoges, France.
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47
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Abstract
Platelet-activating factor (PAF) is a lipid mediator that stimulates the in vitro growth of various human tumour cell lines and that enhances the effect of vascular endothelial growth factor that plays a key role during angiogenesis of human cancer. In this study, we assessed the levels of PAF and of the acetylhydrolase activity (AHA, the PAF degrading enzyme) in patients with lung cancer. Results indicated no significant differences between blood PAF amounts of lung cancer patients (91+/-33 pg/ml, n=31) and a control group of patients with chronic obstructive pulmonary disease (COPD) induced by habitual smoking (117+/-28 pg/ml, n=10). Similarly, their serum AHA levels were not different (67.9+/-3.0 nmol/min/ml as compared to 68.3+/-5.2 nmol/min/ml for lung cancer patients and controls, respectively). In contrast, PAF amounts were markedly (P=0.01, t-test for paired data) reduced in the lung tumour tissues (77+/-29 pg/g, n=10) as compared to the non-tumour tissues (208+/-67 pg/g, n=10). These low levels of PAF were not related to a lower amounts of the lyso-PAF precursor but to an elevated (P=0.01, t-test for paired data) AHA in the tumour tissues (37.0+/-4.9 nmol/min/g, n=10) as compared to the non-tumour tissues (24.6+/-2.6 nmol/min/ml, n=10). Reverse transcriptase polymerase chain reaction experiments showed the presence of the PAF receptor (PAF-R) transcript 1 but not transcript 2 in blood mononuclear cells of lung cancer patients and COPD patients. Flow cytometry experiments did not highlight differences in the number and the distribution of PAF-R on their circulating leukocytes. In conclusion, this clinical study highlights no evidence for a potential important role of PAF during human lung cancer.
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Affiliation(s)
- Y Denizot
- UMR CNRS 6101, Laboratoire d'immunologie, Faculté de Médecine, 2 rue Dr Marcland, 87025 Limoges, France.
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48
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Vodoff MV, Gilbert B, Bertin F, Piguet C, Petit B, Melloni B, Labrousse F, de Lumley L. [Hodgkin's disease limited to intrathoracic sites. Case report]. Arch Pediatr 2001; 8:614-6. [PMID: 11446184 DOI: 10.1016/s0929-693x(00)00286-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Hodgkin's disease without peripheral lymphadenopathy or hepatosplenomegaly is exceptional. CASE REPORT Hodgkin's disease was revealed by lung nodules, one of them cavitating, with mediastinal enlargement. Diagnosis was confirmed on a video-assisted pleuroscopic biopsy. CONCLUSION Hodgkin's disease should be considered in case of mediastinal enlargement with lung nodules.
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Affiliation(s)
- M V Vodoff
- Service de pédiatrie 1, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France
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49
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Aboyans V, Cassat C, Lacroix P, Tapie P, Tabaraud F, Pesteil F, Bertin F, Laskar M, Virot P. Is the morning peak of acute myocardial infarction's onset due to sleep-related breathing disorders? A prospective study. Cardiology 2001; 94:188-92. [PMID: 11279325 DOI: 10.1159/000047315] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Many studies have shown that the risk of experiencing a myocardial infarction (MI) is increased during the first hours of the morning. Sleep apnea syndrome (SAS) is associated with an enhanced adrenergic activity, prolonged a few hours after awakening. We aimed at assessing whether sleep breathing disorders could be a culprit for the morning excess rate of MI. We studied 40 middle-aged men admitted for an acute MI. An overnight polysomnographic study was performed 37.4 +/- 9.4 days after the MI. The prevalence of SAS was high (30%). The prevalence of SAS was significantly higher in patients with the MI onset during the morning. The circadian pattern was significantly different in patients with or without SAS: those with SAS presented an important peak of MI onset during the period between 06.00 and 11.59 h. None of them had their MI during the period between 24.00 and 05.59 h. This different nyctohemeral pattern underlines the potential role of sleep breathing disorders as a trigger of MI.
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Affiliation(s)
- V Aboyans
- Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren's University Hospital, 2, avenue Martin Luther king, F-87042 Limoges Cedex, France.
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50
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Aboyans V, Lacroix P, Waruingi W, Bertin F, Pesteil F, Vergnenègre A, Laskar M. [French translation and validation of the Edinburgh Questionnaire for the diagnosis of intermittent claudication]. Arch Mal Coeur Vaiss 2000; 93:1173-7. [PMID: 11107475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Obliterative arterial disease of the lower limbs is diagnosed by simple, reproducible, sensitive and non-invasive methods. One of these, a questionnaire for the diagnosis on intermittent limping, is a method of choice. Until recent years, the only validated questionnaire was the one proposed by the World Health Organisation. This was criticised a lot, especially for its lack of sensitivity. Recently, a Scottish group proposed an improvement in the diagnostic performance of this questionnaire by carrying out several changes. This new version, called the Edinburgh Questionnaire, has promising diagnostic qualities. The authors present a French version of this questionnaire. This French translation was validated in 105 patients referred for diagnosis of obliterative lower limb arterial disease. A sensitivity of 86.5%, a specificity of 95.6%, a positive predictive value of 91.4% and a negative predictive value of 92.9% of this French version are comparable to the results obtained with the English version. Therefore, the authors suggest using this questionnaire in epidemiological and public health studies in France.
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Affiliation(s)
- V Aboyans
- Service de chirurgie thoracique et cardiovasculaire et angiologie, CHU de Limoges
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