Blood CD9+ B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation

Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24^hi CD38^hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24^hi CD38^hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9⁺ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24^hi CD38^hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.

Success of organic and biodynamic system experiment to produce high quality wines

Reducing input use and in particular pesticide use is very important in OIV 2018 new resolutions. Also Europe and France promote research and co-design with winegrowers in more sustainable viticulture according to a combination of climate change. It is also very important to take into account soil diversity and Protected Designation Areas constraints to make sure that new wines will ensure the sustainability of the wineries. This study explores design, experiment and assess of new realistic viticulture production systems located in Protected Designation of Origin (PDO) areas and with already organic or biodynamic certification for six consecutive years, in winery production conditions. It also discusses the chosen assessment indicators and the adoption of such new production systems by winegrowers. Eleven cases were studied in a system experiment network in Alsace (France) and in six consecutive production years. Contrasted production years, PDO areas combined to organic or biodynamic certification allow testing the resilience of experimented systems over time. Combination of new practices are tested to drastically reduce input and in particular pesticide. Assessed performances of the systems deal with 14 main indicators: social acceptability (1) and economic viability (1), agronomy (yield (1), harvested berries quality (2), fungi damage (3), soil quality (1), and wine sensorial analysis (1) and environment (Frequency Treatment Index (1), Cupper rate (1), INDIGO® method (2)). Several innovations were selected by co-design with winegrowers: adding essential oil and Propolis to copper spraying; total grass cover of the vine site; new decision rules for rate and time pesticide spraying; decision aid tool; resistant grape varieties planted. The assessment results support that the performance of the 14 indicators is very good for most of the eleven systems during the six assessed years. Combinations of tested innovations are neither dangerous nor difficult to enforce in the field by the vineworkers. Innovations do not increase the cost of grape production. The yield ratios were satisfactory the 6-yeared of observation because calculated yield match with targeted yield. Harvested berries quality support that the 7 vine sites succeed in targeted total acidity and sugar rate according to the different PDO conditions every years. Wines were Alsace or Grand Cru PDO labelled and successful marketed. At least, the Treatment Frequency Index is reduced by an average of 40% for all vine sites and assessed years. TFI can be reduced at a maximum of 89% and TFI median is 38%. Cupper rate can be reduced at a maximum of 97% and Cupper rate median is 54%. I-pest from INDIGO® method indicate a minimal risk taking for groundwater, surface water, air and beneficial organisms contamination. And finally, flora richness indicator is stable or steadily increases during the 6 study years. In this study, we demonstrated that drastically monitoring reduction of pesticide and other inputs is possible. Chosen indicators allow a exhaustive assessment, but could also been aggregated all together to give a synthetic information to winegrowers and make them easier to adopt the innovative systems. Introduction of innovation combinations in highly sustainable organic and biodymanic systems are validated to produce high quality wines. Now, it is possible to serenely promote and disseminate these highly sustainable innovative systems, taking into account of course vineyard diversity.

Programme de collaboration franco-suisse pour la création de nouvelles variétés de vigne durablement résistantes au mildiou et à l'oïdium

Une alternative aux traitements phytosanitaires pour lutter contre le mildiou et l'oïdium de la vigne est le développement de variétés résistantes. Leur création doit intégrer non seulement le niveau de résistance mais également sa durabilité, ainsi que les performances agronomiques notamment la productivité et la composition des baies qui doit convenir à la production de vins de haute qualité. L'Inra (France) a engagé le programme de sélection ResDur, basé sur le pyramidage des facteurs de résistance, en 2000. Il a conduit à l'inscription au catalogue français d'une première série de variétés à résistance polygénique – Artaban, Floreal, Vidoc, Voltis – en 2018. Agroscope (Suisse) a démarré la création de variétés résistantes en 1996, en mobilisant les résistances portées par des variétés allemandes, principalement Bronner. Un premier aboutissement a été l'homologation en Suisse de Divico et Divona, respectivement en 2013 et 2018. En 2009 l'Inra et Agroscope ont démarré un programme de sélection commun, visant à combiner les facteurs de résistance aux maladies présents de manière complémentaire dans leurs lignées respectives. Les croisements réalisés ont généré, après sélection assistée par marqueurs, 400 descendants porteurs des facteurs de résistanceRpv1, Rpv10 et/ou Rpv3 ; Run1, Ren3 et/ou Ren3.2. Leur phénotypage agronomique et œnologique est réalisé dans le cadre d'un réseau d'essais situés dans les deux Instituts à Colmar (FR) et à Pully (CH). Les premières observations pluriannuelles, portant sur 80 descendants, ont permis d'étudier leur stabilité phénotypique pour les caractères de résistance, les traits culturaux et la qualité des vins. A l'issue de cette étape, quinze variétés candidates ont été sélectionnées et installées en essais d'évaluation de leur valeur agronomique, technologique et environnementale (VATE) en Valais (CH), ainsi que dans trois régions françaises (Champagne, Val de Loire, Vallée du Rhône). L'inscription au catalogue des premières co-obtentions Inra/Agroscope est prévue à l'horizon 2024–2025.

SEOM clinical guidelines for diagnosis and treatment of glioblastoma (2017)

Glioblastoma (GB) is the most common brain malignancy and accounts for over 50% of all high-grade gliomas. Radiotherapy (RT) with concomitant and adjuvant temozolomide (TMZ) chemotherapy is the current standard of care for patients with newly diagnosed GB up to age 70. Recently, a new standard of care has been adopted for elderly patients (≥ 65 years) based on short course of RT and TMZ. Several clinically relevant molecular markers that assist in diagnosis and prognosis have recently been identified. The treatment for recurrent GB is not well defined, and decision-making is usually based on prior strategies as well as several clinical and radiological factors. The presence of neurologic deficits and seizures can significantly impact quality of life.

High resolution core level spectroscopy of hydrogen-terminated (1 0 0) diamond

Synchrotron-based photoelectron spectroscopy experiments are presented that address a long standing inconsistency in the treatment of the C1s core level of hydrogen terminated (1 0 0) diamond. Through a comparison of surface and bulk sensitive measurements we show that there is a surface related core level component to lower binding energy of the bulk diamond component; this component has a chemical shift of [Formula: see text] eV which has been attributed to carbon atoms which are part of the hydrogen termination. Additionally, our results indicate that the asymmetry of the hydrogen terminated (1 0 0) diamond C1s core level is an intrinsic aspect of the bulk diamond peak which we have attributed to sub-surface carbon layers.

Charge transfer doping of silicon

We demonstrate a novel doping mechanism of silicon, namely n-type transfer doping by adsorbed organic cobaltocene (CoCp2*) molecules. The amount of transferred charge as a function of coverage is monitored by following the ensuing band bending via surface sensitive core-level photoelectron spectroscopy. The concomitant loss of electrons in the CoCp2* adlayer is quantified by the relative intensities of chemically shifted Co2p components in core-level photoelectron spectroscopy which correspond to charged and neutral molecules. Using a previously developed model for transfer doping, the evolution in relative intensities of the two components as a function of coverage has been reproduced successfully. A single, molecule-specific parameter, the negative donor energy of -(0.50±0.15)  eV suffices to describe the self-limiting doping process with a maximum areal density of transferred electrons of 2×1013  cm-2 in agreement with the measured downward band bending. The advantage of this doping mechanism over conventional doping for nanostructures is addressed.

[Aneurysmal subarachnoid hemorrhage: group of study of cerebrovascular pathology of the Spanish society of neurosurgery management guideline]

An actualized revision of the most important aspects of aneurismal subarachnoid hemorrhage is presented from the guidelines previously published by the group of study of cerebrovascular pathology of the Spanish Society of Neurosurgery. The proposed recommendations should be considered as a general guide for the management of this pathological condition. However, they can be modified, even in a significant manner according to the circumstances relating each clinical case and the variations in the therapeutic and diagnostic procedures available in the center attending each patient.

[Spinal granuloma in a patient receiving a spinal infusion of morphine and clonidine]

Patients treated with long-term spinal infusion of high doses of morphine develop a granuloma at the location of the catheter tip. Diagnosis is based on a steady increase in intrathecal morphine dosage after a relatively prolonged period of stability, on the gradual development of neurologic signs and symptoms suggesting radicular or spinal cord compression, and on magnetic resonance images. We describe a man with central neuropathic pain after removal of a tumor. The presence of all 3 of the aforementioned diagnostic criteria led to suspicion of a spinal granuloma.

Complication neurologique après posture obstétricale «en tailleur» lors d'un travail sous analgésie péridurale

Obstetrical positioning is used more and more often because of the supposed or proven benefits although side effects are not well known. We therefore report the case of a patient who presented with a postpartum neurological deficit after a seven hour hip-flexed posture during labour under epidural analgesia. The parturient did not complain of pain or discomfort during labour. The neurological injury was suspected because of delayed recovery of epidural analgesia induced-motor block. Neurological examination disclosed sensory and motor abnormalities in the left femoral and sciatic nerve distribution areas. The early performed lumbar CT scan did not show any complication and electromyographic evaluation performed on the ninth postpartum day was normal. Three months after delivery, some degree of neuropathic pain in the sciatic nerve distribution remained. The risk of neurological injury directly related to obstetrical positioning is discussed. Prolonged positioning using a posture which can induce nerve stretching should be avoided. This is especially true when the patient is receiving epidural analgesia which can mask pain or discomfort.

Complication neurologique après posture obstétricale «en tailleur» lors d'un travail sous analgésie péridurale

Obstetrical positioning is used more and more often because of the supposed or proven benefits although side effects are not well known. We therefore report the case of a patient who presented with a postpartum neurological deficit after a seven hour hip-flexed posture during labour under epidural analgesia. The parturient did not complain of pain or discomfort during labour. The neurological injury was suspected because of delayed recovery of epidural analgesia-induced motor block. Neurological examination disclosed sensory and motor abnormalities in the left femoral and sciatic nerve distribution areas. The early performed lumbar CT-scan did not show any complication and electromyographic evaluation performed on the ninth postpartum day was normal. Three months after delivery, some degree of neuropathic pain in the sciatic nerve distribution remained. The risk of neurological injury directly related to obstetrical positioning is discussed. Prolonged positioning using a posture which can induce nerve stretching should be avoided. This is especially true when the patient is receiving epidural analgesia which can mask pain or discomfort.

Transclival cerebrospinal fluid fistula in a patient with Marfan's syndrome

Marfan's syndrome is a disease associated with reduced structural integrity of connective tissues. We report a 36-year-old patient with Marfan's syndrome who presented with rhinorrhoea, occipital headache and vomiting. Physical examination revealed typical Marfan's syndrome features including dolicocephalous, mandibular micrognathia, tall stature, disproportionately long limbs and digits, and hypermobility of the joints. A high-resolution CT scan demonstrated pneumoencephalous, cerebrospinal fluid (CSF) filling the sphenoidal sinus, and a small bone defect of the clivus. Surgery performed through a transsphenoidal approach revealed the sphenoid sinus to be filled with CSF and a small fenestration in the clivus. The arachnoid diverticulum and the fenestration were repaired and covered with a graft of abdominal fat. In this patient, a deficiency in bone development associated with Marfan's syndrome gave rise to a clival fenestration and a transclival CSF fistula. Although abnormalities of the spinal meningeal membranes have been reported in Marfan's syndrome, to our knowledge, this is the first report of a fistula located in the cranial base in this condition.

Serum anticholinergic activity in patients following cardiac surgery and healthy individuals following amitriptyline application

The serum anticholinergic activity (SAA) is used as a marker for cognitive impairment. Here, two studies have been performed characterizing the SAA profile. In Study 1 the endogenous SAA in relation to the total serum protein concentration was monitored for 24 h in five healthy individuals and compared with that in four inpatients following cardiac surgery. In Study 2 the SAA of seven healthy individuals was assessed following a single amitriptyline dose. In both studies SAA was assessed by an ex vivo assay. In Study 1, the absolute SAA varied in a wide range of 1.2 and 14.5 atropine equivalents (AEs) over 24 h. A circadian pattern was not observed. The mean total serum protein concentration, but not the SAA, was significantly lower in inpatients than in healthy individuals. In Study 2, the SAA increased following amitriptyline to a maximum. The mean SAA increased by 6.39 AE at the amitriptyline peak concentration. High SAA variability showed a low statistical relation to amitriptyline concentrations. Both studies characterize the SAA as an individual parameter not affected per se by surgery or clinical care and poorly correlated with the total serum protein concentration. The relation with amitriptyline concentration helps to quantify SAA values towards a better understanding of the clinical implications and limitations of SAA changes.

Surface transfer doping of diamond

The electronic properties of many materials can be controlled by introducing appropriate impurities into the bulk crystal lattice in a process known as doping. In this way, diamond (a well-known insulator) can be transformed into a semiconductor, and recent progress in thin-film diamond synthesis has sparked interest in the potential applications of semiconducting diamond. However, the high dopant activation energies (in excess of 0.36 eV) and the limitation of donor incorporation to (111) growth facets only have hampered the development of diamond-based devices. Here we report a doping mechanism for diamond, using a method that does not require the introduction of foreign atoms into the diamond lattice. Instead, C60 molecules are evaporated onto the hydrogen-terminated diamond surface, where they induce a subsurface hole accumulation and a significant rise in two-dimensional conductivity. Our observations bear a resemblance to the so-called surface conductivity of diamond seen when hydrogenated diamond surfaces are exposed to air, and support an electrochemical model in which the reduction of hydrated protons in an aqueous surface layer gives rise to a hole accumulation layer. We expect that transfer doping by C60 will open a broad vista of possible semiconductor applications for diamond.

Isotope-disorder-induced line broadening of phonons in the Raman spectra of SiC

The width of phonon lines in the Raman spectra of ideal isotopically pure solids is determined by inelastic scattering processes. In solids that contain a mixture of different isotopes of one atomic constituent, elastic scattering due to isotopic mass disorder opens up decay channels that result in additional line broadening. We use different polytypes of SiC with an associated number of Raman active modes in order to experimentally validate the proportionality between linewidth and phonon density of states predicted by a simple elastic scattering theory.

Origin of surface conductivity in diamond

Hydrogen-terminated diamond exhibits a high surface conductivity (SC) that is commonly attributed to the direct action of hydrogen-related acceptors. We give experimental evidence that hydrogen is only a necessary requirement for SC; exposure to air is also essential. We propose a mechanism in which a redox reaction in an adsorbed water layer provides the electron sink for the subsurface hole accumulation layer. The model explains the experimental findings including the fact that hydrogenated diamond is unique among all semiconductors in this respect.

Spontaneous cerebrospinal fluid fistulae associated with empty sellae: surgical treatment and long-term results

OBJECTIVE

To evaluate the accuracy of different diagnostic tools for cerebrospinal fluid fistulae (CFFs) associated with empty sellae and to assess the long-term results after surgical treatment.

METHODS

Records were retrospectively reviewed for 38 of 44 patients who were treated for CFFs associated with empty sellae between 1972 and 1996. Glucose and radioisotope analyses of nasal fluids were used to establish the CFF diagnosis. Computed tomography, magnetic resonance imaging, and cisternography were used to localize the sites of the CFFs. Treatment was performed using three different approaches, i.e., subfrontal approach, transsphenoidal approach, and lumboperitoneal shunt placement.

RESULTS

Glucose and radioisotope analyses of nasal fluids confirmed CFFs in 97 and 100% of the cases, respectively. For localization of the sites, a leak in the sella was suggested in 32% of the cases using gammagraphy, in 50% using computed tomography or magnetic resonance imaging, and in 75% using computed tomographic contrast cisternography. After surgery, rhinorrhea ceased for 34 patients (89%), but 14 (41%) patients experienced recurrences of the rhinorrhea 6 months to 20 years after surgery (mean, 4.2 yr). Cure rates for the subfrontal approach, transsphenoidal approach, and shunt placement were 94, 85, and 86%, and the recurrence rates were 43, 33, and 50%, with mean times of 7.8, 4.2, and 0.8 years, respectively.

CONCLUSION

In this series, confirmation of CFFs was easy, although localization of the sites remained difficult. Recurrences were more numerous and occurred sooner after treatment with shunts; packing of the sella through a craniotomy achieved better and more stable results, although differences were not statistically significant.

Choroid plexus papillomas of the III ventricle in infants. Report of three cases

The III ventricle is an uncommon location for choroid plexus papilloma at any age. We describe three new cases of choroid plexus papillomas of the III ventricle (CPPs). All children were boys under 4 months of age and all presented with increased intracranial pressure, hydrocephalus and macrocephaly. The three were examined by preoperative computed tomography (CT) and ultrasonography. Two of them were investigated with magnetic resonance imaging (MRI). The first case was treated with a right corticofrontal transventricular approach and subtotal resection, so that he required a second operation through a transcallosal approach. In the other two cases a transcallosal approach was used. Two children needed permanent ventriculo-peritoneal shunts. The average follow-up of 4.3 years has revealed no neurological deficits in any case. The timing of and the need for shunting are major considerations. Clinical and imaging follow-up (CT and/or ultrasonography) are very helpful in controlling postoperative hydrocephalus and subdural effusion, avoiding unnecessary shunting in many cases. The operative approaches, transcortical and transcallosal, are discussed.

Traumatic extradural hematomas of the posterior fossa in children

The most favorable type of traumatic intracranial bleeding in childhood is the extradural hemorrage (EDH). The posterior fossa location is less frequent than the supratentorial site. In the period from January 1989 to January 1994 we treated 2,372 patients with craniocerebral trauma; 31 had extradural hematomas (1.3%); 3 of them were located in the posterior fossa (9.7%): 1 boy and 2 girls aged from 6 to 16 years. The traumatic mechanism was an occipital fall in all cases. Diagnosis was made by computed tomography scan (CT). Two of them had a rapidly deteriorating course. The three patients were operated on without mortality and there was no morbidity. The role of CT in the early detection of lesions and prompt surgical evacuation may reduce the mortality and morbidity from this lesion. The interaction between these factors is discussed.