Cholangitis and pulmonary nodules in a clinical presentation of syphilis in an HIV-infected patient

Several clinical manifestations attributed to syphilitic infection have been described in the literature. This is important because of the increased incidence of this infection mainly among men who have sex with men. We report the case of an HIV-infected patient who was hospitalized due to severe cholestasis, initially interpreted as drug-induced liver disease. It evolved slowly, with increasing intrahepatic cholangitis confirmed by magnetic resonance cholangiography and the appearance of several pulmonary nodules. In lung and liver biopsies, the presence of Treponema pallidum was detected by molecular and immunohistochemistry techniques, and a diagnosis of cholangitis and pulmonary syphilis was made.

Novel CK2α and CK2β subunits in maize reveal functional diversification in subcellular localization and interaction capacity

In plants, CK2α/β subunits are encoded by multigenic families. They assemble as heterotetrameric holoenzymes or remain as individual subunits and are usually located in distinct cell compartments. Here we revise the number of maize CK2α/β genes, bringing them up to a total of eight (four CK2α catalytic and four CK2β regulatory subunits). We characterize CK2β4, which presents nuclear localization and interacts with CK2α1, CK2α3, CK2β1, and CK2β3. We also describe two CK2α isoforms (CK2α2 and CK2α4) containing N-terminal extensions that correspond to putative cTPs (chloroplast transit peptides). These cTPs are functional and responsible for the subcellular localization of CK2α2 and CK2α4 in chloroplasts. Phylogenetic analysis of the CK2α gene family, further supported by the gene structure and architecture of conserved protein domains, reveals the evolutionary expansion and diversification of this family. The subcellular localization of all four CK2α isoforms was found to be altered when were co-expressed with CK2β, thereby pointing to the latter as regulators of CK2α localization.

Choroid Plexus Neoplasms: Toward a Distinction between Carcinoma and Papilloma Using Arterial Spin-Labeling

Pediatric choroid plexus papillomas and carcinomas are highly vascularized neoplasms, which are difficult to distinguish with conventional imaging. We aimed to analyze the diagnostic accuracy of PWI, by using both pseudocontinuous arterial spin-labeling and DSC-PWI. We reviewed the PWI of 13 children with choroid plexus neoplasms (7 papillomas and 6 carcinomas). We quantified CBF, relative CBF, and relative CBV in each lesion and compared papillomas and carcinomas. Relative CBF values by using arterial spin-labeling were significantly higher for carcinomas (P = .028). The median value of relative CBF was 1.7 (range, 1.4-1.9) for carcinomas and 0.4 (range, 0.3-0.6) for papillomas. The CBF median value was 115 mL/min/100 g (range, 90-140 mL/min/100 g) for carcinomas and 41 mL/min/100 g (range, 10-73 mL/min/100 g) for papillomas (P = .056). Measures with DSC-PWI were more variable and not significantly different (P = .393). Arterial spin-labeling is a promising technique to differentiate choroid plexus carcinomas and papillomas.

Interpretations of Polar Bear (

Due to their tracking experience in pursuing Polar Bears (Ursus maritimus), Inuit hunters could provide non-invasive estimates of Polar Bear characteristics from tracks, and Polar Bear monitoring programs could benefit from Inuit input. We determined i) inter-rater reliability of estimates of the sex, age, and size of Polar Bears, and estimates of the age of tracks made by a group of nine Inuit hunters who interpreted 78 tracks; ii) we made preliminary comparisons of sex and size estimates with conventional (scientific) estimates; iii) we catalogued the Polar Bear hunting experience and track interpretation techniques of nine Inuit hunters; and iv) we explored relationships between hunting experience and the ability to interpret tracks. The group of Inuit hunters made reliable and consistent estimates of Polar Bear sex, age, and size, as well as estimates of age of track (after data from one participant was excluded). Although our comparisons are based on small samples, our findings suggest that Inuit hunters may be accurate in estimating the sex of Polar Bears (74.42% agreement with genetic determinations) and the size of Polar Bears from their tracks. Our data indicate shared tracking techniques used by hunters may explain high agreement in making specific estimates, while individual hunting experience and particular methods used to interpret tracks may lead to inter-rater reliability and accuracy in interpreting tracks.

Role of 3.0-T MR colonography in the evaluation of inflammatory bowel disease

Conventional colonoscopy combined with histologic analysis represents the standard of reference for the evaluation of colorectal disease and is usually the initial examination in patients with a suspected or established diagnosis of inflammatory bowel disease (IBD). However, it is increasingly being recognized that colonoscopy is limited to providing information regarding mucosal alterations. Colonoscopy cannot help estimate the depth of involvement of colonic lesions and does not provide information regarding the presence of extraluminal complications such as abscesses or fistulas. Recent technologic advances in magnetic resonance (MR) imaging, with its high spatial and tissue resolution, have raised expectations as to the potential role of this modality in the evaluation of colonic lesions in patients with IBD, as either a complement or an alternative to colonoscopy. MR colonography allows the characterization of colonic changes in acute and chronic IBD and can depict a wide spectrum of related lesions, including ulcers, edema, wall thickening, hyperemia, and fistulas, as well as potential extraluminal complications. The bulk of available evidence indicates that MR colonography can be useful as a problem-solving tool in the evaluation of IBD, as an alternative to colonoscopy whenever tissue sampling is not required, and for the assessment of the entire colon in cases of incomplete colonoscopy.

Large differences in the genome organization of different plant Trypanosomatid parasites (Phytomonas spp.) reveal wide evolutionary divergences between taxa

All currently known plant trypanosomes have been grouped in the genus Phytomonas spp., although they can differ greatly in terms of both their biological properties and effects upon the host. Those parasitizing the phloem sap are specifically associated with lethal syndromes in Latin America, such as, phloem necrosis of coffee, 'Hartrot' of coconut and 'Marchitez sorpresiva' of oil palm, that inflict considerable economic losses in endemic countries. The genomic organization of one group of Phytomonas (D) considered as representative of the genus has been published previously. The present work presents the genomic structure of two representative isolates from the pathogenic phloem-restricted group (H) of Phytomonas, analyzed by pulsed field gel electrophoresis followed by hybridization with chromosome-specific DNA markers. It came as a surprise to observe an extremely different genomic organization in this group as compared with that of group D. Most notably, the chromosome number is 7 in this group (with a genome size of 10 Mb) versus 21 in the group D (totalling 25 Mb). These data unravel an unsuspected genomic diversity within plant trypanosomatids, that may justify a further debate about their division into different genera.

Inhibition of active nuclear transport is an intrinsic trigger of programmed cell death in trypanosomatids

The link between nucleocytoplasmic transport and apoptosis remains controversial. Nucleocytoplasmic exchange of molecules seems indeed essential for the initiation and execution of the apoptotic programme; but inhibition of nuclear transport factors may also represent a powerful apoptotic trigger. The GTPase Ran (together with its partners), first discovered to be essential in nucleocytoplasmic transport, has multiple key functions in cell biology, and particularly in spindle assembly, kinetochore function and nuclear envelope assembly. Among the Ran partners studied, NTF2 appears to be solely involved in nucleocytoplasmic transport. Here, we localised Ran and several of its partners, RanBP1, CAS and NTF2, at the nuclear membrane in the trypanosomatid Leishmania major. Remarkably, these proteins fused to GFP decorated a perinuclear 'collar' of about 15 dots, colocalising at nuclear pore complexes with the homologue of nucleoporin Sec13. In the other trypanosomatid Trypanosoma brucei, RNAi knockdown of the expression of the corresponding genes resulted in an apoptosis-like phenomenon. These phenotypes show that Ran and its partners have a key function in trypanosomatids like they have in mammals. Our data, notably those about TbNTF2 RNAi, support the idea that active nucleocytoplasmic transport is not essential for the initiation and execution of apoptosis, and, rather, the impairment of this transport constitutes an intrinsic signal for triggering PCD.

[Primary brain stem hemorrhage: retrospective study of 25 cases]

INTRODUCTION

We report a retrospective series of 25 cases of brain stem hemorrhage.

METHODS

Cases of spontaneous hemorrhage of the brain stem which were observed from 1990 to 2000 in a department of neurology were reviewed. Etiological factors, CT scan at admission, clinical signs and the course of the disease were analyzed retrospectively.

RESULTS

There were 25 patients, 14 male and 11 female aged from 24 to 91. Fifteen hematomas were related to hypertension, four to coagulation disorders and two to a vascular malformation. The hemorrhage was located in the pons in 22 cases and in the midbrain in three cases. The death rate directly related to the hemorrhage was 14/25 (12 early and two delayed deaths). Prognosis factors were the size of the hemorrhage, a ventricular bleeding, disorders of consciousness and pupillary abnormalities on admission, the need for mechanical ventilation.

CONCLUSION

In brain stem hemorrhage, the size of the hematoma is a more important prognosis factor than age or etiological factors.

LC-MSMS identification of Arabidopsis thaliana heat-stable seed proteins: enriching for LEA-type proteins by acid treatment

Protein identification in systems containing very highly abundant proteins is not always efficient and usually requires previous enrichment or fractionation steps in order to uncover minor proteins. In plant seeds, identification of late embryogenesis abundant (LEA) proteins is often masked by the presence of the large family of storage proteins. LEA-proteins are predicted to play a role in plant stress tolerance. They are highly hydrophilic proteins, generally heat-stable, and correlate with dehydration in seeds or vegetative tissues. In the present work, we analyze the protein composition of heat-stable Arabidopsis thaliana seed extracts after treatment with trichloroacetic acid (TCA). The composition of the proteins that precipitate and those that remain in solution in 3% TCA was analyzed by two different approaches: 1D SDS-PAGE coupled to LC-ESI-MSMS analysis and a gel-free protocol associated with LC-MALDI-MSMS. Our results indicate that treating total heat-soluble extracts with 3% TCA is an effective procedure to remove storage proteins by selective precipitation and this fractionation step provides a soluble fraction highly enriched in Lea-type proteins. The analysis and determination of protein identities in this acid-soluble fraction by MS technology is a suitable system for large-scale identification of Lea-proteins present in seeds.

Révélation d’une myopathie à bâtonnets par une insuffisance respiratoire de l’adulte

INTRODUCTION

We report a case of nemaline myopathy revealed in adulthood by a respiratory insufficiency.

CASE REPORT

A 26-year-old patient, without past history, was admitted with respiratory and right cardiac insufficiency which appeared in a few days. There was a severe restrictive lung impairment with nocturnal hypoventilation. Minor skeletal abnormalities and areflexia suggested a congenital myopathy. Muscle biopsy revealed a nemaline myopathy.

CONCLUSION

Respiratory insufficiency is common in nemaline myopathy with infancy or childhood onset, but very rare in adults. It may be explained by multiple mechanisms.

Une cause rare d’embolie cérébrale : la cardiopathie amyloïde

INTRODUCTION

We report a case of amyloid cardiopathy revealed by a cerebral embolism.

CASE REPORT

A 55-year-old patient was admitted with a right hemiplegia and aphasia due to an infarction in the middle cerebral artery territory. Echocardiography was suggestive of an amyloid cardiopathy, and an IgG lambda multiple myeloma with renal insufficiency was discovered. The patient died suddenly 4 months later after chemotherapy was initiated.

CONCLUSION

Embolic complications are rare and late in cardiac amyloidosis. The diagnosis may be suspected by echocardiography.

Formes tardives de myasthénie. Étude comparative avec la myasthénie du sujet jeune

INTRODUCTION

The incidence of myasthenia gravis appears to be increasing in elderly but few studies have been devoted to late onset myasthenia gravis.

PATIENTS AND METHODS

We retrospectively compared myasthenic patients with an age at onset above or below 35 years which were observed in two departments of Neurology from 1980 to 2002.

RESULTS

81 cases were included, 28 of which were late onset myasthenia gravis. The two populations were similar in terms of sex-ratio, clinical symptoms, course of the disease and therapeutic response. There was a trend for older patients to present more frequently at onset with dysphagia and axial or proximal involvement, and to have extra-ocular symptoms more quickly. Antibodies against acetylcholine receptor and striated muscle were statistically more frequent in elder patients.

CONCLUSIONS

A late onset is not a factor of poor prognosis in myasthenia gravis and older patients must be treated in the same way than younger ones.

Lymphomes malins non Hodgkiniens du système nerveux périphérique

INTRODUCTION

Identifying tumor infiltration or compression in patients with non-Hodgkin's malignant lymphoma presenting peripheral neuropathy can be a difficult task.

METHODS

We collected a series of patients with peripheral neuropathy with demonstrated lymphomatous infiltration or compression managed between October 1977 and October 2001 to search for clinico-pathological correlations.

RESULTS

Ten cases were reviewed. Neurological manifestations were the inaugural symptom of the disease in 7 patients. Clinical presentations included 5 focal (3 cranial nerve palsies, 2 brachial radiculopathies) and 5 diffuse neuropathies (3 polyradiculoneuropathies, 1 polyneuropathy and 1 mononeuritis multiplex). The mechanisms of peripheral nerve involvement were classified into lymphomatous meningoradiculitis (5 cases), involvement of cranial nerves or spinal roots in their extraneuraxial course (3 cases) and infiltration of distal peripheral nerves (2 cases). Four long lasting survivals after treatment were observed.

CONCLUSIONS

Prognosis depends much more on the haematological disease than on the neurological symptoms or tumor location.

Périartérite noueuse révélée par une artérite cérébrale

INTRODUCTION

We report a case of periarteritis nodosa revealed by a cerebral angiitis which recovered under treatment.

OBSERVATION

A 52-year-old patient suddenly presented with a left sensory syndrome and a fluctuating aphasia due to ischemia involving both parietal lobes. The diagnosis of periarteritis nodosa was based on the following criteria: severe loss of weight, renal insufficiency, hypertension, angiography suggesting an arteritis. Instead of an ileo-cecal perforation, the patient recovered under corticosteroid and immunosuppressive therapy.

CONCLUSIONS

Stroke in periarteritis nodosa may occur early be and associated with a good outcome.

Ophtalmoplégie indolore et récidivante révélatrice d’une myosite orbitaire

INTRODUCTION

We report a case of orbital myositis revealed by a relapsing and initially painless ophthalmoplegia.

CASE REPORT

A 50-year-old patient suddenly presented with an isolated palsy of the right lateral rectus muscle which recovered in 3 weeks after a short-lasting corticosteroid therapy but relapsed. Cerebral and orbital imaging were normal. Orbital pain with a fluctuating course occurred 6 months later. Two years after the clinical onset, orbital CT scan revealed a fusiform hypertrophy of the right lateral rectus muscle which was enhanced by contrast. After corticosteroid treatment, the symptoms improved and CT scan became normal.

CONCLUSION

Orbital myositis may not be ruled out in case of painless ophthalmoplegia and systematic and repeated imaging is necessary.

Hémorragie intracrânienne et phéochromocytome

INTRODUCTION

Pheochromocytoma is rarely disclosed by intracranial hemorrhage. We report two cases.

OBSERVATION

The first 26-year-old patient developed subarachnoid hemorrhage due to a ruptured aneurysm of the middle cerebral artery. The second patient, aged 44 years, had a temporal hematoma. Diagnosis was suggested in both patients by hypertension and elevated urinary catecholamines and confirmed by imaging and MIBG scintigraphy. Adrenal gland tumors, on both glands in the first patient and on the right gland in the second were successfully removed; cranial hypertension totally regressed. Von Hippel Lindau disease was diagnosed by molecular genetics in the first patient. Paroxysmal hypertension could explain the brain hemorrhage in the first patient and may have favored aneurysmal rupture in the second.

CONCLUSION

The relationships between pheochromocytoma and cerebral aneurysm are discussed.

Paralysie faciale et infection du système nerveux par le virus VZV après une varicelle de l’adulte

INTRODUCTION

VZV virus-related peripheral neuropathies usually occur after shingles in adults and more rarely after chickenpox in childhood.

CASE REPORT

A 54-year-old patient presented with a right VIIth nerve palsy following a chickenpox rash and recovered after antiviral treatment. CSF analysis revealed lymphocytic meningitis and the virus was identified by PCR.

CONCLUSIONS

Although previous chickenpox was not found in the patient's past history, the probability of reinfection is likely. The virus can be assumed to affect the nervous system directly; the axonal or demyelinating mechanism of the neuropathy may be discussed.

Neuropathie sensitive ataxiante et maladie de Lyme

INTRODUCTION

The clinical spectrum of peripheral neuropathies in Lyme disease is very wide. We report a case which was revealed by an ataxic sensory neuropathy.

OBSERVATION

A 77-year-old patient presented with a subacute ataxic sensory neuropathy which occurred 2 weeks after a skin lesion involving the right lower limb. He fully recovered after specific antibiotic treatment. EMG was suggestive of a predominantly axonal neuropathy. Diagnosis of Lyme disease was assessed by progressive elevation of serum antibodies, demonstration of a lymphocytic meningitis and intrathecal synthesis of antibodies.

CONCLUSION

Lyme disease may be added to the list of diseases which may induce subacute sensory neuropathies.

[Usefulness of tomographic computer colonography for colorectal polyp detection]

BACKGROUND AND OBJECTIVE

Colonoscopy is the procedure of choice for the diagnosis of colorectal neoplasms. CT colonography (CTC), a recently developed minimal invasive radiological technique, permits the identification of colorectal tumors. The aim of the present study was to evaluate the efficacy of CTC in the detection of colorectal polyps, and to establish the factors determining a diagnostic accuracy.

PATIENTS AND METHOD

Patients with colorectal polyps admitted for endoscopic polypectomy were included. CTC was performed prior to colonoscopy in all patients. Demographic and clinical data were registered, as well as the polyp characteristics. Efficacy of CTC was analyzed with respect to each individual polyp and each patient.

RESULTS

Colonoscopy identified 87 colorectal polyps in 30 patients. CTC had a sensitivity of 70% for the detection of polyps of any size, being 92%, 73% and 55% for polyps > or = 10 mm, 5-9 mm and < or = 4 mm, respectively. On the other hand, the sensitivity of CTC for the detection of pedunculated, semipedunculated and sessile polyps was 85%, 92% and 56%, respectively. Accuracy of CTC was associated with polyp size (p = 0.007) and shape (p = 0.007). Sensitivity and specificity of CTC for the identification of patients with polyps > or = 10 mm were 88% and 100%, respectively.

CONCLUSIONS

CTC is a highly accurate technique for the identification of colorectal polyps. Its diagnostic accuracy depends on lesion's size and shape.

[Usefulness of tomographic computer colonography for colorectal polyp detection]

BACKGROUND AND OBJECTIVE

Colonoscopy is the procedure of choice for the diagnosis of colorectal neoplasms. CT colonography (CTC), a recently developed minimal invasive radiological technique, permits the identification of colorectal tumors. The aim of the present study was to evaluate the efficacy of CTC in the detection of colorectal polyps, and to establish the factors determining a diagnostic accuracy.

PATIENTS AND METHOD

Patients with colorectal polyps admitted for endoscopic polypectomy were included. CTC was performed prior to colonoscopy in all patients. Demographic and clinical data were registered, as well as the polyp characteristics. Efficacy of CTC was analyzed with respect to each individual polyp and each patient.

RESULTS

Colonoscopy identified 87 colorectal polyps in 30 patients. CTC had a sensitivity of 70% for the detection of polyps of any size, being 92%, 73% and 55% for polyps > or = 10 mm, 5-9 mm and < or = 4 mm, respectively. On the other hand, the sensitivity of CTC for the detection of pedunculated, semipedunculated and sessile polyps was 85%, 92% and 56%, respectively. Accuracy of CTC was associated with polyp size (p = 0.007) and shape (p = 0.007). Sensitivity and specificity of CTC for the identification of patients with polyps > or = 10 mm were 88% and 100%, respectively.

CONCLUSIONS

CTC is a highly accurate technique for the identification of colorectal polyps. Its diagnostic accuracy depends on lesion's size and shape.

[Hypokalaemic paralysis as a presentation of adrenal tumor]

A 24-year-old patient presented with flaccid quadriplegia due to severe hypokaliemia, initially presumed to have been induced by glycyrrhizin. Persistence of low potassium levels and hypertension led to the diagnosis of primary hyperaldosteronism related to an adrenal cortical tumor. After surgery, the patient recovered from hypertension and hypokaliemia.

[Pituitary tumour as a presenting symptom of a systemic lymphoma]

Pituitary non Hodgkin malignant lymphomas are rare. We report a case of large cell systemic lymphoma with pituitary and meningeal localizations in a 40-year-old patient. The clinical picture was panhypopituitarism with MRI appearance of pituitary adenoma and VII and VIII cranial nerves involvement. Diagnosis was made by identification of lymphomatous cells in CSF. The patient deceased in less than one year despite chemotherapy.

[Hypertensive encephalopathy as revealing symptom of Takayasu's arteritis]

A 29-year-old patient presented with Takayasu's arteritis which was revealed by heart failure, epilepsy, right hemiparesis and fever. Transient abnormalities of MRI and CSF (raised protein and cell content) were initially observed. The hypothesis of a hypertensive encephalopathy is suggested.

[Recurrent acute polyneuropathy and cutaneous vasculitis]

A patient with relapsing cutaneous vasculitis presented 3 times in 10 years with an acute extensive neuropathy and respiratory failure which fully recovered. The relationships between Guillain-Barré syndrome and vasculitis are discussed.

[Continuous nodal reciprocal rhythm and Steinert's disease: treatment by double chamber stimulation. A case report]

We report a case of continuous supraventricular tachycardia in a patient affected by Steinert's myotonic dystrophy. The investigation of this tachycardia showed that there was a "slow-fast" common nodal re-entry, rendered continuous by the existence of significant conduction defects in the fast pathway and the slow anterograde pathway. Implantation of a double chamber cardiac stimulator, necessary for conduction defects present in the basal state in this patient allowed, with the evolution of the conduction defects, the complete eradication of reciprocal rhythm entry, without resorting to ablation.

[Cerebral hemorrhage due to a ruptured mycotic aneurysm. Two cases]

INTRODUCTION

Cerebral hemorrhages due to rupture of mycotic aneurysms are rare but severe complications of infective endocarditis. We report two cases with a good outcome.

EXEGESIS

The first patient presented with a parieto-occipital hematoma which occurred in the course of a relapsing infective endocarditis due to Streptococcus mitis. She fully recovered after neurosurgical treatment. In the second case, a right frontal hematoma revealed two mycotic aneurysms and an infective endocarditis due to Streptococcus gordonii. Motor weakness partially recovered after antibiotic therapy and angiography demonstrated complete resolution of aneurysms.

CONCLUSION

Ruptured mycotic aneurysms are poor prognosis factors in infective endocarditis. Adapted antibiotic therapy is the first-intent treatment. Neurosurgery is indicated when hematomas are poorly tolerated and in cases requiring anticoagulant therapy.

Distinctive features of plant protein kinase CK2

In plants, protein kinase CK2 is involved in different processes that control many aspects of metabolism and development. In mammals and yeast the enzyme is a heterotetramer composed of two types of subunits. During years the subunit composition of the maize protein kinase CK2 enzyme has been a source of controversy. We have recently characterized the maize holoenzyme subunits. Our results show that multiple catalytic and regulatory subunits are expressed in maize and are able to specifically interact with other alpha and beta subunits suggesting a high level of heterogeneity in the typical heterotetrameric structure. Here, we summarize data available on plant CK2 enzymes, in order to clarify the distinctive features and functions of plant protein kinase CK2.

Effect of large targeted deletions on the mitotic stability of an extra chromosome mediating drug resistance in Leishmania

A mitotically stable linear extra chromosome obtained in a Leishmania donovani strain rendered mycophenolic acid-resistant has been physically mapped. This 290-kb chromosome has an inverted duplicated structure around a central inversion region, and is derived from a conservative amplification event of a approximately 140-kb subtelomeric end of chromosome 19. Large-sized targeted deletions of the central region were performed through homologous recombination using three specific transfection vectors. The size of the extra chromosome was thus successfully reduced from 290 to 260, 200 and 120 kb respectively. The mitotic stability of these chromosomes was then analysed in drug-free cultures over >140 days. Results differed according to the deletion created. By contrast with the smallest deletion the two largest deletions altered mitotic stability, leading to progressive loss of the size-reduced chromosomes with similar kinetics in both mutants. The 30-kb region common to both deletions may therefore be considered as involved in mitotic stability. A 44-kb contig covering this region could be assembled and sequenced. The analysis of this sequence did not reveal any sequence elements typical of centromeric DNA. By contrast, its enrichment in homopolymer tracts suggests that this region might contain an origin of replication.

Identification of differentially expressed genes by the cDNA-AFLP technique during dehydration of almond (Prunus amygdalus)

We analyzed several genes that were strongly expressed in response to dehydration of almond (Prunus amygdalus (L.) Batsch) as a means of identifying and determining the genetic basis of mechanisms involved in drought tolerance. The advantages of using almond as a model system for studying dehydration tolerance in woody species include its small diploid genome and its adaptation to drought. We used the differential expression technique cDNA-AFLP (amplified restriction fragment polymorphism derived technique for RNA fingerprinting) to identify transcripts that accumulated in mature embryos and in in-vitro-cultured plantlets subjected to desiccation or abscisic acid (ABA) treatment. The reverse northern approach was used to differentiate between true differential bands and false positives. Some of the predicted polypeptides exhibited similarity to published protein sequences, including a transporter of nitrogenous compounds, a 1-acyl-sn-glycerol-3-phosphate acyl transferase, a low molecular weight heat shock protein, a cysteine proteinase and a constitutively expressed proline-rich protein. We also compared the levels of expression of the identified genes in leaves of young trees of eight almond cultivars differing in drought tolerance.

[Acute onset syringomyelia: two cases]

Two cases of acute presentation of cervical syringomyelia associated with Chiari malformation are reported. In the first case, dysphagia was the main symptom; the second patient had symptoms suggesting acute brain stem ischemia. The mechanism of this acute onset of the illness is discussed.

Role of AP2/EREBP transcription factors in gene regulation during abiotic stress

Crop plants are exposed to many types of abiotic stress during their life cycle. Water deficit derived from drought, low temperature or high salt concentration in the soil, is one of the most common environmental stresses that affects growth and development of plants through alterations in metabolism and gene expression. Adaptation to these conditions may involve passive tolerance or active homeostatic mechanisms for maintaining water balance. Active responses occur at different levels in the plant and may represent a concomitant protection against other types of stress such as pathogen attack. Many morphological and physiological adaptations to water stress are under the control of the plant hormone abscisic acid and involve specific activation of target genes that in one way or another protect cells against water deficit or participate in the regulation of the drought response. Here, we discuss recent advances in our understanding of drought adaptation mediated by specific changes in gene expression and the role of AP2/EREBP nuclear factors in these processes.

Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma

Radiofrequency (RF) ablation is an alternative to percutaneous ethanol injection (PEI) for single nonsurgical hepatocellular carcinoma (HCC) and is currently used as adjuvant therapy before liver transplantation. This phase II study assesses the treatment-related complications and response rate of RF for the treatment of single HCC < or = 5 cm. Percutaneous RF was performed under conscious sedation and ultrasound (US) guidance with an electrical generator connected to a single cooled-tip electrode. Neoplastic cells in peripheral blood (reverse transcription-polymerase chain reaction for alpha fetoprotein [AFP] messenger RNA) were analyzed before and after RF. Treatment response was assessed by spiral computed tomography (CT) at 1 month and every 3 months by US or spiral CT thereafter. Thirty-two patients (20 men; age 67 +/- 4 years; 78% hepatitis C virus; 24 Child-Pugh A) with a mean tumor size of 2.8 cm (25 patients < or = 3 cm) were treated by RF (1.25 sessions; mean time, 22.1 +/- 2 minutes). Adjuvant PEI was performed in 9 cases. Complete response was achieved in 21 patients (65%), being significantly higher for HCC < or = 3 cm (76% vs. 29%, P = .03). After a median follow-up of 10 months, 8 patients showed treatment-related morbidity. Four of them (12.5%) showed biopsy-proven needle-track seeding detected between 4 to 18 months. Neoplastic seeding was related to subcapsular location (P = .009), poor differentiation degree (P = .02), and baseline AFP levels (P = .02). Thus, RF ablation with cooled-tip needle for HCC is associated with a high risk of neoplastic seeding. Iatrogenic dissemination was related to subcapsular location or an invasive tumoral pattern, and has to be considered when selecting curative treatments for HCC or adjuvant therapies before liver transplantation.

[Arterial thrombolysis and angioplasty in atheromatous basilar artery occlusion]

Basilar occlusions treated with conventional therapy (anticoagulants or antiplatelets) have a poor outcome (80p. cent mortality). This unfavorable outcome may require a treatment within 6 hours by intra-arterial thrombolysis, sometimes followed by percutaneous transluminal angioplasty (PTA) in case of atherothrombotic occlusion due to a tight atherosclerotic stenosis. A 48 year-old patient, presented with left hemiparesis, left multimodal hypoesthesia, paralytic dysarthria. CT-scan showed a spontaneous hyperdensity of the basilar artery and arterial occclusion was confirmed by angiography, which showed an atherothrombotic occlusion involving the proximal part of the vessel. Intra-arterial thrombolysis began five hours after the onset with 0,25mg/kg of Rt-Pa (Actilyse((R))), given by bolus followed by 4 others bolus of 10mg. After a total dose of 60mg, arterial recanalization was obtained showing a tight atherosclerotic stenosis involving the proximal part of the basilar artery. PTA was performed 18 hours later with a ballon inflation at 6 atmospheres during 20 seconds. It allowed to decrease the stenosis from 80p. cent to 60p. cent. The patient recovered and MRI at D20 showed a small right lateral infarct involving the pons. Our study confirms the usefulness of intra-arterial thrombolysis in basilar artery occlusion. Consecutive PTA may be proposed in case of associated atherosclerotic stenosis, and the interest of PTA is further discussed.

[Benign acute ataxia in an adult with VZV infection]

In adults, neurological complications of VZV virus usually occur after herpes zoster infection in patients with AIDS. We report a case of acute and benign cerebellar ataxia after chickenpox in a patient without immunodeficiency.