Beyond sense-specific processing: decoding texture in the brain from touch and sonified movement

Texture, a fundamental object attribute, is perceived through multisensory information including touch and auditory cues. Coherent perceptions may rely on shared texture representations across different senses in the brain. To test this hypothesis, we delivered haptic textures coupled with a sound synthesizer to generate real-time textural sounds. Participants completed roughness estimation tasks with haptic, auditory, or bimodal cues in an MRI scanner. Somatosensory, auditory, and visual cortices were all activated during haptic and auditory exploration, challenging the traditional view that primary sensory cortices are sense-specific. Furthermore, audio-tactile integration was found in secondary somatosensory (S2) and primary auditory cortices. Multivariate analyses revealed shared spatial activity patterns in primary motor and somatosensory cortices, for discriminating texture across both modalities. This study indicates that primary areas and S2 have a versatile representation of multisensory textures, which has significant implications for how the brain processes multisensory cues to interact more efficiently with our environment.

[IHC, FISH, CISH, NGS in non-small cell lung cancer: What changes in the biomarker era?]

Lung cancer is the leading cause of cancer deaths in France, with about 30,000 deaths per year. The overwhelming majority (90 %) are tobacco-related. The prognosis is dark but great therapeutic advances have been made with the development of targeted therapies first and then immunotherapy afterwards. These medications are conditioned to the expression of biomarkers that require specific tools in routine to measure them. We will detail in this chapter several techniques of anatomopathology, cytogenetics and molecular biology necessary for the detection of biomarkers in lung cancers, and their applications in thoracic oncology in 2018.

[Bronchoscopic treatment of bronchopleural fistula]

Bronchopleural fistula is an uncommon complication occurring especially following lung resection (pneumonectomy) and associated with high morbidity and mortality rates. The treatment is surgical but some studies reported bronchoscopic treatment. Localization and size of the fistula may indicate different endoscopic procedures. This overview described the different endoscopic procedures and their benefits.

Plasma Levels of Free and Total TFPI, Relationship with Cardiovascular Risk Factors and Endothelial Cell Markers

Free-TFPI (f-TFPI) presents high anticoagulant activity and its plasma level correlates with unfavorable outcomes in unstable angina. Total TFPI (t-TFPI) represents mainly the lipid-bound form which seems to have a poor anticoagulant activity. Until now, it is not known whether the variations of f-TFPI plasma levels are determined by environmental factors. The aim of our study was to evaluate the influence of cardiovascular risk factors on plasma levels of f-TFPI and relations with other endothelial derived molecules in a population of 626 patients (277 men and 349 women) attending a metabolic ward for primary prevention of coronary disease.

Free and total TFPI plasma levels were poorly correlated. f-TFPI levels increased with age in both sexes, t-TFPI in women only. Ageadjusted correlations of TFPI levels with conventional cardiovascular risk factors and endothelial cell markers showed different patterns for f-TFPI and t-TFPI. f-TFPI correlated with parameters associated with insulin resistance, particularly in females. f-TFPI was also positively associated in both genders with fibrinogen and endothelial cell markers: t-PA, thrombomodulin (TM) and von Willebrand factor (vWF). t-TFPI correlated strongly with LDL-C in both sexes. It also correlated negatively with parameters of the insulin resistance syndrome. t-TFPI also correlated with TM but not with other endothelial cell markers. The results of the multivariate step by step analysis showed that cardiovascular risk factors poorly explained the f-TFPI variability (7% and 4% in men and women, respectively), whereas they explained 16 and 20% of t-TFPI variability in men and women respectively (mostly related to LDL-C).

In conclusion, this study showed that free- and total-TFPI are regulated differently. f-TFPI strongly correlates with endothelial cell markers and t-TFPI is more related to conventional cardiovascular risk factors. The strong gender effect on f-TFPI levels remains to be explained.

Cluster randomized trial to evaluate the impact of team training on surgical outcomes

Background

The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation.

Methods

A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization. The primary outcome measure was the occurrence of any major adverse event, including death, during the hospital stay within the first 30 days after surgery. Using a difference-in-difference approach, the ratio of the odds ratios (ROR) was estimated to compare changes in surgical outcomes between intervention and control hospitals.

Results

Some 22 779 patients were enrolled, including 5934 before and 16 845 after team training implementation. The risk of major adverse events fell from 8·8 to 5·5 per cent in 16 intervention hospitals (adjusted odds ratio 0·57, 95 per cent c.i. 0·48 to 0·68; P < 0·001) and from 7·9 to 5·4 per cent in 15 control hospitals (odds ratio 0·64, 0·50 to 0·81; P < 0·001), resulting in the absence of difference between arms (ROR 0·90, 95 per cent c.i. 0·67 to 1·21; P = 0·474). Outcome trends revealed significant improvements among ten institutions, equally distributed across intervention and control hospitals.

Conclusion

Surgical outcomes improved substantially, with no difference between trial arms. Successful implementation of an aviation-based team training programme appears to require modification and adaptation of its principles in the context of the the surgical milieu. Registration number: NCT01384474 (http://www.clinicaltrials.gov).

Perspectives on heterococcolith geochemical proxies based on high-resolution X-ray fluorescence mapping

Heterococcoliths are micron-scale calcite platelets produced by coccolithophores. They have been the most abundant and continuous fossil record over the last 215 million years (Myr), offering great potential for geochemical studies, although the heterococcolith fossil record remains underutilised in this domain. We have mapped heterococcoliths' composition using X-ray fluorescence (XRF) with a 100-nm resolution beam to decipher element distributions in heterococcoliths and to investigate the potential development of geochemical proxies for palaeoceanography. The study presents two Middle Jurassic Watznaueria britannica heterococcoliths from Cabo Mondego, Portugal. XRF analysis was performed with a 17 keV incident energy beam at the European Synchrotron Radiation Facility ID22NI beamline to study elements from Sr down to S. Ca, Sr and Mn are distributed following the heterococcolith crystalline arrangement. Cl, Br and S display an homogeneous distribution, whereas K, Fe, Cu, Zn and Rb are concentrated at the edges and in the central area of the heterococcoliths. Distributions of K, Fe, Ti, Fe, Cu, Zn, Rb and to a lesser extent V and Cr are highly influenced by clay contamination and peripheral diagenetic overgrowth. Mn is related to diagenetic Mn-rich CaCO3 overgrowth on top of or between heterococcoliths shields. Cl and Br are likely to be present in heterococcoliths inside interstitial nano-domains. We assume that the cytoplasm [Cl(-) ] and [Br(-) ] are mediated and constant during heterococcolithogenesis. Assuming a linear correlation between cytoplasm [Cl(-) ] and sea water [Cl(-) ], heterococcolith Cl may have potential as a salinity proxy. As S is incorporated into heterococcoliths by sulphated polysaccharides, our study suggests a role for such polysaccharides in heterococcolithogenesis for at least 170 Myr. The low Sr/Ca in the W. britannica specimens studied here may either highlight an unusual cellular physiology of Mesozoic coccolithophores or result from low growth rates in oligotrophic environments.

Detection of multiple mycotoxin occurrences in soy animal feed by traditional mycological identification combined with molecular species identification

Soy products are a main component of animal feed. Because mycotoxins may harm farm animals, undermining productivity and health, a mycological and toxigenic screening was carried out on 36 batches used in animal feed, collected in 2008, 2009 and 2010 in Italy. The investigated mycoflora of a subset of soy seed (n = 6) suggested that Aspergillus spp. and Fusarium spp. frequently colonize soy seeds. Aflatoxins, fumonisins and deoxynivalenol were detected in 88.9%, 72.2% and 30.6% of samples, respectively. Co-occurrence of at least two toxins was observed in 72% of cases. The molecular analysis of the Fusarium spp. population identified Fusarium verticillioides as potential producers of fumonisins, but no known deoxynivalenol producers were detected. It is suggested that the widespread presence of toxins can be due to non-optimal storing conditions of the feed. Moreover, our results suggest that mycotoxin thresholds should be adapted to consider the frequent case of toxin co-occurrence. This approach would better reflect the real toxigenic risk of feedstuffs.

Modeling and Compensation of the Internal Friction Torque of a Travelling Wave Ultrasonic Motor

This paper deals with the control and experimentation of a one-degree-of-freedom haptic stick, actuated by a travelling wave ultrasonic motor. This type of actuator has many interesting properties such as low-speed operation capabilities and a high torque-to-weight ratio, making it appropriate for haptic applications. However, the motor used in this application displays nonlinear behavior due to the necessary contact between its rotor and stator. Moreover, due to its energy conversion process, the torque applied to the end-effector is not a straightforward function of the supply current or voltage. This is why a force-feedback control strategy is presented, which includes an online parameter estimator. Experimental runs are then presented to examine the fidelity of the interface.

Total hip arthroplasty offset measurement: is C T scan the most accurate option?

BACKGROUND

Femoral offset is difficult to precisely evaluate with conventional X-ray techniques. Femoral offset characterizes the balance between body weight and the resistance provided by the abductor muscles. Total hip arthroplasties should respect this balance.

HYPOTHESIS

Computed tomodensitometry (CT-scan) is more accurate than conventional X-ray to evaluate femoral offset.

MATERIALS AND METHODS

Sixty-one patients who received unilateral total hip arthroplasties were prospectively included in the study. Femoral offset was measured by three-dimensional CT-scan reconstruction using the "Hip Plan" (Symbios) software. Offset was also determined with conventional X-ray and results were compared. This software can be used to measure leg length by frontal telemetry. It was developed for preoperative-planning of cementless femoral stem implants with modular necks of various lengths and angles. All pre- and postoperative measurements were made according to the same protocol.

RESULTS

Femoral offset values in this study were very similar to anatomical values found in the literature. They were significantly higher than values obtained by conventional X-ray by an average of 8%. Implantation of hip replacements resulted in a significant increase in offset (1.88+/-4.71 mm) with a slight variation in leg length. Pre- and postoperative leg length increased slightly in the operated leg by an average of 1.66+/-5.63 mm. Seventeen percent of these femurs had high offset associated with small or average sized proximal medullary canals. This preoperative planning software made it possible to identify these difficulties and to adapt implant components using modular long 8 degrees varus necks to restore high offset. In most of these cases, only small femoral stems could be implanted because of the small size of the intramedullary femoral canal. These individual differences were identified with 3D CT-scan reconstruction and included in the preoperative planning. Moreover, leg length could also be evaluated with this method and included in the preplanning.

DISCUSSION

Compared to conventional X-ray, measurements obtained with this preoperative planning method using 3D CT-scan reconstruction are easy to obtain and not dependent upon test conditions because the frame is placed on the femoral axis. Measurements are not influenced by position inconsistencies or if the hip is fixed in external rotation. The significant number of cases with above average offset confirms the importance of obtaining these measurements and the necessity of adapting the strategy in these cases by using lateralized stems, or, as in our series, modular necks to adjust femoral offset and neck angle.

LEVEL OF EVIDENCE

Level III diagnostic prospective study.

Chronic lateral ankle instability surgical repairs: the long term prospective

The present study sought to assess the clinical and radiological results and long-term joint impact of different techniques of lateral ankle ligament reconstruction.

MATERIAL AND METHODS

A multicenter retrospective review was performed on 310 lateral ankle ligament reconstructions, with a mean 13-year-follow-up (minimum FU: 5 years). Male subjects (53%) and sports trauma (78%) predominated. Mean duration of instability was 92 months; mean age at surgery was 28 years. Twenty-eight percent of cases showed subtalar joint involvement. Four classes of surgical technique were distinguished: C1, direct capsular ligamentous complex reattachment; C2, augmented repair; C3, ligamentoplasty using part of the peroneus brevis tendon and C4, ligamentoplasty using the whole peroneus brevis tendon. Clinical and functional assessment used Karlsson and Good-Jones-Livingstone scores; radiologic assessment combined centered AP and lateral views, hindfoot weight-bearing Méary views and dynamic views (manual technique, Telos or self-imposed varus).

RESULTS

The majority of results (92%) were satisfactory. The mean Karlsson score of 90 [19-100] (i.e., 87% good and very good results) correlated with the subjective assessment, and did not evolve over time. Postoperative complications (20%), particularly when neurologic, were associated with poorer results. Control X-ray confirmed the very minor progression in degenerative changes, with improved stability; there was, however, no correlation between functional result and residual laxity on X-ray. Unstable and painful ankles showed poorer clinical results and more secondary osteoarthritis. Analysis by class of technique found poorer results in C4-type plasties and poorer control of laxity on X-ray in C1-type tension restoration.

DISCUSSION

The present results confirm the interest of lateral ankle ligamentoplasty in the management of instability and protection against secondary osteoarthritis, and of precise lesion assessment (CT-scan/MRI) to adapt surgery to the ligamentary and associated lesions.

LEVEL OF EVIDENCE

Level IV. Retrospective therapeutic study.

[Arterial and venous thrombosis in lung cancer]

We report the case of a 61-year old man in whom a deep venous thrombosis was the presenting feature of disseminated lung carcinoma. A few days later, an arterial thrombosis occurred necessitating amputation. Within a few weeks, the lung cancer progressed dramatically and the patient died. While the association between venous thrombosis and cancer is well known, the relationship between cancer and arterial thrombosis has been less explored. This observation allows discussion of the pathophysiological and clinical aspects of this association, as well as the implications for patient care.

[Bronchial carcinoma and actinomycosis: a dangerous trap]

A 60 year old male patient was admitted to hospital with pulmonary and cerebral abscesses. A percutaneous lung biopsy under CT scanning showed actinomycosis. After 4 weeks antibiotic therapy with ceftriaxone and metronidazole there was an improvement in the pulmonary lesion but new cerebral lesions appeared. A neurosurgical cerebral biopsy showed evidence of metastatic squamous carcinoma, probably of pulmonary origin. The diagnosis had been delayed by the presence of the actinomycosis. His general condition did not permit anti-tumour treatment and the patient soon afterwards. In the presence of pulmonary actinomycosis an associated malignancy should be excluded.

Genetic Fusarium chemotyping as a useful tool for predicting nivalenol contamination in winter wheat

Fusarium graminearum [teleomorph Gibberella zeae] and Fusarium culmorum together with Fusarium poae are the main species known to produce nivalenol (NIV). The NIV content in wheat (Triticum aestivum L.) harvested in Luxembourg was investigated in 2007 and 2008 at 17 different locations. Species determination and genetic chemotyping of F. graminearum and F. culmorum were used to understand the spatial distribution of NIV producers in wheat from Luxembourg. Three hundred thirteen F. graminearum, 175 F. culmorum and 117 F. poae strains respectively were isolated. Chemotypes of the first two species were determined by PCR and confirmed on a sub-sample of single isolates by LC-MS/MS analysis. The 15-acetylated DON chemotype of F. graminearum was dominant in both years representing 94.2% of the population while the NIV chemotype represented 5.8%. The F. culmorum chemotypes were rather evenly distributed, with 3-acetylated DON and NIV profiles present with similar abundances (53.2% and 46.8%, respectively). NIV presence in wheat flour obtained from the 17 sites was correlated with the number of F. culmorum (NIV chemotype) isolated from 100 seeds, suggesting its primary role in NIV production on grains. The predictive power for identifying NIV contamination in grains based on NIV chemotype presence was confirmed by coupling the isolation procedure with a cut-off value, resulting in the successful identification (100%, p=0.008) of NIV contamination in grains collected from 9 additional experimental sites. In conclusion, the results highlight the importance of chemotyping for improved prediction of toxin contamination in wheat.

First Report of the Nivalenol Chemotype of Fusarium graminearum Causing Head Blight of Wheat in the Grand Duchy of Luxembourg

Head blight caused by Fusarium graminearum is one of the major diseases of wheat (Triticum aestivum L.) in Luxembourg (2) and there is concern for mycotoxins in diseased grain. Isolates of F. graminearum have been assigned to chemotypes based on the particular toxins produced. Ten wheat fields representing different topoclimatological areas of Luxembourg were surveyed in 2007 and 2008 to determine the frequency and distribution of chemotypes. Partially blighted wheat heads were collected, and diseased grains were plated on Fusarium-selective agar (dichloran-chloramphenicol-peptone) for 12 days at 22 ± 2°C with a 12-h light period. Monoconidial isolates of F. graminearum (79 in 2007 and 85 in 2008) were obtained by conidia dilution on 2% water agar and needle selection under a microscope. F. graminearum isolates showed rapid growth on potato dextrose agar, dense aerial mycelium with red pigment deposits in the plate, macroconidia with five to six defined septa, and a basal cell with the typical foot shape. Microconidia were absent. To confirm species identification, a PCR reaction was carried out using the F. graminearum species-specific primers Fg16F (5'-CTCCGGATATGTTGCGTCAA-3') and Fg16R (5'-GGTAGGTATCCGACATGGCAA-3') according to Demeke et al. (1). Chemotype of each isolate was determined according to Ward et al. (4). In particular, PCR primer 12CON (5' CATGAGCATGGTGATGTC-3') coupled with primer 12NF (5'-TCTCCTCGTTGTATCTGG-3') and primer 3CON (5'-TGGCAAAGACTGGTTCAC-3') coupled with primer 3NA (5'-GTGCACAGAATATACGAGC-3') identified the nivalenol chemotype, primer 12CON coupled with primer 12-15F (5'-TACAGCGGTCGCAACTTC-3') and primer 3CON coupled with primer 3D15A (5'-ACTGACCCAAGCTGCCATC-3') identified the 15-acetylated deoxynivalenol (DON) chemotype, while primer 12CON coupled with primer 12-3F (5'-CTTTGGCAAGCCCGTGCA-3') and primer 3CON coupled with primer 3D3A (5'-CGCATTGGCTAACACATG-3') identified 3-acetylated DON chemotype. Reactions were repeated two times and positive controls (provided by Kerry O'Donnell, NRRL collection, Peoria, IL) and a negative control (water) were used in each reaction. Frequency of the nivalenol chemotype was found to be 2.5% in 2007 and 1% in 2008. Interestingly, the nivalenol chemotype was absent in southern Luxembourg. According to this finding, nivalenol was likely to be present at low levels in grain from Reisdorf and Echternach in 2007 (central Luxembourg) and in 2008 from grain of Troisvierges (northern Luxembourg). The remaining isolates in both years belonged to the 15-acetylated DON chemotype and the 3-acetylated DON chemotype was not detected. Compared with a previous report from the Netherlands (3), the nivalenol chemotype in Luxembourg is less frequent and widespread. To our knowledge, this is the first report of the nivalenol chemotype of F. graminearum causing head blight on wheat in Luxembourg. References:(1) T. Demeke et al. Int. J. Food Microbiol. 103:271, 2005. (2) F. Giraud et al. Plant Dis. 92:1587, 2008. (3) C. Waalwijk et al. Eur. J. Plant Pathol. 109:743, 2003. (4) T. J. Ward et al. Fung. Genet. Biol. 45:473, 2008.

First Report of Wheat Leaf Rust in the Grand Duchy of Luxembourg and the Progress of its Appearance over the 2003-2008 Period

Wheat leaf rust caused by Puccinia triticina Eriks. was identified for the first time in 2000 in the Grand Duchy of Luxembourg on the basis of orange-to-brown, round-to-ovoid, erumpent uredinia (1 to 1.5 mm in diameter) scattered on the upper and lower leaf surfaces and producing orange-brown urediniospores that are subgloboid, approximately 20 μm in diameter, and with up to eight germ pore scattered in thick, echinulate walls. In a second phase, wheat was monitored weekly (starting from Zadoks growth stage 30, pseudo stem erection) during the 2003-2008 cropping seasons for wheat leaf rust. Disease severity (percentage of leaf area with symptoms) was recorded in four, replicated field experiments located in three villages (Diekirch District: Reuler; and Grevenmacher District: Burmerange and Christnach), which are representative of the different agroclimatological zones of Luxembourg. A significant difference in severity was observed between the sites (P < 0.01) and the years (P < 0.05). Over the 6-year period, Burmerange and Reuler consistently showed the highest and lowest disease severity, respectively. In 2003 and 2007, Burmerange (a southern site with the highest average spring temperatures of 13.6 and 14.0°C, respectively) showed the highest disease severity with 66 and 57%, respectively, whereas the lowest severity (<1% for both years) was observed in the north at Reuler (site with the lowest average spring temperatures of 12.0 and 12.4°C, respectively). Christnach, located midway between Reuler and Burmerange, showed an intermediate disease severity with 7% (2003) and 22% (2007). The disease appeared at growth stages 77 (late milk) and 87 (hard dough) in the period 2003-2005, but at an earlier stage (45, boots swollen) for 2006-2008 (P < 0.001). In 2005, low severity was recorded due to a severe drought during May, June, and July. A reason for this earlier appearance of leaf rust occurrences in the two districts may be related to an increase in the average spring temperature (average March to May temperature for Luxembourg was 8.3°C for the 1971-2000 period, 9.5°C for the 2003-2005 period, 9.9°C for the 2006-2008 period, 2007 was exceptional with 11.9°C, P < 0.01). In the past, cereal disease management strategies were oriented toward the control of predominant and yield-reducing diseases such as that caused by Septoria tritici Desm. Because the succession of mild winters and warm springs during the last 5 years allowed the early occurrence and the fast development of wheat leaf rust in the Grand Duchy of Luxembourg, it is advisable to take this disease into account in fungicide application schemes.

First Report of Fusarium Head Blight on Winter Wheat in the Grand Duchy of Luxembourg

Following a comparatively mild winter (1.9°C above average [2000-2007]), Fusarium head blight (FHB) on winter wheat was observed during the 2007 season in 17 sites representing all three districts of Diekirch, Grevenmacher, and Luxembourg. The cultivars encountered were diverse and included Achat, Akteur, Aron, Bussard, Cubus, Enorm, Exclusiv, Flair, Rosario, Tommi, and Urban. The preceding crops were maize (six sites), rapeseed (three sites), and one site each of pea, triticale, winter barley, and winter wheat. Rainfalls recorded during the flowering period (June 1-23, mean June 12 for GS 65) ranged from 13 to 62 (mean 38) mm. An overall prevalence of FHB (percentage of infected spikes) of 8.9 ± 15.5% (mean ± SD) and a severity (percentage of infected grains per spike) of 21.0 ± 17.8% were recorded. A significant difference in FHB severity was observed between the cantons north and south of Luxembourg City, 13.4 ± 13.1% (range 0.01 to 46.4) and 35.1 ± 18.1% (range 6.2 to 61.9), respectively (Man-Whitney, P = 0.027), indicating the importance to take regional specificities such as topoclimatological aspects into account. Maize as a preceding crop resulted in significant higher prevalence of FHB as opposed to the other crops (5.9 ± 1.6% versus 3.3 ± 2.2%, Man-Whitney, P = 0.022).

[Pericarditis: a giant cell arteritis manifestation]

INTRODUCTION

Temporal arteritis is a vasculitis in which inflammatory manifestations mainly involve the external carotid artery area but not exclusively. Through a clinical observation and a review of the literature, we suggest that inflammatory pericarditis could represent a manifestation of temporal arteritis.

EXEGESIS

A 75-year-old-woman was admitted for progressive physical deterioration which had been evolving for three months, associated with fever, frontotemporal cephalalgia and severe biological inflammatory syndrome. Chest X-ray reveals a cardiomegaly and suggests a pericarditis, which was rapidly confirmed by echocardiogram. Temporal artery biopsy concludes to the diagnosis of a giant cell arteritis. Steroids treatment is prescribed, leading to a rapid regression of the inflammatory state and the pericarditis without relapse after 6 months of follow-up.

CONCLUSION

Only prospective studies on systematic echocardiography when faced with the diagnosis of giant cell arteritis, whatever clinical symptoms, will enable to appreciate the prevalence and prognosis value of this manifestation. Moreover, temporal artery analysis seems to be justified when faced with a sub-acute or chronic "idiopathic" inflammatory pericarditis occurring in the elderly patient. Physiopathogeny is unknown but some hypothesis can be proposed: inflammatory cytokines storm, immune complexes deposition, giant cell vasculitis of pericardial arteries or inflammatory interstitial lesion of the pericardium with or without granuloma.

Positionnement de la cupule d’une prothèse totale de hanche par navigation sans image basée sur la cinématique articulaire

PURPOSE OF THE STUDY

Most navigation systems for computer-assisted total hip arthroplasty (THA) require prior computed tomography (CT) or acquisition of multiple bone landmarks on the pelvis. In order to avoid these problems, we developed a computer-assisted navigation system without CT based on a kinematic approach to the hip joint. The principle is to orient the cup in relation to the cone describing the hip joint range of motion. The purpose of this work was to analyze preliminary results.

MATERIAL AND METHODS

Eighteen primary THA were implanted with the system (16 women, two men, mean age 68 +/- 7.8 years, age range 54-83 years, 18 degenerative hip disease). Two optoelectronic captors were fixed percutaneously on the pelvis and the distal femur. The acetabulum was prepared first followed by the femur using reamers and broaches of increasing size. The last broach placed in the femur was equipped with a large head adapted to the newly prepared acetabulum. The range of hip motion was recorded to determine the maximal range of motion cone. The acetabular cup was thus positioned in order the prosthesis range of motion included entirely the maximal range of motion of the hip joint.

RESULTS

One patient fell three weeks after implantation causing posterior dislocation; there was no recurrence. The Postel-Merle-d'Aubligné score improved from 8 +/- 2.9 (range 3-12) preoperatively to 17 +/- 0.8 (range 16-18) at last follow-up. None of the patients complained about the captor insertion and there were no cases of hematoma or fracture. Operative time was 35-40 minutes longer for the first four cases and was progressively reduced 15-20 minutes for the last four cases. Mean leg length discrepancy was 5.6 +/- 7.5 mm (range 0-25) before implantation and 0.6 +/- 3 mm (range -5 to 10 mm) at last follow-up. CT-scan measurements revealed a mean anteversion of the femoral implant of 18.2 +/- 8.5 degrees (range 0-31). Anatomic anteversion of the cup (measured from the pelvis landmark and thus independently of the position of the pelvis) was 24.7 +/- 8.8 degrees (range 12-40). The sum of the femoral and anatomic acetabular anteversions was 43 +/- 13.1 degrees (range 22-71). Anteversions were 16 degrees for the cup and 16 degrees for the stem for the one case of dislocation.

CONCLUSION

This method can be used in routine without lengthening operative time significantly. It safely controls leg length and helps position the cup. This study demonstrated that there is no ideal position for the cup which can be used for all patients. Because of the wide range of inclination and anteversion figures, half of the cases were outside the safety zone recommended by Lewinnek.

A 3D-QSAR CoMSIA study on 3-azolylmethylindoles as anti-leishmanial agents

A three-dimensional quantitative structure-activity relationship (3D-QSAR) study using Comparative Molecular Similarity Indices Analysis (CoMSIA) was conducted on a series of 3-azolylmethylindoles as anti-leishmanial agents. Evaluation of 24 compounds synthesized in our laboratory served to establish the model. A random search was performed on the library of compounds, and molecules of the training set were aligned on common elements of template molecule 13, one of the most active compounds. The best predictions were obtained from multifit procedure with a CoMSIA model combining steric, electrostatic, hydrophobic and hydrogen bond acceptor fields (q2 = 0.594, r2 = 0.897). The model was validated using an external test set of 7 compounds giving a satisfactory predictive r2 value of 0.649. Information obtained from CoMSIA contour maps could be used for further design of more promising inhibitors.

ATP-induced apoptosis of thymocytes is mediated by activation of P2 X 7 receptor and involves de novo ceramide synthesis and mitochondria

Thymocytes were reported to undergo apoptosis in the presence of extracellular ATP through the activation of the purinergic receptors P2 X 1R, P2 X 7R or both. We investigated the identity of the P2 X R and the signaling pathways involved in ATP-mediated apoptosis. Apoptosis elicited by ATP was prevented by inhibition of P2 X 7R, or in thymocytes bearing a mutated P2 X 7R, and reproduced with a P2 X 7R agonist, but not with a P2 X 1R agonist. Stimulation of thymocytes with either ATP or a P2 X 7R agonist was found to stimulate a late de novo ceramide synthesis and mitochondrial alterations. Inhibition of either processes attenuated apoptosis. Interestingly, stimulation with either ATP or a P2 X 1R agonist induced an early ceramide accumulation and a weak caspases-3/7 activation that did not lead to apoptosis. In conclusion, de novo ceramide generation and mitochondrial alterations, both resulting from P2 X 7R activation, were implicated in ATP-induced thymocyte apoptosis.

Bilan hydrologique d'un marais littoral à vocation agricole : Le marais de Moëze (Charente-Maritime, France)

En France, les sécheresses consécutives des années 1985, 1986, 1989 et 1990 ont mis en lumière les problèmes relatifs à l'alimentation en eau potable, l'irrigation des terres agricoles et la préservation des écosystèmes aquatiques. Dans le cas des zones humides, continentales et littorales, caractérisées par une compartimentation hydraulique souvent complexe, le manque de connaissance se fait particulièrement sentir. Bien que de nombreux travaux aient permis d'évaluer l'évaporation des masses d'eau et l'évapotranspiration de certaines espèces d'hydrophytes et d'hélophytes, les études débouchant sur des bilans quantitatifs restent peu fréquentes. Le bilan hydrologique du marais de Moëze (2250 ha) a été calculé par décade entre le 11/06/89 et le 31/08/89. Il prend en compte le débit au droit de l'ouvrage d'alimentation, les volumes prélevés pour l'irrigation hors marais, les infiltrations et l'évapotransplration sur les 318 km de canaux. L'estimation de la consommation d'eau des parcelles est globalisée au niveau des mesures d'infiltration.

Les pertes par infiltration sont secondaires (9,4 %) au regard des volumes prélevés pour l'irrigation (38,0 %) et évapotransplrés par les canaux (43,7 %) dont 51,1 % uniquement par les 28,6 % des plans d'eau colonisés par Typha latifolia.

L'optimisation de la gestion estivale de l'eau d'un marais littoral agricole nécessite dans un premier temps de minimiser les pertes. C'est essentiellement sur la consommation d'eau des canaux colonisés par les hélophytes que l'on peut intervenir. Nous proposons un abaque qui permet d'évaluer l'importance des économies d'eau réalisées en fonction de plusieurs scénarios d'aménagement du réseau hydraulique.

Flavonoid inhibition of platelet procoagulant activity and phosphoinositide synthesis

Dietary flavonoids are known for their antiplatelet activity resulting in cardiovascular protection. Phosphatidylinositol 4,5-bisphosphate (PIP2) was previously reported to play a direct role in phosphatidylserine (PS) exposure, as a Ca2+ target. Thrombin formation and platelet procoagulant activity are dependent on PS exposure. As flavonoids can inhibit phosphoinositide (PPI) kinases, we examined whether changes in PPI metabolism in flavonoid-treated platelets could be involved in their antiplatelet effects. Treatment with the flavonoids quercetin or catechin reduced PS exposure, thrombin formation, PIP2 level and resynthesis after platelet activation with collagen, thrombin or calcium ionophore. Flavonoids also prevented [Ca2+]i increase induced by collagen, but not by the ionophore. The ability of flavonoids to decrease PS exposure induced by ionophore treatment could result from the diminution of PIP2 levels, whereas PS exposure induced by collagen could also be diminished by flavonoids' effects on calcium signaling dependent on PIP2 hydrolysis. These data favor a role for PIP2 in the antiplatelet effects of flavonoids.

Regulation of K-Cl cotransport by Syk and Src protein tyrosine kinases in deoxygenated sickle cells

Protein tyrosine kinases (PTK) of the Src family are thought to suppress K-Cl cotransport (KCC) activity via negative regulation of protein phosphatases. However, some PTK inhibitors reduce KCC activity, suggesting opposite regulation by different PTK families. We have reported previously that deoxygenation of sickle cells stimulates KCC and activates Syk (a Syk family PTK), but not Lyn (an Src family PTK). In this study the same results were obtained when PTK activities were measured under the conditions used to measure KCC activity and which prevent any change in intracellular [Mg(2+)]. Methyl-2,5-dihydroxycinnamate (DHC), a PTK inhibitor, was more selective for Syk than Lyn, while staurosporine (ST), a broad-specificity protein kinase inhibitor, inhibited Lyn more than Syk. Deoxygenation or 4-amino-5-(4-chlorophenyl)-7-( t-butyl)pyrazolo[3,4- d] pyrimidine (pp2, a specific Src inhibitor) stimulated KCC independently. These effects were not additive and were inhibited by DHC. In contrast, ST-induced KCC activation was resistant to DHC, suggesting a different pathway of activation. Overall, these data indicate that Syk activity is required for KCC activation, either induced by deoxygenation of sickle cells, or mediated by Src inhibition in oxygenated cells, and that Syk and Src PTKs exert opposing and interconnected regulatory effects on the activity of the transporter.

Involvement of phosphatidylinositol 4,5-bisphosphate in phosphatidylserine exposure in platelets: use of a permeant phosphoinositide-binding peptide

During platelet activation, phosphatidylserine (PS) exposure on the extracellular face of the plasma membrane is associated with increased procoagulant activity. PS externalization is generally attributed to an increase in intracellular Ca(2+). Various phospholipid transporters, such as specific scramblases or proteins from the family of multidrug resistance proteins, and cofactors such as phosphatidylinositol 4,5-bisphosphate (PIP2) have been proposed to participate in this process. In this study, we used a membrane-permeant polycationic peptide (RhB-QRLFQVKGRR), derived from the PIP2-binding site of gelsolin (GS 160-169) and linked to rhodamine B, to investigate the role of PIP2 in PS externalization in whole platelets. The peptide penetrated rapidly into the platelets, specifically bound to PIP2, and induced PS exposure to a similar extent as thrombin or collagen, but independently of changes in intracellular Ca(2+) or phosphoinositide 3-kinase activity. A pretreatment of platelets with quercetin, an inhibitor of phosphoinositide metabolism, drastically decreased PS exposure induced by agonists or peptide. In large unilamellar vesicles (LUVs), the presence of PIP2 was strictly required for the induction of scrambling of NBD-labeled phospholipids (PC and PS) by the peptide. In inside-out vesicles from erythrocytes (IOVs), the peptide also induced redistribution of PC and PS. Our data suggest that, in intact platelets, PIP2 acts as a target of polycationic effectors, including Ca(2+), to promote PS exposure. The use of a membrane-permeant and fluorescent peptide which binds to PIP2 is a promising tool to investigate the role of PIP2 in various cellular processes.

[Anterior iliopsoas impingement after total hip arthroplasty: diagnosis and conservative treatment in 9 cases]

PURPOSE OF THE STUDY

Impingement of the iliopsoas muscle due to a protruding acetabular component is an uncommon cause of pain after total hip arthroplasty. Diagnostic signs may be misleading and therapeutic management has varied, leading to divergent findings reported in the literature. The purpose of this prospective work was to determine the frequency of groin pain due to iliopsoas impingement (with or without an identified causal mechanism) in patients with painful total hip arthroplasties and to identify diagnostic criteria that can be used to determine the appropriate therapeutic strategy.

MATERIAL AND METHODS

This prospective study was conducted between 1998 and 2000 and included 206 painful total hip arthroplasties. From this series, we excluded cases where pain was related to loosening (139 cases, 67%), infection (45 cases, 21.7%), bursitis on trochanteric sutures (2 cases, 1%), and aortic aneurysm with gluteal claudication and resulting from a lumbosacral disorder (10 cases, 4.8%). This left 9 cases (4.3%) with a clinical picture suggestive of iliopsoas impingement. These 9 patients (mean age 50 years, age range 38 - 65) had 8 uncemented press-fix cups and 1 cemented cup with an acetabular mesh. Mean delay to the development of pain after the arthroplasty procedure was 7.3 months (1 - 48 months). The most suggestive clinical sign was groin pain triggered by active flexion of the hip and flexion of the hip against force with a painful arc measuring 30 degrees to 70 degrees. None of these 9 patients had any sign of material loosening and puncture aspiration ruled out infection. The final diagnosis was confirmed by sedation of pain after extra-articular infiltration at the anterior border of the cup (overhanging cup in 6/9 cases) under computed tomographic guidance.

RESULTS

Infiltrations with xylocaine and long-release corticosteroids led to complete sedation of pain in 4 out of 9 patients and partial sedation in 1 other. Recurrent pain led to terminal tenotomy of the iliopsoas in 4 patients, that provided total sedation in 3 and partial sedation in 1. In all, successful pain relief was achieved in 7 out of 9 cases: 4 after infiltration (repeated in 1 cases) and 3 after tenotomy. At last follow-up physical examination has not identified any loss of flexion force.

DISCUSSION AND CONCLUSION

Irritation of the iliopsoas muscle can be the cause of pain in 4.3% of patients experiencing pain after total hip arthroplasty. The delay to symptom onset is variable but there appears to be a pain-free period after implantation. An anatomic element (anterior cup overhang) is not necessary for diagnosis since the infiltration test was positive in 1 out of 3 cases without any identified acetabular factor. The infiltration test is an important element for positive diagnosis and should be the first therapeutic measure taken. We achieved success in 4 out of 9 cases. Tenotomy is indicated in case of recurrence, providing complete cure in 3 out of 4 cases in our series. Cure may be achieved without changing the cup by simple infiltration or tenotomy of the iliopsoas that led to complete cure in 7 out of 9 cases in our series, even in patients with an overhanging cup (6 out of 9 cases). An elective procedure might be indicated if a specific anomaly is identified (overly long screw, cement leakage) or for a screwed cup. The infiltration test should however be performed beforehand to confirm the diagnosis.

Biodegradation of anthracene and fluoranthene by fungi isolated from an experimental constructed wetland for wastewater treatment

Pilot-scale constructed wetlands were used to treat water contaminated by polycyclic aromatic hydrocarbons (PAHs), particularly fluoranthene, and the possible role of fungi present in these ecosystems was investigated. A total of 40 fungal species (24 genera) were isolated and identified from samples (gravel and sediments) from a contaminated wetland and a control wetland. All of them were assayed for their ability to remove anthracene (AC) and fluoranthene (FA) from liquid medium. FA was degraded efficiently by 33 species while only 2 species were able to remove AC over 70%. A selection of 10 strains of micromycetes belonging to various taxonomic groups was further investigated for FA and AC degradation, toxicity assays and phenoloxidases (POx) detection. Interesting and not previously reported species were revealed (Absidia cylindrospora, Cladosporium sphaerospermum, and Ulocladium chartarum). They were all able to highly degrade the PAH-model compounds chosen. An interesting inducibility was noted for Ulocladium chartarum. Degradative ability of fungi was not related to their extracellular POx activity. This study may contribute to the improvement of constructed wetlands for water treatment, which may be enriched in efficient fungi.