Biological and radiological exploration and management of non-functioning pituitary adenoma

AbstractNon-functioning pituitary adenoma may be totally asymptomatic and discovered “incidentally” during radiological examination for some other indication, or else induce tumoral signs with compression of the optic chiasm and pituitary dysfunction. Non-functioning adenomas are mainly gonadotroph, but may also be “silent”. Treatment strategy depends on initial clinical, biological, ophthalmological and radiological findings. The present French Society of Endocrinology Consensus work-group sought to update the pitfalls associated with hormone assay and outline a hormonal exploration strategy for diagnosis and follow-up, without overlooking the particularities of silent adenoma. We also drew up basic rules for initial exploration and radiological follow-up of both operated and non-operated pituitary adenomas

Development of MPS Method for Analysing Convection and Solidification of Multi-Component Corium in Severe Accident of a Light Water Reactor

In this study, a numerical approach for analyzing the internal status of Molten CoreConcrete Interaction (MCCI) has been developed based on Moving Particle Semi-implicit (MPS) method. Among the key required models, such as accurate viscosity interaction model for solidifying particles and interface tension models of different liquid phases, preliminary attempts have been made with new models. Namely, a simple mixing model and gas hosting particle model has been implemented to simulate the experiment with affordable calculation cost. The analysis results for VULCANO VF-U1 experiment have shown the possible mechanisms responsible for the characteristic distribution of the solidified metallic corium, which seemed to be highly dependent on the density of surrounding oxidic coriu

Numerical simulations of the agitation generated by coarse-grained bubbles moving at large Reynolds number

We present a numerical method for simulating the flow induced by bubbles rising at large Reynolds number. This method is useful to simulate configurations of large dimensions involving a great number of bubbles. The action that each bubble exerts on the liquid is modelled as a volume source of momentum distributed over a few mesh-grid elements. The flow in the vicinity of the bubbles is thus not finely resolved. The bubbles are treated as Lagrangian particles that move under the influence of the hydrodynamic force exerted by the liquid. The determination of this force on a given bubble requires knowledge of the liquid flow that is undisturbed by this bubble. A model is developed to accurately estimate this disturbance for large-Reynolds-number objects and get rid of any spurious self-induced effect. Thanks to that, a homogeneous swarm of rising bubbles is simulated. Comparisons with experiments show a good agreement with the flow scales larger than the bubbles, which turn out to be controlled by the interactions between bubble wakes and rather independent of unresolved smaller scales. This method can be used to study the coupling between bubble-induced agitation and large-scale motions, such as those produced in industrial bubble columns

A Toolkit and Robust Pipeline for the Generation of Fosmid-Based Reporter Genes in C. elegans

Engineering fluorescent proteins into large genomic clones, contained within BACs or fosmid vectors, is a tool to visualize and study spatiotemporal gene expression patterns in transgenic animals. Because these reporters cover large genomic regions, they most likely capture all cis-regulatory information and can therefore be expected to recapitulate all aspects of endogenous gene expression. Inserting tags at the target gene locus contained within genomic clones by homologous recombination (“recombineering”) represents the most straightforward method to generate these reporters. In this methodology paper, we describe a simple and robust pipeline for recombineering of fosmids, which we apply to generate reporter constructs in the nematode C. elegans, whose genome is almost entirely covered in an available fosmid library. We have generated a toolkit that allows for insertion of fluorescent proteins (GFP, YFP, CFP, VENUS, mCherry) and affinity tags at specific target sites within fosmid clones in a virtually seamless manner. Our new pipeline is less complex and, in our hands, works more robustly than previously described recombineering strategies to generate reporter fusions for C. elegans expression studies. Furthermore, our toolkit provides a novel recombineering cassette which inserts a SL2-spliced intercistronic region between the gene of interest and the fluorescent protein, thus creating a reporter controlled by all 5′ and 3′ cis-acting regulatory elements of the examined gene without the direct translational fusion between the two. With this configuration, the onset of expression and tissue specificity of secreted, sub-cellular compartmentalized or short-lived gene products can be easily detected. We describe other applications of fosmid recombineering as well. The simplicity, speed and robustness of the recombineering pipeline described here should prompt the routine use of this strategy for expression studies in C. elegans

Pourquoi vérifie-t-on que la porte est bien fermée ou que les plaques sont bien éteintes ?

Un bas niveau d’identification de l’action semble être une caractéristique des symptômes de vérification. Le but de la présente étude est d’analyser le lien de causalité, c’est-à-dire d’observer si une focalisation de l’attention sur un bas niveau d’identification de l’action mène à des comportements de vérification. Pour ce faire, nous avons induit une focalisation de l’attention sur un bas versus un haut niveau d’identification de l’action (versus contrôle) lors d’une tâche de vérification sur ordinateur chez 60 participants tout-venants âgés de 18 à 35 ans. L’induction avait lieu pendant la création de l’intention d’agir dans l’expérience 1 (30 participants) et pendant la réalisation de l’action dans l’expérience 2 (30 participants). Les participants avaient la possibilité d’évaluer leurs productions et de les vérifier..

Evaluation plus écologique de la mémoire épisodique chez deux patientes présentant des plaintes mnésiques subjectives

La mémoire épisodique permet de se souvenir et de prendre conscience d'évènements personnellement vécus dans un contexte spatial et temporel spécifique (Tulving, 2002). Il n'est pas rare de rencontrer des personnes adultes se plaignant de difficultés mnésiques qui ont un impact négatif sur leur fonctionnement au quotidien. Ces plaintes peuvent ne pas être objectivées par les tests classiques de la mémoire épisodique utilisés de nos jours dans la pratique clinique. C'est la définition même des plaintes mnésiques subjectives (Jessen et al., 2014). Cette absence de lien entre les plaintes et les résultats aux tests trouve son explication par un manque d'appréhension de l'intégrité des multiples processus impliqués dans la mémoire épisodique et par le faible caractère écologique de ces tests, qui ne reflètent pas le fonctionnement dans la vie quotidienne des personnes..

Le diabète de type 2 (variations de l'hémoglobine glyquée après hospitalisation des patients dans le service d'endocrinologie du CHU de Dijon)

DIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF

Follow-up of coiled intracranial aneurysms: comparison of 3D time-of-flight and contrast-enhanced magnetic resonance angiography at 3T in a large, prospective series.

International audienceOBJECTIVES: To compare 3D-TOF magnetic resonance angiography (MRA) and contrast-enhanced MRA (CE-MRA) sequences at 3T in the follow-up of coiled aneurysms with digital subtracted angiography (DSA) as the gold standard. METHODS: DSA, 3D-TOF and CE-MRA were performed in a prospective series of 126 aneurysms in 96 patients (57 female, 39 male; age: 25-75 years, mean: 51.3 ± 11.3 years). The quality of aneurysm occlusion was assessed independently and anonymously by a core laboratory. RESULTS: Using DSA (gold standard technique), total occlusion was depicted in 57 aneurysms (45.2%), neck remnant in 34 aneurysms (27.0%) and aneurysm remnant in 35 aneurysms (27.8%). Sensitivity, specificity, positive predictive value and negative predictive value were very similar with 3D-TOF and CE-MRA. Visibility of coils was much better with 3D-TOF (95.2%) than with CE-MRA (23.0%) (P < 0.001). Also, substantial artefacts were less frequent with 3D-TOF (4.0%) than with CE-MRA (11.9%; P = 0.012). CONCLUSIONS: In this large prospective series of patients with coiled aneurysms, at 3T 3D-TOF MRA was equivalent to CE-MRA for the evaluation of aneurysm occlusion, but coil visibility was superior at 3D-TOF. Thus the use of 3D-TOF at 3T is recommended for the follow-up of coiled intracranial aneurysms. KEY POINTS: * Different Magnetic Resonance (MR) imaging techniques are used to evaluate intracranial aneurysms. * At 3T MR, 3D-TOF and CE-MRA appear equivalent for evaluating coiled aneurysms.. * Coils are better visualised on 3D-TOF than on CE-MRA. * Combined analysis of 3D-TOF and CE-MRA does not seem helpful. * At 3T, 3D-TOF techniques are recommended for monitoring patients with coiled aneurysms

Liquid metal convection induced by the Lorentz force in a Rayleigh-Bénard cell

International audienc

A unique case of pure lateral spinal cord herniation.

BACKGROUND: Spinal cord herniation (SCH) remains a challenging diagnosis for neuroradiologists and may require treatment challenging for neurosurgeons. Most cord herniations are usually found at anterior thoracic levels. CLINICAL PRESENTATION: A 28-year-old woman presented at our department with a 7-year history of progressive myelopathy. MR analysis showed a displacement of the spinal cord in a lateral thoracic dural defect. The herniated cord was released using a microscope and the patient significantly recovered 6 months after surgery. CONCLUSION: We present a unique case of pure lateral SCH. In the light of reviewed literature and operative findings, the underlying pathophysiological mechanisms are discussed.[Cas unique d’hernie médullaire trans-durale strictement latérale] CONTEXTE : Les hernies médullaires trans-durales restent de diagnostic difficile pour le neuroradiologue et leur traitement constitue un challenge pour le neurochirurgien. La plupart des hernies médullaires sont situées dans un défect dural antérieur, au niveau du rachis thoracique. PRÉSENTATION CLINIQUE : Une patiente de 28 ans s’est présentée dans le service de neurochirurgie avec un tableau clinique de myélopathie, de développement lentement progressif sur une période de 7 ans. L’IRM médullaire a montré une incarcération du cordon médullaire thoracique dans un défect dural strictement latéral. La moelle épinière a été libérée chirurgicalement, sous microscope. L’état neurologique de la patiente s’est significativement amélioré 6 mois après l’intervention. CONCLUSION : Nous présentons un cas unique d’hernie médullaire trans-durale strictement latérale. À la lumière des données de la littérature et de nos constatations opératoires, les mécanismes physiopathologiques sous-jacents sont discutés