Technical recommendations for clinical translation of renal MRI: a consensus project of the Cooperation in Science and Technology Action PARENCHIMA.

PURPOSE: The potential of renal MRI biomarkers has been increasingly recognised, but clinical translation requires more standardisation. The PARENCHIMA consensus project aims to develop and apply a process for generating technical recommendations on renal MRI. METHODS: A task force was formed in July 2018 focused on five methods. A draft process for attaining consensus was distributed publicly for consultation and finalised at an open meeting (Prague, October 2018). Four expert panels completed surveys between October 2018 and March 2019, discussed results and refined the surveys at a face-to-face meeting (Aarhus, March 2019) and completed a second round (May 2019). RESULTS: A seven-stage process was defined: (1) formation of expert panels; (2) definition of the context of use; (3) literature review; (4) collection and comparison of MRI protocols; (5) consensus generation by an approximate Delphi method; (6) reporting of results in vendor-neutral and vendor-specific terms; (7) ongoing review and updating. Application of the process resulted in 166 consensus statements. CONCLUSION: The process generated meaningful technical recommendations across very different MRI methods, while allowing for improvement and refinement as open issues are resolved. The results are likely to be widely supported by the renal MRI community and thereby promote more harmonisation

Multi-tracer study of gas trapping in an East Antarctic ice core

We study a firn and ice core drilled at the new "Lock-In" site in East Antarctica, located 136 km away from Concordia station towards Durmont d'Urville. High resolution chemical and physical measurements were performed on the core, with a particular focus on the trapping zone of the firn where air bubbles are formed. We measured the air content in the ice, closed and open porous volumes in the firn, firn density, firn liquid conductivity and major ion concentrations, as well as methane concentrations in the ice. The closed and open porosity volumes of firn samples were obtained by the two independent methods of pycnometry and tomography, that yield similar results. The measured increase of the closed porosity with density is used to estimate the air content trapped in the ice with the aid of a simple gas trapping model. Results show a discrepancy, with the model trapping too much air. Experimental errors have been considered but do not explain the discrepancy between the model and the observations. The model and data can be reconciled with the introduction of a reduced compression of the closed porosity compared to the open porosity. Yet, it is not clear if this limited compression of closed pores is the actual mechanism responsible for the low amount of air in the ice. High resolution density measurements reveal the presence of a strong layering, manifesting itself as centimeter scale variations. Despite this heterogeneous stratification, all layers, including the ones that are especially dense or less dense compared to their surroundings, display similar pore morphology and closed porosity as function of density. This implies that all layers close in a similar way, even though some close in advance or later compared to the bulk firn. Investigation of the chemistry data suggests that in the trapping zone, the observed stratification is partly related to the presence of chemical impurities

The study of the mercury cycle in polar regions: An international study in Ny-Alesund, Svalbard

Mercury (Hg) is a toxic pollutant and it can be strongly accumulated in the food chain, especially in Polar Regions. This paper presents a part of the work that has been on-going for 3-4 years in Ny-Alesund, Svalbard within the frame of an international collaboration. In Ny-Alesund in spring 2003, the atmospheric chemistry of mercury has been studied so as to better understand the formation of oxidized mercury species in the atmosphere that could be deposited onto snow surfaces. The role of snow as a potential source of mercury to the atmosphere or as a sink has also been approached to better understand the behavior of this metal. Chemical and biological processes seem to play a major role in Hg storage in snow. When melting, snow could be a major source of Hg into the various ecosystems and this toxin could therefore be accumulated into the food chain

Consensus-based technical recommendations for clinical translation of renal ASL MRI

Objectives: To develop technical recommendations for the acquisition, processing and analysis of renal ASL data in the human kidney at 1.5T and 3T field strengths that can promote standardization of renal perfusion measurements and facilitate the comparability of results across scanners and in multi-center clinical studies.Methods: An international panel of 23 renal ASL experts followed a modified Delphi process, including on-line surveys and two in-person meetings, to formulate a series of consensus statements regarding patient preparation, hardware, acquisition protocol, analysis steps and data reporting.Results: Fifty-nine statements achieved consensus, while agreement could not be reached on two statements related to patient preparation. As a default protocol, the panel recommends pseudo-continuous (PCASL) or flow-sensitive alternating inversion recovery (FAIR) labeling with a single-slice spin-echo EPI readout with background suppression, and a simple but robust quantification model.Discussion: This approach is considered robust and reproducible and can provide renal perfusion images of adequate quality and SNR for most applications. If extended kidney coverage is desirable, a 2D multislice readout is recommended. These recommendations are based on current available evidence and expert opinion. Nonetheless they are expected to be updated as more data becomes available, since the renal ASL literature is rapidly expanding

Technical recommendations for clinical translation of renal MRI: a consensus project of the Cooperation in Science and Technology Action PARENCHIMA

Purpose The potential of renal MRI biomarkers has been increasingly recognised, but clinical translation requires more standardisation. The PARENCHIMA consensus project aims to develop and apply a process for generating technical recommendations on renal MRI. Methods A task force was formed in July 2018 focused on fve methods. A draft process for attaining consensus was distributed publicly for consultation and fnalised at an open meeting (Prague, October 2018). Four expert panels completed surveys between October 2018 and March 2019, discussed results and refned the surveys at a face-to-face meeting (Aarhus, March 2019) and completed a second round (May 2019). Results A seven-stage process was defned: (1) formation of expert panels; (2) defnition of the context of use; (3) literature review; (4) collection and comparison of MRI protocols; (5) consensus generation by an approximate Delphi method; (6) reporting of results in vendor-neutral and vendor-specifc terms; (7) ongoing review and updating. Application of the process resulted in 166 consensus statements. Conclusion The process generated meaningful technical recommendations across very diferent MRI methods, while allowing for improvement and refnement as open issues are resolved. The results are likely to be widely supported by the renal MRI community and thereby promote more harmonisation

Neuronal Conduction of Excitation without Action Potentials Based on Ceramide Production

International audienceBACKGROUND: Action potentials are the classic mechanism by which neurons convey a state of excitation throughout their length, leading, after synaptic transmission, to the activation of other neurons and consequently to network functioning. Using an in vitro integrated model, we found previously that peripheral networks in the autonomic nervous system can organise an unconventional regulatory reflex of the digestive tract motility without action potentials. METHODOLOGY/PRINCIPAL FINDINGS: In this report, we used combined neuropharmacological and biochemical approaches to elucidate some steps of the mechanism that conveys excitation along the nerves fibres without action potentials. This mechanism requires the production of ceramide in membrane lipid rafts, which triggers in the cytoplasm an increase in intracellular calcium concentration, followed by activation of a neuronal nitric oxide synthase leading to local production of nitric oxide, and then to guanosine cyclic monophosphate. This sequence of second messengers is activated in cascade from rafts to rafts to ensure conduction of the excitation along the nerve fibres. CONCLUSIONS/SIGNIFICANCE: Our results indicate that second messengers are involved in neuronal conduction of excitation without action potentials. This mechanism represents the first evidence-to our knowledge-that excitation is carried along nerves independently of electrical signals. This unexpected ceramide-based conduction of excitation without action potentials along the autonomic nerve fibres opens up new prospects in our understanding of neuronal functioning

Granulomatoses rénales (40 observations dans le Nord-Est parisien)

Nous rapportons 40 observations de granulomatoses rénales dans le Nord-Est Parisien, recueillies à partir du registre de 3 services d anatomopathologie survenues entre 01/1991 et 02/2004 dans 1 service de Médecine Interne et 3 services de Néphrologie. Le critère d inclusion était la présence dans l interstitium rénal de granulomes épithélioïdes. Il s agissait de 25 hommes (âge médian: 46 ans; extrêmes, 29 à 74 ans) et 15 femmes (64; 26-78) d origine européenne (23 cas), nord-africaine (7), africaine subsaharienne (6), antillaise (2) et asiatique (2). L étude histologique rénale montrait des granulomes épithélioïdes de l interstitium rénal (100%) associés à une glomérulonéphrite proliférative extra-capillaire pauci-immune (5%) et une vascularite granulomateuse (2,5 %). La présentation néphrologique comprenait une insuffisance rénale (100%) (Créatinine médiane: 236,8 124-805 jimolll) associée à une HTA (27,5%), une protéinurie (100%) (0,6gr/l ; 0,08-3), une hématurie microscopique (15%) et une leucocyturie (22,5%). Les principales manifestations extra-rénales étaient un amaigrissement (30%), une toux sèche (25%), des arthralgies (17,5%), une uvéite (12,5%) et une parotidomégalie (5%). Vingt-trois patients (57,5%) ont eu un total de 28 biopsies extra-rénales. Le diagnostic étiologique était une sarcoïdose dans 20 cas, une origine médicamenteuse dans 7 cas, une tuberculose dans 3 cas, une maladie de Wegener dans 2 cas, une lèpre dans 1 cas, une infection à Mycobactérium avium dans 1 cas, une maladie de Crohn dans 1 cas et pas d étiologie dans 5 cas. Le traitement a comporté: des assauts de méthylprednisolone dans 4 cas de sarcoïdose, 2 cas de Wegener et 3 cas d idiopathique; une corticothérapie orale dans 20 cas de sarcoïdose, 5 cas d immunoallergie, 3 cas d idiopathique, 2 cas de Wegener, 1 cas de tuberculose et de maladie de Crohn; du cyclophosphamide dans 2 cas de Wegener; de l a.zathioprine dans 2 cas de Wegener et un cas de Crohn. L évolution rénale fut favorable dans 15 cas de sarcoïdose, 5 cas d origine médicamenteuse immunoallergique, 3 cas de tuberculose, 1 cas de Wegener, de lèpre, d infection à M.avium, de Crohn et 4 cas d idiopathique.A partir des différentes observations, nous avons discuté la stratégie diagnostique et thérapeutiquePARIS13-BU Serge Lebovici (930082101) / SudocSudocFranceF

A Micro-Mechanical Model for the Transformation of Dry Polar Firn Into Ice Using the Level-Set Method

International audienceInterpretation of greenhouse gas records in polar ice cores requires a good understanding of the mechanisms controlling gas trapping in polar ice, and therefore of the processes of densification and pore closure in firn (compacted snow). Current firn densification models are based on a macroscopic description of the firn and rely on empirical laws and/or idealized geometries to obtain the equations governing the densification and pore closure. Here, we propose a physically-based methodology explicitly representing the porous structure and its evolution over time. In order to handle the complex geometry and topological changes that occur during firn densification, we rely on a Level-Set representation of the interface between the ice and the pores. Two mechanisms are considered for the displacement of the interface: (i) mass surface diffusion driven by local pore curvature and (ii) ice dislocation creep. For the latter, ice is modeled as a viscous material and the flow velocities are solutions of the Stokes equations. First applications show that the model is able to densify firn and split pores. Using the model in cold and arid conditions of the Antarctic plateau, we show that gas trapping models do not have to consider the reduced compressibility of closed pores compared to open pores in the deepest part of firns. Our results also suggest that the mechanism of curvature-driven surface diffusion does not result in pore splitting, and that ice creep has to be taken into account for pores to close. Future applications of this type of model could help quantify the evolution and closure of firn porous networks for various accumulation and temperature conditions