CONTRIBUTION A L'ETUDE DE LA REACTION DE TYROSYLATION DES ARNT ET DES PSEUDO-ARNT

STRASBOURG-Sc. et Techniques (674822102) / SudocSudocFranceF

Surgical Management of Open-Angle Glaucoma Associated with Uveitis

■ Uveitic glaucoma poses special challenges for the internist, rheumatologist, uveitis specialist, glaucoma specialist and the patient. ■ Exuberant inflammation, severe conjunctival scarring, iris neovascularization, corticosteroid-induced cataracts, medication side effects and the increased risk of hypotony make uveitic glaucoma especially difficult to manage. ■ Careful preoperative evaluation insures that the correct diagnosis is made and an appropriate treatment plan is implemented. It is imperative that pre- and postoperative intraocular inflammation be controlled adequately with judicious medication use. ■ When conservative measures fail, glaucoma drainage devices can provide an effective means of lowering intraocular pressure. Although several different, effective drainage implants are available, we prefer to use the modified 250 mm2 BGDD for the majority of our uveitic patients with elevated IOP. ■ Innovations in implantation technique and glaucoma drainage device modifications have improved our ability to achieve and maintain a low IOP in these challenging uveitic eyes. ■ Careful preoperative planning and meticulous attention to operative technique can minimize complications and enhance surgical safety and efficacy

Glaucoma drainage implants and vitreoretinal surgery

Glaucoma drainage implants can effectively lower the intraocular pressure in eyes that have undergone prior vitrectomy or scleral buckling surgery. Acute angle closure without pupillary block may develop after scleral buckling surgery, particularly in eyes with pre-existent narrow chamber angles treated with anteriorly positioned, high-encircling elements, and extensive cryopexy. A drainage implant is indicated when conjunctival scarring and recession from a prior scleral buckling surgery reduce the likelihood of a successful trabeculectomy. Vitreoretinal surgeons often encounter patients with neovascular glaucoma associated with diabetic retinopathy, central retinal vein occlusion, prior complicated surgery, or trauma that requires a vitrectomy in conjunction with a Baerveldt Glaucoma Drainage Device (BGDD). Careful assessment of the conjunctiva, cornea, and lens is necessary to determine whether the BGDD tube should be implanted through the limbus or the pars plana. Pars plana tube insertion requires a complete vitrectomy, with special attention being paid to clearing the vitreous base in the quadrant of tube insertion

Novel features in the tRNA-like world of plant viral RNAs.

tRNA-like domains are found at the 3' end of genomic RNAs of several genera of plant viral RNAs. Three groups of tRNA mimics have been characterized on the basis of their aminoacylation identity (valine, histidine and tyrosine) for aminoacyl-tRNA synthetases. Folding of these domains deviates from the canonical tRNA cloverleaf. The closest sequence similarities with tRNA are those found in valine accepting structures from tymoviruses (e.g. TYMV). All the viral tRNA mimics present a pseudoknotted amino acid accepting stem, which confers special structural and functional characteristics. In this review emphasis is given to newly discovered tRNA-like structures (e.g. in furoviruses) and to recent advances in the understanding of their three-dimensional architecture, which mimics L-shaped tRNA. Identity determinants in tRNA-like domains for aminoacylation are described, and evidence for their functional expression, as in tRNAs, is given. Properties of engineered tRNA-like domains are discussed, and other functional mimicries with tRNA are described (e.g. interaction with elongation factors and tRNA maturation enzymes). A final section reviews the biological role of the tRNA-like domains in amplification of viral genomes. In this process, in which the mechanisms can vary in specificity and efficiency according to the viral genus, function can be dependent on the aminoacylation properties of the tRNA-like domains and/or on structural properties within or outside these domains.journal articleresearch support, non-u.s. gov'treview2001 Octimporte

Magnetic Mini-Mover Procedure for pectus excavatum IV: FDA sponsored multicenter trial.

PurposeThe Magnetic Mini-Mover Procedure (3MP) is a minimally invasive treatment for prepubertal patients with pectus excavatum. This multicenter trial sought to supplement safety and efficacy data from an earlier pilot trial.MethodsFifteen patients with pectus excavatum had a titanium-enclosed magnet implanted on the sternum. Externally, patients wore a custom-fitted magnetic brace. Patients were monitored closely for safety. Efficacy was determined by the Haller Index (HI) and satisfaction surveys. After 2 years, the implant was removed.ResultsMean patient age was 12 years (range 8-14), and mean pretreatment HI was 4.7 (range 3.6-7.4). The device was successfully implanted in all patients. Mean treatment duration was 25 months (range 18-33). Posttreatment chest imaging in 13 patients indicated that HI decreased in 5, remained stable in 2, and increased in 6. Seven out of 15 patients had breakage of the implant's titanium cables because of fatigue fracture. Eight out of 13 patients were satisfied with their chest after treatment.ConclusionThe 3MP is a safe, minimally invasive, outpatient treatment for prepubertal patients with pectus excavatum. However, the magnetic implant design led to frequent device breakage, confounding analysis. The HI indicated mixed efficacy, although surveys indicated most patients perceived a benefit.Study type/level of evidenceCase series, treatment study. Level IV

Magnetic Mini-Mover Procedure for pectus excavatum IV: FDA sponsored multicenter trial.

PurposeThe Magnetic Mini-Mover Procedure (3MP) is a minimally invasive treatment for prepubertal patients with pectus excavatum. This multicenter trial sought to supplement safety and efficacy data from an earlier pilot trial.MethodsFifteen patients with pectus excavatum had a titanium-enclosed magnet implanted on the sternum. Externally, patients wore a custom-fitted magnetic brace. Patients were monitored closely for safety. Efficacy was determined by the Haller Index (HI) and satisfaction surveys. After 2 years, the implant was removed.ResultsMean patient age was 12 years (range 8-14), and mean pretreatment HI was 4.7 (range 3.6-7.4). The device was successfully implanted in all patients. Mean treatment duration was 25 months (range 18-33). Posttreatment chest imaging in 13 patients indicated that HI decreased in 5, remained stable in 2, and increased in 6. Seven out of 15 patients had breakage of the implant's titanium cables because of fatigue fracture. Eight out of 13 patients were satisfied with their chest after treatment.ConclusionThe 3MP is a safe, minimally invasive, outpatient treatment for prepubertal patients with pectus excavatum. However, the magnetic implant design led to frequent device breakage, confounding analysis. The HI indicated mixed efficacy, although surveys indicated most patients perceived a benefit.Study type/level of evidenceCase series, treatment study. Level IV