Lemierre Syndrome.

peer reviewedTeaching Point: Lemierre syndrome is a rare complication of bacterial pharyngitis with cervical thrombophlebitis leading to pulmonary abcesses; the radiologist may have a key role

LA RADIOTHÉRAPIE DANS LE CANCER DU RECTUM : quand, comment et pourquoi ?

peer reviewedDepuis plusieurs décades, la radiothérapie préopéra - toire ou postopératoire joue un rôle important dans le contrôle local de l’adénocarcinome du rectum. Cette dernière décennie, avec la systématisation de la chirurgie d’exérèse en totalité du mésorectum (TME), le profil de récidive locale du cancer du rectum a été fortement modifié. Dans un tel contexte, la place de la radiothérapie doit être réévaluée en tenant compte de ces modifications. Dans cet article, nous proposons de faire la revue des différentes grandes études concernant les techniques et les indications d’un traitement de radiothérapie pré- ou post opératoire dans le contexte d’une chirurgie rectale TME

Familial adhesive arachnoiditis associated with syringomyelia

Adhesive arachnoiditis is a rare condition, often complicated by syringomyelia. This pathologic entity is usually associated with prior spinal surgery, spinal inflammation or infection, and hemorrhage. The usual symptoms of arachnoiditis are pain, paresthesia, and weakness of the low extremities due to the nerve entrapment. A few cases have had no obvious etiology. Previous studies have reported one family with multiple cases of adhesive arachnoiditis. We report a second family of Belgian origin with multiple cases of arachnoiditis and secondary syringomyelia in the affected individuals

Sur une modélisation par éléments finis de l'interaction entre organes de la région pelvienne

Ce travail concerne le développement par la méthode des éléments finis d'un modèle numérique du mouvement des organes pelviens (prostate, vessie, rectum) et leurs interactions. Le but recherché à travers cette modélisation est la réduction des marges d'irradiation du volume cible au cours d'une séance de radiothérapie - en déterminant l'emplacement de la prostate - afin de ne pas altérer les organes sains avoisinants. En effet, dans le cas particulier de la prostate, les marges sont importantes puisque celle-ci est en déplacement permanent sous l'influence de plusieurs facteurs. Un premier modèle est construit en se basant sur la géométrie des organes pelviens générée à partir d'images scanner. Les conditions aux limites et les propriétés mécaniques sont définies et le maillage est réalisé. Des comparaisons entre les variations de forme et de position d'organes obtenues par simulation et les mesures effectuées par imagerie scanner ont permis d'asseoir la pertinence du modèle

The brain is a DJ using neuropeptides as sensory crossfaders

Sensory loss induces cross-modal plasticity, often resulting in altered performance in remaining sensory modalities. Whereas much is known about the macroscopic mechanisms underlying cross-modal plasticity, only scant information exists about its cellular and molecular underpinnings. We found that Caenorhabditis elegans nematodes deprived of a sense of body touch exhibit various changes in behavior, associated with other unimpaired senses. We focused on one such behavioral alteration, enhanced odor sensation, and sought to reveal the neuronal and molecular mechanisms that translate mechanosensory loss into improved olfactory acuity. To this end, we analyzed in mechanosensory mutants food-dependent locomotion patterns that are associated with olfactory responses and found changes that are consistent with enhanced olfaction. The altered locomotion could be reversed in adults by optogenetic stimulation of the touch receptor (mechanosensory) neurons. Furthermore, we revealed that the enhanced odor response is related to a strengthening of inhibitory AWC→AIY synaptic transmission in the olfactory circuit. Consistently, inserting in this circuit an engineered electrical synapse that diminishes AWC inhibition of AIY counteracted the locomotion changes in touch-deficient mutants. We found that this cross-modal signaling between the mechanosensory and olfactory circuits is mediated by neuropeptides, one of which we identified as FLP-20. Our results indicate that under normal function, ongoing touch receptor neuron activation evokes FLP-20 release, suppressing synaptic communication and thus dampening odor sensation. In contrast, in the absence of mechanosensory input, FLP-20 signaling is reduced, synaptic suppression is released, and this enables enhanced olfactory acuity; these changes are long lasting and do not represent ongoing modulation, as revealed by optogenetic experiments. Our work adds to a growing literature on the roles of neuropeptides in cross-modal signaling, by showing how activity-dependent neuropeptide signaling leads to specific cross-modal plastic changes in neural circuit connectivity, enhancing sensory performance.status: publishe

Holoprosencephaly

Holoprosencephaly (HPE) is a complex brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and the 28th day of gestation and affecting both the forebrain and the face. It is estimated to occur in 1/16,000 live births and 1/250 conceptuses. Three ranges of increasing severity are described: lobar, semi-lobar and alobar HPE. Another milder subtype of HPE called middle interhemispheric variant (MIHF) or syntelencephaly is also reported. In most of the cases, facial anomalies are observed in HPE, like cyclopia, proboscis, median or bilateral cleft lip/palate in severe forms, ocular hypotelorism or solitary median maxillary central incisor in minor forms. These latter midline defects can occur without the cerebral malformations and then are called microforms. Children with HPE have many medical problems: developmental delay and feeding difficulties, epilepsy, instability of temperature, heart rate and respiration. Endocrine disorders like diabetes insipidus, adrenal hypoplasia, hypogonadism, thyroid hypoplasia and growth hormone deficiency are frequent. To date, seven genes have been positively implicated in HPE: Sonic hedgehog (SHH), ZIC2, SIX3, TGIF, PTCH, GLI2 and TDGF1. A molecular diagnosis can be performed by gene sequencing and allele quantification for the four main genes SHH, ZIC2, SIX3 and TGIF. Major rearrangements of the subtelomeres can also be identified by multiplex ligation-dependent probe amplification (MLPA). Nevertheless, in about 70% of cases, the molecular basis of the disease remains unknown, suggesting the existence of several other candidate genes or environmental factors. Consequently, a "multiple-hit hypothesis" of genetic and/or environmental factors (like maternal diabetes) has been proposed to account for the extreme clinical variability. In a practical approach, prenatal diagnosis is based on ultrasound and magnetic resonance imaging (MRI) rather than on molecular diagnosis. Treatment is symptomatic and supportive, and requires a multidisciplinary management. Child outcome depends on the HPE severity and the medical and neurological complications associated. Severely affected children have a very poor prognosis. Mildly affected children may exhibit few symptoms and may live a normal life

Description d'une série de 31 cas de PAVM à Stenotrophomonas maltophilia dans le service de réanimation de l'hôpital de Versailles (représentations cliniques, schémas thérapeutiques et évolutions)

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Chilling of carcasses from double muscled cattle: time-temperature evolution and predictive modelling of growth of Listeria monocytogenes and Clostridium perfringens

The time/temperature combination during carcass chilling is of concern in order to avoid bacterial growth. The chilling speed is lower in carcasses with high muscular development such as large cattle from the Belgian Blue breed. Three slaughterhouses were selected for temperature and pH measurements during the chilling process at 6 different days on 4 half carcasses in order to obtain representative data from heavy carcasses with high muscular development. Predictive microbiology was used to evaluate the potential growth of Listeria monocytogenes and Clostridium perfringens on the surface and in the depth of the carcasses. The gamma concept was chosen as secondary model taking into account the effect of temperature, pH and water activity on the selected bacteria during the chilling process. The predicted growth potential of Listeria monocytogenes is influenced by the different environmental conditions of the selected slaughterhouses and could reach 1.4 log CFU/cm² after the chilling process. The potential growth of Clostridium perfringens is limited due to unfavourable conditions during the first hours and to low temperature later. It can be concluded that when the initial level of contaminating bacteria is not excessive the speed at which the carcass is currently chilled is sufficient to limit the growth of these two pathogens and to ensure the product quality