CREWS - l'Ecritoire Analysis for the Implementation of a medical image database for mammography

International audienceIn this paper, we present our approach in order to implement a Medical Image Database (MIDB) for archiving mammograms and their related information in the Department of Radiology of the Necker Hospital (Paris). The aim of such a database is to help breast cancer screening in clinics, research and education. As implementation of such a MIDB requires the understanding of users' needs, we have analyzed requirements by using the Crews-l'Ecritoire (Cooperative REquirements With Scenarios) approach developed in our laboratory. This approach is based on the "Requirement Engineering" concept. It helps understanding users' needs using a semi-automatic analysis of textual scenarios, i.e. scenarios written in natural language. This approach mixes concepts of goals and of scenarios into the notion of "Requirement Chunk". Authored scenarios and goal discovery are guided by rules, which lead to a structured network of scenarios. Our analysis resulted in 58 Requirements Chunks gathering 72 authored scenarios and 300 goals which represent MIDB services requested by radiologists in the course of their daily practice

Transition Metal Diazoalkane Complexes. Synthesis, Structure, and Photochemistry of Rh[C(N_2)SiMe_3](PEt_3)_3

Reaction of RhCl(PR_3)_n (R = Me (n = 4), Et (n = 3)) and RhCl(CO)(PEt_3)_2 with (trimethylsilyl)diazomethyl lithium at −78 °C in ether yields the three complexes Rh[C(N_2)SiMe_3](PEt_3)_3 (1), Rh[C(N_2)SiMe_3](PMe_3)_4 (2), and Rh[C(N_2)SiMe_3](CO)(PEt_3)_2 (3). 2 could not be isolated as a solid at room temperature but 1 was precipitated as red crystals that were stable enough to be handled under argon. X-ray work on 1 reveals a tetrahedrally distorted square-planar geometry with the planar (trimethylsilyl)diazomethyl ligand roughly perpendicular to the P3RhC coordination plane. This distortion makes the PEt3 ligands nonequivalent in the crystal and produces an ABB‘X pattern in the solid-state ^(31)P NMR spectrum. Photolysis of Rh[C(N_2)SiMe_3](PEt_3)_3 leads quantitatively to the dimer [Rh{C(SiMe_3)(PEt_3)}(PEt_3)_2]_2 (4). The presence of the two ylide bridges and terminal phosphines is deduced from the COSY ^(31)P−^(31)P NMR spectrum. This photochemical reactivity suggests that the transient carbene (PEt_3)_3RhC̈(SiMe_3) is electrophilic, which is typical of a singlet carbene. We believe the singlet state is stabilized by the presence of the electron-rich low-spin Rh(PEt3)3 fragment. Reaction with ^nBuNC and ^tBuNC leads to stereo- and regioselective formation of a triazole that is σ bonded to the rhodium center. The X-ray structure of the ^tBuNC derivative Rh[CC(SiMe_3)N_2N^tBu](^tBuNC)_2(PEt_3) (5) shows a distorted square-planar geometry around Rh with the planar triazolato ligand roughly orthogonal to this plane. The probable reaction mechanism involves addition and substitution reactions of isocyanides at Rh followed by insertion into the Rh−C bond

Plasmodium falciparum Infection Significantly Impairs Placental Cytokine Profile in HIV Infected Cameroonian Women

BACKGROUND:Placental cytokines play crucial roles in the establishment and maintenance of pregnancy as well as protecting the foetus from infections. Previous studies have suggested the implication of infections such as P. falciparum and HIV in the stimulation of placental cytokines. This study assessed the impact of P. falciparum on placental cytokine profiles between HIV-1 positive and negative women. MATERIALS AND METHODS:P. falciparum infection was checked in peripheral and placental blood of HIV-1 negative and positive women by the thick blood smear test. Cytokines proteins and messenger RNAs were quantified by ELISA and real time PCR, respectively. Non-parametric tests were used for statistical analyses. RESULTS:Placental and peripheral P. falciparum infections were not significantly associated with HIV-1 infection (OR: 1.4; 95% confidence interval (95%CI): 0.5-4.2; p = 0.50 and OR: 0.6; 95%CI: 0.3-1.4; p = 0.26, respectively). Conversely, placental P. falciparum parasitemia was significantly higher in the HIV-1 positive group (p = 0.04). We observed an increase of TNF-alpha mRNA median levels (p = 0.02) and a trend towards a decrease of IL-10 mRNA (p = 0.07) in placenta from HIV-1 positive women compared to the HIV negative ones leading to a median TNF-alpha/IL-10 mRNA ratio significantly higher among HIV-1 positive than among HIV-1 negative placenta (p = 0.004; 1.5 and 0.8, respectively). Significant decrease in median secreted cytokine levels were observed in placenta from HIV-1 positive women as compared to the HIV negative however these results are somewhat indicative since it appears that differences in cytokine levels (protein or mRNA) between HIV-1 positive and negative women depend greatly on P.falciparum infection. Within the HIV-1 positive group, TNF-alpha was the only cytokine significantly associated with clinical parameters linked with HIV-1 MTCT such as premature rupture of membranes, CD4 T-cell number, plasma viral load and delay of NVP intake before delivery. CONCLUSIONS:These results show that P. falciparum infection profoundly modifies the placenta cytokine environment and acts as a confounding factor, masking the impact of HIV-1 in co-infected women. This interplay between the two infections might have implications in the in utero MTCT of HIV-1 in areas where HIV-1 and P. falciparum co-circulate

Seminal Plasma Exposures Strengthen Vaccine Responses in the Female Reproductive Tract Mucosae

HIV-1 sexual transmission occurs mainly via mucosal semen exposures. In the female reproductive tract (FRT), seminal plasma (SP) induces physiological modifications, including inflammation. An effective HIV-1 vaccine should elicit mucosal immunity, however, modifications of vaccine responses by the local environment remain to be characterized. Using a modified vaccinia virus Ankara (MVA) as a vaccine model, we characterized the impact of HIV-1+ SP intravaginal exposure on the local immune responses of non-human primates. Multiple HIV-1+ SP exposures did not impact the anti-MVA antibody responses. However, SP exposures revealed an anti-MVA responses mediated by CD4+ T cells, which was not observed in the control group. Furthermore, the frequency and the quality of specific anti-MVA CD8+ T cell responses increased in the FRT exposed to SP. Multi-parameter approaches clearly identified the cervix as the most impacted compartment in the FRT. SP exposures induced a local cell recruitment of antigen presenting cells, especially CD11c+ cells, and CD8+ T cell recruitment in the FRT draining lymph nodes. CD11c+ cell recruitment was associated with upregulation of inflammation-related gene expression after SP exposures in the cervix. We thus highlight the fact that physiological conditions, such as SP exposures, should be taken into consideration to test and to improve vaccine efficacy against HIV-1 and other sexually transmitted infections

Transition Metal Diazoalkane Complexes. Synthesis, Structure, and Photochemistry of Rh[C(N_2)SiMe_3](PEt_3)_3

Reaction of RhCl(PR_3)_n (R = Me (n = 4), Et (n = 3)) and RhCl(CO)(PEt_3)_2 with (trimethylsilyl)diazomethyl lithium at −78 °C in ether yields the three complexes Rh[C(N_2)SiMe_3](PEt_3)_3 (1), Rh[C(N_2)SiMe_3](PMe_3)_4 (2), and Rh[C(N_2)SiMe_3](CO)(PEt_3)_2 (3). 2 could not be isolated as a solid at room temperature but 1 was precipitated as red crystals that were stable enough to be handled under argon. X-ray work on 1 reveals a tetrahedrally distorted square-planar geometry with the planar (trimethylsilyl)diazomethyl ligand roughly perpendicular to the P3RhC coordination plane. This distortion makes the PEt3 ligands nonequivalent in the crystal and produces an ABB‘X pattern in the solid-state ^(31)P NMR spectrum. Photolysis of Rh[C(N_2)SiMe_3](PEt_3)_3 leads quantitatively to the dimer [Rh{C(SiMe_3)(PEt_3)}(PEt_3)_2]_2 (4). The presence of the two ylide bridges and terminal phosphines is deduced from the COSY ^(31)P−^(31)P NMR spectrum. This photochemical reactivity suggests that the transient carbene (PEt_3)_3RhC̈(SiMe_3) is electrophilic, which is typical of a singlet carbene. We believe the singlet state is stabilized by the presence of the electron-rich low-spin Rh(PEt3)3 fragment. Reaction with ^nBuNC and ^tBuNC leads to stereo- and regioselective formation of a triazole that is σ bonded to the rhodium center. The X-ray structure of the ^tBuNC derivative Rh[CC(SiMe_3)N_2N^tBu](^tBuNC)_2(PEt_3) (5) shows a distorted square-planar geometry around Rh with the planar triazolato ligand roughly orthogonal to this plane. The probable reaction mechanism involves addition and substitution reactions of isocyanides at Rh followed by insertion into the Rh−C bond

Higher placental anti-inflammatory IL-10 cytokine expression in HIV-1 infected women receiving longer zidovudine prophylaxis associated with nevirapine

Placental cytokine balance may be critical for the control of mother-to-child transmission (MTCT) of HIV. We assessed whether the type and duration of antiretrovirals used for prevention of HIV-1-MTCT modified the inflammatory cytokine profile. We investigated the levels of cytokine expression in the placentas of 61 HIV-1-infected women who received zidovudine (ZDV) plus single dose nevirapine (SD-NVP) or ZDV only for prevention of MTCT. Placentas of 38 HIV-1-uninfected women were included as controls. All placentas were obtained after vaginal delivery. Levels of mRNA and cytokine expression were quantified using real-time PCR and ELISA, respectively, in placental explants and 24-hour culture supernatants and analyzed in relation to the women's characteristics and the type and duration of antiretroviral prophylaxis. HIV-1-infected and uninfected women did not show any differences in the expression of placental cytokine secretion except for a trend toward lower TNF-10 mRNA levels in HIV-1-infected women. Within the HIV-1-infected group, women who were exposed to a long duration of ZDV (>72 days) or received SD-NVP less than 5h prior to delivery, more frequently expressed detectable levels of IL-10 in their placentas (32% versus 7% (p = 0.01) and 32% versus 5% (p = 0.02), respectively). No infant was found to be HIV-1-infected. Our results showed a normalization of the placental cytokine balance in HIV-1-infected women receiving antiretroviral prophylaxis. Furthermore, the type and duration of antiretroviral prophylaxis have an impact on the placental anti-inflammatory IL-10 expression level, which may contribute to controlling HIV replication at the placental level, thus reducing MTCT of HIV-1.Fil: Pornprasert, Sakorn. Chiang Mai University; TailandiaFil: Mary, Jean-Yves. Université Paris Diderot - Paris 7; FranciaFil: Faye, Albert. Institut National de la Santé et de la Recherche Médicale; FranciaFil: Leechanachai, Pannee. Chiang Mai University; TailandiaFil: Limtrakul, Aram. Health Promotion Center Region; TailandiaFil: Rugpao, Sungwal. Chiang Mai University; TailandiaFil: Sirivatanapa, Pannee. Chiang Mai University; TailandiaFil: Gomuthbutra, Vorapin. Nakornping Hospital; TailandiaFil: Matanasaravoot, Wanmanee. Lamphun Hospital; TailandiaFil: Le Coer, Sophie. Institut National d’Etudes Démographiques; FranciaFil: Lallemant, Marc. Centre National de la Recherche Scientifique. Institut de Recherche pour le Développement; FranciaFil: Barré-Sinoussi, Françoise. Instituto Pasteur; FranciaFil: Menu, Elisabeth. Instituto Pasteur; FranciaFil: Ngo Giang Huong, Nicole. Centre National de la Recherche Scientifique. Institut de Recherche pour le Développement; FranciaFil: Ayouba, Ahidjo. Instituto Pasteur; FranciaFil: Chailert, Sanupong. Chiang Mai University; Tailandia. Instituto Pasteur; FranciaFil: Chaouat, Gérard. Institut National de la Santé et de la Recherche Médicale; FranciaFil: Derrien, Muriel. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Dolcini, Guillermina Laura. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Sanidad Animal y Medicina Preventiva. Laboratorio de Virología; Argentina. Instituto Pasteur; Francia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; ArgentinaFil: Eteki, Nicole. Hôpital Central de Yaoundé. Maternité Principale; CamerúnFil: Kfutwah, Anfumbom Jude. Instituto Pasteur; FranciaFil: Kouo, Odette. Instituto Pasteur; FranciaFil: Lemen, Brigitte. Instituto Pasteur; FranciaFil: Abal, Facundo Juan Pablo. Instituto Pasteur; FranciaFil: Nerrienet, Eric. Instituto Pasteur; FranciaFil: Njinku, Bernadette. Instituto Pasteur; FranciaFil: Scarlatti, Gabriella. Suan Dok Hospital; TailandiaFil: Tejiokem, Mathurin. Centre Pasteur du Cameroun; CamerúnFil: Téné, Gilbert. No especifíca

Les stratégies de prise en charge des pathologies traumatiques de la sportive sont-elles différentes de celles des sportifs ?

Demarais Yves, Menu Pierre. Les stratégies de prise en charge des pathologies traumatiques de la sportive sont-elles différentes de celles des sportifs ?. In: Les Cahiers de l'INSEP, n°40, 2008. Sport de haut niveau au féminin. Tome 3. Entretiens de l'INSEP 11, 12, 13 décembre 2007. pp. 135-136

La dissection aortique aiguë de type A des patients octogénaires

POITIERS-BU Médecine pharmacie (861942103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L'évaluation des retombées socio-économiques du viaduc de Millau pour le Sud-Aveyron

Extrait de documentLe chapitre applique une démarche d'évaluation de l'action publique à l'identification des impacts potentiels de la construction du viaduc de Millau. Après avoir présenté les effets classiques des aménagements routiers, ainsi que les principes des démarches d'évaluation, il esquisse un diagramme d'impacts du viaduc sur le sud-Aveyron