Scédosporiose disséminée après transplantation pulmonaire : une complication rare chez le patient atteint de mucoviscidose

Date du colloque&nbsp;: 06/2009</p

Binary Phase Diagram of Water/Brij58 Studied by SAXS

The phase diagram of the binary water/Brij58 system has been studied at constant temperature T = 20 • C first by simple optical observation and then by small angle X-ray scattering. The small angle X-ray scattering patterns in the isotropic diluted phase are analyzed in a quantitative way by refining the experimental measurements with a model assuming hard spherical micelles in interaction. The micelles are described by a poly dispersed core-shell model and the interaction by the Perkus-Yevick hard-sphere model. The fitted parameters are analyzed in detail to determine the way polyoxyethylene blocks are hydrated with respect to the volumic fraction of water. In the more concentrated regime, the crystalline phases that are identified are the F m3m cubic, the 2D hexagonal and the lamellar phases. The structural parameters that describe each phases are analyzed and commented. The small angle X-ray scattering study is complemented by the determination of the temperature dependent liquid-solid transition by rheology. PACS: 81.30.−t, 61.05.C−, 64.70.dg Introduction The full understanding of the properties of surfactants when added to oil and water is of considerable interest given their tremendous applications in many scientific fields such as the design of hybrid mesoporous materials, drug delivery, or more prosaically industrial applications of detergents. Among widely used surfactants one finds the non-ionic surfactant of the Brij family characterized by a hydrophilic head made of polyoxyethylene (PEO) and a hydrophobic tail made of an alkyl chain. Quite surprisingly very little information is found in the literature about the phase diagram of the Brij58 (polyoxyethylene(20) cetyl ether). Apart from a neutron study of Brij58 micelles made by Sheffer et al. Our objective in this paper is to present the small angle X-ray scattering (SAXS) determination of the structures developed by the Brij58 when mixed with water from 5% to 95% in weight at a constant temperature of 2

Binary Phase Diagram of Water/Brij58 Studied by SAXS

The phase diagram of the binary water/Brij58 system has been studied at constant temperature T = 20 • C first by simple optical observation and then by small angle X-ray scattering. The small angle X-ray scattering patterns in the isotropic diluted phase are analyzed in a quantitative way by refining the experimental measurements with a model assuming hard spherical micelles in interaction. The micelles are described by a poly dispersed core-shell model and the interaction by the Perkus-Yevick hard-sphere model. The fitted parameters are analyzed in detail to determine the way polyoxyethylene blocks are hydrated with respect to the volumic fraction of water. In the more concentrated regime, the crystalline phases that are identified are the F m3m cubic, the 2D hexagonal and the lamellar phases. The structural parameters that describe each phases are analyzed and commented. The small angle X-ray scattering study is complemented by the determination of the temperature dependent liquid-solid transition by rheology. PACS: 81.30.−t, 61.05.C−, 64.70.dg Introduction The full understanding of the properties of surfactants when added to oil and water is of considerable interest given their tremendous applications in many scientific fields such as the design of hybrid mesoporous materials, drug delivery, or more prosaically industrial applications of detergents. Among widely used surfactants one finds the non-ionic surfactant of the Brij family characterized by a hydrophilic head made of polyoxyethylene (PEO) and a hydrophobic tail made of an alkyl chain. Quite surprisingly very little information is found in the literature about the phase diagram of the Brij58 (polyoxyethylene(20) cetyl ether). Apart from a neutron study of Brij58 micelles made by Sheffer et al. Our objective in this paper is to present the small angle X-ray scattering (SAXS) determination of the structures developed by the Brij58 when mixed with water from 5% to 95% in weight at a constant temperature of 2

Allongement de l’intervalle entre traites : identification de 1ers phénotypes prédicteurs

L’allongement de l’intervalle entre traites peut répondre aux attentes des éleveurs laitiers qui doivent faire face à une faible disponibilité en main d’oeuvre en lien avec un travail d’astreinte conséquent (Pomiès et al., 2008). Cette pratique lorsqu’elle est poussée à l’extrême (24h d’intervalle entre traites) provoque des baisses de production laitière telles, que son développement dans les élevages repose sur l’identification d’individus adaptés, basée sur la mesure précoce de phénotypes prédicteurs. Alors que l’hypothèse d’une régulation mécanique de la production laitière en réponse à cet allongement de l’intervalle entre traites prédomine dans la littérature, aucun phénotype à valeur prédictive de ce type n’a été mis en évidence jusqu’à maintenant. La présente étude a pour objectif d’identifier des premiers phénotypes issus de cette régulation mécanique. Les vaches laitières s’adaptant dès le 1er jour à l’allongement de l’intervalle entre traites, l’étude consiste à décrire la réponse des animaux en utilisant un intervalle unique de 24h

Neogene-Quaternary architecture and sedimentary processes on an isolated carbonate-fed deep-water basin (Fairway Basin, Southwest Pacific)

The Fairway Basin is an intracratonic deep-water basin inherited from cretaceous rifting, perched between the Lord Howe Rise and the New Caledonia Basin in the Southwest Pacific. Its originality lies in its atypical present-day physiography and its carbonate-dominated sedimentary setting since the Miocene. Although very limited well controls are available, its overall structure, seismic stratigraphy and architecture are relatively well known. However, little is known on the detailed sedimentary processes controlling its recent infill. Its remote location from any major clastic sediment sources provides a great setting to study deep-water carbonate sedimentary processes. In this paper, we propose a detailed analysis of surface morphologies based on existing multibeam and subbottom echosounding data together with an analysis of the Neogene to Quaternary basin-fill based on seismic reflection data. This allows us to discuss active sedimentary processes, notably gravity flow processes which are thought to be active since the Middle Miocene. These processes are evidenced by both surface and subsurface features, such as submarine canyons, channels and lobes, composite scarps and mass transport deposits (MTDs). In the northern part of the basin, a 400 km-long axial turbidite system is developed close to the Lansdowne Bank, a partly drowned isolated carbonate platform, where present-day sediment remobilisation seems to be essentially sourced from intra-slope instabilities. These reworked sediments extend over an area of 16,000 km2. Along with this axial turbidite system, seismic data show two main mass transport complexes (covering an area of ca 20% of the basin's surface) originating from the slopes of the basin. The potential triggering mechanisms of MTDs of the northern complex might be directly attributed to overloading and high slope values of the Lansdowne Bank area (>1.5°). For the southern complex, surface slope values are lower (<1.4°), and the role of fluid migration and escape is discussed. The Fairway Basin indeed shows strong evidences for fluid generation (e.g. polygonal faulting, pockmarks, presence of a widespread Opal-A/Opal-CT diagenesis-related bottom simulating reflectors) and fluid overpressures

DLL4 conveys Notch-dependent signals achieving selective macrophage differentiation or death

International audienceMolecular mechanisms underlying vascular and inflammatory cell network at endothelial and macrophage levels are still unclear. Here we found that microvascular inflammation associates with changes in Notch signaling at endothelium/monocyte interface including loss of endothelial Notch4 and the acquisition of the Notch ligand Dll4 in both cell types. We showed that endothelial DLL4 induces circulating monocytes to polarize into a M1-type pro-inflammatory macrophages (CD40highCD64highCD200Rlow HLADRlowCD11blow) eliciting the production of IL-6. Dll4 and IL-6 are both Notch-dependent and are required for macrophage polarization through selective down and upregulation of M2and M1-type markers, respectively. Subsequently, we investigated the ability of DLL4 to interfere with M2 polarization. We found that DLL4 triggers a specific alteration of the IL-4 induced M2 phenotype through a significant inhibition of M2 markers (CD11b, CD206, CD200R). DLL4 also induces caspase3/7-dependent apoptosis specifically in M2 differentiating macrophages while DLL1 had no effect. DLL4 signals via Notch1 and DLL4mediated apoptosis is Notch-dependent. Fully differentiated M2 macrophages became resistant to DLL4 action. DLL4 upregulates gene expression, upon M2 upon differentiation, affecting the Notch pattern (Notch1, 3, Jag1) and activity (Hes1), transcription (IRF5, STAT1) that associates with decrease in Akt but not STAT6 phosphorylation. In conclusion, our findings reveal an interplay between DLL4/Notch and IL-6/IL-6R or IL-4/IL-4R signaling pathways supporting M1 differentiation and impairing M2 differentiation via apoptosis

Creation of software to help cardiac surgeons

Abstract Background: The writing of surgical and hospitalization reports is time-consuming and does not necessarily enable the increment of a statistical database, tool that is indispensable nowadays to evaluate unit activity or to carry out scientific studies. In order to prevent this double data capture, a computer tool, named CordaBase, has been developed by surgeons and set up in a cardiac surgery unit. Materials and Methods: CordaBase is an interactive software that stores medical data. Thanks to its intuitive interface, CordaBase stores data which is classified chronologically in the following categories: past medical history, preoperative assessment, operating gesture, stay in intensive care unit, stay in wards and evolution/monitoring after discharge. This date, stored in an Access base, are then used in the creation of personalized surgical and hospitalization reports. All the data is permanently available and can be used for the carrying out of scientific works or for the evaluation of the unit activity. Results: From March 2009 to December 2010, 2617 consecutive patients operated on in a Cardiac Surgery Unit were recorded prospectively in the software. All of this stored data assisted the surgeon in his or her administrative tasks, thanks to personalized surgical and hospitalization reports, immediately at the secretariat’s disposal. The database, which is requisitely filled by administrative work, enables the carrying out of any statistical study on all unit activity. Conclusion: With a hindsight of almost 2 years, CordaBase has proven its usefulness in an active cardiac surgery unit, both on an administrative and scientific level. The computerized reports have lightened the medical secretariat’s workload and statistical studies have now become possible without having to take the paper medical files out again. In the years to come, the accumulation of medical data prospectively or retrospectively stored will surely confirm the potential of the use of such a software

Renal insufficiency, mortality, and drug management in heart transplant. Results of the CARIN study

International audienceRenal insufficiency (RI) is a frequent complication in heart transplant (HT) patients. The main objectives of the Cardiac trAnsplantation and Renal INsufficiency (CARIN) study were to follow the evolution of renal function after heart transplantation (HTx), to identify the factors associated with the decline of renal function, to describe the impact of RI on mortality during 3 years after the HT, and to observe the renal profile of the prescriptions. CARIN was a French retrospective, multicentric, study. Data were collected for patients who received a HT between 2000 and 2005. Data collection was performed at five time points: before HTx (T0), 1(T1), 6(T6), 12 (T12), and 36 (T36) months after HTx. Glomerular filtration rate (GFR) was estimated with aMDRD formula. RI was defined as GFR \textless 60 ml/min/1.73 m(2). Four hundred and forty-one patients from five HT centers were included. The prevalences of RI were 28.8% (T0), 54.0% (T1), 50.4% (T6), 51.6% (T12), and 59.6% (T36). Age and cyclosporine were independently linked to the decline of renal function. Hypertension and GFR \textless 60 at T0 were independent risk factors of mortality. 48.7-64.7% of the nonimmunosuppressive prescriptions were drugs that required dosage adjustment in RI patients or for which no data were available concerning administration in RI patients. RI is highly frequent after HTx. Because RI is a risk factor of mortality, any sparing renal strategies have to be undertaken

The MITRA-HR study: design and rationale of a randomised study of MITRACLIP(R) transcatheter mitral valve repair in patients with severe primary mitral regurgitation eligible for high-risk surgery

International audienceAIMS: Percutaneous mitral valve repair has become an alternative to conventional surgery in patients suffering primary mitral regurgitation (MR) with a contraindication to surgery and could benefit patients at high surgical risk. The aim of the MITRA-HR study is to raise the level of evidence supporting the use of the MitraClip(R) device in primary MR patients with a pre-defined high risk for surgery. METHODS AND RESULTS: MITRA-HR is a prospective, multicentre, randomised study designed to compare mitral valve repair using MitraClip(R) with conventional surgery in patients with severe primary mitral regurgitation at high risk for surgery. The surgical risk is defined by age, Society of Thoracic Surgeons (STS) risk estimate score, frailty, major organ system dysfunction, and procedure-specific impediments. The study will enrol 330 patients randomised between conventional surgery and MitraClip(R) with a 1:1 ratio. The composite primary endpoint includes all-cause mortality, unplanned rehospitalisation for cardiovascular reasons, and mitral valve reintervention at 12 months. The main secondary safety endpoint is a major adverse event composite assessment evaluated 30 days after the procedure. CONCLUSIONS: The randomised MITRA-HR study is designed to provide additional supportive evidence of non-inferiority in efficacy and superiority in safety for percutaneous mitral valve repair using MitraClip(R) compared to conventional surgery in high surgical risk patients