In Utero Diagnosis of Niemann-Pick Type C in the Absence of Family History

Niemann-Pick type C (NPC) disease is a recessive disorder that results in unesterified cholesterol accumulating in the lysosomal and late endosomal system. It is caused by mutations in NPC1 or NPC2 genes and leads to systemic and neurodegenerative symptoms. Few cases of prenatal presentation of NPC have been reported and only two cases in the absence of previous family history, indicating the diagnosis is particularly difficult in such a situation. We report a prenatal diagnosis of NPC in a couple without family history. An ultrasound screening at 22 weeks of gestation (WG) detected fetal ascites and hepatomegaly, which were still present at 25, 27, and 29 WG, and a splenomegaly progressively appeared. No placentomegaly or other signs of hydrops fetalis were observed. The diagnostic of NPC was prenatally confirmed by a filipin test and NPC1 sequencing and multiplex ligation-dependent probe amplification assay which revealed a maternal missense mutation (c.2608T>C; p.Ser870Pro) and a paternal deletion of exons 5 to 25. This additional prenatal case of NPC suggests that even in the absence of family history, fetal ascites associated with splenomegaly but no hydrops should nonetheless arouse suspicion concerning this disease as a possible diagnosis

The relationship between the phonological strategies employed In reading and spelling

This paper summarises a longitudinal study which examined the relationship between the abilities of young children to read and spell phonologically. Empirical evidence of Bryant and Bradley (1980) and Cataldo and Ellis (1988) to show that children acquire the ability to use a phonological strategy for spelling before the ability to use an equivalent strategy for reading is confirmed. Implications for the teaching of reading are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73266/1/j.1467-9817.1991.tb00011.x.pd

L’éthique de la recherche en psychiatrie adulte

International audienceLa recherche médicale a pour but d'améliorer la condition humaine en développant un corps de connaissances valides et fiables. Cependant, l'histoire de la médecine au cours des siècles fut marquée par de nombreux scandales montrant les dérives possibles de la recherche lorsque celle-ci n'est pas encadrée par une réflexion éthique ni par la loi. La réflexion éthique est donc permanente et les chercheurs doivent sans cesse interroger leur pratique. En psychiatrie, l'objet de la recherche est un être humain rendu vulnérable par ses troubles. Aussi, dans cet article, nous nous proposons d'examiner les fondements théoriques de l'éthique dans la recherche sur l'être humain. Il s'agit donc d'une réflexion sur la signification réelle de ce concept, son histoire, ses principes et ses particularités dans le domaine de la psychiatrie

Partial volume correction strategies for quantitative FDG PET in oncology

Purpose: Quantitative accuracy of positron emission tomography (PET) is affected by partial volume effects resulting in increased underestimation of the standardized uptake value (SUV) with decreasing tumour volume. The purpose of the present study was to assess accuracy and precision of different partial volume correction (PVC) methods. Methods: Three methods for PVC were evaluated: (1) inclusion of the point spread function (PSF) within the reconstruction, (2) iterative deconvolution of PET images and (3) calculation of spill-in and spill-out factors based on tumour masks. Simulations were based on a mathematical phantom with tumours of different sizes and shapes. Phantom experiments were performed in 2-D mode using the National Electrical Manufacturers Association (NEMA) NU2 image quality phantom containing six differently sized spheres. Clinical studies (2-D mode) included a test-retest study consisting of 10 patients with stage IIIB and IV non-small cell lung cancer and a response monitoring study consisting of 15 female breast cancer patients. In all studies tumour or sphere volumes of interest (VOI) were generated using VOI based on adaptive relative thresholds. Results: Simulations and experiments provided similar results. All methods were able to accurately recover true SUV within 10% for spheres equal to and larger than 1 ml. Reconstruction-based recovery, however, provided up to twofold better precision than image-based methods. Cl

Tomographie conique de 6 MV : simulation et évaluation GATE v6.2 Monte-Carlo d’un imageur portal avec application spécifique en radiothérapie ORL

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