Asymptomatic anterior shoulder dislocation of 24-year duration

A 73-year-old woman presented with a very long-standing anterior dislocation of her right shoulder. She had no pain, mild impairment of active shoulder motion and clinical features suggesting no tear of the rotator cuff. CT 3D reconstructions showed a newly formed glenoid cavity below the coracoid process. This case indicates that an anterior shoulder dislocation lasting even decades may be compatible with an almost normal shoulder function

Therapy of clinical stage IIA and IIB seminoma: a systematic review

\ua9 2021, The Author(s). Purpose: The optimal treatment for clinical stage (CS) IIA/IIB seminomas is still controversial. We evaluated current treatment options. Methods: A systematic review was performed. Only randomized clinical trials and comparative studies published from January 2010 until February 2021 were included. Search items included: seminoma, CS IIA, CS IIB and therapy. Outcome parameters were relapse rate (RR), relapse-free (RFS), overall and cancer-specific survival (OS, CSS). Additionally, acute and long-term side effects including secondary malignancies (SMs) were analyzed. Results: Seven comparative studies (one prospective and six retrospective) were identified with a total of 5049 patients (CS IIA: 2840, CS IIB: 2209). The applied treatment modalities were radiotherapy (RT) (n = 3049; CS IIA: 1888, CSIIB: 1006, unknown: 155) and chemotherapy (CT) or no RT (n = 2000; CS IIA: 797, CS IIB: 1074, unknown: 129). In CS IIA, RRs ranged from 0% to 4.8% for RT and 0% for CT. Concerning CS IIB RRs of 9.5%–21.1% for RT and of 0%–14.2% for CT have been reported. 5-year OS ranged from 90 to 100%. Only two studies reported on treatment-related toxicities. Conclusions: RT and CT are the most commonly applied treatments in CS IIA/B seminoma. In CS IIA seminomas, RRs after RT and CT are similar. However, in CS IIB, CT seems to be more effective. Survival rates of CS IIA/B seminomas are excellent. Consequently, long-term toxicities and SMs are important survivorship issues. Alternative treatment approaches, e.g., retroperitoneal lymph node dissection (RPLND) or dose-reduced sequential CT/RT are currently under prospective investigation

Lessons from prospective longitudinal follow-up of a French APECED cohort

Background Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome is a rare disease caused by biallelic mutations of the AIRE gene, usually presenting with the triad hypoparathyroidism-adrenal failure-chronic mucocutaneous candidiasis (CMC) and nonendocrine manifestations. The aim of this study was to determine the molecular profile of the AIRE gene, the prevalence of rare manifestations, and to characterize immunological disturbances in a French cohort. Patients and Methods A national, multicenter prospective observational study to collect genetic, clinical, biological, and immunological data (NCT03751683). Results Twenty-five patients (23 families) were enrolled. Eleven distinct AIRE variants were identified, 2 of which were not previously reported: an intronic variant, c.653-70G > A, and a c.1066del (p.Arg356GlyfsX22) variant (exon 9). The most common was the Finnish variant c.769C > T (16 alleles), followed by the variant c.967_979del13 (15 alleles), which seemed associated with a less severe phenotype. Seventeen out of 25 patients were homozygote. The median number of clinical manifestations was 7; 19/25 patients presented with the hypoparathyroidism-adrenal failure-CMC triad, 8/13 showed pulmonary involvement, 20/25 had ectodermal dystrophy, 8/25 had malabsorption, and 6/23 had asplenia. Fifteen out of 19 patients had natural killer cell lymphopenia with an increase in CD4+ and CD8+ T lymphocytes and an age-dependent alteration of B lymphocyte homeostasis compared with matched controls (P < .001), related to the severity of the disease. All tested sera (n = 18) were positive for anti-interferon-α, 15/18 for anti-IL-22 antibodies, and 13/18 for anti-IL-17F antibodies, without clear phenotypic correlation other than with CMC. Conclusion This first prospective cohort showed a high AIRE genotype variability, with 2 new gene variants. The prevalence of potentially life-threatening nonendocrine manifestations was higher with systematic screening. These manifestations could, along with age-dependent B-cell lymphopenia, contribute to disease severity. Systematic screening for all the manifestations of the syndrome would allow earlier diagnosis, supporting vaccination and targeted therapeutic approaches

SPICAV on Venus Express: Three spectrometers to study the global structure and composition of the Venus atmosphere

Spectroscopy for the investigation of the characteristics of the atmosphere of Venus (SPICAV) is a suite of three spectrometers in the UV and IR range with a total mass of 13.9 kg flying on the Venus Express (VEX) orbiter, dedicated to the study of the atmosphere of Venus from ground level to the outermost hydrogen corona at more than 40,000 km. It is derived from the SPICAM instrument already flying on board Mars Express (MEX) with great success, with the addition of a new IR high-resolution spectrometer, solar occultation IR (SOIR), working in the solar occultation mode. The instrument consists of three spectrometers and a simple data processing unit providing the interface of these channels with the spacecraft. A UV spectrometer (118-320 nm, resolution 1. 5 nm) is identical to the MEX version. It is dedicated to nadir viewing, limb viewing and vertical profiling by stellar and solar occultation. In nadir orientation, SPICAV UV will analyse the albedo spectrum (solar light scattered back from the clouds) to retrieve SO2, and the distribution of the UV-blue absorber (of still unknown origin) on the dayside with implications for cloud structure and atmospheric dynamics. On the nightside, 7 and 6 bands of NO will be studied, as well as emissions produced by electron precipitations. In the stellar occultation mode the UV sensor will measure the vertical profiles of CO2, temperature, SO2, SO, clouds and aerosols. The density/temperature profiles obtained with SPlCAV will constrain and aid in the development of dynamical atmospheric models, from cloud top (similar to 60 km) to 160 km in the atmosphere. This is essential for future missions that would rely on aerocapture and acrobraking. UV observations of the upper atmosphere will allow studies of the ionosphere through the emissions of CO, CO+, and CO2+, and its direct interaction with the solar wind. It will study the H corona, with its two different scale heights, and it will allow a better understanding of escape mechanisms and estimates of their magnitude, crucial for insight into the long-term evolution of the atmosphere. The SPICAV VIS-IR sensor (0.7-1.7 mu m, resolution 0.5-1.2 nm) employs a pioneering technology: an acousto-optical tunable filter (AOTF). On the nightside, it will study the thermal emission peeping through the clouds, complementing the observations of both VIRTIS and Planetary Fourier Spectrometer (PFS) on VEX. In solar occultation mode this channel will study the vertical structure of H2O, CO2, and aerosols. The SOIR spectrometer is a new solar occultation IR spectrometer in the range lambda=2.2-4.3 mu m, with a spectral resolution lambda/Delta lambda > 15,000, the highest on board VEX. This new concept includes a combination of an echelle grating and an AOTF crystal to sort out one order at a time. The main objective is to measure HDO and H2O in solar occultation, in order to characterize the escape of D atoms from the upper atmosphere and give more insight about the evolution of water on Venus. It will also study isotopes of CO2 and minor species, and provides a sensitive search for new species in the upper atmosphere of Venus. It will attempt to measure also the nightside emission, which would allow a sensitive measurement of HDO in the lower atmosphere, to be compared to the ratio in the upper atmosphere, and possibly discover new minor atmospheric constituents. (C) 2007 Elsevier Ltd. All rights reserved

Dynamic control of an accelerometer bandwidth through tunable damping factor and effective moment of inertia

International audienceIn this paper, we report the dynamic bandwidth control of an accelerometer by reducing both its quality factor andits effective inertia. The MEMS is coupled with two builtin resistors to tune the frequency response through a DCvoltage. The conception, the fabrication and the electrical testing of the accelerometer are presented. The reduction ofthe effective moment of inertia is experimentally evidenced on the basis of an analytical model. To the best of ourknowledge, such a control of the bandwidth including inertial effects has not been reported yet. This strategy doesnot impact the quasi-static gain of the device and may be operated in vacuum

Methodology for the study of vacuum gas oil hydrocracking catalysts Coupling of GC-2D data with vapour-liquid equilibrium

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