Merkel Cell Polyomavirus Small T Antigen mRNA Level Is Increased following In Vivo UV-Radiation

Merkel cell carcinoma (MCC) is a rare but aggressive skin cancer involving Merkel cells. Recently, a new human polyomavirus was implicated in MCC, being present in 80% of the samples analyzed. In virus-positive MCC, the Merkel cell polyomavirus (MCPyV) is clonally integrated into the patients DNA, and carries mutations in its large T antigen, leading to a truncated protein. In non-symptomatic tissue MCPyV can reside at very low levels. MCC is also associated with older age, immunosuppression and sun exposure. However, the link with solar exposure remains unknown, as the precise mechanism and steps involved between time of infection by MCPyV and the development of MCC. We thus investigated the potential impact of solar simulated radiation (SSR) on MCPyV transcriptional activity. We screened skin samples of 20 healthy patients enrolled in a photodermatological protocol based on in vivo-administered 2 and 4 J/cm2 SSR. Two patients were infected with two new variants of MCPyV, present in their episomal form and RT-QPCR analyses on SSR-irradiated skin samples showed a specific and unique dose-dependent increase of MCPyV small t antigen transcript. A luciferase based in vitro assay confirmed that small t promoter is indeed UV-inducible. These findings demonstrate that solar radiation has an impact on MCPyV mRNA levels that may explain the association between MCC and solar exposure

Eyelid fat grafting: indications, operative technique and complications; a systematic review

International audienceIntroduction - Many recent studies concerning autologous fat grafting in the eyelids have been published, mostly consisting of case reports and retrospective case series. However, no study on the overall complication or satisfaction rate associated with the various grafting techniques exists. We performed a comprehensive literature review to determine the outcomes and complications of eyelid fat grafting, as well as patient satisfaction.Methods - A systematic review of the literature using the PRISMA criteria was conducted. This protocol was registered at the Prospective Register of Systematic Reviews at the National Institute for Health Research.Results - Sixteen studies, representing 1,159 patients and published between June 2004 and December 2014, were included. Satisfactory results, judged by clinical examination, were observed in all studies. Few postoperative complications were reported.Conclusions - We demonstrated that the procedures were easy to perform, and achieved satisfactory and sustainable results with few complications in both reconstructive and cosmetic surgery. However, a wide disparity exists in the various fat harvesting, fat purification, and reinjection techniques. Further studies are required to assess the long-term outcomes. Our conclusions should be accepted cautiously due to the small number of articles and the lack of evidence in published studies.<br

Influence de paramètre biomécaniques et électrophysiologiques sur la technique de propulsion (transition de la posture classique vers la posture danseuse chez le cycliste)

L'objectif de ce travail est de tenter d'identifier les facteurs qui sous-tendent les adaptations posturales lors de la propulsion du cycliste et notamment lors du passage de la posture classique vers la posture danseuse. Cette adaptation posturale est-elle liée à une recherche de création de forces supplémentaires et/ou permet-elle une économie musculaire? Pour aborder ce questionnement, il a été développé du matériel expérimental permettant de mesurer les contraintes mécaniques à l'interface entre le cycliste et la bicyclette. Ce matériel nous a permis d'enregistrer et d'analyser les paramètres mécaniques (moments articulaires et puissance) et physiologiques (EMG, rythme cardiaque) de chacune des postures lors de tests où la puissance mécanique est incrémentée. Les résultats montrent que l'utilisation de la posture danseuse crée des configurations musculo-squelettiques plus adaptées au développement de puissances qu'en posture classique. L'élévation de la puissance développée est liée à l'augmentation de la contrainte musculaire. Cette augmentation de contrainte invalide l'hypothèse d'économie musculaire à l'origine du choix postural. L'analyse de l'activité électromyographique montre une répartition différente des efforts entre les groupes musculaires en danseuse. Le biceps femoris (acteur essentiel de la propulsion) voit son activité diminuer en durée d'activation et en intensité de ses contractions ce qui augmente sa phase de repos. Cependant, l'amplitude de l'EMG de la majorité des muscles étudiés a augmenté...The aim of this study was to understand which elements induce postural adaptation during cycling propulsion and particularly during transition from the classical posture to the upright one. Lots of works investigate posture effect on cyclist performance. However, few studies interest in the upright posture utilization. In our knowledge, no studies clearly explain why cyclists change their posture from classical to upright when ergocycle's resistance becomes too high. Is this postural adaptation due to more force creation and/or to muscular economy? First, we have developed experimental devices allowing us to measure mechanical strain between cyclist and bicycle. We have studied mechanical and physiological parameters for each posture during power incremental test. Then, we have evaluated the more pertinent parameters influence on the transition trigger. Results show that upright posture allows musculoskeletal configuration favorable to the development of high power output. Using upright posture, absence of saddle support induces better postural adaptations to oppose to the ergocycle resistance increase. Power output growth is principally due to muscle strain increase. Electromyographic analysis shows that muscle activation is different between the two postures. In particular, biceps femoris is less activated in the upright posture in spite of the higher power output. The reduction of the duration and intensity of this muscle contraction permit to increase the rest phase. Better allocations of the effort between the muscles enable some of them to rest. This phenomenon of muscle economy could explain the transition from classical posture to the upright posture when power output get higher.TOULOUSE3-BU Sciences (315552104) / SudocSudocFranceF

Lower Body Lift after Massive Weight Loss: Autoaugmentation versus No Augmentation

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Medial thighplasty after massive weight loss: are there any risk factors for postoperative complications?

International audienceBACKGROUND: With the increasing incidence of obesity in Western societies, an increasing number of patients undergo bariatric surgery that leads to functional and aesthetic sequelae related to a rapid and massive weight loss, namely, skin and fat excess. The goal of surgical management after massive weight loss is to optimize the functional results obtained from bariatric surgery or diet by removal of the redundant skin folds. The authors report their experience with medial thighplasty after massive weight loss and identify factors predictive of postoperative complications. METHODS: This retrospective study investigated 53 patients who underwent surgery for medial thighplasty after massive weight loss. Data were collected through chart review and submitted to statistical analysis. RESULTS: The average weight loss before thighplasty was 43.5 ± 14.9 kg, and 39.6 % of the patients experienced at least one complication. The complications were seroma (9.4 %), wound dehiscence (20.8 %), scar migration (17 %), wound infection (5.7 %), and partial skin necrosis (1.9 %). The body mass index (BMI) before massive weight loss and the BMI before medial thighplasty were found to be risk factors for the development of a postoperative complication. CONCLUSION: Few guidelines exist for the optimization of care and safety in this complex patient population. The information from this retrospective study complements the current data from the literature and can help surgeons select patients eligible for medial thighplasty. This report shows that the BMI before medial thighplasty should be taken into consideration for patients willing to undergo a body-contouring procedure. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Is Abdominoplasty and Concomitant Laparoscopic Umbilical Hernia Repair Feasible by a Plastic Surgeon?

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Abdominoplasty: risk factors, complication rates, and safety of combined procedures

International audienceLetter to the Edito