Radiochirurgie des malformations arterio-veineuses du tronc cerebral stereotactic radiosurgery for brainstem arteriovenous malformations

Introduction: Les malformations artério-veineuses ou angiomes cérébraux sont des anomalies vasculaires congénitales qui se définissent par la présence d’un shunt artério-veineux anormal.Matériels et méthodes: Nous avons mené une étude rétrospective entre Janvier 1992 et Décembre 2010 au service de radiochirurgie de l’hôpital de la Timone, 1557 patients ont été traités par radiochirurgie pour une malformation artérioveineuse dont 61 patients pour une localisation du tronc cérébral (3.91%).Résultats: L’âge moyen de 35.8-/+16.6 ans (4-75).16 patients avaient bénéficié d’une embolisation préradiochirurgicale (26.23%). Le mode de découverte était une hémorragie pour 53 patients (87%). Le volume moyen de traitement était de 1.43+/-1.96 cm3 (0.09-14.20). Le score RBAS était en moyenne de 1.36 +/- 0.34 (0.64-2.35). La dose moyenne de prescription à l’enveloppe l’isodose 50% délivrée était de 22.9 +/-2.9 Gy (12-30), la dose médiane était de 24 Gy).Notre taux d’oblitération global après une ou deux procédures était de 67.27%, pour un délai moyen de suivi est de 56.7 mois+/-43.3 (8.1-251.7). Les facteurs en rapport avec une oblitération) : score RBAS bas (p=0.012), une dose de traitement supérieur à 20Gy (p=0.034). Nous avons eu une mortalité de 1.63% et un pourcentage de saignement après la procédure de 6.55% et 3.2% déficits neurologiques radio-induits.Conclusion: La radiochirurgie est maintenant devenue incontournable dans le traitement des malformations du tronc cérébral même s’il existe un risque hémorragique persistant jusqu’à la guérison (3.5%). Le taux d’oblitération complète est de 67.27%Mots clés: malformations artério-veineuses, tronc cérébral, radiochirurugieEnglish Title: Stereotactic radiosurgery for brainstem arteriovenous malformationsEnglish AbstractIntroduction: Arterioveinous malformations (AVM) or cerebral angiomas are congenital vascular abnormalities which are defined by the presence of abnormal arterio-veinous shunt.Methods:  We lead a retrospective study recruiting 1557 patients treated between January 1992 and December 2010 in the Radiosurgery Unit of La Timone hospital in Marseille. All patients received radiosurgery for management of an AVM, 61 of them being brainstem AVMs (3.91%).Results: Mean age was 35.8 +/- 16.6 years. Sixteen patients underwent arterial embolization before surgery (26.23%). Hemorrhage was the primary onset for 53 patients (87%). Mean volume before treatment was 1.43+/-1.96 cm3 (0.09-14.20). Average RBAS score was 1.36 +/-0.34 (0.64-2.35). Average prescripted dose for 50% delivered iso-dose was 22.9 +/-2.9 Gy (12-30), mean dose was 24 Gy. Our global occlusion rate after one or two treatments was 67.27%, considering an average follow-up of 56.7 months +/- 43.3 (8.1- 251.7). Occlusion related factors were: low RBAS score (p=0.012), received dose higher than 20Gy (p=0.034). Our death rate was 1.63% and our post-procedure bleeding rate was 6.55% with 3.2% of neurological post-procedure deficience.Conclusion: Having regard of remaining hemorrhage risk until complete recovery (3.5%), radiosurgery is nonetheless now a key treatment in the management brainstem AVMS. Complete occlusion rate in our study was 67.27%.Keywords: arteriovenous malformations, brainstem, radiosurger

Result from evaluation of 4D trajectory management with contract-of-objectives

Contract-of-Objectives (CoO) is designed in the context of trajectory-based Air Traffic Management (ATM), using mutually agreed objectives between Air Traffic Control (ATC), airlines and airports. This paper provides an overview of the foreseen validation of CoO and discusses the results of the first Human-in-the-Loop (HIL) evaluation of the concept of operations using CoO between Air Traffic Controllers (ATCos). This HIL real time evaluation is carried out in October 2008 in SkyGuide premises in Geneva, Switzerland. Measurements on system performance (i.e., Safety, Efficiency, and Capacity) as well as Human performances (i.e., workload, Situation Awareness, and acceptability) were collected and analyzed. Results show that ATCos are positive with the concept of operations, and they do agree on the principle of flying what were “planned, agreed and negotiated” on the planning phase as opposed to “first come, first served”. Results of the evaluations also show that CoO can be applied to 2008 and 2020 traffic level in Europe without any impact on System Safety

In Vitro Study of Mutagenesis Induced by Crocidolite-Exposed Alveolar Macrophages NR8383 in Cocultured Big Blue Rat2 Embryonic Fibroblasts

Asbestos-induced mutagenicity in the lung may involve reactive oxygen/nitrogen species (ROS/RNS) released by alveolar macrophages. With the aim of proposing an alternative in vitro mutagenesis test, a coculture system of rat alveolar macrophages (NR8383) and transgenic Big Blue Rat2 embryonic fibroblasts was developed and tested with a crocidolite sample. Crocidolite exposure induced no detectable increase in ROS production from NR8383, contrasting with the oxidative burst that occurred following a brief exposure (1 hour) to zymosan, a known macrophage activator. In separated cocultures, crocidolite and zymosan induced different changes in the gene expressions involved in cellular inflammation in NR8383 and Big Blue. In particular, both particles induced up-regulation of iNOS expression in Big Blue, suggesting the formation of potentially genotoxic nitrogen species. However, crocidolite exposure in separated or mixed cocultures induced no mutagenic effects whereas an increase in Big Blue mutants was detected after exposure to zymosan in mixed cocultures. NR8383 activation by crocidolite is probably insufficient to induce in vitro mutagenic events. The mutagenesis assay based on the coculture of NR8383 and Big Blue cannot be used as an alternative in vitro method to assess the mutagenic properties of asbestos fibres

Physico-chemical and biological characterization of an aquifer polluted with ETBE

International audiencePetroleum compounds and among them, gasoline, is the most massively used chemicals worldwide and, as a consequence gasoline derives compounds are the most frequently found contaminants in groundwate

Ciliary Beating Recovery in Deficient Human Airway Epithelial Cells after Lentivirus Ex Vivo Gene Therapy

Primary Ciliary Dyskinesia is a heterogeneous genetic disease that is characterized by cilia dysfunction of the epithelial cells lining the respiratory tracts, resulting in recurrent respiratory tract infections. Despite lifelong physiological therapy and antibiotics, the lungs of affected patients are progressively destroyed, leading to respiratory insufficiency. Recessive mutations in Dynein Axonemal Intermediate chain type 1 (DNAI1) gene have been described in 10% of cases of Primary Ciliary Dyskinesia. Our goal was to restore normal ciliary beating in DNAI1–deficient human airway epithelial cells. A lentiviral vector based on Simian Immunodeficiency Virus pseudotyped with Vesicular Stomatitis Virus Glycoprotein was used to transduce cultured human airway epithelial cells with a cDNA of DNAI1 driven by the Elongation Factor 1 promoter. Transcription and translation of the transduced gene were tested by RT–PCR and western blot, respectively. Human airway epithelial cells that were DNAI1–deficient due to compound heterozygous mutations, and consequently had immotile cilia and no outer dynein arm, were transduced by the lentivirus. Cilia beating was recorded and electron microscopy of the cilia was performed. Transcription and translation of the transduced DNAI1 gene were detected in human cells treated with the lentivirus. In addition, immotile cilia recovered a normal beat and outer dynein arms reappeared. We demonstrated that it is possible to obtain a normalization of ciliary beat frequency of deficient human airway epithelial cells by using a lentivirus to transduce cells with the therapeutic gene. This preliminary step constitutes a conceptual proof that is indispensable in the perspective of Primary Ciliary Dyskinesia's in vivo gene therapy. This is the first time that recovery of cilia beating is demonstrated in this disease

Analysis of nucleic acid chaperoning by the prion protein and its inhibition by oligonucleotides

Prion diseases are unique neurodegenerative illnesses associated with the conversion of the cellular prion protein (PrPC) into the aggregated misfolded scrapie isoform, named PrPSc. Recent studies on the physiological role of PrPC revealed that this protein has probably multiple functions, notably in cell–cell adhesion and signal transduction, and in assisting nucleic acid folding. In fact, in vitro findings indicated that the human PrP (huPrP) possesses nucleic acid binding and annealing activities, similarly to nucleic acid chaperone proteins that play essential roles in cellular DNA and RNA metabolism. Here, we show that a peptide, representing the N-terminal domain of huPrP, facilitates nucleic acid annealing by two parallel pathways nucleated through the stem termini. We also show that PrP of human or ovine origin facilitates DNA strand exchange, ribozyme-directed cleavage of an RNA template and RNA trans-splicing in a manner similar to the nucleocapsid protein of HIV-1. In an attempt to characterize inhibitors of PrP-chaperoning in vitro we discovered that the thioaptamer 5′-GACACAAGCCGA-3′ was extensively inhibiting the PrP chaperoning activities. At the same time a recently characterized methylated oligoribonucleotide inhibiting the chaperoning activity of the HIV-1 nucleocapsid protein was poorly impairing the PrP chaperoning activities

IV. 1. Taphonomie des squelettes et espace funéraire par

Guichard Yves. IV. 1. Taphonomie des squelettes et espace funéraire par. In: Revue archéologique de Picardie. Numéro spécial 26-1, 2009. Bucy-Le-Long (Aisne). Une nécropole de La Tène ancienne (Ve-IVe siècle avant notre ère). Volume I. Présentations et études : une approche de la population, des sépultures et du mobilier. pp. 163-174