[Cerebral venous thrombosis revealing neurosyphilis]. / Une thrombose veineuse cérébrale révélant une neurosyphilis.

INTRODUCTION: Syphilis is a bacterial infection which is increasing in France. Neurosyphilis is a rare manifestation of syphilis, mainly involving the meninges and the blood vessels. It is a rare cause of cerebral vascular stroke. Venous thrombosis of syphilitic origin is rarely described. OBSERVATION: We reported a case of a fifty-year-old patient hospitalized for bilateral non-painful decreased visual acuity with headache. The CT scan showed cerebral venous thrombosis from the right lateral sinus to the jugular gulf. Patient presented a bilateral papillar oedema on the ocular fundus. Lumbar puncture showed lymphocytic meningitis with blood and CSF serology suggestive of neurosyphilis. The patient received antibiotic therapy with penicillin G for 14days with curative anticoagulation for six months. The evolution was favorable. CONCLUSION: Cerebral venous thrombosis in neurosyphilis is a poorly described entity. This case report confirms the status of great simulator of syphilis. In the context of its worldwide recrudescence, syphilis must be evoked in front of an unexplained neurological disorder.

Lead-vanadate sorbents for iodine trapping and their conversion into an iodoapatite-based conditioning matrix.

New lead-vanadate based sorbents were synthesized with the aim to entrap and confine gaseous iodine in off-gas streams coming from reprocessing facilities of spent nuclear fuel. Their synthesis relies on the shaping of a lead-vanadate, lead sulfide and alginic acid mix as millimetric beads. These beads were calcined between 220°C and 500°C to remove organic alginic compounds template. However, according to the calcination temperature, lead sulfide could be partially oxidized, limiting iodine loading capacity. A compromise temperature between 290°C and 350°C was found to remove most of the alginic acid template and avoiding lead sulfide oxidation. These sorbents were tested for iodine trapping in static conditions at 60°C. They performed well with a sorption capacity up to 155 mg.g-1 by forming PbI2. Furthermore, these iodine-loaded sorbents could be easily converted into an iodine-containing lead-vanadate apatite matrix by spark plasma sintering. A dense sample was produced for a sintering temperature of 500°C under 70 MPa. Such a material could be suitable for radioactive iodine conditioning in deep geological disposal. Finally, lead-vanadate sorbents could provide an easy way to entrap and confine radioactive iodine from off-gas streams into a durable material within a few steps.

The study of the pseudo-polyrotaxane architecture as a route for mild surface functionalization by click chemistry of poly(ε-caprolactone)-based electrospun fibers.

Polycaprolactone (PCL) electrospun fibers are widely developed for biomedical applications. However, their hydrophobicity and passivity towards cell growth is an important limitation. An original method to functionalize PCL nanofibers, making them reactive for bioconjugation of proteins or other molecules of interest in water under mild conditions, is reported here. This method involves the preparation of pseudo-polyrotaxanes (pPRs) of cyclodextrin (CD) and PCL. Core:shell PCL:pPR fibers were then prepared by coaxial electrospinning in order to bring available reactive hydroxyl groups from the CD to the fiber surface. Different pPR architectures (star, miktoarm and block-copolymer-like) were synthesized to study the effect of the pPR structure on fiber morphology and surface reactivity by grafting fluorescein isothiocyanate (FITC). Finally, bicyclononyne groups were grafted onto the star-pPR based fibers allowing the conjugation of a fluorescent dye by click chemistry in water without any copper catalyst proving the potential of the method for the biofunctionalization of PCL-based fibers.

Impact of a tailored oral vitamin D supplementation regimen on serum 25-hydroxyvitamin D levels in early breast cancer patients: a randomized phase III study.

BACKGROUND: A minority of early breast cancer (EBC) patients treated with adjuvant or neoadjuvant chemotherapy have sufficient baseline vitamin D (vitD) level. This randomized phase III study assessed the safety and efficacy of a tailored, high-dose, oral vitD supplementation in restoring a normal 25-hydroxy vitD (25OHD) level in this population. PATIENTS AND METHODS: Participants received a 6-month conventional (C) vitD and calcium supplementation or a 6-month high-dose oral vitD regimen tailored on the deficiency (T) and a conventional calcium supplementation. The primary end point was the 6-month percentage of 25OHD serum level normalization. RESULTS: A total of 215 patients including 197 patients with vitD deficiency were recruited, and 195 patients were randomized (T, 100; C, 95). Compliance to the daily oral supplementation was 68.4% and 67% in the C and T arms, respectively. Discontinuous high-dose vitD compliance appeared higher in the T arm (77%). At 6 months, more patients presented with a normalized vitD level in the T arm (30% versus 12.6%; P = 0.003). Supplementation was well tolerated, and no significant difference in the treatment-related toxicity between the two arms was reported. Fifty-two patients without vitD normalization from the C arm switched to the T arm after 6 months. At 12 months, 44% of these patients achieved vitD normalization. CONCLUSION: A tailored high-dose oral vitD supplementation safely allows a higher percentage of the serum 25OHD level normalization compared with a conventional regimen in chemotherapy-treated EBC patients. As compliance to a daily oral supplementation remains poor in this setting, an adaptation of the treatment schedule is warranted. CLINICAL TRIAL NUMBER: NCT01480869.

[Chronic disease and childhood: image of the body, psychic stakes and therapeutic alliance]. / Maladie chronique et enfance: image du corps, enjeux psychiques et alliance thérapeutique.

The child is an individual in constant development, dependent on his/her parents with whom he interacts everyday to open out, and in particular, to construct a dependable image of his body for growing up comfortably. Announcement of a disease, real traumatism for the whole family, upsets these exchanges and can often induce psychological difficulties masked by the therapeutic somatic stakes placed at the foreground of concerns of each one: child, parents and doctors. The child's stakes are construction of a good image of the body (basis of his own) which can be deteriorated by the disease whatever it is (chronic disease, with relapse or vital prognosis engaged). The family's stakes are the perception of the disease by the parents (distress, culpability, depression) and sibling's reactions (aggressiveness, identification with the sick child, masked depression, functional troubles). Doctor's stakes in the chronic disease is to obtain therapeutic alliance of the child and his family to allow the good progress of the treatments. In front of the chronic disease's reality, it is essential to establish and maintain a multidisciplinary follow up. The child's psychiatrist role will be to take care of the exchanges, and listening among the doctors, the patient and his family are favoured.

Simple and rapid method for cis- and trans-resveratrol and piceid isomers determination in wine by high-performance liquid chromatography using chromolith columns.

A simple and rapid HPLC method has been developed for simultaneous determination of the four resveratrol forms (aglycon and glycosidic) in a Grenache wine from Châteauneuf du Pape (Vaucluse). These analyses were achieved by using two commercial monolith HPLC columns and diode array detection. The method provided reliable separations at low pressure with a short analysis time. The limit of detection (LD) and limit of quantification (LQ) were calculated for each standard. The molecules were separated and quantified in a single run without any purification of the sample.

Failure to demonstrate a direct caroticocavernous fistula due to arterialisation of the ipsilateral cavernous sinus.

We report a woman in whom a small direct caroticocavernous fistula (DCCF) was revealed after successful transarterial occlusion of a contralateral fistula which drained into both cavernous sinuses. We underline that a second smaller fistula can be masked by a contralateral larger one due to the lack of pressure gradient between the internal carotid artery (ICA) and arterialised blood in the ipsilateral cavernous sinus. We suggest that bilateral ICA angiograms should be performed before and after occlusion of all DCCF.

Sedimentation field-flow fractionation of cellular species.

More than 15 years ago a pioneering report on the separation of cellular material using sedimentation field-flow fractionation (SdFFF) was published. Surprisingly, only a few reports on SdFFF applications to cell separations are available as yet. The major limitations which seemed to slow the development of SdFFF applications in biology appeared to be related to the development of specific instrumentation. Therefore, guidelines are given for setting up a biocompatible SdFFF apparatus. SdFFF elution of cells with different characteristics was performed to demonstrate the efficiency, completeness, and rapidity of cell separations by this method. Retention data describing the effect of lifting forces on nucleated cells are compared to those for red blood cells (RBC). The effects of flow rates, field intensity, and injection protocol were studied using normal human RBC eluted in isotonic medium as a probe for retention conditions. When possible, data were also compared to previously published reports. Guidelines for elution and separation optimization are given. Using mixtures of nucleated and living red blood cells, viability studies showed a surprisingly high recovery of each type of material.

On the use of ion-pair chromatography to elucidate doxorubicin release mechanism from polyalkylcyanoacrylate nanoparticles at the cellular level.

The major hypothesis underlying the remarkable efficiency of polyalkylcyanoacrylate particles loaded with doxorubicin against multidrug resistant tumor cells in vitro, is based on the ion-pair association of doxorubicin with soluble hydrolysis products of polyalkylcyanoacrylate. In an attempt to demonstrate the validity of this hypothesis, we have used ion-pair reversed-phase high-performance liquid chromatography and a laboratory-synthetized compound, i.e., the 2-cyano-2-butylhexanoic acid, as a model for polyalkylcyanoacrylate highly polydispersed degradation products. It is shown that, compared to a counter-ion, like heptane sulfonic acid, 2-cyano-2-butylhexanoic acid exhibits an effective ion-pairing effect at different pH values and organic mobile phase conditions. Moreover, at pH close to physiological conditions and at low mobile phase organic modifier percentage, this effect is experimentally observed, which strongly supports the initial hypothesis.

[Neonatal rhinopharyngeal obstruction due to craniopharyngioma]. / Obstruction rhinopharyngée néonatale par craniopharyngiome.

BACKGROUND: Craniopharyngioma, the most common tumor of the sellar and suprasellar regions in childhood, can exceptionally develop in the infrasellar area. CASE REPORT: A premature girl (GA: 30 weeks) weighing 1240 g required intubation and ventilation because she suffered from a neonatal respiratory distress syndrome. Nasal endoscopy showed total obstruction of rhinopharynx by a tumor resembling adenoid tissue. This tumor was successfully excised and its histological examination showed a craniopharyngioma. CONCLUSION: A wide range of intranasal tumors has to be examined, endoscopy and CT scan are necessary for a precise localization and to eliminate meningocele.

[LHRH in the human hypothalamus. Immunohistochemical mapping in normal newborn infants or in sudden death infants]. / LHRH dans l'hypothalamus humain. Etude cartographique immunohistochimique chez des nourrissons témoins ou décédés de "mort subite inexpliquée".

The topographical distribution of neurons containing LHRH has been investigated in newborn hypothalamus using the peroxidase anti-peroxidase technique. In control subjects, LHRH immunoreactive (LHRH-IR) perikarya have been mainly observed essentially in the infundibular nucleus. The preoptic region displayed a moderate density of LHRH-IR cell bodies. High LHRH innervation was observed in the anterior hypothalamus in the lamina terminalis and in the mediobasal hypothalamus in the median eminence, and in the peri- and paraventricular regions. In sudden death infant syndrome, a comparable mapping was observed, except a low density in the mediobasal peri- and paraventricular areas.

[Ulcero-necrotizing enterocolitis: the role of cytomegalovirus. Apropos of a case]. / Entérocolite ulcéro-nécrosante: discussion du rôle du cytomégalovirus. A propos d'une observation.

The authors report a case of Wilson-Mikity syndrome in a preterm newborn, that was followed on the 28th day of life by a necrotizing enterocolitis with colic stenosis. The finding of cytomegalic cells on the pathologic examination of the intestinal lesions, the presence of the virus on direct examination of a tissue sample, the elevated IgG levels and the presence of IgM demonstrated a cytomegalovirus infection. The authors discuss the role of this virus in the pathogenesis of the affection, either as directly responsible for the enterocolitis or as a secondary colonization of previous lesions.

[Which treatment for primary tuberculosis?]. / Quel traitement pour la tuberculose initiale?

Primary tuberculosis should be treated in all cases. In adults, the total treatment course for pulmonary tuberculosis can be shortened to 6 months. If the disease is not symptomatic, the rifampicin-isoniazid combination (10 mg/kg/day each) appears to be preferable to single drug therapy. In patients with symptomatic disease, pyrazinamide (30 mg/kg/day) should be added during the first 6-8 weeks and in some cases, corticosteroid therapy is also required. The drugs are usually well tolerated, but hepatic function should be monitored.

[Neonatal bilateral interstitial emphysema. Surgical treatment. Apropos of 1 case]. / Emphysème interstitiel bilatéral néonatal. Solution chirurgicale. A propos d'un cas.

The authors report a case of respiratory distress secondary to inhalation of meconial amniotic fluid treated by mechanical ventilation, which was complicated by severe interstitial emphysema. Treatment by pleurotomy allowed a favorable evolution. The various therapies of interstitial emphysema of the neonate, in particular surgical technics are described.