[Short-term evaluation of Altis® single-incision sling in women stress urinary incontinence]. / Évaluation à court terme de la mini-bandelette Altis® dans l'incontinence urinaire d'effort chez la femme.

INTRODUCTION: Midurethral slings are the main surgical treatment of stress urinary incontinence. Altis is a minimally invasive single-incision sling system. The aim of this study is to report the safety and efficacity results during a year of follow up. MATERIALS AND METHODS: This single-centre and retrospective study has been performed in a university hospital, between February 2015 and May 2018. We included women aged more than 18, complaining a stress urinary incontinence with a urethral hypermobility and positive support maneuvers, who had failed from non surgical treatment. A prospective data collection has been done at the moment of inclusion, peroperative time, at 6 weeks, 6 months and a year after the procedure. The main evaluation criteria was the cure rate at twelve months. RESULTS: Thirty patients were included in our study. The mean age was 45,4±12,9 years old, the mean ICIQ-UI score was 13,5±4,06 and the median pad test was at 12g. Ninety three percent of the procedures were done as ambulatory surgery. The average operating time was at 22,2minutes. Overall, 75% of our patients were objectively cured and 14,2% were in fail of this treatment. CONCLUSION: The short term results show a good efficacity and safety of this procedure. But its place remains to be defined in relation to other techniques, TVT, TOT and non-prosthetic techniques. LEVEL OF EVIDENCE: 3.

[Elastography shows promise in testicular cancer detection]. / Apport de l'élastographie en temps réel pour la caractérisation des masses testiculaires.

PURPOSE: Elastography is a novel imaging technology that shows promise in the identification of anatomic structures. The widespread use of ultrasound for screening testicular tumors in patients with cancer risk factors highlights unclassified testicular micronodules. We investigated the ability of elastography to accurately diagnose testicular nodules. MATERIAL: Patients with clinical testicular nodules were assigned to undergo elastography in a prospective study. The imaging was carried out by a single radiologist using a static elastography unit with a 9-14MHz frequency linear transducer, to identify hardness score, loss of architecture of testicular parenchyma, and surrounding effect. When orchidectomy was required, the corresponding specimens were subjected to hematoxylin and eosin staining for histologic correlation. RESULTS: We imaged 34 testicular lesions: 26/34 (76%) malignant tumors and 8/34 (24%) non-tumor lesion including 4 hematomas, 3 orchitis and 1 ischemia. Se, Sp, PPV and NPV of hardness in elastography in differentiating between malignant and benign tissue was found to be 96.2%, 37.5%, 83%, and 75%, respectively. Further, for recognizing cancer, the loss of architecture of the testicular parenchyma detecting in elastography was 92.3%, 75%, 92.3%, and 75%, respectively, and the surrounding effect was 84.6%, 87.5%, 95.6% and 63.6%, respectively. CONCLUSION: Elastography may be a promising tool at diagnosing testicular tumor when the loss of architecture and the surrounding effect were present. Further studies are needed to evaluate whether the utility of elastography is worth pursuing to identify of unclassified testicular micronodules. LEVEL OF EVIDENCE: 3.

Milk volatile organic compounds and fatty acid profile in cows fed timothy as hay, pasture, or silage.

Nutrient composition and organoleptic properties of milk can be influenced by cow diets. The objective of this study was to evaluate the forage type effects on volatile organic compounds, fatty acid (FA) profile, and organoleptic properties of milk. Timothy grass was fed as hay, pasture, or silage during a period of 27 d to a group of 21 cows in a complete block design based on days in milk. Each cow also received 7.2 kg/d of a concentrate mix to meet their nutrient requirements. Forage dry matter intake averaged 13.9 kg/d and was not different among treatments. Milk yield was higher for cows fed pasture, intermediate for cows fed silage, and lowest for cows fed hay. However, milk fat content was higher for cows fed hay and silage, compared with cows fed pasture. As a result, fat-corrected milk and fat yield were not different among treatments. Increasing the supply of dietary cis-9,cis-12 18:2 (linoleic acid) and cis-9,cis-12,cis-15 18:3 (α-linolenic acid) when feeding pasture enhanced the concentration of these 2 essential FA in milk fat compared with feeding hay or silage. Moreover, the ratio of 16:0 (palmitic acid) to cis-9 18:1 (oleic acid), which is closely related to the melting properties of milk fat, was lower in milk from cows on pasture than in milk from cows fed hay or silage. Cows fed hay produced milk with higher levels of several free FA and γ-lactones, but less pentanal and 1-pentanol. More dimethyl sulfone and toluene were found in milk of cows on pasture. Cows fed silage produced milk with higher levels of acetone, 2-butanone, and α-pinene. Results from a sensory evaluation showed that panelists could not detect a difference in flavor between milk from cows fed hay compared with silage. However, a significant number of assessors perceived a difference between milk from cows fed hay compared with milk from cows fed pasture. In a sensory ranking test, the percentage of assessors ranking for the intensity of total (raw milk, fresh milk, and farm milk), sweet (empyreumatic, vanilla, caramel, and sugar), and grassy (grass, leafy vegetable, and plant) flavors was higher for milk from cows fed pasture compared with hay and silage. Using timothy hay, pasture, or silage harvested at a similar stage of development, the current study shows that the taste of milk is affected by the forage type fed to cows. More research is, however, needed to establish a link between the sensory attributes of milk and the observed changes in volatile organic compounds and FA profile.

Pattern-motion selective responses in MT, MST and the pulvinar of humans.

Plaid stimuli are often used to investigate the mechanisms involved in the integration and segregation of motion information. Considering the perceptual importance of such mechanisms, only a very limited number of visual brain areas have been found to be specifically involved in motion integration. These are the human (h)MT+ complex, area V3 and the pulvinar. The hMT+ complex can be functionally subdivided into two separate areas, middle temporal area (MT) and medial superior temporal area (MST); however, it is currently unclear whether these distinct sub-regions have different responses to plaid stimuli. To address this issue we used functional magnetic resonance imaging to quantify the relative response of MT and MST to component and pattern motion. Participants viewed plaid stimuli that were constrained to result in the perception of either component motion (segregation of motion information) or pattern motion (integration of motion information). MT/MST segregation was achieved using a moving dot stimulus that allowed stimulation of each visual hemifield either in unison or separately. We found pattern motion selective responses in both MT and MST. Consistent with previous reports, activity indicative of pattern motion selectivity was also found in the pulvinar as well as in other extrastriate areas. These results demonstrate that MT, MST and the pulvinar are involved in the complex motion integration mechanisms that are triggered by plaid stimuli. This reinforces the concept that integrative computations take place in a distributed neuronal circuit both in cortical and sub-cortical networks.

Abnormal cortical processing of pattern motion in amblyopia: evidence from fMRI.

Converging evidence from human psychophysics and animal neurophysiology indicates that amblyopia is associated with abnormal function of area MT, a motion sensitive region of the extrastriate visual cortex. In this context, the recent finding that amblyopic eyes mediate normal perception of dynamic plaid stimuli was surprising, as neural processing and perception of plaids has been closely linked to MT function. One intriguing potential explanation for this discrepancy is that the amblyopic eye recruits alternative visual brain areas to support plaid perception. This is the hypothesis that we tested. We used functional magnetic resonance imaging (fMRI) to measure the response of the amblyopic visual cortex and thalamus to incoherent and coherent motion of plaid stimuli that were perceived normally by the amblyopic eye. We found a different pattern of responses within the visual cortex when plaids were viewed by amblyopic as opposed to non-amblyopic eyes. The non-amblyopic eyes of amblyopes and control eyes differentially activated the hMT+ complex when viewing incoherent vs. coherent plaid motion, consistent with the notion that this region is centrally involved in plaid perception. However, for amblyopic eye viewing, hMT+ activation did not vary reliably with motion type. In a sub-set of our participants with amblyopia we were able to localize MT and MST within the larger hMT+ complex and found a lack of plaid motion selectivity in both sub-regions. The response of the pulvinar and ventral V3 to plaid stimuli also differed under amblyopic vs. non-amblyopic eye viewing conditions, however the response of these areas did vary according to motion type. These results indicate that while the perception of the plaid stimuli was constant for both amblyopic and non-amblyopic viewing, the network of neural areas that supported this perception was different.

Modular organization in area 21a of the cat revealed by optical imaging: comparison with the primary visual cortex.

Area 21a, located on the cat's lateral suprasylvian cortex, is considered as a higher-order cortical area. Little is known about its specific role in visual processing. In this study, the functional organization of area 21a was investigated by optical imaging of intrinsic signals and was compared to that of primary visual areas. We found a clear modular pattern for orientation selectivity in area 21a, with signal amplitude being four times lower than that in primary visual areas. There were no significant differences between the domains' characteristics, nor the tuning bandwidth, in areas of the primary visual cortex (17 and 18) and 21a. This suggests that the basic cortical structure is independent of the hierarchical level or function of one area. A uniform representation of spatial frequency was found in areas 17 and 18, as well as in area 21a. The mean preferred spatial frequency in area 21a was 0.30 c/deg. In contrast to area 18, no direction maps were observed in area 21a whether drifting gratings or random dot kinematograms were used. This study supports the proposal that area 21a plays a pivotal role along the ventral processing stream and is mainly involved in form processing.

Global motion integration in the postero-medial part of the lateral suprasylvian cortex in the cat.

In cats, the postero-medial part of lateral suprasylvian cortex (PMLS) is generally considered a key area for motion processing. While behavioral studies have indeed supported the role of PMLS cortex in higher order motion integration (Cereb Cortex 6:814-822, 1996), there is no evidence that individual PMLS cells can perform such analysis (Vis Neurosci 5:463-468, 1990; J Neurophysiol 63:1529-1543, 1990). Given the fundamental importance of understanding the neural substrate subtending higher order motion processing, we investigated whether PMLS neurons can signal the direction of motion of complex random dot kinematograms (RDKs) wherein comprising elements do not provide any local coherent motion cues. Results indicated that most PMLS cells (82%) can integrate the displacement of individual elements into a global motion percept. Their large receptive fields allowed the integration of motion for elements separated by large spatial intervals (up to 4 degrees ). In most cases, the analysis of complex RDK motion necessitated the contribution of the area of the visual field beyond the classical receptive field. None of the complex RDK-sensitive cells were found to be pattern-motion selective when tested with plaid patterns. Our results provide the first evidence that receptive fields of PMLS neurons can perform global motion analysis and support the behavioral evidence that this area is implicated in complex motion processing (Cereb Cortex 6:814-822, 1996). It also further corroborates the findings that PMLS neurons cannot signal the true direction of a plaid pattern (Vis Neurosci 5:463-468, 1990; J Neurophysiol 63:1529-1543, 1990). Providing that these same neurons can signal the direction of complex RDKs, there may be distinct cortical mechanisms for processing different types of complex motion.

Increased soluble interleukin-1 receptor type II proteolysis in the endometrium of women with endometriosis.

Numerous functional changes were observed in the intrauterine endometrial tissue of women with endometriosis. Our previous studies revealed a marked decrease in the expression of interleukin-1 receptor type 2 (IL-1RII), a decoy receptor known for its ability to buffer IL-1 effects. The aim of the present study was to assess whether post-translational mechanisms such as proteolysis may contribute to the down-regulation of IL-1RII levels. Our data showed that soluble IL-1RII (sIL-1RII) concentrations released by freshly cultured endometrial tissue were significantly lower in women with endometriosis than in normal women (P < 0.01) and further revealed a statistically significant correlation between increased proteolysis and decreased sIL-1RII levels (P < 0.05; r = -0.47). (125)I-labelled soluble recombinant human IL-1RII ([(125)I]srhIL-1RII) was significantly more degraded in culture supernatant of tissues from women with endometriosis compared to normal women (P < 0.05), and natural tissue inhibitor of matrix metalloproteinase (TIMP)-1 inhibited [(125)I]srhIL-1RII degradation. Incubation of srhIL-1RII with active rhMMP-9 resulted in a dose-dependent degradation of srhIL-1RII as analysed by western blotting. Dual immunofluorescence showed an increased immunostaining for matrix metalloproteinase-9 in situ in the endometrial tissue of women with endometriosis compared to normal women and a decreased immunostaining for IL-1RII. The present study showed a reduced release of sIL-1RII by the endometrial tissue of women with endometriosis and revealed a proteolytic post-translational mechanism which may be involved in the down-regulation of IL-1RII levels. This may enhance IL-1-mediated activation of endometrial cells and contribute to the local immuno-inflammatory process observed in endometriosis patients.

Evidence for an increased release of proteolytic activity by the eutopic endometrial tissue in women with endometriosis and for involvement of matrix metalloproteinase-9.

BACKGROUND: For the implantation of endometrium in ectopic locations, remodelling of the extracellular matrix (ECM) is necessary. Many studies have shown an increased expression of various proteases in the ectopic endometrium of women with endometriosis. Few, however, have addressed possible changes in protease expression in the eutopic endometrium. METHODS AND RESULTS: Herein, we reveal an increased release of proteolytic activity by the eutopic endometrium of women with endometriosis compared with normal women (P < 0.01). Using zymography and western blotting, we identified matrix metalloproteinase (MMP)-2 and MMP-9 in the culture medium, and further found that MMP-9 secretion, as assessed by zymography and enzyme-linked immunosorbent assay (ELISA), was elevated in women with endometriosis compared with normal women (P < 0.05). No statistically significant difference in MMP-2 secretion between women with and without endometriosis was noted. However, a significant difference in the levels of the tissue inhibitor of metalloproteinases (TIMP)-1, a known MMP-9 inhibitor, was found (P < 0.05). CONCLUSION: The endometriosis-associated increase in proteolysis and imbalance between the secretion of MMP-9 and that of its natural inhibitor, TIMP-1, revealed in the culture medium of endometrial tissue may reflect in vivo the enhanced capacity of this tissue to break down the ECM in host tissues, thereby favouring its ectopic implantation and development.

Ectopic endometrial cells express high concentrations of interleukin (IL)-8 in vivo regardless of the menstrual cycle phase and respond to oestradiol by up-regulating IL-1-induced IL-8 expression in vitro.

Endometriosis, an oestrogen-dependent disorder affecting women of reproductive age, is associated with active angiogenesis and an increased recruitment of leukocyte into the peritoneal cavity where the implants often develop. The role of oestrogens in the development of endometriosis has been clearly established, but the biochemical mechanisms of their action are still not clearly elucidated. The present study shows that interleukin-1 (IL-1) induces interleukin-8 (IL-8) secretion by endometriotic cells and that oestradiol enhances endometriotic cell responsiveness to IL-1. In contrast, no significant cell responsiveness to progesterone either alone in the culture medium or in combination with oestradiol was noted. Positive immunostaining for IL-8 was observed throughout endometriotic tissue, and no perceptible difference in the intensity of staining regarding the menstrual cycle phase was observed. Together with the in-vitro data, this suggests that IL-8 expression in endometriotic tissue is not subject to cyclic variation. Furthermore, this study provides evidence that oestradiol indirectly up-regulates the expression by ectopic endometrial cells of IL-8, a cytokine endowed with neutrophil chemotactic and angiogenic properties. This may contribute to peritoneal leukocyte recruitment and to the growth of endometriotic implants, and may be a new mechanism for oestradiol action in endometriosis.

[Detection of respiratory syncytial virus using immunohistochemistry. Report of 53 cases of sudden infant death]. / Mise en évidence du virus respiratoire syncytial par méthode immuno-histochimique. A propos de 53 cas de mort subite du nourrisson.

We analyzed 53 cases of sudden infant death to detect immunohistochemical expression of respiratory syncytial virus on pulmonary sections. The virus was identified in 7 cases. The immunohistochemical staining was intracytoplasmic and mainly observed in bronchioles. Among these 7 cases, 6 showed severe pulmonary lesions which were assumed to be accountable for decrease. The inflammatory lesions related to respiratory syncytial virus were diffuse, located with the same intensity to either bronchi, bronchioles, alveoles and upper respiratory tract. The immunohistochemical staining was markedly heterogeneous, requiring numerous pulmonary samples.

Miscibility of Butanol and Cationic Surfactant in the Adsorbed Film and Micelle.

Mixed adsorbed films and micelles were investigated by measuring surface tension of the aqueous solutions for the following four mixtures: the n-butanol (NBA)-dodecylammonium chloride (DAC), t-butanol (TBA)-DAC, NBA-dodecyltrimethylammonium chloride (DTAC), and TBA-DTAC. Experimental results were analyzed thermodynamically. Phase diagrams of adsorption and micelle formation and that exhibiting the composition relation of micelle and adsorbed film at CMC were compared among the four systems. Excess Gibbs energy in the adsorbed film gH,E and activity coefficient in the micelle fM2+/- were calculated from the phase diagrams to estimate the miscibility of the butanol and cationic surfactant quantitatively. By comparing the results of the pairs of NBA-DAC and TBA-DAC systems with those of the NBA-DTAC and TBA-DTAC systems, it was shown that the substitution of the polar head group from ammonium to trimethylammonium changes the gH,E value from positive to negative and increases fM2+/-. Furthermore, by comparing the results of the pairs of NBA-DAC and NBA-DTAC systems with those of the TBA-DAC and TBA-DTAC systems, it was shown that the bulky hydrophobic group weakens the molecular interaction between the butanol and the cationic surfactant in the adsorbed film. Copyright 1998 Academic Press.

Structure Effect on Miscibility of Butanol and Dodecyltrimethylammonium Chloride in Adsorbed Film.

Miscibility of components in the adsorbed film for the n-butanol (NBA)-dodecyltrimethylammonium chloride (DTAC) and tert-butyl alcohol (TBA)-DTAC mixtures were investigated by measuring surface tension of the aqueous solutions. The experimental results were analyzed thermodynamically. Diagrams of the excess Gibbs energy in the adsorbed film gH,E vs the composition in the adsorbed film XH2 were obtained from the phase diagrams of adsorption. The gH,E values of the NBA-DTAC system are more negative than those of the TBA-DTAC system. It is concluded that the molecular interaction between NBA and DTAC is stronger than that between TBA and DTAC. With respect to the mean molar area in the adsorbed film A vs XH2 curve at a fixed surface tension gamma, the criterion of ideal mixing is demonstrated to be a straight line connecting the pure values. The A vs XH2 curves are convex downward in both systems and the deviation from the straight line is attributed to the dependence of gH,E on gamma. Copyright 1998 Academic Press.

Measurement of endometrial thickness with transvaginal ultrasonography: is it reproducible?

To assess the intraobserver and interobserver variability of transvaginal ultrasonographic measurement of endometrial thickness, two investigators (M.V., M.-F. D.) independently evaluated two successive measurements in 55 patients with a 5.0 MHz transvaginal transducer. Each observer was blinded to his or her own and to the other's results. Measurements were taken at the maximal thickness in the longitudinal uterine axis. The intraclass coefficients evaluating the agreement between two measures of a same observer were 94% and 97%; the coefficient was 94% between the two investigators. Intraobserver kappa values (agreement on endometrium < or = 5 mm and > 5 mm) were 0.70 and 0.81, respectively; the interobserver kappa value was 0.74. Transvaginal sonographic measurement of endometrial thickness has excellent intraobserver and good interobserver agreement. However, in clinical practice, an endometrial thickness measuring +/- 1 mm of a cut-off value should be interpreted with caution, especially when this may modify the clinical management.

Differential activity of rosiglitazone enantiomers at PPAR gamma.

Analysis of the enantiomers of rosiglitazone in a PPAR gamma binding assay suggests that the (S)-(-)-isomer is responsible for the antidiabetic activity.

Nonideal Mixing in Adsorbed Film and Micelle of Ionic-Nonionic Surfactant Mixtures

The surface tension of aqueous solutions of dodecylammonium chloride-octyl methyl sulfoxide (OMS) and dodecyltrimethylammonium bromide-OMS mixtures was measured as a function of the total molality of surfactants and the composition of OMS. The results were analyzed according to our thermodynamic procedure; the phase diagrams of adsorption and micelle formation and the diagram illustrating the composition relation between the micelle and the adsorbed film at the critical micelle concentration were drawn. The activity coefficient and excess Gibbs energy in the adsorbed film and the micelle were defined and then evaluated from the phase diagrams. They were found to give useful information on the deviation from ideal mixing and intermolecular interaction in the adsorbed film and micelle. Copyright 1997 Academic Press. Copyright 1997Academic Press

Thermodynamic Study on the Surface Formation of the Mixture of Water and Ethanol

The formation of the water + ethanol mixture/air surface was studied by measuring the surface tension as a function of temperature and the mole fraction of ethanol in the mixture. The surface composition, the entropy Deltas , and energy Deltau of surface formation were evaluated by adopting the thermodynamic equations. It was shown that the surface was enriched in ethanol molecules compared with the bulk solution. The values of Deltas and Deltau were examined closely by estimating the contribution from the nonideal mixing in the bulk solution and that at the surface to Deltas and Deltau . It was concluded that the surface formation is driven by entropy at lower x 2 and by energy at higher x 2 , respectively, and that the surface formation becomes more energetically favorable with rising temperature.

Human endometrial cells cultured in a type I collagen gel.

OBJECTIVE: To elaborate in vitro conditions that enable epithelial and stromal cells of human endometrium to grow within a gel of collagen. STUDY DESIGN: Primary cultures of epithelial cells derived from human endometrial biopsies were dissociated and mixed with a collagen solution, and the gel was allowed to form at physiologic pH. Control cultures were grown in plastic dishes. DNA replication was assessed by 3H-thymidine incorporation, morphology by histology and cell characterization by monoclonal antibodies to cytokeratins. RESULTS: Cells grown on plastic dishes exhibited a typical monolayer arrangement, and replication was increased 1.6-fold by the addition of stromal cell-conditioned medium (50% vol/vol). After a two- to three-week period of culture within the collagen gel in the presence of either stromal cells or stromal cell-conditioned medium, epithelial cells formed circular arrangements of cuboidal to columnar cells with open lumina resembling glands. These glandlike structures were cytokeratin positive as assessed by immunohistochemistry, thereby confirming their epithelial nature. CONCLUSION: The development of differentiated epithelial structures in a three-dimensional gel provides a promising method of studying various biochemical and cellular interactions of eutopic and ectopic endometrium.