[Preterm rupture of membranes: Is home care a safe management?]. / Rupture prématurée des membranes : peut-on proposer une prise en charge à domicile ?

OBJECTIVE: Compare the maternal and neonatal outcomes in pregnancies complicated by preterm prelabour rupture of membranes (PPROM), which were managed either at home (HAD) or hospital (HC). MATERIALS AND METHODS: Retrospective study in two level III maternities during 2 years. Inclusion criteria in HAD were: singleton pregnancy, PPROM between 24 and 35 weeks of gestation, absence of chorioamnionitis, clinical stability at D7 of the rupture, cervical dilatation <3 cm, patient residing in the geographic area. RESULTS: Thirty-two patients were included in the HAD group and 24 in the HC group. Our populations were similar in the 2 groups. The duration of latency was longer in the HAD group than in the HC group (27.5 d [20-37] versus 16.5 d [12.5 to 29.5]; P=0.026). Patients in the HAD group received fewer antibiotics with a similar rate of chorioamnionitis. No difference in terms of obstetrical and neonatal outcomes was observed. Number of days in neonatal resuscitation was lower in the HAD group than in the HC group (12.5 d [10-22] versus 43 d [20-52]; P=0.003). CONCLUSION: HAD seems to be an alternative to continuous hospitalization for patients followed for PPROM between 24 and 35 weeks. A randomized study with a larger number of patients, including other data such as maternal satisfaction and cost analysis, would be interesting to confirm those preliminary results.

[What psychometric scales can be used to assess psychologic distress of pregnant women?]. / Quelles échelles psychométriques utiliser pour évaluer l'état psychologique de la femme enceinte?

Pregnancy can be considered as a maturate crisis, a period of vulnerability, ambivalence, anxiety and uncertainty. Antenatal depression has a prevalence that can be similar to postpartum depression, which is between 10 to 20% depending on the study. Assessing the psychological impact of pregnancy is essential and even more, in the case of a complicated pregnancy with maternal or fetal disease. Yet, this evaluation remains difficult because of the subjective nature of these changes. It is therefore necessary to find and use an appropriate scale to deal with antepartum the best way. We have listed the different scales available to assess this phenomenon. Seven scales were found and their main characteristics were studied. Among them, the scale Edinburgh Prenatal Depression Scale (EPDS) seems to be the most used and the Hospital Anxiety and Depression Scale (HADS) seems to be the most appropriate. However, it has not been validated in obstetric context.

Immunohistochemical and molecular analyses of HER2 status in breast cancers are highly concordant and complementary approaches.

BACKGROUND: Immunohistochemistry (IHC) and fluorescent in situ hybridisation (FISH) are currently the most commonly used methods to assess HER2 status. PCR-based assays allow quantitative determination of HER2 amplification (Q-PCR) or overexpression (Q-RT-PCR), but are not routinely used. We evaluated the relevance of Q-RT-PCR for HER2 status determination. METHODS: We compared IHC and Q-RT-PCR in 466 breast tumours. In discordant or equivocal cases, five additional methods (IHC with two other antibodies, FISH, silver in situ hybridisation (SISH) and Q-PCR) were combined to determine HER2 status. Two cases with HER2 intra-tumour heterogeneity were further explored by allelic profiles analysis and HUMARA clonality determination after microdissection. RESULTS: We observed 97.3% concordance between Q-RT-PCR and non-equivocal IHC. Twelve out of 466 cases (3%) revealed discordances between the two methods. The power of Q-RT-PCR to predict HER2 status (defined by seven methods) was similar to that of IHC. Although rare, some discordances between techniques might be due to HER2 intra-tumour heterogeneity and we report two examples, one tumour containing two distinct clones, another tumour consisting of HER2 amplified and non-amplified subclones. CONCLUSION: Q-RT-PCR and IHC are highly concordant methods for HER2 status assessment, and Q-RT-PCR allows a highly reliable quantitative assessment and could be a useful adjunct to IHC.

Improvement in 90Sr measurements at very low levels in environmental samples

Various anthropogenic sources contribute to the inventory of long lived beta emitters in the environment. Studies have been carried out to obtain the 90Sr distribution in environment in order to estimate its impact in terms of radiation exposure to humans. Various environmental samples were collected and analysed for 90Sr activity concentrations. As natural beta emitters are present in all matrices, an incomplete radiochemical separation leads to over evaluation of the results. An accurate and reliable method has been routinely implemented to extract, purify, and analyse 90Sr in all types of environmental matrices by the Laboratory of Radioactive Measurement in Environment. The radiochemical procedure is combined with a proportional counting for 90Sr detection. After leaching the 20 g aliquot, different protocols have been tested. The effectiveness of Sr-spec resin for Sr isolation has been demonstrated and chosen for the protocol selected. Radiochemical procedure was tested using IAEA reference materials. Results are discussed in terms of recovery, purification efficiency and limit of detection. The influence of a filtrated atmosphere on proportional counting is also discussed.

Molecular interactions in the control region of the carAB operon encoding Escherichia coli carbamoylphosphate synthetase.

The control region of the carAB operon, encoding carbamoylphosphate synthetase, comprises two tandem promoters (P1, upstream and P2, downstream) located 67 base-pairs apart and repressed respectively by pyrimidines and arginine. RNA polymerase and pure arginine repressor bind to the P2 region in mutually exclusive ways. Repressor protects the two adjacent palindromic ARG boxes overlapping P2 against DNase I. Binding of RNA polymerase to P1 is abnormal; the region protected against DNase I is shifted upstream by about 20 nucleotides with respect to the position expected from the transcription startpoint. This pattern is not due to interference with polymerase binding at P2, since it is observed also in the presence of repressor and on an isolated P1 region. Binding of RNA polymerase is relatively weak and heparin-sensitive suggesting that, in vivo, an ancillary factor is required to promote the formation of an open complex. S1 nuclease mapping experiments show that the simultaneous presence of pyrimidines and arginine represses the downstream arginine-specific promoter (P2) more efficiently than arginine alone. This effect is not due to a direct regulatory interaction between pyrimidines and P2, since it is not observed when P1 is inactivated by insertion mutations or partial deletion. It has been shown that transcription initiated at P1 can proceed even when arginine represses P2. We therefore suggest that P2 operator-arginine repressor complex is destabilized by RNA polymerase binding at P1 or transcription from P1. We describe a novel technique to select for expression-down mutants in a lac fusion context.

[Radiation-induced sarcoma of the hip. Apropos of a case]. / Sarcome radio-induit de la hanche A propos d'un cas.

The authors describe a case of post radiation sarcoma of the hip, rare complication in the post radiation lesions. This case associates a post radiation coxopathy treated by total hip arthroplasty, a socket loosening with pelvic fracture, and a post radiation sarcoma. This last complication was fatal.

Synthesis and export of colicin A and colicin E1 during inhibition of lipid synthesis.

The antibiotic cerulenin, a specific inhibitor of fatty acid synthesis was used to demonstrate that colicin A and colicin E1 can be synthesized and exported during inhibition of lipid synthesis.

Alcohol metabolism in Drosophila melanogaster: uselessness of the most active aldehyde oxidase produced by the aldox locus.

Alcohol dehydrogenase is necessary for ethanol detoxification and metabolic utilization. It has been generally assumed that aldehyde oxidase (AO) produced by the Aldox locus (3-56.7) is necessary for a further transformation of acetaldehyde into acetate. We find that various mutant strains (ma-l or Aldoxn) which do not produce an active enzyme show about the same tolerance to alcohol as do wild strains. This physiological paradox is probably to be explained by the discovery of another locus (not localized) which produced a small amount of AO in all tested strains. The adaptive significance of the genetically polymorphic Aldox locus is probably to be looked for in physiological pathways other than ethanol metabolism.

[Genetic tolerance to alcohol in Drosophila: comparison of the effects of selection in D. melanogaster and D. simulans]. / Tolérance génétique à l'alcool chez Drosophila: comparaison des effets de la sélection chez D. melanogaster et D. simulans.

A strain of D. simulans and 3 strains of D. melanogaster having different initial levels of alcohol tolerance were submitted to increasing selection for at least 30 generations. In melanogaster, the relative efficiency of selection was inversely related to the initial level. In simulans, whose natural tolerance is particularly low, only a small increase was obtained. In all cases, tolerance increased progressively and could be considered as a quantitative character. These results are probably due to modifier genes of the alcohol dehydrogenase locus.

[Radiation lesions of the hip]. / Les radio-lésions de la hanche

Irradiation lesions of the hip are much better known than they used to be, and problems diagnosis no longer arise. Study of these 49 cases of irradiation lesions of the hip shows that they occur in 1 to 36 per cent of patients irradiated for pelvic cancer. The rate of occurrence may be reduced by selection and improvement in the techniques of radiotherapy. The extent of the lesions is determined from the time that irradiation is stopped. The lesions appear after a delay of several months and develop progressively throughout their extent. This confer on them a false appearance of a progressive lesion. There are severe lesions, which seriously threaten ambulation. Trans-cervical fractures should be considered separately; these are usually isolated lesions, simple to treat and of good prognosis. Fractures of the acetabulum and necroses of the acetabular roof or of the femoral head, developing usually as paired lesions or in the context of an irradiation coxopathy, constitute another group, in which treatment by total prosthesis raises numerous technical problems. Total prosthesis has however given to these hips; in almost 2 cases out of 3, a function which is at present satisfactory but whose future is unknown. The abnormality high levels of infection and in particular loosening are related to the extent to which the lesions have progressed. Resection of these prosthesis in cases of failure is similar to resection of the head and neck, and has its place as a salvage operation since its allows mobility and pain relief to be obtained at the price of stability.

Biological role of alcohol dehydrogenase in the tolerance of Drosophila melanogaster to aliphatic alochols: utilization of an ADH-null mutant.

The toxicity of the first eight primary alcohols and of four secondary alcohols was compared in a wild-type strain (having active ADH) and an ADH-negative mutant. Differences between LC50 measured in the two strains allowed an evaluation of the biological activity of the enzyme. In vitro, ADH is mainly active on secondary alcohols, while in vivo its main role is the detoxification and metabolism of ethanol. These observations suggest that originally ADH was involved in unknown metabolic pathways and that its utilization in ethanol metabolism could be a recent event.

[Arrangement and local epidermal cell populations of Carcinus maenas (Crustacea, Decapoda)]. / Ordonnance et variations locales des populations cellulaires édidermiques de Carcinus maenas (L.) (Crustacé Décapode)

Surface cuticular differentiations of normal and specialized cells of Carcinus maenas carapace have been observed with a scanning electron microscope. The appearance and polarity of the normal structures happen to be modified in the neighbourhood of the populations of specialized cells. An association of sensory and glandular cells is usually observed.