Photoresponsive, reversible immobilization of virus particles on supramolecular platforms.

Here we report on the covalent attachment of photoresponsive azobenzene moieties to cowpea chlorotic mottle virus (CCMV). The modified virus capsids can be reversibly immobilized on cucurbit[8]uril (CB[8]) bearing surfaces via supramolecular complexation.

[Munchausen by proxy syndrome]. / Le syndrome de Munchausen par procuration.

The Munchausen syndrome by proxy (MSBP) was first described in 1977 by the English paediatrician Roy Meadow. The MSBP is an extremely complicated diagnosis because of the difficulty in finding the incriminating evidence of its existence and because of the ethical issue it raises for caregivers. Its implications from a medical, psychological and legal point of view raise difficult questions for any professional confronted to it. In this article we will first present the case of a 16-year-old teenager who had been bedridden in hospital for a year, before an atypical form of MSBP was finally diagnosed, after a stay in a child and adolescent psychiatry unit. We will then discuss this case in light of a literature review on the MSBP.

Short-term psychological impact of the BRCA1/2 test result in women with breast cancer according to their perceived probability of genetic predisposition to cancer.

BACKGROUND: The effect of BRCA1/2 gene test result on anxiety, depression, cancer-related thought intrusion or avoidance and perceived control over cancer risk was assessed in breast cancer (BC) patients, according to their perceived probability of genetic predisposition to cancer. METHODS: Two hundred and forty-three (89% response rate) women with BC completed questionnaires after an initial genetic counselling visit (T1), of which 180 (66%) completed questionnaires again after receiving the BRCA1/2 results (T2). The discrepancy between women's perceived probability of cancer genetic predisposition at T1 and the geneticist's computed estimates was assessed. RESULTS: In all, 74% of women received a negative uninformative (NU), 11% a positive BRCA1/2 and 15% an unclassified variant (UV) result. On hierarchical regression analysis, in women with a positive BRCA1/2 result (vs NU or UV), a lower perceived probability of cancer genetic predisposition than objective estimates at T1 predicted lower levels of anxiety at T2 (ß=-0.28; P<0.01), whereas in women receiving a UV result (vs NU or positive BRCA1/2), a lower perceived probability of cancer genetic predisposition than objective estimates at T1 predicted higher levels of anxiety (ß=0.20; P<0.01), depression (ß=0.19; P<0.05) and intrusion (ß=0.18; P<0.05) at T2. CONCLUSION: The type of BRCA1/2 test result differently affects distress according to women's perceived probability of genetic predisposition before testing.

[Chronic recurrent subareolar abscess formation]. / Chronische recidiverende subareolaire abcedatie.

Chronic recurrent subareolar abcedation. Chronic recurrent subareolar breast abscess is an unfrequent disease of the breast. The surgeon must be acquainted with the syndrome, otherwise it may lead to unnecessary mutilation. The condition usually develops in younger women, but has no relation with lactation. Inverted nipples are a constant finding. The evolution is a chronical one, with acute exacerbations. Small abscesses rupture spontaneously or necessitate surgical drainage or disappear with antibiotics. The basic pathological factor is squamous metaplasia of the lining epithelium of the milksinus. The ampulla is plugged with keratine debris and leads to abscess formation in the retroareolar space. Chronic recurrent subareolar abscesses have to be distinguished from commedomastitis, also called ductal ectasia. The treatment is different for acute and chronical forms. In the acute form antibiotics are administered and eventually incision and drainage of the abscess are performed. In the chronical form excision of the diseased milksinus and fibrotic tissue with the nipple is mandatory. We do not hesitate to excise the majority of the milksinuses.

Emphysematous pyelonephritis in a solitary kidney.

A middle-aged female diabetic presented with ureteral obstruction, renal failure and emphysematous pyelonephritis in a solitary kidney. She was treated non-operatively with intensive antimicrobial therapy, prolonged ureteral catheter drainage and dialysis. Good recovery of renal architecture and function was eventually obtained. Although the usual indications for surgical extirpation or drainage of the kidney with emphysematous pyelonephritis seem to be well established circumstances may occasionally dictate an alternative course of action.

Permanent cutaneous ureterostomy: 18 years of experience.

We have reviewed 84 patients managed with cutaneous ureterostomy during the last 18 years. If at least 1 hypertrophied and dilated ureter is available cutaneous ureterostomy is a safe and effective diversion, with satisfactory late functional results. Stomal stenosis remains a continuing problem but usually is managed easily if present. Cutaneous ureterostomy should be used in selected patients until the ideal form of vesical substitution is achieved.

Problems associated with Gibbons ureteral catheter.

Two recent cases of bilateral ureteral obstruction secondary to benign retroperitoneal fibrosis were treated initially with Gibbons indwelling ureteral catheters. Inadequate catheter length, calyceal stone formation, catheter encrustation, and distal migration form the basis for this report.