Charge trapping by iodine ions in photorefractive Sn2P2S6 crystals.

Electron paramagnetic resonance (EPR) is used to establish the role of iodine as an electron trap in tin hypothiodiphosphate (Sn2P2S6) crystals. Iodine ions are unintentionally incorporated when the crystals are grown by the chemical-vapor-transport method with SnI4 as the transport agent. The Sn2P2S6 crystals consist of Sn2+ ions and (P2S6)4- anionic groups. During growth, an iodine ion replaces a phosphorus in a few of the anionic groups, thus forming (IPS6)4- molecular ions. Following an exposure at low temperature to 633 nm laser light, these (IPS6)4- ions trap an electron and convert to EPR-active (IPS6)5- groups with S = 1/2. A concentration near 1.1 × 1017 cm-3 is produced. The EPR spectrum from the (IPS6)5- ions has well-resolved structure resulting from large hyperfine interactions with the 127I and 31P nuclei. Analysis of the angular dependence of the spectrum gives principal values of 1.9795, 2.0123, and 2.0581 for the g matrix, 232 MHz, 263 MHz, and 663 MHz for the 127I hyperfine matrix, and 1507 MHz, 1803 MHz, and 1997 MHz for the 31P hyperfine matrix. Results from quantum-chemistry modeling (unrestricted Hartree-Fock/second-order Møller-Plesset perturbation theory) support the (IPS6)5- assignment for the EPR spectrum. The transient two-beam coupling gain can be improved in these photorefractive Sn2P2S6 crystals by better controlling the point defects that trap charge.

Anaesthesia and intensive care management of face transplantation.

The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.

[The law number 2005-370 of April 22, 2005 concerning the patients' rights at the end of life: a case of polytrauma]. / Loi n(o) 2005-370 du 22 avril 2005 relative aux droits des malades et à la fin de vie: application à un cas de polytraumatisme.

The law number 2005-370 of April 22, 2005 concerning the patients' rights at the end of life imposes from now the refusal of futility of care, a shared decision-making in unconscious patients and the duty of a palliative strategy. We describe a case of polytrauma, for which the shared decision-making process led to a palliative strategy after initial aggressive life-support treatments. This case underlines the need for a two-step model of decision-making process, which distinguishes between goals of care and withdrawal or withholding of life support. It suggests that implementation of written procedures could improve the quality of management at the end of life and traceability of decisions.

Comparison of two induction regimens using or not using muscle relaxant: impact on postoperative upper airway discomfort.

BACKGROUND: Muscle relaxants facilitate tracheal intubation, but they are often not used for short peripheral surgical procedures. The consequences of this practice on the upper airway are still a matter of controversy. We therefore compared the incidence of post-intubation symptoms in a randomized study comparing patients intubated with or without the use of a muscle relaxant. METHODS: A total of 300 adult patients requiring tracheal intubation for scheduled peripheral surgery were randomly assigned in a double-blind study to an anaesthetic protocol that either included or did not include a muscle relaxant (rocuronium). The primary end-point was the rate of post-intubation symptoms 2 and 24 h after extubation. The secondary end-points were the intubation conditions score (Copenhagen Consensus Conference), the rate of difficult intubations (Intubation Difficulty Scale), and the incidence of adverse haemodynamic events. RESULTS: Post-intubation symptoms were more frequent in patients intubated without the use of a muscle relaxant, whether 2 h (57% vs 43% of patients; P < 0.05) or 24 h (38% vs 26% of patients; P < 0.05) after extubation. Intubation conditions were better when the muscle relaxant was used. In patients intubated without a muscle relaxant, difficult intubation was more common (12% vs 1%; P < 0.05), as were arterial hypotension or bradycardia requiring treatment (12% vs 3% of patients; P < 0.05). CONCLUSIONS: The use of a muscle relaxant for tracheal intubation diminishes the incidence of adverse postoperative upper airway symptoms, results in better tracheal intubation conditions, and reduces the rate of adverse haemodynamic events.

Inhibition of p42/p44 mitogen-activated protein kinase by oxysterols in rat astrocyte primary cultures and C6 glioma cell lines.

We previously demonstrated that oxysterols inhibit the growth of experimental glioblastoma induced in the rat brain cortex. Mechanism of action of these compounds remains obscure. In this study, we investigated the effect of 7beta-hydroxycholesterol (7beta-OHCH) and 7ketocholesterol (7k-CH) on the growth and MAP kinase activity in three in vitro biological models: rat astrocyte primary cultures, primary cultures treated by dibutyryl-cAMP (reactive cells), and the C6 glioma cell line. The oxysterols are not lethal to primary astrocytes, even if MAP kinase activity is decreased, particularly when cells were treated with 7k-CH. Both oxysterols are toxic to reactive astrocytes, and as compared with untreated primary cultures, they amplified the MAP kinase activity decrease. However, the mechanism of action of oxysterols on reactive astrocytes seems not to be linked to the MAP kinase pathway. In highly proliferating C6 cell lines, only 7beta-OHCH has an antiproliferative effect and is cytotoxic. The inhibition of MAP kinase activity is a function of 7beta-OHCH concentration. PD098059, a MAP kinase pathway inhibitor, has only a time-limited antiproliferative effect on C6 cell growth. We conclude that in C6 cells, the MAP kinase activity decrease is correlated with the toxic effect of 7beta-OHCH and occurs at first stages of 7beta-OHCH action.

Possible involvement of cholinergic and glycinergic amacrine cells in the inhibition exerted by the ON retinal channel on the OFF retinal channel.

In the frog retina, the inhibition exerted by the ON channel on the OFF channel was evidenced by the increase in transient ganglion cell OFF responses, when the ON channel was blocked by 2-amino-4-phosphonobutyrate (APB). Intraocular administration of the neurotoxic choline analog ethylcholine mustard arizidinium ion (ECMA) also provoked an increase in the number of spikes of transient ganglion cell OFF responses, without suppressing the ON responses. APB, when administrated after ECMA, abolished the ON responses, but did not modify the OFF responses already increased by ECMA. Neurons located in the inner part of the inner nuclear layer were histologically altered by the toxin, and choline acetyltransferase activity was significantly depressed in ECMA-treated retinas. A double immunostaining experiment showed that amacrine cells containing glycine bear muscarinic binding sites. These results confirm the participation of cholinergic neurons in the inhibition exerted by the ON retinal channel on the OFF retinal channel, and suggest the involvement of a cholinergic/glycinergic loop of amacrine cells in this mechanism.