Rates of glaucomatous visual field change after trabeculectomy.

BACKGROUND: Trabeculectomy is frequently performed in patients with glaucoma who are deteriorating, although its effects on rates of visual field (VF) progression are not fully understood. We studied the rate of VF progression post trabeculectomy comparing with medically treated patients matched for VF loss. METHODS: Medical records of patients who underwent trabeculectomy alone or combined with cataract extraction were reviewed. Patients with 5 or more 24-2 VF examinations post trabeculectomy were selected. The rate of mean deviation (MD) change after surgery was calculated for each patient. These patients were pairwise matched based on baseline MD with patients with glaucoma who were treated medically and had at least 5 VF tests. RESULTS: 180 surgical patients were identified and matched with 180 medically treated patients (baseline MD of -8.72 (5.24) dB and -8.71 (5.22) dB, respectively). Surgically and medically treated patients were followed for 7.4 (2.9) and 6.8 (3.1) years respectively. The MD slopes were -0.22 (0.55) dB/year and -0.08 (1.10) dB/year in the surgically and medically treated patients, respectively, and not statistically different (p=0.13, 95% CI -0.31 to 0.04). More patients in the surgical group had fast progression (rates worse than -1 dB/year) than in the medical group (17 and 7 patients, respectively, p=0.05). CONCLUSIONS: Our findings suggest that most patients who undergo trabeculectomy demonstrate relatively slow rates of VF progression postoperatively, similar to patients treated medically, although some patients can continue to progress despite adequate surgical control of intraocular pressure.

Fine-scale spatial genetic structure with nonuniform distribution of individuals.

This paper presents the first theoretical study of spatial genetic structure within nonuniformly distributed continuous plant populations. A novel individual-based model of isolation by distance was constructed to simulate genetic evolution within such populations. We found larger values of spatial genetic autocorrelations in highly clumped populations than in uniformly distributed populations. Most of this difference was caused by differences in mean dispersal distances, but aggregation probably also produced a slight increase in spatial genetic structure. Using an appropriate level of approximation of the continuous distribution of individuals in space, we assessed the potential effects of density, seed and pollen dispersal, generation overlapping, and overdominance selection at an independent locus, on fine-scale genetic structure, by varying them separately in a few particular cases with extreme clumping. When selfing was allowed, all these input variables influenced both aggregation and spatial genetic structure. Most variations in spatial genetic structure were closely linked to variations in clumping and/or local density. When selfing was not allowed, spatial genetic structure was lower in most cases.

Linear chromosome of Borrelia burgdorferi.

The DNA organization of several European and American isolates of Borrelia burgdorferi, the aetiological agent of Lyme disease, was analysed in pulse-field agarose gel electrophoresis. The results of in situ cell lysis in agarose plugs demonstrated a unique arrangement for the DNA of this spirochete. The chromosome of Borrelia behaved as a eukaryotic linear chromosome with a size of around 1,000 kb. The genome also comprised several circular and linear plasmids which varied in size from 15 to 60 kb.

Sizing of the Leptospira genome by pulsed-field agarose gel electrophoresis.

Pulsed-field gel electrophoresis allowed the determination of the size of the genome of Leptospira, a bacterium of the spirochete family. The three restriction enzymes, NotI (5'GC/GGCCGC), NheI (5'G/CTAGC), ApaI (5'-GGGCC/C) generated DNA fragments of suitable size. The results are compatible with a size of 5000 kb for the chromosome of both the pathogenic and the saprophytic species of Leptospira.

Spontaneous hemothorax in a patient with hereditary multiple exostoses.

A case of spontaneous hemothorax in a 7-year-old child secondary to erosion of the diaphragm by an exostosis coming from the left sixth rib is reported. This rare case of hemothorax with hereditary multiple exostoses is made even rarer by the concomitant perforation of the diaphragm.

[Tympanic retraction pockets. Evaluation after 3 years of our therapeutic regimen. Apropos of 106 cases]. / Poches de rétraction tympaniques. Bilan á 3 ans de notre attitude thérapeutique. A propos de 106 cas.

A retrospective study of 106 retraction pockets has been achieved: Part of them was treated with ventilation tubes (23 cases) and an other part was treated by tympanoplasty (83 cases). Our purpose was to verify if our indications were wright. We concluded that it is correct to operate the fixed retraction pockets and it is not dangerous. Concerned the indication of ventilation tubes in non-fixed retraction pockets we do not concluded but propose a complementary study.

[Long-term anatomic results of tympanic homografts. Apropos of 170 cases]. / Résultats anatomiques à long terme des homogreffes tympaniques. A propos de 170 cas.

Long-term anatomic results of 170 tympanic homografts performed in the Necker-Enfants-Malades hospital, France between 1977 and 1983 showed high frequency of complications: early perforation (17.7%); late perforation (14%); myringitis (8.5%); recurrence of retraction (7.31%); lateralization (9.4%). These complications are of much higher frequency than after tympanoplasty with autograft, and indications for tympano-ossicular homografts are now limited to total tympanic destruction with absence of handle of malleus.

[Radiological evaluation of major aplasias of the ear]. / Le bilan radiologique des aplasies majeures de l'oreille.

Results of radiologic, radiotomographic and CT scan imaging of patients with major aplasias of ear are presented. In the absence of an indication for functional surgery these explorations allow evaluation of the risk of an epithelial inclusion within an undetected anlage of external auditory canal. When functional surgery is indicated results of these investigations allow assessment of pneumatization of petrous bone, possibility of construction of a new external auditory canal, and the internal ear. Study of middle ear is still insufficient in the region of the ossicula, particularly the fenestrae and stapes.

[Functional results of ossiculoplasty. Apropos of 216 cases]. / Résultats fonctionnels des ossiculoplasties. A propos de 216 cas.

Results of 219 ossiculoplasties performed during closed technic tympanoplasties over a 7-year period are reviewed. Ossiculoplasty involved the implantation of ossiculo-tympanic plate homografts, ossicular auto- or homo-grafts or Klein type prostheses. Results are analyzed as a function of disease causing the ossicular lysis, types of mounting and number of operations required. From these are determined etiopathogenic factors and technics providing improved results. Absence of residual inflammation, stability of mounting and use of remaining ossicles are conditions that ensure best results. Contact between columella and tympanic membrane should be as wide as possible, with greater preference therefore for stapes-malleus or foot of stapes-malleus than stapes-tympanic plate or foot of stapes-tympanic plate mountings. These former mountings improve functional gain in a homogeneous manner throughout the frequency range.

[Use of the pectoralis major myocutaneous flap in transmaxillary buccopharyngectomy]. / Utilisation du lambeau myo-cutané du grand pectoral au cours des bucco-pharyngectomies transmaxillaires.

Pectoralis major musculocutaneous flaps were used for reconstruction after transmaxillary buccopharyngectomy to treat 22 patients with large oropharyngeal tumors. Short and medium term results are discussed. Large excisions such as these raise many functional problems, even though the use of a musculocutaneous flap for reconstruction is a valid procedure from the anatomical point of view. The cancer prognosis must still be reserved as follow up is still limited for these cases.

[Solid cold thyroid nodule. Current data]. / Le nodule froid plein thyroïdien. Données récentes.

Attitudes adopted when confronted with a solid cold thyroid nodule are analyzed in the light of recent developments in paraclinical data represented essentially by results of immunological, ultrasound and fine needle cytopuncture examinations. The use of these new surveillance technics frequently allows surgery to be deferred, while if on the contrary operation is decided then it usually now involves both thyroid lobes to avoid nodular recurrence and repeat surgery. Postoperative follow up surveillance is essential to ensure individual adaptation of attitude: therapeutic abstention, suppressive or possibly compensatory treatment.

[Laryngeal dyspnea of infectious origin in the adult. Apropos of 54 cases]. / Dyspnées laryngées de l'adulte d'origine infectieuse. A propos de 54 cas.

Principal etiologies in 54 patients with acute laryngeal dyspnea of infectious origin were epiglottitis (35 cases), glotto-subglottal laryngitis (8 cases) and adjacent infections (9 cases). These cases are reviewed together with the relevant published literature and various conclusions drawn. The affection is serious (35 deaths out of 425 cases in the literature), and requires careful examination, immediate treatment and routine hospital care under surveillance. Apart from cases where the condition of the patient necessitates urgent intubation, those cases with rapidly evolving signs over 24 hours must be admitted to intensive care since worsening of dyspnea can lead to delayed decompensation. Wide spectrum antibiotic therapy is necessary for patients with epiglottitis and adjacent infective ulcerations since many germs may be implicated, while for the always benign glotto-subglottal laryngitis Amoxicillin + clavulinic acid is sufficient.

[Use of pectoralis major myocutaneous flaps in cervicofacial surgery. Our experience with 46 cases]. / Utilisation du lambeau myo-cutané du grand pectoral en chirurgie cervico-faciale. Notre expérience sur 46 cas.

Musculocutaneous flaps from pectoralis major were used during cervico-facial surgery for repair after cancer operations in 46 patients. Use of this technique in surgical practice is discussed as a function of the site of cancer, and results described in relation to the viability of the flap and the outcome. Removal of the flap is simple and possible by a one-stage operation, and the method provides functional improvement for these patients.

Assessing temporal changes in genetic diversity of maize varieties using microsatellite markers.

To quantify genetic diversity among modern and earlier maize cultivars, 133 varieties, representative of the maize grown in France during the last five decades, were fingerprinted using 51 SSR. The varieties were grouped into four periods. For each period, allelic richness, genetic diversity and genetic differentiation among periods were computed. A total of 239 alleles were generated. Allelic richness, in terms of number of alleles per locus, for each period was 4.5, 3.6, 3.9 and 3.6 respectively. Genetic diversity corresponding to Nei's unbiased heterozygosity was calculated, based on allelic frequencies. Values ranged from 0.56 to 0.61. Period I presented the highest genetic diversity, whereas the three other periods all presented a similar value. A great proportion of the total genetic diversity (H(T)=0.59) was conserved within all periods (H(S)=0.57), rather than among periods (G(ST)=0.04). The analysis of molecular variance showed that the variation among periods represented only 10% of the total molecular variation. However, the differentiation among periods, although low, was significant, except for the last two periods. Our results showed that the genetic diversity has been reduced by about 10% in the maize cultivars bred before 1976 compared to those bred after 1985. The very low differentiation (G(ST)=0.21%) observed among cultivars of the last two decades should alert French maize breeders to enlarge genetic basis in their variety breeding programmes.

Factor regression for interpreting genotype-environment interaction in bread-wheat trials.

The French INRA wheat (Triticum aestivum L. em Thell.) breeding program is based on multilocation trials to produce high-yielding, adapted lines for a wide range of environments. Differential genotypic responses to variable environment conditions limit the accuracy of yield estimations. Factor regression was used to partition the genotype-environment (GE) interaction into four biologically interpretable terms. Yield data were analyzed from 34 wheat genotypes grown in four environments using 12 auxiliary agronomic traits as genotypic and environmental covariates. Most of the GE interaction (91%) was explained by the combination of only three traits: 1,000-kernel weight, lodging susceptibility and spike length. These traits are easily measured in breeding programs, therefore factor regression model can provide a convenient and useful prediction method of yield.

Scattering of the rRNA genes on the physical map of the circular chromosome of Leptospira interrogans serovar icterohaemorrhagiae.

Leptospira interrogans is a pathogenic bacterium with a low G+C content (34 to 39%). The restriction enzymes NotI, AscI, and SrfI cut the chromosome of L. interrogans serovar icterohaemorrhagiae into 13, 3, and 5 fragments separable by one- and two-dimensional pulsed-field gel electrophoresis (PFGE). The genome is composed of a circular 4.6-Mbp chromosome and a 0.35-Mbp extrachromosomal element. A physical map of the chromosome was constructed for NotI, AscI, and SrfI by using single and double digests, or partial NotI digests obtained at random or by cross-protection of NotI sites by FnuDII methylase, and linking clones. rRNA genes were found to be widely scattered on the chromosome.

Genome conservation in isolates of Leptospira interrogans.

Reference strains for each of the 23 serogroups of Leptospira interrogans yielded different pulsed-field gel electrophoresis patterns of NotI digestion products. This was also the case for the 14 serovars belonging to serogroup Icterohaemorrhagiae (with one exception). The NotI restriction patterns of 45 clinical leptospiral isolates belonging to serovar icterohaemorrhagiae were analyzed and compared with those of type strains. No differences were observed between isolates from countries of different continents, namely, France, French Guiana, New Caledonia, and Tahiti. The pattern was indistinguishable from that of the reference strain of serovar icterohaemorrhagiae.

Metamorphic rate in Rana pipiens larvae treated with thyroxine or prolactin at different times in the light/dark cycle.

Premetamorphic Rana pipiens tadpoles at Stages V to VIII on a 12L/12D cycle with photoperiod from 0800 to 2000 hr were treated with 30 micrograms/liter thyroxine (T4) by immersion for various daily 8-hr spans, or by daily intraperitoneal injection at different times with 0.1 to 10 micrograms T4 or 10 micrograms prolactin (PRL), in order to see if the rate of metamorphosis varied with the time of hormone treatment. T4 was most effective in promoting tail resorption and hindlimb growth and development if tadpoles were immersed at least partly in the light or if the hormone was injected late in the dark or in the early or mid light phase. T4 was least effective in accelerating metamorphosis when immersion was totally in the dark or injection early in the dark. PRL antagonized metamorphosis just as well at any time of the day except that tail fin growth was faster when PRL was administered early in the dark. The findings show circadian variations in target tissue responsiveness to exogenous T4 that depend on the occurrence of light during T4 immersion or following T4 injection. The data suggest rhythmicity in the secretion of endogenous T4 in the tadpole and a diurnal effect on T4 utilization by target cells.

Cloning of dapD, aroD and asd of Leptospira interrogans serovar icterohaemorrhagiae, and nucleotide sequence of the asd gene.

Metabolites such as diaminopimelate and some aromatic derivatives, not synthesized in mammalian cells, are essential for growth of bacteria. As a first step towards the design of a new human live vaccine that uses attenuated strains of Leptospira interrogans, the asd, aroD and dapD genes, encoding aspartate beta-semialdehyde dehydrogenase, 3-dehydroquinase and tetrahydrodipicolinate N-succinyltransferase, respectively, were cloned by complementation of Escherichia coli mutants. The complete nucleotide sequence of the asd gene was determined and found to contain an open reading frame capable of encoding a protein of 349 amino acids with a calculated Mr of 38,007. Comparison of this deduced L. interrogans aspartate beta-semialdehyde dehydrogenase amino acid sequence with those of the same enzyme from Saccharomyces cerevisiae and Corynebacterium glutamicum revealed 46% and 36% identity, respectively. By contrast, the identity between the L. interrogans enzyme and the Streptococcus mutans or E. coli enzymes was less than 31%. Highly conserved sequences within aspartate semialdehyde dehydrogenase from the five organisms were observed at the amino and carboxyl termini, and around the cysteine of the active site.