[Epidemiology, etiology and psychosocial impact of urogenital fistulas in a cohort of 170 consecutive patients managed in three treatment centers in Burkina Faso from 2010 to 2012]. / Aspects épidémiologiques, étiologiques et impact psychosocial des fistules urogénitales dans une cohorte de 170 patientes consécutives, prises en charge dans trois centres du Burkina Faso de 2010 à 2012.

OBJECTIVE: To describe the socio-demographical aspects, etiologies and psychosocial consequences of urogenital fistula patients (UGF) in Burkina Faso (BF). PATIENTS AND METHODS: Descriptive study of a cohort of consecutive patients during a period of 18 months (December 1st 2010 to August 31st 2012) in three centers of treatment in BF. Each patient has had a standardized complete medical observation focused on sociodemographics, clinical finding, past medical history and etiologies of UGF. Some patients had an interview with a psychologist. RESULTS: One hundred and seventy patients with mean age 35 years (minimum: 16, maximum: 70) were enrolled during the study period. The majority of patients were housewives (90.5%, n=152) and illiterates (92.9%, n=158). Among the patients, 62.4% (n=106) lived in rural zones. Obstetrical fistula was the most common cause of UGF (87.6%, n=149) in our study and prolonged labor occurred in 93.3% (n=139) of cases with 17.5% (n=26) who delivered at home. The majority of our cases were vesico-vaginal fistula (70.6%, n=120). Fifty-five patients (32.4%) were divorced after the fistula. The sensation of humiliation and sadness were noted at all the patients who had a psychological evaluation and 87.5% (n=14) of them have had suicidal ideas. CONCLUSION: The UGF are frequent in Burkina Faso and obstetrical etiology is dominant. The physical and psychosocial repercussions are important for the women victims of this pathology. LEVEL OF EVIDENCE: 4.

[The impact of hypoxia on the ion channels in cystic fibrosis bronchial epithelial cells]. / Impact de l'hypoxie sur les canaux ioniques dans des cellules épithéliales bronchiques mucoviscidosiques.

Cystic fibrosis is a disease caused by a mutation on the CFTR gene coding for a chloride channel. The dominant mutation F508del eliminates the CFTR protein at the surface of epithelial cells, causing an accumulation of viscous mucus in the airways. In advanced stages of the disease, respiratory failure is associated with cellular hypoxia. Our project aims not only to describe the impact of hypoxia on ion channels and to highlight the underlying signaling pathways involved, but also to test the effectiveness of current CF treatments under the above-mentioned conditions.

Spatial pattern of BOLD fMRI activation reveals cross-modal information in auditory cortex.

Recent findings suggest that neural representations in early auditory cortex reflect not only the physical properties of a stimulus, but also high-level, top-down, and even cross-modal information. However, the nature of cross-modal information in auditory cortex remains poorly understood. Here, we used pattern analyses of fMRI data to ask whether early auditory cortex contains information about the visual environment. Our data show that 1) early auditory cortex contained information about a visual stimulus when there was no bottom-up auditory signal, and that 2) no influence of visual stimulation was observed in auditory cortex when visual stimuli did not provide a context relevant to audition. Our findings attest to the capacity of auditory cortex to reflect high-level, top-down, and cross-modal information and indicate that the spatial patterns of activation in auditory cortex reflect contextual/implied auditory information but not visual information per se.

In-vacuum Faraday isolation remote tuning.

In-vacuum Faraday isolators (FIs) are used in gravitational wave interferometers to prevent the disturbance caused by light reflected back to the input port from the interferometer itself. The efficiency of the optical isolation is becoming more critical with the increase of laser input power. An in-vacuum FI, used in a gravitational wave experiment (Virgo), has a 20 mm clear aperture and is illuminated by an almost 20 W incoming beam, having a diameter of about 5 mm. When going in vacuum at 10(-6) mbar, a degradation of the isolation exceeding 10 dB was observed. A remotely controlled system using a motorized lambda=2 waveplate inserted between the first polarizer and the Faraday rotator has proven its capability to restore the optical isolation to a value close to the one set up in air.

[Primary localized bladder amyloidosis]. / L'amylose vésicaoe primitive localisée.

Amyloidosis constitutes a group of storage diseases concerning various proteins, classified as a function of the type of protein. Localized pseudo tumoral amyloidosis of the urinary tract is a rare affection with bladder like the most frequent localisation. In spite of contribution of computerized tomography scans and MRI, the diagnosis is always based on histological examination of cystoscopy samples. Investigations are required to eliminate a generalized amyloidosis or a malignant lymphoproliferation. Treatment should be as conservative as possible on the outside of a massive and recurrent haematuria to be able to involve vital prognosis.

Dual organisation of the Drosophila neuropeptide receptor NKD gene promoter.

Neuropeptide function in the peripheral and central nervous systems has been described in mammals as well as in insects. We previously reported the cloning of the neuropeptide receptor NKD, a Drosophila melanogaster homologue of the mammalian tachykinin receptors. This receptor is expressed during Drosophila embryonic development and in the adult fly. Use of the NKD promoter region to drive beta-galactosidase expression in transgenic flies reveals a bipartite promoter organisation: the distal region controls NKD expression in neurosecretory cells of the central nervous system during late embryogenesis, whereas the proximal region is responsible for transient expression in peripheral nervous system during late embryogenesis, whereas the proximal region is responsible for transient expression in peripheral nervous system precursor cells early in development. This early NKD expression, first restricted to the sensory organ precursor cell, an atonal positive cell, is abolished in the ato1 mutant. In addition, we show that the proneural protein atonal, in association with daughterless, transactivates the NKD promoter in Schneider S2 cells via the proximal E box NKDE2. Furthermore, heterodimers of atonal and daughterless interact with this E box in gel shift assay.

Maternal and zygotic control of serotonin biosynthesis are both necessary for Drosophila germband extension.

In the accompanying paper, we report that Drosophila gastrulae genetically depleted for the 5-HT(2Dro) serotonin receptor or for serotonin show abnormal germband extension. In wild-type gastrulae, peaks of both the 5-HT(2Dro) receptor and serotonin coincide precisely with the onset of germband extension. Here, we assessed the genetic requirement for this peak of serotonin. We report the characterisation of the serotonin content of individual Drosophila embryos, progeny from flies heterozygous for mutations in genes that are involved in the serotonin synthesis pathway and include the GTP-cyclohydrolase, tryptophan hydroxylase and DOPA decarboxylase loci. The peak of serotonin synthesis at the beginning of germband extension appears strictly dependent upon the maternal deposition of biopterins, products of GTP-cyclohydrolase and cofactors of tryptophan hydroxylase and upon the zygotic synthesis of both tryptophan hydroxylase and DOPA decarboxylase enzymes. Mutant embryos with an impairment in this peak of serotonin synthesis die with a cuticular organisation which is also observed in embryos deficient for the 5-HT(2Dro) receptor. This characteristic cuticular phenotype is thus the hallmark of desynchronisation of the morphogenetic movements during gastrulation. Together, these findings provide additional support for the notion that serotonin, acting through the 5-HT(2Dro) receptor, is necessary for proper gastrulation.

Serotonin synchronises convergent extension of ectoderm with morphogenetic gastrulation movements in Drosophila.

During Drosophila gastrulation, convergent extension of the ectoderm is required for germband extension. Adhesive heterogeneity within ectodermal cells has been proposed to trigger the intercalation of cells responsible for this movement. Segmentation genes would impose this heterogeneity by establishing a pair-rule pattern of cell adhesion properties. We previously reported that the serotonin receptor (5-ht(2Dro)) is expressed in the presumptive ectoderm with a pair-rule pattern. Here, we show that the peaks of 5-ht(2Dro) expression and serotonin synthesis coincide precisely with the onset of convergent extension of the ectoderm. Gastrulae genetically depleted of serotonin or the 5-ht(2Dro) receptor do not extend their germband properly, and the ectodermal movements becomes asynchronous with the morphogenetic movements in the endoderm and mesoderm. Associated with the beginning of this desynchronisation, is an altered subcellular localisation of adherens junctions within the ectoderm. Combined, these data highlight the role of the ectoderm in Drosophila gastrulation and support the notion that serotonin signalling through the 5-HT(2Dro) receptor triggers changes in cell adhesiveness that are necessary for cell intercalation.

Subtractive hybridization identifies chick-cripto, a novel EGF-CFC ortholog expressed during gastrulation, neurulation and early cardiogenesis.

EGF-CFC genes encode a novel class of extracellular, membrane-associated proteins that notably play an important role during vertebrate gastrulation. Whereas the two cysteine-rich domains that characterize these proteins, namely the extracellular EGF-like and the CFC domain, are known to be encoded by two evolutionarily conserved exons, it is generally assumed, based on weak primary sequence identity, that the remaining parts of the protein differ among vertebrates, suggesting that known members of the EGF-CFC family do not represent true orthologs. Here, by characterizing the full cDNA and genomic sequences of a new EGF-CFC gene in chick, and by comparing them with their counterparts in human (CRIPTO), mouse (cripto and cryptic), Xenopus (FRL-1) and zebrafish (one-eyed pinhead), we show that all EGF-CFC genes share an identical genomic organization over the entire coding region. Not only are the central two exons (coding for the EGF-like and CFC motifs) conserved, but also conserved are the total number of exons, their size, their intron phase and their correlation with discrete protein modules, in particular those modules that allow the EGF-CFC motif to become membrane-associated. Therefore, despite apparent divergence between their 5' and 3'-terminal exons, all known CRIPTO-related genes are structurally orthologous. We named this novel ortholog in bird, chick-cripto. We report the mRNA distribution of chick-cripto, which begins in the epiblast of the gastrula, with a pattern similar to EGF-CFC genes of other vertebrates.

New mouse 5-HT2-like receptor. Expression in brain, heart and intestine.

A novel member of the family of G protein-coupled receptors has been isolated from a mouse brain cDNA library by screening with polymerase chain reaction (PCR) generated fragment of mouse genomic DNA amplified using degenerated primers. Sequence comparison demonstrates that the encoded protein sequence shows the highest homology to the 5-HT2 family of receptors. The pharmacological profile of membranes from COS cells transfected with this cDNA, corresponds to a new 5-HT2-like receptor that we propose to call 5-HT2C. Its major sites of expression are in the mouse intestine and heart, also with detectable expression in brain and kidney. We speculate that it could account at least in part for the 'atypical' functions attributed to the 5-HT1C/5-HT2 receptors.

Mouse 5-HT2B receptor-mediated serotonin trophic functions.

5-HT2B receptors, in addition to phospholipase C stimulation, are able to trigger activation of the proto-oncogene product p21ras. During mouse embryogenesis, a peak of 5-HT2B receptor expression is detected at the neurulation stage; we localized the 5-HT2B expression in neural crest cells, heart myocardium, and somites. The requirement for functional 5-HT2B receptors shortly after gastrulation, is supported by culture of embryos exposed to 5-HT2B-high affinity antagonist such as ritanserin, which induces morphological defects in the cephalic region, heart and neural tube. Functional 5-HT2B receptors are also expressed during the serotonergic differentiation of the mouse F9 teratocarcinoma-derived clonal cell line 1C11. Upon 2 days of induction by cAMP, 5-HT2B receptors become functional, and on day 4, the appearance of 5-HT2A receptors coincides with the onset of active serotonin transporter by these cells. Active serotonin uptake is modulated by serotonin suggesting autoreceptor functions for 5-HT2B receptors.

The mouse 5-HT2B receptor: homologous subtype or species variant?

The recently characterized 5-HT2B subfamily of serotonin receptors has now been reported from three different species: human, rat and mouse. Their genomic structures include 2 introns present at identical positions. Despite this similarity, their respective protein sequences show some diversities. In addition, the pharmacology of these receptors is distantly related, and their sites of expression vary amongst species. Thus, it appears difficult at present to unambiguously classify these receptors into the same subfamily, raising the possibility of the existence of other 5-HT2B-like receptors, yet to be discovered.

Prevalence of epilepsy in northeast Madrid.

During a period of 42 months, we studied the prevalence of epilepsy in a specific health district, composing by four towns with 98,405 inhabitants older than 10 years. This has been accomplished by a two-phase cross-sectional study. The prevalence rate observed was 4.12/1000 inhabitants for all types of epilepsy. No significant differences were found between the sexes. Sixty-three per cent of affected individuals had partial seizures, with a confirmed cause in 45%. Fifty-five patients with single unprovoked seizures, were also identified but not included in the prevalence rate.

Direct vascular actions of methyclothiazide and indapamide in aorta of spontaneously hypertensive rats.

In vitro experiments were designed to assess the inhibitory effect of the thiazide diuretics methyclothiazide (MCTZ), the hydrochlorothiazide (HCTZ), and the thiazide-related diuretic indapamide (IND) on contractile responses to norepinephrine (NE) and arginine vasopressin (AVP) of aortic rings from spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY). Changes in the tension of aortic ring preparations were measured isometrically. MCTZ (10(-4) M) induced endothelium-dependent inhibition of the vasoconstrictor responses to NE and AVP only in aortas from SHR, and the maximal vasoconstrictive effect of NE and AVP was decreased by 59 +/- 11% and 32.3 +/- 13%, respectively. Indapamide (10(-4) M) also induced endothelium-dependent inhibition of the contractile response to AVP in aortic rings from SHR, and the maximal vasoconstrictive effect of AVP was decreased by 33 +/- 5%. In contrast, HCTZ did not inhibit the contractile response to either NE or AVP, even at the highest concentration. This study provides evidence that methyclothiazide and indapamide inhibit the contractile response induced by norepinephrine and/or arginine vasopressin on SHR aortic preparations via an endothelium-dependent mechanism.

[Effect of methyclothiazide on the entry of calcium into vascular smooth muscle cells]. / Effets du méthyclothiazide sur l'entrée de calcium dans la cellule musculaire lisse vasculaire.

The possible involvement of calcium and potassium channels in mediating the vascular actions of methyclothiazide (MCTZ), a thiazide diuretic, was investigated in isolated aortic rings from 12 week-old hypertensive rats. MCTZ (10(-4) M) inhibits the contractile response induced by addition of Ca2+ to a depolarizing solution, the maximal contracture is reduced by 87.16 +/- 6.4%. Furthermore this inhibitory effect was unaffected by charybdotoxine a selective blocker of calcium-activated K+ channels (Kca). This suggesting that MCTZ inhibits voltage-gated Ca2+ channels and blunts the Ca2+ entry into vascular smooth muscle cells. This inhibition was partially attenuated by either mechanical removal of the endothelium or N omega-nitro-L-arginine (NOLA) treatment, suggesting that MCTZ effects are also mediated by an endothelium-dependent mechanism involving endothelium-dependent relaxing factor (EDRF)/nitric oxide (NO) release. Taken together, these observations could point to a role of voltage-gated Ca2+ channels and endothelial release of EDRF/NO in the antihypertensive action of MCTZ.

[Fibrinogen: a cardiovascular risk factor]. / Fibrinogène: facteur de risque cardiovasculaire.

AN INDEPENDENT RISK FACTOR: Pathophysiological and epidemiological data show that fibrinogen is an independent risk factor for atherosclerosis with a synergistic effect on classical risk factors. CORONARY ARTERIES: Serum fibrinogen level is an independent predictor of the presence and severity of atheromatous lesions of the coronary arteries. It is also predictive of coronary events such as sudden death, myocardial infarction or angina pectoris. OTHER VESSELS: Fibrinogen is also a marker of cerebrovascular events or transient ischemia and a factor predictive of recurrent cerebrovascular events. Serum fibrinogen level is correlated with the progression of carotid lesions. Finally, fibrinogen is an independent predictive factor of the severity of atherosclerosis of the thoracic aorta, lower limb arteriopathy, and more generally silent atherosclerotic plaques. PERSPECTIVES: A large-scale prospective study is needed to determine whether drug-induced reduction in serum fibrinogen can reduce the rate of cardiovascular events.

[Relationship between primary care and neurological care]. / Interrelación entre atención primaria y asistencia neurológica.

The problems posed by health care are related to health service structure and development. The transformation of a three level care structure into one of just two levels, primary care and specialized care, plays its part. With the aim of analyzing the importance these factors might have in present-day health care, we carried out an aleatoric study of all those patients who attended our neurological service in the years 1992 and 1993. We obtained two sample groups consisting of 921 and 849 patients respectively through interconsultatory requests from practitioners within a limited health care area. We studied the patient's background, the requesting practitioner, diagnosis obtained and complementary tests used. Patients from individual practitioners varied in number from 4 to 38, with some 20% of all patients having been referred by just six practitioners. 20% of the patients we studied showed no neurological pathology. Complementary tests used in all diagnoses sent to us amounted to less than half the number of patients studied. We analyzed the importance these factors have in the present delay in health care services.

[Upward and downward gaze palsy with a unilateral mesencephalic hemorrhage]. / Parálisis combinada de la mirada vertical tras hemorragia unilateral del mesencéfalo.

INTRODUCTION: Acute vascular lesions limited to the midbrain can yield varied disturbances of eye movements. They are more often infarcts than hemorrhages. CLINICAL CASE: We present the case of a 49 year old, non-hypertensive man who presented with sudden onset of bilateral up and down gaze palsy. CT defined a unilateral hemorrhage in the right mesencephalic tegmentum. CONCLUSION: Cases of upward and downward gaze palsy in association with unilateral upper midbrain hemorrhage are very uncommon. We present a new case.

[Prostatic specific antigen and prostatic pathology. Value of preoperative blood assay. Preliminary study apropos of 709 case reports]. / Antigène spécifique de prostate et pathologie prostatique valeur du dosage sérique pré-opératoire. Etude préliminaire à propos de 709 observations.

Prostate specific antigen (PSA) is a prostate tissue marker detected by immunostaining in 97% of specimens examined. Tissue staining is variable and cancers are more heterogeneous than normal or hyperplastic prostate. Serum PSA levels in patients with normal or hyperplastic lesions are 12 ng/ml + 19 and are positively correlated with the weight of the gland. In patients with carcinoma serum PSA levels are 216 ng/ml + 782 and are positively correlated with tumor spread. PSA assay is of little value for screening for prostatic carcinoma. However, carcinoma of prostate is more frequent when PSA levels are above 10 ng/ml and the level of 50 ng/ml indicates capsular penetration, seminal vesicle or lymph node involvement or metastatic spread.

[Traissac voice prosthesis. Apropos of 9 years experiences]. / L'implant phonatoire de Traissac. A propos d'une expérience de 9 ans.

BACKGROUND: Long term results are discussed. PATIENTS: A retrospective study of 9 years (1/01/89, 1/01/98) concern 107 laryngectomized patients with 9 patients a part from this period, and 30% without prosthesis. Among 80 patients with prosthesis, 57% had received primary TEPs (tracheoesophageal puncture), 21% delayed primary TEPs and 22% secondary TEPs. Oesophageal voice is always learned with tracheoesophageal voice. RESULTS: We find a success rate (1 month) in 75% of cases, with a maximum follow up time of 8 years (the average is 3 years 1 month). We find a success rate with a long-term result in 66% of cases. Prosthesis removal exists in 30% of cases and oesophageal voice is successfull once out of 3 in this cases. Mean lifetime Traissac's prosthesis is 18 months. After removal, non closed fistulas can exist in 40% of cases, and surgery is always successful. DISCUSSION: Material Traissac's prosthesis explains extended lifetime. CONCLUSION: Traissac's prosthesis gave us satisfaction during a use of 8 years.