[Urological and medical complications of renal transplant]. / Complications urologiques et médicales de la greffe rénale.

Medical complications from renal transplant (acute tubular necrosis, acute rejection, chronic rejection) are mainly imaged with Doppler ultrasound to first exclude vascular or urological causes for renal function impairment. Once these causes are excluded, imaging features are nonspecific and imaging is mainly used for follow-up and biopsy remains essential. Urological complications include postsurgical collections, urinary fistulas, obstructive uropathy, vesicoureteric reflux, infections and malignancies. Imaging plays a leading role in the diagnostic and therapeutic management of these complications.

[Thermal ablation: tolerance and efficacy in a population mostly composed of primary lung cancers]. / Thermo-ablation pulmonaire: tolérance et efficacité thérapeutique dans une population constituée majoritairement de tumeurs primitives pulmonaires.

PURPOSE: Radiofrequency thermal ablation (TA) of lung tumors currently is considered an alternative to surgical management for early primary lung cancers and non-surgical lung metastases. The purpose of this study was to determine the tolerability and efficacy of this treatment in 29 consecutive patients, most of which with primary lung cancers, managed in our center. MATERIALS AND METHODS: Twenty-nine patients with 32 lung tumors less than 35 mm in diameter underwent radiofrequency thermal ablation between May 2004 and July 2008. The CT examinations performed during and after the ablation were reviewed to determine lesion characteristics, complications, treatment, local recurrence rate and survival rate. RESULTS: Sixty-nine percent of our population consisted of primary lung cancer. The incidence of pneumothorax was 72% with 10% requiring drainage. The rate of complete response was 81%. The survival rate at 1 year was 79%. CONCLUSION: Radiofrequency thermal ablation of lung tumors is a minimally invasive technique with high rate of complete response. It can be considered in non-surgical patients with primary or metastatic lung tumors less than 35 mm in diameter.

The importance of imaging assessment before endovascular repair of thoracic aorta.

Indications for and experience with placement of endovascular stent grafts in the thoracic aorta are still evolving. Recent advances in imaging technologies have drastically boosted the role of pre-procedural imaging. The accepted diagnostic gold standard, digital subtraction angiography, is now being challenged by the state-of-the-art computed tomography angiography (CTA), magnetic resonance angiography (MRA) and trans-oesophageal echocardiography (TEE). Among these, technological advancements of multidetector computed tomography (MDCT) have propelled it to being the default modality used, optimising the balance between spatial and temporal resolutions and invasiveness. MDCT angiography allows the comprehensive evaluation of thoracic lesions in terms of morphological features and extent, presence of thrombus, relationship with adjacent structures and branches as well as signs of impending or acute rupture, and is routinely used in these settings. In this article, we review the current state-of-the-art radiological imaging for thoracic endovascular aneurysm repair (TEVAR), especially focusing on the role of MDCT angiography. After analysing the technical aspects for optimised imaging protocols for thoracic aortic diseases, we discuss pre-procedural determinants of candidacy, and how to formulate interventional plans based on cross-sectional imaging.

Two treatment methods for stormwater sediments--pilot plant and landfarming--and reuse of the treated sediments in civil engineering.

The aim of this research was to present a pilot plant for the treatment of stormwater sediments and to compare the decontamination rate to that obtained by landfarming. The possibilities for reuse of the treated sediments in civil engineering are also studied. Four sediments from retention/infiltration ponds or from street sweeping were studied. In each case organic matter (OM), total hydrocarbons (TH) and polycyclic aromatic hydrocarbons (PAH) were measured. Geotechnical tests were carried out to evaluate the reuse possibilities of the treated sediments. Treatment by means of the pilot plant was efficient at reducing TH and PAH concentrations: THs were reduced by 53-97% and PAHs were decreased by 60-95%. By comparison, a reduction of 45-75% in TH concentration is obtained with landfarming, whereas there is no significant decrease in PAHs. Furthermore, geotechnical tests showed that the treated fractions from the pilot plant can be reused as road embankments and as a capping layer. These results are most encouraging and show that stormwater sediments can valuably be reused after treatment in a pilot plant. Landfarming is less efficient but this technique could be used as a pretreatment in the case of high TH pollution.

[Interventional radiology and thoraco-abdomino-pelvic trauma]. / Radiologie interventionnelle et traumatismes thoraco-abdomino-pelviens.

Multidetector CT is very useful in the evaluation of polytrauma patients. MDCT is valuable for the detection and treatment planning of vascular injuries, but it may not be available to hemodynamically unstable patients. Embolization of visceral and parietal branches of the aorta benefits from advances in catheter technology: hydrophilic catheters and microcatheters are very helpful in this context. Resorbable particles (such as gelatin) and coils are the most useful occlusive agents. Endovascular stenting of aortic rupture is nowadays considered in many centers as the best therapeutic option and can be proposed as an alternative to surgery.

Cloning of a human homolog of the yeast nucleotide excision repair gene MMS19 and interaction with transcription repair factor TFIIH via the XPB and XPD helicases.

Nucleotide excision repair (NER) removes UV-induced photoproducts and numerous other DNA lesions in a highly conserved 'cut-and-paste' reaction that involves approximately 25 core components. In addition, several other proteins have been identified which are dispensable for NER in vitro but have an undefined role in vivo and may act at the interface of NER and other cellular processes. An intriguing example is the Saccharomyces cerevisiae Mms19 protein that has an unknown dual function in NER and RNA polymerase II transcription. Here we report the cloning and characterization of a human homolog, designated hMMS19, that encodes a 1030 amino acid protein with 26% identity and 51% similarity to S.cerevisiae Mms19p and with a strikingly similar size. The expression profile and nuclear location are consistent with a repair function. Co-immunoprecipitation experiments revealed that hMMS19 directly interacts with the XPB and XPD subunits of NER-transcription factor TFIIH. These findings extend the conservation of the NER apparatus and the link between NER and basal transcription and suggest that hMMS19 exerts its function in repair and transcription by interacting with the XPB and XPD helicases.

Sublimiting concentration of TFIIH transcription/DNA repair factor causes TTD-A trichothiodystrophy disorder.

The repair-deficient form of trichothiodystrophy (TTD) most often results from mutations in the genes XPB or XPD, encoding helicases of the transcription/repair factor TFIIH. The genetic defect in a third group, TTD-A, is unknown, but is also caused by dysfunctioning TFIIH. None of the TFIIH subunits carry a mutation and TFIIH from TTD-A cells is active in both transcription and repair. Instead, immunoblot and immunofluorescence analyses reveal a strong reduction in the TFIIH concentration. Thus, the phenotype of TTD-A appears to result from sublimiting amounts of TFIIH, probably due to a mutation in a gene determining the complex stability. The reduction of TFIIH mainly affects its repair function and hardly influences transcription.

Genomic organization and promoter characterization of two human UHS keratin genes.

TTD is a rare human genetic disease caused by mutations in XPB and XPD, two subunits of the transcription/repair factor TFIIH, and whose outstanding clinical characteristic is a lack of most human UHS proteins resulting in sulfur-deficient brittle hair. In an attempt to understand this transcription defect, we report here the genomic cloning of two highly related UHS keratin genes specifically expressed in follicular and epidermal cells. In addition to a high degree of nucleotide homology (87%), both genes also have a similar 90-nt promoter sequence. In-vivo and in-vitro studies allowed us to specify the position of the start sites, the TATA-boxes and some regulatory regions. Results indicate that both genes present common features in the regulation of their transcription and suggest that control of their expression might be affected by mutations in TFIIH subunits.

Genomic organization and promoter characterization of the mouse and human genes encoding p62 subunit of the transcription/DNA repair factor TFIIH.

TFIIH, a multisubunit complex was shown to be involved in several biological fundamental mechanisms of the cell: transcription, nucleotide excision repair and cell cycle regulation. p62 is one of the six subunits that constitutes the core of TFIIH versus the holoenzyme, which contains, in addition, the ternary kinase CAK complex. To gain an insight into the regulation of the expression of the various subunits of the core, we report here the cDNA cloning and the genomic organization of the mouse p62 gene. A promoter analysis of both mouse and human genes allow us to localize two start sites and the regulatory regions, thus demonstrating a significative conservation among both species. Both promoters lack classical elements such as CCAAT and TATA boxes. Analysis of the expression of the p62 gene reveals an overexpression in testis tissue for both species.

Acetoxy-acetylaminofluorene-modified dGTP can be used to label oligonucleotides or DNA enzymatically.

A competitive enzyme immunoassay using a bispecific monoclonal antibody (Bi-MAb) was developed to quantify acetylaminofluorene (AAF) adducts fixed on DNA and then compared to the spectrophotometric method. It was shown that this simple method allowed the measurement of as low as 2 pmol per assay of AAF bound to DNA. This technique was used to monitor synthesis and purification of N-acetoxy-N-2-acetylaminofluorene modified dGTP (AAF-dGTP). It was shown that AAF-dGTP can be a substrate for the terminal deoxynucleotidyl transferase. Finally, using the Bi-MAb we developed a non-radioactive sandwich hybridization assay making use of oligonucleotide covalently bound to microwells and of synthetic oligonucleotide tailed with AAF-dGTP as a probe.

Characterization of serogroup A Neisseria meningitidis strains by rRNA gene restriction patterns and PCR: correlation with the results of serotyping, subtyping and multilocus enzyme electrophoresis.

We studied 35 strains of Neisseria meningitidis serogroup A from different locations (France, Central African Republic, Sudan and Burkina Faso) using both ribotyping and a polymerase chain reaction (PCR). A non-radioactive probe label was used for ribotyping; detection consisted of an immunoenzymatic procedure using a bispecific antibody. The PCR was designed to amplify the 16S-23S rDNA internal transcribed spacer. These techniques were compared with other markers. The strains were identified as belonging to three clones (I, III-1, IV) by multilocus enzyme electrophoresis (MEE) and to three subtypes by serological methods. Ribotyping identified five groups and PCR identified four groups. Ribotyping gave more diversity between strains than either MEE or sero/subtyping, but confirmed the epidemiological data provided by the combination of these two techniques. The PCR provided a simple and convenient one-step procedure for the differentiation of strains of serogroup A.

Development of a bispecific monoclonal antibody for use in molecular hybridisation.

A mouse hybrid hybridoma (tetradoma) was prepared by fusing hybridomas producing monoclonal antibody to acetyl-aminofluorene with hybridomas producing antibody against calf intestine alkaline phosphatase. The tetradoma line established secreted immunoglobulin manifesting parental and bispecific binding characteristics. Bispecific monoclonal antibody was purified and used for a one-step immunodetection assay of non-radioactive DNA and RNA probes. The immunoassay developed was able to detect 5 pg DNA within 2 h and gave low background noise.

Sero-subtyping of group B, C, Y and A meningococci isolated in France in 1988.

During 1988, 291 strains of various serogroups (B, C, Y and A) isolated in France, have been sero and sub-typed. 74.5 p. cent of the strains were isolated from CSF and blood of patients; 25.4 p. cent were isolated from carriers. The "whole cell ELISA" procedure was used with monoclonal antibodies. The distribution of serotypes among serogroup B strains was as follows: serotype 1 (8.1 p. cent); 2a (19 p. cent); 2b (16.2 p. cent); 4 (20.2 p. cent); 14 (13.5 p. cent); 15 (23 p. cent): 40 p. cent remained non typable (NT). Among serogroup C strains serotype 2a represented 74.5 p. cent of the strains. Serogroup A strains were only of the serotype 4. Serogroup Y strains belonged to serotype 14 or were NT. Some associations between serotypes and subtypes were predominant such as B:2a:P1.2 or B:2b:P1.2 or B:4:P1.15 or B:15:P1.7. Among serogroup C strains the antigenic pattern C:2a:P1.2 was most prevalent.

[Frequency of germ isolation from urinary infections in community practice; their sensitivity to 7 antibiotics including a combination of amoxicillin and clavulanic acid. Evaluation on 1611 samples]. / Fréquence d'isolement des germes d'infection urinaire en pratique de ville; leur sensibilité à sept antibiotiques dont l'association amoxicilline-acide clavulanique. Bilan sur 1,611 prélèvements.

A multicenter study including 10 outpatient private laboratories (hospital laboratories excluded) was carried out in France. 1,611 urines samples from patients with UTI were collected during the forth trimester of 1987. The most frequently recovered pathogens were: E. coli (71%), Proteus mirabilis (9%), Staphylococcus coagulase (6%), Klebsiella (6%), Enterobacter (2%). Other sorts (Streptococcus D, Proteus sp, Pseudomonas aeruginosa, Enterobacter sp) were infrequent (less than 1%). The sensitivity of the aerobic Gram-negative bacteria to ampicillin, clavulanic acid-amoxicillin, cephalothin, gentamicin, pipemidic acid, norfloxacin and co-trimoxazole was tested.

[The frequency of isolating urinary infection germs at a community practice and their sensitivity to various antibiotics]. / Fréquence d'isolement de germes d'infection urinaire en pratique de ville et leur sensibilité aux différents antibiotiques.

Nine hundred and thirty one urine's specimens of patients affected by urinary infection have been studied by pathology practising in different towns in France. The most frequently germs retrieved are: Escherichia coli 76%, Proteus mirabilis 12%, Klebsiella 5%, Staphylococcus epidermidis 2%. Were studied Gram negative rods sensibility to ampicillin (A), cephalosporin 1st generation (C), nalidixic acid (Nal), gentamicin (G), norfloxacin (Norf); Gram positive cocci resistance to oxacillin (Oxa), erythromycin (E), pristinamycin (P), gentamicin (G), norfloxacin (Norf). For E. coli: the resistance was 24% A, 2% C1, 0.1% G, 4% Nal, 0.1% Norf. For Klebsiella: the resistance was respectively 96% A, 12% C1, 10% Nal, 18% G., 4% Norf. For P. mirabilis: 11% A, 3% C1, 0% Nal, 9% G, 0% Norf. E. coli strains cephalo R; Gram negative rods Genta R or quinolone R; staphylocoque oxa R or pristina R have been checked by HIA Begin microbiology laboratory. Discrepancies in results have been analysed. This study enabled the participants to improve their bacteriological technic, antibiogramm's reading, results' interpretation.

[Lymphoblast transformation test in osteoarticular tuberculosis]. / Le test de transformation lymphoblastique dans les tuberculoses ostéo-articulaires

Bacteriological proof of an osteoarticular tuberculous lesion is difficult to obtain, notably in Pott's disease. The authors, on the basis of earlier work in the field of pulmonary pathology, wished to assess the value of the lymphocyte transformation test in the diagnosis of this disease. Old tuberculin from the Pasteur Institute and LP48 tuberoulin were used at different concentrations. Out of 10 tuberculous patients (8 with Pott's disease and 2 with white tumours), 9 had positive tests, of which 7 were strongly positive ; the average transformation value was 13 percent. This positiveness was a function of the condition of the patient, of the extent of the lesions, and of the treatment. Of the 25 control patients affected by an infectious, nonmicrobial or other osteoarticular process, 17 gave negative results in the test, and 8 were positive, two of whom had high values. The average transformation value was 4 percent. From this study it seems that a negative result in the LTT is a valuable argument against the diagnosis of osteoarticular tuberculois ; a weak positive result indicates tuberculin hypersensitivity without absolutely defining evolution of tuberculois ; a strongly positive test may be encountered in hyperergic states connected with prolonged infectious conditions in bones or joints.