Synthesis of Ge-imogolite: influence of the hydrolysis ratio on the structure of the nanotubes.

The synthesis protocol for Ge-imogolite (aluminogermanate nanotubes) consists of 3 main steps: base hydrolysis of a solution of aluminum and germanium monomers, stabilization of the suspension and heating at 95 °C. The successful synthesis of these nanotubes was found to be sensitive to the hydrolysis step. The impact of the hydrolysis ratio (from n(OH)/n(Al) = 0.5 to 3) on the final product structure was examined using a combination of characterization tools. Thus, key hydrolysis ratios were identified: n(OH)/n(Al) = 1.5 for the formation of nanotubes with structural defects, n(OH)/n(Al) = 2 for the synthesis of a well crystallized Ge imogolite and n(OH)/n(Al) > 2.5 where nanotube formation is hindered. The capability of controlling the degree of the nanotube's crystallinity opens up interesting opportunities in regard to new potential applications.

The contribution of germline rearrangements to the spectrum of BRCA2 mutations.

BACKGROUND: Few germline BRCA2 rearrangements have been described compared with the large number of germline rearrangements reported in the BRCA1 gene. However, some BRCA2 rearrangements have been reported in families that included at least one case of male breast cancer. OBJECTIVE: To estimate the contribution of large genomic rearrangements to the spectrum of BRCA2 defects. METHODS: Quantitative multiplex PCR of short fluorescent fragments (QMPSF) was used to screen the BRCA2 gene for germline rearrangements in highly selected families. QMPSF was previously used to detect heterozygous deletions/duplications in many genes including BRCA1 and BRCA2. RESULTS: We selected a subgroup of 194 high risk families with four or more breast cancers with an average age at diagnosis of < or = 50 years, who were recruited through 14 genetic counselling centres in France and one centre in Switzerland. BRCA2 mutations were detected in 18.6% (36 index cases) and BRCA1 mutations in 12.4% (24 index cases) of these families. Of the 134 BRCA1/2 negative index cases in this subgroup, 120 were screened for large rearrangements of BRCA2 using QMPSF. Novel and distinct BRCA2 deletions were detected in three families and their boundaries were determined. We found that genomic rearrangements represent 7.7% (95% confidence interval 0% to 16%) of the BRCA2 mutation spectrum. CONCLUSION: The molecular diagnosis of breast cancer predisposition should include screening for BRCA2 rearrangements, at least in families with a high probability of BRCA2 defects.

Factors Influencing Adoption of New Technologies into Dental Practice: A Qualitative Study.

The objective of this study was to explore factors affecting decisions to adopt new technologies into dental practice using a colorimetric rinse test for detection of periodontal disease as a model. Focus groups with key informants in Canadian dentistry and dental hygiene were conducted. A deductive approach used Rogers's diffusion of innovation theory as a framework for organizing codes and subcodes. Two members of the research team independently reviewed and analyzed the data using NVivo 10. The attributes of the technology itself emerged as primary influencers. Perceived relative advantages of the diagnostic mouth rinse over existing methods were potential time efficiency, low implementation cost, and utility of the tool. Low complexity, compatibility with existing routines/beliefs, and the potential for reinvention-the use of a technology for other than its intended purpose (i.e., patient education, monitoring of disease, screening tool in nondental settings)-were other important features enhancing adoption. An overarching concern was that any new technology benefit the patient. Contextual factors also play a role. Numerous communication channels, including opinion leaders, patients, marketing, continuing education courses, and strength of evidence, influenced clinicians, with peer interaction being a stronger influence than marketing. Similar themes arose from specialist, general dentist, and dental hygienist focus groups. Adopter characteristics also came into play: participants ranged in their self-reported innovativeness with many considering themselves "early adopters" of new technology. Findings of this study suggest that the innovation adoption process is not straightforward, but attributes of the innovation, contextual factors, and adopter characteristics play important roles in the process. Knowledge Transfer Statement: Various factors affect the adoption of new tools into clinical dental practice. These include attributes of the test or tool itself, the context of the settings in which the tool is introduced to practitioners, and the characteristics of the clinicians themselves. A qualitative study of dentists and dental hygienists investigated these factors. Situations in which dentists and hygienists interact with their peers and colleagues-through social networks, continuing education courses, conventions, or personal contact-were a major driver in the decision to adopt new technologies. However, even among "early adopters," most were reluctant to use new tests or tools unless they perceived a benefit to their patients or practice.

Expression of the serglycin gene in human leukemic cell lines.

The expression of the human serglycin gene was determined in nine human leukemic cell lines, representing a spectrum of erythrocytic, megakaryocytic, monocytic, granulocytic, and lymphocytic potentialities. By Northern blot analysis, a 1.4 kb transcript was characterized in some of these cell lines, using a cDNA probe coding for human serglycin. Five of these cell lines, HEL, U-937, HL-60, K-562, and KU-812 were treated with phorbol myristic acetate to induce differentiation. Under these conditions the expression of the serglycin gene was modulated compared to the non-induced cells. HL-60, K-562, and KU-812 were also induced with dimethyl sulfoxide and retinoic acid; variations in serglycin transcript level were also observed. The present investigation establishes, at the nucleic acid level, the ability of various cells mimicking different stages in the developmental pathways of the haemopoietic lineage to synthesize proteoglycans belonging to the serglycin family. The results reported here led us to conclude that serglycin expression is closely associated with the haemopoietic cell differentiation pathway. The putative functions of serglycin in the haemopoietic system are briefly discussed.

Complete amino acid sequence of a human platelet proteoglycan.

The primary structure of a human platelet proteoglycan (P.PG) core was established by a combination of amino acid sequence analysis and cDNA cloning. The deduced 131 amino acid long protein contains eight Ser-Gly repeats. The significance of homologies observed between P.PG and promyelocytic leukemia cell line proteoglycans is discussed.

New benzocycloalkylpiperazines, potent and selective 5-HT1A receptor ligands.

A series of 1-(benzocycloalkyl)-4-(benzamidolkyl)piperazine derivatives was prepared in order to obtain compounds with a high affinity and selectivity for 5-HT1A receptors. The modifications of aromatic substituents, the length of the alkyl chain, and the size of the ring were explored. Most of N-(1,2,3,4-tetrahydronaphthyl)-N'-(benzamidoethyl)piperazines (32-37) were bound to 5-HT1A receptors in a nanomolar range and presented a high degree of selectivity. After resolution, levorotatory enantiomers showed affinity and selectivity higher than those of dextrorotory ones for 5-HT1A sites. The agonist type activity of selected derivatives was also confirmed in vitro on the inhibition of the activation of adenylate cyclase induced by forskolin and, in vivo, on the induction of the lower lip retraction in rats.

Carcinoma of the thoracic esophagus. Results of one-stage surgery (271 cases).

A group of 271 squamous carcinomas of the thoracic esophagus were studied. All of these patients underwent the same operation: one-stage esophagogastrectomy through a combined abdominal and right thoracic approach. Adenocarcinomas, tumors of the cardia and excisions through a left-sided thoracic approach were excluded. The resectability of these tumors has increased progressively and, at present, applies to 74 percent of operative cases. A majority of these excisons (73 percent) were only palliative. Operative mortality was 16.6 percent for the group as a whole. In the last 3 years this rate has fallen to 4.6 percent. Overall survival at 5 years was 9.3 percent (8.7 percent without recurrence). There was a marked difference between the 5 year survival rate after curative excision (28 percent) and after palliative excision (2.3 percent). Despite such poor results, palliative excision remains justified and offers the patient longer and more comfortable survival than any other type of treatment. Two-stage excision represents a longer, more complex and more grave procedure than one-stage esophagogastrectomy. The addition of postoperative radiotherapy with or without chemotherapy in the last 3 years had led to a marked improvement in survival.

The advantages of palliative resection in squamous cell carcinoma of the esophagus.

A series of 223 resections for esophageal squamous cell carcinoma performed from 1975 to 1982 (70% were palliative or cleaning resections) is presented. Postoperative mortality and morbidity are not significantly different after palliative resection from those after curative resection. The long-term results are encouraging and clearly superior to those obtained with other medical and surgical palliative therapies. These findings lead the authors to support the use of palliative resection for esophageal carcinoma, except in cases of cervical tumors with a poor prognosis.

[Esophageal and gastric fistulas following surgery of the esophagogastric junction]. / Les fistules oesophagiennes et gastriques après chirurgie de la jonction oesogastrique.

Seven cases of oesophageal and gastric fistulae after hiatal hernia surgery are reported: 4 fistulae occurred after an abdominal anti-reflux repair; 3 after an intrathoracic Nissen repair. The clinical symptomatology of these complications highly influences their therapeutical strategy. The fistulae with only an abdominal manifestation (subphrenic abscess or peritonitis) are opposed to those with mediastinal or pleural symptoms. The different modalities of treatment and their results are analysed. The authors prefer in case of a fistula with abdominal manifestation a directed fistulization associated with enteral alimentation; in case of a fistulae with thoracic manifestation an oesophageal exclusion with delayed restoration of G.I. tract continuity is indicated.

[A case of 2-stage traumatic rupture of the abdominal aorta]. / A propos d'un cas de rupture traumatique de l'aorte abdominale en deux temps.

A case of post traumatic rupture of the abdominal aorta, secondary to blunt abdominal trauma, is reported. Treatment was in two stages due to its masking by an extensive retroperitoneal hematoma. Review of the literature discloses its extreme rarity and poor prognosis.

[Treatment of peptic stenosis of the esophagus. Conservative techniques (author's transl)]. / Traitement conservateur des sténoses peptiques de l'oesophage.

Peptic stenosis of the esophagus is no longer considered as an irreversible lesion. It may stabilize or even regress if gastro-esophageal reflux is suppressed. The treatment of these stenoses during the last decade has been progressively oriented towards conservative techniques, the only ones capable of conferring the necessary low degree of complexity on this type of surgery. The authors report their experience between 1965 and 1980 on 151 operations. Resection was performed in 1/3 of the cases and the remainder were treated conservatively, by either thoracic or abdominal routes. The route of choice is abdominal. Peroperative dilatation of the stenosis is done with a finger or a bougie. The anti-reflux configuration is a Nissen type fundoplicatio when the cardia can be lowered in the abdomen. If the cardia cannot be lowered because of a shortening of the esophagus, the authors utilize a complete wrapping of the gastric cone since 1969. This technique has been used 45 times, often in old and weak patients who would have tolerated no other procedure. Mortality was zero. Long-term results are satisfactory and longlasting in 75% of the cases. Secondary dilatations are sometimes (18%) necessary, especially during the first postoperative year. In case of failure, it remains possible to perform another conservative operation through the thoracic route. No late-arising adenocarcinoma has been observed in the stenotic zone.

[Nephrostomy and percutaneous internal bypass. Technic and results. Apropos of 130 cases]. / Néphrostomies et dérivations internes percutanées. Technique et résultats. A propos de 130 cas.

130 percutaneous nephrostomies have been performed on 106 patients, 6 of whom had transplanted kidneys. On 4 of these patients percutaneous drainage of a perinephric abscess was performed at the same time. Over 50% of the patients were in obstructive anuria. No failure was noted in placement of the nephrostomy tubes. Only one major complication occurred, a resolvent septic shock. Minor complications i.e. pelvocalyceal blood clotting, catheter dislodgement, retroperitoneal urine extravasation, are rare. There is no contra-indication to this procedure. 30 indwelling ureteral catheters and 10 double pigtail stent catheters were also inserted by this antegrade technic. The main indications for these procedures are 1) acute or chronic supravesical obstructions, especially infected cases. The therapeutic decision is often difficult in stenosis of neoplastic origin 2) ureteral fistulas which are always dried by a nephrostomy and which can be definitely cured by indwelling catheters, 3) certain types of calculi, which can be either treated by irrigation in situ with stone-dissolving solutions, or removed percutaneously by extraction or ultrasonic lithotripsy.

[Pulmonary xanthogranulomas (author's transl)]. / Xanthogranulomes pulmonaires.

The authors report on six cases of pulmonary xanthogranuloma. They stress the latent character of these dense, round isolated parenchymatous tumors. The tumors have an homogeneous aspect without calcifications and regional adenopathies. The radio-clinical diagnosis is difficult to assess because the para-clinical examinations are regularly negative. The differential diagnosis is made either clinically, especially with hamartochondroma and peripheral cancer, or histologically according to the predominance of various types of cells, especially with a solitary plasmocytoma, a lymphoma or a sclerosant hemangioma. Histology is the only key to diagnosis. For these reasons, the decision for surgical intervention presents a problem as the patients, often young, present no visible signs and the lesions evolve but very slowly.

[Ultrasonic diagnosis in scrotal pathology. Apropos of 137 tests]. / Apport de l'échographie dans la pathologie des bourses. A propos de 137 examens.

Ultrasound imaging of scrotum in 137 patients detected 31 inflammatory lesions of epididymis or testis, 8 tumors, 23 cystic lesions, 21 hydroceles and 19 other affections. Medical or surgical treatment was instituted in 63% of patients, the other 37% failing to attend. Therapy was effective in 90.5% of cases (100% of fluid lesions, 80.6% of inflammatory lesions and 87.5% of tumors). Ultrasound imaging appears to be an excellent complement to clinical examination, when findings are insufficient or when examination is difficult because of severe pain, allowing identification of the fluid or solid nature of a lesion. It is also of specific value for diagnosis of subclinical tumors, surveillance of patients at risk and detailed investigation of inflammatory lesions.

[Dissolution of obstructive uric acid calculi by percutaneous nephrostomy and in situ alkalinization]. / Dissolution des calculs uriques obstructifs par néphrostomie percutanée et alcalinisation in situ.

Following the introduction of one or two percutaneous nephrostomy drains, 16 obstructive uric acid calculi were treated by perfusion of excretory cavities with 14% sodium bicarbonate solution. Twelve calculi had dissolved within an average of 5 days, 1 required percutaneous lithotripsy because of incomplete dissolution and 3 were unaltered. Success of this treatment appears to be dependent on the total radiotransparency of calculi, a feature difficult to demonstrate. There were no reports of major complications. The only weakly invasive nature of alkalinization in situ makes it a method of choice to be reserved for obstructive calculi, and a therapeutic strategy is proposed.

[Colonic perforations during interventional urinary radiology]. / Les perforations coliques au cours de la radiologie d'intervention urinaire.

Three patients had colonic perforation as a result of percutaneous nephrostomy and lithotripsy. These patients did not respond to conservative measures and required surgery (colostomy, hemicolectomy, drainage). This report reviews the anatomic and technical aspects of percutaneous access to the kidney. Fluoroscopy and ultrasonography do not allow simple and accurate information of the position of the colon, and CT is the method of choice. Some factors seem of high risk : thin and young patient, female, dilated pelvo-calyceal system, associated colonic obstruction.

[Endocrine polyadenomatosis associated with prolactin pituitary adenoma and an intrathyroidal parathyroid adenoma]. / Polyadénomatose endocrinienne associant un adénome hypophysaire à prolactine et un adénome parathyroïdien intrathyroïdien

A pituitary adenoma was removed transsphenoidally from a 20-yr-old woman with secondary amenorrhea, galactorrhea, and hyperprolactinemia. Light and electronic microscopy, immunocytology characterized a prolactin cell tumor. The patient also underwent three surgical explorations for hyperparathyroidism. Only after selective catheterization of thyroid veins with radioimmunoassay for parathormone, an intrathyroidal parathyroid adenoma was found. No other case of proven prolactin adenoma in Wermer's syndrome has been reported.

[Percutaneous placement of ureteral prostheses. 150 cases]. / Mise en place percutanée de prothèses urétérales. 150 observations.

Percutaneous placement of ureteral stents was attempted on 150 occasions with an 85 p. 100 success rate. Whether released or not, this type of prosthesis ensures that the urine is drained internally from kidney to bladder. Stenting is effective as palliative treatment of malignant stenosis or curative treatment of benign stenosis, as it maintains the ureteral lumen diameter after balloon catheter dilatation. It also dries up post-operative urinary fistulae and it controls and promotes their healing. Because of the satisfactory results obtained, the percutaneous technique is increasingly preferred to surgery performed under difficult conditions.

[Obstructive anuria with non-dilated cavities]. / Anuries obstructives à cavités non dilatées.

Four patients with no evidence of acute functional or organic renal failure suddenly developed anuria. Repeated ultrasonographic exploration failed to show any dilatation of the urinary tract. After 4, 5, 7 and 34 days of anuria respectively, an obstacle was detected, located and identified by ultrasonically guided antegrade pyelography, which led to immediate urine derivation by percutaneous nephrostomy. Three of these patients were cured by percutaneous techniques alone. These 4 cases represent a small but not negligible part of a series of 74 patients with obstructive anuria, 70 of whom had dilated renal cavities. They throw doubt not on the reliability of ultrasonography, but on the idea that all obstacles are associated with dilatation upstream. They also confirm that opacification of the urinary tract is the only way of making sure that an obstacle is present. Antegrade pyelography gives excellent contrast images and can be used as first stage of a percutaneous nephrostomy. The other diagnostic methods are fraught with a high proportion of inadequacy or failure.

[The contribution of echo-endoscopy in the evaluation of cancer of the esophagus]. / Apport de l'écho-endoscopie dans le bilan du cancer de l'oesophage.

Images of endoscopic ultrasonography are compared with data of surgery and histology. As to tomodensitometry, endoscopic ultrasonography has proved to be more accurate in study of penetration into the esophageal layers, of extension to surrounding structures, specially peri-esophageal lymph nodes. In contrast, endoscopic ultrasonography is helpless searching distant lymph nodes involvement and metastases. These new imaging techniques, together with tracheo-bronchoscopy, enable high degree of precision in determination of the extent of the tumor. Despite better accuracy of the staging, surgical indications remain controversial.