Pulmonary contusion after bumper car collision: Case report and review of the literature.

Thoracic trauma is a major source of morbi-mortality in injured children. Their pliable chest wall makes pulmonary contusion the most common chest injury. It is most often secondary to blunt trauma caused by traffic accidents. We report a case of severe chest trauma caused by a bumper car collision in an 8-years old girl. She sustained right lung contusion that led to complete atelectasis. After a week of supportive therapy, bronchoscopy removed a mucous plug from the main bronchus, resulting in significant clinical improvement. We aim to raise awareness of the risk of severe chest injuries during bumper car collisions.

Aucun n'est recommandé et ne remplace la désobstruction rhino-pharyngée.

Use of inhaled treatments in acute viral bronchiolitis in infants. Inhaled therapies are widely used by practitioners for treating acute viral bronchiolitis. Therefore, their efficacy has a low level of proof that does not sustain their use. Even if they need to be better studied in atopic infants, beta-2 agonists have no effect, excepted side effects. Anticholinergic drugs are not recommended. Adrenaline, despite some positive effects, is not recommended too. Corticosteroids are not useful, both for treating the acute problem and for preventing a possible post-viral asthma. Ribavirine, an antiviral agent, is reserved to very precise indications. At last, hypertonic saline, which has given some hopes, nowadays cumulates negative studies, and is no longer recommended. At all, in 2016, any inhaled treatment is recommended for treating acute viral bronchiolitis in infants..

Place des traitements inhalés dans la bronchiolite aiguë du nourrisson. Les traitements inhalés sont largement proposés en pratique clinique en cas de bronchiolite aiguë du nourrisson. Cependant, les niveaux de preuve d'efficacité sont en défaveur de ces traitements. Même s'ils méritent d'être mieux étudiés chez l'enfant atopique, les bêta-2-agonistes ne semblent pas avoir d'autres effets que latéraux. Les anticholinergiques ne sont pas recommandés. L'adrénaline, même si quelques effets positifs sont notés, non plus. Les corticoïdes ne sont utiles ni en aigu ni en prévention d'un potentiel asthme viral. La ribavirine, agent antiviral, est réservée à des indications très ciblées. Le sérum salé hypertonique, après avoir été un espoir, accumule les études négatives et n'est pas non plus indiqué. Au total, en 2016, aucun traitement inhalé n'est recommandé dans la bronchiolite aiguë du nourrisson.

[Epithelio-mesenchymal transition and cutaneous wound healing]. / Transition épithélio-mésenchymateuse et réparation des blessures cutanées.

Successful cutaneous wound repair involves in a series of tightly coordinated and overlapping phases, including inflammation and clot formation, keratinocyte activation and migration (re-epithelialization), basement membrane and ECM remodeling, followed by dermal and epidermal maturation. We examine here the process of wound re-epithelialization, emphasizing the similarity between re-epithelialization and developmental epithelial-mesenchymal transition (EMT), based on morphological and molecular criteria. Changes in cell-cell and cell-substrate adhesion during re-epithelialization are also reminiscent of pathological processes described during malignant tumor progression, another situation involving partial or total EMT. We therefore propose that wound re-epithelialization represents a partial and reversible form of EMT.

Erk5 controls Slug expression and keratinocyte activation during wound healing.

Reepithelialization during cutaneous wound healing involves numerous signals that result in basal keratinocyte activation, spreading, and migration, all linked to a loosening of cell-cell adhesion structures. The transcription factor Slug is required for this process, and EGF treatment of human keratinocytes induced activating phosphorylation of Erk5 that coincides with slug transcription. Accordingly, ectopic activation of Erk5 led to increased Slug mRNA levels and faster wound healing, whereas keratinocyte migration was totally blocked by Erk5 pathway inhibition. Expression of a shRNA specific for Erk5 strongly diminished Erk5 levels in keratinocytes and significantly decreased their motility response to EGF, along with induction of Slug expression. These Erk5-deprived keratinocytes showed an altered, more compact morphology, along with disruption of desmosome organization. Accordingly, they displayed an altered ability to form cell aggregates. These results implicate a novel EGFR/Erk5/Slug pathway in the control of cytoskeleton organization and cell motility in keratinocytes treated with EGF.

Roles of the transcription factors snail and slug during mammary morphogenesis and breast carcinoma progression.

The zinc-finger transcription factors Snail and Slug are involved in different processes controlling cell differentiation and apoptosis. They also appear to be involved in tumor progression. Their putative involvement in mammary gland development has not been specifically examined so far. Slug is expressed at a significant level in normal breast, and indirect evidence suggests it could be implicated in tubulogenesis. As an antiapoptotic agent, it could also protect epithelial cells from death during ductal lumen formation and during breast involution. In breast carcinomas, Snail transcription factors have been linked to tumor progression and invasiveness. Possible mechanisms include repression of the E-cadherin gene by Snail or Slug. However, it is not clear how this transcriptional activity is implicated in vivo. Other possible mechanisms involve maintenance of a plastic phenotype by Slug that could participate in local invasion of ductal carcinomas, and interference with apoptotic pathways that could contribute to global tumor growth and radioresistance. These processes probably also involve interactions with estrogen, EGF, or c-kit pathways.