Vector-apodizing phase plate coronagraph: design, current performance, and future development [Invited].

Over the last decade, the vector-apodizing phase plate (vAPP) coronagraph has been developed from concept to on-sky application in many high-contrast imaging systems on 8 m class telescopes. The vAPP is a geometric-phase patterned coronagraph that is inherently broadband, and its manufacturing is enabled only by direct-write technology for liquid-crystal patterns. The vAPP generates two coronagraphic point spread functions (PSFs) that cancel starlight on opposite sides of the PSF and have opposite circular polarization states. The efficiency, that is, the amount of light in these PSFs, depends on the retardance offset from a half-wave of the liquid-crystal retarder. Using different liquid-crystal recipes to tune the retardance, different vAPPs operate with high efficiencies (${\gt}96\%$) in the visible and thermal infrared (0.55 µm to 5 µm). Since 2015, seven vAPPs have been installed in a total of six different instruments, including Magellan/MagAO, Magellan/MagAO-X, Subaru/SCExAO, and LBT/LMIRcam. Using two integral field spectrographs installed on the latter two instruments, these vAPPs can provide low-resolution spectra (${\rm{R}} \sim 30$) between 1 µm and 5 µm. We review the design process, development, commissioning, on-sky performance, and first scientific results of all commissioned vAPPs. We report on the lessons learned and conclude with perspectives for future developments and applications.

[Epidemiology and associated factors with depression among people suffering from epilepsy: A transversal French study in a tertiary center]. / Épidémiologie et facteurs associés au syndrome dépressif chez les patients suivis au centre hospitalo-universitaire de Rennes pour une épilepsie.

OBJECTIVES: The occurrence of depression in people with epilepsy is almost twice as common as in the general population. Furthermore, depression is the first cause of lower quality of life among those patients. Which is why the main goal of this study was to assess the epidemiology of depression and its associated factors among the patients from the tertiary department of epileptology in Rennes. METHODS/RESULTS: The subjects were included prospectively and consecutively at the moment of their consultation or hospitalisation in the department. Personal data about the socio-economic status and the type of epilepsy was collected. The subjects filled validated self-assessment of depression (NDDIE), anxiety (GAD-7) and quality of life (QOLIE-10). Thanks to the NDDIE, the patients were divided into: "depressed" and "not depressed"; and the two groups were compared with univariate and multivariate models. Of the 322 patients followed-up in the department between the 17th of June and the 9th of September 2016 223 of them were included in the study. According to the NDDIE, 22.6% suffered from depression; according to the GAD-7, 46.4% suffered from anxiety. In the "depressed" group, 82% were not under anti-depressant medication. In the univariate model, depression was associated with: anxiety, suicidal ideations, lower quality of life, vague nervus stimulation treatment, anticonvulsant benzodiazepine medication or psychiatric medication, and last of all bitherapy or polytherapy antiepileptic medication compared to monotherapy. In the multivariate model, depression was significantly related to anxiety (OR: 8.86 [3.00; 26.19] p=0.0001), suicidal ideas (OR: 7.43 [2.93; 18.81] p<0.0001), anticonvulsant benzodiazepine medication (OR: 3.31 [1.16; 9.49] p=0.0255), and lower quality of life (OR: 1.09 [1.02; 1.17] p=0.0087). Generalised epilepsy was a protective factor with uni and multivariate models (OR: 0.34 [0.11; 1.00] p=0.0492). CONCLUSIONS: In the tertiary epileptic department of Rennes, more than 20% of patients with epilepsy suffered from depression during the inclusion period according to the NDDIE. Among those "depressed" subjects, fewer than one out of five seemed to receive proper psychiatric care. Which is why this study highlights the importance of interdisciplinary cooperation between neurologists and psychiatrists in order to aim at better management of epileptic patients as a whole.

[Imaging features of neurologic and orthopedic complications from severe trauma]. / Imagerie des complications neuro-orthopédiques des traumatismes graves.

Cranial and spinal trauma are a frequent cause of disability in the general population. Post-traumatic paraplegia or quadriplegia or hemiplegia from vascular injury (CVA) can lead to early complications (respiratory, cardiovascular, urinary, cutaneous, infectious...) that may have an impact on the immediate prognosis. Neurologic and orthopedic complications occur later and further impair the quality of life of patients. Orthopedic complications include: neurogenic paraosteoarthropathy (NPOA) or neurogenic osteoma or myositis ossificans (NMO). The nomenclature currently in use is NMO; Osseous complications: osteoporosis and secondary insufficiency fractures; Joint complications: degenerative arthropathy and stiffness; Overuse mechanical complications; Muscular complications; Infectious complications: arthritis and myositis complicating skin ulcers and bed sores. The purpose of this paper is to describe these neuro-orthopedic complications and review their imaging features.

[Spasticity: clinical and imaging features]. / La spasticité: de la clinique à l'imagerie.

Spasticity, a component of the pyramidal syndrome, characterized by increased tonic stretch reflexes and hyperactive deep tendon reflexes, occurs in patients with central nervous system lesions (stroke, brain or cord injury, multiple sclerosis, cerebral motor impairment). The implementation of standard procedures (patient positioning, increased examination time, turning off certain devices before MR imaging) allows the acquisition of high quality examinations in spastic patients. Worsening spasticity in a handicaped patients is due to an irritative process (deep seated infection, fracture, syrinx...) usually detectable with imaging. Ultrasound or CT guided injections of botulinum agents provides radiologists with the opportunity to further participate in the management of spastic patients.

[Imaging features of post-traumatic spine and cord lesions]. / Imagerie des séquelles médullaires et rachidiennes post-traumatiques.

The imaging evaluation of post-traumatic spine and cord injuries is part of the global management of chronically handicapped patients. Diagnosis and follow-up MR imaging of cord lesions allows differentiation of static lesions from progressive lesions that could require surgical intervention. Follow-up CT imaging is helpful in the evaluation of spine lesions to distinguish between late complications (deformity, malunion, pseudoarthrosis, complications related to surgical hardware) and lesions secondary to the handicap (neurogenic spinal arthropathy).

Correction for patient sway in radiographic biplanar imaging for three-dimensional reconstruction of the spine: in vitro study of a new method.

BACKGROUND: Three-dimensional (3D) reconstructions of the spine in the upright position are classically obtained using two-dimensional, non-simultaneous radiographic imaging. However, a subject's sway between exposures induces inaccuracy in the 3D reconstructions. PURPOSE: To evaluate the impact of patient sway between successive radiographic exposures, and to test if 3D reconstruction accuracy can be improved by a corrective method with simultaneous Moire-X-ray imaging. MATERIAL AND METHODS: Using a calibrated deformable phantom perceptible by both techniques (Moire and X-ray), the 3D positional and rotational vertebral data from 3D reconstructions with and without the corrective procedure were compared to the corresponding data of computed tomography (CT) scans, considered as a reference. All were expressed in the global axis system, as defined by the Scoliosis Research Society. RESULTS: When a sagittal sway of 10 degrees occurred between successive biplanar X-rays, the accuracy of the 3D reconstruction without correction was 8.8 mm for the anteroposterior vertebral locations and 6.4 degrees for the sagittal orientations. When the corrective method was applied, the accuracy was improved to 1.3 mm and 1.5 degrees , respectively. CONCLUSION: 3D accuracy improved significantly by using the corrective method, whatever the subject's sway. This technique is reliable for clinical appraisal of the spine, if the subject's sway does not exceed 10 degrees . For greater sway, improvement persists, but a risk of lack of accuracy exists.

Coraco- or costoclavicular paraosteoarthropathies in patients with severe central neurological disorders.

BACKGROUND: Paraosteoarthropathy (POA) is a frequent disabling orthopedic complication after severe central neurological impairment. The hip is the most frequently affected joint (32.1%) followed by the elbow and the shoulder (25%). PURPOSE: To evaluate coraco- and costoclavicular paraosteoarthropathy in patients with severe central neurological disorders. MATERIAL AND METHODS: We report a series of five consecutive patients with severe central neurological disorders who developed a POA of the clavicular region (coracoclavicular or costoclavicular POA). Every patient underwent a clinical, radiological, and computed tomographic (CT) examination of the shoulder region. RESULTS: Four patients had a history of traumatic brain injury (TBI), and one an acute disseminated encephalomyelitis (ADEM). They developed POA of the clavicular region, although not around the glenohumeral joint. The patients complained of shoulder pain and of moderate limitation of movements. Radiological and CT examinations showed the presence of a bony formation in the coracoclavicular space in four cases and extending from the clavicle to the first rib around the costoclavicular joint in one case. CONCLUSION: In patients with severe brain lesions suffering from shoulder pain and moderate limitation of joint movements, POAs of the clavicular region are rare but should be considered.

Sequential feeding with variations in energy and protein levels improves gait score in meat-type chickens.

Feeding broilers by alternating different diets for 1 or 2 days is known as sequential feeding, and it possibly reduces leg problems since it slows down early growth and may enhance general activity. The present study compared continuous feeding with a standard diet (C: metabolisable energy = 12.55 MJ/kg, crude protein = 190 g/kg) with alternations of a high-energy/low-protein diet (E+P-:+7% ME; -20% CP) and a low-energy/high-protein diet (E-P+: -7% ME,+20% CP) and investigated its effects on growth, behaviour and gait score in 352 male Ross broiler chickens. Sequential feeding was carried out during ten 48-h sequential-feeding cycles from 8 to 28 days of age. Three treatments were compared: complete diet (C) and two alternations of diets varying in protein and energy contents (S1: E+P- followed by E-P+; and S2: E-P+ followed by E+P-). Chickens received the same feed during the starter and finisher periods (0 to 7 and 29 to 38 days of age). Body weight (BW), feed intake, general activity and gait score, bone quality and carcass conformation were measured to evaluate leg condition and general performance. Sequential feeding significantly reduced BW at 28 days of age (S1: -9.1%; S2: -3.7%/C group; P < 0.05) and S1 were lighter than S2. In both sequential groups, time spent standing increased (C: 28%; S1:33%; S2: 35%; P < 0.05) and leg abnormalities decreased (mean gait score: C: 2.61; S1: 2.45; S2: 2.38; P < 0.02). This improvement was not related to changes in bone quality. BW at slaughter was impaired in Group S1 only, and the feed conversion ratio throughout the rearing period was not significantly impaired by sequential feeding. However, abdominal fat was higher in the S2 group. Sequential feeding using diets varying in energy and crude protein can be a useful method of reducing leg problems in broilers since it improves gait score without impairing growth performance when used as early as 8 days of age and up to not less than 8 days before slaughter in order to compensate for reduced growth. This improvement can be explained by reduced early growth and enhanced motor activity. However, it appears that the low-energy diet should be given first in order to avoid a reduction in BW at slaughter.

Effects of various energy and protein levels during sequential feeding on feed preferences in meat-type chickens.

Short-term feed preferences were studied in individually caged chickens fed sequentially in order to understand a previously described imbalance in the intake of diets offered. Sequential feeding (SF) was carried out for four 48 h cycles in male broiler chickens. The diets varied in energy (2800 (E-) and 3200 kcal/kg (E+)) and protein (230 (P+) and 150 g/kg (P-)) contents. SF was compared to standard feeding (C) (3000 kcal/kg ME and CP = 190 g/kg). In experiment 1, three treatments were used: C, SE (E- followed by E+) and SE' (E+ followed by E-). Four treatments were used in experiment 2: C, SP (P+ followed by P-), SE and SEP (P+E- followed by P-E+). Total feed intake was measured during the SF period. After this, short-term preferences were evaluated with a choice test on chickens previously fed with the same feeds during the SF period (experienced birds) and in C chickens (naïve birds). In both experiments, total feed intake was similar among treatments and the percentage of each feed consumed was not significantly different from controls (50%). In experiment 1, SE and SE' chickens over-consumed E+ and under-consumed E- diets only during the first 15 min of the fourth cycle. The choice test indicated that experienced chickens preferred E+, while naïve chickens preferred E-. Similarly, in experiment 2, chickens over-consumed E+ and E+P- during the first 15 min of the fourth cycle, but the intake of diets varying in protein content was not different from controls. During the choice test, as in experiment 1, experienced chickens preferred E+, while naïve chickens preferred E-. There was a slight preference for the protein-poor diet in naïve birds and there was no preference in the diet varying in both protein and energy contents. Experience modified choice between feeds varying in energy content but not in protein. When feeds were known, preference for energy affected the feed intake immediately after switching from one diet to the other, although lower with the diet also varying in protein, it did not influence the total intake of each diet. Interactions between the nutritional properties and sensorial cues of feed could explain these results.

[MRI of intra-abdominal fat and HIV-associated lipodystrophy: a case review]. / IRM du tissu adipeux abdominal et lipodystrophie VIH, étude cas-témoin.

PURPOSE: To characterize intra-abdominal adipose tissue changes in HIV patients with clinical lipodystrophy using a reproducible imaging technique. Materials and methods. 89 HIV patients with clinical lipodystrophy were included. A single axial T1W image was acquired at the mid L4 vertebral level. Two radiologists measured subcutaneous (SAT) and visceral (VAT) adipose tissues using a semi-automated method. Measurements were compared to a matched population (race, sex, age and BMI). RESULTS: Measurements of abdominal adipose tissue on MRI are reproducible. Three clinical types of lipodystrophy are described in males with increased visceral (VAT) and reduced subcutaneous (SAT) adipose tissues compared to control subjects. Two clinical types of lipodystrophy are described in females with increased visceral (VAT) and unchanged subcutaneous (SAT) adipose tissues. CONCLUSION: MRI with comparison between HIV patients and normal control subjects is a reproducible method to characterize adipose tissue changes of lipodystrophy and evaluate its severity. Evaluation of a adipose tissue distribution in a large control population would be helpful to the study of metabolic disorders.

Ankylosing neurogenic myositis ossificans of the hip. An enhanced volumetric CT study.

Neurogenic myositis ossificans is a disabling condition affecting the large joints of patients with severe post-traumatic impairment of the central nervous system. It can result in ankylosis of the joint and vascular or neural compression. Surgery may be hazardous with potential haemorrhage, neurovascular injury, iatrogenic fracture and osteochondral injury. We undertook pre-operative volumetric CT assessment of 45 ankylosed hips with neurogenic myositis ossificans which required surgery. Helical CT with intravenous contrast, combined with two- and three-dimensional surface reconstructions, was the only pre-operative imaging procedure. This gave good differentiation of the heterotopic bone from the adjacent vessels. We established that early surgery, within 24 months of injury, was neither complicated by peri-operative fracture nor by the early recurrence of neurogenic myositis ossificans. Surgical delay was associated with a loss of joint space and a greater degree of bone demineralisation. Enhanced volumetric CT is an excellent method for the pre-operative assessment of neurogenic myositis ossificans and correlates well with the operative findings.

Zenker's diverticulum associated with multilevel cervical osteomyelitis.

STUDY DESIGN: A case report of cervical osteomyelitis possibly associated with a Zenker's diverticulum perforation. OBJECTIVES: To present clinical, radiologic, and surgical findings of a cervical osteomyelitis due to a Zenker's diverticulum perforation. SUMMARY OF BACKGROUND DATA: A 56-year-old patient was in an intensive care unit for a severe head injury. He was fed via a nasogastric tube. Four months later he developed a pyogenic cervical vertebral infection. METHODS: Plain films and magnetic resonance imaging showed a diffuse cervical osteomyelitis. Investigation of his dysphagia revealed a Zenker's diverticulum. RESULTS: After administration of antibiotics and surgical treatment of the diverticulum, the cervical infection resolved. Plain films and magnetic resonance imaging showed healing with vertebral fusion. CONCLUSIONS: Cervical osteomyelitis is uncommon. Only one case of direct contamination leading to cervical vertebral osteomyelitis after esophageal perforation has been previously described. Direct contamination of the prevertebral soft tissues by bacteria traveling through the fistula may have occurred. The development of vertebral osteomyelitis in this case is consistent with the hypothesis of direct contamination. Management relies on appropriate antimicrobial therapy and surgical management of the diverticulum. The association of Zenker's diverticulum with vertebral osteomyelitis and discitis is a unique, previously undescribed situation.

Chronic cervical radiculopathy: lateral-approach periradicular corticosteroid injection.

Thirty-two patients underwent periradicular corticosteroid injections with a lateral percutaneous approach under fluoroscopic guidance, to treat 34 foci of chronic cervical radiculopathy unresponsive to medical treatment alone. The mean evolutionary trends for radicular and neck pain relief were significant at 14 days (P <.001) and at 6 months (P <.001). The procedure did not produce any complications.

Bartonella henselae infection mimicking a splenic lymphoma.

We report a Bartonella henselae infection in a 40-y-old patient who presented with fever, weight loss, night sweats, elevated lactate dehydrogenase and multinodular splenomegaly with multiple abdominal lymphadenopathies. Splenic cat-scratch disease is an exceptional diagnosis in adults and can easily be mistaken for a splenic lymphoma, thereby leading to an unnecessary splenectomy.

[Imaging-guided needle puncture, infiltration and lavage of rotator cuff calcifications. Retrospective evaluation of 50 cases of treated periarthritis]. / Ponction-lavage-infiltration radioguidée des calcifications de coiffe des rotateurs. Evaluation rétrospective de 50 périarthrites traitées.

PURPOSE: To evaluate mid term efficiency of imaging-guided needle puncture trituration and lavage (RPTL) in rotator cuff calcifications after failure of medical treatment. Materials and Methods. Fifty shoulders with rotator cuff calcifications (supra and infra-spinatus: 97%) from 42 patients, mean of 50.2 year old (M/F=10/32), were treated by RPTL. To establish a satisfaction score and potential undesirable effects, the follow-up was obtained by a telephone questionnaire after a median interval of 29.2 months. RESULTS: Eighty-eight percent of patients had excellent or very good results (cured: 62%, very improved: 26%). Four percent felt partially better and 8% failed but did not undergo surgery. No complication was noted. 41% suffered acute pain in the 24 hours following the procedure even though they were on nonsteroidal anti-inflammatory drug therapy (NSAID). CONCLUSION: These good results after more than two years support the promotion of this economical ambulatory treatment.

Vasoactive intestinal polypeptide and pituitary adenylate cyclase-activating polypeptides stimulate mitogen-activated protein kinase in the pituitary cell line GH4C1 by a 3',5'-cyclic adenosine monophosphate pathway.

Vasoactive intestinal polypeptide (VIP) and pituitary adenylate cyclase-activating polypeptide (PACAP38) regulate anterior pituitary cell secretion and proliferation. In the somatolactotrope GH4C1 cell line, these effects are mediated through the type-II-like PACAP receptor (VPAC2) coupled to the cAMP pathway. In this study, the control of the extracellularly responsive kinases (ERKs) by VIP and PACAP38 was investigated in GH4C1 cells. VIP and PACAP38 increased ERK1 and ERK2 phosphorylation and were equipotent stimulators of both kinases. ERK activation was mimicked by cholera toxin, forskolin and 8bromo-cAMP. VIP and PACAP38 activation of ERK2 was blocked by the protein kinase A inhibitor H89, whereas the protein kinase C inhibitor GF109203X, or prior PMA-induced depletion of the protein kinases C, failed to inhibit VIP and PACAP38 activation of ERK2. In contrast, thyrotropin-releasing hormone (TRH) elicited ERK activation by a PKC-dependent process. ERK activation by VIP or PACAP38 and TRH were additive and both sensitive to the MEK inhibitors PD98059 and U0126. In parallel, U0126 reduced prolactin (PRL) mRNA levels induced by VIP. These results demonstrate for the first time that VIP and PACAP38 activate ERK in GH4C1 cells. Cyclic AMP increase is sufficient to elicit ERK activation in these cells and thus likely to represent the transduction pathway underlying VIP- and PACAP38-dependent ERK activation. This mechanism seems to be involved in VIP-induced PRL gene regulation.