[Nodular presentation of a cryptogenic organizing pneumonia]. / Présentation nodulaire d'une pneumopathie organisée cryptogénique.

INTRODUCTION: Cryptogenic organizing pneumonia is inflammatory and proliferative pulmonary diseases whose specific radiologic feature are bilateral and migrant opacities. OBSERVATION: An isolated peripheral nodule of the left lower lobe was discovered on chest X-ray of a man who presented with isolated chronic cough. As this nodule has a positive FDG positron emission tomography uptake (PET) but with inconclusive fiberoptic bronchoscopy, the patient was sent to surgeon and a wedge-resection was processed because intraoperative analysis did not show any tumour. Histopathological study was in favour of organizing pneumonia. Search for potential cause remained negative and the diagnosis of cryptogenic organizing pneumonia was retained. CONCLUSION: Cryptogenic organizing pneumonia may mimic lung cancer, presenting as an isolated peripheral nodule with positive PET. Histopathological study remains absolutely necessary to retain the diagnosis because of dramatic differences in prognosis and therapy.

[Values of the autopsy in the university hospitals illustrated by the casuistry]. / Intérêts de l'autopsie hospitalière illustrés par la casuistique.

PURPOSE: Clinical autopsy rate have been declining since the 1950s, but it remains a useful investigation tool. METHODS AND RESULTS: Through six examples of our experience, we underline its interest for clinical, didactic and public health purposes. CONCLUSIONS: We try to understand the reasons for its decline and, as demonstrated, it can be attributed to a number of factors. These need to be addressed in order to reassert the status of the autopsy as an investigation and audit tool which is crucial to the future effectiveness of modern medicine.

[Risk factors for tumor recurrence after breast conserving therapy: about 254 cases]. / Facteurs de risque de récidive des cancers du sein traités par chirurgie conservatrice: à propos de 254 cas.

OBJECTIVES: To retrospectively study our risk factors of recurrence of infiltrating breast cancers treated by conservative therapy in Saint-Etienne university hospital. MATERIALS AND METHODS: From 1997 to 2000, 254 patients were treated by conservative treatment. Through a univariate then multivariate analysis we identified factors of locoregional and metastatic recurrences. RESULTS: The global rate of recurrence is 21.6%. There is 9.8% of local recurrence, 2.3% of node recurrence and 14.9% of metastatic one. Plurifocality OR: 3.7, tumoral type OR: 2.93, lymphovascular invasion OR: 3.6 and young age are factors of locoregional recurrence. For distant metastases, the recurrences factors are the tumoral size, the node status, the absence of estrogens receptors, the SBR rank, the locoregional recurrence, the rise of CA 15-3 and the addition of chemotherapy but only the SBR rank OR: 2.56 appears in multivariate analysis. CONCLUSION: On one hand, this study revealed known risk factors already used to decide on the adjuvant therapy. On the other hand, plurifocality and lobular cancer must be taken into consideration before a conservative therapy. The surgery will probably be more extensive under these conditions.

Comparative in vitro activities of caspofungin and micafungin, determined using the method of the European Committee on Antimicrobial Susceptibility Testing, against yeast isolates obtained in France in 2005-2006.

The in vitro activities of caspofungin and micafungin against 1,038 yeast isolates have been determined. The caspofungin and micafungin MICs were lower for Candida albicans, Candida glabrata, and Candida tropicalis than for Candida parapsilosis, Candida guilliermondii, and Candida krusei. A clear correlation was seen between the MICs for the two drugs.

Modeling the atomic structure of an amorphous NiZr(3) alloy by anomalous wide angle x-ray scattering and reverse Monte Carlo simulation.

The amorphous atomic structure of a melt-spun NiZr(3) alloy was investigated using the anomalous wide angle x-ray scattering (AWAXS) and reverse Monte Carlo (RMC) simulation techniques. The AWAXS data were collected at four incident photon energies, including ones close to the Ni and Zr K-edges, and four total structure factors S(K) were derived. Differential structure factors DAS(K) around the Ni and Zr atoms were calculated through the difference between the scattered intensities on a per-atom scale obtained at incident photon energy pairs (8330, 9455 eV) and (15622, 17993 eV). The contribution of the partial S(Ni-Ni)(K) for the Ni-DAS(K) factor is six times bigger than the one for the S(K) factors. Then, the use of the Ni-DAS(K) factor with four S(K) factors as input data for the RMC simulations has permitted us to obtain more stable partial S(Ni-Ni)(K), S(Ni-Zr)(K) and S(Zr-Zr)(K) factors. The partial S(ij)(K) factors are very close to those reported earlier for the amorphous NiZr(2) alloy. The structural data (coordination numbers and interatomic distances) for the first neighbors for both amorphous NiZr(2) and NiZr(3) alloys are also very similar.

Robust functional gene validation by adenoviral vectors: one-step Escherichia coli-derived recombinant adenoviral genome construction.

We describe here a clonal approach for efficient and robust construction of recombinant adenoviral genomes that holds certain advantages over existing approaches. Transgenes of interest are cloned into a small, conditionally replicating plasmid containing the left end of a recombinant adenoviral genome, encompassing pIX coding regions. Transformation of this plasmid into recombination-competent Escherichia coli bearing a plasmid containing the right end of a recombinant adenoviral genome, commencing from pIX coding regions, yields a stable co-integrated plasmid encoding a full adenoviral genome, by virtue of shared homology in pIX coding regions contained in both plasmids. The recombination process yielding the full adenoviral plasmid requires only one step, and always results in the formation of only the desired recombinant adenoviral genome. Thus, no screening is required to identify the correct plasmid encoding the desired recombinant adenoviral genome. In addition, the plasmid encoding the right-hand side of the adenoviral genome is itself incapable of producing contaminating adenovirus. We have successfully employed this approach to generate over 200 recombinant adenoviruses, obtaining only the desired recombinant adenoviral species each time. The process is amenable to medium-to-high-throughput parallel construction of adenoviral genomes, and as such should aid efforts aimed towards high-throughput functional annotation of therapeutic gene targets, which aim to leverage the benefits of adenoviruses as gene delivery and expression vectors.

An X-ray absorption spectroscopy study of the pressure and temperature dependence of ZnBr2 aqueous supercritical solutions.

X-ray absorption spectroscopy (XAS) experiments have been performed on 1.0 and 1.6 M ZnBr2 aqueous solutions under ambient to supercritical conditions. Both the X-ray absorption near-edge structure (XANES) and the extended X-ray absorption fine structure (EXAFS) show striking evolutions, which indicate major structural changes, with a strong reduction in hydration and the increasing formation of ZnBr pairs. A quantitative analysis of the evolution of the Zn environment is presented that supports the existence of a transition from an octahedral to a tetrahedral environment.

[Drug protection of the myocardium during cardiac surgery]. / Protection médicamenteuse du myocarde au cours de la chirurgie cardiaque

During aortic clamping, drug protection of the myocardium, far from supplanting hypothermia, complements it, particularly in the case of left ventricular hypertrophy. Ultramicroscopy and new techniques of histobiological exploration of the myocite have enabled one to distinguish the lessions provoked by anoxia from those induced by reperfusion. At present, drug protection, extended to energetic solutions and electrolytes, aim at preserving energy metabolism by stocking of the substrate and at avoiding interferences which precipitate exhaustion of the adenosine triphosphate and phosphocreatinine reserves. In order to do this, hemodilution in particular is limited in subjects with decompensated cardiopathy; choice of anesthetics is orientated towards neuroleptanalgesia or fluothane, and it is attempted to neutralize the adrenergic reaction by the use of beta-blocking substances. Furthermore, it is preferred to interrupt electrogenesis at the stage of polarization: depolarizing cardioplegic solutions rich in potassium and sodium are rejected and in preference membrane stabilizers are used (procaine, magnesium, tetrodoxine...) The ultramicroscopic analysis of the structural modifications leads to sparing of the integrity of the lysosomial membrane by corticoids and alkalines. The use of calcium is deferred, anti-calcium techniques are even proposed (washing poor in calcium, verapamil). Cellular edema is prevented and treated by solution (mannitol - sorbitol) whose osmolarity must be less than 300 M osm/l. A conditioning of the biochemical and physicial structures and of cardiac work is being more and more thought of which leads to the classification of beta stimulating substances as negative, and their indications must be seriously thought of and used with reserve.