NOD1 mediates interleukin-18 processing in epithelial cells responding to Helicobacter pylori infection in mice.

The interleukin-1 family members, IL-1ß and IL-18, are processed into their biologically active forms by multi-protein complexes, known as inflammasomes. Although the inflammasome pathways that mediate IL-1ß processing in myeloid cells have been defined, those involved in IL-18 processing, particularly in non-myeloid cells, are still not well understood. Here we report that the host defence molecule NOD1 regulates IL-18 processing in mouse epithelial cells in response to the mucosal pathogen, Helicobacter pylori. Specifically, NOD1 in epithelial cells mediates IL-18 processing and maturation via interactions with caspase-1, instead of the canonical inflammasome pathway involving RIPK2, NF-κB, NLRP3 and ASC. NOD1 activation and IL-18 then help maintain epithelial homoeostasis to mediate protection against pre-neoplastic changes induced by gastric H. pylori infection in vivo. Our findings thus demonstrate a function for NOD1 in epithelial cell production of bioactive IL-18 and protection against H. pylori-induced pathology.

Wetting Effect on Torricelli's Law.

This Letter presents an experimental study on the effect of wetting on the draining of a tank through an orifice set at its bottom. The investigation focuses on flows of liquids in the inertial regime through an orifice the size on the order of magnitude of the capillary length. The results show that although the flows always follow a Torricelli-like behavior, wetting strongly affects the speed of drainage. Surprisingly, this speed goes through a minimum as the outside surface of the tank bottom plate changes from hydrophilic to hydrophobic. The maximum effect in slowing down the flows (up to 20%) is obtained for a static wetting angle θ_{s} of about 60°. Experiments suggest that the effect of wetting on the exit flows, very likely, is related to the meniscus that forms at the hole's outlet. A simple model is proposed that estimates the variation of kinetic energy within the meniscus. This model captures the main features of the experimental observations, particularly the nonmonotonic variation of the speed of drainage as a function of θ_{s} with a minimum for a static wetting angle of about 60°.

[Primary ovarian leiomyosarcoma in perimenarche]. / Léiomyosarcome primitif de l'ovaire en périménarche.

Primary ovarian leiomyosarcoma is an extremely rare tumor, which is thought to arise predominantly in postmenopausal women. We report the second case in a perimenarchal adolescent. Diagnosis was grounded on light microscopic and histochemical findings. In our case, the treatment was exclusively surgical. As there was no tumoral residue, and according to the low-grade tumor, no adjuvant treatment was performed.

Neumoperitoneo por pneumatosis quística intestinal / Pneumoperitoneum due to pneumatosis cystoides intestinalis

La presencia de neumoperitoneo en el estudio radiológico hace pensar habitualmente en una perforación de víscera hueca. Sin embargo, ante un neumoperitoneo acompañado de poca clínica hay que sospechar otras posibles causas. La pneumatosis quística intestinal (PQI) se caracteriza por la presencia de quistes de gas en la pared intestinal. Su diagnóstico suele ser difícil, se llega hasta él mediante estudio radiológico o en el propio acto quirúrgico y se confirma con el estudio anatomopatológico. Nosotros presentamos una paciente que se diagnosticó de perforación de víscera hueca en puertas de urgencia, siendo posteriormente diagnosticada de PQI en el acto quirúrgico (AU)

Quality control in cytodiagnosis of carcinoma of the cervix.

In many European countries the morbidity and mortality due to cancer of the cervix are too high. Even in countries, where smears have been taken at regular intervals for many years, the percentage of new cases does not decrease as much as it was expected. There are several reasons that may explain this situation. At least two of them can be solved by pathologists: quality control (QC) system and organization of a school of gynaecological cytopathology for pathologists and cytotechnicians. Here we focus on the main aspects of External and Internal QC and new approaches to QC, including new methods and stricter control of the professional level of all persons involved in the screening and diagnosis of cervical cancer.

The vomeronasal cavity in adult humans.

We observed the surface of the anterior part of the nasal septum of living subjects using an endoscope. In approximately 13% of 1842 patients without pathology of the septum, the vomeronasal pit was clearly observed on each side of the septum, and in 26% it was observed only on one side. The remaining observations indicated either the presence of putative pits or no visible evidence of a pit. However, repetitive observations on 764 subjects depicted changes over time, from nothing visible to well-defined pits and vice versa. Based on 130 subjects observed at least four times, we estimate that approximately 73% of the population exhibits at least one clearly defined pit on some days. By computer tomography, the vomeronasal cavities were located at the base of the most anterior part of the nasal septum. Histological studies indicated that the vomeronasal cavities consisted of a pit generally connected to a duct extending in a posterior direction under the nasal mucosa. Many glands were present around the duct, which contained mucus. There was no sign of the pumping elements found in other mammalian species. Most cells in the vomeronasal epithelium expressed keratin, a protein not expressed by olfactory neurons. Vomeronasal epithelial cells were not stained by an antibody against the olfactory marker protein, a protein expressed in vomeronasal receptor neurons of other mammals. Moreover, an antibody against protein S100, expressed in Schwann cells, failed to reveal the existence of vomeronasal nerve bundles that would indicate a neural connection with the brain. Positive staining was obtained with the same antibodies on specimens of human olfactory epithelium. The lack of neurons and vomeronasal nerve bundles, together with the results of other studies, suggests that the vomeronasal epithelium, unlike in other mammals, is not a sensory organ in adult humans.

Does the short variant of the serotonin transporter linked polymorphic region constitute a marker of alcohol dependence?

The serotonin (5-hydroxytryptamine: 5-HT) system has been thought to play an important role in several steps of alcohol craving. A number of studies, including our own, have reported that alcohol dependence is associated with dysfunction of 5-HT transmission. Pharmacological and clinical studies have shown that the 5-HT transporter (5-HTT) and the 5-HT1A receptor appear to be candidate loci for the aetiology of alcohol dependence. We have analysed the presence of different 5-HTT and 5-HT1A variants in 104 alcohol-dependent patients and 38 controls for a possible association with alcohol dependence. In alcohol-dependent patients, we found a high frequency of the S allele of 5-HTTLPR (45.5% vs. 29%, chi2 = 6.33, p = 0.0081). No other significant differences were observed between the two populations for other polymorphisms. These results provide, for the first time, preliminary evidence that alcohol abuse disorders are associated with a genetic variant for 5-HT transmission. It might be possible to use this detection of the "S" allele as a clinical tool for pathology diagnosis and to advise recovering alcoholics and it could represent an aid to the prevention of relapse. Therapeutic actions could be envisaged to use this genotyping to help select the best therapeutic strategy.

Expert consultation for cervical carcinoma smears. Reliability of selected-field videomicroscopy.

OBJECTIVE: To evaluate the diagnostic accuracy of videomicroscopy image selection for expert consultation in cervical cytology. STUDY DESIGN: One hundred diagnostically difficult cervical cytologic smears were selected and rescreened by a general pathologist who chose, from each slide, four or five fields featuring abnormal cells. Video images were digitized and stored on a 512 x 512-pixel matrix using an image acquisition and transmission system. Five experts each reviewed 20 of the 100 cases, and a sixth reviewed all 100 cases. Diagnoses based on selected digitized images were compared to those based on conventional examination of whole slides. RESULTS: Intraobserver agreement was fair to excellent for all six experts (kappa value: 0.47-0.81); it was complete or acceptable in 68.4-85% of cases. Compared to the reference diagnosis, interobserver agreement was not significantly different whether cases were examined by screening the entire slide or by videomicroscopy of selected fields. The marked discordance in four cases concerned very small cells the significance of which was misinterpreted on videomicroscopy because of poor image quality due to lack of focus setting. CONCLUSION: This exploratory study showed that selection of videomicroscopy images seems as reliable as conventional examination of slides for expert consultation on diagnostically difficult cervical cytologic smear cases.

[The management of extra-oral implants. Anachronisms and paradoxes]. / Prise en charge des implants extra-oraux. Anachronismes et paradoxes.

Used in France for ten years and in Sweden since 1977. Extra-Oral Implants (EOI) represent one of the new therapeutic approach of facial defects treatment by maxillo-facial prostheses fixed on implants and of some transmission deafnesses. Audiologic applications are free of charges for the patient but not the prosthetic applications; the authors note this paradox and some other anachronisms. Finally the authors wonder why Extra-Oral implantology is a "correct" science and why Intra-Oral Implantology remains absent from the Administrative texts as if it was a sort of doubtful therapy without scientific principles.

[Implant-supported prosthesis. The significance of endosseous and peri-osseous implants]. / Epithèses implanto-portées. Intérêt des implants endo et juxta-osseux.

The new extra-oral of Farmand (EPITEC system) is a plate-implant. This concept is really different from the Brånemark's implant and the use of EPITEC system give the authors opportunity of a first assessment. It seems that if, of course, Brånemark system is still the reference, the EPITEC system certainly has a real interest in thin osseous implantation areas.

[Recourse to particular arterial embolization in the treatment of some uterine leiomyoma]. / Recours à i'embolisation artérielle particulaire dans le traitement de certains fibromyomes utérins.

UNLABELLED: In 88 women between the ages of 34 and 51 years with one or several symptomatic uterine leiomyomata (menometrorrhagia, mass syndrome) after failure of medical treatment, particulate arterial embolization was proposed as an alternative to the scheduled surgical operation. Free-flow embolization with Ivalon particles (150 to 600 microns) was performed under local anaesthesia after femoral artery puncture and catheterization of the hypogastric then uterine arteries (5 F catheter) including occlusion Pelvic pain was frequently observed immediately after embolization, lasting 12 to 18 hours, and required analgesia. Necrobiosis syndromes can be observed in the case of very large leiomyomata. No immediate complications directly related to vascular catheterization were observed in this series, but complete necrosis of a very large leiomyomatous uterus required hysterectomy. Five embolization failures were observed. The following results were observed in the 80 interpretable cases with a follow-up of 6 to 60 months: the menstrual periods returned to normal in 60 (89%) of the 67 menorrhagic patients, after six months a volume reduction of myomata equal to 69% of initial volume was observed. CONCLUSION: in of 80 interpretable cases, embolization constituted an alternative to surgical treatment, which was avoided in 71 cases, 9 failures were observed. The results of this preliminary series must be valited by further studies.

[Bone-anchored implants: comparison of the techniques and values of endo- and juxta-bone implants]. / Les épithèses implanto-portées: technique et intérêt comparés des implants endo et juxta-osseux.

Extra-oral implants have been used for well-defined application for nearly 20 years; for tupoorting maxillo-facial prostheses and for bone anchored hearing aids (BAHA). In both of these applications, the bone-anchored prostheses support transcutaneous abutments. It is the junction between the implant and the abutment which ensures, given certain preconditions, the permanent percutaneous connection (PPC). The authors describe the two types of implants currently in use-intra- and juxta-osseous implants. They then give a brief description of the two techniques. The advantages and disadvantages of each system are summarised, as well as the conditions required for permanent survival of a PPC.

[Umbilical metastasis of an endometrial adenocarcinoma: "Sister (Mary) Joseph's nodule". Review of the literature]. / Métastase ombilicale d'un adénocarcinome de l'endomètre: "Sister (Mary) Joseph's nodule". Revue de la littèrature.

In the beginning of the XXth century, Sir Hamilton Bailey proposed the name "Sister Joseph's nodule" for the umbilical metastasis of an abdominal cancer. This unusual pathology has multiple primitive etiologies. We report here the 27th case of an umbilical metastasis of an endometrial adenocarcinoma. In case of a malignant umbilical tumor, 75% correspond to a "Sister Joseph's nodule". Their clinical manifestations are quite similar. This secondary localisation could appear before, during or after the diagnosis of the primitive tumor. Adenocarcinoma is the frequently diagnosed histological type. The endometrial origin represents only 1.4% of the cases. Multiple routes of spread exist. Prognosis remains poor. Medico-surgical treatment, in a curative target, will be aggressive and should be adapted at every case. Our case-report recalls a new patho-physiological approach. The extended follow-up of this patient, without further medical treatment, is an additional argument.

[Maxillofacial prosthesis fixed on endosseous implants. Apropos of 15 cases]. / Prothèses maxillo-faciales fixées sur implants endo-osseux. A propos de quinze cas.

In the light of 15 cases of craniofacial defects due to trauma of carcinomas, the authors propose a new approach of the indications for craniofacial prostheses. Progress in materials (silicons) and treatments of maxillo-facial defects (titanium implants) have renewed the interest in maxillo-facial prostheses in maxillo-facial surgery. The advantages and disadvantages of classical methods of prosthesis fixation (on glasses or adhesives) and modern techniques of extra-oral implants (Swedish) are cause of the recent interest for prostheses in plastic surgery. New implants (German) and easier techniques induce a growing interest for extra-oral implants.

[Contribution of computerized cisternography using hydrosoluble contrast media or CT transit to the diagnosis of post-traumatic cerebrospinal rhinorrhea]. / Apport de la cisternographie computérisée aux hydrosolubles, ou transit scanner, au diagnostic des rhinorrhées cérébro-spinales post-traumatiques.

Based on a series of 100 cases, the authors present the value of CT transit in craniofacial traumatology. This examination, systematically performed in cases of fistulogenic fracture, is able to confirm or exclude the presence of an osteomeningeal breach, which is often difficult to detect during the immediate post-traumatic period. CT transit also allows precise localisation of the breach, which guides the operative procedure.

[Pectoralis major muscular flap in thoracic substance loss following mediastinitis. Apropos of 7 cases]. / Le lambeau musculaire de grand pectoral dans les pertes de substance thoracique après médiastinite. A propos de sept cas.

Mediastinitis is a rare complication but can occur after any form of cardiac surgery via midline sternotomy. Despite early diagnosis, management in intensive care and appropriate treatment, the prognosis remains severe. Progression towards a chest wall defect, exposing a sternal flap is not uncommon and requires reconstructive surgery because of the potential life-threatening risk. Among the techniques currently used, the authors emphasize the value of pectoralis major myoplasty centered on perforating vessels derived from the internal mammary artery according to the technique described by Nahai in 1982. They have performed this procedure in 7 patients with a high-risk context, always using a single muscle, and also assessed its technical simplicity, low morbidity, absence of obvious functional handicap associated with the aesthetic aspects by means of regular review with a mean follow-up of 18 months.

[Facial paralysis. Treatment of upper eyelid occlusion by inclusion of a concealed gold plate]. / Paralysie faciale. Traitement de l'occlusion palpébrale supérieure par inclusion d'une plaque d'or protégée.

Inclusion of a gold plate to oppose the action of the levator muscle has been proposed for a long time in the treatment of superior palpebral paralysis. Long-term ulceration of the overlying skin has generally led to the abandonment of this technique. The simultaneous insertion, in front of the gold plate, of a conchal cartilage graft, which is subsequently reinhabited, overcomes this disadvantage. This is a simple, rapid, reversible, effective procedure which is indicated essentially in longstanding or recent permanent facial paralysis, but also as temporary treatment while waiting for the results of suture, graft or anastomosis of the facial nerve.

[Forum on tissue expansion. Value of cutaneous expansion for the covering of synthetic materials used in cranioplasty. Apropos of a case]. / Forum: l'expansion tissulaire. Intérêt de l'expansion cutanée pour la couverture de matériaux synthétiques de cranioplastie. A propos d'une observation.

The authors present a case of cover of synthetic material by expanded skin. In a context of post-sepsis revision, this cover proved to be of excellent quality, superior to normal scalp. The specific characteristics of tissue expansion may possible explain, in this context, the superiority of the expanded skin. The authors intend to adopt a similar therapeutic approach is such a situation should arise in the future.

[Treatment of incisional hernia of the abdominal wall by the skin lacing technique. Apropos of 30 cases]. / Traitement des éventrations de la paroi abdominale par la technique du laçage à la peau. A propos de trente observations.

The treatment of large incisional hernias is often difficult, as reflected by the many surgical techniques proposed and the high recurrence rate. Since 1983, the authors have used a skin lacing procedure in these large hernias which frequently tend to recur. This report was based on the study of 30 consecutively patients operated by this method between 1983 and 1989. The objective results evaluated clinically in terms of the quality of the abdominal wall after more than two years of follow-up appear to argue in favour of this little known technique which combines simplicity, rapidity and reliability. Based on their experience, the authors believe that this method has a place in the therapeutic arsenal for abdominal wall repair as, in some cases, it can resolve the difficult problem of treatment of large, recurrent incisional hernias regardless of the patient's age.