New perspectives for direct PDMS microfabrication using a CD-DVD laser.

A simple and inexpensive alternative to high-power lasers for the direct fabrication of microchannels and rapid prototyping of poly-dimethylsiloxane (PDMS) is presented. By focusing the infrared laser beam of a commercial, low-power CD-DVD unit on absorbing carbon micro-cluster additives, highly localized PDMS combustion can be used to etch the polymer, which is otherwise transparent at such wavelengths. Thanks to a precise and automated control of laser conditions, laser-induced incandescence is originated at the material surface and produces high-resolution micropatterns that present properties normally induced with lasers of much greater energies in PDMS: formation of in situ nanodomains, local fluorescence and waveguide patterns. An extensive study of the phenomenon and its performance for PDMS microfabrication are presented.

Note: fabrication of a simple versatile micro-positioning setup for automated soft lithography.

In this note, we report the simple development of a homemade versatile device that allows micrometric vertical micro-positioning for computer-controlled dip-coating thin film deposition and micro-contact printing capabilities. Using mostly recycled parts, the resulting low-cost setup offers great precision, ease of use, and portability while complying with common soft lithography technique's specifications. It results in an excellent benchtop alternative to more expensive commercial solutions or more complex custom soft lithography devices, especially for organic electronics and quantum optics applications.

[New synthesis empathogenic agents]. / Nouvelles drogues synthétiques empathogènes.

The use of synthesis drugs is the object of numerous written articles and TV programs in the last, decade. These synthesis drugs or "designer drugs", are well known for their ability to enhance, reinforce or appease social difficulties and relationships. In the research for empathetic and entactogenic relations one discover an obvious lack of communication and "warmth" in personal or professional relationship. An image of chemical "well being" has become a frequent stereotype of a society with an atrophying of performance and values while supposedly dedicating itself to individual performance. The youths are the first victims of these new drugs, the economical and social environment are the main reinforcing factors of this behaviour. The main characteristic of these drugs, is the non-recognition of their danger, some users go so far as to describe this category of substances as "drugs which are not drugs". As a characteristic, the use of a these synthesis drugs is almost recreative, during the week-end and holiday. The drug addiction is different than that of opiates or cocaine. One can observe some cases of real dependence--corresponding to the DSW IV criterion--when the personality of the users is the main characteristic (narcissic failure, immature personality, family and school problems). Many adverse effects--hypertension, kidney failure, psychoses--were declared. The mass-media has presented many articles concerning Ecstasy (MDMA). This is the most used drug during the rave parties. Its adverse effects are well known and proven. The authors would like to present other more recent synthesis drugs, also known as "analogs". These drugs, a kind of mixture between amphetamine-like (MDMA, MBDB, MDA) and misused medicines (ketamine, gamma OH, atropine) represent a real danger. GHB, 2 CB, HMB, are some of these recent substances. The possibility to procure them on the Web, or to produce them by oneself, add to their danger because of the lack of controls on toxicity and quality. The original danger signs were revealed by the FDA and currently a major preoccupation within french specialised services. The major problem for the practitionner is to inform the users, in order to prevent addiction and analyse the solutions.

Clinical and physiological study of anal sphincter and ileal J pouch before preileostomy closure and 6 and 12 months after closure of loop ileostomy.

Spontaneous evolution of pouch and anal function, and absorption features has been assessed in 15 patients who underwent proctocolectomy with J ileal pouch anastomosis without conservation of a rectal muscular cuff. All the patients were studied before preileostomy closure and six and 12 months after the closure of the protection loop ileostomy. Stool frequency was identical at six and 12 months (mean +/- SEM: 5.0 +/- 0.4 and 5.3 +/- 0.5/day, respectively). Sixty-six percent of patients at six months and 40% of patients at 12 months need to defecate at least one time during night. Stool weight as well as steatorrhea decreased significantly six months after the closure of loop ileostomy (P less than 0.05). Mean resting anal pressure remained unchanged six and 12 months after closure of the loop ileostomy (41 +/- 6 and 45 +/- 5 cm H2O, respectively). Maximum squeeze anal pressures increased significantly at six (P less than 0.05) and 12 months (P less than 0.05). The rectoanal inhibitory reflex was always absent at the same period. The maximum pouch capacity increased significantly during the first six months (P less than 0.01) from 142 +/- 17 to 279 +/- 27 ml. The maximum infused volume during a saline continence test was not significantly different at six and 12 months; the percentage of evacuation of the reservoir and the volume at which the first ileal contraction appeared in the reservoir increased significantly (P less than 0.05) at six and 12 months. In conclusion, in patients with ileoanal anastomosis and pouch reservoir, the closure of the loop ileostomy is associated with spontaneous modifications of the anal and pouch parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Primary stomal lymphoma. An unusual complication of ileostomy in a patient with transfusion-related acquired immune deficiency syndrome.

A 73-year-old heterosexual man developed a high-grade non-Hodgkin's lymphoma at the site of an ileostomy only 2 years after proctectomy for undetermined colitis not cured by previous colectomy. In fact, the early occurrence of this usually very late and rare complication of ileostomy was probably favored by the simultaneous presence of acquired immune deficiency syndrome (AIDS) due to repeated blood transfusions for refractory anemia with excess blasts. The intestinal location of the tumor, its high-grade malignancy and B-cell origin are all features of AIDS-related non-Hodgkin's lymphoma. This case report seems to be one of the rarely identified examples of the cooperation between general predisposing factors and local irritating agents at the origin of a malignant tumor.

[Post-surgical inflammatory rectal stenosis]. / Sténose rectale inflammatoire post-chirurgicale.

A case of mid rectum stenosis after pelvic surgery is reported. The conservative treatment used here seems to be the more effective compared to the cases reported in the literature.

Motility of the jejunum after proctocolectomy and ileal pouch anastomosis.

Proctocolectomy with ileal pouch anastomosis could modify motility of the small intestine through two mechanisms: obstruction or bacterial overgrowth. Motility of the jejunum was measured in 11 patients with ileoanal anastomosis six (n = 6), or 12 (n = 5) months after closure of the loop ileostomy. Manometric recording from the jejunum were made during fasting (four hours) and after a liquid meal (one hour). These findings were compared with those of six healthy volunteers. Motor events were classified as follows: migrating motor complex (MMC), propagated contractions, or discrete clustered contractions. All patients were investigated for bacterial overgrowth (D-glucose breath test). Only two patients had bacterial overgrowth. The frequency of MMC remained unchanged after ileo-anal anastomosis (2.83 (0.37)/four hours) compared with normal volunteers (2.81 (0.29)/four hours). During fasting, four patients had numerous propagated contractions in the jejunum. This condition was associated in two with bacterial overgrowth and in two with intubation of the reservoir. Discrete clustered contractions were found in the seven patients studied postprandially (7.6 (2.5)/h), but not in volunteers. These seven patients emptied their pouch spontaneously and bacterial overgrowth was found in only one. As this motility pattern was previously described in partial small intestinal obstruction, it is postulated that discrete clustered contractions could be the consequence of a functional obstruction as a result of anastomosis of the small intestine to the high pressure zone of the anal sphincters.

Proctocolectomy and ileoanal pouch anastomosis without conservation of a rectal muscular cuff.

The technique of proctocolectomy and formation of an ileal reservoir with ileoanal anastomosis is well described. It is believed that the conservation of a rectal muscular cuff is necessary for continence but no data are available to support this contention. The aims of this study were to describe the clinical and physiological aspects of continence after proctocolectomy and ileal J pouch anastomosis without conservation of a rectal muscular cuff. Eighteen consecutive patients (mean age 37.3 years, 16 ulcerative colitis, two familial polyposis) who underwent proctocolectomy and ileoanal anastomosis on the dentate line were studied 6 months after closure of the loop ileostomy. The 18 patients and eight controls underwent: (a) anal manometry; (b) determination of maximum tolerable volume (MTV); (c) liquid continence test (infusion of NaCl at 60 ml/min for 25 min) with simultaneous measurement of ileal reservoir pressure. The volume evacuated during 5 min after the continence test was also measured. The frequency of bowel actions was (mean +/- s.e.m.) 5.3 +/- 0.4 per 24 h (nocturnal 1.14 +/- 0.26). Seventeen of 18 patients (94 per cent) had normal continence and defaecation; one patient was incontinent. A decrease in resting anal canal pressure (102.5 +/- 4 versus 47.5 +/- 6 cmH2O) was observed after ileoanal anastomosis. A rectoanal inhibitory reflex was elicited in one of the 18 patients (6 per cent). Patients were able to retain 1023 +/- 68 ml saline during the liquid continence test. The percentage evacuation of the ileal reservoir was 61 +/- 4.5 per cent. Correlations were found (P = 0.05) between daily stool frequency and the volume of saline retained during the liquid continence test. It is concluded that conservation of a rectal muscular cuff is not necessary for the achievement of good clinical results.

Pathophysiological study of diarrhoea in a patient with medullary thyroid carcinoma. Evidence against a secretory mechanism and for the role of shortened colonic transit time.

Intubation techniques and scintigraphic studies were used to determine the origin and mechanism of diarrhoea in a patient with medullary thyroid carcinoma, high plasma immunoreactive calcitonin and normal circulating serotonin, substance P and prostaglandins E2 and F2 alpha. Normal function of the small intestine was found for the following: (a) absorption tests; (b) water and electrolyte absorption in the proximal jejunum; (c) 24 hour flow rate and composition of fluid entering the colon and (d) gastric emptying rate and small intestinal progression of a normal meal. By contrast, colonic function was markedly impaired in three ways: (a) water absorption was decreased by half; (b) as the main excreted solutes were organic acids, a large electrolyte gap was recorded in faecal water, and (c) colonic transit time of the meal marker was very short, and was in agreement with the rapid transit of ingested radioopaque markers. These data strongly suggest that decreased absorption in the colon secondary to a motor disturbance is the main mechanism of diarrhoea in this case of medullary thyroid carcinoma, while calcitonin induced small intestinal fluid secretion suggested earlier is either non-existent, or only of minor importance.

Neuromediated action of beta-casomorphins on ion transport in rabbit ileum.

beta-casomorphins (beta-CMs) are opioid peptides derived from milk beta-casein. The beta-casomorphin analog beta-[DAla2,4, Tyr5] CM-5-NH2 reduced short-circuit current (lsc) and stimulated electrolyte absorption by an opioid effect in rabbit ileum in vitro. This effect was inhibited by 10(-7) M tetrodotoxin, 10(-6) M epinephrine and 10(-5) M naloxone. Atropine in the 10(-7)-10(-5) M range and 10(-5) M hexamethonium did not inhibit the action of the peptide on lsc. In comparison the muscarinic effect of 10(-3) M carbachol was inhibited by atropine in the 10(-8)-10(-5) M range. These results indicate that the action of the beta-casomorphin analog was neuromediated and suggest that this peptide acted on the submucosal plexus located on the blood side of the intestinal epithelium. A physiological role of the food-derived beta-CMs peptides implies the passage of the active sequences from the lumen to the blood side of the intestine.

Opiate activity and transepithelial passage of intact beta-casomorphins in rabbit ileum.

The functional significance of the presence of opioid peptides in enzymatic digestion of food proteins remains uncertain. The effect of natural beta-casomorphins (beta-CMs), beta-CM-5 and beta-CM-4-NH2 (morphiceptine), and the analogue beta-[D-Ala2,4,Tyr5]CM-5-NH2 were studied in isolated rabbit ileum mounted in Ussing chambers. All three peptides caused a naloxone-reversible reduction in short-circuit current (Isc) after addition at a concentration of 10(-4) M to the serosal side of the tissue. After addition to the mucosal side, only the analogue beta-[D-Ala2,4,Tyr5]CM-5-NH2 reduced Isc. Natural beta-CMs were degraded by the intestinal mucosa, and no intact transepithelial passage was detected for these peptides, whereas beta-[D-Ala2,4,Tyr5]CM-5-NH2 was demonstrated to cross the epithelium intact when added at a concentration of 10(-3) M in the mucosal reservoir (mucosal-to-serosal flux = 3.5 +/- 1.2 nmol.h-1.cm-2). These results show that both natural beta-CMs and the protected analogue have an opiate activity on intestinal electrolyte transport. Their action from the luminal side of the intestine seems to depend on the transfer of the intact peptides from the luminal to the blood side of the tissue where opiate receptors are located. This action is prevented by luminal hydrolysis of the natural peptides.

[Pancreatic cystadenoma: diagnostic value of ultrasonics and x-ray computed tomography]. / Cystadénomes pancréatiques: intérêt diagnostique de l'échographie et de la tomodensitométrie.

We report six cases of pancreatic cystadenoma (three mucinous cysts, three microcystic adenomas). All patients were women. The mean age at the time of diagnosis was 50 years (with a range from 24 to 70 years). The mean age of patients having mucinous cysts (36.6 years) was lower than that of patients having microcystic adenomas (63.3 years). Abdominal pain was the first symptom in five patients. A palpable abdominal mass was found in three cases. The type of the tumor was demonstrated by ultrasonography and computed tomography and was confirmed by laparotomy in five cases. The tumors involved the body and tail of the pancreas. A distal pancreatectomy was performed in five cases, with a splenectomy in four cases. The post-operative course was uneventful. One patient was not operated. The histological examination of the three mucinous cysts showed benign tumors. This study emphasizes the usefulness of ultrasonography and computed tomography for the diagnosis of pancreatic cystadenomas. Surgical therapy is mandatory for mucinous cysts because of their potential malignancy, but a careful follow-up might be proposed for poor-risk patients having a microcyst adenoma, since this tumor is benign.

In vitro effects of beta-casomorphins on ion transport in rabbit ileum.

beta-Casomorphins (beta-CM) represent opioid peptides derived from bovine beta-casein. As opiates are known to decrease short-circuit current (Isc) and stimulate intestinal electrolyte absorption, we tested the effects of natural beta-CM-4-OH, beta-CM-5-OH, and three related analogues on electrolyte transport in rabbit ileum in vitro. At concentrations of 10(-7) to 10(-3) M, the three analogues (beta-[D-Ala2]CM-4-NH2, beta-[D-Ala2,Met5]CM-5-NH2, and beta-[D-Ala2,4,Tyr5]CM-5-NH2) caused a dose-dependent, naloxone-reversible reduction in Isc after addition to the serosal side of the preparation. beta-[D-Ala2,4,Tyr5]CM-5-NH2 also decreased Isc after mucosal addition. Serosal addition of the same analogue stimulated absorption of sodium and chloride (+2.90 +/- 0.95 and +2.12 +/- 0.60 mu eq . h-1 . cm-2, respectively) and inhibited residual flux (-1.80 +/- 0.57 mu eq . h-1 . cm-2). The natural beta-CM tested did not decrease Isc. These results demonstrate that beta-CM analogues stimulate intestinal absorption of electrolytes by an opioid mechanism. The fact that beta-[D-Ala2,4,Tyr5]CM-5-NH2 was effective on the mucosal side favored the hypothesis that certain food-related opioid peptides might be absorbed by the intestine.

[Hemorrhagic rectocolitis associated with idiopathic thrombopenic purpura]. / Rectocolite hémorragique associée à un purpura thrombopénique idiopathique.

This case report documents severe autoimmune thrombocytopenia in a 20 yrs. old patient with ulcerative colitis. Diagnosis of idiopathic thrombocytopenic purpura was made on the presence of bound antiplatelet antibodies and on the absence of any other disorder capable of provoking a platelet fall. Colonic lesions were moderate but were resistant to steroids and total parenteral nutrition. Thrombocytopenia resisted to steroids and vincristine and a major fall in the platelet count (less than 10,000/mm3) occurred in two instances. However, platelets rose transiently after high-dose intravenous gamma-globulins. The patient underwent splenectomy, colectomy and ileostomy because of life-threatening colonic hemorrhage. The platelet count rose to normal levels within one week after surgery. Ileorectal anastomosis was subsequently performed. One year later the patient was in good health and his platelet count had returned to normal.

Anticholeraic effect of methylated casein in rat jejunum.

To explore the antisecretory effect of methylated casein (MC) cholera toxin was placed in isolated jejunal loops, and in vivo water fluxes were measured 3 h later in the presence or absence of MC. Secretion was observed in the loops filled with Ringer's solution only, but net absorption was observed in all 10 loops to which MC was added. Its actions was evident within 20 min, and was exerted directly on the luminal side of the epithelium. This response was dose-dependent and the antisecretory effect vanished after boiling MC and after ultrafiltration. In vitro, the antisecretory effect of MC consisted of reversing net Na and Cl fluxes from secretion to absorption (delta JNanet = 6.18 +/- 1.25 and delta JClnet = 5.10 +/- 1.66 microEq . h-1 . cm-2). This change was due to the enhancement of mucosal to serosal flux. Transepithelial potential difference and tissue conductance did not alter. Interestingly, MC did not interfere with intestinal function in the absence of stimulation by cholera toxin. In the presence of cholera toxin, MC and glucose both stimulated ionic absorption by different mechanisms, MC stimulating neutral NaCl absorption, and glucose stimulating electrogenic Na absorption. MC did not alter basal adenylate cyclase activity but it inhibited the cholera toxin-stimulated increase in activity. The present results indicate that methylated casein inhibits water and electrolyte secretion induced by cholera toxin in rat jejunum. Its availability, low cost, and curative effect from the luminal side constitute compelling indications for further investigation.

[Ileal duplication in adults. Value of 99m pertechnetate scintigraphy]. / Duplication iléale de l'adulte. Intérêt de la scintigraphie au 99m pertechnétate.

Duplications of the small bowel are an uncommon group of congenital malformations whose symptoms rarely occur in adults. We report the case of a 21 year-old man who suffered during four years from symptoms related to the ulceration of ectopic gastric mucosa in an ileal duplication (spontaneously resolving peritonitis, pelvic abscess, recurrent gastrointestinal bleeding and chronic abdominal pain). Radiological and endoscopic explorations and a first laparotomy failed to provide the diagnosis. 99m pertechnetate (99mTcO4) scintigraphy demonstrated ectopic gastric mucosa and guided the radiological detection of an ileal ulceration. Injection of 99mTcO4 during a second laparotomy located the ectopic gastric mucosa at the level of a tumefaction found on the mesenteric side of the terminal ileum. Duplication was only recognized at pathological examination of the ileal resection. This case emphasizes the need to evoke a duplication in clinical circumstances like those described in this patient as well as the usefulness of 99mTcO4 in the diagnosis of such a malformation.