Bidirectional reflectance measurement of tungsten samples to assess reflection model in WEST tokamak.

This paper presents the measurement of the bidirectional reflectance distribution function of tungsten (W) samples and the resulting reflection models in the nuclear fusion device WEST (tokamak). For this, an experimental gonio-spectrophotometer was developed to fully characterize the material's optical and thermal-radiative properties of metallic samples with different roughnesses. Ray-tracing photonic simulation was then carried out to predict the photon behavior in a fully metallic environment as a function of reflectance measurement. Low emissivity (0.1 at 4 µm) and highly specular reflectance (fitting with a Gaussian distribution around the specular direction with a small width lower than 10°) are found for W samples. These measurements have been used as input for the photonic simulation, and the resulting synthetic image reproduced the reflection features well on the upper divertor, detected in WEST infrared experimental images.

[Unusual association between auto-immune hepatitis and pyoderma gangrenosum. A case report]. / Association inhabituelle entre une hépatite auto-immune et un pyoderma gangrenosum. A propos d'un cas.

Pyoderma gangrenosum is an uncommon neutrophilic dermatosis that presents as an inflammatory and ulcerative disorder of the skin. This entity is associated with systemic diseases and autoimmune diseases but exceptionally with autoimmune hepatitis. We report the case of a 40 year-old woman diagnosed with type 1 autoimmune hepatitis 12 years earlier and admitted for the appearance of an ulcerative lesion in the left leg. Histology confirmed pyoderma gangrenosum.

Le Pyoderma gangrenosum (PG) est une affection rare appartenant au groupe des dermatoses neutrophiliques. Cette entité est associée à l'existence de maladies systémiques et autoimmunes, mais exceptionnellement à une hépatite auto-immune. Nous rapportons l'observation d'une patiente âgée de 40 ans atteinte d'une hépatite auto-immune (HAI) de type 1 depuis 12 ans admise pour une lésion ulcéreuse du membre inférieur gauche. L'histologie confirmera l'existence d'un pyoderma gangrenosum.

Cleaning of first mirrors in ITER by means of radio frequency discharges.

First mirrors of optical diagnostics in ITER are subject to charge exchange fluxes of Be, W, and potentially other elements. This may degrade the optical performance significantly via erosion or deposition. In order to restore reflectivity, cleaning by applying radio frequency (RF) power to the mirror itself and thus creating a discharge in front of the mirror will be used. The plasma generated in front of the mirror surface sputters off deposition, restoring its reflectivity. Although the functionality of such a mirror cleaning technique is proven in laboratory experiments, the technical implementation in ITER revealed obstacles which needs to be overcome: Since the discharge as an RF load in general is not very well matched to the power generator and transmission line, power reflections will occur leading to a thermal load of the cable. Its implementation for ITER requires additional R&D. This includes the design of mirrors as RF electrodes, as well as feeders and matching networks inside the vacuum vessel. Mitigation solutions will be evaluated and discussed. Furthermore, technical obstacles (i.e., cooling water pipes for the mirrors) need to be solved. Since cooling water lines are usually on ground potential at the feed through of the vacuum vessel, a solution to decouple the ground potential from the mirror would be a major simplification. Such a solution will be presented.

Improvement of psoriasis during glucagon-like peptide-1 analogue therapy in type 2 diabetes is associated with decreasing dermal γδ T-cell number: a prospective case-series study.

BACKGROUND: A few case reports suggest that incretin-based therapies could improve psoriasis in patients with type 2 diabetes, the mechanism(s) of which remain unclear. OBJECTIVES: To determine the effects after 16-20 weeks of treatment with a glucagon-like peptide (GLP)-1 analogue on clinical severity and histopathological aspects of psoriasis in patients with type 2 diabetes, and to examine the presence of γδ T cells and the expression of interleukin (IL)-17 in psoriasis before and after treatment. METHODS: Seven patients with type 2 diabetes and psoriasis were followed. Psoriasis Area and Severity Index (PASI) was measured at baseline (T0) and after 7 ± 1 (T1) and 18 ± 2 (T2) weeks' treatment with exenatide/liraglutide. The histopathological pattern of psoriasis, and flow cytometry and immunological data (γδ T-cell percentage and IL-17 expression) were obtained from psoriatic and control sites. RESULTS: The mean PASI decreased from 12·0 ± 5·9 to 9·2 ± 6·4 (P = 0·04). Histological analysis showed a reduction in epidermal thickness after treatment. The dermal γδ T-cell percentage was higher in psoriatic lesions than in control specimens (P = 0·03), as was IL-17 expression (P = 0·018). A reduction of γδ T cells from 6·7 ± 4·5% to 2·7 ± 3·8% (P = 0·05) was demonstrated in the six patients with improved/unchanged PASI. A correlation between PASI and γδ T-cell percentage evolution during therapy (T2-T0) was noted (r = 0·894, P = 0·007). IL-17 was reduced in the four patients with the highest PASI reductions. CONCLUSIONS: The administration of a GLP-1 analogue improved clinical psoriasis severity in patients with type 2 diabetes. This favourable outcome was associated with a decrease of dermal γδ T-cell number and IL-17 expression. Further studies are needed to establish long-term efficacy in (diabetic) patients with psoriasis.

Thermo-mechanical analysis of ITER first mirrors and its use for the ITER equatorial visible∕infrared wide angle viewing system optical design.

ITER first mirrors (FMs), as the first components of most ITER optical diagnostics, will be exposed to high plasma radiation flux and neutron load. To reduce the FMs heating and optical surface deformation induced during ITER operation, the use of relevant materials and cooling system are foreseen. The calculations led on different materials and FMs designs and geometries (100 mm and 200 mm) show that the use of CuCrZr and TZM, and a complex integrated cooling system can limit efficiently the FMs heating and reduce their optical surface deformation under plasma radiation flux and neutron load. These investigations were used to evaluate, for the ITER equatorial port visible∕infrared wide angle viewing system, the impact of the FMs properties change during operation on the instrument main optical performances. The results obtained are presented and discussed.

Late hypersensitivity to omeprazole and other proton pump inhibitors.

A 63 year-old woman presented with a persistent, red, papular, itching skin eruption localised on the face, right shoulder and the right upper member. The evolution was longer than ten years with a permanent progressive diffuse facial burning sensation and unaesthetic aspect despite topical antibiotic and anti-inflammatory treatments. The clinical and the histological diagnosis corresponded to prurigo. She was treated by omeprazole for gastric reflux since more than ten years, and she had a viral C hepatitis. The relationship between prurigo and omeprazole was evidenced by the complete resolution of symptoms after the drug's interruption and the recurrence after the omeprazole re-introduction. The immediate and late skin tests were negative for the tested drugs. Clinical cross-reactivity was observed with pantoprazole and lansoprazole; this suggested a late hypersensitivity to drugs of the proton pump inhibitors class. To our knowledge, it is the first case of prurigo induced by these drugs.

[Cutaneous collagenous vasculopathy: a rare cause of generalized telangiectasia]. / La vasculopathie cutanée collagénique : une cause rare de télangiectasies généralisées.

BACKGROUND: Cutaneous collagenous vasculopathy (CCV) is an entity first described in 2000 by Salama and Rosenthal [1]. Because of its rarity, we felt it opportune to report the present case. PATIENTS AND METHODS: We describe the case of a 47-year-old woman presenting with widespread telangiectasia distributed symmetrically on the legs, thighs and lower abdomen. The histological and immunohistochemical profile was typical of cutaneous collagenous vasculopathy. DISCUSSION: Cutaneous collagenous vasculopathy is characterized by generalized cutaneous telangiectasia and unique histopathological features consisting of marked collagen deposition within the vascular wall of the post-capillary venules in the superficial dermis. Its cause remains unknown. The differential diagnosis consists mainly of generalized essential telangiectasia (GET) and telangiectasia macularis eruptiva perstans (TMEP).

Availability of digital dermoscopy in daily practice dramatically reduces the number of excised melanocytic lesions: results from an observational study.

BACKGROUND: Digital dermoscopy has been shown to permit an earlier detection of melanoma. However, few studies have investigated its added value in reducing unnecessary excisions in everyday clinical practice. OBJECTIVES: To compare, in daily practice, the efficiency of three dermoscopy methods: dermoscopy alone with little training, dermoscopy alone with adequate training and dermoscopy with adequate training and access to digital dermoscopy, and to confirm the safety of this latter approach. METHODS: Thirty-six dermatologists working without digital dermoscopy were divided into two groups according to their training in dermoscopy. The third group constituted of two dermatologists working in a pigmented lesion clinic with access to the digital dermoscopy technique and eight additional dermatologists working in the same dermatology department. These 46 dermatologists included all presumed melanocytic lesions excised over a period of 1 year. The primary endpoint was the melanoma/nonmelanoma ratio (M/NM-R); secondary endpoints were the ratio of 'problem' naevi to common naevi (PN/CN-R), specificity and sensitivity for the diagnosis of melanoma, in situ/invasive melanoma ratio, and the mean Breslow thickness. RESULTS: In total, 1865 excised lesions, including 231 melanomas, were included. In the digital dermoscopy availability group (DD-G) the M/NM-R was significantly better (1/2.43), as was the PN/CN-R (1/1.48) (P < 0.001 in both cases). The specificity was significantly higher in the DD-G and significantly higher for trained examiners as compared with examiners with little training. More that one-third of all melanomas discovered by digital dermoscopy were in situ, and the mean Breslow thickness was 0.32 mm for the invasive ones. CONCLUSIONS: The reduction of unnecessary excisions when using digital dermoscopy compared with dermoscopy alone in our study suggests that access to digital dermoscopy offers a better management of pigmented lesions in daily practice. The high number of early lesions diagnosed by this technique confirms that its use is safe.

Spectroscopic reflectometry of mirror surfaces during plasma exposure.

An in situ spectroscopic reflectometry system has been built to investigate the evolution of the specular reflectivity spectrum of ITER first mirror samples during plasma exposure. Results are presented for three different types of molybdenum mirror samples that were exposed to deuterium plasma, including single crystalline, nanocrystalline, and polycrystalline molybdenum. The results show good agreement with ex situ measurements of the reflectivity spectrum before and after exposure and extend the results obtained in previous experiments.

Calciphylaxis: an uncommon manifestation of primary hyperparathyroidism. A case report.

Calciphylaxis is a rare disorder which mainly affects patients with end-stage renal disease and secondary hyperparathyroidism. We report here a case of calciphylaxis in a 56-year-old woman with primary hyperparathyroidism, a much more uncommon association. Skin biopsy revealed the characteristic pictures of the disease. Soon after parathyroidectomy, the parameters of the phosphorus-calcium metabolism normalised but the cutaneous lesions persisted for several months.

Engineering and manufacturing of ITER first mirror mock-ups.

Most of the ITER optical diagnostics aiming at viewing and monitoring plasma facing components will use in-vessel metallic mirrors. These mirrors will be exposed to a severe plasma environment and lead to an important tradeoff on their design and manufacturing. As a consequence, investigations are carried out on diagnostic mirrors toward the development of optimal and reliable solutions. The goals are to assess the manufacturing feasibility of the mirror coatings, evaluate the manufacturing capability and associated performances for the mirrors cooling and polishing, and finally determine the costs and delivery time of the first prototypes with a diameter of 200 and 500 mm. Three kinds of ITER candidate mock-ups are being designed and manufactured: rhodium films on stainless steel substrate, molybdenum on TZM substrate, and silver films on stainless steel substrate. The status of the project is presented in this paper.

Rhodium and silicon system: II. Rhodium silicide formation.

Detailed characterizations of rhodium/silicon films prepared by co-deposition using magnetron sputtering have been carried out on silicon substrates at room temperature up to 900 degrees C. The properties of the films were investigated using XPS/UPS, XRD, SIMS, SEM and AFM techniques. It should be emphasized that XPS/UPS measurements are carried out without breaking the vacuum to avoid any contamination of the film. Up to 500 degrees C an interdiffusion between the oxidized silicon wafer and the deposited Rh/Si film occurred leading to hole formation in the entire film at 900 degrees C. Diffraction patterns for the compounds Rh(2)Si, Rh(5)Si(3), RhSi and Rh(3)Si(4) were measured. Upon annealing the covalent character is increased and for the samples forming the compound RhSi the valence band structure is markedly changed. Depth profiling (XPS and SIMS) reveals a stable composition in the bulk of the film. For these measurements the silicon-rich alloy in the interfacial layer is probably an effect of sputtering, by implanting the Rh atoms into the silicon substrate. A previously reported negative shift for the compound Rh(5)Si(3) could be connected to the sample preparation, as sputtering of the surface is reducing the silicon content and inducing a glassy state. For the first phase Rh(2)Si formed on the rhodium-rich side the shift in binding energy is unclear, for all the other compounds encountered in this work a positive shift relative to pure rhodium was found.

Rhodium and silicon system: I. Glassy metallic alloy formation.

Detailed characterizations of rhodium/silicon films prepared by co-deposition using magnetron sputtering have been carried out on silicon substrates at room temperature. Effects of the silicon content incorporated in the film on the chemical bonding state and crystallinity were investigated using XPS/UPS, XRD and SEM. It should be emphasized that XPS/UPS measurements are carried out without breaking the vacuum to avoid any contamination of the film. All x-ray diffraction patterns revealed a high degree of amorphization. There is only a weak Rh pattern and a weak Rh(2)Si pattern for 20 and 37 at.% of Si, respectively, i.e. showing a formation of glassy metallic alloy. A negative shift in the Rh core level binding energy for rhodium-rich alloys is mainly referred to relaxation effects due to a high density of d-states near the Fermi level. The filling of the d-states is completed between 25 and 40 atomic concentration of Si. Valence orbital transformation due to the Si-Rh interactions is causing the progressive positive shift in the binding energy for higher silicon content.

[The "Orf" virus: focus and review of the literature]. / Le virus "Orf": mise au point et revue de la littérature.

Orf is an infection often unknown to practicians throughout the world. The first known cases were registered at the end of the 19th century. The virus affects ovines and caprins and is characterized by cutaneous and/or mucosae lesions. It is strongly resistant and the survival time is important in the outside environment. The morbidity of Orf is far higher than its mortality. The virus is transmitted by direct and indirect contact among humans, who became vectors themselves. Those subjects that are in contact with the animals in question due to professional reasons are at risk in particular. The same goes for attendants and participants of religious feasts. The preferred localization of lesions in humans is the hands. The diagnostic is easily set by the anamnesis and the clinical characteristics of the lesions except when it happens to be a particular form. The complications are nearly exclusively related to the unawareness of the virus in form of inappropriate medical acts. The evolution is spontaneous and the unique treatment is the prophylaxis of bacterial infection as well as a constant surveillance.

Cutaneous infection by Alternaria infectoria in a renal transplant patient.

Skin lesions are common in renal transplant recipients (RTR) and the clinical distinction of malignancy versus infection may be difficult in this patient population, with the need for further histological and biological investigations. We report here on a 73-year-old male RTR who presented with Alternaria infectoria phaeohyphomycosis of 1 year's duration. Mycological cultures were negative, and the diagnosis was performed by real-time polymerase chain reaction assay and direct sequencing. The extension of the lesion under itraconazole treatment required its surgical excision. Alternaria are ubiquitous plant-inhabiting saprobes, which are increasingly associated with opportunistic phaeohyphomycosis in immunocompromised individuals.