Embryotoxicity testing of IVF disposables: how do manufacturers test?

STUDY QUESTION: How do manufacturers perform embryotoxicity testing in their quality control programs when validating IVF consumables? SUMMARY ANSWER: The Mouse Embryo Assay (MEA) and Human Sperm Survival Assay (HSSA) used for IVF disposables differed from one manufacturer to another. WHAT IS KNOWN ALREADY: Many components used in IVF laboratories, such as culture media and disposable consumables, may negatively impact human embryonic development. STUDY DESIGN, SIZE, DURATION: Through a questionnaire-based survey, the main manufacturers of IVF disposable devices were contacted during the period November to December 2018 to compare the methodology of the MEA and HSSA. We focused on catheters for embryo transfer, catheters for insemination, straws, serological pipettes, culture dishes and puncture needles used in the ART procedures. PARTICIPANTS/MATERIALS, SETTING, METHODS: We approached the manufacturers of IVF disposables and asked for details about methodology of the MEA and HSSA performed for toxicity testing of their IVF disposable devices. All specific parameters like mouse strains, number of embryos used, culture conditions (media, temperature, atmosphere), extraction protocol, subcontracting, and thresholds were registered and compared between companies. MAIN RESULTS AND THE ROLE OF CHANCE: Twenty-one companies were approached, of which only 11 answered the questionnaire. Significant differences existed in the methodologies and thresholds of the MEA and HSSA used for toxicity testing of IVF disposables. Importantly, some of these parameters could influence the sensitivity of the tests. LIMITATIONS, REASONS FOR CAUTION: Although we approached the main IVF manufacturers, the response rate was relatively low. WIDER IMPLICATIONS OF THE FINDINGS: Our study confirms the high degree of heterogeneity of the embryotoxicity tests performed by manufacturers when validating their IVF disposable devices. Currently, no regulations exist on this issue. Professionals should call for and request standardization and a future higher degree of transparency as regards embryotoxicity testing from supplying companies; moreover, companies should be urged to provide the users clear and precise information about the results of their tests and how testing was performed. Future recommendations are urgently awaited to improve the sensitivity and reproducibility of embryotoxicity assays over time. STUDY FUNDING/COMPETING INTEREST(S): This study did not receive any funding. L.D. declares a competing interest with Patrick Choay SAS. TRIAL REGISTRATION NUMBER: N/A.

COVID-19 infection in first trimester of pregnancy marked by a liver cytolysis in a woman previously treated by hydroxychloroquine for repeated implantation failure: a case report.

BACKGROUND: In December 2019, a new disease (COVID-19) caused by a novel coronavirus called SARS-CoV-2 emerged in China and spread to many other countries. There is only limited data about the clinical features of COVID-19 during pregnancy, especially in first trimester. CASE PRESENTATION: We report a COVID-19 infection in a 35 years-old patient in first trimester of pregnancy and its consequent medical care. At 7 weeks of pregnancy, the patient, who did not have any pregestational comorbidities, complained of intense nausea and asthenia. An important liver cytolysis was discovered with biological perturbations of transaminases levels. No respiratory symptoms were recorded. Classical viral aetiologies and drug-related toxicity were discarded. Because of the aggravation of the symptoms and the occurrence of the breathlessness, the patient was tested for the COVID-19 in a nasopharyngeal swab. The RTq-PCR assay indicated the presence of SARS-CoV-2 RNA. In the absence of severe symptoms, the patient was monitored at home according to the French government guidelines. After a few days, the symptoms resolved without any complications. The pregnancy is still ongoing without any visible sequelae on the foetus so far. CONCLUSIONS: This first case illustrated the difficulty of COVID-19 diagnosis in patients with isolated digestive symptoms in first trimester of pregnancy that could be confused with gravida hyperemesis. Monitoring of pregnancy after an episode of COVID-19 should be strengthened with bimonthly foetal growth ultrasounds and doppler assessments because of the risks for intrauterine growth restriction. Comprehensive data on larger numbers of first trimester gravid women with COVID-19 are required to better understanding the overall impact of SARS-CoV-2 on maternal and birth outcomes.

Biostimulation to identify microbial communities involved in methane generation in shallow, kerogen-rich shales.

AIMS: The aim of the present study was to design and test a method allowing the detection and quantification of methanogenic consortia in organic-rich rocks to determine the potential of methane biotransformation. METHODS AND RESULTS: Methanogen numbers in the rock are often below the detection levels of quantification methods. Biostimulation was tested as a means to specifically increase bacterial and archaeal numbers above the detection levels in microcosms. Biostimulation reveals the presence of active heterotrophic and syntrophic bacterial consortia, methane accumulation and methanogens in one of four rock samples. Syntrophs and heterotrophs were dominated by Firmicutes, whereas archaeal diversity was limited to methanogens. Methane-producing microcosms were characterized by a higher Firmicutes diversity. CONCLUSIONS: Biostimulation is a reliable tool for detection of methanogenic consortia in organic-rich rocks. For routine and large scale experimentation, methane accumulation monitoring after biostimulation appears as the most time, work and cost efficient approach to detect the presence of active methanogenic consortia. SIGNIFICANCE AND IMPACT OF THE STUDY: We report for the first time the presence of live methanogenic consortia in organic-rich shales and their ability to mineralize the rock into methane. This approach will be instrumental to quantify the potential of these rocks to produce methane as a novel energy source.

Distinct ectomycorrhizospheres share similar bacterial communities as revealed by pyrosequencing-based analysis of 16S rRNA genes.

Analysis of the 16S rRNA gene sequences generated from Xerocomus pruinatus and Scleroderma citrinum ectomycorrhizospheres revealed that similar bacterial communities inhabited the two ectomycorrhizospheres in terms of phyla and genera, with an enrichment of the Burkholderia genus. Compared to the bulk soil habitat, ectomycorrhizospheres hosted significantly more Alpha-, Beta-, and Gammaproteobacteria.

Correlation of the abundance of betaproteobacteria on mineral surfaces with mineral weathering in forest soils.

Pyrosequencing-based analysis of 16S rRNA gene sequences revealed a significant correlation between apatite dissolution and the abundance of betaproteobacteria on apatite surfaces, suggesting a role for the bacteria belonging to this phylum in mineral weathering. Notably, the cultivation-dependent approach demonstrated that the most efficient mineral-weathering bacteria belonged to the betaproteobacterial genus Burhkolderia.

Fractionation of stable zinc isotopes in the zinc hyperaccumulator Arabidopsis halleri and nonaccumulator Arabidopsis petraea.

Zn isotope fractionation may provide new insights into Zn uptake, transport and storage mechanisms in plants. It was investigated here in the Zn hyperaccumulator Arabidopsis halleri and the nonaccumulator A. petraea. Plant growth on hydroponic solution allowed us to measure the isotope fractionation between source Zn (with Zn(2+) as dominant form), shoot and root. Zn isotope mass balance yields mean isotope fractionation between plant and source Zn Δ(66)Zn(in-source) of -0.19 ± 0.20‰ in the nonaccumulator and of -0.05 ± 0.12‰ in the hyperaccumulator. The isotope fractionation between shoot Zn and bulk Zn incorporated (Δ(66)Zn(shoot-in)) differs between the nonaccumulator and the hyperaccumulator and is function of root-shoot translocation (as given by mass ratio between shoot Zn and bulk plant Zn). The large isotope fractionation associated with sequestration in the root (0.37‰) points to the binding of Zn(2+) with a high affinity ligand in the root cell. We conclude that Zn stable isotopes may help to estimate underground and aerial Zn storage in plants and be useful in studying extracellular and cellular mechanisms of sequestration in the root.

Identification of a novel type of glucose dehydrogenase involved in the mineral weathering ability of Collimonas pratensis strain PMB3(1).

The exact molecular mechanisms as well as the genes involved in the mineral weathering (MW) process by bacteria remain poorly characterized. To date, a single type of glucose dehydrogenase (GDH) depending on a particular co-factor named pyrroloquinoline quinone (PQQ) is known. These enzymes allow the production of gluconic acid through the oxidation of glucose. However, it remains to be determined how bacteria missing PQQ-dependent GDH and/or the related pqq biogenesis genes weather minerals. In this study, we considered the very effective mineral weathering bacterial strain PMB3(1) of Collimonas pratensis. Genome analysis revealed that it does not possess the PQQ-based system. The use of random mutagenesis, gene complementation and functional assays allowed us to identify mutants impacted in their ability to weather mineral. Among them, three mutants were strongly altered on their acidification and biotite weathering abilities (58% to 75% of reduction compared to WT) and did not produce gluconic acid. The characterization of the genomic regions allowed noticeably to the identification of a Glucose/Methanol/Choline oxidoreductase. This region appeared very conserved among collimonads and related genera. This study represents the first demonstration of the implication of a PQQ-independent GDH in the mineral weathering process and explains how Collimonas weather minerals.

Higher interleukin-18 and mannose-binding lectin are present in uterine lumen of patients with unexplained infertility.

The uterine luminal environment was explored with regard to interleukin-18 (IL-18) and mannose-binding lectin (MBL) and the possibility that the procedure of flushing the uterine cavity would optimize the physiological initial pseudo-inflammatory uterine reaction. Uterine flushings were performed among 175 IVF/intracytoplasmic sperm injection (ICSI) patients at the time of oocyte retrieval and the cycles were compared with a control group matched for age, number of previous attempts and type of assisted reproductive procedure (IVF or ICSI) in which no flushing were performed (n = 175). Samples collected were divided into two groups according to the presence/absence of endometrial cells in samples. IL-18 and MBL expressions were explored by enzyme-linked immunosorbent assay. Implantation rates were significantly higher in those patients who underwent the uterine flushing compared with controls (P = 0.04). Luminal concentrations of IL-18 and MBL were higher if endometrial cells were present in flushings, suggesting endometrial origin of the secretion. Both concentrations of MBL and IL-18 were higher in patients with unexplained infertility compared with patients involved in IVF/ICSI for male or tubal infertility (P = 0.005 and 0.02, respectively). The exploration of the endoluminal environment before oocyte retrieval may enhance pregnancy rates and show distinct features in patients with unexplained infertility.

[Polycystic ovary syndrome does not affect blastulation nor cumulative live birth rates]. / Le syndrome des ovaires polykystiques n'altère pas les taux de blastulation ni les taux cumulés de naissances vivantes.

OBJECTIVES: Polycystic ovarian syndrome (PCOS) brings complications in the management of the assisted reproductive technology (ART) because of an oocyte quality probably impaired due to modifications of intra- and extra-ovarian factors. Our study aimed to investigate the extended culture in PCOS patients and its influence on the cumulative live birth rates. METHODS: Fifty-nine PCOS patients (as defined by the Rotterdam criteria) and 114 normo-ovulatory patients (i.e. with tubal, male or idiopathic infertility, regular cycles and AMH>2ng/mL) aged<37years old who underwent a 1st or 2nd ART attempt with extended culture to day 6 were included from October 2015 to December 2017. The blastulation and cumulative live birth rates were compared between the two groups. RESULTS: The PCOS and control patients were 32.22 and 32.91years old respectively (P=0.05). The median number of oocytes retrieved was significantly higher in the PCOS group and the median oocyte maturity rate significantly lower compared with controls. The blastulation rates were similar between the PCOS and the control groups, respectively 57.8% vs. 58.6%, P=0.88. Because of the risks of hyperstimulation syndrome, a freeze all strategy was achieved for 38.9% of PCOS patients vs. 14.0% of the control patients (P<0.01). The cumulative live birth rates were not statistically different: 31.7% in the PCOS group vs. 37.2% in the control group, P=0.50. CONCLUSIONS: PCOS was not observed to affect the extended culture nor the cumulative live birth rates in comparison to normo-ovulatory patients, supporting the blastocyst transfer strategy as a suitable option to PCOS patients.

Genetically engineered plants producing opines alter their biological environment.

Little is known about the consequences of releasing genetically engineered plants (GEP) into the environment. Using opine-producing GEP, we show that transgenic plants alter their biological environment, more precisely the root-associated bacterial populations. The alterations were both transgene-specific and target population-specific. Therefore, assessment studies on the introduction of a given transgene into a GEP will be valid on the given transgene. Evidence of any transgene-associated biological effect will depend on the determination of the pertinent target populations, the identification of which is a key step of such studies.

Caballeronia mineralivorans sp. nov., isolated from oak-Scleroderma citrinum mycorrhizosphere.

Six bacterial strains were isolated from the oak-Scleroderma citrinum ectomycorrhizosphere in acidic and nutrient-poor forest soil for their high efficacy to weather minerals. Four of the six isolates, PML1(12)T and PML1(4), PML1(14) and PML1(16), were further characterized extensively. They were Gram negative, obligate aerobic, motile, non spore forming and rod-shaped. The major fatty acids of strain PML1(12)T were cyclo-C17:0, cyclo-C19:0-ω8c, C16:0 and C18:1-ω7c. The GC content of the DNA was 60.8%. The 16S rRNA and GyrB analyses showed that the four PML strains formed a distinct phylogenetic lineage within the genus Caballeronia, most closely related to Caballeronia udeis. This result was confirmed by whole-genome phylogeny analyses done on strain PML1(12)T. The results of digital DNA-DNA relatedness further supported the separation of the new isolates from closely related species. Morphological, chemotaxonomic properties were also consistent with the description of the genus Caballeronia. It is therefore proposed that strains PML1(12)T and PML1(4), PML1(14) and PML1(16) be recognized as a novel species, for which the name Caballeronia mineralivorans sp. nov. is proposed. The type strain is PML1(12)T (=DSM 104028 and LMG 2991).

Can a target zone safer than Lewinnek's safe zone be defined to prevent instability of total hip arthroplasties? Case-control study of 56 dislocated THA and 93 matched controls.

BACKGROUND: Various factors contribute to instability of total hip arthroplasty (THA), with implant orientation being a major contributor. We performed a case-control study with computed tomography (CT) data to determine whether: 1) orientation contributes to THA instability and 2) a safer target zone for stability than Lewinnek's classic safe zone can be defined. MATERIAL AND METHODS: We included prospectively 363 cases of THA dislocation that occurred during the calendar 2013 year in 24 participating hospitals. Of the 128 dislocations that occurred in patients who underwent THA at these centers, 56 (24 anterior, 32 posterior) had CT scans, thus were included in the analysis. The control group was matched 4:1 based on implant type, year of implantation, age, sex, bearing types and THA indication. Of the 428 matched control THA cases, 93 had CT scans. In all, the CT scans from 149 cases (56 unstable, 93 stable) were analyzed to determine the acetabular cup's inclination and anteversion, and the femoral stem's anteversion. RESULTS: In the unstable THA group, cup inclination was 46.9°±7.4°, cup anteversion was 20.4°±10.8° and stem anteversion was 14.2°±9.9°. In the stable THA group, cup inclination was 44.9°±5.3° (P=0.057), cup anteversion was 22.1°±5.1° (P=0.009) and stem anteversion was 13.4°±4.4° (P=0.362). The optimal total anteversion (cup+stem) of 40-60° was achieved in 16.5% of unstable THA cases and 13.9% of stable THA cases, thus this parameter does not predict stability (odds ratio [OR] of 0.40, P=0.144). The cup was positioned in Lewinnek's safe zone in 44.6% of patients in the unstable group and 68.2% of those in the stable group (OR 3.74, P=0.003). A target zone defined as 40-50° inclination and 15-30° anteversion was better able to distinguish between unstable cases (23.2%) and stable cases (71.6%) resulting in an OR of 13.91 (P<0.001). DISCUSSION: Implant positioning was the only risk factor for instability found in this study. Moreover, our findings reinforce the theory put forward by other authors that Lewinnek's safe zone is not specific enough to differentiate between stable and unstable THA implantations. The target zone for acetabular cups proposed here (40-50° inclination and 15°-30° anteversion) is related to a lower risk of instability. This orientation can be used as a guide, but must be combined with other technical elements to optimize stability. By balancing stability and biomechanics, the 40-50° inclination and 15°-30° anteversion target zone redefines the optimal positioning window. LEVEL OF EVIDENCE: III case-control study.

[Pheochromocytoma and pregnancy. Case report]. / Phéochromocytome et grossesse. A propos d'un cas.

The management of a pheochromocytoma during pregnancy is uncommon and is at high risk for both mother and foetus. We report a case of a patient whose first pregnancy was complicated by foetal demise in a context suggestive of preeclampsia. She was diagnosed with pheochromocytoma as she was beginning a second pregnancy. A laparoscopic adrenalectomy was performed in the first trimester of pregnancy, and maternal and neonatal outcome were favourable. This case illustrates the difficulty of diagnosing pheochromocytoma in pregnancy, and the benefits of laparoscopic treatment in the first trimester.

High protein flexibility and reduced hydration water dynamics are key pressure adaptive strategies in prokaryotes.

Water and protein dynamics on a nanometer scale were measured by quasi-elastic neutron scattering in the piezophile archaeon Thermococcus barophilus and the closely related pressure-sensitive Thermococcus kodakarensis, at 0.1 and 40 MPa. We show that cells of the pressure sensitive organism exhibit higher intrinsic stability. Both the hydration water dynamics and the fast protein and lipid dynamics are reduced under pressure. In contrast, the proteome of T. barophilus is more pressure sensitive than that of T. kodakarensis. The diffusion coefficient of hydration water is reduced, while the fast protein and lipid dynamics are slightly enhanced with increasing pressure. These findings show that the coupling between hydration water and cellular constituents might not be simply a master-slave relationship. We propose that the high flexibility of the T. barophilus proteome associated with reduced hydration water may be the keys to the molecular adaptation of the cells to high hydrostatic pressure.

Specific impacts of beech and Norway spruce on the structure and diversity of the rhizosphere and soil microbial communities.

The impacts of plant species on the microbial communities and physico-chemical characteristics of soil are well documented for many herbs, grasses and legumes but much less so for tree species. Here, we investigate by rRNA and ITS amplicon sequencing the diversity of microorganisms from the three domains of life (Archaea, Bacteria and Eukaryota:Fungi) in soil samples taken from the forest experimental site of Breuil-Chenue (France). We discovered significant differences in the abundance, composition and structure of the microbial communities associated with two phylogenetically distant tree species of the same age, deciduous European beech (Fagus sylvatica) and coniferous Norway spruce (Picea abies Karst), planted in the same soil. Our results suggest a significant effect of tree species on soil microbiota though in different ways for each of the three microbial groups. Fungal and archaeal community structures and compositions are mainly determined according to tree species, whereas bacterial communities differ to a great degree between rhizosphere and bulk soils, regardless of the tree species. These results were confirmed by quantitative PCR, which revealed significant enrichment of specific bacterial genera, such as Burkholderia and Collimonas, known for their ability to weather minerals within the tree root vicinity.

Small diameter metal-on-metal total hip arthroplasty at 13 years - a follow-up study.

INTRODUCTION: Theoretically, the properties of second-generation metal-on-metal (MoM) bearings are better for wear, osteolysis and longevity. However, follow-up studies of more than 10 years are rare, in particular with hybrid fixation (cemented stainless steel stems and cementless cup), therefore we evaluated the results of this combination after a mean follow-up of 12.8 years: (1) to analyze the survival rate, (2) to compare it with the survival rate in the same series after 6.4 years (95.8% cup, 94.8% stem), (3) to evaluate clinical and radiographic outcome and (4) to analyze these failures. HYPOTHESIS: The number of revisions would increase after 10 years. MATERIALS AND METHODS: We evaluated 106 total hip arthroplasties (THA) (Cedior™ press-fit cup with cemented Acora™ (n=50) and Exafit™ (n=56) stems and 28mm Metasul™ bearings performed between January 1999 and December 2002. The survival rate was calculated by the Kaplan-Meier method. The clinical assessment included the Postel Merle d'Aubigné (PMA) and Oxford scores. The radiographic assessment evaluated radiolucencies and osteolysis on standard X-rays. A histological analysis was only performed during revision THA. RESULTS: After a mean 12.8 years of follow-up (10-16), 53 THA were reviewed in 48 patients. Thirteen THA revisions (14%) were performed including 11 aseptic revisions (5 stem fractures, 2 cases of impingement and 3 loosenings [1 bipolar and 3 cups] and one case of osteolysis). Overall survival, taking into account revision for aseptic loosening, was 87.6% (CI 95%=77.3 to 99.3%). The mean PMA and Oxford scores at the final follow-up were 17.6±0.8 points (16-18) and 16.5±5.2 points (12-38) respectively. The radiological follow-up mainly identified radiolucencies around the stem in Gruen zones 1 and 7 (17 and 21% respectively). DISCUSSION: The survival rate of hybrid MoM THA in this series decreased after 10 years and is lower than studies evaluating cementless THA with the 28-mm Metasul™ bearings (90.9 to 100% survival). Although the clinical results are satisfactory, survival is lower. However, the role of MoM bearings is relative in these failures, in particular because trunnionoses (stainless steel stem with 28-mm head), impingement and especially 5-stem fractures were the main causes of failure. LEVEL OF EVIDENCE: IV: retrospective study.

Unplanned return to theater: A quality of care and risk management index?

INTRODUCTION: Surgical quality and risk management is a major public health issue. The consequences of unplanned return to theater are social, occupational, financial and even legal. Unscheduled revision surgery is a major adverse event, resulting from serious complications - some of which are thought to be avoidable. The present study sought to assess and analyze the incidence of unplanned return to theater in an orthopedic surgery department. The study hypothesis was that some of the complications involved could be avoided. PATIENTS AND METHOD: A mixed retrospective-prospective study examined a consecutive series of 10,158 patients operated on in an orthopedic and traumatologic surgery department between January 2011 and December 2013. Patients undergoing revision surgery for reasons directly related to the primary procedure were analyzed. Patients were distributed among the following subgroups: infection, implant dislocation; hemorrhagic complication, mechanical complication, problem of primary technique, stiffness, wound healing disorder. Specific indicators of dysfunction liable to have contributed to onset of the complication were applied in each subgroup, to determine the avoidable or unavoidable nature of the event. RESULTS: Two hundred and twenty-four patients (2.2%) underwent revision surgery for reasons directly related to the primary procedure. One hundred and eight cases (48.2%) were considered to have been avoidable: 48 infections (21.4%), 27 implant dislocations (12%), 15 hemorrhagic complications (6.7%), 66 mechanical complications (29.5%), 35 technical problems at primary surgery (15.6%), 21 cases of stiffness (9.3%), and 12 cases of delayed wound healing (5.3%). Mean time to revision surgery was 2.7 ± 2.6 months. Extending the time-window to 1 year recruited extra cases: in 31.7% of cases, onset was after the 90th postoperative day, which is the usual deadline. The rate of unplanned return to theater was higher after unscheduled (traumatic: 3.2%) than scheduled surgery (1.7%, P < 0.001). CONCLUSION: Return to surgery in orthopedic and traumatologic surgery is underestimated. Annual incidence was 2.2%, and twice as high (3.2%) following traumatologic compared to scheduled surgery (1.7%). Analysis found that almost half the cases were avoidable. They represent a relevant and easily assessed indicator of treatment quality and associated risk management. A national or even international database in the form of an anonymous registry of revision surgeries would be useful.

A second T-region of the soybean-supervirulent chrysopine-type Ti plasmid pTiChry5, and construction of a fully disarmed vir helper plasmid.

Agrobacterium tumefaciens Chry5, which is particularly virulent on soybeans, induces tumors that produce a family of Amadori-type opines that includes deoxyfructosyl glutamine (Dfg) and its lactone, chrysopine (Chy). Cosmid clones mapping to the right of the known oncogenic T-region of pTiChry5 conferred Amadori opine production on tumors induced by the nopaline strain C58. Sequence analysis of DNA held in common among these cosmids identified two 25-bp, direct repeats flanking an 8.5-kb segment of pTiChry5. These probable border sequences are closely related to those of other known T-regions and define a second T-region of pTiChry5, called T-right (TR), that confers production of the Amadoriopines. The oncogenic T-left region (TL) was located precisely by identifying and sequencing the likely border repeats defining this segment. The two T-regions are separated by approximately 15 kb of plasmid DNA. Based on these results, we predicted that pKYRT1, a vir helper plasmid derived from pTiChry5, still contains all of TR and the leftmost 9 kb of TL. Consistent with this hypothesis, transgenic Arabidopsis thaliana plants selected for with a marker encoded by a binary plasmid following transformation with KYRT1 co-inherited production of the Amadori opines at high frequency. All opine-positive transgenic plants also contained TR-DNA, while those plants that lacked TR-DNA failed to produce the opines. Moreover, A. thaliana infected with KYRT1 in which an nptII gene driven by the 35S promoter of Cauliflower mosaic virus was inserted directly into the vir helper plasmid yielded kanamycin-resistant transformants at a low but detectable frequency. These results demonstrate that pKYRT1 is not disarmed, and can transfer Ti plasmid DNA to plants. A new vir helper plasmid was constructed from pTiChry5 by two rounds of sacB-mediated selection for deletion events. This plasmid, called pKPSF2, lacks both of the known T-regions and their borders. pKPSF2 failed to transfer Ti plasmid DNA to plants, but mobilized the T-region of a binary plasmid at an efficiency indistinguishable from those of pKYRT1 and the nopaline-type vir helper plasmid pMP90.

[Bulky superinfected tinea capitis of the scalp. Treatment by surgical resection and reconstruction by cutaneous expansion]. / Volumineuse teigne surinfectée du cuir chevelu. Traitement par résection chirurgicale et reconstruction par expansion cutanée.

BACKGROUND: Tinea capitis are usually cured by medical treatment. We present an unusual case which required a surgical treatment. CASE REPORT: A bulky infected kerion ignored for several weeks extended to a large part of the scalp of a 4-year-old girl. Antibiotics and antifungal agents were ineffective so that a total resection was necessary. The loss of substance was covered by a cutaneous graft; the large alopecia was secondarily repaired by a cutaneous expansion. Evolution has been followed for the past 10 years. CONCLUSION: It is exceptional that surgical treatment should be required for this condition.

[Fracture of the great trochanter treated by dynamic hip screw plate: measure of impaction according to fracture type]. / Fractures du massif trochantérien traitées par vis plaque DHS: mesure du glissement selon le type anatomique de fracture.

INTRODUCTION: The sliding plate has appeared to be a reliable answer for trochanteric fractures. However, impaction allowed by the material may, have an adverse effect (medialisation, shortening, jutting out of the lag screw). The aim of our study was to measure the sliding of the screw in order to assess the impaction in various types of fracture, according to the Ender classification. MATERIAL AND METHODS: Hundred trochanteric fractures have been treated between 1991 and 1993. Eighty four have been analyzed with a follow-up of three months after surgery. The average age was 80.1 years with a 4.2 sex ratio (16 males). One hundred and thirty five degrees free sliding plates were employed for fracture fixation. Full weight bearing was allowed in 78.6 per cent of patients. According to Ender classification, 35 per cent of fractures were type 1, 4 or 5. This was the first group. The second group consisted of types 2 and 3 and the third group of types 6, 7 and 8. The results were assessed on AP and lateral X-rays. The ratio between screw thread length (constant) and screw outside the barrel length, was used to measure impaction on AP view. Osteoporosis was evaluated according to Singh. RESULTS: Despite two screw protrusions out of the femoral head and two failures of the plate, we have observed a healing rate of 100 per cent after three months. Sliding averaged 6.2 mm in group 1, 10.5 mm in group 2 and 16.4 mm in groupe 3. Weight bearing had a low influence on the amount of sliding. DISCUSSION: Group 1 consists of fractures (types 1, 4 and 5) which are two parts fractures considered as stable. Group 2 corresponds to types 2 and 3 considered as intermediate fractures with relative stability. In group 3 (types 6, 7 and 8) we have observed major fracture instability. Osteoporosis does not seem to be the major factor regarding screw sliding. CONCLUSION: The sliding plate is reliable. However, complex fractures healed in a wrong position which is definitely not acceptable, especially for young patients. Therefore, we advise to avoid the use of sliding plate in case of Ender type 6, 7 and 8.