Determination of the optimal dose of ephedrine in the treatment of arterial hypotension due to general anesthesia in neonates and infants below 6 months old: the ephedrine study protocol for a randomized, open-label, controlled, dose escalation trial.

BACKGROUND: Arterial hypotension induced by general anesthesia is commonly identified as a risk factor of morbidity, especially neurological, after cardiac or noncardiac surgery in adults and children. Intraoperative hypotension is observed with sevoflurane anesthesia in children, in particular in neonates, infants younger than 6 months, and preterm babies. Ephedrine is commonly used to treat intraoperative hypotension. It is an attractive therapeutic, due to its dual action on receptors alpha and beta and its possible peripheral intravenous infusion. There are few data in the literature on the use of ephedrine in the context of pediatric anesthesia. The actual recommended dose of ephedrine (0.1 to 0.2 mg/Kg) frequently leads to a therapeutic failure in neonates and infants up to 6 months of age. The use of higher doses would probably lead to a better correction of hypotension in this population. The objective of our project is to determine the optimal dose of ephedrine for the treatment of hypotension after induction of general anesthesia with sevoflurane, in neonates and infants up to 6 months of age. METHODS: The ephedrine study is a prospective, randomized, open-label, controlled, dose-escalation trial. The dose escalation consists of 6 successive cohorts of 20 subjects. The doses studied are 0.6, 0.8, 1, 1.2, and 1.4 mg/kg. The dose chosen as the reference is 0.1 mg/kg, the actual recommended dose. Neonates and infants younger than 6 months, males and females, including preterm babies who undergo a surgery with general anesthesia inducted with sevoflurane were eligible. Parents of the subject were informed. Then, the subjects were randomized if presenting a decrease in mean blood pressure superior to 20% of their initial mean blood pressure (before induction of anesthesia), despite a vascular filling with sodium chloride 0.9%. The primary outcome is the success of the therapy defined as an mBP superior to 80% of the baseline mBP (prior to anesthesia) within 10 min post ephedrine administration. The subjects were followed-up for 3 days postanesthesia. DISCUSSION: This study is the first randomized, controlled trial intending to determine the optimal dose of ephedrine to treat hypotension in neonates and infants below 6 months old. TRIAL REGISTRATION: ClinicalTrials.gov NCT02384876 . Registered on March 2015.

Alfalfa leaf curl virus is transmitted by Aphis craccivora in a highly specific circulative manner.

Two members of the genus Capulavirus (Geminiviridae) are transmitted by aphids including Alfalfa leaf curl virus (ALCV) transmitted by Aphis craccivora. The capulavirus Euphorbia caput-medusae latent virus was shown here to be transmitted also by A. craccivora, using the population EuphorbiaSA. ALCV was transmissible by several A. craccivora populations including Robinia, but not the EuphorbiaSA population, reflecting a high transmission specificity. Typical of the circulative-persistent mode of transmission, ALCV persists through insect molts. ALCV accumulation and localization were analyzed in whole insects, midguts, hemolymphs, and heads of aphids from vector and non-vector populations of A. craccivora and from the non-vector species Acyrthosiphon pisum. Vector and non-vector populations could be distinguished by contrasted virus accumulations and midgut intracellular localization consistent with a gut barrier to the transmission of ALCV in A. pisum and a primary salivary gland barrier in A. craccivora.

[The obese patient and acute respiratory failure, a challenge for intensive care]. / Le patient obèse en insuffisance respiratoire aiguë, un défi pour la réanimation.

As a result of the constantly increasing epidemic of obesity, it has become a common problem in the intensive care unit. Morbid obesity has numerous consequences for the respiratory system. It affects both respiratory mechanics and pulmonary gas exchange, and dramatically impacts on the patient's management and outcome. With the potential for causing devastating respiratory complications, the particular anatomical and physiological characteristics of the respiratory system of the morbidly obese subject should be carefully taken into consideration. The present article reviews the management of obese patients in respiratory failure, from noninvasive ventilation to tracheostomy, including postural and technical issues, and explains the physiologically based ventilatory strategy both for NIV and invasive mechanical ventilation up to the weaning from the ventilatory support.

Genetic structure of the invasive pest Bemisia tabaci: evidence of limited but persistent genetic differentiation in glasshouse populations.

The geographic range of plant pests can be modified by the use of glasshouses. Bemisia tabaci, originating from warm to hot climates, has been shown to be a complex of distinct genetic groups with very limited gene flow. The genetic structure of this pest was studied in glasshouses in southern France, a region beyond the northern limit of its open-field development area in Europe. Seven microsatellite loci were scored in 22 populations sampled from various regions over 3 years. Two genetic groups were distinguished using a Bayesian clustering method and were assigned to the so-called biotypes B and Q using the gene sequence of cytochrome oxidase 1 (CO1). All but one population corresponded to biotype Q, even though only biotype B was previously reported. Despite the enclosed environment of glasshouses and their expected isolation due to low outdoor survival during the winter, only limited differentiation among biotype Q glasshouses was observed. A single sample site was notable for a decrease in expected heterozygosity and the mean number of alleles over the years. The lack of spatial genetic structure among biotype Q populations was indicative of a recent colonization event combined with large dispersal at all spatial scales. This migration pattern of biotype Q populations was further supported by additional CO1 sequences, since individuals from France, Asia and America exhibited 100% nucleotide identity. The evolution of genetic diversity observed in glasshouses in France is part of the worldwide invasion of biotype Q, which is discussed in light of human activities.

[Selective dorsal T1-T6 fusion of the thoracic spine and effects on thorax growth: experimental study in prepuberal New Zealand White rabbits]. / Influence de l'arthrodèse vertébrale dorsale sélective T1-T6 sur la croissance thoracique: étude expérimentale chez des lapins New Zealand White prépubertaires.

PURPOSE OF THE STUDY: The purpose of this study is to assess the consequences brought by selective dorsal arthrodesis of thoracic spine (T1-T6) to the growth of spine and thoracic volume in operated and sham-operated New Zealand White rabbits, between prepubertal age and the end of somatic growth, through the study of computerised tomography (CT) scans periodically carried out on them after arthrodesis surgery. MATERIAL AND METHODS: Nine female rabbits were subjected to surgery for selective dorsal arthrodesis of the upper thoracic spine and three were sham-operated. Surgery was performed at age nine weeks, before the onset of puberty. Two "C"-shaped titanium bars were placed beside the spinous processes of the thoracic vertebrae to obtain a selective posterior arthrodesis of the first six thoracic vertebrae. Under general anesthesia, three CT scans were performed, 10 (t1), 55 (t2) and 139 (t3) days after surgery. Measures were obtained by Myrian Pro software for three different groups: group 1 with complete fusion, group 2 with incomplete fusion, group 3 sham-operated. RESULTS: The total dorsal and ventral lengths of thoracic vertebral bodies in the spinal segment T1-T6 was smaller in group 1 and group 2 than in group 3, whereas no differences were observed between the three groups in the T7-T12 segment. The average of the dorsoventral/laterolateral thoracic diameter ratio at fused levels was less than 1 in group 1 as well as in group 2; on the contrary, in group 3 it was greater than 1. The sternum and lung volume grow less. CONCLUSIONS: Vertebral arthrodesis in the treatment of progressive idiopathic scoliosis in prepubertal patients is not ideal, but is still a choice in treating major deformities of the spine. Postoperative assessment of spinal deformity is essential, feasible and recordable through CT scans. Dorsal arthrodesis in prepubertal rabbits changes thoracic growth patterns. In operated rabbits, the dorsoventral thoracic diameter grows more slowly than the laterolateral thoracic diameter. The sternum, the total lengths of thoracic vertebral bodies in the spinal segment T1-T6 and lungs grow less. The Crankshaft phenomenon is evident at the fused vertebral levels where there is a reduction of thoracic kyphosis.

The typical RB76 recombination breakpoint of the invasive recombinant tomato yellow leaf curl virus of Morocco can be generated experimentally but is not positively selected in tomato.

TYLCV-IS76 is an unusual recombinant between the highly recombinogenic tomato yellow leaf curl virus (TYLCV) and tomato yellow leaf curl Sardinia virus (TYLCSV), two Mediterranean begomoviruses (Geminiviridae). In contrast with the previously reported TYLCV/TYLCSV recombinants, it has a TYLCSV derived fragment of only 76 nucleotides, and has replaced its parental viruses in natural conditions (Morocco, Souss region). The viral population shift coincided with the deployment of the popular Ty-1 resistant tomato cultivars, and according to experimental studies, has been driven by a strong positive selection in such resistant plants. However, although Ty-1 cultivars were extensively used in Mediterranean countries, TYLCV-IS76 was not reported outside Morocco. This, in combination with its unusual recombination pattern suggests that it was generated through a rare and possibly multistep process. The potential generation of a recombination breakpoint (RB) at locus 76 (RB76) was investigated over time in 10 Ty-1 resistant and 10 nearly isogenic susceptible tomato plants co-inoculated with TYLCV and TYLCSV clones. RB76 could not be detected in the recombinant progeny using the standard PCR/sequencing approach that was previously designed to monitor the emergence of TYLCV-IS76 in Morocco. Using a more sensitive PCR test, RB76 was detected in one resistant and five susceptible plants. The results are consistent with a very low intra-plant frequency of RB76 bearing recombinants throughout the test and support the hypothesis of a rare emergence of TYLCV-IS76. More generally, RBs were more scattered in resistant than in susceptible plants and an unusual RB at position 141 (RB141) was positively selected in the resistant cultivar; interestingly, RB141 bearing recombinants were detected in resistant tomato plants from the field. Scenarios of TYLCV-IS76 pre-emergence are proposed.

Decreased operator X-ray exposure by optimized fluoroscopy during radiofrequency ablation of common atrial flutter.

PURPOSE: To evaluate operator and patient irradiation during radiofrequency ablation (RFA) of common atrial flutter (AF) using three different fluoroscopy settings. MATERIAL AND METHOD: A total of 38 patients who underwent RFA of AF with three different fluoroscopy settings (low dose, standard dose and collimated field) were included. Twelve patients (11 men, 1 woman; mean age, 67±12 [SD]years) were included in the low dose group (3.75 frames per second), 13 patients (13 men; mean age, 66±8 [SD]years) were included in the standard dose group (7.5 frames per second) and 13 patients (13 men; mean age, 71±12 [SD]years) were included in the collimated field group (7.5 frames per second). Operator and patient exposure were compared between groups. RESULT: No differences in procedure time and radiation exposure were found between the three groups. In the low dose group, mean operator X-ray exposures of eye-lens (4.7±2.9 [SD]µSv/h; range: 0.9-10.5µSv/h), whole body (1.6±1.2 [SD]µSv/h; range 0.5-3.6µSv/h) and hand skin (11.1±10.8 [SD] µSv/h; range 2.4-35.4µSv/h) were significantly lower than those in the standard dose group (P<0.001). Significant patient dose reduction was found between low dose group (0.7±0.4 [SD]Gy/h; range: 0.3-0.9Gy/h) and standard (1.7±0.5 [SD]Gy/h; range: 0.8 to 3.9Gy/h) and collimated (1.8±0.5 [SD]Gy/h; range: 0.7-3.0Gy/h) groups (P<0.01). CONCLUSION: The use of a low dose setting (3.75 f/s) during fluoroscopy dramatically reduces operator's irradiation during RFA of AF by a mean of 90%.

Kangaroo supported diagonal flexion positioning: New insights into skin-to-skin contact for communication between mothers and very preterm infants.

OBJECTIVE: Skin-to-skin contact shows benefits in the relationship developed between a mother and her premature infant. In the skin-to-skin session, face-to-face exchanges are impossible in vertical infant positioning. We therefore undertook an observational, prospective, single-center study using kangaroo "supported diagonal flexion" (SDF) positioning. The first aim was to evaluate the safety of kangaroo SDF positioning compared to the usual vertical positioning. The second aim was to evaluate SDF positioning on early communication between the mother and her infant and to improve their well-being. PARTICIPANTS AND SETTING: Fifteen mothers and their very premature infants (birth 26<32 weeks' gestation) were assigned to one of the two kangaroo positioning modes, either the current vertical positioning (n=7) or SDF positioning (n=8). DESIGN: Physiological variables and critical events were recorded before, during, and after ten successive skin-to-skin contact sessions. The first and last sessions were videotaped to allow later behavioral measurements. Mothers' risk for depression and feelings about the way they experienced communication with their infant were assessed through questionnaires. RESULTS: In terms of the infant's physiology, no negative effects were associated with SDF positioning in comparison with the usual vertical positioning. SDF positioning led to fewer disorganized gestures, negative vocalizations, and drowsiness, in favor of more deep sleep. SDF led to more mother-infant eye-to-eye contact as well as maternal vocalizations, smiles, and caressing, although these differences did not reach significance. The score for the risk of postnatal depression decreased significantly between the first and the last session in the SDF group, whereas it did not change in the vertical positioning group. CONCLUSION: These results support the idea that the kangaroo SDF positioning technique is physiologically safe, has obvious immediate benefits on mothers' infant-directed communicative behaviors, and respects the baby's naturally flexed and asymmetrical tonic neck posture. It is an innovative, inexpensive, easy-to-use technique in daily practice, by all healthcare professionals working in a neonatal intensive care unit. These data suggest that the current kangaroo positioning technique could be improved. More studies are needed to confirm the benefits and safety of the kangaroo SDF positioning in larger groups of preterm infants.

Monitoring the dynamics of emergence of a non-canonical recombinant of Tomato yellow leaf curl virus and displacement of its parental viruses in tomato.

Recombinant viruses are increasingly being reported but the dynamics of their emergence is rarely documented. A new recombinant Tomato yellow leaf curl virus (TYLCV-IS76) was detected for the first time in 2010 in Southern Morocco (Souss). An original diagnostic tool was needed to fit its unusual recombination profile. Although IS76 was detected following the appearance of Tylc symptoms on tolerant tomato plants, symptoms could not be associated to IS76 or to a synergy with criniviruses. According to infection profiles of Tylc-associated viruses determined on 879 plant samples collected between 1998 and 2014 and a Bayesian inference applied to genomic sequences of representatives of TYLCV, IS76 emerged in Southern Morocco at the end of the 1990s, replaced the parental viruses between 2004 and 2012 in Souss and is spreading towards the North of Morocco. The emergence of IS76 coincides with the increasing use of tolerant cultivars in the 2000s.

Four families with loss of function mutations of the thyrotropin receptor.

We observed four families with loss of function mutations of the TSH receptor gene. One patient had a homozygous Pro162 Ala substitution. The three other were compound heterozygotes: 1) Gln324-->Stop and Asp410 Asn2), Cys41 Ser and Phe525 Leu, 3) Cys390 Trp and Trp546-->Stop. In all patients, the plasma TSH concentration was increased, whereas T3 and T4 concentrations were normal. The TSH levels were normal in the heterozygous parents. These results confirmed the recessive character of TSH receptor defects. Expression of the various mutated receptors in transfected COS-7 cells demonstrated the impairment of their function. We studied the expression of the receptors on the cell surface by immunofluorescence, their ability to bind hormone, and their capacity to activate adenylate cyclase. Some mutations allowed us to identify sites that are especially important for receptor function. The substitution Cys390 Trp abolished high affinity hormone binding. Receptor mutated at Asp410 Asn bound the hormone normally, but failed to activate adenylate cyclase. This result underscores the role of this acidic extracellular residue, close to the first transmembrane segment, in signal transmission. The Phe525 Leu substitution also markedly impaired adenylate cyclase activation, underlining the importance of the second intracellular loop in receptor signaling.

Amino acids and memory consolidation in the cricket. II: Effect of injected amino acids and opioids on memory.

The effect of injections of selected amino acids on memory, given before a maze-learning, was investigated. Thirsty crickets (Pteronemobius sp.) were trained to turn only to one side of a symmetrical Y-shaped maze using reinforcements with water. The insects retained the learned task 24 hr later. N2 anoxia applied immediately after training produced retrograde amnesia. Injections of Ala, Arg, Gln or morphine prior to training blocked the amnesic action of anoxia, whereas those of Cys, Met, Pro, Orn, octopamine or naloxone did not. Naloxone blocked long-term memory formation, but not learning, whereas Pro and Orn blocked both. The antiamnesic effect of morphine and Arg, but not that of Ala, was blocked by naloxone. A hypothesis assigning a neuromodulatory role to some amino acids is put forward.

Amino acids and memory consolidation in the cricket. I: Changes in the titer of free amino acids in nervous tissue after learning.

The involvement of certain amino acids in the memory consolidation process was investigated in the cricket Pteronemobius sp. Thirsty crickets were trained to constantly turn to one side of a symmetrical Y-shaped maze using reinforcement with water. Controls were trained to turn to both sides of the maze according to a random program. Animals were sacrificed immediately after training and free amino acid fractions were isolated from whole brain, subesophagic, prothoracic, mesothoracic and metathoracic ganglia homogenates and analyzed by high pressure liquid chromatography. A complex pattern of variation in the titer of amino acids emerged after learning, where the changes differed among the various ganglia. The most conspicuous change was an increase in the levels of urea and an amino acid-like compound related to the urea cycle, in all ganglia except the subesophagic one, if compared to controls. Arginine increased in the subesophagic ganglion, but decreased significantly in the metathoracic ganglion. The variation of ganglionic amino acid levels and its possible relation to mnemonic processes is discussed.

First Report of Tomato Yellow Leaf Curl Geminivirus in Morocco.

In July 1998, shortened internodes, reduced leaf size, leaf curling, and bushy plants were observed in tomato crops in the coastal region near Casablanca, Morocco. The symptoms were similar to those described for tomato yellow leaf curl virus (TYLCV) disease. During September, the disease was present in more than 130 ha of outdoor and protected crops. Economic losses ranged between 20 and 100%. Similar symptoms were observed in tomato crops in the northeastern region of Morocco. During the same period, high populations of Bemisia tabaci (Gennadius) were observed on tomato, sweet pepper, and several weeds, including Sonchus oleraceus L., Chenopodium sp., Malva parviflora L., and Datura stramonium L. Attempts to control whiteflies with insecticides generally were unsuccessful. Using a pair of degenerate primers (3) that are expected to amplify a region of the A component of begomoviruses between the intergenic conserved nonanucleotide sequence and the first 5' quarter of the capsid protein gene, an expected size product of 500 bp was obtained from six tomato leaf samples collected near Casablanca: four were obtained from symptomatic plants and two from apparently symptomless plants. A product of the same size was obtained from a sample of tomato infected with a TYLCV isolate from Reunion Island, France (2), but not from a sample from symptomless tomato plants from Reunion. The polymerase chain reaction (PCR) product obtained from one symptomatic sample from Morocco was cloned and sequenced (2). The resulting sequence (EMBL no. AJ133491) was at least 95.2% identical to sequences of TYLCV isolates from the Dominican Republic (EMBL no. AF024715), Cuba (EMBL no. AJ223505), Israel (EMBL no. X15656; EMBL no. X76319 for the mild clone), Spain (EMBL no. AF071228), and Reunion (EMBL no. AJ010790). Based on sequence comparisons, the tomato leaf sample was infected by a geminivirus isolate belonging to the Israeli species of TYLCV and was most closely related to the Dominican Republic isolate (98.4% nucleotide identity). In symptomless plants from which a 500-bp PCR product was obtained, infection may have been in an early stage. This is consistent with the fact that in the 2-ha field from which tomato samples were collected, only 4% of the plants exhibited TYLCV symptoms at the time of collection, whereas at least 70% of plants showed symptoms later, requiring the farmer to abandon the crop. The presence of the Eastern Mediterranean TYLCV species in a Western Mediterranean country is not a new observation; this virus has been described in Spain and Portugal (1). In Morocco, TYLCV symptoms were observed during the 1996 to 1997 growing season, following importation of grafted tomato plants from the Netherlands, by a farmer from the Casablanca region. References: (1) J. Navas-Castillo et al. Plant Dis. 83:29, 1999. (2) M. Peterschmitt et al. Plant Dis. 83:303, 1999. (3) P. Umaharan et al. Phytopathology 88:1262, 1998.

First Report of Tomato Yellow Leaf Curl Virus in Réunion Island.

In September 1997, stunting, reduced leaf size, leaf curling, and yellow margins were observed on tomato plants on a farm on the south coast of Réunion, a French island belonging to the Mascarenes archipelago. To our knowledge, these symptoms appeared to be characteristic of a tomato yellow leaf curl virus (TYLCV) infection. Diseased plants gave positive reactions with a triple antibody sandwich-enzyme-linked immunosorbent assay (TAS-ELISA), using ADGEN antibodies specific for begomoviruses (1). The serological results were confirmed by polymerase chain reaction (PCR) with a pair of degenerate primers-MP16, 5'-CCTCTAGATAATATTAC(C/T)(G/T)(G/A)(A/T)(T/G)G(G/A)CC-3' and MP82, 5'-CGGAATTC(T/C)TGNAC(C/T)TT(G/A)CANGGNCC(T/C)T C(G/A)CA-3'-designed by Malla Padidam (ILTAB, San Diego, CA) to amplify a region of the A component of begomoviruses, between the intergenic conserved nonanucleotide sequence (TAATATTAC) and the first 5' quarter of the capsid protein gene. A 500-bp PCR product was obtained from a symptomatic plant but not from a healthy looking one. After cloning the PCR product in a pGEM-T Easy vector (Promega, Madison, WI) and sequencing it with plasmid-specific primers (SP6, T7), the sequence was compared with the sequences of the NCBI data base, with the use of BLAST. Nineteen sequences among those producing the highest scoring segment pairs were compared with each other and with the 500-bp PCR product from Réunion by the Clustal method of MegAlign (DNASTAR, London). The Réunion sequence (AJ010790) was at least 94% similar to sequences of TYLCV isolates from the Dominican Republic (AF024715), Cuba (AJ223505), and Israel (X15656, X76319 for the mild clone). Based on these results, it appeared that the analyzed tomato plant was infected by a geminivirus isolate belonging to the Israeli species of TYLCV. A preliminary survey was carried out from December 1997 to April 1998 in both outdoor and protected tomato crops. Infected plants were detected by TAS-ELISA in 52 of the 123 locations visited. Severe economic losses were observed: 14 locations with 60 to 100% yield reduction and 11 locations with 40 to 60% yield reduction. All the infected samples were collected in the leeward coast, which is the driest region of the island. Although Bemisia tabaci (Gennadius) has been recorded since 1938 in Réunion (2), it has been observed on tomato crops only since 1997 and population levels were low compared with those of Trialeurodes vaporariorum Westwood. During the first six months of 1998, B. tabaci was found on Euphorbia heterophylla L., Lantana camara L., Solanum melongena L., S. nigrum L., and Phaseolus vulgaris L. These host plants often occur near infected tomato crops. References: (1) S. Macintosh et al. Ann. Appl. Biol. 121:297, 1992. (2) L. Russell and J. Etienne. Proc. Entomol. Soc. Wash. 87:202, 1985.

First Molecular Identification of a Begomovirus Isolated from Tomato in Madagascar.

In April 2001, reduced leaf size, leaf curling, yellowing symptoms, and reduced yield were observed in tomato plants in the southwestern (Toliary, Morondava, Miandrivazo) and northern (Antsiranana) regions of Madagascar. Symptoms were similar to those caused by Tomato yellow leaf curl virus (TYLCV, genus Begomovirus, family Geminiviridae). Large populations of Bemisia tabaci (Gennadius) were observed colonizing tomato, other crops, and weeds. Leaf samples were collected from tomato plants from 14 sites located in northern, central, and southern Madagascar. Two plant samples collected near Antsiranana, one sample near Morondava, and one sample near Toliary were positive in triple-antibody sandwich enzyme-linked immunosorbent assay using a begomovirus-specific antibody purchased from ADGEN (Nellies Gates, Auchincruive, Scotland, UK). A 500-bp product was amplified and cloned (2) from two leaf samples collected near Toliary and one near Morondava using a pair of degenerate primers that are expected to amplify a region of the A component of begomoviruses between the intergenic conserved nonanucleotide sequence and the first 200 nucleotides of the coat protein ORF. The sequences corresponding to the two Toliary samples (GenBank Accession Nos. AJ422123 and AJ422124) and the Morondava sample (GenBank No. AJ422125) showed the most significant alignments (NCBI, BLAST) with begomoviruses, Tobacco leaf curl virus from Zimbabwe (GenBank Accession No. AF 350330) and Tomato leaf curl virus from Tanzania (GenBank Accession No. U73498) with 76 to 77% nucleotide identity (Clustal method, MegAlign, DNASTAR, London) and South African cassava mosaic viruses (SACMV GenBank Accession Nos. AJ422132 and AF155806) and East African cassava mosaic viruses from Malawi (GenBank Accession Nos. AJ006459 and AJ006460) with 74 to 75.5% nucleotide identity. The low nucleotide identity suggests that the begomovirus isolated from tomato in Madagascar is a new species. Since the core region of the coat protein gene is a molecular marker for provisional classification of begomoviruses (1), this region was amplified for the Morondava isolate with degenerate primers. The 519nt core fragment obtained showed the most significant alignments with SACMV (GenBank Accession No. AF329227), Cassava geminivirus from Mozambique (GenBank Accession No. AF329240), and with TYLCV (GenBank Accession Nos. AB014346 and AF105975) with 81 to 82% nucleotide identity. According to the current taxonomic criteria (4), the begomovirus from Madagascar is a new one that is related to begomoviruses from the southern part of Africa and to TYLCV and is provisionally named Tomato yellow leaf curl Morondava virus (TYLCMV). Tomato yellow leaf curl disease was previously described in Madagascar by Reckhaus (3) who presumed that it was caused by TYLCV. Although symptoms in the tomato plant from which TYLCMV was isolated were similar to those induced by TYLCV, TYLCV was not detected in our samples. References: (1) J. K. Brown et al. Arch. Virol. 146:1581, 2001 (2) M. Peterschmitt et al. Plant Dis. 83:303, 1999. (3) P. Reckhaus, Maladies et ravageurs des cultures maraîchères: A l'exemple de Madagascar. GTZ, Weikersem, 1997. (4) M. H. V. van Regenmortel et al. Virus Taxonomy. Seventh Rep. Int. Comm. Taxon. Viruses. Academic Press, San Diego, 2000.

[Histologic and ultrastructural forms of benign tumors of the kidney with renin secretion. Functional implications]. / Formes histologiques et ultrastructurales des tumeurs bénignes du rein avec sécrétion de rénine. Incidences fonctionnelles.

Two cases of renal benign renin-secreting tumours (juxta-glomerular cells tumors) have been compared by optical and electron microscopy. The first is the simplest type of tumoral form which can be observed. This contains secretory cells similar to epitheloid cells of normal juxta-glomerular apparatus, which multiply in well developed arteriolar and capillary network. As in afferent arterioles of glomeruli, transformation of parietal smooth cells in secretory cells can be observed. This results in the presence of intermediate cells, containing both contractile filaments and secretory granules. This tumor does not contain nerves. The second tumor has a more complex structure. Beside usual secretory cells, tubular formations and adrenergic amyelinic nerves are observed. Tubes and nerves have been described separated in many juxta glomerular cells tumors but had never been observed in association. Tubules with small lumen are made of highly dystrophic cells. High concentration of "kallikrein" in tumoral tissue, strongly suggests that they proceed from distal tubule. Unmyelinated nerves from varicosities containing densely cored vesicles characteristics of adrenergic nerves, and synaptic terminal endings on secretory cells. The presence of nerve bundles suggest a nervous regulation of tumoral secretions. This hypothesis is confirmed by dynamic explorations of sympathetic system.

[Urogenital amyloidosis: clinico-pathological study of 8 cases]. / Amylose urogénitale: étude anatomo-clinique à propos de 8 cas.

Amyloidosis of the genito-urinary tract is uncommon. We report 8 cases, often misdiagnosed as a neoplastic process (6/8). Amyloidosis was localized in the bladder (3 cases), in the ureter (1 case) and in the prostate and/or seminal vesicles (4 cases). The amyloid protein was characterized in 7 cases by immunohistochemistry. Among the bladder and ureter amyloidosis, 2 cases were classified as AL lambda amyloidosis and one case as AA amyloidosis in a patient with long history of chronic arthritis. In the fourth case, the deposits could not be identified. Nevertheless an AL amyloidosis might be suggested. Two cases of prostate and/or seminal vesicles amyloidosis were stained with an anti-B2M antibody, in hemodialyzed patients. The 2 others, positive with the anti-Transthyretina antibody, were classified as senile amyloidosis. This small series illustrated the heterogeneous pathogenic types of amyloidosis in the urogenital tract and emphasized the interest of immunohistochemistry to identify the chemical composition of these deposits.

[A case of neonatal Meckel's diverticulum with prenatal ultrasound diagnosis]. / Un cas de diverticule de Meckel néonatal avec signes échographiques anténatals.

We report one case of cystic Meckel's diverticulum detected by fetal ultrasound echography with an anechogen image during the third trimester of pregnancy. The interest of this antenatal diagnose is to quickly manage surgical care at birth.

[Cyclophosphamide during pregnancy: a safe prescription]. / Cyclophosphamide en cours de grossesse: une prescription acceptable.

Cyclophosphamide is an alkylating agent used to treat haematologic malignant diseases and multisystem diseases with progressive glomerulonephritis. It is rarely prescribed during pregnancy. We report a case of Henoch-Schönlein purpura discovered at the end of the first trimester of pregnancy. Despite steroid therapy, glomerulonephritis worsened and 100 mg/day cyclophosphamide per os was administered from 28th week till delivery. The infant, prematurely born, was normal and did not have any haematological disorder. Congenital malformations are often reported (5 out of 19 newborns exposed in utero to cyclophosphamide), but in all those cases, there was another potentially teratogenic agent: either radiotherapy or another antineoplastic drug. Therefore, if mother's life is in jeopardy, cyclophosphamide therapy should be given and not postponed.