[Surgical strategy for neck burns and their sequelae]. / Stratégie chirurgicale des brûlures du cou et de leurs séquelles.

Burns of the neck are common and expose them to functional and aesthetic complications which are sometimes very serious. Care in the acute stage and treatment of sequelae contribute to a common goal of restoration: Maintain or recreate a chin-neck angle and get a quality skin as close as possible to the original skin, in terms of flexibility, texture, thickness and color. The wide variety of cases encountered requires knowing the armamentarium available to us today, and the anatomical basis and clinical underlying indications.

A Botrytis cinerea emopamil binding domain protein, required for full virulence, belongs to a eukaryotic superfamily which has expanded in euascomycetes.

A previous transcriptomic analysis of 3,032 fungal genes identified the Botrytis cinerea PIE3 (BcPIE3) gene to be up-regulated early in planta (A. Gioti, A. Simon, P. Le Pêcheur, C. Giraud, J. M. Pradier, M. Viaud, and C. Levis, J. Mol. Biol. 358:372-386, 2006). In the present study, BcPIE3 was disrupted in order to determine its implication in pathogenicity. BcPIE3 was shown to be a virulence factor, since the DeltaBcPIE3 mutant was blocked during the colonization of tomato and bean leaves, giving lesions reduced in size by at least 74%. Within the emopamil binding domain (EBD), BcPIE3 shows significant structural similarities to mammalian emopamil binding proteins (EBPs). Mammalian EBPs function as sterol isomerases, but an analysis of the sterol content and the results of growth inhibition experiments with the DeltaBcPIE3 strain indicated that BcPIE3 is dispensable for ergosterol biosynthesis. The systematic identification of EBD-containing proteins included in public databases showed that these proteins constitute a protein superfamily present only in eukaryotes. Phylogenetic analysis showed that the ancestral EBD-encoding gene was duplicated in the common ancestor of animals and fungi after the split from plants. Finally, we present evidence that the EBP phylogenetic clade of this superfamily has further expanded exclusively in euascomycetes, especially in B. cinerea, which contains three copies of the EBP gene.

Expression profiling of Botrytis cinerea genes identifies three patterns of up-regulation in planta and an FKBP12 protein affecting pathogenicity.

The ascomycete Botrytis cinerea is a broad-spectrum plant pathogen. Here, we describe the first macroarray transcriptomic study of the fungus in real-time infection conditions. Infection of Arabidopsis thaliana leaves by B.cinerea was monitored using macroarrays, containing 3032 genes. Variance analysis revealed that 7% of B.cinerea genes are differentially expressed during infection and allowed us to identify 27 genes significantly up-regulated in planta. Among them, two genes have already been associated with fungal pathogenicity, while eight genes have unidentified functions. The 27 genes were separated into three groups according to their expression profile. The first group showed maximal expression at the early stage following fungal penetration, the second one showed maximal expression at the outset of the colonization of plant leaves and the third group showed maximal expression when the colonization of plant leaves was completed. A gene of the last group (BcPIC5), which is homologous to FKBP12 proteins, was disrupted in order to determine its role in pathogenicity. At seven days post-inoculation, the lesions caused by the DeltaBcPIC5 mutant on bean leaves were reduced by 69% and did not further expand compared to the wild-type. These results confirm that transcriptomic analysis under infection conditions can be very valuable for the identification of fungal genes related to pathogenicity.

[Iatrogenic palatine necrosis by embolization of sphenopalatine arteries during management of a rebel epistaxis]. / Nécrose palatine iatrogène par embolisation des artères sphéno-palatines au décours du traitement d'une épistaxis rebelle.

INTRODUCTION: The treatment of epistaxis sometime requires an embolization. This may result in ischemic palate necrosis, oronasal communication and dental losses. The repair of these lesions is complex. OBSERVATION: A 53-year-old patient, suffering from high blood pressure and hypercholesterolemia, benefited from bilateral embolization of the sphenopalatine arteries in order to treat a persistent epistaxis. He developed a middle cerebral artery stroke in the aftermath. During the treatment of the neurological sequelae, a necrosis of the 2/3 of the posterior aspect of the hard palate was discovered. The angio-MRI showed an obstruction of both sphenopalatine arteries and of their vascular supplies resulting in a bilateral involvement of the alveolar bone. The diagnosis of iatrogenic palate necrosis was made. Tissue repair was successfully achieved by two loco-regional flaps. The dental rehabilitation was made by mean of a removable prosthesis. DISCUSSION: Palatine necrosis following embolization of the sphenopalatine arteries is uncommon. Ischemia resulted in a loss of substance in form of a punch, similar to noma's lesions. It could also be a consequence of the vascular background. The management of these lesions is complex and calls for forensic reflection about the iatrogenic origin.

[Amiloride hydrochloride nebulized by oxygen in the treatment of mucoviscidosis]. / Etude d'un nébulisat de chlorhydrate d'amiloride véhiculé par de l'oxygène dans la mucoviscidose.

Bronchial inhalation of amiloride chlorhydrate has been suggested for a number of years in the treatment of the pulmonary disease in cystic fibrosis. However, physiotherapy remains invaluable in the struggle in containing pulmonary infections in this disorder. Physiotherapy may lead to a transient fall in the arterial oxygen as can sessions of nebuliser therapy which precedes physiotherapy. The originality of the system studied and proposed here for the administration of medication depends on an electronic control which guarantees that there is the nebulisation of a constant volume of medication with each inspiration. Triggered by inspiration the active principle nebulised is perfectly co-ordinated to the inspiratory cycle. A comparative chromatography carried out in this slides of silica-gel have enabled us to verify the absence of any degradation of the active principle contained in the nebuliser solution during the ten minutes period of aerosol therapy. Thus a quantification of the administered dose of Amiloride Chlorhydrate is made possible. In association with oxygen it enables an efficacious preparation of respiratory physiotherapy to children. As the expiratory tubing ends in a filter the fraction of the oxygen inhaled by the patient remains very high; 80% (V/V) of the medication is emitted in the form of liquid particles whose diameter lies between 0.5 and 5 micrometers. In practice in order to humidify the sputum and to restore the oximetry before the physiotherapy sessions, it seemed to us an interesting possibility to administer Amiloride Chlorhydrate and oxygen simultaneously. This is achieved in hospital by using wall-mounted oxygen (at a gas pressure of 3.5 bars).(ABSTRACT TRUNCATED AT 250 WORDS)

[Free flaps in elective reconstructive surgery over a 20 year period]. / Transferts libres en chirurgie réparatrice (hors urgence): évolution des indications en 20 ans.

PURPOSE: The purpose of this study was to analyze the evolution of the practice of free flaps in the treatment of tumoral and traumatic pathologies. MATERIALS AND METHODS: This retrospective study was realized on 328 free transfers. The authors compared two periods each of 10 years: series 1 concerns 176 flaps realized from March 12th 1981 to March 13th 1991 (already published); series 2 concerns 152 flaps realized from December 1st 1994 to November 30th 2004. RESULTS: We noticed a decrease of the number of free flaps for lower limbs, a stabilization in the head and neck area and a clear increase in mammary reconstruction. Three donor sites were used in 89% of the cases: latissimus dorsi, forearm and rectus abdominis flaps. Others were used only one to seven times, for specific indications. Some surgical tactics saw their indication decrease (semi-free flap or "apple turnover" technique), others appeared (Y anastomoses). The number of failures decreased from one series to the other (from 5,7 to 2,6%). CONCLUSION: The variety of the flaps remains restricted. The choice is due to the constancy of their vascular anatomy, the size of the pedicles and the reproducibility of their teaching in a University Hospital.

Characterization of two cDNAs encoding auxin-binding proteins in Nicotiana tabacum.

The isolation and the characterization of two tobacco cDNAs, Nt-ERabp1 and Nt-ERabp2, homologous to Zm-ERabp1, encoding the major auxin-binding protein from maize coleoptiles, are described. Their predicted amino acid sequences correspond to proteins of ca. 21 kDa, in which the characteristic regions common to ABP1-related polypeptides are well-conserved. Southern analysis indicates that the genes corresponding to Nt-ERabp1 cDNA and Nt-ERabp2 cDNA derive respectively from Nicotiana tomentosiformis and Nicotiana sylvestris, the diploid progenitors of Nicotiana tabacum. Analysis of mRNA distribution in tobacco plants indicates that these two genes are preferentially expressed in flowers and growing seedlings. Whatever the tissue tested, Nt-ERabp1 mRNA is more abundant than Nt-ERabp2 mRNA. Furthermore, RT-PCR reveals developmental and organ-specific expression of these two genes in flower parts of tobacco plants. In particular, regulation of Nt-ERabp1 mRNA accumulation appears to be correlated with elongation growth of each floral organ. Recombinant Nt-ERabp1, produced in Escherichia coli, is recognized by antibodies raised against Zm-ERabp1.

Wound and ethylene induction of the ACC oxidase melon gene CM-ACO1 occurs via two direct and independent transduction pathways.

The enzyme ACC oxidase catalyses the last step of ethylene biosynthesis in plants. Expression of the melon ACC oxidase gene, CM-ACO1, is rapidly induced (within 10 min) by ethylene treatment or upon wounding in leaves. The inhibitor of ethylene action, 1-methylcyclopropene (1-MCP), inhibited the accumulation of ethylene-induced CM-ACO1 mRNA transcripts, while wound-induced expression of the gene was not affected. The 5'-untranslated region of the CM-ACO1 gene was fused to the beta-glucuronidase (GUS) reporter gene and the corresponding transgenic tobacco plants were analysed. Two separate regions of the CM-ACO1 promoter activated GUS expression in response to ethylene treatment and wounding. These results suggest that induction of CM-ACO1 gene expression occurs via two separate signal transduction pathways in response to wounding and ethylene treatment.

A novel immunological approach establishes that the auxin-binding protein, Nt-abp1, is an element involved in auxin signaling at the plasma membrane.

Interactions of a collection of monoclonal antibodies (mAbs) to the recombinant Nicotiana tabacum auxin-binding protein 1 (Nt-abp1) were extensively characterized using surface plasmon resonance. Dynamic interaction studies using combinations of Nt-abp1, synthetic peptides corresponding to conserved sequences within auxin-binding proteins, and the mAbs have shown that a number of the mAbs recognized discontinuous epitopes revealing the junction of distinct domains in the folded protein. In particular, the two putative auxin binding domains and the C terminus of the protein were shown to interact with each other in the folded protein. Using the auxin-induced electrical response of tobacco protoplasts as a functional assay, all the mAbs exhibited either auxin antagonist or hormonomimetic properties. These effects, measured for the first time in homologous conditions, confirm that Nt-abp1 is present at the plasma membrane and is involved in the activation of the auxin-dependent electrical response of tobacco protoplasts. Based on our surface plasmon resonance data, we propose that the key event leading to the activation of this auxin electrical response consists of a conformational change in Nt-abp1.