g Factor of the

The gyromagnetic factor of the low-lying E=251.96(9) keV isomeric state of the nucleus ^{99}Zr was measured using the time-dependent perturbed angular distribution technique. This level is assigned a spin and parity of J^{π}=7/2^{+}, with a half-life of T_{1/2}=336(5) ns. The isomer was produced and spin aligned via the abrasion-fission of a ^{238}U primary beam at RIKEN RIBF. A magnetic moment |µ|=2.31(14)µ_{N} was deduced showing that this isomer is not single particle in nature. A comparison of the experimental values with interacting boson-fermion model IBFM-1 results shows that this state is strongly mixed with a main νd_{5/2} composition. Furthermore, it was found that monopole single-particle evolution changes significantly with the appearance of collective modes, likely due to type-II shell evolution.

Posttranslational oligomerization and cooperative acid activation of mixed influenza hemagglutinin trimers.

The influenza virus hemagglutinin (HA) is a well-characterized integral membrane glycoprotein composed of three identical subunits. We have analyzed the formation of mixed trimers in cells expressing two different HA gene products. The results show efficient and essentially random assembly of functional hybrid trimers provided that the HAs are from the same HA subtype. Trimerization is thus a posttranslational event, and subunits are recruited randomly from a common pool of monomers in the endoplasmic reticulum. Mixed trimers were not observed between HAs derived from different subtypes, indicating that the trimerization event is sequence specific. Mixed trimers containing mutant subunits were, moreover, used to establish that the acid-induced conformational change involved in the membrane fusion activity of HA is a highly cooperative event.

A proinflammatory peptide from Helicobacter pylori activates monocytes to induce lymphocyte dysfunction and apoptosis.

Infection with Helicobacter pylori causes chronic gastritis, which is characterized by a dense mucosal infiltration by inflammatory cells such as monocytes/macrophages. H. pylori-induced inflammation is a risk factor for the development of gastric adenocarcinoma, but the mechanisms involved in H. pylori-associated carcinogenesis are poorly understood. A cecropin-like H. pylori peptide, Hp(2-20), was found to be a monocyte chemoattractant and activated the monocyte NADPH-oxidase to produce oxygen radicals. The receptors mediating monocyte activation were identified as FPRL1 and the monocyte-specific orphan receptor FPRL2. Hp(2-20)-activated monocytes inhibited lymphocytes with antitumor properties, such as CD56+ natural killer (NK) cells and CD3epsilon+ T cells. The changes observed in NK cells and T cells--a reduced antitumor cytotoxicity, downregulation of CD3zeta expression, and apoptosis--were mediated by Hp(2-20)-induced oxygen radicals. Histamine, a gastric mucosal constituent, rescued NK cells and T cells from inhibition and apoptosis by suppressing Hp(2-20)-induced oxygen radical formation. We conclude that H. pylori expression of this monocyte-activating peptide contributes to its ability to attract and activate monocytes and reduces the function and viability of antineoplastic lymphocytes. These novel mechanisms may be subject to local, histaminergic regulation in the gastric mucosa.

Seasonal variation in chronic heart failure hospitalizations and mortality in France.

BACKGROUND: Circannual variation in blood pressure and in the incidence of acute myocardial infarction is well known but has not been investigated in chronic heart failure. This report describes and compares the seasonal variation of chronic heart failure hospitalizations and mortality in the French population. METHODS AND RESULTS: All deaths that occurred among French adults over the period 1992 to 1996 (n=138 602) and all discharges by adults in French public hospitals for chronic heart failure over the period 1995 to 1997 (n=324 013) were examined retrospectively. First, chronic heart failure deaths in France occurred with a striking annual periodicity and peaked in winter (December through January), both in the overall population and in subgroups defined by age (>44 years old) and sex. The distribution of cumulative monthly deaths differed by nearly 35%, ranging from a peak of 20% above average in January to 15% below average in August (Roger's test: P<0.001). Second, hospitalizations for chronic heart failure in French public hospitals followed a similar seasonal pattern (P<0.001), with a winter-spring predominance (+7% to +10% from December through April). Third, for persons >/=85 years old, excess hospitalizations occurred earlier in the year, with marked synchronized peaks in January for both mortality and hospitalizations (P<0.001). CONCLUSIONS: Clear seasonal variations in adult chronic heart failure hospitalizations and deaths were identified. The considerable economic impact on health care services warrants further epidemiological investigations and a more comprehensive approach to disease management.

17beta-estradiol modulates UVB-induced cellular responses in estrogen receptors positive human breast cancer cells.

Genotoxic agents produce numerous cellular responses that are principally dedicated to maintain or restore DNA integrity. In human cells, nucleotide excision repair (NER) is one of the major pathways for the repair of DNA damage such as ultraviolet (UV) radiation-induced lesions. Endocrine disrupting compounds are environmental contaminants that interfere with the function of the endocrine system. Among them, the natural estrogen 17beta-estradiol (E(2)) exhibits the most potent activity. Some proteins directly or indirectly involved in NER also fulfill other functions such as transcription, DNA damage checkpoints or cell cycle. Moreover, steroids such as E(2) are believed to interact with a large number of proteins including some involved in NER and DNA damage checkpoint control. We therefore investigated the potential modulation of genotoxic stress-cells responses by E(2) treatment. Estrogen receptor (ER)-positive human breast cancer cells were submitted to E(2) before and/or after UVB irradiation and thereafter the repair kinetics of UV-induced DNA damage were evaluated. We report here that the repair rate of UVB-induced DNA damage is enhanced when cells are submitted to an estrogenic stimulation. Moreover, our results suggest that this response could be mediated by cell cycle regulatory proteins in a p53-independent manner.

Exploration of nucleotide binding sites in the mitochondrial membrane by 2-azido-[alpha-32P]ADP.

The ADP/ATP carrier of beef heart mitochondria is able to bind 2-azido-[alpha-32P]ADP in the dark with a Kd value of congruent to 8 microM. 2-Azido ADP is not transported and it inhibits ADP transport and ADP binding. Photoirradiation of beef heart mitochondria with 2-azido-[alpha-32P]ADP results mainly in photolabeling of the ADP/ATP carrier protein; photolabeling is prevented by carboxyatractyloside, a specific inhibitor of ADP/ATP transport. Upon photoirradiation of inside-out submitochondrial particles with 2-azido-[alpha-32P]ADP, both the ADP/ATP carrier and the beta subunit of the membrane-bound F1-ATPase are covalently labeled. The binding specificity of 2-azido-[alpha-32P]ADP for the beta subunit of F1-ATPase is ascertained by prevention of photolabeling of isolated F1 by preincubation with an excess of ADP.

Seasonal variation in cryptogenic and noncryptogenic hemoptysis hospitalizations in France.

STUDY OBJECTIVE: To determine the potential role of seasonality in hospitalizations for cryptogenic and noncryptogenic hemoptysis in the French population. DESIGN: Retrospective analysis of hospital discharge data from a National Register. SETTING: All 29 French university hospitals, between July 1, 1994, and June 30, 1997. PATIENTS: Two thousand six hundred seventy-seven and 3,672 adult hospitalizations for cryptogenic and other hemoptysis, respectively. MEASUREMENTS: Cumulative monthly averages were determined, expressed as the percentage above or below the average monthly value during the entire study period. RESULTS: The distribution of cumulative monthly hospitalizations for cryptogenic hemoptysis peaked in March (32% above the average) and was lowest in summer (30% below the average; p < 0.001). Hospitalizations for noncryptogenic hemoptysis followed a similar seasonal pattern (p < 0. 001). In the 16- to 34-year-old individuals, cryptogenic hemoptysis, compared with noncryptogenic hemoptysis, showed a higher incidence with a larger seasonal amplitude (p < 0.001). CONCLUSIONS: A better understanding of the fundamental pathophysiologic mechanisms underlying this respiratory and hemorrhagic condition may be helpful in developing preventive measures, especially in patients with a risk of recurrence.

Phagocyte chemoattractant receptors.

Myeloid cells are attracted and activated by a variety of chemoattractants that bind to G protein-coupled receptors. In the past few years, the receptors for the classical chemoattractants (fMLF, C5a, PAF) and the chemotactic cytokines, known as C-X-C and C-C chemokines, have been cloned from myeloid cells. This review briefly describes recent advances in structure-function relationships of chemotactic receptors in human leukocytes as well as activation of signaling pathways and regulation of receptor function. In neutrophils, the binding of chemoattractants mainly activates the Gi2 protein inducing PIP2 hydrolysis and activation of the MAP kinase pathway. The C-C chemokine receptor, CC CKR5, and a chemokine receptor homologue, named fusin, have been shown to be the major cofactors for HIV-1 entry in macrophages and T cells. Recent studies suggest that the phosphorylation of chemoattractant receptors is a key event that regulates their biological function.

Modulation of human neutrophil function by fibronectin degradation products isolated from cryoglobulins.

The proteolytic fragments of native fibronectin (cryopeptides) complexed to pathological immunoglobulins in cryoglobulins were isolated from the serum of six different patients. Two peptides of 117,000 daltons and 70,000 daltons were purified and characterized by N-terminal amino acid sequencing. The priming effect of the mixture of these two peptides, referred to as cryopeptides, on neutrophil functions, namely the respiratory burst, exocytosis, and Ca2+ release, was investigated. Cryopeptides and cryoglobulins assayed separately did not increase neutrophil respiration or cytosol free calcium concentration; however, both of them induced granule enzyme secretion. Sequential exposure of neutrophils to either cryopeptides or the respective cryoglobulins, and then to N-formyl-methionyl-leucyl-phenylalanine or serum opsonized zymosan, resulted in a synergistic stimulation of O2 uptake compared to the effect of N-formyl-peptides or opsonized zymosan tested separately; Ca2+ release was significantly enhanced by the pretreatment of neutrophils with cryopeptides. These data suggest that cryopeptides and cryoglobulins may play a role in host defense against bacterial infections through neutrophil activation.

[Data interchange in blood transfusion: the impact of a new standard on the evolution of health electronic data exchange in France]. / Echange de données en transfusion sanguine: impact d'une nouvelle norme sur l'évolution de l'EDI santé en France.

The sanitary and social data interchange within care establishments or networks is today the subject of many national or international considerations. Electronic data interchange in the health field has characteristics linked to ethical and deontological principles of care staff. Used daily, this tool contributes to the quality of care, to the optimization of patient treatment and to the organization of the system care. In the transfusion field, the standardization of messages related to the traceability of blood products in now required by the No. 2 instruction of French Blood Agency, which rules the using of national norms elaborated by the French Agency of Normalization. If the technicality is the greater part of these regulated and formalized messages, this standardization systematizes and justifies the nominative and ciphered data interchange in an open environment, opening a new dimension in the interoperability of data system between care establishments. This article analyzes the characteristics and the potential impact of this normalization on the evolution of the electronic data interchange in the health field.

[Rehabilitation and return to work of patients after aortocoronary bypass]. / Réhabilitation et retour au travail des malades après pontage aorto-coronarien.

A pilot project with medical, physical and psychosocial evaluation and a physical and psychosocial rehabilitation program included 59 men, under age 60, inactive for less than one year and who underwent aortocoronary bypass surgery between november 1978 and march 1980. A control group of 60 comparable patients was studied by questionnaire one year after the operation. The percentage of return-to-work was not significatively different: respectively 92 p. 100 and 89 p. 100. A previous study on a similar population determined 9 predictive sociodemographic and medical factors: age, angina class, duration of symptoms, associated vascular disease, non cardiovascular illness, education, physical workload, length of preoperative unemployment, annual income. The evaluations of this study showed the importance of the psychosocial factors and alcoholism. In comparison with our previous studies, the increased percentage of return-to-work (from 69 p. 100 to 89 p. 100) is mostly due to a shorter preoperative period of inactivity; the percentage of patients operated on within three months of inactivity increased from 44 p. 100 to 74 p. 100 in the last ten years. In the group of patients with a good or excellent preoperative prognosis, 94 p. 100 were working after one year. We conclude that a strategy for improving return-to-work after surgery is to decrease the period of preoperative inactivity. By using nine objective predictive factors and a psychosocial evaluation, it is possible to screen patients with a poor return-to-work prognosis and to submit them to an individualized rehabilitation program.

[Socioeconomic benefits of coronary dilatation]. / Bénéfices socio-économiques de la dilatation coronaire.

The socioeconomic benefits of coronary artery dilatation to the individual and the society in general, were assessed in a review of our first 158 cases in which we studied the length of in-patient treatment, the period off work and the number of patients returning to work after six months and one year. The population included 114 men and 44 women with an average age of 50 +/- 10 years, a history of anginal pain of 18.10 +/- 26.13 months, and of resistant angina of 4.33 +/- 5.72 months. Only one artery was diseased in 130 patients (82%), the remaining patients having multivessel disease. Left ventricular function was normal in 76% of the patients under study. Fifteen patients had already finished working at the time of dilatation and were excluded from the study. One hundred and nineteen (84%) of the 142 patients followed-up were still working before dilatation and 112 (79%) returned to work after 6 months. Of the 94 patients with a good initial result of dilatation, 76 returned to work (81%); 12 initial failures were treated medically, and 6 (50%) returned to work (p less than 0.05); 36 initial failures underwent aorto-coronary bypass surgery and 30.83% are back at work. At one year, 89% of the 103 patients followed-up were working, whilst only 83% of this subgroup were working before dilatation. The 91% of the 69 initial successes have returned to work; 71% of the 7 failures treated medically and 95% of the 27 failures who then underwent bypass surgery, have also returned to work.(ABSTRACT TRUNCATED AT 250 WORDS)

[Semiquantitative evaluation of mitral insufficiency by pulsed Doppler technic. Value of a simple index of left auricular cartography (apropos of a series of 63 patients)]. / Appréciation semi-quantitative de l'insuffisance mitrale par la technique doppler pulsé. Valeur d'un index simple de cartographie auriculaire gauche (a propos d'une série de 63 patients).

The authors advocate a semiquantitative evaluation of mitral regurgitation (MR), based on the extent of the left intra-atrial systolic jet. Their study was performed in a series of 63 consecutive patients explored by: (1) catheterization with left ventriculography on two planes for either ischaemic heart disease (24 cases) or cardiac valve disease (39 cases including 2 with mitral valve prosthesis), and (2) pulsed Doppler ultrasound combined with two-dimensional echocardiography for evaluation of MR carried out 24 or 48 hours prior to catheterization. Five grades of MR (0 to IV) were determined by ventriculography according to the time and degree of left atrial opacification. Similarly, five grades of MR (0 to IV) were determined by Doppler ultrasound, considering only the maximum distance from the mitral annulus plane. This distance was evaluated on at least 3 projections: apical for the 4 and 2 cavities, parasternal for the greater axis. The Doppler method correlated fairly well with the angiography, whether or not grade 0 was included (r = 0.87 and r = 0.72 respectively). However, some major MR may be underestimated; thus, out of 13 RM of angiographic grade III or IV, three (23 p. 100) were graded II by the Doppler technique. Conversely, some minute or moderate MR may be overestimated: out of 33 MR of angiographic grade I or II, four (12 p. 100) were graded III or IV by the Doppler technique.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical, echocardiographic and evolutive aspects of right atrial thrombosis]. / Aspects cliniques, échocardiographiques et évolutifs des thromboses de l'oreillette droite.

The clinical and echocardiographic features of right atrial thrombi were examined in 9 patients, 5 men and 4 women aged 16 to 86 years. The 2D echocardiographic diagnosis was confirmed at autopsy (4 cases) or by the association of severe recurrent pulmonary embolism (5 cases). Three patients had associated ischaemic heart disease and on patient had dilated cardiomyopathy. The clinical presentation was: acute cor pulmonale (5 cases including 2 patients which biventricular myocardial infarction), chronic post-embolic cor pulmonale (1 case), tricuspid valve obstruction (1 case), general ill health with pyrexia (1 case) and heparin-induced thrombocytopenia (1 case). Predisposing factors included: absence of anticoagulent therapy (7 cases), previous supraventricular arrhythmias (2 cases) and right ventricular failure (6 cases, including 2 of right ventricular infarction). In 2 patients the thrombi were relatively immobile and had a wide base of implantation on the interatrial septum; in 1 patient, multiple thrombi were observed lining the right heart cavities from the inferior vena cava to the pulmonary infundibulum. In the other 6 patients, the thrombi were very mobile with a visible pedicule of implantation (2 cases) or totally free (4 cases). The variable polylobulated appearances, completely irregular whirling motion and intermittent prolapse into the tricuspid valve were characteristic features of the latter 4 cases. They disappeared spontaneously (2 cases) or after fibrinolytic therapy (2 cases) in under 36 hours. Three patients were operated with one postoperative death. The global hospital mortality was 22%. The present occasional detection of right atrial thrombosis will certainly become more common if patients with pulmonary embolism, right ventricular infarction or deep venous thrombosis are systematically examined by 2D echocardiography in the acute phase of their illness.

[Vectorcardiography in infarction of the right ventricle]. / Le vectocardiogramme au cours de l'infarctus du ventricule droit.

A vectorcardiogram (VCG) was recorded in 22 patients in the acute phase of a right ventricular infarct in order to investigate any characteristic signs of this diagnosis. The RV infarct had been proven by at least two investigations: 2D echo, isotopes and right ventricular catheterisation. 17 patients had ST depression in V4R. The QRS complex presented two features: there was a reduced refractory period in every case, associated with septal extension in 3 cases and true posterior infarction in 11 cases, and, in the frontal plane, the QRS which was in clockwise rotation had showed an abnormal left axial lead in 18 cases with a maximal vectorial axis of between - 10 degrees and - 60 degrees. These modifications are similar to those seen in experimental infarcts of the RV. In conclusion, repeated VCGs in the acute phase of inferior infarction should suggest the diagnosis of right ventricular extension if it shows the appearance of more marked left axis deviation than that seen with isolated inferior infarcts. However, this sign is no constant and is not specific.

[Isotopic exercise tests and selection of cases of inferior infarction requiring coronarography]. / Epreuves d'effort isotopiques et sélection des infarctus inférieurs nécessitant une coronarographie.

Exercise tests involving isotopes were evaluated in 38 subjects presenting inferior myocardial necrosis. Cardiographic data were used to calculate sensitivity and specificity of the method in detection of subjects requiring surgical treatment. Sensitivity was 90% and specificity 62% when three criteria were employed: ECG of positive exertion, reversible diminished accumulation of thallium 201 outside the necrotic site or decrease in the fraction of ejection force. Examination of the fraction of ejection force improved the results of myocardial scanning using thallium and increased detection of subjects requiring surgery from 61% to 90%.

[Should occupational medicine physicians be linked to future computerized medical record networks?]. / Doit-on connecter les médecins du travail aux futurs réseaux d'information?

Upcoming reforms of the health care system place high expectations on computerized medical file networks to control medical expenditures. In France, information flow from the care delivery sector to the occupational medicine sector is often slow or incomplete. Company and social security expenditures or dysfunctions as well as patient incomfort may result. An analysis of occupational medicine practices and the needs of physicians working in this sector leads to several perspective proposals for improvement including access to future computerized medical file networks and the health data card Sesame.

[Can medical files be used to audit hospital health care? Results of a regional audit of hospital file quality]. / Peut-on utiliser le dossier médical pour des audits de pratique à l'hôpital? Résultats d'un audit régional de la qualité de la tenue du dossier médical hospitalier.

OBJECTIVES: The clinical audit method based on a retrospective analysis of medical files can be used to assess hospital health care. The reliability of the results obtained depends on the validity of the data in the file and its completeness. The aim of this work was to assess the quality of this information source. METHODS: The simplified ANDEM/ANAES from was proposed to 47 medical information departments of public and private hospitals participating in the public health care service in the Provence-Alples-Côte d'Azur region. The audit was conducted on a sample of hospital stays during a regular 6-month quality control assessment of hospital health care activity. RESULTS: Analysis of the 467 forms returned by 39 hospitals, showed that the quality of medical file recordings should be improved as a large amount of data or important documents were missing: reason for hospitalization (recorded on 74.1% of files), operation report (found in 83.2% of files) and discharge summary (found in 66.6% of files). CONCLUSION: Clinical audits would be compromised in certain hospitals by the use of medical files. Efforts to improve the quality of hospital medical files should be a priority.

[Public health education integrated in hospital. An internship proposal, "Medical information and pharmacology"]. / Enseignement de santé publique intégré aux stages hospitaliers. Une proposition de stage "Information médicale et pharmacologie".

According to a recent circular reforming french medical studies, we propose a teaching of medical information and pharmacology in situ within hospital instructions. Students could acquire an investigation methodology on the medicine economy. It will cover in four sessions the succeeding stages of medical information processing and be subject to an assessment: case studies and appreciation on student's, instruction record. By combining public health teaching with clinical practice, our project promotes its development in contact with other learnings and activities such as clinical research.