[Strokein type 2 diabetic patients in the internal medicine department of the Teaching Hospital of Point G]. / Accident vasculaire cerebral (AVC) chez les patients diabetiques de type 2 dans le service de medecine interne du CHU du Point G.

INTRODUCTION: Diabetes is a chronic hyperglycemia which can be discovered with specific organic complications particularly affecting the eyes, kidneys, nerves, heart and vessels. Globally, the prevalence of stroke in people with diabetes is approximately 10%. OBJECTIVE: Study the epidemiological and clinical aspects of stroke in patients with type 2 diabetes. METHODOLOGY: We made a descriptive and analytical study by a retrospective survey over a period of 10 years, in the department of internal medicine at the university Hospital ofPoint G. We focused on all hospitalized patients with type 2 diabetes, in whom the diagnosis of stroke was retained. RESULTS: At the end of the study 24 patients out of 492 diabetes hospitalized in to the period met our inclusion criteria, representing a frequence of 4.9%. The mean age was 64.67 ± 13.409 years with a sex-ratio of 1.4. The reason for hospitalization was muscle weakness in 54.2% of patients. Eighty-seven point five percent (87.5%) of patients were already known to have diabetes before the weakness. Stroke was the mode of discovery of diabetes in 12.5%. Over 70% of our patients had hyperglycemia at the time of admission. Ischemic stroke was seen in 75% of patients. CONCLUSION: Stroke is a great complication of diabetes witch, can be a way discovery of type 2 diabetes.

INTRODUCTION: Le diabète est une hyperglycémie chronique qui peut être découvert avec des complications organiques spécifiques touchant particulièrement les yeux, les reins, les nerfs, le cœur et les vaisseaux.L'AVC en ai une de ces complications. À l'échelle mondiale, la prévalence de l'AVC chez les diabétiques est d'environ 10%. OBJECTIF: Étudier les aspects épidémiologiques et cliniques de l'accident vasculaire cérébral chez les patients diabétiques de type 2. MÉTHODOLOGIE: Il s'agissait d'une étude descriptive et analytique sur la base d'une enquête rétrospective de 10 ans, dans le service de médecine interne du CHU du Point G. Elle a porté sur tous les patients diabétiques de type 2 hospitalisés dans le service de médecine interne, chez qui le diagnostic de l'AVC a été retenu. RÉSULTATS: Au terme del'étude 24 patients répondants à nos critères sur 492 diabétiques soit une fréquence de 4,9%. L'âge moyen était de 64,67 ± 13,409 ans avec un sex-ratio de 1,4. Le motif d'hospitalisation était un déficit moteur chez 54,2% des patients. Quatre-vingt-sept virgule cinq pourcent (87,5%) des patients étaient déjà connus diabétiques avant le déficit. L'AVC a été le mode de découverte du diabète chez 12,5%. Plus de 70% de nos patients avaient une hyperglycémieau moment à l'admission. L'AVC ischémique était observé chez 87,5% des patients. CONCLUSION: L'AVC est une complication redoutable du diabète, il peut être le mode de découverte d'un diabète de type 2.

Health-seeking behaviour among adults with prolonged cough in Vietnam.

OBJECTIVE: To assess health-seeking behaviour among adults with prolonged cough in a population-based, nationally representative sample in Vietnam. METHODS: Cross-sectional survey conducted from September 2006 to July 2007. All inhabitants aged ≥15 years were invited for screening for cough, history of tuberculosis (TB) treatment and chest X-ray (CXR) examination. TB suspects, defined as any survey participant with CXR abnormalities consistent with TB, or productive cough for more than 2 weeks or TB treatment either currently or in the preceding 2 years submitted sputum specimens for smear examination and culture and provided information on health-seeking behaviour in an in-depth interview. RESULTS: Of 94 179 persons participating in the survey, 4.6% had prolonged productive cough. Forty-four percentage of those had sought health care and reported pharmacies (35%), commune health posts (29%), public hospitals (24%) and private physicians (10%) as first point of contact. Only 7% had undergone sputum smear examination. Of TB suspects with prolonged productive cough, 2.9% were diagnosed with TB; 10.2% of these reported smear and 21.9% reported X-ray examination when visiting a health care facility. The average patient delay was 4.1 weeks (95% CI: 3.9-4.4) among cough suspects and 4.0 weeks (95% CI: 3.1-4.9) among TB cases. CONCLUSIONS: In this Vietnamese survey, nearly half of persons with cough for more than 2 weeks had visited a health care provider. The commonest first health facility contacted was the pharmacy. Sputum smears were rarely examined, except in the provincial TB hospital. Our findings highlight the need to improve diagnostic practices by retraining health staff on the performance of sputum examination for TB suspects.

[Stroke in type 2 diabetic patients in the internal medicine department of the Teaching Hospital of Point G]. / Accident vasculaire cerebral (avc) chez les patients diabetiques de type 2 dans le service de medecine interne du CHU du Point G.

INTRODUCTION: Diabetes is a chronic hyperglycemia which can be discovered with specific organic complications particularly affecting the eyes, kidneys, nerves, heart and vessels. Globally, the prevalence of stroke in people with diabetes is approximately 10%. OBJECTIVE: Study the epidemiological and clinical aspects of stroke in patients with type 2 diabetes. METHODOLOGY: We made a descriptive and analytical study by a retrospective survey over a period of 10 years, in the department of internal medicine at the university Hospital ofPoint G. We focused on all hospitalized patients with type 2 diabetes, in whom the diagnosis of stroke was retained. RESULTS: At the end of the study 24 patients out of 492 diabetes hospitalized in to the period met our inclusion criteria, representing a frequence of 4.9%. The mean age was 64.67 ± 13.409 years with a sex-ratio of 1.4. The reason for hospitalization was muscle weakness in 54.2% of patients. Eighty-seven point five percent (87.5%) of patients were already known to have diabetes before the weakness. Stroke was the mode of discovery of diabetes in 12.5%. Over 70% of our patients had hyperglycemia at the time of admission. Ischemic stroke was seen in 75% of patients. CONCLUSION: Stroke is a great complication of diabetes witch, can be a way discovery of type 2 diabetes.

INTRODUCTION: Le diabète est une hyperglycémie chronique qui peut être découvert avec des complications organiques spécifiques touchant particulièrement les yeux, les reins, les nerfs, le coeur et les vaisseaux.L'AVC en ai une de ces complications. À l'échelle mondiale, la prévalence de l'AVC chez les diabétiques est d'environ 10%. OBJECTIF: Étudier les aspects épidémiologiques et cliniques de l'accident vasculaire cérébral chez les patients diabétiques de type 2. MÉTHODOLOGIE: Il s'agissait d'une étude descriptive et analytique sur la base d'une enquête rétrospective de 10 ans, dans le service de médecine interne du CHU du Point G. Elle a porté sur tous les patients diabétiques de type 2 hospitalisés dans le service de médecine interne, chez qui le diagnostic de l'AVC a été retenu. RÉSULTATS: Au terme del'étude 24 patients répondants à nos critères sur 492 diabétiques soit une fréquence de 4,9%. L'âge moyen était de 64,67 ± 13,409 ans avec un sex-ratio de 1,4. Le motif d'hospitalisation était un déficit moteur chez 54,2% des patients. Quatre-vingt-sept virgule cinq pourcent (87,5%) des patients étaient déjà connus diabétiques avant le déficit. L'AVC a été le mode de découverte du diabète chez 12,5%. Plus de 70% de nos patients avaient une hyperglycémieau moment à l'admission. L'AVC ischémique était observé chez 87,5% des patients. CONCLUSION: L'AVC est une complication redoutable du diabète, il peut être le mode de découverte d'un diabète de type 2.

[Problem Of Diabetic Foot Amputations]. / ProbléMatique Des Amputations Du Pied Diabétique.

INTRODUCTION: The diabetic foot wound is a real public health problem, 10% of the reasons for hospitalization. The risk of amputation is 10 to 30 times higher in diabetics than the general population. OBJECTIVE: To study the problem of amputations of the diabetic foot. METHOD: This was a descriptive and cross-sectional study that took place in the Department of Medicine and Endocrinology of the Mali Hospital from July 1st, 2016 to June 30th, 2017. RESULTS: Twenty-five (25) diabetic patients were enrolled in our study. The sex ratio was 0.66. At admission, 100% of our patients had arterial disease, 96% neuropathy, and mixed foot in 80%. Poor glycemic control in 64% of patients; osteitis in 52% of cases; 92% of the patients had a 100% amputation risk according to the University of Texas classification. Nearly half or 46% of patients had amputations in the leg. We recorded 1 death case that is 4%. CONCLUSION: The problem of amputation of diabetic feet is a function of the poor equilibrium and progressive neurological and vascular complications of diabetes.

INTRODUCTION: La plaie du pied diabétique constitue un réel problème de santé publique, 10% des motifs d'hospitalisation. Le risque d'amputation est de 10 à 30 fois plus élevé chez les diabétiques que la population générale. OBJECTIF: Etudier la problématique des amputations du pied diabétique. MÉTHODE: II s'agissait d'une étude descriptive et transversale qui s'est déroulée dans le service de médecine et d'endocrinologie de l'hôpital du Mali du 1er Juillet 2016 au 30 Juin 2017. RÉSULTATS: Vingt-cinq (25) patients diabétiques ont été recrutés dans notre étude. Le sex ratio était de 0,66. A l'admission, 100% de nos patients avaient une artériopathie, 96% une neuropathie, et un pied mixte dans 80%. Un mauvais équilibre glycémique chez 64% des patients ; l'ostéite dans 52% des cas; 92% des patients avaient un risque d'amputation à 100% selon la classification de l'université du Texas. Près de la moitié soit 46% des patients ont été amputé au niveau de la jambe. Nous avons enregistré 1 cas de décès soit 4%. CONCLUSION: La problématique de l'amputation des pieds diabétiques est fonction du mauvais équilibre et des complications évolutives neurologiques et vasculaires du diabète.

High tuberculosis prevalence in a psychiatric hospital in Vietnam.

Little is known about tuberculosis (TB) prevalence in psychiatric hospitals in Vietnam, but prevalence may be higher than in the general population. We assessed the TB prevalence among in-patients of a psychiatric hospital in 2005 in Danang City, Vietnam. Of 300 in-patients, 70 had an abnormal X-ray or prolonged cough, and underwent sputum smear examinations. The prevalence of smear-positive TB was 0.33% (1/300, 95%CI 0.008-1.9). Twenty-three (7.7%) patients had X-ray lesions suggesting active TB and 22 (7.3%) had a history of TB treatment. TB prevalence was high in this psychiatric hospital, and TB infection control needs strengthening.

Population-based chest X-ray screening for pulmonary tuberculosis in people living with HIV/AIDS, An Giang, Vietnam.

SETTING: Human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS) program, An Giang Province, Vietnam. OBJECTIVE: To evaluate the coverage and yield of a chest radiography (CXR) screening program for tuberculosis (TB) among people living with HIV/AIDS (PLHA), risk factors for a TB CXR, inter-rater reliability of CXR readings and direct costs. DESIGN: Retrospective review of routine public health program records and CXRs. RESULTS: An increasing proportion of PLHAs received a screening CXR each year of the program (range 21% in 2001 to 61% in 2004, P<0.001). Of 876 screening CXRs performed, 191 (22%) were classified as suspicious for active TB ('TB CXR'). Compared to PLHAs with a CXR not suspicious for active TB, PLHAs with a TB CXR were more likely to be aged between 24 and 64 years, male and previously treated for TB (P<0.01 for each comparison). Agreement between the expert and local program CXR readings was 81% (kappa 0.50). Direct costs were approximately US$40 per TB suspect identified. Among TB suspects, <10% were followed up with sputum smear examination and enrolled for treatment. CONCLUSION: In An Giang Province, a large proportion of PLHAs are screened for TB annually, and one in five persons screened is classified as a TB suspect based on CXR. Annual CXRs may be a high-yield, inexpensive method for TB screening in PLHAs, but the follow-up of TB suspects to confirm diagnosis and initiate treatment is crucial.

Steep increases in tuberculosis notification among young men in the industrialised districts of Danang, Vietnam.

BACKGROUND: Tuberculosis (TB) notification is increasing among young adults in urban provinces in Vietnam, despite having achieved World Health Organization targets for treatment success and case detection. OBJECTIVES: To identify causes for non-declining TB case rates in an urban area of Vietnam, and to describe trends in new smear-positive pulmonary TB notification by age, sex and district in the period 1999-2004 in Danang City, Vietnam. RESULTS: Age and sex-standardised notification rates declined by 1.3% (95%CI -2.3-0.3%) annually. Notification rates among men aged 15-44 in Danang City increased significantly (5%, 95%CI 2.4-7.7 annually), most notably in industrialised districts (>or=12% annually). CONCLUSION: TB notification rates among young men in an urban setting in Vietnam increased most notably in industrialised districts. We hypothesise that this is due to poor living and working conditions and internal migration rather than to an emerging human immunodeficiency virus epidemic.

Survival and relapse rate of tuberculosis patients who successfully completed treatment in Vietnam.

SETTING: Reported tuberculosis (TB) cure rates are high in Vietnam with the 8-month short-course chemotherapy regimen. However, long-term treatment outcomes are unknown. OBJECTIVE: To assess survival and relapse rates among patients successfully treated for new smear-positive pulmonary tuberculosis (PTB). METHODS: A cohort of patients treated in 32 randomly selected districts in northern Vietnam were followed up 12-24 months after reported cure or treatment success for survival and bacteriologically confirmed relapse. Measurements included sputum smear examination, culture and interview for recent treatment history. RESULTS: Of 304 patients included in the study, no information was available for 31 (10%) and 19 (6%) had died. Bacteriology results were available for 244 (80%). The median interval between treatment completion and follow-up was 19 months. Relapse was recorded in 21/244 (8.6%, 95%CI 5.4-13), including 9 (4%) with positive sputum smears, 3 (1%) with negative smears but positive culture and 9 (4%) who had started TB retreatment. Four of 12 culture-positive relapse cases (33%) had multidrug-resistant strains. If the definition of relapse was extended to include death, reportedly due to TB, the relapse proportion was 26/263 (9.9%, 95%CI 6.6-14). CONCLUSION: A substantial proportion of patients (15%) had died or relapsed after being successfully treated for TB in northern Vietnam.

Low tuberculosis notification in mountainous Vietnam is not due to low case detection: a cross-sectional survey.

BACKGROUND: Studies show that tuberculosis notification declines with increasing altitude. This can be due to declining incidence or declining case detection. In Vietnam notification rates of new smear-positive tuberculosis in the central mountainous provinces (26/100,000 population) are considerably lower than in Vietnam in general (69/100,000 population). In order to clarify whether this is explained by low incidence or low case detection, we aimed to assess the prevalence of new smear-positive tuberculosis among adults with prolonged cough in three mountainous provinces in central Vietnam. METHODS: A house-to-house survey of persons (> or = 15 years) was carried out in twelve randomly selected districts in 2003. Three sputum specimens were microscopically examined of persons reporting a prolonged cough (> or = 3 weeks). Case detection was assessed by the ratio between notification and prevalence. RESULTS: Of 68,946 included persons (95% response), 1,298 (1.9% 95%CI 1.8-2.2) reported a prolonged cough. Of these, eighteen were sputum smear-positive of whom two had had anti-tuberculosis treatment. The prevalence of new smear-positive tuberculosis was 27/100,000 (95%CI 11-44/100,000) and the notification rate was 44/100,000 among persons > or = 15 years. The estimated case detection rate was 76%. CONCLUSION: Low tuberculosis notification in this mountainous setting is probably a true reflection of low tuberculosis incidence. Possible causes for low incidence in mountainous areas include low transmission rates or altitude-related differences in pathology.

[Profil course of SC sickle-cell patients in Dakar: a case-control study with SS sickle cell form]. / Profil evolutif de la drepanocytose SC A Dakar: étude cas-témoin avec la forme SS.

AIMS: The study aim to describe the epidemiological, clinico-biological and evolutionary aspects of SC sickle cell patients compared to SS sickle cell disease. PATIENTS AND METHODS: We realized a case-control study of 12 months duration including 98 major sickle cell patients (49 SC and 49 SS sickle cell patients). SS sickle cell patients were randomly selected according to age and sex. Socio-demographic, clinico-biological and evolutionary data were noted for each patient. RESULTS: Mean age was 24.7 years (5 - 53). Sex ratio was 0.8. Mean number of transfusions was 0.06 of SC patients and 0.34 for SS patients (p=0.0008). Mean number of vaso-occlusive crisis per year was 2.24 of SC patients and 2.37 of SS patients (p=0.3). Mean basic hemoglobin level was 10.8 of SC patients and 7.8 of SS patients (p=0.0000). Priapism was found in 2.04% of SC patients and 4.04% of SS patients (p=0.3) and acute anemia in 2.04% of SC and 24.48% of SS patients (p=0.003); 26.53% of SC patients had a chronic complication compared to 18.36% of SS patients (p=0.0001). CONCLUSION: This study shows that SC sickle cell patients are less symptomatology compared to SS patients, however they would develop more chronic complications from where the utility for regular follow-up.

BUTS: Le but de notre étude était de décrire les aspects épidémiologiques, clinico-biologiques et évolutifs des patients SC comparés aux patients SS. PATIENTS ET MÉTHODES: Il s'agissait d'une étude cas témoins d'une durée de 12 mois portant sur 98 patients (49 SC et 49 SS8). Les témoins SS étaient choisis de façon aléatoire après appariement selon l'âge et le sexe. Pour chaque patient nous avons noté les aspects sociodémographiques, clinicobiologiques et évolutifs. RÉSULTATS: L'âge moyen était de 24,7 ans (5 - 53). Le sex ratio était de 0,8. Le nombre moyen de transfusions était de 0,06 chez les SC et 0,34 chez les SS (p=0,0008). Le nombre moyen de CVO/an était de 2,24 chez les SC et 2,37 chez les SS (p=0,3). Le taux moyen d'hémoglobine de base était de 10,8 chez les SC et 7,8 chez les SS (p=0,0000). Le priapisme était trouvé chez 2,04% des SC et 4,04% des SS (p=0,3) et l'anémie aigue chez 2,04% des SC et 24,48% des SS (p=0,003); 26,53% des SC souffraient d'une complication chronique contre 18,36% des SS (p=0,0001). CONCLUSION: Cette étude montre que les drépanocytaires SC ont une symptomatologie moindre par rapport aux patients SS, cependant ils développeraient plus de complications chroniques d'où l'utilité d'un suivi régulier.

Efficacy and Safety of Manual Partial Red Cell Exchange in the Management of Severe Complications of Sickle Cell Disease in a Developing Country.

INTRODUCTION: The realization of red cell exchange (RCE) in Africa faces the lack of blood, transfusion safety, and equipment. We evaluated its efficacy and safety in severe complications of sickle cell disease. PATIENTS AND METHOD: Manual partial RCE was performed among sickle cell patients who had severe complications. Efficacy was evaluated by clinical evolution, blood count, and electrophoresis of hemoglobin. Safety was evaluated on adverse effects, infections, and alloimmunization. RESULTS: We performed 166 partial RCE among 44 patients including 41 homozygous (SS) and 2 heterozygous composites SC and 1 S/ß0-thalassemia. The mean age was 27.9 years. The sex ratio was 1.58. The regression of symptoms was complete in 100% of persistent vasoocclusive crisis and acute chest syndrome, 56.7% of intermittent priapism, and 30% of stroke. It was partial in 100% of leg ulcers and null in acute priapism. The mean variations of hemoglobin and hematocrit rate after one procedure were, respectively, +1.4 g/dL and +4.4%. That of hemoglobin S after 2 consecutive RCE was -60%. Neither alloimmunization nor viral seroconversion was observed. CONCLUSION: This work shows the feasibility of manual partial RCE in a low-resource setting and its efficacy and safety during complications of SCD outside of acute priapism.

Crystal structure of Pseudomonas fluorescens 4-hydroxyphenylpyruvate dioxygenase: an enzyme involved in the tyrosine degradation pathway.

BACKGROUND: In plants and photosynthetic bacteria, the tyrosine degradation pathway is crucial because homogentisate, a tyrosine degradation product, is a precursor for the biosynthesis of photosynthetic pigments, such as quinones or tocophenols. Homogentisate biosynthesis includes a decarboxylation step, a dioxygenation and a rearrangement of the pyruvate sidechain. This complex reaction is carried out by a single enzyme, the 4-hydroxyphenylpyruvate dioxygenase (HPPD), a non-heme iron dependent enzyme that is active as a homotetramer in bacteria and as a homodimer in plants. Moreover, in humans, a HPPD deficiency is found to be related to tyrosinemia, a rare hereditary disorder of tyrosine catabolism. RESULTS: We report here the crystal structure of Pseudomonas fluorescens HPPD refined to 2.4 A resolution (Rfree 27.6%; R factor 21.9%). The general topology of the protein comprises two barrel-shaped domains and is similar to the structures of Pseudomonas 2,3-dihydroxybiphenyl dioxygenase (DHBD) and Pseudomonas putida catechol 2,3-dioxygenase (MPC). Each structural domain contains two repeated betaalpha betabeta betaalpha modules. There is one non-heme iron atom per monomer liganded to the sidechains of His161, His240, Glu322 and one acetate molecule. CONCLUSIONS: The analysis of the HPPD structure and its superposition with the structures of DHBD and MPC highlight some important differences in the active sites of these enzymes. These comparisons also suggest that the pyruvate part of the HPPD substrate (4-hydroxyphenylpyruvate) and the O2 molecule would occupy the three free coordination sites of the catalytic iron atom. This substrate-enzyme model will aid the design of new inhibitors of the homogentisate biosynthesis reaction.

Structural investigations of basic amphipathic model peptides in the presence of lipid vesicles studied by circular dichroism, fluorescence, monolayer and modeling.

A cationic amphiphilic peptide made of 10 leucine and 10 lysine residues, and four of its fluorescent derivatives in which leucines were substituted by Trp residues at different locations on the primary sequence have been synthesized. The interactions of these five peptides with neutral anionic or cationic vesicles were investigated using circular dichroism, steady state and time-resolved fluorescence with a combination of Trp quenching by brominated lipid probes, monolayers, modeling with minimization and simulated annealing procedures. We show that all the five peptides interact with neutral and anionic DMPC, DMPG, DOPC or egg yolk PC vesicles. The binding takes place whatever the peptide conformation in solution is. In the case of DMPC bilayers the binding free energy DeltaG is estimated at -8 kcal mole-1 and the number of phospholipid molecules involved is about 20-25 per peptide molecule. Peptides are bound as single-stranded alpha helices orientated parallel to the bilayer surface. In the anchoring of phospholipid head groups around the peptides, the lipid molecules are not smeared out in a plane parallel to the membrane surface but are organized around the hydrophilic face of the alpha helices like 'wheat grains around an ear' and protrude outside the bilayer towards the solvent. We suggest that such a lipid arrangement generates transient structural defects responsible for the membrane permeability enhancement. When an electrical potential is applied, the axis of the peptide helices remains parallel to the membrane surface and does not reorient to give rise to a bundle of helix monomers that forms transmembrane channels via a 'barrel stave' mechanism. The penetration depth of alpha helices in relation to the position of phosphorus atoms in the unperturbed lipid leaflet is estimated at 3.2 A.

Capacity building for international tuberculosis control through operations research training.

SETTING: In resource-poor countries, few tuberculosis (TB) program staff at the national, provincial, and even district levels have the basic analytical and epidemiological skills necessary for collecting and analyzing quality data pertaining to national TB control program (NTP) improvements. This includes setting program priorities, operations planning, and implementing and evaluating program activities. OBJECTIVES: To present a model course for building capacity in basic epidemiology and operations research (OR). DESIGN: A combination of didactic lectures and applied field exercises were used to achieve the main objectives of the 6-day OR course. These were to increase the understanding of quantitative and qualitative research concepts, study design, and analytic methods, and to increase awareness of how these methods apply to the epidemiology and control of TB; and to demonstrate the potential uses of OR in answering practical questions on NTP effectiveness. As a final outcome, course participants develop OR proposals that are funded and later implemented. RESULTS: Since 1997, this OR course has been conducted nine times in five countries; 149 key NTP and laboratory staff have been trained in OR methods, and 44 OR protocols have been completed or are underway. CONCLUSION: This low-cost model course can be adapted to a wide range of public health issues.

The fourth national anti-tuberculosis drug resistance survey in Viet Nam.

SETTING: Viet Nam's Fourth National Anti-Tuberculosis Drug Resistance Survey was conducted in 2011. OBJECTIVE: To determine the prevalence of resistance to the four main first-line anti-tuberculosis drugs in Viet Nam. METHODS: Eighty clusters were selected using a probability proportion to size approach. Drug susceptibility testing (DST) against the four main first-line anti-tuberculosis drugs was performed. RESULTS: A total of 1629 smear-positive tuberculosis (TB) patients were eligible for culture. Of these, DST results were available for 1312 patients, including 1105 new TB cases, 195 previously treated TB cases and 12 cases with an unknown treatment history. The proportion of cases with resistance to any drug was 32.7% (95%CI 29.1-36.5) among new cases and 54.2% (95%CI 44.3-63.7) among previously treated cases. The proportion of multidrug-resistant TB (MDR-TB) cases was 4.0% (95%CI 2.5-5.4) in new cases and 23.3 (95%CI 16.7-29.9) in previously treated cases. CONCLUSIONS: The fourth drug resistance survey in Viet Nam found that the proportion of MDR-TB among new and previously treated cases was not significantly different from that in the 2005 survey. The National TB Programme should prioritise the detection and treatment of MDR-TB to reduce transmission of MDR-TB in the community.

[Stomach cancer: a descriptive study of 101 cases at the gastrointestinal endoscopy center at Aristide Le Dantec University Hospital]. / Le cancer gastrique : étude descriptive de 101 cas dans le centre d'endoscopie digestive du CHU Aristide Le Dantec.

INTRODUCTION: Stomach cancer is a real public health problem in Black Africa. We report its epidemiological, endoscopic, and histological aspects, as observed in our gastrointestinal endoscopy center at Aristide Le Dantec University Hospital in Dakar (Senegal). PATIENTS AND METHODS: This retrospective study covered the 5-year period from January 1, 2006, to December 31, 2010 and included all patients with stomach cancer confirmed by anatomo-pathological examination. We collected data about age, sex, indications for the examination, and description of the gastric lesions and any other associated lesions from the upper GI endoscopy reports. We also recorded information from the histological reports of all lesions. RESULTS: The study included 101 patients. The incidence of gastric cancer was 20 cases/year. Patients' mean age was 58 years [range: 24-83]. The sex ratio was 2.48. The main indications for the upper GI endoscopy were epigastralgia (33.3%), vomiting (26.1%), and tumoral hepatomegalia (10.81%). The examination found mainly ulcerative and protruded lesions (59.40%). Other types of lesions associated with the tumor were esophageal candidiasis (34.6%), peptic esophagitis (25%), and gastroesophageal junction incompetence (25%). The tumor was located in the antrum in 68% of the cases and was an adenocarcinoma in 83.2%. CONCLUSION: A cancer register to determine the characteristics and prevalence of stomach cancer in Senegal would be useful. The link with Helicobacter pylori requires further study.

Solution structure and lipid binding of a nonspecific lipid transfer protein extracted from maize seeds.

The three-dimensional solution structure of a nonspecific lipid transfer protein extracted from maize seeds determined by 1H NMR spectroscopy is described. This cationic protein consists of 93 amino acid residues. Its structure was determined from 1,091 NOE-derived distance restraints, including 929 interresidue connectivities and 197 dihedral restraints (phi, psi, chi 1) derived from NOEs and 3J coupling constants. The global fold involving four helical fragments connected by three loops and a C-terminal tail without regular secondary structures is stabilized by four disulfide bridges. The most striking feature of this structure is the existence of an internal hydrophobic cavity running through the whole molecule. The global fold of this protein, very similar to that of a previously described lipid transfer protein extracted from wheat seeds (Gincel E et al., 1994, Eur J Biochem 226:413-422) constitutes a new architecture for alpha-class proteins. 1H NMR and fluorescence studies show that this protein forms well-defined complexes in aqueous solution with lysophosphatidylcholine. Dissociation constants, Kd, of 1.9 +/- 0.6 x 10(-6) M and > 10(-3) M were obtained with lyso-C16 and -C12, respectively. A structure model for a lipid-protein complex is proposed in which the aliphatic chain of the phospholipid is inserted in the internal cavity and the polar head interacts with the charged side chains located at one end of this cavity. Our model for the lipid-protein complex is qualitatively very similar to the recently published crystal structure (Shin DH et al., 1995, Structure 3:189-199).

1H NMR and fluorescence studies of the complexation of DMPG by wheat non-specific lipid transfer protein. Global fold of the complex.

Plant non-specific lipid transfer proteins (LTPs) are proteins which transfer lipids between membranes in vitro and are believed to be involved in the transport of cutin monomers to the cuticle layer in vivo or in the plant defence against phytopathogens. The complexation of DMPG, a diacyl phospholipid, by wheat ns-LTP, a protein extracted from wheat seeds, was followed by 1H NMR and fluorescence spectroscopy. The global fold of the protein was calculated using the DIANA software package from a list of 968 distance constraints. The internal cavity volume, a feature common to all known ns-LTP structures, was estimated to be 750 A3 using the 'CAVITE' program. This model of the complex was obtained by inserting a lipid molecule in the cavity and was energy minimized. The study showed that the protein fold described for the free form was only weakly affected by the insertion of the bulky lipid. Observation of some intermolecular NOEs between the protein and the lipid glycerol moiety revealed that the cavity entrance was located between residues His35 and Arg44. The resulting solution structure was compared to the crystal structure of the maize ns-LTP/palmitate complex.

Radiation disrupts protein-DNA complexes through damage to the protein. The lac repressor-operator system.

Eon, S., Culard, F., Sy, D., Charlier, M. and Spotheim-Maurizot, M. Radiation Disrupts Protein-DNA Complexes through Damage to the Protein. The lac Repressor-Operator System. Radiat. Res. 156, 110-117 (2001). Binding of a protein to its cognate DNA sequence is a key step in the regulation of gene expression. If radiation damage interferes with protein-DNA recognition, the entire regulation process may be perturbed. We have studied the effect of gamma rays on a model regulatory system, the E. coli lactose repressor-operator complex. We have observed the disruption of the complex upon irradiation in aerated solution. The complex is completely restored by the addition of nonirradiated repressor, but not by the addition of nonirradiated DNA. Thus radiation disrupts the DNA-protein complex by affecting the binding ability of the protein. This interpretation is supported by the dramatic loss of binding ability of a free irradiated repressor toward nonirradiated DNA. Interestingly, the dose necessary for the disruption of the irradiated complex is higher than that for inducing the complete loss of the binding ability of the free irradiated repressor. This may be due to the protection of key amino acids by the bound DNA. As seen from calculations of the accessibility of amino acids to radiolytic OH(.), the protection is due to both masking and conformational effects.

Radioimmunoprecipitation of avian reovirus polypeptides using virus-specific IgM and IgG murine monoclonal and chicken polyclonal antibodies.

A simple and improved procedure for radioimmunoprecipitation (RIPA) for the identification of major immunogenic proteins of avian reovirus using murine monoclonal and chicken polyclonal antibodies is described. Bacterial proteins (Staphylococcus aureus-Protein A or Streptococcus species-Protein G) commonly used in RIPA procedures lack reactivities with low avidity monoclonals belonging to immunoglobulin (Ig)G or IgM subtypes, as well as avian Ig. Hence we used an indirect approach utilizing species-specific anti-IgM, IgG or chicken Ig antibodies followed by the precipitation of the immune complexes using Protein A. This improved the sensitivity of the RIPA enabling the antigenic analysis of the major antigenic proteins of avian reovirus. The results indicated that the virus is highly immunogenic in the natural host, chicken than in mice. Furthermore, there exists a direct correlation between a strong neutralizing antibody response and an increased precipitation of the sigma (sigma) proteins of the virus. The results also demonstrate a strong association between the conformational viral epitopes of the three classes of proteins, large (lambda), medium (mu) and small (sigma).