« FORSAFE » forceps et capteurs souples bio-inspirés

Living tissues are mainly constituted of soft matter. This so particular state, neither liquid, neither gas, nor solid led to the use, in simulation, of increasingly complicated mathematical models. These tissues are organised in multi-layers, present anisotropic properties and nonlinear behaviour. The evaluation of the interface pressure by traditional rigid sensors leads to errors of measurement. The device FORSAFE performs the measurement of the pressure on the fetal head. It is aimed to limit the risks due to a bad positioning and a too important tightening of the forceps on the head of the new-born, during the childbirth. It is based on an original method bio-inspired reproducing the sense of touch, by micro-palpations. Complications in forceps deliveries are rare but their consequences might be dramatics. This situation could be avoided if the obstetrician knows the information concerning symmetry of the obstetrical forceps position on the fetal head and the related interface pressure. Indeed, forceps delivery is an emergency gesture which is normally not expected. The aims of the FORSAFE device are: first, to prevent instrumented delivery accidents, secondly, to provide a safe training of forceps technique. This paper presents the original method of the interface pressure measurement, the results obtained on a physical model of interface pressure as well as the corrections performed on the probe placed on the forceps.     

Cellular and molecular purification processes based on the use of magnetic micro-and nanobeads

Magnetic separation is a recent technology using magnetism properties. This technology is aimed to purify cells, cell organelles and biologically active compounds such as nucleic acids and proteins. Many magnetic separation procedures have been developed to isolate cells and molecules. The purpose of this review is to give an other view of various methods and strategies which can be employed for selection of targets cells and molecules. We describe techniques used to positive and negative cells selections, we show that magnetic selection is also aimed to perform multiparameter selection or functional selection. Then, we underline emerging technology used to select transfected cells and macromolecules such as proteins, DNA and RNA.     

Transgenic rat model of Huntington's disease

Huntington's disease (HD) is a late manifesting neurodegenerative disorder in humans caused by an expansion of a CAG trinucleotide repeat of more than 39 units in a gene of unknown function. Several mouse models have been reported which show rapid progression of a phenotype leading to death within 3-5 months (transgenic models) resembling the rare juvenile course of HD (Westphal variant) or which do not present with any symptoms (knock-in mice). Owing to the small size of the brain, mice are not suitable for repetitive in vivo imaging studies. Also, rapid progression of the disease in the transgenic models limits their usefulness for neurotransplantation. We therefore generated a rat model transgenic of HD, which carries a truncated huntingtin cDNA fragment with 51 CAG repeats under control of the native rat huntingtin promoter. This is the first transgenic rat model of a neurodegenerative disorder of the brain. These rats exhibit adult-onset neurological phenotypes with reduced anxiety, cognitive impairments, and slowly progressive motor dysfunction as well as typical histopathological alterations in the form of neuronal nuclear inclusions in the brain. As in HD patients, in vivo imaging demonstrates striatal shrinkage in magnetic resonance images and a reduced brain glucose metabolism in high-resolution fluor-deoxy-glucose positron emission tomography studies. This model allows longitudinal in vivo imaging studies and is therefore ideally suited for the evaluation of novel therapeutic approaches such as neurotransplantation.     

Saethre‐Chotzen syndrome: Notable intrafamilial phenotypic variability in a large family with Q28X TWIST mutation

Saethre‐Chotzen syndrome is an autosomal dominant disease characterized by craniosynostosis, ptosis, and limb and external ear abnormalities. Variable expressivity is a well‐known phenomenon in this disorder. A large Indian family has been recently identified as carrying a nonsense TWIST mutation (Q28 X) in 17 members, of whom 16 were examined in detail. Only 4 (25%) of the patients showed patent craniostenosis, namely, oxycephaly. The penetrance of craniosynostosis in this family is lower than previously reported in the literature. Fifteen patients (93%) had moderate to severe ptosis. Minor limb and external ear abnormalities were present in most patients. Eyelid features were the hallmark of the disease for 12 members of the family, suggesting that mutations in TWIST may lead to a phenotype with mainly palpebral features and no craniostenosis. The clinical analysis of this large family clearly illustrates the significant variable expressivity, probably related to haploinsufficiency because of the TWIST mutation. This phenotypic variability remains unclear but could be the result of modifier genes and/or genetic background effect, as noticed previously in the transgenic twist‐null heterozygous mice. © 2002 Wiley‐Liss, Inc.     

Fine-needle aspiration diagnosis of Kaposi's sarcoma in a developing country

Fine-needle aspiration (FNA) cytology was performed on 15 patients with peripheral lymphadenopathy and/or skin lesions referred to the Department of Pathology of the Hospital Central of Maputo, Maputo, Mozambique. Epitrochlear lymph nodes were the most frequently aspirated site. All aspirates allowed diagnoses of Kaposi's sarcoma (KS). Smears contained loosely cohesive clusters of bland spindle cells, with a radial arrangement and nuclear crush artifacts. These diagnostic clues have not been described in other spindle-cell intranodal lesions that should be considered in differential diagnoses. Taking into consideration the high prevalence of AIDS and limited resources for diagnosis in Africa, FNA cytology appears to be a useful method for the diagnosis of KS in developing countries, reducing the necessity for surgical lymph node excision.     

Intermediate filament expression by normal and diseased human corneal epithelium

Cicatricial conjunctivitis may be a sequel to systemic disorders (eg, Stevens-Johnson syndrome, cicatricial pemphigoid) or local disorders such as chemical burns. The cicatrisation is often associated with corneal epithelial changes that cause visual loss. These have been attributed to encroachment of the conjunctival epithelium over the cornea. However, the epithelial anomalies are poorly understood. We investigated the corneal epithelial changes in cicatricial conjunctivitis with an immunohistochemical study of intermediate filaments in normal and pathological specimens. Our results show that the normal corneal epithelium is immunoreactive for cytokeratin 3 (CK 3) but not cytokeratin 19 (CK 19), whereas normal conjunctival epithelium is CK 3 negative and CK 19 positive. Conjunctiva artificially transposed over the cornea (after therapeutic conjunctival flap reconstruction) retained the normal pattern of conjunctival cytokeratin expression (CK 3 negative, CK 19 positive). Conversely, the entire corneal epithelium exhibited the normal cytokeratin pattern (CK 3 positive, CK 19 negative) in 82% of Stevens-Johnson, 80% of cicatricial pemphigoid, and 69% of chemical burns specimens. The findings suggest that conjunctival encroachment is not responsible for the changes at the corneal surface in cicatricial conjunctivitis and that the abnormal corneal epithelium is derived from native corneal cells in these diseases.     

A simplified drainage/irrigation system for extracapsular cataract extraction

A simplified irrigation/aspiration system has been developed by the author in cooperation with the Klein company of Heidelberg. The suction is produced by connecting the instrument to a commonly used aspirator. The aspiration force is regulated by means of a foot-pedal, which regulates the amount of "bypass air" delivered through a special tube connected to the irrigation/aspiration handpiece. This simple i/a system represents a low-priced alternative to other systems already on the market.     

Deciphering the molecular effects of non-ablative Er:YAG laser treatment in an in vitro model of the non-keratinized mucous membrane

Lasers in Medical Science -