Bases anatomiques pour la chirurgie vertébrale de la jonction thoraco-lombaire

Résumé Les deux premières vertèbres lombaires et les trois dernières vertèbres dorsales forment une région anatomo-chirurgicale caractérisée par des rapports antérieurs diaphragmatiques qui nécessitent une phrénotomie pour un abord antérieur. C'est pourquoi l'étude des gros vaisseaux prévertébraux à mobiliser, des vaisseaux collatéraux à ligaturer, des vaisseaux intrarachidiens à éviter méritait d'être exposée. La zone d'élection des ligatures se situe sur les flancs de l'aorte et les zones dangereuses pour la vascularisation médullaire sont représentées par l'espace compris entre les trous de conjugaison et les apophyses transverses.     

Strategies for improved stability of Peste des Petits Ruminants Vaccine

The main focus of this work was the improvement of the stability of the current PPRV vaccine. First, new formulations based on the Tris buffer were tested, with and without the addition of sucrose and trehalose and compared with the formulation normally used to stabilize the vaccine, the Weybridge medium. The results show a virus half-life of 21 h at 37 °C and 1 month at 4 °C for the Tris/trehalose liquid formulation and, in the lyophilized form, the formulation was able to maintain the viral titer above the 1 × 10⁴ TCID₅₀/mL (>10 doses/mL) for at least 21 months at 4 °C (0.6 log lost), 144 h at 37 °C (0.6 log lost) and 120 h at 45 °C (1 log lost).Secondly, a strategy based on culture medium composition manipulation aiming at improving the intrinsic PPRV vaccine stability was also evaluated. The addition of 25 mM fructose resulted in a higher virus production (1 log increase) with higher stability (2.6-fold increase compared to glucose 25 mM) at 37 °C. Increased concentrations of NaCl, improved virus release, reducing the cell-associated fraction of the virus produced. Moreover this harvesting strategy is scalable and more suitable for a larger scale production than the freeze/thaw cycles normally used.The information gathered in this work showed that it is possible for the PPRV vaccine to have adequate short-term stability at non-freezing temperatures to support manufacturing, short-term shipping and storage. The identification of a more stable formulation should significantly enhance the utility of the vaccine in the control of a PPRV outbreak.     

Impact of X-ray energy on absorbed dose assessed with Monte Carlo simulations in a mouse tumor and in nearest organs irradiated with kilovoltage X-ray beams

Purpose

Radiotherapy treatments to local tumors are always associated with dose deposit in surrounding tissues and even in distant tissues not traversed by the radiation beams. In the present work, we demonstrate by Monte Carlo simulations the impact of radiation energy on absorbed dose in a lung tumor and in other secondary organs in a digital mouse. We also report the energy difference between simulations of monoenergetic and spectral radiations, and between CT-based and atlas-made digital mouse.

Les bases anatomiques du lambeau axillaire thoracodorsal en vue de son transfert par microchirurgie vasculaire

Résumé Une étude anatomique portant sur 30 cadavres frais, utilisant des injections sélectives et un protocole opératoire rigoureux, démontre la fiabilité du lambeau axillaire thoracodorsal axé sur le pédicule scapulaire inférieur, malgré la possibilité de transplant musculo-cutané lorsqu'il n'existe pas d'artère cutanée directe (25% des cas).Cette analyse est la base de la technique du transfert du lambeau axillaire par microchirurgie vasculaire, et a permis la réalisation de 5 succès en clinique humaine.     

Caractéristiques cliniques,paracliniques et profil évolutif de l’atteinte aortique de la maladie de Horton : à propos de 26 cas d’aortite parmi 63 cas de maladie de Horton

Purpose

Aortic involvement that occurs in temporal arteritis is probably underestimated because it is usually asymptomatic. The characteristics of giant cell arteritis with aortic involvement are still poorly described and the relationship between aortitis and vascular outcome of the disease has not been clearly delineated. The objective of this retrospective study of 63 patients with giant cell arteritis, including 26 with aortic involvement, was to compare the features of patients with and without aortitis, and to assess the contribution of CT-scan and FDG-PET-scan in screening for vascular disease, monitoring, and therapeutic management of patients.

Methods

This retrospective study was conducted in the internal medicine department of the university hospital in Marseille, France, from January 1, 2005 to September 30, 2011. Patients had at least three out of the five American College of Rheumatology criteria for temporal arteritis and aortic involvement was investigated in all patients using CT-scan. Aortic wall thickness greater or equal to 3 mm was considered to be abnormal.

Results

Of 63 patients diagnosed with giant cell arteritis, 26 (41.3%) had aortic involvement diagnosed by aortic CT-scan. Age at diagnosis was significantly younger (66.8 vs 73.8 years; P = 0.002) in the group with aortitis. Inflammatory dorsal and low back pain, signs of vascular disease of the upper limbs (P = 0.009), and higher level of acute phase reactants were associated with aortitis. Aneurysmal lesions of the aorta were significantly more frequent in the group with aortitis. Twenty patients had both aortic CT-scan and FDG-PET-scan. For patients in whom aortic involvement was not demonstrated with CT-scan, FDG-PET-scan was always non-contributive. With corticosteroids, aortitis resolved within 6 months in all patients as evaluated by aortic CT-scan. However, aortitis persisted in 80% of cases at 6 months when evaluated with FDG-PET-scan, and in 66% of cases at 12 months, without influencing the treatment.

Conclusion

This case series shows no specific features of aorta and its main roots involvement in giant cell arteritis, justifying a systematic screening by CT-scan. The high frequency of this arterial involvement could help physicians in the diagnosis of giant cell arteritis. Aortitis seems to be associated with vascular complications as highlighted by the frequency of aortic aneurysm and a case of early aortic dissection. Finally, the role of PET-CT-scan for screening vascular disease and therapeutic monitoring remains to be clarified.     

Caprine MAVS Is a RIG-I Interacting Type I Interferon Inducer Downregulated by Peste des Petits Ruminants Virus Infection

The mitochondrial antiviral-signaling protein (MAVS, also known as VISA, IPS-1, or CARDIF) plays an essential role in the type I interferon (IFN) response and in retinoic acid-inducible gene I (RIG-I) mediated antiviral innate immunity in mammals. In this study, the caprine MAVS gene (caMAVS, 1566 bp) was identified and cloned. The caMAVS shares the highest amino acid similarity (98.1%) with the predicted sheep MAVS. Confocal microscopy analysis of partial deletion mutants of caMAVS revealed that the transmembrane and the so-called Non-Characterized domains are indispensable for intracellular localization to mitochondria. Overexpression of caMAVS in caprine endometrial epithelial cells up-regulated the mRNA levels of caprine interferon-stimulated genes. We concluded that caprine MAVS mediates the activation of the type I IFN pathway. We further demonstrated that both the CARD-like domain and the transmembrane domain of caMAVS were essential for the activation of the IFN-β promotor. The interaction between caMAVS and caprine RIG-I and the vital role of the CARD and NC domain in this interaction was demonstrated by co-immunoprecipitation. Upon infection with the Peste des Petits Ruminants Virus (PPRV, genus Morbillivirus), the level of MAVS was greatly reduced. This reduction was prevented by the addition of the proteasome inhibitor MG132. Moreover, we found that viral protein V could interact and colocalize with MAVS. Together, we identified caMAVS as a RIG-I interactive protein involved in the activation of type I IFN pathways in caprine cells and as a target for PPRV immune evasion.     

Testing a new formulation for Peste des Petits Ruminants vaccine in Ethiopia

In this paper extended tests on a new candidate formulation for Peste des Petits Ruminants (PPR) vaccine carried out at National Veterinary Institute (NVI) in Ethiopia are presented. This work was performed in the frame of the VACNADA project from GALVmed which aimed at procuring vaccines against neglected veterinary diseases to African vaccine producing laboratories, in particular PPR.