La prothèse à pivot "GSB"

Résumé L'étude porte sur une série de 50 prothèses totales de genou GSB implantées entre 1981 et 1988 au Centre de Traumatologie et d'Orthopédie de Strasbourg. Cette prothèse entre dans la catégorie des prothèses à charnières cimentées, mais son pivot semi rigide diminue efficacement les contraintes exercées sur le ciment. Les résultats sont conformes à ceux retrouvés dans la littérature concernant les prothèses à charnière. L'accent a été mis plus particulièrement sur les complications spécifiques à ce type d'arthroplastie : infections, fractures, complications rotuliennes. Cependant le caractère semi rigide de la GSB a permis la disparition presque totale des descellements qui compliquaient d'ordinaire les prothèses à charnière. La prothèse GSB nous semble donc supérieure aux autres modèles de prothèse à charnière.     

胃癌中MTS1基因异常甲基化的研究

【目的】探讨多肿瘤抑制基因 (multipletumorsuppressorgene 1,MTS1) 5′端CpG岛异常甲基化与原发性胃癌发病机制之间的关系。【方法】PCR 甲基化检测法研究 31例胃癌标本和 19例正常胃组织中MTS1基因 5′端CpG岛异常甲基化情况。【结果】有 35 5 % (11/ 31)的胃癌标本和 5 3 % (1/ 19)正常胃组织出现MTS1基因 5′端CpG岛异常甲基化 ,两者之间有显著性差异 (P <0 0 5 )。【结论】MTS1基因 5′端CpG岛异常甲基化是其在原发性胃癌中的主要灭活机制 ,与胃癌的发生发展密切相关。     

The inhibitory effect of the antipsychotic drug haloperidol on HERG potassium channels expressed in Xenopus oocytes

1. The antipsychotic drug haloperidol can induce a marked QT prolongation and polymorphic ventricular arrhythmias. In this study, we expressed several cloned cardiac K⁺ channels, including the human ether-a-go-go related gene (HERG) channels, in Xenopus oocytes and tested them for their haloperidol sensitivity.
2. Haloperidol had only little effects on the delayed rectifier channels Kv1.1, Kv1.2, Kv1.5 and I_sK, the A-type channel Kv1.4 and the inward rectifier channel Kir2.1 (inhibition <6% at 3 μM haloperidol).
3. In contrast, haloperidol blocked HERG channels potently with an IC₅₀ value of approximately 1 μM. Reduced haloperidol, the primary metabolite of haloperidol, produced a block with an IC₅₀ value of 2.6 μM.
4. Haloperidol block was use- and voltage-dependent, suggesting that it binds preferentially to either open or inactivated HERG channels. As haloperidol increased the degree and rate of HERG inactivation, binding to inactivated HERG channels is suggested.
5. The channel mutant HERG S631A has been shown to exhibit greatly reduced C-type inactivation which occurs only at potentials greater than 0 mV. Haloperidol block of HERG S631A at 0 mV was four fold weaker than for HERG wild-type channels. Haloperidol affinity for HERG S631A was increased four fold at +40 mV compared to 0 mV.
6. In summary, the data suggest that HERG channel blockade is involved in the arrhythmogenic side effects of haloperidol. The mechanism of haloperidol block involves binding to inactivated HERG channels.

     

Ataque de Nervios and History of Childhood Trauma

Objective: Ataque de nervios is a common, self-labeled Hispanic folk diagnosis. It typically describes episodic, dramatic outbursts of negative emotion in response to a stressor, sometimes involving destructive behavior. Dissociation and affective dysregulation during such episodes suggested a link to childhood trauma. We therefore assessed psychiatric diagnoses, history of ataque, and childhood trauma in treatment-seeking Hispanic outpatients (N = 70). Significantly more subjects with an anxiety or affective disorder plus ataque reported a history of physical abuse, sexual abuse, and/or or a substance-abusing caretaker than those with psychiatric disorder but no ataque. In some Hispanic individuals, ataque may represent a culturally sanctioned expression of extreme affect dysregulation associated with childhood trauma. Patients with ataque de nervios should receive a thorough traumatic history assessment.     

Tratamiento del cáncer de esófago localizado y localmente avanzado: ¿algo ha cambiado?

Esophageal cancer has a dismal prognosis and the surgical treatment only cures a small percentage of patients. The survival achieved by traditional surgical procedures is being improved with extended resections, but at the cost of greater morbidity. Concurrent radiochemotherapy can obtain results similar to those of surgery. Nowadays, locally advanced esophageal cancer should have a multimodal approach, because neoadjuvant chemotherapy, with or without radiotherapy, has demonstrated to improve the survival of chemosensitive patients. Recently, the role of hyperfractionated radiotherapy and new drugs such as paclitaxel, docetaxel and irinotecan in neoadjuvant treatment is being evaluated.     

Le syndrome de Smith-Magenis

Smith-Magenis syndrome is caused by a 17p11.2 deletion. It associates mental retardation, facial dysmorphism and brachydactyly; aberrant behavior and major sleep problems are present in 70% of the cases. It is probably under-diagnosed because the facial abnormalities are mild and the behavioral problems with hyperactivity and self-injuries are dominant, leading to the diagnosis of psychiatric pathology. However these behavioral problems are sufficiently characterized to allow the diagnosis of the syndrome and look for a 17p11.2 microdeletion. Otorhinolaryngologic, ophtalmologic, cardiac and renal abnormalities can be associated and their evaluation is necessary. Smith-Magenis syndrome is considered as a contiguous gene syndrome. Genes have been mapped and isolated to the critical region, but their participation in the pathogenesis of the syndrome remains unclear.     

Hypoglycémie hyperinsulinémique persistante du nouveau-né et du nourrisson

Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is the most frequent cause of hypoglycaemia in infancy. Clinical presentation is heterogeneous, with variable onset of hypoglycaemia and response to diazoxide, and presence of sporadic or familial forms. Underlying histopathological lesions can be focal or diffuse. Focal lesions are characterised by focal hyperplasia of pancreatic islet-like cells, whereas diffuse lesions implicate the whole pancreas. The distinction between the two forms is important because surgical treatment and genetic counselling are radically different. Focal lesions correspond to somatic defects which are totally cured by limited pancreatic resection, whereas diffuse lesions require a subtotal pancreatectomy exposing to high risk of diabetes mellitus. Diffuse lesions are due to functional abnormalities involving several genes and different transmission forms. Recessively inherited PHHI have been attributed to homozygote mutations for the beta-cell sulfonylurea receptor (SUR1) or the inward-rectifying potassium-channel (Kir6.2) genes. Dominantly inherited PHHI can implicate the glucokinase gene, particularly when PHHI is associated with diabetes, the glutamate dehydrogenase gene when hyperammonaemia is associated, or another locus.     

Cancer de l'œsophage : répercussion des thérapeutiques néoadjuvantes sur la morbidité et la mortalité opératoire

Prognosis of œsophageal cancer is poor. There have been phase II–III trials of postoperative chemotherapy with the aim of improving survival. Chemoradiotherapy seems more promising than both chemotherapy and radiotherapy alone. In contrast, better results obtained with chemoradiotherapy were associated with an increase in morbidity and mortality, and finally overall survival was uncommonly improved. It is necessary to implement new multidisciplinary randomised trial.     

L’appréciation des risques sanitaires liés aux aliments : une vision de biométriciens: Seconde partie : mises en œuvre

National and international authorities recommend the use of quantitative risk assessment for any decision-making in the field of the sanitary and nutritional food safety. This paper deals with the principles for the implementation of such analyses. The construction of the model and data specification from food contamination to adverse effects is presented and discussed. While point estimation is the rule for a fast decision-making, the stochastic approach appears to be the only one that allows to answer to the questions of the decision maker. For this approach, Monte-Carlo simulation vs the bayesian approach are compared, the latter is favoured. Nutritionists should be aware of the particular interest to use these methods for the evaluation of the impact of a volontary incorporation of nutriment in food.