Significant anisotropy can be reversibly induced in aqueous suspensions of highly charged latex spheres of about 10 and
20
nm
radius by the application of an electric field. For the first time, ...information is extracted from the rise time of the induced birefringence. The stationary value of the induced birefringence is found to increase with ionic strength, contrasting with what has been observed for non-spherical particles. These results, unexpected on the basis of commonly used particle–field interaction theories, are interpretated as the consequence of a collective reorganization of the system resulting from the electrically induced anisotropy in the particle–particle interactions.
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42.
Une maladie de « vergener Mercier, J.; Theillac, C.; Asli, B. ...
La revue de medecine interne,
June 2016, 2016-06-00, Volume:
37
Journal Article
Peer reviewed
La granulomatose avec polyangéite (GPA, ex-maladie de Wegener) se présente classiquement avec une atteinte ORL, pulmonaire et rénale mais peut affecter tous les organes. Au niveau rénal, il est ...habituel de retrouver une glomérulonéphrite extra-capillaire avec nécrose fibrinoïde, pauci-immune. Nous présentons le cas d’un patient avec une atteinte clinique et une histologie atypiques.
Un homme de 37ans, aux antécédents personnels de rhinite allergique et de polype nasal, consulte en urologie pour une tuméfaction inflammatoire de la verge évoluant depuis 2 mois. Il n’y a pas d’altération de l’état général, l’examen clinique est normal (testicules, aires inguinales). L’IRM retrouve une masse nécrotique dans le corps caverneux gauche, hétérogène, prenant le contraste. Le scanner thoraco-abdomino-pelvien retrouve 3 nodules pulmonaires. Une tumeur maligne est suspectée. La biopsie montre des lésions granulomateuses, épithélioïdes et gigantocellulaires, centrées par une nécrose abcédée et une abondante composante plasmocytaire. Le patient est adressé en médecine interne. Il décrit des arthromyalgies inflammatoires, un amaigrissement (3 kilos en 1 mois), une hypoesthésie dans le territoire du sciatique poplité externe droit, sans déficit moteur. À l’examen, il existe une tuméfaction inflammatoire de la verge, une traînée livedoïde sur le mollet droit. À la biologie, la CRP est à 91mg/L mais la NFP est normale. Il existe une insuffisance rénale débutante (créatinine 104μmol/L, CKD EPI 75mL/min) avec une hématurie microscopique (177 GR/ml) et une protéinurie (1g/L). Les sérologies VIH, VHC, syphilis sont négatives, il est vacciné contre l’hépatite B et le test IGRA est négatif. Les ANCA sont positifs au 320e (N<20) avec une fluorescence cytoplasmique et les anti-PR3 sont à 80 (N<1,2). Le complément n’est pas consommé. Le dosage des IgG4 est normal. La fibroscopie bronchique est macroscopiquement normale et l’aspiration retrouve des éléments granulomateux. L’électromyogramme confirme l’atteinte monotronculaire axonale sensitive. Le scanner des sinus et l’examen ORL sont normaux. La biopsie rénale montre des lésions glomérulaires de nécrose fibrinoïde avec prolifération extra-capillaire sur 30 à 50 % des glomérules (1 pain à cacheter/6) et en immunofluorescence, des dépôts d’IgA mésangiaux, diffus, polyclonaux sont présents. Le diagnostic de GPA est retenu avec atteinte multisystémique. Il est traité par corticoïdes et rituximab selon le protocole RAVE avec une bonne efficacité clinique à la 3e semaine de traitement (disparition de l’hypoesthésie et des arthromyalgies, amélioration de l’état général et de l’inflammation de la verge) mais avec une aggravation progressive de l’insuffisance rénale (créatinine 274μmol/L).
La prévalence de l’atteinte urogénitale (hors insuffisance rénale) est rare dans la GPA, estimée à moins de 1 % avec une atteinte pénienne (typiquement ulcéro-nécrotique), une prostatite, une uréthrite destructrice, une atteinte testiculaire, une épididymite ou encore des atteintes vésicale, urétérale et pseudotumorale rénale. Dans la littérature, à notre connaissance, il n’existe pas d’atteinte pseudotumorale des corps caverneux. D’autre part, malgré des dépôts d’IgA, la présentation clinique (atteinte pulmonaire et neurologique, absence de purpura et de symptômes digestifs) et la présence d’ANCA n’évoquait pas une vascularite à IgA (ex-purpura rhumatoïde). Les dépôts mésangiaux d’IgA sont décrits dans la GPA ; ils peuvent être associés aux lésions classiques ou être isolés début de la maladie. Cette association pourrait être fortuite, la néphropathie à IgA étant la glomérulonéphrite primitive la plus fréquente chez l’adulte, mais il existe possiblement un mécanisme physiopathologique commun. Ceci est conforté par l’apparition de néphropathie à IgA chez des patients ayant une maladie de Wegener en rémission. Enfin, une évolution avec glomérulonéphrite rapidement progressive, malgré un traitement bien conduit, n’évoque pas une néphropathie à IgA mais bien une GPA avec dépôts. Pour finir, nous n’avons pas trouvé de publication rapportant une atteinte urologique de la GPA associée à des dépôts d’IgA.
Devant une atteinte granulomateuse d’organe avec nécrose, une étiologie infectieuse est souvent suspectée mais il faut aussi penser à rechercher une atteinte systémique inflammatoire (interrogatoire, examen clinique, scanner thoraco-abdomino-pelvien), et réaliser le dosage des ANCA à la recherche d’une vascularite nécrosante.
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Summary Detection of MUM1+ cells in follicular lymphoma (FL) tissues was previously found to be associated with poor prognosis in a single report, whereas the usefulness of Ki-67 immunostaining ...remains debated. Our goal was to establish whether these markers have predictive value for patients with FL. We analyzed MUM1 and Ki-67 expression using immunohistochemistry in biopsy samples from 434 patients from the PRIMA randomized trial. The MUM1 prognostic value was then validated in a cohort of 138 patients from the FL2000 randomized trial, using the optimal cutoff value obtained from the PRIMA cohort. The surface of positive staining was quantified using computerized image analysis. In the PRIMA cohort, both high levels of MUM1 positivity (cutoff value of 0.80%) and high levels of Ki-67 positivity (cutoff value of 10.25%) were significantly associated with a shorter progression-free survival (PFS) ( P = .004 and P = .007 for MUM1 and Ki-67, respectively). In a multivariate Cox proportional hazards regression model, only MUM1 retained a statistical significance (hazards ratio 1.56; 95% confidence interval, 1.02-2.37; P = .038) after adjustment for the maintenance arm of treatment and the follicular lymphoma international prognostic index score. In the FL2000 cohort, high levels of MUM1 positivity were significantly associated to a shorter PFS ( P = .004) and to a trend toward a shorter overall survival ( P = .043). This remained significant using a multivariate Cox regression model after adjustment for the follicular lymphoma international prognostic index and the treatment arm for PFS ( P = .016). These results show that MUM1 is a strong and robust predictive immunohistochemical marker in patients with FL.
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Although follicular lymphoma (FL) is usually graded as FL1-2, FL3A, and FL3B, some borderline cases can be observed and led us to investigate the clinicopathologic diversity of grade 3 FL (FL3). ...Among 2449 FL patients enrolled in Lymphoma Study Association (LYSA) trials, 1921 cases with sufficient material underwent a central pathologic review. The resulting diagnoses comprised 89.6% FL1-2 (n=1723), 7.2% FL3A (n=138), and 0.5% purely follicular FL3B (n=9). The remaining 51 unclassifiable cases (2.7%) exhibited high-grade features but did not meet WHO criteria for either FL3A or FL3B; and were considered as “unconventional” high-grade FL (FL3U). FL3U morphological pattern consisted of nodular proliferation of large cleaved cells or small-sized to medium-sized blast cells. Compared with FL3A, FL3U exhibited higher MUM1 and Ki67 expression, less
BCL2
breaks and more
BCL6
rearrangements, together with a higher number of cases without any
BCL2
,
BCL6
or
MYC
rearrangement. FL3U harbored less frequent mutations in
BCL2
,
KMT2D
,
KMT2B
, and
CREBBP
than FL3A.
MYC
and
BCL2
were less frequently mutated in FL3U than FL3B. Rituximab cyclophosphamide, doxorubicin, vincristine, and prednisone treated FL3U patients had a worse survival than FL1-2 patients with similar follicular lymphoma international prognostic index and treatment. These results suggest that high-grade FLs encompass a heterogeneous spectrum of tumors with variable morphology and genomic alterations, including FL3U cases that do not strictly fit WHO criteria for either FL3A or FL3B, and display a worse outcome than FL1-2. The distinction of FL3U may be useful to allow a better comprehension of high-grade FLs and to design clinical trials.
Using a method introduced by Albano et al (Albano, A. M.; Bedeaux, D.; Vlieger, J. Phys. A 1979, 99, 293. Albano, A. M.; Bedeaux, D.; Vlieger, J. Phys. A 1980, 102, 105), we derive an exact analytic ...expression for the dipolar coefficient of a charged sphere in an electrolyte as a function of the frequency which is valid for all double layer thicknesses and is given both for low and for high zeta potentials. The expression is found to have the same form as the expression for a sphere surrounded by a multiple of shells of different complex conductivities. One shell can then be attributed to the double layer and another to a diffusion layer. Including a Stern layer in the model subsequently adds another shell with associated complex dielectric permittivity.
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L'augmentation de la masse du myocarde n'est pas le seul facteur d'adaptation de l'organe à une surcharge mécanique. La biologie moléculaire permet l'analyse de modifications qualitatives survenant ...dans divers systèmes biologiques constitutifs (changement d'expression du génome).
Myocardial hypertrophy is not the only adaptative factor of a chronically overloaded heart. Molecular biology enables the study of qualitative modifications in the various biological systems and notably the change of genome expression.
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Electrically induced birefringence experiments were performed on dispersions consisting of sulfate latex nanospheres of two different sizes and charges dispersed in an electrolyte solution, at ...various ionic strengths. The induced birefringence was found to have an important contribution increasing as a quadratic power law of the volume fraction of the spheres. This shows that interparticle interactions play a role in the observed birefringence. The data were analyzed, using a theory from Hafkenscheid and Vlieger Physica 75 (1974) 57, in terms of the changes of the interparticle separations in the directions parallel and perpendicular to the applied electric field.
Electrically induced birefringence experiments were performed on dispersions consisting of sulfate latex nanospheres of two different sizes and charges dispersed in an electrolyte solution, at various ionic strengths. The induced birefringence was found to have an important contribution increasing as a quadratic power law of the volume fraction of the spheres. This shows that interparticle interactions play a role in the observed birefringence. The data were analyzed, using a theory from Hafkenscheid and Vlieger Physica 75 (1974) 57, in terms of the changes of the interparticle separations in the directions parallel and perpendicular to the applied electric field.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Aims: To review the use of tamoxifen in malignant epithelial–nonepithelial tumours of the endometrium. Tamoxifen has been widely used for almost 20 years as adjuvant therapy for breast cancer. Large ...clinical trials have pointed out that long-term tamoxifen therapy increases the risk of uterine cancers. These tumours include endometrial carcinomas, stromal sarcomas, leiomyosarcomas as well as malignant mixed (epithelial–nonepithelial) tumours. Methods: We report here six more cases of malignant epithelial–nonepithelial tumours which, in addition to those reported in the literature, makes a total of 36 presented cases. The pathogenesis of such tumours remains unclear, but it has been claimed that unopposed oestrogenic stimulation due to the agonistic effect of tamoxifen might be involved, as in the case of endometrial carcinomas. Pelvic irradiation has also been incriminated, especiallly in women under 55 years of age. Results: Among 21 endometrial malignant epithelial–nonepithelial tumours associated with tamoxifen, seven occurred in women less than 55 years old. Five of them had previous pelvic irradiation. The data from the literature and from our series suggest that tamoxifen might favour the occurrence of malignant epithelial–nonepithelial tumours in women with breast cancer aged over 55 years, whereas in younger women both pelvic irradiation and tamoxifen might participate.
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Experimental data on the dielectric response of latex dispersions for a large variety of particle sizes, surface charge densities, and ionic strengths are interpreted using an analytical theory ...developed previously (Chassagne, C.; Bedeaux, D.; Koper, G. J. M. J. Phys. Chem. B 2001, 105, 11743 and Physica A 2002, 317, 321). It is found that the conductivity increment is a crucial variable in the discussion about the need of a Stern layer conductance. Both the dielectric permittivity and the conductivitty increments are fitted using the zeta potential and a Stern layer conductance.
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Abstract
Among 1107 cryptococcosis cases from the French surveillance network (2005–2020), the proportion of HIV-seronegative individuals has recently surpassed that of HIV-seropositive individuals. ...We observed marked differences in patient characteristics, disease presentations, cryptococcal antigen results, infecting species, and mortality according to HIV serostatus.
Graphical Abstract
Graphical Abstract
Among 1,107 cryptococcosis cases from the French surveillance network (2005-2020), the proportion of HIV-seronegative individuals has recently surpassed that of HIV-seropositive individuals. We observed marked differences in patient characteristics, disease presentations, cryptococcal antigen results, infecting species, and mortality according to HIV serostatus.
