Direct Thy-1/alphaVbeta3 integrin interaction mediates neuron to astrocyte communication.

Thy-1 is an abundant neuronal glycoprotein of poorly defined function. We recently provided evidence indicating that Thy-1 clusters a beta3-containing integrin in astrocytes to induce tyrosine phosphorylation, RhoA activation and the formation of focal adhesions and stress fibers. To date, the alpha subunit partner of beta3 integrin in DI TNC1 astrocytes is unknown. Similarly, the ability of neuronal, membrane-bound Thy-1 to trigger astrocyte signaling via integrin engagement remains speculation. Here, evidence that alphav forms an alphavbeta3 heterodimer in DI TNC1 astrocytes was obtained. In neuron-astrocyte association assays, the presence of either anti-alphav or anti-beta3 integrin antibodies reduced cell-cell interaction demonstrating the requirement of both integrin subunits for this association. Moreover, anti-Thy-1 antibodies blocked stimulation of astrocytes by neurons but not the binding of these two cell types. Thus, neuron-astrocyte association involved binding between molecular components in addition to the Thy-1-integrin; however, the signaling events leading to focal adhesion formation in astrocytes depended exclusively on the latter interaction. Additionally, wild-type (RLD) but not mutated (RLE) Thy-1 was shown to directly interact with alphavbeta3 integrin by Surface Plasmon Resonance analysis. This interaction was promoted by divalent cations and was species-independent. Together, these results demonstrate that the alphavbeta3 integrin heterodimer interacts directly with Thy-1 present on neuronal cells to stimulate astrocytes.

Le fixateur externe dans les lésions traumatiques graves du bassin: résultats à propos de 20 cas consécutifs [External fixator in severe traumatic injuries of the pelvis: results apropos of 20 consecutive cases]

From August 91 to December 94, 20 external fixators were used for severely injured patients (avg. ISS 25.2). The fractures were essentially open book with or without lateral compression and vertical lesions. The indication for fixation was treatment of shock and stabilization in 8 cases, stabilization alone in 9 cases, and in 3 cases as complementary fixation after internal fixation of posterior lesions. The fixation of the pelvis was effective on the amount of blood loss. One acetabulum fracture required surgery, two patients had internal fixation for loss of reduction and two others for late pubic and posterior pain. The clinical results are good; they are more related to the severity of the initial lesion than to the mode of fixation or the quality of the reduction. No superficial sepsis or osteitis was observed in relation to the pins.

Secretory IgA, a major immunoglobulin in most bovine external secretions.

Bovine secretory IgA (SIgA), recently identified in colostrum, was shown to be homologous to human SIgA by immunologic cross-reaction. A quantitative study indicated that bovine SIgA, a minor component of colostrum, is a major immunoglobulin in most other external secretions including saliva, spermatic fluid, lacrimal, nasal and gastrointestinal secretions. SIgA was isolated from saliva. The free form of secretory component was found to be abundant in milk. A normal lactating cow produces about 1.2 g of this protein per day. Two forms of IgA were identified in serum: a normal serum IgA with no secretory antigenic determinant, and a small amount of SIgA. In vitro synthesis of SIgA by the salivary gland was studied by tissue cultures with incorporation of labeled amino acids.

Pin guidance of reconstruction plate contour: an expanded role of external fixation

This article presents a modification of intraoperative external fixation for mandibular reconstruction with free tissue flaps. This technique is indicated when preregistration of the reconstruction plate is not possible due to transmandibular tumor extension. Once standard external fixation has been carried out and prior to segmental mandibulectomy, additional pins are fixed to the connecting rod that delineate the mandibular contour in three-dimensional (3D) space. Following mandibulectomy, these pins allow accurate contouring of the reconstruction plate and improved restoration of mandibular contour, projection, and dental occlusion. A step-by-step description of the technique using models and intraoperative photos is presented. This method of mandibular reconstruction is a simple and time-effective alternative to intraoperative computer navigation and 3D modeling in select cases of oral carcinoma where tumor infiltration of the outer mandibular cortex precludes prebending of the reconstruction plates.

A treatment planning method for sequentially combining radiopharmaceutical therapy and external radiation therapy.

PURPOSE: Effective cancer treatment generally requires combination therapy. The combination of external beam therapy (XRT) with radiopharmaceutical therapy (RPT) requires accurate three-dimensional dose calculations to avoid toxicity and evaluate efficacy. We have developed and tested a treatment planning method, using the patient-specific three-dimensional dosimetry package 3D-RD, for sequentially combined RPT/XRT therapy designed to limit toxicity to organs at risk. METHODS AND MATERIALS: The biologic effective dose (BED) was used to translate voxelized RPT absorbed dose (D(RPT)) values into a normalized total dose (or equivalent 2-Gy-fraction XRT absorbed dose), NTD(RPT) map. The BED was calculated numerically using an algorithmic approach, which enabled a more accurate calculation of BED and NTD(RPT). A treatment plan from the combined Samarium-153 and external beam was designed that would deliver a tumoricidal dose while delivering no more than 50 Gy of NTD(sum) to the spinal cord of a patient with a paraspinal tumor. RESULTS: The average voxel NTD(RPT) to tumor from RPT was 22.6 Gy (range, 1-85 Gy); the maximum spinal cord voxel NTD(RPT) from RPT was 6.8 Gy. The combined therapy NTD(sum) to tumor was 71.5 Gy (range, 40-135 Gy) for a maximum voxel spinal cord NTD(sum) equal to the maximum tolerated dose of 50 Gy. CONCLUSIONS: A method that enables real-time treatment planning of combined RPT-XRT has been developed. By implementing a more generalized conversion between the dose values from the two modalities and an activity-based treatment of partial volume effects, the reliability of combination therapy treatment planning has been expanded.

Quand la nourriture se fait parole: Scènes de communication alimentaire dans les récits médiévaux

Depuis les travaux d'Anita Guerreau-Jalabert sur la symbolique des triangles alimentaires dans le roman arthurien, personne ne saurait douter qu'au Moyen Âge la nourriture obéit à des codes. Une scène de table ne se réduit pas à une notation à valeur référentielle, à un éclat de vie aristocratique : intégrée au récit, la notation alimentaire est un élément constitutif du sens de l'oeuvre. Plus particulièrement, un plat peut servir de message adressé par un personnage à un autre. On s'est peu intéressé, si ce n'est pour la légende du coeur mangé, à ces passages où la nourriture vient compléter, voire se substituer à la parole. Des nouvelles de Boccace (traduites par Laurent de Premierfait) aux Cent Nouvelles nouvelles et au Pogge (traduit par Guillaume Tardif), mais aussi dans les romans (Ysaÿe le Triste, Le Cuer d'amours espris, Jehan de Saintré), les exemples ne manquent pas qui, à la fin du Moyen Âge, illustrent la variété des messages alimentaires. Si le plat qu'on sert peut être l'instrument d'une vengeance (le repas cannibale !), il est aussi et surtout utilisé comme moyen de séduction. Parfois, il s'agit d'un avertissement qui, par la transgression des codes, donne voix à la morale ; ailleurs, l'ironie s'en mêle, quand la nourriture traduit une attitude de dérision face au convive. Ce dernier procédé, plus ludique, ne se rencontre pas seulement - comme on pourrait s'y attendre - dans l'univers du fabliau ou de la nouvelle. Il traverse le Moyen Âge et, du XIIe au XVe siècle, prépare l'émergence du cuisinier dont l'art et les « joyeux dits » font un double du poète.

Speaking from the Inside: Challenges Faced by Communication Researchers Investigating Disease-Related Issues in a Hospital Setting.

This commentary came from within the framework of integrating the humanities in medicine and from accompanying research on disease-related issues by teams involving clinicians and researchers in medical humanities. The purpose is to reflect on the challenges faced by researchers when conducting emotionally laden research and on how they impact observations and subsequent research findings. This commentary is furthermore a call to action since it promotes the institutionalization of a supportive context for medical humanities researchers who have not been trained to cope with sensitive medical topics in research. To that end, concrete recommendations regarding training and supervision were formulated.

Communication with terminal cancer patients in palliative care: are there differences between nurses and physicians?

The aim of this study was to find whether there were interprofessional differences in specific elements of communication with terminal cancer patients and decision-making processes that concern such patients. Given that interdisciplinary team work is one of the basic values in palliative care, if there are conflicting views between professions on such important issues it is most important to know about these and to understand them. A questionnaire utilized in an earlier survey of palliative care physicians and addressing their attitudes to and beliefs about specific elements of communication and decision making was sent to a sample of palliative care nurses working in the same regions, i.e. the French-speaking parts of Switzerland, Belgium and France. After a second mailing (reminder), 135 of the 163 questionnaires (83%) were returned. There was general agreement between nurses and physicians on questions dealing with perceptions of patients' knowledge of their diagnosis and stage of disease, patients' need for information, "do not resuscitate" orders and ethical principles in decision-making processes. Statistically significant, but small, differences between professional groups were only observed for a minority of the questions. Interprofessional differences in specific elements of communication with terminal cancer patients and decision-making processes affecting these patients were not so marked that they could be called "conflicting interprofessional views."

Communication skills training in oncology: it works!

While the previous chapter by L. Fallowfield and V. Jenkins focuses on different communication skills training (CST) concepts currently being utilized, this chapter reviews and comments the scientific evidence of the impact of CST on improving communication skills. The aim of this chapter is not to provide a complete review of the evidence-this has already been done in systematic reviews-but to discuss the scientific evidence and reflect on the available results and relevant topics for further investigations.

Oxidation of methane at the CH4/H2O-(CO2) transition zone in the external part of the Central Alps, Switzerland: Evidence from stable isotope investigations

With the aim of understanding the mechanisms that control the metamorphic transition from the CH4- to the H2O-(CO2)-dominated fluid zone in the Helvetic domain of the Central Alps of Switzerland, fluid inclusions in quartz, illite ``crystallinity'' index, vitrinite reflectance, and the stable isotope compositions of vein and whole rock minerals and fluids trapped in quartz were investigated along four cross-sections. Increasing temperature during prograde metamorphism led to the formation of dry gas by hydrocarbon cracking in the CH4-zone. Fluid immiscibility in the H2O-CH4-(CO2)-NaCl system resulted in cogenetic, CH4- and H2O-dominated fluid inclusions. In the CH4-zone, fluids were trapped at temperatures <= 270 +/- 5 degrees C. The end of the CH4-zone is markedby a sudden increase of CO2 content in the gas phase of fluid inclusions. At temperatures > 270 +/- 5 degrees C, in the H2O-zone, the total amount of volatiles within the fluid decreased below 1 mol% with no immiscibility. This resulted m total homogenization temperatures of H2O-(CO2-CH4)-NaCl inclusions below 180 degrees C. Hydrogen isotope compositions of methane in fluid inclusion have delta D values of less than -100 parts per thousand in the CH4-zone, typical for an origin through cracking of higher hydrocarbons, but where the methane has not equilibrated with the pore water. delta D values of fluid inclusion water are around -40 parts per thousand., in isotopic equilibrium with phyllosilicates of the whole rocks. Within the CH4 to H2O(CO2) transition zone, delta D(H2O) values in fluid inclusions decrease to -130 parts per thousand interpreted to reflect the contribution of deuterium depleted water from methane oxidation. In the H2O-zone, delta D(H2O) values increase again towards an average of -30 parts per thousand which is again consistent with isotopic equilibrium with host-rock phyllosilicates. delta C-13 values of methane in fluid inclusions from the CH4-zone are around -27 parts per thousand in isotopic equilibrium with calcite in veins and whole rocks. The delta C-13(CH4) values decrease to less than -35 parts per thousand at the transition to the H2O-zone and are no longer in equilibrium with the carbonates in the whole rocks. delta C-13 values of CO, are variable but too low to be in equilibrium with the wall rock fluids, compatible with a contribution of CO2 from closed system oxidation of methane. Differences in isotopic composition between host-rock and Alpine fissure carbonate are generally small, suggesting that the amount of CO2 produced by oxidation of methane was small compared to the C-budget in the rocks and local pore fluids were buffered by the wall rocks during precipitation of calcite within the fissures. (c) 2006 Elsevier B.V. All rights reserved.