Rousseau et le théâtre : le pour et le contre

Mme Michèle Crogiez traite dans sa communication de la querelle du théâtre à Genève entre Jean-Jacques Rousseau et D’Alembert à l’occasion de la publication de l’article "Genève" de l’ "Encyclopédie". La "Lettre à D’Alembert sur les spectacles" (1758) rédigée à Montmorency par Rousseau n’a rien d’une relation de voyage. Rousseau a quitté adolescent sa ville natale, et D’Alembert ne l’a connaît que très imparfaitement par de courts séjours … et par Voltaire. C’est donc d’un lieu largement imaginaire que parlent les deux écrivains. Paradoxalement, Rousseau qui est connu alors par des "discours" scandaleux l’est aussi par sa participation à la querelle des musiques italienne et française et par son activité d’auteur dramatique ("Le Devin de village"). Le contempteur du théâtre à Genève est lui-même homme de théâtre. Si le but de l’article "Genève" est aussi de faire connaître la République helvétique aux Français, le théâtre fait partie de la dimension politique d’une cité et justifie le développement de l’article sur ce qui n’existe pas à Genève, une vie théâtrale officielle. Dans sa "Lettre" (forme habituelle du débat ouvert au XVIIIe siècle), Rousseau emploie de façon récurrente la notion de "patrie" et de "patriotique" pour désigner la spécificité genevoise. Pour Rousseau, les hommes modernes sont corrompus, mais de manière diversifiée. Si les spectacles peuvent être autorisés à Paris (corruption forte et sans espoir de retour), ils doivent être bannis dans les pays où la corruption n’a pas atteint ce degré et où subsiste quelque chose de la primitive honnêteté. Derrière cette querelle, il y a évidemment Voltaire qui tente, des Délices à Carouge, d’introduire à Genève des spectacles théâtraux privés, complices de l’esprit corrupteur (voir ci-dessous sa lettre au marquis Capacelli). Et D’Alembert est son truchement. Chez Rousseau, Genève est une ville d’utopie pour un voyage dans sa mémoire affective, un lieu intime et menacé.

Three-dimensional electroanatomic entrainment map in atypical atrial flutter late after heart transplantation

Atrial flutter in the donor part of orthotopic heart transplants has been reported and successfully treated by radiofrequency ablation of the cavotricuspid isthmus, but mapping and ablation of atypical flutter circuits may be challenging.(1) Entrainment mapping has been used in combination with activation mapping to define the mechanism of atypical atrial flutter. Here, we report a case where colour-coded three-dimensional (3D) entrainment mapping allowed us to accurately determine and visualize the 3D location of the reentrant circuit and to plan the ablation of a left atrial flutter without the need for activation mapping.

Variable Na(v)1.5 protein expression from the wild-type allele correlates with the penetrance of cardiac conduction disease in the Scn5a(+/-) mouse model

BACKGROUND: Loss-of-function mutations in SCN5A, the gene encoding Na(v)1.5 Na+ channel, are associated with inherited cardiac conduction defects and Brugada syndrome, which both exhibit variable phenotypic penetrance of conduction defects. We investigated the mechanisms of this heterogeneity in a mouse model with heterozygous targeted disruption of Scn5a (Scn5a(+/-) mice) and compared our results to those obtained in patients with loss-of-function mutations in SCN5A. METHODOLOGY/PRINCIPAL FINDINGS: Based on ECG, 10-week-old Scn5a(+/-) mice were divided into 2 subgroups, one displaying severe ventricular conduction defects (QRS interval>18 ms) and one a mild phenotype (QRS< or = 18 ms; QRS in wild-type littermates: 10-18 ms). Phenotypic difference persisted with aging. At 10 weeks, the Na+ channel blocker ajmaline prolonged QRS interval similarly in both groups of Scn5a(+/-) mice. In contrast, in old mice (>53 weeks), ajmaline effect was larger in the severely affected subgroup. These data matched the clinical observations on patients with SCN5A loss-of-function mutations with either severe or mild conduction defects. Ventricular tachycardia developed in 5/10 old severely affected Scn5a(+/-) mice but not in mildly affected ones. Correspondingly, symptomatic SCN5A-mutated Brugada patients had more severe conduction defects than asymptomatic patients. Old severely affected Scn5a(+/-) mice but not mildly affected ones showed extensive cardiac fibrosis. Mildly affected Scn5a(+/-) mice had similar Na(v)1.5 mRNA but higher Na(v)1.5 protein expression, and moderately larger I(Na) current than severely affected Scn5a(+/-) mice. As a consequence, action potential upstroke velocity was more decreased in severely affected Scn5a(+/-) mice than in mildly affected ones. CONCLUSIONS: Scn5a(+/-) mice show similar phenotypic heterogeneity as SCN5A-mutated patients. In Scn5a(+/-) mice, phenotype severity correlates with wild-type Na(v)1.5 protein expression.

Infliximab for Crohn's disease in the Swiss IBD Cohort Study: clinical management and appropriateness

Antitumor necrosis factor a agents have significantly improved the management of Crohn's disease (CD), but not all patients benefit from this therapy. We used data from the Swiss Inflammatory Bowel Disease Cohort Study and predefined appropriateness criteria to examine the appropriateness of use of infliximab (IFX) in CD patients.

Prognostic value of microvascular invasion in predicting the cancer specific survival and risk of metastatic disease in renal cell carcinoma: a multicenter investigation

While microvascular invasion is an accepted risk factor in various cancers, its prognostic role in renal cell carcinoma is still unclear. Therefore, a large multicenter study examining the experience of 5 international institutions was performed to evaluate the prognostic value of microvascular invasion in the occurrence of metastases and cancer specific survival.

Lymph node dissection in renal cell carcinoma

Although lymphadenectomy (lymph node dissection [LND]) is currently accepted as the most accurate and reliable staging procedure for the detection of lymph node invasion (LNI), its therapeutic benefit in renal cell carcinoma (RCC) still remains controversial.