Idiopathic chylothorax and lymphedema in 2 whippet littermates.

Idiopathic chylothorax and limb edema was diagnosed in two 2-year-old male whippet siblings. The fact that the 2 related animals developed similar clinical signs at a young age may suggest a congenital or hereditary etiology.

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients.

BACKGROUND Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time. METHODS Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.7 mg/dL and proteinuria <1 g/day or g/g creatinine despite at least 1 year without any immunosuppressive drug) and 'almost tolerant' patients (minimally immunosuppressed patients (MIS) receiving low-dose steroids) as possible. We reported their number and the total number of kidney transplants performed at each centre to calculate their frequency. RESULTS One hundred and forty-seven questionnaires were returned and we identified 66 TOL (61 with complete data) and 34 MIS patients. Of the 61 TOL patients, 26 were previously described by the Nantes group and 35 new patients are presented here. Most of them were noncompliant patients. At data collection, 31/35 patients were alive and 22/31 still TOL. For the remaining 9/31, 2 were restarted on immunosuppressive drugs and 7 had rising creatinine of whom 3 resumed dialysis. Considering all patients, 10-year death-censored graft survival post-immunosuppression weaning reached 85% in TOL patients and 100% in MIS patients. With 218 913 kidney recipients surveyed, cumulative incidences of operational tolerance and almost tolerance were estimated at 3 and 1.5 per 10 000 kidney recipients, respectively. CONCLUSIONS In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival.

L'oeuvre de Sade et le conte. Le retour refoulé de Barbe-Bleue

Cet article s’intéresse aux différentes fonctions que l’on peut attribuer aux éléments fabuleux dans les œuvres du marquis de Sade. Il s’agit en particulier d’éclaircir les liens intertextuels entre Barbe-Bleue et un conte allégorique que le marquis publie, en 1800, dans la série de ses Crimes de l’amour, sous le titre de Rodrigue ou la tour enchantée. Dans ce texte, la chambre interdite renvoie aussi à un passé criminel, mais elle ne réveille pas la mauvaise conscience et ne suscite aucun remords. Sade semble vouloir faire du conte de Barbe-Bleue le paradigme d’un refoulement manqué, la figure d’une rechute malencontreuse dans un passé archaïque et indigne d’être examiné moralement. Or, les œuvres de Sade ne peuvent plus admettre l’univers surnaturel des contes de fées, considéré comme tout aussi révolu que cette conscience morale qui s’exprime par le remords.