Pièces relatives à l'histoire de la ville de TULLE. I

Contient : Copies de bulles, lettres royaux, etc., concernant l'histoire de la ville de Tulle (1372-1547), extraites des archives et de la Bibliothèque du Roi, des archives de l'église de Tulle et d'originaux en la possession de Baluze ; Accord entre l'évêque et le chapitre de Tulle (1429), extrait du « Codex magnorum statutorum » ; Accords entre Louis d'Aubusson, évêque de Tulle, et Guichard de Comborn, abbé d'Uzerche (1456-1465) ; Hommage fait par Charles de Malemont à Clément de Brillac, évêque de Tulle (18 avril 1503) ; « Acta primi ingressus Hugonis de Albuconia, episcopi Tutellensis » (1451) ; « Acta primi ingressus Dionysii de Barro, episcopi Tutelensis » (1472) ; Serments prêtés par les évêques de Tulle de respecter les libertés de la ville (1495-1561) ; Description de l'église cathédrale de Tulle ; Copie figurée d'une inscription de l'église de Moissac, relative à la dédicace de cette église en 1063 (Cf. Gall. christ., t. I, col. 158) ; Pièces relatives à l'envoi du comte de Ventadour comme gouverneur du Limousin (1634) ; originaux ; Catalogus abbatum et episcoporum Tullensium, par Et. Baluze (placard imprimé ; Tulle, 1669) ; Procès-verbaux « touchant l'argent que la ville a prins des coffres du Roi » (31 octobre 1685) ; copies contemporaines ; Lettres royaux portant convocation de l'assemblée des trois ordres à Tulle pour l'envoi de députés aux Etats généraux (août 1614) ; placard imprimé ; Confirmation par Louis XIII du droit, pour les habitants de Tulle, de percevoir un octroi aux portes de la ville (16 mars 1611-22 novembre 1612) ; Défense faite aux curés de Saint-Pierre et de Saint-Jacques de Tulle de marier des étrangers sans autorisation du maire et des consuls (10 mars 1586) ; Extrait des registres de la Maison de ville de Tulle (1587-1588) ; « Estat de la recette que j'ay fait durant mon quartier, qui a commencé le 1er de septembre 1599 et finy le dernier de novembre audit an ; » original, sans indication de provenance ; Etat de sommes à percevoir dans les diverses parroisses de l'évêché de Tulle (1589) ; original ; Inventaire de titres concernant les vicomtes de Comborn (1441-1489) ; Accensement des revenus de la prévôté de Clergoux (21 janvier 1531-1532 n. st.) ; copie contemporaine ; Pièces relatives au différend entre le vicaire général et le chapitre de Tulle au sujet de l'ouverture du jubilé (avril 1656) ; Lettre du vicaire général, Guillaume Dumas, à M. Javel, sénéchal de Turenne (21 juillet 1655) ; Bulletins de service pour la garde des portes de la ville de Tulle (1586) ; originaux ; Lettre écrite de Tulle [à Baluze ?] par M. Collier (13 mars 1679) ; Mémoires sur la ville de Tulle, par M. Brivazat, vissenéchal de Tulle ; Procès-verbal d'une assemblée de conseillers de ladite ville (20 mars 1586) ; Lettre de G. de Juré aux consuls de la ville de Tulle (s. d.) ; original ; Requête présentée à « nossieurs des Comptes » par Bertrand Fagerdie (s. d.) ; original ; Mémoire sur la gestion du même au siège royal de Tulle (1551) ; Accord entre les habitants de Tulle et ceux de Brive pour le rétablissement du siège royal (1553) ; copie contemporaine ; Lettre d'Etienne de l'Estang à [Antoine] de Noailles, lieutenant du roi en Guyenne, relative à la même affaire (1551) ; copie donnée à Baluze par vyon d'Herouval en 1684 ; Accord entre B. Fagerdie et Antoine de La Tour, chanoine de Tulle (1561) ; original ; Enquête faite au sujet de l'anoblissement de Guillaume de Marne, lieutenant-général au siège de Tulle (1597) ; original ; Anoblissement de Pierre Geneste et de divers autres jurats de la ville de Bordeaux (juin 1589) ; Rôle de taille et taillon de la ville de Tulle (février 1595) ; original ; Factum pour le syndic du clergé du diocèse de Tulle contre les prétendus reformez d'Argentat ; imprimé de 4 p. in-4°, s. d., avec une note relative à la destruction du temple d'Argentat en 1682 ; Mandements et ordonnances des évêques et des vicaires généraux de Tulle (1668-1696) ; placards imprimés

Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner.

BACKGROUND & AIMS: Development of strictures is a major concern for patients with eosinophilic esophagitis (EoE). At diagnosis, EoE can present with an inflammatory phenotype (characterized by whitish exudates, furrows, and edema), a stricturing phenotype (characterized by rings and stenosis), or a combination of these. Little is known about progression of stricture formation; we evaluated stricture development over time in the absence of treatment and investigated risk factors for stricture formation. METHODS: We performed a retrospective study using the Swiss EoE Database, collecting data on 200 patients with symptomatic EoE (153 men; mean age at diagnosis, 39 ± 15 years old). Stricture severity was graded based on the degree of difficulty associated with passing of the standard adult endoscope. RESULTS: The median delay in diagnosis of EoE was 6 years (interquartile range, 2-12 years). With increasing duration of delay in diagnosis, the prevalence of fibrotic features of EoE, based on endoscopy, increased from 46.5% (diagnostic delay, 0-2 years) to 87.5% (diagnostic delay, >20 years; P = .020). Similarly, the prevalence of esophageal strictures increased with duration of diagnostic delay, from 17.2% (diagnostic delay, 0-2 years) to 70.8% (diagnostic delay, >20 years; P < .001). Diagnostic delay was the only risk factor for strictures at the time of EoE diagnosis (odds ratio = 1.08; 95% confidence interval: 1.040-1.122; P < .001). CONCLUSIONS: The prevalence of esophageal strictures correlates with the duration of untreated disease. These findings indicate the need to minimize delay in diagnosis of EoE.

Closing the gap between T-cell life span estimates from stable isotope-labeling studies in mice and humans.

Quantitative knowledge of the turnover of different leukocyte populations is a key to our understanding of immune function in health and disease. Much progress has been made thanks to the introduction of stable isotope labeling, the state-of-the-art technique for in vivo quantification of cellular life spans. Yet, even leukocyte life span estimates on the basis of stable isotope labeling can vary up to 10-fold among laboratories. We investigated whether these differences could be the result of variances in the length of the labeling period among studies. To this end, we performed deuterated water-labeling experiments in mice, in which only the length of label administration was varied. The resulting life span estimates were indeed dependent on the length of the labeling period when the data were analyzed using a commonly used single-exponential model. We show that multiexponential models provide the necessary tool to obtain life span estimates that are independent of the length of the labeling period. Use of a multiexponential model enabled us to reduce the gap between human T-cell life span estimates from 2 previously published labeling studies. This provides an important step toward unambiguous understanding of leukocyte turnover in health and disease.

Can postictal memory predict postoperative memory in patients with temporal lobe epilepsy?

We investigated the contribution of postictal memory testing for lateralizing the epileptic focus and predicting memory outcome after surgery for temporal lobe epilepsy (TLE). Forty-five patients with TLE underwent interictal, postictal, and postoperative assessment of verbal and nonverbal memory. Surgery consisted of anterior temporal lobectomy (36), selective isolated amygdalohippocampectomy (6), or amygdalohippocampectomy coupled to lesionectomy (3). Postictal and postoperative but not interictal memory were significantly lower in left TLE than in right TLE. Nonverbal memory showed no significant difference in left TLE versus right TLE in all conditions. Postictal memory was significantly correlated with postoperative memory, but the effect disappeared when the lateralization of the focus was considered. Postictal verbal memory is a useful bedside tool that can help lateralize the epileptic focus. Larger studies are needed to further estimate its predictive value of the postoperative outcome.

Secular changes of spinal canal dimensions in Western Switzerland: a narrowing epidemic?

STUDY DESIGN: Computed tomography-based anatomical study. OBJECTIVE: To study the secular changes in lumbar spinal canal dimensions. SUMMARY OF BACKGROUND DATA: Development of symptomatic lumbar spinal stenosis, among other factors, is related to the dimensions of the bony canal. The canal reaches its adult size early on in life. Several factors, including protein intake, may influence its final dimensions. As with increases in human stature from improvements of socioeconomic conditions, we hypothesized that adult bony canal size has also grown larger in recent generations. METHODS: This study analyzes computed tomographic reconstructions from 184 subjects performed for either trauma (n = 81) or abdominal pathologies (n = 103) and born either between 1940 and 1949 (n = 88) or 1970 and 1979 (n = 96). The cross-sectional area of the bony canal was digitally measured at the level of the pedicle (i.e., at a level not influenced by degenerative changes) for each lumbar vertebra. Intra- and interobserver reliability was assessed. RESULTS: Intra- and interobserver measurement reliability were excellent (interclass correlation coefficient = 0.87) and good (interclass correlation coefficient = 0.61), respectively. Contrary to our hypothesis, the 1940-1949 generation patient group exhibited larger lumbar canals at all levels as compared with the 1970-1979 group. Statistically this difference was highly significant (P < 0.001) and particularly pronounced in the trauma subgroup. CONCLUSION: Given that human stature evolution has stabilized and adult height is established during the first 2 years of long bone growth, it is possible that antenatal factors are responsible for this surprising finding. Maternal smoking and age may be possible explanations. This finding may have significant implications. An increasing number of patients may emerge with lumbar spinal stenosis as degenerative changes develop, putting a strain on health resources. Further studies in different population groups and countries will be important to further confirm this trend. LEVEL OF EVIDENCE: 3.

Interleukin-17 is a critical mediator of vaccine-induced reduction of Helicobacter infection in the mouse model.

BACKGROUND &amp; AIMS: Despite the proven ability of immunization to reduce Helicobacter infection in mouse models, the precise mechanism of protection has remained elusive. This study explores the possibility that interleukin (IL)-17 plays a role in the reduction of Helicobacter infection following vaccination of wild-type animals or in spontaneous reduction of bacterial infection in IL-10-deficient mice. METHODS: In mice, reducing Helicobacter infection, the levels and source of IL-17 were determined and the role of IL-17 in reduction of Helicobacter infection was probed by neutralizing antibodies. RESULTS: Gastric IL-17 levels were strongly increased in mice mucosally immunized with urease plus cholera toxin and challenged with Helicobacter felis as compared with controls (654 +/- 455 and 34 +/- 84 relative units for IL-17 messenger RNA expression [P &lt; .01] and 6.9 +/- 8.4 and 0.02 +/- 0.04 pg for IL-17 protein concentration [P &lt; .01], respectively). Flow cytometry analysis showed that a peak of CD4(+)IL-17(+) T cells infiltrating the gastric mucosa occurred in immunized mice in contrast to control mice (4.7% +/- 0.3% and 1.4% +/- 0.3% [P &lt; .01], respectively). Gastric mucosa-infiltrating CD4(+)IL-17(+) T cells were also observed in IL-10-deficient mice that spontaneously reduced H felis infection (4.3% +/- 2.3% and 2% +/- 0.6% [P &lt; .01], for infected and noninfected IL-10-deficient mice, respectively). In wild-type immunized mice, intraperitoneal injection of anti-IL-17 antibodies significantly inhibited inflammation and the reduction of Helicobacter infection in comparison with control antibodies (1 of 12 mice vs 9 of 12 mice reduced Helicobacter infection [P &lt; .01], respectively). CONCLUSIONS: IL-17 plays a critical role in the immunization-induced reduction of Helicobacter infection from the gastric mucosa.

Recurrence of status epilepticus: Prognostic role and outcome predictors.

OBJECTIVE: Predictors of morbidity and mortality after status epilepticus (SE) have been studied extensively in hospital- and population-based cohorts. However, little attention has been directed toward SE recurrence after an incident episode. We investigated clinical and demographic characteristics of patients presenting SE recurrence and its specific prognostic role. METHODS: In this observational cohort study, we screened our prospective registry of consecutive adults with SE between April 2006 and February 2014. Demographic and clinical data were compared between incident and recurrent SE episodes; risk of SE recurrence was assessed through survival analysis, and the prognostic role of SE recurrence with multivariable logistic regressions. RESULTS: Of the incident cohort (509 patients), 68 (13%) experienced recurrent SE. The cumulative recurrence rate over 4 years was 32%. Recurrence risk was significantly reduced after an acute SE etiology (hazard ratio [HR] 0.5, 95% confidence interval [CI] 0.31-0.82; p = 0.005), and was borderline increased in women (HR 1.59, 95% CI 0.97-2.65; p = 0.06). Although recurrent SE episodes showed lower morbidity and mortality, prognosis was independently related to Status Epilepticus Severity Score (STESS) and potentially fatal etiology, but not to SE recurrence. SIGNIFICANCE: This study provides class III evidence that SE recurrence involves a significant proportion of patients, and that recurrence risk is independently associated with chronic etiology and to a lesser extent with female gender. However, contrary to underlying cause and SE severity, SE recurrence per se does not independently correlate with outcome. Early identification of patients at higher risk of SE recurrence may influence their management during follow-up.

P value and the theory of hypothesis testing: an explanation for new researchers.

In the 1920s, Ronald Fisher developed the theory behind the p value and Jerzy Neyman and Egon Pearson developed the theory of hypothesis testing. These distinct theories have provided researchers important quantitative tools to confirm or refute their hypotheses. The p value is the probability to obtain an effect equal to or more extreme than the one observed presuming the null hypothesis of no effect is true; it gives researchers a measure of the strength of evidence against the null hypothesis. As commonly used, investigators will select a threshold p value below which they will reject the null hypothesis. The theory of hypothesis testing allows researchers to reject a null hypothesis in favor of an alternative hypothesis of some effect. As commonly used, investigators choose Type I error (rejecting the null hypothesis when it is true) and Type II error (accepting the null hypothesis when it is false) levels and determine some critical region. If the test statistic falls into that critical region, the null hypothesis is rejected in favor of the alternative hypothesis. Despite similarities between the two, the p value and the theory of hypothesis testing are different theories that often are misunderstood and confused, leading researchers to improper conclusions. Perhaps the most common misconception is to consider the p value as the probability that the null hypothesis is true rather than the probability of obtaining the difference observed, or one that is more extreme, considering the null is true. Another concern is the risk that an important proportion of statistically significant results are falsely significant. Researchers should have a minimum understanding of these two theories so that they are better able to plan, conduct, interpret, and report scientific experiments.

Interspinous distraction in lumbar spinal stenosis: a neurophysiological perspective.

STUDY DESIGN: Prospective neurophysiological study. OBJECTIVE: To identify and quantify the neurophysiological effects of interspinous distraction during spine surgery for lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: Interspinous devices have been introduced as an alternative treatment of LSS in selected patients aiming at obtaining indirect decompression. Nevertheless, there is no data on the immediate neurophysiological effect of distraction. METHODS: Thirty patients with LSS undergoing decompression (14 at single level, 16 at multiple levels) were enrolled, resulting in a total of 48 levels to be analyzed. Before decompression, calibrated incremental distraction simulating interspinous device implantation of 8, 10, 12, 14, and 16 mm was performed. Intraoperative motor evoked potentials were acquired before any distraction, during distraction at each incremental value and after bilateral decompression. We evaluated relative changes of motor evoked potentials normalized to hand muscles and related them to the number of affected levels, LSS radiological severity based on the A to D grading, lordosis, and disc height. RESULTS: For single-level disease, 8-mm distraction and open decompression yielded similar improvement in motor evoked potentials not only in levels with morphological grades A or B, but also in levels with morphological grades C or D (i.e., severe or extreme stenosis) (P = 0.32). In contrast, distraction superior to 8 mm was less effective (P ≤ 0.05). In multiple-level stenosis, decompression was significantly more effective than any degree of distraction (P < 0.001). No correlation of those results to disc height or lordosis was observed. Using χ trend test to analyze the effect of distraction, a linear trend favoring moderate over severe stenotic morphology was observed (P = 0.0349). CONCLUSION: Interspinous distraction of 8 mm is sufficient to replicate electrophysiological improvements obtained during full decompression even in severe single-level stenosis but not in multilevel disease. Interspinous distraction has therefore an immediately measurable neurophysiological effect. Level of Evidence: 4.

Measurement of multi-segment foot joint angles during gait using a wearable system.

Usually the measurement of multi-segment foot and ankle complex kinematics is done with stationary motion capture devices which are limited to use in a gait laboratory. This study aimed to propose and validate a wearable system to measure the foot and ankle complex joint angles during gait in daily conditions, and then to investigate its suitability for clinical evaluations. The foot and ankle complex consisted of four segments (shank, hindfoot, forefoot, and toes), with an inertial measurement unit (3D gyroscopes and 3D accelerometers) attached to each segment. The angles between the four segments were calculated in the sagittal, coronal, and transverse planes using a new algorithm combining strap-down integration and detection of low-acceleration instants. To validate the joint angles measured by the wearable system, three subjects walked on a treadmill for five minutes at three different speeds. A camera-based stationary system that used a cluster of markers on each segment was used as a reference. To test the suitability of the system for clinical evaluation, the joint angle ranges were compared between a group of 10 healthy subjects and a group of 12 patients with ankle osteoarthritis, during two 50-m walking trials where the wearable system was attached to each subject. On average, over all joints and walking speeds, the RMS differences and correlation coefficients between the angular curves obtained using the wearable system and the stationary system were 1 deg and 0.93, respectively. Moreover, this system was able to detect significant alteration of foot and ankle function between the group of patients with ankle osteoarthritis and the group of healthy subjects. In conclusion, this wearable system was accurate and suitable for clinical evaluation when used to measure the multi-segment foot and ankle complex kinematics during long-distance walks in daily life conditions.

Sign language in Landau-Kleffner syndrome.

This article reviews the history of sign language (SL) and the rationale for its use in children with profound auditory agnosia due to Landau-Kleffner syndrome (LKS), illustrated by studies of children and adults followed for many years and rare cases from the literature. The reasons that SL was successful and brought some children out of isolation while it could not be implemented in others are discussed. The nowadays earlier recognition and treatment of LKS and better awareness of the crucial need to maintain communication have certainly improved the outcome of affected children. Alternatives to oral language, even for less severe cases, are increasingly accepted. SL can be learned at different ages with a clear benefit, but the ambivalence of the patients and their families with the world and culture of the deaf may sometimes explain its refusal or limited acceptance. There are no data to support the fear that SL learning may delay or prevent oral language recovery in children with LKS. On the contrary, SL may even facilitate this recovery by stimulating functionally connected core language networks and by helping speech therapy and auditory training.

Coexpression of the T-cell receptor constant alpha domain triggers tumor reactivity of single-chain TCR-transduced human T cells.

Transfer of tumor antigen-specific T-cell receptors (TCRs) into human T cells aims at redirecting their cytotoxicity toward tumors. Efficacy and safety may be affected by pairing of natural and introduced TCRalpha/beta chains potentially leading to autoimmunity. We hypothesized that a novel single-chain (sc)TCR framework relying on the coexpression of the TCRalpha constant alpha (Calpha) domain would prevent undesired pairing while preserving structural and functional similarity to a fully assembled double-chain (dc)TCR/CD3 complex. We confirmed this hypothesis for a murine p53-specific scTCR. Substantial effector function was observed only in the presence of a murine Calpha domain preceded by a TCRalpha signal peptide for shuttling to the cell membrane. The generalization to a human gp100-specific TCR required the murinization of both C domains. Structural and functional T-cell avidities of an accessory disulfide-linked scTCR gp100/Calpha were higher than those of a dcTCR. Antigen-dependent phosphorylation of the proximal effector zeta-chain-associated protein kinase 70 at tyrosine 319 was not impaired, reflecting its molecular integrity in signaling. In melanoma-engrafted nonobese diabetic/severe combined immunodeficient mice, adoptive transfer of scTCR gp100/Calpha transduced T cells conferred superior delay in tumor growth among primary and long-term secondary tumor challenges. We conclude that the novel scTCR constitutes a reliable means to immunotherapeutically target hematologic malignancies.