886 resultados para Tendon lesion


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PURPOSE: Orbital wall fracture may occur during endoscopic sinus surgery, resulting in oculomotor disorders. We report the management of four cases presenting with this surgical complication. METHODS: A non-comparative observational retrospective study was carried out on four patients presenting with diplopia after endoscopic ethmoidal sinus surgery. All patients underwent full ophthalmologic and orthoptic examination as well as orbital imaging. RESULTS: All four patients presented with diplopia secondary to a medial rectus lesion confirmed by orbital imaging. A large horizontal deviation as well as limitation of adduction was present in all cases. Surgical management consisted of conventional recession-resection procedures in three cases and muscle transposition in one patient. A useful field of binocular single vision was restored in two of the four patients. CONCLUSION: Orbital injury may occur during endoscopic sinus surgery and cause diplopia, usually secondary to medial rectus involvement due to the proximity of this muscle to the lamina papyracea of the ethmoid bone. Surgical management is based on orbital imaging, duration of the lesion, evaluation of anterior segment vasculature, results of forced duction testing and intraoperative findings. In most cases, treatment is aimed at the symptoms rather than the cause, and the functional prognosis remains guarded.

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The incidental discovery of a solitary pulmonary nodule while performing a CT scan of the chest is a very common clinical problem. The differential diagnosis is large but the main clinical challenge is to exclude or ascertain a neoplasia. The evaluation of preexisting risk factors and the analysis of morphological characteristics of the nodule allow the clinician to solve this challenge in a significant number of cases. When the nature of the lesion remains indeterminate a careful follow-up with volumetric determination is necessary for decision making.

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Résumé Avec 8% des accidents en Suisse, le genou est une articulation fréquemment blessée. Si la majorité des traumatismes surviennent lors de la pratique du sport, les conséquences sur la reprise de l'activite professionnelle sont relativement méconnues. Pourtant, en 2002, un quart des patients hospitalises dans le service de rééducation de l'appareil locomoteur de la CRR, présentait une lésion du genou responsable d'une limitation fonctionnelle significative. Les diagnostics principaux sont les entorses graves et les lésions dégénératives. Une majorité de patients est issue du secteur secondaire et exerce souvent une profession exigeante d'un point de vue physique. Le but de cet article est d'une part de présenter aux praticiens des repères utiles à la compréhension de cette problématique particulière; d'autre part d'initier une reflexion pratique sur la réadaptation professionnelle de ces patients, par la discussion d'un cas clinique. From approximately 8% of the accidents in Switzerland, the knee is a frequently wounded articulation. If the majority of the traumas occur whilst playing sport, the effects on the resumption of professional activity are relatively ignored. However, in 2002, a quarter of the patients hospitalized in the locomotor service of rehabilitation at the CRR, presented a lesion of the knee as factor most commonly responsible for their functional limitations. The principal diagnoses consisted of serious distorsions and degenerative lesions. A majority of patients come from industry which, from a physical point of view, is generally a demanding occupation. The goals of this article are to present information concerning the comprehension of these particular problems as well as to initiate practises for the vocational rehabilitation of these patients, by the discussion of a clinical case.

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In the context of an autologous cell transplantation study, a unilateral biopsy of cortical tissue was surgically performed from the right dorsolateral prefrontal cortex (dlPFC) in two intact adult macaque monkeys (dlPFC lesioned group), together with the implantation of a chronic chamber providing access to the left motor cortex. Three other monkeys were subjected to the same chronic chamber implantation, but without dlPFC biopsy (control group). All monkeys were initially trained to perform sequential manual dexterity tasks, requiring precision grip. The motor performance and the prehension's sequence (temporal order to grasp pellets from different spatial locations) were analysed for each hand. Following the surgery, transient and moderate deficits of manual dexterity per se occurred in both groups, indicating that they were not due to the dlPFC lesion (most likely related to the recording chamber implantation and/or general anaesthesia/medication). In contrast, changes of motor habit were observed for the sequential order of grasping in the two monkeys with dlPFC lesion only. The changes were more prominent in the monkey subjected to the largest lesion, supporting the notion of a specific effect of the dlPFC lesion on the motor habit of the monkeys. These observations are reminiscent of previous studies using conditional tasks with delay that have proposed a specialization of the dlPFC for visuo-spatial working memory, except that this is in a different context of "free-will", non-conditional manual dexterity task, without a component of working memory.

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Although the contribution of inflammatory processes in the etiology of late-onset Alzheimer's disease (AD) has been suspected for years, most studies were confined to the analysis of cell-mediated immunological reactions thought to represent an epiphenomenon of AD lesion development. Based on the traditional view of the "immunological privilege" of the brain, which excludes a direct access of human immunoglobulins (Ig) to the central nervous system under normal conditions, little attention has been paid to a possible role of humoral immunity in AD pathogenesis. In the first part of this review, we summarize evidences for a blood-brain barrier (BBB) dysfunction in this disorder and critically comment on earlier observations supporting the presence of anti-brain autoantibodies and immunoglobulins (Ig) in AD brains. Current concepts regarding the Ig turnover in the central nervous system and the mechanisms of glial and neuronal Fc receptors activation are also discussed. In the second part, we present new ex vivo and in vitro data suggesting that human immunoglobulins can interact with tau protein and alter both the dynamics and structural organization of microtubules. Subsequent experiments needed to test this new working hypothesis are addressed at the end of the review.

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Purpose: First, to report ECU subsheath's normal MRI appearance and the findings in athletic injuries. Second, to determine the best MRI sequence for diagnosis. Methods and materials: Sixteen patients (13 males, 3 females, mean age 30.3 years) with ECU subsheath's athletic injuries sustained between January 2003 and June 2009 were retrospectively reviewed. Wrist MRI studies were performed on 1.5-T units and consisted of at least transverse T1 and STIR sequences in pronation, and FS Gd T1 in pronation and supination. Two radiologists assessed the following items, in consensus: injury type (A to C according to Inoue), ECU tendon stability, and associated lesions (ulnar head oedema, extensor retinaculum injury, ECU tendinosis and tenosynovitis). Then, each reader independently rated the sequences' diagnostic value: 0 = questionable, 1 = suggestive, 2 = certain. Follow-up studies were present in 8 patients. ECU subsheath's normal visibility (medial, central and lateral parts) was retrospectively evaluated in 30 consecutive control MRI studies. Results: FS Gd T1 sequences in supination (1.63) and pronation (1.59) were the most valuable for diagnosis, compared to STIR (1.22) and T1 (1). The study group included 9 type A, 1 type B and 6 type C injuries. There were trends towards diminution in pouches' size, signal intensity and enhancement in follow-up studies, along with tendon stabilization within the ulnar groove. In control studies, ECU subsheath's visibility in medial, central and lateral parts were noted in 66.7-80%, 63.3-80% and 30-50% respectively. Conclusion: ECU subsheath's athletic injuries are visible on 1.5-T MRI studies. FS Gd T1 sequences in supination and pronation are the most valuable.

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A now 36-year-old woman developed a suprahepatic inferior vena cava stenosis, 9 years after liver transplantation for extensive liver echinococcosis. The lesion was treated by percutaneous angioplasty and stenting. Five years later, recurrence of echinococosis with intrastent stenosis together with clinical symptoms, prompted surgical treatment. Hepato-atrial anastomosis was performed under cardiopulmonary bypass with good result.

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Although tissue engineering and cell therapies are becoming realistic approaches for medical therapeutics, it is likely that musculoskeletal applications will be among the first to benefit on a large scale. Cell sources for tissue engineering and cell therapies for tendon pathologies are reviewed with an emphasis on small defect tendon injuries as seen in the hand which could adapt well to injectable cell administration. Specifically, cell sources including tenocytes, tendon sheath fibroblasts, bone marrow or adipose-derived stem cells, amniotic cells, placenta cells and platelet-derivatives have been proposed to enhance tendon regeneration. The associated advantages and disadvantages for these different strategies will be discussed and evolving regulatory requirements for cellular therapies will also be addressed. Human progenitor tenocytes, along with their clinical cell banking potential, will be presented as an alternative cell source solution. Similar cell banking techniques have already been described with other progenitor cell types in the 1950's for vaccine production, and these "old" cell types incite potentially interesting therapeutic options that could be improved with modern innovation for tendon regeneration and repair.

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BACKGROUND AND PURPOSE: Most of the neuropathological studies in brain aging were based on the assumption of a symmetrical right-left hemisphere distribution of both Alzheimer disease and vascular pathology. To explore the impact of asymmetrical lesion formation on cognition, we performed a clinicopathological analysis of 153 cases with mixed pathology except macroinfarcts. METHODS: Cognitive status was assessed prospectively using the Clinical Dementia Rating scale; neuropathological evaluation included assessment of Braak neurofibrillary tangle and Ass deposition staging, microvascular pathology, and lacunes. The right-left hemisphere differences in neuropathological scores were evaluated using the Wilcoxon signed rank test. The relationship between the interhemispheric distribution of lesions and Clinical Dementia Rating scores was assessed using ordered logistic regression. RESULTS: Unlike Braak neurofibrillary tangle and Ass deposition staging, vascular scores were significantly higher in the left hemisphere for all Clinical Dementia Rating scores. A negative relationship was found between Braak neurofibrillary tangle, but not Ass staging, and vascular scores in cases with moderate to severe dementia. In both hemispheres, Braak neurofibrillary tangle staging was the main determinant of cognitive decline followed by vascular scores and Ass deposition staging. The concomitant predominance of Alzheimer disease and vascular pathology in the right hemisphere was associated with significantly higher Clinical Dementia Rating scores. CONCLUSIONS: Our data show that the cognitive impact of Alzheimer disease and vascular lesions in mixed cases may be assessed unilaterally without major information loss. However, interhemispheric differences and, in particular, increased vascular and Alzheimer disease burden in the right hemisphere may increase the risk for dementia in this group.

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PURPOSE: To evaluate the long-term outcome (up to 7 years) of presumed ocular tuberculosis (TB) when the therapeutic decision was based on WHO guidelines. METHODS: Twelve out of 654 new uveitic patients (1998-2004) presented with choroiditis and positive tuberculosis skin test (TST) (skin lesion diameter >15 mm). Therapy was administered according to WHO recommendations after ophthalmic and systemic investigation. The area size of ocular lesions at presentation and after therapy, measured on fluorescein and indocyanine green angiographies, was considered the primary outcome. Relapse of choroiditis was considered a secondary outcome. The T-SPOT TB test was performed when it became available. RESULTS: Visual acuity significantly improved after therapy (p=0.0357). The mean total surface of fluorescein lesions at entry was 44.8 ± 20.9 (arbitrary units) and decreased to 32.5 ± 16.9 after therapy (p=0.0165). The mean total surface of indocyanine green lesions at entry was 24.5 ± 13.3 and decreased to 10.8 ± 5.4 after therapy (p=0.0631). The T-SPOT TB revealed 2 false TST-positive results. The mean follow-up was 4.5 ± 1.5 years. Two relapses out of 10 confirmed ocular TB was observed after complete lesion healing, 2.5 years and 4.5 years after therapy, respectively. CONCLUSIONS: A decrease of ocular lesion mean size and a mean improvement of VA were observed after antituberculous therapy. Our long-term follow-up of chorioretinal lesions demonstrated relapse of ocular tuberculosis in 10% of patients with confirmed ocular TB, despite complete initial retinal scarring.

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OBJECTIVES: To learn upon incidence, underlying mechanisms and effectiveness of treatment strategies in patients with central airway and pulmonary parenchymal aorto-bronchial fistulation after thoracic endovascular aortic repair (TEVAR). METHODS: Analysis of an international multicentre registry (European Registry of Endovascular Aortic Repair Complications) between 2001 and 2012 with a total caseload of 4680 TEVAR procedures (14 centres). RESULTS: Twenty-six patients with a median age of 70 years (interquartile range: 60-77) (35% female) were identified. The incidence of either central airway (aorto-bronchial) or pulmonary parenchymal (aorto-pulmonary) fistulation (ABPF) in the entire cohort after TEVAR in the study period was 0.56% (central airway 58%, peripheral parenchymal 42%). Atherosclerotic aneurysm formation was the leading indication for TEVAR in 15 patients (58%). The incidence of primary endoleaks after initial TEVAR was n = 10 (38%), of these 80% were either type I or type III endoleaks. Fourteen patients (54%) developed central left bronchial tree lesions, 11 patients (42%) pulmonary parenchymal lesions and 1 patient (4%) developed a tracheal lesion. The recognized mechanism of ABPF was external compression of the bronchial tree in 13 patients (50%), the majority being due to endoleak formation, further ischaemia due to extensive coverage of bronchial feeding arteries in 3 patients (12%). Inflammation and graft erosion accounted for 4 patients (30%) each. Cumulative survival during the entire study period was 39%. Among deaths, 71% were attributed to ABPF. There was no difference in survival in patients having either central airway or pulmonary parenchymal ABPF (33 vs 45%, log-rank P = 0.55). Survival with a radical surgical approach was significantly better when compared with any other treatment strategy in terms of overall survival (63 vs 32% and 63 vs 21% at 1 and 2 years, respectively), as well as in terms of fistula-related survival (63 vs 43% and 63 vs 43% at 1 and 2 years, respectively). CONCLUSIONS: ABPF is a rare but highly lethal complication after TEVAR. The leading mechanism behind ABPF seems to be a continuing external compression of either the bronchial tree or left upper lobe parenchyma. In this setting, persisting or newly developing endoleak formation seems to play a crucial role. Prognosis does not differ in patients with central airway or pulmonary parenchymal fistulation. Radical bronchial or pulmonary parenchymal repair in combination with stent graft removal and aortic reconstruction seems to be the most durable treatment strategy.

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BACKGROUND: Cerebellar pathology occurs in late multiple sclerosis (MS) but little is known about cerebellar changes during early disease stages. In this study, we propose a new multicontrast "connectometry" approach to assess the structural and functional integrity of cerebellar networks and connectivity in early MS. METHODS: We used diffusion spectrum and resting-state functional MRI (rs-fMRI) to establish the structural and functional cerebellar connectomes in 28 early relapsing-remitting MS patients and 16 healthy controls (HC). We performed multicontrast "connectometry" by quantifying multiple MRI parameters along the structural tracts (generalized fractional anisotropy-GFA, T1/T2 relaxation times and magnetization transfer ratio) and functional connectivity measures. Subsequently, we assessed multivariate differences in local connections and network properties between MS and HC subjects; finally, we correlated detected alterations with lesion load, disease duration, and clinical scores. RESULTS: In MS patients, a subset of structural connections showed quantitative MRI changes suggesting loss of axonal microstructure and integrity (increased T1 and decreased GFA, P < 0.05). These alterations highly correlated with motor, memory and attention in patients, but were independent of cerebellar lesion load and disease duration. Neither network organization nor rs-fMRI abnormalities were observed at this early stage. CONCLUSION: Multicontrast cerebellar connectometry revealed subtle cerebellar alterations in MS patients, which were independent of conventional disease markers and highly correlated with patient function. Future work should assess the prognostic value of the observed damage. Hum Brain Mapp 36:1609-1619, 2015. © 2014 Wiley Periodicals, Inc.

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Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in vulval carcinoma classification and its scalability is uncertain and unpredictable. Here, we present a case concerning a 48-year-old patient, without follow-up after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows the rarity of this lesion of the female genital tract.

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Contient : Chants royaux. Refrains ; 1 « Logis de Dieu signé du bel ymaige ». « OSMONT » ; 2 « Le lict d'honneur rempli de toute grace ». « BRASMETOT » ; 3 « Lampe illustrant l'eglise militante ». « OSMONT » ; 4 « Mer qui receoit et donne toute grace ». « OSMONT » ; 5 « Cloche sonnant le salut des humains ». « BRASMETOT » ; 6 « Parc virginal exempte de vermine ». « MAROT » ; 7 « Le val plaisant où Dieu voulut descendre ». « LESCARRE » ; 8 « Secours des cieulx, la pucelle Marie ». « BRASMETOT » ; 9 « Temple construict par divin artiffice ». « CRETHIN » ; 10 « Le noble corps de la belle Susanne ». « LESCARRE » ; 11 « Court sans erreur, sur toutes souveraine ». « BRASMETOT » ; 12 « Pour traicter paix salutaire aux humains ». « AVRIL » ; 13 « Cloistre de paix, sans envye et murmure ». « LESCARRE » ; 14 « Car ce qu'il veult, il le peult et le faict ». « BERTOULT » ; 15 « Le chois d'honneur où ne fut oncques blasme ». « BRASMETOT » ; 16 « La terre saincte où Dieu print sa naissance ». « OSMONT » ; 17 « De ung filz tout beau la mere toute belle ». « OSMONT » ; 18 « Mont distillant paix, salut, grace et gloire ». « LESCARRE » ; 19 « Le seau royal donnant grace aux humains ». « BRASMETOT » ; 20 « De tout impost et de suscite exempte ». « TURBOT » ; 21 « De tout peché par grace preservée ». « BRASMETOT » ; 22 « Le doulx myel aux humains salutaire ». « OSMONT » ; 23 « Pure en concept oultre loy de nature ». « MAROT » ; 24 « Le bien d'amour et le moyen de grace ». « PARMENTIER » ; 25 « La saincte paix du doy de Dieu signée ». « THYBAULT » ; 26 « Pure lycorne expellant tout venyn ». « LESCARRE » ; 27 « Sans vice aucun, toute belle conceue ». « BRASMETOT » ; 28 « La forte nef toute plaine de grace » ; 29 « Seule sans sy, divinement tyssue ». « CRETIN » ; 30 « Nom substantif rendant suppost au verbe ». « LESCARRE » ; 31 « Du bon pasteur le sacré tabernacle ». « CRIGNON » ; 32 « Pourpre excellent pour vestir le grant roy ». « CRIGNON » ; 33 « La saincte Bible où verité repose ». « THYBAULT » ; 34 « La main de grace aux pecheurs estendue ». « LESCARRE » ; 35 « Pour le tout beau conceue toute belle ». « THYBAULT » ; 36 « Au chois d'honneur l'honneur de la victoire ». « BRASMETOT » ; 37 « Beigle infaillible en tous caz approuvée ». « CRETIN » ; 38 « Le doctrinal, sans macule imprimé ». « LESCARRE » ; 39 « Le chariot du fort geant celeste ». « LESCARRE » ; 40 « En ung subject quatre pars concordantes ». « LEVESTU » ; 41 « L'ame parfaicte en forme raisonnable ». « LEPREVOST » ; 42 « La fille Adam, pelerine de grace ». « BRASMETOT » ; 43 « Ung aultre Adam et une Eve seconde ». « ALYNE » ; 44 « Harnoys d'espreuve au puissant roy de glore » ; 45 « Le regne franc de la loy tributaire ». « THYBAULT ; 46 « Sans lesion a passé par les picques ». « AUBER » ; 47 « L'oeil cler et nect, plain de grace et lumiere ». « BRASMETOT » ; 48 « D'un pouvre ver triumphante vesture ». « BRASMETOT » ; 49 « Le hault solleil qui luict sur tout le monde ». « TYBAULT » ; 50 « Sans estre assise en la chaire de peste ». « LESCARRE » ; Ballades. Refrains ; 1 « Des jardins la clere fontaine ». « AVRIL » ; 2 « Fontaine de paix et de grace ». « LESCARRE » ; 3 « La fontenelle de salut ». « BRASMETOT » ; 4 « Le blanc habit de purité ». « LESCARRE » ; 5 « La droicte eschelle d'innocence ». « LESCARRE » ; 6 « Mere, vierge et fille à son filz ». « BRASMETOT » ; 7 « Pomme sans ver et pourriture ». « LESCARRE » ; 8 « Marie, la mere de grace ». « THYBAULT » ; 9 « Croyre ce que l'Eglise en tient ». « LEBECIN » ; 10 « Exempte de tous infectz faictz ». « BRASMETOT » ; 11 « Pierre portant huyle et myel ». « LESCARRE » ; 12 « Beaulté excellente et parfaicte ». « CRIGNON » ; 13 « Dieu le peult, le fist et voulut ». « DEVAUX » ; 14 « Du cler solleil environnée ». « AVRIL » ; 15 « Le vray escusson de noblesse ». « BERTIN » ; 16 « La rose en Hierico plantée ». « LESCARRE » ; 17 « Franche du tribut general ». « CRETHIN » ; 18 « Exempte du premier peché ». « LESCARRE » ; 19 « Toute belle en ame et corps nect ». « BRASMETOT » ; 20 « La dame à l'aigneau sans macule ». « THYBAULT » ; 21 « La bouche adnonçant verité ». « THYBAULT » ; 22 « Le coeur, vray principe de vie ». « AVRIL » ; 23 « En ce concept tout parfaict faict ». « DOUBLET » ; 24 « Le samedi sainct et beni ». « LESCARRE » ; 25 « La haulte tour de fortitude ». « LESCARRE » ; 26 « La benoiste Vierge Marie ». « THYBAULT » ; 27 « Pour humains lyez deslyer ». « BRASMETOT » ; 28 « La franche terre du grand roy ». « PARMENTIER » ; 29 « Mouche rendant myel et cire ». « LESCARRE » ; 30 « Chandelle illuminant le monde ». « ALLIX » ; Rondeaux. Refrains ; 1 « Pour son plaisir ». « BRASMETOT » ; 2 « Qui qu'en parle ». « BRASMETOT » ; 3 « Par le meffait ». « TURBOT » ; 4 « Par la vertu ». « LESCARRE » ; 5 « Peuple devot ». « BRASMETOT » ; 6 « Pour traicter ». « AVRIL » ; 7 « Au son du cor ». « DOUBLET » ; 8 « Comme la rose ». « MAROT » ; 9 « Le dieu d'amours ». « LESCARRE » ; 10 « L'accord est faict ». « ALLYNE » ; 11 « Où penses tu » ; 12 « Royne des cieulx ». « TURBOT » ; 13 « Pan et Phebus ». « DOUBLET » ; 14 « Faulx detracteurs ». « LESCARRE » ; 15 « Povres humains ». « DAVAL » ; 16 « Pour donner fruict ». « LESCARRE » ; 17 « Est ce bien faict ». « S. WANDRILLE » ; 18 « Des imparfaictz ». « DESVAULX » ; 19 « Le jour sacré ». « BRASMETOT » ; 20 « Je suis sans sequente ». « AVRIL » ; 21 « Je mercy Dieu ». « AVRIL » ; 22 « Bien le sçavez ». « TURBOT » ; 23 « En mon concept ». « BRASMETOT » ; 24 « Pour posseder ». « LE VESTU » ; 25 « De mon cher filz ». « LESCARRE » ; 26 « Preux roy Françoys ». « LESCARRE » ; 27 « Mon seul plaisir ». « PARMENTIER » ; 28 « Sans vice aucun ». « BRASMETOT » ; 29 « C'est mal pensé ». « CRETHIN » ; 30 « Ne pensez pas ». « THYBAULT » ; 31 « Contre Sathan ». « AVRIL » ; 32 « Mere de Dieu ». « THYBAULT » ; 33 « Le fier serpent ». « BRASMETOT » ; 34 « Mon cher enfant ». « THYBAULT » ; 35 « Hors paradis ». « BRASMETOT » ; 36 « Par mon cher filz ». « THYBAULT » ; 37 « Grace nous vient ». « LESCARRE » ; 38 « Seule sans sy ». « BRASMETOT » ; 39 « S'esbahit on ». « LE PREVOST » ; 40 « A ung chacun ». « AVRIL » ; Epigrammata. Premiers vers ; 1 « Nox erat, et Phebus radios agitare per orbem ». « CHAPPERON » ; 2 « Ecquis in electa genialem virgine sordem ». « BELLENGUES » ; 3 « Frigidus Argestes, glaciali pulsus ab Arcto ». « BELLENGUES » ; 4 « O meritis dignata novis, quo numine salvos ». « DEQUERCU » ; 5 « Dum tua sublimi contemplor numina sensu ». « BELLENGUES » ; 6 « Torva fronte minax, scelerumque acerrimus ultor ». « DEQUERCU » ; 7 « Vidimus Eoo qua Titani surgit ab ortu ». « MARC » ; 8 « Si violenta lues nigrique voragine Ditis ». « JEMBLES » ; 9 « Post operum curas lassis cum festa puellis ». « DEQUERCU » ; 10 « Venerat insultans latebras venator agrestes ». « THEOBALDUS » ; 11 « Urbs fuit eterno quondam delecta parenti ». « LECLERC » ; 12 « Lurida sacrilego qui toxica concipis ore ». « DEBEAUVAIS » ; 13 « Hostis atrox quondam magni tabularia regis ». « LECLERC » ; 14 « Post gemitus longos veterum cum nulla parentum ». « THEOBALDUS » ; 15 « Ordior empyreum mundum quem mole rotunda ». « LECLERC » ; 16 « Concipitur gelide sacro sub viscere matris ». « BELLENGUES » ; 17 « Fecit apis, quondam celesti egressa vireto ». « THEOBALDUS » ; 18 « Nullus originea Mariam rubigine lesam ». « CELESTINUS » ; 19 « Non colit obscenas divina potentia mentes ». « CELESTINUS » ; 20 « Orta mari magno, falsi tamen inscia limi ». « THEOBALDUS » ; 21 « Nondum Romulei renovarant secla Quirites ». « GEMELLUS » ; 22 « Duxit ab antiquo candentem farre farinam ». « THEOBALDUS » ; 23 « Flevimus a magna domitam Babylone Syonem ». « LAIR » ; 24 « Fulsit ab Eoo quadrata fenestra recessu ». « THEOBALDUS » ; 25 « Impia perpendens phrigii perjuria pacti ». « JO. « LIGARIUS » ; 26 « Nil rabidas voces, nil agmina livida pendit ». « THEOBALDUS » ; 27 « Duxit ab obscura radiosam nube columnam ». « TEXTOR » ; 28 « Nuper idumeo solvens a littore puppis ». « THEOBALDUS » ; 29 « Post nimios estus tellus cum torrida fruges » « JO. LIGARIUS » ; 30 « Audite, edomiti populi, quos martius horror ». « LAIR »

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The allele-specific polymerase chain reaction (PCR) was used to screen for the presence of benomyl resistance, and to characterize their levels and frequencies in field populations of Venturia inaequalis during two seasons. Three hundred isolates of V. inaequalis were collected each season from infected leaves of MalusX domestica. Borkh c.v. Mcintosh. The trees used were sprayed in the year prior to collection with five applications of benomyl, its homologue Azindoyle, or water. Monoconidial isolates of V. inaequalis were grown on 2% potato dextrose agar (PDA) for four weeks. Each isolate was taken from a single lesion from a single leaf. Total genomic DNA was extracted from the four week old colonies of V. inaequalis, prepared and used as a template in PCR reactions. PCR reactions were achieved by utilizing allele-specific primers. Each primer was designed to amplify fragments from a specific allele. Primer Vin was specific for mutations conferring the ben^^"^ phenotype. It was expected to amplify a 171 bp. DNA fragment from the ben^"^ alleles only. Primers BenHR and BenMR were specific for mutations conferring the ben"" and ben'^'' phenotypes, respectively. They were expected to amplify 172 bp. and 165 bp. DNA fragments from the ben"" and ben"^" alleles, respectively. Of the 953 isolates tested, 414 (69.9%) were benomyl sensitive (ben^) and 179 (30.1%) were benomyl resistant. All the benomyl resistant alleles were ben^"", since neither the ben"" nor the ben"" alleles were detected. Frequencies of benomyl resistance were 23%, 24%, and 23% for the 1997 collections, and were 46%, 26% and 38% for the 1998 collections for benomyl, Azindoyle and water treatments, respectively. Growth assay was performed to evaluate the applicability of using PCR in monitoring benomyl resistance in fungal field populations. Tests were performed on 14 isolates representing the two phenotypes (ben^ and ben^"'' alleles) characterized by PCR. Results of those tests were in agreement with PCR results. Enzyme digestion was also used to evaluate the accuracy and reliability of PCR products. The mutation associated with the ben^"'' phenotype creates a unique site for the endonuclease enzyme Bsh^236^ allowing the use of enzyme digestion. Isolates characterized by PCR as ben^'^'^ alleles had this restriction site for the SsA7l2361 enzyme. The most time consuming aspect of this study was growing fungal isolates on culture media for DNA extraction. In addition, the risk of contamination or losing the fungus during growth processes was relatively high. A technique for extracting DNA directly from lesions on leaves has been used (Luck and Gillings 1 995). In order to apply this technique in experiments designed to monitor fungicide resistance, a lesion has to be homogeneous for fungicide sensitivity. For this purpose, PCR protocol was used to determine lesion homogeneity. One hundred monoconidial isolates of V. inaequalis from 10 lesions (10-conidia/ lesion) were tested for their phenotypes with respect to benomyl sensitivity. Conidia of six lesions were homogeneous, while conidia of the remaining lesions were mixtures of ben^ and ben^ phenotypes. Neither the ben" nor the ben' phenotype was detected.