Quantification of Myocardial Blood Flow in Absolute Terms Using (82)Rb PET Imaging: The RUBY-10 Study.

OBJECTIVES: The purpose of this study was to compare myocardial blood flow (MBF) and myocardial flow reserve (MFR) estimates from rubidium-82 positron emission tomography ((82)Rb PET) data using 10 software packages (SPs) based on 8 tracer kinetic models. BACKGROUND: It is unknown how MBF and MFR values from existing SPs agree for (82)Rb PET. METHODS: Rest and stress (82)Rb PET scans of 48 patients with suspected or known coronary artery disease were analyzed in 10 centers. Each center used 1 of 10 SPs to analyze global and regional MBF using the different kinetic models implemented. Values were considered to agree if they simultaneously had an intraclass correlation coefficient >0.75 and a difference <20% of the median across all programs. RESULTS: The most common model evaluated was the Ottawa Heart Institute 1-tissue compartment model (OHI-1-TCM). MBF values from 7 of 8 SPs implementing this model agreed best. Values from 2 other models (alternative 1-TCM and Axially distributed) also agreed well, with occasional differences. The MBF results from other models (e.g., 2-TCM and retention) were less in agreement with values from OHI-1-TCM. CONCLUSIONS: SPs using the most common kinetic model-OHI-1-TCM-provided consistent results in measuring global and regional MBF values, suggesting that they may be used interchangeably to process data acquired with a common imaging protocol.

Meta-analyses identify 13 loci associated with age at menopause and highlight DNA repair and immune pathways.

To newly identify loci for age at natural menopause, we carried out a meta-analysis of 22 genome-wide association studies (GWAS) in 38,968 women of European descent, with replication in up to 14,435 women. In addition to four known loci, we identified 13 loci newly associated with age at natural menopause (at P < 5 × 10(-8)). Candidate genes located at these newly associated loci include genes implicated in DNA repair (EXO1, HELQ, UIMC1, FAM175A, FANCI, TLK1, POLG and PRIM1) and immune function (IL11, NLRP11 and PRRC2A (also known as BAT2)). Gene-set enrichment pathway analyses using the full GWAS data set identified exoDNase, NF-κB signaling and mitochondrial dysfunction as biological processes related to timing of menopause.

Trabecular Bone Score (TBS)--A Novel Method to Evaluate Bone Microarchitectural Texture in Patients With Primary Hyperparathyroidism.

Context: In the milder form of primary hyperparathyroidism (PHPT), cancellous bone, represented by areal bone mineral density at the lumbar spine by dual-energy x-ray absorptiometry (DXA), is preserved. This finding is in contrast to high-resolution peripheral quantitative computed tomography (HRpQCT) results of abnormal trabecular microstructure and epidemiological evidence for increased overall fracture risk in PHPT. Because DXA does not directly measure trabecular bone and HRpQCT is not widely available, we used trabecular bone score (TBS), a novel gray-level textural analysis applied to spine DXA images, to estimate indirectly trabecular microarchitecture. Objective: The purpose of this study was to assess TBS from spine DXA images in relation to HRpQCT indices and bone stiffness in radius and tibia in PHPT. Design and Setting: This was a cross-sectional study conducted in a referral center. Patients: Participants were 22 postmenopausal women with PHPT. Main Outcome Measures: Outcomes measured were areal bone mineral density by DXA, TBS indices derived from DXA images, HRpQCT standard measures, and bone stiffness assessed by finite element analysis at distal radius and tibia. Results: TBS in PHPT was low at 1.24, representing abnormal trabecular microstructure (normal ≥1.35). TBS was correlated with whole bone stiffness and all HRpQCT indices, except for trabecular thickness and trabecular stiffness at the radius. At the tibia, correlations were observed between TBS and volumetric densities, cortical thickness, trabecular bone volume, and whole bone stiffness. TBS correlated with all indices of trabecular microarchitecture, except trabecular thickness, after adjustment for body weight. Conclusion: TBS, a measurement technology readily available by DXA, shows promise in the clinical assessment of trabecular microstructure in PHPT.

[Recueil. "Folle de revue" de Fernand Rouvray]

Contient : coupures de presse. - Concerne : représentation du 18 mai 1946 à l'A.B.C

Methadone maintenance treatment in the Swiss Canton of Vaud: demographic and clinical data on 1,782 ambulatory patients.

Using data from the Public Health Service, we studied the demographic and clinical characteristics of 1,782 patients enrolled in methadone maintenance treatment (MMT) during 2001 in the Swiss Canton of Vaud, comparing our findings with the results of a previous study from 1976 to 1986. In 2001, most patients (76.9%) were treated in general practice. Mortality is low in this MMT population (1%/year). While patient age and sex profiles were similar to those found in the earlier study, we did observe a substantial increase in the number of patients and the number of practitioners treating MMT patients, probably reflecting the low-threshold governmental policies and the creation of specialized centers. In conclusion, easier access to MMT enhances the number of patients, but new concerns about the quality of management emerge: benzodiazepine as a concomitant prescription; low rates of screening for hepatitis B, C and HIV, and social and psychiatric preoccupations.

Utility of the trabecular bone score (TBS) in secondary osteoporosis.

Altered bone micro-architecture is an important factor in accounting for fragility fractures. Until recently, it has not been possible to gain information about skeletal microstructure in a way that is clinically feasible. Bone biopsy is essentially a research tool. High-resolution peripheral Quantitative Computed Tomography, while non-invasive, is available only sparsely throughout the world. The trabecular bone score (TBS) is an imaging technology adapted directly from the Dual Energy X-Ray Absorptiometry (DXA) image of the lumbar spine. Thus, it is potentially readily and widely available. In recent years, a large number of studies have demonstrated that TBS is significantly associated with direct measurements of bone micro-architecture, predicts current and future fragility fractures in primary osteoporosis, and may be a useful adjunct to BMD for fracture detection and prediction. In this review, we summarize its potential utility in secondary causes of osteoporosis. In some situations, like glucocorticoid-induced osteoporosis and in diabetes mellitus, the TBS appears to out-perform DXA. It also has apparent value in numerous other disorders associated with diminished bone health, including primary hyperparathyroidism, androgen-deficiency, hormone-receptor positive breast cancer treatment, chronic kidney disease, hemochromatosis, and autoimmune disorders like rheumatoid arthritis. Further research is both needed and warranted to more clearly establish the role of TBS in these and other disorders that adversely affect bone.

Telementoring during endovascular treatment of abdominal aortic aneurysms: a prospective study.

PURPOSE: To explore the use of telementoring for distant teaching and training in endovascular aortic aneurysm repair (EVAR). METHODS: According to a prospectively designed study protocol, 48 patients underwent EVAR: the first 12 patients (group A) were treated at a secondary care center by an experienced interventionist, who was training the local team; a further 12 patients (group B) were operated by the local team at their secondary center with telementoring by the experienced operator from an adjacent suite; and the last 24 patients (group C) were operated by the local team with remote telementoring support from the experienced interventionist at a tertiary care center. Telementoring was performed using 3 video sources; images were transmitted using 4 ISDN lines. EVAR was performed using intravascular ultrasound and simultaneous fluoroscopy to obtain road mapping of the abdominal aorta and its branches, as well as for identifying the origins of the renal arteries, assessing the aortic neck, and monitoring the attachment of the stent-graft proximally and distally. RESULTS: Average duration of telementoring was 2.1 hours during the first 12 patients (group B) and 1.2 hours for the remaining 24 patients (group C). There was no difference in procedural duration (127+/-59 minutes in group A, 120+/-4 minutes in group B, and 119+/-39 minutes in group C; p=0.94) or the mean time spent in the ICU (26+/-15 hours in group A, 22+/-2 hours in group B, and 22+/-11 hours for group C; p=0.95). The length of hospital stay (11+/-4 days in group A, 9+/-4 days in group B, and 7+/-1 days in group C; p=0.002) was significantly different only for group C versus A (p=0.002). Only 1 (8.3%) patient (in group A: EVAR performed by the experienced operator) required conversion to open surgery because of iliac artery rupture. This was the only conversion (and the only death) in the entire study group (1/12 in group A versus 0/36 in groups B + C, p=0.31). CONCLUSIONS: Telementoring for EVAR is feasible and shows promising results. It may serve as a model for development of similar projects for teaching other invasive procedures in cardiovascular medicine.

Small proline-rich protein 1A is a gp130 pathway- and stress-inducible cardioprotective protein.

The interleukin-6 cytokines, acting via gp130 receptor pathways, play a pivotal role in the reduction of cardiac injury induced by mechanical stress or ischemia and in promoting subsequent adaptive remodeling of the heart. We have now identified the small proline-rich repeat proteins (SPRR) 1A and 2A as downstream targets of gp130 signaling that are strongly induced in cardiomyocytes responding to biomechanical/ischemic stress. Upregulation of SPRR1A and 2A was markedly reduced in the gp130 cardiomyocyte-restricted knockout mice. In cardiomyocytes, MEK1/2 inhibitors prevented SPRR1A upregulation by gp130 cytokines. Furthermore, binding of NF-IL6 (C/EBPbeta) and c-Jun to the SPRR1A promoter was observed after CT-1 stimulation. Histological analysis revealed that SPRR1A induction after mechanical stress of pressure overload was restricted to myocytes surrounding piecemeal necrotic lesions. A similar expression pattern was found in postinfarcted rat hearts. Both in vitro and in vivo ectopic overexpression of SPRR1A protected cardiomyocytes against ischemic injury. Thus, this study identifies SPRR1A as a novel stress-inducible downstream mediator of gp130 cytokines in cardiomyocytes and documents its cardioprotective effect against ischemic stress.

MARCADORES RAPD PARA MAPEAMENTO GENÉTICO E SELEÇÃO DE HÍBRIDOS DE CITROS

Os marcadores moleculares apresentam várias aplicações no melhoramento de plantas, permitindo uma série de análises genéticas. Este trabalho foi realizado com o objetivo de estabelecer marcadores RAPD para serem utilizados em estudos de mapeamento genético e na seleção de híbridos entre tangerina-'Cravo' (Citrus reticulata Blanco) e laranja-'Pêra' (C. sinensis (L.) Osbeck). Extraiu-se DNA de folhas dos parentais e de seis híbridos F1. As reações de amplificação foram preparadas em 13 uL de solução, constituída por tampão 1x GIBCO BRL; soluções 1,54 mM de MgCl2 e 0,2 mM de cada dNTP; 15 ng de cada 'primer'; 1,5 unidade de 'Taq DNA Polymerase' e 15 ng de DNA genômico. As reações foram realizadas em termocicladores programados para 36 ciclos de 1 min a 92ºC, 1 min a 36ºC, 2 min a 72ºC e 10 min de extensão a 72ºC. Foram testados 'primers' decâmeros arbitrários dos 'kits' A, AB, AT, AV, B, C, D, E, G, H, M, N, P, Q, R e U da Operon, sendo selecionados 113 por apresentarem polimorfismo, com número de marcadores variando de 1 a 6 por 'primer'. Esses 'primers' amplificaram 201 (23,13%) bandas polimórficas, aplicáveis no mapeamento genético e seleção de híbridos. A freqüência de 'primers' com 1; 2; 3; 4; 5 e 6 bandas polimórficas foi de 49,5%, 33,6%, 9,7%, 4,4%, 1,8% e 1,0%, respectivamente.

Evolution of the epithelial sodium channel and the sodium pump as limiting factors of aldosterone action on sodium transport.

Despite large changes in salt intake, the mammalian kidney is able to maintain the extracellular sodium concentration and osmolarity within very narrow margins, thereby controlling blood volume and blood pressure. In the aldosterone-sensitive distal nephron (ASDN), aldosterone tightly controls the activities of epithelial sodium channel (ENaC) and Na,K-ATPase, the two limiting factors in establishing transepithelial sodium transport. It has been proposed that the ENaC/degenerin gene family is restricted to Metazoans, whereas the α- and β-subunits of Na,K-ATPase have homologous genes in prokaryotes. This raises the question of the emergence of osmolarity control. By exploring recent genomic data of diverse organisms, we found that: 1) ENaC/degenerin exists in all of the Metazoans screened, including nonbilaterians and, by extension, was already present in ancestors of Metazoa; 2) ENaC/degenerin is also present in Naegleria gruberi, an eukaryotic microbe, consistent with either a vertical inheritance from the last common ancestor of Eukaryotes or a lateral transfer between Naegleria and Metazoan ancestors; and 3) The Na,K-ATPase β-subunit is restricted to Holozoa, the taxon that includes animals and their closest single-cell relatives. Since the β-subunit of Na,K-ATPase plays a key role in targeting the α-subunit to the plasma membrane and has an additional function in the formation of cell junctions, we propose that the emergence of Na,K-ATPase, together with ENaC/degenerin, is linked to the development of multicellularity in the Metazoan kingdom. The establishment of multicellularity and the associated extracellular compartment ("internal milieu") precedes the emergence of other key elements of the aldosterone signaling pathway.

In vivo nuclear translocation of mineralocorticoid and glucocorticoid receptors in rat kidney: differential effect of corticosteroids along the distal tubule.

Aldosterone and corticosterone bind to mineralocorticoid (MR) and glucocorticoid receptors (GR), which, upon ligand binding, are thought to translocate to the cell nucleus to act as transcription factors. Mineralocorticoid selectivity is achieved by the 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) that inactivates 11β-hydroxy glucocorticoids. High expression levels of 11β-HSD2 characterize the aldosterone-sensitive distal nephron (ASDN), which comprises the segment-specific cells of late distal convoluted tubule (DCT2), connecting tubule (CNT), and collecting duct (CD). We used MR- and GR-specific antibodies to study localization and regulation of MR and GR in kidneys of rats with altered plasma aldosterone and corticosterone levels. In control rats, MR and GR were found in cell nuclei of thick ascending limb (TAL), DCT, CNT, CD cells, and intercalated cells (IC). GR was also abundant in cell nuclei and the subapical compartment of proximal tubule (PT) cells. Dietary NaCl loading, which lowers plasma aldosterone, caused a selective removal of GR from cell nuclei of 11β-HSD2-positive ASDN. The nuclear localization of MR was unaffected. Adrenalectomy (ADX) resulted in removal of MR and GR from the cell nuclei of all epithelial cells. Aldosterone replacement rapidly relocated the receptors in the cell nuclei. In ASDN cells, low-dose corticosterone replacement caused nuclear localization of MR, but not of GR. The GR was redistributed to the nucleus only in PT, TAL, early DCT, and IC that express no or very little 11β-HSD2. In ASDN cells, nuclear GR localization was only achieved when corticosterone was replaced at high doses. Thus ligand-induced nuclear translocation of MR and GR are part of MR and GR regulation in the kidney and show remarkable segment- and cell type-specific characteristics. Differential regulation of MR and GR may alter the level of heterodimerization of the receptors and hence may contribute to the complexity of corticosteroid effects on ASDN function.

Rapamycin-mediated FOXO1 inactivation reduces the anticancer efficacy of rapamycin.

BACKGROUND: Mammalian target of rapamycin (mTOR) inhibitors such as rapamycin have shown modest effects in cancer therapy due in part to the removal of a negative feedback loop leading to the activation of the phosphatidylinositol 3-kinase/Akt (PI3K/Akt) signaling pathway. In this report, we have investigated the role of FOXO1, a downstream substrate of the PI3K/Akt pathway in the anticancer efficacy of rapamycin. MATERIALS AND METHODS: Colon cancer cells were treated with rapamycin and FOXO1 phosphorylation was determined by Western blot. Colon cancer cells transfected with a constitutively active mutant of FOXO1 or a control plasmid were treated with rapamycin and the antiproliferative efficacy of rapamycin was monitored. RESULTS: Rapamycin induced the phosphorylation of FOXO1 as well as its translocation from the nucleus to the cytoplasm, leading to FOXO1 inactivation. The expression of an active mutant of FOXO1 in colon cancer cells potentiated the antiproliferative efficacy of rapamycin in vitro and its antitumor efficacy in vivo. CONCLUSION: Taken together these results show that rapamycin-induced FOXO1 inactivation reduces the antitumor efficacy of rapamycin.

Sodium and potassium balance depends on αENaC expression in connecting tubule.

Mutations in α, β, or γ subunits of the epithelial sodium channel (ENaC) can downregulate ENaC activity and cause a severe salt-losing syndrome with hyperkalemia and metabolic acidosis, designated pseudohypoaldosteronism type 1 in humans. In contrast, mice with selective inactivation of αENaC in the collecting duct (CD) maintain sodium and potassium balance, suggesting that the late distal convoluted tubule (DCT2) and/or the connecting tubule (CNT) participates in sodium homeostasis. To investigate the relative importance of ENaC-mediated sodium absorption in the CNT, we used Cre-lox technology to generate mice lacking αENaC in the aquaporin 2-expressing CNT and CD. Western blot analysis of microdissected cortical CD (CCD) and CNT revealed absence of αENaC in the CCD and weak αENaC expression in the CNT. These mice exhibited a significantly higher urinary sodium excretion, a lower urine osmolality, and an increased urine volume compared with control mice. Furthermore, serum sodium was lower and potassium levels were higher in the genetically modified mice. With dietary sodium restriction, these mice experienced significant weight loss, increased urinary sodium excretion, and hyperkalemia. Plasma aldosterone levels were significantly elevated under both standard and sodium-restricted diets. In summary, αENaC expression within the CNT/CD is crucial for sodium and potassium homeostasis and causes signs and symptoms of pseudohypoaldosteronism type 1 if missing.

A novel TMPRSS3 missense mutation in a DFNB8/10 family prevents proteolytic activation of the protein.

Pathogenic mutations in TMPRSS3, which encodes a transmembrane serine protease, cause non-syndromic deafness DFNB8/10. Missense mutations map in the low density-lipoprotein receptor A (LDLRA), scavenger-receptor cysteine-rich (SRCR), and protease domains of the protein, indicating that all domains are important for its function. TMPRSS3 undergoes proteolytic cleavage and activates the ENaC sodium channel in a Xenopus oocyte model system. To assess the importance of this gene in non-syndromic childhood or congenital deafness in Turkey, we screened for mutations affected members of 25 unrelated Turkish families. The three families with the highest LOD score for linkage to chromosome 21q22.3 were shown to harbor P404L, R216L, or Q398X mutations, suggesting that mutations in TMPRSS3 are a considerable contributor to non-syndromic deafness in the Turkish population. The mutant TMPRSS3 harboring the novel R216L missense mutation within the predicted cleavage site of the protein fails to undergo proteolytic cleavage and is unable to activate ENaC, thus providing evidence that pre-cleavage of TMPRSS3 is mandatory for normal function.

Integral cohomology of finite postnikov towers

Depuis le séminaire H. Cartan de 1954-55, il est bien connu que l'on peut trouver des éléments de torsion arbitrairement grande dans l'homologie entière des espaces d'Eilenberg-MacLane K(G,n) où G est un groupe abélien non trivial et n>1. L'objectif majeur de ce travail est d'étendre ce résultat à des H-espaces possédant plus d'un groupe d'homotopie non trivial. Dans le but de contrôler précisément le résultat de H. Cartan, on commence par étudier la dualité entre l'homologie et la cohomologie des espaces d'Eilenberg-MacLane 2-locaux de type fini. On parvient ainsi à raffiner quelques résultats qui découlent des calculs de H. Cartan. Le résultat principal de ce travail peut être formulé comme suit. Soit X un H-espace ne possédant que deux groupes d'homotopie non triviaux, tous deux finis et de 2-torsion. Alors X n'admet pas d'exposant pour son groupe gradué d'homologie entière réduite. On construit une large classe d'espaces pour laquelle ce résultat n'est qu'une conséquence d'une caractéristique topologique, à savoir l'existence d'un rétract faible X K(G,n) pour un certain groupe abélien G et n>1. On généralise également notre résultat principal à des espaces plus compliqués en utilisant la suite spectrale d'Eilenberg-Moore ainsi que des méthodes analytiques faisant apparaître les nombres de Betti et leur comportement asymptotique. Finalement, on conjecture que les espaces qui ne possédent qu'un nombre fini de groupes d'homotopie non triviaux n'admettent pas d'exposant homologique. Ce travail contient par ailleurs la présentation de la « machine d'Eilenberg-MacLane », un programme C++ conçu pour calculer explicitement les groupes d'homologie entière des espaces d'Eilenberg-MacLane. <br/><br/>By the work of H. Cartan, it is well known that one can find elements of arbitrarilly high torsion in the integral (co)homology groups of an Eilenberg-MacLane space K(G,n), where G is a non-trivial abelian group and n>1. The main goal of this work is to extend this result to H-spaces having more than one non-trivial homotopy groups. In order to have an accurate hold on H. Cartan's result, we start by studying the duality between homology and cohomology of 2-local Eilenberg-MacLane spaces of finite type. This leads us to some improvements of H. Cartan's methods in this particular case. Our main result can be stated as follows. Let X be an H-space with two non-vanishing finite 2-torsion homotopy groups. Then X does not admit any exponent for its reduced integral graded (co)homology group. We construct a wide class of examples for which this result is a simple consequence of a topological feature, namely the existence of a weak retract X K(G,n) for some abelian group G and n>1. We also generalize our main result to more complicated stable two stage Postnikov systems, using the Eilenberg-Moore spectral sequence and analytic methods involving Betti numbers and their asymptotic behaviour. Finally, we investigate some guesses on the non-existence of homology exponents for finite Postnikov towers. We conjecture that Postnikov pieces do not admit any (co)homology exponent. This work also includes the presentation of the "Eilenberg-MacLane machine", a C++ program designed to compute explicitely all integral homology groups of Eilenberg-MacLane spaces. <br/><br/>Il est toujours difficile pour un mathématicien de parler de son travail. La difficulté réside dans le fait que les objets qu'il étudie sont abstraits. On rencontre assez rarement un espace vectoriel, une catégorie abélienne ou une transformée de Laplace au coin de la rue ! Cependant, même si les objets mathématiques sont difficiles à cerner pour un non-mathématicien, les méthodes pour les étudier sont essentiellement les mêmes que celles utilisées dans les autres disciplines scientifiques. On décortique les objets complexes en composantes plus simples à étudier. On dresse la liste des propriétés des objets mathématiques, puis on les classe en formant des familles d'objets partageant un caractère commun. On cherche des façons différentes, mais équivalentes, de formuler un problème. Etc. Mon travail concerne le domaine mathématique de la topologie algébrique. Le but ultime de cette discipline est de parvenir à classifier tous les espaces topologiques en faisant usage de l'algèbre. Cette activité est comparable à celle d'un ornithologue (topologue) qui étudierait les oiseaux (les espaces topologiques) par exemple à l'aide de jumelles (l'algèbre). S'il voit un oiseau de petite taille, arboricole, chanteur et bâtisseur de nids, pourvu de pattes à quatre doigts, dont trois en avant et un, muni d'une forte griffe, en arrière, alors il en déduira à coup sûr que c'est un passereau. Il lui restera encore à déterminer si c'est un moineau, un merle ou un rossignol. Considérons ci-dessous quelques exemples d'espaces topologiques: a) un cube creux, b) une sphère et c) un tore creux (c.-à-d. une chambre à air). a) b) c) Si toute personne normalement constituée perçoit ici trois figures différentes, le topologue, lui, n'en voit que deux ! De son point de vue, le cube et la sphère ne sont pas différents puisque ils sont homéomorphes: on peut transformer l'un en l'autre de façon continue (il suffirait de souffler dans le cube pour obtenir la sphère). Par contre, la sphère et le tore ne sont pas homéomorphes: triturez la sphère de toutes les façons (sans la déchirer), jamais vous n'obtiendrez le tore. Il existe un infinité d'espaces topologiques et, contrairement à ce que l'on serait naïvement tenté de croire, déterminer si deux d'entre eux sont homéomorphes est très difficile en général. Pour essayer de résoudre ce problème, les topologues ont eu l'idée de faire intervenir l'algèbre dans leurs raisonnements. Ce fut la naissance de la théorie de l'homotopie. Il s'agit, suivant une recette bien particulière, d'associer à tout espace topologique une infinité de ce que les algébristes appellent des groupes. Les groupes ainsi obtenus sont appelés groupes d'homotopie de l'espace topologique. Les mathématiciens ont commencé par montrer que deux espaces topologiques qui sont homéomorphes (par exemple le cube et la sphère) ont les même groupes d'homotopie. On parle alors d'invariants (les groupes d'homotopie sont bien invariants relativement à des espaces topologiques qui sont homéomorphes). Par conséquent, deux espaces topologiques qui n'ont pas les mêmes groupes d'homotopie ne peuvent en aucun cas être homéomorphes. C'est là un excellent moyen de classer les espaces topologiques (pensez à l'ornithologue qui observe les pattes des oiseaux pour déterminer s'il a affaire à un passereau ou non). Mon travail porte sur les espaces topologiques qui n'ont qu'un nombre fini de groupes d'homotopie non nuls. De tels espaces sont appelés des tours de Postnikov finies. On y étudie leurs groupes de cohomologie entière, une autre famille d'invariants, à l'instar des groupes d'homotopie. On mesure d'une certaine manière la taille d'un groupe de cohomologie à l'aide de la notion d'exposant; ainsi, un groupe de cohomologie possédant un exposant est relativement petit. L'un des résultats principaux de ce travail porte sur une étude de la taille des groupes de cohomologie des tours de Postnikov finies. Il s'agit du théorème suivant: un H-espace topologique 1-connexe 2-local et de type fini qui ne possède qu'un ou deux groupes d'homotopie non nuls n'a pas d'exposant pour son groupe gradué de cohomologie entière réduite. S'il fallait interpréter qualitativement ce résultat, on pourrait dire que plus un espace est petit du point de vue de la cohomologie (c.-à-d. s'il possède un exposant cohomologique), plus il est intéressant du point de vue de l'homotopie (c.-à-d. il aura plus de deux groupes d'homotopie non nuls). Il ressort de mon travail que de tels espaces sont très intéressants dans le sens où ils peuvent avoir une infinité de groupes d'homotopie non nuls. Jean-Pierre Serre, médaillé Fields en 1954, a montré que toutes les sphères de dimension >1 ont une infinité de groupes d'homotopie non nuls. Des espaces avec un exposant cohomologique aux sphères, il n'y a qu'un pas à franchir...