Fulminant hepatic and multiple organ failure following acute viral tonsillitis: a case report.

BACKGROUND Pyogenic tonsillitis may often be observed in the general Western population. In severe cases, it may require antibiotic treatment or even hospitalization and often a prompt clinical response will be noted. Here we present an unusual case of progressive multiple organ failure including fulminant liver failure following acute tonsillitis initially mistaken for "classic" pyogenic (that is bacterial) tonsillitis. CASE PRESENTATION A 68-year-old previously healthy white man was referred with suspicion of pyogenic angina. After tonsillectomy, he developed acute liver failure and consecutive multiple organ failure including acute hemodynamic, pulmonary and dialysis-dependent renal failure. Immunohistopathological analysis of his tonsils and liver as well as serum polymerase chain reaction analyses revealed herpes simplex virus-2 to be the causative pathogen. Treatment included high-dose acyclovir and multiorgan supportive intensive care therapy. His final outcome was favorable. CONCLUSIONS Fulminant herpes simplex virus-2-induced multiple organ failure is rarely observed in the Western hemisphere and should be considered a potential diagnosis in patients with tonsillitis and multiple organ failure including acute liver failure. From a clinical perspective, it seems important to note that fulminant herpes simplex virus-2 infection may masquerade as "routine" bacterial severe sepsis/septic shock. This persevering condition should be diagnosed early and treated goal-oriented in order to gain control of this life-threatening condition.

Nouueau liure des cinq ordres d'architecture / par Jacques Barrozio Vignole ; enrichi de differents morceaux de menuiserie, d'ornements et de tout ce qui est necessaire a tous ceux qui veulent étudier cet art ... .

En p. 1 grab. alegórico "Les cinq ordres d'architecture de Vignole"

Propellantless de orbiting of space debris by bare electrodynamic tethers

A 3-year Project started on November 1 2010, financed by the European Commision within the FP-7 Space Program, and aimed at developing an efficient de-orbit system that could be carried on board by future spacecraft launched into LEO, will be presented. The operational system will deploy a thin uninsulated tape-tether to collect electrons as a giant Langmuir probe, using no propellant/no power supply, and generating power on board. This project will involve free-fall tests, and laboratory hypervelocity-impact and tether-current tests, and design/Manufacturing of subsystems: interface elements, electric control and driving module, electron-ejecting plasma contactor, tether-deployment mechanism/end-mass, and tape samples. Preliminary results to be presented involve: i) devising criteria for sizing the three disparate tape dimensions, affecting mass, resistance, current-collection, magnetic self-field, and survivability against debris itself; ii) assessing the dynamical relevance of tether parameters in implementing control laws to limit oscillations in /off the orbital plane, where passive stability may be marginal; iii) deriving a law for bare-tape current from numerical simulations and chamber tests, taking into account ambient magnetic field, ion ram motion, and adiabatic electron trapping; iv) determining requirements on a year-dormant hollow cathode under long times/broad emission-range operation, and trading-off against use of electron thermal emission; v) determining requirements on magnetic components and power semiconductors for a control module that faces high voltage/power operation under mass/volume limitations; vi) assessing strategies to passively deploy a wide conductive tape that needs no retrieval, while avoiding jamming and ending at minimum libration; vii) evaluating the tape structure as regards conductive and dielectric materials, both lengthwise and in its cross-section, in particular to prevent arcing in triple-point junctions.

BETs: Propellant less de orbiting of space debris by bare electrodynamic tethers

As a fundamental contribution to limiting the increase of debris in the Space environment, a three-year project started on 1 November 2010 financed by the European Commission under the FP-7 Space Programme. It aims at developing a universal system to be carried on board future satellites launched into low Earth orbit (LEO), to allow de-orbiting at end of life. The operational system involves a conductive tape-tether left bare of insulation to establish anodic contact with the ambient plasma as a giant Langmuir probe. The project will size the three disparate dimensions of a tape for a selected de-orbit mission and determine scaling laws to allow system design for a general mission. It will implement control laws to restrain tether dynamics in/off the orbital plane; and will carry out plasma chamber measurements and numerical simulations of tether-plasma interaction. The project also involves the design and manufacturing of subsystems: electron-ejecting plasma contactors, an electric control and power module, interface elements, tether and deployment mechanisms, tether tape/end-mass as well as current collection plus free-fall, and hypervelocity impact tests.

Drifting plasma collection by a positive biased tether wire in LEO-like plasma conditions: current measurement and plasma diagnostic

BETs is a three-year project financed by the Space Program of the European Commission, aimed at developing an efficient deorbit system that could be carried on board any future satellite launched into Low Earth Orbit (LEO). The operational system involves a conductive tape-tether left bare to establish anodic contact with the ambient plasma as a giant Langmuir probe. As a part of this project, we are carrying out both numerical and experimental approaches to estimate the collected current by the positive part of the tether. This paper deals with experimental measurements performed in the IONospheric Atmosphere Simulator (JONAS) plasma chamber of the Onera-Space Environment Department. The JONAS facility is a 9- m3 vacuum chamber equipped with a plasma source providing drifting plasma simulating LEO conditions in terms of density and temperature. A thin metallic cylinder, simulating the tether, is set inside the chamber and polarized up to 1000 V. The Earth's magnetic field is neutralized inside the chamber. In a first time, tether collected current versus tether polarization is measured for different plasma source energies and densities. In complement, several types of Langmuir probes are used at the same location to allow the extraction of both ion densities and electron parameters by computer modeling (classical Langmuir probe characteristics are not accurate enough in the present situation). These two measurements permit estimation of the discrepancies between the theoretical collection laws, orbital motion limited law in particular, and the experimental data in LEO-like conditions without magnetic fields. In a second time, the spatial variations and the time evolutions of the plasma properties around the tether are investigated. Spherical and emissive Langmuir probes are also used for a more extensive characterization of the plasma in space and time dependent analysis. Results show the ion depletion because of the wake effect and the accumulation of- ions upstream of the tether. In some regimes (at large positive potential), oscillations are observed on the tether collected current and on Langmuir probe collected current in specific sites.

A VONTADE SOB O IMPACTO DA PÓS-MODERNIDADE (A FÉ INTERPELANDO A FRAGMENTAÇÃO DA VONTADE)

Este trabalho investiga uma das formas pelas quais a condição contemporânea, assim chamada pós-moderna, exerce significativo impacto sobre a vontade humana. Numa perspectiva fenomenológica e existencial, apoiada primordialmente no pensamento de Paul Ricoeur e Paul Tillich, esta abordagem busca identificar a relação entre a condição pós-moderna e a crise contemporânea da vontade que, como hipótese de tese, encontra-se vinculada à forma pela qual é estabelecida a relação entre vontade e desejo. A pós-modernidade é analisada a partir de seu desenvolvimento sócio-cultural desde a década de 1930 e em interlocução com os pensamentos de Jean-François Lyotard e Jean Baudrillard de forma a evidenciar o desenvolvimento desta relação. Algumas perspectivas filosófico-teológicas são exploradas a partir da situação de impacto aqui em questão. São tentativas de contribuir para que a vontade redescubra seu caráter integralizador e possa considerá-lo tão imprescindível quanto seu ímpeto expansionista e dissipador, uma vez que ambos os movimentos são partes integrantes da coragem e do poder-de-ser que a fundamentam.(AU)

A VONTADE SOB O IMPACTO DA PÓS-MODERNIDADE (A FÉ INTERPELANDO A FRAGMENTAÇÃO DA VONTADE)

Este trabalho investiga uma das formas pelas quais a condição contemporânea, assim chamada pós-moderna, exerce significativo impacto sobre a vontade humana. Numa perspectiva fenomenológica e existencial, apoiada primordialmente no pensamento de Paul Ricoeur e Paul Tillich, esta abordagem busca identificar a relação entre a condição pós-moderna e a crise contemporânea da vontade que, como hipótese de tese, encontra-se vinculada à forma pela qual é estabelecida a relação entre vontade e desejo. A pós-modernidade é analisada a partir de seu desenvolvimento sócio-cultural desde a década de 1930 e em interlocução com os pensamentos de Jean-François Lyotard e Jean Baudrillard de forma a evidenciar o desenvolvimento desta relação. Algumas perspectivas filosófico-teológicas são exploradas a partir da situação de impacto aqui em questão. São tentativas de contribuir para que a vontade redescubra seu caráter integralizador e possa considerá-lo tão imprescindível quanto seu ímpeto expansionista e dissipador, uma vez que ambos os movimentos são partes integrantes da coragem e do poder-de-ser que a fundamentam.(AU)

RECONHECENDO-SE SEM-RELIGIÃO NAS PERIFERIAS DA CIDADE: LIBERDADE COMPARTILHADA COMO RESISTÊNCIA

Reconhecendo, a partir da constatação empírica, a multiplicidade de escolhas de crenças no Mundo e em particular na periferia urbana paulistana, reconhecemos, também, a emergência criativa de novas possibilidades de crer e não crer. Tal amplitude não apenas aponta para o crer (segundo as ofertas de um sem número de religiões) e o não crer (ateu e agnóstico), mas para uma escolha que poderia vir a ser silenciada e esquecida, neste binômio arcaico e obsoleto, quando alguém se dá à liberdade crer sem ter religião. Reconhecer interessadamente os sem-religião nas periferias urbanas paulistanas é dar-se conta das violências a que estes indivíduos estão submetidos: violência econômica, violência da cidadania (vulnerabilidade) e proveniente da armas (grupos x Estado). Tanto quanto a violência do esquecimento e silenciamento. A concomitância espaço-temporal dos sem-religião nas periferias, levou-nos buscar referências em teorias de secularização e de laicidade, e, a partir destas, traçar uma história do poder violento, cuja pretensão é a inelutabilidade, enquanto suas fissuras são abertas em espaços de resistências. A história da legitimação do poder que se quer único, soberano, de caráter universal, enquanto fragmenta a sociedade em indivíduos atomizados, fragilizando vínculos horizontais, e a dos surgimentos de resistências não violentas questionadoras da totalidade trágica, ao reconhecer a liberdade de ser com autonomia, enquanto se volta para a produção de partilha de bens comuns. Propomos reconhecer a igual liberdade de ser (expressa na crença da filiação divina) e de partilhar o bem comum em reconhecimentos mútuos (expressa pela ação social), uma expressão de resistência não violenta ao poder que requer a igual abdicação da liberdade pela via da fragmentação individualizante e submissão inquestionável à ordem totalizante. Os sem-religião nas periferias urbanas, nossos contemporâneos, partilhariam uma tal resistência, ao longo da história, com as melissas gregas, os profetas messiânicos hebreus, os hereges cristãos e os ateus modernos, cuja pretensão não é o poder, mas a partilha igual da liberdade e dos bens comuns. Estes laicos, de fato, seriam agentes de resistências de reconhecimento mútuos, em espaços de multiplicidade crescente, ao poder violento real na história.

A DIVERSIDADE RELIGIOSA NO ESPAÇO ESCOLAR ADVENTISTA DO ABCD PAULISTA

Tendo como pano de fundo a confessionalidade da rede adventista de educação presente de maneira marcante no espaço escolar e a intensa diversidade religiosa discente, esta pesquisa analisa a relação de possíveis tensões entre a confessionalidade escolar e a diversidade religiosa presente neste espaço. Leva em consideração o processo de modernidade causadora de importantes transformações na educação, na religião e na forma dos dois institutos se relacionarem. Levou-se em consideração o perfil socioeconômico e religioso dos alunos e possíveis tensões na recepção do religioso no espaço escolar adventista por parte dos discentes, inclusive por aqueles que se declaram adventistas. O espaço escolhido para esta pesquisa foi o de colégios adventistas localizadas no contexto do ABCD Paulista, que ofertam o Ensino Médio. Estas unidades escolares estão situadas nas cidades de Diadema, Santo André e São Caetano do Sul, cidades localizadas na mesma microrregião, mas com distintas realidades socioeconômicas

α1-Antitrypsin Portland, a bioengineered serpin highly selective for furin: Application as an antipathogenic agent

The important role of furin in the proteolytic activation of many pathogenic molecules has made this endoprotease a target for the development of potent and selective antiproteolytic agents. Here, we demonstrate the utility of the protein-based inhibitor α1-antitrypsin Portland (α1-PDX) as an antipathogenic agent that can be used prophylactically to block furin-dependent cell killing by Pseudomonas exotoxin A. Biochemical analysis of the specificity of a bacterially expressed His- and FLAG-tagged α1-PDX (α1-PDX/hf) revealed the selectivity of the α1-PDX/hf reactive site loop for furin (Ki, 600 pM) but not for other proprotein convertase family members or other unrelated endoproteases. Kinetic studies show that α1-PDX/hf inhibits furin by a slow tight-binding mechanism characteristic of serpin molecules and functions as a suicide substrate inhibitor. Once bound to furin’s active site, α1-PDX/hf partitions with equal probability to undergo proteolysis by furin at the C-terminal side of the reactive center -Arg355-Ile-Pro-Arg358-↓ or to form a kinetically trapped SDS-stable complex with the enzyme. This partitioning between the complex-forming and proteolytic pathways contributes to the ability of α1-PDX/hf to differentially inhibit members of the proprotein convertase family. Finally, we propose a structural model of the α1-PDX-reactive site loop that explains the high degree of enzyme selectivity of this serpin and which can be used to generate small molecule furin inhibitors.

Decreased blood pressure response in mice deficient of the α1b-adrenergic receptor

To investigate the functional role of different α1-adrenergic receptor (α1-AR) subtypes in vivo, we have applied a gene targeting approach to create a mouse model lacking the α1b-AR (α1b−/−). Reverse transcription–PCR and ligand binding studies were combined to elucidate the expression of the α1-AR subtypes in various tissues of α1b +/+ and −/− mice. Total α1-AR sites were decreased by 98% in liver, 74% in heart, and 42% in cerebral cortex of the α1b −/− as compared with +/+ mice. Because of the large decrease of α1-AR in the heart and the loss of the α1b-AR mRNA in the aorta of the α1b−/− mice, the in vivo blood pressure and in vitro aorta contractile responses to α1-agonists were investigated in α1b +/+ and −/− mice. Our findings provide strong evidence that the α1b-AR is a mediator of the blood pressure and the aorta contractile responses induced by α1 agonists. This was demonstrated by the finding that the mean arterial blood pressure response to phenylephrine was decreased by 45% in α1b −/− as compared with +/+ mice. In addition, phenylephrine-induced contractions of aortic rings also were decreased by 25% in α1b−/− mice. The α1b-AR knockout mouse model provides a potentially useful tool to elucidate the functional specificity of different α1-AR subtypes, to better understand the effects of adrenergic drugs, and to investigate the multiple mechanisms involved in the control of blood pressure.

Relationships of dehydroepiandrosterone sulfate in the elderly with functional, psychological, and mental status, and short-term mortality: A French community-based study

In human beings of both sexes, dehydroepiandrosterone sulfate (DHEAS) circulating in blood is mostly an adrenally secreted steroid whose serum concentration (in the micromolar range and 30–50% higher in men than in women) decreases with age, toward ≈20–10% of its value in young adults during the 8th and 9th decades. The mechanism of action of DHEA and DHEAS is poorly known and may include partial transformation into sex steroids, increase of bioavailable insulin-like growth factor I, and effects on neurotransmitter receptors. Whether there is a cause-to-effect relationship between the decreasing levels of DHEAS with age and physiological and pathological manifestations of aging is still undecided, but this is of obvious theoretical and practical interest in view of the easy restoration by DHEA administration. Here we report on 622 subjects over 65 years of age, studied for the 4 years since DHEAS baseline values had been obtained, in the frame of the PAQUID program, analyzing the functional, psychological, and mental status of a community-based population in the south-west of France. We confirm the continuing decrease of DHEAS serum concentration with age, more in men than in women, even if men retain higher levels. Significantly lower values of baseline DHEAS were recorded in women in cases of functional limitation (Instrumental Activities of Daily Living), confinement, dyspnea, depressive symptomatology, poor subjective perception of health and life satisfaction, and usage of various medications. In men, there was a trend for the same correlations, even though not statistically significant in most categories. No differences in DHEAS levels were found in cases of incident dementia in the following 4 years. In men (but not in women), lower DHEAS was significantly associated with increased short-term mortality at 2 and 4 years after baseline measurement. These results, statistically established by taking into account corrections for age, sex, and health indicators, suggest the need for further careful trials of the administration of replacement doses of DHEA in aging humans. Indeed, the first noted results of such “treatment” are consistent with correlations observed here between functional and psychological status and endogenous steroid serum concentrations.

Virus-sized self-assembling lamellar complexes between plasmid DNA and cationic micelles promote gene transfer

Gene therapy is based on the vectorization of genes to target cells and their subsequent expression. Cationic amphiphile-mediated delivery of plasmid DNA is the nonviral gene transfer method most often used. We examined the supramolecular structure of lipopolyamine/plasmid DNA complexes under various condensing conditions. Plasmid DNA complexation with lipopolyamine micelles whose mean diameter was 5 nm revealed three domains, depending on the lipopolyamine/plasmid DNA ratio. These domains respectively corresponded to negatively, neutrally, and positively charged complexes. Transmission electron microscopy and x-ray scattering experiments on complexes originating from these three domains showed that although their morphology depends on the lipopolyamine/plasmid DNA ratio, their particle structure consists of ordered domains characterized by even spacing of 80 Å, irrespective of the lipid/DNA ratio. The most active lipopolyamine/DNA complexes for gene transfer were positively charged. They were characterized by fully condensed DNA inside spherical particles (diameter: 50 nm) sandwiched between lipid bilayers. These results show that supercoiled plasmid DNA is able to transform lipopolyamine micelles into a supramolecular organization characterized by ordered lamellar domains.