Prognostic relevance of Masaoka and Müller-Hermelink classification in patients with thymic tumors.

BACKGROUND: To compare the prognostic relevance of Masaoka and Müller-Hermelink classifications. METHODS: We treated 71 patients with thymic tumors at our institution between 1980 and 1997. Complete follow-up was achieved in 69 patients (97%) with a mean follow up-time of 8.3 years (range, 9 months to 17 years). RESULTS: Masaoka stage I was found in 31 patients (44.9%), stage II in 17 (24.6%), stage III in 19 (27.6%), and stage IV in 2 (2.9%). The 10-year overall survival rate was 83.5% for stage I, 100% for stage IIa, 58% for stage IIb, 44% for stage III, and 0% for stage IV. The disease-free survival rates were 100%, 70%, 40%, 38%, and 0%, respectively. Histologic classification according to Müller-Hermelink found medullary tumors in 7 patients (10.1%), mixed in 18 (26.1%), organoid in 14 (20.3%), cortical in 11 (15.9%), well-differentiated thymic carcinoma in 14 (20.3%), and endocrine carcinoma in 5 (7.3%), with 10-year overall survival rates of 100%, 75%, 92%, 87.5%, 30%, and 0%, respectively, and 10-year disease-free survival rates of 100%, 100%, 77%, 75%, 37%, and 0%, respectively. Medullary, mixed, and well-differentiated organoid tumors were correlated with stage I and II, and well-differentiated thymic carcinoma and endocrine carcinoma with stage III and IV (p < 0.001). Multivariate analysis showed age, gender, myasthenia gravis, and postoperative adjuvant therapy not to be significant predictors of overall and disease-free survival after complete resection, whereas the Müller-Hermelink and Masaoka classifications were independent significant predictors for overall (p < 0.05) and disease-free survival (p < 0.004; p < 0.0001). CONCLUSIONS: The consideration of staging and histology in thymic tumors has the potential to improve recurrence prediction and patient selection for combined treatment modalities.

Videvdad 19 : édition critique, traduction et commentaires des textes avestique et moyen-perse

Notre travail porte sur le Videvdad, texte avestique nommé d'après unmot avestique Videvdad-data-, c'est-à-dire la « Un qui tient éloignés les demons ». Ce recueil comprend 22 chapitres édictant des lois religieuses, des préceptes rituels et des mesures de purification Ces prescriptions ont pour but de repousser l'impureté des elements purs de la création d'Ahura Mazda. Notre thèse est une édition du chapitre 19 de ce recueil complétée de sa traduction commentée. Ce chapitre raconte la tentation de Zarathustra par le Mauvais Esprit et sa victoire sur ce dernier Le texte a été traduit et commenté sémantiquement, phonétiquement et philologiquement afin d'en dégager les particularités linguistiques.L'édition de référence du texte avestique est celle de Geldner, qui date de la fin du 19 siècle Dans la mesure où il a été démontré durant ces dernières années quil fallait revoir ce travail, nous avons fait une édition du texte en collationnant 13 manuscits. Notre étude nous a permis à la fois de proposer pour certains termes une autre lecture que celle de Geldner et decontinuer les recherches sur la filiation des manuscrits.De plus le texte avestique a été mis en regard de la version pehlevie. L'intérêt de cette dernière traduction réside dans ses gloses : parfois un long commentaire parfois une simple énonciation de synonymes en pehlevie. le traducteur lui-même comprenant mal le sens du mot original. L'édition du texte pehlevi a également été refaite à partir des deux manuscrits lesplus anciens (L4 et Kl).Videvdad 19 :Critical Edition, Translation and Commentary of the Avestan and Pahlavi TextsWe worked on the Videvdad, an Avestan text whose title is a Middle Persian word coming from the Avestan Videvdad-data- "the law that keeps demons away" This anthology contains 22 chapters dealing with religious laws, ritual precepts and measures of purification. These prescriptions aim ft rejecting impurity from pure elements in Ahura Mazda's creation. Our dissertation is an edition and translation with commentary of chapter 19 of this anthology. lt relates the temptation of Zarathustra by the Bad Evil and how Zarathustra overcame him. The text was translated and annotated semantically, phonetically and philologically to highlight linguistic features.Until today, Geldner's edition, which dates back to the end of the 19th century has been the edition of reference. However, in recent years, scholars have shown that this edition must be revised Therefore, we prepared an edition of the Avestan text by collating 13 manuscripts. This work led us to propose new readings for several words and pursue research onmanuscripts filiation.Furthermore, we also studied the Middle Persian text. This translation is interesting in that it contains glosses that can either be long commentaries or simple synonyms. We also made the edition of the Middle Persian text on the basis of the two oldest manuscripts (L4 and Kl).

Muerte y permanencia de la sustancia en Virgilio, Ovidio y Lucrecio

After a few historical references, from Homer to Plato, to the problem of death and permanence, this paper focuses on the different ways by which ~irgilO, vid and ~ucietiustr y to refute the phantom of death by means of a philosophy of the perennial substratum and the dissolution of phenomenic and episodic compounds.

Cannabis Dependence in Swiss Adolescents Exploration of the Role of Anxiety, Coping Styles, and Psychosocial Difficulties

This naturalistic cross-sectional study explores how and to what extent cannabis dependence was associated with intrapersonal aspects (anxiety, coping styles) and interpersonal aspects of adolescent functioning (school status, family relationships, peer relationships, social life). A convenience sample of 110 adolescents (aged 12 to 19) was recruited and subdivided into two groups (38 with a cannabis dependence and 72 nondependent) according to DSM-IV-TR criteria for cannabis dependence. Participants completed the State-Trait Anxiety Inventory (STAI-Y), the Coping Across Situations Questionnaire (CASQ), and the Adolescent Drug Abuse Diagnosis (ADAD) interview investigating psychosocial and interpersonal problems in an adolescent's life. Factors associated with cannabis dependence were explored with logistic regression analyses. The results indicated that severity of problems in social life and peer relationships (OR = 1.68, 95% CI = 1.21 - 2.33) and avoidant coping (OR = 4.22, 95% CI = 1.01 - 17.73) were the only discriminatory factors for cannabis dependence. This model correctly classified 84.5% of the adolescents. These findings are partially consistent with the "self-medication hypothesis" and underlined the importance of peer relationships and dysfunctional coping strategies in cannabis dependence in adolescence. Limitations of the study and implications for clinical work with adolescents are discussed.

Retinal pigment epithelium protein of 65 kDA gene-linked retinal degeneration is not modulated by chicken acidic leucine-rich epidermal growth factor-like domain containing brain protein/Neuroglycan C/ chondroitin sulfate proteoglycan 5.

PURPOSE: To analyze in vivo the function of chicken acidic leucine-rich epidermal growth factor-like domain containing brain protein/Neuroglycan C (gene symbol: Cspg5) during retinal degeneration in the Rpe65⁻/⁻ mouse model of Leber congenital amaurosis. METHODS: We resorted to mice with targeted deletions in the Cspg5 and retinal pigment epithelium protein of 65 kDa (Rpe65) genes (Cspg5⁻/⁻/Rpe65⁻/⁻). Cone degeneration was assessed with cone-specific peanut agglutinin staining. Transcriptional expression of rhodopsin (Rho), S-opsin (Opn1sw), M-opsin (Opn1mw), rod transducin α subunit (Gnat1), and cone transducin α subunit (Gnat2) genes was assessed with quantitative PCR from 2 weeks to 12 months. The retinal pigment epithelium (RPE) was analyzed at P14 with immunodetection of the retinol-binding protein membrane receptor Stra6. RESULTS: No differences in the progression of retinal degeneration were observed between the Rpe65⁻/⁻ and Cspg5⁻/⁻/Rpe65⁻/⁻ mice. No retinal phenotype was detected in the late postnatal and adult Cspg5⁻/⁻ mice, when compared to the wild-type mice. CONCLUSIONS: Despite the previously reported upregulation of Cspg5 during retinal degeneration in Rpe65⁻/⁻ mice, no protective effect or any involvement of Cspg5 in disease progression was identified.

[Phot. d'un éclair prise par Alfred H. Binden à Wakefield, Massachusetts, le 23 juin 1888, offerte par Mme C.H. Davis et A.H. Binden]

Donateur : Davis, C.H. (18..-1... ; Mme)