Lymphome et grossesse: quelle prise en charge [Management of lymphoma and pregnancy]

With an incidence of 1/6000 pregnancies, per-partum lymphoma is a rare but not an exceptional event, which gynaecologists and family physicians can be confronted in the course of their career The diagnosis, without a peripheral adenopathy, can be challenging because symptoms, such as fatigue or dyspnoea, can easily be attributed to the pregnancy. Although the therapeutic management is complex, because it involves the mother and her embryos, it can be optimal in the majority of cases. The multidisciplinary management, with modern diagnostic and therapeutic approaches, greatly improved the prognosis of these young women. Today, it generally allows the safekeeping of the baby with an outcome for the mother identical to the one observed in the population at large.

Use of GPS for Photogrammetry, HR-342, 1993

Five test flights were conducted to study the use of Global Positioning System (GPS) in Photogrammetry, three in Iowa, one each in California and Texas. These tests show that GPS can be used to establish ground control by the static method and to determine camera location by the kinematic method. In block triangulation, six GPS controls are required and additional elevation control along the centerline is also required in strip triangulation. The camera location determined by aerial triangulation depends on the scale of the photography. The 1:3000 scale photography showed that the absolute accuracy of the camera location by GPS is better than five centimeters. The 1:40000 scale photography showed that the relative accuracy of the camera location by GPS is about one millimeter. In a strip triangulation elevation control is required in addition to the camera location by GPS. However, for block triangulation camera location by GPS is sufficient. Pre-targeting of pass and tie points gives the best results in both block and strip triangulation. In normal mapping for earth work computations the use of 1:6000 scale photography with GPS control instead of 1:3000 scale is recommended. It is recommended that research be done in the use of GPS for navigation in aerial photographic missions. It is highly recommended that research be done in the use of GPS to determine tip and tilt of the aerial camera, that is required in stereoplotting.

Crystallization and properties of poly(ethylene terephtalate) copolymers containing 5-tert-butyl isophtalic units

The influence of incorporating 5-tert-butyl isophthalic units (tBI) in the polymer chain of poly(ethylene terephthalate) (PET) on the crystallization behavior, crystal structure, and tensile and gas transport properties of this polyester was evaluated. Random poly(ethyleneterephthalate-co-5-tert-butyl isophthalate) copolyesters (PETtBI) containing between 5 and 40 mol% of tBI units were examined. Isothermal crystallization studies were performed on amorphous glassy films at 120 8C and on molten samples at 200 8C by means of differential scanning calorimetry. Furthermore, the non-isothermal crystallization behavior of the copolyesters was investigated. It was observed that both crystallinity and crystallization rate of the PETtBI copolyesters tend to decrease largely with the comonomeric content, except for the copolymer containing 5 mol% of tBI units, which crystallized faster than PET. Fiber X-ray diffraction patterns of the semicrystalline PETtBI copolyesters proved that they adopt the same triclinic crystal structure as PET with the comonomeric units being excluded from the crystalline phase. Although PETtBI copolyesters became brittle for higher contents in tBI, the tensile modulus and strength of PET were barely affected by copolymerization. The ncorporation of tBI units slightly increased the permeability of PET, but copolymers containing up to 20 mol% of the comonomeric units were still able to present barrier properties.

Avaliação da qualidade fisiológica de sementes de soja, após o processo de hidratação-desidratação e envelhecimento acelerado

Foi conduzido um experimento com o objetivo de avaliar a qualidade fisiológica de sementes de soja (Glycine max (L.) Merrill) , envolvendo as variedades UFV-10, IAC-8 e Doko RC, submetidas ao processo de hidratação-desidratação, seguido por uma condição de estresse induzida pelo teste de envelhecimento acelerado. As sementes foram pré-condicionadas em PEG 6000, com potencial osmótico de -0,8 MPa, a uma temperatura de 20ºC, por quatro dias. Em seguida, as sementes foram novamente desidratadas, até atingir o conteúdo de umidade inicial, sendo então submetidas ao teste de envelhecimento acelerado pelos seguintes períodos: 0, 24, 48 e 72 horas. As sementes pré-condicionadas foram comparadas com duas testemunhas: sementes não-tratadas e sementes embebidas em água. Após cada período de envelhecimento, as sementes foram avaliadas pelo teste padrão de germinação, comprimento de plântula e biomassa seca das plântulas. Em casa de vegetação, determinaram-se o índice de velocidade de emergência e a emergência final em substrato de areia. O tratamento de hidratação-desidratação em solução de PEG 6000 melhorou o desempenho das sementes em termos de germinação e vigor. O aumento nos períodos de envelhecimento acelerado influenciou negativamente o desempenho das sementes, em todos os tratamentos avaliados. Contudo, o tratamento com PEG 6000 foi satisfatório em manter a qualidade das sementes. A embebição das sementes de soja em água desmineralizada prejudicou a qualidade fisiológica. As variedades de soja mostraram resposta diferenciada aos tratamentos de hidratação-desidratação e aos períodos de envelhecimento acelerado.

Modification of Ca-Montmorillonite by Low-Temperature Heat Treatment, HR-106, 1964

Objectives of this investigation were to measure the effects of moderate heat treatments (below the dehydroxylation temperature) on physical and chemical properties of a calcium-montmorillonite clay. Previous workers have noted the reduction in cation exchange capacity and swelling property after heating in the range 200 to 400°C, and have suggested several possible explanations, such as hysteresis effect, increased inter-layer attractions due to removal of inter-layer water, or changes in the disposition of inter-layer or layer surface ions. The liquid limits of Ca-montmorillonite were steadily decreased with increased temperature of treatment, levelling at about 450°C. The plastic limit decreased slightly up to 350°C, above which samples could no longer be rolled into threads. The gradual change is in contrast with sudden major changes noted for weight loss (maximum rates of change at l00°C and 500°C), glycol retention surface area (520°C), and d001 diffraction peak intensity (17.7 A spacing) and breadth after glycolation (530°C). Other properties showing more gradual reductions with heat treatment were amount of exchangeable calcium (without water soaking), cation exchange capacity by NH4AC method, and d001 intensity (21 A spacing) after storing at 100% r.h. one month and re-wetting with water. Previous water soaking allowed much greater release of fixed Ca++ up to 450°C. Similar results were obtained with cation exchange capacities when samples were treated with N CaCl2 solution. The 21.0 A peak intensity curve showed close similarity to the liquid limit and plastic index curves in the low temperature range, and an explanation is suggested.

Soil solarization for weed control in carrot

Soil solarization is a technique used for weed and plant disease control in regions with high levels of solar radiation. The effect of solarization (0, 3, 6, and 9 weeks) upon weed populations, carrot (Daucus carota L. cv. Brasília) yield and nematode infestation in carrot roots was studied in São Luís (2º35' S; 44º10' W), MA, Brazil, using transparent polyethylene films (100 and 150 mm of thickness). The maximum temperature at 5 cm of depth was about 10ºC warmer in solarized soil than in control plots. In the study 20 weed types were recorded. Solarization reduced weed biomass and density in about 50% of weed species, including Cyperus spp., Chamaecrista nictans var. paraguariensis (Chod & Hassl.) Irwin & Barneby, Marsypianthes chamaedrys (Vahl) O. Kuntze, Mitracarpus sp., Mollugo verticillata L., Sebastiania corniculata M. Arg., and Spigelia anthelmia L. Approximately 40% of species in the weed flora were not affected by soil mulching. Furthermore, seed germination of Commelina benghalensis L. was increased by soil solarization. Marketable yield of carrots was greater in solarized soil than in the unsolarized one. It was concluded that solarization for nine weeks increases carrot yield and is effective for controlling more than half of the weed species recorded. Mulching was not effective for controlling root-knot nematodes in carrot.

The vitamin D receptor gene bAt (CCA) haplotype impairs the response to pegylated-interferon/ribavirin-based therapy in chronic hepatitis C patients.

BACKGROUND: Chronic hepatitis C infection is a major cause of end-stage liver disease. Therapy outcome is influenced by 25-OH vitamin D deficiency. To further address this observation, our study investigates the impact of the vitamin D receptor (NR1I1) haplotype and combined effects of plasma vitamin D levels in a well-described cohort of hepatitis C patients. METHODS: A total of 155 chronic hepatitis C patients were recruited from the Swiss Hepatitis C Cohort Study for NR1I1 genotyping and plasma 25-OH vitamin D level measurement. NR1I1 genotype data and combined effects of plasma 25-OH vitamin D level were analysed regarding therapy response (sustained virological response). RESULTS: A strong association was observed between therapy non-response and the NR1I1 CCA (bAt) haplotype consisting of rs1544410 (BsmI) C, rs7975232 (ApaI) C and rs731236 (TaqI) A alleles. Of the HCV patients carrying the CCA haplotype, 50.3% were non-responders (odds ratio [OR] 1.69, 95% CI 1.07, 2.67; P=0.028). A similar association was observed for the combinational CCCCAA genotype (OR 2.94, 95% CI 1.36, 6.37; P=0.007). The combinational CCCCAA genotype was confirmed as an independent risk factor for non-response in multivariate analysis (OR 2.50, 95% CI 1.07, 5.87; P=0.034). Analysing combined effects, a significant impact of low 25-OH vitamin D levels on sustained virological response were only seen in patients with the unfavourable NR1I1 CCA (bAt) haplotype (OR for non-SVR 3.55; 95% CI 1.005, 12.57; P=0.049). CONCLUSIONS: NR1I1 vitamin D receptor polymorphisms influence response to pegylated-interferon/ribavirin-based therapy in chronic hepatitis C and exert an additive genetic predisposition to previously described low 25-OH vitamin D serum levels.

Vancomycin exposure from active calcium sulfate bone filler

Objective: Bone cements and substitutes are commonly used in surgery to deliver antibiotics locally. The objective of this study was to assess the systemic absorption and disposition of vancomycin in patients treated with active calcium sulfate bone filler and to predict systemic concentrations under various conditions. Method: 277 blood samples were taken from 42 patients receiving vancomycin in bone cement during surgery. Blood samples were collected from 3h to 10 days after implantation. Vancomycin was measured by immunoenzymatic assay. Population pharmacokinetic (PK) analysis was performed using NONMEM to assess average estimates and variability of PK parameters. Based on the final model, simulations with various doses and renal function levels were performed. Results: The patients were 64 ± 20 years old, their body weight was 81 ± 22 kg and Cockcroft-Gault creatinine clearance (CLcr) 98 ± 55 mL/min. Vancomycin doses ranged from 200 mg to 6000 mg and implantation sites were hip (n=16), tibia (10) or others (16). Concentration profiles remained low and consistent with absorption rate-limited first-order release, while showing prominent variability. Mean clearance (CL) was 3.87 L/h (CV 35%), absorption rate constant (ka) 0.004 h-1 (66%) and volume of distribution (V) 9.5 L. Simulations with up to 8000 mg vancomycin implant showed systemic concentrations exceeding 20 mg/L for 3.5 days in 43% of the patients with CLcr 15 mL/min, whereas 7% of the patients with normal renal function had a concentration above 20 mg/L for 1.1 days. Subtherapeutic concentrations (0.4-4 mg/L) were predicted during a median of 22 days in patients with normal renal function and 4000 mg vancomycin implant, with limited influence of dose or renal function. Conclusion: Vancomycin-laden calcium sulfate implant does not raise toxicity concern. Selection of resistant bacteria, such as Enterococcus and Staphylococcus species, might however be a concern, as simulations show persistent subtherapeutic systemic concentrations during 3 to 4 weeks in these patients.

Surface assembly of poly(I:C) on PEGylated microspheres to shield from adverse interactions with fibroblasts.

By expressing an array of pattern recognition receptors (PRRs), fibroblasts play an important role in stimulating and modulating the response of the innate immune system. The TLR3 ligand polyriboinosinic acid-polyribocytidylic acid, poly(I:C), a mimic of viral dsRNA, is a vaccine adjuvant candidate to activate professional antigen presenting cells (APCs). However, owing to its ligation with extracellular TLR3 on fibroblasts, subcutaneously administered poly(I:C) bears danger towards autoimmunity. It is thus in the interest of its clinical safety to deliver poly(I:C) in such a way that its activation of professional APCs is as efficacious as possible, whereas its interference with non-immune cells such as fibroblasts is controlled or even avoided. Complementary to our previous work with monocyte-derived dendritic cells (MoDCs), here we sought to control the delivery of poly(I:C) surface-assembled on microspheres to human foreskin fibroblasts (HFFs). Negatively charged polystyrene (PS) microspheres were equipped with a poly(ethylene glycol) (PEG) corona through electrostatically driven coatings with a series of polycationic poly(L-lysine)-graft-poly(ethylene glycol) copolymers, PLL-g-PEG, of varying grafting ratios g from 2.2 up to 22.7. Stable surface assembly of poly(I:C) was achieved by incubation of polymer-coated microspheres with aqueous poly(I:C) solutions. Notably, recognition of both surface-assembled and free poly(I:C) by extracellular TLR3 on HFFs halted their phagocytic activity. Ligation of surface-assembled poly(I:C) with extracellular TLR3 on HFFs could be controlled by tuning the grafting ratio g and thus the chain density of the PEG corona. When assembled on PLL-5.7-PEG-coated microspheres, poly(I:C) was blocked from triggering class I MHC molecule expression on HFFs. Secretion of interleukin (IL)-6 by HFFs after exposure to surface-assembled poly(I:C) was distinctly lower as compared to free poly(I:C). Overall, surface assembly of poly(I:C) may have potential to contribute to the clinical safety of this vaccine adjuvant candidate.

Objective results at 1 year of a new ultracongruent postero-stabilized total knee arthroplasty

Introduction: A new ultra congruent, postero-stabilized total knee arthroplasty (TKA) with a mobile bearing, the FIRST knee prosthesis (Free Insert in Rotation Stabilized in Translation, Symbios SA), was designed and expected to significantly reduce polyethylene wear, to improve the range of motion and the overall stability of the knee while ensuring a physiological ligament balance. Gait analysis has proven to give really objective outcome parameters after lower limb surgery. The goal of our study was to compare the subjective and really objective results of this new TKA with two other widespread models of TKA. Methods: A clinical prospective monocentric cohort study of 100 consecutive patients (47-88 yrs) undergoing a FIRST TKA for primary osteoarthritis is currently being done. Pre- and post-operative follow-ups (6 weeks, 4 months and 1 year) were done with well-recognized subjective evaluations (EQ-5D and WOMAC scores) and semi-objective questionnaires (KSS score and radiography evaluation) as well as with a really objective evaluation using gait parameters from 6 walking trials, performed at different speeds (slow, normal and fast) with an ambulatory gait analysis system (Physilog®, BioAGM CH). The outcomes of the first 32 new TKA after one year of follow-up were compared to the results after 1 year of a randomized controlled clinical trial comparing 29 NexGen® postero-stabilized TKA (Zimmer Inc) with a fixed bearing and 26 NexGen® TKA with a mobile bearing using the same methods. Results: Subjective and semi-objective results were similar for the three types of TKA. As for the really objective parameters, the gait cycle time of the FIRST TKA was statistically significantly shorter at normal speed of walk, as well as double-support periods, as compared to both standard models. The extension (in terms of range of motion when walking) of the operated knee was significantly improved for all three types of walk in favour of the FIRST TKAs compared to both NexGen TKAs. The normal walking speed was significantly higher with faster swing speed and stride lengths for the new TKA. Significantly better coordination scores were observed at normal walking speed for the FIRST TKA as compared to the fixed-bearing TKAs. Conclusion: The FIRST TKAs showed statistically significantly better objective outcomes in terms of gait after one year of follow-up with similar subjective and semi-objective results in comparison with widespread TKA designs. These encouraging short-terms results will have to be confirmed at a 5 years follow-up of the FIRST TKAs.

Efeito do estresse hídrico e envelhecimento precoce na viabilidade de sementes osmocondicionadas de paineira (Chorisia speciosa)

O objetivo deste trabalho foi avaliar a eficiência do condicionamento osmótico em aumentar a tolerância de sementes de paineira (Chorisia speciosa St. Hil.) ao estresse hídrico e ao envelhecimento precoce. As sementes foram condicionadas em solução de KNO3 (0,1M) a 20ºC durante 24 horas, e desidratadas a 27ºC até atingirem o peso inicial, apresentado antes do tratamento. Em seguida, foram expostas ao estresse hídrico simulado com soluções de PEG 6000 nos potenciais osmóticos de 0,0, -0,1, -0,2, -0,3, -0,4, -0,5, -0,6 e -0,7 MPa e aos efeitos do envelhecimento precoce (45ºC e 100% UR) durante 0, 24, 48, 72, 96 e 120 horas. Nas sementes condicionadas e submetidas ao estresse hídrico, os valores médios de porcentagem e velocidade de germinação foram estatisticamente superiores aos obtidos em sementes não condicionadas. Além disso, o condicionamento osmótico aumentou o limite máximo de tolerância ao estresse hídrico. As sementes condicionadas foram mais sensíveis ao envelhecimento precoce.

Condicionamento osmótico na germinação de sementes de cássia-do-nordeste sob estresse hídrico, térmico e salino

O objetivo deste trabalho foi avaliar o efeito do condicionamento osmótico na germinação de sementes de Cassia excelsa Schrad. sob condições de estresse hídrico, térmico e salino. O condicionamento consistiu na imersão de quatro repetições de 25 sementes cada, em soluções de polietilenoglicol (PEG 6000) com potenciais osmóticos de -0,2, -0,4 e -0,6 MPa por 72, 96, 168 horas, respectivamente, e em água destilada por 48 horas, a 20ºC. Em seguida, as sementes foram colocadas para germinar em três condições: estresse hídrico, simulado com soluções de PEG a -0,2, -0,4, -0,6 e -0,8 MPa a 27ºC; estresse térmico, sob temperaturas subótima (12ºC) e supra-ótima (39ºC) em água destilada; estresse salino, em soluções de NaCl a -0,2, 0,4, 0,6, 0,8, 1,0, 1,2 e 1,4 MPa a 27ºC. Foram avaliadas as porcentagens de germinação e tempos médios de emergência da radícula. A técnica de condicionamento osmótico com PEG ou com água destilada foi eficiente em aumentar a germinabilidade sob estresse hídrico e sob estresse térmico. A porcentagem de germinação sob estresse salino aumentou com o condicionamento com PEG, porém não houve redução no tempo de germinação.

Processo germinativo de sementes de paineira sob estresses hídrico e salino

O ambiente mutável provoca múltiplos estresses, que podem limitar a germinação da semente e a emergência e sobrevivência da plântula. Os objetivos deste trabalho foram determinar o efeito dos estresses hídrico e salino na viabilidade e vigor de sementes de paineira (Chorisia speciosa St. Hil.) e o limite máximo de tolerância a esses estresses. Para avaliação do efeito do estresse hídrico foram utilizadas soluções de manitol e PEG 6000; para o estresse salino, soluções de NaCl, KCl e CaCl2. Após a punção do tegumento, quatro repetições de 50 sementes por tratamento foram submetidas à germinação em substrato de papel-filtro umedecido com as soluções de diferentes potenciais osmóticos e incubadas a 27ºC. As sementes apresentaram menor tolerância ao estresse hídrico simulado com PEG 6000 em relação ao simulado com manitol. O limite máximo de tolerância à seca está situado entre -0,6 e -0,7 MPa de PEG 6000 e entre -1,4 e -1,6 MPa de manitol. Independentemente dos sais utilizados, a porcentagem de germinação decresceu com a diminuição do potencial osmótico do meio. O limite máximo de tolerância ao estresse salino foi o mesmo para todos os sais avaliados e está situado entre -1,0 e -1,2 MPa. A paineira pode ser classificada como glicófita, com moderada tolerância aos sais NaCl, KCl e CaCl2.

Investigation of Plastic Pipes for Highway Applications, HR-373A, Phase II, 1997

It is generally accepted that high density polyethylene pipe (HDPE) performs well under live loads with shallow cover, provided the backfill is well compacted. Although industry standards require carefully compacted backfill, poor inspection and/or faulty construction may result in soils that provide inadequate restraint at the springlines of the pipes thereby causing failure. The objectives of this study were: 1) to experimentally define a lower limit of compaction under which the pipes perform satisfactorily, 2) to quantify the increase in soil support as compaction effort increases, 3) to evaluate pipe response for loads applied near the ends of the buried pipes, 4) to determine minimum depths of cover for a variety of pipes and soil conditions by analytically expanding the experimental results through the use of the finite element program CANDE. The test procedures used here are conservative especially for low-density fills loaded to high contact stresses. The failures observed in these tests were the combined effect of soil bearing capacity at the soil surface and localized wall bending of the pipes. Under a pavement system, the pipes' performance would be expected to be considerably better. With those caveats, the following conclusions are drawn from this study. Glacial till compacted to 50% and 80% provides insufficient support; pipe failureoccurs at surface contact stresses lower than those induced by highway trucks. On the other hand, sand backfill compacted to more than 110 pcf (17.3 kN/m3) is satisfactory. The failure mode for all pipes with all backfills is localized wall bending. At moderate tire pressures, i.e. contact stresses, deflections are reduced significantly when backfill density is increased from about 50 pcf (7.9 kN/m^3) to 90 pcf (14.1 kN/m^3). Above that unit weight, little improvement in the soil-pipe system is observed. Although pipe stiffness may vary as much as 16%, analyses show that backfill density is more important than pipe stiffness in controlling both deflections at low pipe stresses and at the ultimate capacity of the soil-pipe system. The rate of increase in ultimate strength of the system increases nearly linearly with increasing backfill density. When loads equivalent to moderate tire pressures are applied near the ends of the pipes, pipe deflections are slighly higher than when loaded at the center. Except for low density glacial till, the deflections near the ends are not excessive and the pipes perform satisfactorily. For contact stresses near the upper limit of truck tire pressures and when loaded near the end, pipes fail with localized wall bending. For flowable fill backfill, the ultimate capacity of the pipes is nearly doubled and at the upper limit of highway truck tire pressures, deflections are negligible. All pipe specimens tested at ambient laboratory room temperatures satisfied AASHTO minimum pipe stiffness requirements at 5% deflection. However, nearly all specimens tested at elevated pipe surface temperatures, approximately 122°F (50°C), failed to meet these requirements. Some HDPE pipe installations may not meet AASHTO minimum pipe stiffness requirements when installed in the summer months (i.e. if pipe surface temperatures are allowed to attain temperatures similar to those tested here). Heating of any portion of the pipe circumference reduced the load carrying capacity of specimens. The minimum soil cover depths, determined from the CANOE analysis, are controlled by the 5% deflection criterion. The minimum soil cover height is 12 in. (305 mm). Pipes with the poor silt and clay backfills with less than 85% compaction require a minimum soil cover height of 24 in. (610 mm). For the sand at 80% compaction, the A36 HDPE pipe with the lowest moment of inertia requires a minimum of 24 in. (610 mm) soil cover. The C48 HDPE pipe with the largest moment of inertia and all other pipes require a 12 in. (305 mm) minimum soil cover.