Skinfold thickness and adiposity index in premature infants.

In order to assess the validity of the weight per square of length ratio as an index of adiposity during the neonatal period, 37 premature infants (gestational age, mean +/- SD, = 31.5 +/- 1.1 weeks, birthweight, mean +/- SD, = 1.448 +/- 147 g) were studied for weight, length and skinfold thickness at 5 sites (biceps, triceps, subscapular, suprailiac and quadriceps) during their stay in the Neonatal Unit of the University Hospital in Lausanne. The results show a significant correlation between the adiposity index and the sum of 5 skinfold thickness sites in premature infants. The adiposity index gives a fair estimate of the body fat mass during the postnatal growth in premature infants.

Central corneal thickness, intraocular pressure, and degree of myopia in an adult myopic population aged 20 to 40 years in southeast Spain: determination and relationships

Objective: To determine the values of, and study the relationships among, central corneal thickness (CCT), intraocular pressure (IOP), and degree of myopia (DM) in an adult myopic population aged 20 to 40 years in Almeria (southeast Spain). To our knowledge this is first study of this kind in this region. Methods: An observational, descriptive, cross-sectional study was done in which a sample of 310 myopic patients (620 eyes) aged 20 to 40 years was selected by gender- and age-stratified sampling, which was proportionally fixed to the size of the population strata for which a 20% prevalence of myopia, 5% epsilon, and a 95% confidence interval were hypothesized. We studied IOP, CCT, and DM and their relationships by calculating the mean, standard deviation, 95% confidence interval for the mean, median, Fisher’s asymmetry coefficient, range (maximum, minimum), and the Brown-Forsythe’s robust test for each variable (IOP, CCT, and DM). Results: In the adult myopic population of Almeria aged 20 to 40 years (mean of 29.8), the mean overall CCT was 550.12 μm. The corneas of men were thicker than those of women (P = 0.014). CCT was stable as no significant differences were seen in the 20- to 40-year-old subjects’ CCT values. The mean overall IOP was 13.60 mmHg. Men had a higher IOP than women (P = 0.002). Subjects over 30 years (13.83) had a higher IOP than those under 30 (13.38) (P = 0.04). The mean overall DM was −4.18 diopters. Men had less myopia than women (P < 0.001). Myopia was stable in the 20- to 40-year-old study population (P = 0.089). A linear relationship was found between CCT and IOP (R2 = 0.152, P ≤ 0.001). CCT influenced the IOP value by 15.2%. However no linear relationship between DM and IOP, or between CCT and DM, was found. Conclusions: CCT was found to be similar to that reported in other studies in different populations. IOP tends to increase after the age of 30 and is not accounted for by alterations in CCT values.

Central corneal thickness, intraocular pressure, and degree of myopia in an adult myopic population aged 20 to 40 years in southeast Spain: determination and relationships.

Objective: To determine the values of, and study the relationships among, central corneal thickness (CCT), intraocular pressure (IOP), and degree of myopia (DM) in an adult myopic population aged 20 to 40 years in Almeria (southeast Spain). To our knowledge this is first study of this kind in this region. Methods: An observational, descriptive, cross-sectional study was done in which a sample of 310 myopic patients (620 eyes) aged 20 to 40 years was selected by gender- and age-stratified sampling, which was proportionally fixed to the size of the population strata for which a 20% prevalence of myopia, 5% epsilon, and a 95% confidence interval were hypothesized. We studied IOP, CCT, and DM and their relationships by calculating the mean, standard deviation, 95% confidence interval for the mean, median, Fisher’s asymmetry coefficient, range (maximum, minimum), and the Brown-Forsythe’s robust test for each variable (IOP, CCT, and DM). Results: In the adult myopic population of Almeria aged 20 to 40 years (mean of 29.8), the mean overall CCT was 550.12 μm. The corneas of men were thicker than those of women (P = 0.014). CCT was stable as no significant differences were seen in the 20- to 40-year-old subjects’ CCT values. The mean overall IOP was 13.60 mmHg. Men had a higher IOP than women (P = 0.002). Subjects over 30 years (13.83) had a higher IOP than those under 30 (13.38) (P = 0.04). The mean overall DM was −4.18 diopters. Men had less myopia than women (P < 0.001). Myopia was stable in the 20- to 40-year-old study population (P = 0.089). A linear relationship was found between CCT and IOP (R2 = 0.152, P ≤ 0.001). CCT influenced the IOP value by 15.2%. However no linear relationship between DM and IOP, or between CCT and DM, was found. Conclusions: CCT was found to be similar to that reported in other studies in different populations. IOP tends to increase after the age of 30 and is not accounted for by alterations in CCT values.

Value of positron emission tomography in full-thickness chest wall resections for malignancies

Rapport de synthèse : Les tumeurs de la paroi thoracique sont des pathologies graves dont le traitement principal consiste en une résection chirurgicale. L'enjeu majeur de cette intervention ontologique est de réséquer la totalité de la tumeur, ce qui nécessite une planification préopératoire minutieuse. Classiquement, l'identification et la localisation de la tumeur se fait à l'aide de la tomodensitométrie (computed tomography, CT) ou de l'imagerie par résonnance magnétique (1RM). Actuellement, l'imagerie nucléaire fonctionnelle par tomographie par émission de positons (positron emission tomography, PET) qui peut être couplée au CT (PET/CT) est de plus en plus appliquée aux patients présentant une tumeur maligne. Son efficacité a fréquemment été démontrée. Le but de la présente étude est d'évaluer la valeur du PET dans la planification de la résection des tumeurs de la paroi thoracique. Une analyse rétrospective de dix-huit patients opérés entre 2004 et 2006 a été réalisée; Dans ce groupe de patient, la taille de la tumeur mesurée sur la pièce opératoire réséquée a été comparée à la taille de la tumeur mesurée sur le CT et le PET. Les résultats démontrent que le CT surestimait de manière consistante la taille réelle de la tumeur par rapport au PET (+64% par rapport à +1%, P<0.001). De plus, le PET s'est avéré particulièrement performant pour prédire la taille des tumeurs de plus de 5.5 cm de diamètre par rapport au CT (valeur prédictive positive 80% par rapport à 44% et spécificité 93% par apport à 64%, respectivement). Cette étude démontre que le PET permettrait de mesurer la taille des tumeurs de la paroi thoracique de manière plus précise que le CT. Cette nouvelle modalité diagnostique s'avèrerait donc utile pour planifier les résections chirurgicales de telles tumeurs. A notre connaissance, aucune publication ne décrit la valeur du PET dans ce domaine. Les performances accrues du PET permettraient une meilleure délimitation des tumeurs ce qui améliorerait la précision de la résection chirurgicale. En conclusion, cette étude préliminaire rétrospective démontre la faisabilité du PET pour les tumeurs de la paroi thoracique. Ces résultats devraient être confirmés par une étude prospective incluant un plus grand nombre de patients avec la perspective de juger l'impact clinique réel du PET sur la prise en charge thérapeutique des patients.

Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors.

AIMS: Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures. METHODS AND RESULTS: We combined CCIMT data obtained by echotracking on 24 871 individuals (53% men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n = 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference sub-populations, thereby allowing for a standardized comparison between observed and predicted ('normal') values from individuals of the same age and sex. In the sub-population without CVD and treatment (n = 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized βs 0.19 (95% CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)]. CONCLUSION: We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CV-RFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings.

Cartilage thickness at the posterior medial femoral condyle is increased in femorotibial knee osteoarthritis: a cross-sectional CT arthrography study (Part 2).

OBJECTIVE: To evaluate the thickness of cartilage at the posterior aspect of the medial and lateral condyle in Osteoarthritis (OA) knees compared to non-OA knees using computed tomography arthrography (CTA). DESIGN: 535 consecutive knee CTAs (mean patient age = 48.7 ± 16.0; 286 males), were retrospectively analyzed. Knees were radiographically classified into OA or non-OA knees according to a modified Kellgren/Lawrence (K/L) grading scheme. Cartilage thickness at the posterior aspect of the medial and lateral femoral condyles was measured on sagittal reformations, and compared between matched OA and non-OA knees in the whole sample population and in subgroups defined by gender and age. RESULTS: The cartilage of the posterior aspect of medial condyle was statistically significantly thicker in OA knees (2.43 mm (95% confidence interval (CI) = 2.36, 2.51)) compared to non-OA knees (2.13 mm (95%CI = 2.02, 2.17)) in the entire sample population (P < 0.001), as well as for all subgroups of patients over 40 years old (all P ≤ 0.01), except for females above 60 years old (P = 0.07). Increase in cartilage thickness at the posterior aspect of the medial condyle was associated with increasing K/L grade in the entire sample population, as well as for males and females separately (regression coefficient = 0.10-0.12, all P < 0.001). For the lateral condyle, there was no statistically significant association between cartilage thickness and OA (either presence of OA or K/L grade). CONCLUSIONS: Cartilage thickness at the non-weight-bearing posterior aspect of the medial condyle, but not of the lateral condyle, was increased in OA knees compared to non-OA knees. Furthermore, cartilage thickness at the posterior aspect of the medial condyle increased with increasing K/L grade.

Consumer Advisory Bulletin, How to register -- and cut unwanted commercial telemarketing calls, January 2008

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: How to register -- and cut unwanted commercial telemarketing calls.

Geometry, petrology and growth of a shallow crustal laccolith : the Torres del Paine Mafic Complex (Patagonia)

1. ABSTRACTS - RÉSUMÉSSCIENTIFIC ABSTRACT - ENGLISH VERSIONGeometry, petrology and growth of a shallow crustal laccolith: the Torres del Paine Mafi c Complex (Patagonia)The Torres del Paine intrusive complex (TPIC) is a composite mafic-granitic intrusion, ~70km2, belonging to a chain of isolated Miocene plutons in southern Patagonia. Their position is intermediate between the Mesozoic-Cenozoic calc-alkaline subduction related Patagonian batholith in the West and the late Cenozoic alkaline basaltic back-arc related plateau lavas in the East. The Torres del Paine complex formed during an important reconfiguration of the Patagonian geodynamic setting, with a migration of magmatism from the arc to the back-arc, possibly related to the Chile ridge subductionThe complex intruded the flysch of the Cretaceous Cerro Toro and Punta Barrosa Formations during the Miocene, creating a well-defined narrow contact aureole of 200-400 m width.In its eastern part, the Torres del Paine intrusive complex is a laccolith, composed of a succession of hornblende-gabbro to diorite sills at its base, with a total thickness of ~250m, showing brittle contacts with the overlying granitic sills, that form spectacular cliffs of more than 1000m. This laccolith is connected, in the western part, to its feeding system, with vertical alternating sheets of layered gabbronorite and Hbl-gabbro, surrounded and percolated by diorites. ID-TIMS U-Pb on zircons on feeder zone (FZ) gab- bros yield 12.593±0.009Ma and 12.587±0.009Ma, which is identifcal within error to the oldest granite dated so far by Michel et al. (2008). In contrast, the laccolith mafic complex is younger than than the youngest granite (12.50±0.02Ma), and has been emplaced from 12.472±0.009Ma to 12.431 ±0.006Ma, by under-accretion beneath the youngest granite at the interface with previously emplaced mafic sills.The gabbronorite crystallization sequence in the feeder zone is dominated by olivine, plagioclase, clinopyroxene and orthopyroxene, while amphibole forms late interstitial crystals. The crystallization sequence is identical in Hornblende-gabbro from the feeder zone, with higher modal hornblende. Gabbronorite and Hornblende-gabbro both display distinct Eu and Sr positive anomalies. In the laccolith, a lower Hornblende-gabbro crystallized in sills and evolved to a high alkali shoshonitic series. The Al203, Ti02, Na20, K20, Ba and Sr composition of these gabbros is highly variable and increases up to ~50wt% Si02. The lower hornblende-gabbro is characterized by kaersutite anhedral cores with inclusions of olivine, clino- and orthopyroxene and rare apatite and An70 plagioclase. Trace element modelling indicates that hornblende and clinopyroxene are in equilibrium with a liquid whose composition is similar to late basaltic trachyandesitic dikes that cut the complex. The matrix in the lower hornblende gabbro is composed of normally zoned oligoclase, Magnesio-hornblende, biotite, ilmenite and rare quartz and potassium feldspar. This assemblage crystallized in-situ from a Ba and Sr-depleted melts. In contrast, the upper Hbl-gabbro is high-K calc-alkaline. Poikilitic pargasite cores have inclusions of euhedral An70 plagioclase inclusions, and contain occasionally clinopyroxene, olivine and orthopyroxene. The matrix composition is identical to the lower hornblende-gabbro and similar to the diorite. Diorite bulk rock compositions show the same mineralogy but different modal proportions relative to hornblende-gabbrosThe Torres del Paine Intrusive Complex isotopic composition is 87Sr/86Sr=0.704, 143Nd/144Nd=0.5127, 206Pb/204Pb=18.70 and 207Pb/204Pb=15.65. Differentiated dioritic and granitic units may be linked to the gabbroic cumulates series, with 20-50% trapped interstitial melt, through fractionation of olivine-bearing gabbronorite or hornblende-gabbro fractionation The relative homogeneity of the isotopic compositions indicate that only small amounts of assimilation occurred. Two-pyroxenes thermometry, clinopyroxene barometry and amphibole-plagioclase thermometry was used to estimate pressure and temperature conditions. The early fractionation of ultramafic cumulates occurs at mid to lower crustal conditions, at temperatures exceeding 900°C. In contrast, the TPIC emplacement conditions have been estimated to ~0.7±0.5kbar and 790±60°C.Based on field and microtextural observations and geochemical modelling, fractionation of basaltic-trachyandesitic liquids at intermediate to lower crustal levels, has led to the formation of the Torres del Paine granites. Repetitive replenishment of basaltic trachy- andesitic liquid in crustal reservoirs led to mixed magmas that will ascend via the feeder zone, and crystallize into a laccolith, in the form of successive dioritic and gabbroic sills. Dynamic fractionation during emplacement concentrated hornblende rich cumulates in the center of individual sills. Variable degrees.of post-emplacement compaction led to the expulsion of felsic liquids that preferentially concentrated at the top of the sills. Incremental sills amalgamation of the entire Torres del Paine Intrusive Complex has lasted for ~160ka.RESUME SCIENTIFIQUE - VERSION FRANÇAISEGéométrie, pétrologie et croissance d'un laccolite peu profond : Le complexe ma- fique du Torres del Paine (Patagonie)Le Complexe Intrusif du Torres del Paine (CITP) est une intrusion bimodale, d'environ 70km2, appartenant à une chaîne de plutons Miocènes isolés, dans le sud de la Patago-nie. Leur position est intermédiaire entre le batholite patagonien calco-alcalin, à l'Ouest, mis en place au Mesozoïque-Cenozoïque dans un contexte de subduction, et les basal-tes andésitiques et trachybasaltes alcalins de plateau, plus jeune, à l'Est, lié à l'ouverture d'un arrière-arc.A son extrémité Est, le CITP est une succession de sills de gabbro à Hbl et de diorite, sur une épaisseur de ~250m, avec des évidences de mélange. Les contacts avec les sills de granite au-dessus, formant des parois de plus de 1000m, sont cassants. Ce laccolite est connecté, dans sa partie Ouest, à une zone d'alimentation, avec des intrusions sub-ver- ticales de gabbronorite litée et de gabbro à Hbl, en alternance. Celles-ci sont traversées et entourées par des diorites. Les zircons des gabbros de la zone d'alimentation, datés par ID-TIMS, ont cristallisés à 12.593±0.009Ma et 12.587±0.009Ma, ce qui correspond au plus vieux granite daté à ce jour par Michel et al. (2008). A l'inverse, les roches manques du laccolite se sont mises en place entre 12.472±0.009Ma et 12.431 ±0.006Ma, par sous-plaquage successifs à l'interface avec le granite le plus jeune daté à ce jour (12.50±0.02Ma).La séquence de cristallisation des gabbronorites est dominée par Ol, Plg, Cpx et Opx, alors que la Hbl est un cristal interstitiel. Elle est identique dans les gabbros à Hbl de la zone d'alimentation, avec ~30%vol de Hbl. Les gabbros de la zone d'alimentation montrent des anomalies positives en Eu et Sr distinctes. Dans le laccolite, le gabbro à Hbl inférieur évolue le long d'une série shoshonitique, riche en éléments incompatibles. Sa concentration en Al203, Ti02, Na20, K20, Ba et Sr est très variable et augmente rapide-ment jusqu'à ~50wt% Si02. Il est caractérisé par la présence de coeurs résorbés de kaer- sutite, entourés de Bt, et contenant des inclusions d'OI, Cpx et Opx, ou alors d'Ap et de rares Plg (An70). Hbl et Cpx ont cristallisés à partir d'un liquide de composition similaire aux dykes trachy-andesite basaltique du CITP. La matrice, cristallisée in-situ à partir d'un liquide pauvre en Ba et Sr, est composée d'oligoclase zoné de façon simple, de Mg-Hbl, Bt, llm ainsi que de rares Qtz et KF. Le gabbro à Hbl supérieur, quant à lui, appartient à une suite chimique calco-alcaline riche en K. Des coeurs poecilitiques de pargasite con-tiennent de nombreuses inclusions de Plg (An70) automorphe, ainsi que des Ol, Cpx et Opx. La composition de la matrice est identique à celle des gabbros à Hbl inférieurs et toutes deux sont similaires à la minéralogie des diorites. Les analyses sur roches totales de diorites montrent la même variabilité que celles de gabbros à Hbl, mais avec une ten-eur en Si02 plus élevée.La composition isotopique des liquides primitifs du CITP a été mesurée à 87Sr/86Sr=0.704, 143Nd/144Nd=0.5127, 206Pb/204Pb=18.70 et 207Pb/204Pb=15.65. Les granites et diorites différenciés peuvent être reliés à des cumulais gabbronoritiques (F=0.74 pour les granites et F=1-0.5 pour les diorites) et gabbroïques à Hbl (fractionnement supplémentaire pour les granites, avec F=0.3). La cristallisation de 20 à 50%vol de liquide interstitiel piégé dans les gabbros du CITP explique leur signature géochimique. Seules de faibles quantités de croûte continentale ont été assimilées. La température et la pression de fractionnement ont été estimées, sur la base des thermobaromètres Opx-Cpx, Hbl-Plg et Cpx, à plus de 900°C et une profondeur correspondant à la croûte inférieure-moyenne. A l'inverse, les conditions de cristallisation de la matrice des gabbros et diorites du laccolite ont été estimées à 790±60°C et ~0.7±0.5kbar.Je propose que les liquides felsiques du CITP se soient formés par cristallisation frac-tionnée en profondeur des assemblages minéralogiques observés dans les gabbros du CITP, à partir d'un liquide trachy-andesite basaltique. La percolation de magma dans les cristaux accumulés permet la remontée du mélange à travers la zone d'alimentation, vers le laccolite, où des sills se mettent en place successivement. L'amalgamation de sills dans le CITP a duré ~160ka.Le CITP s'est formé durant une reconfiguration importante du contexte géodynamique en Patagonie, avec un changement du magmatisme d'arc vers un volcanisme d'arrière- arc. Ce changement est certainement lié à la subduction de la ride du Chili.RESUME GRAND PUBLIC - VERSION FRANÇAISEGéométrie, pétrologie et croissance d'une chambre magmatique peu profonde : Le complexe mafique du Torres del Paine (Patagonie)Le pourtour de l'Océan Pacifique est caractérisé par une zone de convergence de plaques tectoniques, appelée zone de subduction, avec le plongement de croûte océa-nique sous les Andes dans le cas de la Patagonie. De nombreux volcans y sont associés, formant la ceinture de feu. Mais seuls quelques pourcents de tout le magma traversant la croûte terrestre parviennent à la surface et la majeure partie cristallise en profondeur, dans des chambres magmatiques. Quelles est leur forme, croissance, cristallisation et durée de vie ? Le complexe magmatique du Torres del Paine représente l'un des meilleurs endroits au monde pour répondre à ces questions. Il se situe au sud de la Patagonie, formant un massif de 70km2. Des réponses peuvent être trouvées à différentes échelles, variant de la montagne à des minéraux de quelques 1000ème de millimètres.Il est possible de distinguer trois types de roches : des gabbros et des diorites sur une épaisseur de 250m, surmontées par des parois de granite de plus de 1000m. Les contacts entre ces roches sont tous horizontaux. Entre granites et gabbro-diorite, le contact est net, indiquant que le second magma s'est mis en place au contact avec un magma plus ancien, totalement solidifié. Entre gabbros et diorites, les contacts sont diffus, souvent non-linéaires, indiquant à l'inverse la mise en contact de magmas encore partiellement liquides. Dans la partie Ouest de cette chambre magmatique, les contacts entre roches sont verticaux. Il s'agit certainement du lieu de remplissage de la chambre magmatique.Lors du refroidissement d'un magma, différents cristaux vont se former. Leur stabilité et leur composition varient en fonction de la pression, de la température ou de la chimie du magma. La séquence de cristallisation peut être définie sur la base d'observations microscopiques et de la composition chimique des minéraux. Différents gabbros sont ainsi distingués : le gabbro à la base est riche en hornblende, d'une taille de ~5mm, sans inclusion de plagioclase mais avec des cristaux d'olivine, clinopyroxene et orthopyroxene inclus ; le gabbro supérieur est lui-aussi riche en hornblende (~5mm), avec les mêmes inclusions additionnées de plagioclase. Ces cristaux se sont formés à une température supérieure à 900°C et une profondeur correspondant à la croûte moyenne ou inférieure. Les minéraux plus fin, se trouvant hors des cristaux de hornblende des deux gabbros, sont similaires à ceux des diorites : plagioclase, biotite, hornblende, apatite, quartz et feldspath alcalin. Ces minéraux sont caractéristiques des granites. Ils ont cristallisé à ~790°C et ~2km de profondeur.La cristallisation des minéraux et leur extraction du magma par gravité provoque un changement progressif de la composition de ce dernier. Ainsi, après extraction d'olivine et d'orthopyroxene riches en Mg, de clinopyroxene riche en Ca, de plagioclase riche en Ca et Al et d'hornblende riche en Ca, Al et Mg, le liquide final sera appauvri en ces élé-ments. Un lien peut ainsi être proposé entre les diorites dont la composition est proche du liquide de départ, les granites dont la composition est similaire au liquide final, et les gabbros dont la minéralogie correspond aux minéraux extraits.L'utilisation de zircons, un minéral riche en U dont les atomes se transforment en Pb par décomposition radioactive au cours de millions d'années, permet de dater le refroidissement des roches qui les contiennent. Ainsi, il a été observé que les roches de la zone d'alimentation, à l'Ouest du complexe magmatique, ont cristallisés il y a 12.59±0.01 Ma, en même temps que les granites les plus vieux, se trouvant au sommet de la chambre magmatique, datés par Michel et al. (2008). Les deux roches pourraient donc avoir la même origine. A l'inverse, les gabbros et diorites de la chambre magmatique ont cristallisé entre 12.47±0.01Ma et 12.43±0.01Ma, les roches les plus vieilles étant à la base.En comparant la composition des roches du Torres del Paine avec celles d'autres en-tités géologiques de Patagonie, les causes du magmatisme peuvent être recherchées. A l'Ouest, on trouve en effet des intrusions granitiques, plus anciennes, caractéristiques de zones de convergence de plaque tectonique, alors qu'à l'Est, des laves basaltiques plus jeunes sont caractéristiques d'une dynamique d'extension. Sur la base des compositions chimiques des roches de ces différentes entités, l'évolution progressive de l'une à l'autre a pu être démontrée. Elle est certainement due à l'arrivée d'une dorsale océanique (zone d'extension crustale et de création de croûte océanique par la remontée de magma) dans la zone de subduction, le long des Andes.Je propose que, dans un premier temps, des magmas granitiques sont remontés dans la chambre magmatique, laissant d'importants volumes de cristaux dans la croûte pro-fonde. Dans un second épisode, les cristaux formés en profondeur ont été transportés à travers la croûte continentale, suite au mélange avec un nouveau magma injecté. Ces magmas chargés de cristaux ont traversé la zone d'alimentation avant de s'injecter dans la chambre magmatique. Différents puises ont été distingués, injectés dans la chambre magmatique du sommet à la base concernant les granites, puis à la base du granite le plus jeune pour les gabbros et diorites. Le complexe magmatique du Torres del Paine s'est construit sur une période totale de 160'000±20'000 ans.

Estimation of percentage body fat in 6- to 13-year-old children by skinfold thickness, body mass index and waist circumference.

We evaluated the accuracy of skinfold thicknesses, BMI and waist circumference for the prediction of percentage body fat (PBF) in a representative sample of 372 Swiss children aged 6-13 years. PBF was measured using dual-energy X-ray absorptiometry. On the basis of a preliminary bootstrap selection of predictors, seven regression models were evaluated. All models included sex, age and pubertal stage plus one of the following predictors: (1) log-transformed triceps skinfold (logTSF); (2) logTSF and waist circumference; (3) log-transformed sum of triceps and subscapular skinfolds (logSF2); (4) log-transformed sum of triceps, biceps, subscapular and supra-iliac skinfolds (logSF4); (5) BMI; (6) waist circumference; (7) BMI and waist circumference. The adjusted determination coefficient (R² adj) and the root mean squared error (RMSE; kg) were calculated for each model. LogSF4 (R² adj 0.85; RMSE 2.35) and logSF2 (R² adj 0.82; RMSE 2.54) were similarly accurate at predicting PBF and superior to logTSF (R² adj 0.75; RMSE 3.02), logTSF combined with waist circumference (R² adj 0.78; RMSE 2.85), BMI (R² adj 0.62; RMSE 3.73), waist circumference (R² adj 0.58; RMSE 3.89), and BMI combined with waist circumference (R² adj 0.63; RMSE 3.66) (P < 0.001 for all values of R² adj). The finding that logSF4 was only modestly superior to logSF2 and that logTSF was better than BMI and waist circumference at predicting PBF has important implications for paediatric epidemiological studies aimed at disentangling the effect of body fat on health outcomes.

Radial forearm free flap donor site morbidity: ulnar-based transposition flap vs split-thickness skin graft.

OBJECTIVES: To evaluate morbidity associated with the radial forearm free flap donor site and to compare functional and aesthetic outcomes of ulnar-based transposition flap (UBTF) vs split-thickness skin graft (STSG) closure of the donor site.¦DESIGN: Case-control study.¦SETTING: Tertiary care institution.¦PATIENTS: The inclusion criteria were flap size not exceeding 30 cm(2), patient availability for a single follow-up visit, and performance of surgery at least 6 months previously. Forty-four patients were included in the study and were reviewed. Twenty-two patients had UBTF closure, and 22 had STSG closure.¦MAIN OUTCOME MEASURES: Variables analyzed included wrist mobility, Michigan Hand Outcomes Questionnaire scores, pinch and grip strength (using a dynamometer), and hand sensitivity (using monofilament testing over the radial nerve distribution). In analyses of operated arms vs nonoperated arms, variables obtained only for the operated arms included Vancouver Scar Scale scores and visual analog scale scores for Aesthetics and Overall Arm Function.¦RESULTS: The mean (SD) wrist extension was significantly better in the UBTF group (56.0° [10.4°] for nonoperated arms and 62.0° [9.7°] for operated arms) than in the STSG group (59.0° [7.1°] for nonoperated arms and 58.4° [12.1°] for operated arms) (P = .02). The improvement in wrist range of motion for the UBTF group approached statistical significance (P = .07). All other variables (Michigan Hand Outcomes Questionnaire scores, pinch and grip strength, hand sensitivity, and visual analog scale scores) were significantly better for nonoperated arms vs operated arms, but no significant differences were observed between the UBTF and STSG groups.¦CONCLUSIONS: The radial forearm free flap donor site carries significant morbidity. Donor site UBTF closure was associated with improved wrist extension and represents an alternative method of closure for small donor site defects.

Treatment of penile carcinoma: to cut or not to cut?

PURPOSE: The aim of this study was to assess the outcome in patients with penile cancer. METHODS AND MATERIALS: A total of 60 patients with penile carcinoma were included. Of the patients, 45 (n = 27) underwent surgery, and 51 underwent definitive (n = 29) or postoperative (n = 22) radiotherapy (RT). Median follow-up was 62 months. RESULTS: Median time to locoregional relapse was 14 months. Local failure was observed in 3 of 23 patients (13%) treated with surgery with or without postoperative RT vs. in 19 of 33 patients (56%) given organ-sparing treatment (p = 0.0008). Of 22 local failures, 16 (73%) were salvaged with surgery. Of the 33 patients treated with definitive RT (n = 29) and the 4 patients refusing RT after excisional biopsy, local control was obtained with organ preservation in 13 (39%). In the remaining 20, 4 patients with local failure underwent salvage conservatively, resulting in an ultimate penis preservation rate of 17 of 33 (52%) patients treated with definitive RT. The 5-year and 10-year probability of surviving with an intact penis was 43% and 26%, respectively. There was no survival difference between the patients treated with definitive RT and primary surgery (56% vs. 53%; p = 0.16). In multivariate analysis, independent factors influencing survival were N-classification and pathologic grade. Surgery was the only independent predictor for better local control. CONCLUSION: Based on our study findings, in patients with penile cancer, local control is superior with surgery. However, there is no difference in survival between patients treated with surgery and those treated with definitive RT, with 52% organ preservation.

Increased carotid intima-media thickness in the absence of atherosclerotic plaques in an adult population with Fabry disease.

AIM: Fabry disease is considered primarily as a progressive small vessel disease, with ischaemic degenerative lesions involving the kidneys, brain and heart. Macrovascular involvement in male patients includes an accelerated wall hypertrophy of the radial artery and a thickening of the intima-media of the common carotid artery. The aim of this study is to evaluate the prevalence and severity of carotid artery atherosclerosis in hemizygous and heterozygous patients with Fabry disease, compared with a matched control population. METHODS: The common carotid artery intima-media thickness (IMT) of 53 patients with Fabry disease (24 men, 29 women) was measured by high-definition ultrasonography, and the presence or absence of atherosclerotic plaques reported. Results were compared with those of 120 age-matched healthy individuals (83 men, 37 women). RESULTS: The common carotid artery IMT was increased to the same extent in male and female patients with Fabry disease (706+/-211 microm and 749+/-395 microm, respectively) compared with that of the control population (614+/-113 microm). In the Fabry population, IMT did not correlate with either systolic blood pressure or with renal function (plasma creatinine). In the control population, only systolic blood pressure was positively and significantly correlated with IMT. Atherosclerotic plaques in the common carotid artery were not observed in any patient with Fabry disease, whereas 34% of the control population had carotid artery plaques, as evidenced by focal non-homogeneous intima-media thickening greater than 1.2 mm. CONCLUSION: This study presents evidence of a major increase in common carotid artery IMT, both in hemizygous and heterozygous patients with Fabry disease, in the absence of focal atherosclerotic plaques. These results suggest that the conduit arteries may be protected from atherosclerosis in Fabry disease.