Search

Background Community-based health promotion (CBHP) programmes can yield sustainable and transformational changes to complex problems such as intergenerational transmission of social exclusion. However, investments in these projects are held back by lack of evidence on their effectiveness. The realist evaluation (RE) framework is regarded as a promising approach to improve understanding of how programmes generate their outcomes and the way they interact with their context. We look at two CBHP programmes to reflect on how RE can help relate their interventions to their outcomes. Methods We applied the RE approach to: “Football United” a sports for development programmes aiming to support refugee and newly arrived young people and families in their transition into Australian society and to, “Together, health for all in Pays de Redon –Bretagne Sud” a French programme to improve local capacities in addressing the social determinants of health in decision- and policy-making processes. Analyses were conducted on the basis of data collected through semi-structured interviews, documents, observations, etc. Results In both cases, application of the RE perspective highlighted difficulties in identifying the context-mechanism-outcomes configurations that are at the core of the approach. We clarified the definition of mechanism that was initially repeatedly confused with that of intervention/activity. Whereas both programme theories were quite straightforward, they required a whole array of activities critical in shaping the conditions for the implementation of the interventions. Conclusions Our results echo other critics of the conceptual apparatus of the RE approach. While the RE has proven promising in linking CBHP interventions to their outcomes, practitioners still need better tools to grasp the complexity and the dynamic of changes brought on complex systems of actors. Key messages: CBHP programmes can yield sustainable transformational change to complex situations but current evaluation approaches often fail to bring evidence on their effectiveness For the sake of knowledge transfer, theory-based evaluation approaches such as RE also need to capture the broad array of supporting activities of CBHP programmes

Human mutations of the GRID1 gene encoding the orphan delta1 glutamate receptor-channel (GluD1) are associated with schizophrenia but the explicit role of GluD1 in brain circuits is unknown. Based on the known function of its paralog GluD2 in cerebellum, we searched for a role of GluD1 in slow glutamatergic transmission mediated by metabotropic receptor mGlu1 in midbrain dopamine neurons, whose dysfunction is a hallmark of schizophrenia. We found that an mGlu1 agonist elicits a slow depolarizing current in HEK cells co-expressing mGlu1 and GluD1, but not in cells expressing mGlu1 or GluD1 alone. This current is abolished by additional co-expression of a dominant-negative GluD1 dead pore mutant. We then characterized mGlu1-dependent currents in dopamine neurons from midbrain slices. Both the agonist-evoked and the slow postsynaptic currents are abolished by expression of the dominant-negative GluD1 mutant, pointing to the involvement of native GluD1 channels in these currents. Likewise, both mGlu1-dependent currents are suppressed in GRID1 knockout mice, which reportedly display endophenotypes relevant for schizophrenia. It is known that mGlu1 activation triggers the transition from tonic to burst firing of dopamine neurons, which signals salient stimuli and encodes reward prediction. In vivo recordings of dopamine neurons showed that their spontaneous burst firing is abolished in GRID1 knockout mice or upon targeted expression of the dominant-negative GluD1 mutant in wild-type mice. Our results de-orphanize GluD1, unravel its key role in slow glutamatergic transmission and provide insights into how GRID1 gene alterations can lead to dopaminergic dysfunctions in schizophrenia.

Many diseases are a result of, or are associated with, abnormal blood flow. Usually, these abnormalities are caused by unhealthy red blood cells with modified shape which have difficulty traversing the microvessels. Unfortunately, experimental approaches to these problems are limited due to difficulties in isolating the critical determinants of flow in vivo or in vitro. Computer models overcome these problems, but most strive only to reproduce the macroscopic, continuum aspect of blood flow by making many simplifying assumptions. Unfortunately, these models cannot address the relationship between microscopic, cellular flow dynamics and macroscopic, bulk blood rheology. Here, we demonstrate the wide applicability of a novel, computational model for simulating blood flow that includes each blood cell explicitly. This fully 3D model accounts for cell membrane dynamics and reproduces rest shapes accurately. This model allows us to: (i) extract empirical relationships for use in macroscopic models and (ii) simulate various disease states to identify potential targets for therapy. We show here that the model accurately reproduces the well-documented flow relationships for healthy blood, and also predicts the abnormalities in blood rheology exhibited by malaria and sickle cell patients.

For more than a century, pioneering researchers have been using novel experimental and computational approaches to probe the mysteries of blood flow. Thanks to their efforts, we know that blood cells generally prefer to migrate to the axis of flow, that red and white cells segregate in flow, and that cell deformability and their tendency to reversibly aggregate contribute to the non-Newtonian nature of this unique fluid. All of these properties have beneficial physiological consequences, allowing blood to perform a variety of critical functions. Our current understanding of these unusual flow properties of blood have been made possible by the ingenuity and diligence of a number of researchers, including Harry Goldsmith, who developed novel technologies to visualize and quantify the flow of blood at the level of individual cells. Here we summarize efforts in our lab to continue this tradition and to further our understanding of how blood cells interact with each other and with the blood vessel wall.

Resume Introduction Sous le terme de maladies auto-inflammatoires on regroupe un ensemble d’affections caracterisees par des acces febriles de debut brutal, associes a des manifestations articulaires, abdominales, ganglionnaires et cutanees. Chaque affection comporte une caracteristique genetique et/ou biologique permettant de l’isoler. L’elevation polyclonale des IgD seriques est un signe tres evocateur du syndrome hyper IgD, affection de transmission autosomique recessive debutant generalement avant l’âge de 1 an. Observation Nous rapportons le cas d’une malade de 46 ans qui avait depuis l’âge de 30 ans un tableau clinique tres similaire a celui d’un syndrome hyper IgD hormis une atteinte oculaire et pulmonaire. Cependant les examens ne trouvaient pas la mutation de la mevalonate kinase ni l’augmentation de l’acide mevalonique urinaire. Les poussees quasi mensuelles etaient bien controlees par le mycophenolate mofetil. Discussion Trois cas d’un tableau clinico-biologique, identique a celui rapporte ici, sont mentionnes dans la litterature et diagnostiques comme syndrome hyper IgD a revelation tardive. Seul notre cas a eu une recherche indirecte d’une mutation du gene de la mevalonate kinase qui s’est averee negative. Cette constatation elimine dans notre cas le diagnostic d’un syndrome hyper IgD classique et souleve le diagnostic d’une maladie auto-inflammatoire avec hyper IgD reactionnelle de nature differente soit acquise soit secondaire a une mutation qui resterait a identifier.

The main causes of arteriopathy in young patients include drugs, metabolic diseases, pseudoxanthoma elasticum and Buerger's disease. Arteritis due to Cannabis indica was first reported in 1960, and the role of this drug as a risk factor for arteritis was confirmed in several subsequent publications. A 38-year-old smoker with no previous contributory medical history except for long-standing cannabis abuse developed a dry necrotic lesion of the left big toe. Imaging examinations revealed proximal arteriopathy of the lower limbs that predominated on the left side. He had no atherogenic or thrombogenic risk factors, and no signs of pseudoxanthoma elasticum were found. Remarkably, the development of arteritis paralleled cannabis abuse. The course was slowly favourable after weaning from the drug, vasodilator treatment and hyperbaric oxygen therapy. Despite some subtle clinical differences (more proximal than distal involvement), cannabis arteritis may be considered as a particular form of Buerger's disease, where cannabis, along with tobacco, seems to cause arterial lesions. Along with the noxious effects of cannabis on vessels, a role for contaminating arsenic is also possible. Cannabis arteritis is not widely known, but may prove not to be so rare if one considers consumption of cannabis besides that of tobacco.

We present an improved lattice Boltzmann model of multi-component flow which permits practical, hydrodynamic modelling of multiple immiscible fluids. The model is robust and significantly reduces the interface anisotropy and micro-currents, which are artefacts observed in many schemes. Our new scheme is used on a particular regime of blood flow: that of the veinule mesoscale, where it is necessary to resolve significant numbers of deformable, interacting cells, which we model as incompressible liquid drops. We demonstrate the model's ability to recover the complex flow phenomena typical of the veinule scale.

Influence of pH on the chemical and structural properties of the oxide films formed on 316L stainless steel, alloy 600 and alloy 690 in high temperature aqueous environments. The oxide films formed on 316L stainless steel, alloy 600 and alloy 690 at 320°C in high temperature aqueous environments of different pH have been examined by glow discharge optical spectroscopy, scanning electron microscopy, atomic force microscopy and capacitance measurements. The analytical study reveals that the films formed at pH 5 are mainly composed of chromium oxides. When the pH increases the chromium concentration decreases and those of the other two elements (Ni and Fe) tend to increase. The films formed at pH 5 on 316L stainless steel and alloy 600 are thick and powder-like. The film formed at the same pH on alloy 690 is thin and is composed of a compact protective inner layer and a less-compact outer layer formed by crystals of mixed iron-nickel-chromium oxides. The morphological appearance of the thick films and that of the thin films is very different. However, equivalent morphologies can be observed for the relatively thin duplex films formed at pH8 and pH9.5 on the 316L stainless steel and nickel-base alloys. The evolution of the chemical composition of the films is accompanied by important changes from the point of view of their semiconductivity.

Resume Introduction. – Le mycosis fongoide est un lymphome T malin au tropisme cutane initial. Le developpement dˈune localisation secondaire cerebrale est possible, de pronostic sombre. Exegese. – un homme âge de 59 ans, suivi pour mycosis fongoide avec transformation vers un lymphome T epidermotrope pleiomorphe depuis un an, etait hospitalise pour la survenue dˈun syndrome confusionnel, revelateur dˈune metastase cerebrale. Conclusion. – Cette observation souligne la rarete des atteintes cerebrales au cours de lˈevolution dˈun mycosis fongoide. Une transformation vers un lymphome agressif de plus haut grade semble etre necessaire pour voir apparaitre une telle complication au cours de lˈevolution du mycosis fongoide.

Neutrophilic eccrine hidradenitis (NEH) is a rare dermatosis which usually develops after administration of chemotherapeutic treatments. An infective origin is exceptional. We report a patient, previously operated on for ependymoma, who presented with an eruption typical of NEH even though he had not received chemotherapy. Culture of a skin biopsy revealed Serratia marcescens. The dermatosis improved after antibiotic therapy but recurred twice and culture again isolated S. marcescens; electron microscopy revealed cytoplasmic inclusions within neutrophils, suggestive of bacteria. The disease improved every time with appropriate antibiotic therapy. An infective aetiology for NEH is rare: three such cases have been reported, of which one was due to S. marcescens. The originality of our case is the recurrence of the disease on three occasions with the same bacterium isolated on each occasion, with disease remission after antibiotic therapy. This case confirms that infections may be a possible cause of NEH and underlines the necessity to search for infective agents, especially in patients immunocompromised by haematopoietic malignancies and/or chemotherapeutic treatments.

To examine the engagement of French registered nurses with the Ministry of Health's initiative to spur scientific inquiry in the community.French nursing research has suffered from a lack of dedicated funding. Positive signs of change have recently appeared, with the launch of the first national public funding programme dedicated to nursing research. This initiative, begun in 2010, was launched by the French Ministry of Health. Through this initiative, 149 registered nurses, serving as principal investigators, and their teams submitted research proposals between 2010 and 2011. The administrative guidelines of the funding programme are clearly oriented towards producing quantitative and exogenous nursing research.A cross-sectional analysis of 149 nursing research projects submitted during the first and second years of a French national funding programme for hospital-based nursing research was conducted. Research proposals were included in the analysis whether they received funding or not. Data collection took place in 2011. The categories used in the analysis were the following: (1) the socio-demographic data on the registered nurse principal investigators, (2) the research teams and (3) the research proposals (methodologies, bibliography, focus of the research, output, the status of the research proposals).This study highlights the presence of methodological homogeneity among the research proposals submitted for funding. Clear tendencies were towards interventional and quantitative studies and those with an exogenous factor research objective. Between 2010 and 2011, 25 projects were funded out of 149 submitted. They were mostly quantitative and/or focused on the exogenous factors in patient care.The socio-political context of a funding programme designed to encourage nursing research has had an implicit influence on the type of research to which French nurses have committed themselves to and the scientific positions with which these nurse researchers align themselves.

The following markers of inflammation: enzymatic activity of leukocyte elastase (LE), functional activity of alpha-1-proteinase inhibitor (α1-PI), levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured in the blood plasma of patients with Alzheimer's disease (AD) and vascular dementia (VD). The results confirm the presence of an inflammatory component in the pathogenesis of AD and VD. The high level of CRP may be considered as a marker of VD in the early stages of disease. There was an elevation of α1-PI activity in AD patients compared to age-matched controls. The α1-PI activity, levels of CRP and IL-6 increased with the severity of dementia while the LE activity significantly decreased compared to controls (p0.01). In patients with AD, the IL-6 level was negatively correlated with MMSE scores (Spearman r = -0.46, p=0.0077) and, therefore, can be considered as a biological marker of the severity of the pathological process. Positive correlations between CRP and IL-6 may plausibly reflect an ability of IL-6 to induce the synthesis of CRP.

The mucocutaneous side-effects of systemic retinoids are well known. We report a patient with diffuse oedema, which is a very rare side-effect of retinoids. The pathophysiology of this condition is poorly known because of the rarity of relevant observations, but apparently corresponds to capillary leak syndrome. The outcome is invariably favourable following withdrawal of the drug, which should be definitively contraindicated in the patient.

The lipophilic antioxidant U-18 from the class of hindered phenols prevents the destruction of cultured hippocampal neurons during hypoxia and also in the posthypoxic reoxygenation period, apparently by being stably incorporated into their phospholipid membranes and by safeguarding these from free-radical damage in the course of reoxygenation. On the other hand, the protection afforded to the cultured hippocampal neurons by superoxide dismutase is probably due to its ability to interfere with the posthypoxic neuron-degrading processes mediated through hyperproduction of superoxide radicals in the neuronal cytoplasm.

Parameters of innate and adaptive immunity were studied in the blood serum of 180 patients, aged 15-25 years, with different endogenous mental diseases with depressive and mania disorders in the clinical picture (affective psychoses (29 patients), schizoaffective psychoses (106 patients) , slow-progressive schizophrenia (23 patients) and intermittent-progressive schizophrenia (22 patients)). The activation of innate immunity (the increase in the degranulation activity of leukocyte elastase (LE) and functional activity of alpha-1-proteinase inhibitor (α1-PI) were found in all the diseases. The increase in disease severity (from affective disorders to intermittent-progressive schizophrenia) was correlated with the significant elevation of LE activity. The LE activity did not depend on the polarity and severity of affective pathology in each diagnostic group. The mean levels of autoantibodies to the nerve growth factor and the myelin basic protein did not differ from the control values in all the groups of patients.

Biolan containing carnosine and delta sleep-inducing peptide produced a protective effect on cerebellar granular cells from 7-day-old rats exposed in culture to ischemia (oxygen and glucose deprivation) and cytotoxic influence of glutamate. These results indicate that Biolan holds much promise for correction of ischemic brain damages in clinical practice.

OBJECTIVES The purpose of the study was to assess the impact that funding from the National Network of Libraries of Medicine (NN/LM), Greater Midwest Region (GMR), has on member institutions' ability to conduct outreach on behalf of NN/LM. METHODS The study employed both content analysis and survey methodologies. The final reports from select GMR-funded outreach projects (n = 20) were analyzed based on a set of evaluation criteria. Project principal investigators (n = 13) were then surveyed using the same evaluation criteria. RESULTS Results indicated that outreach projects supported by GMR funding improved access to biomedical information for professionals and the general public. Barriers to conducting outreach projects included time constraints or commitments, staffing, scheduling and absenteeism, inadequate space, and issues associated with technology (e.g., hardware and software, Internet connectivity and firewall issues, and creation and use of new technologies). CONCLUSIONS The majority of project principal investigators indicated that their attempts to conduct outreach were successful. Moreover, most noted that outreach had a positive impact on professionals as well as the general public. In general, it seems that negative outcomes, as with most barriers to conducting outreach, can be mitigated by more thorough planning.

International audience; A tectonic analysis of brittle deformaton was performed in the Rhine-Saône transform in order to decipher and understand the deformation processes in a typical continental hansfer zone. Cenozoic major and minor fault patterns are described, and brittle structures are interpreted in terms of paleostress orientations. The Eocene N-S compression related to Africa-Eurasia convergence is marked mainly by strike-slip faults. It was followed by a major phase of crustal extension, mainly Oligocene in age, related to the west European rifting. This extensional phase is expressed by normal faults, tension gashes, and extensional strike-slip faults which are especially abundant in the transform zone. These two events are found to be quite different in terms of distribution of horizontal shess trajectories. The trend of ol axes is very homogeneous for the N-S compression, whereas o3 orientations associated with the major extension vary from E-W in most of the Rift system to I.&V-SE within the transform zone. Finally, the Mio-Pliocene tectonic emplacement of the Jura fold-and-thrust belt is marked in the field by strike-slip faults associated with a well-defined trend of ol oriented W-IIW-E-SE to NW-SE. The preexisting basement fracture pattern between the grabens was also considered in order to estimate which faults were likely to have been reactivated during the Oligocene transform kinematics, and the theoretical shear motion on these inherited fault surfaces, when submitted to E-W extension, was calculated. Left-lateraUextensional reactivation of a preexisting 60"N trending fault system in the brittle upper crust is likely to have accommodated the shear strain arising between the rift segments in response to crustal stretching. Two independent numerical modelings, based on distinct element and finite element analyses, respectively, enabled us to verify and to refine the hypothesis of transform kinematics related to E-W extension and inducing regional perturbations of extensional stress trajectories. The overall mechanism and the transtensional kinematics of the Rhine-Saône transform zone are thus tightly conshained. The inherited crustal anisotropy, the large-scale perturbations of extensional stress trajectories, and the development of distributed brittle deformation within the sedimentary cover are found to play a major role in the tectonic evolution of continental rift-transform systems.

The different inverse methods used in slip data analysis depend on the general validity of the mechanical model adopted by Carey and Brunier, and others. The mechanical scheme is based on the Wallace-Bott relationship assuming a faulted rock mass as a system of rigid blocks interacting mechanically without friction. Until now the validity of this conceptual model was supported by internally consistent results obtained by applying numerical inversion techniques to fault slip data. This paper presents the first results of a numerical modelling investigation of this simple mechanical model by a direct approach to the problem. The numerical method used here is a three-dimensional Distinct Element Method which is suitable to study discontinuous media. First, by modelling the behaviour of one fault, we propose an extrinsic verification of the Wallace-Bott relation in three dimensions and considering rock linear elasticity and friction effects on faults. According to the small discrepancy obtained (i.e. the deviation between the modelling results and the theoretical results), we conclude that the assumptions of the basic model are justified in the range of stress values that we study. Second, using a two-fault model, the effects of overlap in stress perturbations around the faults results in particular fault slip interactions. The existence of such phenomena invalidates, in a generally minor way taking into account practical uncertainties, the assumption of fault slip independence in the basic model. Finally, we discuss limits to inverse methodologies and the necessity for interactions between data collection, interpretation of these data and the ability of the basic model to be used in microtectonic analyses.

The antiradical activity and the radiation stability of carnosine in water solutions was studied by the pulse radiolysis technique with spectrophotometric registration of absorbance. The transient spectra were recorded in the range 245-670 nm during 2 x 10(-6)-20 s after the pulse using a flow system for continuous change and saturation of the samples by different gases. Also, the spectra of the stable products of radiolysis were studied. The results obtained give evidence that carnosine in water solutions in the presence of oxygen behaves like a multifunctional antioxidant. Even at low concentrations, dipeptide forms a charge-transfer complex (Car ... O2-., lambda max = 265 nm) with the superoxide radical which changes the reactivity of O2-.. The absorbance band of the complex was shifted towards lower energy as compared to superoxide radical lambda max = 255 nm). The interaction of carnosine with OH-radicals proceeding at very high rate and resulting in the formation of a stable product suggested another type of dipeptide activity. The kinetic mechanism of the interaction of carnosine with products of radiolysis of water in aerobic conditions is discussed.

Nous rapportons un cas d’œdeme unilateral du bras associe a un prurit et a une hypereosinophilie. La patiente avait sejourne au Cameroun en zone forestiere. Sur des arguments cliniques, biologiques et geographiques, le diagnostic d’œdeme onchocerquien etait retenu malgre l’absence de microfilaires visibles lors des biopsies cutanees exsangues. La patiente a ete traitee avec succes par ivermectine et doxycycline.

We describe here a rigorous and accurate model for the simulation of three-dimensional deformable particles (DPs). The method is very versatile, easily simulating various types of deformable particles such as vesicles, capsules, and biological cells. Each DP is resolved explicitly and advects within the surrounding Newtonian fluid. The DPs have a preferred rest shape (e.g., spherical for vesicles, or biconcave for red blood cells). The model uses a classic hybrid system: an Eulerian approach is used for the Navier-Stokes solver (the lattice Boltzmann method) and a Lagrangian approach for the evolution of the DP mesh. Coupling is accomplished through the lattice Boltzmann velocity field, which transmits force to the membranes of the DPs. The novelty of this method resides in its ability (by design) to simulate a large number of DPs within the bounds of current computational limitations: our simple and efficient approach is to (i) use the lattice Boltzmann method because of its acknowledged efficiency at low Reynolds number and its ease of parallelization, and (ii) model the DP dynamics using a coarse mesh (approximately 500 nodes) and a spring model constraining (if necessary) local area, total area, cell volume, local curvature, and local primary stresses. We show that this approach is comparable to the more common - yet numerically expensive - approach of membrane potential function, through a series of quantitative comparisons. To demonstrate the capabilities of the model, we simulate the flow of 200 densely packed red blood cells - a computationally challenging task. The model is very efficient, requiring of the order of minutes for a single DP in a 50 microm x 40 microm x 40 microm simulation domain and only hours for 200 DPs in 80 microm x 30 microm x 30 microm . Moreover, the model is highly scalable and efficient compared to other models of blood cells in flow, making it an ideal and unique tool for studying blood flow in microvessels or vesicle or capsule flow (or a mixture of different particles). In addition to directly predicting fluid dynamics in complex suspension in any geometry, the model allows determination of accurate, empirical rules which may improve existing macroscopic, continuum models.

The term "auto-inflammatory diseases" encompasses a group of disorders characterised by febrile episodes of sudden onset associated with joint, abdominal, lymph node and cutaneous signs, each presenting a genetic and/or laboratory specificity allowing their identification. Polyclonal elevation of serum IgD is highly suggestive of hyper-IgD syndrome, a disease with autosomal recessive transmission that usually begins before the age of one year.We report the case of a 46-year-old woman presenting a disease since the age of 30 years clinically very similar to hyper-IgD syndrome except for ocular and pulmonary involvement. However, tests revealed neither mevalonate kinase gene mutation nor elevation of urinary mevalonic acid. The near-monthly attacks were controlled with mycophenolate mofetil.Three cases with identical clinical and laboratory profiles have been reported in the literature and diagnosed as late-onset hyper-IgD syndrome. Our case is the only one involving indirect screening for mutation of the mevalonate kinase gene, which proved negative. This finding rules out the diagnosis of classic hyper-IgD syndrome in our case and raises the possibility of auto-inflammatory disease with reactional hyper-IgD of a different cause, either acquired or secondary to an as yet unidentified mutation.

We present a model of microfluidic flow of several completely immiscible fluids and use it to simulate a whole flow focusing device chamber. Our efficient, practical model supports a large parameter space, spanned by surface wetting, surface tension, liquid-liquid wetting, viscosity ratio, and inlet velocity. It is based upon an N-component lattice Boltzmann method with interrupted coalescence [Dupin et al., Philos. Trans. R. Soc. London, Ser. A 362, 1885 (2004)], here adapted for calculations at low capillary and Reynolds numbers, with wetting and significantly reduced spurious flow. Results over 2 orders of magnitude in Reynolds number are presented.

Impetigo herpetiformis is a rare dermatitis that occurs during pregnancy and may be life threatening for both mother and child. In this case report, we present an Ondine curse involving the baby, and the good response to isotretinoine.A first pregnancy, 26 year-old woman developed at 8 months a widespread skin lesion involving the medial side of the thighs, abdomen and intertriginous areas, with a severe systemic toxic condition and fever. Diagnosis of impetigo herpetiformis was made and corticosteroids, methotrexate and cyclosporine were unsuccessful. Isotretinoine rapidly improved the patient with good control of the disease. The full term baby had an Ondine curse.Our case is typical of impetigo herpetiformis. Maternal and infant complication may be life threatening and we report a real Ondine curse the etiology of which remains unknown. Moreover, this observation is unusual because the lesions did not clear despite delivery and good treatment. In our opinion, the great improvement with isotretinoine would suggest it could be used as first line treatment.

While blood at the macroscopic scale is frequently treated as a continuum by techniques such as computational fluid dynamics, its mesoscale behaviour is not so well investigated or understood. At this scale, the deformability of each cell within the plasma is important and cannot be ignored. However there is currently a lack of efficient computational techniques able to simulate a large number of deformable particles such as blood cells. This paper addresses this problem and demonstrates the applicability of the authors’ recent multi-component lattice Boltzmann method for the simulation of a large number of mutually immiscible liquid species [Dupin MM, Halliday I, Care CM. Multi-component lattice boltzmann equation for mesoscale blood flow. J Phys A: Math Gen 2003;36:8517–34]. In here, biological cells are treated as immiscible, deformable, and relatively viscous drops (compared to the surrounding fluid). The validation of the model is based on the work of Goldsmith on the flow of solid particles, deformable particles and red blood cells [Goldsmith HL, Marlow JC. Flow behavior of erythrocytes. II. Particle motions in concentrated suspensions of ghost cells. J Colloid Interf Sci 1979;71:383–407]. We demonstrate, in particular, that the model recovers Goldsmith’s observations on the flow properties of red blood cells and also the experimental observations of Frank on the flow of solid beads [Frank M, Anderson D, Weeks ER, Morris JF. Particle migration in pressure-driven flow of a brownian suspension. J Fluid Mech 2003;493:363–78]. The current article is the first validation of our new lattice Boltzmann model for a large number of deformable particles in this context and demonstrates that the method provides a new, and effective, approach for the modeling of mesoscale blood flow.

We review our recent multi-component lattice Boltzmann equation method for the simulation of a large number of mutually immiscible liquid species and then apply it to the simulation of dense volume fraction suspensions of deformable particles in internal geometry. In particular, we illustrate the scope of our method by applying it to the simulation of pipe flows containing a high volume fraction of monodisperse suspended, deformable particles. The particles are modelled as immiscible, relatively viscous liquid drops. We modify the ‘solidity’ of the particles by modifying their viscosity and surface tension and demonstrate the effect of the solidity upon the blunting of the velocity profile.

We review the analysis of single and N-component lattice Boltzmann methods for fluid flow simulation. Results are presented for the emergent pressure field of a single phase incompressible liquid flowing over a backward-facing step, at moderate Reynolds Number, which is compared with the experimental data of Denham & Patrick (1974 Trans. IChE 52, 361-367). We then access the potential of the N-component method for transport of high volume fraction suspensions of deformable particles in pressure-driven flow. The latter are modelled as incompressible, closely packed liquid drops. We demonstrate the technique by investigating the particles' transverse migration in a uniform shear ('lift'), and profile blunting and chaining.

We report a case of neuritic borderline tuberculoid leprosy with lingering insidious growth disclosed by a brutal reversal reaction. Inflammatory polyarthralgia and sensory and motor loss in the median and ulnar territories, without skin lesions, suggested vasculitis. A few weeks later, inflammatory skin lesions developed leading to the diagnosis of biopsy proven leprosy. Leprosy should be considered as a possible diagnosis in patients with multineuritis, especially when associated with rheumatic or cutaneous manifestations. Early skin biopsy in neuritic leprosy is discussed.

The recent outbreak of an epidemic of West-Nile fever in New-York revealed this virus' responsibility in some cases of fatal encephalitis. However the clinical manifestations of the infection may be mild as in the case reported herein.A 41-year-old woman without previous medical history presented an acute febrile rash after a trip to Senegal. The course was spontaneously favorable after 5 days, with a biphasic fever at day 3. Reverse passive hemagglutination test confirmed the diagnosis of acute West-Nile fever.West-Nile virus, a mosquito-borne flavivirus is usually responsible for a flue-like disease presenting a maculopapular rash in half of the cases. The biphasic evolution of fever is suggestive of the diagnosis. The diagnosis relies on serological tests but cross-reactivities with heterologous flaviviruses may render the interpretation difficult. A rapid recovery is usual but fatal meningoencephalitis can occur especially in the elderly. Treatment is supportive and prevention is limitation of human exposure. West-Nile virus is widely distributed (Africa, Asia, Middle East), but is also endemic in european areas and responsible for seasonal infections.

The role of the serotonin transporter protein (STP) in the development of somatoform [corrected] disorders was addressed in a correlational study of the levels of immunoreactive STP (IR-STP) using site-specific antibodies against the least conserved (among a group of other cotransporters) epitope at the C-terminal of STP and the level of anxiety symptoms in patients with somatoform [corrected] disorders. A total of 22 patients were studied, with DSM-IV diagnoses of somatoform [corrected] disorders, along with 32 mentally healthy subjects of comparable age and sex. Immunoblotting of IR-STP from patients from healthy donors produced a diffuse band between 68 and 105 kDal and a clear narrow band at 43 kDal. The 43-kDal IR-STP protein was almost completely absent from most patients, as compared with the levels of this protein in healthy donors. This result suggests an abnormality of STP processing or, perhaps, alternative splicing of the gene encoding STP in patients with somatoform [corrected] disorders, and this appears to reflect the dysfunction in serotoninergic transmission in the CNS in these patients.

We studied effects of gangliosides on the level of lipid peroxides and microviscosity of membrane lipid bilayer in primary dissociated cultures of cerebellar granule cells prepared from 8 day-old rats under conditions of neurotoxic effect of glutamate. It was found that glutamate (100 mkM) treatment of primary cultures activated the processes of lipid peroxidation and decreased microviscosity of neuronal membranes determined as a degree of pyrene excimerization. It was also shown that preincubation of granule cells with gangliosides did not prevent the accumulation of TBA-reactive products induced by glutamate. At the same time gangliosides significantly decreased the membrane-fluidizing effect caused by glutamate.

Neutrophilic eccrine hidradenitis (NEH) is a rare dermatosis which usually develops after administration of chemotherapeutic treatments. An infective origin is exceptional. We report a patient, previously operated on for ependymoma, who presented with an eruption typical of NEH even though he had not received chemotherapy. Culture of a skin biopsy revealed Serratia marcescens. The dermatosis improved after antibiotic therapy but recurred twice and culture again isolated S. marcescens; electron microscopy revealed cytoplasmic inclusions within neutrophils, suggestive of bacteria. The disease improved every time with appropriate antibiotic therapy. An infective aetiology for NEH is rare: three such cases have been reported, of which one was due to S. marcescens. The originality of our case is the recurrence of the disease on three occasions with the same bacterium isolated on each occasion, with disease remission after antibiotic therapy. This case confirms that infections may be a possible cause of NEH and underlines the necessity to search for infective agents, especially in patients immunocompromised by haematopoietic malignancies and/or chemotherapeutic treatments.

Dermatofibrosarcoma protuberans (DFSP) is typically diagnosed during early adult life at a tumoral stage. It occurs only rarely in children. We report six childhood cases of DFSP which presented initially with the misleading clinical appearance of atrophic plaques, and we review over 140 cases of DFSP in childhood. As compared with adult forms, DFSP in children does not show distinctive features except for a tendency for acral localization. The diagnosis is difficult because of the slow course of the lesions, which present initially as apparently benign atrophic morphoeaor keloid-like plaques. We believe that DFSP in childhood is probably under-estimated, as a significant proportion of patients diagnosed as young adults had an onset several years earlier. Better knowledge of the initial appearance is important for making an early diagnosis and for an easier surgical treatment.

Erythema dyschromicum perstans (EDP), described by Convit et al. in 1961, is a rare dermatosis. Its relationship with ashy dermatosis (AD), described by Ramirez in 1957, is still a matter of debate. We report a typical case of EDP. The patient, of North African origin, had a dyschromic (hypo- and hyperpigmented) eruption on the chest and limbs for 2 years. The lesions were occasionally surrounded by a papular border which spread slowly and centrifugally. Histological examination showed a lichenoid infiltrate. A carcinoma of the lung was simultaneously discovered. No treatment was given, EDP is infrequent and often considered identical to ashy dermatosis in the literature. However, the clinical aspects of the two diseases differ. The main features of these two diseases are reviewed and compared on the basis of a literature review. We conclude that EDP and AD are distinct clinical entities.

African tick-bite fever is caused by R. africae. All cases reported to date in France have occurred among patients who came from southern Africa, the endemic zone. We report the first case, to our knowledge, of a patient infected in France.A 69-year-old white man who had never left France developed fever and 3 "black spots" on the legs with lymphangitis and enlarged nodes. The clinically suspected diagnosis was confirmed by positive serology reactions to R. africae. As cross immunity with R. conorii can occur, the diagnosis was further confirmed by western blot for R. africae and by the persistence of the reaction after adsorption of the R. conorii serum.African tick-bite fever was identified as a clinical entity different from Mediterranean spotted fever by Kelly in 1992 who demonstrated the causal role of R. africae. The typical clinical presentation associates fever, several black spots, lymphangitis and multiple node enlargement. The serological diagnosis is difficult owing to cross immunity with R. conorii. Western blot and polymerase chain reaction are required for definitive diagnosis. In our case, the infection was probably due to a R. africae imported into France in the luggage of the patient's daughter who had spent 3 months in Zimbabwe.

Deep or infiltrating lipoma is an often misdiagnosed clinical entity. We report two typical cases.Two women, aged 92 and 62 years, were seen for a tumefaction on an upper limb with progressively increasing volume. The clinical presentation suggested deep lipoma, confirmed by magnetic resonance imaging and histology which eliminated liposarcoma, the main differential diagnosis. Surgical excision was successful. There has been no recurrence.These two observations recall the clinical, diagnostic and therapeutic features of infiltrating lipoma.

The neuroprotective effects of synthesized lipophylic antioxidant from hindered phenol class (U-18) and hydrophylic antioxidative enzyme superoxide dismutase (SOD) were tested on long-term mouse hippocampal cell cultures exposed to hypoxia/reoxygenation. The application of U-18 to the cultures during 6-8 hr hypoxia followed by 16-18 hr reoxygenation in the absence of antioxidant significantly reduced neuronal death. Thus, lipophylic free radical scavenger may exert a delayed neuroprotective effect, probably owing to persistent incorporation into phospholipid membranes and prevention of their lipid peroxidation by means of prolonged intramembranous free radical quenching. On the other hand, the exposure of the cultures to U-18 during 15 hr hypoxia without subsequent reoxygenation also led to significant reduction of neuronal death compared with that observed without antioxidant. These findings suggest that free radical neuronal damage may occur under conditions of prolonged restricted oxygen access to the neurons. The hypoxic/posthypoxic neuronal injury significantly decreased in the cultures exposed to hydrophylic cytoplasmic enzyme SOD (300 U/ml). The neuroprotective effects of both lipophylic U-18 and hydrophylic SOD on the cultures exposed to hypoxia/reoxygenation might reflect the damaging free radical overproduction in different morphofunctional compartments of the nerve cell.

The pathophysiology of mycosis fungoides remains uncertain but HTLV I or a similar virus could be involved. We observed a couple who developed mycosis fungoides suggesting the infectious hypothesis might indeed be valid.A 70-year-old man who had often travelled in foreign countries developed parapsoriasis en plaques, lymphomatoid papulosis and mycosis fungoides successively over a thirty year period. Several years after the first manifestation of mycosis fungoides, his wife also developed a single plaque of mycosis fungoides. The diagnosis was confirmed on pathology slides and immunohistochemistry tests as well as on the basis of T-receptor gene rearrangement in both patients. Search for HTLV I was negative using serology tests and PCR on circulating lymphocytes.The epidemiological situation in our observation (several trips in foreign countries and the delayed development of mycosis fungoides in the wife) favours the hypothesis of an infectious mechanism. Search for HTLV I was unsuccessful with classical virology methods. Certain recent work suggests a virus similar but different from the HTLV I virus could be involved in the pathogenesis of mycosis fungoides.