bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Long-Term Sequelae of Compartment Syndrome Involving the Foot and Ankle
Authors: Lintz Francois , Colombier Jean A. , Letenneur Joseph , Gouin Francois
Published: September 2009

Background:

Lower leg compartment syndrome can lead to severe sequelae affecting patient autonomy. Ischemic muscle fibrosis and retraction result in foot and ankle deformities ranging from claw toes to complex multiplanar dislocations with soft tissue impairment requiring amputation. Although these deformities have been reported in relation to compartment syndrome, they have rarely been discussed specifically in the light of a long term follow up.

Materials and Methods:

Between 1981 and 2006, 151 patients were treated in our hospital for compartment syndrome of the lower limb. Ten of them later required further surgery to treat sequelae on the foot and ankle and were followed up prospectively. Personal data and surgical events were recorded, as well as potential risk factors for sequelae and functional outcome. The data was analyzed and compared to that available in previous literature. We analyzed and describe the different surgical procedures available for the management of this condition including arthroscopic ankle arthrodesis which could be a less invasive and efficient technique in mild equinus deformities.

Results:

All ten patients were diagnosed late for compartment syndrome. The anterior and lateral compartments were most often involved but rarely accounted for late sequelae. The deep posterior compartment seems to be the key element in generating after effects. Functional results were good in eight patients. Two required amputation after failed secondary surgery.

Conclusion:

The late, post-compartment syndrome affecting the foot and ankle can be treated efficiently provided surgery is performed acurately, taking into account the multiplanar deformity. However, the best treatment for this condition remains prevention. Level of Evidence: IV, Retrospective Case Series
Triple Nerve Block at the Knee for Foot and Ankle Surgery Performed by the Surgeon: Difficulties and Efficiency
Authors: Varitimidis Sokratis E. , Venouziou Aaron I. , Dailiana Zoe H. , Christou Dimitrios , Dimitroulias Apostolos , Malizos Konstantinos N.
Published: September 2009

Background:

Combined nerve blocks at the knee can provide safe anesthesia below the knee avoiding the potential complications of general or spinal anesthesia while reducing the need for opioids in the postoperative period. This study presents the outcomes of a large series of patients that underwent foot and ankle surgery receiving a triple nerve block at the knee.

Materials and Methods:

Three hundred eighty patients underwent foot and ankle surgery receiving anesthesia with triple nerve block at the knee (tibial, common peroneal and saphenous nerve). Surgery included a variety of bone and soft tissue procedures. The nerve block was performed by an orthopaedic surgeon in the lateral decubitus position.

Results:

The successful nerve block rate was 91 percent. There was no need to convert to general or spinal anesthesia, although 34 patients (9%) needed additional analgesia intraoperatively. Complete anesthesia required 25 to 30 minutes from the time of performing the block. No complication occurred secondary to the use of the anesthetic agent (ropivacaine 7.5%). Postoperative analgesia lasted from 5 to 12 hours, reducing the need of additional analgesics. Hospitalization averaged 1.4 days (from 0 to 5) with the majority of patients discharged the day after the operation (248/380). A high satisfaction rate was reported by the patients with no adverse effects and complications.

Conclusion:

We found triple nerve block at the knee to be a safe and reliable method of regional anesthesia providing low morbidity, high success rate, long acting analgesia, and fewer complications than general or spinal anesthesia. It is a simple method that can be performed by the orthopaedic surgeon. Level of Evidence: IV, Retrospective Case Series
Midfoot Charcot Arthropathy with Improvement of Arch after Achilles Tendon Lengthening: A Case Report
Authors: Holthusen Scott M. , Kolodziej Patricia
Published: September 2009

Level of Evidence: V, Expert Opinion
Agrobacterium-mediated Genetic Transformation of Two Varieties of Jute (Corchorus capsularis L.)
Authors: Sarker Rakha Hari , Al-Amin G.M. , Hassan Fathi , Hoque M.I.
Published: September 2009

Transformation experiments were carried out using different explants of two varieties of white jute (Corchorus capsularis L.), namely, CVL-1 and CVE-3 with Agrobacterium tumefaciens strain (LBA4404/pBI121) containing the GUS and nptII genes. Maximum transformation ability was obtained from petiole-attached cotyledons and mature embryo explants. Kanamycin at a concentration of 200 mg/l was found optimum for selection of transformed shoots developed frommature embryos. Histochemical assay revealed the stable expression of the GUS gene within the various tissues of transformed plantlets. Stable integration of GUS and nptII genes were confirmed by PCR analysis of genomic DNA isolated from these transformed shoots. Key words: Jute, Transformation, GUS expression, PCR analysis D.O.I. 10.3329/ptcb.v18i1.3245 Plant Tissue Cult. & Biotech. 18(1): 7-16, 2008 (June)
Genetic Diversity in Hexaploid and Tetraploid Wheat Genotypes Using Microsatellite Markers
Authors: Uddin M.S. , Boerner A.
Published: September 2009

The genetic diversity of a set of hexaploid and tetraploid wheat germplasm at the IPK gene bank, Gatersleben, Germany was investigated by applying 13 wheat microsatellites (WMS). The materials consisted of 63 accessions of Triticum aestivum, T. dicoccon and T. durum obtained from different collection missions. In total, 126 alleles were detected with an average of 9.7 alleles per locus. The average PIC values per locus varied from 0.65 for the marker Xgwm192 to 0.88 for the marker Xgwm619. All the primer pairs revealed genetic heterogeneity in more than one genotype. Genetic dissimilarity values between genotypes, calculated by the WMS derived data, were used to produce a dendrogram. In the dendrogram the genotypes were clustered in nine clear groups. Key words: Genetic diversity, Microsatellite markers, Hexaploid, Tetraploid, Wheat genotype D.O.I. 10.3329/ptcb.v18i1.3267 Plant Tissue Cult. & Biotech. 18(1): 65-73, 2008 (June)
Callus Induction and High Frequency Regeneration of Plantlets of Scoparia dulcis L., a Perennial Medicinal Herb, Through Auxiliary Shoot Proliferation
Authors: Hassan A.K.M. Sayeed , Afroz Farhana , Bari Laila Shamroze , Munshi John Liton , Jahan Miskat Ara Akter , Khatun Rahima
Published: September 2009

Green compact nodular callus was observed within three weeks from nodal segments of a perennial medicinal herb Scoparia dulcis L. on MS basal medium supplemented with 1.5 mg/l BAP + 0.2 mg/I NAA. The callus produced large number of shoots when subcultured on MS with 0.5 mg/l BAP + 0.1 mg/l NAA. In vitro raised shoots rooted on half strength of MS with 1.0 mg/l IBA + 1.0 mg/l NAA. For acclimatization and transplantation, the plantlets in the rooting culture tubes were kept in normal room temperature for seven days before transplanting in pots where plantlets were reared for three weeks. The survival rate of plantlets was found to be 85%. Regenerated plants were morphologically uniform having normal leaf shape and growth. Key words: Scoparia dulcis, Medicinal plant, Shoot proliferation, Acclimatization D.O.I. 10.3329/ptcb.v18i1.3268 Plant Tissue Cult. & Biotech. 18(1): 75-83, 2008 (June)
Mechanisms Regulating Skin Pigmentation: The Rise and Fall of Complexion Coloration
Authors: Ebanks Jody  P. , Wickett R.  Randall , Boissy Raymond  E.
Published: September 2009

Skin pigmentary abnormalities are seen as aesthetically unfavorable and have led to the development of cosmetic and therapeutic treatment modalities of varying efficacy. Hence, several putative depigmenting agents aimed at modulating skin pigmentation are currently being researched or sold in commercially available products. In this review we will discuss the regulation of processes that control skin complexion coloration. This includes direct inhibition of tyrosinase and related melanogenic enzymes, regulation of melanocyte homeostasis, alteration of constitutive and facultative pigmentation and down-regulation of melanosome transfer to the keratinocytes. These various processes, in the complex mechanism of skin pigmentation, can be regulated individually or concomitantly to alter complexion coloration and thus ameliorate skin complexion diseases.
1,5-Diazacyclohenicosane, a New Cytotoxic Metabolite from the Marine Sponge Mycale sp.
Authors: Coello Laura , Martín María Jesús , Reyes Fernando
Published: September 2009

A new cyclic diamine, 1,5-diazacyclohenicosane (1), was isolated from samples of the marine sponge Mycale sp. collected at Lamu Island (Kenya). Its structure was determined by a combination of spectroscopic techniques, including (+)-HRESIMS and 1D and 2D NMR spectroscopy. The compound displayed cytotoxicity at the μM level against three human tumor cell lines.
Chalcogenide Glass Optical Waveguides for Infrared Biosensing
Authors: Anne Marie-Laure , Keirsse Julie , Nazabal Virginie , Hyodo Koji , Inoue Satoru , Boussard-Pledel Catherine , Lhermite Hervé , Charrier Joël , Yanakata Kiyoyuki , Loreal Olivier , Le Person Jenny , Colas Florent , Compère Chantal , Bureau Bruno
Published: September 2009

Due to the remarkable properties of chalcogenide (Chg) glasses, Chg optical waveguides should play a significant role in the development of optical biosensors. This paper describes the fabrication and properties of chalcogenide fibres and planar waveguides. Using optical fibre transparent in the mid-infrared spectral range we have developed a biosensor that can collect information on whole metabolism alterations, rapidly and in situ. Thanks to this sensor it is possible to collect infrared spectra by remote spectroscopy, by simple contact with the sample. In this way, we tried to determine spectral modifications due, on the one hand, to cerebral metabolism alterations caused by a transient focal ischemia in the rat brain and, in the other hand, starvation in the mouse liver. We also applied a microdialysis method, a well known technique for in vivo brain metabolism studies, as reference. In the field of integrated microsensors, reactive ion etching was used to pattern rib waveguides between 2 and 300 μm wide. This technique was used to fabricate Y optical junctions for optical interconnections on chalcogenide amorphous films, which can potentially increase the sensitivity and stability of an optical micro-sensor. The first tests were also carried out to functionalise the Chg planar waveguides with the aim of using them as (bio)sensors.
A Real-Time Smart Sensor for High-Resolution Frequency Estimation in Power Systems
Authors: Granados-Lieberman David , Romero-Troncoso Rene  J. , Cabal-Yepez Eduardo , Osornio-Rios Roque  A. , Franco-Gasca Luis  A.
Published: September 2009

Power quality monitoring is a theme in vogue and accurate frequency measurement of the power line is a major issue. This problem is particularly relevant for power generating systems since the generated signal must comply with restrictive standards. The novelty of this work is the development of a smart sensor for real-time high-resolution frequency measurement in accordance with international standards for power quality monitoring. The proposed smart sensor utilizes commercially available current clamp, hall-effect sensor or resistor as primary sensor. The signal processing is carried out through the chirp z-transform. Simulations and experimental results show the efficiency of the proposed smart sensor.
Factors Influencing a Community Pharmacist's Interventions in Asthma Care
Authors: Nadaira Natalie , Ouellet Catherine , René-Henri Nola , Khamla Yvonne , Collin Johanne , Blais Lucie , Lalonde Lyne , Beauchesne Marie-France
Published: September 2009

Background:

Little is known about current pharmacists' interventions related to drug counselling and monitoring in asthma, along with the barriers and facilitators to these, in the province of Quebec.

Objectives:

To identify and explore organizational, relational and professional factors that influence community pharmacists' interventions in asthma care and propose solutions to overcome the barriers to these interventions.

Methods:

In 2006, a survey and an invitation to participate in a focus group were sent to community pharmacists in Quebec. Three focus groups were held to discuss the results of the survey about community pharmacists' interventions in asthma and the factors influencing these interventions, along with solutions to identified barriers. Each focus group lasted for approximately 120 minutes and was moderated by 2 investigators.

Results:

Seventeen community pharmacists participated in the study. One focus group was held with pharmacy owners, 1 with salaried pharmacists who graduated before 1990 and 1 with salaried pharmacists who graduated after 1996. Owners and salaried pharmacists of different years of graduation generally made the same comments. Most pharmacists reported intervening with asthma patients, especially when initial prescriptions were filled. Lack of time and unclear definition of tasks were reported as barriers. Solutions were proposed to resolve barriers, such as clearly defining tasks and ensuring quick access to support materials for patient education and drug monitoring.

Conclusion:

Community pharmacists report intervening in asthma care mostly when patients fill their initial prescription. Several barriers to follow-up interventions were identified.
A Retrospective Review Assessing the Efficacy and Safety of Nitrofurantoin in Renal Impairment
Authors: Bains Ajay , Buna Donna , Hoag Nathan A.
Published: September 2009

Background:

Nitrofurantoin (NF) is an antibiotic commonly used to treat uncomplicated urinary tract infections (UTIs). Although NF is contraindicated in patients with an estimated glomerular filtration rate (GFR) of less than 60 mL/min, the evidence demonstrating its lack of efficacy and an increased rate of adverse reactions in these patients is marginal.

Methods:

A retrospective chart review was conducted to determine the efficacy and safety of NF in patients with a UTI and an estimated GFR ≤50 mL/min (impaired renal function group) compared to >50 mL/min (control group).

Results:

A total of 356 patients met our inclusion criteria. The Modified Cockcroft-Gault equation was used to estimate GFR. The point estimate for cure rate in the impaired renal function group was 71% (95% CI 63–79), versus 78% (95% CI 73–84) for the control group.

Conclusions:

Similar NF cure rates were observed in patients with impaired renal function (estimated GFR ≤50 mL/min) and patients in the control group (estimated GFR >50 mL/min). The occurrence of adverse events was comparable between the 2 groups.
Histoire de la rue
Authors: Garden Maurice
Published: September 2009

Résumé La rue n’a pas beaucoup inspiré les historiens, bien qu’elle soit depuis l’origine de la ville un élément constituant fondamental. La rue est d’abord un espace aménagé, bordé des immeubles qui sont le cadre de vie habituel. Elle est ensuite le lieu privilégié des échanges, du commerce et des solidarités de voisinage. Mais son histoire est également chargée d’une forte valeur symbolique, la rue étant théâtre de luttes et enjeu de pouvoirs.
La République, la rue et l'urne
Authors: Hayat Samuel
Published: September 2009

Résumé La République étant née de la rue, les républicains de gouvernement au xix e siècle ne peuvent se contenter d’en réprimer indistinctement toutes les apparitions. Ils construisent la rue revendicatrice comme un lieu de subversion factieuse, quand elle ne se plie pas à un lien de subordination vis-à-vis du pouvoir. Le suffrage « universel » devient le seul moyen d’expression politique légitime, rendant la rue redondante et suspecte.
Une géométrie « naturelle » du politique : les rues de Paris et de Washington D.C.
Authors: Cadot Christine
Published: September 2009

Résumé La rue reflète les propriétés abstraites d’un corps politique ; elle est à ce titre un espace de fondation politique et morale. Entre le tracé courbe des rues européennes, produit des siècles, et le quadrillage américain, symbole de la conscience historique d’un commencement inédit, nous explorons l’élaboration d’une idéologie s’appuyant sur la géométrie afin de mieux opposer Nouveau Monde et Vieille Europe. Après le déclenchement des Révolutions française et américaine, le tracé des rues de Paris et de Washington D.C. illustre la difficulté de concevoir l’espace urbain de la « table rase » et de la régénération nationale lorsque celui-ci est confronté à l’affirmation de la nécessaire rupture entre Ancien et Nouveau Monde. Nous replaçons ainsi notre étude dans le cadre plus large des processus idéologiques de naturalisation du politique.
La rue et la ségrégation sociale
Authors: Castro Roland
Published: September 2009

Résumé La rue est une valeur, et elle doit être conçue comme un bien commun. Pourtant la cité, et toute la misère qu’elle comporte, a tué la rue. Aujourd’hui la rue est ce qui fait défaut au plus pauvre. Face aux dangers des mauvaises villes, l’idée de bonne ville pour tous est devenue un enjeu politique majeur. Nous devons penser au projet de faire des villes magnifiques. Car embellir les villes, c’est construire la dignité visible de chaque citoyen et donner à tous un droit à l’urbanité.
Le destin festif du canal Saint-Martin
Authors: Jolé Michèle
Published: September 2009

Résumé La rue festive renvoie autant à la notion d’ambiance, de style d’être qu’à celle de manifestation calendaire exceptionnelle. Elle est comme une cristallisation d’attentes multiples de différents acteurs et populations qui, à des fins ludiques et revendicatives, font de certaines rues, de certains espaces publics, leurs territoires. Des logiques, contradictoires en soi (marchande, associative, politique), peuvent y coopérer et aboutir à la reconstruction symbolique d’un lieu, comme le canal Saint-Martin, qui à terme peut fonctionner comme un lieu de pur « spectacle ».
Servir l'état, un idéal encore moderne ?
Authors: Dreyfus Françoise
Published: September 2009

Résumé Dans la mesure où le rôle de l’État est mis en question depuis deux décennies et où la signification des valeurs qui le légitiment est de plus en plus incertaine, peut-on encore avoir l’ambition de servir l’État ? Les changements auxquels ce dernier est confronté impliquent que soient repensés le périmètre et les modalités de son action : ce vaste chantier de la « modernisation » devrait attirer, aujourd’hui comme dans le passé, les jeunes diplômés qui ambitionnent d’être des acteurs de la réforme.
Les collectivités locales : un autre modèle
Authors: Colmou Yves
Published: September 2009

Résumé La fonction publique territoriale est née de la décentralisation, de la volonté de doter les collectivités locales d’agents et de cadres capables de piloter leurs nouvelles compétences. Autour des principes d’unité de la fonction publique territoriale, de spécificité et de comparabilité avec la fonction publique d’État, s’est constitué un modèle original et aujourd’hui consensuel, à la fois fonction publique de carrière et marché de l’emploi. Proches des élus, au service du public et d’un territoire, responsables de projets et de budgets conséquents, les cadres des collectivités locales, et notamment les administrateurs territoriaux, exercent des fonctions de plus en plus attractives.
La mémoire et le service de l'État l'affaire Dreyfus
Authors: Duclert Vincent
Published: September 2009

Résumé L’affaire Dreyfus fut une affaire d’État. Les commémorations de l’événement qui commencèrent en 1994, qui se poursuivirent en 1998 et qui s’ouvrent à nouveau cette année pour le centième anniversaire de l’arrêt de la Cour de cassation proclamant la pleine et entière innocence du capitaine Dreyfus invitent à réfléchir sur le rapport des institutions avec leur passé et sur le rôle de l’histoire dans la construction de la mémoire nationale.
L'adaptation de la société polonaise à l'Europe
Authors: Bafoil François
Published: September 2009

Résumé L’impact des transformations économiques a été largement différencié en Pologne selon les secteurs professionnels. Si les ouvriers ont largement subi le poids des restructurations industrielles, les exploitants agricoles ont davantage pu se maintenir en l’état. Des catégories sociales nouvelles sont apparues au sommet de la pyramide sociale suite à la domination progressive du diplôme comme facteur de mobilité ascendante, ou au bas avec les pauvres, les chômeurs, les exclus. Flexibilité de l’emploi et maintien de certaines traditions se sont combinées pour une dynamique d’adaptation considérable de la société polonaise.
L'instabilité du système partisan. Le maillon faible de la consolidation démocratique en Pologne
Authors: Ekiert Grzegorz
Published: September 2009

Résumé Depuis 1989, la démocratie polonaise n’a pas réussi à consolider son système partisan, entraînant un vaste mécontentement populaire. Les dernières élections indiquent que la Pologne est en train de connaître un réalignement politique majeur : pour la première fois, la coalition au pouvoir compte extrémistes de droite, nationalistes et populistes opportunistes qui rejettent le programme de réforme, ainsi que les objectifs et stratégies mis en place par les gouvernements précédents. Ce système partisan idiosyncrasique – marqué par une instabilité inhérente, une faiblesse organisationnelle, une tendance croissante à l’extrémisme politique et dont le programme rétrograde risque d’affecter le processus de modernisation amorcé depuis quinze ans – remet sérieusement en question les engagements de la Pologne envers l’UE.
Progrès et limites de l'état de droit
Authors: Kruk Maria
Published: September 2009

Résumé Cette étude présente le processus de construction de l’État de droit en Pologne, à travers les limites et les risques qui entravent sa réussite. En 1989, en Pologne comme dans d’autres États de l’Europe centrale et orientale, la chute du communisme a permis d’intégrer une clause de l’État de droit dans l’ordre constitutionnel. Dès sa constitutionnalisation, si le principe est d’emblée entré en vigueur, la formation de son arrière-base doctrinale et juridique n’en est qu’à ses balbutiements. L’État de droit est sans cesse menacé par les conditions spécifiques de la transformation : les règlements de comptes du passé, la faiblesse du système des partis politiques, les difficultés des transformations économiques, la fragilité de la société citoyenne, l’insuffisance législative ou le populisme. La dernière période où – d’après certains – le risque s’accroît vérifiera la solidité de l’État en Pologne.
L'église et le catholicisme polonais à l'épreuve du pluralisme
Authors: Michel Patrick
Published: September 2009

Résumé La fonction dévolue à la religion en Pologne, d’indicateur privilégié de l’établissement d’un rapport au pluralisme, n’a pas été modifiée par le changement de régime survenu en 1989. Indicateur majeur de la relation au pluriel, la religion constitue tout autant, dans les réemplois qui en sont opérés, l’espace privilégié d’affichage des ajustements requis par les transformations rapides auxquelles se trouve confrontée la société. Et cette utilisation du catholicisme à des fins de gestion d’un mouvement multiforme conduit à poser les recompositions qu’il connaît en révélateur du désenchantement polonais.
Les radicaux au pouvoir et la transformation de la Pologne
Authors: Smolar Aleksander
Published: September 2009

Résumé Au moment où elle a toutes les raisons de fêter les grands succès d’une transformation postcommuniste, la Pologne traverse une crise politique dont les conséquences sociales, économiques et internationales sont difficiles à prévoir. La droite, parvenue au pouvoir à l’automne 2005, remet en question le modèle de transformation adopté. Selon elle, après les négociations de la « Table ronde » de 1989, les hommes de l’ancien régime avec l’aide de leurs alliés, les modérés de Solidarnosc, ont pu conserver une large part de leur pouvoir. Ensemble, ils dominent l’administration publique, occupent des postes clés dans l’armée, la police, les médias et l’économie, corrompant et affaiblissant l’État. La confrontation avec les ex-communistes et leurs alliés constitue ainsi pour les radicaux un enjeu politique majeur. Il s’agit non seulement de combattre les pathologies des transformations, mais aussi de mettre en œuvre une véritable révolution institutionnelle et juridique, ainsi qu’un ordre moral fondé sur une distinction claire entre la vérité et le mensonge, le bien et le mal.
Les relations germano-polonaises
Authors: Dakowska Dorota
Published: September 2009

Résumé Alors que le début des années 1990 a placé les relations germano-polonaises sous le signe de la réconciliation et de la mise en place des bases d’un bon voisinage, cette tendance a semblé s’inverser à partir de la fin des années 1990. Axée sur l’évolution des relations polonaises depuis 1989, cette contribution s’intéresse en particulier aux usages du passé à des fins politiques. Elle propose en outre de replacer les événements analysés dans le contexte des négociations d’adhésion à l’Union européenne.
La délibération imparfaite
Authors: Missika Jean-Louis
Published: September 2009

Résumé Les démocraties occidentales traversent actuellement une période que l’on pourrait qualifier de « brouillard médiatique » : les médias sont délocalisés, l’information de divertissement prédomine sur l’information de jugement, les médias conversationnels contrecarrent ou outrepassent les médias institutionnels, etc. Ces bouleversements ne sont pas sans conséquences sur les modalités de la délibération politique. Cet article se propose d’en examiner les effets en regard de trois grands types d’intentionnalité communicationnelle : la propagande, la persuasion et la séduction.
Les campagnes présidentielles 1965-2007 : De M. X à Mme Royal
Authors: Gerstlé Jacques
Published: September 2009

Résumé Pour traiter du pouvoir des médias et de leur montée dans les campagnes électorales présidentielles de la V e République, il convient de distinguer ce qui est relatif à la sélection des candidats et ce qui a trait à leur promotion ou leur élimination dans la compétition. Au premier titre, on va considérer l’opération M. X en vue de l’élection de 1965, puis la percée de Ségolène Royal pour 2007. Est ainsi illustrée l’intervention des médias dans la fabrication d’une candidature alors que le cas de Ségolène Royal met plus particulièrement en évidence le poids des sondages. Quant à la promotion ou l’élimination des candidats, les médias y contribuent par l’accent qu’ils placent sur le cadrage en termes de traits personnels ou d’enjeux politiques, mais surtout par la conjonction ou la disjonction qu’ils permettent entre la communication contrôlée par les candidats et l’information qu’ils diffusent.
Le gros mot de contre-pouvoir
Authors: Muhlmann Géraldine
Published: September 2009

Résumé La nécessaire critique de la « connivence » des journalistes avec le pouvoir politique renvoie à l’exigence d’un véritable contre-pouvoir journalistique. Cette exigence, pourtant, semble avoir du mal à être formulée clairement en France. D’une part, il y a une difficulté historique à penser la liberté d’expression, dans ce pays, dans une extériorité absolue par rapport au pouvoir politique, y compris législatif. D’autre part, la France n’a pas « achevé » la révolution du « reportage » qui s’est jouée au xix e siècle : la figure du reporter, figure clé du contre-pouvoir, n’est pas au cœur de la pratique journalistique en France comme elle l’est dans les démocraties anglo-saxonnes.
Un quatrième pouvoir en loques
Authors: Brimo Nicolas
Published: September 2009

Résumé Aujourd’hui, la presse française d’information politique et générale ne remplit plus son rôle. Elle ne cesse de perdre des lecteurs et, en matière de lectorat, la France se situe aujourd’hui au niveau de la Turquie. Depuis dix ans, la situation financière des journaux français ne cesse de se dégrader : sur les huit quotidiens nationaux, malgré un prix moyen de vente élevé et un flot d’aides de l’État, seuls trois titres sont rentables en exploitation. Jamais la dépendance de la presse française vis-à-vis des annonceurs publicitaires et des grands groupes militaro-industriels (Lagardère et Dassault) n’a été aussi forte, limitant d’autant sa capacité de contrôle.
La contrainte commerciale et l'évitement du politique
Authors: Fouks Stéphane
Published: September 2009

Résumé L’âge d’or est révolu : dans les médias, les politiques doivent désormais choisir entre l’audience et le temps. Parce que les médias ne sont pas épargnés par les contraintes financières qui se sont imposées dans toute l’économie. Et parce que le politique connaît un déclin dans la société. De manière paradoxale, nous assistons à la fois à une augmentation du volume de la politique dans les médias et à une rétraction de la place de la politique dans les médias de masse. Ce faisant, une partie de la population voit plus de politique qu’avant et une autre partie en voit moins. Une rénovation est nécessaire. La réglementation doit évoluer pour mettre fin à la rareté artificielle et à l’uniformité excessive des périodes électorales. Les nouvelles technologies, qui permettent de contourner la contrainte financière, doivent être davantage utilisées. Surtout, les responsables publics doivent privilégier le politique sur la politique et s’attacher à rendre lisible le visible quand les médias doivent, eux, se rapprocher de la réalité de la hiérarchie des préoccupations des Français.
Vices et vertus de la satire
Authors: Pétillon René
Published: September 2009

Résumé Les satiristes sont par nature les empêcheurs de gouverner en rond. En même temps, c’est leur goût de la politique qui les conduit à ce métier. Alors, certes, ils appuient où ça fait mal, mais ils le font en s’imposant quelques limites et ne peuvent avoir d’impact que s’ils parviennent à faire rire en exprimant ce que chacun ressent, bien plus qu’en prétendant influencer quiconque.
The First Year of Practice: New Graduate Nurses' Transition and Learning Needs
Authors: Dyess Susan M. , Sherman Rose O.
Published: September 2009

Although the phenomenon of reality shock has been acknowledged as part of the new graduate nurse transition for decades, there is evidence to suggest that the problems with the transition into practice are more serious today. This article presents findings about the new graduate nurse transition and learning needs from qualitative research conducted in a community-based novice nurse transition program. The new graduate nurse transition and learning needs are examined through the eyes of new graduates and the nursing leaders and preceptors who work with them. Recommendations are offered for continuing education initiatives that can be designed to meet these needs.

J Contin Educ Nurs
2009;40(9):403–410.
Progress Meetings: Facilitating Role Transition of the New Graduate
Authors: Goodwin-Esola Marlene , Deely Maureen , Powell Nancy
Published: September 2009

Although the very best orientation will not fully eliminate new graduates' sense of anxiety, a successful orientation will guide the novice registered nurse to use these feelings constructively by promoting a sense of confidence, competence, and satisfaction. This article provides details and examples of how progress meetings can be a beneficial addition to an orientation template. Progress meetings offer an avenue to facilitate social support and clinical growth supporting the transition from new graduate nurse to independent staff nurse.

J Contin Educ Nurs
2009;40(9):411–415.
Educating Nurse Planners: Taking Continuing Nursing Education on the Talk Show Circuit
Authors: Losko Heather A.
Published: September 2009

Current American Nurses Credentialing Center accreditation criteria require that provider units have a process for educating and updating nurse planners. One provider unit's creative approach to meeting this key element is described here.

J Contin Educ Nurs
2009;40(9):389–390.
Metal–Metal Bearing Surfaces in Hip Arthroplasty
Authors: Schmalzried Thomas P.
Published: September 2009

There is no mystery regarding the allure of metal–metal bearings: high stability and low wear potential. The special risks associated with these bearings are coming into focus and include a macrophage response to excessive metal particles (metal reactivity) and a lymphocyte-dominated reaction (metal sensitivity). The most common presentation of an adverse local tissue reaction (ALTR) is persistent pain. The incidence of ALTR has not been completely defined, but the risk appears to be increased in resurfacing, in women, and in bilateral cases. The differential diagnosis includes septic and aseptic loosening, and the evaluation should include aspiration. The diagnosis is confirmed by histological examination.

It can be difficult to assess the fixation status of monoblock cobalt chromium acetabular components. Both metal reactivity and metal sensitivity can cause periprosthetic bone resorption (osteolysis). The development of a large effusion may be a sign of metal sensitivity. Ultrasound is a cost-effective diagnostic tool but is operator dependent. A magnetic resonance imaging scan with metal artifact suppression can identify a periprosthetic fluid collection or cystic/solid mass (pseudotumor). Serum or whole blood ion levels elevated to >10 ppb are suggestive of a suboptimal wear mechanism and an increased risk of ALTR.

The indications for revision include component loosening, progressive osteolysis, large effusion or pseudotumor, and unremitting pain. Correction of any identified mechanical aberrations with conversion to a nonmetal–metal bearing is recommended. A well-fixed cobalt chromium substrate (modular stem or modular acetabular shell) can be retained.
Cement Mantle Retention: Filling the Hole
Authors: Cross Michael , Bostrom Mathias
Published: September 2009

Revision total hip surgery requires a number of techniques that optimizes outcomes while minimizing bone loss. One such technique that has proven useful in revision of the femoral components in revision total hip surgery is leaving an intact cement mantle in place and cementing a new prosthesis within the intact cement mantle. Careful patient selection and preoperative planning are essential for the successful implementation of this technique. The appropriate indications are: (1) if the original stem is broken, but the cement mantle is intact, (2) when removing a well-fixed, cemented stem to improve exposure for an acetabular revision, increase femoral offset, or femoral head diameter, and (3) when removing a debonded femoral component. Although the cement-within-cement revision technique is rarely used, it is an important technique to have in your portfolio. However, it is also important to keep in mind some of the drawbacks of cement-within-revisions and to consider these factors when deciding whether this technique is appropriate for a specific patient.
Extra-articular Deformity Is Always Correctable Intra-articularly: In the Affirmative
Authors: Koenig Jonathan H. , Maheshwari Aditya V. , Ranawat Amar S. , Ranawat Chitranjan S.
Published: September 2009

Patients with arthritis of the knee and an extra-articular deformity present a unique technical challenge, as it becomes more difficult to restore the mechanical axis during total knee replacement (TKR). Current treatment options include a 2-staged procedure in which an extra-articular correctional osteotomy is performed several months before the primary TKR, a 1-stage procedure in which an extra-articular correctional osteotomy is performed at the time of the index TKR, or a 1-stage procedure in which TKR is performed with correction of the extra-articular deformity.

One-stage TKR with intra-articular correction of the extra-articular deformity is our treatment of choice. With proper planning, appropriate bone cuts to restore alignment, and the necessary soft tissue releases to balance the knee in flexion and extension, a satisfactory TKR can be achieved.

Two patients with arthritis and a severe extra-articular deformity (varus/valgus deformity >20°, recurvatum and malunion of a tibial or femoral fracture) were treated with 1-stage TKR with intra-articular correction of the extra-articular deformity. The technique followed had been successfully performed in 15 previous cases. The procedure was clinically successful in both patients without complications. At 2-year follow-up, Knee Society Scores improved from 40 to 95 and there was no evidence of instability in either case.
Computer-assisted TKA: Greater Precision, Doubtful Clinical Efficacy: Affirms
Authors: Berend Michael E.
Published: September 2009

Component and limb alignment are essential surgical variables that influence the long-term performance of a total knee arthroplasty (TKA). Total knee arthroplasty failure remains multifactorial, and computer-assisted surgical techniques may address only part of the failure pathophysiology. Despite attempting to use computer-assisted surgical techniques to improve TKA alignment, recent evidence has reported that the entire nature of the computer-assisted experience is not particularly forgiving, as significant increases in time and complications remain problematic. It appears computer-assisted surgical techniques are not yet “ready for primetime” with reproducible and proven long-term benefits for patients. Further studies are needed to better determine the precise target toward which to aim computer-assisted surgery efforts.
Seven Cuts to the Perfect Total Knee
Authors: Brooks Peter
Published: September 2009

There are a total of 7 bone cuts in a typical total knee replacement (TKR): distal femur, anterior femur, posterior femur, anterior chamfer, posterior chamfer, tibia, and patella. Each of these cuts has its own special science, and each cut can affect the other cuts and potentially the outcome of the TKR.

The distal femoral cut starts the overall alignment of the leg. Five degrees of valgus is cosmetically appealing, avoids excessive valgus, and prevents thighs from rubbing together. The anterior femoral cut sets femoral component rotation, which has effects on patellar tracking and gap balancing. In most knees, correct rotation is approximately 3° of external rotation compared to the posterior condylar axis. An important exception is in valgus knees, where this could lead to accidental internal rotation. The posterior condyle cuts, with the tibial cut, determine the flexion gap. Injury to the medial collateral and posterior cruciate ligaments should be avoided. Anterior and posterior chamfer cuts must avoid these ligaments as well. The tibial cut is challenging. A 3° posterior slope is most typical, and rotation is crucial. Internal rotation is a common error, affecting patellar tracking. Changing rotation on a sloped cut also adds varus or valgus. The patella cut should not be too deep. Component placement should tend medial and superior. If a lateral release is necessary, it should be done from inside-out, with preservation of the blood supply.
Arthroscopic Repair of Delaminated Acetabular Articular Cartilage in Femoroacetabular Impingement
Authors: Sekiya Jon K. , Martin RobRoy L. , Lesniak Bryson P.
Published: September 2009

Lesions to articular cartilage can be difficult to treat and directly impact surgical outcome in hip arthroscopy. This article describes a direct cartilage suture repair technique for a young, active individual with full-thickness acetabular cartilage delamination. Lesions of this type are commonly seen with femoroacetabular impingement.

A 17-year-old boy presented with bilateral hip pain greater in the right than left. Arthroscopic intervention for the right hip included direct cartilage repair for the cartilage lesion, osteoplasty for femoroacetabular impingement, repair for an anterior labral tear, capsular plication for iliofemoral ligament laxity, and psoas lengthening. Twelve weeks postoperatively, a standard capsular plication, osteoplasty, and chondroplasty were performed on the left hip. At follow-up, the patient reported feeling 95% normal. He noted that the right and left hips were essentially the same. Symptoms consisted of stiffness after prolonged sitting and mild pain following sports. The patient reported being pain free 90% of the time, with pain 2/10 at worst. He scored a 96 on the modified Harris Hip Score, 93 on the Hip Outcome Score Activities of Daily Living subscale, and 81 on the Hip Outcome Score Sports subscale. Overall, the patient was satisfied with the outcome. The direct cartilage repair, in addition to osteoplasty, anterior superior labral repair, iliofemoral capsular plication, and psoas lengthening, produced an excellent outcome in this young, active patient.
Targeting NF-κB with a Natural Triterpenoid Alleviates Skin Inflammation in a Mouse Model of Psoriasis
Authors: Wang Honglin , Syrovets Tatiana , Kess Daniel , Büchele Berthold , Hainzl Heidi , Lunov Oleg , Weiss Johannes M. , Scharffetter-Kochanek Karin , Simmet Thomas
Published: September 2009

Psoriasis vulgaris is a common chronic inflammatory skin disease involving cytokines and an activated cellular immune system. At variance to skin from patients with atopic dermatitis or from healthy subjects, human psoriatic skin lesions exhibit strong activation of transcription factor NF-κB that is mainly confined to dermal macrophages, whereas only a few dendritic cells but no CD3+ lymphocytes show activated NF-κB. Since NF-κB signaling is required for the induction and/or function of many cytokines and aberrant cytokine expression has been proposed as an underlying cause of psoriasis, we investigated whether NF-κB targeting would affect the course of the disease in the CD18 hypomorphic (CD18hypo) mouse model of psoriasis. When mice with severe psoriasiform lesions were treated systemically or locally with the IκB kinase inhibitor acetyl-11-keto-β-boswellic acid (AKβBA), NF-κB signaling and the subsequent NF-κB-dependent cytokine production as shown by the TNF-α production of macrophages were profoundly suppressed. Additionally, application of the compound counteracted the intradermal MCP-1, IL-12, and IL-23 expression in previously lesional skin areas, led to resolution of the abundant immune cell infiltrates, and significantly reduced the increased proliferation of the keratinocytes. Overall, the AKβBA treatment was accompanied by a profound improvement of the psoriasis disease activity score in the CD18hypo mice with reconstitution of a nearly normal phenotype within the chosen observation period. Our data demonstrate that NF-κB signaling is pivotal for the pathogenesis in the CD18hypo mouse model of psoriasis. Therefore, targeting NF-κB might provide an effective strategy for the treatment of psoriasis.
The Role of Macrophage-Derived IL-1 in Induction and Maintenance of Angiogenesis
Authors: Carmi Yaron , Voronov Elena , Dotan Shahar , Lahat Nitza , Rahat Michal A. , Fogel Mina , Huszar Monika , White Malka R. , Dinarello Charles A. , Apte Ron N.
Published: September 2009

Inflammation and angiogenesis are pivotal processes in the progression of many diseases, including malignancies. A hypoxic microenvironment often results in a milieu of proinflammatory and proangiogenic cytokines produced by infiltrating cells. We assessed the role of macrophage-derived hypoxia-associated cytokines in promoting inflammation and angiogenesis. Supernatants of macrophages, stimulated under hypoxia with or without an inflammatory stimulus (LPS), promoted angiogenesis when incorporated into Matrigel plugs. However, neutralization of IL-1 in the supernatants, particularly IL-1β, completely abrogated cell infiltration and angiogenesis in Matrigel plugs and reduced vascular endothelial growth factor (VEGF) levels by 85%. Similarly, supernatants from macrophages of IL-1β knockout mice did not induce inflammatory or angiogenic responses. The importance of IL-1 signaling in the host was demonstrated by the dramatic reduction of inflammatory and angiogenic responses in Matrigel plugs that contained macrophage supernatants from control mice which had been implanted in IL-1 receptor type I knockout mice. Myeloid cells infiltrating into Matrigel plugs were of bone marrow origin and represented the major source of IL-1 and other cytokines/chemokines in the plugs. Cells of endothelial lineage were the main source of VEGF and were recruited mainly from neighboring tissues, rather than from the bone marrow. Using the aortic ring sprouting assay, it was shown that in this experimental system, IL-1 does not directly activate endothelial cell migration, proliferation and organization into blood vessel-like structures, but rather activates infiltrating cells to produce endothelial cell activating factors, such as VEGF. Thus, targeting IL-1β has the potential to inhibit angiogenesis in pathological situations and may be of considerable clinical value.
Suppression of Ongoing T Cell-Mediated Autoimmunity by Peptide-MHC Class II Dimer Vaccination
Authors: Li Li , Yi Zuoan , Wang Bo , Tisch Roland
Published: September 2009

Tissue-specific autoimmune diseases such as type 1 diabetes (T1D) are characterized by T cell-driven pathology. Administration of autoantigenic peptides provides a strategy to selectively target the pathogenic T cell response. Indeed, treatment with β cell peptides effectively prevents T1D in NOD mice. However, the efficacy of peptide immunotherapy generally wanes as β cell autoimmunity progresses and islet inflammation increases. With the goal of enhancing the efficacy of peptide immunotherapy, soluble (s)IAg7-Ig dimers covalently linked to β cell autoantigen-derived peptides were tested for the capacity to suppress late preclinical T1D. NOD female mice with established β cell autoimmunity were vaccinated i.v. with a short course of sIAg7-Ig dimers tethered to peptides derived from glutamic acid decarboxylase (GAD)65 (sIAg7-pGAD65). Treatment with sIAg7-pGAD65 dimers and the equivalent of only ∼7 μg of native peptide effectively blocked the progression of insulitis and the development of diabetes. Furthermore, suppression of T1D was dependent on β cell-specific IL-10-secreting CD4+ T cells, although the frequency of GAD65-specific FoxP3-expressing CD4+ T cells was also increased in sIAg7-pGAD65 dimer vaccinated NOD mice. These results demonstrate that MHC class II-Ig dimer vaccination is a robust approach to suppress ongoing T cell-mediated autoimmunity, and may provide a superior strategy of adjuvant-free peptide-based immunotherapy to induce immunoregulatory T cells.
Human Mast Cells Adhere to and Migrate on Epithelial and Vascular Basement Membrane Laminins LM-332 and LM-511 via α3β1 Integrin
Authors: Sime Wondossen , Lunderius-Andersson Carolina , Enoksson Mattias , Rousselle Patricia , Tryggvason Karl , Nilsson Gunnar , Harvima Ilkka , Patarroyo Manuel
Published: September 2009

Mast cells (MCs) are multifunctional effectors of the immune system that are distributed in many tissues, often in close association with the basement membrane of blood vessels, epithelium and nerves. Laminins (LMs), a family of large αβγ heterotrimeric proteins, are major components of basement membrane that strongly promote cell adhesion and migration. In this study, we investigated the role of LM isoforms and their integrin receptors in human MC biology in vitro. In functional assays, α3-(LM-332) and α5-(LM-511) LMs, but not α1-(LM-111), α2-(LM-211), or α4-(LM-411) LMs, readily promoted adhesion and migration of cultured MCs. These activities were strongly enhanced by various stimuli. α3-LM was also able to costimulate IL-8 production. Among LM-binding integrins, MCs expressed α3β1, but not α6β1, α7β1, or α6β4, integrins. Blocking Abs to α3β1 integrin caused inhibition of both cell adhesion and migration on α3- and α5-LMs. Immunohistochemical studies on skin showed that MCs colocalized with epithelial and vascular basement membranes that expressed α3- and α5-LMs and that MCs expressed α3 integrin but not α6 integrin(s). These results demonstrate a role for α3- and α5-LMs and their α3β1 integrin receptor in MC biology. This may explain the intimate structural and functional interactions that MCs have with specific basement membranes.