Comparison of juvenile and adult myasthenia gravis in a French cohort with focus on thymic histology.

Myasthenia gravis (MG) is an autoimmune disease characterized by muscle fatigability due to acetylcholine receptor (AChR) autoantibodies. To better characterize juvenile MG (JMG), we analyzed 85 pre- and 132 post-pubescent JMG (with a cutoff age of 13) compared to 721 adult MG patients under 40 years old using a French database. Clinical data, anti-AChR antibody titers, thymectomy, and thymic histology were analyzed.

Tree architecture, light interception and water-use related traits are controlled by different genomic regions in an apple tree core collection.

Tree architecture shows large genotypic variability, but how this affects water-deficit responses is poorly understood. To assess the possibility of reaching ideotypes with adequate combinations of architectural and functional traits in the face of climate change, we combined high-throughput field phenotyping and genome-wide association studies (GWAS) on an apple tree (Malus domestica) core-collection. We used terrestrial light detection and ranging (T-LiDAR) scanning and airborne multispectral and thermal imagery to monitor tree architecture, canopy shape, light interception, vegetation indices and transpiration on 241 apple cultivars submitted to progressive field soil drying.

A neoprene vest hastens dyspnoea and leg fatigue during exercise testing: entangled breathing and cardiac hindrance?

Symptoms and contributing factors of immersion pulmonary oedema (IPO) are not observed during non-immersed heart and lung function assessments. We report a case in which intense snorkelling led to IPO, which was subsequently investigated by duplicating cardiopulmonary exercise testing with (neoprene vest test - NVT) and without (standard test - ST) the wearing of a neoprene vest. The two trials utilised the same incremental cycling exercise protocol.

Broad individual immersion-scattering of respiratory compliance likely substantiates dissimilar breathing mechanics.

Head-out water immersion alters respiratory compliance which underpins defining pressure at a "Lung centroid" and the breathing "Static Lung Load". In diving medicine as in designing dive-breathing devices a single value of lung centroid pressure is presumed as everyone's standard. On the contrary, we considered that immersed respiratory compliance is disparate among a homogenous adult group (young, healthy, sporty).

Graded and Anisotropic Porous Materials for Broadband and Angular Maximal Acoustic Absorption.

The design of graded and anisotropic materials has been of significant interest, especially for sound absorption purposes. Together with the rise of additive manufacturing techniques, new possibilities are emerging from engineered porous micro-structures. In this work, we present a theoretical and numerical study of graded and anisotropic porous materials, for optimal broadband and angular absorption.

Increased expression of blood muscarinic receptors in patients with reflex syncope.

Aims: Pathophysiology of reflex syncope is not fully understood but a vagal overactivity might be involved in this syncope. Previously, overexpression of muscarinic M2 receptors and acetylcholinesterase was found in particular in the heart and in lymphocytes of rabbits with vagal overactivity as well as in hearts of Sudden Infant Death Syndromes. The aim of this present study was to look at M2 receptor expression in blood of patients with reflex syncope.

Multi-scale high-throughput phenotyping of apple architectural and functional traits in orchard reveals genotypic variability under contrasted watering regimes.

Despite previous reports on the genotypic variation of architectural and functional traits in fruit trees, phenotyping large populations in the field remains challenging. In this study, we used high-throughput phenotyping methods on an apple tree core-collection (1000 individuals) grown under contrasted watering regimes. First, architectural phenotyping was achieved using T-LiDAR scans for estimating convex and alpha hull volumes and the silhouette to total leaf area ratio ().

En Bloc Resection of Thoracic Tumors Invading the Spine: A Single-Center Experience.

Background: Vertebral involvement by a thoracic tumor has long been considered as a limit to surgical treatment, and despite advances, such an invasive operation remains controversial. The aim of this study was to characterize a single-center cohort and to evaluate the outcome, focusing on survival and complications.

Methods: We retrospectively reviewed the data of all patients operated on for tumors involving the thoracic spine in an 8-year period.

Proposal for a Combined Histomolecular Algorithm to Distinguish Multiple Primary Adenocarcinomas from Intrapulmonary Metastasis in Patients with Multiple Lung Tumors.

Introduction: Multiple nodules in the lung are being diagnosed with an increasing frequency thanks to high-quality computed tomography imaging. In patients with lung cancer, this situation represents up to 10% of patients who have an operation. For clinical management, it is important to classify the disease as intrapulmonary metastasis or multiple primary lung carcinoma to define TNM classification and optimize therapeutic options.

Regulatory B cells in myasthenia gravis are differentially affected by therapies.

We analyzed the number and functionality of regulatory B (Breg) cells in well-defined myasthenia gravis patients. We first showed a decreased number of circulating CD19 CD24 CD38 Breg cells and an altered functionality of Breg cells in untreated myasthenia gravis patients. Next, we demonstrated that the proportion of circulating Breg cells was restored in myasthenia gravis patients after thymectomy, probably as Breg cells could be sequestered in the myasthenia gravis thymus.

Synchronous Oligometastatic Lung Cancer Deserves a Dedicated Management.

Background: Oligometastatic stage IV non-small lung cancer (NSCLC) patients have a 5-year overall survival of 30% versus 4% to 6% in historical cohorts of stage IV NSCLC patients. We reviewed data and patterns of care of patients affected by oligometastatic NSCLC in our center between 2001 and 2017.

Methods: We retrospectively reviewed clinical and pathological files of all patients with lung cancer and synchronous isolated adrenal or brain metastases, or both, treated by locally ablative treatments (surgery or radiotherapy, or both) of both primary cancer and distant metastasis.

Clinical presentation and treatment of catameinal pneumothorax and endometriosis-related pneumothorax.

: Catamenial pneumothorax (CP) is defined as a recurrent spontaneous pneumothorax occurring in females of reproductive age. In the 'perimenstrual period,' it is still considered relatively rare although accounting for 20-35% of spontaneous pneumothoraces occurring in premenopausal women. It is the most frequent manifestation of thoracic endometriosis, which can also cause pneumothorax during the intermenstrual period (TER non-CP).

Patients experiencing early acute respiratory failure have high postoperative mortality after pneumonectomy.

Objective: Post-pneumonectomy acute respiratory failure leading to invasive mechanical ventilation carries a severe prognosis especially when acute respiratory distress syndrome occurs. The aim of this study was to describe risk factors and outcome of acute respiratory failure.

Methods: We retrospectively reviewed clinical files of all patients who underwent pneumonectomy in a single center between 2005 and 2015.

[The new reference equations of the Global Lung function Initiative (GLI) for pulmonary function tests].

Until recently, the reference equations available for pulmonary function tests (PFTs) have had several weaknesses: they have often been based on relatively weak samples of normal subjects; they used mathematical models that are not very efficient in describing the evolution of PFTs over age; there were different equations for children/adolescents and for adults; the expression of the results solely as a percentage of the predicted value did not provide a good indication of the statistical significance of any difference that may exist between a measured value and its reference value. The Global Lung Initiative (GLI) aimed to establish new reference equations for PFTs that do not have these disadvantages. Based on large, representative, reference populations and allowing individualization of homogeneous ethnic groups over a wide age range, the GLI uses a statistical model that does not have any a priori hypothesis regarding the evolution of PFTs as a function of age (these models therefore make it possible to describe, in a very precise manner, the PFTs over all age ranges).

Postoperative outcomes of frequent exacerbator patients with Chronic Obstructive Pulmonary Disease after resection of Non-Small Cells Lung Cancer.

Chronic obstructive pulmonary disease (COPD) is a risk factor of post-operative complications after lung cancer resection. The influence of the "frequent exacerbator (FE)" phenotype (at least three exacerbations per year) is unknown. Postoperative outcomes of frequent exacerbators (POFE) was a prospective observational study of patients with COPD undergoing lung resection for cancer.

Influence of Training Load and Altitude on Heart Rate Variability Fatigue Patterns in Elite Nordic Skiers.

We aimed to analyse the relationship between training load/intensity and different heart rate variability (HRV) fatigue patterns in 57 elite Nordic-skiers. 1063 HRV tests were performed during 5 years. R-R intervals were recorded in resting supine (SU) and standing (ST) positions.

Intermittent versus constant aerobic exercise in middle-aged males: acute effects on arterial stiffness and factors influencing the changes.

Purpose: Both constant and intermittent acute aerobic exercises have been found to decrease arterial stiffness. However, direct comparisons of these two types of exercise are sparse. It is not known which type of exercise has the greatest effect.

Immersion pulmonary oedema in a healthy diver not exposed to cold or strenuous exercise.

In healthy divers, the occurrence of immersion pulmonary oedema (IPE) is commonly caused by contributory factors including strenuous exercise, cold water and negative-pressure breathing. Contrary to this established paradigm, this case reports on a 26-year-old, well-trained combat swimmer who succumbed to acute IPE during static immersion in temperate (21°C) water, while using a front-mounted counterlung rebreather. The incident occurred during repeated depth-controlled ascent practice at the French military diving school.

The Key Roles of Negative Pressure Breathing and Exercise in the Development of Interstitial Pulmonary Edema in Professional Male SCUBA Divers.

Background: Immersion pulmonary edema is potentially a catastrophic condition; however, the pathophysiological mechanisms are ill-defined. This study assessed the individual and combined effects of exertion and negative pressure breathing on the cardiovascular system during the development of pulmonary edema in SCUBA divers.

Methods: Sixteen male professional SCUBA divers performed four SCUBA dives in a freshwater pool at 1 m depth while breathing air at either a positive or negative pressure both at rest or with exercise.

Prognostic factors after pulmonary metastasectomy of colorectal cancers: a single-center experience.

Background: Surgical resection has been widely admitted as the treatment of choice for pulmonary metastases of colorectal cancer (CRC). Nevertheless, this practice is not supported by high level of evidence and patients' eligibility remains controversial. Aim of this study was to evaluate long terms results and factors influencing survival after lung metastasectomy of CRC.