Diagnostic strategy for a solitary thyroid nodule. Example of development of recommendations for a practice guideline

The solitary thyroid nodule is frequently observed and many strategies are proposed for the diagnosis of the etiology and for the choice of treatment. Despite many discussions no clear consensus has been so far reached. The french groups concerned by this problem set up a Clinical Practice Guide line with the methodological help of Agence Nationale pour le Développement de l'Evaluation Médicale. Based upon the critical review of the literature a consensus was obtained concerning the natural history of the nodules and the diagnosis value of the complementary explorations. The clinical approach alone completed by a TSH determination gives the therapeutical choice in about 30% of the patient without any other explorations. In the remaining cases 3 methods (isotope scan, echography, cytopuncture) can be used alone or in a combined sequence. So far no strategy can be privilegiated. It is necessary to set up a systematic comparison between the possible strategies and this will be made by the french thyroid specialists after this first step of delimitation of a clinical practise guide line.     

Masked priming from orthographic neighbors: An ERP investigation.

Two experiments combined masked priming with event-related potential (ERP) recordings to examine effects of primes that are orthographic neighbors of target words. Experiment 1 compared effects of repetition primes with effects of primes that were high-frequency orthographic neighbors of low-frequency targets (e.g., faute-faune [error-wildlife]), and Experiment 2 compared the same word neighbor primes with nonword neighbor primes (e.g., aujel-autel [altar]). Word neighbor primes showed the standard inhibitory priming effect in lexical decision latencies that sharply contrasted with the facilitatory effects of nonword neighbor primes. This contrast was most evident in the ERP signal starting at around 300 ms posttarget onset and continuing through the bulk of the N400 component. In this time window, repetition primes and nonword neighbor primes generated more positive-going waveforms than unrelated primes, whereas word neighbor primes produced null effects. The results are discussed with respect to possible mechanisms of lexical competition during visual word recognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fc receptor-mediated phagocytosis requires CDC42 and Rac1

At the surface of phagocytes, antibody-opsonized particles are recognized by surface receptors for the Fc portion of immunoglobulins (FcRs) that mediate their capture by an actin-driven process called phagocytosis which is poorly defined. We have analyzed the function of the Rho proteins Rac1 and CDC42 in the high affinity receptor for IgE (FcepsilonRI)-mediated phagocytosis using transfected rat basophil leukemia (RBL-2H3) mast cells expressing dominant inhibitory forms of CDC42 and Rac1. Binding of opsonized particles to untransfected RBL-2H3 cells led to the accumulation of F-actin at the site of contact with the particles and further, to particle internalization. This process was inhibited by Clostridium difficile toxin B, a general inhibitor of Rho GTP-binding proteins. Dominant inhibition of Rac1 or CDC42 function severely inhibited particle internalization but not F-actin accumulation. Inhibition of CDC42 function resulted in the appearance of pedestal-like structures with particles at their tips, while particles bound at the surface of the Rac1 mutant cell line were enclosed within thin membrane protrusions that did not fuse. These phenotypic differences indicate that Rac1 and CDC42 have distinct functions and may act cooperatively in the assembly of the phagocytic cup. Inhibition of phagocytosis in the mutant cell lines was accompanied by the persistence of tyrosine-phosphorylated proteins around bound particles. Phagocytic cup closure and particle internalization were also blocked when phosphotyrosine dephosphorylation was inhibited by treatment of RBL-2H3 cells with phenylarsine oxide, an inhibitor of protein phosphotyrosine phosphatases. Altogether, our data show that Rac1 and CDC42 are required to coordinate actin filament organization and membrane extension to form phagocytic cups and to allow particle internalization during FcR-mediated phagocytosis. Our data also suggest that Rac1 and CDC42 are involved in phosphotyrosine dephosphorylation required for particle internalization.     

Security of supply and retail competition in the European gas market.: Some model-based insights

In this paper, we analyze the impact of uncertain disruptions in gas supply upon gas retailer contracting behavior and consequent price and welfare implications in a gas market characterized by long-term gas contracts using a static Cournot model. In order to most realistically describe the economical situation, our representation divides the market into two stages: the upstream market that links, by means of long-term contracts, producers in exporting countries (Russia, Algeria, etc.) to local retailers who bring gas to the consuming countries to satisfy local demands in the downstream market. Disruption costs are modeled using short-run demand functions. First we mathematically develop a general model and write the associated KKT conditions, then we propose some case studies, under iso-elasticity assumptions, for the long–short-run inverse-demand curves in order to predict qualitatively and quantitatively the impacts of supply disruptions on Western European gas trade. In the second part, we study in detail the German gas market of the 1980s to explain the supply choices of the German retailer, and we derive interesting conclusions and insights concerning the amounts and prices of natural gas brought to the market. The last part of the paper is dedicated to a study of the Bulgarian gas market, which is greatly dependent on the Russian gas supplies and hence very sensitive to interruption risks. Some interesting conclusions are derived concerning the necessity to economically regulate the market, by means of gas amounts control, if the disruption probability is high enough.