A identificação de espécie de Leishmania é crucial no diagnóstico de leishmaniose cutânea (LC), para terapia e prognóstico, em áreas com diferentes espécies endêmicas. A reação em cadeia de polimerase (PCR) foi usada em amostras de biópsias estocadas em parafina e formol de pacientes com LC, do Espírito Santo, Brasil. Usando sequências de mini-exon do gênero Leishmania, 63,2% (36/57) das amostras em parafina e 46,1% (6/13) das amostras em formol foram positivas. Numa abordagem usando sequências de kDNA e RFLP, 100% (58/58) das amostras de parafina testadas foram identificadas como Leishmania (V.) braziliensis. Estas reações podem ser usadas tanto para diagnóstico como para definição da espécie infectante / The identification of Leishmania species, a crucial step in cutaneous leishmaniasis, had therapeutics and prognostics implications, specially at when several agent species are endemic. Polymerase chain reaction (PCR) was used for analysis of paraffin-embedded and formalin stored skin biopsies from patients with parasitologic confirmed cutaneous formalin stored skin biopsies from patients with parasitologic confirmed cutaneous leishmaniasis, from the Espirito Santo State, Brazil. Tested by PCR targeted to mini-exon genus specific primer, 63,2% (36/57) of parafin and 46,1% (6/13) of formalin stored samples were positive, but using a PCR for kDNA primer followed by RFLP analysis, only Leishamnia (V.) braziliensis was identified in 100% (58/58) of parafin biopsies studied. Those reactions allow either diagnosis or species identification in cutaneous leismaniasis

Nas duas últimas décadas, várias espécies de Candida têm surgido como importantes patógenos hospitalares, no mundo e no Brasil. A identificação da origem da infecção tem importância na definição de estratégias de prevenção e controle. As estratégias para a prevenção de candidíase endógena podem focar, parcialmente, em métodos para redução da colonização de mucosas, por exemplo, a restrição ao uso de antibióticos de largo espectro. Entretanto, nos casos nos quais está envolvida uma fonte exógena, um expressivo reforço, na melhoria da qualidade das práticas de assistência à saúde, é prioritário para prevenção da transmissão. O objetivo deste estudo foi avaliar diferentes sítios de colonização por Candida como potenciais fontes de candidemia. O estudo foi desenvolvido em 3 hospitais no Brasil: Instituto Central do Hospital das Clínicas da Faculdade de Medicina de São Paulo, hospital universitário de nível terciário de complexidade, com mil leitos; o Instituto de Infectologia Emílio Ribas, um hospital com 200 leitos, referência para todo o Estado de São Paulo; e o Hospital Geral de Itapecerica da Serra, hospital de cuidados secundários da Grande São Paulo. Foram incluídos no estudo os pacientes com isolamento de Candida em hemocultura obtida de veia periférica após 48 horas de admissão hospitalar. As culturas de vigilância para Candida foram colhidas dos seguintes sítios: urina, reto, cavidade oral, pele (virilha e axila), pele ao redor do cateter e ponta de cateter caso disponível. A tipagem molecular foi realizada quando a mesma espécie de Candida (C. albicans, C. parapsilosis, C. tropicalis and C. glabrata) foi isolada no sangue e nos sítios de vigilância do mesmo paciente. A eletroforese em campo pulsado foi realizada para os isolados de C. albicans, C. parapsilosis e C. glabrata. A amplificação de segmentos polimórficos do DNA foi realizada para C. albicans e C. tropicalis. No total 63 pacientes consecutivos com candidemia foram incluídos no estudo no período de maio de 2004 a outubro de 2005. C. albicans foi isolada em 42% das hemoculturas, C. parapsilosis em 35%, C. tropicalis em 16%, C. guilliermondii, C. krusei, C. glabrata, e C. holmii, em 2% cada uma. Unicamente seis dos 10 isolados de ponta de cateter apresentaram perfil eletroforético idêntico aos isolados de C. parapsilosis do sangue. Os isolados de C. albicans do sangue e de culturas de vigilância do trato gastrintestinal correspondentes, oriundos de 12 pacientes, apresentaram genótipos idênticos. Os resultados sugerem que a colonização do trato gastrintestinal é a provável fonte de candidemia por C. albicans e que a candidemia por C. parasilosis é de origem exógena. / In the last two decades, Candida spp. have emerged as important nosocomial pathogens in the world and in Brazil. The identification of the source of infection is important in approaching prevention and control strategies. Strategies for the prevention of endogenous candidiasis may focus, to a certain extent, on methods for reducing mucosal colonization, for example limitation use of wide-spectrum antibiotics. However, in cases in which an exogenous source is involved, the aggressive reinforcement of adequate healthcare practices is mandatory to prevent transmission. The objective of this study was to evaluate different Candida colonization sites as potential sources for Candida fungemia. The study was done in 3 hospitals in Brazil: the Central Institute of Hospital das Clinicas, a 1000-bed tertiary-care hospital affiliated to the University of São Paulo; the Institute Emilio Ribas, a 200-bed infectious diseases hospital, reference for all the state of São Paulo; and the General Hospital of Itapecerica da Serra, a secondary-care community hospital located in area of the greater São Paulo. The patients with a positive blood culture for Candida, collected from a peripheral vein, were included in the study if they had to be hospitalized for 48 hours or more before candidemia. The following surveillance cultures for Candida were collected from: urine, rectum, oropharynx, skin (groin and axilla), skin around the catheter and catheter tip if available. Molecular typing was performed when the same species of Candida (C. albicans, C. parapsilosis, C. tropicalis and C. glabrata) was isolated from the blood and from surveillance sites of a single patient. Pulsed-field gel electrophoresis was performed for C. albicans, C. parapsilosis and C. glabrata isolates. Randomly amplified polymorphic DNA was performed for C. albicans and C. tropicalis. A total of 63 consecutive patients with candidemia were included in the period from May 2004 to October 2005. C. albicans comprised 42% of the blood isolates, C. parapsilosis 35%, C. tropicalis 16%, C. guilliermondii, C. krusei, C. glabrata, and C. holmii, 2% each. Six of the 10 isolates from catheter tips presented identical electrophoretic profiles to corresponding C. parapsilosis blood cultures and no other surveillance sites were related. C. albicans isolates from blood and from corresponding gastrointestinal surveillance sites from 12 patients presented identical genotypes. In conclusion, our results suggest that tract gastrointestinal colonization is the probable source of C. albicans candidemia and that C. parapsilosis candidemia is not endogenous.

A identificação de espécie de Leishmania é crucial no diagnóstico de leishmaniose cutânea (LC), para terapia e prognóstico, em áreas com diferentes espécies endêmicas. A reação em cadeia de polimerase (PCR) foi usada em amostras de biópsias estocadas em parafina e formol de pacientes com LC, do Espírito Santo, Brasil. Usando sequências de mini-exon do gênero Leishmania, 63,2% (36/57) das amostras em parafina e 46,1% (6/13) das amostras em formol foram positivas. Numa abordagem usando sequências de kDNA e RFLP, 100% (58/58) das amostras de parafina testadas foram identificadas como Leishmania (V.) braziliensis. Estas reações podem ser usadas tanto para diagnóstico como para definição da espécie infectante / The identification of Leishmania species, a crucial step in cutaneous leishmaniasis, had therapeutics and prognostics implications, specially at when several agent species are endemic. Polymerase chain reaction (PCR) was used for analysis of paraffin-embedded and formalin stored skin biopsies from patients with parasitologic confirmed cutaneous formalin stored skin biopsies from patients with parasitologic confirmed cutaneous leishmaniasis, from the Espirito Santo State, Brazil. Tested by PCR targeted to mini-exon genus specific primer, 63,2% (36/57) of parafin and 46,1% (6/13) of formalin stored samples were positive, but using a PCR for kDNA primer followed by RFLP analysis, only Leishamnia (V.) braziliensis was identified in 100% (58/58) of parafin biopsies studied. Those reactions allow either diagnosis or species identification in cutaneous leismaniasis

Τρεις ευρέως χρησιμοποιούμενες μέθοδοι τυποποίησης, μια βιοχημική (API20NE), μια φαινοτυπική (SDS-PAGE) και μια μοριακή (RAPD) χρησιμοποιήθηκαν για την ταυτοποίηση και ταξινόμηση 160 περιβαλλοντικών ψευδομονάδων που απομονώθηκαν από το υδάτινο περιβάλλον της Νοτιοδυτικής Ελλάδας και συγκεκριμένα από εμφιαλωμένα νερά (46%), νερά δικτύου ύδρευσης (16%), κολυμβητικών δεξαμενών (9%) και θαλασσών (29%). Οι ψευδομονάδες ταυτοποιήθηκαν με βάση το βιοχημικό τους αποτύπωμα δια μέσου του συστήματος ΑΡΙ20ΝΕ, και στη συνέχεια υποβλήθηκαν σε ηλεκτροφόρηση των ολικών πρωτεϊνών τους (SDS-PAGE) και σε ανάλυση του γενετικού τους υλικού με τη μέθοδο RAPD (Random Amplified Polymorphic DNAs) με χρήση δύο διαφορετικών δεκαμερών εκκινητών (primers). Το σύστημα API20NE ταυτοποίησε το 88% των στελεχών διακρίνοντας 14 ομάδες-είδη, ενώ η SDS-PAGE ταξινόμησε το 98.1% σε 20 ομάδες και η RAPD το 94% των στελεχών σε 22 και 34 ομάδες, με εκκινητή τον OPA-13 και τον OPD-13 αντίστοιχα. Η ταξινόμηση προέκυψε με εφαρμογή της ανάλυσης κατά συστάδες (cluster analysis) των αποτυπωμάτων (πρωτεϊνικών και γενετικών) που παρήγαγαν τα στελέχη. Τα 20 στελέχη που δεν ταυτοποιήθηκαν σε επίπεδο είδους με το API20NE, ταξινομήθηκαν με την SDS-PAGE σε ποσοστό 100%, ενώ με την RAPD σε ποσοστό 90%. Οι τρεις μέθοδοι συγκρίθηκαν ως προς την επαναληψιμότητα (reproducibility), την ικανότητα τυποποίησης (typeability) και τη διακριτική ικανότητα (discriminatory power). Την μεγαλύτερη επαναληψιμότητα έδωσαν το API20NE και η RAPD με τον εκκινητή OPA-13, την μεγαλύτερη ικανότητα τυποποίησης η SDS-PAGE, ενώ τη μεγαλύτερη διακριτική ικανότητα έδωσε η RAPD με τον εκκινητή OPD-13. Η πλέον σωστή ταξινόμηση, όπως προέκυψε από τη διακριτή ανάλυση, επιτεύχθη με τη μέθοδο SDS-PAGE. Η παρούσα εργασία αποδεικνύει ότι τα βιοχημικά συστήματα ταυτοποίησης (όπως το API20NE) μπορούν να χρησιμοποιηθούν με αξιοπιστία μόνο για αδρή αναγνώριση των περιβαλλοντικών ψευδομονάδων. Πληροφορίες σε βάθος για την ταυτότητα και τη φύση τους μπορούν να εξαχθούν με τη περαιτέρω εφαρμογή ηλεκτροφορητικών και μοριακών μεθόδων. Δεδομένης της ευρείας διασποράς, της ετερογένειας και της, έστω και δυνητικής, παθογόνου δράσης των ψευδομονάδων, είναι σημαντικό, από πλευράς δημόσιας υγείας, ο προσδιορισμός της ταυτότητάς τους να γίνεται με συνδυασμένη εφαρμογή βιοχημικών, ηλεκτροφορητικών και μοριακών μεθόδων ώστε να καθίσταται δυνατή η αναγνώριση στελεχών που μπορούν να αποτελέσουν αιτιολογικούς παράγοντες ασθενειών, ιδιαίτερα σε ομάδες υψηλού κινδύνου. / Three broadly used typing techniques, one biochemical (API20NE), one phenotypic (SDS-PAGE) and one molecular (RAPD), were employed for the identification and taxonomy of 160 environmental pseudomonas isolated from the aquatic environment in Southwestern Greece. In particular, the isolates were obtained from bottled waters (46%), potable waters (16%), waters from swimming pools (9%) and seawaters (29%). The isolates were identified by the system API20NE and then subjected to whole-cell protein electrophoresis (SDS-PAGE) and Random Amplified Polymorphic DNAs (RAPD) using two 10-mer primers. The API20NE system identified 88% of the whole bacterial population and classified them in 14 species, while SDS-PAGE classified 98.1% of the isolates in 20 groups and RAPD classified 94% of the strains in 22 groups using the primer OPA-13 and 34 groups using the primer OPD-13. The classification was achieved by applying cluster analysis in the protein or RAPD fingerprints of the isolates. Twenty isolates that could not be identified by the API20NE system, at least to the species level, were classified by the SDS-PAGE and the RAPD in a percentage of 100% and 90%, respectively. The reproducibility, typeability and discriminatory power of the three methods were compared to evaluate their application. The API20NE and the RAPD assay with primer OPA-13 showed better reproducibility in comparison with the other methods; the higher typeability was achieved by the SDS-PAGE assay while the higher discriminatory power was that obtained by the RAPD method with the primer OPD-13. The SDS-PAGE gave the higher percentage of “correctly classified” isolates, as it was assessed by discriminant analysis. This study shows that the rapid identification systems, such as the API20NE, may be reliable only for a rough characterization of environmental Pseudomonas. In order to acquire further information about their identities, other phenotypic and molecular techniques have to be applied. Given the ubiquity, heterogeneity and pathogenicity, either established or potential, of the environmental pseudomonas it is important, from a public health point of view, to monitor the identities of environmental Pseudomonas isolates using the combination of specific methods, so as to be possible for strains, which can serve as causative agents of diseases, especially in high risk population, to be recognizable.

This work concerns the interrelationship between thermodynamic, kinetic and structural aspects of crystal polymorphism. It is both experimental and theoretical, and limited with respect to compounds to substituted monocyclic aromatics. Two polymorphs of the compound m-aminobenzoic acid have been experimentally isolated and characterized by ATR-FTIR spectroscopy, X-ray powder diffraction and optical microscopy. In addition, two polymorphs of the compound m-hydroxybenzoic acid have been isolated and characterized by ATR-FTIR spectroscopy, high-temperature XRPD, confocal Raman, hot-stage and scanning electron microscopy. For all polymorphs, melting properties and specific heat capacity have been determined calorimetrically, and the solubility in several pure solvents measured at different temperatures with a gravimetric method. The solid-state activity (ideal solubility), and the free energy, enthalpy and entropy of fusion have been determined as functions of temperature for all solid phases through a thermodynamic analysis of multiple experimental data. It is shown that m-aminobenzoic acid is an enantiotropic system, with a stability transition point determined to be located at approximately 156°C, and that the difference in free energy at room temperature between the polymorphs is considerable. It is further shown that m-hydroxybenzoic acid is a monotropic system, with minor differences in free energy, enthalpy and entropy. 1393 primary nucleation experiments have been carried out for both compounds in different series of repeatability experiments, differing with respect to solvent, cooling rate, saturation temperature and solution preparation and pre-treatment. It is found that in the vast majority of experiments, either the stable or the metastable polymorph is obtained in the pure form, and only for a few evaluated experimental conditions does one polymorph crystallize in all experiments. The fact that the polymorphic outcome of a crystallization is the result of the interplay between relative thermodynamic stability and nucleation kinetics, and that it is vital to perform multiple experiments under identical conditions when studying nucleation of polymorphic compounds, is strongly emphasized by the results of this work. The main experimental variable which in this work has been found to affect which polymorph will preferentially crystallize is the solvent. For m-aminobenzoic acid, it is shown how a significantly metastable polymorph can be obtained by choosing a solvent in which nucleation of the stable form is sufficiently obstructed. For m-hydroxybenzoic acid, nucleation of the stable polymorph is promoted in solvents where the solubility is high. It is shown how this partly can be rationalized by analysing solubility data with respect to temperature dependence. By crystallizing solutions differing only with respect to pre-treatment and which polymorph was dissolved, it is found that the immediate thermal and structural history of a solution can have a significant effect on nucleation, affecting the predisposition for overall nucleation as well as which polymorph will preferentially crystallize. A set of polymorphic crystal structures has been compiled from the Cambridge Structural Database. It is found that statistically, about 50% crystallize in the crystallographic space group P21/c. Furthermore, it is found that crystal structures of polymorphs tend to differ significantly with respect to either hydrogen bond network or molecular conformation. Molecular mechanics based Monte Carlo simulated annealing has been used to sample different potential crystal structures corresponding to minima in potential energy with respect to structural degrees of freedom, restricted to one space group, for each of the polymorphic compounds. It is found that all simulations result in very large numbers of predicted structures. About 15% of the predicted structures have excess relative lattice energies of <=10% compared to the most stable predicted structure; a limit verified to reflect maximum lattice energy differences between experimentally observed polymorphs of similar compounds. The number of predicted structures is found to correlate to molecular weight and to the number of rotatable covalent bonds. A close study of two compounds has shown that predicted structures tend to belong to different groups defined by unique hydrogen bond networks, located in well-defined regions in energy/packing space according to the close-packing principle. It is hypothesized that kinetic effects in combination with this structural segregation might affect the number of potential structures that can be realized experimentally. The experimentally determined crystal structures of several compounds have been geometry-optimized (relaxed) to the nearest potential energy minimum using ten different combinations of common potential energy functions (force fields) and techniques for assigning nucleus-centred point charges used in the electrostatic description of the energy. Changes in structural coordinates upon relaxation have been quantified, crystal lattice energies calculated and compared with experimentally determined enthalpies of sublimation, and the energy difference before and after relaxation computed and analysed. It is found that certain combinations of force fields and charge assignment techniques work reasonably well for modelling crystal structures of small aromatics, provided that proper attention is paid to electrostatic description and to how the force field was parameterized. A comparison of energy differences for randomly packed as well as experimentally determined crystal structures before and after relaxation suggests that the potential energy function for the solid state of a small organic molecule is highly undulating with many deep, narrow and steep minima. / QC 20110527

Nas duas últimas décadas, várias espécies de Candida têm surgido como importantes patógenos hospitalares, no mundo e no Brasil. A identificação da origem da infecção tem importância na definição de estratégias de prevenção e controle. As estratégias para a prevenção de candidíase endógena podem focar, parcialmente, em métodos para redução da colonização de mucosas, por exemplo, a restrição ao uso de antibióticos de largo espectro. Entretanto, nos casos nos quais está envolvida uma fonte exógena, um expressivo reforço, na melhoria da qualidade das práticas de assistência à saúde, é prioritário para prevenção da transmissão. O objetivo deste estudo foi avaliar diferentes sítios de colonização por Candida como potenciais fontes de candidemia. O estudo foi desenvolvido em 3 hospitais no Brasil: Instituto Central do Hospital das Clínicas da Faculdade de Medicina de São Paulo, hospital universitário de nível terciário de complexidade, com mil leitos; o Instituto de Infectologia Emílio Ribas, um hospital com 200 leitos, referência para todo o Estado de São Paulo; e o Hospital Geral de Itapecerica da Serra, hospital de cuidados secundários da Grande São Paulo. Foram incluídos no estudo os pacientes com isolamento de Candida em hemocultura obtida de veia periférica após 48 horas de admissão hospitalar. As culturas de vigilância para Candida foram colhidas dos seguintes sítios: urina, reto, cavidade oral, pele (virilha e axila), pele ao redor do cateter e ponta de cateter caso disponível. A tipagem molecular foi realizada quando a mesma espécie de Candida (C. albicans, C. parapsilosis, C. tropicalis and C. glabrata) foi isolada no sangue e nos sítios de vigilância do mesmo paciente. A eletroforese em campo pulsado foi realizada para os isolados de C. albicans, C. parapsilosis e C. glabrata. A amplificação de segmentos polimórficos do DNA foi realizada para C. albicans e C. tropicalis. No total 63 pacientes consecutivos com candidemia foram incluídos no estudo no período de maio de 2004 a outubro de 2005. C. albicans foi isolada em 42% das hemoculturas, C. parapsilosis em 35%, C. tropicalis em 16%, C. guilliermondii, C. krusei, C. glabrata, e C. holmii, em 2% cada uma. Unicamente seis dos 10 isolados de ponta de cateter apresentaram perfil eletroforético idêntico aos isolados de C. parapsilosis do sangue. Os isolados de C. albicans do sangue e de culturas de vigilância do trato gastrintestinal correspondentes, oriundos de 12 pacientes, apresentaram genótipos idênticos. Os resultados sugerem que a colonização do trato gastrintestinal é a provável fonte de candidemia por C. albicans e que a candidemia por C. parasilosis é de origem exógena. / In the last two decades, Candida spp. have emerged as important nosocomial pathogens in the world and in Brazil. The identification of the source of infection is important in approaching prevention and control strategies. Strategies for the prevention of endogenous candidiasis may focus, to a certain extent, on methods for reducing mucosal colonization, for example limitation use of wide-spectrum antibiotics. However, in cases in which an exogenous source is involved, the aggressive reinforcement of adequate healthcare practices is mandatory to prevent transmission. The objective of this study was to evaluate different Candida colonization sites as potential sources for Candida fungemia. The study was done in 3 hospitals in Brazil: the Central Institute of Hospital das Clinicas, a 1000-bed tertiary-care hospital affiliated to the University of São Paulo; the Institute Emilio Ribas, a 200-bed infectious diseases hospital, reference for all the state of São Paulo; and the General Hospital of Itapecerica da Serra, a secondary-care community hospital located in area of the greater São Paulo. The patients with a positive blood culture for Candida, collected from a peripheral vein, were included in the study if they had to be hospitalized for 48 hours or more before candidemia. The following surveillance cultures for Candida were collected from: urine, rectum, oropharynx, skin (groin and axilla), skin around the catheter and catheter tip if available. Molecular typing was performed when the same species of Candida (C. albicans, C. parapsilosis, C. tropicalis and C. glabrata) was isolated from the blood and from surveillance sites of a single patient. Pulsed-field gel electrophoresis was performed for C. albicans, C. parapsilosis and C. glabrata isolates. Randomly amplified polymorphic DNA was performed for C. albicans and C. tropicalis. A total of 63 consecutive patients with candidemia were included in the period from May 2004 to October 2005. C. albicans comprised 42% of the blood isolates, C. parapsilosis 35%, C. tropicalis 16%, C. guilliermondii, C. krusei, C. glabrata, and C. holmii, 2% each. Six of the 10 isolates from catheter tips presented identical electrophoretic profiles to corresponding C. parapsilosis blood cultures and no other surveillance sites were related. C. albicans isolates from blood and from corresponding gastrointestinal surveillance sites from 12 patients presented identical genotypes. In conclusion, our results suggest that tract gastrointestinal colonization is the probable source of C. albicans candidemia and that C. parapsilosis candidemia is not endogenous.

No description available.

Les patients atteints de cancer traversent des conditions d’existence extrêmes demandant un cadre spécifique de prise en charge psychothérapique. Le cancer et les soins anticancéreux indispensables, forment pourtant la situation cancéreuse envahie par les logiques processuelles du cancer, violentes. Cette situation peut être un raz de marrée dans la vie d’un sujet, emportant les convictions les plus établies et les bases narcissiques-identitaires et du caractère les plus ancrées. Le sujet présente un risque majeur d’effondrement. De plus, la puissance du traumatisme actuel puise ses racines dans la reviviscence de traumatismes primaires restés jusque là éteints. Leur retour a lieu sous la forme de sensations hallucinatoires induisant des états de corps et des états de perception du monde extérieur psychiquement irreprésentables. Le sujet se vit et s’éprouve alors passivement, sans pouvoir s’affecter véritablement. Mortifères, la pesanteur, l’inertie et la douleur dominent ou au contraire, le sujet se sent à vif, hypersensible, envahi, persécuté, au risque de l’éclatement. Le monde s’articule alors essentiellement sur cette bipolarité que vient recouvrir la défense opératoire radicale de la blancheur. Elle jette son dévolu sur le monde, les relations, les objets, les affects, le corps du sujet. Parfois, rien ne touche ce dernier dont la psyché s’est resserrée autour de son noyau archaïque aux limites psyché-soma. Le cancer éradique la subjectivité, subtilisant le principe actif des logiques de l’originaire. Cet état de mélancolie blanche parfois durable, n’est que l’une des phases d’une processualité mélancolique polymorphe. Cette dynamique domine la vie du sujet selon deux tendances à la proto-mélancolie et à la proto-manie, qui remplacent le monde affectif par une propension à l’inertie ou à la psychomotricité. Le travail de mélancolie vise la relance des capacités d’identification en impasse. Nous allons étudier les modalités spécifiques du transfert et en particulier la mobilisation essentielle d’un transfert formel de base. Il fonctionne à partir de l’activation originaire en double de signifiants formels alors partagés par le thérapeute et son patient. Des mouvements de léthargie et d’excitations psychocorporelles peuvent gagner le clinicien et plonger la relation thérapeutique dans des états crépusculaires, relatifs au cancer et au retour des traumatiques primaires. Nous verrons comment le but premier de la psychothérapie vise l’utilisation psychique – et non l’éradication – de l’objet-cancer, comme moyen de forger les conditions de viabilité du cadre : permettre la mise en représentation des états de corps, rétablir la symbolisation, l’imagination et le recours aux fantasmes inconscients. Ce sont là les bases indispensables d’une psychothérapie auprès des patients atteints de cancer. / Cancer patients experience extreme conditions of existence requiring a specific form of psychotherapy. The cancer and essential anticancer treatments together form the cancerous situation, invaded by the cancer’s violent, processual logic. This situation can constitute a sea change in the subject’s life, sweeping away their most firmly held convictions and the most deeply rooted foundations of their narcissistic identity and character. The subject is at major risk of suffering a breakdown. In addition, the ‘actual’ trauma draws strength from the revival of primary traumas up until now extinguished. Their return takes the form of hallucinatory sensations producing states of body and perception of the external world psychologically unrepresentable. The subject sees and experiences themself passively, without really being capable of feeling affected. Deadly dullness, inertia and pain dominate or, on the contrary, the subject feels vividly alive, hypersensitive, invaded and persecuted, at the risk of bursting. The world essentially revolves around this bipolarity, which the radical operational defence system covers in whiteness. It throws its mantle over the world, relationships, objects, affects and the subject’s body. Sometimes nothing can touch the subject at all, and their psyche is reduced to its archaic core, at the edge of psyche-soma. The cancer eradicates subjectivity, steeling away the active principle of primal logic. This sometimes lasting state of white melancholy is but one phase in a polymorphic melancholic processuality. This force dominates the subject’s life, with a tendency either to proto-melancholy or proto-mania, which replace the affective world by a propensity to inertia or psychomotricity. The aim of melancholy work is to revive the deadlocked capacity for identification. We will examine the specific use of transference and, in particular, the key implementation of a basic formal transference. This works based on the dual primal activation of formal signifiers shared by the therapist and their patient. The therapist may be subject to motions of lethargy and psychocorporal excitations, plunging the therapeutic relationship into crepuscular states, relative to the cancer and to the return of primary traumas. We will look at how the principle aim of psychotherapy is the psychological use, and not eradication, of the cancer object, as a means of forging the conditions rendering the therapeutic context feasible: allow the representation of states of body, restore symbolisation, imagination and recourse to unconscious fantasy. Together, these form the essential basis of psychotherapy for cancer patients.

Many imprinted genes are necessary for normal human development. Approximately 70 imprinted genes have been identified in humans. I developed a novel approach to identify candidate imprinted genes in humans using the premise that imprinted genes are often associated with nearby parent-of-origin-specific DNA differentially methylated regions (DMRs). I identified parent-of-origin-specific DMRs using sodium bisulfite-based DNA (CpG) methylation profiling of uniparental tissues, mature cystic ovarian teratoma (MCT) and androgenetic complete hydatidiform mole (AnCHM), and biparental tissues, blood and placenta. In support of this approach, the CpG methylation profiling led to the identification of parent-of-origin-specific differentially methylated CpG sites (DMCpGs) in known parent-of-origin-specific DMRs. I found new DMRs for known imprinted genes NAP1L5 and ZNF597. Most importantly, I discovered many new DMCpGs, which were associated with nearby genes, i.e., candidate imprinted genes. Allelic expression analyses of one candidate imprinted gene, AXL, suggested polymorphic imprinting of AXL in human blood.

Many imprinted genes are necessary for normal human development. Approximately 70 imprinted genes have been identified in humans. I developed a novel approach to identify candidate imprinted genes in humans using the premise that imprinted genes are often associated with nearby parent-of-origin-specific DNA differentially methylated regions (DMRs). I identified parent-of-origin-specific DMRs using sodium bisulfite-based DNA (CpG) methylation profiling of uniparental tissues, mature cystic ovarian teratoma (MCT) and androgenetic complete hydatidiform mole (AnCHM), and biparental tissues, blood and placenta. In support of this approach, the CpG methylation profiling led to the identification of parent-of-origin-specific differentially methylated CpG sites (DMCpGs) in known parent-of-origin-specific DMRs. I found new DMRs for known imprinted genes NAP1L5 and ZNF597. Most importantly, I discovered many new DMCpGs, which were associated with nearby genes, i.e., candidate imprinted genes. Allelic expression analyses of one candidate imprinted gene, AXL, suggested polymorphic imprinting of AXL in human blood.