Congenital atrioventricular block: histological aspects

It is known that maternal immunological factors such as systemic disease are involved in the genesis of cardiac conduction problems in the fetus but the histologic changes in the conduction system are less documented. We report the case of a 33-year-old woman with no significant medical history. Her first pregnancy was induced by Clomifene. At 17 weeks of gestation, the fetus presented sonographic abnormalities characteristic of a complete atrioventricular block. Biological investigations found anti-SSA and -SSB antibodies. Clinical history search for systemic disease was positive for photosensitivity, lasting 10 years, suggesting the diagnosis of systemic lupus erythematosus. The patient was treated with prednisone 20 mg per day but fetal death occurred at 29 weeks of gestation. Histological examination of the fetal heart showed an altered atrioventricular node and bundle of His with fibrosis, calcifications, endocardial fibroelastosis and mononucleated inflammatory cells. The search for these specific lesions can be determinant in establishing the disease pathogenesis; also, it is important to eliminate this diagnosis in an unexplained fetal death.     

La planification stratégique à Ottawa et à Québec: une comparaison de quelques ministères

Sommaire: Douze ministères (six à Ottawa et six à Québec) ont fait l'objet d'une recherche visant àétudier le processus de planification stratégique. Cette planification vise d'abord à identifier les enjeux stratégiques et à déterminer les orientations d'un ministère. Elle vise aussi, dans plusieurs ministères étudiés, à introduire un changement culturel, à mieux intéger les diverses parties de l'organisation, à améliorer l'efficacité et la productivité, à accroître la satisfaction et la qualité de vie au travail, ainsi qu'à améliorer les services à la clientèle et les communications. Au niveau de la gestion du processus, les auteurs ont constaté de grandes différences entre les ministères québécois mais une certaine homogénéité au niveau des ministères fédéraux où le processus semble davantage institutionnalisé. Par ailleurs, à Québec, les plans stratégiques donnent lieu à la préparation de plans annuels d'action élaborés pour l'ensemble du ministère, alors qu'à Ottawa, la responsabilité de la mise en application est laissée aux responsables de secteurs. Enfin, les auteurs ont identifié certaines conditions de succès: l'implication personnelle du sousministre et de l'équipe de direction, l'appui du ministre, la stabilité de la direction, un exercice conçu sur mesure, la simplicité du processus, la capacité de gérer les conflits, la volonté de régler les problèmes urgents sans attendre la fin du processus, la consultation et la responsabilisation des gestionnaires et, enfin, l'intégration de la planification stratégique au processus de prise de décision central du ministère. Abstract: This study designed to analyse the strategic planning process covered twelve departments (six in Ottawa and six in Quebec City). This planning effort is designed primarily to identify the strategic stakes and to determine the orientation of a department. In several departments studied, it also aims to introduce cultural change, to better integrate the various components of the organization, to improve efficiency and productivity, and to raise work satisfaction and the quality of working life, thus improving client services as well as communications. Regarding the management of the process, the authors found major differences between Quebec departments, but a certain homogeneity among federal departments, where the process seems more institutionalized. Moreover, in Quebec, strategic plans involve the preparation of annual action plans developed for an entire department, whereas in Ottawa responsibility for implementation is left to sector heads. Finally, the authors identify certain conditions for success: the personal involvement of the deputy minister and the management team, the minister's support, management stability, a custom-designed exercise, the simplicity of the process, the ability to manage conflict, a willingness to solve urgent problems without waiting for the end of the process, consultation and accountability of managers and, finally, integration of strategic planning into the department's central decision-making process.     

Quantification of mitochondrial DNA in human blood cells using an automated detection system

The 4977 bp deletion of mitochondrial DNA (mtDNA) accumulates in postmitotic tissues with advancing age. The purpose of our study was to detect and quantify these deletion even in blood cells with a high turnover activity. Whole venous blood, isolated human platelets and peripheral blood mononuclear cells (PBMCs) were collected from 10 unrelated donors aged 20-71 years and total DNA was extracted. PCR was performed for total and mutated mtDNA using two different primer pairs and two fluorogenic probes labeled with the fluorescent dyes FAM and VIC. Specific PCR products were generated, detected and quantified in a real-time PCR. The amplification products of total and deleted mtDNA could be detected in each sample and did not exhibit any differences in the amount of the deleted mtDNA in whole blood, human platelets or PBMCs. Our data did not show any accumulation of the 4977 bp deletion with increasing age as it was observed for several other tissues.     

Fatal rupture of hepatic adenomatosis: Autopsy case and review of the literature

Hepatic adenomatosis is a rare disease consisting of multiple adenomas in otherwise-normal liver parenchyma. Though the discovery of this entity goes back several years, its diagnosis is still challenging in terms of its definition and pathophysiology. Clinically, patients may be completely asymptomatic and the diagnosis is only made incidentally through imaging tests. The discovery could be made when complications occur such as intraperitoneal hemorrhage with hypovolemic shock due to the rupture of an adenoma. We report a fatal case of a ruptured adenoma in a case of hepatic adenomatosis discovered at autopsy. In order to achieve a better view of this disease, we conducted a literature review on this subject describing the pathogenesis, manifestations, and autopsy contribution to addressing this entity.     

Japan’s reluctance in East Asian economic integration

Until 1997, the only preferential trading arrangement, which existed in East Asia, was the ASEAN Free Trade Area (AFTA). Former Prime Minister of Malaysia Tun Dr. Mahathir had realized earlier the deficiency of AFTA in terms of stimulating economic development. In 1990, he proposed to ASEAN members to form the East Asian Economic Group. Due to regional political factors, his proposal was turned down and replaced with the East Asian Economic Caucus in 1992. In 1997, again, he proposed that ASEAN needed to establish large economic cooperation with other countries in East Asia. His suggestion had been warmly responded by the members of East Asian countries. At the ASEAN summit in Manila 1999, ASEAN Plus 3 (APT) was created. ASEAN, China, Japan, and South Korea had agreed and reached a joint statement to form a free-trade area by the year 2020. The establishment of APT was timely since most countries in the world are moving toward establishing wider or larger economic blocs due to the failure of multilateralism of the WTO in creating a new trade agreement. However, there is a shortcoming in the process of building APT, in the minimal and uncertain role of Japan in integrating economies in East Asia. This behavior has disappointed members of the group. The intention of this paper is to discuss the behavior of Japan in the economic integration process in East Asia.

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The Heritability of Palatal Rugae Morphology Among Siblings*†

Although there is clinical applicability of the palatal rugae as an identification tool in forensic odontology, controversy exists whether the palatal rugae patterns are stable or variable. The greater the genetic component, the higher the probability that palatal rugae patterns are stable. The aim of this study was to compare the palatal rugae morphology between full siblings and the proportion of variability due to genetic component. This cross-sectional study was conducted on digital models of 162 siblings aged 15–30 years old. The palatal rugae patterns were assessed with Thomas and Kotze (1983) classification using Geomagic Studio software (3D Systems, Rock Hill, SC). The palatal rugae morphology between siblings showed significantly similar characteristics for total number of left rugae (p = 0.001), left primary rugae (p = 0.017), secondary rugae for right (p = 0.024) and left sides (p = 0.001), right straight rugae (p = 0.010), and right convergent rugae (p = 0.005) accounting for at least 6.25%-12.8% of the variability due to heredity. Despite the similarities found, the palatal rugae patterns showed significant differences between siblings of at least 46.9% (p = 0.001). Zero heritability was found in 9 of the 14 rugae patterns. Meanwhile, total number of rugae, primary, backward, and convergent rugae showed moderate heritability (h² > 0.3) and total number of secondary rugae showed high heritability (h² > 0.6). In conclusion, despite the individuality characteristics, an appreciable hereditary component is observed with significant similarities found between sibling pairs and the palatal rugae patterns were both environmentally and genetically influenced.     

Elective Affinity as an Intellectual Connection: a Review of Mohammed Arkoun’s Relation to the Institute of Ismaili Studies

A prominent name in modern-day philosophy and a true public intellectual, Mohammed Arkoun (1928–2010) enjoys an international academic reputation. The present article aims to analyse the relationship Arkoun maintained with a specific learning space, the Institute of Ismaili Studies (IIS). This research institute, based in London, strives to promote research that focuses on Islam and on Muslims and serves as a junction point for the Ismaili community. This paper will attempt to clarify the processes at play in this collaboration between a thinker and an institution: what are the conditions that influence the institutional ties of an intellectual? How is an affinity formed and negotiated between a specific organisational framework and a personal project?     

Fiscal transparency puzzle and electoral institutions: applying a 3Ds approach for tracking the action cycle in Egypt

This article aims at contributing to the discussion on the fiscal transparency puzzle. The authors challenge the idea that fiscal disclosure can directly increase fiscal accountability. Using an original data set at the level of individual members of parliament (MPs) in the Egyptian parliament, constructed from content analysis of budgetary discussions during the period 2000–10, it is shown that political incentives determined by a majoritarian electoral system curbed the willingness to check government fiscal behaviour, even among opposition MPs. This is because MPs still favoured pork-barrel behaviour to boost their re-election chances. Moreover, fiscal data disclosed could not be communicated to voters and the opposition showed a relatively higher avoidance against fiscal disclosure. The authors conclude that the electoral system is a dominant factor in shaping the final effect of transparency given its influence on the structure of political incentives.     

Mahmud Muhammad Taha and the Rise and Demise of the Jumhuri Movement

Mahmud Muhammad Taha founded the Jumhuri (Republican) Party in 1945 in the context of the fight for Sudan's independence. The nature of the party's ideology went through a radical change after Taha emerged from a mystical retreat in 1951. In the light of this ideology, the party advocated a "neo-Islamist" position committed to a reconciliation of Islam and modernity. Some of Taha's social and political stances are critically examined. Particular attention is paid to the reasons at the root of the demise of the Jumhuri movement after Taha's execution in January of 1985.