Biomedical subjects
Publications and source records attributed to M Robin.
The authors report a case of acute fetal distress and immediate respiratory distress in a neonate presenting with large hydrometrocolpos. This diagnosis, infrequently concerned in such a situation, should be suggested in cases with abdominal tumors.
The potential of a new, potent, irreversible and selective inhibitor of monoamine oxidase type B, (E)-2-(3,4-dimethoxyphenyl)-3-fluorallyamine (MDL 72145), to augment the effects of L-DOPA in an animal model which reproduces the biochemical defect of Parkinson's disease has been evaluated. In rats bearing unilateral 6-hydroxydopamine lesions of the nigro-striatal dopamine pathways, both MDL 72145 and clorgyline, a selective inhibitor of MAO A, augmented the contralateral turning response to L-DOPA combined with carbidopa. The potential of inhibitors of MAO to interact adversely in the periphery with L-DOPA was investigated in the pithed rat; L-DOPA was given either intravenously or intraduodenally. Clorgyline consistently potentiated L-DOPA when given 18 h before testing. Neither MDL 72145 nor the selective inhibitor of MAO B, L-deprenyl, augmented the cardiovascular effects of intraduodenally administered L-DOPA. The data provide no reason to suppose that MDL 72145 would be very different in clinical use from L-deprenyl which is both effective and well-tolerated as an adjunct to the L-DOPA-based therapy of Parkinson's disease.
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Axillary lymphoscintigraphy (ALS) has been investigated in 51 patients with operable breast carcinoma between July 1982 and February 1984. Pre-operative intra-tumoral injection of 2.5 cm Ci of technetium 99 m antimony sulfide colloid has been performed before axillary dissection. We compared the scans produced by ALS with the results of pre-operative clinical examination of the axilla (UICC criterias) and to the histological status of the nodes surgically removed. We focused on the statistical methodology because, for us, most of the studies use inadequate tests. Axillary lymphoscintigraphy did not predict axillary metastase in breast cancer with precision. Its score was under clinical exam. Today, we are not allowed to abandon axillary dissection for pre-operative ALS. That simple and non traumatic examination appeared to be of no value in order to determine the axillary metastatic nodal status in breast cancer.
The authors have studied the incidence and short term prognosis of neonatal bacterial infections among 3,833 newborn babies admitted into 12 intensive care and/or neonatal units of Ile-de-France (Paris region) during 1984. this study was carried out with a computerized data base system. Septicemia was present in 3% of the total population, purulent meningitis in 0/6% and urinary tract infection in 1.4%. The authors have found a great incidence of group B streptococci (26% of septicemia) and e. coli (18% of septicemia). The frequency of use of antibiotics is very different among the units, without evidence of correlation with therapeutic results or with incidence of demonstrated bacterial infections. So, it appears necessary to reevaluate the indications of antibiotherapy, with more objective arguments. The authors emphasize the interest for such studies of computerized epidemiologic multicentric works.
This article aims to demonstrate the value of the analysis of maternal language in the study of mother-infant interactions. It reviews questions confronting three types of data in the literature: modifications in the language of mothers when they address a baby, the early mother infant interactions in their verbal and non-verbal aspects, the recent linguistic findings and notably those of utterance acts theory. The different approaches discussed complement each other. Through them one sees how the analysis of maternal language can enrich the description of observable behavior in mother-child interactions and can make possible the exploration of the successive representations which the mother has both of her child and of herself as a maternal figure. In conclusion, we propose several lines of inquiry, drawn from utterance acts theory, which reveals the relationship between the words addressed to the baby, the partners in the interaction, and the situational context. This permits us to look at the way in which the baby's identity as a subject is progressively constituted for the mother.
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Pupillary effects of several opioids were examined as part of a broader in vivo study of multiple opioid receptors in the rat. Agonist activity, stereospecificity, and naloxone sensitivity were determined by methadone (Me), ethylketocyclazocine (EK), and N-allylnormetazocine (SKF 10,047), selected for their purportedly predominant actions at mu, kappa, and sigma receptors, respectively. After an acute, subcutaneous injection of each drug, pupil area and fluctuations in pupil size were measured by means of an infrared video pupillometer on line with a microcomputer data processing and storage system. Despite differences in the magnitude of the response, each opioid tested produced an increase in pupil size which was stereospecific, independent of behavioral responses to the drugs and, for 1-Me and 1-SKF 10,047, dose-related. Other differences among the opioids were found in their ability to induce fluctuations (1-Me and 1-EK) and a pendular nystagmus (1-SKF 10,047 only), and in their sensitivity to naloxone. Although 1.0 mg/kg naloxone completely reversed 1-Me-induced mydriasis, 10 mg/kg was needed to reverse 1-EK, and this dose only partially antagonized 1-SKF 10,047. These characteristic patterns of pupillary responses to opioids in terms of agonist activities and naloxone sensitivities indicate that the different opioid receptor types subserve different functions with respect to pupillary control.
The pharmacological properties of two selective inhibitors of monoamine oxidase (MAO) type B, L-deprenyl and MDL 72145 [(E)-2-(3,4-dimethoxyphenyl)-3-fluoroallylamine, HCl], have been investigated in rats and mice in relation to their effects on MAO. Selective inhibition of MAO B achieved following 18 h pretreatment with L-deprenyl and/or MDL 72145 did not per se lead to prominent pharmacological activity; no effects were seen in the mouse "Behavioural Despair" test, hypothermia induced by reserpine in mice was neither prevented nor reversed and there was no change in the cardiovascular responsiveness of the pithed rat to tyramine, noradrenaline or stimulation of the spinal sympathetic outflow. L-Deprenyl differed from MDL 72145 in that short term treatment with this drug caused positive effects in the "Behavioural Despair" test, reversal of reserpine hypothermia, indirect sympathomimetic stimulation of blood pressure and heart rate in the pithed rat and ipsilateral rotation in rats with unilateral nigro-striatal lesions. Qualitatively similar effects were seen with dexamphetamine. The marked difference between the pharmacological effects of MDL 72145 and L-deprenyl despite equivalent inhibition of MAO B suggests that many of the pharmacological actions of L-deprenyl result from its amphetamine-like sympathomimetic properties. MDL 72145 can, therefore, be considered a more reliable tool with which to explore the functional importance of MAO B inhibition in experimental animals and man.
We hypothesised that it would be possible to prevent the development of post-synaptic dopamine receptor supersensitivity to 6-hydroxydopamine lesions of the nigro-striatal tract in rats if they were constantly infused with the dopamine agonist apomorphine. Using osmotic minipumps to infuse apomorphine for 15 days in unilaterally lesioned rats, it was possible to delay the development of supersensitivity of the lesioned side for 9 days but not to prevent its eventual appearance. At the same time, evidence for the development of subsensitivity of presynaptic dopamine receptors of the intact side following chronic infusion of apomorphine was inferred from the production of rotations directed towards the lesioned side.
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Fourteen patients with histologically proven embryonal carcinoma of the testis with pulmonary metastasis (10 pts) or para-aortic nodal involvement (4 pts) were treated by a chemotherapy regimen including vinblastine, bleomycin and cisplatin. Extreme ages were 19 and 51 years with a median age of 32 years. Median duration of treatment was 6 months (6 cycles of chemotherapy) without maintenance treatment. After completion of chemotherapy, 6 patients in complete remission received para-aortic node irradiation (45 Grays in 25 fractions). One patient had a para-aortic node dissection, histologically negative. With a median follow-up of 47 months (maximum 92 months, minimum 12 months), eleven patients are in complete remission (78.6%). Three patients are dead from the disease, in spite of salvage chemotherapy. There were no toxic deaths. Disease-free actuarial survival is 74% at 4 years. Our results confirm the excellent therapeutic results of this chemotherapy regimen in embryonal carcinoma of the testis with pulmonary metastasis and/or para-aortic nodal involvement.
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In 182 critically ill patients, after admission delayed hyersensitivity skin testing have been systematically performed with 3 antigens (tuberculin, candidin, varidase). Mortality in anergic patients was 55% while it dropped to 19% when at least one response was positive. A highly significant relationship was found between anergy and mortality (p less than 10(-5)) whether death was related to sepsis (p less than 10(-4)) or not (p less than 0.02). In patients with major sepsis, anergy was more frequent (38%) than in non septic patients (21%) (p less than 0.01). In 69 patients skin testing with phytohemagglutinin was performed. Seven out of 8 unresponsive patients were anergic and 5 died. The results suggest that in critically ill patients cellular immunity skin testing may early select high risk patients exposed to septic complication. In these patients several important measures should be promptly taken including superinfections prevention, adapted nutritional intake and septic focus eradication.
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