Biomedical subjects
Publications and source records attributed to M Dumont.
What took place following the delivery of princess Charlotte of England's 4 000 gm stillborn infant? Two hours after manual removal of the placenta she suddenly developed malaise and weakness, followed by somnolence then agitation, with progressive worsening and death. Professor Dumont comments on the accounts describing this event at that time in history and offers a retrospective diagnosis.
The authors have studied 600 cases histories of fetal growth retardation over a period of 11 years from 1970 to 1981. The incidence of growth retardation was 600 cases in 24,906 deliveries from October 1970 to the end of 1981. This gives an incidence of 2.41%. This figure tends to get less progressively, going from 2.5% at the beginning of our study to a little more than 2% in the last years. 1,498 babies were born weighing less than 2,500 g: 600 of them were really true intra-uterine growth retardations (40%) and 898 were babies born prematurely with normal weight for their gestational age. 227 of the 600 small for date babies were born before the 38th week of pregnancy (37.8%). Girls represented 55% of the cases of growth retardation. There was no significant difference in the distribution of age groups of the mothers of small for date babies and the control population. 57% of the women were primiparas whereas only 38% were primiparas in the control population. There is a close relationship between primiparity and young maternal age. 80% of mothers who were under 25 years of age were primiparas. The height of the mother, less than 1,50 m, in our study was significantly less than in the control population (11.9% as against 2.5%). 24% of the mothers weighed less than 45 kg as compared with 7.1% in the general population. The weight gain was not significantly different from that in the control population, if it is not taken in account of mothers who had toxaemia of pregnancy. 158 cases out of the 600, which represents 26% of the mothers, had toxaemia of pregnancy and this confirms how important this aetiological factor is in intra-uterine growth retardation. 113 placentas (18.8%) were studied. They showed histological abnormalities such as infarcts (47 cases) and ischaemic necrosis (18 cases). These features are often associated with toxaemia of pregnancy and/or heavy maternal smoking in 58% of cases. There were abnormalities of the umbilical cords. These were variable so that one could not say that any one was an important cause of intra-uterine growth retardation. A single umbilical artery was found in 8 cases (1.33%). We only speak of recurrent fetal growth retardation, excluding cases of toxaemia, when three or more small for date babies have been born without any particular aetiological reason.(ABSTRACT TRUNCATED AT 400 WORDS)
The biliary maximum secretory rate (SRmax.) of glycoursodeoxycholate in the bile fistula anaesthetized rat was about five times that of unconjugated ursodeoxycholate. Likewise, the biliary SRmax. of tauro-7-ketolithocholate was more than three times that of unconjugated 7-ketolithocholate. The SRmax. of 7-ketolithocholate infused with taurine (to avoid depletion of the taurine pool) was still significantly lower than that of exogenous tauro-7-ketolithocholate. These data support the hypothesis that, for bile acids that are poorly water soluble, the maximal biliary secretion rate is dependent on conjugating capacity, which is the limiting step in the overall transport from plasma into bile.
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Immunoreactive dynorphin (ir-Dyn), immunoreactive leucine-enkephalin (ir-Leu-Enk) and various other neuropeptides were measured in acid extracts of bovine adrenal medulla and isolated adrenal chromaffin cells. Their respective levels ranged as follows: Leu-Enk greater than Dyn greater than bombesin greater than vasoactive intestinal peptide (VIP) greater than neurotensin greater than substance P. Comparisons of the total catecholamine levels with the levels of Leu-Enk in both extracts gave ratios in the same order of magnitude (2600, tissue extract and 5000, cell extract). However, the catecholamine/Dyn ratio in the tissue extract (138 000) was much higher than that found in the cell extract (20 180), suggesting a possible selective degradation of Dyn in tissue extract as compared with cell extract or an induction of Dyn biosynthesis in cells which have been isolated from their natural microenvironment. Immunofluorescence staining of isolated chromaffin cell sections revealed the presence of ir-Dyn in 5 to 10% of the total cell population. To localize ir-Dyn in regard to Leu-Enk and catecholamines, adrenal chromaffin cells were separated into three populations (I, II, and III) on a stepwise bovine serum albumin (BSA) gradient. Relative high levels of ir-Dyn were measured in cell layer I (4 pmol/10(6) cells), a cell population enriched in noradrenaline. However, ir-Leu-Enk was more concentrated in cell layers II and III (5.3 and 8.3 pmol/10(6) cells), two populations enriched in adrenaline. Isolation and high pressure liquid chromatography (HPLC) analysis of adrenomedullary Dyn indicated the presence of at least five molecular forms corresponding to Dyn-(1-11), Dyn-(1-12), Dyn-(1-13), Ala-containing-Dyn-(1-13) and a nonidentified molecule eluting closely to Dyn-(1-13). These data indicate that adrenal ir-Dyn and ir-Leu-Enk have distinct cellular distributions. In addition, the identification of Dyn fragments in bovine adrenal medulla indicates that these short peptides may be considered as natural active forms of Dyn.
Using prototypic ligands for each type of opioid receptors (mu, delta, kappa, and sigma) as well as compounds derived from each class of endogenous opioid peptides (beta-endorphin, enkephalins, and dynorphins), we have undertaken the characterization of adrenomedullary opioid binding sites. The specific binding of [3H]etorphine ([3H]ET) to a membrane preparation of bovine adrenal medulla was greatly increased when the incubation temperature was raised from 22 to 37 degrees C. Characterization of the opioid binding sites was obtained at 37 degrees C with [3H]ET (nonspecific opioid ligand), [3H]ethylketocyclazocine ([3H]EKC; kappa), [3H]dihydromorphine ([3H]DHM; mu), [3H]-[D-Ala2,D-Leu5]enkephalin ([3H]DADLE: delta), and N-[3H]allylnormetazocine ([3H]SKF-10047; sigma) in the absence or presence of blocking agents for cross-reacting receptors. [3H]ET had a high affinity binding site (KD = 0.98 nM) with a Bmax of 119 pmol/g protein. All the other opioid compounds showed biphasic saturation curves with KD ranging from 0.6 to 1.29 nM for the high affinity binding site and from 2.49 to 12.1 nM for the low affinity binding site. The opioid mu-receptor was characterized by the high affinity binding site for [3H]DHM (KD = 1.29 nM; Bmax = 38 pmol/g protein). Blockade of the cross-reacting receptor sites for [3H]EKC, [3H]DADLE, and [3H]SKF-10047 revealed the presence of kappa (KD = 0.66 nM; Bmax = 12 pmol/g protein), kappa 2 (benzomorphan site; KD = 11.1 nM; Bmax = 56 pmol/g protein), delta (KD = 0.67 nM; Bmax = 4.7 pmol/g protein), and sigma (KD = 4.54 nM; Bmax = 32 pmol/g protein) opioid receptors.(ABSTRACT TRUNCATED AT 250 WORDS)
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The author starts by showing that the first forceps were originally designed to handle hot metal in founderies and that the word derived from "formus" (hot) and "capere" (to take). The author, Professor Dumont, tries to trace the history of the development of modern forceps, discussing whether the Arabs or such well known authors of classical works as Roesslin, Raynald, Rueff and Rousset knew of the instrument or whether they just described instruments of destruction. Crainz in 1941 had written an article to discuss whether the early Romans had forceps and came to no firm conclusion. Speert in 1957 said that a live baby had been born earlier than the 17th Century, possibly as early as the 2nd or 3rd century of the Roman empire, i.e. over 300 years before Jesus-Christ, by forceps. The description is given of a bas-relief depicting forceps delivery but no one knows whether the bas-relief is genuine or not. The discovery of the Chamberlen forceps in 1813 at Woodham Mortimer Hall in Essex, England, and the lengthy description of how the Chamberlens kept the secret of the invention of the forceps over several generations is very well described. Then follows the story of Jean Palfyn's "mains de fer" which led later to Levret and his long curved forceps. Returning to England, the authors describes how William Smellie covered his forceps with leather so that the patients should not feel the cold metal or hear the clink of the handles. The author then quotes Dr Slop, who appears in Laurence Sterne's "Tristram Shandy" and who knew the Smellie's forceps. Sacombe was an arch enemy of instrumental delivery. The role of the Dane Saxtorph, and how Antoine Dubois delivered Napoleon's son, the future King of Rome, by forceps, is reviewed. Madame La Chapelle and her work as well as that of Scanzoni, and finally of Simpson who first used anaesthesia after inventing a forceps, continues the history. Great names such as Pajot, Tarnier with his axis-traction forceps and finally Barton, Piper and Kielland with their inventions are all described in this beautiful history of forceps.
The authors have studied the progress of labour and the neonatal consequences for 100 patients who started labour with a high temperature. A control group consisted of 100 patients with normal temperature and the comparison showed that there was a raised risk of dystocia and of fetal distress during labour. The maternal and neonatal complications were studied in relationship to the aetiology, which was most frequently premature rupture of the membranes. The authors suggest the way these cases should be managed to lessen the maternal and neonatal risk which is associated with pyrexia in labour. These are: culturing blood, urine and a vaginal or, better still, endocervical swab; giving penicillin with gentamycin and metronidazole throughout the labour and in the first few days after delivery. Very careful monitoring should also be carried out.
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In 1963 F.D. Moore and his colleagues described "the body cell mass", but up till now there has not been a practical method to isolate other components of the body. Electrical body impedance measurement makes it possible in pregnant women not only to separate the values relating to maternal tissues from those relating to fetal tissues but it is also possible to make out in the Lean Mass of the mother those parts that are due to extra-cellular fluid in the supporting tissues and particularly those that come from the cytoplasmic mass (water, proteins, electrolytes and dissolved substances). The method, which is founded on a well-known scientific basis, is simple and almost a-traumatic. It consists in measuring the electrical resistance given to the passage of a weak alternating current that is passed through two electrodes, one of which is placed on one hand and the other on the foot of the other side. This method gives a result in units of electricity (ohms) of the value of the active cellular component of the mother. As we know that the normal values are closely linked to the morphological features of the woman which are fixed, it is easy to determine them and compare the measurement obtained by impedance at the time the measurements are being taken. We therefore obtain an index N which is normally equal to 1 +/- 0.10 which gives evidence of an excess of cellular content when Nis greater than 1.10 or a decrease if N is less than 0.90.(ABSTRACT TRUNCATED AT 250 WORDS)
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Veralipride was given to 74 women with menopausal disorders. Clinical tolerance proved excellent and no abnormal variations were recorded in monitored biological parameters. Effectiveness is very satisfactory, all the more so that disorders are more specific and severe.
The distribution of immunoreactive-dynorphin (ir-Dyn) in isolated subpopulations of bovine adrenal chromaffin cells was examined and compared with that of adrenaline (A), noradrenaline (NA) and ir-Leucine-Enkephalin (ir-Leu-Enk). Using a stepwise bovine serum albumin (BSA) gradient, various populations of catecholamine-storing cells were separated and designated as cell layers I, II and III. Cell layer I contained more NA than A; cell layer II contained slightly more A than NA whereas cell layer III was highly enriched in A. The original cell preparation contained 2.9 times more ir-Leu-Enk than ir-Dyn (4.7 and 1.6 pmoles per 10(6) cells, respectively). After separation of the cells on BSA gradient, ir-Dyn was mainly detected in cell layer I (4.0 pmoles/10(6) cells) whereas ir-Leu-Enk was concentrated in cell layer III (8.3 pmoles/10(6) cells). Both peptides were secreted in response to acetylcholine (5 x 10(-5) M), but the amount secreted was in accordance with the cell content in each peptide. After subcellular fractionation of the adrenal medulla, the neuropeptides were found in close association with catecholamines in the secretory granules. These results indicate that bovine adrenal chromaffin cells can be isolated according to their specific content in A, NA and opioid peptides and are consistent with the hypothesis of distinct biosynthetic pathways for Dyn and the Enk.
Twelve enzymatic activities, involved in the metabolism of proteins, collagen, glycosaminoglycans, or in the energy metabolism, were studied in 72 cervical biopsies obtained after delivery of the placenta and in 12 cervices obtained by hysterectomy in nonpregnant patients. Although these activities display high interindividual variations, they are greatly and significantly increased at parturition as compared to the nonpregnant state, with the exception of creatine kinase, which is maximum in cervices obtained from nulliparous nonpregnant women. The activities are low in the group of women who are 35 to 40 years old. The other studied factors (blood group, parity, pregnancy duration, labor length, treatment, state of the cervix at the 9-month examination) have no clear influence on the enzymatic levels. The results are discussed in relation to the well-known structural changes of the cervix at parturition.
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