Biomedical subjects
Publications and source records attributed to P Albert.
We report a case of non-ruptured tubal pregnancy at 38 weeks of pregnancy with the survival of mother and baby. Following salpingotomy a 1860 gr and 43 cm normal healthy male infant was delivered. The fallopian tube with placental tissue was removed by salpingectomy. Fetal development post partum and recovery of the mother were normal.
The authors present a patient with a complex vascular malformation composed of bilateral spontaneous carotid-cavernous fistulas (CCF's). The abnormality was supplied on the right side by the right external carotid artery (ECA) and the right internal carotid artery (ICA), and on the left side only by the left ICA. There was also an arteriovenous communication between the right ECA and the lateral sinus. Surgical embolization of both cavernous sinuses with oxidized cellulose was achieved on one side by direct puncture and on the other through one of its venous affluents, successfully occluding both CCF's and preserving the patency of both ICA's without any neurological deficit. The arteriovenous communication between the right ECA and the lateral sinus was occluded by embolization of the occipital artery and ligation of the right ECA.
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The reserved prognosis of stage T1 (A) bladder tumours is emphasised in relation to a series of 41 cases: 95% of tumours recurred, one third of these recurrent tumours posed a therapeutic problem because of their diffuse nature (15%) or tumour progression (24%). The risk of allowing a limited tumour to progress towards and extensively infiltrating carcinoma justifies the search for a prognostic factor allowing the early recognition of the more aggressive lesions. At the present time, no one prognostic element can indicate with certainty the course of the T1 tumour. All of the data obtained from detailed histological examination of the tumour and the adjacent urothelium and from the early course of the tumour allow a better evaluation of the prognosis. The search for surface antigens (ABO) and, more recently, chromosome analysis and study of the DNA content of the tumour by flow cytometry, may complete this prognostic evaluation.
The authors report their experience concerning 25 cases of ureterectomy by stripping, introduced by Dell'Ami. The technique carried out in the department is described. Cases of failures and possible complications are also discussed.
A prospective study was designed to evaluate the efficacy of radionuclide hysterosalpingoscintigraphy using 99mTc-labelled human serum albumin macroaggregates in 17 patients (34 tubes). In normal females the macroaggregates migrate spontaneously through the female reproductive tract following application into the posterior vaginal fornix. They can be seen in the uterine fornix 20 min p.i. (range: 5-90 min) and as free pelvic activity 120 min p.i. (range 40-180 min). Free pelvic activity could also be demonstrated by culdocentesis. In infertile patients with failure of tubal patency images after 180 min offered no additional information. For the routine diagnosis camera images 5, 60 and 180 min p.i. are recommended. Using 5-10 MBq 99mTc the radiation exposure to the ovaries is about 1/9th of the exposure from a normal radiologic hysterosalpingogram. The reported data show results comparable with those of hysterosalpingography (HSG) in females with patent or with nonpermeable tubes, but in cases of high-pressure by patency by HSG the results of scintigraphy are superior to those of HSG. Moreover, this method provides new insights into sperm motility under various physiological and pathological conditions.
Primary cultures of mesenchymal cells of axolotl limb blastemas provide a very sensitive in vitro bioassay for studying nerve dependence of newt regeneration. These cells can be stimulated by crude spinal cord extracts of non-amputated animals in a dose-dependent manner up to 60 micrograms protein/ml of culture medium; at this concentration the mitotic index is increased 4-fold. Spinal cord extracts of axolotls 14 days after forelimb amputation (i.e., late bud stage) are more efficient in stimulating blastema cell proliferation (+50%) than extracts of axolotls 7 days after forelimb amputation (i.e., early bud stage) or of axolotls without amputation. In a similar manner, spinal cord extracts of young axolotls 14 days after forelimb amputation, are more stimulatory than older axolotls 14 d after forelimb amputation which regenerate only a very small blastema during the same time. It appears that spinal cord mitogenic activity is enhanced after limb amputation, probably in correlation with blastema cell requirements for limb regeneration.
Three hundred and sixty nine extracorporeal lithotripsies for renal stones have been performed using the EDAP apparatus (ultrasound detection, piezoelectric destruction). In 7.1% of cases, the stone could not be located. By using low frequencies (1.25 to 5 cycles per second), extracorporeal lithotripsy was able to be performed in 82% of cases without anaesthesia and without premedication. 96.5% of patients treated have been followed and reviewed at one and three months: 169 (61%) cases were successful, 59 (21.3%) were partial results and 49 (17.7%) were failures. The best results were obtained in stones less than 20 mm in diameter. A poor result can only be improved by a second session of extracorporeal lithotripsy. The scintigraphic scars observed after high frequency extracorporeal lithotripsy were not observed when low frequencies were used. This new outpatient extracorporeal lithotripsy procedure without anaesthesia currently represents 79% of our primary indications in renal stones.
45 patients underwent urinary diversion by caecocystoplasty following simple or radical cystectomy with or without prostatectomy. The immediate postoperative course of such a major operation was surprisingly simple both in terms of the gastrointestinal tract (due to the use of automatic sutures) and in terms of the urinary tract. Micturition and diurnal continence were perfect. The few cases of incontinence related to high caecal pressure were controlled by perineal reeducation and/or the prescription of oxybutynin. A Peniflow apparatus controls the inevitable enuresis of these neobladders when the trigone has not been preserved. The upper tract is perfectly protected. The authors consider that the caecal reservoir warrants a place of choice in bladder replacement after cystectomy.
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The analgesic and euphoric properties of some plant alkaloids such as morphine have been known and exploited for centuries. In contrast, only during the last twenty years have we begun to unravel the molecular basis by which opiates exert their effects, mechanisms important to our general understanding of the nervous system. The analgesic response to opiates is the result of a cascade of biochemical events that are triggered by the interaction of the opiate with specific macromolecular components found on the membranes of nervous system tissues, the opioid receptors. The endogenous ligands of these receptors are small peptides, the opioid peptides. Although much has been learned about the structures and the mode of synthesis of the opioid peptides, little is understood about the structure of their receptors. The application of molecular genetic techniques was of great importance to the studies of the opioid peptides. It is now expected that this same technology will unravel the physical mysteries of the opioid receptors.
After amputation of a newt limb, a blastema forms on the amputation plane and later differentiates to regenerate all the missing parts of the limb. Proliferation of blastema cells is under the control of severed nerves which deliver a 'neurotrophic factor' (NTF) of unknown nature. In order to characterize this factor we use a primary culture of blastema mesenchymal cells; changes in mitotic index after 48-h colchicine treatment indicate mitogenic activity of potential growth substances. These cells, which are stimulated by nerve extracts (mitotic index X 6), were tested with two purified growth factors extracted from bovine retina or brain (EDGF I = basic FGF and EDGF II = acidic FGF). We show that these two growth factors stimulate proliferation of blastema cell cultures in a dose-dependent manner. Maximal stimulation was obtained at 3 pM for EDGF I (mitotic index X 5.7) or 300 pM for EDGF II (mitotic index X 4.9). So it appears that these two growth factors have a mitogenic activity on blastema mesenchymal cells similar to that obtained with nerve extracts. The fact that two different growth factors can stimulate these cells raises the question of whether both are present in NTF and/or whether there are receptors to both EDGF I and EDGF II on mesenchymal cell membranes.
Rats can use both "proximal" and "distal" cues to locate goal objects in their environments (Morris, 1981). In the proximal-cue situation, local stimuli that spatially co-occur with the goal are available to guide behavior. In the distal-cue situation, there are no cues that co-occur with the goal object; thus to directly locate the goal, the rat must learn about the spatial location of the goal relative to distal cues. Using the Morris water maze, we found that these two navigation behaviors are dissociated during ontogeny. Rats only 17-days-old are capable of using proximal cues to locate a safe platform. It was not until the rats were 20-days-old, however, that they began to display minimal evidence of distal-cue utilization. Control experiments indicated that the 17-day-old subjects' failure on the distal problem was likely due to their inadequate spatial learning skills. These results were interpreted within a Jacksonian perspective of brain-behavior relations.
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For the purpose of investigating the nature of the nervous factor which controls cell proliferation in limb blastema of Newts, we have cultured primary mesenchymous cells from limb blastemas of Axolotl. The cultures were carried out in Petri dishes (Primaria, Falcon) with a basal medium with contained diluted MEM supplemented with hormones (insulin, somatotropin, hydrocortisone and thyroxine). In this medium, the cells disperse from the explant from the 4th day of culture and begin to divide from the 7th day; 3 weeks later the culture begins to decline. During the course of culture, beginning at the 8th day, differentiation of myotubes and chondrogenesis occur. The mitotic index, measured on the 16th day after 48 hr of colchicine treatment, is about 1.6%. Addition of foetal calf serum to the basal medium favours cell migration and survival and stimulates proliferation (mitotic: index 6%); beef embryo extract has no effect on cell migration and a small effect on proliferation (mitotic index: 2.3%). Addition to the basal medium of insulin or nerve extracts (brain and spinal cord of adult newts, brain of 12 days chick embryos) 6 days before we measure the mitotic index stimulates proliferation in proportion to the dose, up to 6 times the mitotic index in basal medium. These results are discussed with respect to the problem of cell proliferation control during limb regeneration.
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