Biomedical subjects
Publications and source records attributed to P Lemoine.
After investigating 127 offspring of alcoholic parents (mostly mothers), we consider the role of chronic alcoholism on the offspring to be very harmful, causing the following: miscarriages, stillbirths, prematurity, growth retardation, psychosomatic alterations with very specific facial features, and malformations.
The aim of this study was to test for an influence of benzodiazepine (BZD) on various perceptual and/or cognitive auditory processes. Loudness, auditory selective attention, and the ability of subjects to form perceptual streams out of alternating tone sequences were tested. Nine subjects were tested before, 1, 3, 7, and 24 h after a single-dose oxazepam vs placebo administration in a crossover design. A sample of blood allows us to measure plasma oxazepam concentration. The results revealed a significant reduction in stream segregation expressed as d' scores 1 h after oxazepam intake in the test subjects. No significant change occurred across time in the same subjects when they were administrated a placebo in another session. Furthermore, oxazepam had no substantial and systematic influence either on auditory selective attention or on loudness perception. Altogether, these results suggest that the perceptual organization of sound sequences involves inhibitory neural mechanisms, which can be affected by BZDs. This outcome is consistent with existing models of auditory stream segregation and may be paralleled with earlier findings on the effect of BZDs on perceptual binding in the visual modality.
The asymmetric unit of the title compound, [CuCl(C(10)H(6)NO(2))(C(14)H(12)N(2))], contains two monomeric copper molecules, A and B. Each Cu atom is coordinated to one 2,9-dimethyl-1,10-phenanthroline (neocuproine) ligand via both N atoms, to one isoquinoline-1-carboxylate anion (IQC(-)) via the N and one O atom, and to one Cl(-) anion. The environment of the Cu atom is approximately square pyramidal, with the apical position occupied by an N atom of neocuproine. In molecule A, the Cu atom is 0.301 (1) A above the basal plane; this distance is 0.316 (1) A in molecule B. The crystal packing is characterized by several hydrogen bonds.
Most matrix metalloproteinases (MMPs) are secreted as inactive proenzymes. Their expression is well documented in several human tissues, but their activators in vivo are still unknown. To address this question, the activation of progelatinase B (proMMP-9) in the human endometrium was selected as a model system. ProMMP-9 was detected by gelatin zymography in homogenates of fresh endometrial tissue sampled during all phases of the menstrual cycle, whereas its active form was observed only during the late secretory and menstrual phases. Furthermore, proMMP-9 was expressed and activated in endometrial explants sampled outside the perimenstrual phase and cultured in the absence of both progesterone and oestradiol, mimicking the menstrual condition in vivo. Analysis of such tissue cultures by gelatin zymography and Western blotting showed that activation of proMMP-9 depended on a secreted factor and was selectively inhibited by either a synthetic inhibitor of stromelysin 1 (MMP-3) or a monoclonal antibody that specifically blocks MMP-3, thus providing strong evidence for the activation of proMMP-9 in vivo by MMP-3. The activation of proMMP-3 was itself inhibited by a broad-range MMP inhibitor in most cultures, but seemed to involve multiple pathways, implying both serine proteinases and metalloproteinases, which could operate in parallel or sequentially.
A COMMON DISORDER: Sleep is one of the most often altered functions in elderly people. Obviously, insomnia is one of the main complain, inducing benzodiazepine (BSD) abuse, but we must keep in mind that sleep apnoea syndrome (SAS) and restless legs syndrome (RLS) are also frequent in this group of age. After exclusion of the various age-related conditions that could induce sleep disorders, we must focalise on primary and secondary sleep disorders. As an introduction, methods of sleep analysis are described and qualitative and quantitative sleep variables are given. PHYSIOLOGICAL SLEEP: Comparing the sleep of elderly people to the one of young adult give us the opportunity to define the limits of the physiological sleep aging. It seems that the main age-induced sleep disturbances are problems to maintain sleep and chronobiological disorganisation of the sleep-wake rhythm, both responsible for insomnia complains. It is important to note that SAS and RLS prevalence are correlated with age. Also crucial is the complex association between sleep, depression and dementia. These interactions are addressed from a diagnostic and a therapeutic point of view. THERAPEUTIC APPROACH: Lastly, concerning insomnia we emphasise the importance of therapeutic alternative to BZD, responsible for addictions and cognitive impairment, mainly behavioural and chronotherapeutic methods (phototherapy, melatonin). For clinicians, it is recommended to respect the individual rhythms of each elderly patient and to prefer nonpharmacological methods.
The Michael reaction of chiral 3-substituted secondary enaminoesters with 2-substituted nitroethylenes leads to (Z)-adducts, with good to excellent diastereoselectivity. The nitro group of these adducts was catalytically reduced to give, after cyclization and chiral amine elimination, pyrrolines or pyrrolidines after further reduction. In particular, the syntheses of ethyl (2R,3S,4S)-2,4-dimethylpyrrolidine-3-carboxylate and ethyl (2R,3R,4S)-2-(4-methoxyphenyl)-4-(3,4-(methylenedioxy)phenyl)pyrrolidine-3-carboxylate are described.
Multi-electrode sensor arrays are made of soft and wet materials not easily examined by most microscopic techniques. In this paper, we have demonstrated that low-vacuum scanning electron microscopy (LVSEM) and energy-dispersive X-ray analysis (EDX) are adequate for studying the hydration, swelling, and possible delamination of multi-electrode sensor arrays. We found that the LVSEM environment had no detectable effect on the morphology of Na(+), K(+), and Ca(++) sensors, and EDX analysis indicated that all three membranes have similar compositions. However, once hydrated, the sensors exhibited different behaviors. The K(+) and Ca(++) sensors swelled more than the Na(+) sensor did. This swelling is due principally to water sorption in the membrane. We believe that the larger thickness of the K(+) and Ca(++) membrane is partly responsible for the observed swelling effect. A simple Griffith analysis of the interface rupture confirms the experimental evidence that these thicker membranes also are more prone to delamination failure.
The aim of this study was to investigate for the effects of valpromide on heart rate circadian rhythm in remitted recurrent unipolar and bipolar disorders (DSM-III-R). It consisted of a comparative, randomized, double-blind, repeated cross-over study of valpromide versus placebo over four four-week periods. The primary evaluation criteria was heart rate (HR). Secondary criteria comprised motor activity (MA) and the Bech and Rafaelsen mania assessment scale, Horne and Ostberg questionnaire, Montgomery and Asberg depression rating scale, Spiegel questionnaire, a sleep diary, and Clinical Global Impression. Fifteen patients were included, giving 60 one-month periods (30 valpromide periods and 30 placebo periods). Cosinor analysis of HR and MA data revealed a difference in amplitude (P = 0.037, analysis of variance, one-tailed test). The clinical sleep study shows that the duration of sleep was greater with valpromide than with placebo (P = 0.007, one-tailed test). Similarly, evaluation of the quality of sleep by patients themselves showed valpromide to be superior to placebo (P = 0.045, one-tailed test). The results of analysis of the Spiegel questionnaire also confirm the superiority of valpromide over placebo. Safety and compliance were comparable for the active drug and the placebo. In conclusion, the relatively small sample size requires cautious interpretation of this study. Nevertheless, these initial results show a definite effect of valpromide on a biological rhythm that leads one to suppose that it may be effective through a 'synchronizing' effect.
Unpredictable endometrial bleeding is the major side-effect of levonorgestrel-releasing s.c. implants (Norplant), otherwise a method of choice for long-term contraception. The mechanisms responsible for bleeding are still unknown and no reliable treatment is available. Several matrix metalloproteinases (MMP) are expressed and activated in human endometrium only at menstruation and specific synthetic inhibitors of MMP fully prevent the tissue breakdown that occurs in menstrual-like endometrial explants. To investigate whether MMP are inappropriately expressed and activated in Norplant-treated endometria during bleeding episodes, volunteers were recruited to provide blood and endometrial biopsies at the start of bleeding episodes and during non-bleeding intervals. Whereas serum concentrations of levonorgestrel and sex hormones showed no change at bleeding, except for a slight decrease of oestradiol concentration, the expression and activation of stromelysin-1 released by explants cultured for 1 day were consistently increased at the start of bleeding episodes. Furthermore, stromelysin-1 was immunolocalized in stromal cells within breakdown areas of several bleeding endometria, but not in non-bleeding endometria. These observations suggest that the expression and activation of stromelysin-1 participate in the initiation of bleeding episodes upon Norplant contraception. New strategies in the prevention and treatment of abnormal bleeding based on MMP control should be envisaged.
The pathogenesis of irregular endometrial bleeding, the main reason for stopping contraception with progestins only, is unknown. Based on the recent reappraisal of the mechanisms of menstrual bleeding, we hypothesized that matrix metalloproteinases initiate this disorder. Volunteers upon Norplant treatment provided endometrial biopsies at the start of a bleeding episode and during nonbleeding intervals. Focal stromal breakdown, collagen fiber lysis, and collagenase-1 messenger ribonucleic acid were evidenced in most bleeding endometria, but never in the nonbleeding ones. In the breaking down areas, immunolabeling for gelatinase A was strongly increased, and that of progesterone and estrogen receptors was decreased. Explants from bleeding endometria produced high collagenase and gelatinase activities, whereas release from nonbleeding endometria was negligible. Bleeding endometria released more latent and active forms of collagenase-1 and active gelatinases A and B, but less tissue inhibitor of metalloproteinases-1, than nonbleeding endometria. Collagenase-1 release closely correlated with that of interleukin-1alpha. In contrast, N:-acetyl-beta-hexosaminidase and tissue inhibitor of metalloproteinases-2 were similarly released in both groups. Thus, endometrial bleeding occurs together with focal stromal breakdown, collagen lysis, expression and activation of several matrix metalloproteinases, and decreased production of tissue inhibitor of metalloproteinases-1. These results may lead to new pharmacological treatment of this common medical problem.
OBJECTIVE: To investigate the regulation of perimenstrual MMP-1 expression in human endometrium. DESIGN: In vitro study utilizing epithelial-stromal co-cultures. SETTING: Cell Biology Unit, International Institute of Cellular and Molecular Pathology, and Departments of Pathology and Gynecology, Saint-Luc University Clinics, Louvain University Medical School, Brussels, Belgium. METHODS: Contact-dependent and contact-independent co-cultures were established and resulting MMP-1 gene and protein expression was analyzed by RNase protection assays and soluble-collagen assays. RESULTS: MMP-1 expression in endometrial fibroblasts is markedly stimulated by epithelial cell-conditioned medium. This stimulation can be prevented by antibodies directed against interleukin 1 alpha (IL-1 alpha). Ovarian steroids inhibit MMP-1 production by IL-1 alpha-stimulated fibroblasts in vitro. CONCLUSION: Taken together, our results suggest that epithelium-derived IL-1 alpha is the most important paracrine induced of MMP-1 in endometrial fibroblasts. However, IL-1 alpha-stimulated MMP-1 production in the human endometrium is effectively blocked by ovarian steroids. We believe that this mechanism responsible for the MMP-1 repression that occurs when systemic sex steroid concentrations are high and the MMP-1 production and activity during the perimenstrual phase when estrogen and progesterone concentrations are low.
Although frequently investigated in the general population, the epidemiology of insomnia complaints and their treatment have received little attention in general practice. This study recruited patients > or =15 years of age, consecutively, from 127 general practitioners in France. The physicians collected data from 11,810 of their patients, of whom 55.5% were women. Insomnia complaints were reported by 26.2% (25.4% to 27%) of the sample and use of sleep-promoting medication by 10.1% (9.7% to 10.7%). About 47% of the prescribed drugs used were anxiolytics and 45% hypnotics. Most consumers took sleep-enhancing drugs on a daily and long-term basis and most reported that the medication improved their quality of sleep. However, few distinctions emerged between elderly drug-taking insomniacs and elderly nontreated insomniacs with respect to the various dimensions of sleep. Results underscore the persistent general tendency among French general practitioners to overprescribe anxiolytics for the treatment of insomnia complaints and that they do so on a long-term basis, despite the findings of numerous studies showing that benzodiazepines are ineffective in the treatment of sleep complaints over the long term.
The endometrium is the only human tissue to undergo cyclic breakdown and regeneration. This physiological alternation renders it an advantageous system for studying tissue remodelling. Our previous observations indicate that menstrual endometrial breakdown is initiated by matrix metalloproteinases (MMPs), which are controlled overall by ovarian steroids but are also locally regulated by cytokines. We have therefore compared the effect of several endometrial cytokines on the gene expression of eight MMPs and their tissue inhibitors (TIMP)-1, -2 and -3, in primary cultures of human endometrial fibroblasts. Three categories of gene expression were identified: (a) MMP-13, -15 and -16 mRNAs were not detected despite stimulation by various cytokines; (b) MMP-2 and -14 as well as TIMP-1, -2 and -3 mRNAs were constitutively expressed but not markedly affected by the six cytokines tested; (c) mRNAs for MMP-1, -9 and -11 were selectively induced by specific cytokines: insulin-like growth factor-II, epidermal growth factor (EGF), platelet derived growth factor (PDGF)-BB and interleukin (IL)-6 stimulated MMP-11 expression; MMP-1 was induced by EGF, PDGF-BB, tumour necrosis factor (TNF)alpha and IL-1alpha, which also exerted additive effects. In contrast with MMP-1 and MMP-11 gene expression, which was sustained for 48 h, MMP-9 mRNA was quickly induced by TNFalpha, but disappeared within 12 h despite continuing stimulation. These results show that several cytokines are able to induce the selective expression of MMPs in cultured human endometrial fibroblasts and are thus good candidates for involvement in local triggering of menstrual tissue breakdown.
The expression of interstitial collagenase-1 in the cycling human endometrium is restricted to the perimenstrual phase and is a key event for matrix degradation that initiates menstruation. In the absence of ovarian steroids, collagenase production by endometrial fibroblasts is induced by epithelial cell-derived interleukin-1alpha. Media conditioned by endometrial epithelial cells were found to contain interleukin-1alpha but not interleukin-1beta, and their capacity to induce collagenase production by endometrial fibroblasts correlated with interleukin-1alpha concentration in a saturable manner. Collagenase induction by recombinant interleukin-1alpha was severely inhibited by interleukin-1 receptor antagonist alone and abolished by its combination with soluble interleukin-1 type-II receptor. By contrast, the association of the receptor antagonist with soluble type-I receptor was less effective than each factor alone. Induction of collagenase by epithelial cell-conditioned media was severely inhibited by neutralizing interleukin-1alpha antibodies, whereas the combination of receptor antagonist with soluble type-II receptor proved less effective. We conclude that the collagenase response of endometrial fibroblasts to epithelial cell-derived interleukin-1alpha is effectively blocked in vitro by soluble members of the interleukin-1 family and can thus be modulated in vivo by these or other local factors.
The photochemical hypoiodination of cortisol acetonide, without neutralization of the excess of acidity during the work-up of the reaction, led to a mixture of 11 beta,18-oxido-17 alpha,21-dihydroxy-4-pregnen-3,20-dione and 11 beta,19-oxido-17 alpha,21-dihydroxy-4-pregnen-3,20-dione. Side chain cleavage of the former compound gave 11 beta,18-oxido-4-androsten-3,17-dione. The crystal structures of both of these 11 beta,18-oxidosteroids were determined by X-ray. The ring conformations are discussed and compared with those of aldosterone.
By using otoacoustic emission, we looked for change in outer hair cell (OHC) motile activity and medial olivocochlear (MOC) system inhibition due to benzodiazepine administration, a drug that is known to produce a pharmacological effect by interacting with GABAergic inhibitory neurotransmission. No effect was observed on OHC motile activity, in contrast benzodiazepines decreased MOC system effectiveness suggesting the existence of GABAergic fibers projecting onto the MOC system.
In the cycling human endometrium, the expression of interstitial collagenase (MMP-1) and of several related matrix metalloproteinases (MMPs) follows the late-secretory fall in sex steroid plasma concentrations and is thought to be a critical step leading to menstruation. The rapid and extensive lysis of interstitial matrix that precedes menstrual shedding requires a strict control of these proteinases. However, the mechanism by which ovarian steroids regulate endometrial MMPs remains unclear. We report here that, in the absence of ovarian steroids, MMP-1 expression in endometrial fibroblasts is markedly stimulated by medium conditioned by endometrial epithelial cells. This stimulation can be prevented by antibodies directed against interleukin 1alpha (IL-1alpha) but not against several other cytokines. Ovarian steroids inhibit the release of IL-1alpha and repress MMP-1 production by IL-1alpha-stimulated fibroblasts. In short-term cultures of endometrial explants obtained throughout the menstrual cycle, the release of both IL-1alpha and MMP-1 is essentially limited to the perimenstrual phase. We conclude that epithelium-derived IL-1alpha is the key paracrine inducer of MMP-1 in endometrial fibroblasts. However, MMP-1 production in the human endometrium is ultimately blocked by ovarian steroids, which act both upstream and downstream of IL-1alpha, thereby exerting an effective control via a "double-block" mechanism.
PURPOSE: Long-term consumption of hypnotics may lead to various side-effects, including impaired daytime and cognitive functioning and increased risk of accidents. Unfortunately, few guidelines exist for physicians to apply when attempting to withdraw hypnotics from patients. This study investigated whether withdrawal is facilitated by using zopiclone as a substitute drug and evaluated abrupt and gradual substitution techniques. METHODS: This open, multicentre and randomized study involved 1,002 male and female outpatients aged 18 years or over recruited by psychiatrists in Lyon, France. Patients had a mean age of 44 years, and 65.9% were women. Outpatients were chronic insomniacs being treated with a hypnotic for at least three weeks. The study included a substitution (D0-D35) and a withdrawal (D36-D56) stage. Patients were randomly drawn into three parallel groups: Group A underwent gradual substitution of zopiclone for the initial BZD; Group B was subjected to complete and immediate withdrawal of the initial BZD in favor of zopiclone; and Group C remained on the initial BZD, though told otherwise. The withdrawal stage began on D36 with a 50% reduction in medication and ended on D50 with complete withdrawal. RESULTS: Groups A (gradual substitution) and B (abrupt substitution) presented a net improvement in sleep during the substitution stage. However, Group B displayed a better improvement in sleep-onset period, a decrease in nocturnal awakenings and an increased quantity of sleep. In the withdrawal stage, Groups A and B were similar but Group C displayed a deterioration in sleep. Following the withdrawal stage, 29% of patients in Group C, 18% in Group A and 19% in Group B resumed hypnotic use. CONCLUSIONS: Discontinuation of this type of medication is possible in over three quarters of cases, provided that the prescribing physician adheres to a precise withdrawal protocol. Patients on zopiclone were less likely to resume consumption of hypnotics during the week of full withdrawal and were more satisfied with sleep than when treated with a BZD hypnotic. Finally, the results of the study showed that abrupt substitution yielded better results for chronic users of hypnotics.