Quelques considérations sur l'enseignement de la médecine physique et de la réhabilitation

Particularly since World War II physical medicine and rehabilitation have assumed a growing importance. The efforts of the Canadian Association of Physical Medicine and Rehabilitation, following a survey of Canadian universities, to increase the theoretical and practical teaching of physiatrics are emphasized. It is considered important that the teaching of physical medicine and rehabilitation should be carried out concurrently with other medical and surgical teaching programs. Paramedical and auxiliary rehabilitation personnel should participate in the teaching program. The number of hours devoted to physiatrics should be increased, and the medical student should be permitted to choose physical medicine and rehabilitation as a part of his internship program.     

A propos de l'intervention des aéroions dans les processus de régulation de la lipémie et de la cholestérolémie

Resume Les expériences ont porté sur des lapins repartis en deux groupes parallèles — un groupe étant traité avec des aéroions négatifs en concentrations moderées (n^– = 10 – 40.000; n⁺ = 1.000) et l'autre sans aéroionothérapie (témoins). Par rapport aux animaux témoins (pas exposés aux aéroions),on a enregistré,sous l'influence de l'aéroionothérapie, que: (1)il y a une tendence de normalisation de la motilité spontanée, deprimée par une alimentation contenant un excès de cholestérol(0,3 g/kg/jour); (2) la lipémie et la cholestérolémie sont restées à un niveau plus bas chez les animaux alimentés au cholestérol; (3) la lipémie et la cholestérolémie, de même que l'iode thyroïdien, sont restées aux valeurs voisines de celles normales,chez les animaux nourris avec un excès (20 mg/kg/jour), de substances antithyroïdiennes naturelles (provenant du chou).

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Groups of rabbits were exposed to negative air ions of moderate concentrations (n^– = 10 – 40,000; n⁺ = 1,000) while others served as controls. (1) When rabbits were fed a cholesterol-rich diet (0.3 g/kg/day)causing reduction of motility in the control animals, their motility was normalized under air ion treatment. (2) The blood cholesterol and lipid levels of rabbits on a cholesterol-rich diet were lower with air ion treatment than in controls.(3) When rabbits were fed a diet with thyroid blocking agents from cabbage the blood cholesterol and lipid levels and the thyroid iodine content remained unchanged with air ion treatment.

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Zusammenfassung Gruppen Kaninchen wurden mit negativen Luftionen in mässigen Konzentrationen (n^– = 100 000 – 40 000; n⁺ = 1 000) behandelt, während andere als Kontrollen dienten. (1) Die durch Fütterung von cholesterinreicher Diät (0,3 g/kg/Tag) verminderte Motilität der Tiere wurde unter der Luftionenbehandlung normalisiert. (2) Der durch Fütterung von cholesterinreicher Diät erhöhte Blutcholesterin- und-fettspiegel fiel durch Luftionenbehandlung ab. (3) Der durch Fütterung von strumipriven Substanzen aus Kohl erhöhte Cholesterin- und Fettspiegel im Blut und verminderte Jodgehalt der Schilddrüse wurde durch Luftionenbehandlung nicht beeinflusst.

     

Action de l'actinomycine D sur la différenciation cellulaire au cours de la régénération de Planaires qui viennent d'éclore

Résumé Nous avons montré, à l'aide d'actinomycine tritiée, que cet inhibiteur pénètre en quantité égale dans les cellules de planaires adultes qui ne régéénèrent pas en présence de fortes concentrations (50 g/cm³) et dans celles de jeunes planaires qui peuvent former un blastème en présence d'actinomycine D, malgré l'inhibition de nouvelles synthèses d'ARN qui en résulte. Chez les jeunes, le taux de pénétration de l'antibiotique est comparable dans les noyaux des cellules indifférenciées qui participent à la formation du blastème et dans les noyaux des cellules différenciées. Les noyaux à nucléoles dissociés ne sont pas plus radioactifs que les noyaux où le nucléole est seulement appauvri en granulations. La radioactivité diminue uniformément dans toutes les cellules si les animaux sont remis en élevage dans l'eau. La radioactivité cytoplasmique observée est probablement due à la nature des fixateurs qui favorisent la rétention de molécules non liées.Nous pouvons conclure que les noyaux de toutes les catégories cellulaires présentent la même perméabilité à l'actinomycine. Celle-ci est présente dans les cellules de régénération des jeunes qui édifient cependant un blastème où le taux de synthèse des protéines est au même niveau que dans une régénération normale.

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On the action of actinomycin D on the cellular differentiation during the regeneration in Planarians

Summary ³H actinomycin inhibitor of RNA synthesis enters equally cells of adult planarians which never regenerate when applying the drug at high concentration (50 g/cm³), and young planarians which can form a blastem in the same solution; regeneration occurs despite of the inhibition of new RNA synthesis which ensues.Ultrastructural histoautoradiographs of newly hatched Planarian tissues show that this drug enters equally nuclei of undifferentiated cells which make up the blastem of regeneration and whose nucleoli are not dissociated, and nuclei of differentiated cells whose nucleoli are very often dissociated. The radioactivity is very often located upon heterochromatin. After return of the animals into water, radioactivity becomes reduced evenly in all cells.The cytoplasmic radioactivity that we have observed probably depends on the nature of fixatives which favour the retention of non linked molecules.We can conclude that the nuclei of all cells have the same permeability to actinomycin D, whatever the state of morphological differentiation. The inhibitor is present within the regeneration cells of young Planarians which build a blastem wherein the rate of protein synthesis is at the same level as in normal regenerating tissues.

     

Action de l'actinomycine D sur la différenciation cellulaire au cours de la régénération de Planaires qui viennent d'éclore

Résumé L'utilisation de l'actinomycine D, au cours de la régénération de Planaires à l'éclosion ou de celle d'adultes, montre que ces deux groupes d'animaux réagissent différemment à l'antibiotique.La régénération se produit en présence de l'antibiotique chez les jeunes Planaires, alors que, pour la même concentration (50 g/cm³), elle est totalement bloquée chez les adultes. Elle débute dès la décapitation des animaux; le retour dans l'eau, après un traitement par l'antibiotique qui va de 1 à 4 jours, ne modifie pas son déroulement morphologique.L'examen ultrastructural montre que les cellules différenciées présentent le plus souvent des dissociations nucléolaires importantes.Les lésions s'étendent progressivement à toute la cellule qui dégénère fréquemment. Les cellules morphologiquement indifférenciées ne sont que faiblement altérées (raréfaction du composant granulaire du nucléole), et récupèrent une structure normale après retour dans l'eau.Ces résultats conduisent à envisager l'étude des synthèses d'ARN, au cours de ces expériences, au niveau des organismes entiers et au niveau cellulaire.

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On the action of actinomycin D on the cellular differentiation during the regeneration in PlanariansI. Morphological, histological and ultrastructural studies on the regeneration capacity in presence of the antibiotic

Summary The utilization of actinomycin D during the regeneration of young and adult Planarians shows that the two groups of animals react differently to the antibiotic.Regeneration takes place in the presence of the antibiotic in young Planarians, whereas it is entirely inhibited in adult ones, applying the same concentration (50 g/cm³). In the young animals it begins immediately after decapitation. Their return into the water, after a treatment with the antibiotic lasting from 1 to 4 days, does not interfere with the morphological differentiation. The ultrastructural investigation exhibits that in the majority of the undifferentiated cells the nucleolus is largely dissociated.The lesions gradually extend to the whole cell which frequently degenerates. The morphologically undifferentiated cells are weakly impaired (depletion of the granular component of the nucleolus), and they recover a normal structure after their return into water.These results lead us to study the RNA synthesis, during these experimentations, on the whole organism as well as the cellular level.

     

Importance de l'étude de la répartition écologique pour la taxonomie des éponges calcaires

Résumé 1. Les travaux deSarà (1953) et deBurton (1963) ont remis en question la valeur systématique des caractères morphologiques dans la classification des Eponges Calcaires, et ont proposé de considérer de nombreuses formes connues comme des variétés individuelles et régionales d'espèces très plastiques et variables. Nous avons essayé de préciser, par l'observation directe en plongée libre, la distribution et les préférences écologiques des Calcaires, de définir ainsi les limites naturelles de leurs populations, et d'étudier ensuite la variabilité des caractères morphologiques à l'intérieur de ces populations.2. Nous exposons ici l'exemple des espèces des genresClathrina etAscandra, étudiées en Adriatique, dans les régions de Marseille et de Roscoff. Leur distribution est en rapport direct et très précis avec l'exposition aux vagues et à la lumière, à tel point que sur une surface réduite plusieurs espèces se succèdent et se remplacent en fonction de l'exposition de l'endroit. Dans la règion de Roscoff cette distribution est plus large ce qui est dû aux effets des marées, mais les zones écologique préférentielles pour les espèces deClathrina ont pu être établies en fonction de l'importance de l'apport des sédiments par les eaux côtières.3. La possibilité de définir des populations dont la distribution est très précisemment délimitée malgré une coexistence dans un espace réduit, et qui ne sont pas réliées par les formes transitoires, permet d'éliminer l'hypothèse de la cospécificité de ces populations. Elle permet également d'établir les variations morphologiques possibles au sein d'une espèce, de retenir les caractères significatifs pour la classification, et finalement de distinguer les espèces qui se ressemblent morphologiquement. Dans le cas d'animaux qui, commeClathrina, possèdent très peu de caractères utilisables en systématique, c'est la seule façon de résoudre les problèmes de leur taxonomie.

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The importance of research on the ecological distribution for the taxonomy of calcareous sponges

The particular difficulties of the taxonomy of calcareous sponges are due to their great plasticity and their capacity for adaptation which obscure the natural limits of species. An attempt was made to define the natural populations of the Mediterranean species of the generaClathrina andAscandra through a study of their ecological distributions. The populations not connected by the transitory forms were defined by their ecological preferences, and, as they are found in a close cohabitation, were treated as having the specific values. The variability of different morphological features is discussed, the features significant for taxonomy are pointed out and the morphologically close species are defined.

     

Testostérone circulante et cancer de la prostate. Revue de données récentes

In vitro andin vivo studies show that androgens stimulate prostate cancer. However, evidence from epidemiological studies of an association between circulating levels of androgens and prostate cancer risk has been inconsistent, but most studies have likely been undersized given that the association may be relatively weak. We review prospective studies on the association of serum levels of free and total testosterone, the principal androgen in circulation with risk of prostate cancer. No significant association between total or free testosterone and risk of prostate cancer was found in studies that together included 1,525 cases of prostate cancer and 4,349 controls. No support was found for the hypothesis that high levels of circulating testosterone within a physiological range stimulate development and growth of prostate cancer. Intraprostatic androgen metabolism may still be of importance for prostate cancer development.     

Les inhibiteurs spécifiques de la recapture de la sérotonine dans la dépression de l’enfant et de l’adolescent: revue des controverses récentes

European and US drug regulatory authorities have recently warned against the use of selective serotonin reuptake inhibitors (SSRIs) in childhood and adolescent depression. Through an extensive literature review on the use of SSRIs to treat depression in children and adolescents — including psychiatric clinical trials, pharmacology, and drug safety data — we will: i) describe the main arguments justifying various regulatory decisions; ii) present published data and subsequent meta-analyses; iii) discuss how to integrate the recommendations into daily clinical practice, freeing professionals from a Manichean approach. We reach the limits of evidence-based medicine, which provide the basis of the scientific work of the regulatory authorities.     

Quelques organismes sporadiques du plancton de la région d'Amsterdam

Sans résuméLaboratoire du Service Medical et Sanitaire de la ville d'Amsterdam.     

Effets de la fluorescence résiduelle dans les tissus biologiques sur les signaux de fluorescence résolus temporellement par la méthode des éléments finis

A computational model based on finite element method is derived to examine how the simulated time-dependent signals are related to the presence of residual fluorescence in biological media surrounding a fluorescent object. We apply a subtraction technique on recorded data when imperfect uptake of fluorescing agent into the tumor is considered. We show the limits of the subtracting method for low target: background fluorescent absorption contrast by extracting the time to reach the half maximum and analyzing the maximum of the time-resolved signals versus target depth.     

Le Paléolithique supérieur de la région centre de l’île de Honshû

Tokai area is situated in the middle of Japan and has various configurations of ground. The eastern area has thick natural layers with volcanic ash which has been supplied from Mt. Fuji. About five chronological stages of Paleolithic culture from trapeze and edge-ground axe culture to microlith culture through backed blade culture have been found in the layers. These stages of Paleolithic culture are indicators of chronological studies in Tokai area. On the other hand, it is difficult to advance chronological studies in the middle east, middle, and west areas, because they have little thickness of layers with volcanic ash. However, different Paleolithic artifacts are found in top and bottom layers which put the AT layer between at Tsubakibora Site in Gifu Prefecture, and they have helped very much chronological studies of Paleolithic culture in the west area. Here is the first result of Paleolithic studies in Tokai area with artifacts which have been found on the forth layer of scoriae at Idemaruyama Site are dated about 35,000 years, one of the oldest Paleolithic culture in Japan. In addition, some lines of pits which were dated 30,000 years were found at Hatsunegahara Site, and they provided valuable data to study Paleolithic hunting. Finally, a holed pendant which had 10 notches on one side was unearthed from Fujiishi Site, and it was dated 19,000 years ago. At Terada and Hino Site, a flat big stone which had carvings was found, though the shape and use were seemed to be different from the pendant at Fujiishi Site.     

Intérêt de la TEP dans le bilan d’extension et l’évaluation de la maladie résiduelle des séminomes testiculaires : étude rétrospective

AimsTo evaluate the value of PET/CT comparatively to CT in staging and restaging after chemotherapy of testicular seminoma, to assess quantitative methods and prognostic value of PET in post-chemotherapy residual masses.MethodsThirty-two patients and a maximum of 65 targeted lesions visualized on PET-CT and CT performed for staging and therapeutic response assessment were analysed and compared. Each lesion was quantified according to miscellaneous SUV normalized methods. Optimal threshold of SUV for prediction of residual disease was obtained (ROC method). The prognostic value of PET/CT at the completion of treatment was determined with progression free survival study (Kaplan-Meier method).ResultsPET/CT exhibited higher accuracy than CT in the initial staging and assessment of therapeutic response, respectively 98% versus 83.3% and 95.1% versus 75.6%. Quantification, whichever method, was not more efficient than visual reading for prediction of residual disease. Progression-free survival was higher with negative than with positive PET/CT (P = 0.0033).ConclusionOur work demonstrates that PET/CT exhibits better accuracy than CT in both staging and restaging at the end of treatment. Quantification methods do not improve accuracy of PET/CT for prediction of viable residual disease. The prognostic value of PET/CT appears very promising and needs to be confirmed by large prospective studies. PET/CT appears to be a relevant method of prognostic stratification of the risk of relapse in seminoma.     

Les résidents et l'enseignement: revue de la littérature.

We reviewed the available data on residents'' teaching role in the clinical setting to develop programs to improve their teaching skills. Articles published from 1966 to 1989 were identified through a computerized search of MEDLINE, and the bibliographies of identified papers were reviewed. Articles directly related to the topic were included and analysed. Taking into account their quality, we extracted data relevant to specific issues. Approximately 15% to 25% of an average work week was spent by residents in different teaching activities. Students acknowledged the importance of their contribution to clinical teaching. Residents benefitted from teaching by increasing their medical knowledge and promoting the development of important attitudes. Insufficient preparation for this task and the numerous practical problems faced by residents may explain their modest performance as teachers. Nevertheless, programs directed to residents might improve the quality of their teaching. We suggest some guidelines for the development of programs to improve their teaching skills and for future research.