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The performance of deformable medical image registration (DIR) algorithms has become a major concern.We aimed to obtain updated information on DIR algorithm performance quantification through a literature review of articles published between 2010 and 2022. We focused only on studies using operator-based methods to treat real patients. The PubMed, Google Scholar and Embase databases were searched following PRISMA guidelines.One hundred and seven articles were identified. The mean number of patients and registrations per publication was 20 and 63, respectively. We found 23 different geometric metrics appearing at least twice, and the dosimetric impact of DIR was quantified in 32 articles. Forty-eight different at-risk organs were described, and target volumes were studied in 43 publications. Prostate, head-and-neck and thoracic locations represented more than ¾ of the studied locations. We summarized the type of DIR and the images used, and other key elements. Intra/interobserver variability, threshold values and the correlation between metrics were also discussed.This literature review covers the past decade and should facilitate the implementation of DIR algorithms in clinical practice by providing practical and pertinent information to quantify their performance on real patients.

Exerting self-control depletes capacity for future self-control, which can promote greater alcohol use. However, certain populations may be more susceptible to these effects of depleted self-control capacity. For example, individuals with lower alcohol sensitivity (i.e., requiring more drinks to experience the effects of alcohol) are a high-risk group who are likely to engage in hazardous alcohol use and develop an alcohol use disorder. Those lower in alcohol sensitivity also exhibit heightened motivational reactivity in response to alcohol-related cues, which may be enhanced following exertion of self-control. However, whether drinkers lower in alcohol sensitivity are at higher risk for exhibiting greater motivations toward alcohol-related cues after exerting self-control is unclear. The current research examined the role of alcohol sensitivity in predicting approach motivation following exertion of self-control. It was expected drinkers exerting self-control would exhibit greater orientation toward rewarding cues, particularly after viewing alcohol-related cues. However, we predicted this pattern would be most prominent among drinkers lower in alcohol sensitivity. Experiment 1 supported these hypotheses, with lower alcohol sensitivity predicting greater approach motivation among drinkers required to exert self-control prior to viewing alcohol-related compared to neutral cues. Experiment 2 aimed to replicate these findings by assessing asymmetrical frontal cortical activation, an index of approach motivation. Drinkers with lower alcohol sensitivity exhibited greater relative left frontal cortical activation, consistent with approach motivation, while viewing alcohol-related cues following exertion of self-control. Results have implications for interventions aimed at identifying those at risk for greater alcohol motivations during states of mental exhaustion. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Risky alcohol use is prevalent among college students. Pre-intervention research has established methods of influencing alcohol cognition and reducing short-term alcohol consumption among students using evaluative conditioning (EC), repeatedly pairing alcohol with emotionally valenced images. Specifically, negative EC promotes negative attitudes toward alcohol, but additional research is needed to understand the range of EC effects and conditions under which it is or is not effective. For example, whether pairing alcohol with positive images promotes positive alcohol attitudes has not been tested. Further, drinking motives may influence the effectiveness of conditioning alcohol attitudes, since these motives are strongly associated with emotional stimuli like those presented in EC. The current experiment tested the interaction of drinking motives (coping and enhancement) and EC valence (negative or positive) on implicit alcohol avoidance. Participants (N = 95) were undergraduate students reporting active alcohol use. Results indicated no main effect of EC condition on implicit alcohol avoidance. However, drinking motives interacted with EC procedures assigned to participants. Those reporting greater coping motives exhibited less implicit alcohol avoidance following negative EC, whereas those reporting greater enhancement motives exhibited less alcohol avoidance following positive EC. Findings indicate drinking motives may influence the effectiveness of EC for altering alcohol attitudes. Negative EC did not promote alcohol avoidance among college students reporting higher coping motives, and positive EC only reduced avoidance among students reporting higher enhancement motives. These results indicate drinking motives interact with situational cues to impact both positive and negative responses to alcohol.

Pelvic bone marrow is the site of nearly 50% of total hematopoiesis. Radiation therapy of pelvic lymph node areas, and cancers located near the bony structures of the pelvis, exposes to hematological toxicity in the range of 30 to 70%. This toxicity depends on many factors, including the presence or absence of concomitant chemotherapy and its type, the volume of irradiated bone, the received doses, or the initial hematopoietic reserve. Intensity modulated radiation therapy allows the optimisation of dose deposit on at risk organs while providing optimal coverage of target volumes. However, this suggests that dose constraints should be known precisely to limit the incidence of radiation side effects. This literature review focuses firstly on pelvic lymph node areas and bony volumes nearby, then on the effects of irradiation on bone marrow and the current dosimetric constraints resulting from it, and finally on hematological toxicities by carcinologic location and progress in reducing these toxicities.

International audience; BACKGROUND:Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established.MATERIAL & METHODS:Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed.RESULTS:In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10-4), although, as in SNMM, it was not a significant prognostic predictor.CONCLUSION:Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.

International audience; Anaplastic oligodendroglioma (AO), IDH‐mutant and 1p/19q codeleted (IDHmut+/1p19qcodel), is a high‐grade glioma with only limited prognostic markers. The primary objective of this study was to evaluate, by immunohistochemistry, the prognostic value of two proliferation markers, MCM6 and Ki‐67, in a large series of IDHmut+/1p19qcodel AO included in the POLA (“Prise en charge des Oligodendrogliomes Anaplasiques”) French national multicenter network. We additionally examined the transcriptome obtained from this series to understand the functional pathways dysregulated with the mRNA overexpression of these two markers. The labelling indices (LI) of MCM6 and Ki‐67 were obtained via computer‐assisted color image analyses on immunostained AO tissues of the cohort (n=220). Furthermore, a subgroup of AO (n=68/220) was used to perform transcriptomic analyses. A high LI of either MCM6 (≥50%) or Ki‐67 (≥ 15%) correlated with shorter overall survival, both in univariate (P=0.013 and P=0.004, respectively) and multivariate analyses (P=0.027; multivariate Cox model including age, mitotic index, MCM6 and Ki‐67). MCM6 and Ki‐67 LI also correlated with overall survival in an additional retrospective cohort of 30 grade II IDHmut+/1p19qcodel oligodendrogliomas. The prognostic value of MCM6 mRNA level was confirmed in The Cancer Genome Atlas (TCGA) IDHmut+/1p19qcodel gliomas. The transcriptomic approach revealed that high transcriptional expressions of MCM6 and MKI67 were both linked positively with cell cycle progression, DNA replication, mitosis, pro‐neural phenotype as well as neurogenesis, and negatively with microglial cell activation, immune response, positive regulation of myelination, oligodendrocyte development, beta‐amyloid binding, and postsynaptic specialization.In conclusion, the overexpression of MCM6 and/or Ki‐67 is independently associated to shorter overall survival in IDHmut+/1p19qcodel AO. These two easy‐to‐use and cost‐effective markers could thus be used concurrently in routine pathology practice. Additionally, the transcriptomic analyses showed that AO with high proliferation index have down‐regulated immune response and lower microglial cells activation, and bears pro‐neural phenotype.

Heavy episodic drinking (HED) is a dangerous and pervasive problem in college populations. Two experiments examined the asymmetric effects of evaluative conditioning (EC) on cognitions underlying HED in a nonclinical, student sample. Based on the associative-propositional evaluation (APE) model, we predicted that negative EC would result in stronger implicit alcohol avoidance motivation compared to neutral EC but would not impact explicit alcohol expectancies; further, we hypothesized stronger negative EC effects among students reporting HED compared to light drinkers. Experiment 1 supported these hypotheses. In Experiment 2, participants were required to focus on either feelings or knowledge about alcohol following EC. Replicating Experiment 1, negative EC was effective in promoting implicit alcohol avoidance motivation among students reporting HED compared to neutral EC, whereas no differences in explicit alcohol expectations or urges emerged. However, greater implicit alcohol avoidance predicted lower explicit alcohol urges among participants instructed to focus on alcohol-related feelings, but not alcohol-related knowledge, regardless of condition. Findings suggest students reporting HED, but not light drinkers, may exhibit implicit alcohol avoidance following negative EC and that instructions to focus on alcohol-related feelings may align explicit and implicit responses. Results have implications for interventions aimed at retraining implicit alcohol cognitions among college students. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Since decades, stereotactic radiotherapy has spread out worldwide. Published results are very numerous. To clarify obviousness among all the publications, this recommendation review was written. Voluntarily, authors limited analysis of international best evidence literature on malignant tumors of lung, liver, prostate, head and neck, and metastasis of bone and brain. These data could be used to advance standardization and quality improvement of treatments performed in the nationwide radiotherapy departments and can provide useful guidance for centers worldwide.

Prior to drinking onset, children report stronger negative versus positive beliefs on self-report alcohol expectancy questionnaires, with some attenuation of this negativity as they transition into adolescence. Traditional alcohol expectancy assessments, however, capture endorsement of deliberative propositions about drinking outcomes. Measurement of implicit alcohol associations may elucidate automatic evaluations, clarifying the role of nondeliberative cognition in the initiation of alcohol use among youth. Few studies have assessed implicit alcohol cognition among children and younger adolescents, with inconsistent findings regarding the nature of these automatic associations within and between age groups. Eighty-nine 3rd and 4th graders and 91 7th and 8th graders completed an alcohol expectancy measure and two unipolar alcohol Implicit Association Tests (IAT) measuring positive and negative alcohol associations independently. On the explicit measure older compared with younger participants rated positive drinking outcomes as more likely and negative outcomes as less likely. Older compared with younger students were also more neutral/moderate in their evaluations of positive drinking outcomes. On the IATs, scores for the full sample indicated negative alcohol associations, and Negative IAT scores were higher for older compared with younger participants. However, the valence of implicit alcohol associations was qualified by the order of explicit versus implicit assessment; for those who completed the IATs prior to the explicit expectancy measure, alcohol associations were positive. Findings replicate and extend prior research conducted with preonset youth. Implications regarding the role of automatic and controlled processes in drinking onset and directions for future work on children's alcohol cognition are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved). Language: en

Sepsis is a difficult condition to treat and is associated with a high mortality rate. Sepsis is known to cause a marked depletion of lymphocytes, although the function of different lymphocyte subsets in the response to sepsis is unclear. gammadelta T cells are found largely in epithelial-rich tissues, and previous studies of gammadelta T cells in models of sepsis have yielded divergent results. In the present study, we examined the function of gammadelta T cells during sepsis in mice using cecal ligation and puncture (CLP). Mice deficient in gammadelta T cells had decreased survival times and increased tissue damage after CLP compared with wild-type mice. Furthermore, bacterial load was increased in gammadelta T cell-deficient mice, yet antibiotic treatment did not change mortality. Additionally, we found that recruitment of neutrophils and myeloid suppressor cells to the site of infection was diminished in gammadelta T cell-deficient mice. Finally, we found that circulating levels of IFN-gamma were increased, and systemic levels of IL-10 were decreased in gammadelta T cell-deficient mice after CLP compared with wild-type mice. gammadelta T cell-deficient mice also had increased intestinal permeability after CLP compared with wild-type mice. Neutralization of IFN-gamma abrogated the increase in intestinal permeability in gammadelta T cell-deficient mice. The intestines taken from gammadelta T cell-deficient mice had decreased myeloperoxidase yet had increased tissue damage as compared with wild-type mice. Collectively, our data suggest that gammadelta T cells modulate the response to sepsis and may be a potential therapeutic target.

The authors present the empirical characteristics of the Experience of Discrimination Scale (EDS) using baseline data from the Center for Mental Health Services-funded, multisite Consumer Operated Services Project. Specific hypotheses focused on the influence of multiple identity status on reports of discrimination. Data indicated that discrimination caused by mental disability was associated with level of psychiatric symptoms and perceived social rejection as a result of mental illness, whereas discrimination for other reasons was associated with broader quality of life and social interaction indicators. The clinical and policy implications of findings are discussed.

Background Recent data about hepatitis A virus (HAV) seroprevalence in industrialized countries and the impact of travels to endemic areas are sparse or absent, particularly for children. Objective To determine the impact of travel to endemic areas on HAV seroprevalence and estimate the overall HAV seroprevalence in children in France. To identify risk factors for positive HAV serologic results. Study design This prospective multicentre cross-sectional seroprevalence study took place in eight paediatric emergency units throughout France. Children 1–16 years of age following all inclusion and exclusion criteria were included. Demographic, socioeconomic, and travel data were prospectively collected with a standardized questionnaire before measurement of specific HAV antibodies. HAV seroprevalence was determined and its association with diverse variables assessed by univariate and multivariate analyses. Results 430 children were included, of whom 116 had travelled to endemic areas. The HAV seroprevalence in the overall population was 5% (95%CI, 3–7) and was higher among the travellers (12% [95%CI, 6–18]) than among the others (2% [95%CI, 0–3]), OR = 7.0 [95%CI, 2.6–18.8]. Risk factors identified for positive serologic results for HAV were travel to an endemic area >7 days (adjusted OR [aOR] = 4.3 [95%CI, 1.5–12]), age of 14–16 years (aOR = 7.7 [95%CI, 1.6–38.3]) and mother's birth in an endemic area (aOR = 5.2 [95%CI, 1.8–14.8]). Conclusion Statistical evidence showed that travel to endemic areas and parents’ place of birth both play a role in HAV serologic results in children with a significant difference of HAV seroprevalence between traveller and non-traveller children in France.

Poor children are more susceptible to infectious diseases. Routine medical follow-up is infrequent in these patients, sometimes resulting in immunization delays. The aim of this study was to correlate a number of socioeconomic factors related to poverty with vaccination coverage in children visiting a pediatric emergency ward.Previous routine vaccinations and various socioeconomic features were prospectively recorded for children aged 9 months to 7 years visiting two public pediatric emergency departments in Marseilles (southern France) from 2009 to 2010.Three hundred and seventy-five children were included. Vaccination coverage was 87% for diphtheria, tetanus, poliomyelitis, Haemophilus influenzae type b infections and pertussis, 69% for tuberculosis (Bacillus Calmette-Guérin), 77% for measles, mumps and rubella, 74% for pneumococcal infections (conjugate vaccine), and 55% for hepatitis B. Socioeconomic factors related to poverty were significantly associated with delays in immunizations. Children not attending school (OR=2.5), having parents who were not fluent in French (OR=5.7), living in caravans or squatting (OR=11.5), or being recipients of the national medical assistance for foreigners (OR=12.8) had significant delays with diphtheria, tetanus, and poliomyelitis vaccines. The measles-mumps-rubella vaccine was also delayed in homeless children (OR=3.4). Children who were recipients of the national medical assistance for citizens were better vaccinated against tuberculosis and hepatitis B.Poor children living in southern France had significant delays in their routine immunizations, resulting in gaps in their protection. Every medical visit, even those conducted in an emergency ward, should identify children with immunization delays and offer a catch-up schedule if necessary.

To evaluate the values of clinical signs and the rapid diagnostic test (RDT) in the diagnosis of influenza H1N1 new variant in the pediatric emergency room.From 18 August to 1st December 2009, children admitted to the pediatric emergency department of CHU Nord (Marseille, France) and suspected of flu according to French guidelines, were tested for influenza using both an influenza RDT and a polymerase chain reaction (PCR) assay specific for H1N1. From 3 November to 3 December, clinical signs were also noted (fever, headaches, myalgia-arthralgia, shivers, diarrhea).A total of 1122 children were tested: 367 children (32.1%) had a positive specific PCR. The RDT value was: sensitivity 65.2% [55.8-73.6], specificity 99.5% [98.1-100], positive predictive value (PPV) 97.5% [91.8-100], negative predictive value (NPV) 91.2% [90.3-91.5], positive likelihood ratio (LRP) 153.7 [53.5-452.9] and negative likelihood ratio (LRN) 0.393 [0.387-0.411]. Clinical data were available for 504 children (328 over 2 years of age). In children more than 2 years of age and in multivariate analysis, headaches were the only sign significantly associated with a positive PCR (aOR=2.53 [1.25-5.12]). Overall, headaches and/or myalgia-arthralgia were valuable indicators for clinical diagnosis of flu, with a 75.8% NPV. Among children with a positive PCR, diarrhea was more frequent in children under 2 years of age (OR=2.76 [1.19-6.40]). The sensitivity of the RDT improved (90.9% [85.2-94.6]) when flu signs were also present.Associating clinical signs and RDT for the diagnosis of influenza A (H1N1) new variant in a pediatric emergency room improves selection of children requiring appropriate antiviral treatment.

The purpose of this study was to assess the standpoint of family physicians in the Southern French region Provence-Alpes-Cote d'Azur concerning human Papillomavirus vaccination and to evaluate the factors associated with a favorable standpoint.A questionnaire was sent to a random sample of 1,000 family physicians. The survey focused on their profile, their views on vaccination generally and on HPV vaccination, their knowledge of HPV, their standpoint concerning STD prevention and cervical cancer screening. Multivariable linear regression system was used to study the variations associated with a favorable response to HPV vaccination.Response was 36.6%. The responses were analyzed taking into account gender of the family physicians, location and size of their practice. There was reasonable similarity amongst those questioned. Around 89.6% of family physicians answers were in favor of HPV. The ideal age for vaccination was between 11 and 13 years of age for 34.4% and between 14 and 15 for 53.9%. The family physicians most in favor of vaccination were those involved in screening for STDs, those who did not think that the vaccine would have a negative effect on the image of sexuality and on screening for cervical cancer, and those who were confident about the vaccine safety.The study identified the negative elements concerning HPV in order to optimize information strategies among family physicians.

Thermal injury increases the number of macrophage progenitors in the bone marrow but leads to a decrease in the number of granulocyte progenitors. In the spleen, thermal injury increases the numbers of myeloid progenitors, but the lineage commitment of these cells is unknown. In this study mice were given a scald burn, and the number of splenic myeloid progenitors as well as their progeny was determined. BrdU uptake was used to monitor the de novo production of splenocytes for 8 days after the burn. Burn injury increased the numbers of splenic granulocyte-macrophage (GM), granulocyte (G), and macrophage (M) progenitors at postburn day 8 by 12-, 11-, and 18-fold, respectively. Scald injury increased the number of mature PMN (CD11b+ GR1bright) in the spleen and increased the number of white pulp monocyte/macrophages. Increased numbers of BrdU-positive PMN and monocyte/macrophages were seen after injury. Burn macrophages produced increased levels of the anti-inflammatory hematopoietic cytokine G-CSF. Our work clearly shows that the increased myelopoiesis observed postinjury leads to the production of mature myeloid cells. However, the effects of thermal injury on progenitors in the spleen and marrow are not equivalent.

Central nervous system leiomyosarcomas are extremely rare, however, they became more frequent among immunodeficient patients, either in a patients infected with human immunodeficiency virus (HIV), or after organ transplantation. The data of the literature indicate that the infection by Epstein-Barr virus (EBV) plays a causal role in the development of these tumours but its precise role in the oncogenesis remains unresolved. We report a new case of EBV associated leiomyosarcoma of the left cavernous sinus occurring after renal transplantation. The epidemiological, clinical, pathological and therapeutic characteristics of these tumours are discussed.

Objectives: The authors sought to gain further perspective on discrimination experienced by persons with mental illness by comparing selfreports of discrimination due to mental illness to self-reports of discrimination due to other group characteristics, such as race, gender, and sexual orientation. Methods: A total of 1,824 persons with serious mental illness who participated in a baseline interview for a multistate study on consumer-operated services completed a two-part discrimination questionnaire. The first part of the questionnaire assessed participants’ perceptions about discrimination due to mental illness as well as more than half a dozen other group characteristics. The second part of the questionnaire asked participants who reported some experience with discrimination to identify areas in which this discrimination occurred, such as employment, education, and housing. Results: More than half of the study participants (949 participants, or 53 percent) reported some experience with discrimination. The most frequent sources of this discrimination were mental disability, race, sexual orientation, and physical disability. Areas in which discrimination frequently occurred included employment, housing, and interactions with law enforcement. Areas in which discrimination was experienced did not significantly differ among groups of study participants characterized by mental disability, race, gender, sexual orientation, or physical disability. Conclusions: Discrimination based on group characteristics other than mental illness does not diminish the impact of stigma associated with mental illness. Antistigma programs need to target not only discrimination related to mental illness but also that associated with other group characteristics, such as race, gender, sexual orientation, and physical disability. (Psychiatric Services 54:1105–1110, 2003)

The newly identified suppressors of cytokine signaling (SOCS) family of proteins act as intracellular inhibitors of several cytokine signal transduction pathways. Their expression is induced by cytokine activation of the Janus kinase/signal transducer and activator of transcription (Jak/STAT) pathway, and they act as a negative feedback loop by subsequently inhibiting the Jak/STAT pathway either by direct interaction with activated Jaks or with the receptors. In this study we investigated the expression and translation of SOCS proteins after burn injury. Thermal injury increased the expression of SOCS3 compared with sham at 4 h, 24 h, and 10 days after thermal injury in the liver. SOCS3 protein was increased at 4 and 24 h after thermal injury in the liver. Expression of SOCS1 mRNA was not detected in sham or burn liver. SOCS2 mRNA and cytokine-inducible SH2-containing protein (CIS) mRNA were detected at the same levels for both sham and burn at all time points in the liver. In the spleen there was a trend towards an increase in SOCS1 mRNA at all time points; thermal injury significantly decreased SOCS2 mRNA compared with sham at 4 h, SOCS3 mRNA was significantly increased at 24 h compared with 10 days, and CIS mRNA was detected at the same levels for both sham and burn at all time points. In conclusion, thermal injury causes elevations in SOCS3 within 4 h after a burn, reaching a maximum at 24 h post injury. Levels continue to be elevated for up to 10 days post injury. SOCS3 may be very important in regulating the balance between immunosuppression and inflammation after thermal injury.

To compare two airway management techniques, face mask (FM) with oropharyngeal airway and laryngeal mask airway (LMA), with respect to the effectiveness of positive pressure ventilation and airway maintenance.After induction of anaesthesia, two airway management techniques (FM or LMA) and three peak pressures (20, 25 and 30 cm H2O) were randomly applied during controlled ventilation in 60 patients. Data collected included inspiratory and expiratory volumes and presence of gastro-oesophageal insufflation. Leak was calculated by subtracting the expiratory from the inspiratory volume, expressed as a fraction of the inspiratory volume.Expiratory volumes (mean +/- SD) at 20, 25 and 30 cm H2O for LMA ventilation were 893 +/- 260, 986 +/- 276 and 1006 +/- 262 respectively, and for FM ventilation 964 +/- 264, 1100 +/- 268 and 1116 +/- 261. Leak fractions at 20, 25 and 30 cm H2O for LMA ventilation were 0.21 +/- 0.15, 0.24 +/- 0.18 and 0.26 +/- 0.18 respectively, and for FM ventilation 0.14 +/- 0.09, 0.14 +/- 0.09 and 0.12 +/- 0.08. The frequency of gastro-oesophageal insufflation was 1.6%, 5% and 5% for the LMA and 5%, 15% and 26.6% for the FM for ventilation pressures of 20, 25 and 30 cm H2O respectively which was greater with LMA use.Ventilation was adequate in all patients using both techniques. Leak was pressure dependent and greater with LMA use. Most of the leak was vented to the atmosphere via the pharynx. Gastro-oesophageal insufflation was more frequent with ventilation using the face mask. LMA use with positive pressure ventilation would appear to be a better airway management method than the face mask.

Thermal injury quantitatively and qualitatively alters hematopoiesis, including monocyte-macrophage lineage changes, resulting in altered mononuclear cell function. These bone marrow cells (BMCs) ultimately become fixed tissue macrophages (e.g., Kupffer cells). To study the effects of thermal injury on macrophage-hepatocyte interactions, rat BMCs were isolated 24 hours after burn injury, and myelopoiesis was induced by 7-day culture in granulocyte-macrophage colony-stimulating factor. Separate cultures included inflammatory mediators with growth factor function (IL-6 or PGE2). Cultured cells were incubated up to 96 hours with isolated normal hepatocytes (+/- lipopolysaccharide stimulation). The 96-hour exposure to postburn BMCs produced less of the acute phase proteins (APPs), C3 and transferrin, but more cytotoxicity as measured by 1-lactate dehydrogenase release. Sham BMCs cultured with added IL-6 caused higher APP release and minimal cytotoxicity, whereas burn BMCs stimulated lower APP release and retained cytotoxicity. In conclusion, myeloid cells regulate APP synthesis differently after thermal injury and may become more cytotoxic to hepatocytes.

Peripheral membership status in a desirable ingroup was predicted to elevate outgroup derogation when Ss believed other ingroup members might learn of their responses. Less negativity toward outgroups was expected when peripheral members' responses were to remain private. Core ingroup members, in contrast, were not expected to show public-private differences in derogation of outgroups. The results of 2 experiments supported these predictions, with peripheral but not core ingroup members advocating the most coercion for the outgroup under public conditions in both laboratory-created ingroups (Experiment 1) and naturally occurring groups that had meaning for the participants (Experiment 2). Thus, outgroup derogation can serve a public presentation function that allows for enhancement of an insecure status within a desirable ingroup.

Glutamine is essential for the function of lymphocytes and macrophages, where it serves, among other things, as a source of energy. Little information is available concerning the fuel that polymorphonuclear cells use for their metabolic and bactericidal functions. It was the purpose of this study to determine whether glutamine would enhance the in vitro bactericidal function of normal neutrophils and whether the amino acid would restore the observed impaired function in burn patients to or above the normal level. Twelve burn patients with total body surface area burns ranging from 32% to 87% were studied. At various postburn times, neutrophils were isolated and their ability to kill Staphylococcus aureus in the presence and absence of glutamine was determined and compared with that in normal subjects. Glutamine enhanced the bactericidal function of normal neutrophils. In every patient, at all but two postburn times, glutamine caused an improvement in the observed abnormal neutrophil bactericidal function and often restored it to or slightly above the normal level. Glutamine had no effect on the expression of C3b receptors (CR1 or CD35) or on phagocytosis by the cells. This study confirms the beneficial effects of glutamine in at least one arm of the immune system and adds evidence for the possible advantage of including this amino acid in the diets of burn and other trauma patients.

Risk factors for non proliferative retinopathy were investigated by comparing two groups of insulin dependent diabetic patients: group NR of 25 patients without retinopathy and group R of 25 patients studied at the time of discovery of non proliferative retinopathy. The two groups were matched for age, sex and diabete duration. They were significantly different for insulin treatment regimens, blood glucose control and blood pressure. Lipid parameters and renal function were similar in the two groups.

Treatment of amiodarone iodine-induced thyrotoxicosis is often unsuccessful. Nevertheless, severe forms require a rapidly efficient therapy. Twelve patients with severe amiodarone iodine-induced thyrotoxicosis, as demonstrated on clinical and biological findings, were studied. After amiodarone withdrawal, 6 patients (group A) were treated with thionamides alone (Carbimazole 60 mg daily and benzylthiouracile 1.5 g daily), and 6 patients (group B) received in addition to the same antithyroid drugs prednisone, 0.50 to 1.25 mg/kg/ day for 40 days; in group A, T4 levels did not change over the study period of 40 days; T3 levels decreased only after 30 days; clinical status did not improve. In group B: T3 and T4 levels decreased dramatically at 10 days of treatment, to values significantly lower than in group A; clinical improvement occurred mainly in patients treated with high doses of prednisone; elevated thyroglobulin levels diminished rapidly. Improvement was maintained after cessation of prednisone. The rapid effect of prednisone suggests an impairement of proteolysis of thyroglobulin possibly due to a lysosomal action.

Cerebral blood flow variation patterns have been studied in 20 control subjects and in 30 schizophrenics. This study demonstrates "hypofrontality" in schizophrenics and their lack of reactivity to strong verbal and somesthetic stimulations.

A method of quantitative rheography is presented. The important parameters are the peak time and the damping of the terminal part of the slope. These parameters were compared with the isotopic transit time and with the regional cerebral blood flow (rCBF) measured on 47 subjects by the 133 Xe clearance method. A close correlation was demonstrated between the isotopic transmit time and the peak time of the rheogram. An F index was calculated which correlates very closely with the fast component of the rCBF.

A group of clinical senile dementia patients underwent a series of cerebrovascular examinations. Some of them were standard examinations (fundus oculi, electroencephalogram, rheoencephalogram, cerebral angiogram and pneumonencephalogram) while the others were studying regional cerebral blood flow (rCBF) and modification of flow under fonctional tests (hypercapnia, hypocapnia and intravenous injection of 50 mg chl. papaverine) using the 133Xe clearance technique. The senile dementia group (III) was compared with 'normal' old patients group (I) and with patients suffering from sequelae of a previous stroke or from minor mental disorders (group II). Elderly subjects regarded as 'normal' often present alterations in usual vascular examinations but reveal a relative integrity of cerebral autoregulation. Some patients considered irreversibly 'sclerotic' still have a good grey matter flow (r1CBF) with real vasomotor possibilities. In each of the three groups of elderly subjects, there seemed to be a lack of correlation between the clinical symptoms and certain specific vascular examination.

The presence of residual urine was determined by postvoid bladder ultrasonography in 37 control subjects and 102 unselected insulin-dependent and non-insulin-dependent diabetic patients. Significant residual volume was detected in 19 diabetic subjects without explanation other than diabetic neurogenic bladder dysfunction in 15. The four others had prostatic hypertrophy. Excluding these four subjects, those with residual urine were slightly older than the others (P < 0.05), but the known duration of diabetes was increased only for the insulin-dependent group (P < 0.05). The presence of residual urine was strongly associated with peripheral neuropathy (P < 0.001). In contrast, of all the manifestations of autonomic failure studied, only impotence (P < 0.01) and decreased pupil motility (P < 0.05) were associated with residual urine. The prevalence of urinary tract infection was higher in women than in men (P < 0.02). This prevalence was increased in the presence of residual urine (P < 0.02) but only for men (P < 0.001).

Probenecid was administered to 7 unipolar depressed patients, 7 parkinsonians and 7 extrapyramidal patients with senile dementia matched for age and sex. Before and after the administration of probenecid, the levels of 5-hydroxindoleacetic acid (5HIAA) and homovanillic acid (HVA) were determined in the cerebrospinal fluid (CSF) of all patients in order to study the central turnover rate of serotonin and dopamine. Unipolar depressed patients showed a significantly lower increase in CSF 5HIAA levels after probenecid than parkinsonians. Patients with parkinsonism had a reduced increment of CSF HVA levels following probenecid administration when compared to unipolar depressed and extrapyramidal patients with senile dementia. The authors conclude that the biochemical study of CSF biogenic amines using the probenecid method can be used as a highly sensitive biological screening test for diagnosing Parkinson and depressive syndromes among an aging population of retarded, tremoring, rigid and hypokinetic patients.

The validity of the dexamethasone suppression test was evaluated for the differential diagnosis of primary and secondary depressions. Forty hospitalized psychiatric patients (14 primary depressed, 15 secondary depressed and 11 non-depressed controls) were studied. The Research Diagnostic Criteria of Spitzer et al. (1978) were used to classify these patients. Eight out of the 14 primary depressed patients had an abnormally high plasma cortisol at 4 p.m. after dexamethasone. Only 2 out of the 15 secondary depressed patients and none of the 11 controls had an abnormal response to dexamethasone. Based on these results, the dexamethasone suppression test has a sensitivity of 57%, a specificity of 87% and a predictive value of 80%. The determination of urinary free cortisol excretion does not improve the performance of the test.

We have determined in 46 control subjects and 117 diabetic patients with or without peripheral neuropathy (PN) the blood pressure response to standing and the heart rate variations during deep breathing (HRV) and standing (T/B ratio). HRV was abnormal in 20% of diabetics and T/B ratio only in 8%. HRV and T/B ratio decreased with age both in control and diabetic group and significant alterations of these two tests in diabetic patients were found only for the youngest subjects; HRV and T/B ratio were not related to the duration of diabetes. Ten diabetics had orthostatic hypotension. Diabetics with PN had lower HRV and T/B ratio than the others and, excluding the 10 subjects with large orthostatic hypotension, a lack of increase in diastolic blood pressure and a transient fall in systolic blood pressure on standing. T/B ratio appears in our subjects of less value than HRV for the diagnosis of cardiac autonomic neuropathy; because of the spontaneous alterations with age of the response to these tests interpretation of the results in diabetics is possible only in the presence of appropriate data in control subjects. PN in diabetic patients is strongly associated with abnormalities of heart rate regulation suggestive of cardiac vagal neuropathy and with abnormalities of blood pressure regulation suggestive of peripheral sympathetic lesions.

The state of mental alertness preceding a motor task is accompanied by an increase in cerebral blood flow. During the first trials, these changes seem to be chiefly related to ascending reticular impulses. Habituation lateralizes and focalizes changes which are probably due to metabolic modifications in selective expectancy. The factor E of Eysenck seems to have some correlation with the individual variations observed.

A method of quantitative rheoencephalography estimating the rapid cerebral blood flow, defined by the clearance of Xe 133 is applied to normal, hemiplegic and demented subjects. In the normal child the flow is twice that of the elderly. In adults a decrease of 13% is observed in the fifties. The flow is decreased in both hemispheres of the hemiplegics. The cerebral flow is decreased in the two clinical groups of demented patients (vascular and non-vascular); different values of flow are obtained in these two groups.

We have indirectly assessed the role of free fatty acids (FFA) and of hepatic ketogenesis in the regulation of ketone body levels in euthyroid and hyperthyroid subjects. All studies were performed under controlled dietary conditions (35 and 45 kcal/kg body weight/day respectively for euthyroid and hyperthyroid subjects). In the post-absorptive state hyperthyroid patients had normal, glucagon levels and, in spite of increased insulinemia (p less than 0.02), elevated concentrations of blood glucose (p less than 0.01), glycerol (p less than 0.001) and ketone bodies (p less than 0.05). In the face of this hyperketonaemia, there was no significant increase of plasma FFA, suggesting possible increased hepatic conversion of FFA to ketone bodies. However, when FFA were acutely raised to high levels, the induced rise of ketone bodies was similar in hyperthyroid and euthyroid subjects. Oral propranolol administration to hyperthyroid patients in the post-absorptive state decreased the concentrations of glycerol (p less than 0.05) and ketone bodies (p less than 0.05) without altering insulin concentrations. Ketone bodies fell without any significant decrease of FFA suggesting a possible direct effect of propranolol administration on hepatic ketogenesis. However, the ketone body response to raised FFA levels was unaffected by propranolol. We have evidence in hyperthyroid patients of increased lipolysis and ketogenesis in spite of increased daily caloric intake. These results suggest that these metabolic abnormalities are not merely due to relative starvation. We have tentative evidence for modification of the intra-hepatic conversion of FFA to ketone bodies in the post-absorptive state but no supporting evidence when FFA levels were experimentally raised.

Cerebral impedance changes (F changes) indicating cerebral blood flow variations were measured with a rheographic technique in 10 non-blind and in 7 blind subjects. An F decrease of 14% was elicited in the occipital areas in the blind, while their global hemispheric F was similar to that found in the normal group. In normal subjects reading induced a more marked increase in the left hemisphere while a spatial perception test brought out more activation in the non-dominant hemisphere. Braille reading by the blind caused an increase most important in the left precentral and temporal areas, as well as in the right parietal area.

We have determined in 128 diabetic (57 non insulin-dependent (NIDDM) and 71 insulin-dependent (IDDM) patients) and in control subjects, serum total cholesterol, HDL cholesterol, triglycerides and Hb Alc levels. Presence of macroangiopathy was assessed by clinical findings. In IDDM increasingly poor control of diabetes was associated with significant increases in total cholesterol (p less than 0.001) and triglycerides (p less than 0.01). HDL cholesterol (1.19 +/- 0.39 mM/l) did not differ from control subjects (1.30 +/- 0.35 mM/l) and was not related to Hb Alc levels. NIDDM had increased total cholesterol (5.91 +/- 1.45 vs 5.38 +/- 0.93 mM/l, p less than 0.05) and triglycerides (2.06 - 0.32 to 8.80- vs 1.03 - 0.22 à 2.20 mM/l, p less than 0.01) and decreased HDL cholesterol (1.08 +/- 0.44 vs 1.31 +/- 0.36 mM/l, p less than 0.01). These differences could be explained only in part by the overweight of the NIDDM patients. There was no significant correlation in NIDDM between Hb Alc and serum lipids levels but overweight and triglycerides were positively correlated (p less than 0.02) and triglycerides and HDL cholesterol negatively correlated (p less than 0.05). IDDM with macroangiopathy had higher total cholesterol levels than those without (6.44 +/- 1.60 vs 5.29 +/- 1.22 mM/l, p less than 0.01). IDDM and NIDDM with macroangiopathy had slightly decreased HDL cholesterol; however, the diabetic subjects with macroangiopathy were older and had a longer duration of diabetes than subjects without macroangiopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral impedance changes (F changes) indicating cerebral blood flow were studied in 17 children aged 6-11 years and in 10 normal adults. At rest, large values were found in children, who never exhibited the 'hyperfrontality' pattern of the adults. Reading induced an F increase in both the dominant and non-dominant hemispheres, in contrast with a larger increase in the dominant hemisphere in adults. A spatial test was designed in adults which triggered a larger increase in the non-dominant hemisphere.

Cerebral impedance changes (F changes) indicating cerebral blood flow variations in the central and precentral areas were measured with a rheographic technique in normal subjects preparing for and carrying out a motor task. The time course of the F changes was studied and several significant correlations were established between the amount of F changes, their distribution and the motor performance. Our findings confirm that frontal and premotor regions play an important part in decision making.

The REG technique permitting an estimation of the grey matter flow was applied in conjunction with the simultaneous recording of the EEG analysed by the SULG manual method with 21 normal adult subjects. A relationship was established between the REG index and the EEG frequency index in a resting situation with eyes closed. An increase of the REG index was observed when the eyes were open, for looking at a picture and during a test of visual attention. At opening of the eyes a delay is observed between the desynchronisation of the EEG and the increase of the REG.

Reflections on the consciousness of disability and somatognosis in cases of acute spinal injuries