Regulation of LRP-1 expression: make the point.

The low-density lipoprotein receptor-related protein-1 (LRP-1) is a membrane receptor displaying both scavenging and signaling functions. The wide variety of extracellular ligands and of cytoplasmic scaffolding and signaling proteins interacting with LRP-1 gives it a major role not only in physiological processes, such as embryogenesis and development, but also in critical pathological situations, including cancer and neurological disorders. In this review, we describe the molecular mechanisms involved at distinct levels in the regulation of LRP-1, from its expression to the proper location and stability at the cell surface.

[Current aspects of the use of clozapine in the Châlons-sur-Marne Psychiatric Hospital: intestinal occlusion with clozapine]. / Actualité de l'utilisation de la clozapine à l'Hôpital psychiatrique de Châlons-sur-Marne: occlusions intestinales sous clozapine.

The authors report three cases--one of them lethal--of intestinal occlusion among 30 patients treated with clozapine between 1991 and 1994 in Châlons-sur-Marne Psychiatric Hospital. The responsibility of clozapine seems to be linked with its potent anticholinergic property. The attention of prescriptors is necessary and the monitoring of the drug should not be limited to the hematologic aspect.

[Critical approach to emergency care in consultation psychiatry]. / Approche critique de la notion d'urgence en psychiatrie de liaison.

36 patients consecutively admitted in medical and surgical wards of Reims' University Hospital, and referred to the Psychiatric Emergency Unit, were assessed for their psychiatric morbidity (DMS-III-R, axis I) and their psychiatric dangerousness. Approximately one third of the patients didn't suffer from any mental disorder and belonged to the area of psychological medicine. One third showed reactional disorders, were dangerous and were then admitted in a psychiatric department. The risks of the development of liaison psychiatry are discussed by authors--for example, the hardly admitted concept of psychiatric emergency is in danger of losing value.

[Non-verbal clinical psychiatric aspects]. / La clinique psychiatrique non verbale.

Mimic, involuntary movements, agitation or immobility, are parts of description, comprehension and evaluation of any human behaviour, normal or not: they were included in the classic european psychiatries. They almost disappear from the actual scales of evaluation, or from the training through scales. It seems possible to complete such scales, exclusively verbal, by scales of behaviours-suicidal attempt being a good instance of such behaviours.

[Treatment of puerperal mental disorders and dysfunctioning of the early mother-child relation at the maternity of the General Hospital Center of Charleville-Mzières]. / Traitement des troubles psychiatriques de la puerpéralité et des dysfonctionnements de la relation précoce mère-enfant à la maternité du C.H.G. de Charleville-Mézières (08).

The psychiatric care of the motherhood disorders and of their consequences over the early mother-child relation has become necessary from P.C. Racamier's writings and after studies about maltreated young children. Maltreatment has been defined by us in a broad sense, that is to say from marked cruelties to neglect, including various forms of aggressiveness and rejection. The Maternity Hospital, as a structure, has been considered as a well-suited place because nearly all the future mothers of the department are delivered there. The work undertaken for one year at Charleville-Mézières Maternity Hospital is clinically described, with its advantages and its difficulties, revealing the increasing need of a correctly trained multidisciplinary staff, even specialized, which could ensure psychiatric care over a period long enough to be effective.

[Emergency psychiatry at the University Hospital Center of Reims: current data]. / Psychiatrie d'urgence au C.H.U. de Reims: données actuelles.

The population of Reims Hospital Psychiatric Emergency Unit is described for the years 1989 and 1975-76. This population is essentially composed of young adults of both sexes, frequently mentally ill. Between the two periods there are a numerical stability of the patients, and a higher chronicity rate of these patients in the unit despite their lower psychiatric hospitalization rate.

[Biomedical researches: for whom? for what? how?]. / Recherches bio-médicales: pour qui? pour quoi? comment?

The law of December 20th 1988 provides for the protection of those people who lend themselves to clinical research, both patients and healthy subjects. The ex-expert clinicians are confronted with new drugs and protocols of experimentation enacted by industry. Grey areas still exist, authors try to limit them for want of being able to through light on them, today.

[Evaluation of the risk factors of suicide in patients treated for mental disorders. Review of the literature from 1978 to 1988]. / Evaluation des facteurs de risque de suicide chez les malades mentaux traités. Revue de la littérature de 1978 à 1988.

Research on suicide risk factors among psychiatric patients has developed considerably over the last 10 years. The methodological problems are numerous. Tentatives of global prediction have been unsuccessful in describing one complete and specific picture of the mentally ill suicide, whereas lawsuits against psychiatrists are frequent after patients' suicides. Through the analysis of 37 publications from 1978 to 1988 the authors review the main suicide risk factors identified among treated psychiatric patients.

[Standardized symptomatologic inventory adapted to psychiatric emergency]. / Inventaire séméiologique standardisé adapté à l'urgence psychiatrique.

Clinical psychiatry, particularly in the case of hospital emergency, begins with the patient's benevolent observation. It goes on with the verbal communication, subordinated itself to linguistic problems. There are now daily cross-cultural practising and education in France. This is the presentation of a standardized inventory and of its instructions for use, created in connection with a multicentric currently analysed survey. The inventory can be used without major difficulty by non clinicians and general practitioners.

[Lithium as founding the concept of endogenous mental disease]. / Le lithium fonde le concept de maladie mentale endogène.

The abnormal life--potentially the death--of the cell can be restored by a metalloid--lithium--which is nearly as common as sodium in the mineral world. This established fact grounds indirectly, contrary to apparent and scientific logic, the concept of endogenous brain disease which was until then an abstract concept because of a lack of objective evidence. Seven case reports are described.

[Suicidal alcoholic patients: profile, risk factors and review of the literature from 1955 to 1988]. / Le patient alcoolique suicidaire: profil, facteurs de risque et revue de la littérature de 1955 à 1988.

Alcoholism and suicide are two Public Health problems which are linked at the epidemiological and clinical levels. Research over suicide risk factors among alcoholic subjects has developed mainly among medicalized psychiatric populations. Suicide occurs late among alcoholic patients, and affects particularly men and socially isolated subjects. The main risk factors relate to the decrease of the socio-economic status. loss of job and of income-, to the interpersonal loss--i.e. family bereavement or breach of relation, to the existence of a suicidal ideation often communicated or of suicidal antecedents, to a degradation of the physical state or the presence of some affections like gastro-duodenal ulcer. The identified factors are of little specificity. It is difficult to assess their interrelations and their respective true values. The reliable prediction of a later suicide remains presently impossible. Progress in analytic research over the alcoholic patients' suicide could result from the standardization of populations and of studied factors and from the use of multivariate analysis statistical methods.

[Demethylation and blood dosage of antidepressive imipramine drugs. Preliminary note]. / Déméthylation et dosage des antidépresseurs imipraminiques dans le sang. Note préliminaire.

The ability to demethylate the classical imipraminic antidepressants is a key factor for the immediate and long-term management of long cycles primary unipolar depressions. These are preliminary observations concerning two different cases of a well-demethylating patient, and a badly-demethylating one.

[Consumption of psychotropic drugs and medical care preceding voluntary drug poisoning in 63 patients with major depressive disorders according to the DSM III-R]. / Consommation de psychotropes et prise en charge médicale avant une intoxication médicamenteuse volontaire chez 63 déprimés majeurs selon la DSM III-R.

Twenty years after the large development of the use of psychotropic drugs and of a psychiatric formation for doctors, 63 subjects with a major depressive episode following the D.S.M. III-R criteria were interviewed in a psychiatric emergency unit about their psychotropic drugs consumption and their medical care preceding a drug self-poisoning. There is a discrepancy between the subjects' depressive pathology and their care consumption. During the depressive episode 3% of the subjects received a treatment considered to be adequate--existence of an antidepressant therapy at sufficient dosage and duration together with a medical psychological follow-up. The results indicate a relative failure of the health care system. The importance of the selection of the sample and the limits of a medical approach are stressed. The usefulness of anti-depressant drugs and the necessity for a psychiatric training for doctors cannot be questioned. Only prospective studies could demonstrate whether a better suited medical action is able to reduce the incidence of suicidal behaviour among depressive patients.