Management of oncologic transplant recipient: the profile of the radiation oncologist.

Long-term survival after organ transplantation is increasing. As a result, many physicians may encounter various solid organ cancers during follow up. We review papers who address their attention on those malignancies and their treatment. Aim of this work is to discuss the role of radiotherapy especially when helped by new technologies in the management of brain, skin, head and neck, lung, breast, prostate and anal cancer. In our institution we are used to treat such patients by Helical Tomotherapy in order to avoid graft and to limit high risk toxicity. As example, we include a scalp and pelvic irradiation in which high dose conformality is linked to best organ sparing.

[Staff-patient meetings at the psychiatric unit of a university hospital center]. / Réunion soignants-soignés dans un service de psychiatrie de C.H.U.

Staff/patients meetings have been held for 10 years within a mental teaching hospital for adults. The meeting was initiated by a clinical psychologist still in charge of it. The patients have developed the following themes: (i) entrance conditions, (ii) everyday life information, (iii) inconveniences, (iv) mental illness, (v) the exclusion process. The least severely affected patients will exclude the other ones on ground of insanity. Yet all patients consider themselves banned from society, and even feel rejected by the stall at times. The meeting is meant as a regular talk scène. Individual or collective conflicts arising between the patients can be settled there. Patient passivity may also be counteracted. Staff seminar should work up clearly the data provided by the meeting.

[Clomipramine and demethylclomipramine. Correlation of plasma levels and efficacy in 24 depressive patients]. / Clomipramine et déméthylclomipramine. Corrélation taux plasmatiques/efficacité chez 24 déprimés.

Plasma concentrations of clomipramine (CL) and demethylclomipramine (DMCL) were determined in 24 patients with an endogenous (9) or non endogenous (15) depressive syndrome, treated in hospital for 21 days, with clomipramine; simultaneous clinical evaluations were performed with Hamilton Rating Scale. Optimal therapeutic effect was observed when the sum of CL + DMCL plasma levels was less 200 ng/ml or more 400 ng/ml. In our responders, the CL/DMCL ratio was around 0.6. The relation between demethylation and clinical outcome is considered.

[Plasma levels of clomipramine and declomipramine in patients with depression: a study of its correlation with therapeutic efficacy]. / Concentrations plasmatiques de clomipramine et de déclomipramine chez des patients atteints de dépression: recherche de corrélations avec l'efficacité thérapeutique.

Twenty four in-patients with an endogenous or non endogenous depressive syndrome (9 and 15, respectively) were treated in hospital for 21 days with various dosages regimens of clomipramine. Plasma concentrations of clomipramine and demethylclomipramine were determined once a week in blood samples. Therapeutic effects were assessed with Hamilton Rating Scale. At day 21, optimal therapeutic effect was observed when the sum of clomipramine and demethylclomipramine plasma levels was situated between 200-400 ng/ml.

[A peripheral biological marker of organicity. Chromosome mosaic anomalies in general psychiatry]. / Un marqueur biologique périphérique d'organicité. Les anomalies chromosomiales en mosaïques en psychiatrie générale.

During February 1979 to December 1982 we studied the karyotype of 706 psychiatric adult patients without making a clinical selection. We found a chromosomial mosaïc aberration in 37 cases, concerning one leukocyte mitosis for ten studied cells : so a proportion of 5.2% cases. There do not exist statistics concerning the general population's mosaïc aberrations but in the same population the proportion of the homogeneous aberrations is near 0.5%, so 10 times lower than the proportion that we observed. The largest number of aberrations found concern the gonosomes, essentially some monosomics 45,XO or some trisomics 47,3X, among women who present a maniac depressive psychosis or another type of depression.

[Lewis-negative blood group. Definite frequency, probable prognostic value in adult psychiatry]. / Groupe sanguin Lewis négatif. Fréquence certaine, valeur pronostique probable en psychiatrie de l'adulte.

The negative Lewis blood type is meaningfully more frequent with our psychiatric patients than with the general population. The theoretical interest of this fact is certain for the reason of two particularities of this blood type. It is not genetically and definitely determined at birth: the absence of passing over negativity through positivity seems to constitute a factor in favour of the blossoming of a psychiatric pathology. It is in connection with the secretory aptitude of some cells: this fact opens some perspectives for the comprehension of the deficits in the neurotransmitters. The application of theory will be confirmed by others statistics. But it indeed appears that the control of the chemiotherapy is more difficult with the negative Lewis blood type patients.

[The Lewis blood group is more frequently nonexpressed in psychiatry than in the general population]. / Le groupe sanguin Lewis est plus fréquemment non exprimé en psychiatrie que dans la population générale.

The Lewis-negative blood group seems to occur more frequently in psychiatry than in the overall population. The Lewis group is not genetically determined at birth as Lewis-positive or negative; the latter occurs significantly more often among 219 "overall" psychiatric patients than in the overall population: 47% instead of 10%. As a first approximation, the absence of transition from its negativity to positivity seems to constitute a favoring factor for the subsequent clinical development of a psychiatric syndrome, without allowing to predict its nature or severity. For the other blood groups, the genetic determination of which is irreversible, the same sample shows the same repartition as in the overall population.

[Unipolar periodic depressive psychosis and chronic tricyclic antidepressive treatment]. / Psychose unipolaire dépressive périodique et traitement antidépresseur tricyclique chronique.

Part of unipolar periodic déxpressions may - enjoy an active and comfortable existence, with-out recourse; - during at the less 10 years after beginning of the cure; - under condition of a long-course treatment by tricyclic antidepressors, the patient being trained to module himself the daily doses.

[136 karyotypes in psychiatry: surprising results]. / 136 caryotypes en psychiatrie: résultats surprenants.

136 patients admitted into a psychiatric unit underwent a routine caryotype examination, without any previous selection, 9 anomalies were noticed, including one case of X-tetrasomia, reported elsewhere, and eight mosaics. The patients concerned do not present any morphological anomaly or intellectual deficiency. The authors consider those--mostly gonosomial--mosaics as a minimal brain damage, favourising the appearance of the particular psychiatric syndrome.

[Manic-depressive psychoses. Chronic treatment with tricyclic antidepressive agents]. / Psychose maniaco-dépressive. Traitement antidépresseur tricyclique chronique.

Long-course Tricyclic anti-depressing treatment affonds clinical healing--i.e. abolition of the recurrences--in melancolic unipolary periodic depressions. This treatment--T.A.T.C.--allows a good prevention of melancolic recurrences in bipolar periodic patterns of psychosis. For the authors Lithium and/or Dipropylacétamide are not sufficient protection for melancolic or maniac recurrences in this patterns. It seems to be three patterns in fact: pure melancolic, pure maniac, and maniaco-depressive. Therapeutic and psychopathologic considerations.