[Electrophysiological studies of chronic pelvic and perineal pain]. / Explorations électrophysiologiques des douleurs pelvipérinéales chroniques.

OBJECTIVE: To describe electrophysiological studies, what they investigate, and their contribution and limitations in the assessment of pelvic and perineal pain. MATERIAL AND METHOD: Description of the electrophysiological techniques generally used to evaluate somatic nerves of the pelvic and perineal region (analytical electromyography, nerve conduction velocities, reflexology), their applications and the difficulties of interpretation. RESULTS: Electrophysiological studies can demonstrate signs in favour of peripheral neuropathy, specify the axonal and/or demyelinating type of lesion, and provide topographic arguments on the type of trunk or nerve root involved (pudendal nerve, sacral nerve roots, ilioinguinal or iliohypogastric nerve, genitofemoral nerve, obturator nerve). CONCLUSION: Electrophysiological studies require a technically skilled operator and can provide a better understanding of some types of pain, but are not sufficiently sensitive and specific. The conclusions of electrophysiological study reports must be closely correlated with clinical findings.

[Therapeutic education and alternative medicine]. / Éducation et thérapies parallèles dans la prise en charge thérapeutique des douleurs pelvipérinéales chroniques.

OBJECTIVE: To review the most common Complementary and Alternative Medical (CAM) therapies described for chronic pelvic pain care and to analyze their results as reported in the literature. MATERIAL AND METHODS: Review of articles and consensus conferences published on this subject in the Medline (PubMed) database, selected according to their scientific relevance. RESULTS: Lifestyle interventions have a positive impact on patients' self-management of their chronic pain. Positive outcomes are associated with well-balanced diet, dietary changes and certain dietary supplementations for bladder pain syndrome and chronic pelvic pain syndrome. Limited data exist supporting the use of acupuncture for chronic pelvic pain, endometriosis, bladder pain syndrome and urethral pain syndrome. There is no evidence for homeopathy and mesotherapy. CONCLUSIONS: Published data on many CAM therapies suggest their potential as complementary treatment options of chronic pelvic pain. As conventional treatments, CAM therapies warrant further studies to assist in their validation as permanent treatment options for this patient population.

[Neurostimulation techniques in the therapeutic management of chronic pelvic and perineal pain]. / Les techniques de neurostimulations dans la prise en charge thérapeutique des douleurs pelvipérinéales chroniques.

INTRODUCTION: Neuromodulation is a nonspecific analgesic treatment whose mechanism of action has not yet been elucidated. The purpose of this article is to review the techniques and results of neuromodulation in the management of chronic pelvic and perineal pain. MATERIAL AND METHODS: A comprehensive review of the literature was performed by searching PUBMED for articles on the various neuromodulation techniques used in the management of chronic pelvic and perineal pain. RESULTS: Several levels of neuromodulation of the somatic nervous system have been evaluated in the management of pelvic pain: transcutaneous electrical nerve stimulation (TENS), percutaneous nerve stimulation (PNS), nerve root or nerve trunk stimulation, spinal cord stimulation. An improvement was obtained in an average of two thirds of cases, but with declining efficacy over time. The various studies were difficult to compare due to the heterogeneous study populations and very diverse endpoints. Interesting studies on the value of autonomic nervous system intervention have been described, but with no specific trials of neuromodulation. CONCLUSION: The place of neuromodulation in the management of patients with chronic pelvic and perineal pain has yet to be defined, as it is too frequently used as a last resort. It appears important to develop and analyse this treatment modality in large-scale, randomized, prospective studies.

[Alternative treatments for interstitial cystitis]. / Les traitements de recours dans la cystite interstitielle.

Interstitial cystitis is the first cause of bladder pain. In case of failure of the usual treatments, several other modalities have been proposed. These therapeutic modalities are posterior sacral root neuromodulation, posterior tibial nerve stimulation, vanilloid agent intravesical instillation, intradetrusor botulinum toxin injections and surgery. A certain efficiency of each of these treatments in the interstitial cystitis has been reported. However, the evaluation of these treatments is limited and the level of evidence is too low to propose these treatments in routine.

[Sufficient autotransfusion with a single-use device in experimental vascular surgery]. / Autosuffisance transfusionnelle réalisée au moyen d'un dispositif à usage unique en chirurgie vasculaire expérimentale.

The authors used a disposable original system to recover total blood during surgery and realized 17 transfusions of autologous blood in sheep. No biological or clinical disturbance was observed.

How is leghemoglobin involved in peribacteroid membrane degradation during nodule senescence?

An increase in the rate of succinate and glutamate uptake by isolated symbiosomes from French bean nodules was observed in the presence of iron plus H2O2. The lipid bilayer, and not proteins involved in transport, seems to be the major target of radical attack. Leghemoglobin in the presence of a 6-fold excess of H2O2 (where heme breakdown and iron release occurred) provoked also an increase in peribacteroid membrane permeability. In contrast, this hemoprotein in the presence of a 2-fold excess of H2O2 (where a protein radical was generated) was without effect. We suggest that in vivo the release of heme iron may constitute the major process concerning the involvement of leghemoglobin in the degradation of the peribacteroid membrane during nodule senescence.

delta-Aminolevulinate uptake by Rhizobium bacteroids and its limitation by the peribacteroid membrane in Legume nodules.

Heme is overproduced during Rhizobium-Legume symbiosis and delta-aminolevulinate (ALA) is a common precursor in both bacterial and plant synthesis pathways of this molecule. ALA uptake by bacteroids from French bean and soybean nodules was characterized. The action of several metabolic inhibitors and the competition effect of malate on this uptake were studied. ALA transport appeared to be mediated by the dicarboxylate carrier system. Purified symbiosomes--bacteroids surrounded by the peribacteroid membrane--failed to accumulate significant amount of ALA. These experiments rule out the possibility for the plant cytosol to provide the bacteroid with ALA and strengthen the restrictive role of the peribacteroid membrane for exchanges between the two symbiotic partners.

[Use of a disposable peroperative autotransfusion device in uncomplicated vascular surgery]. / Utilisation d'un dispositif d'autotransfusion peropératoire à usage unique en chirurgie vasculaire réglée.

We used a simple single process to recover total blood during surgery. All the process stands on a low burdensome jib and does not require additional staff in theater. Its cost is low. The indications concern all surgical operations enduring low or mean bleeding, except in septic and cancer surgery. It may be used in emergencies, even in war surgery with an incorporated source of depression.

Monomer-oligomer equilibrium of bacteriorhodopsin in reconstituted proteoliposomes. A freeze-fracture electron microscope study.

An improved freeze-fracture electron microscope procedure has been developed and applied to the study of the association of bacteriorhodopsin in large proteoliposomes reconstituted by reverse-phase evaporation with egg lecithin. Due to the improved accuracy and resolution of this procedure, intramembrane particles, the diameter of which (4.5 nm) closely matched that of bacteriorhodopsin monomer, could be observed at high lipid to protein ratios (greater than or equal to 40 w/w). At lower lipid to protein ratios, larger particles (diameter 7.5 nm) progressively appeared, resulting in bimodal particle size distributions up to a lipid to protein ratio of 1, where the large particles were the sole species present. These large particles were interpreted as corresponding to bacteriorhodopsin oligomers. Because of the large size and homogeneity of proteoliposomes, accurate particle density measurements could be performed. These confirmed the occurrence of a lipid to protein ratio-dependent bacteriorhodopsin monomer-oligomer equilibrium and further allowed us to identify the oligomer as a trimer or a tetramer. In complementary experiments, it was found that the bacteriorhodopsin monomer and oligomer had identical visible CD spectra and light-induced proton pumping rates. However, a large increase of the proton passive leak rate of proteoliposomes was found to be associated with oligomer formation. The appearance of these oligomers may be important as the first step in the formation of two-dimensional crystals of bacteriorhodopsin.

The relationship between the chromophore moiety and the cation binding sites in bacteriorhodopsin.

Bleaching of the purple membrane strongly reduces the number of divalent cation binding sites as well as their affinities. Conversely, deionization of the bleached membrane drastically inhibits the chromophore regeneration. Proteolysis experiments using bromelain show that the bleached membrane has an additional cleavage site probably located at the fifth loop, whereas in the blue membrane, the C-terminal tail is no longer susceptible to proteolysis. It is suggested that there exists a close relationship between the retinal environment and one or more of the cation binding sites.

[Identification and analysis of hydrogenated cyclic monomeric acids in the hepatic lipids of rats ingesting heated linseed oil]. / Identification et dosage des acides monomères à structure cyclique hydrogénés dans les lipides hépatiques du rat ayant ingéré de l'huile de lin chauffée.

In a short-term (15 days) experiment, weanling Wistar rats were given diets at weaning containing 10% of different linseed oils: fresh linseed oil (lot F), linseed oil heat polymerized at 275 degrees C for 12 h under nitrogen (lot T) and linseed oil oxidized in the presence of air at 200 degrees C for 100 h (lot O). We analyzed the fatty acids of total liver lipids and assayed the hydrogenated cyclic monomeric acids and identified them by using a combination of gas-liquid chromatography and mass spectrometry. Compared to lot F animals, those of lots T and O showed considerable hepatic hypertrophy but total liver lipids were not increased. However, the usual fatty acid composition of these lipids was modified: the level of several monounsaturated (16: 1, 18: 1) and polyunsaturated (mainly 20: 4n - 6) fatty acids was increased in lots T and O, which could result in increased activity of the enzymatic systems (desaturases) biosynthesizing them. Moreover, cyclic monomeric acids from heated oils were deposited at a 10 times higher concentration in the liver of lot T animals than in that of lot O animals. The significance of these changes has been discussed.