Spatiotemporal BOLD dynamics from a poroelastic hemodynamic model.

A quantitative theory is developed for the relationship between stimulus and the resulting blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) signal, including both spatial and temporal dynamics for the first time. The brain tissue is modeled as a porous elastic medium, whose interconnected pores represent the vasculature. The model explicitly incorporates conservation of blood mass, interconversion of oxygenated and deoxygenated hemoglobin, force balance within the blood and of blood pressure with vessel walls, and blood flow modulation due to neuronal activity. In appropriate limits it is shown to reproduce prior Balloon models of hemodynamic response, which do not include spatial variations. The regime of validity of such models is thereby clarified by elucidating their assumptions, and when these break down, for example when voxel sizes become small.

Popliteal vein compression under general anaesthesia.

OBJECTIVES: To determine the incidence of popliteal vein compression in supine patients, who are under general anaesthesia and using heel elevators. DESIGN: A prospective cohort study. METHODS: The popliteal veins of 50 patients, lying supine under general anaesthesia, were insonated using duplex ultrasonography to determine the incidence of popliteal vein compression when the knees were flexed and extended. RESULT: There was a statistically significant reduction in popliteal vein diameter in extension compared with the diameter in flexion (median diameter: flexed 7.6mm, extended 2.1mm, p<0.001, Wilcoxon test). In extension, 43% of veins occluded, and a further 21% was compressed by >or=50%. There was a significant relationship to body mass index (BMI) but not to height, gender or age; all patients with BMI >or=30 displayed narrowing at least one vein by >or=50%. The relative risk of vein narrowing >or=50% or occlusion was 1.55 for BMI >or=25 versus <25, and 1.67 for BMI >or=30 versus <25. CONCLUSION: Knee hyperextension in supine patients during general anaesthesia leads to popliteal vein compression or occlusion. The likelihood of compression increases with higher BMIs.

Functional independence training program: an example of a sub-acute care model for patients following primary joint replacement.

The Orthopaedic and Arthritic Hospital is a specialty institution dedicated to the provision of elective reconstructive orthopaedic surgery and rehabilitation to individuals with musculoskeletal disorders. This facility is the largest volume joint replacement centre in Canada, performing over 1,000 hip and knee replacement/revision procedures annually. In 1995, the hospital established a Functional Independence Training (FIT) program--a seven-day reactivation program for patients following primary joint replacement. The program aims to promote early independence, improve functional level and return patients to normal activity as quickly and cost-effectively as possible. The program has received positive patient feedback and has demonstrated the potential to save the health care system approximately $479,655 annually through the reduction of 1,453 acute and rehabilitation hospital inpatient days, based on the hospital's annual primary joint replacement caseload.

Des-enkephalin-gamma-endorphin in the treatment of schizophrenia.

Ninety-three patients with an exacerbation of chronic schizophrenia were included in a 4 week trial comparing placebo with 1, 3 and 10 mg des-enkephalin-gamma-endorphin (DE gamma E; beta-lipotrophin 66-77; Org 5878) per day (i.m.). Maintenance antipsychotic and other medications were continued unchanged. Treatment effects were assessed by means of the Comprehensive Psychopathological Rating Scale--subscale schizophrenia (CPRS-S), Brief Psychiatric Rating Scale (BPRS) and Global Assessment Scale (GAS) rating scales at weekly intervals. Safety data, i.e. laboratory investigations, vital signs and ECG recordings, were assessed before and during the trial. Side-effects were evaluated by means of a Record of Symptoms Emerging. Sixty-eight patients completed the trial, the reason for drop-out mainly being inadequate treatment effects and refusal of medication administration. One patient violated the protocol. After 4 weeks of treatment the mean CPRS-S score of the group receiving 10 mg DE gamma E daily had decreased statistically significantly more than the corresponding score of the placebo group (p less than 0.01). The same trend was apparent with BPRS (p = 0.08) and GAS (p greater than 0.1) scores. Therefore, the study should be considered inconclusive. No clinically relevant side-effects attributable to DE gamma E were observed.

[Acedia or the depressed between sin and illness]. / L'acédie ou le déprimé entre le péché et la maladie.

Acedia is a term of the classical greek vocabulary that a christian author of the IVth century, Evagre the Pontic, uses in a special sense, to describe a mental state characterized among other things, by disgust and dejection, and which, according to him, falls into what became the first list of deadly sins. The word was conveyed to us by another monk of the egyptian deserts, Jean Cassien, with a change of meaning which made it very difficult to distinguish from sadness: his audience being very different from his predecessor's, as he wrote for Latins, little inclined to anachoretic life but among which developed the first great coenobitic institutions of the Occident. One century later, Pope Gregory the great removes acedia from the list of deadly sins, either because he does not distinguish it from sadness (and laziness) or because he considers it a morbid state and, as such, depending on medical care. The word has nevertheless survived until Thomas Aquinas and later, and its study provides valuable data on the mental states prefiguring our modern depressions.

[Affective disorders in the AMDP-4 psychopathological scale]. / Les troubles affectifs dans l'échelle psychopathologique AMDP-4.

The AMDP-4 Psychopathology rating scale contains a category on "Disturbances of affect". It seemed interesting to us to define and explicit the items of this category since "affectivity" is an ill-used concept because it is ill-defined. The same holds for different terms connected to this concept: feelings, emotions, sensations, affects, sensitivity etc. It should be emphasized that the present contribution could only be done thanks to the psychopathological richness of the AMDP; with the most widely used rating scales, it would have been meaningless.

[Aid to patients with mental disorders in Provence in the 18th century]. / L'assistance aux malades mentaux en Provence au XVIIIe siècle.

The provençal attitude towards the "insane" presents during the studied period several leading characteristics; they separate it clearly from the other part of the Kingdom, but, on the other hand, integrate it into a more specific latino-mediterranean behaviour. These characteristics are chiefly: a comparatively kind demeanor towards the mentally ill; an already very medical sight of madness, compared with that of North Europe; the foundation of specialized institutions for insane earlier than in other parts of Western World. The investigations of the leading "provençal" mental hospitals, public and private, confirms this statement. The authors have studied for that purpose: the three "lunatic asylums" of Avignon (1681, the most conclusive), Aix (1691) and Marseille (1699); several private foundations at Saint Remy, Salon de Provence, Manosque. The study of the attendance on mental patients in Provence during the Classic Era shows the danger to speculate perilously as Michel Foucault in his book "La Folie à l'Age Classique much greater than. The investigations on the institutions, that only begins, proves it was very diversified, and the patients were took charge medically long before Pinel.

SV40 DNA injected into Xenopus oocyte nuclei is transcribed by RNA polymerase B.

SV40 DNA I. injected into Xenopus oocyte nuclei is transcribed. The SV40-specific RNA molecules migrate on sucrose gradients as do viral RNAs formed in infected green monkey cells but a variable proportion of RNA sequences complementary to SV40 DNA is also found in the light region of the gradients. All SV40-specific RNA species seem to be synthesized by RNA polymerase B as their synthesis is completely sensitive to low concentrations (0.1 microgram/ml) of alpha-amanitin. Concomittantly, the formation of SV40-specific proteins (tumor antigens) is inhibited by injecting alpha-amanitin together with the SV40 DNA.

[AMDP system and psychopathology (author's transl)]. / Système AMDP et psychopathologie.

The psychopathological scale of AMDP system is voluntary limited to descriptive aspects of psychopathology. If the term psychopathology could be considered identical to psychiatric semiology, the words signs and symptoms go above the descriptive stade: the greek name sumptôma contains sun (with) and piptein (appear), while the word sign is an intellectual deduction of observed symptoms. In the AMDP-3, the sense of evaluated symptoms results from the configurational approach, for example a factor analysis. The splitting of german psychopathological concepts in items and the evaluation of these items in relation to observable compounds bind to their configurational structure will, no doubt, permit to avoid the obstacle of a different conceptualisation of the same symptoms from one school to the other. Furthermore, the AMDP-3 scale and its manual constitute a remarkable teaching instrument for psychopathology, not always enough appreciated.

[Regional medico-psychologic centers]. / Les centres médico-psychologiques régionaux

The intervention of the psychiatrist in the prison world is a comparatively recent phenomenon, since it has been actually effective only since 1945 onwards, at least in France. It is not until 1959 that the Penal Regulations have provided for the setting up of Regional Medical and Psychological Centers (C.M.P.R.). Among the main duties of these centers, the following two are of paramount importance: -- The supervision and treatment of patients who, although they are free from mental disorders calling for institutionalization, show behavioral troubles which may create difficulties, or danger, if they are remanded in normal custody; -- Psychiatrist's advice and, if required (albeit not compulsorily), prescription of medicines. Psychiatrist's advice may be sought either at the request of the inmate (which is the most common procedure), or of the other medical staff of the prison, or required by the Judicial Authority or Administration. The major cause of concern currently challenging the C.M.P.R. is the always unsufficient, and sometimes underqualified, staff.

[Amitriptyline in psychiatric therapeutics. Apropos of 8 years of its use in hospital practice]. / L'amitriptyline en thérapeutique psychiatrique. A propos de huit années d'utilisation en pratique hospitalière

A hundred and thirty patients have been treated with Amitriptylin in the "Clinique de Psychiatrie" in Marseille during the last eight years. The review of the hundred cases for which the information are the most detailed show that Amitriptylin remains one of the most powerful, manageable and well-tolerated anti-depressant drugs available at the present time. Its therapeutic indications are numerous, but the best ones are proceeding from depressed states with high anxious participation in subjects of less that 60 years of age.