Short-term effects of the strobilurin fungicide dimoxystrobin on zebrafish gills: A morpho-functional study

Strobilurins represent the most widely used class of fungicides nowadays andare considered relatively non-toxic to mammals and birds but highly toxic to aquatic biota. Dimoxystrobin is one of the novel strobilurins, recently included in the 3rd Watch List of the European Commission as available data indicate that it could pose a significant risk to aquatic species. As yet, the number of studies explicitly assessing the impact of this fungicide on terrestrial and aquatic species is extremely low, and the toxic effects of dimoxystrobin on fish have not been reported. Here we investigate for the first time the alterations induced by two environmentally relevant and very low concentrations of dimoxystrobin (6.56 and 13.13 μg/L) in the fish gills. morphological, morphometric, ultrastructural, and functional alterations have been evaluated using zebrafish as a model species. We demonstrated that even short-term exposure (96 h) to dimoxystrobin alters fish gills reducing the surface available for gas exchange and inducing severe alterations encompassing three reaction patterns: circulatory disturbance and both regressive and progressive changes. Furthermore, we revealed that this fungicide impairs the expression of key enzymes involved in osmotic and acid-base regulation (Na⁺/K⁺-ATPase and AQP3) and the defensive response against oxidative stress (SOD and CAT). The information presented here highlights the importance of combining data from different analytical methods for evaluating the toxic potential of currently used and new agrochemical compounds. Our results will also contribute to the discussion on the suitability of mandatory ecotoxicological tests on vertebrates before the introduction on the market of new compounds.

Effects of chronic exposure to the water-soluble fraction of crude oil and in situ burn residue of oil on egg-bearing Northern shrimp (Pandalus borealis)

Oil spill clean-up measures using in situ burning can potentially result in seafloor contamination affecting benthic organisms. To mimic realistic exposure and measure effects, ovigerous Northern shrimp were continuously exposed for two weeks to the water-soluble fraction of oil coated on gravel followed by two weeks in clean seawater. North Sea crude oil (NSC) and field generated in situ burn residue (ISBR) of NSC were used (Low: 3 g/kg gravel, Medium: 6 g/kg gravel and High: 12 g/kg gravel). The concentrations of polyaromatic hydrocarbons (PAHs) in the water resulting from NSC were higher compared to ISBR. No mortality was observed in any treatment and overall moderate sublethal effects were found, mostly after exposure to NSC. Feeding was temporarily reduced at higher concentrations of NSC. PAH levels in hepatopancreas tissue were significantly elevated following exposure and still significantly higher at the end of the experiment in NSCHigh and ISBRHigh compared to control. Mild inflammatory response reactions and tissue ultrastructural alterations in gill tissue were observed in both treatments. Signs of necrosis occurred in ISBRHigh. No change in shrimp locomotory activity was noted from NSC exposure. However, ISBR exposure increased activity temporarily. Larvae exposed as pleopod-attached embryos showed significant delay in development from stage I to stage II after exposure to NSCHigh. Based on this study, oil-contaminated seafloor resulting from in situ burning clean-up actions does not appear to cause serious effects on bottom-living shrimp.

Reintroduction of DJ-1 in Müller Cells Inhibits Retinal Degeneration in the DJ-1 Deficient Retina

The eye is continuously under oxidative stress due to high metabolic activity and reactive oxygen species generated by daily light exposure. The redox-sensitive protein DJ-1 has proven to be essential in order to protect retina and retinal pigment epithelium (RPE) from oxidative-stress-induced degeneration. Here, we analyzed the specific role of Müller cell DJ-1 in the adult zebrafish retina by re-establishing Müller-cell-specific DJ-1 expression in a DJ-1 knockout retina. Loss of DJ-1 resulted in an age-dependent retinal degeneration, including loss of cells in the ganglion cell layer, retinal thinning, photoreceptor disorganization and RPE cell dysfunction. The degenerative phenotype induced by the absence of DJ-1 was inhibited by solely expressing DJ-1 in Müller cells. The protective effect was dependent upon the cysteine-106 residue of DJ-1, which has been shown to be an oxidative sensor of DJ-1. In a label-free proteomics analysis of isolated retinas, we identified proteins differentially expressed after DJ-1 knockout, but with restored levels after Müller cell DJ-1 re-insertion. Our data show that Müller cell DJ-1 has a major role in protecting the retina from age-dependent oxidative stress.

Sulfate homeostasis in Atlantic salmon is associated with differential regulation of salmonid-specific paralogs in gill and kidney

Sulfate ( SO 4 2 - ) regulation is challenging for euryhaline species as they deal with large fluctuations of SO 4 2 - during migratory transitions between freshwater (FW) and seawater (SW), while maintaining a stable plasma SO 4 2 - concentration. Here, we investigated the regulation and potential role of sulfate transporters in Atlantic salmon during the preparative switch from SO 4 2 - uptake to secretion. A preparatory increase in kidney and gill sodium/potassium ATPase (Nka) enzyme activity during smolt development indicate preparative osmoregulatory changes. In contrast to gill Nka activity a transient decrease in kidney Nka after direct SW exposure was observed and may be a result of reduced glomerular filtration rates and tubular flow through the kidney. In silico analyses revealed that Atlantic salmon genome comprises a single slc13a1 gene and additional salmonid-specific duplications of slc26a1 and slc26a6a, leading to new paralogs, namely the slc26a1a and -b, and slc26a6a1 and -a2. A kidney-specific increase in slc26a6a1 and slc26a1a during smoltification and SW transfer, suggests an important role of these sulfate transporters in the regulatory shift from absorption to secretion in the kidney. Plasma SO 4 2 - in FW smolts was 0.70 mM, followed by a transient increase to 1.14 ± 0.33 mM 2 days post-SW transfer, further decreasing to 0.69 ± 0.041 mM after 1 month in SW. Our findings support the vital role of the kidney in SO 4 2 - excretion through the upregulated slc26a6a1, the most likely secretory transport candidate in fish, which together with the slc26a1a transporter likely removes excess SO 4 2 - , and ultimately enable the regulation of normal plasma SO 4 2 - levels in SW.

Expression and localization of the aryl hydrocarbon receptors and cytochrome P450 1A during early development of Atlantic cod (Gadus morhua)

The aryl hydrocarbon receptor (Ahr) is a ligand-activated transcription factor that mediates the toxicity of dioxins and dioxin-like compounds (DLCs) in vertebrates. Two clades of the Ahr family exist in teleosts (Ahr1 and Ahr2), and it has been demonstrated that Ahr2 is the main protein involved in mediating the toxicity of dioxins and DLCs in most teleost species. Recently, we characterized the Atlantic cod (Gadus morhua) Ahr1a and Ahr2a receptors. To further explore a possible subfunction partitioning of Ahr1a and Ahr2a in Atlantic cod we have mapped the expression and localization of ahr1a and ahr2a in early developmental stages. Atlantic cod embryos were continuously exposed in a passive-dosing exposure system to the Ahr agonist, benzo[a]pyrene (B[a]P), from five days post fertilization (dpf) until three days post hatching (dph). Expression of ahr1a, ahr2a, and the Ahr-target genes, cyp1a and ahrrb, was assessed in embryos (8 dpf and 10 dpf) and larvae (3 dph) with quantitative real-time PCR analyses (qPCR), while in situ hybridization was used to assess the localization of expression of ahr1a, ahr2a and cyp1a. Quantitative measurements showed an increased cyp1a expression in B[a]P-exposed samples at all sampling points, and for ahr2a at 10 dpf, confirming the activation of the Ahr-signalling pathway. Furthermore, B[a]P strongly induced ahr2a and cyp1a expression in the cardiovascular system and skin, respectively, of embryos and larvae. Induced expression of both ahr2a and cyp1a was also revealed in the liver of B[a]P-exposed larvae. Our results suggest that Ahr2a is the major subtype involved in mediating responses to B[a]P in early developmental stages of Atlantic cod, which involves transcriptional regulation of biotransformation genes, such as cyp1a. The focused expression of ahr1a in the eye of embryos and larvae, and the presence of ahr2a transcripts in the jaws and fin nodes, further indicate evolved specialized roles of the two Ahrs in ontogenesis.

Evolution of adjuvant treatment in endometrial cancer-no evidence and new questions?

PURPOSE

For endometrial cancer (EC), clinical and pathological risk factors are taken to triage patients and estimate their prognosis. Lymph node involvement (pN+), lymphovascular space involvement (LSVI), grading, age of the patients, and T classification are internationally accepted parameters for treatment decisions.

MATERIALS AND METHODS

Studies on adjuvant radiation, chemotherapy, and chemoradiation are discussed against the background of risk stratification and clinical decision-making in early-to-advanced stage endometrial cancer. Recent publications on adjuvant treatment in high-risk disease and its implications for the patients with regard to expected oncologic benefit and treatment-related toxicity are discussed.

RESULTS

Surgery is the mainstay of treatment of EC patients. Well-differentiated tumors and early disease (FIGO IA) should be followed up without further treatment. In FIGO I stage without risk factors, VBT remains the standard treatment after surgery. FIGO I, II patients with one or more risk factors (MI ≥ 50%, Grading[G]3, age >60 years, LVSI) benefit from external beam radiotherapy (EBRT) in terms of survival. There are no data of acceptable quality demonstrating that chemotherapy is superior to radiation in locally advanced carcinomas. Therefore, even in locally advanced disease (FIGO III, IV), EBRT remains the standard of care after surgery. EBRT contributes to the very low rate of local relapses and better DFS in these patients and should not be replaced by chemotherapy only. Whether and which subgroups of patients benefit from an additional (concomitant and/or adjuvant) chemotherapy in terms of disease-free survival remains a controversial issue. The recently published PORTEC-3 trial could not create clear evidence. With a high rate of isolated tumors cells and micrometastases in the specimens, the increasing use of unvalidated sentinel concepts in endometrial cancer raises more questions with regard to indications for adjuvant treatment. In the future, integrated genomic characterization of tumors might be helpful for treatment individualization in the adjuvant setting.

Astroglial DJ-1 over-expression up-regulates proteins involved in redox regulation and is neuroprotective in vivo

DJ-1, a Parkinson's disease-associated protein, is strongly up-regulated in reactive astrocytes in Parkinson's disease. This is proposed to represent a neuronal protective response, although the mechanism has not yet been identified. We have generated a transgenic zebrafish line with increased astroglial DJ-1 expression driven by regulatory elements from the zebrafish GFAP gene. Larvae from this transgenic line are protected from oxidative stress-induced injuries as caused by MPP⁺, a mitochondrial complex I inhibitor shown to induce dopaminergic cells death. In a global label-free proteomics analysis of wild type and transgenic larvae exposed to MPP⁺, 3418 proteins were identified, in which 366 proteins were differentially regulated. In particular, we identified enzymes belonging to primary metabolism to be among proteins affected by MPP⁺ in wild type animals, but not affected in the transgenic line. Moreover, by performing protein profiling on isolated astrocytes we showed that an increase in astrocytic DJ-1 expression up-regulated a large group of proteins associated with redox regulation, inflammation and mitochondrial respiration. The majority of these proteins have also been shown to be regulated by Nrf2. These findings provide a mechanistic insight into the protective role of astroglial up-regulation of DJ-1 and show that our transgenic zebrafish line with astrocytic DJ-1 over-expression can serve as a useful animal model to understand astrocyte-regulated neuroprotection associated with oxidative stress-related neurodegenerative disease.

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Increases astrocytic proteins linked to oxidative stress regulation & inflammation.

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Protects from MPP⁺-induced changes in central metabolism and protein nitrosylation.

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Protects from MPP⁺-induced tyrosine hydroxylase loss and motor deficits.

Involvement of nitric oxide in corticosterone release and glucose metabolism in food deprived rats

This study was performed to investigate the involvement of nitric oxide (NO) in corticosterone, endpoint product of hypothalamo-pituitary-adrenal (HPA) axis activation, and metabolic responses to 3 days of food deprivation. To investigate this aim, we used a nonspecific inhibitor of nitric oxide synthases, N-nitro- L-arginine methyl ester (L-NAME). In food deprived group we have noted a significant increase in plasma corticosterone concentration accompanied by a significant depletion in hepatic glycogen content with concomitant increase in glycogen phosphorylase (GP) activity by 63.72%, key enzyme of glycogenolysis and decrease in hexokinase (HK) activity by 25.16%, leading to significant decrease in glucose concentration. However, L-NAME administration in food deprived rats decreased slightly corticosterone level and GP activity (16.39%) and increased HK activity (11.26%) as compared to food deprived group. Considering these results, we can deduce that in food deprivation nitric oxide is involved in the regulation of corticosterone release and in glucose metabolic responses via glycogenolysis activation by the stimulation of GP activity and the inhibition of HK activity. However, more studies are necessary to further clarify the mechanisms by which NO induces these responses.

Additive effect of diets and training on total insulin-like growth factor-1 (IGF-1) in rats

OBJECTIVES

Although it is known that circulating levels of insulin-like growth factor-1 (IGF-1) are influenced by both physical exercise and dietary intake separately, there is little information regarding the additive effect of diets and training on IGF-1 regulation. To test this, we examined the combined effect of 30 days of two different diets (high-protein and high-carbohydrate) and exercise training on total IGF-1.

MATERIALS AND METHODS

The study was carried out with four groups of rats; the sedentary group with standard diet (SS) (control group), standard diet with exercise (SE), high-protein diet with exercise (PE) and high-carbohydrate diet with exercise (CE). Serum IGF-1, insulin, corticosterone were analyzed.

RESULTS

IGF-1 concentrations were decreased by exercise training (p<0.001) and only with protein diet (p<0.05). Physical training, with and without diet, decreased body weight and food intake (p<0.01) and increased corticosterone levels (p<0.05). Carbohydrate diet did not cause major hormonal and metabolic alterations.

CONCLUSION

The main result of this study was the decreased levels of IGF-1 in spite of high-protein diet, which is known to enhance IGF-1 secretion, and the little changes with carbohydrate diet. This may be related to the negative energy balance as a result of the catabolic state induced by exercise training and decreased calorie intake in protein diet. Thus, it can be concluded that the caloric restriction, regardless of dietary composition, decreased IGF-1 secretion.

Spirometric values in Tunisian children: relationship with pubertal status

BACKGROUND

Little is known about the effect of pubertal stages on lung function parameters in Tunisian children.

AIM

The purpose of this study is to determine the relationship between lung function and pubertal stage in Tunisian children using anthropometric parameters.

SUBJECTS AND METHODS

Pulmonary function parameters were measured with a Minato portable spirometer in 684 healthy Tunisian children (351 males and 333 females) aged between 8 and 16. The pubertal status was assessed for males and females according to the Tanner Method.

RESULTS

A large variation was observed in the distribution of children's age and height by pubertal stages in both sexes. Height increased with age and pubertal stage in both males and females. The results also showed a significant increase in parameters of lung function (FVC, FEV(1), PEF, MEF(50) and MMEF(25-75)) with pubertal stage in Tunisian children. The analysis of covariance adjusting for anthropometric parameters showed that pubertal status had a significant independent effect on some pulmonary function parameters in both sexes.

CONCLUSION

The results indicated that the parameters of pulmonary function for healthy Tunisian school children increased with age, height and pubertal stage. The present study has indicated that the use of only one morphological parameter such as height is not sufficient, but the pubertal status could be taken into account to standardize the lung function.

Protective effect of resveratrol on ethanol-induced lipid peroxidation in rats

AIM

Chronic ethanol treatment induces an increase in oxidative stress. As polyphenolic compounds are potent antioxidants, we aimed to examine whether dietary supplementation of resveratrol may attenuate lipid peroxidation, the major end-point of oxidative damage resulting from chronic ethanol administration.

METHOD

Three groups of male Wistar rats were used. The first group served as control and received a daily intraperitoneal injection of 0.9% saline. The second group of rats was daily injected with 35% ethanol at 3 g/kg body weight. The third group was given the same dose of ethanol and supplemented with resveratrol (5 g/kg) in the standard diet. Malondialdehyde (MDA), an indicator of oxidative stress, was measured in the liver, heart, brain, and testis.

RESULTS

At the end of a 6 weeks treatment period, MDA levels were significantly increased by 51.5, 53.7, 72.7, and 40.5% in the liver, heart, brain, and testis, respectively. However, when ethanol treated rats were given resveratrol the increase in MDA levels was significantly reduced in all organs to nearly those of control rats.

CONCLUSION

Resveratrol is able to inhibit the ethanol-induced lipid peroxidation and have protective effect against oxidative injury.

Vasopressin and nitric oxide synthesis after three days of water or food deprivation

Nitric oxide has been suggested to be involved in the regulation of fluid and nutrient homeostasis. In the present investigation, vasopressin and nitric oxide metabolite (nitrite and nitrate) levels were determined in plasma of male Wistar rats submitted to water or food deprivation for three days. Hematocrit and plasma sodium showed marked increase in dehydrated and starved rats. Potassium levels and plasma volume decreased in both treated groups. Plasma osmolality and vasopressin levels were significantly elevated in water deprived (362.8 +/- 7.1 mOsm/kg H2O, 17.3 +/- 2.7 pg/ml, respectively, p < 0.001) rats, but not in food deprived (339.9 +/- 5.0, 1.34 +/- 0.28) rats, compared to the controls (326.1 +/- 4.1, 1.47 +/- 0.32). The alterations observed in plasma vasopressin levels were related to plasma osmolality rather than plasma volume. Plasma levels of nitrite and nitrate were markedly increased in both water and food deprived rats (respectively, 2.19 +/- 0.29 mg/l and 2.22 +/- 0.17 mg/l versus 1.33 +/- 0.19 mg/l, both p < 0.01). There was a significant negative correlation between plasma nitrite and nitrate concentration and plasma volume. These results suggest that both dehydration and starvation increase plasma nitric oxide, probably by activation of nitric oxide synthases. The release of nitric oxide may participate in the regulation of the alteration in blood flow, fluid and nutrient metabolism caused by water deprivation or starvation.

Spirometric Reference Values in Tunisian Children

BACKGROUND

In Tunisia, there are no normal values of pulmonary function for healthy Tunisian children.

OBJECTIVES

The purpose of this study was to set reference values for spirometric lung function in Tunisian children and to compare these results with other data sets.

METHODS

Spirometric values were measured with a Minato portable spirometer in 1,114 asymptomatic, nonsmoking Tunisian children (581 boys and 533 girls) 6-16 years of age. Natural logarithmic values of lung function and standing height were used in the final regression model.

RESULTS

Prediction equations for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC x 100, maximum mid expiratory flow (MMEF 25-75%) and peak expiratory flow (PEF) for both sexes are presented with standing height as the dependent variable. Our data show a significant increase in lung function with standing height in both sexes. Comparing our results with recent data, values of FVC and FEV(1) in both sexes in the present study are close to those in European, white US and Asian children, whereas our values are higher than the Libyan ones.

CONCLUSIONS

Healthy Tunisian children showed similar spirometric reference values compared to European, white US and Asian children. Thus, these standards of lung function could also be used in Tunisia.

Parathyroid hormone concentrations during and after two periods of high intensity exercise with and without an intervening recovery period

The purpose of this study was to examine the effect of a recovery period between two periods of exercise on bone metabolism and related hormones. Concentrations of serum parathyroid hormone ([PTH]), plasma ionized calcium ([Ca(2+)]) and total calcium were measured. A group of 12 healthy men aged 20-27 years participated in this study. They took part in two exercise protocols (P(1) and P(2)) on two separate weeks. The exercise in P(1) comprised two successive periods of 21 min each at 70% and 85% of maximal oxygen uptake; P(2) comprised two periods of exercise at the same intensities but separated by 40 min of recovery. Venous blood samples were collected 1 day before the sessions (control), before each protocol, during (7th and 21st min), at the end (42nd min in P(1) and 82nd min in P(2)) and after 24 h of recovery. The [PTH] was significantly elevated during the two protocols ( P<0.01), remained raised in P(1) after 24 h of recovery ( P<0.05) and was significantly lower ( P<0.01) at the end of P(2) when compared to P(1). The [Ca(2+)] decreased significantly during and at the end of the two protocols ( P<0.01) and had returned to control values after 24 h of recovery. Plasma lactate concentration increased during the two protocols ( P<0.01) and returned to control values after recovery. These results indicate firstly that [Ca(2+)] decreases during continuous exercise as [PTH] increases and remains raised after 24 h of recovery, secondly that a recovery period between two periods of exercise attenuates the variations in [Ca(2+)] and [PTH], and thirdly that recovery may have anabolic effects on bone. However, the small physiological changes observed prevent us from forming any firm conclusion about this.

[Dispensation of opioids by pharmacists in Tunisia]

This national survey aims to evaluate opioid availability and prescription by pharmacists in Tunisia and to examine pharmacists' attitude regarding Tunisian law. We surveyed a sample of 300 pharmacists randomly selected from the National Council of Pharmacists list and using the random table. This study started in September 1999 by sending to pharmacists a confidential questionnaire asking about the importance, the rate of sale and the availability of analgesics in their pharmacy. It also tried to determine pharmacists' opinions regarding Tunisian law. A total of 157 pharmacists out of 300 responded to the survey (52 per cent), 95 per cent were working in pharmacies and 15 per cent in hospitals. Analgesics were estimated to be important to very important in their work in 84 per cent and less important in 16 per cent of cases. They were given under advice with great importance in 85 per cent of cases and with less importance in 15 per cent of cases. Analgesic self-medication was frequent in 95 per cent of cases and rare in 4 per cent of cases. Analgesics of levels 1 and 2 were often to always available in 97 per cent of cases and rarely available in 1.5 per cent of cases. Some 84.7 per cent of pharmacists had opioid supplies and 8.9 per cent had no opioids in stock and 6.4 per cent hadn't given a response. 30 per cent of pharmacists think that the 7 days law for opioid prescription should be modified and 66 per cent think it should not, fearing illicit use, fraud and dependance. Pharmacists think that the minimal list of opioids to be stocked in a pharmacy is sufficient because of low demand.

Vasopressin and A1 noradrenaline turnover during food or water deprivation in the rat

In the present study, we have examined in Wistar rats the effects of food or water deprivation of 3 days on the hypophyso-adrenal axis, vasopressinergic system and activity of A1 noradrenergic brain stem cell group, which is involved in the control of the hypothalamic neuro-endocrine activity. Levels of adrenocorticotropic hormone (ACTH) and vasopressin (AVP) were determined by radio-immunoassay, and corticosterone level was determined by fluorimetric method. Plasma levels of ACTH and corticosterone were greatly increased in both groups of rats. In water-deprived rats, plasma AVP (13.83 +/- 1.63 vs. 3.03 +/- 0.23 pg/ml) and osmolality levels were significantly elevated with a marked decrease of AVP hypophysis content (272 +/- 65 vs. 1098 +/- 75 ng/mg protein), but not in food-deprived rats in which osmolality did not change and AVP remained stocked (2082 +/- 216 ng/mg protein) in the hypophysis without release in the plasma (1.11 +/- 0.23 pg/ml). These observations indicated that both food-deprivation and water-deprivation stimulated the pituitary adrenal axis thereby suggesting a stress state. AVP production is stimulated both by fluid and food restriction but is secreted with differential effects: during food restriction AVP secretion is limited to supporting the hypothalamic pituitary-adrenal system.

[Plastic surgery in ambulatory practice]

We have analysed 283 patient studies operated of ambulatory during the last two years. These patients represent only 12% of the patient group. It's especially a matter of patients operated urgently. The local anaesthesia in the regional local was practised in terms of 90% of cases. The complications where exceptional. We wanted to insist on the necessary guidelines and pitfalls to forget during the practice of that surgery and we wanted to focus on its advantages.

[The effect of age and dehydration on the activity of the vasopressinergic system in rats]

The aim of our work was to study the different blood parameters as well as the activity of the vasopressinergic axis in young and mature male rats under normal conditions and following a 3-day dehydration cycle by water deprivation. Under normal conditions, our study demonstrates higher levels of vasopressin in mature rats as compared to young rats. This could be due in part to the higher blood osmolality in the mature rats. After dehydration, hypovolemia, plasmatic hyperosmolality, hypernatremia and hyperproteinemia cause a stimulation in vasopressin synthesis and release, as seen in results obtained from the hypothalamus, hypophysis and plasma in both young and mature rats. However, the response of the vasopressinergic axis to dehydration is greater in young rats, suggesting a more pronounced sensitivity to osmotic factors.

[Postpneumonectomy syndrome in adults: description and therapeutic propositions apropos of 8 cases]

BACKGROUND

Adult post-pneumonectomy syndrome can be defined as an extrinsic compression of the main bronchus or a lobe bronchus on the aorta resulting from excessive mediastinal deviation after pneumonectomy.

PATIENTS

Eight cases in adults are reported. The delay to symptom onset was a mean 34 months. Three patients complained of increased dyspnea and 5 patients experienced a must more rapid course with adult respiratory distress syndrome in 1. Fibroscopy and chest CT confirmed the diagnosis of extrinsic compression of the main bronchus or a lobe bronchus.

RESULTS

In the first 2 patients, endoscopic treatment with an endobronchial prosthesis was unsuccessful. The mediastinum was recentered in the following patients using an inflatable prosthesis positioned in the pneumonectomy cavity. Clinical improvement was achieved in all patients. Fibroscopy and chest CT confirmed the reduction in bronchial compression.

DISCUSSION

Early diagnosis and mediastinal recentering are required for good outcome. Surveillance after pneumonectomy should include a search for mediastinal deviation and its consequences, particularly concerning the permeability of the remaining bronchi.

[Effect of fasting on glycemia and proteinemia in young and adult rats]

The aim of Our work has consisted of studying the effects of a severe three-day fast on the evolution of the body weight, on glycemia and on proteinemia among the young and mature male rats. The decrease in body weight which is more marked among young rats after starvation shows that the loss of body mass due to fasting decreases with the age of the rats. The physiological perturbations of nutritive constants that have been recorded during this period of fast show that the mature rat first attacks its non-protein stocks or glucides, which leads to a decrease in its glycemia and in its lipids; whereas the young rat uses its proteins after only three days of starvation because of its small stock of lipids.

Tissue norepinephrine turnover and cardiovascular responses during intermittent dehydration in the rat

We investigated the central and peripheral sympathetic responses to intermittent dehydration in rats. The norepinephrine (NE) turnover, a biochemical index correlated with noradrenergic neuronal activity, was measured. The modification of blood pressure was also determined by telemetry during the different cycles of dehydration. Dehydration caused a decrease of NE turnover in A2, A5 and A6 nuclei and in peripheral organs. The vasopressinergic level of dehydrated rats decreased in hypophysis and hypothalamus, and increased in plasma. A repeated gradual increase of arterial blood pressure during the first three days of dehydration, followed by a sudden drop when the rats were rehydrated on the fourth day was observed. In conclusion, our study revealed an increase in blood pressure and in central sympathetic activity during dehydration.

Effects of acute and chronic starvation on central and peripheral noradrenaline turnover, blood pressure and heart rate in the rat

When faced with stress, an organism calls upon several mechanisms to maintain biological homeostasis. The cardiovascular system is the first to respond usually with an increase in arterial pressure and tachycardia. Therefore we investigated the central and peripheral sympathetic responses to acute and chronic starvation in Wistar rats. The noradrenaline (NA) turnover rate was determined in different catecholaminergic nuclei (A1, A2, A5, A6) as well as the arterial blood pressure and heart rate modifications. During acute starvation (3 days of starvation), the NA turnover was increased in the A1 and rostral A2 nuclei as well as in ventricles and kidneys and decreased in the A6 nucleus. During chronic starvation (4 consecutive cycles of 3 days of starvation plus 1 day of feeding), the NA turnover was increased in the A5 and caudal A2 nuclei as well as in ventricles and atria and decreased in the A1 nucleus and kidneys. The arterial blood pressure revealed a gradual decrease during the first 3 days of fasting but the heart rate was not modified. We conclude that starvation should be considered as an unusual state of stress because of the absence of locus coeruleus response (A6 nucleus) despite its well-defined role in stress reactions. One of the manifestations of these central and peripheral noradrenergic changes is the change in blood pressure during the starvation-feeding cycles.

Effects of acute and chronic starvation on central and peripheral noradrenaline turnover, blood pressure and heart rate in the rat

When faced with stress, an organism calls upon several mechanisms to maintain biological homeostasis. The cardiovascular system is the first to respond usually with an increase in arterial pressure and tachycardia. Therefore we investigated the central and peripheral sympathetic responses to acute and chronic starvation in Wistar rats. The noradrenaline (NA) turnover rate was determined in different catecholaminergic nuclei (A1, A2, A5, A6) as well as the arterial blood pressure and heart rate modifications. During acute starvation (3 days of starvation), the NA turnover was increased in the A1 and rostral A2 nuclei as well as in ventricles and kidneys and decreased in the A6 nucleus. During chronic starvation (4 consecutive cycles of 3 days of starvation plus 1 day of feeding), the NA turnover was increased in the A5 and caudal A2 nuclei as well as in ventricles and atria and decreased in the A1 nucleus and kidneys. The arterial blood pressure revealed a gradual decrease during the first 3 days of fasting but the heart rate was not modified. We conclude that starvation should be considered as an unusual state of stress because of the absence of locus coeruleus response (A6 nucleus) despite its well-defined role in stress reactions. One of the manifestations of these central and peripheral noradrenergic changes is the change in blood pressure during the starvation-feeding cycles.

[Pulmonary resections for cancer in the octogenarian]

More and more elderly subjects are offered for pulmonary resection. The object of this study was to review the results of excision for cancer in octogenarians.

PATIENTS

51 consecutive patients (44 men, 7 women) with a mean age of 82 years (80-91) were operated on. 31 lobectomies, 2 bilobectomies, 13 pneumonectomies, 1 segmental resection and 4 exploratory thoracotomies were carried out. 17 tumours were classed as stage I, 15 as stage II and 15 as stage III.

RESULTS

38 patients (75%) had uncomplicated post-operative periods; the predicted factors for complication were the existence of weight loss and alteration of respiratory function. 2 patients (4%) died in the post-operative phase. Neither the type of operation, the staging or the existence of cardiovascular dysfunction had any influence on the post-operative phase. The level of the survival at 3 and 5 years was 39% and 16% respectively. 30% of the late deaths were related to intercurrent events.

CONCLUSIONS

Pulmonary excision may be envisaged in an octogenarian who is in good physical and intellectual state with a limited tumour. This surgery in general is applied to a population which probably only marginally consists of octogenarians but the results here justify their inclusion in the indications for selection.

[Adrenal cortex activity in the malnourished newborn rat]

Newborn rats (4 day-old) were subjected to chronic malnutrition through their mothers submitted to an intermittent fasting (one day out of two) during 41 days. These offspring were compared with others undergoing a treatment of a 21 days malnutrition followed by 20 days ad libitum realimentation. Rats whose mothers were nourished ad libitum with a standard diet served as controls. The body growth was hindered by the malnutrition but restored when fasting was followed by realimentation. The weight of the encephalon, the heart and the ovary was unchanged. In contrast, testicle atrophy was observed without correction by realimentation. A corticoadrenal activation characterized by an increase in blood and adrenal corticosterone levels and by an adrenal gland hypertrophy was observed in undernourished animals. A lower response of the adrenal cortex to ether stress (added stress) was also observed. All these perturbations were suppressed when fasting was followed by refeeding.

Bronchioloalveolar lung carcinoma: results of surgical treatment and prognostic factors

STUDY DESIGN

To determine the long-term results after surgical treatment of bronchioloalveolar lung carcinoma (BALC) and to identify prognostic factors.

PATIENTS AND METHODS

A retrospective study of 70 patients (49 men, 21 women), mean age 61+/-10 years, was carried out. Their carcinomas were classified into three clinicopathologic types: nodular or tumoral, pneumonic, and diffuse types. All the diagnosed BALC cases were reviewed and were classified into histologic types: mucinous, nonmucinous (including fibrotic center), and mixed tumors. Univariate and multivariate analyses were carried out.

RESULTS

The nodular or tumoral type was identified in 42 patients, pneumonic in 21, and diffuse in seven. Histologically, there were 36 mucinous, 25 nonmucinous, and nine mixed tumors. Resection was complete in 61 instances (87%) and incomplete in five. The 5-year survival rate was 34% in patients with curative resections. Five prognostic factors were identified by univariate analysis, but in multivariate analysis, only three factors remained significant: the absence of symptoms, the TNM stage, and completeness of resection. Thirty-six patients with curative resection (59%) developed recurrences (in the lung in 26 patients; mediastinal lymph nodes, four; distant metastases, nine). The frequency of recurrence was significantly greater in patients with pneumonic-type BALC than in nodular or tumoral types (p<0.01), and pulmonary recurrences were significantly more frequent in pneumonic than in tumoral types (p<0.02).

CONCLUSIONS

This study confirmed that the overall prognosis of BALC is not significantly different from that of the other non-small cell lung cancers. We found that the lungs are the predominant site of recurrence in BALC, especially in the pneumonic types. The complete surgical resection of localized BALC offers the best chances of long-term survival.

[Effects of simulated weightlessness on the hypophyseal-cortical-adrenal axis in the pregnant rat]

The eventual part of stress in the hormonal responses to simulated weightlessness was studied during gestation in the rat. We have compared these responses with the effects of two other situations well-known to provoke stress: ultrasounds and denutrition. An increase of blood and adrenal corticosterone levels was found in mothers after denutrition, neither after ultrasounds nor after simulated weightlessness. In foetuses, a decrease of weight was noted after denutrition and simulated weightlessness. Foetal suprarenal corticosterone remained normal when mothers were submitted to simulated weightlessness. In this group, a decrease in foetal weight was found that could be explained by non suprarenal hormonal factors or by circulation disturbances.

Cortico-adrenal function under simulated weightlessness during gestation in the rat--effects on fetal development

To examine the effects of simulated weightlessness on cortico-adrenal function and on fetal development, we suspended pregnant rats for 20 days. The levels of adrenal and plasma corticosterone were examined in mothers and in fetuses. The animal control group was kept single in standard cages. Growth of the suspended animals was repressed for the first 8 days of the experiment, but thereafter it increased greatly, as did the daily food intake. By the 18th day of the experiment, the body masses and food intake of the two groups were equal. No modification in circulating corticosterone was found. It appears that there is no stress in pregnant rats submitted to simulated weightlessness.