Indirect Lymphoscintigraphy in Patients with Limb Oedema

One thousand four hundred and fifty-five lymphoscintigraphies using a radio-labelled colloid were performed as an objective test for the diagnosis and the survey of lower limb oedemas. It is a non-invasive method involving only a subdermic bipedal injection into the first web space of each foot. Our results demonstrate that in chronic swollen legs due to venous causes occuring from post-thrombotic syndrome or varicose disease the lymphatic system can be insufficient (14.9% and 19.8% of these cases). Abnormal results are found in 91.3% of clinically primary lymphoedemas. In unilateral primary lymphoedemas the clinically healthy controlateral limb can be insufficient (25%). In post-traumatic lower limb oedemas the lymphatic flow remains normal while perilymphatic extravasation and dermal filling are always to be found at the trauma site. The lymphoscintigraphy is a simple, physiological and reliable test. The morphological findings based upon 1455 examinations allow us to think that this method may resolve the clinical problems without recourse to more invasive procedures. We can expect that in a few years this morphological study will be completed with a functional lymphatic test.

Value of Image Fusion in Coronary Angiography for the Detection of Coronary Artery Bypass Grafts

BACKGROUND

Coronary angiography is more complex in patients with coronary artery bypass grafts (CABG). Image fusion is a new technology that allows the overlay of a computed tomography (CT) three-dimension (3D) model with fluoroscopic images in real time.

METHODS AND RESULTS

This single-center prospective study included 66 previous CABG patients undergoing coronary and bypass graft angiography. Image fusion coronary angiographies (fusion group, 20 patients) were compared to conventional coronary angiographies (control group, 46 patients). The fusion group included patients for whom a previous chest CT scan with contrast was available. For patients in this group, aorta and CABG were reconstructed in 3D from CT acquisitions and merged in real time with fluoroscopic images. The following parameters were compared: time needed to localize the CABG; procedure duration; air kerma (AK); dose area product (DAP); and volume of contrast media injected. Results are expressed as median. There were no significant differences between the 2 groups in patient demographics and procedure characteristics (access site, number of bypass to be found, and interventional cardiologist's experience). The time to localize CABG was significantly shorter in the fusion group (7.3 versus 12.4 minutes; P=0.002), as well as the procedure duration (20.6 versus 25.6 minutes; P=0.002), AK (610 versus 814 mGy; P=0.02), DAP (4390 versus 5922.5 cGy·cm(2); P=0.02), and volume of iodinated contrast media (85 versus 116 cc; P=0.002).

CONCLUSIONS

3D image fusion improves the CABG detection in coronary angiography and reduces the time necessary to localize CABG, total procedure time duration, radiation exposure, and volume of contrast media.

Comparative Analysis of Sequential Proximal Optimizing Technique Versus Kissing Balloon Inflation Technique in Provisional Bifurcation Stenting: Fractal Coronary Bifurcation Bench Test

OBJECTIVES

This study used a fractal bifurcation bench model to compare 6 optimization sequences for coronary bifurcation provisional stenting, including 1 novel sequence without kissing balloon inflation (KBI), comprising initial proximal optimizing technique (POT) + side-branch inflation (SBI) + final POT, called "re-POT."

BACKGROUND

In provisional bifurcation stenting, KBI fails to improve the rate of major adverse cardiac events. Proximal geometric deformation increases the rate of in-stent restenosis and target lesion revascularization.

METHODS

A bifurcation bench model was used to compare KBI alone, KBI after POT, KBI with asymmetric inflation pressure after POT, and 2 sequences without KBI: initial POT plus SBI, and initial POT plus SBI with final POT (called "re-POT"). For each protocol, 5 stents were tested using 2 different drug-eluting stent designs: that is, a total of 60 tests.

RESULTS

Compared with the classic KBI-only sequence and those associating POT with modified KBI, the re-POT sequence gave significantly (p < 0.05) better geometric results: it reduced SB ostium stent-strut obstruction from 23.2 ± 6.0% to 5.6 ± 8.3%, provided perfect proximal stent apposition with almost perfect circularity (ellipticity index reduced from 1.23 ± 0.02 to 1.04 ± 0.01), reduced proximal area overstretch from 24.2 ± 7.6% to 8.0 ± 0.4%, and reduced global strut malapposition from 40 ± 6.2% to 2.6 ± 1.4%.

CONCLUSIONS

In comparison with 5 other techniques, the re-POT sequence significantly optimized the final result of provisional coronary bifurcation stenting, maintaining circular geometry while significantly reducing SB ostium strut obstruction and global strut malapposition. These experimental findings confirm that provisional stenting may be optimized more effectively without KBI using re-POT.

Pre-PCI angiographic TIMI flow in the culprit coronary artery influences infarct size and microvascular obstruction in STEMI patients

OBJECTIVE

The influence of initial-thrombolysis in myocardial infarction (i-TIMI) coronary flow in the culprit coronary artery on myocardial infarct and microvascular obstruction (MVO) size is unclear. We assessed the impact on infarct size of i-TIMI flow in the culprit coronary artery, as well as on MVO incidence and size, by contrast-enhanced cardiac magnetic resonance (ce-CMR).

METHODS

In a prospective, multicenter study, pre-percutaneous coronary intervention (PCI) coronary occlusion was defined by an i-TIMI flow ≤1, and patency was defined by an i-TIMI flow ≥2. Infarct size, as well as MVO presence and size, were measured on ce-CMR 72h after admission.

RESULTS

A total of 140 patients presenting with ST-elevated myocardial infarction referred for primary PCI were included. There was no significant difference in final post-PCI TIMI flow between the groups (2.95±0.02 vs. 2.97±0.02, respectively; p=0.44). In the i-TIMI flow ≤1 group, infarct size was significantly larger (32±17g vs. 21±17g, respectively; p=0.002), MVO was significantly more frequent (74% vs. 53%, respectively; p=0.012), and MVO size was significantly larger [1.3 IQR (0; 7.1) vs. 0 IQR (0; 1.6)], compared to in the i-TIMI ≥2 patient group.

CONCLUSION

Initial angiographic TIMI flow in the culprit coronary artery prior to any PCI predicted final infarct size and MVO size: the better was the i-TIMI flow, the smaller were the infarct and MVO size.

Diagnostic and medical strategy for renovascular hypertension: report from a monocentric pediatric cohort

Renovascular hypertension accounts for 5-10 % of hypertension cases in children; there is currently no consensus on treatment. Here, we report on our clinical experience with this disease and outline the different pathways in which to investigate it. We report retrospectively on ten children diagnosed with renovascular hypertension at the University Hospital of Nantes from 2001 to 2012. The main findings were obtained by fortuitous screening of children aged 2 months to 14 years old with neurofibromatosis (n = 2) and fibromuscular dysplasia (n = 8). The hypertension was always severe yet asymptomatic. Lesions were complicated in nine out of ten cases and included bilateral, multiple, mid-aortic syndrome and aneurysm. Doppler ultrasound associated with computed tomography allowed for a precise diagnosis in seven out of ten cases. Where ambiguities persisted, they were highlighted by arteriography, the gold standard investigation. Medical treatment was insufficient, leading to invasive procedures in nine out of ten children: 2 nephrectomies, 2 autotransplantations, and 21 repetitive percutaneous transluminal angioplasties. After invasive procedures, blood pressure control improved in four cases and was resolved in three.

CONCLUSION

Arteriography remains to be the gold standard technique for renovascular hypertension in children and can be combined with angioplasty when medical treatment is rendered obsolete. The role of computed tomography is controversial. Despite the heterogeneity of the children studied, we present a general medical and therapeutic management pathway for the treatment of this disease.

Effects of dodecyl acetate andZ-10-tridecenyl acetate on attraction ofEupoecilia ambiguella males to the main sex pheromone component,Z-9-Dodecenyl acetate

Attraction ofE. ambiguella males toZ-9-dodecenyl acetate (Z9-12∶Ac), alone and in combination with dodecyl acetate (12∶Ac) orZ-10-tridecenyl acetate (Z10-13∶Ac) was tested in both wind-tunnel and field experiments. In the laboratory, response toZ9-12∶Ac reached a distinct dosage optimum at which attraction was nearly as good as to live females. Addition of 12∶Ac, a minor component of female glands and effluvia, had no effect at low doses ofZ9-12∶Ac and only marginally improved attraction at the optimum. However, inclusion of 12∶Ac with an overdose ofZ9-12∶ Ac fully restored activity. In the field,Z9-12∶Ac alone was not very attractive at any dose; catches markedly increased by adding 12∶Ac and climbed with increasing dose of each compound up to 10 mg. Optimum ratio ofZ9-12∶Ac to 12∶Ac was 1∶1 to 1∶5. Another compound,Z10-13∶Ac, had the same effect as 12∶Ac in the laboratory and the field but was effective at a lower dose. In the field, inclusion of the synergist permits use of high cap loads to attract more males, perhaps from greater distances.

Electrografting of a biodegradable layer as a primer adhesion coating onto a metallic stent: in vitro and in vivo evaluations

Drug-eluting stents have been developed to reduce the risk of restenosis after angioplasty. To facilitate the adhesion of a poly(lactic acid) (PLA) overlayer loaded with rapamycin (20 wt%), a biodegradable macromonomer based on poly(lactic acid) (HEMA-PLA) was grafted onto the metallic stent by electrografting in a one-step reaction involving the immobilization of aryl diazonium onto the metal followed by an in situ surface electro-polymerization. The HEMA-PLA coating was chemically characterized. Mechanical performance during stent expansion was tested. Morphology examinations showed a strong adhesion of PLA topcoat in the presence of the electrografted layer. Biocompatibility and degradation of the coating were studied in vitro and in vivo in rabbit iliac arteries. These 28 days implantations resulted in a minimal inflammatory process with a partial degradation of the coating. These results suggest that this kind of anchoring of a biodegradable layer shows great potential for drug-eluting stents.

[Superior vena cava syndrome induced by pacemaker probes, 12 years after introduction]

Superior vena cava syndrome is a rare disease, most often found to result from a malignant process, which causes extrinsic compression of the superior vena cava. In recent years, there has been an increase of superior vena cava syndrome related to medical devices (implantable site, pacemaker [PM], central venous line for parenteral nutrition...). We report the case of a 37-year-old patient who developed a superior vena cava syndrome 12 years after implantation of a PM. The diagnosis was established on venography after two negative venous-CT focused on the superior vena cava. The superior vena cava syndrome improved immediately after angioplasty and stenting covering the PM probes at the superior vena cava/brachiocephalic venous trunk junction.

Fracture of the lower cervical spine in patients with ankylosing spondylitis: Retrospective study of 19 cases

INTRODUCTION

Controversy exists surrounding optimal treatment of cervical spine fractures secondary to ankylosing spondylitis (AS).

HYPOTHESIS

The anterior approach is an effective surgical technique for these fractures and can be used to correct the AS-induced cervical-thoracic kyphosis.

MATERIALS AND METHODS

This continuous, retrospective series between 1990 and 2010 included 19 patients aged 33 to 84 years who presented with a lower cervical spine fracture in the context of AS. The average follow-up was 45 months. Sixteen of these patients were surgically treated using an anterior approach and anterior fixation. In five patients without any neurological deficit, their cervical-thoracic kyphosis was corrected during the same surgery. Regional kyphosis was measured before the surgery, immediately after the surgery and at the last follow-up.

RESULTS

Five deaths occurred; these were all patients with post-traumatic complete quadriplegia. Most the incomplete neurological problems improved (66%). In no cases did the neurological condition worsen. Among the 16 patients operated with the anterior approach, two patients also required an additional procedure with a posterior approach because of a persistent neurological deficit. The fractures in the operated patients who survived (14 patients) had healed within an average 4-month delay (range 3-7 months), without worsening of the kyphosis at final follow-up. In the five cases where the kyphosis was corrected, the correction averaged 26° (range 18-36°); there were no neurological complications.

DISCUSSION

Based on these results, we suggest using the anterior approach to perform internal fixation as a treatment for cervical fractures secondary to AS and to correct the cervical-thoracic kyphosis in patients without neurological deficits.

LEVEL OF EVIDENCE

Level IV - retrospective study.

Late pseudocoarctation syndrome after stent-graft implantation for traumatic aortic rupture

The present observation illustrates an unusual complication occurring after stent-grafting (S-graft) for aortic isthmus rupture. A 22-year-old patient, treated by S-graft in the emergency department for traumatic aortic rupture, was readmitted 10 months later with pseudocoarctation syndrome. A membrane was found inside the stent-graft that had induced a pseudo-dissection, which caused the pseudocoarctation syndrome. Surgical treatment consisted of removing the stent-graft and membrane and replacing it with a vascular implant. The patient's clinical course was fair. The suggested mechanism was circumferential neoendothelialization of the stent-graft. Dehiscence caused the superior part of the membrane to drop into the lumen of the stent-graft creating a "false channel" that compressed the "true lumen" and induced "pseudocoarctation" syndrome. The cause of the extensive neointimalization remains unexplained. Thoracic aortic stent-grafts require regular follow-up monitoring by angioscan or angio-magnetic resonance imaging.

Reduction in heat-induced gastrointestinal hyperpermeability in rats by bovine colostrum and goat milk powders

Male Sprague-Dawley rats were assigned to one of three dietary groups [standard diet (Cont; n = 8), standard diet plus bovine colostrum powder (BColost 1.7 g/kg; n = 8), or goat milk powder (GMilk 1.7 g/kg; n = 8)] to determine the ability of these supplements to reduce gastrointestinal hyperpermeability induced by heat. Raising core body temperature of rats to 41.5 degrees C increased transfer of (51)Cr-EDTA from gut into blood 34-fold relative to the ambient temperature value (P < 0.05) in the Cont group of rats, indicative of increased gastrointestinal permeability. Significantly less (P < 0.01) (51)Cr-EDTA was transferred into the blood of rats in either the BColost (27% of Cont) or GMilk group (10% of Cont) after heating, showing that prior supplementation with either bovine colostrum or goat milk powder significantly reduced the impact of heat stress on gastrointestinal permeability. The changes in the BColost group were not significantly different than those of the GMilk group. The potential mechanism of the protective effect of bovine colostrum and goat milk powders may involve modulation of tight junction permeability, because both powders were able to maintain transepithelial resistance in Madin Darby canine kidney cells challenged with EGTA compared with cells maintained in media only. The results show that bovine colostrum powder can partially alleviate the effects of hyperthermia on gastrointestinal permeability in the intact animal. Moreover, goat milk powder was equally as effective as bovine colostrum powder, and both may be of benefit in other situations where gastrointestinal barrier function is compromised.

Coating of fertilizers by degradable polymers

The conventional agriculture leads to some important pollution of ground water (particularly, by nitrates). The solution is the coating of fertilizers by degradable polymers. In this work, we have studied the water vapour and liquid diffusion through polymer films detached from their support. Therefore, we may classify polymers as a function of their properties like water vapour and liquid barrier. We may choose the best polymer(s) for coating.coated fertilizers by chosen polymer(s) with mechanical techniques such as fluidised bed and pan coating. Moreover, the electron microscopy used to see the quality of the wall has showed the presence of pores due to the rapid evaporation of solvent. A drying in air current and an annealing could be done to avoid this problem.followed the ions release of fertilizers immersed in distilled water by conductimetry. The more interesting result was obtained with fertilizers coated by polylactic acid. In effect, the total release reached three weeks.

Towards a new functional assessment of autistic dysfunction in children with developmental disorders: the Behaviour Function Inventory

In order to assess particular disorders of psychological development and functioning in children with developmental disorders, we have developed a new tool, the Behaviour Function Inventory (BFI), based on 11 neurophysiological functions, disorders of which are considered to contribute to the core autistic syndrome. This article reports the reliability and validity study of this new scale. Factorial analysis computed on the 55 initial items identified six main dimensions which we characterized and labelled: interaction dysfunction, praxis dysfunction, auditory dysfunction, attention dysfunction, islet of ability and emotional dysfunction. Relationships between these six new variables and diagnostic subgroups, and chronological and developmental age, are discussed. The BFI offers precise information of the functional symptomatology of autism, showing clear evidence of some disordered areas of functioning. This new approach may provide valuable information in clinical research, especially for psychopathology and physiopathology studies.

Bioactive functionalized polymer of malic acid for bone repair and muscle regeneration

A bioactive poly(beta-hydroxyalkanoate) derived from malic acid was prepared and tested on bone repair and muscle regeneration. This functionalized and hydrolyzable polymer was obtained after several steps, the first one being the anionic copolymerization of three malolactonic acid esters. Chemical modifications were carried out on the terpolymer to turn benzyl-protecting groups into carboxyl groups and allyl groups into sulfonate groups. The resulting polymer bore carboxylate, sulfonate, and sec-butyl pendent groups in 65/25/10 molar proportions and were aimed at interacting with heparan binding growth factors. This polymer did not present any toxic effect in cell viability of HepG2 cells, over a large range of concentrations (0.01-0.25 mgl(-1)). Its ability to improve wound healing was tested in vivo and positive results are reported. Furthermore, the bioactivity of this polymer was evaluated using the regeneration model of Extensor digitorum longus (EDL) rat muscle. The study displayed a significant increase in the muscle regeneration and maturation.

Synthesis and polymerization of benzyl (3R,4R)-3-methylmalolactonate via enzymatic preparation of the chiral precursor

beta-methylaspartate ammonia-lyase, EC 4.3.1.2, (beta-methylaspartase) from Clostridium tetanomorphum was used to produce a 40/60 molar ratio of (2S,3R) and (2S,3S)-3-methylaspartic acids, 2a and 2b, respectively, from mesaconic acid 1 as substrate, on a large scale. To prepare (3R,4R)-3-methyl-4-(benzyloxycarbonyl)-2-oxetanone (benzyl 3-methylmalolactonate) 6, 2a and 2b were transformed, in the first step, into 2-bromo-3-methylsuccinic acids 3a and 3b and separated. After three further steps, (2S,3S)-3a yielded the alpha, beta-substituted beta-lactone (3R,4R) 6 with a very high diastereoisomeric excess (> 95% by chiral gas chromatography). The corresponding crystalline polymer, poly[benzyl beta-(2R,3S)-3-methylmalate] 8, prepared by an anionic ring opening polymerization, was highly isotactic as determined by 13C NMR. Catalytic hydrogenolysis of lactone 6 yielded (3R,4R)-3-methyl-4-carboxy-2-oxetanone (3-methylmalolactonic acid) 7, to which reactive, chiral, or bioactive molecules can be attached through ester bonds leading to polymers with possible therapeutic applications. Because of the ability of beta-methylaspartase to catalyse both syn- and anti-elimination of ammonia from (2S,3RS)-3-methylaspartic acid 2ab at different rates, the (2S,3R)-stereoisomer 2a was retained and isolated for further reactions. These results permit the use of the chemoenzymatic route for the preparation of both optically active and racemic polymers of 3-methylmalic acid with well-defined enantiomeric and diastereoisomeric compositions.

Albuquerque Target Cities: preliminary findings

Overall, there appeared to be a decline in frequency of use in the substance patterns of the 46 cases investigated for this analysis. The rising frequency with which prescription drugs are reported may be explained by the fact that these clients are in treatment, a situation which frequently necessitates the prescription of various medications. Additionally, the rise in methadone use can also be explained by the fact that it is prescribed to individuals who are undergoing treatment for a heroin addiction. Finally, it is probable that polysubstance use is underreported in the intake data, thus explaining the apparent increase reported at follow-up.

[Congenital left ventricular aneurysms and diverticula. Two case reports]

The authors report the cases of two young adults (25 and 27 years) presenting with congenital left ventricular aneurysm or diverticulum with healthy coronary arteries. This saccular evagination of the ventricular wall is rare. The authors describe a classification distinguishing muscular (contractile) diverticula, composed of the three cardiac tunics, fibrous diverticula and finally aneurysms with a dyskinetic wall. Although the limits of this classification are sometimes poorly defined, it presents a prognostic value, because it appears logical to propose nonsurgical management in the context of muscular diverticula and it seems legitimate to operate on fibrous diverticula and aneurysms due to the risks of rupture, extension, thrombosis or arrhythmia.

The mammalian oviduct: biochemistry and physiology

Oviduct fluid and oviduct epithelium seem able to modulate in-time maturation and transport of gametes and embryos. They probably allow selection of spermatozoa through too early activation. Subtle changes in the composition of tubal secretion permit fertilization and embryo development in the best conditions. The mechanisms of these changes of oviduct fluid composition (induced by endocrine stimuli and/or by embryo) are under investigation. Numerous compounds isolated in oviduct fluid are now added to the synthetic media for in vitro maturation/in vitro fertilization/embryo culture (IVM/IVF/EC). The rationale is now to mimic more and more, the biochemical composition of tubal and uterine fluids even if interactions with embryo metabolism is still far from being understood.

Neuropathological study of a case of autistic syndrome with severe mental retardation

Infantile autism is a syndrome of unknown aetiology and unknown neuro-anatomic substrate. The authors report a histological study of the brain of a well-documented 16-year-old female with autistic syndrome and severe mental retardation, using direct microscopic examination of the whole brain. The major findings are low brain weight, a thin corpus callosum and ventricular dilatation. No abnormalities were found in the hippocampus or cerebellum. Excessive axonal elimination during brain development is hypothesized. The relations of hypothetical developmental events with the clinical features of autistic syndrome are discussed.

Thin melanomas with unusual aggressive behavior: a report on nine cases. Melanoma Group of French Federation of Cancer Centers

BACKGROUND

The major factor influencing the prognosis of cutaneous malignant melanoma (MMs) is the maximum thickness of the tumor as measured by Breslow's method. However, it has been reported that thin melanomas, which should have an excellent prognosis, may have the potential to metastasize, some with an unusually rapid course.

OBJECTIVE

Our purpose was to examine prognostic indicators in relation to unusually rapid aggressive behavior in patients with thin MMs (<0.76mm).

METHODS

We describe nine cases of thin MM (<.76mm) that exhibited a recurrence or metastasis during a follow-up period ranging from 3 to 10 years, among computerized records of 1118 MMs treated in a multicenter epidemiologic study. The data obtained from these nine cases were compared with nonrecurring thin MM (149 cases) of the same cohort.

RESULTS

The particular aggressiveness of these thin melanomas was reflected by the short disease-free interval (3 years or less) in all ine patients. The recurring thin MM more frequently involved head and neck sites, occurred in male patients, and showed Clark's level III and IV.

CONCLUSION

Our review suggests that the head and neck area is particularly involved by unusually rapidly recurring thin MM. Possible explanations are the specific problems of surgical management and the greater sun exposure of this location.

Evaluation by polymerase chain reaction on the effect of beta-propiolactone and binary ethyleneimine on DNA

Inactivating treatments for viruses such as pasteurization or alkylation by beta-propiolactone or binary ethyleneimine were tested for their capacity to modify nucleic acids. The modification of a nucleic acid was measured as the decrease in spot intensity in Southern blots after polymerase chain reaction (PCR) amplification. The inactivating treatments were applied to cellular and viral genomic material from a human lymphoblastoid cell line immortalized by Epstein Barr Virus (EBV), which produced a monoclonal antibody. Pasteurization did not modify the ability to amplify and detect cellular or viral DNA. Binary ethyleneimine strongly reduced the amount of detectable DNA and beta-propiolactone under particular conditions of incubation abolished all trace of DNA.

Theoretical and experimental investigation of x-ray diffraction by a lamellar multilayer amplitude grating

We present experimental and theoretical studies of the diffraction by an x-ray lamellar multilayer amplitude grating. The main diffraction properties of such a device are given. Experimental efficiency curves are obtained at 800 eV photon energy using synchrotron radiation. The features observed in these curves are identified and interpreted by means of two theoretical methods. Particular emphasis is given to structures observed for the first time which had been theoretically predicted.

Mycobacterium avium intracellulare suppurative thyroiditis in a patient with Hashimoto's thyroiditis

A case of suppurative thyroiditis occurring in a 72-year-old woman is reported. The clinical history of this woman, treated by tianeptine for mild exogenous affective disorder and by conventional insulin therapy for long-standing insulin-dependent diabetes, was remarkable for the pseudotumoral signs which led to the simultaneous diagnosis of hypothyroidism due to Hashimoto's thyroiditis and of mycobacterium avium intracellulare suppurative thyroiditis. To our knowledge, this is the second reported case of mycobacterium avium intracellulare thyroiditis. This case is also exemplary, given its occurrence in the absence of severe immunodepression, setting apart the mild impact on the immune system of affective disorder and of long duration's insulin-dependent diabetes.

[Scales and questionnaires for the evaluation of behavior disorders in children]

The need for quantitative clinical evaluation tools for use in child psychiatry is obvious. Behavior rating scales are useful for comparing clinical and laboratory data, monitoring the effects of treatments, and enhancing communication between clinicians and investigators. The methodological principles used to construct and validate such tools are described. This approach is of benefit in most psychiatric disorders of children and adolescents. The questionnaires and scales most widely used throughout the world and available in French are reviewed. The advantages and drawbacks of evaluation scales in everyday practice and in research are discussed, with the BSE-A scale (Behavior Summarized Evaluation of Austism) as an example.

Theoretical aspects of the study of benzodiazepine receptors in infantile autism

This paper is part of a special section on 'psychopharmacotherapy in children' and focuses on benzodiazepine receptors in autism. Infantile autism in an early and pervasive developmental disorder described by Kanner in 1943. Anatomical, pathological and magnetic resonance imaging studies have indicated changes in the cerebellum and hippocampus of autistic subjects. Given the numerical importance and diffuse benzodiazepine receptors, their study by functional brain imaging methods in vivo could be value in cases of infantile autism as a gauge of neuronal potentiality. The main data concerning benzodiazepine complex are presented. The relations between these data and the neurophysiological hypotheses of autism are discussed.

Measles virus-induced suppression of lymphocyte proliferation

The mechanism by which measles virus induces immunosuppression was investigated using an in vitro system employing phytohemagglutinin (PHA)-induced human peripheral mononuclear cell (PBMC) proliferation. At a multiplicity of infection of 1.0 or greater measles virus significantly inhibited (45%) the proliferation of PBMC. This inhibition was not due to an alteration in the kinetics of proliferation. PHA-stimulated PBMC were then infected with measles virus for 72 hr and irradiated (3200 rad) to prevent further proliferation. These infected, irradiated PBMC when added to fresh autologous PBMC caused significant inhibition of lymphoproliferation over a wide range of infected:fresh cell ratios (maximum inhibition seen at a 1:1 ratio, 85% inhibition). Virus recovered from the irradiated, infected cells was 100-fold lower than the virus titer needed to cause inhibition by direct addition of measles virus. However, antibody to measles virus reversed the inhibition. Virus-free supernatant fluids from the infected irradiated cells caused immunosuppression of the PHA response. This immunosuppressive material induced by the measles virus was maximally produced after 72 hr and did not appear to require viral replication. This factor was not prostaglandin E or interferon-alpha or -gamma. The production of such suppressive factors during viral infection may explain some of the profound immunosuppression seen in situations in which little or no infectious virus can be detected.