Endogenous activation of adenosine A(1) receptors accelerates ischemic suppression of spontaneous electrocortical activity

Cerebral ischemia induces a rapid suppression of spontaneous brain rhythms prior to major alterations in ionic homeostasis. It was found in vitro during ischemia that the rapidly formed adenosine, resulting from the intracellular breakdown of ATP, may inhibit synaptic transmission via the A(1) receptor subtype. The link between endogenous A(1) receptor activation during ischemia and the suppression of spontaneous electrocortical activity has not yet been established in the intact brain. The aim of this study was to investigate in vivo the effects of A(1) receptor antagonism by 8-cyclopentyl-1,3-dipropylxanthine (DPCPX) on the time to electrocortical suppression during global cerebral ischemia. Adult male Wistar rats under chloral hydrate anesthesia were subjected to 1-min transient "four-vessel occlusion" ischemic episodes, separated by 20-min reperfusion. The rats were injected intraperitoneally with either 1.25 mg/kg DPCPX dissolved in 2 ml/kg dimethyl sulfoxide (DMSO) or the same volume of DMSO alone, 15 min before the third ischemic episode. Time to electrocortical suppression was estimated based on the decay of the root mean square of two-channel electrocorticographic recordings. During the first two ischemic episodes, electrocortical suppression appeared after approximately 12 s in both groups. After DMSO administration, ischemic suppression remained unchanged. After DPCPX administration, the time to electrocortical suppression was increased by approximately 10 s, and bursts of activity were recorded during the entire ischemia. These effects disappeared within 15 h after DPCPX administration. Our data provide evidence that during cerebral ischemia endogenous activation of A(1) receptors accelerates the electrical "shut-down" of the whole brain.     

The place of general practitioners in cancer care in Champagne-Ardenne

IntroductionIn France, general practitioners (GPs) are playing a key role in cancer care since the HPST law and the second national cancer plan.MethodA postal questionnaire survey was conducted in Champagne-Ardenne Area to evaluate GPs’ satisfaction and needs in cancer management. A questionnaire was sent by mail in March and April 2011 to 1231 GPs. Statistical analysis of the results was done using Sphinx software (France).ResultsParticipation rate was 33% (n = 405/1231). Most of the participants were male (n = 296; 73%), and the mean age was 51.8 years (s.d.: 9 years). Participants described as acceptable their communication with oncologists (n = 343; 85%), the delay of receiving the multidisciplinary team meeting report (n = 353; 88%) and the patient personalised care plan (n = 319; 81%). However, 69% (n = 269) stated that the communication between GPs and oncologists should improve and 64% (n = 243) were not satisfied with their level of oncology knowledge.ConclusionThis study identified important key points that need to be improved in order to strengthen the place of GPs in cancer management.     

The challenges of androgen insensitivity syndrome

Androgen insensitivity syndrome (AIS) is an X-linked recessive genetic syndrome that occurs as result of an androgen receptor mutation; it affects the normal masculinization process in chromosomal male patients. More than 900 androgen receptor mutations that can lead to AIS have been identified. The complete androgen insensitivity is characterized by a total lack of response to androgens, usually in patients with 46XY karyotype but with feminine phenotype. Primary amenorrhoea and inguinal swellings in female patients are the main signs that could raise suspicion for this syndrome. Patients with partial androgen insensitivity have ambiguous genitalia at birth and gynecomastia during puberty, whereas those with mild androgen insensitivity present a normal male phenotype but altered spermatogenesis during adulthood and pubertal gynecomastia. The diagnosis of AIS often proves to be a challenge; its management is complex and requires a multidisciplinary approach to meet decision-making challenges in sex assignment, fertility and timing of gonadectomy, psychological outcomes and genetic counselling.     

Otoplasty: a combined approach to different structures of the auricle

A technique for otoplasty is presented, which combines the advantages of different methods. The procedure includes a dorsal skin excision, a cartilage incision at the border between the concha and scapha, scoring of the crus superior on the anterior side, and if necessary a reduction of the conchal height and modification of the position of the cauda helicis by cartilage excision. The results of the treatment of 526 ears in 312 patients are retrospectively analysed by a patient questionnaire and a chart review.     

Sexual Orientation,Sexual Arousal,and Finger Length Ratios in Women

Archives of Sexual Behavior - In general, women show physiological sexual arousal to both sexes. However, compared with heterosexual women, homosexual women are more aroused to their preferred sex,...