La santé mentale comme philosophie politique. La psychologie du soi et le progrès social

Psychology and psychiatry have significantly extended their scope of action by addressing the topic of mental health and by focusing, beyond the study of disabilities, on well-being through personal development. This approach was already widely popular in the 1960's, especially in the field of anti-psychiatry. As a result, mental health, as a therapeutic perspective, went on to become a major concern for moral and political philosophy. This paper aims to trace back the origins of this shift and delineate its foundations. To this end, the pioneering work of William James serves as a basis for showing how the notion of mental health relates to the tenets of the psychology of the self. Then, this paper uses this analysis to demonstrate how this approach combined epistemological and methodological principles to support a new clinical project that was supposed to contribute to social change.     

Massive excretion of 2-oxoglutaric acid and 3-hydroxyisovaleric acid in a patient with a deficiency of 3-methylcrotonyl-CoA carboxylase.

A three-month old child, presenting with a history of feeding problems, suspected respiratory infection and failure to thrive, later developed fits and a profound irreversible metabolic acidosis. Chromatographic investigation of the urine revealed a gross excretion of 2-oxoglutaric and 3-hydroxyisovaleric acids. The identity of these two acids was confirmed by mass spectrometry. Enzyme studies on liver obtained at post-mortem demonstrated a deficiency of 3-methylcrotonyl-CoA:carbon dioxide ligase (ADP) (EC 6.4.1.4).     

Computer-vision-enabled augmented reality fundus biomicroscopy.

PURPOSE: To guide treatment for macular diseases and to facilitate real-time image measurement and comparison, investigations were initiated to permit overlay of previously stored photographic and angiographic images directly onto the real-time slit-lamp biomicroscopic fundus image. DESIGN: Experimental study in model eyes, and preliminary observations in human subjects. METHODS: A modified, binocular video slit lamp interfaced to a personal computer and framegrabber allows for image acquisition and rendering of stored images overlaid onto the real-time slit-lamp biomicroscopic fundus image. Development proceeds with rendering on a computer monitor, while construction is completed on a miniature display interfaced directly with one of the slit-lamp oculars. Registration and tracking are performed with in-house-developed software. MAIN OUTCOME MEASURES: Tracking speed and accuracy, ergonomic acceptability. RESULTS: Computer-vision algorithms permit robust montaging, tracking, registration, and rendering of previously stored photographic and angiographic images onto the real-time slit-lamp fundus biomicroscopic image. In model eyes and in preliminary studies in a human eye, optimized registration permits near-video-rate image overlay with updates at 3 to 10 Hz and misregistration errors on the order of 1 to 5 pixels. CONCLUSIONS: A prototype for ophthalmic augmented reality (image overlay) is presented. The current hardware/software implementation allows for robust performance.     

The impact of the optic neuritis treatment trial on the practices of ophthalmologists and neurologists

OBJECTIVE: To determine whether the Optic Neuritis Treatment Trial (ONTT) results have altered the practice patterns of ophthalmologists and neurologists. DESIGN: Mail survey. PARTICIPANTS: A random sample of 987 ophthalmologists and 900 neurologists practicing in the United States were mailed a questionnaire that inquired into decision-making with regard to management of optic neuritis before and after the publication of the ONTT results. MAIN OUTCOME MEASURES: Responses received from 202 ophthalmologists and 244 neurologists, a response rate of 47%. RESULTS: Following the ONTT reports, nearly all ophthalmologists and neurologists have reduced their use of oral prednisone alone, substituting a regimen that includes intravenous methylprednisolone. A large proportion of practitioners in both specialties mistakenly believe that intravenous methylprednisolone treatment improves final visual outcome. Only 7% of neurologists and 36% of ophthalmologists (P = 0.0001) are adhering to the ONTT suggestion to use magnetic resonance imaging as a basis for initiating treatment. CONCLUSIONS: The ONTT has led to a dramatic reduction in the use of oral prednisone without a preceding course of intravenous methylprednisolone in the treatment of acute optic neuritis. Ophthalmologists and neurologists have changed some of their practices without fully understanding the results of the ONTT.     

Aleukemic leukemia cutis: juvenile chronic granulocytic leukemia presenting with figurate cutaneous lesions

We report a 3 1/2-year-old girl who developed a figurate cutaneous eruption. Distinctive findings in her skin biopsies, as well as unusual red cell characteristics, in the presence of a normal peripheral smear and bone marrow biopsy, led us to suspect the diagnosis of preleukemic juvenile type chronic granulocytic leukemia. This is the first case we know of in which this diagnosis was suspected prior to abnormal findings in the peripheral smear or bone marrow.     

Reversal of P-glycoprotein-mediated multidrug resistance by the novel tetrandrine derivative W6

Overexpression of ATP-dependent efflux pump P-glycoprotein (P-gp) is the main cause of multidrug resistance (MDR) and chemotherapy failure in cancer treatment. Inhibition of P-gp-mediated drug efflux is an effective way to overcome cancer drug resistance. The present study investigated the reversal effect of the novel tetrandrine derivative W6 on P-gp-mediated MDR. KBv200, MCF-7/adr and their parental sensitive cell lines KB, MCF-7 were used for reversal study. The intracellular accumulation with P-gp substrates of doxorubicin was determined by flow cytometry. The expression of P-gp and ERK1/2 was investigated by western blot and real-time-PCR (RT-PCR) analysis. ATPase activity of P-gp was performed by P-gp-Glo^TM assay systems. In comparison with P-gp-negative parental cells, W6 produced a favorable reversal effect in the MDR cells, as determined using the MTT assay. W6 significantly and dose-dependently increased intracellular accumulation of P-gp substrate doxorubicin (DOX) in P-gp overexpressing KBv200 cells, and also inhibited the ATPase activity of P-gp. W6 inhibited P-gp expression in KBv200 cells in a time-dependent manner, but it had no effect on MDR1 expression. In addition, W6 significantly decreased the ERK1/2 activation in KBv200 cells. Our results showed that W6 effectively reversed P-gp-mediated MDR by inhibiting the transport function and expression of P-gp, demonstrating the potential clinical utility of W6.     

The total alkaloids of Aconitum tanguticum protect against lipopolysaccharide-induced acute lung injury in rats

Ethnopharmacological relevance

Aconitum tanguticum has been widely used as a remedy for infectious diseases in traditional Tibetan medicine in China. The total alkaloids of Aconitum tanguticum (TAA) are the main active components of Aconitum tanguticum and have been demonstrated to be effective in suppressing inflammation. Our aim was to investigate the protective effects of TAA on acute lung injury (ALI) induced by lipopolysaccharide (LPS) in rats.

Materials and methods

TAA was extracted in 95% ethanol and purified in chloroform. After vacuum drying, the TAA powder was dissolved in dimethyl sulfoxide. Adult male Sprague-Dawley rats were randomly divided into six groups. Rats were given dexamethasone (DXM, 4 mg/kg) or TAA (60 mg/kg, 30 mg/kg) before LPS injection. The PaO₂and PaO₂/FiO₂ values, lung wet/dry (W/D) weight ratio and histological changes in lung tissue were measured. The cell counts, protein concentration, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) in bronchoalveolar lavage fluid (BALF), and myeloperoxidase (MPO) activity in lung tissue were determined at 6, 12 or 24 h after LPS treatment. In addition, the NF-κ B activation in lung tissue was analyzed by western blot.

Results

In ALI rats, TAA significantly reduced the lung W/D ratio and increased the value of PaO₂ or PaO₂/FiO₂ at 6, 12 or 24 h after LPS challenge. TAA also reduced the total protein concentration and the number of total cells, neutrophils or lymphocytes in BALF. In addition, TAA decreased MPO activity in the lung and attenuated histological changes in the lung. Furthermore, TAA inhibited the concentration of TNF-α, IL-6 and IL-1β in BALF at 6, 12 or 24 h after LPS treatment. Further study demonstrated that TAA significantly inhibited NF-κ B activation in lung tissue.

Conclusions

The current study proved that TAA exhibited a potent protective effect on LPS-induced ALI in rats through its anti-inflammatory activity.     

W/W c-Kit mutant mice possess interstitial cells of Cajal in the deep muscular plexus layer of the small intestine

The c-Kit receptor tyrosine kinase regulates the development and differentiation of various progenitor cells. W mutant mice with spontaneous mutations in the c-kit gene show various phenotypes such as anemia, infertility, loss of coat color and mast cells. c-Kit also regulates the development of the interstitial cells of Cajal (ICC) that are responsible for the motility regulation of the gastrointestinal musculature. W^sh/W^sh mice possess an inversion mutation upstream of the c-kit promoter region; this mutation is responsible for reducing c-Kit activity, leading to a decrease in the number of mast cells, melanocytes, and ICC. We extensively examined the small intestine of W^sh/W^sh mice by using immunohistochemistry and electron microscopy. Although the musculature of the W^sh/W^sh mice did not show any c-Kit immunoreactivity, there were neurokinin 1 receptor (NK1R)-immunopositive cells that were associated with the nerve fibers in the deep muscular plexus (DMP) region. These NK1R-immunopositive cells showed a bipolar shape with long processes and were identified as ICC in the DMP layer (ICC-DMP). Electron microscopic analysis revealed that ICC-DMP had numerous mitochondria, caveolae, and gap junctions and were closely associated with nerve terminals. In contrast, ICC were not observed at the myenteric layer. In the small intestine of the W^sh/W^sh mice, we detected ICC-DMP that showed NK1R immunoreactivity and ultrastructural characters. This type of ICC may develop and maturate structurally without c-Kit expression and regulate gastrointestinal motility.