Laparoscopic hysterectomy

Summary Thirty-three patients were selected for laparoscopic hysterectomy and operated on in the Department of Obstetrics, Gynecology and Reproductive Medicine of Clermont-Ferrand University Hospital. Surgical techniques included blunt dissection with scissors and bipolar coagulation to achieve hemostasis. A case was considered successful when all the uterine vessels were treated by laparoscopy. Twenty-four cases were completed laparoscopically (72.7%). None of these patients had postoperative bleeding; 22 had an uneventful postoperative recovery. Nine procedures were converted to laparotomy (27.3%), five because of a difficult or unsatisfactory hemostasis. We conclude that in selected cases, a total hysterectomy can be performed safely by experienced laparoscopists. Further technological progress is necessary to make this procedure more acceptable. Its value as compared to the others will have to be demonstrated.     

Effects of 1-week head-down tilt bed rest on bone formation and the calcium endocrine system.

To understand the potential early responses of human bone and the calcium endocrine system to spaceflight, we studied 8 healthy men, aged 35-44 years before, during, and after bed rest in a -6 degrees head-down tilt model for microgravity. Based on a novel single-dose labeling schedule, average rates of bone formation in the iliac crest were reduced in 6, unchanged in 1, and increased in 1 following the bed rest period. The decrease was greatest for subjects whose daily walking miles were highest (r = -0.762, p less than 0.05, n = 7). Before a measurable increase in ionized serum calcium the sixth bed rest day, there was increased excretion of urinary calcium and sodium, evident the first 2 bed-rest days and parallel for the entire week (r = 0.92, p less than 0.001). Reduced excretion of phosphorus and 3', 5' cyclic adenosine monophosphate on the first and second bed rest days was followed by an increase in serum phosphorus by the sixth bed rest day. Depressed serum concentrations of parathyroid hormone and 1,25-dihydroxyvitamin D were manifest by the sixth and seventh bed rest days. The similarity of the response of bone and the calcium endocrine system of healthy men after only 7 days to results of longer term bed rest studies emphasizes the responsiveness of the adult human skeleton to biomechanical stimuli induced by changes in activity and/or position.     

The erythropoietic stimulating activity of normal mouse serum: effect on erythroid precursors from different haematopoietic tissues and suggested role of accessory cells

The addition of normal mouse serum (NMS) to mouse bone marrow cell cultures was found to stimulate the growth of late erythroid precursors (CFU-E). The stimulating activity was called Erythropoietic Stimulating Cofactor (ESCF) (Blanchet et al 1984). In this article, we report that CFU-Es from foetal liver are not sensitive to serum addition, in contrast to CFU-Es from bone marrow or spleen taken from the same foetuses. When foetal liver cells were co-cultured with irradiated adult bone marrow cells, addition of NMS stimulated the foetal liver CFU-Es, suggesting that ESCF acts via some accessory cells not present (or in too low a frequency) among foetal liver cells. Moreover, NMS should be added at onset of adult bone marrow cell culture to be fully stimulatory. In addition, a very large increase (by a factor of 5 to 7) was observed for CFU-Es from spleen and bone marrow from 6- to 20-d-old newborn mice. This high sensitivity was correlated with a post-natal anaemia. We propose the existence of two different CFU-E population, one stimulated by the accessory cells, the other not, the proportion of which could be modified in response to anaemia.     

Recombination between HLA-A and C and between HLA-B and complement locus C4 in the same individual

In a French family with 2 parents and 5 children a crossing over was found in the HLA region on both of the parental haplotypes of one of the children. The following markers were studied: HLA-A, B, C,DR, DQ(MB), DP(SB), complement allotypes C4 and Bf and glyoxalase I polymorphism. In the third child, the paternal haplotype had a recombination between HLA-A and HLA-C and the maternal haplotype a recombination between HLA-B and complement locus C4. Mixed lymphocyte cultures confirmed the serological findings and non-HLA markers (blood groups and immunoglobulin allotypes) showed no evidence of extrapaternity. The family also demonstrates a probable duplication of the C4B1 gene in one of the paternal haplotypes.     

Treatment of idiopathic inflammatory myositis associated interstitial lung disease: A systematic review and meta-analysis

Objective

Interstitial lung disease (ILD) is the most severe complication of idiopathic inflammatory myositis (IIM), resulting in significant increase in morbidity and mortality and for which the best treatment remains controversial. We conducted a meta-analysis to evaluate the efficacy of therapies used for the management of IIM-related ILD.

A-raf oncogene localizes on mouse X chromosome to region some 10–17 centimorgans proximal to hypoxanthine phosphoribosyltransferase gene

The localization of the A-rafcellular oncogene on the mouse X chromosome has been determined using Xbal-restricted DNAs prepared from progeny of an interspecies backcross between the B6.CBA.R1 and the Spe/Pas mouse strains. This localization to the proximal part of the mouse X chromosome has been confirmed by the use of somatic cell hybrids, carrying partially deleted X chromosomes and suggests that the A-raf oncogene localizes to a region lying some 10–17 centimorgans proximal to the hypoxanthine phosphoribosyltransferase (Hprt) gene between the locus DXPas4and the locus DXPas7defined by the cross-reacting human X chromosome-specific probe DXS32 (M2C). This localization on the mouse X chromosome is compatible with the presence of the A-rafoncogene on the short arm of the human X chromosome between the centromere and Xp21.     

Concentration of zinc, copper, selenium and aluminium in nutritive solutions for parenteral administration]

Total parenteral nutrition (TNP) therapy is widely used. However the quantitative requirements or the toxicity of trace elements in parenteral solutions are difficult to assess. This paper deals with a study performed by the Trace Element Commission of the Société Fran?aise de Biologie Clinique. Trace metals (zinc, copper, selenium and aluminium) which are mainly involved in TPN solutions are analyzed in 12 different parenteral nutrition solutions commercially available. This multicentric assay (5 different sites of analysis) shows that a slight pollution can be noted for nearly all the solutions examined. But at this level (10 mumol/l for the most concentrated solution), the zinc intake cannot induce any toxicity. For copper and selenium the results indicated a negligible pollution. Small-volume solutions added with zinc, copper and selenium are correctly supplemented. As regard aluminium pollution, 4 solutions among 12 contain non negligible amounts of aluminium. The consequences of this TPN overload especially for young infants, indicate that the struggle against this pollution has to be strengthened.