Perceptions of homeopathy in supportive cancer care among oncologists and general practitioners in France.

OBJECTIVES: In France, homeopathy is the most frequently used complementary therapy in supportive care in oncology (SCO); its use is steadily increasing. However, data is limited about the perception and relevance of homeopathy by oncologists and general practitioners (GPs) both with and without homeopathic training (HGPs and NHGPs, respectively). Our aim was to evaluate French physicians' perceptions of homeopathy to clarify its place in SCO through two original observation survey-based studies. MATERIALS AND METHODS: Two cross-sectional surveys of French physicians were conducted involving (1) 150 specialist oncologists; (2) 97 HGPs and 100 NHGPs. Questions evaluated physician attitudes to homeopathy and patterns of use of homeopathic therapies in patients requiring SCO. Survey responses were described and analyzed on the basis of physician status. RESULTS: Ten percent of oncologists stated they prescribe homeopathy; 36% recommend it; 54% think that homeopathy is potentially helpful in SCO. Two-thirds of the NHGPs sometimes prescribe homeopathy in the context of SCO and 58% regularly refer their patients to homeopathic doctors. HGPs have a positive perception of homeopathy in SCO. CONCLUSIONS: Homeopathy is viewed favorably as an integrated SCO therapy by the majority of French physicians involved with cancer patients-oncologists and GPs. Symptoms of particular relevance include fatigue, anxiety, peripheral neuropathy, sleep disturbance, and hot flashes. In such clinical situations, response to conventional therapies may be suboptimal and homeopathy is considered a reliable therapeutic option. These two studies highlight the fact that homeopathy has gained legitimacy as the first complementary therapy in SCO in France.

[Complementary and alternative medicines taken by cancer patients]. / Médecines complémentaires et alternatives suivies par les patients cancéreux en France.

244 cancer patients from 2 public hospitals (one adult, one pediatric) and one private clinic receiving chemotherapy were asked about complementary and alternative medicine (CAM). Nearly 28% used one or several CAM, especially homeopathy (60%), special diets or dietary supplements (44%), mistletoe (40%) and less frequently acupuncture or other treatments. These CAM are started 4 to 5 months after the onset of chemotherapy. The reasons for using CAM are enhance host defenses, better tolerance of treatment, but also for nearly 27% to treat cancer. All patients were treated by anticancer classical treatments and none thought to stop them. CAM are prescribed especially by homeopathic doctors. 30% of patients using CAM did not inform their oncologist of their CAM treatment. The same conclusions were drawn for the only 10 pediatric patients. The majority of all patients did not take any CAM before their cancer. In a multivariate analysis, female, young age (30-50 y) are correlated to CAM. All patients taking CAM are satisfied by the CAM treatment with good subjective results on their general status, fatigue and nausea-vomiting. These results are similar to other studies done in Europe.

Molecular mechanisms of ATP and insulin synergistic stimulation of coronary artery smooth muscle growth.

Coronary artery disease (CAD) is the major cause of death in diabetics. Abnormal proliferation of coronary artery smooth muscle cells (CASMC) leads to intimal thickening in CAD. We examined signaling mechanisms involved in the mitogenic effect of ATP and insulin on CASMC. ATP and insulin individually stimulated DNA synthesis by 4- and 2-fold, respectively; however, they acted synergistically to stimulate an increase of 17-fold over basal. A similar synergistic stimulation of extracellular signal-regulated kinase (ERK) and mitogen-activated protein or ERK kinase activities was observed (ATP, 7-fold; insulin, 2-fold; and ATP + insulin, 16-fold over basal). However, the combination of ATP and insulin stimulated only an additive activation of Raf (ATP, 5-fold; insulin, <2-fold; and ATP + insulin, 8-fold over basal) and Ras (ATP, 5-fold; insulin, 2-fold; and ATP + insulin, 8-fold over basal). Thus convergence of ATP and insulin signals appears to be at the level of Ras and Raf. In addition, insulin stimulated activation of Akt (also known as protein kinase B) (10-fold over basal), whereas ATP had little effect. However, when ATP and insulin were added in combination, ATP dramatically reduced the insulin-stimulated Akt activation (2-fold above basal). Thus these results are consistent with ATP relieving an insulin-induced Akt-dependent inhibitory effect on the ERK signaling pathway, leading to synergistic stimulation of CASMC proliferation.

P2Y receptor regulation of PAI-1 expression in vascular smooth muscle cells.

P2Y-type purine and pyrimidine nucleotide receptors play important roles in the regulation of vascular hemostasis. In this article, the regulation of plasminogen activator inhibitor-1 (PAI-1) expression in rat aortic smooth muscle cells (RASMCs) by adenine and uridine nucleotides was examined and compared. Northern analysis revealed that RASMCs express multiple P2Y receptor subtypes, including P2Y(1), P2Y(2), and P2Y(6). Treatment of RASMCs with UTP increased PAI-1 mRNA expression and extracellular PAI-1 protein levels by 21-fold (P<0.001) and 7-fold (P<0.001), respectively. The ED(50) for the effect of UTP on PAI-1 expression was approximately 1 micromol/L, and its maximal effect occurred at 3 hours. UDP stimulated a 5-fold increase (P<0.005) in PAI-1 expression. In contrast to these potent stimulatory effects of uridine nucleotides, ATP and 2-methylthioadenosine triphosphate (2-MeSATP) caused a small and transient increase in PAI-1 mRNA at 1 hour, followed by a rapid decrease to baseline levels. ADP produced only an inhibitory effect, reducing PAI-1 mRNA levels by 63% (P<0.05) at 3 hours. The relative nucleotide potency in stimulating PAI-1 expression is UTP>UDP>ATP=2-MeSATP, consistent with a predominant role of the P2Y(6) receptor. Further studies revealed that exposure of RASMCs to either ATP or ADP for 3 hours inhibited both UTP- and angiotensin II-stimulated PAI-1 expression by up to 90% (P<0.001). Thus, ATP induced a small and transient upregulation of PAI-1 that was followed by a strong inhibition of PAI-1 expression. These results show that extracellular adenine and uridine nucleotides exert potent and opposing effects on vascular PAI-1 expression.

Hemispheric asymmetry in transient visual evoked potentials induced by the spatial factor of the stimulation.

In order to enhance the effect of spatial frequency on the hemispheric asymmetry of visual evoked potentials (VEP), the response amplitudes to ON-OFF modulated gratings were compared with the responses to pattern reversal stimulation. Sinusoidal gratings of different spatial frequencies were presented to six righthanders. VEPs were recorded from temporal leads on each hemisphere. In the left hemisphere, the amplitude was constant for the two modes of presentation and independent of spatial frequency. In the right hemisphere, the response amplitude was larger to the ONSET stage of ON-OFF stimulation than to reversal and presented the characteristic spatial frequency tuning curve. This asymmetry is assumed to reflect a difference in sensitivity of the two hemispheres to the spatiotemporal characteristics of the stimulus. The relevance of these findings is discussed in relation to the other hemispheric specialization models.

Sensitivity to colour- and to orientation-carried motion respectively improves and deteriorates under equiluminant background conditions.

This study presents two distinct effects produced by manipulation of the background illumination on the directional sensitivity to colour- and orientation-carried motion. The two motion percepts were produced with two of a class of stimuli extensively used by the first and last authors in apparent-motion studies. The stimuli were designed to produce motion perception by virtue of spatiotemporal matching of (a) colour with orientation systematically mismatched (Colour across Orientation, CxO) and of (b) orientation with colour systematically mismatched (OxC). An increase in background illumination from dark to the equiluminance point (relative to the luminance of the discrete stimulus microelements) entails a significant increase and decrease of directional performances with CxO and OxC stimuli, respectively. It is proposed that these anti-symmetrical background effects have distinct neurophysiological origins. For CxO stimuli, improvement of directional performances at the equiluminant point is presumably due to the inactivation of the inhibitory effect of the luminance-motion pathway on the chromatic-motion pathway. The opposite effect obtained with OxC stimuli, previously referred to as the veto effect (Gorea and Papathomas, 1988 Invest. Ophthal. Vis. Sci. Suppl., 29, 265), is supposed to be entailed by the inactivation of the luminance-oriented mechanism, the only motion sensitive mechanism activated by this stimulus configuration.

Influence of spatial frequency and handedness on hemispheric asymmetry in visually steady-state evoked potentials.

Recent suggestions on the involvement of the spatial frequency of visual stimuli in the hemispheric lateralization were investigated by recording steady-state evoked potentials in two groups of subjects: five right-handers and five left-handers. Sinusoidal gratings at spatial frequency of 0.5, 1, 3, 4, 6, 8, 10, 12 or 16 cpd were phase reversed at 4 Hz or 12 Hz. Evoked potentials recorded from temporal leads over each hemisphere were submitted to a FFT analysis. Results concern the amplitude of the fundamental component. In right-handers, the temporal frequency was the deciding factor of the lateralization: the evoked activities were greatest in the RH at 4 Hz and in the LH at 12 Hz. This effect was obvious for the range of spatial frequencies from 3-12 cpd. Results, discussed in terms of global/local information, suggested the existence of two transient and sustained systems. In left-handers, both the spatial and temporal parameters were relevant to the lateralization. A spatio-temporal interaction was observed which was reversed at 6 cpd.

Hemispheric asymmetries in the visual evoked potentials to temporal frequency: preliminary evidence.

Steady-state evoked potentials were recorded in eight adult subjects from occipital and temporal leads of both hemispheres to investigate the effect of temporal frequency on the hemispheric specialization for basic visual information. A 3 cycles deg-1 grating was phase-reversed at different temporal frequencies (from 4 to 18 Hz), and the frequency spectrum of evoked potentials was computed by means of a fast Fourier transform program. Significant results were obtained for the component at twice the temporal frequency of stimulation. Occipital evoked potentials did not show hemispheric asymmetry, whereas temporal evoked potentials showed an interaction between hemisphere and temporal frequency: right and left hemispheres were respectively prominent for low (4 and 6 Hz) and for high (8-18 Hz) temporal frequencies. The results are discussed in the context of current research on hemispheric specialization for basic spatiotemporal parameters of visual information processing.

[The Gardner-Diamond syndrome or painful recurrent ecchymotic purpura]. / Syndrome de Gardner Diamond ou purpura douloureux ecchymotique récidivant.

A case of Gardner-Diamond's syndrome is reported in which the lesions were localized to the face. The syndrome is characterized by the spontaneous onset of recurrent painful ecchymoses mainly in young women. The elective site of the lesions is on the limbs, sometimes on the abdomen or thorax, and only rarely on the face. They are accompanied by a very rich symptomatology contrasting with normal biological test results. An autoerythrocytic sensitization mechanism has been suggested but few biological arguments exist to support this auto-immune hypothesis of its origin. In contrast, the psychological background is hysterical in type, and the affection can be included among the psychogenic purpuras.

[Functional alterations in the retina following a 10 Gy gamma irradiation localized in the eye]. / Altérations fonctionnelles de la rétine consécutives à une irradiation gamma de 10 Gy localisée à l'oeil.

A single-eye irradiation of 10 Gy (0.8 Gy. min-1) induces impairments of the electrical responses of the rabbit retina in dark adaptation. These are associated with reversible alteration of the photoreceptors and the preganglionic neurons and a disturbance of all the mechanisms of adaptation. Possible relationships between these functional alterations and the effects of irradiation are discussed.

[Unit activities of the salmon Salmo salar preoptic nucleus in Parr, Parr-Smolt and Smolt stadia]. / Etude des activités unitaires du noyau préoptique du Saumon Salmo salar aux stades Parr, Parr-Smolt et Smolt

UNLABELLED: The olfactory and gustatory stimulations with NaCl (10(-5)-10(-2) M/1) bring about certain typical modifications of the preoptic cells activity in the case of "Parr" and "Parr smolt". The "on" or "off" or "on and off" effects are very marked. Unlike the "Smolt" stage is accompanied by an important decrease of the preoptic cells activity, sometimes until complete silence of the nucleus. DATA ANALYSIS: sequential analysis and statistical analysis. The activities recorded on a magnetic tape are feld to a mini computer.