Women's attractiveness is linked to expected age at menopause.

A great number of studies have shown that features linked to immediate fertility explain a large part of the variance in female attractiveness. This is consistent with an evolutionary perspective, as men are expected to prefer females at the age at which fertility peaks (at least for short-term relationships) in order to increase their reproductive success. However, for long-term relationships, a high residual reproductive value (the expected future reproductive output, linked to age at menopause) becomes relevant as well. In that case, young age and late menopause are expected to be preferred by men. However, the extent to which facial features provide cues to the likely age at menopause has never been investigated so far. Here, we show that expected age at menopause is linked to facial attractiveness of young women. As age at menopause is heritable, we used the mother's age at menopause as a proxy for her daughter's expected age of menopause. We found that men judged faces of women with a later expected age at menopause as more attractive than those of women with an earlier expected age at menopause. This result holds when age, cues of immediate fertility and facial ageing were controlled for. Additionally, we found that the expected age at menopause was not correlated with any of the other variables considered (including immediate fertility cues and facial ageing). Our results show the existence of a new correlate of women's facial attractiveness, expected age at menopause, which is independent of immediate fertility cues and facial ageing.

Traumatic epidural retroclival hematoma with odontoid fracture and cardiorespiratory arrest.

STUDY DESIGN: Case report. OBJECTIVES: To describe a case or traumatic retroclival hematoma with features not previously reported. SETTING: Single center. METHODS: Description of a case, in the context of relevant literature on the subject. RESULTS: Traumatic retroclival hematomas are a rare, typically pediatric, entity. Only four cases of epidural hematoma in adult patients have been reported. We describe an additional case, the first with a fatal course in the acute setting. It is also the first retroclival hematoma associated to an odontoid base fracture. CONCLUSION: Retroclival hematomas are a rare diagnosis, to be considered in pediatric patients with flexion-extension, high-energy injuries. Morphology is typically epidural. Brain stem and cranial nerve symptoms are typical. Treatment is usually conservative. Outcome is regarded as favorable, with partial recovery and neurologic sequelae. Adult cases are extremely rare. The case we describe adds new characteristics to the scarcity of cases.

Uncal decompression in gliomatosis cerebri.

Gliomatosis cerebri is defined as an infiltration, by an infiltrative glioma, of more than two cerebral lobes. Depending on response to treatment (chemotherapy and radiotherapy), clinical course may prolong over several months. Surgical excision has a very limited role in the management of this diagnosis. We present the case of a 48 year-old woman in whom a decompressive temporal lobectomy was performed in the context of a gliomatosis. Relief of intracranial hypertension allowed further treatment and a survival of 23 months. Relevant literature on the subject has been reviewed. There is the possibility of offering a decompressive lobectomy in selected cases of gliomatosis, allowing to undergo other treatment modalities.

[Filtering surgery in glaucoma: comparative study of three surgical approaches]. / Chirurgie filtrante dans le glaucome: étude comparative de trois approches chirurgicales.

INTRODUCTION: The multiple complications observed with trabeculectomy encouraged the re-emergence of non penetrating glaucoma surgery (NPGS) in the 1980's. Since then, several modifications have been developed in order to improve success rates and safety. We describe a new variation of deep sclerectomy (DS) in which we include an autologous corneal stromal implant soaked in mitomycin C and sutured to the scleral bed. Next, we compare intraocular pressure (IOP) at 2 years in three groups: I: DS; II: DS with autologous implant soaked in mitomycin C; III: conventional trabeculectomy. PATIENTS AND METHODS: All surgeries were performed by the same surgeon. There were 40, 22 and 15 eyes with medically uncontrolled primary open angle glaucoma (POAG) in groups I, II and III, respectively. All patients underwent the usual pre- and postoperative exams over 24 months. Selected patients underwent Visante OCT (Optical Coherence Tomography) (Carl Zeiss, Meditec, Inc. Germany) examination of their anterior segments. RESULT: Age and sex distribution in all three groups showed no statistical difference. Mean preoperative IOP was 24 ± 11 mmHg, 26 ± 14 mmHg and 25 ± 9 mmHg in group I, II and III, respectively (P>0.8). Mean postoperative IOP was 14 ± 3 mmHg, 10 ± 3 mmHg and 13 ± 4 mmHg (P=0.05) at six months; 16 ± 4 mmHg, 13 ± 3 mmHg and 11 ± 4 mmHg (P=0.02) at 12 months; and 15 ± 4 mmHg, 12 ± 3 mmHg and 14 ± 4 mmHg (P=0.2) at 24 months. Mean number of eye medications dropped from 1.85, 2.18 to 1.92 (P>0.05) preoperatively in group I, II, and III, respectively, to and 0.25, 0.05 to 0.18 (P=0.02) at 24 months. Patients with a visible implant under the bleb at 24 months had a better outcome. DISCUSSION: DS with autologous implant significantly reduced IOP at 12 and 24 months. The results seem better than those obtained with collagen implants, most likely due to the persistence of the corneal implant under the bleb at 2 years. Its non-resorption and the minimal fibrosis at the level of the scleral bed may be related to the fact that it is an autologous material which has been soaked with mitomycin C. CONCLUSION: DS with autologous implant soaked in mitomycin C, an inexpensive technique, demonstrates medium-term efficacy in the surgical management of POAG. Our results suggest that our technique may enhance both success rate and efficacy in lowering IOP. Further long-term studies are needed.

Tumor fibroso solitario meníngeo del surco olfatorio / No disponible

No disponible

Pseudophakic ametropia managed with a phakic posterior chamber intraocular lens.

We report the use of a phakic posterior chamber intraocular lens (IOL) to correct pseudophakic ametropia. Two eyes of 2 patients developed ametropia after unilateral phacoemulsification and IOL implantation. The manifest refraction was -6.00 -0.50 x 50 in the first patient and +4.50 -1.00 x 15 in the second. Both patients were bothered by the induced anisometropia and had posterior chamber phakic IOL implantation in the pseudophakic eye. Postoperatively, uncorrected visual acuity improved from 20/400 to 20/30 in the first patient and from 20/200 to 20/40 in the second patient. The manifest refraction was -0.50 -0.75 x 55 and +1.50 -1.50 x 30, respectively. No complications were noted. Implantation of a phakic posterior chamber IOL may be an alternative to currently available methods of managing pseudophakic ametropia.

[Subjective perception of the effect of neuroleptics by outpatient schizophrenic patients: a cross-sectional study]. / La perception subjective de l'effet des neuroleptiques chez des patients schizophrènes ambulatoires: une étude transversale.

UNLABELLED: Subjective response to neuroleptics is essential to long term observance of treatment and quality of life of patients. Numerous factors (pharmacological, relational and psychopathological) are responsible of this subjective response. Objectives of this study are: (a) to examine psychometric features of the french version of the Drug Attitude Inventory (DAI-30) [13] and (b) to explore pharmacological, relational and psychopathological factors related to this subjective response. SUBJECTS AND METHODS: 78 subjects were rated (self rated response rate 61% (n = 48)) for (a) subjective response to neuroleptics, (b) compliance, (c) therapeutic alliance, (d) symptoms (e) severity of disorder. RESULTS: Factor analysis yielded 2 main clinically relevant factors, similar to the original version: (I) global subjective response and (II) specific subjective response. Internal consistency is high. Correspondance analysis showed two important dimensions in the treatment of schizophrenic patients: (I) Recovery--aggravation, (II) Therapeutic ambition--positive or negative symptoms. CONCLUSION: French version of DAI-30 seems to have a similar structure and psychometric features as the original version. It shows concordance with the degree of compliance. Pharmacological factors are not the only factors implicated in subjective response, but are still to be identified. Limitations of our study are: (a) nonhomogenous indication for treatment, (b) small rate and degree of non compliance in our sample. Relationships between therapeutic ambition, type of symptoms and treatment outcome should be further studied.

[Mortality and birthdays]. / Mortalité et anniversaire de naissance.

The authors study the date of death in relationship, in the annual cycle, to date of birth of every person who died of natural causes in Switzerland between 1st January, 1969 and 31st December, 1992 (N = 12,275,033). They highlight a maximal mortality (17% over expected) on the actual anniversary of birth with the entire population, a slightly lower figure being found under 80 years of age, higher over this age. They tie this phenomenon to the classical group of "anniversary reactions", in which problems of identity probably play a role. An uncertainty hangs nevertheless over the value of these findings, which are not confirmed by any published material, and even denied by some.

[Informed consent in the framework of biomedical research: a survey]. / Le consentement éclairé dans le cadre des recherches biomédicales: une enquête.

Inquiry on the quality and steps taken to obtain informed consents for biomedical research projects, based on the cases of 39 patients coming from 15 different projects with immediate therapeutic goals and 16 healthy subjects coming from 4 different projects without immediate therapeutic goals. Comparison between observed reality and the more or less demanding norms that were recommended. We noted a much bigger gap (therefore a consent actually informed in a lesser way) in the group of patients than in the group of healthy subjects. Explanatory hypotheses: the healthy subjects' higher social and cultural level, but also the investigators' difficulty and comprehensible discomfort to integrate, with respect to the patient, the essentially different and possibly contradictory points of view of scientific research and medical care; the "double market" notion.

[Comparison of astigmatism due to ambulatory cataract surgery with 3 different techniques]. / Comparaison de l'astigmatisme induit dans la chirurgie ambulatoire de la cataracte selon 3 techniques différentes.

We show that there was little difference in the average astigmatism induced in three surgical groups (Extracapsular (EC), Phacoemulsification with and without scleral tunnelization) at the last control. An examination of a second group of patients shows a significant reduction in the time necessary for recovering at least 80% of the final visual function and a significant shortening of the time elapsed before the prescription of the glasses in the group of patients operated on using phaco with tunnellization. Just as there is a significant relationship between the post-operative cyclinder and postoperative phase 1, there is also a reduction in, and early and lasting stabilisation of, the cyclinder induced by surgery using small incisions. We show that the technique of vectorial calculation brings into play discontinuous trigonometric functions that require great prudence when interpreting statistics of cylinders induced by surgery.

[Benefits of ambulatory surgery in cataract surgery]. / Qu'apporte la chirurgie ambulatoire à l'opération de la cataracte.

We monitored 300 patients who had undergone ambulatory cataract operations. Patients are more and more preferring this type of surgery, which allows them to go home immediately after the operation. We compare ambulatory ECCE and phacoemulsification operations and their complications, advantages and disadvantages. We shall not go into the real cost-saving benefits of this type of surgery compared with conventional surgery, as these have already been demonstrated in other countries. Ambulatory surgery requires that the patient is to be monitored after the operation, which is difficult to do in large centers. We explain the reasons for this. We discuss the indications and contra-indications of this type of cataract procedure.

Homing in humans: A different look.

A current model holds that the long-distance homing abilities of free-ranging mammals rest primarily on a strategy of course reversal, based on outward journey information. In this study, I measured the ability to orient toward home in humans displaced under conditions that promote the use of this strategy, namely along an outward route that was direct, and the main bearing of which could be extrapolated by reference to a pre-existant mental map and by visual backup during the outward journey. Even though the individual course estimates obtained did show a certain amount of dispersion and/or error, they were more accurate and less dispersed than in experiments by other authors, where subjects could not use this strategy, because they were displaced blindfolded and/or along circuitous routes.

NMR paramagnetic relaxation enhancements due to manganese in the S0 and S 2 states of Photosystem II-enriched membrane fragments and in the detergent-solubilized Photosystem II complex.

The NMR paramagnetic relaxation enhancement (NMR-PRE) produced in the solvent proton resonance by manganese in the S0 and S2 states of the oxygen evolving center (OEC) has been recorded for three Photosystem II (PS II)-enriched preparations: (1) PS II-enriched thylakoid membrane fragments (TMF-2 particles); (2) salt-washed (2M NaCl) TMF-2 particles; and (3) the octylglucopyranoside (OGP)-solubilized PS II complex. The second and third preparations, but not the first, are depleted of the peripheral 17 and 23 kD polypeptides associated with the OEC. It has been proposed that depletion of these polypeptides increases the exposure of OEC manganese to the aqueous phase. The NMR-PRE response measures the quantity (T1m+τm)(-1), where T1m is the spin relaxation time and τm is the mean residence time with respect to chemical exchange reactions of solvent protons in the manganese coordination sphere, and, thus, the NMR-PRE provides a direct measure of the solvent proton chemical exchange rate constant τm (-1). This study tested whether the 17 and 23 kD polypeptides shield the OEC from the solvent phase and whether their depletion enhances the S2 and S0 NMR-PRE signals by removing a kinetic barrier to the solvent proton chemical exchange reaction. The amplitude of the S2 NMR-PRE signal, measured in its chemical exchange-limited regime (τm>T1m), is slightly decreased, rather than increased, in preparations (2) and (3) relative to (1), indicating that removal of the 17 and 23 kD polypeptides slightly slows, rather than accelerates, the rate-limiting steps of the solvent proton chemical exchange reactions. In addition, the lifetime of the S2 state was shortened several-fold in the solubilized PS II complex and in salt-washed TMF-2 membranes relative to untreated TMF-2 control samples. The S0 NMR-PRE signal, which is present in TMF-2 suspensions, was not detected in suspensions of the solubilized PS II complex, even though these samples contained high concentrations of active manganese centers (approximately double those of the TMF-2 control) and exhibited an S2 NMR-PRE signal of comparable amplitude to that of the TMF-2 preparation. These results suggest that the 17 and 23 kD extrinsic polypeptides do not shield the NMR-visible water binding site in the OEC from the aqueous phase, although their removal substantially alters the proton relaxation efficiency by shortening T1m.

[Phacoemulsification: technical initiation at what price?]. / Phacoémulsification: initiation a quel prix?

Phacoemulsification of the cataract is perhaps technically superior which is considered "classic". This technic consists however of a number of difficulties that may be mastered during an apprentiship. Considerable complications may arise during this initiation periods; imposing this surgical method on patients is thus an ethical problem. If the risks encountered during the apprentiship of phacoemulsification appear comparable to those during the classic extracapsular technique, phacoemulsification may be recommended with less reservation. We have compared 250 initial cases of classic extracapsular extraction with 250 "initial cases" of phacoemulsification, taking into account operative and post-operative complications and final functional results.

[Development and concept of a new operatory chair]. / Développement et conception d'une nouvelle chaise operatoire.

We present a novel type of operatory chair which directs an operation microscope by remote control using infrared beams: XV, zoom, focal and accessories. The advantage of this system is the absence of transmission cables, and consequently represents an important improvement in terms of flexibility. It is a vast improvement as well for maintaining sterile conditions in the operation room. The ergonomics of this chair was especially designed for microsurgery. The adjustment and stability of the forearm has been considerably improved.

[The eye as an art form: the ocular prosthesis]. / L'oeil tout un art: la prothèse oculaire (film).

The technique of fabricating an ocular prosthesis out of glass is a rare art originating from Thüringen (formerly DDR). This technique is still practised by a few artists. A close collaboration between the ocularist and surgeon is indispensible towards achieving an optimal adaptation. We present several rules of plastic surgery enabling the cavity to receive the prosthesis after enucleation. The realization and adaptation of such a prosthesis has been filmed and will be presented.