Non-invasive short-term assessment of retinoids effects on human skin in vivo using multiphoton microscopy.

BACKGROUND: The occlusive patch test developed for assessing topical retinoids activity in human skin has been extended as a short-term screening protocol for anti-ageing agents. In this model, biopsies are performed at the end of the occlusion period for morphological and immuno-histochemistry analysis. Multiphoton microscopy is a recent non-invasive imaging technique that combined with image processing tools allows the in vivo quantification of human skin modifications. OBJECTIVE: To validate with gold standards of anti-ageing that are retinoids, the relevance of multiphoton microscopy for kinetic and quantitative assessment in this model. METHODS: Twenty women, aged 50-65 years, were enrolled. Retinol 0.3% (RO) and Retinoic acid 0.025% (RA) were applied to the dorsal photo-damaged side of their forearm under occlusive patches for 12 days. A patch alone was applied to a third area as control. Evaluation was performed at day D0, D12 (end of treatment), D18 and D32 using multiphoton microscopy. Epidermal thickness, normalized area of the dermal-epidermal junction (DEJ) and melanin density were estimated using 3D image processing tools. RESULTS: Main significant results are: Epidermal thickening at D12, D18 and D32 with RO and at D12, D18 with RA vs. baseline and vs. CONTROL: Increased DEJ undulation at D32 with RO and at D12 with RA vs. baseline and vs. CONTROL: Decreased melanin content with RO (at D12 and D18 vs. baseline and at D32 vs. baseline and vs. control) and with RA (at D12 vs. baseline). CONCLUSIONS: This study shows that multiphoton microscopy associated to specific 3D image processing tools allows cutaneous effects induced by topical retinoids in this in vivo model to be non-invasively detected, quantified and followed over time. This innovative approach could be applied to the evaluation of other active compounds.

[Ambulatory surgery in otorhinolaryngology: what is possible, suitable, prohibited?]. / La chirurgie ambulatoire en oto-rhino-laryngologie: qu'est-ce qui est possible, souhaitable, interdit?

A rational examination of technical conditions in E.N.T. face and neck surgery is realized with the intention of determining the best directions of ambulatory surgery. This application is based on technical requirements due to modernization of equipment and surgical ways, specially in ear and nose surgery. In surgery of upper air and alimentary ways, patient's security is at risk. These considerations allow to discuss states in which ambulatory surgery is possible, others where it is wished and particular states where it is not recommended.

[Indications and results apropos of 290 endonasal ethmoidectomies]. / Indications et résultats à propos de 290 ethmoïdectomies endonasales.

An intranasal ethmoidectomy prospective study was carried out from 1985 to 1991 on 152 patients and 290 ethmoidectomies. This surgery is intended for patients who have been treated often for nasal polyps, chronic ethmoiditis and recurrent sinus barotrauma. A discrepancy was observed between patients satisfaction (82%) and clinical symptoms, given that results remain good in 75% of the cases three years afterwards but only in 60 cases after five years. There is a recurrence of nasal polyps in 36% of the cases.

[Focal infection? Did you say focal infection ... focal infection and uveitis]. / Infection focale? Vous avez dit infection focale ... Infection focale et uvéites.

A chronic seat of infection more often than not situated in the E.N.T. area is responsible for remote pathological symptoms commonly called focal infection. The eye may be a target organ, where focal infection appears in the form of a uveitis. Four clinical observations are reported as demonstration. The transmission mechanism operates through an immune phenomenon from bacterial antigens which engender reactions of hypersensitivity. The E.N.T. specialist must be aware of these symptoms and seek a pharyngeal, sinusal or latent buccodental infection.

[Current aspects of sinus barotrauma. The impact on treatment, prevention and fitness]. / Aspects actuels du barotraumatisme sinusien. Incidence sur le traitement, la prévention et l'aptitude.

Among the barotraumatism which affects divers and airplane pilots, sinus barotraumatism is one of the less known and studied, as the scarceness of series published can testify. The interest of this study stands in doing an up to date synthesis (recap) of the bibliography, and to understand the "physio-pathologic" mechanism after the exploitation of series of 22 observations. That work will allow a better knowledge of therapeutic on the one hand, and of the "prophylactic" on the other hand.

Respiratory function and bronchial reactivity in mill workers.

Professional exposure to vegetable dusts affect the respiratory function of the exposed subjects. A previous survey conducted in an industrial flour-mill demonstrated a higher frequency of respiratory symptoms in workers compared to a control group. Ten subjects employed in a work site particularly exposed to dust were studied. Each subject answered a questionnaire and performed on Mondays and Fridays, at the beginning and end of his work shift, a flow volume curve and an isocapnic hyperventilation test. The aerobiology of the professional environment was also measured. We noted: 1) in the flow volume curves: a drop in the FEV1 during the Monday morning shift, a significant difference between the FEV1 (p less than 0.05) and the MMEFR 25-75 (p less than 0.05) measured at 6 am on Monday and Friday, and between the MMEFR 25-75 values obtained at 12 noon on Monday and Friday (p less than 0.05). 2) after isocapnic hyperventilation, a significant drop in the MMEFR 25-75 at 6 am on Monday (p less than 0.01) and in the FEV1 and MMEFR 25-75 at 12 noon on Mondays (p less than 0.05), a significant drop in the FEV1 at 1 pm on Monday (p less than 0.01).

Respiratory function in flour-mill workers.

The frequency of bronchial symptoms and the alteration of respiratory function parameters were studied in a group of 63 workers of an industrial flour-mill, and in a control group matched according to age, social class, and tobacco intake. In the exposed group the answers to a questionnaire indicated a greater incidence of cough (p less than 0.01) and chronic expectoration (p less than 0.01) as well as clinical airway hyperreactivity (p less than 0.01). No differences were noted for either asthma or allergy. The respiratory function parameters did not differ between the two groups studied. These results suggest that workers exposed to the vegetable dust found in fluor-mills are subject to develop chronic bronchial irritation.