[Demonstration of the effect of estrogen and progesterone receptors on survival in breast cancer without cytostatic and hormonal treatment in a small set of patients]. / Prukaz vlivu estrogenových a progesteronových receptoru na prezití u karcinomu prsu bez cytostatické a hormonální lécby v malém souboru pacientek.

BACKGROUND: With respect to diagnostic and therapeutic progress, it may occur that the statistical sets of patients evaluated and treated with uniform methods are small. As a consequence, it is meaningful to check a greater number of statistical approaches. It is suitable to verify whether, for instance, the differences between the results (+) and (++) for estrogen and progesterone receptors (ER and PR) in breast cancer have an effect on the length of survival. This question could be answered with the use of several Kaplan-Meier survival curves. However, it is also profitable to judge the simple graph of survival in dependence on receptor concentration. Nevertheless, traditional regression brings too great an error to this method of assessment. Therefore, the use of orthogonal regression is much more precise. Since it can be assumed that no non-revealable micro-metastases were present at the time of operation in some patients with N0, it is possible to achieve healing ad integrum of them using only simple surgery. Consequently, we concluded that it was necessary to exclude from the evaluation the group of patients in N0 surviving 10 years (in the search for evidence of the post-operative impact of age-based reduction of blood estrogen on survival). DESIGN AND SUBJECTS: We verified these considerations when monitoring the ER and PR influence on overall survival. We performed this analysis in an approximately 2-year sample of 74 female patients who received the described treatment in Pardubice hospital. At the time of operation, 56 were postmenopausal and 21 of these postmenopausal patients were in stage N1. METHODS AND RESULTS: ER and PR in breast tumours were examined in the cytosol of operational biopsies. Adjuvant radiological treatment was used in addition to the surgical treatment of primary tumours and their original and post-operative metastases. In the case of premenopausal patients with ER, (+) therapeutic sterilization was performed. The finding of higher ER in postmenopausal surviving patients (in comparison to dead ones) was below the boundary of statistical significance. Also, longer survival in cases of higher ER concentrations in the group of dead N1 patients was below the boundary of statistical significance in the use of traditional regression. Therefore, we put together evidence from the group of surviving patients with evidence from the group of dead patients. In the case of N1 patients surviving 10 years, we rounded their survival period to 15 years for inclusion in the graph of survival dependence on ER. In the case of the combined (premenopausal with postmenopausal) group, statistical reliability appeared for longer survival of higher ER already in traditional regression. However, for the postmenopausal alone, the difference was statistically insignificant. Nevertheless, if we used orthogonal regression (similar to Deming regression) instead of traditional regression, then the reliability of the dependence of the length of survival on ER increased (in the last cited graph) to such a degree that it was statistically highly significant (at the level of 0.001) even in case of just postmenopausal patients. The same level of statistical reliability was achieved in the Kaplan-Meier analysis. Also in the case of PR--the higher concentrations of this receptor in survivors compared to dead patients were not statistically significant. But (in contrast to ER) in the case of PR, we observed a statistically significant increase in survival time depending on the receptor concentration within the group of only the dead patients--hence without putting them together with the surviving patients). CONCLUSIONS: The graph of the Kaplan-Meier analysis is more frequently used when solving these problems but the graph of simple dependence of survival on receptor concentration should not be neglected either because, for example, it better shows the difference in survival between ER(+) and (++). Nevertheless, it is necessary to use orthogonal regression in it. The greater suitability of PR and ER for short-term and long-term prognosis, respectively, which we identified in our statistical set, is in concordance with the literature.

Ratio of concentrations of estrogen receptors to progesterone receptors (ER/PR) in the cytosol of breast cancers (stratification by forming of groups differing in PR).

The ratio of cytosol concentrations of estrogen receptors to progesterone receptors (ER/PR) can help at the diagnosis of the excessive production of estrogens or (on the contrary) of the lowered function of ER or of the too small expression of the PR gene. We divided the statistical set into the groups with the approximately same concentrations of PR for stronger judgement of this ratio because PR is nearly not changing due to the age (in contrast to the age unstable ER). We used this stratification into the PR-limited groups at the radio-receptor analysis of 147 patients. 1) The ER/PR quotient was higher in the older patients but predominantly it was approximately 10-times lower in case of the high PR than in case of the low PR. This is why the more than 10-fould error can arise at uncorrected judgement whether ER of some patient is inadequately high or low in the comparison with her PR. It implies that e.g. in case of any one patient it is possible to infer the excessive production of ER from the comparison of her ER/PR--best only in the range of her PR-limited group (and in the addition taking account of the age). It can be important for therapy and prognosis. 2) The interpersonal differences of ER and ER/PR were approximately 10-times smaller in PR-limited groups than in the whole statistical set. This is why e.g. the correlation coefficients of the age increase of ER and ER/PR in the PR-limited groups were more favourable than in the whole non-stratified statistical set. In case if PR decreases in the higher age in case of some authors, it is necessary to create the PR-limited groups by another manner. For instance, 20 % of the tumors with the highest PR from each age group will be in the same PR-limited group (despite the fact that they differ in PR). The impact of the age will be then more marked in case of ER/PR than in case of ER only because the numerator elevates and denominator decreases. The impact of the ovarian cycle might be detected more sensitively on the same principle. It is possible to analyse by this manner the possibility to transform the receptor results to the average age or to the optimal phase of the ovulation cycle to prevent e.g. the false negativity of ER. The principles of this mathematical approach might be exploited even for a judgement of the prognosis and therapy on the basis of the mutual ratio of different isotypes of receptors for one hormone only (ERalpha / ERbeta or PRA / PRB). It concerns not only the breast cancers but also the cancers of the uterus.

What happens to children with PDD when they grow up? Prospective follow-up of 219 children from preschool age to mid-childhood.

OBJECTIVE: To describe the psychological development of children with pervasive developmental disorders over a period of 3 years and to identify the factors linked to their developmental paths. METHOD: The study was a collaborative and prospective follow-up study of 219 preschoolers. Retrospective data and enrollment data were collected at the beginning of the study and 3 years later. RESULTS: We observed high variability in the short-term outcomes of preschoolers. In line with previous research, our results showed that intellectual, linguistic and adaptive functioning were useful for predicting outcome. The severity of a child's autistic symptoms appears to be related to his or her future development. These variables can therefore be used as predictors of outcome for preschoolers with autism. CONCLUSION: Developmental and symptom changes in young children with autism should not be overlooked and need to be assessed regularly in view of choosing suitable servicing programs.

Social behaviour in pervasive developmental disorders: effects of informant, group and "theory-of-mind".

Theory of mind skills and a range of social behaviour in everyday life were assessed in a sample of 21 children with pervasive developmental disorders and 22 normally-developing preschoolers. Parents, teachers and therapists were interviewed using the Vineland Adaptive Behaviour Scales and a new supplementary scale, the "Echelle d'Adaptation Sociale pour Enfants" (EASE). Teachers and therapists were able to differentiate subtle forms of social problems in everyday life between subgroups of children diagnosed later to have either autism (n = 13) or PDDNOS (n = 8), according to DSM-III-R (1) criteria. This study offers a (small) cross-cultural replication of recent work suggesting that differences in the mentalising skills of children with autism are reflected in the everyday social behaviour of this group. A significant effect of informant was found for the PDD group, and this effect was particularly pronounced when children with autism were considered separately. The implications of informant differences are discussed.

[Paul Girard and the left-handed]. / Paul Girard et les gauchers.

Paul Girard's original theory of left handedness and of its relationship with stuttering, writer's cramp, and obsessive compulsive disorders is described and connected with its historical background.

Histoautoradiographical detection of DNA repair synthesis in different organs of mice after methylnitrosourea "in situ".

Methylnitrosourea (MNU) was applied by gavage into the stomach in a dose of 123.1 mg/kg. Hydroxyurea (250 mg/kg) and 6 (3)H thymidine (dTh - 2 MBq/g) were injected intraperitoneally. DNA repair synthesis as the labelling of non-proliferating cells was most reliably established in the testicles, bronchi, duodenum, kidney, liver and pancreas after 3 months to 3 years exposure of the histoautoradiograms. The findings in the stomach and rectum are near to this group. Less reliable positivity was found in the adrenals, urinary vesicle, spleen and heart, while in the musculature of the abdominal wall and in the thymus the results were negative. There is some correlation of these results with literary data about organ specific development of tumors after orally applied MNU to mice. This suggests wide applicability of this autoradiographical method. The possibility of increasing the dose of 3H thymidine is also discussed.

[René Allendy and the medicine of the imponderables]. / René Allendy et la médecine des impondérables.

René Allendy was one of the first French psychoanalysts. He was also a homeopath. A text by him on the "medicine of the imponderables" demonstrates his proximity to esoteric theories. The objective of this article is to illustrate a cultural misunderstanding at the time of the introduction of psychoanalysis in France, when it met up with a Gnostic and Illuminist heritage that was still very much alive. This initial confusion between the Freudian approach, which was in keeping with the thinking of the Lumières, and a certain obscurantism, explains perhaps some of the resistance as well as some of the subsequent deviations of psychoanalysis in France.

[The carcinogenicity of gasoline (review of the literature)]. / Karcinogenita benzínu (prehled literárních údaju).

In accord with new findings, the gasoline is no more believed to be free of cancerogenic risk. Renal tumours in male rats and those of liver in murine females had been described also after inhalatory exposure to unleaded gasoline. A reliable epidemiological study in occupationally gasoline exposed humans is still not available (higher rate of tumours in workers of chemical petrol processing industry due to the influence of gasoline appears to be an indirect proof, because apart from gasoline also other substances are involved simultaneously). With regard to a mechanism of action, those first published have been the negative results of testing for chromosomal abnormalities and bacterial genetic mutations. However, the mutagenicity was proved further on molecular level with the use of appropriate tests (e. g. induction of DNA repair synthesis). Certain authors ascribe more importance to the promotional rather than initiational effect of gasoline. However, the former is not accentuated by the IARC. Further studies should be predominantly based on molecular genetic approaches and epidemiological studies.

[Disease models and models of handicap in psychiatry]. / Modèles de la maladie et modèles du handicap en médecine mentale.

Throughout psychiatric history, the handicap model has been referred to a mineral image as opposed to the vegetal image of disease. The structural model, after Freud, seeks to overcome the opposition between disease and handicap. Present day disregard for this model, especially in the United States, stems from economical and ideological reasons. The come-back of a psychopathology of "faculties" linked to the notion of deficiency and reinforced by fascination with computers, also represents the need of humankind to believe in an incorruptible soul.

Quantification of histoautoradiographic evidence of DNA repair synthesis in the liver.

Histoautoradiography was used to detect dimethylnitrosamine-induced 3H-thymidine incorporation in vivo into G phase hepatocytes. A description of the standard procedure for counting the grains as well as the mode of mathematical evaluation is presented. The results exhibited higher sensitivity than those in the investigation of the DNA repair synthesis by means of a scintillation counter using the method of detection of hydroxyurea-resistant incorporation of 3H-thymidine. Thus it was possible to simplify the investigation by lowering the number of evaluated cells. A suitable compromise between precision and laboriousness will probably be achieved by counting 20 hepatocytes per animal. In case that there are striking differences between the experimental and the control group, a qualitative conclusion may be drawn even without counting the grains.

[Institutional treatment of schizophrenics today.]. / Le traitement institutionnel des schizophrènes aujourd'hui.

This article suggests that the solution to treating schizophrenia can only be found in an institution. The author reaches this conclusion after pointing out the disastrous effects on patients of a poorly-understood liberating theory and the misguided emphasis on social skills and readaptation at the expense of patient care. The author uses his vast knowledge acquired in clinical work to discuss his argument and lay out the conditions needed to make institutional treatments possible.

Utilization of hydroxyurea for detection of DNA repair synthesis in liver following dimethylnitrosamine action by means of scintillation counting.

We detected DNA repair synthesis by employing hydroxyurea as an inhibitor of DNA semiconservative synthesis in various time schedules of experiments. We came to the conclusion that prolongation of the time interval between [3H]thymidine administration and sacrifice of the animals from 0.5 h to 7.5 h increases the sensitivity of examination. Some artifacts associated with detection of the repair (hydroxyurea-resistant) synthesis of DNA are discussed.

[Community psychiatry. Evaluation and research perspectives]. / La psychiatrie de secteur. Evaluation et perspectives de recherche.

The author deals with 3 possible types of epidemiological studies in community mental health services: studies on the efficiency measuring the difference between the objectives of each team and the results; studies on the distribution between the teams and within each team, institutionalised models and implicit defensive modalities elaborated by the staff against the fear of the insane; studies on the populations considered at risk by psychoanalytical theories en vogue (depressive mothers, relationship anomalies). These studies would have the advantage to limit the "etiopathogenic pretentions" in psychiatry and avoid the "realistic slide" of imaginary constructions (myths or fiction of origin) which the community health service psychiatrist needs to work with but which has only an uncertain relationship with historical truth.

Histoautoradiographic detection of DNA repair synthesis in mouse liver following dimethylnitrosamine treatment using whole-body application of labeled thymidine.

DNA repair synthesis following dimethylnitrosamine (DMN) treatment in mouse liver was detected in vivo by means of histoautoradiography. This phenomenon was more significant around the acinus center (practically in all hepatocytes) than around the portobiliary space. Besides this also a decrease in semiconservative DNA synthesis was observed. Another finding was an increase of the background over the liver sections in the groups with DMN due to the altered metabolism of tritiated thymidine. This effect responsible for the difficulties encountered with in vivo autoradiographic detection of the repair synthesis was eliminated by prolonging the time between the 3H-thymidine application and sacrificing the animals. Based on this method, it is possible to develop a short-term assay for determining mutagenic and carcinogenic effects of various compounds.

[Fear of the mad.]. / La peur du fou.

The author shows us that, apart from a physical fear that we may experience at times, there exists a more subtle and destructive fear of the insane which determined - and still determines in many circumstances - the attitudes and even the policies which we advocate in regard to the mentally ill. The fear of being overcome, of being consumed by the avidity, the hate, and the projective identification which exist in the psychotic. In the face of this fear we have developed a series of rather inadequate and inefficient defense mechanisms which range from the denial of insanity to institutiona-lization and include all forms of activism and intolerance. In the end, however, this fear must not create in us a state of helplessness nor an oppressive reaction of omnipotence. Perhaps all that is necessary is simply to continue to listen to oneself and others?

The influence of pH on the excision of UV-photoproducts from HeLa cells.

Excision of pyrimidine dimers with pH decreasing in UV irradiated HeLa cells can be depressed. This depression is independent of the UV dose within the investigated range. The excision capacity of HeLa repair system from absolute amount of excised dimers is shown.

[Elements of a theory of psychiatric care]. / Eléments pour une théorie de la fonction soignante en psychiatrie

According to traditional psychiatric care, hospitalisation is indicated as soon as a schizophrenic patient presents an acute episode. If one, on the contrary, tries to apply psychiatric crisis intervention in the home of the patient, it seems very useful, in order to make people aware of the family's dynamics, to observe the psychological transactions related to the medication.

Contribution to the study of excision repair following UV irradiation in mammalian cells cultivated in vitro.

The absence of pyrimidine dimer excision after UV irradiation in rat cell line was confirmed. The possibility of excision repair system depression by acidification of medium with H3PO4 in HeLa cells has been proved. The results obtained by two different methods of deproteinization and DNA isolation are in good conformity.