Concordance between self-report and clinician's assessment of depression.

In order to assess differences between self-assessment and clinician's assessment of depression, 64 depressed in-patients were assessed for depressive symptomatology at admission (D0), 10 days (D10) and 28 days (D28) after the beginning of antidepressant treatment, using the Inventory for Depressive Symptomatology Clinician Rated (IDS-C) and the Inventory for Depressive Symptomatology Self-Rated (IDS-SR). Associated symptoms (SCL-90R) were assessed at D0 and personality dimensions (TCI) at D28. Although agreement was high between IDS-C and IDS-SR total scores, D0, D0-D10 and D0-D28 total scores were significantly different between IDS-C and IDS-SR, showing a higher sensitivity to change for IDS-C as compared to IDS-SR. Differences between IDS-C and IDS-SR were due mostly to mood items and not to somatic items. Discrepancies between self-assessment and clinician's assessment of depressive symptomatology were linked neither to age, sex, familial status, single/recurrent and length of episode, nor to depression severity, but to associated symptoms and, to a lesser extent, personality dimensions: patients over-estimating their depressive symptomatology change relative to the psychiatrist tended to score high on phobic anxiety, Cooperativeness (especially Social Acceptance) and Self-Transcendence (especially Self-forgetfulness) and vice-versa.

IDS-C and IDS-sr: psychometric properties in depressed in-patients.

Sixty-eight depressed in-patients were assessed at admission (DO), and after 5 days (D5), ten days (D10) and 28 days (D28) of antidepressant treatment, with the Inventory for Depressive Symptomatology-Clinician (IDS-C) and the Inventory for Depressive Symptomatology-Self-Rated (IDS-SR) (Rush et al., 1986), the Montgomery and Asberg Depression Rating Scale (MADRS) (Montgomery and Asberg, 1979) and the depression factor of the Symptom Check List (SCL-90R) (Derogatis, 1977), in order to assess IDS-C and IDS-SR psychometric properties in depressed in-patients and to compare IDS-C to MADRS and IDS-SR to the SCL-90R depression factor. Most of the IDS-C and IDS-SR items were significantly correlated to the final score and the Cronbach alpha coefficients were high (0.75 for the IDS-C and 0.79 for the IDS-SR). Principal Component Analyses (PCA) showed three factors for both IDS-C and IDS-SR: 'depression', 'anxiety/arousal' and 'sleep/appetite'. These results suggest satisfactory internal consistency of IDS-C and IDS-SR. Concurrent validity of the IDS-C with the MADRS was high (r = 0.81), as well as concurrent validity of the IDS-SR with the SCL-90R depression factor (r = 0.84). Concerning sensitivity to change, the four scales were able to discriminate between different levels of severity of depression. Moreover, considering paired t-tests on score changes, IDS-C sensitivity to change may be higher than MADRS sensitivity to change, this phenomenon being related to the number of items and degrees but not to the item contents. Contrary to IDS-C and MADRS, IDS-SR and SCL-90R depression factor were not different in terms of sensitivity to change. Finally, psychometric properties of IDS-C and IDS-SR in depressed in-patients are satisfactory and close to those obtained in depressed out-patients. The high sensitivity to change of the IDS-C may be an advantage for this scale as compared to the MADRS, especially in antidepressant drug trials.

Effects of cholecystokinin tetrapeptide on respiratory function in healthy volunteers.

OBJECTIVE: The authors evaluated respiratory response to cholecystokinin tetrapeptide (CCK-4) in healthy volunteers. METHOD: Subjects were randomly assigned to either a CCK-4 (N = 15) or placebo (N = 15) challenge under double-blind conditions. RESULTS: Dyspnea was reported by all of the subjects who received CCK-4 but only one subject who received placebo. CCK-4 caused a significant increase in tidal volume and minute ventilation but had no effect on breathing frequency. Placebo had no effect on any of the respiratory measures. CONCLUSIONS: These data indicate that the behavioral effects of CCK-4 are accompanied by changes in respiration in healthy volunteers.

Morphometric analysis of collagen and elastic fibers in normal skin and gingiva in relation to age.

The morphometric parameters of the human gingival elastic fiber network were determined by image analysis and compared with human skin elastic fibers in relation to age. Similarly, collagen fibers were also investigated in both tissues. In this study, 47 healthy patients, 10-75 years old were studied for gingiva and another 50 patients in the same age range were included for skin biopsies. Three groups were compared: group 1 from the age of 10-24 years, group 2 from 25 to 49 years, and group 3 from 50 to 75 years. The diameters of the oxytalan fibers were invariable in both tissues, whatever the age considered. On the other hand, the diameters of elastic fibers increased regularly with age in the gingiva (P < 0.01) and in the skin (P < 0.01) between each age group. The area fraction occupied by the oxytalan fibers decreased significantly in both tissues (P < 0.01) for the skin and (P < 0.001) for the gingiva. The area fraction occupied by the gingival elastic fibers remained constant with age while the skin elastic fibers increased significantly with age between groups 2 and 1 (P < 0.01) and between groups 3 and 2 (P < 0.001). In the mid-dermis and in the mid-gingiva, the diameters of the collagen fibers increased strongly with age, between groups 2 and 1 (P < 0.01) and between groups 3 and 2 (P < 0.001). The area fraction occupied by the collagen bundles increased regularly with age in the mid-gingival (P < 0.05 between each age group), while a significant decrease was observed in the mid-dermis from the age of 50-75 years (P < 0.05). The results obtained contribute to a better understanding of some modifications which dermis and gingiva undergo with aging and provide data to perfect diagnosis and therapy in odontology and dermatology.

Clinical testing of dental materials--histological considerations.

In order to assess the biocompatibility of dental materials, clinical studies, as well as in vitro studies, are needed. Although no bacteria were detected inside tubules, pulp reactions were observed when either adhesives of the last generation aiming to create an hybrid layer were used or restorative materials controlling the interface between the biomaterial and dental tissues. However, the reactions were feeble to moderate. Reparative dentine seldom appeared after such treatments. Differences between odontoblast and pulp cells, the nature of the lesion (necrosis or apoptosis), and differences between sound experimental and carious teeth seen in the real clinical situation are discussed in the context of in vivo human studies.

[Lysosomal storage diseases, genetic or drug-induced? effect of glycosaminoglycan and sphingolipid disorders on dental tissues]. / Maladies de surcharge lysosomale, génétiques ou induites pharmacologiquement: effets de pathologies de glycosaminoglycanes et de sphingolipides sur les tissus dentaires.

In vivo studies were carried out on dental tissues of rat incisor after a single injection of suramin, a drug which induces mucopolysaccharidosis-like disease. Accumulation of lysosome-like structures was seen in secretory ameloblasts and odontoblasts. In vitro studies on embryonic tooth germ buds showed similar changes when they were cultured in presence of suramin. Anti-phospholipid immunolabelling revealed a developmentally regulated temporo-spatial pattern. Radiolabeling with 3H-suramin indicated cytosolic and nuclear incorporation. The drug acting as polyanion interacted directly with predentine. 35S sulphate incorporation was impaired by the drug. Another lysosomal storage disease, the sphingolipidosis, Krabbe's disease was also investigated in human. Changes were observed in pulp cells and as a consequence in dentin. Enamel also displayed many changes. Pharmacological or genetically acquired diseases constitute models providing insights on the role played by glycosaminoglycans and phospholipids in biomineralization.

Scanning electron microscopy of the forming enamel of rat incisor: influence of fixative and treatments interacting with the organic matrix.

The forming enamel of rat incisor was either treated before fixation with one of these five treatments: ultrasonication, NaOCl, chloroform/methanol, NaOH or tween 20; or the incisors were first fixed and then submitted to one of these treatments. The structure of the forming enamel, compared with sections fixed with aldehyde and submitted to osmic maceration, depends on the way the samples were treated and on the fixative used. An amorphous material, removed by osmium tetroxide but not by aldehyde solution was seen to be located between fiber-like structures. In the region of inner enamel secretion the thickness of interrod septa was fairly constant, whereas in the region of outer enamel secretion, transverse septa of interrod enamel gradually became thinner and finally disappeared. The longitudinal septa did not display such changes. Longitudinal grooves and ridges were seen at the end of enamel completion. These longitudinal septa finally merged and formed a flat surface.

[Primary hyperoxaluria. Clinical, histological and crystallographic study of the ocular lesions]. / Hyperoxalurie primaire. Etude clinique, histologique et cristallographique des lésions oculaires

A post-mortem histological examination of the eyes of a case of primary hyperoxaluria revealed the presence of crystals in the ciliary processes and at the level of the retinal pigment epithelium. The crystallography study demonstrated that it consisted of wewhellite. The ocular lesions are compared with those found by other authors in primary hyperoxaluria, after prolonged methoxyflurane anaesthesia, after experimental administration of dibutyloxalic acid or naphthalene, and in the human retina in longstanding detachments. Most of the factors which give rise to the presence in the eye of oxalate and its selective precipitation in the midst of certain ocular tissues remain hypothetical. The retinal lesions observed in primary hyperoxaluria appear to be pathognomonic for hyperoxalaemia.