Characterization of choline compounds with in vitro 1H magnetic resonance spectroscopy for the discrimination of primary brain tumors.

RATIONALE AND OBJECTIVES: The authors sought to compare 1H magnetic resonance spectroscopy (MRS) spectra from extracts of low-grade and high-grade gliomas, especially with respect to the signals of choline-containing compounds. METHODS: Perchloric acid extracts of six high-grade and six low-grade gliomas were analyzed by 1H MRS at 9.4 Tesla. RESULTS: The signals of glycerophosphocholine (GPC) at 3.23 ppm, phosphocholine (PC) at 3.22 ppm, and choline (Cho) at 3.21 ppm were identified in both types of tumors. The absolute concentrations of all Cho-containing compounds (GPC + PC + Cho) in high-grade and low-grade gliomas were significantly different. The relative contributions of each of the Cho-containing compounds to the total choline signal were also statistically different. For high-grade gliomas, the choline signal is composed of GPC, PC, and Cho in a well-balanced contribution, whereas in low-grade gliomas, the signal is largely due to GPC with a small involvement of PC and Cho. CONCLUSIONS: The differences in the concentration and the repartition of Cho-containing compounds seem to be a marker of high-grade gliomas. They could also help to discriminate between high- and low-grade gliomas in some difficult cases, especially if there is histologic uncertainty between anaplastic astrocytomas and low-grade oligodendrogliomas.

Individualized aerobic and high intensity training for asthmatic children in an exercise readaptation program. Is training always helpful for better adaptation to exercise?

In order to define the role of individualized training intensity in a conditioning program for asthmatic children, we have trained seven asthmatics (age = 11.4 +/- 1.8 years) at their ventilatory threshold (VTh) intensity level for a three-month period (aerobic training) and at maximal intensity also for three months (high intensity training). VTh is the point at which a nonlinear increase of VE occurs. Another group of seven asthmatics (age = 11.4 +/- 1.5) served as control subjects. Cardiopulmonary fitness was determined on a cycle ergometer before and after each training session. This study demonstrated that aerobic training, correctly adapted to the child's physical ability, induces the following: (1) a rapid and marked cardiovascular fitness increase; and (2) a decrease in VE over a given work range so that VTh is increased. This is of great importance because hyperventilation is a major determinant of exercise-induced bronchospasm. In contrast, even if high intensity training is well tolerated in an indoor swimming pool, the long-term effects are unsuitable for asthmatic children because the decrease of VTh will involve an increase of hyperventilation, even when exercise is performed at submaximal intensity.

[Effects of individualized aerobic training in the readaptation of the asthmatic child to exercise]. / Effets d'un entraînement individualisé de type aérobie dans la réadaptation à l'effort de l'enfant asthmatique.

There have been few works studying the effects of training in asthmatics and there does not yet exist any study utilising the idea of the individualization of training. This is why the aim of this study was to assess the value of the effects of individualised aerobic training on cardio-respiratory aptitude in the asthmatic child. This study was carried out on two populations of asthmatics, swimmers and non-swimmers matched for age, height, degree of bronchial obstruction during a remission and baseline of physical fitness. Each child in the swimming group was trained to a metabolic level corresponding to the ventilatory threshold. After a period of 3 months a second cardio-respiratory evaluation was carried out. A clear cut improvement (20%) of VO2 max was observed as well as a proportional elevation of the ventilatory threshold in the swimming group. The VE max, the VT max, the VT/Timax, the FC max and the maximal oxygen uptake were also recorded. On the other hand aerobic training seems to be without effect on resting pulmonary function, even if the clinical state of the children improved. In conclusion this study shows that aerobic training closely adapted to the level of each child, obtains an important and rapid gain in cardio-respiratory fitness which leads to a better exercise adaptation. In addition the progression of the ventilatory threshold implies an increased capacity for work without the appearance of hyperventilation. This enables an understanding of how aerobic training is generally accompanied in the asthmatic with a better respiratory comfort and argues in favour of the perfect efficacy of this type of reconditioning in the re-adaptation to effort in these patients.

Placebo-controlled double-blind food challenge in asthma.

To determine the prevalence of food allergy as a cause of exacerbation of asthma, we studied 300 consecutive patients with asthma (7 months to 80 years of age) who attended a respiratory clinic. Each patient was screened for possible food allergy by means of a questionnaire and by skin prick tests with the six food allergens most common in our area. Patients with either a suggestive history and/or a positive prick test and/or RAST underwent double-blind food challenge with lyophilized food in capsules or food mixed in a broth to disguise its taste. Pulmonary function tests and symptoms were followed for 8 hours after each challenge. Of the 300 patients screened, only 25 had either a history or skin prick tests or RAST responses suggestive of food allergy. Twenty patients had interpretable food challenges. In these 20 patients, food challenge caused asthma in six and caused other symptoms (atopic dermatitis and gastrointestinal symptoms) in five. On rechallenge after pretreatment with disodium cromoglycate (300 mg 30 minutes before the food challenge), the asthmatic response was blocked in four of five subjects. The patients with asthma with food allergy were generally young, had a current or past history of atopic dermatitis, and high total serum IgE levels. Our findings confirm that food allergy can elicit asthma, but its incidence is low, even in the population attending a specialty clinic. Food elimination diets should not be prescribed for all patients reporting an adverse reaction to foods or having a positive skin prick test and/or RAST with food allergens. In patients with asthma caused by food allergy, disodium cromoglycate may be used to complement elimination diets.

[Influence of estrogens on histamines liberation by whole blood induced by allergens in vitro]. / Influence des estrogènes sur l'histamino-libération du sang total induite par des allergènes in vitro.

A relapse of bronchial obstruction during women's menstrual cycle in often observed. Incubating blood and rising rates of estrogens produce an increase of histamine-release induced by allergens. As estrogens alter the membranous potentialities of cells, they may increase their sensibility and produce a degranulation.

[Evaluation of the medical and therapeutic theorical cost of bronchial asthma during the first year of its treatment (author's transl)]. / Evaluation du cout théorique médical et thérapeutique d'un asthme bronchique durant la première année de son traitement.

The medical and therapeutic cost of type II allergic asthma, was determined during the first year of its diagnosis and its treatment. The cost ranges from 4 000 up to 10 000 French francs. In every case, the basic treatment represents about three quarters of the total cost; whereas the initial assessment doesn't exceed one fifth. The most changing modules according to the patient and the physician (symptomatic contribution treatment, antibiotherapy, corticotherapy), are as well and by far the cheapest.

[Experimental basis of acupuncture analgesia]. / Bases expérimentales de l'analgésie acupuncturale

The research realised at INSERM, Unité 103, on the acupuncture analgesia in animal has brought to light certain phenomenon concerning physical, histological and physiological facts. The acupuncture point is a point having the least electrical resistance in relation to the surrounding teguments. The analgesia points studied has an even lower resistance than the other points of the same dermatoma. This is not bound to the phenomenon of surface, as it is also found in cadaver after having cleared the skin with alcohol, ether or acetone. The microscopic analysis of certain points in man and in animal has shown specific elements of the acupuncture point, under the form of a thickness of the epiderm, a modification of the collagen fibers of the derma, of the vascular spiral vessels surrounded by a network of a amyelinic fibers of the cholinergic type, with interlaced myelinic fibers. The acupuncture analgesia of the hind limb can be reproduced experimentally in rabbit, in a proportion of 72 percent in 58 rabbits. The algometric method chosen was the pin prick of the skin. This territorial analgesia can be transmitted by the serum on another rabbit.