[Laparoscopic surgery versus laparotomy. Comparative analysis of stress markers]. / Coelio-chirurgie comparée à la laparotomie. Analyse comparative des marqueurs du stress.

The place of laparoscopic surgery continues to increase in the field of surgery in our specialty. Although the advantages would seem to be obvious, it seemed to us interesting to quantify, if possible, the parameters of operative stress and compare laparoscopic surgery with conventional surgery. Markers studied are Prolactin, Cortisol, Adrenaline, Nor-Adrenaline, Dopamine and the Beta-Endorphins. The only marker that shows any difference in the two procedures in our study is Beta-Endorphin which is significantly less raised in laparoscopic surgery directly after the operation (p less than 0.01). This was very specific for pain, which is one of the benefits of this technique and shown in this parameter which confirms the clinical impression. The curves of the changes in the different markers have been analysed and discussed.

[In vitro fertilization. Analysis of results after the first 2 years' activity]. / Fécondation in vitro. Analyse des résultats sur les deux premières années d'activité.

413 menstrual cycles were monitored in the first two years of the work of the In-Vitro Fertilization Unit in La Pitié-Salpêtrière. On-going pregnancies were achieved from the very first months of activity, with a level which stayed relatively constant in the first year. Technical changes were introduced and in particular a higher recovery rate of oocytes when ultrasound was used and above all when LH-RH analogues were used in the process of stimulation. It is this last point that seems to be the most interesting. In fact, when the results are examined there is a definite rise in the number of on-going pregnancies of which the level went up by 2.3 times as compared with using a classical protocol of Clomithene citrate and HMG. In the 153 cycles when D-Trp6 LH-RH was used, the percentage of on-going pregnancies was 13.7% for each cycle and 20% for embryo implants. Furthermore, it became possible to work out the dates for the patients and this appears to us essential as the numbers of couples attending increase.

Simultaneous evaluation of mRNAs of dopamine ?-hydroxylase, tyrosine hydroxylase and proenkephalin a from three human pheochromocytomas.

Using the rabbit reticulocyte cell-free translation system, the relative proportions of in vitro translatable mRNAs of three proteins in three human pheochromocytomas: tyrosine hydroxylase (TH), dopamine ?-hydroxylase (DBH) and proenkephalin A have been compared. TH expression appeared rather constant in the three tumors. In contrast, those of DBH and proenkephalin A were more variable. Though the actual level of each mRNA was not determined, the identical value of DBH/proenkephalin A mRNAs ratio in the three tumors could suggest a coordination in the expression of these two proteins.

In vitro translation of human pheochromocytoma messenger RNAs: characterization of tyrosine-hydroxylase and dopamine-beta-hydroxylase.

mRNAs extracted from human pheochromocytoma were translated in vitro in a lysate of a rabbit reticulocytes. Two enzymes of the biosynthetic pathway of the catecholamines, tyrosine-hydroxylase (TH) and dopamine-beta-hydroxylase (DBH), were characterized as translation products after immunoprecipitation by specific antisera and electrophoretic analysis. The precursor of TH is a polypeptide having a molecular mass of 62,000 identical to that found for the mature protein. The molecular mass of the precursor of DBH 73,000 while that of the mature form is 79,000. TH and DBH have been translated from mRNAs having sedimentation coefficients of 22S and 25S, respectively.

Simultaneous evaluation of the catecholamine pathway and three opioid peptide-producing systems in human pheochromocytomas.

Tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH) activities, dopamine (DA), noradrenaline (NA), adrenaline (A), met 5-enkephalin (Met-Enk), leu5-enkephalin (Leu-Enk), dynorphin (Dyn) and beta-endorphin (beta-end) were measured simultaneously in ten human pheochromocytomas = 1 - TH activity was highly variable, from 22 to 2220 U/g tissue. 2 - DBH activity, in contrast, was rather constant, from 96 to 582 U/g. 3 - Catecholamines (A and NA) concentrations showed only small variations. 4 - The four opioid peptides were detected in all cases and exhibited a wide range of tissue concentrations (Enk much greater than Dyn greater than beta-end). 5 - Met-Enk and Leu-Enk concentrations were highly correlated; no correlation was observed with the other opioid peptides. 6 - A very strong correlation was observed between enkephalins concentrations and both catecholamines concentrations and DBH activities. These results are discussed in term of the significance of the co-localization of these various biologically active substances, principally with regard to the possible regulation of catecholamine synthesis by opioid peptides and conversely.

[Blockade of renin secretion by epidural anaesthesia (author's transl)]. / Blocage de la sécrétion de rénine par l'anesthésie péridurale.

In order to determine the rule of neurologic stimuli on the renin-angiotensin system, during surgery, plasma renin activity (PRA) was measured in two groups of patients submitted to either general (group I, N = 7) or epidural (group II, N = 5) anaesthesia during total hip replacement. Salt intakes were normal for all patients before the operation and the perfusion rate, of isotonic saline solution was 5 ml/minute during the surgical procedure. A significant rise in PRA was observed after the skin incision in the first group of patients under general anaesthesia. Epidural anaesthesia suppressed the renin response to surgery. The blockade of conduction along nervous pathways afferent from the surgical area and along renal sympathetic pathways explains the effect of epidural anaesthesia. The lack of increase in PRA despite a significant fall in blood pressure after epidural anaesthesia, also suggests an inhibition of the catecholamines secretion.

Circadian and circannual rhythms in plasma hormones and other variables of five healthy young human males.

Every other month (plasma) and every month (urine) circadian rhythms were documented during the course of 14 months. Annual changes were validated in the 24 h mean of: plasma FSH (annual crest time: February), LH (March), thyroxine (September), cortisol (February), renin activity (April), testosterone (October), urinary 17-hydroxycorticosteroids (March), aldosterone (March), potassium (May) as well as sexual activity (September) [self-recorded daily]. Plasma prolactin did not show an annual variation. In addition, annual changes in the circadian acrophase (crest time location in the 24 h scale) occurred for some of the documented variables: plasma thyroxine, cortisol, renin activity, testosterone, urinary aldosterone and potassium.

Radioimmunological determination of urinary tetrahydroaldosterone.

A method is presented for radioimmunological determination of 3alpha, 5beta-tetrahydroaldosterone. It is based upon the reactivity of this steroid with an antiserum induced by the 3-carboxymethyloxime of 18, 21-aldosterone diacetate conjugated with bovine serum albumin. One hundred microliters of urine enzymatically hydrolyzed with an helix pomatia preparation, containing tritiated tetrahydroaldosterone for the yield calculation, were extracted with dichloromethane and chromatographed on a small celite column. The yield after extraction and chromatography was 64 +/- 17%. The radioimmunological determination was carried out in a conventional manner. The method is specific, sensitive (10 pg/tube), exact, reproducible, very simple and extremely rapid. The results showed good agreement with values given by a colorimetric method (p less than 0.001). The median value measured in 45 healthy adult subjects under standard sodium diet was 53.3 microgram/24h (95 % of the population within a 16.6 to 131.1 microgram/24h range). In 78 cases of adrenocortical insufficiency, 60 cases of obesity and 28 cases of hypokalemia, the median values (and the ranges : microgram/24h) were respectively 7.7 (1.0 - 51.0), 80.9 (17.0 - 503.0) and 64.3 (8.0 - 181.0). In 330 hypertensive patients the excretion of tetrahydroaldosterone exceeded the normal range in 115 cases (35%) with a median of 199.7 microgram/24h (131 to 620 microgram/24h).

[5 minutes incubation for the radioimmunologic determination of somatomammotrophic chorionic hormone]. / Une incubation de cinq minutes pour le dosage radio-immunologique de l'hormone chorionique somatomammotrophique

A radioimmunoassay procedure for human chorionic somatomammotrophin in indiluted plasma has been developed in which the incubation lasts only five minutes rather than one half hour to four days in the previously described methods. The values obtained had excellent correlation (p less than or equal to 0,001) with those obtained by a two-hours technique. The intra-assay and inter-assay coefficients of variation are respectively 7 percent and 11 percent. Twenty women at term showed human chorionic somatomammotrophin values of 7.5 +/- 2.5 mug/ml plasma (mean +/- SD).

[Radioimmunoassay of tetrahydroaldosterone in urine]. / Dosage radioimmunologique de la tétrahydroaldostérone dans l'urine

A radioimmunoassay for urinary tetrahydroaldosterone is described. An antiserum, elicited by a 3-carboxy-methyloxime 18-21 aldosterone diacetate conjugated to bovine serumalbumine, with which tetrahydroaldosterone cross reacts, is used. The method is specific, sensitive (10 pg/tube), accurate, reproducible (7%), thus allowing sufficient reliability for clinical applications. In 19 normal adults subjects under unrestricted sodium intake, the urinary tetrahydroaldosterone averaged 59,8+/-29,4 mug/24 h.