Pulmonary vascular effects of sildenafil on the development of chronic pulmonary hypertension in the ovine fetus.

We investigated the pulmonary vascular effects of prophylactic use of sildenafil, a specific phosphodiesterase-5 inhibitor, in late-gestation fetal lambs with chronic pulmonary hypertension. Fetal lambs were operated on at 129 +/- 1 days gestation (term = 147 days). Ductus arteriosus (DA) was compressed for 8 days to cause chronic pulmonary hypertension. Fetuses were treated with sildenafil (24 mg/day) or saline. Pulmonary vascular responses to increase in shear stress and in fetal PaO2 were studied at, respectively, day 4 and 6. Percent wall thickness of small pulmonary arteries (%WT) and the right ventricle-to-left ventricle plus septum ratio (RVH) were measured after completion of the study. In the control group, DA compression increased PA pressure (48 +/- 5 to 72 +/- 8 mmHg, P < 0.01) and pulmonary vascular resistance (PVR) (0.62 +/- 0.08 to 1.15 +/- 0.11 mmHg x ml(-1) x min(-1), P < 0.05). Similar increase in PAP was observed in the sildenafil group, but PVR did not change significantly (0.54 +/- 0.06 to 0.64 +/- 0.09 mmHg x ml(-1) x min(-1)). Acute DA compression, after brief decompression, elevated PVR 25% in controls and decreased PVR 35% in the sildenafil group. Increased fetal PaO2 did not change PVR in controls but decreased PVR 60% in the sildenafil group. %WT and RVH were not different between groups. Prophylactic sildenafil treatment prevents the rise in pulmonary vascular tone and altered vasoreactivity caused by DA compression in fetal lambs. These results support the hypothesis that elevated PDE5 activity is involved in the consequences of chronic pulmonary hypertension in the perinatal lung.

[Immunocytochemical analysis of human prolactin receptors using anti-idiotypic antibodies in human breast cancer]. / Analyse immunocytochimique des récepteurs prolactiniques (R-PRL) humains à l'aide d'anticorps antiidiotypes dans les cancers du sein humain.

In this study, we have prepared antiidiotypic antibodies specific of human prolactin receptors (PRL-R) in order to localize these receptors in breast cancer. Antiidiotypic antibodies were prepared using anti-human prolactin (anti-hPRL) sera obtained from New Zealand rabbits. 25 breast cancer were PRL-R positive using radio receptor assay. For immunohistochemistry, the tissues fixed with Nakane and treated by NH4Cl and Saponin to improve staining specificity, were incubated with antiidiotypic antibodies (1/100e). Cytoplasm and membrane of human breast cancer cells were PRL-R positive in 20/25 breast cancer with antiidiotypic antibodies. There was no staining with preimmune serum and immunohistochemical staining elimination by prior absorption with anti-hPRL antibodies.

[Analysis of the results obtained in fertilization in vitro according to the degree and type of teratospermia]. / Analyse des résultats obtenus en fécondation in vitro selon le degré et le type de tératospermie.

The aim of this study was to evaluate the consequences of sperm morphology abnormalities on fertilization capacity. We selected 115 couples who consulted for in vitro fertilization at the Salengro Maternity Ward (Lille, France). Teratospermia was > 40% in all. The mean rate of cleavage was 23% and was significantly lower than in a population which had had in vitro fertilization for a tube indication (63%, p < or = 0.001). In addition, this level was significantly correlated with teratospermia (p < or = 0.05). The ROC method demonstrated that above the threshold of 74% teratospermia, fertilization decreases significantly. We distinguished several types of abnormal morphology and demonstrated a weak correlation between head abnormalities and the rate of cleavage, a stronger correlation between abnormalities of the intermediary piece and rate of cleavage and finally the absence of any correlation between flagella abnormalities and the rate of fertilization. Teratospermia is therefore an important factor in evaluating fertilization capacity. A better selection of normal spermatoids could improve the chance of success in cases of male sterility.

[Importance of the study of the cytology and proteins of the spinal fluid in lumbago]. / Intérêt de l'étude de la cytorachie et de la protéinorachie dans les lombalgies.

In the cerebrospinal fluid (C.S.F.) of hundred patients suffering from lumbago we have studied the existence of cytobiochemical and cytoradiological correlations in order to confirm the demonstration of cytologic and biochemical signs of organicisty or seriousness of this frequent pathology. We have realized cytorachia, that is to say differential cells counts and formulas on C.S.F. samples after cytocentrifugation and staining associated with biochemical determinations. Cytologically 96% of C.S.F. samples had normal count but 67% of them had a disturbed formula often associated with hyperproteinorachia. We have found lymphocytes and histiomonocytes the normal cells of C.S.F. but also neutrophilic, eosinophilic and basophilic polymorphonuclears and above all leptomeningeal cells. A disturbed cytorachia is often related with a pathological radiological picture (68% of cases). A cytologic anomaly with hyperproteinorachia in the same C.S.F. sample seems to be a sign of seriousness and to reveal a resistance to medical treatment. A technical presentation of cytorachia and an attempt of physiopathological explanation of observed cytologic abnormalities are proposed.

[Fulminating cryptococcal meningoencephalitis. An anatomo-clinical case]. / Cryptococcose neuro-méningée foudroyante. Un cas anatomo-clinique.

We report a case of cryptococcal meningoencephalitis in a 52 year-old man. The patient had complained of headache and drowsiness for a few hours before he became comatose with a bilateral sixth cranial nerve palsy. The cerebrospinal fluid contained less than one lymphocyte per cubic millimeter, a low glucose level (0.20 g/l) and numerous Cryptococcus neoformans encapsulated yeasts. A neuropathological study showed that the cortex and midbrain were involved. To our knowledge, such an acute case with death within the first 20 hours has not yet been reported.