[A medical reading of Nerval's Aurelia]. / Lecture médicale d'Aurélia de Gérard de Nerval.

The single literary study of Aur6lia of Gerard de Nerval-eliminates the author's mental illness expression. We set a clinical analysis that brings to the fore some unrecognized aspects of the work.

[The unexplained death of Blandine Liszt Ollivier]. / La mort inexpliquée de Blandine Liszt Ollivier.

Franz Liszt's eldest daughter, Blandine Ollivier, died at the age of 26, two months after the birth of her son Daniel. The reasons of that death remain obscure. There are contradictions between the asserted good health of Blandine during her pregnancy and what was learnt later on through the publication in French of Richard Wagner's autobiography. He was the husband of Cosima who was herself Blandine's sister. We put forward some hypotheses that can be discussed; Blandine would have contracted a serious anemia of pregnancy, unknown, with a streptococcus septicemia in post partum; no sign or symptom in consideration of mastitis carcinosis.

Cardiovascular actions of the stress-related neurohormonal peptides, corticotropin-releasing factor and urotensin-I in the trout Oncorhynchus mykiss.

In this review, we summarize the most significant data concerning the cardiovascular effects of centrally and peripherally administered synthetic trout corticotropin-releasing factor (CRF) and urotensin-I (U-I) in our animal model, the unanesthetized trout Oncorhynchus mykiss. Although there is more than 60% sequence identity between these two stress-related neurohormonal peptides, CRF and U-I-induced differential actions upon the mean dorsal aortic blood pressure (Pda) and the heart rate (HR) in trout maintained under similar experimental situations. After intracerebroventricular injections, only U-I induced an increase in Pda while in non-cannulated trout, CRF only decreased the HR and elevated the heart rate variability by a presumed activation of the parasympathetic nervous system activity to the heart. The CRF antagonist, the alpha-helical CRF(9-41) blocked these central actions of CRF. After intra-arterial (IA) injections, U-I induced a direct hypotensive action and an elevation in HR. This hypotensive phase was reversed to hypertension by the release of catecholamines. IA injection of CRF caused no change in Pda or HR. These cardiovascular effects are compared with the much better established actions of CRF and the orthologous urocortins in mammals.

Sleep of preterm neonates under developmental care or regular environmental conditions.

UNLABELLED: Sleep is the main behavioral state of the premature infant. In adult intensive care units, sleep deprivation has been reported as one of the major stressors. Developmental care (DC) aims to decrease stressful events in neonatal intensive care unit and support well-being. AIM: To assess whether DC is accompanied by changes in sleep in preterm neonates. METHODS: A prospective cross-over study included 33 preterm neonates [mean (S.D.): gestational age: 29.3 (1.8) weeks; birth weight: 1245 (336) g]. Polysomnography was performed in two randomly ordered 3-h periods with and without DC. A blinded electrophysiologist analyzed sleep. The total sleep time (TST) was the primary outcome, duration of active (AS), quiet (QS) and indeterminate sleep, and latency before sleep were the secondary outcomes. Non-parametric Wilcoxon tests and ANOVA were used. RESULTS: In DC condition vs. control: TST increased [in minutes, mean (S.E.M.): 156.2 (2.9) vs. 139.2 (4.6), p=0.002], with increase in AS [86.6 (3.7) vs. 77.0 (4.2), p=0.024] and in QS [47.1 (4.1) vs. 36.9 (4.2), p=0.015], and sleeping latency decreased (2.1 (0.7) vs. 10.5 (2.0), p=0.0005]. CONCLUSION: DC promoted sleep in our study. The impact of DC on the neuro-behavioral outcome needs futures studies.

Central effects of native urotensin II on motor activity, ventilatory movements, and heart rate in the trout Oncorhynchus mykiss.

Urotensin II (UII) has been originally isolated from fish urophysis. However, in fish as in mammals, UII is also produced in brain neurons. Although UII binding sites are widely distributed in the fish central nervous system (CNS), little is known regarding its central activities. In the present study, we have investigated the effects of intracerebroventricular (ICV) administration of synthetic trout UII on the duration of motor activity (ACT; evidenced by bursts of activity on the trace of the ventilatory signal), ventilatory frequency (VF), ventilatory amplitude (VA), and heart rate (HR) in unanesthesized trout, Oncorhynchus mykiss. ICV injection of very low doses of UII (1 and 5 pmol) produced a dose-dependent increase of ACT without affecting VF, VA, or HR. At a higher dose (50 pmol), UII stimulated ACT as well as VF, VA, and HR. ICV injection of trout angiotensin II (5 pmol) did not affect ACT, VF, and VA, but provoked a robust increase in HR. These data provide the first evidence that central administration of UII stimulates motor activity in a nonmammalian vertebrate.

Captopril blocks the cardiac actions of centrally administered angiotensin I in the trout Oncorhynchus mykiss.

The present study was performed in order to gain new insights into the existence of a brain renin-angiotensin system (RAS) in teleost fish. For this purpose, we investigated the effects of centrally administered angiotensin (ANG) I ([Asn(1),Val(5),Asn(9)]ANG I) and ANG II ([Asn(1),Val(5)]ANG II) on heart rate (HR) and heart rate variability (HRV) in the unanesthetized trout. The animals were studied before and after treatment with captopril, an angiotensin-converting enzyme (ACE) inhibitor. Trout were equipped with two subcutaneous electrocardiographic electrodes and with an intracerebroventricular (i.c.v.) cannula inserted within the third ventricle of the brain. The i.c.v. injection of vehicle had no effect on the recorded parameters. The i.c.v. injections of ANG I and ANG II at doses of 5 and 50 pmol had a marked effect on HR and HRV. At a dose of 50 pmol, ANG I and ANG II produced a progressive and significant increase in HR (+36% and+45%, respectively) but elicited a profound decrease in HRV (-88% and-92%, respectively). I.c.v. injection of captopril (10 microg) had no effect on HR or HRV. However, this ACE inhibitor prevented the tachycardia and abolished the decrease in HRV mediated by 50 pmol of ANG I. In contrast, captopril had no effect upon the cardiac actions of 50 pmol of ANG II. These results give the first support for the existence of functional important ACE-like activity in the brain of a teleost fish and suggest that the brain RAS in this class of vertebrate may be involved in the control of cardiac chronotropic activity.

Induction of bradycardia in trout by centrally administered corticotropin-releasing-hormone (CRH).

The cardiovascular effects of centrally and peripherally administered synthetic salmon corticotropin-releasing-hormone (CRH), a member of a family of stress-related neuropeptides, were investigated in the unanesthetized trout, Oncorhynchus mykiss. In group 1, trout bearing a cannula in the dorsal aorta, neither intracerebroventricular (i.c.v.) nor intra-arterial (i.a.) injections of CRH produced any significant change in mean heart rate (HR) and mean dorsal aortic blood pressure. These results stand in contrast to the previously reported hypertensive effects of i.a. and i.c.v. injections of trout urotensin-I. In group 2, non-cannulated trout bearing two subcutaneous electrocardiographic electrodes, conditions that are considered to be less stressful to the animals, the baseline level of HR was significantly reduced compared to the corresponding value for cannulated trout. In these trout, no significant change occurred in the HR after i.c.v. administration of 1 pmol of CRH. However, i.c.v. injection of 5 pmol of CRH caused a 12% (P<0.01) decrease in HR during the 20-25 min post-injection period. In addition, the heart rate variability (HRV), a marker of vagal input to the heart, was increased by 120%. The CRH antagonist, CRH-(9-41)-peptide alone had no effect on HR or HRV but blocked CRH-induced bradycardia. In the non-cannulated trout, i.c.v. injection of trout urotensin-I (5 pmol) produced no significant change in HR and HRV. In contrast, i.c.v. administration of angiotensin II (5 pmol) elicited a highly significant 33% (P<0.001) increase in the mean HR as well as inducing a marked (64%) reduction in HRV. Our results suggest that picomolar doses of CRH act centrally to evoke a bradycardia by a probable mechanism that involves enhancement of the parasympathetic drive to the heart.

[Centenary of Victor Segalen's thesis]. / Centenaire de la thèse de Victor Segalen.

Victor Segalen has attended his thesis of doctorate of medicine on January the 29th, 1902, L'Observation médicale chez les écrivans naturalists, known by the title Les Cliniciens ès-lettres. In this thesis we analyse the medical observation of the death of Jules de Goncourt, according to Goncourt's Journal.

A case of cutaneous sensory neuropathy associated with Churg-Strauss syndrome.

Cutaneous sensory neuropathy manifests as multiple, sharply demarcated areas of hypoesthesia with a variable degree of pain. This rare neuropathy is caused by a multifocal infection or inflammation of the small sensory nerves of the skin. We report a case in a patient with febrile arthritis and eosinophilia. Her chronic cough and the presence of extravascular infiltrates of eosinophils in a neuromuscular biopsy specimen suggested Churg-Strauss syndrome. The course was favorable under corticosteroid therapy.

Heart rate variability, a target for the effects of angiotensin II in the brain of the trout Oncorhynchus mykiss.

This study was conducted on unanesthetized rainbow trout equipped with two ECG electrodes and with an intracerebroventricular (i.c.v.) micro-guide. The ECG signal was recorded during three experimental sessions of 30 min and the heart rate variability (HRV) spectral analysis was performed during stabilized periods of recording. The first recording session was conducted during the control period and the mean heart rate (HR) of the trout was 44+/-2 bpm. The total power spectral density (PSD) of the R-R interval signal of the ECG was 21233+/-4400 ms(2)/Hz. A major high frequency (HF) spectral band centered at 0.16 Hz and a minor low frequency (LF) spectral band centered at 0.04 Hz were the two main components of the PSD. An i.c.v. injection of 0.5 microl of vehicle during the second session had no significant statistical effect, either on the mean HR (43+/-2 bpm), the total PSD (24693+/-6394 ms(2)/Hz) or on the center frequency and power of the two main spectral bands. Conversely, an i.c.v. injection of ANGII (1.5, 6.25 and 50 pmol) during the third recording session induced a significant increase in the mean HR (+3%, +15%, +30%, respectively) but the effect of the peptide was more obvious on the total PSD which was profoundly decreased (-27%, -65%, -76%, respectively). The two main spectral bands of the PSD were totally blunted after the injection of 50 pmol of ANGII. In another group of control trout, intraperitoneal (i.p.) injection of atropine abolished the PSD of the R-R interval signal of the ECG demonstrating that the parasympathetic system is the main contributor of HRV in trout. Our results have thus demonstrated for the first time, at least in a non-mammalian species, that i.c.v. injection of native ANGII profoundly reduces HRV. We hypothesize that ANGII in the brain of the trout alters the pattern of the electrical activity along preganglionic cardiac vagal motoneurons.