Conséquences de la chimiothérapie anticancéreuse sur la fertilité de la femme

Sterility is a potential toxic effect of chemotherapy. This risk is well established for alkylating agents, but is less clearly defined for anthracyclines, methotrexate and fluorouracil and poorly defined for alkaloids, platinum, etoposide and taxanes. The main predictive factors for ovarian toxicity are the additive effect of cytotoxic drugs, the cumulative dose of each drug and the patient’s age. This effect of chemotherapy is evaluated on menstrual cycles, hormonal assays and the number of pregnancies observed in patient cohorts. Chemotherapy induces destruction of oocytes and granulosa cells. In mice, it has been shown that adriamycin may induce oocyte apoptosis, which can be prevented by modulation of cycle cell signalling (dysregulation of Bax gene or, on the contrary, expression of its antagonist gene Bcl-2 or inhibition of apoptosis with sphingosine-1-phosphate or caspase inhibitors). Clinical data in the literature are usually based on retrospective studies and are somewhat confused: global fertility after MOPP chemotherapy for Hodgkin’s disease is about 20%, adjuvant chemotherapy with CMF, F(A)C or TAC for breast cancer induces amenorrhea in 50% to 70% of cases, PVB or BEP chemotherapy for ovarian germ cell tumors has little effect on fertility when the uterus and one ovary can be preserved, and the majority of women treated with methotrexate, actinomycin D or various combinations for persistent trophoblastic disease remain fertile. Preservation of fertility is a major goal for cancer patients receiving chemotherapy: in vitro fertilization could preserve the couple’s fertility, but is usually not feasible as it would delay initiation of chemotherapy until after stimulation of ovulation; oocyte or ovarian tissue cryopreservation is at the stage of research; oral contraceptives have not been demonstrated to be effective to preserve ovarian function; gonadotropin releasing hormone (GnRH) agonists prevent cyclophosphamide toxicity in rat and monkey ovaries, and a few pilot clinical studies suggest that chemotherapy-induced amenorrhea could be prevented by administration of GnRH analogues simultaneously to chemotherapy, but randomised studies are necessary.     

Sur la spécificité deVagoiavirus melolonthae

Summary The activity ofVagoiavirus melolonthae towards 16 species ofScarabaeidae, 3 Coleoptera, 3 Lepidoptera and 2 Diptera was studied by injection into the hemocoel and contamination of the substratum or of the rearing host plant. Only insects belonging to 3 sub-families ofScarabaeidae: Hopliinae, Melolonthinae, Rutelinae, are susceptible to the disease.      

Efficacité de la mémoire associative inhérente à la potentiation post-tétanique

An associative memory is modeled in networks of cells that are assumed to have the short-term plasticity of the neuromuscular junction of the frog. The data relating synaptic transmission efficiency and stimulation frequency for post-tetanic potentiation of the neuromuscular junction are represented by polynomial expansions. Simulation of storage and retrieval demonstrates that functional associative memory is feasible based on this particular synaptic plasticity. Retrieval reaches a maximum efficiency at a delay of three minutes after storage and is lost after about 9 min. The signal to noise ratio of the retrieved pattern drops steadily as additional associations are stored in memory but retrieval appears to be possible with up to four stored associations. Although the data are derived from synapses not normally proposed as a basis for memory functions, the results here will generalize to other synaptic junctions located more centrally that have similar characteristics. This simulation technique allows the efficiency of associative memory based on various types of synaptic plasticity to be evaluated.     

Étude cinétique de l'hypersensibilité de type retardé dans la candidose expérimentale de la souris

Mice were inoculated with different quantities of blastospores ofCandida albicans by subcutaneous or intravenous ways. Delayed hypersensitivity was then studied during the course of infection by means of the inhibition of macrophage spreading test. In the same time retrocultures were done from kidney material, target organs in the experimental candidiasis. The results obtained in this way enabled the authors to think that cellular immunity plays a role in this experimental model as described by Mackaness.

Travail de l'Unité 42 de l'INSERM et du Groupe de Mycologie Fondamentale et Appliquée de LILLE.     

Étude de la variabilité de la clairance hépatique de la mébrofénine-99mTc en scintigraphie hépatobiliaire

AimThe purpose of this study was to investigate some of the parameters likely to influence mebrofenin-^99mTc hepatic clearance calculation and inter-and intra-observers reproducibility.Materials and methodsHepatic clearance (%/min m²) of 30 scintigraphies was calculated from the values of hepatic, cardiac, and total activities, according to the method recommended in the literature. We studied: 1) impact of injection–acquisition delay variations; 2) acquisition type: anterior face only (FA) or geometric mean (GM); 3) clearances calculated according to four different body surface area (BSA) formulas; 4) intra-and inter-observers reproducibility for three observers (two evaluations for each observer).Results1) Clearance differences between different studied intervals were statistically significant, more important if the studied interval was far from reference interval (150–350 secondes) and even more when the interval studied was too early (110–310 secondes). 2) There was a statistically significant difference between clearance calculated using either FA or GM datasets (0.85 %/min m²). 3) There were small but statistically significant differences for four of the clearance comparisons using different BSA formulas. 4) Despite differences in size of cardiac and hepatic regions of interest (ROI), intra-observer reproducibility of hepatic clearance was excellent for each observer. Inter-observers reproducibility was also excellent (r = 0.982).ConclusionHepatic clearance of mebrofenin-^99mTc appears to be a highly reproducible method provided that acquisition and clearance calculation are standardized. It provides additionnal functional information to morphological and biological data usually performed before major hepatectomy. Thereby, the definition of a standardized protocol would enable realization of multicentric studies.     

Le vécu de la sexualité chez les paraplégiques

In spinal cord injury, sexual reactions have a common dimension with ablebodied mankind, but also particular features corresponding to particular neurological syndromes. The third dimension which has to be taken into account is the singular one, every man, paraplegic or able-bodied, being unique. When the level of the lesion is above T10, genito-sexual responses to stimulations have a reflex functioning. In such cases, erotic tricks must be used to complete psycho-physiological reactions. On the contrary, technical devices are ill-tolerated both by the paraplegic man and by his spouse. Incomplete lesions in T12-L1 have to psychogenic responses to stimulations, i.e. partial erection and/or semen emission due to the neurophysiological mecanisms of desire. In the complete lesions of the conus medullaris or of the cauda equina, men become impotent and can no longer produce semen. In such cases, technical devices and drugs directly injected in the corpus cavernosum are technically efficacious but psychologically ill-tolerated. Facing his new sexual responses, the paraplegic man and his spouse have to adjuste themselves to the new circumstances. The way of adjustment is similar to a mourning process. One has to pay attention to let every paraplegic live every period of adjustment on his own, and at the same time one must be present to help him and answer his questioning.     

Évaluation de la faisabilité de la tomoscintigraphie myocardique précoce au sestamibi synchronisée à l’électrocardiogramme

BackgroundOur aim was to assess the feasibility of early acquisition (10 min) gated single photon emission computed tomography (SPECT) by comparison to conventional imaging at one hour.Methods and resultsOne hundred and four patients referred for exercise test and SPECT were included. Sequential imaging was started 10 min (SPECT 10) and 60 min (SPECT 60) after injection of the radiotracer (Tc-99m sestamibi). Stress myocardial perfusion was visually analyzed from 10 to 60 min stress by two experienced nuclear-cardiologists. Six patients were further excluded, because of high digestive accumulation: one patient at 10 min, three at 10 and 60 min, two at rest. The participants were classified as follows: group G1 (normal SPECT 10 and 60, n = 53), group G2 (abnormal SPECT 10 and/or SPECT 60, n = 45). The left ventricle ejection fraction (EF) and volumes (end-systolic and end-diastolic volumes, ESV, EDV) were calculated with the Cedars-Sinai program.ResultsQuality imaging was the same at SPECT 10 min and SPECT 60 min. Perfusion scores: G1 10 min = 0,4 versus G1 60 min = 0,4 (p = NS); G2 10 min = 10,2 versus G2 60 min = 10,1 (p = NS); EFG1 10 min = 71 ± 11% versus EFG1 60 min = 68 ± 10% (p = 4E-04); EFG2 10 min = 56 ± 15% versus EFG2 60 min = 53 ± 15% (p = 0,002); EDV G1 10 min = 72 ± 20 ml versus EDV G1 60 min = 76 ± 19 (p = 0,002); EDV G2 10 min = 98 ± 46 ml versus EDV G2 60 min = 105 ± 38 (p = 0,08); ESVG1 10 min = 22 ± 12 m versus ESV G1 60 min = 25 ± 12 (p = 9E-04); ESVG2 10 min = 47 ± 35 ml versus ESV G2 60 min = 53 ± 36 (p = 3E-04).ConclusionsThis study suggests that early gated Sestamibi SPECT after stress provides same perfusion analysis than classical late imaging.     

Polyéthisme et défense de la société chez la fourmi champignonnisteAtta laevigata (Fr. Smith)

Résumé L'étude du comportement de défense du nid chezAtta laevigata permet de classer les 4 castes physiques d'individus stériles étudiés en deux groupes. Le premier groupe, constitué par les ouvrièresminor etmedia, rassemble des individus pouvant reconnaître avec précision des intrus de même espèce. Menacés et mordus, ces derniers sont alors mutilés ou transportés puis abandonnés par les fourmis résidentes aux frontières de leur territoire. Les ouvrièresmajor et les soldats, formant le second groupe, nécessitent quant à eux le marquage de l'ennemi par la phéromone d'alarme de leurs congénères pour pouvoir prendre part aux affrontements intraspécifiques avec efficacité. Les soldats se montrent en revanche très performants dans la défense du nid contre des envahisseurs appartenant à d'autres espèces, développant dans ce cas une agressivité supérieure à celle observée chez les ouvrières. L'âge de ces dernières ou le type de tâche qu'elles assument ne semble pas influencer leur comportement agonistique qui est comparable dans les deux castes temporelles de récolteuses et d'architectes.

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Polyethism and nest-defense in the leaf-cutting ant Atta laevigata (Fr. Smith)

Summary The study of the nest-defense behavior inAtta laevigata makes out the four physical castes of sterile individuals studied in two groups.Minor andmedia workers (first group) are able to recognize precisely the intruders of the same species that they threat, bite and mutilate or carry outside the territorial limits of the nest. As formajor workers and soldiers (second group), they need their ennemy to be impregnated by the alarm pheromone of their nestmates before they can take part with efficiency in the intraspecific fights. Soldiers though appear to be quite performent in the nest-defense against invaders from other species, showing in this case an aggressiveness superior to the one observed amongst workers. Age, for these, or the sort of work they assume don't seem to interfere with the agonsitic behavior that can be observed in both architects and foragers temporal castes.

     

Observations sur la spécificité de la coloration aux acides phosphotungstique et phosphomolybdique

Résumé Les Auteurs ont démontré que, en conditions histochimiques sur du matériel fixé au formol, les acides phosphotungstique et phosphomolybdique ont une double action: 1. une action oxydative à la charge des radicaux PAS-positifs (vic-glycols et éthyleniques) en milieu aqueux, et à la charge des radicaux aminiques en milieu anhydre; cette action entraine la transformation de ces radicaux en aldéhydes; 2. la formation d'une liaison chimique entre les aldéhydes et les molécules des acides phosphomolybdique et phosphotungstique. — La coloration du collagène, au contraire, n'est pas due ni aux radicaux aminiques ni vic-glycols et implique un mécanisme encore inconnu.

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Observations about the specificity of staining of phosphotungstic and phosphomolybdic acid

Summary The authors demonstrated that phosphotungstic and phosphomolybdic acid applied to formol-fixed tissues explete two following actions: 1. An oxidative action on the PAS-positive radicals (double bonds, vic-glycols groups) if in water solution and on aminogroups if in anhydrous solution. This oxidation results in a production of aldehydic radicals 2. The formation of chemical bonds between the aldehydic new-formed groups and the molecules of phosphotungstic or phosphomolybdicacid.— However, the above mentioned mechanism of action is not applicable to the collagen staining for which a different explanation has to be supposed.

     

Efficacité comparée de l'antibioprophylaxie par la céfoxitine en une ou trois doses dans la césarienne.

To compare the effectiveness of three doses and of a single dose of cefoxitin, a second-generation cephalosporin, in preventing infection after nonelective cesarean section, we carried out a prospective study in 255 women who underwent the procedure between March 1983 and February 1985. The rate of postoperative infection was 7% in the group that received three doses and 8% in the one-dose group. The sensitivity and specificity of perioperative cultures were low. The rate of asymptomatic bacteriuria was high, at 20%, but few symptomatic urinary tract infections were found. Routine antibiotic prophylaxis with a single dose is suggested for all nonelective cesarean sections.     

Dégénérescence des cellules visuelles photoréceptrices et persistance d'une sensibilité de la rétine a la stimulation photique

Résumé Chez les souris du Basler Laboratoriumsstamm, atteintes d'une lésion dégénérative héréditaire du neuro-épithélium rétinien, les cellules visuelles se différencient de façon normale au cours de la première semaine post-natale. Les premiers signes de condensation et puis de pycnose nucléaires apparaissent au niveau de la granuleuse externe au moment même où s'ébauche la différenciation de l'article externe des bâtonnets. L'immense majorité des cellules visuelles disparaît au cours des deuxième et troisième semaines de la vie. Quelques rares cellules visuelles survivent pourtant jusqu'aux stades les plus avancés de l'affection dégénérative, et ces cellules conservent des bourgeons cytoplasmiques dont la structure rappelle celle des articles internes des bâtonnets.Parallèlement avec la disparition progressive des cellules visuelles, on observe la prolifération à partir de la région apicale de l'épithéliuni pigmentaire, d'un système lamellaire organisé qui entre en contact étroit avec les cellules visuelles subsistantes, et plus précisément avec ce qui reste de leurs articles internes.Une hypothèse est formulée, selon laquelle ce système lamellaire organisé pourrait être porteur d'un pigment photolabile et pourrait ainsi suppléer à l'absence des articles externes des bâtonnets. Le processus initial de l'excitation visuelle prendrait naissance au niveau de ce système membranaire organisé, l'état d'excitation se propageant ensuite à la membrane plasmique des restes d'articles internes.