Stratégie d’étude des anticorps anti-nucléaires

Le terme d’anticorps anti-nucléaires (ANA), consacré par l’usage, est trop restrictif puisque certains de ces anticorps reconnaissent des antigènes cytoplasmiques. Un très grand nombre d’ANA a été identifié au cours des 30 dernières années. Seul un nombre restreint de ceux-ci est spécifiquement associé à des maladies précises, connues sous le vocable de connectivites. Toutefois, des ANA peuvent assui être rencontrés dans d’autres affections, un syndrome infectieux ou inflammatoire, une néoplasie, une maladie spécifique d’organe, en particulier les maladies du foie comme l’hépatite auto-immune et certaines cholangiopathies. Enfin, il ne faut pas oublier l’apparition d’ANA survenant lors de la prise de certains médicaments. La spécificité de ces anticorps est tout à fait différente de celle que l’on observe dans les connectivites.     

L’automatisation des sérologies auto-immunes

Pendant longtemps les analyses d’auto-immunité ont été réalisées de fa?on manuelle, en utilisant des techniques parfois artisanales. Plusieurs facteurs conduisent aujourd’hui les laboratoires à automatiser ces examens.     

Physiopathologie des troubles de l’érection chez l’homme paraplégique

Peripheral mechanisms responsible for penile erection are dependant upon a complex control by the nervous system, including peripheral nervous pathways, spinally mediated reflex loops and supraspinal nervous structures. Spinal cord injury is accompanied by a partial or a complete modification of these controls. In relation to the reflexogenic or psychogenic origin of penile erection, spinal cord injury does not cause the same effects. Reflexogenic erections sitll occur after spinal cord injury at a suprasacral level. After lesions at a level lower than the thoracolumbar spinal cord, tumescence following psychogenic stimulation has been observed. The hypotheses resulting from clinical and experimental observations and explaining the differences at the origin of these response are detailed. The recent developments in the neurophysiology of penile erection and the role of neurotransmitters allow a more analytical approach of the phenomenous and also bring new insights into possible compensatory pathways following spinal cord injury.     

Régulation des fonctions de l’épithélium épididymaire des mammifères: état des lieux

Male gametes formed in the testis, the site of spermatogenesis, continue their maturation outside of the gonad in the genital tract. The epididymis is at the centre of this process of post-testicular maturation of spermatozoa, responsible for acquisition of their mobility and their ability to recognize and penetrate an oocyte, essential events for fertilization. During their transit in the epididymal ducts, gametes evolve in a perpetually changing luminal environment due to complex interactions of secretion and reabsorption activities of the epididymal epithelium. These numerous secretion and reabsorption activities are closely regulated in space and time, which makes this epididymal epithelium a very complex tissue subject to an elaborate network of cross-regulations. Apart from classical endocrine and paracrine regulations, the proximal part of the epididymis is also subject to lumicrine regulation by testicular factors which increase the complexity of the regulation networks involved. The present study tries to present an exhaustive review of the factors demonstrated in the literature to exert a modulation of epididymal activity.     

L’échographie doppler dans la prévention des amputations des membres inférieurs du diabétique en Côte d’Ivoire

ObjectiveThe aim of this study was to demonstrate the role of the Doppler ultrasound examination in the management of diabetic feet and particularly in the prevention of the diabetic's amputation.Patients and methodIt is about a retrospective study carried out over a 4-year period at Yopougon University Hospital (Abidjan, Côte d’Ivoire). It consisted in the analysis of the records of 78 patients hospitalized for diabetic foot and in whom was performed a Doppler ultrasound examination of the lower limbs vessels. The analysis of patients’ records helped to bring out the epidemiological, clinical, radiographic, biologic, therapeutic and evolutional elements.ResultsPatients’ mean age was 57.6 years. The sex ratio was 1.05. Adult diabetes accounted for 93.5% of cases and had been developing for 11.49 years on average. On the Doppler ultrasound scan of the lower limbs arterial anomalies of these limbs were found in 70 cases. They were associated with a venous anomaly in four cases. Arterial anomalies were represented by stenosis (34 cases), occlusions (10 cases), medialarterosclerosis (four cases), small arteries (six cases) and the associations of several elementary lesions (nine cases). In three cases, the arterial abnormality was not indicated. A medical treatment was instituted for all the patients. The outcome was favorable for 61 patients, 13 were amputated and four deaths were recorded.ConclusionColor Doppler ultrasound examination of lower limbs vessels helped to bring out a vascular anomaly in 89.7% of patients with diabetic foot whose treatment helped to keep the lower limb in 78.2%. We recommend the systematic request of this examination in the African diabetic with adult diabetes which has been developing for more than 10 years before the onset of diabetic foot.     

Contribution à l’étude des groupements Végétaux du vercors méridional: Les groupements fontinaux et des bas-marais de l’étage subalpin

Conclusions L’important mémoire deJ. Braun-Blanquet (1971) sur les Associations des basmarais suisses ainsi que d’autres travaux (E. Oberdorfer, 1970;H. Ellenberg, 1963), permettent d’affirmer que les groupements de l’Eriophorion latifoliae (Br.-Bl. et Tx. 43) et des Caricetalia Davallianae (Br.-Bl. 49) sont représentés dans l’ensemble de la cha?ne alpine sur substrat riche en calcium et, en général, à partir de l’étage montagnard supérieur. Dans les Alpes et Préalpes fran?aises, plusieurs auteurs ont décrit des groupements du Caricion Davallianae (M. Guinochet en Tinée et en Haute-Savoie, 1938 et 1939;G. Aubert, L. Borel, A. Lavagne etP. Moutte dans l’étage subalpin de la feuille d’Embrun-Est, 1965). Dans le Vercors, seuleCh. Faure (1968) signale simplement l’existence du Caricion Davallianae (Klika 34) dans la partie septentrionale du massif (feuille de Vif). Enfin, dans les Préalpes du sud où les étages montagnard et, a fortiori, subalpin sont peu ou pas représentés.A. Archiloque, L. Borel etA. Lavagne (1970) constatent l’absence du Cratoneurion commutati (W. Koch. 28) et du Caricion Davallianae (Klika 34) sur la feuille de Javie (préalpes de Digne). Bien que la nature de la roche-mère soit déterminante pour l’existence des groupements de source et bas-marais alcalins, c’est en définitive la relative permanence de l’alimentation en eau courante et fra?che qui représente le facteur décisif pour ces associations. Dans la région étudiée, celles-ci sont à leur limite méridionale, ce qui confirme—s'il en était besoin—l’originalité et la richesse de ce secteur des Préalpes. Laboratoire de Taxonomie Expérimentale et de Phytosociologie de la Faculté des Sciences de BESAN?ON (25)—FRANCE.     

évaluation des pratiques professionnelles dans le cadre de l’accréditation des établissements psychiatriques

As regards evaluation of professionnal practices (EPP), Formep’s has decided to stay in the limits of psychiatric institutions, for reason of experience. Every medical doctor working in these institutions is concerned by evaluation, but also institutions in the specific framework of V2 44, 45 and 46 references. The EPP is multidisciplinary and involves everybody who takes part of patient caring. Formep’s is adviser, training agent, and partner. Follow-up takes place both on-site and off-site all along the EPP, by a team including psychiatrists, medical practitioners, quality and risk management engineers. They are all experienced to work in psychiatric institutions. Formep’s program includes preliminary and definitive choice of themes, putting methology is place, work of teams, initial analysis of results and deviations, further work of teams, final analysis, which purpose is to improve practices and therefore medical benefit.     

De l’origine des anthropoïdes à l’émergence de la famille humaine

The human lineage has a very ancient origin, as most of the mammals. Its oldest representatives, anthropoid primates, have been described from Asia some 45 million years ago. During this long evolutionary story, two critical stages have appeared as especially important, their beginning in Asia and the emergence of hominids in Africa, some seven million years ago. These two stages are discussed hereby with new data relative to their Asian origins and their dispersal into Africa between 45 and 40 million years ago. Following this dispersal event, these primates evolved in Africa and gave rise to the early hominids. These appeared around seven million years ago and have three distinct representatives. Among them, Toumaï appears as the oldest and the closest to our ancestry, a point that is evidenced here.     

L’évolution des premiers arbres : les stratégies dévoniennes

The earliest axes exceeding 10 cm in diameter, and presumed to represent small trees, evolved in the Middle Devonian (about 395 million years). They belong to the Cladoxylopsida, a basal group of ferns s.l. lacking leaves. These trees grow mainly vertically, the trunk producing short-lived branches at the top and adventitious roots at the base. They show a dissected vascularisation, and little if any secondary tissues. The Archaeopteridales that evolved at the end of the Middle Devonian, have leaves, abundant wood, and secondary phloem. Growth in the aerial and subterranean parts is tri-dimensional and extensive. Contrary to these two strategies that evolved several times independently during the history of terrestrial plants, that exhibited by the lycophytes became extinct at the end of the Mesozoic. These trees are characterized by a symmetrical development of the aerial and underground parts that branch dichotomously. Branch production by the trunk is relatively late. These trees show a narrow vascular system and a wide cortex.     

Etiologie des infertilités secondaires de l’homme

Introduction

Secondary infertility is defined as the inability to achieve a new pregnancy for a couple that has been able to procreate in the past.

Material and methods

Over a 16-year period, 49 patients consulted for male secondary infertility. Clinical, laboratory or ultrasound assessment demonstrated the cause of infertility.

Results

These patients had a mean age of 33.6 years (range: 26 to 44 years). These couples had an average of 1 living child per family, corresponding to a girl in two-thirds of cases and a boy in one-third. In these patients, infertility was due to the presence of varicocele in 15 patients (31% of cases), infection in 14 patients (29%), and varicocele associated with infection in 11 cases (22%).

Conclusion

This assessment revealed two main aetiologies, but some causes remain obvious, such as surgery with resection of the prostate or testicles, or certain cytotoxic therapies.     

Criblage de nouveaux gènes cibles des récepteurs nucléairesdes oxystérols LXRs impliqués dans le maintien de l’épithélium épididymaire et la maturation des spermatozoïdes dans l’épididyme

Liver X receptors (LXRs) are involved in cholesterol homeostasis and lipid metabolism.Ixr knock-out mice for the two isoformsIxra andIxrb exhibit severe disruption of the structure of caput epididymidis segment 1 and 2 epithelium and increased sperm fragility. These defects generate infertility in 10-month-old male mice. The role of LXRs in the epididymis have not yet been investigated. A cell line obtained from mouse caput epididymidis (B2 cells) was used to screen for LXR epididymal target genesin vitro. The presence of one isoform of LXR (LXRα) was detected by immunocytochemistry and the capacity of B2 cells to respond to a synthetic agonist of LXRs (T0901317) was verified. These results validated the use of B2 cells as a model. Bidimensional electrophoresis was performed on B2 cells treated with T0901317. Eight proteins up-regulated by LXRs were isolated. Only one protein has been identified: polyubiquitin, which has already been reported to be involved in cellular cholesterol homeostasis.     

L’insémination intrautérine dans l’éjaculation rétrograde. Importance du pH et de l’osmolarité sur la mobilité des spermatozoïdes

The effect of pH and osmolarity on motility of human spermatozoa in retrograde ejaculation was studied in a freshly voided urine specimen. The maximum rate of motility is obtained when the pH ranged from 7.0 to 7.5 and osmolarity from 300 to 400 m.osmol/Kg. Thus the control of these two parameters allowed us to improve sperm motility and to perform intrauterine insemination with ovarian hyperstimulation. The different causes of retrograde ejaculation in this study are diabetes, surgical injury and idiopathic. Fifty-one intrauterine insemination cycles were realized in twenty-three patients, and eleven pregnancies are obtained (21.5% per cycle).     

L’humanisation au prisme des pierres taillées

Knapped stone tools constitute an interesting evidence of the mental abilities of their makers. Almost imperishable, they bear visible traces of the successive removals they come from, and of the flaking techniques used. On that basis, we present a few remarkable achievements along the evolution of prehistoric lithic technology, and discuss their capabilities. The tools of the oldest Palaeolithic already surpass the nut cracking from Chimpanzees. Some core reductions into flakes, as early as 2.3 My, show a repeated organization of the removals, and the capacity to prevent a problem. The regular and symmetrical hand-axes from Africa and Europe, appearing between 1 and 0.5 My, provide evidence of a mental template and hence a capacity of conceptualization. The Levalloisian core reduction, somewhat more recent, give evidence of a goal structured method: the technical actions were hierarchized and subordinate to morphological intentions.     

Importance de l’étape pré-analytique en spermiologie pour le diagnostic et l’évaluation des thérapeutiques

Semen analysis is subject to great variability, partly due to the mechanism of ejaculation. This variability can be reduced by taking certain precautions, such as interviewing the patient to eliminate any external factor of variability, by imposing a 3- to 5-day period of sexual abstinence, by explaining the procedures to avoid bacterial contamination of the sample, by verifying whether the whole semen sample has been collected, by checking that the temperature of the sample is maintained at 37°C and finally, by carefully homogenising the sample to obtain good quality liquefaction.     

L’anthropologie clinique au carrefour des psychothérapies

Individualism, which characterises modern, democratic society, impacts the social bond and the institutions that protect it. Psychotherapy reflects this change in the social context through the ever-increasing fragmentation of its theories and methods. Within the context of the resulting division of therapeutic approach, the tendency for technical specialisation and mutual dismissal among the various schools sometimes overshadows the very object of psychotherapy, namely, suffering human beings. The future of humane psychotherapy, therefore, requires therapists to increase their awareness of the scope and limits of the approach they pledge allegiance to, relative to other schools. Therapists must epistemologically clarify the implicit presuppositions of the theories and methods they adopt and emotionally distance themselves from their theoretical school. Phenomenology-inspired clinical anthropology provides essential tools to meet this goal.     

Distribution et activités des alcaloïdes défensifs des Coccinellidae

From a survey of 30 species and varieties of ladybugs the presence of alkaloids appears to be correlated with the existence of aposematic colour and not with being carnivorous or phytophagous. The alkaloids described until now all belong to the Coccinellini and are closely related, but other types of bases have been detected in some genera. The observed distributions are in agreement with the modern taxonomy of the family.Ladybug alkaloids constitute an effective defence against ants, Myrmica rubra, and quails, Coturnix coturnix, but all the beetles containing alkaloids do not possess the same degree of protection. Individual quail react differently towards moderately protected species.The bioassay used for the first isolation of coccinelin is described. The repulsive activities of aqueous solutions of coccinellin and convergin towards ants have been compared.     

La contribution de la pensée d’Alfred Kraus à l’étude phénoménologique des troubles bipolaires

German psychiatry is one of the areas where we see the development of an unconventional psychiatry, characterized by its reference to philosophical traditions that are remote from the natural sciences, and by its emphasis on the overall nature of the mentally ill person. This approach first emerged during the period of comprehensive psychiatry promoted by Karl Jaspers and Kurt Schneider. This particular form of psychopathology focuses its attention on the inner experience of the ill person and attempts to understand it, in particular through empathy. This approach was soon reinforced by a philosophical method founded by Husserl and further developed by Heidegger: phenomenology. Firstly, this consists of a way of approaching and examining the discrete elements of consciousness, leading to the notion of intentionality (Brentano, Husserl). The central place of consciousness in this approach leads to the questioning of existence and of the person supporting this consciousness: this philosophy thus leads to existentialism (Jaspers, Sartre) and Heidegger’s concept of Dasein (the existential analytic, Dasein’s ontology). Phenomenological psychiatry is thus a clinical science characterized by its approach and its reference to what might overall be described as comprehensive anthropology. There are numerous authors who affiliate themselves with this phenomenological psychology. Our article is devoted to Alfred Kraus’s approach. We will first of all address the notions of comprehensive psychiatry and phenomenology. After introducing Alfred Kraus and the specific philosophical and clinical foundations of his work, we will examine the Krausian theory of identity based on Mead and Sartre, which establishes a distinction between ego-subject (a free element that produces ego achievements) and ego-object (identifications, in particular with social roles in the case of depressives). The ego-subject is the transcendent element (Sartre), which constantly exceeds what I am (ego-object) and there is thus an internal negativity. We will then address the clinical concept of manic-depressive illness. The identity structure of the depressive is characterized by hyper-identification. The notion of psychotic breakdown will then be covered, where it appears that melancholia is not an affective disorder, a mood disorder, but a case of depersonalisation. The personality disorder which precedes melancholia results from a threat that weighs on this fragile identity propped up against its identifications, which is expressed in hypernomic behaviour: this being a reinterpretation of the notions of a specifically depressive temperament, constitution, premorbid personality or typus melancholicus. Hypernomic behaviour is characterized by the scrupulous observance of role expectations and an extreme respect for laws and norms which is expressed as a form of hyperadaptation. Finally, the last part is devoted to the intolerance of ambiguity, which can be cognitive or emotional (the inability to experience negative feelings).     

L’emploi des méthodes de la théorie des ensembles flous à l’étude biométrique de l’espèce Nummulites millecaput dans la partie occidentale de la Téthys

Application of the fuzzy set theory to the biometric evaluation of the species Nummulites millecaput in the western part of the Tethys. The goal of this paper is to demonstrate the ability of the fuzzy-set theory to contribute to the evaluation of paleontological problems. As an example, the species Nummulites millecaput, Boubée has been chosen. One hundred specimens of this species, collected from four localities (Arrimblar, Adelholzen, Dudar, and Mount-Kotuc) have been prepared (equatorial sections) for the biometric measurement of the external and internal characteristics. First a traditional statistical evaluation was performed, followed by the construction of membership functions, the latter ones expressing in the best way the transitions from one locality to the other. The results of this evaluation confirmed that from Aquitaine (France) to Armenia, the same species – Nummulites millecaput – was distributed during the Eocene. To cite this article: G. Bárdossy et al., C. R. Palevol 2 (2003).