Effets de la radiothérapie sur la fonction testiculaire de l'adulte

Radiation therapy plays a major role in the curative management of numerous neoplasms, such as Hodgkin's disease or testicular cancer. However, the adverse effects of low-dose radiation scattered to radiosensitive normal tissues adjacent to the radiation fields, such as the testes, have been recognized. Experimental studies performed on healthy volunteers showed that no lesion was detectable on sperm counts or testicular biopsies after single doses of less than 10 cGy. Oligospermia has been reported after 15 cGy and 100 cGy result in a 90% incidence of azoospermia. In the radiotherapy of cancer, fractionated regimens are used to increase the differential effect between normal and tumoral tissues. For the same dose, a fractionated radiation regimen results in a higher incidence and a longer period of azoospermia than a single dose irradiation. Fractionated doses of >50 cGy result in a 100% incidence of azoospermia. For doses up to 200 cGy, recovery occurs but normal sperm production remains uncertain. Although the recovery time can be very long (more than 10 years), there is a risk of definitive azoospermia after doses of >200 cGy. Spermatogonia are the most radio-sensitive cell type and their depletion after small irradiation doses explain the effect of radiotherapy on fertility. Clinical hypogonadism is very unfrequent in usual practice, what seems to prove a relative radio-resistance of the Leydig cells. However, functionals studies show that there is a rise in serum LH with increasing dose to the testes. A decrease in testosterone levels has been reported after high testicular doses.     

Resultado de la actualización de la vía clínica de la fractura de cadera del anciano en un hospital universitario de Madrid

Background and objectivesOrthogeriatric management with clinical pathways (CP) in hip fracture (HF) has been shown to be superior to other models. We studied whether updating the CP, through prioritization of admission and surgery, improvement in the prevention and treatment of delirium, management of anticoagulants and antiplatelet agents and the use of perioperative peripheral nerve block, modifies surgical delay, stay, readmissions, mortality, suffering delirium and functional status at discharge.Material and methodA retrospective observational study of unicenter cohorts of 468 patients with HF, 220 from 2016 (old VC) and 248 from 2019 (new VC). The variables are: intervention in the first 48 hours, surgical delay (hours), stay (days), stay less than 15 days, delirium, functional loss at discharge (Barthel prefracture scale less Barthel scale at discharge), readmission at one month, and mortality at admission, month and year.ResultsMedian age: 87.0 [interquartile range 8.0], mostly women (76.7%). Significantly, with the new VC, there was a greater number of patients operated on in the first 48 hours (27,7% vs 36,8% p = 0.036), less surgical delay (72.5 [47,5-110,5] vs 64.0 [42,0-88,0] p < 0.001), shorter stay (10,0 [7,0-13,0] vs 8,0 [6,0-11,0] p < 0.001), greater number of discharges in 15 days (78,2% vs 91,5% p < 0.001), lower delirium (54,1% vs 43,5% p = 0.023). No significant changes in readmissions, functional loss at discharge, mortality at admission, 3 months or year.ConclusionsUpdating the VC brings benefits to the patient (less surgical delay, equal functional status at discharge with fewer days of admission) and benefits in management (lower admission) without modifying mortality.     

Influence de la concentration du glucose et de l'azote sur la morphologie de Candida albicans et la formation de ses chlamydospores dans un milieu de culture synthétique

Résumé Candida albicans a été cultivé à l'obsurité, à 28 °C, dans un milieu de culture synthétique liquide dans lequel on fait varier les concentrations de glucose et d'azote. Des indices de chlamydosporulation ont pu etre calculés pour les milieux contenant au plus 0,08 g/l de glucose. Lorsque la concentration de glucose est plus importante, les thalles pseudomycéliens portent, dans certains cas, de nombreuses chlamydospores, mais aussi des chaines de cellules à contenu dense; ces thalles bourgeonnent des éléments levuriformes qui se détachent et continuent à bourgeonner dans le milieu de culture. Les différentes morphologies rencontrées sont décrites, illustrées et ordonnées en fonction des concentrations de glucose et d'azote du milieu.

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Candida albicans was grown in the darkness, at 28 °C, in a synthetic medium in which glucose and nitrogen concentrations were varied. Numeric appraisal of the chlamydospore index was possible only in the medium where glucose concentration was 0,08 g/l or less. When the glucose concentration raised, pseudomycelial thalli bore numerous chlamydospores but sometimes also chains of cells with a dense granular content. These thalli bud yeast cells which separate and bud again in the medium. The different morphological aspects of the cultures are decribed, illustrated and classified according to the glucose and nitrogen concentration of the medium.

     

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.     

Calidad de la alimentación de adultos mayores de Santiago de Chile

IntroductionWith the increase in the elderly population of Chile, it is very important to evaluate the quality of food of this age group using simple and quick tools.ObjectiveTo compare the food quality of the elderly, according to gender and age.Material and methodsA cross sectional study was conducted on 458 elderly subjects ≥ 60 years-old of Santiago de Chile. Each one of them were interviewed in their home using the Food Quality Survey for Elderly (FQSE). The objective of this survey is to measure the quality of the food and preparations considered healthy and/or unhealthy for elderly. Weight and height, was obtained from the control document of the elderly.ResultsMen consume a higher number of unhealthy foods compared to women (P = .01). On comparing ages, those over 80 years-old consumed less unhealthy foods (P = .01). The elderly obese showed a lower score in unhealthy eating habits and total intake score.ConclusionWomen eat healthier compared to men, and better eating habits are observed at an older age, especially in men. Finally, on comparing nutritional status, the elderly obese are those who eat in the most inadequate form.     

Controle de la multiplication et de la polyploïdie des hepatocytes du rat

Résumé L'injection de substances irritantes de nature chimique variée perturbe les mécanismes qui contrÔlent la multiplication des hépatocytes du rat.Les très jeunes rats réagissent de faÇon intense et reproductible. 15 heures après l'injection il se produit une augmentation brève et intense du nombre des cellules entrant en phase S de sorte que les divisions cellulaires, qui normalement auraient été réparties sur les 30 ou 40 prochaines heures, débutent en l'espace de 2 heures seulement. La croissance hépatique a pris une importante avance qui est suivie par une période de diminution du nombre des mitoses due à une rétroaction inhibitrice.La réaction des rats plus âgés met en évidence un mécanisme inhibiteur permanent qui entraÎne une réponse moins intense et moins régulière.La production d'hépatocytes binucléés et polyploÏdes parait liée à ce mécanisme inhibiteur.La régularité et la sensibilité des réactions des très jeunes rats en fait un matériel de choix pour l'étude des mécanismes régulateurs de la croissance hépatique.

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Control of multiplication and polyploidy of rat hepatocytesA study of the perturbations of physiological regulation induced by injection of irritants

Summary The injection of irritating substances of various chemical nature disturbs the mechanisms regulating the multiplication of rat hepatocytes.The reaction of baby rats is intense and reproducible. It results, 15 hours after the injection, in an increase of the number of cells entering the S phase, so that practically all the divisions which would normally have been scattered over 36 hours are initiated within 2 hours. This burst of synchronized mitosis corresponding to a 36 hours advance in the hepatic growth is followed by a decrease of mitoses due to a feed-back inhibition.The reaction of older rats brings to evidence a permanent inhibitory mechanism that results in a less regular and intensive response.The production of binucleated and polyploÏd hepatocytes seems to be correlated to this inhibitory mechanism.The regularity and sensivity of the baby rat reactions make them a choice material for the study of hepatic growth.

     

Observations ultrastructurales sur la parathyroïde de souris

Résumé La parathyroïde de souris ne diffère pas essentiellement par sa structure générale de celles des autres espéces étudiées. Les cellules glandulaires se caractérisent cependant par une plus grande richesse en matériel sécrétoire figuré. La présence de ce matériel figuré dans les cavités golgiennes permet de suivre l'élaboration de granules sécrétoires typiques d'un diamètre de 160 à 200 m qui sont spécialement abondants chez la souris. Ces granules ne sont pas excrétés au pôle vasculaire des cellules; ils migrent vers les parois cellulaires apicales et latérales, fusionnent avec la membrane plasmique et semblent être excrétés sous forme soluble dans les espaces intercellulaires. Il n'existe dans la parathyroïde de souris, comme dans celle du hamster et du rat, qu'un seul type cellulaire fondamental. Les éléments clairs et sombres ne diffèrent que par leur densité hyaloplasmique; cette différence s'accuse plus ou moins selon la qualité du prélèvement.

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Summary The structure of the mouse parathyroid does not differ essentially from other species studied. However, the glandular cells are characterized through an abundance in visible secretory material. The presence of this material in the cavities of the Golgi apparatus makes it possible to observe the formation of the typical secretory granules (160–200 m in diameter) which are particularly abundant in the mouse parathyroid. These granules are not secreted directly at the vascular pole; they migrate to the apical and lateral walls, fuse with the plasma membrane, and seen to pass into the cellular space in a soluble form. In the mouse parathyroid, as in the hamster and rat, there is only one fundamental cell type. The difference between dark and clear cells lies in the density of their hyaloplasm, which, however, is a consequence of the pretreatment of the material (fixation).

     

Localisations ultrastructurales dans le labyrinthe du placenta de chatte de la phosphatase acide de la thiamine pyrophosphatase et de la coloration par l'acide phosphotungstique à bas pH

Résumé Les localisations de la phosphatase acide (ACPase) et de la thiamine pyrophosphatase (TPPase) ont été recherchées dans le labyrinthe du placenta de chatte, durant les derniers jours de la gestation. L'ACPase est essentielement localisée au niveau du syncytiotrophoblaste, et dans la substance inerte interstitielle (S.I.I.) qui sépare les tissus foetaux des tissus maternels. La présence du produit de réaction, dans la lumière du système tubulaire lisse du syncytiotrophoblaste communicant avec la S.I.I., semble indiquer une origine syncytiotrophoblastique de l'activité ACPase de la S.I.I.L'activité TPPase se manifeste dans le syncytiotrophoblaste, rarement dans la Golgi mais toujours dans la lumière du système tubulaire. La présence de ces tubules TPPase positifs à la proximité de l'appareil de Golgi, semble indiquer une origine golgienne de ces structures qui pourraient véhiculer les phosphatases vers la S.I.I.Après action de l'acide phosphotungstique à bas pH, le cell coat de la face hémale de l'endothélium maternel est toujours bien visualisé, par contre la surface du syncytiotrophoblaste baignée par la S.I.I. n'est jamais marquée. Le dépôt intense de la lumière des tubules est en continuité avec celui de la S.I.I.L'activité ACPase de la S.I.I. doit permettre la dégradation de molécules maternelles durant leur transfert vers le sang foetal. La S.I.I. semble correspondre physiologiquement à la zone tampon immunitaire de l'interface des tissus maternels et foetaux.

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Ultrastructural localization of acid phosphatase and thiamine pyrophosphatase activities and of phosphotungstic staining at low pH in the placental labyrinth of the cat

Summary The localizations of acid phosphatase (ACPase) and thiamine pyrophosphatase (TPPase) activities were studied in the placental labyrinth of the cat during the last days of gestation. ACPase activities were observed essentially in the syncytiotrophoblast and in the interstitial inert substance (S.I.I.) that separates maternal from foetal tissues. Reaction product was localized in lysosomes, multivesicular bodies, and in the network of smoothmembraned tubules which open on the cell surface of the syncytiotrophoblast facing the S.I.I. The S.I.I. exhibit a strong activity, probably of syncytiotrophoblastic origin.TPPase activities were found in the syncytiotrophoblast, rarely in the Golgi apparatus but always in the lumen of the network of smooth-membrande tubules. The S.I.I. shows a moderate activity. These TPPase positive tubules being frequently observed very close to the Golgi cisternae, it is proposed that they arise from the Golgi complex and convey phosphatases to the S.I.I.After phosphotungstic acid staining at low pH, luminal surface coat of maternal endothelium is always strongly and continuously visualized, while the plasma membrane of the syncytiotrophoblast facing the S.I.I. is never stained. Staining is intense in the lumen of tubules, and continuous with the stain of the S.I.I.ACPase activity of the S.I.I. could be implicated in enzymatic degradation of maternal molecules during their transfer from maternal to foetal blood. The S.I.I. may correspond to the immunological buffer zone at the interface between maternal and foetal tissues.

     

Aspects ultrastructuraux de la glande mammaire de lapine pendant la lactogénèse

Résumé L'évolution de l'ultrastructure de la cellule épithéliale mammaire de la Lapine est décrite au cours de:L'apparition des phénomènes sécrétoires qui prennent place normalement pendant le premier tiers de la gestation des Lapines primipares.La lactogénèse expérimentale produite par des injections de prolactine à des Lapines pseudo-gestantes.L'ultrastructure de la cellule mammaire de Lapine en sécrétion active (lactation) se distingue de celle des cellules inactives pour la sécrétion (début de la gestation et pseudogestation) par: le développement considérable de l'ergastoplasme organisé en lamelles parallèles ou concentriques; l'hypertrophie de l'appareil de Golgi; la présence de granules protéiques inclus dans des vacuoles d'origine golgienne au sein d'un cytoplasme hypertrophié, celle des gouttelettes lipidiques étant moins indicatrice d'un état d'activité sécrétoire.L'induction de la sécrétion lactée au cours de la gestation normale ou à la suite de l'injection de prolactine, conduit à des modifications ultrastructurales de la cellule mammaire qui se caractérisent principalement par le développement progressif des systèmes membranaires ergastoplasmiques, qui est déjà net entre 12 et 24 heures et aboutit le 3e jour de l'administration hormonale à des images se rapprochant de celles d'une cellule de glande mammaire en lactation. La formation d'un important réticulum endoplasmique auquel est liée la majorité des ribosomes, ainsi que le développement des citernes et vacuoles golgiennes, paraissent ainsi sous le contrôle de la prolactine. Nous discutons enfin de la signification de l'existence transitoire dans les premiers stades de la lactogénèse d'une organisation vacuolaire de l'ergastoplasme.

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Ultrastructural aspects of the rabbit mammary gland during lactogenesis

Summary The ultrastructural development of the rabbit epithelial mammary gland cell is described during:The appearance of secretory phenomena usually occuring in primiparous rabbits in the last third of pregnancy.Experimental lactogenesis induced by injecting pseudopregnant rabbits with prolactin.The ultrastructure of the active secretory (lactating) rabbit mammary gland cell is distinguished from that of inactive epithelial cells (beginning of pregnancy or pseudo-pregnancy) by: a considerable development of the ergastoplasm organized in parallel or concentric lamellae; hypertrophy of the Golgi apparatus; the presence of protein granules included in vacuoles of Golgian origin in the middle of hypertrophied cytoplasm. The presence of lipid droplets is less indicative of an active secretory state.The induction of milk secretion during normal gestation or after a prolactin injection produces ultrastructural modifications in the mammary gland cell which are characterized by progressive development of the ergastoplasmic membrane system. This transformation becomes evident between 12–24 hours and on the third day of hormonal administration resembles that of the lactating mammary gland. The formation of a large endoplasmic reticulum to which the majority of ribosomes are bound and the development of cisterns and Golgi vacuoles appear under the influence of prolactin. The signification of the temporary existence, during the early stage of lactogenesis, of a vacuolar ergastoplasmic organization, is discussed.

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Les tirages photographiques sont dus à Messieurs Scandolo et Amar que nous remercions vivement.     

Rétablissement du cytoplasme et de la force motrice au cours de la restauration de la cyclose chezNitella après irradiation

Résumé En irradiant (500 kR) une fraction seulement du volume cellulaire de la cellule internodale deNitella, il est possible de distinguer au cours des phénomènes de restauration du mouvement cytoplasmique ceux qui dépendent de Pendoplasme (observation de la cyclose dans la zone protégée) et ceux qui dépendent de l'ectoplasme siège de la force motrice (observation de la cyclose dans la zone irradiée).Dans la zone protégée, la vitesse de la fraction endoplasmique irradiée se rétablit en fonction du temps suivant une équation du second ordre. L'augmentation du volume irradié diminue la rapidité du premier des deux processus de restauration et la quantité d'endoplasme qui reste altérée s'accroît.Dans la zone irradiée, le courant cytoplasmique est suspendu; il ne reprend que 4 minutes après le traitement alors que la couche chloroplastique se réorganise. Le glissement des inclusions qu'il charrie se fait un certain temps par saccades. La vitesse de la fraction endoplasmique protégée y augmente régulièrement témoignant ainsi du rétablissement de la force motrice. Le rétablissement a lieu suivant un schéma analogue à celui de Pendoplasme irradié sauf que ce phénomène y est plus rapide et que la force motrice du moins pendant les premières heures se rétablit intégralement. Ces résultats sont discutés (rôle des groupes SH, effet indirect d'empoisonnement, nature des lésions) et comparés à ceux obtenus pour des cellules irradiées in toto.

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Cytoplasm and motive force separated recovery during the re-establishment of the gyclosis in irradiatedNitella cells

Summary In these experiments onNitella internodal cells, only a fraction of the cellular volume is irradiated (by 500 kR). The restoring of the endoplasm (by measurement of the cyclosis in the shielded zone) and the restoring of the ectoplasm where the motive force is generated (by measurement of the cyclosis in the irradiated zone) can be examinated separately during the recovery of the cytoplasmic streaming.In the shielded zone, the plot on a semi-logarithmic scale of a typical rate of streaming-time curve shows that the speed of the irradiated endoplasm. increases again according to a second order equation. With increasing irradiated cellular volume, there are a gradual slowing down of the first processus of restauration and an increase of the definitively altered fraction of the endoplasm.In the irradiated zone, the cytoplasmic streaming stopped completely. About 4 minutes after the treatment, when the chloroplasts layer is reorganising, it exhibits a tendency to flow again. The carried inclusions slide then in jerks during several minutes. The rate of the protected fraction of the endoplasm increases regularly, proving the recovery of the motive force. An analysis of this processus versus time shows that it can be exprimed by a second order equation as that of the irradiated endoplasm. But it is faster and the motive force resumes until full recovery (at least during the first hours).These results are discussed (importance of SH-groups, indirect poisoning effect, kind of lesions) and compared with those observed in completely irradiated cells.

     

Apports de la palynologie a la connaissance du Pliocène du Roussillon (sud de la France)

The present study illustrates clearly how pollen analysis may be applied to stratigraphy from a botanical point of view. Within a chronologically reliable frame (Middle Pliocene for the marine deposits on the basis of Foraminifera record; two subzones for continental deposits on the basis of Mammals record: Hautimagne for Terrats fauna, Sète for Serrat-d'en-Vacquer fauna), palynology provides a good stratigraphical boundary: the extinction of the Taxodiaceae. In a remblayage area, it is established that a continental level is not necessarily younger than a marine one unless they are superposed. Many profiles are replaced according to the «progradation of the pliocene gulf of Roussillon. The boundary between marine and continental deposits cuts through the chronological line of the Taxodiaceae extinction. The flora investigated (93 taxa) is the first known for the Pliocene of this area. The extinction of the Taxodiaceae in southern France has a climatic cause: the setting in of a mediterranean rhythm (dry summers). This extinction is much older than the one which took place in Italy (Tiberian boundary) and in the Netherlands (Reuverian-Pretiglian boundary).