Ejaculation provoquée chez le paraplégique

90% of spinal cord injury patients cannot have an ejaculation during either sexual intercourse or masturbation From 1987 to 1993: 52 patients were treated by vibratory stimulation, 21 by electrostimulation, 4 by Physostigmine. Overall success rate during vibratory stimulation is of 65% and 83% if one considers only patients with a sublesional syndrome below T10. We obtained 15 successes among 21 tetraplegic patients and 19 successes among 20 paraplegic patients. Ejaculation was always obtained within three minutes. We did not obtain any success in paraplegic patients group whose lesional level was T12, L1, L2. After having trained the couple for the technique, we realised on two occasions, during ovulation (twelfth to sixteenth day before next menstruation date), intravaginal autoinseminations with a syringe for a minimal duration of one year, necessary time to improve semen quality before treating procreation as a medical issue. Among these 52 patients treated by vibratory stimulation, only 12 couples came to take our advice in order to procreate. Out of the 12 followed up couples, we obtained 3 births and 1 current pregnancy. 16 patients out of the 21 treated by electrostimulation have an ejaculation. Out of the 30 realised ejaculations, 11 were retrograde. Semen volume and quality are much lower to what we obtained by vibratory stimulation. Actually, this technique has not allowed a pregnancy. 2 out of the 4 patients having had a treatment by Physostigmine had an ejaculation. Ejaculation by vibratory stimulation is the easiest technique and it must be proposed as a first purpose. In a second time, proposed intrarectal electrostimulation allows nearly always to get semen if a sufficient number of sympathetic thoracolumbar fibres are preserved.     

Chimiothérapie anticancéreuse chez le mâle: risques pour la descendance

Up to now, studies concerning the progeny of males undergoing chemotherapy have been difficult to interpret because of their heterogeneity and conflicting nature. Morever, the long term follow up of children has not been carried out. Experimental studies carried out with the cytostatic drug cyclophosphamide have shown that if mating of male rats takes place during the treatment, the frequency of post-implantation losses and fetal malformations increases. If this mating takes place after a recovery period of one to two seminiferous cycles, there is no malformation but only neonatal deaths, and behavioral disorders in adult progeny including diminished learning capacity. These abnormalities are inherited and can present the characteristics of dominant autosomic syndromes. Biochemical analyses of the brains of the first and second generation offspring from treated males show a decrease in two biochemical substrates of memory: hippocampal choline acetyltransferase and fronto-parietal cortex norepinephrine. Abnormalities can also present complex genetic rearrangements revealed in the third generation by, amongst other things, increases in weight gain. Finally, the experimental results suggest that genetic repair may be possible with time. These data and the uncertainty concerning the consequences of chemotherapy in males should systematically lead to:

- the cryopreservation of sperm before any mutagenic treatment;

- a minimum of two years contraception from the end of treatment;

- the long term follow up of children born from treated fathers.

     

Chronologie du Paléolithique supérieur dans le Nord-Est de la principale île du Japon

Palaeolithic archaeology in Tohoku region has long been discussed on constructing chronology, however it is difficult to build reliable chronological order because of poor stratigraphic excavations. In recent radiocarbon dating has advanced. In this paper I discuss the relation between chronology and radiocarbon dating in Tohoku region. At first, I categorize the Palaeolithic industries and establish the chronology by analyzing tool typology, lithic technology, and stratigraphic data. I correlate it with radiocarbon data from sites in Tohoku region. The result of analysis shows that Upper Palaeolithic industries are divided into 18 categories and 8 periods on chronology. The calibration curve IntCal 13 indicated that oldest Early Upper Palaeolithic site appeared around 37,000 cal BP, and late Upper Palaeolithic started about 27,000 cal BP. The pottery first appeared as far back as around 16,000 cal BP. Now we do not have enough radiocarbon data, so we have to gather and examine more ¹⁴C data.     

Données nouvelles sur le spectre d'hôtes et le parasitisme du nématode entomophageNeoaplectana carpocapsae

Résumé Des essais réalisés au laboratoire en conditions standards et destinés à compléter la connaissance du spectre d'h?tes deNeoaplectana carpocapsae Weiser ont été effectués à Antibes, en Guadeloupe et à Madagascar. 128 espèces d'insectes appartenant aux ordres des Odonates, Dictyoptères, Isoptères, Phasmoptères, Orthoptères, Planipennes, Lépidoptères, Diptères, Coléoptères, Hyménoptères, Homoptères, Hėtéroptères, ont été étudiées ainsi que quelques autres arthropodes (diplopodes et acariens). Les rėsultats ont confirmé le fait que la gamme d'h?tes potentiels deN. carpocapsae est très large malgré quelques cas de résistance chez les Diptères essentiellement. La rapidité d'action deN. carpocapsae, sa capacité à se multiplier dans l'h?te, ainsi que certaines de ses exigences écologiques en vue de son utilisation pratique, ont été examinées.

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Summary Laboratory tests under controlled conditions were carried out in Antibes, Guadeloupe and Madagascar, to investigate the host range ofNeoaplectana carpocapsae Weiser. 128 insect species including members of Odonata, Dictyoptera, Isoptera, Phasmida, Orthoptera, Planipennia, Lepidoptera, Diptera, Coleoptera, Hymenoptera, Homoptera, Heteroptera and a few other arthropods, were tested. Results confirmed that the potential host range ofN. carpocapsae is very broad in spite of some cases of resistance, mainly in Diptera. The effectiveness rapidity of the nematode, its ability to multiply in the host and some other of its ecological requirements for practical use, were also studied.

     

L’effet des rayons x sur le protoplasme,le noyau et le chondriome de la cellule végétale d'après les observations sur le vivant

Sans résumé Avec planches I et II     

Relation fonctionnelle entre la masse grasse,les plis cutanés,le déficit ou l'excédent pondéra et le « poids théorique idéal

Underscoring a functional relation between fat mass, skinfolds, under or overweight and the ‘ideal theoretical weight’, constitutes a fundamental datum in anthropology. Indeed, this relation, which differs according to age, sex, ethnic group and physical activity, provides information on the distribution of fat contained in the skinfolds, the under or overweight and the ‘ideal theoretical weight’. The value of this relation lies not only in limiting the use of the corpulence index (W/H²) as an indicator of fat mass, but above all in the importance of physical activity and in the existence of a significant change in the distribution of fat according to the factors mentioned above.     

Une syringocèle révélée par un abcès périntéal

Purpose

The authors present a clinical report of a perforate syringocele diagnosed in a male patient and they review the clinical, radiological and therapeutic aspects of this disease.

Case report

A 50-year-old man attended the emergency room with perineal abscess. Computerized Tomography (CT) scan was used to establish the diagnosis. This patient also underwent urethrocystoscopy, sonography and retrograde urethrography.

Results

Treatment consisted of open surgical evacuation of the perineal abscess with bladder catheter. Urethrocystoscopy showed a large perforate syringocele in the urethra with no need for endoscopy marsupialization. No recurrence was observed at follow-up at 3 months.

Conclusion

Syringocele is a rare malformation which usually is asymptomatic. It can be congenital or acquired and can be classified into four morphological types. The most frequent treatment is endoscopic marsupialization of the syringocèle. Open surgical excision is recommended for complicated syringocèle with abscess or perineal pain.     

Testostérone et contrôle central de l’érection

Testosterone orchestrates the perinatal organization and activation of cerebral and spinal neuronal structures involved in the expression of male sexual behaviour in adults. The present review briefly describes testosterone effects in the regulation of sexual motivation and erection, as well as the genetic models developed to date in order to unravel its central mechanisms of action.     

Identification des cellules hypophysaires sécrétant l'ACTH chez le rat

Résumé Dans le but d'identifier la cellule hypophysaire responsable de la sécrétion d'ACTH chez le rat, des études morphologiques, en microscopie optique et électronique, furent entreprises chez des animaux surrénalectomisés, c'est-à-dire dans des conditions où la sécrétion d'ACTH est spécifiquement augmentée. Le prélèvement des hypophyses fut effectué à des intervalles allant de 1 à 21 jours après surrénalectomie. Des hypophyses d'animaux surrénalectomisés et traités par la dexaméthasone, un inhibiteur de la secrétion d'ACTH, furent également étudiées. Il découle de ces expériences qu'un type cellulaire est stimulé en même temps que la sécrétion d'ACTH augmente. Cette cellule, hypertrophiée après surrénalectomie, possède une forme irrégulière et est très souvent en contact avec les cellules somatotropes; son ergastoplasme peu développé contraste avec un appareil de Golgi très important. Les granules secrétoires corticotropes ont un diamètre d'environ 200 m, sont peu abondants et disposés le long de la membrane cellulaire. Ces granules n'ont cependant pas été caractérisés en microscopie optique. L'administration de dexaméthasone provoque une régression spécifique de la cellule corticotrope ainsi qu'une accumulation des granules sécrétoires dans le cytoplasme. Chez l'animal intact, il devient possible d'identifier la cellule corticotrope qui possède les caractéristiques générales de la cellule stimulée, mais dont le cytoplasme et l'appareil de Golgi sont peu importants.

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Identification of the ACTH secreting cells in the rat pituitary

Summary In order to clarify the identity of the ACTH-secreting cells in the rat pituitary, morphological studies were performed in adrenalectomized rats which have a specific increase in ACTH secretion. Pituitaries were removed and fixed for both light and electron microscopy at different time intervals (1 to 21 days) after adrenalectomy. Pituitaries of adrenalectomized animals which received dexamethasone, a potent inhibitor of ACTH secretion, were also studied. In these experiments, it was found that a specific cell type was stimulated as ACTH secretion was increased. This cell, which became enlarged after adrenalectomy, is characterized by an irregular shape and frequent association with somatotropic cells. The rough endoplasmic reticulum was poorly developed in contrast to a prominent Golgi apparatus. The secretory granules of this corticotropic cell were about 200 m in diameter and located in a single row along the plasma membrane. By light microscopic examination, these secretory granules could not be clearly identified. Dexamethasone administration provoked a specific decrease in size of corticotrophic cells, as well as an accumulation of secretory granules. Identification of corticotrophic cells in control rats was facilitated by comparison with those of adrenalectomized rats. In both cases, the general appearance of this cell type was similar except for size difference. Also in the control animals the Golgi apparatus was less prominent than in adrenalectomized rats.

Boursier du Conseil de la Recherche Médicale du Québec.     

Communication interventriculaire avec défaillance cardiaque chez le nouveau-né et le nourrisson: Evaluation du traitement médical

Twenty-seven infants with ventricular septal defects and in cardiac failure were followed regularly under medical treatment for an average period of 17 months. The diagnosis was proved in all cases by cardiac catheterization.At the end of the follow-up period, the patients could be classified as follows: Sixteen patients showed no change in their cardiovascular status, and six had signs of pulmonary infundibular stenosis. One child had died from bronchopneumonia. Another was classified as having probable functional closure of the defect. Finally, three other children, because of failure of medical treatment, underwent banding of the pulmonary artery. One died during the operation.It is concluded that the great majority of patients with ventricular septal defects and cardiac failure can be carried successfully under medical management until the age at which corrective surgery is feasible. Palliative procedures which in themselves carry a fairly high mortality risk should be used only as a last resort.     

Contrôle neurologique de l’éjaculation

The brain control of the genital tract and sexual behaviour remains poorly understood. Clinical results and basic research indicate that the neural control of ejaculation depends on three levels of organization. The first level consists of peripheral autonomic and somatic nerves. Leaving the spinal cord, these nerves control the motility, secretions and blood supply of the genital tract, and contractions of perineal striated muscles. Their path in the abdominal cavity and the effects of their neuro-transmitters on peripheral tissues have been established. These nerves also convey sensory information from the genital tract to the spinal cord. The second level is represented by the spinal cord. The thoracolumbar (sympathetic), and sacral (parasympathetic and pudendal) segments of the cord contain the somata of autonomic and somatic motoneurons, whose axons run in the above nerves. These motoneurons are part of a spinal network that likely organizes the activity of the whole genital tract in a given context such as copulation. The role of the different spinal cord segments in the control of ejaculation is mainly inferred from observations of the deleterious effects of spinal cord injury in human patients. A small population of galaninergic positive neurons has recently been identified in the lumbar segments of the rat spinal cord that plays a major role in ejaculation (Truitt and Coolen, 2003). Selective lesion of this population abolishes in copula ejaculations, but spares erection. Finally, the third level of organization is represented by supraspinal nervous structures. The spinal cord receives direct excitatory and inhibitory information from the brainstem, pons and hypothalamus. In turn, these structures receive sensory information from the genital tract. However, their role in the control of ejaculation remains poorly investigated. Again, it is mainly inferred from the observation of the deleterious effects of pharmacological treatments on brain neurotransmission. Positron emission tomography has recently been used to observe brain areas whose activity is enhanced during ejaculation in humans (Holstege et al., 2003). In this study, several areas of the right side of the cortex and the cerebellum were activated. The targets of future clinical and basic research include: the neural basis of the required coordination between spinal autonomic and somatic nuclei that innervate the genital tract, the role of sensory information from the genital tract in the recruitment and coordination of spinal and supraspinal nuclei, and finally the integration of descending excitatory and inhibitory influences onto the spinal cord. Both the organization during development and the activation at puberty of the spinal neural network that controls the genital tract are dependent on androgens. Future research should identify the regulatory factors that, in response to the action of androgens, provide neurons with the possibility of building their connexions and selecting their neurotransmitters and receptors.     

Recherches histophysiologiques sur le développement post-embrynnaire et le cycle annuel deFormica rufa (Hyménoptère)

Histochemical methods applied to the fat body ofFormica rufa queens show during the postembryonnic development, the following results:

1. Synthesis of lipids, glycogen and protein, successively occur in the cytoplasm of larval adipose cells. At the time of cocoon spinning, the energetic reserves (glycogen and mainly lipids) regress. During the nymphosis, the proteins are used for the histogenesis of the imaginal organs; yet, part of the proteins synthetised by the prenymph is transformed by the nymph into lipids, or constitutes the protein reserves of the swarming imago.
2. The nitrogenous products, which are copious for the larva, undergo transformations during the nymphosis, but reappear in microscristallin form at the hatching.

     

Recherches histophysiologiques sur le développement post-embryonnaire et le cycle annuel de Formica (Hyménoptère)

Résumé Les cellules du mésentéron des ouvrières, des reines et des mâles de Formica polyctena F. possèdent un certain nombre de particularités cytologiques dont l'évolution a été suivie au cours du développement post-embryonnaire et du cycle annuel.A l'apex des cellules de régénération les microvillosités se différencient avant l'élimination des cellules caduques larvaires ou nymphales. A partir de la nymphose une activité sécrétoire apocrine se manifeste dans la partie dorsale de l'épithélium du mésentéron, l'ensemble des cellules assurant par ailleurs la fonction absorbante de l'organe. Il existe deux sortes d'inclusions cytoplasmiques, des polysaccharides et des concrétions minérales. Les polysaccharides sont surtout abondants chez les larves et les nymphes: le glycogène, polysaccharide de réserve, est utilisé au cours de l'histogénèse; des mucopolysaccharides acides, d'origine golgienne, représentent une sécrétion muqueuse. Les sphérocristaux sont constitués de strates concentriques de phosphates et chlorures de calcium et d'une matrice de mucopolysaccharides. La cristallisation des éléments minéraux s'effectue, à partir de la nymphose seulement, dans les citernes ergastoplasmiques. Cette accumulation d'ions pourrait être en relation avec le régime alimentaire de l'insecte ou représenter une voie d'excrétion.

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Histophysiological studies on the postembryonic development and the annual cycle of Formica II. Histochemical and ultrastructural characteristics of the midgut of F. polyctena

Summary The midgut cells of workers, queens and males of the ant Formica polyctena show cytological characteristics which were studied in the course of postembryonic development and annual cycle. The microvilli of the regenerating cells appear before the elimination of the regressing larval and pupal cells. At the time of pupation, an active phase of apocrine secretion begins in the dorsal part of the midgut epithelium, while the absorptive function is carried out by all cells of the organ.Two types of cytoplasmic inclusions coexist: polysaccharides and mineral concretions. The polysaccharides are particulary abundant in larvae and pupae. Glycogen is metabolized during histogenesis; acid mucopolysaccharides, elaborated in the Golgi apparatus, represent a mucous secretion. The spherites are composed of concentric strata of calcium phosphate and chloride and a matrix of mucopolysaccharides. These minerals form in the ergastoplasmic cisternae of pupal cells only. Their accumulation could be related to the insect's diet, or it could reflect a process of excretion.

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Abréviations utilisées dans les figures B Basale anhyste - CL cellule larvaire - CR cellule de régénération - G Dictyosomes - GM Gaine musculaire - M Mitochondries - Mt Microtubules - Mv Microvillosités - R Ribosomes libres Avec la collaboration technique de Mme A. Anglo. Travail exécuté dans le cadre de la Recherche coopérative sur programme n 162 du Centre National de la Recherche Scientifique.     

Place de l’embolisation percutanée de la varicocèle dans le traitement de l’infertilité

Objectives

To describe percutaneous embolization of varicocele and to evaluate the effect on fertility disorders.

Materials and methods

One hundred nineteen patients, aged 11 to 48 years, underwent percutaneous embolization for varicocele indicated by a fertility disorder in 23% of cases. Correction of the varicocele and resolution of associated pain, improvement of testicular trophicity and the effect on fertility were studied and a review of the literature was performed.

Results

Percutaneous embolization was performed using neuroleptanalgesia on an outpatient basis. The technique combined venous sclerotherapy and placement of coils in the gonadal vein. The technique was successful in 95% of cases and one complication was observed. At 3 months, the varicocele and related pain had resolved in 98% of treated patients. According to previous reports in the literature, the relations between varicocele and fertility disorders are still unclear, but improvement of fertility (semen quality and conception rates) after varicocele repair has been established.

Conclusion

Although the consequences of varicocele on fertility have not been fully elucidated, treatment of varicocele appears to be beneficial. Percutaneous embolization of varicocele is a safe and effective alternative to surgery. This technique, based on a urological and radiological consensus, is the first-line treatment for varicocele in our institution.