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.     

Recherche de facteurs de risque de la thrombopénie induite par le 177Lu-DOTATATE dans le bilan de suivi standard

PurposeThe thrombocytopenia induced by the ¹⁷⁷Lu-DOTATATE is one of its frequent, adverse effects. Its persistence causing problems in the subsequent management of patients, especially when the disease progression occurs, predicting it is a major issue. Due to the lack of knowledge about this subject, we searched to determine the existence of predisposing factors concerning the platelet toxicity in the standard follow-up.Material and methodsThis monocentric retrospective study included 20 patients with gastroenteropancreatic neuroendocrine tumors. Various parameters were analyzed, including: the standard blood analysis, the osteomedullary invasion factor, the spleen's volume and the estimated activity in the bone marrow or the spleen 24 hours post-injection.ResultsFour patients had a persistent grade 2 thrombocytopenia, one year after the last treatment. A decrease in platelet count after the first treatment above 30% and an osteomedullary invasion factor above 30% were highlighted as risk factors odds-ratio = ∞ (P = 0.0379) and odds-ratio = ∞ (P = 0.003) respectively. The initial platelet count, splenic length and estimated activity in the spleen after 24 h were correlated with platelet nadir value r = 0.5459 (P = 0.0128); r = − 0,8105 (P < 0,0001) and r = − 0.467; (P < 0.0001) respectively.ConclusionThis study has shown that the decrease of platelet's count after the first round of treatment and the scale of osteomedullary invasion are risk factors for thrombocytopenia and has brought to light that the spleen acts as a factor impacting the severity of this thrombocytopenia.     

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.     

Un cas de leishmaniose féline disséminée dans le sud de la France

We report a case of disseminated feline leishmaniasis in a FIV-seropositive 14-year-old male cat (Felis catus) living in the Alpes-Maritimes (south of France). The cat presented with erythematous ulcerated papules on the head and withers, and with an ulcerated proliferative lesion on the left pinnae. The condition was diagnosed, along with a squamous cell carcinoma of the pinnae, after histopathological examination of the cutaneous lesions. Total remission of the cutaneous lesions was obtained after oral administration of 100 mg of allopurinol once a day for four months. Necropsic samples revealed that the parasite was still present in the organism after six months of treatment. This case discusses of the cat sensibility to the leishmaniasis pathology and of his potential ability of being a reservoir host.     

Le Paléolithique supérieur de la région centre de l’île de Honshû

Tokai area is situated in the middle of Japan and has various configurations of ground. The eastern area has thick natural layers with volcanic ash which has been supplied from Mt. Fuji. About five chronological stages of Paleolithic culture from trapeze and edge-ground axe culture to microlith culture through backed blade culture have been found in the layers. These stages of Paleolithic culture are indicators of chronological studies in Tokai area. On the other hand, it is difficult to advance chronological studies in the middle east, middle, and west areas, because they have little thickness of layers with volcanic ash. However, different Paleolithic artifacts are found in top and bottom layers which put the AT layer between at Tsubakibora Site in Gifu Prefecture, and they have helped very much chronological studies of Paleolithic culture in the west area. Here is the first result of Paleolithic studies in Tokai area with artifacts which have been found on the forth layer of scoriae at Idemaruyama Site are dated about 35,000 years, one of the oldest Paleolithic culture in Japan. In addition, some lines of pits which were dated 30,000 years were found at Hatsunegahara Site, and they provided valuable data to study Paleolithic hunting. Finally, a holed pendant which had 10 notches on one side was unearthed from Fujiishi Site, and it was dated 19,000 years ago. At Terada and Hino Site, a flat big stone which had carvings was found, though the shape and use were seemed to be different from the pendant at Fujiishi Site.     

Modèle géométrique de l'œuf de Ver à soie

Résumé L'uf de ver à soie qui se prête à de nombreuses recherches génétiques et physiologiques a été assimilé à un volume géométrique simple afin qu'on puisse calculer aisément l'aire de sa surface totale et son volume. On a d'abord cherché à justifier le modèle géométrique proposé grâce à une étude expérimentale et statistique. On a ensuite établi les formules mathématiques utiles. Enfin on a discuté de l'approximation donnée par ces formules et de leur signification biologique.

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Summary The egg of the silkworm which permits a lot of genetical and physiological researches has been assimilated to a simple geometric volume, so that the area of its total surface and its volume might be easily calculated. First we have tried to justify the geometrical model which is proposed by means of an experimental and statistical study. We have then demonstrated the useful mathematical formulas. Finally we have discussed the approximation given by these formulas and their biological significance.

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Zusammenfassung Das Seidenraupenei, das viele genetische und physiologische Forschungen ermöglicht, hat man mit einem einfachen geometrischen Modell verglichen, um seine ganze Fläche und sein Volumen leicht rechnen zu können. Zuerst hat man versucht, das vorgeschlagene geometrische Modell dank einer experimentalen und statistischen Arbeit zu rechtfertigen. Dann sind die nötigen mathematischen Formeln festgesetzt worden. Zuletzt hat man die durch diese Formeln gegebenen Annäherungen und ihre biologischen Bedeutung erörtert.

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Avec la collaboration technique de Mme.Donas     

Problematique de réalisation des projets de biométhanisation dans le secteur agro-industriel: cas de l'abattoir de Dakar

Résumé Chaque jour 130 m³ d'eaux résiduaires de l'abattoir de Dakar sont évacués à la mer. Ces eaux contiennent les matières stercoraires des animaux abattus (9.5 tonne/jour), les eaux de lavage et les graisses. Les besoins en énergie de l'abattoir sont de deux types: électricité et eau chaude. L'électricité alimente les chambres frigorifiques à raison de 90% et représente une facture annuelle de 50 millions de francs CFA. L'eau chaude est utilisée pour l'échaudage de porcs: 3 m³ à 60°C sont produits par jour par cuisson sur feu de bois. La facture qui en résulte est de 450 000 francs CFA.

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Summary Every day more than 130 m³ of wastewaters from the Dakar municipal slaughterhouse are disposed off in the ocean. These waters comprise mainly stercoral matters, washing waters and greases. The energy requirements in the slaughterhouse are mainly of two types: electricity and heated water. Electricity is used to operate the refrigerating rooms, which corresponds to a total cost per year of 50 million CFA. Heated water is used for the pigs scalding with a bare 3 m³ of water used per day, at a temperature 60°C, obtained with fuel wood, the annual costs of which amounts to 450 000 CFA.

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Resumen Cada día más de 130 cm³ de aguas residuales del matadero municipal de Dakar se vierten al oceano. Estas aguas consisten principalmente en estiércoles, aguas de lavado y grasas. Los requerimientos energéticos del matadero son principalmente de dos tipos: electricidad y agua caliente. La electricidad se usa para las cámaras frigoríficas con un coste total de 50 millones de CFA anuales. El agua caliente se utiliza para escaldar cerdos con una media de 3 m³ de agua por día a una temperatura de 60°C, se calienta mediante carburante vegetal, con un coste anual de 450000 CFA.

     

Biogéographie et spéciation des Odonates de l’île de la Réunion

Du fait de l’histoire géologique des Mascareignes et des trajectoires cycloniques dans le sud-ouest de l’océan Indien, l’affinité de la faune odonatologique de la Réunion est essentiellement mauricienne. L’étude de la distribution des Odonates en fonction des différents écosystèmes aquatiques de l’île montre que: 1. Les espèces indigènes ayant une vaste répartition géographique se rencontrent essentiellement dans les écosystèmes ouverts de basse et moyenne altitude (de 0 à 800 m d’altitude). Ces écosystèmes peuvent héberger jusqu’à 13 espèces et possèdent les plus fortes densités odonatologiques. 2. La faune odonatologique de la Réunion se distingue de celle des autres îles de la sous-région malgache par la présence de deux espèces continentales cantonnées à des altitudes supérieures à 1000 m. 3. Les espèces endémiques fréquentent surtout les écosystèmes forestiers. Ces écosystèmes ne présentent au plus que cinq espèces de la faune odonatologique de l’île. En définitive, il apparaît donc que la spéciation des Odonates à la Réunion ne se fait pas dans les écosystèmes diversifiés comportant des espèces à large répartition géographique, mais dans un ensemble d’écosystèmes marginaux à faible diversité odonatologique.     

Etude de la migration des cellules somitiques dans le mésoderme somatopleural de l'ébauche de l'aile

Summary In chick embryos, observations were made on serial semithin transverse sections of the wing level. In addition homo- or heterotopic replacements of the wing or leg somitic mesoderm by labelled somitic or nonsomitic mesoderm were made in 2-to 2.5-day embryos. The nuclear label used was either natural (quail donor embryos in heterotopic transplantations) or isotopic (chick donors labelled with tritiated thymidine).Histological examination revealed that the first somitic cells to leave somite 15 apparently did so at the 20 to 22 somite stage, while the last ones to leave somite 20 apparently did so shortly before the 36 somite stage.Transplantation experiments with labelled donor cells revealed the routes of migratory somitic cells and the time-course of their invasion into the outgrowing limb bud (non-somitic graft cells did not noticeably invade the limb anlage). They showed furthermore that the somitic mesoderm is not regionalized with respect to its limb myogenic properties.These results are compared with those obtained in other classes of vertebrates.

Ce travail a été subventionné en partie par la D.G.R.S.T. et le C.N.R.S.     

Comparaison de deux modes de prophylaxie de l'infection urinaire chez l'enfant avec le triméthoprime--sulfaméthoxazole.

Two types of prophylaxis of urinary tract infection with trimethoprim-sulfamethoxazole (TMP-SMZ) were studied in 72 children with recurrent urinary tract infections or vesicoureteral reflux or both. Daily prophylaxis only was used in 36 children and thrice-weekly prophylaxis only in 25 others, and 11 children received successively both types of prophylaxis. The same dosage was used in all cases: 2 mg/kg of TMP and 10 mg/kg of SMZ, given at bedtime. With daily prophylaxis the infection rate over 556 patient-months was 5.4 cases per 1000 patient-months, compared with 285.4 cases in the year before prophylaxis; side effects were noted in 11% of the patients during treatment. With thrice-weekly prophylaxis the infection rate over 381 patient-months was 15.7 cases per 1000 patient-months, compared with 313.6 cases in the year before prophylaxis; only 3% of the patients receiving this treatment had a side effect that was possibly drug-related. These results indicate that effective prophylaxis of urinary tract infection in children can be obtained with these two types of treatment.     

Intérêt de l’utilisation de la scintigraphie osseuse dans le diagnostic et le suivi de l’ostéochondrite primitive de la hanche

Osteochondritis, or Legg-Calvé-Perthes disease (LCP), is a necrosis of the proximal femoral epiphysis. This vascular accident entails on the complex phenomenon of growth of the child's hip and can result in deformations or even a strict destruction of the proximal femoral epiphysis. The aim of this article is to show the interest of the bone scintigraphy (BS) in precocious diagnosis and follow-up of LCP disease. In this aim, we introduced a clinical case of LCP disease where BS allowed a precocious diagnosis and a strigent monitoring. Discussion of case includes a systematic review of literature.     

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.     

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.     

Transmission héréditaire de l’information épigénétique par le gamète mâle

What determines phenotype is one of the most fundamental questions in biology. Historically, most studies have focused on genetics but more recent studies have revealed the existence of epigenetic modifications that are not based on DNA sequencing but are essential for appropriate gene expression. Importantly, these epigenetic modifications can be inherited by the offspring. Thus, both male and female gametes contain inherited epigenetic information.     

Comparaison de l’estimation du débit de filtration glomérulaire par le 99mTc-DTPA au radiotraceur de référence le 51Cr-EDTA comparativement aux méthodes basées sur la mesure de la créatininémie

Since the end of 2018, the distribution of the reference tracer for the measurement of glomerular filtration rate (GFR), the 51Cr-EDTA, is no longer provided by radiopharmaceutical companies around the world. In this study, we propose to compare the measurement of glomerular filtration rate by 99mTc-DTPA to that by 51Cr-EDTA. A double estimation of GFR by plasma clearance was performed in 12 patients, 10 of which were referred for GFR calculation prior to possible kidney donation. Linear regression coefficients and intraclass correlation coefficient (ICC) were calculated for the GFR measurement by 99mTc-DTPA, and by MDRD, CKD-EPI and Cockcroft and Gault formulas, relative to the 51Cr-EDTA measurement. The clearance measurement with 99mTc-DTPA is on average 7.25 [2.00; 14.96] mL/min/1.73m² higher than that of 51Cr-EDTA. The GFR measurement with 99mTc-DTPA showed a trend towards better agreement with the 51Cr-EDTA measurement in terms of linear regression parameters, but also in terms of ICC compared to the MDRD, CKD-EPI and Cockcroft and Gault methods. In conclusion, our study supports the use of the 99mTc-DTPA tracer in place of 51Cr-EDTA and shows a higher reliability compared to methods based on blood creatinine measurement.     

Apport de l’iode 131 dans le traitement de la maladie de Basedow dans le service de médecine nucléaire de l’hôpital Ibn Sina de Rabat

One hundred and twenty-nine Grave's Basedow diseases in any gender and variable age patients, coming from several cities of Morocco, were randomized in a study of radio-iodine treatment who took place at the nuclear medicine department of Ibn Sina Hospital (Rabat, Morocco) during the period (from January 2001 to December 2008). The radio-iodine treatment was a first, second or third option and radio-iodine activities delivered varied (from 222 to 555 MBq 6 to 15 mCi) according to the age, the thyroid volume, the degree of hyperthyroidism and socio-economical situation. The high amounts of ¹³¹I were reserved especially to the patients who live far and whose socio-economic level is low with an aim of quickly obtaining an easily controllable state of hypothyroidism by a substitute treatment. The results showed that: (1) 57.36% of patients reverted to euthyroïdism (n = 74) with a patient having received two ¹³¹I cures. The second cure was justified by recurrence of hyperthyroidism after the first cure; (2) 34.88% passed in hypothyroidism (n = 45) with three patients having received two cures of ¹³¹I, the second cure was justified by recurrence of hyperthyroidism after the first cure in two patients and by the persistence of the hyperthyroidism after the first cure for the third patient. The average time of passage in hypothyroidism was 4.5 months; (3) 7.76% had remained in hyperthyroidism after the radioactive iodine treatment. Finally, 92.24% of our patients treated by radioactive iodine had passed in euthyroïdism or hypothyroidism against 7.76% whose hyperthyroidism had persisted or occurred.     

Rôle et activités de l'Administration Générale Belge de la Coopération au Développement

Résumé L'AGCD gère 60% de l'aide publique belge au développement. Celle-ci consiste essentiellement en l'envoi de personnel belge qualifié ou d'experts, en l'apport d'équipement et de matériel, en le financement d'études ou en la formation de cadres locaux. En pratique l'AGCD travaille soit en responsabilité directe soit en collaboration avec des institutions spécialisées, universités, centres de recherche, organisations non gouvernementales ou internationales. De plus l'AGCD dispose de moyens d'intervention de type financier tels que le Fonds des Prêts à des Etats Etrangers et le Fonds de la Coopération au Développement.

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Summary The Belgian Administration for Development Cooperation (AGCD) is responsible for 60% of the Belgian public cooperation with Developing Countries. In addition to the standard means of cooperation like training, fellowships, Belgian experts, feasibility studies, donation of equipment and materials, etc., AGCD has been recently given two new instruments of cooperation, namely: the Fund for Loan to Foreign Countries and the Fund for Development Cooperation. Thanks to these new instruments AGCD is now in a position to assist by offering concessional loans, by participating in the equity of state-owned companies and by granting credit lines to national development banks. In the field of anaerobic digestion AGCD is presently undertaking two main projects: one in Burundi with the University of Louvain-la Neuve and another in Indonesia with the University of Ghent. It also co-finances punctual initiatives of non-governmental organisations and is finalizing the negotiations for the Belgian contribution to the World Bank Energy System Management Assistance Programme (better known as the ESMAP). Furthermore, Belgium is preparing a cooperation programme jointly with the World Bank to promote the biomethanation of organic domestic refuse.

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Resumen La Administración General de Cooperación para el Desarrollo es responsable del 60% de la cooperación belga con países en desarrollo. Además de los sistemas tradicionales de cooperación tales como ayudas para formación, becas, profesionales belgas, proyectos, donación de equipo y materiales, etc. se ha dotado recientemente a la AGCD con dos nuevos instrumentos de cooperación, más concretamente: la Fundación de Crédito a países Extranjeros y la Fundación para la Cooperación al Desarrollo. Gracias a estos nuevos instrumentos la AGCD puede ahora ofrecer asistencia mediante la concesión de prestamos, participando en la gestión de empresas públicas y asegurando lineas de crédito para los bancos nacionales de desarrollo. En el area de la digestión anaerobia la AGCD tiene dos proyectos en curso: uno en Burundi en colaboración con la Universidad de Louvain-la-Neuve y otro en Indonesia con la Universidad de Ghent. La AGCD también co-financia iniciativas puntuales de organizaciones extra gubernamentales y esta en vías de finalizar las negociaciones para determinar la contribución belga al programa del Banco Mundial de asistencia para la gestión de recursos energéticos (conocido como ESMAP). Belgica esta además preparando un programa de cooperación con el Banco Mundial para promover la biometanación de desechos orgánicos domésticos.