Cancer et Hérédité

Sans résumé     

Radiopharmaceutiques et réglementations

The radiopharmaceuticals are products that combine two very stringent regulatory requirements from two different authorities: as medicine from a pharmaceutical point of view (Afssaps) and as radioactive source with specific authorization (ASN). This article discusses the different regulatory constraints imposed by these authorities but suggests also that legislation is supposed to be modified in the coming years in collaboration with nuclear physicians and their Society (SFMN).     

La réaction acrosomique

The acrosome reacting capacity of spermatozoa is essential for the fertilization of the oocyte. Several methods are available for the evaluation of the acrosomal status; each method detects a step of the reaction which is a continuous process. Due to the diversity and the relative specificity of each technique, it is difficult to compare results in absolute values. The reaction is Ca++ dependent. The use of Ca++ ionophores is valuable for a dynamic study which gives a better appreciation of the capacity of spermatozoa to react to a specific stimulus. Many authors have attempted to correlate the acrosomal status to the fertilizing ability of spermatozoa. The results show a reduced induction of AR in hypofertile sperm. More studies with standard materials and methods are needed in order to confirm the diagnostic value of this test.     

Scintigraphie de perfusion cérébrale positionnelle : résultats physiologiques et applications cliniques

To assess the impact of standing on brain perfusion, 125 brain perfusion scans in the upright and supine position were performed, including 108 patients. Perfusion values were compared using a relative quantitative approach and a segmentation of vascular territories with the help of an atlas of brain perfusion. We found a change in the distribution of the perfusion in favor of the vertebro-basilar system in the upright position. We discuss the case of a patient whose symptoms could be explained with the help of the comparison of brain perfusion scans in the upright and supine position. Atheromatous and post-dissection stenosis and their influence on perfusion are also discussed.     

Kyste du tractus thyréoglosse dégénéré révélant un microcarcinome papillaire multifocal de la thyroïde

The malignant degeneration of thyroglossal duct cyst (TDC) is a very rare phenomenon. It occurs 1% of operated cysts where papillary carcinoma represents the most frequent pathological type. The authors report a clinical observation of a papillary carcinoma of thyroid occurring in a thyroglossal duct cyst concomitant to a multifocal micropapillary thyroid discovered in a 21-year-old woman. A total thyroidectomy was performed. A complementary treatment by radioactive iodine 131 (3,7 GBq) was undertaken. Two years later, the patient is doing well and does not present any sign of recurrence. In the light of this observation, the authors propose to report the diagnosis and therapeutic aspects of degenerated thyroglossal duct cyst.     

Hypoglycémie spontanée et insuffisance rénale chronique.

Although glucose intolerance occurs as a consequence of chronic renal failure, improvement of a diabetic state by deterioration of renal function is a well known phenomenon. Recently occasional cases of spontaneous hypoglycemia in patients with chronic renal failure have been reported; two such cases and the results of metabolic studies are described in this paper. Pituitary, thyroid and adrenal function appeared to be normal. The results of an oral glucose tolerance test were normal; an appropriate insulin response was demonstrated in one patient, and a slightly elevated basal insulin value with a delayed insulin response to oral administration of glucose was demonstrated in the other. An insulin tolerance test did not support the hypothesis of increased insulin sensitivity as a factor, and the growth hormone response to hypoglycemia was normal. An intravenous glucagon test caused a subnormal increase in plasma glucose concentration, and the intravenous administration of tolbutamide produced hypoglycemia without an increase insulin sensitivity as a factor, and the growth hormone response to hypoglycemia was normal. An intravenous glucagon test caused a subnormal increase in plasma glucose concnetration, and the intravenous administration of tolbutamide produced hypoglycemia without an increase in insulin values. The plasma alanine concentration was low and the proinsulin/insulin ratio was increased. The origin of this hypoglycemia is not clear but is probably multifactorial. However, low hepatic glycogen stores and inadequate gluconeogenesis due to substrate deficiency seem to be involved.     

L'histogenèse régénératrice chez les phoronidiens

Summary The regeneration (organogenesis was studied by Emig, 1972 a, b) of Phoronida can be divided into three phases: the first one, cicatrisation, is characterized by a provisional mesodermal scar-tissue, later the old epidermis cover this scar-tissue. The regenerating blastema, second phase, takes place by cellular dedifferentiation processes; each germ layer (ectoderm, mesoderm, endoderm) regenerates itself from its own elements. One exception only seems to be oesophagel regeneration by metaplasia of the prestomacal cells during the asexual reproduction. The differentiation of the amputated structures (third phase) appears submitted to the inductive influence of the mesoderm and to the trophic action of the nervous system (especially the epithelial plexus). The polarity in regeneration sets a problem in Phoronida.

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Ce travail a été effectué dans le cadre du contrat L. A. n 41 au C. N. R. S.     

Comment je raisonne devant une masse rétropéritonéale

The retroperitoneal masses are various and heterogeneous and include tumors from different organs (kidneys), the primary retroperitoneal tumors and metastasis. The primary retroperitoneal tumors are rare, frequently malignant with a delayed diagnosis. More than half of them are sarcoma. Rarity and heterogeneity of retroperitoneal tumors explain the difficulties of diagnostic. The goal of this article is to review the imaging characteristics of CT scan and RMN of retroperitoneal mass and to clarify the diagnosis. The management of sarcoma requires an expert multidisciplinary team (pathologist, radiologist, surgeon, oncologist) and pathology analysis by retroperitoneal transcutaneous biopsy.     

Familles moléculaires et réactions croisées en allergie

Le risque pour une personne de développer des manifestations allergiques est plus grand si elle a des antécédents familiaux d’allergie: on parle de terrain atopique.