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.     

Température et plasticité du chromatisme de la coquille chez le mollusque pulmoné Helix aspersa

Phenotypic plasticity of shell pigmentation in the land snail Helix aspersa was investigated with the help of image processing followed by pixel counting for each colour present on the shell. Thus, the use of three different growth temperatures under artificial conditions showed, for the two subspecies considered, a continuous colour gradient from red to dark of the shell banding. Darker pigmentation characterized low temperatures while red bands were related to the higher temperature (25 °C). No interpretable difference appeared between the two forms.     

Varicocèle et infertilité masculine

Introduction

Male responsibility in couple infertility has been established in several studies. The purpose of this research was to report varicocele clinical and spermatic aspects and assess the outcomes of open retroperitoneal varicocelectomy.

Patients and methods

Our study is a retrospective assessment of the outcomes of open retroperitoneal varicocelectomy at the urology department of Aristide Le Dantec teaching hospital (Senegal). Our focus is on patients with varicocelectomy facing couple infertility (inability for sexually active couples who are not using contraceptive methods to obtain a pregnancy over a year), patients among which no other infertility cause was revealed in their partner or partners in polygamist households. To assess the results, we compared the averages of preoperative and postoperative spermatic parameters by using the Z test (comparison test of two averages on two mated series). A difference was regarded as significant if P ?? 0.05.

Results

Five hundred and fourteen cases were examined over 6 years (January 2005?CDecember 2010). The average age of the patients was 36.5 ± 7.3 years. The infertility was primary in 62.4%. The analysis of the preoperative spermograms revealed that severe oligozoospermia (33.7%) was the most common abnormalities in the sperm cells concentrations. The abnormalities in the sperm cells concentrations were variously connected with an asthenozoospermia and to a theratozoospermia. The patients were monitored with an average hindsight of 22 months (6?C48 months). The improvement of the parameters was more significant on the concentration and the mobility of sperm cells. The natural pregnancy rate obtained in our study was 20.8%. The registered pregnancies were more important in the group IV (48%). No case of natural pregnancy was noted in the group I but an induction of the spermatogenesis was noted in 20.5% of the cases. About two thirds of natural pregnancies (64%) were noted during the first 12 post-operative months.

Conclusion

The surgical treatment of varicocele allows improving the spermatic parameters. Not only do these improvements help obtain natural pregnancies but also simplify the techniques of ART planned with the preoperative spermatic parameters.     

Mise au point Estrogènes et reproduction chez le mâle

Aromatase is the terminal enzyme responsible for estrogen biosynthesis. Besides somatic cells, the aromatase gene expression and its transduction in a fully active protein in germ cells of rodent testes in one hand, the widespread distribution of estrogen receptors (ERα and ERβ) in the genital tract of the male in an other hand, are clearly in favour of a physiological role for estrogens in the regulation of mammalian testicular functions. In mouse and man, the aromatase deficiency is associated with severe bone maturation problems and sterility. Therefore, together with gonadotrophins and androgens, estrogens (or the balance androgens/estrogens) likely play a physiological role (either directly or via testicular somatic cells) in maintenance of male gonadal functions and obviously, several steps are concerned especially the spermatid production (both in terms of quality and number) and epididymal sperm maturation.     

Le recueil de sperme chez le blessé médullaire

Infertility is a major issue for men with spinal cord injury (SCI). Male infertility is due to a combination of ejaculatory dysfunction and abnormal sperm quantity and quality. The reported ability to ejaculate during sexual stimulation or masturbation is about 15%. Techniques to remediate ejaculation have vastly improved the fertility potential of men with SCI. Penile vibratory stimulation (PVS) to induce ejaculation is now recommended as first-line treatment due to its safety and relative efficacy. PVS can also be used at home for fertility purposes with success rates of more than 70%. Pharmacological treatments can be associated with PVS to enhance ejaculation. Midodrine, an alpha1-adrenergic agonist, has been recently used with success rates of 66% in SCI patients who failed PVS alone. PVS with midodrine can now be considered as second-line treatment for anejaculation, after PVS and before electroejaculation. It is a safe procedure, but requires cardiovascular monitoring. PVS with midodrine can also be effective in the treatment of retrograde ejaculation by inducing bladder neck closure.     

Asynchronisme cardiaque chez le sujet à QRS fin. Étude par échocardiographie Doppler tissulaire

ObjectiveTo assess the prevalence of different types of cardiac dyssynchrony by pulsed Doppler ultrasound and Doppler tissue in patients with narrow QRS with or without left ventricular systolic dysfunction.MethodologyProspective, cross-sectional survey at the Institute of Cardiology of Abidjan, from January to April 2012, in subjects with narrow QRS. Group 1: patients with dilated cardiomyopathy with severe left ventricular dysfunction (left ventricular end diastolic diameter greater than 60 mm and/or 30 mm/m² and ejection fraction less than 35% NYHA stage IV). Group 2: normal subjects with normal echocardiography. All patients underwent an evaluation including tissue Doppler search for different types of dyssynchrony (atrioventricular, interventricular and left intraventricular).ResultsPatients in group 1 were significantly older (51.5 ± 15.8 vs. 35.8 ± 7.8, P = 0.03), with larger left ventricular diameters and significantly higher pulmonary systolic pressure. The prevalence of different types of dyssynchrony in group 1 were: atrioventricular dyssynchrony 43.7%, interventricular dyssynchrony 37.5%, left ventricular dyssynchrony 65.6%. Group 2: atrioventricular dyssynchrony 0%, interventricular dyssynchrony 0%, left ventricular dyssynchrony 35%.ConclusionA large proportion of patients with left ventricular systolic dysfunction and narrow QRS have cardiac dyssynchrony and left ventricular dyssynchrony can be found in healthy patients. This raises the problem of the specificity of Doppler ultrasound criteria using cardiac tissue Doppler to assess cardiac dyssynchrony.     

Localisation ultimobranchiale et thyroidienne des cellules C (cellules à calcitonine) chez deux Columbidae: le pigeon et le tourtereau

Résumé Chez les deux Columbidae étudiés, les cellules C sont présentes à la fois dans les corps ultimobranchiaux et dans la thyroïde. Les corps ultimobranchiaux sont constitués de cordons renfermant des cellules glandulaires et des cellules bordantes. Dans certaines zones périphériques de la thyroïde, des cordons ultimobranchiaux typiques sont localisés dans les espaces interfolliculaires et sous-capsulaires. Des cellules C folliculaires basales analogues à celles de la thyroïde du mammifère sont rarement observées.Les caractères morphologiques des cellules C sont identiques quelle que soit leur localisation: ultimobranchiale, thyroidienne extrafolliculaire ou folliculaire basale. Les granules sécrétoires diffèrent légèrement par leur forme chez le pigeon et le tourtereau; leur diamètre moyen est plus variable d'une cellule à l'autre chez le pigeon.Des contacts neuroglandulaires existent au niveau des cordons glandulaires localisés dans les corps ultimobranchiaux et dans la thyroïde. Leur signification reste obscure.

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Ultimobranchial and thyroidian localization of C cells in two Columbidae: the pigeon and the turtle-doveAn electron microscopic study

Summary In the two Columbidae we studied, C cells are present both in the ultimobranchial bodies and in the thyroid. Ultimobranchial bodies consist of cords which are made up of glandular cells and limiting cells. In certain peripheral regions of the thyroid, typical ultimobranchial cords are situated in the interiollicular and infracapsular spaces. Basal follicular C cells similar to those of the mammalian thyroid are rarely observed.The morphological characteristics of the C cells are identical whatever their situation may be: ultimobranchial or thyroidian, be it extrafollicular or basal follicular. The secretory granules differ slightly by their shape in the pigeon and the turtle-dove; their medium diameter varies more from one cell to another in the pigeon.Neuroglandular contacts exist at the level of the glandular cords situated in the ultimobranchial body and in the thyroid. Their signification is not clearly understood.

     

Polymorphisme électrophorétique des protéines et enzymes sériques et érythrocytaires chez le chimpanzé (Pan troglodytes)

Summary The electrophoretic mobilities of serum enzymes and other proteins were investigated at 35 loci in 25 unrelated individuals of the chimpanzee Pan troglodytes. In this population the mean average of individual polymorphism is =0181, and the average level of heterozygoty =0.022. The same pattern of individual variability is found in Pan troglodytes and Homo sapiens.