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.     

Pour une histoire du désir

The striking feature of the history of sexual desire is the contrast between the omnipresence of sexual desire in human societies, regardless of the period considered, and the negative representation constantly and systematically given to this desire by philosophers and religious leaders. Sexual desire was automatically rejected by those who were disgusted by the animal side of man. The Stoics of the first century A.D., rapidly followed by theologians of the young Christian religion, were convinced that animals only act to satisfy their physical needs, but that moral man had to distinguish himself from the animals by refusing to act simply for pleasure. For Cicero and Seneca “seeking an act because of the pleasure it procures is an abuse”. They applied this principle to food as well as bodily care: unthinking animals live to eat, while moral humans eat to live; food and maintenance of the body ensure health but do not provide pleasure. Similarly, sexuality is only justified for reproductive purposes. However, as already observed by Saint Augustine, this is not the way in which human beings act, and this Church Father had to admit that he had never met a husband able to claim that he “only had sexual intercourse in the hope of fathering”. Other thinkers were more moderate and distinguished acceptable desire, kept under the control of reason and leading to positive action from degrading, irrational desire ending in passion (always considered to be unreasonable). Only the second form of desire must be avoided; the first leads to happiness and fulfilment and remains the force that usually drives human action. Christian thinkers of the Middle Ages, attentive to the real life of believers, finally accepted that the human characteristic of memory is one of the most beautiful gifts of God, allowing man to remember past pleasures and therefore to rightfully experience the desire to repeat these pleasures: coitus without a reproductive purpose therefore appears to be part of the divine plan. A theologian, in contrast with dominant religious opinion, even declared “if someone eats a pear or a beautiful fruit only for the pleasure, it is not a sin. The same applies when a man has intercourse with his wife only for the pleasure”. However, far from theoretical discussions, individuals declared their deep attachment to desire, during the Renaissance, at the court of the Sun King, in salons of the Enlightenment or even, in contrast with a widely held belief, in the new industrial world of the 19th century. Today, while religious authorities still generally have a Stoic view of pleasure and desire, modern thought has advanced in its understanding of the place of desire in human experience and recognizes it an essential driving role responsible for fulfilment and a powerful stimulus for all forms of creativity. The history of sexual desire therefore corresponds to the steps of enrichment of basic animal instinct by the human species and the individual and social forms of expression of this desire.     

La biologie délocalisée, une activité transversale

A ce jour, aucun texte réglementaire ne permet d’obliger le biologiste à mettre en œuvre un système d’assurance qualité adapté à la gestion de la biologie délocalisée. La SFBC a réuni un groupe d’experts afin de formaliser des recommandations dès 1998 [1]. Actuellement, ce sujet est à l’ordre du jour des organismes internationaux, et il est vraisemblable qu’une normalisation interviendra dans le futur, à terme opposable aux biologistes en relation avec un établissement de soins pratiquant une délocalisation des analyses de biologie médicale: une annexe à la future norme ISO/CEN 15189 concernant les recommandations pour la biologie délocalisée est en cours de validation, faisant suite aux recommandations du groupe européen EC4 [2].     

Expérience clinique avec une épreuve de réserve hypophysaire

A test of pituitary reserve was used in the investigation of 14 children with retarded growth and 15 adults with endocrine disorders. Mepyrapone (Metopiron), 500 mg. every four hours, was administered orally for 48 hours. The pituitary response was determined by the amount of 17-hydroxycorticosteroid in a 24-hour urine sample (by a modification by Peterson of the Porter-Silber method). Pituitary reserve was decreased in four patients who were pituitary dwarfs, one who had retarded growth, two patients with Sheehan''s syndrome, three with pituitary tumours, one who had panhypopituitarism without a tumour, and one case of limited adrenal reserve (confirmed by a negative response to ACTH stimulation). The pituitary reserve was normal in three patients with gonadal dysgenesis, three who exhibited retarded growth, one case of diabetes insipidus, one cretin, one patient treated by steroids, three with psychogenic amenorrhea, and five normal controls. It is concluded that this test of pituitary reserve is useful in the assessment of children with growth retardation and in establishing the diagnosis of pituitary insufficiency in adults.     

Une rickettsiose chez une Cétoine de Madagascar

Résumé Des larves de Cétoines non encore déterminées se sont révélées atteintes d'une rickettsiose dans une localité du nord-est de Madagascar. L'agent pathogène, de 730 mμ×240 mμ, se développe dans le cytoplasme du tissu adipeux, de l;hypoderme et des œnocytes et est accompagné par les cristaux déjà observés dans la plupart des rickettsioses d'insectes.Rickettsiellen cetonidarum est proposé comme dénomination.

---

Summary Larvae ofCetonidae not yet determined were found affected with a rickettsial disease in a biotop in the North East of Madagascar. The pathogenic agent measuring 730 mμ×240 mμ develops in the cytoplasm of the fat body, the hypoderm and the oenocysts; it involves formation of accompanying crystals previously observed in most of the insect rickettsioses. Rickettsiella cetonidarum is suggested as a denomination of the pathogenic agent.

     

Le sujet cérébral: une esquisse historique et conceptuelle

Since the middle of the 20th century, numerous discourses and practices, both within and outside scientific and philosophical disciplines, have manifested the development of the notion of the human being as acerebral subject. The brain appears to be the only organ of the body that we need, and that has to be exclusively ours, in order for each individual to be himself or herself. Sincepersonhood is the quality or condition of being an individual person,brainhood is thus the quality or condition of being a brain. This property defines the cerebral subject. The anthropology ofbrainhood may seem a natural consequence of progress in the neurosciences. However, it is rooted in 17th-century developments in the philosophies of matter and personal identity. The neurosciences confirm and reinforce this perspective. The author outlines the historical narrative concerning the development of the cerebral subject as well as some contemporary issues arising from the neurosciences.     

Impact de la varicocélectomie chez les patients ayant une azoospermie non obstructive ou une oligozoospermie sévère

Objective

To evaluate the changes induced by retroperitoneal varicocelectomy on infertile men with nonobstructive azoospermia or severe oligozoospermia.

Patients and methods

The records were retrospectively evaluated for 46 infertile men with severe oligozoospermia (group I) and 15 infertile men with non-obstructive azoospermia (group II). The parameters of sperm before and after surgery and unassisted pregnancy rate were comparatively analysed.

Results

In the severe oligozoospermia group, the mean age of patients was 35.5 ± 6.4 (23–47 years). The mean duration of infertility was 4.9 ± 3.4 years (1–13 years). Of these patients, 41(89.1%) had bilateral varicocele and five (10.9%) had unilateral left-side varicocele. The varicocele was classified as grade I in two cases (4.3%), grade II in 39 cases (84.7%) and grade III in five cases (10.9%). After surgery, the mean sperm count increased from 1.85 ± 1.4 to 8.3 ± 10.3 millions/ml and mean sperm normal motility from 43.3 ± 21.5 to 47.6 ± 29.2%. The mean sperm abnormal morphology decreased from 65.05 ± 21.6 to 50.08 ± 26.9%. After a mean follow-up of 26.2 ± 11.6 months, the unassisted pregnancy rate in this group was 26.1%. In the non-obstructive azoospermia group (N = 15), the mean age of patients was 40.8 ± 7.2 (27–47 years). The mean duration of infertility was 6 ± 3.1 years (3–15 years). After varicocelectomy, an induction of spermatogenesis was observed in three patients (20%) with presence of motile sperm in the ejaculate. In this group, only one of the 15 men achieved unassisted pregnancy.

Conclusion

Retroperitoneal varicocele repair resulted in spermatogenesis induction with presence of motile ejaculated spermatozoa for some men with non-obstructive azoospermia. It induced spermatogenesis and fertility enhancement in men with severe oligozoospermia. Varicocele repair should be considered in men with non-obstructive azoospermia or severe oligozoospermia.     

La consultation psychologique dans l’indication d’une prothèse pénienne : une expérience originale de complémentarité médicopsychologique

In the Center for the Study and Treatment of Male Sexual Dysfunction (CETISM) of our University Department of Urology, a psychological consultation is systematically provided when penile prosthesis implantation is considered by the patient ?? and the urologist ?? as a possible solution to his erectile dysfunction. This consultation has three key objectives: to identify ?? rare ?? cases of psychological contraindication, to complete the information already given to the patient during urologic consultations, and to explore the relational, emotional, cognitive and erotic aspects that could influence the decision-making and the integration of the prosthetic solution. It is also and especially to give to the man a central position, an active position, not only for the decision-making, but also for developing a life project which takes into account the decision (positive or negative), a position he often lost from the time he had become ??powerless??.     

Réduction des effets de la respiration en imagerie TEP pulmonaire par une acquisition synchronisée à la respiration associée à une TDM en apnée

Respiratory motion causes a spread of lesion uptake over a larger area in Positron Emission Tomography (PET) images for moving structures. When CT images are used for attenuation correction of emission data, this motion may alter the quantization of PET images. We present the clinical results of a respiratory-gated PET processing “CT-based” method, which aims to improve PET-CT coregistration by using an additional breath-hold CT (BH-CT). The CT-based protocol consisted in a 10-min List Mode respiratory-gated PET acquisition, followed by an end-expiration BH-CT acquisition. During these two examinations, the respiratory signal was recorded continuously. Eleven pulmonary lesions were studied. Patients underwent both a standard clinical PET protocol (free breathing) and the CT-based protocol. The respective performances of the CT-based and clinical PET methods were evaluated by comparing the distances between the lesions’ centroids on PET and CT images. SUV_MAX (Standardized Uptake Value) and volume variations were also investigated. The CT-based method showed a significant reduction (p = 0.049) of centroid distances (mean relative change versus standard method: 49%). We also noted a higher SUV_MAX (mean change: 39%). Lesion volumes were significantly lower (p = 0.026) in CT-based PET volumes (mean change: 43%) compared with standard ones. The CT-based method improves PET-CT coregistration of pulmonary lesions. This protocol should lead to more accurate attenuation correction and thus improve SUV measurement.     

Création d'une lignée homozygote pour une translocation réciproque chez l'Amphibien Pleurodeles waltlii

Résumé Chez le Pleurodèle, une étude cytogénétique portant sur quatre géné-rations successives a permis d'obtenir une lignée stable d'individus féconds homozygotes pour une translocation réciproque.L'anomalie a d'abord été décelée à l'état hétérozygote chez une femelle résultant du croisement entre une femelle normale et un mâle irradié aux rayons X. Le remaniement chromosomique initial consiste en un échange réciproque de segments inégaux entre le bras court d'un chromosome 5 et le bras long d'un chromosome 6. Il en résulte un allongement du bras court d'un chromosome 5 correspondant à un raccourcissement d'égale amplitude du bras long d'un chromosome 6, soit la formule 24, t(5p+; 6q-) par analogie avec le système utilisé pour les caryotypes humains.Contrairement à ce que l'on aurait pu supposer, la ségrégation des chromosomes remaniés n'est pas perturbée au cours de la méïose des animaux 24, t(5p+;6q–).Lors des croisements entre un individu hétérozygote pour la trans-location et un individu normal ou entre deux hétérozygotes, la descendance est constituée de germes phénotypiquement normaux ou anormaux selon leur constitution chromosomique.Les sujets 24, t(5p+; 6q–) et 24, 2(5)–, 2(6)–,2(5p+) +, 2(6q–)+ ont un caryotype équilibré, leur phénotype est normal. Les formules déséquilibrées sont par contre léthales ou semi-léthales.Les embryons 24, 6–, (6q–)+ et 24, 5–, 2(6)–, 5p+, 2(6q–)+ présentent rigoureusement le même syndrome. Ils meurent peu de temps après l'éclosion sans pouvoir se nourrir. Les ébauches branchiales sont pratiquement inexistantes, l'il est malformé et la bouche reste béante.Les deux formules 24, 5–, (5p+)+ et 24, 2(5)–, 6–, 2(5p+)+, (6q–)+ déterminent de même un autre syndrome caractéristique. Dans ce cas, chez les embryons âgés et les jeunes larves, les malformations sont discrètes et transitoires. Elles se situent au niveau des yeux et des branchies. Il est difficile d'élever ces animaux jusqu'à l'âge adulte. Ceux qui survivent ont un corps disproportionné et des anomalies du squelette vertébral.Les deux formules 24, 2(6–), 2(6q–)+ et 24, 2(5)–, 2(5p+)+ ont un déséquilibre tel que les embryons ne dépassent pas le stade de la gastrula.L'examen des figures méïotiques de mâles hétérozygotes pour l'anomalie confirme les résultats obtenus à partir de l'étude des phénotypes et des caryotypes des descendants. La première division méïotique comporte 10 bivalents et un tétravalent tandis que l'examen des caryotypes établis à partir des métaphases II montre qu'il ne se forme que quatre types différents de gamètes.Le chromosome 6q– se reconnaissant aisément à l'examen microscopique direct, la translocation constitue un marqueur nucléaire facilement utilisable car les individus homozygotes pour l'anomalie ont une croissance et une méïose normales.

---

A homozygous reciprocal translocation in a strain of the newt Pleurodeles waltlii

A cytogenic study dealing with four generations of the newt Pleurodeles waltlii has lead us to a stock of fertile homozygotes for a reciprocal translocation. —The chromosomal rearrangement has first been detected at the heterozygous state in a female resulting from a cross between a normal female and a male submitted to X ray-irradiation. The initial aberration consists of a reciprocal exchange of unequal segments between the short arm of a chromosome 5 and the long arm of a chromosome 6. Consequently, the short arm of chromosome 6 grows shorter in the same proportion (formula 24, t(5p+; 6q–), on the analogy of the human chromosome standardization).—Against all expectation, meiosis in 24, t(5p+;6q–) animals leads to a normal segregation of abnormal chromosomes.—When a heterozygote for translocation is bred with a normal individual or when two heterozygotes are crossed, the offspring is composed of phenotypically normal or abnormal animals, depending on their karyotypes.—The subjects 24, t(5p+; 6q–) and 24, 2(5) –, 2(6) –, 2(5p+) +, 2(6q–)+ have balanced karyotypes; their phenotype is normal. On the other hand, the unbalanced types are lethal or semi-lethal.— The 24, 6–, (6q–)+ and 24, 5–, 2(6) –, 5p+, 2(6q–)+ embryos show a strictly identical syndrome. They die soon after the hatching stage without having been able to eat. The branchial outlines are almost inexistant, the eyes are poorly-formed and the mouth stays wide-open.—The two formulas 24, 5-, (5p+)+ and 24, 2(5) –, 6 –, 2(5p+)+, (6q–)+ produce the same phenotypic aberrations as well. In this case, malformations in older embryos and young larvae are discrete and transient. They are localized at the eye and branchial levels. It is difficult to rear these animals until adulthood. Those that survive, have a disproportionate body and malformations of the vertebral skeleton.—The two formulas 24, 2(6) –, 2(6q–)+ and 24, 2(5) –, 2(5p+) + are so unbalanced that the embryos do not survive beyond the gastrula stage.—The study of the meiotic slides of male heterozygotes bring a cytologie confirmation to the results obtained from the study of the phenotypes and karyotypes established on the offspring. The first meiotic division shows 10 bivalents and one quadrivalent, whereas the study of the karyotypes from the metaphases of the second meiotic division prooves that only four types of different gametes can be formed.—The 6q– chromosome is easily recognizable under direct microscopic study. This translocation constitutes a nuclear marker which can be easily used because the homozygotes for the aberration grow normally and show a normal meiosis.

---

---

Cet article recouvre en partie le travail d'une thèse de Doctorat d'Etat de Sciences naturelles qui sera soutenue dans le courant de l'année 1971.     

Bilan scintigraphique osseux d’une hypercondylie unilatérale

A 10-year-old girl with unilateral condylar hyperplasia was referred to our department for a bone scan. We describe the role of the bone scan in this condition. Unilateral condylar hyperplasia is a rare disease of the mandibular condyle cartilage growth leading to facial deformity. Bone scan demonstrates the active or inactive nature of condylar hyperplasia and orients therapy. A planar bone scan completed by single-photon emission computed tomography (SPECT) combined with CT was performed. Increased uptake of the left mandibular condyle, particularly well demonstrated on SPECT images, was seen. This was confirmed by relative quantification and helped decision making to surgical treatment.     

Sur une Sphaerophrya (Cilié) ectoparasite des Euplotes

Résumé Sphaerophrya canelli n. sp. est un Tentaculifère ectoparasite exclusivement fixé sur les Ciliés Euplotes eurystomus et patella; en culture il n'a parasité aucune autre espèce de Ciliés Hypotriches, Hétérotriches ou Gymnostomes cyrtophores. Il ne présente pas de stade pédonculé ni de kyste. Il est sphérique, de 10 à 25 µ de diamètre; il se place de préférence dans le péristome des Euplotes, où il se divise par bourgeonnement externe en donnant un embryon nageur dont la ciliature est composée de 5 à 6 rangées qui font le tour du bourgeon d'un pôle à l'autre sans se rejoindre. Sa présence sur l'Euplotes provoque de profondes lésions dont la plus grave est une dégénérescence du no yau de l'hôte, phénomène de pycnose déjà dècrit par Canella (1957). Une révision des genres ecto-et endoparasites, et des espèces du genre Sphaerophrya, permet de dire que Sphaerophrya canelli n`a pas été décrite avant Canella.Centre de Recherches Hydrobiologiques     

Présence dans une population congolaise deMus (Leggada) triton Th. de femelles hétérozygotes pour une délétion caractérisée par la suppression du bras court de l'un des chromosomes X métacentriques

A sample of 12Mus (Leggada) triton Th. from the region of Bukavu (Democratic Republic of Congo) contains 5 ♂♂ and 7 ♀♀. 2N=32. All the autosomes are acrocentric. The sex-chromosomes of the ♂ are of the typeX—Y, theX beeing a big submetacentric (I.C.=0,4). Three ♀♀ possess two metacentricX, as expected. By four ♀♀, there is only one typicalX whose partner is acrocentric and as long as the long arm of a normalX. ThisX must have been arisen through the deletion of the short arm and is calledX _ddc. The statistical analysis of the sample is compatible with this pattern:

$$\begin{array}{*{20}c} { \circ \circ } \\ { + + } \\ \end{array} \begin{array}{*{20}c} {X---X = 4/9} \\ {X---X_{dc} = 4/9} \\ {X_{dc} ---X_{dc} = 1/9} \\ \end{array} \begin{array}{*{20}c} { \nearrow \nearrow } \\ { \circ \circ } \\ \end{array} \begin{array}{*{20}c} {X---Y = 2/3} \\ {X_{dc} ---Y = 1/3} \\ \end{array} $$