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.

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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.

     

Modifications faunistiques engendrées par une faible variation de débit dans une grande rivière

Artificial substrates suspended in the water column and benthic dredging were employed to study the drift of macrofauna and the macrobenthic populations respectively, in a cross section of the Rhône River upstream of Lyon, France. The samples were collected in autumn 1979: first in September under a low flow egime around 400 m³·s^–1, then in October during a discharge increase up to 630 m³·s^–1.The first factor of correspondence analysis showed a clear cleavage between the two periods, especially for drift communities. The differences are most important in the centre of the stream channel. In October, the water column was invaded by unusual and abundant fauna. This dynamics is due to the increase in number of Crustacea (Gammarus fossarum, Asellus aquaticus), the decrease of some insect larvae (Leuctra fusca, Simuliidae, Baetis fuscatus, stages 1 and 2 of Hydropsyche) and the appearance of typical wetland taxa (some limnophilous Coleoptera and Trichoptera). For some other dominant invertebrates, a modification may occur only in their distribution (stages 3 to 5 of Hydropsyche, Heptagenia sulphurea) while the distribution of Psychomyia pusilla remains the same.These results are discussed with respect to the effects of species biology and the unusual consequences caused by a minor increase in discharge.

Structure et fonctionnement des écosystèmes du Haut Rhône français n° 46.     

Les lésions de l’urètre associées à une fracture des corps caverneux. A propos d’une série de 4 cas et revue de la littérature

Introduction

Urethral injury associated with corpora cavernosa fracture is a relatively uncommon form of urological trauma. Early diagnosis and immediate surgical repair are essential.

Patients and methods

Between January 1990 and December 2004, a total of 4 male patients with urethral injury associated with fracture of the corpora cavernosa were retrospectively studied from a series of 96 cases of penile fracture.

Results

The mean age of the patients was 36.5 years (range: 27–45 years). Urethral bleeding was noted in all patients. Immediate surgical repair via a penile circular subcoronal incision was performed in all cases. Two partial urethral injuries associated with a unilateral corpus cavernosum lesion were identified. In the other cases, total urethral injury was associated with bilateral rupture of the corpora cavernosa. The tunica albuginea defect was closed and the urethral laceration repaired over a urethral catheter. With a mean follow-up of 2.5 years, 2 short urethral strictures were observed and were managed non-operatively with good outcome.

Comments

Secondary urethral lesions associated with corpora cavernosa fracture most frequently affect young adults. In North African countries, forced self-manipulation of an erect penis is the most frequent cause, but the associated urethral lesion is usually related to vaginal intercourse. The diagnosis can generally be made on the basis of history and physical examination alone. Blood at the meatus or haematuria or voiding difficulties suggest associated trauma to the urethra [4]. Additional imaging examinations are rarely required. The standard treatment is prompt surgical exploration, evacuation of haematoma, and primary repair of the urethral and corpora cavernosa defects. Late complications after surgical repair are penile curvature and pain during coitus. They are usually attributable to a residual fibrotic area.

Conclusion

Urethral injury associated with corpora cavernosa fracture usually has typical signs. The mechanism of trauma is very suggestive. Early surgical treatment is the only guarantee of a satisfactory functional result.     

Détection scintigraphique préopératoire de métastases pulmonaires d’un carcinome vésiculaire de la thyroïde associé à une hyperthyroïdie

Preoperative accumulation of radioiodine in metastases of thyroid carcinoma and its association with hyperthyroidism are uncommon. We report a case of 58-year-old woman with follicular thyroid carcinoma revealed by thyrotoxicosis caused by a hot nodule, and bilateral pulmonary uptake of I-131 before total thyroidectomy. Despite four ablative doses of I-131, bone metastases were identified and the patient died 42 month after the initial diagnosis.     

Sur l'espace topologique lié à une nouvelle théorie de l'apprentissage

There have been two contrasting doctrines concerning learning, more generally about acquisition of knowledge: empiricism and rationalism. The theory of learning in such a field as artificial intelligence seems to fall within the empiricist framework. On the hand, N. Chomsky and his followers have discussed, during the last decade, concerning learning, especially about language learning, from the rationalist point of view (Chomsky, 1965). The main feature in the rationalist approach toward a theory of learning lies in the speculation that in order to acquire knowledge it is indispensable for a learner to be endowed with “innate ideas”, and that “experience” in the external world are merely subsidiary types of information for the learner. If this is acceptable, we can inquire: Under what kind of innate ideas can the learner understand the structure of the external world? In our previous paper (Uesaka, Aizawa, Ebara, and Ozeki, 1973), we formalized this by introducing the mathematical notion of “learnability”, and gave a partial answer to the above inquiry. In this formalization we assumed that the set F of objects to be learned consists of mappings of N to itself, where N is the set of positive integers. Then, constructing a topological space (F, \(\mathcal{O}\) ) by an appropriate family \(\mathcal{O}\) of open sets, we observed that the notion of learnability can be well described in terms of topological properties of the learning space (F, \(\mathcal{O}\) ). Many problems must be solved, however, before we raise the theory to a complete model of the rationalist theory of learning. The topological study of the space (F, \(\mathcal{O}\) ) is, we believe, the first step toward this approach. In this context, we discuss the topological aspects of this space. Now we define \(\mathcal{O}\) as follows: By N ² we mean the direct product of two N's. Let s be a subset of N ². If, for any (x, y), (x′, y′) in s, x=x′ implies y=y′, then we say that s is single-valued. Let f ∈ F, If, for any (x, y) in s, y=f(x), then f is said to be on s, denoted as \(f\underline \supseteq s\) . Let \(\pi \left( s \right) = \left\{ {g;g \in F,g\underline \supseteq s} \right\}\) . A single-valued finite subset of N ² is called datum. Let D denote the family of all data. Let \(\mathcal{O}* = \left\{ \phi \right\} \cup \left\{ {\pi \left( d \right);d \in D} \right\}\) , and \(\mathcal{O}\) denote the family of all subsets of F, each of which is written as \(\mathop \cup \limits_\alpha W_{\alpha }\) , where W _α is in \(\mathcal{O}*\) . Then, it is easily seen that \(\mathcal{O}\) satisfies the axiom of the open system of a topological space. It is shown that the learning space (F, \(\mathcal{O}\) ) has the following properties:

1. It satisfies the first and the second countability axioms.
2. It is separable and is totally disconnected.
3. It is a Hausdorff space and, further, is regular and normal.
4. It is neither compact nor locally compact.
5. It is metrizable, or more precisely there exists a complete but not totally bounded metric space which is homeomorphic to learning space.
6. Any of its subspace can be embedded into its special subspace.

     

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.     

Pour une approche « neurocognitive « de la mémoire: apport de la neuropsychologie

Cognitive models suggest that memory consists of potentially independant modules. In addition, clinical data lead to a reference to the central systems that interact with these operative modules, and which assign significance and pertinence to the information being processed. Such an organization fits better with clinicial data, since it can be demonstrated with the example of episodic or procedural memories as both require the activation of strategic processes, under the control of the prefrontal cortex, needed for the organization or the control of the information to be processed.     

Une discordance ante albienne datée par une fauned'Ammonites et de Brachiopodes de type téthysien au Mexique central

North of Leon (Guanajuato), a major unconformityis described under a shallow marine carbonate horizon overlying a strongly folded volcanic and detritical series. The Late Albian age of the limestone is indicated by a small assemblage of ammonites including the genera Eohypoturrilites, Pseudouhligella, Salaziceras and Eutrephoceras and Terebratulinidae of the genus Moutonithyris. The emplacement of this fauna demonstrates the westward extension of the Lower Cretaceous carbonates of the eastern Mexican platform. This unconformity shows the importance of pre-Albian tectonics as far as central Mexico.     

Carcinome urothélial de l’urètre: une nouvelle observation et revue de la littérature

Urothelial carcinoma of the male urethra is a rare tumour. We report a new case of urothelial carcinoma of the urethra in a 64-year old man who was examined due to a dysuria. Retrograde and voiding urethrocystography carried out had shown images of bulbopenile urethral stricture treated by urethroplasty. Histological examination of the urethrectomy part revealed a urothelial carcinoma of the urethra. The patient refused any additional treatment and survived 14 months after diagnosis.     

Face à une suspicion de cancer ou de récidive de cancer : pratiques,communication et difficultés des médecins nucléaires français

Nuclear imaging techniques have been occupying an increasingly large place in the study of potentially cancerous morphological abnormalities. A National French survey was conducted among members of the French Society of Nuclear Medicine (Société française de médecine nucléaire) to study the usual practices of nuclear medicine physicians regarding information and communication during the “pre-announcement” stage of a cancer diagnosis. Sixty-six doctors (with an average of 44.7 years of age and 16.3 years of experience) working in mainland France responded to the online survey between November 2013 and February 2014. Most physicians said that they were uncomfortable in this kind of situation. Half of the doctors interviewed faced that situation at least 5 times a month. Communication habits were varied: 20% of them adopted a systematic approach (chose ‘always’ or ‘never’ to communicate information regardless of the patients’ demands) and 80% adapted their approach to the situations and to the patients (communication ‘on case by case basis’ and ‘upon request’). The survey also showed that professionals have contrasting views on the relevance, interest and risks of informing patients about the results of the tests in this kind of situation. Our study shows that it is necessary to discuss the position of nuclear medicine physicians in the pre-announcement procedure set out in the French Cancer Plan so as to reduce the challenges facing them while at the same time organizing and defining their roles.     

Mollusques terrestres et températures : une nouvelle fonction de transfert quantitative

Terrestrial molluscs are reliable environmental proxies in Quaternary sequences. Correlations between the geographic distribution of the species and the minimum mean monthly temperature and the annual thermal magnitude distributions have been characterised. New temperature estimates based on the Mutual Climatic Range method were then performed. The latitudinal thermal gradient has been reconstructed using modern assemblages from Western Europe, and a calibration on modern temperature values has been calculated. The application to the sequence of Achenheim (Alsace, France) allowed the reconstruction of the temperature variations of the last climatic cycle. To cite this article: O. Moine, D.-D. Rousseau, C. R. Palevol 1 (2002) 145–151.     

Les manifestations hématologiques du lupus érythémateux systémique. A propos de 70 cas dans une série de 80 LES

Abstract

Systemic lupus erythematosus is a non-organ specific auto-immune disease which commonly has haematological manifestations. The aim of this study was to assess the epidemiological aspects of haematological manifestations among 80 patients with systemic lupus erythematosus (SLE).

Methods

A retrospective study of 80 SLE patients covering the period between 1990 and May 2005.

Results

From among the 80 patients with SLE, 70 had haematological manifestations, of which 65 women and 5 men. Average age was 32.41 years. The most commonly-observed haematological manifestation was anaemia (83.75%), followed by bicytopaenia (63.75%) then leukocytopaenia and/or lymphocytopaenia (62.5).     

Longueur du chromosome Y,intelligence et comportement dans une population de médico-légaux

Summary The Y/F ratio was established in 128 mentally disordered offenders in a maximum security hospital. The 50 Y/F 0.90 subjects were compared with the 78 Y/F<0.90 subjects as regards intelligence and behaviour. With the exception of the highest frequency of intelligence quotients lower than 70 in the criminal patients Y/F 0.90, no statistical correlation exists to support the theory of a relation between a long Y chromosome and the type of psychiatric (psychopathy, psychosis) or criminality diagnosis.

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To whom offprint requests should be sent     

Étude de l’expression de LAT-1 et de la fixation de la 18F-FDOPA dans les tumeurs cérébrales. Illustration par une série de cas

IntroductionPET imaging of amino acid analogues, in particular with ¹⁸F-FDOPA, is increasingly used for the diagnosis and post-therapeutic evaluation of brain tumors. The mechanism of ¹⁸F-FDOPA uptake in brain tumors is still debated in the literature, the main hypothesis being uptake via L-amino-transporter 1 (LAT-1).MethodWe present 4 cases of patients with primary or secondary brain lesions who underwent ¹⁸F-FDOPA PET/CT or PET/MRI for the evaluation of suspected tumor recurrence and who underwent surgical removal with immunostaining labeling of LAT-1 transporters within 3 months. For each of these patients, a correspondence between semi-quantitative PET parameters (SUVmax, TBRmax and TSRmax) and anatomopathological characteristics was performed.ResultsAll patients had a significant and intense tumor uptake on ¹⁸F-FDOPA PET. In contrast, the expression level of LAT-1 receptors was very variable from one patient to another (LAT-1 score ranging from 0 to 193).ConclusionThis article reflects the persistent questioning of the link between the LAT-1 receptor and the uptake intensity on ¹⁸F-FDOPA PET, especially in patients who have received a first line of treatment.     

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.     

Intérêt d’une semi-quantification et d’une analyse statistique automatique pour l’interprétation de la tomoscintigraphie cérébrale de perfusion dans la maladie d’Alzheimer

IntroductionAs the visual interpretation of the brain perfusion SPECT for the diagnosis of Alzheimer's disease might be difficult, it is wished to benefit from techniques allowing to improve the diagnostic accuracy especially for the inexperienced readers.Materials and methodsThree readers retrospectively interpreted 77 ^99mTc-ECD SPECT studies within the context of suspected neurodegenerative disease. The probability of Alzheimer's disease was quoted from 1 to 5, and the optimum sensitivity and specificity values were determined from ROC curves. The readers also attributed a hypoperfusion score to 13 brain regions; a diagnosis was obtained from this semi-quantification using a simple logic rule. The SPECT scans were also analyzed using the Planet Neuro software and a diagnosis was reached from a threshold for 2 of the 90 analyzed regions. The gold standard was established by a comprehensive neurological evaluation with at least 5 years of follow-up.ResultsThe sensitivities and specificities of the three readers were 50 %, 56 %, 28 % and 76 %, 83 % and 90 %, respectively. Using the semi-quantification they were 50 %, 67 %, 61 % and 54 %, 85 %, 69 %. The results of two readers were more in agreement. Using the automatic quantification, sensitivity was 78 % and specificity 81 %.ConclusionThe semi-quantification seems to ameliorate the results of and the agreement between certain readers. However, the automatic quantification seems to be the only way of assisting all of the readers to improve their diagnostic performances.