Chirurgie cardiaque chez le nouveau-né et le nourrisson

During the past five years, 127 newborn infants with marked anoxia, severe cardiac failure or respiratory problems secondary to a cardiac lesion were operated upon at l''Hôpital Ste-Justine, Montreal, Quebec.Infants in cardiorespiratory distress from a cardiac lesion for which the surgical treatment is well established, such as complicated coarctation of the aorta, were either cured or improved in 78% of cases. The fatal outcome following medical treatment of patients suffering from lesions for which the surgical treatment is not yet well established, e.g. interruption of the aortic arch, led us to operate upon these infants with the hope of salvaging some of them despite the high surgical risk.The decision to operate was usually based on clinical grounds; however, cine-angiocardiography was at times required to establish the exact diagnosis. Light anesthesia was essential to the success of the operation. Postoperative care was facilitated by a team of nurses well experienced in the treatment of newborn subjects with heart lesions. Fluids were administered in a minimum quantity of 700 c.c./m.² for 24 hours, and potassium was the only electrolyte added to the replacement fluids. Respiratory problems were reduced to a minimum by active physiotherapy. However, intubation with aspiration of tracheobronchial secretions was carried out when necessary.     

L’effet des rayons x sur le protoplasme,le noyau et le chondriome de la cellule végétale d'après les observations sur le vivant

Sans résumé Avec planches I et II     

Rôle du sens de l’effort dans le syndrome d’influence

Centrally generated signals from premotor areas play a key role in voluntary muscle force perception. Indeed, sensations of effort, rather than sensations of intramuscular tension, make it possible to evaluate the intensity of willed muscle forces. We suggest that the sense of effort is involved in agency, the cognitive process by which one is aware of one’s actions. We argue that effort awareness accompanies each action and is the key component of the feeling of will. In delusions of alien control, patients with schizophrenia do not recognize some of their acts as their own and are convinced that they are under the control of someone else. Some experimental data suggest that delusions of control are related to an altered awareness of effort and an exaggerated awareness of afferent neural information, caused by neurological disorders in the frontal and parietal lobes. This impairment could lead to the inability to identify the author of an action. In this pathological condition, the cerebral state coding for “I intend to act” might move toward the state coding for “someone else intends to act”, even in the absence of another agent.     

Chimiothérapie anticancéreuse chez le mâle: risques pour la descendance

Up to now, studies concerning the progeny of males undergoing chemotherapy have been difficult to interpret because of their heterogeneity and conflicting nature. Morever, the long term follow up of children has not been carried out. Experimental studies carried out with the cytostatic drug cyclophosphamide have shown that if mating of male rats takes place during the treatment, the frequency of post-implantation losses and fetal malformations increases. If this mating takes place after a recovery period of one to two seminiferous cycles, there is no malformation but only neonatal deaths, and behavioral disorders in adult progeny including diminished learning capacity. These abnormalities are inherited and can present the characteristics of dominant autosomic syndromes. Biochemical analyses of the brains of the first and second generation offspring from treated males show a decrease in two biochemical substrates of memory: hippocampal choline acetyltransferase and fronto-parietal cortex norepinephrine. Abnormalities can also present complex genetic rearrangements revealed in the third generation by, amongst other things, increases in weight gain. Finally, the experimental results suggest that genetic repair may be possible with time. These data and the uncertainty concerning the consequences of chemotherapy in males should systematically lead to:

- the cryopreservation of sperm before any mutagenic treatment;

- a minimum of two years contraception from the end of treatment;

- the long term follow up of children born from treated fathers.

     

Les dysfonctions érectiles chez le diabétique: Rôle des facteurs neurologiques

Objective

To assess the etiological factors of erectile dysfunction in male diabetics.

Material and methods

We have performed a prospective evaluation including 69 diabetic patients suffering from erectile dysfunction. Studied parameters including age, type and duration of diabetes, complications, treatments and associated risk factors were analysed. Comparison was done with a control group of 138 diabetic patients without erectile dysfunction.

Results

There was a significant difference between the diabetic with neurologic complications and the others without neuropathy (p=0.0004). The duration of the diabete was was another risk factor of erectile dysfunction (p=0.049)

Conclusion

We confirm various authors who demonstrated that diabetic impotence seems to be mainly neuropathic in etiology even though it was a multifactorial discomfort.     

Contrôle de la dynamique à court terme du microphytobenthos intertidal par le cycle exondation-submersion

We test herein the hypothesis that the succession of low tides — during which biomass increases — and high tides — during which biomass decreases — controls the dynamic behaviour of the microphytobenthic compartment. Results indeed show that during a complete lunar cycle (14 d) biomass exhibits a series of oscillations due to biomass increases during low tides and decreases during high tides. Moreover, the datasets show that the production level is in the range of previously recorded values and they indicate that the major part of the photosynthetically produced biomass during low tide can be exported into the water column during high tide. This clearly suggests that microphytobenthos is the major autochtonous source of organic matter production in the littoral zone and that it directly supplies the associated pelagic trophic web.     

La TEP au 18F-FDG dans le diagnostic et le suivi évolutif des plasmocytomes solitaires

AimTo assess the role of [¹⁸F]FDG-PET in solitary plasmacytoma with regards to staging, therapeutic follow-up and monitoring.Patients and methodsTwenty consecutive patients were included in the present study when following conditions were met: (i) solitary plasmacytoma histologically confirmed (bone, n = 16; extramedullary, n = 4); (ii) [¹⁸F]FDG-PET scan from July 2004 to April 2009. The clinical follow-up was over than 2 years for 13 patients. Ten patients underwent a post-therapy PET scan. PET scans were visually analysed.ResultsPET scan enabled confirmation of all main lesions (sensitivity: 100%) and also detected infra-clinical lesions in eight cases. Follow-up for more than 2 years showed a progression disease into myeloma in five from six cases (83%) with infraclinical lesions at the baseline PET scan. Among 10 patients who underwent post-therapeutic PET scan, six experienced a complete response at the main lesion site and four experienced a partial response.ConclusionFDG-PET may play an important role in plasmacytoma staging and enables detection of smaller lesions (otherwise undetected).     

Hypothèse : le modèle du lieu de rencontre pour la maladie des prions

Prions are responsible for spongiform diseases such as scrapie and bovine spongiform encephalopathy. It is now generally accepted that the disease mechanism involves the conversion from the normal form, PrP^C, to the pathogenic form, PrP^Sc, and that this isoform is infectious. In the case of scrapie, 15 different forms of the disease have been described and some of these different phenotypes can be conferred by infectious prions that are themselves encoded by normal genes. We propose here that a prion with an altered structure has a correspondingly altered preference for lipids; this altered preference creates a proteolipid domain containing different lipids and other factors such as chaperonins and enzymes responsible for post-translational modifications. Normal prions associated with this abnormal domain adopt the conformation dictated by its lipidic composition (and by the other factors present) and so acquire the lipidic preference of the original pathogenic prions. These transformed prions could then create new proteolipid domains. This process may be considered as semi-conservative replication in which prion and lipids are analogous to the Watson and Crick strands and the proteolipid domain to the double helix itself.     

Analyse des courbes de survie de nématodes phytoparasites selon le modèle de Teissier

Four survival curves of plant parasitic nematodes are analysed with Teissier's model. The model is based upon the assumption of an exponential decrease with time of the life expectancy, E(t) = E₀ exp(−αt), with E₀ the life expectancy at time 0 and α a decay coefficient. By integrating this formula we obtain an expression for the number of survivors at time t, S(t), as a function of the time, t, and S₀, the number of individuals at time 0, and the parameters E₀ and α: S(t) = S₀exp[αt −(exp(αt) −1)/αE₀. S₀ is a scaling parameter, related to the initial number of individuals in the population, thus the form of the curve depends only on the parameters E₀ and α, which are readily understandable in a biological model. These parameters E₀ and α are estimated by fitting the model to experimental data using a non-linear regression based on a least squares procedure. The results show a highly significant fit of the model to the data indicating the ability of the model to describe the plant parasitic nematodes survival curve. Results are discussed and the hypothesis of Teissier is compared with other related hypotheses.     

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.     

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.     

Rôle du pathologiste dans la prise en charge et le diagnostic d’une infection osseuse

The diagnosis of a bone infection is sometimes made difficult when clinical signs and imaging are not typical. In these cases, the role of a pathologist is important since he makes the diagnosis and improves the management of the infection. The main histopathological features of a bone infection and its complications, as well as the involvement of a pathologist in this pathology, are described in this article.     

Données nouvelles sur le spectre d'hôtes et le parasitisme du nématode entomophageNeoaplectana carpocapsae

Résumé Des essais réalisés au laboratoire en conditions standards et destinés à compléter la connaissance du spectre d'h?tes deNeoaplectana carpocapsae Weiser ont été effectués à Antibes, en Guadeloupe et à Madagascar. 128 espèces d'insectes appartenant aux ordres des Odonates, Dictyoptères, Isoptères, Phasmoptères, Orthoptères, Planipennes, Lépidoptères, Diptères, Coléoptères, Hyménoptères, Homoptères, Hėtéroptères, ont été étudiées ainsi que quelques autres arthropodes (diplopodes et acariens). Les rėsultats ont confirmé le fait que la gamme d'h?tes potentiels deN. carpocapsae est très large malgré quelques cas de résistance chez les Diptères essentiellement. La rapidité d'action deN. carpocapsae, sa capacité à se multiplier dans l'h?te, ainsi que certaines de ses exigences écologiques en vue de son utilisation pratique, ont été examinées.

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Summary Laboratory tests under controlled conditions were carried out in Antibes, Guadeloupe and Madagascar, to investigate the host range ofNeoaplectana carpocapsae Weiser. 128 insect species including members of Odonata, Dictyoptera, Isoptera, Phasmida, Orthoptera, Planipennia, Lepidoptera, Diptera, Coleoptera, Hymenoptera, Homoptera, Heteroptera and a few other arthropods, were tested. Results confirmed that the potential host range ofN. carpocapsae is very broad in spite of some cases of resistance, mainly in Diptera. The effectiveness rapidity of the nematode, its ability to multiply in the host and some other of its ecological requirements for practical use, were also studied.

     

Comment identifier le spermatozoïde vivant?

Testicular sperm extraction (TESE) has been used to retrieve spermatozoa in patients with secretory azoospermia for intracytoplasmic sperm injection (ICSI). However, testicular spermatozoa have poor motility that significantly decreases after cryopreservation and thawing. The major difficulty with testicular spermatozoa is to distinguish between living and dead spermatozoa, as most spermatozoa are immotile. The aim of this study was firstly to report the various methods used to explore spermatozoa vitality. Most tests assess the functional and structural integrity of the sperm membrane, such as staining methods and hypo-osmotic swelling test (HOS-test). We then evaluates the potential of pentoxifylline (PTX), a phosphodiesterase inhibitor of the methylxanthine group, to improve the distinction between living and dead immotile testicular spermatozoa by increasing the number of post-thawed motile spermatozoa. We also analysed the results of 100 ICSI cycles performed with frozen-thawed testicular (n=72) and epididymal (n=28) spermatozoa treated with 3.5 mM PTX. To test the effect of PTX on motility, 14 samples of frozen-thawed testicular spermatozoa from eight patients with secretory azoospermia and six patients with excretory azoospermia were divided into three equal samples: one sample treated with 3.5 mM PTX, one sample initially migrated on two-layer Percoll gradient and then divided into two aliquots (one treated with 3.5 mM PTX, one without treatment), and the last sample without migration and without PTX treatment. The number of motile spermatozoa was evaluated in 10 μL of each sample with an inverted microscope at 15, 30, 60, 120 minutes and 24 hours. We also compared the outcome of ICSI in 100 cycles using frozen-thawed epididymal or testicular spermatozoa between secretory and excretory patients. PTX significantly increased the number of motile frozen-thawed testicular spermatozoa in secretory and excretory azoospermia. In excretory azoospermia, the number of motile spermatozoa was further increased when PTX was associated with migration on Percoll gradient, while PTX alone gave the best results in secretory azoospermia. Fertilization and pregnancy rates as well as embryo quality and division stages were comparable in the two groups. By increasing the number of motile frozen-thawed testicular spermatozoa, PTX improves the selection of living spermatozoa.     

La fluorocholine(18F) a une utilité clinique dans le cancer de la prostate et le carcinome hépatocellulaire… parfois chez le même malade

Case reportIn order to stage hepatocellular carcinoma (HCC), a patient was referred to PET/CT using fluorodeoxyglucose(18F) (FDG) and, if necessary, fluorocholine(18F) (FCH). HCC was proven by biopsy of a hepatic mass discovered on CT performed for a biological recurrence of prostate cancer.ResultFDG PET/CT did not show any anomaly. FCH PET/CT was thus performed and showed various foci: the hepatic mass, a large abdominal adenopathy and an unexpected subcentimetre lung nodule. The diagnostic uncertainty mostly concerned this lung nodule which was biopsied and consisted of a metastasis of the prostate cancer. Due to the presence of two metastatic cancers, the patient's management was altered, with chemotherapy for the HCC and hormone therapy for the prostate cancer.ConclusionSeveral types of cancer take-up fluorocholine(18F), which is a powerful tool to detect metastases, in particular in case of rising levels of marker with a negative FDG PET/CT. Even when FDG PET/CT is positive, FCH may reveal unexpected foci with other metabolic characteristics, although it is not specific of a given primary cancer, as well as FDG. For staging of HCC, we thus recommend to perform PET/CT with both tracers.