Conséquences de la chimiothérapie anticancéreuse sur la fertilité de la femme

Sterility is a potential toxic effect of chemotherapy. This risk is well established for alkylating agents, but is less clearly defined for anthracyclines, methotrexate and fluorouracil and poorly defined for alkaloids, platinum, etoposide and taxanes. The main predictive factors for ovarian toxicity are the additive effect of cytotoxic drugs, the cumulative dose of each drug and the patient’s age. This effect of chemotherapy is evaluated on menstrual cycles, hormonal assays and the number of pregnancies observed in patient cohorts. Chemotherapy induces destruction of oocytes and granulosa cells. In mice, it has been shown that adriamycin may induce oocyte apoptosis, which can be prevented by modulation of cycle cell signalling (dysregulation of Bax gene or, on the contrary, expression of its antagonist gene Bcl-2 or inhibition of apoptosis with sphingosine-1-phosphate or caspase inhibitors). Clinical data in the literature are usually based on retrospective studies and are somewhat confused: global fertility after MOPP chemotherapy for Hodgkin’s disease is about 20%, adjuvant chemotherapy with CMF, F(A)C or TAC for breast cancer induces amenorrhea in 50% to 70% of cases, PVB or BEP chemotherapy for ovarian germ cell tumors has little effect on fertility when the uterus and one ovary can be preserved, and the majority of women treated with methotrexate, actinomycin D or various combinations for persistent trophoblastic disease remain fertile. Preservation of fertility is a major goal for cancer patients receiving chemotherapy: in vitro fertilization could preserve the couple’s fertility, but is usually not feasible as it would delay initiation of chemotherapy until after stimulation of ovulation; oocyte or ovarian tissue cryopreservation is at the stage of research; oral contraceptives have not been demonstrated to be effective to preserve ovarian function; gonadotropin releasing hormone (GnRH) agonists prevent cyclophosphamide toxicity in rat and monkey ovaries, and a few pilot clinical studies suggest that chemotherapy-induced amenorrhea could be prevented by administration of GnRH analogues simultaneously to chemotherapy, but randomised studies are necessary.     

Recherches sur la conservation du virus de la densonucléose

Résumé Le virus de la densonucléose (VDN) conserve une partie de sa virulence en solution aqueuse entre 0°C et 30°C pendant deux mois. Son pouvoir infectieux se maintient à—10°C pendant deux mois mais est supprimé après dix jours de dessication. On peut done considérer ceParvovirus d’Insectes comme un virus relativement résistant aux températures que l’on rencontre ordinairement dans la nature et au laboratoire.

---

Summary The persistence of DNV is described. This virus retains a part of its infectivity in aqueous solution between 0°C and 30°C. The log LD₅₀ initially 7,15 drops to 2 after two months. The virus keeps its infectivity at 10°C but it loses all its pathogenicity after 10 days in dry conditions.

---

---

Ce travail a été réalisé en partie dans le cadre d’une convention I.N.R.A.-D.R.M.E.     

Déficit androgénique: effet de la substitution sur la composition corporelle

Male hypogonadism is responsible for an increase in fat body mass and a decrease in lean body mass. Similar changes are observed in aging men. Aging is also frequently associated with a decrease in testicular function. Androgen replacement therapy in adult men with hypogonadism has been shown to reverse these changes in body composition. Androgens stimulate protein synthesis, especially in muscles, leading to a gain of muscle mass and muscle strength. In contrast, androgen therapy inhibits tissue utilization of lipids, predominantly in visceral fat and consecutively induces a decrease in fat body mass. As the same changes in body composition are observed in aging and in hypogonadal adult men, the value of androgen replacement therapy was evaluated in aging men with an age-related decrease in androgen production. About ten studies have included human males over the age of 65. The results obtained indicate the benefit of such therapy in terms of improvement in body composition in aging men due to a rise in plasma testosterone levels up to the normal range of young adult men.     

Effets de la radiothérapie sur la fonction testiculaire de l'adulte

Radiation therapy plays a major role in the curative management of numerous neoplasms, such as Hodgkin's disease or testicular cancer. However, the adverse effects of low-dose radiation scattered to radiosensitive normal tissues adjacent to the radiation fields, such as the testes, have been recognized. Experimental studies performed on healthy volunteers showed that no lesion was detectable on sperm counts or testicular biopsies after single doses of less than 10 cGy. Oligospermia has been reported after 15 cGy and 100 cGy result in a 90% incidence of azoospermia. In the radiotherapy of cancer, fractionated regimens are used to increase the differential effect between normal and tumoral tissues. For the same dose, a fractionated radiation regimen results in a higher incidence and a longer period of azoospermia than a single dose irradiation. Fractionated doses of >50 cGy result in a 100% incidence of azoospermia. For doses up to 200 cGy, recovery occurs but normal sperm production remains uncertain. Although the recovery time can be very long (more than 10 years), there is a risk of definitive azoospermia after doses of >200 cGy. Spermatogonia are the most radio-sensitive cell type and their depletion after small irradiation doses explain the effect of radiotherapy on fertility. Clinical hypogonadism is very unfrequent in usual practice, what seems to prove a relative radio-resistance of the Leydig cells. However, functionals studies show that there is a rise in serum LH with increasing dose to the testes. A decrease in testosterone levels has been reported after high testicular doses.     

Données synchorologiques sur la végétation littorale européenne

Four aspects of the synchorology of plant communites along the European coastline are treated: (1) with examples from sand dunes (Agropyreta and Ammophileta) and salt marshes (Puccinellieta maritimae) synvicariance is elucidated; (2) The increase in synvicariance towards the inner sand dunes is discussed as a result of an increasing effect of autochthonous climatic features; (3) with examples from sand dunes and cliffs the concept of synendemism is elucidated; (4) synvicariance at the landscape (geosigmetum) is discussed with examples from the French coastline.

     

Quelques considérations sur l'enseignement de la médecine physique et de la réhabilitation

Particularly since World War II physical medicine and rehabilitation have assumed a growing importance. The efforts of the Canadian Association of Physical Medicine and Rehabilitation, following a survey of Canadian universities, to increase the theoretical and practical teaching of physiatrics are emphasized. It is considered important that the teaching of physical medicine and rehabilitation should be carried out concurrently with other medical and surgical teaching programs. Paramedical and auxiliary rehabilitation personnel should participate in the teaching program. The number of hours devoted to physiatrics should be increased, and the medical student should be permitted to choose physical medicine and rehabilitation as a part of his internship program.     

Questions sur la remédiation cognitive dans les schizophrénies

What are the implications of an approach to schizophrenia using a cognitive remediation and what is the case for such an approach? What are its strengths and its weaknesses? More critically, can we find supporting evidence of its efficacy? Overall, what do we really know of the cognitive disorders associated with the schizophrenias? Opening on a review of the existing literature in order to investigate such questions, the paper develops a critical assessment of the issue.     

Quelques remarques sur l'épidémiologie de la poliomyélite antérieure aiguë

Sans résumé     

Impact d’une réduction d’activité sur la mesure de la fraction d’éjection du ventricule gauche sur caméra D-SPECT

IntroductionRadionuclide ventriculography provides a reproducible measurement of the left ventricular fraction ejection (LVEF) but with a significant body radiation (effective dose of 5,9 mSv for the injection of 850 Mbq of ^99mTc). The highly sensitive semi-conductor (CZT) cameras could allow decreasing the injected activity by a factor 3, similarly to that of myocardial perfusion imaging. Our study was aimed to determine whether the LVEF measurement provided by radionuclide ventriculography on the CZT D-SPECT camera is impacted by a 70% reduction in recorded counts.Materials and methodsAfter the in vivo labeling of red blood cells with 850 MBq of ^99mTc, 49 patients completed a conventional 2D recording (Conv-2D) on Anger camera followed by a 3D recording on the D-SPECT camera (3D-100%). The CZT recordings of all projections were subsequently shortened to 30% of their initial durations (3D-30%) in order to assess the LVEF measured with a 70% reduction in recorded counts.ResultsMean LVEF values were 62.7 ± 11.1% on Conv-2D and higher on both 3D-100% (66.8 ± 14.8%, P < 0.001) and 3D-30% (66.3 ± 15.7%, P < 0.001). The correlation coefficients with the LVEF determined with the reference Conv-2D method were equivalents for 3D-100% (r² = 0.73) and 3D-30% (r² = 0.70) and with a similar level of overestimation for the highest LEVF values.ConclusionA 70% reduction in recorded counts does not significantly impact the LVEF measured with radionuclide ventriculography on the CZT D-SPECT camera. These values are coherent with those obtained with the reference 2D method but with a clear overestimation for the highest LVEF values.     

Nouvelles expériences sur le Termite de Müller (Macrotermes mülleri) et considérations sur la théorie de la stigmergie

Résumé Dans ce mémoire est décrit le comportement des ouvriers deMacrotermes mülleri après que leur termitière ait eu sa partie épigée taillée de façon à supprimer les communications entre les parties supérieure et hypogée du nid.Par l'établissement de trois pistes odorantes, recouvertes d'un revêtement terreux et la construction d'une large galerie-tunnel, les Termites font communiquer les parties séparées.Le mécanisme de la construction et la stimulation des ouvriers sont analysés dans le détail. Il ne semble pas à l'auteur qu'un problème se soit posé aux ouvriers du Macrotermite. L'apparence de problème n'est qu'un reflet de la pensée humaine.Comme dans la reconstruction du nid étudiée antérieurement par l'auteur, la construction de l'uvre et sa cohérence s'expliquent parfaitement par la théorie de la stigmergie (Grassé, 1959). Le comportement des Macrotermites construisant les galeries-tunnels, à l'instar de celui desBellicositermes etCubitermes rebâtissant leur nid, est une manifestation épigénétique de l'activité des ouvriers.

---

Summary In this paper the author describes the behavior of the workers ofMacrotermes mülleri after the cutting of the epigeous part of the nest so as to suppress any communication between its upper and hypogeous parts.The termites allow a communication between the separated parts by establishing 3 smelling tracks lined with an earthy covering and the building of a wide tunnel-shaped gallery.The mechanism of the building and the stimulation of the workers are thoroughly studied. It is not the author's impression that the workers of the Macrotermite have been involved in a problem. The semblance of the latter is only a reflection of the human thought.As in the case of the building of the nest previously studied by the author, the building of these works and its coherence are perfectly explained by the theory of stigmergy (Grassé, 1959). The behavior of tunnel-gallery building Macrotermites is an epigenetic manifestation of the workers activity as the one found withBellicositermes andCubitermes rebuilding their nest.

---

Zusammenfassung In dieser Abhandlung wird das Betragen der ArbeiterMacrotermes mülleri beschrieben, nachdem der epigäische Teil ihres Termitennestes geschnitten worden ist, so dass jede Verbindung zwischen dem oberen und dem hypogäischen Teil des Nestes unmöglich wird.Durch die Anlegung von drei wohlriechenden, mit Erde übergezogenen Spuren, so wie durch die Erbauung einer breiten Tunnel-Galerie, setzen die Termiten die getrennten Teile wieder in Verbindung.Der Mechanismus der Erbauung und die Anreizung der Arbeiter werden ausführlich analysiert. Dem Verfasser scheint es nicht, ein Problem habe sich für die Arbeiter der Macrotermite gestellt. Ein scheinbares Problem wäre nur der Wiederschein des menschlichen Denkens.So wie für die vom Verfasser zuvor erforschte Wiedererbauung des Nestes, werden die Erbauung des Werkes und dessen Zusammenhang durch die Theorie der Stigmergie (Grassé, 1959) vollkommen erklärt. Das Betragen der Macrotermiten, wenn sie ihre Tunnel-Galerien bauen, so wie das Betragen derBellicositermes undCubitermes wenn sie ihre Nester wiedererbauen, ist eine epigenetische Manifestation von der Tätigkeit der Arbeiter.

     

Influence de la température sur la cinétique,de croissance et le coefficient de maintenance de Candida lipolytica cultivé sur n-alcane

The effect of growth temperature on the evolution of kinetic parameters and yields was determined for Candida lipolytica cultures with ntetradecane as substrate, in a temperature range of 18°C to 30°C, which is below the critical growth temperature in order to work only in the activation zone of these parameters.In such a culture limited by substrate transfer, growth rate depends on biological rates, related to microorganisms characteristics, and diffusional rates, related to mass transfer. The effect of temperature thus depends on the limiting step. The activation energy, calculated from exponential growth rate determinations is .When the activation energy is calculated from the maximal rate of cell production (determined at the growth curve's inflexion point), it's found to be E _X=71,200 J/mole in the 18°C–24°C range, and E _X=28,000 J/mole in the 24°C–30°C range. The latter one is characteristic of a diffusion-limited process. Above 24°C, growth is controlled by substrate-transfer, as physiological potentialities are preferentially increased with temperature than diffusional ones: 24°C is thus the transition temperature T _t from physiological to diffusional limitation.The apparent yield is almost constant, over the 18°C to 30°C temperature range, although maintenance coefficients are very dependent on temperature. The activation energies related to maintenance coefficients for alkane and oxygen respectively are and .The m _s/m_{O 2} ratio is about 3 (g/g), whereas that, for a strict oxidation reaction of n-tetradecane ought to be 3.47 (g/g). A satisfactory correlation, relating maintenance coefficients to the maximal growth rate of yeast, is given.

---

Liste des symboles A constante de saturation de modèle de croissance(1) - B vitesse spécifique considérée - C substrat carboné ou oxygène (g/l) - E energie d'activation (J/mole) - S _m quantité de substrat consommée par maintenance au cours d'une fermentation discontinue (g) - O₂ quantité d'oxygène transférée au milieu de culture (g/l) - R rendement global de la fermentation - R rendement global de la fermentation - constante des gaz parfaits (J/mole K) - S concentration en substrat carboné (g/l) - T température de croissance (°K) - X concentration en biomasse (g/l) - Y rendement limite - m coefficient de maintenance (h^-1) - t duree de fermentation (h) - tømpérature de croissance (^o Celsius) - taux de croissance (h^-1) Indices 1 relatif à la température 1. - 2 relatif à la température 2 - c relatif au substrat carboné ou à l'oxygène - f relatif au temps final - i relatif au point d'inflexion - m maximum - mO₂ relatif au coefficient de maintenance sur l'oxygène - m _s relatif au coefficient de maintenance sur le substrat carboné - o relatif au temps initial - O₂ relatif à l'oxygène - s relatif au substrat carboné - t de transition - T relatif à la température de croissance T - U _m relatif au taux de croissance maximal - X relatif à la productivité maximale en biomasse     

Observations sur la spécificité de la coloration aux acides phosphotungstique et phosphomolybdique

Résumé Les Auteurs ont démontré que, en conditions histochimiques sur du matériel fixé au formol, les acides phosphotungstique et phosphomolybdique ont une double action: 1. une action oxydative à la charge des radicaux PAS-positifs (vic-glycols et éthyleniques) en milieu aqueux, et à la charge des radicaux aminiques en milieu anhydre; cette action entraine la transformation de ces radicaux en aldéhydes; 2. la formation d'une liaison chimique entre les aldéhydes et les molécules des acides phosphomolybdique et phosphotungstique. — La coloration du collagène, au contraire, n'est pas due ni aux radicaux aminiques ni vic-glycols et implique un mécanisme encore inconnu.

---

Observations about the specificity of staining of phosphotungstic and phosphomolybdic acid

Summary The authors demonstrated that phosphotungstic and phosphomolybdic acid applied to formol-fixed tissues explete two following actions: 1. An oxidative action on the PAS-positive radicals (double bonds, vic-glycols groups) if in water solution and on aminogroups if in anhydrous solution. This oxidation results in a production of aldehydic radicals 2. The formation of chemical bonds between the aldehydic new-formed groups and the molecules of phosphotungstic or phosphomolybdicacid.— However, the above mentioned mechanism of action is not applicable to the collagen staining for which a different explanation has to be supposed.

     

Applications à la conchyliculture des récentes acquisitions sur la biologie des mollusques bivalves

Today, mollusc farming represents the fourth part of the mundial aquaculture production. These results have been permitted by the improvement of farming techniques commercially important but also by advances in the biology of a species. Valuable reproductive studies have been carried out in s.a. hatcheries on triploids and tetraploids animals. Since the last decade, advances in the knowledge of metabolism and growth mechanisms has helped the improvement of the brood stock. Nevertheless, the mundial expansion of bivalve farming increases the outbreak of strong epizooties. Investigations allow a valuable knowledge on the scope of molluscan defence mechanisms against pathogen agents. The results are discussed in relation to a possible selection for bivalve farming.     

Evaluation de la circoncision réalisée en ambulatoire chez l’adulte: impact sur les M.S.T. et sur la sexualité

With the help of a questionnaire, we assessed the impact of circumcision, practiced on adult patients for various indications, on sexually transmitted diseases (STD) and sexuality. Recurrent or obstinate STD represented the most frequent indication (75%). Subsequentely almost 96% of the patients declared to be satisfied with their sexuality and nearly 80% did not mention any recurrence of their disease.