Le développement de l’inventaire de dépistage ERIraos: un outil global d’appréciation du risque d’évolution psychotique

Adequate identification of patients for early intervention programmes requires reliable and valid assessment tools. Within the German Schizophrenia Network (Kompetenznetz Schizophrenie) a set of schedules for early detection of schizophrenia has been proposed: the Early Recognition Inventory ERIraos. ERIraos is a two-step procedure with a 17-item checklist used at step 1 by GPs, psychologists, teachers, while a comprehensive 110-item symptom list is applied at early intervention centres at the expert level. In addition, ERIraos allows the assessment of several risk factors for psychosis such as familial load, childhood deficiencies, alcohol and drug use by special modules. Some preliminary results are presented here. The frequency of the 17 checklist symptoms increases from the early to the late prodrome, and more specific symptoms occur over time. The 17 checklist symptoms are grouped by factor analysis to 5 factors (psychotic, depressive, disorganised, withdrawn, dysphoric). In addition to prodromal symptoms, most patients (86.2%) report at least one additional risk factor (mean: 1.7 risks). 68% demonstrate some schizotypal features, 53% report alcohol and/or drug consumption, 24% demonstrate some deficiency or delay in childhood development, 21% report definite obstetric or birth complications, and 10% have a family history of schizophrenia or some schizophrenia-like diagnosis in first degree relatives. So far, the results are of a preliminary nature, and when sufficient information on psychotic transitions is available, the predictive value of ERIraos will be determined.     

Recueil chirurgical de spermatozoïdes dans un groupe de 50 patients avec un antécédent de cryptorchidie bilatérale: facteurs pronostics d’extraction

Bilateral cryptorchidism is a severe factor of male infertility. We evaluated the results of testicular sperm extraction in 50 men with nonobstructive azoospermia associated with cryptorchidism between 1995 to 2001. We evaluated clinical parameters predictive of successful sperm extraction. Serum follicle stimulating hormone (FSH) was elevated in 67% of cases and testicular volume was decreased in 70% of cases, confirming the secretory origin of the azoospermia. Serum follicle stimulating hormone (FSH), testicular volume and histological parameters were examined as predictive factors for sperm recovery. The positive sperm recovery rate was 68%. As in the population of men with nonobstructive azoospermia, the sperm recovery rate for patients with a history of orchidopexy is approximately 68% and there are currently no clinical parameters predicting successful sperm retrieval in this subpopulation of patients.     

Développement et évaluation d’un algorithme de segmentation automatisée des ventricules gauche et droit sur des images ciné d’IRM

An automated segmentation of the left and right ventricles on cine MRI is presented here. A rectangular region around the object of interest is defined in the original image, a morphological filter is then applied that combines openings and closings on connected sets, providing an image with homogeneous regions, which is finally segmented with an active contour model. The algorithm was tested on two databases with an expert's segmentation on the ventricles. One of the databases was provided by the Multicentric Initiative for a Platform of Evaluation in Cardiac Imaging (IMPEIC) group. Results show a very satisfactory correlation between the area (given in mm²) of expertise (x) and the area of automated segmentation (y) of the left ventricle (y = 1.00x + 8.6, r = 0.99). First results on the right ventricle show more than 83% similarity. The systolic phase proved to be more difficult to segment, which could be taken into consideration by introducing time regularization criteria in the algorithm.     

ForenSeek: un programme de simulation du développement des insectes nécrophages dédié à l’entomologie médico-légale

L’entomologie médico-légale repose sur l’utilisation des insectes nécrophages pour estimer le moment de la mort dans le cadre d’enquêtes judiciaires et permet dans certains cas de préciser les circonstances du décès. Cette technique repose sur des bases scientifiques solides et est désormais couramment utilisée en France comme à l’étranger dans le cadre d’affaires criminelles. Le projet ForenSeek est un outil informatique d’aide à la décision, dédié à la réalisation de simulations et d’expertises en entomologie médico-légale. Le cæur de ce programme est un modèle de comportement et de développement des larves de diptères nécrophages basé sur un système multi-agents (SMA). Ce procédé permet de modéliser des comportements de groupes complexes à partir de données individuelles simples, et est done particulièrement bien adapté à l’étude des populations d’insectes. De plus, les résultats de ce modèle sont destines à être traités automatiquement pour en extraire des informations sur la pertinence de chaque simulation, et ainsi estimer de manière automatisée et avec précision l’intervalle post-mortem (IPM).     

Contribution a l’etude de la forme des plantes: discussion d’un modele de ramification

The problem of the forms of plants and models of branching are discussed using experimental data on the mistletoe. The number of branches by division, the distribution of divisions with regard to the number of branches per division and to the level of division, the geometrical characters of branches according to the level of division and the host, the stability of model are studied. One gives an interpretation of the model of branching as a model of growth.      

Comparaison de techniques de débruitage des images scintigraphiques

Scintigraphic images are strongly affected by Poisson noise. This article presents the results of a comparison between denoising methods for Poisson noise according to different criteria: the gain in signal-to-noise ratio, the preservation of resolution and contrast, and the visual quality. The wavelet techniques recently developed to denoise Poisson noise limited images are divided into two groups based on: (1) the Haar representation, (2) the transformation of Poisson noise into white Gaussian noise by the Haar–Fisz transform followed by a denoising. In this study, three variants of the first group and three variants of the second, including the adaptative Wiener filter, four types of wavelet thresholdings and the Bayesian method of Pizurica were compared to Metz and Hanning filters and to Shine, a systematic noise elimination process. All these methods, except Shine, are parametric. For each of them, ranges of optimal values for the parameters were highlighted as a function of the aforementioned criteria. The intersection of ranges for the wavelet methods without thresholding was empty, and these methods were therefore not further compared quantitatively. The thresholding techniques and Shine gave the best results in resolution and contrast. The largest improvement in signal-to-noise ratio was obtained by the filters. Ideally, these filters should be accurately defined for each image. This is difficult in the clinical context. Moreover, they generate oscillation artefacts. In addition, the wavelet techniques did not bring significant improvements, and are rather slow. Therefore, Shine, which is fast and works automatically, appears to be an interesting alternative.     

Etude d’un modèle expérimental d’infection de l’appareil génital mâle

Injection of uropathogenic E. coli into the rat cauda epididymidis results in chronic epididymitis in 74.2% of cases, accompanied by necrotic orchitis (16.1% of cases) or non-infectious testicular lesions (45.2% of cases). Injection of killed bacteria caused the same noninfectious testicular lesions, most probably due to toxic damage. Injection of bacteria into the seminal vesicles caused a vesiculitis which regressed after seven days and disappeared progressively. Simultaneously, the prostate was invaded by polymorphonuclear leucocytes, an infection which persisted for more than three months. E. coli injection in association with bilateral castration gave rise to the formation of chronic vesicular abscesses. Examination of the male genital tract lymphatic system allowed explanation of the spread of infection from the epididymis to the testis, and from the seminal vesicle to the prostate. The epididymis is an organ with poor defense against against infection whereas the seminal vesicle is able, owing to the activity of its epithelium, to fight infection. On the other hand, prostatitis secondary to vesiculitis is immediately chronic.     

Le cystadénome des vésicules séminales : à propos d’un cas et revue de la littérature

The primitive tumors of seminal vesicles are rare. Almost one hundred cases were reported in the literature. This is most often benign tumours with cystadenomas, primary malignant tumours are too rare.We relate a new case of tumour of the left seminal vesicle with a 70 years aged patient discovered next to an acute retention of urine associated with a constipation. The diagnosis was confirmed by imaging (CT and IRM) that showed a large multi-cystic mass of the left seminal vesicle. The treatment was surgical (vesiculectomy) preceded by a suction drainage of the mass. The anatomopatholgic exam of surgical piece has reached to a cystadenoma of the left seminal vesicle. Throughout this observation, we discuss the different clinical, radiological, histological and therapeutic aspects of seminal vesicles tumours.     

Ostéite tuberculeuse de l’os frontal simulant une métastase lytique d’un carcinome papillaire de la thyroïde : à propos d’un cas

The authors report a case of patient followed for papillary thyroid carcinoma with osteolytic calvarial image at left frontal bone. Bone metastasis of thyroid carcinoma is suspected in the first. Histopathological examination of the material of craniotomy revealed granulomatous lesion in favour of tuberculous osteitis. Such an association is exceptional and only histology allows a definitive diagnosis.     

Proposition d’un protocole de prélèvement pour les spermocultures

The purpose of the protocol is to put the patients into contribution on an aseptic way of obtaining semen in order to avoid renewal of numerous uninterpretable tests due to the presence of contaminating germs. This protocol of semen collection in aseptic conditions is recommended before IVF and artifical insemination.     

Plastie pénoscrotale pour volumineux éléphantiasis des organes génitaux externes : à propos d’un cas à la clinique universitaire d’urologie-andrologie de Cotonou

Although historically an area of lymphatic filariasis endemic, repercussions from this disease are becoming rarer in Benin. We are reporting on an extreme case of penoscrotal elephantiasis, treated at the Urology-Andrology University Clinic in Cotonou. Penoscrotal plastic surgery was performed through the reduction in volume and reconstruction of the scrotum using two lateral flaps. Results after a follow-up at six months are satisfactory.     

Les génotypes responsables de mucoviscidose ou d’absence bilatérale des canaux déférents ABCD

Over the last decade, the genetic basis for CBAVD has been identified by its association with CFTR gene mutations, and CBAVD is now generally considered to be a mild or incomplete form of CF. In this review, the author summarizes the main results of compilation of CFTR gene analysis conducted in French laboratories for 3,923 patients with CF and 800 males with CABVD. The degree of clinical expression can be affected by several variables, including the molecular mechanisms by which the various CFTR mutations impair or disrupt the function of the CFTR chloride channel. Phenotypic expression of CFTR mutational genotypes varies from severe, progressive pulmonary disease with pancreatic insufficiency (CF-PI), to mild pulmonary disease with pancreatic sufficiency (PS) or singleorgan forms of “CFTR-opathies”. In CF, a total of 310 different CFTR mutations accounting for 94% of 7,846 CF alleles have generated almost 500 different genotypes, comprising 2 severe mutations in 88% of cases (CF-PI), one severe mutation in trans to a mild mutation in 11% (CF-PS), and 2 mild mutations in 1% of identified genotypes. In CBAVD, 137 mutations scattered over the whole gene were identified in 60% of 1,600 CBAVD alleles during the study. Among the 150 characterized mutational CFTR genotypes, compound heterozygosity was the rule, and the most frequent CBAVD combinations were ΔF508/5T (35%), ΔF508/other mutation (30%, including ΔF508/R117H-7T: 5,6%), and 5T/other mutation (17%). No combination of two severe mutations was found in CBAVD (0%); by contrast with the CF population, 88% of genotypes identified in CBAVD comprised a severe mutation in trans to a mild mutation, and 12% consisted of 2 mild mutations. A total of 22 genotypes were shared by both CF and CBAVD. The role of the 5T allele as a splicing variant with variable, incomplete disease penetrance in CBAVD is reviewed. Other haplotype backgrounds, such as the TG12 sequence and the M470V polymorphism, may influence CFTR splicing and/or function. This study confirms the high molecular heterogeneity of CFTR mutations in CBAVD and emphasizes the importance of extensive CFTR analysis in these patients. Longterm follow-up studies of CBAVD patients are necessary in order to predict the phenotypic consequences of numerous CFTR mutational genotypes.     

Le cycle de développement des Castes chezReticulitermes

Résumé La production des castes, notamment des nymphes, futurs imagos ailés et des ouvriers chez leReticulitermes lucifugus est soumise à un cycle biologique annuel. L'auteur montre que dans les colonies naturelles les nymphes apparaissent quelques semaines après l'essaimage des jeunes imagos, vers la fin du printemps en une fois et en grande quantité. Elles se développent pendant l'été et arrivent en automne à l'avant-dernier ou même au dernier stade avant la mue imaginale. En hiver le développement de la colonie est normalement arrêté par le froid. Au début du printemps les nymphes se transforment en imagos et quittent la colonie. Pendant le repos hivernal les sexuées femelles accumulent beaucoup de corps gras et, au moment où les grandes nymphes se transforment en imagos, une ponte massive se produit dans le nid. Après la disparition des imagos la colonie voit son potentiel nutritif considérablement augmenté, puisqu'il n'y a plus de nymphes à nourrir. Pour cette raison les larves, à leur tour bien alimentées, peuvent se transformer en nymphes. Celles-ci, par leur croissance et leur constant besoin de nourriture, abaissent de nouveau le potentiel alimentaire. En conséquence de cette baisse, les larves qui apparaissent pendant l'été et l'automne sont mal nourries et donnent des ouvriers.Si les colonies deReticulitermes l. santonensis ont leur nid dans une maison bien chauffée en hiver, comme c'est le cas dans quelques immeubles de La Rochelle, lecycle annuel peut se transformer encycle semestriel. Les nymphes formées au printemps arrivent à l'état imaginal en automne et essaiment alors. Quand ils quittent la colonie un nouveau cycle commence qui permet un autre essaimage cinq à six mois plus tard, au printemps.L'auteur suppose que le facteur climatique et le facteur alimentaire jouent le rôle principal dans la formation des nymphes et dans le cycle biologique des Termitières.     

Alcide d’Orbigny,un précurseur dans l’étude de la faune du Danien du bassin de Paris

One of the major contributions of Alcide d’Orbigny to palaeontology is his work on the Danian of the Paris Basin. The Danian material includes well-preserved external imprints of Invertebrates. By making casting of these imprints, Alcide d’Orbigny inaugurated an original technique, which enabled him to describe more than 40 species. The question of the age of the Danian localities has long been debated since that time. It was settled once and for all in the seventies by micropalaeontologists.     

Pré-traitement d’un volume IRM par filtrage anisotrope robuste pour la segmentation de l’épaule

A novel pre-treatment process for image segmentation, based on anisotropic diffusion and robust statistics, is presented in this paper. Image smoothing with edge preservation is shown to help upper limb segmentation (shoulder segmentation in particular) in MRI datasets. The anisotropic diffusion process is mainly controlled by an automated stopping function that depends on the values of voxel gradient. Voxel gradients are divided into two classes: one for high values, corresponding to edge voxels or noisy voxels, one for low values. The anisotropic diffusion process is also controlled by a threshold on voxel gradients that separates both classes. A global estimation of this threshold parameter is classically used. In this paper, we propose a new method based on a local robust estimation. It allows a better removing of noise while preserving edges in the images. An entropy criterion is used to quantify the ability of the algorithm to remove noise with different signal to noise ratios in synthetic images. Another quantitative evaluation criterion based on the Pratt Figure of Merit (FOM) is proposed to evaluate the edge preservation and their location accuracy with respect to a manual segmentation. The results on synthetic and MRI data of shoulder show the assets of the local model in terms of areas homogeneity and edges locations.     

Stratégie d’étude des anticorps anti-nucléaires

Le terme d’anticorps anti-nucléaires (ANA), consacré par l’usage, est trop restrictif puisque certains de ces anticorps reconnaissent des antigènes cytoplasmiques. Un très grand nombre d’ANA a été identifié au cours des 30 dernières années. Seul un nombre restreint de ceux-ci est spécifiquement associé à des maladies précises, connues sous le vocable de connectivites. Toutefois, des ANA peuvent assui être rencontrés dans d’autres affections, un syndrome infectieux ou inflammatoire, une néoplasie, une maladie spécifique d’organe, en particulier les maladies du foie comme l’hépatite auto-immune et certaines cholangiopathies. Enfin, il ne faut pas oublier l’apparition d’ANA survenant lors de la prise de certains médicaments. La spécificité de ces anticorps est tout à fait différente de celle que l’on observe dans les connectivites.