Aspects cliniques, biologiques et thérapeutiques de la cryptorchidie diagnostiquée à l’âge adulte: analyse d’une série de 69 cas

Objective

To report the clinical, biological and therapeutic features of adult cryptorchidism and to determine whether orchidopexy at adulthood may improve male fertility.

Material and methods

We retrospectively studied the clinical pattern, biological and therapeutic features of 69 men aged of more than 18 years admitted for cryptorchidism at the urological department of Aristide-Le-Dantec teaching hospital between January 1999 and December 2007.

Results

The mean age of our patients was 31.04 ± 8.4 years. In the majority of cases, cryptorchidism was diagnosed in a context of infertility (38 cases), scrotum vacancy (21 cases) and testicular cancer (six cases). Cryptorchidism was unilateral in 69.5% and bilateral in 30.4% of cases. Semen analyses were done for 60 patients and showed azoospermia in 46.6%, oligozoospermia in 38.3% and a normal sperm count in 15% of cases. In all bilateral cryptorchidism cases, semen analyses showed azoospermia. At surgery, the undescended testis was found in 66 cases (95.6%) and orchidopexy was the most done surgical procedure. Seven patients (without testicular cancer) underwent unilateral orchiectomy and histology of specimens showed sertoli-cell-only syndrome with no spermatogenesis in all cases. The histological type of testicular cancer was seminoma (three cases) and embryonic carcinoma (three cases). In azoospermic men (28 cases) no induction of spermatogenesis was achieved after orchidopexy. In infertile patients, the improvement of sperm count was seen in three patients with unilateral cryptorchidism. Three patients with unilateral crytorchidism achieved pregnancy (pregnancy rate of 7.8%).

Conclusion

Orchidopexy for adult cryptorcidism had little impact in male fertility. Because of the risk of testicular cancer, orchidectomy was recommended as treatment of unilateral cryptorchidism. But with the recent development of TESE, orchidopexy appears as a reasonable treatment of adult cryptorchidism.     

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.     

Accumulation et excrétion de substances organiques par les cellules à chlorure de la branchie d'Anguilla anguilla L. adaptée à l'eau de mer

Résumé Les sites branchiaux d'accumulation de certaines substances (bleu de méthylène, urée, paraaminohippurate et inuline) injectées dans la circulation générale ont été localisés sur des anguilles adaptées à l'eau de mer. Le bleu de méthylène est accumulé et excrété par les cellules à chlorure. Les autoradiographies des corps marqués au ¹⁴C: inuline, PAH et urée, faites après cryodessication montrent que les cellules à chlorure accumulent ces substances. La signification de ces résultats est discutée.

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Accumulation and excretion of organic substances by the branchial chloride cells in sea-water adapted eel (anguilla anguilla L.)

Summary The branchial site of accumulation of various organic substances (methylene blue, urea, inulin and paraaminohippurate) following intracardiac injection has been localised in sea-water adapted eels. Methylene blue is concentrated and excreted by chloride cells. By combining freeze-drying and radioautographic technique it was possible to demonstrate that chloride cells concentrate urea, inulin and paraaminohippurate. The signification of these results is discussed in relation with the branchial excretion of organic substances.

     

Sensibilité comparée de divers animaux de laboratoire à l'infection par instillations nasales de la phase saprophytique d'Emmonsia crescens Emmons & Jellison, 1960: Fréquence et intensité du parasitisme,réactions histopathologiques

Comparative observations were made on the development of Emmonsia crescens in the lungs of laboratory rats and mice, golden hamsters and guinea pigs after a nasal instillation of a heavy suspension of the saprophytic phase of the fungus. 95% of 80 experimental rats were found to be parasited against 80% of 200 inoculated mice, while only 30% of 70 hamsters and all of 4 guinea pigs showed an infection. The lungs of the mice, rats and guinea pigs were frequently more heavily infected than those of the hamsters. In addition, the adiaspores obtained from the mice and rats had, on average, a diameter double those from the hamsters and their walls were thicker. Thus, the laboratory mice and rats were shown to be better hosts of E. crescens than were golden hamsters.     

Arthrite rhumato?de juvénile et HLA-B27.

Forty children with juvenile rheumatoid arthritis were studied to determine the frequency of the histocompatibility antigen HLA [human leukocyte antigen)-B27 in this disease and to characterize the arthropathy associated with this antigen. HLA-B27 was detected in four patients (10%). Its presence was associated in a statistically significant manner with sacroiliitis demonstrated radiologically and with a greater age at the time symptoms in the joints first appeared; this age was, on average, 10 years, compared with 6.29 years for the children without HLA-B27.     

Dynamique et èvolution de l'herbier à Posidonia oceanica en Méditerranée

Abstract

The natural growth of a Posidonia oceanica meadow is the result of a long process of development (series of events), but the dynamics are often difficult to establish because of the lack of a zero state and of sufficiently long chronological series. In addition, while it is sometimes possible to observe major regressions, the phenomena of recolonisation and of small-scale fluctuations are rarely detected. Nevertheless, with the emergence of new investigatory techniques (lepidochronology, microcartography, monitoring networks, accurate dating techniques, etc.,) considerable progress has been made in this field. The development in space and time of the seagrass beds is dependant on hydrodynamic action and sedimentary deposits. This means that in sheltered bays Posidonia oceanica may form original structures such as barrier reefs or micro-atolls, while in turbulent waters one observes the formation of spectacular structures resulting from erosion (intermatte, “rivière de retour”). A disequilibrium in sedimentation may result in dramatic regression in some seagrass beds. The multiplicity of prevailing environmental conditions results in the occurrence of a range of meadow types: “herbiers de plaines”, “herbiers de collines”, “herbiers tigrés”, “herbiers en escalier”. The impact of human pressure over the past few decades has not been insignificant. Coastal development constructions that have altered the direction of currents and the sedimentation, sewage outfalls that have resulted in an increase in the turbidity of the water and the mechanical action of anchors or trawl nets which have damaged certain areas of seagrass meadow have caused extensive regression. Conversely, the rehabilitation of previously degraded areas has made it possible to monitor the process of recolonisation.     

La glomérulonéphrite de shunt: manifestations cliniques et histopathologiques.

In patients with cerebrospinal fluid internal shunts, immune complex glomerulonephritis sometimes develops. Of two new cases the first was classic, while the second was in an adult who had had a ventriculoatril shunt for 8 years; furthermore, the patient had acute renal failure and is the first to have been reported to have Peptococcus septicemia. Shunt glomerulonephritis is characterized by the following: (a) its occurrence following, most often, Staphylococcus albus infection in a patient who usually has a ventriculoatrial shunt; (b) transitory improvement of the symptoms by antibiotherapy only; and (c) full recovery if the prosthesis is removed. Laboratory studies show a low serum concentration of the C3 component of complement, the presence of cryoglobulins and a positive rheumatoid factor test. These abnormalities are reversible with removal of the prosthesis. Optical microscopy of a renal biopsy specimen in the two cases showed cellular proliferation of the glomerular tuft, electron microscopy demonstrated subepithelial deposits and immunofluorescent studies revealed intramembranous and intramesangial immune complexes. These features are similar to those observed in experimental nephritis induced in animals by foreign protein.     

Radiothérapie interne vectorisée par 177Lu-PSMA-617 de l’adénocarcinome prostatique métastatique résistant à la castration : à propos d’un cas et revue de la littérature

The prostate-specific membrane antigen (PSMA) is a type II glycoprotein which is over-expressed in prostate cancer tissue, especially in high grade tumours, metastatic disease, as an effect of androgen-deprivation therapies and in castrate-resistant prostate cancer (CRPC). Recent studies about radioligand therapy using PSMA ligands labeled with lutetium-177 (¹⁷⁷Lu) in CRPC patients have suggested its interest as a third line of treatment after second generation anti-androgens and chemotherapy by taxane. We present the case of a CRPC patient who was treated by iterative radioligand therapy using PSMA-617 ligand labeled with ¹⁷⁷Lu. This case illustrates on the one hand the efficacy of the treatment, and on the other hand the fragility of the patients who are at an advanced stage of their disease. Then we present a short review of the literature on this topic, focusing on the published efficacy and tolerance of ¹⁷⁷Lu-PSMA radioligand therapy of CRPC patients.     

Scintigraphie de perfusion cérébrale positionnelle : résultats physiologiques et applications cliniques

To assess the impact of standing on brain perfusion, 125 brain perfusion scans in the upright and supine position were performed, including 108 patients. Perfusion values were compared using a relative quantitative approach and a segmentation of vascular territories with the help of an atlas of brain perfusion. We found a change in the distribution of the perfusion in favor of the vertebro-basilar system in the upright position. We discuss the case of a patient whose symptoms could be explained with the help of the comparison of brain perfusion scans in the upright and supine position. Atheromatous and post-dissection stenosis and their influence on perfusion are also discussed.     

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.     

L'eutypiose de la vigne : isolement d'une molécule synthétisée par Eutypa lata et toxique pour la vigne

Eutypa dieback, caused by the ascomycet fungus Eutypa lata, is currently the most serious disease of the grapevine. This disease now affects a great number of vineyards throughout the world, its economic impact is very important, and there is no remedy available for the destruction of the parasitic fungus. In this article, we describe the dieback symptoms, the management practices, the economic impact and the present knowledge on the interactions between E. lata and grapevine. We also present findings concerning the role of a toxic compound, hydroxy-4(methyl-3 butene-3 ynyl-1)-3 benzaldehyde, name eutypine, synthesized by the parasitic fungus and which was shown to be involved in the expression of the disease symptoms. The recent progress made in understanding eutypine's mechanism of action has opened new prospects regarding development of efficient tools for stopping this disease.