Apport du TDM en imagerie multimodalité : le point de vue du physicien médical

The recent introduction of hybrid systems SPECT/CT and PET/CT in nuclear medicine, greatly improved the diagnostic accuracy for particular clinical indications, due to the possible attenuation correction of functional images and the availability of helpful anatomic information. The introduction of CT in the nuclear diagnostic process results in a significant increase of the patient dose. This increase should be justified and optimized considering both the clinical question and the CT settings available on these systems. The choice of CT settings directly affects the effective dose. It varies basically as the square of the tube voltage, linearly with the length of the scan and the product of the current by the rotation time of the tube. It is also inversely proportional to the pitch. For attenuation correction, the literature shows that it is possible to use a low CT tube current without significant effect on tumor FDG uptake or lesion size. Conversely low CT voltage must be used with caution, depending on the algorithm implemented in the CT hybrid device to transform CT Hounsfield units to the attenuation map at the appropriate energy. The radiation dose for anatomic correlation can be substantially lower than for diagnostic-quality CT. It is possible to reduce the patient's radiation dose by a factor of 2 or 3 by acquiring a low-dose PET/CT scan for anatomic correlation of adequate image quality if compared with diagnostic ¹⁸FDG PET/CT. Using specific CT settings, the effective dose can range 7.3–11.3 mSv depending on the patient weight and age.     

Quand le renne entra au panthéon du Paléolithique supérieur ?

By means of critical analysis of style of reindeers figures calling on graphic detailed conventions and on their associations with a cattle into that species of very rigorous climate prevail over the others, such musk-beef, glutton and saïga, but also plenty of bison's, as well as horses, it appears hardly likely, to do not say impossible, that reindeers of Chauvet's cave can have aurignacian origin. That all the more as they would be all alone in this case among one hundred sixty-six taking the census of representation. Their comparison with the other reindeers of the different sites generally do not distinguish from solutrian or Magdalenian reindeers and bring together particularly with Gabillou by many stylistic concurrents. If A. Leroi-Gourhan has already established that link between horse and reindeer only appears at Magdalenian, it seems now that it is possible to extend to superior Solutrian in support of representations of our inventory, reflecting climate aggravation that takes place at this moment and promotes plenty of two species in the neighbourhood.     

Les occupations humaines du Nord du Maroc,du Paléolithique Moyen et du Paléolithique Supérieur. Nouvelles données sur la base des recherches archéologiques des projets de 2005 à 2020

In this work, we present a synthetic panorama of the human occupations of northern Morocco, with an emphasis on the association of anthropological with cultural records, within the framework of the Middle Palaeolithic (MSA) and the Upper Palaeolithic. We also present the projects developed over the past 15 years and the most interesting results we have obtained. And we conclude bay providing some reflections on the cultural and historical evaluation of the archaeological records from the Tetouan region in the Middle and the Upper Palaeolithic phases.     

Cellules souches et biomatériaux injectables pour la médecine régénératrice du cartilage : le consortium « chondrograft »

Articular cartilage is a non innerved, nonvascularized and poorly cellularized connective tissue that is frequently damaged as a result of trauma or age-linked degenerative diseases. It hardly heals spontaneously and its alterations often lead to further extracellular matrix degradation and ultimately, to the loss of joint function. Past decades, many therapeutic approaches have been developed to improve the poor intrinsic self-repair properties of cartilage. Unfortunately, these techniques have not proved really satisfying. In this context, the regeneration of a functional cartilage through tissue engineering and regenerative medicine has recently been contemplated. In particular, the transplantation of autologous reparative cells using a synthetic biomaterial appears promising. We have thus developed and patented a biocompatible self-setting cellulose hydrogel that can be used as an injectable scaffold for cell-based regenerative medicine. Our studies associate this hydrogel with adult mesenchymal stem cells derived from adipose tissue, as a source of reparative cells for cartilage tissue engineering. In a first set of experiments, we have determined the optimal culture conditions required to induce the controlled chondrogenic commitment of stem cells (morphogens, hypoxia, three-dimensional environments…). The preclinical potential of hybrid constructs associating cells and hydrogel has then been assessed with success in animals (mouse, rabbit). Today, trauma and degenerative pathologies of joint tissues remain a major challenge for clinicians and cartilage engineers. Establishing the proof of concept of hydrogel-associated stem cells-based regenerative medicine could help us open new therapeutic windows in the treatment of joint disorders.     

Sélaciens nouveaux du London Clay de l'Essex (Yprésien du bassin de Londres)

The Ypresian locality of Burnham-on-Crouch(Essex) has yielded numerous Selachian species, some of which are new: Hexanchus agassizi sp. nov., Scyliorhinus burnhamensis sp. nov., S. casieri sp. nov., S. pattersoni sp. nov., S. woodwardi sp. nov., Pararhincodon ypresiensis sp. nov., Triakis wardi sp. nov., Mustelus whitei sp. nov. The Hexanchid teeth classicaly refered to Notidanus serratissimusAg. include in fact two separate species belonging to different genera: Notorhynchus serratissimus (Ag.) and Hexanchus agassizi sp. nov. Lamna affinis (Casier) is arranged in the genus Isurolamna nov. in consideration of his dental peculiarities. The genus Burnhamia nov. is created for Rhinoptera daviesiWoodward that can be regarded as a Mobulid. Oxyrhina sheppeyensisCasier must be classified in the genus Anomotodon. The genus Triakis, Mustelus, Anomotodon and Pararhincodon are pointed out for the first time in the Ypresian.     

Anémie du sujet âgé

Anaemia is common in patients older than 75 years. Patho-physiologic mechanisms of anaemia are similar to that involved in younger patients even though certain mechanisms are more common in the elderly. Practical decisional algorithms have to be used for the diagnosis of anaemia. Risk factors for anaemia have been identified in this age group: institutionalization, bad socio-economic conditions, co-morbid conditions. Particular emphasis is given to several points:

1. The clinical tolerance of anaemia is the most important feature to take into account in older patients, rather than the decline of the haemoglobin level. Even if the haemoglobin level is only slightly decreased, evaluation of anaemia should be performed by the geriatrician, including, if needed, the achievement of a bone-marrow aspiration.
2. Causes of anaemia are often multiple, due to frequent comorbid conditions and acute illnesses, associated with nutritional deficiencies, inflammation… Chronic kidney disease and dysthyroidia are also common.
3. Nutritional deficiencies (iron, folate and/or B12 deficiency) are frequent and their cause has to be identified.
4. The prevalence of myelodysplastic syndromes, which are clonal diseases, is probably underestimated in this age group.

     

Détermination par TEP-TDM au 18FDG du statut ganglionnaire dans les cancers du col utérin – intérêt de la mesure du SUV de la tumeur primitive

Purpose. – To evaluate the value of ¹⁸F-fluoro-2-désoxyglucose (FDG) PET-CT and maximal standardized uptake value (SUV_max) of the primary tumor for lymph node staging in cervical cancer.Materials and methods. – This retrospective study involved a series of 18 consecutive patients who had benefited from PET-CT and MRI at initial staging for a stage IB or higher cervical carcinoma. The SUV_max of each primary tumor was measured retrospectively. All patients had been previously treated by radiochemotherapy. Lymph node status was obtained in 12 of 18 cases.Results. – The sensitivity and specificity for determining lymph node status was 80 and 86%, respectively, for PET-CT, and 80 and 71% for MRI. In 16.6% of cases, PET-CT revealed unknown sus-diaphragmatic lesions. SUV_max of the primary tumor was significantly higher in the N+ than in the N− group (15.6 ± 1.6 vs 8.5 ± 3.9, p < 0.01). The optimal threshold was determined to be 10.8 from ROC analysis.Conclusion. – When staging with FDG PET-CT, SUV_max of a primary cervical cancer seems to be a good predictor of lymph node status. This could lead to an intensification of treatment for patients whose SUV_max is higher than 10.8. A prospective study would allow to assess a potential benefit of treatment intensification for patients with SUV_max higher than 10.8.     

Dérivés Monotritylés du D-xylose

Monotritylation of O-acetyl derivatives of D-xylopyranose and D-xylofuranose with trityl chloride in acetonitrile-pyridine gave the tri-O-acetyl derivatives of 1-,2-, 3-, and 5-O-trityl-D-xylofuranose and of 1-, 2-, 3-, and 4-O-trityl-D-xylopyranose which were required for the identification of the various monotrityl derivatives obtained in the tritylation at 50° of D-xylose with trityl chloride in pyridine or hexamethylphosphoric triamide-silver acetate.     

Les sépultures italiennes du Paléolithique supérieur. Reconstitutions du régime alimentaire

The identification of dietary habits is increasingly seen as a fundamental aspect for studying the ancient human populations. Accordingly, several projects aiming to identify Paleolithic individuals’ dietary patterns were developed to analyze the organic component of bone tissue and identify isotopic markers to reconstruct the food typology. Bone fragments from six individuals were selected for carbon and nitrogen stable isotopes analysis. The interpretation of human isotopic data was framed through a dataset of twenty-one Italian Paleolithic individuals. The isotopic data generated for the Paleolithic individuals agree with the information already provided by the archaeological record concerning the Italian hunter and gatherer communities. Their subsistence economy was essentially grounded upon the exploitation of high protein foods, either from terrestrial fauna resources or inland lacustrine or riverine species.     

Études du Paléolithique du Japon à partir des téphras

Many studies and discussions have been made on the problem of when the earliest human beings appeared in Japan. In general, hominid fossils in the latest Pleistocene are not preserved except for coralline limestone sequence in Ryukyu islands, but earlier Paleolithic tools were excavated from volcanic ash soil with a ¹⁴C age of about 30,000–35,000 yr. BP or younger at several archeological sites in almost all Japan. Recent studies, however, show a need for revision and refinement of these ages because calibration techniques have progressed from conventional to calendar ages and high-resolution oxygen isotope chronology has given a global standard sequence. Aïra-Tn tephra (AT), the most important time-marker of the Paleolithic age in Japan, was formerly dated at 21,000–22,000 yr ¹⁴C BP by conventional radiocarbon methods but was dated again at ca. 24,500 yr ¹⁴C BP by accelerated mass spectrometry radiocarbon methods. However, it has been further calibrated to a high-resolution calendar age of 30,000 cal yr. by varve chronology of lake sediments of Suigetsu of central Japan, well matched with combined date between oxygen isotope dates based and calibration from AMS radiocarbon dates. As the earliest Paleolithic tools in south Kanto are found in volcanic ash soil significantly below AT ash and above Sambe-Ikeda ash (SI, ca.46 ka), just above the oxygen isotopic stage 3.3, they are estimated to be dated slightly older than 40 ka. Palaeo-environment at that time is estimated mild to cool climate and relatively low sea level after the oxygen isotope stage 3.3. Sill land bridges between Japan islands and continents have not been formed at major straits. We have not yet obtained useful data for calibration older than ca. 45 ka. Also, correlation of oxygen isotopic fluctuation with the terrestrial sequences is incomplete in Stage 3.     

Figures sédimentaireset traces d'origine biologique du Trias moyen de la bordure orientale du Massif Central signification sédimentologique et paléoécologique

The sandstones with foot-prints of reptiles and saltcasts from the Middle Triassic of the eastern border of the Massif Central (France) show a striking reptilian ichnofauna. The numerous sedimentary figures and trace fossils which are described here allow to deduce the following characteristics of the depositional environment: shallow water, lower flow regime, periodical increase of salinity. The reptiles used to pass through that environment where numerous stretches of water alternated with emerged, plant overgrown areas.     

Endémie bilharzienne à Schistosoma mansoni à la vallée du Kou : caractérisation du système de transmission et impact socioéconomique

Schistosomiasis is one of the waterborne diseases which benefit from environmental and behavioral changes induced by the mobilization of surface water resources in Sahelian countries, such as Burkina Faso. Studies have established the existence of human schistosomiasis in the Kou valley, one of the oldest hydro-agricultural zones in the country. However, the role of population behavior in the transmission pattern of this disease and its socioeconomic impact in this valley are poorly understood. It is in response to these questions that this study was undertaken. The objectives of this study were to identify activities that exposed most of the Valley's population to infection by schistosomiasis, and to contribute knowledge on the consequences of this disease. The study was conducted in the cold dry season at the Kou Valley, located in the South Sudanese area of Burkina Faso. It has adopted the strategy of direct observation to examine host–parasites interactions. The study of the socioeconomic consequences of the infection has been first to identify subjects that actually carry the parasite by screening the population by the Kato–Katz method. These were then subjected to a questionnaire. Data were analyzed using Epi Info 6.4. This work has revealed six activities at risk of infection for the residents of the Valley with an increased risk of factor for rice farming, household activities and swimming. In view of these activities, women and young people seem to be most vulnerable to infection. This disease causes significant economic losses as a function of socio-professional categories of infected persons.     

Hétérochronies du développement sensu Gould chez les foraminifères planctoniques cénomaniens : exemple de néoténie dans le bassin du Western Interior américain

Development heterochronies sensu Gould in the Cenomanian planktonic foraminifera: case of neotony in the American Western Interior Basin. During the Cenomanian–Turonian boundary, the anoxic event OAE2 has involved the disappearance of Rotalipora, complex keeled planktonic foraminifera which had conquered deep oceanic water. In the Western Interior basin, the last rotalipores are associated with Anaticinella, morphotypes without keel. The heterochronical relationship between these morphotypes is investigated. The loss of the keel would be a selective advantage enabling them to remain in the surface water, less reached by oceanic anoxia. Thus, two endemic species, only known in the American seaway, are observed: A. multiloculata (Morrow) and A. planoconvexa (Longoria). These species would respectively result by neoteny from R. greenhornensis and R. cushmani. To cite this article: D. Desmares et al., C.R. Palevol 2 (2003).     

Les hétérochronies du développement : un outil pour l'étude de la variabilité et des relations phylétiques ?: Exemple de Nigericeras,Ammonitina du Crétacé supérieur africain

Ontogenetic heterochronies: a tool to study both variability and phyletic relationships? Example: Nigericeras, Ammonitina of the african Upper Cretaceous. The Nigericeras gadeni ontogenesis (Saharian Upper Cretaceous) is characterized by three ornamental stages: multi-tuberculate inner-whorls, ombilical bi-tuberculate medium-whorls, then finally smooth adult stage. Ontogenetic Heterochonies account for their adult variability, which extends between both paedomorphic (thick/ornamented) morphotype, and peramorphic (thin/smooth) morphotype. That species may take root in the older Pseudocalycoceras. A peramorphocline characterizes the evolution of these ammonites and their younger relatives, leading to different Nigerian and Nigerien, highly compressed taxa. Such morphologies seem to be related to shallow-water palaeo-environments. The general transgressive context leads to the progressive scarcity of their supposed ecological niches. To cite this article: P. Courville, C. Crônier, C. R. Palevol 2 (2003).     

Impact du délai diagnostique sur la survie du cancer du testicule

Objectives

Testicular cancer is the leading cancer of young adults and its incidence is increasing in almost all industrialized countries. The survival rate after testicular cancer is 95%, all stages combined, but a group of patients with poor prognosis still fails to respond to treatment. The time to diagnosis is defined as the time in months between perception of the first symptoms of testicular cancer by the patient and the diagnosis of the disease by the doctor. The objective of this study is to determine whether the time to diagnosis has a prognostic value, particularly whether it is correlated with the stage of the disease and survival.

Material and Methods

The time to diagnosis was studied in 542 patients with a diagnosis of testicular cancer between 1983 and 2002 in the Midi-Pyrenées region. Information concerning the disease and treatments contained in medical files was collected on a summary document. The time to diagnosis was correlated with prognostic parameters, including stage and survival.

Results

The mean time to diagnosis was 3.7±5.1 months and was longer for seminomas (4.9±6.1 months) than for non-seminomatous germ cell tumours (NSGCT) (2.8 ±4.0 months). The time to diagnosis was correlated with the stage of the disease and the 5-year survival on the overall population and in the NSGCT group, but not in the seminoma group.

Conclusions

Early diagnosis has a prognostic value (correlation with stage of the disease and 5-year survival rate). Testicular cancer information campaigns should therefore be envisaged.