Personnalisation des émotions et cortex médial préfrontal

Functional brain imaging studies in healthy subjects suggest that several regions (prefrontal cortex, amygdala, thalamus, hippocampus, anterior cingulate) have specialized functions for emotional operations. Within these regions, the medial prefrontal cortex (MPFC) is considered to have a general role in emotional processing. Using a memory paradigm with verbal material, we recently demonstrated that the MPFC is specifically involved in self-related processing of emotional stimuli. Study with mood induction also suggest that personality traits may modulate the reactivity of the MPFC to emotional Stressors. Taken together these findings support the hypothesis that the MPFC subserve processes involved in emotion regulation. Dysfunction of the MPFC and related structures (i.e. amygdala) may increase the vulnerability to emotional disorders.     

Le Mésolithique. Continuité et développement métaphysique

The Mesolithic is a fascinating period, where ancient traditions are tilting towards a new paradigm. Many changes can be recognised without being able to establish a real split with the Palaeolithic. Far from being just a bridge towards the Neolithic, the Mesolithic is truly a new and stable metaphysical structure. In our article, we are interested in the structural mechanisms by which Palaeolithic metaphysics slides towards the Mesolithic, where the individual occupies a central role.     

La méta-analyse: évaluation qualitative et quantitative de l’information scientifique en médecine

Meta-analysis is a method which uses statistical techniques for combining results from several different studies, in order to get an estimation of the global effect for a procedure on a global outcome. This technique leads to an increase in the power of statistical testing. It also gives an information which cannot be drawn from one individual study. Two approaches are possible, and often combined. The qualitative approach consists of weighing various studies according to their methodological quality. The quantitative approach consists of pooling the results of different studies. The different steps of the meta-analysis are described. Meta-analysis shows many advantages, such as the estimation of the effect size or the increase in generalizability. It also helps physicians and health policy makers in answering to a specific question.     

Les essais cliniques en médecine nucléaire : état et perspectives

The particular status of radiopharmaceuticals, together with the positioning of nuclear medicine in multidisciplinary approach of oncology, lead to real difficulties for conception, validation and granting of clinical trials which are necessary for demonstrating clinical interest of new compounds, for diagnosis as well as for therapeutic use. This article is a presentation of some recent clinical trials conducted in nuclear medicine in France, showing its dynamism but also pointing out some encountered difficulties. These experiences could lead to reflexion in order to improve the clinical research performances, taking into account a scientific and regulatory context more and more constraining.     

Histologie testiculaire et études méiotiques dans les stérilités de type non obstructif

There has been a renewed interes in testicular biopsy to evaluate infertility since the introduction, in 1993, of ICSI in azoospermic men with testicular sperm extraction (TESE) and intracytoplasmic sperm injection for the treatment of obstructive azoospermia. TESE is now performed for the treatment of nonobstructive azoospermia, and the testicular material sampled for therapeutic purposes can also be used for diagnostic and research purposes. The development of new methods of investigation of spermatogenesis, such as immunocytochemistry and fluorescent in situ hybridization (FISH) have also led to a renewed interest in analysis of spermatogenesis on testicular biopsy. A precise “testicular phenotype” must now be established to propose an aetiological diagnosis, and to determine the mechanisms and risks of nonobstructive azoospermia and severe oligozoospermia for the embryo. We systematically perform testicular histopathology and meiotic study for each patient undergoing testicular biopsy for ICSI. We first describe the histopathological lesions. Examination of the testicular biopsy specimen determines whether the lesion is focal or diffuse. If it is focal, the percentage of altered tubules, evaluated on 50 tubules, should be calculated. Quantitative evaluation of seminiferous epithelium and a qualitative study of cell morphology must also be performed. There are four frequent lesion patterns: 1-Sertoli-cell-only syndrome; 2-tubular hyalinisation; 3-diffuse lesions in spermatogenesis; 4-mixed atrophy. However, the reliability of interpretation of testicular histology presents certain limitations, as no standard method of analysis of testicular biopsies has been defined and there is a marked variability in the histologist’s capacity to recognize the various histological patterns. Meiotic study is performed on the cell suspension remaining after ICSI, which contains immature germ cells. New methods using immunocytochemistry have replaced older methods. The panel of antibodies which detect individual protein components at different stages of meiosis provides a valuable tool for the detection and interpretation of abnormal meiotic profiles. We performed meiotic studies on 41 patients and 13 controls after Giemsa staining, and synaptonemal complexes (SC) from nine of these patients and one control were immunostained with a polyclonal antibody which recognizes the COR1/SCP3 protein of the lateral element of the SC. Nineteen of the patients presented obstructive infertility (O) and 22 presented nonobstructive infertility (NO). We showed that the rate of asynaptic nuclei from the NO group (25.4%) was significantly higher than that of the O group (9.8%) and the controls (9.8%). Two patients of the NO group had a high percentage of asynaptic nuclei (86% and 91.8%), which could arise from a primary meiotic defect. One of these patients had an AZFc microdeletion. The meiotic study in a patient with classical complete AZFb microdeletion revealed a high prevalence of early meiotic stages: leptotene, zygotene and early pachytene stages and marked impairment of the synaptic process in most spermatocytes. In the light of these findings, we conclude that the pachytene checkpoint is localized at the mid-pachytene stage in humans.     

Dysplasie des crêtes épidermiques, à hérédité dominante autosomique

Résumé Les auteurs décrivent une grande famille où sur 4 générations, 15 sujects sont atteints de dysplasie des crêtes épidermiques digitales, palmaires et plantaires. Dans cette famille, l'anomalie se transmet visiblement sur le mode dominant autosomique avec pénétrance complète et expressivité variable.

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Dysplasia of epidermal ridges, with autosomal dominant transmission

Summary A large family is described where 15 individuals on 4 generations are affected with a dysplasia of the digital, palmar and plantar epidermal ridges. In this family, the anomaly is transmitted according to the autosomal dominant mode of inheritance with complete penetrance and variable expressivity.

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Ce travail a reçu l'appui du Fonds de la Recherche Scientifique Médicale (Belgique).     

Psammocarcinome ovarien et médecine nucléaire

We report three cases of ovarian psammocarcinoma, which is a serous adenocarcinoma having psammoma calcifications. The FDG uptake in the psammomatous lesions is due to the tissular part of the lesion and the technetium-99m labelled agents uptake to its calcified part. Calcifications are detected on CT scans. Therefore, they are relatively simple to diagnose by nuclear medicine which is useful given relatively the better prognosis of the psammomatous ovarian serous carcinoma when compared to the serous one.     

Anxiété et personnalité: études catégorielle et dimensionnelle de leur association et facteurs de vulnérabilité

Anxiety disorders often appear in patients with particular personality traits, and in some cases with actual personality disorders. This clinical observation may question the respective interactions between personality and anxiety disorders: Is it possible to evaluate the personality of patients with severe anxiety disorders reliably? What is the real co-morbidity between personality disorders and anxiety disorders? Are there psychopathological and etiological links between these two disorders? Studies relying on categorical approaches of personality suggest that about 40-60% of anxious patients fulfill the diagnostic criteria of at least one personality disorder. The most frequent diagnoses belong to the cluster C of the DSM-IV axis II classification, with a majority having avoidant and dependent personalities, but without any real specificity according to the types of anxiety disorders. On the other hand, dimensional studies have shown that anxiety disorders are often associated with avoidant personality traits, with very deviant scores in some cases, even after treatment of the anxiety disorder. These works support the existence of some temperament traits, underlined by psychobiological, stable, and inheritable dimensions, which may constitute early vulnerability factors for anxiety disorders in both children and adults.