Le pré-analytique en hémostase

La phase pré-analytique est celle de tous les dangers, en particulier lorsque le biologiste n’a pas la ma?trise du recueil de l’échantillon et de son acheminement au laboratoire. En hémostase thrombose, elle est essentielle. Les paramètres pré-analytiques sont d’importance inégale selon les différents examens et leur retentissement peut varier d’un réactif à l’autre et selon les patients. De fait, il existe un risque de rendre un résultat erroné, même avec une technique irréprochable, ainsi qu’un problème de responsabilité technico-légale. La littérature sur les conditions pré-analytiques est pauvre et de nouvelles études sont nécessaires, même si elles sont difficiles à mener et peuvent para?tre de peu d’intérêt. En réalité, leur utilité est aujourd’hui indéniable, en raison notamment du regroupement des laboratoires.     

Le point sur les niveaux de référence diagnostiques en médecine nucléaire en 2011

Seven years after the publication of the first diagnostic reference levels (DRL) order, the analysis of the data allows the French Institute for radiation protection and nuclear safety (IRSN) to assess and evaluate the increase of the nuclear medicine departments involvement and of the level administered activities to the patients during the most common examinations performed in France. IRSN analyses show a good agreement between the distribution of transmitted examinations and the frequency of examinations performed in France, taking into account 95% of the number of examinations and 95% of the dose delivered to patients by nuclear medicine. These analyses highlight the necessary consistency between DRL regulation, the French society of nuclear medicine (SFMN) recommendations and national practice. The IRSN recommendations established from data analyses have leaded the authorities to publish a new DRL order in January 2012. This first update of the regulation takes into account actual clinical practice in nuclear medicine and introduces fundamental points as pediatric DRL. In the future, periodical updates will be implemented in order to take into account procedures and devices evolutions.     

Illustrations cliniques en pédiatrie

The examples and clinical cases presented in this section are not intended to be considered as absolute models in terms of image quality or device parameter settings. They must initiate an individual analysis according to CT parameters and image quality. Nevertheless, they present practically different CT levels which can be used according to the clinical context and the type of device.     

Illustrations cliniques en ostéo-articulaire

The examples and clinical cases presented in this section are not intended to be considered as absolute models in terms of image quality or device parameter settings. They must initiate an individual analysis according to CT parameters and image quality. Nevertheless, they present practically different CT levels, which can be used according to the clinical context and the type of device.     

Les profils de composition en oligoéléments des pollens,marqueurs potentiels en cladistique végétale

In botany tentative attempts have been made to classify species, based not on the plant as a whole, but on a particular character, for example pollen characteristics. Pollen, which is involved in the transmission of male genetic information during sexual reproduction, is of particular interest in distinguishing plants and their relationships.

These characters, observed in photon- and scanning electron- microscopy are symmetry, form, number and position of germinating areas. Being genetically stable for a given species, they identify a plant.

Recently, a novel character has been added: the concentration of elements in the exine, determined by electron probe micro-X-ray analysis. It is interesting to follow relationship of plant species, based on the mineral composition of their pollen as a whole, taking into account both plastic and oligoelements, obtained via an inductive coupled plasma spectrometer. Samples of pollen from different plant species, at distinct taxonomic levels, were analyzed; the results were submitted to a normalisation procedure and the standard patterns obtained were investigated by means of a number of numerical techniques (clustering and factor analysis). The aim was to establish if elements could be considered as chemical markers in plant cladistics. The mineral composition in a given species appeared quite stable and this furnished a convenient identification-critorion.

This approach further allows a chemo-taxonomy of species, in as much as organization of families, and perhaps orders, would conform to the phylogenetic proximity-criterion. Hence, we found clusters including pollen of Gramineae, Coniferae, Betulaceae…

This methodology, that should be completed and corroborated on a wider range of samples would provide an original responsee to the problems of identification and classification encountered in a pollen bank. It follows that:

Hence, the working hypothesis that the chemical markers and, in particular, oligo-elements, complete pollen typologies based on morphological and structural characters, appears quite reasonable.

In conclusion, this paper brings a complement to the mineral composition of the exine.

En botanique, des tentatives ont été faites pour classer les espèces non plus à partir d'individus pris dans leur intégralité, mais sur la base d'une de leurs particularités, par exemple à partir des caractéristiques offertes par les pollens. Ainsi, le pollen, dont le rôle est de transmettre l'information génétique mâle de la plante au moment de la reproduction sexuée, présente des caractères de premier ordre utilisables pour distinguer les différentes plantes et pour situer leur parenté et leur filiation.

Ces caractères, que l'on observe en microscopies photonique et électronique à balayage sont la symétrie, la forme, le nombre et la position des zones germinatives. Pour une espèce génétiquement stable, ils constituent la carte d'identité de la plante.

Il est intéressant de continuer à explorer la voie de la structuration des espèces végétales basée sur la connaissance chimique du pollen en déterminant sa composition en oligo-éléments par l'utilisation d'un spectromètre à plasma à couplage inductif. Ainsi, des échantillons de pollens appartenant à diverses espèces végétales situées à différents niveaux taxinomiques ont été analysés et les résultats normalisés sous forme de profils standard ont été soumis à différentes techniques d'analyse statistique mathématique (classification automatique et analyse factorielle). Le but de cette approche est d'apprécier l'aptitude des éléments minéraux à être des marqueurs chimiques en cladistique végétale.

Les résultats obtenus ont permis de constater la relative stabilité du profil en composition minérale au sein d'une même espèce végétale, ce qui donne accès à un critère d'identification commode.

Cette approche permet d'autre part une chimiotaxinomie des plantes étudiées.

Cette approche méthodologique semble susceptible d'apporter une réponse originale aux problèmes de conservation. Les pollens conservés doivent avoir la même composition minérale que les pollens frais.

— the pattern of pollen composition of oligo-elements, calcium and magnesium is a marker in plant cladistics. Since a typology depending on proximity is found between plant species, families and orders.

— an unknown pollen sample may be located, tentatively, on the base of a described model of pollen relation (shortest connexion network — Prim algorithm — and pollen of Bactris-oil palm and Phoenix dactylifera).     

Les essais cliniques en médecine nucléaire

The EU clinical trials directive (2001/20/EC) was published on the 4th April 2001 and was transposed into French law in 2004. This new clinical trial regulation has modified considerably the research area including clinical trials conducted with radiopharmaceutical medicinal products. This new regulation aims at ensuring the protection of the health and safety of clinical trial participants, the ethical soundness and the reliability and robustness of data generated in clinical trials. In practice, the sponsor has to submit a clinical trial application to the Afssaps for authorization and to the concerned Ethics Committee for a positive opinion. The content of the clinical trial application regarding the investigational medicinal product is very detailed and a heavy technical dossier could be required in order to justify the quality of the medicinal product used in the clinical trial. Furthermore, pharmacy and radiopharmacy required specific authorizations for preparing these medicinal products. This new regulation could refrain nuclear medicine from conducting clinical trials.     

Blessé médullaire: prise en charge en andrologie

Sexual reactions are under neurological control. Spinal cord trauma alters neurological structure and induces sexual dysfunction. Pharmacological drugs used currently allow erectile function to be recovered in spinal cord-injured men, an essential step towards the resumption of a sex life. Triggering of ejaculation is often difficult. Perineal stimulation techniques, used either in isolation or in association with pharmacological treatment, promote ejaculation and allow sperm collection and freezing. The possibility of achieving ejaculation during sexual intercourse in spinal cord-injured men remains rare and there is as yet no real therapy available. Despite poor semen quality, spinal cord-injured men maintain reproductive possibilities in 40 to 60% of couples. The use of assisted reproductive technologies is often required. Management of sexual dysfunction in spinal cord-injured men must be integrated into a rehabilitation and re-insertion programme.     

Le Jas d’en Biel 2, nouveau site gravettien du piémont est-méditerranéen des Pyrénées

The Corbières massif forms the lowest part of the Eastern Pyrenees, and as such is the easiest natural passage to connect the coastal plains of Languedoc and Roussillon in Southern France with those of Gironès and Barcelona in Northern Spanish Catalonia. This geographical situation confers on each of the sites discovered in this passage a role of milestone that can allow us to apprehend the dynamics of anthropic movements and relationships across these spaces. In 2007, the presence of a first Gravettian site in this Northern Pyrenean foothill was published: Jas d’en Biel 1. This discovery filled an “archaeological void” between the Gravettian sites of Languedoc and those of Spanish Catalonia. The discovery of a new site: Jas d’en Biel 2, 300 m from the first, reinforces the Gravettian presence in this region. The fact that the two sites present similar characteristics in terms of anthropic choices (solar orientation, proximity to a watercourse, lightness of the soil, protection from the wind, etc.) are all parameters that demonstrate the choices made by Gravettian men. The respective compositions of the lithic industries of the series do not show significant differences, allowing us to imagine a certain synchronism between the two sites. Burins are the most numerous tools, but at Jas d’en Biel 2 we find specimens close to the Raysse type that were absent from Jas d’en Biel 1. Jas d’en Biel 2, as well as its neighbor Jas d’en Biel 1, shows similarities with certain sites in Languedoc, such as Bois-des-Brousses, La Treille, La Verrière, the caves of Bize or La Crouzade. These are usually small deposits that belong to terminal moments of the Gravettian period. All these parameters point to similarities between the Languedoc sites and Jas d’en Biel 1 and 2. The geographical position of the Corbières massif allows us to consider the Jas d’en Biel sites as the last milestones of the Gravettian period upstream from the crossing of the Pyrenean passes, before the sites of the Serinyà region, such as l’Arbreda. Recent surveys carried out in the same valley of the Ravin d’en Saman have made it possible to locate and identify several other open-air settlements related to the Gravettian lato sensu. An analysis of intra- and extra-site characteristics will aim to understand the parameters that led men to settle in this micro-zone, as well as the reasons for this “concentration”.     

Familles moléculaires et réactions croisées en allergie

Le risque pour une personne de développer des manifestations allergiques est plus grand si elle a des antécédents familiaux d’allergie: on parle de terrain atopique.     

La simulation Monte Carlo en médecine nucléaire

The Monte Carlo method allows for simulating random processes by using series of pseudo-random numbers. It became an important tool in nuclear medicine to assist in the design of new medical imaging devices, optimise their use and analyse their data. Presently, the sophistication of the simulation tools allows the introduction of Monte Carlo predictions in data correction and image reconstruction processes. The availability to simulate time dependent processes opens up new horizons for Monte Carlo simulation in nuclear medicine. In a near future, these developments will allow to tackle simultaneously imaging and dosimetry issues and soon, case system Monte Carlo simulations may become part of the nuclear medicine diagnostic process. This paper describes some Monte Carlo method basics and the sampling methods that were developed for it. It gives a referenced list of different simulation software used in nuclear medicine and enumerates some of their present and prospective applications.     

Réflexions sur la place des médecins spécialistes en médecine nucléaire dans le dispositif d’annonce en cancérologie

Nuclear medicine physicians are very involved in French's oncology announcement procedure. However, their role needs to be analysed and evaluated. Before diagnosis’ announcement, information provided by nuclear medicine physicians are never neutral for patients. Information must not increase patient's anxiety or false patient's sense of reassurance. In this context, it seems necessary to engage in ethical reflexions about nuclear medicine physicians communication challenges.     

L'analyse et la synthèse en systématique végétale

Analysis and synthesis have been widely used in systematics since, at least, the XIXth Century. Even now, the four major authors (Cronquist, Dahlgren, Takhtajan, Thorne) of angiosperm systems use “synthetic” to qualify their classifications. This word — synthetic or synthesis — has many different meanings that can create ambiguity. Among these meanings, is there one that can be justifiably used to define biological classifications? Although much more than the following applications can be found in the botanical literature, this paper will mainly deal with six meanings which are still in use in contemporary systematics. A synthetic classification has been understood as a classification built upward, from the lower to the higher categories. If we define synthesis as the operation that starts with elements and proceeds to a whole, then upward classification could be viewed as a synthesis in which the concept of hierarchy plays a primordial role, a role that is not initially a part of synthesis. Moreover, synthesis cannot replace all classificatory processes, and other criteria of taxa must be used in addition to synthesis Historically, synthesis has replaced analysis; the latter being employed by Linnaeus in his sexual system. Indeed, Linnaeus used a divisive method in producing his classification; and since division was seen as synonymous to analysis and recognized as a method that led to artificial taxa, leading French taxonomists Adanson, Lamarck and A.-L. de Jussieu among others, rejected analysis and viewed their classifications as synthetic, i.e., based on the natural method. Therefore, a system of value took place: natural was better than artificial, synthesis better than analysis. Reinforcing the importance of synthesis was the belief in a concept widely accepted at the end of the XVIIIth Century: that of continuity. Linking groups and forming a continuum was a procedure eminently synthetic. Such a procedure, known as “chaining”, produced series or sequences of taxa. Analysis was used solely to express the idea of dichotomous or analytical keys, a Lamarckian innovation that enabled taxonomists to identify plants. But whether classifications are built from lower to higher categories (a synthesis of taxa) or from higher to lower categories (an analysis of taxa), another simultaneous, concomitant movement is implied: with the latter, a synthesis of characters, with the former, an analysis of characters. Therefore, a synthetic classification is nevertheless an analytical classification.Basing groups on resemblance instead of difference, results in yet another application of synthesis. This application is probably due to the analogy with “composition”. Already, a separation between resemblance and difference among characters is an analysis. More important, still, is that at a certain rank some characters are used to join whereas, at another rank, they separate. Thus, depending on ranks and taxa, characters are applied in a synthetic or analytical procedure. Here also, other criteria are needed to support group delimitation.In connection with the upward (synthetic) movement in classifying taxa, the use of a great number of characters was also considered to be synthesis. This has been a recurring theme in taxonomy over the last two centuries and was sometimes seen as the Gilmourian approach to classification. When would we be justified to talk about synthesis? After how many characters? In fact, it is not the number of characters that matters but how characters are handled. The use of many characters has been closely linked to the idea of natural groups and its joining with synthesis seems to derive from the association of “natural” and “synthetic”.Synthetic classifications equally imply the common idea that they must represent a résumé of information stemming from all biological fields or disciplines. If classifications portray evolution, as many systematists suggest, then it cannot be just a résumé. And one must first decide what classifications are about: a controversial subject among different schools of thought in taxonomy. This explains another meaning attached to synthesis. Biological classifications have been said to be a synthesis or résumé of two types of information: that of similarity and that of phylogeny. Anagenesis is sometimes viewed as incremental to classification and makes up for a third type of information. Even though taxonomists would (for once!) agree that a classification should be based on phenetic, cladogenetic and anagenetic data, such a classification cannot qualify as a synthesis since it is not a composition and does not meet the definition given above (an operation that starts with elements and goes on to a whole). It is impossible to represent these three types of data together in one classification scheme; they express three, sometimes irreducible, points of view. For such a classification, the word “eclectic” is preferable and closer to reality.The use of synthesis as one term of the dialectical movement has made hesitant steps in taxonomy. Indeed, the two opposed theses that evolve into the synthesis are hardly met in classification and the “dialectical” synthesis promulgated by a few taxonomists can be referred back to synthesis as a résumé.Is classification synthetic because it appears to be based on inductive procedures, as it is sometimes implied by different authors who link deduction and analysis (stemming from downward classification)? In logic, synthesis is sometimes (and questionably so) associated with deduction. Moreover, synthesis cannot follow from induction which deals, for example, with the universality of characters. In that sense, there is no composition and so no synthesis. Thus, although induction has been part of classification, it is not a synthetic method.Apart from the ambiguity originating from the multiple meanings of the word “synthesis” in the context of taxonomy, synthetic classifications do not fully express all the complexity and procedures that lead to it. Actually, a classification is as much a synthesis as an analysis. Both methods are complementary, and should not be opposed as is sometimes the case. This opposition was implicit in the debate between Linneans and Jussieans, surrounding the development of the natural method. If one wants to use “synthetic”, then one should be explicit about its meaning. Taxonomists should also be aware of the incompleteness of synthesis in constructing a classification and should be careful not to create a system of value based upon philosophical ground. They should always prefer a complementary mode of thinking when feasible, instead of an “either-or” approach.     

Le système neuro-sécrétoire caudal du téléostéen Jenynsia lineata

Résumé On décrit le système neurosécrétoire caudal de Jenynsia lineata. L'urophyse de cette espèce est un organe bien différencié, séparé de la moelle par une membrane méningée discontinue, et formé de fibres qui y arrivent après avoir constitué un pédoncule principal. Les fibres ne pénètrent pas par celui-ci, le font par les orifices de la membrane méningée.Dans l'urophyse comme dans les cellules neurosécrétoires du système, la neurosécrétion se colore à l'aldéhyde fuchsine après oxydation par le KMnO₄/ H₂SO₄; à l'hématoxyline chromique de Gomori elle se colore aussi, mais faiblement, et toujours après mordançage par de l'alun chromique dans le Bouin. On en discute les causes, par rapport aux données obtenues par d'autres auteurs.Il n'y a pas de cellules géantes, si caractéristiques du systéme neurosécréteur caudal d'autres Téléostéens. Les cellules neurosécrétoires du système sont petites et peu remarquables.Nous tenons à remercier le Dr. Juan H. Tramezzani de la lecture du manuscrit de ce travail, et des précieuses suggestions qu'il a bien voulu nous faire parvenir.