Anticorps anti-spermatozoïdes: Revue de la littérature

Auto immune infertility represents about 15% of all sterilities. The most commun mechanisms of autoimmunity in males are genitals infections (epidymitis) and traumatisms (vasectomies, testiculat biopsies). Mixt agglutination reaction test and immunobead test are the most commun tests used for detection of antibodies. Since 1981, researchs tried to characterize spermatozoa antigens by using polyclonal and monoclonal antibodies. More than 30 antigens had been found during this last decade. Naz and coll had identified an antigen called FA 1 antigen. FA 1 Ag is a 23 Kd glycoprotein. Anti FA1 antibodies inhibit binding and penetration of sperm to zona intact mice oocytes and also zona free hamster oocytes. They do so without causing agglutination or immobilization of sperm and by the way they cannot be detected by usual tests.     

Guide à la lecture et interprétation de l’imagerie PET des plaques amyloïdes

The extracellular deposits of beta-amyloid are one of the histological lesions required for the neuropathological diagnosis of Alzheimer's disease. During the last decade, various PET tracers have been validated and have market authorization for the visualisation in vivo of amyloid plaques, with excellent sensitivity and specificity. The aim of this paper is to provide a practical guide for the visual read and interpretation of this image modality and to discuss its most recent developments for the integration in the diagnostic process and in patient management.     

Le bilan sénologique : indication et interprétation

Breast cancer is the most common cancer in women in France. The aim of this article is to describe modalities of detection and to explain how the images interpretation and the review are realized.     

Indications de la recherche des anticorps anti-spermatozoïdes

The clinical significance of antisperm antibodies (ASA) is highly controversial. A significant percentage of infertile men and women present immunity to spermatozoa, suggesting that ASA may interfere with the fertilizing capacity. ASA can act negatively on sperm parameters, sperm-cervical mucus interaction, gamete fusion and possibly also on the first step of embryonic development. ASA are present in approximately 2.8% to 26% of the male population and 0.2% to 1.6% of women. The pathogenesis of immunity to spermatozoa had not been fully elucidated: breakdown of normal protective mechanisms, i.e. blood-testis barrier, or epithelial barrier in women, and other mechanisms of immunological sperm tolerance, such as regulation of suppressor T lymphocytes. The indication for antisperm antibody testing is based on clinical and laboratory findings of infertile patients. In men, indictions for ASA testing include a history of genital disease, surgery for genital abnormalities, vasectomy, obstruction or injuries of the male genital tract, infection of accessory glands, long-standing infertility, alteration of semen parameters (agglutination, motility), mucus penetration, and reduced fertilizing capacity in IVF. In many cases, no etiological cause of autoimmunity is found and a genetic predisposition has been suggested. A majority of women do not develop antisperm antibodies, despite repeated contact with spermatozoa during their sexual life. Upper genital tract infection is the main cause of isoimmunization in females, although sexual practices, endometriosis, surgery for cervical neoplasia, recurrent spontaneous abortion and long-term infertility may also be involved. Sperm-cervical mucus impairment is the most obvious effect of immunization in women associated with IVF failure. Autoantibodies are frequently associated with antisperm antibodies. One of the consequences of the success of ICSI has been a decreased research effort to further the understanding of the origin and relevance of antisperm antibodies and specific antibody-antigen interactions. A better understanding of the natural history of immunological infertility would be useful for patient conseiling and to develop the most effective, efficient and safest management strategies. Such data could also be useful for the development of new tests and immunological methods of male contraception.     

Intérêt d’une semi-quantification et d’une analyse statistique automatique pour l’interprétation de la tomoscintigraphie cérébrale de perfusion dans la maladie d’Alzheimer

IntroductionAs the visual interpretation of the brain perfusion SPECT for the diagnosis of Alzheimer's disease might be difficult, it is wished to benefit from techniques allowing to improve the diagnostic accuracy especially for the inexperienced readers.Materials and methodsThree readers retrospectively interpreted 77 ^99mTc-ECD SPECT studies within the context of suspected neurodegenerative disease. The probability of Alzheimer's disease was quoted from 1 to 5, and the optimum sensitivity and specificity values were determined from ROC curves. The readers also attributed a hypoperfusion score to 13 brain regions; a diagnosis was obtained from this semi-quantification using a simple logic rule. The SPECT scans were also analyzed using the Planet Neuro software and a diagnosis was reached from a threshold for 2 of the 90 analyzed regions. The gold standard was established by a comprehensive neurological evaluation with at least 5 years of follow-up.ResultsThe sensitivities and specificities of the three readers were 50 %, 56 %, 28 % and 76 %, 83 % and 90 %, respectively. Using the semi-quantification they were 50 %, 67 %, 61 % and 54 %, 85 %, 69 %. The results of two readers were more in agreement. Using the automatic quantification, sensitivity was 78 % and specificity 81 %.ConclusionThe semi-quantification seems to ameliorate the results of and the agreement between certain readers. However, the automatic quantification seems to be the only way of assisting all of the readers to improve their diagnostic performances.     

Intérêt de l’analyse de la morphologie fine et de la qualité nucléaire des spermatozoïdes dans le cadre des techniques d’AMP

Routine semen examination does not identify minor malformations of the sperm nucleus and chromatin architectural defects, which may be associated with ART outcome and cannot be detected by the embryologist even at 1000x magnification. Recent publications have demonstrated the advantages, compared to routine analysis, of a new method of real-time detailed morphological evaluation of motile spermatozoa: motile sperm organellar morphology examination (MSOME). MSOME is performed with an inverted light microscope equipped with high-power differential interference contrast optics enhanced by digital imaging to achieve a magnification of 10000x. To be considered morphologically normal, a sperm nucleus must have both a normal shape and a normal chromatin content. The aim of the present study was to combine MSOME and sperm DNA fragmentation characteristics to assess reproductive outcome. The study population consisted of the male partners of 52 couples referred for conventional IVF or split cycles (half IVF-half ICSI cycles) and exhibiting normal routine sperm parameters. Spermatozoa were analysed by examining the fine nuclear morphology and DNA integrity using the sperm chromatin dispersion test (SCD test), based on the principle that the deproteinized nuclei of spermatozoa with nonfragmented DNA show extended halos of DNA dispersion that are either absent or only minimally present in sperm nuclei with fragmented DNA. Fertilization rates were significantly lower in the group showing less than 8% of normal spermatozoa according to MSOME criteria, but early embryo development was not affected. Fine sperm morphology correlated with DNA fragmentation rate. These results demonstrate that the assessment of sperm nuclear normality by MSOME analysis and SCD test improves characterization of the semen sample and should be evaluated as a tool for allocating patients to specific assisted reproduction treatments.     

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.     

Particularités méthodologiques et interprétation du dosage de thyroglobuline sérique

Thyroglobulin (Tg) is a large glycoprotein produced and excreted by thyrocytes exclusively. Thus, Tg is a central marker for the follow-up of differentiated thyroid cancer (DTC). This review presents recent analytical and related clinical advances in Tg assay. Indeed, recent advances in Tg assay challenge the previous use of the assay in the management of DCT. Indeed, a recent assay seems sensitive enough to be used to predict DTC differentiated recurrences without stimulation of thyrocytes by rhTSH. This improvement in analytical sensitivity is combined with international standardisation and reduced interferences by Tg autoantibodies. Such assays could reduce the cost of DCT follow-up by associating echography with a single assay, reducing the need of rhTSH stimulation to rare ambiguous cases.     

Distribution et activités des alcaloïdes défensifs des Coccinellidae

From a survey of 30 species and varieties of ladybugs the presence of alkaloids appears to be correlated with the existence of aposematic colour and not with being carnivorous or phytophagous. The alkaloids described until now all belong to the Coccinellini and are closely related, but other types of bases have been detected in some genera. The observed distributions are in agreement with the modern taxonomy of the family.Ladybug alkaloids constitute an effective defence against ants, Myrmica rubra, and quails, Coturnix coturnix, but all the beetles containing alkaloids do not possess the same degree of protection. Individual quail react differently towards moderately protected species.The bioassay used for the first isolation of coccinelin is described. The repulsive activities of aqueous solutions of coccinellin and convergin towards ants have been compared.     

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.     

Etude sur la végétation des dunes et des landes de la bretagne

Sans résumé     

Principes de préparation et de congélation des spermatozoïdes testiculaires humains

The advantages and feasibility of human testicular spermatozoa cryoconservation for intracytoplasmic sperm injection (ICSI) have now been clearly demonstrated. However, the freezing protocol is based on empirical knowledge obtained from freezing of ejaculated spermatozoa. Testicular spermatozoa may not be fully mature gametes and may also be retrieved in only limited quantities. Little research has been conducted to determine whether they have the same cryobiological requirements as ejaculated spermatozoa. A better understanding of their cryobiological features and assessment of possible subcellular changes after thawing would help to optimize testicular preparations for cryopreservation (whole biopsies, seminiferous tubules, shredded suspension, single spermatozoa, etc.), freezing-thawing procedure, freezing media, and storage. Finally, there is a growing need for welldefined criteria (nuclear quality, etc.) to evaluate the tolerance of testicular spermatozoa to freezing-thawing procedure for ICSI