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.     

TEP/TDM multi-phase : revue de la littérature

This article reviews the literature of studies that have used multiple-time or later PET image acquisitions mainly with 18F-FDG, for the characterization of solid cancers, their staging or as a prognostic tool. The performances of these PET multiphase acquisitions are presented by organ. References from this literature review were searched using Medline and Google Scholar. Only articles in French and English were selected.     

Les résidents et l'enseignement: revue de la littérature.

We reviewed the available data on residents'' teaching role in the clinical setting to develop programs to improve their teaching skills. Articles published from 1966 to 1989 were identified through a computerized search of MEDLINE, and the bibliographies of identified papers were reviewed. Articles directly related to the topic were included and analysed. Taking into account their quality, we extracted data relevant to specific issues. Approximately 15% to 25% of an average work week was spent by residents in different teaching activities. Students acknowledged the importance of their contribution to clinical teaching. Residents benefitted from teaching by increasing their medical knowledge and promoting the development of important attitudes. Insufficient preparation for this task and the numerous practical problems faced by residents may explain their modest performance as teachers. Nevertheless, programs directed to residents might improve the quality of their teaching. We suggest some guidelines for the development of programs to improve their teaching skills and for future research.     

Hypercalcémie idiopathique de l'enfant: Deux nouvelles observations et revue de la littérature

Several reports of idiopathic hypercalcemia of childhood have been published since Lightwood in 1932 described dwarfism associated with mental retardation, strabismus, hypercalcemia, nephrocalcinosis and osteosclerosis. The present paper adds two new cases. The first patient was 15 months old when first seen with stunted physical and mental growth, a systolic murmur, and a serum calcium value of 13 mg. %. This child suffered several severe infections and in spite of a low calcium intake and the administration of chelating agents her blood calcium rose until death six months later. The other patient, three years old, also had delayed physical and mental development, typical facies, a systolic murmur, skeletal lesions, and nephrocalcinosis. Varied therapeutic attempts failed.Idiopathic hypercalcemia of childhood is reviewed in the light of the 94 reports already published.     

Le cancer de la verge : à propos d’un cas et revue de la littérature

Cancer of the penis is rare. It often raises the issue of acceptability of the amputation of penis. We report a case of cancer of the penis following a late circumcision. The treatment consisted of amputation of two-thirds of the penis. The patient is alive without any local recurrence 2 years after surgery. Literature review suggests that this type of cancer is very rare. The factors associated with such cancer include lack of circumcision and infection with human papilloma virus.     

Carcinome urothélial de l’urètre: une nouvelle observation et revue de la littérature

Urothelial carcinoma of the male urethra is a rare tumour. We report a new case of urothelial carcinoma of the urethra in a 64-year old man who was examined due to a dysuria. Retrograde and voiding urethrocystography carried out had shown images of bulbopenile urethral stricture treated by urethroplasty. Histological examination of the urethrectomy part revealed a urothelial carcinoma of the urethra. The patient refused any additional treatment and survived 14 months after diagnosis.     

Les tumeurs testiculaires à cellules de Leydig: à propos de quatre cas et revue de la littérature

Introduction

Leydig cell tumors of the testis are uncommon, and represent 1 to 3% of all testicular tumors, it’s the most common of sex cord stromal tumors. They can be found in all age groups, but they mainly occur in subjects aged 15 to 50 years (50%), 25% occurring in older men and a little less than 20% in children aged 5 to 9 years. The most common revealing symptom is gynecomastia in adults, whereas in children it is isosexual pseudo-precocious puberty. They pose a problem during diagnosis, nonpalpable tumors, and during the choice of surgical treatment, because it is difficult to make a clear distinction between benign and malignant tumors.

Material and methods

We describe four different presentations of this disease. The parameters studied were: age, revealing symptom, hormonal profile, type of treatment, and mode of evolution.

Results

The average age of our patients was 37.5 years. The first revealing symptom was a unilateral increasing size of purse in two cases, a bilateral increasing size of purse in one case, and gynecomastia in the last one. In all cases testosterone was normal or low, and oestradiol was normal or elevated. Our four patients underwent an orchidectomy, associated with an enucleation of the contralateral testis in only one case. A favorable evolution was observed in every case for a mean follow-up of 15 months.

Conclusion

On the basis of four different clinical observations and the analysis of the literature, the aim of this review is to present the various clinical, biological, radiological, pathological and therapeutic aspects of Leydig cell tumors of the testis.