Le développement de l’inventaire de dépistage ERIraos: un outil global d’appréciation du risque d’évolution psychotique

Adequate identification of patients for early intervention programmes requires reliable and valid assessment tools. Within the German Schizophrenia Network (Kompetenznetz Schizophrenie) a set of schedules for early detection of schizophrenia has been proposed: the Early Recognition Inventory ERIraos. ERIraos is a two-step procedure with a 17-item checklist used at step 1 by GPs, psychologists, teachers, while a comprehensive 110-item symptom list is applied at early intervention centres at the expert level. In addition, ERIraos allows the assessment of several risk factors for psychosis such as familial load, childhood deficiencies, alcohol and drug use by special modules. Some preliminary results are presented here. The frequency of the 17 checklist symptoms increases from the early to the late prodrome, and more specific symptoms occur over time. The 17 checklist symptoms are grouped by factor analysis to 5 factors (psychotic, depressive, disorganised, withdrawn, dysphoric). In addition to prodromal symptoms, most patients (86.2%) report at least one additional risk factor (mean: 1.7 risks). 68% demonstrate some schizotypal features, 53% report alcohol and/or drug consumption, 24% demonstrate some deficiency or delay in childhood development, 21% report definite obstetric or birth complications, and 10% have a family history of schizophrenia or some schizophrenia-like diagnosis in first degree relatives. So far, the results are of a preliminary nature, and when sufficient information on psychotic transitions is available, the predictive value of ERIraos will be determined.     

Etude d’un modèle expérimental d’infection de l’appareil génital mâle

Injection of uropathogenic E. coli into the rat cauda epididymidis results in chronic epididymitis in 74.2% of cases, accompanied by necrotic orchitis (16.1% of cases) or non-infectious testicular lesions (45.2% of cases). Injection of killed bacteria caused the same noninfectious testicular lesions, most probably due to toxic damage. Injection of bacteria into the seminal vesicles caused a vesiculitis which regressed after seven days and disappeared progressively. Simultaneously, the prostate was invaded by polymorphonuclear leucocytes, an infection which persisted for more than three months. E. coli injection in association with bilateral castration gave rise to the formation of chronic vesicular abscesses. Examination of the male genital tract lymphatic system allowed explanation of the spread of infection from the epididymis to the testis, and from the seminal vesicle to the prostate. The epididymis is an organ with poor defense against against infection whereas the seminal vesicle is able, owing to the activity of its epithelium, to fight infection. On the other hand, prostatitis secondary to vesiculitis is immediately chronic.     

Ostéite tuberculeuse de l’os frontal simulant une métastase lytique d’un carcinome papillaire de la thyroïde : à propos d’un cas

The authors report a case of patient followed for papillary thyroid carcinoma with osteolytic calvarial image at left frontal bone. Bone metastasis of thyroid carcinoma is suspected in the first. Histopathological examination of the material of craniotomy revealed granulomatous lesion in favour of tuberculous osteitis. Such an association is exceptional and only histology allows a definitive diagnosis.     

Proposition d’un protocole de prélèvement pour les spermocultures

The purpose of the protocol is to put the patients into contribution on an aseptic way of obtaining semen in order to avoid renewal of numerous uninterpretable tests due to the presence of contaminating germs. This protocol of semen collection in aseptic conditions is recommended before IVF and artifical insemination.     

Alcide d’Orbigny,un précurseur dans l’étude de la faune du Danien du bassin de Paris

One of the major contributions of Alcide d’Orbigny to palaeontology is his work on the Danian of the Paris Basin. The Danian material includes well-preserved external imprints of Invertebrates. By making casting of these imprints, Alcide d’Orbigny inaugurated an original technique, which enabled him to describe more than 40 species. The question of the age of the Danian localities has long been debated since that time. It was settled once and for all in the seventies by micropalaeontologists.     

Recueil chirurgical de spermatozoïdes dans un groupe de 50 patients avec un antécédent de cryptorchidie bilatérale: facteurs pronostics d’extraction

Bilateral cryptorchidism is a severe factor of male infertility. We evaluated the results of testicular sperm extraction in 50 men with nonobstructive azoospermia associated with cryptorchidism between 1995 to 2001. We evaluated clinical parameters predictive of successful sperm extraction. Serum follicle stimulating hormone (FSH) was elevated in 67% of cases and testicular volume was decreased in 70% of cases, confirming the secretory origin of the azoospermia. Serum follicle stimulating hormone (FSH), testicular volume and histological parameters were examined as predictive factors for sperm recovery. The positive sperm recovery rate was 68%. As in the population of men with nonobstructive azoospermia, the sperm recovery rate for patients with a history of orchidopexy is approximately 68% and there are currently no clinical parameters predicting successful sperm retrieval in this subpopulation of patients.     

Pré-traitement d’un volume IRM par filtrage anisotrope robuste pour la segmentation de l’épaule

A novel pre-treatment process for image segmentation, based on anisotropic diffusion and robust statistics, is presented in this paper. Image smoothing with edge preservation is shown to help upper limb segmentation (shoulder segmentation in particular) in MRI datasets. The anisotropic diffusion process is mainly controlled by an automated stopping function that depends on the values of voxel gradient. Voxel gradients are divided into two classes: one for high values, corresponding to edge voxels or noisy voxels, one for low values. The anisotropic diffusion process is also controlled by a threshold on voxel gradients that separates both classes. A global estimation of this threshold parameter is classically used. In this paper, we propose a new method based on a local robust estimation. It allows a better removing of noise while preserving edges in the images. An entropy criterion is used to quantify the ability of the algorithm to remove noise with different signal to noise ratios in synthetic images. Another quantitative evaluation criterion based on the Pratt Figure of Merit (FOM) is proposed to evaluate the edge preservation and their location accuracy with respect to a manual segmentation. The results on synthetic and MRI data of shoulder show the assets of the local model in terms of areas homogeneity and edges locations.     

Scintigraphie myocardique et séquelles de myocardite : présentation d’un cas clinique

Acute and subacute myocarditis are well-defined pathological entities but it is often difficult to identify them because their clinical expression is variable and the diagnosis is histological showing myocardial inflammation associated with degeneration and/or necrosis. Often symptoms are similar to those of acute pericarditis with “chest-crushing” pain that mimics myocardial infarction and prompts practitioners to request angiography, especially when there are cardiovascular risk factors. We report the case of a 61-year-old patient with neither cardiac history nor cardiovascular risk factor who consulted for a long and self-limited atypical chest pain with normal clinical examination and electrocardiogram. Myocardial perfusion scintigraphy showed a non-reversible photopenic area suspected of being a nontransmural necrosis or an artifact. The discovery of inferolateral hypokinesis of left ventricle on echocardiography led to perform a coronary angiography which was finally normal. Cardiac MRI allowed to diagnose scars of a previous episode of myocarditis.     

ForenSeek: un programme de simulation du développement des insectes nécrophages dédié à l’entomologie médico-légale

L’entomologie médico-légale repose sur l’utilisation des insectes nécrophages pour estimer le moment de la mort dans le cadre d’enquêtes judiciaires et permet dans certains cas de préciser les circonstances du décès. Cette technique repose sur des bases scientifiques solides et est désormais couramment utilisée en France comme à l’étranger dans le cadre d’affaires criminelles. Le projet ForenSeek est un outil informatique d’aide à la décision, dédié à la réalisation de simulations et d’expertises en entomologie médico-légale. Le cæur de ce programme est un modèle de comportement et de développement des larves de diptères nécrophages basé sur un système multi-agents (SMA). Ce procédé permet de modéliser des comportements de groupes complexes à partir de données individuelles simples, et est done particulièrement bien adapté à l’étude des populations d’insectes. De plus, les résultats de ce modèle sont destines à être traités automatiquement pour en extraire des informations sur la pertinence de chaque simulation, et ainsi estimer de manière automatisée et avec précision l’intervalle post-mortem (IPM).     

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.     

Détection scintigraphique préopératoire de métastases pulmonaires d’un carcinome vésiculaire de la thyroïde associé à une hyperthyroïdie

Preoperative accumulation of radioiodine in metastases of thyroid carcinoma and its association with hyperthyroidism are uncommon. We report a case of 58-year-old woman with follicular thyroid carcinoma revealed by thyrotoxicosis caused by a hot nodule, and bilateral pulmonary uptake of I-131 before total thyroidectomy. Despite four ablative doses of I-131, bone metastases were identified and the patient died 42 month after the initial diagnosis.     

Métastases gingivales d’un carcinome thyroïdien différencié

The differentiated thyroid carcinoma metastases concern habitually the lymphatic chains, the bone, the lung, and to a lesser degree the other organs. We report a rare case of gingival metastasis of differentiated thyroid carcinoma with bony invasion, in a 50 year-old patient, in whom the gingival metastasis revealed the thyroid carcinoma. Such extension follows a protracted course. Metastasis clinically appears years after the diagnostic of initial tumour. The lack of any specific sign, makes them to be mistaken for inflammatory or infectious pathologies. Their prognosis is in general good, if they are early and accurately diagnosed.     

Intérêt de la TEP-FDG dans le syndrome d’hyper-IgG4 : à propos d’un cas et revue de la littérature

Hyper-IgG4 syndrome, or IgG4-related systemic disease (IgG4-RSD), is a recently described entity of fibro-inflammatory systemic damage. Multiorgan lesions can occur synchronously or metachronously in a same patient. The common histological features include a lymphoplasmacytic infiltration (especially to IgG4), and fibrosis. Elevated serum level of IgG4 is also often present. The main concerned organs are: pancreas, biliary ducts, mediastinal lymph nodes, peritoneum, lacrimal and salivary glands. We report a case of an unusual location of this disease at the nasophyrnx in a patient of 84 years for which the diagnosis was made through immunolabelling with IgG4 in lesions biopsied, and we illustrate the potential role of PET-FDG in this systemic disease.     

Les enjeux de l’intégration de l’automate d’immunohématologie AutoVue d’Ortho-Clinical Diagnostics au sein du laboratoire

Evaluation des critères de sécurité, productivité et conformité à la réglementation. L’automatisation de la paillasse d’immuno-hématologie au laboratoire est une démarche dont l’objectif est d’optimiser les contraintes organisationnelles et économiques tout en préservant la qualité des résultats par l’utilisation des techniques analytiques de référence dans un cadre sécuritaire et réglementaire de haut niveau.