Anticorps anti-spermatozoïdes: techniques de dépistage et interprétation des résultats

Since the first publication on the detection of sperm-agglutinating antibodies in infertile men, multiple assays have been described. The most useful tests are able to detect antibodies bound to the sperm membrane of motile spermatozoa. The immunobeads test (IBT) is considered to be the most advantageous in terms of its sensitivity, the low incidence of false-positive results, and its ability to localize antibodies of different immunoglobulin classes on the sperm surface. The IBT assay can be used in parallel with the mixed antiglobulin reaction (MAR), to detect sperm-associated antibodies in the ejaculates of infertile men, the most rational way to test for antisperm antibodies (ASA) in males. In view of the high level of agreement between the two assays, MAR, the easier of the two, may be used as a first step in the detection of these antibodies. A positive MAR must be confirmed by IBT, as this assay is more specific for the detection of IgA antibodies. The clinical significance of sperm-associated antibodies is usually established according to the proportion of motile spermatozoa coated with immunobeads, its class and its localization on the sperm surface. However, binding of immunobeads does not provide any information about the antigens against which the antibodies are directed. As the functional effects of sperm-associated antibodies may vary as a function of their antigenic specificities, other assays, using purified fertilization related antigens, are necessary to establish, for each individual, the specific impact of the antibodies on the fertilization process. The indirect IBT assay has recently become the most widely used test to detect the various classes of ASA in serum and cervical mucus of infertile women and in the serum and seminal fluid of infertile men, in combination with the direct assay described above. However, in most laboratories, it is performed with only one dilution of the biological fluid tested, usually a low dilution, so that antibody levels of no significance for fertility could be detected. This may explain a recente debate (Human Reprod, 1999) on the significance of ASA as a cause of infertility. At present, and in the absence of standardized assays able to identify the antigens involved in each individual immune reaction, antibody assays, as detected by the IBT assay, in the serum and/or genital secretions of infertile subjects might provide useful clinical guidance.     

Le cycle de développement des Castes chezReticulitermes

Résumé La production des castes, notamment des nymphes, futurs imagos ailés et des ouvriers chez leReticulitermes lucifugus est soumise à un cycle biologique annuel. L'auteur montre que dans les colonies naturelles les nymphes apparaissent quelques semaines après l'essaimage des jeunes imagos, vers la fin du printemps en une fois et en grande quantité. Elles se développent pendant l'été et arrivent en automne à l'avant-dernier ou même au dernier stade avant la mue imaginale. En hiver le développement de la colonie est normalement arrêté par le froid. Au début du printemps les nymphes se transforment en imagos et quittent la colonie. Pendant le repos hivernal les sexuées femelles accumulent beaucoup de corps gras et, au moment où les grandes nymphes se transforment en imagos, une ponte massive se produit dans le nid. Après la disparition des imagos la colonie voit son potentiel nutritif considérablement augmenté, puisqu'il n'y a plus de nymphes à nourrir. Pour cette raison les larves, à leur tour bien alimentées, peuvent se transformer en nymphes. Celles-ci, par leur croissance et leur constant besoin de nourriture, abaissent de nouveau le potentiel alimentaire. En conséquence de cette baisse, les larves qui apparaissent pendant l'été et l'automne sont mal nourries et donnent des ouvriers.Si les colonies deReticulitermes l. santonensis ont leur nid dans une maison bien chauffée en hiver, comme c'est le cas dans quelques immeubles de La Rochelle, lecycle annuel peut se transformer encycle semestriel. Les nymphes formées au printemps arrivent à l'état imaginal en automne et essaiment alors. Quand ils quittent la colonie un nouveau cycle commence qui permet un autre essaimage cinq à six mois plus tard, au printemps.L'auteur suppose que le facteur climatique et le facteur alimentaire jouent le rôle principal dans la formation des nymphes et dans le cycle biologique des Termitières.     

Développement et évaluation d’un algorithme de segmentation automatisée des ventricules gauche et droit sur des images ciné d’IRM

An automated segmentation of the left and right ventricles on cine MRI is presented here. A rectangular region around the object of interest is defined in the original image, a morphological filter is then applied that combines openings and closings on connected sets, providing an image with homogeneous regions, which is finally segmented with an active contour model. The algorithm was tested on two databases with an expert's segmentation on the ventricles. One of the databases was provided by the Multicentric Initiative for a Platform of Evaluation in Cardiac Imaging (IMPEIC) group. Results show a very satisfactory correlation between the area (given in mm²) of expertise (x) and the area of automated segmentation (y) of the left ventricle (y = 1.00x + 8.6, r = 0.99). First results on the right ventricle show more than 83% similarity. The systolic phase proved to be more difficult to segment, which could be taken into consideration by introducing time regularization criteria in the algorithm.     

Intérêt potentiel des images paramétriques des temps d’éjection et de relaxation en tomoscintigraphie des cavités cardiaques dans l’évaluation des cardiopathies asynchrones

Intraleft dyssynchrony is strongly correlated to contractile dysfunction associated to severe heart failure. Dyssynchrony is also a predictive marker for cardiac resynchronization therapy response. We measured dyssynchrony values for both ventricles from gated blood pool SPECT images.Material and methodsThree groups of patients were sampled from normal patients (n = 7), mild heart failure patients (n = 24) and severe heart failure patients (n = 9). Time-derivative parametric images were obtained from 24-time bins gated blood pool SPECT data. We measured intraleft and interventricular contractile and relaxing dyssynchrony values from these images.ResultsIntraleft dispersions values linked to ventricular peak emptying rate were 107 ± 21 ms, 141 ± 58 ms and 515 ± 104 ms for each of the three groups. The values linked to left ventricular peak filling rate were 122 ± 62 ms, 219 ± 117 ms and 603 ± 164 ms respectively. Statistical significant differences (p < 0.01) were observed both for contractile and relaxing phases for severe heart failure patients. Mild heart failure patients had isolated statistical significant (p < 0.01) alterations of the ventricular relaxing phase. Correlation between isotopic dyssynchrony values and left ejection fraction led to a R square coefficient of 0.71 and 0.64 for time to peak emptying and to peak filling respectively. Correlation to QRS width values led to a R square coefficient of 0.76 and 0.62 respectively.ConclusionVentricular dyssynchrony correlated to the importance of the ventricular mechanical dysfunctions is a robust predictor of heart failure. Separate analysis of contractile and relaxing dyssynchrony may lead to a better understanding and characterization of the mechanical dysfunctions involved in heart failure.     

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.     

Apport des techniques de chromatographie liquide couplée à la spectroscopie de masse tandem aux dosages des stéroïdes

Because of its sensitivity and selectivity, liquid chromatography coupled with tandem mass spectrometry (MS/MS) triple quadrupole is often considered the “gold standard” for quantification of compounds in a complex environment. Its use in clinical laboratory is now extended to the analysis of many steroids. But a biologist before purchasing such equipment must know exactly what he wants to do: is it for identification or quantification of one steroid or steroid group?     

Cinétique de dégradation des hydrocarbures par Candida lipolytica

Résumé Le mécanisme d'assimilation des hydrocarbures par une levure, Candida lipolytica est étudié au moyen de l'analyse cinétique de la croissance du microorganisme et de la disparition du substrat hydrocarboné. Les hydrocarbures utilisés sont des n-paraffines. On ajoute au milieu soit un seul hydrocarbure (n-tetradécane ou n-hexadécane), soit un mélange binaire (n-dodécane et n-heptadécane), soit un mélange complexe (du n-undécane au n-octadécane). Contrairement à d'autres auteurs, nous pensons qu'il est peu probable que l'essentiel de la réaction s'effectue par contact des gouttes de substrat et des microorganismes puisque l'on observe des retards d'assimilation de certains hydrocarbures: ceux de faible poids moléculaire (les plus solubles) sont assimilés plus rapidement. Il semble donc que l'assimilation se fasse en grande partie à partir d'hydrocarbures préablement solubilisés.

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Kinetics of hydrocarbon assimilation by Candida lipolytica

Summary The mechanism of hydrocarbon uptake by a yeast, Candida lipolytica has been studied by means of the kinetic analysis of micro-organism growth and substrate assimilation. Hydrocarbons used as only source of carbon are normal alkanes either pure (n-tetradecane or n-hexadecane) or in mixture of two paraffins (n-dodecane and n-heptadecane) or eight paraffins (n-undecane to n-octadecane). In these last cases delays in n-alkanes consumption are observed. They show that the most soluble substrates (lower molecular weight) are first consumed. In opposition to other authors we think that there is little probability for main reaction occurring by direct contact between drops and micro-organisms. The evidence indicates that n-alkanes are mainly utilized in the dissolved state.

     

Comparaison de différentes méthodes de segmentation en TEP/TDM pour le ciblage en radiothérapie des carcinomes épidermoïdes des VADS

IntroductionTo assess interobserver variability for biological target volume (BTV) delineation and to compare the reproductibility of different semiautomatic segmentation methods in pretreatment 18-fluorodeoxyglucose positron emission tomography (PET/CT) of head and neck squamous cell carcinoma (HNSCC).Patients and methodsPatients with histologically proved HNSCC referred to the nuclear medicine service in Brest for pretreatment PET/CT were prospectively included from February 2009 to June 2010. Three nuclear medicine physicians (two specialized in oncology) delineated manually and independently BTV on each primary tumor. Four semiautomatic segmentation methods have been studied; three using a fixed threshold and one applying an adaptive threshold based on the signal-to-background ratio (Daisne). The variability between κ observers and/or methods has been assessed. The concordance between the various BTV intersections and unions has been also assessed.ResultsThirty patients (29M; 1F) were included. The primary site location was oropharynx in six patients, oral cavity in 10 patients, hypopharynx in five patients and larynx in nine patients. A statistically significant global interobserver variability (P = 0.01) was showed, but without statistically difference between the two experienced oncologists (P = 0.15). The maximal concordance of the two experienced observers with the semiautomatic methods was found for the Daisne method (CI = 61.5%; κ = 0.68), expressing a good agreement according to the Landis and Koch criteria, better than with the segmentation method using a fixed threshold with 40% of maximal signal intensity (CI = 52.1%; κ = 0.53).ConclusionOur results suggest the feasibility of achieving HNSCC BTV delineation by PET/CT using semiautomatic methods, in particular those which apply an adaptative threshold but under the supervision of an experienced operator.     

Intégration des Facteurs Humains dans les démarches de conception et d’implémentation des NTIC en Santé

This paper addresses the question of Human Factors/Ergonomics approach to ensure a safe and effective design and implementation of Health Information Technologies in healthcare environments. It provides an overview of the domain and presents an illustration of the integration of the Human Factors principles and methods in the design cycle of an analgesia monitor.     

Etude des premiers stades de développement de la Coccidie Coelotropha durchoni

Summary This study considers the earlier growth stages of Coccidium Coelotropha durchoni in its host, Nereis diversicolor. Before evolving into free trophozoites and gamontes in coeliac fluid, the parasites remain in muscular and coeliac cells in microscopic intracellular form. Electron microscope reveals that these stages show an intermediary fine structure between that of a sporozoite — from which they keep some typical characteristics such as the conoid, the fibers and the involuted tubuli — and that of the future free trophozoites. The wall consisting in two clear membrans is provided with one or several micropores. The classical cytoplasmic organites clearly stand out: dictyosomes show constant relationship with ergastoplasm, the mitochondria contain short inner tubuli. Besides the paraglycogen granules and lipoid vacuoles, at least three types of vacuoles may be observed. Peculiar topographic relationship connects mitochondria and paraglycogen granules probably in formation. In the nucleus with classical membrane and heterogeneous structure, a rather voluminous nucleolus may be seen.     

Comparaison de deux méthodes de mesure des TLG en TEP au 18-FDG dans le mélanome métastatique

IntroductionThere are many automated segmentation softwares in PET-CT, but none of them is used as gold standard. The aim of this study is to compare two segmentation softwares, one based on maximum intensity projection (MIP-based) and the second: PETVCAR^®, to measure TLG in patients with metastatic melanoma treated by vemurafenib.Materials and methodsSixteen patients were assessed by PET using 18-fluorodesoxyglucose (18-FDG) before and during the treatment with vemurafenib. TLG were measured by MIP-based and PETVCAR^® and then analysed in initial PET, all PET, by organ and added for each PET.ResultsThere is a good correlation between TLG in each method (r = 0.96 with P = 0 on 439 lesions on all PET). The mean difference between TLG PETVCAR^® and TLG MIP-based is negative. Segmentations are larger with MIP-based than with PETVCAR^® with discrepancies observed for larger and heterogeneous lesions. SUV_max doesn’t seem to be the factor causing these discrepancies. Correlation between the difference of TLG and their mean is also strong especially in bones, nodes and subcutaneous lesions.ConclusionBoth methods have a good correlation in spite of discrepancies observed for large or heterogeneous lesions. These lesions segmentations are larger with the method based on MIP than with PETVCAR^®.     

Comparaison tridimensionnelle des crânes de Pan et Pongo par superpositions procrustéennes

Comparative anatomy of the skulls of Pan and Pongo using procruste superimposition shows that airorynchy, classically described as a change in palatal tilting, is a complex movement involving a downward shift of the posterior part and an upward shift of the anterior part. Our 3D analysis shows that airorynchy could be interpreted as the functional consequence of the anatomic differences between the temporal muscle mass of those two genera. It also appears that the palatal tilting and the morphology of the supra-orbital torus are two independent features. A statistical test shows that the torus development is dependant, at least partly, on the relationship between the orbital cavity and the frontal bone.