Procréation médicalement assistée et paraplégie masculine — Expérience Montpellieraine

Between 1980 and 1993, seventy one tetra or paraplegic patients consulted in order to know more about their “procreative status”. After being taken into care in an appropriate enviroinment, specialized in the treatment of ejaculation disorders and following a semen analysis, twenty two patients decided to procreate. Their vertebral lesions were located in the cervical region (5 cases), drom D1 to D10 (10 cases), from D11 to L1 (6 cases) and from L2 to L5 (1 case). Eighteen patients suffered from complete lesions. Nineteen patients achieved an ejaculation: fifteen cases of antegrade ejaculations, three cases of retrograde ejaculations and one mixed one. Out of eighteen pregnancies — for fourteen couples — nine were obtained in Assisted Reproductive Technology: three of them after an intravaginal artificial insemination, one following an intracervical artificial insemination, two after an intrauterine artificial insemination, two through an in vitro fertilization (IVF), one following a transfer of frozen embryos obtained through IVF with some epididymal spermatozoon. An Assisted Reproductive Technology strategy is being proposed, which takes into account the number of available progressive moving spermatozoon.     

Cytochrome P450 et activation génétique — de la pharmacologie à l’élimination du cholestérol et à la régression de l’athérosclérose

Background

Lipoproteins are closely associated with the atherosclerotic vascular process. Elevated levels of highdensity lipoprotein cholesterol (HDL-C) and apolipoprotein AI (apo AI) in plasma indicate a low probability of coronary heart disease (CHD) together with enhanced longevity, and elevated levels of low-density lipoproteincholesterol (LDL-C) and apo B indicate an increased risk of CHD and death. Studies linking gene activation and the induction of cytochrome P450 with elevated plasma levels of apo AI and HDL-C and lowered plasma levels of LDL-C presented a new potential approach to prevent and treat atherosclerotic disease.

Objective and methods

This is a review aimed at clarifying the effects of P450-enzymes and gene activation on cholesterol homeostasis, the atherosclerotic vascular process, prevention and regression of atherosclerosis and the manifestation of atherosclerotic disease, particularly CHD, the leading cause of death in the world.

Results

P450-enzymes maintain cellular cholesterol homeostasis. They respond to cholesterol accumulation by enhancing the generation of hydroxycholesterols (oxysterols) and activating cholesterol-eliminating mechanisms. The CYP7A1, CYP27A1, CYP46A1 and CYP3A4 enzymes generate major oxysterols that enter the circulation. The oxysterols activate — via nuclear receptors — ATP-binding cassette (ABC) A1 and other genes, leading to the elimination of excess cholesterol and protecting arteries from atherosclerosis. Several drugs and nonpharmacologic compounds are ligands for the liver X receptor, pregnane X receptor and other receptors, activate P450 and other genes involved in cholesterol elimination, prevent or regress atherosclerosis and reduce cardiovascular events.

Conclusions

P450-enzymes are essential in the physiological maintenance of cholesterol balance. They activate mechanisms which eliminate excess cholesterol and counteract the atherosclerotic process. Several drugs and nonpharmacologic compounds induce P450 and other genes, prevent or regress atherosclerosis and reduce the occurrence of non-fatal and fatal CHD and other atherosclerotic diseases.     

Génétique moléculaire des dysgénésies testiculaires

The first step of male differentiation is the testis determination which is genetically controled. The key role of SRY gene is now established. However, a number of clinical and genetic data favoured the role of other genes taking place upstream or downstream SRY. Most of 46, XX males possess a translocated SRY gene and thus develop testis, but SRY gene is not found in 10% of such patients. Likewise, the molecular study of 46, XY females participated in the identification of SRY as testis determining factor, but 80% of XY gonadal dysgenesis are not explained by an abnormality of SRY gene. Several clinical situations permitted to suspect the role of autosomal (chromosome 1, 9, 10 17 …) and X chromosome loci in the pathology of sex determination. Some recent works concern, in particular, the testis determining factor of the X chromosome (TDF-X) that could act as a repressor of the testis differentiation. In conclusion, molecular mechanisms of sexual determination appear to be much complex, involving probably several genes in a pathway that remain to be elucidated.     

Cancer et Hérédité

Sans résumé     

Considérations sur la présence du Microsporon cookei — Ajello 1959, dans le sol roumain; ses propriétés immuno-biologiques

Resumé Les auteurs ont réussi à isoler du sol roumain deux souches deMicrosporon cookei —Ajello 1959, dont l'une a été trouvée dans une forêt de sapins près d'une station alpine et l'autre dans un jardin public de Bucarest. Les inoculations expérimentales n'ont pas réussi. Les propriétés immuno-biologiques des 2 couches se sont montrées semblables à celles de tous les dermatophytes communs. Plus précisément, la valeur thérapeutique et diagnostique de la trichophytine préparée à partir de leurs cultures n'a été guère inférieure à celle de la trichophytine standard.

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Summary The authors were able to isolate from Rumanian soils two strains ofMicrosporon cookei, viz. one from a fir forest in the mountains and the other from a public garden in Bucharest. The cultures of these isolates yielded a trichophytin, the antigenic properties of which were those of the standard trichophytin, proved by cutaneous reactions and therapeutical value.

     

Considérations sur l'ubiquité duTrichophyton terrestre—Durié & Frey 1957—saprophyte du sol. Son inoculabilité

Résumé Les auteurs ont isolé 11 souches deTrichophyton terrestre—Durie &Frey 1957. Une de ces souches a été isolée d'un échantillon de terre qui leur avait été envoyé de Hanoi (Vietnam). Les 10 autres souches ont été isolées en Roumanie, à savoir 4 à Bucarest et 6 en province. Ces 10 souches ont été isolées des portions très limitées de terrain et—9 fois même—chacune d'un seul échantillon de terre, minutieusement exploré par le procédé deVanbreuseghem (mise en contact de la terre avec les cheveux). Les terrains, d'où l'on avait prélevé les échantillons de terre, ont été des jardins, des terrains rocheux, marécageux, steppes, abris pour le bois etc. LeTrichophyton terrestre a été trouvé toutes les fois qu'il a été cherché, sans aucune exception. Selon les auteurs, certains perfectionnements apportés au procédé deVanbreuseghem ont contribué largement à la réussite constante de cet isolement. Ils sont parvenus à provoquer, à la souris blanche, avec l'une des 11 souches mentionnées, une mycose expérimentale qui a envahi l'épiderme ainsi que les poils. La trichophytine produite par ces souches a été tout aussi active que la trichophytine produite par leTrichophyton mentagrophytes, et, en même temps, tout aussi spécifique. Les auteurs arrivent à la conclusion que leTrichophyton terrestre est probablement ubiquitaire dans le sol et qu'il n'est pas dépourvu de pouvoir pathogène. Au contraire, il est en voie d'adaptation à la vie parasitaire et peut être inclus dans le groupe des dermatophytes.

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Summary UsingVanbreuseghem's procedure (baiting moistened soil samples with filaments of hair), the authors were able to isolate 11 strains ofTrichophyton terrestre—Durie &Frey 1957. One of them has been recovered from a sample of soil sent from Hanoi (Vietnam), whereas the other strains have been recovered from different Rumanian soil samples. Four strains have been recovered from Bucarest and the other six ones from the province. Each strain has been isolated from a very small piece of ground and even, except for one strain, it was not necessary to control more than one sample of soil for each of them. The Rumanian soil samples were collected from gardens, rocky and marshy grounds, waste-lands, woodsheds and so on.Trichophyton terrestre has been recovered everywhere it was looked for, without any exception. The authors believe that the constantly positive results of their investigations concerning the presence ofTrichophyton terrestre in the soil, may be partially explained by some improvements they added toVanbreuseghem's method. The inoculation in white mice, guinea pigs and men were positive only in one case, a white mouse, in which the causative fungus has been found also in the hair. From the cultures of the isolated strains, the authors obtained a trichophytin, as active as the trichophytin produced byTrichophyton mentagrophytes, and not less specific. They conclude thatTrichophyton terrestre, as saprophyte of the soil, is probably an ubiquitous (cosmopolitan) mold and, moreover, it is not completely without pathogenity. On the contrary, it is on the way to become a parasite and, therefore, it may be included in the group of dermatophytes.

     

Rhizopodes Thécamoebiens du Vénézuéla

Sans résumé