L’apport de la neuro-imagerie dans la maladie d’Alzheimer

Today, the role of neuroimaging in the diagnosis of Alzheimer’s disease (AD) extends beyond its traditional role of excluding other conditions such as neurosurgical lesions. Modern challenges for neuroimaging techniques aim to contribute to the early diagnosis of AD. Early diagnosis includes recognition of pre-demented conditions, such as people with mild cognitive impairment (MCI) or with high risk of developing AD. In addition, early diagnosis would allow early treatment using currently available therapies or new therapies in the future. In this article, we will present the modern role of neuroimaging in AD. Structural MRI can detect and follow the time course of medial temporal lobe atrophy as a surrogate marker for the pathological process. New MRI techniques and image analysis software can detect subtle brain diffusion, perfusion or metabolic changes thus providing new tools for studying the pathological process. New ligands are also available for studies using tracers and positron emission tomography.     

Synthese de la Desamino 9’ Sinefungine

Abstract

La sinéfungine dont nous avons récemment achevé la synthèse (1) possède une activité antiparasitaire en particulier sur différentes souches de Leishmania (2) mais présente 1′inconvénient d'ine toxicité non négligeable; nous avons donc entrepris la synthèse d'analogues, en particulier du dérivé 9’ désamino è partir de l'adénosine et è partir du ribose.     

Physiologie de l’interaction gametique: Revue de la litterature

Our knowledge of gamete interaction in vitro and in vivo has grown rapidly over the last century. Its importance has been reinforced by the development of in vitro fertilization and assisted conception procedures on one hand, and by research on the development of contraceptive vaccines on the other. This literature review synthesizes our current understanding of the successive steps in the fertilization process from sperm capacitation allthrough gamete fusion, including sperm interaction with the cumulus oophorus and the zona pellucida, as well as consideration on the mechanisms and timing of the acrosome reaction.     

Rappels physiques et outils d’optimisation de la qualité image et de la dose

Many parameters can affect the patient's dose and the CT image quality. It is therefore essential, in order to optimize the patient's dosimetry, to know the influence of these parameters as well as their link with the dose modulation tools.     

Perspectives de l’analyse de la mobilité des spermatozoïdes

Several studies have shown a good correlation between sperm motility and fertility though the microscopic evaluation of the percentage of motile sperm is highly subjective by nature. Therefore in the last decade, various objectives methods have been proposed to overcome this problem. Two types of methods were developed: The methods based on the analysis of images obtained by microphotography, microcinematography and microvideography and the global, undirect methods based on physical principles. Several systems based on video and image analysis (Computer Aided Sperm Analysis, CASA) have been developed and are used in numerous laboratories of reproductive biology. CASA technology offers the possibility to analyse some characteristics of sperm motion which are related to the fertilization potential and to develop new parameters related to some important aspects of sperm behavior such as hyperactivation. However, there is a large amount of interactions between the operator and the CASA machine. CASA instruments are not “ready-to-use” robots: the reliability of CASA depends largely on the expertise and training of the user and the application of standardized procedures and quality control schemes. By contrast, there is only minimal interaction between the operator and the Sperm Quality Anlyser which is a new device measuring and index of sperm motility highly correlated to the concentration of progressively motile sperm. The device uses light passed through a small sample of semen introduced in a capillary tube to detect variations in optical density that result from moving particles. The reproducibility of the measurements is excellent, the device is easy to use and this is a potentially useful tool for field-work studies. Further investigations of this device in the managment of male infertility is warranted. Finally, both types of objectives approaches are complementary to the conventional analysis of sperm motility and they will not replace it. Standardized procedures have been proposed by the World Health Organization for the subjective evaluation of sperm motility. Such procedures are very useful to reduce significantly the intra- and interlaboratory variations but internal and external quality controls schemes indicate that they are not sufficient to achieve acceptable levels of variation and regular quality controls followed by the definition and the application of corrective procedures are required.     

Les inhibiteurs spécifiques de la recapture de la sérotonine dans la dépression de l’enfant et de l’adolescent: revue des controverses récentes

European and US drug regulatory authorities have recently warned against the use of selective serotonin reuptake inhibitors (SSRIs) in childhood and adolescent depression. Through an extensive literature review on the use of SSRIs to treat depression in children and adolescents — including psychiatric clinical trials, pharmacology, and drug safety data — we will: i) describe the main arguments justifying various regulatory decisions; ii) present published data and subsequent meta-analyses; iii) discuss how to integrate the recommendations into daily clinical practice, freeing professionals from a Manichean approach. We reach the limits of evidence-based medicine, which provide the basis of the scientific work of the regulatory authorities.     

Intérêt de l’utilisation de la scintigraphie osseuse dans le diagnostic et le suivi de l’ostéochondrite primitive de la hanche

Osteochondritis, or Legg-Calvé-Perthes disease (LCP), is a necrosis of the proximal femoral epiphysis. This vascular accident entails on the complex phenomenon of growth of the child's hip and can result in deformations or even a strict destruction of the proximal femoral epiphysis. The aim of this article is to show the interest of the bone scintigraphy (BS) in precocious diagnosis and follow-up of LCP disease. In this aim, we introduced a clinical case of LCP disease where BS allowed a precocious diagnosis and a strigent monitoring. Discussion of case includes a systematic review of literature.     

L’analyse automatisée de la morphologie du spermatozoïde

Examination of sperm morphology is one factor of evaluation of sperm function, but it can also be considered as a biomarker of testicular function. All publications showed a high variability in observed results, in relation with different methods of staining slides and classifying sperm morphology, and a large subjectivity in the visual assessment. Automated sperm morphology analysis (ASMA) have the potential to provide more objective, accurate, and precise morphometric measurements of spermatozoa. Standardisation of the methods of slides preparation is first essential. Analysis of the sperm head morphometry appears the more accessible for the ASMA and could give selective parameters in the evaluation of fertility, in complement with motion sperm analysis. In the other hand automated analysis of all sperm abnormalities appears illusory with actual instruments, because the midpiece or the flagellum is a little structure weakly stained, and thus difficult to be identified by the computer. Until more rigorous and consistent definitions of sperm features can be developped, in relation with testicular function, the pronostic value of existing sperm abnormalities classifications is limited.     

Les premiers villages agricoles de l’est du plateau Iranien à la vallée de l’Indus : état de la question

The birth of agriculture east of the Fertile Crescent, between the Iranian plateau, Central Asia and South Asia, is poorly known. This area is vast and the archaeological data relating to this period, the Neolithic, is extremely limited. Most researchers agree that plants and animals’ domestication was introduced in this area from south-west Asia, similarly to what happened in Europe. In this scenario, agriculture emerged in the Fertile Crescent, between the Levant, Anatolia and the Zagros, 12.000 to 11.000 years ago, and then spread to other regions further east, across the Iranian plateau to Central Asia and the north-western part of the Indian subcontinent, beginning between the 8th and 7th millennia BCE. This article summarizes the main available data relating to this topic with a focus on the Indo-Iranian Borderlands, between southeastern Iran and Pakistan. Currently available paleoclimatic, paleogenetic and archaeological records are presented. A synthesis and discussion is then provided in the conclusion as well as reconstructions based on these records. Issues or challenges relating to the research on the earliest farming villages are mentioned while directions for future research are evoked.     

Reactivite thermique de la peau scrotale chez l’homme

Although the existence of heat exchange between the testicular artery and the adjacent veins is well known, it may be insufficient to maintain the lower temperature of the testis. In order to investigate the role of the scrotum in testicular thermoregulation, the dynamics of scrotal and other skin temperatures was studied in relation to thermal stress. The results of this study revealed that the scrotal skin exhibited a greater thermal inertia than did other skin areas. This finding may be due to modifications in scrotal blood flow patterns as temperature increased, as well as changes in the scrotal surface area. Other possible thermoregulatory factors may include the evaporation of sweat from the scrotum. In conclusion, there seems to be a complex collection of mechanisms, rather than a single specific mechanism, regulating testicular temperature.     

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.     

Application de la technique de PCR en temps réel à l’étude de l’ADN ancien

Real-time Polymerase Chain Reaction (PCR) for the study of ancient DNA. The properties of ancient DNA (aDNA) make difficult the retrieval of DNA sequence. The advantage of Real-Time PCR was exploited, for the first time, in the study of aDNA. We determined the optimal condition to amplify, in one round of PCR, aDNA, which should be directly sequenced. Beside the verification of aDNA authenticity, we compared two cleaning bone methods: scalpel and ethanol. The ethanol specimens showed the best DNA yield. The aDNA was extracted and amplified (mitochondrial hypervariable region I) from five skeletons exhumed from the archaeological site of Notre-Dame-du-Bourg (France), dated from 3rd to 17th century. To cite this article: R. Kefi et al., C. R. Palevol 2 (2003) 125–132.     

Place de l’embolisation percutanée de la varicocèle dans le traitement de l’infertilité

Objectives

To describe percutaneous embolization of varicocele and to evaluate the effect on fertility disorders.

Materials and methods

One hundred nineteen patients, aged 11 to 48 years, underwent percutaneous embolization for varicocele indicated by a fertility disorder in 23% of cases. Correction of the varicocele and resolution of associated pain, improvement of testicular trophicity and the effect on fertility were studied and a review of the literature was performed.

Results

Percutaneous embolization was performed using neuroleptanalgesia on an outpatient basis. The technique combined venous sclerotherapy and placement of coils in the gonadal vein. The technique was successful in 95% of cases and one complication was observed. At 3 months, the varicocele and related pain had resolved in 98% of treated patients. According to previous reports in the literature, the relations between varicocele and fertility disorders are still unclear, but improvement of fertility (semen quality and conception rates) after varicocele repair has been established.

Conclusion

Although the consequences of varicocele on fertility have not been fully elucidated, treatment of varicocele appears to be beneficial. Percutaneous embolization of varicocele is a safe and effective alternative to surgery. This technique, based on a urological and radiological consensus, is the first-line treatment for varicocele in our institution.     

Sur quelques hyménoptères intervenant dans la biocoenose de ravageurs de l’Artichaut dans le sud-est de la France

Summary No discovery of any parasite ofSphaeroderma rubidium Graell.,Ceratapion carduorum Kirbi, andDepressaria subpropinquella Stain. has been mentioned for France. However considerable collections ofMymaridae obtained on layings ofS. rubidium, show that parasitism may have a part in the limitation of this species. The few parasites of larvae and pupae ofC. carduorum obtained do not seem to have any considerable regulating influence. Although the parasitism of caterpillars ofD. subpropinquella byAngitia is frequent, the latter do not seem to be the essential factor in the evolution of the population of this species. The caterpillars ofChoreutis bjerkandrella thnb. may be used as a refuge by manyHymenoptera in summer, as a consequence of the scarcety ofMicrolepidoptera at a vulnerable stage.      

Cryptorchidie: influence sur la fertilité de l’âge au moment de l’orchidopexie, du siège et de la taille du testicule et de l’existence d’anomalies épididymaires

Despite surgical treatment, cryptorchidism is the most common cause of infertility. Through a literature review, the authors report current data on the influence of age at the time of orchidopexy, testicular size, the position of the testis, and the existence of epididymal anomalies on fertility.     

La cognition dans le trouble obsessionnel compulsif : à l’intersection de la clinique et de la neuro-imagerie

The investigation of neural activity in OCD (Obsessive Compulsive Disorder) has allowed to link obsessive compulsive symptoms and cortico-striatal dysfunction. In the present article, we try to show the significance of cognition in an integrative physiopathologic model of OCD. Clinically, patients are unable to inhibit irrelevant thoughts or actions. In a cognitive way, decision making, planification or organisation are impaired. Those impairments are related to an executive deficit, which depends on frontal structures. Finally, we present a current study which tries to identify executive deficit functions related to cerebral dysfunction in patients presenting different OCD features (washing, checking, hoarding).