Optimisation de l’utilisation du PSA

PSA is a tumor marker usually determined for prostate cancer at diagnosis for its pronostic value and at therapy follow-up. But lack of specificity of PSA for prostate cancer and variability between assays demonstrated by the quality program survey make this marker not valuable in mass screening program. Market control of Afssaps on analysis devices of PSA showed a correct harmonization for total PSA. Biological tools available and easy to perform could improve ability of PSA for early detection of prostate cancer at a curable stage without induction of unnecessary biopsies prescribed because elevated total PSA values.     

L’Equipement chromosomique du spermatozoïde

Cytogenetics of human sperm chromosomes has been developped by few laboratories during the last decade, in order to investigate dysfuncitons of meiosis in normal men and in carriers of chromosomal abnormalities. On the basis of pooled data, it can be established that normal men produce almost 10% of abnormal spermatozoa, including a majority of structural aberrations (6.5%). Frequency of hyperhaploïdies, resulting from chromosome malsegregations, seems to be equally distributed among all chromosome groups. A study of in vivo recently irradiated patients demonstrates that despite a high incidence of multiple rearrangements, the sperm fertilizing ability is not reduced. Segregation of additional chromosomes can also be studied in fertile carriers; such as study has demonstrated that, in a mosaic patient, 47 XXY germ cells are able to complete meiosis. Finally the major application of the technique consists in direct segregation analysis of structural chromosome rearrangements. The sperm of such carriers exhibits a higher proportion of unbalanced spermatozoa than generally expected in offsprings.     

Effets de l’Oxygenation du Milieu d’Incubation des Cotyledons de Ricin sur les Flux de Protons et sur l’Absorption du Saccharose

Some of the effects of oxygen concentration in the external medium bathing castor bean cotyledons were investigated. At 700 μM O₂, the sucrose-dependent proton influx was dependent on external pH while sucrose influx was independent of pH between 4,5 and 6; proton influx and sucrose influx were both dependent on external sucrose concentration; both were saturated above 50 mM sucrose. The stoichiometry H+/S decreased with increasing pH and sucrose concentration. These data were consistent with the results obtained in stirred or aerated external medium. Oxygen consumption, acidification of the medium, sucrose-dependent proton influx and sucrose uptake increased with increasing oxygen concentration up to 700 μM where saturation was reached. Bubbling with air (O₂, 160 μM) resulted in the same increase despite lower oxygen concentration. It is suggested that not only O₂ concentration but also CO₂ concentration act on O₂ consumption, and proton and sucrose fluxes.

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Évaluation de l’exposition des travailleurs du service de radioimmunoanalyse du Bénin aux rayonnements ionisants de l’iode 125

Occupational radiation dose of staff handling ¹²⁵I assessment at the Benin radioimmunoassay laboratory, have been undertaken from October 2012 to April 2013 to determine level of radiation safety. Equivalent dose to skin, whole body and extremities, were measured by the mean of thermoluminescence dosimetry. Firstly, three permanent workers and two students were provided with finger ring dosimeters to wear at index finger base of both hands. Ring dosimeters were used for four months. Secondly, three permanent workers and three students were provided with badge dosimeters to wear at the chest level. Badge dosimeters were renewed monthly for six months. The exposed ring and badge dosimeters were evaluated in Ghana. Permanent workers highest average equivalent dose received at index finger base of both hands was 142.75 ± 89.54, microSV/2 months and that of students was 34.69 ± 29.23, microSV/2 months. Workers skin exposure was below one third of prescribed dose limits for permanents workers (500mSv/yr) and students (150mSv/yr). Whole body exposure, expressed in mSv/month, of permanent workers and students, respectively ranged from 0.12 to 0.23 and from 0.11 to 0.16. Radio-immuno-assay laboratory workers are weakly exposed to ionizing radiation. They are safe from deterministic effect risk.     

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.     

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.     

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.     

Incidences de la restriction calorique et du Nickel sur l’aromatase testiculaire du rat

This study was designed to determine whether intermittent fasting induces malnutrition that, according to many authors, accentuates the cytotoxic effects of environmental pollutants, or caloric restriction that reduces these effects. Ninety six male Wistar rats (180g) were divided into two groups: one group was fed daily (N) and the other group was fed every second day (J) for one month. At the end of one month, each group was then divided into two subgroups, one subgroup received an injection of 0.9% NaCI (groups NO and JO), the other subgroup received an injection of 4 mg/kg NiCI^b2 (groups NNi and JNi). Intermittent fasting was continued in parallel to treatment for 1, 3, 5 and 10 days. Under these experimental conditions, nickel increased testicular aromatase activity and altered total RNA, while no alteration of these biomarkers was observed with intermittent fasting. The combination of these two factors, nickel and intermittent fasting, did not amplify these effects. In contrast, protection of RNA by intermittent fasting was observed, especially overexpression of aromatase mRNA.     

Place du scanner dans l’imagerie de l’hyperparathyroïdie primaire

Primary hyperparathyroidism is a biological diagnosis. The reference treatment is surgery. When minimally invasive surgery is considered, it is recommended to perform a cervical ultrasound and a scintigraphic examination to localize the hypertrophied parathyroid glands. The multiphasic scanner (4D CT) is a very effective examination to detect and locate precisely the parathyroid adenomas. The study of densities makes it possible to differentiate the adenoma from the thyroid and the lymph nodes that are the differential diagnoses. Without injection, the adenoma is more hypodense than the thyroid with a threshold set at 75 UH. On the early phase after injection, the adenoma appears very hypervascularized with a density > 114 UH. The ganglion appears hypovascularized with a density < 114 UH. In the late phase, there is a decrease in the density within the adenoma, while density within the ganglion increases. The parathyroid scan is indicated in case of negativity or discordance of the couple ultrasound scintigraphy. It is also strongly recommended, in case of persistence or recurrence of hyperparathyroidism after surgery, as well as to better study a parathyroid ectopy.     

Place de l’imagerie dans l’évaluation de l’efficacité des traitements dans le cancer du sein

This paper describes, from the current literature, the role of various imaging methods to assess the response to therapy in breast cancer. Two different clinical situations are considered: neoadjuvant chemotherapy of locally advanced breast cancer and the metastastic breast cancer. Significant clinical data are available for three criteria: the volume of the tumour, the uptake of fluorodeoxyglucose using PET and the perfusion of the tumor evaluated either by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) or by PET using ¹⁵O water. ¹⁸F FDG PET allows prediction of the response after one or two cycles of neoadjuvant chemotherapy. New approaches will offer opportunities to refine the role of imaging in monitoring the response to chemotherapy. PET using thymidine as biomarker is promising in assessing the tissular proliferation. Estrogen analogs could be used to predict hormonally responsive breast cancer. Many other approaches, although less developed, might offer new insights in the response to therapy of breast cancer like magnetic resonance spectroscopy or optical imaging of hemoglobin oxygenation. Imaging also offers potential of monitoring the down-regulation of specialized receptors of the cell membrane in response to treatment: the most studied receptor in preclinical model has been the human epidermal growth factor receptor type 2 (HER2). Integrin, a family of cell adhesion receptor, is also an important target for imaging. Apoptosis, multidrug resistance and hypoxia can also be studied using appropriate biomarkers. To allow reliable multicenter trials of new drugs, these different imaging approaches still require an improved standardization of image acquisition and processing.     

Le principe de l’anonymat du donneur de gamètes à l’épreuve de son contexte. Analyse des conceptions juridiques de l’identité

This study clarifies the lively debate surrounding the anonymity of gamete donors. This principle, which has not been challenged since 1994, is currently criticized by a number of people, who were conceived through medically assisted procreation technologies with donor and who now have reached adulthood. Their testimony has a very significant impact on French public opinion. Several official reports have already suggested that the anonymity of gamete donors may well be removed under certain circumstances. To understand why public opinion has evolved so dramatically, we must revisit the legal position of gamete donors in the specific context of less visible changes in the law. Indeed, the legal concepts of parenthood and identity have been reshuffled over time, and such changes have deeply affected the legal issues relating to the anonymity of gamete donors. Formerly, the law governing the identification of individuals was shaped by political and social objectives. Now it is more concerned with the sense of identity and personal fulfilment of people. This change, based on modern western notions of egalitarianism and individuality, has dramatically affected the outcome of parenthood trials. Moreover, biological tests have made the truth available like never before. The possibility of finding out the truth has shocked the practice of many areas of family law and has created a new set of challenges, especially when the secrecy of the genetic parents has been legally established. In France, women have traditionally been able to deliver their children anonymously. A deadlock has resulted, which may now be overcome by introducing a new concept of personal origins. Now the law is evolving to permit the children to demand their biological mothers’ identity under certain circumstances, but without affecting anyone’s rights. The concept of personal origins has been quite successful on the European scene and has also charged the debate. It is now recognized under French and European laws that individuals must have privileged access to their personal origins. Can the principle of anonymity of gamete donors remain immune from such a (r)evolution ?     

Rôle du sens de l’effort dans le syndrome d’influence

Centrally generated signals from premotor areas play a key role in voluntary muscle force perception. Indeed, sensations of effort, rather than sensations of intramuscular tension, make it possible to evaluate the intensity of willed muscle forces. We suggest that the sense of effort is involved in agency, the cognitive process by which one is aware of one’s actions. We argue that effort awareness accompanies each action and is the key component of the feeling of will. In delusions of alien control, patients with schizophrenia do not recognize some of their acts as their own and are convinced that they are under the control of someone else. Some experimental data suggest that delusions of control are related to an altered awareness of effort and an exaggerated awareness of afferent neural information, caused by neurological disorders in the frontal and parietal lobes. This impairment could lead to the inability to identify the author of an action. In this pathological condition, the cerebral state coding for “I intend to act” might move toward the state coding for “someone else intends to act”, even in the absence of another agent.     

L’utilisation du MSOME: expérience de six ans

Introduction

MSOME (Motile Sperm Organellar Morphology Examination) is a new method for real-time evaluation of sperm morphology under 6600x high magnification. ICSI modified procedure with sperm selected by MSOME is named IMSI (Intracytoplasmic Morphologically Selected sperm Injection). IMSI has been developed to improve ongoing pregnancy rate in couples with repeated implantation failure.

Material and methods

The study concern an observational cohort of 11535 ICSI performed with fresh ejaculated sperm in our ART lab between January 2004 and July 2009. Among them, 2509 were realized with IMSI. The primary outcome measures were cleavage rate per injected oocyte on day 2, clinical pregnancy and abortion rates. Comparisons were performed using Chi square² test and univariate analysis of variance.

Results

There were no significant difference between conventional ICSI and IMSI groups in term of cleavage and pregnancy rates. Couples with abnormal sperm (teratozoospermia, oligozoospermia and oligoteratozoospermia) and no previous ICSI failure, had a significantly higher clinical pregnancy with IMSI than with ICSI (34.4% vs. 27.1%, p = 0.02). Furthermore, pregnancies obtained in patients with teratozoospermia were associated with a lower abortion rate after IMSI than after ICSI, close to significance (12.6% vs. 19.6%, p = 0.08).

Conclusion

In cases of severe teratozoospermia, IMSI appears to improve pregnancy rate and pregnancy outcome.     

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.     

Place de la tomographie d’émission de positons (TEP) pour l’évaluation thérapeutique et le suivi du cancer du sein

Positron emission tomography (PET) with fluorodeoxyglucose (FDG) is a nuclear imaging method whose interest in oncology has only grown over the past fifteen years. This article summarizes the results in monitoring and therapeutic evaluation of breast cancer. For the search of locoregional or distant recurrence, the performance of FDG-PET are very interesting. The impact of FDG-PET on the therapeutic management is undeniable. For therapeutic evaluation, this imaging is useful to evaluate the neoadjuvant chemotherapy and hormonotherapy efficacy. FDG-PET is indicated in cases of suspected recurrence (clinical, biological or imaging suspicious). It is the most sensitive exam for the detection of bone or visceral metastases. It allows the re-staging during a relapse proved whether local or remote, and can change the therapeutic management.     

Les échinides du Turonien de la Formation de l’Azilé du bassin côtier gabonais dans la région de Libreville Sud

Study of Turonian echinoids from Gabon store section allowed us to distinguish 10 species belonging to 2 genera: Mecaster pseudofourneli (Péron et Gauthier 1878), Mecaster toucasanus (d’Orbigny, 1854), Mecaster africanus (Coquand, 1862), Mecaster semicavatus (Peron et Gauthier 1880), Mecaster verneuili (Desor, 1847), Mecaster cf. orbignyanus (Desor, 1857), Mecaster palpebratus (Loriol, 1888), Mecaster sp.1, Mecaster sp. 2, Epiaster michelini (Agassiz) 1847. All species are found for the first time in Gabonese coastal basin. The composition and the distribution of echinoids fauna and the sedimentary characteristics indicate a proximal shallow platform deposit environment, with warm water and soft substrate. Two types of depositional environment are suggested: (1) a deep part of the proximal platform, represented by silty limestones and (2) a shallower part of the proximal platform, represented by limestones.     

Aspects réglementaires et organisationnels de l’activité d’autoconservation. Le point de vue du juriste

At the present time, legal texts in application of bioethics laws only briefly mention cryopreservation. The conditions of cryopreservation differ according to the type of tissue stored: while cryopreservation of oocytes and ovarian tissue corresponds to the field of biomedical research, semen cryopreservation corresponds to medically assisted procreation. Cryopreservation activity is more clearly defined in the draft revision of the bioethics law. Concerning the cryoconservation of ovarian tissue and oocytes, these difficulties result in particular in this activity’s mixed nature. It is located indeed, halfway between research and care. These two spheres of medical activity are subjected to their own distinct and exclusive, and their application is conditioned by the qualification of the implemented act. However, this qualification is dubious here, because of, in particular, the impossibility of determining which acts of sampling, cryoconservation and use might be concerned with a research protocol. Concerning the cryoconservation of sperm, the texts, first of all, seem to assimilate the activity of cryoconservation within an activity of assisted medical procreation. However, such assimilation would be equivalent to the impossibility of its implementation, because of the difficulty of respecting all of the legal conditions of assisted medical procreation. However, another more favourable interpretation of the provisions seems to be possible. Taking into consideration these uncertainties, contradictions and difficulties, the legislator intervened and devoted, by the widening of the indications of assisted medical procreation, the activity of cryoconservation in the project of revision of the laws of bioethics. He however did not solve all the difficulties. These cryoconserved elements can be restored only to the depositor. Indeed, the texts make obstacle to a delivery for a third party of the cryoconserved sperm, whatever the moment. They can also be used. This use can consist of assisted medical procreation, which is the first finality of cryoconservation — but it could only be implemented in respect of the whole of the legal conditions. It seems that the cryoconserved elements could also be used within the framework of research, whatever its nature (biomedical or not) and the moment of its implementation (while the person is alive or after his death). Its implementation should however be subjected to prior agreement and expressed while the person, whose elements were preserved, is alive. Such a use is expressly made possible in the project of revision of the laws of bioethics. Following a partial use or a lack of such a use, the destruction of the cryoconserved elements can be considered, as well as the continuation of the cryoconservation. However, these hypotheses raise difficulties that have not yet been resolved in the draft revision of the bioethics law.     

L’industrie du Paléolithique inférieur du site de Wujiagou,Hubei Province,République Populaire de Chine

The site of Wujiagou, Hubei Province in China, dated to just over 800,000 years, in sandy deposits and sandy-silt which covers a river terrace of the end of the Early Pleistocene, delivered a rich lithic industry, mainly composed of pebbles tools. This industry has an archaic aspect, consisted by the abundance of pebbles tools, the presence of hand-axes, and the small amount of small tools. The pebble tools include choppers and picks, in addition of band-axes. Small tools are relatively poor and have few simple retouched scrapers.