Testing the fertility of the spermatozoa

The sperm count, an absolutely necessary examination, seems no longer sufficient to establish a prognosis of fertility. Fertilization in vitro, for a diagnostic purpose, would be the ideal examination, but because of the ethical and technical problems it raises, other tests have been developed. The test of spermatozoid survival at 24 hours in Menezzo's B2 medium and interspecific fertilization in vitro (hamster-test) are carried out on isolated spermatozoids according the FIV protocol. The survival test provides two parameters: the presence of mobility and the rate of retention of the mobility after 24 hours. With the hamster-test it is possible to study the penetration and decondensation of the spermatozoids in the ovocytes. The results obtained with the survival test show that the absence of gradual mobility and a retention rate below 25 p. cent after 24 hours, significantly affect the cleavage of ovocytes during FIV. These two parameters affect, in a similar fashion, the percentage of fertilized ovocytes in the hamster-test. The latter seems less specific than the survival test to establish a prognosis before FIV. However, it is interesting as it allows the study of the different stages of fertilization of spermatozoid samples, from the same ejaculation, under varied experimental conditions. These tests require a standardization and present a definite advantage during exploration prior to FIV, AIC.     

Particle size of solid food after human mastication and in vitro simulation of oral breakdown

Mastication, the first step in food digestion, results in the breakdown of solid food and its lubrication with saliva. Although the rate and extent of starch digestion are closely dependent on the way food is chewed, this factor has not been adequately considered in the preparation of food for in vitro digestion experiments. The purpose of this study was to determine the size distribution of starchy food particles before swallowing and to use an in vitro mincing procedure to simulate how food is divided up during chewing. Foods differing in texture and size (bread, spaghetti and tortiglioni) were chewed by 12 healthy subjects and spat out before swallowing. Chewing time and saliva impregnation were measured for each mouthful. The particle sizes resulting from experiments with chewed and minced bread and pasta were analysed respectively by light laser diffraction and image analysis. Chewing time was longer for bread than pasta, resulting in higher saliva impregnation. Chewed bread showed a bimodal distribution of particle size (30 microns, 500 microns), whereas both kinds of pasta produced particles of similar size (0.5 to 30 mm2) after mastication. Mincing reproduced the division of bread and pasta as achieved by chewing in an acceptable way. From our results it seems that the size of particles resulting from mastication depends on food texture. We succeeded by wetting and mincing food to prepare food in a similar bolus-like form before swallowing. Mincing provides a simple means of simulating the reduction of food into particles for in vitro digestion studies.     

Intermediate neurological development of 60 neonates weighing 1500 grams or less at birth. Predictive value of initial findings (clinical aspects, electroencephalograms and brain imaging)

60 low birthweight (less than or equal to 1,500 g) are distributed according to existence or not, and intensity of brain disturbances, during the neonatal period; appreciated by neurological examinations, early EEG and brain imaging during the second month of life. At 18 months, at least, neurological outcome is normal for 46 children (but 6 had transient neuromotor anomalies), 14 have sequelae (7 mild, 7 major). All children with clinical neurological examination carried out during the neonatal period are normal at follow up. It is true also for the children without EEG anomaly and normal brain imaging. The early prediction of neurological outcome can be made easily with consideration of these three data. Standardised test are proposed, during the neonatal period, for these low birth weight infants.     

Course of headaches associated with cAVMs after radiosurgery

The purpose of this study is to evaluate the response of headaches associated with cerebral arteriovenous malformations following radiosurgery and determine the factors that are associated with a positive outcome. From our series of 700 patients whose cAVM was treated by radiosurgery, this study includes 109 patients (48 males, 61 females) with a mean age of 32 when radiosurgery was performed. Headaches resolved in 37 patients (53.7%), decreased in 14 patients (20.3%), persisted in 16 patients (23.2%), and even increased in frequency in 2 (2.9%). Headaches disappeared 2 years following radiosurgery in the majority of patients (31 out of 37: 83.3%). The disappearance rate of headaches was better when it was the only sign of the malformation (64%) or preceded an epileptic seizure (60%) with respect to the case when it preceded cerebral hemorrhage (34.8%). Headaches having the best response were those with 1 to 2 episodes per month (64.9%) and whose episode duration was less than 3 hours (67.6%). Unilateral headaches accounted for 86.5% of resolved headaches whereas bilateral headaches were only 8.1% and even less were the diffuse ones (5.4%). The best evolution was obtained for those associated with a parietal location of the cerebral arteriovenous malformation, followed by rolandic (respectively 55.5% and 50%). Occipital malformation was associated with headache disappearance in 38.1% and temporal with 34.3%, whereas frontal location was associated with headache disappearance in only 25% of the cases. Headache disappearance was often correlated with cerebral arteriovenous malformation outcome after radiosurgery (64.9% of disappearance in case of complete obliteration). However, in 24.8%, headaches disappeared prior to the malformation obliteration and were associated with a decrease of the flow, of the nidus volume or with the nidus disappearance with the persistence of a precocious venous drainage. Headaches disappeared in spite of the malformation persistence in 5.4% of the cases. We found de novo headaches in one patient one year following RS. Another patient presented an episode of headache 12 hours following RS. The course of headaches associated with cerebral arteriovenous malformations after radiosurgery is positive in the majority of cases and correlated to the malformation outcome. This correlation suggests a link between cerebral arteriovenous malformations and headaches and the equal benefit of radiosurgery on both of them.     

Prospects and future: evolution of stereotactic methodology for planning

We have been using the stereotactic methodology of Talairach for Linac radiosurgery of cerebral arteriovenous malformations since 1984, and updated it with addition of CT and MR images into the stereotactic space. The target remains defined, as in most other centers, by stereotactic angiography. However, tridimensional configuration of cerebral arteriovenous malformations is better defined using MR or CT-angiography. Therefore, pre-radiosurgical imaging tends to combine multimodal images oriented into the stereotactic space. Frame-based radiosurgery, with invasive frame placement, will be replaced in the future by frameless irradiation with real-time tracking of the patients head, as performed by the recently described Cyber-knife. Intraoperative X-ray will be no longer long-distance fixed equipments but mobile, short-distance fluoroscopic systems integrated in the surgical workstation environment. Finally, biplane conventional angiography performed for cerebral arteriovenous malformations identification will be replaced by CT and MR-angiography, except in some cases who could still require DSA for accurate target identification.     

Traitement médicamenteux d’urgence des ruptures de varices œsophagiennes (place de la Glypressine)

Acta Endoscopica - Trois études sont sont passées en revue dans cet article: Freeman et coll. [13, 14], Söderlund et coll. [24].     

Non-invasive evaluation of the cardiac function in Golden Retriever dogs by radionuclide angiography

Golden Retriever dogs manifest an X-linked, Duchenne-like, muscular dystrophy with a characteristic lack of dystrophin. Histologic findings have demonstrated the cardiac involvement in these dogs to be a model for the cardiac insufficiency in human Duchenne muscular dystrophy (DMD). The goal of this study was to assess the capability of radionuclide angiography (RNA) as an assessment tool to measure the ventricular dysfunction in these dogs. Three dogs, one normal and two with muscular dystrophy (MD), were studied by equilibrium gated blood pool. Red blood cells were labelled with 420 MBq of 99mTc. The three dogs lying on their left sides on the table, received no drugs and were not restrained in any manner. RNA left ejection fraction (EF) and echographic measurements of left ventricular fractional shortening (FS) were performed during the same session. EF values were 61%, 48%, 36% and FS values were 47%, 32%, 26%, respectively, for the control dog, the 6 month old MD dog and the 12 month old MD dog. This preliminary study demonstrates the potential usefulness of RNA for the non-invasive follow-up exams of specific therapy in a canine model of muscular dystrophy.     

Interaction of a spin-labeled long chain acylcholine with the cholinergic receptor protein in its membrane environment.

The choline ester of a spin-labeled fatty acid, 8-doxylpalmitocylcholine, CH3--(CH2)7--CR-(CH2)6-- + COO--(CH2)2--N(CH3)3, where R is the paramagnetic 4',4'-dimethyloxazolidine-N-oxyl (doxyl) ring has been synthesized. 8-Doxylpalmitoylcholine blocks reversibly the depolarization of Electrophorus electroplaque elicited by the bath application of carbamylcholine. It slows down the initial rate of binding of the alpha-[3-H]toxin from Naja nigricollis to receptor-rich membranes fragments from Torpedo, and it displaces [3-H]acetylcholine bound to the cholinergic receptor site present in these fragments. Electron spin resonance spectra of 8-doxylpalmitoylcholine in the presence of the receptor-rich membrane fragments show complete immobilization of the spin label. Various cholinergic agents tested, including N. nigricollis alpha-toxin, reverse this immobilization, probably by displacing the 8-doxylpalmitoylcholine from its complex with the cholinergic receptor protein to the lipid phase of the membrane.