Prenatal description of retinal coloboma.

Retinal coloboma is a rare condition which is difficult to diagnose in foetuses. It can cause blindness. It can be isolated or associated with other malformations in various syndromes. Our objective is to describe the different prenatal ultrasound findings and management of coloboma. We describe a case of prenatal ultrasound diagnosis of retinal coloboma at 27.5 weeks of gestation. Our case adds to the 8 previously reported in the prenatal ultrasound literature, which together illustrate that microphthalmia is the main associated sign, present in 66.6% (6/9) of cases followed by retro-orbital cysts (44.4%) (4/9). These two ultrasound findings should alert us to a close examination of the eye to look for a posterior retinal cleft, the main direct sign of a chorioretinal coloboma.

[Uterine necrosis after arterial embolization for postpartum hemorrhage]. / Nécrose utérine après embolisation hémostatique des artères utérines.

Radiologic embolization of the uterine arteries is increasingly used to treat severe postpartum hemorrhage, as an alternative to surgical procedures. Guidelines have been published in order to standardize the indications as well as the technique. An important objective was to limit severe complications such as uterine necrosis. We report a case of a uterine necrosis after arterial embolization for severe postpartum hemorrhage due to uterine atony on a uterus with fibroids. This complication occurred despite the use of the recommended technique.

[Amniocentesis trainer: development of a cheap and reproducible new training model]. / Simulateur d'amniocentèse : intérêts et développement d'un nouveau modèle reproductible et économique.

Amniocentesis is the most common invasive procedure for prenatal diagnosis. It is essential to master this sampling technique prior to performing more complex ultrasound-guided interventions (cordocentesis, drain insertion). Training is a challenge because of the risks associated with the procedure, as well as the impact on the patient's anxiety. An amniocentesis simulator allows for safe training and repeats interventions, thus accelerating the learning curve, and also allows for periodic evaluation of proficiency. We present here a new, simple, and cost-effective amniotrainer model that reproduces real life conditions, using chicken breast and condoms filled with water.

[Chorionic villus sampling training method]. / Technique d'apprentissage de la biopsie de trophoblaste.

OBJECTIVES: Chorionic villus sampling (CVS) in the first trimester of pregnancy has become a major tool in prenatal diagnosis. To increase the safety of CVS during training period, we have built a "BT-Trainer". MATERIALS AND METHODS: A medical device has been developed which simulates the in vivo procedure with the various layers to cross. The stratum of the layer and the accessibility of the placenta can modulate the level difficulty. CONCLUSION: Traditional strategies for clinical teaching are often insufficient and trainees may fail to achieve competence in even basic procedural skills. We present herein an easy and reproducible model of "BT-Trainer" which allows a safe and repeatable training. Efficacy of this model is currently under evaluation in a teaching program. This trainer could help gynaecologists in order to learn gradually and safely the technique and to enhance their skills and coordination.

Spatiotemporal expression of molecules associated with junctional complexes during the in vivo maturation of renal podocytes.

Epithelial glomerular cells differentiate from mesenchymal cells of the metanephrogenic blastema. During the first stages of glomerulogenesis, the cells acquire the morphological features of epithelial cells. Then, podocytes lose these characteristics at the maturing glomerular stage. We have studied the molecules associated with junctional complexes during glomerular differentiation in human and pig fetal kidneys. We show for the first time the expression of P-cadherin in renal cells. Epithelial cells of ureteral buds and ampullae display all the molecules associated with junctional complexes and coexpress E- and P-cadherin. However, P-cadherin, plakoglobin and vinculin are the only markers detected in future glomerular cells. We have established a spatiotemporal correlation between the time of appearance and disappearance of junctional complexes as previously described (Saxén and Wartiovaara, Int. J. Cancer 1:271-290, 1966; Saxén et al., Adv. Morphog. 7:251-293, 1968; Reeves et al., Lab. Invest. 39:90-100, 1978), and the expression of their associated molecules. Epithelial cells with stable, typical junctional complexes strongly express the molecules associated with junctions, whereas cells endowed with transient, atypical junctional complexes express low amounts of components associated with junctions. These observations suggest a correlation between the level of expression of these components and an authentic, stable epithelial phenotype.

Modified lysosomal compartment as carrier of slowly and non-degradable tracers in macrophages.

A previous immunocytochemical study of macrophages infected with Bacillus subtilis showed that a cell wall antigen could be detected for several days in a population of small vesicles randomly distributed within the cells and apparently distinct from perinuclear lysosomes. These observations suggested the possibility that these vesicles might constitute a "storage" compartment for non-degradable compounds. In the present report we compared in pulse-chase experiments the location and fate of a series of degradable and non-degradable pinocytic tracers within the macrophages. The tracers, detected by fluorescent microscopy, were bovine serum albumin (BSA), hen egg ovalbumin (OVA), horseradish peroxidase (HRP). Lucifer Yellow, fluorescent dextran, and levan. BSA and OVA remained located in perinuclear lysosomes during the chase period until their disappearance occurring within 3 h. In contrast, the other tracers, although initially located in perinuclear lysosomes, were found after a 3 to 5-h chase in small vesicles homogeneously distributed in the macrophage cytoplasm where they remained visible for 2 to 3 days. The use of markers for different cell organelles indicated that these dispersed vesicles exhibited several of the lysosomal features. They were acidic, they contained the 100 kDa and the 120 kDa lysosomal proteins as well as some acid proteases albeit these markers were in lesser concentrations than in the perinuclear lysosomal compartment. The addition of bacteria to the macrophages previously loaded with fluorescent dextran showed that all dispersed vesicles have the same fusion property as lysosomes and that slowly degraded or non-degradable tracers turn over through the perinuclear lysosomal compartment by using the endocytic pathway. Measurement of the release of some of the tracers into the culture medium suggested that the "dispersed vesicles" were probably not implicated in exocytosis of the tracers.

Bacterial antigen immunolabeling in macrophages after phagocytosis and degradation of Bacillus subtilis.

After phagocytosis of Bacillus subtilis 168 by bone marrow-derived macrophages, the intracellular pathway followed by different antigens was studied by immunofluorescence and immunoelectron microscopy. Three different rabbit antisera were used: (i) an antiserum to B. subtilis whole cells mainly recognizing the cell wall constituents, (ii) an antiserum to teichoic acid, and (iii) an antiserum to peptidoglycan recognizing the disaccharide tetrapeptide molecules resulting from peptidoglycan degradation. During the first 3 h after phagocytosis of B. subtilis, the three antisera were confined to the same vacuolar compartments, as follows. They were first found in phagosomes gathered in the perinuclear region. Upon bacterial degradation, the three antisera colocalized in an increasing number of small dense vesicles, located in the perinuclear region, that seemed to result from the fragmentation of phagolysosomes. These vesicles correspond to an acidic compartment since they also stained for 3-(2,4-dinitroanilino)-3'-amino-N-methyldipropylamine, a drug known to accumulate in the acidic compartments of cells. At later time points, the antigens recognized by the three antisera followed different pathways. After 18 h, teichoic acid and peptidoglycan were no longer detectable in macrophages whereas an antigen(s) labeled with antiserum to B. subtilis whole cells remained stocked for several days in small acidic vesicles randomly distributed throughout the macrophage. This compartment appeared to be different from the one labeled during the first 3 h after ingestion of bacteria. These results suggest that the transport rate and the compartments implicated in antigen processing differ according to the antigen.

[An aid toward decision in congenital hip dislocation. Value of decision trees in the determination and treatment of hips at risk (preliminary study)]. / L'aide à la décision dans la luxation congénitale de hanche. Apport des arbres de décision dans la détermination et le traitement des hanches à risque (étude préliminaire).

Well established procedures exist for treatment of congenital dislocation of hip, whereas unanimity is lacking with respect to management of a hip at risk during the neonatal period. Based on a homogeneous series of 720 case-reports of neonates at risk a decision tree has been developed to determine essential risk factors and to demonstrate preferential pathways when evaluating appropriate therapy.

Studies on "repeated epilation" mouse mutant embryos: I. Development of facial malformations.

Repeated Epilation Er/Er mouse embryos show severe facial malformations. The most obvious is an important decrease in prominence of facial features. The protuberance of the snout is reduced. The eyes, the mouth, the nares and the ears are modified. From 13.5 days onwards the lips begin to close, the joining proceeding from the lateral to the central part. The nares, eyelids, oral opening, and auditory ducts are in the course of closure from 14 days of pregnancy. This process is terminated at 15 days. At the microscopic level, disturbances begin to appear at 13 days. They are limited to the anterior part of the face. During the next few hours, they become more important. At 14 days, the maxillae are joined from the anterior extremity of the snout. The oral opening is thus closed. Then, an oral cavity of very reduced form and dimensions is formed. The tongue connects the nasal septum to the mandible. A general process of closure occurs between: nasal septum, maxillae, tongue, and palatal shelves. Extensive modifications result from the compression of all these areas, especially of the tongue and shelves which remain in vertical position. An atypical cleft palate is seen, due to the absence of shelf movement, impeded by the tongue and the joinings mentioned earlier. The compression increases at 15 and 16 days. However, complete epithelial fusions do not occur. In 18-day-old embryos, cystic malformations appear in the glosso muscular system.

[Role of the mesenchyme in the fusion of palatine shelves (author's transl)]. / Rôle du mésenchyme dans la fusion des bourgeons palatins.

Na2 35SO4 was either injected to pregnant mice or added to a "Wolff and Haffen" culture medium. In various experiments, palatine shelves and half-lips remained one hour on this labeled culture medium. They were thereafter associated to another labeled fragment, either to their homologous shelf in a homotypical culture, or to a half-lip in heterotypical culture. In the same way, labeled half-lips were coupled to unlabeled palatine shelves. In all these cases, the mesenchyme was labeled by the tracer while the epithelial cells remained empty. In the medio-palatine epithelium, some dislocations could be noticed between the cells. These gaps were filled by the labeled mesenchyme with which they were in continuity. At this level the tracer appeared on the external surface. In the homotypical associations, it invaded, through these channels, the labeled antagonistic explant; in the heterotypical associations, lips plus palatine shelves, the labial epithelium prevented all the penetrations, except when alterations occurred, due to a long lasting culture. The role of the mesenchyme in the process of fusion and in the possible building of a surface coating is discussed.