Thalamo-hippocampal pathway regulates incidental memory capacity in mice.

Incidental memory can be challenged by increasing either the retention delay or the memory load. The dorsal hippocampus (dHP) appears to help with both consolidation from short-term (STM) to long-term memory (LTM), and higher memory loads, but the mechanism is not fully understood. Here we find that female mice, despite having the same STM capacity of 6 objects and higher resistance to distraction in our different object recognition task (DOT), when tested over 1 h or 24 h delays appear to transfer to LTM only 4 objects, whereas male mice have an STM capacity of 6 objects in this task. In male mice the dHP shows greater activation (as measured by c-Fos expression), whereas female mice show greater activation of the ventral midline thalamus (VMT). Optogenetic inhibition of the VMT-dHP pathway during off-line memory consolidation enables 6-object LTM retention in females, while chemogenetic VMT-activation impairs it in males. Thus, removing or enhancing sub-cortical inhibitory control over the hippocampus leads to differences in incidental memory.

[Pelvic pain related to pelvic ligament support]. / Algies pelviennes liées à des troubles de la statique pelvienne.

In the context of organic pelvic pain, alongside post-infectious pain or pain related to endometriosis, ruptured ligaments of the pelvic fascia are an important cause of the pelvic congestion syndrome well known to classical authors. Surgical treatment combines two procedures: suture of the tear and exclusion of the pouch of Douglas.

[Conservative surgical treatment in breast cancer]. / Le traitement chirurgical conservateur dans le cancer du sein.

Conservative surgery, i.e. tumorectomy with lymph nodes ablation and radiotherapy or Iridium 92, has replaced completely mastectomy in limited forms of breast cancer (stage I or II less than 3 cms) with the same results for mid and long term But contradictions must be known: large lymph nodes, aged women, evolutive forms, recurrences after conservative surgery and also intra canal multi foci forms. These forms must impose secondary mastectomy as first treatment.

[Clinical aspects and complementary tests in pelvic congestive states]. / Aspects cliniques et examens complémentaires dans les états congestifs pelviens.

Pelvic congestion syndrome is common to three pathologies: premenstrual syndrome, intermenstrual syndrome and chronic pelvic fibrous congestion syndrome. The two first syndromes are well-known. They are periodical and hormonal treatment is relevant in premenstrual syndrome (all forms of progesterone and provascular treatment). Chronic pelvic congestion syndrome or fibrous congestion is linked with fibrous changes of the subperitoneal cellular tissue after more or less lasting chronic congestion. It is sometimes secondary to low noised and unknown sepsis (Bret and De Brux fibro-sclerous pelviperitonis). It is usually linked with the traumatical rupture of cellular pelvic tissue from obstetrical etiology (Masters and Allen syndrome). In varicocele, uterine plexus and ilio-lumbar ligament, hormonal action has been suggested. Three signs overnite polymorphic clinical study: deep dyspareunia, moving cervix, uterus retroversion. But primitive or secondary congestion is only in fact evoked by coelioscopy even with its limits. When coelioscopy is negative, hysterophlebography will be achieved and will visualize sometimes extremely pelvic plexus vasodilatation. As function of findings lesions, treatment lays down 3 principles: first principle not to abuse with surgery except in case of testing patent ligamentary lesions. Second principle to prescribe a polyvalent general treatment with triade antibiotic, antiinflammatory and phlebotonic drugs. Third principle to be preventive by improving obstetrical exercise as usually this syndrome succeeds to a more or less traumatic delivery.

Results of planned in-vitro fertilization programming through the pre-administration of the oestrogen-progesterone combined pill.

The use of an oestrogen-progesterone combined pill permits the induction of ovulation in the absence of any developing follicle. Two treatments were compared. In the first, patients received no prior treatment before stimulation. In the second, combined oestrogen-progesterone treatment was given during approximately two menstrual cycles prior to stimulation. No differences between the two groups were found in relation to oocyte maturity, fertilization in vitro, cleavage, replacement and pregnancy. Fewer luteinizing hormone surges occurred in patients pre-treated with steroids. The utilization of the oestrogen-progesterone combined pill prior to induction of ovulation facilitates the forward planning of patients for in-vitro fertilization.

PIP: In order to facilitate the scheduling and management of cases for in vitro fertilization, a trial of pre-administration of a combined oral contraceptive was conducted. 103 women took 2 mg norethisterone acetate and 0.05 mg ethinyl estradiol for 45 to 70 days before induction of ovulation, allowing 5 days between treatments. This group then received either Clomid 100 mg for 6 days and HMG 225 IU on days 5, 7 and 9 (34 women), or HMG only (dose not specified, 69 women). The control groups were given identical ovulation induction regimens: Clomid and HMG (130 women) or HMG only (188 women). 70 of the patients selected for preliminary inhibition of ovulation had irregular menstrual cycles with normal prolactin; the others were picked for scheduling reasons only. No differences were documented between the groups in oocyte maturity, fertilization in vitro, cleavage, replacement and pregnancy. Pregnancy rates ranged from 10 to 16.6% in the 4 subgroups. Fewer LH surges occurred in patients pretreated with steroids. Thus the pretreatment of candidates for in vitro fertilization with ovulation blocking steroids has no quantitative effect on results, but does facilitate scheduling patients for the procedure.

[The value of an antiprogesterone steroid in the treatment of extra-uterine pregnancy. Preliminary results]. / Intérêt d'un stéroïde à action antiprogestérone dans le traitement de la grossesse extra-utérine. Résultats préliminaires.

The aim of this work is to study the effects of an antiprogesterone drug (RU 486) on extrauterine pregnancy and to draw from it possible inferences for therapy. The study was carried out on 28 patients presenting an extrauterine pregnancy, the levels of plasma chorionic gonadotrophins of whom were higher than or equal to 250 mIU/ml. Different modes of administration were employed and a coelioscopic salpingotomy was carried out for a pathological study.

[Tuboscopy]. / Tuboscopie.

Tuboscopy permits the observation of the tubal mucosa and the discernment of two types of lesions: synechiae and mucosal "plates". The coincidence of the interpretation of hysterography and the results of tuboscopy does not exceed 1 case in 2. Experience shows that intrauterine pregnancies which develop beyond the first trimester only survive when tuboscopy shows us a normal mucosa, whatever may be the salpingographic picture. It is better to abandon the idea of a plasty when the tubal mucosa is in a bad condition.

Endoscopy of the tube (= tuboscopy): its prognostic value for tuboplasties.

A tuboscopy was performed during tuboplasties, in 131 cases; this method gives the surgeon a direct, panoramic view of the ampullary mucosa; the lesions observed differ in 50% of cases from what was expected according to the hysterosalpingography. A 2 year follow-up shows that normal uterine pregnancies occurred only in women with at least one tube with normal mucosa according to the tuboscopy, whichever the lesions or the results of the hysterosalpingography; the other cases only had ectopic pregnancies or spontaneous abortions.

[Results of preparatory surgery for in vitro fertilization with embryo transfer]. / Résultats de la chirurgie préparatoire à la F.I.V.E.T.E.

68 cases out of a total of 407 patients who were destined to have IVF (16.7%) had most adhesions in the pelvis which made the ovaries inaccessible for laparoscopic recovery, in the two years between September 1981 and September 1983. Using very severe criteria for selection we rejected 46 cases as unsuitable for surgery at that time. Only 22 therefore remained to have preparatory surgery. This surgery was particularly aimed at improving the local conditions for laparoscopic recovery as well as improving the quality of ovulation. The results are encouraging because those women who were operated on had about the same level of success in the three stages of IVF as women who were not operated on. This three-stage protocol of exploratory laparoscopy, operation and recovery laparoscopy does seem to be a heavy one and probably will be able to be replaced by a transvaginal ultrasound technique when this has been developed far enough to show that it has advantages.

[Role of Chlamydia trachomatis in the etiology of acute salpingitis. Value of the determination of IgG in 2 blood samples collected at 6 week intervals]. / Place de Chlamydia trachomatis dans l'étiologie des salpingites aiguës. Intérêt du dosage d'IgG sur 2 sérums prélevés à six semaines d'intervalle.

Cultures of specimens from the abdominal cavity (14) or the lower genital tract (11) were positive for Chlamydia trachomatis in 25 (22.7%) of 110 patients with a laparoscopic diagnosis of acute salpingitis. Microimmunofluorescence serodiagnosis showed positive IgG levels (greater than or equal to 1/64) in 35 patients (32%). Of the 34 patients in whom a second serodiagnosis was performed after 6 weeks, 20 (58%) had positive IgG levels (greater than or equal to 1/64) and 12 (35%) had a fourfold or more change in dilution. Thus, culture and serodiagnosis provided evidence of Chlamydia infection in 46% of the patient population. Forty-six patients were followed up for several months to evaluate the response to antibiotic therapy. Among tetracyclines, lymecycline was effective in 19/25 cases, doxycycline in 15/19 cases and minocycline in 2/4 cases. Switching to another tetracycline after failure of the first one usually gave satisfactory results.

Pregnancies after terminal microsurgical tuboplasties with early laparoscopic control on the 8th day.

226 terminal or bipolar tuboplasties performed in a continuous series from 1976 to 1982, using microsurgical techniques, are reviewed. 5 varieties of fimbrioplasties and 5 of salpingostomies are described. As previously published, an early laparoscopy was systematically performed 8 days after the plasty, with destruction of new adhesions, the latter being a bilateral obstacle to fecundation in 10% of the total. Out of 175 primary tuboplasties, cumulative pregnancy rate (CPR) is 66% +/- 2 X 6,5 and "real" pregnancy rate (RPR) 46%. For 96 cases of hydrosalpinges, CPR is 49% +/- 2 X 7,5 and RPR 43%. The ectopic pregnancy rate is 9% and spontaneous abortion rate 8%. Out of 47 terminal iterative tuboplasties CPR is 30% +/- 2 X 9 and RPR 25%. 10% of the pregnancies are attributed to the early laparoscopy, which enabled one to destroy bilateral adhesions in these cases.

Chlamydia trachomatis associated with chronic inflammation in abdominal specimens from women selected for tuboplasty.

Chronic inflammation is a frequent cause of tuboplasty failure. Therefore, it would be useful for one to know the microbiologic agent of infection and to treat it before the tuboplasty. By laparoscopy, a search for Chlamydia trachomatis, Ureaplasma urealyticum, and other microbiologic agents was carried out in the peritoneum and tubes of 118 women divided into 3 groups. Sixty-nine had a checkup before tuboplasty, of which 30 were found to have a chronic inflammatory condition discovered during laparoscopy (group 1) and 39 to have no sign of inflammation (group 2). Forty-nine women with a completely normal pelvis, being followed for possible sterility, were used as a control group. Cultures and serodiagnosis show a significant difference for C. trachomatis between the pathologic groups and the control group. They show no noticeable difference for U. urealyticum. These findings, compared with those by other authors, indicate that C. trachomatis could be an important microbiologic agent in tubal sterility, strongly connected with a low-grade chronic inflammatory condition, and their presence at the time of tuboplasty is to be considered.