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Disponible en France depuis la fin des années 1990, suite à la création des premières lois de bioéthique, le diagnostic préimplantatoire (DPI) peut être proposé à des patients à risque de transmettre à leur descendance des maladies génétiques particulièrement graves. Leur prise en charge est multidisciplinaire et associe la médecine et la biologie de la reproduction et la génétique. Le DPI consiste à analyser des cellules issues d'embryons obtenus par fécondation in vitro afin de ne transférer que des embryons indemnes de la pathologie recherchée. Après une description du contexte législatif français, nous aborderons le parcours des patients et les techniques d'analyse actuellement utilisées, donnerons quelques chiffres de l'activité nationale et ouvrirons des perspectives d'évol ution de cette pratique. Available in France since the late 1990s, since the advent of the first bioethics laws, preimplantation testing (PGT) can be offered to patients at risk of transmitting particularly serious genetic diseases to their offspring. Treatment is multidisciplinary, combining reproductive medicine and biology with genetics. PGD consists in analysing cells from embryos obtained by in vitro fertilization, in order to transfer only embryos free of the pathology of interest. After a description of the French legislative context, the patient pathway and the analysis techniques currently used will be described, some figures for national activity will be presented as well as open up prospects for the future development of this practice. [ABSTRACT FROM AUTHOR]

BackgroundThe bone-tumor microenvironment encompasses unique interactions between the normal cells of the bone and marrow cavity and the malignant cells from a primary or metastasized cancer. A multitude of paracrine factors within this microenvironment such as the growth factor, TGF-beta, and the chemokine, MCP-1, are secreted by many of these cell types. These factors can act in concert to modulate normal and malignant cell proliferation, malignant cell migration and invasion and, often, mediate bone cancer pain. Although many valuable in vitro and in vivo models exist, identifying the relevant paracrine factors and deciphering their interactions is still a challenge. The aim of our study is to test an ex vivo coculture model that will allow monitoring of the expression, release and regulation of paracrine factors during interactions of an intact femur explant and tumor cells.MethodsIntact or marrow-depleted neonatal mouse femurs and select murine and human sarcoma or carcinoma cell lines were incubated singly or in coculture in specialized well plates. Viability of the bone and cells was determined by immunohistochemical stains, microscopy and marrow cytopreps. Secretion and mRNA expression of paracrine factors was quantitated by ELISA and real-time RT-PCR.ResultsCompartments of the bone were optimally viable for up to 48 h in culture and tumor cells for up to 4 days. Bone was the major contributor of TGF-beta and MMP2 whereas both bone and sarcoma cells secreted the chemokine MCP-1 in cocultures. Synergistic interaction between the femur and sarcoma resulted in enhanced MCP-1 secretion and expression in cocultures and was dependent on the presence of the hematopoietic component of the bone as well as other bone cells. In contrast, coculturing with breast carcinoma cells resulted in reduction of TGF-beta and MCP-1 secretion from the bone.ConclusionThese studies illustrate the feasibility of this model to examine paracrine interactions between intact bone and tumor cells. Further study of unique regulation of MCP-1 secretion and signaling between these cell types in different types of cancer will be possible using this simulated microenvironment.

Objective: The authors assessed the prevalence of domestic violence among patients examined in the emergency service of a general hospital. They compared the socio-demographic status and psychiatric comorbidity of victims of domestic violence and other patients., Method: An assessment was made on 126 consecutive patients received by the emergency service of Bichat-Claude Bernard hospital (Paris, France). Assessment of domestic violence was made through the use of a specific questionnaire., Results: The prevalence rate of domestic violence was 18% among patients examined by the emergency service. Thirty-five percent of the cases were physical violence, 22% sexual violence, 17% psychological violence and 26% multiple forms of domestic violence. Domestic violence had been going on for less than 1 month in only one case. In 74% of the cases, violence lasted for more than 1 year. No differences were found in terms of socio-demographic characteristics (age, marital status, rate of unemployment, sex ratio) and psychiatric comorbidity between victims of domestic violence and others., Conclusion: Patients seen in an emergency service must be identified as a population at risk for domestic violence (18%). These situations can be identified only by a systematic assessment using a standardized questionnaire.

The simultaneous disclosure of a lymphoblastic B cell lymphoma and sarcoidosis is reported herein. The initially undiagnosed sarcoidosis leads to discuss the differential diagnosis of a sarcoid-like reaction associated to the lymphoma. The association of sarcoidosis and malignant lymphoproliferative disease is not fortuitous; nevertheless the simultaneity of the two diagnoses, the lymphoblastic type of the lymphoma and the colocalization of granulomatous and lymphomatous lesions in lung and liver are unusual features.

The present clinicopathological study concerns 22 cases of hepatocellular carcinoma in non cirrhotic liver; they all underwent hepatectomy performed in the same surgical unit, and this group is clinically homogeneous. This cancer shows higher frequency in males (17/22), and in ages between 40 and 72. No etiologic relevance is shown. An abdominal mass is detected as first clinical symptom. Macroscopically: the tumor most often appears as a chief nodule 2-4 cm in diameter surrounded by smaller ones, always in close proximity. Histologically: the tumors are usually well or rather well differentiated hepatocarcinomas; 4 of them are fibrolamellar. Because of these macroscopical features and because of the absence of metastasis at the time of laparotomy even in case of recurrence, partial hepatectomy seems justified. A rich reticulin framework and its even distribution seem to be the best morphological signs indicating good prognosis. Long lasting survival, exceeding 11 years for one patient, concerns chiefly fibrolamellar tumors.