[Non invasive assessment of embryo quality: proteomics, metabolomics and oocyte-cumulus dialogue]. / Approches non invasives de l'embryon : protéomique, métabolomique, dialogue ovocyte-cumulus.

Preimplantation embryo development is one of the key features with implantation itself to achieve a pregnancy. Assisted Reproductive Technologies both in human and animal have improved our knowledge on these events, although it remains elusive to predict embryo potential to give a baby. Among various ways to define embryo viability, noninvasive approaches get a serious advantage linked to the final transfer of the embryo. Techniques devoted to characterize the embryo secretome using proteomic or metabolomic approaches may be non invasive. Based on a direct identification of products of the embryo metabolism or an assessment of profile(s) related with embryo viability, they have greatly improved their sensitivity to allow their use in clinical embryology, once validated. Oocyte-cumulus dialogue, as a key factor for oocyte competence to meiosis and embryo development, was particularly concerned with both genomic and proteomic assessment of cumulus cells. While it is not possible to designate at the time being which among these approaches will be robust and cost-efficient enough to help routinely the clinical embryologist in assisted reproductive techniques (ART), one can predict that our ability to select the "right" embryo will combine morphological criteria already available with validated biomarkers.

Gene expression in human cumulus cells: one approach to oocyte competence.

BACKGROUND: Dialogue between the oocyte and cumulus cells is essential for oocyte maturation. A prospective laboratory research project was designed to evaluate transcription of specific genes in cumulus cells harvested before intracytoplasmic sperm injection from pre-ovulatory follicles, according to individual oocyte nuclear maturity and developmental competence. Genes were chosen because their expression was induced by the LH peak [Steroidogenic Acute Regulatory protein (STAR), Cyclooxygenase 2 (COX2 or PTGS2), Amphiregulin (AREG)] or because they were involved in oocyte lipidic metabolism [Stearoyl-Coenzyme A Desaturase 1 and 5 (SCD1 and SCD5)] or in gap-junctions [Connexin 43 (CX43 or GJA1)]. METHODS: mRNA levels in cumulus cells were assessed by real-time PCR. RESULTS: Expression levels of all genes investigated, except Cx43, were increased after resumption of meiosis. Nuclear maturation was thus associated with increased expression of STAR, COX2, AREG, SCD1 and SCD5 by cumulus cells. When considering only cumulus associated with metaphase II oocytes, gene expression was independent of morphological status at Day 2. In contrast, transcript levels were lower and distributed over a narrower range in cumulus enclosing oocytes achieving blastocyst development at Day 5/6 than in cumulus enclosing oocytes unable to develop beyond the embryo stage. CONCLUSION: Further developmental potential from embryo to blastocyst stage was associated with lower expression in a narrow range for these genes.

[Oocyte-cumulus dialog]. / Le dialogue ovocyte-cumulus.

The dialog between oocyte and cumulus cells brings a major contribution for oocyte meiotic and developmental competence. On the one hand, the oocyte will modulate follicle growth through specific gene expression (Figalpha, GDF-9, BMP15) as well as its meiosis (GPR3 et PDE3A). Beyond its action on proliferation, oocyte will control in part the differentiation of cumulus cells with a particular involvement of GDF-9, BMP15 in this late maturation process. On the other hand, somatic cells are the main targets of gonadotropins and will modulate both oocyte growth and maturation. Gap-junctions between oocyte and cumulus cells have a major role in this interaction, since they allow the action of some oocyte specific genes (GDF9) but also the control of its own metabolism and calcium movements. While ovulation will involve gonadotropins action on somatic cells, EGF-like factors recruited at the cumulus level will participate in this process. Finally we may suspect that improving the knowledge on oocyte-cumulus dialog will contribute to better define oocyte competence, while bringing some clues for in vitro maturation.

[Retrograde intravenous perfusion with cytostatic drugs in angiosarcoma]. / Retrograde intravenöse Perfusion mit Zytostatika bei Angiosarkom.

Case-report of an 82 year old female with an angiosarcoma developing in a venous ulcer and lymphedema. The patient was successfully treated by retrograde intravenous perfusion with vinblastin and vincristin with subsequent blunt removal of the tumor.

Linking health screening to health education learning modules for elementary school students: a feasibility study.

The purpose of this study was to develop and assess an elementary health education curriculum based upon health screening procedures. A modular format was used which enables students to progress at a self-determined pace. Mastery of subject matter is insured, since progression to other modules is based upon satisfactory completion of preceding packets. A total of 60 fourth grade students from two classes were selected by a block randomization process to participate in the study. An experimental and control group were designated and pre-tested. The experimental group was subjected to the prototype curriculum, while the control group was exposed to the traditional health screening program routinely implemented in the district. Upon completion of their respective units, both groups were post-tested to assess gains in achievement. No significant (p less than .01) pre-test differences existed between each group of students. While both groups made gains in health knowledge on post-test scores, the experimental group scored significantly (p less than .01) higher than the control group. It appears the prototype curriculum is a more effective approach in teaching health than the traditional approach at this grade level. The authors suggest that this study be replicated on a larger scale and include the entire complement of modules.