Le médecin, son patient et ses pairs:Une nouvelle approche de la relation thérapeutique

Les travaux relatifs à la relation thérapeutique ont jusqu'alors négligé un élément décisif: les relations entre médecins. Le cas de la cancérologie révèle que l'attention portée à ces relations est susceptible d'apporter un nouvel éclairage à la compréhension de la relation thérapeutique. En particulier, la concurrence entre médecins sur l'activité et sur la définition du bon traitement représente une incertitude supplémentaire majeure pour chaque médecin dans sa tentative de maîtriser la relation avec son patient. Dès lors, les stratégies médicales d'organisation et de réorganisation locale de la prise en charge peuvent s'analyser comme des tentatives de réduction de cette incertitude. Réciproquement, la relation au patient n'a pas pour seule fin la guérison mais constitue aussi un autre moyen de maîtriser cette incertitude et, consécutivement, d'améliorer les relations thérapeutiques futures : le patient est pour le médecin un moyen d'obtenir de l'information sur les comportements de ses pairs et un moyen d'échange pour entretenir des relations privilégiées avec certains d'entre eux

Localization of tumor necrosis factor in the canine testis, epididymis and spermatozoa LOCALIZATION OF TUMOUR NECROSIS FACTOR IN THE CANINE TESTIS

Abstract 22 23 Tumour necrosis factor (TNF), formerly known as Tumour necrosis factor alpha is now 24 regarded as a natural component of the mammalian seminal plasma (SP). Although not 25 completely clarified, its functions in the SP have been associated with paradoxal roles, 26 such as sperm survival in the female genital tract, while at high levels negatively affect 27 sperm survival and fertility potential. Recently, it has been discovered that canine 28 inseminated spermatozoa display a strong immunoreaction for TNF when lining the 29 female endometrium. As a continuation of this finding, the present work aimed at 30 documenting TNF localization in the canine testes and epididymis and in freshly 31 ejaculated spermatozoa (SPZ) through immunohisto-or cytochemistry. 32 Immunoreaction for TNF was found in all samples used. In the dog testis, TNF 33 immunoexpression was limited to the seminiferous tubules, where late round spermatids 34 (SPD) showed weak intensity of immunostaining, whilst elongating and elongated SPD 35 evidenced moderate and the residual bodies a strong intensity. In the epididymis, a 36 gradual progressive increase of TNF immunolabelling was found throughout the 37 epididymal regions, ranging from a weak intensity at the caput epididymis to a moderate 38 intensity at the cauda. TNF immunolabelling was found in mature SPZ during the 39 epididymal transit and also in freshly ejaculated SPZ, which showed a strong mid-piece 40 immunolabelling. Data presented here provide important information on expression of 41 TNF in spermatozoa, which is acquired by the SPZ during their formation at the testis. It 42 further provides the basis for subsequent studies on the physiological importance of 43 cytokines in sperm function. 44 4

Localization of tumor necrosis factor in the canine testis, epididymis and spermatozoa

Tumor necrosis factor (TNF), formerly known as Tumor necrosis factor alpha is now regarded as a natural component of the mammalian seminal plasma (SP). Although not completely clarified, its functions in the SP have been associated with paradoxal roles, such as sperm survival in the female genital tract, while at high levels negatively affect sperm survival and fertility potential. Recently, it has been discovered that canine inseminated spermatozoa display a strong immunoreaction for TNF when lining the female endometrium. As a continuation of this finding, the present work aimed at documenting TNF localization in the canine testes and epididymis and in freshly ejaculated spermatozoa (SPZ) through immunohisto- or cytochemistry. less thanbrgreater than less thanbrgreater thanImmunoreaction for TNF was found in all samples used. In the dog testis, TNF immunoexpression was limited to the seminiferous tubules, where late round spermatids (SPD) showed weak intensity of immunostaining, while elongating and elongated SPD evidenced moderate and the residual bodies a strong intensity. In the epididymis, a gradual progressive increase of TNF immunolabelling was found throughout the epididymal regions, ranging from a weak intensity at the caput epididymis to a moderate intensity at the cauda. TNF immunolabelling was found in mature SPZ during the epididymal transit and also in freshly ejaculated SPZ, which showed a strong midpiece immunolabelling. Data presented here provide important information on expression of TNF in spermatozoa, which is acquired by the SPZ during their formation at the testis. It further provides the basis for subsequent studies on the physiological importance of cytokines in sperm function.Funding Agencies|Portuguese Science and Technology Foundation (FCT)|PEst-OE/AGR/UI0772/2011SFRH/BSAB/938/2009BII/UNI/0772/AGR/2009

Immunolocalization of E-cadherin and beta-catenin in the cyclic and early pregnant canine endometrium

Putative changes in E-cadherin and beta-catenin during implantation in dogs are of interest to study, as they are relevant proteins for epithelial integrity. E-cadherin and beta-catenin were immunolocalized in the canine endometrium during the estrous cycle and early pregnancy, using monoclonal antibodies. Both proteins were detected in all types of endometrial epithelia (surface epithelium [SE], superficial glandular, and deep glandular epithelia) at all stages of the estrous cycle and in early placental structures. E-cadherin depicted a gradient of intensity apparently being lowest in the SE to progressively increase toward the deepness of the endometrial glands, regardless of the stage of estrous cycle. The overall immunostaining was, however, weaker at diestrus. In pregnant samples, the trophoblast was conspicuously immunolabeled compared with the endometrial surface lining epithelium. In the latter, the cytoplasmic pattern predominated over the membrane bound, as was also seen in the decidual cells of the placental labyrinth. In the early placenta, only trophoblast cells and lacunae retained membrane signals. beta-Catenin membrane labeling appeared relatively constant throughout the cycle, although a tendency toward a decrease in intensity was detected at the secretory stages. In addition, a dislocation of the immunoreaction from membrane to the cytoplasm was observed in both the SE and the glandular epithelia at particular stages of the cycle. In early pregnancy, a loss of the membranous pattern was observed in the SE and labyrinth, but neither on trophoblast nor in lacunae. The results show the existence of a softening of the adherens junctional complex in progestagen-dominated stages favoring embryo-maternal interactions and endometrial invasion during canine implantation. (C) 2016 Elsevier Inc. All rights reserved.Funding Agencies|Portuguese Science and Technology Foundation (FCT) [PEst-OE/AGR/UI0772/2014]; [SFRH/BSAB/938/2009]</p