Mucocele fronto-ethmoïdale geante avec extension intracranienne: a propos d’un cas et revue de la litterature

Les mucocèles sont des pseudotumeurs kystiques développées aux dépens des sinus paranasaux. D’évolution lente et silencieuse elles se révèlent le plus souvent par des complications rhinologiques ou ophtalmologiques. Les auteurs rapportent un cas rare d’une mucocèle fronto-ethmoidale géante avec céphalées et baisse de l’acuité visuelle de l’oeil gauche. Le scanner montre une lésion kystique ayant entrainé une lyse des parois antérieure, postérieure du sinus frontal avec une extension intracrânienne et intra-orbitaire avec lyse de la paroi interne de l’orbite. Un abord trans-crânien a permis la cure de la malformation et une oblitération du canal naso-frontal. L’évolution est favorable avec une récupération visuelle complète. Les aspects physio-pathogéniques, thérapeutiques et pronostiques sont discutés.Mots clés : mucocèle fornto-ethmoidale, traitement, pronosti

Relation entre les anomalies du spermogramme et les constituants biochimiques du liquide séminal de sujets consultant pour hypofertilité masculine à Ouagadougou

La présente étude visait à analyser le profil biochimique du liquide séminal de patients consultant pour hypofertilité masculine à Ouagadougou, en relation avec les anomalies du spermogramme. La population d’étude était constituée de 220 sujets masculins âgés de 23 à 64 ans. Les dosages du glucose, du cholestérol, des triglycérides, des protéines totales, du fructose, du calcium, du magnésium, du zinc et de l’α-glucosidase ont été réalisés avec un automate Cobas Mira (Roche) alors que le sodium et le potassium ont été dosés avec un photomètre de flamme (PHF 104 de Hycel). L’électrophorèse a été réalisée sur support hydragel avec une chaîne d’électrophorèse Hydrasis (Sébia). L’analyse du spermogramme a montré que seuls 35 sujets soit 15,9% avaient un spermogramme normal contre 84,1% d’anomalies. La répartition des anomalies du spermogramme observées était : asthénospermie (25%), oligo-asthénospermie (15,5%), oligo-asthéno-tératospermie (13,6%), azoospermie (10,5%), oligospermie (10,5%), tératospermie (9,1%). Le profil électrophorétique des protéines du liquide séminal n’a pas apporté un intérêt notable dans l’étude des différentes anomalies du spermogramme. Cependant, l’augmentation du sodium dans l’azoospermie, la diminution du magnésium et l’augmentation des triglycérides dans l’asthénospermie et la diminution du potassium dans l’oligospermie présenteraient un intérêt s’ils étaient confirmés par d’autres travaux. En effet, ces paramètres de réalisation courante dans la plupart des laboratoires africains, pourraient être utiles dans l’exploration de l’hypofertilité masculine.Mots clés: sperme, profil biochimique, anomalies morphologiques, infertilit&#233

A novel myelin P0–specific T cell receptor transgenic mouse develops a fulminant autoimmune peripheral neuropathy

Autoimmune-prone nonobese diabetic mice deficient for B7-2 spontaneously develop an autoimmune peripheral neuropathy mediated by inflammatory CD4+ T cells that is reminiscent of Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. To determine the etiology of this disease, CD4+ T cell hybridomas were generated from inflamed tissue–derived CD4+ T cells. A majority of T cell hybridomas were specific for myelin protein 0 (P0), which was the principal target of autoantibody responses targeting nerve proteins. To determine whether P0-specific T cell responses were sufficient to mediate disease, we generated a novel myelin P0–specific T cell receptor transgenic (POT) mouse. POT T cells were not tolerized or deleted during thymic development and proliferated in response to P0 in vitro. Importantly, when bred onto a recombination activating gene knockout background, POT mice developed a fulminant form of peripheral neuropathy that affected all mice by weaning age and led to their premature death by 3–5 wk of age. This abrupt disease was associated with the production of interferon γ by P0-specific T cells and a lack of CD4+ Foxp3+ regulatory T cells. Collectively, our data suggest that myelin P0 is a major autoantigen in autoimmune peripheral neuropathy

Infants with esophageal atresia and right aortic arch: Characteristics and outcomes from the Midwest Pediatric Surgery Consortium

Purpose Right sided aortic arch (RAA) is a rare anatomic finding in infants with esophageal atresia with or without tracheoesophageal fistula (EA/TEF). In the presence of RAA, significant controversy exists regarding optimal side for thoracotomy in repair of the EA/TEF. The purpose of this study was to characterize the incidence, demographics, surgical approach, and outcomes of patients with RAA and EA/TEF. Methods A multi-institutional, IRB approved, retrospective cohort study of infants with EA/TEF treated at 11 children's hospitals in the United States over a 5-year period (2009 to 2014) was performed. All patients had a minimum of one-year follow-up. Results In a cohort of 396 infants with esophageal atresia, 20 (5%) had RAA, with 18 having EA with a distal TEF and 2 with pure EA. Compared to infants with left sided arch (LAA), RAA infants had a lower median birth weight, (1.96 kg (IQR 1.54–2.65) vs. 2.57 kg (2.00–3.03), p = 0.01), earlier gestational age (34.5 weeks (IQR 32–37) vs. 37 weeks (35–39), p = 0.01), and a higher incidence of congenital heart disease (90% vs. 32%, p  0.29). Conclusion RAA in infants with EA/TEF is rare with an incidence of 5%. Compared to infants with EA/TEF and LAA, infants with EA/TEF and RAA are more severely ill with lower birth weight and higher rates of prematurity and complex congenital heart disease. In neonates with RAA, surgical repair of the EA/TEF is technically feasible via thoracotomy from either chest. A higher incidence of anastomotic strictures may occur with a right-sided approach

Understanding the Value of Tumor Markers in Pediatric Ovarian Neoplasms

Purpose The purpose of this study was to determine the diagnostic accuracy of tumor markers for malignancy in girls with ovarian neoplasms. Methods A retrospective review of girls 2–21 years who presented for surgical management of an ovarian neoplasm across 10 children's hospitals between 2010 and 2016 was performed. Patients who had at least one concerning feature on imaging and had tumor marker testing were included in the study. Sensitivity, specificity, and negative and positive predictive values (PPV) of tumor markers were calculated. Results Our cohort included 401 patients; 22.4% had a malignancy. Testing for tumor markers was inconsistent. AFP had high specificity (98%) and low sensitivity (42%) with a PPV of 86%. The sensitivity, specificity, and PPV of beta-hCG was 44%, 76%, and 32%, respectively. LDH had high sensitivity (95%) and Inhibin A and Inhibin B had high specificity (97% and 92%, respectively). Conclusions Tumor marker testing is helpful in preoperative risk stratification of ovarian neoplasms for malignancy. Given the variety of potential tumor types, no single marker provides enough reliability, and therefore a panel of tumor marker testing is recommended if there is concern for malignancy. Prospective studies may help further elucidate the predictive value of tumor markers in a pediatric ovarian neoplasm population

Changing the Paradigm for Management of Pediatric Primary Spontaneous Pneumothorax: A Simple Aspiration Test Predicts Need for Operation

Purpose Chest tube (CT) management for pediatric primary spontaneous pneumothorax (PSP) is associated with long hospital stays and high recurrence rates. To streamline management, we explored simple aspiration as a test to predict need for surgery. Methods A multi-institution, prospective pilot study of patients with first presentation for PSP at 9 children’s hospitals was performed. Aspiration was performed through a pigtail catheter, followed by 6 h observation with CT clamped. If pneumothorax recurred during observation, the aspiration test failed and subsequent management was per surgeon discretion. Results Thirty-three patients were managed with simple aspiration. Aspiration was successful in 16 of 33 (48%), while 17 (52%) failed the aspiration test and required hospitalization. Twelve who failed aspiration underwent CT management, of which 10 (83%) failed CT management owing to either persistent air leak requiring VATS or subsequent PSP recurrence. Recurrence rate was significantly greater in the group that failed aspiration compared to the group that passed aspiration [10/12 (83%) vs 7/16 (44%), respectively, P = 0.028]. Conclusion Simple aspiration test upon presentation with PSP predicts chest tube failure with 83% positive predictive value. We recommend changing the PSP management algorithm to include an initial simple aspiration test, and if that fails, proceed directly to VATS

A meta-analysis of the relationship of academic performance and Social Network Site use among adolescents and young adults

This meta-analysis explores the relationship between SNS-use and academic performance. Examination of the literature containing quantitative measurements of both SNS-use and academic performance produced a sample of 28 effects sizes (N ¼ 101,441) for review. Results indicated a significant negative relationship between SNS-use and academic performance. Further moderation analysis points to test type as an important source of variability in the relationship. We found a negative correlation between SNS-use and GPA, while a positive one for SNS-use and language test. Moreover, we found that the relationship of SNS-use and GPA was more strongly negative in females and college students

Radial Basis Functions Generated Finite-Difference Method for the Korteweg-de Vries Equation

The Korteweg-de Vries equation (KDV) is a third order non-linear Partial Differential Equation(PDE) which solutions are traveling waves called solitons. A numerical method namely radial basis functions generated finite-difference (RBF-FD) integrating factor method was applied and the numerical solutions of the KDV equations were compared with the analytical solutions for 1, 2 and 3 solitons . Hyperviscosity was used for stability of the RBF-FD method in the case of irregular nodes

Pollution in strategic multilateral exchange: taxing emissions or trading on permit markets?

We introduce polluting emissions in a sequential noncooperative oligopoly model of bilateral exchange. In one sector a leader and a follower use polluting technologies which create negative externalities on the payoffs of strategic traders who belong to the other sector. By modeling emissions as a negative externality, we show that the leader pollutes more (less) than the follower when strategies are substitutes (complements). Then, we consider the implementation of public policies to control the levels of emissions, namely two taxation mechanisms and a permit market. We study the effects of these public policies. Moreover, we determine the conditions under which these public policies can implement a Pareto-improving allocation