Left pancreatectomy for primary hydatid cyst of the body of pancreas

Hydatid disease is a considerable health problem Worldwide. Primary hydatid disease of the pancreas is very rare. We report the case of a 30-year-old woman who presented with abdominal pain and an epigastric mass. A  diagnosis of hydatid cyst of the pancreas was established by ultrasonographybefore surgery. The treatment consisted of a distal pancreatectomy. The postoperative evolution was uneventful. Hydatid disease should be consideredin the differential diagnosis of all cystic masses in the pancreas, especially in the geographical regions where the disease is endemic. Surgical removal remains the main form of defi nitive treatment

Paratesticular Liposarcoma: What is the Best Therapeutic Strategy?

Introduction: Liposarcomas are neoplasms of mesodermal origin derived from adipose tissue and correspond to 10–14% of all soft tissue sarcomas. Paratesticular liposarcoma is very rare.Case report: We report a 60-year old man who presented with a left testicular tumor 20 cm in diameter. Initial incisional biopsy was reported as fibromatosis. Chest and abdominal CT scan did not show distant metastases. Through an inguinal incision orchidectomy with homolateral inguinal node dissection was performed. Histopathological examination showed a paratesticular myxoid liposarcoma. Adjuvant radiotherapy without chemotherapy was administered. The patient remains well at 11 months followup, with no evidence of recurrence.Conclusion: Complete surgical extirpation reduces the risk of local recurrence. Neoadjuvant chemotherapy or radiotherapy may reduce the tumor size, thus facilitating complete excision

Case report: Acute peritonitis from non-traumatic rupture of the bladder

Spontaneous bladder rupture (SBR) is rare. This entity occurs outside of any traumatic context. A 70 years-old man was admitted for acute peritonitis, acute urinary retention and hematuria. Laparotomy and exploration showed acute generalized peritonitis related to a centimeter hole in the bladder dome. Peritoneal lavage was done with biopsy of the perforation edges, a cystostomy and suturing of the bladder. The immediate postoperative course was uneventful. The etiological investigation revealed a locally advanced and metastatic prostate cancer. The evolution was rapidly fatal and the patient’s death occurred two months later due to metastatic disease. The causes, diagnosis and treatment of SBR are reviewed by the authors

Tumeur maligne des gaines nerveuses périphériques révélant une neurofibromatose type 1

La Neurofibromatose type 1 (NF1) ou maladie de Von Recklinghausen est une affection à expression clinique variable. La transformation maligne est rare et redoutable. Le but de ce travail est d’étudier les critères diagnostiques ainsi que la prise en charge thérapeutique de cette transformation maligne. Observation : A.B, âgé de 16 ans, a consulté pour une tuméfaction basicervicale antérieure d’apparition récente, ayant augmenté progressivement de taille sans signes de compression ni de dysthyroïdie. L’examen clinique a trouvé une masse dure, bien limitée, indolore, de 4 cm de grand axe siégeant en regard du manubrium sternal, adhérente au plan profond et débordant sur le creux sus sternal. A cette masse s’associaient des taches cutanées café au lait disséminées sur tout le corps, des nodules de Lish iriens et des neurofibromes occipitaux et parotidiens. Après une exérèse de la masse par voie cervicale, l’examen histologique a conclu à une tumeur maligne de la gaine nerveuse. Le malade a eu dans un 2ème temps, une exérèse plus large emportant le manubrium sternal et les tissus adjacents  avec une reconstruction par des fragments de côtes mais avec des limites chirurgicales envahies. L’évolution a été marquée par une poursuite évolutive précoce imposant une exérèse chirurgicale plus large suivie d’une chimiothérapie et d’une radiothérapie externe (RT). Le malade était cependant toujours en poursuite évolutive et le décès est survenu dans un contexte d'envahissement médiastinal.Mots-clés : Neurofibromatose type 1, Sarcome, tissus mous, gaines nerveuses périphériques, Chirurgie

Appendagite épiploïque primitive: à propos de cinq cas

La torsion de frange épiploïque (ou appendagite) est une pathologie rare qui survient principalement chez les adultes entre 20 et 50 ans.L'incidence de cette pathologie n'est pas réellement connue et elle varie de 2 à 7% chez les patients hospitalisés pour suspicion d'appendicite oude sigmoïdite. Nous rapportons cinq cas d'appendagites dont nous précisons les particularités cliniques, radiologiques et thérapeutiques. Il s'agit de 5 patients dont l'âge moyen est de 34.6 ans (24-55). Le sexe ratio est de 1.5. Le principal motif de consultation était un syndrome douloureux de l'abdomen principalement au niveau de la fosse iliaque droite. L'examen abdominal montrait toujours une sensibilité localisée. La fièvre était présente chez 3 patients. Le bilan biologique révèle un syndrome inflammatoire biologique chez trois patients. Les examens complémentaires radiologiques en particulier échographie abdominale et TDM abdominale ont éliminé formellement une urgence chirurgicale et ont évoqué le diagnostic d'appendagite dans trois cas. Trois patients ont bénéficié d'une coelioscopie diagnostique confirmant le diagnostic  d'appendagite. L'évolution était favorable chez tous les patients. Les appendagites épiploïques primitives sont des étiologies rares et  sous-estimées de syndrome abdominal aigu. Le diagnostic peut être affirmé par imagerie notamment avec le scanner hélicoïdal injecté,  permettant d'instaurer ainsi un traitement médical premier et d'éviter un traitement chirurgical et des hospitalisations excessives

A cell type-specific cortico-subcortical brain circuit for investigatory and novelty-seeking behavior

INTRODUCTION: Motivational drives are internal states that can be different even in similar interactions with external stimuli. Curiosity as the motivational drive for novelty-seeking and investigating the surrounding environment is for survival as essential and intrinsic as hunger. Curiosity, hunger, and appetitive aggression drive three different goal-directed behaviors—novelty seeking, food eating, and hunting—but these behaviors are composed of similar actions in animals. This similarity of actions has made it challenging to study novelty seeking and distinguish it from eating and hunting in nonarticulating animals. The brain mechanisms underlying this basic survival drive, curiosity, and novelty-seeking behavior have remained unclear. RATIONALE: In spite of having well-developed techniques to study mouse brain circuits, there are many controversial and different results in the field of motivational behavior. This has left the functions of motivational brain regions such as the zona incerta (ZI) still uncertain. Not having a transparent, nonreinforced, and easily replicable paradigm is one of the main causes of this uncertainty. Therefore, we chose a simple solution to conduct our research: giving the mouse freedom to choose what it wants—double free-access choice. By examining mice in an experimental battery of object free-access double-choice (FADC) and social interaction tests—using optogenetics, chemogenetics, calcium fiber photometry, multichannel recording electrophysiology, and multicolor mRNA in situ hybridization—we uncovered a cell type–specific cortico-subcortical brain circuit of the curiosity and novelty-seeking behavior. RESULTS: We analyzed the transitions within action sequences in object FADC and social interaction tests. Frequency and hidden Markov model analyses showed that mice choose different action sequences in interaction with novel objects and in early periods of interaction with novel conspecifics compared with interaction with familiar objects or later periods of interaction with conspecifics, which we categorized as deep and shallow investigation, respectively. This finding helped us to define a measure of depth of investigation that indicates how much a mouse prefers deep over shallow investigation and reflects the mouse’s motivational level to investigate, regardless of total duration of investigation. Optogenetic activation of inhibitory neurons in medial ZI (ZIm), ZImGAD2 neurons, showed a dramatic increase in positive arousal level, depth of investigation, and duration of interaction with conspecifics and novel objects compared with familiar objects, crickets, and food. Optogenetic or chemogenetic deactivation of these neurons decreased depth and duration of investigation. Moreover, we found that ZImGAD2 neurons are more active during deep investigation as compared with during shallow investigation. We found that activation of prelimbic cortex (PL) axons into ZIm increases arousal level, and chemogenetic deactivation of these axons decreases the duration and depth of investigation. Calcium fiber photometry of these axons showed no difference in activity between shallow and deep investigation, suggesting a nonspecific motivation. Optogenetic activation of ZImGAD2 axons into lateral periaqueductal gray (lPAG) increases the arousal level, whereas chemogenetic deactivation of these axons decreases duration and depth of investigation. Calcium fiber photometry of these axons showed high activity during deep investigation and no significant activity during shallow investigation, suggesting a thresholding mechanism. Last, we found a new subpopulation of inhibitory neurons in ZIm expressing tachykinin 1 (TAC1) that monosynaptically receive PL inputs and project to lPAG. Optogenetic activation and deactivation of these neurons, respectively, increased and decreased depth and duration of investigation. CONCLUSION: Our experiments revealed different action sequences based on the motivational level of novelty seeking. Moreover, we uncovered a new brain circuit underlying curiosity and novelty-seeking behavior, connecting excitatory neurons of PL to lPAG through TAC1+ inhibitory neurons of ZIm

Conductance statistics from a large array of sub-10 nm molecular junctions

Devices made of few molecules constitute the miniaturization limit that both inorganic and organic-based electronics aspire to reach. However, integration of millions of molecular junctions with less than 100 molecules each has been a long technological challenge requiring well controlled nanometric electrodes. Here we report molecular junctions fabricated on a large array of sub-10 nm single crystal Au nanodots electrodes, a new approach that allows us to measure the conductance of up to a million of junctions in a single conducting Atomic Force Microscope (C-AFM) image. We observe two peaks of conductance for alkylthiol molecules. Tunneling decay constant (beta) for alkanethiols, is in the same range as previous studies. Energy position of molecular orbitals, obtained by transient voltage spectroscopy, varies from peak to peak, in correlation with conductance values.Comment: ACS Nano (in press

A fast FPTAS for single machine scheduling problem of minimizing total weighted earliness and tardiness about a large common due date

We address the single machine scheduling problem to minimize the total weighted earliness and tardiness about a nonrestrictive common due date. This is a basic problem with applications to the just-in-time manufacturing. The problem is linked to a Boolean programming problem with a quadratic objective function, known as the half-product. An approach to developing a fast fully polynomial-time approximation scheme (FPTAS) for the problem is identified and implemented. The running time matches the best known running time for an FPTAS for minimizing a half-product with no additive constan

Prevalence of Mood Disorders and Associated Factors at the Time of the COVID-19 Pandemic: Potocol for a Community Survey in La Manouba Governorate, Tunisia

Aims: The present survey aims to assess the overall mood disorder prevalence and identify associated socio-demographic and clinical factors in a Tunisian community sample, with special attention to the COVID-19 pandemic. Background: Mood disorders are one of the leading causes of all non-fatal burdens of disease, with depression being at the top of the list. The COVID-19 pandemic may have increased the prevalence of mood disorders, especially in Low and Middle-income countries (LMICs) and in vulnerable populations. Objective: 1/ Assess point and lifetime prevalence of depressive and bipolar disorders as well as subthreshold bipolarity in a representative population sample of La Manouba governorate and assess treatment patterns for these disorders; 2/Study socio-demographic and clinical correlates of mood disorders 3/ Assess the association between mood disorders and quality of life 4/ Study the impact of the COVID-pandemic on the prevalence of mood disorders 5/ Assess coping mechanisms to the COVID-pandemic and whether these mechanisms moderate the appearance of mood disorders or symptoms since the beginning of the pandemic Methods: This is a household cross-sectional observational survey to be conducted in La Manouba Governorate in a sample of 4540 randomly selected individuals aged ≥ 15 years. Data collection will be carried out by trained interviewers with clinical experience, through face-to-face interviews and the use of the computer assisted personal interviewing approach (CAPI). The following assessment tools are administered: Results: Structured clinical Interview for DSM IV-TR (Mood disorder section and Screening questions on Anxiety), Mood Disorder Questionnaire (MDQ), Suicide Behaviors Questionnaire-Revised (SBQ), 12-item Short Form Survey (SF-12), the Brief-COPE, and a questionnaire about a headache. In addition, socio-demographic and clinical data will be collected. Conclusion: This will be one of the very few household surveys in a general population sample to assess mental health problems and COVID-19-related variables since the beginning of the pandemic. Through this research, we aim to obtain an epidemiological profile of mood disorders in Tunisia and an estimation of the impact of the COVID-19 pandemic on their prevalence. Results should contribute to improving mental health care in Tunisia