Otites externes nécrosantes: Apport de l’imagerie isotopique

Objective : the Necrotizing (malignant) External Otitis is a very serious, potentially lethal affection. It touches exclusively a debilitated population, where from the necessity of a premature and reliable diagnosis for a beam of cliniquo-biological, radiological and isotopic arguments. Its care as well as its treatment are heavy and require a better definition of themoment of cure. The purpose of our work is to specify the place of the isotopic explorations in the care of the NEO.Materials and methods : we report a retrospective study bringing together 29 patients hospitalized for suspicion of necrotizing external otitis of period going from 2003 till 2009.Résultats : the Middle Age of our population is 64.2 years, with a clear male prevalence. The majority of our patients are diabetics (90% of the cases) with a cardiac and hypertensive Co-morbidity among 19 patients. All our patients consulted, within 47 average days. An assessment of imagery was carried out, comprising a scanner for 16 of our patients. It wasnormal in 4 cases and had shown lesions of osteitis in 12 cases. The osseous scintigraphy marked in MDP-Tc99 was carried out among 24 patients, within 9.69 average day. It was positive for all our patients, objectifying an osseous hyperfixation. All our patients received an adapted treatment. After amendment of the clinico-biological signs, a scintigraphy in Ga67 was practiced for 16 patients within 74 average days. It confirmed the cure among 12 patients, at which one decided to stop the antibiotic therapy. In the other cases, it objectified an osseous hyperfixation translating the persistence of the active infectious process, from where prolongation of the treatment.Conclusion : it comes out from our work that the imagery is essential to confirm the diagnosis and to specify the extent of the osteitis. Indeed, the scanner and the MRI offer an excellent resolution and evaluate the extension of the infection perfectly. However, because of their poor sensitivity, they have little interest to the early phase of the diagnosis and for the therapeutic follow-up. The osseous scintigraphy has the advantage of an excellent sensitivity, approximately 100% in particular at the early stage, but is not specific. The tomographic techniques (SPECT) and the quantification improve however its specificity. The scintigraphy with gallium 67 seems quite as sensitive as and more specific than the osseousscintigraphy, especially if it is quantified, and appears essential with the therapeutic follow-up. Its standardization would have an excellent predictive value of cure, allowing the stop of the antibiotic therapyKeywords : Necrotizing External Otitis, scintigraphy with gallium, the osseous scintigraphy

Bridging the gap: Short structural variants in the genetics of anorexia nervosa

Anorexia nervosa (AN) is a devastating disorder with evidence of underexplored heritability. Twin and family studies estimate heritability (h2) to be 57%–64%, and genome-wide association studies (GWAS) reveal significant genetic correlations with psychiatric and anthropometric traits and a total of nine genome-wide significant loci. Whether significantly associated single nucleotide polymorphisms identified by GWAS are causal or tag true causal variants, remains to be elucidated. We propose a novel method for bridging this knowledge gap by fine-mapping short structural variants (SSVs) in and around GWAS-identified loci. SSV fine-mapping of loci associated with complex disorders such as schizophrenia, amyotrophic lateral sclerosis, and Alzheimer's disease has uncovered genetic risk markers, phenotypic variability between patients, new pathological mechanisms, and potential therapeutic targets. We analyze previous investigations' methods and propose utilizing an evaluation algorithm to prioritize 10 SSVs for each of the top two AN GWAS-identified loci followed by Sanger sequencing and fragment analysis via capillary electrophoresis to characterize these SSVs for case/control association studies. Success of previous SSV analyses in complex disorders and effective utilization of similar methodologies supports our proposed method. Furthermore, the structural and spatial properties of the 10 SSVs identified for each of the top two AN GWAS-associated loci, cell adhesion molecule 1 (CADM1) and NCK interacting protein with SH3 domain (NCKIPSD), are similar to previous studies. We propose SSV fine-mapping of AN-associated loci will identify causal genetic architecture. Deepening understandings of AN may lead to novel therapeutic targets and subsequently increase quality-of-life for individuals living with the illness

Five million years in the darkness: A new troglomorphic species of Cryptops Leach, 1814 (Chilopoda, Scolopendromorpha) from Movile Cave, Romania

A new species of Cryptops Leach, 1814, C. speleorex sp. nov., is described from Movile Cave, Dobrogea, Romania. The cave is remarkable for its unique ecosystem entirely dependent on methane- and sulfur-oxidising bacteria. Until now, the cave was thought to be inhabited by the epigean species C. anomalans, which is widespread in Europe. Despite its resemblance to C. anomalans, the new species is well-defined morphologically and molecularly based on two mitochondrial (cytochrome c oxidase subunit I COI and 16S rDNA) and one nuclear (28S rDNA) markers. Cryptops speleorex sp. nov. shows a number of troglomorphic traits such as a generally large body and elongated appendages and spiracles, higher number of coxal pores and saw teeth on the tibia of the ultimate leg. With this record, the number of endemic species known from the Movile Cave reaches 35, which ranks it as one of the most species-rich caves in the world

Traiement chirurgical du diverticule de Zenker

Le diverticule de zenker représente la très grande majorité des diverticules pharyngo-oesophagiens et oesophagiens. C’est une hernie de la  muqueuse pharyngée à travers la couche musculaire de la jonction pharyngo-oesophagienne. il est actuellement considéré comme la  conséquence d’un défaut d’ouverture du muscle cricopharyngien.il est la plupart du temps peu ou asymptomatique. Son diagnostic est fait par opacification de l’oesophage. il n’y a pas de traitement médical. Seuls les diverticules très symptomatiques doivent être opérés. différentes options sont envisageables : chirurgie ouverte avec résection ou pexie, associée à une myotomie du muscle cricopharyngé, ou traitement endoscopique avec diverticulostomie oesophagienne. Nous rapportons deux cas de patients âgés respectivement de 50 et 56 ans. Les  manifestations cliniques étaient une dysphagie, des régurgitations, des infections pulmonaires et une hialitose. Le diagnostic de diverticule de zenker a été confirmé sur le transit pharyngo-oesophagien. Une patiente a eu une diverticulectomie sans myotomie, et le deuxième une résection avec myotomie. La durée moyenne de la reprise de l’alimentation orale et de l’hospitalisation ont été respectivement de 6 et 8 jours. Lors de l’évaluation à distance de l’intervention (recul de 1 et 2 ans), une disparition de la symptomatologie fonctionnelle a été notée.Mots clés : diverticule de zenker, diverticulectomie, dysphagie

Traitement chirurgical des metastases sternales du cancer differencie de la thyroide

Le carcinome folliculaire est la deuxième tumeur maligne la plus fréquente de la thyroïde et l’invasion hématologique est le moyen de propagation le plus courant de ses métastases. Les localisations secondaires à ces cancers siègent principalement au niveau des poumons, suivi par les localisations osseuses, cérébrales et hépatiques. L’irathérapie est classiquement le traitement de choix des métastases des cancers différenciés de la thyroïde ; toutefois les métastases osseuses sont réputées résistantes à cette forme de traitement. La résection chirurgicale des métastases à distance des cancers différenciés de la thyroïde offre de meilleures chances d’obtenir de longues survies et d’espérer une meilleure qualité de vie. Nous rapportons deux cas de métastases sternales d’un carcinome différencié de la thyroïde qui ont été bien contrôlées par un traitement chirurgical impliquant une exérèse partielle du sternum avec reconstruction par suture directe dans un cas et utilisant un lambeau du grand pectoral dans le deuxième cas. Avec un suivi moyen de 28 mois, aucune récidive locale ou à distance n’a été détectée. A travers une revue de la littérature évaluant les caractéristiques de métastases sternales des carcinomes différenciés la thyroïde traitées chirurgicalement, on a démontré qu’une résection radicale de ces métastases peut être réalisée chez des patients ayant un faible pronostic initial afin d’obtenir une rémission et d’optimiser le traitement par l’iode radioactif.Mots clés : Thyroïde, traitement, cancer, métastases sternales, sternectomies

Tuberculose lymphonodale cervicale chez les enfants vaccines par le BCG

La tuberculose ganglionnaire cervicale est une localisation extrapulmonaire relativement fréquente chez l’enfant. Elle pose essentiellement des difficultés de prévention. L’objectif de ce travail est d’étudier les particularités diagnostiques et thérapeutiques chez des enfants vaccinés par le BCG.Matériel et méthodes: Nôtre étude rétrospective porte sur 23 cas de tuberculose ganglionnaire chez des enfants vaccinés, colligés sur une période de 10 ans allant de 2002 à 2011.Résultats : La moyenne d’âge des enfants était de 8 ans. Le délai de consultation était en moyenne de 1 mois. Seize enfants présentaient une polyadénopathie cervicale bilatérale. L’échographie cervicale a objectivé une nécrose intra ganglionnaire dans 17 cas. Le diagnostic de tuberculose ganglionnaire a été confirmé par l’examen anatomopathologique d’une pièce d’adénectomie dans tous les cas. Aucun des enfants n’a présenté de forme grave ou compliquée. Un traitement antituberculeux selon le schéma national a été instauré dans tous les cas. L’évolution a été favorable dans tous les cas.Conclusion : Malgré tous les efforts déployés par notre pays pour la lutte contre la tuberculose, cette dernière sévit toujours à l’état endémique. La vaccination par le BCG a permis de diminuer considérablement le nombre des formes graves mais ne protège pas parfaitement contre cette maladie.MOTS CLES : Tuberculose; enfant; Adénopathie cervicale; Adénectomie.The cervical lymph node tuberculosis is a extrapulmonary form relatively common in children, it poses difficulties essentially preventive. The purpose of this work was to study the diagnostic and therapeutic features in children vaccinated with BCG.Material and Methods: Our study is retrospective including 23 cases of lymph node tuberculosis in vaccinated children, collected over a period of 10 years from 2002 to 2011.Results: The average age of the children was 8 years old. The consultation delay was on average 1 month. Sixteen children had bilateral cervical lymphadenopathy. Ultrasound cervical objectified intra nodal necrosis in 17 cases. The diagnosis of lymph node tuberculosis was confirmed by histological examination of a piece of lymphadenectomy in all cases. None of the children presented with severe or complicated form. All patients were treated according to the national scheme. The outcome was favorable in all cases.Conclusion: Despite all efforts by our country in the fight against tuberculosis, the latter sévie still endemic. BCG vaccination has reduced considerably the number of severe but does not protect completely against this disease.KEYWORDS: Tuberculosis; Child; Cerical adenopathy; Adenectomy

Carcinome hybride de la fosse nasale

Hybrid carcinoma is a rare neoplasm, accounting for less than 0.1% of all registered tumors in salivary glands. Up to now, only one case of hybrid carcinoma of the nasal cavity has been described. In this report, we describe a case of hybrid carcinoma composed of epithelial-myoepithelial carcinoma with an adenoid cystic carcinoma component occurring in the nasal cavity in a 56-year-old woman. Caldwell-Luc means resection was performedand the patient revisited because of the tumor recurrence within two years of evolution. A second surgery was accomplished by means of Red Denker and a adjuvant radiation therapy is envisaged. We have not enough detachmentto speak about actual evolution. It is in our knowledge the second case of hybrid tumor of the nasal cavity described in the literature. Hybrid carcinoma of the nasal cavity is possible although rare. Therefore recognition of other component that is more aggressive and has a worse prognosis has therapeutic and prognostic ramifications.Keywords: Carcinoma; hybrid; tumors of nasal cavity

Investigation of CuIn1-xGaxSe2 thin films co-evaporated from two metal sources for photovoltaic solar cells

 CuIn1-xGaxSe2 (CIGS) thin films were grown by co-evaporation using two sources for the metal elements (Cu, Ga and In). A Mo coated soda lime glass substrates heated at 500 °C was used for the deposition. X-ray diffraction (XRD) and scanning electron microscopy (SEM) confirm that these films are polycrystalline with a chalcopyrite structure and showed homogeneous grain size estimate about 25 nm. X-ray photoelectron spectroscopy (XPS) was performed to analyse the binding energy values of Ga3d and O1s onto CIGSe layers. The conductivity measurements in the temperature range of 40-400 K were carried out for 0.05≤ x ≤ 0.23. The effect of grain boundary scattering on the electrical transport played an important role in describing the transport processes in these films. The bowing factor is discussed taking into account the deposition techniques of CIGS films. It has been noticed that the open circuit voltage (Voc) is influenced by Ga content and the energy gap value of the absorber CIGS thin layers and yielded a poor efficiency of solar cells

Phylogeny of Lithobiidae Newport, 1844, with emphasis on the megadiverse genus Lithobius Leach, 1814 (Myriapoda, Chilopoda)

Abstract Phylogenetic analyses based on molecular and morphological data were conducted to shed light on relationships within the mostly Palaearctic/Oriental centipede family Lithobiidae, with a particular focus on the Palaearctic genus Lithobius Leach, 1814 (Lithobiidae, Lithobiomorpha), which contains >500 species and subspecies. Previous studies based on morphological data resolved Lithobius as nonmonophyletic, but molecular-based phylogenetic analyses have until now sampled few species. To elucidate species inter-relationships of the genus, test the validity of its classification into subgenera, and infer its relationships with other Lithobiidae, we obtained molecular data (nuclear markers: 18S rRNA, 28S rRNA; mitochondrial markers: 16S rRNA, COI) and 61 morphological characters for 44 species of Lithobius representing four of its eight subgenera and nine other representatives of Lithobiidae. The data were analyzed phylogenetically using maximum-likelihood, parsimony and Bayesian inference. This study suggests that (i) a close relationship between L. giganteus and the pterygotergine Disphaerobius loricatus highlighted in recent morphological analyses is also strongly supported by molecular data, and Pterygoterginae is formally synonymized with Lithobiinae; (ii) the Oriental/Australian genus Australobius is consistently resolved as sister group to all other sampled Lithobiidae by the molecular and combined data; (iii) the subfamily Ethopolyinae may be paraphyletic; (iv) the genus Lithobius is nonmonophyletic; (v) the subgenera Lithobius, Sigibius and Monotarsobius are nonmonophyletic and should not be used in future taxonomic studies; and (vi) there are instances of cryptic species and cases in which subspecies should be elevated to full species status, as identified for some European taxa within Lithobius

Osteomyelite atypique ou centrale de la base du crane d’origine sinusienne

Introduction : L’ostéomyélitede la base du crâne esttypiquement secondaire à une otite externe nécrosante chez des patients âgés, diabétiques. Elle atteint l’os temporal et est habituellement due au pseudomonasaeruginosa. Dans sa forme atypique, l’ostéomyélite atteint les os sphénoïdal ou occipital sans otite externe associéeet est beaucoup moins fréquente. Le but de cette étude est d’analyser les caractéristiques cliniques et de déterminer les modalités thérapeutiques de l’ostéomyélite nonotologique de la base du crâne.Méthodes : Nous avons revu rétrospectivement deux casd’ostéomyélite atypique de la base du crâne.Résultats : Les deux patients se sont présentés dans un tableau d’altération de l’état général, une asthénie, des céphalées et de la fièvre. Les signes rhinologiques étaient discrets. Aucun des deux patients n’avait de déficit neurologique. L’imagerie avait montré une destruction osseuse, la biologie a objectivé un syndrome infectieux et une biopsie osseuse trans sphénoïdale a confirmé le diagnostic d’ostéomyélite. Un traitement antibiotique prolongé a été instauré et les deux patients ont été guéris sans récidive moyennant un recul de 12 mois.Conclusion : l’atteinte ostéomyélitique centrale de la base du crâne est une affection rare dont la prise en charge passe par un prélèvement osseux précoce et un traitement approprié afin de prévenir ou limiter d’autres complications telles qu’une extension endocrânienne, un empyème, ou la mort.Mots Clés: Ostéomyélite; Base du crâne; sphenoïdite; IRMIntroduction : Skull base osteomyelitis typically arises as a complication of ear infection in older diabetic patients, involves the temporal bone, and has Pseudomonas aeruginosaas the usual pathogen. Atypical skull base osteomyelitis arising from the sphenoid or occipital bones without associated external otitis occurs much less frequently. The purpose of this study was to review the clinical featuresand determine efficacy of treatment for nonotologic osteomyelitis of the skull base.Methods : We retrospectively reviewed two cases of central or atypical skull base osteomyelitis.Results : The two patients presented with asthenia, headache, and fever. No patient presented with neurologic deficits. Contrary to malignant otitis externa, our cases were not preceded by immediate external infections and had normal external ear examinations. One patient had an underlying immunocompromising condition. Imaging demonstrated bone destruction, subsequent microbiological analysis diagnosed infection and a biopsy proved diagnosis of osteomyelitis, a prolonged antibiotic treatment was instored. The two patients were cured with no recurrence of skull base infection over 12-month follow-up period.Conclusion : Central skull base osteomyelitis is a rare disease whose treatment requires an early bone biopsy and appropriate treatment to prevent or limit other complications such as intracranial extension, empyema, or dead.Key Words : Osteomyelitis; Skull base; sphenoïditis; MR