Hypocalcémie post-thyroïdectomie

Introduction : L’hypocalcémie est la complication la plus préoccupante de la thyroïdectomie totale. Elle impose un traitement substitutif et un suivi à vie. Objectifs : Le but de cette étude est d’évaluer l’incidence de l’hypocalcémie après chirurgie et d’étudier sa corrélation avec les caractéristiques cliniques, biologiques et le type de chirurgie pratiqué. Matériels et méthodes : Etude rétrospective portant sur 488 cas de thyroïdectomies, opérées entre 1992 et 1996. L’hypocalcémie est définie par une calcémie inférieure à 80 mg/l «2 mmol/l ». Les patients, toujours dépendants d’un traitement substitutif un an après la chirurgie, ont été considérés comme ayant une hypocalcémie définitive. Résultats : Dans notre étude, 368 patients ont eu une thyroïdectomie totale et 120 ont eu une thyroïdectomie subtotale. Le goitre multinodulaire était la pathologie la plus fréquente, noté dans 359 cas, suivie des cancers thyroïdiens noté dans 83 cas. L’hypocalcémie postopératoire a été retrouvée chez 54 patients (11,06%) dont 25 étaient asymptomatique. Cette hypocalcémie s’est révélée définitive chez 14 d’entre eux (2,8%). Nous n’avons pas trouvé de corrélation statistiquement significative entre l’hypoparathyroïdie définitive et les caractéristiques cliniques biologiques et le type de chirurgie.Conclusion : Dans la plupart des cas, l’hypocalcémie est liée à un hypoparathyroïdisme transitoire, secondaire au traumatisme ou à la dévascularisation des parathyroïdes. L’hypoparathyroïdie définitive est rare, elle est toujours secondaire à une lésion irréversible des parathyroïdes. Les caractéristiques cliniques initiales des patients et les examens biologiques précoces ne permettent pas de prédire l’évolution.Mots-clés : Thyroïde, chirurgie, hypocalcémie, parathyroïde

Phlegmon peri-amygdalien aspects diagnostiques et thérapeutiques

Introduction: The Peritonsillar abscesse (PTA) is a suppurated complication of the face and the neck often met as a matter of urgency ENT. He can raise diagnostic and therapeutic problems and be life-threatening. The objective of this study is to specify the epidemiological and clinical particularities of this affection and to revise the therapeutic possibilities from a review of the literature.PATIENTS AND METHODS: This retrospective study concerning 75 patients hospitalized for PTA in the Department of Otolaryngology-Head and Neck Surgery of the Hospital of Nabeul over a period of 7 years (in January 2001 to December 2007). The study of files allowed us to find all the clinical and therapeutic data. Our drop is of two years.RESULTS : The average age of our patients was of 26 years with a sex ratio of 1. The classic set of three of the PTA was complete only in 49 % of the cases. All the patients were the object of a needle aspiration, it was positive in 74 % among which 92 % benefited from a drainage under local anesthetic. A germ was identified in 16 cases with a Streptococcus â-hemolytic group A in 13 cases. The clinical and biological cure was noticed on average in the tenth day. Forty-seven patients underwent tonsillectomy at a later date after an interval from 2 to 6 months. No emergency tonsillectomy was realized.CONCLUSION : The Peritonsillar abscesses is a frequent urgency in ENT. The diagnostic is clinical. The practicable of needle aspiration in every case allows to confirm the diagnosis in the incomplete forms. The treatment is medical and surgical.KEYWORDS : Peritonsillar abscesses, diagnostic, treatmen

Carcinome anaplasique de la thyroide

Objectives: Thyroid anaplasic carcinoma is a rare variety of thyroid cancer and one of the most aggressive tumors known to affect humans. It accounts for less than 2%of thyroid cancers and it is often extremelymalignant and rapidly fatal.Material and methods: It is a retrospective study of 12 cases of thyroid anaplasic carcinoma hospitalized over one 16 years period (1990-2005)Our aim is to study the clinical aspects and to discuss the therapeutic modalities of this cancer.Results: The average age of our patients was of 68 years (51-79), there are10 women and 2 men. The signs of local compression were present in 10 cases and the physical examination objectified a goiter among 11 patients with an average size of 7 cm. Lymph nodes were observed in two cases and metastases were noted among 7 patients. Two patientshad a tracheotomy in urgency with thyroid biopsy in 5 cases, total thyroidectomy in 4 cases and partial thyroidectomy in 3 cases Bilateral neck dissection was realized in two cases. The radiotherapy was palliative in one case. The survival was less than one year for all patientsConclusion: Thyroid anaplasic carcinoma is a very aggressive tumor, the prognosis is very bad with a survival exceeding rarely a year. Despite multimodality approaches, it still carries a dismal prognosis.Keywords: cancer, thyroid, anaplasic, chirurgic, radiotherapy, chemotherap

Carcinome spinocellulaire de la levre inferieure: Sur cicatrice de lupus erythemateux chronique

Epidermoïd carcinoma is the most common malignant tumor of the lips.They often develop on precancerous lesions. Leukoplasia is the most frequent precancerous lesion. We report a case of a 35 years old man, who suffered from discoid lupus erythematous since 20 years; and wasn't treatedfrom. He consulted for a squamous ulceration of the under lip, developed from one year. The biopsy concluded to an epidermoïd carcinoma.He was treated with surgical excision with reconstruction and homolateral triangular recovery.Keywords: Squamous cell carcinoma, epidermoïd carcinoma, discoid lupus erythematosus, precancerous lesion

Carcinome papillaire sur kyste du tractus thyreoglosse

Introduction :: Cysts of the thyroglossal duct are a congenital anomaly. they are common but the incidence of papillary carcinoma arising in a thyroglossal duct cyst (TDC) is rare. The clinical presentation of these cancers is generally nonspecific. There are usually identified only after histopathologic examinationAim: Modalities of treatment and prevention are discussed.Methods: We report 4 cases of a papillary carcinoma developed on a thyroglossal duct cyst, who underwent surgery. Two cases have been detected on préopératory and two at the definitive anatomopathology. Our therapeutic attitude has been discussed in each of our 4cases.Conclusion: there is no consensus about the modalities of treatment of papillary carcinoma in thyroglossal duct cyst.Keywords: Thyroglossal duct cyst, Thyroid, Papillary carcinoma, surgery, Total thyroidectomy

Inhibition of protein ubiquitination by paraquat and 1-methyl-4-phenylpyridinium impairs ubiquitin-dependent protein degradation pathways

Intracytoplasmic inclusions of protein aggregates in dopaminergic cells (Lewy bodies) are the pathological hallmark of Parkinson’s disease (PD). Ubiquitin (Ub), alpha [α]-synuclein, p62/sequestosome 1 and oxidized proteins are major components of Lewy bodies. However, the mechanisms involved in the impairment of misfolded/oxidized protein degradation pathways in PD are still unclear. PD is linked to mitochondrial dysfunction and environmental pesticide exposure. In this work, we evaluated the effect of the pesticide paraquat (PQ) and the mitochondrial toxin 1-methyl-4-phenylpyridinium (MPP+) on Ub-dependent protein degradation pathways. No increase in the accumulation of Ub-bound proteins or aggregates was observed in dopaminergic cells (SK-N-SH) treated with PQ or MPP+, or in mice chronically exposed to PQ. PQ decreased Ub protein content, but not its mRNA transcription. Protein synthesis inhibition with cycloheximide depleted Ub levels and potentiated PQ–induced cell death. Inhibition of proteasomal activity by PQ was found to be a late event in cell death progression, and had no effect on either the toxicity of MPP+ or PQ, or the accumulation of oxidized sulfenylated, sulfonylated (DJ-1/PARK7 and peroxiredoxins) and carbonylated proteins induced by PQ. PQ- and MPP+-induced Ub protein depletion prompted the dimerization/inactivation of the Ub-binding protein p62 that regulates the clearance of ubiquitinated proteins by autophagic. We confirmed that PQ and MPP+ impaired autophagy flux, and that the blockage of autophagy by the overexpression of a dominant-negative form of the autophagy protein 5 (dnAtg5) stimulated their toxicity, but there was no additional effect upon inhibition of the proteasome. PQ induced an increase in the accumulation of α-synuclein in dopaminergic cells and membrane associated foci in yeast cells. Our results demonstrate that inhibition of protein ubiquitination by PQ and MPP+ is involved in the dysfunction of Ub-dependent protein degradation pathways

Role of natural phenolics in hepatoprotection: A mechanistic review and analysis of regulatory network of associated genes

The liver is not only involved in metabolism and detoxification, but also participate in innate immune function and thus exposed to frequent target Thus, they are the frequent target of physical injury. Interestingly, liver has the unique ability to regenerate and completely recoup from most acute, non-iterative situation. However, multiple conditions, including viral hepatitis, non-alcoholic fatty liver disease, long term alcohol abuse and chronic use of medications can cause persistent injury in which regenerative capacity eventually becomes dysfunctional resulting in hepatic scaring and cirrhosis. Despite the recent therapeutic advances and significant development of modern medicine, hepatic diseases remain a health problem worldwide. Thus, the search for the new therapeutic agents to treat liver disease is still in demand. Many synthetic drugs have been demonstrated to be strong radical scavengers, but they are also carcinogenic and cause liver damage. Present day various hepatic problems are encountered with number of synthetic and plant based drugs. Nexavar (sorafenib) is a chemotherapeutic medication used to treat advanced renal cell carcinoma associated with several side effects. There are a few effective varieties of herbal preparation like Liv-52, silymarin and Stronger neomin phages (SNMC) against hepatic complications. Plants are the huge repository of bioactive secondary metabolites viz; phenol, flavonoid, alkaloid etc. In this review we will try to present exclusive study on phenolics with its mode of action mitigating liver associated complications. And also its future prospects as new drug lead

La lutte contre l’oubli dans la littérature syrienne de résistance : étude des romans Ṭiflat al-samāʾ, Ṣalṣāl et Lahā marāyā de Samar Yazbek (Perspective sociocritique)

The literary commitment resonates as the ideological guideline in Samar Yazbek’s novel. It appears through the study of her three novels: Ṭiflat al-samāʾ (Girl of heaven, 2002), Ṣalṣāl (Clay, 2005) and Lahā marāyā (In her mirrors, 2010), that one of the author’s essential issue deals with the question of the consequences of cultural, religious and socio-political traditions on society and individuals. Her work raises the question: what extent the will to preserve traditions or free from all the rules can compromise the social system and, beyond that, whether any liberation necessarily imply a cultural and religious breaking? This is why, in our thesis, we will examine this corpus to determine the Yazbekian position on the process of social and political emancipation of Syrians as well as their perception of the notion of cultural, religious and political heritage. In order to do this, we will study Samar Yazbek’s novels through a sociocritical perspective - revisited throughout the complex thought of Edgar Morin - supported by the transtextuality, the narratology and the semiotic method. Thus, our goal will be to shed light on the processes of perpetuation or rupture of tradition among the Syrians of the “contemporary extreme”, articulating our double interrogation around the notions of freedom, modernity, political struggle and resistance to social oppression.L’engagement littéraire et la création romanesque résonnent comme la ligne de conduite idéologique des romans de Samar Yazbek. Au travers d’un corpus composé de trois romans de l’autrice : Ṭiflat al-samāʾ (La fille du ciel, 2002), Ṣalṣāl (Argile, 2005) et Lahā marāyā (Dans ses miroirs, 2010), il appert que l’une des problématiques essentielles de Samar Yazbek concerne la question des conséquences des traditions culturelles, religieuses et socio-politiques sur la société et les individus. Ses œuvres posent la question de savoir dans quelle mesure la volonté de conserver les traditions ou de se libérer de toutes les règles peut compromettre le système social et, au-delà, celle de savoir si toute libération implique nécessairement une rupture culturelle et religieuse. C’est la raison pour laquelle, dans notre thèse, nous interrogerons le corpus afin de déterminer la position yazbékienne sur le processus d’émancipation sociale et politique des Syriens ainsi que leur perception de la notion d’héritage culturel, religieux et politique. Pour ce faire, nous abordons l’œuvre yazbékienne à travers une perspective sociocritique - revisitée à travers la pensée complexe d’Edgar Morin - soutenue et renforcée par la transtextualité, la narratologie et la sémiotique de la littérature. Notre objectif sera de faire la lumière sur les processus de perpétuation ou de rupture de la tradition chez les Syriens de l’extrême-contemporain, en articulant notre double interrogation autour des notions de liberté, de modernité, de lutte politique et de résistance à l’oppression social

Isomérisation et hydrogénation des huiles végétales pour la production des acides linoléiques conjugués

Ce travail doctoral présente différentes voies de recherches pour l'élaboration d'un catalyseur hétérogène bifonctionnel favorisant la production des acides linoléiques conjugués (ALC) bénéfiques pour la santé humaine, aux dépens des acides gras trans (AG/) et saturés (AGs) néfastes, au cours du procédé d'hydrogénation/isomérisation de l'huile de carthame. De tous les catalyseurs à base de cristallites de métaux très dispersées sur la silice mesoporeuse SBA-15, modifiée ou non avec l'aluminium, qui ont été synthétisés et testés pour l'hydrogénation/isomérisation de l'huile de carthame, le catalyseur 1%Rh/SBA-15 s'avère être le plus actif et optimise la production des ALC sous des conditions opératoires douces de transfert de matière gaz/liquide/solide. L'huile partiellement hydrogénée contient 73 mg ALC/g huile et moins de 2% AGt mono-insaturés. L'addition de 1 ppm de soufre permet de doubler la production à 131 mg ALC/g huile avec 8% AGr mono-insaturés. Un mécanisme réactionnel est proposé pour décrire les effets positifs du soufre sur l'activité d'isomérisation de conjugaison de 1%Rh/SBA-15