Nécrose pariétale utérine partielle après capitonnage hémostatique au cours d’une hémorragie de la délivrance

L'hémorragie de la délivrance reste la première cause de mortalité dans la majorité des pays y compris le Maroc. Sa prise en charge doit être multidisciplinaire, rapide, avec mise en 'uvre de moyens médicaux et parfois chirurgicaux pour contrôler l'hémorragie. Les techniques de compression ou de cloisonnement utérins ont été peu évaluées mais diffusées rapidement dans le monde entier vu la facilité de leur réalisation; Néanmoins des complications secondaires ont été rapportées dans la littérature dont la nécrose utérine. Nous rapportons le cas d'une patiente de 33ans césarisée à 38 semaines d'aménorrhée pour utérus cicatriciel associé à une grossesse gémellaire avec inertie utérine. Un capitonnage hémostatique a été nécessaire pour contrôler l'hémorragie, l'évolution a été marquée par la survenue d'une nécrose partielle utérine confirmée histologiquement. Nous insistons à travers cette observation et sous la lumière de la revue de la littérature sur la nécessité d'un suivi post opératoire des patientes qui bénéficient de capitonnage hémostatique pour mieux documenter l'efficacité et les complications de cet acte chirurgical qui reste encore sous évalué.Key words: Hémorragie de la délivrance, Atonie utérine, capitonnage utérin, nécrose utérin

Le mélanome primitif de la muqueuse génitale féminine: à propos de trois observations et revue de littérature

Le mélanome malin primitif de l'appareil génital féminin est une tumeur extrêmement rare. Il est fréquemment observé au niveau de la vulve mais il est rare au niveau du col utérin et du vagin. Il est le plus souvent   diagnostiqué à un stade tardif à l'occasion de métrorragies ou de massetumorale. Son histogénèse a été longtemps débattue. Le diagnostic est anatomo-pathologique avec recours nécessaire à l'étude   immunohistochimique. Sa prise en charge n'est pas codifiée avec plusieurs thérapeutiques proposées notamment dans le mélanome métastatique.Son pronostic est désastreux, associé à un taux élevé de récidives et à une courte survie. Les auteurs présentent trois observations, de  mélanomes primitifs vaginal, vulvaire et cervical, chez trois patientes âgées  respectivement de 70, 65 et 40 ans. Et à travers ces observations, ils mettent en relief les principaux aspects cliniques, histologiques, thérapeutiques de cette entité avec une revue de la littérature

Q^2 Dependence of the S_{11}(1535) Photocoupling and Evidence for a P-wave resonance in eta electroproduction

New cross sections for the reaction $ep \to e'\eta p$ are reported for total center of mass energy $W$=1.5--2.3 GeV and invariant squared momentum transfer $Q^2$=0.13--3.3 GeV$^2$. This large kinematic range allows extraction of new information about response functions, photocouplings, and $\eta N$ coupling strengths of baryon resonances. A sharp structure is seen at $W\sim$ 1.7 GeV. The shape of the differential cross section is indicative of the presence of a $P$-wave resonance that persists to high $Q^2$. Improved values are derived for the photon coupling amplitude for the $S_{11}$(1535) resonance. The new data greatly expands the $Q^2$ range covered and an interpretation of all data with a consistent parameterization is provided.Comment: 31 pages, 9 figure

Measurement of Deeply Virtual Compton Scattering with a Polarized Proton Target

The longitudinal target-spin asymmetry A_UL for the exclusive electroproduction of high energy photons was measured for the first time in p(e,e'p\gamma). The data have been accumulated at Jefferson Lab with the CLAS spectrometer using 5.7 GeV electrons and a longitudinally polarized NH_3 target. A significant azimuthal angular dependence was observed, resulting from the interference of the Deeply Virtual Compton Scattering and Bethe-Heitler processes. The amplitude of the sin(phi) moment is 0.252 +/- 0.042(stat) +/- 0.020(sys). Theoretical calculations are in good agreement with the magnitude and the kinematic dependence of the target-spin asymmetry, which is sensitive to the generalized parton distributions H and H-tilde.Comment: Modified text slightly, added reference

First Measurement of Beam-Recoil Observables Cx and Cz in Hyperon Photoproduction

Spin transfer from circularly polarized real photons to recoiling hyperons has been measured for the reactions $\vec\gamma + p \to K^+ + \vec\Lambda$ and $\vec\gamma + p \to K^+ + \vec\Sigma^0$. The data were obtained using the CLAS detector at Jefferson Lab for center-of-mass energies $W$ between 1.6 and 2.53 GeV, and for $-0.85<\cos\theta_{K^+}^{c.m.}< +0.95$. For the $\Lambda$, the polarization transfer coefficient along the photon momentum axis, $C_z$, was found to be near unity for a wide range of energy and kaon production angles. The associated transverse polarization coefficient, $C_x$, is smaller than $C_z$ by a roughly constant difference of unity. Most significantly, the {\it total} $\Lambda$ polarization vector, including the induced polarization $P$, has magnitude consistent with unity at all measured energies and production angles when the beam is fully polarized. For the $\Sigma^0$ this simple phenomenology does not hold. All existing hadrodynamic models are in poor agreement with these results.Comment: 28 pages, 18 figures, Submitted to Physical Review

Electroproduction of ϕ(1020)\phi(1020) mesons at 1.4≤Q2≤1.4\leq Q^2\leq GeV2^2 measured with the CLAS spectrometer

Electroproduction of exclusive $\phi$ vector mesons has been studied with the CLAS detector in the kinematical range $1.4\leq Q^2\leq 3.8$ GeV$^{2}$, $0.0\leq t^{\prime}\leq 3.6$ GeV$^{2}$, and $2.0\leq W\leq 3.0$ GeV. The scaling exponent for the total cross section as $1/(Q^2+M_{\phi}^2)^n$ was determined to be $n=2.49\pm 0.33$. The slope of the four-momentum transfer $t'$ distribution is $b_{\phi}=0.98 \pm 0.17$ GeV$^{-2}$. Under the assumption of s-channel helicity conservation (SCHC), we determine the ratio of longitudinal to transverse cross sections to be $R=0.86 \pm 0.24$. A 2-gluon exchange model is able to reproduce the main features of the data.Comment: Phys Rev C, 15 pages, 18 figure

Photodisintegration of 4^4He into p+t

The two-body photodisintegration of $^4$He into a proton and a triton has been studied using the CEBAF Large-Acceptance Spectrometer (CLAS) at Jefferson Laboratory. Real photons produced with the Hall-B bremsstrahlung-tagging system in the energy range from 0.35 to 1.55 GeV were incident on a liquid $^4$He target. This is the first measurement of the photodisintegration of $^4$He above 0.4 GeV. The differential cross sections for the $\gamma$$^4$He$\to pt$ reaction have been measured as a function of photon-beam energy and proton-scattering angle, and are compared with the latest model calculations by J.-M. Laget. At 0.6-1.2 GeV, our data are in good agreement only with the calculations that include three-body mechanisms, thus confirming their importance. These results reinforce the conclusion of our previous study of the three-body breakup of $^3$He that demonstrated the great importance of three-body mechanisms in the energy region 0.5-0.8 GeV .Comment: 13 pages submitted in one tgz file containing 2 tex file and 22 postscrip figure

A Precise Measurement of the Neutron Magnetic Form Factor GMn in the Few-GeV2 Region

The neutron elastic magnetic form factor GMn has been extracted from quasielastic electron scattering data on deuterium with the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. The kinematic coverage of the measurement is continuous from Q2=1 GeV2 to 4.8 GeV2. High precision was achieved by employing a ratio technique in which many uncertainties cancel, and by a simultaneous in-situ calibration of the neutron detection efficiency, the largest correction to the data. Neutrons were detected using the CLAS electromagnetic calorimeters and the time-of-flight scintillators. Data were taken at two different electron beam energies, allowing up to four semi-independent measurements of GMn to be made at each value of Q2. The dipole parameterization is found to provide a good description of the data over the measured Q2 range.Comment: 14 pages, 5 figures, revtex4, submitted to Physical Review Letters, Revised version has changes recommended by journal referee

Exclusive ρ0\rho^0 electroproduction on the proton at CLAS

The $e p\to e^\prime p \rho^0$ reaction has been measured, using the 5.754 GeV electron beam of Jefferson Lab and the CLAS detector. This represents the largest ever set of data for this reaction in the valence region. Integrated and differential cross sections are presented. The $W$, $Q^2$ and $t$ dependences of the cross section are compared to theoretical calculations based on $t$-channel meson-exchange Regge theory on the one hand and on quark handbag diagrams related to Generalized Parton Distributions (GPDs) on the other hand. The Regge approach can describe at the $\approx$ 30% level most of the features of the present data while the two GPD calculations that are presented in this article which succesfully reproduce the high energy data strongly underestimate the present data. The question is then raised whether this discrepancy originates from an incomplete or inexact way of modelling the GPDs or the associated hard scattering amplitude or whether the GPD formalism is simply inapplicable in this region due to higher-twists contributions, incalculable at present.Comment: 29 pages, 29 figure

Azimuthal asymmetries of charged hadrons produced by high-energy muons scattered off longitudinally polarised deuterons

Azimuthal asymmetries in semi-inclusive production of positive (h^+) and negative hadrons (h^-) have been measured by scattering 160 GeV muons off longitudinally polarised deuterons at CERN. The asymmetries were decomposed in several terms according to their expected modulation in the azimuthal angle phi of the outgoing hadron. Each term receives contributions from one or several spin and transverse-momentum-dependent parton distribution and fragmentation functions. The amplitudes of all phi-modulation terms of the hadron asymmetries integrated over the kinematic variables are found to be consistent with zero within statistical errors, while the constant terms are nonzero and equal for h^+ and h^- within the statistical errors. The dependencies of the phi-modulated terms versus the Bjorken momentum fraction x, the hadron fractional momentum z, and the hadron transverse momentum p_h^T were studied. The x dependence of the constant terms for both positive and negative hadrons is in agreement with the longitudinal double-spin hadron asymmetries, measured in semi-inclusive deep-inelastic scattering. The x dependence of the sin phi-modulation term is less pronounced than that in the corresponding HERMES data. All other dependencies of the phi-modulation amplitudes are consistent with zero within the statistical errors.Comment: 12 pages, 11 Figures; revision 1 signs in Eq 5 corrected, polishe