Carcinome basocellulaire métatypique : a propos de deux cas

Introduction : : Le carcinome métatypique est une entité rare. Il touche essentiellement la région cervico-faciale chez un sujet de sexe masculin. Les auteurs étudieront, à travers deux observations, les caractéristiques cliniques et évolutives du cancer métatypique ainsi que les difficultés thérapeutiques. Observation 1 : Un homme âgé de 41 ans, a présenté un carcinome métatypique temporo-pariétal droit traité initialement par chirurgie. Cinq ans plus tard, il a été réopéré pour une récidive locale et ganglionnaire et a bénéficié ensuite d’une cobaltothérapie, stabilisant ainsi la maladie pendant 4 ans au bout desquels on a noté la survenue d’une deuxième récidive locale avec des métastases pulmonaires. Le malade est décédé, à 10 ans de recul, dans un tableau de pneumopathie diffuse avec septicémie sévère. Observation 2 : Un homme de 71 ans, a présenté un carcinome métatypique de la région rétro- auriculaire. Il a eu une exérèse tumorale avec des limites chirurgicales envahies. Il a présenté plusieurs récidives locales traitées par des exérèses larges jusqu’à une pétrectomie totale. Les limites chirurgicales étaient toujours tumorales. Une radiothérapie postopératoire a été réalisée pour chaque récidive. A 7 ans de recul, il a présenté une récidive locale envahissant l’angleponto-cérébelleux et le cerveau, jugée en dehors de toutes ressources thérapeutiques. Discussion : Le carcinome métatypique est caractérisé par son agressivité et sa tendance à la récidive. Son traitementest essentiellement chirurgical. Une large marge de sécurité lors de l’exérèse est indispensable. La radiothérapie est un traitement adjuvant, devenu incontournable vu le haut risque de récidive. Le rôle de la chimiothérapie n’est pas encore prouvé.

Myasthenie - spondylarthropathies: association fortuite ? A propos d’un cas et revue de la littérature

Propos Nous rapportons le cas d’un patient atteint d’une myasthénie associée à une spondylarthropathie. Cette observation est originale de part sa rareté, six cas seulement on été rapportés dans la littérature et le problème que pose cette association : est ce qu’elle est fortuite ou impliquerait-elle d’autres facteurs génétiques qui restent à prouver ?Observation Monsieur J.H. âgé de 32 ans, aux antécédents de myasthénie depuis 2002, était hospitalisé en avril 2004 pour polyarthrite chronique bilatérale et asymétrique évoluant depuis un an, touchant le poignet gauche, les inter phalangiennes proximales des 3ème et 5ème doigts droits et le genou droit associées à des talalgiesbilatérales et une douleur des articulations sacro-iliaques. La biologie montrait un syndrome inflammatoire modéré, des facteurs rhumatoïdes faiblement positifs et un typage HLA B7 et B17. Le bilan radiologiquemontrait une arthrite des mains, une enthésite calcanéenne et permettait de suspecter une sacro-iliite bilatérale qui était confirmée par un scanner. L’évolution était bonne sous anti- inflammatoires nonstéroïdiens pendant 6 mois. Il consulte en janvier 2006 pour le même tableau associé à une sècheresse buccale et oculaire. Le bilan trouvait une VS à 20, des facteurs rhumatoïdes faiblement positifs mais desAAN positifs à un taux 1/160 homogènes avec des anti SSA. Les radiographies standard montraient une carpite stade II gauche. L’examen ophtalmologique a confirmé le syndrome sec oculaire. La biopsie des glandes salivaires accessoires a montré un syndrome de Gougerot Sjögren grade 2 de Shisholm

Quel bilan d’extension faut-il faire pour les carcinomes indifferencies du nasopharynx ?

Introduction: Nasopharyngeal carcinoma prognosis is often correlated with its local extension but especially lymphatic node and metastatic.The aimof our work was to study sensitivity and the specificity of clinical and paraclinic explorations in the initial assessmentPatients and methods : It .s about a retrospective study of 366 patients having nasopharyngeal carcinoma, diagnosed over eleven years period between 1993 and 2003 in Sfax hospital. Into pretherapeutic, all the patients had a complementary assessment including:- Nasopharyngeal tomodensitometry (TDM), in all the cases, extended to the cervical area in 112 cases and a magnetic resonnance Imagery (MRI) of the nasopharynx and cerebral in 18 cases.- Metastatic assessment: comprising systematically a chest radiography, an abdominal ultrasonography and an osseous scintiscanning. The statistical study comprised a descriptive study and an analytical study.Results : The metastasis diagnosis was retained in 39 cases (10,7%): osseous in 82%, hepatic in 23% and pulmonary in 12,8% of the cases. The tumour was associated to lymph node N3 in 25 cases (64%). At univariate study, we retained the presence of significant difference between the groups of the metastatic and lack metastatic patients for : the male sex, reason for consultation (cervical node, rhinologic signs and otologic signs) and cervical node at the examination.The multivariate analysis for all the factors was without interest. We choose the parameters according to the result of the univariate study, the literature and parameters' found among all patients with discovered CNP. It comes out from this study that the following elements are providers of metastases: age between 40 and 45years, male sex and cervical node N3a stage.Discussion : The assessment of extension is not standardized for all the authors. Indeed, for the study of the pulmonary extension (AJCC)/ (UICC) recommends the systematic practice of the chest radiography. For (NCCN), the practice of chest radiography is only for patients classified at the stage 2 and 3 in WHO classification. For KUMAR, LEUNG and our results, it is recommended systematically to practice the chest radiography . This radiography would be supplemented by a thoracic tomodensitometry with the least suspect lesion. For the hepatic assessment, some recommend the systematic practice of abdominal echography for the advanced nodestages (N3). For others, it will be indicated only for the symptomatic patients. For (AJCC)/ (UICC) abdominal echography is systematic.For the osseous assessment, KRAIPHIBUL recommends the practice of the osseous scintiscanning only for patients having signs of osseous call but LEUNG and SHAM recommend the practice of the osseous scintiscanning only for the patients having cervical node N3.Key words: Nasopharyngeal carcinoma/ extension assessment/ metastasis

Building an XML document warehouse

International audienceData Warehouses and OLAP (On Line Analytical Processing) technologies are dedicated to analyzing structured data issued from organizations' OLTP (On Line Transaction Processing) systems. Furthermore, in order to enhance their decision support systems, these organizations need to explore XML (eXtensible Markup Language) documents as an additional and important source of unstructured data. In this context, this paper addresses the warehousing of document-centric XML documents. More specifically, we propose a two-method approach to build Document Warehouse conceptual schemas. The first method is for the unification of XML document structures; it aims to elaborate a global and generic view for a set of XML documents belonging to the same domain. The second method is for designing multidimensional galaxy schemas for Document Warehouses

Literature curation of protein interactions: measuring agreement across major public databases

Literature curation of protein interaction data faces a number of challenges. Although curators increasingly adhere to standard data representations, the data that various databases actually record from the same published information may differ significantly. Some of the reasons underlying these differences are well known, but their global impact on the interactions collectively curated by major public databases has not been evaluated. Here we quantify the agreement between curated interactions from 15 471 publications shared across nine major public databases. Results show that on average, two databases fully agree on 42% of the interactions and 62% of the proteins curated from the same publication. Furthermore, a sizable fraction of the measured differences can be attributed to divergent assignments of organism or splice isoforms, different organism focus and alternative representations of multi-protein complexes. Our findings highlight the impact of divergent curation policies across databases, and should be relevant to both curators and data consumers interested in analyzing protein-interaction data generated by the scientific community

Exercise-induced bronchoconstriction and atopy in Tunisian athletes

<p>Abstract</p> <p>Background</p> <p>This study is a cross sectional analysis, aiming to evaluate if atopy is as a risk factor for exercise induced bronchoconstriction (EIB) among Tunisian athletes.</p> <p>Methods</p> <p>Atopy was defined by a skin prick test result and EIB was defined as a decrease of at least 15% in forced expiratory volume in one second (FEV1) after 8-min running at 80–85% HRmaxTheo. The study population was composed of 326 athletes (age: 20.8 ± 2.7 yrs – mean ± SD; 138 women and 188 men) of whom 107 were elite athletes.</p> <p>Results</p> <p>Atopy was found in 26.9% (88/326) of the athletes. Post exercise spirometry revealed the presence of EIB in 9.8% of the athletes including 13% of the elite athletes. Frequency of atopy in athletes with EIB was significantly higher than in athletes without EIB [62.5% vs 23.1%, respectively].</p> <p>Conclusion</p> <p>This study showed that atopic Tunisian athletes presented a higher risk of developing exercise induced bronchoconstriction than non-atopic athletes.</p

Importance of TP53 codon 72 and intron 3 duplication 16bp polymorphisms in prediction of susceptibility on breast cancer

<p>Abstract</p> <p>Background</p> <p><it>TP53 </it>is one of major tumour suppressor genes being essential in preservation of genome integrity. Two very common polymorphisms have been demonstrated to contribute to cancer susceptibility and tumour behaviour. The purpose of this study was to evaluate the role of <it>Arg72Pro </it>and <it>PIN3 Ins16bp </it>polymorphisms in <it>TP53 </it>gene as genetic susceptibility and predictive markers to breast cancer.</p> <p>Methods</p> <p>We analysed DNA samples from 264 breast cancer patients and 440 controls, for <it>TP53 Arg72Pro </it>and <it>PIN3 Ins16bp </it>polymorphisms using PCR-RFLP.</p> <p>Results</p> <p>We observed that women with <it>A2A2 </it>genotype have increased risk for developing breast cancer, either in women with or without familial history (FH) of the disease (OR = 4.40, 95% CI 1.60–12.0; p = 0.004; OR = 3.88, 95% CI 1.18–12.8; p = 0.026, respectively). In haplotype analysis, statistically significant differences were found between <it>TP53 Arg-A2 </it>haplotype frequencies and familial breast cancer cases and the respective control group (OR = 2.10, 95% CI 1.08–4.06; p = 0.028). Furthermore, both <it>TP53 </it>polymorphisms are associated with higher incidence of lymph node metastases.</p> <p>Conclusion</p> <p>Our findings suggest <it>TP53 PIN3 Ins16bp </it>polymorphism as a real risk modifier in breast cancer disease, either in sporadic and familial breast cancer. Furthermore, both TP53 polymorphisms are associated with higher incidence of lymph node metastases.</p

Phylogeography and Molecular Evolution of Potato virus Y

Potato virus Y (PVY) is an important plant pathogen, whose host range includes economically important crops such as potato, tobacco, tomato, and pepper. PVY presents three main strains (PVYO, PVYN and PVYC) and several recombinant forms. PVY has a worldwide distribution, yet the mechanisms that promote and maintain its population structure and genetic diversity are still unclear. In this study, we used a pool of 77 complete PVY genomes from isolates collected worldwide. After removing the effect of recombination in our data set, we used Bayesian techniques to study the influence of geography and host species in both PVY population structure and dynamics. We have also performed selection and covariation analyses to identify evolutionarily relevant amino acid residues. Our results show that both geographic and host-driven adaptations explain PVY diversification. Furthermore, purifying selection is the main force driving PVY evolution, although some indications of positive selection accounted for the diversification of the different strains. Interestingly, the analysis of P3N-PIPO, a recently described gene in potyviruses, seems to show a variable length among the isolates analyzed, and this variability is explained, in part, by host-driven adaptation