Les carcinomes adénoïdes kystiques de la parotide a propos de 3 cas

Les carcinomes adénoïdes kystiques (CAK) représentent 2 à 4% des tumeurs de la parotide et 12% des tumeurs malignes. Ce sont des tumeurs à croissance lente qui sont caractérisées par leur capacité à infiltrer les gaines nerveuses. Les auteurs rapportent trois cas de CAK de la glande parotide diagnostiqués et traités entre l’année 2000 et 2007. Il s’agissait de 2 hommes et une femme qui ont consulté devant l’apparition d’une tuméfaction de la loge parotidienne associée à une paralysie faciale dans un cas. Les aires ganglionnaires étaient libres. Tous les patients ont bénéficié d’une exploration comportant une échographie, une TDM dans un cas et une IRM chez un patient. Le traitement a consisté en une parotidectomie totale associée à un curage ganglionnaire dans tous les cas et à une radiothérapie complémentaire. L’évolution a été favorable dans deux cas. Le carcinome adénoïde kystique de la parotide est une tumeur rare, caractérisée par une évolution très lente, une agressivité locale, un caractère fortement récidivant localement et un haut pouvoir métastatique à distance.Mots-clés : Carcinome adénoïde kystique, glande parotide, chirurgie, radiothérapie

Translocations of threatened plants in the Mediterranean Basin: current status and future directions

The Mediterranean Basin is one of the World's plant diversity hotspots and a region prone to several anthropic pressures, besides being one of the World's areas most susceptible to climate change. In this region, which hosts a high percentage of threatened species, there has been a large increase in practical conservation actions to prevent the extinction of many plants or improve their conservation status. In this framework, plant translocations have become increasingly important. To obtain a picture of the status and to depict possible directions, data on plant translocations was collected through the available databases, national experts, and the grey literature available online. Overall, a list of 836 translocations relating to 572 plant species was found. These actions are mainly concentrated in Spain, France, and Italy (c. 87%) and, except for some pioneering actions, translocations have strongly increased starting from 2010. A subsequent in-depth bibliographic search of the scientific databases was conducted to determine how much information about plant translocations was documented in the scientific literature. This search resulted in a list of 133 peer-reviewed papers, of which only 17 describing one or more translocations and, as a whole, reporting 101 experiences carried out on 56 plant species. Our research highlighted a great discrepancy between the scarce scientific documentation in comparison to the large number of practical conservation actions carried out. The great experience gained in these translocations constitutes an enormous heritage potentially available to implement the necessary conservation actions to preserve the plant diversity of the Mediterranean Basin

La déhiscence du canal semi circulaire supérieur

Introduction : Superior semicircular canal dehiscence is a rare entity witch is recently described. The common symptom is pressure-induced vertigo.Patients and methods: we report 2 cases of superior semicircular canal dehiscence identified by computed tomography (CT) of the petrous bone in patients with mixed hearing loss and a normal tympanic membrane.Results: Superior semicircular canal dehiscence was bilateral in 1 patient.Mixed hearing loss with a normal tympanic membrane without vertigo was the presenting manifestation in all cases. Ultrahigh-resolution CT of the petrous bones with coronal and sagittal sections provided the diagnosis of superior semicircular canal dehiscence.Conclusion: Mixed hearing loss with a normal tympanic membrane should suggest superior semi circular canal dehiscence. Coronal and sagittal CT sections less than 1 mm in thickness establish the diagnosis.Key words : Superior semicircular canal, dehiscence, hearing loss

Les Tumeurs Malignes De La Parotide

Buts : Analyser les divers aspects cliniques, histologiques et thérapeutiques des tumeurs malignes de la parotide. Méthode : Étude rétrospective portant sur 17 cancers parotidiens opérés dans le service d\'ORL de la Rabta entre 1994 et 2006. Résultats : Sur une période de13 ans, suite à 77 parotidectomies pour tumeur parotidienne, nous avons diagnostiqué 17 cas de cancers parotidiens soit un pourcentage de 22% de l\'ensemble des tumeurs parotidiennes, réparties en 6 types histologiques. L\'âge moyen des patients est de 49 ans avec des extrêmes allant de 16 à 86 ans et un pic à la 7ème décade de vie. Le sex-ratio est égal à 1,8. Quatre cas de Paralysies faciales (PF) transitoires et un cas de PF définitive ont été déplorés. Deux cas de récidive ont été notés et repris chirurgicalement. Conclusion : Les cancers de la parotide se caractérisent par une grande diversité histologique. Le pronostic dépend du type histologique, du stade évolutif et du traitement.Aim : to analyse clinical, histopathologic and therapeutic aspects of parotid cancers. Method : data from a retrospective study of 17 cases treated in the ENT department of Rabta hospital between 1994 and 2006. Result : in this period 77 patients were operated of parotid tumors, 17 of them were malignants (22%) divided on 6 different histological types. Mean age was 49 years and sex ratio was 1.8. Transitory facial pulsy was observed in 4 patients. Only one definitive facial palsy was observed. Recurrence was observed in 2 patients.They were operated and received a complement of radiptherapy. Conclusion : Parotid cancers are caracterised by great histopathological variety. Their prognosis depends on histological type, tumor stage and treatment Keywords: Parotid gland, cancer, parotid tumor. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 18 2007: pp. 25-2

Hematome organise du sinus maxillaire a propos d’un cas

L’hématome organisé du sinus maxillaire est une entité rare. Son étiopathogénie reste incertaine. Nous rapportons le cas d’une patiente âgée de 16 ans présentant une épistaxis unilatérale droite de grande abondance avec une endoscopie nasale strictement normale. L’imagerie était en faveur d’une tumeur vasculaire du sinus maxillaire. Une exérèse chirurgicale complète a été réalisée par voie combinée avec des suites simples. L’examen anatomopathologique a conclu à un hématome organisé du sinus maxillaire. Nous discutons, dans ce travail, l’étiopathogénie, les caractéristiques cliniques, radiologiques et les volets thérapeutiques de cette entité.Mots clés : Hématome organisé, sinus maxillaire, tomodensitométrie, chirurgie

Extracellular vesicle features are associated with COVID-19 severity

COVID-19 is heterogeneous; therefore, it is crucial to identify early biomarkers for adverse outcomes. Extracellular vesicles (EV) are involved in the pathophysiology of COVID-19 and have both negative and positive effects. The objective of this study was to identify the potential role of EV in the prognostic stratification of COVID-19 patients. A total of 146 patients with severe or critical COVID-19 were enrolled. Demographic and comorbidity characteristics were collected, together with routine haematology, blood chemistry and lymphocyte subpopulation data. Flow cytometric characterization of the dimensional and antigenic properties of COVID-19 patients' plasma EVs was conducted. Elastic net logistic regression with cross-validation was employed to identify the best model for classifying critically ill patients. Features of smaller EVs (i.e. the fraction of EVs smaller than 200 nm expressing either cluster of differentiation [CD] 31, CD 140b or CD 42b), albuminemia and the percentage of monocytes expressing human leukocyte antigen DR (HLA-DR) were associated with a better outcome. Conversely, the proportion of larger EVs expressing N-cadherin, CD 34, CD 56, CD31 or CD 45, interleukin 6, red cell width distribution (RDW), N-terminal pro-brain natriuretic peptide (NT-proBNP), age, procalcitonin, Charlson Comorbidity Index and pro-adrenomedullin were associated with disease severity. Therefore, the simultaneous assessment of EV dimensions and their antigenic properties complements laboratory workup and helps in patient stratification

Electrical tuning of elastic wave propagation in nanomechanical lattices at MHz frequencies

Nanoelectromechanical systems (NEMS) that operate in the megahertz (MHz) regime allow energy transducibility between different physical domains. For example, they convert optical or electrical signals into mechanical motions and vice versa. This coupling of different physical quantities leads to frequency-tunable NEMS resonators via electromechanical non-linearities. NEMS platforms with single- or low-degrees of freedom have been employed to demonstrate quantum-like effects, such as mode cooling, mechanically induced transparency, Rabi oscillation, two-mode squeezing and phonon lasing. Periodic arrays of NEMS resonators with architected unit cells enable fundamental studies of lattice-based solid-state phenomena, such as bandgaps, energy transport, non-linear dynamics and localization, and topological properties, directly transferrable to on-chip devices. Here we describe one-dimensional, non-linear, nanoelectromechanical lattices (NEML) with active control of the frequency band dispersion in the radio-frequency domain (10–30 MHz). The design of our systems is inspired by NEMS-based phonon waveguides and includes the voltage-induced frequency tuning of the individual resonators. Our NEMLs consist of a periodic arrangement of mechanically coupled, free-standing nanomembranes with circular clamped boundaries. This design forms a flexural phononic crystal with a well-defined bandgap, 1.8 MHz wide. The application of a d.c. gate voltage creates voltage-dependent on-site potentials, which can significantly shift the frequency bands of the device. Additionally, a dynamic modulation of the voltage triggers non-linear effects, which induce the formation of a phononic bandgap in the acoustic branch, analogous to Peierls transition in condensed matter. The gating approach employed here makes the devices more compact than recently proposed systems, whose tunability mostly relies on materials’ compliance and mechanical non-linearities

Is visual estimation of passive range of motion in the pediatric lower limb valid and reliable

<p>Abstract</p> <p>Background</p> <p>Visual estimation (VE) is an essential tool for evaluation of range of motion. Few papers discussed its validity in children orthopedics' practice. The purpose of our study was to assess validity and reliability of VE for passive range of motions (PROMs) of children's lower limbs.</p> <p>Methods</p> <p>Fifty typically developing children (100 lower limbs) were examined. Visual estimations for PROMs of hip (flexion, adduction, abduction, internal and external rotations), knee (flexion and popliteal angle) and ankle (dorsiflexion and plantarflexion) were made by a pediatric orthopaedic surgeon (POS) and a 5^thyear resident in orthopaedics. A last year medical student did goniometric measurements. Three weeks later, same measurements were performed to assess reliability of visual estimation for each examiner.</p> <p>Results</p> <p>Visual estimations of the POS were highly reliable for hip flexion, hip rotations and popliteal angle (ρ_c≥ 0.8). Reliability was good for hip abduction, knee flexion, ankle dorsiflexion and plantarflexion (ρ_c≥ 0.7) but poor for hip adduction (ρ_c= 0.5). Reproducibility for all PROMs was verified. Resident's VE showed high reliability (ρ_c≥ 0.8) for hip flexion and popliteal angle. Good correlation was found for hip rotations and knee flexion (ρ_c≥ 0.7). Poor results were obtained for ankle PROMs (ρ_c< 0.6) as well as hip adduction and abduction, the results of which not being reproducible. Influence of experience was clearly demonstrated for PROMs of hip rotations, adduction and abduction as well as ankle plantarflexion.</p> <p>Conclusion</p> <p>Accuracy of VE of passive hip flexion and knee PROMs is high regardless of the examiner's experience. Same accuracy can be found for hip rotations and abduction whenever VE is performed by an experienced examiner. Goniometric evaluation is recommended for passive hip adduction and for ankle PROMs.</p