Prise en charge des complications de la chirurgie partielle du larynx

Introduction : Le cancer du larynx est un cancer fréquent occupant la première place des cancers des voies aéro-digestives chez l’homme en Tunisie. Le tabac est le principal facteur favorisant surtout s’il est associé à l’éthylisme chronique. Il s’agit le plus souvent d’un carcinome épidermoïde plus ou moins différencié. Son pronostic est généralement bon, en raison de son développement dans un tube rigide bien limité et d’un traitement chirurgical actuellement bien codifié. La chirurgie partielle du cancer du larynx est une chirurgie à risque de complications postopératoires nécessitant une prise en charge adéquate.Patients et méthodes : Notre série comprend 54 patients ayant bénéficié d’une chirurgie partielle du larynx au sein du service de chirurgie carcinologique de l’institut Salah Azaiez sur une période de 15 ans (1997-2011).But : Présenter notre expérience en matière de prise en charge des complications de la chirurgie partielle du larynx.Résultats : La moyenne d’âge de nos patients était de 54,9 ans avec des extrêmes allant de 33 à 69 ans. La prédominance masculine était nette avec un sex-ratio de 26. La consommation tabagique était notée dans 92,6% des cas et la dysphonie était présente chez 40 patients porteurs d’une tumeur à localisation glottique. Six types d’interventions ont été pratiqués: cordectomie (9 cas), laryngectomie fronto-latérale (4 cas), laryngectomie frontale antérieure reconstructive type Tucker (10 cas), laryngectomie partielle supra-cricoïdienne avec crico-hyoïdopexie (CHP) (4 cas), laryngectomie partielle supra-cricoïdienne avec crico-hyoïdo-épiglottopexie (CHEP) (24 cas) et laryngectomie horizontale supra-glottique (3 cas). Une antibioprophylaxie était administrée chez 79,6% des patients pour une durée moyenne de 7 jours. Les complications postopératoires ont été analysées et discutées en fonction du type de la chirurgie partielle pratiquée et du type d’antibiothérapie utilisée. Ces complications étaient les suivantes: infection du trachéostome (20,4%), infection de paroi (5 cas), complications respiratoires (29,6%), emphysème sous cutané (7,4%), fistule salivaire (1 cas) et pancréatite aigüe (1 cas).Conclusion : Cette étude montre dans l’ensemble des bons résultats tant sur le plan infectieux que respiratoires, justifiant ainsi l’importance de la prise en charge des complications de la chirurgie partielle du cancer du larynx.Introduction : Laryngeal cancer is a common cancer occurring mainly in men. Smoking is the main risk factor especially if associated with chronic alcoholism. Squamous cell carcinoma is the most common histologic type. Prognosis is generally good, due to the development of the tumor in a very limited rigid tube and to a well-codified surgical treatment. Partial surgery of laryngeal cancer is characterized by postoperative complications requiring an adequate management.Methods : Our series includes 54 cases of laryngeal cancer treated with partial laryngectomy in the ENT department of Salah Azaiez Institute over a period of 15 years from 1997 to 2011.Objective : To present our experience in the management of partial laryngeal surgery complications.Results : Average age of our patients was 54.9 years ranging from 33 to 69 years. Male predominance was marked with a sex ratio of 26. Tobacco abuse was found in 92.6%. Dysphonia was the most common symptom found in 40 patients with glottic cancer. Six varieties of partial laryngectomy were performed: cordectomy (9 cases), fronto-lateral laryngectomy (4 cases), fronto-anterior reconstructive laryngectomy (10 cases), partial supra-cricoid laryngectomy with CHP (4 cases), partial supra-cricoid laryngectomy with CHEP (24 cases) and supra glottic horizontal laryngectomy (3 cases). 79.6 % of our patients received prophylactic antibiotics for an average of 7 days. Postoperative complications were analyzed and discussed in terms of the type of surgery performed and the antibiotic used. Complications observed were: infection of the tracheostoma (20.4%), parietal infection (5 cases), respiratory complications (29.6%), subcutaneous emphysema (7.4%), salivary fistula (1 case) and acute pancreatitis (1 case).Conclusion : This study shows overall good results for partial laryngeal cancer surgery with minimal post-operative complications and oncologic failure justifying the importance of an early management of these complications

Méningiome primitif ethmoïdonasal.

Introduction : Les méningiomes primitifs des fosses nasales et des sinus paranasaux sont des tumeurs bénignes rares, la sémiologie clinique et radiologique n’est pas spécifique. L’objectif de ce travail est de décrire les aspects épidémiologiques, diagnostiques et thérapeutiques de cette localisation ectopique des méningiomes.Observation : Patient âgé de 52 ans, présentant une obstruction nasale bilatérale avec hyposmie et épistaxis depuis 4 ans, l’examen endonasal a montré un processus tissulaire polypoïde occupant les deux fosses nasales, la TdM a montré un processus tumoral ethmoïdonasal étendu aux sphénoïdes et vers les deux fosses nasales sans extension endocrânienne. Le patient a été opéré par voie transfaciale, l’examen anatomopathologique était en faveur d’un méningiome méningothélial gradei. Les contrôles cliniques, endoscopiques et scannographiques n’ont pas montré de résidu tumoral ni de récidive avec un recul de 4ans.Conclusion : Les fosses nasales et les sinus paranasaux représentent une localisation ectopique exceptionnelle des méningiomes extra crâniens primitifs. Ces tumeurs se développent lentement et leur pronostic est généralement bon après exérèse chirurgicale.Mots clés : Méningiomes ectopiques, sinus paranasaux, anatomie pathologique, immunohistochimie, chirurgie.Introductione : Primary extracranial meningiomas of the nasal cavity and paranasal sinuses are rare benign tumors, the clinical and radiological presentations are not specific. The objective of this work is to describe the epidemiological, diagnostic and therapeutic aspects of this ectopic location of meningiomas.Case report : 52-year-old patient, presented a bilateral nasal obstuction with hyposmie and epistaxis for 4 years, the endonasal examination showed a polypoid process occupying both nasal cavity, the CT examination showed a ethmoïdonasal tumoral process extending to sphenoid bones and both nasal cavity without endocranial extension. The patient was operated by transnasal approach, histopathological examination was in favour of a méningothélial meningioma rank i.The clinical, endoscopic and CT controls did not show tumor residue or a local recurrence with a recession of 4years. Nasal cavity and paranasal sinuses represent an exceptional ectopic location of primary extracranial meningiomas , these tumors are slowly growing, and their prognosis is generally good after surgical excision.Keyswords : ectopic meningioma, paranasal sinuses, histopathology, immunohistochemistry, surgery

The dilatancy-diffusion hypothesis and earthquake predictability

The dilatancy-diffusion hypothesis was one of the first attempts to predict the form of potential geophysical signals that may precede earthquakes, and hence provide a possible physical basis for earthquake prediction. The basic hypothesis has stood up well in the laboratory, where catastrophic failure of intact rocks has been observed to be associated with geophysical signals associated both with dilatancy and pore pressure changes. In contrast, the precursors invoked to determine the predicted earthquake time and event magnitude have not stood up to independent scrutiny. There are several reasons for the lack of simple scaling between the laboratory and the field scales, but key differences are those of scale in time and space and in material boundary conditions, coupled with the sheer complexity and non-linearity of the processes involved. 'Upscaling' is recognized as a difficult task in multi-scale complex systems generally and in oil and gas reservoir engineering specifically. It may however provide a clue as to why simple local laws for dilatancy and diffusion do not scale simply to bulk properties at a greater scale, even when the fracture system that controls the mechanical and hydraulic properties of the reservoir rock is itself scaleinvariant. © The Geological Society of London 2012

Assessment of Antioxidant and Antibacterial Activities of Cystoseira mediterranea and Padina pavonica from Algerian North-East for a Potential Use as a Food Preservative

The aim of this work was to evaluate the antioxidant and antibacterial activities of two marine algae, Cystoseira mediterranea and Padina pavonica, extracts. Total phenols (TPC), carotenoids, and phlorotannins contents of the extracts obtained by four extraction solvents were determined and compared. The highest TPC content was observed for aqueous extract of C. mediterranea with 37.09±0.46 mg GAE/g DE followed by ethanol extract of P. pavonica (24.28±0.99 mg GAE/g DE), which showed the highest phlorotannins content (1.18±0.18 mg PE/g DE), while its methanol extract held carotenoids content of 66.96±4.78 μg g–1 DE. Ethanol extract of C. mediterranea exhibited the best antioxidant activity with an EC50 of 58.3±1.16 μg ml–1. The antibacterial activity screening against MRSA and E. coli showed that ethanol extract of C. mediterranea towards a Methicillin resistant Staphyloccocus aureus (20.33±0.28 mm) and E. coli (15.66±0.57 mm) was more efficient with MICs about 80 mg ml–1 and 20 mg ml–1, respectively. Ethanol extract of C. mediterranea seems to have the highest potential for use in food industries

Facile preparation of N-S co-doped graphene quantum dots (GQDs) from graphite waste for efficient humidity sensing

In this work, graphene quantum dots (GQDs) were prepared from Graphitic waste. The resulting GQDs were evaluated for the potential application for resistive humidity sensors. The resistive humidity sensors were fabricated on the pre-patterned interdigital ITO electrodes using the three different concentrations (2.5, 5.0, and 10 mg) of GQDs in DMF. The GQDs films were deposited using the spin coating technique. The GQDs (10 mg/ml) based impedance sensors showed good sensitivity and lowered hysteresis as compared to the other ratios (2.5 and 5 mg) of the GQDs. The maximum calculated hysteresis of the GQDs (10 mg) based humidity sensor is around 2.2 % at 30%RH, and the minimum calculated hysteresis of the GQDs (10 mg/ml) based humidity sensor is approximately 0.79 % at 60 %RH. The response and recovery time found to be 15 s and 55 s, respectively. The interesting humidity-dependent resistive properties of these prepared GQDs make them promising for potential application in humidity sensing.Scopu

Caveolin-1 protects B6129 mice against Helicobacter pylori gastritis.

Caveolin-1 (Cav1) is a scaffold protein and pathogen receptor in the mucosa of the gastrointestinal tract. Chronic infection of gastric epithelial cells by Helicobacter pylori (H. pylori) is a major risk factor for human gastric cancer (GC) where Cav1 is frequently down-regulated. However, the function of Cav1 in H. pylori infection and pathogenesis of GC remained unknown. We show here that Cav1-deficient mice, infected for 11 months with the CagA-delivery deficient H. pylori strain SS1, developed more severe gastritis and tissue damage, including loss of parietal cells and foveolar hyperplasia, and displayed lower colonisation of the gastric mucosa than wild-type B6129 littermates. Cav1-null mice showed enhanced infiltration of macrophages and B-cells and secretion of chemokines (RANTES) but had reduced levels of CD25+ regulatory T-cells. Cav1-deficient human GC cells (AGS), infected with the CagA-delivery proficient H. pylori strain G27, were more sensitive to CagA-related cytoskeletal stress morphologies ("humming bird") compared to AGS cells stably transfected with Cav1 (AGS/Cav1). Infection of AGS/Cav1 cells triggered the recruitment of p120 RhoGTPase-activating protein/deleted in liver cancer-1 (p120RhoGAP/DLC1) to Cav1 and counteracted CagA-induced cytoskeletal rearrangements. In human GC cell lines (MKN45, N87) and mouse stomach tissue, H. pylori down-regulated endogenous expression of Cav1 independently of CagA. Mechanistically, H. pylori activated sterol-responsive element-binding protein-1 (SREBP1) to repress transcription of the human Cav1 gene from sterol-responsive elements (SREs) in the proximal Cav1 promoter. These data suggested a protective role of Cav1 against H. pylori-induced inflammation and tissue damage. We propose that H. pylori exploits down-regulation of Cav1 to subvert the host's immune response and to promote signalling of its virulence factors in host cells

Rapid Detection of Carbapenem Resistance in Acinetobacter baumannii Using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry

Rapid detection of carbapenem-resistant Acinetobacter baumannii strains is critical and will benefit patient care by optimizing antibiotic therapies and preventing outbreaks. Herein we describe the development and successful application of a mass spectrometry profile generated by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) that utilized the imipenem antibiotic for the detection of carbapenem resistance in a large series of A. baumannii clinical isolates from France and Algeria. A total of 106 A. baumannii strains including 63 well-characterized carbapenemase-producing and 43 non-carbapenemase-producing strains, as well as 43 control strains (7 carbapenem-resistant and 36 carbapenem-sensitive strains) were studied. After an incubation of bacteria with imipenem for up to 4 h, the mixture was centrifuged and the supernatant analyzed by MALDI-TOF MS. The presence and absence of peaks representing imipenem and its natural metabolite was analyzed. The result was interpreted as positive for carbapenemase production if the specific peak for imipenem at 300.0 m/z disappeared during the incubation time and if the peak of the natural metabolite at 254.0 m/z increased as measured by the area under the curves leading to a ratio between the peak for imipenem and its metabolite being <0.5. This assay, which was applied to the large series of A. baumannii clinical isolates, showed a sensitivity of 100.0% and a specificity of 100.0%. Our study is the first to demonstrate that this quick and simple assay can be used as a routine tool as a point-of-care method for the identification of A. baumannii carbapenemase-producers in an effort to prevent outbreaks and the spread of uncontrollable superbugs