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

Le Traitement Chirurgical Des Poches De Retraction Tympaniques De L\'enfant

Objectifs : Préciser les principes du traitement chirurgical et les particularités des poches de rétraction tympaniques (PDR) chez l\'enfant. Matériel et méthodes : Nous rapportons une étude rétrospective à propos de 37 PDR (28 enfants) opérés entre 1995 et 2006. Tous les patients avaient bénéficié d\'un examen clinique et un bilan audiométrique. Le traitement consistait en un renforcement tympanique par un greffon cartilagineux éventuellement associé à une attico-mastoïdectomie. Les résultats anatomiques et fonctionnels post opératoires ont été évalués avec un recul moyen de 29 mois. Résultats : L\'âge moyen des patients était de 10,5 ans et le sex-ratio de 1,33. Sept enfants avaient des antécédents d\'otite séromuqueuse bilatérale, avec pose d\'ATT. L\'hypoacousie était le signe fonctionnel le plus fréquent (67,8%). Les PDR étaient classées stade III, II et I (Charachon) respectivement dans 56,8%, 29,7% et 13,5% des cas. L\'audiométrie trouvait une surdité de transmission moyenne à 25 ± 15 dB. Une chirurgie de renforcement a été pratiquée dans tous les cas, associée à une mastoïdectomie chez 12 patients. Aucune récidive de rétraction n\'a été notée en post opératoire. Par ailleurs, l\'analyse des résultats fonctionnels a montré un gain auditif moyen de 10 dB et un Rinne résiduel < 15 dB dans 75,6% des cas. Conclusion : La chirurgie de renforcement tympanique par du cartilage, prend une place importante dans la prise en charge des PDR de l\'enfant et donne d\'excellents résultats anatomiques et fonctionnels.Objective: To precise the bases of surgical treatment and the particularities of tympanic retraction pockets (RP) in children. Materials and methods: We report a retrospective study about 37 RP (28 children) operated between 1995 and 2006. All patients had otological examination, nasal endoscopy and audiometric explorations. Treatment consists in reinforcement of the tympanic membrane with cartilage graft in all cases. After treatment, anatomical and functional results were evaluated with a mean follow-up of 29 months. Results: Mean-age was 10,5 years and sex-ratio 1,33. Seven children had bilateral seromucous otitis with ventilation tube insertion. Hearing-loss was the most frequent sign (67,8%). RP were classified (Charachon) stage III, II and I in 56,8%, 29,7% et 13,5%, respectively. Audiometery showed an average air conduction threshold of 25± 10 dB. Reinforcement tympanoplasty was performed in all cases, associated with canal wall-up mastoidectomy in 12 ears. No recurrence of retraction of the graft has been noted after treatment. Furthermore, analysis of functional results showed an average air conduction gain of 10 dB and air conduction gap < 15 dB in 75,6 % of cases. Conclusion: Reinforcement tympanoplasty with cartilage, takes a large place in the management of RP in children and achieves good anatomical and functional results. Keywords: Tympanic retraction – Surgery – Cartilage – Supervision Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 18 2007: pp. 12-1

L’acupuncture : comme alternative dans la prise en charge de la paralysie faciale peripherique idiopathique : experience tunisienne

La paralysie faciale périphérique idiopathique ou à frigoré (PfPi) est la plus fréquente des paralysies faciales. Elle pose un problème thérapeutique malgré la diversité des traitements proposés. L’acupuncture est une des alternatives proposées parmi cet arsenal thérapeutique. Le but de ce travail est d’évaluer l’apport de l’acupuncture dans le traitement de la PfPi et de dégager les différents facteurs pronostiques pouvant influencer la récupération de la fonction faciale. Notre étude a regroupé 40 patients porteurs de PfPi recrutés aux services d’ORL de l’hôpital régional de Jendouba et de l’hôpital de Charles Nicolle sur une période de 14 mois et pris en charge aux centres d’acupuncture à l’hôpital Mongi Slim et à l’hôpital régional de Jendouba. Tous les patients ont été traités, auparavant, selon le concept de la médecine occidentale, et n’ont été adressés qu’après échec du traitement médical conventionnel. L’évaluation de notre travail est basée sur deux tests : le testing musculaire de freyss et le grading de House et Brackman. L’étude statistique s’est basée sur le logiciel « SPSS ». Les résultats de cette étude montrent que le traitement par acupuncture trouve son indication lorsque le traitement médical conventionnel a échoué, même après un long délai de consultation.Mots-clés : paralysie faciale périphérique, acupuncture, traitement.The Bell’s palsy is the most common peripheral facial paralysis. it poses a therapeutic problem despite the diversity of treatments. Acupuncture is an alternative among the proposed therapeutic arsenal. The purpose of this study was to evaluate the contribution of acupuncture in the treatment of facial paralysis and to identify different prognostic factors that may influence the recovery of facial function. Our study included 40 patients with Bell’s palsy recruited in the services of ENT in Jendouba hospital and Charles Nicolle hospital over a period of 14 months and supported in centers of acupuncture in Mongi Slim hospital and Jendouba hospital. All patients were previously under the concept of medical treatment, and were sent after failure of this treatment. The evaluation of our work is based on two tests: muscle testing of freyss and grading of House and Brackman. The study is based on statistical software "SPSS". The results of this study show that treatment with acupuncture is indicated in Bell’s palsy when conventional medical treatment has failed and even after a long period of consultation.Keywords: facial palsy, acupuncture, treatment

Lymphomes malins non-hodgkiniens primitifs des amygdales palatines

Introduction: The most predominant localization for extranodal  non-hodgkinien lymphoma (NHL) in the head and neck region is the tonsil. The vast majority of NHL at this site is B-cell lymphomas.Materials and methods: The authors presented three cases of primary Non Hodgkin's Lymphoma of the tonsil, treated between 1995 and 2007Results: we report the cases of three men aged respectively 15, 42 and 72 years. They complained of a persistent odynophagia during three months ago. Clinical examination detected unilateral enlarged tonsil with ulcerated surface. All of them have bilateral tonsillectomy. The histopathologic examination concluded at a NHL with a B phenotype. The treatment consisted on chemotherapy for two patients and on radio and  chemotherapy for the third patient. We have noted one death for our three patients.Conclusion: Primary NHL of the tonsil is rare. An advanced diagnosis is often difficult. Both histopathologic identification of the tumor and evaluation of the patient are essentiel for the therapeutic decision. Prognostic depends on the stage of the lymphoma.Keywords: Non Hodgkin lymphoma, Oral cavity, Radiotherapy, Chemotherapy, antineoplastic agent, malignant hemopathy, Oral cavity disease

An Experimental Microarchitecture for a Superconducting Quantum Processor

Quantum computers promise to solve certain problems that are intractable for classical computers, such as factoring large numbers and simulating quantum systems. To date, research in quantum computer engineering has focused primarily at opposite ends of the required system stack: devising high-level programming languages and compilers to describe and optimize quantum algorithms, and building reliable low-level quantum hardware. Relatively little attention has been given to using the compiler output to fully control the operations on experimental quantum processors. Bridging this gap, we propose and build a prototype of a flexible control microarchitecture supporting quantum-classical mixed code for a superconducting quantum processor. The microarchitecture is based on three core elements: (i) a codeword-based event control scheme, (ii) queue-based precise event timing control, and (iii) a flexible multilevel instruction decoding mechanism for control. We design a set of quantum microinstructions that allows flexible control of quantum operations with precise timing. We demonstrate the microarchitecture and microinstruction set by performing a standard gate-characterization experiment on a transmon qubit.Comment: 13 pages including reference. 9 figure