Synovialosarcome cervical: a propos d’un cas

Introduction : Le synovialosarcome est une tumeur maligne agressive. Les localisations cervico-faciales sont très rares. Nous rapportons un nouveau cas de synovialosarcome dans la région antéro-latérale du cou.Observation : Il s’agit d’un patient âgé de 37 ans, qui a consulté pour une volumineuse tuméfaction latéro-cervicale évoluant depuis 8 mois. La TDM a montré une masse tissulaire bien limitée de la région antérolatérale gauche du cou qui se rehausse faiblement après injection de produit de contraste. Le patient a eu une exérèse tumorale complète. L’examen anatomopathologique a conclu à un synovialosarcome. L’évolution était marquée par la récidive locale rapide, après 15 jours, pour laquelle il a été réopéré avec une radio-chimiothérapie post opératoire. Cependant le patient a présenté une métastase pulmonaire avec une poursuite évolutive.Conclusion : Le synovialosarcome cervical ne présente pas de spécificité clinique et radiologique. Le traitement de choix est la chirurgie.La valeur du traitement adjuvant n’est pas encore bien définie. Le pronostic est mauvais.Mots clés : synovialosarcome, région cervicale, chirurgie, radiothérapie, récidiveIntroduction : The synovial sarcoma is a malignant and aggressive tumor. The cervicofacial locations are rares. We report a new case of synovial sarcoma in the anterolateral region of the neck.Observation : He is a 37 years old patient, with a large latero-cervical tumefaction evolving for 8 months. CT showed well circumscribed tissue mass of the left anterolateral area neck which enhances low after contrast injection. The patient had a complete tumor resection. Histological examination concluded a synovial sarcoma. The evolution was marked by rapid local recurrence, after 15 days, for which he was reoperated with postoperative chemoradiotherapy. However, the patient had a pulmonary metastasis with continued progression.Conclusion : The cervical synovial sarcoma has no specific clinical and radiological character. The treatment of choice is surgery. The value of adjuvant therapy is not well defined. The prognosis is poor.Keywords : synovial sarcoma, neck, surgery, radiotherapy, recurrenc

Structural characterization of Si(m)Ge(n) strained layer superlattices

SimGen strained layer superlattice (SLS) structures were grown by molecular beam epitaxy on GexSi1-x buffer layers on Si substrates to determine the effects of buffer layer composition, SLS thickness ratio, and superlattice periodicity, on the overall quality of these structures. X-ray diffraction methods were used to determine how closely actual periodicities and compositions met targeted values, and to evaluate the quality of these samples. In most instances the as-grown structures matched the targeted values to within 10%, though in some instances deviations of 20-25% in either the period or composition were observed. The quality of the SLS structures was greatly dependent on the composition of the buffer layer on which it was grown. SimGen SLS structures grown on Si- and Ge-rich buffer layers were of much higher quality than SimGem SLSs grown on Ge0.50Si0.50 layers, but the x-ray rocking curves of the SimGen samples indicated that they were far from perfect and contained moderate levels of defects. These results were confirmed by cross sectional transmission electron microscopy, which showed that the SimGem structures contained significant numbers of dislocations and that the layers were nonuniform in thickness and wavy in appearance. SimGen structures, however, displayed fewer defects but some dislocations and nonparallelism of layers were still observed

Traitement des diplegies laryngees en fermeture: Apport du laser

Introduction: Les diplegies laryngees en fermeture sont rares et mal tolerees par les patients. Leur prise en charge therapeutique a connu de nombreuses avancees au cours des dernieres annees. Le but de ce travail est dfetudier la place du laser dans leur prise en charge.Malades et methodes : Notre etude est retrospective a propos de six patients porteurs de diplegie laryngee en fermeture. Lfage moyen etait de 46 ans (16 et 70 ans). Lfetiologie etait une intubation prolongee ou traumatique dans 3 cas, post thyroidectomie totale dans deux autres cas et idiopathique dans 1 cas. Le traitement a consiste en une tracheotomie en urgence dans 5 cas. Tous les patients ont beneficie dans un secondtemps dfun traitement au laser apres 9 mois de surveillance.Resultats : La cordectomie posterieure a ete realisee en premier temps dans 4 cas. Elle etait bilaterale en deux temps dans 2 cas et unilaterale dans 2 cas. Une aryteno.dectomie initiale a ete realisee pour les deux autres patients. Une revision chirurgicale a consiste en une arytenoidectomie dans 2 cas et une cordotomie partielle posterieure controlaterale dans un cas. La decanulation etait bien toleree pour 4 patients. Un seul malade a garde une gene respiratoire sans veritabledyspnee avec une canule parlante fermee et la decanulation a ete refusee. Une voix satisfaisante a ete obtenue pour tous les malades. Des fausses route transitoires ont ete note dans 2 cas.Discussion : Actuellement, le traitement endoscopique au laser constitue le traitement de choix dans la diplegie laryngee et doit etre propose en premiere intension. Deux techniques principales sont decrites :  lfaryteno.dectomie au laser type Ossof et la cordectomie posterieure transverse de kashima. plusieurs series ont defendu chacune des deux techniques. Notre serie a montre que les deux techniques peuvent etre associees pour donner de meilleurs resultats.Mots cles : diplegie laryngee, Laser, aryteno.dectomie, cordectomie posterieure

Abces amibien cerebral: a propos de trois cas avec revue de la litterature

Introduction L’abcès amibien cérébral est une infection rare mais mortelle. Depuis son identification en 1965, peu de cas ont été observés dans le monde entier.Matériel et méthode Les objectifs de cette étude étaient de caractériser les aspects cliniques, radiologiques, histologique, pronostic ainsi que thérapeutique de cette pathologie avec une revue de la littérature. Nous rapportons trois cas d’abcès amibien cérébral qui ont été admis dans notre service entre 2010 et 2013.Résultats Il s’agit de deux hommes et une femme, âgés respectivement de 33, 43 et 56 ans qui ont été opérés. Le diagnostic a été confirmé par les examens histologique et sérologique. Nous n’avons observé aucune mortalité.Conclusion Il s’agit d’une atteinte sporadique mais représente un problème de santé publique et dont le pronostic est habituellement sombre.Mots clés : amibiase; abcès cérébral; IRM ; TDM; examen histologiqu

High-Dose, Extended-Interval Colistin Administration in Critically Ill Patients: Is This the Right Dosing Strategy? A Preliminary Study

In critically ill patients with otherwise untreatable nosocomial infection due to gram-negative bacteria susceptible only to colistin, a high-dose, extended-interval colistin dosing regimen is, according to the pharmacokinetic/pharmacodynamic behavior of the drug, associated with low renal toxicity and high efficacy

An improved geometric inequality via vanishing moments, with applications to singular Liouville equations

We consider a class of singular Liouville equations on compact surfaces motivated by the study of Electroweak and Self-Dual Chern-Simons theories, the Gaussian curvature prescription with conical singularities and Onsager's description of turbulence. We analyse the problem of existence variationally, and show how the angular distribution of the conformal volume near the singularities may lead to improvements in the Moser-Trudinger inequality, and in turn to lower bounds on the Euler-Lagrange functional. We then discuss existence and non-existence results.Comment: some references adde

Molecular weight influence on shape memory effect of shape memory polymer blend (poly(caprolactone)/ styrene‐butadiene‐styrene )

The shape memory effect (SME) does not only concern the macroscopic structure. It concerns also the polymer structure at morphological, macromolecular, and molecular scales. This effect may depend on different physicochemical properties like morphology heterogeneity, chain rigidity, steric hindrance, chain polarity, free volume, cross-linking or entanglement density, molecular shape and weight, and so on. Hence, finding the relationship between the SME and these properties is very important. This can help to obtain the knowledge about the phenomenon origin and mechanism. One of the basic polymer properties, which can have direct SME, may be the molecular weight (Mw). The question here is: If the Mw of a shape memory polymer (SMP) changes, for different reasons like degradation, what will be the effect of this change on its SME. In order to answer to this question, the investigation is focused on an SMP blend of 40% poly(ɛ-caprolactone) (PCL) and 60% styrene-butadiene-styrene (SBS). Then, enzymatic hydrolysis is performed on this blend to change its Mw. It is shown that this change is only related to the variation in the Mw of PCL. After that, different samples with a distinct average Mw are prepared and characterized by various experimental methods. Shape memory tests are performed on these blends, and the recovery rate (Rr) for each of them is determined. It is found that when Mw of PCL decreases, its degree of crystallinity, its glass transition, and its melting temperatures, corresponding to the PCL phase, increase. However, the elongation at break of the blend declines with the reduction in Mw. The tests show that the alteration in the blend's Mw influences its SME. Indeed, Rr of the (PCL/SBS) mixture drops with the decrease in Mw of PCL

Cryptic Leishmania infantum infection in Italian HIV infected patients

<p>Abstract</p> <p>Background</p> <p>Visceral leishmaniasis (VL) is a protozoan diseases caused in Europe by <it>Leishmania (L.) infantum</it>. Asymptomatic <it>Leishmania </it>infection is more frequent than clinically apparent disease. Among HIV infected patients the risk of clinical VL is increased due to immunosuppression, which can reactivate a latent infection. The aims of our study were to assess the prevalence of asymptomatic <it>L. infantum </it>infection in HIV infected patients and to study a possible correlation between <it>Leishmania </it>parasitemia and HIV infection markers.</p> <p>Methods</p> <p>One hundred and forty-five HIV infected patients were screened for the presence of anti-<it>Leishmania </it>antibodies and <it>L. infantum </it>DNA in peripheral blood. Statistical analysis was carried out by using a univariate regression analysis.</p> <p>Results</p> <p>Antibodies to <it>L. infantum </it>were detected in 1.4% of patients. <it>L. infantum </it>DNA was detected in 16.5% of patients. Significant association for PCR-<it>Leishmania </it>levels with plasma viral load was documented (p = 0.0001).</p> <p>Conclusion</p> <p>In our area a considerable proportion of HIV infected patients are asymptomatic carriers of <it>L. infantum </it>infection. A relationship between high HIV viral load and high parasitemic burden, possibly related to a higher risk of developing symptomatic disease, is suggested. PCR could be used for periodic screening of HIV patients to individuate those with higher risk of reactivation of <it>L. infantum </it>infection.</p

Southwest Atlantic water mass evolution during the last deglaciation

The rise in atmospheric CO2 during Heinrich Stadial 1 (HS1; 14.5–17.5 kyr B.P.) may have been driven by the release of carbon from the abyssal ocean. Model simulations suggest that wind‐driven upwelling in the Southern Ocean can liberate 13C‐depleted carbon from the abyss, causing atmospheric CO2 to increase and the δ13C of CO2 to decrease. One prediction of the Southern Ocean hypothesis is that water mass tracers in the deep South Atlantic should register a circulation response early in the deglaciation. Here we test this idea using a depth transect of 12 cores from the Brazil Margin. We show that records below 2300 m remained 13C‐depleted until 15 kyr B.P. or later, indicating that the abyssal South Atlantic was an unlikely source of light carbon to the atmosphere during HS1. Benthic δ18O results are consistent with abyssal South Atlantic isolation until 15 kyr B.P., in contrast to shallower sites. The depth dependent timing of the δ18O signal suggests that correcting δ18O for ice volume is problematic on glacial terminations. New data from 2700 to 3000 m show that the deep SW Atlantic was isotopically distinct from the abyss during HS1. As a result, we find that mid‐depth δ13C minima were most likely driven by an abrupt drop in δ13C of northern component water. Low δ13C at the Brazil Margin also coincided with an ~80‰ decrease in Δ14C. Our results are consistent with a weakening of the Atlantic meridional overturning circulation and point toward a northern hemisphere trigger for the initial rise in atmospheric CO2 during HS1.Key PointsDeep SW Atlantic was unlikely source of light carbon to atmosphere during HS1Mid‐depth isotopic anomalies due to change in northern component waterNorthern component water had robust influence in South Atlantic during HS1Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111970/1/palo20190.pd