Fracture panfaciale: un challenge thérapeutique: à propos d’une observation et revue de la littérature

La gestion des traumatismes de la face a subi plusieurs progrès dans la dernière décennie. Avec l'avènement de la tomodensitométrie bi- ettridimensionnelle, qui permet de dresser une cartographie précise des lésions osseuses, le développement du matériel d'ostéosynthèse, et lesprocédés de réduction des fractures. L'objectif est la restauration totale de la forme et la fonction de la face, seul garant pour empêcher lasurvenue de préjudices esthétiques et fonctionnels. Nous rapportons l'observation de Mme assal khadija, âgée de 38 ans, admise le 25 Aout 2010, au service des urgences d'ORL et maxillo-faciales, à l'hôpital 20 aout de Casablanca, victime d'un AVP, occasionnant un traumatisme facial grave, avec un important délabrement de la face, et asphyxie. Une trachéotomie a été réalisée en urgence. Le bilan lésionnel a objectivé un important fracas du massif facial intéressant l'étage supérieure, moyen et inférieur. Dans l'immédiat, un parage a été réalisé sous anesthésie  générale, la réparation des parties molles délabrées a été effectuée en endobuccale (vestibules, langue et plancher buccal) et pour les téguments de la face. Une semaine après, la patiente a été reprise pour la  reconstruction du massif facial, nous avons opté pour le «inside-out, de bas en haut" pour la réduction des fractures. Nous avons procédé à la fixation de la mandibule qui a précédé la reconstruction du maxillaire, de la pyramide nasale, et de l'orbite. L'évolution a été marquée par  l'apparition d'un orostome, qui fera l'objet après tarissement de l'infection, d'une réparation grâce à un lambeau myocutané, et une nécrose cutanée de la région zygomatique laissée à la cicatrisation dirigée. Toutes les  lésions traumatiques de la face ont des répercussions esthétiques et fonctionnelles à moyen et long termes, dont le degré dépend de la qualité de la prise en charge, qui étant la plus précoce et la plus complète possible avant la consolidation des fractures est le meilleur garant d'un résultat satisfaisant à long terme

Chemical analysis of acoustically levitated drops by Raman spectroscopy

An experimental apparatus combining Raman spectroscopy with acoustic levitation, Raman acoustic levitation spectroscopy (RALS), is investigated in the field of physical and chemical analytics. Whereas acoustic levitation enables the contactless handling of microsized samples, Raman spectroscopy offers the advantage of a noninvasive method without complex sample preparation. After carrying out some systematic tests to probe the sensitivity of the technique to drop size, shape, and position, RALS has been successfully applied in monitoring sample dilution and preconcentration, evaporation, crystallization, an acid–base reaction, and analytes in a surface-enhanced Raman spectroscopy colloidal suspension

Novel Structurally Designed Vaccine for S. aureus α-Hemolysin: Protection against Bacteremia and Pneumonia

Staphylococcus aureus (S. aureus) is a human pathogen associated with skin and soft tissue infections (SSTI) and life threatening sepsis and pneumonia. Efforts to develop effective vaccines against S. aureus have been largely unsuccessful, in part due to the variety of virulence factors produced by this organism. S. aureus alpha-hemolysin (Hla) is a pore-forming toxin expressed by most S. aureus strains and reported to play a key role in the pathogenesis of SSTI and pneumonia. Here we report a novel recombinant subunit vaccine candidate for Hla, rationally designed based on the heptameric crystal structure. This vaccine candidate, denoted AT-62aa, was tested in pneumonia and bacteremia infection models using S. aureus strain Newman and the pandemic strain USA300 (LAC). Significant protection from lethal bacteremia/sepsis and pneumonia was observed upon vaccination with AT-62aa along with a Glucopyranosyl Lipid Adjuvant-Stable Emulsion (GLA-SE) that is currently in clinical trials. Passive transfer of rabbit immunoglobulin against AT-62aa (AT62-IgG) protected mice against intraperitoneal and intranasal challenge with USA300 and produced significant reduction in bacterial burden in blood, spleen, kidney, and lungs. Our Hla-based vaccine is the first to be reported to reduce bacterial dissemination and to provide protection in a sepsis model of S. aureus infection. AT62-IgG and sera from vaccinated mice effectively neutralized the toxin in vitro and AT62-IgG inhibited the formation of Hla heptamers, suggesting antibody-mediated neutralization as the primary mechanism of action. This remarkable efficacy makes this Hla-based vaccine a prime candidate for inclusion in future multivalent S. aureus vaccine. Furthermore, identification of protective epitopes within AT-62aa could lead to novel immunotherapy for S. aureus infection

A Study on Residential Houses Using Shape Grammar (Case Study: Houses of Pahlavi Era in Tehran Province)

This article aims to explain a new model and achieve a basic pattern for the shape of houses using shape grammar. This study is a qualitative research based on description, explanation and interpretation. Phenomenological research is one of the most widely used traditions of qualitative research. The phenomenological method of this study is based on van Manen's methodology. The data analysis is conducted using shape grammar. In shape grammar process, the data are the houses selected by the researcher (five houses of Pahlavi era in Tehran). Finally, the main themes of research, e.g. connection to environment, calm, happiness and separation from everyday life, are extracted from spaces such as the Iwan (porch), basement, Howzkhaneh (spring house), green space, Hashti (vestibule) and Shahneshin (alcove room). Eventually, new patterns are created using shape grammar process in the decision tree. After understanding the concept, the basic shape pattern is created using shape grammar. Thus, the role of user in architectural quality of space and its types and evaluation of language pattern are identified by gathering the literature and researches, deepening the views of experts and architects and classifying them as introversion, privacy and types and typology

Quantifying the biomass of Australian subtropical woodlands using SAR inversion models

cited By 5The inversion of a numerical closed-form forest scattering model for quantifying woodland biomass and structure was investigated. A set of polynomials was established for double bounce scattering mechanism, which involves the stem height, diameter, dielectric constant, soil dielectric constant and root mean square roughness. Spatial estimates of total and component biomass were generated based on the resulting data layers derived through the modeling process, and by applying ratios of wet to dry biomass for key specie

Effect of maternal probiotic intervention on HPA Axis, immunity and gut microbiota in a rat model of irritable bowel syndrome

Objective: To examine whether maternal probiotic intervention influences the alterations in the brain-immune-gut axis induced by neonatal maternal separation (MS) and/or restraint stress in adulthood (AS) in Wistar rats. Design: Dams had free access to drinking water supplemented with Bifidobacterium animalis subsp lactis BB-12® (3x109 CFU/mL) and Propionibacterium jensenii 702 (8.0x108 CFU/mL) from 10 days before conception until postnatal day (PND) 22 (weaning day), or to control ad lib water. Offspring were subjected to MS from PND 2 to 14 or left undisturbed. From PND 83 to 85, animals underwent 30 min/day AS, or were left undisturbed as controls. On PND 24 and 86, blood samples were collected for corticosterone, ACTH and IgA measurement. Colonic contents were analysed for the composition of microflora and luminal IgA levels. Results: Exposure to MS significantly increased ACTH levels and neonatal fecal counts of aerobic and anaerobic bacteria, E. coli, enterococci and clostridia, but reduced plasma IgA levels compared with non-MS animals. Animals exposed to AS exhibited significantly increased ACTH and corticosterone levels, decreased aerobic bacteria and bifidobacteria, and increased Bacteroides and E. coli counts compared to non-AS animals. MS coupled with AS induced significantly decreased anaerobes and clostridia compared with the non-stress adult controls. Maternal probiotic intervention significantly increased neonatal corticosterone levels which persisted until at least week 12 in females only, and also resulted in elevated adult ACTH levels and altered neonatal microflora comparable to that of MS. However, it improved plasma IgA responses, increased enterococci and clostridia in MS adults, increased luminal IgA levels, and restored anaerobes, bifidobacteria and E. coli to normal in adults. Conclusion: Maternal probiotic intervention induced activation of neonatal stress pathways and an imbalance in gut microflora. Importantly however, it improved the immune environment of stressed animals and protected, in part, against stress-induced disturbances in adult gut microflora