Neoangiogenesis assessment in gliomas with 68Ga‐NODAGA‐RGD PET and IVIM MR Imaging - a pilot study.

Background and purpose: Recent development of anti-angiogenic drugs in oncology without any direct marker of angiogenesis has lead to the elaboration of a new PET tracer referred as 68Ga-NODAGA-RGD. This radiotracer consists of a sequence of three amino acids abbreviated RGD and has the to capacity to bind to αVβ3 integrins present tumoral vessels. We evaluate this new tracer in the framework of tumoral angiogenesis in native gliomas. The aim of this study is to describe the distribution of the tracer compared to 18F- FET PET that highlights tumor protein transport and to IVIM MRI that highlights micro-perfusion. Long-term work consists of determining whether RGD tracer could allow a better selection of patients who could benefit from an anti-angiogenic treatment and an earlier assessment of response to treatment. Materials and methods: Two patients were included in this study. A qualitative analysis of the tracer uptake compared to 18F-FET PET and IVIM MRI was realized. Results: Our first patient had a bi-component glioblastoma/high-grade glioma with an anterior part corresponding to a WHO grade IV glioblastoma and a posterior part to a high-grade glioma. RGD was only taken up by the glioblastoma part whereas 18F-FET was taken up by both parts. The comparison with IVIM showed no correlation in this patient. The second patient with a WHO grade II ganglioglioma showed no RGD uptake, no IVIM signal but a high 18F-FET uptake by the whole tumor. Conclusions: RGD uptake shows a different process than 18F-FET PET and IVIM MRI in gliomas in two patients. This needs to be further examined in a larger cohort to consolidate our interesting preliminary results

"Menghidupkan" Undang-Undang Dasar 1945 tanpa Amandemen

Penelitian ini mengkaji tentang penyebab sulitnya amendemen kelima UUD 1945 dan mengkaji cara lain untuk mewujudkan UUD 1945 sebagai konstitusi yang hidup tanpa melalui prosedur formal. Penelitian ini adalah penelitian hukum normatif dengan menggunakan pendekatan peraturan Perundang-undangan, konsep, sosiologis, politik, dan pendekatan sejarah. Hasil penelitian ini menunjukkan bahwa sulitnya menghidupkan UUD 1945 melalui amendemen kelima dikarenakan prosedur formal Perubahan UUD 1945 yang terlalu rigid, amendemen kelima tidak mendapatkan dukungan politik, dan persoalan momentum yang belum tepat. Kendatipun demikian, ada cara lain yang dapat ditempuh untuk mewujudkan UUD 1945 sebagai konstitusi hidup yaitu melalui pengaturan di dalam undang-undang, melalui interpretasi hakim konstitusi, dan melalui konvensi ketatanegaraan

Physiological Intracranial Calcifications in Children: A computed tomography-based study

Objectives: Physiological intracranial calcifications (PICs) are benign in nature and related to aging. We aimed to study the frequency of physiological intracranial calcifications (PICs) in pediatric population using computed tomography (CT). Methods: The brain CT scans of consecutive patients (age range, 0-15 years) who had visited Sultan Qaboos University Hospital from January 2017 to December 2020 were retrospectively assessed for the presence of PICs. The presence of calcifications was identified using 3 mm thick axial images, and coronal and sagittal reformats. Results: A total of 460 patients were examined and the mean age was 6.54 ± 4.94 years. The frequency of PIC in boys and girls was 35.1% and 35.4%, respectively. PICs were most common in choroid plexus with 35.21% (age range 0.4 -15 years; median, 12 years), followed by the pineal gland in 21.08% (age range 0.5 -15 years; median, 12 years) and the habenular nucleus in 13.04% of subjects (2.9 -15 years; median, 12 years). PICs were less common in falx cerebri with 5.86% (age range 2.8-15 years; median, 13 years) and tentorium cerebelli in 3.04% (age range 7-15 years; median, 14 years) of subjects. PICs increased significantly with increasing age (p<0.001). Conclusion: Choroid plexus is the most frequent site of calcification. Choroid plexus and pineal gland calcifications may be present at less than 1 year of age. Recognizing PICs is clinically important for radiologists as they can be mistaken for hemorrhage or pathological entities like neoplasms or metabolic diseases. Keywords: Calcification; Pineal gland; Dura Mater; Brain; Computed Tomograph

Carcinome papillaire sur kyste du tractus thyreoglosse

Introduction :: Cysts of the thyroglossal duct are a congenital anomaly. they are common but the incidence of papillary carcinoma arising in a thyroglossal duct cyst (TDC) is rare. The clinical presentation of these cancers is generally nonspecific. There are usually identified only after histopathologic examinationAim: Modalities of treatment and prevention are discussed.Methods: We report 4 cases of a papillary carcinoma developed on a thyroglossal duct cyst, who underwent surgery. Two cases have been detected on préopératory and two at the definitive anatomopathology. Our therapeutic attitude has been discussed in each of our 4cases.Conclusion: there is no consensus about the modalities of treatment of papillary carcinoma in thyroglossal duct cyst.Keywords: Thyroglossal duct cyst, Thyroid, Papillary carcinoma, surgery, Total thyroidectomy

Diagnostic et prise en charge de l’hyperparathyroïdie primaire

Objectif : L’hyperparathyroïdie primaire (hPTP) est définie par la production excessive et inappropriée de parathormone (PTh). Les formes asymptomatiques et modérées sont devenues de plus en plus fréquentes. Le but de ce travail est d’étudier les caractéristiques cliniques et paracliniques de l’hPTP, de préciser les indications thérapeutiques et de les discuter en comparant nos résultats avec ceux de la littérature.Matériel et méthodes: Il s’agit d’une étude rétrospective à propos de 86 patients colligés entre Janvier 2005 et Décembre 2010. Tous les patients ont bénéficié d’un examen ORL et d’un bilan biologique comportant une calcémie et un dosage de la PTh. Le bilan radiologique comportait une échographie cervicale, une scintigraphie au MIBI et/ou une IRM cervicale.Tous les patients ont été opérés sous anesthésie générale et ont eu une cervicotomie par approche classique. La surveillance a été clinique et biologique avec un recul moyen de 16 mois (4-36 mois).Résultats : La calcémie était élevée chez 77 patients (89,5%) et la PTh chez tous les patients. Une échographie cervicale a été réalisée chez 79 patients et a montré une image en faveur d’un adénome parathyroïdien chez 37 d’entre eux (46,8%). La scintigraphie au MIBI, pratiquée chez 46 patients, a montré une hyperfixation dans 31 cas (67,4%). L’IRM aété pratiquée chez 5 patients et a révélé un adénome dans 3 cas.L’exploration chirurgicale avec examen extemporané a révélé un adénome unique chez 65 patients deux adénomes chez 12 patients, et une hypertrophie des 4 PTh chez 9 autres. Une exérèse des adénomes a été ainsi réalisée chez 77 patients et une parathyroïdectomie subtotale dans 9 cas. en post-opératoire, 12 patients (14%) ont présenté une hypocalcémietransitoire. Aucune hypocalcémie définitive ni paralysie récurrentielle n’ont été notées. L’examen anatomopathologique définitif a révélé un adénome unique, un adénome double, une hyperplasie et PTh normale respectivement chez 58, 3, 24 et 1 patients. L’évolution à long terme a été marquée par l’amélioration clinique et biologique chez 81 patients  (94,2%). Une non-amélioration clinique et biologique a été notée chez 5 patients. Ils ont été réopérés et ont eu une parathyroïdectomie subtotale. L’anatomopathologie confirmait l’hyperplasie dans tous les cas.Conclusion : Le traitement de l’hPTP symptomatique est chirurgical. L’approche classique a fait preuve de son efficacité. Les progrès récents des explorations préopératoires et le dosage peropératoire de la PTh ont rendu possible une approche mini-invasive. Des controverses persistent quant à la prise en charge de l’hPTP asymptomatique dont l’indicationthérapeutique doit être bien étudiée.Mots-clés : hyperparathyroïdie primaire, adénome, glande parathyroïde, parathormone, scintigraphie, parathyroïdectomi

Kyste Amygdaloïde Oropharynge A Propos D\'un Cas

Le kyste amygdaloïde est une tumeur kystique latéro-cervicale haute rare, issue de la 2ème fente branchiale. Il représente 2% des tumeurs latéro-cervicales du cou, et 6,1à 85,2% des anomalies de la deuxième fente. La forme oropharyngée est très rare. Nous rapportons une observation d\'un kyste amygdaloïde oropharyngé, chez une femme de 56 ans. Aucune symptomatologie particulière n\'a été notée. L\'examen clinique a révélé une tuméfaction de la loge amygdalienne droite, refoulant le pilier antérieur. La TDM a objectivé un processus expansif nécrosé de l\'amygdale palatine droite comblant l\'espace parapharyngé droit, en contact avec la base de la langue et le muscle ptérygoïdien médial homolatéral. Une résection complète et sans rupture du kyste a été pratiquée par voie transorale, le geste a été complété par une amygdalectomie droite. L\'histologie a confirmé le diagnostic par la co-existence d\'un revêtement épithélial et d\'une infiltration de tissu lymphoïde. Le recul est de 6 mois sans récidiveSecond branchial cleft cysts are the most common type of branchial abnormalities and usually found high in the neck. Oropharyngeal presence of branchial cleft cyst is very rare. We report a case of oropharyngeal branchial cleft cyst in 56 years women, wich had any specific symptom. Radiologic examination (TDM) revealed an expansive mass of the palatin tonsil. It was removed completely with right palatin tonsil. Cyst had a squamous epithelium-lined wall with lymphoid aggregation in histopathologic study, which was chareacteristic finding of branchial cleft cyst. There was no evidence of recurrence for 6 months for follow-up. We review reported oropharyngeal or nasopharyngeal presentation of these cases in literature and embryologic explanation. Keywords: Oropharyngeal, branchial, cysts Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 18 2007: pp. 49-5

Hematome Retropharynge Spontane : Apropos D\'un Cas

L\'hématome retro-pharyngé est une affection rare souvent d\'origine traumatique. La survenue d\'un HRP de façon spontané est exceptionnelle. Le but de notre travail est de rapporter à travers une observation les manifestations cliniques, les différentes hypothèses étiopathogéniques ainsi que les modalités thérapeutiques des HRP. Notre patiente âgée de 40 ans a consulté en urgence pour une ecchymose cervicale apparue spontanément. Les différentes investigations se sont révélées non concluantes. Sous surveillance, l\'évolution a été spontanément favorable.Spontaneous Retropharyngeal Haematoma (SRH) is a rare affection witch occur without traumatism. We report a case of 40\'s old year woman who present a SRH and discuss ethiopathogeny, clinic\'s and therapeutic\'s involvement Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 16 2006: pp. 33-3

Osteite frontale post-sinusitique: Etude rétrospective à propos de 31 cas

Objective : Post-sinusitic frontal osteitis is defined as an extension of frontal sinus infection to the adjacent bony structures. It is an emergency that should rapidly be diagnosed and treated. The aim of this study is to analyze epidemiologic, clinical and paraclinical features, and to review different therapeutic modalities of this disease.Materials and methods : We carry a retrospective study about 31 patients diagnosed and treated between 1996 and 2010. All patients underwent complete ENT and neurological examination, biological investigations, sino-nasal and cerebral CT scan. Antibiotherapy was administrated intravenously. Surgical drainage of the frontal sinus was performed eitherby trephination, by osteoplastic flap confection, or by Lemoyne drain placement. Endonasal drainage consisted of middle meatotomy with anterior ethmoidectomy. Frontal sinus cranialisation was performed with coronal approach. Evolution was assessed on clinical, biological and radiological criteria.Results : Mean age was 24,4 years (8-62 years) and sex-ratio 4,16. Frontal headache (10 cases) and intracranial hypertension signs (8 cases) were the most frequent functional symptoms. Frontal tumefaction was noted in 9 patients, associated in 5 cases with orbital tumefaction of the internal eye angle. Rhinological signs were essentially purulent rhinorrhea(9 cases) and nasal obstruction (5 cases). Nasal endoscopy showed purulent secretions at themiddlemeatus in 12 cases. CT scan revealed a typical aspect of frontal osteitis with bony lysis. A sub-periostal abscess was associated in 7 patients. Intracranial extension was noted in 15 cases and orbital extension in 7 cases. Bacteriological examination was positivein 8 cases. Most frequent bacteria were streptococcus and staphylococcus aureus (3 cases each). Antibiotic therapy was initially administrated in all cases. Concerning initial surgical treatment, 9 patients underwent frontaldrainage and 2 others orbital drainage. On the other hand, 4 patients underwent only sub-periostal abscess drainage. This one was associated with cranialisation in another case. For patients having endocranial complications, empyema drainage was realized in 14 cases, associed in 6 of them with cranialisation. Cerebral abscess drainage was performedin one other patient. Clinical and radiological evolution was favourable in 24 patients (77,4%). The seven other patients were reoperated because of persistence or aggravation of clinical symptoms. Later evolution was favourable.Conclusion : Post-sinusitic frontal osteitis a rare and serious affection. Diagnosis, based on clinical and radiological features, should be early made. Adequate treatment have to be instituted to prevent life-threatening complications.Keywords : osteitis, frontal sinus, sinusitis, computed tomography, drainage, cranialisatio

Adhesion Mechanisms of Plant-Pathogenic Xanthomonadaceae

The family Xanthomonadaceae is a wide-spread family of bacteria belonging to the gamma subdivision of the Gram-negative proteobacteria, including the two plant-pathogenic genera Xanthomonas and Xylella, and the related genus Stenotrophomonas. Adhesion is a widely conserved virulence mechanism among Gram-negative bacteria, no matter whether they are human, animal or plant pathogens, since attachment to the host tissue is one of the key early steps of the bacterial infection process. Bacterial attachment to surfaces is mediated by surface structures that are anchored in the bacterial outer membrane and cover a broad group of fimbrial and non-fimbrial structures, commonly known as adhesins. In this chapter, we discuss recent findings on candidate adhesins of plant-pathogenic Xanthomonadaceae, including polysaccharidic (lipopolysaccharides, exopolysaccharides) and proteineous structures (chaperone/usher pili, type IV pili, autotransporters, two-partner-secreted and other outer membrane adhesins), their involvement in the formation of biofilms and their mode of regulation via quorum sensing. We then compare the arsenals of adhesins among different Xanthomonas strains and evaluate their mode of selection. Finally, we summarize the sparse knowledge on specific adhesin receptors in plants and the possible role of RGD motifs in binding to integrin-like plant molecules

Enhancement of Workers' Occupational Health, Safety and Welfare in Ashghal Projects

One of Ashghal's core values and top priority is the occupational health and safety of customers, employees and contractors. Ashghal prioritizes and is concerned about developing the welfare of workers on the site and in the camp. Ashghal develops welfare specifications for the projects to protect workers and be sure the specifications align with international and national requirements. The specification covers the facilities within the site, such as: number of toilets, handwashing basins, rest area/mess hall, shelter, drinking water, first aid room, transportation, clinic, etc. Ashghal develops an implementation and monitoring system to be sure welfare specifications are provided to all workers, referring to welfare specifications as contractual requirements, then linking workers' welfare as one of the monthly KPIs for the project, implementing it by the contractor, and monitoring it by the consultant. Ashghal is also working on developing specifications and requirements for workers' welfare, for example, developing and updating the specifications and requirements for their welfare on Ashghal construction sites, which will be issued soon as the "ACS.