Mucocèle sphénoïdale bilatérale : a propos d’un cas

Les mucocèles sphénoïdales sont des formations pseudokystiques expansives, d’évolution lente, qui se développent au sein de la cavité sinusienne sphénoïdale. Elles possèdent la capacité d’éroder les parois osseuses et présentent une évolution pseudotumorale. Les rapports neuroméningés et orbitaires font la gravité de cette localisation sinusienne  la présentation clinique qui est souvent d’apparition retardée par rapport à la constitution de la mucocèle. L’imagerie (TDM et IRM) permet le diagnostic positif et le diagnostic différentiel avec certains processus développés au niveau de l’étage moyen de la base du crâne. La marsupialisation chirurgicale par voie endoscopique endonasale permet l’effondrement de la mucocèle.Mots-clés : mucocèle, sinus sphénoïda

Soliton pinning by long-range order in aperiodic systems

We investigate propagation of a kink soliton along inhomogeneous chains with two different constituents, arranged either periodically, aperiodically, or randomly. For the discrete sine-Gordon equation and the Fibonacci and Thue-Morse chains taken as examples, we have found that the phenomenology of aperiodic systems is very peculiar: On the one hand, they exhibit soliton pinning as in the random chain, although the depinning forces are clearly smaller. In addition, solitons are seen to propagate differently in the aperiodic chains than on periodic chains with large unit cells, given by approximations to the full aperiodic sequence. We show that most of these phenomena can be understood by means of simple collective coordinate arguments, with the exception of long range order effects. In the conclusion we comment on the interesting implications that our work could bring about in the field of solitons in molecular (e.g., DNA) chains.Comment: 4 pages, REVTeX 3.0 + epsf, 3 figures in accompanying PostScript file (Submitted to Phys Rev E Rapid Comm

Morning melatonin ingestion and diurnal variation of short-term maximal performances in soccer players

Aim Very few studies have investigated the temporal specificity of melatonin (MEL) ingestion upon short-term maximal athletic performances. The aim of the present study was to explore the effect of morning MEL ingestion on cognitive and physical performances measured in the afternoon. Methods Twelve soccer players from a Tunisian squad (17.9 ± 1.3 years, 1.74 ± 0.06 m and 62.0 ± 8.8 kg) participated in the present study. They performed two testing sessions at 08:00 h, 12:00 h and 16:00 h after either MEL (5mg) or placebo (PLA) ingestion, in a randomized order. During each period, the participants performed the following cognitive and physical tests: reaction time and vigilance tests, medicine-ball throw (MBT), five jumps, handgrip strength (HG), and agility tests. Results cognitive and physical performances were significantly higher at 16:00 h compared to 08:00 h during the two conditions (p < 0.05). Moreover, performances of MBT and HG were lower in the morning with MEL in comparison to PLA (p < 0.05). However, MEL ingestion did not affect physical and cognitive performances measured at 12:00 h and 16:00 h. Conclusion morning MEL ingestion has no unfavourable effect on afternoon physical and cognitive performances in soccer players

Far-infrared study of the Jahn-Teller distorted C60 monoanion in C60 tetraphenylphosphoniumiodide

We report high-resolution far-infrared transmission measurements on C(60)-tetraphenylphosphoniumiodide as a function of temperature. In the spectral region investigated (20-650 cm(-1)), we assign intramolecular modes of the C(60) monoanion and identify low-frequency combination modes. The well-known F(1u)(1) and F(1u)(2) modes are split into doublers at room temperature, indicating a D(5d) or D(3d) distorted ball. This result is consistent with a dynamic Jahn-Teller effect in the strong-coupling limit or with a static distortion stabilized by low-symmetry perturbations. The appearance of silent odd modes is in keeping with symmetry reduction of the hall, while activation of even modes is attributed to interband electron-phonon coupling and orientational disorder in the fulleride salt. Temperature dependences reveal a weak transition in the region 125-150 K in both C(60)(-) and counterion modes, indicating a bulk, rather than solely molecular, effect. Anomalous softening (with decreasing temperature) in several modes may correlate with the radial character of those vibrations. [S0163-1829(98)03245-7]

Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire

Introduction The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK. Methods A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined. Results 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50–80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0–3.0) and 2.0 plastic surgeons (IQR:1.0–3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures. Conclusions The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients