Peri-insular hemispherotomy in paediatric epilepsy

Objects: Outline the indications, investigation, surgical technique, pitfalls, complications and benefits of peri-insular hemispherotomy (PIH) in the surgical treatment of paediatric epilepsy. Materials and methods: This report is based on a consecutive series of 43 children who underwent PIH. Sixty percent were males; there were slightly more left-sided surgeries. Median interval between seizure onset and surgery was 5 years. In more than half the cases, the anatomical substrate was congenital. There were few complications: one death, one hydrocephalus and two anatomically remote haemorrhages. Ninety percent of the patients have remained in Engel's class I epilepsy outcome. Conclusions: There are clear indications for hemispherectomy in children. In some instances of incomplete deficit, timing of surgery remains a major concern. The less invasive approach to eliminate the influence of the diseased hemisphere, in our opinion, is with disconnective techniques of hemispherectomy, and among the latter, peri-insular hemispherotomy provides, in our opinion, the best complications-benefits rati

First Confirmed Occurrence of a Wolf, Canis lupus, South of the St. Lawrence River in Over 100 Years

A large canid was snared near Sainte-Marguerite-de-Lingwick, Québec, in January 2002. DNA analysis confirmed the animal to be a Wolf (Canis lupus). Wolves were extirpated from this region around 1850-1900 and this is the first confirmed observation since then

Isolation and characterization of gelatin-binding proteins from goat seminal plasma

A family of proteins designated BSP-A1, BSP-A2, BSP-A3 and BSP-30 kDa (collectively called BSP proteins for Bovine Seminal Plasma proteins) constitute the major protein fraction in the bull seminal plasma. These proteins interact with choline phospholipids on the sperm surface and play a role in the membrane stabilization (decapacitation) and destabilization (capacitation) process. Homologous proteins have been isolated from boar and stallion seminal plasma. In the current study we report the isolation and preliminary characterization of homologous proteins from goat seminal plasma. Frozen semen (-80°C) was thawed and centrifuged to remove sperm. The proteins in the supernatant were precipitated by the addition of cold ethanol. The precipitates were dissolved in ammonium bicarbonate and lyophilised. The lyophilised proteins were dissolved in phosphate buffer and loaded onto a gelatin-agarose column, which was previously equilibrated with the same buffer. The column was successively washed with phosphate buffer, with phosphate buffer saline and with 0.5 M urea in phosphate buffer saline to remove unadsorbed proteins, and the adsorbed proteins were eluted with 5 M urea in phosphate buffer saline. Analysis of pooled, dialysed and lyophilised gelatin-agarose adsorbed protein fraction by SDS-PAGE indicated the presence of four protein bands that were designated GSP-14 kDa, GSP-15 kDa, GSP-20 kDa and GSP-22 kDa (GSP, Goat Seminal Plasma proteins). Heparin-affinity chromatography was then used for the separation of GSP-20 and -22 kDa from GSP-14 and -15 kDa. Finally, HPLC separation permitted further isolation of each one from the other. Amino acid sequence analysis of these proteins indicated that they are homologous to BSP proteins. In addition, these BSP homologs bind to hen's egg-yolk low-density lipoproteins. These results together with our previous data indicate that BSP family proteins are ubiquitous in mammalian seminal plasma, exist in several forms in each species and possibly play a common biological role

The role of posterior fossa decompression in acute cerebellitis

Background: We present two cases of children who were diagnosed with cerebellitis with acute cerebellar swelling. This rare pathology is potentially fatal, and no clear treatment guidelines are described in the literature. Discussion: Considering our experience, we discuss the different therapeutic strategies and propose aggressive surgical measures consisting of external ventricular drainage and posterior fossa decompression in case of failure of early response to medical treatment to limit secondary cerebellar and brainstem lesion

Lymphomatoid granulomatosis in a renal transplant patient

Lymphomatoid granulomatosis is a rare angiocentric and angiodestructive pulmonary angiitis considered as a variant of the lymphoproliferative disorder group. Patients with organ transplantation are at an increased risk for post-transplant lymphoproliferative disorders secondary to their immunosuppression. However, lymphomatoid granulomatosis has rarely been described in patients with renal transplantation. It often presents with severe pulmonary signs. We describe a case whose initial presentation was an isolated VIth nerve palsy. We review the radiological and pathological findings and discuss the etiopathogenesis and therapeutic options of this particular lymphoproliferative disorder. With careful and stepwise reduction in her immunosuppression, our patient showed a complete disappearance of her lymphomatoid granulomatosis, and she is clinically well more than 3years after the diagnosis, with good kidney functio

« L’empêchement moteur » : les fonctions des procédés métatextuels dans l’œuvre d’Hervé Bouchard

L’ensemble de l’œuvre d’Hervé Bouchard adopte à la fois une esthétique autoréflexive et un rapport apparemment mimétique avec le réel. Ce travail de l’illusion et de l’artificialité est constant et produit plusieurs effets de distanciation qui participent à la prise de conscience de la situation d’énonciation et plus amplement à une réflexion sur l’écriture. Dans ce mémoire, nous montrons les différents rapports entre les procédés métatextuels, les effets de distanciation et l’empêchement de dire des personnages, thématisé dans l’œuvre. Non seulement les procédés métatextuels, par leur fonction de révélation, renvoient aux thèmes explorés par Bouchard, tels que la honte, le deuil et les tabous de l’enfance, mais ils témoignent également des choix formels de l’écrivain, qui interroge les limites de toute forme de représentation, dont le théâtre et le langage. Notre premier chapitre est consacré à la théâtralité, utilisée comme procédé métatextuel, manifestée par une mise en forme dramaturgique, une mise en abyme du théâtre comme lieu et comme métaphore d’un cadre prescriptif. À partir de ces ruptures génériques et référentielles, notre deuxième chapitre porte sur les répercussions de l’empêchement de dire des personnages sur la syntaxe et la structure de l’œuvre. L’analyse des formes répétitives, des ellipses et des digressions nous permet d’établir un échantillon des différents procédés auxquels l’écrivain a recours. Dans une perspective plus poétique, notre troisième chapitre montre les liens entre les interruptions et les digressions qui sont autant d’amorces de petites histoires dont la somme constitue, à la manière de fragments, l’œuvre dans son ensemble. L’analyse des effets de continuité produits, entre autres, par les références intratextuelles, la langue, le lieu et les figures de l’auteur, en appelle ainsi à un horizon légendaire, un récit plus vaste auquel se rattacheraient toutes ces histoires. Dans le même mouvement, la cohérence de l’œuvre est fortement et intentionnellement soulignée.The work of Hervé Bouchard embraces a self-reflective aesthetic and, at the same time, a mimetic link with reality. This approach of illusion and artificiality is perpetual and produces distancing effects that take part in the awareness of the context of enunciation and largely of an ongoing reflection on the act of writing. In this thesis, we show different relationships between the metatextual processes, distancing effects and the characters’ impediment to express themselves, thematized in Bouchard’s work. The metatextual processes, in their function of exposure, can refer to the themes explored by the author, like shame, mourning and childhood taboos ; in addition they attest to his aesthetic choices, that question the limits of all types of representation, including theater and language. Our first chapter is dedicated to the theatricality and how it is used as a metatextual process, expressed by a dramaturgic formatting, a mise en abyme of theater as a space and the metaphorical use of theater as a prescriptive framework. From those generic and referential ruptures, our second chapter takes on the repercussions of the characters’ impediment to express themselves on the texts’ syntax and structure. The analysis of the repetitive patterns, ellipses and digressions allows us to establish a sample of the various processes used by the author. With a more poetic perspective, our third chapter shows the links between the interruptions and the digressions. They are the start of brief stories, which can be perceived as fragments of a larger narrative. The analysis of the effects of continuity created by intratextual references, the language, the place and the forms of the author, call for a legendary horizon in which these stories would be connected. In the same way, the coherence of Bouchard’s work is strongly and willingly emphasised

Myxoid fibroblastic tumor of the maxillary sinus in a 21-month-old child: an unusual diagnosis

Myxoid tumors of the soft tissue are a heterogeneous group of lesions with significant differences in behavior, from being totally harmless to malignant tumors with metastasizing potential. We describe the unusual case of a 21-month-old boy who developed a paranasal low-grade myxoid neoplasm with recurrent potential. The histological findings showed a proliferation of spindle cells within a vascular and myxoid background. The immunohistochemistry had the features of myofibroblasts and fibroblasts with strong Vimentin and light Smooth Muscle Actin reactivity. Close collaboration between clinician and pathologist is necessary to deal with these unusual lesions to predict their local aggressiveness and long-term behavior. Most of these cellular myxomas have been described in adults, involving primarily the limbs, but this case shows that any localization is possibl