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This work relates the experience of three French surgical missions in the care of the war wounded during the armed conflict in Nagorno Karabakh which took place from September 27 to November 10, 2020.Three surgical missions were carried out in Armenia between October 2020 and January 2021. Surgeons intervened in different hospitals, at different times of the conflict and on various war wounds.The presence of a plastic surgeon proved to be essential in the care of war wounded, especially in delayed emergency and secondary care. The ortho-plastic treatment offered during these missions has proven to be effective in the reconstruction of limbs. These missions made it possible to introduce the induced membrane technique of Masquelet AC in Armenia. During our visit to the Yerevan burn center, we mentioned the very probable use of white phosphorus as an etiology in several of the cases analyzed.We relate the particular experience of civilian surgeons in the context of a modern armed conflict. The presence of a plastic surgeon proved to be indispensable in the care of war wounded and especially in their secondary reconstructions.

This publication presents the results of 10 years of nomadic plastic surgery missions by a small French non-governmental organization: Interplast-France/surgery without borders (www.Interplast-France.net). This NGO is specialized in reconstructive surgery in challenging conditions and works in developing countries. We present a view of 10 years of missions carried out between 2003 and 2013. This experience covers a uniform period both by the objectives proposed and the regularity of missions observed. This work shows the way surgical missions take place and the methodology used. We carried out 30 missions. We made more than 4000 consultations and we operated 1500 patients. Interventions are divided into one quarter cleft, one quarter tumors, one quarter burn injuries and one quarter of various diseases such as noma and Buruli ulcer. We show some adaptations such as autonomy during missions, the adjustment guidance in relation to this new environment and the integration of local traditions in our therapeutic action. We offer practical notions on the surgical procedures and some reflections on the societal level. This work aims primarily to pay tribute to all the invisible actors in this long chain of humanity, and thanks to the simple intervention of men, a patient can have the same medical treatment whether he is in an industrial country or in some isolated place on this earth.

International audience; Beginning in the Early Neolithic Period (or LBK) and increasingly in the Middle and Later Neolithic periods (a transition spanning about 5,000-2,300 B.C.) in Europe, considerable energy was invested in quarrying and miningchert and flint for tool production. Acquisition of stone combined local sources with regional transport. Chipped stone was used in everyday activities and for objects that likely played a special role in exchange networks. Linkages between quarries and surrounding landscapes thus can shed light on patterns of travel, work, and trade at local and regional scales. Archaeologists are rarely able to link quarries and settlements in a detailed analysis. This paper reports on a long-term regional project investigating chert acquisition and tool production in quarry and settlement contexts in a chert-rich upland in southern Germany. We combine collections analysis, archaeological and geophysical survey, and targeted test excavations to document stone sources and site locations. We compare assemblages from a large open-pit quarry complex (Asch-Borgerhau) and from settlements at varying distances using a uniform coding system. Systematic, non-destructive petrographic characterization of chert enables us to trace material from the quarry or other sources to settlements. The resulting database offers rich potential for exploring chronological and spatial variation in stone acquisition, tool production, and activities on a Neolithic landscape

Die Gräberfelder Nebringen (Lkr. Böblingen/D), Münsingen-Rain (Kt. Bern/CH) und Monte Bibele (prov. Bologna/I) sind wichtige Fundorte im Kern- und Expansionsraum der Latènekultur, die sich im 4./3. Jahrhundert v. Chr. über die Alpen bis nach Norditalien ausweitete. Einige Grabfunde geben Hinweise auf Mobilität unter den Bestatteten. Dieses Phänomen wird in den Ergebnissen einer Strontiumisotopenanalyse teilweise widergespiegelt. Ortswechsel konnten für einzelne Individuen oder kleinere Personengruppen nachgewiesen werden – die Bewegung großer Bevölkerungsteile, wie sie uns von den antiken Autoren als keltische Wanderungen überliefert ist, wird hingegen nicht bestätigt., Archäologisches Korrespondenzblatt, Bd. 43 Nr. 3 (2013): Archäologisches Korrespondenzblatt

This work was done essentially for the benefit of the surgeon who wishes to practice plastic surgery under challenging conditions. The questions he asks himself are most often aimed at what type of pathology he will encounter during his mission, on the operating techniques he will have to adopt and the surgical principles he will have to observe in this type of environment. This presentation tries to come up with an answer, among others, by offering a concept which could be adapted to surgical techniques under challenging conditions. The study, retrospectively, of 100 patients operated during a mission led us to suggest six techniques of reconstructive surgery. We have observed the conditions in which we can apply these different techniques and we have paid a lot of attention and reflection on the environment of our therapy. Before going on a plastic surgery mission we strongly advise the surgeon to bear in mind, in his choice of a surgical technique, the following concepts: the ultimate goal to be reached, the feasibility of the surgical practice, the safety of the technique, the familiarity of the surgical procedure and the easiness to teach of the method.

The Buruli ulcer is a skin infection with Mycobacterium ulcerans which progresses silently. This infection affects mostly women and children who live near stagnant waters. Buruli ulcer is disease that has terrible consequences if not promptly diagnosed and treated. It destroys progressively skin tissues and consequently leaves very important scars. There is no efficient medical treatment. This presentation proposes to take care efficiently of the Buruli ulcer by simple plastic surgery techniques. We relate our experience of a mission in Benin, in the context of the national programme of struggle against the Buruli ulcer.

A questionnaire was addressed to 600 members of the French Society of Plastic Reconstructive and Aesthetic Surgery. Out of 19,000 interventions, thanks to the analysis of 112 answers, we were able to get a good picture of the activity in aesthetic surgery, showing the number and type of complications experienced during each intervention. Cosmetic surgical procedure represents 35% of global surgical activity of the French plastic surgeon. The most frequent interventions are liposuction (19%), breast augmentation (16%), eye-lid surgery (14%), abdominoplasty (12%), mammaplasty (10%), facelift (10%) and rhinoplasty (8%). The techniques for which we register more than 10% of problems are: abdominoplasty and mammaplasty. The techniques for which we register between 5% and 10% of problems are: rhinoplasty, facelift and breast augmentation. The techniques for which we register less than 5% of problems are: liposuction and eye-lid surgery. On average, the most frequent cosmetic surgical procedures give rise to 7% of complications.

Must a face be disfigured by a terrible tropical disease, in order to make us realise that the well being of our gesture is aesthetically acceptable? Must our reparative motivation remain the only trace of our skill and our humanity? During a plastic surgery mission, so-called humanitarian mission, can this surgery be aesthetic? Can aesthetic surgery be humanitarian? We learnt from aesthetic surgery on humanitarian missions, that aesthetic is only a technic to assist the reparation aspect. There is no need to justify aesthetic by reconstruction, because aesthetic belongs, in its entirety, to reparation. There is no need either to feel guilty, when our technical gesture is aesthetic, since what really motivates our intervention is not for us to decide. Is the reparation of the cleft lip of a little Asian girl, a reparation gesture or only an aesthetic approach? You may think that this will be a reparation gesture, because it will be more "popular" or because you will reconstruct the muscular belt. This child will most probably look for a more beautiful or aesthetic lip (in any case, she ignores the intricacies of facial growth principles). Therefore, it will be an aesthetic intervention. Never mind the motivation, since your technic will be the same, and you will try to do your very best and the most aesthetically you can. Only the very intention behind an intervention will decide whether it is an aesthetic or a plastic intervention, whereas your technical gesture will remain the same. All this illustrates that our definitions are of a minor importance, compared with the mere satisfaction of our little Asian girl, which, hopefully, will be a "beautiful" satisfaction. In fact, we have learnt not to do aesthetic surgery, but to give an aesthetic approach to our surgery, even during our humanitarian missions. The form aesthetic surgery will take is very subjective and only the final result will have the last say. Hopefully this surgical result will be aesthetically and humanly acceptable.

The authors wanted to evoke the main steps of the "star" operation that is the face lifting. They also wanted to recall what had been done, what is being done and what has passed off. They also wanted to toss out some ideas concerning the future, knowing of course that it is unpredictable.

This study proposes intraarterial in situ thrombolysis for the treatment of microthrombi occurring after tissue crushing. In order to assess the efficacy of the thrombolytic, the authors assayed the serum creatine phosphokinase (CPK) level in the crushed muscle capillary bed. The action of thrombolytics has now been clearly established. In contrast, the correlation between local thrombolysis and the serum CPK variation in crush injuries of striated muscle constitutes the originality of this paper. This experiment was conducted in twenty Wistar rats in which striated muscle crushing was performed. The serum CPK level assayed in venous blood, obtained from the capillary bed concerned, before and after local thrombolysis. The increased CPK level provided an objective indication of the efficacy of intra-arterial thrombolysis after crush injury. The authors now apply local thrombolysis according to a prospective clinical protocol for hand emergencies associated with a crush mechanism.

The elegance of the cervical region is due to a certain balance between concave and convex surfaces, and is based on the presence of a well-defined cervicomental angle, generally between 90 degrees to 110 degrees. An excessively wide-open cervicomental angle makes the cervical profile inelegant. Numerous surgical techniques can improve this angle. There is however a certain limit to this correction: an excessively caudal and anterior hyoid bone. In this case the last proposal is a modification of the hyoid bone position in order to replace it in a backward and upper location. To achieve this goal we studied postero-superior suspension of the hyoid bone by plication of the tendon of the digastric muscle in 20 anatomic dissection. Each an dissection was controlled by x-ray of the profile of the cervical region before and after application of this technique. Cephalometric measures were performed and statistically analysed using the "Paired t-test" on Statview II. Analysis of the results after the plication of the tendon of the digastric muscle, demonstrated an average closing of the cervicomental angle of 25.6 degrees with an average ascent of the hyoid bone of 13.27 millimeters and an average posterior transposition of 3.75 millimeters. This experimental cervicoplasty appears to be feasible. A precise surgical technique has been developed with an easy approach to the digastric tendon during standart faced lift procedures. The effect of the compression generated on the pharyngo-oesophageal complex by posterior transposition of the hyoid bone is unknown. This problem is now under investigation.

The calcium concentration of the bones of the hand measured by neutron activity was lowered in 93% of osteoporotic women aged between 50 and 60 years and in 66% of women between 60 and 70 years, whereas from the 8th decade onwards, only 5% had a bone calcium concentration of the hand less than that of controls. In the male sex, nearly 80% of osteoporotic patients, had a calcium concentration of the hand less than that of controls whatever their age. Considering the radiological criterion retained for the diagnosis of osteoporosis, the existence of at least one fracture of a vertebral body, the authors discuss the significance of these facts.

Cet article présente la mesure de la période, T1/2 = (2,15 ± 0,08) ns du premier niveau excité de 40Ca. Les mesures de coïncidences différées dans 132I ont permis de fixer l'ordre d'émission des deux rayons gamma de 52 keV et 232 keV ; les périodes sont égales à T1/2 = (0,96 ± 0,04) ns pour le niveau à 52 keV et à T1/2 = (1,42 ± 0,05) ns pour le niveau à 284 keV. Ces valeurs, et des mesures du coefficient de conversion interne α K, permettent d'attribuer les ordres multipolaires M1 + E2 et E2 respectivement pour les transitions de 52 et 232 keV.

Un multicompteur comprenant sept détecteurs NaI(T1) 3" x 3" a été construit. Il permet de mesurer simultanément les valeurs correspondant à 16 angles de la fonction de corrélation angulaire W(θ1, θ 2, ϕ) ou les sept géométries définies par Litherland et Ferguson. Cet ensemble a été expérimenté avec succès dans le cas de corrélations angulaires bien connues aussi bien en désintégrations radioactives qu'en réactions nucléaires.

Des corrélations angulaires entre neutrons émis dans l'axe du faisceau et les rayons γ ont été mesurées dans la réaction 48Ca(p, n) 48Sc. Les deux premiers niveaux excités ont été étudiés ; les rayons γ de 122 et 131 keV ont été détectés dans une jonction Li-Ge. Les coïncidences γ-γ ont été rejetées par une sélection de temps de vol des neutrons.