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Background: Following WHO guidelines, microscopy is the reference for malaria diagnosis in endemic countries. The Parasitology-Mycology laboratory (LPM) is the National Reference Laboratory and is currently undergoing ISO 15189 accreditation. In this perspective, we proceeded to laboratory verification through assessing the performance of the laboratory by confirming the reliability and the accuracy of the results obtained in accordance with the requirements of the ISO 15189 standards. This study aimed to verify the method of microscopic diagnosis of malaria at the LPM, in the Aristide Le Dantec hospital (HALD) in Dakar, Senegal. Methods: This is a validation/verification study conducted from June to August 2020. Twenty (20) microscopic slides of thick/thin smear with known parasite densities (PD) selected from the Cheick Anta Diop University malaria slide bank in Dakar were used for this assessment. Six (6) were used to assess readers' ability to determine PD and fourteen (14) were used for detection and identification of parasites. Four (4) LPM-HALD microscopists read and recorded their results on prepared sheets. Data analysis was done with Microsoft Excel 2010 software. Results: Of these twenty (20) slides read, a 100% agreement was obtained on eight (8) slides. Four (4) out of the six (6) parasite density evaluation slides obtained a concordance of less than 50%. Thirteen (13) out of the fourteen (14) identification slides obtained a concordance greater than 50%. Only one (1) identification slide obtained zero agreement from the readers. On the other hand, for species identification it was noted a score greater than 80% and the PD obtained a score between 0.20 and 0.4. Readers obtained 100% precision, sensitivity, specificity and both negative and positive predictive values. Conclusion: This work demonstrated that the microscopic method of malaria diagnosis used in the LPM/HALD are in accoradance with all the reliability required by ISO 15189.

Objective The Maze IV (M-IV) procedure is regarded as the golden standard in treatment for surgical ablation of atrial fibrillation (AF); however, long-term follow-up results are scarce. We present our institutional 10-year experience. Methods We collected data of 117 consecutive patients who have undergone a concomitant M-IV procedure between April 2006 and April 2016. Primary endpoints are freedom of atrial arrhythmias and freedom of atrial arrhythmias off antiarrhythmic drugs (AAD). Results Forty-seven patients (40.2%) had paroxysmal AF. Two-thirds of the procedures included mitral valve surgery. The average follow-up time per patient was 3.8 years (SD 2.8). Freedom of AF at 1 year was 79%, at 5 years freedom of AF was 69% and freedom of AF off AAD was 56%. Predictors of AF recurrence in multivariate analysis were age, preoperative pacemakers, redo cardiac surgery and in-hospital AF. Preoperative PVI ablation was found to be a protective factor. Conclusions The long-term outcomes of the M-IV procedure are good and remain stable over the years. Results could be improved if follow-up were to be intensified and recurrences dealt with aggressively. Key question: How many patients are free from AF in a 10-year period after concomitant M-IV surgical ablation? Key findings: In the long term around 70% of patients are free of AF with an increasing need for anti-arrhythmic drugs. Take home message: Early to midterm freedom from AF after concomitant M-IV procedure is high and remains stable after 3 years.

Inguino-scrotal sliding hernia of the bladder (IBH) is a rare condition. Frequently, it is asymptomatic but sometimes it can be complicated by urosepsis and incarceration.A 74-year-old male with an IBH was admitted to the intensive care unit with urosepsis, acute renal insufficiency and incarceration of the herniated bladder. A two-step approach was performed to repair this complicated hernia. Firstly, the incarcerated bladder was reduced during a laparoscopic, trans-abdominal approach. Ten days later - after treatment of the urosepsis with antibiotics and normalisation of the inflammatory parameters - a Lichtenstein hernia repair was completed. The laparoscopic approach allowed correcting the acute incarceration of the bladder with possibility to inspect the bladder for iatrogenic bladder perforation. And after treating the urosepsis with adequate antibiotics, the second step was performed through an open Lichtenstein hernia repair, thus minimising the risk of mesh infection.In case of an IBH, complicated by urosepsis, a laparoscopic reduction of the herniated bladder followed by a Lichtenstein hernia repair in a second time is a valid option.

Conclusions et Resume. 1. L'E.R.G. donne, dans la retinopathie diabetique, des valeurs sensiblement normales, meme dans les cas graves avec nombreux exsudats et hemorragies de la retine, aa l'exception des cas de retinite proliferante, ou la reponse est subnormale; la duree du potentiel b a tendance a augmenter. Dans la retinopathie hypertensive par contre, du moins au stade III ou IV de Wagener et Keith, la reponse devient subnormale et la duree de l'onde b est plutot reduite. 2. L'interposition de filtres interferentiels blue et vert donne des tracees qui ne se distinguent en rien des traces normaux. 3. L'action des vasodilatateurs (priscol) sur l'amplitude du potentiel b est tres variable aussi bien dans la retinopathie diabetique que dans la retinopathie hypertensive. Aussi ne pouvons nous, en clinique, attribuer aucune signification generalement dans les limites des variations spontanees que l'on peut observer chez sujets normaux.

Resume. Dans les paralysies oculaires completes ou incompletes, le trace oculographique obtenu lors de la rotation du globe oculaire par contraction du muscle attient, pr%eAsente des modifications caracteristiques: absence de deflexion de la ligne isoelectrique, deflexion irreguliere et amplitude diminuee, mouvements nystagmiformes, etc. Dans les paresies oculaires legeres ou gueries les modifications du trace peuvent n'apparaitre que les petits mouvements qui se produisent a la lecture ou dans le nystagmus optocinetique. Summary. In the ocular palsies, complete or incomplete, the oculographic record taken during the rotation of the eyeball caused by contraction of the paralysed muscle, presents characteristic modifications: no deflexion at all of the iso-electric line, irregular deflexion, diminished amplitude, nystagmiform movements etc. In the slight or healed ocular palsies, modifications of the oculographic record may only appear for small movements, as those produced by reading or optokinetic nystagmus.

En raison du probleme pathogknique qui se pose, il nous a paru interessant de rapporter deux cas de zona ophtalmique, qui se sont compliques d'une hyper- tension oculaire subaigue homolaterale, celle-ci s'etant declaree 6 et 14 jours apreks I'apparition des veksicules cutanPes et ayant precede de 2 et de 8 jozlrs des signes evidents d'iridocyclite.

Resume. 1 Dans le syndrome de Basedow aussi bien la retraction hypertonique de la paupiere superieure avec asynergie oculopal palpebrale que l'exophtalmie habituelle ou maligne sont sous la dependance de l'hormone thyreotrope. 2 L'amelioration des manifestations tant orbitaires que palpebrales de la maladie de Basedow par la folliculinothepie constitue une preuve supplementaire du role de l'hormone thyreotrope. 3 Les oestrogenes constituent en effet d'excellents agents hypophysofreateurs et diminuent de ce fait la production de l'hormone therkotrope. 4 I1 faut employer les oestrogenes naturels a hautes doses, quotidiennes et longtemps prolongees: on injecte par voie intramusculaire au moins 5 milligr. de benzoate d'oestradiol tous les jours ou tous les deux jours.

Resume. Les auteurs rapportent trois observations de tumeur primitive du nerf optique: un cas de gliome et deux cas de meningoblastome. Ces derniers paraissent bien, tant au point de vue topographique qu'au point de vue histologique, s'etre developpes primitivement aux depens des gaines intraorbitaires du nerf optique. Dans le premier cas de meningoblastome, la plus grande partie de la tumeur est constituee par des cellules fusiformes qui se groupent en faisceaux tourbillonnants; en differents endroits les groupes cellulaires prennent une disposition alveolaire. Dans le second cas on trouve des cellules fortement allongees et d'apparence fibrillaire. A certains endroits la tumeur prend un aspect myxomateux. A d'autres on revolt les groupes cellulaires a disposition nettement alveolaire comme le premier cas. Le gliome du nerf optique, presentant une proliferation massive de cellules gliales du type oligodendrocyte ou du type astrocyte protoplasmique, a ete etudie au microscope par contraste de phase. Les auteurs insistent d'une part sur la symptomatologie tres differente du meningiome orbitaire et du gliome du nerf optique et d'autre part sur l'inutilite de la classification des meningoblastomes en differents types, qui ne servent qu'a entretenir une certaine confusion. Summary. The authors report three cases of primitive tumour of the optic nerve: one gliome and two meningoblastomes. Topographically as well as histologically the meningoblastomes seem to have found their origin in the intraorbital sheaths of the optic nerve. The largest part of the tumor, in the first case of meningoblastome, shows spindle-shaped cells, grouped in whirled bundles, which usually show an alveolar disposition. In the second case, the greatest part of the tumor consists of very long cells of fibrillar appearance. In some small areas we meet a rather myxomatous structure, but in other places we meet again the typical alveolar structure which is striking in the former case. They studied the gliome of the optic nerve by means of the phase contrast microscope. The tumour is constituted of a mass of proliferated glial cells (type oligodendrocytome or protoplasmic astrocytome). The authors underline the very different histological features of the orbital meningiomes and gliomes of the optic nerve. They also claim that the classification of the meningoblastome in different types is of no practical use and is only apt to confuse. Zusammenfassung. Die Verfasser melden drei Falle eines primitiven Tumors des N. Opticus: einen Fall von Gliom und zwei Falle von Meningoblastom. Diese Meningoblastomen scheinen sich, ebenso gut vom topographischen als vom histologischen Gezichtspunkt aus, im primitiven stadium zu Kosten der intraorbitalen Opticusscheiden entwickelt zu haben. Im ersten Fall von Meningoblastom bilden Spulenformige Zellen, welche sich zu durch einandergeflochten Bundel zusammenstellen, den grosseren Teil des Tumors. An verschiedenen Stellen ist die Struktur des Tumors deutlich alveolar. Im zweiten Fall findet man sehr stark verlangerte und nahezu faserformige Zellen. An einigen Stellen hat die wucherung ein mehr myxomatoses Aussehen. An anderen Stellen finden wir die typische alveolare Gestalt des ersten Fall zuruck. Man hat den Gliom des N. Opticus, der eine Wucherung von Glialzellen des oligodendrocytalen oder des Astrocytoprotoplasmischen Typus darstellt, mit dem Phasencontrast-Mikroskop untersucht. Mit Nachdruck weisen die Verfasser einerseits auf die sehr verschiedene histologische Formen des orbitalen Meningioms und Glioms des N. Opticus, und anderzeits auf die Zwecklosigkeit einer Einteilung der Meningoblastomen in verschiedenen typen, welche nur dienen um eine bestimmte Irrung lebendig zu halten.

The only macular heredodegeneration which can be diagnosed by electrophysiological tests is the dominant vitelliform degeneration of the macula, the ERG being normal and the EOG very pathologic. In the pre- or subclinical or polymorphous atrophic stages it is even the only possibility of making the diagnosis. Autosomal dominant pigmentary retinopathy can rather often be differentiated from autosomal or sex-linked recessive pigmentary retinopathy by the fact that there is still an ERG response and more particularly a cone response and that its progressive deterioration is observed, while in autosomal or sex-linked recessive pigmentary retinopathy the ERG is mostly extinguished. The gene carriers of autosomal and sex-linked recessive pigmentary retinopathy as well as of choroideremia cannot be detected by electrophysiological tests. The visual evoked cortical potential cannot predict an optic disorder and is not able to distinguish hereditary from nonhereditary diseases of the optic nerve.

On the basis of his studies on Fabry's disease, the dyscephalic syndrome of François, ligneous conjunctivitis and macular dystrophy of the cornea, the author stresses the importance of heredity in ophthalmology.

In three patients treated for macular degeneration with argon laser photocoagulation choroidal neovascularization occurred four to six weeks later at the photocoagulation site. Two of the patients were treated for angioid streaks of the macular region, the third patient was treated for disciform macular degeneration. Argon laser photocoagulation also induced neovascularization experimentally in pigmented rabbits.

A new typical case of the FranCois’ dyscephalic syndrome is reported and the importance of the skin involvement is stressed. Connective tissue lesions and elastin changes were demonstrated by histological and histochemical examinations, revealing anomalies even in apparently healthy skin. These changes may be due to a primary disturbance in the metabolism of the glycoproteins.

Besides oxygen administration and immaturity of the premature retinal vessels, there are other risk factors for retrolental fibroplasia: (1) respiratory distress syndrome; (2) multiple episodes of bradycardia apnoea; (3) exchange transfusions; (4) hyaline membrane disease; (5) anemia of prematurity; (6) hyperbilirubinemia; (7) avitaminosis E; (8) cardiovascular defects; (9) infectious diseases; (10) multiple births; (11) hypocalcemia; (12) hypothermia; (13) hemorrhagic tendency; (14) delayed coaptation of the retina, and (15) spastic diplegia.

Toutain Jules-François. Une nouvelle inscription d'Alésia. In: Revue des Études Anciennes. Tome 16, 1914, n°3. pp. 324-328.

As a continuation of previous investigations, a comparative study of the protein composition in the normal and cataractous lens was made using a thin-layer gel filtration technique (Sephadex G-200). This technique permits a good separation of proteins with high molecular weight. The remarkable persistence of α-crystallin, and the diminution in concentration of some proteins with low molecular weight, are discussed.

Toutain Jules-François. Le temple dolménique de Bellona à Sigus et le sanctuaire dolménique d'Alésia. In: Revue des Études Anciennes. Tome 17, 1915, n°1. pp. 43-62.