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The structural and physio-chemical properties of biochar are crucial to determining biochar’s quality and the adequate application. Specifically, the large porosity of biochar has been known as a favorable feature, especially for environmental remediation. In this regard, physical and chemical modifications have been used to improve biochar’s porosity which requires high-energy consumption and involves chemical agents. The objective of this study was to prepare biochar with developed porosity using mild treatments. Arundo donax and olive stone were demineralized by a water-washing method. Treated and non-treated biomasses were pyrolyzed, and part of the derived samples was subjected to wet ball milling. Samples were characterized with proximate, Fourier transform infrared, particle size, and physisorption analyses. The effect of demineralization depended on the biomass type, as ash reduction only influenced Arundo donax-derived biochar, which was attributed to the difference in initial ash content that was relatively low for olive stone. The carbonization yield decreased by 46% for the Arundo donax biomass after demineralization. Moreover, demineralization expanded the surface area and total pore volume of the Arundo donax biochar. The ball milling was effective in producing micro-sized biochar particles with a mean size ranging between 30 ± 2 µm and 42 ± 2 µm and between 13 ± 1 µm and 22 ± 2 µm for Arundo donax and olive stone without and with demineralization, respectively. Ball milling increased the surface area of non-demineralized Arundo donax by 47% and demineralized Arundo donax by 124%. Additionally, ball milling increased the surface area of non-demineralized olive stone by 65% and demineralized olive stone by 62%. Graphical abstract

This study aimed to analyse the frequency of genes encoding virulence factors and to characterize resistance profiles of Staphylococcus aureus isolated from raw milk. In total, 47 and 9 S. aureus isolates were recovered from 150 and 100 raw bovine and ovine milk samples, respectively, in Tunisia. The majority of isolates was resistant to penicillin, and no methicillin-resistant S. aureus was detected. Eighteen and two isolates harboured etd and eta genes respectively. Sixteen enterotoxin-encoding genes were detected (n, %): sed (25, 44·6%), sec (16, 28·6%), sei (16, 28·6%), seh (13, 23·2%), seln (13, 23·2%), sell (10, 17·8%), seg (9, 16%), selu (8, 14·3%), selq (7, 12·5%), selo (7, 12·5%), selm (7, 12·5%), seb (7, 12·5%), sea (6, 10·7%), selk (3, 5·4%), ser (1, 1·8%) and selp (1, 1·8%). Ten isolates carried the tsst1 gene. All isolates carried the haemolysin toxin (hla, hld and hlg). The immune evasion cluster system-type B was predominant (20 isolates) followed by C (3 isolates), A and E (1 isolate each). The occurrence of enterotoxigenic S. aureus in raw milk constitutes a potential risk for human health. SIGNIFICANCE AND IMPACT OF THE STUDY: This paper describes the characteristics of Staphylococcus aureus isolated from raw milk samples from healthy cows and ewes collected from small family farms in Tunisia. Fifty-six strains were analysed by determining their antibiotic susceptibility and genes encoding antibiotic resistance and virulence factors. Methicillin-resistant strains were not detected, and overall low level of antimicrobial resistance was reported. However, our strains harboured several genes encoding virulence factors and 87·5% of them carried at least one gene encoding for enterotoxins showing a high risk of spread of food-borne diseases.

Sicilo-Sarde is a local breed from northern Tunisia resulting from crossing Sarda and Comisana dairy sheep and is traditionally used for cheese production after lamb weaning. A sample of 52 adult Sicilo-Sarde lactating ewes was used for studying their udder morphological traits and milk yield potential during weeks 4–8 (milking–suckling period) and 10 (milking period) of lactation. Daily milk yield was estimated on a daily basis by using the double oxytocin injection method 4 h after machine-milking at d 30 and 45. Udder and teat morphology were also measured at d 45 of lactation. Cisternal area (by ultrasonography) and udder compartments (cisternal and alveolar milk) were evaluated 8 h after milking by using atosiban and oxytocin on d 72 of lactation. Milk yield averaged 0.56 ± 0.10 L/d and ewes had small (volume, 496 ± 28 mL) and healthy udders (CMT

The friction and wear behaviors of polyester coatings incorporating graphite particles and deposited on an aluminum substrate by a spraying technique were analyzed in this study. Four volume ratios of the graphite particles in the polyester matrix were considered in the range of 0% to 35%. The coatings tribological behaviors were analyzed using high chromium steel ball antagonist. The friction experiments were conducted using a reciprocating tribometer. For each of the considered coating, evolutions of the friction coefficient, the weight losses and the wear scar morphology with the number of sliding cycles were analyzed. The microstructure of polyester coatings and the wear scar micrographs were characterized using an optical microscope and a scanning electron microscope (SEM). Severe wear mechanism is activated for the polyester coating without graphite particles. Incorporating graphite particles in the polyester coating enhances the development of a specific third body which reduces friction and wear. The best friction and wear properties are obtained for highest ratio were the third body was formed on the entire sliding stripe.

Resume Introduction L’arthrodese du genou est l’une des indications de conservation des membres apres resection tumorale maligne. L’utilisation d’un greffon fibulaire vascularise permet une reconstruction biologique et donc definitive. Le but de ce travail etait d’analyser les resultats de l’arthrodese du genou par fibula vascularisee retournee apres resection tumorale et de discuter la fiabilite de cette technique. Materiel et methodes Nous rapportons une serie retrospective de 13 patients d’âge moyen 29,6 ans. Le diagnostic histologique etait un sarcome osseux dans 12 cas et un chondrosarcome synovial dans un cas. Une resection/arthrodese a ete realisee d’emblee dans 11 cas. Dans deux cas, l’arthrodese a ete indiquee suite a l’echec d’une prothese massive. La reconstruction etait assuree par une fibula vascularisee retournee dans tous les cas. Pour la stabilisation, un fixateur externe a ete utilise dans huit cas, un clou femorotibial dans trois cas et une plaque dans deux cas. Les resultats ont ete analyses avec un recul moyen de six ans. Resultats Nous avons observe une infection dans 53 % des cas, une complication mecanique dans 53 % des cas et une paralysie nerveuse dans 23 % des cas. Quatre patients sont decedes par metastases (un seul avait consolide son arthrodese). Chez les neuf patients en vie, l’arthrodese etait consolidee dans sept cas, apres un delai moyen de 36 mois. Le score fonctionnel (cotation de Enneking) moyen etait de 20 points. Discussion L’arthrodese du genou apres resection tumorale est une technique complexe. Les complications septiques et les echecs mecaniques sont frequents quelle que soit la technique utilisee. Ils sont lies a l’importance du sacrifice osseux mais aussi celui des parties molles. L’utilisation de la fibula vascularisee seule et la stabilisation par fixateur externe etaient les deux defauts techniques majeurs releves dans cette serie.

Resume L'objectif de notre travail etait de preciser l'interet du Telos dans le diagnostic d'une laxite anterieure du genou, de rechercher les facteurs d'aggravation de cette pathologie, d'evaluer les resultats objectifs de la ligamentoplastie et d'etablir une valeur seuil. Il s'agit d'une etude retrospective portant sur 78 patients presentant une laxite chronique anterieure du genou, traites et suivis a notre institut sur une periode de dix ans. L'âge moyen des patients etait de 27,6 ans avec une predominance masculine. Une ligamentoplastie a ete realisee selon la technique de Kenneth-Jones sous arthroscopie et a ete evaluee au Telos a six mois. La laxite moyenne preoperatoire etait de 15,3 mm : 95 % des patients avaient une laxite anterieure absolue superieure ou egale a 8 mm alors que la differentielle etait superieure ou egale a 4 mm dans 87 % des cas ou un Telos comparatif a pu etre effectue. L'amplitude du Lachman radiologique etait correlee avec l'importance du Lachman clinique. Une correlation significative a ete retrouvee entre l'importance de la laxite, l'existence d'une lesion meniscale et un delai accident–chirurgie de plus de 12 mois. En postoperatoire, la laxite moyenne etait de 8,2 mm et le gain etait proportionnel a l'importance de la translation tibiale anterieure initiale. Les resultats ont ete meilleurs pour les laxites preoperatoires inferieures a 20 mm et pour les laxites postoperatoires inferieures ou egales a 10 mm. La laximetrie au Telos s'est averee etre un complement objectif a l'examen clinique dans un but diagnostique, pronostique et therapeutique.

The single scrotal incision orchidopexy was described by Bianchi in 1989. Despite its popularity, the place of this technique in the treatment of cryptorchidism in children is still unclear.To evaluate and compare the outcomes of the conventional inguinal approach and the scrotal approach for the treatment of palpable undescended testis in children.A prospective study for all patients with palpable undescended testis undergoing orchidopexy between January 2011 and December 2013 was conducted. Totally 200 patients were randomly divided into two groups: group 1: two incisions inguinal approach (80 patients, 100 testis); group 2: single scrotal incision approach (89 patients, 100 testis).The patients' mean age was 53.9±13 months in group 1 and 45.8±9 months in group 2. There was no statistical difference between the two groups in terms of patient age (P=0.8) and location of the undescended testis (P=0.359). Operative time was statistically significantly lower in the scrotal group (P0.05). There was a significant difference in the complications rates between the two groups.The single scrotal incision orchidopexy is safe and effective for undescended testicles palpable in the inguinal canal or in high scrotal position.

While a number of pumped sum-frequency experiments have been done to study the dynamics occurring at surfaces and interfaces, all these experiments involve coincident infrared-visible probe pulses. Here, we analyze the possibilities of using time-delayed infrared-visible probe pulses in five-wave mixing spectroscopy to study the dynamical processes which take place in the higher vibrational molecular levels. To this end, we introduce in the present work a general analytical description of time-delayed infrared-visible probe pulses to test the influence of the physical parameters driving the internal dynamics of the molecular adsorbate on the five-wave mixing signal. Two different configurations have been considered with the infrared probe beam resonant with either the first or the second vibrational transition showing different sentivities to the dephasing processes acting on the upper vibrational states.

Introduction Les atteintes medullaires dans la thyroidite de Hashimoto sont rares et tres peu decrites dans la litterature. Leur physiopathologie reste encore mal elucidee. Nous rapportons le cas d’une thyroidite de Hashimoto decouverte dans le cadre d’un bilan etiologique d’une myelite transverse focale. Observation Il s’agit d’une patiente âgee de 33 ans ayant ete hospitalisee en neurologie pour un trouble de la marche d’aggravation progressive. A l’examen, elle avait une paraparesie et un syndrome quadri-pyramidal avec un niveau sensitif ombilical. L’IRM cerebromedullaire a montre une lesion medullaire en hypersignal T2 non specifique en regard de la 10e vertebre thoracique prenant le Godalinium evoquant une myelite transverse focale. Le bilan etiologique (ponction lombaire, bilan inflammatoire et bilan immunologique) etait negatif en dehors d’un taux eleve des anticorps antiperoxydases a 160 mUI/mL. La patiente etait en euthyroidie clinique et biologique (TSH a 1,59 mUI/mL) et elle avait un goitre a l’examen. Elle a ete mise sous corticotherapie avec une bonne evolution. Discussion La myelopathie peut etre une manifestation neurologique revelatrice de la thyroidite de Hashimoto mais qui reste bien rare. Il s’agit d’un diagnostic d’exclusion apres avoir elimine les autres causes les plus frequentes. La mise en evidence des anticorps antithyroidiens positifs chez notre patiente avec une amelioration de la symptomatologie sous corticotherapie sont en faveur de ce diagnostic. Sur le plan physiopathologique, plusieurs hypotheses ont ete suggerees telles que l’interaction des autoanticorps antithyroidiens avec les antigenes de la moelle epiniere ou avec les antigenes des vaisseaux sanguins spinaux.

A cluster dynamics model is being developed for the prediction of the entire microstructure evolution of austenitic stainless steel (SS) under irradiation. The particular features of the model are the description of (i) the creation and evolution of Stacking Fault Tetrahedra (SFT), (ii) the evolution of the Frank loops and network dislocation microstructure, (iii) the influence of helium considering the mean number of helium atoms in cavities. This model was calibrated against 304L austenitic SS data on Frank loops and SFTs after irradiation in the Bor60 fast reactor at 320°C and 9.4×10−7 dpa/s. The predictions of the model were then compared to experimental data (i) from the Ringhals PWR thimble tube CW316 SS irradiated at 315°C, 10−7 dpa/s, and 20 appm He/dpa, and (ii) EBR-II fast breeder reactor SA316 SS irradiated at 470°C and 6×10−7 dpa/s. Results were found to be in good agreement with the experimental data at 315°C, and in poor agreement at 470°C. The heterogeneous nucleation of cavities at the interface of precipitates, which is known to occur at high temperature and is not described in the model, is believed to be responsible for this discrepancy at 470°C. The effect of helium on the cavity microstructure evolution at (i) 315°C and 10−7 dpa/s and (ii) 470°C and 6x10−7 dpa/s was investigated by comparing predictions of the model at 0 and 20 appm He/dpa. Helium was predicted to have no significant influence on the cavity microstructure at 315°C, and a significant influence at 470°C.

Objectifs La mise en place de la sonde ureterale type JJ est souvent associee a des symptomes dont le traitement n’est pas encore consensuel. Le but de l’etude est d’evaluer la place de la phytotherapie dans l’amelioration des symptomes lies a la mise en place d’une endoprothese ureterale autostatique type JJ. Methodes Il s’agit d’une etude prospective randomisee controlee realisee entre juin 2012 et janvier 2014. Nous avons inclus les malade ayant eu une ureteroscopie (URS) pour calcul ureteral pelvien suivie par la mise en place d’une sonde JJ et qui repondent aux criteres d’inclusion. Nous avons evalues les resultats des traitements par International Prostate Symptom Score/Quality of life (IPSS/Qol) et l’EVA pour la douleur a j1, j14 et j30 postoperatoire, et ceci apres avoir eu le consentement eclaire des patients et l’accord du comite d’ethique. Nous avons utilise les tests statistiques appropries et le seuil de signification « p » a ete fixe a 0,05. Resultats Soixante-neuf (69) patients consecutifs ont ete randomises en trois groupes: groupe I bras controle (23 patients), groupe II traite par Seronoa Repens (24 patients) et le groupe III traite par Tamsulosine (22 patients). Nous avons note une difference statistiquement significative concernant le score moyen d’IPSS a J14 postoperatoire entre le groupe I et le groupe II avec respectivement IPSS total de 11,79 ± 6,375 (GI) vs 5,07 ± 1,87 (GII); de meme, entre le groupe I et le groupe III avec IPSS total de 11,79 ± 6,375(GI) vs 6,64 ± 2,763 (GIII). A J30 postoperatoire, nous avons revele une amelioration statistiquement significative du score IPSS, entre le GI et le GII et entre GI et G III. L’analyse de l’EVA moyen a j14 et j30 postoperatoire a montre une amelioration statistiquement significative entre le GI et le GII. Conclusion A notre connaissance, notre etude est la premiere jusqu’a ce jour ayant mis en exergue la place de la phytotherapie dans le traitement des symptomes secondaires a la mise en place d’une sonde JJ.

Knee arthrodesis is one of the reconstruction options for limb preservation after malignant tumor resection. Vascularised rotatory fibular transfer allows biological and, thus,definitive reconstruction. The goal of this work was to analyse the results of knee arthrodesis with vascularised fibular graft after tumor resection and to discuss the reliability of this technique.We report a retrospective series of 13 patients with an average age of 29.6 years. The pathological diagnosis was bone sarcoma in 12 cases and synovial chondrosarcoma in one case. Resection/arthrodesis was undertaken as the primary procedure in 11 cases.In two cases, arthrodesis was indicated after failure of an endoprosthesis. Reconstruction was achieved with a vascularised fibular rotatory transfer in all cases. For stabilisation, an external fixator was utilised in eight cases, a femorotibial nail in three cases, and a plate in two cases.Mean follow-up was 6 years.We encountered infection in 53% of cases, mechanical complications in 53% of cases,and nerve palsy in 23% of cases. Four patients died from metastases (only one had arthrodesis complete union). In the nine surviving patients, arthrodesis was fully united in seven cases,after an average period of 36 months. The functional score average (Enneking classification)was 20 points.Knee arthrodesis after tumor resection is a complex technique. Septic complications and mechanical failure are frequent regardless of the technique employed. They are related to the extent of bone sacrifice but also to that of soft tissues. The use of vascularised fibula alone and stabilisation by external fixation were the main shortcomings in this series. TYPE OF STUDY RETROSPECTIVE: Level IV.

Patients with spinal cord injuries are prone to knee hydrarthrosis (also known as “water on the knee”), which can cause pain, functional impairment and the restriction of social activities. Total knee arthroplasty is a potentially appropriate treatment. Here, we report on a patient presenting partial T12 AIS grade C paraplegia who was able to walk with two forearm crutches, an ankle-foot orthosis on the right leg and a knee-ankle-foot orthosis on the left leg. Thirteen years after the spinal cord injury, the patient presented with septic arthritis of the right knee, complicated by recurrent hydrarthrosis during standing and walking. Arthroscopy revealed advanced osteoarthritis. Total knee arthroplasty was performed, with very good functional and social outcomes two and half years after surgery.

The peculiar role of the substrate field on the nonlinear optical response of a molecular adsorbate experiencing a resonant Raman scattering process is analyzed. The description of the internal dynamics is done in terms of the renormalized normal mode coordinates that account for the conformational changes induced in the adsorbate by the substrate field. This analytical description, well-adapted to weak substrate fields, points out the underlying mechanisms that are responsible for the enhancement of the resonant Raman signal observed in some molecules. They involve elementary processes bringing additional intermediate vibrational states into play, depending on the nature of the field inhomogeneities. Also, according to the relative values of the unperturbed equilibrium positions of the modes, their displacements, and frequency changes due to the substrate field, enhancement as well as decrease of the signal can possibly be observed and are evaluated. Of course, for a strong substrate field, the number of intermediate vibrational levels participating in the Raman process becomes very large, and a complete numerical evaluation is required.

Objectifs Evaluer la place du traitement medical dans l’amelioration des symptomes lies a la mise en place d’une endoprothese ureterale autostatique type JJ. Methodes Il s’agit d’une etude prospective randomisee controlee menee entre decembre 2012 et avril 2015. Les criteres d’inclusion sont : homme ou femme jeune ou adulte, hospitalise pendant la periode sus-citee ayant eu une URS sous anesthesie generale pour calcul ureteral unilateral de localisation pelvienne de Resultats A j14, nous avons objective une amelioration statistiquement significative du score IPSS total entre le groupe temoin (G IV) et les trois autres groupes : le score moyen de l’IPSS total est, respectivement de 6,12 ± 2,455 (GI alpha-bloqueur) vs 5,12 ± 1,509 (GII phytotherapie) vs 5 ± 1,383 (GIII anticholinergique) vs 9,28 ± 5,69 (G IV) (p Conclusion A la lumiere de nos resultats, il semble que l’alpha-bloqueur, la phytotherapie et les anticholinergiques ont un impact positif sur la tolerance de la sonde JJ ; mais les anticholinergiques peuvent etre indiques surtout en cas de symptomes irritatifs predominent, alors que la phytotherapie essentiellement en cas de symptomatologie douloureuse.

The nonlinear optical response of an adsorbate, whose structure is altered by the inhomogeneous electrostatic field of the substrate, has been evaluated with a particular emphasis on the sum-frequency generation process. In the limiting case of an homogeneous electrostatic field, besides the contributions associated with the induced dipole moments, we have additional contributions which only exist if the adsorbed molecule has permanent dipole moments. Also, the Franck-Condon factors of the unperturbed molecule weight the internal couplings induced by the electrostatic field. For the more general inhomogeneous electrostatic field case, while the main observations remain valid, the Franck-Condon factors are modified by the molecular structure changes induced by the electrostatic field. In addition, we have a strong redistribution of the vibronic couplings resulting from the analytical Q dependence of the partial charge distribution which is a signature of the field inhomogeneities.

The involvement of the peripheral nervous system in Behçet's disease is very rare.We report a case of a 47-year-old man with a six-year history of Behçet's disease and a two-year history of peripheral nervous system involvement. This patient presented with paraesthesia and weakness of the upper and lower limbs, diarrhea and erectile dysfunction. The electromyogram showed evidence of an axonal sensorimotor neuropathy and the nerve biopsy showed an axonal neuropathy. Routine blood tests were normal, there was no increase of serum creatine kinase, aspartate aminotransfease or lactate dehydrogenase and no signs of hyperthyroidism. Fibroscopy and colonoscopy showed no signs of entero-Behçet. The patient was treated with prednisone, cyclophosphamide and carbamazepine with an improvement of paraesthesia.The mechanism of the peripheral neuropathy in Behçet's disease is still unknown, it might be due to vasculitis of the vasa nervorum or to the side effects of colchicine. Our report is particular by the association of sensorimotor and autonomic involvement of peripheral neuropathy in a patient with Behçet's disease.

The authors report the results of a retrospective study of 36 cases of tibiotalar arthrodesis performed in 22 men and 14 women with an average age of 32 years. All patients were reviewed with an average of 8.5 years follow-up. The predominating etiologies were ankle osteoarthritis (15 cases) and neurologic deformities of the foot (13 cases). Arthrodesis was performed using the Meary technique in 60% of cases, using the Charnley technique in 20% and the Crawford-Adams technique or with clamps in the other cases. Fusion was obtained in 97% of cases. Long-term results were assessed using Duquennoy et al.'s scoring system. They were very good or good in 58% of cases, fair in 31% and poor in 11%. The study of distal repercussions of tibiotalar arthrodesis shows progressive deterioration of the subtalar joint in 70% of cases and appearance or increase of degenerative changes in 75% of cases. The final results of the procedure depend on this deterioration; the latter is related with the arthrodesis position. Midtalar joint is a compensation joint showing hypermobility in 40% of cases. Degenerative changes were limited and asymptomatic in 80% of cases. Based on the findings in this study and on the literature, we conclude that the foot should be fixed at 90 degrees or with less than 5 degrees of equinus, with 5 degrees of valgus and 10 to 15 degrees of external rotation.

The distal end of the radius is one of the sites commonly affected by giant-cell tumor of bone; it poses problems of reconstruction after resection of the distal radius. The authors present a retrospective study of 5 giant cells tumors treated by resection-arthrodesis of the wrist. These tumors were seen in 3 men and 2 women. From the radiological point of view, all tumors were extensive and lytic lesions centered in the epiphysis and involving the metaphysis; the wrist joint was respected. From the histological point of view, the tumors were grade I in 3 cases and grade II in 2 cases. With a mean follow up of 8 years, the results were considered good in 3 cases, fair in 1 case and poor in 1 case. A high incidence of bone complications was noted: delayed union (up to 11 months) and fracture of the graft, which occurred in 3 patients.

The purpose of the study was to clarify the clinico pathological features of periosteal ganglion. The authors present a case of an unusual diaphyseal bony tumor in a 27 years old man. The diagnosis of diaphyseal periosteal ganglion cyst was made on roentgenographic appearance, presence of mucoid material and histologic evidence of a synovial type cellular lining. The patient was successfully treated with excision. The follow-up examination showed no recurrence one year after surgery. The radiological differential diagnosis were considered and possible pathogenes for a periosteal ganglion was discussed. Periosteal ganglia must be considered as a cause of cortical erosions. This lesion may radiologically mimic other periosteal lesions. Treatment with excision is successful in most cases.

The authors report two cases of rare localization of intra muscular myxoma: one in the buttock, and the other in the lumbar area. The first case, a 58 years old woman had a four month history of a mass in the buttock. Computed tomography revealed the presence of a solid tumor. Diagnosis was based on histological examination. After surgical treatment no recurrence was observed after fourteen months. The second case was a 54 years old woman who presented a sciatica with back pain and neurological signs. The symptoms didn't response to medical treatment. Computed tomography showed an enlarged and-cystic lumbar lesion extending to the first sacral hole, with bone erosion of L3 and L4 articular apophysis and spinous process. Needle biopsy and surgical excision of the tumor were performed. Total neurological recovery was observed and no recurrence was observed after three years. The authors reminded the characteristics of this rare and benign soft tissue tumor and specified the place of magnetic resonance imaging (MRI) to establish the diagnosis which was still confirmed by histological examination of an open biopsy. Clinical follow-up revealed exceptional recurrence and no metastasis.

This paper presents comparative analysis of electronics and different types of optical links for transmissions of results of measurements from a `hot' zone. This problem is important in high energy physics experiments with accelerators and in experiments with nuclear reactors. It is generally preferable to use an optical fiber link before the electronic link. We compare parameters of optical links with light emission diode and with semiconductor laser, with external and with internal modulation, for analogical and for digital signals. The specified demands are conditioned by bandwidth more than 108 Hz and distance less than 102 m. The design and results of measurements of the technical parameters of the optical links with light emission diode and with low-threshold semiconductor Ga-As microlaser are shown. The program of the radiation resistance testing of this equipment in framework of the `ENTOREL' project is also discussed.© (1994) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Summary Introduction As osteoclast, giant cell tumors express calcitonin receptors. The aim of this paper is to assess treatment using salmon calcitonin after curettage. Patients and methods We retrospectively reviewed 25 patients with giant cell tumor of the appendicular skeleton treated with a single protocol of calcitonin administration following curettage in order to assess the effectiveness of calcitonin in reducing the rate of local recurrence. Results The mean duration follow-up was 68 months. Thirteen patients (52 %) had local recurrence. Eight of them were treated successfully after repeated curettage and calcitonin. Four patients had bone resection and one patient had curettage and cement filling. All patients with cavity left empty had ossified and the functional score as assessed by the MSTS score was 28.02/30. Conclusion This study suggests that the use of calcitonin as adjuvant is not effective and that filling agents are not required after curettage of giant cell tumors. Level of evidence Level IV.

This paper presents a short study of 17 cases of tuberculosis of the greater trochanter seen during a period of 19 years at the National Orthopaedic Institute in Tunis. The onset of the infection is slow with patients presenting at a mean of 7 years after initial symptoms. The diagnosis is confirmed by biopsy and culture of the organism. Management is based on treatment with antituberculous drugs, although surgical excision of the lesion is sometimes required. Successful resolution of the symptoms is usually achieved unless the hip joint becomes involved. Our patients showed good results at a mean follow up of 5 1/2 years.

This paper presents a short study of 17 cases of tuberculosis of the greater trochanter seen during a period of 19 years at the National Orthopaedic Institute in Tunis. The onset of the infection is slow with patients presenting at a mean of 7 years after initial symptoms. The diagnosis is confirmed by biopsy and culture of the organism. Management is based on treatment with antituberculous drugs, although surgical excision of the lesion is sometimes required. Successful resolution of the symptoms is usually achieved unless the hip joint becomes involved. Our patients showed good results at a mean follow up of 5 1/2 years.

Osteoid osteoma of the acetabulum can be expected to cause nonspecific symptoms of hip inflammation. In a sixteen year old girl, investigation by routine radiographs and a bone scan suggested a focus of inflammation with a nidus and sclerosis of the acetabulum and overgrowth of the head and neck of the femur. Removal of the lesion by an anterior approach with dislocation of the hip gave excellent results when seen after three years with a normal gait and normal hip motion.

Introduction Passe 40 ans, un patient presentant une laxite chronique anterieure symptomatique se voit regulierement refuser la chirurgie en raison de son âge sous pretexte de resultats moins bons et de risque d’arthrose. Le but de cette etude est d’analyser les resultats de la reconstruction du ligament croise anterieur chez les patients de plus de 40 ans. Methodes La serie a comporte 44 patients âges en moyenne de 43,5 ans (40 a 55). Le derobement etait present chez 90,9 % des patients et la douleur dans 50 % des cas. Les sportifs representaient 68,18 %. Une pre-arthrose etait notee dans 11 cas et une gonarthrose femoro-tibiale interne dans 3 cas. Le tiroir anterieur differentiel etait en moyenne de 9,44 mm (5 a 17,5). Le delai moyen accident chirurgie etait de 5 ans. La ligamentoplastie sous arthroscopie etait realisee par le tendon rotulien dans 68,18 % des cas et les ischiojambiers dans 31,82 % des cas. Resultats Le recul moyen etait de 33 mois (11 a 120). Selon les criteres de l’International Knee Documentation Commity et l’Association pour la Recherche et la promotion de l’Etude du Genou, le resultat global etait excellent dans 47,7 %, bon dans 34,1 %, moyen dans 13,6 % et mauvais dans 4,5 %. Le taux de complication represente 6,8 %. La laxite etait controlee avec un excellent et bon score ligamentaire dans 86,6 % des cas et un tiroir anterieur direct differentiel moyen de 6,76 mm (2,5 a 15 mm). Les douleurs residuelles constituaient le symptome majeur (40,9 %). Dans 72,22 % des cas, elle existait en preoperatoire. Une aggravation des signes arthrosiques etait observee dans 6 cas (2 arthroses et 4 remodeles). Tous les moyens et mauvais resultats etaient lies a l’arthrose et aux echecs (2 cas). Le delai accident chirurgie, l’âge, le niveau sportif initial, le transplant utilise, la conservation ou non du capital meniscal etaient sans influence sur le resultat global. La presence de douleur et ou une arthrose meme debutante etait un facteur pejoratif. Conclusion L’âge n’est pas une contre-indication a la ligamentoplastie a condition de tenir compte de deux elements essentiels : la douleur et la degradation arthrosique.