Disseminated erythematous lupus with bilateral diaphragmatic involvement

The diaphragm is an unusual localization for disseminated erythematous lupus and is generally not recognized. We present the case of a 34-year-old woman who developed bilateral pain in the base of the thorax 15 days before hospitalization without any bronchial signs and NYHA stage II dyspnea. The patient's general health status remained satisfactory and the physical examination was normal except for diffuse inflammatory joint pain and cutaneous photosensitivization. The chest x-ray disclosed ascension of both hemidiaphragms with retracted lungs associated with bilateral basal atalectasia. The diagnosis of lupus with diaphragmatic involvement was retained due to the clinical presentation with diffuse joint pain, photosensitization with facial erythema, pericardial effusion and elevated antinuclear antibody and lymphopenia (1 100/mm3). Lung function tests revealed a restrictive syndrome. Oral corticosteroids 1 mg/kg/d enabled clinical and functional improvement. In light of this observation we discuss the pathogenic mechanisms of this uncommon localization of lupus and the difficulty of establishing a sure diagnosis.     

Screening of biological activities of Polygonum maritimum L. from Algerian coast

Objective

To investigate the antioxidant and the antibacterial activities of crude extract from aerial part of Polygonum maritimum L. (Polygonaceae) (P. maritimum) and to find new actives biomolecules.

Methods

The whole plant was collected from the Rechgoune coast (West of Algeria), and methanolic crude extract of aerial parts of P. maritimum (PMCE) was prepared. The extract was tested against different bacterial strain and tested for his ability to neutralize free radical (DPPH) and to scavenge the H₂O₂.

Results

PMCE had a very high content of total phenol, which was (352.49±18.03) mg/g dry weight, expressed as gallic acid equivalent. PMCE exhibited excellent antioxidant activity, as measured using DPPH and H₂O₂ scavenging assays. It also showed a high antibacterial activity against gram-positive bacterial strains: Bacillus cereus, Bacillus subtilis and Staphylococcus aureus with an highest MIC of 120 µg/mL.

Conclusions

The antioxidant and antibacterial activity of the PMCE is probably due to phenolic compounds present in the extract. The contemporary presence of antioxidant and antibacterial activities in the PMCE suggests that this plant may be a source of bioactive substances with multifaceted activity.     

Identification, localization and function of glutamate-gated chloride channel receptors in the honeybee brain

Glutamate‐gated chloride channels (GluCls) are members of the cys‐loop ligand‐gated ion channel superfamily whose presence has been reported in a variety of invertebrate tissues. In the honeybee, a single gene, amel_glucl, encoding a GluClα subunit, was found in the genome but both the pattern of expression of this gene in the bee brain and its functional role remained unknown. Here we localised the expression sites of the honeybee GluClα subunit at the mRNA and protein levels. To characterise the functional role of GluCls in the honeybee brain, we studied their implication in olfactory learning and memory by means of RNA interference (RNAi) against the GluClα subunit. We found that the GluClα subunit is expressed in the muscles, the antennae and the brain of honeybees. Expression of the GluClα protein was necessary for the retrieval of olfactory memories; more specifically, injection of dsRNA or siRNA resulted in a decrease in retention performances ～24 h after injection. Knockdown of GluClα subunits impaired neither olfaction nor sucrose sensitivity, and did not affect the capacity to associate odor and sucrose. Our data provide the first evidence for the involvement of glutamate‐gated chloride channels in olfactory memory in an invertebrate.     

Kyphectomy in Children with Myelomeningocele

Background  

Patients with myelomeningocele and rigid lumbar and thoracolumbar kyphosis face substantial functional difficulties with sitting and lying supine and are prone to skin breakdown over the gibbus and risk of infection. Kyphectomy, along with cordotomy and segmental spinal instrumentation down to the pelvis, is one alternative that can provide reliable correction of the deformity but also can maintain that correction over a period of time.     

Chondroblastoma in adult age

Purpose

Chondroblastoma (CB) is a rare benign tumor that occurs most commonly in the second decade of life. No studies on CB in adulthood have been reported. Our purposes were to report a single-institution experience on CB in adults and to discuss the clinical and imaging findings, type of treatment, oncologic and functional outcomes.

Patients and methods

All patients diagnosed and treated for CB from 1981 to 2014 were reviewed. The main inclusion criterion was patients above their 30 years of age at diagnosis. Clinical presentation, imaging, surgical treatment, complications and functional outcome were evaluated. Local recurrences were recorded.

Results

There were 15 males (65%) and 8 females (35%) with a mean age of 40 years (range 30–59 years). Tumor involved the small bones (talus, calcaneus, acromion, cuneiform, metatarsals) in 15 patients (65%) and the long bones in eight patients (35%). Treatment consisted of curettage only (6 cases), curettage plus phenol (13 cases), curettage plus radiotherapy (one patient with vertebral tumor), resection (two patients with CB of the acromion) and chopart amputation (one patient with a metatarsal tumor). At a mean follow-up of 8.4 years (range 3–30 years), twenty patients (87%) remained continuously disease-free, whereas three had local recurrences. None of the patients received chemotherapy.

Conclusion

This study confirms that the occurrence and outcome of adult patients with CB are similar with those affecting younger patients. The main difference consists of the involved bones; flat bones and short tubular bones of the foot, especially the talus and calcaneus, are most commonly involved as opposed to long tubular bones.

Level of evidence

Therapeutic study, level IV-1 (case series).

     

Un cas inhabituel de luxation tibiotalaire postéromédiale pure ouverte suite à un accident de ski

Pure tibiotalar dislocation is a rare injury. It is not commonly seen as a sport accident. It results most often from high energy trauma in traffic accidents. Authors report a case of an open type 2 Gustillo and Anderson pure posteromedial tibiotalar dislocation in ski accident. Immediate reduction and tibiotalar fixation were performed followed by immobilization during six weeks. After 14 months of follow-up, functional results were satisfying.     

Penetrating atherosclerosis aortic ulcer: a re-appraisal

Background: Penetrating aortic ulcer is a rare pathology, often clinically silent, but potentially fatal when manifesting as an acute aortic syndrome. It is more often detected in recent years, due to ageing of the population and more widespread use of computed tomography. A literature review aims to define the distinct disease entity of penetrating aortic ulcer.

Methods: Five recent cases of penetrating aortic ulcer, treated in authors’ department are reported. A review of English-language medical literature from 1980 to 2015 was undertaken using PubMed and EMBASE databases, to identify studies reporting surgical (open and endovascular) treatment of penetrating aortic ulcer.

Results: From September 2013 to September 2015, five cases of acute aortic syndrome caused by a penetrating atherosclerotic ulcer of the descending thoracic aorta were observed in authors’ department. This represents 9% of all acute aortic syndromes admitted to our hospital in the same period. All five patients benefitted from thoracic endovascular stent grafting with a 100% success rate. Natural history and optimal management of penetrating aortic ulcer are outlined according to the most recent insights.

Conclusion: Penetrating aortic ulcer represents 2–7% of all acute aortic syndromes. Symptomatic penetrating aortic ulcer requires coverage by thoracic endovascular stent grafting according to the recent guidelines.