[Invasive squamous cell carcinoma: about 2 cases]. / Carcinome épidermoïde conjonctival invasif : à propos de 2 cas.

Conjunctival tumors are common in tropical areas, where exposure to ultraviolet radiation is high and almost permanent. Malignant tumors are quite rare and the most represented is conjunctival squamous cell carcinoma. We report two cases of invasive squamous cell carcinoma of the conjunctiva received in the ophthalmology department of the Sominé Dolo hospital in Mopti, Mali. The patients were 25 and 51 years old, living in a rural desert area exposed to sunlight and dust. They presented with a mass developed in the area of the palpebral fissure, invading the cornea and preventing palpebral occlusion. The mass was raised, multi-lobulated, well circumscribed, pearly white in color and papillomatous in appearance with dilation of the feeder vessels. A wide surgical excision at 4 - 5 mm from the healthy tissue edges was performed with anatomopathological examination of the specimen, which confirmed a mature and invasive differentiated squamous cell carcinoma of the conjunctiva. The extension workup and HIV serology were negative. The evolution was favorable in the medium term without recurrence.

Les tumeurs conjonctivales sont fréquentes dans les zones tropicales,où l'exposition aux rayons ultraviolets est forte et quasi permanente. Les tumeurs malignes sont assez rares et la plus représentée est le carcinome épidermoïde de la conjonctive.Nous rapportons deux cas de carcinome épidermoïde invasif de la conjonctive reçus dans le service d'ophtalmologie de l'hôpital Sominé Dolo de Mopti au Mali. Il s'agissait de deux patientes de 25 et 51 ans, vivant en zone rurale et désertique exposées aux rayons solaires et à la poussière. Elles présentaient une masse développée dans l'aire de la fente palpébrale, envahissant la cornée et empêchant l'occlusion palpébrale. La masse était en relief, multi lobulée, bien circonscrite, de couleur blanc nacré et d'aspect papillomateux avec une dilatation des vaisseaux nourriciers. Une exérèse chirurgicale large à 4 - 5 mm des berges de tissu sain a été réalisée avec examen anatomopathologique de la pièce qui a confirmé un carcinome épidermoïde différencié mature et invasif de la conjonctive. Le bilan d'extension et la sérologie HIV étaient négatifs. L'évolution était favorable à moyen terme sans récidive.

Symmetric and asymmetric shocked gas jets for laser-plasma experiments.

Shocks in supersonic flows offer both high density and sharp density gradients that are used, for instance, for gradient injection in laser-plasma accelerators. We report on a parametric study of oblique shocks created by inserting a straight axisymmetric section at the end of a supersonic "de Laval" nozzle. The effect of different parameters, such as the throat diameter and straight section length on the shock position and density, is studied through computational fluid dynamics (CFD) simulations. Experimental characterizations of a shocked nozzle are compared to CFD simulations and found to be in good agreement. We then introduce a newly designed asymmetric shocked gas jet, where the straight section is only present on one lateral side of the nozzle, thus providing a gas profile well adapted for density transition injection. In this case, full-3D fluid simulations and experimental measurements are compared and show excellent agreement.

[Evaluation of the quality of life of adult patients treated in low vision at the CHU-IOTA]. / Évaluation de la qualité de vie des patients adultes pris en charge en basse vision au CHU-IOTA.

INTRODUCTION: Visual impairment is a handicap defined as any alteration of visual function responsible for a partial or total limitation of the activities of daily living (OMS, 2004). The objective of this study is to assess quality of life in patients before and after management of low vision. PATIENTS AND METHODS: This was a mono-centric, transverse, analytical study over a period of 6 months. Our study population included all adult patients seen in ophthalmologic consultation and followed in the low vision unit with visual acuity less than 3/10 and greater than or equal to 1/20 in the best eye with best optical correction. The National Eye Institute's quality of life questionnaire, the NEF VFQ 25, was administered to patients on site prior to management and then a month later. RESULTS: Low-vision management improved overall the dimensions of the quality of life questionnaire. Following the end-of-care assessment, the score for ocular pain was lowest (38.20), followed by the overall vision score (44.95) and near vision difficulty score (45.33). DISCUSSION: Our sample population was distinguished by a cultural mix, with diversity of beliefs and lifestyles, and also by the relatively advanced age of the subjects constituting it. This can influence the individual's perception of him- or herself within his or her environment, modifying the patient's estimation of his or her condition and therefore his or her behavior. CONCLUSION: Low-vision rehabilitation can improve the quality of life of visually impaired patients, particularly for near vision, activities of daily living and psychological health.

Note: Real-time monitoring via second-harmonic interferometry of a flow gas cell for laser wakefield acceleration.

The use of a gas cell as a target for laser wakefield acceleration (LWFA) offers the possibility to obtain stable and manageable laser-plasma interaction process, a mandatory condition for practical applications of this emerging technique, especially in multi-stage accelerators. In order to obtain full control of the gas particle number density in the interaction region, thus allowing for a long term stable and manageable LWFA, real-time monitoring is necessary. In fact, the ideal gas law cannot be used to estimate the particle density inside the flow cell based on the preset backing pressure and the room temperature because the gas flow depends on several factors like tubing, regulators, and valves in the gas supply system, as well as vacuum chamber volume and vacuum pump speed/throughput. Here, second-harmonic interferometry is applied to measure the particle number density inside a flow gas cell designed for LWFA. The results demonstrate that real-time monitoring is achieved and that using low backing pressure gas (<1 bar) and different cell orifice diameters (<2 mm) it is possible to finely tune the number density up to the 10(19) cm(-3) range well suited for LWFA.

[Epidemiology and prognosis of childhood cancers at Gabriel-Touré Teaching Hospital (Bamako, Mali)]. / Épidémiologie et pronostic des cancers pédiatriques au CHU Gabriel-Touré de Bamako (Mali).

UNLABELLED: Cancer today is being treated as a public health problem in Africa, as in developed countries. OBJECTIVE: The aim of this retrospective study was to evaluate the epidemiology and outcome of children treated in the Pediatric Oncology Unit of Gabriel Touré Teaching Hospital in Bamako (Mali), six years after it opened. METHODS: Retrospective study of the files of all children aged 15 and younger diagnosed with cancer and treated by chemotherapy between January 1, 2005, and December 31, 2010. RESULTS: The study included 690 children. Their mean age was 24 months. The time from observation of first symptoms to consultation was less than 3 months in 200 cases (29%), from 3 to 10 months in 256 (37.1%), and more than 10 months in 234 (33.9%). The five most common childhood cancers were malignant non-Hodgkin's lymphoma (NHL) (n=231, 33.5%), retinoblastoma (n=170, 24.6%), nephroblastoma (n=102, 14.8%), acute lymphoblastic leukemia (n=54, 7%), and Hodgkin's disease (n=34, 4%). Six years after the unit opened and after a mean follow-up of 3 years, we recorded 272 deaths (39.4%); at least 238 children are still alive (34.5%), with 180 cases (26.1%) lost to follow-up. CONCLUSION: Childhood cancer survival is still low in Mali, and the rate of loss to follow-up quite high.

Development and characterization of very dense submillimetric gas jets for laser-plasma interaction.

We report on the characterization of recently developed submillimetric He gas jets with peak density higher than 10(21) atoms/cm(3) from cylindrical and slightly conical nozzles of throat diameter of less than 400 µm. Helium gas at pressure 300-400 bar has been developed for this purpose to compensate the nozzle throat diameter reduction that affects the output mass flow rate. The fast-switching electro-valve enables to operate the jet safely for multi-stage vacuum pump assembly. Such gaseous thin targets are particularly suitable for laser-plasma interaction studies in the unexplored near-critical regime.

[Exophthalmia in children at the African Institute of Tropical Ophthalmology (AITO)]. / L'exophtalmie de l'enfant à l'Institut d'ophtalmologie tropicale de l'Afrique.

INTRODUCTION: Exophthalmia is a rare entity. The purpose of this study was to ascertain epidemiological features, clinical aspects, and potential treatment modalities for exophthalmia in children at the University Teaching Hospital- African Institute of Tropical Ophthalmology (UTH-AITO). PATIENTS AND METHOD: This prospective and descriptive study was carried out from July 2006 to June 2007 at the IOTA-UTH in collaboration with the pediatric hematology and oncology unit of the Gabriel Toure UTH. All patients between the ages of 0 to 15 years who presented unilateral or bilateral exophthalmia whether measurable or not were included. In all cases thorough clinical workup was performed and any appropriate additional examinations were ordered. All data were consigned to a questionnaire. RESULTS: A total of 46 eyes in 38 children were included, i.e., unilateral right in 15 cases, unilateral left in 15 and bilateral in 8. Mean age was 9.6 years (range, 2 days to 15 years). The male-to-female sex ratio was 1.9:1. The incidence of exophthalmia was 0.3%. Exophthalmia was the reason for seeking medical advice in 68.4% of cases (26 children). Classification according to underlying pathology divided patients into four groups, i.e., inflammatory and/or infectious pathologies in 36.9% (14 cases), tumor pathologies in 31.6% (12 cases), trauma in 13.1% (5 cases) and undetermined in 18.4% (7 cases). A Hertel millimetric regression of exophthalmia was observed in 23.9% of cases (11 eyes) and a gain in visual lines of acuity was observed in 8.7% (4 eyes). DISCUSSION: Given the normally low frequency of exophthalmia, observation of a 0.3% incidence at a third level reference center warrants alerting of health authorities. Etiological classification was comparable to Crawford's as described by Desjardins. Cellulites (50%) and retinoblastoma (33.3%) were the main causes of exophthalmia. CONCLUSION: Since exophthalmia can cause loss of vision and even be life-threatening, early diagnosis and treatment is important particularly in children.

[Genital carriage of Streptococcus group B in the pregnant woman in Abidjan (Ivory Coast)]. / Portage génital du streptocoque du groupe B chez la femme enceinte a Abidjan (Cote-d'Ivoire).

To determine the prevalence of group B streptococci to the pregnant woman in Abidjan, we have proceeded an inquiry to a carrier regrouping 150 women examined during a systematic prenatal consultation. The pregnant women did not present any clinical symptoms which can evoke a genital infection. The sampling to the research of group B streptococci have been made to the level of vulva, vagina and cervix. The global frequency of isolation to the pregnant woman is of 19.33% with a frequency of 9.33% to the level of the cervix and the vagina and of 11.33% to the level of the vulva.