Search for Dark Matter Annihilation Signals in the H.E.S.S. Inner Galaxy Survey.

The central region of the Milky Way is one of the foremost locations to look for dark matter (DM) signatures. We report the first results on a search for DM particle annihilation signals using new observations from an unprecedented γ-ray survey of the Galactic Center (GC) region, i.e., the Inner Galaxy Survey, at very high energies (≳100 GeV) performed with the H.E.S.S. array of five ground-based Cherenkov telescopes. No significant γ-ray excess is found in the search region of the 2014-2020 dataset and a profile likelihood ratio analysis is carried out to set exclusion limits on the annihilation cross section ⟨σv⟩. Assuming Einasto and Navarro-Frenk-White (NFW) DM density profiles at the GC, these constraints are the strongest obtained so far in the TeV DM mass range. For the Einasto profile, the constraints reach ⟨σv⟩ values of 3.7×10^{-26} cm^{3} s^{-1} for 1.5 TeV DM mass in the W^{+}W^{-} annihilation channel, and 1.2×10^{-26} cm^{3} s^{-1} for 0.7 TeV DM mass in the τ^{+}τ^{-} annihilation channel. With the H.E.S.S. Inner Galaxy Survey, ground-based γ-ray observations thus probe ⟨σv⟩ values expected from thermal-relic annihilating TeV DM particles.

[Rejuvenate, it's as old as the hills ]. / Rajeunir, c'est vieux comme le monde .

Legends and myths regarding eternal youth exist since Antiquity. Prior to the 19th century those wishing to rejuvenate used baths or blood injections, searching to the Fountain of Youth or calling for an alchemist claiming to have found the Elixir of Youth. In the 19th century, Charles Edouard Brown Séquard (1819-1894), after the discovery of the function of the endocrinal glands and testicular secretions, inject himself with an extract from guinea pigs and dogs. He found himself rejuvenated! In the beginning of the 20th century, several surgeons transplanted human testicles coming from death row prisoners inmates or voluntary donors. The transplantation of monkey testicles by Serge Voronoff (1866-1951) had a important aftermath and more than 300 similar interventions took place. The simple ligation of the vas deferens (vasectomy) was recommended by Eugen Steinach (1866-1944). Sigmund Freud was one of the "beneficiaries". Steinach also advised the irradiation of the ovaries for female rejuvenation. In 1935, Alexis Carrel (1873-1944) and Charles Lindbergh (1902-1974) built a pump to feed and regenerate targeted organs. The discovery of pluripotent stem cells and senolytic molecules are building up new hopes on the matter.

[Pierre Mornard (1883-1929), unrecognized plastic surgeon]. / Pierre Mornard, (1883­1929), un plasticien méconnu.

Many operations of aesthetic surgery were described between 1920 and 1930. Several French surgeons are recognized as pioneers of the speciality. Pierre Mornard (1883-1929) published numerous articles of plastic and aesthetic surgery between 1925 and 1929 the date of his death. The articles were illustrated with drawings of surgery he had practiced. He described in 1929 the first abdominoplasty with umbilical transposition. Pierre Mornard can be considered a pioneer of aesthetic surgery.

[The history of pediatric plastic surgery]. / Histoire de la chirurgie plastique pédiatrique.

The history of pediatric plastic surgery is linked to that of paediatrics. Until the early 19th century, there was no children's hospital. Only some operations were performed before the discovery of anesthesia, aseptic and antisepsis: cleft lip repair, amputation for polydactyly. Many operations were described in the 19th century for cleft lip and palate repair, hypospadias, syndactylies. The first operation for protruding ears was performed in 1881. Pediatric plastic surgery is diversified in the 2nd half of the 20th century: cleft lip and palate, burns, craniofacial surgery, hand surgery become separate parts of the speciality.

[The history of facial paralysis]. / Histoire de la paralysie faciale.

Facial paralysis has been a recognized condition since Antiquity, and was mentionned by Hippocratus. In the 17th century, in 1687, the Dutch physician Stalpart Van der Wiel rendered a detailed observation. It was, however, Charles Bell who, in 1821, provided the description that specified the role of the facial nerve. Facial nerve surgery began at the end of the 19th century. Three different techniques were used successively: nerve anastomosis, (XI-VII Balance 1895, XII-VII, Korte 1903), myoplasties (Lexer 1908), and suspensions (Stein 1913). Bunnell successfully accomplished the first direct facial nerve repair in the temporal bone, in 1927, and in 1932 Balance and Duel experimented with nerve grafts. Thanks to progress in microsurgical techniques, the first faciofacial anastomosis was realized in 1970 (Smith, Scaramella), and an account of the first microneurovascular muscle transfer published in 1976 by Harii. Treatment of the eyelid paralysis was at the origin of numerous operations beginning in the 1960s; including palpebral spring (Morel Fatio 1962) silicone sling (Arion 1972), upperlid loading with gold plate (Illig 1968), magnets (Muhlbauer 1973) and transfacial nerve grafts (Anderl 1973). By the end of the 20th century, surgeons had at their disposal a wide range of valid techniques for facial nerve surgery, including modernized versions of older techniques.

[Louis Ombrédanne (1871-1956) pediatric and plastic surgeon]. / Louis Ombrédanne (1871-1956), chirurgien pédiatre et plasticien.

One of the fathers of pediatric surgery in France, Louis Ombrédanne (1871-1956) was a great plastic surgeon. During his residency he was initiated to plastic surgery by Charles Nélaton (1851-1911). Both wrote two books: "La rhinoplastie" and "Les autoplasties", taking stock of these techniques in the early 20th century. In 1906, he was the first to describe the pectoral muscle flap for immediate breast reconstruction after mastectomy. He used this flap in conjunction with an axillo thoracic flap. From 1908 to 1941, Louis Ombrédanne practised pediatric surgery, most of which was devoted in reconstruction of congenital and acquire anomalies. From 1924 to 1941, he was Professor of pediatric surgery at the hospital Enfants-Malades in Paris. In 1907, Louis Ombrédanne created a prototype of an ether inhaler as a safe anesthetic device. The device was successfully used for fifty years in Europe.

A low level of extragalactic background light as revealed by gamma-rays from blazars.

The diffuse extragalactic background light consists of the sum of the starlight emitted by galaxies through the history of the Universe, and it could also have an important contribution from the 'first stars', which may have formed before galaxy formation began. Direct measurements are difficult and not yet conclusive, owing to the large uncertainties caused by the bright foreground emission associated with zodiacal light. An alternative approach is to study the absorption features imprinted on the gamma-ray spectra of distant extragalactic objects by interactions of those photons with the background light photons. Here we report the discovery of gamma-ray emission from the blazars H 2356 - 309 and 1ES 1101 - 232, at redshifts z = 0.165 and z = 0.186, respectively. Their unexpectedly hard spectra provide an upper limit on the background light at optical/near-infrared wavelengths that appears to be very close to the lower limit given by the integrated light of resolved galaxies. The background flux at these wavelengths accordingly seems to be strongly dominated by the direct starlight from galaxies, thus excluding a large contribution from other sources-in particular from the first stars formed. This result also indicates that intergalactic space is more transparent to gamma-rays than previously thought.

Discovery of very-high-energy gamma-rays from the Galactic Centre ridge.

The source of Galactic cosmic rays (with energies up to 10(15) eV) remains unclear, although it is widely believed that they originate in the shock waves of expanding supernova remnants. At present the best way to investigate their acceleration and propagation is by observing the gamma-rays produced when cosmic rays interact with interstellar gas. Here we report observations of an extended region of very-high-energy (> 10(11) eV) gamma-ray emission correlated spatially with a complex of giant molecular clouds in the central 200 parsecs of the Milky Way. The hardness of the gamma-ray spectrum and the conditions in those molecular clouds indicate that the cosmic rays giving rise to the gamma-rays are likely to be protons and nuclei rather than electrons. The energy associated with the cosmic rays could have come from a single supernova explosion around 10(4) years ago.

[Jacques Mathieu Delpech and School of Montpellier: 1st part Jacques Mathieu Delpech (1777-1832)]. / Jacques Mathieu Delpech et l'École de Montpellier: 1ère partie Jacques Mathieu Delpech (1777-1832).

Two surgeons have labeled, in France, the first period of the 19th century. The one is universally known, it is Dupuytren, the other one underestimated who can be nevertheless considered as his equal: Jacques Mathieu Delpech. From Toulouse, child of the Revolution, he taught the anatomy from the age of 14 years, became assistant chief warrant officer in the revolutionary armies, gave up competing with Dupuytren, and became Professor of Surgery in Montpellier in 1812. Delpech reintroduced the teaching of the Anatomy and the Surgery. Author of first forehead flap in France, he revolutionized the treatment of the clubfoot. He created an Institute of Orthomorphia where he made practice the gymnastics and the active reeducation. He was interested in the healing process and in the correction of the deformations of the body. He was murdered when he was 55 by one of his patients. He is the founder of the School of plastic surgery of Montpellier, which will compete in the 19th century with the school of Berlin of Dieffenbach.

Time-resolved hadronic particle acceleration in the recurrent nova RS Ophiuchi.

Recurrent novae are repeating thermonuclear explosions in the outer layers of white dwarfs, due to the accretion of fresh material from a binary companion. The shock generated when ejected material slams into the companion star's wind can accelerate particles. We report very-high-energy (VHE; [Formula: see text]) gamma rays from the recurrent nova RS Ophiuchi, up to 1 month after its 2021 outburst, observed using the High Energy Stereoscopic System (H.E.S.S.). The temporal profile of VHE emission is similar to that of lower-energy giga-electron volt emission, indicating a common origin, with a 2-day delay in peak flux. These observations constrain models of time-dependent particle energization, favoring a hadronic emission scenario over the leptonic alternative. Shocks in dense winds provide favorable environments for efficient acceleration of cosmic rays to very high energies.

[The Golden book of the French plastic surgery]. / Un livre d'or de la chirurgie plastique française.

Susruta, Tagliacozzi and Dieffenbach are considered to be the first plastic surgeons. Many French surgeons deserve to figure in the "Golden Book" of the specialty. From Pierre Franco to Paul Tessier, many famous or sometimes unknown surgeons introduced important innovations. In the XVIth century, Pierre Franco realized the first autoplasty of the face as well as the first suture of a cleft lift. This was modified by Mirault, three centuries later. Delpech created at Montpellier a real "school" dedicated to plastic surgery where there was an attempt to oppose a French technique to the success of surgeons from Berlin. Roux was the first (or the second according to Von Graefe) to succeed a cleft palate closure. The first Z plasty was performed by Denonvilliers and Morestin devoted many works to plastic surgery insisting on scar discretion. After World War II, the main cosmetic procedures were described and performed by French surgeons: Bourguet, Passot, Dartigues… Suzanne Noel was the first female plastic surgeon and the first to perform outpatient operations. After the creation of the French Society of Plastic surgery, Paul Tessier conceived the craniofacial surgery. An important step in cosmetic surgery was liposuction described by Y.G. Illouz. More recently, French teams performed the first allotransplantation of the face and of the upper limbs.

[Pioneers and martyrs: Delpech, Guinard, Pozzi]. / Pionniers et martyrs : Delpech, Guinard, Pozzi.

Jacques Mathieu Delpech, Aimé Guinard Samuel Pozzi, three famous surgeons of the 19th and early 20th century were murdered by patients. All three contributed to the history of plastic surgery. Delpech (1777-1832) carried out the first plastic surgery in France using a forehead flap to replace a loss of substance on the face, Guinard (1856-1911) did the first reduction mammaplasty. Pozzi (1846-1918) was probably the first to perform an operation of face lift on one of his patients but did not publish it. These three surgeons were killed by unbalanced patients they had operated of benign lesions.

[Jules Guérin (1801-1885) and wound pneumatic occlusion, a precursor of V.A.C.((R))]. / Jules Guérin (1801-1885) et l'occlusion pneumatique des plaies, un précurseur du V.A.C.((R))

Vacuum-Assisted Closure System((R)) (V.A.C.((R))), tested and introduced by MJ Moryk- was and LC Argenta in 1977, is a wide-spread procedure used for the treatment of defects and chronic wounds. In the middle of the 19th century, a French surgeon tried hopelessly to convince the medical authorities by that time of the interest of a similar method. In 1844, Jules Guérin (1801-1885) imagined a process and described the technique and the results in the prestigious Academy of Medicine and Sciences in Paris in 1866 and 1867. Jules Guérin proposed to treat chronic wounds and defects by what he called "pneumatic occlusion". He proposed an apparatus with three parts: a process dressing applied to be wound a rubber occlusive membrane linked to an empty bell with a manometer. Jules Guérin presented his method with the indications, severed times at the Academy of Medicine. Results were detailed on complex wounds or amputations strumps. He explained with detail the action of the pneumatic occlusion but without taking on to account the role microorganisms and the absence of hygiene in infections. Unfortunately for him, his presentations were contemporary to the works of Pasteur and Lister. All surgeons privileged the use of antiseptics on wounds. The works of Jules Guérin were forgotten.

Advantage of the presence of living dermal fibroblasts within in vitro reconstructed skin for grafting in humans.

Methods for serial cultivation of human keratinocytes can provide large quantities of epidermal cells, which have the potential of restoring the vital barrier function of the epidermis in extensive skin defects such as burns. To investigate the value of combining an epidermis with a dermal component, fibroblasts originated from the superficial dermis were used to seed a collagen lattice as described by E. Bell (dermal equivalent). Beginning in 1981, we grafted 18 patients (burns and giant nevi) using 35 grafts 10 x 10 cm in size. In the course of this work, the original technique was modified and improved as experience was gained. We began by using small skin biopsy samples as a source of keratinocytes cultured on a dermal equivalent before grafting in a one-step procedure, but this gave poor cosmetic results, because of a nonhomogeneous epidermalization. We then chose to cover the graft bed using a two-step procedure. The first step consisted of grafting a dermal equivalent to provide a dermal fibroblast-seeded substrate for subsequent in vivo epidermalization by cultured epidermal sheets. Whatever the epidermalization technique used, a living dermal equivalent applied to the graft bed was found to reduce pain, to provide good hemostasis, and to improve the mechanical and cosmetic properties of the graft. A normal undulating dermal-epidermal junction reappeared by 3 to 4 months after grafting and elastic fibers were detectable 6 to 9 months after grafting. As a result of the biosynthesis of these products, the suppleness (e.g., elasticity) of the grafts was closer to that of normal skin than the cicatricial skin usually obtained with epidermal sheets grafted without the presence of living dermal cells. This rapid improvement of the mechanical properties of the graft could be attributed to the presence of fibroblasts cultured from the dermis and seeded into the collagen matrix.

The hand in recessive dystrophic epidermolysis bullosa.

Recessive dystrophic epidermolysis bullosa is still a difficult challenge for surgeons and doctors. Hand retractions are different from burns. The medical team must have a good knowledge of the disease. Surgery must be performed with the collaboration of every member of the team, as well as the family. In young children, complete correction of the retractions is possible. On the other hand, when retractions are present for a long time in children and adolescents, surgery is purely functional. Static and dynamic splints delay recurrences, but their prolonged use presents psychological obstacles in adolescents and adults.

[Anesthesia for hand surgery in patients with epidermolysis bullosa]. / Anesthésie pour chirurgie de la main chez des patients atteints d'épidermolyse bulleuse.

OBJECTIVE: To report on the anaesthetic management with axillary block of patients suffering from recessive dystrophic epidermolysis bullosa (RDEB), undergoing repetitive surgery of the hand. STUDY DESIGN: Retrospective analysis of a case series. PATIENTS: Twenty-two patients, including 11 children less than 8-year-old and with a body weight under 20 kg, treated since 1988, were considered. METHODS: For surgery, including usually three stages at a 7-day interval, an axillary block was placed when feasible, after oral premedication midazolam (0.1-0.2 mg.kg-1) with a 25 gauge needle in patients of less than 30 kg of body weight and 22 gauge beyond. The local anaesthetic mixture included 2% lidocaine (5-10 mg.kg-1) and 0.5% bupivacaine (2-3 mg.kg-1). A catheter for repetitive injections had not been inserted. For children less than 10-year-old a parent was present in the theater during all the course of operation. RESULTS: Between 1988 and 1995, 22 patients underwent 160 operative interventions on 54 hands. Regional anaesthesia was used in 142 cases, including 140 axillary and 2 interscalene blocks. General anaesthesia was only required in 20 cases, either alone or associated with regional anaesthesia. The success rate of axillary blocks was 98%. DISCUSSION: For surgery of the hand in patients with RDEB, we switched in 1988 from general anaesthesia with ketamine to axillary block, even in young children, as it is closer to the no-touch principle, which is essential to prevent from blistering. In comparison to general anaesthesia, regional anaesthesia raises neither the problems of airway and vascular access, nor those of instrumental monitoring. The main factors of success with regional anaesthesia are technical skills, expertise in the management of patients with RDEB and parental presence in the operating room which makes the procedure less stressful for children.

[Pachydermodactyly: a report of two cases]. / Pachydermodactylie: deux nouvelles observations.

Pachydermodactyly is a superficial benign, symmetrical and painless fibromatosis, characterized by a swelling of the proximal interphalangeal joints of the fingers. Histological examination shows epidermal hyperplasia increase of dermal collagen bundles and an increased number of fibroblasts. We report two cases of pachydermodactyly in male teenagers. The aetiology remains unknown. Pachydermodactyly has to be distinguished from knuckle pads.

Fractures of the base of the first metacarpal in children. Role of K-wire stabilisation.

In order to define the factors of instability of fractures of the base of the first metacarpal in children, the authors reviewed 30 children presenting this lesion with a follow-up greater than 10 months. Patients in whom the growth cartilage of the base of the first metacarpal was still open and presenting a fracture with angular displacement greater than 30 degrees or metaphyso-epiphyseal sliding greater than 1 mm were included. Three groups were defined on the basis of radiographic findings: Group A: pure metaphyseal fractures (14 cases: 10 pinnings and 4 orthopaedic treatments); Group B: Salter II epiphyseal detachment fractures with a medial metaphyso-epiphyseal corner (10 cases: 1 pinning and 9 orthopaedic treatments); group C: Salter II epiphyseal detachment fractures with a lateral metaphyso-epiphyseal corner (6 cases: 2 pinnings and 4 orthopaedic treatments). The authors studied early secondary displacements as a function of the emergency treatment modality. No secondary displacement was observed for group B lesions regardless of treatment and for lesions stabilized immediately by intermetacarpal pinning. In contrast, one half of group A and C lesions treated orthopaedically subsequently became displaced, requiring surgical revision with stabilization by pinning. The authors recommend orthopaedic treatment for group B lesions and immediate surgical stabilization for group A and C lesions.