[Endometriosis: Assessment of the Ultrasound-Based Endometriosis Staging System score (UBESS) in predicting surgical difficulty]. / Endométriose : évaluation du score Ultrasound-Based Endometriosis Staging System (UBESS) dans la prédiction de la difficulté chirurgicale.

OBJECTIVES: Surgical management of endometriosis may require different levels of surgical skill which influences the orientation of the patient. The Ultrasound-Based Endometriosis Staging System (UBESS) is a score developed in 2016 to predict the difficulty of surgery. To study the correlation between UBESS score and two main surgical classifications in the literature. METHODS: Study performed at the center of Poissy, France, between July 2016 and December 2017. Patients who underwent prospective UBESS staging then operated of their endometriosis were included. The patients were classified according to the levels of surgical difficulty of the Royal College of Obstetricians and Gynecologists (RCOG) and the classification created by Chi et al. The criterion of judgment was the correlation between the UBESS stages and RCOG and CHI levels. In a second analysis, we determined the predictive value of the operative plan for items included in the systematic sonographic evaluation described by Menakaya et al. RESULTS: Thirty-three patients were included in the study. Correlation was found to be low between UBESS and RCOG (θ=0.22) and between UBESS and CHI (θ=0.30). The prediction of the operative plan was good for endometrioma, sites specific tenderness, sliding sign, vaginal and digestive tract involvement; but modest for the anterior compartment and uterosacrals ligaments. CONCLUSION: In our study on a small number of patients, the UBESS score does not adequately predict the surgical difficulty. Taken separately, the items of systematic sonographic evaluation based on 5 domains successfully predict the operative plan.

Association study of MICA gene polymorphisms with rheumatoid arthritis susceptibility in south Tunisian population.

The aim of this study was to investigate the role of major histocompatibility complex (MHC) class I chain-related gene A (MICA) polymorphisms, important in natural killer (NK) cell function, in patients with rheumatoid arthritis (RA). A transmembrane (TM) alanine-encoding GCT repeats, termed A4, A5, A5.1, A6 and A9 in the MICA gene, and single-nucleotide polymorphisms (SNPs): the Met129Val polymorphism (rs1051792) and the nonsynonymously coding SNP (rs1051794) were genotyped in 142 patients with RA and 123 unrelated healthy individuals using, respectively, PCR fluorescent method, nested PCR-RFLP and allele specific PCR (ASP). Association was assessed based on the χ2 test, genotype relative risk (GRR) and odds ratio (OR) with 95% confidence intervals (CIs). Our results show a trend of association of the different MICA genotypes G/G, G/A and A/A (P = 0.029) which did not attain the significance after Bonferroni's correction (pc = 0.08). Although, we revealed a significant association of the genotype A/A of MICA-250 in patients with RA compared to healthy controls (pc = 0.033). In contrast, no significant differences between alleles and genotypes frequencies were found either with MICA-TM or MICA met129 val (P > 0.05) in our sample. Moreover, stratification of patients with RA according to clinical and immunological data for the different polymorphisms studied shows a significant association of both MICA-250 G allele (pc = 0.0075) and MICA-250 GG genotype (pc = 0.008) and both allelic (val) (pc = 0.021) and genotypic (val/val) distribution (pc = 0.0095) for MICA met129 val in the RF-positive subgroup compared to RF-negative patients with RA. In contrast, we found a strong association of the MICA-TM A9 allele in RF-negative patients with RA (pc = 0.0003). This study indicates the involvement of the MICA-250 polymorphism in the genetic susceptibility and severity to RA and suggests that variations in MICA-TM and MICA met129 val may have an effect on RA severity in our south Tunisian sample.

Bizarre Parosteal Osteochondromatous Proliferation: Nora's Lesion.

The purpose of this study was to review the imaging and anatomopathologic findings and to discuss the main differential diagnosis of bizarre parosteal osteochondromatous proliferation (BPOP) or Nora's lesion, a rare benign surface lesion of the bone. Histologically confirmed plain radiographs, ultrasound, CT and MRI images of four patients with BPOP were obtained and retrospectively reviewed. Three cases involving the hand and one involving the foot are reported. On plain radiographs, BPOP is a wellmarginated, calcified or ossified mass arising directly from the cortical surface of the underlying bone. Ultrasound images show a low echoic peripheral cap around the lesion. CT images show the wide base of the lesion. On MRI, BPOP was of a low signal on T1, enhancing following gadolinium administration. Underlying bone and adjacent surrounding soft tissues were normal.

[Isolated synovial chondromatosis of the subacromial bursa: report of a new case and review of the literature]. / La chondromatose synoviale isolée de la bourse sous acromiodeltoïdienne: un nouveau cas et revue de la littérature.

Synovial chondromatosis is a rare metaplasia of the synovium of unknown etiology that may involve occasionally the subacromial bursa. We report a new case diagnosed by ultrasound in a 30-year-old man and we present pathogenetic, diagnostic and therapeutic features of this disease with a literature review.

[Balò's concentric sclerosis in a North-African patient]. / Sclérose concentrique de Balò chez un patient nord-africain.

INTRODUCTION: Balo's concentric sclerosis is a rare variant of multiple sclerosis described by Balo in 1928. It is characterized by alternating rings of demyelination and spared myelin. CASE REPORT: We report a case of Balo's concentric sclerosis diagnosed by the typical MRI findings of concentric rings of demyelination. Medullar and brain localisation were found and clinical course was good under intravenous corticosteroids. CONCLUSION: MRI provides the best diagnostic information for Balo's concentric sclerosis, allowing early diagnosis and treatment.

Subcutaneous fat necrosis: report of two cases.

Subcutaneous fat necrosis of the newborn is an uncommon, benign process in full-term infants or postmature neonates who experienced a perinatal distress. It is a transient condition of unknown origin; however, hypercalcemia may be a potentially life-threatening complication of this otherwise self-healing process. We report two cases of subcutaneous fat necrosis and discuss the clinical features, etiology, and complications of the disease.

[The industrial management and the management of surgical units]. / La gestion industrielle et la gestion des blocs opératoires.

Management of operating rooms is moving nowadays. Financial constraints as well as new operating practices prompt the hospital manager to optimise the operating room utilisation. The manufacturing systems faced a similar situation in the early 1980, due to the increase in the cost of the energetic products and the new competitive environment. Manufacturers had to improve dramatically their management capabilities in order to overcome their financial and technical difficulties. If the manufacturing management is extensively developed nowadays, the operating room is still running on an intuitive, individual and manual basis. The purpose of this review is to describe the main features of the manufacturing management and to identify those relevant to the management of operating rooms.

Lipolytic action of Buthus occitanus tunetanus venom: involvement of the beta adrenergic pathway.

Scorpion venoms contain active neurotoxins known to act selectively at the level of voltage sensitive Na+ and K+ channels on mammal nervous system. In the present report, we show for the first time that the venom of scorpion Buthus occitanus tunetanus (Bot) contains compounds able to activate another cell function in non excitable cells. Addition of this venom to the culture media of 3T3-L1 adipocytes or freshly dissociated rat adipocytes rapidly increases lipolysis as estimated by glycerol release (approximately 3 to 4 fold over basal values) in a dose-dependent manner (EC50 approximately 12 +/- 1.25 micrograms/ml; n = 3). Bot venom effect was lower and not additive to the effect produced by isoproterenol (IPE) (10 microM), a main lipolytic agent, n = 3. In Sephadex G-50 size exclusion chromatography, the lipolytic activity was excluded and not associated to the included neurotoxic fraction. Furthermore, no lipolytic effect could be detected in the Na+ channel specific toxin II purified from Androctonus australis hector (AaHII) or the K+ voltage-dependent channel toxin from Androctonus mauritanicus mauritanicus (KTx). Propranolol (a non selective beta adrenoreceptor (beta AR) antagonist), alprenolol and pindolol (selective beta 1/beta 2 antagonists) totally inhibited in a dose-dependent manner the lipolytic response to Bot venom (IC50 approximately 1 x 10(-7), 7.5 x 10(-8) and 3 x 10(-7)M, respectively), suggesting that venom stimulated lipolysis through the beta AR pathway. The pharmacological profiles of molecules acting more selectively on beta AR subtypes such as CGP 12177 (beta 1/ beta 2 antagonist with beta 3 agonist properties), CGP 20712A (beta 1 antagonist) and ICI 118551 (beta 2 antagonist) strongly suggest that lipolytic action of venom mainly involves the beta 2/beta 1 AR subtypes.