Lead-free Cu–Sb solder alloys of nominal composition Cu–20 at % Sb were fabricated by SHS and electrothermal explosion (ETE) and characterized by XRD, SEM, and vibrating sample magnetometry (VSM). Combustion products were found to represent a mixture of δ-Cu 11 Sb 3 , β-Cu 3 Sb, and Cu. The ETE and SHS methods were recommended as a facile route to synthesis of Cu–Sb intermetallics.

Al and Ce films have been deposited on TA6V alloy by physical vapor deposition of Al and cathodic electrode position process from a Ce(NO3)3, 6H2O and mixed water-ethyl alcohol solution at 0.01 M, respectively. The experimental conditions for the achievement of a uniform deposit, adherent and non-cracking were identified and determined by electrochemical methods. The transformation of the deposited layers into CeO2 and Al2O3 oxides obtained by heat treatment of the coated alloy, is expected to increase the resistance to high temperature oxidation. The coating films were characterized by differential scanning calorimetry (DSC), X-ray diffraction (XRD) and scanning electron microscopy (SEM).

To review in the literature, all the epidemiological, clinical, radiological, histological and therapeutic data regarding chordomas as well as various notochordal entities: ecchordosis physaliphora, intradural and intraparenchymatous chordomas, benign notochordal cell tumors, parachordomas and extra-axial chordomas. To identify different types of chordomas, including familial forms, associations with tuberous sclerosis, Ollier's disease and Maffucci's syndrome, forms with metastasis and seeding. To assess the recent data regarding molecular biology and progress in targeted therapy. To compare the different types of radiotherapy, especially protontherapy and their therapeutic effects. To review the largest series of chordomas in their different localizations (skull base, sacrum and mobile spine) from the literature.The series of 136 chordomas treated and followed up over 20 years (1972-2012) in the department of neurosurgery at Lariboisière hospital is reviewed. It includes: 58 chordomas of the skull base, 47 of the craniocervical junction, 23 of the cervical spine and 8 from the lombosacral region. Similarly, 31 chordomas in children (less than 18 years of age), observed in the departments of neurosurgery of les Enfants-Malades and Lariboisière hospitals, are presented. They were observed between 1976 and 2010 and were located intracranially (n=22 including 13 with cervical extension), 4 at the craniocervical junction level and 5 in the cervical spine.In the entire Lariboisière series and in the different groups of localization, different parameters were analyzed: the delay of diagnosis, of follow-up, of occurrence of metastasis, recurrence and death, the number of primary patients and patients referred to us after progression or recurrence and the number of deaths, recurrences and metastases. The influence of the quality of resection (total, subtotal and partial) on the prognosis is also presented. Kaplan-Meier actuarial curves of overall survival and disease free survival were performed in the entire series, including the different groups of localization based on the following 4 parameters: age, primary and secondary patients, quality of resection and protontherapy. In the pediatric series, a similar analysis was carried-out but was limited by the small number of patients in the subgroups.In the Lariboisière series, the mean delay of diagnosis is 10 months and the mean follow-up is 80 months in each group. The delay before recurrence, metastasis and death is always better for the skull base chordomas and worse for those of the craniocervical junction, which have similar results to those of the cervical spine. Similar figures were observed as regards the number of deaths, metastases and recurrences. Quality of resection is the major factor of prognosis with 20.5 % of deaths and 28 % of recurrences after total resection as compared to 52.5 % and 47.5 % after subtotal resection. This is still more obvious in the group of skull base chordomas. Adding protontherapy to a total resection can still improve the results but there is no change after subtotal resection. The actuarial curve of overall survival shows a clear cut in the slope with some chordomas having a fast evolution towards recurrence and death in less than 4 years and others having a long survival of sometimes more than 20 years. Also, age has no influence on the prognosis. In primary patients, disease free survival is better than in secondary patients but not in overall survival. Protontherapy only improves the overall survival in the entire series and in the skull base group. Total resection improves both the overall and disease free survival in each group. Finally, the adjunct of protontherapy after total resection is clearly demonstrated. In the pediatric series, the median follow-up is 5.7 years. Overall survival and disease free survival are respectively 63 % and 54.3 %. Factors of prognosis are the histological type (atypical forms), localization (worse for the cervical spine and better for the clivus) and again it will depend on the quality of resection.Many different pathologies derived from the notochord can be observed: some are remnants, some may be precursors of chordomas and some have similar features but are probably not genuine chordomas. To-day, immuno-histological studies should permit to differentiate them from real chordomas. Improving knowledge of molecular biology raises hopes for complementary treatments but to date the quality of surgical resection is still the main factor of prognosis. Complementary protontherapy seems useful, especially in skull base chordomas, which have better overall results than those of the craniocervical junction and of the cervical spine. However, we are still lacking an intrinsic marker of evolution to differentiate the slow growing chordomas with an indolent evolution from aggressive types leading rapidly to recurrence and death on which more aggressive treatments should be applied.

To review in the literature, all the epidemiological, clinical, radiological, histological and therapeutic data regarding chordomas as well as various notochordal entities: ecchordosis physaliphora, intradural and intraparenchymatous chordomas, benign notochordal cell tumors, parachordomas and extra-axial chordomas. To identify different types of chordomas, including familial forms, associations with tuberous sclerosis, Ollier's disease and Maffucci's syndrome, forms with metastasis and seeding. To assess the recent data regarding molecular biology and progress in targeted therapy. To compare the different types of radiotherapy, especially protontherapy and their therapeutic effects. To review the largest series of chordomas in their different localizations (skull base, sacrum and mobile spine) from the literature.The series of 136 chordomas treated and followed up over 20 years (1972-2012) in the department of neurosurgery at Lariboisière hospital is reviewed. It includes: 58 chordomas of the skull base, 47 of the craniocervical junction, 23 of the cervical spine and 8 from the lombosacral region. Similarly, 31 chordomas in children (less than 18 years of age), observed in the departments of neurosurgery of les Enfants-Malades and Lariboisière hospitals, are presented. They were observed between 1976 and 2010 and were located intracranially (n=22 including 13 with cervical extension), 4 at the craniocervical junction level and 5 in the cervical spine.In the entire Lariboisière series and in the different groups of localization, different parameters were analyzed: the delay of diagnosis, of follow-up, of occurrence of metastasis, recurrence and death, the number of primary patients and patients referred to us after progression or recurrence and the number of deaths, recurrences and metastases. The influence of the quality of resection (total, subtotal and partial) on the prognosis is also presented. Kaplan-Meier actuarial curves of overall survival and disease free survival were performed in the entire series, including the different groups of localization based on the following 4 parameters: age, primary and secondary patients, quality of resection and protontherapy. In the pediatric series, a similar analysis was carried-out but was limited by the small number of patients in the subgroups.In the Lariboisière series, the mean delay of diagnosis is 10 months and the mean follow-up is 80 months in each group. The delay before recurrence, metastasis and death is always better for the skull base chordomas and worse for those of the craniocervical junction, which have similar results to those of the cervical spine. Similar figures were observed as regards the number of deaths, metastases and recurrences. Quality of resection is the major factor of prognosis with 20.5 % of deaths and 28 % of recurrences after total resection as compared to 52.5 % and 47.5 % after subtotal resection. This is still more obvious in the group of skull base chordomas. Adding protontherapy to a total resection can still improve the results but there is no change after subtotal resection. The actuarial curve of overall survival shows a clear cut in the slope with some chordomas having a fast evolution towards recurrence and death in less than 4 years and others having a long survival of sometimes more than 20 years. Also, age has no influence on the prognosis. In primary patients, disease free survival is better than in secondary patients but not in overall survival. Protontherapy only improves the overall survival in the entire series and in the skull base group. Total resection improves both the overall and disease free survival in each group. Finally, the adjunct of protontherapy after total resection is clearly demonstrated. In the pediatric series, the median follow-up is 5.7 years. Overall survival and disease free survival are respectively 63 % and 54.3 %. Factors of prognosis are the histological type (atypical forms), localization (worse for the cervical spine and better for the clivus) and again it will depend on the quality of resection.Many different pathologies derived from the notochord can be observed: some are remnants, some may be precursors of chordomas and some have similar features but are probably not genuine chordomas. To-day, immuno-histological studies should permit to differentiate them from real chordomas. Improving knowledge of molecular biology raises hopes for complementary treatments but to date the quality of surgical resection is still the main factor of prognosis. Complementary protontherapy seems useful, especially in skull base chordomas, which have better overall results than those of the craniocervical junction and of the cervical spine. However, we are still lacking an intrinsic marker of evolution to differentiate the slow growing chordomas with an indolent evolution from aggressive types leading rapidly to recurrence and death on which more aggressive treatments should be applied.

In der Migränetherapie steht die medikamentöse Behandlung zurzeit im Vordergrund, da für komplementäre Therapien noch nicht genügend wissenschaftliche Wirksamkeitsnachweise vorliegen. Die vorliegende klinische randomisierte Interventionsstudie sollte daher untersuchen, inwiefern osteopathische Behandlungen zusätzlich zur medikamentösen Therapie einen positiven Einfluss auf den Analgetikaverbrauch, das Schmerzausmaß und der Lebensqualität bei Migränepatienten hat.Die Ergebnisse zeigten, dass eine Serie von befundabhängigen osteopathischen Behandlungen sich positiv auf das Schmerzausmaß und die Lebensqualität von Patienten mit Migräne auswirken kann. Über den Einfluss auf den Analgetikaverbrauch konnte aufgrund methodischer Fehler keine statistisch gesicherte Aussage getroffen werden.The standardized medical treatment stands in the foreground in therapy of migraine. There are not yet enough scientific efficacy proofs for complementary therapies. The intention of this randomized, controlled intervention trial was to examine the influence of osteopathic treatment, in addition to a medical therapy, has a positive effect on analgesic consumption, pain severity and quality of life of migraine patients.The results showed a positive impact of osteopathic therapy related to individual diagnostic findings of migraine patients on pain degree as well as on quality of life. Further studies with bigger samples and longer treatment durations have to reiterate and proove our results and measure possible positive long-term effects, especially with regard to significant decreases in medicament intake. A statement about the consumption of analgesics cannot be made. Due to methodical errors the information about analgesic consumption was not precise enough for a statistical analysis.

Computer-assisted surgery has been more and more widely used in craniofacial surgery in recent years. It is useful in many situations: stereolithographic models, surgical simulations of osteotomies and bone repositioning, and cutting guides and customized implants. The present paper argues that computer-assisted surgery is particularly useful in complex cases such as rare malformations, or to address the sequelae of previous surgeries. The various advantages of the technique are emphasized from a surgical and from a teaching standpoint.Forty cases of various computer-assisted surgeries were analyzed, allowing a comprehensive review of outcomes in cases such as craniosynostosis, complex craniosynostosis, hypertelorism, craniosynostosis sequelae and cranio-facial and orbital trauma.Results were promising in all of the cases reviewed, except in a few cases for which computer-assisted surgery with cutting guides may not be necessary. In these specific cases, the pedagogical input is nevertheless interesting for residents and students.Computer-assisted surgery is revolutionizing the surgical approach to complex craniofacial malformations, as well as easing management of less complex ones. It is likely that in the years to come this technique will supersede previous ones. However, using this technique implies being willing to rely on a non-human device. We need to consider computer-assisted surgery as a tool that can change surgical practices. The surgeon can rely on it, yet nothing will replace his/her eye and experience. It is the combination of both this experience and the appropriate use of computer-assisted surgery that, ultimately, leads to successful surgery.

Purpose. - The aim of this study was to analyze the indications and the effect of permanently maintaining silicone oil in the treatment of certain cases of vitreoretinal pathology.Patients and methods. - Twenty-seven cases seen from January 2002 to December 2008 were retrospectively studied. Silicone oil was kept in the eyes for more than 2 years. The surgical file was analyzed in all cases. The evaluation criteria were ocular pressure, emulsification, cataract, corneal dystrophy, and the functional response of the retina and optic nerve. Ultrasound echography (12 MHz), magnetic resonance imaging, and electrophysiological explorations (visual evoked potential and electroretinography) were performed.Results. - Twenty-seven eyes of 27 patients were included in this study. The main reasons for maintaining long-term silicone oil are recurrent vitreous hemorrhage, retinal detachment with severe proliferative vitreoretinopathy, and penetrating injury. The patients were distributed into two groups: group 1 included patients with both functional and anatomic failure, group 2 patients had achieved ambulatory vision. Follow-up ranged from 27 to 72 months. Cataract incidence was approximately 91% in group 2. Emulsification was noted without high pressure in 50% of the cases in group 1. High pressure averaged 31.8% in group 2. Keratopathy was observed in 9% of the cases in group 2. Intraorbital migration of silicone oil was found in one case. The visual field was improved in 77% of the cases in group 2.Conclusion. - This study provided interesting insights into certain clinical situations in which silicone oil has to be maintained permanently. The complications stem not only from the presence of silicone oil, but also from the preoperative status of the eye and the vitreoretinal surgery. (C) 2012 Elsevier Masson SAS. All rights reserved.

BACKGROUND:After completing a craniotomy, it is important to replace the removed bone flap in its natural position in order to guarantee brain protection as well as improve cosmesis. A skull defect can expose the brain to accidental damage, and in cases of larger defects it may also cause the patients psychosocial problems. The ideal fixation device should provide reliable attachment of the flap to the skull and promote fast bony healing to avoid possible pseudo-arthrosis and/or osteolytic changes.MATERIALS AND METHODS:This is a pilot randomized clinical trial on a series of 16 patients undergoing different craniotomies for benign brain lesions in which the bone flaps were replaced using traditional sutures (Prolene 0.0) in 8 cases and with a new skull fixation device (Skull Grip) in the other 8 (randomly allocated). All patients underwent CT scans of the head with 3D reconstruction at day 1 and day 90 postoperatively to evaluate bone flap position and fusion. These scans were independently reviewed by a neuroradiologist. Cosmesis was also evaluated clinically by the surgeon and radiologically by the neuroradiologist in the 2 patient groups.RESULTS:The new "Skull Grip" device has shown stronger fixation qualities with optimal bone flap fusion and increased cosmetic healing features vs. traditional sutures.CONCLUSION:The "Skull Grip" has shown to be a reliable, effective and stronger bone flap fixation device when compared to traditional sutures.

The aging of the population in westernized countries constitutes an important issue for the health systems struggling with limited resources and increasing costs. Morbidity and mortality rates reported for neurosurgical procedures in the elderly vary widely. The lack of data on risk benefit ratios may result in challenging clinical decisions in this expanding group of patients. The aim of this paper is to analyze the elderly patients cohort undergoing neurosurgical procedures and any trend variations over time. The medical records of elderly patients (defined as an individual of 70 years of age and over) admitted to the Neurosurgical and Neuro-ICU Departments of a major University Hospital in Paris over a 25-year period were retrospectively reviewed. The analysis included: (1) number of admissions, (2) percentage of surgically treated patients, (3) type of procedures performed, (4) length of hospital stay, and (5) mortality. The analysis showed a progressive and significant increase in the proportion of elderly presenting for neurosurgical elective and/or emergency procedures over the last 25 years. The number of procedures on patients over 70 years of age increased significantly whereas the mortality dropped. Though the length of hospital stay was reduced, it remained significantly higher than the average stay. The types of procedures also changed over time with more craniotomies and endovascular procedures being performed. Age should not be considered as a contraindication for complex procedures in neurosurgery. However, downstream structures for postoperative elderly patients must be further developed to reduce the mean hospital stay in neurosurgical departments because this trend is likely to continue to grow.

Deep brain mapping has been proposed for direct targeting in stereotactic functional surgery, aiming to personalize electrode implantation according to individual MRI anatomy without atlas or statistical template. We report our clinical experience of direct targeting in a series of 156 patients operated on using a dedicated Inversion Recovery Turbo Spin Echo sequence at 1.5-tesla, called White Matter Attenuated Inversion Recovery (WAIR).After manual contouring of all pertinent structures and 3D planning of trajectories, 312 DBS electrodes were implanted. Detailed anatomy of close neighbouring structures, whether gray nuclei or white matter regions, was identified during each planning procedure. We gathered the experience of these 312 deep brain mappings and elaborated consistent procedures of anatomical MRI mapping for pallidal, subthalamic and ventral thalamic regions. We studied the number of times the central track anatomically optimized was selected for implantation of definitive electrodes.WAIR sequence provided high-quality images of most common functional targets, successfully used for pure direct stereotactic targeting: the central track corresponding to the optimized primary anatomical trajectory was chosen for implantation of definitive electrodes in 90.38%.WAIR sequence is anatomically reliable, enabling precise deep brain mapping and direct stereotactic targeting under routine clinical conditions.

Les tumeurs de la fosse infratemporale (FIT) sont rares et leur épidémiologie mal connue. Il est parfois difficile pour le clinicien, rarement confronté à ces lésions, de distinguer une tumeur bénigne d’une tumeur maligne sur les seules données de l’examen clinique et de l’imagerie. Les objectifs de cette étude étaient, à partir d’une série rétrospective : (i) de décrire la prévalence des différents types histologiques de tumeurs de la FIT et (ii) d’étudier l’association entre certains signes cliniques et/ou radiologiques et la présence d’une tumeur maligne.Il s’agit d’une étude rétrospective monocentrique, menée dans un centre hospitalier universitaire. Tous les nouveaux cas consécutifs de tumeur de la FIT pris en charge entre janvier 2000 et décembre 2016 ont été inclus. Le type histologique, les données démographiques, la présentation clinique ainsi que les données radiologiques ont été analysés.Un total de 62 patients ont été inclus. Il s’agissait de tumeurs bénignes dans 74 % des cas (n = 46) et de tumeurs malignes dans 26 % des cas. Le fibrome nasopharyngien, le carcinome adénoïde kystique et le schwannome étaient les types histologiques les plus fréquents (47 %, 16 % et 10 % respectivement). La présence d’un trismus, d’une douleur faciale, d’une hypoesthésie faciale et l’invasion nerveuse visualisée à l’IRM étaient significativement associées à la présence d’une tumeur maligne (valeur de p < 0,05).Cette étude fournit des données épidémiologiques générales concernant les tumeurs de la FIT et identifie plusieurs signes cliniques et radiologiques devant faire suspecter une tumeur maligne.

Cerium oxide films are widely studied as a promising alternative to the toxic hexavalent Chromium Cr(VI) based pre-treatments for the corrosion protection of different metals and alloys. Cathodic electro-deposition of Cerium compound thin films was realised on Ti alloy (TA6V) substrates from a Ce(NO3)3, 6H2O in water-ethyl alcohol solutions at 0.01 M. Experimental conditions to obtain homogeneous and crack free thin films were determined. The deposited cerium quantity, as expected, is proportional to the used electric charge, following the Faraday law. Subsequent thermal treatment led to a CeO2 coating, which is expected to increase the TA6V oxidation resistance at high temperatures. The deposits were characterized by Differential Scanning Calorimetry (DSC), optical and scanning electron microscopies.

Neurofibromatosis type 2 (NF2) affects about one in 25,000 to 40,000 people. Most NF2 patients have private loss-of-function mutations scattered along the NF2 gene. Here, we present our NF2 investigation strategy.We report a comprehensive NF2 mutation analysis of 221 NF2 French patients: 134 unrelated typical NF2 patients fulfilling the Manchester criteria and 87 unrelated patients presenting symptoms that partially fulfilled the Manchester criteria.A NF2 mutation was identified in 56 of the 221 patients, giving a global mutation detection rate of 25%. This rate reached 37% (49/134) for typical NF2 patients fulfilling the Manchester criteria and only 8% (7/87) for patients presenting symptoms suggestive of NF2. Six of these seven patients were under 25 of age. Our approach showed that 77% of NF2 identified variants were detected by coding exons sequencing. Multiplex ligation-dependent probe amplification allowed the identification of restricted rearrangements (23% of NF2 identified variants corresponding to complete deletion or partial deletion/duplication of NF2).High mutation detection rate can be achieved if well phenotyped NF2 patients are studied with multiple complementary and optimized techniques. NF2 somatic mosaicism detection was improved by frozen tumor samples molecular analysis.La neurofibromatose de type 2 (NF2) atteint environ une personne sur 25 000 à 40 000. La plupart des patients atteints de NF2 présentent des mutations privées de type perte-de-fonction, qui sont réparties sur l’ensemble du gène NF2. Nous présentons ici notre stratégie d’analyse moléculaire du gène NF2.Une analyse moléculaire exhaustive du gène NF2 a été réalisée chez 221 patients français atteints de NF2 : 134 patients non apparentés « typiques » répondant aux critères de Manchester et 87 patients non apparentés présentant des symptômes évocateurs de NF2, répondant seulement partiellement aux critères de Manchester.Une mutation de NF2 a été identifiée chez 56 des 221 patients, soit un taux global de détection de 25 %. Ce taux atteignait 37 % (49/134) pour les patients « typiques » répondant aux critères de Manchester et seulement 8 % (7/87) pour les patients avec un phénotype évocateur de NF2. Six de ces sept patients étaient âgés de moins de 25 ans. Dans notre approche moléculaire, 77 % des variants de NF2 ont été retrouvés par séquençage des régions codantes du gène. La MLPA a permis la détection de réarrangements de NF2 (23 % des variants identifiés de NF2 correspondaient à des délétions complètes ou à des délétions/duplications partielles de NF2).Un très bon taux de détection de mutation peut être obtenu chez des patients correctement phénotypés et par une étude moléculaire incluant des techniques complémentaires et optimisées. La détection des mosaïques somatiques peut en particulier être améliorée en analysant des échantillons tumoraux congelés.

Les intrications pathologiques de l'œil et du revêtement cutané sont très nombreuses, du fait de leurs analogies embryologiques et histologiques. Les génodermatoses représentent un vaste groupe de désordres cutanés d'origine génétique, dont le mécanisme moléculaire est connu et le gène est localisé sur la carte chromosomique. Nous nous intéressons particulièrement aux genodermatoses qui s'accompagnent de manifestations palpébrales ou oculo-palpébrales, observées dans notre consultation d'ophtalmologie. Les génodermatoses sont principalement représentées par l'ichtyose lamellaire, les albinismes oculo-cutanés, le xéroderma pigmentosum, la neurofibromatose type 1, les épidermolyses bulleuses héréditaires, le syndrome de Sturge Weber Krabbe et l'hyalinose cutanéo-muqueuse. Les lésions les plus caractéristiques sont les lésions rétractiles dans les ichtyoses et les carcinomes spino-cellulaires dans le cadre du xéroderma pigmentosum. Les manifestations palpébrales peuvent parfois représenter le signe révélateur de la génodermatose, d'où le rôle primordial de l'ophtalmologiste dans le diagnostic et la prise en charge de ces pathologies oculo-cutanées.

Cerium oxide films are widely studied as a promising alternative to Cr(VI) based pre-treatments for the corrosion protection of different metals and alloys. Cathodic electrodeposition of Cerium containing thin films was realised on TA6V substrates from a Ce(NO3)3, 6H2O and mixed water–ethyl alcohol solutions at 0.01 M. Experimental conditions to obtain homogeneous and crack free thin films were determined. The deposited cerium quantity appears proportional to the quantity of electricity used, as indicated by the Faraday law. Subsequent thermal treatment lead to a CeO2 coating, expected to provide an increase of TA6V oxidation resistance at high temperatures. The deposits were characterized by differential scanning calorimetry (DSC), optical and scanning electron microscopies.

L'anisométropie est une différence réfractive entre les deux yeux. Lorsque cette différence dépasse deux dioptries, il y aurait une altération de la vision binoculaire. Nous nous proposons de mettre le point sur l'intérêt du Lasik dans l'anisométropie de l'enfant et l'adolescent. Nous rapportons les observations de trois enfants dont l'âge moyen était de 15 ans. Les trois avaient une amblyopie modérée unilatérale d'origine anisométropique avec un port irrégulier de lunette et une intolérance aux lentilles de contact. Le lasik a été réalisé après skiascopie, topographie et pachymétrie. L'amblyopie anisométropique est l'une des principales causes de baisse de la vision chez les enfants. Le lasik a été proposé en cas d'échec de la correction optique et d'intolérance aux lentilles de contact mais aussi en cas d'échec du traitement conventionnel. Après l'âge de 6 ans, la tolérance à l'aniséiconie diminue d'où l'échec du traitement conventionnel surtout en cas de forte anisométropie (> 3,5 D), le lasik trouve alors sa place. Plusieurs études attestent l'efficacité du lasik dans l'anisométropie myopique mais aussi hypermétropique et permet d'améliorer effectivement l'acuité visuelle avec une meilleure tolérance. Par ailleurs, la non coopération des enfants en pré-opératoire qui était à l'origine de plusieurs complications est jugulé grâce au progrès techniques. Le Lasik est une alternative thérapeutique efficace dans la réduction de l'anisométropie de l'enfant. Elle permet ainsi d'éviter l'amblyopie, d'améliorer la qualité de vie des enfants avec une meilleure adaptation psychosociale.

Les hémangiomes capillaires orbito-palpébraux sont des malformations vasculaires fréquentes chez l’enfant. Malgré la possibilité d’involution spontanée fréquente avant l’âge de 7 ans, cette localisation orbito-palpébrale peut nécessiter un traitement urgent si l’atteinte visuelle est menacé par une amblyopie de privation. Nous proposons une étude rétrospective portant sur 19 cas d’hémangiomes capillaires. Nous présentons les caractéristiques cliniques de noter série ainsi que notre conduite thérapeutique et nos résultats. Dans noter série, la conduite thérapeutique se résume à une abstention si l’hémangiome est de petite taille sans ptôsis, une corticothérapie locale sous forme d’infiltrations péri-lésionnelles et une corticothérapie générale dans les formes étendues et en cas d’extension orbitaire. Le traitement chirurgical est fait de première intention ou après un échec des corticoïdes Les hémangiomes immatures ne sont pas rares chez l’enfant. Leur diagnostic est généralement facile. Sur le plan thérapeutique en l’absence de complication, une surveillance oculaire est la plus adaptée. En cas d’absence d’involution, l’augmentation de la taille ou en cas de risque d’amblyopie, un traitement s’impose. Les moyens thérapeutiques sont essentiellement la chirurgie et la corticothérapie locale ou générale. Les hémangiomes orbito-palpébraux du nouveau né et de l’enfant ne sont pas rares. En l’absence de complications l’abstention thérapeutique avec surveillance est l’attitude la plus adoptée.

Forecasts of water levels in the St. Lawrence River on the east coast of Canada have been issued every working day since 1997 using a one-dimensional hydrodynamic model (One-D) for periods extending up to 30 days. In order to assess the performance of these forecasts, a comparison between the model forecasts and the observations of the water levels during 2005 was done at 12 stations of the SINECO network located between Montreal and Quebec City. The statistical analysis shows that mean errors are small compared to the water level fluctuations. Confidence intervals of the forecasted values for all stations are evaluated.