Review of photoacoustic flow imaging: its current state and its promises.

Flow imaging is an important method for quantification in many medical imaging modalities, with applications ranging from estimating wall shear rate to detecting angiogenesis. Modalities like ultrasound and optical coherence tomography both offer flow imaging capabilities, but suffer from low contrast to red blood cells and are sensitive to clutter artefacts. Photoacoustic imaging (PAI) is a relatively new field, with a recent interest in flow imaging. The recent enthusiasm for PA flow imaging is due to its intrinsic contrast to haemoglobin, which offers a new spin on existing methods of flow imaging, and some unique approaches in addition. This review article will delve into the research on photoacoustic flow imaging, explain the principles behind the many techniques and comment on their individual advantages and disadvantages.

Handheld probe integrating laser diode and ultrasound transducer array for ultrasound/photoacoustic dual modality imaging.

Ultrasound and photoacoustics can be utilized as complementary imaging techniques to improve clinical diagnoses. Photoacoustics provides optical contrast and functional information while ultrasound provides structural and anatomical information. As of yet, photoacoustic imaging uses large and expensive systems, which limits their clinical application and makes the combination costly and impracticable. In this work we present and evaluate a compact and ergonomically designed handheld probe, connected to a portable ultrasound system for inexpensive, real-time dual-modality ultrasound/photoacoustic imaging. The probe integrates an ultrasound transducer array and a highly efficient diode stack laser emitting 130 ns pulses at 805 nm wavelength and a pulse energy of 0.56 mJ, with a high pulse repetition frequency of up to 10 kHz. The diodes are driven by a customized laser driver, which can be triggered externally with a high temporal stability necessary to synchronize the ultrasound detection and laser pulsing. The emitted beam is collimated with cylindrical micro-lenses and shaped using a diffractive optical element, delivering a homogenized rectangular light intensity distribution. The system performance was tested in vitro and in vivo by imaging a human finger joint.

A Case of a Metastatic Disease to the Pancreas from a Small-Cell Lung Carcinoma Documented by a CT-Scan-Guided Trucut Biopsy: The Diagnostic Role of Cytomorphology and Immunohistochemistry.

Unlike primary pancreatic carcinoma, metastatic lesions of the pancreas are uncommon and account for approximately 2% of pancreatic malignancies. Small-cell lung carcinoma (SCLC) represents a group of highly malignant tumors giving rise to early and widespread metastasis at the time of diagnosis. However, the pancreas is a relatively infrequent site of metastasis by this neoplasm, and reports on metastatic small-cell carcinoma (SCC) in the pancreas, either of pulmonary or extrapulmonary origin, to be diagnosed by CT-scan-guided trucut biopsy (CT-TCB) are very rare. A 56-year-old man presented with a laterocervical lymphadenopathy associated to a mixed-density lung mass and a mass in the pancreatic body. CT-TCB slides from the pancreatic mass contained small, round tumor cells with extensive nuclear molding. The cytomorphological and histological diagnosis was metastatic SCC. Immunocytochemical staining showed that a variable number of neoplastic cells were positive for cytokeratin 7, TTF1, chromogranin A, and synaptophysin but negative for leukocyte common antigen and cytokeratin 20 with a very high expression of KI67. The transbronchial needle biopsy confirmed the diagnosis of an SCC. This case represents a rare metastatic lesion in the pancreas from SCLC, diagnosed by CT-TCB histological and immunohistochemical studies.

Signet Ring Cell Carcinoma of the Vater's Ampulla: A Very Rare Malignancy.

Most tumors affecting Vater's ampulla are adenocarcinomas, and other histological variants are less frequent. Signet ring cell carcinoma is more commonly found in the stomach than at other sites of the digestive system. Signet ring cell carcinoma of the Vater's ampulla is extremely rare, and only 15 cases have previously been described in the literature. It mainly occurs in elderly patients (median age = 57 years). We report a case of advanced signet ring cell carcinoma of the ampulla of Vater, with invasion of the duodenum (D3) admitted in the Medical Oncology Unit of HASSAN II University Hospital.

Correcting photoacoustic signals for fluence variations using acousto-optic modulation.

We present a theoretical concept which may lead to quantitative photoacoustic mapping of chromophore concentrations. The approach supposes a technique capable of tagging light in a well-defined tagging volume at a specific location deep in the medium. We derive a formula that expresses the local absorption coefficient inside a medium in terms of noninvasively measured quantities and experimental parameters and we validate the theory using Monte Carlo simulations. Furthermore, we performed an experiment to basically validate the concept as a strategy to correct for fluence variations in photoacoustics. In the experiment we exploit the possibility of acousto-optic modulation, using focused ultrasound, to tag photons. Results show that the variation in photoacoustic signals of absorbing insertions embedded at different depths in a phantom, caused by fluence variations of more than one order of magnitude, can be corrected for to an accuracy of 5%.

[Pseudoexfoliation syndrome in Moroccan patients with cataract scheduled for sugery]. / Le syndrome pseudo-exfoliatif chez les patients marocains programmés pour chirurgie de la cataracte.

PURPOSE: To evaluate the prevalence of pseudoexfoliation syndrome (PES) in Moroccan patients with age-related cataract scheduled for surgery. PATIENTS AND METHODS: In a retrospective study, 837 consecutive eyes with age-related cataract scheduled for surgery were evaluated for the prevalence of PES, type of cataract, intraocular pressure (IOP) and operative complications. RESULTS: Exfoliation material was detected in 82 patients (9.8 %). The mean age was 69.3 years with no sex predilection. The condition was unilateral in 44 cases (53.7%) and bilateral in 38 cases (46.3%). The prevalence of PES increased with age (p=0.02). Patients with hypermature cataract had significantly more PES (p <0.001). Mean IOP was significantly higher in eyes with PES (17.7 +/- 6.4 mmHg) than those without PES (14.3 +/- 2.9 mmHg) (p<0.001). Operative complications occurred more frequently in patients with PES: 14 (17 %) than in those without PES: 58 (6.9 %). DISCUSSION: PES is a generalized degenerative fibrillopathy bound to age. The ethiopathogeny remains even unknown. The epidemiological data concerning the prevalence of the SPE in the African populations are scarce, and have not been published in Morocco, what motivated this study. Our study shows that this syndrome is common in Moroccan patients scheduled for cataract surgery with a prevalence of 9.8%. Its presence constitutes an important risk factor of primary open-angle glaucoma, and exposes more to peroperative complications at the time of surgery of cataract, independently of the technique used. CONCLUSION: There is great variation in the prevalence of PES among people of different regions and ethnic groups, although many factors interfere in the comparative analysis of results, hence the interest to achieve other complementary epidemiological studies.

Orbital osteoma: three case reports.

INTRODUCTION: Osteoma is the most frequent benign tumor of paranasal sinuses. It is generally asymptomatic and usually discovered by chance during radiological imaging. Three cases with orbital extension are reported and discussed. OBSERVATIONS: 1st observation: Mrs. M.N. is an 18 years-old caucasian female who presented a stony orbital deformity associated with chronical dacryocystitis. Tomography of the orbit revealed a probable ethmoidal osteoma compressing the lacrimal canals. The management consisted in a surgical excision of the whole tumor by external approach, associated with a dacryocystorhinostomy. The patient's follow-up for the last 12 months was normal. 2nd observation: Miss K.A. is a 16 years-old caucasian female who came to consultation for a swelling of the medial angle of the left eye. Computed tomography images showed a fronto-ethmoidal process displaying a bone density consistent with an osteoma. The tumor was removed through an external ethmoidectomy. The patient was free of symptoms at 6 months follow-up. 3rd observation: Mrs. F. Z. is a 45 years-old patient who presented a 5 years history of right painful exophthalmos. The computed tomography was consistent with a fronto-ethmoidal osteoma with intraorbital extension near the optic nerve. The surgical excision was limited to the intraorbital portion. Postoperative complications included ptosis and diplopia. DISCUSSION: Osteomas most commonly affect the fronto-ethmoid sinuses. They rarely show intraorbital extension or cause intracranial complications. They are generally asymptomatic. Symptoms are generally of late onset and are a consequence of tumoral growth and compression of neighbouring organs, as it is the case in our patients. Tumoral exophtalmos is the major ophthalmological sign. The computed tomography is of a great contribution, not only for diagnosis but also for the choice of the surgical approach. The classical surgical technique consists generally in a surgical excision of the osteoma. This surgery may induce ocular or neurochirurgical complications. CONCLUSION: Osteomas of the paranasal sinuses are usually asymptomatic. If they become voluminous, they may cause orbital manifestations and serious complications. The rarity of ethmoidal osteoma with orbital growth made our cases interesting to report.

[Tyrosinemia type II. Case report]. / La tyrosinemie type II. A propos d'un cas.

Tyrosinemia type II or Richner-Hanhart syndrome is a rare hereditary disease characterized by the association of pseudoherpetiform corneal ulcerations and palmoplantar hyperkeratosis. We report the case of a 12 year-old young man presenting a superficial punctate keratitis and a corneal dystrophy in both eyes, associated with a palmoplantar hyperkeratosis. The dosage of the serum level of tyrosine is meaningfully raised to 1236 micromol/l. A dietary treatment restraining tyrosine and phenylalanine is started with favorable results after an evolution of 6 months. Tyrosinemia type II is an autosomal recessive disease, due to an enzymatic deficit in tyrosine aminotransferase. The diagnosis is based on the clinic and high level of serum and urinary tyrosine as well as of its urinary metabolites. This disease must be suspected in all cases of dentritic keratitis not reacting on the antiviral treatment, and more especially if it is associated with cutaneous lesions such as palmo-plantar keratosis.

[Bourneville's tuberous sclerosis. A case report]. / La sclérose tubéreuse de Bourneville. A propos d'un cas.

INTRODUCTION: Bourneville's tuberous sclerosis (BTS) is an autosomal dominant phakomatosis characterized by the development of a benign hamartoma-like tumor, which is usually located in the skin, kidney, heart, brain, and eyes. We present here a case of a retinal BTS of late diagnosis. We also discuss the clinical course and progress of this condition. OBSERVATION: A 28-year-old man was a known BTS patient followed in the dermatology clinic. The ophthalmologic exam and the angiography with fluorescein revealed retinal astrocytic hamartomas bilaterally. Dermatologic examination also showed facial angiofibromas. The remainder of the physical examination was unremarkable. The chest X-ray, renal scan, heart scan and a CT scan of the brain failed to show any other localizations of the disease. The lesions described had remained unchanged over a period of 6 years. CONCLUSION: Retinal lesions during BTS are dominated by the presence of astrocytic hamartomas essentially around the papillae. They are often an incidental diagnosis and evolve slowly. Except in complicated cases, their prognosis is usually satisfactory.

[Marcus-Gunn Syndrome. Based on a case report]. / Syndrome de Marcus-Gunn. A propos d'un cas.

The Marcus-Gunn syndrome associates an unilateral congenital blepharoptosis and "jaw-winking" synkinesia. We report a 12-year-old girl presenting an unilateral Marcus-Gunn syndrome and discuss the clinic, pathogenesis and treatment of this syndrome.

[Predictive factors of local recurrence of in situ intraductal carcinoma. Apropos of 217 cases]. / Facteurs prédictifs de récidives locales de carcinomes canalaires in situ. A propos de 217 cas.

The authors have reviewed 217 cases of pure intraductal carcinomas with a mean follow-up of 98 months (with 2 deaths out of 31 recurrences from which 35% into adenocarcinomas). The data concerning the diagnosis, the tumor size, the pathological type, the surgical treatment, more of less associated to radiation therapy are detailed. The aim of this work was to give a more reliable way or approaching the recurrence rate (31/217) to be able to apply a more conservative treatment to these cases. The lymph node dissection and removal seams to be useless in the in situ carcinomas. Concerning the tumor size, the local tumors can be treated by conservative surgical procedures and do not get any benefit from radiotherapy. The opposite is true concerning more largely invasive tumor. Concerning the histology, the non-comedocarcinomatous tumors get less benefit from radiotherapy than the comedocarcinomatous type. The study of the tumor limits and the reliquats seem to be useful. The treatment chosen and applied remains the major prognostic element in the probability of recurrence.

[Umbilical endometriosis. A case report]. / Endométriose ombilicale. A propos d'un cas.

Umbilical endometriosis is a rare site of the disease. The authors report a case of umbilical endometriosis only. Umbilical involvement is estimated at 0.5 to 1% of all site of the disease. This is a disorder affecting women of childbearing age, with a mean age of about 40. Medical treatment by progestogens or Danazol is inconstantly and partially effective regarding umbilical endometriosis. Surgical excision remains the only effective treatment: omphalectomy with wide removal of the tumor and reconstruction of an umbilicus. Surgery enables histologic study and, in the presence of suggestive symptomatology, search for and treatment of other genital sites.

[Monitoring of pregnancy in HIV seropositive women]. / Surveillance de la grossesse chez la femme séropositive pour le VIH.

The management of pregnancy in a seropositive woman implies awareness of the effects of the disease on pregnancy and, inversely, of the pregnancy on HIV infection. It is important to be aware of the risk of materno-fetal transmission, as well as of the recent positive results of therapeutic trials of AZT during pregnancy regarding the prevention of such transmission. This quite stereotyped management approach is relatively simple, both clinically and regarding laboratory investigations, and in particular when the patient is at an asymptomatic stage of the disease. Obstetric management is, for the present, the same as in normal women. It is important to stress the need for specialised management of the newborn infant and of taking advantage of the postpartum period to ensure future effective contraception.

[Evaluation of risks of HIV transmission during medically assisted reproduction]. / Evaluation des risques de transmission du VIH au cours des PMA.

HIV transmission risks were specified during infertility treatment. An investigation was performed by gynecologists who work in IVF. Most of gynecologist refuse to treat infertility in these cases.