Solar-Driven Thermocatalytic Synthesis of Octahydroquinazolinone Using Novel Polyvinylchloride (PVC)-Supported Aluminum Oxide (Al2O3) Catalysts.

The chemical industry is one of the main fossil fuel consumers, so its reliance on sustainable and renewable resources such as wind and solar energy should be increased to protect the environment. Accordingly, solar-driven thermocatalytic synthesis of octahydroquinazolinone using polyvinylchloride (PVC)-supported aluminum oxide (Al2O3) as a catalyst under natural sunlight is proposed in this work. The Al2O3/PVC catalysts were characterized by FT-IR, SEM, BET, XRD, and XPS techniques. The obtained results indicate that the yield and reaction time can be modified by adjusting the molar ratio of the catalyst. To investigate the stability of the catalyst, the spent catalyst was reused in several reactions. The results indicated that, when a 50% Al2O3 catalyst is employed in an absolute solar heat, it performs exceptionally well in terms of yield (98%) and reaction time (35 min). Furthermore, the reaction times and yield of octahydroquinazolinone derivatives with an aryl moiety were superior to those of heteroaryl. All the synthesized compounds were well characterized by FT-IR, 1H-NMR, and 13C-NMR. The current work introduces a new strategy to use solar heat for energy-efficient chemical reactions using a cost-effective, recyclable environmentally friendly PVC/Al2O3 catalyst that produces a high yield.

Mesoporous Tungsten Trioxide Photoanodes Modified with Nitrogen-Doped Carbon Quantum Dots for Enhanced Oxygen Evolution Photo-Reaction.

Nanostructured photoanodes are attractive materials for hydrogen production via water photo-electrolysis process. This study focused on the incorporation of carbon quantum dots doped with nitrogen as a photosensitizer into mesoporous tungsten trioxide photoanodes (N-CQD/meso-WO3) using a surfactant self-assembly template approach. The crystal structure, composition, and morphology of pure and N-CQD- modified mesoporous WO3 photoanodes were investigated using scanning electron and transmission microscopy, X-ray diffraction, and X-ray photoelectron spectroscopy. Due to their high surface area, enhanced optical absorption, and charge-carrier separation and transfer, the resulting N-CQD/meso-WO3 photoanodes exhibited a significantly enhanced photocurrent density of 1.45 mA cm-2 at 1.23 V vs. RHE under AM 1.5 G illumination in 0.5 M Na2SO4 without any co-catalysts or sacrificial reagent, which was about 2.23 times greater than its corresponding pure meso-WO3. Moreover, the oxygen evolution onset potential of the N-CQD/meso-WO3 photoanodes exhibited a negative shift of 95 mV, signifying that both the charge-carrier separation and transfer processes were promoted.

Endoscopic treatment of anterior glottic webs according to Lichtenberger technique and results on 18 patients.

Anterior glottic webs are most frequently acquired and result in a major vocal handicap. Many treatment modalities have been reported in the literature. None of them achieves perfect morphological or functional results. We present our series treated by an endoscopic technique based on CO(2) laser section of the web, mitomycin application and placement of a temporary silastic stent. We retrospectively reviewed the charts of 18 consecutive patients with anterior webs treated at our university hospital between 2003 and 2010. The endoscopic technique consisted of the section of the web with the CO(2) Acublade system, immediate application of mitomycin C and placement of a silastic stent. No tracheostomy was required. The stent was removed 3 weeks later. Patients had a vocal evaluation pre and postoperatively. It consisted of a video-stroboscopic examination, the global score of the Voice Handicap Index, the global and roughness scores of the perceptive voice evaluation according to Hirano, acoustic and aerodynamic parameters. Eighteen patients were included in the study with a mean age of 46 years (min. = 5, max. = 76). Twenty-two percent were women. All patients had postoperative speech therapy. The mean follow-up is 48.4 months (3-87 months). At the last follow-up, none of the patients had recurrence of the laryngeal web. The grade G of dysphonia significantly decreased from 2 to 1 (p = 0.035). CO(2) laser resection of anterior webs with mitomycin C application and placement of a silastic stent for 3 weeks induces a good morphological result with absence of web reformation but without substantial voice improvement observed in our series.

[Vulvar Darier-Ferrand dermatofibrosarcoma: Unusual localization of a rare tumour (about one case and a review of the literature)]. / Dermatofibrosarcome de Darier-Ferrand vulvaire : une localisation inhabituelle d'une tumeur rare (à propos d'un cas et revue de la littérature).

First described by Darier and Ferrand in 1984, the dermatofibrosarcoma is a fibrous tumour of the skin with high local malignancy, progressive evolution and great opportunity of recidivism. We report unusual case of Darier-Ferrand dermatofibrosarcoma relapsing of the vulva in a 76-year-old female patient. The clinical examination showed a big, rounded mass with fixed consistence. The surgical resection was complete, passing to 3 cm laterally with economy of healthy tissues that leaves the least of functional and esthetical sequelae. The histological examination of the operative piece confirmed the diagnosis. This case shows the huge nature of the mass, the local aggressiveness of the tumour and the possible difficulties of the complete exeresis of the lesion in significant anatomic region.

[Breast reconstruction with superior gluteal artery perforator (SGAP) flap without intraoperative setup change. About eight cases]. / Reconstruction mammaire par lambeau de superior gluteal artery perforator (SGAP) sans changement d'installation. À propos de huit cas.

INTRODUCTION: The superior gluteal artery perforator flap (SGAP) typically requires a peroperative change of the patient's position that increase the duration time of the procedure and the hospitalization. The aim of this study is to present our serie of eight consecutive SGAP flaps without setup change, and to precise the surgical technique we used. PATIENTS AND METHODS: This is a retrospective series of eight consecutive SGAP flaps performed between September 2001 and March 2010. All these flaps were performed without peroperative setup change. We studied the number of perforators used and their origins, the type of recipient vessels, the duration time of the procedure and the hospitalization. We also analyzed the morphological and functional outcomes for the donor site. RESULTS: All eight flaps were raised on a single septo-cutaneous perforator located between the gluteus maximus and gluteus medius muscles. The internal mammary vessels were chosen as recipients in all cases. The average duration time of the operation was 6 hours and 5 minutes. We report one flap loss. No functional or morphological complications were reported on the donor site. The morphological results on the reconstructed breast were satisfactory or very satisfactory in most cases. CONCLUSION: A satisfying breast reconstruction can be achieved with the SGAP flap without changing setup. The use of the septo-cutaneous branch between the gluteus maximus and gluteus medius muscles lengthens the pedicle and reduces the surgery time by facilitating the dissection. SGAP is therefore another autologous technique for breast reconstruction with low morbidity, when a DIEP flap cannot be harvested.

Laryngeal Kaposi sarcoma: case report and literature review.

PROBLEM/OBJECTIVE: Kaposi sarcoma is the most frequently-occurring neoplasm in AIDS patients. Laryngeal localization is infrequent. We discuss the management options for laryngeal Kaposi sarcoma based on a literature review. CASE REPORT: A 42 year old, HIV-positive male receiving HAART therapy presented with mild hoarseness and sore throat. Fiberoptic laryngeal examination identified a small purple lesion in the right ventricular fold. He underwent biopsy under general anaesthesia. The lesion was histologically diagnosed as a Kaposi sarcoma. Systemic treatment was pursued, but 6 weeks later the patient developed severe dysphagia and acute airway obstruction when the lesion became glotto-supraglottic and obstruced the airway. Transoral tumour vaporization with a CO2 laser was performed in the emergency department. Post-operative chemotherapy was administered. Three months later, the patient was completely asymptomatic and the laryngeal examination was normal. CONCLUSION: Transoral CO2 laser vaporization combined with chemotherapy is a valid option for managing obstructive laryngeal Kaposi sarcoma.

[Intra-uterine fetal death by knife: case report]. / Mort foetale intra-utérine par arme blanche (à propos d'un cas).

INTRODUCTION: Opened injuries by knife are rare in pregnant women and are responsible of foetal death in most cases. OBSERVATION AND COMMENTARY: We report a case of a 27-years woman, in her 8th months of pregnancy, victim of three knife punchs in her right iliac fossa. An emmergent laparotomy revealed deep wounds in the uterus and its right vascular pedicles, and a right external iliac artery lesion. Hysterectomy was performed and the extracted fetus was dead. He had two wounds in skull and back. Foetal death is common in opened knife injuries especially at the end of pregnancy. On one hand, the fetus has an abdominal situation that expose him to penetrating lesions. On the other hand, the uterus is richly vascularized during this period of pregnancy, thus any uterine or pedicular wound could result in a maternal hemorrhagic shock and hence a poor foetal and maternal prognosis. CONCLUSION: Knife injuries in pregnant women could compromise the foetal prognosis. Managmanent should be early and requires a close collaboration between resuscitators, obstetricians and vascular surgeons.

[Pregnancy in rudimentary uterine horn: diagnostic and therapeutic difficulties]. / Grossesse sur corne utérine rudimentaire: difficultés diagnostiques et aspects thérapeutiques.

Ectopic pregnancy in a rudimentary uterine horn is extremely uncommon. Implantation of one embryo in the uterine cavity and of another in a rudimentary uterine horn is an extremely uncommon form of twin pregnancy. The authors report three cases of pregnancies in a rudimentary uterine horn. One was associated to a heterotopic pregnancy in the other eutrophic horn. Through these three cases, they report the risks incurred and the difficulties of the assumption of responsibility of this type of pathology, on the diagnostic as well as therapeutic level. But generally underline the interest of echography especially endovaginale and the coelioscopy in the early diagnosis of this type of uterine malformation.

[Severe neonatal myasthenia with arthrogryposis]. / Myasthénie néonatale sévère avec arthrogrypose: à propos d'un cas et revue de la littérature.

Maternal myasthenia gravis has been associated with the presence of neonatal myasthania and sometimes fetal congenital anomalies. The purpose of this paper is to present an infant with multiple deformations born to a mother with myasthenia gravis. The infant presented with arthrogryposis multiplex and pulmonary hypoplasia. The new born died within the first day of life. Twenty-seven other cases of neonatal myasthenia with arthrogryposis have been reported. Twenty-two of them were stillborn or died. The surviving children needed ventilatory assistance for a long period.

[Vesico-uterine fistula of obstetrical origin. Report of 3 cases]. / Les fistules vésico-utérines d'origine obstétricale. A propos de 3 cas.

Vesico-uterine fistulae (VUF) lead to an abnormal breech between the bladder and the womb. They are responsible for urinary incontinence and/or cyclic hematuria. They are rare and, in most cases, lead to complications following caesarean deliveries. We report observations of 3 vesico-uterine fistulae treated over a 5 years period at university maternity based at Casablanca, Morocco; they all occurred following caesarean deliveries. These patients were consulted for urinary leakage occurring few weeks up to many years following surgical traumatism. Diagnosis was evoked clinically in all cases and confirmed by intravenous urography and/or hysterography. These VUF were successfully treated by simple breech suture at laparotomy. Treatment is very simple and efficient when the diagnosis is made early and fistula simple. Surgery is recommended after medical treatment failure aiming at fistula drainage.

[Pelvic lymphocele: report of a case and review of the literature]. / Lymphocèle pelvienne: un diagnostic à ne pas méconnaître! A propas d'un cas et revue de la littérature

Lymphadenectomy for pelvic cancer can lead to complications, particularly lymphocele. We report a case of pelvic lymphocele, which occurred in a patient who underwent surgery for stage IIa cervical carcinoma after preoperative radiotherapy. The intervention consisted in colpohysterectomy, with lymphadenectomy without peritonisation. Five months later she developed dysuria and pelvic pain. Ultrasound and computed tomography showed a pelvic lymphocele complicated by renal insufficiency. Kidney function was re-established after intraperitoneal marsupialisation. One year later the patient was in good clinical condition with no disorder of kidney function.

[Current profile of obstetrical vesicovaginal fistulas at the maternity unit of the University of Casablanca]. / Profil actuel des fistules vésicovaginales obstétricales à la maternité universitaire de Casablanca.

Obstetrical vesicovaginal fistulas are secondary to dystocia. Late and inappropriate treatment are still a health public problem in under development countries. In five years (1993-1997), twelve vesicovaginal fistulas were repertored in the department of obstetrics and gynaecology of Casablanca (Morocco) with a frequency of 0.33@1000 deliveries and 2.4 new cases a year. 80% of the cases occurred after a long labour without efficient obstetrical care. Most of the cases (75%) were simple with an easy surgical treatment. All the fistulas were resolved after one or two surgical procedures realised by vaginal route in eight cases (2/3). During these last decades, with the efforts in obstetrical care in our country, we are assisting in a diminution of the frequency of this pathology and specially the number of complicated fistulas.

[Prevalence of urinary incontinence in Moroccan women. Report of 1,000 cases]. / Prévalence de l'incontinence urinaire chez la femme marocaine. A propos de 1,000 cas.

An inquiry concerning the prevalence of urinary incontinence for the moroccan women has been archived about 1000 women aged more than 18 years to study prevalence, epidemiology and risk factors of urinary incontinence. 271 women among the 1000 women said that they had suffered from the mictional disorder at least one time during the last month, let 27.1%; 48.7% of the incontinent women are from 30 to 60 years; 22.5% are less than 30 years old, and 8.85% are more than 75 years old. Among these 271 women, 49.44% suffered from leakage after making an effort; 42.80% an imperiosity, and 7.76% spontaneous leakage. Seventy per cent among these women had level of study at least medium; 85.97% among these women suffered the discomfort; but 8.48% of them had been consulted for this disorder, 78.96% are able to consult a medical and to have a clinical or paraclinical exams. The elements who are responsible of this disorder are: menopause, parity, the use of forceps, the weight of first child birth over 3.5 kg, the perineal tearing. Among the medical antecedents we find: chronic bronchitis, urinary infections, chronic constipation, diabetes, and in the other way among surgical antecedents are: hysterectomy and prolapsus cure.

[Mammary tuberculosis: a series of 14 cases]. / Tuberculose mammaire.

OBJECTIVES: We examined cases of mammary tuberculosis in order to determine the different modes of presentation and analyze diagnostic difficulties. METHODS: Retrospective analysis of 14 cases of mammary tuberculosis treated at the Ibn Rochd University Hospital in Casablanca over a 16 year period. RESULTS: Patient age ranged from 16 to 65 years. Contact with a contaminated person was recognized in 2 cases. The predominant clinical presentation was a tumor formation (12 cases) which sometimes simulated cancer. Axillary nodes were observed in 10 cases with 1 case of fistulization. Mammography suggested cancer in 3 cases. The diagnosis of mammary tuberculosis was based on pathology findings in 14 cases (2 biopsies, 12 peroperative specimens) and isolation of bacilli from pus in one case. Medical treatment was given. Surgery was associated as needed (abscess drainage, residual lesions). Except for one death due to tuberculous meningoencephalitis, clinical course was favorable with ad integrun breast recovery. DISCUSSION: Mammary tuberculosis is uncommon and often produces a pseudoneoplastic presentation. Pathology confirmation is required for diagnosis.

[Delivery of large baby after cesarean section: role of trial of labor. Apropos of 355 cases]. / Accouchement du gros bébé sur utérus cicatriciel : la place de l'épreuve utérine.

OBJECTIVE: Our goal is to determine whether a trial of labor in women with suspected fetal macrosomia would be a valuable alternative to elective repeat cesarean. MATERIAL: and methods: Based on retrospective analysis of 355 women with previous cesarean section who delivered macrosomic infants (> or =4,000g), we tried to determine the impact of fetal weight on a trial of labor. The outcomes of trial of labor with fetal macrosomia were compared on the one hand to those of elective repeat cesarean and on the other hand to those of trial of labor with normal birth weight (<4,000g). RESULTS: The trial of labor was conducted in 297 cases (83,7%), and had led to vaginal birth in 189 cases (63,6%). There were 4 uterine ruptures (1,3%) and 8 uterine dehiscences (2,7%) among the women who underwent a trial of labor. In this group, there were 4 perinatal deaths (1,3%) related in one case to uterine rupture, and 2 brachial plexus injuries related to shoulder dystocia after vaginal birth. Perinatal and maternal outcomes of trial of labor were similar to those of elective repeat cesarean. A trial of labor was more associated with scar separations and lower success rate if the infant weighed 4,000g or more. CONCLUSIONS: It appears that the use of trial of labor for delivery of large baby with prior cesarean section was associated with lower success rate and the maternal and fetal risks could be increased. However, carefully others controlled studies are necessary to establish the appropriate management in this setting.

[Maternal complications of cesarean section: retrospective analysis of 3,231 interventions at the Casablanca University Hospital, Morocco]. / Complications maternelles des césariennes: analyse rétrospective de 3,231 interventions à la maternité universitaire de Casablanca, Maroc.

We carried out a retrospective analysis of 3,231 cases of cesarean section between 1994 and 1997, to assess the maternal mortality and morbidity associated with this intervention. The frequency of cesarean delivery was 12.4%. The indications for cesarean section were of three types: elective indications (627 cases, 19.4%), emergency indications (454 cases, 14.1%), failure of normal labor (2,150 cases, 66.5%). Nine maternal deaths were noted (2.8 per thousand), one of which was directly linked to surgery. The peroperative complications were primarily major hemorrhagia (39 cases, 1.2%), visceral lesions such as bladder rupture (3 cases, 0.1%) and intestinal lesions (3 cases, 0.1%). Postoperative morbidity was predominated by infectious complications, particularly endometritis (5.1%). Thromboembolism was reported in 7 cases (0.2%). Cesarean section is used to preserve the life of both the mother and the child. However, maternal morbidity and mortality rates are higher with cesarean section than with vaginal delivery and therefore its indications must be justified.

[Induction of labor by misoprostol, an analog of PGE1. A prospective study of 200 cases]. / Induction du travail par misoprostol, analogue de PGE1. Etude prospective à propos de 200 cas.

We carried out a prospective study of 200 pregnant women who required induction of labor at full term, at the Lalla Meryem maternity unit of the Ibn Rochd University Hospital, Casablanca, between January 1st 1996 and June 30th 1997. The aim of this study was to evaluate the efficacy, tolerance and acceptance of misoprostol (Cytotec) as a drug for inducing labor in unfavorable conditions (Bishop < 5). Misoprostol (a PGE1 analog) was administered to the women via the vagina, with a dose of 1/4 tb (50 mg) given every 6 hours, and a maximum of 3 doses (150 mg). If labor had not begun 18 h after the start of the protocol, misoprostol induction was considered to have failed. We found that misoprostol failed to induce labor in 5% of cases, Syntocinon was required in 40% of cases and the interval between misoprostol insertion and vaginal delivery was 13.3 + 11.1 h. The rate of delivery by cesarean section was 22% and the mean amount of misoprostol required was 1.3 doses (66 mg). The mean cost of labor induction was 0.6 FF, the frequency of uterine hyperstimulation was 3.5% and maternal, fetal and neonatal tolerance was good. Our results confirm that intravaginal misoprostol is very effective and well tolerated for the induction of labor in pregnant women at full term, in unfavorable obstetric conditions.

[Use of gracilis musculocutaneous flap in tissue loss caused by Fournier's gangrene. Apropos of 4 cases]. / De l'utilisation du lambeau musculo-cutané de droit interne dans les pertes de substance de la gangrène de Fournier. A propos de quatre cas.

The gracilis myo-cutaneous flap was used in 4 patients to cover soft tissue defects of the perineal, scrotal, penile and inguinal regions after Fournier's gangrene. This is a simple technique, which allows a simultaneous reconstruction of the perineoscrotal region. Very satisfactory esthetic and functional results were obtained in the recipient and donor sites.