Paratesticular leiomyoma: A case report of a rare entity

Paratesticular leiomyoma is an extremely rare benign tumour. It is often asymptomatic. It is sometimes difficult to distinguish leiomyomas from malignant testicular tumours, which leads to radical orchidectomy, despite its benign nature. Magnetic resonance imaging can be helpful to make conservative management of this lesion.

A cadaveric anatomical study of the adrenals: Relationship with the posterior abdominal wall muscles revisited

AIM OF THE STUDY

The main difficulties during retroperitoneal laparoscopic adrenalectomies are due to its location. Our objective was to define the relationship of the adrenals with the diaphragm and the psoas muscle.

METHODS

Our work is an anatomical dissection of 80 fresh cadavers' adrenals. To study the right adrenal, we performed a right nephrectomy and adrenal remained attached to the Inferior vena cava by its main vein. On the left, the edges of the adrenal have been identified by needles and the adrenal was reclined to study its projection on the posterior muscular wall.

RESULTS

The right adrenal is located higher, 13mm [4-20mm] above the medial arcuate ligament (MAL) in 16 cases (40%). Its lower border was at the same level as the MAL in 18 cases (45%) and 11mm [10-17mm] below the MAL in 6 cases (15%). The posterior support of the right adrenal was the right crus of the diaphragm (Right-CD) in 34 cases (85%) and straddling the Right-CD and the psoas in 6 cases (15%). The study of the relationships of the left adrenal with the MAL showed that the lower edge of the gland was at its same level in 16 cases (40%) and below in 24 cases (60%) by 14mm [8-24mm]. The posterior support of the left adrenal was the left crus of the diaphragm (Left-CD) in 16 cases (40%) and straddling the Left-CD and the psoas in 24 cases (60%).

CONCLUSIONS

Our results showed that the right adrenal is higher. The MAL is an important posterior element to the adrenal gland that could serve as an anatomical landmark to identify the adrenal during laparoscopic adrenalectomy.

[Diagnosis delay of pleural and pulmonary tuberculosis]

Tuberculosis (TB) is still being endemic in our country. Time until management determines both evolution and prognosis of this condition. The aim of this work is to evaluate the delay in diagnosis of TB in a respiratory unit from a university hospital series. The authors conducted a cross-sectional study including patients with pulmonary TBC and/or pleural. An evaluation of time management was conducted from the beginning of symptoms and various consultations with reference to the date of hospitalization and treatment set up. One hundred patients were included (pulmonary TB: 68 cases, pleural TB 23 cases, miliary pulmonary TB: 4 cases, pulmonary TB associated with other extrathoracic locations: 5 cases). The mean time of patient delay and total delay institution were respectively 43.6, 25.7 and 69.3 days. Variables responsible for long delays were: number of consultations more than 3 before hospitalization, empirical antibiotic therapy, of a regional hospital first consultation and the presence of extra-respiratory impairment. The patient delay was considered long. A reorganization of the TB control program, in particular by partial decentralization of care and health education is imperative in order to improve the quality of tuberculosis management in our country.

Modelling the Marangoni convection in laser heat treatment

Epitaxial Laser Metal Forming (E-LMF) consists in impinging a jet of metallic powder onto a molten pool formed by controlled laser heating and thereby, generating epitaxially a single crystal deposit onto the damaged component. This new technique aims to be used for the repair and reshape single crystal gas turbine components. Because of the very localised melting pool, the high temperature gradients produced during the process must be carefully controlled in order to avoid both the columnar-to-equiaxed transition (CET) and the appearance of hot tears. To this end, heat flow modelling is required to establish the relationship between process parameters such as laser power, beam diameter and scanning speed, and the local solidification conditions. When modelling the heat transfer within the sample, it is necessary to include the liquid flow pattern generated by the surface tension driven convection known as the Marangoni effect. Indeed, the fluid flow in the liquid pool dictates the shape of the traces as shown by the measurements carried out at EPF-Lausanne in re-melting experiments. A three dimensional (3D) model is implemented in the finite element software calcosoft$^\text{\textregistered}$ in order to model the development of the fluid convection within the liquid pool. It is shown that the velocities due to natural convection are of the order of 1 mm/sec whereas Marangoni convection produces velocities of the order of 1 m/sec. Moreover, at low scanning speeds, the liquid pool becomes larger than the beam diameter and the development of Marangoni eddies leads to a widening and deepening of the pool. The local solidification conditions such as the thermal gradient and the solidification speed can be extracted at both the solidus and liquidus temperatures to assess the risk of CET and hot cracking.