Les premières étapes de la colonisation de l’Europe et l’arrivée de l’Homme sur les rives de la Méditerranée

Over recent years, many discoveries have renewed our knowledge about the oldest stone industries and also about the behaviour and lifestyle of the hominids that made them, not only in East Africa, but also in the Near East, in Trans Caucasia and in southern Europe. If the first tools making hominids appear in East Africa as early as 2.55 million years ago, they are present in the Levant a little over 2 million years ago, as early as 1.81 million years ago at the gates of Europe in Trans-Caucasia, and a little over 1.4 million years ago on the Mediterranean coasts of Europe.     

Le « nucléus Donggutuo » et sa signification dans l’industrie du paléolithique inférieur de Donggutuo, bassin de Nihewan, Chine du Nord

As one of the most important Lower Pleistocene sites of the Nihewan basin in North China, Donggutuo (DGT) site is well known for its fine retouched small tools and characters of flake industry. However, new excavations still reveal some new discoveries and educe some new issues to us. For example, the “DGT core” introduced in this article is a new discovered typotechnology and indicates new economic strategy of the local people, which was never known before in this area at the time of 1.1 Ma B.P. The paper provides general background and statistic analysis of DGT industry including special method applied to the “DGT core” and discusses possible influence of environmental change for the emerging of the “DGT core”. The “DGT core” shows a germinated microlithic tradition and reflects a cultural diversity of early humans in the Lower Paleolithic in North China.     

Les principales étapes de l’occupation humaine en bordure de l’Himalaya occidentale

Lithic industries attest that Western Himalayas, Hindu Kush and Pamir as well as the sub-Himalayan belt that is the Siwalik range, were inhabited during the prehistoric times. However, in thin transition zone between plains and high mountains, distinction is to be kept between low-middle altitude regions and high altitude regions (above 2000 m). In the former regions, the first human occupation tenuously appears around 2 Ma. In the Middle Pleistocene, the Lower Palaeolithic industries belong to two technological facies, the Acheulian and the Early Soanian. In the North-Western Siwaliks, the Soanian occurs in plenty on the river terraces, which were all built after 0.4 Ma, and the Acheulian appears between 0.5 and 0.7 Ma. The Middle Palaeolithic is still rich in cobble tools and therefore named Late Soanian. The Upper Palaeolithic is missing, perhaps due to climatic factors and the Neolithic is characterised by polished axes/adzes, but actually many of the cobble tools usually considered as Early Soanian may well belong to the cobble tool technical tradition common in South-East Asia during the Late Pleistocene and Early Holocene. In the north of the mountain range, the entire Palaeolithic sequence yielded by the loess in Southern Tajikistan is characterised, right from the late Lower Pleistocene, by lithic industries mainly compose of flakes, sometimes with cobble tools. In the high altitude zones, prehistoric sites are unknown before the Holocene and therefore they are contemporaneous with the Neolithic but some technological facies display particular features. The question is to know whether the originality of the industries, observed at different periods of time, is linked to techno-cultural adaptations to particular environments or to the isolation of the mountain populations.     

Barogali et l’Oued Doure. Deux gisements représentatifs du Paléolithique ancien en République de Djibouti

In the Republic of Djibouti, surveys and excavations, carried out from 1985 to 1992, confirmed the presence of the pre-Acheulean (Oldowan) and Acheulean sites in the country. Three seasons of excavations (1985-1987 in the Gobaad Basin, have unearthed in a hardened compact clay strata of an ancient marshland dating to the Lower Pleistocene, the fossilized skeletal remains of an Elephas recki ileretensis. Numerous stone tools have been gathered with the bones. The E.S.R. dating the elephant’s lower third molar gave a date between 1,.6 and 1,.3 MY that would confirm its paleontological grouping and the membership of this butchery site to the Oldowan period. The animal appeared to have been lying on its left side. The cranial roof had been separated from the calvarium, perhaps to get at the brain; but the skull remains in anatomic connection with the tusks. The jaw (mandible) seems to have been broken to extract the tongue. Hominids, perhaps Homo ergaster, knapped tools from a nearly outcrop of poor quality lava. The tools were specifically adapted to their needs, such as scraping, chopping and scattering the bones. The site has yielded 569 artifacts: utilized material and hammerstones (121); pebble tools (32); cores (14); “debitage” products (366); retouched flakes (36). Artifacts are rarely retouched and often broken. Five different types of choppers have been classified. The polyedrons and one bola make up 22% of the pebble tools. The cores are divided into unipolar, centripetal and polyhedrical types. In another site, Haïdalo, an almost complete skeleton of an Elephas recki recki in anatomical connection and without any sign of predation, has been found at eight kilometers from Barogali. During surveys in the Ali Sabîh region (1990-1992) seven sectors have been discovered and prospected in the Oued Doure Basin. On the surface area and also in situ into some little pits, 345 rhiolitic Acheulean artifacts have been found, near rhyolitic outcrop. These artifacts are generally large. The choppers (18) can be dividended into 2 sets : side choppers (55%) and end choppers (27%), often with a bifacial cutting edge. There is only one polyedron, but we have found eight heavy scrapers. The Acheulean group is important (43 tools). The bifaces are varied and there are also a few cleavers and picks. Cores are numerous (92) and Levallois cores are preponderant (45%). We find also centripetal cores (27%) and so unipolar, bipolar and polyhedral cores. Tools made of flakes (118) are numerous: scrapers are typologically diversified. Some of them have a double utilization. Notch tools, denticulate tools are presents but also end scrapers, burin, borer, back knifes and scantily retouched flakes. The characters of this lithic material, large cores and big flakes, large bifaces of various types, cleavers and retouched flakes, indicates that they are Acheulean products. So, the Doure Site can be placed in the Middle / Upper Acheulean transition.     

Le Paléolithique ancien de l’Europe orientale et du Caucase

Currently, only Tréhougol’naya Cave has reliably dated evidence for human settlement in Eastern Europe and Caucasus, from the beginning through the middle of the Middle Pleistocene. In Eastern Europe, assemblages from Khriatchi and Mikhailovskoé, and possibly Darvagchai I, appear to be the only stratified locations that tentatively can be compared (despite problems with these materials) with Tréhougol’naya. In the eastern limits of Central Europe, layer VI in Korolevo I is the only stratified assemblage that may be compared with Tréhougol’naya. All these Lower Paleolithic occupations yielded the Pre-Mousterian small tool industries with some pebble tools, but without Acheulean bifaces and Levallois technique. These data suggest that Eastern Europe lies outside the distribution range of the Acheulean techno-complex demarcated with the “Movius Line”. In the Southern Caucasus, the Dmanissi hominine and lithic records document the fact that the earliest small-brained humans – probably later H. habilis-rudolfensis or earlier H. ergaster-erectus hominids bearing Pre-Oldowan technology – initially left Africa and appeared in Western Asia as early as 1.8 Ma ago. However, in the Southern Caucasus, the available chronological data indicate that the Acheulean complex has a later temporal appearance here compared to the Upper Acheulean or Acheulo-Yabrudian in Western Asia. Two main Upper Acheulean industrial variants currently can be recognized in the Southern Caucasus. The first, called the Kudarian by the author (from the caves of Kudaro I, Kudaro III, and Azyk), is characterized by lithics made from mostly siliceous rocks, rare Acheulean bifaces, and non-Levallois flaking technique. The second variant is characterized by lithics made from volcanic rocks, numerous Acheulean bifaces, and often more laminar or Levallois debitage. It can be suggested that there are independent origins for these Southern Caucasus Upper Acheulean industrial variants. Possible roots of the Acheulean assemblages of Kudarian variant might be in the local earlier Lower Paleolithic small tool assemblages with some pebble tools but without Acheulean bifaces. The other Caucasus variant of the Upper Acheulean appears to be related to the Levantine Upper Acheulean.     

El fenómeno de las caídas en residencias e instituciones: revisión del Grupo de Trabajo de Osteoporosis,Caídas y Fracturas de la Sociedad Española de Geriatría y Gerontología (GCOF-SEGG)

The Workshop on Osteoporosis, Falls and Fractures (GCOF) of The Spanish Geriatrics and Gerontology Society (SEGG) formed a committee in order to review the state of the art on the detection, risk factors and assessment tools for falls, and intervention protocols when falls occurs in nursing homes, long-term hospitals or medium-stay units. The different patient profiles are described in order to make a comprehensive approach to this heterogeneous topic and population, offering a risk classification and specific advice according to these categories.     

Intérêt des traceurs de l’hypoxie en radiothérapie

Tumor hypoxia is a major parameter of radioresistance. Hypoxia PET imaging using several radiotracers (F-Miso, FAZA, Cu-ATSM, EF5…) may help predict response to radiotherapy. Hypoxic area evaluation may also help select patients for hypoxia-targeting drugs, and thus reinforcing radiotherapy effects. Hypoxia imaging may also be fused with radiotherapy planning CT to define radioresistance areas that may be boosted by dose-painting radiotherapy. Despite several difficulties (patient positioning, organ and tumor motion, image definition…), targeting hypoxic regions within tumors is one of the most promising research strategies of modern radiotherapy.     

Les conceptions religieuses et idéologiques des tribus de l’âge du bronze en Azerbaïdjan et leurs traditions

The primitive religious view of tribes in Azerbaijan Bronze Age was in close connection with nature. Fire rituals had taken the main place in ancient people’s belief.     

Autres applications de la MIBG : « applications de la scintigraphie de l’innervation myocardique à la 123-I-MIBG en neurologie »

Myocardial 123-I-metaiodobenzylguanidine (MIBG) imaging enables the assessment of postganglionic sympathetic cardiac innervation. Recently myocardial 123-I-MIBG scintigraphy has been found to be useful to distinguishing Parkinsońs disease (PD) from other akinetic rigid syndromes. The absence of published guidelines for cardiac 123-I-MIBG imaging makes standardization of procedures among individual users of this technique even more important. Cardiac MIBG study showed markedly decreased uptake in PD, dementia with Lewy bodies (DLB) and pure autonomic failure, which is a common feature of Lewy body disease. The cardiac MIBG uptake is severely impaired even in the early disease stage. Atypical parkinsonian syndromes, including Multiple System Atrophy, Progressive Supranuclear Palsy, and other, show modest reduction of cardiac MIBG uptake. The MIBG study can be used for differentiating patients with extrapyramidal signs and dementia, and might provide useful diagnostic information to discriminate DLB and Alzheime?s disease.     

Utilisation des isotopes stables pour l’identification de l’origine du carbone dans la datation du charbon de bois du Paléolithique

Recent years have brought many results of radiocarbon dating the earliest periods of the Upper Palaeolithic that can bring light on the origins of figurative art by Sapiens or Neanderthals. These dates are often close to the limit of the field of radiocarbon dating; because they require measurements of the lowest amounts of radiocarbon, controls are particularly essential. Here we examine the case of the dating of charcoal, whose identification after decontamination is difficult. We suggest a method that does not require additional manipulation to determine whether carbon comes exclusively from charcoal: using the proportion of stable carbon isotopes 13C/12C which is often regarded as a signature (δ13C).     

Arkaïm-Sintachta : expérience de la mise en valeur des steppes eurasiatiques à l’Âge du Bronze

The “Earth of fortified settlement” is one of the last big discoveries of the end of the XXth century. Situated on the oriental slopes of the mounts of Ural, fortified settlement, date the Middle Bronze Age. These strengthened structures are particular in the archaeology of steppes. They were built according to geometrical plans, Cities in oval being the most ancient, the rectangular cities being the most recent. The most remarkable are together of strengthened structures appropriate for the culture of Sintachta-Arkaïm. This city distinguishes itself from the others by the unique integrity of the works of fortification and by the graves which are connected to these last ones. Situated on a prominence, Arkaim consists of two defensive walls, maybe of a third, the rampart and the ditch. The space between the defensive walls was occupied by the houses of shape trapezoidale and directed as beams to the center of the city. The center of the city, the rectangular shape, was not built and formed a place where foyers were found. Complex entrances were at the four corner of the city. The excavations of fortified settlement and graves allowed to have an idea on the level of development of the everyday life at the time of the Middle Bronze Age in transouraliennes plains.     

Cancer de prostate métastatique résistant à la castration : le point de vue de l’oncologue médical

Most of patient suffering from a prostate cancer will develop a castration resistance. In this common and clinically challenging situation, chemotherapy was not considered very useful until mid 2000s. Docetaxel is now recognized as a standard of care, improving overall survival and quality of life. However, new drugs are needed. Two compounds (cabazitaxel and abiraterone) are now underway to official registration and an autologous vaccin strategy (Sipuleucel) demonstrated a benefit in survival. Based on a greater knowledge of biology, many other agents are currently under development, such as new specific peripheral anti-androgens, anti-angiogenic therapies, or proteasome inhibitors. All these new drugs are promising and may provide more efficient therapies against this incurable disease in the near future.     

Traitement de l’hyperthyroïdie par l’iode 131 : à propos de 280 cas

We report through this work the experience of nuclear medicine department at Ibn-Sina hospital (Rabat), in the treatment of hyperthyroidism with iodine-131. We retrospectively studied a cohort of 280 patients with hyperthyroidism, from several regions of Morocco between January 2001 and January 2010. A clinical examination and a serum assessment of TSHus, FT4 and FT3 have been made at baseline and at 3, 6, 12 and 24 months after radioiodine therapy. The activity of iodine-131 administered ranged from 296 to 740 MBq and depended on the pathology being treated, age, thyroid volume, intensity of clinical and biological hyperthyroidism and socioeconomic situation. Radioiodine therapy has often been proposed as a treatment for second or third intention, 71 patients were initially treated with iodine-131, while 209 patients had received iodine-131 after failure of medical treatment and/or recurrence after surgical treatment. Graves’ disease was the most common etiology (60%), followed by toxic adenoma (20%), and multinodular toxic goiter (13%). The therapeutic efficacy of a single dose of radioiodine evaluated after a 6-months follow-up was 92% in Graves’ disease, 98% in toxic adenomas and 97% in toxic multinodular goiter. No acute complication was observed. Taking into account our socioeconomic context, radioiodine therapy remains the preferred treatment of hyperthyroidism in our country with good value vs. price and excellent tolerance.     

« Terre des cités fortifiées ». Sites de la civilisation des steppes de l’époque du Bronze moyen en Oural du Sud

The “Earth of fortified settlement” is one of the last big discoveries of the end of the xx^th century. Situated on the oriental slopes of the mounts of Ural, fortified settlement, date the Middle Bronze Age. These strengthened structures are particular in the archaeology of steppes. They were built according to geometrical plans, Cities in oval being the most ancient, the rectangular cities being the most recent. The most remarkable are together of strengthened structures appropriate for the culture of Sintachta-Arkaïm. This city distinguishes itself from the others by the unique integrity of the works of fortification and by the graves which are connected to these last ones. Situated on a prominence, Arkaim consists of two defensive walls, maybe of a third, the rampart and the ditch. The space between the defensive walls was occupied by the houses of trapezoidal shape and directed as beams to the center of the city. The center of the city, the rectangular shape, was not built and formed a place where foyers were found. Complex entrances were at the four corner of the city. The excavations of fortified settlement and graves allowed to have an idea on the level of development of the everyday life at the time of the Middle Bronze Age in transuralian plains.     

Apport de l’imagerie hybride TEMP-TDM dans le suivi d’un cancer différencié de la thyroïde

In the management of patients with differentiated thyroid cancer (DTC), abnormalities detected on planar whole body scan and ¹³¹I-SPECT are difficult to interpret because of a lack of anatomical landmarks and limited specificity. Integrated ¹³¹I-SPECT-CT imaging has an additional value for characterization of equivocal tracer uptake seen on planar imaging as well as for precise localization. We illustrate through an observation the incremental diagnostic value of ¹³¹I-SPECT-CT images in the diagnosis of a cervical lymph node mimicking a physiological uptake on planar views. A 35-year-old Tunisian female was followed for papillary thyroid carcinoma, for which she underwent total thyroidectomy and iratherapy. Three years after a complete remission, the thyroglobulin (Tg) level on TSH stimulation increased. Diagnostic planar images with ¹³¹I did not disclose any obvious pathological foci. Furthermore, we noticed an increased ¹³¹I-uptake in the left sub-mandibulary area, which suggested a salivary physiological activity. SPECT-CT of the neck and chest were then performed with a Symbia T camera. Fused images demonstrate that this activity corresponds to a cervical lymph node closely adjacent to sub-mandibulary gland. Management of the patient was then changed. In selected patients with DTC, hybrid imaging should be used as a complementary to planar imaging in terms of diagnostic accuracy, because of superior focus localization and additional anatomic information derived from the CT component. Integrated SPECT-CT is then a useful tool, especially in cases of unclear diagnoses, precising anatomical localization of areas of increased ¹³¹I-uptake and distinguishing malignant lesions from normal physiological uptakes. This is particularly important in an oncologic center, as ours, where we don’t yet have a positron emission tomography (PET) camera is not yet available.     

L’analyse des unités techno-fonctionnelles appliquée à l’étude du macro-outillage néolithique

Ground stone tools are lithic tools made on coarse blanks that are not included in the chipped or polished stone studies. During the study of a ground stone tools collection coming from the Campaniform site of Beg ar Loued (Molène island, Finistère, France), the techno-functional unit (TFU) analysis as been adapted to these objects. A TFU is a part of a tool that is technologically independent, having his own part in this tool's overall functioning. The application of this method to ground stone tools needed some adaptations to their characteristics. The aim is to obtain a high level technological analysis for these tools, succeeding to express functional hypothesis. Two concrete examples from Beg ar Loued's collection illustrate the TFU analysis method's application to ground stone tools. This method has the advantage to organize the progress of each piece's analysis. The TFU analysis helps to understand the multifunctional tools by considering each function as a full tool. This allows us to talk about function's hierarchisation and their adaptation to blanks. We also obtain some informations about blank's selection. These many and varied results make the TFU analysis essential for ground stone tool's technological and functional analysis.     

Des crosses transformées en haches dans l’art néolithique armoricain : l’exemple du signe D de Dissignac (Saint-Nazaire, Loire-Atlantique, France)

A large number of Armorican engravings (Brittany, France) have been made by “pecking”. Each hammerstone impact caused the removal of a few square millimetres of rock, leaving distinctive groove called “flake negative”. The flake negatives are an authentic “signature of percussion” which informs us about the gestures employed by the engraver. The study of the signatures of percussion makes it possible for us to identify cases of superposition or to show as yet unperceived modifications of the engraved signs or transformations that have been carried out. For example, the technological study of Dissignac (Saint-Nazaire, Loire-Atlantique) showed the case of a crook transformed into a hafted axe. This method thus represents a new way in the development of the relative chronology of neolithic engravings in Armorica.     

L’industrie aurignacienne de la grotte de Šandalja II (Istrie, Croatie) dans le contexte de la région de l’Est de l’Adriatique

This paper presents the results obtained by lithic analysis of Early Upper Palaeolithic levels in Šandalja II Cave, Istria, Croatia. Technological and typological analysis of stone and typological analysis of bone artefacts have been carried out. Production of flakes in Aurignacian levels (G, F, E and E/F) is dominant, but blade and bladelets production is also present. Blades and bladelets were produced by direct soft hammer technique. Aurignacian people of Šandalja II produced their debitage mainly on local grey chert, which is often patinated. Šandalja II is one of the rare—if not the only—site with Aurignacian industry in eastern Adriatic region. The main reason for absence of such industry at other sites can be seen in scarce population or abandonment of some parts of this region.     

Apport de l’imagerie hybride TEMP/TDM dans la détection des ganglions sentinelles : à propos de 32 cas

Objectives

Retrospective evaluation of the SPECT/CT role in the Sentinel Lymph Node identification.

Patients and methods

Thirty-two patients underwent a lymphoscintigraphy with SPECT/CT imaging. Those patients presented several cancer types (16 melanoma, one squamous cell carcinoma, three breast cancers, eight vulvar cancers, three cervical cancers).

Results

The scintigraphic detection rate was 81% with planar imaging while this rate was 89% with SPECT/CT. The SPECT/CT provided an additional quantitative information in 66% cases. Moreover, the quality of the interpretation was better in two different conditions (planar interpretation followed by routine and blinded SPECT/CT interpretation) with SPECT/CT. In our study, the false negative rate is 4.5%.

Conclusions

SPECT/CT provides quantitative and qualitative informations in the sentinel lymph node detection. Therefore, it can be a valuable tool for the surgeon to find and harvest the sentinel lymph node especially where the lymphatic drainage pattern can be unusual or hard to predict (cervical or trunk localisation). It's a new tool for preoperative detection and it can decrease the false negative rate.