Biofilm and siderophore effects on secondary waste water disinfection.

The efficiency of ultraviolet (UV) light disinfection of wastewater effluent using a large-scale pilot system was studied. The relationship between biofilm and siderophore production and UV doses received by Pseudomonas aeruginosa strain ATCC 15442 was determined. UV decreased pyoverdine production and enhanced biofilm production. Consequently external factors conditioned by both pyoverdine and biofilm may affect the UV effect on bacterial disinfection.

[Primary digestive tract Kaposi sarcoma with idiopathic CD4+ lymphocytopenia, HIV negative, HHV8 positive]. / Sarcome de Kaposi digestif primitif avec lymphocytopénie CD4 idiopathique, VIH négatif, HHV8 positif.

A 52-year-old Tunisian patient had fever, impaired health and several opportunistic infections (Campylobacter jejuni, Mycobacterium hominis, Herpes virus, Giardia intestinalis, Vibrio metschnikovii). Lymphocytopenia was noted (348/mm3; CD4+: 2.2%; CD4+/CD8+: 0.1). Polymerase chain rection search for HIV was negative in serum and in tumor tissue. Diagnosis of primary digestive Kaposi sarcoma was established at autopsy due to the deep location of the lesions. There was an ulcerofungating tumor spreading over 1.3 m of the duodenojejunum. This is the fourth reported case of CD4+ lymphocytopenia, a new and very rare immunodeficiency syndrome recently defined by the Centers for Disease Control. We detected human herpes virus 8 by immunohistochemistry of tumor tissue. Human herpes virus 8 is implicated in the pathogenesis of Kaposi sarcoma.

[Unusual localization of embryonal rhabdomyosarcoma of the gallbladder]. / Localisation exceptionnelle du rhabdomyosarcome embryonnaire à la vésicule biliarie.

We report a second case of gallbladder embryonal rhabdomyosarcoma diagnosed in a 54 year old female. We had previously published a first similar case in a 48 year old male. In the review of the literature 5 other cases were collected. Five of the 7 cases occurred in 4 females and one male adult mean aged 63.4 years, and 2 in young girls aged 40 months. Three cases were of botryoid type, three were of alveolar type and one was of undetermined type. Immunohistochemistry demonstrated intra-cytoplasmic positivity of tumoral cells with anti-vimentin, anti-desmin and anti-actin anti-bodies. The prognosis remains bad. Death occurred, in 5 patients, in a period going from 18 days to 8 months after clinical diagnosis with a 5 months mean survival. The shortest survival was observed in a 40 month old child with AIDS. Only one case with surgical resection followed by radiochemotherapy had a 9 month survival.

[Pseudotumor extramedullary hematopoiesis. Report of 3 cases and review of the literature]. / L'hématopoïèse extramédullaire pseudo tumorale. A propos de 3 observations avec revue de la littérature.

We report 3 cases of extramedullary hematopoiesis with a sacrococcygeal, right obturatory hole and paravertebral dorso lumbar locations respectively in 30, 34 and 58 years old patients (two males and woman). A medullary tuberculosis was discovered in one case, a beta thalassemia in the second, and the third was classified as idiopathic. Radiologic picture often permitted to evoke the diagnosis on the aspect of a well limited multilocular tumor especially when there is a paravertebral location as in our third patient. Fine needle punction cytologic examination can permit the diagnosis and avoid surgery, except if complications occur.

[Intestinal perforation by a fish bone. Apropos of a case and review of the literature]. / Perforation intestinale par arête de poisson. A propos d'une observation avec revue de la littérature.

We report a case of transverse colon perforation by a fish bone (Grouper) in a toothless-old female. A review of the literature revealed a great variety of foreign bodies which may cause perforations at variable sites of the gastrointestinal tract. Fish bones were responsible for 46% of intestinal perforations in a review of 24 cases collected in 1984. Advanced age and poor patient dentition, as well as mental debility constitute predisposing factors for the swallowing of foreign bodies. Emergency radiology may be required. An exaggerated inflammatory reaction may give rise to a misleading pseudo tumor appearance. We agree that a well conducted and well analysed clinical history associated with a careful pathologic examination are very helpful in the diagnosis.

[Intraepithelial carcinoma and invasive carcinoma of the sclero-corneal limbus. Anatomo-clinical study apropos of 20 cases]. / Carcinome intraépithélial et carcinome invasif du limbe scléro-cornéen. Etude anatomo-clinique à propos de 20 cas.

We report a retrospective multicentric study of 20 cases of sclero-corneal limbus tumours carcinome including 9 cases of Bowen's disease and 11 squamous cell carcinomas. These cases were observed over two 10 and 20-year periods in two pathology departments. Epidemiological, clinical, pathological and therapeutic data as well as the clinical course were studied and the results compared with a large review of the literature. The mean age of the patients was 38 years for Bowen's disease and 47 for carcinoma. Two young subjects, 5 and 22 years, had xeroderma pigmentosum and had Bowen's disease and an epidermoid microinvasive carcinoma, respectively. All of the patients with Bowen's disease were men and were more than 90% of the patients with carcinoma. Tumour size was greater in carcinomas (7 to 10 mm) than in Bowen's disease (1 to 5 mm). All tumours were unilateral. Clinical manifestations included irritative or inflammatory reactions in one-fourth of the patients with Bowen's disease and in one-third of those with carcinoma. Pathology examination revealed an intact basal membrane separating healthy tissue from Bowen's lesions which showed disrupted cell architecture mostly involving the medial layers of the epithelium in 37% of the cases. All of the lesions were treated by exeresis. No recurrence has been observed after a follow-up of 1 month to 2 years for Bowen's disease and 1 year (maximum) for squamous cell carcinomas.

[Ag-NORS and non-pigmented tumors of the sclerocorneal limbus. Apropos of 20 cases]. / Ag-NORS et tumeurs non pigmentées du limbe scléro-cornéen. A propos de 20 cas.

We studied nucleolar organizers (Ag-NORS) in 20 cases of ocular limbic tumours of which 7 were Bowen disease or intraepithelial carcinoma and 13 were invasive carcinomas. The NOR-Index, reflecting cellular activity, increased from intraepithelial carcinoma (3.97) to microinvasive (5.45) and invasive carcinoma (5.81). Results of Nor-Index, reflecting proliferation, was in agreement with other technics such as immuno-labelling with Ki67 and PCNA antibodies.

[Placental aspergillosis: myth or reality? Apropos of a case with fetal death in utero]. / L'aspergillose placentaire: mythe ou réalité? A propos d'une observation avec mort foetale in utero.

The authors report an original case-history of massive aspergillosis of the placenta that occurred in a 24 year old primigravida who had had no previous history or clinical changes in pregnancy. It caused fetal death in utero with retention and maceration of the fetus. Macroscopic examination showed that the left lip was cleft and that the placenta was studded with isolated confluent diffuse whitish granulations. Histologic examination made us think that these appearances were those of aspergillar granulomas occurring even in the placental villi and intravillous spaces. Laboratory findings showed that there was Aspergillus Niger in the blood of the mother. A wide search of the literature failed to find any case in humans. On the other hand aspergillosis occurs frequently in animals causing intrauterine growth retardation and prematurity with abortion. There is great economic loss as a result. Why the animal placenta should be susceptible to infection of aspergillosis and how it acquires it is discussed! Finally the association of aspergillosis of the placenta with a cleft lip found in our case, is unique and one wonders if there is any relationship.

[Thoracic computed tomography data and cytology of the bronchoalveolar lavage fluid in an adult case of Niemann-Pick disease. The physiognomy of the disease in Tunisia]. / Manifestation tomodensitométrique thoracique et cytologie du liquide de lavage broncho-alvéolaire dans un cas adulte de maladie de Nieman-Pick. Physionomie de la maladie en Tunisie.

From a personal observation of a case of the chronic type-B form Niemann-Pick's disease in a 23 year old adult, the authors decided to review all the Tunisian published cases. They bring to light, in a review of the literature, the pulmonary disorder that occurs during this disease and discuss the contribution of computed tomography and the value of broncho-alveolar lavage as a method of diagnosis and prognosis in this disorder.

[The nucleolus organizer region (Ag NORS) in urothelial tumors. Apropos of 10 cases]. / Etude des organisateurs nucléolaires (Ag NORS) dans les tumeurs urothéliales. A propos de dix cas.

The authors study nucleolar organisers (Ag NORS) in ten cases of urothelial tumours, graded as grade I in five cases, grade II in two cases, grade III in two cases and intermediate grade II-III in one case. Study of the NOR index showed a mean value of 3.89 for grade I, 4.66 for grade II, 5.88 for grade III and 4.90 for the intermediate grade II-III. Different values were recorded in the same heterogeneous tumours containing tumour zones of different grades, providing an additional argument in favour of the heterogeneity of these urothelial tumours and accounting for the difficulties of their classification reported in the literature. Adequate sampling should allow a more objective and more representative study of all of the tumours examined.

[Prognostic study of cell proliferative markers ki67, PCNA and p53 oncoprotein in bladder tumors]. / Etude pronostique des marqueurs de prolifération Ki67 et PCNA et de l'oncoprotéine p53 dans les tumeurs vésicales.

We report a study of cell proliferative factors Ki67, PCNA and p53 oncoprotein in 55 patients with bladder tumors. Fifty-three of the patients were male and two were female, with a mean age of 56.6 and 68.5 years, respectively. These tumors were of transitional cell type in 97.9% of the cases. Staging was, respectively, pTis (4.76%), pTa (30.9%), pT1 (19.04%), pT2 (23.8%) and Pt3 (21.4%). Our study of proliferative nuclear markers Ki67 showed that cell proliferation increased in bladder tumors according to grade in the same stage. This variation was highlighted by our results for PCNA but was not verified for Ki67. However, these results revealed an increase of cell proliferation for a same grade (grade I and II) in different stages (pTa, pT1, pT2) for PCNA; this was not ascertained for Ki67. The study of p53 oncoprotein showed that detection of mutated p53 protein increased according to grade only for grades II and III and to stage only when moving from pTis to superficial tumors (pTa, pT1) and to deep tumors (pT2, pT3), thus individualizing two groups without significant variation within these groups. A variation according to grade in the same stage was noted only for stages pT1 and pT2. A variation for a same grade (grades II and III) was reported between stages pTa, pT1 and pT2. The combined study of Ki67, PCNA and p53 oncoprotein showed a prognostic correlation between these three markers in general.

[Anesthesia and resuscitation in Arabo-Islamic medicine: analytic study through Ibn Sina].

Nervous system anatomy knowledge acquired by arabo-islamic physicians enabled them to know its physiology represented by its excitability and its conductibility, and to understand pain physiology. Ibn Sina in his book entitle "The Canon of Medicine" precise anesthetic drugs and their side effects. Among these anesthetic means there were opium and ice. Ibn Sina distinguished organic pain and psychogenic pain. He used sedative and antalgic and soporific drugs in treatment of some psychologic diseases as melancholia. Moslem physicians were the first to use cold water to treat superficial burns. Anesthesia which lead to heavy sleep to used achieve surgical operations by oral, nasal(inhalation) and rectal route as it was described by Ibn Sina who indicated dosage to achieve three or four hour anesthesia which was necessary in an amputation surgery.

Gastric MALT lymphoma. A clinico-pathological study of 65 cases. Relationship to Helicobacter pylori.

We report 65 cases of MALT gastric lymphomas. HP was looked for with Giemsa and Whartin Starry stains. Immunohistochemistry was done with PAP method. Anti-HP treatment was used in 9 cases. 38 were of low grade of malignancy, 23 were high grade, 4 were high grade with a low grade component. The mean age was 51.5 years, the sex ratio 1.5. Epigastric pain was the most frequent feature (87.7% of cases). Endoscopically, low grade lymphomas presented as unique or multiple ulcerations (55.3% of cases) with antral localisation (52.6% of cases). 60% of our patients were stage IE, of which 61% had low grade lymphoma, 18% were at stage II2E, 10% at stage III and 10% at stage IV. From 23 operated patients, 29% had early lymphoma which was low grade malignant in 71.5% of cases, and 71% had lymphomas which were widely spread beyond the submucosa. HP was found in 63% of cases. Histologic regression of two early lymphomas of low grade malignancy was achieved after HP eradication.

[Ewing's sarcoma. Retrospective study of 108 cases with review of the literature]. / Le sarcome d'Ewing. Etude rétrospective de 108 cas avec revue de la littérature.

108 cases of Ewing's Sarcoma are collected at the "Curie Institute" and studied by the authors using the modern Technics of electron microscopy, cytochemistry, immunohistochemistry and cytogenetics. They raise the histogenesis and etiological factors not entirely resolved yet at the light of literature review.