[Lymphoceles after renal transplantation: Study of risk factors]. / Facteurs de risque de la lymphocèle post-greffe rénale.

AIM: To identify the risk factors of post renal transplant lymphocele. PATIENTS AND METHOD: Over a period of 20 years (1986-2006) we carried out 377 renal transplants on 372 patients. Thirty cases of lymphocele were recorded (8%). The medical history of patients was retrospectively examined in order to identify the risk factors of this complication among the data relating to recipents, donors, the operation itself and post operative incidents. The different parameters liable to correlate with the incidence of lymphocele were subjected to a univaried then multivaried statistical study. RESULTS: Unifactorial analysis identified four predictive factors related to the incidence of lymphocele. They were the age of the recipient greater or equal to 35 years old, the cadaverous origin of the transplanted organ, the duration of ischemy greater or equal to 24hours for the kidneys of deceased donors, and immunosuppressor treatment associated with Mycophenolate mofetil-Cyclosporine. The only independent risk factor significant in multifactorial analysis was the cadaverous origin of the transplanted organ. CONCLUSION: Our study showed that the cadaverous origin of the transplanted organ would appear to play an important role in the genesis of post renal transplant lymphocele. A better preparation of the organs of cadaverous origin before their implantation with meticulous ligature of the hilum of lymph nodes could reduce the incidence of this complication. This observation, as well as the benefit of such a procedure, remains to be confirmed by studies on a larger scale.

Periodic variation of the water use efficiency in durum wheat.

Water Use Efficiency (WUF) of five durum wheat varieties (Khiar, Karim, Nasr, Razzak and Sobirano) cultivated in Tunisia was investigated. The experiment was conducted under rainfed field conditions, irrigated pots and test tubes at ESA Kef experiment station during the cropping season of 2010-2011. Under rainfed conditions, Khiar has the highest grain yield with 29.35 q ha(-1). Biological WUE ranged from 1.72-1.49 mg dry matter per g of water for Razzak and Nasr, respectively. The WUE of grain ranged.from 0.81-0.48 mg grain per g of water for Khiar and Sobirano, respectively. Biological WUE showed positive correlation to grain yield and stomatal density and negatively correlated with leaf area. Periodic water use efficiency in pot and test tube trials indicated variation of wheat genotypes according to stage periods and how the experiment was conducted. Test tubes trials showed high, accurate and maximum value of water use. Therefore, we can consider that Khiar has a high WUE in the first period; germination-early tillering (6.70 mg dry matter per g water). Nasr and Sobirano valorise well had got water use during the second period; tillering (9.16 and 10.20 mg dry matter per g of water). Razzak shows a high WUE for the third period; booting-early heading (9.06 mg dry matter per g of water). Finally, Karim cultivar has the highest WUE during for the fourth period; heading-physiological maturity (22.13 mg dry matter per g of water). Periods of high WUE can be targeted for appropriate time of wheat cultivar irrigation.

Post-kidney transplantation lymphocele due to a lymphatic filariasis.

Lymphocele is a well-known complication of renal transplantation. Presenting symptoms are nonspecific; most patients are entirely asymptomatic. Herein, we have reported a case of lymphocele due to an asymptomatic lymphatic Wuchereria bancrofti filariasis with deterioration of graft function. A 53-year-old man with end-stage renal disease secondary to vascular disease was admitted 40 days after transplantation with vague, isolated abdominal pain. An abdomen and pelvis ultrasound examination demonstrated a cystic structure in the renal hilus. Graft function deteriorated, so the patient underwent puncture of the lymphocele followed by povidone iodine sclerotherapy. In the percutaneous drainage, we noted a fine whitish strand 4-mm thick similar to the shape of the stent, a part of which seemed to go into the transplantation fossa. Parasitological examination showed an adult female worm of W bancrofti measuring 6 cm. The test for microfilaremia was negative. The patient was treated for 10 days with a combination of Ivermectin and Albendazole associated with Doxycycline. The collection rapidly decreased after worm treatment. This case describes a post-renal transplantation lymphocele due to asymptomatic lymphatic filariasis.

Surfactant protein C gene (SFTPC) mutation-associated lung disease: high-resolution computed tomography (HRCT) findings and its relation to histological analysis.

AIM OF THE STUDY: Determine high-resolution tomography (HRCT) scan characteristics in children with SFTPC mutation and correlate them to histological findings. PATIENTS AND METHODS: This retrospective multicenter study included 15 children (7 females and 8 males) with SFTPC mutations. HRCT scans have been performed in all the children and lung biopsies in 8 children. RESULTS: From all signs assessed on initial HRCT scans, ground-glass opacities (n =14, 93%) and lung cysts (n = 6, 40%) were predominant. Interlobular septal thickening (n = 1, 7%), air space consolidation (n = 1, 7%), paraseptal emphysema (n = 2, 13%), and pulmonary nodules (n = 1, 7%) were also found. Histological analysis revealed accumulation of macrophages in the alveolar lumen, type II pneumocyte hyperplasia, and alveolar septal thickening. Dilatation of the respiratory bronchiole and alveolar duct associated with muscular hyperplasia were also described. Interestingly, lung cysts on HRCT scans were associated with dilatation of terminal bronchioli and alveolar duct in lung biopsies. CONCLUSION: In children with SFTPC mutations, HRCT scan finding was highly correlated to the histological findings and, as such, represent a useful tool to identify patients that may require SFTPC gene sequencing.