Hydrological and hydraulic behaviour of a surface flow constructed wetland treating agricultural drainage water in northern Italy.

A surface flow constructed wetland (SFCW) treating agricultural drainage water was investigated with the aim to detect modifications in hydrological and hydraulic characteristics after more than a decade of operation. Ponded infiltration tests were conducted to estimate the saturated hydraulic conductivity, Ks, of the surface soil layer at the point scale. At the global scale, infiltration rate, i, was computed from the water balance to detect leakages from the pervious wetland surface. Tracer tests were conducted to analyse the existence of preferential flow inside the system and to estimate its hydraulic retention time (HRT). Clogging phenomena occurred given a mean Ks value of 30 mm h-1 was measured near the SFCW inlet, that was 9.61 times lower than the value at the outlet zone. The estimated infiltration losses were two orders of magnitude lower than infiltration measured at the point scale. The results also confirmed the existence of a moderate amount of preferential flow paths and dead zones in the SFCW as the actual HRT (6.7 days) was shorter than the nominal one (8.1 days). Despite this, it can be concluded that the system performance is still good after 17 years of operation.

The predictive value of the presence of different antibodies and thymus pathology to the clinical outcome in patients with generalized myasthenia gravis.

OBJECTIVES: To analyze the predictive value of anti-acetylcholine receptor antibodies (anti-AChR Ab) and anti-muscle specific kinase antibodies (anti-MuSK Ab), as well as the thymus pathology to the clinical outcome in patients with generalized myasthenia gravis (MG). METHODS: We analyzed 138 patients with generalized MG, who were thymectomized and assayed for anti-AChR Ab and anti-MuSK Ab. RESULTS: Anti-AChR Ab were detected in 84% of patients, while anti-MuSK Ab were present in 36% of the AChR Ab negative patients. Severe forms of the disease were more frequent in MuSK Ab positive, compared to the AChR Ab positive and complete seronegative patients. Thymic lymphoid follicular hyperplasia (LFH) was present in 60%, thymoma in 23%, atrophic thymus in 9% and the normal thymus in 8% of patients. LFH was more frequent among women, while thymoma and atrophic thymus were more frequent in men. The younger patients mainly had LFH and normal thymus, while thymoma and atrophic thymus were more frequent in older patients. The mildest clinical presentation was present in patients with normal thymus, while severe forms of the disease were registered in the patients with thymoma. The AChR Ab positive patients had more often LFH and thymoma, while within MuSK Ab positive patients atrophic thymus was most common. CONCLUSION: The best disease outcome was observed in patients with normal thymus or LFH with anti-AChR Ab or without both types of antibodies.

Papillary glioneuronal tumor: unexplored entity.

Papillary glioneuronal tumors represent a new and rare entity of an uncommon morphologic subtype of low-grade mixed neuronal-glial neoplasms with an unclear etiology. They are described as benign lesions with extraventricular localization. We report the second case of papillary glioneuronal tumor with recurrent nature after gross-total resection, and the third case of this tumor with intraventricular localization. While conventional magnetic resonance imaging of papillary glioneuronal tumors is well described in literature, there are no data based on advanced magnetic resonance techniques. The present article represents a review of clinicopathological and both conventional and advanced magnetic resonance imaging characteristics of papillary glioneuronal tumors, with focus on 2 cases with atypical course and localization.

Intraventricular textiloma with granuloma formation following third ventricle colloid cyst resection - a case report.

Despite precautions, cotton and gauze pads used for dissection or to achieve haemostasis during neurosurgical procedures can inadvertently be left behind and result in clinically symptomatic or asymptomatic and radiologically apparent mass lesion, sometimes referred to as "textilomas" or "gossypibomas", often mimicking recurrent tumour or abscess on neuroimaging studies. We report the neuroimaging evaluation, including computed tomography (CT), magnetic resonance imaging (MRI) and spectroscopy (H1-MRS), in a case of textiloma developing after the treatment of a third ventricle colloid cyst.

[Comparison of detection of brain lesions in multiple sclerosis in magnetic resonance imaging at magnetic field strength of 1.0 and 3.0 Tesla].

To estimate the relative sensitivity of MR examination for brain lesions in multiple sclerosis at 1.0 Tesla (T) and 3.0 T using identical acquisition conditions. 54 patients with multiple sclerosis were examined both at 1.0T (Siemens Impact Expert) and 3.0T (Philips Intera) using T1-weighted spin echo (T1W-SE) with and without gadolinium contrast injections, T2W SE and fluid attenuated inversion recovery (FLAIR) imaging. Images were examined independently by three experienced neuroradiologists using focal lesion counting. 3.0T scans compared with 1.0T scans demonstrate a 27.3%, increase in the number of detected contrast enhanced lesions and an 22.7% increase in the number of detected lesions on FLAIR MR tomograms. Highfield 3.0T MR imaging demonstrates better sensitivity in the detection of focal brain lesions in multiple sclerosis. This improvement is more apparent in contrast enhanced lesion detection and less noticeable in FLAIR detected lesions.

Chemoembolization for liver metastases from colorectal carcinoma: risk or a benefit.

Results from clinical trials do not allow definitive conclusions about the role of chemoembolization (ChE) in the treatment of colorectal cancer (CRC) liver metastases. The aim of present phase II study was to investigate toxicity and efficacy of ChE for patients, with unresectable colorectal liver metastases after failure of 5-FU based chemotherapy. Secondary endpoint was clinical benefit measurement. Eleven patients were enrolled in first stage (two-stage Simon design), 2 males/9 females, median age 60 (46-71). Performance status was I in 8 patients and II in 3 patients. All patients had radical surgery, 7 of them adjuvant chemotherapy and 4 systemic chemotherapy. The ChE regimen consisted of an injection of iodinated oil Lipiodol with mitomycin C (3 mg/ml). Repeated treatments were performed at 9- to 12-week intervals. We applied 17 ChE (median 1/pts.). Clinical benefit was a composite of measurements of pain, ECOG performance status, weight and tumor fever. Study was stopped after first stage because non of the patients (pts) achieved objective response (RECIST). Stable disease occurred in 5 pts (45%). Median time to progression was 3 months (range 3-9 months). Median survival was 9 months (range 4-16 months). A decrease of the baseline carcinoembryonic antigen level occurred in 0% of the cases. Clinical benefit was recorded in one patient. Common toxicity included a "postembolization syndrome," which consisted of fever, pain in the right upper quadrant, nausea, and vomiting. Grades 3-4 toxicity (NCI-CTC) followed transaminases 6/11, LDH 4/11. In addition, a drop in F V levels was noted in 5 pts, F VII in 9, F IX in 2 and F X in 10 pts. Decrease in At III levels occurred in 6 pts and FDP appeared in one. Thus, The ChE as performed in the present study did not appear to bring any benefit; furthermore, significant liver toxicity compromises the safety of such procedure.

Epidemiological and clinical characteristics of myasthenia gravis in Belgrade, Yugoslavia (1983-1992).

This is the first epidemiological study of myasthenia gravis (MG) in the area of Belgrade. During the survey period (1983 1992), 124 incidental cases of MG were observed, producing an average annual incidence rate of 7.1 per million population (women, 8.3; men, 5.8). Age and sex specific incidence rates for females demonstrated a bimodal pattern, with the first peak in the age group between 20 and 40, and the second peak in the age group 70-80. The age-specific rates for males showed unimodal pattern, reaching a maximum in the age group between 60 and 80. There was a tendency of more frequent disease appearance in the urban as opposed to the suburban districts. On the prevalence day, December 31, 1992, the point prevalence rate was 121.5 per million (women, 142.5; men, 98.8). Only for incidental cases, the point prevalence rate was 77.1 (women, 83.2; men, 70.4). The average annual mortality rate was 0.47 per million (females, 0.52; males, 0.42), while cumulative lethality was 5.6 (women, 5.6; men, 5.7). Most frequently initial symptoms were ocular, occurring in 58% patients. Through the period of investigation ocular symptoms were generalized in 68%, most frequently in the first 2 years (62.5%). Thymoma was confirmed in 11.3% of patients. In this group there was equal presence of both sexes, older median age at onset, and more severe clinical course of MG. Associated autoimmune disease was found in 17 out of 124 incidental cases (13.7%). The most common were thyroid diseases (7.3%). Family history of MG was recorded in 2 cases belonging to 1 family (1.6%).

[von Recklinghausen's neurofibromatosis]. / Neurofibromatosis von Recklinghausen.

We present a case of unusual clinical picture of the well defined Morbus Von Recklinghausen. In a 35-year-old male patient, after an uncontrolled rapid movement of the neck, the disease was suddenly manifested with spastic quadriparesis. Three years later the clinical picture showed spastic quadriplegia. Antalgic torticollis confirmed by X-ray of the neck clearly showed vertebral subluxation at the level of C3-C4. However, additional magnetic resonance imaging revealed large extradural tumorous formation at the level of C1-C2, and two small oval tumours in the splenium of the corpus callosum as well as in the left lateral ventricle. "Café au lait" spots, "molluscum fibrosum" and few subcutaneous fibromas appeared as skin changes which explained the possible nature of the registered intracranial and intraspinal tumours. Neurosurgery has been performed at the spinal level with good results; it confirmed the diagnosis of Von Recklinghausen's Neurofibromatosis.