Altered expression of cytokines, chemokines, growth factors, and soluble receptors in patients with colorectal cancer, and correlation with treatment outcome.

Insofar as they play an important role in the pathogenesis of colorectal cancer (CRC), this study analyzes the serum profile of cytokines, chemokines, growth factors, and soluble receptors in patients with CRC and cancer-free controls as possible CRC signatures. Serum levels of 65 analytes were measured in patients with CRC and age- and sex-matched cancer-free controls using the ProcartaPlex Human Immune Monitoring 65-Plex Panel. Of the 65 tested analytes, 8 cytokines (CSF-3, IFN-γ, IL-12p70, IL-18, IL-20, MIF, TNF-α and TSLP), 8 chemokines (fractalkine, MIP-1ß, BLC, Eotaxin-1, Eotaxin-2, IP-10, MIP-1a, MIP-3a), 2 growth factors (FGF-2, MMP-1), and 4 soluble receptors (APRIL, CD30, TNFRII, and TWEAK), were differentially expressed in CRC. ROC analysis confirmed the high association of TNF-α, BLC, Eotaxin-1, APRIL, and Tweak with AUC > 0.70, suggesting theranostic application. The expression of IFN-γ, IL-18, MIF, BLC, Eotaxin-1, Eotaxin-2, IP-10, and MMP1 was lower in metastatic compared to non-metastatic CRC; only AUC of MIF and MIP-1ß were > 0.7. Moreover, MDC, IL-7, MIF, IL-21, and TNF-α are positively associated with tolerance to CRC chemotherapy (CT) (AUC > 0.7), whereas IL-31, Fractalkine, Eotaxin-1, and Eotaxin-2 were positively associated with resistance to CT. TNF-α, BLC, Eotaxin-1, APRIL, and Tweak may be used as first-line early detection of CRC. The variable levels of MIF and MIP-1ß between metastatic and non-metastatic cases assign prognostic nature to these factors in CRC progression. Regarding tolerance to CT, MDC, IL-7, MIF, IL-21, and TNF-α are key when down-regulated or resistant to treatment is observed.

Emerging organic compounds as markers of the degradation of groundwater qualitative and quantitative equilibrium in a context of rapid urban expansion.

With the neo-metamorphosis of the residential landscape worldwide and sluggish sanitation strategies in urban environments, rudimentary on-site sanitation systems remain commonly used, especially in developing countries, despite the risks of groundwater contamination. The effective management of such water resources relies on assessment of the sensitivity of anthropized aquifers to man-made impact, including groundwater behavioural alteration, in terms of both quality and quantity. Associated with tracking of changes in land use, this study proposes an approach involving emerging organic contaminants (EOCs) as indicators of the alteration of groundwater balance due the exposure of shallow aquifers to the risks of infiltration of untreated wastewater from soak pits. This methodology was applied to the shallow aquifer beneath the urban agglomeration of Grand-Sfax (Tunisia). Combined with an updated follow-up of groundwater piezometric fluctuations in relation with inputs from surface contamination sources, the spatialisation of contamination levels by EOCs provided a clear delineation of the most impacted aquifer zones. This approach revealed a significant link between the continuous rise in piezometric levels by contributions from untreated inputs and the accumulation of high levels of contamination in groundwater. The understanding of EOC underground pathways allowed the determination of the fates and processes responsible for the diffusion of contamination throughout the studied aquifer. The ability of groundwater to reflect population life style and the use patterns of such organic molecules was also assessed. Besides revealing the legacy of persistent contamination, this approach involving EOCs as tracers with different levels of persistence provided a spatial observation of the aquifer exposure to continuous contamination processes. This approach made it possible to develop a conceptual presentation of aquifer vulnerability to urban pressures and to predict the effects of subsequent expansion of unplanned urbanisation on groundwater quality.

A critical assessment of widely used techniques for nitrate source apportionment in arid and semi-arid regions.

The assessment of nitrate pollution origin using stable isotope techniques is a fundamental prerequisite for the application of sustainable groundwater management plans. Although nitrate pollution is a worldwide groundwater quality problem, existing knowledge on the origin of nitrate pollution in arid and semi-arid regions is still scarce. Using the example of the Grombalia aquifer (NE Tunisia), this work summarizes the main strengths and constraints of multi-isotope techniques targeting at nitrate source identification and apportionment The results highlighted that, even in the case of well-established methodologies, like those of isotope hydrogeochemistry (δ15NNO3, δ 18ONO3 and δ 11B) and mixing modelling for source apportionment, it is fundamental to take into account regional and local end-members to avoid biased data interpretation and to fully exploit the potential of such accurate tools.

Integrated socio-hydrogeological approach to tackle nitrate contamination in groundwater resources. The case of Grombalia Basin (Tunisia).

Nitrate contamination still remains one of the main groundwater quality issues in several aquifers worldwide, despite the perduring efforts of the international scientific community to effectively tackle this problem. The classical hydrogeological and isotopic investigations are obviously of paramount importance for the characterization of contaminant sources, but are clearly not sufficient for the correct and long-term protection of groundwater resources. This paper aims at demonstrating the effectiveness of the socio-hydrogeological approach as the best tool to tackle groundwater quality issues, while contributing bridging the gap between science and society. An integrated survey, including land use, hydrochemical (physicochemical parameters and major ions) and isotopic (δ15NNO3 and δ18ONO3) analyses, coupled to capacity building and participatory activities was carried out to correctly attribute the nitrate origin in groundwater from the Grombalia Basin (North Tunisia), a region where only synthetic fertilizers have been generally identified as the main source of such pollution. Results demonstrates that the basin is characterized by high nitrate concentrations, often exceeding the statutory limits for drinking water, in both the shallow and deep aquifers, whereas sources are associated to both agricultural and urban activities. The public participation of local actors proved to be a fundamental element for the development of the hydrogeological investigation, as it permitted to obtain relevant information to support data interpretation, and eventually guaranteed the correct assessment of contaminant sources in the studied area. In addition, such activity, if adequately transferred to regulators, will ensure the effective adoption of management practices based on the research outcomes and tailored on the real needs of the local population, proving the added value to include it in any integrated investigation.

Intraperitoneal rupture of hydatid cysts.

PURPOSE: Hydatid cyst rupture into abdominal cavity is a rare but a serious complication. The rupture can occur after a trauma, or spontaneously as a result of increased intracystic pressure. It is a surgical emergency with high morbidity and mortality rates. Early diagnosis and appropriate surgical management of this complication can be life saving. The objective of the current paper is to evaluate the clinical, and radiographic findings and surgical treatment of this complication. METHODS: A retrospective study on 12 patients operated in our department for intraperitoneal rupture of hydatid cyst between January 1990 and May 2015. We reviewed age, gender, imaging findings, surgical treatment procedures, mortality, morbidity and recurrence. RESULTS: Our study includes 12 cases of intraperitoneal rupture of hydatid cysts; eight of the patients were men, and four were women. Four patients had a history of abdominal trauma and the other ruptures occurred spontaneously. All the patients had peritoneal irritation signs at presentation. All them underwent ultrasonography and CT scan. Imaging showed intraabdominal free fluid in all of cases. In 11 cases the cyst was unique and only in one case an associated mesenteric hydatid cyst was noted. Ruptured cysts were located in the right lobe of the liver in nine cases, in the left lobe in the other three cases. All the patients underwent emergency surgery after imaging. The procedure applied was conservative associated with drainage in all the cases. Some associated procedures were performed during the same operation. In only one case total pericystectomy for intraperitoneal cyst was performed. There were no post operative deaths. A total of five morbidities developed in three patients (one case of evisceration, three cases of biliary fistula and a case of pulmonary infection). CONCLUSIONS: Hydatid cyst rupture in peritoneal cavity is a rare complication. Imaging assessment has an important role in diagnosis but clinical signs are mandatory. A quick diagnosis and emergency surgery can decrease postoperative death. Surgery and postoperative care constitute the basis of treatment.

Investigation of uranium geochemistry along groundwater flow path in the Continental Intercalaire aquifer (Southern Tunisia).

Environmental tracers ((2)H, (18)O, isotopes of Uranium) and geochemical processes occurring within groundwaters from the Continental Intercalaire (CI) in Southern Tunisia were used to understand the hydrodynamics and the recharge conditions of this aquifer. This study investigates the chemical and isotopic compositions of the CI groundwater. The water types are dominated by Na(+), SO4(2-), Cl(-) throughout most of the basin with a general increase in total dissolved solids from the Saharan Platform margins towards the Chotts region. Large scale groundwater flow paths are toward the Chotts region. The stable isotopes composition of the analyzed groundwater ranges from -8.8 to -6‰ vs V-SMOW for δ(18)O and from -67 to -40‰ vs V-SMOW for δ(2)H. The relatively enriched stable isotopes contents suggest the contribution of the Dahar sandstones outcrops in the current recharge of the CI aquifer in an arid context. However, the most depleted values in heavy isotopes indicate a paleorecharge of the aquifer under wetter conditions revealing a long residence time of groundwaters. The results from water samples using alpha spectrometry method indicate a range in (238)U concentrations and (234)U/(238)U activity ratios (AR) of 0.044-1.285 µg kg(-1) and 1.2 to 8.84 respectively. The geochemistry of uranium isotopes in groundwater is controlled by many factors, essentially, the influence of water rock interactions, the preferential dissolution of (234)U relative to (238)U due to alpha recoil and the mixing processes between different waters with distinct AR as well as (238)U concentrations.

Associated primary esophageal and lung carcinoma: a study of 39 patients.

From 1979 to 1992, of 1,294 patients with esophageal squamous cell carcinoma, 39 patients (3.2%) (38 male patients, 1 female patient; mean age, 58 years) had associated primary lung carcinoma. Criteria for the diagnosis of primary lung carcinoma were: (1) non-squamous cell carcinoma tumors, (2) tumors existing before the esophageal squamous cell carcinoma, and (3) solitary squamous cell carcinoma presenting with endobronchial involvement. The two tumors were observed synchronously in 22 patients (56%) and metachronously in 17, with a mean tumor-free interval of 46 months (range, 18 to 77 months). In patients with synchronous disease, 10 underwent nonoperative treatment or a palliative surgical procedure, and 12 (55%) underwent a curative operation. In patients with metachronous disease, a curative operation was performed in all for the first tumor and in 9 (53%) for the second tumor. The overall postoperative mortality rate was 15%. Two patients (10%) died after the curative operation. None of the patients died who underwent curative esophagectomy combined with lobectomy. For the patients with synchronous disease, the 5-year survival rate was 11% in those who underwent a curative operation, and the longest survival in those who received palliative treatment was 18 months. For the patients with metachronous disease, the 5-year survival rates from the date of the diagnosis of the second tumor were 17% for those who had a curative operation and 11% for those who received palliative treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Long-term outcome of surgically treated peptic ulcer. Review of a series of 419 patients operated for peptic ulcer]. / Le devenir lointain de l'ulcère gastro-duodénal opéré. Réflexions sur une série de 419 ulcéreux opérés.

The authors report an analysis of 419 cases of operated peptic ulcer. 68.78% of patients had a mean follow-up of 4 years. After clinical and endoscopic examination, the results of the survey were assessed on the basis of various parameters, which demonstrated that the results of surgery were related to socio-occupational problems, smoking, the site of the ulcer, the stage, the history of the ulcer prior to the operation, the conditions of the operation and obviously the surgical technique used.

[Hydatic cyst of the psoas muscle. Apropos of 3 cases]. / Le kyste hydatique du muscle psoas. A propos de trois cas.

In the three patients, the localization and the hydatic origin have been determined by preoperative ultrasonography in two instances, the diagnosis was confirmed by CT scan. Ultrasonography and computed tomography allowed a direct and simple surgical approach of the cyst.

[Abdominal cystic lymphangioma in children]. / Le lymphangiome kystique abdominal de l'enfant.

Cystic lymphangioma is a rare tumour (6% of benign tumours in children), frequently situated in the cervical or axillary region and exceptionally intraabdominal. It arises due to a congenital defect in the connection of the primary lymphatic channels with the central collecting system. It presents clinically either in the form of a pseudo-appendix or pseudo-ascites syndrome or in the form of an abdominal tumour with or without compression of adjacent structures. It can now be easily diagnosed by ultrasonography. Treatment is well defined and consists of surgical resection of the isolated lymphangioma or associated with the adjacent intestine, depending on the site of the tumour. It has a good prognosis.

[Pterygium: surgical treatment]. / Ptérygion: traitement chirurgical.

PURPOSE: The surgical management of pterygium is often complicated by recurrence of disease. The goal of this study was to compare three different surgical techniques used for the treatment of pterygium. METHOD: We propose a prospective and partly retrospective study on 167 cases of pterygium 151 were primary and 16 were recurrent, treated between 1 January, 1995 and 30 June, 1998. The surgical treatment used of 3 different techniques: pterygium excision for 111 eyes, pterygium excision with conjunctival autograft for 29 eyes, pterygium excision with application of mitomycin C for 27 eyes. RESULTS: Immediate results for the three kinds of treatment were good. No serious complications were noted. Long-term results show a recurrence rate of 10.3% for conjunctival autograft, 11.1% for mitomycin C application, while the pterygium excision alone had a recurrence rate of 55.9%. CONCLUSION: This study demonstrated that conjunctival autografting and the application of mitomycin C are safe surgical techniques that reduce the probability of recurrence after surgery for pterygium. They can be recommended for young people and patients exposed to sun. Mitomycin therapy is the most appropriate treatment for these cases, because of its simplicity, lower lost and the relative lack of complication.

[Abdominal actinomycosis. Three cases]. / L'actinomycose abdominale. 3 observations.

BACKGROUND: Abdominal actinomycosis is a suppurating affection caused by a positive Gram germ, Actinomyces israelii. Manifestations of this rare disease are usually pseudotumoral syndromes leading to surgical exeresis. The diagnosis is obtained from the histologic report. CASES REPORT: We report three cases in all of which this disease presents with tumoral symptoms. The first affected the sigmoïd, the second affected the mesentery and the last affected the greater omentum and abdominal wall. In no case, the diagnosis was done before surgery. In 2 of the cases reported here, the patients had an old, incontrolled intra-uterine device. DISCUSSION: From a review of the literature, we observed that the diagnosis of abdominal actinomycosis remains difficult. The radiologic findings are nonspecific. Actinomycosis is treated with prolonged antibiotics, and surgery is only needed in abdominal abscess and fistula. CONCLUSION: Theses observations illustrates the difficulties of the diagnosis of this rare unrecognized disease.

[Hydatid cyst of the thigh: three cases]. / Kyste hydatique musculaire de la cuisse.

Three patients presented a benign soft tissue mass in the thigh muscles. Ultrasonography provided the diagnosis of hydatid cyst. Total pericystecomy was performed in all cases with no recurrence at 8 months, 3 years and 4 years. We point out the importance of preoperative diagnosis and the need for radical excision to avoid recurrence.

[Value of posterior vertical lumbar incision in renal surgery. Based on a series of 1,126 cases]. / L'intérêt de la lombotomie verticale postérieure dans la chirurgie du rein. A propos d'une série de 1,126 cas.

The authors report their experience of 1,126 cases of posterior vertical lumbar incision. The essential indication for this approach is stones in the renal pelvis or lumbar ureter (788 cases). The authors subsequently extended the indications for this incision to all plastic operations on the pyeloureteric junction (56 cases) and the extraction of certain staghorn calculi (114 cases). The posterior approach is anatomically simple and direct. It has the advantage of causing less muscular mutilation with a simpler postoperative course.

Uranium isotopes in groundwater from the continental intercalaire aquifer in Algerian Tunisian Sahara (Northern Africa).

The disequilibrium between (234)U and (238)U is commonly used as a tracer of groundwater flow. This paper aims to identify uranium contents and uranium isotopic disequilibria variation in groundwater sampled from deep Continental Intercalaire aquifer (southern Algeria and Tunisia). Large variations in both U contents (0.006-3.39ppb) and (234)U/(238)U activity ratios (0.4-15.38) are observed. We conduct a first assessment in order to verify whether the results of our investigation support and complete previous hydrogeological and isotopic studies. The dissolved U content and (234)U/(238)U activity ratio data were plotted on a two-dimensional diagram that was successfully utilized on sharing the CI aquifer into different compartments submitted to different oxidising/reducing conditions and leads also to distinguished two preferential flow paths in the Nefzaoua/Chott Fejej discharge area. Uranium isotopes disequilibrium indicate that ranium chemistry is mainly controlled by water-rock interaction enhanced by long residence time recognised for this aquifer.

[A case of esophageal duplication discovered in a newborn]. / A propos d'un cas de duplication oesophagienne de révélation néonatale.

A case of esophageal duplication discovered in the neonatal period is reported and discussed. This infrequent malformation (9% of all childhood mediastinal tumors) is an entoblastic duplication of the digestive tract and is often accompanied with spinal malformations. The duplication may be either cystic or tubular; the latter form usually opens into the normal esophagus. The most common clinical manifestations are respiratory symptoms caused by compression. The diagnosis, suggested by the findings on the plain chest film and osephageal opacification, is confirmed by the ultrasound examination and, above all, the CT scan. The treatment of this malformation is surgical. Reconstruction may be difficult but overall results and prognosis are excellent.

[Posterior vertical lumbotomy in pediatric practice. Apropos of a series of 294 cases]. / La lombotomie verticale postérieure en pratique pédiatrique. A propos d'une série de 294 cas.

The study involves 294 cases. Essentials indications of posterior approach were for pelvic stones or lumbar ureteral stones 198 cases. Theres used this approach for abnormalities in the uretero-pelvic-jun (32 cases) and some staghorn srones (24 cases). The lateral posterior vertical lumbotomy passesses the advantage over classical lateral lumbotomy of being less disturbing to muscle, being less painful postoperatively stay.