Tracheal stenosis after intubation and/or tracheostomy

The tracheal iatrogenic stenosis remains a frequent, sometimes severe tracheal resection, anastomosis is the treatment of choice. However, the endoscopic treatment is used as an alternative therapy. We report a retrospective study for a period of 8 years. 174 patients had an iatrogenic tracheal stenosis of intubation [55.17%] and/or tracheotomy [44.82%]. The appearance and extent of stenosis were assessed by bronchoscopy, we noted a tracheal mala-cia [15%], a circumferential stenosis [58%], a little tight stenosis [12%] and diaphragm [5%]. Some patients have benefited from several therapeutic procedures, 90 patients were operated on early interventions with 53 and 37 after surgery, an improvement of the patient's clinical status have been postponed earlier, after failure of endoscopic methods. 293 interventional bronchoscopies were performed, 192 stenting, 45 Nd-YAG laser, 55 patients required a recalibration in the tube of the bronchoscope and one patient received cryotherapy, knowing that there are the patients who received combination therapy. We lamented death in the immediate postoperative sepsis, a recurrence of stenosis in 117 patients, and among the 192 implants placed we identified 37 migrations, 52 congestion, development of granulomatous lesions, an overhaul of the prosthesis is noted in 7.29%, three implants were embedded in the tracheal mucosa and there was only one spontaneous rejection. The long-term evolution was satisfactory in 92 patients. Nevertheless, the management of post intubation tracheal stenosis and/or post tracheostomy cannot be that requiring a multidisciplinary collaboration

Heavy metal distribution in soil and plant in municipal solid waste compost amended plots

A field study was carried out to evaluate long-term heavy metal accumulation in the top 20 cm of a Tunisian clayey loam soil amended for four consecutive years with municipal solid waste compost at three levels [0, 40 and 80 t/ha/y]. Heavy metals uptake and translocation within wheat plants grown on these soils were also investigated. Compared to untreated soils, compost-amended soils showed significant increases in the content of all measured metals: cadmium, chromium, copper, nickel, lead and zinc in the last three years, especially for plots amended with municipal solid waste compost at 80 t/ha/y. Wheat plants grown on compost-amended soils showed a general increase in metal uptake and translocation, especially for chromium and nickel. This heavy metal uptake was about three folds greater in plots amended at 80 t/ha/y as compared to plots amended at 40 t/ha/y. At the end of the experimental period, the diluting effect resulting from enhanced growth rates of wheat plants due to successive compost applications resulted in lower concentrations in the plants [grain part] grown on treated plots. On the other hand, chromium and nickel were less mobile in the aerial part of wheat plants and were accumulated essentially in root tissues. Plant/soil transfer coefficients for compost-amended treatments were higher than threshold range reported in the literature, indicating that there was an important load/transfer of metal ions from soils to wheat plants

[Malignant nerve tumors about 8 cases]

Malignant nerve tumors, currently called malignant peripheral nerve sheath tumors, are uncommun, and represent less than 10 percent of adult soft tissues sarcomas. The authors report in this article a series of 8 cases of malignant nerve tumors and propose an epidemiologic, diagnostic, therapeutic study and the outcome of these tumors

[ chinese flap about 26 cases]

The chinese flap, alsow called antebrachial radial flap is a fascio-cutaneous flap based on the radial artery. Since the description, it opened indisputably a new chapter in plastic surgery. Through a series of 26 cases realized in our service of which 24 pediculed and 2 free flaps, we ware able to confirm it's reliability, and we studied its advantages and the inconveniences. It's a quite simple flap who can gives a good quality of skin supple and thick. The principal inconvenient is that it scarify a main artery of the hand, that is why, we have to think about it before potting its indication, although we had no complication inherent to this taking. The zone donor always keeps an unaesthetic scar at the level of the fore arm; and consequently the indication at the woman most be studied well I Finally to hairy subjects this flap must be avoided in certain locations such as the palm of th hand and the face