Removal of lead and cadmium ions from aqueous solutions using dried marine green macroalga [caulerpa racemosa]

In this study Caulerpa racemosa has been characterized and used for the removal of Cd[II] and Pb [II] from aqueous solutions. The effect of pH, adsorbent dosage, contact time and temperature on adsorption process was studied in batch experiments. Langmuir and Freundlich models were applied to describe the biosorption isotherm of the metal ions by C. racemosa biomass. The adsorption data can be well described by Langmuir isotherm. The monolayer biosorption capacity of C. racemosa biomass for Pb[II] and Cd[II] ions was found to be 34.5 mg/g and 29mg/g, respectively. Kinetics data of both metal ions were best described by pseudo second order model. The thermodynamic studies indicated that the adsorption was spontaneous and exothermic in nature. The analysis with FTIR indicated that possible functional groups involved in metal sorption by this alga were O-H bending, N-H stretching, C-N stretching, C-O and S=O stretching

Intracranial abscess and empyema from ENT origin

Intracranial abscess and empyemas from ENT infection are rare. The aim of our study was to recall the treatment and therapeutic results. It was a retrospective study from 1995 to 2006 concerning. 23 patients who had brain abscesses secondary to an ENT infection. The infections origin was otological in 56% of cases, sinusal in 44%. Bacterias were identified in 40% of cases. All patients benefited a medical treatment to basis of at least 2 antibiotics a long length going from 20 days to 3 less by intravenous way. Nine patients benefited neurosurgery with an ENT treatment surgical. Nine patients had alone neurosurgery and 5 cases had an ENT surgery alone. The treatment consists in excision or single punction of the abscess. 72% are alive and well. We have no dead. The classical intracranial hypertension associated to high fever is usually truncated. The diagnosis is more precocious thanks to the progress of the medical imagery. Multibacterial infections are frequent. Treatment is medical and surgical. Recovery requires a specific surgical treatment of the ENT infection in more than 60% of cases. An adapted treatment permits a recovery without after effects in at least the half of cases

[False positive vascular increased uptake during cervico-thoracic radioiodine scan]

The total body radioiodine 131 scan is an important tool for the postoperative management of thyroid carcinomas. However, it has multiple false positives. Congenital or acquired vascular abnormalities such as ectasis or aneurism can be responsible for an increased uptake during the whole body radioiodine I[131] scan because of stagnation of the iodine and because of its delayed elimination when these malformations are present. We report the case of such a false positive

[Laparoscopic management of perforated duodenal ulcers results of a retrospective study]

Perforation of peptic duodenal ulcer is a frequent surgical emergency. The aim of this retrospective study is to evaluate the faisabiity and the results of laparoscopic management of perforated duodenal ulcers. Eighty-four patients had laparoscopic surgery for perforated duodenal ulcer. The duration of the study was seven years [2001 to 2007]. There were 81 men and 3 women aged from 16 to 64 years [mean: 28 years]. The mean duration between the onset of perforation and the time of operation was 20 hours [range: 6-72 hours]. The surgical procedure was suture and irrigation of the abdominal cavity. Conversion into laparotomy was performed in 14.2%of the patients. Mean operative time was 95 minutes. There was no post operative death. The morbidity rate was 15.4%. There was two surgical complications [post operative peritonitis and duodenal fistula] and ii medical complications. Mean hospital stay was 6 days. All patients were discharged with antibiotics for Helicobacter pylon eradication. Laparoscopic repair of perforated duodenal ulcer is a safe option providing low rates of morbidity, reoperation and mortality, and can be considered as the treatment of choice

[Overlap syndrome autoimmune hepatitis=primary biliary cirrhosis. Comparative study with isolated autoimmune hepatitis results of a multicentric Tunisian]

Autoimmune hepatitis [AIR] and primary biliary cirrhosis [PBC] are two autoimmune diseases affecting the liver. Suggestive signs of the two diseases can however occur simultaneously or consecutively in the same patient leading to an overlap syndrome. The aim of our multicentric retrospective study was to study clinical, biological, immunological and histological features of 17 patients with overlap syndrome and to compare them with those of 62 patients with isolated autoimmune hepatitis. Overlap syndrome "AIH-PBC" accounts for 20,5%of patients with autoimmune hepatitis in our series. Our two groups were similar in age and gender. Clinically, in overlap syndrome group, a significantly higher prevalence of pruritus arid significantly lower prevalence of ascites were observed as compared to isolated AIH group. No significant differences were observed between the two groups of patients with regard to frequency of concurrent immune diseases. Biologically, serum alkaline phosphatase and garnma-glutamyl-transpeptidase were significantly higher in overlap syndrome than in patients with isolated AIH. Significantly more overlap syndrome patients were positive for anti-mitochondrial antibodies than isolated AIR patients. The patients with isolated AIR had a higher frequency of cirrhosis at presentation that the patients with overlap syndrome. The histologic profile was not different between isolated AIR and Overlap syndrome. Overlap syndrome "AIR-PBC" is not rare. Compared with isolated AIH, it is characterised by a higher frequency of clinical and biological signs of cholestasis, a higher frequency of antimitochondrial antibodies and the rarity of cirrhosis at the diagnosis of the disease

[Hypopharyngeal Zenker's diverticulum about four cases]

The hypopharyngeal Zenker's diverticulum is a rare pathology [1%of oesophagien pathology]. It is up to a hernia of the oesophagus posterior wall throught the fibres of the pharynx inferior constrictor muscle. Many pathogenic hypotheses are put forword; it is generally benign but can cause serious complications. The treatment can be difficult. The best treatment seems to be diverticulectomy with cricopharyngeal myotomy. Endoscopic treatment can be a good therapeutic alternative. We report four cases of patients with DPO three women and one man; the mean age of patients was 67 years. All our patients suffered from dysphagia and loss of weight. The diagnostic, clinically suspected was cofirmed by radiological examinations. All our patients were operated. Surgery was satisfactory for three patients. One patient died

Microsurgical direct transnasal approach to pituitary adenomas assisted by endoscope: description and advantages

The sub-labial transsphenoidal approach is frequently used in pituitary surgery. The direct transnasal transsphenoidal route is a minimally invasive technique. The main difficulty associated in this approach is its tendency to take an oblique trajectory, so it can benefit from the combination of use of the microscope and the endoscope. We have analysed the data of the first 10 patients operated on through the direct transnasal route for pituitary adenomas in our institution. The operating procedure was done in 2 steps: 1. Direct transnasal approach to the sphenoid sinus to reach the floor of the sella turcica with the endoscope for trajectory guidance 2. Effraction of the sella turcica floor, opening of the dura mater and adenoma excision under the operating microscope We have analysed the feasibility, endoscopic benefits and effectiveness of this procedure. Ten patients were operated having pituitary adenomas between March 2003 and September 2004. The endoscope is introduced through the right nostril to reach the sphenoid sinus. We did not resort to fluoroscopy. Adenoma exeresis was made under microscope and was complete in 8 cases. Complications such as transient CSF leakage and epistaxis were observed in one case. The initial use of the endoscope permits rapid and direct access to the sella turcica. Relay by the operating microscope allows ease of tumoural exeresis. Moreover, this approach avoids the traditional drawbacks of the sub-labial route

[Situation de la borreliose de Lyme au Maghreb]

Many epidemiological studies were conducted for studying Lyme borreliosis [LB] which represents a new global public health problem. It is now the most common vector-borne disease in Europe and North America. The causative agent Borrelia burgdorferi sl is a bacterial species complex comprising 12 delineated and named species. In North Africa, few studies based on clinical and serological features, have suggested that LB could occur. Indeed, recent studies conducted in Tunisia, Algeria and Morocco have shown that Ixodes ricinus is present in cooler and humid area of these regions. These studies also revealed that this species is a vector of B. burgdorferi sl with high prevalence of infection. Using IFI and PCR tests, the mean rate of Borrelia infection ranged from 50 to 60 % in I. ricinus adult collected in Tunisia and Morocco and from 30 to 40% in nymphs; in contrast, the prevalence in larvae is less than 2.5 %. Several strains of B. burgdorferi were isolated from adult and nymph I. ricinus collected in Tunisia and Morocco. The identification of these strains and DNAs directly extracted from Ixodes was done by PCRRFLP and sequence analysis. The results showed that B.lusitaniae [genotypes Poti B2 and Poti B3] is the predominant species circulating in I. ricinus in Tunisia and Morocco, B. garinii and B. burgdorferi ss and B lusitaniae were also present but very rare. These results provide the evidence for the existence of B. burgdorferi sl in North Africa; however, the impact of LB in the human population seem to be negligible and the seroprevalence of Borrelia in forest workers [considered as population at high risk] in Tunisia is less than 4%