Endovascular treatment of haemoptysis: medium and long-term assessment.

PURPOSE: To assess the short, medium and long-term results of bronchial artery embolisation (BAE) and identify the factors favouring the recurrence of haemoptysis. PATIENTS AND METHODS: This is a retrospective study, between January 2001 and June 2010, comprising 53 consecutive patients with BAE. The mean age was 53.8 years. There were 15 women (28.30%) and 38 men (71.69%). RESULTS: The aetiologies of haemoptysis were dominated by the residual signs of pulmonary tuberculosis: 18 cases (33.96%), bronchial dilations: 12 cases (22.64%) and aspergilloma: five cases (9.43%). The bronchial arteriography showed signs of bronchial hypervascularisation in 92.45% of the cases. Forty-six patients had a first embolisation (86.79%) with immediate efficacy in 84.90% of the cases (n=45). This efficacy was noted after more than 3 years in 60.08% of the cases. Short (< 30 days) and medium-term (> 30 days and < 3 years) recurrence of haemoptysis were noted in 17.39% and 8.69% of the cases respectively. A statistically significant correlation between aspergilloma and the immediate recurrence was found (P=0.013). The risk of medium and long-term recurrence (> 3 years) was correlated with age. The survival without recurrence was statistically higher when the age was less than 60 years (P=0.0041). CONCLUSION: BAE is an effective treatment. Aspergilloma is a major risk factor in the recurrence of haemoptysis. Repeated embolisation may be proposed for these patients.

Anaerobic biodegradation of 2,4,6-trichlorophenol in expanded granular sludge bed and fluidized bed biofilm reactors bioaugmented with Desulfitobacterium spp.

The biodegradation of 2,4,6-trichlorophenol (246TCP) was studied using expanded granular sludge bed (EGSB) reactors and a fluidized bed biofilm reactor (FBBR) filled with activated carbon. One of the EGSB reactor and the FBBR were bioaugmented with Desulfitobacterium strains. 246TCP loading rate was gradually incremented from 10 to 250 mg L(-1) day(-1). The main pathway of dechlorination was in ortho-position, generating 4-chlorophenol and 2,4-dichlorophenol. The maintenance of both COD degradation efficiency (higher than 80%) and methanogenic efficiency (between 0.3 and 0.6 g CH4-COD g(-1) COD consumed) in EGSB reactor implies a great stability of the process. Through isotherm studies in FBBR, it could be deduced that around 52% of 246TCP was completely dechlorinated, whereas the adsorption involved around 16%. By means of FISH studies it was proved that the methanogenic Archaea community was maintained in the bioaugmented EGSB reactor, whereas in the FBBR this community was gradually developed until reaching stability. Desulfitobacterium community was also maintained in the reactors, although D. chlororespirans proportion rise in the FBBR at the higher 246TCP loading rates, implying that this species can withstand the 246TCP toxicity better than D. hafniense.

[Cardiac metastasis of renal cell carcinoma, a rare location]. / Métastase cardiaque du cancer du rein : site inhabituel.

The renal carcinoma is situated in the third rank of the urologic cancers. It is metastatic in a third of the cases, when we made the diagnosis of the cancer. Lungs, bone, the liver, the suprarenal gland and the brain stay metastatic sites of preference. Some metastatic locations are anecdotal and made the object of some publications. We report the case of a cardiac metastasis of renal carcinoma at an old patient 81 years old operated for cardiac tumor.

[Nasopharyngeal angiofibroma: report of 15 cases treated by embolization]. / Le fibrome nasopharyngien: à propos de 15 cas traités par embolisation.

PURPOSE: To report a series of 15 new cases of nasopharyngeal angiofibroma treated with presurgical embolization along with a review of the literature. MATERIALS AND METHOD: Retrospective review of 15 cases of nasopharyngeal angiofibroma treated with presurgical embolization. The clinical, CT and MR features as well as postsurgical follow-up are reviewed. RESULTS: Presurgical embolization reduced surgical difficulties, especially hemorrhage, allowing complete tumor resection in most cases. Two cases of recurrent disease and 1 case of residual tumor were noted and treated by repeat embolization. CONCLUSION: Presurgical embolization reduces intraoperative hemorrhage and allows complete resection of these highly vascularized tumors.

[Traumatic lumbosacral fracture dislocation: a case report and review of the literature]. / Fracture luxation lombosacrée: à propos d'un cas et revue de la littérature.

Lumbosacral dislocation is uncommon. We report a case of traumatic lumbosacral dislocation which occurred in a 33-year-old pedestrian traffic accident victim. The posterior impact produced lumbar injury with diffuse pain exacerbated at the lumbosacral junction. Ecchymotic diffusion involving the entire lumbar region fluctuated due to the presence of a subcutaneous hematoma. The neurological examination revealed incomplete L5 paraplegia. Standard x-rays revealed L5-S1 spondylolisthesis and fracture of the L5 spinous process as well as fractures of the L3, L4, and L5 transverse processes. Computed tomography disclosed biarticular L5-S1 fracture dislocation and a voluminous herniation of the L5-S1 disc. Emergency surgery was performed and revealed subaponeurotic detachment from T4 to S1 and bald iliac pyramids. After L5 laminectomy and extraction of the voluminous herniation of the L5-S1 disc, a short L5-S1 posteriolateral fusion was achieved using pedicular screws and two rods on either side as well as a posterolateral iliac autograft. The clinical course was satisfactory with nearly complete neurological recovery (persistent levator ani paresis). This clinical case and a review of the literature illustrate the pathogenic, clinical, radiological and therapeutic aspects of lumbosacral fracture dislocation.

[MRI findings in neuro-Behcet's disease]. / Aspect en IRM du neuro-Behcet.

PURPOSE: Describe the patterns and location of lesions seen on MR imaging in neuro-Behçet's disease. OBSERVATIONS: 33 patients with neuro-Behçet's disease (mean age: 27 years) imaged by MRI were reviewed. Most common neurologic symptoms included headaches and pyramidal signs. MRI examinations (Siemens Magnetom Impact 1 Tesla) included the following sequences: T1wi, T2wi, Flair, MPR-3D and MRA sequences. RESULTS: Parenchymal lesions were identified in 21 patients. Brainstem, internal capsule, cerebral white matter, basal ganglia were involved respectively in 14, 10, 7, and 5 cases. Vascular thrombosis (venous: n=7; arterial: n=1) were observed in eight. MRI was normal in four patients. CONCLUSION: This study shows the value of MR imaging for the exploration of parenchymal lesions of neuro-Behçet's and confirms the frequency of brainstem involvement.

[Osteoid osteoma of the coccyx: a case report]. / Ostéome ostéoïde du coccyx: à propos d'un cas.

The spine is a rare localization of osteoid osteoma and the coccyx even more exceptional. We report a case of osteoid osteoma of the coccyx in a young man who consulted for sacrococcygeal pain partially relieved with salicylates. Computed tomography of the region demonstrated a typical osteoid osteoma lesion. CT-guided localization enabled complete resection of the nidus as demonstrated by the CT of the operative specimen Pathology confirmed the diagnosis of osteoid osteoma. Outcome has been quite favorable at two years.

[Malignant pheochromocytomas: about three cases]. / Les phéochromocytomes malins: à propos de trois observations.

The authors report three cases of malignant pheochromocytomas. Metastases occurred in the liver in two cases whereas malignancy was suspected in the third case because of recurrence and local invasion. One case was pregnant at diagnosis of pheochromocytoma. Pheochromocytoma was associated to papillary thyroïd carcinoma in another case. The treatment considered was surgery in all cases.

[Transverse fracture of the sacrum: value of imaging. A case report]. / Fracture transversale du sacrum: place de l'imagerie. A propos d'un cas.

Transverse fractures of the sacrum with major displacement are rare and often misdiagnosed. A case of transverse fracture of the sacrum with cauda equina injury is reported. The diagnosis was not recognized initially. Conventional radiographs of the pelvis failed to demonstrate the fracture. True lateral sacral views and CT scan with reconstructions allowed analysis of the different sagittal fracture lines to facilitate surgical planning. These examinations should be considered in all patients with history of high energy trauma and clinical signs indicating lumbosacral injury.

[Imaging of rhinocerebral mucormycosis]. / L'imagerie dans la mucormycose rhinocérébrale.

PURPOSE: Rhinocerebal mucormycosis is a rare life threatening fungal infection observed in immunocompromised patients. We report six cases of patients with rhinocerebral mucormycosis confirmed histologically. Our study confirms the necessity of early diagnosis when clinical and CT findings are suggestive. MATERIALS AND METHODS: This is a retrospective study including 6 diabetic patients (3 women and 3 men) aged from 28 and 63 years. Five patients had ethmoiditis evolving for a few days (3 to 5 days), and one patient was in an ketoacidotic coma and had a severe infectious syndrome with purulent rhinorrhea evolving for 4 days. All of our patients underwent computed tomography (CT) scan of the paranasal sinuses. MRI was performed in two patients with neurological findings. RESULTS: Unilateral ethmoido-maxillary sinusitis was noted in 5 cases. Only one case of pansinusitis was found. All patients presented orbital involvement. Cerebral involvement was noted in 4 cases (cerebral venous thrombosis: 2 cases; abscess: 2 cases; cerebral ischemia: 2 cases). The diagnosis of mucormycosis was based on endonasal biopsy. When available, MRI allowed a more precise evaluation of the orbital and cerebral extension. CONCLUSION: Mucormycosis is an opportunist mycosis due to mucoralis fungus. It is very invasive with a highly aggressive potential in diabetic or immunocompromised patients. Imaging study particularly CT scan, plays an important role in diagnosis especially to evaluate cerebral extension.

[Percutaneous treatment of a gas containing epidural pseudocyst: an uncommon cause of sciatica]. / Traitement percutané d'un pseudo-kyste gazeux épidural: cause rare de sciatique.

Gas containing epidural pseudocyst is a rare cause of lumbar radicular compression. We present the case of a 42 year old woman presenting with right L5 radicular pain. CT showed vacuum phenomenon and a gas containing epidural pseudocyst compressing the right L5 root. Resolution of radicular pain occurred following CT guided aspiration and steroid injection. The patient remained asymptomatic at one year follow-up.

[Ectopic thyroid: two cases]. / L'ectopie thyroïdienne: à propos de deux cas.

Ectopic thyroid is a rare condition (1/4000 to 1/8000 among patients with hypothyroidism). The underlying etiological pathogenic mechanisms remain unknown. Diagnosis is established on the basis of imaging findings. We report two cases of hypothyroidism in adult females who had ectopic sublingual thyroid glands. The first patient was a 20-Year-old woman who had been treated for hypothyroidism since the age of 13 Years before the diagnosis of ectopic thyroid 7 Years later. In both patients, the thyroid gland was palpable. In the first patient the physical examination revealed an ectopic sublingual gland. Scintigraphy confirmed the diagnosis in both patients. The CT-scan and MRI were positive in the second patient. Hormonal substitution therapy using L-thyroixine was given.

[Septic arthritis of posterior lumbar facet joint]. / Arthrite septique interapophysaire postérieure lombaire.

Septic arthritis of the posterior lumbar joints is extremely rare. The clinical picture of this unusual site of infection can easily lead to confusion with spondylodiscitis which is more common. We report a case of a 50-year-old woman with Staphylococcus aureus septic arthritis of the left L5-S1 lumbar facet joint. CT scan was helpful to establish the diagnosis and to guide the percutaneous needle biopsy.

[Nutritional condition, food consumption and nutritional intake in students in Saudi Arabia. II. Food consumption and nutritional intake]. / Ernährungsstatus, Nahrungsverbrauch und Nährstoffzufuhr von Schülern in Saudi-Arabien II. Nahrungsverbrauch und Nährstoffzufuhr.

In field surveys in 13 schools in different regions of Saudi-Arabia, energy expenditure, food consumption, and nutrient intake were studied. Cereal products, especially bread, have the greatest significance in nutrition. Many students do not eat other foodstuffs regularly. A certain dependency of food consumption from the region was found in regard to the schools. The frequency of foodstuffs was generally low, but lowest in remote villages. In some age groups, the sufficient energy intake leaves much to be desired, 70 % do not reach recommended dietary allowances of animal protein and 100 % in fat. Intake of carbohydrates was too high, while intake of linoleic acid, minerals and vitamins is too low of nearly all test persons. To secure regularly a sufficient intake of essential nutrients, a school lunch program for the Saudi-Arabian boys is to be recommended.

[Nutritional status, food consumption and food supply of studies in Saudi Aribia. I. Anthropometric data]. / Ernährungsstatus, Nahrungsverbrauch und Nährstoffzufuhr von Schülern in Saudi-Arabien. I. Anthropometrische Daten

A field study about the nutritional status was made in school classes with boys 6 to 19 years old in different regions of Saudi-Arabia. It is reported about 341 pupils in regard to weight, height, skinfold-thickness, circumferences and other body-size measurements. In comparison with anthropometric measurements of comparable surveys in other countries, the Saudi-Arabian school boys were found to be smaller and leaner than boys from the USA, Europe, other Arabian countries and well-to-do Indian boys.