Wastewater treatment plant effluents as source of cosmetic polyethylene microbeads to freshwater.

Microplastics in the environment are either a product of the fractionation of larger plastic items or a consequence of the release of microbeads, which are ingredients of cosmetics, through wastewater treatment plant (WWTP) effluents. The aim of this study was to estimate the amount of microbeads that may be released by the latter pathways to surface waters using Ljubljana, Slovenia as a case study. For this purpose, microbeads contained in cosmetics were in a first step characterized for their physical properties and particle size distribution. Subsequently, daily emission of microbeads from consumers to the sewerage system, their fate in biological WWTPs and finally their release into surface waters were estimated for Ljubljana. Most of the particles found in cosmetic products were <100 µm. After application, microbeads are released into sewerage system at an average rate of 15.2 mg per person per day. Experiments using a lab-scale sequencing batch biological WWTP confirmed that on average 52% of microbeads are captured in activated sludge. Particle size analyses of the influent and effluent confirmed that smaller particles (up to 60-70 µm) are captured within activated sludge while bigger particles were detected in the effluent. Applying these data to the situation in Ljubljana indicates that about 112,500,000 particles may daily be released into the receiving river, resulting in a microbeads concentration of 21 particles/m3. Since polyethylene particles cannot be degraded and thus likely accumulate, the data raise concerns about potential effects in aquatic ecosystems in future.

Evaluation of muscle atrophy after axillary lymph node dissection.

INTRODUCTION: Axillary node status is the most important prognostic factor for patients with primary breast carcinoma, making axillary lymph node dissection (ALND) a standard surgical treatment of breast cancer. Postoperative sequelae to ALND is frequently reported. In this study we aimed to find out objectively, how much damage is caused to these nerves during ALND. PATIENTS AND METHODS: A total of 50 breast cancer patients who underwent surgical treatment in our Breast and Endocrine Surgery Unit between March 1998 and July 2004 were included in the study. Surgical treatment of these patients consisted of breast conserving surgery or total mastectomy combined with ALND. To compare operated patients with non-operated patients as a control, only patients who had undergone unilateral surgery were included in the study so that the non-operated side served as the normal control for each patient. All patients had a postoperative review with an anatomical and functional examination at least 6 months after the operation. Computed tomography was then performed and the M. latissimus dorsi (MLD), M. pectoralis major (MPM) and M. serratus anterior (MSA) thicknesses were measured. RESULTS: On physical examination, the aforementioned muscles in all the patients were found to be intact and functional. Sixty-four percent of the operated patients group were found to have various degrees of hypoesthesia. MLD, MPM and MSA amongst the non-operated patients group were found to be significantly thicker than the corresponding muscles amongst operated patients group. CONCLUSION: We conclude that a significant amount of reduction in the thickness of the MLD, MPM and MSA occurs after ALND. Also, sensory deficit occurs, especially on the upper medial portion of the arm, showing damage to the intercostobrachial nerves.

Diffuse lipomatosis of thyroid gland.

A case of diffuse lipomatosis of the thyroid gland is presented. Previously documented cases of this rare disorder are reviewed. Diffuse lipomatosis of the thyroid, amyloid goiter with adipose tissue, and the relationship between lipomatosis and adenolipoma are discussed.

Surgical treatment of advanced alveolar hydatid disease of the liver: a report of five cases.

We report herein the cases of five patients with alveolar hydatid disease (AHD) of the liver who were diagnosed and underwent surgery at the Department of Surgery of Ankara University between 1989 and 1994. In all five patients, the final diagnosis was established by frozen section of the lesion during laparotomy. Lesions of AHD were found only in the liver. Hepatic resections including right lobectomy and segmentectomy were performed in three patients while palliative procedures were carried out in the remaining two patients with unresectable disease. There was no operative mortality, and only one late death occurred 3 years after the hepatic resection. In this paper, we present the clinical and operative findings of these five patients and their outcomes, followed by a review of the surgical treatment of AHD.

Total lower lip reconstruction in advanced squamous carcinoma: application of the gate-flap technique.

During the years 1986 to 1988, seven patients with advanced squamous cancer of the lower lip were operated on in our department and the defects were reconstructed by the gate-flap technique. We found that this method affords satisfactory total reconstruction of the lower lip. Better results may be obtained if more attention is given to details such as the thickness of the pedicles, the opening of Stensen's duct, and advancement of the mucosa to form the vermilion. Late distortion due to scar contracture can be corrected by defatting and W plasty.

Unilateral gate flap for reconstruction of the lower lip.

A unilateral gate-flap technique consisting of a nasolabial island flap is presented for the reconstruction of defects in the lower lip after excision of large, laterally located epidermoid tumors. The amount of healthy tissue resected is optimal. The reconstructed lower lip retains sensation and muscle function and is continent with a satisfying appearance. Temporary flap edema and a vermilion notch at the apex of the flap are both avoidable problems. This method may be used in selected patients with large advanced epidermoid cancers of the lower lip.