儿童肾细胞癌不典型的影像学表现

肾细胞癌罕见于儿童,通常在儿童晚期被发现。本文报道1例10岁女孩的特殊肾细胞癌。其影像学表现容易导致误诊,但在既往文献中未见报道。因先天性巨输尿管而导致肾皮质变薄,因此当原发性泌尿道上皮疾病(肿瘤或炎性)首次被发现时,肿瘤完全长入排泄腔(临近的输尿管)。萎缩的肾皮质     

Left ventricular aneurysm complicated by congestive heart failure: an analysis of long-term results and risk factors of surgical treatment

The results of surgical treatment of post-infarction left ventricular aneurysms in 49 patients with congestive heart failure preoperatively were analyzed. Average patient age was 55 years. Preoperative total ejection fraction averaged 30.5 +/- 1.5% (mean +/- SEM), contractile segment ejection fraction was 42.5 +/- 1.1% and end-diastolic volume of aneurysm was 81.4 +/- 10.4 ml. Seventy eight percent of patients underwent coronary artery bypass grafting concomitantly with aneurysmectomy. Mean follow-up after operation was 41.5 +/- 3.5 months. Hospital mortality was 8.2%, the 5 year survival rate was 70 +/- 7% and the 5 year complication free rate was 52 +/- 8%. Mean functional class of dyspnea improved significantly from 2.9 +/- 0.1 preoperatively to 1.6 +/- 0.1 at late follow-up (p less than 0.001). Likewise, isotopic ejection fraction at rest increased from 13.7 +/- 1.3% preoperatively to 30.9 +/- 3.0% postoperatively (p less than 0.0001). Logistic regression analysis isolated two factors which influenced postoperative survival independently: contractile segment ejection fraction (p = 0.045) and myocardial score of left anterior descending coronary artery (p = 0.035). Combining these two risk factors, it was possible to identify a low risk group of patients with a 5 year survival probability of 93 +/- 6%, contrasting with a high risk group of patients having a 5 year survival of 57 +/- 9% (p less than 0.02). Thus, resection of left ventricular aneurysms complicated by congestive heart failure provides improvement in left ventricular function and clinical status.(ABSTRACT TRUNCATED AT 250 WORDS)     

Presence of parasitic protozoa and helminth in sewage and efficiency of sewage treatment in Tunisia

Helminth eggs and protozoan cysts were enumerated in raw and treated wastewater in Tunisia in order to determine their removal by wastewater treatment and to provide quantitative data for developing regulations for wastewater quality that are currently lacking. Raw and treated wastewater samples were collected from 17 plants in Tunisia during 2006–2007 and analyzed for parasites using the modified Bailenger method. Two groups of parasites, namely, Ascaris sp., Entamoeba coli, Enterobius vermicularis, and Taenia sp. (group 1) and Entamoeba histolytica/dispar, Giardia sp., and Taenia sp. (group 2) could statistically be distinguished according to their removal by wastewater treatment. Group 1 parasites were removed by 1.1 log₁₀ (92.4%) and group 2 parasites by 0.61 log₁₀ (76%). The ubiquitous presence of parasitic protozoa in Tunisian wastewater and ineffective wastewater treatment lead to their proliferation in surface waters with a high probability of exposure of human and animals to these parasites and consequent adverse health effects, as is apparent from epidemiologic data as well. This study provides a quantitative basis for risk assessment studies and development of mitigation strategies, such as improving wastewater treatment efficiency.