Apport de l’IRM et de la tomodensitométrie dans le diagnostic des affections de l’oreille chez les carnivores domestiques

Les données actuelles rapportent que les affections de l’oreille chez les carnivores domestiques sont communes et représentent 2% à 16.5% des pathologies rencontrées. Cependant on pense que ces affections sont sous-évaluées par manque d’outils diagnostics appropriés. L’oreille est l’organe vestibulo-cochléaire responsable à la fois de l’ouïe et de l’équilibre. Elle possède une structure extrêmement complexe, contenue en quasi totalité au sein de l’os temporal. Un examen complet et précis de cet organe nécessite l’utilisation d’outils d’imagerie de dernière génération que sont l’IRM et la tomodensitométrie. L’étude détaillée de l’anatomie de l’oreille est nécessaire à la compréhension et à l’interprétation des images obtenues avec les appareils d’IRM et de tomodensitométrie. C’est donc l’objet de la première partie de cette thèse. Les principes physiques ainsi que le fonctionnement de l’IRM et de la tomodensitométrie sont décrits en deuxième partie. Une étude détaillée de l’image normale de l’oreille des carnivores domestique y est inclue. Enfin les pathologies de l’oreille des carnivores domestiques, les plus communes et nécessitant l’utilisation de l’IRM et de la tomodensitométrie pour l’établissement de leur diagnostic, sont rapportées en troisième partie de cette thèse

Analog MIMO Radio-over-Copper: Prototype and Preliminary Experimental Results

Analog Multiple-Input Multiple-Output Radio-over-Copper (A-MIMO-RoC) is an effective all-analog FrontHaul (FH) architecture that exploits any pre-existing Local Area Network (LAN) cabling infrastructure of buildings to distribute Radio-Frequency (RF) signals indoors. A-MIMO-RoC, by leveraging a fully analog implementation, completely avoids any dedicated digital interface by using a transparent end-to-end system, with consequent latency, bandwidth and cost benefits. Usually, LAN cables are exploited mainly in the low-frequency spectrum portion, mostly due to the moderate cable attenuation and crosstalk among twisted-pairs. Unlike current systems based on LAN cables, the key feature of the proposed platform is to exploit more efficiently the huge bandwidth capability offered by LAN cables, that contain 4 twisted-pairs reaching up to 500 MHz bandwidth/pair when the length is below 100 m. Several works proposed numerical simulations that assert the feasibility of employing LAN cables for indoor FH applications up to several hundreds of MHz, but an A-MIMO-RoC experimental evaluation is still missing. Here, we present some preliminary results obtained with an A-MIMO-RoC prototype made by low-cost all-analog/all-passive devices along the signal path. This setup demonstrates experimentally the feasibility of the proposed analog relaying of MIMO RF signals over LAN cables up to 400 MHz, thus enabling an efficient exploitation of the LAN cables transport capabilities for 5G indoor applications.Comment: Part of this work has been accepted as a conference publication to ISWCS 201

experience of percutaneous access under ultrasound guidance in renal transplant patients with allograft lithiasis

Objective: Urolithiasis of the transplanted kidney has an incidence of 0.2 to 1.7%, it increases the risk of infection in immunosuppressed patients and it can lead to ureteral obstruction that is often associated with deterioration of renal function. Urolithiasis of the transplanted kidney has different characteristics compared to the native kidney, due to the absence of innervation, which does not lead to colic pain. Percutaneous approach is an optimal choice in transplant patients. Material and methods: Here we report our experience in two cadaveric transplant patients with urolithiasis. The first case was a patient of 68 years with a 20 mm stone located in the transplanted kidney pelvis and another smaller in a lower calyx. The second case was a patient of 65 years with a 15 mm stone in the distal part of the transplanted ureter. In both cases the patients were asymptomatic, but they had a reduction in urine output associated with worsening of the transplanted kidney function. The diagnosis was performed in both cases with ultrasound study, showing a severe hydronephrosis and it was confirmed by computed tomography scan. In both cases, we performed a Percutaneous Nephrolithotomy (PCNL). Access was made after targeting the stone, through a lower pole puncture under ultrasound guidance. The first case was treated with pneumatic and laser energy, breaking stones through a nephroscope. In the second case we performed a laser lithotripsy of the ureteral stone, using a flexible videoureteroscope. At the end of both procedures a Double-J stent and a 14 Fr Malecot nephrostomy were positioned, that were removed at 6 weeks and 10 days, respectively. Results: Both patients achieved a resolution of the worsening of renal function, recovering the spontaneous diuresis. The surgical procedure using ultrasound guidance was safe and allowed quick access to the renal pelvis. Both patients experienced no bleeding or infection during hospitalization. Conclusions: Percutaneous Nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for larger renal calculi in renal allografts. The ultrasound guided access to the transplanted kidney in percutaneous treatment of urolithiasis is useful and fast, minimizing patient exposure to ionizing radiation

A challenging surgical approach to locally advanced primary urethral carcinoma: A case report and literature review

Primary urethral carcinoma (PUC) is a rare and aggressive cancer, often underdetected and consequently unsatisfactorily treated. We report a case of advanced PUC, surgically treated with combined approaches. A 47-year-old man underwent transurethral resection of a urethral lesion with histological evidence of a poorly differentiated squamous cancer of the bulbomembranous urethra. Computed tomography (CT) and bone scans excluded metastatic spread of the disease but showed involvement of both corpora cavernosa (cT3N0M0). A radical surgical approach was advised, but the patient refused this and opted for chemotherapy. After 17 months the patient was referred to our department due to the evidence of a fistula in the scrotal area. CT scan showed bilateral metastatic disease in the inguinal, external iliac, and obturator lymph nodes as well as the involvement of both corpora cavernosa. Additionally, a fistula originating from the right corpus cavernosum extended to the scrotal skin. At this stage, the patient accepted the surgical treatment, consisting of different phases. Phase I: Radical extraperitoneal cystoprostatectomy with iliac-obturator lymph nodes dissection. Phase II: Creation of a urinary diversion through a Bricker ileal conduit. Phase III: Repositioning of the patient in lithotomic position for an overturned Y skin incision, total penectomy, fistula excision, and "en bloc" removal of surgical specimens including the bladder, through the perineal breach. Phase IV: Right inguinal lymphadenectomy. The procedure lasted 9-and-a-half hours, was complication-free, and intraoperative blood loss was 600 mL. The patient was discharged 8 days after surgery. Pathological examination documented a T4N2M0 tumor. The clinical situation was stable during the first 3 months postoperatively but then metastatic spread occurred, not responsive to adjuvant chemotherapy, which led to the patient's death 6 months after surgery. Patients with advanced stage tumors of the bulbomembranous urethra should be managed with radical surgery including the corporas up to the ischiatic tuberosity attachment, and membranous urethra in continuity with the prostate and bladder. Neo-adjuvant treatment may be advisable with the aim of improving the poor prognosis, even if the efficacy is not certain while it can delay the radical treatment of the disease

Le garanzie delle obbligazioni. Lezioni di diritto romano.

Mode of access: Internet

Pseudobulbar Affect: Burden of Illness in the USA

Pseudobulbar affect (PBA) is characterized by involuntary and uncontrollable laughing and/or crying episodes, occurring secondary to neurological disease or injury. The impact of PBA on social and occupational function, health status, quality of life (QOL), and quality of relationships (QOR) is not well studied.This US survey conducted by Harris Interactive compared health status and daily function of patients with and without PBA. Eligible respondents were Harris Panel Online registrants previously diagnosed with stroke, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, traumatic brain injury, or amyotrophic lateral sclerosis, or primary, nonpaid caregivers for such patients who were too debilitated to participate. PBA was identified by a Center for Neurologic Study lability scale score of 13 or greater. Measures included the 36-item short form health survey (SF-36), the work productivity and impairment (WPAI) questionnaire, visual analog scales (VAS) for impact of PBA symptoms on QOL and QOR, and customized questions related to burden and impact of involuntary laughing/crying episodes on patients’ lives. Survey responses were weighted to adjust for the relative proportion of the primary neurological conditions in the overall population and between group differences in patient age and gender. PBA and non-PBA group responses were compared using two-tailed t tests adjusted for severity of the primary neurological conditions.The 1,052 respondents included 399 PBA group participants and 653 controls. The PBA group showed significantly worse scores versus non-PBA controls on component and summary SF-36 scores (P < 0.05 for all), VAS scores (P < 0.05 for both), and WPAI scores (P < 0.05). Among PBA group respondents, PBA contributed a great deal to or was the main cause of patients becoming housebound for 24% and being moved to supervised living placement for 9% of respondents.PBA is associated with considerable burden incremental to that of the underlying neurological conditions, affecting QOL, QOR, health status, and social and occupational functioning

Space-time multiuser detectors for TDD-UTRA: Design and optimization

Linear multiuser detection (MUD) for frequency selective channels has always been considered a prohibitive computational task in CDMA systems. In time slotted CDMA, the block-type MUD involves the inversion of a large matrix that depends on the block size and on the number of users. Sub-optimal techniques are computationally efficient but show some performance degradation. The reduced complexity detectors can be either block-type or one-shot. Compared to one-shot approximation of MUD, the block-type detectors have less computational complexity and large latency. However, the tracking of channel variations within the block is not feasible with any block-type processing (e.g., for the adaptive receiver). These compelling aspects force us to use a one-shot MUD algorithm for space-time channels such as the sliding window decorrelator (SWD). Block-based MUD and SWD algorithms for TDD-UTRA system are compared in term of performance, computational complexity, parallelism and hardware implementation