Portal dissection during TIPS placement

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Comportement d'interfaces metal-céramique réalisées par frittage et insertion à la coulée

Mechanisms and Behavior of Metal-Ceramic interfaces processed by sintering and casting insertion: The development of ceramo-metallic systems, needs studies concerning the knowledge of the basic mechanisms responsible for optimal bonds. In addition other technological routes different from brazing or solid state bonding have to be studied. The purpose of this work is to perform metal-ceramic assembling by sintering or casting insertion. Moreover, the reactions occuring during processing are identified

Traumatisme pelvien : impact de l’extravasation du produit de contraste iodé au scanner multidétecteur dans la prise en charge thérapeutique

articlePURPOSE: To determine the impact of iodinated contrast material extravasation at MDCT in selecting patients with pelvic fractures that require vascular embolization. PATIENTS AND METHODS: All patients with severe pelvic fracture admitted to the trauma unit between 1998 and 2004 underwent contrast enhanced MDCT prior to additional specific treatment. All patients with extravasation underwent immediate vascular embolization for hemodynamic stabilization. Orthopedic management was proposed when no contrast extravasation was demonstrated. The presence or absence of contrast extravasation on MDCT and the hemodynamic status of the patients were recorded. RESULTS: Seventy-four patients with pelvic fracture (mean age: 34 years) underwent contrast enhanced MDCT prior to therapeutic management. Vascular embolization was performed in 42 patients: 38 showed contrast extravasation and 4 were in hemodynamic shock but showed no extravasation. Orthopedic management was performed in 27 patients after negative MDCT and 5 hemodynamically stable patients with positive MDCT. CONCLUSION: In our patient population, the presence of iodinated contrast material extravasation at MDCT was a determinant factor in the selection of patients for vascular embolization

Long-term outcome of percutaneous transhepatic therapy for benign bilioenteric anastomotic strictures

articlePURPOSE: To evaluate the long-term outcomes of a percutaneous transhepatic approach in benign bilioenteric anastomoses with calibration of the stenosis to 15 F and extended internal/external drainage. MATERIALS AND METHODS: Between February 2000 and May 2007, the efficacy of this percutaneous transhepatic procedure was retrospectively studied in 39 patients with benign postoperative bilioenteric anastomotic strictures. The main purpose of the protocol was to repair the anastomosis by calibration of the stenosis to 15 F with a silicone drain and perform internal/external drainage for at least 1 year. The follow-up period ranged from 12 to 65 months (mean, 34.4 months), and outcomes were classified according to the patient's clinical symptoms and laboratory parameters and the need for further interventions. RESULTS: The procedure was successful in 38 of 39 patients. Four patients were lost to follow-up during or after drainage. The duration of drainage (41 internal catheters in 34 patients) ranged from 126 days to 488 days (mean, 346 d). Twenty-seven patients had positive outcomes during the mean follow-up of 34 months, and six patients had negative outcomes. The bile duct patency probability according to the Kaplan-Meier method was and 70.6% at 34 months after drain removal. CONCLUSIONS: Percutaneous treatment of benign biliary strictures with calibrated stent implantation and extended drainage has good long-term results and may be an effective alternative to surgery. Advantages over surgery are its minimal invasiveness and reduced risk of complications

Glycemic increase induced by intravenous glucose infusion fails to affect hunger, appetite, or satiety following breakfast in healthy men.

Meal-dependent fluctuations of blood glucose and corresponding endocrine signals such as insulin are thought to provide important regulatory input for central nervous processing of hunger and satiety. Since food intake also triggers the release of numerous gastrointestinal signals, the specific contribution of changes in blood glucose to appetite regulation in humans has remained unclear. Here we tested the hypothesis that inducing glycemic fluctuations by intravenous glucose infusion is associated with concurrent changes in hunger, appetite, and satiety. In a single blind, counter-balanced crossover study 15 healthy young men participated in two experimental conditions on two separate days. 500 ml of a solution containing 50 g glucose or 0.9% saline, respectively, was intravenously infused over a 1-h period followed by a 1-h observation period. One hour before start of the respective infusion subject had a light breakfast (284 kcal). Blood glucose and serum insulin concentrations as well as self-rated feelings of hunger, appetite, satiety, and fullness were assessed during the entire experiment. Glucose as compared to saline infusion markedly increased glucose and insulin concentrations (peak glucose level: 9.7 ± 0.8 vs. 5.3 ± 0.3 mmol/l; t(14) = -5.159, p < 0.001; peak insulin level: 370.4 ± 66.5 vs. 109.6 ± 21.5 pmol/l; t(14) = 4.563, p < 0.001) followed by a sharp decline in glycaemia to a nadir of 3.0 ± 0.2 mmol/l (vs. 3.9 ± 0.1 mmol/l at the corresponding time in the control condition; t(14) = -3.972, p = 0.001) after stopping the infusion. Despite this wide glycemic fluctuation in the glucose infusion condition subjective feelings of hunger, appetite satiety, and fullness did not differ from the control conditions throughout the experiment. These findings clearly speak against the notion that fluctuations in glycemia and also insulinemia represent major signals in the short-term regulation of hunger and satiety

O-267 Uterine volume is dramatically decreased in Stem Cell Hematopoietic Transplantation childhood survivors whatever the conditioning regimen. A case-control MRI study in the L.E.A cohort

International audienceStudy question: Could a hydrogel with similar mechanical properties of reproductive age ovarian cortex support the growth of human preantral follicles? Summary answer: Yes, our optimized PEGylated fibrin hydrogel with tailored mechanical strength provides a suitable substrate for follicle survival and growth. What is known already: The most challenging part of assembling an engineered ovary is developing an appropriate scaffold that can maintain follicle spatial architecture and allow them to have radial growth and development 1-3. Fibrin is a promising biomaterial due to its biocompatibility and bioactivity. Although fibrin has been used as a scaffold in fabricating different tissues such as the ovary, it has a fast degradation rate resulting in loss of physical support for the isolated follicles 4-6. Therefore, various approaches such as physical or chemical modifications have been investigated to overcome the fibrin limitation 7-10. Study design, size, duration: PEGylation as a chemical reaction was used to control fibrin degradation. Moreover, to create an appropriate scaffold for encapsulating human preantral follicles, the Response Surface Methodology was used to find a hydrogel formulation with similar mechanical properties to the reproductive-age ovarian cortex. The chosen hydrogel was used to in vitro culture isolated human preantral follicles for 7 days. Participants/materials, setting, methods: Design-Expert V R software was employed to optimize PEGylated fibrin formulation to match mechanical properties of human ovarian tissues. Preantral follicles isolated from reproductive age patients were embedded in the hydrogel and in vitro cultured for 7 days. Follicle viability and diameter were evaluated on days 1 and 7. Moreover, confocal microscopy analysis was performed on whole follicles to confirm their growth by Ki67 staining of granulosa cells. Main results and the role of chance: In this study, the biomechanically optimized PEGylated fibrin formulation was obtained by mathematical modeling. The hydrogel formulation was established by setting the specific goal of targeting 3178 § 245 Pa, Young's modulus of ovarian tissue fragments in reproductive-age women 11 , in order to obtain the optimized concentration of PEGylated fibrinogen and thrombin. Our results showed that the optimum condition with the desirability of 97.5% occurred by the PEGylated fibrin hydrogel containing 39.06 mg/ml of PEGylated fibrinogen and 50.36 IU/ml of thrombin with Young's modulus of 3512.31 §656.97 pa. Isolated follicles cultured in our hydrogel significantly increased in their diameter from 48.5 §10.8mm (day 1) to 222.5 §84.5mm (day 7), indicating the suitability of the optimized PEGylated fibrin formulation to support radial follicle growth. Moreover, follicles survival on days 1 and 7 did not significantly differ (86.9 §8.9% and 83.4 §6.4%, respectively). Follicle growth was confirmed by the presence of Ki67-positive granulosa cells from follicles at day 7. Limitations, reasons for caution: In this study, the optimized hydrogel was first evaluated only in vitro, which is different from the actual physiological condition. Therefore, it is essential to perform a study analyzing the follicles after their encapsulation in the optimized hydrogel and transplantation, which will be the next step of our study. Wider implications of the findings: Our results introduced an appropriate biomaterial, which resembles Young's modulus of ovarian tissues in reproductive age, for encapsulating human preantral follicles. The optimal concentration of PEGylated fibrin allowed follicles to maintain their viability and have radial growth. Moreover, PEGylation enhanced the fibrin stability and physical support of follicles. Trial registration number: not applicable Abstract citation ID: deac106.049 O-267 Uterine volume is dramatically decreased in Stem Cell Hematopoietic Transplantation childhood survivors whatever the conditioning regimen. A case-control MRI study in the L.E.A cohor