The EGS Soultz Project (France): From Reservoir Development to Electricity Production.

International audienceOver two decades of research and development of the EGS Soultz reservoir carried out with French, German and Swiss governmental and European funding, a pilot geothermal power plant has been built by a French-German industrial consortium. The drilling of various exploration and geothermal boreholes at great depth, the deepest penetration into crystalline rock in France, has yielded fundamental insights into the geology, nature of fracturing, fluid geochemistry, temperature and hydraulic properties of deep crystalline rock masses. After the drilling operations, all the wells were hydraulically stimulated as well as chemically stimulated. Several circulation tests were done and showed encouraging results. The 3-well system was circulated in 2005 under buoyancy drive for 5 months with re-injection in the central well GPK-3 and production from the two outer wells, GPK-2 and GPK-4. This showed a good linkage between one duplet pair (GPK-3-GPK-2) but not the other (GPK-3-GPK-4). Further acidization operations on the low-productivity well, GPK-4, led to its productivity increasing to almost the same level than the other well. On surface, a binary power plant was designed and built based on an ORC technology (Organic Rankine Cycle). Surface equipments (turbine, heat exchanger, filtering system) and a corrosion loop as well as two different types of down-hole pumps (Line Shaft Pump-LSP, Electro Submersible Pump-ESP) were installed respectively on surface and in the production wells in 2008. The on-going Soultz project has been able to produce the first kWh of electricity in June 2008 but several components of the geothermal plant are still in their testing phase

Timing gastroenteric perforations : statistical meaning of histomorphologic data and sensibility of the histocronologic method

Chronology of lesions represents a theme forensic pathology has always paid great attention to; its employment in fact allows to ascribe or exclude penal and civil liability concerning medical behavior. Objective: the aim of this study has been to verify the statistical meaning of histomorphologic data and the sensibility of the histocronologic method in timing gastroenteric perforations. Nature of the study: it is a retrospective histomorphologic study formed on tissues taken in surgical treated perforation cases. Materials and methods: alla cases of spontaneous and traumatic gastroenteric perforations, that underwent surgical operation in the Emergency Department of Niguarda Hospital in Milan between 1980 and 2000 have been reviewed. through the inspection of clinical records of the hospital archives, alla cases in which perforation time was known have been selected. Routine histochemical stain (Hematoxyline-eosine) and speciales (Masson's Trichromic, Perls and carstair) have been performed the relative histological material. Each prepared slide has been blindly and separately examined by more pathologists, who kept to uniform and agreed criteria in describing the inflammatory reaction pointed out. Conclusions: first of all, qualitative and quantitative histomorphologic findings have been correlated to the known perforation times and have been analyzed in order to assess their statistical meaning in dating perforations. Besides, the same histological evidences have been dated by using classical histochronologic criteria for the purpose of verifying sensibility of such a firm method when it's applied to gastroenteric perforations

Reappraisal of surgical treatment of small hepatocellular carcinomas in cirrhosis: clinicopathological study of resection or transplantation

Thirty-two patients with hepatocellular carcinoma (HCC) occurring in individuals with cirrhosis had a potentially curative surgical procedure. Twenty-two had segmental hepatic resections (HR), and 10 underwent orthotopic liver transplantation (OLTx). The diagnosis of hepatic malignancy was established in each case preoperatively, and each case was studied intraoperatively by means of sonography. Postoperatively each surgical specimen was examined pathologically with attention to the possibility of intrahepatic tumor spread. Twenty-three of the 32 patients had single small HCC lesion (<5 cm diameter) identified preoperatively. Sixteen of these underwent HR and seven underwent OLTx. Multiple additional neoplastic lesions were found in 19% of the 16 HR cases and in 14% of those undergoing OLTx when the resection specimens were examined pathologically. Vascular invasion was present in 43% of the OLTx patients and in 25% of the HR patients. Subtotal hepatic resection for small HCC occurring in cirrhosis has produced few long-term survivals. Both pre- and intraoperative sonography have been shown to underestimate the extent and distribution of these tumors. Based upon this experience that (1) vascular spread occurs often in HCC and (2) a high risk of postoperative hepatic failure can be expected after HR in cirrhotic individuals, OLTx is the most rational surgical procedure for such cases as it has the potential to cure

Trauma deaths in an Italian urban area : an audit of pre-hospital and in-hospital trauma care

In Italy, a comprehensive regional study of trauma deaths has never been performed. We examined the organization and delivery of trauma care in the city area of Milan, using panel review of trauma deaths. Two panels evaluated the appropriateness of care of all trauma victims occurred during 1 year, applying predefined criteria and judging deaths as not preventable (NP), possible preventable (PP), and definitely preventable (DP). Two hundred and fifty-five deaths were reviewed. Blunt trauma were 78.04% and motor vehicle crashes accounted for over 50%. Most victims (73.72%) died during pre-hospital settings and 91.1% died within the first 6h, principally because of central nervous system injuries in blunt and hemorrhage in penetrating trauma. Panels judged 57% of deaths NP, 32% PP, 11% DP (inter-panel K-test 0.88). Preventable deaths were higher after in-hospital admission. Main failures of treatment were lack in airway control or intravenous infusions in pre-hospital and mismanagement with missed injuries in emergency department. The high rate of avoidable deaths in Milan supports the need of trained pre-hospital personnel and of well equipped referring hospitals for trauma