Développement du procédé de compression de l’acier par tréfilage

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Ultrasound analysis of the upper esophageal sphincter during swallowing in the healthy subject

SummaryObjectivesThe purpose of this study was to develop a methodology and standard settings for ultrasound study of the upper esophageal sphincter (UES) during swallowing.Material and methodsThis was a prospective study of 25 healthy volunteers (15 women and 10 men) aged 20 to 56years. Neck ultrasonography was performed as each volunteer swallowed 10mL of water three times. The parameters studied were: diameter of the closed UES; diameter of the open UES; anterior and lateral displacement (measured in cm) of the UES as the water bolus flowed through it; duration of UES opening; and average duration of UES displacement (measured in ms). Student's t tests for paired and unpaired samples were applied for the statistical analysis.ResultsThe mean diameter of the closed UES was 0.78±0.13cm, while the mean duration of opening was 415±57.66ms and the mean duration of displacement was 937±120.98ms. Maximum anterior and lateral displacement of the UES was 0.42±0.12cm and 0.35±0.18cm, respectively. There was a significant difference between men and women for lateral displacement of the UES (P=0.04).ConclusionThis study established standards for ultrasound study of the UES during swallowing, using a non-invasive readily accessible method that may be useful for assessing swallowing disorders involving the UES (Zenker's diverticulum, fibrosis, stricture)

Thyroid gland invasion in laryngopharyngeal squamous cell carcinoma: Prevalence, endoscopic and CT predictors

SummaryObjectivesThe authors studied the prevalence of histological thyroid gland invasion in laryngopharyngeal cancer and the preoperative endoscopic and CT signs predictive of this invasion.Patients and methodsRetrospective study of patients with laryngopharyngeal squamous cell carcinoma (T3 and T4) treated by total laryngectomy or total laryngopharyngectomy associated with concomitant total thyroidectomy or ipsilateral lobectomy and isthmectomy.ResultsEighty-seven patients were included. Eleven patients (12.6%) presented thyroid gland invasion. Subglottic tumour extension greater than or equal to 10mm (P=0.008) and cricoid cartilage destruction on CT (P=0.001) were statistically correlated with histological thyroid gland invasion. An intact appearance of the laryngeal cartilages on CT was associated with a low probability of thyroid gland invasion.ConclusionThyroid gland invasion must not be underestimated in patients with advanced laryngopharyngeal cancer. Preoperative CT is an essential part of the preoperative work-up. Thyroidectomy must not be performed systematically

Primärprophylaxe der HIV-Infektion

Primary prophylaxis by a change of behaviour in the population continues to be the only effective possibility to prevent a further spread of the aids epidemic. The most important presupposition for this is the precise knowledge of the ways of transmission and the corresponding protective measures. Informations referring to this must turn up repeatedly and above all free of contradictions at all levels of the preventive campaign. The desired changes of behaviour suppose also a climate of confidence and solidarity. The physician's task of prevention is part of the comprehensive strategy of HIV-prevention in Switzerland (effect in width and depth on population- and target groups and on the individual level). It is naturally the physician's domain to look after and counsel individually. Most variable possibilities of beginning a conversation about Aids prevention offer themselves to him. He should put the indication for this as generous as possible and deal extensively with a possible risky behaviour which might not be conscious to both the patient and the physician. The HIV antibody test is indicated in certain situations, however the pre- and posttest counselling is in any case much more decisive than the result of the test. The preventive measures recommended up to now for the most important ways of transmission (sexual contact, intravenous drug use, perinatal transmission, blood/blood products) are still valid without modification

12 fs pulses from a cw-pumped 200 nJ Ti:sapphire amplifier at a variable repetition rate of up to 4 MHz

We demonstrate a novel compact femtosecond Ti:sapphire laser system operating at repetition rates from 10 kHz to 4 MHz. The scheme is based on the combination of a broadband cavity-dumped oscillator and a double-pass Ti:sapphire amplifier pumped by a low-noise cw solid-state laser. Amplified pulses with an extremely smooth spectrum, a duration of only 12 fs, and less than 0.25% rms fluctuation are generated in a beam with M2 < 1.2 . A maximum pulse energy of 210 nJ and an average output power of as much as 720 mW are achieved. This output energy is sufficient to generate a stable continuum in a sapphire disk

Lebensqualität bei Krebserkrankungen – Integration in die Versorgung (working paper von Versorgern und Betroffenen)

Im Rahmen einer Projektgruppe haben sich sowohl Versorger (ÄrztInnen, KrebsberatungsstellenmitarbeiterInnen oder PsychoonkologInnen) sowie Betroffene mit einer regulären Integration von Lebensqualitätsdaten in der Versorgung befasst. Dabei wurde ein digitales System konzipiert, dass eine alltagsnahe und longitudinale Erhebung ermöglicht. Im working paper wurde über alle Teilnehmenden hinweg eine Problemidentifikation der derzeitigen IST-Situation integriert, um anhand dieser Probleme und Hemmschwellen ein übergreifendes Lösungskonzept zu erarbeiten. Im Lösungsraum wurden sowohl spezifische Anforderungen seitens der Versorger als auch PatientInnen zusammengefasst und gegenübergestellt. Dabei wurde ebenfalls die Vernetzung der einzelnen Akteure untereinander beleuchtet sowie die Thematik der Datenspende angerissen