Orographically forced stratospheric waves over northern Scandinavia

Simulations were carried out using the two-dimensional version of a non-hydrostatic numerical model in order to calculate the mesoscale response to flow across the Scandinavian mountain range. The initial conditions were deduced from an upstream sounding of 27 January 1992 during the EASOE campaign. Over and to the east of the mountain crest regions of mesoscale extent developed which experienced cooling up to 7 K. Air parcel trajectories passed these areas in approximately 10 min

Operational monitoring of radioelectric exposure in an urban environment

International audiencePolemics about base stations of cellular telephones have become a recurrent source of conflict among telecommunication companies, city authorities and citizens. Following early work performed within the framework of a doctoral thesis, the french research projet ANR Samper (2008-2011) has set up, for the first time, a network of monitoring stations in an urban environment, whose measurements are processed continuously by geostatistical methods, in order to inform daily the inhabitants on the hourly variations of radioelectric exposure in their surroundings. More precisely, the system uses a kriging of the exposure measurements including as external drift the output of a physical model of the propagation of the radioelectric signal emitted at different frequencies by the base stations. We present the implementation of the ANR Samper pre-operational monitoring system set up during several months in a section of the city of Grenoble

Bronchogenic cyst of the left lower lobe associated with severe hemoptysis

Bronchogenic cysts result from congenital disorders, are often asymptomatic at diagnosis, but complications are not uncommon. We report the case of a 19-year-old woman with severe hemoptysis. This rare presentation of an intrapulmonary bronchogenic cyst should be considered as differential diagnosis in patients with cavernous lesion of a lobe. Surgery was performed as a diagnostic and therapeutic measur

DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Osteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone

Morbidity and validity of the hemiclamshell approach for thoracic surgery

Objective: This is a prospective study to evaluate the indications and outcome of the hemiclamshell incision (longitudinal partial sternotomy combined with an antero-lateral thoracotomy) as used for a consecutive series of patients requiring surgery for various thoracic pathologies not ideally approached by postero-lateral thoracotomy, sternotomy or thoracoscopy. Methods: All patients with a hemiclamshell incision performed between 1994 and 1998 were prospectively analyzed regarding indications, postoperative morbidity and outcome (clinical examination and pulmonary function testing) in order to validate this incision for thoracic surgery. Results: 25 patients (15 men, 10 women) with an age ranging from 16 to 73 years (mean 43 years) underwent a hemiclamshell incision. The indications for the hemiclamshell approach were (1) chest trauma with massive hemorrhage requiring urgent access to the mediastinum and the ipsilateral pleural space (40%), (2) tumors of the anterior cervico-thoracic junction with suspicion of vascular involvement (28%) and (3) lesions involving both one chest cavity and the mediastinum (32%). The 30-day mortality was 8%. One patient suffered a sternal wound infection, mediastinitis and pleural empyema after a gun shot wound, whereas wound healing was uneventful in all other patients. Analgesic requirements for postoperative pain relief were not increased as compared to those following a standard thoracotomy. At 3 months normal sensitivity of the entire chest wall and intact shoulder girdle function was noted in 90% of the patients. Pulmonary function testing showed no restriction due to the hemiclamshell incision. Conclusions: The hemiclamshell incision is a useful approach in selected patients and does not cause more morbidity or long-term sequelae than a standard thoracotom

Mediastinal reinforcement after induction therapy and pneumonectomy: comparison of intercostal muscle versus diaphragm flaps

Objective: Prospective non-randomised comparison of full-thickness pedicled diaphragm flap with intercostal muscle flap in terms of morbidity and efficiency for bronchial stump coverage after induction therapy followed by pneumonectomy for non-small cell lung cancer (NSCLC). Methods: Between 1996 and 1998, a consecutive series of 26 patients underwent pneumonectomy following induction therapy. Half of the patients underwent mediastinal reinforcement by use of a pedicled intercostal muscle flap (IF) and half of the patients by use of a pedicled full-thickness diaphragm muscle flap (DF). Patients in both groups were matched according to age, gender, side of pneumonectomy and stage of NSCLC. Postoperative morbidity and mortality were recorded. Six months follow-up including physical examination and pulmonary function testing was performed to examine the incidence of bronchial stump fistulae, gastro-esophageal disorders or chest wall complaints. Results: There was no 30-day mortality in both groups. Complications were observed in one of 13 patients after IF and five of 13 after DF including pneumonia in two (one IF and one DF), visceral herniations in three (DF) and bronchopleural fistula in one patient (DF). There were no symptoms of gastro-esophageal reflux disease (GERD). Postoperative pulmonary function testing revealed no significant differences between the two groups. Conclusions: Pedicled intercostal and diaphragmatic muscle flaps are both valuable and effective tools for prophylactic mediastinal reinforcement following induction therapy and pneumonectomy. In our series of patients, IF seemed to be associated with a smaller operation-related morbidity than DF, although the difference was not significant. Pedicled full-thickness diaphragmatic flaps may be indicated after induction therapy and extended pneumonectomy with pericardial resection in order to cover the stump and close the pericardial defect since they do not adversely influence pulmonary functio

A comparative evaluation of intrathoracic latissimus dorsi and serratus anterior muscle transposition

Background: Comparison of intrathoracic latissimus dorsi (LD) versus serratus anterior (SA) muscle transposition for treatment of infected spaces, broncho-pleural fistulae, and for prophylactic reinforcement of the mediastinum after extended resections following induction therapy. Patients and methods: Twenty LD and 17 SA transfers were performed for prophylactic reinforcement (11 LD; nine SA), and treatment of infections (nine LD; eight SA) from 1995 to 1998. Results: The 30-day mortality was 0% following prophylactic reinforcement and 29% following treatment of infections (three LD; two SA). Prophylactic mediastinal reinforcement was successful in 11 of 11 patients with LD and nine of nine with SA transpositions, and treatment of infected spaces in eight of nine patients with LD and two of three with SA transfers. Morbidity requiring re-intervention consisted of flap necrosis (one LD), bleeding (one SA), and skin necrosis over a winged scapula (one SA). Subcutaneous seromas and chest wall complaints were more frequent following LD (45 and 36%, respectively) compared with SA transfers (29 and 27%, respectively), whereas impaired shoulder girdle function was more frequent after SA than after LD transfer (27 vs. 21%). Conclusion: Intrathoracic LD and SA muscle transpositions are both efficient for the prevention or control of infections following complex thoracic surgery, and are both associated with similar and acceptable morbidity and long-term sequela

What was your fracture risk evaluated by FRAX® the day before your osteoporotic fracture?

Osteoporotic fracture (OF) is one of the major causes of morbidity and mortality in industrialized countries. Switzerland is among the countries with the greatest risk. Our aim was (1) to calculate the FRAX® in a selected Swiss population the day before the occurrence of an OF and (2) to compare the results with the proposed Swiss FRAX® thresholds. The Swiss Association Against Osteoporosis proposed guidelines for the treatment of osteoporosis based on age-dependent thresholds. To identify a population at a very high risk of osteoporotic fracture, we included all consecutive patients in the active OF pathway cohort from the Lausanne University Hospital, Switzerland. FRAX® was calculated with the available data the day before the actual OF. People with a FRAX® body mass index (BMI) or a FRAX® (bone mineral density) BMD lower than the Swiss thresholds were not considered at high risk. Two-hundred thirty-seven patients were included with a mean age of 77.2years, and 80% were female. Major types of fracture included hip (58%) and proximal humerus (25%) fractures. Mean FRAX® BMI values were 28.0, 10.0, 13.0, 26.0, and 37.0% for age groups 50-59, 60-69, 70-79, and 80-89years old, respectively. Fifty percent of the population was not considered at high risk by the FRAX® BMI. FRAX® BMD was available for 95 patients, and 45% had a T score < −2.5 standard deviation. Only 30% of patients with a normal or osteopenic BMD were classified at high risk by FRAX® BMD. The current proposed Swiss thresholds were not able to classify at high risk in 50 to 70% of the studied population the day before a major O

Significance of a new fluorodeoxyglucose-positive lesion on restaging positron emission tomography/computed tomography after induction therapy for non-small-cell lung cancer †

OBJECTIVES Restaging of patients with locally advanced non-small-cell lung cancer (NSCLC) is of paramount importance, since only patients with down-staging after induction therapy will benefit from surgery. In this study, we assessed the aetiology of new 18fluoro-2-deoxy-d-glucose (FDG)-positive focal abnormalities on restaging positron emission tomography/computed tomography (PET/CT) in patients with a good response after induction chemotherapy in the primary tumour and lymph nodes. METHODS Between 2004 and 2008, 31 patients with histological proven stage III NSCLC had a PET/CT prior and after induction chemotherapy. Their medical charts were retrospectively reviewed. RESULTS Restaging PET/CT revealed a new FDG-positive lesion in 6 of 31 (20%) patients. The initial clinical stage of the disease was IIIA N2 in four and IIIB T4 in two patients. The maximal standard uptake value in the primary tumour (P=0.043) and in the initially involved mediastinal nodes (P=0.068) decreased after induction treatment in all patients. The new PET/CT findings were located in an ipsilateral cervical lymph node in two patients, a contralateral mediastinal in one patient and an ipsilateral mammary internal lymph node in one patient. Two other patients had a lesion on the contralateral lung. Malignant lymph node infiltrations were excluded following fine-needle puncture, intraoperative biopsy or follow-up PET/CT. Contralateral pulmonary lesions were diagnosed as benign following mini thoracotomy and pulmonary wedge resection. CONCLUSIONS New solitary FDG-positive lesions on restaging PET/CT after induction chemotherapy for NSCLC are not rare in good responders to chemotherapy. In our experience, all these lesions were not associated with malignanc

Temperature dependence of the elastic constants for biaxial nematic liquid crystals

The elastic constants K ij of the Frank-Oseen energy density for uniaxial nematic liquid crystals depend on the Maier-Saupe order parameter S and hence on temperature. Longa et al. recently used an extended Landau-Ginzburg-de Gennes theory to expand the functions K ij(S) up to fourth order in S. Here, a similar procedure is applied for the elastic energy density of biaxial nematic liquid crystals. The three chiral and 15 achiral constants are expressed as fourth-order polynomials in the order parameter S and the degree of biaxiality T. Via the temperature dependence of the quantities S and T also the temperature dependence of the elastic constants is fixed.Die elastischen Konstanten K ij der Frank-Oseen-Energiedichte für einachsige nematische Flüssigkristalle hängen über den Maier-Saupe-Ordnungsparameter von der Temperatur ab. Longa et al. haben kürzlich eine erweiterte Theorie nach Landau-Ginzburg-de Gennes benutzt, um die Funktionen K ij(S) bis zur vierten Ordnung nach S zu entwickeln. Hier wird ein ähnliches Verfahren bei der elastischen Energiedichte von biaxialen nematischen Flüssigkristallen angewandt. Die drei chiralen und 15 nichtchiralen Konstanten werden als Polynome vierten Grades in Ordnungsparameter S und Biaxialitätsparameter T ausgedrückt. Durch deren Temperaturabhängigkeit ist damit das Temperaturverhalten der elastischen Konstanten bestimmt