Calcifying Bowel Inflammation: A Case Report

We report about a previously healthy 72-year-old woman, presented with 6 days of left lower quadrant abdominal pain and constipation. There was no report of fever, melena, hematochezia or change in appetite. The physical exam demonstrated a distended abdomen with palpable left lower quadrant pain, without guarding. CT showed images compatible with a sigmoid diverticulitis and a calcification of the sigmoid colon. After antibiotic threatment, a colonoscopy was performed which revealed the presence of a shell in the sigmoid colon. Our case illustrates the need for a colonoscopy following an attack of diverticulitis to look for a cancer or rarely a foreign body

Machine d'essai en fatigue biaxiale disposant d'une éprouvette

Machine d'essai en fatigue disposant d'une éprouvette (10), cette machine comportant un poinçon mobile appliquant une charge axiale cyclique sur une face de l'éprouvette (14) perpendiculaire à l'axe du poinçon, cette éprouvette étant en appui sur une base fixe par une face opposée (12) à la première face, caractérisée en ce que la machine d'essai comporte deux appuis annulaires de rayons différents centrés sur l'axe du poinçon, appliquant la charge du poinçon ou de la base fixe sur chacune des faces opposées (12, 14) de l'éprouvette (10), la partie centrale de cette éprouvette comprenant une zone de contrainte bi-axiale (22) comportant deux surfaces parallèles, et la face (12) comportant l'appui annulaire de plus grand rayon (A), recevant sur la zone de contrainte bi-axiale (22) des jauges de déformation (20)

Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

The management of acute appendicitis during pregnancy is not fully established, especially regarding the choice between open and laparoscopic surgery during the third trimester. We report herein the case of a major uterine variecele hemorrhage during a laparoscopic appendectomy in a 27-year old pregnant patient at 33 weeks of amenorrhea. After conversion to a Pfannenstiel incision, the baby was delivered, the bleeding stopped and the appendectomy completed. While both mother and child fully recovered, this «near miss» complication underlines the challenges linked to the management of acute appendicitis during pregnancy. Based on a literature review, we propose an algorithm favoring the laparoscopic approach during the first and second trimesters, and the open approach during the third trimester (especially after the 26th week of amenorrhea). In case of unclear pre-operative diagnosis, a laparoscopy should be conducted even during the third trimester with a Mc Burney conversion when the diagnosis of appendicitis is confirmed

Ribonucleoparticle-independent transport of proteins into mammalian microsomes

There are at least two different mechanisms for the transport of secretory proteins into the mammalian endoplasmic reticulum. Both mechanisms depend on the presence of a signal peptide on the respective precursor protein and involve a signal peptide receptor on the cis-side and signal peptidase on the trans-side of the membrane. Furthermore, both mechanisms involve a membrane component with a cytoplasmically exposed sulfhydryl. The decisive feature of the precursor protein with respect to which of the two mechanisms is used is the chain length of the polypeptide. The critical size seems to be around 70 amino acid residues (including the signal peptide). The one mechanism is used by precursor proteins larger than about 70 amino acid residues and involves two cytosolic ribonucleoparticles and their receptors on the microsomal surface. The other one is used by small precursor proteins and relies on the mature part within the precursor molecule and a cytosolic ATPase

Liver Trauma During Combined Liposuction and Abdominoplasty: A Rare but Potentially Lethal Complication

Liposuction is a well-established procedure that is generally safe. However, rare complications can occur. The authors report on a 38-year-old woman who underwent combined abdominoplasty and liposuction at a private clinic. Four hours after the procedure, severe hypovolemic shock developed and required emergency transfer to a tertiary-care center. After primary fluid resuscitation, abdominal ultrasonography and computerized tomography revealed severe right-sided liver trauma, with active bleeding and free intra-abdominal fluid. Two attempts at right hepatic artery embolization failed to fully control the bleeding, and surgical hemostasis was required. After a 2-week hospitalization, the patient was discharged, and she returned to work 3 months later. Although it appears that this is the first reported case of liver trauma during liposuction, this potential complication should be kept in mind and identified early to permit efficient and effective management. Level of Evidence 5 Ris

Development of an ultra-fast X-ray camera using hybrid pixel detectors

L objectif du projet, dont le travail présenté dans cette thèse est une partie, était de développer une caméra à rayons X ultra-rapide utilisant des pixels hybrides pour l imagerie biomédicale et la science des matériaux. La technologie à pixels hybrides permet de répondre aux besoins des ces deux champs de recherche, en particulier en apportant la possibilité de sélectionner l énergie des rayons X détectés et de les imager à faible dose. Dans cette thèse, nous présentons une caméra ultra-rapide basée sur l utilisation de circuits intégrés XPAD3-S développés pour le comptage de rayons X. En collaboration avec l ESRF et SOLEIL, le CPPM a construit trois caméras XPAD3. Deux d entre elles sont utilisée sur les lignes de faisceau des synchrotrons SOLEIL et ESRF, et le troisième est installé dans le dispositif d irradiation PIXSCAN II du CPPM. La caméra XPAD3 est un détecteur de rayons X de grande surface composé de huit modules de détection comprenant chacun sept circuits XPAD3-S équipés d un système d acquisition de données ultra-rapide. Le système de lecture de la caméra est basé sur l interface PCI Express et sur l utilisation de circuits programmables FPGA. La caméra permet d obtenir jusqu à 240 images/s, le nombre maximum d images étant limité par la taille de la mémoire RAM du PC d acquisition. Les performances de ce dispositif ont été caractérisées grâce à plusieurs expériences à haut débit de lecture réalisées dans le système d irradiation PIXSCAN II. Celles-ci sont décrites dans le dernier chapitre de cette thèse.The aim of the project, of which the work described in this thesis is part, was to design a high-speed X-ray camera using hybrid pixels applied to biomedical imaging and for material science. As a matter of fact the hybrid pixel technology meets the requirements of these two research fields, particularly by providing energy selection and low dose imaging capabilities. In this thesis, high frame rate X-ray imaging based on the XPAD3-S photons counting chip is presented. Within a collaboration between CPPM, ESRF and SOLEIL, three XPAD3 cameras were built. Two of them are being operated at the beamline of the ESRF and SOLEIL synchrotron facilities and the third one is embedded in the PIXSCAN II irradiation setup of CPPM. The XPAD3 camera is a large surface X-ray detector composed of eight detection modules of seven XPAD3-S chips each with a high-speed data acquisition system. The readout architecture of the camera is based on the PCI Express interface and on programmable FPGA chips. The camera achieves a readout speed of 240 images/s, with maximum number of images limited by the RAM memory of the acquisition PC. The performance of the device was characterize by carrying out several high speed imaging experiments using the PIXSCAN II irradiation setup described in the last chapter of this thesis.AIX-MARSEILLE2-Bib.electronique (130559901) / SudocSudocFranceF

The effects of β1-adrenergic blockade on cardiovascular oxygen flow in normoxic and hypoxic humans at exercise

At exercise steady state, the lower the arterial oxygen saturation (SaO2), the lower the O2 return (\ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2}). A linear relationship between these variables was demonstrated. Our conjecture is that this relationship describes a condition of predominant sympathetic activation, from which it is hypothesized that selective β1-adrenergic blockade (BB) would reduce O2 delivery (\ifmmode\expandafter\dot\else\expandafter\.\fi{Q}{\text{aO}}_{2} ) and \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} . To test this hypothesis, we studied the effects of BB on \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}{\text{aO}}_{2} and \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} in exercising humans in normoxia and hypoxia. O2 consumption (\ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} ), cardiac output (\ifmmode\expandafter\dot\else\expandafter\.\fi{Q}, CO_{2}\; \hbox{rebreathing}), heart rate, SaO2 and haemoglobin concentration were measured on six subjects (age 25.5±2.4years, mass 78.1±9.0kg) in normoxia and hypoxia (inspired O2 fraction of 0.11) at rest and steady-state exercises of 50, 100, and 150W without (C) and with BB with metoprolol. Arterial O2 concentration (CaO2), \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}{\text{aO}}_{2}, and \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} were then computed. Heart rate, higher in hypoxia than in normoxia, decreased with BB. At each \ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} , \ifmmode\expandafter\dot\else\expandafter\.\fi{Q} was higher in hypoxia than in normoxia. With BB, it decreased during intense exercise in normoxia, at rest, and during light exercise in hypoxia. SaO2 and CaO2 were unaffected by BB. The \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}{\text{aO}}_{2} changes under BB were parallel to those in \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}. \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} was unaffected by exercise in normoxia. In hypoxia the slope of the relationship between \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}{\text{aO}}_{2} and \ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} was lower than 1, indicating a reduction of \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} with increasing workload. \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} was a linear function of SaO2 both in C and in BB. The line for BB was flatter than and below that for C. The resting \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} in normoxia, lower than the corresponding exercise values, lied on the BB line. These results agree with the tested hypothesis. The two observed relationships between \ifmmode\expandafter\dot\else\expandafter\.\fi{Q}\bar{{\text{v}}} {\text{O}}_{2} and SaO2 apply to conditions of predominant sympathetic or vagal activation, respectively. Moving from one line to the other implies resetting of the cardiovascular regulatio