The Four Different Types of Internal Hernia Occurring After Laparascopic Roux-en-Y Gastric Bypass Performed for Morbid Obesity: Are There Any Multidetector Computed Tomography (MDCT) Features Permitting Their Distinction?

BACKGROUND: Four different types of internal hernias (IH) are known to occur after laparoscopic Roux-en-Y gastric bypass (LRYGBP) performed for morbid obesity. We evaluate multidetector row helical computed tomography (MDCT) features for their differentiation. METHODS: From a prospectively collected database including 349 patients with LRYGBP, 34 acutely symptomatic patients (28 women, mean age 32.6), operated on for IH immediately after undergoing MDCT, were selected. Surgery confirmed 4 (11.6%) patients with transmesocolic, 10 (29.4%) with Petersen's, 15 (44.2%) with mesojejunal, and 5 (14.8%) with jejunojejunal IH. In consensus, 2 radiologists analyzed 13 MDCT features to distinguish the four types of IH. Statistical significance was calculated (p < 0.05, Fisher's exact test, chi-square test). RESULTS: MDCT features of small bowel obstruction (SBO) (n = 25, 73.5%), volvulus (n = 22, 64.7%), or a cluster of small bowel loops (SBL) (n = 27, 79.4%) were inconsistently present and overlapped between the four IH. The following features allowed for IH differentiation: left upper quadrant clustered small bowel loops (p < 0.0001) and a mesocolic hernial orifice (p = 0.0003) suggested transmesocolic IH. SBL abutting onto the left abdominal wall (p = 0.0021) and left abdominal shift of the superior mesenteric vessels (SMV) (p = 0.0045) suggested Petersen's hernia. The SMV predominantly shifted towards the right anterior abdominal wall in mesojejunal hernia (p = 0.0033). Location of the hernial orifice near the distal anastomosis (p = 0.0431) and jejunojejunal suture widening (p = 0.0005) indicated jejunojejunal hernia. CONCLUSIONS: None of the four IH seems associated with a higher risk of SBO. Certain MDCT features, such as the position of clustered SBL and hernial orifice, help distinguish between the four IH and may permit straightforward surgery.

[32 phot. de types et de costumes de Serbie, par Jean Lacroix, phot. à Genève, B. Danilovic, F. Regetzky, D. Krstovic, Georg Kraljevacki, M.M. Handzserlija, N. Lekitsch, tous phot. à Belgrade, F. Luckhardt, phot. à Vienne, don Vladimir Yakchitch en 1885]

Donateur : Yakchitch, Vladimir (18..-19..? ; Statisticien)

Parental care time in four European countries: comparing types and contexts

The intensity of parental investments in child care time is expected to vary across families with different norms and time-constraints. Additionally, it should also differ across countries, since the abilities of parents to harmonize family and work vary by national context. In our opinion, however, this question remains inconclusive for two main reasons: 1) only some countries have been studied from a comparative approach; 2) previous studies have not paid enough attention to the analysis of how the conditional effects of education and employment affect parental investments.In this paper we used nationally representative time-use data from Denmark, Flanders, Spain and the United Kingdom (N=4,031) to explore how employment and education predict variations in child care time. IN Britain and Spain employment has a strong negative effect on fathers’ child care, but a weaker one in Flanders and particularly in Denmark. In contrast, maternal employment has a strong negative impact in all four countries. Education increases child care time significantly only among Spanish mothers and fathers, as well as British mothers. Nonetheless, we find that college-educated mothers under similar time-constraints increase substantially their expected child care time in Britain, Flanders and Spain; for fathers we find a more mixed picture. Routine child care activities are more sensitive to both maternal and paternal employment than interactive child care activities. Finally, we observe that working a public sector job generally increases a total time allocated to parental care, controlling for several demographic and socioeconomic variables.

Neuropathies diabétiques: tableaux cliniques, détection précoce et appel au spécialiste [Diabetic neuropathies: clinical sub-types, early detection and asking help from the specialist].

In diabetes mellitus, it is expected to see a common, mainly sensitive, distal symmetrical polyneuropathy (DPN) involving a large proportion of diabetic patients according to known risk factors. Several other diabetic peripheral neuropathies are recognized, such as dysautonomia and multifocal neuropathies including lumbosacral radiculoplexus and oculomotor palsies. In this review, general aspects of diabetic neuropathies are examined, and it is discussed why and how the general practionner has to perform a yearly examination. At the present time, some consensuses emerge to ask help from the specialist when faced to other forms of peripheral neuropathies than distal symmetrical DPN.

Identification of a new oncofoetal antigen associated with several types of human carcinomas.

In experimental animals, oncofoetal antigens1 have been found to be associated with both chemical-2 and virus-induced tumours3. In man the two best known oncofoetal antigens are the α-foetoprotein (AFP) described by both Abelev4 and Tatarinov5 and the carcinoembryonic antigen (CEA) of the human digestive system identified by Gold and Freedman6. We describe here a different human oncofoetal antigen, common to several types of carcinomas and various foetal organs. This antigen has been identified by rabbit antisera raised against semipurified fractions of colon carcinoma soluble extracts. Because of its β-immunoelectrophoretic mobility, this antigen will be referred to as β-oncofoetal antigen (BOFA).

Quotient spaces of boundedly rational types

By identifying types whose low-order beliefs up to level li about the state of nature coincide, weobtain quotient type spaces that are typically smaller than the original ones, preserve basic topologicalproperties, and allow standard equilibrium analysis even under bounded reasoning. Our Bayesian Nash(li; l-i)-equilibria capture players inability to distinguish types belonging to the same equivalence class.The case with uncertainty about the vector of levels (li; l-i) is also analyzed. Two examples illustratethe constructions.

Selling to consumers with endogenous types

For many goods (such as experience goods or addictive goods), consumers preferences may change over time. In this paper, we examine a monopolist s optimal pricing schedule when current consumption can affect a consumer s valuation in the future and valuations are unobservable. We assume that consumers are anonymous, i.e. the monopolist can t observe a consumer s past consumption history. For myopic consumers, the optimal consumption schedule is distorted upwards, involving substantial discounts for low valuation types. This pushes low types into higher valuations, from which rents can be extracted.For forward looking consumers, there may be a further upward distortion of consumption due to a reversal of the adverse selection effect; low valuation consumers now have a strong interest in consumption in order to increase their valuations. Firms will find it profitable to educate consumers and encourage forward looking behavior.

Contrasting magma types and timing of intrusion in the Permian layered mafic complex of Mont Collon (Western Alps, Valais, Switzerland): evidence from U/Pb zircon and 40Ar/39Ar amphibole dating

We have selected and dated three contrasting rock-types representative of the magmatic activity within the Permian layered mafic complex of Mont Collon, Austroalpine Dent Blanche nappe, Western Alps. A pegmatitic gabbro associated to the main cumulus sequence yields a concordant U/Pb zircon age of 284.2 +/- 0.6 Ma, whereas a pegmatitic granite dike crosscutting the latter yields a concordant age of 282.9 +/- 0.6 Ma. A Fe-Ti-rich ultrabasic lamprophyre, crosscutting all other lithologies of the complex, yields an 40Ar/39Ar plateau age of 260.2 +/- 0.7 Ma on a kaersutite concentrate. All ages are interpreted as magmatic. Sub-contemporaneous felsic dikes within the Mont Collon complex are ascribed to anatectic back-veining from the country-rock, related to the emplacement of the main gabbroic body in the continental crust, which is in accordance with new isotopic data. The lamprophyres have isotopic compositions typical of a depleted mantle, in contrast to those of the cumulate gabbros, close to values of the Bulk Silicate Earth. This indicates either contrasting sources for the two magma pulses - the subcontinental lithospheric mantle for the gabbros and the underlying asthenosphere for the lamprophyres - or a single depleted lithospheric source with variable degrees of crustal contamination of the gabbroic melts during their emplacement in the continental crust. The Mont Collon complex belongs to a series of Early Permian mafic massifs, which emplaced in a short time span about 285-280 Ma ago, in a limited sector of the post-Variscan continental crust now corresponding to the Austroalpine/ Southern Alpine domains and Corsica. This magmatic activity was controlled in space and time by crustal-scale transtensional shear zones.

[37 vues et types d'Islande, dont une phot. de l'lndre, corvette de guerre, en rade de Reykjavik, qui transportait l'expédition française et le phot. H. Labonne en 1886, don du phot. en 1887. Il y a aussi, du même phot., 2 phot. du voyageur A. Cotteau et du paléontologiste B. Cotteau devant leur maison de Châtelcensoir (Yonne), s.d]

Donateur : Labonne, Henry (1853-1936?)

[Portrait de la reine Olga de Grèce (même type que Wc 218) non signé, 2 phot. de types grecs par Rubellin, phot. à Smyrne, le tout donné par P.P. Potagos en 1887]

Donateur : Potagos, Panagiotes (1839-1903)

A catalogue of types of Conopoidea, Diopsoidea, Nerioidea and Tephritoidea (Diptera, Schizophora) in the collection of the Museu de Zoologia da Universidade de São Paulo

A catalogue is provided with the type material of four superfamilies of "Acalyptrate" (Conopoidea, Diopsoidea, Nerioidea and Tephritoidea) held in the collection of the Museu de Zoologia da Universidade de São Paulo (MZUSP), São Paulo, Brazil. Concerning the taxa dealt with herein, the Diptera collection of MZUSP held 77 holotypes, 4 "allotypes" and 194 paratypes. In this paper, information about data labels, preservation and missing structures of the type specimens is given.