Pathologies vasculaires lymphatiques: apport de la lympho-fluoroscopie [Lymphatic vascular pathologies: contribution of lympho-fluoroscopy].

Si l'examen clinique revêt une importance essentielle en lymphologie et exige des praticiens expérimentés, la lymphoscintigraphie et plus récemment la lympho-fluoroscopie au vert d'indocyanine constituent des moyens d'investigation précieux dans la prévention, le diagnostic et le traitement des pathologies vasculaires lymphatiques. L'intérêt de la lymphoscintigraphie réside dans l'analyse qualitative et quantitative de la migration des macromolécules par les vaisseaux lymphatiques et l'évaluation du secteur lymphatique profond. La lympho-fluoroscopie se distingue de la lymphoscintigraphie par l'obtention d'une cartographie détaillée des vaisseaux lymphatiques superficiels et d'images dynamiques en temps réel. Elle apporte à l'angiologue et au physiothérapeute des informations irremplaçables sur leur contractilité et la présence de dérivations compensatoires à privilégier lors du drainage lymphatique manuel. If clinical examination has an essential importance in lymphology disorders and requires experimented practitioners, lymphoscintigraphy and more recently green indocyanine lympho-fluoroscopy constitute precious complementary investigations in prevention, diagnosis, and treatment of lymphatic vascular pathologies. The lymphoscintigraphy interest lies in qualitative and quantitative analysis of macromolecules migration within lymphatic vessels and the deep lymphatic network. The lympho-fluoroscopy distinguishes itself from lymphoscintigraphy allowing real time superficial lymphatic vessels detailed mapping, gathering important information on their contractility, and the presence of compensatory derivations to be favored during manual lymphatic drainage to angiologist and physiotherapist.

Abcès pulmonaires: évolution dans la prise en charge [Lung abscess: changes in the management?].

L'abcès pulmonaire se présente de manière très pléomorphe selon les germes initialement impliqués. Des symptômes gé­ néraux et une évolution souvent subaiguë sont retrouvés en cas d'aspiration de la flore oropharyngée, chez des patients avec des troubles de l'état de conscience ou de la déglutition. L'infection est très souvent polymicrobienne, avec présence de germes anaérobes dans deux tiers des cas. La prise en charge consiste en un traitement antibiotique prolongé, jusqu'à résolution ou stabilité de l'image radiologique. En cas d'état toxique ou d'absence de drainage bronchique spontané, un drainage de l'abcès est à discuter. Les sanctions chirurgicales sont peu souvent nécessaires et envisagées indépendamment de la taille de l'abcès excepté lors de néoplasie sous-jacente. Lung abscess occurs in very pleomorphic according to germs initially involved. The mechanism commonly found is an aspiration of the oropharyngeal flora in patients with disorders of consciousness or swallowing. The infection is polymicrobial, with presence of anaerobic germs in 2/3 of the cases. The support consists of a prolonged antibiotic treatment, as well as anaerobic until resolution or stability of the radiological image. In case of prolonged toxic state, drainage of the abscess is to be discussed especially if there is no airways drainage. Surgical sanctions is rarely needed regardless of the size of the abscess, unless underlying carcinoma is present.

Confiabilidade da análise qualitativa da ressonância magnética do encéfalo em prematuros extremos

OBJETIVO: O objetivo deste estudo foi avaliar a confiabilidade da análise visual qualitativa dos achados de imagem de ressonância magnética (RM) em recém-nascidos prematuros extremos. MATERIAIS E MÉTODOS: Uma coorte de 45 recém-nascidos de idade gestacional de 30 semanas ou menos foram inseridos neste estudo. Dois neurorradiologistas, cegos quanto aos dados clínicos, avaliaram de forma independente as RMs de crânio em relação aos seguintes achados: presença de hipersinal difuso e excessivo (DEHSI), dilatação dos ventrículos laterais, hemorragia intracraniana, áreas de sinal anormal em núcleos da base e córtex, áreas de aspecto cístico, deformidades ventriculares, dilatação do espaço subaracnóideo, leucoencefalomalácia precoce e anormalidades corticais. RESULTADOS: Quarenta e um pacientes (91,1%) apresentaram exame de RM anormal. Os achados mais comuns foram DEHSI (75,6%) e dilatação dos ventrículos (42,2%). A concordância interobservadores entre os dois experientes neurorradiologistas foi alta (κ > 0,60) para a maioria das alterações detectadas pela RM. O valor de kappa foi moderado (κ = 0,52) para alargamento do espaço subaracnoide e fraco (κ = 0,39) para DEHSI na substância branca. CONCLUSÃO: A avaliação qualitativa da maioria dos achados de imagem por RM de neonatos prematuros extremos foi considerada confiável, entretanto, a presença de DEHSI na substância branca demonstrou um grau de confiabilidade menor

Gestion et communication de l'information en surveillance biologique. Une approche éthique et interdisciplinaire [Biomonitoring information management and communication: an ethical and interdisciplinary perspective]

This study explores biomonitoring communication with workers exposed to risks. Using a qualitative approach, semi-directive interviews were performed. Results show that occupational physicians and workers share some perceptions, but also point out communication gaps. Consequently, informed consent is not guaranteed. This article proposes some recommendations for occupational physicians' practices.

Sedation palliative: aspects cliniques pratiques [Clinical and practical aspects of palliative sedation]

Un certain nombre de patients palliatifs en fin de vie présentent des symptômes qui ne peuvent pas être soulagés malgré la mise en oeuvre de tous les moyens traditionnels à disposition. Pour ces patients, lorsque des symptômes réfractaires induisent une souffrance intolérable, la sédation palliative est un moyen de dernier recours qui peut leur offrir un soulagement transitoire ou même définitif. Tout en présentant les enjeux éthiques, cet article explore les dimensions cliniques d'ordre pratique qui peuvent se présenter lors d'une sédation palliative chez un patient en fin de vie. Patients at the end-of-life may present with refractory symptoms which cannot be adequately relieved despite the use of all traditional means. When refractory symptoms lead to intolerable suffering, palliative sedation is a last recourse temporary or definitive treatment. While discussing ethical issues, clinical practice dimensions of palliative sedation are explored in this article

Programme de prise en charge des maladies chroniques : quels bénéfices dans l'asthme? : revue Cochrane pour le praticien

L'asthme impose un fardeau important sur les patients et les systèmes de soins. Les programmes de prise en charge des maladies chroniques (chronic disease management) ont pour but d'améliorer la qualité et l'efficacité des soins et du suivi des patients. Ils se composent d'une série d'interventions centrées sur les besoins des patients, encouragent la coordination et l'intégration des soins fournis par différents professionnels de la santé et mettent l'accent sur l'éducation du patient et l'autogestion de sa maladie. L'objectif de cette revue était d'évaluer l'efficacité de tels programmes chez l'adulte asthmatique.

High Altitude Increases Alteration in Maximal Torque but Not in Rapid Torque Development in Knee Extensors after Repeated Treadmill Sprinting.

We assessed knee extensor neuromuscular adjustments following repeated treadmill sprints in different normobaric hypoxia conditions, with special reference to rapid muscle torque production capacity. Thirteen team- and racquet-sport athletes undertook 8 × 5-s "all-out" sprints (passive recovery = 25 s) on a non-motorized treadmill in normoxia (NM; FiO2 = 20.9%), at low (LA; FiO2 = 16.8%) and high (HA; FiO2 = 13.3%) normobaric hypoxia (simulated altitudes of ~1800 m and ~3600 m, respectively). Explosive (~1 s; "fast" instruction) and maximal (~5 s; "hard" instruction) voluntary isometric contractions (MVC) of the knee extensors (KE), with concurrent electromyographic (EMG) activity recordings of the vastus lateralis (VL) and rectus femoris (RF) muscles, were performed before and 1-min post-exercise. Rate of torque development (RTD) and EMG (i.e., Root Mean Square or RMS) rise from 0 to 30, -50, -100, and -200 ms were recorded, and were also normalized to maximal torque and EMG values, respectively. Distance covered during the first 5-s sprint was similar (P > 0.05) in all conditions. A larger (P < 0.05) sprint decrement score and a shorter (P < 0.05) cumulated distance covered over the eight sprints occurred in HA (-8 ± 4% and 178 ± 11 m) but not in LA (-7 ± 3% and 181 ± 10 m) compared to NM (-5 ± 2% and 183 ± 9 m). Compared to NM (-9 ± 7%), a larger (P < 0.05) reduction in MVC torque occurred post-exercise in HA (-14 ± 9%) but not in LA (-12 ± 7%), with no difference between NM and LA (P > 0.05). Irrespectively of condition (P > 0.05), peak RTD (-6 ± 11%; P < 0.05), and normalized peak RMS activity for VL (-8 ± 11%; P = 0.07) and RF (-14 ± 11%; P < 0.01) muscles were reduced post-exercise, whereas reductions (P < 0.05) in absolute RTD occurred within the 0-100 (-8 ± 9%) and 0-200 ms (-10 ± 8%) epochs after contraction onset. After normalization to MVC torque, there was no difference in RTD values. Additionally, the EMG rise for VL muscle was similar (P > 0.05), whereas it increased (P < 0.05) for RF muscle during all epochs post-exercise, independently of the conditions. In summary, alteration in repeated-sprint ability and post-exercise MVC decrease were greater at high altitude than in normoxia or at low altitude. However, the post-exercise alterations in RTD were similar between normoxia and low-to-high hypoxia.

Módulo eletrônico de controle para válvulas solenóides

This technical note describes a new and simple electronic circuit for driving solenoid valves. The circuit is based on a single integrated circuit DRV103, which is able to drive resistive or inductive loads up to 1.5 A. Switching of 12-V loads can be controlled by TTLlevel signals in two distinct steps. Initially, 12 V is applied during 110 ms, followed by 4.2 V RMS until the end of the activation TTL pulse. This mode of operation is particularly suitable to drive solenoids, because it requires a higher voltage to start and a lower maintenance voltage. By using this circuit, power consumption and heating are reduced and the solenoid lifetime is enhanced. Moreover, this circuit is specially appropriated to build computercontrolled solenoid valves systems.

Garvey-Kelson relations for nuclear charge radii

The Garvey-Kelson relations (GKRs) are algebraic expressions originally developed to predict nuclear masses. In this letter we show that the GKRs provide a fruitful framework for the prediction of other physical observables that also display a slowly-varying dynamics. Based on this concept, we extend the GKRs to the study of nuclear charge radii. The GKRs are tested on 455 out of the approximately 800 nuclei whose charge radius is experimentally known. We find a rms deviation between the GK predictions and the experimental values of only 0.01 fm. This should be contrasted against some of the most successful microscopic models that yield rms deviations almost three times as large. Predictions -with reliable uncertainties- are provided for 116 nuclei whose charge radius is presently unknown.

Aplicação de alguns modelos quimiométricos à espectroscopia de fluorescência de raios-X de energia dispersiva

The objective of this work was to accomplish the simultaneous determination of some chemical elements by Energy Dispersive X-ray Fluorescence (EDXRF) Spectroscopy through multivariate calibration in several sample types. The multivariate calibration models were: Back Propagation neural network, Levemberg-Marquardt neural network and Radial Basis Function neural network, fuzzy modeling and Partial Least Squares Regression. The samples were soil standards, plant standards, and mixtures of lead and sulfur salts diluted in silica. The smallest Root Mean Square errors (RMS) were obtained with Back Propagation neural networks, which solved main EDXRF problems in a better way.

RTOS Framework for Real-Time Control System

This thesis is done as a complementary part for the active magnet bearing (AMB) control software development project in Lappeenranta University of Technology. The main focus of the thesis is to examine an idea of a real-time operating system (RTOS) framework that operates in a dedicated digital signal processor (DSP) environment. General use real-time operating systems do not necessarily provide sufficient platform for periodic control algorithm utilisation. In addition, application program interfaces found in real-time operating systems are commonly non-existent or provided as chip-support libraries, thus hindering platform independent software development. Hence, two divergent real-time operating systems and additional periodic extension software with the framework design are examined to find solutions for the research problems. The research is discharged by; tracing the selected real-time operating system, formulating requirements for the system, and designing the real-time operating system framework (OSFW). The OSFW is formed by programming the framework and conjoining the outcome with the RTOS and the periodic extension. The system is tested and functionality of the software is evaluated in theoretical context of the Rate Monotonic Scheduling (RMS) theory. The performance of the OSFW and substance of the approach are discussed in contrast to the research theme. The findings of the thesis demonstrates that the forged real-time operating system framework is a viable groundwork solution for periodic control applications.

Tasasähkönjakeluverkon vaihtosuuntaaja galvaanisella erotuksella

Suomessa sähkönjakeluverkko koostuu pääasiassa 20 kV ja 400 V jännitetasoista. Tällöin sähkö viedään lähelle kuluttajia suuremmalla jännitetasolla ja muunnetaan alhaisemmaksi lähellä asiakkaita. Haittapuolena on se, että haja-asutusalueilla jakelumuuntajien määrä kasvaa suureksi, koska ne täytyy sijoittaa lähelle kuluttajaa. Vaihtoehtona on toteuttaa osa sähkönjakelusta tasajännitteellä, jolloin tehollinen jännite olisi suurempi. Tällöin sähköä voitaisiin siirtää pidempiä matkoja ilman, että asiakaskohtaisia tai muutaman asiakkaan kattavia 20 kV siirtolinjoja tarvitsisi käyttää. Tämä taasen edellyttää asiakaskohtaisien vaihtosuuntaajien käyttöä. Tässä työssä esiteltävällä 1 kVA vaihtosuuntaajalla muodostetaan tasasähköjakeluverkosta saatavasta 750 V tasasähköstä yksivaiheista (230 VRMS, 50 Hz) verkkojännitettä. Laite on suunniteltu toteuttamaan galvaaninen erotus mahdollisimman hyvän hyötysuhteen puitteissa. Vaihtosuuntaaja on toteutettu käyttämällä resonanssikonvertteria, joka vaihtosuuntaa jakelujännitteen korkeataajuiseksi vaihtojännitteeksi. Tämän jälkeen toteutetaan galvaaninen erotus käyttäen suurtaajuusmuuntajaa. Tätä seuraa syklokonvertteri, joka pulssintiheysmodulaatiota soveltaen muodostaa lähtöjännitteen. Tämä suodatetaan lopuksi LC- alipäästösuotimella säröltään standardin mukaiseksi. Laite on jaettu työssä kolmeen osaan, joista jokaisen toiminta on selitetty ja simuloitu itsenäisesti. Lopussa koko järjestelmä on simuloitu yhtenä kokonaisuutena. Hyötysuhteeksi arvioitiin karkeasti 94 % ja lopullisista tuloksista voidaan päätellä, että laitteen toteuttaminen prototyypiksi voisi olla kannattavaa.

Permanent Magnet Synchronous Machine for Parallel Hybrid Vehicle

The aim of this thesis is to describe hybrid drive design problems, the advantages and difficulties related to the drive. A review of possible hybrid constructions, benefits of parallel, series and series-parallel hybrids is done. In the thesis analytical and finite element calculations of permanent magnet synchronous machines with embedded magnets were done. The finite element calculations were done using Cedrat’s Flux 2D software. This machine is planned to be used as a motor-generator in a low power parallel hybrid vehicle. The boundary conditions for the design were found from Lucas-TVS Ltd., India. Design Requirements, briefly: • The system DC voltage level is 120 V, which implies Uphase = 49 V (RMS) in a three phase system. • The power output of 10 kW at base speed 1500 rpm (Torque of 65 Nm) is desired. • The maximum outer diameter should not be more than 250 mm, and the maximum core length should not exceed 40 mm. The main difficulties which the author met were the dimensional restrictions. After having designed and analyzed several possible constructions they were compared and the final design selected. Dimensioned and detailed design is performed. Effects of different parameters, such as the number of poles, number of turns and magnetic geometry are discussed. The best modification offers considerable reduction of volume.

Galvaanisen erotuksen toteuttaminen tasavirtasähkönjakelun asiakaspäätelaitteessa

Suomessa sähkönjakeluverkon pääasialliset jännitetasot ovat 20 kV ja 400 V. 20 kV jännitetasolla sähkö viedään lähelle kuluttajia ja muunnetaan pienemmäksi lähellä asiakkaita. Haittapuolena on se, että 20 kV avojohtosähkönsiirtoverkko on hyvin vika-altis ja usein yhden haaran vikaantuessa monta muutakin jää ilman sähköä. Lisäksi hintavien ja suurien jakelumuuntajien määrä on suuri. Vaihtoehtona on toteuttaa osa sähkönjakelusta tasajännitteellä, jolloin tehollinen pienjännite olisi 400 V:a suurempi. Tällöin sähköä voitaisiin siirtää pidempiä matkoja ilman, että asiakaskohtaisia tai muutaman asiakkaan kattavia 20 kV siirtolinjoja tarvitsisi käyttää. Tämä edellyttää vaihtosuuntauksen toteuttamista kuluttajan päässä. Tässä työssä esiteltävällä 1 kVA:n tehoisella vaihtosuuntaajalla muodostetaan tasasähköjakeluverkosta saatavasta 750 V tasasähköstä yksivaiheista (230 VRMS, 50 Hz) verkkojännitettä. Laite on suunniteltu toteuttamaan galvaaninen erotus mahdollisimman hyvällä hyötysuhteella. Suurtaajuusmuuntajan mitoitus mahdollisimman hyvälle hyötysuhteelle on haastava tehtävä, koska vaatimuksia sille asettavat sekä syöttävä resonanssikonvertteri että syötettävä syklokonvertteri. Mitoituksessa on pyrittävä löytämään mahdollisimman hyvä hyötysuhde kustannusten ja toteutettavuuden suhteen.

Distribución espacial de la rugosidad en parcelas agrícolas en Provincia de Buenos Aires - Argentina

O uso de imagens SAR para estimar e monitorar a umidade superficial do solo requer que se considere outros fatores que influenciam na retrodifusão do sinal-radar, entre os quais a rugosidade da cobertura da superfície à escala de centímetro é muito importante. Há diversos métodos para determinar a rugosidade, mas muitos são caros ou de operação de campo complexa. Neste trabalho, é apresentado um método versátil e econômico que usa máquina fotográfica e tela quadrada. Cada fotografia é processada numericamente obtendo a altura RMS, como parâmetro da rugosidade da cobertura. Por meio de técnicas geoestatísticas de krigagem é estimada a distribuição espacial da rugosidade. São mostradas experiências em áreas com cobertura de trigo, localizadas na área agrícola serrana da Província o Buenos Aires, Argentina. Os valores de RMS encontrados (29 mm < RMS < 48 mm) foram analisados com quatro critérios de rugosidade. É expressa sua utilidade para estimar o estado hídrico superficial de solos em áreas agrícolas mediante sua aplicação como entrada (input) nos modelos de retrodispersão de imagens SAR.