L'oeil, aux carrefours de l'humain

« Les yeux sont du visage humain la partie la plus noble et la plus importante, les yeux sont composés de corps, d'âme et d'esprit, ou plutôt les yeux sont la fenêtre où l'âme et l'esprit viennent se montrer » (Alphonse Karr, 1853). L'oeil est le regard, mais pour l'ophtalmologue il est aussi une fenêtre ouverte et un regard possible sur le reste du corps. Prolongement du système nerveux central en contact direct avec le monde extérieur dont il est l'un des « senseurs » le plus subtil et le plus complexe, il est sujet à des réactions inflammatoires, allergiques et toxiques chez l'enfant et chez l'adulte. Alors que notre environnement visuel change (modification des systèmes d'éclairage domestique dans les villes, écrans, mode de vie et habitudes de travail), que les polluants se multiplient et se combinent et que les environnements climatisés deviennent la règle, le nombre de patients souffrant de pathologies de la surface oculaire atteint 30 % des motifs de nos consultations et le nombre des patients myopes est en hausse. L'oeil est l'un des « senseurs » le plus subtil et le plus complexe Si la surface oculaire peut aussi être le témoin des pathologies systémiques, c'est la rétine qui en est plus fréquemment le reflet. Les atteintes du lit vasculaire, du nerf optique ou de la rétine peuvent être des manifestations de pathologies générales ou d'effets secondaires ou toxiques de médicaments. L'examen du fond d'oeil et la rétinophotographie restent les examens de dépistage de référence en particulier pour la rétinopathie diabétique, véritable fléau mondial et première cause de cécité dans les pays industrialisés chez les jeunes adultes. Mais ce n'est que par la collaboration entre ophtalmologues, médecins traitants et autres spécialistes que les pathologies rétiniennes peuvent être prises en charge de façon optimale pour qu'à des traitements oculaires spécifiques soit associée la prise en charge globale des maladies causales ou interférentes. Au-delà du fond d'oeil, les progrès technologiques contribuent au développement de multiples méthodes d'exploration des différentes structures de l'oeil offrant ainsi la possibilité d'utiliser l'oeil comme témoin de manifestations précoces de maladies neurologiques périphériques ou centrales. L'imagerie cornéenne semble aujourd'hui capable de révéler et de suivre de façon longitudinale la neuropathie diabétique périphérique et il n'est pas impossible que la rétine devienne le site de détection précoce de la maladie d'Alzheimer. Sur le plan de la prise en charge, l'ophtalmologue ne peut pas se contenter de traiter l'oeil, il doit aussi assurer une prise en charge pluridisciplinaire et accompagner le patient qui, perdant la vision, est sujet à la dépression et à la majoration de tout autre handicap. La perte visuelle est le handicap le plus redouté des populations et la perte d'autonomie qu'il induit limite l'observance et le suivi thérapeutique (comparable en termes de gravité ressentie à un « alitement brutal dans les suites d'un AVC »). La médecine personnalisée et les interactions multidisciplinaires prennent ici tout leur sens. Les développements thérapeutiques ont été majeurs ces dernières années et la cécité n'est plus une fatalité, au moins dans certains cas. Mais la rétine étant un tissu nerveux post-mitotique, les traitements et donc le dépistage doivent être précoces pour prévenir la perte visuelle irréversible. Spécifiquement, les espoirs lointains comme la thérapie génique entrent dans les essais cliniques laissant entrevoir la lumière au bout du tunnel. A portée de vue, la rétine artificielle constitue une avancée concrète, encore perfectible mais accessible dès aujourd'hui. Si les progrès sont manifestes dans le domaine de l'ophtalmologie, il reste encore beaucoup à apprendre et à comprendre en particulier dans les mécanismes pathogéniques multifactoriels des maladies oculaires plus fréquentes. Seule une exploration approfondie des maladies humaines pourra nous permettre de mieux appréhender de nouvelles stratégies thérapeutiques. Comme le disait André Isaac (1893-1975), pour voir loin, il faut regarder de près.

Hardcopy quality parameters to ensure structures detection at digital mammography

Objective To develop procedures to ensure consistency of printing quality of digital images, by means of hardcopy quantitative analysis based on a standard image. Materials and Methods Characteristics of mammography DI-ML and general purpose DI-HL films were studied through the QC-Test utilizing different processing techniques in a FujiFilm®-DryPix4000 printer. A software was developed for sensitometric evaluation, generating a digital image including a gray scale and a bar pattern to evaluate contrast and spatial resolution. Results Mammography films showed maximum optical density of 4.11 and general purpose films, 3.22. The digital image was developed with a 33-step wedge scale and a high-contrast bar pattern (1 to 30 lp/cm) for spatial resolution evaluation. Conclusion Mammographic films presented higher values for maximum optical density and contrast resolution as compared with general purpose films. The utilized digital processing technique could only change the image pixels matrix values and did not affect the printing standard. The proposed digital image standard allows greater control of the relationship between pixels values and optical density obtained in the analysis of films quality and printing systems.

The analgesic efficacy of ultrasound-guided transversus abdominis plane block (TAP Block) in adult patients : a meta-analysis

Introduction : Le bloc transverse de l'abdomen (bloc TAP, Transversus Abdominis Plane) échoguidé consiste en l'injection d'anesthésique local dans la paroi abdominale entre les muscles oblique interne et transverse de l'abdomen sous contrôle échographique. Ceci permet de bloquer l'innervation sensitive de la paroi antérolatérale de l'abdomen afin de soulager la douleur après des interventions chirurgicales. Auparavant, cette procédure reposait sur une technique dite « à l'aveugle » qui utilisait des repères anatomiques de surface. Depuis quelques années, cette technique est effectuée sous guidage échographique ; ainsi, il est possible de visualiser les structures anatomiques, l'aiguille et l'anesthésique local permettant ainsi une injection précise de l'anesthésique local à l'endroit désiré. Les précédentes méta- analyses sur le bloc TAP n'ont inclus qu'un nombre limité d'articles et n'ont pas examiné l'effet analgésique spécifique de la technique échoguidée. L'objectif de cette méta-analyse est donc de définir l'efficacité analgésique propre du bloc TAP échoguidé après des interventions abdominales chez une population adulte. Méthode : Cette méta-analyse a été effectuée selon les recommandations PRISMA. Une recherche a été effectuée dans les bases de donnée MEDLINE, Cochrane Central Register of Controlled Clinical Trials, Excerpta Medica database (EMBASE) et Cumulative Index to Nursing and Allied Health Literature (CINAHL). Le critère de jugement principal est la consommation intraveineuse de morphine cumulée à 6 h postopératoires, analysée selon le type de chirurgie (laparotomie, laparoscopie, césarienne), la technique anesthésique (anesthésie générale, anesthésie spinale avec/ou sans morphine intrathécale), le moment de l'injection (début ou fin de l'intervention), et la présence ou non d'une analgésie multimodale. Les critères de jugement secondaires sont, entre autres, les scores de douleur au repos et à l'effort à 6 h postopératoires (échelle analogique de 0 à 100), la présence ou non de nausées et vomissements postopératoires, la présence ou non de prurit, et le taux de complications de la technique. Résultats : Trente et une études randomisées contrôlées, incluant un total de 1611 adultes ont été incluses. Indépendamment du type de chirurgie, le bloc TAP échoguidé réduit la consommation de morphine à 6 h postopératoires (différence moyenne : 6 mg ; 95%IC : -7, -4 mg ; I =94% ; p<0.00001), sauf si les patients sont au bénéfice d'une anesthésie spinale avec morphine intrathécale. Le degré de réduction de consommation de morphine n'est pas influencé par le moment de l'injection (I2=0% ; p=0.72) ou la présence d'une analgésie multimodale (I2=73% ; p=0.05). Les scores de douleurs au repos et à l'effort à 6h postopératoire sont également réduits (différence moyenne au repos : -10 ; 95%IC : -15, -5 ; I =92% ; p=0.0002; différence moyenne en mouvement : -9 ; 95%IC : -14, -5 ; I2=58% ; p<0. 00001). Aucune différence n'a été retrouvée au niveau des nausées et vomissements postopératoires et du prurit. Deux complications mineures ont été identifiées (1 hématome, 1 réaction anaphylactoïde sur 1028 patients). Conclusions : Le bloc TAP échoguidé procure une analgésie postopératoire mineure et ne présente aucun bénéfice chez les patients ayant reçu de la morphine intrathécale. L'effet analgésique mineure est indépendant du moment de l'injection ou de la présence ou non d'une analgésie multimodale.

Security Authentication using Phase-Encoded Nanoparticle Structures and Polarized Light

Phase encoded nano structures such as Quick Response (QR) codes made of metallic nanoparticles are suggested to be used in security and authentication applications. We present a polarimetric optical method able to authenticate random phase encoded QR codes. The system is illuminated using polarized light and the QR code is encoded using a phase-only random mask. Using classification algorithms it is possible to validate the QR code from the examination of the polarimetric signature of the speckle pattern. We used Kolmogorov-Smirnov statistical test and Support Vector Machine algorithms to authenticate the phase encoded QR codes using polarimetric signatures.

Many valued algebraic structures as measures of comparison

This thesis studies the properties and usability of operators called t-norms, t-conorms, uninorms, as well as many valued implications and equivalences. Into these operators, weights and a generalized mean are embedded for aggregation, and they are used for comparison tasks and for this reason they are referred to as comparison measures. The thesis illustrates how these operators can be weighted with a differential evolution and aggregated with a generalized mean, and the kinds of measures of comparison that can be achieved from this procedure. New operators suitable for comparison measures are suggested. These operators are combination measures based on the use of t-norms and t-conorms, the generalized 3_-uninorm and pseudo equivalence measures based on S-type implications. The empirical part of this thesis demonstrates how these new comparison measures work in the field of classification, for example, in the classification of medical data. The second application area is from the field of sports medicine and it represents an expert system for defining an athlete's aerobic and anaerobic thresholds. The core of this thesis offers definitions for comparison measures and illustrates that there is no actual difference in the results achieved in comparison tasks, by the use of comparison measures based on distance, versus comparison measures based on many valued logical structures. The approach has been highly practical in this thesis and all usage of the measures has been validated mainly by practical testing. In general, many different types of operators suitable for comparison tasks have been presented in fuzzy logic literature and there has been little or no experimental work with these operators.

The morphology and reproductive structures of Mediterranean species of the genus Nemastoma J. Agardh, nom. cons. (Nemastomataceae, Nemastomatales): Nemastoma dichotomum and N. dumontioides

The morphology and reproductive structures of Mediterranean species of the genus Nemastoma J. Agardh, nom. cons. (Nemastomataceae, Nemastomatales): Nemastoma dichotomum and N. dumontioides

Group preference structures in AHP–group decision making

This paper presents a procedure that allows us to determine the preference structures(PS) associated to each of the different groups of actors that can be identified in a groupdecision making problem with a large number of individuals. To that end, it makesuse of the Analytic Hierarchy Process (AHP) (Saaty, 1980) as the technique to solvediscrete multicriteria decision making problems. This technique permits the resolutionof multicriteria, multienvironment and multiactor problems in which subjective aspectsand uncertainty have been incorporated into the model, constructing ratio scales correspondingto the priorities relative to the elements being compared, normalised in adistributive manner (wi = 1). On the basis of the individuals’ priorities we identifydifferent clusters for the decision makers and, for each of these, the associated preferencestructure using, to that end, tools analogous to those of Multidimensional Scaling.The resulting PS will be employed to extract knowledge for the subsequent negotiationprocesses and, should it be necessary, to determine the relative importance of thealternatives being compared using anyone of the existing procedures

Contribution of subcortical structures to cognition assessed with invasive electrophysiology in humans

Implantation of deep brain stimulation (DBS) electrodes via stereotactic neurosurgery has become a standard procedure for the treatment of Parkinson's disease. More recently, the range of neuropsychiatric conditions and the possible target structures suitable for DBS have greatly increased. The former include obsessive compulsive disease, depression, obesity, tremor, dystonia, Tourette's syndrome and cluster-headache. In this article we argue that several of the target structures for DBS (nucleus accumbens, posterior inferior hypothalamus, nucleus subthalamicus, nuclei in the thalamus, globus pallidus internus, nucleus pedunculopontinus) are located at strategic positions within brain circuits related to motivational behaviors, learning, and motor regulation. Recording from DBS electrodes either during the operation or post-operatively from externalized leads while the patient is performing cognitive tasks tapping the functions of the respective circuits provides a new window on the brain mechanisms underlying these functions. This is exemplified by a study of a patient suffering from obsessive-compulsive disease from whom we recorded in a flanker task designed to assess action monitoring processes while he received a DBS electrode in the right nucleus accumbens. Clear error-related modulations were obtained from the target structure, demonstrating a role of the nucleus accumbens in action monitoring. Based on recent conceptualizations of several different functional loops and on neuroimaging results we suggest further lines of research using this new window on brain functions.

Time-Resolved Photoluminescence in Antimonide and Dilute Nitride Quantum Well Structures

This Master's thesis is devoted to semiconductor samples study using time-resolved photoluminescence. This method allows investigating recombination in semiconductor samples in order to develop quality of optoelectronic device. An additional goal was the method accommodation for low-energy-gap materials. The first chapter gives a brief intercourse into the basis of semiconductor physics. The key features of the investigated structures are noted. The usage area of the results covers saturable semiconductor absorber mirrors, disk lasers and vertical-external-cavity surface-emittinglasers. The experiment set-up is described in the second chapter. It is based on up-conversion procedure using a nonlinear crystal and involving the photoluminescent emission and the gate pulses. The limitation of the method was estimated. The first series of studied samples were grown at various temperatures and they suffered rapid thermal annealing. Further, a latticematched and metamorphically grown samples were compared. Time-resolved photoluminescence method was adapted for wavelengths up to 1.5 µm. The results allowed to specify the optimal substrate temperature for MBE process. It was found that the lattice-matched sample and the metamorphically grown sample had similar characteristics.

Crystal structures of 5-chloro-2-methoxybenzoates of Mn(II), Co(II), Ni(II) and Zn(II)

The crystal and molecular structures of [bis(5-chloro-2-methoxybenzoate)tetraaquamanganese(II)], [pentaaqua(5-chloro-2-methoxybenzoato)cobalt(II)] (5-chloro-2-methoxybenzoate), [pentaaqua(5-chloro-2-methoxybenzoato)nickel(II)] (5-chloro-2-methoxybenzoate) and [aquabis(5-chloro-2-methoxybenzoate)zinc(II)] monohydrate were determined by a single-crystal X-ray analysis. Mn(H2O)4L2 (where L = C8H6ClO3) crystallizes in the monoclinic system, space group P21/c. [Co(H2O)5L]L and [Ni(H2O)5L]L both are isostructural, space group P212121. The crystals of [Zn(H2O)L2] H2O are monoclinic, space group Pc. Mn(II) ion is positioned at the crystallographic symmetry center. Mn(II) and Co(II) ions adopt the distorted octahedral coordination but Zn(II) tetrahedral one.The carboxylate groups in the complexes with M(II) cations function as monodentate, bidentate and/or free COO-groups. The ligands exist in the crystals as aquaanions. The complexes of 5-chloro-2-methoxybenzoates with Mn(II), Co(II) and Zn(II) form bilayer structure.

Network Structures and Modularity among Biofuel Heating System Manufacturers

The aim of this thesis was to study network structures and modularity among biofuel heating system manufacturers in the Finnish bioenergy sector by utilizing the perspectives of numerous Finnish bioenergy specialists. The study is qualitative due to the fact that the research material was gathered with semi-structured theme interviews during May and June 2010. The research methodology used in the thesis combines conceptual and action-oriented approach. Networks, value nets, and modularity were studied from different perspectives. Three network and platform strategies were discovered and a general network structure was formed. Moreover, benefits and disadvantages of networks and modularity among biofuel heating system manufacturers were illustrated. The analysis provides a comprehensive perception of the industry. The results of the research were constructed by implementing existing theories into practice. Also future recommendations for the biofuel heating system manufacturers were given. The results can be considered to be beneficial because the number of previous studies about the subject is relatively small. The reliability of the study is eminent because the number of the interviews was inclusive.

The structures of the honeydew oligosaccharides synthesized by Claviceps africana

The structures of the principal oligosaccharides in the honeydew exudate of the sorghum ergot pathogen Claviceps africana, which has become epidemic in the Americas, have been characterized through linkage analysis using FAB-MS and GC-MS techniques, as 1,6-di-b-D-fructofuranosyl-D-mannitol and 1,5-di-b-D-fructofuranosyl-D-arabitol trisaccharides, 1-b-D-fructofuranosyl-D-mannitol and 5-b-D-fructofuranosyl-D-arabitol disaccharides and other minor disaccharides and trisaccharides. Their structural diversity is explained according to perceived biosynthetic interrelationships in pathways that appear to be unique amongst ergot fungi, particularly concerning intra-molecular reduction of fructose. The oligosaccharide, 1,6-di-b-D-fructofuranosyl-D-mannitol, which inhibits C. africana macrospore germination at a concentration in water of 1 g/mL or more, forms together with other slightly less bioactive oligosaccharides, the basis of a novel strategy to limit ergot disease losses in hybrid sorghum seed production.

Advanced welding technologies used for arctic metal structures

Rapid depletion of easy-to-access fossil fuel, predominantly, oil and gas resources has now necessitated increase in need to develop new oil and gas sources in ever more remote and hostile environments. This is necessary in order to explore more oil and gas resources to meet rapidly rising long-term energy demand in the world, both at present and in the nearest future. Arctic is one of these harsh environments, where enormous oil and gas resources are available, containing about 20% of the world total oil and gas, but the environmental conditions are very harsh and hostile. However, virtually all the facilities required for the exploration and development of this new energy source are constructed with metals as well as their alloys and are predominantly joined together by welding processes and technologies. Meanwhile, due to entirely different environment from the usual moderate temperate region, conventional welding technologies, common metals and their alloys cannot be applied as this Arctic environment demand metals structures with very high toughness and strength properties under extremely low temperature. This is due to the fact that metals transit from ductility to brittleness as the temperature moves toward extreme negative values. Hence, this research work investigates and presents the advanced welding technologies applicable to Arctic metal structures which can give satisfactory weldments under active Arctic service conditions. .