Scapulalgie et neuropathie sus-scapulaire en pathologie sportive [Scapular pain and supra-scapular neuropathy in sports medicine]

Eight patients with shoulder pain are reported with a history of athletic activities. On examination, performed with a delay of several months, all patients had painful paresis and atrophy of spinati fossa. Electroneuromyography was carried out in all cases and showed a suprascapular nerve axonal loss from the spinati muscles or infraspinatus muscle, signs of denervation-reinnervation in spinati or infraspinatus muscles, normal examination of other scapular girdle muscles, and a coordinate spinati contraction with shoulder displacement excluding rotator cuff tears. All patients had conservative treatment and only two improved. Six patients underwent surgical decompression of the suprascapular nerve; in three, motor function clearly improved, and in three others pain improved. The factors leading to entrapment include stretch mechanisms associated with shoulder movements, leading to suprascapular nerve liability to mechanical lesions. In patients with shoulder pain, the authors recommend an early electrophysiological work-up to recognize an isolated suprascapular neuropathy. The surgical decompression of the nerve should be based on persistent shoulder pain after conservative treatment.

Differentiation of heroin and cocaine using dual-energy CT-an experimental study.

OBJECTIVE: To evaluate if heroin and cocaine can be distinguished using dual-energy CT. MATERIALS AND METHODS: Twenty samples of heroin and cocaine at different concentrations and standardized compression (SC) were scanned in dual-energy mode on a newest generation Dual Energy 64-row MDCT scanner. CT number, spectral graphs, and dual-energy index (DEI) were evaluated. Results were prospectively tested on six original samples from a body packer. Wilcoxon's test was used for statistical evaluation. RESULTS: Values are given as median and range. Under SC, the CT number of cocaine samples (-29.87 Hounsfield unit (HU) [-125.85; 16.16 HU]) was higher than the CT number of heroin samples (-184.37 HU [-199.81; -159.25 HU]; p < 0.01). Slope of spectral curves for cocaine was -2.36 HU/keV [-7.15; -0.67 HU/keV], and for heroin, 1.75 HU/keV [1.28; 2.5 HU/keV] (p < 0.01). DEI was 0.0352 [0.0081; 0.0528] for cocaine and significantly higher than for heroin samples (-0.0127 [-0.0097; -0.0159]; p < 0.001). While CT number was inconclusive, all six original packs were correctly classified after evaluation of the spectral curve and DEI. In contrast to the CT number, slope of the spectral curve and DEI were independent of concentration and compression. CONCLUSION: The slope of the spectral curve and the DEI from dual-energy CT data can be used to distinguish heroin and cocaine in vitro; these results are independent of compression and concentration in the measured range.

Low-dose radiotherapy (2x2 Gy) in indolent lymphoma

Dans la prise en charge des maladies oncologiques, la priorité est évidemment d'assurer le contrôle de la maladie (soit le taux de récidive local et la survie globale), surtout lorsque celle-ci est diagnostiquée tôt, à un stade précoce. Cependant, lorsque la maladie est plus avancée et que ce contrôle ne peut être assuré de façon raisonnable, l'accent de la prise en charge est surtout axé sur le confort du patient. Le principe est de fournir à celui-ci, dans la mesure du possible, une qualité de vie acceptable, avec notamment des douleurs bien contrôlées.Dans le cadre de ce travail de thèse, nous nous sommes intéressés à la prise en charge palliative des lymphomes non hodgkiniens (LNH) de bas grade. La survie de ces patients peut être relativement longue (de 5 à 10 ans selon les séries), cependant, le traitement est rarement à visée curative, contrairement aux lymphomes de haut grade, dont la survie est bien moindre, mais avec une chance de guérison après un traitement intensif.Plusieurs études cliniques, à la fois prospectives et rétrospectives, ont démontré l'intérêt d'une irradiation à faible dose {2x2 Gy) lors d'atteintes tymphomateuses à l'origine de symptômes gênants (douleurs, compression par une masse, dyspnée, entre autres). Etant donné la facilité d'administration de ce traitement (seulement 2 séances de radiothérapie sont nécessaires), et sa quasi absence de survenue d'effets secondaires avec cette faible dose totale (4 Gy), nous avons voulu y apporter une contribution suisse.Notre étude rétrospective a permis d'inclure 43 patients entre le CHUV et les HUG. Les résultats que nous avons obtenus sont également dans la ligne des autres études parues, avec un excellent contrôle local, soit un soulagement rapide et durable des symptômes dans la majorité des cas.Nous espérons que ce travail de thèse, publié sous forme d'un article dans « International Journal of Radiation Oncology, Biology, Physics », permettra une prise en charge plus optimale des ces patients en leur apportant un traitement facile à administrer, efficace, sans effets secondaires dans la majorité des cas, et pouvant être répété un grand nombre de fois si nécessaire.

Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial.

BACKGROUND: Multislice CT (MSCT) combined with D-dimer measurement can safely exclude pulmonary embolism in patients with a low or intermediate clinical probability of this disease. We compared this combination with a strategy in which both a negative venous ultrasonography of the leg and MSCT were needed to exclude pulmonary embolism. METHODS: We included 1819 consecutive outpatients with clinically suspected pulmonary embolism in a multicentre non-inferiority randomised controlled trial comparing two strategies: clinical probability assessment and either D-dimer measurement and MSCT (DD-CT strategy [n=903]) or D-dimer measurement, venous compression ultrasonography of the leg, and MSCT (DD-US-CT strategy [n=916]). Randomisation was by computer-generated blocks with stratification according to centre. Patients with a high clinical probability according to the revised Geneva score and a negative work-up for pulmonary embolism were further investigated in both groups. The primary outcome was the 3-month thromboembolic risk in patients who were left untreated on the basis of the exclusion of pulmonary embolism by diagnostic strategy. Clinicians assessing outcome were blinded to group assignment. Analysis was per protocol. This study is registered with ClinicalTrials.gov, number NCT00117169. FINDINGS: The prevalence of pulmonary embolism was 20.6% in both groups (189 cases in DD-US-CT group and 186 in DD-CT group). We analysed 855 patients in the DD-US-CT group and 838 in the DD-CT group per protocol. The 3-month thromboembolic risk was 0.3% (95% CI 0.1-1.1) in the DD-US-CT group and 0.3% (0.1-1.2) in the DD-CT group (difference 0.0% [-0.9 to 0.8]). In the DD-US-CT group, ultrasonography showed a deep-venous thrombosis in 53 (9% [7-12]) of 574 patients, and thus MSCT was not undertaken. INTERPRETATION: The strategy combining D-dimer and MSCT is as safe as the strategy using D-dimer followed by venous compression ultrasonography of the leg and MSCT for exclusion of pulmonary embolism. An ultrasound could be of use in patients with a contraindication to CT.

Alternate Methods of Bridge Strengthening, HR-302, 1989

The need for upgrading a large number of understrength and obsolete bridges in the United States has been well documented in the literature. Through the performance of several Iowa DOT projects, the concept of strengthening bridges (simple and continuous spans) by post-tensioning has been developed. The purpose of this project was to investigate two additional strengthening alternatives that may be more efficient than post-tensioning in certain situations. The research program for each strengthening scheme included a literature review, laboratory testing of the strengthening scheme, and a finite-element analysis of the scheme. For clarity the two strengthening schemes are presented separately. In Part 1 of this report, the strengthening of existing steel stringers in composite steel beam concrete-deck bridges by providing partial end restraint was shown to be feasible. Part 2 of this report summarizes the research that was undertaken to strengthen the negative moment regions of continuous, composite bridges. Two schemes were investigated: post-compression of stringers and superimposed trusses within the stringers.

Strengthening of Existing Single Span Steel Beam and Concrete Deck Bridges, HR-238, Part 1, 1983

The Phase I research, Iowa Department of Transportation (IDOT) Project HR-214, "Feasibility Study of Strengthening Existing Single Span Steel Beam Concrete Deck Bridges," verified that post-tensioning can be used to provide strengthening of the composite bridges under investigation. Phase II research, reported here, involved the strengthening of two full-scale prototype bridges - one a prototype of the model bridge tested during Phase I and the other larger and skewed. In addition to the field work, Phase II also involved a considerable amount of laboratory work. A literature search revealed that only minimal data existed on the angle-plus-bar shear connectors. Thus, several specimens utilizing angle-plus-bar, as well as channels, studs and high strength bolts as shear connectors were fabricated and tested. To obtain additional shear connector information, the bridge model of Phase I was sawed into four composite concrete slab and steel beam specimens. Two of the resulting specimens were tested with the original shear connection, while the other two specimens had additional shear connectors added before testing. Although orthotropic plate theory was shown in Phase I to predict vertical load distribution in bridge decks and to predict approximate distribution of post-tensioning for right-angle bridges, it was questioned whether the theory could also be used on skewed bridges. Thus, a small plexiglas model was constructed and used in vertical load distribution tests and post-tensioning force distribution tests for verification of the theory. Conclusions of this research are as follows: (1) The capacity of existing shear connectors must be checked as part of a bridge strengthening program. Determination of the concrete deck strength in advance of bridge strengthening is also recommended. (2) The ultimate capacity of angle-plus-bar shear connectors can be computed on the basis of a modified AASHTO channel connector formula and an angle-to-beam weld capacity check. (3) Existing shear connector capacity can be augmented by means of double-nut high strength bolt connectors. (4) Post-tensioning did not significantly affect truck load distribution for right angle or skewed bridges. (5) Approximate post-tensioning and truck load distribution for actual bridges can be predicted by orthotropic plate theory for vertical load; however, the agreement between actual distribution and theoretical distribution is not as close as that measured for the laboratory model in Phase I. (6) The right angle bridge exhibited considerable end restraint at what would be assumed to be simple support. The construction details at bridge abutments seem to be the reason for the restraint. (7) The skewed bridge exhibited more end restraint than the right angle bridge. Both skew effects and construction details at the abutments accounted for the restraint. (8) End restraint in the right angle and skewed bridges reduced tension strains in the steel bridge beams due to truck loading, but also reduced the compression strains caused by post-tensioning.

Innovative Solutions for Slope Stability Reinforcement and Characterization: Vol. I, TR-489, 2005

Soil slope instability concerning highway infrastructure is an ongoing problem in Iowa, as slope failures endanger public safety and continue to result in costly repair work. Characterization of slope failures is complicated, because the factors affecting slope stability can be difficult to discern and measure, particularly soil shear strength parameters. While in the past extensive research has been conducted on slope stability investigations and analysis, this research consists of field investigations addressing both the characterization and reinforcement of such slope failures. The current research focuses on applying an infrequently-used testing technique comprised of the Borehole Shear Test (BST). This in-situ test rapidly provides effective (i.e., drained) shear strength parameter values of soil. Using the BST device, fifteen Iowa slopes (fourteen failures and one proposed slope) were investigated and documented. Particular attention was paid to highly weathered shale and glacial till soil deposits, which have both been associated with slope failures in the southern Iowa drift region. Conventional laboratory tests including direct shear tests, triaxial compression tests, and ring shear tests were also performed on undisturbed and reconstituted soil samples to supplement BST results. The shear strength measurements were incorporated into complete evaluations of slope stability using both limit equilibrium and probabilistic analyses. The research methods and findings of these investigations are summarized in Volume 1 of this report. Research details of the independent characterization and reinforcement investigations are provided in Volumes 2 and 3, respectively. Combined, the field investigations offer guidance on identifying the factors that affect slope stability at a particular location and also on designing slope reinforcement using pile elements for cases where remedial measures are necessary. The research findings are expected to benefit civil and geotechnical engineers of government transportation agencies, consultants, and contractors dealing with slope stability, slope remediation, and geotechnical testing in Iowa.

Innovative Solutions for Slope Stability Reinforcement and Characterization: Vol. II, TR-489, 2005

Soil slope instability concerning highway infrastructure is an ongoing problem in Iowa, as slope failures endanger public safety and continue to result in costly repair work. While in the past extensive research has been conducted on slope stability investigations and analysis, this current research study consists of field investigations addressing both the characterization and reinforcement of such slope failures. While Volume I summarizes the research methods and findings of this study, Volume II provides procedural details for incorporating an infrequently-used testing technique, borehole shear tests, into practice. Fifteen slopes along Iowa highways were investigated, including thirteen slides (failed slopes), one unfailed slope, and one proposed embankment slope (the Sugar Creek Project). The slopes are mainly comprised of either clay shale or glacial till, and are generally gentle and of small scale, with slope angle ranging from 11 deg to 23 deg and height ranging from 6 to 23 m. Extensive field investigations and laboratory tests were performed for each slope. Field investigations included survey of slope geometry, borehole drilling, soil sampling, in-situ Borehole Shear Testing (BST) and ground water table measurement. Laboratory investigations mainly comprised of ring shear tests, soil basic property tests (grain size analysis and Atterberg limits test), mineralogy analyses, soil classifications, and natural water contents and density measurements on the representative soil samples from each slope. Extensive direct shear tests and a few triaxial compression tests and unconfined compression tests were also performed on undisturbed soil samples for the Sugar Creek Project. Based on the results of field and lab investigations, slope stability analysis was performed on each of the slopes to determine the possible factors resulting in the slope failures or to evaluate the potential slope instabilities using limit equilibrium methods. Deterministic slope analyses were performed for all the slopes. Probabilistic slope analysis and sensitivity study were also performed for the slope of the Sugar Creek Project. Results indicate that while the in-situ test rapidly provides effective shear strength parameters of soils, some training may be required for effective and appropriate use of the BST. Also, it is primarily intended to test cohesive soils and can produce erroneous results in gravelly soils. Additionally, the quality of boreholes affects test results, and disturbance to borehole walls should be minimized before test performance. A final limitation of widespread borehole shear testing may be its limited availability, as only about four to six test devices are currently being used in Iowa. Based on the data gathered in the field testing, reinforcement investigations are continued in Volume III.

Preventing Cracking at Diaphragm/Plate Girder Connections in Steel Bridges, HR-393, 1998

Some of the Iowa Department of Transportation (Iowa DOT) continuous, steel, welded plate girder bridges have developed web cracking in the negative moment regions at the diaphragm connection plates. The cracks are due to out-of-plane bending of the web near the top flange of the girder. The out-of-plane bending occurs in the "web-gap", which is the portion of the girder web between (1) the top of the fillet welds attaching the diaphragm connection plate to the web and (2) the fillet welds attaching the flange to the web. A literature search indicated that four retrofit techniques have been suggested by other researchers to prevent or control this type of cracking. To eliminate the problem in new bridges, AASHTO specifications require a positive attachment between the connection plate and the top (tension) flange. Applying this requirement to existing bridges is expensive and difficult. The Iowa DOT has relied primarily on the hole-drilling technique to prevent crack extension once cracking has occurred; however, the literature indicates that hole-drilling alone may not be entirely effective in preventing crack extension. The objective of this research was to investigate experimentally a method proposed by the Iowa DOT to prevent cracking at the diaphragm/plate girder connection in steel bridges with X-type or K-type diaphragms. The method consists of loosening the bolts at some connections between the diaphragm diagonals and the connection plates. The investigation included selecting and testing five bridges: three with X-type diaphragms and two with K-type diaphragms. During 1996 and 1997, these bridges were instrumented using strain gages and displacement transducers to obtain the response at various locations before and after implementing the method. Bridges were subjected to loaded test trucks traveling in different lanes with speeds varying from crawl speed to 65 mph (104 km/h) to determine the effectiveness of the proposed method. The results of the study show that the effect of out-of-plane loading was confined to widths of approximately 4 in. (100 mm) on either side of the connection plates. Further, they demonstrate that the stresses in gaps with drilled holes were higher than those in gaps without cracks, implying that the drilling hole technique is not sufficient to prevent crack extension. The behavior of the web gaps in X-type diaphragm bridges was greatly enhanced by the proposed method as the stress range and out-of-plane distortion were reduced by at least 42% at the exterior girders. For bridges with K-type diaphragms, a similar trend was obtained. However, the stress range increased in one of the web gaps after implementing the proposed method. Other design aspects (wind, stability of compression flange, and lateral distribution of loads) must be considered when deciding whether to adopt the proposed method. Considering the results of this investigation, the proposed method can be implemented for X-type diaphragm bridges. Further research is recommended for K-type diaphragm bridges.

Fluid-rock interaction during late stages of the Alpine exhumation

Résumé de la thèseLa fracturation des roches au cours de phases compressives ou extensives est un souvent évoquée pour expliquer la circulation de fluide au sein des roches cristallines. Dans le cadre de cette thèse, la circulation des fluides lors de l'exhumation tardive des Alpes a été étudiée en utilisant deux approches différentes: analyses structurales de la déformation fragile d'une part et analyses géochimiques des roches et des minéraux (isotopes stables, datations U/Pb, thermochronologie (U-Th)/He) d'autre part. Cette approche combinée a permis de mieux comprendre l'interaction existante entre les fluides métamorphiques et les fluides météoriques, ainsi que leur interaction avec les roches encaissantes. Le travail a été effectué dans la zone Pennique du Valais suisse.La première partie était focalisée sur la déformation fragile, le but étant de définir les différents types de déformations existantes et de déterminer l'âge relatif des différentes familles de failles. Dans la région d'étude, quatre domaines ont été distingués. Chacun d'eux comportent deux types de structures fragiles, certaines sont minéralisées alors que d'autre non. Au sein de chaque domaine, la direction principale des structures minéralisées correspond à l'orientation des accidents tectoniques majeurs de la région (Aosta- Ranzola Line au Sud, Rhône Line au Nord et Simplon Fault Zone à l'Est), alors que les structures non- minéralisées montrent des orientations plus variables. Ainsi, le premier type de structure est interprété comme résultant d'une dislocation tectonique alors que le deuxième type de structure résulterait d'une dislocation gravitaire locale. Il n'est néanmoins pas possible de classer chronologiquement la formation de ces deux types de structure ni d'attribuer un âge relatif aux changements d'orientation des contraintes majeures.La deuxième étude a été effectuée dans la région de la zone de faille du Simplon. Dans cette zone, la composition isotopique des minéraux ayant cristallisé à l'intérieur des fractures tardives permet de distinguer différents types de circulation de fluide. Les valeurs δ180 du quartz de la roche encaissante ainsi que ceux des veines tardives du bloque inférieur de la faille sont comparables. Ces valeurs indiquent un rééquilibrage et un tamponnage isotopique des fluides tardifs au contact de la roche encaissante lors de la fracturation de cette dernière et de la cristallisation des veines tardives. La même situation est observée dans la partie nord du bloque supérieur ainsi que dans sa partie sud. Ceci n'est néanmoins pas le cas pour la partie centrale du bloque supérieur où les valeurs isotopiques des minéraux dans les veines tardives sont approximativement 3 %o plus basses (avec des valeurs extrêmes négatifs), indiquant une contribution d'eau météorique aux fluides circulant dans les veines. Ces données suggèrent qu'une infiltration d'eau météorique a pu avoir lieu dans le bloque supérieur, où la fracturation des roches est plus intensive car le déplacement relatif le long de la faille y fut plus important, et la température maximale du métamorphisme plus basse. La troisième contribution traite de la géo-thermochronologie de la zone de contact entre la klippe de la Dent Blanche et la nappe de Tsaté. De petits zircons euhédraux ont été trouvés dans un plan de faille minéralisé (parallèle à la Faille du Rhône, voir première partie de l'étude), riche en hématite et quartz, de la zone d'étude. Les analyses U/Pb donnent des âges radiométriques autour de 270 - 280 Ma aux zircons extraits de la minéralisation ainsi que ceux extraits de la roche encaissante, ce qui correspond à l'âge de la nappe de la Dent Blanche et non celui de la nappe du Tsaté qui est elle-même classiquement interprétée comme une ophiolite Jurassique de l'Océan Liguro-Piémontais. Ces données suggèrent que les zircons contenus dans la veine ont été hérités de la roche encaissante. Les résultats (U-Th)/He indiquent un âge de refroidissement différent pour la roche encaissante (25.5 ± 2.0 Ma) que celui de la minéralisation (17.7 ±1.4 Ma). Le thermomètre isotopique quartz-hématite indique une température d'équilibre, et donc de mise en place de la minéralisation, d'environ 170 °C, température très proche de la température de -180 °C de fermeture du zircon pour le système (U-Th)/He. Ceci suggère que l'âge de refroidissement des zircons de la minéralisation correspond aussi à l'âge de formation de la faille.Thesis abstractFluid circulation in fractured rocks is a common process in geology, and it is generally the consequence of faulting and fracturing during both tectonic compression and extension. This thesis is focused on fluid circulation during late stages of the Alpine exhumation. After a structural analysis of the late brittle deformation of the studied samples, several analytical methods (stable isotope investigations, U/Pb radiometric dating, (U-Th)/He thermochronology) have been applied to understand the interaction of metamorphic and meteoric fluids with one another as well as with the host rock. This thesis is articulated around three study directions. All studies were conducted in the Penninic Zone of the Valais, Switzerland. The first study deals with late, brittle deformation and focuses on the different deformation styles and on the relative age of the different families of fractures. In order to do this, late brittle structures observed in four different domains have been subdivided as a function of the existence (or not) and type of mineralization. Comparisons between mineralized and non-mineralized strike directions for all four domains show that mineralized structures follow the strike orientation of major tectonic movements indicated in the Penninic Zone of the Valais (Aosta-Ranzola Line to the S, Rhône Line to the Ν and Simplon Fault Zone to the E), whereas non-mineralized fractures have a more variable strike orientation. This difference could be interpreted as indicative of tectonic-related faulting (mineralized structures) vs. local, collapse-related faulting (non-mineralized fractures), but it is not strong enough to indicate a relative age of the late brittle structures, and/or a change in the orientation of the strain field in post-Miocene times. The second studied area is focused on the Simplon Fault Zone (SFZ). Stable isotope analyses of minerals filling these late fractures indicate that there are two different fluid circulation systems in the footwall and hanging wall of the SFZ. In the footwall, δ180 values of quartz from both the host rock and the late veins range from +10 %o to +12 %o. This is consistent with buffering of circulating fluids by the host rock during fracturing and vein precipitation. In the hanging wall, δΙ80 values for quartz crystals from the host rock and the late veins are similar in both the northern and southern parts of the detachment that are both affected by the same degree of metamorphism (greenschist to the Ν and amphibolite to the S). This is not the case in the central part of the SFZ, where there is a jump from amphibolite facies in the footwall to greenschist facies in the hanging wall. δ,80 values for quartz from the hanging wall late veins are approximately 3.0 %o lower (down to negative values in some cases) than the values observed in the footwall These data suggest that infiltration of meteoric water may have occurred in the most fractured parts of the hanging wall, where relative displacement on the SFZ was the greatest and the peak temperature lower. In the less fractured footwall the δ180 values reflect a host rock-buffered system.The third study is focused on geo-thermochronology at the contact between the Dent Blanche nappe and the Tsaté nappe where small, euhedral zircons were found in a hematite- and quartz-rich mineralization on a late normal fault plane parallel to the Rhône Line (see first part of the study). U/Pb analysis indicates that the zircons - both in the late mineralization and in the host rock - have absolute radiometric ages clustering around 270 - 280 Ma, which is the accepted age for intrusive rocks from the Austroalpine Dent Blanche units but not for the Tsaté nappe. The latter is classically interpreted as an ophiolitic remnant of the Jurassic Liguro-Piemontais Ocean. U/Pb analyses suggest that zircons in late mineralization are all inherited from the host rock; however, results of (U-Th)/He analyses indicate that cooling ages for the host rocks are different to the cooling ages for the zircons in late mineralization. Indeed, the calculated cooling age for the Arolla gneiss is 25.5 ± 2.0 Ma, whilst the cooling age for the associated mineralized fault plane is 17.7 ±1.4 Ma. Oxygen stable isotope fractionation between quartz and hematite in the same late mineralization corresponds to temperatures of about 170 °C. The proximity of the calculated emplacement temperature for the mineralization and the lower accepted closure temperature for zircon in the (U-Th)/He system (-180 °C) imply that the age of 17.7 ± 1.4 Ma can also be interpreted as the formation age of this late brittle fault.Résumé grand publicLa circulation des fluides dans les roches fracturées est typique de nombreux processus géologiques, et très souvent est la conséquence de la fracturation des roches. Cette thèse aborde la question de la circulation des fluides pendant les dernières phases du soulèvement des Alpes. Après une analyse structurale de la fracturation directement sur le terrain, plusieurs méthodes géochimiques ont été appliquées pour comprendre l'interaction entre les différents fluides circulants, et avec leur propre roche mère. L'étude, concentrée sur trois directions principales, a été conduite dans la zone Pennique du Valais suisse. La première partie traite de la déformation cassante dans le secteur cité. L'analyse détaillée des fractures a permis de les subdiviser en structures minéralisées et non-minéralisées, sur quatre domaines différents. La comparaison entre les directions des structures minéralisées et non-minéralisées a permis de montrer que les premières suivent l'orientation des accidents tectoniques majeurs de la région, alors que les structures non- minéralisées ont une orientation plus variable. Cette différence pourrait être interprétée comme indication d'une dislocation tectonique (structures minéralisées) contre une dislocation gravitaire locale (structures non-minéralisées), mais elle n'est pas assez forte pour indiquer un âge relatif des structures tardives et/ou un changement de l'orientation des contraintes après -20 Ma vers le présent.A partir de ces observations, la deuxième étude est concentrée dans la région de la faille du Simplon. Les analyses géochimiques sur les minéraux remplissant les structures tardives indiquent qu'il y a deux différents systèmes de circulation des fluides dans les deux parties (toit et mur) de la faille. Dans le mur, les valeurs isotopiques des minéraux cristallisés à partir d'un fluide tardif sont les mêmes de ceux de la roche mère, donc il y a eu rééquilibration chimique entre fluide et roche pendant la fracturation de cette dernière et la précipitation des minéraux. Dans le toit, les valeurs isotopiques dans la roche mère et dans les minéraux des veines tardives sont comparables dans les parties Ν et S de la faille, où les roches du toit et du mur ont atteint une température maximale - pendant phase prograde de la formation des Alpes - comparable. Au contraire, dans la partie centrale, où le mur a atteint des températures maximales plus élevées par rapport au toit, les valeurs géochimiques des minéralisations tardives du toit sont parfois plus basses que les valeurs observées dans le mur. Ces données suggèrent que l'infiltration de l'eau de surface aurait pu se produire dans la partie plus fracturée du toit, où le déplacement relatif le long de la faille était majeur et les températures maximales mineures. Au contraire, les données géochimiques du mur de la partie centrale indiquent un système isotopique équilibré par la roche mère.La troisième partie de ce travail se base sur l'étude géochimique intégrée des isotopes stables d'Oxygène et radioactifs du Plomb, Uranium, Thorium et Hélium, auprès d'une faille normale minéralisée et des roches de la région à cheval entre deux nappes, la nappe de la Dent Blanche et la nappe de Tsaté. Ici, des petits zircons ont été trouvés dans la minéralisation citée, riche en hématite et quartz. L'analyse radiométrique Uranium/Plomb a montré que les zircons dans la minéralisation et dans les roches autour ont des âges comparables (autour 280 Ma). Cela signifie que les zircons dans la minéralisation tardive ont été hérités de la roche mère pendant la fracturation et la circulation des fluides tardives. De l'autre coté, les résultats des analyses Uranium-Thorium/Hélium indiquent que les âges de refroidissement pour les roches mères sont différents comparés aux âges de refroidissement pour les zircons dans la minéralisation tardive: ces derniers sont plus jeunes d'environ 8 Ma (autour 25 Ma et autour 17 Ma respectivement). Les analyses des isotopes de l'oxygène sur quartz et hématite dans la même minéralisation donnent une température de mise en place de cette dernière d'environ 170° C. La température de fermeture du système chimique des zircons dans le système (Uranium-Thorium)/Hélium est d'environ 180 °C: la proximité de ces deux températures implique que l'âge de refroidissement de la minéralisation tardive peut également être interprété comme âge de formation de la faille.

Metric Short Course for the Office of Bridges and Structures, HR-378, 1995

This metric short course was developed in response to a request from the Office of Bridges and Structures to assist in the training of engineers in the use of metric units of measure which will be required in all highway designs and construction after September 30, 1996 (CFR Presidential Executive Order No. 12770). The course notes which are contained in this report, were developed for a half-day course. The course contains a brief review of metrication in the U.S., metric units, prefixes, symbols, basic conversions, etc. The unique part of the course is that it presents several typical bridge calculations (such as capacity of reinforced concrete compression members, strength of pile caps, etc.) worked two ways: inch-pound units throughout with end conversion to metric and initial hard conversion to metric with metric units throughout. Comparisons of partial results and final results (obtained by working the problems the two ways) are made for each of the example problems.

Lime or Chloride Treatment of Granular Base Course Materials, HR-99

Results are presented of triaxial testing of three crushed limestones to which either hydrated high-calcium lime, sodium chloride or calcium chloride had been added. Lime was added at rates of 1, 3, 10 and 16 percent, chlorides were added at 0.5 percent rate only. Speciments were compacted using vibratory compaction apparatus and were tested in triaxial compression using lateral pressures from 10 to 100 psi. Triaxial test results indicate that: (1) sodium chloride slightly decreased the angle of internal friction and increased cohesion, (2) calcium chloride slightly increased the angle of internal friction and decreased cohesion, and (3) lime had no appreciable effect on angle of internal friction but increased cohesion, decreased density and increased pore water pressure.

Void Ratio and Shear Strength of Two Compacted Crushed Stones, Progress Report, HR-99

Triaxial compression tests of two crushed limestones of differing highway service records indicate a fundamental difference in their shear strength -- void ratio relationship. Analyses were based on stress parameters at minimum sample volume, i.e., before there was significant sample dilation due to shear. The better service record sample compacted to higher density, and had a high effective angle of internal friction and zero effective cohesion. The other sample compacted to lower density and had a lower friction angle, but gained significant stability from effective cohesion. Repeated loading-unloading cycles reduced the cohesion, apparently due to modification of the sample structure. Extrapolations of the results to zero void ratio agree with sliding friction data reported on calcite, or with triaxial parameters reported on carbonate rocks.

Fast Track and Fast Track II Cedar Rapids, Iowa, HR-544, 1993

Two lanes of a major four-lane arterial street in Cedar Rapids, Iowa, needed reconstruction. Because of the traffic volume and the detour problem, closure of the intersections, even for 1 day was not feasible. Use of Fast Track concrete paving on the mainline portion of the project permitted achievement of the opening strength of 400 psi in less than 12 hr. Fast Track II, used for the intersections, achieved the opening strength of 350 psi in 6 to 7 hr. Flexural and compression specimens of two sections each in the Fast Track and Fast Track II sections were subjected to pulse velocity tests. Maturity curves were developed by monitoring the temperatures. Correlations were performed between the pulse velocity and flexural strength and between the maturity and flexural strength. The project established the feasibility of using Fast Track II to construct portland cement concrete pavement at night and opening the roadway to traffic the next day.

Entorse aiguë de la Cheville: quelle immobilisation [Acute ankle sprain: which immobilization?]

Acute ankle sprain is the most frequent orthopaedic injury. Up to 4% of patients admitted to the emergency room will present with an acute ankle sprain. The lateral ligaments are involved at various degrees (anterior talo-fibular and calcaneo-fibular ligaments). Grade I acute ankle sprains are well treated with a compression bandage or an Aircast brace. Grade II and III acute ankle sprains are best treated with a below-knee cast. The Aircast brace is the next best treatment for such lesions (grades II and III) and will provide satisfactory support, but has been shown to be not as effective as the below-knee cast in terms of short to mid-term patients outcome (pain and function).