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Search Results: 1 - 10 of 219496 matches for " C. Letoublon "
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LIVER CONTUSIONS: PRINCIPLES OF SURGICAL TECHNIQUE AND TACTICS
C. Letoublon,Catherine Arvieux
Jurnalul de Chirurgie , 2005,
Abstract: The prognostic of the liver trauma is conditioned by the type of the hepatic injuries. Their anatomic and hemorhagic characteristics will influence the kind of treatment: emergency laparotomy or non-surgical treatment. The most important condition for a non-surgical treatment of the liver trauma is a stable patient. Operative option is indicated for unstable patients, when there are other visceral injuries or when the surgical unit hasn't accurate imagistics posssibilities. For optimal operative management of the liver trauma, some principles need to be followed: 1) the patient is positioned with the arms at right angles on arm boards, wich allowes better access to intravenous or intraarterial lines; 2) skin preparation is for a toarco-abdominal approach; 3) the primary incision is a midline one wich can be branched with a right transverse. After laparotomy there are two situations: liver injuries without or with active haemorrhage. For the first situation, evacuation of the hemoperitoneum, lavage and drainge are the only procedures indicated. For the second types of injuries we also describe favorable and unfavorable injuries. When the hand compression of the liver is effective and hepatic injury is anterior, the hemostasis after clampage of the hepatic pedicle (Pringle maneuver) is indicated. Perihepatic packing is indicated in case of choagulopaty. Hepatic resection it isn't recommended. The unfavorable situation is association of acidose-hypotermia and choagulopaty wich cause a "biological hemorrhage". In this cases are indicated"abbreviated laparotomy" with perihepatic packing (damage control) and planned reoperation or arterial embolisation (interventional radiology). When the clampage of the hepatic pedicle it isn't efficient, probably a hepatic vein is injured and a a perihepatic packing is also indicated. The unefficiency of the perihepatic packing, the clampage of the hepatic pedicle + inferior vena cava (under and above the liver) ± aorta it is necessary to stop the active bleeding. The closure of the laparotomy it is necessary to be made very fast, especially for the "abbreviated laparotomy". In the case of trauma of the main hepatic duct an external billiary drainage it is recommended. The reoperation it is indicated in some cases: intraabdominal hyperpression syndrome, perihepatic packing, other intraabdominal complications. Conclusion: The prognostic of the liver trauma depends by the anatomical type of the injuries. Operative management of the liver trauma is very difficult. The clampage of the hepatic pedicle (with or without vena cava
LIVER CONTUSIONS: INDICATIONS FOR NON OPERATIVE APPROACH
C. Letoublon,Catherine Arvieux
Jurnalul de Chirurgie , 2005,
Abstract: The most important condition for a conservative treatment of the liver trauma is a stable patient. Ultrasound and computerized tomography (CT) examinations are essential for the investigation of abdominal trauma. These explorations allow visualization of solid organ anatomy and have the ability to grade and quantify the livers' injuries (Mirvis classification). After the first exploration and the decision for initial non-operative approach, the patients will be followed in the intensive care unit (hemodynamic status, biological exploration, CT or ultrasonography). In this second survey period it is possible to appear complications (hemorrhage, peritonitis, intra-abdominal hyper-pressure syndrome etc.) and emergency laparotomy can be necessary. The overall mortality for non operative approach is about 9%, and direct mortality is under 1%. Secondary operations are necessary in 7-10% from these patients. Interventional radiology techniques and endoscopic procedures (such as endoscopic retrograde cholangio-pancreatography) allowed the reduction of the secondary surgical interventions. Hospital stay depends by the grade of the liver injury. Long term follow-up it is necessary; some cystic image can appear in the liver parenchyma at CT exam after months or years from the trauma, but without clinical significance.
LIVER CONTUSIONS. DECISIONS AT ARRIVALS: THE RESUSCITATION AND EVALUATION OR LAPAROTOMY
C. Letoublon,Catherine Arvieux
Jurnalul de Chirurgie , 2005,
Abstract: The liver is the largest solid abdominal organ with a relatively fixed position, which makes it prone to injury. The liver is the second most commonly injured organ in abdominal trauma, but damage to the liver is the most common cause of death after abdominal injury. The most common cause of liver injury is blunt abdominal trauma, which is secondary to motor vehicle accidents in most instances. In the past, most of these injuries were treated surgically. However, surgical literature confirms that many of liver injuries have stopped bleeding by the time surgical exploration is performed, and some operations performed for blunt abdominal trauma are nontherapeutic. Imaging techniques and non-operative management, have made a great impact on the treatment of patients with liver trauma, and use of these techniques has resulted in marked reduction in the number of patients requiring surgery and nontherapeutic operations
Self-Organized Growth of Nanoparticles on a Surface Patterned by a Buried Dislocation Network
F. Leroy,G. Renaud,A. Letoublon,R. Lazzari,C. Mottet,J. Goniakowski
Physics , 2007, DOI: 10.1103/PhysRevLett.95.185501
Abstract: The self-organized growth of Co nanoparticles with 10 nm periodicity was achieved at room temperature on a Ag(001) surface patterned by an underlying dislocation network, as shown by real time, in situ Grazing Incidence Small and Wide Angle X-ray Scattering. The misfit dislocation network, buried at the interface between a 5nm-thick Ag thin film and a MgO(001) substrate, induces a periodic strain field on top of the surface. Nucleation and growth of Co on tensile areas are found as the most favorable sites as highlighted by Molecular Dynamic simulations.
Strain, size and composition of InAs Quantum Sticks, embedded in InP, by means of Grazing Incidence X-ray Anomalous Diffraction
A. Letoublon,V. Favre-Nicolin,H. Renevier,M. G. Proietti,C. Monat,M. Gendry,O. Marty,C. Priester
Physics , 2003, DOI: 10.1103/PhysRevLett.92.186101
Abstract: We have used x-ray anomalous diffraction to extract the x-ray structure factor of InAs quantum stick-like islands, embedded in InP. The average height of the quantum sticks (QSs), as deduced from the width of the structure factor profile is 2.54nm. The InAs out of plane deformation, relative to InP, is equal to 6.1%. Diffraction Anomalous Fine Structure provides a clear evidence of pure InAs QSs. Finite Difference Method calculations reproduce well the diffraction data, and give the strain along the growth direction. Chemical mixing at interfaces is at most of 1ML
Computer-aided hepatic tumour ablation : requirements and preliminary results
David Voirin,Yohan Payan,Miriam Amavizca,Christian Letoublon,Jocelyne Troccaz
Physics , 2006,
Abstract: Surgical resection of hepatic tumours is not always possible, since it depends on different factors, among which their location inside the liver functional segments. Alternative techniques consist in local use of chemical or physical agents to destroy the tumour. Radio frequency and cryosurgical ablations are examples of such alternative techniques that may be performed percutaneously. This requires a precise localisation of the tumour placement during ablation. Computer-assisted surgery tools may be used in conjunction with these new ablation techniques to improve the therapeutic efficiency, whilst they benefit from minimal invasiveness. This paper introduces the principles of a system for computer-assisted hepatic tumour ablation and describes preliminary experiments focusing on data registration evaluation. To keep close to conventional protocols, we consider registration of pre-operative CT or MRI data to intra-operative echographic data.
Computer-aided hepatic tumour ablation
David Voirin,Yohan Payan,Miriam Amavizca,Antoine Leroy,Christian Letoublon,Jocelyne Troccaz
Physics , 2006,
Abstract: Surgical resection of hepatic tumours is not always possible. Alternative techniques consist in locally using chemical or physical agents to destroy the tumour and this may be performed percutaneously. It requires a precise localisation of the tumour placement during ablation. Computer-assisted surgery tools may be used in conjunction to these new ablation techniques to improve the therapeutic efficiency whilst benefiting from minimal invasiveness. This communication introduces the principles of a system for computer-assisted hepatic tumour ablation.
Diffraction Anomalous Fine Structure spectroscopy at the beamline BM2 at the European Synchrotron Radiation Facility
H. Renevier,S. Grenier,S. Arnaud,J. F. Berar,B. Caillot,J. L. Hodeau,A. Letoublon,M. G. Proietti,B. Ravel
Physics , 2003,
Abstract: Diffraction Anomalous Fine Structure (DAFS) spectroscopy uses resonant elastic x-rays scattering as an atomic, shell and site selective probe that gives information on the electronic structure and the local atomic environment as well as on the long range ordered crystallographic structure. A DAFS experiment consists of measuring the Bragg peak intensities as a function of the energy of the incoming x-ray beam. The French CRG (Collaborative Research Group) beamline BM2-D2AM (Diffraction Diffusion Anomale Multi-longueurs d'onde) at the ESRF (European Synchrotron Radiation Facility) has developed a state of the art energy scan diffraction set-up. In this article, we present the requirements for obtaining reliable DAFS data and report recent technical achievements.
Development of miniaturized light endoscope-holder robot for laparoscopic surgery
Jean-Alexandre Long,Philippe Cinquin,Jocelyne Troccaz,Sandrine Voros,Jean-Luc Descotes,Peter Berkelman,Christian Letoublon,Jean-Jacques Rambeaud
Computer Science , 2007, DOI: 10.1089/end.2006.0328
Abstract: PURPOSE: We have conducted experiments with an innovatively designed robot endoscope holder for laparoscopic surgery that is small and low cost. MATERIALS AND METHODS: A compact light endoscope robot (LER) that is placed on the patient's skin and can be used with the patient in the lateral or dorsal supine position was tested on cadavers and laboratory pigs in order to allow successive modifications. The current control system is based on voice recognition. The range of vision is 360 degrees with an angle of 160 degrees . Twenty-three procedures were performed. RESULTS: The tests made it possible to advance the prototype on a variety of aspects, including reliability, steadiness, ergonomics, and dimensions. The ease of installation of the robot, which takes only 5 minutes, and the easy handling made it possible for 21 of the 23 procedures to be performed without an assistant. CONCLUSION: The LER is a camera holder guided by the surgeon's voice that can eliminate the need for an assistant during laparoscopic surgery. The ease of installation and manufacture should make it an effective and inexpensive system for use on patients in the lateral and dorsal supine positions. Randomized clinical trials will soon validate a new version of this robot prior to marketing.
ВПЛИВ Х М ЧНОГО СКЛАДУ НА ТИСК НАСИЧЕНО ПАРИ В МОТОРНИХ Б ОЛОГ ЧНИХ ПАЛИВАХ The influence of chemical composition on the saturated vapor pressure in biological motor fuels Влияние химического состава на давление насыщенного пара в моторных биологических топливах
?.В. Полунк?н,C.О. Зубенко,О.О. Гайдай,А.В. Струнгар
Proceedings of National Aviation University , 2010,
Abstract: Розглянуто вплив випаровуваност альтернативних палив на р шення проблеми холодного пуску двигуна за рахунок використання пропан-бутаново сум ш для п двищення тиску насичено пари. Volatility fuels fraction of the estimated parameters and letkosti. Volatility characterizes the ability to switch fuels in vaporous state. Selecting indicators to assess the volatility depends on the chemical composition of fuel. The main measure letkosti etanolnogo fuel is vapor pressure. The most simple and cost-effective to improve cold start is putting in fuel lehkoletyuchyh components: butane, izopentanu, gas and other petroleum. It was investigated the influence of DEE on alcohol-gasoline blend, the results show that DEE positive impact on increasing vapor pressure to the desired minimum for starting the engine. But because the ether to 19%, then at such high levels can actively formed peroxide compounds, which is undesirable. Very promising is the use of propane-butane gas mixture as lehkoletyuchoyi gaseous component. Butanizovani spirit-petrol mixture can be recommended for use as alternative fuel vehicles after further study of their stability and himmotolohichnyh characteristics. Автомобильные бензины и альтернативные биологические топлива на основе этанола преимущественно предназначены для применения в двигателях внутреннего сгорания. При использовании альтернативного биологического топлива, особенно этанольного, возникает проблема недостаточной испаряемости бензина при низкой температуре, в результате чего в холодное время года двигатель может не запуститься. Пусковые свойства бензина зависят от содержания в них летучих фракций или летучих соединений. Проблему холодного запуска предлагается решать за счет использования пропан-бутановой смеси для повышения давления насыщенного пара. Для перспективного применения газов пропан-бутановой смеси легколетучего газообразного компонента необходимы дальнейшие исследования стабилизации такой композиции.
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