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Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma

World Journal of Gastroenterology 2008年第32期14卷 5032-5038页

作者： Jaap Jacob Kloek Otto Marinus van Delden Deha Erdogan Fibo Jan ten Kate Erik Anthoni Rauws olivier robert busch Dirk Joan Gouma Thomas Mathijs van Gulik Department of Surgery Academic Medical Center University of Amsterdam Department of Radiology Academic Medical Center University of Amsterdam Department of Pathology Academic Medical Center University of Amsterdam Department of Gastroenterology Academic Medical Centre University of Amsterdam

AIM: To identify the criteria for the differentiation of hilar cholangiocarcinoma (HCCA) from benign strictures. METHODS: A total of 68 patients underwent resection of lesions suspicious for HCCA between 1998 and 2006. The results of laboratory investigations, imaging studies and brush cytology were collected. These fi ndings were analyzed to obtain the fi nal diagnosis. RESULTS: Histological examination of the resected specimens confirmed HCCA in 58 patients (85%, group Ⅰ) whereas 10 patients (15%, groupⅡ) were diagnosed to have benign strictures. The most common presenting symptom was obstructive jaundice in 77% patients (79% group Ⅰvs 60% group Ⅱ P = 0.23). Laboratory findings showed greater elevation of transaminase levels in group Ⅰcompared to group Ⅱ The various imaging modalities showed vascular involvement exclusively in the malignant group (36%,P < 0.05). Brush cytology was positive for malignant cells in only 50% patients in group Ⅰ whereas none in group Ⅱ showed malignant cells. CONCLUSION: Despite improvements in imaging techniques, 10 patients (15%) with a presumptive diagnosis of HCCA were ultimately found to have benign strictures. Except for vascular involvement which was associated significantly with malignancy, there were no conclusive features of malignancy on regular imaging modalities. This uncertainty should be taken into account when patients with a suspicious lesion at the liver hilum are considered for resection.

关键词： Biliary stricture Hilar cholangiocarcinoma Benign Radiological Vascular involvement cholangio

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Optimizing laser coupling,matter heating,and particle acceleration from solids using multiplexed ultraintense lasers

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Matter and Radiation at Extremes 2024年第4期9卷 16-28页

作者： Weipeng Yao Motoaki Nakatsutsumi Sébastien Buffechoux Patrizio Antici Marco Borghesi Andrea Ciardi Sophia N.Chen Emmanuel d’Humières Laurent Gremillet robert Heathcote Vojtech Horny Paul McKenna Mark N.Quinn Lorenzo Romagnani Ryan Royle Gianluca Sarri Yasuhiko Sentoku Hans-Peter Schlenvoigt Toma Toncian olivier Tresca Laura Vassura Oswald Willi Julien Fuchs LULI-CNRS CEASorbonne UniversitéEcole PolytechniqueInstitut Polytechnique de ParisF-91128 Palaiseau CedexFrance Sorbonne Université Observatoire de ParisUniversité PSLCNRSLERMAF-75005 ParisFrance INRS-EMT 1650 BoulLionel-BouletVarennesQuebec J3X 1S2Canada Center for Plasma Physics School of Mathematics and PhysicsQueen’s University BelfastBelfast BT71NNUnited Kingdom “Horia Hulubei”National Institute for Physics and Nuclear Engineering 30 Reactorului StreetRO-077125 Bucharest-MagureleRomania University of Bordeaux Centre Lasers Intenses et ApplicationsCNRSCEAUMR 5107F-33405 TalenceFrance CEA DAMDIFF-91297 ArpajonFrance Université Paris-Saclay CEALMCE91680 Bruyères-le-ChatelFrance Central Laser Facility STFC Rutherford Appleton LaboratoryDidcotUnited Kingdom SUPA Department of PhysicsUniversity of StrathclydeGlasgow G40NGUnited Kingdom Department of Physics University of NevadaRenoNevada 89557USA Institute of Laser Engineering Osaka University2-6 YamadaokaSuitaOsaka 565-0871Japan Institut fur Laser und Plasmaphysik Heinrich Heine Universitat DusseldorfDusseldorfGermany

Realizing the full potential of ultrahigh-intensity lasers for particle and radiation generation will require multi-beam arrangements due to technology ***,we investigate how to optimize their coupling with solid ***,we show that overlapping two intense lasers in a mirror-like configuration onto a solid with a large preplasma can greatly improve the generation of hot electrons at the target front and ion acceleration at the target *** underlying mechanisms are analyzed through multidimensional particle-in-cell simulations,revealing that the self-induced magnetic fields driven by the two laser beams at the target front are susceptible to reconnection,which is one possible mechanism to boost electron *** addition,the resistive magnetic field generated during the transport of the hot electrons in the target bulk tends to improve their *** simulations also indicate that such effects can be further enhanced by overlapping more than two laser beams.

关键词： laser acceleration particle

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Iverya averyi *** ***.,a New Triadotypomorphan Species from the Middle Triassic at Picton,New South Wales,Australia

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Acta Geologica Sinica(English Edition) 2010年第4期84卷 688-692页

作者： olivier BETHOUX robert G.BEATTIE Freiberg University of Mining and Technology Institute of GeologyDepartment of PalaeontologyD-09596 FreibergGermany Senckenberg Natural History Collections of Dresden Museum of ZoologyD-01109 DresdenGermany P.O.Box 320 BerryN.S.W.Australia The Australian Museum SydneyNSW 2010Australia

A new specimen assigned to the species Iverya averyi gen. nov. and sp. nov. is described. This species is considered as a triadotypomorphan insect, a poorly known group of Triassic stem-odonatans. Like other triadotypomorphans, this species exhibits an area between MA and MP that is comparatively broad, and a cubitoanal area involving an AA stem distinct from CuA ＋ CuP ＋ AA emitting several posterior branches. Diagnostic character states of the new species are listed. Although incomplete, the specimen provides new information on the wing morphology of triadotypomorphans. This discovery might contribute to better assessment of the phylogenetic position of triadotypomorphan species with respect to other stem-odonatans.

关键词： Odonatoptera Odonata Triadotypidae Wianamatta

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Pancreaticoduodenectomy: Secondary stenting of the celiac trunk after inefficient median arcuate ligament release and reoperation as an alternative to simultaneous hepatic artery reconstruction

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World Journal of Gastroenterology 2017年第5期23卷 919-925页

作者： Théophile Guilbaud Jacques Ewald olivier Turrini Jean robert Delpero Department of Surgery Institut Paoli Calmettes13009 MarseilleFrance

In patients undergoing pancreaticoduodenectomy(PD),unrecognized hemodynamically significant celiac axis(CA) stenosis impairs hepatic arterial flow by suppressing the collateral pathways supplying arterial flow from the superior mesenteric artery and leads to serious hepatobiliary complications due to liver and biliary ischemia, with a high rate of mortality. CA stenosis is usually due to an extrinsic compression by a previously asymptomatic median arcuate ligament(MAL). MAL is diagnosed by computerized tomography in about 10% of the candidates for PD, but only half are found to be hemodynamically significant during the gastroduodenal artery clamping test with Doppler assessment, which is mandatory before any resection. MAL release is usually efficient to restore an adequate liver blood inflow and prevent ischemic complications. In cases of failure in MAL release, postponed PD with secondary stenting of the CA and reoperation for PD should be considered as an alternative to immediate hepatic artery re-construction, which involves the risk of postoperative thrombosis of the arterial reconstruction. We recently used this two-stage strategy in a patient undergoing surgery for pancreatic adenocarcinoma.

关键词： Pancreaticoduodenectomy Celiac axis stenosis Median arcuate ligament

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Pancreaticoduodenectomy with combined superior mesenteric vein resection without reconstruction is possible:A case report and review of the literature

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World Journal of Clinical Cases 2018年第8期6卷 214-218页

作者： Lionel Jouffret Theophile Guilbaud olivier Turrini Jean-robert Delpero Department of Surgical Oncology Institut PaoliC almettes

We report the case of a 56-year-old woman with pancreatic adenocarcinoma(PA) discovered during an episode of febrile jaundice. A computed tomography(CT) scan showed a mass in the head of the pancreas with circumferential infiltration of the superior mesenteric vein(SMV) and dilatation of the biliary and pancreatic ducts without metastases. The patient benefited from neoadjuvant chemotherapy(FOLFIRINOX) followed by radio-chemotherapy(45 Gy) and chemotherapy(LV5 FU2). The revaluation CT revealed SMV thrombosis without portal vein(PV) thrombosis. There was no contact of the tumor with the PV. Pancreatoduodenectomy with combined resection of the SMV was performed with no reconstruction of this venous axis after confirmation of adequate PV, splenic, and left gastric venous flow and the absence of bowel ischemia. The pathological diagnosis was p T4 N1 R0 PA. There were no bowel angina issues during the follow-up period. At 15 mo after surgery, the patient died of metastatic recurrence.

关键词： Pancreatic ducts Locally advanced No reconstruction Pancreatic adenocarcinoma Superior mesenteric vein

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A positron source using an axially oriented crystal associated to a granular amorphous converter

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Chinese Physics C 2012年第9期36卷 871-878页

作者：徐成海 robert Chehab Peter Sievers Xavier Artru Michel Chevallier olivier Dadoun 裴国玺 Vladimir M.Strakhovenko Alessandro Variola Institute of High Energy Physics Chinese Academy of Sciences Laboratoire de l'Accélérateur Linéaire IN2P3/CNRS et Université de Paris-SudBP 34-91898Orsay cedexFrance Institut de Physique Nucléaire de Lyon IN2P3/CNRS et Université Lyon 169622 VilleurbanneFrance CERN CH-1211Genéve 23Switzerland Budker Institute of Nuclear Physics Av.Lavrentyeva11630090 NovosibirskRussia

A non-conventional positron source using the intense y radiation from an axially oriented monocrys- tal which materializes into e^＋e^- pairs in a granular amorphous converter is described. The enhancement of photon radiation by multi-GeV electrons crossing a tungsten crystal along its 〈111〉 axis is reported. The resulting enhancement of pair production in an amorphous converter placed 2 meters downstream, is also re- ported. Sweeping off the charged particles from the crystal by a bending magnet upstream of the converter allows a significant reduction of the deposited energy density. Substituting a granular target made of small spheres for the usual compact one, makes the energy dissipation easier. The deposited energy and correspond- ing heating are analyzed and solutions for cooling are proposed. The configurations studied here for this kind of positron source allow its consideration for unpolarized positrons for the ILC.

关键词： channeling effect crystal positron source ILC

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Effect of rapamycin on hepatic osteodystrophy in rats with portasystemic shunting

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World Journal of Gastroenterology 2006年第28期12卷 4504-4510页

作者： Schalk W van der Merwe Maria M Conradie robert Bond Brenda J olivier Elongo Fritz Martin Nieuwoudt Rhena Delport Tomas Slavik Gert Engelbrecht Del Kahn Enid G Shephard Maritha J Kotze Nico P de Villiers Stephen Hough Department of Internal Medicine and Gastroenterology ImmunologyHepatology and GI- research laboratoryUniversity of PretoriaSouth Africa Department of Internal Medicine and Endocrinology University of StellenboschSouth Africa Department of Internal Medicine and Gastroenterology1 Hepatology and GI- research laboratoryUniversity of PretoriaSouth Africa Department of Hepatology and GI- research laboratory University of PretoriaSouth Africa Department of Chemical Pathology University of PretoriaSouth Africa Department of Ampath pathology PretoriaSouth Africa Department of Surgery Grootte Schuur HospitalUniversity of Cape TownSouth Africa MRC Liver Research Centre Grootte Schuur HospitalUniversity of Cape TownSouth Africa Department of Genecare Molecular Genetics Christiaan Barnard Memorial HospitalCape TownSouth Africa

AIM： TO study if T-cell activation related to portasystemic shunting causes osteoclast-mediated bone loss through RANKL-dependent pathways. We also investigated if T-cell inhibition using rapamycin would protect against bone loss in rats. METHODS： Portasystemic shunting was performed in male Sprague-Dawley rats and rapamycin 0.1 mg/kg was administered for 15 wk by gavage. Rats received powderized chow and supplemental feeds to prevent the effects of malnutrition on bone composition. Weight gain and growth was restored after surgery in shunted animals. At termination, biochemical parameters of bone turnover and quantitative bone histology were assessed. Markers of T-cell activation, inflammatory cytokine production, and RANKL-dependent pathways were measured. In addition, the roles of IGF-1 and hypogonadism were investigated. RESULTS： Portasystemic shunting caused low turnover osteoporosis that was RANKL independent. Bone resorbing cytokine levels, including IL-1, IL-6 and TNFα, were not increased in serum and TNFα and RANKL expression were not upregulated in PBMC. Portasystemic shunting increased the circulating CD8＋ T-cell population. Rapamycin decreased the circulating CD8＋ T-cell population, increased CD8＋ CD25＋ T-regulatory cell population and improved all parameters of bone turnover. CONCLUSION： Osteoporosis caused by portasystemic shunting may be partially ameliorated by rapamycin in the rat model of hepatic osteodystrophy.

关键词： Osteopenia Liver disease Portasystemic shunting T-lymphocyte Rapamycin

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Pandemic influenza 2009: Impact of vaccination coverage on critical illness in children, a Canada and France observational study

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World Journal of Clinical Pediatrics 2016年第4期5卷 374-382页

作者： olivier Fléchelles olivier Brissaud robert Fowler Thierry Ducruet Philippe Jouvet the Pediatric Canadian Critical Care Trials Group H1N1 Collaborative and Groupe Francophone de Réanimation et Urgences Pédiatriques Pediatric and Neonatal ICU MFME HospitalFort de France97261 MartiniqueFrance Sainte-Justine Hospital University of MontrealMontrealQC H3T 1C5Canada Pediatric and Neonatal ICU Hopital des EnfantsCHU Bordeaux33000 BordeauxFrance Department of Critical Care Medicine Sunnybrook HospitalTorontoON M4N 3M5Canada 不详

AIM To study the impact of vaccination critical illness due to H1N1pdm09, we compared the incidence and severity of H1N1pdm09 infection in Canada and *** We studied two national cohorts that included children with documented H1N1pdm09 infection, admitted to a pediatric intensive care unit(PICU) in Canada and in France between October 1, 2009 and January 31, *** Vaccination coverage prior to admission to PICUs was higher in Canada than in France(21% vs 2% of children respectively, P < 0.001), and in both countries, vaccination coverage prior to admission of these critically ill patients was substantially lower than in the general pediatric population(P < 0.001). In Canada, 160 children(incidence = 2.6/100000 children) were hospitalized in PICU compared to 125 children(incidence = 1.1/100000) in France(P < 0.001). Mortality rates were similar in Canada and France(4.4% vs 6.5%, P = 0.45, respectively), median invasive mechanical ventilation duration and mean PICU length of stay were shorter in Canada(4 d vs 6 d, P = 0.02 and 5.7 d vs 8.2 d, P = 0.03, respectively). H1N1pdm09 vaccination prior to PICU admission was associated with a decreased risk of requiring invasive mechanical ventilation(OR = 0.30, 95%CI: 0.11-0.83, P = 0.02).CONCLUSION The critical illness due to H1N1pdm09 had a higher incidence in Canada than in France. Critically ill children were less likely to have received vaccination prior to hospitalization in comparison to general population and children vaccinated had lower risk of ventilation.

关键词： Vaccine Children Intensive care Critical care Influenza Pandemic

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High-elevation hypoxia impacts perinatal physiology and performance in a potential montane colonizer

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Integrative Zoology 2020年第6期15卷 544-557页

作者： Jérémie SOUCHET Eric J.GANGLOFF Gaëlle MICHELI Coralie BOSSU Audrey TROCHET Romain BERTRAND Jean CLOBERT olivier CALVEZ Albert MARTINEZ-SILVESTRE Elodie DARNET Hugo LE CHEVALIER olivier GUILLAUME Marc MOSSOLL-TORRES Laurent BARTHE Gilles POTTIER HervéPHILIPPE Fabien AUBRET Station d’Ecologie Théorique et Expérimentale du Centre National de la Recherche Scientifique MoulisFrance Department of Zoology Ohio Wesleyan UniversityDelawareOhioUSA Catalonia Reptile and Amphibian Rescue Center(CRARC) MasquefaBarcelonaSpain Bomosa Pl.Parc de la MolaLes EscaldesAndorra Pirenalia EncampAndorra Nature En Occitanie ToulouseFrance Département de Biochimie Centre Robert-CedergrenUniversitéde MontréalMontréalCanada

Climate change is generating range shifts in many organisms,notably along the elevational gradient in mountainous ***,moving up in elevation exposes organisms to lower oxygen availability,which may reduce the successful reproduction and development of oviparous *** test this possibility in an upwardcolonizing species,we artificially incubated developing embryos of the viperine snake(Natrix maura)using a split-clutch design,in conditions of extreme high elevation(hypoxia at 2877 m above sea level;72%sea-level equivalent O2 availability)or low elevation(control group;*** at 436 m above sea level).Hatching success did not differ between the two *** developing at extreme high elevation had higher heart rates and hatched earlier,resulting in hatchlings that were smaller in body size and slower swimmers compared to their siblings incubated at lower ***,post-hatching reciprocal transplant of juveniles showed that snakes which developed at extreme high elevation,when transferred back to low elevation,did not recover full performance compared to their siblings from the low elevation incubation *** results suggest that incubation at extreme high elevation,including the effects of hypoxia,will not prevent oviparous ectotherms from producing viable young,but may pose significant physiological challenges on developing offspring in *** early-life performance limitations imposed by extreme high elevation could have negative consequences on adult phenotypes,including on fitness-related traits.

关键词： developmental plasticity embryonic metabolism high-elevation hypoxia locomotor performance Natrix maura

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Interband cascade technology for energy-efficient mid-infrared free-space communication

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Photonics Research 2023年第4期11卷 582-590页

作者： PIERRE DIDIER HEDWIG KNÖTIG olivier SPITZ LAURENT CERUTTI ANNA LARDSCHNEIDER ELIE AWWAD DANIEL DIAZ-THOMAS ANBARANOV robert WEIH JOHANNES KOETH BENEDIKT SCHWARZ FRÉDÉRIC GRILLOT LTCI Télécom Paris Institut Polytechnique de ParisPalaiseau 91120France mirSense Centre d’intégration NanoInnovPalaiseau 91120France Institute for Solid State Electronics TU Wien1040 ViennaAustria Currently with CREOL College of Optics and PhotonicsUniversity of Central FloridaOrlandoFlorida 32816USA Institut d’Electronique et des Systèmes Universitéde MontpellierCNRS UMR 5214Montpellier 34000France Nanoplus Nanosystems and Technologies GmbH 97218 GerbrunnGermany Center for High Technology Materials University of New MexicoAlbuquerqueNew Mexico 87106USA

Space-to-ground high-speed transmission is of utmost importance for the development of a worldwide broadband ***-infrared wavelengths offer numerous advantages for building such a system,spanning from low atmospheric attenuation to eye-safe operation and resistance to inclement weather *** demonstrate a full interband cascade system for high-speed transmission around a wavelength of 4.18μ*** low-power consumption of both the laser and the detector in combination with a large modulation bandwidth and sufficient output power makes this technology ideal for a free-space optical communication *** proof-of-concept experiment employs a radio-frequency optimized Fabry–Perot interband cascade laser and an interband cascade infrared photodetector based on a type-II InAs/GaSb *** bandwidth of the system is evaluated to be around 1.5 *** allows us to achieve data rates of 12 Gbit/s with an on–off keying scheme and 14 Gbit/s with a 4-level pulse amplitude modulation *** quality of the transmission is enhanced by conventional pre-and post-processing in order to be compatible with standard error-code correction.

关键词： communication system free

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