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Role of endoscopic ultrasound in the molecular diagnosis of pancreatic cancer

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World Journal of Gastroenterology 2014年第31期20卷 10758-10768页

作者： Barbara Bournet Marion Gayral Jérme Torrisani Janick Selves Pierre Cordelier Louis Buscail Department of Gastroenterology CHU Toulouse Rangueil University of Toulouse INSERM UMR 1037 CHU Toulouse Rangueil University of Toulouse Department of Pathology CHU Toulouse Purpan University of Toulouse

Pancreatic ductal adenocarcinoma remains one of the most deadly types of tumor. Endoscopic ultrasoundguided fine-needle aspiration(EUS-FNA) is a safe, cost-effective, and accurate technique for evaluating and staging pancreatic tumors. However, EUS-FNA may be inconclusive or doubtful in up to 20% of cases. This review underlines the clinical interest of the molecular analysis of samples obtained by EUS-FNA in assessing diagnosis or prognosis of pancreatic cancer, especially in locally advanced tumors. On EUS-FNA materials DNA, mRNA and miRNA can be extracted, amplified, quantified and subjected to methylation assay. Kras mutation assay, improves diagnosis of pancreatic cancer. When facing to clinical and radiological presentations of pseudo-tumorous chronic pancreatitis, wildtype Kras is evocative of benignity. Conversely, in front of a pancreatic mass suspected of malignancy, a mutated Kras is highly evocative of pancreatic adenocarci-noma. This strategy can reduce false-negative diagnoses, avoids the delay of making decisions and reduces loss of surgical resectability. Similar approaches are conducted using analysis of miRNA expression as well as Mucin or markers of invasion(S100P, S100A6, PLAT or PLAU). Beyond the diagnosis approach, the prediction of response to treatment can be also investigated form biomarkers expression within EUS-FNA materials.

关键词： Pancreatic ductal adenocarcinoma Endoscopic ultrasound-guided fine-needle aspiration Solid pancreatic mass KRAS-mutation assay qPCR analysis Micro-RNA Chronic pancreatitis

Piezoelectric resonant ice protection systems-Part 2/2:Evaluation of benefits at aircraft level

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Chinese Journal of Aeronautics 2024年第6期37卷 50-63页

作者： Valerian PALANQUE Thomas PLANES Pommier-Budinger VALERIE Budinger MARC Delbecq SCOTT Institut Clement Ader(ICA) INSAISAE-SUPAEROMINES ALBIUPSCNRSUniversity of Toulouse31400 ToulouseFrance Federation ENAC ISAE-SUPAERO ONERA University of Toulouse31400 ToulouseFrance

Piezoelectric resonant de-icing systems are attracting great *** paper aims to assess the implementation of these systems at the aircraft *** article begins with the model to compute the power requirement of a piezoelectric resonant de-icing system sized from the prototype detailed in Part 1/2 of this *** the mass,drag,and fuel consumption of this system and the subcomponents needed for its implementation are *** features of a piezoelectric resonant de-icing system are finally computed for aircraft similar to Airbus A320 aircraft and aircraft of different categories(Boeing 787,ATR 72 and TBM 900)and compared with the existing thermal and mechanical ice protection systems.A sensitivity analysis of the main key sizing parameters of the piezoelectric de-icing system is also performed to identify the main axes of improvement for this *** study shows the potential of such ice protection *** particular,for the realistic input parameters chosen in this work,the electro-mechanical solution can provide a 54% reduction in terms of mass and a 92% reduction in terms of power consumption for an A320 aircraft architecture,leading to a 74% decrease in the associated fuel consumption compared to the actual air bleed system.

关键词： Ice protection system De-icing Piezoelectric Electro-mechanical system Power Fuel consumption

Piezoelectric resonant ice protection systems–Part1/2:Prediction of power requirement for de-icing a NACA 0024 leading edge

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Chinese Journal of Aeronautics 2024年第3期37卷 92-103页

作者： Valerian PALANQUE Jason POTHIN Vale′rie POMMIER-BUDINGER Marc BUDINGER Institut Clement Ader University of ToulouseINSAISAE-SUPAEROMINES ALBIUPSCNRSToulouse 31055France ISAE-SUPAERO University of Toulouse10 Avenue Edouard BelinToulouse 31055France

This paper proposes a numerical method to analyze the ice protection capability and predict the power requirements of a piezoelectric resonant de-icing *** method is based on a coupled electro-mechanical finite element analysis which enables the fast computation of the modes of resonance of interest to de-ice curved surfaces and the estimation of the input voltage and current required for a given configuration(defined by its mode,actuator location,ice deposit,etc.).Eventually,the electric power to be supplied can be also *** method is applied to a NACA 0024 leading edge equipped with piezoelectric ***,two extension modes are analyzed and compared with respect to their efficiency and power ***,tests are carried out in an icing tunnel to verify the effectiveness of the piezoelectric ice protection system and the predictions of the maximal required *** system allows de-icing the leading edge in less than 2 s for a glaze ice deposit.

关键词： Ice protection system Piezoelectric Resonance mode Ice fracture Leading edge de-icing

Outcomes of nonresected main-duct intraductal papillary mucinous neoplasms of the pancreas

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World Journal of Gastroenterology 2015年第9期21卷 2658-2667页

作者： Mathieu Daudé Fabrice Muscari Camille Buscail Nicolas Carrère Philippe Otal Janick Selves Louis Buscail Barbara Bournet Department of Gastroenterology CHU Toulouse RangueilUniversity of Toulouse31059 ToulouseFrance Department of Digestive Surgery CHU Toulouse Rangueil and PurpanUniversity of Toulouse31059 ToulouseFrance Department of Public Health and Epidemiology CHU Rennes PontchaillouUniversity of Rennes35033 RennesFrance Department of Radiology CHU Toulouse RangueilUniversity of Toulouse31059 ToulouseFrance Department of Pathology CHU Toulouse PurpanUniversity of Toulouse31300 ToulouseFrance

AIM:To compare characteristics and outcomes of resected and nonresected main-duct and mixed intraductal papillary mucinous neoplasms of the pancreas(IPMN).METHODS:Over a 14-year period,50 patients who did not undergo surgery for resectable main-duct or mixed IPMN,for reasons of precluding comorbidities,age and/or refusal,were compared with 74 patients who underwent resection to assess differences in rates of survival,recurrence/occurrence of malignancy,and prognostic *** study participants had dilatation of the main pancreatic duct by ≥ 5 mm,with or without dilatation of the branch *** of the nonsurgical patients showed evidence of mucus upon perendoscopic retrograde cholangiopancreatography or endoscopic ultrasound and/or after fine needle *** the surgical patients,pathologic analysis of resected specimens confirmed a diagnosis of IPMN with involvement of the main pancreatic duct or of both branch ducts as well as the main pancreatic *** and biologic follow-ups were conducted for all patients at least annually,through hospitalization or consultation every six months during the first year of follow-up,together with abdominal imaging analysis(magnetic resonance cholangiopancreatography or computed tomography) and,if necessary,endoscopic ultrasound with or without fine needle ***:The overall five-year survival rate of patients who underwent resection was significantly greater than that for the nonsurgical patients(74% vs 58%; P =0.019).The parameters of age( 10 mm,branch ductdiameter > 30 mm,or presence of extra pancreatic cancers did not significantly influence the *** the nonsurgical patients,pancreatic malignancy occurred in 36% of cases within a mean time of 33 mo(median:29 mo; range:8-141 mo).Comparison of the nonsurgical patients who experienced disease progression

关键词： Main-duct intraductal papillary mucinous neoplasms

The Challenges of Identifying and Managing Epistemic Inequalities in PHIR(Population Health Intervention Research):An Illustration in the Conception and Implementation of a TPE(Therapeutic Patient Education)Program in Oncology

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Psycho-Oncologie 2023年第3期17卷 181-189页

作者： Philippe Terral Charlotte Bruneau Jean-Paul Génolini CreSco University of ToulouseToulouse31000France

Aims:The joint dynamics of knowledge(of patients,health professionals,decision-makers,researchers)and of the powers(of speech and action,asymmetries,and hierarchies established between individuals and their knowledge)of the people who carry them at the heart of the PHIR,are analyzed from the perspective of the management of epistemic *** study the nature of knowledge sharing or non-sharing between these different categories of agents involved in health ***:The qualitative methodology is based on 36 interviews and six years of ethnographic observations of the TPE program(design or implementation),as well as steering committees and workshops of the PHIR where researchers,decisionmakers,health professionals,and patients share their experiences and ***:The research highlights three major theoretical and methodological issues of PHIR concerning epistemic *** argue for broadening the spectrum of health expertise(researchers,decision-makers,health professionals,patients)and for their *** account for the nature and evolution of collaborations,it is necessary to closely study the dynamics of the avenues of coordination between these fields of ***,we call to identify the resources(knowledge,values,material elements,etc.)and strengths that enable these hybrid groups to bind(or not)and to potentially generate ***:Considering these three major issues allows PHIR to reflect and take action to reduce inequalities by linking epistemic and social issues.

关键词： Epistemic inequalities intervention research theoretical issues methodological issues

A diagnostic protocol designed for determining allergic causes in patients with blood eosinophilia

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Military Medical Research 2017年第4期4卷 181-192页

作者： Jean-François Magnaval Guy Laurent Noemie Gaudré Judith Fillaux Antoine Berry Department of Medical Parasitology Faculty of MedicineToulouse University37 aliees Jules-GuesdeToulouseFrance Purpan Center for Pathophysiology INSERM UMR Ulo43CNRS UMR S282Toulouse UniversityToulouseFrance Department of Hematology Toulouse University HospitalsToulouseFrance Cancer Institute Toulouse University and OncopoleToulouseFrance Department of Parasitology and Mycology Toulouse University HospitalsToulouseFrance PharmaDev IRD UMR 152Toulouse UniversityToulouseFrance

Background: Blood eosinophilia is a common laboratory abnormality, and its characterization frequently represents a quandary for primary care physicians. Consequently, in France, specialists and particularly hematologists, often must investigate patients who present with blood eosinophilia that often, but not always, occurs because of allergic causes. Both the Departments of Hematology and Parasitology at toulouse university Hospitals established a collaboration to rule out allergic causes of eosinophilia, particularly helminthiases, prior to initiating more sophisticated ***: Since 2004, the authors employed the same protocol to investigate eosinophilic outpatients who attended the clinic of Parasitology at toulouse university Hospitals, and they reported the performance of this diagnostic procedure that was designed to be rapid(no hospitalization required) and only moderately ***: A total of 406 patients who presented with blood eosinophilia greater than 0.5(×10~9, giga cells per litter, G/L) had an allergic etiology in 350(86.2%) cases. Among the remaining 56 subjects, 17 did not undergo a follow-up and 39 were referred to another specialized department, mostly Hematology. However, only 21 patients attended then were subsequently investigated. Non-allergic causes of eosinophilia, including 3 cases of the lymphoid variant of hypereosinophilic syndrome and 2 cases of myeloproliferative disorder, were identified in 14 patients, whereas 7 remained diagnosed as having idiopathic ***: This study underlines the need to investigate patients presenting with even moderate blood eosinophilia. The work-up that was employed appears to be efficient and versatile and may be used by any medical specialist, such as in hematology, infectious disease, or internal medicine departments, who needs to investigate eosinophilic patients and should initially rule out any etiology of allergic eosinophilia.

关键词： Blood eosinophilia Diagnostic protocol Classification Secondary eosinophilias Allergy Helminthiases

Predictive factors of histological response of colorectal liver metastases after neoadjuvant chemotherapy

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World Journal of Gastrointestinal Oncology 2019年第4期11卷 295-309页

作者： Chloé Serayssol Charlotte Maulat Florence Breibach Fatima-Zohra Mokrane Janick Selves Rosine Guimbaud Philippe Otal Bertrand Suc Emilie Berard Fabrice Muscari Department of Digestive Surgery and Liver Transplantation Toulouse-Rangueil University Hospital Department of Pathology Toulouse University Hospital Department of Radiology Toulouse-Rangueil University Hospital Department of Oncology Toulouse-Rangueil University Hospital The toulouse Research Methodology Support Unit Toulouse University Hospital

BACKGROUND Colorectal cancer is the third most common cancer in men and the second most common in women worldwide. Almost a third of the patients has or will develop liver metastases. Neoadjuvant chemotherapy(NAC) has recently become nearly systematic prior to surgery of colorectal livers metastases(CRLMs). The response to NAC is evaluated by radiological imaging according to morphological *** recently, the response to NAC has been evaluated based on histological criteria of the resected specimen. The most often used score is the tumor regression grade(TRG), which considers the necrosis, fibrosis, and number of viable tumor *** To analyze the predictive factors of the histological response, according to the TRG, on CRLM surgery performed after *** January 2006 to December 2013, 150 patients who had underwent surgery for CRLMs after NAC were included. The patients were separated into two groups based on their histological response, according to Rubbia-Brandt *** on their TRG, each patient was either assigned to the responder(R) group(TRG 1, 2, and 3) or to the non-responder(NR) group(TRG 4 and 5). All of the histology slides were re-evaluated in a blind manner by the same specialized pathologist. Univariate and multivariate analyses were *** Seventy-four patients were classified as responders and 76 as *** postoperative mortality rate was 0.7%, with a complication rate of 38%.Multivariate analysis identified five predictive factors of histological *** were predictive of non-response: More than seven NAC sessions, the absence of a radiological response after NAC, and a repeat hepatectomy(P <0.005). Two were predictive of a good response: A rectal origin of the primary tumor and a liver-first strategy(P < 0.005). The overall survival was 57% at 3 yr and 36% at 5 yr. The disease-free survival rates were 14% at 3 yr and 11% at 5 *** factors contributing to a poor prognosis for disease-free survi

关键词： Colorectal liver metastasis Tumor regression grade Neoadjuvant chemotherapy Liver surgery Histological response Hepatectomy

A case of atypical neurological symptoms and high cerebro-spinal fluid acetone level due to transdermal exposure to isopropanol

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World Journal of Emergency Medicine 2023年第2期14卷 152-154页

作者： Côme Fruit Sophie Guillotin Marie Wolfrum Thomas Lanot Florent Battefort Pierre Girardie Marie Rafiq Nicolas Delcourt Poison Control Center Toulouse University HospitalToulouse 31509France Neurology Department Toulouse University HospitalToulouse 31509France Pharmacokinetics and Toxicology Laboratory Federative Institute of BiologyToulouse University HospitalToulouse 31509France Poison Control Center and INSERM 1214 Toulouse University HospitalToulouse 31509France

Dear editor, Isopropanol, also named 2-propanol or isopropyl alcohol(IPA), is a colorless, volatile liquid found in numerous household chemicals, such as cleaners and disinfectants, which typically contain a 70% solut... 详细信息

关键词： acetone typically alcohol

Using Leading Indicators to Improve Project Performance Measurement

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Journal of Systems Science and Systems Engineering 2019年第5期28卷 529-554页

作者： Li Zheng Claude Baron Philippe Esteban Rui Xue Qiang Zhang Shanlin Yang LAAS-CNRS Université de Toulouse Toulouse France School of Management Hefei University of Technology HefeiChina

Project performance measurement offers a wide range of methods to help project managers monitor ***,several critical issues remain in project performance measurement,such as an unbalanced use of indicators due to a lack of prediction-based (leading) indicators with regard to outcome-based (lagging) *** its part,systems engineering measurement,although a more recent discipline,offers a wide variety of indicators,including a set of leading *** our objective is to increase project performance and success rates,this involves improving project performance measurement on which project management decisions are *** purpose,the proposal put forward in this paper is to extend the number and type of indicators used in project performance measurement by adapting the leading indicators defined in systems engineering *** methodology involves first mapping the systems engineering indicators with the project management activities,resulting in identification of a set of potentially useful indicators for measuring the different activities,then tailoring a selection of these indicators with project-specific data to define a set of the most relevant indicators for a given *** methodology is illustrated by means of a case study in a manufacturing company.

关键词： Project performance measurement systems engineering measurement leading indicators lagging indicators