The usefulness of the timeliness of endoscopic sphincterotomy in severe acute pancreatitis of biliary origin

There are evidence indicating that endoscopic retrograde cholangiopancreatography with sphincterotomy (ERCP+S) reduces the rate of complications in patients with severe acute biliary pancreatitis (ABP). The aim of this study was to analyze our experience in the treatment of severe ABP with ERCP+S and compare the evolution of the patients treated early (3 days or less following admission) with those treated late (after the 3rd day). A retrospective review of the clinical histories of the 16 patients with severe ABP treated with ERCP+S over the last two years is presented, analyzing their clinical features on admission and evolution. Biliary stones or biliary sludge was observed in 11 cases (69%). Nine patients had undergone early, and 7 late, ERCP+S. The patients of the latter group presented a greater number of complications during evolution than the former group (43% vs 0%; p = 0.025). The mortality of the patients of the late ERCP+S was also greater although without statistical significance (28.6% vs 0%; p = 0.15). No complication secondary to ERCP+S was detected. These findings confirm the fact that ERCP+S performed early in severe ABP significantly reduces the number of complications and is associated with a lower mortality.     

In times of survival, the right of silence

The purpose of this study was to assess cortical and cancellous bone responses to unilateral limb immobilization and, subsequently, to remobilization with exercise, in a young adult canine model. Right forelimbs of 14 1-2-year old mongrel dogs were immobilized in a non-weight-bearing position by a bandage for 16 weeks. Six control dogs were untreated. At 16 weeks, seven immobilized and three control dogs were euthanized. The remaining seven immobilized dogs began a recovery protocol consisting of 16 weeks of kennel confinement (without the right forelimb bandaged) followed by 16 weeks of treadmill exercise conducted three times per week. These seven dogs and three control dogs were euthanized at 48 weeks. Bone mineral density of the proximal radii was determined with dual-energy X-ray absorptiometry and humeral middiaphyseal cross-sectional areas were determined with computed tomography. Humeri were tested in cranio-caudal three-point bending to failure. Cancellous bone cores from the lateral humeral condyles had wet apparent density determined and were tested to failure in compression. Mechanical properties, bone density, and cross-sectional areas were compared between immobilized (right forelimb), contralateral weight bearing (left forelimb), and control forelimbs with Kruskal-Wallis and post hoc tests. At 16 weeks, bone mineral density, cortical load, yield, and stiffness as well as cancellous bone failure stress, yield stress, and modulus were significantly lower (p < 0.02) for immobilized limbs than control limbs. Immobilized limb cancellous bone mechanical properties were 28%-74% of control values, and cortical bone mechanical properties were 71%-98% of control values. After 32 weeks of remobilization, cortical and cancellous bone mechanical properties were not different from control values except that cortical bone failure stress and modulus were significantly higher (p < 0.01) between remobilized and control limbs. In summary, 16 weeks of forelimb immobilization was associated with significantly lower mechanical properties, and with greater differences in cancellous than cortical bone properties. Mechanical properties were not different from control values after 32 weeks of recovery that included 16 weeks of treadmill exercise.     

Treatment and prognosis of secondary glaucoma in Fuchs' heterochromic iridocyclitis

After reviewing the records of 111 patients with Fuchs' heterochromic iridocyclitis, we studied the therapy and prognosis of secondary glaucoma in 30 of these 111 patients (27%) who had glaucoma or could be considered glaucoma suspects. Maximal medical therapy was unsuccessful in 22 of the 30 patients (73%). Surgical intervention (mostly trabeculectomies, half with 5-fluorouracil) successfully controlled intraocular pressure (< or = 21 mm Hg with or without medication) in 13 of the 18 operated-on patients (72%) after a mean follow-up of 26 months. All successfully operated-on patients retained a visual acuity of 20/80 or better. We had favorable results, possibly because of modern surgical techniques (use of 5-fluorouracil, sodium hyaluronate) or earlier surgical intervention, or both.     

Constant stretching rate experiments on low density polyethylene

A simple apparatus for elongational test of molten polymers is presented. Its realiability is demonstrated by means of stress growth in constant stretching rate experiments and relaxation test on a low density polyethylene sample.     

The new intra-urban dynamics: Suburbanisation and functional specialisation in French cities

This article examines the relationships between the employment suburbanisation from central cities towards their suburbs, and the process of intra-urban specialisation that occurred simultaneously in the fifty largest French metropolitan areas. A methodology is proposed to identify urban subcentres and to analyse the effects of the intra-urban specialisations on suburbanisation patterns. We conclude that the specialisation of both subcentres and central cities has a significant effect on suburbanisation rates. Lastly, an intra-metropolitan shift/share analysis provides additional insights into the employment dynamics of central cities and suburbs during the last twenty years. Received: 25 July 2000 / Accepted: 29 May 2001     

Determination du coefficient d'extinction molaire de OH− dans les verres fluores a base de metaux lourds

The extinction coefficient ? at 2.9 μm for OH in fluoride glasses is measured by determining the amount of HF evolved during heating of the glass under steam and the corresponding intensity of the OH absorption band. This coefficient is respectively equal to 31 litre mole^?1 cm^?1 for BTYbZ glass (15 BaF₂ - 29 ThF₄ - 28 YbF₃ - 28 ZnF₂) and 19.5 litre mole^?1 cm^?1 for BALLA glass (34 BaF₂ - 57 ZrF₄ - 4 AlF₃ - 5 LaF₃).     

Le décodage pondere en tant que procédé de réévaluation d’une distribution de probabilité

We propose to redefine weighted decoding of a redundant code as consisting of reestimating a given prior probability distribution in order to take into account the code constraints. The optimum solution of this problem results from using the « minimum cross-entropy » principle and is shown to coincide with the computation of the probabilities to be compared in order to perform maximum likelihood decoding when the prior distribution is exactly known. The principle however also holds when the prior distribution is approximate or biased, which explains the robustness of decoding with respect to weighting information. Such a redefinition also enables using the intermediate steps of decoding, in the case of codes associated by concatenation or product, as a source of weighting information for the subsequent steps. One is led for simplicity’s sake to an estimate of the posterior probability in separable form with respect to the information symbols ; its definition is given and certain of its applications are discussed.