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A new artificial neural-network-based methodology for a microstrip antenna design was studied and presented. The methodology is applicable to DCS, GSM, WLL, WLAN, large band planar antennas, and fractals. In this paper, we present five applications of this methodology, three of which are applicable in the WLL, 802.11a, and 802.11b antenna standards. The two others are broadband designs with 500 MHz and 1 GHZ bandwidth, respectively. All the antennas radiate an end-fire beam, and have compact sizes of 29 mm /spl times/ 25 mm, 10 mm /spl times/ 13.5 mm, 10.3 mm /spl times/ 17.2 mm, 35 mm /spl times/ 25 mm, and 35 mm /spl times/ 25 mm, respectively.

In this work, a novel design of compact dual-band antenna based on the use of split ring resonator (SRR) is presented. The first resonant frequency can be attributed to the excitation of the second microstrip line which acts a monopole antenna; however the second frequency resonance is originated from the excitation of the SRR resonator embedded on the top layer. Excitation of the SRR element is performed by adequately position the microstrip line with respect to the confinement plane of the split ring resonator. The simulated results are analyzed and compared with measured data.

Prolonged inhalation of gas butane induced mostly neurological and cardiovascular symptoms. We reported two very rare cases of acute rhabdomyolysis caused by accidental prolonged inhalation of butane. The early diagnosis and the symptomatic treatment were associated with favourable evolution in the two cases. The mechanism of this complication is discussed and compared with the literature.

One case of inflammatory pseudo-tumor revealed by mictional disorders is reported. Ultrasonography and computed tomography visualised a non specific formation of bladder dome witch extend to the Retzius space and umbilicus. The diagnosis of urachal tumor had been suspected. Anatomopathologic analysis of the operative piece disclose a diagnosis of the urachal remnants with foreign body type of inflammation. Since malignant transformation of urachal remnants is possible, surgical resection is advised.

Central venous catheterisation is a common procedure in intensive care and hemodialysis units. Tunnelled catheters of hemodialysis are a great contribution for patients for whom an arteriovenous fistula is not feasible, especially for prolonged use. However, multiple complications have been described from their practice. Through a case of perforation of the left brachio-cephalic vein with a venous catheter for dialysis and a review of the literature, the authors discuss the mechanisms and ways to prevent this complication.

Les sarcomes primitifs de la vesicule biliaire sont extremement rares. Le leiomyosarcome est une entite rare de ces sarcomes, frequente chez la femme dont le diagnostic definitif repose sur l’examen immunohistochimique. Nous rapportons un autre cas de cette rare tumeur maligne de la vesicule biliaire, et nous decrirons les differents aspects epidemiologiques, radiologiques et les modalites therapeutiques.

Video-assisted mitral valve surgery by right mini-thoracotomy is adopted systematically in many centers in the world. It is a safe procedure that offers good results with low morbidity. His major interest can be appreciated in surgical management of mitral valve regurgitation after coronary artery bypass.

The scapula is an uncommon site for a chondroma. We report the case of a chondroma in the left acromion, which presented as a painful shoulder in a 19-year-old teenager. The diagnosis was suspected on radiographs and CT scan and confirmed by histological findings.

Now that the aerospace industry is no longer a dream, but a promising market, high performance structural materials are in great need. For such applications, Ceramic Matrix Composites (CMCs) are hopeful candidates. However, one of the most important problems actually hindering CMC research and development is the high cost of common process routes. To try to solve such problem, a new concept for the R&D of advanced materials such as CMCs is proposed, namely, the Cost-Effectiveness Concept (CEC). This concept is one way to bring together scientific and technological targets. In this work, this strategy will be defined and then illustrated in the case of the elaboration of 3D CMCs and of the development of oxidation protection materials.

La tumeur a cellules geantes (TCG) est une tumeur benigne rare de l’os. Elle se voit surtout au niveau des extremites des os longs apres la maturite osseuse. L’atteinte des os du pied est exceptionnelle. Nous rapportons un cas de tumeur osseuse a cellules geantes de l’os cuneiforme median, survenant chez une jeune fille et revele par des douleurs du pied. Nous discutons les differents aspects cliniques, radiologiques et les differentes modalites therapeutiques.

Middle aortic syndrome (MAS) results from a diffuse narrowing of the distal thoracic or abdominal aorta commonly involving both the visceral and renal arteries. Congenital, acquired, inflammatory, and infectious etiologies have been described. Symptoms typically occur within the first three decades of life and include hypertension, lower extremity claudication, and mesenteric ischemia. The condition is considered a life-threatening emergency as a result of the complications associated with severe hypertension. Diagnosis is made with magnetic resonance and computed tomography angiography. Surgical bypass grafting is the optimal method of treatment and must be tailored depending on the distribution of disease. We report one case of MAS treated with thoracic aorta to abdominal aorta bypass and reimplantation of the right renal artery.

Le pied de Madura, ou mycetome, est une pathologie infectieuse, chronique, deformante des parties molles, de la peau et des structures osseuses. Elle est caracterisee par des nodules indolores, des fistules qui laissent echapper des grains colores. Nous rapportons deux cas de pied de Madura avec une breve discussion.

L\'infarctus testiculaire est une entité rare. L\'étiopathogénie est encore mal connue. Sa symptomatologie est faite de douleurs testiculaires brutales sans contexte traumatique ou detorsion, simulant souvent une tumeur. Les marqueurs tumoraux sont normaux et les urines stériles. L\'échographie montre une zone hypoéchogène, avasculaire au Doppler. L\'imagerie par resonance magnétique (IRM) demeure l\'examen de choix. L\'orchidectomie est la règle, mais elle peut être évitée au profi t d\'une exérèse segmentaire conservatrice en cas d\'infarctus segmentaire. Les auteurs rapportent une observation d\'infarctus testiculaire segmentaire pour lequel ils proposent une abstention surveillanceAfrican Journal of Urology Vol. 14 (1) 2008: pp. 63-65

The aneurysms of digestive arteries are a rare pathological entity, with a risk of rupture associated to a high mortality rate, often asymptomatic, then they are discovered incidentally during a exam for other diagnostic purposes. We report three cases of digestive aneurysms, one of celiac trunk, one of mesenteric artery on behçet disease, and one of splenic artery, which were treated surgically with success.

This paper presents the latest developments and validation results of a hybrid model which combines a broad-scale stochastic small-world network model with a macroscopic deterministic approach, to simulate the effects of large fires burning in heterogeneous landscapes. In the extended version of the model, vegetation is depicted as an amorphous network of combustible cells, and both radiation and convection from the flaming zone are considered in the preheating process of unburned cells. Examples are given to illustrate small-world effects and fire behavior near the percolation threshold. The model is applied to a Mediterranean fire that occurred in Corsica in 2009 showing a good agreement in terms of rate of spread, and area and shape of the burn. A study, based on a fractional factorial plan, is conducted to evaluate the influence of variations of model parameters on fire propagation.

Given the important role of discrete gauge symmetries in viable models, we discuss these symmetries in the intersecting D6-brane trinification model, where the symmetry is investigated and its identification is shown.

The aim of this study was to detect extended-spectrum beta-lactamases (ESBL) in Enterobacteriaceae isolates in the intensive care unit (ICU) of Tlemcen hospital in north-western Algeria. Antimicrobial susceptibility testing, molecular typing, characterization of ESBL-encoding genes and the genetic environment, conjugation experiments and plasmid analysis were carried out. In all, 28 Enterobacteriaceae isolates were isolated from specimens recovered from patients in the ICU and 2 from surfaces of the unit. Of these, 11 isolates (4 Escherichia coli, 5 Klebsiella pneumoniae and 2 Enterobacter cloacae) produced ESBL of the CT-X-M-15 type. Molecular typing of the isolates showed the clonal nature of 4 K. pneumoniae isolates. The bla(CTXM-15) gene was genetically linked to insertion sequence lSEcp1B and was transferable by conjugation from 3 isolates. Regular monitoring of resistance mechanisms, the establishment of a prevention strategy, and more rational and appropriate use of antibiotics are needed.

Objectives Enterobacter cloacae is a major nosocomial bacterium causing severe infections. A multicenter retrospective cohort study was conducted to collect baseline information on the molecular characteristics of β-lactamase producing Enterobacter cloacae in the west of Algeria . Materials and methods We report a series of 42 extended-spectrum β-lactamase (ESBL) producing non-repetitive Enterobacter cloacae strains, collected in 3 university hospital (Tlemcen, Oran, and Sidi Bel Abbes). Antibiotic susceptibility testing (antibiogram and MIC) and screening for ESBL were performed according to the French Society for Microbiology guidelines. PFGE typing was used to characterize the clonality of all the strains. β-lactamase genes ( bla TEM , bla SHV , bla CTX-M , bla ECB , and bla CMY-2 ) were amplified by PCR with specific primers. Plasmid isolation, electroporation, and conjugation experiments were carried out using standard methods. Results Sequence analysis revealed that most strains produced CTX-M type ESBLs (CTX-M-15 and CTX-M-3), whereas only 5 produced SHV-type ESBLs (SHV-12). The bla TEM gene was identified in all strains of Enterobacter cloacae . Several epidemic clones were determined. One strain was found to produce plasmid-mediated AmpC β-lactamase (CMY-2); this gene was transferred from E. cloacae by electroporation. Conjugation experiments showed that bla CTX-M , bla TEM , and bla SHV were carried by conjugative plasmids of high molecular weight (≥ 70 kb). Conclusion The emergence of resistance genes is a public health problem.

To investigate of predictor's factors of difficult venous access device in the operating room in elective surgery.In a prospective study in central operating room, were included all patients scheduled for a surgical or diagnostic intervention. Were excluded all patients admitted with functional venous access. For each, were recorded patient's demographic characteristics (age, gender, ASA class, BMI), history (chemotherapy, prolonged ICU stay, hospitalization for more than five days), data from the clinical examination (presence of skin lesions, arteriovenous fistulas, burns, neurological deficits) and the type of operator (trainee, nurse, resident, senior). The difficulty was judged on the number of attempts required for successful venous access. Puncture was considered easier for a number of attempts to one to two and difficult if the number of attempts was greater than two. Predictor's factors were identified after univariate and multivariate analysis.During one year (March 2008 to February 2009), form returns in 1500 were met, 1325 were usable. Venous catheterization was successful in 50.9% at the first attempt in 24.2% of patients at the second attempt and after three attempts in 18% of patients. Only 6.8% of patients required more than three attempts. A central venous catheter was required in seven patients. In multivariate analysis, chemotherapy (OR=4.54, 95% CI [2.92 to 7.03]; P0.001), a nurse in training (OR=2.27, 95% CI [1.40 to 3.63]; P=0.001), a resident in training (OR=2.14, 95% CI [1.29 to 3.58]; P=0.003) and the presence of burns (OR=3.59, 95% CI [2.44 to 5.27]; P0.001) were identified as independent predictors of difficulty of peripheral venous access.The optimization of venous access devices in the operating room through the search for predictors of difficulty.

The aim of this study was to compare the results of myocardial revascularisation with or without cardiopulmonary bypass in patients with impaired left ventricular function.Five hundred and sixteen consecutive patients who underwent coronary artery bypass grafting from January 2000 through December 2007 were analyzed retrospectively. One hundred and eight cases had a left ventricular EF (ejection fraction) of 45% or less. Of these patients, 78 underwent conventional coronary artery bypass (CCABG) and 30 underwent off-pump procedure (OCABG). The CCABG group received 300IU/kg of heparin while the OCABG received 100IU/kg. The off-pump coronary surgery was carried out using a tissue stabilizer Octopus II. Different pre-, per- and postoperative variables were evaluated among both groups. Statistical analysis was performed by SPSS 11.5. The variables were compared between these two groups using univariate analysis (Chi(2) test, Fisher's test exact) for qualitative variable and (Student's t test, Mann-Whitney's test) for quantitative variable.Patients profiles and risk factors were similar among both groups except for age (CCABG: 57.8±9.2 year vs OCABG: 52±9.9 year; P=0.004) and left ventricular EF (CCABG: 37.4±6.3% vs OCABG: 34±7.8%; P=0.02). The number of grafts performed per patient was significantly more among patients who underwent extracorporeal circulation (CCABG: 2.53±0.7 graft/patient vs OCABG: 1.77±0.8 graft/patient; P0.0001). The hospital mortality was more among CCABG group 9% vs 3.3% in OCABG but the difference was not significant (P=0.3). However, the operative time and the operative room stay were long in CCABG (252±61min vs 175±38min; P0.0001 - 389±70min vs 298±54min; P0.0001). The ventilation time was also long in CCABG (32.3±67hour vs 10.4±5.9hour; P=0.15). There was more postoperative myocardial infarction in CCABG (P=0.008), but the EF increased and was better in CCABG.Off-pump coronary artery bypass surgery provides satisfactory operative results for most patients with reduced left ventricular function. Prospective and randomly study will be necessary before concluding.

Aortic valve replacement improves clinical symptoms and left ventricular systolic function in patients with chronic aortic regurgitation despite a higher surgical risk. The objective of this study is to determine if left ventricular function will be normalized after surgery.This retrospective study included 40 patients (nine females and 31 males) with chronic aortic regurgitation and left ventricular systolic dysfunction who were evaluated by echocardiography Doppler. Were included patients with left ventricular ejection fraction less or equal to 45%. Ages ranged from 18 to 77 years (mean = 46.4 ± 12.6 years). Preoperatively, six patients (15%) were asymptomatic, ten (25%) were in NYHA II, half (50%) in NYHA III and four (10%) in NYHA IV. The mean preoperative ejection fraction (EF) was 36.2 ± 2%. The mean end systolic and diastolic dimensions were 61.7 ± 8.5 mm and 78.9 ± 9.7 mm respectively. Aortic regurgitation was quantified grade III in sixteen patients (40%) and grade IV in twenty-four (60%).Thirty-seven patients underwent aortic valve replacement and three Bentall operations. Hospital mortality was 7.5% (3/40). The mean follow-up period was 69.7 months. All survivor patients were investigated. Out of these, five were lost and 32 were controlled. Symptomatic improvement was noted in most of the survivors. Sixty percent (24/40) were severely symptomatic before and only 6.25% (2/32) during follow-up. The ejection fraction increased significantly after surgery (36.2 ± 2% in preoperative period vs. 55.2 ± 10% in postoperative period, P0.02). Left ventricular diameters decreased significantly also. Survival rates were 3-year 94%, 5-year 91% and 7-year 89%.Despite reduced left ventricular systolic function, aortic valve replacement in chronic aortic regurgitation was associated with acceptable operative risk. Surgery improves functional status, symptoms and ejection fraction in most patients.

The damage characterization of a type of 2D SiCSiC composite material made of Nicalon SiC fibres, a pyrocarbon interphase and a β-SiC matrix is conducted using uniaxial tensile tests. Damage is evaluated by the variations of the Young's modulus and the total number of cracks (either in the total volume of the specimen or only between the fibres inside the bundles) as functions of the applied strain, from the end of the linear behaviour to failure. It is shown that the Aveston. Cooper & Kelly model commonly used for the interfacial shear stress estimation is not applicable to this material.

The dye penetrant technique was used to measure crack lengths in the volume of SENB specimens of polycrystalline alumina tested using three-point bending. The incremental work of fracture was calculated from these crack length values assuming linear elastic behaviour (G R ∗ ), and the R curve was derived taking into account linear non-elastic behaviour ( G R ∗ = φ - G ). In the first case the incremental work of fracture starts from 26 J m 2 and increases up to a plateau value of 73 J m -2 while in the second case the resistance increases continuously. Crack mouth bridging by grains partially pulled out is shown to be at the origin of these R curves, the increase in which was used to evaluate the bridging stress in the wake of the propagating crack. The cumulated number of counts in acoustic emission ψN is shown to be a linear function of the macroscopic crack extension Δa.

Video-assisted mitral valve surgery by right mini-thoracotomy is adopted systematically in many centers in the world. It is a safe procedure that offers good results with low morbidity. His major interest can be appreciated in surgical management of mitral valve regurgitation after coronary artery bypass.

The scapula is an uncommon site for a chondroma. We report the case of a chondroma in the left acromion, which presented as a painful shoulder in a 19-year-old teenager. The diagnosis was suspected on radiographs and CT scan and confirmed by histological findings.

National audience; OBJECTIVE: Pseudomonas aeruginosa is a major causative agent of hospital infections. Studies on this subject being rare in Algeria, we determined the antibiotic susceptibility of P. aeruginosa and investigated the mechanisms of beta-lactam resistance and the spread of multidrug resistant strains in the university affiliated Hospital of Tlemcen (Algeria). DESIGN: One hundred and ninety-nine consecutive strains of P. aeruginosa were collected between November 2005 and February 2007. MICs of antibiotics were measured by the agar dilution method. The resistance mechanisms to beta-lactams were identified phenotypically or by molecular methods (isoelectrofocusing, PCR and sequencing). Strains expressing a secondary beta-lactamase were serotyped and genotyped (Random Amplified Polymorphic DNA). RESULTS: The proportion of susceptible isolates were: ticarcillin (56%), piperacillin-tazobactam (81%), ceftazidime (88%), cefepime (80%), aztreonam (64%), imipenem (65%), amikacin (83%), tobramycin (81%) and ciprofloxacin (97%) according to the French CASFM breakpoints. Resistance to beta-lactams was linked to the production of transferable beta-lactamases (16%), overproduction of cephalosporinase AmpC (12%) and/or non-enzymatic mechanisms such as the loss of porin OprD (35%) and overproduction of the active efflux system MexAB-OprM (24%). High level resistance to ticarcillin was due to the expression of beta- lactamase OXA-10 alone or associated with TEM-110. A genotypic analysis revealed the spread of a multidrug resistant epidemic clone expressing these two acquired beta-lactamases in the surgical ICU. CONCLUSIONS: This study shows that resistance to antibiotics, in particular to imipenem of P. aeruginosa, is becoming a cause of concern in the Hospital of Tlemcen.

Evaluate the effects of skin infiltration with ropivacaine 0,75% on postoperative pain after caesarean section in the first 24h.A prospective randomized double blind study was realized during three months in Auxerre Hospital. All ASA 1-2 patients presenting for elective caesarean section under spinal anesthesia were enrolled in the study. Drug addicts and patients with chronic pain were excluded from the study. The patients were randomly divided into two groups to receive skin infiltration 20 ml of ropivacaine 0,75% (Gr R) or skin infiltration of 20 ml of 0,9% saline solution. All patients received systematically propacetamol 1g per six hours and ketoprofen 50mg per six hours. Intravenous morphine titration was delivered to patients with a simple numerical scale greater or equal to three (SNSor =3). Postoperative pain (SNS), morphine consumption and adverse reactions were compared.From July to September 2005, 42 patients were enrolled in the study. The SNS was lower in the Gr R. Total morphine consumption was reduced in the Gr R. The incidence of the adverse effects were higher in the Gr P. One case of parietal haematoma was detected in the Gr P, the evolution of which was favorable.Skin infiltration of ropivacaine 0,75% is a simple technique able to reduce postoperative pain score and morphine consumption after caesarean section.

We show that whenever densely similar operators on a Banach spaces, their approximate point spectra must have non-empty intersection. Also, we introduce the class $\mathcal A$ that consists of those operators for which the Goldberg spectrum coincides with the right essential spectrum. We study spectral properties of quasisimilar operators satisfying Bishop's property $(\beta)$ in the class $\mathcal A$. Finally, as an application to the class $\mathcal N$ that consists of those operators $T$ whose range $R(T)$ is contained in the linear span of finite number of orbits of $T$, we show that any two quasisimilar operators such that are in $\mathcal N$ and satisfying property $(\beta)$ must have the same approximate point spectrum.

This retrospective study has for objective to compare the effect of tranexamic acid with low-dose of aprotinin therapy on blood loss in reoperative cardiac surgery.Ninety-one adult patients underwent repeated open-heart surgery. Two groups of patients were collected. The aprotinin group AP (N=60) has received an intravenous full low dose of 500000 UIK of aprotinin. The tranexamic group TA (N=31) has received 30 mg/kg of tranexamic acid. Criteria for assessment included: cumulative blood loss at 4 hours and 20 hours after operation, need for transfusion and parameters of coagulation (platelet, fibrinogen count).Demographics characteristics and echocardiographic data were similar between the tow groups. Postoperative blood loss at 4th hour and at 20th hour were reduced in tranexamic group compared with aprotinin group (P=0,009, P=0,001). The transfusion requirement was frequent in the AP group 39% vs 19.4% in TA group. The TA group received fewer total unit of red blood (0.38 unit RBC/patient vs 1.06 in AP group) [RBC=red blood cells]. There was no statistically significant difference in platelet and fibrinogen profiles.This study concludes that tranexamic acid and low dose aprotinin effectively reduces postoperative bleeding in repeat open-heart surgery. However, the marked difference in superiority between these tow drug therapies needs the randomized and controlled study.

To discuss the diagnostic and the prognostic problems of vesicouterine fistulas (VUF) emphasizing on the therapeutic characteristics that lead to successful treatment.The authors retrieve retrospective series of 16 cases, collected between 1989 and June 2006, and they analyze the clinical, diagnostic and therapeutic aspects.The patients were young (29-40 years) with an average having three children. Cesarean was the most frequent etiology. The presentation symptoms were hematuria (in five cases), a urinary incontinence through the vagina (in eight cases) and both of them (in three cases). The diagnosis was suspected from the history and confirmed by the additional analyses. The treatment was surgical (excision of the fistulas) in 15 cases with an average follow-up of 2.5 years, the results on the functional aspect were satisfactory hence they were marked by the absence of urinary incontinence as well as the hematuria. On the obstetric aspect, the occurrence of pregnancy was noted in a patient at four years post-VUF repair.Vesicouterine fistulas are not very frequent and most often secondary to a cesarean or to consequences of difficult delivery. The treatment is essentially preventive by improving the obstetrical techniques through avoiding the bladder injuries during the cesareans.

Middle aortic syndrome (MAS) results from a diffuse narrowing of the distal thoracic or abdominal aorta commonly involving both the visceral and renal arteries. Congenital, acquired, inflammatory, and infectious etiologies have been described. Symptoms typically occur within the first three decades of life and include hypertension, lower extremity claudication, and mesenteric ischemia. The condition is considered a life-threatening emergency as a result of the complications associated with severe hypertension. Diagnosis is made with magnetic resonance and computed tomography angiography. Surgical bypass grafting is the optimal method of treatment and must be tailored depending on the distribution of disease. We report one case of MAS treated with thoracic aorta to abdominal aorta bypass and reimplantation of the right renal artery.

In this paper we propose an EBG antenna which presents a good candidate for microwave links systems and more specifically for point to point and the point to multipoint applications required directives antennas with a high gain. The design of the antenna is consisting of a waveguide-fed slot antenna on which we add a one dimension EBG resonator structure, to obtain the required goals. The frequency band chooses for this antenna is the band 38-40 GHz. The results of simulations and the experimental measurements are presented and compared. We obtained an antenna with 20 dBi of gain and a half-power angle of 9° in the two principals planes H and E with a good adaptation (S 11