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Resume Les metastases hypothalamo-hypophysaires sont rares. Elles peuvent etre revelees soit de facon fortuite, soit pendant l’evaluation des symptomes lies a un dysfonctionnement hypothalamo-hypophysaire. Le diabete insipide demeure la presentation la plus commune. Dans ce travail, nous rapportons l’observation d’une patiente traitee pour un cancer du sein ayant presente une metastase hypothalamo-hypophysaire apres six ans d’evolution. Le diagnostic a ete confirme par une IRM.

This paper presents a 2-layer 3D stacked Back Side Illuminated vision chip performing high speed programmable parallel computing by exploiting in-focal-plane pixel readout circuits. The proposed circuit exhibits a 5500fps frame rate, 5 times higher than previous works without reducing ADC resolution. It allows heterogeneous parallel computations on up to 31×31 inter-pixels neighborhoods in a single chip.

International audience; Copper-copper direct bonding is a fundamental procedure in three-dimensional integration. It has been reported that voiding occurs in bonded copper layers if process temperatures exceed 300A degrees C; this leads to serious reliability issues. However, voiding nucleation and growth mechanisms have not been clearly established. Void characteristics were compared for different bonded structures specifically designed to identify the origin of void formation and its contribution. It seems that mechanical stress caused by different dilatation of silicon substrates and metal thin films leads to metallurgical creep. This stress-driven vacancy diffusion makes a major contribution to the reliability problem. This study provides better understanding of these physical phenomena and can be used as guideline for metal integration.

International audience; Wafer level metal bonding involving copper layers is a key technology for three-dimensional integration. An appropriate surface activation can be performed in order to obtain room temperature direct bonding with bonding strength to be compatible with microelectronic device integration. In this paper, we focus on bonding strengthening mechanisms in the low temperature range from 20 to 100 A degrees C. In order to improve the bonding interface closure, several process parameters are studied: water amount available when surfaces are brought into contact and copper layers deposition technique have been identified to be predominant in this low temperature range. Based on metal oxidation theory, several mechanisms are proposed and some calculations on this bonding strengthening are performed. For the first time, activation energies of this phenomenon are obtained for copper layers deposited by different method in the specific environment of the bonding interface. This study gives guidelines and recommendations for the integration of this metal bonding technique at low temperature.

For its good resistivity and reliability, copper remains the most widely used material for metal interconnections since the early 1990s [1]. Concerning the 3D-integration technological transition for next generation integrated circuits, copper still remains interesting as a bonding material. In this specific configuration, this metal allows wafer or die level assembly of active component strata with high bonding strength and it also ensures interlayer electrical conduction, reducing interconnection delays and increasing overall performances [2-3]. In the process temperature range from 300°C to 400°C, the voiding mechanism that drives the structure failure [4-5] shows similar characteristics to stress-induced voiding previously reported in basic encapsulated copper interconnections [6]. However, regardless of the bonding technique, void density, shape and location exhibit variations which cannot be explained by the mechanisms previously established. In this paper, we investigate several factors, including copper surfaces roughness, copper layer microstructure and bonding processing parameters to weight their impact on the voiding phenomenon. Better understanding of void formation has enabled the achievement of wafer assemblies exhibiting much higher reliability and bonding quality. 200mm thermally oxidized silicon substrates are used in this study. 500nm-thick copper layer are then deposited on a 20nm-thick titanium nitride layer which is used to prevent copper diffusion into silicon substrate. Copper-copper bonding is studied through two different bonding techniques: direct bonding at room temperature under atmospheric pressure after surface activation by chemical and mechanical polishing (CMP activated bonding) and thermocompression bonding (TC bonding) using a combination of a thermal budget and compressive stress. In both cases, additional post-bonding annealing is accomplished under nitrogen atmosphere. In our bonded copper layers configuration, voiding phenomenon is supposed to have different origins: - Residues of the copper surface roughness which is brought into contact during bonding process and trap some volume - Presence of metal oxide on sample surfaces and its subsequent degradation by annealing - Nucleation and growth of cavities due to standard metallurgical creep mechanisms of copper layers during its thermomechanical loading In order to evaluate roughness impact on the voiding phenomenon, bonding was performed thanks the two different techniques on copper surfaces exhibiting identical surface topology properties (post CMP treatments) (Fig. 1a). In order to aggravate void creation, TC bonding was also performed with extreme parameters in terms of pressure values and copper surface roughness (Fig. 1b). Void densities and volumes were estimated by high resolution Secondary Electron Microscopy (SEM) cross-sections observations (Fig. 2). A special attention was paid to imaging conditions and analysis. Indeed we operated data collection over large sections of about 40µm. In the context of this study we were able to appreciate significant differences between bonded samples. More specifically we focused on volume variations and size distributions which enabled us for instance to highlight the role of roughness in voiding phenomenon. Other possible causes for void generation were also investigated using dedicated experiments: - Gold-gold TC bonding was performed as a bonding reference system involving oxide free metallic layers - Bonding of copper layers carefully deposited on copper bulk substrates to highlight the influence of thermomechanical stress (Fig. 3) In the light of these results, the impact of the different factors will be discussed and the main source of voiding due to creep deformation will be demonstrated. FIGURES CAPTIONS Fig 1 : 20 x 20 µm² AFM scans of copper surface. a- In CMP bonding configuration: RMS roughness is 0.2 nm. b- In TC bonding configuration: RMS roughness is 22 nm. Fig 2 : SEM cross section. a – On CMP activated bonding after a post bonding annealing at 400°C. b – On TC bonding performed at 400°C under a pressure of 2.9 MPa on high-roughness surfaces. Voids are arrowed. Fig 3 : SEM cross section of TC bonding involving copper layers deposited directly on copper bulk substrate. Voids are arrowed. ACKNOWLEDGEMENTS The authors would like to thanks the French Direction Générale de l’Armement (DGA), the French Direction Générale de la Compétitivité de l’Industrie et des Services (DGCIS) and SOITECSA for its financial support. REFERENCES [1] P. C. Andricacos, et al., IBM J. Res. Dev., vol. 42, no. 5, pp. 567–574, Sep. 1998. [2] N. Sillon, et al., pp. 1 –4., IEDM 2008. [3] R. Taibi, et al., pp. 219–225, ECTC 2010. [4] C. S. Tan, et al., Appl. Phys. Lett., vol. 87, no. 20, pp. 201909, 2005. [5] P. Gondcharton, et al., MRS Online Proc. Libr., vol. 1559, 2013, doi : 10.1557/opl.2013.718. [6] H. Okabayashi, Mater. Sci. Eng. R Rep., vol. 11, no. 5, pp. 191–241, 1993.

For the first time, a full 3D CMOS over CMOS CoolCube™ integration is demonstrated with a top level compatible with state of the art high performance FDSOI (Fully-Depleted Silicon On Insulator) process requirements such as High-k/metal gate or raised source and drain. Functional 3D inverters with either PMOS or NMOS on the top level are highlighted. Furthermore, Si layer transfer above a 28nm W Metal 1 level of an industrial short loop and the return in a front end environment is presented, confirming the industrial compatibility of CoolCube™ integration.

Objectif . Rapporter un mode de declaration rare de la periarterite noueuse revelee par un hematome spontane perirenal bilateral recidivant. Materiel et methodes . Un homme de 40 ans, sans antecedent, a presente de facon aigue un syndrome douloureux abdominal febrile explore par echographie et scanner. Resultats . L’echographie et le scanner abdominaux ont objective un hematome perirenal droit avec des multiples infarctus corticaux renaux bilateraux. L’etude histologique de la piece operatoire de la nephrectomie d’hemostase a conclu au diagnostic de periarterite noueuse (PAN). Le patient est revenu trois ans plus tard pour un hematome perirenal du rein restant. La tomodensitometrie a objective un hematome avec des multiples infarctus renaux. Conclusion . La tomodensitometrie volumique en montrant l’association de l’hematome perirenal spontane, des multiples infarctus corticaux renaux chez ce patient mal suivi pour une PAN, a permis de rattacher cet hematome a sa cause par saignement d’un infarctus cortical dans le cadre de l’evolution de la periarterite noueuse malgre l’absence de microanevrismes, et d’eviter le recours a l’arteriographie renale jugee a risque sur ce terrain de rein unique.

We report wafer level assembly of an advanced image sensor with control logic units and memories. The stack includes all back-end levels of a 0.13μm double damascene technology. The back-side imaging structure consists of 12 metal levels connected via direct hybrid copper-copper and oxide-oxide bonding. Thanks to a 3 step Chemical Mechanical Polishing (CMP) process applied at the bonding level and a proper wafer conditioning, the bonding was achieved at room temperature (RT) and under atmospheric pressure, with an x-y alignment precision below 400nm. The annealed structure has a pure copper metal connection with excellent mechanical and electrical properties. Beyond the next generation image sensors and hybrid integration, this demonstration appears as a good omen for a general three-dimensional (3D) IC integration via direct bonding.

From low density 3D integrations embedding Via Last Through Silicon Vias (TSV) to high densities hybrid bonding or 3D VSLI CoolCubeTM solutions, a multitude of new product opportunities is now envisioned. An overview of existing emerging 3D integrations is provided covering Image sensors, Photonics, MEMS, Wide I/O memories and Silicon Interposers for advanced logics. Associated key challenges and developments are highlighted focusing on 3D platform performance assessment.

session 5: 3D Systems and Packaging; International audience; 3D VLSI with a CoolCube™ integration allows vertically stacking several layers of devices with a unique connecting via density above a million/mm 2 . This results in increased density with no extra cost associated to transistor scaling, while benefiting from gains in power and performance thanks to wire-length reduction. CoolCube™ technology leads to high performance top transistors with Thermal Budgets (TB) compatible with bottom MOSFET integrity. Key enablers are the dopant activation by Solid Phase Epitaxy (SPE) or nanosecond laser anneal, low temperature epitaxy, low k spacers and direct bonding. New data on the maximal TB bottom MOSFET can withstand (with high temperatures but short durations) offer new opportunities for top MOSFET process optimization.

Promoted by the component miniaturization trend, three-dimensional integration appears as a promising option for implementation of the next generation of integrated circuits. In this context, copper is still an interesting material to be integrated to vertical interconnexion through direct metal-metal bonding processes. However, it was already reported that voiding phenomena occur in bonded copper layers for temperature beyond 300°C leading to serious reliability problems. This paper aims at explaining voiding mechanisms in the specific metal bonding configuration. Voiding characteristics are compared in different structures allows highlighting several thermal effects. It appears that the mechanical stress sustained by copper layers during post-bonding thermal processes is the main contribution in the voiding phenomenon. Creep mechanisms occurring in polycrystalline copper structure could be considered as the origin of this phenomenon. This study offers better understanding of reliability problems in structures involving encapsulated copper layers and can be used as guideline for metal bonding integration.

In recent years, a great interest has emerged in the development of new wafer-scale assembly processes. Beside the mechanical strength required, some applications need a vertical conductivity leading to implement metal thin films as bonding layers. For its interesting properties in terms of resistivity and reliability, copper has been already used in metal-metal direct bonding configuration. Initially developed on amorphous silicon dioxide layers, the polycristallinity character of metal films has a direct impact on the direct bonding mechanisms. In this paper, we will study the effect of grain size on direct bonding of polycrystalline copper thin films. More specifically at temperature below 150°C, a fine-grain copper microstructure demonstrates a fast sealing strengthening. For higher temperature application, a larger grain size enables limiting the copper-barrier interface damage and preserves a strong mechanical link between substrates.

Summary — Introduction — Blood measure of carbon monoxide: · methods of measure · results — Review of the literature: · historical studies in healthy volunteers · relationship between the atmospheric CO concentration and carboxyhemoglobin (COHb) · relationship between the COHb and the severity of the symptoms · relationship between the psychome-trics tests, the COHb and blood pH · prognostic value of the COHb — Conclusion

We have successfully produced and characterized thin single crystal Ge films on sapphire substrates (GeOS). Such a GeOS template offers a cost-effective alternative to bulk germanium substrates for applications where only a thin (

The thermal budget/integration challenges for SOLES have been investigated. A process window has been found that allows for the successful demonstration of a monolithically integrated III-V/Si differential amplifier. A method of increasing the integration flexibility of SOLES by introducing SiN x interlayers has been demonstrated. Future work will explore the increased thermal budget/integration flexibility of SOLES provided by incorporating embedded GaAs layers.

We present results on the direct monolithic integration of III–V devices and Si CMOS on a silicon substrate. InP HBTs (0.5 × 5 um2 emitter) with ft and fmax ≫ 200GHz were grown directly in windows adjacent to CMOS transistors on silicon template wafers or SOLES (Silicon on Lattices Engineered Substrates). A BCB based multilayer interconnect process was used to interconnect the InP HBT and Si CMOS to create a differential amplifier demonstration circuit. The heterogeneously integrated differential amplifier serves as the building block for high speed, low power dissipation mixed signal circuits such as ADCs and DACs.

We present results on the direct monolithic integration of III–V devices and Si CMOS on a silicon substrate. Through optimization of device fabrication and material growth processes III–V devices with electrical performance comparable to devices grown on native III–V substrates were grown directly in windows adjacent to CMOS transistors on silicon template wafers or SOLES (Silicon on Lattices Engineered Substrates). While the results presented here are for InP HBTs, our direct heterogeneously integration approach is equally applicable to other III–V electronic (FETs, HEMTs) and opto-electronic (photodiodes, VSCLS) devices and opens the door to a new class of highly integrated, high performance, mixed signal circuits.

Introduction Le diabete est un sujet toujours d’actualite avec l’evolution epidemique du diabete de type 2 dans le monde. De ce fait, il implique une actualisation reguliere de nos connaissances et de nos positions en medecine aeronautique, notamment vis-a-vis du traitement. De nouvelles therapeutiques basees sur les hormones incretines, paraissent prometteuses et meritent toute l’attention de l’expert aeronautique. A travers un cas clinique demonstratif, on va objectiver l’apport de ces nouveaux traitements ainsi que la decision d’aptitude dans ce nouveau contexte. Cas clinique Il s’agit d’un pilote de ligne âge de 51 ans, diabetique type 2 depuis 2001, non complique, initialement controle sous Metformine, ayant une aptitude par derogation avec suivi semestriel. En 2009 l’HbgA1c a 8,1 % continuait a progresser sous dose maximale de Metformine et ensuite sous association d’un inhibiteur de l’alfa glucosidase. L’indication de l’association d’un inhibiteur de la DPP4 etait posee par l’endocrinologue, ainsi le controle glycemique est obtenu (HbgA1c Discussion L’aptitude du pilote diabetique de type 2 implique outre un bon equilibre et l’absence de complications hautement dangereuses pour la securite des vols, un traitement compatible avec l’activite aeronautique. Les inhibiteurs de la DPP4 sont une nouvelle classe therapeutique permettant un gain d’HbgA1c de 0,6 % a 1,1 %, presentant par leur mecanisme d’action l’absence de risque d’hypoglycemie, condition majeure pour l’autorisation d’un antidiabetique en aeronautique sous couvert d’une derogation et d’un suivi rigoureux. Ces nouvelles therapeutiques permettent d’eviter une inaptitude definitive du pilote qui serait une deception double pour le navigant et pour la societe.

We observed a 51-year-old woman who was admitted for severe amitriptyline overdose. Besides major cardiovascular complications, the patient developed severe hyperpyrexia with a central body temperature of more than 43 degrees C for 5 h. The patient died on day 3 from cardiocirculatory collapse and arrhythmias. Hyperthermia was unresponsive to cooling with ice water, gastric lavage, muscle relaxation, and dantrolene and bromocriptine administration. The possible mechanisms of refractory hyperthermia are discussed.

SYSTEMIC AND LOCAL EFFECT: Smoke inhalation causes systemic and local, mainly respiratory, toxicity due to the asphyxiant and irritant properties of toxic gases.The syndrome of oxygen deprivation and intoxication by asphyxiant gases is caused by combustion-induced oxygen deprivation and exposure to carbon monoxide (CO) and cyanide (CN), but also to other toxic gases. A loss of consciousness is a good sign of systemic toxicity; however, the respective role of CO, CN and other toxic gases cannot be determined. The presence of apnea, lactic acidosis, and severe cardiovascular disturbances is consistent with CN poisoning. A correlation exists between blood CO concentration determined on a sample obtained at the site of the fire, and the occurrence and severity of the clinical disorders.This syndrome explains the mucosal injury affecting the eyes and the lungs. These complications are better diagnosed by clinical examination rather than by various investigations such as chest X-ray or fiberoptic bronchoscopy. Dysphonia is always a sign of severe poisoning.In non-burned victims, delayed neurological and respiratory complications can be observed. Oxygen administration is the cornerstone supportive therapy. Hyperbaric oxygen should be discussed according to the severity of the syndrome of oxygen deprivation and intoxication by asphyxiant gases. In case of cyanide poisoning, a safe and effective antidote should be given; hydroxocobalamine seems to be the drug of choice. Supportive treatment is efficient to treat respiratory failure. Endotracheal intubation should be considered in patients exhibiting early dysphonia associated with dyspnea.

hemangiome vertebral est la tumeur primitive osseuse la plus frequente au niveau du rachis. Cette tumeur vasculaire benigne est asymptomatique dans la majorite des cas et est souvent de decouverte radiologique fortuite. Nous rapportons ici le cas d’un enfant presentant des signes neurologiques en rapport avec un hemangiome vertebral compressif dont le diagnostic et le bilan lesionnel ont ete faits par l’IRM.

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Resume Les auteurs presentent une revue iconographique de l’imagerie de la pathologie aigue de l’aorte en tomodensitometrie et en imagerie par resonance magnetique. La strategie diagnostique et les indications des differentes techniques d’imagerie tiennent compte de l’etat d’urgence, mais souvent l’angioscanner se revele comme l’examen a faire en urgence.

Objectifs pedagogiques Savoir suspecter une atteinte tuberculeuse osteo-articulaire extra-rachidienne devant des signes radiologiques. Decrire les differents signes semiologiques d’une atteinte tuberculeuse osteo-articulaire. Rechercher les complications de ces lesions. Messages a retenir En dehors de l’atteinte rachidienne, la tuberculose osteo-articulaire est plus frequente au niveau des membres inferieurs. Les tableaux radiologiques sont atypiques. Une atteinte corticale avec extension vers les parties molles avec abces juxta-corticaux est un excellent signe en faveur de la tuberculose. L’IRM est l’examen de choix pour delimiter cette affection. L’evolution est chronique aboutissant a une destruction de l’articulation et a de graves sequelles fonctionnelles.

In acute carbon monoxide intoxication the presence of altered consciousness, ranging from transient loss of consciousness to coma, represents a poor prognostic factor and modifies the approach to therapy. Transient loss of consciousness is, as a rule, contemporaneous to the exposure, generally occurring at the scene of the intoxication. We report an unusual case of delayed transient loss of consciousness, occurring in the absence of any other evident aetiology, in one member of an orchestra composed of 110 members after a mass carbon monoxide poisoning.

Effects on cerebral blood flow and oxygenation with vasopressin or epinephrine during experimental CPR.