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Objective. Current wearable respiratory monitoring devices provide a basic assessment of the breathing pattern of the examined subjects. More complex monitoring is needed for healthcare applications in patients with lung diseases. A multi-sensor vest allowing continuous lung imaging by electrical impedance tomography (EIT) and auscultation at six chest locations was developed for such advanced application. The aims of our study were to determine the vest’s capacity to record the intended bio-signals, its safety and the comfort of wearing in a first clinical investigation in healthy adult subjects. Approach. Twenty subjects (age range: 23–65 years) were studied while wearing the vests during a 14-step study protocol comprising phases of quiet and deep breathing, slow and forced full expiration manoeuvres, coughing, breath-holding in seated and three horizontal postures. EIT, chest sound and accelerometer signals were streamed to a tablet using a dedicated application and uploaded to a back-end server. The subjects filled in a questionnaire on the vest properties using a Likert scale. Main results. All subjects completed the full protocol. Good to excellent EIT waveforms and functional EIT images were obtained in 89% of the subjects. Breathing pattern and posture dependent changes in ventilation distribution were properly detected by EIT. Chest sounds were recorded in all subjects. Detection of audible heart sounds was feasible in 44%–67% of the subjects, depending on the sensor location. Accelerometry correctly identified the posture in all subjects. The vests were safe and their properties positively rated, thermal and tactile properties achieved the highest scores. Significance. The functionality and safety of the studied wearable multi-sensor vest and the high level of its acceptance by the study participants were confirmed. Availability of personalized vests might further advance its performance by improving the sensor-skin contact.

This paper presents the results of 4D (time-lapse) seismic analysis of the westerly dipping Brent Group fault blocks of Alwyn North, a TotalFinaElf oil field located in the northern North Sea. Two legacy 3D surveys were used; one shot in 1980–1981, the second in 1996 with different sources, shooting directions and other acquisition and processing parameters. The Brent reservoir is of Middle Jurassic age, Alwyn North burial depths are in excess of 3000 m and oil production commenced in 1987. Careful processing and imaging of the amplitudes from the two surveys produced a visual qualitative comparison with hydrocarbon production, water injection and fluid movement within the reservoir. The 4D results show a close correspondence to the sweep determined by reservoir simulation after nine years of production and confirmed by well results. A third 3D survey was acquired in 2001, following commencement of miscible gas injection, and further 4D work is planned to follow on from the encouraging results of the present study.

We report here a combination of site-directed mutations that eliminate the high-affinity Ca(2+) response of the large-conductance Ca(2+)-activated K(+) channel (BK(Ca)), leaving only a low-affinity response blocked by high concentrations of Mg(2+). Mutations at two sites are required, the "Ca(2+) bowl," which has been implicated previously in Ca(2+) binding, and M513, at the end of the channel's seventh hydrophobic segment. Energetic analyses of mutations at these positions, alone and in combination, argue that the BK(Ca) channel contains three types of Ca(2+) binding sites, one of low affinity that is Mg(2+) sensitive (as has been suggested previously) and two of higher affinity that have similar binding characteristics and contribute approximately equally to the power of Ca(2+) to influence channel opening. Estimates of the binding characteristics of the BK(Ca) channel's high-affinity Ca(2+)-binding sites are provided.

The rupture appearances and pressures are compared for clamped disks, biaxially stressed to rupture under upward increasing pressures of helium or of an embrittling fluid such as gaseous hydrogen isotopes. Usually the downward surface is available for observation during the test in progress, but it can be exposed to a second embrittling medium. Factors studied include: (a) for the materials; chemistry (aluminum, cobalt, chromium, copper, iron, nickel, platinum, titanium, uranium, and zirconium, base), surface conditions, thermomechanical processing, and welding, (b) for the testing conditions (-196 to -450$sup 0$C), H$sub 2$ pressure, purity, and pressure increase rate. Low-cycle fatigue and delayed failure tests can also be conducted and discontinuous cracking monitored by various techniques, especially permeation. The disk pressure test (DPT) can be used for selection and quality control of bulk materials, protective coatings against hydrogen environment embrittlement (HEE), and their processing. Materials selection is made according to screening tests of increasing severity. The DPT shows evidence of other causes of embrittlement and their synergistic effects with HEE, which is quite important. Other advantages of DPT, such as sensitivity, versatility, rapidity, simplicity of operation and maintenance, safety, low cost of specimens, and equipment, are outlined and compared with other methods. (auth)

The overall status of the fast breeder reactor (FBR) system is periodically reviewed in France. In 1983, a report was prepared on the status and prospects of the FBR system at the request of the then Minister of Industry. Five years later, Electricite de France (EdF) and the French Atomic Energy Commission (CEA) jointly updated this report. The FBR reactor system economic considerations mentioned here are taken from the work performed in 1987—88 for this updating. The position in 1983 is reviewed to highlight concrete developments. Developments that have occurred since then are presented, along with the prospects that today enable us to define better the technical and economic potential of the FBR system. In conclusion, the effects of these findings on desirable directions are discussed, in particular with regard to European FBR cooperation.

In patients with fulminating pulmonary edema not responsive to conventional therapy, venoarterial membrane lung bypass can provide assistance if decreased systemic blood pressure prevents use of high-level positive end-expiratory pressure ventilation. In 10 patients with acute respiratory failure, partial venoarterial bypass provided a rapid and marked improvement of systemic oxygenation. Measurement of pulmonary blood flow (PBF) and intrapulmonary shunting (QD s /QD p ) during bypass via prolonged left heart catheterization showed that left ventricular PaO2 was increased through a rapid and profound reduction of QD s /QD p . During the first days of bypass, derecruitment of pulmonary vessels is probably the mechanism of improved pulmonary oxygenation. When low pulmonary arterial pressures (PAP) are sustained, resorption of pulmonary edema is favored. Despite the beneficial effects of bypass, death occurred in every case due to diffuse interstitial fibrosis and/or parenchymal damage. The absence of healing, due to prolonged circulatory exclusion, may be detrimental despite immediate improvement. Because of this possibility, venovenous or mixed perfusion should be more extensively explored.

SummaryA study was carried out to investigate the pharmacokinetic parameters of erythromycin lactobionate and erythromycin ethylsuccinate in patients with acute exacerbation of chronic bronchitis. Erythromycin concentrations in serum and sputum were determined after 1 g oral doses of the ethylsuccinate and after a 500 mg intravenous injection of the lactobionate. Models of the doses and regimens were simulated from the data. The results demonstrated the fast diffusion of erythromycin lactobionate in the peripheral compartment. Plasma and bronchial secretion concentrations of the two products were particularly high, especially in the case of the lactobionate which, therefore, is indicated in the most severe infections.

33 patients with serious gram-negative bacillary infections were treated with cefotaxime. In patients with normal renal function the dose varied between 1.5 to 4 g/day. 17 patients had urinary tract infections, 5 respiratory tract infections, 1 combined urinary tract infection and respiratory tract infection, and 10 miscellaneous infections. 16 patients had septicemia. 25 infections were due to pathogens resistant in vitro to ampicillin, cephalothin, gentamicin and/or tobramycin. 15 infections had failed to respond to ampicillin, cefazolin, gentamicin or tobramycin therapy. 32/33 patients responded favourably to cefotaxime (cure or improvement) but 4 patients developed superinfection with cefotaxime-resistant bacteria. No evidence of nephrotoxicity was observed except for a transient moderate rise in creatinine in one patient.

Right heart catheterisation was undertaken in six patients with accidental deep hypothermia. Studies were carried out before and after rapid blood volume expansion, with and without Isoproterenol infusion, and were repeated at normal body temperatures. The initial haemodynamic pattern indicated a marked hypovolemia with a simultaneous decrease of both cardiac output and ventricular filling pressures, and a decreased measured total blood volume. Rapid correction of the hypovolemia revealed cardiac insufficiency, in part due to the persisting bradycardia. Left ventricular function was depressed in patients with prolonged cold exposure and normal in patients with short exposure. These abnormalities disappeared after Isoproterenol infusion during hypothermia, and spontaneously after return to normothermia. No imbalance existed between the decreased cardiac output and oxygen uptake in hypothermia, arterio-venous oxygen difference being within normal limits.

A prospective study was undertaken in a multidisciplinary intensive care unit to determine the proportion of complications due to anticoagulant therapy, to evaluate their severity and to estimate what proportion was potentially avoidable. Among 1911 hospitalized patients over a 3 year period, 30 patients had a complication of anticoagulant therapy (1,57 p. 100). The causality was definite in 14 cases, probable in 14 and possible in 2 cases. Nineteen p. 100 were hemorrhagic complications. These iatrogenic illnesses were fatal in 5 cases, life-threatening in 6, moderate in 15 and minor in 4 cases. Potentially avoidable complications accounted for 60 p. 100 of the cases and were due to biological overdosage or interaction between drugs. Our results indicate that some complications of anticoagulant therapy could be reduced or eliminated by medical education and increased information.

All patients admitted during a 33-month period to a multidisciplinary intensive care unit were prospectively studied in order to determine the incidence and severity of drug-induced illness leading to the admission. The role of underlying diseases was assessed and the avoidability of drug-induced illness considered. Out of 1651 patients, 97 (5.88%) were admitted because of drug-induced illness; 74 of these had serious underlying diseases. 13 (13.4%) of the 97 patients died, but underlying diseases accounted for 4 of the 13 fatalities. In nearly half of the cases, the drug-induced illness appeared potentially avoidable.

SummaryThe rationale for the use of a narrow-spectrum antibiotic such as erythromycin is reviewed and the results are reported of the use of erythromycin lactobionate, 2 g daily given by intravenous infusion for 5 days, in 17 patients with acute exacerbations of chronic bronchitis. Thirteen of the patients showed an excellent response to treatment, as assessed by clinical and radiological findings, although the results were not always supported by the bacteriological data. Gram-negative bacilli were isolated from the sputum of all 4 patients who failed to respond to erythromycin, and 3 were subsequently treated successfully when antibiotic therapy was changed.

Resume Les variations de resistivite electrique en fonction de la temperature ont ete determinees pour huit alliages Pu-Ga en phase delta a la temperature ambiante entre 5°K et 300°K. Apres une description succincte du dispositif experimental et des caracteristiques des echantillons, les resultats sont exprimes sous forme de courbes ρ = f(T) pour chaque teneur en gallium et de courbes ρ = f (teneur % Ga) aux differentes temperatures. Comme pour le plutonium α non allie, la resistivite de chaque alliage Pu-Ga en phase δ presente un maximum et comme pour les alliages Pu-Al et Pu-Ce, ce maximum est relie etroitement a la concentration. De 3 a 10 at % les alliages Pu-Ga ne subissent aucun changement de phase quand ils sont refroidis a 5°K. Par contre ceux a faible teneur en gallium (de 1 a 1,7 at %) se transforment partiellement en phase α en dessous de 300°K. La phase α obtenue se maintient dans un etat metastable a 300°K.

Resume Le diagramme de phase ( P , T ) a ete determine pour les alliages Pu- n at % Ga (avec n = 2, 4, 6, 8) entre 20°C et 700°C dans l'intervalle de pressions de 0 a 40 kbars. De cette etude a ete deduit un diagramme a trois dimensions (pression, temperature, teneur %). L'accent a ete mis principalement sur les limites du domaine correspondant a la phase δ.

Resume L'existence des composes PuCu 2 et PuCu 4 est mise en evidence par diffusion dans l'etat solide. La cinetique de croissance et le mecanisme de formation de ces phases sont etudies en utilisant des couples constitues d'un alliage bi-phase Pu-Cu et de cuivre pur. Une phase ternaire de composition approximative PuCu 3 avec une teneur variable en gallium a ete mise en evidence en utilisant des couples constitues de cuivre pur et d'alliages Pu-Ga. Les parametres cristallins sont determines par la methode de Debye-Sherrer sur des alliages obtenus par elaboration directe ou par diffusion.

The investigation of 49 cases of septic shock shows very low plasma kaolin induced arginine esterase. This is due not only to a decrease in prekallikrein and often in Hageman factor, but also to a decrease in a prekallikrein activator, whose level is independent of Hageman factor levels.

Age, previous health status (HS), and severity of acute illness were assessed prospectively on 228 unselected patients admitted over 1 yr to the multidisciplinary ICU, to determine their influence on outcome. One hundred and fifty patients (66%) were discharged from the ICU, but the survival rate fell to 50% at 6 months, and was similar after 1 yr (49%). Over a 6-month period, there was improved HS in survivors which gradually leveled off. Compared to prior HS, the final HS was worsened in 37% of survivors. Three factors were important predictors of late survival: age under 50, good previous HS, and less than two visceral failures. We conclude that evaluation of ICU outcome should provide information on 6-month survival and HS and include important variables as age, previous HS, and severity of acute illness.

Resume L'auteur rappelle la definition et les possibilites d'application d'une politique antibiotique en milieu hospitalier. Il presente les modalites de mise en place a partir d'une classification en 4 groupes des antibiotiques utilises en milieu hospitalier. La necessite d'une mise a jour des donnees est soulignee.

Pulmonary complications of lymphography are usually described as radiological infiltrates without clinical symptoms. However, a case is here reported of an adult respiratory distress syndrome occurring after lymphography in a 60 year old female lymphoma patient. Pulmonary oedema developed within 48 h; haemodynamic study showed a normal capillary wedge pressure. The patient died from intractable low cardiac output within 24 h. Post-mortem examination showed pulmonary lymphocytic infiltration and multiple fat emboli. The lack of lymphatic drainage was probably responsible for the intravascular passage of lipid-soluble contrast medium, this giving endothelial lesions. In such patients with preexisting lung disease or pulmonary involvement in haematological disease, lymphography has to be considered carefully.

Resume Les informations suivantes ont ete recueillies dans un cas de leptospirose grave chez un homme de 54 ans : absence de reaction meningee ; etiologie mixte de la defaillance circulatoire : myocardite et choc hypovolemique ; mecanisme probablement immuno-pathologique de la thrombopenie ; possibilite de recuperation du germe a partir d'hemocultures aerobies standard par repiquage sur milieu special ; serodiagnostic de depistage (antigene TR-IPP) moins sensible que la sero-agglutination specifique.

The French energy situation can easily be characterized by three figures: 3% of the world energy consumption 0.7% of the world energy production 0.11% of the world proven energy reserves

This work aims at the evaluation of the effects of dobutamine in the effects of dobutamine in the treatment of septic shock and to compare them to the effects of dopamine used in the same conditions. Eleven patients presenting with both a state of septic shock and confirmed cardiac insufficiency were submitted to the protocol. The dosage was determined by the clinical results : 6.22 microgram/kg/min for dopamine and 4.2 to 25 microgram/kg/min for dobutamine. The results show that although the effect on cardiac output is comparable with the two drugs, some differences in their effects delineates their respective distinct indications. Indeed, although dobutamine seems less arythmic, lovers more the ventricular filling pressure and increases less the intra-pulmonary shunt, dopamine causes less reduction in the systemic resistance which in the case of septic shock seems more logical. Nevertheless dobutamine is perhaps easier to handle.