Search

Summary Introduction Renal arterial vasculature presents a great anatomical variation. A good knowledge of this anatomy is essential in the field of kidney transplantation. The aim of this study is to describe the anatomical variations of the renal arterial vasculature based on the retrieved but not transplanted kidneys (RNTK) and their contralateral grafted kidneys (CGK), which anatomy is described by surgeons themselves after aortic dissection during multi-organ procurement (MOP). Material and methods Using the “Crystal” database of the French “Agence de la biomedecine” (ABM), all RNTK were retrospectively selected over one year. Then, the arterial anatomy of each RNTK and their CGK was studied using the surgical and the histopathological reports. The surgical report was completed by the surgeon at the end of the MOP from deceased donors. The qualitative variables were expressed in numbers (percentage of the population) and were compared by a Chi2 test or an exact Fisher test depending on the sample size. A P-value of less than 0.05 was considered statistically significant. Results In total, 356 kidneys were studied (241 RNTK – 115 CGK), 69% had a single artery and 31% had multiple arteries (26% with two arteries and 5% with three or more). The incidence of multiple arteries was similar between the right and left kidneys (32% vs. 30% respectively). A modal arrangement with 1 artery on each side was present in 51% of cases. Thus, 1 in 2 donors had at least 2 arteries on one side. Multiple arteries were bilateral in 12% of cases. The RNTK group presented more kidneys with multiple arteries than the CGK group (35% vs. 22%). Conclusion Our study shows a higher incidence of multiple renal arteries than the literature (31% vs. 25%). Thus, MOP can be considered as an accurate and reliable method of describing renal arterial anatomy, especially that some small arteries may be missed when using radiological or cadaveric dissection techniques.

The charge radius of the proton, the simplest nucleus, is known from electron-scattering experiments only with a surprisingly low precision of about 2%. The poor knowledge of the proton charge radius restricts tests of bound-state quantum electrodynamics (QED) to the precision level of about 6 × 10–6, although the experimental data themselves (1S Lamb shift in hydrogen) have reached a precision of 2 × 10–6. The determination of the proton charge radius with an accuracy of 10–3 is the main goal of our experiment, opening a way to check bound-state QED predictions to a level of 10–7. The principle is to measure the 2S–2P energy difference in muonic hydrogen (µ–p) by infrared laser spectroscopy. The first data were taken in the second half of 2003. Muons from our unique very-low-energy muon beam are stopped at a rate of ~100 s–1 in 0.6 mbar H2 gas where the lifetime of the formed µp(2S) atoms is about 1.3 µs. An incoming muon triggers a pulsed multistage laser system that delivers ~0.2 mJ at λ ≈ 6 µm. Following the laser excitation µp(2S) → µp(2P) we observe the 1.9 keV X-rays from 2P–1S transitions using large area avalanche photodiodes. The resonance frequency, and, hence, the Lamb shift and the proton radius, is determined by measuring the intensity of these X-rays as a function of the laser wavelength. A broad range of laser frequencies was scanned in 2003 and the analysis is currently under way. PACS Nos.: 36.10.Dr, 14.20.Dh, 42.62.Fi

Solid pseudopapillary tumor of the pancreas is a rare pathologic entity. Although the role of laparoscopy in surgery of the pancreas is still controversial, laparoscopic distal pancreatectomy has been reported with good results in adults. We report a laparoscopic spleen-preserving distal pancreatectomy in a 9-year-old boy who presented with a low-grade malignant tumor. Needle biopsy was impossible. A laparoscopic spleen-preserving distal pancreatectomy was performed. We used four trocars, and the operative time was 240 min. Conversion to open surgery was not necessary. The boy's postoperative recovery was uneventful, and he was discharged on the 6th day. CT-scan control at 6 months was normal. This case shows that even in advanced surgical cases, such as spleen-preserving distal pancreatectomy, laparoscopic procedures can be done safely, within a reasonable operative time, in children.

The behaviour of large-area avalanche photodiodes for X-rays, visible and vacuum-ultra-violet (VUV) light detection in magnetic fields up to 5 T is described. For X-rays and visible light detection, the photodiode pulse amplitude and energy resolution were unaffected from 0 to 5 T, demonstrating the insensitivity of this type of detector to strong magnetic fields. For VUV light detection, however, the photodiode relative pulse amplitude decreases with increasing magnetic field intensity reaching a reduction of about 24% at 5 T, and the energy resolution degrades noticeably with increasing magnetic field. http://www.sciencedirect.com/science/article/B6TJM-47K21KV-1/1/9eb7bcce781352042c63344265f8da97

The operating characteristics of a xenon driftless gas proportional scintillation counter with a P10 microstrip gas chamber photosensor in magnetic fields up to 5Â T are described. Energy resolution of 19% for 2.3-keV X-rays and an equivalent noise of

Large-area 1.9-keV X-ray detectors operating in magnetic fields up to 5 T are required for the /spl mu/p-Lamb shift experiment. Xenon gas proportional scintillation counters provide high detection efficiency together with good energy and timing resolutions. Three prototypes with alternative vacuum ultraviolet photosensors of the xenon scintillation light are explored and discussed: a CsI-coated microstrip plate either integrated within the xenon envelope or in a separate chamber in a P-10 atmosphere and an avalanche photodiode integrated within the xenon envelope.

A measurement of the 2S Lamb shift in muonic hydrogen (µ − p) is being prepared at the Paul Scherrer Institute (PSI). The goal of the experiment is to measure the energy difference �E( 2 5 P3/2 − 2 3 S1/2) by laser spectroscopy (λ ≈ 6µm) to a precision of 30 ppm and to deduce the root mean square (rms) proton charge radius with 10 −3 relative accuracy, 20 times more precise than presently known. An important prerequisite to this experiment is the availability of long-lived µp2S -atoms. A 2S- lifetime of ∼1 µs - sufficiently long to perform the laser experiment - at H2 gas pressures of 1-2 hPa was deduced from recent measurements of the collisional 2S-quenching rate. A new low-energy negative muon beam yields an order of magnitude more muon stops in a small low-density gas volume than a conventional cloud muon beam. A stack of ultra-thin carbon foils is the key element of a fast detector for keV-muons. The development of a 2 keV X-ray detector and a 3-stage laser system providing 0.5 mJ laser pulses at 6 µ mi s on the way.

The vast majority of muon catalyzed fusion research has been concerned with muonic molecules of hydrogen isotopes only, since the dynamics of higher-Z muonic atoms in general preclude the formation of molecular systems. In the specific case of hydrogen–helium mixtures, bound muonic molecular states can exist, and thus it is possible to search for the reaction μd 3He $$\xrightarrow{{\tilde \lambda f}}$$ μ+α(3.66 MeV)+p(14.64 MeV). Until recently, the theoretical predictions for the nuclear fusion rate in the μd 3He molecule, $${\tilde \lambda }$$ f , ranged over one order of magnitude, from 105 to 106 per second. An experimental upper limit has been measured for $${\tilde \lambda }$$ f in HD + 3He giving a value (

The contribution of the root mean square (RMS) proton charge radius to the Lamb shift (2S–2P energy difference) in muonic hydrogen (μp) amounts to 2%. Apart from the uncertainty on this charge radius, theory predicts the Lamb shift with a precision on the ppm level. We are going to measure ΔE (2 S1/2(F=1)–2 P3/2(F=2)) in a laser resonance experiment to a precision of 30 ppm (i.e., 10% of the natural linewidth) and to deduce the RMS proton charge radius with 10−3 relative accuracy, 20 times more precise than presently known. The most important requirement for the feasibility of such an experiment, namely the availability of a sufficient amount of long lived metastable μp atoms in the 2S state, has been investigated in a recent experiment at PSI. Our analysis shows that in the order of one percent of all muons stopped in low pressure hydrogen gas form a long lived μp(2S) with a lifetime of the order of 1 μs. The technical realization of our experiment involves a new high intensity low energy muon beam, an efficient low energy muon entrance detector, a randomly triggered 3 stage laser system providing the 0.5 mJ, 7 ns laser pulses at 6.02 μm wavelength, and a combination of a xenon gas proportional scintillation chamber (GPSC) and a microstrip gas chamber (MSGC) with a CsI coated surface to detect the 2 keV X rays from theμp(2P → 1S) transition.

Many atomic and molecular processes may occur after a muon has been stopped in a mixture of hydrogen and helium isotopes. In particular, the muonic molecule μd3He can be formed. This molecule either decays or undergoes muon catalyzed fusion. Theory predicts a fusion rate much lower than the decay rate; moreover, the various theoretical predictions differ from each other by several orders of magnitude. With the experiment presented here we intend to measure the effective fusion rate via the detection of the 14.7 MeV fusion proton. A new target and gas mixing system, designed at JINR, were used in a ten-day test run at PSI. The fusion protons and products from other transfer and background reactions were measured with several different detectors (plastic scintillators, BGO, Germanium, neutron, and Silicon detectors). The formation rate of the μd 3He molecule and an upper limit for the effective fusion rate have been measured and are presented here.

Introduction En 2013, 150 organes ont ete preleves sur Lyon dont seulement 5 blocs bipulmonaires. Devant ce faible recrutement, il nous a semble important, dans notre population de donneurs en mort encephalique (ME), de verifier la bonne adhesion aux recommandations pour la prise en charge du donneur pulmonaire potentiel [1] , et d’identifier les causes de non-proposition ou de non-selection des greffons pulmonaires par les equipes de greffe. Materiel et methodes Parmi les patients en ME de 18 a 70 ans recenses a Lyon en 2013, nous avons analyse ceux eligibles pour un don de greffon pulmonaire. L’eligibilite des donneurs etait determinee de maniere retrospective de 3 manieres differentes : – selon les criteres d’attribution elargis de l’ABM ; – selon les criteres ideaux de l’ABM; – selon les criteres de selection definis en 2003 par Turlock et al. [2] . Les parametres ventilatoires etaient colliges chez les patients en ME quelques heures avant la realisation de l’epreuve d’apnee (EA), la PaO2 a FiO 2 = 1 etait realisee au debut de l’EA. Les criteres de non-proposition et de non selection ont ete recueillis a partir du dossier donneur CRISTAL de l’ABM. Resultats Sur les 87 adultes recenses, 38 ont ete donneurs d’organes, 24 d’entre-eux presentaient les criteres elargis de l’ABM d’eligibilite au don pulmonaire. Neanmoins, seulement 3 patients presentaient les criteres ideaux de Turlock et aucun n’avait les criteres ideaux de l’ABM. Tous les donneurs proposes ont presente une duree de ventilation mecanique (VM) inferieure ou egale a 3 jours. Les causes de non-proposition ou de refus par les equipes de greffe sont detaillees dans le Tableau 1 . Six donneurs ont ete acceptes par les equipes de greffe et finalement 5 ont ete preleves. Les patients etaient ventiles avec un volume courant moyen de 7,74 ± 1,21 mL/kg de poids theorique, avec une pression expiratoire positive moyenne (PEP) a 6 ± 1.8 cmH 2 O. Les manœuvres de recrutement preconisees et les modalites de realisation de l’epreuve d’hypercapnie etaient rarement rapportees. Discussion Les donneurs potentiels presentant des criteres elargis de l’ABM devraient etre plus largement proposes d’autant plus que des possibilites d’optimisation sont en cours de developpement (systemes de rehabilitation). L’inhalation et l’hematose alteree sont souvent avancees comme causes de non proposition. L’optimisation de l’oxygenation avec une PEP entre 8 et 10 cm H2O devrait donc etre plus systematique. Le seuil de PaO 2 /FiO 2 [3] . Dans notre experience, l’absence ou manque d’information pulmonaire complementaire (fibroscopie, analyse microbiologique) participe egalement a la « non-selection » d’un donneur par l’equipe de greffe. Enfin, l’acces aux images tomodensitometriques pour les equipes de greffe representera un progres majeur notamment en cas de contusions pulmonaires.

s S63 when compare to male donors of the same age group (30-day 8.5% vs 6.9%, 1-year 17.9% vs 15.1%, both p< 0.05). Conclusion: Donor age greater than 50 and particularly above 55 is associated with increased lengths of stay as well as higher 30-day and 1-year mortality rates in cardiac transplant recipients. Female donor age greater than 50 confers an additional risk of short term mortality compared to males. Although additional consideration should be weighed when using donors greater than age 50, survival achieved with older donors remains better than published rates with optimal medical management.

s S61 Methods: 117 patients undergoing HTx at IKEM were prospectively enrolled. AKI was defined as an increase of serum creatinine level by ≥ 50% or worsening of renal function requiring renal replacement therapy (RRT) during 1st week postHTx. Serum Cystatin-C and urinary Neutrophil gelatinase-associated lipocalin (NGAL), alpha-1-microglobulin (A1M) or albumin were serially sampled. Results: 30 patients (25.6% of total) fulfilled the criteria of AKI. Preoperative renal function, demographics and comorbidities were similar between AKI and non-AKI groups. Cystatin-C displayed earliest and the most robust separation between AKI and non-AKI group, with significant difference present already 3 hours after surgery (figure left, arrow) and persisting on day 7 and 10. The increase in Cystatin-C preceded the serum creatinine elevation by 4 days. In univariate analysis, Cystatin-C> 1.6 mg/L at 3-hours after HTx predicted AKI with OR 5.1 (95%CI: 2.2-13) and in multivariate analysis (adjustment to presence of sepsis, bleeding or need of RVAD) with OR 4.4 (95% CI:1.7-12). Urinary NGAL raised significantly only on day 3 in AKI group (p= 0.003). Differences in ACR and A1M values between groups did not reach significance. Interestingly, elevated Cystatin-C (≥ 2.5mg/L at day 7) predicted also long-term mortality after HTx (figure right). Conclusion: Cystatin-C was the most useful for evaluation and prediction of AKI. Measurement of serum Cystatin-C in patients early after HTx (3h after surgery) may help to promptly identify the patients with high risk for renal complications. Elevated cystatin-C also predicts long-term outcome. (Grant NT/11269 5 and NT/ 11262-6 and Institutional support 00023001) ascending aortic diameter was also a predictor and may reflect the risks associated with an undersized allograft. The final predictor was total ischemic time emphasizing the need for improvements in allograft preservation and storage.

We present the final results of an experimental study of $\ensuremath{\mu}d$ and $\ensuremath{\mu}t$ atom scattering in solid hydrogen cooled to $3\phantom{\rule{0.3em}{0ex}}\mathrm{K}$. Strong effects resulting from the Ramsauer-Townsend effect have been observed in the TRIUMF experiment E742 where muons were stopped in thin frozen layers of hydrogen. The measured Ramsauer-Townsend minimum energy for both $\ensuremath{\mu}d$ and $\ensuremath{\mu}t$ atoms and the minimum cross section are in agreement with theory.

Laser spectroscopy of the 2S-Lamb shift in muonic hydrogen (μ−p) is being performed at the Paul Scherrer Institute, Switzerland, to determine the root-mean-square (rms) proton charge radius with 10−3 precision. A multistage laser system has been developed which provides 0.2 mJ pulse energy tunable at 6 μm wavelength. An excimer pumped dye laser is used to drive a titanium sapphire (Ti:Sa) system whose wavelength is then shifted to 6 μm using a multipass Raman cell filled with hydrogen. The short cavity length of the Ti:Sa oscillator (7 cm) guarantees a pulse width of 7 ns and a pulse energy of 1.2 mJ at 708 nm, a wavelength controlled by a mono-mode cw-Ti:Sa laser. The laser is triggered at a maximum 60 s−1 repetition rate by muons entering the apparatus at random times. A new type of multipass cavity has been developed to provide a homogeneously illuminated volume (25 × 7 × 170 mm³).

An experiment measuring the 2S Lamb shift in muonic hydrogen mup is being performed at the Paul Scherrer Institute, Switzerland. It requires small and compact detectors for 1.9 keV x rays (2P-1S transition) with an energy resolution around 25% at 2 keV, a time resolution better than 100 ns, a large solid angle coverage, and insensitivity to a 5 T magnetic field. We have chosen Large Area Avalanche Photodiodes (LAAPDs) from Radiation Monitoring Devices as x-ray detectors, and they were used during the last data taking period in 2003. For x-ray spectroscopy applications, these LAAPDs have to be cooled in order to suppress the dark current noise, hence, a series of tests were performed to choose the optimal operation temperature. Specifically, the temperature dependence of gain, energy resolution, dark current, excess noise factor, and detector response linearity was studied. Finally, details of the LAAPDs application in the muonic hydrogen experiment as well as their response to alpha particles are presented., 20 pages, 19 figures, submitted to Nucl. Instr. and Methods A

We present experimental results of $\ensuremath{\mu}$-atomic and $\ensuremath{\mu}$-molecular processes induced by negative muons in pure helium and helium-deuterium mixtures. The experiment was performed at the Paul Scherrer Institute (Switzerland). We measured relative intensities of muonic x-ray $K$ series transitions in ${(\ensuremath{\mu}^{3,4}\mathrm{He})}^{*}$ atoms in pure helium as well as in helium-deuterium mixtures. The $d\ensuremath{\mu}^{3}\mathrm{He}$ radiative decay probabilities for two different helium densities in ${\mathrm{D}}_{2}+^{3}\mathrm{He}$ mixture were also determined. Finally, the ${q}_{1s}^{\mathrm{He}}$ probability for a $d\ensuremath{\mu}$ atom formed in an excited state to reach the ground state was measured and compared with theoretical calculations using a simple cascade model.

The paper describes an experiment aimed at studying muon capture by ${}^{3}\mathrm{He}$ nuclei in pure ${}^{3}\mathrm{He}$ and ${\mathrm{D}}_{2}{+}^{3}\mathrm{He}$ mixtures at various densities. Energy distributions of protons and deuterons produced via ${\ensuremath{\mu}}^{\ensuremath{-}}{+}^{3}\mathrm{He}\ensuremath{\rightarrow}p+n+n+{\ensuremath{\nu}}_{\ensuremath{\mu}}$ and ${\ensuremath{\mu}}^{\ensuremath{-}}{+}^{3}\mathrm{He}\ensuremath{\rightarrow}d+n+{\ensuremath{\nu}}_{\ensuremath{\mu}}$ are measured for the energy intervals 10--49 MeV and 13--31 MeV, respectively. Muon capture rates ${\ensuremath{\lambda}}_{\mathrm{cap}}^{p}(\ensuremath{\Delta}{E}_{p})$ and ${\ensuremath{\lambda}}_{\mathrm{cap}}^{d}(\ensuremath{\Delta}{E}_{d})$ are obtained using two different analysis methods. The least-squares methods give ${\ensuremath{\lambda}}_{\mathrm{cap}}^{p}=(36.7\ifmmode\pm\else\textpm\fi{}1.2){\mathrm{s}}^{\ensuremath{-}1},$ ${\ensuremath{\lambda}}_{\mathrm{cap}}^{d}=(21.3\ifmmode\pm\else\textpm\fi{}1.6){\mathrm{s}}^{\ensuremath{-}1}.$ The Bayes theorem gives ${\ensuremath{\lambda}}_{\mathrm{cap}}^{p}=(36.8\ifmmode\pm\else\textpm\fi{}0.8){\mathrm{s}}^{\ensuremath{-}1},$ ${\ensuremath{\lambda}}_{\mathrm{cap}}^{d}=(21.9\ifmmode\pm\else\textpm\fi{}0.6){\mathrm{s}}^{\ensuremath{-}1}.$ The experimental differential capture rates, $d{\ensuremath{\lambda}}_{\mathrm{cap}}^{p}{(E}_{p}{)/dE}_{p}$ and $d{\ensuremath{\lambda}}_{\mathrm{cap}}^{d}{(E}_{d}{)/dE}_{d},$ are compared with theoretical calculations performed using the plane-wave impulse approximation with the realistic nearest-neighbor interaction Bonn B potential. Extrapolation to the full energy range yields total proton and deuteron capture rates in good agreement with former results.

We report on an experiment at the Paul Scherrer Institute, Villigen, Switzerland measuring x rays from muon transfer from deuterium to helium. Both the ground state transfer via the exotic dmu3,4He* molecules and the excited state transfer from mud* were measured. The use of CCD detectors allowed x rays from 1.5 keV to 11 keV to be detected with sufficient energy resolution to separate the transitions to different final states in both deuterium and helium. The x-ray peaks of the dmu3He* and dmu4He* molecules were measured with good statistics. For the D2+3He mixture, the peak has its maximum at E_dmu3He = 6768 +- 12 eV with FWHM Gamma_dmu3He = 863 +- 10 eV. Furthermore the radiative branching ratio was found to be kappa_dmu3He = 0.301 +- 0.061. For the D_2+4He mixture, the maximum of the peak lies at E_dmu4He = 6831 +- 8 eV and the FWHM is Gamma_dmu4He = 856 +- 10 eV. The radiative branching ratio is kappa_dmu4He = 0.636 +- 0.097. The excited state transfer is limited by the probability to reach the deuterium ground state, q_1s. This coefficient was determined for both mixtures: q^3He_1s = 68.9 +- 2.7% and q^4He_1s = 90.1 +- 1.5., Comment: 9 pages, 11 figures

An experiment to measure the energy difference between the 2S-2P atomic levels (Lamb shift) in muonic hydrogen is being prepared at PSI. Since the energy levels of muonic hydrogen are a factor of 186 more energetic than those of hydrogen, according to the ratio of reduced masses, the transitions lie in the soft X-ray region. The experiment needs long-lived muonic hydrogen in the 2S state. This is achieved by stopping a low energy muon beam in a small volume of low pressure hydrogen in a 5 T magnetic field. A pulsed beam from a tunable laser induces the 2S-2P transition and the 1.9 keV X-ray photons resulting from the 2P-1S deexcitation will be detected. Measuring the coincidences between the laser pulse and the X-ray as a function of the laser wavelength allows us to determine the Lamb shift. In this presentation we will discuss the perspectives of using large area avalanche photodiodes for the direct detection of the X-rays. Compared to gaseous detectors, they are more compact and simpler in operation. They are also insensitive to magnetic fields. http://www.sciencedirect.com/science/article/B6TJM-4871204-X/1/e33bbbdca623e18bf326aab66966ba9f

Large-area avalanche photodiodes have been investigated as 1.9-keV X-ray detectors for the muonic hydrogen Lamb-shift experiment. We report experimental tests carried out for evaluation of the avalanche photodiode capabilities for X-ray detection in the intense radiation and low counting rate environment of experiments with muonic atoms. Several muonic atoms were used and it was shown that the electronic background of muonic atom X-ray spectra can be reduced simply by timing the X-ray signal against the gate signal produced by the muon entrance. Furthermore, the background can be eliminated using coincidences between the X-ray signal and the signal resulting from the electron due to the muon decay. This coincidence discrimination results, however, in a reduction of the X-ray detection efficiency. http://www.sciencedirect.com/science/article/B6THN-4B6608X-11/1/4bb8c2b08d267e2eba00e1ae64b143a9

We present the results of experimental and theoretical study of the scattering of low energy p$\mu$ atoms in solid hydrogen cooled to 3 K. The resulting emission of low energy p$\mu$ atoms from the hydrogen layer into the adjacent vacuum was much higher than that predicted by calculations which ignored the solid nature of the hydrogen. New differential scattering cross sections have been calculated for the collisions of p$\mu$ atoms on solid hydrogen to acount for its quantum crystalline nature. Analysis of the experimental data performed using such cross sections shows the important role of the coherent scattering in p$\mu$ atom diffusion. For p$\mu$ energies lower than the Bragg cutoff limit (2 meV) the elastic Bragg scattering vanishes which makes the total scattering cross section fall by several orders of magnitude, and thus the hydrogen target becomes transparent allowing the emission of cold p$\mu$ atoms to occur., Comment: revtex4, 15 pages, 19 figures, 6 tables, submitted to PRA, revised

Background: Solitary ulcer of rectum syndrome occurs rarely in children, and the diagnosis may be difficult. Rectopexy has already been reported with good results in adults and children. We report the first laparoscopic rectopexy in children. Methods: We report the first case of rectopexy performed according to the Orr-Loygue technique using a laparoscopic approach in children. Three trocars were used. A polypropylene mesh was sutured on each side of the rectum and fixed to the promontary with a nonabsorbable suture. The operative time was 150 min. Results: The postoperative course was uneventful. The boy was discharged on postoperative day 3. The rectoscopy at 4 months was normal. The rectal bleeding and pain had disappeared by the 18-month follow-up assessment. Conclusion: We report a successful laparoscopic rectopexy for solitary ulcer of rectum syndrome in a child. The procedure is simple, safe, and reproductible, giving good results in the reported case.

Objectifs Malgre une penurie d’organes, un nombre non negligeable de greffons renaux preleves ne sont pas greffes. Les objectifs de cette etude etaient de determiner les causes principales de refus, le taux de lesions iatrogeniques, d’analyser la proportion de greffons refuses a tort et de decrire les resultats des patients greffes avec un rein controlateral a un rein refuse. Methodes Cette etude nationale multicentrique a inclus, a partir de la base de donnees CRISTAL, tous les reins preleves non greffes du 1er janvier au 31 decembre 2012. La description des greffons a ete recueillie de maniere retrospective a partir des bordereaux reins et des resultats de l’analyse anatomopathologique du greffon. L’identification du taux de greffons refuses a tort a ete realisee par deux chirurgiens urologues dont un expert en transplantation. Resultats 252 reins ont ete preleves non greffes. Les causes de refus etaient vasculaire (104/41,3 %), tumorale (48/19 %) avec suspicion de tumeur renale (17/6,7 %) ou d’autre cancer (31/12,3 %) et secondaire aux resultats de la biopsie preimplantatoire (35/13,8 %). 68 (27 %) reins etaient porteurs de lesions iatrogeniques : 33 (13 %) ont eu une artere sectionnee (9 principales/24 polaires), 23 (9,1 %) ont ete decapsules et 12 (4,7 %) ureteres ont ete sectionnes. 66 (26 %) reins ont ete estimes refuses a tort et 126 (50 %) refuses a raison. L’interpretation etait impossible pour 60 (24 %) reins. 115 patients ont ete greffes avec un rein controlateral a un rein refuse. 10 (8,7 %) patients sont decedes et 17 (14,8 %) etaient en arret fonctionnel dans l’annee post-greffe. Parmi les 88 (76,5 %) patients porteurs d’une greffe fonctionnelle, le taux moyen de creatininemie etait de 148 μmol/l avec un recul moyen de 13mois. Conclusion Une meilleure formation des chirurgiens au prelevement ainsi que la mise en place d’une double expertise en cas de rein juge « non greffable » pourraient permettre de diminuer la perte inutile de greffons.

The availability of long-lived metastable muonic hydrogen atoms (μp) in the 2S state has been investigated in a recent series of experiments at PSI. From the low-energy part of the initial kinetic energy distribution of μp(1S) we determined the fraction of long-lived μp(2S) to be ~ 1.5% for pressures between 1 and 64 hPa. Another analysis involving μp(1S) with a kinetic energy of ~ 1 keV originating from quenching of thermalized μp(2S) via the resonant process \( \mu p\left( {2S} \right) + {\text{H}}_{\text{2}} \to \left\{ {\left[ {\left( {pp\mu } \right)^ + } \right]^* pee} \right\}^* \to \mu p\left( {1S} \right) + p + ... + 2 \) keV gives the same result. This is the first direct observation of long-lived μp(2S) atoms.

An experiment involving muonic hydrogen requires an X-ray detector having large area and working under strong magnetic fields (5 T) with good energy and timing resolution. A compact, driftless gas proportional scintillation counter (GPSC) capable of operating under such magnetic fields is investigated. This GPSC uses a CsI photocathode deposited onto a microstrip plate as the UV scintillation readout photosensor. This photocathode has the advantage of operating in direct contact with the scintillation gas. The detector is filled with pure xenon and is designed to have a high detection efficiency for 2 keV X-rays. Energy resolutions of 23% and 22% were obtained for 1.74 and 2.3 keV X-rays, respectively. The low-energy detector limit due to the electronic noise is 300 eV. Its performance in the presence of strong magnetic fields was tested. At magnetic field of 5 T the detector pulse amplitudes are reduced by less than 25%, while the detector energy resolution and pulse rise time present a relative increase of less than 10%. http://www.sciencedirect.com/science/article/B6TJM-42K5F95-9/1/cb2196b3a13bfd131ce31c16751ed7fc

A measurement of the 2S Lamb shift (2S−2P energy difference) in muonic hydrogen (μ−p) is being prepared at the Paul Scherrer Institute (PSI). The goal of the experiment is to measure the Lamb shift with 30 ppm precision and to deduce the root mean square (rms) proton charge radius with 10−3 relative accuracy, 20 times more precise than presently known. The experiment is based on the availability of long-lived metastable muonic hydrogen atoms in the 2S state which has been investigated in a recent series of experiments at PSI. From the low-energy part of the initial kinetic energy distribution of μp(2S) atoms we determined the fraction of long-lived μp(2S) to be ∼1.5% for H2 gas pressures between 1 and 64 hPa. Another analysis involving μp(1S) with a kinetic energy of 0.9 keV originating from quenching of thermalized μp(2S) via the resonant process μp(2S)+H2→{[(ppμ)+]*pee}*→μp(1S)+p+…+2 keV gives the same result. This is the first direct observation of long-lived μp(2S) atoms. The realization of the μp Lam...

Purpose The shortage of available donor lungs limits lung transplantation. In 2003, French transplant community set up a new definition of eligibility of lungs for transplantation (Table). In 2011, l'Agence de la biomedicine in collaboration with the transplant teams decided to extensively offer the lungs from extended criteria donors in order to improve utilization of potential lung donors. We report here the effect of this new policy on the number of multiorgan donors in whom lungs were offered and harvested as well as on patient survival. Methods and Materials All brain dead donors (BDDr) from which at least 1 organ was retrieved in France between 2007 and 2011 were included. Descriptive analyses were performed with regard to lung proposal, lung non acceptance and lung procurement number. These descriptions were detailed according to donor category. The main causes for lung non-proposal and lung refusal were also collected. One-year graft survival was studied using Kaplan-Meier estimates. Results In 2011 as compared to 2007 the number of BDDr whose lungs were proposed increased by 58%. This rise was exclusively due to a proposal increase in the ECD group. In the same time, the refusal rate increased slightly (74% in 2007 to 86% in 2011). Eventually the number of lung procured from ECD rose from 195 in 2007 to 297 in 2011, a 52% enhance over the period. One year survival rate was similar for specific donor types: 76% [68.5%-81.2%] for OD and 77% [72.8%-79.8%] for ECD; but was not measurable for CI donor due to small size. Conclusions This study demonstrates that an extensive lung offer policy may be associated with an enhanced use of potential donors with similar post transplantation survival. Optimal Donor (OD)Extended Criteria Donors (ECD)Marginal Donors (MD) * Age 70 years* PaO2 > 400 mm Hg+ 200 ≤ PaO2 ≤ 400 mm Hg+ PaO2 * Normal chest Xray+ Abnormal chest Xray * No inhalation+ Inhalation * Non smoker*: And + : Or

The present manuscript summarizes novel studies on the application of large area avalanche photodiodes (LAAPDs) to the detection of X-rays and vacuum ultraviolet (VUV) light. The operational characteristics of four different LAAPDs manufactured by Advanced Photonix Inc., with active areas of 80 and 200 mm^2 were investigated for X-ray detection at room temperature. The best energy resolution was found to be in the 10-18% range for 5.9 keV X-rays. The LAAPD, being compact, simple to operate and with high counting rate capability (up to about 10^5/s), proved to be useful in several applications, such as low-energy X-ray detection, where they can reach better performance than proportional counters. Since X-rays are used as reference in light measurements, the gain non-linearity between 5.9 keV X-rays and light pulses was investigated. The gain ratio between X-rays and VUV light decreases with gain, reaching 10 and 6% variations for VUV light produced in argon (~128 nm) and xenon (~172 nm), respectively, for a gain 200, while for visible light (~635 nm) the variation is lower than 1%. The effect of temperature on the LAAPD performance was investigated. Relative gain variations of about -5% per Celsius degree were observed for the highest gains. The excess noise factor was found to be independent on temperature, being between 1.8 and 2.3 for gains from 50 to 300. The energy resolution is better for decreasing temperatures due mainly to the dark current. LAAPDs were tested under intense magnetic fields up to 5 T, being insensitive when used in X-ray and visible-light detection, while for VUV light a significant amplitude reduction was observed at 5 T., 25 pages, 40 figures, submitted to JINST

This open, non comparative study was designed to establish a suitable dose regime for propofol when used as the main anaesthetic agent and given as a continuous infusion. Thirty patients (ASA I and II) were studied; five received muscle relaxants and were excluded from the analysis of maintenance and recovery. Immediately after an i.v. bolus dose of fentanyl (2 μg · kg−1), anaesthesia was induced in all patients with a mean dose of 2.03 mg · kg−1 propofol. Apnoea at induction was seen in 14 patients, with a mean duration of 151 s (range : 20 to 360 s). Mean, systolic and diastolic arterial pressures and heart rate decreased slightly but statistically significantly following induction. Fourteen patients, four of whom received propofol into a vein of the hand, noted pain on the injection site without venous sequelae immediately nor 24 h after anaesthesia. The mean duration of anaesthesia from induction to the patient ability to obey a simple command was approximately 40 min (range : 10 to 95 min). The mean infusion rate of propofol during maintenance was 0,86±0.04 mg · kg−1 · min−1. During maintenance, a satisfactory depth of anaesthesia was achieved in 23 patients without any further bolus injection of propofol. The mean time from stopping the infusion to eye opening on verbal command was 6.2 min, whilst that for orientation was 8.4 min. The anaesthesist assessed the quality of recovery as good or adequate in all the patients, who all were satisfied by the anaesthesia. No major adverse reactions occurred during or after anaesthesia and the incidence of minor side-effects was low.

Nous rapportons le cas d'un abces du cerveau a Moraxella phenylpyruvica survenu chez un enfant d'un an, probablement a la suite d'une meningite passee inapercue. Le germe identifie selon les criteres de Bovre et Henriksen, est tres sensible aux β lactamines et aux aminosides. La guerison a ete obtenue apres intervention chirurgicale et antibiotherapie. Les Moraxella comprennent six especes principales : M. lacunata, M. non liquefaciens, M. bovis, M. osloensis, M. phenylpyruvica et M. atlantae (1, 3, 6). Ce sont des bacteries commensales des muqueuses, surtout respiratoires, parfois du tractus genito-urinaire ; en-dehors de M. lacunata isolee de conjonctivites et de keratites, leur role pathogene chez l'homme est encore peu connu. Nous rapportons un cas d'abces du cerveau a Moraxella phenylpyruvica gueri apres intervention chirurgicale et antibiotherapie.

This study was designed to: (1) determine plasma midazolam concentrations producing adequate sedation in ICU patients; (2) establish an intravenous regimen to provide continuous sedation and rapid recovery after discontinuation of infusion. Initially, 13 ICU patients were given midazolam as a bolus injection, 0.20 mg.kg-1 over 30 s in order to define the midazolam plasma concentration corresponding to an adequate level of sedation. The optimal level was reached in a mean time of 61 +/- 26 min and the mean corresponding midazolam plasma concentration was 163 +/- 62 ng.ml-1. Estimations of the main pharmacokinetic parameters (elimination half life: 230 +/- 102 min, total body clearance: 520 +/- 283 ml.min-1, total volume of distribution: 2.23 +/- 1.15 l.kg-1) showed no marked differences with normal patients. From those variables, an infusion regimen (loading dose and maintenance rate) to provide long term (24 to 80 h) sedation was derived in 9 patients. The mean loading dose was 0.33 +/- 0.18 mg.kg-1 over 30 min and the mean continuous infusion dose was 0.06 +/- 0.02 mg.kg-1.h-1. The mean midazolam plasma concentration during infusion was 215 +/- 61 ng.ml-1, and the mean midazolam plasma concentration at the end of infusion was 199 +/- 93 ng.ml-1. The level of sedation was considered as optimal in most patients throughout the study. After discontinuation of infusion, the mean time for normalization of the mental state was 97 min.

This open, non comparative study was designed to establish a suitable dose regime for propofol when used as the main anaesthetic agent and given as a continuous infusion. Thirty patients (ASA I and II) were studied; five received muscle relaxants and were excluded from the analysis of maintenance and recovery. Immediately after an i.v. bolus dose of fentanyl (2 micrograms X kg-1), anaesthesia was induced in all patients with a mean dose of 2.03 mg X kg-1 propofol. Apnoea at induction was seen in 14 patients, with a mean duration of 151 s (range: 20 to 360 s). Mean, systolic and diastolic arterial pressures and heart rate decreased slightly but statistically significantly following induction. Fourteen patients, four of whom received propofol into a vein of the hand, noted pain on the injection site without venous sequelae immediately nor 24 h after anaesthesia. The mean duration of anaesthesia from induction to the patient ability to obey a simple command was approximately 40 min (range: 10 to 95 min). The mean infusion rate of propofol during maintenance was 0.86 +/- 0.04 mg X kg-1 X min-1. During maintenance, a satisfactory depth of anaesthesia was achieved in 23 patients without any further bolus injection of propofol. The mean time from stopping the infusion to eye opening on verbal command was 6.2 min, whilst that for orientation was 8.4 min. The anaesthesist assessed the quality of recovery as good or adequate in all the patients, who all were satisfied by the anaesthesia. No major adverse reactions occurred during or after anaesthesia and the incidence of minor side-effects was low.

An experiment measuring the 2S Lamb shift in muonic hydrogen (/spl mu//sup -/p) is being performed at the Paul Scherrer Institute (PSI), Switzerland. It requires small detectors for 1.9 keV X-rays (2P-1S transition) with an energy resolution around 25%, a time resolution better than 100 ns, a large solid angle coverage, and insensitivity to a 5 T magnetic field. We used large area avalanche photodiodes (LAAPDs) from radiation monitoring devices (RMD) for the latest data taking period in 2003. For soft X-ray spectroscopy applications, they have to be cooled, hence, a series of tests were performed to choose the optimal operation temperature. The temperature dependence of gain, energy resolution, dark current, excess noise factor, and detector response linearity was studied. Finally, details of the LAAPDs application in our experiment as well as their response to alpha particles are presented.