Journal of the American College of Cardiology, 1995
The standard ten week cardiac rehabilitation program of moderate intensity dynamic exercise leads... more The standard ten week cardiac rehabilitation program of moderate intensity dynamic exercise leads to a highly significant improvement in exercise tolerance, but does not have a beneficial effect on blood viscosity in patients with ischemic heart disease. Exercise 98 ± 13* 103 ± 17* 28 ± 15* 3,6 ± 2.4 31 ± 11* 72 ± 12 82 ± 12 19 ± 9 3.1 ± 2.0 18 ± 6 Rest Exercise Capacity and Coronary Row Reserve in Patients with Intermediate Coronary Stenoses Can Post-Stenotic Coronary Blood Flow be Increased by Exercise? Heart Rate Ibpml Mean arterial pressure (mmHg) APV CSA CBF "'p < 0.01 vs rest
Se analizan los signifi cados culturales sobre la sexualidad y el genero que permean las activida... more Se analizan los signifi cados culturales sobre la sexualidad y el genero que permean las actividades sexuales de los migrantes temporales en Estados Unidos, asi como las condiciones sociales que favorecen su involucramiento en practicas de riesgo. Los resultados muestran como la construccion social de los signifi cados en las comunidades de origen y las condiciones sociales subyacentes al movimiento migratorio, incluyendo los procesos de hibridacion cultural, favorecen el ejercicio depracticas riesgosas. Estas afectan a varones migrantes, a mujeres de reciente ingreso a Estados Unidos y a las que se quedan en las comunidades de origen, porque no estan culturalmente posibilitadas para establecer y negociar relaciones sexuales seguras con sus parejas y porque atribuyen mayor valor social y sexual a los varones que han migrado. ABSTRACT We analyze the cultural meanings of sexuality and gender that permeate the sexual practices of seasonal migrant workers in the United States and the so...
The numerical study of the divers magnetic field configurations in the Novillo Tokamak developed ... more The numerical study of the divers magnetic field configurations in the Novillo Tokamak developed by means of the CAMTOK code is presented to illustrate not only the application of classical analysis to a specific case but also a straightforward technique to develop magnetic design codes. Algorithms and results in the case of the ohmic heating transformer, toroidal, and equilibrium systems are presented. On the basis of CAMTOK simulations and measured values, stray components of the fields are identified and suppressed, leading to the redesign of the original concept of the Novillo tokamak into its current operating configuration.
The evaluation of the electron temperature, density, and plasma potential in a glow cleaning disc... more The evaluation of the electron temperature, density, and plasma potential in a glow cleaning discharge hydrogen plasma in the Novillo tokamak is presented. The objective was to investigate the plasma conditions allowing the removal of impurities from the vacuum vessel, thus avoiding the formation of other chemical compounds that could remain adhered to its inner walls. The discharges were accomplished through two anodes and one cathode within the 0.07 to 0.2-mbar-pressure interval at a power density in the range of 100 to 900 W/m 2. The plasma parameters were obtained using Langmuir probes. The results indicated that the electron temperature lay between 3 and 10 eV, the electron density was approximately 10 8 to 10 9 cm Ϫ3 , and the plasma potential was in the 10-to 18-V range. The electron energy was in the range of the dissociation energy for most impurities found in the Novillo tokamak.
Optical linewidth broadening through both white noise (WNS) and pseudo-random binary sequence (PB... more Optical linewidth broadening through both white noise (WNS) and pseudo-random binary sequence (PBRS) phase modulation are effective techniques for suppressing stimulated Brillouin scattering (SBS) in high- power fiber amplifiers. However, detailed studies comparing both coherent beam combining and SBS suppression of these phase modulation schemes have not been reported. In this study, a passive fiber cutback experiment is performed comparing the SBS threshold enhancement factor of a PRBS and WNS broadened seed as a function of linewidth and fiber length. Particularly, assuming an optimal PRBS pattern is chosen, pseudo-random modulation provides superior SBS suppression than WNS for a given fiber length and signal linewidth. Furthermore, two WNS and PRBS modulated 150 W fiber lasers are coherently combined to measure and compare the combining efficiency, beam quality, and coherence as a function of optical path length difference. Notably, the discrete spectral density of PRBS modulation provides a re-coherence effect where the lasers periodically come back into phase. Overall, this may reduce path length matching complexity in coherently combined fiber laser systems.
Fiber Lasers X: Technology, Systems, and Applications, 2013
ABSTRACT We present an experimental study on active coherent combining of five Yb (Ytterbium)-dop... more ABSTRACT We present an experimental study on active coherent combining of five Yb (Ytterbium)-doped fiber laser amplifiers that employs multiplexed volume Bragg gratings (MVBGs), reporting a combining efficiency of 82% and near-diffraction limited beam quality at a combined input power of 380 W, and 70% combining efficiency with equal beam quality at 670 W input power.
Conference on Lasers and Electro-Optics 2012, 2012
ABSTRACT We report the first experimental demonstration of active coherently combining of fiber l... more ABSTRACT We report the first experimental demonstration of active coherently combining of fiber laser arrays with multiplexed volume Bragg gratings up to 70W combined output power with diffraction limited beam quality achieved at 82% combining efficiency.
Aortoiliac duplex scanning can be difficult to perform owing to the deep location of these vessel... more Aortoiliac duplex scanning can be difficult to perform owing to the deep location of these vessels. We propose a new method to indirectly screen for aortoiliac disease by performing duplex examination of the distal external iliac artery (DEIA). After performing a preliminary study on 21 patients, the parameters of the Doppler waveform that best distinguish normal from diseased arteries were the presence or absence of reverse flow, peak systolic velocity, and resistance index. These values were used in a derived equation, with the value Y ≥ 0.78 predicting normal proximal inflow. We then studied 118 aortoiliac segments in 81 consecutive patients with arteriography and DEIA duplex ultrasonography. To predict moderate to severe stenosis, duplex ultrasonography had a sensitivity of 95.7%, a specificity of 84.1%, a positive predictive value of 80%, and a negative predictive value of 96.8%. Our formula thus predicted significant disease in 55 of the 118 aortoiliac segments (47%), with these segments needing further arteriographic evaluation. The other 63 limbs can be safely considered as having normal aortoiliac inflow. Our method accurately screens for aortoiliac disease and is excellent for predicting normal inflow. This information can be used to better plan the intraoperative diagnostic study and intervention.
There is great interest in optical fibers for military applications. We focus on fiber laser rese... more There is great interest in optical fibers for military applications. We focus on fiber laser research for directed energy platforms. Power scaling of fiber amplifiers and beam combining are the cornerstones of developing these platforms
This paper presents an application of adaptive neural networks based on a dynamic neural network ... more This paper presents an application of adaptive neural networks based on a dynamic neural network to trajectory tracking of unknown nonlinear plants. The main methodologies on which the approach is based are recurrent neural networks and Lyapunov function methodology and Proportional-Integral (PI) control for nonlinear systems. The proposed controller structure is composed of a neural identifier and a control law defined by using the PI approach. The new control scheme is applied via simulations to Chaos Synchronization. Experimental results have shown the usefulness of the proposed approach for Chaos Production. To verify the analytical results, an example of a dynamical network is simulated and a theorem is proposed to ensure tracking of the nonlinear system.
This paper presents the application of adaptive neural networks to robot manipulator control. The... more This paper presents the application of adaptive neural networks to robot manipulator control. The main methodologies, on which the approach is based, are recurrent neural networks and Lyapunov functions methodology and Proportional-Integral-Derivative (PID) control for nonlinear systems. The proposed controller structure is composed of a neural identifier and a control law defined by using the PID approach. The proposed new control scheme is applied via simulations to control a robot manipulator two-link model. Experimental results in two degrees of freedom of the robot arm shown the usefulness of the proposed approach. To verify the analytical results, an example of dynamical network is simulated and a theorem is proposed to ensure the tracking of the nonlinear system.
Photonics Packaging, Integration, and Interconnects IX, 2009
We report on various single and multimode channel waveguide structures fabricated via microtransf... more We report on various single and multimode channel waveguide structures fabricated via microtransfer molding and microfluidic techniques. These soft lithographic fabrication techniques can result in an inexpensive and rapid turnover of various types of channel waveguide structures and general integrated optic devices. It may be particularly useful for production of waveguides on user-desired surface substrates including those of a curved
ABSTRACT A flexible array waveguide evanescent coupler for card-to-backplane optical interconnect... more ABSTRACT A flexible array waveguide evanescent coupler for card-to-backplane optical interconnects is presented. Evanescent coupling between a backplane waveguide and a flexible polymer ribbon waveguide is demonstrated. This eliminates 45° waveguide mirrors and local waveguide terminations.
Background: Renal artery embolization is a procedure that has been shown to be useful as a concom... more Background: Renal artery embolization is a procedure that has been shown to be useful as a concomitant treatment for the resection of large renal tumors. Over the years, preoperative renal artery embolization concomitant with nephrectomy as a treatment option has proved to be useful in reducing morbi-mortality rates; however this procedure is not exempt from significant iatrogenia. Performing this technique in conjunction with nephrectomy in a single surgical act helps to maintain the advantages of this treatment, which in turn considerably reduces the associated morbi-mortality rates. Methods: This study presents seven patients selected by the Urology Service in a nonconsecutive manner who underwent renal artery embolization concomitant with nephrectomy in a single surgical procedure for large renal tumors, thus presenting a variation to the usual techniques to improve and simplify the procedure. Results: General data were obtained from all patients including age, gender, characteristics of the tumor, and symptomatology at the time of diagnosis. For all the cases, use of resources was analyzed in terms of duration of surgery, the amount of iodinated contrast medium used during the embolization procedure, and the mean duration of hospital and intensive care unit stay. Complications were evaluated with respect to general morbi-mortality associated with the complete procedure, hematic losses during the procedure, transfusion requirements, and renal function (calculated by measuring preoperative and 48-hour postoperative serum creatinine levels). All patients reported having symptoms at the time of diagnosis, all of them had tumors measuring >13 cm in diameter (major). In all the cases, 100% technical success was obtained with the embolization and nephrectomy. The mean duration of surgery in the case of embolization with coils was 45 minutes, and 25 minutes in the case of embolization with Amplatzer. A mean volume of 115 mL of contrast medium was used in the case of embolization with coils, whereas for the other cases, a mean volume of 71 mL of iodinated contrast was used. Among all the patients, only two of them required to be cared at the intensive care unit during 24 hours. On an average, reported blood loss was 380 mL. During the procedure, two patients (28.6%) required a transfusion of two units of red cells. No cases of perioperative or postoperative mortality were reported. With respect to morbidity, only one patient (14.3%) experienced a complication in the form of a superficial infection of the surgical wound, which was later resolved by antibiotic therapy. One patient (14.3%) presented a slightly higher preintervention level of creatinine (1.42). Two patients (28.6%), both of whom underwent embolization by using coils, experienced deterioration of postoperative renal function.
L'objectif de cette etude etait de comparer, dans le cadre de l'isch emie critique, le projet th ... more L'objectif de cette etude etait de comparer, dans le cadre de l'isch emie critique, le projet th erapeutique d etermin e sur l' evaluation doppler pr eop eratoire avec le traitement finalement r ealis e, a la lumi ere des r esultats du traitement chirurgical ou endovasculaire. Sur une p eriode de 51 mois, un doppler pr eop eratoire etait r ealis ee chez 335 patients cons ecutifs en une isch emie critique, afin de d eterminer la meilleure strat egie th erapeutique. Les deux projets etaient finalement concordants dans 80%, 82,7% et 59% des cas respectivement, apr es examen des art eres iliaques, f emoro-poplit ees et jambi eres. Le plan op eratoire etait plus fr equemment modifi e dans les proc edures portant sur les vaisseaux distaux (10/44 [22,7%], p<0,01). En conclusion, l' evaluation doppler des patients ayant une maladie art erielle occlusive des membres inf erieurs permet de d eterminer un projet th erapeutique m edical, chirurgical ou endovasculaire avec un niveau elev e de concordance par rapport a ce qui est observ e lors des proc edures de revascularisation.
Primary venous leiomyosarcoma of the extremities is an uncommon, but aggressive, tumoral entity w... more Primary venous leiomyosarcoma of the extremities is an uncommon, but aggressive, tumoral entity with a high rate of local recurrence and early hematogenous metastasis. In the present article, we report a case of leiomyosarcoma of the vena profunda femoris. This pathology causes deep venous thrombosis-like symptoms. No improvement in lower limb status and a significant and progressive increase in the diameter of the vein as seen using ultrasonography could indicate tumor disease. Particular care must be taken to avoid biopsies due to the possible dissemination. We must complete the medical study with imaging techniques, and the tumor must be removed as soon as possible for histopathological diagnosis. After a follow-up of 12 months, there was no evidence of local or metastatic recurrence in our patient.
ABSTRACT Rationnelle Il a été montré que l’embolisation de l’artère rénale est un procédé utile c... more ABSTRACT Rationnelle Il a été montré que l’embolisation de l’artère rénale est un procédé utile comme traitement concomitant à la résection de volumineuses tumeurs rénales. Au cours des années, l’embolisation préopératoire de l’artère rénale avant néphrectomie s’est avérée utile en réduisant les taux de morbi-mortalité ; cependant ce procédé n’est pas exempt d’une iatrogénie significative. La réalisation de cette technique en même temps que la néphrectomie au cours du même acte chirurgical aide à maintenir les avantages de ce traitement, ce qui réduit considérablement les taux de morbi-mortalité. Méthodes Cette étude présente sept patients non consécutifs sélectionnés du service d’urologie qui ont eu l’embolisation de l’artère rénale associée à une néphrectomie dans le même temps pour de volumineuses tumeurs rénales, ce qui constitue une variante des techniques habituelles visant à améliorer et à simplifier la procédure. Résultats Les caractéristiques générales de tous les patients ont été obtenues comprenant l’âge, le sexe, les caractéristiques de la tumeur, et la symptomatologie au moment du diagnostic. Pour tous les cas, l’utilisation des données était analysée en termes de durée opératoire, de quantité de produit de contraste iodée utilisée pendant la procédure d’embolisation, et de durée moyenne d’hospitalisation et de séjour en unité de soins intensifs. Les complications ont été évaluées en ce qui concerne la morbi-mortalité générale liée à la procédure, les pertes sanguines, les besoins de transfusion, et la fonction rénale (calculée en mesurant la créatinine sérique préopératoire et postopératoire à 48 heures). Tous les patients ayant des symptômes au moment du diagnostic avaient des tumeurs mesurant &gt;13 cm de diamètre (capital). Dans tous les cas, un succès technique de 100% a été obtenu avec l’embolisation et la néphrectomie. La durée opératoire moyenne en cas d’embolisation avec des spires était de 45 minutes, et de 25 minutes en cas d’embolisation avec des Amplatzer. Un volume moyen de 115 mL de produit de contraste était employé en cas d’embolisation avec des spires, tandis que dans les autres cas, un volume moyen de 71 mL de contraste iodé était employé. Parmi tous les patients, seulement deux d’entre eux ont été en unité de soins intensifs pendant 24 heures. En moyenne, le saignement était de 380 mL. Pendant la procédure, deux patients (28,6%) ont eu besoin d’une transfusion de deux unités globulaires. Aucun cas de mortalité périopératoire ou postopératoire n’a été rapporté. En ce qui concerne la morbidité, un seul patient (14,3%) a eu une complication sous forme d’une infection superficielle de paroi, qui a guéri sous antibiotiques. Un patient (14,3%) a eu un taux légèrement augmenté de créatinine (1,42). Deux patients (28,6%), embolisés avec des coils ont eu une détérioration postopératoire de la fonction rénale. Conclusion L’embolisation préopératoire de l’artère rénale comme traitement adjuvant des cancers rénaux à haut risque a des avantages techniques clairs pour la néphrectomie et également des avantages médicaux pour les patients. La réalisation des deux procédures simultanément comme acte chirurgical unique semble maintenir les avantages de l’embolisation, en réduisant les taux de mortalité et en produisant peu de morbidité associée. Techniquement, l’embolisation avec des bouchons Amplatzer semble être plus rapide et plus facile par rapport à l’embolisation avec des coils.
Conference on Lasers and Electro-Optics 2010, 2010
... M. Thomas, P. Jone cs in Quantum Ele Amplifier Arrays, 3, 2008. z, MA Culpepper ng of an opt... more ... M. Thomas, P. Jone cs in Quantum Ele Amplifier Arrays, 3, 2008. z, MA Culpepper ng of an optical arr ngton and CA Lu ed Topics in Quan m Combining and P . Pourtal, G. Canat pagation Through A p. 257-268 used a common ow powers but ir (scattered lig ed light from th ...
Journal of the American College of Cardiology, 1995
The standard ten week cardiac rehabilitation program of moderate intensity dynamic exercise leads... more The standard ten week cardiac rehabilitation program of moderate intensity dynamic exercise leads to a highly significant improvement in exercise tolerance, but does not have a beneficial effect on blood viscosity in patients with ischemic heart disease. Exercise 98 ± 13* 103 ± 17* 28 ± 15* 3,6 ± 2.4 31 ± 11* 72 ± 12 82 ± 12 19 ± 9 3.1 ± 2.0 18 ± 6 Rest Exercise Capacity and Coronary Row Reserve in Patients with Intermediate Coronary Stenoses Can Post-Stenotic Coronary Blood Flow be Increased by Exercise? Heart Rate Ibpml Mean arterial pressure (mmHg) APV CSA CBF "'p < 0.01 vs rest
Se analizan los signifi cados culturales sobre la sexualidad y el genero que permean las activida... more Se analizan los signifi cados culturales sobre la sexualidad y el genero que permean las actividades sexuales de los migrantes temporales en Estados Unidos, asi como las condiciones sociales que favorecen su involucramiento en practicas de riesgo. Los resultados muestran como la construccion social de los signifi cados en las comunidades de origen y las condiciones sociales subyacentes al movimiento migratorio, incluyendo los procesos de hibridacion cultural, favorecen el ejercicio depracticas riesgosas. Estas afectan a varones migrantes, a mujeres de reciente ingreso a Estados Unidos y a las que se quedan en las comunidades de origen, porque no estan culturalmente posibilitadas para establecer y negociar relaciones sexuales seguras con sus parejas y porque atribuyen mayor valor social y sexual a los varones que han migrado. ABSTRACT We analyze the cultural meanings of sexuality and gender that permeate the sexual practices of seasonal migrant workers in the United States and the so...
The numerical study of the divers magnetic field configurations in the Novillo Tokamak developed ... more The numerical study of the divers magnetic field configurations in the Novillo Tokamak developed by means of the CAMTOK code is presented to illustrate not only the application of classical analysis to a specific case but also a straightforward technique to develop magnetic design codes. Algorithms and results in the case of the ohmic heating transformer, toroidal, and equilibrium systems are presented. On the basis of CAMTOK simulations and measured values, stray components of the fields are identified and suppressed, leading to the redesign of the original concept of the Novillo tokamak into its current operating configuration.
The evaluation of the electron temperature, density, and plasma potential in a glow cleaning disc... more The evaluation of the electron temperature, density, and plasma potential in a glow cleaning discharge hydrogen plasma in the Novillo tokamak is presented. The objective was to investigate the plasma conditions allowing the removal of impurities from the vacuum vessel, thus avoiding the formation of other chemical compounds that could remain adhered to its inner walls. The discharges were accomplished through two anodes and one cathode within the 0.07 to 0.2-mbar-pressure interval at a power density in the range of 100 to 900 W/m 2. The plasma parameters were obtained using Langmuir probes. The results indicated that the electron temperature lay between 3 and 10 eV, the electron density was approximately 10 8 to 10 9 cm Ϫ3 , and the plasma potential was in the 10-to 18-V range. The electron energy was in the range of the dissociation energy for most impurities found in the Novillo tokamak.
Optical linewidth broadening through both white noise (WNS) and pseudo-random binary sequence (PB... more Optical linewidth broadening through both white noise (WNS) and pseudo-random binary sequence (PBRS) phase modulation are effective techniques for suppressing stimulated Brillouin scattering (SBS) in high- power fiber amplifiers. However, detailed studies comparing both coherent beam combining and SBS suppression of these phase modulation schemes have not been reported. In this study, a passive fiber cutback experiment is performed comparing the SBS threshold enhancement factor of a PRBS and WNS broadened seed as a function of linewidth and fiber length. Particularly, assuming an optimal PRBS pattern is chosen, pseudo-random modulation provides superior SBS suppression than WNS for a given fiber length and signal linewidth. Furthermore, two WNS and PRBS modulated 150 W fiber lasers are coherently combined to measure and compare the combining efficiency, beam quality, and coherence as a function of optical path length difference. Notably, the discrete spectral density of PRBS modulation provides a re-coherence effect where the lasers periodically come back into phase. Overall, this may reduce path length matching complexity in coherently combined fiber laser systems.
Fiber Lasers X: Technology, Systems, and Applications, 2013
ABSTRACT We present an experimental study on active coherent combining of five Yb (Ytterbium)-dop... more ABSTRACT We present an experimental study on active coherent combining of five Yb (Ytterbium)-doped fiber laser amplifiers that employs multiplexed volume Bragg gratings (MVBGs), reporting a combining efficiency of 82% and near-diffraction limited beam quality at a combined input power of 380 W, and 70% combining efficiency with equal beam quality at 670 W input power.
Conference on Lasers and Electro-Optics 2012, 2012
ABSTRACT We report the first experimental demonstration of active coherently combining of fiber l... more ABSTRACT We report the first experimental demonstration of active coherently combining of fiber laser arrays with multiplexed volume Bragg gratings up to 70W combined output power with diffraction limited beam quality achieved at 82% combining efficiency.
Aortoiliac duplex scanning can be difficult to perform owing to the deep location of these vessel... more Aortoiliac duplex scanning can be difficult to perform owing to the deep location of these vessels. We propose a new method to indirectly screen for aortoiliac disease by performing duplex examination of the distal external iliac artery (DEIA). After performing a preliminary study on 21 patients, the parameters of the Doppler waveform that best distinguish normal from diseased arteries were the presence or absence of reverse flow, peak systolic velocity, and resistance index. These values were used in a derived equation, with the value Y ≥ 0.78 predicting normal proximal inflow. We then studied 118 aortoiliac segments in 81 consecutive patients with arteriography and DEIA duplex ultrasonography. To predict moderate to severe stenosis, duplex ultrasonography had a sensitivity of 95.7%, a specificity of 84.1%, a positive predictive value of 80%, and a negative predictive value of 96.8%. Our formula thus predicted significant disease in 55 of the 118 aortoiliac segments (47%), with these segments needing further arteriographic evaluation. The other 63 limbs can be safely considered as having normal aortoiliac inflow. Our method accurately screens for aortoiliac disease and is excellent for predicting normal inflow. This information can be used to better plan the intraoperative diagnostic study and intervention.
There is great interest in optical fibers for military applications. We focus on fiber laser rese... more There is great interest in optical fibers for military applications. We focus on fiber laser research for directed energy platforms. Power scaling of fiber amplifiers and beam combining are the cornerstones of developing these platforms
This paper presents an application of adaptive neural networks based on a dynamic neural network ... more This paper presents an application of adaptive neural networks based on a dynamic neural network to trajectory tracking of unknown nonlinear plants. The main methodologies on which the approach is based are recurrent neural networks and Lyapunov function methodology and Proportional-Integral (PI) control for nonlinear systems. The proposed controller structure is composed of a neural identifier and a control law defined by using the PI approach. The new control scheme is applied via simulations to Chaos Synchronization. Experimental results have shown the usefulness of the proposed approach for Chaos Production. To verify the analytical results, an example of a dynamical network is simulated and a theorem is proposed to ensure tracking of the nonlinear system.
This paper presents the application of adaptive neural networks to robot manipulator control. The... more This paper presents the application of adaptive neural networks to robot manipulator control. The main methodologies, on which the approach is based, are recurrent neural networks and Lyapunov functions methodology and Proportional-Integral-Derivative (PID) control for nonlinear systems. The proposed controller structure is composed of a neural identifier and a control law defined by using the PID approach. The proposed new control scheme is applied via simulations to control a robot manipulator two-link model. Experimental results in two degrees of freedom of the robot arm shown the usefulness of the proposed approach. To verify the analytical results, an example of dynamical network is simulated and a theorem is proposed to ensure the tracking of the nonlinear system.
Photonics Packaging, Integration, and Interconnects IX, 2009
We report on various single and multimode channel waveguide structures fabricated via microtransf... more We report on various single and multimode channel waveguide structures fabricated via microtransfer molding and microfluidic techniques. These soft lithographic fabrication techniques can result in an inexpensive and rapid turnover of various types of channel waveguide structures and general integrated optic devices. It may be particularly useful for production of waveguides on user-desired surface substrates including those of a curved
ABSTRACT A flexible array waveguide evanescent coupler for card-to-backplane optical interconnect... more ABSTRACT A flexible array waveguide evanescent coupler for card-to-backplane optical interconnects is presented. Evanescent coupling between a backplane waveguide and a flexible polymer ribbon waveguide is demonstrated. This eliminates 45° waveguide mirrors and local waveguide terminations.
Background: Renal artery embolization is a procedure that has been shown to be useful as a concom... more Background: Renal artery embolization is a procedure that has been shown to be useful as a concomitant treatment for the resection of large renal tumors. Over the years, preoperative renal artery embolization concomitant with nephrectomy as a treatment option has proved to be useful in reducing morbi-mortality rates; however this procedure is not exempt from significant iatrogenia. Performing this technique in conjunction with nephrectomy in a single surgical act helps to maintain the advantages of this treatment, which in turn considerably reduces the associated morbi-mortality rates. Methods: This study presents seven patients selected by the Urology Service in a nonconsecutive manner who underwent renal artery embolization concomitant with nephrectomy in a single surgical procedure for large renal tumors, thus presenting a variation to the usual techniques to improve and simplify the procedure. Results: General data were obtained from all patients including age, gender, characteristics of the tumor, and symptomatology at the time of diagnosis. For all the cases, use of resources was analyzed in terms of duration of surgery, the amount of iodinated contrast medium used during the embolization procedure, and the mean duration of hospital and intensive care unit stay. Complications were evaluated with respect to general morbi-mortality associated with the complete procedure, hematic losses during the procedure, transfusion requirements, and renal function (calculated by measuring preoperative and 48-hour postoperative serum creatinine levels). All patients reported having symptoms at the time of diagnosis, all of them had tumors measuring >13 cm in diameter (major). In all the cases, 100% technical success was obtained with the embolization and nephrectomy. The mean duration of surgery in the case of embolization with coils was 45 minutes, and 25 minutes in the case of embolization with Amplatzer. A mean volume of 115 mL of contrast medium was used in the case of embolization with coils, whereas for the other cases, a mean volume of 71 mL of iodinated contrast was used. Among all the patients, only two of them required to be cared at the intensive care unit during 24 hours. On an average, reported blood loss was 380 mL. During the procedure, two patients (28.6%) required a transfusion of two units of red cells. No cases of perioperative or postoperative mortality were reported. With respect to morbidity, only one patient (14.3%) experienced a complication in the form of a superficial infection of the surgical wound, which was later resolved by antibiotic therapy. One patient (14.3%) presented a slightly higher preintervention level of creatinine (1.42). Two patients (28.6%), both of whom underwent embolization by using coils, experienced deterioration of postoperative renal function.
L'objectif de cette etude etait de comparer, dans le cadre de l'isch emie critique, le projet th ... more L'objectif de cette etude etait de comparer, dans le cadre de l'isch emie critique, le projet th erapeutique d etermin e sur l' evaluation doppler pr eop eratoire avec le traitement finalement r ealis e, a la lumi ere des r esultats du traitement chirurgical ou endovasculaire. Sur une p eriode de 51 mois, un doppler pr eop eratoire etait r ealis ee chez 335 patients cons ecutifs en une isch emie critique, afin de d eterminer la meilleure strat egie th erapeutique. Les deux projets etaient finalement concordants dans 80%, 82,7% et 59% des cas respectivement, apr es examen des art eres iliaques, f emoro-poplit ees et jambi eres. Le plan op eratoire etait plus fr equemment modifi e dans les proc edures portant sur les vaisseaux distaux (10/44 [22,7%], p<0,01). En conclusion, l' evaluation doppler des patients ayant une maladie art erielle occlusive des membres inf erieurs permet de d eterminer un projet th erapeutique m edical, chirurgical ou endovasculaire avec un niveau elev e de concordance par rapport a ce qui est observ e lors des proc edures de revascularisation.
Primary venous leiomyosarcoma of the extremities is an uncommon, but aggressive, tumoral entity w... more Primary venous leiomyosarcoma of the extremities is an uncommon, but aggressive, tumoral entity with a high rate of local recurrence and early hematogenous metastasis. In the present article, we report a case of leiomyosarcoma of the vena profunda femoris. This pathology causes deep venous thrombosis-like symptoms. No improvement in lower limb status and a significant and progressive increase in the diameter of the vein as seen using ultrasonography could indicate tumor disease. Particular care must be taken to avoid biopsies due to the possible dissemination. We must complete the medical study with imaging techniques, and the tumor must be removed as soon as possible for histopathological diagnosis. After a follow-up of 12 months, there was no evidence of local or metastatic recurrence in our patient.
ABSTRACT Rationnelle Il a été montré que l’embolisation de l’artère rénale est un procédé utile c... more ABSTRACT Rationnelle Il a été montré que l’embolisation de l’artère rénale est un procédé utile comme traitement concomitant à la résection de volumineuses tumeurs rénales. Au cours des années, l’embolisation préopératoire de l’artère rénale avant néphrectomie s’est avérée utile en réduisant les taux de morbi-mortalité ; cependant ce procédé n’est pas exempt d’une iatrogénie significative. La réalisation de cette technique en même temps que la néphrectomie au cours du même acte chirurgical aide à maintenir les avantages de ce traitement, ce qui réduit considérablement les taux de morbi-mortalité. Méthodes Cette étude présente sept patients non consécutifs sélectionnés du service d’urologie qui ont eu l’embolisation de l’artère rénale associée à une néphrectomie dans le même temps pour de volumineuses tumeurs rénales, ce qui constitue une variante des techniques habituelles visant à améliorer et à simplifier la procédure. Résultats Les caractéristiques générales de tous les patients ont été obtenues comprenant l’âge, le sexe, les caractéristiques de la tumeur, et la symptomatologie au moment du diagnostic. Pour tous les cas, l’utilisation des données était analysée en termes de durée opératoire, de quantité de produit de contraste iodée utilisée pendant la procédure d’embolisation, et de durée moyenne d’hospitalisation et de séjour en unité de soins intensifs. Les complications ont été évaluées en ce qui concerne la morbi-mortalité générale liée à la procédure, les pertes sanguines, les besoins de transfusion, et la fonction rénale (calculée en mesurant la créatinine sérique préopératoire et postopératoire à 48 heures). Tous les patients ayant des symptômes au moment du diagnostic avaient des tumeurs mesurant &gt;13 cm de diamètre (capital). Dans tous les cas, un succès technique de 100% a été obtenu avec l’embolisation et la néphrectomie. La durée opératoire moyenne en cas d’embolisation avec des spires était de 45 minutes, et de 25 minutes en cas d’embolisation avec des Amplatzer. Un volume moyen de 115 mL de produit de contraste était employé en cas d’embolisation avec des spires, tandis que dans les autres cas, un volume moyen de 71 mL de contraste iodé était employé. Parmi tous les patients, seulement deux d’entre eux ont été en unité de soins intensifs pendant 24 heures. En moyenne, le saignement était de 380 mL. Pendant la procédure, deux patients (28,6%) ont eu besoin d’une transfusion de deux unités globulaires. Aucun cas de mortalité périopératoire ou postopératoire n’a été rapporté. En ce qui concerne la morbidité, un seul patient (14,3%) a eu une complication sous forme d’une infection superficielle de paroi, qui a guéri sous antibiotiques. Un patient (14,3%) a eu un taux légèrement augmenté de créatinine (1,42). Deux patients (28,6%), embolisés avec des coils ont eu une détérioration postopératoire de la fonction rénale. Conclusion L’embolisation préopératoire de l’artère rénale comme traitement adjuvant des cancers rénaux à haut risque a des avantages techniques clairs pour la néphrectomie et également des avantages médicaux pour les patients. La réalisation des deux procédures simultanément comme acte chirurgical unique semble maintenir les avantages de l’embolisation, en réduisant les taux de mortalité et en produisant peu de morbidité associée. Techniquement, l’embolisation avec des bouchons Amplatzer semble être plus rapide et plus facile par rapport à l’embolisation avec des coils.
Conference on Lasers and Electro-Optics 2010, 2010
... M. Thomas, P. Jone cs in Quantum Ele Amplifier Arrays, 3, 2008. z, MA Culpepper ng of an opt... more ... M. Thomas, P. Jone cs in Quantum Ele Amplifier Arrays, 3, 2008. z, MA Culpepper ng of an optical arr ngton and CA Lu ed Topics in Quan m Combining and P . Pourtal, G. Canat pagation Through A p. 257-268 used a common ow powers but ir (scattered lig ed light from th ...
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