Le 17 novembre 2016 a eu lieu la 3ème journée mondiale de lutte contre le cancer du pancréas.Cette prise en considération tardive rend compte de la dualité entre une incidence faible et un pronostic redoutable. Sa réputation de cancer rapidement mortel est attestée par un ratio incidence/mortalité proche de 1. Au 10ème rang en termes de localisations de cancers, il se hisse au 4ème rang en termes de mortalité par cancer et devrait devenir, en 2020, la 2ème cause de décès par cancer devant le cancer du côlon et juste après le cancer du poumon. Le taux de survie à 5 ans, tous stades confondus, est de 5% aux USA et en Europe.L’adénocarcinome canalaire pancréatique représente la tumeur la plus fréquente (80% des tumeurs pancréatiques exocrines). Sa localisation dans la glande pancréatique est céphalique dans 2/3 des cas.A ce jour, le traitement chirurgical reste le seul traitement potentiellement curatif. Celui-ci ne s’adresse qu’à une faible proportion de patients. En effet, seul 20% des patients présentant un adénocarcinome pancréatique céphalique sont effectivement résécables permettant d’obtenir un taux de survie globale à 5 ans d'environ 10 à 20% si la résection est suivie de chimiothérapie adjuvante ou non. Ces résultats modestes sont en outre à pondérer par la morbi-mortalité des résections pancréatiques céphaliques. Dans la série de l’Association Française de Chirurgie, reprenant les résections pancréatiques céphaliques réalisées en France entre 2004 et 2010, la mortalité était de 3,8% et la morbidité de 54%. Parmi les complications post-opératoires, la fistule pancréatique représente la principale complication en termes de mortalité (15 à 25%), génératrice de coût important dans les soins et d’une augmentation significative de la durée de séjour. La fistule pancréatique demeure la pierre angulaire de l’amélioration du pronostic des patients.L’objectif de ce travail sur l’adénocarcinome canalaire pancréatique céphalique traité chirurgicalement était d’analyser certains facteurs influençant la morbi-mortalité au trois temps de sa prise en charge :- Avant l’intervention, avec l’étude d’un facteur pronostic préopératoire, sur une cohorte de patients, pouvant influencer la survenue d’une fistule pancréatique et la mortalité- Pendant l’intervention, avec la réalisation d’une méta-analyse sur le type de reconstruction pancréatique et son influence sur la survenue d’une fistule pancréatique- Après l’intervention, avec l’étude de l’influence de la survenue d’une complication sévère sur la survie et la survie sans récidive.Au cours de cette thèse nous avons vu, que la réduction du taux de fistule pancréatique, par le seul biais de techniques peropératoires semble difficilement réalisable au regard de la multiplicité des techniques et de la difficulté à réaliser des études randomisées contrôlées méthodologiquement satisfaisantes. En revanche, la recherche des facteurs liés aux patients, prédisposant à la survenue d’une fistule pancréatique semble l’approche à privilégier. Ceci est d’autant plus primordial dès lors que nous avons mis en évidence un lien entre la survenue d’une complication sévère et la survie ou la récidive chez les patients réséqués. Ce travail souligne l’importance d’être capable d’identifier, dès la consultation, les patients à haut risque de complications sévères et de fistule post-opératoire d’une part, pour sélectionner les bons candidats à la chirurgie et d’autre part, pour être capable de leur apporter une information franche et loyale indispensable éthiquement au consentement éclairé. / The third World Day on pancreatic cancer took place the 17th November 2016. This late consideration is due to the duality between his relative scarcity and a dreadful prognosis.Its aggressiveness is underlined by a mortality rate equal to its incidence. Ranked 10th on cancer-related localization and 4th on cancer-related mortality, he will become the second cause of cancer-related deaths in 2020 just behind pulmonary cancer and before colorectal cancer. 5-yr survival rate is 5% irrespective of the stage.Pancreatic ductal adenocarcinoma is the most frequent form (80% of exocrine pancreatic tumors). He is localized in cephalic pancreas in 2/3 of cases.Although pancreatic resection provides the only chance of long-term survival, no more than 20% of patients will be eligible for surgery in curative intent leading to a 5-yr survival rate of 10 to 20%. Pancreaticoduodenectomy for pancreatic head, neck and uncinated process is still a challenging procedure. In the study of the French Surgery Association, mortality and morbidity rate were respectively 3.8% and 54%. Postoperative pancreatic fistula is considered as the Achilles’ heel of pancreaticoduodenectomy and is associated with increased post-operative mortality. Postoperative pancreatic fistula generates significant costs and prolonged hospital stay. Thus postoperative pancreatic fistula is the corner stone of patient’s prognosis improvement.The aim of this study on operated pancreatic ductal adenocarcinoma was to analyze several factors influencing morbidity and mortality.- Before surgery, by testing the impact of body surface area in a cohort of patients.- During surgery, by conducting a meta-analysis on reconstruction methods for pancreatic anastomosis.- After surgery, by evaluating the influence of severe complications on survival and recurrence.We show that the use of various surgical refinements, such as type of pancreatic anastomoses, are equivocal to decrease postoperative pancreatic fistula rate and that performing randomized controlled trials will be difficult. In contrast, the search for patient’s factors leading to postoperative pancreatic fistula seems to be the promising approach. This is of major concern as we demonstrated the causal link between the occurrence of severe postoperative complications and survival or recurrence. This work highlights the need for surgeons to distinguish during preoperative consultation high-risk patients in order to select the best candidates suitable for surgery as well as to give them a full and frank information ethically necessary for free and informed consent.

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Mesoporous γ-alumina is the most extensively used catalysts support in a wide range of catalytic processes. The usefulness of γ-alumina relies on its favorable combination of physical, textural, thermal, and chemical properties. Pore structure properties are among the most important properties, since high surface area and large pore volume enable higher loading of active catalytic phases, while design of pore size and pore size distribution is critical to optimize pore diffusional transport and product selectivity. In addition, accurate determination of surface area (SA), pore volume (PV) and pore size distribution (PSD) of porous supports, catalysts, and nanomaterials is vital to successful design and optimization of these materials and to the development of robust models of pore diffusional resistance and catalyst deactivation.In this dissertation, we report a simple, one-pot, solvent-deficient process to synthesize mesoporous γ-alumina without using external templates or surfactants. XRD, TEM, TGA and N2 adsorption techniques are used to characterize the morphologies and structures of the prepared alumina nanomaterials. By varying the aluminum salts or the water to aluminum molar ratio in the hydrolysis of aluminum alkoxides, γ-alumina with different morphologies and pore structures are synthesized. The obtained alumina nanomaterials have surface areas ranging from 210 m2/g to 340 m2/g, pore volumes ranging from 0.4 cm3/g to 1.7 cm3/g, and average pore widths from 4 to 18 nm. By varying the alcohols used in the rinsing and gelation of boehmite/bayerite precursors derived from a controlled hydrolysis of aluminum alkoxides, the average pore width of the γ-aluminas can be tuned from 7 to 37 nm. We also report improved calculations of PSD based on the Kelvin equation and a proposed Slit Pore Geometry model for slit-shaped mesopores of relatively large pore size (>10 nm). Two structural factors, α and β, are introduced to correct for non-ideal pore geometries. The volume density function for a log normal distribution is used to calculate the geometric mean pore diameter and standard deviation of the PSD. The Comparative Adsorption (αs) Method is also employed to independently assess mesopore surface area and volume.

Nanomaterials have attracted substantial attention in the area of catalysis due to the unique properties they exhibit such as high surface areas, intricate pore networks and unique morphologies. TiO2 has attracted attention as a catalyst since the discovery of its high photocatalytic activity by Fuishima and Honda in 1972. Given its high thermal stability, low cost, low environmental impact, and versatility, TiO2 is a widely used commercial catalyst and catalyst support. TiO2 is used in many applications such as photocatalysis is also an excellent support material for noble metals in a number of oxidative synthesis and pollution-control reactions. Though TiO2 is a widely used catalyst support, currently available commercial titanias often have low surface area and poor thermal and hydrothermal stability. While several methods reported in literature produce materials of higher surface area and more ideal porosity relative to commercially available titanias, these procedures generally involve inherent drawbacks including time-consuming, complicated, and expensive processes that are not industrially viable. Cost-effective, large-scale preparations of stable, high surface area, mesoporous TiO2 need to be developed. The work in this dissertation focuses on (1) producing high surface area stabilized TiO2 supports of controlled pore diameters and (2) the preparation of well dispersed Pt on these supports using industrially viable processes. The effects of dopants Al, La, Si, and Zr on the stability, surface area, and porosity of anatase TiO2 supports were investigated. Results show that dopants increased the surface area and thermal stability of anatase through structural modifications and grain growth inhibition. Stabilized titanias produced by this method demonstrated equivalent or higher thermal stability and surface area compared with pure anatase and previously reported materials after treatment at 400°C and 700°C including 22 mol% Al-TiO2 calcined at 400°C which had a surface area of 479 ± 39 m2/g, a pore volume of 0.46 ± 0.04 cm3/g, and a pore diameter of 2.9 ± 0.2 nm. Ten synthesis variables were examined and optimized using statistically designed experiments (DOEs). Equations were developed to predict the conditions to obtain the highest surface area and pore volume at the desired pore diameter and predict the pore diameter range that may be obtained for aluminum-modified anatase TiO2. Confirmation trials closely matched predicted surface areas, pore volumes, and pore diameters in all but one trial, demonstrating the power of DOEs in identifying and controlling synthesis variables in relatively few experiments. The structure of Al-modified anatase TiO2 was analyzed to determine the mechanism of Al stabilization. Surface Al stabilized TiO2 by lowering anatase surface energy, stabilizing planes of high surface energy which would otherwise join to achieve stabilization. Al in TiO2 lattice vacancies stabilized TiO2 through increasing lattice strain and limiting mass transport necessary for grain growth. Results demonstrate the importance of structure analysis of doped nanomaterials in the development of stabilized catalysts and catalyst supports. An industrially viable, one-pot synthesis of Pt supported on 22 mol% Al-modified anatase is presented. Pt dispersions as high as 54% (one-pot method) and 59% (DI method) have been obtained. Results show that this one-pot method and the DI method using our Al-modified supports are promising syntheses of highly dispersed Pt catalysts and demonstrate that the alumina-stabilized anatase support is superior to other many available anatase supports.

Background: Periodontal disease has been associated with gestational complications and both conditions have a high prevalence in rural populations from developing regions. A cross-sectional study was carried out to explore the relationship between periodontal inflamed surface area (PISA), blood pressure (BP), and, serum uric acid levels (UA) in a group of rural North Chinese pregnant women in the third trimester of pregnancy. Methods: Three hundred and thirty-five rural women aged 20–34 years, with normal body mass index (BMI) were examined in a cross-sectional study during their third trimester of gestation. Exclusion criteria were history of pregnancy complications,multiple pregnancy, smoking habits, diabetes, hypertension or any known infectious disease. Socio-demographic variables, including age and socioeconomic status (SES), systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings, serum UA levels, and PISA values were recorded. A structural equation model was implemented with two constructed latent variables including “Dem” (comprising of age and SES category to represent unobserved demographic variables) and, “BP” (comprising of SBP and DBP to account for measurement error and lack of multiple BP readings). The model accounted for co-variance of BP and UA, and implemented simultaneous regressions for BP and UA as outcomes, upon Dem and PISA values as exogenous variables. Results: The median PISA score was 1,081.7 (IQR = 835.01), reflecting high levels of periodontal inflammation in the sample. SEM showed a significant association of PISA with BP (estimate = 0.011, 95%CI = 0.009–0.012 p < 0.001) and UA (estimate = 0.001, 95% CI = 0.001–0.001, p < 0.001). Conclusion: Higher PISA values were significantly associated with higher blood pressure and uric acid levels among rural pregnant women in a cross-sectional sample from a center in North China after accounting for a latent demographic construct derived from age and SES.

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Yes / Recent studies have reported that quantifying symphyseal and auricular surfaces curvature changes on 3D models acquired by laser scanners have a potential for age estimation. However, no tests have been carried out to evaluate the repeatability of the results between different laser scanners. 3D models of the two pelvic joints were generated using three laser scanners (Custom, Faro, Minolta). The surface curvature, the surface area and the distance between co-registered meshes were investigated. Close results were found for surface areas (differences between 0.3% and 2.4%) and for distance deviations (average < 20 μm, SD < 200 μm). The curvature values were found to be systematically biased between different laser scanners, but still showing similar trends with increasing phases / scores. Applying a smoothing factor to the 3D models, it was possible to separate anatomy from the measurement error of each instrument, so that similar curvature values could be obtained (p < 0.05) independent of the specific laser scanner. / The full text was made available at the end of the publisher's embargo: 31st March 2016

Το π–κυμένιο (p–ισοπρόπυλο τολουόλιο) είναι ένα πολύ σημαντικό προϊόν με μεγάλο εμπορικό ενδιαφέρον, καθώς αποτελεί κύριο συστατικό πολλών καλλυντικών, αρωμάτων, φαρμακευτικών προϊόντων, καθώς και την πρώτη ύλη για την παραγωγή της p–κρεσόλης. Η τρέχουσα διαδικασία παραγωγής του π–κυμενίου είναι η κατά Friedel–Crafts αλκυλίωση του τολουολίου με προπυλένιο ή προπανόλη–2, η οποία χρησιμοποιεί μεγάλες ποσότητες επιβλαβών οξέων, προκαλώντας πολλά προβλήματα χειρισμού στους εργαζόμενους με αυτό, προβλήματα διάβρωσης και προβλήματα διάθεσης των παραγόμενων αποβλήτων. Τα τελευταία χρόνια, η Πράσινη Χημεία έχει παρουσιασθεί ως η νέα προσέγγιση της Χημείας για την πρόληψη της μόλυνσης του περιβάλλοντος, καθώς και του σχεδιασμού χημικών προϊόντων και διεργασιών που είναι περισσότερο φιλικά προς το περιβάλλον. Η κατάλυση αποτελεί μία από τις κύριες αρχές, αλλά ταυτόχρονα και εργαλείο της Πράσινης Χημείας. Πιο συγκεκριμένα η ετερογενής κατάλυση, που εξυπηρετεί τους στόχους της Πράσινης Χημείας, λόγω της εξάλειψης της ανάγκης διαχωρισμού του παραγόμενου προϊόντος από τον καταλύτη. Επίσης, μία άλλη βασική παράμετρος της Πράσινης Χημείας είναι η χρήση της βιομάζας, ως ανανεώσιμη πρώτη ύλη, με σκοπό την παραγωγή ενέργειας και χημικών προϊόντων. Στην παρούσα εργασία, μελετάται η δυνατότητα καταλυτικής παραγωγής π–κυμενίου, βασιζόμενη στις αρχές της Πράσινης Χημείας. Για το σκοπό αυτό χρησιμοποιείται ως αντιδρών το α–λεμονένιο, ένα μονοτερπένιο το οποίο αποτελεί ανανεώσιμη πρώτη ύλη, καθώς είναι παραπροϊόν της βιομηχανίας χυμών λεμονιού και πορτοκαλιού, καθώς και της βιομηχανίας χάρτου και πολτού. Πιο αναλυτικά, μελετήθηκε η καταλυτική συμπεριφορά οξειδίων με μεγάλη ειδική επιφάνεια, όπως η SiO2, το MCM–41, ο ζεόλιθος NaY, η γ–Al2O3 και δύο δείγματα TiO2, με διαφορετικές ειδικές επιφάνειες, στην αντίδραση μετατροπής του λεμονενίου προς π–κυμένιο. Επίσης, ερευνήθηκε η επίδραση στη διεργασία τόσο της θερμοκρασίας της αντίδρασης, όσο και της σύστασης της ατμόσφαιρας κάτω από την οποία διεξαγόταν η αντίδραση. Τα πειράματα διεξήχθησαν σε αντιδραστήρα σταθερής κλίνης – ατμοσφαιρικής πίεσης, ενώ για την ανάλυση των λαμβανόμενων προϊόντων χρησιμοποιήθηκε αέριος χρωματογράφος – φασματογράφος μάζας (GC–MS). Από τους καταλύτες που μελετήθηκαν ο πιο αποτελεσματικός αποδείχθηκε η τιτάνια με τη σχετικά μεγάλη ειδική επιφάνεια ακολουθούμενη από την τιτάνια με την χαμηλότερη ειδική επιφάνεια, τον ζεόλιθο NaY και τη γ–Al2O3. Τόσο η σίλικα όσο και το MCM–41 παρουσίασαν μάλλον αμελητέα δραστικότητα. Επίσης, παρατηρήθηκε ότι η απόδοση σε π–κυμένιο αυξανόταν γενικά με τη θερμοκρασία, ενώ δεν επηρεαζόταν πρακτικά από την ατμόσφαιρα που διεξαγόταν η αντίδραση. Τέλος, στους 300 οC και χρησιμοποιώντας την τιτάνια με τη σχετικά μεγάλη ειδική επιφάνεια ως καταλύτη επιτεύχθηκε 90% απόδοση για το π–κυμένιο και 100% μετατροπή για το λεμονένιο. Η αυξημένη απόδοση της τιτάνιας αποδόθηκε σε επιτυχή συγκερασμό ανάμεσα στη σχετικά μεγάλη οξύτητα Brönsted και στη σχετικά εύκολη μεταβολή του λόγου Ti(IV)/Ti(III) κατά τη διάρκεια της αντίδρασης. Τα κινητικά αποτελέσματα επέτρεψαν να γραφεί ένα κινητικό σχήμα για τη διεργασία. / P–cymene is a very important product with great commercial interest because of its use as a main ingredient of cosmetics, perfumes and pharmaceutical products as well as raw material for the production of p–cresol. Current production is achieved by using the Friedel–Crafts reaction of toluene with propylene or propanol–2 which uses large quantities of harmful acids which, in turn, leads to industrial accidents, corrosion problems and the general difficulty of handling toxic wastes. A new concept of chemistry has been developed for confronting environmental problems. Green Chemistry is related to products and processes that are environmentally friendly. One of the basic tools of Green Chemistry is catalysis, mainly heterogeneous catalysis, because it allows the easy separation of the catalysts used from the final product. Moreover, following the principles of the Green Chemistry, biomass should be used in the production of renewable energy and chemical products. The present Thesis deals with the catalytic production of p–cymene based on the principles of Green Chemistry. In particular, we use a–limonene, by–product of the juice of orange and lemon industry as well as the paper industry, to produce p–cymene. A number of oxides with large specific surface area, such as SiO2, MCM–41, zeolite NaY, γ–Al2O3 and two samples of TiO2, were studied as catalysts. The effect of the reaction temperature and the composition of the atmosphere were also studied. All experiments were conducted on a fixed bed micro–reactor operating under atmospheric pressure coupled with an on–line Gas Chromatograph–Mass Spectrometer (GC – MS). The titania with the relatively high specific surface area was proved to be the most efficient catalyst among those studied. The following activity series has been obtained: «high surface area titania > small surface area titania > zeolite NaY > γ–Al2O3 > MCM–41 > SiO2». Negligible activity is exhibited by MCM–41 and SiO2. The percentage yield for p–cymene increases with temperature whereas is practically independent from the carrier gas. Very high percentage yield for p–cymene was obtained at 300οC over the high specific surface area titania (~90%). Complete transformation of a–limonene was obtained over the above catalyst at the same temperature. The very high activity obtained over this catalyst was attributed to good compromise between high acidity and easy transformation of the ratio Ti(IV)/Ti(III) during reaction. The kinetic results allow the clarification of the reaction scheme.

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