Thèse Médecine Paris, 1823, n°172.

Thèse Médecine Paris, 1835 numéro 119.

Thèse Médecine Paris, 1813 numéro 8.

Reproduction de : Thèse d' exercice : Médecine : Nancy 1 : 2003. / Thèse : 2003NAN11046. Titre provenant de l'écran-titre.

Thèse ou mémoire avec insertion d'articles / Ce mémoire comporte deux études portant sur la biopsie transthoracique à l'aiguille (BTTA) sous guidage échographique. La première étude est une étude de cohorte rétrospective, monocentrique, avec l'objectif d'évaluer les variables cliniques et radiologiques qui influencent la sensibilité et les complications de la BTTA sous guidage échographique. Pour étudier cette question, 488 patients consécutifs ayant subi 528 BTTA sous guidage échographique entre 2008 à 2017 à l'IUCPQ ont été inclus. Les patients inclus avaient une lésion pleurale ou pulmonaire périphérique en contact avec la plèvre. Des 528 BTTA sous guidage échographique, 75% (397/528) des lésions étaient malignes. La sensibilité pour poser le diagnostic d'une lésion maligne était de 72% (285/397). L'analyse multivariée a révélé que la longueur de contact pleural était la seule variable qui influençait la sensibilité (rapport de cote [RC] 1.08 par mm jusqu'à 30 mm). Un pneumothorax est survenu dans 15% (77/528) des BTTA sous guidage échographique. Un drain thoracique a été placé chez 2% des patients (9/528). La longueur de contact pleurale (RC 0.98 par mm ; 95% IC 0.97-0.99 ; p=0.013), la taille de la lésion (RC 0.98 par mm ; 95% IC 0.96-0.99 ; p=0.006) et l'utilisation d'une aiguille-trocart de calibre 18G (RC 0.47 comparé à 20G ; 95% IC 0.26-0.83 ; p=0.010) étaient associés avec une diminution du taux de pneumothorax. Ainsi, la longueur de contact pleural est une variable clé qui influence à la fois la performance et la sécurité de la BTTA sous guidage échographique. La BTTA sous guidage échographique est une procédure efficace et sécuritaire. La deuxième étude est une revue systématique avec méta-analyse portant sur la performance diagnostique et les complications de la BTTA sous guidage échographique. La méta-analyse comporte 83 études représentant 11,722 BTTA sous guidage échographique dans une population de 11,767 patients. La méta-analyse a démontré une sensibilité de 88% et une spécificité de 100%. Des complications sont survenues dans 4% des procédures. Le pneumothorax (3%) était la complication la plus fréquente dont un drain thoracique a été placé dans 0.4% des BTTA / This memoir contains two studies on ultrasound-guided transthoracic needle biopsy (US-TTNB).The first study is a retrospective single-centre study with the aim to identify clinical and imaging variables affecting the sensitivity and complication rate of biopsy US-TTNB for diagnosing pleural and peripheral pulmonary lesions. To study this question, 488 patients underwent a consecutive series of 528 US-TTNB from 2008 through 2017. Included patients had a pleural lesion or a peripheral lung lesion with pleural contact. Of the 528 US-TTNB, 75% (397/528) of the lesions had a final diagnosis of malignancy. Sensitivity of malignancy was 72% (285/397). Multivariate analysis showed that increasing pleural contact length was the only variable associated with increased sensitivity (odds ratio [OR] 1.08 per mm up to 30 mm). Pneumothorax occurred in 15% (77/528) of the US-TTNB which led to a chest tube placement in 2% of all the US-TTNB (9/528). Pneumothorax was associated with lower pleural contact length (OR 0.98 per mm), lower lesion size (OR 0.98 per mm)and the use of 18G core needle (OR 0.47). Pleural contact length is therefore a keyvariable that influenced both performance and security outcomes of US-TTNB. USTTNB is an efficient and safe procedure.The second study is a diagnostic accuracy systematic review with meta-analysis on US-TTNB. The meta-analysis comprised 62 studies which reported an overall 6,815 US-TTNB. The meta-analysis reported a sensitivity of 88% and a specificity of 100%. Complications occur in 4% of the procedures with pneumothorax (3%) being the most frequent leading to a chest tube in 0.4% of the procedures

Thèse doctorat : Mécanique : Paris 12 : 2003. / Version électronique uniquement consultable au sein de l'Université Paris 12 (Intranet). Titre provenant de l'écran-titre. Bibliogr. : 123 réf.

Research related to the control of upright posture and balance has historically focussed on the lower extremities, often treating the trunk as a single, rigid segment. The principal objective of this work, therefore, was to characterize the response of the multiarticular trunk, in healthy individuals, to unexpected support surface translations. Three dimensional trunk motions were captured, in both standing and sitting, during horizontal support surface translations in 8 directions. A 4-segment model, consisting of pelvic, lumbar, upper and lower thoracic segments, was used for all kinematic and kinetic analyses. Electromyographic (EMG) data was simultaneously acquired, bilaterally, from 7 trunk muscles and 1 hip muscle.[...] / La recherche liée au maintien de l'équilibre s'est historiquement concentrée sur les membres inferieurs, traitant souvent Ie tronc comme un segment unique et rigide. L'objectif principal de ce travail était donc, de caractériser la réponse du tronc multi articulaire chez les individus sains, suite a un mouvement inattendu de la surface de support. Le mouvement tridimensionnel du tronc a été capture durant les mouvements horizontaux de la surface de support dans 8 directions, en position debout et assise. Un modèle du tronc comprenant Ie bassin, un segment lombaire, et des segments thoraciques inferieur et supérieur, a été utilise pour les analyses cinématiques et cinétiques. Des données electromyographiques (EMG) bilatérales de 7 muscles du tronc et d'un muscle de la hanche ont été acquises simultanément.[...] fr

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 28-29).

Th.--Méd.--Reims, 1981. N°: 56.

Electrical Impedance Tomography (ElT) is an emerging imaging technique with applications in the medical field and in the field of industrial process tomography (lPT). Until recently, data acquisition and image reconstruction schemes have been constructed with the assumption that the object being imaged is two-dimensional. In recent years, some research groups have started to address the third dimensional aspects of ElT by both building three dimensional enabled data acquisition systems and solving the three dimensional Forward Problem numerically since this allows the possibility of modelling complex shapes. However, solving the Forward Problem analytically is still very attractive as an analytical solution does not depend on the way the domain has been meshed. Furthermore, if dynamic images are reconstructed which are less sensitive to the model of the electrodes employed, the shape of the object being imaged and the position of the electrodes, an analytical solution to the Forward Problem can be used to reconstruct dynamic three dimensional images. This thesis will start by describing how a full analytical solution for a finite right circular cylinder (which approximately models the human thorax) on which two electrodes have been placed, is derived. It will be shown that the analytical solution has two different forms. Results will be presented detailing the convergence performance of the two different forms as well as comparisons between the analytical solution and experimentally obtained data. Finally three dimensional images reconstructed using these methods will be presented. In order to better approximate the shape of the human thorax, the above work has been extended to provide an analytical solution for an elliptical cylinder and this is presented in this thesis for the first time together with some simulation results. Today in Multi-frequency Electrical Impedance Tomography (MEIT), new hardware for recording measurements operating above 1MHz is now available. This high operating frequency raises the question of the validity of the employed quasi-static conditions used in the associated Forward Problem modelling. It is important to be able to determine when the quasi-static conditions fail and to investigate the differences between a solution to the Forward Problem based on quasi-static conditions and the one based on non quasistatic conditions at these frequencies. This thesis details the derivation of a new analytical solution based on non quasi-static conditions for a finite right circular cylinder having two electrodes placed on its boundary. Some comparisons between the new analytical solution and data obtained from in-vitro experiments will be presented in this thesis. A comparison between the new analytical solution and the analytical solution derived earlier in this thesis (which is based on quasi-static conditions) is also conducted. Whilst these results are preliminary results, they reveal that for situations associated with imaging the human thorax the quasi-static assumption appear violated when most modern MEIT systems are employed. This frequency dependent three dimensional analytical Forward Problem work has wide ranging implications for the future of MEIT. The thesis will conclude with some initial thoughts on how to incorporate anisotropy into three dimensional Forward Problem solutions.