1. INTRODUCTION Spontaneous pneumothorax is one of the most common types of aeropathic syndrome, caused by chronic obstructive pulmonary diseases, tuberculosis and complicated lung cancer. Nearly two hundred years have passed since the first description of the first cases of pneumothorax. Although during this period the scientist´s view of the etiology, pathogenesis, diagnostics and treatment methods has changed, a number of issues related to the diagnostics and treatment of this complication of pulmonary diseases remain unsolved. The aim of the treatment of spontaneous pneumothorax is to remove the cause of this condition, to perform the decompression of the pleural cavity, to induce the obliteration of the pleural cavity and to prevent the recurrence of the disease. Pleural puncture and drainage of the pleural cavity are not sufficiently effective – the incidence of incomplete lung expansion and rapid recurrence of the disease (relapse) reaches 25% [Mova VA, 1999]. Urgent thoracotomy is performed in cases when the drainage of the pleural cavity fails to reduce the symptoms of the aeropathic syndrome and breathing and blood circulation insufficiency caused by the spontaneous pneumothorax. Frequently thoracotomy is performed after pleural drainage in cases of exudative pleuritis or starting pleural empyema. The postoperative period is marked by a large number of complications and prolongation of hospital stay, and post-operative mortality in the group of geriatric... [to full text]

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Due to the nature of war, persons are killed with various types of weapons. Throughout the history of humanity, weapons were used in this regard and these weapons left injuries on the victims that are distinguishable. The type of force conveyed by the ancient weapons effected injuries that enable modern-day bioarchaeologists to extrapolate which weapons caused which injuries. The Assyrians depicted their wars and battles on reliefs. An analysis of these depictions, with an extrapolation of the lesions expected in skeletal remains, could contribute to better understanding of the strategies of war in ancient times. This dissertation will discuss how the evaluation of human remains in comparison to Assyrian reliefs may contribute to the chronological knowledge of war and warfare in the Iron Age Ancient Near East – especially at Lachish. A discourse of the approaches available to researchers regarding access to data in the forensic bioarchaeological field will be presented. / Biblical and Ancient Studies / M.A. (Biblical Archaeology)

The objective of this thesis research is to improve our understanding of the flow obstacle effect on heat transfer at supercritical and high subcritical pressures by experimentally studying the effect of different obstacles on heat transfer in two vertical upward-flow test sections: a 3-rod bundle and an 8 mm ID tube. The heat transfer measurements cover the region of interest of the Canadian Super-critical Water Cooled Reactor (SCWR). A thorough analysis of the obstacle effect on supercritical heat transfer (SCHT) was performed. In the 3-rod bundle, two types of obstacles were employed: wire wraps and low-impact grid spacers. Wire wraps were found to be more effective than grid spacers to enhance the SCHT. In the tubular test section, obstacles appeared to suppress the heat transfer deterioration (HTD) or decrease its severity; obstacles also generally enhanced the SCHT both in the liquid-like and the gas- like region. The experiment in the tubular test section revealed that, at certain flow conditions (low mass flux, low inlet subcooling), flow obstacles can have an adverse impact on the SCHT. A criterion to predict the onset of this adverse effect was developed. At high subcritical pressures, obstacles increased the CHF and reduced the maximum post-CHF temperature. A comparison of the experimental data with prediction methods for the SCHT, single phase heat transfer, CHF and post-dryout heat transfer was performed. Lastly, a new correlation to predict the enhancement in SCHT due to obstacles was developed for heat transfer in the liquid-like and gas-like regions.

L’association lésionnelle d’une contusion pulmonaire et d’un état de choc hémorragique est fréquente et constitue un réel chalenge thérapeutique. La prise en charge de ce choc va nécessiter une réanimation hémodynamique dans laquelle le remplissage vasculaire tient une place centrale. Mais dans ce contexte de poumon contus, il devra être raisonné car délétère sur le plan pulmonaire, notamment en terme d'oedème et d'altération de la compliance. Ce remplissage devra donc être titré, basé sur des objectifs tensionnels clairs et un monitorage hémodynamique fiable. L'utilisation de solutés à haut pouvoir d'expansion volémique (sérum salé hypertonique, colloïdes) présente un intérêt, de même que l'introduction précoce de vasopresseurs. Le monitorage hémodynamique permettra de conduire cette réanimation sur des objectifs de pression artérielle, sur des indices de précharge dépendance et sur la mesure de l'eau pulmonaire extravasculaire. Notre travail, basé sur des études expérimentales et cliniques, a pour objectif de caractériser les modalités actuelles de prise en charge d’une contusion pulmonaire, sur les plans hémodynamiques et respiratoires. / Pulmonary contusion is often associated with hemorrhagic shock, constituting a challenge in trauma care. For patients who have sustained lung contusions, fluid resuscitation should be carefully performed, because injured lungs are particularly vulnerable to massive fluid infusions with an increased risk of pulmonary edema and compliance impairment. Fluid administration should be included in an optimized and goal directed resuscitation, based on blood pressure objectives and hemodynamical monitoring. The use of fluids with high volume-expanding capacities (hypertonic saline, colloids) is probably interesting, as well as early introduction of vasopressors. Hemodynamic monitoring will allow to conduct resuscitation on blood pressure objectives, on preload parameters and on extravascular lung water measurement.Our work, based on experimental and clinical studies, objective to characterize the current modalities of ventilatory and hemodynamical aspect of pulmonary contusion care.

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Depuis plusieurs décennies, l’évaluation des armes à létalité réduite (ALR) et des gilets pare-balles suscite l’intérêt majeur des forces de l’ordre autour du globe. En effet, ces armes présumées à létalité réduite ou non létales sont tenues d’occasionner uniquement une douleur suffisamment importante à un individu afin d’assurer sa neutralisation. Les gilets pare-balles, quant à eux, doivent garantir un certain niveau de protection pour réduire le risque de traumatismes lié à leur déformation dynamique. Le Centre de Recherche, d’Expertise et d’appui Logistique (CREL) du Ministère de l’Intérieur français a ainsi pour objectif le développement d’un outil de prédiction du risque lésionnel thoracique lors d’impacts balistiques non pénétrants. Cela permettrait alors d’évaluer les performances des ALR et des gilets pare-balles avant leur déploiement en théâtre d’opérations. Plus précisément, cette méthode doit uniquement être fondée sur la mesure directe du processus dynamique de déformation d’un bloc de gel synthétique soumis à un impact balistique. Pour répondre à ce besoin, l’approche numérique est considérée dans ces travaux de thèse par l’emploi du mannequin numérique du thorax humain HUByx comme un outil intermédiaire permettant la détermination de fonctions de transfert entre les mesures expérimentales sur un bloc de gel et le risque lésionnel. La reproduction de conditions d’impact réelles sur HUByx nécessite la caractérisation et la modélisation de projectiles ALR ainsi que de projectiles d’armes à feu et de gilets pare-balles. Elles reposent sur une procédure d’identification par méthode inverse appliquée à l’essai de Taylor pour la modélisation des ALR et à l’essai du cône dynamique d’enfoncement sur le bloc de gel pour celle du couple projectile/gilet pare-balles. Des travaux sont dédiés à la caractérisation mécanique et à la modélisation du gel synthétique sous sollicitations dynamiques. Enfin, une approche statistique basée sur des analyses de corrélation est introduite exploitant à la fois les mesures expérimentales, les données numériques ainsi que les rapports de cas de la littérature. Une cartographie du thorax associée au risque de fractures costales est établie et est uniquement fonction d’une mesure expérimentale. / For decades, the assessment of less-lethal weapons (LLW) and bulletproof vests has generated major interest from law enforcement agencies around the world. Indeed, these presumed less-lethal or non-lethal weapons are required to cause only significant pain to an individual to ensure their neutralization. Bulletproof vests, in turn, must provide a certain level of protection to reduce the risk of trauma related to their dynamic deformation. The Center for Research, Expertise and Logistics Support (CREL) of the French Ministry of the Interior aims to develop a tool to predict thoracic injury risk during non-penetrating ballistic impacts. It would therefore be possible to evaluate the performance of LLW and bulletproof vests before their deployment in operations. More precisely, this method must only be based on the direct measurement of the dynamic process of deformation of a synthetic gel block subjected to a ballistic impact. To address that issue, the numerical approach is considered in this thesis by the use of the human thorax dummy HUByx as an intermediate tool for the determination of transfer functions between experimental metrics on a gel block and the risk of injury. The reproduction of real impact conditions on HUByx thus requires the characterization and modeling of less-lethal projectiles as well as projectiles of firearms and bulletproof vests. They rely on an inverse method identification procedure applied to the Taylor test for modeling LLW and on the analysis of blunt impacts on the gel block for projectiles/bulletproof vests. Work is then dedicated to the mechanical characterization and modeling of the synthetic gel under dynamic loadings. Finally, a statistical approach based on correlation analyses is introduced using both experimental measurements, numerical data as well as case reports from the literature. A thorax mapping associated with the risk of rib fractures is established and only depends on an experimental metric.