O objetivo deste estudo é o de comparar os resultados clínicos e radiográficos do tratamento cirúrgico das fraturas da diáfise do úmero com haste intramedular bloqueada ou placa em ponte. Quarenta fraturas da diáfise do úmero, em 39 pacientes, dos tipos A, B ou C da classificação do grupo A.O., foram tratadas no período compreendido entre junho de 2003 e dezembro de 2007. Destas, após seleção por sorteio, 21 fraturas foram submetidas à osteossíntese com placas em ponte de 4,5 mm e parafusos (grupo PP) e 19 com hastes intramedulares bloqueadas não fresadas (grupo HIB). Duas eram fraturas expostas, uma do tipo II e outra do tipo III-a de Gustilo. Vinte e cinco pacientes eram do sexo masculino (64%) e a idade variou de 19 a 75 anos (idade média de 41 anos e 10 meses). O lado direito foi acometido em 22 pacientes (55%) e a queda, o mecanismo de trauma mais freqüente (46%). O tempo mínimo de seguimento foi de seis meses e o máximo de 60 meses para o grupo PP (M=34,5 meses) e de oito e 58 meses (M=27meses) para o grupo HIB. Em apenas um caso, operado com haste intramedular bloqueada, não houve a consolidação. Houve um caso de infecção profunda no grupo PP e um de infecção superficial no grupo HIB. Dois casos do grupo PP evoluíram com capsulite adesiva e, em apenas um dos casos do grupo HIB, o parafuso distal ficou saliente. Ocorreu neuropraxia do nervo cutâneo lateral do antebraço em um dos casos do grupo HIB que regrediu em três dias. Não houve diferença entre os grupos com relação ao tempo total da cirurgia. O tempo de utilização da radioscopia no ato operatório foi maior no grupo HIB. Houve semelhança entre os dois métodos de fixação nos resultados referentes à dor, à função, à flexão ativa e à força de flexão na articulação do ombro e também com relação à dor, mobilidade, força muscular e estabilidade na articulação do cotovelo. Segundo os critérios da UCLA para o ombro, obtivemos resultados excelentes e bons em 85,7% no grupo operado com placa em ponte e 79% no grupo com haste intramedular bloqueada e de acordo com os critérios de Broberg e Morrey para o cotovelo, obtivemos resultados excelentes e bons em 85,7% no grupo operado com placa em ponte e 90,5% no grupo com haste intramedular bloqueada. Na avaliação subjetiva, duas pacientes, uma do grupo HIB e outra do PP, não ficaram satisfeitas. Conclusão: Não houve diferença no resultado clínico e radiográfico entre os dois métodos / The purpose of the study is to compare clinical and radiographic outcomes between nonreamed locked intramedullary nail and bridging plate for the treatment of humeral shaft fracture. Forty humeral shaft fractures in 39 patients, A, B or C AO types were treated between June 2003 and December 2007. The cases were randomly assigned into two groups being 21 fractures fixed by a 4.5 mm bridging plate, and 19 by nonreamed intramedullary locking nail. Two cases had open fractures, one Gustilo type II, the other type IIIa. Twenty five patients were male (64%), ages ranging from 19 to 75 years old (mean age 41 years and 10 months). The right side was treated in 22 patients (55%) and fall was the most frequent cause of fracture (46%). The minimal period of follow-up was six months and the maximum was 60 months for the bridging plate group (mean=34.5 months) and ranged from eight to 58 months (mean=27months) for the nail group. Only one case from the nail group presented a nonunion. One case, in the plate group, developed a deep infection, and another one, in the nail group, had a superficial infection. Two cases of the bridging plate group had adhesive capsulites and in one case of the nail group the distal screw became prominent. A transient neuropraxis of the antebrachial lateral cutaneous nerve was found in one case of the nail group, but it recovered in three days. There were no differences between the groups concerning pain, function, active flexion and strength of flexion of the shoulder, as well as pain, range of motion, muscle strength, and stability of the elbow. According to the UCLA score, we had 85.7% excellent and good results in the plate group and 79% in the nail group. According to Broberg and Morrey score for the elbow, we had 85.7% excellent and good results in the plate group and 90.5% in the nail group. Just one patient, from the nail group, was not satisfied with the final result, according to subjective criteria. In conclusion, there were no differences in the final clinical and radiographic results between the two methods of fixation

Les télomères sont des structures nucléoprotéiques localisées aux extrémités des chromosomes. Ils jouent un rôle important dans le maintien de l’information génétique, la stabilité et la protection des extrémités chromosomiques. Les télomères sont composés de séquences d’ADN répétées riches en guanines (TTAGGG) et des protéines télomériques qui les protègent. Parmi celles-ci, TRF1 et TRF2 se fixent directement sur le double brin. Toute modification de la structure des télomères (composition en protéines télomériques, raccourcissement de leur longueur, dommages) peut entrainer la mort des cellules cancéreuses. Ainsi les télomères sont considérés comme des cibles thérapeutiques. Etant riches en guanines adjacentes, les télomères sont donc des cibles potentielles du cis-platine, agent pharmacologique utilisé dans le traitement d’un certain nombre de tumeurs. Nous avons analysé, sur deux lignées de cancer d’ovaire A2780 sensibles et résistantes au cis- platine, les modifications éventuelles de la structure de leurs télomères après traitement par le cis-platine et quantifié le cis-platine fixé au niveau des télomères afin de déterminer s’il pourrait être l’origine de ces perturbations. Suite au traitement par le cis-platine, une délocalisation de TRF2 des télomères (maximum 55%) a été mise en évidence dans les deux lignées, accompagnée de dommages au niveau des télomères (2-3 dommages/cellule) mais elle est cependant insuffisante pour induire leur raccourcissement. Ensuite, la quantification par ICP-MS du cis-platine fixé au niveau de l’ADN télomérique purifié montre que le cis-platine se fixe bien au niveau des télomères. Cependant cette quantité fixée est 5 fois moins importante que celle trouvée au niveau de l’ADN génomique et 12 fois moins importante que celle attendue d’après les études in vitro, suggérant que les guanines de l’ADN télomérique sont moins accessibles que celles de l’ADN génomique. D’autre part, la quantité de cis-platine fixé par base est trop faible pour expliquer le déplacement de TRF2. Ces résultats suggèrent que la fixation du cis-platine au niveau des télomères ne peut donc pas être le mécanisme majoritaire responsable du déplacement de TRF2 des télomères et de la mort des cellules. Ce travail ouvre ainsi la voie à la conception de nouveaux complexes anti-tumoraux de platine qui cibleraient plus spécifiquement les télomères des cellules cancéreuses afin de les déstructurer plus efficacement. / Telomeres are nucleoprotein structures located at the ends of chromosomes. They play an important role in the maintenance of the genetic information, the stability and protection of chromosome’s ends. Telomeres consist of repeated DNA sequences G-rich (TTAGGG)n, and telomeric proteins that protect them. Among them, TRF1 and TRF2 bind directly to double-stranded. Any change in the structure of telomeres (telomeric protein composition, shortening their length, damage) can cause the death of cancer cells. Thus telomeres are considered as therapeutic targets. Since they are rich in adjacent guanines, telomeres are therefore potential targets for cis-platin, a pharmacological agent used in the treatment of a certain number of tumours. We looked for, at the cellular level, using two lines of ovarian cancer A2780: sensitive and resistant to cis-platin any changes in the structure of their telomeres after cis-platin treatment. And we checked the amount of cis-platin bound to telomeres to determine if it could be the cause of these perturbations. Following treatment with cis-platin, a delocalisation of TRF2 from telomere (maximum 55%) was observed within both cell lines, with damages at telomeres (2-3 damages / cell). But it is still not enough to induce their shortening. Then, the quantification by ICP-MS of the cis-platin fixed at purified telomeric DNA, shows that cis-platin binds well at telomeres. However, this amount is 5 times less than that the one found at genomic DNA and 12 times less than the one expected from in vitro studies, suggesting that the guanines of the telomeric DNA are less accessible than those of the genomic DNA. On the other hand, the amount of cis-platin bound by base is too small to explain the displacement of TRF2. So, these results suggest that the binding of cis-platin at telomeres cannot be the principal mechanism responsible of cell death, and that the displacement of TRF2 from telomere is not related directly to this phenomenon. Thus, this work opens the way for the design of new anti-tumour platinum complexes that target telomeres of cancer cells more specifically, in order to induce more efficiently their dysfunction.

No description available.

Les fondements théoriques pour la saillance visuelle ont été dressés, il y a 35 ans, par Treisman qui a proposé "feature-integration theory" pour le système visuel humain: dans n’importe quel contenu visuel, certaines régions sont saillantes en raison de la différence entre leurs caractéristiques (intensité, couleur, texture, et mouvement) et leur voisinage. Notre thèse offre un cadre méthodologique et expérimental compréhensif pour extraire les régions saillantes directement des flux compressés (MPEG-4 AVC et HEVC), tout en minimisant les opérations de décodage. L’extraction de la saillance visuelle à partir du flux compressé est à priori une contradiction conceptuelle. D’une part, comme suggéré par Treisman, dans un contenu vidéo, la saillance est donnée par des singularités visuelles. D’autre part, afin d’éliminer la redondance visuelle, les flux compressés ne devraient plus préserver des singularités. La thèse souligne également l’avantage pratique de l’extraction de la saillance dans le domaine compressé. Dans ce cas, nous avons démontré que, intégrée dans une application de tatouage robuste de la vidéo compressée, la carte saillance agit comme un outil d’optimisation, ce qui permet d’augmenter la transparence (pour une quantité d’informations insérées et une robustesse contre les attaques prescrites) tout en diminuant la complexité globale du calcul. On peut conclure que la thèse démontre aussi bien méthodologiquement que expérimentalement que même si les normes MPEG-4 AVC et HEVC ne dépendent pas explicitement d’aucun principe de saillance visuelle, leurs flux préservent cette propriété remarquable reliant la représentation numérique de la vidéo au mécanisme psycho-cognitifs humains / The theoretical ground for visual saliency was established some 35 years ago by Treisman who advanced the integration theory for the human visual system: in any visual content, some regions are salient (appealing) because of the discrepancy between their features (intensity, color, texture, motion) and the features of their surrounding areas. This present thesis offers a comprehensive methodological and experimental framework for extracting the salient regions directly from video compressed streams (namely MPEG-4 AVC and HEVC), with minimal decoding operations. Note that saliency extraction from compressed domain is a priori a conceptual contradiction. On the one hand, as suggested by Treisman, saliency is given by visual singularities in the video content. On the other hand, in order to eliminate the visual redundancy, the compressed streams are no longer expected to feature singularities. The thesis also brings to light the practical benefit of the compressed domain saliency extraction. In this respect, the case of robust video watermarking is targeted and it is demonstrated that the saliency acts as an optimization tool, allowing the transparency to be increased (for prescribed quantity of inserted information and robustness against attacks) while decreasing the overall computational complexity. As an overall conclusion, the thesis methodologically and experimentally demonstrates that although the MPEG-4 AVC and the HEVC standards do not explicitly rely on any visual saliency principle, their stream syntax elements preserve this remarkable property linking the digital representation of the video to sophisticated psycho-cognitive mechanisms

Environ, 2% des enfants de moins de 7 ans sont porteurs d'un strabisme (Williams et al., 2008) entraînant une perturbation de leur système visuel. Dans un premier temps, nous allons étudier les mouvements oculaires pendant la lecture d'un texte et pendant la poursuite d'une cible chez des enfants strabiques et de comparer ces résultats à des enfants non strabiques du même âge. Dans un second temps, nous avons étudié l'équilibre postural en condition de simple et de double tâche, puis nous avons examiné le rôle des informations proprioceptives sur le contrôle postural chez ces enfants. Nous émettons l'hypothèse selon laquelle le déficit visuel des enfants strabiques est à l'origine d'un retard ou d'un mauvais traitement cognitif de l'information visuelle ainsi qu'à l'origine d'un développement moteur modifiés s'appuyant sur d'autres systèmes sensoriels pour compenser leur déficit visuel. Quatre études publiées dans des revues internationales ont été réalisés pour tester ces hypothèses. L'ensemble de ces travaux a été réalisé afin d'apporter une meilleure compréhension des mécanismes et des interactions entre oculomotricité et contrôle postural chez les enfants strabiques. Ceci permet d'apporter des éléments fondés à l'aide au diagnostic, à la prise en charge rééducative mais aussi chirurgical de ces enfants strabiques. / Approximately 2% of children under 7 years old suffer strabismus (Williams et al., 2008), leading to a deficit in their visuel system. Firstly, we studied eye movements during reading and during smooth pursuit in strabismic children and compared these results to non strabismic age-matched children. Secondly, we studied postural control in both simple and double task, and the role of proprioceptive information on postural control in these children. We hypothesize that visual deficit in strabismic children delayed cognitive processing of visual information, and modified motor development by using other sensory systems to compensate their visual deficit. Four peer reviews were conducted to confirm these assumptions. Taken together, these studies provide a better understanding about mechanisms and interactions between oculomotricity and postural control in strabismic children. These findings allow to bring evidence for improve the diagnosis, rehabilitation treatment and also surgical treatment of strabismic children.

La prothèse totale de la hanche (PTH) avec cupule acétabulaire monobloc et articulation de grand diamètre (LDH) offre une amplitude articulaire supraphysiologique et une stabilité accrue. Reposant sur une fixation primaire par press-fit, l’implantation de ces prothèses sur des cotyles atypiques peut représenter un défi technique. L’objectif principal de ce mémoire est d’évaluer la stabilité de la fixation primaire et secondaire de ces implants lorsqu’utilisés dans un cotyle atypique en première intention ou en révision prothétique. Comme objectif secondaire, nous évaluerons les résultats fonctionnels rapportés par le patient (PROMs) à l’aide de scores validés. Deux séries de cas consécutifs de PTHs LDH monoblocs sur cotyles atypiques ont été évaluées : 125 PTHs primaires et 47 révisions de PTH (rPTH). La mesure d’efficacité primaire était la révision acétabulaire pour toutes causes aseptiques. Les PROMs ont été évalués au dernier suivi avec les scores de Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Forgotten Joint Score (FJS) et Patient’s Joint Perception (PJP). Une évaluation radiologique à la recherche de signes de descellement aseptique a été complétée au dernier suivi. En PTH primaire, après un suivi moyen de 9,2 ans (2,2-15,8), aucun descellement aseptique de la cupule n’a été identifié. Il y a eu 13 (10,4%) révisions sans lien avec la fixation acétabulaire. En rPTH, après un suivi moyen de 4,5 ans (2,0-13,7), il y a eu 5 (10,6%) ré-révision de la cupule incluant 2 pertes de fixation primaire. Le taux de luxation fut de 0% en PTH primaire et de 8,5% (4/47) en rPTH. Les résultats fonctionnels moyens en PTH primaire et rPTH étaient un WOMAC de 9,2 et 19,5 ainsi qu’un FJS de 80,9 et 57,3, respectivement. Quant au PJP en PTH primaire et en rPTH, respectivement, 49,4% et 8,8% des patients percevaient leurs hanches comme naturelle, 19,1% et 23,5% comme une articulation artificielle sans restriction tandis que 31,5% et 67,7% rapportaient un certain degré de restriction. Lorsqu’utilisés par des opérateurs expérimentés sur cotyles présentant un défi de fixation primaire, les cupules monoblocs LDH sont des options intéressantes offrant un faible taux de révision et de complication ainsi que d’excellents résultats cliniques à moyen terme. / Total hip arthroplasty (THA) with monobloc acetabular cup with large diameter bearing (LDH) offers supraphysiologic range of motion and increased stability. Relying on primary press-fit fixation, implantation of these prostheses on atypical acetabula can represent a technical challenge. The main objective of this thesis is to evaluate the stability of primary and secondary fixation of these implants on atypical acetabula in first intention or prosthetic revision. As a secondary objective, we will assess the mid-term clinical results using validated patient-reported outcome measures (PROMs). Two consecutive case series of monobloc LDH THA with atypical acetabula were evaluated: 125 THAs and 47 revisions THA (rTHA). The primary efficacy measure was acetabular revision for all aseptic causes. PROMs were assessed at last follow-up with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Forgotten Joint Score (FJS) and Patient’s Joint Perception question (PJP). A radiological evaluation assessing for signs of aseptic loosening was completed at last follow-up. In primary THA, after a mean follow-up of 9,2 years (2,2-15,8), no aseptic loosening of the acetabular cup was identified. There were 13 (10,4%) revisions unrelated to acetabular fixation. In rTHA, after a mean follow-up of 4,5 years (2,0-13,7), there were 5 (10,6%) cup re-revisions: 2 loss of primary fixation and 3 recurrent instabilities. The dislocation rate in primary THA was 0% and 8,5% (4/47) in rTHA. The average functional scores in primary THA and rTHA were a WOMAC of 9,2 and 19,5 and a FJS of 80,9 and 57,3, respectively. As for PJP in primary THA and rTHA, respectively, 49,4% and 8,8% of patients perceived their hip as natural, 19,1% and 23,5% as an unrestricted artificial joint while 31,5% and 67,7% reported some degree of restriction. When used by experienced operators on acetabula presenting a technical challenge for primary fixation, LDH monoblocs cups are attractive options offering low revision and complication rates and excellent mid-term clinical results.

No description available.

No description available.

Einleitung: Aufgrund der hohen Inzidenz der vorderen Kreuzbandverletzungen und der damit einhergehenden funktionellen Einschränkung besteht ein anhaltendes Interesse an der Verbesserung bestehender und Entwicklung neuer, besserer Techniken zur Rekonstruktion dieser Bandstruktur des Kniegelenkes. In dieser Studie wurde der Einfluss des Verankerungsniveaus (anatomisch vs. extrakortikal) und der Verankerungsart (direkt vs. indirekt) auf das mechanische Verhalten von drei exemplarischen, in der Klinik häufig angewandten Rekonstruktionstechniken, untersucht. Material & Methoden: An insgesamt 24 Kniegelenken humaner Spender mittleren Alters (40 Jahre) wurden drei Rekonstruktionstechniken (n=8 pro Gruppe) des VKB durchgeführt. Als Transplantat wurden jeweils humane Hamstringsehnen verwendet: 1.) HADBIO: anatomische und direkte Verankerung mit biodegradierbaren Interferenzschrauben, 2.) HADTIT: semi-anatomische und direkte Verankerung mit Titanschrauben, 3.) HEIButton: extrakortikale, indirekte Verankerung mit Faden-Button Verbindung. Alle rekonstruierten Kniegelenke wurden einer zyklischen, inkremental zunehmenden Belastung bis zum Versagen unterzogen. Es wurden die Parameter Konstruktsteifigkeit, absorbierte Energie, Transplantatauslenkung und Laxizitätszunahme bei Belastungen von 200, 300, 400 N, sowie die maximale Steifigkeit und Versagenskraft bestimmt. Ergebnis: Die anatomische und direkte Transplantatverankerung mit biodegradierbarer Interferenzschraube zeigt die vorteilhaftesten mechanischen Eigenschaften, während die extrakortikale und indirekte Verankerung die niedrigsten mechanischen Eigenschaften aufwies. Die tibiale Verankerungsseite ist bei Interferenzschraubenverankerung der Schwachpunkt, während die Fadenverbindungen bei der extrakortikalen Verankerungstechnik die Schwachstelle darstellten. Auch bei anatomischer und direkter Transplantatfixation findet ein nicht zu vernachlässigender permanenter Verankerungsverlust bei vergleichsweise geringer Versagenskraft statt, der vor allem auf der tibialen Verankerungsseite zu beobachten ist. Diskussion: Eine anatomische und direkte Transplantatverankerung ist von mechanischem Vorteil. Allerdings hängt die Konstruktsteifigkeit auch in erheblichem Maße vom Fixationsobjekt ab. Extrakortikale Fixationstechniken, die eine indirekte Faden-Knoten-Transplantatverbindung erfordern, unterliegen einer erheblichen nicht-reversiblen Lockerung unter zyklischer Belastung und sollten durch direkte Verankerungstechniken ersetzt werden. Aufgrund der permanenten Laxizitätszunahme auch in der anatomischen und direkten Interferenzschraubenverankerung, vor allem der tibialen Seite, sollte über Sicherungsverankerungen, so genannten Hybridfixationen nachgedacht werden, um die mechanischen Vorteile dieser Rekonstruktionsart voll zum Tragen bringen zu können. / Introduction: There is a continuous interest in the improvement and development of new techniques for the reconstruction of the anterior cruciate ligament (ACL) because of the high incidence of its injury and the resulting functional deficit. Purpose of this study was the impact of fixation level (anatomic vs. extracortical) and fixation method (direct vs. indirect) on the mechanical properties of three frequently used reconstruction techniques. Material & Methods: 24 human cadaveric knees with an average age of 40 years were used for simulation of three reconstruction techniques (n=8 per group). Human hamstring tendons were utilized as tendon grafts. 1.) HADBIO: anatomic and direct fixation with biodegradable interference screws, 2.) HADTIT: semi-anatomic and direct fixation with titanium interference screws, 3.) HEIButton: extracortical, indirect fixation with tape/button combination. All reconstructed knee joints underwent cyclic incremental loading until failure. Construct stiffness, absorbed energy, displacement and laxity increase were calculated at loads up to 200, 300, 400 N. Maximum stiffness and failure load were also recorded. Results: The anatomic and direct graft fixation with biodegradable interference screws provided the highest, while the combination of extracortical and indirect fixation showed the lowest mechanical properties. The tibial fixation site is the critical factor in interference screw fixation, while the tape/suture interfaces were the location of failure in the extracortical reconstructions. Even in the anatomic and direct reconstruction technique a considerable permanent loss of fixation, especially at the tibial fixation site and a comparably lower failure load were observed. Discussion: The combination of anatomic and direct fixation showed to be of mechanical benefit. However, construct stiffness seemed to be also affected by the fixation device. Extracortical fixation techniques, which require suture-tape/knot interfaces for graft fixation, undergo significant permanent loosening of fixation under cyclic loads and should be replaced by direct fixation techniques. Since a permanent laxity increase was still observed in the anatomic and direct interference screw reconstructions, especially on the tibial site, backup or so called hybrid fixations should be considered, which would allow to take full advantage of the mechanical improvements in these reconstruction techniques.

Master of Science / Department of Agronomy / Michel D. Ransom / Many soils in southeastern Kansas are characterized by high clay contents and high shrink-swell potentials. Their vertic properties and claypan characteristics cause soil management to be difficult and pose problems for agricultural, environmental, and engineering uses. Thus, collecting more information and improving our understanding of these soils is an important step towards bettering our soil management techniques. The objectives of this study were to examine the morphology, processes of soil genesis, clay mineralogy, micromorphology, and potassium fixation potential of the soils of interest and how these characteristics varied between and within individual pedons. Ten pedons expected to represent varying degrees of vertic expression were selected. Methods included the use of field descriptions, routine soil laboratory characterization, micromorphological investigations, the determination of clay mineralogy by X-ray diffraction, and the measurement of potassium fixation potential. Field morphology reflected the geologic parent materials available in the region. The fine sediments that compose these clayey soils are primarily provided by the Pennsylvanian and Permian shales and limestones underlying this region and the Flint Hills to the west. Dominant pedogenic processes currently at work are clay illuviation and shrink-swell processes. Silty, non-expansive surface soils at all but sites 6 and 7 are thought to buffer the rapid wetting and drying cycles needed for maximum vertic expression. Four of the soils were dominated by smectitic minerals in the clay fraction while the rest exhibited a more mixed mineralogy. Disruption of illuvial clay features by shrink-swell movement was evident in thin section. Striated b-fabrics dominated the micromorphology except in non-expansive surface soils. K fixation of the soil surface was found to be negative in all soils, thus K fixation potential is considered very low. In subsurface horizons, K fixation generally increased with increasing vermiculite content. In addition to limited quantities of K-fixing clay minerals, naturally high K levels limited the amount of K fixation in this study. The information presented can be used to improve our understanding and management of high clay, vertic and claypan soils in southeastern Kansas.