[Development of multidisciplinary community-based health care centres in Germany]. / Le développement de centres de santé pluridisciplinaires de proximité en Allemagne : les Medizinische Versorgungszentren.

MVZ provide community-based health care services improving integrated primary care and specialist care and allow hospital to outsource outpatient activities. They also provide patient-centered care and promote internal and external multidisciplinary coordination. MVZ can provide an example for possible changes to private specialist organisation and structuring of hospital services in France, while MSP mainly focus on primary care and only a few specialist CS have been created..

Identification of novel QTL for resistance to Fusarium head blight in a tetraploid wheat population.

Most tetraploid durum wheat (Triticum turgidum L var. durum) cultivars are susceptible to Fusarium head blight (FHB). This study reports novel quantitative trait loci (QTL) associated with FHB resistance. A backcross recombinant inbred line (BCRIL) population was developed from the cross BGRC3487/2*DT735, and 160 lines were evaluated for resistance to Fusarium graminearum Schwabe (teleomorph Gibberella zeae (Schwein. Petch) in field trials over 3 years (2008-2010) and to a F. graminearum 3-acetyl-deoxynivalenol (3-ADON) chemotype in greenhouse trials. The population was genotyped with 948 polymorphic loci using DArT and microsatellite markers. Eleven QTL were associated with FHB resistance under field conditions on chromosomes 2A, 3B, 5A, 5B, 7A, and 7B. Two of these, QFhb.usw-3B from BGRC3487 and QFhb.usw-7A2, were consistently detected over environments. The QFhb.usw-3B QTL was in a similar position to a resistance QTL in hexaploid wheat. The combination of the two QTL reduced field index by 53.5%-86.2%. Two QTL for resistance to the 3-ADON chemotype were detected on chromosomes 1B and 4B. Both BGRC3487 and DT735 could provide new sources of FHB resistance and the combination of QTL reported here could be valuable tools in breeding FHB-resistant durum wheat.

Sub-pixel shifted acquisitions for super-resolution proton magnetic resonance spectroscopy (1H MRS) mapping.

PURPOSE: (1)H MRS typical studies lead to low-resolution maps (voxels size>1cm(3)). The low-resolution maps may involve the presence of two or more different tissues in a single voxel which gives partial volume effects. Such insufficient spatial resolution remains an obstacle for most routine clinical examinations and restricts the ability in the detection of small lesions. MATERIALS AND METHODS: The proposed algorithm is based on the combination of three ideas: controlled sub-pixel shift, averaging, and initial pixel size reduction until the spectrum extinction because initial pixel size will determine the final spatial resolution. Frequency range limits are studied to determine the optimal window of spectral peak (WSP). This method is validated in-vitro and in-vivo. RESULTS: The results in-vitro allowed us to consolidate the theoretical one. Results in-vivo are compared with the clinical protocol to demonstrate the increase in spatial resolution. The proposed method allowed us to reduce the pixel size to1/16 of its initial pixel size in total scan time (TS) of 17min 10s. We demonstrated that the optimal WSP is 80% of its initial value and the interpolation "Bilinear" has the minimum error. CONCLUSION: A novel approach is established for processing images and reconstructing high-resolution map from low-resolution maps. We have presented a robust algorithm for high spatial resolution in-vivo (1)H MRS, and have achieved a super spatial resolution up to 0.034cm(3) to overcome the major technical challenges.

Myelin characterization of fetal brain with mono-point estimated T1-maps.

Magnetic resonance imaging (MRI) allows non-invasive assessment of fetus brain maturation at the beginning of the third trimester because of its high sensitivity for fat and water content changes accompanying the myelin formation. In this article we propose a new ultra-fast mono point T(1)-map method based on simplified optimized Gradient Echo (GE) two-point method. Results are compared between the two methods and the precision discussed. This quantitative method can be used in clinical routine, as sedation is not needed for patients.

A new production method of elastic silicone carotid phantom based on MRI acquisition using rapid prototyping technique.

In vitro experimental simulations of blood fluid in carotid artery require ideal phantoms that are as precise as possible. The purpose of this work is to demonstrate a method for carotid phantom fabrication by rapid prototyping technique (RP). By using 3D reconstructed projection of the 3D time-of-flight (TOF) Magnetic Resonance Imaging (MRI) sequence, a 12.5 cm multi-dimensional spatial structure of a carotid artery has been set up. Y-shaped and patient specific models have been generated respectively using silicone elastomer, which has a high resilience and a good tensile strength. The final patient specific model has internal carotid artery (ICA) with a highly spiraling siphon and an external carotid artery (ECA). Elastic properties of carotid walls have also been evaluated by Young's elastic modulus test and dynamic behaviors in optical and echography simulation experiments.

Clinical engineering education in France situation in 2007 and evolution.

Compiegne's University of Technology is one of the main contributors in clinical engineering education in France. Knowledge and skills have been acquired since 1974 through professional specialization courses and new programs such as master's degrees, engineering and PhD degrees, and continuing education courses for technicians. To face current hospitals needs, new investments in distance learning have been made. The first results are presented in the following.

Biomedical education for clinical engineers.

Biomedical equipment Master's degree is recognized by the French Ministry of Health, since its creation in 1975 under the denomination of "Specialization for Hospital Biomedical Engineers". Since the new national status of technical staff in the public service by decree of September 5th of 1991, it allows to access directly to the level of Chief Hospital Engineer (first category, second class, by ordinance of October 23rd, 1992). Biomedical Engineers jobs in French hospitals are selected after an examination organized by the recruiting hospital. Master's graduates are most often the best qualified.

MR imaging detection of superparamagnetic iron oxide loaded tris-acryl embolization microspheres.

PURPOSE: To assess by magnetic resonance (MR) imaging the detectability of superparamagnetic iron oxide (SPIO)-labeled microspheres (MSs) in vitro on gelose, ex vivo in kidneys from embolized sheep, and in vivo in kidneys from embolized pigs. MATERIALS AND METHODS: With various sizes of SPIO-labeled MSs, common neck and pelvic spin-echo and gradient-echo sequences were acquired on a 1.5-T MR unit. SPIO-labeled MSs of four sizes were embedded in a hydrogel as single MSs or in multiple units, or multiplets. Detection rate on MR imaging was assessed according to the real size and number of MSs. SPIO-loaded and unloaded MSs of four sizes were injected into eight sheep kidneys, which underwent MR and pathologic examinations. For each size, the location of MSs in renal vasculature was determined and compared according to the technique used. Kidneys were embolized in pigs with various amounts of MSs in three sizes. MR was performed immediately after embolization and SPIO-labeled MS detection was assessed according to size, organ, and amount injected. Results SPIO-labeled MSs provide a low signal intensity on T1-weighted sequences, without distortion. In vitro, 28% of 100-300-microm single MSs were detected and more than 80% were detected for larger sizes. MS multiplets were all detected in all sizes. Ex vivo, all sizes of MSs were detected by MR imaging in kidneys, whereas control MSs were not observed. Histologic analysis showed that there was no difference in vascular distribution between SPIO-labeled MS and control MSs, and therefore for each caliber (P > .05). Arterial location of SPIO-labeled MSs was the same on MR imaging and histologic analysis. In vivo, SPIO-labeled MS were detected in the kidney vasculature when volumes greater than 1 mL of 100-300-microm or 500-700-microm MSs were injected. Volumes lower than 1 mL SPIO-labeled MSs were hardly detected in kidneys, regardless of MS size. Conclusions SPIO-labeled MSs are detected by MR imaging with common gradient-echo sequences in vitro in gelose and ex vivo and in vivo in kidneys. SPIO-labeled MSs could allow better control of embolization and thereby enhance efficacy and safety of the procedure.