Extended source models for wind turbine noise propagation.

Accurate prediction of wind turbine noise propagation over long distances requires modeling the dominant broadband aerodynamic noise sources, as well as the main outdoor sound propagation effects. In this study, two methods are compared to include extended aeroacoustic source models in a parabolic equation (PE) code for wind turbine noise propagation in an inhomogeneous atmosphere. In the first method, an initial starter is obtained for each segment of the blade using the backpropagation approach. In the second method, the blade segments are viewed as moving monopole sources, and only a limited number of PE simulations are needed for different source heights across the rotor plane. The two methods are compared to the point source approximation first in a homogeneous medium for validation purposes, and then in a stratified inhomogeneous atmosphere. The results show that an extended source model is necessary to calculate the sound pressure level upwind, where a shadow zone is present, and obtain the correct amplitude modulation levels. Furthermore, the second method is seen to yield as accurate results as the first method when a sufficient number of source heights is considered with a computation time that is much reduced.

Does prevention of intraperitoneal spillage when removing a dermoid cyst prevent granulomatous peritonitis?

In this retrospective study of 314 patients undergoing surgery for ovarian dermoid cysts, conducted over a 20-year period, we evaluated the impact of the routine use of laparoscopic surgery without recourse to laparotomy to retrieve the specimen, using an endoscopic retrieval bag placed under the cyst to prevent intraperitoneal spillage of cyst contents, and subsequent postoperative granulomatous peritonitis. Accidental cyst rupture was more frequent when a total laparoscopic approach was used (26/174 or 15% versus 39/140 or 28%; P = 0.005), but there were no cases of intraperitoneal spillage when an endoscopic bag was used. Two cases of granulomatous peritonitis developed out of 26 women with intraperitoneal spillage of cyst contents (8%). We conclude that the risk of granulomatous peritonitis can be minimised by undertaking laparoscopic removal of dermoid cysts with the routine intraoperative use of an endoscopic retrieval bag to prevent intraperitoneal spillage of cyst contents.

[Health-related quality of life in women operated on by surgical anti-incontinence procedures: comparison of three techniques]. / Qualité de vie après cure d'incontinence urinaire d'effort: comparaison de trois techniques.

OBJECTIVES: To assess the health-related quality of life (Contilife) after three surgical anti-incontinence procedures (Tension-Free Vaginal Tape [TVT], Transobturator Vaginal Tape [TOT], and Transobturator Vaginal Tape [TVT-O]). PATIENTS AND METHODS: We performed a prospective analysis of 90 women (30 TVT, 30 TOT, 30 TVT-0) with genuine stress incontinence pre- and postoperatively at 18 months. The objective cure rate was determined by clinical and urodynamic examination and the subjective cure rate by the Contilife questionnaire. RESULTS: Prior to surgery, patients complained more of effort activities, followed by global well-being. Postoperatively, all domains improved significantly without statistical difference between the three groups and 90% of the patients would advise the intervention to one of their friends. DISCUSSION AND CONCLUSION: Surgical outcomes vary greatly depending on the methodology of the study. Health-related quality of life seems paramount to decide time of surgery and to evaluate postoperatory results. We have chosen the Contilife questionnaire because of its scientific and clinical validity, reliability, responsiveness and linguistic validation. These results confirm that TVT/TOT/TVT-O procedures are a safe and effective surgical method and that they significantly improved health-related quality of life.

[Unusual perineal pain in postpartum period: contribution of perineal ultrasound]. / Douleur périnéale du post-partum inhabituelle: apport de l'échographie.

We report two cases of persistent [correction of persistant] perineal pain in postpartum period due to transfixation of the anus with a suture and the contribution of perineal ultrasound in the diagnosis of unusual perineal pain.

[Role of ultrasound in the evaluation of patients after laparoscopic sacropexy: preliminary study]. / Intérêt de l'échographie dans le suivi des patientes après promontofixation par coelioscopie: étude préliminaire.

OBJECTIVES: To evaluate results of laparoscopic sacropexy with introital and vaginal ultrasonography, that is to observe dynamic behavior of the mesh, to measure precisely its position and to conclude on the feasibility of this exam. PATIENTS AND METHODS: The surgery was a laparoscopic subtotal hysterectomy and a suspension of the cervix with an anterior vesicovaginal mesh and a posterior rectovaginal mesh. These meshes are joined together and fixed on the sacrum. Ultrasound was performed in fifteen patients to see in the sagital plane the position of the mesh. The distance anterior mesh-bladder neck and the distance posterior mesh-anal sphincter were measured at rest, during straining and during retaining. The spreading out and the dynamic behavior of the mesh were studied. RESULTS: The distance anterior mesh-bladder neck is 12 mm at rest, 15 mm during straining and 13 mm during retaining. The distance posterior mesh-anal sphincter is 30 mm at rest, 26 mm during straining and 31 mm during retaining. The mesh is always seen as spread out, or folded, but never strained. Video recording shows that sacropexy does not block pelvic dynamics. DISCUSSION AND CONCLUSION: Ultrasound imaging appears in this study as a simple and efficient exam to study and measure prosthesis. It could be a good help for clinical examination to explain failure or complication of surgery.

[The use of ultrasonographic 3D power Doppler to describe an ovarian Sertoli-Leydig cell tumor]. / Description échographique d'une tumeur ovarienne de Sertoli-Leydig à l'aide du doppler énergie tridimensionnel.

We report one case of unilateral ovarian Sertoli-Leydig tumor with intermediate grade and heterologous element, in a young woman with clinical and biological typical presentation. We discuss 2D and 3D ultrasonographic and doppler features.

[Autoimmune hepatitis and pregnancy: about a patient's three consecutive pregnancies]. / Hépatite auto-immune et grossesse: à propos de trois grossesses consécutives chez une patiente.

Spontaneous evolution of autoimmune hepatitis during pregnancy is not well known, nor are its consequences on pregnancy evolution. Immunosuppressive treatment during pregnancy is sometimes necessary but the long- and short-term consequences are unrecognized. We relate a patient's disease with autoimmune hepatitis and cirrhosis and three consecutive pregnancies with different obstetrical and medical complications.

[Management of gestational hypertriglyceridemia by plasmapheresis]. / Prise en charge d'une hypertriglycéridémie gravidique par plasmaphérèse.

We report a case of unexpected severe hypertriglyceridemia (140N) diagnosed at 33 weeks during a second gestation. The risk of acute pancreatitis indicated plasmapheresis (three procedures) with reduction of hypertriglyceridemia (6N) and no impact on fetal well-being. Immediate recurrence led to induction of labour at 34 weeks. Spontaneous regression occurred after delivery. We demonstrated reduced lipoprotein lipase activity with no mutation for apolipoprotein E, nor lipoprotein lipase in favour of a potential pregnancy-induced inhibitor of lipoprotein degradation.

[Comparison of transobturator tape (TOT) and tension-free vaginal tape (TVT) using perineal ultrasound]. / Les trajets anatomiques des bandelettes sous-urétrales, rétropubiennes TVT et transobturatrices TOT, sont-ils différents? Apport de l'échographie introïtale.

OBJECTIVE: Using perineal ultrasound in two groups of patients having either TVT or TOT procedure to know if TOT is sufficiently oblique and if the large dissection in TOT procedure might be responsible for migration of the tape. PATIENTS AND METHODS: Thirty-two patients, 16 TVT and 16 TOT, had a sonography. The tape is visualised in the sagittal and frontal planes at rest, maximum holding and valsalva straining. The angle between the two limbs of the tape is measured as well as the distance tape-bladder neck and the width of the tape. RESULTS: The aspect of the tape at rest is like a V, in both groups. During straining, the urethra is flattened on the tape which becomes round. During maximum retaining, the V closes by traction on the limbs. The mean angle under the urethra at rest is 109.9 degrees. In the TVT group it is 101.6 degrees versus 118.1 degrees in the TOT group. This difference is statistically significant (P=0.001). The width of the tape is 6.7 mm (2.4-10.3). The distance tape-bladder neck is 14.8 mm (8.2-25.7), 14.6 mm for the TVT group and 15.6 mm for the TOT group, the mean urethral length being 33.1 mm. DISCUSSION AND CONCLUSION: The angle of TOT is more open. It remains sufficiently oblique and allows the tape to be put with light tension if needed in low-pressure urethra. In spite of larger urethrovaginal dissection in TOT, the tape does not migrate close to the bladder neck and remains at mid-urethra.

[Fertiloscopy: Clermont-Ferrand's experiment]. / Fertiloscopie: l'expérience clermontoise.

OBJECTIVE: Evaluation of fertiloscopy's place in the management of female infertility. PATIENTS AND METHODS: Retrospective study including 229 women presenting primary or secondary infertility without pathology raising of an evident surgical sanction and benefitting from a fertiloscopy. Perioperative data analysis (context of the infertility, operating technique, complications). RESULTS: Two hundred and three fertiloscopic procedures succeeded (88.6%), revealing lesions in 58 cases (28.6%) requiring a laparoscopy. These are represented by adherences (21 cases), endometriosis (17 cases), an abnormality of the tubal permeability (10 cases), complete or partial failure to visualize the adnexae (6 cases) and ovarian cysts visualization (4 cases). Five complications (2.5%) without major consequence will be deplored: two rectal injuries, two hemorrhagic complications and a postoperative salpingitis. Most of procedures (97.5%) have been performed in an ambulatory setting except when a geographic remoteness did not allow it (5 patients). DISCUSSION AND CONCLUSION: Fertiloscopy is a safe and reliable procedure. It can be substituted to laparoscopy in the routine assessment of infertile women management in case of not obvious surgical indication.

A 69 bp fragment in the pyrroline-5-carboxylate reductase promoter of Arabidopsis thaliana activates minimal CaMV 35S promoter in a tissue-specific manner.

The Arabidopsis thaliana gene that encodes pyrroline-5-carboxylate reductase (At-P5R), the last enzyme in proline biosynthesis in A. thaliana, is developmentally regulated and is highly expressed in cells that divide rapidly or undergo changes in osmotic potential. A 69 bp region (P69; -120 to -51) has previously been identified in a 5' deletion analysis of the At-P5R promoter to be necessary for the basal expression. Here, the essential role of P69 for tissue-specific expression of At-P5R is demonstrated by loss- and gain-of-function experiments.

[Evaluation of a perinatal network using the first certificates of health]. / Évaluation d'un réseau périnatal à partir des premiers certificats de santé

OBJECTIVE: To describe the methodology for continuous reporting of perinatal indicators in Maternité en Yvelines et Pays Associés (MYPA) network, and the main results for its evaluation. To discuss the implications for practice in a perinatal network. MATERIAL AND METHODS: CoNaissance 78 program is a collaboration between MYPA network, Conseil général des Yvelines, ARS Île-de-France and U953 Inserm unit. Continuous recording of data is produced using the first certificate of health (PCS) of infants born in the network maternities, an additional health certificate including data about severe maternal morbidity, perineal tears and episiotomies, and a stillbirth certificate including all cases of fetal deaths and medical termination of pregnancy from 22weeks of gestation. Description of the population and obstetric practices with comparison between the network maternities covers the period from 2008 to 2011. RESULTS: The analysis includes 79,232 births. The used variables had a missing data rate below 5%. The mean maternal age at delivery was 30.9, women aged 35years or above accounting for 23.2% of deliveries (from 17.1 to 32.8% according to the maternity, P<0.001). Nullipara rate was 42.5% (from 36.6 to 50% according to the maternity, P<0.001) and multiple pregnancies rate was 1.8% (from 0.3 to 3.4% according to the maternity, P<0.001). Mode of onset of labor was spontaneous in 66.1% cases (from 55.5 to 72.9% according to the maternity, P<0.001), induced in 21.5% cases (from 16.9 to 30.8% according to the maternity, P<0.001) and a planned cesarean section was performed in 12.4% cases (from 8.4 to 19.6% according to the maternity, P<0.001). The global mean rate of cesarean sections was 24.3% (from 18.4 to 29.6% according to the maternity, P<0.001). The cesarean section rate was in a selected low risk group was 14.7% (from 11.4 to 20.2% [P<0.001] according to the maternity). The episiotomy rate was 26.1% (from 16.3 to 43.6% [P<0.001] according to the maternity). The rate of very preterm neonates born alive inside a tertiary center was 70.8%. CONCLUSION: This program allowed to observe a large disparity in practices, and highlighted significant shortcomings in the organization of in utero transfers to the tertiary center for very preterm births.

Developmental regulation of pyrroline-5-carboxylate reductase gene expression in Arabidopsis.

At-P5R, a gene encoding the last enzyme of the proline (Pro) biosynthetic pathway in Arabidopsis thaliana, is developmentally regulated. To characterize the cis elements responsible for this developmental regulation, a series of 5' deletions of the At-P5R promoter were transcriptionally fused to a beta-glucuronidase (GUS)-coding region and transformed into Arabidopsis. The complete promoter of At-P5R directs strong GUS activity in root tips, the shoot meristem, guard cells, hydathodes, pollen grains, ovules, and developing seeds, all of which contain rapidly dividing cells and/or are undergoing changes in osmotic potential. This expression pattern is consistent with the function of Pro as an energy, nitrogen, and carbon source and as an osmoticum in response to dehydration. Promoters longer than 212 base pairs (bp) showed the same expression pattern, whereas those shorter than 143 bp did not direct any detectable GUS activity in any organs. This suggests that a 69-bp promoter region located between -212 and -143 bp is necessary to establish the tissue-specific expression of At-P5R during development. The Pro content measured in different organs suggests that, in addition to transcriptional control of the biosynthetic pathway, the transport of Pro may play a role in its distribution within Arabidopsis. Several aspects of the relationship between Pro metabolism and plant physiology are discussed.

At-HSP17.6A, encoding a small heat-shock protein in Arabidopsis, can enhance osmotolerance upon overexpression.

Owing to their sessile lifestyle, it is crucial for plants to acquire stress tolerance. The function of heat-shock proteins, including small heat-shock proteins (smHSPs), in stress tolerance is not fully explored. To gain further knowledge about the smHSPs, the gene that encoded the cytosolic class II smHSP in Arabidopsis thaliana (At-HSP17.6A) was characterized. The At-HSP17.6A expression was induced by heat and osmotic stress, as well as during seed development. Accumulation of At-HSP17.6A proteins could be detected with heat and at a late stage of seed development, but not with osmotic stress, suggesting stress-induced post-transcriptional regulation of At-HSP17.6A expression. Overproduction of At-HSP17.6A could increase salt and drought tolerance in Arabidopsis. The chaperone activity of At-HSP17.6A was demonstrated in vitro.

The 5' untranslated region of the At-P5R gene is involved in both transcriptional and post-transcriptional regulation.

The steady-state level of transcripts coding for the pyrroline-5-carboxylate reductase of Arabidopsis (At-P5R) increased under salt and heat stress, mainly because of an enhanced mRNA stability. However, the At-P5R protein level was not induced, and its translation was inhibited at initiation stage and probably also at later stages. Replacement of the 5' untranslated region (5'UTR) and beta-glucuronidase (gus) fusion analysis revealed that the first 92 bp region of the At-P5R 5'UTR was sufficient to mediate transcript stabilization and translation inhibition during salt and heat stresses. Furthermore, the first 92 bp region of the At-P5R 5'UTR was also involved in transcription efficiency in a promoter-dependent manner. The results demonstrated that the stress regulation of At-P5R is complex and involves the 5'UTR which acts at three levels, partly in opposing directions.

Expression of cell cycle regulatory genes and morphological alterations in response to salt stress in Arabidopsis thaliana.

Hyperosmotic stress severely affects plant growth and development. To examine the effect of salt stress on cell cycle activity in Arabidopsis thaliana (L.) Heynh., the transcriptional regulation of a cyclin-dependent kinase, CDC2aAt, and two mitotic cyclins, Arath;CycB1;1 and Arath;CycA2;1, was studied by using the beta-glucuronidase (gus) reporter gene. Moreover, the mRNA abundance of these cell cycle genes as well as CDC2bAt were monitored during salt stress. Upon NaCl treatment, the promoter activities and transcript levels of all cell cycle genes diminished initially in the shoot apex and were subsequently induced during salt-stress adaptation. Additionally, the promoter activities of CDC2aAt and CycA2;1 decreased in the vascular cylinder of the root in correlation with reduced lateral root formation. In the root tips, a regression of CDC2aAt, CycA2;1, and CycB1;1:gus expression was observed, concomitant with a shrinkage of the root meristem and inhibition of root growth. Our data indicate that salt stress interferes with cell cycle regulation at the transcriptional level, resulting in an adaptive growth response.