PTA e stenting carotideo: valutazione morfologica ed evolutiva, a breve e medio termine

In un periodo di tre anni è stato svolto un lavoro mirato alla valutazione delle complicanze correlate all’utilizzo dello stenting carotideo. Dopo la preparazione di un protocollo con definizione di tutti i fattori di rischio sono stati individuati i criteri di inclusione ed esclusione attraverso i quali arruolare i pazienti. Da Luglio 2004 a Marzo 2007 sono stati inclusi 298 pazienti e sono state valutate le caratteristiche della placca carotidea, con particolare riferimento alla presenza di ulcerazione e/o di stenosi serrata, la tortuosità dei vasi e il tipo di arco aortico oltre a tutti i fattori di rischio demografici e metabolici. E’ stato valutato quanto e se questi fattori di rischio incrementino la percentuale di complicanze della procedura di stenting carotideo. I pazienti arruolati sono stati suddivisi in due gruppi a seconda della morfologia della placca: placca complicata (placca con ulcera del diametro > di 2 mm e placca con stenosi sub occlusiva 99%) e placca non complicata. I due gruppi sono stati comparati in termini di epidemiologia, sintomatologia neurologica preoperatoria, tipo di arco, presenza di stenosi o ostruzione della carotide controlaterale, tipo di stent e di protezione cerebrale utilizzati, evoluzione clinica e risultati tecnici. I dati sono stati valutati mediante analisi statistica di regressione logistica multipla per evidenziare le variabili correlate con l’insuccesso. Dei 298 pazienti consecutivi sottoposti a stenting, 77 hanno mostrato una placca complicata (25,8%) e 221 una placca non complicata (74,2%). I due gruppi non hanno avuto sostanziali differenze epidemiologiche o di sintomatologia preoperatoria. Il successo tecnico si è avuto in 272 casi (91,2%) e sintomi neurologici post-operatosi si sono verificati in 23 casi (23.3%). Tutti i sintomi sono stati temporanei. Non si sono avute differenze statisticamente significative tra i due gruppi in relazione alle complicanze neurologiche e ai fallimenti tecnici. L’età avanzata è correlata ad un incremento dei fallimenti tecnici. I risultati dello studio portano alla conclusione che la morfologia della placca non porta ad un incremento significativo dei rischi correlati alla procedura di stenting carotideo e che l’indicazione alla CAS può essere posta indipendentemente dalla caratteristica della placca.

Analisi morfologica e molecolare di cellule da colture primarie umane esposte a resine biocompatibili

The cytotoxicity of dental composites has been attributed to the release of residual monomers from polymerized adhesive systems due to degradation processes or the incomplete polymerization of materials. 2-Hydroxyethyl methacrylate (HEMA) is one of the major components released from dental adhesives. Cytotoxic effects due to high concentrations of HEMA have already been investigated, but the influence of minor toxic concentrations for long-term exposition on specific proteins such as type I collagen and tenascin has not been studied in depth. The objective of this project was to study the effect of minor toxic concentrations of HEMA on human gingival fibroblasts (HGFs) and human pulp fibroblasts (HPFs), investigating modification in cell morphology, cell viability, and the influence on type I collagen and tenascin proteins. Different concentrations of the resin monomer and different times of exposition were tested on both cell lines. The cell vitality was determined by MTT assay, and high-resolution scanning electron microscopy analysis was performed to evaluate differences in cell morphology before and after treatment. To evaluate the variability in the expression and synthesis of procollagen α1 type I and tenascin proteins on HGFs and HPFs treated with HEMA at different concentrations immunofluorescence, RT-PCR and western blot analysis, were carried out. The treatments on HGFs with 3mmol/L HEMA, showed a strong reduction of procollagen α1 type I protein at 72h and 96h, demonstrating that HEMA interferes both with the synthesis of the procollagen α1 type I protein and its mRNA expression. The results obtained on HPFs treated with different concentrations of HEMA ranging from 0,5mmol/L to 3mmol/L and for different exposition times showed a strong reduction in cell viability in specimens treated for 96h and 168h, while immunofluorescence and western blotting analysis demonstrated a reduction of procollagen α1 type I and an overexpression of tenascin protein. In conclusion, our results showed that the concentrations of HEMA we tested, effect the normal cell production and activity, such as the synthesis of some dental extracellular matrix proteins.

Metodi di ottimizzazione morfologica nel progetto preliminare di propulsori aeronautici avanzati

The aim of this Doctoral Thesis is to develop a genetic algorithm based optimization methods to find the best conceptual design architecture of an aero-piston-engine, for given design specifications. Nowadays, the conceptual design of turbine airplanes starts with the aircraft specifications, then the most suited turbofan or turbo propeller for the specific application is chosen. In the aeronautical piston engines field, which has been dormant for several decades, as interest shifted towards turboaircraft, new materials with increased performance and properties have opened new possibilities for development. Moreover, the engine’s modularity given by the cylinder unit, makes it possible to design a specific engine for a given application. In many real engineering problems the amount of design variables may be very high, characterized by several non-linearities needed to describe the behaviour of the phenomena. In this case the objective function has many local extremes, but the designer is usually interested in the global one. The stochastic and the evolutionary optimization techniques, such as the genetic algorithms method, may offer reliable solutions to the design problems, within acceptable computational time. The optimization algorithm developed here can be employed in the first phase of the preliminary project of an aeronautical piston engine design. It’s a mono-objective genetic algorithm, which, starting from the given design specifications, finds the engine propulsive system configuration which possesses minimum mass while satisfying the geometrical, structural and performance constraints. The algorithm reads the project specifications as input data, namely the maximum values of crankshaft and propeller shaft speed and the maximal pressure value in the combustion chamber. The design variables bounds, that describe the solution domain from the geometrical point of view, are introduced too. In the Matlab® Optimization environment the objective function to be minimized is defined as the sum of the masses of the engine propulsive components. Each individual that is generated by the genetic algorithm is the assembly of the flywheel, the vibration damper and so many pistons, connecting rods, cranks, as the number of the cylinders. The fitness is evaluated for each individual of the population, then the rules of the genetic operators are applied, such as reproduction, mutation, selection, crossover. In the reproduction step the elitist method is applied, in order to save the fittest individuals from a contingent mutation and recombination disruption, making it undamaged survive until the next generation. Finally, as the best individual is found, the optimal dimensions values of the components are saved to an Excel® file, in order to build a CAD-automatic-3D-model for each component of the propulsive system, having a direct pre-visualization of the final product, still in the engine’s preliminary project design phase. With the purpose of showing the performance of the algorithm and validating this optimization method, an actual engine is taken, as a case study: it’s the 1900 JTD Fiat Avio, 4 cylinders, 4T, Diesel. Many verifications are made on the mechanical components of the engine, in order to test their feasibility and to decide their survival through generations. A system of inequalities is used to describe the non-linear relations between the design variables, and is used for components checking for static and dynamic loads configurations. The design variables geometrical boundaries are taken from actual engines data and similar design cases. Among the many simulations run for algorithm testing, twelve of them have been chosen as representative of the distribution of the individuals. Then, as an example, for each simulation, the corresponding 3D models of the crankshaft and the connecting rod, have been automatically built. In spite of morphological differences among the component the mass is almost the same. The results show a significant mass reduction (almost 20% for the crankshaft) in comparison to the original configuration, and an acceptable robustness of the method have been shown. The algorithm here developed is shown to be a valid method for an aeronautical-piston-engine preliminary project design optimization. In particular the procedure is able to analyze quite a wide range of design solutions, rejecting the ones that cannot fulfill the feasibility design specifications. This optimization algorithm could increase the aeronautical-piston-engine development, speeding up the production rate and joining modern computation performances and technological awareness to the long lasting traditional design experiences.

Caratterizzazione morfologica e neurochimica dei neuroni sensitivi e motori del trigono vescicale e del muscolo uretrale di maiale

Il trigono della vescica urinaria (UBT) è un'area limitata attraverso la quale penetrano nella vescica la maggior parte dei vasi e fibre e in cui le fibre nervose e neuroni intramurali sono più concentrati. Mediante l’utilizzo combinato di un tracciante retrogrado(FB) e dell’immunoistochimica sono stati valutati il fenotipo e l’area del soma dei neuroni dei gangli spinali (DRG), dei neuroni post-gangliari, il fenotipo dei gangli della catena simpatica (STG) e i gangli mesenterici caudali (CMG) innervanti l’UBT. - Caratterizzazione dei neuroni dei DRG con: peptide correlato al gene della calcitonina (CGRP)(30±3%, 29±3%, rispettivamente), sostanza P(SP)(26±8%, 27±12%), ossido nitrico sintasi neuronale (nNOS)(21±4%; 26±7%), neurofilamento 200kDa (NF200)(75±14%, 81±7% ) , transient receptor potential vanilloid1 (TRPV1)(48±13%, 43±6%) e isolectina-B4-positivi (IB4) (56±6%;43±10%). I neuroni sensoriali, distribuiti da L2 a Ca1 (DRG), hanno presentato una localizzazione segmentale, mostrando maggior densità nei DRG L4-L5 e S2-S4. I neuroni sensoriali lombari sono risultati significativamente più grandi di quelle sacrali (1.112±624μm2 vs716±421μm2). Complessivamente, questi dati indicano che le vie lombari e sacrali probabilmente svolgono ruoli diversi nella trasmissione sensitiva del trigono della vescica urinaria. -I neuroni FB+ della STG e dei CMG sono risultati immunoreattivi per la tirosina idrossilasi (TH)(66±10,1%, 53±8,2%, rispettivamente), la dopamina beta-idrossilasi (DβH)(62±6,2%, 52±6,2%), neuropeptideY (NPY)(59±8%; 66±7%), CGRP(24±3%, 22±3%), SP(22±2%; 38±8%), polipeptide intestinale vasoattivo (VIP)(19±2%; 35±4%), nNOS(15±2%; 33±8%), trasportatore vescicolare dell'acetilcolina (VAChT)(15±2%; 35±5%), leu-encefalina (LENK)(14±7%; 26±9%), e somatostatina (SOM)(12±3%;32±7%).Il numero medio di neuroni FB+ (1845,1±259,3) era nella STG in L1-S3, con i pirenofori più piccoli (465,6±82.7μm2). Un gran numero (4287,5±1450,6) di neuroni FB+ di piccole dimensioni (476,1±103,9μm2) sono stati localizzati lungo il margine dei CMG. Il maggior numero (4793,3±1990,8) di neuroni FB + è stato osservato nel plesso pelvico, dove i neuroni marcati erano raggruppati in micro-gangli e con pirenoforo ancora più piccolo (374,9±85,4 μm2).