ParTec and KarnUMa-Digital tools as a help for freshman learning

[EN]Freshman students always present lower success rates than other levels of students. Digital systems is a course usually taught at first year studentsand its success rate is not very high. In this work we introduce three digital tools to improve freshman learning designed for easy use and one of them is a tool for mobile terminals that can be used as a game. The first tool is ParTec and is used to implement and test the partition technique. This technique is used to eliminate redundant states in finite state machines. This is a repetitive task that students do not like to perform. The second tool is called KarnUMa and is used for simplifying logic functions through Karnaugh Maps. Simplifying logical functions is a core task for this course and although students usually perform this task better than other tasks, it can still be improved. The third tool is a version of KarnUMa, designed for mobile devices. All the tools are available online for download and have been a helpful tool for students.

Revisione critica dei risultati e nuovi algoritmi decisionali sulla chirurgia dell'OSAS

Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is the periodic reduction or cessation of airflow during sleep. The syndrome is associated whit loud snoring, disrupted sleep and observed apnoeas. Surgery aims to alleviate symptoms of daytime sleepiness, improve quality of life and reduce the signs of sleep apnoea recordered by polysomnography. Surgical intervention for snoring and OSAHS includes several procedures, each designed to increase the patency of the upper airway. Procedures addressing nasal obstruction include septoplasty, turbinectomy, and radiofrequency ablation (RF) of the turbinates. Surgical procedures to reduce soft palate redundancy include uvulopalatopharyngoplasty with or without tonsillectomy, uvulopalatal flap, laser-assisted uvulopalatoplasty, and RF of the soft palate. More significant, however, particularly in cases of severe OSA, is hypopharyngeal or retrolingual obstruction related to an enlarged tongue, or more commonly due to maxillomandibular deficiency. Surgeries in these cases are aimed at reducing the bulk of the tongue base or providing more space for the tongue in the oropharynx so as to limit posterior collapse during sleep. These procedures include tongue-base suspension, genioglossal advancement, hyoid suspension, lingualplasty, and maxillomandibular advancement. We reviewed 269 patients undergoing to osas surgery at the ENT Department of Forlì Hospital in the last decade. Surgery was considered a success if the postoperative apnea/hypopnea index (AHI) was less than 20/h. According to the results, we have developed surgical decisional algorithms with the aims to optimize the success of these procedures by identifying proper candidates for surgery and the most appropriate surgical techniques. Although not without risks and not as predictable as positive airway pressure therapy, surgery remains an important treatment option for patients with obstructive sleep apnea (OSA), particularly for those who have failed or cannot tolerate positive airway pressure therapy. Successful surgery depends on proper patient selection, proper procedure selection, and experience of the surgeon. The intended purpose of medical algorithms is to improve and standardize decisions made in the delivery of medical care, assist in standardizing selection and application of treatment regimens, to reduce potential introduction of errors. Nasal Continuous Positive Airway Pressure (nCPAP) is the recommended therapy for patients with moderate to severe OSAS. Unfortunately this treatment is not accepted by some patient, appears to be poorly tolerated in a not neglible number of subjects, and the compliance may be critical, especially in the long term if correctly evaluated with interview as well with CPAP smart cards analysis. Among the alternative options in Literature, surgery is a long time honoured solution. However until now no clear scientific evidence exists that surgery can be considered a really effective option in OSAHS management. We have design a randomized prospective study comparing MMA and a ventilatory device (Autotitrating Positive Airways Pressure – APAP) in order to understand the real effectiveness of surgery in the management of moderate to severe OSAS. Fifty consecutive previously full informed patients suffering from severe OSAHS were enrolled and randomised into a conservative (APAP) or surgical (MMA) arm. Demographic, biometric, PSG and ESS profiles of the two group were statistically not significantly different. One year after surgery or continuous APAP treatment both groups showed a remarkable improvement of mean AHI and ESS; the degree of improvement was not statistically different. Provided the relatively small sample of studied subjects and the relatively short time of follow up, MMA proved to be in our adult and severe OSAHS patients group a valuable alternative therapeutical tool with a success rate not inferior to APAP.

International cooperation in endourology: percutaneous and flexible ureteroscopic treatment of lower pole kidney stones

Introduction Lower pole kidney stones represent at time a challenge for the urologist. The gold standard treatment for intrarenal stones <2 cm is Extracorporeal Shock Wave Lithotripsy (ESWL) while for those >2 cm is Percutaneous Nephrolithotomy (PCNL). The success rate of ESWL, however, decreases when it is employed for lower pole stones, and this is particularly true in the presence of narrow calices or acute infundibular angles. Studies have proved that ureteroscopy (URS) is an efficacious alternative to ESWL for lower pole stones <2 cm, but this is not reflected by either the European or the American guidelines. The aim of this study is to present the results of a large series of flexible ureteroscopies and PCNLs for lower pole kidney stones from high-volume centers, in order to provide more evidences on the potential indications of the flexible ureteroscopy for the treatment of kidney stones. Materials and Methods A database was created and the participating centres retrospectively entered their data relating to the percutaneous and flexible ureteroscopic management of lower pole kidney stones. Patients included were treated between January 2005 and January 2010. Variables analyzed included case load number, preoperative and postoperative imaging, stone burden, anaesthesia (general vs. spinal), type of lithotripter, access location and size, access dilation type, ureteral access sheath use, visual clarity, operative time, stone-free rate, complication rate, hospital stay, analgesic requirement and follow-up time. Stone-free rate was defined as absence of residual fragments or presence of a single fragment <2 mm in size at follow-up imaging. Primary end-point was to test the efficacy and safety of flexible URS for the treatment of lower pole stones; the same descriptive analysis was conducted for the PCNL approach, as considered the gold standard for the treatment of lower pole kidney stones. In this setting, no statistical analysis was conducted owing to the different selection criteria of the patients. Secondary end-point consisted in matching the results of stone-free rates, operative time and complications rate of flexible URS and PCNL in the subgroup of patients harbouring lower pole kidney stones between 1 and 2 cm in the higher diameter. Results A total 246 patients met the criteria for inclusion. There were 117 PCNLs (group 1) and 129 flexible URS (group 2). Ninety-six percent of cases were diagnosed by CT KUB scan. Mean stone burden was 175±160 and 50±62 mm2 for groups 1 and 2, respectively. General anaesthesia was induced in 100 % and 80% of groups 1 and 2, respectively. Pneumo-ultrasonic energy was used in 84% of cases in the PCNL group, and holmium laser in 95% of the cases in the flexible URS group. The mean operative time was 76.9±44 and 63±37 minutes for groups 1 and 2 respectively. There were 12 major complications (11%) in group 1 (mainly Grade II complications according to Clavidien classification) and no major complications in group 2. Mean hospital stay was 5.7 and 2.6 days for groups 1 and 2, respectively. Ninety-five percent of group 1 and 52% of group 2 required analgesia for a period longer than 24 hours. Intraoperative stone-free rate after a single treatment was 88.9% for group 1 and 79.1% for group 2. Overall, 6% of group 1 and 14.7% of group 2 required a second look procedure. At 3 months, stone-free rates were 90.6% and 92.2% for groups 1 and 2, respectively, as documented by follow-up CT KUB (22%) or combination of intra-venous pyelogram, regular KUB and/or kidney ultrasound (78%). In the subanalysis conducted comparing 82 vs 65 patients who underwent PCNL and flexible URS for lower pole stones between 1 and 2 cm, intreoperative stone-free rates were 88% vs 68% (p= 0.03), respectively; anyway, after an auxiliary procedure which was necessary in 6% of the cases in group 1 and 23% in group 2 (p=0.03), stone-free rates at 3 months were not statistically significant (91.5% vs 89.2%; p=0.6). Conversely, the patients undergoing PCNL maintained a higher risk of complications during the procedure, with 9 cases observed in this group versus 0 in the group of patients treated with URS (p=0.01) Conclusions These data highlight the value of flexible URS as a very effective and safe option for the treatment of kidney stones; thanks to the latest generation of flexible devices, this new technical approach seems to be a valid alternative in particular for the treatment of lower pole kidney stones less than 2 cm. In high-volume centres and in the hands of skilled surgeons, this technique can approach the stone-free rates achievable through PCNL in lower pole stones between 1 and 2 cm, with a very low risk of complications. Furthermore, the results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, with no difference detectable between the prone and supine position.

Nuove tecniche per il trattamento della malattia paranale di Crohn

Studio prospettico su 75 pazienti con malattia paranale di Crohn che ha come obiettivo quello di confrontare i risultati tra le nuove terapie medico-chirurgiche emergenti. La prima procedura è comune a tutti i pazienti e consiste in un intervento di incisione degli ascessi, fistulectomia e posizionamento di setoni di drenaggio nei tramiti fistolosi per il controllo della sepsi.Successivamente i pazienti vengono divisi in cinque gruppi e sottoposti ai trattamenti per la chiusura dei tramiti fistolosi: terapia sistemica con Infliximab,terapia sistemica con Adalimumab,confezionamento di Flap endoanale, instillazione di colla di fibrina o posizionamento di protesi biologiche. Abbiamo osservato una chiusura completa dei tramiti fistolosi nel 60% dei pazienti trattati con Infliximab, 53% di quelli trattati con Adalimumab, 40% di quelli in terapia con colla di fibrina, 80% di quelli sottoposti a Flap endoanale e 60% di quelli trattati con protesi biologiche. Gli ottimi risultati raggiunti in con le diverse metodiche di trattamento chirurgico locale rappresentano una valida alternativa alla terapia con farmaci biologici. Tali nuove metodiche risultano anzi fondamentali per il trattamento di quei pazienti che dopo una terapia con farmaci biologici non hanno raggiunto una completa risoluzione del quadro (rescue therapy). Terapia biologica e nuove tecniche chirurgiche risultano pertanto complementari, la prima contribuendo al miglioramento della qualità della mucosa del canale anale e del retto basso sulla quale risulta quindi più agevole agire con le seconde con una percentuale di successo sempre maggiore.

Efficacia delle griglie in titanio con osso particolato nella ricostruzione dei difetti alveolari tridimensionali dei mascellari

Questa tesi valuta l’efficacia della tecnica delle griglie in titanio con osso particolato nella ricostruzione dei difetti alveolari tridimensionali ai fini della riabilitazione dentale implanto-protesica. Il primo studio ha considerato la metodica in termini di complicanze post-operatorie e di risultati implanto-protesici. Sono stati considerati 24 pazienti con difetti tridimensionali trattati con l’applicazione di 34 griglie di titanio e osso particolato e riabilitati protesicamente dopo circa 8-9 mesi. 4 su 34 griglie sono state rimosse prima dell’inserimento implantare (11.76% di fallimento totale); 20 su 34 griglie si sono esposte per deiscenza dei tessuti molli (58.82% di complicanze): 4 (11.77%) prima e 16 (47.05%) dopo le prime 4-6 settimane dall’intervento; in nessun caso il piano di trattamento implanto-protesico ha subito variazioni. Dopo un follow-up medio di 20 (3-48) mesi dal carico protesico, nessuno degli 88 impianti ha perso la propria osteo-integrazione (100% di sopravvivenza implantare), con un valore complessivo di successo implantare di 82.9%. Il secondo studio ha calcolato in termini volumetrici la ricostruzione ossea ottenuta con griglie e la sua corre-lazione con l’estensione dell’esposizione e la tempistica del suo verificarsi. Sono stati valutati 12 pazienti con 15 difetti alveolari. Per ciascun sito sono state studiate le immagini TC con un software dedicato per misurare i volumi in tre dimensioni: il volume di osso non formatosi rispetto a quanto pianificato, lacking bone volume (LBV), è stato calcolato sottraendo il volume di osso ricostruito, reconstructed bone volume (RBV) in fase di ri-entro chirurgico dal volume di osso pianificato pre-operativamente, planned bone volume (PBV). LBV è risultato direttamente proporzionale all’area di esposizione della griglia, con un valore del 16.3% di LBV per ogni cm2 di griglia esposta. Si sono evidenziate, inoltre, correlazioni positive tra LBV , la tempistica precoce di esposizione e il valore di PBV.

Motorisches Lernen in Drosophila melanogaster

In der vorliegenden Arbeit wurden die durch Training induzierten motorischen Gedächtnisleistungen der Taufliege Drosophila melanogaster beim Überklettern von acht symmetrisch verteilten Lücken auf einem rotierenden Ring untersucht. Durch den auf sie einwirkenden optischen Fluss der vorbeiziehenden äußeren Umgebung wurden die Fliegen angeregt, diesem optomotorischen Reiz entgegenzuwirken und die Lücken laufend zu überqueren. Durch Training verbessert und langfristig gelernt wird die kompensatorische Lückenüberquerung X+ gegen die Rotation. In der aus diesem Training erhaltenen Lernkurve war eine überdurchschnittlich hohe Leistungsverbesserung nach einem einzigen Trainingslauf mit einem zeitlichen Bestand von ca. 40 Minuten abzulesen, um danach vom motorischen Gedächtnisspeicher trainierter Fliegen nicht mehr abgerufen werden zu können. Nach einer Ruhephase von einem bis mehreren Tagen wurden die Fliegen auf mögliche Langzeitlernleistungen untersucht und diese für verschiedene Intervalle nachgewiesen. Sowohl die Leistungsverbesserung während des Trainings, als auch der Lerneffekt nach 24h bleiben in mutanten rutabaga2080 sowie rut1 Fliegen aus. Betroffen ist das Gen der Adenylylzyklase I, ein Schlüsselprotein der cAMP-Signalkaskade, die u.a. im olfaktorischen und visuellen Lernen gebraucht wird. Damit ergab sich die Möglichkeit die motorischen Gedächtnisformen durch partielle Rettung zu kartieren. Die motorische Gedächtniskonsolidierung ist schlafabhängig. Wie sich herausstellte, benötigen WTB Fliegen nur eine Dunkelphase von 10h zwischen einem ersten Trainingslauf und einem Testlauf um signifikante Leistungssteigerungen zu erzielen. In weiterführenden Versuchen wurden die Fliegen nachts sowie tagsüber mit einer LED-Lampe oder in einer Dunkelkammer, mit einem Kreisschüttler oder einer Laborwippe depriviert, mit dem Ergebnis, dass nur jene Fliegen ihre Leistung signifikant gegenüber einem ersten Trainingslauf verbessern konnten, welche entweder ausschließlich der Dunkelheit ausgesetzt waren oder welchen die Möglichkeit gegeben wurde, ein Gedächtnis zunächst in einer natürlichen Schlafphase zu konsolidieren (21Uhr bis 7Uhr MEZ). In weiteren Experimenten wurden die experimentellen Bedingungen entweder während des Trainings oder des Tests auf eine Fliege und damit verbunden auf eine erst durch das Training mögliche motorische Gedächtniskonsolidierung einwirken zu können, untersucht. Dazu wurden die Experimentparameter Lückenweite, Rotationsrichtung des Lückenringes, Geschwindigkeit des Lückenringes sowie die Verteilung der acht Lücken auf dem Ring (symmetrisch, asymmetrisch) im Training oder beim Gedächtnisabruf im Testlauf verändert. Aus den Ergebnissen kann geschlussfolgert werden, dass die Lückenweite langzeitkonsolidiert wird, die Rotationsrichtung kurzzeitig abgespeichert wird und die Drehgeschwindigkeit motivierend auf die Fliegen wirkt. Die symmetrische Verteilung der Lücken auf dem Ring dient der Langzeitkonsolidierung und ist als Trainingseingang von hoher Wichtigkeit. Mit Hilfe verschiedener Paradigmen konnten die Leistungsverbesserungen der Fliegen bei Abruf eines Kurz- bzw. Langzeitgedächtnisses hochauflösend betrachtet werden (Transfer). Die Konzentration, mit der eine WTB Fliege eine motorische Aufgabe - die Überquerung von Lücken entgegengesetzt der Rotationsrichtung - durchführt, konnte mit Hilfe von Distraktoreizen bestimmt werden. Wie sich herausstellte, haben Distraktoren einen Einfluss auf die Erfolgsquote einer Überquerung, d.h. mit zunehmender Distraktionsstärke nahm die Wahrscheinlichkeit einer Lückenüberquerung ab. Die Ablenkungsreize wirkten sich weiterhin auf die Vermessung einer Lücke aus, in dem entweder "peering"-artigen Bewegungen im Training durchgeführt wurden oder je nach Reizstärke ausschließlich nur jene Lücken vermessen wurden, welche auch überquert werden sollten.

Oblique ionograms automatic scaling and eikonal based ray tracing

A method for automatic scaling of oblique ionograms has been introduced. This method also provides a rejection procedure for ionograms that are considered to lack sufficient information, depicting a very good success rate. Observing the Kp index of each autoscaled ionogram, can be noticed that the behavior of the autoscaling program does not depend on geomagnetic conditions. The comparison between the values of the MUF provided by the presented software and those obtained by an experienced operator indicate that the procedure developed for detecting the nose of oblique ionogram traces is sufficiently efficient and becomes much more efficient as the quality of the ionograms improves. These results demonstrate the program allows the real-time evaluation of MUF values associated with a particular radio link through an oblique radio sounding. The automatic recognition of a part of the trace allows determine for certain frequencies, the time taken by the radio wave to travel the path between the transmitter and receiver. The reconstruction of the ionogram traces, suggests the possibility of estimating the electron density between the transmitter and the receiver, from an oblique ionogram. The showed results have been obtained with a ray-tracing procedure based on the integration of the eikonal equation and using an analytical ionospheric model with free parameters. This indicates the possibility of applying an adaptive model and a ray-tracing algorithm to estimate the electron density in the ionosphere between the transmitter and the receiver An additional study has been conducted on a high quality ionospheric soundings data set and another algorithm has been designed for the conversion of an oblique ionogram into a vertical one, using Martyn's theorem. This allows a further analysis of oblique soundings, throw the use of the INGV Autoscala program for the automatic scaling of vertical ionograms.

Gestione pre, intra e post-operatoria del cane sottoposto ad ipofisectomia transfenoidale

L’approccio chirurgico agli adenomi ipofisari ACTH secernenti è la terapia d’elezione nell’uomo. L’ipofisectomia transfenoidale è invece una tecnica poco diffusa in ambito veterinario. La terapia più diffusa nel cane con ipercortisolismo ipofisi dipendente (PDH) è di tipo medico e prevede la somministrazione di farmaci inibitori della sintesi del cortisolo. Gli adenomi ipofisari possono aumentare di volume e determinare una conseguente sintomatologia neurologica; in questi casi le uniche opzioni terapeutiche sono rappresentate dall’asportazione chirurgica della neoplasia e dalla radioterapia. Nella presente tesi vengono descritti 8 interventi di ipofisectomia transfenoidale effettuati su 7 cani con macroadenoma ipofisario presso il Dipartimento di Scienze Mediche Veterinarie dell’Università di Bologna. La difficoltà maggiore per il chirurgo è rappresentata dalla localizzazione della fossa ipofisaria rispetto ai punti di repere visibile in tomografia computerizzata o in risonanza magnetica nucleare, oltre ai problemi di sanguinamento durante la rimozione della neoplasia. Nel periodo post-operatorio maggiori complicazioni si riscontrano in soggetti con adenomi ipofisari di maggiori dimensioni. Al contrario, in presenza di adenomi di dimensioni più contenute, la ripresa post-operatoria risulta più rapida e il tasso di successo maggiore. Al fine di poter eseguire nel cane l’exeresi mirata della sola neoplasia ipofisaria, al pari di quanto avviene nell’uomo, è stato condotto uno studio sulla tomografia computerizzata (TC) in 86 cani con PDH. Il protocollo TC non ha tuttavia permesso di individuare con precisione la posizione della neoplasia per guidare il chirurgo nella sua rimozione. In due casi riportati nel presente lavoro si è verificata una recidiva della neoplasia ipofisaria. In un soggetto si è optato per il reintervento, mentre nell’altro caso per la radioterapia. Entrambe le opzioni hanno garantito una buona qualità di vita per più di un anno dall’intervento terapeutico. Questi casi clinici dimostrano come il reintervento e la radioterapia possano essere considerate valide opzioni in caso di recidiva.

Fistole retto-vaginali Crohn-relate trattate mediante trasposizione del muscolo gracile: risultati a lungo termine e qualità della vita

OBIETTIVO: Le fistole retto-vaginali Crohn-relate hanno un impatto significativo sulla qualità della vita. Quando il canale anale è alterato da ulcerazioni e stenosi o in pazienti con difetti estesi del perineo, la chirurgia locale produce risultati insoddisfacenti. Lo scopo di questo studio è quello di valutare l'efficacia della trasposizione del muscolo gracile nelle fistole retto-vaginali Crohn-relate e determinare i suoi effetti sulla qualità della vita. MATERIALI E METODI: Da gennaio 2012 a ottobre 2014 sono state trattate 10 pazienti; sono state raccolte alcune variabili (età, BMI, il fumo, CDAI, setone perioperatorio, precedenti procedure, uso di immunomodulatori e steroidi). Tutte le pazienti sono state sottoposte ad ileostomia temporanea prima della graciloplastica. La percentuale di successo è stata misurata come numero di pazienti con fistola guarita dopo la chiusura della stomia. Sono stati utilizzati tre questionari prima della graciloplastica e 3 mesi dopo la chiusura della stomia al fine di valutare la qualità della vita (SF-36), l’ incontinenza fecale e la funzione sessuale. RISULTATI: La fistola retto-vaginale è stata chiusa in 9 pazienti su 10 dopo graciloplastica, con un follow-up medio di chiusura della stomia di 19 mesi (range 4 -34). È stata documentata una recidiva di RVF. Il tempo operatorio era 90-150 minuti (media, 120). La degenza postoperatoria era 7-16 giorni (media 10). Complicanze postoperatorie precoci includevano deiscenza delle suture perineali in 2 casi. Le complicanze a lungo termine includevano disestesia della cicatrice perineale. Nei dati post-operatori abbiamo riportato un miglioramento della qualità di vita, della funzione sessuale e della continenza fecale. CONCLUSIONI: La chiusura della fistola retto-vaginale utilizzando la trasposizione del muscolo gracile è associata a morbidità minima e un alto tasso di successo.

Mac protocols for linear wireless (sensor) networks

Wireless sensor networks (WSNs) consist of a large number of sensor nodes, characterized by low power constraint, limited transmission range and limited computational capabilities [1][2].The cost of these devices is constantly decreasing, making it possible to use a large number of sensor devices in a wide array of commercial, environmental, military, and healthcare fields. Some of these applications involve placing the sensors evenly spaced on a straight line for example in roads, bridges, tunnels, water catchments and water pipelines, city drainages, oil and gas pipelines etc., making a special class of these networks which we define as a Linear Wireless Network (LWN). In LWNs, data transmission happens hop by hop from the source to the destination, through a route composed of multiple relays. The peculiarity of the topology of LWNs, motivates the design of specialized protocols, taking advantage of the linearity of such networks, in order to increase reliability, communication efficiency, energy savings, network lifetime and to minimize the end-to-end delay [3]. In this thesis a novel contention based Medium Access Control (MAC) protocol called L-CSMA, specifically devised for LWNs is presented. The basic idea of L-CSMA is to assign different priorities to nodes based on their position along the line. The priority is assigned in terms of sensing duration, whereby nodes closer to the destination are assigned shorter sensing time compared to the rest of the nodes and hence higher priority. This mechanism speeds up the transmission of packets which are already in the path, making transmission flow more efficient. Using NS-3 simulator, the performance of L-CSMA in terms of packets success rate, that is, the percentage of packets that reach destination, and throughput are compared with that of IEEE 802.15.4 MAC protocol, de-facto standard for wireless sensor networks. In general, L-CSMA outperforms the IEEE 802.15.4 MAC protocol.

Medicalgenomics.org : an open source database and retrieval system for biomedical analysis

Die Molekularbiologie von Menschen ist ein hochkomplexes und vielfältiges Themengebiet, in dem in vielen Bereichen geforscht wird. Der Fokus liegt hier insbesondere auf den Bereichen der Genomik, Proteomik, Transkriptomik und Metabolomik, und Jahre der Forschung haben große Mengen an wertvollen Daten zusammengetragen. Diese Ansammlung wächst stetig und auch für die Zukunft ist keine Stagnation absehbar. Mittlerweile aber hat diese permanente Informationsflut wertvolles Wissen in unüberschaubaren, digitalen Datenbergen begraben und das Sammeln von forschungsspezifischen und zuverlässigen Informationen zu einer großen Herausforderung werden lassen. Die in dieser Dissertation präsentierte Arbeit hat ein umfassendes Kompendium von humanen Geweben für biomedizinische Analysen generiert. Es trägt den Namen medicalgenomics.org und hat diverse biomedizinische Probleme auf der Suche nach spezifischem Wissen in zahlreichen Datenbanken gelöst. Das Kompendium ist das erste seiner Art und sein gewonnenes Wissen wird Wissenschaftlern helfen, einen besseren systematischen Überblick über spezifische Gene oder funktionaler Profile, mit Sicht auf Regulation sowie pathologische und physiologische Bedingungen, zu bekommen. Darüber hinaus ermöglichen verschiedene Abfragemethoden eine effiziente Analyse von signalgebenden Ereignissen, metabolischen Stoffwechselwegen sowie das Studieren der Gene auf der Expressionsebene. Die gesamte Vielfalt dieser Abfrageoptionen ermöglicht den Wissenschaftlern hoch spezialisierte, genetische Straßenkarten zu erstellen, mit deren Hilfe zukünftige Experimente genauer geplant werden können. Infolgedessen können wertvolle Ressourcen und Zeit eingespart werden, bei steigenden Erfolgsaussichten. Des Weiteren kann das umfassende Wissen des Kompendiums genutzt werden, um biomedizinische Hypothesen zu generieren und zu überprüfen.

Physiologie eines erlernten Körpermodells in Drosophila melanogaster

In der vorliegenden Dissertation wird ein Körpergrößengedächtnis untersucht. Es wird dargestellt, wie diese Information über die Reichweite der Fliege beim Lückenklettern unter kotrollierten Umweltbedingungen erworben und prozessiert wird. Zusätzlich wird geklärt, welche biochemischen Signale benötigt werden, um daraus ein lang anhalten-des Gedächtnis zu formen. Adulte Fliegen sind in der Lage, ihre Körperreichweite zu lernen. Naive Fliegen, die in der Dunkelheit gehalten wurden, versuchen erfolglos, zu breite Lücken zu überqueren, während visuell erfahrene Fliegen die Kletterversuche an ihre Körpergröße anpassen. Erfahrene kleine Fliegen scheinen Kenntnis ihres Nachteils zu haben. Sie kehren an Lückenbreiten um, welche ihre größeren Artgenos-sen durchaus noch versuchen. Die Taufliegen lernen die größenabhängige Reichweite über die visuelle Rückmeldung während des Laufens (aus Parallaxenbewegung). Da-bei reichen 15 min in strukturierter, heller Umgebung aus. Es gibt keinen festgelegten Beginn der sensiblen Phase. Nach 2 h ist das Gedächtnis jedoch konsolidiert und kann durch Stress nicht mehr zerstört oder durch sensorische Eingänge verändert werden. Dunkel aufgezogene Fliegen wurden ausgewählten Streifenmustern mit spezifischen Raumfrequenzen ausgesetzt. Nur die Insekten, welche mit einem als „optimal“ klassi-fizierten Muster visuell stimuliert wurden, sind in der Lage, die Körperreichweite einzu-schätzen, indem die durchschnittliche Schrittlänge in Verbindung mit der visuellen Wahrnehmung gebracht wird. Überraschenderweise ist es sogar mittels partieller Kompensation der Parallaxen möglich, naive Fliegen so zu trainieren, dass sie sich wie kleinere Exemplare verhalten. Da die Experimente ein Erlernen der Körperreich-weite vermuten lassen, wurden lernmutante Stämme beim Lückenüberwinden getes-tet. Sowohl die Ergebnisse von rut1- und dnc1-Mutanten, als auch das defizitäre Klet-tern von oc1-Fliegen ließ eine Beteiligung der cAMP-abhängigen Lernkaskade in der Protocerebralbrücke (PB) vermuten. Rettungsexperimente der rut1- und dnc1-Hinter-gründe kartierten das Gedächtnis in unterschiedliche Neuronengruppen der PB, wel-che auch für die visuelle Ausrichtung des Kletterns benötigt werden. Erstaunlicher-weise haben laterale lokale PB-Neurone und PFN-Neurone (Projektion von der PB über den fächerförmigen Körper zu den Noduli) verschiedene Erfordernisse für cAMP-Signale. Zusammenfassend weisen die Ergebnisse darauf hin, dass hohe Mengen an cAMP/PKA-Signalen in den latero-lateralen Elementen der PB benötigt werden, wäh-rend kolumnäre PFN-Neurone geringe oder keine Mengen an cAMP/PKA erfordern. Das Körperreichweitengedächtnis ist vermutlich das am längsten andauernde Ge-dächtnis in Drosophila. Wenn es erst einmal konsolidiert ist hält es länger als drei Wo-chen.rnAußerdem kann die Fruchtliege Drosophila melanogaster trainiert werden, die kom-plexe motorische Aufgabe des Lückenkletterns zu optimieren. Die trainierten Fliegen werden erfolgreicher und schneller beim Überqueren von Lücken, welche größer sind als sie selbst. Dabei existiert eine Kurzeitkomponente (STM), die 40 min nach dem ersten Training anhält. Nach weiteren vier Trainingsdurchläufen im Abstand von 20 min wird ein Langzeitgedächtnis (LTM) zum Folgetag geformt. Analysen mit Mutati-onslinien wiesen eine Beteiligung der cAMP-abhängigen Lernkaskade an dieser Ge-dächtnisform auf. Rettungsexperimente des rut2080-Hintergrunds kartierten sowohl das STM, als auch das LTM in PFN-Neuronen. Das STM kann aber ebenso in den alpha- und beta- Loben der Pilzkörper gerettet werden.rnLetztendlich sind wildtypische Fliegen sogar in der Lage, sich an einen Verlust eines Mittelbeintarsuses und dem einhergehenden Fehlen des Adhäsionsorgans am Tarsusende anzupassen. Das Klettern wird zwar sofort schlechter, erholt sich aber bis zum Folgetag wieder auf ein normales Niveau. Dieser neue Zustand erfordert ein Ge-dächtnis für die physischen Möglichkeiten, die nur durch plastische Veränderungen im Nervensystem des Insekts erreicht werden können.

Endovascular treatment of popliteal artery aneurysms: a single-center experience

PURPOSE: To evaluate the use of covered stent-grafts in the endovascular treatment (ET) of popliteal artery aneurysms (PAAs). MATERIALS AND METHODS: A retrospective analysis was conducted over a period of 52 months in 18 consecutive patients (17 men; mean age +/- SD, 70 years +/- 11) undergoing ET of PAAs with the Viabahn endograft in a single center. Patient symptoms, aneurysm characteristics, technical outcomes, complications, and follow-up were assessed. RESULTS: Aneurysm diameters ranged from 12 to 51 mm with a mean of 30 mm (+/-11). Thirteen aneurysms (72.2%) were partially thrombosed and 12 patients (66.6%) had symptoms of lower limb ischemia at presentation (11 chronic and one acute). The technical success rate was 94%. Intraprocedural emboli and endoleak occurred in one and two patients, respectively. Fourteen patients were available for follow-up after successful treatment, with a mean follow-up time of 15 months (range, 7-37 months). All stent-grafts were patent after 1 month, with no mortality or limb loss. The primary patency rate with complete exclusion of the aneurysm at 6 months was 86%. Pre- and postprocedural noninvasive arterial studies were available in 10 patients, demonstrating improvement of the ankle-brachial index from 0.96 +/- 0.41 to 1.17 +/- 0.18, respectively (P = .06). CONCLUSIONS: Endovascular stent-graft repair of PAAs is a feasible treatment option. However, further follow-up studies regarding the durability of results are required.

Early loading at 21 days of non-submerged titanium implants with a chemically modified sandblasted and acid-etched surface: 3-year results of a prospective study in the posterior mandible

BACKGROUND: This study evaluates 3-year success rates of titanium screw-type implants with a chemically modified sandblasted and acid-etched surface (mod SLA), which were functionally loaded after 3 weeks of healing. METHODS: A total of 56 implants, inserted in the posterior mandibles of 39 partially edentulous patients, underwent undisturbed healing for 3 weeks. At day 21, the implants were fully loaded with provisional crowns. Definitive metal ceramic restorations were fabricated after 6 months of healing. Clinical measurements regarding soft tissue parameters and radiographs were obtained at different time points up to 36 months after implant placement. The soft tissue and radiographic parameters for the mod SLA implants after 3 years in function were compared to a historic control group of implants with an SLA surface using an early loading protocol after 6 weeks. RESULTS: None of the implants failed to integrate. However, two implants were considered "spinners" at day 21 and were left unloaded for an extended period. Therefore, 96.4% of the inserted implants were loaded according to the protocol tested. All 56 implants, including the "spinners," showed favorable clinical and radiographic findings at the 3-year follow-up examination. All 56 implants were considered successfully integrated, resulting in a 3-year survival and success rate of 100%. Dental implants with a mod SLA surface demonstrated statistically significant differences for probing depths and clinical attachment level values compared to the historic control group, with the mod SLA surface implants having overall lower probing depths and clinical attachment level scores. CONCLUSION: This prospective study using an early loading protocol demonstrates that titanium implants with the mod SLA surface can achieve and maintain successful tissue integration over a period of 3 years.

Early loading after 21 days of healing of nonsubmerged titanium implants with a chemically modified sandblasted and acid-etched surface: two-year results of a prospective two-center study

PURPOSE: The aim of this two-center study was to evaluate screw-type titanium implants with a chemically modified, sandblasted and acid-etched surface when placed in the posterior maxilla or mandible, and loaded 21 days after placement. MATERIAL AND METHODS: All 56 patients met strict inclusion criteria and provided informed consent. Each patient displayed either a single-tooth gap, an extended edentulous space, or a distal extension situation in the posterior mandible or maxilla. Eighty-nine dental implants (SLActive, Institut Straumann AG, Basel, Switzerland) were inserted according to an established nonsubmerged protocol and underwent undisturbed healing for a period of 21 days. Where appropriate, the implants were loaded after 21 days of healing with provisional restorations in full occlusion. Definitive metal ceramic restorations were fabricated and positioned on each implant after 6 months of healing. Clinical measurements regarding soft tissue parameters and radiographs were obtained at different time points up to 24 months after implant placement. RESULTS: Of the 89 inserted implants, two (2.2%) implants failed to integrate and were removed during healing, and two (2.2%) additional implants required a prolonged healing time. A total of 85 (95.6%) implants were therefore loaded without incident after 21 days of healing. No additional implant was lost throughout the study period, whereas one implant was lost to follow-up and therefore left unaccounted for further analysis. The remaining 86 implants all exhibited favorable radiographic and clinical findings. Based on strict success criteria, these implants were considered successfully integrated 2 years after insertion, resulting in a 2-year success rate of 97.7%. CONCLUSION: The results of this prospective two-center study demonstrate that titanium implants with a modified SLA surface can predictably achieve successful tissue integration when loaded in full occlusion 21 days after placement. Integration could be maintained without incident for at least 2 years of follow-up.