886 resultados para POSITIONED FLAP
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Cuando una empresa se decide a realizar una iniciativa comercial en Internet, al igual que en el mundo físico, es necesario definir un diseño adecuado del sitio web que se ajuste a su idea de negocio y a su público objetivo. El presente trabajo trata de analizar como influye el diseño del establecimiento virtual en el desarrollo de la gestión comercial, incidiendo en los siguientes aspectos: diseño gráfico, usabilidad y accesibilidad. A partir de este análisis, se estudian los distintos grupos de consumidores con comportamientos homogéneos y se posicionan en función de sus actitudes. El análisis también permite definir la calidad del servicio prestado por este tipo de establecimientos, así como las principales dimensiones en que se despliega. En las conclusiones se citan aspectos en los que el gestor de una tienda online debe incidir para mejorar la calidad de su servicio.
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BACKGROUND: Infected postpneumonectomy chest cavities may be related to chronic postpneumonectomy empyema or arise in rare situations of necrotizing pneumonia with complete lung destruction where pneumonectomy and pleural debridement are required. We evaluated the safety and efficacy of an intrathoracic vacuum-assisted closure device (VAC) for the treatment of infected postpneumonectomy chest cavities. METHOD: A retrospective single institution review of all patients with infected postpneumonectomy chest cavities treated by VAC between 2005 and 2013. Patients underwent surgical debridement of the thoracic cavity, muscle flap closure of the bronchial stump when a fistula was present, and repeated intrathoracic VAC dressings until granulation tissue covered the entire chest cavity. After this, the cavity was obliterated by a Clagett procedure and closed. RESULTS: Twenty-one patients (14 men and 7 women) underwent VAC treatment of their infected postpneumonectomy chest cavity. Twelve patients presented with a chronic postpneumonectomy empyema (10 of them with a bronchopleural fistula) and 9 patients with an empyema occurring in the context of necrotizing pneumonia treated by pneumonectomy. In-hospital mortality was 23%. The median duration of VAC therapy was 23 days (range, 4-61 days) and the median number of VAC changes per patient was 6 (range, 2-14 days). Infection control and successful chest cavity closure was achieved in all surviving patients. One adverse VAC treatment-related event was identified (5%). CONCLUSIONS: The intrathoracic VAC application is a safe and efficient treatment of infected postpneumonectomy chest cavities and allows the preservation of chest wall integrity.
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There is growing public concern about reducing saturated fat intake. Stearoyl-CoA desaturase (SCD) is the lipogenic enzyme responsible for the biosynthesis of oleic acid (18:1) by desaturating stearic acid (18:0). Here we describe a total of 18 mutations in the promoter and 3′ non-coding region of the pig SCD gene and provide evidence that allele T at AY487830:g.2228T>C in the promoter region enhances fat desaturation (the ratio 18:1/18:0 in muscle increases from 3.78 to 4.43 in opposite homozygotes) without affecting fat content (18:0+18:1, intramuscular fat content, and backfat thickness). No mutations that could affect the functionality of the protein were found in the coding region. First, we proved in a purebred Duroc line that the C-T-A haplotype of the 3 single nucleotide polymorphisms (SNPs) (g.2108C>T; g.2228T>C; g.2281A>G) of the promoter region was additively associated to enhanced 18:1/18:0 both in muscle and subcutaneous fat, but not in liver. We show that this association was consistent over a 10-year period of overlapping generations and, in line with these results, that the C-T-A haplotype displayed greater SCD mRNA expression in muscle. The effect of this haplotype was validated both internally, by comparing opposite homozygote siblings, and externally, by using experimental Duroc-based crossbreds. Second, the g.2281A>G and the g.2108C>T SNPs were excluded as causative mutations using new and previously published data, restricting the causality to g.2228T>C SNP, the last source of genetic variation within the haplotype. This mutation is positioned in the core sequence of several putative transcription factor binding sites, so that there are several plausible mechanisms by which allele T enhances 18:1/18:0 and, consequently, the proportion of monounsaturated to saturated fat.
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While it is widely acknowledged that the ubiquitin-proteasome system plays an important role in transcription, little is known concerning the mechanistic basis, in particular the spatial organization of proteasome-dependent proteolysis at the transcription site. Here, we show that proteasomal activity and tetraubiquitinated proteins concentrate to nucleoplasmic microenvironments in the euchromatin. Such proteolytic domains are immobile and distinctly positioned in relation to transcriptional processes. Analysis of gene arrays and early genes in Caenorhabditis elegans embryos reveals that proteasomes and proteasomal activity are distantly located relative to transcriptionally active genes. In contrast, transcriptional inhibition generally induces local overlap of proteolytic microdomains with components of the transcription machinery and degradation of RNA polymerase II. The results establish that spatial organization of proteasomal activity differs with respect to distinct phases of the transcription cycle in at least some genes, and thus might contribute to the plasticity of gene expression in response to environmental stimuli.
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BlueGiga Technologies on uusi Bluetooth -teknologiaa soveltava pk-yritys. Yrityksen tuotekehitysprosessia täydentämään tarvittiin testausprosessi. Testausprosessin luominen oli haastavaa, koska Bluetooth -teknologia on uutta ja yritys on vielä nuori. Lisäksi se integroi kovo- ja ohjelmistokomponentteja tuotteissaan. Testaus aloitettiin evaluoimalla standardinmukaista tapaa dokumentoida testit. Tämän jälkeen tutkittiin BlueGigan ohjelmistokehitysprosessin suhdetta olemassa oleviin ohjelmistokehitysprosesseihin. Samanaikaisesti perehdyttiin Bluetooth -kvalifikaation testaukselle asettamiin vaatimuksiin. Tämän seurauksena TTCN:ää kokeiltiin helppolukuisen testitapauksen määrittelyssä. Käyttötapauksiin perustuvan testauksen sopivuutta Wireless Remote Access Platform:in (WRAP) testaamiseen arvioitiin kokeilemalla sitä Man-to-Machine -käyttötapauksen testaamisessa. Yllämainittujen tehtävien aikana kerätyn tiedon ja hankittujen kokemusten pohjalta laadittiin testausprosessi, joka kattaa yksikkö-, integraatio- ja järjestelmätason testauksen. Painopiste on järjestelmätason testauksessa. Prosessi määrittelee myös vastuuhenkilön tai -henkilöt eri testaustasoille.
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Tutkimuksen tavoitteet Tutkimuksen tavoitteina oli selvittää millaisella toimintamallilla voidaan varmistaa asiakaslähtöinen ja kustannustehokas toimintatapa, joka tuottaa tasalaatuiset palvelut sekä varmistaa yhteisesti sovittujen toimenpiteiden toteutumisen case-yrityksen ylläpitämissä henkilöstöravintoloissa nopeasti ja tehokkaasti. Tutkimusongelmaa lähestyttiin strategisesta näkökulmasta. Kilpailustrategian avulla yritys asemoidaan ympäristöönsä sekä valitaan käytettävät kilpailukeinot. Kilpailuetua haetaan toimintamalleja ja niiden osia kehittämällä. Tällaisia ovat esimerkiksi oppiminen, organisaatiorakenne ja asiakkuuden hallinta. Kustannustehokkuus aikaansaadaan ketjuohjauksella ja asiakaslähtöisyys hyväksikäyttämällä massaräätälöintiä. Asiakasryhmien määrittämiseen käytettiin segmentoinnin teoriaa. Lähdeaineisto Teoriaosuudessa lähdeaineistona käytettiin kotimaista ja ulkomaista kirjallisuutta, jotka käsittelevät strategista ajattelua, kilpailustrategiaa, kilpailuetua, ketjutoimintaa, massaräätälöintiä, segmentointia ja asiakkuuden hallintaa. Empiriaosuuden lähdeaineistona toimivat case-yrityksen strategiaprosessia varten keräämät materiaalit sekä tutkijan omat kokemukset projektin vetäjänä. Tulokset Lopputuloksena case-yritykselle ehdotetaan tutkimuksessa rakentuneita valikoimien- ja toiminnanohjausmalleja. Valikoimien ohjausmallin muodostamiseen käytettiin massaräätälöinnin teoriaa. Toiminnanohjausmalli rakennettiin puolestaan ketjutoiminnan teoriaan perustuen.
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Aim: To identify prophylactic antibiotic prescription practices among Spanish dentists with preferential dedication to Oral Surgery in different types of tooth extraction surgeries. Method: Members of the Spanish Oral Surgery Society were surveyed on antibiotic prophylaxis use in 4 different tooth extraction modalities scaled according to their surgical invasiveness. Results: Sixty-nine of the 105 distributed questionnaires were returned completed. Thirteen percent of the surveyed surgeons would prescribe antibiotics to prevent postoperative wound infection when confronted with conventional tooth extraction lasting less than 5 minutes. In the case of surgery lasting more than 5 minutes, the percentage of participants that would prescribe antibiotics increased to 39%. When a mucoperiosteal flap was elevated or an ostectomy was performed, 87% and 100%, respectively, would prescribe antibiotic prophylaxis. Amoxicillin and its combination with clavulanic acid were the most commonly prescribed antibiotics. All participants would prescribe the antibiotic orally, starting after surgery and with a duration that ranged from 2-8 days. Conclusions: The results obtained suggest that antibiotic prophylaxis for preventing local odontogenic infection is not being correctly implemented in Spain. This can generate new bacterial resistances, facilitate adverse drug reactions and favor opportunistic infections. Better designed studies are needed in order to clarify the role of antibiotics in the prevention of postsurgical wound infection
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The NG2(+) glia, also known as polydendrocytes or oligodendrocyte precursor cells, represent a new entity among glial cell populations in the central nervous system. However, the complete repertoire of their roles is not yet identified. The embryonic NG2(+) glia originate from the Nkx2.1(+) progenitors of the ventral telencephalon. Our analysis unravels that, beginning from E12.5 until E16.5, the NG2(+) glia populate the entire dorsal telencephalon. Interestingly, their appearance temporally coincides with the establishment of blood vessel network in the embryonic brain. NG2(+) glia are closely apposed to developing cerebral vessels by being either positioned at the sprouting tip cells or tethered along the vessel walls. Absence of NG2(+) glia drastically affects the vascular development leading to severe reduction of ramifications and connections by E18.5. By revealing a novel and fundamental role for NG2(+) glia, our study brings new perspectives to mechanisms underlying proper vessels network formation in embryonic brains.
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Deep sternal wound infection (DSWI) is a feared complication following cardiac surgery. This study describes clinical, microbiological, and treatment outcomes of DSWI and determines risk factors for complications. Of 55 patients with DSWI, 66% were male and mean age was 68.2years. Initial sternotomy was for coronary artery bypass graft in 49% of patients. Sternal debridement at mean 25.4±18.3days showed monomicrobial (94%), mainly Gram-positive infection. Secondary sternal wound infection (SSWI) occurred in 31% of patients, was mostly polymicrobial (71%), and was predominantly due to Gram-negative bacilli. Risk factors for SSWI were at least 1 revision surgery (odds ratio [OR] 4.8 [95% confidence interval {CI} 1.0-22.4], P=0.047), sternal closure by muscle flap (OR 4.6 [1.3-16.8], P=0.02), delayed sternal closure (mean 27 versus 14days, P=0.03), and use of vacuum-assisted closure device (100% versus 58%, P=0.008). Hospital stay was significantly longer in patients with SSWI (69days versus 48days, P=0.04).
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OBJECTIVE: To demonstrate five discal cysts with detailed magnetic resonance imaging findings in nonsurgical and following postoperative microdiscectomy. MATERIALS AND METHODS: Five discal cysts in four patients who underwent magnetic resonance imaging were found through a search in our database and referral from a single orthopedic spine surgeon. Computed tomography in two cases and computed tomography discography in one case were also performed. RESULTS: Five discal cysts were present in four patients. Three patients had no history of previous lumbar surgery and the other patient presented with two discal cysts and recurrent symptoms after partial laminectomy and microdiscectomy. All were oval shaped and seated in the anterior epidural space. Four were ventrolateral, and the other one was centrally positioned in the anterior spinal canal. One showed continuity with the central disc following discography. Three were surgically removed. CONCLUSION: Magnetic resonance imaging can easily depict an epidural cyst and the diagnosis of a discal cyst should be raised when an homogeneous ventrolateral epidural cyst contiguous to a mild degenerated disc is identified.
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Abstract Objective: To evaluate three-dimensional translational setup errors and residual errors in image-guided radiosurgery, comparing frameless and frame-based techniques, using an anthropomorphic phantom. Materials and Methods: We initially used specific phantoms for the calibration and quality control of the image-guided system. For the hidden target test, we used an Alderson Radiation Therapy (ART)-210 anthropomorphic head phantom, into which we inserted four 5mm metal balls to simulate target treatment volumes. Computed tomography images were the taken with the head phantom properly positioned for frameless and frame-based radiosurgery. Results: For the frameless technique, the mean error magnitude was 0.22 ± 0.04 mm for setup errors and 0.14 ± 0.02 mm for residual errors, the combined uncertainty being 0.28 mm and 0.16 mm, respectively. For the frame-based technique, the mean error magnitude was 0.73 ± 0.14 mm for setup errors and 0.31 ± 0.04 mm for residual errors, the combined uncertainty being 1.15 mm and 0.63 mm, respectively. Conclusion: The mean values, standard deviations, and combined uncertainties showed no evidence of a significant differences between the two techniques when the head phantom ART-210 was used.
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Objectives: To determine the efficacy of the pediculate flap with the buccal fat pad in the sealing of orosinusal communications, describe the surgical technique used, and report the main complications. Patients and method: A retrospective study was made of 8 patients seen in the Service of Oral Surgery of the University of Barcelona Dental Clinic (Spain) for the treatment of orosinusal communications between the years 2007 and 2009. In all cases a pediculate flap with the buccal fat pad was used to solve the problem. Results: All of the orosinusal communications were successfully resolved with this technique. The immediate postoperative complications were pain (37.5%), inflammation (37.5%), edema (32.5%), trismus (37.5%), halitosis (14.3%), suppuration (12.5%) and rhinorrhea (12.5%). Conclusions: The use of Bichat"s buccal fat pad is not regarded as the technique of choice for sealing small to medium sized orosinusal communications. However, in the case of large communications, it is a good option, and the results obtained are optimum.
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A flow cell assembled on the original geometry of a graphite tube to achieve permanent chemical modifier is proposed. The graphite tube operates as the working electrode. A stainless steel tube, positioned downstream from the working electrode, was used as the auxiliary electrode. The potential value applied on the graphite electrode was measured against a micro reference electrode (Ag/AgCl) inserted into the auxiliary electrode. Palladium solutions in acetate buffer (100 mmol L-1, pH = 4.8), flowing at 0.5 mL min-1 for 60 min was used to perform the electrochemical modification. A mercury solution (1 ng) was used to evaluate the performance of the permanent palladium modifier.
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Well-ordered Georgia kaolinite (Kga-1b) obtained from the source Clay Repository of the Clay Minerals Society (USA) was intercalated with urea using grinding procedures. To achieve complete intercalation 20% of urea (in weight) was used, producing Al2Si2O5(OH)4 (N2H4CO)0,86 with an interplanar basal spacing of 1,08nm. After washing with water under ultrasound stirring at 363K, urea was completely removed and kaolinite was partially exfoliated. After drying under air, the material was converted to hydrated kaolinite with the composition Al2Si2O5(OH)4 (H2O)0,64 and an interplanar basal spacing of 0,84nm. In this compound, water molecules positioned between the layers of the silicate can be removed after calcination at 573K, regenerating structurally disordered kaolinite.
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In this work two procedures were proposed for analytical curves construction using a single standard solution employing a flow injection system with solid phase spectrophotometric detection (FI-SPS). A flow cell contends the chromogenic reagent 1-(2-tiazolylazo)-2-naphtol was positioned on the optical path. The first procedure was based on controlled concentration of analyte on solid phase and the relations between absorbance and the total volume of injected allowed the calculation of analyte concentration. The second procedure was developed employing controlled dispersion/retention in flow system where analyte concentration was obtained by exploiting the relation between transient signals of samples and single standard solution at equivalent reading time. The procedures were successfully applied for zinc determination in synthetic solutions with good precision and accuracy at 95% confidence level.