608 resultados para Apically repositioned flap


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Studio della ipersostentazione di un velivolo non convenzionale degli anni ‘40, il Vought V-173 Flying Pancake. Per realizzare l’intero lavoro si sono adoperati dei software di fluidodinamica computazionale come Flow Simulation di SolidWorks e il programma JavaFoil, inoltre, si è scelto l’ambiente Matlab di supporto ai calcoli e per rappresentare i risultati ottenuti a seguito delle simulazioni, realizzando script e funzioni per l’approssimazione di questi e la loro successiva raffigurazione grafica. In particolar modo, a partire dal modello tridimensionale in SolidWorks del V-173 si sono ricreate le curve CL-α e CD-α a partire dai punti ottenuti dalle simulazioni per diverse configurazioni del velivolo. In una prima fase si è valutata l’aerodinamica del velivolo ‘pulito’ senza la presenza delle eliche e di ipersostentatori, successivamente si sono seguite due strade diverse per valutare il comportamento del velivolo: nel primo caso si sono eseguiti studi dell’aerodinamica del Pancake in presenza degli ipersostentatori già presenti sul velivolo (i plain flap), proponendo soluzioni alternative per migliorare l’ipersostentazione del V-173 tramite spillamenti (slots) e diverse configurazioni di vortex generator che energizzassero lo strato limite e ottimizzassero le prestazioni del velivolo con particolare attenzione alla fase di atterraggio. In secondo luogo, tenendo in considerazione che il Pancake è un aeroplano bielica, si è voluta studiare l’influenza delle due eliche sulla sua aerodinamica: dopo aver riprodotto nel modo più verosimile entrambe le eliche utilizzando SolidWorks si è fatto uno studio di massima ricavando risultati che potessero indicare la compatibilità tra elica e velivolo a seguito dei risultati sperimentali ottenuti con Flow Simulation.

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L’azienda GGP, leader europeo nella produzione di rasaerba e prodotti per il giardinaggio, ha avviato, in collaborazione con il Laboratorio di aerodinamica sperimentale della Facoltà di ingegneria dell’Università di Bologna, uno studio atto alla valutazione delle prestazioni dei rasaerba commercializzati, al fine di comprendere quali siano le vie percorribili per ottenere un miglioramento delle prestazioni associate. Attualmente il metodo utilizzato per compiere tali valutazioni consiste nel far percorrere al rasaerba un percorso di lunghezza prestabilita e valutare il peso dell’erba raccolta nel sacco. Tale approccio presenta delle forti limitazioni in quanto le prove non sono per loro natura ripetibili. Si pensi ad esempio alla non uniformità del terreno e all’altezza dell’erba. È pertanto necessario un approccio in grado di definire con maggior precisione e ripetibilità le prestazioni dei macchinari rasaerba. Tra le diverse prestazioni c’è la capacità della macchina di trattare una portata di aria più elevata possibile garantendo un’elevata aspirazione dell’erba tagliata. Da questo punto vista la geometria della lama riveste un’importanza particolare. Per valutare le prestazioni della singola lama, è stato realizzato un “test-rig lame”, uno strumento con cui è possibile trattare il flusso per renderlo misurabile e valutare la portata d’aria attraverso semplici misure di pressione. Una volta costruito il “test-rig”, sono stati individuati i parametri geometrici delle lame che influenzano la portata, quali apertura, corda e calettamento del flap della lama. Lo studio svolto si limita a valutare gli effetti causati dalla sola geometria della lama prescindendo dalla forma della voluta, in quanto la sua interazione con la lama risulta di grande complessità. Si è quindi avviata una campagna di test sperimentali effettuati su lame caratterizzate da diversi valori dei parametri, che l’azienda stessa ha prodotto e fornito al laboratorio, al fine di trovare relazioni funzionali tra la portata elaborata e la geometria delle lame.

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La malattia paranale di Crohn rappresenta una condizione clinica complessa e invalidante. La chirurgia da sola è efficace nel migliorare i sintomi mediante il controllo della sepsi, ma è raramente associata alla guarigione definitiva. L'introduzione dei farmaci biologici ha aumentato le possibilità di chiusura definitiva delle fistole. Tuttavia molti pazienti non rispondono a questo trattamento bio-chirurgico combinato. Il ruolo del mucosal healing del retto ottenuto con i farmaci non è al momento ancora chiaro. L'obiettivo del presente studio è quello di identificare possibili terapia alternative per pazienti non responsivi ai biologici. Lo studio ha valutato efficacia e sicurezza della chirurgia riparativa, confezionamento di flap mucosi endorettali e posizionamento di protesi biologiche, nei pazienti non responsivi ai biologici ma che grazie ad essi abbiano ottenuto un mucosal healing del retto.

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Studio di fattibilità della conversione del Vought V-173 per il volo ad alta quota. Per realizzare l'intero lavoro si è adoperato il software di fluidodinamica computazionale Flow Simulation di SolidWorks e si è scelto l'ambiente Matlab per la fase di elaborazione e presentazione dati. A partire dal modello tridimensionale in SolidWorks del V-173 si sono ricreate le curve CL e CD a partire dai punti ottenuti dalle simulazioni per diverse configurazioni del velivolo. Si è valutata l'aerodinamica del velivolo senza la presenza di eliche e di ipersostentatori e successivamente si sono seguite due strade diverse per valutare il comportamento del velivolo: nel primo caso si sono eseguiti studi dell'aerodinamica del Pancake in presenza degli ipersostentatori già presenti sul velivolo originario (i plain flap). In secondo luogo, tenendo in considerazione che il Pancake è un aeroplano bielica, si è voluta studiare l'influenza delle due eliche sulla sua aerodinamica: dopo aver riprodotto nel modo più verosimile entrambe le eliche utilizzando SolidWorks si è fatto uno studio di massima ricavando risultati che potessero indicare la compatibilità tra elica e velivolo a seguito dei risultati sperimentali ottenuti con Flow Simulation. Questa parte è stata realizzata per lo stesso tipo di elica tripala, ma prendendo in considerazione due diversi diametri, una di 4:9m e una da 2:5m.

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Congenital pseudarthrosis of the tibia (CPT) is caused by an ill-defined, segmental disturbance of periosteal bone formation leading to spontaneous bowing, followed by fracture and subsequent pseudarthrosis in the first 2 years of life. The results of conventional treatment modalities (e.g., bracing, internal and external fixation and bone grafting) are associated with high failure rates in terms of persisting pseudarthrosis, malunion and impaired growth. As a more promising alternative, a more aggressive approach, including wide resection of the affected bone, reconstruction with free vascularised fibula grafts from the healthy contralateral leg and stable external fixation at a very early stage has been suggested. Between 1995 and 2007, 10 children (age 12-31 months, median 20 months) suffering from CPT were treated at our institutions according to this principle. Two patients were treated before a fracture had occurred. The length of the fibula graft was 7-9cm. End-to-end anastomoses were performed at the level of the distal tibia stump. The follow-up was 80 months (median, range 12 months to 12 years). Radiologic examination at 6 weeks postoperatively showed normal bone density and structure of the transplanted fibula in all cases and osseous consolidation at 19 of the 20 graft/tibia junctions. One nonunion was sucessfully treated with bone grafting and plate osteosynthesis. Pin-tract infection occurred in three patients. Five children sustained graft fractures that were successfully treated with internal or external fixation. Two patients developed diminished growth of the affected limb or foot; all others had equal limb length and shoe size. At long-term follow-up, tibialisation of the transplant had occurred, and normal gait and physical activities were possible in all children. We conclude that in spite of a relatively high complication rate and the reluctance to perform free flap surgery in infants at this young age, the present concept may successfully prevent the imminent severe sequelae associated with CPT.

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In surgical animal studies anesthesia is used regularly. Several reports in the literature demonstrate respiratory and cardiovascular side effects of anesthesiologic agents. The aim of this study was to compare two frequently used anesthesia cocktails (ketamine/xylazine [KX] versus medetomidine/climazolam/fentanyl [MCF]) in skin flap mouse models. Systemic blood values, local metabolic parameters, and surgical outcome should be analyzed in critical ischemic skin flap models. Systemic hypoxia was found in the animals undergoing KX anesthesia compared with normoxia in the MCF group (sO(2): 89.2% +/- 2.4% versus 98.5% +/- 1.2%, P < 0.01). Analysis of tissue metabolism revealed impaired anaerobic oxygen metabolism and increased cellular damage in critical ischemic flap tissue under KX anesthesia (lactate/pyruvate ratio: KX 349.86 +/- 282.38 versus MCF 64.53 +/- 18.63; P < 0.01 and glycerol: KX 333.50 +/- 83.91 micromol/L versus MCF 195.83 +/- 29.49 micromol/L; P < 0.01). After 6 d, different rates of flap tissue necrosis could be detected (MCF 57% +/- 6% versus KX 68% +/- 6%, P < 0.01). In summary we want to point out that the type of anesthesia, the animal model and the goal of the study have to be well correlated. Comparing the effects of KX and MCF anesthesia in mice on surgical outcome was a novel aspect of our study.

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BACKGROUND: The aim of the study is to clinically and histologically evaluate the healing of advanced intrabony defects treated with open flap debridement and the adjunct implantation of granular beta tricalcium phosphate (beta-TCP). METHODS: Five patients, each displaying advanced combined 1- and 2-wall intrabony defects around teeth scheduled for extraction or root resection, were recruited. Approximately 6 months after surgery, the teeth or roots were removed together with a portion of their surrounding soft and hard tissues and processed for histologic evaluation. RESULTS: The mean probing depth (PD) was reduced from 10.8 +/- 2.3 mm presurgically to 4.6 +/- 2.1 mm, whereas a mean clinical attachment level (CAL) gain of 5.0 +/- 0.7 mm was observed. The increase in gingival recession was 1.2 +/- 3.2 mm. The histologic evaluation indicated the formation of new cellular cementum with inserting collagen fibers to a varying extent (mean: 1.9 +/- 0.7 mm; range: 1.2 to 3.03 mm) coronal to the most apical extent of the root instrumentation. The mean new bone formation was 1.0 +/- 0.7 mm (range: 0.0 to 1.9 mm). In most specimens, beta-TCP particles were embedded in the connective tissue, whereas the formation of a mineralized bone-like or cementum-like tissue around the particles was only occasionally observed. CONCLUSION: The present data indicates that treatment of intrabony periodontal defects with this beta-TCP may result in substantial clinical improvements such as PD reduction and CAL gain, but this beta-TCP does not seem to enhance the regeneration of cementum, periodontal ligament, and bone.

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The purpose of the present retrospective study was to evaluate the post-traumatic healing of the pulp and periodontium of 32 permanent teeth with horizontal root fractures. Twenty-nine patients, 8-48 years old, who presented at our department with a root fracture between January 2001 and April 2007, participated in the study. Root-fractured teeth with a loosened or dislocated coronal fragment were repositioned and splinted for 14-49 days (average: 34 days). In cases of severe dislocation of the coronal fragment, prophylactic endodontic treatment was performed. Follow-up examinations were conducted routinely after 1,2,3,6, and 12 months. For this study, follow-up took place for up to 7 years post trauma. Of 32 root-fractured teeth, 29 (91%) survived. 10 teeth (31%) exhibited pulpal healing; 13 teeth (41%) were prophylactically endodontically treated within 2 weeks of injury. At the fracture line, interposition of calcified tissue was evident in 6 teeth (19%), and interposition of granulation tissue was observed in 8 teeth (25%). The prognosis of the root-fractured teeth was good, and one-third of the teeth with root fractures possessed a vital pulp at the final examination.

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Major efforts have been undertaken to reduce donor-site morbidity after abdominal flaps, which eventually culminated in the introduction of the deep inferior epigastric perforator (DIEP) flap. However, due to anatomical variations (absence of dominant perforators) and the risk of ischaemic complications, the selection of patients qualifying for a DIEP flap is limited. Furthermore, DIEP flaps can only be used as free flaps. We present our long-term experience with a dissection technique of rectus abdominis myocutaneous (RAM) flaps that was developed to circumvent these drawbacks. The dissection is characterised by preventing to sacrifice any perforators nourishing the flap and by fully preserving the anterior rectus sheath, but not the muscle. The study comprises a consecutive series of prospectively assessed patients, treated between February 2000 and April 2008. A total of 100 fascia-sparing RAM flaps were operated on 97 patients (age 22-84 years, median 64 years). Free flaps were mainly used for breast reconstruction (47 flaps/24 patients), and cranially (34) or caudally (19) pedicled flaps for soft-tissue coverage after sternectomy, urogenital tumour resection or rectum amputation. Eighty patients had a total of 213 risk factors, such as cardiovascular diseases, obesity, hyperlipidaemia, diabetes mellitus, smoking or steroid medication. Partial tissue loss (skin or fat necrosis) occurred in 13 flaps, out of which seven required surgical revision. The ischaemic complications were evenly distributed between the patient subsets. At a follow-up of 2-89 months (median 20 months), one patient showed a flap harvest-related abdominal bulge after bilateral-free transverse rectus abdominis myocutaneous (TRAM) flap. We conclude that the present dissection technique provides maximal perforator-related perfusion and minimal donor-site morbidity even in pedicled flaps and high-risk patients. In free flaps, it may, therefore, be recommended as an alternative to the DIEP flap.

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An Italian greyhound was presented three times during a two-year period for dental prophylaxis due to periodontal disease. Clinical examination revealed lesions on several teeth. Radiographs revealed extensive resorptive root lesions. On histological examination, the presence of odontoclasts and signs of boney remodeling of the roots confirmed the resorptive nature of the lesions. Given the extent of the lesions, and poor prognosis with conservative treatment alone, teeth affected by the most severe resorption were extracted at each visit using a flap technique combined with alveolar vestibular osteotomy. Dental resorptive lesions are rarely detected in the dog but may be more frequent than previously thought. The routine use of dental radiographs can be used to reveal these lesions in the dog.

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Palatal scarring is assumed to be a primary cause of facial growth derangement in cleft lip and palate. Evidence supporting this hypothesis is confounded by the clinical involvement of various surgeons, and therefore definitive conclusions are not possible. In this study, we investigated the dental arch relationship in two groups, Exposed (47 children; 11.2 yrs) and Unexposed (61 children; 11.2 yrs), with a unilateral cleft lip and palate operated on by the same surgeon. The technique of hard palate repair differed between the two groups. In the Exposed group, palatal bone of the non-cleft side only was left denuded, inducing scar formation. In the Unexposed group, a vomerplasty with tight closure of the soft tissues was applied. Three raters graded the dental arch relationship and palatal morphology using the EUROCRAN Index. The dental arch relationship in the Exposed group was less favorable than in the Unexposed group (p = 0.009). Palatal morphology in both groups was comparable (p = 0.323). This study demonstrates that reduction of denuded bony areas on the palate after palatal repair with a vomer flap had a favorable effect on the dental arch relationship. For palatal morphology, no effect of the type of palatal repair was found.

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With the understanding of angiogenesis and arteriogenesis, new theories about the orchestration of these processes have emerged. The aim of this study was to develop an in vivo model that enables visualization of vascular regenerating mechanisms by intravital microscopy techniques in collateral arteriolar flap vascularity.

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The title compound, C(34)H(24)Cl(4)N(4)O(8)S, is a linear penta-cyclic system formed of two substituted benzoxazinyl groups fused to 2-n-butyl-tetra-hydro-thio-phene. The oxazine ring, which is fused to the n-butyl-substituted side of the thio-phene ring, is in a boat conformation. The other fused oxazine ring and the tetra-hydro-thiene ring are each in an envelope conformation. The bridgehead C atom alpha to both the S and N atoms forms the flap of each envelope. This results in a twist of the penta-cyclic system such that the dihedral angle between the terminal dichloro-benzene rings is 82.92 (8)°. In the crystal, inversion-related mol-ecules form a weakly hydrogen-bonded dimer, with two C-H⋯O inter-actions between an H atom on the oxazine ring and an amide O atom. Additionally, C-H⋯O inter-actions occur between an H atom on a screw-related nitro-benzene ring and an O atom on the nitro-benzene ring of one mol-ecule. One of the Cl atoms and the butyl group are disordered over two sets of sites with occupancy ratios of 0.94 (2):0.06 (2) and 0.624 (4):0.376 (4), respectively.

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Six techniques not yet widely known or used in the dermatologic surgery of the nails are briefly described. Small-to-medium-sized tumours of the proximal nail fold (PNF) can be excised and the defect repaired with advancement or rotation flaps. A superficial biopsy technique of the matrix for the diagnosis of longitudinal brown streaks in the nail, which allows rapid histological diagnosis of the melanocyte focus to be performed, is described here. Because the excision is very shallow and leaves the morphogenetic connective tissue of the matrix intact, the defect heals without scarring. Laterally positioned nail tumours can be excised in the manner of a wide lateral longitudinal nail biopsy. The defect repair is performed with a bipedicled flap from the lateral aspect of the distal phalanx. Malignant tumours of the nail organ often require its complete ablation. These defects can be covered by a full-thickness skin graft, reversed dermal graft, or cross-finger flap. The surgical correction of a split nail is often difficult. The cicatricial tissue of the matrix and PNF have to be excised and the re-attachment of these wounds prevented. The matrix defect has to be excised and sutured or covered with a free matrix graft taken either from the neighbouring area or from the big toe nail.

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Radiodermatitis is a known complication in patients having undergone radiotherapy. It usually appears 2 to 5 years after irradiation. We are reporting on a case of radiodermatitis that occurred within months after coronary dilatation and stenting. It started with painful swelling, followed by a typical appearance on the skin surface. Histological finding confirmed the diagnosis. However, magnetic resonance imaging showed changes in the subcutaneous tissue extending into the ribs. A radical debridement was performed including removal of a partially necrotic 4th rib. The defect was closed with a latissimus dorsi transposition flap. Our findings are compared with the literature reports.