Vulvar reconstruction should be performed using gluteal-fold perforator flap because of less morbidities and complications

The autors present a case of bilateral vulvar defects after abrasion of malignant skin neoplasm, reconstructed with a gluteal-fold perforator flap, resulting in a successful outcome.

Splenic vein graft for the reconstruction of the mesenteric-portal trunk after gastroduodenopancreatectomy

Resection of the confluence of the superior mesenteric and portal veins has been performed most frequently in the treatment of adenocarcinoma of the pancreas, in view of the reported positive results, but it can also be used in cases of benign pancreatic neolpasias when they are strongly adhered to the mesenteric-portal trunk. Nevertheless, there is no study on the best type of venous grafts for reconstruction of the mesenteric-portal trunk when required. The choice of graft depends on the preference of the surgeon or the institution. This technical note critically discusses the use of the splenic vein as an option for mesenteric-portal trunk reconstruction after gastroduodenopancreatectomy.

Ureteral reconstruction with abdominal wall muscle flap: experimental study in rabbits

The authors detail the experimental development of a technique for the reconstruction of the ureter using a tubular shape, muscle flap of the abdominal wall. the preliminary results indicate the feasibility of this surgical technique.

Use of the amniotic membrane to cover the peritoneal cavity in the reconstruction of the abdominal wall with polypropylene mesh in rats

OBJECTIVE: to evaluate the efficacy of the amniotic membrane used with polypropylene mesh against the formation of adhesions and its influence on healing. METHODS: twenty five female Wistar rats were anesthetized for creating a parietal defect in the anterior abdominal wall. Its correction was made with polypropylene mesh alone and associated with amniotic membrane. In the control group (n=11), the screen was inserted alone. In group A (n=7) we interposed the amniotic membrane between the screen and the abdominal wall. In group B, the amniotic membrane was placed on the mesh, covering it. After seven days, the animals were euthanized for macroscopic and microscopic evaluation of healing. RESULTS: adhesions were observed in all animals except one in the control group. Severe inflammation was observed in all animals in groups A and B and in three of the control group, with significant difference between them (A and B with p=0.01). Pronounced angiogenic activity was noted in one animal in the control group, six in group A and four in group B, with a significant difference between the control group and group A (p=0.002) and group B (p=0.05). The scar collagen was predominantly mature, except in five animals of the control group, with significant difference between the control group and group A (p=0.05) and group B (p=0.05). CONCLUSION: The amniotic membrane did not alter the formation of adhesions in the first postoperative week. There were also pronounced inflammation, high angiogenic activity and predominance of mature collagen fibers, regardless of the anatomical plane that it was inserted in.

Plastic surgery in chest wall reconstruction: relevant aspects - case series

Objective: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. Methods: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. Results: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. Conclusion: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.

On Innovative Search: the use of internal and external sources of innovation among Finnish innovators

This dissertation explores the use of internal and external sources of knowledge in modern innovation processes. It builds on a framework that combines theories such as a behavioural theory of the firm, the evolutionary theory of economic change, and modern approaches to strategic management. It follows the recent increase in innovation research focusing on the firm-level examination of innovative activities instead of traditional industry-level determinants. The innovation process is seen as a problem- and slack- driven search process, which can take several directions in terms of organizational boundaries in the pursuit of new knowledge and other resources. It thus draws on recent models of technological change, according to which firms nowadays should build their innovative activities on both internal and external sources of innovation rather than relying solely on internal resources. Four different research questions are addressed, all of which are empirically investigated via a rich dataset covering Finnish innovators collected by Statistics Finland. Firstly, the study examines how the nature of problems shapes the direction of any search for new knowledge. In general it demonstrates that the nature of the problem does affect the direction of the search, although under resource constraints firms tend to use external rather than internal sources of knowledge. At the same time, it shows that those firms that are constrained in terms of finance seem to search both internally and externally. Secondly, the dissertation investigates the relationships between different kinds of internal and external sources of knowledge in an attempt to find out where firms should direct their search in order to exploit the potential of a distributed innovation process. The concept of complementarities is applied in this context. The third research question concerns how the use of external knowledge sources – openness to external knowledge – influences the financial performance of firms. Given the many advantages of openness presented in the current literature, the focus is on how it shapes profitability. The results reveal a curvilinear relationship between profitability and openness (taking an inverted U-shape), the implication being that it pays to be open up to a certain point, but being too open to external sources may be detrimental to financial performance. Finally, the dissertation addresses some challenges in CISbased innovation research that have received relatively little attention in prior studies. The general aim is to underline the fact that comprehensive understanding of the complex process of technological change requires the constant development of methodological approaches (in terms of data and measures, for example). All the empirical analyses included in the dissertation are based on the Finnish CIS (Finnish Innovation Survey 1998-2000).

Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory

PURPOSE: To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams.METHODS: The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service.RESULTS: Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated.CONCLUSION: An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

From network pictures to network insight in solution business – the role of internal communication

Operating in business-to-business markets requires an in-depth understanding on business networks. Actions and reactions made to compete in markets are fundamentally based on managers‘ subjective perceptions of the network. However, an amalgamation of these individual perceptions, termed a network picture, to a common company level shared understanding on that network, known as network insight, is found to be a substantial challenge for companies. A company‘s capability to enhance common network insight is even argued to lead competitive advantage. Especially companies with value creating logics that require wide comprehension of and collaborating in networks, such as solution business, are necessitated to develop advanced network insight. According to the extant literature, dispersed pieces of atomized network pictures can be unified to a common network insight through a process of amalgamation that comprises barriers/drivers of multilateral exchange, manifold rationality, and recursive time. However, the extant body of literature appears to lack an understanding on the role of internal communication in the development of network insight. Nonetheless, the extant understanding on the amalgamation process indicates that internal communication plays a substantial role in the development of company level network insight. The purpose of the present thesis is to enhance understanding on internal communication in the amalgamation of network pictures to develop network insight in the solution business setting, which was chosen to represent business-to-business value creating logic that emphasizes the capability to understand and utilize networks. Thus, in solution business the role of succeeding in the amalgamation process is expected to emphasize. The study combines qualitative and quantitative research by means of various analytical methods including multiple case analysis, simulation, and social network analysis. Approaching the nascent research topic with differing perspectives and means provides a broader insight on the phenomenon. The study provides empirical evidence from Finnish business-to-business companies which operate globally. The empirical data comprise interviews (n=28) with managers of three case companies. In addition the data includes a questionnaire (n=23) collected mainly for the purpose of social network analysis. In addition, the thesis includes a simulation study more specifically achieved by means of agent based modeling. The findings of the thesis shed light on the role of internal communication in the amalgamation process, contributing to the emergent discussion of network insights and thus to the industrial marketing research. In addition, the thesis increases understanding on internal communication in the change process to solution business, a supplier‘s internal communication in its matrix organization structure during a project sales process, key barriers and drivers that influence internal communication in project sales networks, perceived power within industrial project sales, and the revisioning of network pictures. According to the findings, internal communication is found to play a substantial role in the amalgamation process. First, it is suggested that internal communication is a base of multilateral exchange. Second, it is suggested that internal communication intensifies and maintains manifold rationality. Third, internal communication is needed to explicate the usually differing time perspectives of others and thus it is suggested that internal communication has role as the explicator of recursive time. Furthermore, the role of an efficient amalgamation process is found to be emphasized in solutions business as it requires a more advanced network insight for cross-functional collaboration. Finally, the thesis offers several managerial implications for industrial suppliers to enhance the amalgamation process when operating in solution business.

A new climatic periodisation of the Gold and Guinea Coasts in West Africa, 1750-1798 : a reconstruction of the climate during the slave trade era, including an analysis of the climatically facilitated Trans-Atlantic slave trade

Avsikten med studien är att producera den första rekonstruktionen av det västafrikanska klimatet mellan 1750 och 1798. Kunskapen om det västafrikanska klimatet före 1800-talet är till dags dato bristfällig, vilket gör det svårare att förstå framtida klimatvariationer. Det är bristen på instrumentell meteorologisk data (temperatur, regnmängd, och lufttryck), vilket i princip bara täcker det senaste århundradet, som är orsaken till att tidigare klimat är bristfälligt kartlagda. Klimatet och miljön är även sådana att proxydata från ’naturens arkiv’ (såsom t.ex. trädringar) har begränsad användning. Således är historiska dokument, främst från gästande kulturer/nationer/intressenter, innehållande deskriptiv information om vädret och klimatet, klimatforskarens viktigaste källa. Genom att använda tidigare, för det här syftet, oanvända källor påvisade den här undersökningen att klimatet i västra Afrika och Guldkusten (Ghana) har ändrats sedan 1700-talet. Monsunregnen var svagare och kortvarigare, speciellt den sekundära regnperioden under hösten var betydligt svagare än idag. Det förekom kraftiga årliga variationer i monsunregnen, men sett ur längre tidsperspektiv utmärktes torrare och blötare perioder. Studien kunde också visa en viss korrelation mellan det globala väderfenomenet El Niño och regnperiodens intensitet längs med kusten. Flera torrperioder sammanföll med tidigare registrerade El Niño sekvenser. Speciellt slutet av 1760-talet påverkades kraftigt av El Niño och även det globala klimatet verkar ha genomgått graftiga förändringar just dessa år. På basis av den nya klimatrekonstruktionen genomfördes också en jämförelse av klimatets inverkan på den transatlantiska slavhandeln från 1750 till 1798, en fråga som historikerna gjort anspelningar på i över 30 år. Utförseln av slavar från västra Afrika var som kraftigast under 1700-talets andra hälft. Analysen visade att slavhandeln delvis tilltog i samband med klimatanomalierna.

Heat transfer inside internal combustion engine: modelling and comparison with experimental data

The paper is devoted to study specific aspects of heat transfer in the combustion chamber of compression ignited reciprocating internal combustion engines and possibility to directly measure the heat flux by means of Gradient Heat Flux Sensors (GHFS). A one – dimensional single zone model proposed by Kyung Tae Yun et al. and implemented with the aid of Matlab, was used to obtain approximate picture of heat flux behavior in the combustion chamber with relation to the crank angle. The model’s numerical output was compared to the experimental results. The experiment was accomplished by A. Mityakov at four stroke diesel engine Indenor XL4D. Local heat fluxes on the surface of cylinder head were measured with fast – response, high – sensitive GHFS. The comparison of numerical data with experimental results has revealed a small deviation in obtained heat flux values throughout the cycle and different behavior of heat flux curve after Top Dead Center.

Heat flux measurement inside internal combustion engine with gradient heat flux sensor.

This master’s thesis is devoted to study different heat flux measurement techniques such as differential temperature sensors, semi-infinite surface temperature methods, calorimetric sensors and gradient heat flux sensors. The possibility to use Gradient Heat Flux Sensors (GHFS) to measure heat flux in the combustion chamber of compression ignited reciprocating internal combustion engines was considered in more detail. A. Mityakov conducted an experiment, where Gradient Heat Flux Sensor was placed in four stroke diesel engine Indenor XL4D to measure heat flux in the combustion chamber. The results which were obtained from the experiment were compared with model’s numerical output. This model (a one – dimensional single zone model) was implemented with help of MathCAD and the result of this implementation is graph of heat flux in combustion chamber in relation to the crank angle. The values of heat flux throughout the cycle obtained with aid of heat flux sensor and theoretically were sufficiently similar, but not identical. Such deviation is rather common for this type of experiment.

The Shadow Moiré method using the phase shifting technique and digital image processing: computational implementation and application to the 3D-reconstruction of a buckled plate

The Shadow Moiré fringe patterns are level lines of equal depth generated by interference between a master grid and its shadow projected on the surface. In simplistic approach, the minimum error is about the order of the master grid pitch, that is, always larger than 0,1 mm, resulting in an experimental technique of low precision. The use of a phase shift increases the accuracy of the Shadow Moiré technique. The current work uses the phase shifting method to determine the surfaces three-dimensional shape using isothamic fringe patterns and digital image processing. The current study presents the method and applies it to images obtained by simulation for error evaluation, as well as to a buckled plate, obtaining excellent results. The method hands itself particularly useful to decrease the errors in the interpretation of the Moiré fringes that can adversely affect the calculations of displacements in pieces containing many concave and convex regions in relatively small areas.

Improving internal performance of a company - Introducing employee empowerment via job redesign in Finnish small and medium sized enterprises

This bachelor's thesis is about to find out to what extent Finnish managers and small and medium sized organizations are willing and able to put employee empowerment into practice and what experiences they have got from employee empowerment as an approach towards job redesign. Some of the top enterprises in the world are known for their empowered employees as a single most important factor for their success and this thesis focuses on introducing the subject to Finnish managers and organizations to find out what benefits, barriers and other thoughts they have about the whole idea of empowered employees in Finnish organization culture. Most notable findings in this thesis are that Finnish managers do think that their organization's employees are capable to work efficiently if their job is extended and the organizations would perform better when right person's job is enriched and he/she is given more power to solve problems.

Erythrocytes may contain a ouabain-insensitive K+-ATPase which plays a role in internal K+ balance

Erythrocytes are useful in evaluating K+ transport pathways involved in internal K+ balance. Several forms of H+,K+-ATPase have been described in nephron segments active in K+ transport. Furthermore, the activity of a ouabain-insensitive isoform of H+,K+-ATPase expressed in collecting duct cells may be modulated by acid-base status. Various assays were performed to determine if a ouabain-insensitive K+-ATPase is present in rat erythrocytes and, if so, whether it plays a role in internal K+ balance. Kinetic studies demonstrated that maximal stimulation of enzyme activity was achieved with 2.5 mM K+ at pH 7.4. Subsequent experiments were performed on erythrocyte membranes collected from animals submitted to varying degrees of K+ homeostasis: control rats, K+-depleted rats, K+-loaded rats, and rats rendered hyperkalemic due to acute renal failure. As observed in the collecting duct cell studies, there was a significant decrease in the activity of ouabain-insensitive K+-ATPase in the erythrocytes of both K+-loaded and metabolically alkalotic K+-depleted rats. However, this enzyme activity in erythrocyte membranes of rats with metabolic acidosis-related hyperkalemia was similar to that of control animals. This finding may be interpreted as resulting from two potentially modulating factors: the stimulating effect that metabolic acidosis has on K+-ATPase and the counteracting effect that hyperkalemia and uremia have on metabolic acidosis. In summary, we present evidence of a ouabain-insensitive K+-ATPase in erythrocytes, whose activity is modulated by acid-base status and K+ levels.

Low variation in ribosomal DNA and internal transcribed spacers of the symbiotic fungi of leaf-cutting ants (Attini: Formicidae)

Leaf-cutting ants of the genera Atta and Acromyrmex (tribe Attini) are symbiotic with basidiomycete fungi of the genus Leucoagaricus (tribe Leucocoprineae), which they cultivate on vegetable matter inside their nests. We determined the variation of the 28S, 18S, and 5.8S ribosomal DNA (rDNA) gene loci and the rapidly evolving internal transcribed spacers 1 and 2 (ITS1 and ITS2) of 15 sympatric and allopatric fungi associated with colonies of 11 species of leafcutter ants living up to 2,600 km apart in Brazil. We found that the fungal rDNA and ITS sequences from different species of ants were identical (or nearly identical) to each other, whereas 10 GenBank Leucoagaricus species showed higher ITS variation. Our findings suggest that Atta and Acromyrmex leafcutters living in geographic sites that are very distant from each other cultivate a single fungal species made up of closely related lineages of Leucoagaricus gongylophorus. We discuss the strikingly high similarity in the ITS1 and ITS2 regions of the Atta and Acromyrmex symbiotic L. gongylophorus studied by us, in contrast to the lower similarity displayed by their non-symbiotic counterparts. We suggest that the similarity of our L. gongylophorus isolates is an indication of the recent association of the fungus with these ants, and propose that both the intense lateral transmission of fungal material within leafcutter nests and the selection of more adapted fungal strains are involved in the homogenization of the symbiotic fungal stock.