Recondicionamento pulmonar ex vivo: uma nova era para o transplante pulmonar

O transplante pulmonar consolidou-se como a melhor opção terapêutica para diversas pneumopatias terminais. O baixo número de doadores viáveis ainda persiste como uma grande limitação ao aumento do número de transplantes de pulmão, causando alta mortalidade na lista de espera. Diferentemente do transplante de outros órgãos sólidos, a maior limitação do transplante pulmonar não é o número absoluto de doadores e sim a viabilidade desses órgãos, que é reduzida devido às agressões ao pulmão ocasionadas pela morte encefálica e aos cuidados na UTI. Diversas são as propostas para o aumento do número de doadores: intensificação das campanhas de doação, o uso de doadores com coração parado, transplante pulmonar lobar intervivos e maior flexibilidade dos critérios para aceitação de doadores de pulmão. Todavia, a proposta que atrai a atenção de diversos grupos de transplante pulmonar é a perfusão pulmonar ex vivo, principalmente pela perspectiva de recuperação de pulmões inicialmente descartados. Esse sistema consiste na reperfusão e ventilação do bloco pulmonar isolado em um circuito de circulação extracorpórea modificado. Devido aos bons resultados apresentados e à perspectiva de aumento no número de órgãos aptos a transplante, diversos grupos têm estudado a técnica. Pesquisadores na Suécia, Canadá, Áustria, Inglaterra, Espanha e Brasil já possuem experiência sólida com o método e introduziram algumas variações. O objetivo deste artigo foi revisar o desenvolvimento, o estado da arte e as perspectivas futuras do modelo ex vivo de perfusão e recondicionamento pulmonar.

När spelaren tappar pokerfejset - En studie av spelberoendets omfattning, karaktär och behov av behandling

Syftet med denna uppsats är att belysa fenomenet spelberoende utifrån tre områden, vilka är omfattning, karaktär och behov av behandling. Vi undersöker överensstämmelsen mellan forskning och behandling kring spelberoende. De metoder som använts är litteraturöversikt samt halvstrukturerade intervjuer med personal på Folkhälsoinstitutets Spelberoendeprojekt i Malmö och i Göteborg. Den forskning som projektet grundats på gjordes innan den digitala spridningen av spel slog igenom. Därför täcker inte forskningen alla målgrupper för behandling och behandlingen måste ha stöd i forskningen för att få legitimitet. Den internationella forskningen som finns om spelberoende rör framförallt karaktären, medan omfattningen och behovet av behandling inte berörs i samma utsträckning. Spelberoendeproblematiken har stor vikt för socialt arbete, då det är ett beroende som alla andra och drabbar alla samhällsgrupper och alla åldrar. Kunskaper i ämnet är viktigt för att upptäcka och komma åt problemet i ett tidigt stadium.

Präzisionsmessung des magnetischen Moments des Elektrons in wasserstoffähnlichem Kohlenstoff

In dieser Arbeit wird eine Messung des magnetischen Moments des Elektronsin wasserstoffähnlichem Kohlenstoff vorgestellt. Das Ergebnis derMessungen an einem einzelnen gespeicherten¹²C⁵⁺-Ionist: g = 2,001 041 596 4 (8)(6)(44). Der erste Fehler bezeichnet die statistischeUnsicherheit, der zweite Fehler die systematische Unsicherheit. Der letzteFehler resultiert aus der Unsicherheit des Verhältnisses der Massedes ¹²C⁵⁺-Ions und der des Elektrons. Die hohe Genauigkeitder Messung wurde durch die räumliche Trennung des Nachweises derAusrichtung des Spins und des Induzierens der spin-flips erreicht. DieMessung stellt die bisher genaueste Bestimmung eines atomaren g-Faktorsdar und bestätigt den theoretischen Wert der Göteborger Theoriegruppeauf 7*10^-9. Zusammen mit diesen Rechnungen verifiziert sie dieBound-State-QED-Korrekturen genauer als 1%. Somit ist der g-Faktor desin¹²C⁵⁺ gebunden Elektrons neben Messungen der Lambshiftin schweren hochgeladenen Ionen der genaueste Test der Bound-State-QED.
Wird auf die Richtigkeit der Berechnung des g-Faktors des gebundenenElektrons vertraut, kann folgender Wert für die atomare Masse desElektrons gewonnen werden: m_e= 0,000 548 579 912 8 (15) u.

Qualita' istituzionale e capitale sociale: Un'analisi regionale

Il capitale sociale e la qualità istituzionale sono due fenomeni che, da circa venti anni, hanno assunto il ruolo di protagonisti all’interno delle scienze sociali. Anche se per molto tempo sono stati analizzati separatamente, già dalla loro definizione è possibile intuire come essi rappresentino due facce della stessa medaglia. Questo lavoro ha l’obiettivo di comprendere quale è le relazione che lega il capitale sociale e la qualità istituzionale all’interno delle regioni dell’Unione Europea. Nonostante buona parte della letteratura si sia maggiormente dedicata all’analisi dei due fenomeni a livello nazionale, in questo elaborato si ritiene che la dimensione territoriale regionale sia l’unità di misura più idonea per analizzarli entrambi. La prima parte del lavoro analizza il capitale sociale sia da un punto di vista definitorio che da un punto di vista più prettamente empirico, suddividendolo in diversi elementi. Il capitale sociale è un fenomeno estremamente multidimensionale, analizzarne solo una parte condurrebbe ad un’analisi parziale ed approssimativa. All’interno del testo vengono individuate cinque dimensioni, utilizzate successivamente per la creazione di un nuovo indice di capitale sociale regionale. Nella seconda parte si affronta il tema delle istituzioni e della qualità istituzionale. Dopo aver definito le istituzioni, si provvede ad effettuare una rassegna degli indici più comunemente utilizzati per misurarne la qualità, selezionando l’European Quality of Government Index del Quality of Government Institute di Göteborg come il più appropriato, sia per la sua definizione di governance che per l’unità di analisi prescelta. Nella terza parte, infine, in seguito ad un’analisi di quella parte di letteratura che ritiene i due fenomeni indissolubilmente legati ed utilizzando l’indice di capitale sociale regionale sviluppato nel primo capitolo, si propone una risposta, sicuramente parziale e non definitiva, alla domanda che da vent’anni anima questo interessante filone di ricerca: che relazione sussiste tra qualità istituzionale e capitale sociale?

Two-year outcome with Nobel Direct implants: a retrospective radiographic and microbiologic study in 10 patients

INTRODUCTION: The Nobel Direct implant (Nobel Biocare AB, Göteborg, Sweden) was developed to minimize marginal bone resorption and to result in "soft tissue integration" for an optimized aesthetic outcome. However, conflicting results have been presented in the literature. The aim of this present study was to evaluate the clinical and microbiologic outcomes of Nobel Direct implants. MATERIALS AND METHODS: Ten partially edentulous subjects without evidence of active periodontitis (mean age 55 years) received 12 Nobel Direct implants. Implants were loaded with single crowns after a healing period of 3 to 6 months. Treatment outcomes were assessed at month 24. Routine clinical assessments, intraoral radiographs, and microbiologic samplings were made. Histologic analysis of one failing implant and chemical spectroscopy around three unused implants was performed. Paired Wilcoxon signed-rank test was used for the evaluation of bone loss; otherwise, descriptive analysis was performed. RESULTS: Implants were functionally loaded after 3 to 6 months. At 2 years, the mean bone loss of remaining implants was 2.0 mm (SD +/- 1.1 mm; range: 0.0-3.4 mm). Three out of 12 implants with an early mean bone loss >3 mm were lost. The surviving implants showed increasing bone loss between 6 and 24 months (p = .028). Only 3 out of the 12 implants were considered successful and showed bone loss of <1.7 mm after 2 years. High rates of pathogens, including Aggregatibacter actinomycetemcomitans, Fusobacterium spp., Porphyromonas gingivalis, Pseudomonas aeruginosa, and Tanerella forsythia, were found. Chemical spectroscopy revealed, despite the normal signals from Ti, O, and C, also peaks of P, F, S, N, and Ca. A normal histologic image of osseointegration was observed in the apical part of the retrieved implant. CONCLUSION: Radiographic evidence and 25% implant failures are indications of a low success rate. High counts and prevalence of significant pathogens were found at surviving implants. Although extensive bone loss had occurred in the coronal part, the apical portion of the implant showed some bone to implant integration.

Prosthetically driven, computer-guided implant planning for the edentulous maxilla: a model study

OBJECTIVES: To analyze computer-assisted diagnostics and virtual implant planning and to evaluate the indication for template-guided flapless surgery and immediate loading in the rehabilitation of the edentulous maxilla. MATERIALS AND METHODS: Forty patients with an edentulous maxilla were selected for this study. The three-dimensional analysis and virtual implant planning was performed with the NobelGuide software program (Nobel Biocare, Göteborg, Sweden). Prior to the computer tomography aesthetics and functional aspects were checked clinically. Either a well-fitting denture or an optimized prosthetic setup was used and then converted to a radiographic template. This allowed for a computer-guided analysis of the jaw together with the prosthesis. Accordingly, the best implant position was determined in relation to the bone structure and prospective tooth position. For all jaws, the hypothetical indication for (1) four implants with a bar overdenture and (2) six implants with a simple fixed prosthesis were planned. The planning of the optimized implant position was then analyzed as follows: the number of implants was calculated that could be placed in sufficient quantity of bone. Additional surgical procedures (guided bone regeneration, sinus floor elevation) that would be necessary due the reduced bone quality and quantity were identified. The indication of template-guided, flapless surgery or an immediate loaded protocol was evaluated. RESULTS: Model (a) - bar overdentures: for 28 patients (70%), all four implants could be placed in sufficient bone (total 112 implants). Thus, a full, flapless procedure could be suggested. For six patients (15%), sufficient bone was not available for any of their planned implants. The remaining six patients had exhibited a combination of sufficient or insufficient bone. Model (b) - simple fixed prosthesis: for 12 patients (30%), all six implants could be placed in sufficient bone (total 72 implants). Thus, a full, flapless procedure could be suggested. For seven patients (17%), sufficient bone was not available for any of their planned implants. The remaining 21 patients had exhibited a combination of sufficient or insufficient bone. DISCUSSION: In the maxilla, advanced atrophy is often observed, and implant placement becomes difficult or impossible. Thus, flapless surgery or an immediate loading protocol can be performed just in a selected number of patients. Nevertheless, the use of a computer program for prosthetically driven implant planning is highly efficient and safe. The three-dimensional view of the maxilla allows the determination of the best implant position, the optimization of the implant axis, and the definition of the best surgical and prosthetic solution for the patient. Thus, a protocol that combines a computer-guided technique with conventional surgical procedures becomes a promising option, which needs to be further evaluated and improved.

Formen aus Stahl, Bauteile aus Titan und Stahl

Die Arcam Technologie setzt erstmals weltweit mit der ‚CAD to Metal®’ Methode einen Elektronenstrahl ein. Mit dieser Methode können homogene Stahlkomponenten und Formen in kürzester Zeit aus einem Metallpulver geschmolzen werden. Die in zunehmendem Maße geforderte Herstellung von Prototypen im Zielwerkstoff, wird mit dem EBM Verfahren erstmals für Stahl- und Titanwerkstoffe ermöglicht. Die Arcam-Methode setzt CAD-Datenmodelle direkt in homogene Metallmodelle um. Mit der Einbringung von konturnahen Kühlkanälen ist es nun auch machbar, Werkzeuge in hochlegierten Stählen im Rapid Prototyping Verfahren herzustellen. So erstellte Werkzeuge können die Zykluszeiten im Spritzguss- und Druckgussprozess um 30% verringern. Die Festigkeiten liegen ohne jegliche Nachbehandlung bei ca. 50 Rockwell. Jede beliebige Formgebung ist sofort in Stahl und neuerdings auch in Titan zu erstellen. Von besonderer Bedeutung ist, dass konturnahe Kühlungen in beliebiger Komplexität integriert werden. Die Arcam Technologie stellt die schnellste Produktionsmöglichkeit von Funktionsprototypen dar, welche in Festigkeit und Temperaturstabilität die gleichen Parameter wie herkömmliche gefertigte Bauteile aufweist. Es stehen Werkzeugstahl (DIN 1.2344), legierte Stähle und Titan (Ti6A14V) zur Verfügung. Die EBM Technologie setzt einen Elektronenstrahl zum Aufschmelzen der Metallpulver ein. Stahl wird z.B. mit einer Temperatur von 1700 °C schichtweise aufgetragen. Ein Verschleiß, wie man ihn von Anlagen mit Lasertechnologie kennt, tritt nicht auf. Neuinvestition in Abständen von 3000 – 4000 Betriebsstunden sind bei dieser Technologie für neue Laser nicht notwendig. Die Arcam-Technologie ist in 24 Ländern patentrechtlich geschützt. Arcam ist ein schwedisches Unternehmen, mit Sitz in Mölndal in der Nähe von Göteborg.

Success in Offshoring of Application Development – Does Culture Matter?

Recently, offshoring of information systems (IS) services to external vendors has seen considerable growth. Outsourcing to vendors in foreign countries brings about unique challenges which need to be understood and managed effectively. This paper explores cultural differences in IS offshoring arrangements involving German client organizations that outsource application development activities to Indian vendors. For this purpose, a research framework is developed based on both theoretical considerations and specific empirical observations from multiple case studies. The goal is to (1) explore the nature of cultural differences in offshoring arrangements in depth and to (2) analyze the relationship between those cultural differences and offshoring success. Based on the case findings, implications and practices for the management of offshore development projects are outlined.

Long-distance spore dispersal in wood-inhabiting Basidiomycetes

Eight species of wood-inhabiting basidiomycetes (Laurilia sulcata, Peniophora aurantiaca, Resinicium bicolor, Scytinostroma galactinum, Terana caerulea, Trichaptum abietinum, T. biforme and T. fuscoviolaceum) were used in a spore-trapping test to evaluate their individual ability for long-distance spore dispersal. Petri dishes with single spore mycelia were used as baits. In the experiment, carried out at the Botanical Institute in Göteborg, spores from the air were regularly captured. Surprisingly, spores were captured from species whose nearest known natural occurrence was located quite far from Göteborg. The closest population of Peniophora aurantiaca is about 1000 km south of Göteborg. The results from this experiment support the hypothesis that fungal spores are widely and efficiently dispersed. Such a broad and extensive dispersal ability is of vital importance, especially for wood-inhabiting species which are highly dependent on a substrate which is onlv temporarily available.

Major elements and trace ferrides in deep sea cores obtained during the Swedish Deep-Sea Expedition in 1947-1948

Samples from sediment cores collected during the Swedish Deep-Sea Expedition 1947-1948 have been analyzed in the Geochemical laboratory of the Geological Survey of Sweden. Most samples were placed at our disposal by Professor Hans Pettersson, leader of the expedition mentioned. For complementary studies, samples from the Atlantic and Indian oceans were included in our investigation and the samples placed at our disposal by Professor B. Kullenberg, Göteborg. From the Tyrrhenian Sea we got samples from Professor E. Norin, Uppsala.

Cuando dialogan dos Antígonas : La tumba de Antígona de María Zambrano y Antígona furiosa de Griselda Gambaro

Antígona ha sido un tópico por más de 2.000 años, participando de una historia que siempre puede ser reconocida. Tanto la Guerra Civil española como la dictadura argentina vieron surgir Antígonas en busca de justicia. A partir de los trabajos de María Zambrano y Griselda Gambaro, este artículo busca rehabilitar discursivamente estas versiones. Por un lado, la filósofa española nunca regresó del exilio iniciado en 1939 y defendió hasta el final los valores republicanos. Cuando asumió que su expatriación era irreversible, ingresó en un exilio profundo del cual Antígona revela lo esencial, pasando de la "privación" a la "revelación" tanto en un modo filosófico como en el poético, tanto en sus ensayos como en su única pieza teatral, La Tumba de Antígona (1967), una significativa metáfora de la guerra fratricida y del exilio. Por otro, Antígona furiosa (1986) de Gambaro, reescribe la tragedia de Sófocles cuando denuncia el terrorismo de estado argentino en una furiosa Antígona. Gambaro, hermana y madre de desaparecidos de la guerra sucia eleva su grito por justicia en nombre de la fraternidad humana