Optimizing the nipple-areola sparing mastectomy with double concentric periareolar incision and biodimensional expander-implant reconstruction: Aesthetic and technical refinements

Although the biodimensional anatomical expander-implant system (BEIS) is a reliable technique, little information has been available regarding outcome following nipple-areola sparing mastectomy (NSM). To perform the resection of glandular tissue, while improving the surgical access and maintaining the nipple-areola vascularization we have developed a new approach for NSM based on the double concentric periareolar incision (DCPI). The purpose of this study is to analyze the feasibility, surgical planning and its outcome following NSM. 18 patients underwent NSM reconstructions. Mean time of follow-up was 29 months. The technique was indicated in patients with small/moderate volume breasts. Flap complications were evaluated and information on aesthetic results and patient satisfaction were collected. 83.3% had tumors measuring 2 cm or less (T1) and 72.1% were stage 0 and 1. All patients presented peripherally tumors located (at least 5 cm from the nipple). Skin complications occurred in 11.1%. One patient (5.5%) presented small skin necrosis and a wound dehiscence was observed in one patient (5.5%). The aesthetic result was good/very good in 94.4 percent and the majority of patients were very satisfied/satisfied. No local recurrences were observed. All complications except one were treated by a conservative approach. DCPI-BEIS is a simple and reliable technique for NSM reconstruction. The success depends on patient selection, coordinated planning with the oncologic surgeon and careful intra-operative and post-operative management. (C) 2009 Elsevier Ltd. All rights reserved.

Right coronary artery fistula to the coronary sinus and right atrium associated with giant right coronary enlargement detected by transthoracic echocardiography

We present the case of a 54-year-old female with a previous history of lung fibrosis secondary to methotrexate used for rheumatoid arthritis who was referred to cardiology evaluation due to precordial pain. Echocardiography showed biatrial enlargement with an enlarged coronary sinus and tubular image posterior to the heart. On the coronary angiogram, the right coronary artery was enlarged, and a distal fistula was identified. The patient underwent a contrast enhanced cardiac computed tomography which demonstrated an aneurysmatic right coronary artery with a distal fistula to the right atrium and coronary sinus. As the chest pain did not recur and there was a high risk of the intervention to correct coronary fistula, the patient remained on conservative treatment.

Modelling the secular evolution of migrating planet pairs

The subject of this paper is the secular behaviour of a pair of planets evolving under dissipative forces. In particular, we investigate the case when dissipative forces affect the planetary semimajor axes and the planets move inwards/outwards the central star, in a process known as planet migration. To perform this investigation, we introduce fundamental concepts of conservative and dissipative dynamics of the three-body problem. Based on these concepts, we develop a qualitative model of the secular evolution of the migrating planetary pair. Our approach is based on the analysis of the energy and the orbital angular momentum exchange between the two-planet system and an external medium; thus no specific kind of dissipative forces is invoked. We show that, under the assumption that dissipation is weak and slow, the evolutionary routes of the migrating planets are traced by the Mode I and Mode II stationary solutions of the conservative secular problem. The ultimate convergence and the evolution of the system along one of these secular modes of motion are determined uniquely by the condition that the dissipation rate is sufficiently smaller than the proper secular frequency of the system. We show that it is possible to reassemble the starting configurations and the migration history of the systems on the basis of their final states and consequently to constrain the parameters of the physical processes involved.

Reproductive ecology of dipsadine snakes, with emphasis on South American species

A relatively large amount of variation occurs in the reproductive ecology of tropical snakes, and this variation is generally regarded as being a consequence of seasonality in climate and prey availability. In some groups, even closely related species may differ in their reproductive ecology; however, in others it seems to be very conservative. Here we explore whether characters related to reproduction are phylogenetically constrained in a monophyletic group of snakes, the subfamily Dipsadinae, which ranges from Mexico to southern South America. We provide original data on reproduction for Leptodeira annulata, Imantodes cenchoa, and three species of Sibynomorphus from southern, southeastern and central Brazil, and data from literature for other species and populations of dipsadines. Follicular cycles were seasonal in Atractus reticulatus, Dipsa, albifrons, Hypsiglena torquata, Leptodeira maculata, L. punctata, Sibynomorphus spp. and Sibon sanniola from areas where climate is seasonal. In contrast, extended or continuous follicular cycles were recorded in Dipsas catesbyi, D. neivai, Imantodes cenchoa, Leptodeira annulata, and Ninia maculata from areas with seasonal and aseasonal climates. Testicular cycles also varied from seasonal (in H. torquiata) to continuous (in Dipsa,5 spp., Leptodeira annulata, L. maculata, N. maculata, and Sibynomorphus spp.). Most dipsadines are small (less than 500 rum SVL), and females attain sexual maturity with similar relative body size than males. Sexual dimorphism occurred in terms of SVL and tail length in most species, and clutch size tended to be small (less than five eggs). Combat behavior occurs in Imantodes cenchoa, which did not show sexual size dimorphism. Reproductive timing, for both females and males, varied among species but in general there were no differences between the tribes of Dipsadinae in most of the reproductive characteristics, such as mean body size, relative size at sexual maturity, sexual size and tail dimorphism, duration of vitellogenesis or egg-carrying in oviducts.

The comparative field body temperature among Liolaemus lizards: Testing the static and the labile hypotheses

Two competing hypotheses have been suggested to explain thermal sensitivity of lizards to environmental conditions. These are the static and the labile hypotheses. The static hypothesis posits that thermal physiology is evolutionary conservative and consequently relatively insensitive to directional selection. Contrarily, the labile hypothesis states that thermal physiology does respond readily to directional selection in some lizard taxa. In this paper, we tested both hypotheses among species of Liolaemus lizards. The genus Liolaemus is diverse with about 200 species, being broadly distributed from central Peru to Tierra del Fuego at the southern end of South America. Data of field body temperature (T(b)) from Liolaemus species were collected from the literature. Based on the distributional range of the species we also collected data of mean annual ambient temperatures. We observed that both the traditional analysis and the phylogenetic approach indicate that in the genus Liolaemus T(b) of species varies in a manner that is consistent with ecological gradient of ambient temperature. The data suggest that the thermal physiology of Liolaemus lizards is evolutionarily flexible, and that this plasticity has been partially responsible for the colonization of a wide array of thermal environments. (C) 2009 Elsevier Ltd. All rights reserved.

Astyanax bockmanni Vari and Castro, 2007: an ambiguous karyotype in the Astyanax genus

Despite the widespread distribution of Astyanax bockmanni in streams from Upper Parana River system in central, southeastern, and southern Brazil, just recently, it has been identified as a distinct Astyanax species. Cytogenetic studies were performed in two populations of this species, revealing conservative features. A. bockmanni shows 2n = 50 chromosomes, a karyotypic formula composed of 10 M + 12SM + 12ST + 16A and multiple Ag-NORs. Eight positive signals in subtelocentric/acrocentric chromosomes were identified by fluorescent in situ hybridization (FISH) with 18S rDNA probes. After FISH with 5S rDNA probes, four sites were detected, comprising the interstitial region of a metacentric pair and the terminal region on long arms of another metracentric pair. Little amounts of constitutive heterochromatin were observed, mainly distributed at distal region in two chromosomal pairs. Additionally, heterochromatin was also located close to the centromeres in some chromosomes. No positive signals were detected in the chromosomes of A. bockmanni by FISH with the As-51 satellite DNA probe. The studied species combines a set of characteristics previously identified in two different Astyanax groups. The chromosomal evolution in the genus Astyanax is discussed.

Resting metabolic rates of two orbweb spiders: A first approach to evolutionary success of ecribellate spiders

Spiders are considered conservative with regard to their resting metabolic rate, presenting the same allometric relation with body mass as the majority of land-arthropods. Nevertheless, web-building is thought to have a great impact on the energetic metabolism, and any modification that affects this complex behavior is expected to have an impact over the daily energetic budget. We analyzed the possibility of the presence of the cribellum having an effect on the allometric relation between resting metabolic rate and body mass for an ecribellate species (Zosis geniculata) and a cribellate one (Metazygia rogenhoferi), and employed a model selection approach to test if these species had the same allometric relationship as other land-arthropods. Our results show that M. rogenhoferi has a higher resting metabolic rate, while Z. geniculata fitted the allometric prediction for land arthropods. This indicates that the absence of the cribellum is associated with a higher resting metabolic rate, thus explaining the higher promptness to activity found for the ecribellate species. If our result proves to be a general rule among spiders, the radiation of Araneoidea could be connected to a more energy-consuming life style. Thus, we briefly outline an alternative model of diversification of Araneoidea that accounts for this possibility. (C) 2011 Elsevier Ltd. All rights reserved.

Fractal structures in nonlinear plasma physics

Fractal structures appear in many situations related to the dynamics of conservative as well as dissipative dynamical systems, being a manifestation of chaotic behaviour. In open area-preserving discrete dynamical systems we can find fractal structures in the form of fractal boundaries, associated to escape basins, and even possessing the more general property of Wada. Such systems appear in certain applications in plasma physics, like the magnetic field line behaviour in tokamaks with ergodic limiters. The main purpose of this paper is to show how such fractal structures have observable consequences in terms of the transport properties in the plasma edge of tokamaks, some of which have been experimentally verified. We emphasize the role of the fractal structures in the understanding of mesoscale phenomena in plasmas, such as electromagnetic turbulence.

The non-twist standard map with robust tori

The non-twist standard map occurs frequently in many fields of science specially in modelling the dynamics of the magnetic field lines in tokamaks. Robust tori, dynamical barriers that impede the radial transport among different regions of the phase space, are introduced in the non-twist standard map in a conservative fashion. The resulting non-twist standard map with robust tori is an improved model to study transport barriers in plasmas confined in tokamaks.

A geochemical and lead isotopic record from a small pond in a remote equatorial island, Fernando de Noronha, Brazil

A 72 cm long core was collected from Lagoa da Viracao (LV), a small poind in the Fernando de Noronha island, northern Brazil. Sediments from the lower section of the core (20-72 cm depth) contain essentially mineral matter, while in the upper section (0-20 cm depth) mineral matter is mixed with organic matter. Lithogenic conservative elements - Si, Al, Fe, Ti, Co, Cr, Cu, Ba, Ga, Hf, Nb, Ni, Y, V, Zn, Zr and REE - exhibit remarkably constant values throughout the core, with concentrations similar to those of the bedrock. The vertical distribution of soluble elements - Ca, Mg, Na, K, P, Mn and Sr - is also homogeneous, but these elements are systematically depleted in relation to the bedrock. LOI, TOC, Br, Se, Hg and Pb, although showing nearly constant values in the lower section of the core, are significantly enriched in the upper section. The concentration profiles of Br and Se suggest that they may be accounted for by natural processes, related to the slight affinity of these elements for organic matter. On the other hand, the elevated levels of Hg and Pb in recent sediments may be explained by their long-range atmospheric transport and deposition. Furthermore, the isotopic composition of Pb clearly indicates that anthropogenic sources contributed to the Pb burden in the uppermost pond sediments.

Three-dimensional, fully adaptive simulations of phase-field fluid models

We present an efficient numerical methodology for the 31) computation of incompressible multi-phase flows described by conservative phase-field models We focus here on the case of density matched fluids with different viscosity (Model H) The numerical method employs adaptive mesh refinements (AMR) in concert with an efficient semi-implicit time discretization strategy and a linear, multi-level multigrid to relax high order stability constraints and to capture the flow`s disparate scales at optimal cost. Only five linear solvers are needed per time-step. Moreover, all the adaptive methodology is constructed from scratch to allow a systematic investigation of the key aspects of AMR in a conservative, phase-field setting. We validate the method and demonstrate its capabilities and efficacy with important examples of drop deformation, Kelvin-Helmholtz instability, and flow-induced drop coalescence (C) 2010 Elsevier Inc. All rights reserved

Txtng as a replacement for standard written English : an attitude survey based on Age and Gender

Text messaging is a new form of writing, brought about by technological development in the last couple of decades. Mobile phone usage has increased rapidly worldwide and texting is now part of many people's everyday communcation. A large number of users send or receive texts which include some abbreviations and shortenings, commonly referred to as textspeak. This novel linguistic phenomenon is perceived by some with indifference and by others with aggravation. The following study examines attitudes towards this linguistic change from a gender and age perspective. The comparison between two groups show that the most conservative and least positive to change are young women. The analysis and discussion around this focuses on power, prestige and patterns.

Combates entre la memoria y la historia de Chile : Conflictos sobre el pasado reciente

The reestablishment of democracy in Chile has seen an intense debate about the events of the recent past, especially on the issue of human rights. From the very beginning, the Concertacion Government has been determined to discover the truth of the repression carried out by the national security forces with a series of commissions that have gathered the testimonies of victims and their relatives. These efforts have been resisted by conservative sectors linked to the dictatorship and the Armed Forces. There has been intense conflict in the media during the past 20 years about events that occurred during the rule of Salvador Allende and the Military Regime. In this regard, a great diversity of information has been produced which, together with the debate evoked, has enabled historians not only to rigorously and thoroughly reconstruct the operation of the state terror but also to explain how a significant sector of Chile’s civil society allowed that situation. This article presents, on one hand, different methodological tools in order to study the recent past and, on the other hand, the social discussion on how to do it.

The Björling 'Opera' : A children's Nursery Academy and an Italian Conservatory in Miniature

The aim in this chapter is to develop a deeper understanding about the informal Björling 'School' in Sweden. Contextually the example is related to the micro history of opera education contributing to the macro perspective illuminating a provincial example of the concept of domestic opera schooling. The specific focus was on Karl David Björling (1873-1926), the teaching parent of the Swedish tenor Jussi Björling (1911-1960) and his brothers Gösta and Olle.   The Björling family model of opera schooling belongs to the classical canon of domestic home education which was common during the epoch. The phenomenon is also within the field of opera singing an important reference to the historical context of the Nordic opera history of vocal education.   The uniqueness concerning the Björling School seems to be the rigorous and exceptionally early training. David Björling’s pedagogy was rooted in earlier German theories of musical upbringing. It's clear from his results that he was familiar with the neo-humanistic ideal on which reformed music education was based. Of a specific interest is the term Gesang als Unterricht as a concept for developing childrens musical and memorising capacities.   Conceptually the roots of the Björling model are in the eighteenth-century Romantic view of prodigies and their abilities. The extensive touring is connected to the promotion of wonder-children, and David Björling’s educational style to the conservative Master-pupil tradition.   David Björling's vocal ideal was a part of the contemporary debate about “The decadence of the singing art”, and seems to have its roots in an older Italian tradition. There are recurring similarities between his educational methods and the didactic principles of the Lamperti School: Enjoying a revival around the late 1800s and early 1900s, it has been called the natural or the national school. Nevertheless, through authentic experiences and gramophone recordings the Italian tenor Enrico Caruso became David Björling’s pedagogical role model.

The Family Novel in the Emerging Nation-State: A Comparative Study of Ba Jin’s Jia and Lev Tolstoy’s Anna Karenina

The theme of family in literature and in popular discourse occurs at times when the family as an institution is under attack. Attacks against the family coupled with defence of the family are viewed as the barometer of people’s satisfaction with the society in which they live. This outpouring of emotion, whether it is in defence of or attacking the family, is the result of the family’s position on the bridge between nature and society – a fortunate (or a detrimental) link between an individual and the units that make up a society. Across the United States and much of the western world, the battle for gay marriage and inclusive civil unions has revealed the fissures in our collective moral view of the family. The conservative concern about the absence of ‘family values’ is magnified by our situation in a world of flux. Inflation, war, terrorist threats, and the depletion of natural resources are but a few examples. When so much is unknown, how do we position ourselves? What anchors us to the past, gives us comfort in the present, and supports us in the future if not the family? Alternatively, what coddles us more in the past, shackles us more to the present, and lulls us more into a fixed conception of the future than the family? My research is not a sociological survey into the family nor does it stake any claims to understanding the present state of the family in society. The study seeks, however, to shed light on the rhetorical uses of the family by analysing two novels that are inextricably concerned with the theory of the family in times of heightened social change. In particular, my research focuses upon the social role and political meaning of the family in Anna Karenina and Jia.