Tomografia computadorizada da coluna lombar após artrodese com emprego de material metálico: avaliação da qualidade da imagem para diferentes algoritmos matemáticos

OBJETIVO: Selecionar os melhores algoritmos para o exame de coluna lombar na avaliação de artrodese com material metálico. MATERIAIS E MÉTODOS: Utilizou-se um equipamento de tomografia computadorizada de 16 fileiras de detectores. Imagens de dez pacientes foram reconstruídas com filtros 20, 40, 60 e 80 e realizadas reformatações em três dimensões e multiplanares com espessuras de 2 mm e 4 mm. Um total de 320 imagens foi avaliado por três experientes radiologistas, que deram notas de 1 a 5 (1 = não-aceitável; 2 = abaixo dos padrões; 3 = aceitável; 4 = acima da média; 5 = excelente). Além disso, foram realizadas medidas de ruído para correlação com o tipo de filtro utilizado. RESULTADOS: As médias do valor de ruído para reconstrução com 2 mm e filtros 20, 40, 60 e 80 foram de 24,7 ± 4,3; 35,5 ± 4,2; 106,0 ± 18,5 e 145,9 ± 26,9, respectivamente, e para 4 mm foram de 18,1 ± 2,4; 25,1 ± 4,6; 76,7 ± 17,2 e 106,6 ± 23,4. CONCLUSÃO: As imagens coloridas em três dimensões são mais bem visualizadas com filtro 20, entretanto, nas imagens em tons de cinza um filtro intermediário de 40 ou 60 pode ser útil para demonstrar os parafusos com maior detalhe. Para reconstruções multiplanares com espessura de 2 mm o filtro 40 é mais bem aceito, e para uma espessura de 4 mm um filtro 60 apresentou melhor qualidade.

Toimitusketjun materiaalihankinnan kehittäminen ja johtaminen

Tämän työn päätavoite on luoda toimintamalli alihankintaostoille siten, että alihankkijat voisivat käyttää materiaaliostoissaan päätoimittajan materiaalisopimuksia. Päätavoite voidaan jakaa osatavoitteisiin, joita ovat ennustemallin luominen materiaalitoimittajalle, käsittäen pituusleikkureiden raskaat rakenteet, tilaus-toimitusprosessi välille päätoimittaja-alihankkija materiaalitoimittaja ja kustannussäästöjen saavuttaminen toimitusketjussa. Työssä keskityttiin pituusleikkureiden raskaiden rakenteiden toimitusketjuun yhden alihankkijan ja materiaalitoimittajan kanssa. Raskaat rakenteet määriteltiin käsittämän teräslevyjä, jotka ovat yli 16 mm paksuudeltaan. Uutta toimintamallia lähdettiin kehittämään päätoimittajan tarpeiden pohjalta. Mukaan otettiin, myös alihankkijan ja materiaalitoimittajan tarpeita. Uusi toimintamalli sisältää ennustemallin ja uuden tilaus-toimitusprosessin. Uuden toimintamallin käyttöönotto kuitenkin keskeytyi matalasta kuormitustilanteesta johtuen. Saatuja tuloksia verrattiin osin teoriassa esitettyihin asioihin.

Keskisuuren teknologiayrityksen logistiikkaratkaisujen arviointi

Asiakkaat ovat nykyisin yhä tietoisempia tuotteen tuomasta arvosta. Uusiksi kilpailutekijöiksi ovat hinnan sijasta muodostumassa asiakaslähtöisyys, toiminnan laadukkuus ja yrityksen kyky synkronoida liiketoimintaprosesseja yhteistyössä asiakkaiden kanssa. Toimitusketjun hallinta on avainasemassa, kun pyritään saavuttamaan kilpailuetua uudessa kilpailutilanteessa. Yrityksien haasteeksi muodostuu koko arvoketjun kattavan strategisen yhteensopivuuden saavuttaminen sekä tasapainon löytäminen reagoivuuden ja tehokkuuden välille. Diplomityö käsittelee kohdeyrityksen nykyistä toimitusketjua ja kartoittaa kuinka eri logistiikkaratkaisut vaikuttaisivat yrityksen toimitusketjun materiaalivirtoihin ja kustannusrakenteeseen sekä kilpailukykyyn tulevaisuudessa. Työssä pyritään arvioimaan myös eri ratkaisujen vahvuuksia ja heikkouksia sekä käyttöönottoon liittyviä haasteita. Muutoksia on pyritty arvioimaan luomalla nykytilakuvauksen pohjalta simulointimalleja, joiden avulla voidaan mallintaa sekä materiaalivirtojen että kustannuksien muutoksia. Empiriaosassa on kuvattu eri logistiikkaratkaisujen vaikutukset materiaalivirtoihin ja logistiikkatoimintojen kokonaiskustannuksiin, sekä niiden edut ja haitat. Tämä mandollistaa eri logistiikkaratkaisujen arvioinnin ja tuo esille kuinka nykyistä toimitusketjua olisi kehitettävä, jotta kohdeyritys pystyy tulevaisuudessa parantamaan kilpailukykyään kustannustehokkaasti.

Sertifioidun puuraaka-aineen ja sertifioitujen tuotteiden tietojärjestelmän määrittely

Asiakkaiden kiinnostus tuotteiden raaka-aineiden alkuperää kohden on kasvanut. Puuraaka-aineesta tehtyjen tuotteiden alkuperä voidaan todentaa sertifikaatilla, jos puu on peräisin sertifioidusta metsästä ja sen alkuperäketju tunnetaan. Tieto sertifioidusta tuotteesta kulkeutuu asiakkaalle leimaamalla tuotteita sertifioinnista kertovin merkein tai merkitsemällä esimerkiksi tuotteen asiakirjaan sertifioinnista kertova teksti. Tutkimus tehtiin Stora Enson Imatran tehtaalle, jolla oli tarve uudelle tietojärjestelmälle. Tutkimuksen tarkoituksena oli määritellä sertifioidun puuraaka-aineen käytön ja sertifioituina myytävien tuotteiden seurannan mandollistava tietojärjestelmä. Puun alkuperäketjun hallinnan standardit määiittävät, paljonko sertifioitua puuta kohdennettava tuotteelle, jos tuotteita halutaan myydä sertifioituna. Tietojärjestelmän määrittelyn lisäksi oli tarve selvittää prosessi, kuinka tuotteisiin ja asiakirjoihin saataisiin sertifioinnista kertova leima. Tutkimusta tehdessä selvisi, että tehtaan nykyiset myyntitoiminnot ja tietojärjestelmät asettavat rajoituksia tuotteiden ja asiakirjojen leimaukselle. Prosessia kartoitettiin mm. haastatt elemalla tehtaan ti etojärj estelmi en, myynti- ja varastotoimintojen parissa työskenteleviä ihmisiä. Haastattelujen perusteella koottiin myös tietojärjestelmän asiakasvaatimukset. Vaatimusmäärittelyä tehdessä huomioitiin myös alkuperäketjun hallinnan standardien vaatimukset. Määriteltävän tietojärjestelmän toimintaa pyrittiin havainnollistamaan tehtaan edustajille prototyyppien avulla. Lisäksi tutkimuksessa on pyritty havainnollistamaan järjestelmän toimintaa erilaisin kaavioin ja kuvin. Haasteena työssä oli tulkita standardeja ja kerätä yhteen toisistaan poikkeavia asiakasvaatimuksia.

Disseny de les llantes en material compòsit de les rodes davanteres i roda posterior del vehicle de baix consum "Àguila"

Durant els últims dos anys un grup d’estudiants de l’Escola Politècnica Superior de laUniversitat de Girona han construït i evolucionat un prototip per competir en la Shell EcoMarathon, una cursa de caràcter internacional que es celebra cada any a Nogaro (França) ia on l’objectiu primordial és aconseguir el mínim consum. Equips de diferents països delmón recorren amb els seus prototips la mateixa distància i el guanyador és qui en finalitzarhagi fet servir menys quantitat de combustible. La intenció de l’equip és continuar competint en aquest cursa durant els propers anys, peraquest motiu cada any es plantegen noves modificacions a realitzar per tal d’aconseguir unprototip més competitiu. Una de les modificacions consisteix en substituir les actuals llantesd’alumini equipades en el vehicle per unes llantes lenticulars fabricades en fibra de carboni.Aquestes llantes en material compòsit representen una millora en prestacions respecte lesllantes convencionals en reduir la inèrcia.Escollir la fibra de carboni com el material a emprar no ha estat a l’atzar. Els avantatges quecomporta la fibra de carboni en referència als rati rigidesa/pes i resistència/pes sónindiscutibles. La resistència a la fatiga d’aquest tipus de material és més elevada que la del’alumini, material utilitzat en les actuals llantes, a més, la voluntat d’entendre millor elcomportament i els processos de fabricació d’aquest material per part dels membres del’equip posicionen a la fibra de carboni com el material més idoni.La solució final adoptada pel disseny de les llantes consta per la unió adhesiva de duespeces iguals fabricades en fibra de carboni. La facilitat de poder fabricar dos “plats” simètricsresulta el punt fort d’aquest disseny, el qual, amb un únic motllo s’arriben a construir latotalitat de les llantes

Cultura material i formes de vida a la Barcelona de mitjan segle XVII (1655-1660) : Les llars de taverners i hostalers a través dels inventaris dels seus béns

L'estudi dels inventaris postmortem ens ha permès apropar-nos a la quotidianitat de taverners i hostalers que visqueren durant el segle XVII a la ciutat de Barcelona. Aquest tipus de document notarial ens deixa, entre d'altres, testimoni de la cultura material; els objectes, estris, mobles, robes... que ens poden ajudar a entendre diferents usos i costums, així com altres aspectes relacionats amb les mentalitats.

Fiber-reinforced Composite as Oral Implant Material. Experimental studies of glass fiber and bioactive glass in vitro and in vivo

Fiber-reinforced composite as oral implant material: Experimental studies of glass fiber and bioactive glass in vitro and in vivo Department of Prosthetic Dentistry and Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland 2008. Biocompatibility and mechanical properties are important variables that need to be determined when new materials are considered for medical implants. Special emphasis was placed on these characteristics in the present work, which aimed to investigate the potential of fiber-reinforced composite (FRC) material as an oral implant. Furthermore, the purpose of this study was to explore the effect of bioactive glass (BAG) on osseointegration of FRC implants. The biocompatibility and mechanical properties of FRC implants were studied both in vitro and in vivo. The mechanical properties of the bulk FRC implant were tested with a cantilever bending test, torsional test and push-out test. The biocompatibility was first evaluated with osteoblast cells cultured on FRC substrates. Bone bonding was determined with the mechanical push-out test and histological as well as histomorplanimetric evaluation. Implant surface was characterized with SEM and EDS analysis. The results of these studies showed that FRC implants can withstand the static load values comparably to titanium. Threaded FRC implants had significantly higher push-out strength than the threaded titanium implants. Cell culture study revealed no cytotoxic effect of FRC materials on the osteoblast-like-cells. Addition of BAG particles enhanced cell proliferation and mineralization of the FRC substrates The in vivo study showed that FRC implants can withstand static loading until failure without fracture. The results also suggest that the FRC implant is biocompatible in bone. The biological behavior of FRC was comparable to that of titanium after 4 and 12 weeks of implantation. Furthermore, addition of BAG to FRC implant increases peri-implant osteogenesis and bone maturation.

Aggregate material formulated with MSWI bottom ash and APC fly ash for use as secondary building material

The main goal of this paper is to obtain a granular material formulated with Municipal Solid Waste Incinerarion (MSWI) bottom ash (BA) and air pollution control (APC) ash to be used as secondary building material. Previously, an optimum concrete mixture using both MSWI residues as aggregates was formulated. A compromise between the environmental behaviour and the economy of the process was considered. Unconfined compressive strength and abrasion resistance values were measured in order to evaluate the mechanical properties. From these results, the granular mixture was not suited for certain applications owing to the high BA/APC content and low cement percentages used to reduce the costs of the final product. Nevertheless, the leaching test performed showed that the concentrations of all heavy metals were below the limits established by the current Catalan legislation for their reutilization. Therefore, the material studied might be mainly used in embankments, where high mechanical properties are not needed and environmental safety is assured.

Reversible mitochondrial respiratory chain impairment during symptomatic hyperlactatemia associated with antiretroviral therapy

Direct evidence confirming the hypothesis that a dysfunction of the mitochondrial respiratory chain (MRC) underlies the pathogenesis of hyperlactatemia associated with highly active antiretroviral therapy (HAART) is scarce. We studied mitochondrial DNA (mtDNA) content and MRC function in the skeletal muscle of an HIV-infected patient during an episode of symptomatic hyperlactatemia. Skeletal muscle biopsy was performed during the episode when the patient was symptomatic and 3 months later when the patient was clinically recovered. Assessment of mitochondria was performed using histological, polarographic, spectrophotometrical, and Southern blot and real time PCR DNA quantification methods. The histological study disclosed extensive mitochondrial impairment in the form of ragged-red fibers or equivalents on oxidative reactions. These findings were associated with an increase in mitochondrial content and a decrease in both mitochondrial respiratory capacity and MRC enzyme activities. Mitochondrial DNA content declined to 53% of control values. Mitochondrial abnormalities had almost disappeared later when the patient became asymptomatic. Our findings support the hypothesis that MRC dysfunction stands at the basis of HAART-related hyperlactatemia.

Reversible mitochondrial respiratory chain impairment during symptomatic hyperlactatemia associated with antiretroviral therapy

Direct evidence confirming the hypothesis that a dysfunction of the mitochondrial respiratory chain (MRC) underlies the pathogenesis of hyperlactatemia associated with highly active antiretroviral therapy (HAART) is scarce. We studied mitochondrial DNA (mtDNA) content and MRC function in the skeletal muscle of an HIV-infected patient during an episode of symptomatic hyperlactatemia. Skeletal muscle biopsy was performed during the episode when the patient was symptomatic and 3 months later when the patient was clinically recovered. Assessment of mitochondria was performed using histological, polarographic, spectrophotometrical, and Southern blot and real time PCR DNA quantification methods. The histological study disclosed extensive mitochondrial impairment in the form of ragged-red fibers or equivalents on oxidative reactions. These findings were associated with an increase in mitochondrial content and a decrease in both mitochondrial respiratory capacity and MRC enzyme activities. Mitochondrial DNA content declined to 53% of control values. Mitochondrial abnormalities had almost disappeared later when the patient became asymptomatic. Our findings support the hypothesis that MRC dysfunction stands at the basis of HAART-related hyperlactatemia.

Gestió dels residus alimentaris municipals procedents de les activitats comercials del municipi de Montmeló per tal de reduir, reutilitzar i reciclar-los

En el present treball es proposa com lluitar contra el malbaratament alimentari que es genera al llarg de tota la cadena alimentària, sent aquest degut a causa d'una planificació poc adequada. L'objectiu principal és planificar i implantar un sistema de gestió per tal de recuperar l'excedent alimentari que es genera als comerços i les indústries del municipi de Montmeló, elaborant així un protocol per tal de poder redistribuir aquest aliment als sectors de la població en situacions econòmiques més precàries. Com a objectius secundaris, es pretén conscienciar, fomentar i potenciar el treball en xarxa entre els diferents agents implicats, com ara: la ciutadania, les entitats socials (Càritas Parroquial Montmeló), sector privat (establiments alimentaris del municipi, mercat municipal, indústries del sector alimentari) i el sector públic (departament de serveis socials, medi ambient, comerç i brigada municipal). A l'hora de planificar i implantar un sistema de gestió per tal de recuperar l'excedent alimentari, s'ha analitzat i valorat el camí que hi realitza, des d'on es genera fins al beneficiari final. Aquest s'ha gestionat per etapes, en les que s'han identificat els generadors, el tipus i quantitat d'aliment que malbaraten. S'ha proposat un nou sistema de recollida d'informació i les pautes que han de seguir per garantir el bon estat de l'aliment com: una taula de conservació, un protocol de funcionament, un document d'entrega i una fitxa de control de les condicions d'higiene. Per tal d'assolir una bona coordinació entre totes les parts, s'han realitzat reunions conjuntes entre els generadors, serveis socials i Càritas on s'ha acabat signant un acord de col·laboració. Entre les conclusions més rellevants cal destacar que ha servit per establir un precedent d'aprofitament alimentari al municipi de Montmeló, aconseguint alimentar a un gran nombre de famílies amb greus problemes econòmics. A més s'ha arribat a disminuir la quantitat de residus generats, amb el conseqüent estalvi de recursos econòmics i materials on s'ha recuperat un total de 5.760 Kg d'aliments aptes pel consum.

Auto Poisoning of the Respiratory Chain by a Quorum-Sensing-Regulated Molecule Favors Biofilm Formation and Antibiotic Tolerance.

Bacterial programmed cell death and quorum sensing are direct examples of prokaryote group behaviors, wherein cells coordinate their actions to function cooperatively like one organism for the benefit of the whole culture. We demonstrate here that 2-n-heptyl-4-hydroxyquinoline-N-oxide (HQNO), a Pseudomonas aeruginosa quorum-sensing-regulated low-molecular-weight excreted molecule, triggers autolysis by self-perturbing the electron transfer reactions of the cytochrome bc1 complex. HQNO induces specific self-poisoning by disrupting the flow of electrons through the respiratory chain at the cytochrome bc1 complex, causing a leak of reducing equivalents to O2 whereby electrons that would normally be passed to cytochrome c are donated directly to O2. The subsequent mass production of reactive oxygen species (ROS) reduces membrane potential and disrupts membrane integrity, causing bacterial cell autolysis and DNA release. DNA subsequently promotes biofilm formation and increases antibiotic tolerance to beta-lactams, suggesting that HQNO-dependent cell autolysis is advantageous to the bacterial populations. These data identify both a new programmed cell death system and a novel role for HQNO as a critical inducer of biofilm formation and antibiotic tolerance. This newly identified pathway suggests intriguing mechanistic similarities with the initial mitochondrial-mediated steps of eukaryotic apoptosis.

O6-Methylguanine-DNA methyltransferase protein expression by immunohistochemistry in brain and non-brain systemic tumours: systematic review and meta-analysis of correlation with methylation-specific polymerase chain reaction

Background: The DNA repair protein O6-Methylguanine-DNA methyltransferase (MGMT) confers resistance to alkylating agents. Several methods have been applied to its analysis, with methylation-specific polymerase chain reaction (MSP) the most commonly used for promoter methylation study, while immunohistochemistry (IHC) has become the most frequently used for the detection of MGMT protein expression. Agreement on the best and most reliable technique for evaluating MGMT status remains unsettled. The aim of this study was to perform a systematic review and meta-analysis of the correlation between IHC and MSP. Methods A computer-aided search of MEDLINE (1950-October 2009), EBSCO (1966-October 2009) and EMBASE (1974-October 2009) was performed for relevant publications. Studies meeting inclusion criteria were those comparing MGMT protein expression by IHC with MGMT promoter methylation by MSP in the same cohort of patients. Methodological quality was assessed by using the QUADAS and STARD instruments. Previously published guidelines were followed for meta-analysis performance. Results Of 254 studies identified as eligible for full-text review, 52 (20.5%) met the inclusion criteria. The review showed that results of MGMT protein expression by IHC are not in close agreement with those obtained with MSP. Moreover, type of tumour (primary brain tumour vs others) was an independent covariate of accuracy estimates in the meta-regression analysis beyond the cut-off value. Conclusions Protein expression assessed by IHC alone fails to reflect the promoter methylation status of MGMT. Thus, in attempts at clinical diagnosis the two methods seem to select different groups of patients and should not be used interchangeably.

Pulmonary 64-MDCT angiography with 50 mL of iodinated contrast material in an unselected patient population: a feasible protocol

Abstract Objective: To propose a protocol for pulmonary angiography using 64-slice multidetector computed tomography (64-MDCT) with 50 mL of iodinated contrast material, in an unselected patient population, as well as to evaluate vascular enhancement and image quality. Materials and Methods: We evaluated 29 patients (22-86 years of age). The body mass index ranged from 19.0 kg/m2 to 41.8 kg/m2. Patients underwent pulmonary CT angiography in a 64-MDCT scanner, receiving 50 mL of iodinated contrast material via venous access at a rate of 4.5 mL/s. Bolus tracking was applied in the superior vena cava. Two experienced radiologists assessed image quality and vascular enhancement. Results: The mean density was 382 Hounsfield units (HU) for the pulmonary trunk; 379 and 377 HU for the right and left main pulmonary arteries, respectively; and 346 and 364 HU for the right and left inferior pulmonary arteries, respectively. In all patients, subsegmental arteries were analyzed. There were streak artifacts from contrast material in the superior vena cava in all patients. However, those artifacts did not impair the image analysis. Conclusion: Our findings suggest that pulmonary angiography using 64-MDCT with 50 mL of iodinated contrast can produce high quality images in unselected patient populations.

Enhancing actions of peptides derived from the γ-chain of fetal human hemoglobin on the immunostimulant activities of monophosphoryl lipid A.

Hemoglobin and its structures have been described since the 1990s to enhance a variety of biological activities of endotoxins (LPS) in a dose-dependent manner. To investigate the interaction processes in more detail, the system was extended by studying the interactions of newly designed peptides from the γ-chain of human hemoglobin with the adjuvant monophosphoryl lipid A (MPLA), a partial structure of lipid A lacking its 1-phosphate. It was found that some selected Hbg peptides, in particular two synthetic substructures designated Hbg32 and Hbg35, considerably increased the bioactivity of MPLA, which alone was only a weak activator of immune cells. These findings hold true for human mononuclar cells, monocytes and T lymphocytes. To understand the mechanisms of action in more detail, biophysical techniques were applied. These showed a peptide-induced change of the MPLA aggregate structure from multilamellar into a non-lamellar, probably inverted, cubic structure. Concomitantly, the peptides incorporated into the tightly packed MPLA aggregates into smaller units down to monomers. The fragmentation of the aggregates was an endothermic process, differing from a complex formation but rather typical for a catalytic reaction.