Introduction to "Propeller Flaps"

open2siThe editors of this issue of Seminars in Plastic Surgery dedicated to propeller flaps met in 2009 at the "1st Tokyo Meeting on Perforator and Propeller Flaps." On that occasion, as part of the advisory panel of the meeting, they contributed to the definition and classification of these flaps. Since then, several evolutions and new applications of propeller flaps appeared in the literature. In 2019, the editors met again in Bologna, Italy, where they decided to collect the experiences from prominent authors in propeller flap surgery and provide them to the readers in this monographic dedicated publication.embargoed_20210921Pignatti, M; Hallock, GGPignatti, M; Hallock, G

MIVIS image geocoding experience on merging position attitude system data and public domain GPS stream (ASI-GeoDAF)

The use of airborne scanners involves geo-referencing problems, which are difficult because of the need to know the exact platform position and attitude for each scan line. The errors of the onboard navigation system are normally corrected using ground control point on the image. This post-processing correction procedure is too long in case of multiple flight campaigns, and besides it implies the need to have available 1:10000 orthophotoimages or maps in digital format. To optimize the above procedure a new method to correct MIVIS navigational data in the post-processing phase has been implemented. The procedure takes into consideration the GPS stream in Rinex format of common knowledge and findable on the web, acquired at the ground stations of the Geodetic Data Archiving Facilities provided by ASI. The application of this correction entails the assumption that the environmental variables affecting both onboard and geodetic GPS equally affect the position measurements. The airborne data correction was carried out merging the two data sets (onboard and ground station GPS) to achieve a more precise aircraft trajectory. The present study compares the geo-coded images obtained by means of the two post-processing methods

Prevalence of low antithrombin levels in preeclamptic women and perinatal outcome

Objective. The aim of this study is to evaluate the prevalence of low antithrombin levels in our population in order to assess an intervention trial feasibility. Methods. This is a retrospective study. A database was created by using queries to find out medical records of patients requiring hospitalization for preeclampsia or gestational hypertension or superimposed preeclampsia to chronic hypertension at Modena University Hospital between June 2015 and July 2019. Results. We screened 11845 deliveries. Overall, 221 (1.9%) cases of preeclampsia were identified. Antithrombin level was available for 201 women, thus included in the analysis. Median antithrombin value was 87% (IQ range: 77-98). The prevalence of low antithrombin levels was 9%. Antithrombin < 80% was found in 21% of the subjects. The remnant showed normal values. Median antithrombin was significantly lower in severe respect with mild preeclampsia (83% ± 14 vs 89% ± 14, p = 0.003). The rate of small for gestational age was significantly higher in low antithrombin levels group (44.4% vs 22.4%, p = 0.042). Considering mean values, antithrombin levels were also significantly lower in case of small for gestational age (84% ± 14 vs 89% ± 14; p = 0.040). Conclusions. In our population, low antithrombin levels (1 in 10 patients) were associated with severity of preeclampsia, namely with small for gestational age babies. Data suggest this subpopulation as a better target for trials assessing the efficacy of antithrombin supplementation

Vaginal alpha-lipoic acid shows an anti-inflammatory effect on the cervix, preventing its shortening after primary tocolysis. A pilot, randomized, placebo-controlled study

Introduction: Inflammation might be an important underlying cause of preterm birth. Our aim is to explore whether vaginal administration α-lipoic acid reduces cervical inflammation and shortening after primary tocolysis. Materials and methods: Singleton pregnancies between 24–30 weeks remaining undelivered after hospitalization for preterm labor were randomly allocated to placebo (20 women, 15 analyzed) or vaginal ALA 400 mg (active ingredient 10 mg) daily (20 women, 17 analyzed) for 30 days. A cervical swab to quantify pro-inflammatory (IL1, IL2, IL6, IL8, TNFα) and anti-inflammatory (IL4, IL10) cytokines as well as transvaginal ultrasound cervical length measurement (CL) were performed before and after treatment. Results: The % changes of pro-inflammatory cytokines do not differ between treatment groups, while IL4 significantly increases by vaginal ALA in comparison to placebo (118.0 ± 364.3% versus 29.9 ± 103.5%, p = 0.012). Combined anti-inflammatory cytokines show same trend (292.5 ± 208.5% versus 64.5 ± 107.4, p = 0.03). CL remains similar in vaginal ALA group (from 23.1 ± 6.6 to 20.80 ± 7.9 mm), while it significantly decreased in placebo group (from 20.4 ± 6.5 to 13.8 ± 7.5 mm, p < 0.001 versus Baseline; p = 0.003 versus vaginal ALA). Conclusion: Vaginal ALA significantly stimulates anti-inflammatory ILs in the cervix of undelivered women after a preterm labor episode. This effect is associated with a stabilization of the CL

Treatment of Recurrent Tracheocutaneous Fistulas in the Irradiated Neck with a Two Layers-Two Flaps Combined Technique

The development of a tracheocutaneous fistula (TCF) is a well-documented complication after tracheostomy, especially in chronic morbid patients, in whom tubes or cannulas are left in place over time, or in irradiated patients. Surgical treatments are therefore needed which range from simple curettage and dressings to local skin flaps, muscle flaps and, in the more complex cases, microsurgical free tissue transfers. We present a novel combined technique used to successfully treat recurrent TCFs in irradiated patients, involving a superiorly based turnover fistula flap and a sternocleidomastoid transposition flap

Induced pluripotent stem cell-based models: Are we ready for that heart in a dish?

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Relations between morphological settings and vegetation covers in a medium relief landscape of Central Italy

Mount area, a medium relief structure within the Italian Latium region. The study aims at defining the relationships between vegetation and landform types and highlighting the main morphological characteristics within examined land cover classes. These were the result of the application of a supervised classification method to the first 28 (VISNIR) bands of the airborne MIVIS data collected within an extensive survey campaign over Rome Province. The analysis was supported by photo-interpretation of peculiar MIVIS band combinations and by data acquired during field surveys and from a pre-existing vegetation map. The morphometric data were obtained by processing a raster DEM created from topographic maps. These data were processed by means of a new morphometric classification method based on the statistical multivariate investigation of local topographic gradients, calculated along the 8 azimuth directions of each pixel neighbourhood. Such approach quickly estimates the spatial distribution of different types of homogeneous terrain units, emphasizing the impact of erosional and tectonic processes on the overall relief. Mutual relations between morphometric units and vegetation types were assessed by performing a correspondence analysis between the results of the two classifications

MIVIS image geocoding experience on merging position attitude system data and public domain GPS stream (ASI-GeoDAF)

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Bronchoalveolar lavage, sputum and exhaled clinically relevant inflammatory markers: values in healthy adults.

11noBronchoalveolar lavage (BAL), induced sputum and exhaled breath markers (exhaled nitric oxide and exhaled breath condensate) can each provide biological insights into the pathogenesis of respiratory disorders. Some of their biomarkers are also employed in the clinical management of patients with various respiratory diseases. In the clinical context, however, defining normal values and cut-off points is crucial. The aim of the present review is to investigate to what extent the issue of defining normal values in healthy adults has been pursued for the biomarkers with clinical value. The current authors reviewed data from literature that specifically addressed the issue of normal values from healthy adults for the four methodologies. Most studies have been performed for BAL (n = 9), sputum (n = 3) and nitric oxide (n = 3). There are no published studies for breath condensate, none of whose markers yet has clinical value. In healthy adult nonsmokers the cut-off points (mean+2sd) for biomarkers with clinical value were as follows. BAL: 16.7% lymphocytes, 2.3% neutrophils and 1.9% eosinophils; sputum: 7.7 x 10(6).mL(-1) total cell count and 2.2% eosinophils; nitric oxide: 20.2 ppb. The methodologies differ concerning the quantity and characteristics of available reference data. Studies focusing on obtaining reference values from healthy individuals are still required, more evidently for the new, noninvasive methodologies.nonemixedBALBI B; PIGNATTI P; CORRADI M; BAIARDI P; BIANCHI L; BRUNETTI G; RADAELI A; MOSCATO G; MUTTI A; SPANEVELLO A; MALERBA MBalbi, B; Pignatti, P; Corradi, M; Baiardi, P; Bianchi, L; Brunetti, G; Radaeli, A; Moscato, G; Mutti, A; Spanevello, Antonio; Malerba, M