Dynamic titanium prosthesis based on 3D-printed replica for chest wall resection and reconstruction

3D-printing technologies can assist the surgical planning and prosthesis engineering for the management of extended chest wall resection. Different types of prosthesis have been utilized over time, but some concerns remain about their impact on the respiratory function. Here we present a new kind of 3D-printed titanium prosthesis designed to be either strong and flexible. The prosthesis was created on a 1:1 3D-printed anatomic replica of the chest, used to delineate surgical margins and to define the reconstructive requirements

Effects of Forage Availability on Grazing Behavior of Heifers

Effects of decreasing availability of crested wheatgrass (Agropyron desertorum and Agropyron cristatum) on grazing time and biting rate of Angus heifers were investigated. In the first year of the study, as standing crop decreased from 474 to 170 kg dry matter/ha, grazing time increased from 517 to 203 min/day, while biting rate increased from 56 to 64 bites/min. In the second year, as standing crop decreased from 919 to 144 kg dry matter/ha, grazing time increased from 380 to 656 min/day while biting rate increased from 37 to 50 bites/min. Grazing times were similar to those reported in the literature for pastures having much higher levels of available forage. Although grazing times may be correlated with available forage, comparison of grazing times under different pasture conditions are not meaningful unless considered along with other forage and animal factors. On crested wheatgrass pastures, maximum biting rates occurred at lower levels of available forage than reported on tropical pastures.This material was digitized as part of a cooperative project between the Society for Range Management and the University of Arizona Libraries.The Journal of Range Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202

Diet and forage quality of intermediate wheatgrass managed under continuous and short-duration grazing

Diet quality and forage quality were determined under short-duration and continuous grazing of intermediate wheatgrass (Agropyron intermedium) in 72-day grazing trials in 1985 and 1986. The short-duration unit was divided into 8 subunits grazed sequentially for 3 days each. Six crossbred heifers and 2 esophageally fistulated steers were randomly assigned to each grazing treatment. Animals were weighed and fecal samples, pasture samples, and diet (esophageal masticate) samples were collected in each of the three 24-day periods. In vitro organic matter disappearance (IVOMD) of steer diets under short-duration grazing declined linearly across periods of both years and across days within periods in 1986. Crude protein content of steer diets under short-duration grazing declined quadratically across periods in 1986. Crude protein and IVOMD content of steer diets under continuous grazing declined linearly in 1985. The effects of 4 maturities of intermediate wheatgrass on digestibility and ruminal kinetics were compared in a 4 × 4 Latin square design with 4 ruminally and abomasally fistulated crossbred wethers. Organic matter intake and digestibility, in situ rate and extent of NDF digestion, liquid passage rate and particulate mass flowing from the rumen decreased linearly with increased forage maturity. These data suggested that effects of forage maturity or period of grazing had similar effects on diet quality and forage quality. However, diet quality under short-duration grazing also declined across days within subunits.This material was digitized as part of a cooperative project between the Society for Range Management and the University of Arizona Libraries.The Journal of Range Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202

[Primary hyperparathyroidism: the recent findings].

Primary hyperparathyroidism is a quite frequent disease, the incidence of which has been found to increase over the past two decades. At the same time there has been a remarkable change in its clinical presentation; therefore this endocrine disorder earlier considered rare but almost always associated with complications, now appears a quite common and uncomplicated disease. In our series of 150 patients diagnosed between 1966 and 1989 the female/male ratio was found to be 1.77. The ratio has significantly increased (2.09), beginning from 1983; this was mainly due to the availability of a bone densitometer at our Mineral Metabolism Service with consequent greater demand of serum calcium determination as a part of routine metabolic screening for prevention of postmenopausal osteoporosis. Whilst the percentage of patients with renal manifestations of the disease has not significantly changed during these years, the amount of asymptomatic patients (yrs 1966-1983 = 3.7% vs yrs 1984-1989 = 39.7%) has progressively increased to the detriment of patients with skeletal symptoms. Serum intact parathyroid hormone determination by immunoradiometric assay (and possibly by immunochemiluminometric assay) seems to have overcome some of the methodological problems inherent in conventional radioimmunoassay. Surgical treatment of primary hyperparathyroidism is safe and highly effective in experienced hands. Recurrence has been observed only in three cases after resection of parathyroid adenoma, thus indirectly supporting a monoclonal origin of the tumor. Medical behavior (conservative or surgical management) in respect to patients with the mild or asymptomatic form of the disease, especially when diagnosed in old age, is uncertain at this point in time. Future prospective studies carried out on a large number of patients are needed to better clarify this issue

SERUM OSTEOCALCIN IN PRIMARY HYPERPARATHYROIDISM - SHORT-TERM EFFECT OF SURGERY

[No abstract available

Impatto della microalbuminuria nel decorso post operatorio in chirurgia toracica

IMPATTO DELLA MICROALBUMINURIA NEL DECORSO POSTOPERATORIO IN CHIRURGIA TORACICA Topic: Le nuove tecnologie; Tipo di presentazione: Presentazione orale Scopo del lavoro La micro-albuminuria (MA) è manifestazione di un aumento generalizzato della permeabilità vascolare ed un marker precoce e sensibile di disfunzione endoteliale. Alcuni studi hanno attribuito un significato prognostico negativo al brusco aumento di MA dopo trauma, ustioni, pancreatiti, danno da rivascolarizzazione, chirurgia maggiore, ALI e ARDS. Le potenziali implicazioni dell’aumento della MA nel postoperatorio in chirurgia toracica non sono state ancora indagate. Materiali e Metodi Studio prospettico osservazionale, a breve termine, condotto su 171 pazienti consecutivi sottoposti in elezione ad intervento di chirurgia toracica. In aggiunta alle valutazioni eseguite di routine, i pazienti sono stati sottoposti pre-operatoriamente, in prima e quarta giornata postoperatoria a determinazione urinaria di microalbumina espressa in valore assoluto (mediante determinazione quantitativa immuno-istochimica) e come rapporto microalbuminuria/creatininuria. Obiettivo primario: documentare se l’escrezione di MA implichi un rischio aumentato di complicanze a breve periodo. Obiettivo secondario: relazione tra MA e una serie di parametri fisiopatologici peri-operatori quali ritenzione idrica post-operatoria, BNP, rapporto pa02/Fi02. Risultati Sono stati arruolati 59 donne e 112 uomini, età media 63 anni; 19 diabetici, 63 ipertesi e 75 affetti da BPCO. Abbiamo eseguito 80 lobectomie, 8 pneumonectomie, 6 timectomie, e 87 resezioni polmonari sublobari; 122 in toracotomia e 49 VATS. Mortalità postoperatoria: 2 (ARDS); Complicanze maggiori: 9 (chilotorace: 3, insufficienza respiratoria: 3, fistola bronchiale minima: 1, IMA: 1, IRA: 1). Complicanze minori: 16 (FA: 14, perdite aeree > 7 giorni: 2). La MA preoperatoria era normale, valore medio: 0.61 mg/dl (0.48 - 0.79). In prima giornata abbiamo documentato un marcato aumento, valore medio: 4.45 (3.50 - 5.65), p<0.001. Un aumento ancora più spiccato si è osservato nei pazienti diabetici ed ipertesi valore medio rispettivamente: 8.95 (1.54 - 52.09), p<0.001 e 5.852 (4.04 - 8.46), p<0.001. In prima giornata postoperatoria abbiamo trovato differenze statisticamente non significative in relazione all’approccio chirurgico. Le complicanze postoperatorie non sono risultate statisticamente correlate con l’escrezione di MA. Conclusioni Il nostro studio conferma che MA è espressione della reazione dell’organismo allo stress chirurgico e costituisce un indice precoce di aumentata permeabilità vascolare in parte rapportato all’entità dello stress. Come atteso, nel post-operatorio, è stato riscontrato incremento maggiore di MA nei pazienti diabetici, ipertesi e sottoposti ad intervento toracotomico, quest’ultimo dato, peraltro, statisticamente non significativo. Non viene confermato il valore prognostico negativo a breve periodo espresso da altri autori