Three-dimensional minimally invasive video-assisted thyroidectomy: preliminary report

Three-dimensional (3D) minimally invasive video-assisted thyroidectomy (MIVAT) was carried out with a 4-mm, 3D 0-degree stereoscopic endoscope. The procedure was applied on 3 patients who underwent total thyroidectomy and data were prospectively collected. Operative time for total thyroidectomy ranged from 72 to 90 minutes. Neither intra-nor post-operative complications were reported during the study. The surgical team noticed a good perception of depth and easy recognising of anatomic structures, especially concerning the upper and lower vascular pedicle, the parathyroids, the superior and inferior laryngeal nerves. Preliminary impression emerging from this study seems to suggest that 3D MIVAT is safe and effective. Future studies with larger case series are required to determine the role of this procedure

Infrahyoid fascio-myocutaneous flap as an alternative to free radial forearm flap in head and neck reconstruction.

The use of microvascular free flaps is currently the favored method for the reconstruction of defects after resection of head and neck cancer. The flap most commonly used for head and neck reconstruction is the free radial forearm flap, but the less popular infrahyoid flap represents a good alternative in selected cases. This flap has proven to be helpful in the reconstruction of a wide range of moderate-sized head and neck defects.We reviewed a series of 13 patients with defects resulting from cancer of the head and neck, who underwent infrahyoid flap reconstruction as an alternative to free radial forearm flap. The series includes 12 squamous cell carcinomas arising from the oral cavity and oropharynx, and 1 Merkel cell carcinoma of the submental skin. In the harvesting of the flap, the technical modifications recently suggested by Dolivet et al were used in all cases. Furthermore, another technical change has been introduced so creating a new infrahyoid facio-myocutaneous flap (IHFMCF). The surgical technique is described in detail.No total or partial flap necrosis was experienced. All reconstructions healed quickly without wound complications and with good functional results. The healing process in the donor site was excellent in every case with good aesthetic results.The IHFMCF is a versatile, reliable, and convenient flap suitable for repairing small and medium-sized defects of the oral cavity and oropharynx and obviates the need for a microvascular reconstruction

Magnetic-Oriented Nickel Particles and Nickel-Coated Carbon Nanotubes: An Efficient Tool for Enhancing Thermal Conductivity of PDMS Composites

In this study, PDMS composites are thermally cured with nickel particles and nickel-coated carbon nanotubes as fillers. Both fillers are oriented with the aim to increase the thermal conductivity of the silicone polymer network, due to the formation of a continuous thermal path. Scanning electron microscopy (SEM) gives a picture of the polymer network's morphology, proving the effective alignment of the nickel particles. Rheology and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) studies confirm the full curing of the silicon network and no influence in the curing kinetics of the type and content of fillers and their orientation. Dynamic mechanical thermal analysis (DMTA) and tensile analysis show instead different thermo-mechanical behavior of the polymer network due to the presence of different fillers, different fillers percentage, and orientation. Finally, the thermal transmittance coefficient (k) is studied by means of hot disk analysis, revealing the increment of almost 200% due to magnetic filler orientation

Autologous stem cell transplantation for aggressive non-Hodgkin's lymphomas

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Coating of bioactive glasses with chitosan: The effects of the glass composition and coating method on the surface properties, including preliminary in vitro results

Two bioactive glasses were coated with chitosan: SCNB belongs to the SiO2-CaO-Na2O system, and SCNA has the addition of Al2O3 to enhance chemical stability. Different coating methods were compared: direct physical attachment, surface activation through tresyl chloride, and polydopamine as a linker. The samples were char-acterized through SEM-EDS, contact angle measurements, FTIR, zeta potential titrations, tape tests, in vitro precipitation of hydroxylapatite (bioactivity), and cell cultures (RAW 264.7 and UMR-106) on some selected samples. Direct physical attachment (in acetic acid) or use of polydopamine allowed complete surface coverage, while it dropped to one-quarter on both glasses by using tresyl chloride. The coating had a contact angle of about 80 degrees and it well showed typical functional groups (FTIR). The coatings on SCNA were chemically and mechan-ically stable (classified as 4-5B by the tape tests, partially maintained after soaking for 14 days), and showed an isoelectric point around 8. On SCNB, the coatings were unstable (classified as 0-3B, dissolved during soaking) but bioactivity was preserved. The coating affected the biological outcome of SCNA with M0/M1 polarization (1 day) and reduced viability of macrophages (3 days), while osteoblastic cells showed poor adhesion but maintained cell viability and osteogenic potential (3-7 days)

Radioterapia intraoperatoria nei tumori maligni avanzati estesi all’orecchio medio: valutazione da uno studio retrospettivo

Obiettivo dello studio è stato quello di valutare la sicurezza, l’efficacia e i risultati funzionali della radioterapia intraoperatoria (IORT) seguita dalla radioterapia a intensità modulata (IMRT) nel trattamento di tumori maligni avanzati estesi all’orecchio medio. Sono stati inclusi nello studio in modo retrospettivo 13 pazienti consecutive affetti da tumore dell’orecchio esterno esteso all’orecchio medio. Il follow-up è stato in media di 33 mesi (range 6-133). Cinque pazienti (38%) erano di stadio III e 8 pazienti (62%) erano di stadio IV secondo la classificazione dell’Università di Pittsburgh. Una petrosectomia laterale (LTBR) è stata eseguita in tutti i pazienti, la LTBR è stata associata a parotidectomia in 5 (38%) casi e a svuotamento latero-cervicale associato a parotidectomia in 6 (46%) casi. In tutti i casi si è effettuata asportazione della malattia macroscopicamente evidente. Il trattamento chirurgico è stato completato da IORT (12 Gy) e IMRT (50Gy). Chemioterapia adiuvante è stata eseguita in 4 (30%) casi. Test audiometrici pre- e post-operatori sono stati eseguiti per valutare la perdita uditiva. Il tasso di controllo di malattia locale (LC) a 5 anni, di metastasi a distanza (DM) a 5 anni, la sopravvivenza libera da malattia (DFS) e la sopravvivenza globale (OS) a 5 anni sono state calcolate con il metodo di Kaplan-Meyer. Variazioni significative nella conduzione per via ossea sono state osservate dopo trattamento. Una necrosi parziale del lembo di ricostruzione è stata l’unica complicanza precoce osservata in 3(23%) casi, mentre una fistola meningea è stata osservata in un solo caso (7,6%) come complicanza tardiva. Il tasso di LC è stato del 68%. Il tasso di DM è stato del 90%. Il tasso di DFS è stato del 61%. Il tasso di OS è stato del 69%. La IORT seguita dalla IMRT nel trattamento dei tumori maligni avanzati dell’orecchio esterno e medio sembra essere sicuro. Nel nostro studio non sono riportati morti. La IORT può ridurre la dose di radioterapia postoperatoria a livello del tessuto residuo ottenendo la medesima dose a livello della sede del tumore. Non abbiamo osservato alcuna complicanza a livello dell’orecchio esterno residuo, mentre si è notato un peggioramento dell’udito anche a livello neurosensoriale. Sono necessari studi prospettici al fine di confermare quanto da noi osservato

Surface modification of Ti-6Al-4V alloy for biomineralization and specific biological response: Part I, inorganic modification

Titanium and its alloys represent the gold standard for orthopaedic and dental prosthetic devices, because of their good mechanical properties and biocompatibility. Recent research has been focused on surface treatments designed to promote their rapid osteointegration also in case of poor bone quality. A new surface treatment has been investigated in this research work, in order to improve tissue integration of titanium based implants. The surface treatment is able to induce a bioactive behaviour, without the introduction of a coating, and preserving mechanical properties of Ti6Al4V substrates (fatigue resistance). The application of the proposed technique results in a complex surface topography, characterized by the combination of a micro-roughness and a nanotexture, which can be coupled with the conventional macroroughness induced by blasting. Modified metallic surfaces are rich in hydroxyls groups: this feature is extremely important for inorganic bioactivity (in vitro and in vivo apatite precipitation) and also for further functionalization procedures (grafting of biomolecules). Modified Ti6Al4V induced hydroxyapatite precipitation after 15 days soaking in simulated body fluid (SBF). The process was optimised in order to not induce cracks or damages on the surface. The surface oxide layer presents high scratch resistance