Triple-Cut Computer-Aided Design-Computer-Aided Modeling: More Oncologic Safety Added to Precise Mandible Modeling

PURPOSE: Computer-aided design-computer-aided modeling (CAD-CAM) has become standard in mandibular reconstruction because it offers better outcomes. Occasionally, the reconstructive plans need to be changed intraoperatively and the custom-made prefabricated devices may become inadequate. We present an efficient adjunct to the standard CAD-CAM technique that resolves this problem. MATERIALS AND METHODS: Customized surgical devices with our "triple-cut" concept were used in 5 patients for mandibular reconstruction with free fibula flap (4 after mandibular resection for squamous cell carcinoma and 1 after mandibular osteoradionecrosis). In all patients the mandibular and fibular cutting guides were provided with 3 different cutting levels per side. RESULTS: Three different cutting levels on the mandible permitted an accurate resection based on the intraoperative needs. The corresponding 3 "cutting levels" on the fibula created perfectly matching segments of vascularized bone. Good contact of bony segments was obtained in all patients. CONCLUSIONS: The prefabricated triple-cut cutting guides make changing the dimensions of bony resection, while still using the prefabricated CAD-CAM reconstructive plate, possible

MEDEA: a real time imaging pipeline for pixel lensing

Pixel lensing is a technique used to search for baryonic components of dark matter (MACHOs) and allows to detect microlensing events even when the target galaxies are not resolved into individual stars. Potentially, it has the advantage to provide higher statistics than other methods but, unfortunately, traditional approaches to pixel lensing are very demanding in terms of computing time. We present the new, user friendly, tool MEDEA (Microlensing Experiment Data-Analysis Software for Events with Amplification). The package can be used either in a fully automatic or in a semi-automatic mode and can perform an on-line identification of events by means of a two levels trigger and a quasi-on-line data analysis. The package will find application in the exploration of large databases as well as in the exploitation of specifically tailored future surveys.Comment: To appear in New Astronom

Correlations between atazanavir Ctrough and hyperbilirubinemia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hyperbilirubinemia is a common side effect of the antiretroviral agent atazanavir but is generally reversible upon discontinuation of treatment. We used therapeutic drug monitoring to investigate the occurrence of hyperbilirubinemia in a 49-year-old Hispanic man infected with HIV, following an overdose of ritonavir in ritonavir-boosted atazanavir therapy.</p> <p>Case presentation</p> <p>A 49-year-old Hispanic man with HIV who had received several highly active antiretroviral therapy regimens over a number of years including atazanavir-containing regimens, was diagnosed with hyperbilirubinemia. An inappropriate doubling of ritonavir boosting resulted in a high atazanavir C_troughand an initial rise in bilirubin plasma levels. Bilirubin levels later decreased, probably as a consequence of enzyme induction, while atazanavir plasma concentrations remained elevated.</p> <p>Conclusion</p> <p>This article describes an occurrence of hyperbilirubinemia in a man infected with HIV and supports the importance of therapeutic drug monitoring in investigations of hyperbilirubinemia among patients receiving antiretroviral agents. That the patient tolerated exceptionally high atazanavir levels further strengthens the tolerability profile of this drug.</p

Effect of vascular endothelial growth factor gene therapy on post-traumatic peripheral nerve regeneration and denervation-related muscle atrophy

Functional recovery after peripheral nerve injury depends on both improvement of nerve regeneration and prevention of denervation-related skeletal muscle atrophy. To reach these goals, in this study we overexpressed vascular endothelial growth factor (VEGF) by means of local gene transfer with adeno-associated virus (AAV). Local gene transfer in the regenerating peripheral nerve was obtained by reconstructing a 1-cm-long rat median nerve defect using a vein segment filled with skeletal muscle fibers that have been previously injected with either AAV2-VEGF or AAV2-LacZ, and the morphofunctional outcome of nerve regeneration was assessed 3 months after surgery. Surprisingly, results showed that overexpression of VEGF in the muscle-vein-combined guide led to a worse nerve regeneration in comparison with AAV-LacZ controls. Local gene transfer in the denervated muscle was obtained by direct injection of either AAV2-VEGF or AAV2-LacZ in the flexor digitorum sublimis muscle after median nerve transection and results showed a significantly lower progression of muscle atrophy in AAV2-VEGF-treated muscles in comparison with muscles treated with AAV2-LacZ. Altogether, our results suggest that local delivery of VEGF by AAV2-VEGF-injected transplanted muscle fibers do not represent a rational approach to promote axonal regeneration along a venous nerve guide. By contrast, AAV2-VEGF direct local injection in denervated skeletal muscle significantly attenuates denervation-related atrophy, thus representing a promising strategy for improving the outcome of post-traumatic neuromuscular recovery after nerve injury and repair

Lyme Borreliosis, Po River Valley, Italy

We aimed to determine the presence of Ixodes ricinus ticks in heavily populated areas of the Po River Valley after report of a Lyme disease case. Eighteen percent of ticks examined from 3 locations were positive for Lyme disease borreliae. Lyme disease was diagnosed for 3 workers at risk for tick bite

Microlensing as a probe of the Galactic structure; 20 years of microlensing optical depth studies

Microlensing is now a very popular observational astronomical technique. The investigations accessible through this effect range from the dark matter problem to the search for extra-solar planets. In this review, the techniques to search for microlensing effects and to determine optical depths through the monitoring of large samples of stars will be described. The consequences of the published results on the knowledge of the Milky-Way structure and its dark matter component will be discussed. The difficulties and limitations of the ongoing programs and the perspectives of the microlensing optical depth technique as a probe of the Galaxy structure will also be detailed.Comment: Accepted for publication in General Relativity and Gravitation. General Relativity and Gravitation in press (2010) 0

The POINT-AGAPE Survey I: The Variable Stars in M31

The POINT-AGAPE collaboration has been monitoring M31 for three seasons with the Wide Field Camera on the Isaac Newton Telescope. In each season, data are taken for one hour per night for roughly sixty nights during the six months that M31 is visible. The two fields of view straddle the central bulge, northwards and southwards. We have calculated the locations, periods and amplitudes of 35414 variable stars in M31 as a by-product of our microlensing search. The variables are classified according to their period and amplitude of variation. They are classified into population I and II Cepheids, Miras and semi-regular long-period variables. The population I Cepheids are associated with the spiral arms, while the central concentration of the Miras and long-period variables varies noticeably, the stars with brighter (and shorter) variations being much more centrally concentrated. A crucial role in the microlensing experiment is played by the asymmetry signal. It was initially assumed that the variable stars would not be a serious problem as their distributions would be symmetric. We demonstrate that this assumption is not correct. We find that differential extinction associated with the dust lanes causes the variable star distributions to be asymmetric. The size and direction of the asymmetry of the variable stars is measured as a function of period and amplitude of variation. The implications of this discovery for the successful completion of the microlensing experiments towards M31 are discussed. (Abridged)Comment: To appear in MNRAS. Revised version including additional discussion on color of variables. Additional data table will be available once the paper is publishe

MOA-2010-BLG-477Lb: constraining the mass of a microlensing planet from microlensing parallax, orbital motion and detection of blended light

Microlensing detections of cool planets are important for the construction of an unbiased sample to estimate the frequency of planets beyond the snow line, which is where giant planets are thought to form according to the core accretion theory of planet formation. In this paper, we report the discovery of a giant planet detected from the analysis of the light curve of a high-magnification microlensing event MOA-2010-BLG-477. The measured planet-star mass ratio is $q=(2.181\pm0.004)\times 10^{-3}$ and the projected separation is $s=1.1228\pm0.0006$ in units of the Einstein radius. The angular Einstein radius is unusually large $\theta_{\rm E}=1.38\pm 0.11$ mas. Combining this measurement with constraints on the "microlens parallax" and the lens flux, we can only limit the host mass to the range $0.13<M/M_\odot<1.0$. In this particular case, the strong degeneracy between microlensing parallax and planet orbital motion prevents us from measuring more accurate host and planet masses. However, we find that adding Bayesian priors from two effects (Galactic model and Keplerian orbit) each independently favors the upper end of this mass range, yielding star and planet masses of $M_*=0.67^{+0.33}_{-0.13}\ M_\odot$ and $m_p=1.5^{+0.8}_{-0.3}\ M_{\rm JUP}$ at a distance of $D=2.3\pm0.6$ kpc, and with a semi-major axis of $a=2^{+3}_{-1}$ AU. Finally, we show that the lens mass can be determined from future high-resolution near-IR adaptive optics observations independently from two effects, photometric and astrometric.Comment: 3 Tables, 12 Figures, accepted in Ap