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1.
Materials (Basel) ; 17(5)2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38473550

RESUMO

Temperature evolution during plastic deformation is of great importance for the design of manufacturing processes, as well as for the analysis and prediction of tool wear. However, the results from experimental- and numerical-type research are still often contradictory. In this paper, we analyze methods for estimating plasticity-induced heating directly from displacement fields that can be recorded during experiments or extracted from simulation results. In terms of computational methodology, the thermodynamically motivated energy-based variational formulation of the coupled thermo-mechanical boundary-value problem is adapted to the problem at hand. Since an analysis of this variational formulation exhibits challenges and distinct inconsistencies with respect to the problem at hand, an alternative approach is proposed. This alternative approach is essentially a purely thermal finite element simulation, and it is conducted using a heat source term that is empirically based on the fraction of irreversible deformation work converted to heat. Our approach estimates plasticity-induced heating based on the strain and strain rate data derived from displacement fields. We therefore incorporate thermo-visco-plastic constitutive behavior (Johnson-Cook) with a thermodynamically motivated model that specifies the fraction of plastic work converted to heat (the Taylor-Quinney coefficient).

2.
Sensors (Basel) ; 23(9)2023 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-37177611

RESUMO

Material models are required to solve continuum mechanical problems. These models contain parameters that are usually determined by application-specific test setups. In general, the theoretically developed models and, thus, the parameters to be determined become increasingly complex, e.g., incorporating higher-order motion derivatives, such as the strain or strain rate. Therefore, the strain rate behaviour needs to be extracted from experimental data. Using image data, the most-common way in solid experimental mechanics to do so is digital image correlation. Alternatively, optical flow methods, which allow an adaption to the underlying motion estimation problem, can be applied. In order to robustly estimate the strain rate fields, an optical flow approach implementing higher-order spatial and trajectorial regularisation is proposed. Compared to using a purely spatial variational approach of higher order, the proposed approach is capable of calculating more accurate displacement and strain rate fields. The procedure is finally demonstrated on experimental data of a shear cutting experiment, which exhibited complex deformation patterns under difficult optical conditions.

3.
J Imaging ; 8(9)2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36135396

RESUMO

Increasingly complex numerical analyses require more and more precise, accurate and varied input parameters in order to achieve results that are as realistic and reliable as possible. Therefore, experimental analyses for material parameter identification are of high importance and a driving force for further developments. In this work, opportunities by applying fractal analysis to optical measurement data of a shear cutting process are investigated. The fractal analysis is based on a modification of the concept of scale-space filtering. Scale exponent fields are calculated for the image sequences of the shear cutting process that are taken by a mobile microscope. A least-square approximation is used for the automated evaluation of the local scale exponent values. In order to determine the change of the scale exponent of individual material points, a digital image correlation is applied.

4.
Materials (Basel) ; 15(11)2022 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-35683099

RESUMO

Binder jetting is a layer-based additive manufacturing process for three-dimensional parts in which a print head selectively deposits binder onto a thin layer of powder. After the deposition of the binder, a new layer of powder is applied. This process repeats to create three-dimensional parts. The binder jetting principle can be adapted to many different materials. Its advantages are the high productivity and the high degree of freedom of design without the need for support structures. In this work, the combination of binder jetting and casting is utilized to fabricate metal parts. However, the achieved properties of binder jetting parts limit the potential of this technology, specifically regarding surface quality. The most apparent surface phenomenon is the so-called stair-step effect. It is considered an inherent feature of the process and only treatable by post-processing. This paper presents a method to remove the stair-step effect entirely in a binder jetting process. The result is achieved by controlling the binder saturation of the individual voxel volumes by either over or underfilling them. The saturation is controlled by droplet size variation as well as dithering, creating a controlled migration of the binder between powder particles. This work applies the approach to silica sand particle material with an organic binder for casting molds and cores. The results prove the effectiveness of this approach and outline a field of research not identified previously.

5.
Materials (Basel) ; 14(22)2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34832456

RESUMO

Non-oriented electrical steel sheets are applied as a core material in rotors and stators of electric machines in order to guide and magnify their magnetic flux density. Their contouring is often realized in a blanking process step, which results in plastic deformation of the cut edges and thus deteriorates the magnetic properties of the base material. This work evaluates the influence of the material's grain size on its iron losses after the blanking process. Samples for the single sheet test were blanked at different cutting clearances (15 µm-70 µm) from sheets with identical chemical composition (3.2 wt.% Si) but varying average grain size (28 µm-210 µm) and thickness (0.25 mm and 0.5 mm). Additionally, in situ measurements of blanking force and punch travel were carried out. Results show that blanking-related iron losses either increase for 0.25 mm thick sheets or decrease for 0.5 mm thick sheets with increasing grain size. Although this is partly in contradiction to previous research, it can be explained by the interplay of dislocation annihilation and transgranular fracturing. The paper thus contributes to a deeper understanding of the blanking process of coarse-grained, thin electrical steel sheets.

6.
Materials (Basel) ; 14(13)2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34279285

RESUMO

The structural optimization of manufacturable casting parts is still a challenging and time-consuming task. Today, topology optimization is followed by a manual reconstruction of the design proposal and a process assurance simulation to endorse the design proposal. Consequently, this process is iteratively repeated until it reaches a satisfying compromise. This article shows a method to combine structural optimization and process assurance results to generate automatically structure- and process-optimized die casting parts using implicit geometry modeling. Therefore, evaluation criteria are developed to evaluate the current design proposal and qualitatively measure the improvement of manufacturability between two iterations. For testing the proposed method, we use a cantilever beam as an example of proof. The combined iterative method is compared to manual designed parts and a direct optimization approach and evaluated for mechanical performance and manufacturability. The combination of topology optimization (TO) and process assurance (PA) results is automated and shows a significant enhancement to the manual reconstruction of the design proposals. Further, the improvement of manufacturability is better or equivalent to previous work in the field while using less computational effort, which emphasizes the need for suitable metamodels to significantly reduce the effort for process assurance and enable much shorter iteration times.

7.
Front Nutr ; 8: 634410, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33634161

RESUMO

We illustrate how scientific understanding of Food Oral Processing enables food product development with specific benefits for several target populations. in vivo, in vitro, and in silico approaches are discussed in the context of their ability to quantify oral processing from the molecular to the macroscopic scale. Based on this understanding, food structures with enhanced performance in terms of hedonic and nutritional properties as well as appropriateness for age and certain medical conditions can be developed. We also discuss current gaps and highlight development opportunities from an industry perspective.

8.
Materials (Basel) ; 14(2)2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33419146

RESUMO

Inorganically-bound core materials are used in foundries in high quantities. However, there is no validated mechanical failure criterion, which allows performing finite-element calculations on the core geometries, yet. With finite-element simulations, the cores could be optimised for various production processes from robotic core handling to the decoring process after the casting. To identify a failure criterion, we propose testing methods, that enable us to investigate the fracture behaviour of inorganically-bound core materials. These novel testing methods induce multiple bi-axial stress states into the specimens and are developed for cohesive frictional materials in general and for sand cores in particular. This allows validating failure criteria in principal stress space. We found that a Mohr-Coulomb model describes the fracture of inorganic core materials in a plane stress state quite accurately and adapted it to a failure criterion, which combines the Mohr-Coulomb model with the Weakest-Link theory in one consistent mechanical material model. This novel material model has been successfully utilised to predict the fracture force of a Brazilian test. This prediction is based on the stress fields of a finite element method (FEM) calculation.

9.
Curr Res Food Sci ; 3: 304-313, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33336192

RESUMO

The perception of some food attributes is related to mechanical stimulation and friction experienced in the tongue-palate contact during mastication. This paper reports a new bench test to measure friction in the simulated tongue-palate contact. The test consists of a flat PDMS disk, representing the tongue loaded and reciprocating against a stationary lower glass surface representing the palate. The test was applied to molten chocolate samples with and without artificial saliva. Friction was measured over the first few rubbing cycles, simulating mechanical degradation of chocolate in the tongue-palate region. The effects of chocolate composition (cocoa solids content ranging between 28 â€‹wt% and 85 â€‹wt%) and structure (micro-aeration/non-aeration 0-15 â€‹vol%) were studied. The bench test clearly differentiates between the various chocolate samples. The coefficient of friction increases with cocoa solids percentage and decreases with increasing micro-aeration level. The presence of artificial saliva in the contact reduced the friction for all chocolate samples, however the relative ranking remained the same.

10.
Oncotarget ; 11(20): 1862-1875, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32499871

RESUMO

PLAC1 (placenta enriched 1) is a mammalian trophoblast-specific protein. Aberrant expression of PLAC1 is observed in various human cancers, where it is involved in the motility, migration, and invasion of tumor cells, which are associated with the phosphoinositide 3-kinase (PI3K)/AKT pathway. We previously demonstrated that AKT activation mediates the downstream effects of PLAC1; however, the molecular mechanisms of PLAC1-induced AKT-mediated tumor-related processes are unclear. We studied human choriocarcinoma and breast cancer cell lines to explore the localization and receptor-ligand interactions, as well as the downstream effects of PLAC1. We show secretion and adherence of PLAC1 to the extracellular matrix, where it forms a trimeric complex with fibroblast growth factor 7 (FGF7) and its receptor, FGF receptor 2 IIIb (FGFR2IIIb). We further show that PLAC1 signaling via FGFR2IIIb activates AKT phosphorylation in cancer cell lines. As the FGF pathway is of major interest in anticancer therapeutic strategies, these data further promote PLAC1 as a promising anticancer drug target.

11.
Materials (Basel) ; 13(11)2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32503107

RESUMO

Inorganically-bound sand cores are used in many light-metal foundries to form cavities in the cast part, which cannot be realised by the mould itself. To enable FEM simulations with core materials, their mechanical properties have to be measured. In this article, we adapt methods to determine the Young's and shear modulus, the Poisson ratio and the fracture strain of sand cores. This allows us to fully parametrise an ideal brittle FEM model. We found that the Young's and shear modulus can be obtained acoustically via the impulse excitation technique. The fracture strain was measured with a high-speed camera and a digital image correlation algorithm.

12.
Food Chem ; 240: 573-578, 2018 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28946313

RESUMO

Flow injection mass spectrometry (FIMS) combined with chemometrics was evaluated for rapidly detecting economically motivated adulteration (EMA) of milk. Twenty-two pure milk and thirty-five counterparts adulterated with soybean, pea, and whey protein isolates at 0.5, 1, 3, 5, and 10% (w/w) levels were analyzed. The principal component analysis (PCA), partial least-squares-discriminant analysis (PLS-DA), and support vector machine (SVM) classification models indicated that the adulterated milks could successfully be classified from the pure milks. FIMS combined with chemometrics might be an effective method to detect possible EMA in milk.


Assuntos
Leite/química , Animais , Contaminação de Alimentos , Espectrometria de Massas , Proteínas do Leite , Mapeamento de Peptídeos , Análise de Componente Principal
13.
Artigo em Inglês | MEDLINE | ID: mdl-27055356

RESUMO

Synthetic and natural steroid hormones have attracted some attention in recent years as endocrine active substances (EAS) that interact or interfere with the endocrine system. Endogenous hormones occur naturally in food of animal origin, among which bovine milk represents an important source. This study was conducted to determine the occurrence of steroid hormones (oestrogens, androgens, progestogens and glucocorticoids) in cow's milk samples from three farms in Switzerland. An isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the quantification of 12 hormones in milk. Some hormonal levels from individual cows showed large variations. The average levels of the hormones analysed (17α-estradiol = 31 ng kg(-)(1), 17ß-estradiol = 6 ng kg(-)(1), estrone = 159 ng kg(-)(1), 4-androstenedione = 684 ng kg(-)(1), progesterone = 15486 ng kg(-)(1), 17-hydroxyprogesterone = 214 ng kg(-)(1), cortisone = 112 ng kg(-)(1), and cortisol = 235 ng kg(-)(1)) were comparable with literature data. Estriol, testosterone and androstenediols were not detected at their respective limit of quantification. No significant differences of hormonal content among milk from cows at different lactation/calving numbers were evidenced, except for progesterone and 4-androstenedione. Due to confounding parameters linked to the physiological stage of the animal, like pregnancy and gestational stage (pregnancy trimester), the causal correlation between the variation of the levels for these two hormones and the lactation/calving number could not be unambiguously demonstrated.


Assuntos
Androgênios/análise , Estrogênios/análise , Contaminação de Alimentos , Inspeção de Alimentos/métodos , Glucocorticoides/análise , Leite/química , Progestinas/análise , Animais , Animais Endogâmicos , Bovinos , Cromatografia Líquida de Alta Pressão , Indústria de Laticínios , Resíduos de Drogas/análise , Feminino , Técnicas de Diluição do Indicador , Lactação , Gravidez , Espectrometria de Massas por Ionização por Electrospray , Suíça , Espectrometria de Massas em Tandem
14.
PLoS Comput Biol ; 11(12): e1004640, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26714277

RESUMO

Even in the absence of sensory stimulation the brain is spontaneously active. This background "noise" seems to be the dominant cause of the notoriously high trial-to-trial variability of neural recordings. Recent experimental observations have extended our knowledge of trial-to-trial variability and spontaneous activity in several directions: 1. Trial-to-trial variability systematically decreases following the onset of a sensory stimulus or the start of a motor act. 2. Spontaneous activity states in sensory cortex outline the region of evoked sensory responses. 3. Across development, spontaneous activity aligns itself with typical evoked activity patterns. 4. The spontaneous brain activity prior to the presentation of an ambiguous stimulus predicts how the stimulus will be interpreted. At present it is unclear how these observations relate to each other and how they arise in cortical circuits. Here we demonstrate that all of these phenomena can be accounted for by a deterministic self-organizing recurrent neural network model (SORN), which learns a predictive model of its sensory environment. The SORN comprises recurrently coupled populations of excitatory and inhibitory threshold units and learns via a combination of spike-timing dependent plasticity (STDP) and homeostatic plasticity mechanisms. Similar to balanced network architectures, units in the network show irregular activity and variable responses to inputs. Additionally, however, the SORN exhibits sequence learning abilities matching recent findings from visual cortex and the network's spontaneous activity reproduces the experimental findings mentioned above. Intriguingly, the network's behaviour is reminiscent of sampling-based probabilistic inference, suggesting that correlates of sampling-based inference can develop from the interaction of STDP and homeostasis in deterministic networks. We conclude that key observations on spontaneous brain activity and the variability of neural responses can be accounted for by a simple deterministic recurrent neural network which learns a predictive model of its sensory environment via a combination of generic neural plasticity mechanisms.


Assuntos
Aprendizagem/fisiologia , Modelos Neurológicos , Plasticidade Neuronal/fisiologia , Biologia Computacional , Humanos , Modelos Estatísticos , Redes Neurais de Computação
15.
Oncotarget ; 6(28): 25356-67, 2015 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-26327325

RESUMO

Triple-negative breast cancer (TNBC) is a high medical need disease with limited treatment options. CD8+ T cell-mediated immunotherapy may represent an attractive approach to address TNBC. The objectives of this study were to assess the expression of CXorf61 in TNBCs and healthy tissues and to evaluate its capability to induce T cell responses. We show by transcriptional profiling of a broad comprehensive set of normal human tissue that CXorf61 expression is strictly restricted to testis. 53% of TNBC patients express this antigen in at least 30% of their tumor cells. In CXorf61-negative breast cancer cell lines CXorf61 expression is activated by treatment with the hypomethylating agent 5-aza-2'-deoxycytidine. By vaccination of HLA-A*02-transgenic mice with CXorf61 encoding RNA we obtained high frequencies of CXorf61-specific T cells. Cloning and characterization of T cell receptors (TCRs) from responding T cells resulted in the identification of the two HLA-A*0201-restricted T cell epitopes CXorf6166-74 and CXorf6179-87. Furthermore, by in vitro priming of human CD8+ T cells derived from a healthy donor recognizing CXorf6166-74 we were able to induce a strong antigen-specific immune response and clone a human TCR recognizing this epitope. In summary, our data confirms this antigen as promising target for T cell based therapies.


Assuntos
Antígenos de Neoplasias/administração & dosagem , Vacinas Anticâncer/administração & dosagem , Neoplasias de Mama Triplo Negativas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antígenos de Neoplasias/genética , Antígenos de Neoplasias/imunologia , Antígenos de Neoplasias/metabolismo , Linfócitos T CD8-Positivos/imunologia , Vacinas Anticâncer/genética , Vacinas Anticâncer/imunologia , Vacinas Anticâncer/metabolismo , Clonagem Molecular , Técnicas de Cocultura , Metilação de DNA , Mapeamento de Epitopos , Feminino , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Células HEK293 , Antígeno HLA-A2/genética , Antígeno HLA-A2/imunologia , Antígeno HLA-A2/metabolismo , Humanos , Esquemas de Imunização , Células K562 , Linfócitos do Interstício Tumoral/imunologia , Camundongos Transgênicos , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Receptores de Antígenos de Linfócitos T/genética , Receptores de Antígenos de Linfócitos T/imunologia , Receptores de Antígenos de Linfócitos T/metabolismo , Transfecção , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/imunologia , Neoplasias de Mama Triplo Negativas/metabolismo , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/imunologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-26793070

RESUMO

Recent evidence suggests that parallel synapses from the same axonal branch onto the same dendritic branch have almost identical strength. It has been proposed that this alignment is only possible through learning rules that integrate activity over long time spans. However, learning mechanisms such as spike-timing-dependent plasticity (STDP) are commonly assumed to be temporally local. Here, we propose that the combination of temporally local STDP and a multiplicative synaptic normalization mechanism is sufficient to explain the alignment of parallel synapses. To address this issue, we introduce three increasingly complex models: First, we model the idealized interaction of STDP and synaptic normalization in a single neuron as a simple stochastic process and derive analytically that the alignment effect can be described by a so-called Kesten process. From this we can derive that synaptic efficacy alignment requires potentiation-dominated learning regimes. We verify these conditions in a single-neuron model with independent spiking activities but more realistic synapses. As expected, we only observe synaptic efficacy alignment for long-term potentiation-biased STDP. Finally, we explore how well the findings transfer to recurrent neural networks where the learning mechanisms interact with the correlated activity of the network. We find that due to the self-reinforcing correlations in recurrent circuits under STDP, alignment occurs for both long-term potentiation- and depression-biased STDP, because the learning will be potentiation dominated in both cases due to the potentiating events induced by correlated activity. This is in line with recent results demonstrating a dominance of potentiation over depression during waking and normalization during sleep. This leads us to predict that individual spine pairs will be more similar after sleep compared to after sleep deprivation. In conclusion, we show that synaptic normalization in conjunction with coordinated potentiation--in this case, from STDP in the presence of correlated pre- and post-synaptic activity--naturally leads to an alignment of parallel synapses.


Assuntos
Aprendizagem/fisiologia , Modelos Neurológicos , Sinapses/fisiologia , Potenciais de Ação/fisiologia , Animais , Simulação por Computador , Espinhas Dendríticas/fisiologia , Potenciação de Longa Duração/fisiologia , Depressão Sináptica de Longo Prazo/fisiologia , Redes Neurais de Computação , Processos Estocásticos
17.
J Plast Reconstr Aesthet Surg ; 67(8): 1026-32, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24860933

RESUMO

Toxic epidermal necrolysis syndrome (TEN) is a potentially catastrophic exfoliative muco-cutaneous disorder first described by Lyell in 1956. It represents the most extensive form of Steven-Johnson syndrome. TEN is defined varyingly around the globe, but in the United Kingdom the consensus opinion describes the process as involving >30% of the total body surface area. It can rapidly become more extensive and threatens life. The estimated annual incidence is approximately 1-2 cases per million population. The risk of mortality increases with surface area involved and meta-analysis of the literature shows this risk to be between 16% and 55%. Over a six month period the Chelsea and Westminster Hospital Burns Service treated five consecutive patients with more than 80% total body surface area involvement or a more than 80% mortality risk, using the severity-of-illness score for toxic epidermal necrolysis (SCORTEN). All patients were treated according to the Chelsea and Westminster Hospital wound management algorithm with excellent outcome and no mortalities. The aim of this paper is to propose a generic TEN wound management algorithm according to the severity of skin lesions, using a simple wound grading system.


Assuntos
Algoritmos , Índice de Gravidade de Doença , Síndrome de Stevens-Johnson/classificação , Síndrome de Stevens-Johnson/terapia , Administração Tópica , Adulto , Unidades de Queimados , Materiais Revestidos Biocompatíveis/uso terapêutico , Ciclosporina/uso terapêutico , Emolientes/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Silicones/uso terapêutico , Dermatopatias Bacterianas/prevenção & controle , Transplante de Pele , Reino Unido
18.
Physiol Behav ; 124: 61-4, 2014 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-24471180

RESUMO

The human diet contains a large variety of aromas, tastes and textures. The latter is particularly important since it determines whether foods are difficult to process orally and thus can be one source of food avoidance. It has also been reported in recent literature that food texture was a main driver for satiation processes and thus it is of interest for the food manufacturing industry to be able to control textural properties of food within the limits of acceptability for the consumer. For solid foods, fracture force is an important aspect of texture and we were interested in understanding the physiological drivers of this variable.We present a third order lever model of human bite force and the space between teeth based on data from the literature on human oral anatomy. The results from the model are compared with experimental data available in the literature. The model compares well with the experimental data (r2 = 0.95, p = 0.0010, MPE = 0.18), and can thus be used to derive a diagram of how food properties such as piece size or fracture force can be used to define whether foods are close to the limits of what the human jaw is capable of breaking. Such modeling tools can be used to define texture rules for tailor-made nutrition for specific populations based on their mastication abilities. The limitations of this modeling approach are also discussed, particularly the fact that tooth shape should also be considered, as this will ultimately define fracture stress, which is the deterministic factor of food fracture.


Assuntos
Alimentos , Mastigação , Modelos Biológicos , Força de Mordida , Humanos
19.
Plast Reconstr Surg ; 132(4): 737-748, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24076666

RESUMO

BACKGROUND: Widespread adoption of the extended latissimus dorsi myocutaneous flap in breast reconstruction has been limited by donor-site complications. The dissection plane may be either above or below the superficial layer of the thoracolumbar fascia, which may be transferred with the flap or retained on the back skin flaps. The aim of this study was to investigate whether varying the plane of dissection improves donor-site morbidity and complications. METHODS: A comparative analysis of consecutive women treated with extended latissimus dorsi myocutaneous breast reconstruction by a single surgeon (D.F.) between 2006 and 2012 was performed. RESULTS: Eighty patients were reviewed. Between 2006 and 2011, 47 patients were treated with traditional suprafascial harvest (group A); the subsequent 33 patients between 2011 and 2012 had subfascial harvest (group B), retaining the superficial fascia on the back skin flaps. When compared with group A, group B patients showed significant reduction in both mean number of seroma drainage events (p = 0.027) and mean total aspirated seroma volume, which was reduced by half (p = 0.006). Group B patients also reported significant reduction in donor-site pain (p = 0.041) and donor-site scar adherence to the chest wall (p = 0.026). No increases in flap or donor-site dehiscence, partial flap loss, or other minor or major complications were observed. CONCLUSION: The technique of subfascial harvest during autologous latissimus dorsi flap breast reconstruction significantly improves back donor-site morbidity without compromising flap survival. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Retalho Miocutâneo , Complicações Pós-Operatórias/prevenção & controle , Músculos Superficiais do Dorso/transplante , Coleta de Tecidos e Órgãos/métodos , Fasciotomia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Morbidade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Parede Torácica/cirurgia , Resultado do Tratamento
20.
J Plast Reconstr Aesthet Surg ; 66(3): e66-8, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22871429

RESUMO

Radionecrotic ulcers due to breast cancer treatment is a highly morbid and disabling condition, causing pain, malodour, need for frequent dressings, reduced range of shoulder movements and an unacceptable cosmetic appearance. In patients with radiotherapy to the chest and/or axilla and general poor health the usual reconstructive options may not be suitable due to regional tissue damage and inappropriate long anaesthetic time, respectively. Described procedures include the pedicled latisimus dorsi flap, transverse rectus abdominal flap (TRAM) and omental transposition flap, as well as free tissue transfer (e.g. free TRAM, DIEP). We report a case of a morbidly obese female patient presenting with a large radionecrotic ulcer in her left axilla, following mastectomy, axillary clearance and local radiotherapy to left chest and axilla for breast cancer. She underwent reconstruction using an omental transposition flap, despite previous abdominal surgery.


Assuntos
Omento/transplante , Lesões por Radiação/cirurgia , Úlcera Cutânea/cirurgia , Retalhos Cirúrgicos , Axila/efeitos da radiação , Axila/cirurgia , Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/cirurgia , Feminino , Humanos , Mamoplastia/métodos , Mastectomia/métodos , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Obesidade Mórbida , Omento/cirurgia , Lesões por Radiação/fisiopatologia , Radiodermite/cirurgia , Radioterapia Adjuvante/efeitos adversos , Reto do Abdome/cirurgia , Medição de Risco , Índice de Gravidade de Doença , Úlcera Cutânea/etiologia , Resultado do Tratamento , Cicatrização/fisiologia
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