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Abstract:In spite of more recent techniques for breast reduction, the inferior pedicle technique has proven to be enduring being a still a very popular option in the plastic surgeons armamentarium despite certain shortcomings. This utility is especially so for the treatment of large breasts with a long sternal notch to nipple distance. The modifications we describe in this article, overcome some of the main drawbacks of the standard inferior pedicle technique, and is particularly effective when used with appropriately selected patients. This is achieved principally by the making of a strong, durable and internalized "dermal cage" that remains fixed to the chest wall in the upper part, as well as on both sides, to support the majority of the remaining breast tissue. This serves several purposes, including the narrowing of the breast, thereby giving good projection and reduction of the N-IMF length of the inferior pedicle.Through suspension and fixation of the inferior pedicle to the chest wall, one can obtain mitigation of the effects of gravity on the inferior pedicle. The benefits include reduced tension on the T junction, thereby reducing the incidence of wound dehiscence in the immediate post-operative phase; whilst reduction of tension on the NAC reduces "bottoming" out over the longer-term. This process has been the main short coming of the inferior pedicle technique to date.The technique was used for 26 patients over a 7 year period with a mean long term follow up of 41 months. The results demonstrate the short and long time effectiveness of our own particular combination of modifications to previously described techniques and modifications of the inferior pedicle breast reduction.EBM level: V 2

Arterial myocardial revascularization using different arterial conduits as mammary, radial, gastroepiploic, subscapular and epigastric arteries are well documented. This report describes a preparation and use of thoracodorsal artery as a free graft for coronary artery bypass grafting. The preparation and removal of thoracodorsal artery were performed through right axilla. The artery was used as a free conduit for left anterior descending artery (LAD) in a 58-year-old female for the second revascularization. The saphenous veins, mammary arteries, right radial artery and epigastric artery were not available. The perioperative course was uneventful and we can recommend the graft as an alternative for such cases.

The research project named "Flexibly Beyond" studied and experimented innovative models for the enhancement of the role of senior workers and prolongation of their working life. The research was based on the application of innovative methods and tools to the ageing society and in particular to the European manufacturing companies represented in the project by apparel and footwear sectors. The project was funded under the Innovative Measures of the art.6 of the European Social Fund (VS/2006/0353) and coordinated by Politecnico Calzaturiero. The real strength of the project was the large network including all the actors of the value chain which allows transferring the theoretical findings to practical level in SMEs manufacturing context.

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