Superomedial pedicle skin-reducing mastectomy in ptotic and large-sized breasts with two-stage reconstruction through transaxillary video-assisted technique: An effective surgical and anesthetic approach.

Introduction: Skin-reducing mastectomy has been applied to several surgical techniques in which subcutaneous mastectomy is associated with various types of skin reduction, with preservation of a lower dermal flap to reinforce the inferior lateral seat of an implant. The aim of the study is to present a case series of patients with pendulous/ptotic and/or large-sized breasts treated for breast cancer at the Breast Surgery Unit of Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy, with the superomedial pedicle skin-reducing mastectomy technique, two-stage reconstruction, and transaxillary video-assisted technique, when a postoperative radiotherapy was indicated. We verified its effectiveness by discussing its results, especially in patients who are candidates for postmastectomy radiotherapy. Materials and methods: A single-center retrospective study was performed between January 2020 and March 2021 on a prospectively filled database of conservative mastectomies. Of the 64 patients who underwent nipple/skin-sparing mastectomies in the mentioned period, 17 (mean age 46 years, range 30-62 years) were treated with superomedial pedicle skin-reducing mastectomy, with two-stage breast reconstruction through transaxillary video-assisted replacement expander with definitive prosthesis and contralateral symmetrization, selected for postmastectomy radiotherapy. Results: We had only three minor complications. No flap necrosis, no infections, no breast seromas, and no reconstructive failures were observed. During follow-up of the patients treated with video-assisted reconstruction, there were no cases of infection, hematoma, implant rupture, or suture dehiscence in the reconstructed breast. Discussion: Skin-reducing mastectomy with superomedial pedicle is a safe and reliable procedure to treat breast cancer in selected patients, i.e., those with pendulous/ptotic and or large-sized breasts. Particularly, in patients who undergo postmastectomy radiotherapy, the two-stage reconstruction with video-assisted transaxillary endoscopic approach can find its main indication, using incisions positioned far from the mammary region, offering numerous advantages.

Dual Langmuir-probe array for 3D plasma studies in TORPEX.

We have designed and installed a new Langmuir-probe (LP) array diagnostic to determine basic three-dimensional (3D) features of plasmas in TORPEX. The diagnostic consists of two identical LP arrays, placed on opposite sides of the apparatus, which provide comprehensive coverage of the poloidal cross section at the two different toroidal locations. Cross correlation studies of signals from the arrays provide a basic way to extract 3D information from the plasmas, as experiments show. Moreover, the remarkable signal-to-noise performance of the front-end electronics allows us to follow a different approach in which we combine information from all probes in both arrays to reconstruct elementary 3D plasma structures at each acquisition time step. Then, through data analysis, we track the structures as they evolve in time. The LP arrays include a linear-motion mechanism that can displace radially the probes located on the low field side for experiments that require fine-tuning of the probe locations, and for operational compatibility with the recently installed in-vessel toroidal conductor.

X-Point Effect on Plasma Blob Dynamics.

Plasma blob dynamics on the high-field side in the proximity of a magnetic field null (X point) is investigated in TORPEX. A significant acceleration of the blobs towards the X point is observed. Close to the X point the blobs break apart. The E×B drifts associated with the blobs are measured, isolating the background drift component from the fluctuating contribution of the blob internal potential dipole. The time evolution of the latter is consistent with the fast blob dynamics. An analytical model based on charge conservation is derived for the potential dipole, including ion polarization, diamagnetic, and parallel currents. In the vicinity of the X point, a crucial role in determining the blob motion is played by the decrease of the poloidal magnetic field intensity. This variation increases the connection length that short circuits the potential dipole of the blob. Good quantitative agreement is found between the model and the experimental data in the initial accelerating phase of the blob dynamics.

The new TORPEX in-vessel toroidal conductor for the generation of a poloidal magnetic field.

TORoidal Plasma EXperiment (TORPEX) is a Simple Magnetized Torus featuring open helical magnetic field lines obtained from the superposition of a small vertical component on the main toroidal field. This work introduces the experimental setup developed to include a poloidal magnetic field. The toroidal and poloidal fields generate a rotational transform, making the magnetic geometry of TORPEX closer to that of a tokamak. This upgrade opens the possibility to deal with closed and open flux surfaces, as well as with the transition region across the last closed flux surface. The main technical solutions are discussed together with the physical considerations at the basis of the system design. Selected examples of the magnetic configurations accessible with the set of magnetic field coils available on TORPEX are discussed, ranging from single-null X-points to magnetic snowflakes. The simplest magnetic configuration of quasi-circular concentric flux surfaces is tested experimentally. Measurements of the two-dimensional electron plasma density profiles and the particle confinement time are presented, together with the first steps towards the understanding of plasma production mechanisms.

A new technique for the selective intra-arterial chemotherapy in advanced cancer of the head and neck.

A new technique of selective intracarotid infusion is reported. This method involves the common and external carotid subcutaneous transposition. The advantages of this method are described. They have been experimented for 15 years, in 93 cases, with a total infusion time of 19600 hours.