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As compared with the skin sparing mastectomy, nipple sparing mastectomy (NSM) preserves the skin of the nipple-areolar complex (NAC). The risk of loco regional recurrence after preserving the skin envelope and NAC is the major concern in NSM. In 2012, Petit et al1 reported that the rate of local recurrence in the breast and the NAC was 3.6% and 0.8%, respectively. Several other publications confirmed the safety of the NSM in selected patients.2–5 The skin envelope and the NAC after removing the gland under the dermis, the NAC, and the peripheral skin are poorly vascularized by the subdermal vessel network.6,7 The size and the degree of ptosis increase the length of the skin flap between the thoracic wall and the NAC and increase the risk of poor blood supply of the tip of the breast. Therefore, the volume of the breast and the degree of ptosis are hypothesized as a risk factor of necrosis of the NAC area. Moreover, the pressure on the vessels by the tension due to the prosthesis also increases the risk of skin necrosis in the NAC area. Petit et al8 reported 3.5% of complete nipple loss and partial NAC necrosis in 5.5%. Several recent studies showed that the rate of nipple necrosis ranged from 0% to 29% but most series showed less than 10%.9–18 Algaithy et al19 analyzed the correlation between surgical factors and NAC necrosis. Several publications of NSM were concerned with oncologic safety, surgical technique, and cosmetic results and other sequelae.1,6,8 Few studies focus the factors predisposing to necrotic complications. Age, skin incision, flap thickness, reconstruction type, and smoking have been reported as the risk factors for NAC necrosis and NAC removal.14,17,19 Lohsiriwat et al20 demonstrated that clinicopathological features had no significant impact on necrotic complications. No study reported the correlation between breast morphology and necrotic complications. Our prospective study aims at identifying the patient and the breast morphology factors that might increase necrotic complications after performing NSM with immediate reconstruction.

Summary: Secondary correction of nipple areola complex (NAC) malposition represents a major concern after breast reconstructive procedures. It is frequently requested by patients complaining about asymmetric areolas impairing the whole reconstructive procedure and asking for improved cosmetic outcomes. Several methods have been described to achieve a good symmetry between the 2 areolas, either natural or reconstructed. We describe our correction technique with free NAC graft. A total of 16 patients were treated with free NAC grafts between April 2010 and April 2013 at the European Institute of Oncology, Milan, Italy. This series focused on the surgical technique and its postoperative outcomes. Three cases of partial graft loss (18%) were observed in the postoperative period. No total NAC necrosis occurred. No infection was observed. All the complications were managed with a conservative treatment, not requiring any further surgery. NAC malposition following breast reconstructive procedures can be corrected using the technique of free NAC graft with reliable and satisfactory results.

Some functions of the nervous system are pain transduction and pain perception. These functions are directly involved in many chronic diseases due to the pain condition to which they are associated. Peripheral and central nervous system are the main targets of pain therapy. Pain therapy uses variety of drugs in relationship of severity of the illness and the degree of the patient's response. The individual variability in response to drugs depends on different variables such as pathological (timing and severity), physiological (age, gender and weight), genetic and environmental aspects involved in pharmacokinetics and pharmacodynamics. Although patients can be classified as poor, intermediate, normal or extensive responders, 30% of patients do not respond to pain treatments. Our aim is to collect and analyse DNA samples in terminal patients to define their drug response phenotype. A bioinformatics analysis of the GWA DNA samples will be performed to identify mutations in candidate genes. A molecular dynamic study will be used to investigate the misfolding structures and the molecular docking will be applied for testing the binding activity of the drugs in use. Variants with low binding affinity will be submitted to virtual screening to identify all the potential leads by using the ZINC database of UCSF with over 21 million ligands. We have developed the molecular dynamics and docking pipeline analysis based on the High-Performance and Distributed Computing (eg. GPU and GRID clusters) to perform large scale of analysis. Data will be collected in a portal infrastructure organised in three layers: a Portal layer, an Application layer and a Data layer. The Application layer is a variety of java portlets, each of which allow the end user, depending on its permissions, to add and retrieve records stored in the Data layer. The Data layer will be subdivided into three layers: the first is a database that interacts with the Portal layer, the second contains all patients clinical data, the third and last contains personal data of the patients. The infrastructure will use a unique retrieval system that randomly codes patients information to prevent users to obtain a correlation between pathologies and personal data of the patients. This procedure will be used to support high-throughput genome analysis and drug discovery oriented to personalized pain therapy in non-responsive patients.

The world has widely changed in terms of communicating, acquiring, and storing information. Hundreds of millions of people are involved in information retrieval tasks on a daily basis, in particular while using a Web search engine or searching their e-mail, making such field the dominant form of information access, overtaking traditional database-style searching. How to handle this huge amount of information has now become a challenging issue. In this paper, after recalling the main topics concerning information retrieval, we present a survey on the main works on literature retrieval and mining in bioinformatics. While claiming that information retrieval approaches are useful in bioinformatics tasks, we discuss some challenges aimed at showing the effectiveness of these approaches applied therein.

This book is one out of 8 IAEG XII Congress volumes, and deals with the theme of urban geology. Along with a rapidly growing world population, the wave of urban growth continues, causing cities to swell and new metropolitan centers to emerge. These global trends also open new ventures for underground city development. Engineering geology plays a major role in facing the increasing issues of the urban environment, such as: finding aggregates for construction works; providing adequate water supply and waste management; solving building problems associated to geological and geomorphological conditions; evaluating host rock conditions for underground constructions; preventing or mitigating geological and seismic hazards. Furthermore, this book illustrates recent advancements in sustainable land use planning, which includes conservation, protection, reclamation and landscape impact of open pit mining and alternative power generation. The Engineering Geology for Society and Territory volumes of the IAEG XII Congress held in Torino from September 15-19, 2014, analyze the dynamic role of engineering geology in our changing world and build on the four main themes of the congress: Environment, processes, issues, and approaches. The congress topics and subject areas of the 8 IAEG XII Congress volumes are: Climate Change and Engineering Geology Landslide Processes River Basins, Reservoir Sedimentation and Water Resources Marine and Coastal Processes Urban Geology, Sustainable Planning and Landscape Exploitation Applied Geology for Major Engineering Projects Education, Professional Ethics and Public Recognition of Engineering Geology Preservation of Cultural Heritage.

This book is one out of 8 IAEG XII Congress volumes, and deals with climate change affecting different natural processes and environments, such as slope dynamics, water courses, coastal and marine environments, hydrological and littoral processes, and permafrost terrain. Due to climate change, major effects are also expected on territorial planning and infrastructure, particularly in extreme climate regions. The volume and its contents aim to analyze the role of engineering geology and the solutions it may offer with respect to the ongoing environmental changes. Contributions regard the modeling of both the factors and the effects induced by climate change. Potential impacts of the climate change on the common practice and routine work of engineering geologists are also analyzed, with particular attention to the risk assessment and mitigation procedures and to the adaptation measures adopted. The Engineering Geology for Society and Territory volumes of the IAEG XII Congress held in Torino from September 15-19, 2014, analyze the dynamic role of engineering geology in our changing world and build on the four main themes of the congress: environment, processes, issues, and approaches. The congress topics and subject areas of the 8 IAEG XII Congress volumes are: Climate Change and Engineering Geology Landslide Processes River Basins, Reservoir Sedimentation and Water Resources Marine and Coastal Processes Urban Geology, Sustainable Planning and Landscape Exploitation Applied Geology for Major Engineering Projects Education, Professional Ethics and Public Recognition of Engineering Geology Preservation of Cultural Heritage.

The transverse rectus abdominis myocutaneous (TRAM) flap has been the gold standard in breast reconstruction for many years, but the donor-site morbidity remains a major concern when the rectus muscle is harvested. Common long-term abdominal contour abnormalities of the lower abdomen after performing TRAM flap breast reconstruction include abdominal bulge, epigastric fullness, and hernia.1,2 These complications can occur after various techniques for creating flaps, such as the pedicled TRAM, free TRAM, and the deep inferior epigastric perforator flaps, with an incidence ranging from 0% to 35%.3–8 The wide range of incidence is most likely related to the differences in techniques of harvesting the flap and closure of the abdominal wall. Management of the abdominal wall at the donor site of TRAM flap is thus a challenge. Several techniques have been described for the closure of the anterior abdominal wall defect, including the use of relaxing incisions, one- or two-layer fascial closure, preservation of the rectus muscle and anterior rectus sheath,1,9 and the use of a synthetic mesh,10–12 all designed to reduce morbidity at the donor site after harvesting the flap. Currently, there is no consensus on the best surgical technique for closure of the abdominal wall defect.2,13 We present a technique for the closure of the anterior abdominal wall to prevent abdominal bulging and hernia (contour deformities) by transversely dividing the anterior fascia and rectus abdominis at the arcuate line in combination with reinforcement sutures above this level. We compare the results of this procedure with the results of our last publication in 2003 before the introduction of this new technique.14