Mechanical exfoliation and layer number identification of single crystal monoclinic CrCl3.

After the recent finding that CrI3, displays ferromagnetic order down to its monolayer, extensive studies have followed to pursue new two-dimensional (2D) magnetic materials. In this article, we report on the growth of single crystal CrCl3 in the layered monoclinic phase. The system after mechanical exfoliation exhibits stability in ambient air (the degradation occurs on a time scale at least four orders of magnitude longer than is observed for CrI3). By means of mechanical cleavage and atomic force microscopy (AFM) combined with optical identification, we demonstrate the systematic isolation of single and few layer flakes onto 270 nm and 285 nm SiO2/Si (100) substrates with lateral size larger than graphene flakes isolated with the same method. The layer number identification has been carried with statistically significant data, quantifying the optical contrast as a function of the number of layers for up to six layers. Layer dependent optical contrast data have been fitted within the Fresnel equation formalism determining the real and imaginary part of the wavelength dependent refractive index of the material. A layer dependent (532 nm) micro-Raman study has been carried out down to two layers with no detectable spectral shifts as a function of the layer number and with respect to the bulk.

Antibody-reactive class I epitopes defined by pairs of mismatched eplets and self-eplets.

The identification of human leukocyte antigen (HLA) antibodies in the sera of candidates awaiting organ transplantation has evolved over time. This has been possible because of the introduction of more sensitive techniques and to the increasing focus on the structural aspects of the HLA epitopes. The use of the HLAMatchmaker algorithm in the analysis of positive sera and the verification of HLA ABC epitopes in the HLA Epitope Registry website provide new stimuli on the interpretation of antibody reactivity. The epitopes defined by eplet pairs often involve a nonself-eplet and a self-eplet (nonself-self paradigm), suggesting that the antibody response to an HLA mismatch must have an auto-reactive component. Here, we report an application of the nonself-self paradigm that provides a basis for better knowledge and interpretation of HLA-antibody reactivity in Luminex assays with single alleles.

Metachronous Paget's disease of the breast: case report.

Paget breast disease is a kind of intraductal carcinoma that through an intracanalicular diffusion invades the basal epidermal layer, reaching the areola and nipple, producing a typical erythematous desquamative eczematous-like lesion. This neoplasia can remain undetected for a long time and inadequately treated as a dermatological affection. Synchronous or metachronous lesions are very uncommon. Surgical choice is conditioned by the presence of a tumor below the epidermal lesion, by its dimensions, and by the possible lymph node involvement. Surgical therapy can be radical or conservative. From our experience we think that lesion biopsy is always necessary to formulate a correct diagnosis and to schedule an appropriate therapeutic approach. In our case, a biopsy was performed first, then on the basis of the frozen section analysis a radical mastectomy with axillary third level lymph nodes dissection, because of the large dimensions of the lesion and the previous history of a methachronous lesion.

[Conservative anal fistula treatment with collagenic plug and human fibrin sealant. Preliminary results]. / Trattamento conservativo delle fistole perianali con plug in matrice extracellulare biologica e colla di fibrina umana: esperienza preliminare.

The authors, on the basis of a long clinical experience with human fibrin glue in general surgery, compared two different extracellular matrix (collagen), Surgisis and TissueDura, with human fibrin glue, applied during the operation, and sometimes in postoperative, to obtain the healing of perianal fistulas. The collagenic extracellular matrix provides, according to the rationale suggested, an optimal three-dimensional structure for the fibroblastic implant and neoangiogenesis, hence for the fistula "fibrotizzation" and closure. The encouraging results for transphincteric fistulas and a simple and easy technique push to researchers on samples statistically significant.

Regulatory mechanism of erythropoietin production: effects of hypoxemia and hypercarbia.

The purpose of this study was twofold: (1) to define the relationship between erythropoietin (Ep) production and some of the coincident variables which control oxygen delivery in hypoxic and hypoxic-hypercarbic rats (2) to define the mechanism whereby hypercarbia suppresses Ep production in hypoxemic rats. Rats were exposed to O2 concentrations ranging from 5% to 9% O2 for either 3 or 16 h. Arterial whole blood pH, pCO2, pO2, O2 saturation, p50 and Ep levels were measured in each rat. There was a highly significant inverse correlation between both the arterial pO2 and O2 saturation and the Ep level. Ep levels were not increased above normal if the pO2 was greater than 50 mm Hg or the O2 saturation was greater than 80%. The addition of 5% CO2 to all inhaled gas mixtures was associated with a 10 mm Hg increment in the pO2 together with a marked reduction in plasma Ep levels. Of the measured variables only the pO2 and O2 saturation showed a consistent correlation with the Ep levels when rats exposed to hypoxia were compared with rats exposed to hypoxia + CO2.

Laparoscopic pancreatectomy: Did the indications change? A review from literature.

Pancreatic Cancer (PC) is the fourth cause of death for tumors in Western countries. Symptoms are not specific, and can vary according to the tumor size and place. Diagnostic workup includes CA 19-9, CT and MRI. Surgery is the only treatment for PC, associated to radio-chemo therapy. Laparoscopic approaches are actually used for PC treatment in few specialized centers, and could be an alternative to laparotomic surgery. The aim of our study is to evaluate the efficacy of laparoscopy for PC treatment compared to laparotomy. We reviewed 19 articles in literature to assess the feasibility and efficacy of Laparoscopic Distal Pancreatectomy (LDP) and Laparoscopic Pancreaticoduodenectomy (LPD). The results have shown that LDP is nowadays a safe technique, and the outcomes are comparable to laparotomic surgery. Regarding to LPD instead, results are controversial and the data are still not sufficient to consider this technique as a valid alternative to laparotomic surgery.

Efficacy of methods for determining ovulation in a natural family planning program.

OBJECTIVE: To evaluate the efficacy in ovulation detection of methods used in natural family planning in comparison with pelvic ultrasonography. DESIGN: Prospective analysis of ovulation detection by natural family planning methods and ultrasonography. SETTING: Natural family planning clinic, Department of Obstetrics and Gynecology, University of Naples "Federico II". PATIENT(S): Forty healthy women who were highly motivated to use natural family planning. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Transvaginal ultrasonographic findings, urinary LH levels, salivary beta-glucuronidase activity, salivary ferning levels and characteristics of cervical mucus, and BBT. RESULT(S): Urinary LH level determination yielded a 100% correlation with the simultaneous ultrasonographic diagnosis of ovulation. Mucus sensations and characteristics yielded a 48.3% correlation when simultaneously evaluated with ovulation. Beta-glucuronidase levels yielded a 27.7% correlation. The salivary ferning test had a 36.8% ovulation-detection rate the day of ovulation, but 58.7% of results were uninterpretable. Body temperature measurements yielded a 30.4% correlation with the simultaneous ultrasonographic diagnosis of ovulation. CONCLUSION(S): Measuring urinary LH levels is an excellent method for determining ovulation. Although variations in mucus characteristics and basal body temperature correlate somewhat with ovulation, the length of the fertile period is overestimated with these methods. The salivary ferning test and measurement of beta-glucuronidase levels are not good methods for home ovulation testing.

PIP: This methodological study aims to evaluate the efficacy of methods used for determining ovulation in a natural family planning in comparison with pelvic ultrasonography. Prospective analysis of ovulation detection methods was conducted with 40 women. Ovulation-detection methods employed in the study include transvaginal ultrasonography, daily morning urinary luteinizing hormone (LH) determinations, determination of salivary beta-glucuronidase activity, salivary ferning test, determination of cervical mucus levels and characteristics, and measurement of rectal or oral basal body temperature. Results revealed a 100% correlation between urinary LH level and ovulation diagnosis obtained from ultrasonographic examination. Other ovulation-detection methods contain the following correlation results: mucus sensations and characteristics, 48.3%; alpha-glucuronidase, 27.7%; and salivary ferning test, 36.8%. These findings draw the researchers to conclude that self-determination of LH levels could be an excellent method in ovulation determination.

Spontaneous motor activity in normal fetuses.

AIM: The aim of this work was to perform a quantitative analysis of the different activities (mouth, eye and gross body movements) in the fetuses of 15 women with normally evolving pregnancies, and also to show the existence of intrauterine neurological maturation. METHODS: At 28, 34 and 38 weeks of gestation, 15 fetuses underwent a 60-min ultrasound observation. The data from the activities observed allowed the calculation, for each patient and each type of activity, of incidence, duration and intervals; relation between these and of each fetal activity for each gestational period; and the correlation between the different findings. RESULTS: The analysis of the data showed only a significant decrease in the incidence of gross body movements and a significant increase in the incidence of mouthing movements between 28 and 38 weeks of gestation. A correlation analysis failed to show any significant correlation between the various activities at 28 weeks, but found a positive correlation between eye, gross body movements and "other mouth movements," and a negative correlation between mouthing activity and the other activities examined at 34 and 38 weeks of gestation. CONCLUSION: The authors conclude that there is a trend of fetal activities, which is an expression of fetal neurological maturation.

Computer-assisted analysis of fetal movements in intrauterine growth retardation (IUGR).

A quantitative analysis of various fetal activities (mouth, eye and gross body movements) was made in 10 IUGR human fetuses. The aim of the study was to see whether IUGR fetuses move differently to normal fetuses. Each real-time ultrasound recording lasted 1 h and the analysis of various activities was carried out during replay of video recordings by means of a specially designed computer program. The following aspects have been investigated: (1) incidence, duration and interval for each of the fetal activities described; (2) the relationship between incidence, duration and interval for each single activity; (3) the correlations between the different activities. The results were compared with a group of 10 fetuses from normal pregnancies. On quantitative evaluation no clear effects due to uncomplicated IUGR could be detected except for median duration of eye movements, which turned out to be longer in the IUGR group. The evaluation of correlations between the characteristics (incidence, duration and interval) of each activity showed a positive correlation between incidence and duration of mouthing movements in the IUGR group, not found in the normal group. The study of the correlation between different fetal activities has shown an inverse correlation between mouthing and other activities in the normal fetuses, not found in the IUGR group. We conclude that in mildly affected fetuses with no evidence of hypoxia, there are no quantitative differences compared to normal fetuses in terms of the motility studied. The only differences found were in relation to the performance of such activities and they could reflect a dysfunction of the central nervous system resulting from a metabolic disturbance.

Effects of partial occlusion of circulation on frequency and amplitude of surface electromyography.

We examined two distinct questions. First, would the amplitude and frequency changes characteristic of fatigue produced by an isometric exercise be produced by fatiguing isotonic exercise? Second, are the frequency shifts produced during fatiguing exercise the result of increased metabolite concentration? Ten subjects (five men and five women, aged 22-43 years) performed two sets of 25 biceps curls at between 50 and 60% of their maximal voluntary contraction (MVC). One set was performed with the circulation to the arm unimpaired (NO); during the other set, a blood pressure (BP) cuff held midway between systolic and diastolic pressure was used to partially occlude (PO) circulation. Both the NO and PO conditions produced significant changes in root mean square (rmsEMG) of the amplitude and the mean power frequency (MPF) of the signal. Both the increase in amplitude and the downward shift in MPF of the frequency power spectrum characteristic of fatigue were significantly greater for the PO versus NO condition (PO = 29.47 Hz, NO = 7.39 Hz). These results indicate that the changes in amplitude and frequency characteristic of fatigue observed during isometric exercise can be produced to a lesser degree during dynamic exercise. In addition, these changes can be amplified by addition of occlusion caused by external compression. Because the compressive force used for occlusion allowed blood flow into the working muscle while impairing venous return, this degree of change appears to be directly related to reduced metabolite washout.

[Hormonal therapy in oncologic treatment: pathogenic hypotheses and interactions between thyroid and breast pathologies]. / La terapia ormonale nel trattamento oncologico: ipotesi patogenetiche e interazioni tra patologia tiroidea e mammaria.

INTRODUCTION: The aim to individuate the eventual correlation between the two pathologies has justified deeper studies to achieve new prospective approaches for both disease. BACKGROUND: We have selected 4 groups of patients who presented an association between the two pathologies: a) malignant breast pathology associated to a malignant thyroid pathology, b) patients with breast carcinoma who presented association with some thyroid alterations, c) patients with thyroid carcinoma who presented association with some breast alterations, d) patients who presented some associations between benign breast pathology and benign thyroid pathology. MATERIALS AND METHODS: We have excluded all patients with a clear physiological or surgical menopausal status, and we've so considered only patients with a regular menstrual cycle. We've so selected a group of 120 patients and we've performed in all these patients during the early follicular phase the following exams: breast echographic evaluation and thyroid echographic-structure and volume determination and finally hormonal determinations we have so obtained two breast subgroups: 32 patients with hyperestrogenic integrative hormonal characteristics, 28 patients subjected to adjuvant hormonal therapy with hypoestregenic hormonal status and finally two thyroid subgroups, 22 patients showing clinical or subclinical hypothyroidism, 38 patients showing clinical or subclinical hyperthyroidism. We've compared these data to a random age-matched health control women group of 25 patients. RESULTS: The first group of patient showed a thyroid hormonal pattern of subclinical hypothyroidism or at least free T3 and free T4 mean value currently under and TSH and TPO Ab levels curve currently over the mean values of the control group. The second group showed the TSH suppressed with free T3 and free T4 curves currently over the mean value of the control group. The third group showed slight elevations in serum PRL levels curve. The fourth group showed increased estrogen levels-curve, often over the mean value of the control group. CONCLUSION: How much is it allowed to perform an hormonal therapy, specially for a benign pathology if we're not yet able to understand the deep and unknown interaction between breast and thyroid?

Impact of CF summer camp.

In two consecutive years, patients with cystic fibrosis were studied at the beginning and end of a nine-day summer camp program to assess the program's effects on weight gain and pulmonary function. The camp experience includes daily exercise and a high-protein and high-fat diet. There were a total of 58 children between 6 and 12 years of age (42 different patients) and 10 adult counselors from 19 to 30 years of age (eight different patients). On the first and eighth days patients were weighed, sputum cultures were collected, and spirometry was performed. In year 2, peak expiratory flow rate was monitored daily. Also in year 2, campers and counselors with CF were prescreened by sputum culture and excluded from camp if they had Pseudomonas cepacia in their sputum. Only one candidate screened was positive before camp. In year 1, no significant group changes in pulmonary function were identified. In year 2, significant increases on post-camp testing were found for FEF 25%-75% and PEF. Mean body weight for all patients increased significantly, by 0.4 kg in year 1 and 0.9 kg in year 2 (p less than .05). In year 1, a total of nine patients acquired a new organism in their follow-up sputum culture, including five who acquired a new Pseudomonas species. There was no intra-cabin pattern of spread. Four patients were positive for P. cepacia on day 1 culture. No new subjects acquired this organism on follow-up examination. In year 2, only one subject had P. cepacia on the first camp collection; he alone was positive on day 9.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of transport on some metabolic parameters and meat quality in pigs.

Two groups of 40 castrated male pigs were selected at random in an abattoir from pigs arriving from two farms, situated 650 km (group A) and 180 km (group B) from the plant, respectively. The animals were kept in lairage overnight and slaughtered the following morning. At slaughter, samples of blood were collected to determine serum levels of some enzymes [lactic dehydrogenase (LDH), glutamic oxaloacetic transaminase (GOT) and glutamic phosphatase transaminase (GPT)]. Measurements of pH were then taken on the Longissimus thoracis at the level of the last rib 45 min, 3 h and 24 h post mortem. After overnight chilling of the sides at +2°C, a portion of the Longissimus thoracis was removed for colour and drip measurements. Results show that distance travelled affects pH values at 45 min and 24 h, group A presenting higher values than group B (P < 0·001). Drip loss did not differ significantly between the two groups, while group A showed lower values of L (∗) and higher a (∗) values than group B (P < 0·05 and P < 0·01, respectively), with no differences in the mean values of b (∗). In group A, a higher value of LDH was observed (P < 0·001) than in group B. GOT and GPT showed no significant difference between the two groups. It is concluded that, although some significant effects of treatment were recorded on some quality traits, the magnitude of the differences are not considered of much practical significance.

[The use of hearing aids in children with profound deafness. Methodology and results]. / La protesizzazione acustica dei bambini con sordità profonda. Metodologia e risultati.

The early application of hearing aids in children with severe and profound hearing loss is rather an hard problem that has to be solved, according to the Authors, by taking care of several factors. Usually, as far as these patients concern, two kinds of hearings aids are used. The first one emphasizes all the frequencies in the same way, including low tones that, in the early ages, are very important for improving prosodic pattern, occlusive and liquid phonemas, primary words and sentences. The second type, emphasizing only medium and high frequencies, is useful for discrimination processes. The Authors suggest to applicate the hearing aids in these patients, following a behavior be themselves named "dynamic application". In the first phase the Authors use hearing aids emphasizing also low tones; in the second one they modify the device, according more precise data turning out form audiometric evaluation and speech therapy. The results concerning a research on 27 children with profound hearing loss are debated; the application of hearing aids occurred in early age and the speech therapy followed the same criteria for all patients. The subjects were divided in two groups, homogeneous for age, degree of hearing loss and social environment. For the 12 children of groups A the "dynamic application" was used. For the 15 patients of group B the traditional strategy, using only devices for the amplification of medium and high tones, was applied. The best results concerning voice intonation and learning occlusive phonemas were obtained in group A subjects. The Authors, introducing their results and discussion, compare them with references data. In conclusion, the "dynamic application" is effective because of the better results in speech therapy and also because its ratio permits the application of hearing aids in children with hearing loss of different degrees, especially in the most difficult cases.

Laparoscopic ovarian treatment in infertile patients with polycystic ovarian syndrome (PCOS): endocrine changes and clinical outcome.

During the years 1991-1994, 97 anovulatory infertile women with polycystic ovarian syndrome (PCOS) were treated with laparoscopic electrocautery of the ovarian surface after they had failed to ovulate under ovarian stimulation. To assess the endocrinological and clinical outcome and in an attempt to determine the mechanism of action, the serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), androstenedione, testosterone and dehydroepiandrosterone sulfate (DHEAS) were determined before and after laparoscopic ovarian cautery. Fifty regularly cycling women undergoing laparoscopy for investigation of infertility or tubal ligation served as controls. In patients with PCOS but not in controls, the reduction of androgen levels and normalization of cycle length were highly significant. In contrast, LH and FSH levels rose during the first 2 days after the operation. These results resemble those reported after ovarian wedge resection. Ovulation was obtained in 90% (81 of 90) and pregnancy in 81.1% (73 of 90) of the patients; that increased to 84.4%, including the non-responders (nine patients) treated with clomiphene citrate (CC), after electrocautery. The response to ovarian electrocautery was influenced by body weight, with an ovulation rate of 95-96% in the slim and moderately obese women, decreasing to 81-82% in the really obese ones. When ovulation was established, the pregnancy rate was independent of body weight. However, a striking relationship was detected between smoking habits and pregnancy rate subsequent to ovarian electrocautery, ranging from 24% in smokers to 92% in non-smoking couples. In 30 second-look operations, de novo adhesions were found in 23.3% of the patients (7 of 30). Therefore, ovarian electrocautery is an effective procedure to improve the intraovarian mechanism of selecting a dominant follicle for patients with PCOS in whom initial medical management fails, and it appears to be one of the possible treatments for this disease. A possible postoperative complication may be adhesion formation that seem to be lower than after ovarian wedge resection.

Further evidence of the in vivo role of erythropoietin or companion molecules induced by hypoxia on proliferation and continuing differentiation of BFU-e in PCDC.

Normal and plethoric bone marrow cells were grown in plasma clot diffusion chambers (PCDC) implanted into the peritoneum of normal mice or mice submitted to 7 her of hypoxia (23,000 ft) daily, on a single day or on 2 consecutive days at different times after implantation of the PCDC's. Daily discontinuous hypoxia (DDH) produced more 6-day bursts than other treatments. Hypoxia on days 1 and 2 after implantation was nearly as effective as DDH on day-6 bursts. Later bouts of hypoxia or a singly hypoxic exposure on day 1 or 2 was less effective. Erythropoietin (Ep) levels were measured by bioassay on both diffusion chamber (DC) contents and serum. Serum Ep levels peaked at 160 mU/ml after a 7-hr hypoxic exposure while the DC content Ep levels were in the nondetectable range (less than 50 mU/ml). The data implies that either higher than normal Ep levels or a companion molecules (s) produced by hypoxia are required for 1-2 days early in the culture period of force an increasing number of BFU-d-e down the erythrocytic pathway and thus increase red cell production at times of need in vivo.

Epidemiological survey on bacterial, viral and parasitic agents in patients affected by acute enteritis.

During the period June 1983-May 1984, faecal specimens from 797 patients with acute enteritis were examined for the presence of bacterial, viral and parasitic agents; 209 (26.2%) enteritic pathogens were identified, of whom 118 (35.4%) in 333 samples from the pediatrics wards. Bacterial agents were detected in 122 (15.3%), viruses in 63 (7.9%) and parasites in 25 (3.1%) of the 797 specimens. LT-producing E. coli, Salmonella and Rotavirus were the most frequent pathogens. Bacterial agents occurred most frequently in the summer and autumnal months, whereas viruses showed two peaks, the first one in summer due to cultivable agents, the second in winter to Rotavirus mainly.

The effects of humoral factors on amplification of nonrecognizable erythrocytic and granulocytic precursors.

These studies were to evaluate the effects of humoral factors on amplification of nonrecognizable erythrocytic and granulocytic precursors by the in vivo plasma clot diffusion chamber and the in vitro plasma clot culture methods. Changes in the plasma erythropoietin levels in the reticulocyte concentration and hematocrits of irradiated and nonirradiated Long-Evans rats exposed to hypoxia were also determined. While erythropoietin plasma concentrations appeared to affect BFU-E and CFU-E growth, results suggest erythropoietin may not be the sole regulator of red cell production and that inhibitors of chalone-like mechanisms may be involved. Measurements made on granulocyte precursors treated with colony stimulating factor (CSF) containing L-cell-conditioned medium revealed granulocytic colonies and burst-like formations similar to those seen for erythrocytic growth. There is strong evidence suggesting that CSF is a regulator of granulopoiesis; however, it is not the sole regulator and it appears that inhibitors may play an in vivo role. Growth of colonies with cell numbers not a power of 2 implies either asymmetric mitosis due to loss of genetic information required for continuing division, or differences in concentrations of, or ability to recognize, inhibitory factors. These possibilities are examined in the light of results from in vivo and in vitro culture techniques.

Capillary growth in anemia-induced ventricular wall remodeling in the rat heart.

To determine whether anemia-induced cardiac hypertrophy affects ventricular size and shape and the component structures of the capillary network of the left and right ventricles, young male rats were fed an iron- and copper-deficient diet for 7 weeks. By that time, blood hemoglobin content fell to 5 +/- 1 g/dl, and packed cell volume fell to 18 +/- 3%. To further characterize the implications of anemia, red blood cell number, hemoglobin corpuscular content, systemic arterial pressure, heart rate, and blood viscosity were measured. Moreover, the changes in ventricular weights were analyzed in terms of the alterations in ventricular wall area and ventricular wall thickness to establish the impact of the elevation in load associated with a high cardiac output state on ventricular remodeling. The quantitative properties of the capillary circulation were also examined biventricularly by low power electron microscopic morphometry to evaluate the adaptive growth potential of the coronary microcirculation in this form of cardiac hypertrophy. Anemia was found to interfere with the production of red blood cells and their mean corpuscular hemoglobin content and resulted in a 40% reduction in blood viscosity and a 12% and 27% decrease in systolic and diastolic blood pressure, respectively. The changes in heart rate were not statistically significant. In comparison with control animals, heart weight increased by 50%, but the enlargement in right ventricular mass (65%) was greater than that of the left ventricle (47%). Ventricular hypertrophy occurred with increases in wall area and wall thickness although the former increased consistently more than the latter in either ventricle. Tissue growth was accompanied by a 60% lengthening of the capillary network, which in combination with an increase in capillary diameter resulted in a 65% and 34% expansion in capillary luminal volume and 56% and 20% larger luminal surface density in the left and right sides of the heart, respectively. In conclusion, hypochromic microcytic anemia leads to eccentric ventricular hypertrophy with a significant amount of capillary proliferation that may tend to protect the myocardium from the increased potential for ischemic injury.