Semitransparent Perovskite Solar Cells with Ultrathin Protective Buffer Layers

Semitransparent perovskite solar cells (ST-PSCs) are increasingly important in a range of applications, including top cells in tandem devices and see-through photovoltaics. Transparent conductive oxides (TCOs) are commonly used as transparent electrodes, with sputtering being the preferred deposition method. However, this process can damage exposed layers, affecting the electrical performance of the devices. In this study, an indium tin oxide (ITO) deposition process that effectively suppresses sputtering damage was developed using a transition metal oxides (TMOs)-based buffer layer. An ultrathin (<10 nm) layer of evaporated vanadium oxide or molybdenum oxide was found to be effective in protecting against sputtering damage in ST-PSCs for tandem applications, as well as in thin perovskite-based devices for building-integrated photovoltaics. The identification of minimal parasitic absorption, the high work function and the analysis of oxygen vacancies denoted that the TMO layers are suitable for use in ST-PSCs. The highest fill factor (FF) achieved was 76%, and the efficiency (16.4%) was reduced by less than 10% when compared with the efficiency of gold-based PSCs. Moreover, up-scaling to 1 cm2-large area ST-PSCs with the buffer layer was successfully demonstrated with an FF of ∼70% and an efficiency of 15.7%. Comparing the two TMOs, the ST-PSC with an ultrathin V2Ox layer was slightly less efficient than that with MoOx, but its superior transmittance in the near infrared and greater light-soaking stability (a T80 of 600 h for V2Ox compared to a T80 of 12 h for MoOx) make V2Ox a promising buffer layer for preventing ITO sputtering damage in ST-PSCs.

Cyclic Stretch-Induced Mechanical Stress Applied at 1 Hz Frequency Can Alter the Metastatic Potential Properties of SAOS-2 Osteosarcoma Cells

Recently, there has been an increasing focus on cellular morphology and mechanical behavior in order to gain a better understanding of the modulation of cell malignancy. This study used uniaxial-stretching technology to select a mechanical regimen able to elevate SAOS-2 cell migration, which is crucial in osteosarcoma cell pathology. Using confocal and atomic force microscopy, we demonstrated that a 24 h 0.5% cyclic elongation applied at 1 Hz induces morphological changes in cells. Following mechanical stimulation, the cell area enlarged, developing a more elongated shape, which disrupted the initial nuclear-to-cytoplasm ratio. The peripheral cell surface also increased its roughness. Cell-based biochemical assays and real-time PCR quantification showed that these morphologically induced changes are unrelated to the osteoblastic differentiative grade. Interestingly, two essential cell-motility properties in the modulation of the metastatic process changed following the 24 h 1 Hz mechanical stimulation. These were cell adhesion and cell migration, which, in fact, were dampened and enhanced, respectively. Notably, our results showed that the stretch-induced up-regulation of cell motility occurs through a mechanism that does not depend on matrix metalloproteinase (MMP) activity, while the inhibition of ion-stretch channels could counteract it. Overall, our results suggest that further research on mechanobiology could represent an alternative approach for the identification of novel molecular targets of osteosarcoma cell malignancy.

Active stabilization of a pseudoheterodyne scattering scanning near field optical microscope

Scattering scanning near-field optical microscopes (s-SNOMs) based on pseudoheterodyne detection and operating at ambient conditions typically suffer from instabilities related to the variable optical path length of the interferometer arms. These cause strong oscillations in the measured optical amplitude and phase comparable with those of the signal and, thus, resulting in dramatic artifacts. Besides hampering the comparison between the topography and the optical measurements, such oscillations may lead to misinterpretations of the physical phenomena occurring at the sample surface, especially for nanostructured materials. Here, we propose a stabilizing method based on interferometer phase control, which improves substantially the image quality and allows the correct extraction of optical phase and amplitude for both micro- and nanostructures. This stabilization method expands the measurement capabilities of s-SNOM to any slowly time-dependent phenomena that require long-term stability of the system. We envisage that active stabilization will increase the technological significance of s-SNOMs and will have far-reaching applications in the field of heat transfer and nanoelectronics.

Oxidized Alginate Dopamine Conjugate: In Vitro Characterization for Nose-to-Brain Delivery Application

BACKGROUND

The blood-brain barrier (BBB) bypass of dopamine (DA) is still a challenge for supplying it to the neurons of Substantia Nigra mainly affected by Parkinson disease. DA prodrugs have been studied to cross the BBB, overcoming the limitations of DA hydrophilicity. Therefore, the aim of this work is the synthesis and preliminary characterization of an oxidized alginate-dopamine (AlgOX-DA) conjugate conceived for DA nose-to-brain delivery.

METHODS

A Schiff base was designed to connect oxidized polymeric backbone to DA and both AlgOX and AlgOX-DA were characterized in terms of Raman, XPS, FT-IR, and 1H- NMR spectroscopies, as well as in vitro mucoadhesive and release tests.

RESULTS

Data demonstrated that AlgOX-DA was the most mucoadhesive material among the tested ones and it released the neurotransmitter in simulated nasal fluid and in low amounts in phosphate buffer saline. Results also demonstrated the capability of scanning near-field optical microscopy to study the structural and fluorescence properties of AlgOX, fluorescently labeled with fluorescein isothiocyanate microstructures. Interestingly, in SH-SY5Y neuroblastoma cell line up to 100 μg/mL, no toxic effect was derived from AlgOX and AlgOX-DA in 24 h.

CONCLUSIONS

Overall, the in vitro performances of AlgOX and AlgOX-DA conjugates seem to encourage further ex vivo and in vivo studies in view of nose-to-brain administration.

Tissue degeneration in ALS affected spinal cord evaluated by Raman spectroscopy

The Raman spectral features from spinal cord tissue sections of transgenic, ALS model mice and non-transgenic mice were compared using 457 nm excitation line, profiting from the favourable signal intensity obtained in the molecular fingerprint region at this wavelength. Transverse sections from four SOD1G93A mice at 75 days and from two at 90 days after birth were analysed and compared with sections of similarly aged control mice. The spectra acquired within the grey matter of tissue sections from the diseased mice is markedly different from the grey matter signature of healthy mice. In particular, we observe an intensity increase in the spectral windows 450-650 cm-1 and 1050-1200 cm-1, accompanied by an intensity decrease in the lipid contributions at ~1660 cm-1, ~1440 cm-1 and ~1300 cm-1. Axons demyelination, loss of lipid structural order and the proliferation and aggregation of branched proteoglycans are related to the observed spectral modifications. Furthermore, the grey and white matter components of the spinal cord sections could also be spectrally distinguished, based on the relative intensity of characteristic lipid and protein bands. Raman spectra acquired from the white matter regions of the SOD1G93A mice closely resembles those from control mice.

Detection and localization of gold nanoshells inside cells: near-field approximation

The optical properties of metal nanoparticles play a fundamental role for their use in a wide range of applications. In hyperthermia treatment, for example, gold nanoshells (NSs, dielectric core+gold shell) pre-embedded in a cancer cell absorb energy when exposed to appropriate wavelengths of a laser beam and heat up, thereby destroying the cancer cell. In this process, nevertheless, healthy tissues (not targeted by the NSs) along the laser path are not affected; this is because most biological soft tissues have a relatively low light absorption coefficient in the near-infrared (NIR) regions-a characteristic known as the tissue optical window. Over such a window, NIR light transmits through the tissues with scattering-limited attenuation and minimal heating, thereby avoiding damage to healthy tissues. As a consequence, the identification of NSs assumed a fundamental role for the further development of such cancer treatment. Recently, we have demonstrated the possibility to identify 100-150 nm diameter gold NSs inside mouse cells using a scanning near-optical microscope (SNOM). In this paper, we provide a numerical demonstration that the SNOM is able to locate NSs inside the cell with a particle-aperture distance of about 100 nm. This result was obtained by developing an analytical approach based on the calculation of the dyadic Green function in the near-field approximation. The implications of our findings will remarkably affect further investigations on the interaction between NSs and biological systems.

Imaging cervical cytology with scanning near-field optical microscopy (SNOM) coupled with an IR-FEL

Cervical cancer remains a major cause of morbidity and mortality among women, especially in the developing world. Increased synthesis of proteins, lipids and nucleic acids is a pre-condition for the rapid proliferation of cancer cells. We show that scanning near-field optical microscopy, in combination with an infrared free electron laser (SNOM-IR-FEL), is able to distinguish between normal and squamous low-grade and high-grade dyskaryosis, and between normal and mixed squamous/glandular pre-invasive and adenocarcinoma cervical lesions, at designated wavelengths associated with DNA, Amide I/II and lipids. These findings evidence the promise of the SNOM-IR-FEL technique in obtaining chemical information relevant to the detection of cervical cell abnormalities and cancer diagnosis at spatial resolutions below the diffraction limit (≥0.2 μm). We compare these results with analyses following attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy; although this latter approach has been demonstrated to detect underlying cervical atypia missed by conventional cytology, it is limited by a spatial resolution of ~3 μm to 30 μm due to the optical diffraction limit.

Ferromagnetic Mn-doped Si0.3Ge0.7 nanodots self-assembled on Si(100)

Densely packed epitaxial Mn-doped Si(0.3)Ge(0.7) nanodots self-assembled on Si(100) have been obtained. Their structural properties were studied using reflection high-energy electron diffraction, energy dispersive x-ray diffraction, atomic force microscopy, extended x-ray absorption fine structure measurements and high-resolution transmission electron microscopy. Mn(5)Ge(1)Si(2) crystallites embedded in Si(0.3)Ge(0.7) were found. They exhibit a ferromagnetic behaviour with a Curie temperature of about 225 K.

ELF Non Ionizing Radiation Changes the Distribution of the Inner Chemical Functional Groups in Human Epithelial Cell (HaCaT) Culture

Human skin cell culture (HaCaT) that has been exposed to an AC magnetic field undergoes detectable changes in its biochemical properties and shapes. Such changes were observed by infrared wavelength-selective scanning near-field optical microscopy with a resolution of 80-100 nm. We specifically investigated the changes in the distribution of the inner chemical functional groups and in the cell morphology induced by a 24 h exposure to a 1 mT (rms), 50 Hz sinusoidal magnetic field in a temperature regulated solenoid. These results further accentuate the crucial questions, raised by several recent studies, about the impact of low-frequency electromagnetic field on human cells.

SNOM and AFM microscopy techniques to study the effect of non-ionizing radiation on the morphological and biochemical properties of human keratinocytes cell line (HaCaT)

In this study we have employed atomic force microscopy (AFM) and scanning near-field optical microscopy (SNOM) techniques to study the effect of the interaction between human keratinocytes (HaCaT) and electromagnetic fields at low frequency. HaCaT cells were exposed to a sinusoidal magnetic field at a density of 50 Hz, 1 mT. AFM analysis revealed modification in shape and morphology in exposed cells with an increase in the areas of adhesion between cells. This latter finding was confirmed by SNOM indirect immunofluorescence analysis performed with a fluorescent antibody against the adhesion marker beta4 integrin, which revealed an increase of beta4 integrin segregation in the cell membrane of 50-Hz exposed cells, suggesting that a higher percentage of these cells shows a modified pattern of this adhesion marker.

Chemically resolved imaging of biological cells and thin films by infrared scanning near-field optical microscopy

The infrared (IR) absorption of a biological system can potentially report on fundamentally important microchemical properties. For example, molecular IR profiles are known to change during increases in metabolic flux, protein phosphorylation, or proteolytic cleavage. However, practical implementation of intracellular IR imaging has been problematic because the diffraction limit of conventional infrared microscopy results in low spatial resolution. We have overcome this limitation by using an IR spectroscopic version of scanning near-field optical microscopy (SNOM), in conjunction with a tunable free-electron laser source. The results presented here clearly reveal different chemical constituents in thin films and biological cells. The space distribution of specific chemical species was obtained by taking SNOM images at IR wavelengths (lambda) corresponding to stretch absorption bands of common biochemical bonds, such as the amide bond. In our SNOM implementation, this chemical sensitivity is combined with a lateral resolution of 0.1 micro m ( approximately lambda/70), well below the diffraction limit of standard infrared microscopy. The potential applications of this approach touch virtually every aspect of the life sciences and medical research, as well as problems in materials science, chemistry, physics, and environmental research.

Spectroscopic scanning near-field optical microscopy with a free electron laser: CH2 bond imaging in diamond films

Hydrogen chemistry in thin films and biological systems is one of the most difficult experimental problems in today's science and technology. We successfully tested a novel solution, based on the spectroscopic version of scanning near-field optical microscopy (SNOM). The tunable infrared radiation of the Vanderbilt free electron laser enabled us to reveal clearly hydrogen-decorated grain boundaries on nominally hydrogen-free diamond films. The images were obtained by SNOM detection of reflected 3.5 microm photons, corresponding to the C-H stretch absorption, and reached a lateral resolution of 0.2 microm, well below the lambda/2 (lambda = wavelength) limit of classical microscopy.

Non-specific nasal provocation test with histamine. Analysis of the dose-response curve

Non-Specific Nasal Hyper-reactivity (NSNH) is described as a clinical condition characterized by the presence of rhinitic symptoms that are a consequence of non-specific stimulations. Because of its effects on vascular, epithelial, and glandular receptors, NSNP Test (NSNPT) with histamine allows the study of NSNH. The aims of this study are 1. to analyze the behavior of NSNH both in non-allergic chronic vasomotory patients and in healthy control subjects 2. to correlate total nasal resistance(TNR) to each dosage of histamine to derive the dose/response curves and 3. to study these curves to analyze and possibly define different stages according to the intensities of response of NSNH. We have studied 26 subjects affected by non-allergic vasomotor rhinitis and 10 healthy control subjects. We sprayed a NSNPT with histamine-phosphate (0.2-0.3-0.4-0.5-0.6-0.8 mg) in different sessions to avoid accumulation phenomena. Five minutes before and five minutes after each challenge, TNR was determined by active anterior rhinomanometry. TNR was correlated to the doses of histamine by an empirical equation. The most important results of this study are as follows: a) the variation of TNR follows a model of exponential curve, b) it is possible to classify NSNH, as a function of the regression b coefficient belonging to the empirical equation used, in reactivity classes, c) from one reactivity class to another, post-stimulation TNRs double; 0.5 mg of histamine of the NSNPT is the optimal dose, d) there is an overlap between the responses of some normal subjects and rhinopathic patients that will be the subject of a further study. Finally, our data suggest that, in a future perspective, it is possible to use the NSNPT with histamine for diagnostic, prognostic and therapeutic control purposes.

Non-specific hyperreactivity before and after nasal specific immunotherapy

BACKGROUND

Specific local immunotherapy (SLIT) improves symptom scores for allergic rhinitis during treatment and after its conclusion, as confirmed by non-specific tests. However, the duration of clinical and instrumental improvement after discontinuing SLIT is unknown.

OBJECTIVE

To evaluate the changes in the non-specific reaction time of patients with allergy to Dermatophagoides pteronissinus before and during 3 years of SLIT, and 6, 12, 18, and 24 months after discontinuing SLIT.

MATERIAL AND METHODS

Sixteen patients were diagnosed by clinical history, positive skin test for D. pteronissinus, RAST, nasal provocation test (NPT) specific for D. pteronissinus, NPT with cold water solution. SLIT was administered by nasal spray. Patients were evaluated before, at 6, 12, 24, and 36 months of SLIT, and 6, 12, and 18 months after discontinuing SLIT. At the beginning of SLIT, the allergen concentration used was similar to that used in NPT. Maintenance doses were administered 3 times a week for 1 year and 2 times a week for 2 years. All patients kept a symptom diary.

RESULTS

After the first year of SLIT, total nasal resistance (TNR) decreased sharply. TNR then remained constant at the end of the second year and decreased at the end of the third year of treatment. Discontinuation of SLIT did not produce evident variations in average TNR at 6 or 12 months, but 3/16 patients at 6 months and 9/16 patients at 12 months complained of symptomatic deterioration. The most evident deterioration was noted at the 18-month post-SLIT visit, in which TNR values were similar to those recorded at the onset of treatment. Positive response to stimulation and increased TNR were found after SLIT in 8/16 patients at 6 months, 13/16 at 12 months, 12/13 at 18 months, and 7/7 at 24 months. The symptom score indicated the return of symptoms. Twelve months after discontinuing SLIT, the patients complained about increased secretion and itching. The initial non-specific hyperreactivity, which had been present in all patients, was not evident in 68.7% after 3 years of SLIT, but persisted in a milder form in 31.3%.

CONCLUSION

SLIT successfully reduced symptoms of D. pteronissinus sensitivity. Non-specific hyperreactivity was absent at the end of SLIT, but returned by 6 months after discontinuing SLIT. Therefore, SLIT did not maintain the clinical results achieved at the beginning of treatment for more than 12 months.

Low proportion of BRCA1 and BRCA2 mutations in Finnish breast cancer families: evidence for additional susceptibility genes

One hundred breast and breast-ovarian cancer families identified at the Helsinki University Central Hospital in southern Finland and previously screened for mutations in the BRCA2 gene were now analyzed for mutations in the BRCA1 gene. The coding region and splice boundaries of BRCA1 were analyzed by protein truncation test (PTT) and heteroduplex analysis (HA)/SSCP in all 100 families, and 70 were also screened by direct sequencing. Contrary to expectations based on Finnish population history and strong founder effects in several monogenic diseases in Finland, a wide spectrum of BRCA1 and BRCA2 mutations was found. In the BRCA1 gene, 10 different protein truncating mutations were found each in one family. Six of these are novel Finnish mutations and four have been previously found in other European populations. Six different BRCA2 mutations were found in 11 families. Altogether only 21% of the breast cancer families were accounted for by mutations in these two genes. Linkage to both chromosome 17q21 (BRCA1) and 13q12 (BRCA2) was also excluded in a subset of seven mutation-negative families with four or more cases of breast or ovarian cancer. These data indicate that additional breast and breast-ovarian cancer susceptibility genes are likely to be important in Finland.

Research of non-specific hyperreactivity of upper airways in subjects with gastro-esophageal reflux (G.E.R.): preliminary reports

An association between asthma and gastro-esophageal reflux (GER) is well recognized but the underlying mechanism is still unclear. The authors suggest that could exist an association between GER and upper airways hyperreactivity and this association could represents the mechanism underlying the lower esophageal sphincter releasing, that determine the reflux. In fact they suppose that, the noxious injury of acid reflux follows a course that could be: pharynx-->larynx-->bronchi-->1/3 inferior of the esophagus-->reflux. From these presuppositions the authors carried out a study on the possible relationship between GER and non-specific hyperreactivity of upper airways on 14 subjects, divided in 2 groups: 10 subjects with functional GER, 4 subjects suffering from GER caused by hiatus hernia as control group. All patients had a thorough medical history, ENT examination with rigid and flexible endoscope, anterior Rhinomanometry (RRM), skin-test for inhalant and alimentary allergens, RAST, audiometric exam, non-specific nasal provocation test (NSNPT) with histamine, using as control the number of sneezes. From a through analysis of objective examination and from the results of the NSNPT with histamine resulted that all subjects with functional GER were rhinopathics. In all tests both in vivo (Skin-test) and in vitro(RAST) for the most common allergens (pollens-inhalant-mycophites-alimentary) the results were negative. The authors also found an involvement of paranasal sinuses that raised: 91% in the patients with recurrents phlogosis due to non specific nasal hyperreactivity; 40.9% in the allergic subjects (20% in the Graminacee +; 32% in the Parietaria O. +; 76% in the Dermatophagoides Pt. +; others 4%); 100% in the ASA-intolerance subjects. The NSNSPT with histamine showed in the group with functional GER a hyperreactivity with sneezes in 6/10 subjects, and 1/4 subjects of the group with GER with hiatus hernia. The RRM variations showed an unilateral nasal hyperreactivity in 6/10, bilateral in 3/10 subjects of the group with functional GER. In the group with GER with hiatus hernia only 1/4 subject showed reliable unilateral RRM variation. From the analysis of data resulted that subjects with functional GER showed a completely involvement of the upper airways and not only of the pharynx and larynx, caused by non specific hyperreactivity at the NSNPT with histamine, associated with a chronic pathology.

BRCA1 sequence analysis in women at high risk for susceptibility mutations. Risk factor analysis and implications for genetic testing

CONTEXT

A mutation in the BRCA1 gene may confer substantial risk for breast and/or ovarian cancer. However, knowledge regarding all possible mutations and the relationship between risk factors and mutations is incomplete.

OBJECTIVES

To identify BRCA1 mutations and to determine factors that best predict presence of a deleterious BRCA1 mutation in patients with breast and/or ovarian cancer.

DESIGN

A complete sequence analysis of the BRCA1 coding sequence and flanking intronic regions was performed in 798 women in a collaborative effort involving institutions from the United States, Italy, Germany, Finland, and Switzerland.

PARTICIPANTS

Institutions selected 798 persons representing families (1 person for each family) thought to be at elevated a priori risk of BRCA1 mutation due to potential risk factors, such as multiple cases of breast cancer, early age of breast cancer diagnosis, and cases of ovarian cancer. No participant was from a family in which genetic markers showed linkage to the BRCA1 locus.

MAJOR OUTCOME MEASURES

Sequence variants detected in this sample are presented along with analyses designed to determine predictive characteristics of those testing positive for BRCA1 mutations.

RESULTS

In 102 women (12.8%), clearly deleterious mutations were detected. Fifty new genetic alterations were found including 24 deleterious mutations, 24 variants of unknown significance, and 2 rare polymorphisms. In a subset of 71 Ashkenazi Jewish women, only 2 distinct deleterious mutations were found: 185delAG in 17 cases and 5382insC in 7 cases. A bias in prior reports for mutations in exon 11 was revealed. Characteristics of a patient's specific diagnosis (unilateral or bilateral breast cancer, with or without ovarian cancer), early age at diagnosis, Ashkenazi Jewish ethnicity, and family history of cancer were positively associated with the probability of her carrying a deleterious BRCA1 mutation.

CONCLUSIONS

Using logistic regression analysis, we provide a method for evaluating the probability of a woman's carrying a deleterious BRCA1 mutation for a wide range of cases, which can be an important tool for clinicians as they incorporate genetic susceptibility testing into their medical practice.

Homozygous inactivation of the NF1 gene in bone marrow cells from children with neurofibromatosis type 1 and malignant myeloid disorders

BACKGROUND

The risk of malignant myeloid disorders in young children with neurofibromatosis type 1 is 200 to 500 times the normal risk. The gene for neurofibromatosis type 1 (NF1) encodes neurofibromin, a protein that negatively regulates signals transduced by Ras proteins. Genetic and biochemical data support the hypothesis that NF1 functions as a tumor-suppressor gene in immature myeloid cells, but inactivation of both NF1 alleles has not been demonstrated in leukemic cells from patients with neurofibromatosis type 1.

METHODS

Using an in vitro transcription and translation system, we screened bone marrow samples from 18 children with neurofibromatosis type 1 and myeloid disorders for NF1 mutations that cause a truncated protein. Mutations were confirmed by direct sequencing of genomic DNA from the patients, and from their affected parents, in cases of familial neurofibromatosis type 1.

RESULTS

Specimens from 9 of the 18 children contained abnormal peptide fragments, and truncating mutations of the NF1 gene were found in specimens from 8 of these children. The normal NF1 allele was absent in bone marrow samples from five of the eight children. We detected the same mutation in DNA from the affected parent of each child with familial neurofibromatosis type 1.

CONCLUSIONS

Both alleles of the NF1 gene are inactivated in leukemic cells in some patients with neurofibromatosis type 1. NF1 appears to function as a tumor-suppressor gene in immature myeloid cells.

Recurrent germ-line BRCA1 mutations in extended African American families with early-onset breast cancer

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Rapid identification of RT-PCR clones containing translation-terminating mutations

The technique of in vitro transcription/translation (IVTT) has become an important method of detecting mutations that result in a prematurely terminated protein. Subsequent characterization of the mutations by cloning and sequencing the RT-PCR products, however, is often difficult and time consuming. This is due in large part to the altered metabolism to which transcripts containing translation terminating mutations are subject. Recent data has shown that mRNAs with nonsense or frame shift mutations are often selectively degraded, so that mutation bearing transcripts are significantly less abundant that wild-type transcripts and, after cloning, mutant clones are correspondingly scarce. We have developed a reliable method of identifying the cDNA clones containing translation terminating mutations by a 'second round' of IVTT. Clones are subjected to PCR and IVTT using similar conditions as in the initial IVTT reaction and are identified unequivocally as either wild-type or mutant prior to sequencing. Wasteful 'blind' sequencing is thus avoided as well as possible misidentification of taq polymerase errors as the mutation of interest.

The non-specific hypersensitivity of the upper and lower airways in Reinke's edema: preliminary results

Reinke's edema is characterized by swelling of the vocal cords, which generally is bilateral but often is more pronounced in one cord. The disease is named after the anatomist Reinke, who undertook a morphological study of the subepithelial connective tissue of the vocal cords in order to investigate edematous spread. In general, swelling of the vocal cords develops gradually and may increase considerably over months or even years. To evaluate an eventual relation ship between airways (nasal and bronchial) and Reinke's edema of the vocal cords, the authors studied 9 subjects suffering from Reinke's edema. These patients underwent to an accurate clinical history, skin-test for inhalant pollens and mycetes to evaluate the eventual presence of specific allergies, non-specific nasal provocation test with Histamine, baseline RRM to evaluate the non-specific nasal hypersensitivity and besides the RRM values has been considered the number of sneezes after Histamine stimulation, finally a bronchial provocation test with ultrasonic fog to evaluate the presence of non-specific hypersensitivity of the lower airways.

Nonthoracotomy implantation of cardioverter defibrillators: preliminary experience with a defibrillation lead placed at the right ventricular outflow tract

Although morbidity and mortality associated with defibrillator implantation using a nonthoracotomy approach have decreased as compared with a thoracotomy approach, defibrillation thresholds have been higher and fewer patients satisfied implant criteria. It may be possible to improve on the success of nonthoracotomy defibrillator implantation by the placement of a right ventricular (RV) outflow defibrillation lead. Implantable cardioverter defibrillator implantation data of 30 consecutive patients with clinical VT or VF were reviewed. Three defibrillation leads were routinely used. When either pacing threshold at the RV apex was inadequate (n = 2) or 18-J shocks were not successful in terminating VF in 3 of 4 trials (n = 8), the RV apex lead was positioned to the RV outflow tract attaching to the septum. Defibrillation testing was first performed with the RV apex lead in combination with CS, SVC, and/or subcutaneous leads. Twenty patients satisfied implant criteria with a defibrillation threshold of 13.5 +/- 3.6 J. In 7 of the 10 patients, whose RV lead was repositioned to the RV outflow tract, this lead in combination with SVC, CS, or subcutaneous leads produced successful defibrillation at < or = 18 J or in 3 of 4 trials. This approach improved the overall success of nonthoracotomy implantation of defibrillators from 69% to 90%. After a follow-up of 27 +/- 6 months, there was no dislodgment of the RV outflow tract defibrillation leads.

CONCLUSIONS

This article reports the preliminary observation that placement of defibrillation leads to the RV outflow tract in humans was possible and without dislodgment. RV outflow tract offers an alternative for placement of defibrillation leads, which may improve on the success of nonthoracotomy defibrillator implantation.

Local treatment of nasal polyposis with capsaicin: preliminary findings

The inflammatory process triggered by the nasal hyperreactivity, whether specific or aspecific, presents three components: immunomediation-neurogenic-interconnection between the nervous and the immunitary systems. Neuropeptides (eg SP and CGRP) are among the agents responsible for neurogenic phlogosis and, in our opinion, they contribute towards the onset of polyps. Capsaicin, which acts on the C fibres, has been applied locally (30 microns) by the AA in 15 patients affected by aspecific nasal hyperreactivity with polyps, in the course of a double blind study with an equal number of patients. Treatment was given once a week for 5 consecutive weeks in order to evaluate the effect on both the hyperreactivity and the polyps. Before and after each session and at the 1- and 3-month controls the following tests were carried out: assessment of symptoms, nasal endoscopy, sizing of the polyps, aspecific nasal provocation test and nasal cytology. Apart from an improvement in symptoms and in nasal hyperreactivity, results showed a reduction in the size of the polyps even though accompanied by a gradual increase of eosinophiles which was not correlated to a degranulation process.

Rhinoreactivity in a patient affected by the Darier-White disease

The Darier-White disease is a rare hyperkeratosic skin-disease which can also affect other organs. From an otoiatric point or view, there are alterations of the oral cavity, salivary glands and congenital deafness, but there is nothing against the nasal mucosa. The clinical case we studied, shows the presence of aspecific nasal hyperreactivity correlated to sun exposure as it happens for cutaneous lesions, independently of the presence of eosinophiles in the nasal secretion. This could mean that the Darler-White disease can also alter the function of the nasal mucosa.

Local treatment of aspecific nasal hyperreactivity with capsaicin

Ten patients with vasomotor rhinitis underwent local treatment with capsaicin (30 micromol.), once per week for five weeks; controls were carried out at weekly intervals and 1, 3 and 6 months after therapy. Assessment was made using symptom score and nasal resistance scores both basal and subsequent to aspecific nasal provocation. Results showed abatement of symptoms, and reduction of nasal resistance and aspecific hyperreactivity already during the second week. This trend continued for six months, with endoscopic improvement also. Hence, this treatment proved to be efficient in reducing nasal reactivity.

Otorhinolaryngological aspects of HIV infections: personal experience

The involvement of the ENT sphere in HIV infections is fairly common, but the relative manifestations, though not to be considered atypical, are not pathognomonic. The present study has been set up for the otoiatric assessment of a group of HIV patients and the correlation of ENT symptoms with the various stages of the disease. To this end, 60 patients were examined (35 belonged to groups 2-3 and 25 to group 4) of whom 50% were drug addicts, 36% homosexuals and 14% heterosexuals. All patients underwent a complete ENT examination as well as the assessment of hearing and vestibular function, of olfactory and taste functions, of respiratory and nasal mucociliary functions along with an anti-HIV antibody check of nasal secretion. Results showed a prevalence of otologic and rhinosinusal symptoms as well as cervical-facial swelling. Testing revealed a hearing loss of mainly conductive origin caused by otitis and tubal stenosis; vestibular hyporeflexia; mixed hyposmia and hypogeusia owing to the involvement of multiple cranial nerves; respiratory and mucociliary changes due to rhinitis and hypertrophy of the nasal mucosa. In all cases anti-HIV antibodies were found in nasal secretion. From a diagnostic point of view there was a prevalence of specific pathologies: oropharyngeal candidosis, stage 4; cervical lymphoadenopathy, stages 2-3; chronic rhinosinusitis, nasal vestibulitis and nosebleed; mainly chronic otitis media. All such manifestations suggest a marked involvement of ENT organs, which can be attributed to the anatomical characteristics of the area, with the relative diagnostic and prognostic implications of HIV infection.

[The preparation for self-care of the diabetic client and his family]

Partial report, quanti-qualitative of action-research developed in the ward test/ambulatory of a University Hospital, extensive to home; integrating students, teachers and nursing team.

OBJECTIVE

to establish standards to integrate hospital/community, seeking the man in the home circle, oppose the recovery/rehabilitation and the integration to work/society, considering the problems in the home/work and put into practice the proposition of the SUDS with extension to the hospital/community actions. Home visits raising the home conditions, family and/or community, consolidating their participation in the process. During the hospital stay nursing care was oriented to conduct the participation and realization of the care by the client and relatives happening the same in the ambulatory probation.

Brain responses to semantic incongruity in bilinguals

Event-related potentials were examined in the first and second languages of bilinguals, and in monolinguals. Stimuli were anomalous sentences presented one word at a time on a CRT monitor. The principal dependent measure was the N400 component, and an accompanying frontal negativity, which provided an estimate of the amount of time the nervous system takes to determine the semantic incongruity of a given word. The results indicate that N400 latency is slightly, but significantly, delayed in bilinguals, with monolinguals having the shortest mean N400 latency, the first language of bilinguals next, and the second language of bilinguals longest. The frontal negativity varied in amplitude somewhat independently of the parietal N400. The amplitude of the frontal negativity was sometimes reduced in the second language, tending to be smaller in those subjects who used their second language the least. Neither N400 nor the frontal negativity varied as a function of age of acquisition of the second language. The results are discussed with reference to the relative automaticity of language in bilinguals, and the sensitivity of N400 to variations in the automaticity of language processing.

Acute upper airway obstruction in rheumatoid arthritis of the cricoarytenoid joints

We have reported two cases of acute, life-threatening upper airway obstruction due to previously unrecognized rheumatoid arthritis of the cricoarytenoid joints with severe acute and chronic deformities of the larynx. Attempted endotracheal intubation with the rigid laryngoscope failed in each case, resulting in the need for emergency tracheostomy. We recommend the use of the fiberoptic bronchoscope for elective or emergency endotracheal intubations in patients with severe rheumatoid arthritis involving the cervical spine and the larynx.

Oral health in children: prevention of dental caries

Dental problems are common among children and adolescents in the United States. More than 90 percent of our youth have dental caries, malocclusions, injury to teeth and mouth and gum disease. However, it is possible to maintain oral health and prevent dental problems and, specifically, dental caries, through education and motivation. Nurses working with children and families are more frequently in a position to initiate a program for dental health than are members of the dental profession. We feel that it is essential in light of disease occurrence and current levels of dental caries, for nurses to incorporate oral health maintenance in their care of children in ambulatory and acute care settings.