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1.
Rhinology ; 59(1): 40-48, 2021 Feb 01.
Article in English | MEDLINE | ID: mdl-32628224

ABSTRACT

BACKGROUND: Narrow band imaging (NBI) endoscopy is an optical method that helps to characterise tissue vasculature. Its appli- cation in sinonasal pathology remains scarce and a systematic study of its application to rhinology is lacking. The aim of this study is to analyse and describe the normal sinonasal mucosa under NBI light and to characterise the microvascular features of various sinonasal pathologies. We also want to suggest a classification of the patterns, peculiar to this district, and to evaluate whether they can be indicative of a specific physiological or pathological condition. METHODS: Digital videos and images under white light and NBI of 103 patients (82 evaluated) with 29 sinonasal pathologies and 55 controls (33 evaluated). were independently analysed by three otolaryngologists and the final pattern was then arranged for each image, reaching an agreement between the individual evaluations. RESULTS: Once the appearance of normal sinonasal (SN) mucosa was established (SN1), four patterns for the pathological mucosa were described and a working classification was proposed (SN2, SN3, SN4, SN5). We calculated specificity (80.6% vs 90.6%), sensi- tivity (20% vs 38.5%), PPV (46.1% vs 50%), NPV (54.7% vs 85.7%) and accuracy (53% vs 80.3%) of the ability of SN4 and SN5 pattern to discriminate between benign and malignant nasal neoformations. CONCLUSIONS: This is the first study to propose a systematic NBI description and a classification of the vasculature of healthy and pathological mucosa in the sinonasal tract. Our preliminary results show that this technique can help in the workup of several rhinologic conditions and especially in distinguishing benign from malignant tumors.


Subject(s)
Endoscopy , Narrow Band Imaging , Humans , Sensitivity and Specificity
2.
Clin Rheumatol ; 37(5): 1249-1255, 2018 May.
Article in English | MEDLINE | ID: mdl-29470737

ABSTRACT

Iloprost (ILO) is employed intravenously for the treatment of severe Raynaud phenomenon (RP) and digital ulcers (DU) in systemic sclerosis (SSc). The aim of this study was to evaluate the safety and tolerability of the intravenous treatment with ILO in different phases of SSc. Eighty-one consecutive non-selected SSc patients, all on nifedipine, with moderate RP, treated with ILO infusion, were retrospectively evaluated. Patients were sub classified according to the edematous or fibrotic/atrophic cutaneous phase of the disease. ILO was infused with a progressive increase of the dosage up to the achievement of patient's tolerance, 1 day/week. In cases of slower infusion regimen due to adverse events (AE) at the beginning of the administration, patients received a lower dose of the drug (not possible to quantify precisely the final cumulative dosage). 16/81 SSc patients presented digital edema, 5 developed diarrhea, and 9 developed transient hypotension during the infusion at 20 ml/h that ameliorated when the drug was withdrawn. Moreover, 10/16 edematous patients experienced significant and painful digital swelling, unlike patients in the fibrotic group (p < 0.0001); 11/16 patients reported flushing and 7/16 headache, always controlled with dose tapering below 10 ml/h. In the atrophic/fibrotic phase patients (65/81), 10 developed diarrhea and 24 hypotension at infusion rate of 20 ml/h that led to temporary withdrawal of the drug. When ILO was restarted and kept below 10 ml/h, no side effects were experienced. 23/65 patients experienced flushing and 8/65 headache, all controlled with infusion reduction below 10 ml/h. In these patients, adverse events were significantly less frequent than in the edematous group (p = 0.023 and p = 0.008, respectively). Our data suggest that calcium channel blockers should be transitorily stopped while using ILO and that a pre-treatment approach might reduce or control adverse events. In patients with digital edema, ILO infusion should be carefully employed after the evaluation of patient's drug tolerance.


Subject(s)
Iloprost/adverse effects , Raynaud Disease/drug therapy , Scleroderma, Systemic/complications , Skin Ulcer/drug therapy , Adult , Diarrhea/chemically induced , Female , Fingers , Humans , Iloprost/therapeutic use , Male , Microscopic Angioscopy , Middle Aged , Raynaud Disease/etiology , Retrospective Studies , Skin Ulcer/etiology , Treatment Outcome
3.
Nanoscale ; 9(48): 19390-19397, 2017 Dec 14.
Article in English | MEDLINE | ID: mdl-29206255

ABSTRACT

We explore nanoribbons from topological two-dimensional stanene as a channel material in tunnel field effect transistors. This novel technological option offers the possibility of building pure one-dimensional (1D) channel devices (comprised of a 1D chain of atoms) due to localized states placed at the nanoribbon edges. The investigation is based on first-principles calculations and multi-scale transport simulations to assess the performance of devices against industry requirements and their robustness with respect to technological issues like line edge roughness, detrimental for nanoribbons. We will show that edge states are robust with respect to the presence of non-idealities (e.g., atom vacancies at the edges), and that 1D-channel TFETs exhibit interesting potential for digital applications and room for optimization in order to improve the ION/IOFF at the levels required by the ITRS, while opening a path for the exploration of new device concepts at the ultimate scaling limits.

4.
Nano Lett ; 16(6): 3788-94, 2016 06 08.
Article in English | MEDLINE | ID: mdl-27152475

ABSTRACT

Among atomically thin two-dimensional (2D) materials, molybdenum disulfide (MoS2) is attracting considerable attention because of its direct bandgap in the 2H-semiconducting phase. On the other hand, a 1T-metallic phase has been revealed, bringing complementary application. Recently, thanks to top-down fabrication using electron beam (EB) irradiation techniques, in-plane 1T-metal/2H-semiconductor lateral (Schottky) MoS2 junctions were demonstrated, opening a path toward the co-integration of active and passive two-dimensional devices. Here, we report the first transport measurements evidencing the formation of a MoS2 Schottky barrier (SB) junction with barrier height of 0.13-0.18 eV created at the interface between EB-irradiated (1T)/nonirradiated (2H) regions. Our experimental findings, supported by state-of-the-art simulation, reveal unique device fingerprint of SB-based field-effect transistors made from atom-thin 1T layers.

7.
Rev Sci Instrum ; 84(10): 104702, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24182139

ABSTRACT

We present a novel method for device noise measurement, based on a two-channel cross-correlation technique and a direct "in situ" measurement of the transimpedance of the device under test (DUT), which allows improved accuracy with respect to what is available in the literature, in particular when the DUT is a nonlinear device. Detailed analytical expressions for the total residual noise are derived, and an experimental investigation of the increased accuracy provided by the method is performed.

8.
Surg Endosc ; 27(10): 3799-805, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23708711

ABSTRACT

BACKGROUND: Endoscopic mucosal resection (EMR) is an effective therapeutic technique well-standardized worldwide for the treatment of gastrointestinal neoplasm limited to the mucosal layer. To date, no study has compared technical and clinical differences based on the number of EMRs performed per year. This study aimed to compare EMR technical success, complications, and clinical outcome between low-volume centers (LVCs) and high-volume centers (HVCs). A total of nine endoscopic centers were included in the study. METHODS: This prospective study investigated consecutive patients with sessile polyps or flat colorectal lesions 1 cm or larger referred for EMR. RESULTS: A total of 427 lesions were resected in 384 patients at nine endoscopic centers. Males accounted for 60.4% and females for 39.6% of the patients. Most of the EMRs (84.8%) were performed in HVCs and only 15.2% in LVCs. All the lesions were resected in only one session. Argon plasma coagulation was performed on the margins of piecemeal resection in 15.7% of the patients in HVCs only. Complete excision was achieved for 98.6% of the lesions in HVCs and 98.8% of the lesions in LVCs. The complication rate was 4.4% in HVCs and 4.6% in LVCs (p = 0.94). Delayed bleeding occurred in 2.5% of the HVC cases and 3.1% of the LVC cases. Perforation occurred in 1.9% of the HVC cases and 1.5% of the LVC cases (p = 1.00). Recurrences were experienced with 15% of the lesions: 15.5% in HVCs and 14% in LVCs (p = 0.79). CONCLUSIONS: The study showed that EMR can be performed also in LVC.


Subject(s)
Colonoscopy/methods , Colorectal Neoplasms/surgery , Intestinal Mucosa/surgery , Intestinal Polyps/surgery , Surgicenters/statistics & numerical data , Workload , Adenocarcinoma/surgery , Adenoma/surgery , Aged , Colonic Polyps/surgery , Colonoscopy/statistics & numerical data , Coloring Agents , Female , Gastrointestinal Hemorrhage/etiology , Humans , Indigo Carmine , Italy , Lymphoma, B-Cell, Marginal Zone/surgery , Male , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Postoperative Hemorrhage/etiology , Prospective Studies
11.
Nano Lett ; 12(3): 1324-8, 2012 Mar 14.
Article in English | MEDLINE | ID: mdl-22339809

ABSTRACT

The emergence of graphene with its unique electrical properties has triggered hopes in the electronic devices community regarding its exploitation as a channel material in field effect transistors. Graphene is especially promising for devices working at frequencies in the 100 GHz range. So far, graphene field effect transistors (GFETs) have shown cutoff frequencies up to 300 GHz, while exhibiting poor voltage gains, another important figure of merit for analog high frequency applications. In the present work, we show that the voltage gain of GFETs can be improved significantly by using bilayer graphene, where a band gap is introduced through a vertical electric displacement field. At a displacement field of -1.7 V/nm the bilayer GFETs exhibit an intrinsic voltage gain up to 35, a factor of 6 higher than the voltage gain in corresponding monolayer GFETs. The transconductance, which limits the cutoff frequency of a transistor, is not degraded by the displacement field and is similar in both monolayer and bilayer GFETs. Using numerical simulations based on an atomistic p(z) tight-binding Hamiltonian we demonstrate that this approach can be extended to sub-100 nm gate lengths.


Subject(s)
Amplifiers, Electronic , Graphite/chemistry , Membranes, Artificial , Nanostructures/chemistry , Nanostructures/ultrastructure , Transistors, Electronic , Electric Conductivity , Equipment Design , Equipment Failure Analysis , Macromolecular Substances/chemistry , Materials Testing , Molecular Conformation , Particle Size , Surface Properties
13.
Clin Exp Rheumatol ; 27(3 Suppl 54): 51-4, 2009.
Article in English | MEDLINE | ID: mdl-19796562

ABSTRACT

BACKGROUND: In systemic sclerosis (SSc), digital ulcers (DU) are painful, difficult to heal and frequently infected, thus greatly affecting quality of life and increasing SSc-related disability. Vitamin E has been previously used in cutaneous lesions for its antioxidant and anti-inflammatory effects. OBJECTIVES: To study the healing effect of D-alpha-tocopheryl acetate (acetic ester of alpha-tocopherol) (VE) gel on DU of SSc patients. METHODS: 27 SSc patients with a total of 86 DU were enrolled in an open pilot study. The patients were randomly assigned to two groups: 15 patients were treated until DU healing with the local standard ulcer care protocol with the application of vitamin E gel (experimental group), while 12 patients were treated with standard ulcer care protocol only (control group). In both groups, DU were treated twice a week and pain was scored by a NRS (numeric rating scale). In both groups the cost of medications was analysed. RESULTS: VE induced a faster healing of DU in respect to controls (13.22+/-2.72 weeks, versus 20.94+/-3.65; p<0.0001) with a lower number of medications (26.18+/-5.63 vs. 41.88+/-7.31; p<0.0001). Resolution of pain was faster in experimental (17.82+/-4,59 medications) than in controls (26.26+/-19.16 medications) (p=0.0022). In the experimental group, the cost of medications was significantly lower (6,919.15 euros/patient) than in the control group (11,056.32 euros/patient). CONCLUSION: The application of VE reduces time of healing and has a faster resolution of pain, with a significant reduction of costs. Topical VE may improve the management of DU in SSc.


Subject(s)
Antioxidants/therapeutic use , Scleroderma, Systemic/drug therapy , Skin Ulcer/drug therapy , Vitamin E/therapeutic use , Administration, Topical , Antioxidants/administration & dosage , Female , Fingers , Gels , Humans , Male , Middle Aged , Pain/drug therapy , Pain/etiology , Pain/physiopathology , Pilot Projects , Scleroderma, Systemic/complications , Scleroderma, Systemic/physiopathology , Severity of Illness Index , Skin/drug effects , Skin/pathology , Skin Ulcer/etiology , Skin Ulcer/physiopathology , Vitamin E/administration & dosage
15.
Dig Liver Dis ; 41(6): 447-9, 2009 Jun.
Article in English | MEDLINE | ID: mdl-18295559

ABSTRACT

The association between gastric carcinoma and lymphoma is rare. Confocal laser endomicroscopy is a new diagnostic tool that allows the identification of cellular and vascular architecture during endoscopy. This is the first report of an in vivo early gastric carcinoma diagnosis by confocal laser endomicroscopy in a patient successfully treated for a primary gastric diffuse large-B-cell lymphoma.


Subject(s)
Adenocarcinoma/diagnosis , Endoscopy, Digestive System/methods , Lymphoma, Large B-Cell, Diffuse/diagnosis , Microscopy, Confocal/methods , Neoplasms, Second Primary/diagnosis , Stomach Neoplasms/diagnosis , Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Antineoplastic Combined Chemotherapy Protocols , Combined Modality Therapy , Early Detection of Cancer , Gastrectomy , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/surgery , Male , Middle Aged , Neoplasms, Second Primary/drug therapy , Neoplasms, Second Primary/pathology , Neoplasms, Second Primary/surgery , Stomach/pathology , Stomach Neoplasms/drug therapy , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery
16.
Dig Liver Dis ; 41(8): 578-85, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19013113

ABSTRACT

BACKGROUND: Pouchitis and dysplasia may affect the reservoir after restorative proctocolectomy. AIMS: To assess the suitability of confocal laser endomicroscopy for the in vivo diagnosis of mucosal changes in ileal pouch for ulcerative colitis and familial adenomatous polyposis. METHODS: Standard endoscopy and endomicroscopy were performed in 18 pouches. Confocal images were scored for the presence of villous atrophy, inflammation, ulceration, colonic metaplasia and dysplasia. Targeted biopsies were taken. Endomicroscopic and histological findings were compared. RESULTS: At standard endoscopy, the signs of pouchitis were recorded in 7/18 (38.9%) patients. At endomicroscopy, pathological features were found in 16/18 (88.9%), villous atrophy in 15/18 (83.3%), inflammation in 13/18 (72.2%), ulceration in 3/18 (16.7%), and colonic metaplasia in 12/18 (67.7%). No dysplasia was observed. At histology, abnormalities were present in 17/18 (94.4%): villous atrophy in 15/18 (83.3%), inflammation in 17/18 (94.4%), ulceration in 6/18 (33.3%), colonic metaplasia in 15/18 (83.3%). Morphological changes of the ileal pouch could be predicted with an accuracy of 94.4% (95% CI: 74.2-99.0). The k-value for intra- and interobserver agreement was 0.93 and 0.78, respectively. CONCLUSIONS: Endomicroscopy may be helpful in the evaluation of morphologic changes in ileal pouch. The small size of the population sample requires further studies for the results to be confirmed.


Subject(s)
Ileum/pathology , Intestinal Mucosa/pathology , Microscopy, Confocal , Proctocolectomy, Restorative , Adenomatous Polyposis Coli/pathology , Adenomatous Polyposis Coli/surgery , Adult , Aged , Colitis, Ulcerative/pathology , Colitis, Ulcerative/surgery , Female , Humans , Male , Middle Aged , Young Adult
17.
Ann Rheum Dis ; 68(1): 94-8, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18308744

ABSTRACT

BACKGROUND: In systemic sclerosis (SSc) reduced capillary density decreases blood flow and leads to tissue ischaemia and fingertip ulcers. Nail fold videocapillaroscopy (NVC) is a diagnostic and follow-up parameter useful to evaluate the severity, activity and the stage of SSc microvascular damage. Autologous haemopoietic stem cell transplantation (HSCT) is a new treatment for patients with severe diffuse cutaneous systemic sclerosis (dcSSc) refractory to conventional therapies. We aimed to evaluate the improvement of microvasculature after HSCT using NVC. METHODS: A total of 16 patients with severe dcSSc with a "late" videocapillaroscopy pattern underwent an immunesuppressive treatment: 6 were treated with HSCT and 10 with monthly pulse cyclophosphamide (CYC) 1 g for 6 months and then orally with 50 mg/day for further 6 months. NVC was performed before and after 3 months from the beginning of each treatment and then repeated every 3 months. RESULTS: In all patients, before HSCT NVC showed large avascular areas and ramified capillaries and vascular architectural disorganisation ("late" pattern). At 3 months after HSCT, the NVC pattern changed from "late" into "active", showing frequent giant capillaries (>6/mm) and haemorrhages, absence of avascular areas and angiogenesis phenomena; 1 year after HSCT, microvascular abnormalities were still in the "active" pattern. In patients treated with CYC, no NVC modifications were observed during 24 months of follow-up and the pattern always remained "late". CONCLUSIONS: These results indicate that HSCT with a high dose CYC regimen may foster vascular remodelling, while CYC at lower doses and with a chronic regimen does not influence the microvasculature.


Subject(s)
Hematopoietic Stem Cell Transplantation , Microcirculation , Scleroderma, Diffuse , Adult , Cyclophosphamide/therapeutic use , Drug Administration Schedule , Female , Humans , Immunosuppressive Agents/therapeutic use , Male , Microscopic Angioscopy/methods , Middle Aged , Nails/blood supply , Prospective Studies , Regional Blood Flow , Scleroderma, Diffuse/drug therapy , Scleroderma, Diffuse/physiopathology , Scleroderma, Diffuse/surgery , Statistics, Nonparametric , Transplantation, Autologous , Video Recording
18.
Eur Respir J ; 33(3): 586-93, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19047313

ABSTRACT

Screening for active tuberculosis (TB) and latent TB infection (LTBI) is mandatory prior to the initiation of tumour necrosis factor-alpha inhibitor therapy. However, no agreement exists on the best strategy for detecting LTBI in this population. The aim of the present study was to analyse the performance of the tuberculin skin test (TST) and QuantiFERON-TB Gold in-tube (QFT-GIT) on LTBI detection in subjects with immunomediated inflammatory diseases (IMID). The TST and QFT-GIT were prospectively performed in 398 consecutive IMID subjects, 310 (78%) on immunosuppressive therapy and only 16 (4%) had been bacillus Calmette-Guérin (BCG) vaccinated. Indeterminate results to QFT-GIT were found in five (1.2%) subjects. Overall, 74 (19%) out of 393 subjects were TST-positive and 52 (13%) were QFT-GIT-positive. Concordance between TST and QFT-GIT results was good (87.7%): 13 were QFT-GIT-positive/TST-negative and 35 QFT-GIT-negative/TST-positive. By multivariate analysis both tests were significantly associated with older age. Only the TST was associated with BCG vaccination and radiological lesions of past TB. Use of immunosuppressive drugs differently modulated QFT-GIT or TST scoring. Use of the QuantiFERON-TB Gold in-tube, as a screening tool for latent tuberculosis among immunomediated inflammatory disease subjects, is feasible. Until further data will elucidate discordant tuberculin skin test/QuantiFERON-TB Gold in-tube results, a strategy of simultaneous tuberculin skin and QuantiFERON-TB Gold in-tube testing in a low prevalence bacillus Calmette-Guérin vaccinated population, should maximise potentials of latent tuberculosis diagnosis.


Subject(s)
Autoimmune Diseases/blood , Autoimmune Diseases/complications , Tuberculin Test/instrumentation , Tuberculin Test/methods , Tuberculosis/complications , Tuberculosis/immunology , Adult , Aged , Autoimmune Diseases/diagnosis , BCG Vaccine/immunology , Female , Humans , Immunosuppressive Agents/therapeutic use , Inflammation , Male , Middle Aged , Multivariate Analysis , Prospective Studies , Tuberculosis/diagnosis , Tumor Necrosis Factor-alpha/biosynthesis
20.
Dig Liver Dis ; 39(6): 537-43, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17433795

ABSTRACT

BACKGROUND AND AIMS: Type 1 gastric neuroendocrine tumour surveillance and treatment are a matter of debate. Endoscopic, or surgical, resection and chronic somatostatin analog therapy have been proposed. Based on the favourable behaviour of this neoplasm, we performed an endoscopic and clinical follow-up in 11 patients affected by type 1 gastric neuroendocrine tumours, avoiding any specific treatment. METHODS: Between 1994 and 2006, we prospectively recorded the data of 11 untreated patients with type 1 gastric neuroendocrine tumours who underwent an endoscopic and clinical follow-up. All the patients were also evaluated by means of an abdominal computed tomography scan, somatostatin receptor scintigraphy and blood tests. RESULTS: During the follow-up (median 54 months, range 9-136), the endoscopic picture of 4 (36%) out of 11 patients changed in terms of increased number of lesions. In none of the cases were detected any lesions that exceeded 10mm in diameter, and none of the patients demonstrated any evidence of local or distant metastases. CONCLUSIONS: Our data confirm the literature data of the indolent behaviour of type 1 gastric neuroendocrine tumours and suggest that a careful endoscopic follow-up, without any treatment, might represent a reasonable and safe option in selected patients.


Subject(s)
Gastroscopy , Neuroendocrine Tumors/pathology , Stomach Neoplasms/pathology , Treatment Refusal , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Time Factors
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