High-Mobility Epitaxial Graphene on Ge/Si(100) Substrates.

Graphene was shown to reveal intriguing properties of its relativistic two-dimensional electron gas; however, its implementation to microelectronic applications is missing to date. In this work, we present a comprehensive study of epitaxial graphene on technologically relevant and in a standard CMOS process achievable Ge(100) epilayers grown on Si(100) substrates. Crystalline graphene monolayer structures were grown by means of chemical vapor deposition (CVD). Using angle-resolved photoemission spectroscopy and in situ surface transport measurements, we demonstrate their metallic character both in momentum and real space. Despite numerous crystalline imperfections, e.g., grain boundaries and strong corrugation, as compared to epitaxial graphene on SiC(0001), charge carrier mobilities of 1 × 104 cm2/Vs were obtained at room temperature, which is a result of the quasi-charge neutrality within the graphene monolayers on germanium and not dependent on the presence of an interface oxide. The interface roughness due to the facet structure of the Ge(100) epilayer, formed during the CVD growth of graphene, can be reduced via subsequent in situ annealing up to 850 °C coming along with an increase in the mobility by 30%. The formation of a Ge(100)-(2 × 1) structure demonstrates the weak interaction and effective delamination of graphene from the Ge/Si(100) substrate.

Metal-Free CVD Graphene Synthesis on 200 mm Ge/Si(001) Substrates.

Good quality, complementary-metal-oxide-semiconductor (CMOS) technology compatible, 200 mm graphene was obtained on Ge(001)/Si(001) wafers in this work. Chemical vapor depositions were carried out at the deposition temperatures of 885 °C using CH4 as carbon source on epitaxial Ge(100) layers, which were grown on Si(100), prior to the graphene synthesis. Graphene layer with the 2D/G ratio ∼3 and low D mode (i.e., low concentration of defects) was measured over the entire 200 mm wafer by Raman spectroscopy. A typical full-width-at-half-maximum value of 39 cm-1 was extracted for the 2D mode, further indicating that graphene of good structural quality was produced. The study also revealed that the lack of interfacial oxide correlates with superior properties of graphene. In order to evaluate electrical properties of graphene, its 2 × 2 cm2 pieces were transferred onto SiO2/Si substrates from Ge/Si wafers. The extracted sheet resistance and mobility values of transferred graphene layers were ∼1500 ± 100 Ω/sq and µ ≈ 400 ± 20 cm2/V s, respectively. The transferred graphene was free of metallic contaminations or mechanical damage. On the basis of results of DFT calculations, we attribute the high structural quality of graphene grown by CVD on Ge to hydrogen-induced reduction of nucleation probability, explain the appearance of graphene-induced facets on Ge(001) as a kinetic effect caused by surface step pinning at linear graphene nuclei, and clarify the orientation of graphene domains on Ge(001) as resulting from good lattice matching between Ge(001) and graphene nucleated on such nuclei.

Understanding the growth mechanism of graphene on Ge/Si(001) surfaces.

The practical difficulties to use graphene in microelectronics and optoelectronics is that the available methods to grow graphene are not easily integrated in the mainstream technologies. A growth method that could overcome at least some of these problems is chemical vapour deposition (CVD) of graphene directly on semiconducting (Si or Ge) substrates. Here we report on the comparison of the CVD and molecular beam epitaxy (MBE) growth of graphene on the technologically relevant Ge(001)/Si(001) substrate from ethene (C2H4) precursor and describe the physical properties of the films as well as we discuss the surface reaction and diffusion processes that may be responsible for the observed behavior. Using nano angle resolved photoemission (nanoARPES) complemented by transport studies and Raman spectroscopy as well as density functional theory (DFT) calculations, we report the direct observation of massless Dirac particles in monolayer graphene, providing a comprehensive mapping of their low-hole doped Dirac electron bands. The micrometric graphene flakes are oriented along two predominant directions rotated by 30° with respect to each other. The growth mode is attributed to the mechanism when small graphene "molecules" nucleate on the Ge(001) surface and it is found that hydrogen plays a significant role in this process.

Muscarinic cholinergic receptors in the human melanoma cell line SK-Mel 28: modulation of chemotaxis.

Primary and metastatic human melanomas express muscarinic receptors. In embryonic tissues, expression of muscarinic receptors is correlated with morphogenesis. The hypothesis has been put forward that muscarinic receptors are involved in morphogenetic movements in the embryo, and in cellular movements in melanoma cells during invasive growth. The purpose of the present study was to characterize the muscarinic receptors in the human melanoma cell line SK-Mel 28 and to test in a Boyden chamber assay whether the chemotactic activity towards fibronectin can be influenced by muscarinic stimulation. In Western blots with the monoclonal antibody M35, muscarinic receptors were localized in a strong band at 66 kDa, and in a weak band at 63 kDa. Western blot with M3 subtype specific antibodies reproduced the line at 66 kDa. RT-PCR revealed mRNA for subtypes M3 and M5. These findings suggest that SK-Mel 28 cells express a large number of subtype M3 and a small number of subtype M5 receptors. Microscopic observation of calcium mobilization after muscarinic stimulation indicated that all cells carried functional muscarinic receptors. A standardized chemotaxis assay was established in modified Boyden chambers using fibronectin as chemotactic agent. After addition of carbachol to the upper compartment, an increase of fibronectin induced chemotaxis of approximately 30% was observed, an effect abrogated by atropine. These results demonstrate that muscarinic cholinergic treatment has a modulatory effect on fibronectin-induced chemotaxis in SK-Mel 28 melanoma cells, indicating that the muscarinic system is involved in regulation of cell movement.

Electrophysiological correlates of visual impairments after traumatic brain injury.

Our aims were to investigate: (i) the VEP correlates of functional visual impairments following traumatic brain injury (TBI), in particular of the reduced spatial form perception; and (ii) the VEP correlates of visual sustained arousal in TBI patients. We used two approaches: (i) the analysis of latency and amplitude of the peaks; and (ii) the study of the correlations among the latencies of the peaks as a label of temporal synchronization. Thirty-five severe TBI outcome inpatients and 35 matching controls were studied. Pattern-reversal VEPs were recorded at Oz-Fz and Cz-A1, first without counting, then with counting of the reversals. Seven peaks of the waveform at Oz and eight peaks at Cz were measured. We found several differences in amplitude and latency between patients and controls, and between nocount/count. The temporal binding of the peaks within each channel and between the two channels was calculated by correlation matrices, and tested by factor analysis. Results indicated that the synchronization of the peaks within each channel did not differ between patients and controls. The temporal covariation between peaks occurring at Oz and Cz, however, was highly significantly altered in patients. This suggests that visual impairments in TBI patients may be due to a deranged synchronization of the activity of different brain regions.

Effects of enflurane and isoflurane on splanchnic oxygenation in humans.

STUDY OBJECTIVES: To determine the effects of enflurane and isoflurane on hepatic venous oxygen saturation (ShvO2) and splanchnic oxygen (O2) extraction. To measure hemodynamic parameters and ShvO2, mixed venous, and arterial lactate concentrations during enflurane and isoflurane anesthesia. DESIGN: Randomized, prospective study. SETTING: University hospital. PATIENTS: 20 ASA physical status I, II, and III adults, who underwent major abdominal surgery requiring mechanical ventilation a few hours postoperatively. INTERVENTIONS: After placement of catheters in the pulmonary artery, radial artery, peripheral and right hepatic vein, one hour postoperatively either enflurane or isoflurane was applied at different minimum alveolar concentration (MAC) of 0.5, 1.0, and 1.5 in a randomized order. MEASUREMENTS AND MAIN RESULTS: Before and 10 minutes after administration of each desired end-expiratory anesthetic concentration, the following parameters were determined: hemodynamic parameters, arterial (SaO2), mixed venous (SvO2), and hepatic venous oxygen saturations, systemic and splanchnic O2 extraction, arterial, mixed venous, and hepatic venous lactate concentrations. Cardiac output (CO) and mean arterial pressure (MAP) decreased in a dose dependent manner. SaO2, SvO2, and systemic O2 extraction remained unchanged with enflurane and isoflurane anesthesia. In the enflurane group, but not in the isoflurane group, ShvO2 decreased with increasing inhalational concentrations. This decrease in ShvO2 reflected an increase in splanchnic O2 extraction with enflurane; in contrast to isoflurane. CONCLUSIONS: Enflurane causes a decrease in ShvO2, which indicates an impairment of splanchnic perfusion corresponding to the reduction in CO and MAP in a dose-dependent manner. Isoflurane maintains splanchnic perfusion in contrast to enflurane.

Effects of positive end-expiratory pressure ventilation on splanchnic oxygenation in humans.

OBJECTIVES: To examine the influence of positive end-expiratory pressure (PEEP) ventilation on splanchnic oxygenation and lactate production in humans without pulmonary disorders. DESIGN: Prospective study. SETTING: Single-institutional surgical intensive care unit in a university hospital. PARTICIPANTS: Twenty patients who underwent major abdominal surgery. INTERVENTIONS: Radial artery, pulmonary artery, and right hepatic vein catheters. Blood samples were collected to determine lactate concentrations and oxygen saturations. MEASUREMENTS AND MAIN RESULTS: Six hours postoperatively PEEP levels (5, 10, and 15 cmH2O) were applied in a randomized order, and the following parameters were determined before and at the end of each PEEP level: cardiac output (CO); mean arterial pressure (MAP); arterial (SaO2), mixed venous (SvO2) and hepatic venous oxygen saturation (ShvO2); systemic (C[a-v]O2) and splanchnic (C[a-hv]O2) arterial venous oxygen content difference; and arterial, mixed venous, and hepatic venous lactate concentration. CO and MAP were reduced at PEEP 10 and 15 cmH2O, accompanied by a decrease in SvO2 but unchanged SaO2. A decrease in ShvO2 was seen at PEEP 15 cmH2O. C(a-v)O2 and C(a-hv)O2 were increased at PEEP 15 cmH2O. However, at PEEP 15 cmH2O, the percent increment in C(a-hv)O2 was greater than the increment in C(a-v)O2. Lactate concentrations remained unchanged. CONCLUSIONS: Ventilation with PEEP causes reductions in CO and MAP, resulting in a comparable impairment of systemic and splanchnic oxygen. The absence of changes in lactate concentrations indicates that a critical reduction in systemic and splanchnic oxygenation is unlikely during ventilation with low or high PEEP levels.

[The effect of PEEP-ventilation on gas exchange and airway closure in experimental pulmonary emphysema]. / Der Einfluss der PEEP-Beatmung auf Gasaustausch und Atemwegsverschluss im experimentellen Lungenemphysem.

The benefits of mechanical ventilation with positive end-expiratory pressure (PEEP) are well documented, especially for patients with acute respiratory failure. PEEP increases functional residual capacity (FRC) and reduces closing volume (CV) and ventilation-perfusion mismatching. Little is known about the effects of PEEP in patients with chronic obstructive pulmonary disease, where closing volume and ventilation-perfusion mismatching are increased. We investigated the effects of PEEP in a canine model of panlobular emphysema (PLE). METHODS. After completion of control-period measurements, PLE was induced in eight dogs by intratracheal application of 20 ml aerosolized 16% papain solution. Three weeks later the effects of continuous positive-pressure ventilation (CPPV, PEEP 10 cmH2O) on gas exchange, FRC, and CV were investigated. Conventional intermittent positive-pressure ventilation (IPPV) served as reference. Measurements of CV were done using both the foreign gas bolus method and the single-breath oxygen test. FRC was determined by the nitrogen dilution technique. RESULTS. The papain-induced emphysema produced a deteriation in oxygenation, enlargement of FRC and CV, and an increase in quasi-static lung compliance. CPPV led to a further increase of FRC, but gas exchange was not improved nor was CV reduced. In the PLE period, mean pulmonary arterial pressures (MPAP) were higher during both modes of ventilation. CPPV tended to increase MPAP and pulmonary capillary wedge pressure when compared with IPPV. Systemic hemodynamic conditions were stable throughout the experiment. CONCLUSIONS. The application of PEEP to emphysematous lungs seemed to enlarge FRC, predominantly in the nondependent rather than in the dependent lung regions, which are prone to airway closure. In patients with emphysema, ventilation with PEEP may further deteriorate the impaired distribution of ventilation and thus counteract any improvement of gas exchange.

High frequency jet ventilation in experimental pulmonary emphysema.

The effects of high frequency jet ventilation (HFJV, f = 2 Hz and 8 Hz, I:E = 0.43, FiO2 = 0.4) were studied and compared with intermittent positive pressure ventilation (IPPV, f = 10-14 breaths/min, VT = 15 ml/kg, I:E = 0.5, FiO2 = 0.4) in 8 dogs before and after induction of panlobular emphysema (PLE). PLE increased alveolar-arterial PO2 difference (PA-aO2) during all modes of ventilation, whereas PaCO2 did not change significantly. In both periods of the study, HFJV8 Hz was less effective in terms of CO2-elimination and oxygenation. In the control-period, functional residual capacity (FRC) was 937 +/- 212 ml. The increase during HFJV (HFJV2 Hz: 1156 +/- 508 ml, HFJV8 Hz: 1153 +/- 433 ml) did not reach significance (P = 0.09). Closing volume (CV) increased from 1.5 +/- 4.3% of vital capacity (%VC) (IPPV) to 6.3 +/- 7.1%VC (HFJV2 Hz) and 10.8 +/- 9.8% VC (HFJV8 Hz), respectively. In the PLE-period, FRC and CV increased significantly to 1107 +/- 207 ml and 14.1 +/- 7.0% VC respectively during IPPV (P less than 0.05). Application of HFJV neither increased FRC (HFJV2 Hz: 1153 +/- 433 ml, HFJV8 Hz: 1005 +/- 344 nor CV 14.8 +/- 6.0% VC and 13.9 +/- 8.1% VC, respectively). It is concluded that HFJV induces no alveolar overdistension in dogs with emphysematous lungs.

Psychogeriatric consultation. General Hospital versus home for the aged.

As more elderly persons are institutionalized in long-term care settings, there will be an increasing need for psychiatric consultation-liaison (C/L) services. An understanding of how patterns of C/L service provision differ in these settings from those in the general hospital is important for efficient use of resources. In this study, certain characteristics of psychiatric consultations for the elderly patients in a general hospital were compared to consultations in a home for the aged. Three groups of 30 patients were examined: patients age 60 and over in a general hospital (GH), patients under age 60 in a general hospital (GHY), and patients in a home for the aged (HA). GH and GHY shared many characteristics, but there were significant differences between HA and GH: Consultations for HA were less likely to be urgent and more likely to be for management. Dementia was diagnosed in 70% of HA versus 27% in GH. Types of interventions were similar in GH and HA except that more psychotherapy was done in HA. In HA more contact was made with allied health professionals, while in GH there was more contact with medical personnel. GH patients were seen more intensively during the first 2 weeks following referral. We conclude that the major part-time attendance of a psychiatrist skilled in both the behavioral management of demented patients and liaison with allied health professionals is likely to be sufficient in long-term care institutions for elderly patients. However, the psychiatrist must also be proficient in the education of the staff of the institution so as to encourage the referral of all those patients who require psychiatric attention.

Unconventional cancer remedies.

Unproven and disproven remedies continue to abound for illnesses for which conventional treatment is only partially effective. This is particularly true with cancer, for which up to 50% of patients may be receiving unorthodox therapy. This article examines unconventional cancer remedies, their adverse effects, their common factors and the basis for their appeal, as well as what motivates and characterizes patients who choose these treatments. Also discussed is an approach that may be used by the conventional physician for patients who are likely to seek unorthodox treatment. This approach will help patients make the best decision about their treatment and protect them from the hazards of unconventional remedies.

The psychiatrist's role in determining competency to consent in the general hospital.

In the general hospital, consultation-liaison psychiatrists are frequently consulted regarding issues of competency to consent to medical and surgical procedures and treatments. It is necessary that psychiatrists practicing in this setting have a thorough awareness of both the legal aspects of competency and consent and the clinical situations which can arise. In this paper we discuss the legal basis for consent and various definitions proposed for mental competency to consent to treatment. We describe a number of typical situations which lead to psychiatric consultation and suggest an appropriate approach to their resolution.

Psychiatric consultation-liaison services to an obstetrics and gynecology department.

This paper describes the psychiatric consultation-liaison services provided to an Obstetrics and Gynecology Department. Clinical services are provided both by program consultation and by individual inpatient and outpatient referral. Clinical problems in obstetrics and gynecology that result in psychiatric referral are discussed. Research interests which play an important role in the program are described. Educational activities are directed toward ward and clinic staff, undergraduate medical students, residents and the practising specialist. The combination of well articulated consumer requests, interested gynecologists and obstetricians, broadened gynecology residency training objectives, and greater involvement of consultation-liaison psychiatrists suggests a promising future for psychosomatic obstetrics and gynecology.

Mood disorder and multiple sclerosis.

A systematic psychiatric evaluation was performed on 100 consecutive patients attending a multiple sclerosis clinic. Forty-two percent of the patients had lifetime history of depression, and 13% fulfilled criteria for manic-depressive illness. Only 28% of the patients had no psychiatric diagnosis. The relationship of psychiatric disorder to neurologic dysfunction and other aspects of multiple sclerosis are presented. Clinical and theoretical implications of these findings are discussed.

Personal and family history of affective illness in patients with multiple sclerosis.

There is a high prevalence of affective illness, both depression and bipolar disorder, in patients with multiple sclerosis. In this study, the family history method was used to assess the prevalence of affective illness in first-degree relatives of patients with multiple sclerosis. There was not an excess of affective illness in the relatives suggesting that affective disorder associated with multiple sclerosis does not have a familial pattern similar to primary affective disorder. Clinical and theoretical implications of these findings are discussed.

Excessive concern about AIDS in two bisexual men.

The Acquired Immune Deficiency Syndrome (AIDS) has become an increasingly common cause of severe morbidity and death among homosexual men. As such it has become a major source of concern to this group. In this paper I report the cases of two bisexual men who developed a severe illness characterized by fatigue, malaise and infirmity for which no physical etiology could be determined despite extensive and complete investigations. At psychiatric consultation it became apparent that each man had a mental disorder, one symptom of which was an excessive and groundless concern that he suffered from AIDS. These men both received appropriate psychiatric treatment consisting of psychotropic medication and short-term psychotherapy. This resulted in the remission of the mental disorder, resolution of the overconcern about AIDS and the return to good physical health. Also discussed is the connection between the symptom of overconcern about AIDS and the concept of hypochondriasis.