Electronic Processes at the Carbon-Covered (100) Collector Tungsten Surface.

We have performed density functional VASP calculations of a pure and of a carbon-covered (100) tungsten surface under the presence of an electric field E directed away from the surface. Our aim is to answer the question of an increased penetrability of electrons at the collector side of a nanometric tunnel diode when covered by carbon atoms, a purely quantum mechanical effect related to the value of the workfunction Φ. To obtain Φ at a non-zero electric field we have extrapolated back to the electrical surface the straight line representing the linear increase in the potential energy with distance outside the metal-vacuum interface. We have found that under the presence of E the workfunction Φ = Evac - EF of the (100) pure tungsten surface has a minor dependence on E. However, the carbon-covered tungsten (100) surface workfunction Φ(C - W) has a stronger E dependence. Φ(C - W) decreases continuously with the electric field. This decrease is ΔΦ = 0.08 eV when E = 1 V/nm. This ΔΦ is explained by our calculated changes with electric field of the electronic density of both pure and carbon-covered tungsten. The observed phenomena may be relevant to other surfaces of carbon-covered tungsten and may explain the reported collector dependence of current in Scanning Field Emission Microscopy.

[Side effects in aesthetic medicine. Spectrum, management and avoidance]. / Nebenwirkungen in der ästhetischen Medizin. Spektrum, Management und Vermeidung.

Aesthetic medicine has become increasingly popular in the last two decades. The same trend has occurred in dermatology. Aesthetic dermatology prefers minimally invasive procedures. Nevertheless, even these procedures are not free of possible adverse effects. The spectrum of possible adverse effects, their management and prevention are discussed for four popular procedures in aesthetic dermatology, i.e. chemical peels, mesotherapy, botulinum toxin, and dermal fillers. Aesthetic procedures should only be performed by well-educated, well-trained medical doctors with an excellent medical background, never by lay persons.

Removal of heavy metals from sewage sludge by acid treatment.

Sludge samples were found to contain significant amounts of heavy metals (Cr, Cu, Ni, Pb and Zn) and were subjected to acid treatment using either hydrochloric, sulfuric, nitric or phosphoric acid. The optimum combination, in terms of metal removal efficiency and environmental impacts was sought through a variety of tests by applying a ratio of 1:5 of sludge quantity (g) per volume of acid (ml). The concentrations of the different acids used, were in the range of 5%-20% and the contact times ranged between 15 and 60 minutes. The optimum combination was achieved when the sludge samples were in contact with H2SO4 20% v/v for 60 minutes. In order to estimate the metal leachability, the heavy metal content as well as the metal distribution in the residue were investigated and it was found that most of the heavy metal content was extracted while the remaining was removed from the initial mobile phases to the more stable ones.

Long-term results of total parathyroidectomy without autotransplantation in patients with and without renal failure.

The optimal surgical procedure for severe renal secondary hyperparathyroidism (sHPT) is still a point of controversy. Total parathyroidectomy (PTX) without auto-transplantation was abandoned for fear of an adynamic bone condition; however, in the case of autotransplantation recurrent sHPT is frequent and promotes atherosclerosis. We studied 11 hemodialysis patients (age 59+/-12 years) on dialysis for 18 (12-30) years in whom total PTX was performed due to severe sHPT (group I; intact PTH: 1,240+/-230 pg/ml), and 5 patients (age 55+/-10 years) without renal insufficiency who inadvertently received total PTX during thyroid surgery (group II). After total PTX (group I, 26+/-18 [9-59] months; group II, 252+/-188 [22 480] months) both groups showed no measurable intact PTH levels. Calcium homeostasis was maintained by oral substitution with calcium (group I, calcium dialysate of 2.0 mmol/l), vitamin D and calcitriol (serum parameters in groups I and II: calcium 2.4 and 2.2 mmol/l; phosphate 1.8 and 1.1 mmol/l; 25(OH)-vitamin D(3) 21 and 34 ng/ml; 1,25(OH)(2)-vitamin D(3) 32 and 41 pg/ml, respectively). In group I, after total PTX there was a rapid and sustained improvement in bone pain with markedly enhanced physical activity and endurance. High turnover osteopathy markedly improved as indicated by declining levels of native osteocalcin (90+/-17 vs. 26+/-18 ng/ml), bone alkaline phosphatase (74+/-12 vs. 12+/-6 ng/ml), and carboxyterminal cross-linked telopeptide of type-I collagen (65+/-16 vs. 40+/-21 ng/ml) but increasing levels of carboxyterminal propeptide of type-I procollagen (120+/-36 vs. 148+/-41 ng/ml). Recalcification of bone was excellent as demonstrated by X-ray and confirmed by bone histology. Itching extravascular calcific deposits and calcifications of blood vessel and cardiac valves immediately stopped after total PTX. Moreover, 6 sHPT patients suffered from severe atherosclerotic lesions such as thoracic aortic aneurysm (n = 3) or abdominal aortic aneurysm (n = 3) which showed size progression before but not after total PTX when annually controlled by ultrasonography. In group II, even long after total PTX, there was no clinical, radiological, histological or biochemical evidence for low turnover osteopathy. In conclusion, our data indicate that substitution with vitamin D(3) metabolites and calcium can prevent deleterious bone effects of hypoparathyroidism in hemodialysis patients and in patients with normal kidney function and may compensate for the missing PTH action. Over this, a better survival rate is expected as a consequence of the beneficial effect of total PTX on the progression of atherosclerotic lesions. We suggest reconsideration of total PTX without autotransplantation in dialysis patients with severe sHPT who are not eligible for renal transplantation.

A histological and immunohistochemical study of medical-grade fluid silicone.

BACKGROUND: Medical-grade injectable silicone for use in soft tissue augmentation is administered subcutaneously by injections of the pure material. OBJECTIVE: To examine histologically and immunohistochemically the characteristics of medical-grade silicone and to identify the advantages and disadvantages of the serial puncture technique. RESULTS: In early biopsies, perivascular lymphocytic infiltration with the characteristic reaction of delayed hypersensitivity (doses, 0.05-0.07 mL) was observed. Immunohistochemically, small local deposits of IgG and IgA were observed around the walls of small vessels. In later biopsies, the inflammation had progressed to a fibroblastic reaction. Additionally, the implantation of large doses provoked giant cell granulomas. CONCLUSIONS: Small doses (0.05-0.07 mL) of injected silicone produce an immunologic and fibroblastic reaction in the skin. The use of this substance with the serial puncture technique is not hazardous when proper technique is used.