Piezo/sono-catalytic activity of ZnO micro/nanoparticles for ROS generation as function of ultrasound frequencies and dissolved gases.

We report an accurate study on sonocatalytic properties of different ZnO micro and nanoparticles to enhance OH radical production activated by cavitation. In order to investigate some of the still unsolved aspects related to the piezocatalytic effect, the degradation of Methylene Blue and quantification of radicals production have been evaluated as function of different ultrasonic frequencies (20 kHz and 858 kHz) and dissolved gases (Ar, N2 and air). The results shown that at low frequency the catalytic effect of ZnO particles is well evident and influenced by particle dimension while at high frequency a reduction of the degradation efficiency have been observed using larger particles. An increase of radical production have been observed for all ZnO particles tested while the different saturating gases have poor influence. In both ultrasonic set-up the ZnO nanoparticles resulted the most efficient on MB degradation revealing that the enhanced radical production may arise more from bubbles collapse on particles surface than the discharge mechanism activate by mechanical stress on piezoelectric particles. An interpretation of these effects and a possible mechanism which rules the sonocatalytic activity of ZnO will be proposed and discussed.

Obstructed defecation syndrome associated with paradoxical puborectalis contraction: osteopathic treatment versus anal biofeedback. Results of a pilot study.

BACKGROUND: Biofeedback is the most widespread rehabilitative therapy for the treatment of anismus after failed conservative treatment. Osteopathy represents an alternative therapy for constipation. The aim of this study was to evaluate short- and long-term results of osteopathic treatment as compared to biofeedback in patients with dyssynergic defecation. METHODS: This was a prospective cohort pilot study on 30 patients with dyssynergic defecation enrolled at the Colorectal Clinic of the University Hospital of Ferrara, Italy, from May 2015 to May 2016 and followed until May 2020. Dyssynergic defecation was defined as the inappropriate contraction of the pelvic floor or less than 20% relaxation of basal resting sphincter pressure (on anal manometry) with adequate propulsive forces during attempted defecation. Dyssynergic patients were divide into 2 treatment groups: 15 patients had osteopathy and 15 patients had biofeedback. Before and 3 months after rehabilitation treatment, all patients had anorectal manometry, defecography, and ultrasound, and were evaluated with the Cleveland Clinic Florida (CCF) constipation score, obstructed defecation syndrome (ODS) score, Colo-rectal-anal Distress Inventory (CRADI-8), Colo-rectal-anal Impact Questionnaire (CRAIQ-7), and the Brusciano Score (BS). To evaluate the efficacy of osteopathy and biofeedback in the long-term, all patients completed the above-mentioned questionnaires 5 years later via a telephone interview. RESULTS: The two treatments were similarly effective in the short term with reduction in questionnaires scores, and increase in the percentage of anal sphincter release at straining at anorectal manometry in both groups. The ODS score was significantly reduced in biofeedback group (p = 0.021). The 3-month post-treatment BS was lower in the osteopathy group, but this just failed to reach statistical significance (p = 0.050). Periodic rehabilitation reinforcements were provided. The CCF constipation score decreased significantly in the osteopathy group (p = 0.023) after 5 years. CONCLUSIONS: Osteopathy is a promising treatment for dyssynergic defecation, and it can be associated with biofeedback.

Sonochemical hydrogenation of metallic microparticles.

We report the sonochemical synthesis of hydrogenated metallic microparticles through room-temperature ultrasonic irradiation of aqueous metallic slurries. The role of saturating gases and of reduction-oxidation mechanism on promoting the hydride formation is investigated. The method is then applied to study the synthesis of different metallic hydrides (Mn, Ti) and the hydrogenation of La(Fe,Mn,Si)13, an intermetallic compound with magnetocaloric properties used in magnetic refrigeration applications. The samples were characterized by X-ray diffraction to identify the presence of hydrogenated phases, by differential scanning calorimetry to evaluate hydrogen release and temperature stability of the hydrides and by electron microscopy to identify morphological modifications induced by acoustic cavitation. The hydrogenation of metallic microparticles and intermetallic compounds is reported for the first time by means of this experimental technique which could represent a new tool for fast and cheap hydrogenation of materials for different technological applications, such as hydrogen storage and magnetic refrigeration.

Laparoscopic versus open incisional hernia repair: a retrospective cohort study with costs analysis on 269 patients.

PURPOSE: To compare clinical outcomes and institutional costs of elective laparoscopic and open incisional hernia mesh repairs and to identify independent predictors of prolonged operative time and hospital length of stay (LOS). METHODS: Retrospective observational cohort study on 269 consecutive patients who underwent elective incisional hernia mesh repair, laparoscopic group (N = 94) and open group (N = 175), between May 2004 and July 2014. RESULTS: Operative time was shorter in the laparoscopic versus open group (p < 0.0001). Perioperative morbidity and mortality were similar in the two groups. Patients in the laparoscopic group were discharged a median of 2 days earlier (p < 0.0001). At a median follow-up over 50 months, no difference in hernia recurrence was detected between the groups. In laparoscopic group total institutional costs were lower (p = 0.02). At Cox regression analysis adjusted for potential confounders, large wall defect (W3) and higher operative risk (ASA score 3-4) were associated with prolonged operative time, while midline hernia site was associated with increased hospital LOS. Open surgical approach was associated with prolongation of both operative time and LOS. CONCLUSIONS: Laparoscopic approach may be considered safely to all patients for incisional hernia repair, regardless of patients' characteristics (age, gender, BMI, ASA score, comorbidities) and size of the wall defect (W2-3), with the advantage of shorter operating time and hospital LOS that yields reduced total institutional costs. Patients with higher ASA score and large hernia defects are at risk of prolonged operative time, while an open approach is associated with longer duration of surgical operation and hospital LOS.

Low glucose under hypoxic conditions induces unfolded protein response and produces reactive oxygen species in lens epithelial cells.

Aging is enhanced by hypoxia and oxidative stress. As the lens is located in the hypoglycemic environment under hypoxia, aging lens with diabetes might aggravate these stresses. This study was designed to examine whether low glucose under hypoxic conditions induces the unfolded protein response (UPR), and also if the UPR then generates the reactive oxygen species (ROS) in lens epithelial cells (LECs). The UPR was activated within 1 h by culturing the human LECs (HLECs) and rat LECs in <1.5 mM glucose under hypoxic conditions. These conditions also induced the Nrf2-dependent antioxidant-protective UPR, production of ROS, and apoptosis. The rat LECs located in the anterior center region were the least susceptible to the UPR, whereas the proliferating LECs in the germinative zone were the most susceptible. Because the cortical lens fiber cells are differentiated from the LECs after the onset of diabetes, we suggest that these newly formed cortical fibers have lower levels of Nrf2, and are then oxidized resulting in cortical cataracts. Thus, low glucose and oxygen conditions induce the UPR, generation of ROS, and expressed the Nrf2 and Nrf2-dependent antioxidant enzymes at normal levels. But these cells eventually lose reduced glutathione (GSH) and induce apoptosis. The results indicate a new link between hypoglycemia under hypoxia and impairment of HLEC functions.

Severe hemoperitoneum after patient self-induced fecal evacuation.

An increasing incidence of rectal injuries following patient self-induced harmful acts, aimed to sexual or laxatives porpouses, is a fact reported in literature (El-Ashaal et al., 2008). We herein report a case of severe hemoperitoneum related to a middle and upper rectal third seromuscolar tear caused by a self-induced fecal evacuation by means of an arrow with a covered cork tip. An urgent intestinal diversion by means of a Hartmann's operation was performed. The clinical case is presented in relation to the literature debate, regarding the issue of primary repair or resection and anastomosis versus fecal diversion for penetrating rectal injuries (Fabian, 2002; Cleary et al., 2006; Office of the Surgeon General, 1943; Busic et al., 2002). In conclusion, the importance of avoiding an anastomotic breakdown in a patient undergoing a hemorrhagic shock is highlighted.

Can patent foramen ovale affect rehabilitation? The uncommon association of platypnea-orthodeoxia syndrome and stroke.

Platypnea-orthodeoxia is a rare syndrome characterized by dyspnea and deoxygenation induced by a change to a sitting or standing from a recumbent position. It is the result of posturally accentuated intracardiac or pulmonary right-to-left shunt leading to arterial oxygen desaturation. Only few cases of platypnea-orthodeoxia syndrome are reported in the literature and the association between stroke and platypnea-orthodeoxia syndrome with evidence of patent foramen ovale is extremely rare. We describe the case of a 67-year-old female admitted to our Rehabilitation Unit for disabling basilar stroke due to paradoxical embolism from patent foramen ovale that during the first days of rehabilitation showed signs and symptoms of platypnea-orthodeoxia syndrome. To remove a life-threatening condition for the patient and in order to develop the normal rehabilitation project, that was stopped by the platypnea-orthodeoxia syndrome, the patient fastly underwent to percutaneous closure of patent foramen ovale. The stabilization of oxygen arterial saturation with postural changes and the disappearance of symptoms of POS allowed to develop the rehabilitation project with progressive neurological improvement.

The role of vapour pressure in multibubble sonoluminescence from organic solvents.

The action of high intensity cavitation on several liquid halocarbons (C(2)Cl(4) CCl(4), CHCl(3), C(2)H(2)Br(4)) and other organic solvents (acetone, benzene and their mixtures) was investigated by recording multibubble sonoluminescence UV-Vis spectra over the temperature range between 246 and 298 K. The temperature induced variation of some thermophysical properties of the solvents Favours the interpretations of their role in determining the salient characteristics of the recorded spectra. We observed that high volatility does not necessarily quench sonoluminescence emission and that argon flow plays a key role in the appearance of radical emission lines. While for each investigated substance the intensity of C*(2) emission lines was clearly correlated to temperature, a comparative test between different halocarbons did not show a clear correlation with vapour pressure. Following recently reported results which evidenced the formation of dynamically differentiated populations of emitting bubbles in sulphuric acid, we performed MBSL experiments in liquid mixtures of halocarbons and sulphuric acid to investigate the correlation between the production of emitting species and the halocarbon volatility.

Preparation of tunable silicon q-dots through ultrasound.

Silicon quantum dots (QDs) have been prepared through ultrasound treatments of light-emitting porous silicon layers (PSL) electrochemically etched from a p(+) type crystalline silicon (c-Si). The sonication treatments allowed separating the porous fraction from the bulk of c-Si as well as to mechanically reduce their dimensions. The ultrasounds processes have been carried out in two different organic solvents (toluene and tetrahydrofuran), and allowed obtaining silicon QDs emitting light in the blue-green part of the visible spectrum (estimated QDs diameter around 5 nm). Moreover, by adding the proper chemicals in the solvents, such as alkenes, or simply paraffin oil, we have stabilized the QDs achieving surface modification and observed an effect on size reduction. Photoluminescence spectra of the QDs, TEM images and a preliminary micro-FTIR investigation of functionalised QDs will be presented in this paper.

Sonochemical preparation of high surface area MgAl2O4 spinel.

High surface area MgAl(2)O(4) has been synthesised by a sonochemical method. Two kinds of precursors were used, alkoxides and nitrates/acetates and in both cases nanostructured MgAl(2)O(4) was obtained. The effect of the addition of a surfactant during the sonication, cetyl trimethyl ammonium bromide, was also investigated. In the case of alkoxides precursors the as-made product is a mixture of hydroxides of aluminium and magnesium, while with nitrates/acetates a gel is obtained after sonication, containing the metal hydroxides and ammonium nitrate. Heating at 500 degrees C transforms the as-made products into MgAl(2)O(4) spinel phase. The surface area is up to 267 m(2)/g after treatment at 500 degrees C and 138 m(2)/g at 800 degrees C.

Genetic and phytochemical difference between some Indian and Italian plants of Withania somnifera (L.) Dunal.

The geographical distribution of Withania somnifera (L.) Dunal is quite wide. However, in Italy, this species is very rare and grows spontaneously only in Sicily and in Sardinia. The PCR-RAPD technique has been utilized in this work to determine the genetic relationship among Sicilian, Sardinian and Indian samples and the HPLC analysis of whitaferin A was used as a marker to evaluate the phytochemical differences. The genetic difference between Indian and Sicilian plants of W. somnifera turned out to be smaller than that between Indian and Sardinian plants of this species. The phytochemical analysis as well showed that the Sardinian specimen strongly differed from the Indian and Sicilian ones in its contents of withaferin A. Our results seem to confirm the hypothesis that the Italian populations of this species may not be indigenous but naturalised. Due to the high withaferin A content of the Sardinian samples, these plants could be used as a source for pharmaceutical purposes.

Single bubble sonochemistry: decomposition of alkyl bromide and the isomerization reaction of maleic acid.

Single bubble cavitation offers an unique opportunity to evaluate the effect of bubble activity in promoting chemical reactions. In this paper we study the isomerization reaction of maleic acid into fumaric acid using an aqueous solution of maleic acid saturated with CH2Br2. The Br* radicals are generated at the bubble surface and a whitish thread forms. For comparison, the same reaction was conducted in a sonochemical bath. A possible scheme of the reactions activated at bubble surface after the decomposition of organic brominated substances is proposed.

Moving single bubble sonoluminescence in phosphoric acid and sulphuric acid solutions.

The phenomenon of sonoluminescence still presents some unsolved aspects. Recently [Y.T. Didenko, K. Suslick, Molecular Emission during Single Bubble Sonoluminescence, Nature 407 (2000) 877-879.], it was found that a single cavitating air bubble in polar aprotic liquids (including formamide and adiponitrile) can produce very strong sonoluminescence while undergoing macroscopic translation movements in the resonator, a condition known as moving single bubble sonoluminescing (MSBSL). Here we describe some experiments conducted in aqueous solutions of phosphoric and sulphuric acid. In these liquid media, it is possible to reproduce MSBSL and luminescence is emitted even if a trapped bubble is subjected to a strong shape instability, named in the literature "jittering phase". When a moving and luminescing bubble was present and the acoustic pressure gradually increased, we observed the generation of a discrete lattice of trapped bubbles. The bubbles in the lattice emit very intense light flashes and can change their position while maintaining the overall spatial distribution in time. Some preliminary results, obtained from Mie-scattering and measurements of relative light intensity, are reported.

Evidence for liquid phase reactions during single bubble acoustic cavitation.

We extended the recent experiment by Lepoint et al. [Sonochemistry and Sonoluminescence, NATO ASI Series, Series C 524, Kluwer Academic Publishers, Dordrecht/Boston/London, 1999, p. 285], involving a so-called single bubble sonochemistry process, to a three-phase system. We have found experimental evidence that a single cavitating bubble can activate the oxidation of I- ions after the injection of a CCl4 liquid drop in the bubble trapping apparatus. The solvent drop (CCl4 is almost water insoluble) is pushed towards the bubble position and forms a thin film on the bubble surface. When the acoustic pressure drive is increased above 100 kPa, the three-phase system gives rise to a dark filament, indicating the complexation reaction between starch (added to the water phase) and I2. I2 species is the product of surface reactions involving bubble-induced decomposition of CCl4. Further increase of the acoustic drive causes the thin CCl4 film to separate from the bubble and stops I2 production. The study of the chemical activity of this three-phase system could give new advances on dynamics of the bubble collapse.

Evaluation of methods for opto-electronic body surface sensing applied to patient position control in breast radiation therapy.

The accuracy gap between the high levels of accuracy in radiotherapy planning and the uncertain set-up of each therapy fraction represents a crucial factor in the optimisation of radiation treatment. This occurs because the conventional means of patient alignment and immobilisation do not guarantee accurate implementation of the therapy plan in the actual irradiation treatment. A patient repositioning technique is proposed, based on opto-electronic motion capture and on methods of registration of body surfaces described by a limited dataset. The validation of the method was related to breast cancer radiotherapy and was based on simulated and experimental repositioning procedures involving a phantom and two subjects. With respect to previous work, the surface registration procedure was, in this case, implemented as a constrained non-linear least-square problem (constraints were given by the position of a couple of passive markers placed on the sternum), and three different algorithms were compared in terms of accuracy in misalignment detection and of computational cost. The simulation and experimental activities identified the best performing algorithm, which systematically limited the repositioning errors to below clinically acceptable thresholds (5 mm), with residual surface mismatches lower than 2 mm.

Neuropathies associated with IgG and IgA monoclonal gammopathy.

Neuropathy has been frequently reported in patients with monoclonal gammopathy, particularly those with monoclonal gammopathy of undetermined significance (MGUS). While the neuropathy associated with IgM-MGUS is well characterized and is often associated with a reactivity of the monoclonal protein with neural antigens, the relationship between the neuropathy and IgG and IgA MGUS is less clear. We review here the clinical, electrophysiological and pathogenetic features of neuropathies associated with IgG and IgA M-proteins in order to determine whether they represent distinct clinical entities and, most importantly, whether the finding of an IgG or IgA monoclonal gammopathy in a patient with neuropathy should led to different diagnostic or therapeutical approaches. This review will mainly focus on neuropathies associated with MGUS since the disclosure of a malignant monoclonal gammopathy, including multiple or osteosclerotic myeloma, lymphoma or primary amyloidosis, in a patient with neuropathy usually divert the therapeutical decisions to the hematologist for an appropriate therapy of the underlying life threatening condition.

[Opto-electronic techniques and 3D body surface reconstruction for the control of patient positioning in the radiotherapy of breast cancer]. / Tecnichi opto-electtroniche e ricostruzione di superfici corporee in 3-d per il controllo della posizione del paziente nella radioterapia del carcinoma mammario.

PURPOSE: In radiotherapy clinical practice, the currently existing gap between the high degree of accuracy in treatment planning and, the possibility of conforming the high-energy radiation beams on the one hand, and the uncertain set-up of each irradiation session on the other is a decisive factor for optimizing radiation treatment. Indeed there is wide experimental evidence that the current methods used for patient alignment and immobilization do not guarantee the necessary precision in delivering therapy with respect to the specifications of the treatment plan. The main reason for this is the lack of control systems that may be applied systematically to provide quantitative real-time feedback on the quality of patient repositioning and immobility during radiation emission. MATERIAL AND METHODS: Opto-electronic techniques and body surface registration methods were sygergisically used for the automatic three-dimensional verification and correction of patient position at the therapy unit. The method is based on radiotherapy applications of real-time opto-electronic human motion analysis using passive markers to control patient repositioning and to acquire and describe body surfaces in three dimensions. The quantitative detection of the localization error relies on the real-time detection of the position of an hybrid set of control points, namely physical passive markers and laser light markers, and their immediate comparison with a reference data set. The data set consists of the reference positions of the passive markers and a three-dimensional model of the body surface. The method was experimentally tested at the Radiotherapy Division of the European Institute of Oncology to control the repositioning of a phantom and of a volunteer, with reference to the clinical realignment procedure applied for breast cancer radiotherapy. RESULTS: The results confirm that the technique represents a valuable method to detect and automatically correct localization errors in the irradiation set-up. The use of the information provided by the laser markers allows one to reduce the potential inaccuracies in the manual relocation of the passive markers on the subject's skin and guarantees that position control is based on a redundant set of data describing the three-dimensional localization and configuration of the irradiated body surface portion. The experimental results show that the initial displacements of the controlled body area were systematically reduced to median values below 1 millimeter and 1.2 millimeters for the phantom and the volunteer, respectively. CONCLUSIONS: The synergistic use of opto-electronic technologies and stereophotogrammetric techniques associated to surface registration methods proved to provide an accurate description of the spatial transformation between the reference position and the actual position of the controlled body area. This allowed us to define an effective procedure to correct the patients position and recover the quality of the irradiation set-up, in agreement with the clinical requirements. The reported results confirm that the dynamic sensing of the body surface by opto-electronic technologies is a particularly promising technique that allows to systematically achieve swift and accurate patient alignment, thus ensuring that the treatment plan specifications are reproduced in the reality of each irradiation session.